EMDR for Survivors of Life-Threatening Cardiac Events: Results of a Pilot Study

2011 ◽  
Vol 5 (1) ◽  
pp. 2-13 ◽  
Author(s):  
Emanuele Arabia ◽  
Maria Luisa Manca ◽  
Roger M. Solomon
Keyword(s):  
Pilot Study ◽  
Cardiac Event ◽  
Anxiety Symptoms ◽  
Depression And Anxiety ◽  
Ptsd Symptoms ◽  
Cardiac Events ◽  
Life Threatening ◽  
Clinically Significant ◽  
Better Than

This pilot study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) in treating posttraumatic stress disorder (PTSD) symptoms and concomitant depressive and anxiety symptoms in survivors of life-threatening cardiac events. Forty-two patients undergoing cardiac rehabilitation who (a) qualified for the PTSD criterion “A” in relation to a cardiac event and (b) presented clinically significant PTSD symptoms were randomized to a 4-week treatment of EMDR or imaginal exposure (IE). Data were gathered on PTSD, anxiety, and depressive symptoms at pretreatment, posttreatment, and 6-month follow-up. EMDR was effective in reducing PTSD, depressive, and anxiety symptoms and performed significantly better than IE for all variables. These findings provide preliminary support for EMDR as an effective treatment for the symptoms of PTSD, depression, and anxiety that can follow a life-threatening cardiac event.

scholarly journals Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial

2016 ◽  
Vol 30 (12) ◽  
pp. 1181-1197 ◽  
Author(s):  
Roland R Griffiths ◽  
Matthew W Johnson ◽  
Michael A Carducci ◽  
Annie Umbricht ◽  
William A Richards ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Depressed Mood ◽  
Well Being ◽  
High Dose ◽  
Depression And Anxiety ◽  
Double Blind ◽  
Symptoms Of Depression ◽  
Life Threatening ◽  
Clinically Significant

Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes. Trial Registration ClinicalTrials.gov identifier: NCT00465595

Post-traumatic stress symptoms in hematopoietic stem cell transplant (HCT) recipients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7505-7505 ◽  
Author(s):  
Sarah Griffith ◽  
Alyssa L. Fenech ◽  
Ashley Nelson ◽  
Joseph A. Greer ◽  
Jennifer S. Temel ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Cell Transplant ◽  
Depression And Anxiety ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Hematopoietic Stem ◽  
Post Traumatic ◽  
Clinically Significant

7505 Background: Patients admitted for HCT, an intensive and potentially curative therapy for hematologic malignancies, experience a prolonged, isolating hospitalization and endure substantial physical and psychological symptom burden. However, data are limited regarding long-term post-traumatic stress (PTSD) in HCT survivors and its risk factors. Methods: We conducted a secondary analysis examining longitudinal data from 250 patients who underwent autologous and allogenic HCT. We used the Post-Traumatic Stress Checklist (PTSD-CL) to assess for PTSD symptoms at six months post-HCT. We used the Functional Assessment of Cancer Therapy—Bone Marrow Transplant (FACT-BMT), and the Hospital Anxiety and Depression Scale to assess quality of life (QOL), depression, and anxiety symptoms at the time of admission for HCT, at week-2 during hospitalization, and at six months post-HCT. We used multivariate regression models to assess factors associated with PTSD symptoms, modeling QOL, depression, and anxiety symptoms separately given their collinearity. Results: The mean age was 56.3 (SD = 13.3). The rate of clinically significant PTSD symptoms at six months post-HCT was 18.9% and these patients experienced hypervigilance (92.3%), avoidance (92.3%), and intrusion (76.9%) symptoms. Among patients without clinically significant PTSD symptoms, 24.5% and 13.7% had clinically significant hypervigilance and avoidance symptoms, respectively. Lower QOL at time of HCT admission (B = -0.04, P = 0.004), and being single (B = -3.35, P = 0.027) were associated with higher PTSD symptoms at six months post-HCT. Higher anxiety at time of HCT admission (B = 1.34, P < 0.001), change in anxiety during HCT hospitalization (B = 0.59, P = 0.006), and being single (B = -3.50, P = 0.017), were associated with higher PTSD symptoms at six months. In a separate model, younger age (B = -0.13, P = 0.017), being single (B = -3.58, P = 0.018), and higher baseline depression symptoms were also associated with higher PTSD symptoms at six months (B = 0.97, P < 0.001). Conclusions: Approximately one fifth of patients undergoing HCT experienced clinically significant PTSD symptoms at six months post-transplant. Patients’ baseline QOL and psychological symptoms emerged as important predictors of their risk for PTSD at six months post-HCT. Thus, interventions to prevent and treat PTSD symptoms in HCT recipients are clearly warranted.

scholarly journals Emotion regulation therapy for cancer caregivers—an open trial of a mechanism-targeted approach to addressing caregiver distress

