Biosocial processes predicting multisystemic therapy treatment response

Objective: To identify pretreatment laboratory parameters associated with treatment response and to describe the relationship between treatment response and liver decompensation in patients with primary biliary cholangitis treated with ursodeoxycholic acid. Methods: We defined treatment response as both ALP ≤ 1.67 × ULN and total bilirubin ≤ 2 × ULN. Multiple logistic regression analyses were performed to adjust for confounding effects of sociodemographic variables. Results: Pretreatment total bilirubin ((TB); OR = 0.3388, 95%CI = 0.1671–0.6077), ALT (OR = 0.5306, 95%CI = 0.3830–0.7080), AST (OR = 0.4065, 95%CI = 0.2690–0.5834), ALP (OR = 0.3440, 95%CI = 0.2356–0.4723), total cholesterol ((TC); OR = 0.7730, 95%CI = 0.6242–0.9271), APRI (OR = 0.3375, 95%CI = 0.1833–0.5774), as well as pretreatment albumin (OR = 1.1612, 95%CI = 1.0706–1.2688) and ALT/ALP (OR = 2.4596, 95%CI = 1.2095–5.5472) were associated with treatment response after six months of treatment. Pretreatment TB (OR = 0.2777, 95%CI = 0.1288–0.5228), ALT (OR = 0.5968, 95%CI = 0.4354–0.7963), AST (OR = 0.4161, 95%CI = 0.2736–0.6076), ALP (OR = 0.4676, 95%CI = 0.3487–0.6048), APRI (OR = 0.2838, 95%CI = 0.1433–0.5141), as well as pretreatment albumin (OR = 1.2359, 95%CI = 1.1257–1.3714) and platelet count (OR = 1.0056, 95%CI = 1.0011–1.0103) were associated with treatment response after 12 months of treatment. Treatment response after 6 months of UDCA therapy is significantly associated with treatment response after 12 months of UDCA therapy (OR = 25.2976, 95% CI = 10.5881–68.4917). Treatment responses after 6 and 12 months of UDCA therapy decrease the risk of an episode of liver decompensation in PBC patients (OR = 12.1156, 95%CI = 3.7192–54.4826 and OR = 21.6000, 95%CI = 6.6319–97.3840, respectively). Conclusions: There are several pretreatment laboratory parameters associated with treatment response in patients with primary biliary cholangitis. Treatment response after six months is significantly associated with treatment response after 12 months of ursodeoxycholic acid (UDCA) therapy. Treatment responses after 6 and 12 months of UDCA decrease the risk of an episode of liver decompensation.

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A Time-Out Before Every Electroconvulsive Therapy Treatment—Response to Letter

Journal of Ect ◽

10.1097/yct.0000000000000447 ◽

2017 ◽

Vol 33 (3) ◽

pp. 219

Author(s):

Bradley Vincent Watts

Keyword(s):

Treatment Response ◽

Electroconvulsive Therapy ◽

Time Out ◽

Therapy Treatment

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Adolescent Physiological and Behavioral Patterns of Emotion Dysregulation Predict Multisystemic Therapy Response

Journal of Emotional and Behavioral Disorders ◽

10.1177/1063426616638315 ◽

2016 ◽

Vol 25 (3) ◽

pp. 131-142 ◽

Cited By ~ 3

Author(s):

D. Anne Winiarski ◽

Julia C. Schechter ◽

Patricia A. Brennan ◽

Sharon L. Foster ◽

Phillippe B. Cunningham ◽

...

Keyword(s):

Emotion Regulation ◽

Treatment Response ◽

Hierarchical Linear Modeling ◽

Emotion Dysregulation ◽

Child Behavior Checklist ◽

Therapy Response ◽

Multisystemic Therapy ◽

Linear Modeling ◽

Treatment Protocols ◽

Cortisol Reactivity

This study examined whether physiological and behavioral indicators of emotion dysregulation assessed over the course of multisystemic therapy (MST) were related to treatment response. Participants were 180 ethnically diverse adolescents ( n = 120 males), ranging in age from 12 to 17 years. Treatment response was assessed through therapist report and official arrest records. Changes in cortisol reactivity and changes in scores on a Behavioral Dysregulation subscale of the Child Behavior Checklist were used as indicators of emotion dysregulation. Hierarchical linear modeling analyses examined whether a less favorable treatment response was associated with cortisol reactivity measures collected (a) early in treatment and (b) over the course of treatment as well as with behavioral reports of emotion dysregulation reported (c) early in treatment and (d) over the course of treatment. Sex was explored as a moderator of these associations. Results indicated that both cortisol and behavioral indices of emotion dysregulation early in treatment and over the course of therapy predicted treatment responsiveness. This relationship was moderated by sex: Girls were more likely to evidence a pattern of increasing emotion regulation prior to successful therapy response. The results lend further support to the notion of incorporating emotion regulation techniques into treatment protocols for delinquent behavior.

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