scholarly journals A compassionate imagery intervention for patients with persecutory delusions

2021 ◽  
pp. 1-13
Author(s):  
Ava Forkert ◽  
Poppy Brown ◽  
Daniel Freeman ◽  
Felicity Waite
Keyword(s):  
Change Score ◽  
The Self ◽  
Clinical Effects ◽  
Serious Adverse Events ◽  
Persecutory Delusions ◽  
Self Compassion ◽  
Negative Beliefs ◽  
Clinical Benefits ◽  
Therapy Sessions

Abstract Background: Negative beliefs about the self, including low self-compassion, have been identified as a putative causal factor in the occurrence of paranoia. Therefore, improving self-compassion may be one route to reduce paranoia. Aims: To assess the feasibility, acceptability, and potential clinical effects of a brief compassionate imagery intervention for patients with persecutory delusions. Method: Twelve patients with persecutory delusions received an individual four-session compassionate imagery intervention. Assessments of self-concept and paranoia were completed before treatment, immediately after treatment, and at 1-month follow-up. A qualitative study exploring participants’ experiences of the treatment was also completed. Results: Twelve out of 14 eligible patients referred to the study agreed to take part. All participants completed all therapy sessions and assessments. Post-treatment, there were improvements in self-compassion (change score –0.64, 95% CI –1.04, –0.24, d = –1.78), negative beliefs about the self (change score 2.42, 95% CI –0.37, 5.20, d = 0.51), and paranoia (change score 10.08, 95% CI 3.47, 16.69, d = 0.61). There were no serious adverse events. Three themes emerged from the qualitative analysis: ‘effortful learning’, ‘seeing change’ and ‘taking it forward’. Participants described a process of active and effortful engagement in therapy which was rewarded with positive changes, including feeling calmer, gaining clarity, and developing acceptance. Conclusion: This uncontrolled feasibility study indicates that a brief compassionate imagery intervention for patients with persecutory delusions is feasible, acceptable, and may lead to clinical benefits.

scholarly journals Cognitive Behavioural Therapy for Nightmares for Patients with Persecutory Delusions (Nites): An Assessor-Blind, Pilot Randomized Controlled Trial

2019 ◽  
pp. 070674371984742 ◽  
Author(s):  
Bryony Sheaves ◽  
Emily A. Holmes ◽  
Stephanie Rek ◽  
Kathryn M. Taylor ◽  
Alecia Nickless ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Behavioural Therapy ◽  
Serious Adverse Events ◽  
Persecutory Delusions ◽  
Treatment As Usual ◽  
Cognitive Behavioural

Objective:Nightmares are relatively common in patients experiencing psychosis but rarely assessed or treated. Nightmares may maintain persecutory delusions by portraying fears in sensory-rich detail. We tested the potential benefits of imagery-focused cognitive behavioural therapy (CBT) for nightmares on nightmare severity and persecutory delusions.Method:This assessor-blind parallel-group pilot trial randomized 24 participants with nightmares and persecutory delusions to receive CBT for nightmares delivered over 4 weeks in addition to treatment as usual (TAU) or TAU alone. Assessments were at 0, 4 (end of treatment), and 8 weeks (follow-up). Feasibility outcomes assessed therapy uptake, techniques used, satisfaction, and attrition. The primary efficacy outcome assessed nightmare severity at week 4. Analyses were intention to treat, estimating treatment effect with 95% confidence intervals (CIs).Results:All participants offered CBT completed therapy (mean [SD], 4.8 [0.6] sessions) with high satisfaction, and 20 (83%) participants completed all assessments. Compared with TAU, CBT led to large improvements in nightmares (adjusted mean difference = −7.0; 95% CI, –12.6 to –1.3; d = –1.1) and insomnia (6.3; 95% CI, 2.6 to 10.0; d = 1.4) at week 4. Gains were maintained at follow-up. Suicidal ideation was not exacerbated by CBT but remained stable to follow-up, compared with TAU, which reduced at follow-up (6.8; 95% CI, 0.3 to 3.3; d = 0.7). CBT led to reductions in paranoia (–20.8; 95% CI, –43.2 to 1.7; d = –0.6), although CIs were wide. Three serious adverse events were deemed unrelated to participation (CBT = 2, TAU = 1).Conclusions:CBT for nightmares is feasible and may be efficacious for treating nightmares and comorbid insomnia for patients with persecutory delusions. It shows promise on paranoia but potentially not on suicidal ideation.