2018 ◽  
Vol 10 (2) ◽  
pp. 413-422 ◽  
Author(s):  
Allison J Applebaum ◽  
Aliza A Panjwani ◽  
Kara Buda ◽  
Mia S O’Toole ◽  
Michael A Hoyt ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Caregiver Burden ◽  
Psychosocial Interventions ◽  
Anxiety Symptoms ◽  
Open Trial ◽  
Self Report ◽  
Central Feature ◽  
Depression And Anxiety ◽  
Before And After ◽  
Clinically Significant

Abstract Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious treatment principles (e.g., cognitive behavior therapy [CBT]) show disappointing results in reducing anxiety and depression in ICs. This may reflect failure of these interventions to specifically target crucial mechanisms underlying the central feature of distress caused by the patient’s illness—notably, perseverative negative thinking (PNT). Emotion Regulation Therapy (ERT) is an efficacious CBT developed to explicitly target mechanisms underlying PNT and the emotional concomitants that arise in response to stressful situations. This open trial was conducted to evaluate the acceptability and initial efficacy of ERT adapted to the experience of cancer ICs (ERT-C). Thirty-one ICs provided informed consent and completed eight weekly individual sessions of ERT-C. Participants completed self-report measures of depression and anxiety symptoms, PNT, emotion regulation deficits, and caregiver burden before and after treatment. ERT-C was well tolerated as indicated by 22 treatment completers and feedback provided in exit interviews. ICs demonstrated reduced depression and anxiety symptoms, PNT, and emotion regulation deficits with moderate to large effect sizes (Hedge’s g range: 0.36–0.92). Notably, caregiver burden was not reduced but ICs expressed more ability to confront caregiving-related challenges. Findings offer promising but preliminary support for ERT-C as a conceptual model and treatment modality for distressed cancer ICs.

Effectiveness of Cognitive Behavioral Couple Therapy on Reducing Depression and Anxiety Symptoms and Increasing Dyadic Adjustment and Marital Social Skills: An Exploratory Study

2020 ◽  
Vol 28 (4) ◽  
pp. 344-355
Author(s):  
Ricardo Silva Santos Durães ◽  
Tatiana Cohab Khafif ◽  
Francisco Lotufo-Neto ◽  
Antonio de Pádua Serafim
Keyword(s):  
Social Skills ◽  
Marital Conflict ◽  
Couple Therapy ◽  
Anxiety Symptoms ◽  
Dyadic Adjustment ◽  
Cognitive Behavioral ◽  
Depression And Anxiety ◽  
Communication Problems ◽  
Group 2

Several kinds of marital conflict might be solved through constructive communication, development of interaction skills, and behavioral and thought modification. The aim of this study was to show results of the application of a protocol based on cognitive behavioral couple therapy (CBCT) on dyadic adjustment, marital social skills, depression, and anxiety symptoms. The sample consisted of 32 participants (16 couples) divided in two groups by length of marriage: Group 1 (1–7 years) and Group 2 (8–12 years). All subjects recruited were older than 18 and reported having communication problems in their relationship. The ages were M = 30.4, SD = 4.13. The measures were Dyadic Adjustment Scale (DAS), Beck Depression Inventory–II (BDI-II), Beck Anxiety Inventory (BAI), Marital Social Skills Inventory (Inventário de Habilidades Sociais Conjugais [IHSC]), and the Sociodemographic Questionnaire. Participants were assessed pre- and postintervention and had a 6-month follow-up. The intervention consisted of twelve 50-min sessions per couple. Based on three time analyses, both groups obtained the following results: DAS ( p = .001), BDI-II ( p = .000), BAI ( p = .000), and IHSC ( p = .001). We conclude that the CBCT protocol developed for this study, resulted in statistically significant improvements in the couple’s relationship for all variables studied in both groups.

scholarly journals Sleep symptoms and long-term outcome in adolescents with major depressive disorder: a naturalistic follow-up study

2019 ◽  
Vol 29 (5) ◽  
pp. 595-603 ◽  
Author(s):  
Anna S. Urrila ◽  
◽  
Olli Kiviruusu ◽  
Henna Haravuori ◽  
Linnea Karlsson ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Young Adulthood ◽  
Psychosocial Functioning ◽  
Anxiety Symptoms ◽  
Depression And Anxiety ◽  
Major Depressive ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Sleep abnormalities in major depressive disorder (MDD) have been suggested to represent a vulnerability trait, which might predispose the individual to long-term psychiatric morbidity. In this study, we sought to assess whether the presence of sleep symptoms among adolescents with MDD is associated with poorer long-term outcome in young adulthood during naturalistic follow-up. Adolescent outpatients diagnosed with MDD (n = 166; age 13–19 years, 17.5% boys) were followed up during 8 years in naturalistic settings. N = 112 adolescents (16.1% boys) completed the 8-year assessment. Sleep symptoms and psychosocial functioning were assessed with structured clinical interviews, and depressive and anxiety symptoms with questionnaires. The severity of sleep symptoms at baseline was not associated with worse outcome at 8 years in terms of any of the outcome measures tested. In particular, the presence of a disturbed sleep–wake rhythm at baseline was associated with a more favourable outcome at 8 years: less depression and anxiety symptoms and higher level of psychosocial functioning. The presence of sleep symptoms in young adulthood was associated with the presence of current depression and anxiety symptoms and poorer psychosocial functioning. The presence of sleep symptoms at follow-up seems to be state-dependent: they are observed in conjunction with other psychiatric symptoms. Contrary to our hypothesis, our results suggest that sleep complaints among adolescents with MDD do not lead to poorer long-term clinical outcome in young adulthood. The link between sleep–wake rhythm disturbance and better long-term outcome needs to be confirmed and examined in detail in further studies, but here we speculate about possible explanations.

