Behavior Therapy and Pharmacotherapy for Trichotillomania: Choice of Treatment, Patient Acceptance, and Long-Term Outcome

CNS Spectrums ◽  
1998 ◽  
Vol 3 (9) ◽  
pp. 72-78 ◽  
Author(s):  
Nancy J. Keuthen ◽  
Richard L. O’Sullivan ◽  
Paige Goodchild ◽  
Dayami Rodriguez ◽  
Michael A. Jenike ◽  
...  
Keyword(s):  
Behavior Therapy ◽  
Rating Scale ◽  
Massachusetts General Hospital ◽  
Combined Treatment ◽  
Outcome Expectations ◽  
Patient Acceptance ◽  
Hair Pulling ◽  
Term Outcome ◽  
Long Term Outcome

AbstractSixty-three trichotillomania (TTM) patients treated in a specialty clinic were retrospectively studied for treatment referral patterns, comparison of treatment outcomes, and long-term follow-up. Patients subjectively rated their individual treatments based on success, logicality, confidence in recommending the treatment to others, outcome expectations, and compliance. Subjects referred for combined behavior therapy (BT) and medication treatment (MT) were more depressed, more anxious, and reported greater psychosocial impairment and impact secondary to hair pulling than individuals referred for either treatment alone. Neither the Massachusetts General Hospital Hair Pulling Severity Scale (HPS) nor the Rosenberg Self-Esteem Scale (SES) scores differed between those referred for combined treatment vs those receiving monotherapy. The combination therapy patients showed a greater reduction in HPS scores than those receiving single-modality treatment and no longer differed significantly from monotherapy patients following treatment in terms of Beck Depression Inventory (BDI), Beck Anxiety Index (BAI), and Sickness Impact Profile (SIP) scores. Patients treated with both BT and MT rated BT as more successful and had greater confidence in recommending the intervention. Conversely, compliance was significantly higher for MT than BT. Other treatments, especially support groups, were rated positively. Comparison of patients currently receiving treatment with those no longer in active treatment revealed no statistically significant differences. Ten of 19 patients who were out of treatment for over 1 year rated themselves as treatment responders. Significant improvements in HPS, BDI, BAI, and SES scores were reported in the few hair pullers out of treatment more than 1 year for whom objective rating scale scores were available.

Long-term outcome following ilioinguinal neurectomy for chronic pain

2010 ◽  
Vol 112 (4) ◽  
pp. 784-789 ◽  
Author(s):  
Andrew C. Zacest ◽  
Stephen T. Magill ◽  
Valerie C. Anderson ◽  
Kim J. Burchiel
Keyword(s):  
Abdominal Surgery ◽  
Hernia Repair ◽  
Rating Scale ◽  
Chronic Groin Pain ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ilioinguinal Nerve ◽  
The Mean

