Psychotherapy and Psychosomatics最新文献

{"title":"Illness Denial in Medical Conditions: The Time Has Come to Include It in DSM Iterations.","authors":"Thomas N Wise","doi":"10.1159/000533287","DOIUrl":"10.1159/000533287","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"292-294"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Development of Symptoms and Staging in Psychiatry and Clinical Psychology: A Tribute to Giovanni Fava.","authors":"Ulrich Schnyder","doi":"10.1159/000527462","DOIUrl":"https://doi.org/10.1159/000527462","url":null,"abstract":"The introduction of diagnostic manuals, such as the first mention of mental disorders in the International Classification of Diseases (ICD-6) in 1948 [1] and the Diagnostic and Statistical Manual of Mental Disorders in 1952 [2], was a big step forward in the fields of psychiatry and clinical psychology. The operationalization of diagnostic criteria for mental disorders such as depression or schizophrenia, which lacked characteristic morphological features or laboratory biomarkers, greatly increased the reliability of clinicians’ diagnoses and their capacity to communicate with one another. However, those classifications were based on a cross-sectional view and informed clinicians, researchers, patients, and their relatives only little about the expected longitudinal course and development of a mental disorder. More specifically, cross-sectional diagnostics did not inform about trajectories of symptom severity over time, individual characteristics and combinations of symptoms, or comorbidities. Such elements are important when it comes to developing a sequential treatment plan and adjusting it as illness characteristics and symptom levels change over time. As early as 1967, Feinstein encouraged clinicians to develop their own “basic science” to use clinical phenomena and data to generate classification systems and to ultimately analyze the clinical process quantitatively [3]. Feinstein appears to have been a lone voice calling in the wilderness at that time though.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 1","pages":"4-8"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10570123","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":"Patients as Health Producers: The Psychosomatic Foundation of Lifestyle Medicine.","authors":"Giovanni A Fava","doi":"10.1159/000529953","DOIUrl":"https://doi.org/10.1159/000529953","url":null,"abstract":"N/A.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 2","pages":"81-86"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9949292","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":"Virtual Reality Exposure to a Healthy Weight Body Is a Promising Adjunct Treatment for Anorexia Nervosa.","authors":"Simone C Behrens,&nbsp;Joachim Tesch,&nbsp;Philine J B Sun,&nbsp;Sebastian Starke,&nbsp;Michael J Black,&nbsp;Hannah Schneider,&nbsp;Jacopo Pruccoli,&nbsp;Stephan Zipfel,&nbsp;Katrin E Giel","doi":"10.1159/000530932","DOIUrl":"https://doi.org/10.1159/000530932","url":null,"abstract":"<p><strong>Introduction/objective: </strong>Treatment results of anorexia nervosa (AN) are modest, with fear of weight gain being a strong predictor of treatment outcome and relapse. Here, we present a virtual reality (VR) setup for exposure to healthy weight and evaluate its potential as an adjunct treatment for AN.</p><p><strong>Methods: </strong>In two studies, we investigate VR experience and clinical effects of VR exposure to higher weight in 20 women with high weight concern or shape concern and in 20 women with AN.</p><p><strong>Results: </strong>In study 1, 90% of participants (18/20) reported symptoms of high arousal but verbalized low to medium levels of fear. Study 2 demonstrated that VR exposure to healthy weight induced high arousal in patients with AN and yielded a trend that four sessions of exposure improved fear of weight gain. Explorative analyses revealed three clusters of individual reactions to exposure, which need further exploration.</p><p><strong>Conclusions: </strong>VR exposure is a well-accepted and powerful tool for evoking fear of weight gain in patients with AN. We observed a statistical trend that repeated virtual exposure to healthy weight improved fear of weight gain with large effect sizes. Further studies are needed to determine the mechanisms and differential effects.