Psychotherapy and Psychosomatics最新文献

{"title":"Rumination-Focused Cognitive Behavioral Therapy for Negative Symptoms in Early Psychosis: Results of a Pilot Randomized Clinical Trial.","authors":"Benjamin Arnfred, Christin Nymann Lund, Alexander T Ysbæk-Nielsen, Ulrik Nykjær Jeppesen, Lars Clemmensen, Julie Midtgaard, Jeppe Feigenberg Johansen, Anne Vestervang Fuglsang, Louise Birkedal Glenthøj","doi":"10.1159/000551732","DOIUrl":"https://doi.org/10.1159/000551732","url":null,"abstract":"<p><strong>Introduction: </strong>Repetitive negative thinking may contribute to negative symptoms in psychosis. We report clinical outcomes from a pilot randomized clinical trial evaluating the feasibility and efficacy of group rumination-focused cognitive behavioural therapy (RFCBT) added to early outpatient care (OPUS) versus OPUS alone, i.e., treatment-as-usual (TAU).</p><p><strong>Methods: </strong>Young adults with schizophrenia spectrum disorders receiving OPUS care were randomized 1:1 to 13 weeks of group RFCBT plus OPUS or to TAU. Assessments were conducted at baseline and post-treatment. Feasibility was defined as ≥80% of participants completing ≥six sessions. The primary outcome was Brief Negative Symptom Scale (BNSS). Secondary outcomes were Perseverative Thinking Questionnaire (PTQ), Ruminative Responses Scale (RRS), Scale for the Assessment of Positive Symptoms (SAPS), Calgary Depression Scale for Schizophrenia (CDSS), Behavior Rating Inventory of Executive Function (BRIEF), and Social Functioning Scale (SFS). Between-group differences in change scores were tested with Welch t-tests.</p><p><strong>Results: </strong>Fifty-nine participants were included, but one withdrew consent, meaning fifty-eight participants were analyzed intention-to-treat (RFCBT n=28, TAU n=30). The treatment was feasible with 82.14 % of participants in the RFCBT group completing ≥six sessions. Compared with TAU, RFCBT produced greater improvement in BNSS (between-group Δ -5.90; p=0.05; d=0.72). Repetitive negative thinking and rumination improved significantly: PTQ (Δ -8.35; p=0.016; d=0.89) and RRS (Δ -9.62; d=1.15; p=0.001). No significant between-group differences were observed for SAPS, CDSS, BRIEF, or SFS.</p><p><strong>Conclusion: </strong>Adding group RFCBT to OPUS was feasible and yielded large reductions in negative symptoms and repetitive negative thinking relative to TAU, supporting progression to a fully powered trial.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-14"},"PeriodicalIF":17.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding \"Online Intensive Short-Term Dynamic Psychotherapy for Treatment-Resistant Somatic Symptom Disorder: An Interrupted Time-Series Study\".","authors":"Chen Chunyan","doi":"10.1159/000552223","DOIUrl":"https://doi.org/10.1159/000552223","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"28 1","pages":"1-5"},"PeriodicalIF":22.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial clustering of hypochondriasis.","authors":"Josep Pol-Fuster, Lorena Fernández de la Cruz, Daniel Rautio, Ebba Du Rietz, Zheng Chang, Brian M D Apos Onofrio, Henrik Larsson, Paul Lichtenstein, Ralf Kuja-Halkola, David Mataix-Cols","doi":"10.1159/000552073","DOIUrl":"https://doi.org/10.1159/000552073","url":null,"abstract":"<p><strong>Introduction: </strong>Hypochondriasis is a prevalent psychiatric condition associated with substantial individual suffering and healthcare utilization. Despite its clinical importance, little is known about its etiology, and the extent to which familial and genetic factors contribute to its development remains unclear.</p><p><strong>Methods: </strong>In this population-based cohort study, we identified 5,809,325 individuals born in Sweden between 1950 and 2008 with information on both biological parents, excluding those who emigrated or died before age 6 or before 1997. From this cohort, we identified clusters of full siblings, half siblings, and cousins. We compared the risk of hypochondriasis among relatives of individuals diagnosed with hypochondriasis to that of relatives of individuals without hypochondriasis. Previously validated ICD-10 diagnoses of hypochondriasis were identified through the Swedish National Patient Register (NPR). Cox regression models with time-varying exposures and attained age as the underlying time scale were used to estimate hazard ratios (HRs).</p><p><strong>Results: </strong>A total of 3,202 individuals were diagnosed with hypochondriasis (57% women; median age at first diagnosis 32.1 years). Relatives of individuals with hypochondriasis had a higher risk of the disorder, compared with relatives of individuals without hypochondriasis, and the risk increased with the degree of genetic relatedness. The strongest association was observed in full siblings (HR, 9.5; 95% CI, 5.1 - 17.5), followed by half siblings (HR, 5.6; 95% CI, 2.1 - 14.9), and cousins (HR, 2.6; 95% CI, 1.4 - 4.9).