T94. VIRTUAL REALITY STRESS REDUCTION FOR PATIENTS WITH PSYCHIATRIC DISORDERS: CROSS-OVER RANDOMIZED CONTROLLED TRIAL

Abstract Background Psychosocial stress is associated with onset and relapse of psychosis, and stress-reactivity is high in patients with psychotic disorder. Stress management is an important part of treatment, but stress-reducing interventions are challenging for people with psychotic or other psychiatric disorder. We developed a virtual reality self-management relaxation tool (VRelax; 360o nature videos with interactive elements) and investigated its immediate effects on stress level, mood states and symptoms in patients with a psychotic or other psychiatric disorder, compared to standard relaxation exercises. Methods A randomized cross-over trial was conducted in 50 patients receiving ambulatory treatment for psychotic, anxiety, depressive or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation, and used both interventions for 10 days at home. They completed Visual Analogue Scales (VAS) of stress level and mood states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel repeated-measures regression models and two-way ANOVA. Results Both VRelax and standard relaxation exercises reduced subjective stress and improved momentary mood states. Compared to standard relaxation, VRelax resulted in a significantly greater immediate improvement of anxiety (B=-4.30, 95%CI=-5.86;-2.73), sadness (B=-3.65, 95%CI =-5.39;-1.91), cheerfulness (B=3.67, 95%CI=2.15;5.18), overall positive mood (B=7.59, 95%CI=2.28;12.89), and overall negative mood (B=10.88, 95%CI=5.89;15.87). There were no significant differences between short-term effects of the two treatments on symptoms and global perceived stress. Discussion If the results of this trial are replicated and extended, VRelax may provide a much needed effective self-management stress intervention to enhance treatment of patients with psychotic and other psychiatric disorders.

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Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial (Preprint)

10.2196/preprints.17233 ◽

2019 ◽

Author(s):

Wim Veling ◽

Bart Lestestuiver ◽

Marieke Jongma ◽

H J Rogier Hoenders ◽

Catheleine van Driel

Keyword(s):

Virtual Reality ◽

Psychiatric Disorder ◽

Perceived Stress ◽

Psychiatric Symptoms ◽

Self Management ◽

Affective States ◽

Short Term ◽

Before And After ◽

Relaxation Exercises ◽

Short Term Effects

BACKGROUND Virtual reality (VR) relaxation is a promising mental health intervention that may be an effective tool for stress reduction but has hardly been tested in clinical trials with psychiatric patients. We developed an easy-to-use VR self-management relaxation tool (VRelax) with immersive 360° nature videos and interactive animated elements. OBJECTIVE To investigate the immediate effects of VR relaxation on negative and positive affective states and short-term effects on perceived stress and symptoms in patients with a psychiatric disorder, compared to standard relaxation exercises. METHODS A randomized crossover trial was conducted in 50 patients receiving ambulatory treatment for anxiety, psychotic, depressive, or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation and used both interventions for 10 days at home. They completed 8 visual analog scales of momentary negative and positive affective states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel mixed model regression analyses and 2-way analysis of variance. RESULTS Both VRelax and standard relaxation exercises led to a statistically significant immediate improvement of all negative and positive affective states. Compared to standard relaxation, VRelax resulted in a significantly greater reduction of total negative affective state (change 16.2% versus 21.2%; t1684=−2.02, 95% CI −18.70 to −0.28; P=.04). Specifically, VRelax had a stronger beneficial effect on momentary anxiety (t1684=−3.24, 95% CI −6.86 to −1.69), sadness (t1684=−2.32, 95% CI −6.51 to −0.55), and cheerfulness (t1684=2.35, 95% CI 0.51 to 5.75). There were no significant differences between short-term effects of the two treatments on global perceived stress and symptoms. CONCLUSIONS If the results of this trial are replicated and extended, VRelax may provide a much-needed, effective, easy-to-use self-management relaxation intervention to enhance psychiatric treatments. CLINICALTRIAL Netherlands Trial Register NTR7294; https://www.trialregister.nl/trial/7096

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Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/17233 ◽

2021 ◽

Vol 23 (1) ◽

pp. e17233

Author(s):

Wim Veling ◽

Bart Lestestuiver ◽

Marieke Jongma ◽

H J Rogier Hoenders ◽

Catheleine van Driel

Keyword(s):

