Psychotherapy and Psychosomatics最新文献

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

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

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

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

{"title":"Efficacy of a Stepped Care Approach for Adolescents and Adults with Attention-Deficit/Hyperactivity Disorder (ADHD): An Adaptive Intervention Study Including Randomized Controlled Trials (ESCAlate).","authors":"Toivo Zinnow,Wolfgang Retz,Anna Kaiser,Esther Sobanski,Daniel Brandeis,Roberto D Amelio,Sergyi Davydenko,Thomas Ethofer,Ann-Christine Ehlis,Andreas J Fallgatter,Samira Groß,Beate Krecklow,Petra Retz-Junginger,Peter Praus,Marcel Schulze,Johannes Thome,Sabina Millenet,Tobias Banaschewski,Alexandra Philipsen,Michael Rösler","doi":"10.1159/000551307","DOIUrl":"https://doi.org/10.1159/000551307","url":null,"abstract":"INTRODUCTIONThis study evaluated the effectiveness of a stepped-care approach - a staged model that escalates from lower- to higher-intensity treatments according to clinical response - for the treatment of adolescents and adults with ADHD, taking into account symptom severity and prior treatment response.METHODSIn a multicenter study, adolescents and adults with ADHD (16-45y) participated in a two-step treatment program including randomized controlled trials. Step1: Patients were (block-)randomized to 3 months of Psychoeducation (PE), Telephone-assisted self-help (TASH), or waiting control (WC). Step2: Based on Step1-response (full, partial, none), patients received either counseling or were randomized to counseling with/without neurofeedback (NF) or pharmacological treatment (with/without NF) for 6 months. The primary outcome was change in clinician-rated ADHD symptoms, analyzed using linear (mixed-)effects models for repeated measures to account for correlations within participants over time.RESULTSBetween 01/2015-09/2020, N=299 (mean age=28y, 55.2% male) patients were randomized in Step1. The primary outcome showed no significant between-group differences (PE vs. TASH: d=-0.12, 95%-CI [-3.18,1.19], p=0.64; PE vs. Control: d=-0.26, 95%-CI [-4.25,0.05], p=0.13; TASH vs. Control: d=-0.14, 95%-CI [-3.24,1.04], p=0.57). However, significant within-group effects emerged (PE: d=-0.60; TASH: d=-0.48; WC: d=-0.34; p<0.001). Step2 also showed no between-group differences but significant within-group effects (MPH: d=-0.59; MPH+NF: d=-0.76; counseling: d=-0.57/-1.35, p=0.01/p<0.001). Mixed-models revealed symptom reduction in all Step1 responders and Step1 non-responders in Step2.CONCLUSIONThe lack of Step1-RCT differences questions the specific effects of PE/TASH. Similar patterns emerged in Step2, but intensified treatment for Step1 non-responders improved outcomes in MPH groups. Step1 response influenced later treatment success. Some stepped-care combinations did not further reduce symptoms, but no rebound effects occurred. The main limitations of this study are the two-step design complexity, limited information on certain (additional) psychosocial components, and the need to make assumptions about missing data. Nevertheless, findings support the feasibility and partial effectiveness of a stepped-care approach.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"1 1","pages":"1-32"},"PeriodicalIF":22.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490052","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":"Methodological considerations, clinical implications, and future directions in individual participant data meta-analyses of psychotherapy for borderline personality disorder.","authors":"Johanne Pereira Ribeiro,Ole Jakob Storebø","doi":"10.1159/000551562","DOIUrl":"https://doi.org/10.1159/000551562","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"85 1","pages":"1-7"},"PeriodicalIF":22.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490057","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":"Association of borderline personality disorder with physical diseases and mortality: a 16-year population-based electronic health-record cohort study in Hong Kong.","authors":"Joe Kwun Nam Chan,Ryan Cheuk Yin Li,Corine Sau Man Wong,Vanessa Ramesh Mahboobani,Kam Ming Ku,Wing Chung Chang","doi":"10.1159/000551534","DOIUrl":"https://doi.org/10.1159/000551534","url":null,"abstract":"INTRODUCTIONBorderline-personality-disorder (BPD) research is scarce. This study quantified risks of physical-diseases and assessed mortality patterns in individuals with BPD.METHODSThis retrospective population-based cohort study investigated individuals with a first-recorded diagnosis of BPD in 2006-2021, utilizing a medical-record database of public-healthcare services in Hong-Kong. Individuals without mental-disorders attending primary-care-clinics in the study-period served as unexposed-comparison (i.e., PCC cohort). We estimated risks of physical-diseases and all-cause and cause-specific mortality using Cox-proportional hazards-regression models, and calculated excess life-years lost (LYLs).RESULTSThis analysis included 3092 patients with BPD and 902927 individuals in the PCC cohort. BPD was associated with increased risks of a wide-spectrum of physical-diseases, with the highest hazards-ratio (HR) for epilepsy (7.58 [95% confidence-intervals:5.33-10.79]). HRs for other physical-diseases ranged from 1- to 3-fold higher than the PCC cohort. Individuals with BPD experienced elevated risk of all-cause (5.65 [4.83-6.61]), natural-cause (2.02 [1.56-2.62]) and external-cause mortality (30.35 [23.52-39.17]), with suicide and cardiovascular-diseases as the leading-contributors. External-causes accounted for 40.4% of deaths in BPD, while natural-causes explained 37.3%. The excess-LYL for BPD was 13.01 years (9.35-15.52). The association between BPD and physical-diseases generally became statistically non-significant among males but remained significantly elevated among females. BPD-associated all-cause mortality risk was higher in females than males. Statistically-significant associations between BPD and physical-diseases were predominantly-observed in individuals with BPD-diagnoses at younger-ages.CONCLUSIONBPD is associated with increased risk of physical-diseases, excess-mortality and reduced life-expectancy. Suicide-prevention strategies and physical-health monitoring are urgently-warranted to reduce physical-health disparities and premature-mortality in BPD.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"12 1","pages":"1-18"},"PeriodicalIF":22.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147471742","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":"Core Variables Sets (CVS): beyond outcome measures.","authors":"Jorge Arias-de la Torre,Jose M Valderas","doi":"10.1159/000551469","DOIUrl":"https://doi.org/10.1159/000551469","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"27 1","pages":"1-4"},"PeriodicalIF":22.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147465463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Psychotherapy and Psychosomatics.","authors":"Stephan Zipfel","doi":"10.1159/000550766","DOIUrl":"https://doi.org/10.1159/000550766","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"192 1","pages":"1-7"},"PeriodicalIF":22.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446851","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":"Before treatment begins: The dynamic landscape of interacting therapeutic mechanisms.","authors":"Sigal Zilcha-Mano","doi":"10.1159/000551420","DOIUrl":"https://doi.org/10.1159/000551420","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"61 1","pages":"1-4"},"PeriodicalIF":22.8,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147393997","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}