Postal self-exposure treatment of recurrent nightmares

1998 ◽  
Vol 172 (3) ◽  
pp. 257-262 ◽  
Author(s):  
Mary Burgess ◽  
Isaac M. Marks ◽  
Michael Gill
Keyword(s):  
Treatment Method ◽  
The Self ◽  
Waiting List ◽  
Drop Out ◽  
Control Group ◽  
Drop Out Rate ◽  
Intent To Treat ◽  
Treatment Manuals ◽  
At Home

BackgroundMarry nightmare sufferers do not consult a health care professional. Though behaviour and cognitive therapy can help, they have not been tested as a self-treatment method at home using a manual.MethodOne hundred and seventy adults with primary nightmares were randomised to four weeks' self-exposure or self-relaxation at home using manuals posted to them, or to a waiting-list as a control group for four weeks. Individuals recorded nightmare frequency and intensity in four-week diaries.ResultsAt one- and six-month follow-up, the self-rated nightmare frequency felt more significantly in exposure subjects than relaxation or waiting-list subjects. The self-exposure group had the most drop-outs but remained superior in an over-cautious intent-to-treat analysis. The individuals' partners confirmed the superiority of self-exposure to self-relaxation at one- and six-month follow-up.ConclusionsRecurrent nightmare sufferers improved more with self-exposure manuals than with self-relaxation manuals or by being on a waiting-list. Self-exposure may be needed for longer than four weeks in order to reduce nightmare intensity as well as frequency. Despite a high drop-out rate, some sufferers of other conditions may benefit from self-treatment manuals.

Problems of Drop-out in the Self-help Treatment of Chronic, Occupational Pain of the Upper Limbs

1993 ◽  
Vol 21 (4) ◽  
pp. 311-328 ◽  
Author(s):  
Susan H. Spence ◽  
Louise Sharpe
Keyword(s):  
The Self ◽  
Drop Out ◽  
Pain Beliefs ◽  
Drop Out Rate ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Chronic Pain Patients ◽  
Pain Patients ◽  
Very High

The present study evaluated the effectiveness of a self-help, cognitive-behavioural programme in the rehabilitation of a sample of chronic pain patients. The results demonstrated significant benefits for subjects who completed the self-help treatment on measures of depression, anxiety, coping strategies, impact on daily living, pain beliefs and self-monitored pain. These benefits were generally maintained at 6 month follow-up and no differences were found in outcome between subjects who completed the self-programme compared to those who completed the same treatment in a traditional clinic-based format. Unfortunately, a very high drop-out rate was found for the self-help condition, indicating the approach to be unsuitable for many clients. Attempts to identify the characteristics of subjects who completed the self-help programme versus those who dropped-out revealed only one predictor, namely pretreatment ratings of the credibility of the programme.

Attendance at a psychiatric day centre

1994 ◽  
Vol 11 (4) ◽  
pp. 180-182
Author(s):  
Gerry Lynch ◽  
Margaret McKee ◽  
Daniel M Brennan
Keyword(s):  
Service Quality ◽  
Psychotic Disorders ◽  
Drop Out ◽  
Satisfaction Survey ◽  
First Year ◽  
Service Utilisation ◽  
Diagnostic Data ◽  
Drop Out Rate ◽  
At Home

AbstractObjective: To examine the service utilisation of a newly opened psychiatric day centre. We wished to determine if different diagnostic groups had different perspectives of the day centre, and to see if the drop-out rate differed among clients with neurotic or psychotic disorders.Method: Demographic and diagnostic data was gathered for all clients referred in the first year of operation of the day centre. Those who defaulted from attendance were visited at home and asked to detail reasons for non-attendance. Those who continued to attend 16 months after the centre opened completed a satisfaction survey.Results: The drop-out rate was high for both clients with neurotic and psychotic disorders. Clients who continued to attend were very positive about the day centre. Both client groups saw the benefits of attendance in social rather than therapeutic terms.Conclusions: Consumer opinion may have a valuable part to play in overall measure,measurement of service quality, particularly if it includes the opinion of those who no longer use that service.

scholarly journals Interruzione del trattamento nei pazienti con schizofrenia che ricevono olanzapina o aripiprazolo: metanalisi degli studi clinici controllati

2005 ◽  
Vol 6 (1) ◽  
pp. 69-76
Author(s):  
Benedetta Santarlasci ◽  
Giovanni Biricolti ◽  
Cecilia Orsi
Keyword(s):  
Treatment Group ◽  
Literature Search ◽  
Drop Out ◽  
Inclusion Criteria ◽  
Antipsychotic Therapy ◽  
Therapy Discontinuation ◽  
Randomized Controlled ◽  
Drop Out Rate ◽  
Number Of Patients

