The Efficacy of EMDR in the Treatment of Depression

2016 ◽  
Vol 10 (2) ◽  
pp. 59-69 ◽  
Author(s):  
Yasmeen Wajid Mauna Gauhar
Keyword(s):  
Quality Of Life ◽  
Primary Diagnosis ◽  
Trauma Symptoms ◽  
Trauma Symptom ◽  
Negative Beliefs ◽  
Treatment Of Depression ◽  
Quality Of Life Index ◽  
Emdr Therapy

This study investigated the efficacy of eye movement desensitization and reprocessing (EMDR) psychotherapy in treating the primary diagnosis of major depressive disorder by processing past or present trauma that was affecting the quality of life. The 26 diagnosed participants were randomly assigned to 6–8 sessions of EMDR treatment or the waiting list control. Beck Depression Inventory-II, Trauma Symptom Checklist-40, and Quality of Life Index Inventory were used at pre- and postassessment to measure depressive and trauma symptoms and quality of life of the participants for both groups. The targets for EMDR therapy were selected by the participants determining the negative cognitions most strongly associated with reduced functioning and then identifying a related disturbing event. Paired and independent sample t tests were applied for data analysis. Results showed significant improvements on all measures with large effect sizes. At 95% confidence interval, the results found EMDR as an effective treatment for depressive and trauma symptoms and for improving the quality of life of the participants. A generalization effect was found for the depressogenic cognitions, with the number and strength of negative beliefs markedly decreased at posttreatment, even for beliefs not targeted in the therapy. Three-month follow-up interview with the EMDR participants confirmed that the results had been maintained.

Endoscopic Fundoplication

2017 ◽  
Vol 12 (3) ◽  
pp. 180-185 ◽  
Author(s):  
Michael I. Ebright ◽  
Praveen Sridhar ◽  
Virginia R. Litle ◽  
Chaitan K. Narsule ◽  
Benedict D. Daly ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Atypical Symptoms ◽  
Related Quality ◽  
Health Related ◽  
Quality Of Life Index ◽  
Grade 3 ◽  
Laparoscopic Techniques

Objective Transoral incisionless fundoplication (TIF) is a completely endoscopic approach to treat gastroesophageal reflux disease (GERD). We previously reported our initial results demonstrating safety and early effectiveness. We now present an updated experience describing outcomes with longer follow-up. Methods For a three-year period, TIF procedures were performed on 80 patients. Preoperative workup routinely consisted of contrast esophagram and manometry. PH testing was reserved for patients with either atypical symptoms or typical symptoms unresponsive to protonpump inhibitors (PPIs). Heartburn severity was longitudinally assessed using the GERD health-related quality of life index. Safety analysis was performed on all 80 patients, and an effectiveness analysis was performed on patients with at least 6-month follow-up. Results Mean procedure time was 75 minutes. There were seven (8.75%) grade 2 complications and one (1.25%) grade 3 complication (aspiration pneumonia). The median length of stay was 1 day (mean, 1.4). Forty-one patients had a minimum of 6-month of follow-up (mean, 24 months; range, 6–68 months). The mean satisfaction scores at follow-up improved significantly from baseline ( P < 0.001). Sixty-three percent of patients had completely stopped or reduced their PPI dose. Results were not impacted by impaired motility; however, the presence of a small hiatal hernia or a Hill grade 2/4 valve was associated with reduced GERD health-related quality of life scores postoperatively. Conclusions At a mean follow-up of 24 months, TIF is effective. Although symptoms and satisfaction improved significantly, many patients continued to take PPIs. Future studies should focus on longer-term durability and comparisons with laparoscopic techniques.

