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J Anal Psychol ; 67(1): 306-316, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1788803


'Civilization in Transition' was the theme of the JAP conference in 2021, and also the reality we are facing today, especially amidst the pandemic of COVID-19. From an oriental perspective, within the context of Psychology of the Heart, the author presents his thoughts in this paper, 'Civilization within the heart: the image and meaning of "civilization" and "culture" in Chinese characters'. The meaning of the heart is at the core of Chinese culture, as well as Chinese philosophy and psychology. Most of the basic psychological terms in Chinese characters are formed originally with the images of the heart; even the Chinese character for 'culture' and 'civilization'. C.G. Jung learned Chinese characters, and named them with I Ching symbols as readable archetypes. Today in world affairs we are confronted with highly turbulent and uncertain conditions that threaten any sense of coherent meaning, both personally and collectively. Jung's insights gained from the I Ching and his reflections on analytical psychology are still inspiring us. The images and meaning of the hexagrams which C.G. Jung used: 'Ting' (The Cauldron), 'Bi' (Grace), and 'Chin' (Progress), are the main threads of this paper and presentation, 'Civilization within the Heart', responding to the theme 'Civilization in Transition'.

« La civilisation en transition ¼ est le thème de la conférence du JAP en 2021, et également la réalité à laquelle nous faisons face aujourd'hui, particulièrement avec la pandémie de COVID-19. A partir d'une perspective orientale, dans le contexte de la Psychologie du Cœur, l'auteur présente ses pensées dans cet article « La civilisation à l'intérieur du cœur: l'image et le sens de 'civilisation' et de 'culture' dans les caractères chinois ¼. La signification du cœur est centrale à la culture chinoise, et à la philosophie et la psychologie chinoises. La plupart des termes psychologiques fondamentaux en caractères chinois sont à l'origine formés avec les images du cœur; même ceux pour «culture¼ et pour «civilisation¼. C.G. Jung a appris les caractères chinois, et les a nommés avec les symboles du Yi Jing en tant qu'archétypes lisibles. Aujourd'hui dans les affaires du monde nous sommes confrontés à des conditions hautement turbulentes et incertaines qui menacent toute cohérence de sens, aussi bien au niveau personnel que collectif. Les éclairages de Jung provenant du Yi Jing et ses réflexions sur la psychologie analytique nous inspirent encore. Les images et la signification des hexagrammes que Jung a utilisés: 'Ting' (Le Chaudron), 'Pi' (La grâce), et 'Tsien' (Le Progrès), sont les fils conducteurs principaux de cet article et présentation: « La civilisation à l'intérieur du cœur ¼, pour répondre au thème de « Civilisation en Transition ¼.

'Civilización en Transición' es el tema de la Conferencia del JAP en 2021, y también la realidad que estamos enfrentando hoy, especialmente en medio de la pandemia de COVID-19. Desde una perspectiva oriental, en el contexto de la Psicología del Corazón, el autor ofrece su reflexión en el presente trabajo, 'Civilización en el corazón: la imagen y el sentido de la 'civilización' y la 'cultura' en los caracteres chinos'. El sentido del corazón está al centro de la cultura China, así como también de la psicología y filosofía China. La mayoría de los términos psicológicos básicos en los caracteres chinos están formados originalmente con las imágenes del corazón; aún el signo chino para 'cultura' y 'civilización'. C. G. Jung aprendió los caracteres chinos, y los denominó junto a los símbolos del I Ching como arquetipos legibles. Actualmente, estamos siendo confrontados a nivel mundial con condiciones excesivamente turbulentas e inciertas que amenazan cualquier sentido de coherencia, tanto personal como colectivamente. Las comprensiones que Jung tomó del I Ching y sus reflexiones en la psicología analítica aún hoy nos inspiran. Las imágenes y el sentido de los hexagramas que Jung usó: 'Ting' (El Caldero), 'Bi' (Gracia), y 'Chin' (El Progreso), son las hebras principales de este trabajo y presentación, 'Civilización en el Corazón', respondiendo al tema 'Civilización en Transición'.

