Effects of DBT-based interventions on alexithymia: a systematic review.

While dialectical behavior therapy (DBT) appears effective for some psychiatric conditions commonly associated with alexithymia, it is unclear whether DBT improves difficulties experienced by alexithymic individuals. This review investigated the current evidence on the effectiveness of DBT-based interventions in improving alexithymia. A qualitative synthesis of studies that investigated the efficacy of DBT on self-reported alexithymia was performed, identifying eligible studies using EBSCO/Essentials, Google Scholar, PubMed, Web of Science, and PsychINFO databases. Eight studies were identified. Overall, the results were inconclusive due to the heterogeneity of the studies but suggest that DBT-based interventions may be associated with self-reported decreases in alexithymia and increases in the ability to identify emotional states. The literature is limited by significant methodological problems, such as the low number of controlled trials, small samples, and high variability between DBT programs, which increases the risk of bias across study outcomes. More research is needed to reach conclusions regarding the effectiveness of DBT in improving alexithymia. Future studies should conduct randomized controlled trial designs (primarily with active treatment control conditions), greater standardization of DBT-based interventions, and a more in-depth examination of the level of participant involvement in long-term DBT-based interventions may help to understand whether DBT improves alexithymia difficulties.

Medo do parto: uma revisão das intervenções baseadas na Terapia Cognitivo-Comportamental / Fear of childbirth: a review of interventions based on Cognitive Behavioral Therapy / Miedo al parto: una revisión de intervenciones basadas en Terapia Cognitivo-Conductual

O medo do parto vaginal é bastante comum e pode ter impactos relevantes na saúde materno-infantil. O objetivo deste estudo foi investigar de que forma a Terapia Cognitivo-Comportamental (TCC) tem sido aplicada em casos de medo do parto e avaliar a eficácia dessas intervenções. Realizou-se uma revisão sistemática da literatura através das bases de dados BVS Brasil, Scopus e PubMed, no período de fevereiro de 2019 a abril de 2019. Após a análise dos critérios de inclusão e exclusão, um total de oito textos completos constituíram a amostra final. Técnicas terapêuticas como a reestruturação cognitiva, a exposição e a atenção plena demonstraram ser relevantes para a elaboração de uma percepção menos catastrófica do parto e para o desenvolvimento de maior confiança nas próprias habilidades de enfrentamento do trabalho de parto. Conclui-se que as intervenções em TCC apresentam potencial benefício para o tratamento do medo do parto.

Fear of childbirth is a very common phenomenon among women and may significantly impact maternal-infant health. The goal of this study is to investigate how Cognitive Behavioral Therapy (CBT) has been applied in cases of fear of childbirth and assess the efficacy of such interventions. A systematic review of these practices was made using the BVS Brazil, Scopus, and PubMed databases, from February to April 2019. After analyzing the inclusion and exclusion criteria, a total of six full studies were selected as the final sample for this research. Therapeutic techniques such as cognitive restructuring, exposure, and mindfulness have proven to be important means of developing a less catastrophic perception of childbirth along with greater self-confidence in the abilities to cope with labor. The review led to the conclusion that CBT does have the potential to treat fear of childbirth.

El miedo al parto es muy común y puede afectar significativamente la salud materno-infantil. El objetivo de este estudio fue investigar cómo se ha aplicado la Terapia Cognitivo-Conductual (TCC) en casos de miedo al parto y evaluar la eficacia de las intervenciones. Se realizó una revisión sistemática a través de las bases de datos BVS Brasil, Scopus y PubMed, de febrero a abril de 2019. Después de analizar los criterios de inclusión y exclusión, un total de seis textos completos constituyeron la muestra final. Las técnicas terapéuticas como la reestructuración cognitiva, la exposición y la atención plena demostraron ser relevantes para la elaboración de una percepción menos catastrófica del parto y para el desarrollo de una mayor confianza en las capacidades propias para enfrentar el parto. La revisión llevó a la conclusión de que la TCC tiene potencial benéfico para tratar el miedo al parto.

Panic Disorder and Chronic Caffeine Use: A Case-control Study.

