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Mentalization based therapy

Louise Johns, Suzanne Jolley, Philippa Garety, Mizanur Khondoker, Miriam Fornells-Ambrojo, Juliana Onwumere, Emmanuelle Peters, Craig Milosh, Alison Brabban, Majella Byrne
Implementation of evidence-based cognitive behavioural therapy for psychosis (CBTp) remains low in routine services. The United Kingdom Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) initiative aimed to address this issue. The project evaluated whether existing services could improve access to CBTp and demonstrate effectiveness using a systematic approach to therapy provision and outcome monitoring (in a similar way to the Improving Access to Psychological Therapies (IAPT) model for people with anxiety and depression)...
March 8, 2019: Behaviour Research and Therapy
Youngkook Kim, Seong Hoon Lim, Geun-Young Park
OBJECTIVE: To investigate whether CCD is associated with functional outcome in the subacute rehabilitation phase of stroke. DESIGN: Retrospective case-control study. SETTING: Hospital-based cohort. PARTICIPANTS: The study enrolled 48 participants who underwent brain single-photon emission computed tomography. Patients with CCD were identified (n=24). Twenty-four controls were selected for each case-patient by matching age, stroke type (ischemic or hemorrhagic), lesion laterality, and lesion location...
March 12, 2019: Archives of Physical Medicine and Rehabilitation
Hanneke Kip, Saskia M Kelders, Kirby Weerink, Ankie Kuiper, Ines Brüninghoff, Yvonne H A Bouman, Dirk Dijkslag, Lisette J E W C van Gemert-Pijnen
Background: Although literature and practice underline the potential of virtual reality (VR) for forensic mental healthcare, studies that explore why and in what way VR can be of added value for treatment of forensic psychiatric patients is lacking. Goals: This study aimed to identify (1) points of improvements in existing forensic mental health treatment of in- and outpatients, (2) possible ways of using VR that can improve current treatment, and (3) positive and negative aspects of the use of VR for the current treatment according to patients and therapists...
2019: Frontiers in Psychology
Valery Krupnik
Integrative psychotherapies have become the mainstay in mental health care. The most researched therapy, CBT, being integrative itself, continues to integrate such new elements as mindfulness, spirituality, and experiential techniques. There is no commonly accepted strategy for psychotherapy integration. New elements are sometimes added on a trial and error basis with a following post-hoc theoretical and empirical justification. Other times, they are incorporated based on an ad-hoc theoretical premise, and empirical studies follow to support or invalidate it...
2019: Frontiers in Psychology
David Zilles
Background: Catatonia is a syndrome comprising psychomotor, behavioral, and autonomous symptoms which may occur in the context of severe schizophrenic, affective, and other mental disorders or medical conditions. Treatment options include high dose benzodiazepines (lorazepam) and electroconvulsive therapy (ECT) with some evidence for the effectiveness of glutamate antagonists. However, due to a lack of randomized controlled studies in this severely ill population, evidence base is weak. Methods: On occasion of the case of a patient with treatment resistant catatonia in schizoaffective disorder, we developed the hypothesis of vagus nerve stimulation (VNS) being a potential therapy for treatment resistant catatonia...
2019: Frontiers in Psychiatry
Markus Stracke, Kristin Gilbert, Meinhard Kieser, Christina Klose, Johannes Krisam, David D Ebert, Claudia Buntrock, Hanna Christiansen
Background: Mental health problems are highly frequent, as well as being associated with enormous societal and economic costs and significant disability-adjusted life years. Children of parents with a mental illness (COPMI) are at a tremendously increased risk to develop disorders themselves. According to the literature, parental mental disorders launch a wave of risk factors that in turn predict the emergence of psychological problems in the offspring, and effective treatment of the parental disorder has been associated with reduced child psychopathology (launch and grow assumption)...
2019: Frontiers in Psychiatry
Alexandra Badaoui, Sandra Abou Kassm, Wadih Naja
PURPOSE OF REVIEW: This paper seeks to identify the risk factors of fear of childbirth (FOC) and posttraumatic stress disorder (PTSD) related to birth and reviews the efficacy of their respective screening tools and therapeutic interventions. RECENT FINDINGS: Biofeedback, hypnosis, internet-based cognitive behavioral therapy, and antenatal education are promising treatments for FOC. Training midwives to address traumatic birth experiences could help in preventing PTSD...
