scholarly journals Nutritional psychiatry: the present state of the evidence

2017 ◽  
Vol 76 (4) ◽  
pp. 427-436 ◽  
Author(s):  
Wolfgang Marx ◽  
Genevieve Moseley ◽  
Michael Berk ◽  
Felice Jacka
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Diet Quality ◽  
Age Groups ◽  
Significant Proportion ◽  
Behavioural Therapy ◽  
Future Research ◽  
Reverse Causality ◽  
Dietary Interventions ◽  
Cognitive Behavioural

Mental illness, including depression, anxiety and bipolar disorder, accounts for a significant proportion of global disability and poses a substantial social, economic and heath burden. Treatment is presently dominated by pharmacotherapy, such as antidepressants, and psychotherapy, such as cognitive behavioural therapy; however, such treatments avert less than half of the disease burden, suggesting that additional strategies are needed to prevent and treat mental disorders. There are now consistent mechanistic, observational and interventional data to suggest diet quality may be a modifiable risk factor for mental illness. This review provides an overview of the nutritional psychiatry field. It includes a discussion of the neurobiological mechanisms likely modulated by diet, the use of dietary and nutraceutical interventions in mental disorders, and recommendations for further research. Potential biological pathways related to mental disorders include inflammation, oxidative stress, the gut microbiome, epigenetic modifications and neuroplasticity. Consistent epidemiological evidence, particularly for depression, suggests an association between measures of diet quality and mental health, across multiple populations and age groups; these do not appear to be explained by other demographic, lifestyle factors or reverse causality. Our recently published intervention trial provides preliminary clinical evidence that dietary interventions in clinically diagnosed populations are feasible and can provide significant clinical benefit. Furthermore, nutraceuticals including n-3 fatty acids, folate, S-adenosylmethionine, N-acetyl cysteine and probiotics, among others, are promising avenues for future research. Continued research is now required to investigate the efficacy of intervention studies in large cohorts and within clinically relevant populations, particularly in patients with schizophrenia, bipolar and anxiety disorders.

The effectiveness, feasibility and acceptability of a school-based intervention to improve sleep and psychological wellbeing in adolescents.

2021 ◽  
Author(s):  
Stephanie McCrory ◽  
Astrid McLellan ◽  
Karolina Kiper ◽  
Clare Munro ◽  
Christopher-James Harvey ◽  
...  
Keyword(s):  
Behavioural Therapy ◽  
Self Report ◽  
Psychological Wellbeing ◽  
Future Research ◽  
Convenience Sample ◽  
School Based ◽  
Cognitive Behavioural ◽  
Physical Health Problems ◽  
Improvement Interventions ◽  
Measure Change

Introduction: Adolescents are vulnerable to experiencing insufficient sleep which can increase the risk of developing insomnia, mental/physical health problems and mood regulation. School-based sleep improvement interventions (SBSII) have been developed utilising Cognitive Behavioural Therapy for Insomnia techniques and found improvements in sleep knowledge and behaviour. This study aimed to evaluate the effectiveness, feasibility and acceptability of a school-based sleep improvement intervention (iSLEEP) for improving sleep and psychological wellbeing in adolescents.Methods: A mixed-methods approach was adopted. The participants (115, aged 12-15) were recruited from secondary schools in Scotland. iSLEEP comprised of three lessons, combining formal sleep education and CBT-I, and were delivered over three consecutive weeks. Baseline (1 week before lesson 1) and follow-up (1 week following lesson 3) assessments comprised of self-report questionnaires to measure change in sleep, depression, anxiety and stress. Two weeks following the final lesson, a convenience sample of 19 pupils (14 females) were recruited to participate in focus groups.Results: There were significant improvements in overall sleep and marginal differences between those who were categorised with ‘probable insomnia’ at baseline and likewise for ‘good sleepers’. There were no significant improvements in symptoms of depression, anxiety or stress. Two themes and two sub-themes were generated. Participants reported that iSLEEP was acceptable and improved their sleep.Conclusions: These findings indicate that iSLEEP is an effective, feasible and acceptable SBSII. Future research should aim to utilise a controlled design to further investigate the efficacy of iSLEEP.

