scholarly journals Integrating non-drug treatments in early schizophrenia

2005 ◽  
Vol 187 (S48) ◽  
pp. s65-s71 ◽  
Author(s):  
Shôn W. Lewis ◽  
Nicolas Tarrier ◽  
Richard James Drake
Keyword(s):  
Cognitive Remediation ◽  
Behavioural Therapy ◽  
Treatment Modalities ◽  
First Episode ◽  
Psychological Interventions ◽  
Neurocognitive Deficits ◽  
Psychological Treatments ◽  
Adherence To Medication ◽  
Cognitive Behavioural ◽  
Drug Treatments

SummaryThere is a range of psychological interventions for established schizophrenia. These include family interventions, motivational interventions for substance misuse and for non-adherence to medication, cognitive remediation for neurocognitive deficits and cognitive–behavioural therapy for symptoms. Psychological interventions may explicitly target risk factors for poor outcome, such as substance use, or protective factors, such as adherence to medication, or be directed at specific symptoms or deficits. There is emerging evidence for efficacy of psychological treatments during, following and even prior to the first episode. Important areas for further study are how different treatment modalities can interact productively and patient and carer preferences for treatment. Many trials of psychological treatments have design flaws and this tends to overestimate the treatment effect.

scholarly journals Influence of age on outcome of psychological treatments in first-episode psychosis

2006 ◽  
Vol 188 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Gillian Haddock ◽  
Shôn Lewis ◽  
Richard Bentall ◽  
Graham Dunn ◽  
Richard Drake ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Behavioural Therapy ◽  
First Episode ◽  
Treatment As Usual ◽  
Psychological Treatments ◽  
Treatment Providers ◽  
Cognitive Behavioural ◽  
Episode Psychosis ◽  
Supportive Counselling ◽  
Randomised Controlled

BackgroundPsychological treatments have been shown to be effective in patients with psychosis. However, the studies published to date have included participants across wide age ranges, so few conclusions can be reached about the effectiveness of such treatments in relation to age.AimsTo evaluate outcomes by age in a randomised controlled trial designed to evaluate the effectiveness of cognitive-behavioural therapy (CBT), supportive counselling and treatment as usual.MethodOutcomes were evaluated in terms of symptoms, social functioning, insight and therapeutic alliance according to age at 3- and 18-month follow-up.ResultsYounger participants responded better to supportive counselling than to treatment as usual and CBTover 3 months. Older participants responded better to CBT than to supportive counselling over 18 months. Younger participants showed a greater increase in insight after CBT compared with treatment as usual and supportive counselling, and were more difficult to engage in therapy.ConclusionsYoung people may have different needs with regard to engagement in psychological treatments. Treatment providers need to take age-specific factors into account.

Psychotherapeutic interventions for bipolar disorder

2017 ◽  
Author(s):  
María Reinares
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Remediation ◽  
Family Intervention ◽  
Target Population ◽  
Behavioural Therapy ◽  
High Morbidity ◽  
Behaviour Therapy ◽  
Psychological Treatments ◽  
Psychotherapeutic Interventions ◽  
Cognitive Behavioural

The recurrent nature of bipolar disorder (BD), and the high morbidity and mortality associated with the illness advocate for an integrative treatment in which medication is complemented with psychological approaches. This chapter explores the role of adjunctive psychotherapy in BD. The most commonly tested psychological treatments have been cognitive-behavioural therapy, psychoeducation, interpersonal and social rhythm therapy, and family intervention. Functional remediation represents a new option for patients with functional impairment. Most findings indicate the benefits of adjunctive psychological treatments to improve the outcomes of BD. Controversial results have also been found, highlighting the need for a better identification of treatment moderators and mediators to design interventions tailored to the target population. Recently, cognitive remediation, mindfulness-based cognitive therapy, dialectical behaviour therapy, and eye movement desensitization and reprocessing have begun to be tested, as well as Internet-based psychological interventions, but it is too early to draw conclusions about their efficacy.

scholarly journals Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review

2015 ◽  
Vol 100 (4) ◽  
pp. 308-316 ◽  
Author(s):  
Sophie Bennett ◽  
Roz Shafran ◽  
Anna Coughtrey ◽  
Susan Walker ◽  
Isobel Heyman
Keyword(s):  
Psychiatric Symptoms ◽  
Behavioural Therapy ◽  
Physical Illness ◽  
Psychological Interventions ◽  
Chronic Physical Illness ◽  
Psychological Treatments ◽  
Symptoms Of Depression ◽  
Cognitive Behavioural ◽  
Health Disorders ◽  
Randomised Controlled

