{"title":"Developing and Testing Complex Interventions in Psychosomatic Medicine.","authors":"Christopher Burton","doi":"10.1159/000541742","DOIUrl":"10.1159/000541742","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"26-30"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506629","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":"Hidden Costs: The Clinical and Research Pitfalls of Mistaking Antidepressant Withdrawal for Relapse.","authors":"Mark A Horowitz, James Davies","doi":"10.1159/000542437","DOIUrl":"10.1159/000542437","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"3-7"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751386","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}
Luisa de Siqueira Rotenberg, Renata Curvello, Clara Nardini, Milene da Silva Franco, Maria Eduarda Carozzino, Taís Boeira Biazus, Thuani Campanha, Alia Garrudo Guirado, Grace O'Malley, Thomas J Stamm, Beny Lafer
{"title":"Metacognitive Training for Subjects with Bipolar Disorder: A Randomized Controlled Trial.","authors":"Luisa de Siqueira Rotenberg, Renata Curvello, Clara Nardini, Milene da Silva Franco, Maria Eduarda Carozzino, Taís Boeira Biazus, Thuani Campanha, Alia Garrudo Guirado, Grace O'Malley, Thomas J Stamm, Beny Lafer","doi":"10.1159/000542091","DOIUrl":"10.1159/000542091","url":null,"abstract":"<p><strong>Introduction: </strong>Impairments in social cognition in bipolar disorder (BD) have been extensively described in the last decade but few treatment strategies have been studied to address this issue. This study presents findings from a randomized controlled trial (RCT) investigating the efficacy of metacognitive training for bipolar disorder (MCT-BD) compared to Treatment as Usual (TAU) among individuals with BD in remission. The aim was to determine whether MCT-BD could improve social cognition and overall functioning in this population.</p><p><strong>Methods: </strong>Participants (N = 56) were recruited via social media and an internal database at the University of São Paulo Medical School. Inclusion criteria included a confirmed BD diagnosis, current state of remission, and the presence of social functioning impairments. Exclusion criteria included any impairments that could hinder neuropsychological testing. Patients were randomly assigned to either MCT-BD or TAU, with assessments conducted at baseline and follow-up. The MCT-BD program consisted of nine sessions.</p><p><strong>Results: </strong>The overall attendance rate across all MCT-BD intervention sessions was 96.6%. The MCT-BD program demonstrated added value in improving social cognition, specifically in emotion recognition reaction time. However, no significant changes were found in theory of mind, psychosocial functioning, or quality of life.</p><p><strong>Conclusion: </strong>This RCT provides preliminary evidence for the efficacy of MCT-BD in improving emotion recognition latency, emphasizing the importance of targeted interventions in social cognition outcomes for individuals with BD. The study's strengths include high completion rates and comprehensive cognitive assessments. Future studies should explore long-term effects and personalized treatment approaches aiming to improve social-cognitive deficits in this population.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"71-88"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979798","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}
Jojo Yan Yan Kwok, Lily Man Lee Chan, Charis Ann Lai, Philip Wing Lok Ho, Zoe Yuen-Kiu Choi, Man Auyeung, Shirley Yin Yu Pang, Edmond Pui Hang Choi, Daniel Yee Tak Fong, Doris Sau Fung Yu, Chia-Chin Lin, Richard Walker, Samuel Yeung Shan Wong, Rainbow Tin Hung Ho
{"title":"Effects of Meditation and Yoga on Anxiety, Depression and Chronic Inflammation in Patients with Parkinson's Disease: A Randomized Clinical Trial.","authors":"Jojo Yan Yan Kwok, Lily Man Lee Chan, Charis Ann Lai, Philip Wing Lok Ho, Zoe Yuen-Kiu Choi, Man Auyeung, Shirley Yin Yu Pang, Edmond Pui Hang Choi, Daniel Yee Tak Fong, Doris Sau Fung Yu, Chia-Chin Lin, Richard Walker, Samuel Yeung Shan Wong, Rainbow Tin Hung Ho","doi":"10.1159/000543457","DOIUrl":"10.1159/000543457","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical guidelines recommend a holistic approach to Parkinson's disease (PD) care, yet randomized trials examining mindfulness-based interventions in this context are scarce. This study investigated the effects of two mindfulness practices - meditation and yoga - on biopsychosocial outcomes in PD patients, including anxiety symptoms, depressive symptoms, motor/nonmotor symptoms, health-related quality-of-life (HRQOL), mindfulness, and stress and inflammation biomarkers, compared to usual care.