March 12, 2019: Current Psychiatry Reports
Margo E Godersky, Andrew J Saxon, Joseph O Merrill, Jeffrey H Samet, Jane M Simoni, Judith I Tsui
BACKGROUND: Buprenorphine effectively reduces opioid craving and illicit opioid use. However, some patients may not take their medication as prescribed and thus experience suboptimal outcomes. The study aim was to qualitatively explore buprenorphine adherence and the acceptability of utilizing video directly observed therapy (VDOT) among patients and their providers in an office-based program. METHODS: Clinical providers (physicians and staff; n = 9) as well as patients (n = 11) were recruited from an office-based opioid treatment program at an urban academic medical center in the northwestern United States...
March 13, 2019: Addiction Science & Clinical Practice
Karina M Egeland, Ane-Marthe Solheim Skar, Mathilde Endsjø, Erlend Høen Laukvik, Harald Bækkelund, Aida Babaii, Lene Beate Granly, Gry Kristina Husebø, Randi Hovden Borge, Mark G Ehrhart, Marisa Sklar, C Hendricks Brown, Gregory A Aarons
BACKGROUND: Alignment across levels of leadership within an organization is needed for successful implementation of evidence-based practice. The leadership and organizational change for implementation (LOCI) intervention is a multi-faceted multilevel implementation strategy focusing on enhancing first-level general and implementation leadership while also engaging with organization upper management to develop an organizational climate for implementation. The aim of the project is to evaluate the effectiveness of LOCI in supporting the implementation of evidence-based treatment for PTSD in child- and adult-specialized mental health clinics in health trusts in Norway...
March 13, 2019: Implementation Science: IS
Danielle Hitch, Kate Lhuede, Lindsay Vernon, Genevieve Pepin, Karen Stagnitti
BACKGROUND: In 2014, a large metropolitan mental health service in Australia developed a senior role (Lead Research Occupational Therapist) to address an identified need for greater research and knowledge translation, and associated capacity building. The aim of this study was to evaluate the impact, in the first 2.5 years, of this role across a range of variables. METHODS: Multiple methods were used to gather a comprehensive range of data. Workforce surveys were completed both online and in hard copy in early 2014 (n = 42) and late 2016 (n = 44)...
March 12, 2019: BMC Health Services Research
Zelalem Belayneh, Wagaye Alemu, Birhanie Mekuriaw, Zegeye Abebe
Background: Bipolar spectrum disorders (BPSDs) are more common among HIV-positive individuals than the general population. Although BPSDs have very diverse and devastating consequences (immune suppression, cognitive impairment and poor medication adherence), little is known about BPSDs among HIV-positive individuals in Ethiopia. Therefore, this study was aimed to assess the prevalence and associated factors of BPSDs among adults attending antiretroviral therapy (ART) clinics in Gedeo zone health centers, southern Ethiopia...
2019: Neuropsychiatric Disease and Treatment
Chizimuzo T C Okoli, Janet K Otachi, Sarret Seng
BACKGROUND: Tobacco-related morbidity and mortality is high among people with mental illnesses (PMI); yet tobacco treatment (TT) is often not provided by mental health care providers (MHPs). Studies that examine barriers to TT for people with MI are critical in addressing this disparity. AIMS: To determine factors associated with MHPs' opinions of, self-efficacy in, barriers to and training needs for providing TT by job role. METHODS: 205 MHPs in a psychiatric facility were surveyed using a standardized questionnaire on demographics and opinions, self-efficacy, barriers and needs to providing TT...
March 12, 2019: Journal of Mental Health
Jackson M Steinkamp, Nathaniel Goldblatt, Jacob T Borodovsky, Amy LaVertu, Ian M Kronish, Lisa A Marsch, Zev Schuman-Olivier
BACKGROUND: Medication adherence is critical to the effectiveness of psychopharmacologic therapy. Psychiatric disorders present special adherence considerations, notably an altered capacity for decision making and the increased street value of controlled substances. A wide range of interventions designed to improve adherence in mental health and substance use disorders have been studied; recently, many have incorporated information technology (eg, mobile phone apps, electronic pill dispensers, and telehealth)...
March 12, 2019: JMIR Mental Health
Anthonie Janse, Arno van Dam, Coby Pijpers, Jan F Wiborg, Gijs Bleijenberg, Marcia Tummers, Jos Twisk, Stephanie Nikolaus, Hans Knoop
BACKGROUND: Cognitive behavioural therapy (CBT) is an evidence-based treatment for chronic fatigue syndrome (CFS). Stepped care for CFS, consisting of a minimal intervention followed by face-to-face CBT, was found efficacious when tested in a CFS specialist centre. Stepped care implemented in a community-based mental health centre (MHC) has not yet been evaluated. AIMS: (1) To test the effectiveness of stepped care for CFS implemented in a MHC at post-treatment and at long-term follow-up; and (2) compare post-treatment outcomes of implemented stepped care with treatment outcomes of a CFS specialist centre...