BackgroundChildren with chronic physical illness are significantly more likely to develop common psychiatric symptoms than otherwise healthy children. These children therefore warrant effective integrated healthcare yet it is not established whether the known, effective, psychological treatments for symptoms of common childhood mental health disorders work in children with chronic physical illness.MethodsEMBASE, MEDLINE, PsycINFO and CINAHL databases were searched with predefined terms relating to evidence-based psychological interventions for psychiatric symptoms in children with chronic physical illness. We included all studies (randomised and non-randomised designs) investigating interventions aimed primarily at treating common psychiatric symptoms in children with a chronic physical illness in the review. Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality analysis.ResultsTen studies (209 children, including 70 in control groups) met the criteria for inclusion in the review. All studies demonstrated some positive outcomes of cognitive behavioural therapy for the treatment of psychiatric symptoms in children with chronic physical illness. Only two randomised controlled trials, both investigating interventions for symptoms of depression, were found.ConclusionsThere is preliminary evidence that cognitive behavioural therapy has positive effects in the treatment of symptoms of depression and anxiety in children with chronic physical illness. However, the current evidence base is weak and fully powered randomised controlled trials are needed to establish the efficacy of psychological treatments in this vulnerable population.

Psychological treatment of depression in children and adolescents

1998 ◽  
Vol 173 (4) ◽  
pp. 291-298 ◽  
Author(s):  
Richard Harrington ◽  
Jane Whittaker ◽  
Philp Shoebridge
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Preventive Intervention ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Psychological Treatments ◽  
Literature Searches ◽  
Cognitive Behavioural ◽  
Treatment Of Depression

BackgroundThis paper reviews research on the psychological treatment of depression in children.MethodManual and computer literature searches were performed.ResultsThe most promising psychological interventions for depression in children are individual rather than family therapies. Cognitive – behavioural therapy seems to be an effective treatment for depressive symptoms and mild depressive disorders. It may also be a useful preventive intervention, though this remains to be conclusively demonstrated. There have been no systematic studies comparing psychological treatments with medication.ConclusionsStudies comparing psychological treatments and medication are now required.

A naturalistic, randomized, controlled trial combining cognitive remediation with cognitive–behavioural therapy after first-episode non-affective psychosis

2013 ◽  
Vol 44 (9) ◽  
pp. 1889-1899 ◽  
Author(s):  
R. J. Drake ◽  
C. J. Day ◽  
R. Picucci ◽  
J. Warburton ◽  
W. Larkin ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Cognitive Remediation ◽  
Behavioural Therapy ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Affective Psychosis ◽  
Cognitive Behavioural ◽  
Significant Difference ◽  
Group Time

BackgroundCognitive remediation (CR) preceding cognitive–behavioural therapy for psychosis (CBTp) was trialled within routine clinical services, with the hypothesis that following first-episode non-affective psychosis CR would enhance CBTp efficacy by improving neuropsychological performance.MethodA total of 61 patients with DSM-IV non-affective psychoses waiting for routine CBTp were randomized to computerized CR over 12 weeks, supported by a trained support worker, or time-matched social contact (SC). Primary outcome was the blind-rated Psychotic Symptoms Rating Scale (PSYRATS). Secondary outcomes included measures of CBTp progress, cognition, symptoms, insight and self-esteem: all at baseline, after CR (12 weeks) and after CBTp (42 weeks). PSYRATS and global neuropsychological efficacy were tested using mixed-effects models with a group × time interaction term. Measures of CBTp progress and some neuropsychological measures were modelled by regression.ResultsThere was no significant difference between the CR and SC groups in PSYRATS (group × time coefficient 0.3, 95% confidence interval −0.4 to 1.1, p = 0.39). However, after CR CBTp was shorter [median 7 sessions, interquartile range (IQR) 2–12 after CR; median 13, IQR 4–18 after SC; model p = 0.011] and linked to better insight (p = 0.02). Global cognition did not improve significantly more after CR (p = 0.20) but executive function did (Wisconsin Card Sort, p = 0.012).ConclusionsCBTp courses preceded by CR were far shorter but achieved the same outcome as CBTp preceded by an active control, consistent with neuropsychological improvement enhancing CBTp. CR was delivered by staff with minimal training, offering the potential to reduce the costs of CBTp considerably.

Psychological Treatments and Prevention in Bipolar Disorder - Recent Developments

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Kuehner
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Cognitive Behavioural ◽  
Recent Developments ◽  
Social Rhythm ◽  
Future Work ◽  
High Risk Children

This contribution provides a systematic review on recent developments in psychological interventions for bipolar disorder. The main focus of research to date has investigated the role of different psychotherapeutic approaches (cognitive behavioural therapy, family focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to pharmacotherapy for remission and relapse prevention. The review will assess efficacy and effectiveness of these interventions, their common ingredients, limitations and predictors of outcome. It will further explore the potential role of psychological interventions for primary prevention of bipolar disorders in high risk children and adolescents. Suggestions will be made for future work in these areas.