scholarly journals Long-Term and Preventive Effects of Sublingual Allergen-Specific Immunotherapy: A Retrospective, Multicentric Study

2003 ◽  
Vol 16 (1) ◽  
pp. 73-79 ◽  
Author(s):  
E. Madonini ◽  
F. Agostinis ◽  
R. Barra ◽  
A. Berra ◽  
D. Donadio ◽  
...  
Keyword(s):  
Skin Tests ◽  
Clinical Effects ◽  
Allergen Specific Immunotherapy ◽  
Multicentric Study ◽  
Length Of Treatment ◽  
Asthma Patients ◽  
Clinical Benefits ◽  
Preventive Effects

There is now an increasing body of evidence to support the practice of allergen-specific sublingual-swallow immunotherapy (SLIT) in the treatment of IgE-mediated respiratory allergies. Recent studies on traditional injection therapy have pointed out that this form of treatment is not only capable to decrease actual allergic symptoms, but may also have long-term clinical and preventive effects and may influence atopy natural history. In the year 2000, our group published a retrospective, multicenter study showing the efficacy and safety of SLIT in a survey of 302 patients. We now carried out a second study on the same patients, with the aim of investigating long-term and preventive effects of SLIT. Beside the well-known safety and efficacy of this treatment (80.8 % of patients reported clinical benefits), SLIT proved also to elicit long term clinical effects: over a mean follow-up of 11.6 months after the end of treatment, 80.8 % of patients still mantained the previously achieved benefits. During the follow-up period, only 1 % of non-asthma patients reported an onset of respiratory symptoms, and only 9.6 % of patients undergoing new skin tests showed new sensitizations. All the clinical benefits were strongly linked to the length of treatment: patients with long-lasting benefits were treated for a mean length of 29.1 months, while patients showing a return to pre-SLIT condition were treated for a mean 13.3 months. SLIT can obtain long-term and preventive effects so far attributed to injection immunotherapy.

scholarly journals Long-Term Clinical and Immunological Effects of Repeated Mesenchymal Stem Cell Injections in Patients With Progressive Forms of Multiple Sclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Panayiota Petrou ◽  
Ibrahim Kassis ◽  
Ariel Ginzberg ◽  
Michel Halimi ◽  
Nour Yaghmour ◽  
...  
Keyword(s):  
Clinical Effects ◽  
Clinical Trial Registration ◽  
Clinical Benefits ◽  
Immunological Effects ◽  
The Mean ◽  
Edss Score ◽  
Open Prospective Study ◽  
Proliferative Ability

Background: Mesenchymal stem cells (MSC) were shown to possess immunomodulatory and neurotrophic effects. Our previous trials, have shown that intrathecal (IT) and intravenous (IV) administration of MSCs were safe and provided indications of beneficial clinical effects.Methods: This is an open prospective study to evaluate the safety and the long-term clinical and immunological effects of multiple injections of autologous MSCs in 24 patients with active-progressive MS. At inclusion, the mean age of the patients was 47.0 ± 9.22, and the mean EDSS score was 6.75 ± 0.68 (range: 5.5–7.5). Patients were initially treated with 1 ×106 MSCS/kg of body weight (IT + IV) and subsequently with up to additional eight courses of MSCs, at intervals of 6–12 months. The duration of the trial was 4 years.Results: No serious, treatment-related adverse events were observed during the follow-up period. Twenty-two of the 24 patients were either stable or improved at the last follow-up visit. Ten patients had a lower than baseline EDSS at the last follow-up (nine were among those who received >2 treatments and one in the subgroup of ≤ 2 treatments, p = 0.04). The mean EDSS score reduced from 6.75 ± 0.68 at baseline to 6.42 ± 0.84 at the last visit, during a median follow-up period of 27.8 months (p = 0.028). Immunological follow-up showed a transient upregulation of CD4+CD25+FoxP3+ cells and downregulation of the proliferative ability of lymphocytes.Conclusions: Repeated MSC treatments in patients with progressive MS were shown safe at the short/intermediate term and induced clinical benefits (especially in patients treated with >2 injections) that lasted for up to 4 years, paralleled by short-term immunomodulatory effects.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04823000.

scholarly journals Evaluation of Clinical Effects and Tolerability of Cefepime in Hospital Settings in Bangladesh

