Psychotherapy and Psychosomatics最新文献

{"title":"Dynamics of cognitions and symptoms during treatment: A prospective test of Beck's cognitive theory of depression.","authors":"Otto Robert Smith,Marit Knapstad,Leif Edvard Aarø","doi":"10.1159/000551172","DOIUrl":"https://doi.org/10.1159/000551172","url":null,"abstract":"BACKGROUNDBeck's cognitive theory posits that maladaptive beliefs causally drive depressive symptoms. Yet empirical support for the cognition-to-symptoms pathway is mixed, often due to sparse sampling, conflation of within- and between-person variance, and limited temporal modeling. We therefore aimed to address these limitations by testing reciprocal cognition-symptom dynamics in routine care using a more robust within-person longitudinal approach drawing on session-to-session assessments.METHODSAdults in Norwegian primary care receiving CBT-oriented treatment (baseline N=1,564; PHQ-9≥10) completed eight assessments across ≈16 weeks (PHQ-9; three-item negative self-beliefs measure). Primary analyses were observation-level Dynamic Panel Models (DPMs); residual-level models served as corroboration. We modeled nonlinearity and time trends, tested equality-over-time and varying intervals, and reported model-implied long-run effects.RESULTSSymptoms and negative self-beliefs declined nonlinearly. Time-lagged models supported reciprocity: lower negative self-beliefs predicted later symptom reductions, and lower symptoms predicted later belief change. In DPMs, a one-point improvement in negative self-beliefs forecast a long-run .46-point PHQ-9 reduction (95%CI .22-.70); a one-point PHQ-9 improvement forecast a .16-point belief change (95%CI .09-.22). Standardized long-run effects were .36 (cognition→symptoms; 95%CI .13-.42) and .21 (symptoms→cognition; 95%CI .12-.26); magnitudes did not differ (χ²(1)=1.77, p=.18). Findings were robust across specifications.CONCLUSIONSThis study provides credible longitudinal, within-person evidence in line with Beck's model: improvements in negative self-beliefs precede and accumulate into subsequent symptom relief, while symptoms also feed back on beliefs. As such, it fills an important empirical gap by demonstrating a robust cognition-to-symptoms pathway under rigorous temporal modeling.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"7 1","pages":"1-20"},"PeriodicalIF":22.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147381389","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":"Online Intensive Short-Term Dynamic Psychotherapy (ISTDP) for Treatment-Resistant Somatic Symptom Disorder: An Interrupted Time-Series Study.","authors":"Peter Lilliengren,Malin Ljungdahl,Mattias Rööst,Fredrik Falkenström,Joel M Town,Daniel Maroti","doi":"10.1159/000550629","DOIUrl":"https://doi.org/10.1159/000550629","url":null,"abstract":"BACKGROUNDSomatic symptom disorder (SSD) is associated with substantial impairment and high healthcare use, particularly among patients with chronic symptoms, psychiatric comorbidity, and poor response to standard interventions. Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a promising emotion-focused approach, but evidence in treatment-resistant SSD remains limited.METHODSIn this interrupted time-series study, 25 SSD patients who showed no improvement across two empirically supported online interventions in the preceding project year received up to 16 sessions (M = 14.1) of online ISTDP. Piecewise multilevel modeling compared PHQ-15 trajectories across 60 weeks before and 21 weeks after start of ISTDP. Secondary measures (PHQ-9, GAD-7, PCL-5, DERS-16) were administered pre-, post-, and at 12-week follow-up.RESULTSPHQ-15 trajectories were stable or slightly worsening during the pre-treatment year but declined significantly after ISTDP began, corresponding to a large estimated slope difference (d = 1.08) at the end of the treatment phase. Among completers (n = 22), 59% achieved minimal clinically meaningful improvement (≥3 PHQ-15 points), 27% showed ≥30% reduction, and 14% met recovery criteria. Secondary outcomes showed significant pre-post improvements in depression (d = 0.68) and anxiety (d = 0.42), while trauma symptoms and emotion regulation showed small, non-significant changes (d ≤ 0.30). Gains were largely maintained at 12-week follow-up. Emotional responses to treatment were common, but serious adverse events rare and dropout low.CONCLUSIONSOnline ISTDP appears feasible and effective for SSD patients who do not benefit from lower-intensity interventions and may represent a useful next step in stepped-care pathways for complex, treatment-resistant presentations.