Psychotherapy and Psychosomatics最新文献

{"title":"Exploring the Black Box: What Happens during Brief Concentrated Exposure and Response Prevention for Obsessive-Compulsive Disorder?","authors":"Franziska Miegel, Jakob Scheunemann, Saskia Pampuch, Josephine Schultz, Bjarne Hansen, Kristen Hagen, Jürgen Gallinat, Antonia Zapf, Amir H Yassari, Lena Jelinek","doi":"10.1159/000545178","DOIUrl":"10.1159/000545178","url":null,"abstract":"<p><strong>Introduction: </strong>Brief concentrated exposure and response prevention (cERP) has shown promise as an efficacious treatment for obsessive-compulsive disorder (OCD) with higher response and remission rates compared to the first-line treatment. However, the mechanisms driving this success remain unclear.</p><p><strong>Methods: </strong>This longitudinal study included 56 patients with OCD who underwent cERP (Bergen 4-day treatment). Treatment mechanisms (e.g., willingness to engage in exposure and response prevention (ERP), confidence in future self-guided ERP, leaning into anxiety) were assessed before and after each of the 4 treatment days by the Pre- and Post-Session Questionnaire (PPSQ-cERP). Changes in the PPSQ-cERP were used to predict treatment response assessed from baseline to post-treatment and 3-month follow-up.</p><p><strong>Results: </strong>All variables assessed by the PPSQ-cERP showed improvement throughout the cERP, as calculated using linear mixed models. Several variables, including willingness to engage in ERP and self-efficacy, improved after day 3, with small to medium effects (0.34-0.70). Confidence in future self-guided ERP improved on day 4 (the day on which it was addressed), with a small effect (0.31). Leaning into anxiety during ERP tasks on day 3 was identified as a predictor of OCD symptom improvement (β = 0.516, p = 0.050) by least absolute shrinkage and selection operator regression, while group cohesion reached trend level (β = 0.239, p = 0.081).</p><p><strong>Conclusion: </strong>This study highlights day-specific effects across all treatment mechanism variables. Notably, leaning into anxiety during ERP tasks was a key predictor of symptom improvement, offering new insights into refining OCD treatment strategies and enhancing clinical outcomes.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"162-174"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754247","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":"Active Components in Internet-Based Cognitive-Behavioral Therapy for Social Anxiety Disorder: A Randomized Full Factorial Trial.","authors":"Dajana Šipka, Rodrigo Lopes, Tobias Krieger, Jan Philipp Klein, Thomas Berger","doi":"10.1159/000542425","DOIUrl":"10.1159/000542425","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Many studies have demonstrated that social anxiety disorder (SAD) can be effectively treated with psychotherapy, particularly cognitive-behavioral therapy (CBT), including internet-based CBT (ICBT). Despite evidence-based treatments, many individuals do not sufficiently benefit from them. Identifying the active components could help improve the effectiveness of SAD treatment. This study tested the effects of four treatment components (psychoeducation, cognitive restructuring, attention training, and exposure) within ICBT for SAD to investigate its active components.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This randomized full factorial trial consisted of four factors (i.e., treatment components) and 16 conditions. A total of 464 adults with a diagnosed SAD were recruited from the community. The primary outcome was SAD symptoms at 8 weeks (post-assessment). Secondary outcomes included SAD diagnosis, SAD symptoms at follow-up (4 months after post), depression and anxiety symptoms, quality of life, client satisfaction, and adverse effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Conditions including psychoeducation and exposure were significantly more effective in reducing SAD symptoms at post compared to conditions without these components. Conditions including cognitive restructuring and attention training did not show superiority over conditions without them at post. However, all treatment conditions significantly reduced symptoms compared to the condition without a treatment component. At follow-up, the superiority of psychoeducation and exposure was not significant anymore due to the version without the respective components catching up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings suggest that while all treatment components of ICBT for SAD are beneficial compared to no treatment, psychoeducation and exposure include specific active components that significantly improve treatment outcomes more quickly in ICBT for SAD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Many studies have demonstrated that social anxiety disorder (SAD) can be effectively treated with psychotherapy, particularly cognitive-behavioral therapy (CBT), including internet-based CBT (ICBT). Despite evidence-based treatments, many individuals do not sufficiently benefit from them. Identifying the active components could help improve the effectiveness of SAD treatment. This study tested the effects of four treatment components (psychoeducation, cognitive restructuring, attention training, and exposure) within ICBT for SAD to investigate its active components.