A randomized clinical trial to assess the efficacy of trial-based cognitive therapy compared to prolonged exposure for post-traumatic stress disorder: preliminary findings.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a prevalent mental health condition that is often associated with psychiatric comorbidities and changes in quality of life. Prolonged exposure therapy (PE) is considered the gold standard psychological treatment for PTSD, but treatment resistance and relapse rates are high. Trial-based cognitive therapy (TBCT) is an effective treatment for depression and social anxiety disorder, and its structure seems particularly promising for PTSD. Therefore, we evaluated the efficacy of TBCT compared to PE in patients with PTSD. METHODS: Ninety-five patients (77.6% females) who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for PTSD were randomly assigned to receive either TBCT (n = 44) or PE (n = 51). Patients were evaluated before and after treatment, and at follow-up 3 months after treatment. The primary outcome was improvement in PTSD symptoms as assessed by the Davidson Trauma Scale (DTS). Secondary outcomes were depression, anxiety, and dysfunctional attitudes assessed by the Beck Depression/Anxiety Inventories and Dysfunctional Attitudes Scale, as well as the dropout rate. RESULTS: A significant reduction in DTS scores was observed in both arms, but no significant difference between treatments. Regarding the secondary outcomes, we found significant differences in depressive symptoms in favor of TBCT, and the dropout rate was lower in the TBCT group than the PE group. CONCLUSION: Our preliminary results suggest that TBCT may be an effective alternative for treating PTSD. Further research is needed to better understand its role and the mechanisms of change in the treatment of this disorder.

Avaliação de traços de personalidade em pacientes com fobia social / Evaluation of personality traits in social phobia patients

CONTEXTO: Os sintomas de transtornos de personalidade (Eixo II) comumente encontrados em pacientes com fobia social se sobrepõem com os sintomas que descrevem o transtorno pelo Eixo I. OBJETIVO: O presente estudo teve por objetivo avaliar traços de personalidade em pacientes com diagnóstico de fobia social. MÉTODO: Cento e oito sujeitos com idade entre 18 e 65 anos foram avaliados pelo Inventário de Temperamento e Caráter de Cloninger. RESULTADO: Os pacientes com fobia social diferiram dos dados normativos nos seguintes traços de personalidade: Busca à Novidade, Fuga de Danos, Persistência, Autodirecionamento e Autotranscendência. CONCLUSÃO: Esses achados apontam para uma sobreposição entre a descrição dos traços de personalidade citados por Cloninger e a descrição dos sintomas de fobia social do DSM-IV, Eixo I.

BACKGROUND: The symptoms of personality disorders (Axis II) commonly found in social phobia patients overlap highly with the symptoms that typify the Axis I disorder and are thus linked to diagnostic process in symptomatic patients. OBJECTIVE: The aim of the present study was to evaluate personality traits of social phobia patients. METHOD: One hundred and eight subjects were selected, from 18 to 65 years of age, who fulfilled the criteria of social phobia. The Cloninger's Temperament and Character Inventory (TCI) was applied. RESULTS: Social phobia patients differed in normalized data in the following personality traits: Novelty Seeking, Harm Avoidance, Persistence, Self Directedness, and Self-Transcendence. DISCUSSION: These findings point to a high overlap between Cloninger's description of the observed predominant personality traits and DSM-IV Axis I symptoms description for social phobia.

Cinematerapia como intervenção psicoterápica: características, aplicações e identificação de técnicas cognitivo-comportamentais: [revisão] / Cinematherapy as psychotherapeutic intervention: characteristics, applications and identification of cognitive-behavior techniques: [review]

CONTEXTO: Filmes têm sido utilizados como recurso terapêutico. A cinematerapia propõe uma nova intervenção psicoterápica por meio da indicação de filmes comerciais. OBJETIVOS: Realizar uma revisão sistemática da literatura sobre as características, aplicações e o efeito terapêutico da cinematerapia e identificar técnicas da terapia cognitivo-comportamental (TCC) nessa revisão. MÉTODOS: Sem limite de data, fez-se uma busca bibliográfica manual e nos seguintes bancos de dados: LILACS, MEDLINE, SciELO e PsycINFO. Combinaram-se os seguintes descritores em inglês e, na base LILACS, os correspondentes em português: "motion pictures as topic" E "psychiatry" OU "psychotherapy", além de "cinematherapy". Estipularam-se critérios precisos de inclusão e exclusão. RESULTADOS: Quatro artigos indexados, três livros e dois artigos não indexados. Vinte e cinco técnicas da TCC foram identificadas. DISCUSSÃO: A análise dos resultados permitiu delinear a cinematerapia desde suas características até seus efeitos terapêuticos. Embora positivo, o impacto do uso de filmes comerciais em psicoterapia partiu na maioria de relatos de caso e inferências pessoais; houve apenas dois ensaios clínicos. CONCLUSÃO: A identificação de várias técnicas da TCC e os resultados de alguns estudos apontam para uma provável eficácia da cinematerapia. Entretanto, seu efeito terapêutico precisa de melhor evidência científica que o sustente.

BACKGROUND: Motion pictures can be used as a therapeutic resource. Cinematherapy proposed a new psychotherapeutic intervention indicating commercial films. OBJECTIVES: A systematic literature review of the characteristics and therapeutic effects of cinematherapy and to identify cognitive-behavior techniques (CBT) in this review. METHODS: With no date limits, we searched the databases: LILACS, MEDLINE, SciELO and PsycINFO. We used the following terms in English and, in LILACS, their equivalent in Portuguese: "motion pictures as topic" AND "psychiatry" OR "psychotherapy"; besides "cinematherapy". A manual search was also done. Accurate inclusion and exclusion criteria were stipulated. RESULTS: Four indexed articles, three books and two no indexed articles. Twenty-five CBT were identified. DISCUSSION: The analysis of data allowed the description of cinematherapy: its characteristics and therapeutic effects. The positive impact of cinematherapy was shown mainly through case reports and personal inferences; only two clinical essays were found. CONCLUSION: The identification of several CBT and the results of some studies have indicated a probable efficacy of cinematherapy. Controlled studies are necessary.

Effects of osteopathic manipulative treatment on pediatric patients with asthma: a randomized controlled trial.

Asthma is a common chronic condition that has long plagued the pediatric patient population. Asthma in children can cause excessive school absenteeism, hospitalizations, and even death. Osteopathic manipulative treatment (OMT) is an underutilized noninvasive treatment method for patients with asthma. The use of OMT may help decrease mortality and morbidity rates among this patient group. The authors conducted a randomized controlled trial attempting to demonstrate the therapeutic relevance of OMT in the pediatric asthma population. With a confidence level of 95%, results for the OMT group showed a statistically significant improvement of 7 L per minute to 9 L per minute for peak expiratory flow rates. These results suggest that OMT has a therapeutic effect among this patient population. The authors suggest that more clinical trials are required to better demonstrate the effectiveness of OMT in patients with asthma.

Estudo do perfil epidemiológico das pacientes com aborto provocado na Maternidade da Encruzilhada / Epidemiological profile's study of the patients with induced abortion in the Maternity Encruzilhada

Realizou-se uma entrevista com 143 mulheres que ingressaram com o diagnóstico de aborto séptico durante o período de maio a dezembro de 1988, na Maternidade da Encruzilhada, sendo que 110 mulheres confirmaram terem provocado o aborto. Muitas variáveis foram estudadas: idade, paridade, estado civil, nível sócio-econômico, idade gestacional, história de aborto e religiäo. Observou-se no estudo do perfil epidemiológico das mulheres que o aborto constitui um sério problema de saúde pública, ocupando um lugar destacado em nosso meio