Virtual Reality ◽

Psychiatric Disorder ◽

Perceived Stress ◽

Psychiatric Symptoms ◽

Self Management ◽

Affective States ◽

Short Term ◽

Before And After ◽

Relaxation Exercises ◽

Short Term Effects

Background Virtual reality (VR) relaxation is a promising mental health intervention that may be an effective tool for stress reduction but has hardly been tested in clinical trials with psychiatric patients. We developed an easy-to-use VR self-management relaxation tool (VRelax) with immersive 360° nature videos and interactive animated elements. Objective To investigate the immediate effects of VR relaxation on negative and positive affective states and short-term effects on perceived stress and symptoms in patients with a psychiatric disorder, compared to standard relaxation exercises. Methods A randomized crossover trial was conducted in 50 patients receiving ambulatory treatment for anxiety, psychotic, depressive, or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation and used both interventions for 10 days at home. They completed 8 visual analog scales of momentary negative and positive affective states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel mixed model regression analyses and 2-way analysis of variance. Results Both VRelax and standard relaxation exercises led to a statistically significant immediate improvement of all negative and positive affective states. Compared to standard relaxation, VRelax resulted in a significantly greater reduction of total negative affective state (change 16.2% versus 21.2%; t1684=−2.02, 95% CI −18.70 to −0.28; P=.04). Specifically, VRelax had a stronger beneficial effect on momentary anxiety (t1684=−3.24, 95% CI −6.86 to −1.69), sadness (t1684=−2.32, 95% CI −6.51 to −0.55), and cheerfulness (t1684=2.35, 95% CI 0.51 to 5.75). There were no significant differences between short-term effects of the two treatments on global perceived stress and symptoms. Conclusions If the results of this trial are replicated and extended, VRelax may provide a much-needed, effective, easy-to-use self-management relaxation intervention to enhance psychiatric treatments. Trial Registration Netherlands Trial Register NTR7294; https://www.trialregister.nl/trial/7096

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What Are the Psychosocial Factors Associated With Migraine in the Child? Comorbid Psychiatric Disorders, Family Functioning, Parenting Style, or Mom’s Psychiatric Symptoms?

Journal of Child Neurology ◽

10.1177/0883073817749377 ◽

2018 ◽

Vol 33 (2) ◽

pp. 174-181 ◽

Cited By ~ 5

Author(s):

Gozde Kandemir ◽

Selma Tural Hesapcioglu ◽

Aysegül N. Citak Kurt

Keyword(s):

Psychiatric Disorder ◽

Family Functioning ◽

Psychiatric Disorders ◽

Parenting Style ◽

Psychiatric Comorbidity ◽

Psychiatric Symptoms ◽

Treatment Plan ◽

Depression And Anxiety ◽

Factors Associated ◽

Migraine Group

Objective: Psychiatric diagnoses, parenting style, family functioning among children and adolescents with migraine, and psychiatric symptoms of their mothers were examined. Methods: The K-SADS and other measurements were used to assess psychiatric disorders in 50 children with migraine (aged 8-18) and matched 50 controls. Results: At least one psychiatric disorder was diagnosed in 56% of the migraine group. The presence of any psychiatric disorder in children (odds ratio [OR] = 2.765, P = .027) and somatization symptoms in their mothers (OR = 2.061, P = .025) were increasing the risk of migraine diagnosis. The parenting style scale assessments revealed that parents in the migraine group grant their children less autonomy. Conclusion: Psychiatric comorbidity, especially depression and anxiety disorders, is more common in children with migraine. The frequency of eating disorder is also higher. Evaluating comorbidity, family functioning, and particularly affective responsiveness in migraine families may guide the clinician to a targeted treatment plan.

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Managing a Co-occurring Psychiatric Disorder

Managing Your Substance Use Disorder ◽

10.1093/med-psych/9780190926670.003.0020 ◽

2019 ◽

pp. 159-168

Author(s):

Dennis C. Daley ◽

Antoine Douaihy

Keyword(s):

Substance Use ◽

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Substance Use Disorder ◽

Psychiatric Symptoms ◽

The Other ◽

Medication Assisted Treatment ◽

Different Types

The term “co-occurring disorders” refers to the presence of a psychiatric disorder and a substance use disorder. A psychiatric disorder increases the risk of a substance use disorder and vice versa. Treating one disorder improves the outcomes in treating the other. Psychiatric medications can be both effective and appropriate in treating the psychiatric disorder in people with co-occurring disorders. Medication-assisted treatment (MAT) can treat effectively the substance use disorder in people with co-occurring disorders. The goals of this chapter are to learn about the different types of psychiatric disorders, to learn about the causes of psychiatric disorders, and to assess the client’s psychiatric symptoms, if applicable.

