scholarly journals Japanese Project for Telepsychiatry Evaluation during COVID-19: Treatment Comparison Trial (J-PROTECT): Rationale, design, and methodology

Author(s):  
Taishiro Kishimoto ◽  
Shotaro Kinoshita ◽  
Shogyoku Bun ◽  
Yasunori Sato ◽  
Momoko Kitazawa ◽  
...  

Introduction: The COVID-19 pandemic has had a profound impact on the mental health of people around the world. Anxiety related to infection, stress and stigma caused by the forced changes in daily life have reportedly increased the incidence and symptoms of depression, anxiety disorder and obsessive-compulsive disorder. Under such circumstances, telepsychiatry is gaining importance and attracting a great deal of attention. However, few large pragmatic clinical trials on the use of telepsychiatry targeting multiple psychiatric disorders have been conducted to date. Methods: The targeted study cohort will consist of adults (>18 years) who meet the DSM-5 diagnostic criteria for either (1) depressive disorders, (2) anxiety disorders, or (3) obsessive-compulsive and related disorders. Patients will be assigned in a 1:1 ratio to either a telepsychiatry group (at least 50% of visits to be conducted using telemedicine, with at least one face-to-face treatment [FTF] every six months) or an FTF group (all visits to be conducted FTF, with no telemedicine). Both groups will receive the usual treatment covered by public medical insurance. The study will utilize a master protocol design in that there will be primary and secondary outcomes for the entire group regardless of diagnosis, as well as the outcomes for each individual disorder group. Discussion: This study will be a non-inferiority trial to test that the treatment effect of telepsychiatry is not inferior to that of FTF alone. This study will provide useful insights into the effect of the COVID-19 pandemic on the practice of psychiatry.

2014 ◽  
Author(s):  
David MB Christmas ◽  
Ian Crombie ◽  
Sam Eljamel ◽  
Naomi Fineberg ◽  
Bob MacVicar ◽  
...  

2020 ◽  
Vol 30 (2) ◽  
pp. 23-26
Author(s):  
Sultana Algin ◽  
Mohammad Waliul Hasnat Sajib ◽  
SM Yasir Arafat

Obsessive Compulsive Disorder (OCD) is a common disorder and usually runs a chronic course with waxing and waning course. It leads to pervasive impairments in multiple domains of life. The aim of the study was to assess the demographic characteristics of the OCD patients and symptom severity of this disorder. This was a cross-sectional study done in OCD clinic of outpatient department (OPD) of BSMMU, during the period from May, 2015 to April, 2017. Four hundred patients fulfilling the inclusion and exclusion criteria were selected consecutively. After taking written consent a predetermined questionnaire was filled for each patient through face-to-face interview. Then patients were evaluated covering the following areas: Axis I diagnoses (DSM-IV) and Y-BOCS severity scale. The results showed that, the mean age of the respondents was 26.6 (SD±9.9) years, ranging from 8 to 63 years. According to Y-BOCS symptoms severity used for adult patients found that majority (70%) of the patients had moderate to severe sufferings. Male had co-morbid anxiety disorders (panic disorder, agoraphobia, social phobia) more but female patients were found more depressive disorders. Female had more hypothyroidism, diabetes, skin disorders and hypertension than male. These demographic status, co-morbidity profile and symptoms severity can serve as the baseline data for a country like Bangladesh and further large scale, multi-centered study would better generalize the study results. Bang J Psychiatry December 2016; 30(2): 23-26


2021 ◽  
Author(s):  
Medard Adu ◽  
Ejemai Eboreime ◽  
Adegboyega Sapara ◽  
Andrew J. Greenshaw ◽  
Pierre Chue ◽  
...  

