Psychological treatments

Author(s):  
Philip Wilkinson

This introduction to psychological treatments reviews the range and applications of talking therapies with older people. Reminiscence therapy is described and reference is made to the therapies addressed in later chapters. The potential benefits of psychological therapy are discussed with guidance on applying findings from clinical trials to individual patients. The wider benefits of an understanding of psychological approaches are outlined; these include use of psychological formulations and augmenting the effects of psychotropic medication. The status of psychological treatment services for older people is reviewed and barriers to access are considered.

2021 ◽  
Author(s):  
Rob Saunders ◽  
Joshua Eusty Jonathan Buckman ◽  
Judy Leibowitz ◽  
John Cape ◽  
Stephen Pilling

BackgroundGeneral population surveys have shown that some groups, particularly young women experienced increased distress during nationally mandated restrictions to control the spread of COVID-19. However, there has been limited research on such trends among people with pre-existing mental health conditions, leaving mental health services ill equipped to plan for currents and future lockdowns.MethodsMean weekly scores on the GAD-7 and PHQ-9 between 01/01/2020-22/06/2020 (n=9,538 individuals) for all patients of two psychological treatment services in London, were compared to mean weekly scores from the same time periods in 2017-2019 (n=37,849). The proportion of scores which were above the clinical thresholds for ‘caseness’ each week were compared, and scores between groups based on gender, age group, and ethnicity, were also compared. ResultsConfirmed community transmission in the UK (26/02/2020-03/03/2020) and the announcement of the national ‘lockdown’ (23/03/2020) were associated with significant increases in anxiety symptom scores. ‘Lockdown’ was associated with a decrease in depression scores. These changes were not maintained during lockdown. Significant increases in depression and anxiety were observed at week 23, as restrictions were eased.LimitationsThis was an exploratory analysis in two services only. Residual confounding and selection biases cannot be ruled out.ConclusionsDifferences in the weekly average symptom scores were short-term; they did not continue throughout ‘lockdown’ as might have been expected, except among older people. Replication of this study in other settings and investigating the potential benefits of more regular reviews or more intensive treatments for older adults seeking support, are warranted.


Author(s):  
Philip Wilkinson ◽  
Ken Laidlaw

This introductory chapter provides a summary of the range of psychological treatments used with older people, and the main clinical applications of each treatment. It reviews possible barriers to uptake of psychological treatment by older people and how these barriers may be overcome. It provides an overview of the range of efficacious psychological treatments for older people with consideration of indication, access, and adaptation, and then discusses different modes of delivering treatment, including collaborative care models. It then reviews the modification of psychological treatments for working with people experiencing cognitive impairment and it briefly covers the approaches to working in dementia care.


2019 ◽  
Vol 20 (13) ◽  
pp. 1108-1121 ◽  
Author(s):  
Miriam Dibo ◽  
Eduardo C. Battocchio ◽  
Lucas M. dos Santos Souza ◽  
Matheus D. Veloso da Silva ◽  
Bruna K. Banin-Hirata ◽  
...  

The epidemiological impact of viral diseases, combined with the emergence and reemergence of some viruses, and the difficulties in identifying effective therapies, have encouraged several studies to develop new therapeutic strategies for viral infections. In this context, the use of immunotherapy for the treatment of viral diseases is increasing. One of the strategies of immunotherapy is the use of antibodies, particularly the monoclonal antibodies (mAbs) and multi-specific antibodies, which bind directly to the viral antigen and bring about activation of the immune system. With current advancements in science and technology, several such antibodies are being tested, and some are already approved and are undergoing clinical trials. The present work aims to review the status of mAb development for the treatment of viral diseases.


Pathogens ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 1073
Author(s):  
Juan-Carlos Saiz

West Nile virus (WNV) is a widely distributed enveloped flavivirus transmitted by mosquitoes, which main hosts are birds. The virus sporadically infects equids and humans with serious economic and health consequences, as infected individuals can develop a severe neuroinvasive disease that can even lead to death. Nowadays, no WNV-specific therapy is available and vaccines are only licensed for use in horses but not for humans. While several methodologies for WNV vaccine development have been successfully applied and have contributed to significantly reducing its incidence in horses in the US, none have progressed to phase III clinical trials in humans. This review addresses the status of WNV vaccines for horses, birds, and humans, summarizing and discussing the challenges they face for their clinical advance and their introduction to the market.