2018 ◽  
Vol 27 (1) ◽  
pp. 17-24
Author(s):  
Mohammad Manirul Islam ◽  
ABM Fazlur Rahman ◽  
Bidhan C Das ◽  
Mohammad Zaid Hossain ◽  
Kumkum Pervin
Keyword(s):  
Treatment Strategy ◽  
Clinical Success ◽  
Outcome Evaluation ◽  
Fourth Generation ◽  
Outcome Analysis ◽  
Clinical Effects ◽  
Serious Adverse Events ◽  
The Mean ◽  
Tract Infections

Background: Cefepime a parenteral fourth generation cephalosporin is active against many Gram-positive and Gram-negative organisms. The study aimed to evaluate the effectiveness and tolerability of cefepime when used alone or in combination with other antibiotics for the treatment of infections in hospital settings in Bangladesh. Methods: This multi-centric, prospective observational study enrolled eligible males and females >18 years who had been prescribe cefepime as a part of treatment strategy regardless of the purpose of hospitalization. No therapeutic intervention was implied rather treatment strategy and dosage of cefepime was on individual physician’s discretion as per routine clinical practice. Percentage of patients who would have clinical success in terms of cure, improvement or failure was evaluated during the end of cefepime therapy. Patient’s overall tolerability to cefepime therapy as excellent, good, satisfactory and poor was considered for safety assessment. The outcome analysis was done in patients’ available follow-up at the end of therapy. Results: A total of 1000 patients were enrolled in this study between March 2013 and September 2014 in different hospital settings of Internal Medicine, Coronary Care Unit, Orthopedic, Intensive Care Unit, Surgery and Nephrology (51.6%, 17.8%, 15.2%, 11.6%, 2.2% & 1.6%). The mean (±SD) age of patients was 50.1 (±14.7) years (range 18-100) and 64.3% were males. Bacteriology or culture sensitivity report was available with 67 patients at baseline and most common microorganisms were E coli (35.8%), Pseudomonas sp. (20.8%), Klebsiella sp. (16.4%), Staphylococcus sp. (11.9%) and Streptococcus sp. (7.4%) and others (7.4). Cefepime was used as medical or surgical prophylaxis in 52.2% of the patients. In 47.8% of patients cefepime was prescribed for treatment of infections including lower respiratory tract infections, trauma / fracture related wound infections, urinary tract infections, treatment of gangrene and septicaemia (39.7%, 31.8%, 10.9%, 9.2% & 8.4%). The dose of cefepime was 500 mg to 2 gm twice or thrice daily with the mean (±SD) duration of 6.1 (±2.1) days (range 2-14). 55 patients were lost to follow-up at the end of therapy and 25 died due to congestive heart failure, renal or hepatic failure and multiple organ failure. On physicians end of therapy overall clinical outcome evaluation, 70.7% of the patients were cured, 24.9% improved and 4.4% had no improvement or worsening in the sign and symptoms. Overall tolerability of cefepime was good in 56.6 %, excellent in 28.7%, satisfactory in 9.8% and poor in 4.9% of patients. No non-serious adverse event was reported in this study. Nonetheless, the 25 death cases would be considered as serious adverse events. Conclusion: Cefepime therapy in different indications was effective in hospitalized patients for cure (67.5 %) or improvement (26.9 %) of sign and symptoms. It was also well tolerated in 85.3% of patients as assessed by the treating physicians J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 17-24

scholarly journals Can We Boost Treatment Adherence to an Online Transdiagnostic Intervention by Adding Self-Enhancement Strategies? Results From a Randomized Controlled Non-inferiority Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Andreea Bogdana Isbăşoiu ◽  
Bogdan Tudor Tulbure ◽  
Andrei Rusu ◽  
Florin Alin Sava
Keyword(s):  
Treatment Adherence ◽  
The Self ◽  
Self Concept ◽  
Short Version ◽  
Generalized Anxiety ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Self Compassion ◽  
Secondary Outcomes

