Viel Leiden mit der Haut, aber keine Ursache - ein Blick in die neue Leitlinie hilft

Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease. This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years. We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

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Theraplay

Advances in Psychology, Mental Health, and Behavioral Studies - Emerging Research in Play Therapy, Child Counseling, and Consultation ◽

10.4018/978-1-5225-2224-9.ch003 ◽

2017 ◽

pp. 42-59 ◽

Cited By ~ 1

Author(s):

Catherine Tucker ◽

Sondra Smith-Adcock

Keyword(s):

Behavioral Problems ◽

Evidence Base ◽

Emotional And Behavioral Problems ◽

Current Evidence ◽

Clinical Settings ◽

Neuroscience Research ◽

Wide Range ◽

Current Evidence Base ◽

Childhood Problems ◽

Families With Children

Theraplay® is a brief, attachment-based parent-child psychotherapy approach that uses interactional play to establish ‘affectional' bonds between caregiver and child. Recent research related to Theraplay suggests it is an evidence-based practice for use in schools and clinical settings for a wide range of childhood problems, including those that are trauma-based. Of particular importance, Theraplay is emerging as an approach that is consistent with current neuroscience research on children's brain development and new understandings of attachment and disruption advanced by researchers. Young clients with some form of trauma-related symptoms comprise a large percentage of clinical cases, and present with complicated emotional and behavioral problems In this chapter, we will explore the basic theoretical underpinnings of Theraplay, the relevant mechanisms of change, and current evidence base. Although Theraplay can be used with a wide range of clients and problems, in this chapter, the focus will be on the applicatio with families with children who have experienced trauma.

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Cognitive analytic therapy at 30

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.113.011817 ◽

2014 ◽

Vol 20 (4) ◽

pp. 258-268 ◽

Cited By ~ 22

Author(s):

Anthony Ryle ◽

Stephen Kellett ◽

Jason Hepple ◽

Rachel Calvert

Keyword(s):

Public Mental Health ◽

Evidence Base ◽

Current Evidence ◽

Personal Construct ◽

List Type ◽

National Guidelines ◽

Wide Range ◽

Current Evidence Base ◽

Analytic Therapy ◽

Cognitive Analytic Therapy

SummaryCognitive analytic therapy (CAT) was formalised in 1984 by Anthony Ryle. It facilitated the clinical integration of psychodynamic therapy and personal construct/cognitive psychology. It is a brief, user-friendly relational therapy, applicable to the wide range of psychological problems typically seen in public mental health settings. It has recently been included in national guidelines for the treatment of personality disorder in the National Health Service. CAT provides a coherent model of development and psychopathology, which centrally views the self as both socially formed and embedded. Owing to its core relational grounding, CAT is being increasingly applied to team contexts/systems, enabling a ‘common language’ for team formulation/practice. It is also being successfully delivered as a group therapy. This article describes the development and unique features of the CAT model, analyses the current evidence base and identifies potential future directions for the model.LEARNING OBJECTIVESBe able to describe the core principles of the CAT approach.Appreciate the evidence base for CAT.Understand CAT's place today among talking therapies.

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Characterising the evidence base for advanced clinical practice in the UK: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-036192 ◽

2020 ◽

Vol 10 (5) ◽

pp. e036192 ◽

Cited By ~ 3

Author(s):

Catrin Evans ◽

Brenda Poku ◽

Ruth Pearce ◽

Jeanette Eldridge ◽

Paul Hendrick ◽

...

Keyword(s):

Clinical Practice ◽

Scoping Review ◽

Health Workforce ◽

Grey Literature ◽

Evidence Base ◽

Current Evidence ◽

Multiprofessional Team ◽

Wide Range ◽

Current Evidence Base ◽

The Uk

IntroductionA global health workforce crisis, coupled with ageing populations, wars and the rise of non-communicable diseases is prompting all countries to consider the optimal skill mix within their health workforce. The development of advanced clinical practice (ACP) roles for existing non-medical cadres is one potential strategy that is being pursued. In the UK, National Health Service (NHS) workforce transformation programmes are actively promoting the development of ACP roles across a wide range of non-medical professions. These efforts are currently hampered by a high level of variation in ACP role development, deployment, nomenclature, definition, governance and educational preparation across the professions and across different settings. This scoping review aims to support a more consistent approach to workforce development in the UK, by identifying and mapping the current evidence base underpinning multiprofessional advanced level practice in the UK from a workforce, clinical, service and patient perspective.Methods and analysisThis scoping review is registered with the Open Science Framework (https://osf.io/tzpe5). The review will follow Joanna Briggs Institute guidance and involves a multidisciplinary and multiprofessional team, including a public representative. A wide range of electronic databases and grey literature sources will be searched from 2005 to the present. The review will include primary data from any relevant research, audit or evaluation studies. All review steps will involve two or more reviewers. Data extraction, charting and summary will be guided by a template derived from an established framework used internationally to evaluate ACP (the Participatory Evidence-Informed Patient-Centred Process-Plus framework).DisseminationThe review will produce important new information on existing activity, outcomes, implementation challenges and key areas for future research around ACP in the UK, which, in the context of global workforce transformations, will be of international, as well as local, significance. The findings will be disseminated through professional and NHS bodies, employer organisations, conferences and research papers.

