Single Subcutaneous Ketamine Dose Followed by Oral Ketamine for Depression Symptoms in Hospice Patients: A Case Series

2021 ◽  
pp. 1-10
Author(s):  
Natalie M. Latuga ◽  
Debra L. Luczkiewicz ◽  
Pei C. Grant ◽  
Kathryn Levy ◽  
Eric Hansen ◽  
...  
Keyword(s):  
Case Series ◽  
Depression Symptoms ◽  
Oral Ketamine ◽  
Hospice Patients

scholarly journals Exposure therapy for PTSD during pregnancy: a feasibility, acceptability, and case series study of Narrative Exposure Therapy (NET)

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Natalie R. Stevens ◽  
Michelle L. Miller ◽  
Christina Soibatian ◽  
Caitlin Otwell ◽  
Anne K. Rufa ◽  
...  
Keyword(s):  
Mental Health Treatment ◽  
Exposure Therapy ◽  
Case Series ◽  
Perinatal Outcomes ◽  
Post Treatment ◽  
Depression Symptoms ◽  
Narrative Exposure Therapy ◽  
Ptsd Treatment ◽  
Case Series Study ◽  
Increased Risk

Abstract Background Prenatal posttraumatic stress disorder (PTSD) is a significant complication of pregnancy linked to increased risk of adverse perinatal outcomes. Although 1 in 5 pregnant trauma-exposed individuals have PTSD, most PTSD treatment trials exclude participants who are pregnant, and none focus on treatment specifically during pregnancy. Moreover, access to mental health treatment is particularly challenging in low-resource settings with high rates of trauma. This study examined implementation of Narrative Exposure Therapy (NET), a short-term evidence-based PTSD treatment, in an urban prenatal care setting. Partial telehealth delivery was used to increase accessibility. Study aims were to examine (a) feasibility, (b) acceptability, and (c) case-based treatment outcomes associated with NET participation. Method Eight pregnant participants (median age = 27, median gestational week in pregnancy = 22.5) received up to six sessions of NET with partial telehealth delivery. PTSD and depression symptoms were assessed at pre-treatment intake (T1), at each session (T2), and 1-week post-treatment (T3). A multiple case study approach was used to examine recruitment and engagement, retention, treatment completion, treatment barriers, use of telehealth, participants’ experiences of treatment, and PTSD and depression symptoms. Results Nine of the 16 participants (56%) who were invited to participate engaged in treatment, and one dropped out after the first session. Eight participants completed the minimum “dose” of 4 NET sessions (N = 8/9, 89%). Seven participants gave the highest ratings of treatment acceptability. The most frequently reported barriers to treatment were competing priorities of work and caring for other children. Pre-post treatment symptom measures revealed clinically meaningful change in PTSD severity for nearly all participants (7/8, 88%). Conclusions Results suggest that a brief exposure therapy PTSD treatment can be successfully implemented during pregnancy, suggesting promising results for conducting a larger-scale investigation. Trial registration ClinicalTrials.gov, NCT04525469. Registered 20 August 2020–Retrospectively registered, https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U00058T2&ts=3&sid=S000A59A&cx=-w1vnvn

scholarly journals Comparative Effectiveness of Multiple Psychological Interventions for Psychological Crisis in People Affected by Coronavirus Disease 2019: A Bayesian Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yang Yang ◽  
Shaodan Sun ◽  
Shaowen Hu ◽  
Chunzhi Tang ◽  
Yimin Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bayesian Network ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
Psychological Interventions ◽  
Self Rating ◽  
Better Than