</p><p><strong>Conclusion: </strong>Hypochondriasis is a familial and likely heritable disorder.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-11"},"PeriodicalIF":17.4,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating Default and Salience/Ventral Attention networks: Exploring the treatment effect of transcranial alternating current stimulation on chronic insomnia.","authors":"Hongxing Wang,Danhao Zheng,Jing Huang,Wenfeng Zhao,Huang Wang,Xiaolei Liu,Furong Shang,Jiliang Fang,Haixia Leng,Qing Xue,Baoqun Min,Liucen Tan,Jinfeng Wu,Kangan Li,Keming Gao,Jie Lu,Jie Wang","doi":"10.1159/000552137","DOIUrl":"https://doi.org/10.1159/000552137","url":null,"abstract":"Chronic insomnia necessitates novel therapeutic strategies. While transcranial alternating current stimulation (tACS) shows promise, its neural mechanisms remain elusive. We conducted a 4-week, double-blind, randomized, sham-controlled trial to investigate the effects of high-intensity tACS (15 mA). Eighteen patients completed the protocol and longitudinal resting-state fMRI. Clinical results demonstrated a significant reduction in Pittsburgh Sleep Quality Index (PSQI) scores within the active tACS group [13.8 (3.0) vs. 7.7 (3.0), p < 0.001], indicating substantial clinical improvement, whereas the sham group showed no significant change [13.8 (2.9) vs. 13.9 (2.4), p = 0.74]. Furthermore, the spontaneous brain activity exhibited extensive reductions in both the Default and Salience/Ventral Attention networks, showing a negative correlation with increase in clinical sleep scores. The functional connectivity was significantly altered within the Default and Salience/Ventral Attention networks, and the majority of changes displayed a decreasing trend. Graph theoretical analysis revealed a topological reorganization in these networks, characterized by reduced clustering coefficients and characteristic path lengths, coupled with increased global efficiency. The study provides valuable insights into the potential mechanisms of tACS as an innovative intervention for improving sleep quality in insomnia, contributing to further research and optimization for insomnia treatment.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"4 1","pages":"1-24"},"PeriodicalIF":22.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Expectation to Learning: A Mediational Model of Exposure Therapy Outcome in Anxiety Disorders.","authors":"Benjamin Straube,Lukas Kirchner,Gina L Haccou,Isabelle C Ridderbusch,Ingmar Heinig,Jan Richter,Ulrike Lueken,Paul Pauli,Jürgen Deckert,Katharina Domschke,Peter Neudeck,Katja Koelkebeck,Udo Dannlowski,Volker Arolt,Thomas Fydrich,Andreas Ströhle,Jürgen Margraf,Silvia Schneider,Jürgen Hoyer,Alfons O Hamm,Hans-Ulrich Wittchen,Tilo Kircher,Winfried Rief,Andre Pittig","doi":"10.1159/000551966","DOIUrl":"https://doi.org/10.1159/000551966","url":null,"abstract":"INTRODUCTIONNegative expectations about treatment outcomes are associated with poorer recovery in anxiety disorders. However, it remains unclear whether (1) patients' expectations about how effective the treatment will be (treatment-specific expectations) mediate the link between generalized negative expectations (i.e. unspecific pessimistic beliefs) and treatment outcomes, and (2) these expectations affect outcomes via the learning rate during exposure therapy, that is, the extent to which patients update their fear-related beliefs based on corrective experiences. Since treatment-specific expectations may be more modifiable, clarifying these mechanisms could improve interventions. This study investigated whether treatment-specific expectations and learning rate mediate the effect of generalized negative expectations on treatment outcomes.METHODSData from 605 patients with various anxiety disorders undergoing 12 sessions of manualized exposure therapy were analyzed. Generalized negative expectations at baseline (session 0) were hypothesized to predict treatment outcomes (i.e., symptom severity at post treatment) via expectations about treatment success measured at session 4 and learning rate during exposure. Depression and anxiety at baseline were covariates. Mediation analyses were conducted using the PROCESS macro with bootstrap confidence intervals.RESULTSGeneralized negative expectations predicted poorer treatment outcomes (higher symptom severity), mediated by lower expectations about treatment success (β = 0.0375; 95% CI: 0.0088-0.0730). A sequential mediation via these treatment-specific expectations and learning rate was also significant (β = 0.0059; 95% CI: 0.0008-0.0134), even after accounting for baseline symptom levels (R² = 0.3375).CONCLUSIONTargeting both generalized and treatment-specific expectations early in treatment may enhance exposure-based learning and improve clinical outcomes in anxiety disorders.