Psychotherapy with couples

2012 ◽  
pp. 1369-1380
Author(s):  
Michael Crowe
Keyword(s):  
Couple Therapy ◽  
Controlled Trials ◽  
Individual Psychotherapy ◽  
Simple Relationship ◽  
Presenting Problems ◽  
Self Help ◽  
Treatment Of Depression ◽  
Proven Efficacy ◽  
Psychiatric Conditions ◽  
Anxiety Depression

The field of couple therapy is a wide and varied one, and there are almost as many different approaches to treatment as in individual psychotherapy. The relatively brief therapeutic method presented here, behavioural systems couple therapy, is an eclectic one, taking techniques from two approaches of proven efficacy and combining them into a flexible and versatile therapy capable of being used in a wide variety of presenting problems. These include simple relationship problems, psychosexual problems, and such psychiatric conditions as anxiety, depression, and morbid jealousy. It is relatively easy to teach, and although it has not yet been subjected to controlled trials it can be assumed to be no less effective than its component therapies which are both effective. It has recently also been recommended in a package for self-help with homework exercises and theoretical explanations to be used without the intervention of a therapist. There are few contraindications for the therapy, and it can be used both as a therapy in its own right or as an adjunctive therapy in, for example, the treatment of depression, psychosis or sexual dysfunctions. It can thus be a useful addition to the various methods available for the reduction of distress, whether in couples or individuals.

scholarly journals Digital Interventions for Generalized Anxiety Disorder (GAD): Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Pedro Saramago ◽  
Lina Gega ◽  
David Marshall ◽  
Georgios F. Nikolaidis ◽  
Dina Jankovic ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Meta Analysis ◽  
Antidepressant Medication ◽  
Generalized Anxiety ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Self Help ◽  
Digital Interventions ◽  
Better Than

Background: Generalized anxiety disorder is the most common mental health condition based on weekly prevalence. Digital interventions have been used as alternatives or as supplements to conventional therapies to improve access, patient choice, and clinical outcomes. Little is known about their comparative effectiveness for generalized anxiety disorder.Methods: We conducted a systematic review and network meta-analysis of randomized controlled trials comparing digital interventions with medication, non-digital interventions, non-therapeutic controls, and no intervention.Results: We included 21 randomized controlled trials with a total of 2,350 participants from generalized anxiety disorder populations. Pooled outcomes using analysis of Covariance and rankograms based on the surface under the cumulative ranking curves indicated that antidepressant medication and group therapy had a higher probability than digital interventions of being the “best” intervention. Supported digital interventions were not necessarily “better” than unsupported (pure self-help) ones.Conclusions: Due to very wide confidence intervals, network meta-analysis results were inconclusive as to whether digital interventions are better than no intervention and non-therapeutic active controls, or whether they confer an additional benefit to standard therapy. Future research needs to compare digital interventions with one-to-one therapy and with manualized non-digital self-help and to include antidepressant medication as a treatment comparator and effect modifier.

‘Soother of mind’ – meditation in psychiatric disorders: a narrative review

2021 ◽  
pp. 1-7
Author(s):  
Vinod Kumar ◽  
Shree Raksha Bhide ◽  
Rashmi Arasappa ◽  
Shivarama Varambally ◽  
Bangalore N. Gangadhar
Keyword(s):  
Psychiatric Disorders ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Complete Absorption ◽  
Psychiatric Conditions ◽  
Biological Aspects ◽  
The Mind ◽  
Anxiety Depression ◽  
Meditative Practices

SUMMARY Meditation, a component of ashtanga yoga, is an act of inward contemplation in which the mind fluctuates between a state of attention to a stimulus and complete absorption in it. Some forms of meditation have been found to be useful for people with psychiatric conditions such as anxiety, depression and substance use disorder. Evidence for usefulness of meditation for people with psychotic disorders is mixed, with reported improvements in negative symptoms but the emergence/precipitation of psychotic symptoms. This article narrates the benefits of meditation in psychiatric disorders, understanding meditation from the yoga perspective, biological aspects of meditation and practical tips for the practice of meditation. We also explain possible ways of modifying meditative practices to make them safe and useful for the patient population and useful overall as a society-level intervention.