2021 ◽  
pp. 1-11
Author(s):  
Maxi Weber ◽  
Sarah Schumacher ◽  
Wiebke Hannig ◽  
Jürgen Barth ◽  
Annett Lotzin ◽  
...  

Abstract Several types of psychological treatment for posttraumatic stress disorder (PTSD) are considered well established and effective, but evidence of their long-term efficacy is limited. This systematic review and meta-analysis aimed to investigate the long-term outcomes across psychological treatments for PTSD. MEDLINE, Cochrane Library, PTSDpubs, PsycINFO, PSYNDEX, and related articles were searched for randomized controlled trials with at least 12 months of follow-up. Twenty-two studies (N = 2638) met inclusion criteria, and 43 comparisons of cognitive behavioral therapy (CBT) were available at follow-up. Active treatments for PTSD yielded large effect sizes from pretest to follow-up and a small controlled effect size compared with non-directive control groups at follow-up. Trauma-focused treatment (TFT) and non-TFT showed large improvements from pretest to follow-up, and effect sizes did not significantly differ from each other. Active treatments for comorbid depressive symptoms revealed small to medium effect sizes at follow-up, and improved PTSD and depressive symptoms remained stable from treatment end to follow-up. Military personnel, low proportion of female patients, and self-rated PTSD measures were associated with decreased effect sizes for PTSD at follow-up. The findings suggest that CBT for PTSD is efficacious in the long term. Future studies are needed to determine the lasting efficacy of other psychological treatments and to confirm benefits beyond 12-month follow-up.


Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 551
Author(s):  
Sara Scarpini ◽  
Francesca Morigi ◽  
Ludovica Betti ◽  
Arianna Dondi ◽  
Carlotta Biagi ◽  
...  

Human cytomegalovirus (hCMV) is one of the most common causes of congenital infection in the post-rubella era, representing a major public health concern. Although most cases are asymptomatic in the neonatal period, congenital CMV (cCMV) disease can result in permanent impairment of cognitive development and represents the leading cause of non-genetic sensorineural hearing loss. Moreover, even if hCMV mostly causes asymptomatic or pauci-symptomatic infections in immunocompetent hosts, it may lead to severe and life-threatening disease in immunocompromised patients. Since immunity reduces the severity of disease, in the last years, the development of an effective and safe hCMV vaccine has been of great interest to pharmacologic researchers. Both hCMV live vaccines—e.g., live-attenuated, chimeric, viral-based—and non-living ones—subunit, RNA-based, virus-like particles, plasmid-based DNA—have been investigated. Encouraging data are emerging from clinical trials, but a hCMV vaccine has not been licensed yet. Major difficulties in the development of a satisfactory vaccine include hCMV’s capacity to evade the immune response, unclear immune correlates for protection, low number of available animal models, and insufficient general awareness. Moreover, there is a need to determine which may be the best target populations for vaccine administration. The aim of the present paper is to examine the status of hCMV vaccines undergoing clinical trials and understand barriers limiting their development.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1543-1543
Author(s):  
Peter Blankenship ◽  
David DeLaRosa ◽  
Marc Burris ◽  
Steven Cusson ◽  
Kayla Hendricks ◽  
...  