Objective: The objective of our current research is to compare the different psychological interventions and distinguish the most effective way to treat psychological crisis according to different clinical manifestations in people affected by coronavirus disease 2019 (COVID-19). No previous systematic review has provided a comprehensive overview by performing a Bayesian network meta-analysis of this current topic.Method: A systematic review and a Bayesian network meta-analysis were conducted on randomized controlled trials (RCTs), non-RCTs, case–control studies, self-controlled case series (SCCS), cohort studies, and cross-sectional studies of all the available interventions for psychological crisis in people affected by COVID-19. We searched the electronic databases EMBASE, PubMed, Web of Science, PsycINFO, and Cochrane Library, as well as the Chinese databases such as Sinomed, Chinese Biomedicine Literature (CBM), Chinese Scientific Journal Database (VIP), WanFang Database, and China National Knowledge Infrastructure (CNKI), from 2019 to April 30, 2020. The main outcomes were self-rating anxiety scale (SAS), self-rating depression scale (SDS), patient health questionnaire (PHQ-9), and symptom checklist (SCL-90). The study is registered with Inplasy, number 202050076.Result: Sixteen self-controlled case series (SCCS) comprising 1,147 participants compared five different psychological interventions with four different measurement scales were included in this study. For effectiveness, all the psychological therapies were significantly more effective than before intervention. Our results showed that supportive therapy (ST), which is adjusted to the COVID-19-related mental crisis, is the best treatment compared with behavioral therapy (BT), nursing-based psychological therapy (NBPT), traditional Chinese medicine therapy (TCMT), and COVID-19-related standard training (CRST) at reducing the anxiety-related symptoms assessed by SAS. When measured by SDS, BT was better than ST and NBPT treatment for reducing the depression symptoms. And ST was better than BT and ST+BT as assessed by PHQ-9. In the end, the last network meta-analysis indicated that NBPT was more effective than ST by the measurement of SCL-90.Conclusion: Our research suggested the potential effectiveness of psychological interventions for decreasing psychological crisis in people affected by COVID-19 and try to introduce the best effective treatment options for clinical practice according to the clinical manifestations of psychological problems, but further confirmation from high-quality RCTs is needed.

Amplification of Positivity Therapy for Co-occurring Alcohol Use Disorder with Depression and Anxiety Symptoms: Pilot Feasibility Study and Case Series

2021 ◽  
pp. 014544552110305
Author(s):  
Elisabeth Akeman ◽  
Evan White ◽  
Kate Wolitzky-Taylor ◽  
Jessica Santiago ◽  
Timothy J. McDermott ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Randomized Clinical Trials ◽  
Case Series ◽  
Depression Symptoms ◽  
Treatment Implementation ◽  
Significant Depression ◽  
Positive Valence ◽  
Clinically Significant ◽  
Intent To Treat

Positive valence system dysregulation is a relatively unexplored transdiagnostic mechanism and potential treatment target underpinning alcohol use and anxiety and depression symptoms. The current study examined the feasibility and potential benefit of a behavioral intervention focused on amplification of positivity (AMP) with eight adults (five female) diagnosed with alcohol use disorder and clinically significant depression or anxiety (ClinicalTrials.gov: NCT04278365). AMP for alcohol use (AMP-A) was delivered in 11 individual sessions involving positive activity interventions integrated alongside psychoeducation and alcohol use monitoring. Case descriptions are provided to illustrate treatment implementation. Treatment credibility and acceptability, participant endorsement of the therapy, and homework compliance were rated moderate to high. Exploratory, intent-to-treat analyses suggested medium to large effect sizes for post-treatment improvements in alcohol use, depression, anxiety, and positive affect. Results provide initial evidence of feasibility and acceptability of AMP-A and will be useful for informing future randomized clinical trials to examine clinical efficacy.

scholarly journals Predicting therapeutic response to oral ketamine for chronic suicidal ideation: a Bayesian network for clinical decision support

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Denise Beaudequin ◽  
Adem T. Can ◽  
Megan Dutton ◽  
Monique Jones ◽  
Cyrana Gallay ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Suicidal Ideation ◽  
Bayesian Network ◽  
Roc Curve ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Depression Symptoms ◽  
Oral Ketamine ◽  
Pre Treatment