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 3","pages":"170-179"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9766041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Psychotherapeutic Intervention Compared with Treatment as Usual for Adolescents with Nonsuicidal Self-Injury: Outcomes over a 2-4-Year Follow-Up.","authors":"Franziska Rockstroh,&nbsp;Alexandra Edinger,&nbsp;Johannes Josi,&nbsp;Romuald Brunner,&nbsp;Franz Resch,&nbsp;Michael Kaess","doi":"10.1159/000531092","DOIUrl":"10.1159/000531092","url":null,"abstract":"<p><strong>Introduction: </strong>The \"Cutting Down Programme\" (CDP), a brief psychotherapeutic intervention for treating nonsuicidal self-injury (NSSI) in adolescents, was comparable to high-quality treatment as usual (TAU) in a previous randomized controlled trial (RCT).</p><p><strong>Objective: </strong>The aim of the study was to evaluate the long-term outcomes of the CDP over up to 4 years.</p><p><strong>Methods: </strong>Assessments of NSSI, suicide attempts, borderline personality disorder (BPD), depression, and quality of life took place 2 to 4 years (T3) after enrollment in a RCT. The evolution of NSSI, suicide attempts, depression, and quality of life was analyzed using (generalized) linear mixed-effects models. Ordered logistic regression was used for analyzing BPD diagnoses. Data from T0, T2, and T3 are reported.</p><p><strong>Results: </strong>Out of 74 patients, 70 (95%) were included in the T3 assessment. The frequency of NSSI events alongside with suicide attempts and depression further decreased between T2 and T3 and BPD between T0 and T3 in both groups. Quality of life remained stable in both groups between T2 and T3. Both groups received substantial but comparable additional treatment between T2 and T3. More treatment sessions during the follow-up period were linked to larger improvements of NSSI.</p><p><strong>Conclusions: </strong>The CDP was found to be as effective as TAU in promoting recovery from NSSI and comorbid symptoms in the long term. Results suggest that treatment effects from a brief psychotherapeutic intervention may endure and even further improve after completion of the program. However, additional treatment seems to improve chances for recovery independent from CDP versus TAU.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"243-254"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9864959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More Treatment, but Not Less Anxiety and Mood Disorders: Why? Seven Hypotheses and Their Evaluation.","authors":"Johan Ormel,&nbsp;Paul M G Emmelkamp","doi":"10.1159/000528544","DOIUrl":"https://doi.org/10.1159/000528544","url":null,"abstract":"Mood and anxiety disorders are not only common and responsible for much functional disability [1], but epidemiological studies also indicate that their prevalence, circa 10% in Western countries, has not fallen since the 1970s despite the development of evidence-based treatments [2–8]. Prevalence refers to the percentage of adults in the general population that meet diagnostic criteria in a defined period, usually the 30 days (point prevalence) or 12 months (12-month prevalence) preceding the examination irrespective of possible earlier episodes. In sharp contrast, multiple studies have documented substantial increases in expenditures on mental health care and in treatment rates in Western countries [9–15]. The evidence on increased treatment rates comes from both general practice [16–18], nation-wide morbidity registrations [19, 20], and repeated population-based surveys [8, 21]. The treatment rate increase was bolstered by the introduction of a new class of drugs in the 1980s, the selective serotonin reuptake inhibitors, aggressively marketed by Big Pharma [22]. In addition, a number of evidence-based psychological treatments became available for people with mood and anxiety disorders. The trend data on prevalence and treatment rate reveal a remarkable paradox: more treatment but not less disorders, the treatment-prevalence paradox. The expectation to see a declining trend in the prevalence of mood and anxiety disorders with an increasing trend in treatment is not unfounded. Treatment seeks to shorten illness episodes, prevent worsening and the development of comorbidity, reduce relapses and curtail recurrences. If effective, increased treatment rates should result in lower prevalence rates in the general population, but this prevalence reduction has not occurred. The increase in the use of statins has led to significant reduction in population cholesterol levels [23]. Likewise, more and better treatment of hypertension has led to less hypertension and associated illness such as heart attacks and strokes illness [24, 25]. At least