Background: Internet-delivered psychotherapy represents an impactful large-scale solution for addressing psychological disorders. In spite of its flexibility and scalability, the fact that the ones in need have to initiate and sustain the curse of the treatment by themselves comes with considerable downsides in terms of treatment adherence. One solution could be to increase the ease of use and attractivity of the strategies and assignments from such programs. The present study aims to address this issue by incorporating a series of self-oriented strategies to the validated internet-delivered short version of the Unified Protocol (UP). By this mean we intend to complement the symptom-focused assignments, which may be more suitable in a therapist assisted context, with ones designed for self-enhancement, which may be easier approached as self-initiated. Based on a randomized controlled non-inferiority trial we compared the modified version of the UP with the standard short version.Method: The trial design was factorial, with two parallel arms and three measurement moments (baseline, post-intervention and 6-months follow-up). A total of 284 participants were randomly assigned to the intervention or the active control groups. The intervention group (baseline n = 142) received the self-enhanced nine modules of the UP (Self-enhanced 9UP) while the active control (baseline n = 142) received the standard nine modules (9UP). The newly added techniques were inspired by the acceptance and commitment therapy and were specific for self-concepts such as self-compassion or unconditional self-acceptance. Both programs lasted for 9 weeks. The non-inferiority of the Self-enhanced 9UP was tested against a margin of d = −0.35, on the following primary outcome measures: Patient Health Questionnaire 9 (PHQ9) – operationalization for depression; Generalized Anxiety Disorder 7 (GAD7) – operationalization for generalized anxiety or worry; Social Phobia Inventory (SPIN) – operationalization for social phobia; and Panic Disorder Severity Scale-Self Report (PDSS-SR) – that showed participants’ level of panic. Treatment adherence was assessed through the drop-out analyses and the engagement in completing the homework assignments. Secondary outcome measures included several self-concept measures: Self-Compassion Scale (SCS); Rosenberg Self-Esteem Scale (RSES); Unconditional Self-Acceptance Questionnaire (USAQ); New General Self-Efficacy Scale (NGSE); and Self-Concept Clarity Scale (SCCS). On the secondary outcomes we explored the potential boost of effectiveness produced by the newly added self-enhancement components.Results: The dropout rates were similar in both groups (approximately 45%) and high overall. Adherence to treatment assignments was also modest and similar between groups (on average participants completed approximately half of the tasks), without a statistically significant bias toward the self-enhancement ones. Overall, both the intention-to-treat and completers analyses yielded no significant group by time interactions for any of the post-intervention and follow-up measurements, but a few non-inferiority analyses suggested that the Self-enhanced 9UP had a significantly weaker effectiveness than the standard 9UP. Within-group analyses showed significant alleviations on all the primary and secondary outcomes for both groups. The effect size estimates were mainly medium and high, and their magnitude tended to be kept also at 6-months follow-up.Discussion: We failed to increase treatment adherence, but we found support with some exceptions, for the non-inferiority hypothesis. Hence, the alterations performed to the 9UP protocol, although they did not boost the treatment attractiveness, they also did not decrease the treatment effectiveness as suggested by most non-inferiority analyses. Likewise, the gain on self-concepts was produced by both groups. Hence, the short version of the UP seems to have the potential of effectively alleviating a larger palette of psychological variables associated with mental health symptoms than previously known. Even though our main objective was only partially achieved, these secondary results are insightful and could open new avenues of research.Clinical Trial Registration: This trial has been registered at ClinicalTrials.Gov (NCT03917550; 17 April 2019; https://clinicaltrials.gov/ct2/show/NCT03917550).

scholarly journals T100. BELIEFS ABOUT THE SELF AND OTHERS IN PARANOIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S269-S269
Author(s):  
Poppy Brown ◽  
Felicity Waite ◽  
Aitor Rovira ◽  
Alecia Nickless ◽  
Daniel Freeman
Keyword(s):  
The Self ◽  
Control Group ◽  
Social Environments ◽  
Paranoid Ideation ◽  
Image Study ◽  
Loving Kindness ◽  
Self Compassion ◽  
Negative Beliefs ◽  
Randomised Controlled ◽  
Embedded Tests

Abstract Background Compassionate imagery may be one method of targeting the negative beliefs about the self and others that paranoid thoughts build upon. This talk presents two interventionist-causal studies testing this hypothesis, one targeting compassion for the self and one targeting compassion for others. These studies form part of the programme of work testing the manipulation of putative causal factors in paranoia, in individuals from the general population scoring highly for current paranoid ideation. Methods Two hundred such individuals were recruited. The studies used a randomised controlled experimental design, with embedded tests for mediation. Study one targeted self-compassion via creation of a compassionate coach image. Study two targeted compassion for others via loving kindness meditation. Individuals repeatedly entered neutral virtual reality social environments and changes in compassion and paranoia were assessed. Results Study one showed that, in comparison to the control group, those who practised compassionate coach imagery significantly increased in self-compassion (group difference=2.12, C.I.=1.57;2.67, p=<0.0001, d=1.4) and decreased in paranoia (group difference=-1.73, C.I.=-2.48;-0.98, p=<0.0001, d=0.8). Mediation analysis indicated that change in self-compassion explained 57% of the change in paranoia. Study two showed that in comparison to the control group, those who practised loving kindness meditation significantly increased their compassion for others (group difference=3.26, 95% C.I.: 2.72;3.80, p=<0.0001, d=1.7), and decreased their paranoia (group difference=-1.70, C.I.=-2.51;-0.89, p=<0.0001, d=0.8). Change in compassion for others explained 63% of the change in paranoia. Discussion Together, the studies suggest that targeting negative beliefs about the self and others using compassionate imagery causes reductions in paranoia, which may have benefits in clinical populations.