Primary laparoscopic fundoplication in selected patients with gastroesophageal reflux disease

2021 ◽  
Author(s):  
K H Fuchs ◽  
W Breithaupt ◽  
G Varga ◽  
B Babic ◽  
T Schulz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Patient Selection ◽  
Laparoscopic Fundoplication ◽  
Quality Of Life Index ◽  
Selection For ◽  
Gastrointestinal Quality Of Life

Summary Background Despite proton pump inhibitors being a powerful therapeutic tool, laparoscopic fundoplication (LF) has proven successful in the treatment of gastroesophageal reflux disease (GERD), through mechanical augmentation of a weak antireflux barrier and the advantages of minimally invasive access. A critical patient selection for LF, based on thorough preoperative assessment, is important for the management of GERD-patients. The purpose of this study is to provide an overview on the management of GERD-patients treated by primary LF in a specialized center and to illustrate the possible outcome after several years. Methods Patients were selected after going through diagnostic workup consisting of patient’s history and physical examination, upper gastrointestinal endoscopy, assessment of gastrointestinal Quality of Life Index, screening for somatoform disorders, functional assessment by esophageal manometry, (impedance)-24-hour-pH-monitoring, and selective radiographic studies. The indication for LF was based on EAES-guidelines. Either a floppy and short Nissen fundoplication was performed or a posterior Toupet-hemifundoplication was chosen. A long-term follow-up assessment was attempted after surgery. Results In total, n = 1131 patients were evaluated (603 males; 528 females; mean age; 48.3 years; and mean body mass index: 27). The mean duration between onset of symptoms and surgery was 8 years. Nissen: n = 873, Toupet: n = 258; conversion rateerativ: 0.5%; morbidity 4%, mortality: 1 (1131). Mean follow-up (n = 898; 79%): 5.6 years; pre/post-op results: esophagitis: 66%/12.1%; Gastrointestinal Quality of Life Index: median: 92/119; daily proton pump inhibitors-intake after surgery: 8%; and operative revisions 4.3%. Conclusions In conclusion, our data show that careful patient selection for laparoscopic fundoplication and well-established technical concepts of mechanical sphincter augmentation can provide satisfying results in the majority of patients with severe GERD.

scholarly journals Validation of the German Classification of Diverticular Disease (VADIS)—a prospective bicentric observational study

2020 ◽  
Vol 36 (1) ◽  
pp. 103-115
Author(s):  
Johannes C. Lauscher ◽  
Johan F. Lock ◽  
Katja Aschenbrenner ◽  
Rahel M. Strobel ◽  
Marja Leonhardt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diverticular Disease ◽  
Life Index ◽  
Sf 36 ◽  
Quality Of Life Index ◽  
Gastrointestinal Complaints ◽  
Gastrointestinal Quality Of Life

Abstract Purpose The German Classification of Diverticular Disease was introduced a few years ago. The aim of this study was to determine whether Classification of Diverticular Disease enables an exact stratification of different types of diverticular disease in terms of course and treatment. Methods This was a prospective, bicentric observational trial. Patients aged ≥ 18 years with diverticular disease were prospectively included. The primary endpoint was the rate of recurrence within 2 year follow-up. Secondary outcome measures were Gastrointestinal Quality of Life Index, Quality of life measured by SF-36, frequency of gastrointestinal complaints, and postoperative complications. Results A total of 172 patients were included. After conservative management, 40% of patients required surgery for recurrence in type 1b vs. 80% in type 2a/b (p = 0.04). Sixty percent of patients with type 2a (micro-abscess) were in need of surgery for recurrence vs. 100% of patients with type 2b (macro-abscess) (p = 0.11). Patients with type 2a reached 123 ± 15 points in the Gastrointestinal Quality of Life Index compared with 111 ± 14 in type 2b (p = 0.05) and higher scores in the “Mental Component Summary” scale of SF-36 (52 ± 10 vs. 43 ± 13; p = 0.04). Patients with recurrent diverticulitis without complications (type 3b) had less often painful constipation (30% vs. 73%; p = 0.006) when they were operated compared with conservative treatment. Conclusion Differentiation into type 2a and 2b based on abscess size seems reasonable as patients with type 2b required surgery while patients with type 2a may be treated conservatively. Sigmoid colectomy in patients with type 3b seems to have gastrointestinal complaints during long-term follow-up. Trial registration https://www.drks.de ID: DRKS00005576

scholarly journals Possibility of application of a self–fixing mesh ProGrip™ in laparoscopic plasty of large hiatal hernias