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"68 1","pages":"1-25"},"PeriodicalIF":22.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effectiveness of different feedback intensities in a pain management app - A multicenter randomized controlled trial with youths with chronic pain and their caregivers.","authors":"Amelie Florentine Schmidt,Dorothee Meyer,Lisa-Marie Rau,Gerrit Hirschfeld,Michael Frosch,Michael C Frühwald,Rosemarie Ahnert,Lea Höfel,Magdalena Storf,Markus Blankenburg,Kerstin Steinert,Udo Schneider,Ursula Marschall,Julia Wager,Boris Zernikow","doi":"10.1159/000551681","DOIUrl":"https://doi.org/10.1159/000551681","url":null,"abstract":"INTRODUCTIONMany children and adolescents suffer from high-impact chronic pain. While preliminary evidence suggests that intensive interdisciplinary pain treatment is effective, there is limited post-treatment support. Individualized support through a pain management app may help close this gap.METHODSWe conducted a multicenter randomized controlled trial with N = 453 youths with chronic pain aged 8-17 and their caregivers. Participants had access to the app MyBrainCity from admission until six months following discharge. Immediately after discharge, participants had access to either (1) app usage statistics (reference group), (2) plus push notifications and suggestions, (3) plus on-demand chat communication with a psychologist, or (4) plus psychologist-initiated chat communication. Data were collected up to nine months after discharge. Outcomes included the functional disability inventory, the Revised Anxiety and Depression Scale, and numeric rating scales to assess pain intensity.RESULTSThe primary analysis showed no significant differences in functional impairment between groups nine months post-discharge (χ2(3)=6.122, p=.106). Secondary analyses revealed that patients in Groups 3 and 4 showed significantly greater improvements in functional impairment compared to the reference group (-1.13 points, p<.001). Only patients in Group 4 demonstrated additional improvements in emotional burden (anxiety: -0.91 points, p<.001; depression: -0.72 points, p=.012). Patients in Group 2 had significantly greater reductions in both average (-0.24 points, p=.007) and maximum pain intensity (-0.33 points, p=.001) compared to the reference group.CONCLUSIONSPediatric pain management apps may be most effective when designed to include individualized, personal support. Patients especially benefit from clinician-delivered feedback following discharge.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"22 1","pages":"1-25"},"PeriodicalIF":22.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health AI Chatbots as Pharmakon: A Tripartite Theory of Use Despite Risk.","authors":"Anthony P Weiss,Matcheri Keshvan,John Torous","doi":"10.1159/000551841","DOIUrl":"https://doi.org/10.1159/000551841","url":null,"abstract":"The rapid uptake of AI for therapeutic uses has outpaced our ability to carefully understand risks and benefits, to assess and regulate its use. This is particularly true with AI-based mental health chatbots, with large percentages of the population globally now using these tools as an adjunct to, or replacement for, formal psychiatric care. While there is great potential in the use of this new tool, there are also clear risks. We use the Platonic concept of pharmakon to describe this, and go on to hypothesize about the three mechanisms which may be driving AI Chatbot use despite consequences. We believe this frame allows for testable research endeavors, and also provides a set of precedents related to the incorporation of previous technologies in the care of patients with mental illness.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"7 1","pages":"1-7"},"PeriodicalIF":22.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brief intervention for the treatment of anxiety in pregnancy. A pilot randomized controlled trial (The TAP study).","authors":"Sophie Grigoriadis,Neeti Sharma,Cindy-Lee Dennis,Simone N Vigod,Neil Rector,Peggy Richter,Janet Bodley,Karen Fleming,Jon Barret,Alex Kiss,Anthony Levitt,Steven Selchen","doi":"10.1159/000551731","DOIUrl":"https://doi.org/10.1159/000551731","url":null,"abstract":"Introduction Anxiety during pregnancy affects 1 in 4 pregnancies and is often co-morbid with other mental health disorders. Early intervention is crucial to avoid persistent mental health issues and adverse obstetrical, neonatal and child outcomes. Traditional mindfulness-based cognitive therapy is effective, but its uptake is limited by its high resource intensity