BACKGROUND: Acute administration of caffeine produces panic attacks in most Panic Disorder (PD) patients, but little is known about chronic caffeine use in these patients. OBJECTIVE: To assess caffeine use in patients with PD and to ascertain if caffeine consumption is associated with sociodemographic or clinical features. METHODS: 65 adults with PD and 66 healthy controls were included in the current study. Their caffeine intake within the previous week was quantified with a questionnaire and compared. Harmful caffeine use was defined as consumption above 400 mg/day of caffeine. We tested for correlations between caffeine intake, demographic and clinical features. RESULTS: Patients consumed significantly more caffeine than controls (P < 0.001). 14% (N = 9) of the PD patients made harmful use of caffeine. The use of caffeine-containing medications was observed in 40% (N = 26) of the PD patients and 6% (N = 4) of controls. Consumption of energy drinks was observed in 11% (N = 7) of PD patients and in none of the healthy subjects. Patients reported sleeping significantly less than controls (P < 0.001). In PD patients, caffeine consumption was not correlated with the presence of panic attacks or comorbidity with depression. The use of benzodiazepines or sedative medications was not correlated with caffeine intake. CONCLUSION: High caffeine consumption in PD patients could be explained by the development of tolerance with regular use of this substance. Subtypes of sensitive and non-sensitive PD patients could also explain why some of these patients are able to tolerate high doses of caffeine.

Neuroimaging findings as predictors of treatment outcome of psychotherapy in anxiety disorders.

Anxiety disorders are the largest group of mental disorders and a leading cause of impairment, implicating in high costs for health systems and society. Effective pharmacological and psychological treatments are available, but a significant fraction of these patients does not respond adequately to these treatments. The objective of this study is to identify neuroimaging findings that could predict response to psychotherapy in anxiety disorders. METHODS: The authors reviewed psychotherapy clinical trials with neuroimaging conducted with patients with anxiety disorders. A systematic review was performed in MEDLINE database through PubMed, the Cochrane Collaboration's Clinical Trials Register (CENTRAL), PsycINFO and Thomson Reuters's Web of Science. RESULTS: From the studies included in this review, 24 investigated anxiety disorder patients, and findings in the amygdala, dorsolateral prefrontal cortex (dlPFC), anterior cingulate cortex (ACC) and insula predicted response to psychotherapy in social anxiety disorder. Findings in ACC, hippocampus, insula, dlPFC, amygdala and inferior frontal gyrus (iFG) predicted response to psychotherapy in panic disorder and generalized anxiety disorder. LIMITATIONS: There was great heterogeneity between the included studies regarding neuroimaging techniques and the tasks performed during functional neuroimaging. CONCLUSION: Neuroimaging studies suggest that abnormalities in hippocampus, amygdala, iFG, uncus and areas linked with emotional regulation (dlPFC and ACC), predict a good outcome to psychotherapy in anxiety disorders.

Treatment outcomes in patients with Internet Addiction and anxiety / Resultado de tratamento de pacientes com dependência de internet e ansiedade

OBJECTIVE: To investigate the effectiveness of a treatment for Internet addiction and anxiety disorders, using cognitive behavioral therapy combined with medication, and to analyze the relationship between anxiety and Internet addiction. METHOD: An open clinical trial included 84 patients (42 in the "comorbidities" group; 42 in the "no comorbidities" group) seeking treatment for anxiety symptoms and/or Internet Addiction. The subjects responded to The Mini International Neuropsychiatric Interview 5.0; the Hamilton Anxiety Scale (HAM-A), the Hamilton Depression Scale (HDRS), Clinical Global Impressions Severity and Improvement (CGI-S and CGI-I) and the Young Internet Addiction Scale (IAT). Patients who had only Internet addiction received psychoeducation on conscious internet use and bibliotherapy; they were defined as the group without comorbidities; patients diagnosed with Internet addiction and anxiety disorder (the group with comorbidities) were forwarded for pharmacotherapy and psychotherapy. RESULTS: Both Internet Addiction and anxiety decreased after treatment; the average of Hamilton Anxiety Scale of the "comorbidities" group at the beginning was 33.9 ± 7.6, suggesting severe anxiety, and at the end of treatment it was 15.0 ± 5.1, suggesting mild anxiety and a significant improvement. The average Internet Addiction score at the beginning was 67.8 ± 9.0; at the end of the psychotherapy an average score of 37.7 ± 11.4 was registered, indicating a notable and highly significant improvement. CONCLUSIONS: The relationship between anxiety and Internet Addiction existed and was strong. Treatment significantly improved both.

