Psychotherapy and Psychosomatics最新文献

{"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}

{"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}

{"title":"Telephone-Guided Sleep Restriction for Insomnia: A Randomized Sleep Diary-Controlled Trial.","authors":"Mathilde I Looman, Tessa F Blanken, Tim M Schoenmakers, Joyce E Reesen, Marieke Effting, Floris E Linnebank, Annemieke van Straten, Jan H Kamphuis, Jaap Lancee","doi":"10.1159/000545138","DOIUrl":"10.1159/000545138","url":null,"abstract":"<p><strong>Introduction: </strong>Insomnia is common, but access to its first-line treatment, cognitive behavioral therapy for insomnia (CBT-I), is limited. To explore a scalable alternative, we investigated the efficacy of sleep restriction therapy (SRT), a core component of CBT-I, delivered via telephone.</p><p><strong>Methods: </strong>In a randomized controlled trial, 147 adults with insomnia were allocated to 6 weeks of telephone-guided SRT (n = 76) or a sleep diary control group (n = 71). The SRT group received weekly supporting phone calls lasting 10-15 min. At baseline and posttest, we measured insomnia severity (primary outcome), sleep diary measures, anxiety symptoms, depressive symptoms, presleep arousal, sleep-safety behaviors, daytime sleepiness, and dysfunctional sleep-related cognitions (secondary outcomes). The SRT group repeated these measures at 3- and 6-month follow-ups.</p><p><strong>Results: </strong>Telephone-guided SRT showed large between-group effects on insomnia severity at posttest relative to the sleep diary control group (d = 1.52; p < 0.001). Based on intention-to-treat, 36 (47%) participants randomized to SRT achieved clinical improvement, and 23 (30%) achieved insomnia remission. We found medium-to-large between-group effects at posttest (d = 0.53-1.18) for all secondary outcomes except daytime sleepiness and total sleep time. At 3- and 6-month follow-ups, the primary and all secondary outcomes, including daytime sleepiness and total sleep time, improved relative to baseline within the SRT group (d = 0.50-1.93).</p><p><strong>Conclusion: </strong>This trial shows that telephone-guided SRT is an effective insomnia treatment requiring minimal therapist guidance. If direct comparisons with CBT-I corroborate these findings, SRT could be an interesting scalable alternative to CBT-I as a first-line insomnia treatment.</p><p><strong>Trial registry: </strong>NCT05548907.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"147-161"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693119","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":"Efficacy of Cognitive Behavioral Therapy and Acceptance- and Mindfulness-Based Treatments in Adults with Bodily Distress: A Network Meta-Analysis.","authors":"Frederic Maas Genannt Bermpohl, Alexandra Martin","doi":"10.1159/000544825","DOIUrl":"10.1159/000544825","url":null,"abstract":"<p><strong>Introduction: </strong>Many physical complaints cause long-term bodily distress. Meta-analyses show that cognitive behavioral therapy (CBT) and acceptance- and mindfulness-based treatments (AMBT) reduce somatic symptom severity, but evidence on differential efficacy is limited. This study evaluates the efficacy of CBT and AMBT for bodily distress (e.g., somatoform disorders, functional somatic syndromes, and related disorders).</p><p><strong>Methods: </strong>A network meta-analysis of randomized controlled trials on adults with bodily distress compared CBT and AMBT either directly or with nonspecific control groups. Cohen's d based on between-group effect sizes was aggregated using a random effects model. Primary outcome was somatic symptom severity; secondary outcomes included depression, anxiety, and perceived health status.</p><p><strong>Results: </strong>Based on 74 studies (N = 8,277), CBT (d = -0.50, 95% CI, -0.70 to -0.29; between-group effect sizes vs. wait-list [WL]) and AMBT (d = -0.55, 95% CI, -1.06 to -0.23; between-group effect sizes vs. WL) were equally effective in reducing somatic symptoms at posttreatment. AMBT were more effective than CBT in reducing depression (d = -0.31, 95% CI, -0.58 to -0.04; between-group effect sizes) and anxiety (d = -0.42, 95% CI, -0.73 to -0.11; between-group effect sizes) posttreatment. At long-term follow-up, effects were partly maintained; AMBT remained more effective than CBT for anxiety, with no differential effects for other outcomes.</p><p><strong>Conclusions: </strong>Both treatments showed benefits compared to various controls. Evidence suggests potential differential treatment effects, indicating some patient groups may benefit more from AMBT. Clinicians should view CBT as foundational but remain open to variations, especially for comorbid pathology.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"207-224"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493448","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":"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}

{"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":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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}