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"14 1","pages":"1-10"},"PeriodicalIF":22.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329332","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":"Disrupted Prefrontal Regulation of Social Rejection in Irritable Bowel Syndrome.","authors":"Nana Xiong, Qingtian Mi, Qiqing Sun, Qi Liu, Tengteng Fan","doi":"10.1159/000551116","DOIUrl":"10.1159/000551116","url":null,"abstract":"<p><strong>Introduction: </strong>Psychosocial stress plays a critical role in symptom exacerbation in irritable bowel syndrome (IBS), yet neural mechanisms linking social rejection to visceral pain remain poorly understood. This study examined the behavioral and neural responses to social rejection in patients with IBS, focusing on prefrontal regulation.</p><p><strong>Methods: </strong>Using functional magnetic resonance imaging and a validated social exclusion paradigm, we compared the behavioral and neural responses of 35 patients with IBS (Rome IV criteria, without comorbid depression or anxiety disorders) and 36 matched healthy controls (HCs). Participants experienced phases of inclusion, exclusion, and re-inclusion while reporting emotional distress and abdominal pain severity.</p><p><strong>Results: </strong>Compared to HCs, patients with IBS reported a greater increase in abdominal pain during exclusion and showed a pattern suggesting prolonged emotional distress upon re-inclusion. At the neural level, patients with IBS exhibited reduced activation in the dorsomedial prefrontal cortex (dmPFC) during exclusion and in the left inferior frontal gyrus (LIFG) during re-inclusion. Functional connectivity analyses further revealed altered interactions within prefrontal regions (LIFG-dmPFC) and between prefrontal and limbic areas (dmPFC-amygdala) in IBS. Moreover, greater dmPFC-amygdala coupling was associated with heightened emotional distress during social exclusion and was related to greater abdominal pain at 1-year follow-up.</p><p><strong>Conclusions: </strong>These findings indicate altered engagement and coordination of prefrontal regulatory networks during social rejection in IBS, offering insights into neural mechanisms linking psychosocial stress to pain chronicity in IBS.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-17"},"PeriodicalIF":17.4,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309478","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":"By the First Session: Initial Evidence Regarding the Early Therapeutic Environment.","authors":"Scott T Meier, Susan R Davis","doi":"10.1159/000551149","DOIUrl":"10.1159/000551149","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-2"},"PeriodicalIF":17.4,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277115","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":"Identifying Transdiagnostic Predictors of Depression across Psychoses: Informing Stratified Antidepressant Treatments.","authors":"Sergio Mena, Fiona Coutts, Jana von Trott, Grace R Jacobs, Esin Ucur, Nicoleta Sirbu, Louise Moles, Linda Bryant, Clara Vetter, Ariane Wiegand, Rene R Kahn, W Wolfgang Fleischhacker, John M Kane, Alastair Flint, Aristotle Voineskos, Paris A Lalousis, Nikolaos Koutsouleris","doi":"10.1159/000551070","DOIUrl":"10.1159/000551070","url":null,"abstract":"<p><strong>Introduction: </strong>Depression frequently co-occurs with psychosis and is associated with poor outcomes. Early identification of patients at risk of persistent depression remains challenging, limiting opportunities for stratified treatment planning. This study aimed to evaluate the transdiagnostic generalizability of machine learning (ML) models predicting depressive episodes across the affective-psychotic spectrum and whether model-informed predictions could identify patients who may benefit from antidepressant treatment.</p><p><strong>Methods: </strong>Support vector machine models were trained to predict depressive episodes within 6 months using clinical and physiological data from two large, multisite first-episode psychosis (FEP) trials: EUFEST (n = 447) and RAISE-ETP (n = 288), totalling 735 participants. A nested cross-validation framework was used to evaluate model performance. Generalizability was tested in psychotic depression (PD) patients from the STOP-PD trial (n = 142), which compared olanzapine plus sertraline versus olanzapine plus placebo.