</p><p><strong>Methods: </strong>159 participants with a clinical diagnosis of idiopathic PD and a Hoehn and Yahr stage of 1, 2, and 3, were randomized into meditation (n = 53), yoga (n = 52), and control (n = 54). Meditation and yoga were delivered in 90-min groups for 8 weeks. Primary outcomes included anxiety symptoms and depressive symptoms. Secondary outcomes included motor and nonmotor symptoms, HRQOL, mindfulness, and serum levels of interleukin-6, cortisol and TNF-alpha. Assessments were done at baseline (T0), 2 months (T1), and 6 months (T2). Linear mixed models were conducted following intention-to-treat principle.</p><p><strong>Results: </strong>Compared to control, both meditation, and yoga groups had significant improvements in anxiety symptoms (meditation: mean difference [MD] = -1.36, 95% CI: -2.46 to-0.26; yoga: MD = -1.61, CI: -2.70 to -0.52), motor symptoms (meditation: MD = -5.35, CI: -8.61 to-2.09; yoga: MD = -6.59, CI: -9.82 to-3.36), HRQOL (meditation: MD = -2.01, CI: -3.41 to-0.62; yoga: MD = -1.45, CI: -2.83 to-0.08), and describing skills (meditation: MD = 0.97, CI: 0.04-1.89; yoga: MD = 0.92, CI: 0.01-1.84) at T1, and significant reductions in serum interleukin-6 levels (meditation: MD = -1.14, CI: -2.18 to-0.10; yoga: MD = -1.11, CI: -2.09 to-0.13) at T2. Only meditation significantly reduced depression (MD = -1.44, CI: -2.57 to-0.30) at T1 and sustained the motor and HRQOL improvements at T2.</p><p><strong>Conclusion: </strong>Meditation and yoga significantly improved anxiety symptoms, chronic inflammation, motor symptoms, mindfulness-describing facet, and HRQOL in PD patients. Meditation provided additional benefits in reducing depressive symptoms and sustaining motor and HRQOL improvements.</p><p><strong>Introduction: </strong>Clinical guidelines recommend a holistic approach to Parkinson's disease (PD) care, yet randomized trials examining mindfulness-based interventions in this context are scarce. This study investigated the effects of two mindfulness practices - meditation and yoga - on biopsychosocial outcomes in PD patients, including anxiety symptoms, depressive symptoms, motor/nonmotor symptoms, health-related quality-of-life (HRQOL), mindfulness, and stress and inflammation biomarkers, compared to usual care.</p><p><strong>Methods: </strong>159 participants with a clinical diagnosis of idiopathic PD and a Hoehn and Yahr stage of 1, 2, and 3, were randomized into meditation (n = 53), yo","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"101-118"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537626","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}
Yanjuan Li, Yi Zhang, Chun Wang, Jia Luo, Yang Yu, Shixing Feng, Chunxue Wang, Qianwen Xu, Pengchong Wang, Junxuan Chen, Ning Zhang, Qianmei Yu, Yuqing Liu, Danyun Chen, Stefan G Hofmann, Xinghua Liu
{"title":"Supported Mindfulness-Based Self-Help Intervention as an Adjunctive Treatment for Rapid Symptom Change in Emotional Disorders: A Practice-Oriented Multicenter Randomized Controlled Trial.","authors":"Yanjuan Li, Yi Zhang, Chun Wang, Jia Luo, Yang Yu, Shixing Feng, Chunxue Wang, Qianwen Xu, Pengchong Wang, Junxuan Chen, Ning Zhang, Qianmei Yu, Yuqing Liu, Danyun Chen, Stefan G Hofmann, Xinghua Liu","doi":"10.1159/000542937","DOIUrl":"10.1159/000542937","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid symptom relief is crucial for individuals with emotional disorders. The current study aimed to determine whether facilitator-supported mindfulness-based self-help (MBSH) intervention as an adjunctive treatment could provide rapid improvement for individuals with emotional disorders.</p><p><strong>Methods: </strong>A practice-oriented randomized controlled trial was conducted on a sample of 302 patients with emotional disorders from four centers. Participants were randomly assigned to either MBSH+TAU (treatment as usual; n = 152) or TAU-only group (n = 150). Assessments were conducted at baseline, week 3, week 5, immediately after intervention and at a 3-month follow-up. Primary outcomes included self-reported and clinician-reported anxiety and depression symptoms. Secondary outcomes included mindfulness, physical symptoms, perceived stress, sleep quality, and inner peace.</p><p><strong>Results: </strong>The MBSH+TAU group achieved significantly greater improvements in all primary and secondary outcome measures as compared with TAU-only immediately after intervention (Cohen's d = 0.19-0.51). In addition, relatively greater improvements were observed in self-reported depression, mindfulness, physical symptoms, perceived stress, and inner peace as early as week 3 or 5, which were sustained at the 3-month follow-up (Cohen's d = 0.20-0.34).</p><p><strong>Conclusions: </strong>Facilitator-supported MBSH offers a scalable and effective adjunctive treatment option for patients with emotional disorders in clinical practice, facilitating rapid improvements.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"119-129"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984610","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}