BACKGROUND Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive procedure in which brain neural activity is stimulated by direct application of a magnetic field to the scalp. rTMS is considered a therapeutic tool in various neuropsychiatric conditions. Since its approval in Canada in 2002 and despite its wide and continuous usage for the management of depressive disorders, knowledge on the use of rTMS for Obsessive-Compulsive Disorder (OCD) is sparse. OBJECTIVE Objectives: This scoping review seeks to; (i) explore the relevant literature available regarding the use of rTMS as a mode of treatment for OCD; (ii) To evaluate the evidence to support the use of rTMS as a treatment option for OCD. METHODS Method: We electronically conducted data search in five research databases (MEDLINE, CINAHL, Psych INFO, SCOPUS, and EMBASE) using all identified keywords and index terms across all the data bases to identify empirical studies and randomized controlled trials. We included articles published with randomized control designs which aimed at the treatment of OCD with rTMS. Only full-text published articles written in English were reviewed. Review articles on treatment for conditions other than OCD were excluded. RESULTS NA CONCLUSIONS Conclusion: The application of rTMS as a treatment intervention for OCD looks promising despite diversity in terms of outcomes and clinical significance. Further studies with well-defined stimulation parameters are needed in order to be able to draw a definite conclusion of its clinical effectiveness in the treatment of OCD.


2020 ◽  
Author(s):  
Lidewij H Wolters ◽  
Bernhard Weidle ◽  
Lucía Babiano-Espinosa ◽  
Norbert Skokauskas

BACKGROUND Although the evidence base of cognitive behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been broadly established, the treatment is hampered by limited access, poor compliance, and nonresponse. New technologies offer the opportunity to improve the accessibility, user friendliness, and effectiveness of traditional office-based CBT. By employing an integrated and age-appropriate technologically enhanced treatment package, we aim to execute a more focused and attractive application of CBT principles to increase the treatment effect for pediatric OCD. OBJECTIVE The aim of this open study is to explore the acceptability, feasibility, and effectiveness of a newly developed enhanced CBT (eCBT) package for pediatric OCD. METHODS This study is an open trial using a historical control design conducted at the outpatient clinic of the Department of Child and Adolescent Psychiatry at St. Olavs University Hospital (Trondheim) or at BUP Klinikk (Aalesund). Participants are 30 children (age 7-17 years) with a primary Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnosis of OCD, and their parents. All participants receive eCBT. eCBT consists of the usual evidence-based CBT for pediatric OCD in an “enhanced” format. Enhancements include videoconferencing sessions (supervision and guided exposure exercises at home) in addition to face-to-face sessions; an app system of interconnected apps for the child, the parents, and the therapist; psychoeducative videos; and frequent online self-assessments with direct feedback to patients and the therapist. Primary outcome measures are the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) (effectiveness), the Client Satisfaction Questionnaire-8 (acceptability), and treatment drop out (feasibility). Assessments are conducted pretreatment, posttreatment, and at 3- and 6-month follow-ups. A 12-month follow-up assessment is envisioned. The treatment outcome (CY-BOCS) will be compared to traditional face-to-face CBT (data collected in the Nordic Long-term OCD Treatment Study). RESULTS Ethical approval has been obtained (2016/716/REK nord). Inclusion started on September 04, 2017. Data collection is ongoing. CONCLUSIONS This study is the first step in testing the acceptability, feasibility, and preliminary effectiveness of eCBT. In case of positive results, future steps include improving the eCBT treatment package based on feedback from service users, examining cost-effectiveness in a randomized controlled trial, and making the package available to clinicians and other service providers treating OCD in children and adolescents. CLINICALTRIAL ISRCTN, ISRCTN37530113; registered on January 31, 2020 (retrospectively registered); https://www.isrctn.com/ISRCTN37530113. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24057


2000 ◽  
Vol 28 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Karina Lovell ◽  
Linda Fullalove ◽  
Rachel Garvey ◽  
Charles Brooker

Whilst there is substantial evidence of the efficacy of exposure and response prevention in Obsessive-Compulsive Disorder (OCD), little research has focused on delivering treatment in a more cost-effective way. This study investigated the use of brief treatment of a single 45-minute face-to-face treatment session, followed by eight weekly 15-minute telephone therapy sessions, and a final face-to-face session of 30 minutes. Of the four patients included in this small pilot study, of whom all completed treatment, three clients improved and one client made slight improvement. Given these promising results, further investigation of exposure and response prevention delivered in this way is warranted.