</p><p><strong>Results: </strong>Models predicted depressive episodes in the FEP sample with a balanced accuracy (BAC) of 69% (sensitivity: 65.7%, specificity: 72.4%). When applied to STOP-PD patients treated with olanzapine plus placebo, FEP-trained models achieved a BAC of 65.2% (sensitivity: 58.3%, specificity: 72.0%) in predicting 3-month non-remission. In the olanzapine plus sertraline group, predictions were at chance levels (BAC: 47.2%, sensitivity: 48.4%, specificity: 46.0%), reflecting sertraline's therapeutic effects.</p><p><strong>Conclusion: </strong>ML models can identify shared risk signatures for depression across the psychosis-affective spectrum. Patterns of depressive episodes in FEP patients share predictive features with PD patients not receiving antidepressants, while adjunctive antidepressant treatment improves remission outcomes beyond model expectations. These findings support ML-informed treatment stratification to identify patients unlikely to benefit from antipsychotic monotherapy.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-14"},"PeriodicalIF":9.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228203","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":"Three-Year Effects of a Multidomain Lifestyle Intervention on Impulsivity: Results from a Randomized Clinical Trial.","authors":"Carlos Gómez-Martínez, Sangeetha Shyam, Lucía Camacho-Barcia, Hernando J Margara-Escudero, Nancy Babio, Laura Forcano, Dolores Corella, Aida Cuenca-Royo, Rafael de la Torre, Susana Jimenez-Murcia, Xavier Pintó, Montse Fitó, Rebeca Fernández-Carrión, Silke Matura, Barbara Franke, Jan Haavik, Fernando Fernández-Aranda, Jordi Salas-Salvadó","doi":"10.1159/000550126","DOIUrl":"10.1159/000550126","url":null,"abstract":"<p><strong>Introduction: </strong>Research has consistently shown associations between elevated impulsivity and adverse physical and mental health outcomes. Specifically, impulsivity has been associated with higher body mass index and cardiometabolic issues. However, evidence from randomized clinical trials (RCTs) on whether impulsivity is responsive to a multidomain lifestyle intervention in older adults with overweight or obesity who are at high cardiovascular risk is limited.</p><p><strong>Methods: </strong>Participants from the PREDIMED-Plus-Cognition sub-study, followed for 3 years as part of the PREDIMED-Plus RCT, were included. Eligible participants had overweight or obesity and metabolic syndrome at baseline. Participants were randomly allocated to either an intensive intervention group (IIG), with an energy-restricted Mediterranean diet (MedDiet), physical activity, and behavioral support, or to a control group (CG), advised to follow an ad libitum MedDiet. The primary outcome of the current study was the evaluation of impulsivity, which was only assessed in participants from the PREDIMED-Plus-Cognition sub-study. Trait impulsivity was assessed using the UPPS-P Impulsive Behavior Scale and behavioral impulsivity through 4 neuropsychological evaluations at baseline, 1-year, and 3-year follow-ups. Z-score composites for global, trait, and behavioral impulsivity were estimated. Multivariate linear mixed models were used to assess the effect of the PREDIMED-Plus intervention on impulsivity among the participants who participated in the PREDIMED-Plus-Cognition sub-study.</p><p><strong>Results: </strong>A total of 306 participants (CG: n = 156; IIG: n = 150; mean age [SD]: 65.0 [4.7] years; 45.7% female) had impulsivity data at baseline. Compared to the CG, participants in the IIG exhibited decreases in trait impulsivity at 1 year (mean z-score change [95% CI]: -0.26 [-0.49, -0.03]) and in global (-0.28 [-0.52, -0.03]) and behavioral (-0.28 [-0.54, -0.02]) impulsivity at 3-year follow-up.</p><p><strong>Conclusion: </strong>An intensive lifestyle intervention combining MedDiet, physical activity, and behavioral support resulted in a long-term reduction of impulsivity among older adults at high cardiometabolic risk. Public health guidelines may consider multidomain lifestyle intervention strategies to decrease impulsivity.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-14"},"PeriodicalIF":17.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228154","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 Letter to Editor regarding \"Treatment Moderators of Symptom Severity in Psychotherapy for People with Borderline Personality Disorder: Systematic Review with Meta-Analyses of Individual Participant Data\".","authors":"Jiayi Chen","doi":"10.1159/000551069","DOIUrl":"10.1159/000551069","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-2"},"PeriodicalIF":17.4,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213875","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":"Brief Cognitive Behavioral Insomnia Treatment for Primary Care Veterans at Elevated Risk for Suicide: A Randomized Clinical Trial.","authors":"Wilfred R Pigeon, Jennifer S Funderburk, Todd M Bishop, Wendi Cross, Hugh F Crean","doi":"10.1159/000550973","DOIUrl":"10.1159/000550973","url":null,"abstract":"<p><strong>Introduction: </strong>Many patients at risk for suicide present in primary care (PC) where insomnia and other suicide risk factors are prevalent. Addressing insomnia in this milieu may augment suicide prevention strategies.