OBJETIVO: Investigar a eficácia de tratamento para dependência de internet e transtornos de ansiedade, utilizando terapia cognitivo comportamental combinada com medicação, e analisar a relação entre ansiedade e dependência de internet. MÉTODO: Ensaio clínico aberto realizado no Laboratório de Pânico e Respiração no Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ) com 84 pacientes (42 do grupo com comorbidades e 42 do grupo sem comorbidades) que procuravam tratamento para transtornos de ansiedade e/ou dependência de internet. Os sujeitos responderam ao MINI Entrevista Neuropsiquiátrica Internacional 5.0; a Escala Hamilton de Ansiedade (HAM-A), a Escala Hamilton de Depressão (HDRS), a Escala Clínica de Impressão Global de Severidade e de Melhora (CGI-S e CGI-I) e a Escala de Dependência de Internet de Young (IAT). Os pacientes com apenas dependência de internet receberam psicoeducação sobre o uso consciente da internet e biblioterapia, e foram considerados o grupo sem comorbidades, enquanto que, os pacientes com transtornos de ansiedade e dependência de internet foram encaminhados para o tratamento medicamentoso e psicoterapia. RESULTADOS: Tanto a dependência de internet quanto a ansiedade diminuíram após o tratamento, a média da HAM-A no grupo com comorbidades no início foi de 33,9 ± 7,6, sugerindo ansiedade grave e ao final do tratamento foi de 15 ± 5,1, sugerindo uma significativa melhora. A media de dependência de internet obtida na IAT no início do tratamento foi de 67.8 ± 9.0 e ao final da psicoterapia a maioria dos participantes apresentou média de 37.7 ± 11.4 indicando uma melhora notável. CONCLUSÃO: A relação entre ansiedade e dependência de internet existe e é forte.

Treatment of Internet Addiction with Anxiety Disorders: Treatment Protocol and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy.

BACKGROUND: The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient's life. OBJECTIVE: This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). METHODS: Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction. RESULTS: Before treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (P<.001). A significant improvement in mean Internet addiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (P<.001), indicating medium Internet use. With respect to the relationship between IA and anxiety, the correlation between scores was .724. CONCLUSIONS: This study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the treatment from a behavioral perspective, and gave patients the confidence to continue to manage Internet use in their lives.

Stimulation by Light and Sound: Therapeutics Effects in Humans. Systematic Review.

Introduction : The objective of the study was to make a systematic review of published studies that used the brain stimulation by light and sound as means to optimize brain function and increase the different treatments. Methods : The methods followed the Prisma model for eligibility of studies. Results : Four studies on the systematic review were included 3 experimental studies and 1 case report. Two of these studies were focused in learning and sportive performance, and 2 focused on increasing physical and mental health. Conclusion : It was concluded that the investigation of brain stimulation technique can be applied to induce favorable mental states to enlarge treatments of several disorders that affect humans in a safe and noninvasive way. It is suggested that positive results can also be found through the association of brain stimulation by light and sound with therapies that combat depression and anxiety states.

Treatment of internet addiction in patient with panic disorder and obsessive compulsive disorder: a case report.

Problematic Internet use is a worldwide social issue and it can be found in any age, social, educational, or economic range. In some countries like China and South Korea internet addiction (IA) is considered a public health condition and this governments support research, education and treatment. Internet addiction has been associated with others psychiatric disorders. Panic disorder (PD) and Obsessive Compulsive Disorder (OCD) are anxiety disorders that involve a lot of damages in patient's life. We report a treatment of a patient with Panic Disorder and Obsessive Compulsive Disorder and internet addition involving pharmacotherapy and Cognitive Behavioral Therapy (CBT). The Cognitive Behavioral Therapy was conducted 1 time per week during 10 weeks and results suggest that the treatment was an effective treatment for the anxiety and for the internet addiction.