Pedro F Zuccolo,André R Brunoni,Tatiane Borja,Alicia Matijasevich,Guilherme V Polanczyk,Daniel Fatori
{"title":"Efficacy of a Standalone Smartphone Application to Treat Postnatal Depression: A Randomized Controlled Trial.","authors":"Pedro F Zuccolo,André R Brunoni,Tatiane Borja,Alicia Matijasevich,Guilherme V Polanczyk,Daniel Fatori","doi":"10.1159/000541311","DOIUrl":"https://doi.org/10.1159/000541311","url":null,"abstract":"INTRODUCTIONSmartphone app interventions based on cognitive-behavioral therapy (CBT) are promising scalable alternatives for treating mental disorders, but the evidence of their efficacy for postpartum depression is limited. We assessed the efficacy of Motherly, a standalone CBT-based smartphone app, in reducing symptoms of postpartum depression.METHODSWomen aged 18-40 with symptoms of postpartum depression were randomized either to intervention (Motherly app) or active control (COMVC app). The primary outcome was symptoms of depression measured by the Edinburgh Postnatal Depression Scale (EPDS) at post-treatment. Secondary outcomes were anxiety symptoms, parental stress, quality of sleep, behavioral activation, availability of response-contingent positive reinforcement, and clinical improvement at post-treatment and 1-month follow-up. Exploratory analyses were performed to investigate if app engagement was associated with treatment response.RESULTSFrom November 2021 to August 2022, 1,751 women volunteered, of which 264 were randomized, and 215 provided primary outcome data. No statistically significant differences were found between groups at post-treatment: intervention: mean (SD): 12.75 (5.52); active control: 13.28 (5.32); p = 0.604. There was a statistically significant effect of the intervention on some of the secondary outcomes. Exploratory analyses suggest a dose-response relationship between Motherly app engagement and outcomes.CONCLUSIONOur standalone app intervention did not significantly reduce postnatal depression symptoms when compared to active control. Exploratory findings suggest that negative findings might be associated with insufficient app engagement. Consistent with current literature, our findings suggest that standalone app interventions for postpartum depression are not ready to be implemented in clinical practice.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"1 1","pages":"1-13"},"PeriodicalIF":22.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489499","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":"Challenges for the Moral Injury Construct.","authors":"Richard A Bryant","doi":"10.1159/000541281","DOIUrl":"https://doi.org/10.1159/000541281","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"30 1","pages":"1-4"},"PeriodicalIF":22.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489500","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":"Evolution of Psychotropic Medication Prescription in Young People: Reflection from the Quebec Experience.","authors":"Joël Monzée","doi":"10.1159/000541555","DOIUrl":"https://doi.org/10.1159/000541555","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"63 1","pages":"1-7"},"PeriodicalIF":22.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488321","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}
Nadja Wolf,Patricia van Oppen,Adriaan W Hoogendoorn,Odile A van den Heuvel,Harold J G M van Megen,Aniek Broekhuizen,Mirjam Kampman,Daniëlle C Cath,Koen R J Schruers,Saskia M van Es,Tamara Opdam,Anton J L M van Balkom,Henny A D Visser