Spiritually integrated psychotherapy

2021 ◽  
pp. 383-394
Author(s):  
Marianna de Abreu Costa ◽  
David H. Rosmarin
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Cognitive Behavioural Therapy ◽  
Treatment Process ◽  
Cognitive Restructuring ◽  
Behavioural Therapy ◽  
Behavioural Activation ◽  
Cognitive Behavioural ◽  
Integrated Psychotherapy ◽  
Motivation For Treatment

There is growing recognition that it is important to understand how spirituality is related to mental health and distress, and how it can be integrated into psychotherapy. Spiritually integrated psychotherapy (SIP) involves the adaptation of secular psychotherapies in order to be more culturally sensitive and client-centred to spiritually and religiously inclined clients. Literature shows that SIPs are at least as effective as conventional psychotherapy for treating different mental disorders, and cognitive behavioural therapy (CBT) is the most widely investigated clinical modality that has been adapted to include spiritual content. The objective of this chapter is to describe the adaptation of traditional CBT techniques by integrating spirituality to enhance cognitive restructuring, behavioural activation, coping, psychoeducation, and to facilitate greater motivation for treatment. Several practical examples are given, including the use of meditation and prayer in the treatment process.

Psychotherapy

2019 ◽  
pp. 881-930
Author(s):  
David Semple ◽  
Roger Smyth
Keyword(s):  
Mental Disorders ◽  
Behavioural Therapy ◽  
Object Relations Theory ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
History Of ◽  
Behavioural Therapies ◽  
The Individual ◽  
Background Context ◽  
Selection Of

This chapter covers the psychotherapies, a collection of treatments for mental disorders which employ language and communication as a means of producing change. It covers assessment and selection of an appropriate method for the individual patient, a history of Freud and other pioneers of psychotherapy to provide a background context, before examining different types of therapy. Briefly explaining the theory of psychotherapy, the phases of psychosexual development, and the object relations theory, it goes into detail on behavioural therapies such as cognitive behavioural therapy, interpersonal psychotherapy, dialectical behaviour therapy, and solution therapy. Counselling methods are described to aid the reader in developing their skills.

scholarly journals Cultural adaptations of CBT: a summary and discussion of the Special Issue on Cultural Adaptation of CBT

2019 ◽  
Vol 12 ◽  
Author(s):  
Farooq Naeem
Keyword(s):  
Cultural Adaptation ◽  
Behavioural Therapy ◽  
Vital Role ◽  
Sufficient Evidence ◽  
Future Research ◽  
Full Potential ◽  
Special Issue ◽  
Current Form ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

AbstractCognitive behavioural therapy (CBT) in its current form might not be acceptable to service users from a variety of backgrounds. Therefore, it makes sense to adapt CBT when working with diverse populations. Contributors to this special issue of theCognitive Behaviour Therapisthave tackled the issues around the cultural adaptation of CBT from various perspectives, using a variety of methods, and have addressed topics ranging from cultural adaptation to improving access to CBT. Here, I briefly summarize and discuss the papers in this special issue. I start with a systematic review of CBT for social anxiety across cultures. Seven articles cover aspects of adaptation of therapies for people from different backgrounds. Three papers discuss the issues of gender and sexuality when using CBT, while another three papers focus on refugees, asylum seekers and the homeless, and two papers describe the application of CBT with religious populations. Finally, there are seven papers on issues related to service delivery, practice and training and supervision when working with a diverse population. Collectively, papers in this special issue provide us with sufficient evidence that cultural considerations play a vital role when using CBT, offer practical suggestions for improving cultural competence and most importantly, can catalyse future research. However, the full potential of culturally adapted interventions will not be realized until and unless access to CBT is improved. Therefore, there is a need to build robust evidence to convince funders, policy makers and service managers.

scholarly journals Can pain catastrophizing be changed in surgical patients? A scoping review

2018 ◽  
pp. 311-318
Author(s):  
Eric Gibson ◽  
Marlis T. Sabo
Keyword(s):  
Surgical Outcomes ◽  
Pain Catastrophizing ◽  
Behavioural Therapy ◽  
Surgical Patients ◽  
Future Research ◽  
Surgical Patient ◽  
Original Research ◽  
Surgery Patient ◽  
Cognitive Behavioural ◽  
Before And After

