scholarly journals Sleep And Positive Emotions In Adolescents With Anorexia Nervosa In Relation To The Covid-19 Pandemic

2022 ◽  
Author(s):  
Lucia Rossi ◽  
Catarina Da Silva ◽  
Isabelle Charvin ◽  
David Da Fonseca ◽  
Flora Bat-Pitault
Keyword(s):  
Anorexia Nervosa ◽  
Positive Emotions ◽  
Behavioral Therapy ◽  
Severity Index ◽  
Vulnerable Groups ◽  
Level Of Evidence ◽  
Severity Index Score ◽  
Sleep Alterations ◽  
The Impact ◽  
Over Time

Abstract Purpose: The recent COVID-19 pandemic, and its consequent lockdown measures raised concerns about people’s mental health. Identified vulnerable groups may be especially at risk. This study investigated the impact of this unprecedent situation on sleeping patterns and emotionality in adolescents with anorexia nervosa (AN).Methods: Variations in sleeping patterns and emotionality of 101 adolescents with AN, assessed during the pandemic (Covid-19 Group), and the year before (No-Covid-19 Group) were analyzed. We further investigated these variations over time: before the lockdown, 9 months later and after the lockdown.Results: Adolescents in the Covid-19 Group had significantly higher rates of sleep alterations and lower rates of positive emotions, compared to the No-Covid-19 Group. A higher insomnia severity index score and a tendency to lengthen sleep latency time were also associated with the pandemic period. Considering three different groups of patients over time, the kinetics of the impact of the changes shows that the worsening of values is not strictly limited to the acute lockdown phase but is increasing over time. Conclusions: These sleep and emotionality features could have participated to increase severity and incidence of AN in adolescents during the Covid-19 pandemic. As such, these features could represent therapeutic targets to optimize the care of adolescents with AN, particularly urgent to improve considering the kinetic of the deterioration. Tools such as those provided by cognitive behavioral therapy for insomnia (CBTi) and by the positive psychology seem appropriate to guide clinicians in this context. Level of evidence: Level V, descriptive study (evaluation data retrospectively studied).

scholarly journals Substance Use Among Patients Receiving Out- and Inpatient Dependence Care: a Prospective Norwegian Cohort Study From 2016 to 2020

2021 ◽  
Author(s):  
Jørn Henrik Vold ◽  
Fatemeh Chalabianloo ◽  
Christer F. Aas ◽  
Else-Marie Løberg ◽  
Kjell Arne Johansson ◽  
...  
Keyword(s):  
Substance Use ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Severity Index ◽  
Future Research ◽  
Opioid Agonist ◽  
Low Threshold ◽  
The Mean ◽  
The Impact ◽  
Over Time

Abstract BackgroundContinuous use of amphetamines, alcohol, benzodiazepines, cannabis, cocaine, or opioids contributes to health impairments, increased morbidity, and overdose deaths among patients with substance use disorders (SUDs). This study evaluates the impact of inpatient detoxification, specialized opioid agonist therapy (OAT), and low-threshold municipality care on substance use over time. MethodsWe used data from a cohort of SUD patients in Norway through health assessments of self-reported substance use and sociodemographic and clinical factors. A total of 881 substance use measurements, including type and amount of substances, were assessed from 708 SUD patients in 2016-2020. Substance use for individual and total substances was calculated, creating a substance use severity index (SUSI) ranging from zero (no use) to one (daily use). We defined baseline as the first substance use measurement when the measurements were listed chronologically. Time was defined as years from baseline. We used a linear mixed model to analyze associations between the SUSI and inpatient detoxification, specialized OAT compared with low-threshold municipality care, as well as the factors like injecting substance use, gender, and age, presented with coefficients and 95% confidence intervals (CI).ResultsNeither inpatient detoxification (mean SUSI change: 0.01, -0.03;0.04) nor specialized OAT (0.03, -0.09;0.14) compared with low-threshold municipality care were associated with changes in substance use over time. Patients who were over 60 years of age (mean SUSI difference: -0.06, -0.13;0.00) had a lower SUSI than those under 30 years of age, while patients who injected substances had a higher SUSI than those who did not inject substances (0.18, 0.15;0.20) at baseline. The mean SUSI for the individual substances were 0.50 (standard deviation (SD): 0.38) for cannabis, 0.40 (0.37) for benzodiazepines, 0.33 (0.34) for amphetamines and cocaine, 0.31 (0.29) for alcohol, and 0.22 (0.31) for opioids at baseline. The mean SUSI of all substances was 0.35 (0.20). Conclusion The present study demonstrates that neither inpatient detoxification nor specialized OAT compared to low-threshold municipality care were associated with changes in substance use over time. Future research needs to evaluate the impact on substance use and healthy survival of multiple health care interventions to this patient group.

