scholarly journals Cognitive behaviour therapy meets psychopharmacotherapy

2010 ◽  
Vol 3 (4) ◽  
pp. 117-131
Author(s):  
David Veale ◽  
Anna Stout

AbstractThis article provides an overview of the role of psychopharmacotherapy in common emotional disorders for cognitive behaviour therapists. We consider some of the philosophical difference between CBT and medication, when medication might interfere with CBT, when it may enhance outcome and when it might be safely discontinued. We highlight how to differentiate side-effects and symptoms of discontinuation of antidepressants from that of the underlying disorder. The scope of this article is confined to common emotional disorders and does not discuss the interaction of CBT with medication in, e.g. schizophrenia, bipolar disorder or dementia.

1996 ◽  
Vol 24 (3) ◽  
pp. 195-208 ◽  
Author(s):  
Jan Scott

There is increasing support for the use of systematic psychological interventions in combination with pharmacotherapy in the treatment of bipolar disorder (BD). A “manualised” approach, such as cognitive behaviour therapy (CBT), can be used to facilitate adjustment to the disorder, increase the acceptability of prescribed medications and reduce morbidity. This paper outlines psychosocial issues of relevance to individuals with BD and a model to engage individuals in therapy is described. A brief overview is given of some of the interventions that may help sufferers identify and control the acute symptoms of BD, reduce the risk of relapse and improve how they cope with the disorder and its treatment. The available outcome data on the use of CBT and the need for research are also noted.


2013 ◽  
Vol 51 (9) ◽  
pp. 547-554 ◽  
Author(s):  
Jennifer H. Mitchell ◽  
Carol Newall ◽  
Suzanne Broeren ◽  
Jennifer L. Hudson

2020 ◽  
Author(s):  
Olav Nielssen ◽  
Lauren Staples ◽  
Eyal Karin ◽  
Rony Kayrouz ◽  
Blake Dear ◽  
...  

Abstract BackgroundMindSpot is a national digital mental health service providing free assessment and treatment for anxiety and depression. Mindspot services have been accessed by people with a broad range of psychiatric conditions, including people who report a diagnosis of bipolar disorder (BD). There is comparatively little research reporting the outcome of internet delivered cognitive behaviour therapy (iCBT) for the depressed phase of BD (BDd), including as part of routine care. MethodDemographic characteristics, baseline scores and treatment outcomes were examined for patients who reported taking Lithium and had entries in their clinic records confirming the diagnosis of BD. Results were compared to the clinic benchmarks. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety as measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), respectively. ResultsA total of 21,745 people completed a MindSpot assessment between January 2013 and December 2019 and enrolled in a MindSpot treatment course. Of these, 124 reported that they were currently taking Lithium, of whom 83 had entries in their clinic records confirming a diagnosis of BD. Mean age of patients with confirmed BD was 43.8 years, compared to the clinic mean of 39.8 years. Their baseline symptom scores were higher than the benchmark. However, reductions in symptoms on the K-10, PHQ-9, and GAD-7 were large (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. ConclusionsMindSpot treatments were effective in treating anxiety and depression in people diagnosed with BD, and the outcomes were comparable to clinic benchmarks. Results suggest that the routine provision of iCBT can help overcome the under-use of evidence based psychological treatments of people with BDd.


2021 ◽  
Author(s):  
Olav Nielssen ◽  
Lauren Staples ◽  
Eyal Karin ◽  
rony kayrouz ◽  
Blake Dear ◽  
...  

Abstract BackgroundThere is little research reporting the outcome of internet delivered cognitive behaviour therapy (iCBT) for the depressed phase of bipolar disorder as part of routine care. MethodsDemographic information, baseline scores and treatment outcomes were examined for patients of MindSpot Clinic, a national iCBT service who reported taking Lithium and their clinic records confirming the diagnosis of bipolar disorder. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), compared to clinic benchmarks. ResultsOut of 21,745 people completed a MindSpot assessment and enrolled in a MindSpot treatment course in a 7 year period, 83 reported taking Lithium and had a confirmed a diagnosis of bipolar disorder. Reductions in symptoms were large on all measures (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. ConclusionsMindSpot treatments were effective in treating anxiety and depression in people diagnosed with bipolar, and suggest that the routine provision of iCBT can help overcome the under-use of evidence based psychological treatments of people with bipolar depression.


2013 ◽  
Vol 51 (9) ◽  
pp. 579-587 ◽  
Author(s):  
Hanne N. Fentz ◽  
Asle Hoffart ◽  
Morten B. Jensen ◽  
Mikkel Arendt ◽  
Mia S. O'Toole ◽  
...  

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Tania Perich ◽  
Philip B. Mitchell ◽  
Tanya Meade

Abstract Objective Anxiety is prominent for many people living with bipolar disorder, yet the benefit of psychological interventions in treating this co-morbidity has been minimally explored and few studies have been conducted in a group format. This study aimed to assess the feasibility and acceptability of a transdiagnostic cognitive behaviour therapy group anxiety programme (CBTA-BD) for people living with bipolar disorder. Methods Participants were recruited to take part in a 9-week group therapy programme designed to treat anxiety in bipolar disorder using cognitive behaviour therapy. They were assessed by structured interview (SCID-5 RV) to confirm the diagnosis of bipolar disorder and assessed for anxiety disorders. Self-report questionnaires—DASS (depression, anxiety, stress), ASRM (mania), STAI (state and trait anxiety) and Brief QOL.BD (quality of life) pre- and post-treatment were administered. Results Fourteen participants enrolled in the programme, with 10 participants (5 male; 5 female) completing the follow-up assessments. Two groups (one during working hours, the other outside working hours) were conducted. The programme appeared acceptable and feasible with a mean of 6.9 (77%) sessions attended, though five (50%) participants completed less than 3 weeks homework. Conclusion The transdiagnostic cognitive behaviour therapy group anxiety programme (CBTA-BD) proved feasible and acceptable for participants; however, homework compliance was poor. A larger randomised pilot study is needed to assess the benefits of the intervention on symptom measures and address homework adherence, possibly through providing support between sessions or tailoring it more specifically to participant needs.


2010 ◽  
Vol 39 (1) ◽  
pp. 77-97 ◽  
Author(s):  
Paul Cromarty ◽  
Jaime Jonsson ◽  
Steve Moorhead ◽  
Mark H. Freeston

Background: Research has clearly established the efficacy of pharmacotherapy and cognitive behaviour therapy (CBT) for depression. There is less literature addressing cessation of treatment, such as relapse during withdrawal from antidepressant medication. Aims: The current study examines the role of psychological constructs that may influence relapse or fear of relapse and lead to resumption of medication. This hypothesizes that during withdrawal individuals may misinterpret normal variations in mood and dysphoric or other symptoms as reduced levels of medication in their bodies in keeping with a simplistic rationale for antidepressants. Method: The study uses an intensive single case AB style design in three cases during the withdrawal process. All participants had been treated with CBT plus antidepressants and had previously attempted to withdraw from antidepressants. The first part of the study naturalistically tracks belief changes as medication decreases; the second examines changes in these if/when a CBT intervention is introduced due to relapse or potential near-relapse. Daily self-monitoring diaries were used to measure target variables, together with standardized questionnaires up to 6 months follow-up. Results: Changes in symptoms, appraisal of symptoms, and beliefs about medication changed throughout the study. All participants remained medication free at 6 months follow-up. Two cases received CBT intervention due to possible relapse; the third underwent an unproblematic withdrawal. Conclusions: Patterns of change are discussed in terms of current approaches to medication cessation and the role of CBT during withdrawal.


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