2012 ◽  
Vol 29 (4) ◽  
pp. 213-229 ◽  
Author(s):  
Samantha Fitt ◽  
Clare Rees

Evidence-supported therapy for obsessive-compulsive disorder (OCD) is often difficult to access, especially in rural and remote areas. Videoconferencing is gaining momentum as a means of improving access. Metacognitive therapy (MCT) has already been found to be effective for OCD when delivered face-to-face. This preliminary study explored whether videoconference-based MCT can be effective for OCD. Three participants completed a brief course of MCT using videoconferencing. Participants experienced clinically significant reductions in OCD symptoms, depression, anxiety, and stress, some of which were maintained after a 6- to 8-week follow-up period. Results suggest that videoconferencing MCT can be effective for OCD. Implications for clinicians are discussed.


2018 ◽  
Author(s):  
Kazuki Matsumoto ◽  
Chihiro Sutoh ◽  
Kenichi Asano ◽  
Yoichi Seki ◽  
Yuko Urao ◽  
...  

BACKGROUND Cognitive behavioral therapy (CBT) is the first-line treatment for adults with obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD). Patients in rural areas can access CBT via the internet. The effectiveness of internet-delivered cognitive behavioral therapy (ICBT) has been consistently shown, but no clinical studies have demonstrated the feasibility of ICBT with real-time therapist support via videoconference for OCD, PD, and SAD at the same time. OBJECTIVES This study aimed to evaluate the feasibility of videoconference-delivered CBT for patients with OCD, PD, or SAD. METHODS A total of 30 Japanese participants (mean age 35.4 years, SD 9.2) with OCD, SAD, or PD received 16 sessions of individualized videoconference-delivered CBT with real-time support of a therapist, using tablet personal computer (Apple iPad Mini 2). Treatment involved individualized CBT formulations specific to the presenting diagnosis; all sessions were provided by the same therapist. The primary outcomes were reduction in symptomatology, using the Yale-Brown obsessive-compulsive scale (Y-BOCS) for OCD, Panic Disorder Severity Scale (PDSS) for PD, and Liebowitz Social Anxiety Scale (LSAS) for SAD. The secondary outcomes included the EuroQol-5 Dimension (EQ-5D) for Quality of Life, the Patient Health Questionnaire (PHQ-9) for depression, the Generalized Anxiety Disorder (GAD-7) questionnaire for anxiety, and Working Alliance Inventory-Short Form (WAI-SF). All primary outcomes were assessed at baseline and at weeks 1 (baseline), 8 (midintervention), and 16 (postintervention) face-to-face during therapy. The occurrence of adverse events was observed after each session. For the primary analysis comparing between pre- and posttreatments, the participants’ points and 95% CIs were estimated by the paired t tests with the change between pre- and posttreatment. RESULTS A significant reduction in symptom of obsession-compulsion (Y-BOCS=−6.2; Cohen d=0.74; 95% CI −9.4 to −3.0, P=.002), panic (PDSS=−5.6; Cohen d=0.89; 95% CI −9.83 to −1.37; P=.02), social anxiety (LSAS=−33.6; Cohen d=1.10; 95% CI −59.62 to −7.49, P=.02) were observed. In addition, depression (PHQ-9=−1.72; Cohen d=0.27; 95% CI −3.26 to −0.19; P=.03) and general anxiety (GAD-7=−3.03; Cohen d=0.61; 95% CI −4.57 to −1.49, P<.001) were significantly improved. Although there were no significant changes at 16 weeks from baseline in EQ-5D (0.0336; Cohen d=-0.202; 95% CI −0.0198 to 0.00869; P=.21), there were high therapeutic alliance (ie, WAI-SF) scores (from 68.0 to 73.7) throughout treatment, which significantly increased (4.14; 95% CI 1.24 to 7.04; P=.007). Of the participants, 86% (25/29) were satisfied with videoconference-delivered CBT, and 83% (24/29) preferred videoconference-delivered CBT to face-to-face CBT. An adverse event occurred to a patient with SAD; the incidence was 3% (1/30). CONCLUSIONS Videoconference-delivered CBT for patients with OCD, SAD, and SAD may be feasible and acceptable.


