Efectividad de la psicoterapia cognitivo-conductual bajo estado hipnótico en pacientes deprimidos con la COVID-19

Introducción: En Santa Clara se recibieron los primeros casos diagnosticados en Cuba de la COVID-19. A partir de alteraciones emocionales reportadas se decidió utilizar la psicoterapia cognitivo conductual como recurso terapéutico para tratar los estados depresivos consecuentes. Objetivo: Evaluar la efectividad de la psicoterapia cognitivo conductual bajo estado hipnótico en pacientes con depresión post-COVID-19. Métodos: Se realizó un estudio explicativo con enfoque cuantitativo. La muestra se seleccionó de manera aleatoria en 30 pacientes divididos en 2 grupos, ingresados entre abril y septiembre del 2020 y diagnosticados con la COVID-19. Se empleó el inventario de depresión de Beck para evaluar el estado depresivo antes y después de la intervención con psicoterapia en estado de vigilia y en hipnosis. Resultados: En ambos grupos, los síntomas depresivos desaparecieron, en el 97 % de los pacientes el estado depresivo se eliminó. La psicoterapia de enfoque cognitivo conductual en estado de vigila e hipnótico se consideró efectiva en la depresión post-COVID-19 a partir de evaluar mejoría en más del 50 % de los casos. El grupo que recibió la psicoterapia en estado hipnótico necesitó la mitad de las sesiones que el grupo en vigilia. Conclusiones: La terapia cognitivo conductual en estado hipnótico es efectiva, reduce las distorsiones cognitivas, los niveles de depresión y la sintomatología depresiva.

Introduction: The first cases diagnosed in Cuba of COVID-19 were received in Santa Clara. Based on reported emotional disturbances, it was decided to use Cognitive Behavioral psychotherapy as a therapeutic resource to treat consequent depressive states. Objective: To evaluate the effectiveness of Cognitive Behavioral psychotherapy under hypnosis in patients with post-COVID-19 depression. Methods: An explanatory study with a quantitative approach was carried out. The sample was randomly selected in 30 patients divided into 2 groups, admitted between April and September 2020 and diagnosed with COVID-19. The Beck Depression Inventory was used to assess depressive state before and after the intervention with psychotherapy in the waking state and in hypnosis. Results: In both groups, the depressive symptoms disappeared, in 97% of the patients the depressive state was eliminated. Psychotherapy with a Cognitive Behavioral approach in a vigilant and hypnotic state was considered effective in post-COVID-19 depression after evaluating improvement in more than 50% of cases. The group that received psychotherapy in a hypnotic state required half as many sessions as the waking group. Conclusions: Cognitive behavioral therapy in a hypnotic state is effective, reducing cognitive distortions, levels of depression and depressive symptoms.

Effectiveness of an internet-based self-guided program to treat depression in a sample of Brazilian users: a study protocol

Although psychological treatments for depressive disorders are available, they are often expensive or inaccessible for many. Web-based interventions that require minimal or no contact with therapists have been shown effective. To the best of our knowledge, no study using this treatment format has been conducted in Brazil. The Deprexis program was designed using empirically established principles of cognitive-behavioral therapy to reduce depressive symptoms. The objective of this study was to evaluate the effectiveness of Deprexis in Brazil. This randomized controlled trial will include 128 Brazilians with clinically significant depression symptoms or who have been diagnosed with depressive disorder (major depressive disorder or dysthymia), recruited over the internet (Brazilian forums, social networks, or e-mail lists). Individuals with other psychiatric diagnoses that require significant attention (e.g., bipolar disorder, psychosis) will not be included in the trial. Participants will be randomly assigned to 1) treatment as usual plus immediate access to Deprexis or 2) treatment as usual plus delayed access to Deprexis (after 8 weeks). Participants will be able to obtain other treatment types in addition to the online intervention. If found effective, this web-based intervention would increase the evidence-based care options for depression treatment in Brazil. Clinical trial registration: RBR-6kk3bx, UTN U1111-1212-8998

Autolesión no suicida en adolescentes peruanas: Una aproximación diagnóstica y psicopatológica / Non suicidal self-injury in Peruvian adolescents

Una aproximación diagnóstica y psicopatológica a la autolesión no suicida es planteada a partir de la recolección de datos de un grupo de diez adolescentes peruanas que sufrían esta patología. Se revisan las aproximaciones del DSM 5 a este diagnóstico, las que dan lugar a su configuración como una entidad que requiere mayor estudio para ser considerada como independiente de la sintomatología del trastorno límite de personalidad. Se formulan algunas tesis acerca de su psicopatología y las características que la singularizan frente a ese trastorno y la llamada conducta suicida. A partir de una formulación cognitivo-conductual, se examina el papel de esta sintomatología autolesiva como refuerzo automático y social, tanto en su vertiente positiva como la negativa. Ulteriormente se toman en cuenta las once creencias irracionales de Ellis como un instrumento para dilucidar la adaptación a la realidad de las pacientes que conformaron el grupo explorado. Finalmente se esbozan algunos alcances en torno a la terapia dialéctico-conductual de Linehan, mentalizing de Bateman y el uso del aripiprazol y los inhibidores selectivos de recaptación de serotonina (ISRS) en estos casos.

A psychopathological and diagnostic approach regarding non suicidal self-injury is proposed as a result of an exploratory study of a group of ten Peruvian adolescents suffering that condition. The DSM 5 status for this category is taken into account, as well as its relationship with entities like suicidal behavior and the borderline personality disorder diagnosis. On the basis of a cognitive-behavioral formulation, the meaning of this self damaging pathology in terms of automatic and social reinforcement, both positive and negative, is elucidated in order to clarify further developments. One of them being the use of Ellis’ irrational beliefs as a tool to evaluate the sense of reality of the patients. Some comments about Linehan’s dialectical behavioral psychotherapy, Bateman’s mentalizing and aripiprazole or selective serotonine reuptake inhibitors (SSRIs) in the treatment of these patients are proposed.

O uso da terapia cognitivo-comportamental no tratamento do transtorno depressivo: uma abordagem em grupo / The use of cognitive behavioral therapy in the treatment of depressive disorder: a group approach

A depressão tem atingido amplos grupos sociais sem distinção entre eles e, constantemente, está associada como comorbidade a outras doenças. A Terapia Cognitivo-Comportamental (TCC) começou a ser estruturada pelo psicanalista e psiquiatra Aaron Beck para oferecer tratamento a pessoas deprimidas. Foi aprimorada e chegou a propostas de tratamento em grupo desenvolvidas por Aaron Beck e demais colaboradores. Este estudo procura fazer uma breve revisão dos temas da TCC e de sua aplicação no tratamento em grupo para depressão, desde a sua formulação até a revisão do uso dessa terapia na atualidade. Foram analisados artigos do ano de 2008 dessa metodologia de trabalho e comparados com os cânones dessa tipologia de tratamento.

Depression affects a variety of social groups without distinction, and usually occurs as comorbidity with other disorders. The Cognitive Behavioral Therapy (CBT) was originally structured by Aaron Beck to provide treatment to depressed people. It was later improved by him and his collaborators and developed into a proposal of group therapy. This study comprises a brief review of CBT topics and their application in group therapy of depression, from its formulation to its current employment. Recent publications regarding this method were analyzed and compared to the canons of this type of treatment.