Object Ilioinguinal neuralgia is one cause of chronic groin pain following inguinal hernia repair, and it affects ~ 10% of patients. Selective ilioinguinal neurectomy is one proposed treatment option for carefully selected patients. The goal of this study was to determine the long-term outcome of patients who underwent selective ilioinguinal neurectomy for chronic post-hernia pain. Methods The authors retrospectively reviewed the clinical assessment, surgical treatment, and long-term outcome in 26 patients with ilioinguinal neuralgia who underwent selective ilioinguinal neurectomy performed by the senior author (K.J.B.) at Oregon Health & Science University between 1998 and 2008. Data were collected from patient charts and a follow-up telephone questionnaire. Results Twenty-six patients (14 men and 12 women) had a clinical diagnosis of ilioinguinal neuralgia based on a history of radiating neuropathic groin, medial thigh, and genitalia pain. One patient had bilateral disease (therefore there were 27 surgical cases). A selective nerve block was performed in 21 (81%) of 26 patients and was positive in 20 (77%) of the 26. In all but 2 patients, pain onset followed abdominal surgery (for hernia repair in 18 patients), and was immediate in 16 (67%) of 24 patients. The mean patient age was 48.7 years, and the mean duration of pain prior to neurosurgical consultation was 3.9 years. Surgery was performed after induction of local or general anesthesia in 17 and 10 cases, respectively. The ilioinguinal nerve was identified in 25 cases, and the genitofemoral nerve in 2, either entrapped in mesh, scar, or with obvious neuroma (22 of 27 cases). The identified nerve was doubly ligated, cut, and buried in muscle at its most proximal point. At the 2-week follow-up evaluations, 14 (74%) of 19 patients noted definite pain improvement. Nineteen (73%) of the 26 patients were contacted by telephone and agreed to participate in completing long-term follow-up questionnaires. The mean follow-up duration was 34.78 months. Return of pain was reported by 13 (68%) of 19 patients. Using a verbal numerical rating scale (0–10), pain was completely relieved in 27.8%, better in 38.9%, no better in 16.7%, and worse in 16.7% of patients. Conclusions Ilioinguinal neurectomy is an effective and appropriate treatment for selected patients with iatrogenic ilioinguinal neuralgia following abdominal surgery. Although a high proportion of patients reported some long-term recurrence of pain, complete or partial pain relief was achieved in 66.7% of the patients observed.

Chemotherapy Alone for Localized Non-Bulky Hodgkin Lymphoma

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2591-2591 ◽  
Author(s):  
George P. Canellos
Keyword(s):  
Radiation Therapy ◽  
Massachusetts General Hospital ◽  
Combined Modality Therapy ◽  
Progression Free Survival ◽  
Multiple Series ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Combined Modality ◽  
Asymptomatic Patients

Abstract Combined modality therapy with radiation and chemotherapy has been the standard treatment for limited-stage HL. Long-term toxicities, including cardiac and disease and secondary cancers, s have been reported in multiple series with long follow-up. Lower doses and smaller fields may be less toxic, but mediastinal/cardiac radiation is unavoidable in most cases. The Dana-Farber Cancer Institute and Massachusetts General Hospital lymphoma teams have now treated 74 patients with localized, non-bulky classical HL with chemotherapy as the only therapy. The median age of the series was 29 years (17–42). The M/F ratio was 33/41. The clinical stages were IA (10), IIA (56), IIB (9). The treatment consisted of ABVD × 6 cycles (70 pts), ABVD × 4 cycles (3 pts), and variants of ABVD (2 pts). The median F/U is 48+ months (4+–174+). One patient had primary refractory disease. Seven patients (median age 30, range 20–38) have relapsed (6, 10, 10, 11, 14, 20 and 63 months) whose original stage was IA (1), IIA (3), IIB (3). The progression-free survival at 4 years is 91%. All patients are alive. Six of seven patients received salvage RT and autologous stem cell transplantation, and only one has relapsed to date. In retrospect, all seven patients who relapsed from CR or CRu were FDG-PET negative at mid-cycle. Thus far, there has been no long-term, chemotherapy-related toxicity in the patients who remain in remission. 94% (62/66) asymptomatic patients remain in remission compared to 6/9 (67%) IIB patients. Conclusion: In young adults with non-bulky, localized HL chemotherapy alone with ABVD can achieve excellent progression-free and overall survival, especially those asymptomatic at diagnosis. These data and previously published results indicate an equivalent long-term outcome when compared to combined modality trials but without the long-term risks of radiation therapy. Avoidance of radiation therapy may be even more important in the pediatric age group.

scholarly journals Long-Term Outcome After Operative Management of Talus Fractures

2018 ◽  
Vol 39 (12) ◽  
pp. 1432-1443 ◽  
Author(s):  
Wouter Vints ◽  
Giovanni Matricali ◽  
Eric Geusens ◽  
Stefaan Nijs ◽  
Harm Hoekstra
Keyword(s):  
Rating Scale ◽  
Short Form ◽  
Operative Management ◽  
Numeric Rating Scale ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Foot Function ◽  
Numeric Rating