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The Effects of Virtual Reality Treatment on Prefrontal Cortex Activity in Patients With Social Anxiety Disorder: Participatory and Interactive Virtual Reality Treatment Study (Preprint)

10.2196/preprints.31844 ◽

2021 ◽

Author(s):

Hojun Lee ◽

JongKwan Choi ◽

Dooyoung Jung ◽

Ji-Won Hur ◽

Chul-Hyun Cho

Keyword(s):

Virtual Reality ◽

Prefrontal Cortex ◽

Anxiety Disorder ◽

Social Anxiety ◽

Psychiatric Disorders ◽

Social Anxiety Disorder ◽

Cognitive Task ◽

Neural Correlates ◽

Functional Near Infrared Spectroscopy ◽

Before And After

BACKGROUND Attempts to use virtual reality (VR) as a treatment for various psychiatric disorders have been made recently, and many researchers have identified the effects of VR in psychiatric disorders. Studies have reported that VR therapy is effective in social anxiety disorder (SAD). However, there is no prior study on the neural correlates of VR therapy in patients with SAD. OBJECTIVE The aim of this study is to find the neural correlates of VR therapy by evaluating the treatment effectiveness of VR in patients with SAD using portable functional near-infrared spectroscopy (fNIRS). METHODS Patients with SAD (n=28) were provided with 6 sessions of VR treatment that was developed for exposure to social situations with a recording system of each participant’s self-introduction in VR. After each VR treatment session, the first-person view (video 1) and third-person view (video 2) clips of the participant’s self-introduction were automatically generated. The functional activities of prefrontal regions were measured by fNIRS while watching videos 1 and 2 with a cognitive task, before and after whole VR treatment sessions, and after the first session of VR treatment. We compared the data of fNIRS between patients with SAD and healthy controls (HCs; n=27). RESULTS We found that reduction in activities of the right frontopolar prefrontal cortex (FPPFC) in HCs was greater than in the SAD group at baseline (t=–2.01, P=.049). Comparing the frontal cortex activation before and after VR treatment sessions in the SAD group showed significant differences in activities of the FPPFC (right: t=–2.93, P<.001; left: t=–2.25, P=.03) and the orbitofrontal cortex (OFC) (right: t=–2.10, P=.045; left: t=–2.21, P=.04) while watching video 2. CONCLUSIONS Activities of the FPPFC and OFC were associated with symptom reduction after VR treatment for SAD. Our study findings might provide a clue to understanding the mechanisms underlying VR treatment for SAD. CLINICALTRIAL Clinical Research Information Service (CRIS) KCT0003854; https://tinyurl.com/559jp2kp

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Burden of psychiatric disorder in young adulthood and life outcomes at age 30

The British Journal of Psychiatry ◽

10.1192/bjp.bp.109.076570 ◽

2010 ◽

Vol 197 (2) ◽

pp. 122-127 ◽

Cited By ~ 107

Author(s):

Sheree J. Gibb ◽

David M. Fergusson ◽

L. John Horwood

Keyword(s):

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Young Adulthood ◽

Educational Outcomes ◽

Educational Achievement ◽

Living Standards ◽

Confounding Factors ◽

Life Outcomes ◽

Workforce Participation ◽

Before And After

BackgroundPsychiatric disorders are common during young adulthood and comorbidity is frequent. Individual psychiatric disorders have been shown to be associated with negative economic and educational outcomes, but few studies have addressed the relationship between the total extent of psychiatric disorder and life outcomes.AimsTo examine whether the extent of common psychiatric disorder between ages 18 and 25 is associated with negative economic and educational outcomes at age 30, before and after controlling for confounding factors.MethodParticipants were 987 individuals from the Christchurch Health and Development Study, a longitudinal study of a birth cohort of individuals born in Christchurch, New Zealand, in 1977 and followed to age 30. Linear and logistic regression models were used to examine the associations between psychiatric disorder from age 18 to 25 and workforce participation, income and living standards, and educational achievement at age 30, before and after adjustment for confounding factors.ResultsThere were significant associations between the extent of psychiatric disorder reported between ages 18 and 25 and all of the outcome measures (all P<0.05). After adjustment for confounding factors, the associations between psychiatric disorder and workforce participation, income and living standards remained significant (all P<0.05), but the associations between psychiatric disorder and educational achievement were not significant (all P>0.10).ConclusionsAfter due allowance had been made for a range of confounding factors, psychiatric disorder between ages 18 and 25 was associated with reduced workforce participation, lower income and lower economic living standards at age 30.

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Military deployment to the Gulf War as a risk factor for psychiatric illness among US troops

The British Journal of Psychiatry ◽

10.1192/bjp.188.5.453 ◽

2006 ◽

Vol 188 (5) ◽

pp. 453-459 ◽

Cited By ~ 40

Author(s):

Nancy Fiedler ◽

Gozde Ozakinci ◽

William Hallman ◽

Daniel Wartenberg ◽

Noel T. Brewer ◽

...

