Fresh Symptom Emergence After Intensive Behaviour Therapy

1976 ◽  
Vol 129 (4) ◽  
pp. 378-383 ◽  
Author(s):  
R. Julian Hafner

SummaryThe outcome of a standard four-day intensive symptomatic treatment programme with 39 agoraphobics is examined in relation to the incidence of fresh symptom emergence. Twenty-six patients suffered fresh symptom emergence during follow-up, and there was a significant association of fresh symptom emergence with poorer outcome at one-year follow-up. About 18 per cent of patients were adversely affected by the treatment programme, as judged on a wide range of symptoms and measures of inter- and intra-personal adjustment. Sixteen individually treated patients are then compared with the 39 group-treated patients and differences in drop-out rate are discussed.

2017 ◽  
Vol 41 (S1) ◽  
pp. s784-s784
Author(s):  
J. Valdes-Stauber ◽  
S. Merath ◽  
S. Krämer

BackgroundThe research on sustainability of effectiveness of inpatient psychosomatic treatment is necessary for epidemiological and economic reasons as well as towards their legitimacy.Objectives and aimsTo investigate whether the achieved clinical improvement by the inpatient treatment continues one year after discharge and whether the utilization of medical services display a significant reduction post-discharge compared to the year before admission.MethodsNaturalistic 1 year follow-up study of a cohort (n = 122). Three measuring time points: T1 (discharge), T2 (6 months after discharge; drop-out rate about 33%), T3 (12 months after discharge; drop-out rate about 49%). Assessment by means of standardized tests of changes in clinical variables, self-efficacy, quality of life, and personality between discharge and one year after discharge. Utilization variables (hospital days, days of incapacity, medication and doctor visits) were compared with ranges in the year before admission.ResultsImprovements at discharge in general functionality, psychological and somatic stress, depressiveness, bitterness level, quality of life and self-efficacy remain one year after discharge sustainably. Furthermore, hospital days, days of incapacity, number of doctor visits and of prescribed drugs decreased significantly in comparison with the year prior to admission.ConclusionsInpatient psychotherapy is effective not only in short-term but also in medium-term. One year after discharge clinically improvement at discharge time-point remains stable and the utilization of medical services decreased significantly. Longer periods of observation, identification of risk groups and of resilient prognostic factors, as well as ensuring post-discharge care are necessary in order to prevent relapses and to made early interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1227.2-1227
Author(s):  
E. Berard ◽  
T. Barnetche ◽  
L. Rouxel ◽  
C. Dutriaux ◽  
L. Dousset ◽  
...  

Background:Description and initial management of rheumatic immune-related adverse-events (irAEs) from cancer immunotherapies have been reported by several groups but to date, few studies have evaluated the long-term outcomes and management of rheumatic irAEs (1).Objectives:To describe the long-term management and assess the one-year outcomes of patients who experienced rheumatic immune-related adverse events (irAEs) due to immune checkpoint inhibitors (ICI).Methods:This was a single-centre prospective observational study including patients referred for musculoskeletal symptoms while treated with ICI. After baseline rheumatological evaluation defining the clinical entity presented, follow-up visits were organised according to the type and severity of irAE. At one year, persistence of irAE, ongoing treatment, as well as cancer outcomes were assessed.Results:63 patients were included between September 2015 and June 2018. 24 patients (38%) presented with non-inflammatory musculoskeletal conditions managed with short-term symptomatic treatment and did not require specific follow-up. 39 patients (62%) experienced inflammatory manifestations, mimicking either rheumatoid arthritis (RA, n=19), polymyalgia rheumatica (PMR, n=16), psoriatic arthritis (PsA, n=3) and one flare of a preexisting axial spondyloarthritis. Overall, 32 patients (82%) received systemic glucocorticoids, with a median rheumatic dosage of 15mg/day (range: 5-60mg/day). None of the patients had to permanently discontinue ICI therapy for rheumatic irAE. 20 patients (67%) were still receiving glucocorticoids at one year, with a median dosage of 5mg/day (range: 2-20mg/day). Glucocorticoids were more frequently discontinued for patients with RA-like condition (44%) than PMR-like condition (23%), but no other predictive factor of glucocorticoids withdrawal could be identified. At one year, overall survival and progression-free survival were comparable between patients who were still receiving glucocorticoids for rheumatic irAE and patients who have discontinued. Eight patients required csDMARDs.Conclusion:At one year, a majority of patients required long-term low-dose glucocorticoids for chronic rheumatic irAE, which seems not altering oncological control.References:[1]Braaten TJ, Brahmer JR, Forde PM, et al. Immune checkpoint inhibitor-induced inflammatory arthritis persists after immunotherapy cessation. Ann Rheum Dis. 2019 Sep 20.Disclosure of Interests:None declared


2001 ◽  
Vol 70 (6) ◽  
pp. 298-306 ◽  
Author(s):  
Valdo Ricca ◽  
Edoardo Mannucci ◽  
Barbara Mezzani ◽  
Sandra Moretti ◽  
Milena Di Bernardo ◽  
...  

