Clinical outcome evaluations and CBT response prediction in Myotonic Dystrophy

Background: The European OPTIMISTIC clinical trial has demonstrated a significant, yet heterogenous effect of Cognitive Behavioural Therapy (CBT) for Myotonic Dystrophy type 1 (DM1) patients. One of its remaining aims was the assessment of efficacy and adequacy of clinical outcome measures, including the relatively novel primary trial outcome, the DM1-Activ-c questionnaire. Objectives: Assessment of the relationship between the Rasch-built DM1-Activ-c questionnaire and 26 commonly used clinical outcome measurements. Identification of variables associated with CBT response in DM1 patients. Methods: Retrospective analysis of the to date largest clinical trial in DM1 (OPTIMISTIC), comprising of 255 genetically confirmed DM1 patients randomized to either standard care or CBT with optionally graded exercise therapy. Correlations of 27 different outcome measures were calculated at baseline (cross-sectional) and of their respective intervention induced changes (longitudinal). Bootstrap enhanced Elastic-Net (BeEN) regression was validated and implemented to select variables associated with CBT response. Results: In cross-sectional data, DM1-Activ-c correlated significantly with the majority of other outcome measures, including Six Minute Walk Test and Myotonic Dystrophy Health Index. Fewer and weaker significant longitudinal correlations were observed. Nine variables potentially associated with CBT response were identified, including measures of disease severity, executive cognitive functioning and perceived social support. Conclusions: The DM1-Activ-c questionnaire appears to be a well suited cross-sectional instrument to assess a variety of clinically relevant dimensions in DM1. Yet, apathy and experienced social support measures were less well captured. CBT response was heterogenous, requiring careful selection of outcome measures for different disease aspects.

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Cognitive Behavioural Therapy for Paruresis or “Shy Bladder Syndrome”: A Case Study

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465816000321 ◽

2016 ◽

Vol 45 (1) ◽

pp. 79-84 ◽

Cited By ~ 3

Author(s):

David Hambrook ◽

Tracey Taylor ◽

Victoria Bream

Keyword(s):

Outcome Measures ◽

Behavioural Therapy ◽

Evidence Based ◽

Cross Sectional ◽

Behavioural Interventions ◽

Cognitive Behavioural ◽

Anxiety Depression ◽

Effective Treatments

Background: Paruresis, or “shy bladder syndrome”, is a relatively common anxiety disorder, yet little is known about the causes of, and effective treatments for this disabling condition. Aim: This report describes a case study in which a man (Peter) presenting with paruresis was treated using formulation-driven CBT, which aimed to address the idiosyncratic processes that were maintaining his anxiety and avoidance of urinating in public. Method: Peter attended 12 sessions of CBT including one follow-up session a month after treatment had ended. Treatment involved collaboratively developing an idiosyncratic case conceptualization (identifying longitudinal and cross-sectional factors involved in the development and maintenance of his difficulties), followed by a number of standard cognitive and behavioural interventions commonly used in evidence-based CBT protocols for other anxiety disorders. Peter completed sessional outcome measures of paruresis symptomatology, anxiety, depression, social anxiety and functional impairment. Results: Peter subjectively found the intervention helpful and his scores on all of the outcome measures reduced over the course of his therapy, and were maintained at one month follow-up. Conclusions: This report adds to the scarce literature regarding effective treatments for individuals suffering with paruresis. Limitations of the design are acknowledged and ideas for further research in this area are discussed.

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Religiously-Integrated Cognitive Behavioural Therapy for Major Depression in Chronic Medical Illness: Review of Results from a Randomized Clinical Trial

Health and Social Care Chaplaincy ◽

10.1558/hscc.v4i2.31655 ◽

2016 ◽

Vol 4 (2) ◽

pp. 237-253 ◽

Cited By ~ 1

Author(s):

Harold G Koenig ◽

Nathan A Boucher ◽

Keisha-Gaye N O’Garo ◽

Michelle Pearce

Keyword(s):

Clinical Trial ◽

Major Depression ◽

Randomized Clinical Trial ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Medical Illness ◽

Chronic Medical Illness ◽

Cognitive Behavioural

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Integrated neuropsychological and cognitive behavioural therapy after acquired brain injury: A pragmatic randomized clinical trial

Neuropsychological Rehabilitation ◽

10.1080/09602011.2021.1908902 ◽

2021 ◽

pp. 1-35

Author(s):

Cornelia Exner ◽

Bettina K. Doering ◽

Nico Conrad ◽

Anna Künemund ◽

Sarah Zwick ◽

...

Keyword(s):

Clinical Trial ◽

Brain Injury ◽

Randomized Clinical Trial ◽

Cognitive Behavioural Therapy ◽

Acquired Brain Injury ◽

Behavioural Therapy ◽

Cognitive Behavioural

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IDDF2019-ABS-0189 Yoga-enhanced cognitive behavioural therapy (Y-CBT) versus rifamixin-probiotic sequential treatment for irritable bowel syndrome (IBS): a randomised clinical trial

10.1136/gutjnl-2019-iddfabstracts.188 ◽

2019 ◽

Author(s):

Debanjan Banerjee ◽

Sujata Bhatt ◽

Soumalyo Chatterjee ◽

Rajesh Sharma

Keyword(s):

Clinical Trial ◽

Irritable Bowel Syndrome ◽

Cognitive Behavioural Therapy ◽

Randomised Clinical Trial ◽

Behavioural Therapy ◽

Sequential Treatment ◽

Cognitive Behavioural ◽

Irritable Bowel

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Long‐term benefits of digital cognitive behavioural therapy for insomnia: Follow‐up report from a randomized clinical trial

Journal of Sleep Research ◽

10.1111/jsr.13018 ◽

2020 ◽

Vol 29 (4) ◽

Cited By ~ 1

Author(s):

Annemarie I. Luik ◽

Antonia Marsden ◽

Richard Emsley ◽

Alasdair L. Henry ◽

Richard Stott ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Cognitive Behavioural

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The concept of ‘illness without disease’ impedes understanding of chronic fatigue syndrome: a response to Sharpe and Greco

Medical Humanities ◽

10.1136/medhum-2019-011807 ◽

2020 ◽

pp. medhum-2019-011807

Author(s):

Steven Lubet ◽

David Tuller

Keyword(s):

Chronic Fatigue Syndrome ◽

Medical Humanities ◽

Chronic Fatigue ◽

Behavioural Therapy ◽

Behavioural Interventions ◽

Fatigue Syndrome ◽

Cognitive Behavioural ◽

Graded Exercise Therapy ◽

Objective Evidence ◽

Graded Exercise

In a recent article in Medical Humanities, Sharpe and Greco characterise myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as an ‘illness without disease’, citing the absence of identified diagnostic markers. They attribute patients’ rejection of psychological and behavioural interventions, such as cognitive–behavioural therapy (CBT) and graded exercise therapy (GET), to a ‘paradox’ resulting from a supposed failure to acknowledge that ‘there is no good objective evidence of bodily disease’. In response, we explain that understandings about the causes of and treatments for medical complaints have shifted across centuries, and that conditions once thought to be ‘psychosomatic’ have later been determined to have physiological causes. We also note that Sharpe and Greco do not disclose that leading scientists and physicians believe that ME/CFS is a biomedical disease, and that numerous experts, not just patients, have rejected the research underlying the CBT/GET treatment approach. In conclusion, we remind investigators that medical classifications are always subject to revision based on subsequent research, and we therefore call for more humility before declaring categorically that patients are experiencing ‘illness without disease’.

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