2018 ◽  
Vol 85 (7) ◽  
pp. 5-8
Author(s):  
V. V. Grubnik ◽  
N. R. Paranyak ◽  
V. V. Grubnik ◽  
V. V. Ilyashenko
Keyword(s):  
Quality Of Life ◽  
Average Duration ◽  
Group I ◽  
Sf 36 ◽  
Quality Of Life Index ◽  
Group Ii ◽  
Mesh Implant ◽  
Better Than

Objective. Studying of possibility of application of a self-fixing mesh ProGrip™ while plasty performing for large hiatal hernias (HH).Маterials and methods. In the investigation 144 patients, ageing 30 – 78 yrs old, owing HH with square 10 - 20 сm2, took part. The patients were divided into two groups. Group I consisted of 71 patients, to whom crurorhaphy with additional strengthening of the sutures, using a self-fixing mesh ProGrip™ was peformed. Group II consisted of 73 patients, in whom sutures of crurorhaphy were not strengthened by the mesh implant. Dynamical follow-up in patients was conducted in 3, 6, 12, 24, 36, 48 and 60 mo after the surgical treatment.Results. Average duration of the operation in patients of Group i and Group II did not differ essentially – (94 ± 12) and (92 ± 15) min, accordingly (p > 0.1). In late terms of follow-up the HH recurrence have occurred in 3.2% in the Group I patients and in 21.5% - in the Group II patients. The quality of life index in patients of Group I, in accordance to questionnaire SF-36, was trustworthily better, than in patients of Group II (p < 0.05).Conclusion. The mesh ProGrip™ application while doing plasty of large HH permits to lower the recurrence rate significantly and to improve the operative interventions results essentially.

Long-term Effects of Implanted Cardioverter-Defibrillators on Health Status, Quality of Life, and Psychological State

2008 ◽  
Vol 17 (3) ◽  
pp. 222-230 ◽  
Author(s):  
Diane L. Carroll ◽  
Glenys A. Hamilton
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Status ◽  
Short Form ◽  
Psychological State ◽  
Short Form 36 ◽  
Cardioverter Defibrillator ◽  
Quality Of Life Index

Background Living with an implanted cardioverter-defibrillator increases survival, but the effects of the device on health status, quality of life, and psychological state over time are not clear. Objectives To investigate changes in health status, quality of life, and psychological state associated with implantation of a cardioverter-defibrillator from implantation to 4 years later. Methods A prospective, longitudinal design was used to measure changes in scores on the Short Form 36 of the Medical Outcomes Study, the Quality of Life Index–Cardiac III, and the Profile of Moods States short form at implantation, 6 months, and 1, 2, 3, and 4 years later. Results A total of 30 men and 11 women (mean age, 60.4 years) completed all 4 years of follow-up. The physical and mental health composite summary scores of the Short Form 36 changed significantly over time; the mental health score improved (F = 2.95; P = .03), and the physical score worsened (F = 3.69; P = .003). Scores on the Quality of Life Index–Cardiac III did not change significantly. Negative moods were significantly fewer, and the total psychological distress score was significantly lower (F = 10.21; P &lt; .001) during the 4 years of follow-up. Conclusions Patients had improved mental health and reduced psychological distress by 6 months after implantation. Perception of physical health declined during the 4 years after implantation; the role physical subscore of the Short Form 36 indicated significant improvement in functioning at 6 months and a trend toward reduced functioning at 3 and 4 years after implantation.

scholarly journals Short- and Long-Term Follow-Up of Patients with Benign Esophageal Perforation

2020 ◽  
Author(s):  
Sebastian Brinkmann ◽  
Laura Knepper ◽  
Hans Friedrich Fuchs ◽  
Arnulf Heinrich Hoelscher ◽  
Kathrin Kuhr ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Perforation ◽  
Related Quality ◽  
Long Term Follow Up ◽  
Health Related ◽  
Quality Of Life Index ◽  
Short And Long Term

