scholarly journals Network changes associated with transdiagnostic depressive symptom improvement following cognitive behavioral therapy in MDD and PTSD

2018 ◽  
Vol 23 (12) ◽  
pp. 2314-2323 ◽  
Author(s):  
Zhen Yang ◽  
Shi Gu ◽  
Nicolas Honnorat ◽  
Kristin A. Linn ◽  
Russell T. Shinohara ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Symptom Improvement

Cognitive Behavioral Therapy and Acceptance and Commitment Therapy as Augmentation Treatment for Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): A Case Report

2017 ◽  
Vol 41 (S1) ◽  
pp. s781-s782
Author(s):  
A. Pozza
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Antibiotic Prophylaxis ◽  
Test Score ◽  
Behavioral Therapy ◽  
Neuropsychiatric Disorders ◽  
Tic Disorders ◽  
Cognitive Behavioral ◽  
Symptom Improvement ◽  
Streptococcal Infections ◽  
Compulsive Disorder

IntroductionPaediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are a subgroup of conditions including obsessive-compulsive disorder (OCD), tic disorders, pre-pubertal and sudden onset, temporal association between streptococcal infections and associated neurological abnormalities. Some strategies were developed, including the use of antibiotic prophylaxis to prevent streptococcal-triggered exacerbations, and immunomodulatory interventions for the management of acute symptoms. Cognitive-behavioral therapy (CBT), which has been demonstrated to be the first-line treatment for OCD, can be a valid adjuvant during the difficult course of PANDAS to target acute symptoms and prevent exacerbations.ObjectivesThe study presented a case of a patient with PANDAS treated with antibiotic medication and CBT as augmentation.MethodsThe 11-year-old patient (Y-BOCS pre-test score = 32), had been hospitalized for three weeks for acute onset of PANDAS. The clinical picture consisted of asthenia, contamination fears and washing compulsions, separation anxiety, severe depression and anxiety. Pharmacotherapy involved risperidone 2 mg/die and sertraline 250 mg/die for five months combined with antibiotic prophylaxis for two years. The CBT intervention started at discharge from hospital and included psycho-education on anxiety, intensive exposure and response prevention (2 hour sessions three times a week) for twelve months, cognitive restructuring, diffusion and mindfulness for the subsequent twelve months.ResultsAnxiety and OCD symptoms substantially improved. The patient gradually started school again. Post-test score was 11 on the Y-BOCS.ConclusionsAlong with psychiatric and antibiotic medications, CBT may be a valid augmentation strategy for PANDAS to reduce risk of exacerbations and enhance symptom improvement. Limitations are discussed.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals The Temporal Associations of Therapeutic Alliance and Manual Adherence With Depressive Symptom Change in Cognitive Behavioral Therapy for Adult Outpatient Major Depression

2021 ◽  
Vol 11 ◽  
Author(s):  
Frank J. Don ◽  
Ellen Driessen ◽  
Jaap Peen ◽  
Jan Spijker ◽  
Robert J. DeRubeis ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Cognitive Behavioral Therapy ◽  
Therapeutic Alliance ◽  
Linear Mixed Model ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Symptom Change ◽  
Depression Change ◽  
Perceived Helpfulness

Background: The therapeutic alliance is considered an important causal agent of psychotherapy efficacy. However, studies in cognitive behavioral therapy (CBT) for depression have suggested that alliance might be more of a consequence rather than a cause of depressive symptom change, while adherence to CBT specific techniques was found to be associated with subsequent depression change. We aimed to add to this body of literature by assessing the temporal associations of both therapeutic alliance and manual adherence with depressive symptom change in a relatively large sample of depressed adult outpatients over the full course of CBT.Methods: Adults with a major depressive episode (n = 98) participating in a randomized clinical trial were offered 22 weeks of CBT and rated the Penn Helping Alliance Questionnaire (HAq-I) at weeks 5 and 22. Therapists rated their adherence to the CBT manual after each session and observers assessed the Hamilton Depression Rating Scale scores at weeks 0, 5, 10, and 22. Linear mixed model analyses were used to assess the associations of alliance and adherence with prior and subsequent depression change.Results: HAq-I Relationship and manual adherence ratings were not significantly associated with prior nor with subsequent depression change (p > 0.14). Prior depression change was associated with the HAq-I subscale Perceived helpfulness at the end of treatment (r = 0.30, CI = 0.03–0.56, p = 0.03).Conclusion: We were not able to replicate prior depression change in CBT for depression to be associated with improved quality of the therapeutic alliance when using a more “pure” measure of the therapeutic relationship. Limitations of this study include the subjective alliance and adherence assessments. Our findings indicate the need to appropriately distinguish between the perceived helpfulness and the relationship factors when examining therapeutic alliance.

