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 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.