Tamoxifen in breast cancer

1986 ◽  
Vol 24 (17) ◽  
pp. 65-67
Keyword(s):  
Breast Cancer ◽  
Develop Breast Cancer ◽  
Common Disease ◽  
Controlled Trials ◽  
Carcinoma Of The Breast ◽  
Randomized Controlled ◽  
Proven Efficacy ◽  
First Recurrence ◽  
New Treatments

About one in every fourteen women in Britain will develop breast cancer at some time, the risk increasing with age. Breast cancer has a long natural history and can still prove fatal up to 30 years after diagnosis. The median survival from first recurrence is less than 2 years, but the disease may progress very slowly and some patients may live for many years without treatment. New treatments in breast cancer can therefore be assessed only by randomized controlled trials which should preferably be long term. Tamoxifen has become widely used in the treatment of all stages of carcinoma of the breast. Its proven efficacy and minimal toxicity are now well established. This article assesses its contribution to the management of this common disease.

Exercise as a Treatment for Depression

Depression ◽  
2019 ◽  
pp. 345-356
Author(s):  
Chad D. Rethorst
Keyword(s):  
Clinical Practice ◽  
Personalized Medicine ◽  
Randomized Controlled Trials ◽  
Treatment Response ◽  
Exercise Prescription ◽  
Patient Adherence ◽  
Future Research ◽  
Controlled Trials ◽  
Practical Advice ◽  
Treatment Of Depression

Beginning with epidemiological evidence and moving to randomized controlled trials, researchers have established evidence supporting the effectiveness of exercise in the treatment of depression. This chapter will provide an overview of the benefits of exercise for patients with depression, discuss the challenges clinicians face in using exercise as a treatment in clinical practice, and provide practical advice on exercise prescription. The chapter concludes with a discussion of areas of need for future research, focusing on three areas: identifying strategies to ensure patient adherence with exercise prescriptions, identifying predictors of treatment response that will facilitate a personalized medicine approach to exercise prescription, and the use of exercise as a complementary agent with other depression treatments.

scholarly journals Clinical trials of antidepressant medications are producing meaningless results

2003 ◽  
Vol 183 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Gordon Parker ◽  
Ian M. Anderson ◽  
Peter Haddad
Keyword(s):  
Clinical Trials ◽  
Antidepressant Treatment ◽  
Meta Analysis ◽  
Antidepressant Medication ◽  
Unipolar Depression ◽  
Controlled Trials ◽  
Antidepressant Medications ◽  
Treatment Of Depression ◽  
Randomised Controlled ◽  
The Uk

A recent alert from the UK Committee on Safety of Medicines stated that the dangers of treatment of depression with paroxetine outweigh the benefits in those under 18. Such a warning should focus our minds on the evidence on which clinical practice is based. Antidepressant treatment of depression in the under-18s has been thought to be justified because clinical trials show that it works so well in over-18s. But is that a reasonable assessment of the evidence? Kirsch et al (2002) use the analogy of ‘The Emperor's New Clothes' to describe the findings from their meta-analysis of randomised placebo-controlled trials of antidepressants. They conclude that antidepressant medication appears to have only a small effect on outcome over and above placebo. In this analogy psychiatry is the emperor, drug trials are the fraudsters and the deception is being revealed by a growing body of critical opinion proposing that, once methodological problems with clinical trials are taken into account, antidepressants either do not work at all or have an effect that is so small as to be clinically unimportant (Andrews, 2001; Moncrieff, 2002). A large number of randomised placebo-controlled trials of antidepressants have been carried out over the past decades, mostly funded by the pharmaceutical industry, and it is now recognised that about 50% of negative trials go unpublished (Thase, 1999). Meanwhile, unipolar depression has jumped into the top five of the world's total burden of disease, and there is an imperative need for effective and safe treatments. Do we need more randomised controlled trials (RCTs) of antidepressant medications, or has that research paradigm outlived its usefulness? In this month's debate, Professor Gordon Parker, University of New South Wales and Black Dog Institute, Australia, and Drs Ian Anderson and Peter Haddad from the University of Manchester discuss whether clinical trials for antidepressant medication produce meaningless results.