'Civilização em Transição' é o tema da conferência do JAP em 2021, e também a realidade que enfrentamos hoje, especialmente em meio à pandemia de COVID-19. De uma perspectiva oriental, dentro do contexto da Psicologia do Coração, o autor apresenta seus pensamentos neste artigo, 'Civilização dentro do coração: a imagem e o significado de "civilização" e "cultura" em caracteres chineses'. O significado do coração está no centro da cultura chinesa, assim como da filosofia e psicologia chinesas. A maioria dos termos psicológicos básicos em caracteres chineses é formado originalmente com as imagens do coração; até mesmo o caractere chinês para "cultura" e "civilização". C.G. Jung aprendeu caracteres chineses e os nomeou com símbolos I Ching como arquétipos legíveis. Hoje, nos assuntos mundiais, somos confrontados com condições altamente turbulentas e incertas que ameaçam qualquer senso de significado coerente, tanto pessoal quanto coletivamente. Os insights de Jung obtidos com o I Ching e suas reflexões sobre psicologia analítica ainda estão nos inspirando. As imagens e o significado dos hexagramas que C.G. Jung usou: 'Ting' (O Caldeirão), 'Bi' (Graça) e 'Chin' (Progresso), são os principais tópicos deste artigo e apresentação, 'Civilização dentro do Coração', para responder ao tema 'Civilização em Transição'.

COVID-19 , Jungian Theory , China , Civilization , Humans , Psychotherapy
Int Psychogeriatr ; 34(2): 105-107, 2022 02.
Article in English | MEDLINE | ID: covidwho-1778556
BMC Psychiatry ; 22(1): 219, 2022 03 27.
Article in English | MEDLINE | ID: covidwho-1765443


BACKGROUND: There is increasing recognition of the substantial burden of mental health disorders at an individual and population level, including consequent demand on mental health services. Lifestyle-based mental healthcare offers an additional approach to existing services with potential to help alleviate system burden. Despite the latest Royal Australian New Zealand College of Psychiatrists guidelines recommending that lifestyle is a 'first-line', 'non-negotiable' treatment for mood disorders, few such programs exist within clinical practice. Additionally, there are limited data to determine whether lifestyle approaches are equivalent to established treatments. Using an individually randomised group treatment design, we aim to address this gap by evaluating an integrated lifestyle program (CALM) compared to an established therapy (psychotherapy), both delivered via telehealth. It is hypothesised that the CALM program will not be inferior to psychotherapy with respect to depressive symptoms at 8 weeks. METHODS: The study is being conducted in partnership with Barwon Health's Mental Health, Drugs & Alcohol Service (Geelong, Victoria), from which 184 participants from its service and surrounding regions are being recruited. Eligible participants with elevated psychological distress are being randomised to CALM or psychotherapy. Each takes a trans-diagnostic approach, and comprises four weekly (weeks 1-4) and two fortnightly (weeks 6 and 8) 90-min, group-based sessions delivered via Zoom (digital video conferencing platform). CALM focuses on enhancing knowledge, behavioural skills and support for improving dietary and physical activity behaviours, delivered by an Accredited Exercise Physiologist and Accredited Practising Dietitian. Psychotherapy uses cognitive behavioural therapy (CBT) delivered by a Psychologist or Clinical Psychologist, and Provisional Psychologist. Data collection occurs at baseline and 8 weeks. The primary outcome is depressive symptoms (assessed via the Patient Health Questionnaire-9) at 8 weeks. Societal and healthcare costs will be estimated to determine the cost-effectiveness of the CALM program. A process evaluation will determine its reach, adoption, implementation and maintenance. DISCUSSION: If the CALM program is non-inferior to psychotherapy, this study will provide the first evidence to support lifestyle-based mental healthcare as an additional care model to support individuals experiencing psychological distress. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12621000387820 , Registered 8 April 2021.

COVID-19 , Telemedicine , Adult , Anxiety , Depression/complications , Depression/therapy , Humans , Life Style , Psychotherapy , Telemedicine/methods , Victoria
Int J Environ Res Public Health ; 19(6)2022 03 19.
Article in English | MEDLINE | ID: covidwho-1760605


(1) Background: Ongoing specialized programs for health professionals (HPs) adapted their treatment services during the COVID-19 pandemic. (2) Methods: We conducted a retrospective observational study of medical e-records of HPs with mental disorders working in Catalonia that were consecutively admitted to the Galatea Care Program Clinical Unit. The sample (N = 1461) was divided into two periods: 21.5 months before (n = 637) and after (n = 824) 14 March 2020. (3) Results: There was a significant increase (29.4%) in the number of referrals to the specialized Clinical Unit during the pandemic, especially with respect to physicians compared to nurses. The percentage of HP women at admission and the clinical severity of the first treatment episode remained without changes before and after the COVID-19 pandemic. The most prevalent main diagnoses also remained similar: adjustment disorders (41.5%), mood disorders (24.9%), anxiety disorders (14.4%), and substance use disorders (11.8%). (4) Conclusions: HPs, particularly physicians, more frequently sought voluntary help from specialized mental health programs during the COVID-19 pandemic. Future studies are needed to analyze the reasons behind this finding and the evolution of referrals to these types of programs after the COVID-19 outbreak.