2005 ◽  
Vol 6 (1) ◽  
pp. 69-76
Author(s):  
Benedetta Santarlasci ◽  
Giovanni Biricolti ◽  
Cecilia Orsi

BACKGROUND: In schizophrenia the drop-out rate can be used as proxy of effectiveness. The drop-out evaluation is also important considering the relevant economic impact for NHS of an antipsychotic therapy discontinuation in terms of patient hospitalization and other related healthcare resources consumption. OBJECTIVE: To analyze the differences in the rates of drop-out from clinical trials between olanzapine and aripiprazole. METHODS: Literature search was based on MEDLINE, on Iowa-IDIS and Drugdex databases (1966-Dec 2004). Analysis included 12 randomized controlled trials (3.778 patients), 8 for olanzapine (2.559 patients) and 4 for aripiprazole (1.219 patients). RCT inclusion criteria were: a) Patients affected by schizophrenia; b) Randomized assignment to olanzapine or aripiprazole treatment group; c) Number of patients included in the treatment group higher than 100; d) Drop-out frequency evaluation between 4th and 26th weeks of follow-up. RESULTS: The rate of treatment discontinuation was greater for aripiprazole than for olanzapine (42,2% vs. 31,6% respectively). The comparison between drop-out percentages is statistically significant (p


1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 51-53
Author(s):  
Clair C. Williams

Of 508 patients trained for CAPD during the first five years, 115 (22.6%) were transferred to an alternative dialysis modality. Of these 87% were transferred to centre dialysis programs, equally divided between hemodialysis and intermittent peritoneal dialysis. Advanced age favoured transfer to intermittent peritoneal dialysis and failure due to peritonitis, transfer to hemodialysis. Three year survival after transfer from CAPD was 38%. The presence of diabetes and advanced age adversely affected survival after transfer. Dialysis modality and peritonitis as the cause of CAPD failure did not affect survival. Other treatment options are available to patients who fail CAPD. A relatively high drop-out is therefore acceptable and preferable to continuing CAPD in patients encountering complications which might ultimately influence their survival. Since its introduction in Toronto in 1977, continuous ambulatory peritoneal dialysis (CAPD) has achieved increasing prominence in the management of end-stage renal disease. Throughout its comparatively short history, one of the major criticisms of this technique has been the relatively high drop-out rate. This report provides a follow-up of patients transferred from CAPD to alternative dialysis modalities.


1975 ◽  
Vol 127 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Peter Tyrer ◽  
Derek Steinberg

Summary1.Twenty-six out of 28 out-patients with agoraphobia and social phobias who had originally been treated with phenelzine or placebo in a double-blind clinical trial were followed up for a mean period of one year. During the follow-up period patients received further pharmacotherapy or behaviour therapy, except that those patients originally receiving placebo were not allowed therapy with monoamine oxidase inhibitors.2.Ratings of phobic and additional symptoms, social adjustment and degree of personality disorder were made after one year by one of the authors (D.S.) who had no prior knowledge of the treatment each patient had received.3.There were no significant differences in any of the ratings between the patients of the two groups, but those originally receiving placebo had more additional treatment in the follow-up period. Patients continuing to receive phenelzine frequently experienced a return of symptoms if the drug was withdrawn before six months treatment had elapsed.4.Degree of personality disorder showed a significant negative correlation (p = –0.6) with improvement in the phenelzine group but not in those receiving placebo originally.5.Improvement in social adjustment items was less than improvement in symptoms at follow-up. The implications of this are discussed.6.The results suggest that phenelzine is of comparable efficacy to other symptomatic treatments for agoraphobia and social phobias, but that it acts mainly by symptom suppression. Prolonged treatment in patients with personality disorders is not indicated, for improvement is less likely and the dangers of dependence are greater.


EP Europace ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. 1487-1494 ◽  
Author(s):  
Katharina Schoene ◽  
Arash Arya ◽  
Friederike Grashoff ◽  
Helge Knopp ◽  
Alexander Weber ◽  
...  