{"title":"Inference-Based Cognitive Behavioral Therapy versus Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: A Multisite Randomized Controlled Non-Inferiority Trial.","authors":"Nadja Wolf,Patricia van Oppen,Adriaan W Hoogendoorn,Odile A van den Heuvel,Harold J G M van Megen,Aniek Broekhuizen,Mirjam Kampman,Daniëlle C Cath,Koen R J Schruers,Saskia M van Es,Tamara Opdam,Anton J L M van Balkom,Henny A D Visser","doi":"10.1159/000541508","DOIUrl":"https://doi.org/10.1159/000541508","url":null,"abstract":"INTRODUCTIONAlthough cognitive behavioral therapy (CBT) effectively treats obsessive-compulsive disorder (OCD), many patients refuse CBT or drop out prematurely, partly because of anxiety regarding exposure and response prevention (ERP) exercises. Inference-based cognitive behavioral therapy (I-CBT) focuses on correcting distorted inferential thinking patterns, enhancing reality-based reasoning, and addressing obsessional doubt by targeting underlying dysfunctional reasoning, without incorporating an ERP component. We hypothesized that I-CBT would be non-inferior to CBT. Additionally, we hypothesized that I-CBT would be more tolerable than CBT.METHODS197 participants were randomly assigned to 20 sessions CBT or I-CBT and assessed at baseline, posttreatment, and 6 and 12 months' follow-up. The primary outcome was OCD symptom severity measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; non-inferiority margin: 2 points). The secondary outcome, treatment tolerability, was assessed using the Treatment Acceptability/Adherence Scale (TAAS). A linear mixed-effects model was used to assess the non-inferiority of the primary outcome and superiority of secondary outcomes.RESULTSStatistically significant within-group improvements in the primary and secondary outcomes were observed in both treatments. No statistically significant between-group differences in Y-BOCS were found at any assessment point, but the confidence intervals exceeded the non-inferiority threshold, making the results inconclusive. The estimated mean posttreatment TAAS score was significantly higher in the I-CBT group than in the CBT group.CONCLUSIONWhile both CBT and I-CBT are effective for OCD, whether I-CBT is non-inferior to CBT in terms of OCD symptom severity remains inconclusive. Nevertheless, I-CBT offers better tolerability and warrants consideration as an alternative treatment for OCD.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"8 1","pages":"1-15"},"PeriodicalIF":22.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486383","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":"Study of Rates and Factors Associated to Psychosomatic Syndromes Assessed Using the Diagnostic Criteria for Psychosomatic Research across Different Clinical Settings.","authors":"Wei Xu,Wenhao Jiang,Rongjing Ding,Hong Tao,Yanyong Wang,Yanping Tang,Dongfeng Liang,Yuping Wang,Mingwei Wang,Bingwei Chen,Youyong Kong,Lei Liu,Yingying Yue,Liangliang Tan,Lu Yu,Fiammetta Cosci,Yonggui Yuan,","doi":"10.1159/000541404","DOIUrl":"https://doi.org/10.1159/000541404","url":null,"abstract":"INTRODUCTIONDiagnostic Criteria for Psychosomatic Research (DCPR) serve as an instrument for identifying and classifying specific psychosomatic syndromes that are not adequately encompassed in standard nosography. The present study aimed at measuring the prevalence of DCPR syndromes in different clinical settings and exploring factors associated to such diagnoses.METHODSA cross-sectional and nationwide study recruited 6,647 patients in different clinical settings: 306 were diagnosed with fibromyalgia (FM), 333 with irritable bowel syndrome, 1,109 with migraine, 2,550 with coronary heart disease (CHD), and 2,349 with type 2 diabetes (T2D). Participants underwent DCPR diagnostic interview and were assessed for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder 7-Item Scale), and subjective well-being (World Health Organization-5 Well-Being Index). The PsychoSocial Index was used to evaluate global well-being, stress, and abnormal illness behavior. The prevalence of DCPR diagnoses was calculated, and factors associated to such diagnoses were analyzed by logistic regression.RESULTSAlexithymia (64.47%), irritable mood (20.55%), and demoralization (15.60%) were the most prevalent psychosomatic syndromes, with demoralization being most common in FM (49.02%). The factors associated to DCPR diagnoses encompassed high anxiety or abnormal illness behavior, and poor well-being. Notably, stress was found to be associated specifically to FM and T2D, with OR of 1.24 (95% CI: 1.06-1.46) and 1.26 (95% CI: 1.18-1.36), respectively.CONCLUSIONDCPR is a clinically helpful complementary assessment tool in need of being widely implemented in clinical settings in order to have a comprehensive picture of the patients.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"104 1","pages":"1-11"},"PeriodicalIF":22.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449368","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}