COVID-19 , Anxiety Disorders/epidemiology , COVID-19/epidemiology , Female , Humans , Mental Health , Pandemics , Psychotherapy
Brain Behav Immun ; 87: 40-48, 2020 07.
Article in English | MEDLINE | ID: covidwho-1719336


In addition to being a public physical health emergency, Coronavirus disease 2019 (COVID-19) affected global mental health, as evidenced by panic-buying worldwide as cases soared. Little is known about changes in levels of psychological impact, stress, anxiety and depression during this pandemic. This longitudinal study surveyed the general population twice - during the initial outbreak, and the epidemic's peak four weeks later, surveying demographics, symptoms, knowledge, concerns, and precautionary measures against COVID-19. There were 1738 respondents from 190 Chinese cities (1210 first-survey respondents, 861 s-survey respondents; 333 respondents participated in both). Psychological impact and mental health status were assessed by the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21), respectively. IES-R measures PTSD symptoms in survivorship after an event. DASS -21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. This study found that there was a statistically significant longitudinal reduction in mean IES-R scores (from 32.98 to 30.76, p < 0.01) after 4 weeks. Nevertheless, the mean IES-R score of the first- and second-survey respondents were above the cut-off scores (>24) for PTSD symptoms, suggesting that the reduction in scores was not clinically significant. During the initial evaluation, moderate-to-severe stress, anxiety and depression were noted in 8.1%, 28.8% and 16.5%, respectively and there were no significant longitudinal changes in stress, anxiety and depression levels (p > 0.05). Protective factors included high level of confidence in doctors, perceived survival likelihood and low risk of contracting COVID-19, satisfaction with health information, personal precautionary measures. As countries around the world brace for an escalation in cases, Governments should focus on effective methods of disseminating unbiased COVID-19 knowledge, teaching correct containment methods, ensuring availability of essential services/commodities, and providing sufficient financial support.

Anxiety/epidemiology , Coronavirus Infections/epidemiology , Depression/epidemiology , Pneumonia, Viral/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Stress, Psychological/epidemiology , Adolescent , Adult , Anxiety/psychology , Anxiety/therapy , Betacoronavirus , COVID-19 , Child , China/epidemiology , Coronavirus Infections/prevention & control , Depression/psychology , Depression/therapy , Epidemics , Female , Hand Hygiene , Health Behavior , Humans , Internet-Based Intervention , Longitudinal Studies , Male , Masks , Mental Health , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Psychotherapy , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Stress, Psychological/psychology , Stress, Psychological/therapy , Young Adult
Int J Psychoanal ; 103(1): 108-119, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1708338
BMJ Open ; 12(2): e050350, 2022 02 22.
Article in English | MEDLINE | ID: covidwho-1702825