scholarly journals Applying Self-Compassion in Sport: An Intervention With Women Athletes

2013 ◽  
Vol 35 (5) ◽  
pp. 514-524 ◽  
Author(s):  
Amber D. Mosewich ◽  
Peter R.E. Crocker ◽  
Kent C. Kowalski ◽  
Anita DeLongis
Keyword(s):  
Women Athletes ◽  
The Self ◽  
Control Group ◽  
Negative Events ◽  
Self Compassion ◽  
Cognitive States ◽  
Concern Over Mistakes ◽  
Post Hoc ◽  
Attention Control Group

This study investigated the effects of a self-compassion intervention on negative cognitive states and selfcompassion in varsity women athletes. Athletes who self-identified as being self-critical were randomly assigned to a self-compassion intervention (n = 29) or attention control group (n = 22). The self-compassion intervention consisted of a psychoeducation session and writing components completed over a 7-day period. Measures of self-compassion, state self-criticism, state rumination, and concern over mistakes were collected pretreatment, at 1 week posttreatment, and at a 4-week follow-up. A mixed factorial MANOVA with follow-up post hoc tests demonstrated moderate-to-strong effects for the intervention at posttest and follow-up (Wilks’s Λ = .566, F (8, 42) = 4.03, p < .01, η2 = .43). The findings demonstrate the effectiveness of the self-compassion intervention in managing self-criticism, rumination, and concern over mistakes. Fostering a self-compassionate frame of mind is a potential coping resource for women athletes dealing with negative events in sport.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

scholarly journals Real-World Outcomes of Ivacaftor Treatment in People with Cystic Fibrosis: A Systematic Review

2021 ◽  
Vol 10 (7) ◽  
pp. 1527
Author(s):  
Jamie Duckers ◽  
Beth Lesher ◽  
Teja Thorat ◽  
Eleanor Lucas ◽  
Lisa J. McGarry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cystic Fibrosis ◽  
Real World ◽  
Safety Profile ◽  
Clinical Trial Data ◽  
Patient Characteristics ◽  
Healthcare Resource Utilization ◽  
Patient Reported ◽  
Clinical Benefits

Cystic fibrosis (CF) is a rare, progressive, multi-organ genetic disease. Ivacaftor, a small-molecule CF transmembrane conductance regulator modulator, was the first medication to treat the underlying cause of CF. Since its approval, real-world clinical experience on the use of ivacaftor has been documented in large registries and smaller studies. Here, we systematically review data from real-world observational studies of ivacaftor treatment in people with CF (pwCF). Searches of MEDLINE and Embase identified 368 publications reporting real-world studies that enrolled six or more pwCF treated with ivacaftor published between January 2012 and September 2019. Overall, 75 publications providing data from 57 unique studies met inclusion criteria and were reviewed. Studies reporting within-group change for pwCF treated with ivacaftor consistently showed improvements in lung function, nutritional parameters, and patient-reported respiratory and sino-nasal symptoms. Benefits were evident as early as 1 month following ivacaftor initiation and were sustained over long-term follow-up. Decreases in pulmonary exacerbations, Pseudomonas aeruginosa prevalence, and healthcare resource utilization also were reported for up to 66 months following ivacaftor initiation. In studies comparing ivacaftor treatment to modulator untreated comparator groups, clinical benefits similarly were reported as were decreases in mortality, organ-transplantation, and CF-related complications. The safety profile of ivacaftor observed in these real-world studies was consistent with the well-established safety profile based on clinical trial data. Our systematic review of real-world studies shows ivacaftor treatment in pwCF results in highly consistent and sustained clinical benefit in both pulmonary and non-pulmonary outcomes across various geographies, study designs, patient characteristics, and follow-up durations, confirming and expanding upon evidence from clinical trials.

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