March 12, 2019: Behavioural and Cognitive Psychotherapy
Sven Streit, Rosalinde K E Poortvliet, Wendy P J den Elzen, Jeanet W Blom, Jacobijn Gussekloo
PURPOSE: Hypertension trials often exclude patients with complex health problems and lack generalizability. We aimed to determine if systolic blood pressure (SBP) in patients undergoing antihypertensive treatment is associated with 1-year changes in cognitive/daily functioning or quality of life (QoL) in persons aged ≥75 years with or without complex health problems. METHODS: We analyzed data from a population-based prospective cohort study (Integrated Systematic Care for Older Persons [ISCOPE]) with a 1-year follow-up...
March 2019: Annals of Family Medicine
Kazuhiro Ueda, Atsushi Kiyota, Mariko Tsuchida, Mikako Okazaki, Nobuaki Ozaki
Myxedema coma is a rare endocrine emergency resulting from the decompensation of severe hypothyroidism, which is associated with a high mortality rate. It is characterized by the deterioration of mental status, hypothermia, hypotension, hyponatremia, and hypoventilation. Early disease diagnosis and advancements in intensive supportive care have reduced the mortality rate. Besides intensive supportive care, appropriate management of the underlying thyroid hormone deficiency is essential. However, as the disease is rare and unrecognized, evidence-based treatment of myxedema has not yet been established in many countries...
March 8, 2019: Endocrine Journal
Claire E Kendall, Esther S Shoemaker, Janessa E Porter, Lisa M Boucher, Lois Crowe, Ron Rosenes, Christine Bibeau, Philip Lundrigan, Marissa L Becker, Shabnam Asghari, Sean B Rourke, Clare Liddy
PURPOSE: For people living with HIV (PLWH) using continuous antiretroviral therapy, HIV is now a complex chronic condition often managed in primary care settings. The patient-centered medical home (PCMH) is a model to deliver comprehensive, coordinated, and integrated primary care that promotes collaboration between primary and specialist care and allied services. The study assessed how both Canadian primary and specialist HIV care settings align with the PCMH. METHODS: Mixed-methods surveys and interviews with providers in Canadian HIV care settings...
March 2019: Journal of the American Board of Family Medicine: JABFM
Fabrizio Didonna, Mariangela Lanfredi, Erica Xodo, Clarissa Ferrari, Roberta Rossi, Laura Pedrini
BACKGROUND: Cognitive-behavioral therapy (CBT) is the first-choice intervention for obsessive-compulsive disorder (OCD); however, a notable proportion of patients either do not respond to treatment or relapse after CBT. Mindfulness-based treatment has been suggested as an alternative or complementary therapeutic strategy for OCD. However, only a few studies have focused on its application in clinical samples. OBJECTIVE: To evaluate the impact of a new treatment, called "Mindfulness-based Cognitive Therapy for OCD...
March 2019: Journal of Psychiatric Practice
Darshan Zala, Alison Brabban, Alex Stirzaker, Muralikrishnan Radhakrishnan Kartha, Paul McCrone
This is the first site level economic evaluation of the Improving Access to Psychological Therapies programme for severe mental illness (IAPT-SMI) that is funded by NHS England. It also aims to illustrate the challenges involved in evaluations based on routine data with low internal validity. Six IAPT-SMI pilot sites treated 1 of 2 clinical groups: (i) psychosis or bipolar disorder; (ii) personality disorder. A decision analytical model nested in a before-after framework- the same patients 12 months after treatment versus 12 months before treatment-was used to compare the cost-effectiveness of IAPT-SMI with treatment as usual (TAU)...
March 8, 2019: Community Mental Health Journal
Justyna Pollok, Joep Em van Agteren, Adrian J Esterman, Kristin V Carson-Chahhoud
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been recognised as a global health concern, and one of the leading causes of morbidity and mortality worldwide. Projections of the World Health Organization (WHO) indicate that prevalence rates of COPD continue to increase, and by 2030, it will become the world's third leading cause of death. Depression is a major comorbidity amongst patients with COPD, with an estimate prevalence of up to 80% in severe stages of COPD. Prevalence studies show that patients who have COPD are four times as likely to develop depression compared to those without COPD...
March 6, 2019: Cochrane Database of Systematic Reviews
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