PMH8 Long-Term Follow-Up Effects of Computerized or Internet-Based Cognitive Behavioral Therapy for Depression and Anxiety: A Meta-Analysis

Abstract Introduction Patients with chronic non-cancer pain often report insomnia as a significant comorbidity. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment for insomnia, and several randomized controlled trials (RCTs) have examined the efficacy of CBT-I on various health outcomes in patients with comorbid insomnia and chronic non-cancer pain. We conducted a systematic review and meta-analysis on the effectiveness of CBT-I on sleep, pain, depression, anxiety and fatigue in adults with comorbid insomnia and chronic non-cancer pain. Methods A systematic search was conducted using ten electronic databases. The duration of the search was set between database inception to April 2020. Included studies must be RCTs assessing the effects of CBT-I on at least patient-reported sleep outcomes in adults with chronic non-cancer pain. Quality of the studies was assessed using the Cochrane risk of bias assessment and Yates quality rating scale. Continuous data were extracted and summarized using standard mean difference (SMD) with 95% confidence intervals (CIs). Results The literature search resulted in 7,772 articles, of which 14 RCTs met the inclusion criteria. Twelve of these articles were included in the meta-analysis. The meta-analysis comprised 762 participants. CBT-I demonstrated a large significant effect on patient-reported sleep (SMD = 0.87, 95% CI [0.55–1.20], p < 0.00001) at post-treatment and final follow-up (up to 9 months) (0.59 [0.31–0.86], p < 0.0001); and moderate effects on pain (SMD = 0.20 [0.06, 0.34], p = 0.006) and depression (0.44 [0.09–0.79], p= 0.01) at post-treatment. The probability of improving sleep and pain following CBT-I at post-treatment was 81% and 58%, respectively. The probability of improving sleep and pain at final follow-up was 73% and 57%, respectively. There were no statistically significant effects on anxiety and fatigue. Conclusion This systematic review and meta-analysis showed that CBT-I is effective for improving sleep in adults with comorbid insomnia and chronic non-cancer pain. Further, CBT-I may lead to short-term moderate improvements in pain and depression. However, there is a need for further RCTs with adequate power, longer follow-up periods, CBT for both insomnia and pain, and consistent scoring systems for assessing patient outcomes. Support (if any):

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Long Term Effect of Cognitive Behavioral Therapy in Patients with Health Anxiety

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1887 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S111-S112

Author(s):

K.E. Veddegjaerde

Keyword(s):

Quality Of Life ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Health Anxiety ◽

Term Effect ◽

Cognitive Behavioral ◽

Long Term Effect

IntroductionCognitive-behavioral therapy (CBT) has been found to be an effective treatment of excessive health anxiety (HA), but the long-term effect over 18months has not been examined.ObjectivesSeveral studies have shown effect of CBT for HA-patients. However, these effects have been short or immediate after therapy. To our knowledge no studies have examined long-term effect of CBT for HA over 18 months.AimsTo investigate the long-term effect of CBT on HA, focusing on level of HA, quality of life, subjective health complaints and general anxiety. Follow-up time was at least 10 years. Our hypothesis was that the effect was sustained.MethodsPatients with HA received 16 sessions of CBT over a period of 12–18 months, and were followed up over at least 10 years. All patients fulfilled criteria for F45.2, hypochondriacal disorder according to ICD-10.The patients answered several questionnaires, exploring areas such as HA, Quality of life, somatization, and mental health problems. Questionnaires were answered before CBT, after CBT and at follow up. Mixed model analysis was performed in SPSS 23.0 for all questionnaires.ResultsAll scores were found to be significant in the Pre-CBT–Post-CBT and Pre-CBT–FU (0.034– < 0.001), and none were found to be significant in the Post-CBT–FU.ConclusionsOur findings suggest that for the majority of patients with HA, CBT has a significant and lasting long-term effect. This effect lasts up to ten years post therapy.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

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Long-Term Effectiveness of Cognitive Behavioral Therapy in Routine Outpatient Care: A 5- to 20-Year Follow-Up Study

Psychotherapy and Psychosomatics ◽

10.1159/000500188 ◽

2019 ◽

Vol 88 (4) ◽

pp. 225-235 ◽

Cited By ~ 3

Author(s):

Ruth von Brachel ◽

Gerrit Hirschfeld ◽

Arleta Berner ◽

Ulrike Willutzki ◽

Tobias Teismann ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Outpatient Care ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Follow Up Study

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Long-Term Follow-up of Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: Symptom Severity and the Role of Exposure 8–10 Years After Inpatient Treatment

Journal of Cognitive Psychotherapy ◽

10.1891/jcpsy-d-20-00002 ◽

2020 ◽

Vol 34 (3) ◽

pp. 261-271 ◽

Cited By ~ 1

Author(s):

Anne Katrin Külz ◽

Sarah Landmann ◽

Magdalena Schmidt-Ott ◽

Bartosz Zurowski ◽

Andreas Wahl-Kordon ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Obsessive Compulsive Disorder ◽

Behavioral Therapy ◽

Healthcare Services ◽

Cognitive Behavioral ◽

Long Term Effects ◽

Obsessive Compulsive ◽

Compulsive Disorder

Obsessive-compulsive disorder (OCD) can be effectively treated by cognitive behavioral therapy (CBT) with exposure and response prevention (ERP). Yet, little is known about the long-term effects of inpatient CBT up to one decade after treatment. Thirty patients who had been treated with 12 weeks of intensive inpatient CBT with ERP were examined 8–10 years after their stay in hospital with regard to obsessive-compulsive symptoms, secondary outcomes, and use of healthcare services. Significant (p < .001) improvements in OC symptoms with medium and large effects compared to baseline on the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) and on the Obsessive-Compulsive Inventory (OCI-R) could still be observed, with 20% of the patients reaching remission status. Continuation of exposure exercises after the inpatient stay was the sole significant factor for improved scores at follow-up. The results suggest that OCD does not necessarily take a chronic course. However, maintenance of exposure training seems to be crucial for sustained improvement.

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