scholarly journals Unravelling the impact of COVID-19 on mental health: A scoping review on traumatogenic events using the phases of response to disaster model

2021 ◽  
pp. 218-236
Author(s):  
den Cruyce Nele Van
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Disaster Response ◽  
Mental Health Problems ◽  
Economic Status ◽  
Psychological Needs ◽  
Vulnerable Groups ◽  
Cross Sectional ◽  
The Impact ◽  
Over Time

Background: Disease outbreaks such as the COVID-19 pandemic give rise to high levels of psychological distress in people worldwide. Since this is the first pandemic of its kind, the best available evidence is needed on what psychological needs could be expected during and after the pandemic. Objectives: In this scoping review existing research on traumatogenic events is examined in order to identify the potential impact on mental health of the COVID pandemic. The research findings are organized using the the phases of disaster response model. Results: A total of 34 longitudinal studies, 2 studies with multiple waves of data collection and 92 cross-sectional studies met the inclusion criteria. The studies included in this scoping review could be classified as: 87 studies on COVID-19, 2 on SARS, 19 on wars, 19 on terrorist attacks and 1 on a nuclear accident. Results indicate that stress, anxiety, depressive symptoms, insomnia, denial, anger, grief and fear can be anticipated as common reactions. The longer a pandemic continues, the higher the psychological strain is expected to be. Conclusions: The phases of response to disaster model offers a valid frame to unravel the impact of the pandemic on mental health over time. Specific attention must be given to vulnerable groups, whereby specific risk factors include age, gender, pre-existing mental health problems, healthcare profession, migration background, isolation and low socio economic status. However, these may change over time, and a delayed manifestation of psychosocial problems needs to be considered too. Mental health governance is, therefore, warranted throughout and even up to 6 months after the pandemic.

scholarly journals Efficacy of Online Versus In-Person Cognitive Behavioral Therapy for Insomnia

2020 ◽  
Vol 3 ◽  
Author(s):  
Emily Wilson ◽  
Aaron Roberts
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Clinical Decision Making ◽  
Behavioral Therapy ◽  
Adult Population ◽  
Severity Index ◽  
The United States ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Insomnia Severity ◽  
Over Time

Background and Hypothesis: Up to 30% of the adult population may suffer from insomnia symptoms. Insomnia not only diminishes the individual’s quality of life, but also has a broad financial impact, costing the United States over $100 billion per year. Systemic barriers limit access to cognitive behavioral therapy for insomnia (CBT-I), the first-line treatment for insomnia. However, newly developed internet CBT-I (iCBT-I) programs, if effective, may reduce this disparity. In this study, we hypothesized that there is no difference in the efficacy of the experimental iCBT-I and the control CBT-I interventions in reducing insomnia severity over time.    Project Methods: A projected 120 participants will be recruited for this non-inferiority prospective cohort study. 60 patients will be assigned to each arm of the study (CBT-I and iCBT-I). The control group will attend 6 in-person CBT-I sessions over 6 weeks. The experimental group will complete the iCBT-I program Go! To Sleep over 6 weeks. Participants will complete the Insomnia Severity Index (ISI) before and after treatment, as well as 3, 6, and 12 months after finishing the program. The Kruskal-Wallis statistical test will utilize ISI data to compare efficacy of the interventions over time.     Results: Based on previous literature, the projected results of this study align with the hypothesis that there will be no difference in efficacy of the CBT-I and iCBT-I interventions over time.    Potential Impact: If indeed there is no difference in effectiveness between the iCBT-I program and in-person CBT-I, this result would have implications in clinical decision-making. Improved access to iCBT-I may reduce prescriptions for addictive pharmacologic treatments, as well as offer an inexpensive, convenient, and effective treatment for insomnia. Future studies could compare efficacy of iCBT-I in patients with co-morbidities, such as anxiety or depression.  