Keyword(s):

Risk Factors ◽

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Psychiatric Symptoms ◽

Female Gender ◽

Gulf War ◽

Psychiatric Diagnoses ◽

War Veterans ◽

Gulf War Veterans ◽

Axis I

BackgroundSeveral studies document an excess of psychiatric symptoms among veterans of the 1991 Gulf War. However, little is known about the prevalence of psychiatric disorders in those who were deployed to that conflict.AimsTo compare the 12-month prevalence and associated risk factors for DSM Axis I psychiatric diagnoses between random samples of Gulf War-deployed veterans and veterans of the same era notdeployed to the Persian Gulf (era veterans).MethodInterview data from 967 Gulf War veterans and 784 era veterans were examined to determine current health status, medical conditions, symptoms and Axis I psychiatric disorders. Logistic regression models evaluated risk factors for psychiatric disorder.ResultsGulf War veterans had a significantly higher prevalence of psychiatric diagnoses, with twice the prevalence of anxiety disorders and depression. Lower rank, female gender and divorced or single marital status were significant independent predictors of psychiatric disorder.ConclusionsDeployment to the Gulf War is associated with a range of mental health outcomes more than 10 years after deployment.

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Effects of use of an eHealth platform e-Vita for COPD patients on disease specific quality of life domains

Tijdschrift voor Gerontologie en Geriatrie ◽

10.36613/tgg.1875-6832/2020.04.03 ◽

2020 ◽

Keyword(s):

Quality Of Life ◽

Functional State ◽

Mental State ◽

Self Management ◽

Copd Patients ◽

Before And After ◽

Ehealth Intervention ◽

The Impact ◽

Disease Specific

Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients’ involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings. Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients. Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the eHealth intervention. Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0,20% before the intervention and 0,27% after the intervention; this difference was statistically significant (P=0.027). The decrease of CCQ-mental was 0,97% before the intervention and after the intervention there was an increase of 0,017%; this difference was statistically significant (P=0,01). No significant difference was found in the slopes of CCQ (P=0,12) and CCQ-function (P=0,11) before and after the intervention. Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. In conclusion, this study shows that after the introduction of the COPD platform, patients experienced fewer symptoms, but their mental state deteriorated slightly at the same time. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.

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The Value of Neuroimaging Techniques in the Translation and Transdiagnostic Validation of Psychiatric Diagnoses - Selective Review

Current Topics in Medicinal Chemistry ◽

10.2174/1568026620666200131095328 ◽

2020 ◽

Vol 20 (7) ◽

pp. 540-553 ◽

Cited By ~ 1

Author(s):

Anna Todeva-Radneva ◽

Rositsa Paunova ◽

Sevdalina Kandilarova ◽

Drozdstoy St. Stoyanov

Keyword(s):

Psychiatric Disorders ◽

Psychiatric Symptoms ◽

Medical Science ◽

Self Report ◽

Current Status ◽

Diagnostic Tools ◽

Main Concept ◽

Directional Change ◽

The Mind ◽

Neuroimaging Techniques

: Psychiatric diagnosis has long been perceived as more of an art than a science since its foundations lie within the observation, and the self-report of the patients themselves and objective diagnostic biomarkers are lacking. Furthermore, the diagnostic tools in use not only stray away from the conventional medical framework but also remain invalidated with evidence-based concepts. However, neuroscience, as a source of valid objective knowledge has initiated the process of a paradigm shift underlined by the main concept of psychiatric disorders being “brain disorders”. It is also a bridge closing the explanatory gap among the different fields of medicine via the translation of the knowledge within a multidisciplinary framework. : The contemporary neuroimaging methods, such as fMRI provide researchers with an entirely new set of tools to reform the current status quo by creating an opportunity to define and validate objective biomarkers that can be translated into clinical practice. Combining multiple neuroimaging techniques with the knowledge of the role of genetic factors, neurochemical imbalance and neuroinflammatory processes in the etiopathophysiology of psychiatric disorders is a step towards a comprehensive biological explanation of psychiatric disorders and a final differentiation of psychiatry as a well-founded medical science. : In addition, the neuroscientific knowledge gained thus far suggests a necessity for directional change to exploring multidisciplinary concepts, such as multiple causality and dimensionality of psychiatric symptoms and disorders. A concomitant viewpoint transition of the notion of validity in psychiatry with a focus on an integrative validatory approach may facilitate the building of a collaborative bridge above the wall existing between the scientific fields analyzing the mind and those studying the brain.

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A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n9p98 ◽

2019 ◽

Vol 9 (9) ◽

pp. 98 ◽

Cited By ~ 1

Author(s):

Kisokanth G. ◽

Indrakumar J. ◽

Prathapan S. ◽

Joseph J. ◽

Ilankoon I.M.P.S.

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Management Education ◽

Self Management ◽

Rank Test ◽

Diabetic Patients ◽

Effective Measure ◽

Before And After ◽

Patients With Diabetes ◽

Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

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