Self-Directed Approaches to the Treatment of Depression

2016 ◽  
pp. 468-477
Author(s):  
Pim Cuijpers ◽  
Annet Kleiboer
Keyword(s):  
Depressive Disorders ◽  
Future Research ◽  
Evidence Based ◽  
Advantages And Disadvantages ◽  
Self Help ◽  
Treatment Of Depression ◽  
High Prevalence ◽  
Evidence Based Treatments ◽  
The Common

This article examines self-directed approaches to the treatment of depression. It first considers some of the reasons why the uptake of mental health services by depressed people is low, despite the high prevalence of depressive disorders and the availability of evidence-based treatments. It then looks at the role of self-management in increasing access to evidence-based treatments for depression. It also defines what self-directed treatments are and goes on to discuss the different types of self-directed therapy, the common components of self-directed interventions for depression, Internet-based interventions for depression, and the advantages and disadvantages of self-directed interventions. Finally, it summarizes the findings from research on self-directed interventions for depression and suggests directions for future research and development in this area. Some titles of self-help books that can be used in self-directed interventions are presented.

Depression, demoralization, and suicidality

2015 ◽  
Author(s):  
David W. Kissane ◽  
Matthew Doolittle
Keyword(s):  
Symptom Control ◽  
Combined Treatment ◽  
Mental Condition ◽  
Medical Treatments ◽  
Cognitive Behavioural ◽  
Treatment Of Depression ◽  
Screening For Distress ◽  
Behavioural Therapies ◽  
Meta Analyses ◽  
Anxiety Depression

The development of clinical depression is common during palliative care, adversely affects quality of life and adherence to medical treatments, yet regrettably can pass unrecognized. Screening for distress as the sixth vital sign is therefore highly recommended. Demoralization is another form of distress where the apparent pointlessness of continued life may lead to suicidal thinking. As the mental condition deteriorates, co-morbid states of anxiety, depression, and demoralization become more likely. Rates of suicide are increased with advanced cancer and poor symptom control. Fortunately, combined treatment with medication and counselling is effective in ameliorating depression, demoralization, and suicidality. Meta-analyses of psychotherapy trials confirm clear benefits, with behavioural activation, supportive, interpersonal, and cognitive behavioural therapies all making contributions. Group, couple, and family therapies optimize support for all involved. All members of the multidisciplinary team contribute to the active treatment of depression, demoralization, and the prevention of suicide.

A controlled trial of cavodil (Pheniprazine) in depression

1962 ◽  
Vol 108 (457) ◽  
pp. 856-858
Author(s):  
T. E. Lear ◽  
M. W. Browne ◽  
J. A. Greeves
Keyword(s):  
Mental State ◽  
Amine Oxidase ◽  
Controlled Trial ◽  
Controlled Trials ◽  
Disease Entity ◽  
Mood Change ◽  
Treatment Of Depression ◽  
Definition Of

In reviewing controlled trials using mono-amine oxidase inhibitors in the treatment of depression it is soon obvious that workers vary as to whether they consider “depression” as a symptomatic mood change in diverse conditions or as a disease entity. Where the latter occurs, a variety of classifications of depressive illnesses appear, and that most widely used is the broad separation between endogenous and reactive depressions. Other points to note are the authors' definition of improvement, and particularly whether this refers to one aspect of the mental state only and whether the patient left hospital before receiving any treatment other than the drug.

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