Abstract Background Esophageal perforation is associated with high morbidity and mortality. In addition to surgical treatment, endoscopic endoluminal stent placement and endoscopic vacuum therapy (EVT) are established methods in the management of this emergency condition. As health-related quality of life (HRQoL) is becoming a major issue in the evaluation of any therapeutic intervention not much is known about HRQoL, particular in the long-term follow-up of patients treated for benign esophageal perforation with different treatment strategies. Methods Patients treated for benign esophageal perforation at the University Hospital Cologne from January 2003 to December 2014 were included. Primary outcome and management of esophageal perforation were documented and long-term quality of life was assessed using the Gastrointestinal Quality of Life Index (GIQLI), the Health-Related Quality of Life Index (HRQL) for patients with gastroesophageal reflux disease (GERD) and the European Organization for Research and Treatment of Cancer (EORTC) questionnaires for general and esophageal cancer specific QoL (QLQ-C30 and QLQ-OES18). . Results 58 patients were included in the study. Based on primary treatment patients were divided into an endoscopic (n = 27; 46.6%), surgical (n = 20; 34.5%) and conservative group (n = 11; 19%). Short- and long-term outcome, as well as quality of life were compared. HRQoL was measured after a median follow-up of 49 months HRQoL was generally reduced in patients with benign esophageal perforation. Endoscopically treated patients showed the highest GIQLI overall score and highest EORTC general health status, followed by the conservative and the surgical group. Conclusion HRQoL in patients with benign esophageal perforation is reduced even in the long-term follow-up. Temporary stent or EVT is effective and provides a good alternative to surgery not only in the short-term but also in the long-term follow-up.

scholarly journals Spectrum of Quality of Life after Valve Surgery in Patients with Rheumatic Heart Disease.

2021 ◽  
Vol 18 (1) ◽  
pp. 53-56
Author(s):  
Dikshya Joshi ◽  
Anushruti Shrestha ◽  
Minani Gurung ◽  
Navin C Gautam ◽  
Yogeshwor M. Singh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Confidence Interval ◽  
Heart Valves ◽  
Valve Surgery ◽  
Cross Sectional ◽  
Life Index ◽  
Significant Difference ◽  
Quality Of Life Index

Background and Aims: Improvement in quality of life is one of the principal goals of valve surgery. The purpose of this study was to assess the quality of life in patients living with mechanical heart valves. Methods: We conducted a cross-sectional descriptive study among 131 (42 Males, and 89 Female) patients, who had undergone valve procedures at different times in clinic visit of department of cardiac surgery, unit I of Shahid Gangalal National Heart Centre from August 1 till August 29, 2019. Quality of life index was measured using Ferrans and Power quality of life index, cardiac version IV via written questionnaire or verbal interview. Results: Mean age was 40.57±1.4 (16-75) years. Mean duration of follow up was 4.68±4.03 years (3 months to 18 years). Subjects reported the lowest quality of life scores in the health and functioning domain prior to surgery (15.61±1.30), which improved 47.15% after surgery (22.95±0.45), psychological/spiritual domain improved 16.68%, social and economic domain 26.24%, family domain 11.49%, with overall improvement 28.62%. Women had significantly lower mean overall quality of life index (22.99±03.58) (95% confidence interval 22.24-23.75) compared to male counterparts (24.21±4.11) (95% confidence interval 22.92-25.49) (p<0.05). Family domain had the highest score at the latest follow up (28.84±1.63). There was a statistically significant correlation between the duration of operation and overall quality of life index (Pearson's rho 0.217, p<0.01). There was no significant difference with the patients’ age. Conclusion: This study confers significant improvement of quality of life after valve surgery with time. Age does not appear to limit the quality of life. Family support seems to be the biggest strength in our population.

scholarly journals Quality of life in children with atopic dermatitis: A one-year prospective cohort study

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Tatjana Gazibara ◽  
Vesna Reljic ◽  
Slavenka Jankovic ◽  
Jelena Peric ◽  
Milos Nikolic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Life Quality ◽  
Severe Atopic Dermatitis ◽  
Related Quality ◽  
Quality Of Life Index ◽  
One Year ◽  
The One

