scholarly journals An Update on Assessment, Therapeutic Management, and Patents on Insomnia

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Amit Porwal ◽  
Yogesh Chand Yadav ◽  
Kamla Pathak ◽  
Ramakant Yadav
Keyword(s):  
Behavioural Therapy ◽  
Pharmacological Treatments ◽  
Pharmacological Agents ◽  
Family Doctors ◽  
Cognitive Behavioural ◽  
Melatonin Receptor Agonists ◽  
H1 Antagonists ◽  
Histamine H1 Antagonists

Insomnia is an ordinary situation related to noticeable disability in function and quality of life, mental and actual sickness, and mishappenings. It represents more than 5.5 million appointments to family doctors every year. Nonetheless, the ratio of insomniacs who are treated keeps on being low, demonstrating the requirement for proceeding with advancement and dispersal of effective treatments. Accordingly, it becomes significant to provide a compelling treatment for clinical practice. It indicates a need for the determination of various critical viewpoints for the evaluation of insomnia along with various accessible alternatives for treatment. These alternatives incorporate both nonpharmacological therapy, specifically cognitive behavioural therapy for insomnia, and a number of pharmacological treatments like orexin antagonists, “z-drugs,” benzodiazepines, selective histamine H1 antagonists, nonselective antihistamines, melatonin receptor agonists, antipsychotics, antidepressants, and anticonvulsants. Besides in individuals whose insomnia is due to restless leg syndrome, depression/mood disorder, or/and circadian disturbance, there is insignificant proof favouring the effectiveness of different prescriptions for the treatment of insomnia though they are widely used. Other pharmacological agents producing sedation should be prescribed with care for insomnia therapy because of greater risk of next-day sleepiness along with known adverse effects and toxicities. This review is also aimed at providing an update on various patents on dosage forms containing drugs for insomnia therapy.

scholarly journals A Tailored, Therapist-Guided Internet-Based Cognitive Behavioral Intervention as an Addition to Care as Usual for Patients With Rheumatoid Arthritis: Economic Evaluation alongside an RCT (Preprint)

2018 ◽  
Author(s):  
Maaike Ferwerda ◽  
Sylvia van Beugen ◽  
Henriët van Middendorp ◽  
Henk Visser ◽  
Harald Vonkeman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Usual Care ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Healthcare Use ◽  
Cognitive Behavioural ◽  
Related Quality ◽  
Health Related

BACKGROUND A chronic somatic condition, such as rheumatoid arthritis (RA), can significantly reduce health related quality of life due to psychological, social and physical consequences. Cognitive behavioural therapy can aid in improving outcomes for patients, for example in terms of disease trajectory, health care utilization, and workplace disability of patients. In recent years internet-based cognitive behavioural therapy has been proposed as an effective and efficient way to offer cognitive behavioural therapy and further implementation. However, little research has been conducted to support this proposition. OBJECTIVE To stimulate the implementation of effective treatment strategies for improving health-related quality of life (HRQoL) of patients with rheumatoid arthritis (RA), cost-benefit ratios are required to inform stake-holders. A cost-effectiveness study from a societal perspective was conducted alongside a randomized controlled trial on a tailored and therapist-guided internet-based cognitive behavioural intervention (ICBT) for patients with elevated levels of distress, as an addition to usual care alone. METHODS Data were collected at baseline/pre-intervention, 6 months/post-intervention, and three-monthly thereafter during one year follow-up. Effects were measured in quality-adjusted life years (QALYs) and costs from a societal perspective including healthcare sector costs (including healthcare use, medication, and intervention costs), patient travel costs for healthcare use, and costs associated with loss of labor. RESULTS The intervention improved quality of life compared to usual care alone (Δ QALYs= 0.059), but also led to higher costs (Δ= € 4.211,44), which reduced substantially when medication costs were left out of the equation (Δ= € 1.862,72). Most (93%) of the simulated ICERS were in the north-east quadrant, suggesting a high probability that the intervention is effective in improving HRQoL, but at a greater monetary cost for society compared to usual care alone. CONCLUSIONS A tailored and guided ICBT intervention as an addition to usual care for patients with RA with heightened distress was effective in gaining quality of life. Consequently, implementation of the ICBT into standard healthcare for patients with RA is recommended, yet further study into cost reductions in this population is warranted. CLINICALTRIAL National trial registry number:NTR2100

Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up

2011 ◽  
Vol 30 (3) ◽  
pp. 381-389 ◽  
Author(s):  
Montserrat Núñez ◽  
Joaquim Fernández-Solà ◽  
Esther Nuñez ◽  
José-Manuel Fernández-Huerta ◽  
Teresa Godás-Sieso ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Related Quality ◽  
Health Related ◽  
Randomised Controlled

scholarly journals Cost-effectiveness of internet-delivered cognitive–behavioural therapy for adolescents with irritable bowel syndrome

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023881 ◽  
Author(s):  
Filipa Sampaio ◽  
Marianne Bonnert ◽  
Ola Olén ◽  
Erik Hedman ◽  
Maria Lalouni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Cost Effectiveness ◽  
Resource Use ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
The Difference ◽  
Irritable Bowel

ObjectiveTo assess whether exposure-based internet-delivered cognitive–behavioural therapy (internet-CBT) is a cost-effective treatment for adolescents with irritable bowel syndrome (IBS) compared with a waitlist control, from a societal perspective, based on data from a randomised trial.DesignWithin-trial cost-effectiveness analysis.SettingParticipants were recruited from the whole of Sweden via primary, secondary and tertiary care clinics reached through news media and advertising.ParticipantsAdolescents (aged 13–17) with a diagnosis of IBS.InterventionsParticipants were randomised to either an exposure-based internet-CBT, including 10 weekly modules for adolescents and five modules for parents, or a waitlist.Outcome measuresThe main health outcome was the quality-adjusted life-year (QALY) estimated by mapping Pediatric Quality-of-Life Inventory (PedsQL) scores onto EQ-5D-3L utilities. The secondary outcome was the point improvement on the PedsQL scale. Data on health outcomes and resource use were collected at baseline and 10 weeks post-treatment. Resource use was measured using the Trimbos and Institute of Medical Technology Assessment Cost Questionnaire for Psychiatry (TIC-P) . Incremental cost-effectiveness ratios (ICER) were calculated as the difference in average costs by the difference in average outcomes between groups.ResultsThe base-case results showed that internet-CBT costs were on average US$170.24 (95% CI 63.14 to 315.04) more per participant than the waitlist. Adolescents in the internet-CBT group showed small QALY gains (0.0031; 95% CI 0.0003 to 0.0061), and an average improvement of 5.647 points (95% CI 1.82 to 9.46) on the PedsQL compared with the waitlist. Internet-CBT yielded an ICER of $54 916/QALY gained and a probability of cost-effectiveness of 74% given the Swedish willingness-to-pay threshold. The ICER for the outcome PedsQL was US$85.29/point improvement.ConclusionsOffering internet-CBT to adolescents with IBS improves health-related quality of life and generates small QALY gains at a higher cost than a waitlist control. Internet-CBT is thus likely to be cost-effective given the strong efficacy evidence, small QALY gains and low cost.Trial registration numberNCT02306369; Results.

scholarly journals The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chen Ling ◽  
Debra Evans ◽  
Yunfang Zhang ◽  
Jianying Luo ◽  
Yanping Hu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Maintenance Haemodialysis ◽  
Cognitive Behavioural

Prophylactic Treatment of Migraine in Children. Part 1. A Systematic Review of non-Pharmacological Trials∗