</p><p><strong>Methods: </strong>A randomized clinical trial was conducted to test the effectiveness of brief cognitive behavioral therapy for insomnia (bCBTi) for PC patients at risk for suicide recruited from three US Veterans Health Administration practices. The 194 participants (77% male; mean age 51.5 ± 13.6 years) with insomnia, co-occurring depression and/or posttraumatic stress disorder (PTSD) and recent death or suicide ideation, were randomized to receive four 30-min sessions of bCBTi or sleep hygiene over 6 weeks. Blinded assessments occurred every 6 weeks from baseline to 30 weeks. Change in Insomnia Severity Index (ISI) across 30 weeks was the primary outcome with co-secondary outcomes measured by the Scale for Suicidal Ideation (SSI), Patient Health Questionnaire-9 (PHQ-9), and PTSD Checklist (PCL).</p><p><strong>Results: </strong>Mixed-level modeling showed a significant condition effect at post-treatment (6 weeks) for ISI favoring bCBTi (t[df] = -4.58 [153]; p < 0.0001) which was maintained through 30 weeks (t[df] = 0.35 [141]; p > 0.05). PHQ-9 was lower at 6 weeks in the bCBTi condition (t[df] = -2.07 [155]; p = 0.04) maintained through 30 weeks (t[df] = -0.47 [137]; p > 0.05). No PCL differences and no difference in SSI at post-treatment. However, a significant time × condition effect from 6 to 30 weeks existed for SSI favoring bCBTi (t[df] = -2.60 [118]; p = 0.01).</p><p><strong>Conclusion: </strong>The bCBTi intervention designed for PC settings effectively reduces insomnia severity with modest effects for depression and suicidal thoughts, offering an adjuvant to suicide prevention strategies.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-13"},"PeriodicalIF":17.4,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182084","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":"Adverse Childhood Experiences in the Digital Era: An Urgent Call for Precision Assessment.","authors":"Jane Pei-Chen Chang, Kuan-Pin Su","doi":"10.1159/000550728","DOIUrl":"10.1159/000550728","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-3"},"PeriodicalIF":17.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126170","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":"Blended Cognitive Behavioral Therapy Versus Standard CBT for Unipolar Depression: A Multicenter Randomized Controlled Trial.","authors":"Jan Kalde,Ece Atik,Johannes Stricker,Magnus Schückes,Peter Neudeck,Pamela Abel,Johanna Hollank,Andre Pittig,Reinhard Pietrowsky","doi":"10.1159/000550820","DOIUrl":"https://doi.org/10.1159/000550820","url":null,"abstract":"This study evaluates the effectiveness of blended cognitive behavioral therapy (bCBT) with a digital health application (elona therapy) compared to standard cognitive behavioral therapy (CBT) for unipolar depression in outpatient care. This multicenter, randomized, two-arm controlled trial recruited 283 adult patients with unipolar depression in Germany. Patients were randomized to receive either standard face-to-face CBT combined with the digital health application (bCBT group) or standard face-to-face CBT alone. Symptoms of depression and anxiety, along with other patient-related characteristics, were assessed at baseline (T0: week 0) and post-intervention (T1: week 12). Patients in the bCBT group showed greater improvements in depressive symptoms (primary outcome: d = .62, p < .001), anxiety (d = .61, p < .001), quality of life (d = .42, p < .001), perceived self-efficacy (d = .41, p = .003), depression literacy (d = .66, p < .001) and overall disease severity outcomes (d = .45-.60, ps < .005) compared with patients in the CBT group. In conclusion, this study provides evidence supporting the effectiveness of bCBT in patients diagnosed with unipolar depressive disorder across a broad range of clinically relevant outcomes. The discussion addresses important limitations of this trial.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"38 1","pages":"1-20"},"PeriodicalIF":22.8,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095513","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}