The case for early post-vasectomy semen analysis combining small non-motile sperm and azoospermia

2018 ◽  
Vol 12 (1) ◽  
pp. 50-53
Author(s):  
Jane Hendry ◽  
Robert Small ◽  
Abdullah Zreik ◽  
Niamh Smyth ◽  
Joby Taylor
Keyword(s):  
Patient Compliance ◽  
Semen Analysis ◽  
Motile Sperm ◽  
Success Rates ◽  
Level Of Evidence ◽  
Verbal Instructions ◽  
Time Period ◽  
Sampling Protocols ◽  
The Impact ◽  
Over Time

Background: Post-vasectomy semen analysis timing and criteria guidelines have evolved over time. Through analysis of our unit’s practice of post-vasectomy semen analysis from earlier sampling protocols at 8 weeks to single sampling at 12 weeks then 16 weeks, the impact on success rates and patient compliance were assessed. In addition, the use of small numbers of non-motile sperm and azoospermia combined rates as a marker of sterility were examined. Methods: All patients who underwent vasectomy in 2011 (8 and 12-week samples), 2013 (12-week samples) and 2016 (16-week samples) were included. Patients were given written and verbal instructions explaining the sample delivery protocol and samples. χ2 Testing was used to compare patient compliance and the results of post-vasectomy semen analysis with significance set at P<0.05. Results: In total 1124 vasectomies were performed, with 21% ( N=232) of patients non-compliant with submitting samples at the requested time period. Azoospermia rates increased with a longer time to post-vasectomy semen analysis from 82% to 95%, P<0.001; however, declining compliance meant the proportion of patients given clearance remained the same (70% vs. 68%, P=0.32). Rates of small non-motile sperm declined over an increasing time to post-vasectomy semen analysis. Therefore combined azoospermia and small non-motile sperm rates remained stable over an increasing sampling time (95% vs. 99%, P=0.39). Conclusion: The use of earlier post-vasectomy semen analysis is recommended as patient compliance decreases with the time from vasectomy. When azoospermia and small non-motile sperm rates are combined the rates of success of the procedure remain the same over time therefore earlier testing at 8 weeks is feasible without compromising clearance rates. Level of evidence: Not applicable for this single centre audit.

scholarly journals 664 Characteristics of respondents to a virtual trial of a digital behavioral treatment for insomnia during the COVID-19 pandemic

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A259-A260
Author(s):  
Frances Thorndike ◽  
Keith Saver ◽  
Stephen Braun ◽  
Karren Williams ◽  
Xiaorui Xiong
Keyword(s):  
Clinical Trial ◽  
Behavioral Treatment ◽  
Sleep Problems ◽  
Behavioral Therapy ◽  
Medication Use ◽  
Severity Index ◽  
Alternative Methods ◽  
Open Label ◽  
Fda Guidance ◽  
The Impact

Abstract Introduction Rates of sleep disturbance and sleep medication use have increased during the COVID-19 pandemic, at a time when face-to-face delivery of behavioral insomnia treatments is severely limited. To support research during the pandemic, the FDA released guidelines promoting the use of “alternative methods” to conduct trials in a virtual or decentralized manner. Currently, few data exist regarding the impact of virtual trial enrollment during a pandemic. This abstract presents data from a decentralized, open-label, single-arm real-world clinical trial of the Somryst prescription digital therapeutic for insomnia, which provides insight on who seeks care for insomnia using virtual research methods. Methods In alignment with FDA guidance, the DREAM trial began enrolling patients in March, 2020 with an expected final sample size of 350 adults (Clinical Trial # NCT04325464). This abstract presents data from participants seeking enrollment into the trial via an online screening. Demographic and sleep variables were collected to confirm eligibility. Results Of 1,063 respondents, the majority were female (62%) and the most common age brackets were ages 30–39 (22%); 40–49 (20%); and 50–59 (20%). Most respondents (63.8%) did not report being under the care of a healthcare provider for their insomnia. Respondents reported sleep problems for an average of 12.9 years; sleep problems 5 nights/week; and sleeping an average of 5.4 hours/night. Geographic diversity was high with respondents from 45 states and Washington DC. Of those passing initial screening (N=270), 5.5% reported having another diagnosed sleep disorder, 14.4% reported a comorbid psychological condition, 58.9% reported taking a medication for insomnia, and 30.7% reported taking a medication for depression. Using the Insomnia Severity Index, 16.7% had subthreshold/mild insomnia (score 8–14), 60.0% had moderate insomnia (score 15–21), and 23.7% had severe insomnia (score &gt; 21). Conclusion Respondents to this decentralized trial reported moderate-severe, long-lasting insomnia with high rates of medication use for sleep and depression. Results demonstrate that virtual trials can quickly draw a highly geographically diverse research population, overcoming logistical challenges inherent in a pandemic and resulting in recruiting appropriate, but more geographically diverse, samples than those typically observed in randomized trials of cognitive behavioral therapy for insomnia (CBT-I). Support (if any):