Schizophrenia (SCZ) is a major psychiatric disorder and often presents with psychiatric comorbidities. But, the interactions or links between the pathogenesis of SCZ and comorbidities are not known. In this study, we aimed to develop an integrated multi-omics approach based on gene expression, gene ontology, pathways, protein-protein interactions data that help clinical researchers to assess the links between SCZ and major psychiatric pathologies. We compared the transcriptomic alterations between diseases and controls and observed significant perturbed gene expression patterns i.e. differentially expressed (DEGs) shared among SCZ and major depressive disorders, obsessive-compulsive disorder, alcoholism, eating disorder. We observed deregulated expression of three DEGs, namely, HAPLN1, CNDP1, SLC12A2 in SCZ and pathologies, which were common among the selected pathologies suggesting the selected disorders are comorbidities of SCZ. The pathways including FoxO signaling pathway, MAPK signaling pathway, transcriptional misregulation in cancer, cellular senescence, cell cycle, PI3-Akt signaling pathway, TNF signaling pathway, and TGF-beta signaling pathway altered by the shared SCZ and psychiatric comorbidities also identified. The present study revealed biomolecules (DEGs), ontologies, and cellular pathways of the etiopathogenetic mechanisms of SCZ and psychiatric comorbidities.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Farzad Allameh ◽  
Mahtab Motamed ◽  
Morteza Fallah-Karkan ◽  
Mohammad Poury ◽  
Saba Faraji ◽  
...  

Background: Overactive bladder (OAB) syndrome correlates with mental disorders, especially depressive disorders and anxiety disorders, and less frequently obsessive-compulsive symptoms, and occurs mostly in older people. Obsessive-compulsive disorder (OCD) is more frequent in OAB patients. Most OCD people are diagnosed at the age of about 19, typically with an earlier age of onset in boys than in girls, but the onset after age 35 does occur less frequently. Objectives: This study aimed to evaluate the relationship between OCD and OAB. Methods: In this case-control study, 1,160 cases who were over 18 years old who were referred to the urodynamic clinic of Shohada-e-Tajrish center from June 2013 to February 2018 in Tehran, Iran, enrolled of whom 580 were considered the control group who were non-OAB patients, and 580 subjects were considered the case group who were OAB patients. The diagnosis of OAB was confirmed by a single urologist. All cases had detrusor overactivity (DO) in urodynamic study (UDS). The OAB-validated 8-questionnaire screen test (OAB-V8) was conducted, and the diagnosis of OCD was confirmed by a single psychiatrist according to DSM-5 criteria. Moreover, the Yale-Brown questionnaire was completed for each patient to rate the severity of OCD symptoms. Results: About the Yale-Brown Obsessive-compulsive Scale (Y-BOCS) total score, there is a significant difference between patients with obsessive traits and the control group (P < 0.001). OCD scores were significantly higher in the OAB group compared to the control group (P < 0.001). Logistic regression analysis showed that the population of the studied patients with OAB was more probable to have OCD than non-OAB control subjects in aged classified groups (OR: 6.23; P < 0.001). Conclusions: The findings of this study showed that OAB patients reported higher obsessive-compulsive scores (Y-BOCS) compared to the controls. There is an independent correlation between OCD and OAB. However, the linkage between OCD and OAB justifies the need for more research.


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