Advocacy for patients with neuropathic pain

2019 ◽  
pp. 347-360
Author(s):  
Ligia Onofrei ◽  
A. Gordon Smith
Keyword(s):  
Health System ◽  
Coping Styles ◽  
Belief Systems ◽  
Healthcare Providers ◽  
Behavioural Therapy ◽  
System Level ◽  
Treatment Modalities ◽  
Educational Materials ◽  
Cognitive Behavioural ◽  
Key Issues

Pain is a nearly universal yet highly individual experience, with broad determinants including genetic factors, mechanism of injury, medical comorbidities, social aspects, and variations in coping styles and belief systems. In this chapter we examine how pain impacts individuals, healthcare providers who care for individuals with pain, and the overall health system with an emphasis on the importance of advocacy at each level. Key issues include the importance of continuing research in developing effective treatments with minimal side effects, improving access to and understanding of complementary and alternative treatment modalities such as cognitive behavioural therapy, developing continuing medical education programmes that empower physicians in the management of complex pain disorders, developing educational materials for patients that enable them to participate in the prevention and/or treatment of pain disorders, and integrating efforts within and across institutions and at a health system level.

Antidepressant, antipsychotic and psychological interventions in subjects at high clinical risk for psychosis: OASIS 6-year naturalistic study

2014 ◽  
Vol 45 (6) ◽  
pp. 1327-1339 ◽  
Author(s):  
P. Fusar-Poli ◽  
M. Frascarelli ◽  
L. Valmaggia ◽  
M. Byrne ◽  
D. Stahl ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Naturalistic Study ◽  
Randomized Controlled ◽  
Real World Setting ◽  
Cognitive Behavioural ◽  
High Clinical Risk ◽  
Reduced Risk

Background.Recent randomized controlled trials suggest some efficacy for focused interventions in subjects at high risk (HR) for psychosis. However, treating HR subjects within the real-world setting of prodromal services is hindered by several practical problems that can significantly make an impact on the effect of focused interventions.Method.All subjects referred to Outreach and Support in South London (OASIS) and diagnosed with a HR state in the period 2001–2012 were included (n = 258). Exposure to focused interventions was correlated with sociodemographic and clinical characteristics at baseline. Their association with longitudinal clinical and functional outcomes was addressed at follow-up.Results.In a mean follow-up time of 6 years (s.d. = 2.5 years) a transition risk of 18% was observed. Of the sample, 33% were treated with cognitive behavioural therapy (CBT) only; 17% of subjects received antipsychotics (APs) in addition to CBT sessions. Another 17% of subjects were prescribed with antidepressants (ADs) in addition to CBT. Of the sample, 20% were exposed to a combination of interventions. Focused interventions had a significant relationship with transition to psychosis. The CBT + AD intervention was associated with a reduced risk of transition to psychosis, as compared with the CBT + AP intervention (hazards ratio = 0.129, 95% confidence interval 0.030–0.565, p = 0.007).Conclusions.There were differential associations with transition outcome for AD v. AP interventions in addition to CBT in HR subjects. These effects were not secondary to baseline differences in symptom severity.

scholarly journals Health anxiety: detection and treatment

2018 ◽  
Vol 24 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Peter Tyrer ◽  
Helen Tyrer
Keyword(s):  
Health Anxiety ◽  
Behavioural Therapy ◽  
Learning Objectives ◽  
List Type ◽  
Psychological Treatments ◽  
Cognitive Behavioural ◽  
New Diagnosis ◽  
Changing Attitudes ◽  
Term Benefit

SUMMARYHealth anxiety is an important new diagnosis that is increasing in frequency because of changing attitudes towards health, particularly excessive use of health information on the internet (cyberchondria). People with abnormal health anxiety become over-diligent monitors of their health, misinterpret most somatic sensations as evidence of disease, consult medical professionals unnecessarily and frequently, and are often over-investigated. Relatively few patients with health anxiety present to psychiatrists; most are seen in primary and secondary medical care. This paper reviews the diagnosis and presenting features of health anxiety, its identification in practice and its treatment. A range of simple psychological treatments have been shown to have long-lasting benefit for the disorder but are greatly under-used.LEARNING OBJECTIVES•To be able to identify abnormal health anxiety with the aid of probe questions•To respond to people whom you have identified with excessive health anxiety in a way that facilitates its treatment•To learn a few simple techniques derived from cognitive–behavioural therapy that can lead to long-term benefitDECLARATION OF INTERESTNone.

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