Repetitive transcranial magnetic stimulation (rTMS) to treat refractory panic disorder patient: a case report.

Panic disorder (PD) is an anxiety disorder that is highly disruptive to the patient's life and needs new options for effective treatments. In this case report, we present an application of repetitive transcranial magnetic stimulation (rTMS) in a refractory patient resistant to cognitive behavior therapy (CBT) and pharmacotherapy who was treated with a combined protocol of rTMS with a sequential stimulation of right and left dorsolateral prefrontal cortex (DLPFC). The protocol was conducted 3 times per week during 4 weeks, with one month follow-up. The fact that the patient showed improvement suggests that rTMS can be an effective option of treatment.

The role of positive emotion and contributions of positive psychology in depression treatment: systematic review.

The present study aims to conduct a systematic review of the literature by checking the impact of positive emotion in the treatment of depression and on the use of strategies of positive psychology which involves positive emotion to treat and reduce symptoms of depression. For this purpose, we conducted searches in databases ISI Web of Knowledge, PsycINFO and PubMed and found a total of 3400 studies. After inclusion application and exclusion criteria, 28 articles remained, presented and discussed in this study. The studies have important relations between humor and positive emotion as well as a significant improvement in signs and symptoms of depression using differents strategies of positive psychology. Another relevant aspect is the preventative character of the proposed interventions by positive psychology by the fact that increase well-being and produce elements such as resilience and coping resources that reduce the recurrent relapses in the treatment of depression. The strategies of positive psychology, such as increasing positive emotions, develop personal strengths: seeking direction, meaning and engagement for the day-to-day life of the patients, appear as potentially tools for the prophylaxis and treatment of depression, helping to reduce signs and symptoms as well as for prevention of relapses.

Analysis of genetic relatedness between populations of Aedes aegypti from different geographic regions of São Paulo state, Brazil.

RAPD markers have been used for the analysis of genetic differentiation of Aedes aegypti, because they allow the study of genetic relationships among populations. The aim of this study was to identify populations in different geographic regions of the S o Paulo State in order to understand the infestation pattern of A. aegypti. The dendrogram constructed with the combined data set of the RAPD patterns showed that the mosquitoes were segregated into two major clusters. Mosquitoes from the Western region of the S o Paulo State constituted one cluster and the other was composed of mosquitoes from a laboratory strain and from a coastal city, where the largest Latin American port is located. These data are in agreement with the report on the infestation in the S o Paulo State. The genetic proximity was greater between mosquitoes whose geographic origin was closer. However, mosquitoes from the coastal city were genetically closer to laboratory-reared mosquitoes than to field-collected mosquitoes from the S o Paulo State. The origin of the infestation in this place remains unclear, but certainly it is related to mosquitoes of origins different from those that infested the West and North region of the State in the 80's.

Analysis of genetic relatedness between populations of Aedes aegypti from different geographic regions of São Paulo state, Brazil

RAPD markers have been used for the analysis of genetic differentiation of Aedes aegypti, because they allow the study of genetic relationships among populations. The aim of this study was to identify populations in different geographic regions of the São Paulo State in order to understand the infestation pattern of A. aegypti. The dendrogram constructed with the combined data set of the RAPD patterns showed that the mosquitoes were segregated into two major clusters. Mosquitoes from the Western region of the São Paulo State constituted one cluster and the other was composed of mosquitoes from a laboratory strain and from a coastal city, where the largest Latin American port is located. These data are in agreement with the report on the infestation in the São Paulo State. The genetic proximity was greater between mosquitoes whose geographic origin was closer. However, mosquitoes from the coastal city were genetically closer to laboratory-reared mosquitoes than to field-collected mosquitoes from the São Paulo State. The origin of the infestation in this place remains unclear, but certainly it is related to mosquitoes of origins different from those that infested the West and North region of the State in the 80's