Background: Literature on the quality of life trends across time in children with atopic dermatitis are scarce. Aims: To assess factors associated with quality of life of children with atopic dermatitis after a one-year follow-up and to examine the factors contributing to greater improvement in the atopic dermatitis-related quality of life over one year. Methods: Our cohort consisted of 98 children who were treated for atopic dermatitis at the clinic of dermatovenereology. Data collection included atopic dermatitis scoring using the SCORing Atopic Dermatitis (SCORAD) index, Children’s Dermatology Life Quality Index (CDLQI) for children aged > four years and Infants’ Dermatitis Quality of Life Index (IDLQI) for children aged 0–4 years. Categorization of the impairment of quality of life score due to atopic dermatitis was as follows: mild (score from 0 to 6), moderate (score from 7 to 12) and severe (score from 13 to 30). The cohort was followed for one year after which a total of 80 children were reassessed. Results: Improvements of both CDLQI and IDLQI were observed in children whose impairment of quality of life due to atopic dermatitis after one year was ‘mild’. This was not observed in children whose atopic dermatitis caused either ‘moderate’ or ‘severe impairment’ of their quality of life. Adjusted analysis showed that lower initial SCORAD and greater improvement in SCORAD after the one-year follow-up were associated with a better quality of life at follow-up. Limitations: The size of our cohort was relatively small. Study participants were recruited from the largest urban and medical referral center in Serbia. Persons from suburban or rural regions may have had different perceptions of atopic dermatitis-related quality of life. Conclusion: Children with less severe atopic dermatitis were more likely to improve their atopic dermatitis-related quality of life. Lower SCORAD was associated with both better quality of life initially and greater improvement in quality of life after one year of follow-up.

scholarly journals Short- and long-term follow-up of patients with non-neoplastic esophageal perforation

2021 ◽  
Author(s):  
Sebastian Brinkmann ◽  
Laura Knepper ◽  
Hans Fuchs ◽  
Arnulf Hoelscher ◽  
Kathrin Kuhr ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Perforation ◽  
Related Quality ◽  
Long Term Follow Up ◽  
Health Related ◽  
Quality Of Life Index ◽  
Short And Long Term

Abstract Purpose Esophageal perforation is associated with high morbidity and mortality. In addition to surgical treatment, endoscopic endoluminal stent placement and endoscopic vacuum therapy (EVT) are established methods in the management of this emergency condition. Although health-related quality of life (HRQoL) is becoming a major issue in the evaluation of any therapeutic intervention, not much is known about HRQoL, particularly in the long-term follow-up of patients treated for non-neoplastic esophageal perforation with different treatment strategies. The aim of this study was to evaluate patients’ outcome after non-neoplastic esophageal perforation with focus on HRQoL in the long-term follow-up. Methods Patients treated for non-neoplastic esophageal perforation at the University Hospital Cologne from January 2003 to December 2014 were included. Primary outcome and management of esophageal perforation were documented. Long-term quality of life was assessed using the Gastrointestinal Quality of Life Index (GIQLI), the Health-Related Quality of Life Index (HRQL) for patients with gastroesophageal reflux disease (GERD), and the European Organization for Research and Treatment of Cancer (EORTC) questionnaires for general and esophageal specific QoL (QLQ-C30 and QLQ-OES18). Results Fifty-eight patients were included in the study. Based on primary treatment, patients were divided into an endoscopic (n = 27; 46.6%), surgical (n = 20; 34.5%), and a conservative group (n = 11; 19%). Short- and long-term outcome and quality of life were compared. HRQoL was measured after a median follow-up of 49 months. HRQoL was generally reduced in patients with non-neoplastic esophageal perforation. Endoscopically treated patients showed the highest GIQLI overall score and highest EORTC general health status, followed by the conservative and the surgical group. Conclusion HRQoL in patients with non-neoplastic esophageal perforation is reduced even in the long-term follow-up. Temporary stent or EVT is effective and provides a good alternative to surgery, not only in the short-term but also in the long-term follow-up.

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