seven hypotheses can explain why more and better treatments have not reduced common mental disorder prevalence: 1. Increased willingness of individuals to report symptoms and pressures to diagnose distress as anxiety or depression has inflated prevalence rates and masked a true treatment-driven prevalence drop (further: diagnostic inflation).","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 2","pages":"73-80"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9639174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing the Biopsychosocial Model in Clinical Medicine: A Tribute to Giovanni Fava.","authors":"Stephan Zipfel,&nbsp;Bernd Löwe,&nbsp;Katrin Giel,&nbsp;Hans-Christoph Friederich,&nbsp;Peter Henningsen","doi":"10.1159/000528451","DOIUrl":"https://doi.org/10.1159/000528451","url":null,"abstract":"aDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany; bDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center HamburgEppendorf, Hamburg, Germany; cDepartment of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany; dDepartment of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany Received: October 28, 2022 Accepted: November 24, 2022 Published online: December 23, 2022","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 1","pages":"21-26"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10566682","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":"Maternal Benzodiazepines and Z-Drugs Use during Pregnancy and Adverse Birth and Neurodevelopmental Outcomes in Offspring: A Population-Based Cohort Study.","authors":"Adrienne Y L Chan,&nbsp;Le Gao,&nbsp;Louise M Howard,&nbsp;Emily Simonoff,&nbsp;Dave Coghill,&nbsp;Patrick Ip,&nbsp;Wallis C Y Lau,&nbsp;Katja Taxis,&nbsp;Ian C K Wong,&nbsp;Kenneth K C Man","doi":"10.1159/000529141","DOIUrl":"https://doi.org/10.1159/000529141","url":null,"abstract":"<p><strong>Introduction: </strong>The use of benzodiazepines and/or z-drugs in women of childbearing age has increased.</p><p><strong>Objective: </strong>The aim of the study was to evaluate whether gestational benzodiazepine and/or z-drug exposure is associated with adverse birth and neurodevelopmental outcomes.</p><p><strong>Methods: </strong>A population-based cohort including mother-child pairs from 2001 to 2018 in Hong Kong was analysed to compare gestationally exposed and nonexposed children on the risk of preterm birth, small for gestational age, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) through logistic/Cox proportional hazards regression with a 95% confidence interval (CI). Sibling-matched analyses and negative control analyses were applied.</p><p><strong>Results: </strong>When comparing gestationally exposed with gestationally nonexposed children, the weighted odds ratio (wOR) was 1.10 (95% CI = 0.97-1.25) for preterm birth and 1.03 (95% CI = 0.76-1.39) for small for gestational age, while the weighted hazard ratio (wHR) was 1.40 (95% CI = 1.13-1.73) for ASD and 1.15 (95% CI = 0.94-1.40) for ADHD. Sibling-matched analyses showed no association between gestationally exposed children and their gestationally nonexposed siblings for all outcomes (preterm birth: wOR = 0.84, 95% CI = 0.66-1.06; small for gestational age: wOR = 1.02, 95% CI = 0.50-2.09; ASD: wHR = 1.10, 95% CI = 0.70-1.72; ADHD: wHR = 1.04, 95% CI = 0.57-1.90). Similarly, no significant differences were observed when comparing children whose mothers took benzodiazepines and/or z-drugs during pregnancy to children whose mothers took benzodiazepines and/or z-drugs before but not during pregnancy for all outcomes.</p><p><strong>Conclusions: </strong>The findings do not support a causal relationship between gestational benzodiazepines and/or z-drugs exposure and preterm birth, small for gestational age, ASD, or ADHD. Clinicians and pregnant women should carefully balance the known risks of benzodiazepines and/or z-drugs use against those of untreated anxiety and sleep problems.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 2","pages":"113-123"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9594282","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":"Antidepressants and Social Functioning in Patients with Major Depressive Disorder: Systematic Review and Meta-Analysis of Double-Blind, Placebo-Controlled RCTs.","authors":"Stefanie Kremer, Teresa Wiesinger, Tom Bschor, Christopher Baethge","doi":"10.1159/000533494","DOIUrl":"10.1159/000533494","url":null,"abstract":"<p><strong>Introduction: </strong>Social functioning (SF) is the ability to fulfil one's social obligations and a key outcome in treatment.