scholarly journals Feasibility of computerised positive mental imagery training as a treatment adjunct in in-patient mental health settings: randomised controlled trial

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Katharina Westermann ◽  
Marcella L. Woud ◽  
Jan C. Cwik ◽  
Christian Graz ◽  
Peter W. Nyhuis ◽  
...  
Keyword(s):  
Mental Health ◽  
Positive Affect ◽  
Mental Imagery ◽  
Controlled Trial ◽  
Specific Effect ◽  
Treatment As Usual ◽  
Imagery Training ◽  
Mental Health Settings ◽  
Randomised Controlled ◽  
Cognitive Control Training

Background Positive affect and anhedonia are important but challenging targets for mental health treatments. Previous research indicates the potential of a computerised cognitive training paradigm involving generation of positive mental imagery, termed positive mental imagery training (PMIT), to increase positive affect and reduce anhedonia. Aims Our main aim was to investigate the feasibility of PMIT as a positive affect-focused, transdiagnostic adjunct to treatment as usual for patients in in-patient mental health settings. Method We ran an open feasibility, randomised controlled trial with three parallel arms: treatment as usual; treatment as usual plus PMIT; and treatment as usual plus an active comparator, cognitive control training. Fifty-seven patients from two different in-patient mental health treatment clinics in Germany were randomised in a 1:1:1 ratio. PMIT and cognitive control training comprised an introductory session followed by eight 15-min training sessions over 2 weeks. Clinical outcomes such as positive affect (primary outcome measure) and anhedonia were assessed at pre- and post-training, and at a further 2-week follow-up. Results Adherence was good and attrition was low. The patterns of results for the outcome data were not consistent with a specific effect of PMIT on positive affect, but were more consistent with a specific effect on anhedonia. Conclusions The results indicate feasibility and potential promise of a larger efficacy trial investigating PMIT as a treatment adjunct in in-patient mental health settings. Limitations include lack of researcher blinding, small sample size and lack of pre-specified feasibility outcomes. Anhedonia may be a more suitable primary outcome for a future larger trial.

scholarly journals Feasibility of computerized positive mental imagery training as a treatment adjunct in inpatient mental health settings: a randomized controlled trial

2021 ◽  
Author(s):  
Katharina Westermann ◽  
Marcella Woud ◽  
Jan Christopher Cwik ◽  
Christian Graz ◽  
Peter Nyhuis ◽  
...  
Keyword(s):  
Mental Health ◽  
Positive Affect ◽  
Mental Imagery ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Specific Effect ◽  
Imagery Training ◽  
Randomized Controlled ◽  
Inpatient Mental Health ◽  
Mental Health Settings

Background: Positive affect and anhedonia are important but challenging targets for mental health treatments. Previous research indicates the potential of a computerized cognitive training paradigm involving generation of positive mental imagery, here termed positive mental imagery training (PMIT), to increase positive affect and reduce anhedonia. Aims: Our main aim was to investigate feasibility of PMIT as a positive affect-focussed transdiagnostic adjunct to treatment as usual (TAU) for patients in inpatient mental health settings (clinicaltrials.gov: NCT02958228). Method: We ran an open feasibility randomized controlled trial (RCT) with three parallel arms: TAU, TAU + PMIT, and TAU + an active comparator, cognitive control training (CCT). Fifty-seven patients from two different inpatient mental health treatment clinics in Germany were randomized in a 1:1:1 ratio. PMIT or CCT consisted of an introductory session then eight 15-minute training sessions over two weeks. Clinical outcomes such as positive affect (primary outcome measure) and anhedonia were assessed at pre- and post-training, and at a further 2-week follow-up. Results: Adherence was good and attrition low. The patterns of results for the outcome data were not consistent with a specific effect of PMIT on positive affect, but were more consistent with a specific effect on anhedonia.Conclusion: The results indicate feasibility and potential promise of a larger efficacy RCT investigating PMIT as a treatment adjunct in inpatient mental health settings. Limitations include lack of researcher blinding, the small sample size, and lack of pre-specified feasibility outcomes. Anhedonia may be a more suitable primary outcome for a future larger trial.

scholarly journals Family Talk versus usual services in improving child and family psychosocial functioning in families with parental mental illness (PRIMERA—Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children): study protocol for a randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mairead Furlong ◽  
Sinead McGilloway ◽  
Christine Mulligan ◽  
Colm McGuinness ◽  
Nuala Whelan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Randomised Controlled Trial ◽  
Psychosocial Functioning ◽  
Controlled Trial ◽  
Evidence Base ◽  
Parental Mental Illness ◽  
Research And Innovation ◽  
Mental Health Settings ◽  
Randomised Controlled