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This randomized full factorial trial consisted of four factors (i.e., treatment components) and 16 conditions. A total of 464 adults with a diagnosed SAD were recruited from the community. The primary outcome was SAD symptoms at 8 weeks (post-assessment). Secondary outcomes included SAD diagnosis, SAD symptoms at follow-up (4 months after post), depression and anxiety symptoms, qu","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"40-59"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972089","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":"Enhancing the Scalability and Impact of the Motherly App for Postnatal Depression.","authors":"Qiang Xie, Weiying Chen","doi":"10.1159/000543542","DOIUrl":"10.1159/000543542","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"69-70"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365527","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":"Group Acceptance and Commitment Therapy versus Cognitive Behavioral Therapy/Exposure Response Prevention for Obsessive Compulsive Disorder: A Block Randomized Controlled Trial.","authors":"S K K Nielsen, A C Stuart, C Winding, M Øllgaard, K Wolitzky-Taylor, S I F Daniel, S Vangkilde, N Rosenberg, I Hageman, M B Jørgensen","doi":"10.1159/000544070","DOIUrl":"10.1159/000544070","url":null,"abstract":"<p><strong>Introduction: </strong>Acceptance and commitment therapy (ACT) may be as effective for treating obsessive compulsive disorder (OCD) as the gold standard treatment, cognitive behavioral therapy (CBT) with exposure response prevention (ERP), but ACT has never been directly compared to CBT/ERP in a randomized control trial. This study aimed to compare the efficacy of group-based ACT and CBT/ERP in two outpatient mental health service clinics for adults with OCD.</p><p><strong>Methods: </strong>A total of 176 patients with OCD participated in a single-blinded, non-inferiority, block randomized controlled trial (RCT). Patients were assigned to either the ACT (n = 101) or CBT/ERP (n = 75) groups for 14 weekly sessions. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score at post-treatment and at the 6-month follow-up with prespecified non-inferiority criteria. Quality of life, measured using the Quality of Life Inventory (QOLI), was the secondary outcome.</p><p><strong>Results: </strong>Linear mixed models showed that Y-BOCS scores in the ACT group were non-inferior to those in the CBT/ERP group both post-treatment and at 6, and 12 months of follow-up. QOLI scores also showed no significant differences in ACT compared to CBT/ERP across the three measurement points.</p><p><strong>Conclusion: </strong>This RCT demonstrated that group-delivered ACT is non-inferior to CBT/ERP in reducing OCD symptoms and improving the quality of life of patients with OCD in outpatient mental health services. These findings suggest that ACT may serve as a viable alternative to CBT/ERP in adults with OCD in outpatient mental health settings, although further replication is necessary.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"135-146"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483812","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":"Comparative Efficacy and Safety of Benzodiazepines in the Treatment of Patients with Generalized Anxiety Disorder: A Systematic Review and Network Meta-Analysis.","authors":"Hélder Fernandes, Catarina Novais, Bernardo Sousa-Pinto, Patrício Soares-da-Silva, Luís Filipe Azevedo","doi":"10.1159/000546269","DOIUrl":"10.1159/000546269","url":null,"abstract":"<p><strong>Introduction: </strong>Guidelines recommend that benzodiazepines (BZDs) might be used as an add-on to antidepressant therapy during the first weeks of treatment of generalized anxiety disorder (GAD) or as a first-line and stand-alone. Our aim was to evaluate the comparative efficacy and safety of individual BZD in the treatment of patients with GAD.</p><p><strong>Methods: </strong>In this systematic review and network meta-analysis, we included randomized controlled trials including adults (≥18 years) with GAD and comparing BZD against placebo or an active intervention. We assessed the certainty of evidence using the confidence in network meta-analysis (CINeMA) framework. This study is registered with PROSPERO (registration number CRD42022330264).</p><p><strong>Results: </strong>We included 56 studies (7,556 participants). The certainty of the evidence for the primary outcomes, as measured with CINeMA, varied from high to very low (overall; 40 comparisons scored \"very low,\" 7 scored \"low,\" and 814 scored \"high\"). Regarding efficacy, all BZDs, in general, were significantly better than placebo, but there were no significant differences between the different BZDs (high heterogeneity and inconsistency were detected). Regarding treatment discontinuation, with some exceptions, no significant differences were observed in the comparisons against placebo or other BZD (no or low heterogeneity and inconsistency were observed in the different analyses). Regarding treatment tolerability, none of the BZD showed significant differences compared to placebo, except diazepam (RR = 1.61; 95% CI = 1.32; 1.96). Moderate heterogeneity and low inconsistency were observed in the treatment tolerability network meta-analysis.</p><p><strong>Conclusion: </strong>BZDs are overall efficacious for the treatment of GAD and have a favorable safety profile. No distinctive differences were identified when comparing BZD among themselves.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"373-388"},"PeriodicalIF":17.