Background: Controversies remain regarding the preferred treatment strategy for talus fractures. The primary goal of this study was to evaluate the long-term outcome after operative management of talus fractures. Secondarily, we identified those factors that affected the outcome and defined strategies to improve the outcome. Methods: This is a retrospective outcome study of 84 patients with an average follow-up time of 9.1 years. We assessed the functional results, return to daily activities, and general health status using the Foot Function Index-5pt, a numeric rating scale for pain, and the Short Form-36 Health Survey. Furthermore, we conducted a correlation analysis between the outcomes and 14 demographic, clinical, and radiologic variables. Results: We found moderate mean Foot Function Index pain and disability scores of 30.2 and 28.7, respectively. The mean numeric rating scale score was 3.2. Of all responders, 41% (27/66) did not return to their daily activities. We reported low physical, but good mental, Short Form-36 component summary scores of 42.7 and 48.3, respectively. We recorded a complication rate of 56%. Osteoarthritis, articular incongruence and talus body fractures correlated significantly with a poorer functional outcome. Delayed surgery after trauma was associated with better outcome measures. Conclusions: Talus fractures have a major long-term impact on ankle and hindfoot function and on physical health. Success of operative treatment depends on the occurrence of osteoarthritis postoperatively, type of fracture, and quality of fracture reduction. Because only the latter is modifiable, efforts should be made to restore articular congruence in order to improve the outcome. Therefore, we recommend reviewing the quality of the reduction postoperatively on CT. Furthermore, talus fractures should not be considered operative emergencies, but rather treated after recovery of the soft-tissues. Level of Evidence: Level III, comparative study.

scholarly journals Long-Term Outcome of 106 Consecutive Pediatric Ruptured Brain Arteriovenous Malformations After Combined Treatment

Stroke ◽  
2014 ◽  
Vol 45 (6) ◽  
pp. 1664-1671 ◽  
Author(s):  
Thomas Blauwblomme ◽  
Marie Bourgeois ◽  
Philippe Meyer ◽  
Stéphanie Puget ◽  
Federico Di Rocco ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Combined Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Brain Arteriovenous Malformations

Emotion perception and theory of mind in adolescents with major depression

2021 ◽  
pp. 1-6
Author(s):  
Chen Dror ◽  
Victor Portnoy ◽  
Shomrit Dayan-Rosenblum ◽  
Yari Gvion ◽  
Yuval Bloch ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Theory Of Mind ◽  
Rating Scale ◽  
Emotion Perception ◽  
Recognition Task ◽  
Expression Recognition ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Children’S Depression

Abstract Background: The research of theory of mind (ToM) and emotion perception (EP) in adolescents with major depressive disorder (MDD) is scarce, and no study to date has investigated the association between EP and long-term outcomes of adolescents with MDD. The aim of the current study was to evaluate ToM and EP in adolescents with MDD, as compared to healthy controls (HCs). In addition, we aimed to assess the association between impairment in ToM and EP, depressive symptom severity, and long-term outcome in the MDD group. Methods: We compared the performance of 14 adolescents with MDD and 25 HC in the Facial Expression Recognition Task (FERT) and the Interpersonal Perception Task. We followed up with the MDD group 2 years later to assess the level of their depressive symptoms using the Children’s Depression Rating Scale–Revised (CDRS-R). Results: No differences were found between adolescents with MDD and HC in the ToM and FERT tasks. Also, within the MDD group, there was no association between the severity of depressive symptoms and task performance. In the MDD group, there was a significant correlation between lower levels of accuracy in the FERT during the index depressive episode and lower CDRS-R scores on follow-up 2 years later (r2 = 0.35, p = 0.021). Conclusions: EP impairments in adolescents with MDD might predict worse long-term outcome. Further research is needed to verify our findings and to assess for a possible neurobiological underpinning for the state and trait impairments in EP in adolescents with MDD.

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