for patients and healthcare services. This study investigated the feasibility, acceptability, and preliminary efficacy of a novel, brief psychotherapy, \"Mindful Adaptive Practice in Pregnancy\" (MAPP), delivered in a synchronous virtual group format. Methods This pilot randomized controlled trial (RCT) was conducted at two university-affiliated health centers. Pregnant persons with elevated anxiety symptoms were randomly assigned to MAPP plus treatment as usual (TAU) or TAU alone. MAPP was delivered in five, 2-hour virtual group sessions, over four weeks. Feasibility was assessed by recruitment rates and participant eligibility, intervention acceptability through online questionnaires, and adherence by session attendance and follow-up completion. Efficacy was preliminarily evaluated by anxiety symptom change post-treatment. Results Participants were recruited from November 2021 to May 2022, with 69 randomized to MAPP (36 participants) or TAU (33 participants). High acceptability and adherence were reported for MAPP with over 80% attending 3 or more sessions. Preliminary results suggest significant reduction in anxiety symptoms for participants receiving MAPP compared to TAU. Conclusion MAPP was feasible and well-accepted. Preliminary data suggest that this brief, synchronous virtual therapy may effectively reduce anxiety symptoms. Further investigation into MAPP's efficacy in a larger-scale RCT can confirm its viability as an intervention for anxiety during pregnancy.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"21 1","pages":"1-32"},"PeriodicalIF":22.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Large-Group 1-Day RCT Investigating the Effectiveness of Four Different Strategies to Promote the Outcome of Exposure Therapy in 519 Patients with Phobic Fear of Flying.","authors":"André Wannemüller, Aline Beckers, Leilah Beideck, Claudia Horzela, Katrin Hötzel, Antonia Jansen, Darija Jordan, Eva Liebert, Marie Mertens, Peter Rosenkranz, Nina Valentina Ruschmeier, Svenja Schaumburg, Henri Schettler, Sally Tavenrath, Tobias Teismann, Jürgen Margraf","doi":"10.1159/000550395","DOIUrl":"https://doi.org/10.1159/000550395","url":null,"abstract":"<p><strong>Introduction: </strong>Despite its status as the gold standard for treating fear and anxiety, exposure therapy leaves room for optimization. Clarifying and testing the clinical relevance of proposed mechanisms may enhance outcomes. This randomized controlled trial (DRKS00031220) examined the effects of four psychological strategies aimed at facilitating exposure outcomes in individuals with clinically significant fear of flying due to specific phobia or agoraphobia (N = 519).</p><p><strong>Methods: </strong>All participants underwent a standardized large-group one-session treatment (LG-OST) including psychoeducation, debriefing, and an in vivo exposure flight. Participants were randomized to one of four conditions targeting distinct mechanisms: peer support (SUPPORT), self-efficacy (SELF-EFFIC), expectancy violation (EXPECT), or coping with bodily fear symptoms (COPE). These mechanisms were reinforced prior and during paralleled exposure flights, conducted in separate aircraft per condition.</p><p><strong>Results: </strong>Across all conditions, LG-OST led to substantial symptom reduction short- and long-term. Fear ratings halved, over 50% flew again within the 6-month follow-up interval, and ∼70% no longer met diagnostic criteria. However, no condition yielded superior outcomes. While manipulation checks confirmed partial activation of target mechanisms (e.g., greater perceived peer support in SUPPORT, increased use of breathing techniques in COPE), these effects did not translate into differential clinical benefits.</p><p><strong>Conclusion: </strong>Findings support the efficacy and scalability of LG-OST, while suggesting that tailoring preparatory strategies to specific mechanisms may have limited added value. They also highlight the need to advance mechanistic research to better understand the intertwined processes underlying exposure success. Future work should focus on improving accessibility and sustaining long-term gains.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-19"},"PeriodicalIF":17.4,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for flexible, co-developed Adverse Childhood Experiences (ACEs) assessment: response to Chang & Su, Adverse Childhood Experiences (ACEs) in the Digital Era: An Urgent Call for Precision Assessment.","authors":"Line Caes,Aikaterini Christogianni,Tim G Hales,Lesley A Colvin","doi":"10.1159/000551662","DOIUrl":"https://doi.org/10.1159/000551662","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"13 1","pages":"1-6"},"PeriodicalIF":22.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}