INTRODUCTION: Anorexia nervosa (AN) is a severe mental health condition associated with high mortality rates and significantly impaired quality of life. National guidelines outline psychotherapeutic interventions as treatments of choice for adults with AN, but outcomes are limited and therapy drop-out high, resulting in calls for new innovative treatments. The Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS) research programme sought to develop the SPEAKS intervention avoiding some difficulties inherent in development of earlier interventions, such unclear hypotheses about change processes. SPEAKS focuses on a core hypothesised maintaining factor (emotional experience) with clear proposed model of change. The current feasibility trial aims to provide an initial test of SPEAKS and inform design of a full randomised controlled trial protocol. METHODS AND ANALYSIS: This study employs a multisite, single-arm, within-group, mixed-methods design. Up to 60 participants (36 therapy completers) meeting inclusion criteria will be offered the SPEAKS intervention instead of treatment-as-usual (TAU). SPEAKS is a weekly psychotherapy lasting nine to 12 months, provided by trained and experienced eating disorders therapists. All other clinical input remains inline with TAU. Acceptability will be assessed using VAS scales and end of therapy interview. Reach and recruitment, such as recruitment yield, will be monitored. To support sample size estimation and economic estimation, data pertaining to eating disorder-related symptoms will be recorded every 3 months, alongside service usage and intervention-specific measures. Videoed therapy sessions will inform model adherence. Additional analyses coding videoed therapy will test SPEAKS change process hypotheses. ETHICS AND DISSEMINATION: Ethical approval has been granted by London-Bromley Research Ethics Committee (NHS Rec Reference: 19/LO/1530). Data will be disseminated via high-impact, peer-reviewed journals (Open Access preferred), conferences, service user and charity networks (eg, UK charity BEAT) and through a free open conference hosted by National Health Service Trusts and Higher Education Institutions. TRIAL REGISTRATION NUMBER: ISRCTN11778891. TRIAL STATUS: Recruitment began on 12 December 2019 and ends on 28 February 2021. All data will be collected and the trial ended by 28 February 2022. PROTOCOL VERSION: SPEAKS protocol V.3.0 (30 August 2020). Changes were made to the original protocol due to the COVID-19 pandemic. A further set of changes were made to incorporate the measures of change processes, resulting in this being the third version of the protocol.

Anorexia Nervosa , COVID-19 , Feeding and Eating Disorders , Adult , Anorexia , Anorexia Nervosa/complications , Anorexia Nervosa/psychology , Anorexia Nervosa/therapy , Emotions , Feasibility Studies , Humans , Multicenter Studies as Topic , Outpatients , Pandemics , Psychotherapy/methods , Quality of Life , Randomized Controlled Trials as Topic , SARS-CoV-2 , State Medicine
Psychol Serv ; 19(Suppl 1): 5-12, 2022.
Article in English | MEDLINE | ID: covidwho-1661945


The coronavirus disease (COVID-19) pandemic elicited huge stress responses in most world populations, and at this time psychotherapy is an important protective service against this stress. However, a somewhat neglected question is: How stressful was the COVID-19 outbreak for psychotherapists themselves? The main aim of the present study was to investigate whether dispositional resilience predicted the perceived stress reported by psychotherapists during the COVID-19 outbreak. A total of 338 psychotherapists organized within the national psychotherapy associations of three European countries (Czech Republic, Germany, and Slovakia) were included in this online study (mean age 46.7, 77.8% female, 22.2% male). The participants were administered the Perceived Stress Scale (PSS-10) and the Connor-Davidson Resilience Scale (CD-RISC). For the data analysis, nonparametric ANOVA and two-level (mixed-effect) linear regression models were used. Dispositional resilience significantly predicted the perceived stress reported by psychotherapists during the COVID-19 outbreak. Higher dispositional resilience significantly reduced the level of perceived stress among psychotherapists (adjusted ß = -0.47, p < .001). Those with moderate resilience (between mean ± SD values) had a lower perceived stress score than those with low resilience (mean + SD value) had a lower perceived stress score than the low resilience group by an average of 6.5. The results of this study imply that the involvement of psychotherapists in resilience supportive training may reduce their vulnerability to stress. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

COVID-19 , Resilience, Psychological , Female , Humans , Male , Pandemics , Psychotherapists , Psychotherapy , Stress, Psychological/epidemiology
Acta Biomed ; 92(S2): e2021508, 2021 12 21.
Article in English | MEDLINE | ID: covidwho-1625689


BACKGROUND AND AIM OF THE WORK: the new coronavirus pandemic COVID-19 has had a strong psy- chological impact on the world population. Volunteer psychologists, and psychologists that work in the emer- gencies have also been exposed to the consequences of the impact of the pandemic. The purpose of this study was to explore the experiences of the psychologist during the Covid-19 emergency intervention. METHODS: an exploratory study, following a qualitative design using Focus Group method was adopted. A total of 24 psychologists was recruited from volunteers of the "Pronto Pșy - Covid-19" service, organized by the Ital- ian Society of Emergency Psychology Social Support, Emilia Romagna. Focus Group Discussions (FGDs) was held about: their experiences during the online psychological support; needs detected by users; training needs that emerged during the intervention and professional skills applied. RESULTS: five themes were identi- fied: psychological distress of rescuers; online emergency setting; support of colleagues and gratitude as stress management strategies; need of skill and tools in pandemic emergency intervention; integrated psychological intervention. DISCUSSION: the stress reaction of the emergency psychologists was due in particular to the type of emergency and lack of standardized approach. The group meetings represented an important resource to face traumatic stress. CONCLUSIONS: this study showed the role the need for specific tools for pandemic intervention to protect the well-being of the professional from impact of stress. Further research is needed. (