Attention bias away from threat during life threatening danger predicts PTSD symptoms at one-year follow-up

2011 ◽  
Vol 28 (5) ◽  
pp. 406-411 ◽  
Author(s):  
I. Wald ◽  
T. Shechner ◽  
S. Bitton ◽  
Y. Holoshitz ◽  
D.S. Charney ◽  
...  
Keyword(s):  
Attention Bias ◽  
Ptsd Symptoms ◽  
Life Threatening ◽  
One Year

scholarly journals Previous psychopathology predicted severe COVID-19 concern, anxiety and PTSD symptoms in pregnant women during lockdown in Italy

2020 ◽  
Author(s):  
Claudia Ravaldi ◽  
Valdo Ricca ◽  
Alyce Wilson ◽  
Caroline Homer ◽  
Alfredo Vannacci
Keyword(s):  
Pregnant Women ◽  
Technology Use ◽  
Post Partum ◽  
Depression And Anxiety ◽  
Ptsd Symptoms ◽  
Multivariable Logistic Regression Model ◽  
Psychological Disturbances ◽  
Clinically Significant ◽  
Temporary Closure ◽  
Staying At Home

Italy was the first COVID-19 pandemic epicenter among European countries and established a period of full lockdown, consisting of travel bans, mandatory staying at home and temporary closure of non-essential businesses. Similar measures are known risk factors for psychological disturbances in the general population, still very little is known about their impact on pregnant women's mental health during COVID-19 pandemic. The national survey 'COVID-19 related Anxiety and StreSs in prEgnancy, poSt-partum and breaStfeeding' (COVID-ASSESS) was conducted during the first month of full lockdown in Italy. The questionnaire was specifically developed to examine COVID-19 concerns and included the psychometric tests NSESSS for PTSD and STAI-Y for anxiety. A multivariable logistic regression model was fitted to explore the association of the concern, anxiety and PTSD symptoms with age, gestational weeks, parity, days of lockdown, assisted reproductive technology use, psychopathological history and previous perinatal losses. Out of 1015 pregnant women reached, 737 (72.6%) fully answered the questionnaire; no woman reported a COVID-19 infection. Median age was 34.4 years [quartiles 31.7, 37.2], median days in lockdown were 13.1 [11.0, 17.0], median gestational weeks were 27.8 [19.8, 34.0]. Clinically significant PTSD symptoms were present in 75 women (10.2%, NSESSS cut-off 24) and clinically significant anxiety symptoms were present in 160 women (21.7%, STAI-Y1 cut-off 50). Women were less worried about their own health than the health of their baby and of their elderly relatives. Previous anxiety predicted higher concern and PTSD symptoms; previous depression and anxiety were independently associated with current PTSD symptoms.

scholarly journals Long-Term Follow-Up of Patients with Catecholaminergic Polymorphic Ventricular Arrhythmia

2020 ◽  
Vol 9 (4) ◽  
pp. 903
Author(s):  
Michael Veith ◽  
Ibrahim El-Battrawy ◽  
Gretje Roterberg ◽  
Laura Raschwitz ◽  
Siegfried Lang ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Beta Blockers ◽  
Polymorphic Ventricular Tachycardia ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
Life Threatening

Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited disorder causing life-threatening arrhythmias. Long-term outcome studies of the channelopathy are limited. Objective: The aim of the present study was to summarize our knowledge on CPVT patients, including the clinical profile treatment approach and long-term outcome. Methods: In this single center study, we retrospectively and prospectively collected data from nine CPVT patients and analyzed them. Results: We reviewed nine patients with CPVT in seven families (22% male), with a median follow-up time of 8.6 years. Mean age at diagnosis was 26.4 ± 12 years. Symptoms at admission were syncope (four patients) and aborted cardiac arrest (four patients). Family history of sudden cardiac death was screened in five patients. In genetic analyses, we found five patients with ryanodine type 2 receptor (RYR2) mutations. Seven patients were treated with beta-blockers, and if symptoms persisted flecainide was added (four patients). Despite beta-blocker treatment, three patients suffered from seven adverse cardiac events. An implantable cardioverter defibrillator was implanted in seven patients (one primary, six secondary prevention). Over the follow-up period, three patients suffered from ventricular tachycardia (ten times) and five patients from ventricular fibrillation (nine times). No one died during follow-up. Conclusion: Our CPVT cohort showed a high risk of cardiac events. Family screening, optimal medical therapy and individualized treatment are necessary in affected patients in referral centers.

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