Abstract Background The glutamatergic modulator ketamine has been shown to result in rapid reductions in both suicidal ideation (SI) and depressive symptoms in clinical trials. There is a practical need for identification of pre-treatment predictors of ketamine response. Previous studies indicate links between treatment response and body mass index (BMI), depression symptoms and previous suicide attempts. Our aim was to explore the use of clinical and demographic factors to predict response to serial doses of oral ketamine for chronic suicidal ideation. Methods Thirty-two participants completed the Oral Ketamine Trial on Suicidality (OKTOS). Data for the current study were drawn from pre-treatment and follow-up time-points of OKTOS. Only clinical and sociodemographic variables were included in this analysis. Data were used to create a proof of concept Bayesian network (BN) model of variables predicting prolonged response to oral ketamine, as defined by the Beck Scale for Suicide Ideation (BSS). Results The network of potential predictors of response was evaluated using receiver operating characteristic (ROC) curve analyses. A combination of nine demographic and clinical variables predicted prolonged ketamine response, with strong contributions from BMI, Social and Occupational Functioning Assessment Scale (SOFAS), Montgomery-Asberg Depression Rating Scale (MADRS), number of suicide attempts, employment status and age. We evaluated and optimised the proposed network to increase the area under the ROC curve (AUC). The performance evaluation demonstrated that the BN predicted prolonged ketamine response with 97% accuracy, and AUC = 0.87. Conclusions At present, validated tools to facilitate risk assessment are infrequently used in psychiatric practice. Pre-treatment assessment of individuals’ likelihood of response to oral ketamine for chronic suicidal ideation could be beneficial in making more informed decisions about likelihood of success for this treatment course. Clinical trials registration number ACTRN12618001412224, retrospectively registered 23/8/2018.

Prevalence of Self-Reported Depression Symptoms and Perceived Anxiety Among Community-Dwelling U.S. Adults Reporting Tinnitus

2020 ◽  
Vol 5 (4) ◽  
pp. 959-970
Author(s):  
Kelly M. Reavis ◽  
James A. Henry ◽  
Lynn M. Marshall ◽  
Kathleen F. Carlson
Keyword(s):  
Mental Health ◽  
Fold Increase ◽  
Community Dwelling ◽  
Self Report ◽  
Depression Symptoms ◽  
Community Based Interventions ◽  
Data Set ◽  
Health Distress ◽  
Validated Questionnaire ◽  
Mental Health Distress

Purpose The aim of this study was to examine the relationship between tinnitus and self-reported mental health distress, namely, depression symptoms and perceived anxiety, in adults who participated in the National Health and Nutrition Examinations Survey between 2009 and 2012. A secondary aim was to determine if a history of serving in the military modified the associations between tinnitus and mental health distress. Method This was a cross-sectional study design of a national data set that included 5,550 U.S. community-dwelling adults ages 20 years and older, 12.7% of whom were military Veterans. Bivariable and multivariable logistic regression was used to estimate the association between tinnitus and mental health distress. All measures were based on self-report. Tinnitus and perceived anxiety were each assessed using a single question. Depression symptoms were assessed using the Patient Health Questionnaire, a validated questionnaire. Multivariable regression models were adjusted for key demographic and health factors, including self-reported hearing ability. Results Prevalence of tinnitus was 15%. Compared to adults without tinnitus, adults with tinnitus had a 1.8-fold increase in depression symptoms and a 1.5-fold increase in perceived anxiety after adjusting for potential confounders. Military Veteran status did not modify these observed associations. Conclusions Findings revealed an association between tinnitus and both depression symptoms and perceived anxiety, independent of potential confounders, among both Veterans and non-Veterans. These results suggest, on a population level, that individuals with tinnitus have a greater burden of perceived mental health distress and may benefit from interdisciplinary health care, self-help, and community-based interventions. Supplemental Material https://doi.org/10.23641/asha.12568475

Abstract #856 A Case Series Review of Clinical and Biochemical Characteristics of Pituitary Abcess in Mexican Patients

2018 ◽  
Vol 24 ◽  
pp. 202-203
Author(s):  
Mireya Perez-Guzman ◽  
Alfredo Nava de la Vega ◽  
Arturo Pena Velarde ◽  
Tania Raisha Torres Victoria ◽  
Froylan Martinez-Sanchez ◽  
...  
Keyword(s):  
Case Series ◽  
Biochemical Characteristics ◽  
Mexican Patients

Cannabis-associated arteritis

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Grotenhermen
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Cardiovascular Effects ◽  
Causative Factor ◽  
Cannabis Use ◽  
Thromboangiitis Obliterans ◽  
Pathological Features ◽  
Scientific Support ◽  
Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term “cannabis arteritis” should be avoided until or unless more convincing scientific support is forthcoming.

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