COVID-19 , Pandemics , Humans , Psychotherapy , SARS-CoV-2 , Social Support
Int J Environ Res Public Health ; 18(23)2021 11 29.
Article in English | MEDLINE | ID: covidwho-1560683


According to the WHO definition, "telemedicine is the provision of health services, where distance is a critical factor, by all health professionals who use information and communication technologies for the exchange of valid information for the diagnosis, treatment and prevention of diseases, research and evaluation, and for the continuous training of health professionals, all in the interest of advancing the health of individuals and their communities". The purpose of our review work is specifically to investigate the effects of telemedicine in the treatment and prevention of eating disorders in adolescents. From June 2021 to (September 2021) in the databases of the Web of Science, EMBASE, PsycINFO and CINHAL, using search terms such as telehealth, eating disorder, adolescents, Internet/online treatments CBT and FB-T, anorexia nervosa, bulimia nervosa and binge eating disorder. The articles resulting from the search phases in the databases listed above produced a total of 176 items. Once the procedures for selecting the works were completed, only four studies were included in the review. Modern e-health psychological approaches in the treatment of eating disorders provide potential bases of continuous assistance that are decidedly less burdensome in the costs of territorial services in the case that they are not identified as necessary.

Binge-Eating Disorder , Bulimia Nervosa , Feeding and Eating Disorders , Telemedicine , Adolescent , Feeding and Eating Disorders/prevention & control , Humans , Psychotherapy
Eur Rev Med Pharmacol Sci ; 25(22): 7127-7134, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1552079


OBJECTIVE: The anxiety of life that comes with the pandemic process increases the health anxiety and the level of perceived stress. However, there are uncertainties about which individuals are more sensitive. This study aims to investigate the effects of alexithymic characteristics on health anxiety and perceived stress. MATERIALS AND METHODS: The authors invited the participants to study via social media and e-mail. The data of 793 individuals, aged 18-65, collected over the internet (Google Forms) between November and December 2020 were statistically evaluated. Evaluations were made with the sociodemographic data form, the General Health Questionnaire-12 (GHQ-12), the Health Anxiety Scale (HAS), the Toronto Alexithymia Scale (TAS-20), and the Perceived Stress Scale (PSS). RESULTS: In mediation analyzes between TAS subscales and HAS, Difficulty in Identifying Feelings (DIF) most strongly predicted HAS (B=0.469, p<0.001) and indirectly affected HAS only through GHQ (CS: 0.08, B=0.108, SE:0.021, CI: 0.070, 0.153). However, both PSS (CS: 0.0128, B=0.084, SE:0.027, CI: 0.032, 0.139) and GHQ (CS: 0.02, B=0.139, SE:0.028, CI: 0.090, 0.198) played a mediating role between Difficulty Describing Feelings (DDF) and HAS. CONCLUSIONS: The present study suggests that individuals with alexithymic features are more sensitive to stress during periods of health-related increased stress, such as pandemics, and that individuals with alexithymic features should be given priority in psychotherapeutic interventions.

Affective Symptoms/psychology , Anxiety Disorders/psychology , COVID-19/psychology , Adult , Affective Symptoms/diagnosis , Affective Symptoms/therapy , Anxiety Disorders/diagnosis , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Female , Humans , Internet/instrumentation , Male , Middle Aged , Psychotherapy/methods , SARS-CoV-2/genetics , Surveys and Questionnaires , Turkey/epidemiology
Psychiatr Prax ; 49(2): 107-110, 2022 Mar.
Article in German | MEDLINE | ID: covidwho-1537355


The ward-equivalent psychiatric treatment (StäB) is an intensive form of treatment and offers patients with severe and/or chronic illnesses the opportunity to take advantage of guideline-oriented treatment.This case description is intended to show the extent to which this form of community-based care - with psychiatric as well as psychotherapeutic treatment in the familiar home context - should be considered as a treatment option for patients with severe obsessive-compulsive disorders, not only in times of the COVID-19-Pandemic.