1543 Background: Tissue requirements in oncology clinical trials are increasingly complex due to prescreening protocols for patient selection and serial biopsies to understand molecular-level treatment effects. Novel solutions for tissue processing are necessary for timely tissue procurement. Based on these needs, we developed a Tissue Tracker (TT), a comprehensive database for study-related tissue tasks at our high-volume clinical trial center. Methods: In this Microsoft Access database, patients are assigned an ID within the TT that is associated with their name, medical record number, and study that follows their request to external users: pathology departments, clinical trial coordinators and data team members. To complete tasks in the TT, relevant information is required to update the status. Due to the high number of archival tissue requests from unique pathology labs, the TT has a “Follow-Up Dashboard” that organizes information needed to conduct follow-up on all archival samples with the status “Requested”. This results in an autogenerated email and pdf report sent to necessary teams. The TT also includes a kit inventory system and a real-time read only version formatted for interdepartmental communication, metric reporting, and other data-driven efforts. The primary outcome in this study was to evaluate our average turnaround time (ATAT: average time from request to shipment) for archival and fresh tissue samples before and after TT development. Results: Before implementing the TT, between March 2016 and March 2018, we processed 2676 archival requests from 235 unique source labs resulting in 2040 shipments with an ATAT of 19.29 days. We also processed 1099 fresh biopsies resulting in 944 shipments with an ATAT of 7.72 days. After TT implementation, between April 2018 and April 2020, we processed 2664 archival requests from 204 unique source labs resulting in 2506 shipments (+28.0%) with an ATAT of 14.78 days (-23.4%). During that same period, we processed 1795 fresh biopsies (+63.3%) resulting in 2006 shipments (+112.5%) with an ATAT of 6.85 days (-11.3%). Conclusions: Oncology clinical trials continue to evolve toward more extensive tissue requirements for prescreening and scientific exploration of on-treatment molecular profiling. Timely results are required to optimize patient trial participation. During the intervention period, our tissue sample volume and shipments increased, but the development and implementation of an automated tracking system allowed improvement in ATAT of both archival and fresh tissue. This automation not only improves end-user expectations and experiences for patients and trial sponsors but this allows our team to adapt to the increasing interest in tissue exploration.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015383 ◽  
Author(s):  
Alexandra Stuart ◽  
Amanda L Baker ◽  
Jenny Bowman ◽  
Kristen McCarter ◽  
Alexandra Mary Janice Denham ◽  
...  

IntroductionPeople who use methamphetamine (MA) regularly, often experience symptoms of mental ill health associated with the use of the drug. These include symptoms of psychosis, depression, anxiety and also cognitive deficits. Accordingly, psychological treatments aim to reduce MA use and related problems, including symptoms of mental ill health. Although there has been a substantial body of research reporting on the evidence of effectiveness of psychological treatments for MA use, there is a paucity of research addressing the effectiveness of these treatments for coexisting symptoms of mental ill health. We aim to address this gap by providing a comprehensive overview of the evidence for psychological treatments for MA use and associated symptoms of mental ill health in experimental/controlled clinical studies. In addition, a critical evaluation of study methods and the outcomes of psychological interventions on MA use and symptoms of mental ill health will be conducted.Methods and analysisThe Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement will be used to inform the methods of this review. Eight electronic peer-reviewed databases will be searched. Pilot searches have been conducted for MA literature considering controlled clinical trials only. Eligible articles will be independently assessed against inclusion criteria. Before final analyses are completed, searches will be rerun and if eligible, additional studies will be retrieved for inclusion. A quantitative synthesis of the findings will be reported where possible, and ‘summary of findings’ tables will be generated for each comparison. Risk ratios and 95% CI (dichotomous outcomes) will be calculated and/or effect size according to Cohen’s formula (continuous outcomes) for the primary outcome of each trial.Ethics and disseminationNo ethical issues are foreseen. Findings will be disseminated widely to clinicians and researchers via journal publication and conference presentation(s).Trial registration numberCRD42016043657.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Jiang ◽  
Panote Siriaraya ◽  
Dongeun Choi ◽  
Noriaki Kuwahara

In Japan, a shift in family patterns has led to a sense of social isolation among older people, which increases the risk of major neurocognitive disorder. Interventions for them using old photos to implement reminiscence therapy (RT) have been proved to be effective. A super-aged society has in turn led to a shortage of medical resources and older people prefer home care over institutional care. Therefore, there is an urgent need for volunteers to help in RT. However, the age of volunteers tends to be increasingly younger. The lack of knowledge and experience of the past for the young volunteers makes it difficult for them to select appropriate stimulated materials. To improve this situation, a library of old photos for RT was developed to support conversation between the two generations. A two-factor experiment and emotion assessment scales were designed to explore the effect of different old photo types on the fluency of conversation between the two generations and their emotion. It was found that the types of old photos have little effect on older people and that conversations were almost pleasant. However, the pleasantness of older people was enhanced when using photos that they wanted to talk about (P = 0.006). Meanwhile, pleasure in conversation of the older people increased with the attention of the young people to the topic (R = 0.304, p < 0.001). Conversely, photo type has a strong impact on young people. When photos are selected that older people do not want to talk about or photos that young people do not know the content and are not interested in, concern for the topic of young people drops dramatically. Therefore, when RT, it is important to avoid using the types of photos above that cause a drop in younger people's attention.


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