</p><p><strong>Objective: </strong>The aim of the study was to estimate the effects of antidepressants on SF in patients with major depressive disorder (MDD).</p><p><strong>Methods: </strong>This meta-analysis and its reporting are based on Cochrane Collaboration's Handbook of Systematic Reviews and Meta-Analyses and PRISMA guidelines (protocol registration at OSF). We systematically searched CENTRAL, Medline, PubMed Central, and PsycINFO for double-blind RCTs comparing antidepressants with placebo and reporting on SF. We computed standardized mean differences (SMDs) with 95% CIs and prediction intervals.</p><p><strong>Results: </strong>We selected 40 RCTs out of 1,188 records screened, including 16,586 patients (mean age 46.8 years, 64.2% women). In 27 studies investigating patients with MDD (primary depression), antidepressants resulted in a SMD of 0.25 compared to placebo ([95% CI: 0.21; 0.30] I2: 39%). In 13 trials with patients suffering from MDD comorbid with physical conditions or disorders, the summary estimate was 0.24 ([0.10; 0.37] I2: 75%). In comorbid depression, studies with high/uncertain risk of bias had higher SMDs than low-risk studies: 0.29 [0.13; 0.44] versus 0.04 [-0.16; 0.24]; no such effect was evident in primary depression. There was no indication of sizeable reporting bias. SF efficacy correlated with efficacy on depression scores, Spearman's rho 0.67 (p &lt; 0.001), and QoL, 0.63 (p &lt; 0.001).</p><p><strong>Conclusions: </strong>The effect of antidepressants on SF is small, similar to its effect on depressive symptoms in primary MDD, and doubtful in comorbid depression. Strong correlations with both antidepressive and QoL effects suggest overlap among domains.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"304-314"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128491","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":"At the Head and Heart of Oxytocin's Stress-Regulatory Neural and Cardiac Effects: A Chronic Administration RCT in Children with Autism.","authors":"Kaat Alaerts, Nicky Daniels, Matthijs Moerkerke, Margaux Evenepoel, Tiffany Tang, Stephanie Van der Donck, Viktoria Chubar, Stephan Claes, Jean Steyaert, Bart Boets, Jellina Prinsen","doi":"10.1159/000534114","DOIUrl":"10.1159/000534114","url":null,"abstract":"<p><strong>Introduction: </strong>Intranasal administration of oxytocin presents a promising new approach to reduce disability associated with an autism spectrum disorder diagnosis. Previous investigations have emphasized the amygdala as the neural foundation for oxytocin's acute effects. However, to fully understand oxytocin's therapeutic potential, it is crucial to gain insight into the neuroplastic changes in amygdala circuitry induced from chronic oxytocin administrations, particularly in pediatric populations.</p><p><strong>Objective: </strong>We aimed to examine the impact of a 4-week course of intranasal oxytocin on amygdala functional connectivity in children with autism, compared to placebo. Additionally, we investigated whether oxytocin improves cardiac autonomic arousal, as indexed by high-frequency heart rate variability.</p><p><strong>Methods: </strong>Fifty-seven children with autism aged 8-12 years (45 boys, 12 girls) participated in a double-blind, randomized pharmaco-neuroimaging trial involving twice-daily administrations of intranasal oxytocin or placebo. Resting-state fMRI scans and simultaneous, in-scanner heart rate recordings were obtained before, immediately after, and 4 weeks after the nasal spray administration period.</p><p><strong>Results: </strong>Significant reductions in intrinsic amygdala-orbitofrontal connectivity were observed, particularly at the 4-week follow-up session. These reductions were correlated with improved social symptoms and lower cardiac autonomic arousal. Further, oxytocin's neural and cardiac autonomic effects were modulated by epigenetic modifications of the oxytocin receptor gene. The effects were more pronounced in children with reduced epigenetic methylation, signifying heightened expression of the oxytocin receptor.</p><p><strong>Conclusion: </strong>These findings underscore that a 4-week oxytocin administration course decreases amygdala connectivity and improves cardiac autonomic balance. Epigenetic modulators may explain inter-individual variation in responses to oxytocin.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"315-328"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210705","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}