Cephalalgia ◽  
2006 ◽  
Vol 26 (4) ◽  
pp. 373-383 ◽  
Author(s):  
L Damen ◽  
J Bruijn ◽  
BW Koes ◽  
MY Berger ◽  
J Passchier ◽  
...  
Keyword(s):  
Prophylactic Treatment ◽  
Behavioural Therapy ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Behavioural Treatment ◽  
Cognitive Behavioural Treatment ◽  
Trial Quality ◽  
Data Analyses ◽  
Conflicting Evidence ◽  
Cognitive Behavioural

The aim of this study was to assess the efficacy of non-pharmacological prophylactic treatments of migraine in children. Databases were searched from inception to June 2004 and references were checked. We selected controlled trials reporting the effects of non-pharmacological prophylactic treatments in children with migraine. We assessed trial quality using the Delphi list and extracted data. Analyses were carried out according to type of intervention. A total of 19 trials were included. Relaxation, relaxation + biofeedback, relaxation + biofeedback + cognitive behavioural treatment were more effective compared with waiting list controls. Relaxation + behavioural therapy was more effective than placebo. There is conflicting evidence for the use of oligoantigenic diets. A few non-pharmacological treatments such as relaxation may be effective as prophylactic treatment for migraine in children. Because of the small number of studies and the methodological shortcomings, conclusions on effectiveness have to be drawn with caution.

scholarly journals Economic evaluation of online computerised cognitive–behavioural therapy without support for depression in primary care: randomised trial

2010 ◽  
Vol 196 (4) ◽  
pp. 310-318 ◽  
Author(s):  
S. A. H. Gerhards ◽  
L. E. de Graaf ◽  
L. E. Jacobs ◽  
J. L. Severens ◽  
M. J. H. Huibers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Significant Group ◽  
Efficient Treatment ◽  
Cognitive Behavioural ◽  
The Cost

BackgroundEvidence about the cost-effectiveness and cost utility of computerised cognitive–behavioural therapy (CCBT) is still limited. Recently, we compared the clinical effectiveness of unsupported, online CCBT with treatment as usual (TAU) and a combination of CCBT and TAU (CCBT plus TAU) for depression. The study is registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (ISRCTN47481236).AimsTo assess the cost-effectiveness of CCBT compared with TAU and CCBT plus TAU.MethodCosts, depression severity and quality of life were measured for 12 months. Cost-effectiveness and cost-utility analyses were performed from a societal perspective. Uncertainty was dealt with by bootstrap replications and sensitivity analyses.ResultsCosts were lowest for the CCBT group. There are no significant group differences in effectiveness or quality of life. Cost-utility and cost-effectiveness analyses tend to be in favour of CCBT.ConclusionsOn balance, CCBT constitutes the most efficient treatment strategy, although all treatments showed low adherence rates and modest improvements in depression and quality of life.

scholarly journals Correlates of psychiatric and psychological distress in patients with Parkinson’s disease

2019 ◽  
pp. 50-60
Author(s):  
Helena M van Oers
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Distress ◽  
Neurodegenerative Disorder ◽  
Psychiatric Symptoms ◽  
Behavioural Therapy ◽  
Dopaminergic Drugs ◽  
Cognitive Behavioural ◽  
Psychological Difficulties

Parkinson’s disease is the second most commonly diagnosed neurodegenerative disorder worldwide and the physical manifestations of the disease are well documented in the literature. However, in excess of 60% of patients with the disease report having one or more psychiatric symptoms which worsen as the disease progresses. These symptoms arise differentially from the same pathology which underlies the disease or from the treatment with dopaminergic drugs. Psychiatric and psychological difficulties tend to be under-recognised and undertreated yet cause great disability, significantly impact the quality of life of patients and add to greater burden on their caregivers. These symptoms can be relieved through adjusting the doses of anti-Parkinson’s drug therapy and success in improving psychological distress has been found using adjuvant psychotherapeutic intervention, most notably with Cognitive Behavioural Therapy.