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

ASSESSING THE TAKE UP AND ACCEPTABILITY OF A SELF-HELP ROOM USED BY PATIENTS AWAITING THEIR INITIAL OUTPATIENT APPOINTMENT

2001 ◽  
Vol 29 (3) ◽  
pp. 333-343 ◽  
Author(s):  
Graeme E. Whitfield ◽  
Chris J. Williams ◽  
David A. Shapiro
Keyword(s):  
Psychological Health ◽  
General Health Questionnaire ◽  
The Self ◽  
Waiting List ◽  
Dysfunctional Attitudes ◽  
Control Group ◽  
Low Mood ◽  
Self Help ◽  
Group Data ◽  
Scale Scores

This open study measured the proportion of routine referrals from primary care to a psychiatric sector team with symptoms of anxiety and/or low mood who chose to take up the option of attending a self-help room to use the CBT self-help manual Mind over mood during a 6-week waiting list period. It assessed changes in psychological health, dysfunctional attitudes and degree of hopelessness during the period of use of the self-help manual, as well as patient satisfaction with it. Twenty-two of 42 consecutive referrals attended the room (mean 3.55 sessions – SD 1.71). The Beck Hopelessness Scale (BHS), the General Health Questionnaire (GHQ), and Dysfunctional Attitudes Scale (DAS), as well as measures of patient participation and satisfaction, were completed at the beginning and end of the 6-week period for those patients who attended the room. All three scale scores fell significantly over the study period, and the DAS and BHS scores at 6 weeks were negatively correlated with the number of sessions attended. The patients generally judged that the self-help intervention was acceptable and effective, and that their knowledge in a number of key areas had been improved. Conclusions regarding effectiveness are limited by the absence of control group data; nonetheless, this study does suggest that the provision of a self-help room containing Mind over mood is useful for patients with anxiety and low mood on a waiting list for a psychiatric outpatient assessment.

Life After Capo

1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 51-53
Author(s):  
Clair C. Williams
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Options ◽  
Drop Out ◽  
Advanced Age ◽  
Dialysis Modality ◽  
Short History ◽  
Drop Out Rate ◽  
Stage Renal Disease ◽  
End Stage

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.

Effects of a simple reminiscence intervention program on the reminiscence functions in older adults

2020 ◽  
pp. 1-10
Author(s):  
Encarnación Satorres ◽  
Iraida Delhom ◽  
Juan C. Meléndez
Keyword(s):  
Older Adults ◽  
Problem Solving ◽  
Intervention Program ◽  
Intervention Group ◽  
The Self ◽  
Control Group ◽  
Identity Problem ◽  
Healthy Older Adults ◽  
Positive Functions

ABSTRACT Objectives: Reminiscence promotes the acceptance of oneself and others, a sense of meaning, and the integration of the present and the past. The currently accepted classification contains eight reminiscence functions grouped in three broader functions: self-positive functions (identity, problem-solving, and death preparation); self-negative functions (bitterness revival, boredom reduction, and intimacy maintenance); and prosocial functions (conversation and teach-inform). The main objective of this study was to investigate how the eight dimensions change over time in a sample of healthy older adults after an intervention based on simple reminiscence and subsequent follow-up. Design: Participants were randomly assigned to the treatment or control group. Setting: Participants were evaluated individually before, immediately after, and 3 months after the intervention. Participants: Participants included 139 healthy older adults (71 intervention group and 68 control group). Intervention: Ten weekly sessions lasting 2 hours each were administered, based on a simple reminiscence program. Measurements: Participants were assessed with the Reminiscence Functions Scale. Results: After the intervention, in the treatment group, there was a significant increase in the self-positive functions of problem-solving and death preparation, and these effects were maintained even at the follow-up; there was a significant reduction in the self-negative functions of bitterness revival and intimacy maintenance; and there was a significant increase in the prosocial function of conversation. Conclusions: When applying an intervention based on reminiscence, it is important to evaluate how it influences these functions because this information can help us to modify the objectives of the intervention and increase its effectiveness.

Oesophageal Probe Evaluation in Radiofrequency Ablation of Atrial Fibrillation (OPERA): results from a prospective randomized trial

EP Europace ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. 1487-1494 ◽  
Author(s):  
Katharina Schoene ◽  
Arash Arya ◽  
Friederike Grashoff ◽  
Helge Knopp ◽  
Alexander Weber ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Energy Levels ◽  
Randomized Study ◽  
Posterior Wall ◽  
Drop Out ◽  
Peak Temperature ◽  
Drop Out Rate ◽  
Higher Power

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.