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369165","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":"Reconsidering Persistent Somatic Symptoms: A Transdiagnostic and Transsymptomatic Approach.","authors":"Bernd Löwe, Stephan Zipfel, Omer van den Bergh, Peter Henningsen","doi":"10.1159/000541741","DOIUrl":"10.1159/000541741","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"20-25"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547008","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":"Erratum.","authors":"","doi":"10.1159/000542083","DOIUrl":"10.1159/000542083","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"68"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506630","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 Neural Signature of Touch Aversion and Interpersonal Problems in Borderline Personality Disorder.","authors":"Jella Voelter, Jella Voelter, Danilo Postin, Ilona Croy, René Hurlemann, Dirk Scheele","doi":"10.1159/000545973","DOIUrl":"10.1159/000545973","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with borderline personality disorder (BPD) suffer from severe social impairments and interpersonal problems. Social touch can provide comfort and facilitate the maintenance of social bonds, and preliminary evidence indicates a negative evaluation of social touch in patients with BPD. However, the neural mechanisms underlying aberrant touch processing in BPD and its role for social impairments are still unclear.</p><p><strong>Methods: </strong>We recruited 55 BPD patients and 31 healthy controls and used functional magnetic resonance imaging to probe neural responses to slow (i.e., C-tactile [CT]-optimal; affective) and fast (i.e., CT-suboptimal; discriminative) touch before and after 4 weeks of a residential dialectical behavior therapy (DBT) program. In addition to assessing BPD symptoms and interpersonal problems, we evaluated touch allowance maps and the attitude toward social touch.</p><p><strong>Results: </strong>BPD patients showed a comprehensive negative bias toward social touch before the DBT, evident in a significantly more negative attitude toward and reduced comfort zones of social touch compared to healthy controls. Activation in the posterior insular cortex in response to CT-optimal touch was significantly reduced and correlated with the severity of interpersonal problems in BPD patients. Despite significant improvements in overall BPD symptom load, dysfunctional social touch processing persisted after 4 weeks of DBT, indicating trait-like disturbances in BPD.</p><p><strong>Conclusions: </strong>An impaired insula-mediated integration of affective and sensory components of touch may constitute a clinically relevant biological signature of the complex interpersonal problems in BPD.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"358-372"},"PeriodicalIF":17.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027548","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":"Erratum.","authors":"","doi":"10.1159/000544060","DOIUrl":"10.1159/000544060","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"306"},"PeriodicalIF":17.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764983","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":"Integrating DCPR-R and DSM-5 into Clinical Psychosomatic Practice in Taiwan: Their Relationship with Psychopathologies and Quality of Life.","authors":"Wei-Lieh Huang, Yi-Ting Chiu, Chi-Shin Wu, Bernd Löwe, Shih-Cheng Liao","doi":"10.1159/000545409","DOIUrl":"10.1159/000545409","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the benefit of integrating the Diagnostic Criteria for Psychosomatic Research-Revised (DCPR-R) into the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). Specifically, it examined whether this integration enhances the understanding of psychopathologies and quality of life (QOL) in psychosomatic medicine.</p><p><strong>Methods: </strong>In this cross-sectional study conducted in Taiwan, 277 patients from psychosomatic clinics and 225 community participants were included. Standardized interview tools based on DCPR-R and DSM-5 were used to assess the presence of various diagnoses. Participants also completed several scales related to persistent somatic symptoms, negative emotions, and QOL. Latent class analysis was used to explore the clustering of diagnoses, and multiple linear regression analysis was employed to investigate the relationship between diagnoses, psychopathologies, and QOL under conditions of possible comorbidity.</p><p><strong>Results: </strong>Three classes were identified via latent class analysis: somatic symptoms, demoralization and stress, and insomnia. In the multivariate analysis considering multiple diagnoses simultaneously, the number of diagnoses significantly associated with psychopathologies and QOL was greatly reduced compared to the univariate analysis. Persistent somatization was more strongly associated with somatic distress than somatic symptom disorder. Several DCPR-R constructs showed significant associations with illness-related anxiety. The DCPR-R diagnoses with broader influences on QOL were demoralization, demoralization with hopelessness, and irritable mood.</p><p><strong>Conclusions: </strong>The results suggest the potential clinical significance of integrating DCPR-R and DSM-5 in Eastern societies. The DCPR-R diagnoses with significant findings mentioned above may contribute to the personalized treatment plans for patients in psychosomatic medicine.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"232-246"},"PeriodicalIF":17.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693117","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}