Abstract Aims The aim of the study was to determine the incidence of oesophageal lesions after radiofrequency ablation (RFA) of atrial fibrillation (AF) with or without the use of oesophageal temperature probes. Methods and results Two hundred patients were prospectively randomized into two groups: the OPERA+ group underwent RFA using oesophageal probes (SensiTherm™); the OPERA− group received RFA using fixed energy levels of 25 W at the posterior wall without an oesophageal probe. All patients underwent post-interventional endoscopy and Holter-electrocardiogram after 6 months. (Clinical.Trials.gov: NCT03246594). One hundred patients were randomized in OPERA+ and 100 patients in OPERA−. The drop-out rate was 10%. In total, 18/180 (10%) patients developed endoscopically diagnosed oesophageal lesions (EDEL). There was no difference between the groups with 10/90 (11%) EDEL in OPERA+ vs. 8/90 (9%) in OPERA− (P = 0.62). Despite the higher power delivered at the posterior wall in OPERA+ [28 ± 4 vs. 25 ± 2 W (P = 0.001)], the average EDEL size was equal [5.7 ± 2.6 vs. 4.5 ± 1.7 mm (P = 0.38)]. The peak temperature did not correlate with EDEL size. During follow-up, no patient died. Only one patient in OPERA− required a specific therapy for treatment of the lesion. Cumulative AF recurrence after 6 (3–13) months was 28/87 (32%) vs. 34/88 (39%), P = 0.541. Conclusion This first randomized study demonstrates that intraoesophageal temperature monitoring using the SensiTherm™ probe does not affect the probability of developing EDEL. The peak temperature measured by the thermoprobe seems not to correlate with the incidence of EDEL. Empiric energy reduction at the posterior wall did not affect the efficacy of the procedure.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Rita Moretti ◽  
Paola Caruso ◽  
Matteo Dal Ben

Over 90% of PDD patients show at least one neuropsychiatric symptom (NPS); in the 60–70% two or more NPS are present. Their incidence is important in terms of prognosis and severity of pathology. However, among all NPS, apathy is often the most disturbing, associated with greater caregiver’s burden. Similar to other NPS, apathy may be due to a dysfunction of the nigrostriatal pathway, even though, not all the PD patients become apathetic, indicating that apathy should not entirely be considered a dopamine-dependent syndrome, and in fact it might also be related to acetylcholine defects. Apathy has been treated in many ways, without sure benefits; among these, Rivastigmine may present benefic properties. We present a series of 48 patients, suffering from PDD, treated with Rivastigmine, and followed-up for one year; they have been devotedly studied for apathy, even though all the other NPS disorders have been registered. Rivastigmine did not have a prolonged benefic effect on apathy, in our work, on the contrary of what had been observed in the literature, probably due to the longer follow-up of our patients.


2004 ◽  
Vol 94 (3_suppl) ◽  
pp. 1447-1454 ◽  
Author(s):  
Zenong Yin ◽  
Justin B. Moore

The purpose of the present study was to examine the relationships of interscholastic sports participation with locus of control, self-concept, cognitive test scores, and school dropout in adolescents via a secondary analysis of National Educational Longitudinal Study 1988 (NELS:88). Subjects were 1,883 students who completed all measurements in 8th grade (1988), at Follow-up 1 (10th, 1990), and Follow-up 2 (12th, 1992). Scales utilized to measure locus of control, self-concept, and cognitive ability were developed by the National Center for Educational Statistics. Dropout was assessed through school records and contact with participants. At baseline and Follow-up 1, students self-reporting sport participation displayed higher self-concept and locus of control; however, these differences were no longer observed at Follow-up 2. Drop-out rate for boys at Follow-up 2 was significantly lower for students reporting interscholastic sport participation at baseline or at Follow-up 1. Similarly, drop-out rate for girls at Follow-up 2 was significantly lower for students reporting interscholastic sport participation at baseline or at Follow-up 1. These findings support the presumed positive role of sport participation for adolescents in American schools.


2011 ◽  
Vol 35 (6) ◽  
pp. 511-530 ◽  
Author(s):  
Gilly Koritzky ◽  
Eldad Yechiam

The authors examined the effectiveness of a novel behavior modification method for dysfunctional and impulsive habits, based on nonremovable reminders (NrRs). NrRs were implemented by having participants wear nonremovable wristbands designated to constantly remind them of their resolution to quit the targeted habit (nail-biting). Participants were 80 nail-biters who resolved to quit. The NrR approach was contrasted with an aversion-based behavioral modification technique. Recovery was assessed after 3 and 6 weeks of treatment and in a 5-month follow-up. The NrR method was associated with lower drop-out rate and was as successful as the aversion-based method altogether. When considering only non-dropouts, the aversion-based method was more effective. This suggests that the use of constantly present reminders broadens the target population that can benefit from reminders in the course of behavior modification.


Sign in / Sign up

Export Citation Format

Share Document