COVID-19 , Obsessive-Compulsive Disorder , Germany , Humans , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/psychology , Obsessive-Compulsive Disorder/therapy , Psychotherapy , SARS-CoV-2
Int J Environ Res Public Health ; 18(22)2021 Nov 22.
Article in English | MEDLINE | ID: covidwho-1534065


During the COVID-19 pandemic, outpatient psychotherapy transitioned to telemedicine. This study aimed to examine barriers and facilitators to resuming in-person psychotherapy with perinatal patients as the pandemic abates. We conducted focus group and individual interviews with a sample of perinatal participants (n = 23), psychotherapy providers (n = 28), and stakeholders (n = 18) from Canada and the U.S. involved in the SUMMIT trial, which is aimed at improving access to mental healthcare for perinatal patients with depression and anxiety. Content analysis was used to examine perceived barriers and facilitators. Reported barriers included concerns about virus exposure in a hospital setting (77.8% stakeholders, 73.9% perinatal participants, 71.4% providers) or on public transportation (50.0% stakeholders, 26.1% perinatal participants, 25.0% providers), wearing a mask during sessions (50.0% stakeholders, 25.0% providers, 13.0% participants), lack of childcare (66.7% stakeholders, 46.4% providers, 43.5% perinatal participants), general transportation barriers (50.0% stakeholders, 47.8% perinatal participants, 25.0% providers), and the burden of planning and making time for in-person sessions (35.7% providers, 34.8% perinatal participants, 27.8% stakeholders). Reported facilitators included implementing and communicating safety protocols (72.2% stakeholders, 47.8% perinatal participants, 39.3% providers), conducting sessions at alternative or larger locations (44.4% stakeholders, 32.1% providers, 17.4% perinatal participants), providing incentives (34.8% perinatal participants, 21.4% providers, 11.1% stakeholders), and childcare and flexible scheduling options (31.1% perinatal participants, 16.7% stakeholders). This study identified a number of potential barriers and illustrated that COVID-19 has fostered and amplified barriers. Future interventions to facilitate resuming in-person sessions should focus on patient-centered strategies based on empathy regarding ongoing risk-aversion among perinatal patients despite existing safety protocols, and holistic thinking to make access to in-person psychotherapy easier and more accessible for perinatal patients.

COVID-19 , Pandemics , Female , Humans , Parturition , Pregnancy , Psychotherapy , SARS-CoV-2
PLoS One ; 16(11): e0259167, 2021.
Article in English | MEDLINE | ID: covidwho-1504045


BACKGROUND: Mindfulness-Based Interventions (MBIs) are widely used in clinical and non-clinical populations, but little attention has been given to potential adverse effects (AEs). AIMS: This study aimed to gain insight in the prevalence and course of AEs during Mindfulness-Based Cognitive Therapy (MBCT) for patients with bipolar disorder (BD). METHOD: The current mixed-methods study was conducted as part of a RCT on (cost-) effectiveness of MBCT in 144 patients with BD (Trial registered on 25th of April 2018,, NCT03507647). During MBCT, occurrence of AEs was monitored prospectively, systematically, and actively (n = 72). Patients who reported AEs were invited for semi-structured interviews after completing MBCT (n = 29). Interviews were analysed with directed content analysis, using an existing framework by Lindahl et al. RESULTS: AEs were reported by 29 patients, in seven of whom the experiences could not be attributed to MBCT during the interview. AEs were reported most frequently up to week 3 and declined afterwards. Baseline anxiety appeared to be a risk factor for developing AEs. Seven existing domains of AEs were observed: cognitive, perceptual, affective, somatic, conative, sense of self, and social. Influencing factors were subdivided into predisposing, precipitating, perpetuating, and mitigating factors. With hindsight, more than half of patients considered the reported AEs as therapeutic rather than harmful. CONCLUSIONS: Although the occurrence of AEs in MBCT for patients with BD is not rare, even in this population with severe mental illness they were not serious or had lasting bad effects. In fact, most of them were seen by the patients as being part of a therapeutic process, although some patients only experienced AEs as negative.

Bipolar Disorder/therapy , Mindfulness/methods , Psychotherapy/methods , Adult , Aged , Cognitive Behavioral Therapy , Female , Humans , Interviews as Topic , Male , Middle Aged , Prospective Studies , Randomized Controlled Trials as Topic , Treatment Outcome