Abstract Background Parental mental illness is common and can lead to dependent children incurring a high risk of developing mental disorders, physical illness, and impaired educational and occupational outcomes. Family Talk is one of the better known interventions designed to prevent the intergenerational transmission of mental illness. However, its evidence base is small, with few robust independent randomised controlled trials, and no associated process or cost evaluations. The PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children) research programme involves a mixed method evaluation of Family Talk which is being delivered in mental health settings in Ireland to improve child and family psychosocial functioning in families with parental mental illness. Methods The study comprises a multi-centre, randomised controlled trial (RCT), with nested economic and process evaluations, to assess the clinical and cost-effectiveness and implementation mechanisms of Family Talk compared to usual services. The study is being conducted in 15 adult and child mental health settings in Ireland. Families with a parent with mental illness, and children aged 5–18 years (n = 144 families) will be randomised to either the 7-session Family Talk programme (n = 96) or to standard care (n = 48) using a 2:1 allocation ratio. The primary outcomes are child psychosocial functioning and family functioning. Secondary outcomes are as follows: understanding and experience of parental mental illness, parental mental health, child and parental resilience, partner wellbeing and service utilisation. Blind assessments will take place at pre-intervention and at 6- and 12-month follow-up. Discussion Given the prevalence and burden of intergenerational mental illness, it is imperative that prevention through evidence-based interventions becomes a public health priority. The current study will provide an important contribution to the international evidence base for Family Talk whilst also helping to identify key implementation lessons in the scaling up of Family Talk, and other similar interventions, within routine mental health settings. Trial registration ISRCTN Registry, ISRCTN13365858. Registered 5th February 2019.

scholarly journals Crisis-focused Cognitive Behavioural Therapy for Psychosis (CBTp) vs Treatment as Usual in Acute Mental Health Inpatient Settings (The CRISIS Study): Protocol For a Feasibility Randomised Controlled Trial

2021 ◽  
Author(s):  
Lisa Wood ◽  
Claire Williams ◽  
Vanessa Pinfold ◽  
Fiona Nolan ◽  
Anthony P Morrison ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Inpatient Care ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Treatment As Usual ◽  
Feasibility Randomised Controlled Trial ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Feasibility Rct

Abstract Background Cognitive Behavioural Therapy for psychosis (CBTp) is a psychological therapy which should be offered during the acute phases of psychosis. However, few research studies have examined the efficacy of CBTp interventions specifically adapted for the acute mental health inpatient context with most research trials being conducted with white European community populations. Aims The aim of this study is to conduct a feasibility Randomised Controlled Trial (RCT) of a crisis-focused CBTp intervention adapted for an ethnically diverse acute mental health inpatient population. The study will examine the feasibility of undertaking the trial, the acceptability and safety of the intervention, and the suitability of chosen outcome measures. This will inform the planning of a future, fully powered RCT. Methods A single-site, parallel group, feasibility RCT will be conducted examining the intervention. Drawing on principles of coproduction, the intervention has been adapted in partnership with key stakeholders; service users with lived experience of psychosis and of inpatient care (including those from ethnic minority backgrounds), carers, multidisciplinary inpatient clinicians, and researchers. Sixty participants with experience of psychosis and in current receipt of acute mental health inpatient care will be recruited. Participants will be randomly allocated to either the crisis-focused CBTp intervention or Treatment as Usual (TAU). Discussion Findings of this feasibility RCT will indicate whether a larger multi-site RCT is needed to investigate the efficacy of the intervention. If the initial results demonstrate that this trial is feasible and the intervention is acceptable, it will provide evidence that a full-scale effectiveness trial may be warranted. Trial registration: This trial has been prospectively registered on the ISRCTN registry (ISRCTN59055607) on the 18th February 2021 https://www.isrctn.com/ISRCTN59055607

scholarly journals Democratic therapeutic community treatment for personality disorder: Randomised controlled trial

2017 ◽  
Vol 210 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Steve Pearce ◽  
Lisle Scott ◽  
Gillian Attwood ◽  
Kate Saunders ◽  
Madeleine Dean ◽  
...  
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Therapeutic Community ◽  
Psychiatric Treatment ◽  
Controlled Trial ◽  
Community Treatment ◽  
Satisfaction With Care ◽  
Crisis Planning ◽  
Treatment As Usual ◽  
Randomised Controlled

BackgroundDemocratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent.AimsTo test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder.MethodAn RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317). The intervention was DTC and the control condition was crisis planning plus treatment as usual (TAU). The primary outcome was days of in-patient psychiatric treatment. Secondary outcomes were social function, mental health status, self-harm and aggression, attendance at emergency departments and primary care, and satisfaction with care. All outcomes were measured at 12 and 24 months after randomisation.ResultsNumber of in-patient days at follow-up was low among all participants and there was no difference between groups. At 24 months, self- and other directed aggression and satisfaction with care were significantly improved in the DTC compared with the TAU group.ConclusionsDTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion.

scholarly journals Study protocol for a pilot high-intensity interval training intervention in inpatient mental health settings: a two-part study using a randomised controlled trial and naturalistic study design

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Rebecca Martland ◽  
Juliana Onwumere ◽  
Brendon Stubbs ◽  
Fiona Gaughran
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Interval Training ◽  
Naturalistic Study ◽  
High Intensity Interval Training ◽  
Inpatient Mental Health ◽  
Mental Health Settings ◽  
High Intensity Interval ◽  
Randomised Controlled

Abstract Background Severe mental illnesses (SMI), including schizophrenia spectrum disorder, bipolar disorder and major depressive disorder, are associated with physical health comorbidities and premature mortality. Physical activity and structured exercise have a beneficial impact on cardiometabolic risk and ameliorate mental health symptomology and cognition. This protocol describes a feasibility study for a high-intensity interval training (HIIT) intervention among inpatients with SMI, to improve their physical and mental health. Methods The feasibility study follows a two-part design owing to COVID-19-related adaptations to project design: (a) a non-blinded randomised controlled trial (RCT) of 12 weeks of bicycle-based HIIT, delivered twice weekly in a face-to-face, one-to-one setting, compared to treatment as usual (TAU) and (b) a naturalistic study of inpatient HIIT; eligible participants will be invited to two sessions of HIIT per week, delivered by the research team remotely or in person. Additionally, participants in the naturalistic study may use the bike to conduct self-directed sessions of their chosen length and intensity. We will measure the feasibility and acceptability of the HIIT intervention as primary outcomes, alongside secondary and tertiary outcomes evaluating the physical, mental and cognitive effects of HIIT. The study aims to recruit 40 patients to the RCT and 6–8 patients to the naturalistic design. Discussion Exercise is a modifiable lifestyle barrier that can reverse cardiometabolic disease risk. If HIIT is found to be feasible and acceptable in inpatients with SMI, there would be scope for large-scale work to evaluate the clinical, cost and implementation effectiveness of HIIT in inpatient mental health settings. Trial registration ClinicalTrials.gov NCT03959735. Registered June 22, 2019.

scholarly journals Effects of brief family psychoeducation for caregivers of people with schizophrenia in Japan provided by visiting nurses: protocol for a cluster randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034425
Author(s):  
Naonori Yasuma ◽  
Sayaka Sato ◽  
Sosei Yamaguchi ◽  
Asami Matsunaga ◽  
Takuma Shiozawa ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Treatment As Usual ◽  
Visiting Nurses ◽  
Cluster Randomised ◽  
Randomised Controlled ◽  
Visiting Nurse

IntroductionDevelopment of a support system for families caring for people with schizophrenia in routine psychiatric care settings is an important issue worldwide. Regional mental health systems are inadequate for delivering effective services to such family members. Despite evidence that family psychoeducation (FPE) alleviates the burden of schizophrenia on families, its dissemination in routine clinical practice remains insufficient, suggesting the need for developing an effective and implementable intervention for family caregivers in the existing mental health system setting. In Japan, the visiting nurse service system would be a practical way of providing family services. Visiting nurses in local communities are involved in the everyday lives of people with schizophrenia and their families. Accordingly, visiting nurses understand their needs and are able to provide family support as a service covered by national health insurance. The purpose of this study is to discover whether a brief FPE programme provided by visiting nurses caring for people with schizophrenia will alleviate family burden through a cluster randomised controlled trial (cRCT).Methods and analysisThe study will be a two-arm, parallel-group (visiting nurse agency) cRCT. Forty-seven visiting nurse agencies will be randomly allocated to the brief FPE group (intervention group) or treatment as usual group (control group). Caregivers of people with schizophrenia will be recruited by visiting nurses using a randomly ordered list. The primary outcome will be caregiver burden, measured using the Japanese version of Zarit Burden Interview. Outcome assessments will be conducted at baseline, 1-month follow-up and 6-month follow-up. Multiple levels of three-way interactions in mixed models will be used to examine whether the brief FPE programme will alleviate the burden on caregivers relative to treatment as usual.Ethics and disseminationThe Research Ethics Committee of the Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Japan (No 2019065NI) approved this study. The results will be published in a scientific peer-reviewed journal.Trial registration numberUMIN000038044.

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