Two psychological treatments for hypochondriasis

1998 ◽  
Vol 173 (3) ◽  
pp. 218-225 ◽  
Author(s):  
David M. Clark ◽  
Paul M. Salkovskis ◽  
Ann Hackmann ◽  
Adrian Wells ◽  
Melanie Fennell ◽  
...  
Keyword(s):  
Stress Management ◽  
Cognitive Therapy ◽  
Specific Treatment ◽  
Post Treatment ◽  
Waiting List ◽  
Control Group ◽  
One Year ◽  
Almost All ◽  
Better Than

BackgroundHypochondriasis is generally considered difficult to manage. This study aimed to assess the effectiveness of cognitive therapy and to compare it with an equally credible, alternative treatment.MethodForty-eight patients with hypochondriasis were initially randomly assigned to either cognitive therapy, behavioural stress management or a no treatment waiting list control group. At the end of the waiting period, patients in the control group were randomly assigned to one of the two treatments. Assessments were at pre-, mid- and post-treatment or waiting list and at three-, six- and 12-month post-treatment follow-up.ResultsComparisons with the waiting list group showed both treatments were effective. Comparisons between the treatments showed that cognitive therapy was more effective than behavioural stress management on measures of hypochondriasis, but not general mood disturbance at mid-treatment and at post-treatment. One year after treatment patients who had received either treatment remained significantly better than before treatment, and on almost all measures the two therapies did not differ from each other.ConclusionsCognitive therapy is a specific treatment for hypochondriasis. Behavioural stress management is also effective but its specificity remains to be demonstrated.

Psychosomatic Inpatient Treatment Achieves in the Medium Term Sustainable Clinical Improvement as well as a Reduction in Utilization of Medical Services-Results of a one-year follow-up

2017 ◽  
Vol 41 (S1) ◽  
pp. s784-s784
Author(s):  
J. Valdes-Stauber ◽  
S. Merath ◽  
S. Krämer
Keyword(s):  
Drop Out ◽  
Medical Services ◽  
Medium Term ◽  
Post Discharge ◽  
Doctor Visits ◽  
Drop Out Rate ◽  
One Year ◽  
Hospital Days

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.

scholarly journals Metacognitive reflection and insight therapy (MERIT) for patients with schizophrenia

2018 ◽  
Vol 49 (2) ◽  
pp. 303-313 ◽  
Author(s):  
S. de Jong ◽  
R. J. M. van Donkersgoed ◽  
M. E. Timmerman ◽  
M. aan het Rot ◽  
L. Wunderink ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Drop Out ◽  
Future Research ◽  
Control Group ◽  
Treatment As Usual ◽  
Self Reflection ◽  
Intention To Treat ◽  
Metacognitive Reflection ◽  
Secondary Outcomes

AbstractBackgroundImpaired metacognition is associated with difficulties in the daily functioning of people with psychosis. Metacognition can be divided into four domains: Self-Reflection, Understanding the Other's Mind, Decentration, and Mastery. This study investigated whether Metacognitive Reflection and Insight Therapy (MERIT) can be used to improve metacognition.MethodsThis study is a randomized controlled trial. Patients in the active condition (n = 35) received forty MERIT sessions, the control group (n = 35) received treatment as usual. Multilevel intention-to-treat and completers analyses were performed for metacognition and secondary outcomes (psychotic symptomatology, cognitive insight, Theory of Mind, empathy, depression, self-stigma, quality of life, social functioning, and work readiness).ResultsEighteen out of 35 participants finished treatment, half the drop-out stemmed from therapist attrition (N = 5) or before the first session (N = 4). Intention-to-treat analysis demonstrated that in both groups metacognition improved between pre- and post-measurements, with no significant differences between the groups. Patients who received MERIT continued to improve, while the control group returned to baseline, leading to significant differences at follow-up. Completers analysis (18/35) showed improvements on the Metacognition Assessment Scale (MAS-A) scales Self Reflectivity and metacognitive Mastery at follow-up. No effects were found on secondary outcomes.ConclusionsOn average, participants in the MERIT group were, based on MAS-A scores, at follow-up more likely to recognize their thoughts as changeable rather than as facts. MERIT might be useful for patients whose self-reflection is too limited to benefit from other therapies. Given how no changes were found in secondary measures, further research is needed. Limitations and suggestions for future research are discussed.

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