{"title":"Eye Movement Desensitization and Reprocessing with and without Dialectical Behavior Therapy for Posttraumatic Stress Disorder and Comorbid Borderline Personality Disorder Symptoms: A Randomized Controlled Trial.","authors":"Aishah Cecile Snoek, Arne van den End, Aartjan T F Beekman, Jack Dekker, Inga Aarts, Matthijs Blankers, Chris Vriend, Odile A van den Heuvel, Nick Lommerse, Kathleen Thomaes","doi":"10.1159/000544918","DOIUrl":"10.1159/000544918","url":null,"abstract":"<p><strong>Introduction: </strong>Comorbidity between posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) is prevalent. Despite evidence-based therapies, high rates of nonresponse and dropout persist. This study therefore aimed to examine whether the concurrent application of eye movement desensitization and reprocessing (EMDR) for PTSD and dialectical behavior therapy (DBT) for BPD yields better results than EMDR alone.</p><p><strong>Methods: </strong>Patients with a PTSD diagnosis and at least four BPD symptoms were randomly assigned to EMDR (n = 63) or concurrent EMDR-DBT (n = 61). Over 1 year, changes in PTSD symptoms were measured using the Clinician-Administered PTSD Scale for DSM-5. Secondary outcomes included BPD symptoms, global functioning, and quality of life.</p><p><strong>Results: </strong>Both treatments led to large reductions in PTSD symptoms, without significant differences after 1 year (p = 0.312, d = -0.23, 95% CI = -0.6, 0.1). Both treatments also yielded large and comparable reductions in BPD symptoms and improved quality of life. Global functioning improved only in the EMDR condition according to one measure (World Health Organization Disability Assessment Schedule 2.0), while the other measure (Outcome Questionnaire 45) showed improvements in both groups. Additionally, patients in the EMDR-DBT condition were twice as likely to drop out from EMDR treatment compared to those in the EMDR-only condition.</p><p><strong>Conclusion: </strong>Stand-alone EMDR demonstrated safety and efficacy in alleviating PTSD and BPD symptoms, as well as enhancing quality of life. These findings support the use of EMDR as a strong therapeutic option for patients with PTSD and comorbid BPD symptoms. Further research is needed to assess longer-term outcomes beyond 1 year.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"175-193"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524164","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":"Exploring the Impact of Metacognitive Interpersonal Therapy on Borderline Personality Disorder: A Retrospective Observational Study Using a Latent Transition Analysis of Symptoms and Functional Changes over 12 Months.","authors":"Matteo Aloi, Antonio Semerari, Giulio Amadei, Ilaria Bucci, Livia Colle, Giuseppe Nicolò, Ilaria Riccardi, Cristina Segura-Garcia, Antonino Carcione","doi":"10.1159/000545385","DOIUrl":"10.1159/000545385","url":null,"abstract":"<p><strong>Introduction: </strong>Borderline personality disorder (BPD) is marked by emotional instability, interpersonal dysfunction, and high comorbidity, posing significant treatment challenges. Metacognitive Interpersonal Therapy (MIT) targets core features of BPD, including metacognitive impairments and emotional dysregulation. This study used Latent Transition Analysis to assess changes in BPD symptoms and psychological factors over a 12-month MIT intervention, hypothesizing that MIT will reduce symptom severity and improve emotional regulation, metacognitive abilities, and interpersonal functioning.</p><p><strong>Methods: </strong>This single-center, retrospective, observational study included 98 patients, all diagnosed with BPD according to DSM-IV-TR criteria, without severe psychiatric comorbidities or concurrent psychotherapy. These patients underwent a 12-month MIT intervention, delivered in five phases, targeting metacognitive and emotional regulation skills. Clinical assessments included the Structured Clinical Interview for DSM Axis II Disorders for BPD diagnosis, Symptom Cecklist-90-Revised for symptom severity, Metacognition Assessment Interview for metacognitive abilities, and IIP for interpersonal difficulties.</p><p><strong>Results: </strong>Latent Class Analysis identified three baseline profiles: \"Affective dysregulation and anger\" (14.3%), \"Low symptomatic\" (7.1%), and \"Identity and interpersonal sensitivity\" (78.6%). After 12 months of treatment, most participants (58.2%) transitioned to a \"Recovered\" class, with significant reductions in BPD symptoms. The \"Recovered\" class showed the greatest improvements in metacognitive abilities, emotional regulation, and interpersonal functioning compared to other groups.</p><p><strong>Conclusions: </strong>MIT was associated with significant improvements in BPD symptoms, with over half of participants achieving full recovery. These findings suggest that MIT may play a role in enhancing emotional regulation and interpersonal functioning. However, residual symptoms in some participants confirm the complexity of BPD, suggesting the need for further research into long-term outcomes and comorbidities.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"194-206"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731263","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":"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}