scholarly journals Effectiveness of cognitive behavioural therapy on quality of life in patients with prostate cancer after androgen deprivation therapy: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049314
Author(s):  
Fan Yuan ◽  
Degui Chang ◽  
Mingyi Jing ◽  
Baohua Zhu ◽  
Yaodong You
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Side Effects ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Data Synthesis ◽  
Cognitive Behavioural ◽  
Mean Differences

IntroductionProstate cancer (PCa), as a malignant tumour with rapid development in recent years, significantly affects men’s health, work, life and economy. Androgen deprivation therapy (ADT) plays an important role in the treatment of PCa and can be used as a complementary therapy in the late stage of castration-resistant prostate cancer. Though ADT targeting PCa shows an effective therapeutic effect, the underlying side effects (cognitive disorder, hot flashes, a decrease in sexuality) cannot be ignored. At present, cognitive behavioural therapy (CBT) has been widely used for patients with PCa after ADT due to its confirmed efficacy, fewer side effects and lower economic burden. However, the effectiveness of CBT for patients with PCa after ADT is still controversial. Therefore, we will conduct a systematic review and meta-analysis of the effectiveness of CBT for patients with PCa after ADT.Methods and analysisLiteratures will be searched from establishment of the database to 31 May 2021 with the language restrictions of English and Chinese in eight online databases (PubMed, Embase, the Web of Science, Cochrane Library, VIP, CNKI, CBM, and WAN FANG). This study will include RCTs that performed CBT as the main method of the experimental group for patients with PCa after ADT. Two or more reviewers will independently conduct the selection of studies, data extraction and data analysis. The risk ratios with 95% CIs will be used to present the data synthesis result of dichotomous data, while weighted mean differences or standardised mean differences with 95% CIs will be used to present the data synthesis result of continuous data. Meanwhile, evidence quality of outcome will be assessed by using the Grading of Recommendations Assessment, Development and Evaluation method. Stata V.13.0 and Review Manager software V.5.3 will be used for analysis and synthesis.Ethics and disseminationThis protocol is a second study based on a completed randomised controlled study. Thus, ethical approval is not required, and no additional data are available.OSF registration numberDOI 10.17605/OSF.IO/FUVEA

scholarly journals Effect of Cognitive Behavioural Therapy on the Quality of Life of People with Schizophrenia in South-West Nigeria

2021 ◽  
Vol 4 (3) ◽  
pp. 35-44
Author(s):  
Makanjuola J.O. ◽  
Chiejina E.N. ◽  
Umunnah J.O.
Keyword(s):  
Quality Of Life ◽  
Intervention Group ◽  
Behavioural Therapy ◽  
Mean Value ◽  
Control Group ◽  
P Value ◽  
South West ◽  
Cognitive Behavioural ◽  
Z Value

The quality of life (QoL) of patients with schizophrenia is impaired compared to the general population. This study aimed to evaluate the effect of Cognitive Behavioural Therapy (CBT) on the quality of life of people with schizophrenia in selected Neuropsychiatric Hospitals in South-West Nigeria. A quasi-experimental research design was adopted in the study, 60 participants with schizophrenia were selected purposely, 30 participants to the intervention group and another 30 participants to the control group. Eight sessions of CBT were given to each participant in the intervention group. Data were collected with the use of the WHO Quality of life Bref questionnaire. Data collected were summarized using frequency, percentages, mean score, and standard deviation to answer research questions. The hypotheses were tested using the Mann-Whitney U Test and Wilcoxon Test at 0.05 level of significance. The outcome revealed that there was an overall post-intervention improvement in the Quality of life among the participants in the intervention group with a mean value of 3.63 ± 0.89, Z-value 3.72, p-value <0.001, unlike the control group with a mean value of 2.90 ± 0.85, Z-value= 1.77, p-value=0.08. CBT intervention with pharmacological management was effective in improving the quality of life in schizophrenic patients. CBT should be integrated into routine care given to schizophrenic clients in nursing interventions.

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