Association between BDNF DNA methylation and symptom improvement following cognitive-behavioral therapy in stress-related mental disorders

2020 ◽  
Vol 119 ◽  
pp. 105009
Author(s):  
Eva Unternaehrer ◽  
Samuel Carleial ◽  
Anke Koebach ◽  
Anja Zeller ◽  
Gunther Meinlschmidt ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Mental Disorders ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Symptom Improvement

scholarly journals Depression-related anterior cingulate prefrontal resting state connectivity normalizes following cognitive behavioral therapy

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Spiro P. Pantazatos ◽  
Ashley Yttredahl ◽  
Harry Rubin-Falcone ◽  
Ronit Kishon ◽  
Maria A. Oquendo ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Cognitive Behavioral Therapy ◽  
Resting State ◽  
Behavioral Therapy ◽  
Post Treatment ◽  
Anterior Cingulate ◽  
Cognitive Behavioral ◽  
Symptom Improvement ◽  
Whole Brain ◽  
Before And After

Abstract Background. Aberrant activity of the subcallosal cingulate (SCC) is a common theme across pharmacologic treatment efficacy prediction studies. The functioning of the SCC in psychotherapeutic interventions is relatively understudied, as are functional differences among SCC subdivisions. We conducted functional connectivity analyses (rsFC) on resting-state functional magnetic resonance imaging (fMRI) data, collected before and after a course of cognitive behavioral therapy (CBT) in patients with major depressive disorder (MDD), using seeds from three SCC subdivisions. Methods. Resting-state data were collected from unmedicated patients with current MDD (Hamilton Depression Rating Scale-17 > 16) before and after 14-sessions of CBT monotherapy. Treatment outcome was assessed using the Beck Depression Inventory (BDI). Rostral anterior cingulate (rACC), anterior subcallosal cingulate (aSCC), and Brodmann’s area 25 (BA25) masks were used as seeds in connectivity analyses that assessed baseline rsFC and symptom severity, changes in connectivity related to symptom improvement after CBT, and prediction of treatment outcomes using whole-brain baseline connectivity. Results. Pretreatment BDI negatively correlated with pretreatment rACC ~ dorsolateral prefrontal cortex and aSCC ~ lateral prefrontal cortex rsFC. In a region-of-interest longitudinal analysis, rsFC between these regions increased post-treatment (p < 0.05FDR). In whole-brain analyses, BA25 ~ paracentral lobule and rACC ~ paracentral lobule connectivities decreased post-treatment. Whole-brain baseline rsFC with SCC did not predict clinical improvement. Conclusions. rsFC features of rACC and aSCC, but not BA25, correlated inversely with baseline depression severity, and increased following CBT. Subdivisions of SCC involved in top-down emotion regulation may be more involved in cognitive interventions, while BA25 may be more informative for interventions targeting bottom-up processing. Results emphasize the importance of subdividing the SCC in connectivity analyses.

scholarly journals Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement

Microbiome ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jonathan P. Jacobs ◽  
Arpana Gupta ◽  
Ravi R. Bhatt ◽  
Jacob Brawer ◽  
Kan Gao ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Functional Connectivity ◽  
Cognitive Behavioral Therapy ◽  
Gut Microbiome ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Symptom Improvement ◽  
Abdominal Symptoms ◽  
Irritable Bowel ◽  
The Brain

Abstract Background There is growing recognition that bidirectional signaling between the digestive tract and the brain contributes to irritable bowel syndrome (IBS). We recently showed in a large randomized controlled trial that cognitive behavioral therapy (CBT) reduces IBS symptom severity. This study investigated whether baseline brain and gut microbiome parameters predict CBT response and whether response is associated with changes in the brain-gut-microbiome (BGM) axis. Methods Eighty-four Rome III-diagnosed IBS patients receiving CBT were drawn from the Irritable Bowel Syndrome Outcome Study (IBSOS; ClinicalTrials.gov NCT00738920) for multimodal brain imaging and psychological assessments at baseline and after study completion. Fecal samples were collected at baseline and post-treatment from 34 CBT recipients for 16S rRNA gene sequencing, untargeted metabolomics, and measurement of short-chain fatty acids. Clinical measures, brain functional connectivity and microstructure, and microbiome features associated with CBT response were identified by multivariate linear and negative binomial models. Results At baseline, CBT responders had increased fecal serotonin levels, and increased Clostridiales and decreased Bacteroides compared to non-responders. A random forests classifier containing 11 microbial genera predicted CBT response with high accuracy (AUROC 0.96). Following treatment, CBT responders demonstrated reduced functional connectivity in regions of the sensorimotor, brainstem, salience, and default mode networks and changes in white matter in the basal ganglia and other structures. Brain changes correlated with microbiome shifts including Bacteroides expansion in responders. Conclusions Pre-treatment intestinal microbiota and serotonin levels were associated with CBT response, suggesting that peripheral signals from the microbiota can modulate central processes affected by CBT that generate abdominal symptoms in IBS. CBT response is characterized by co-correlated shifts in brain networks and gut microbiome that may reflect top-down effects of the brain on the microbiome during CBT.

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