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A systematic scoping review of psychological therapies for psychosis within acute psychiatric in-patient settings

The British Journal of Psychiatry ◽

10.1192/bjp.2018.106 ◽

2018 ◽

Vol 213 (2) ◽

pp. 490-497 ◽

Cited By ~ 10

Author(s):

Pamela Jacobsen ◽

Kathleen Hodkinson ◽

Emmanuelle Peters ◽

Paul Chadwick

Keyword(s):

Outcome Measures ◽

Scoping Review ◽

Psychotic Disorders ◽

Evidence Base ◽

Allocation Concealment ◽

Current Evidence ◽

Psychological Therapies ◽

Affective Symptoms ◽

Wide Range ◽

Current Evidence Base

BackgroundPeople with psychotic disorders account for most acute admissions to psychiatric wards. Psychological therapies are a treatment adjunct to standard medication and nursing care, but the evidence base for such therapies within in-patient settings is unclear.AimsTo conduct a systematic scoping review of the current evidence base for psychological therapies for psychosis delivered within acute in-patient settings (PROSPERO: CRD42015025623).MethodAll study designs, and therapy models, were eligible for inclusion in the review. We searched PubMed, PsycINFO, EThOS, ProQuest, conference abstracts and trial registries.ResultsWe found 65 studies that met criteria for inclusion in the review, 21 of which were randomised controlled trials (RCTs). The majority of studies evaluated cognitive–behavioural interventions. Quality was variable across all study types. The RCTs were mostly small (n<25 in the treatment arm), and many had methodological limitations including poorly described randomisation methods, inadequate allocation concealment and non-masked outcome assessments. We found studies used a wide range of different outcome measures, and relatively few studies reported affective symptoms or recovery-based outcomes. Many studies described adaptations to treatment delivery within in-patient settings, including increased frequency of sessions, briefer interventions and use of single-session formats.ConclusionsBased on these findings, there is a clear need to improve methodological rigour within in-patient research. Interpretation of the current evidence base is challenging given the wide range of different therapies, outcome measures and models of delivery described in the literature.Declaration of interestNone.

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Employment Supports for Adults With Disabilities in Low- and Middle-Income Countries: A Campbell Systematic Review

Research on Social Work Practice ◽

10.1177/1049731517715316 ◽

2017 ◽

Vol 29 (3) ◽

pp. 243-255 ◽

Cited By ~ 1

Author(s):

Janice Tripney ◽

Nina Hogrebe ◽

Elena Schmidt ◽

Carol Vigurs ◽

Ruth Stewart

Keyword(s):

Systematic Review ◽

Research Evidence ◽

Evidence Base ◽

Current Evidence ◽

Market Outcomes ◽

High Quality Research ◽

Middle Income ◽

Employment Supports ◽

Wide Range ◽

Current Evidence Base

Objective: To identify, appraise, and synthesize studies of interventions to improve labor market outcomes of adults in developing countries with physical and/or sensory disabilities. Method: Systematic review methods, following Campbell Collaboration guidelines, were utilized. A comprehensive search was used to identify relevant studies published between 1990 and 2013, which were graded for study quality and a narrative approach used to synthesize the research evidence. Results: Fourteen studies covering a wide range of interventions met the inclusion criteria. Although individual studies reported improvements in outcomes, heterogeneity was high and studies were generally of poor methodological quality. Conclusions: There is a lack of high-quality research evidence to inform decision-making in this area. Stakeholders should be cautious when interpreting the results of the current evidence base.

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Prevention strategies for adolescent depression

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.112.010314 ◽

2014 ◽

Vol 20 (2) ◽

pp. 116-124 ◽

Cited By ~ 4

Author(s):

Cheryl Bennett ◽

Rhys Bevan Jones ◽

Daniel Smith

Keyword(s):

Adolescent Depression ◽

Signs And Symptoms ◽

Evidence Base ◽

Current Evidence ◽

List Type ◽

Prevention Strategies ◽

Interpersonal Therapy ◽

Theoretical Concepts ◽

Wide Range ◽

Current Evidence Base

SummaryDepression is missed more often in adolescents than in adults, partly because they present with symptoms different from those in adults and because many do not seek help. Early detection or the delay of onset can have a significant effect on a young person's development and social functioning. We briefly discuss diagnosis and screening instruments before presenting the wide range of educational and psychological preventive approaches developed for adolescent depression. Many of the latter are based on the cognitive-behavioural or interpersonal therapy models. We consider how clinicians might use the current evidence base to identify and prevent depression in adolescents, and outline the principles of management of the disorder.LEARNING OBJECTIVES•Identify signs and symptoms of adolescent depression and recognise the difficulties in making a diagnosis.•Recognise the risk factors for adolescent depression.•Appreciate the aims and theoretical concepts of prevention strategies for adolescent depression.

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Faculty Opinions recommendation of Care for patients with multiple endocrine neoplasia type 1: the current evidence base.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.6870956.7050054 ◽

2010 ◽

Author(s):

Alberto Falchetti

Keyword(s):

Multiple Endocrine Neoplasia ◽

Multiple Endocrine Neoplasia Type ◽

Evidence Base ◽

Current Evidence ◽

Endocrine Neoplasia ◽

Endocrine Neoplasia Type ◽

Current Evidence Base

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Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

Brain Plasticity ◽

10.3233/bpl-200111 ◽

2020 ◽

pp. 1-15

Author(s):

Daniel Joseph Lamport ◽

Claire Michelle Williams

Keyword(s):

Systematic Reviews ◽

Evidence Base ◽

Epidemiological Studies ◽

Cognitive Outcome ◽

Current Evidence ◽

Duration Of Treatment ◽

Current Evidence Base ◽

Cognitive Benefits ◽

Meta Analyses ◽

The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

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