Background: Catastrophizing, a coping style characterized by an exaggerated negative affect when experiencing or anticipating pain, is an important factor that adversely affects surgical outcomes. Various interventions have been attempted with the goal of reducing catastrophizing and, by extension, improving treatment outcomes. We performed a systematic review to determine whether catastrophizing can be altered in surgical patients and to present evidence for interventions aimed at reducing catastrophizing in this population. Methods: Using a scoping design, we performed a systematic search of MEDLINE and Embase. Studies reporting original research measuring catastrophizing, before and after an intervention, on the Pain Catastrophizing Scale (PCS) or Coping Strategies Questionnaire (CSQ) were selected. Studies were assessed for quality, the nature of the intervention and the magnitude of the effect observed. Results: We identified 47 studies that measured the change in catastrophizing score following a broad range of interventions in surgical patients, including surgery, patient education, physiotherapy, cognitive behavioural therapy, psychologist-directed therapy, nursing-directed therapy and pharmacological treatments. The mean change in catastrophizing score as assessed with the PCS ranged from 0 to –19, and that with the CSQ, from +0.07 to –13. Clinically important changes in catastrophizing were observed in 7 studies (15%). Conclusion: Catastrophizing was observed to be modifiable with an intervention in a variety of surgical patient populations. Some interventions produced greater reductions than others, which will help direct future research in the improvement of surgical outcomes.

scholarly journals Cognitive-behavioural therapy for severe mental disorders: Back to the future?

2008 ◽  
Vol 192 (6) ◽  
pp. 401-403 ◽  
Author(s):  
Jan Scott
Keyword(s):  
Clinical Trials ◽  
Mental Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Severe Mental Disorders ◽  
Efficacy Trials ◽  
Cognitive Behavioural ◽  
The Future ◽  
Effectiveness Trials ◽  
Clinical Populations

SummaryLike recent medication studies, it appears that when cognitive-behavioural therapy is tested in pragmatic effectiveness trials involving routine clinical populations it does not fare as well as in efficacy trials. Given the multitude of factors that can ‘muddy the waters’ in clinical trials, how do we best make sense of the findings?

scholarly journals A Pragmatic Pilot Study Of Cognitive Behavioural Therapy For Insomnia Among People Living With HIV

2021 ◽  
Author(s):  
Tyler Gordon Tulloch
Keyword(s):  
Pilot Study ◽  
Sleep Disturbance ◽  
Cognitive Behavioural Therapy ◽  
Thematic Analysis ◽  
Behavioural Therapy ◽  
Future Research ◽  
People Living With Hiv ◽  
Cognitive Behavioural ◽  
Living With Hiv ◽  
Insomnia Severity

The prevalence of insomnia among people living with HIV (PWH) is considerably higher than in the general population. Cognitive, behavioural, and biopsychosocial explanations for this elevated prevalence have been proposed, but there is a lack of consensus in the literature. Sleep disturbance is associated with disrupted immune functioning at the cellular level and increased risk of contracting infectious diseases; therefore, insomnia may be particularly problematic for PWH. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for insomnia, and is effective at treating insomnia among individuals with comorbid medical disorders. Surprisingly, no study has examined its efficacy among PWH. This pragmatic pilot study examined features of insomnia among 48 PWH and was the first study to examine sleep disturbance among PWH using American Academy of Sleep Medicine guidelines for evaluating chronic insomnia. On average, insomnia chronicity was 8.2 years and was of moderate severity. Psychiatric comorbidity was common, as were comorbid sleep disorders. Insomnia severity was associated with psychosocial variables including sleep effort, self-efficacy for sleep, depression, anxiety, stress, and social functioning-related quality of life. This study was also the first to examine safety, feasibility, acceptability, and intervention effects of CBT-I. These were examined among a subsample of 10 PWH using single-case interrupted time-series design. Thematic analysis was used to explore participant perceptions of CBT-I. Large effect sizes were observed for improvement in insomnia severity, sleep efficiency, and total wake time. Reliable and clinically significant reduction in insomnia severity was observed for all but one participant, and half met criteria for insomnia remission. Overall, CBT-I was an efficacious treatment for insomnia, and participant feedback was consistent with quantitative results. Participants viewed CBT-I as a safe and acceptable treatment for insomnia. Participant feedback identified preexisting needs, positive impacts and challenges of CBT-I, perceived mechanisms of change, and suggested modifications to tailor CBT-I for PWH. Given this preliminary support for the efficacy of CBT-I among PWH, future research should seek to demonstrate generalizability of these effects. Partnering with HIV community organizations may be important next step in conducting future research and increasing accessibility of CBT-I to PWH. Keywords: HIV, insomnia, cognitive behavioural therapy, pilot study, pragmatic trial, thematic analysis

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