scholarly journals The Effects of a Digital Well-Being Intervention on Patients With Chronic Conditions: Observational Study (Preprint)

2019 ◽  
Author(s):  
Acacia C Parks ◽  
Allison L Williams ◽  
Gina M Kackloudis ◽  
Julia L Stafford ◽  
Eliane M Boucher ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Intervention Program ◽  
Behavioral Therapy ◽  
Past Research ◽  
Well Being ◽  
Subjective Well Being ◽  
The Impact ◽  
Over Time

BACKGROUND Chronic conditions account for 75% of health care costs, and the impact of chronic illness is expected to grow over time. Although subjective well-being predicts better health outcomes, people with chronic conditions tend to report lower well-being. Improving well-being might mitigate costs associated with chronic illness; however, existing interventions can be difficult to access and draw from a single theoretical approach. Happify, a digital well-being intervention program drawing from multiple theoretical traditions to target well-being, has already been established as an efficacious means of improving well-being in both distressed and nondistressed users. OBJECTIVE This study aimed to compare change in well-being over time after using Happify for users with and without a chronic condition. METHODS Data were obtained from Happify users, a publicly available digital well-being program accessible via website or mobile phone app. Users work on tracks addressing a specific issue (eg, conquering negative thoughts) composed of games and activities based on positive psychology, cognitive behavioral therapy, and mindfulness principles. The sample included 821 users receiving at least 6 weeks’ exposure to Happify (ranging from 42 to 179 days) who met other inclusion criteria. As part of a baseline questionnaire, respondents reported demographic information (age and gender) and whether they had any of the prespecified chronic conditions: arthritis, diabetes, insomnia, multiple sclerosis, chronic pain, psoriasis, eczema, or some other condition (450 reported a chronic condition, whereas 371 did not). Subjective well-being was assessed with the Happify Scale, a 9-item measure of positive emotionality and life satisfaction. To evaluate changes in well-being over time, a mixed effects linear regression model was fit for subjective well-being, controlling for demographics and platform usage. RESULTS At baseline, users with a chronic condition had significantly lower subjective well-being (mean 38.34, SD 17.40) than users without a chronic condition (mean 43.65, SD 19.13). However, change trajectories for users with or without a chronic condition were not significantly different; both groups experienced equivalent improvements in well-being. We also found an effect for time from baseline (<italic>b</italic>=0.071; SE=0.010; <italic>P</italic>&lt;.01) and number of activities completed (<italic>b</italic>=0.03; SE=0.009; <italic>P</italic>&lt;.01), and a 2-way interaction between number of activities completed and time from baseline (<italic>b</italic>=0.0002; SE=0.00006; <italic>P</italic>&lt;.01), such that completing more activities and doing so over increasingly longer periods produced improved well-being scores. CONCLUSIONS Data from this study support the conclusion that users with a chronic condition experienced significant improvement over time. Despite reporting lower subjective well-being on the whole, their change trajectory while using Happify was equivalent to those without a chronic condition. Consistent with past research, users who completed more activities over a longer period showed the most improvement. In short, the presence of a chronic condition did not prevent users from showing improved well-being when using Happify.

scholarly journals The Impact of Alexithymia on Emotion Dysregulation in Anorexia Nervosa and Bulimia Nervosa over Time

2017 ◽  
Vol 26 (2) ◽  
pp. 150-155 ◽  
Author(s):  
Tiffany A. Brown ◽  
Jade C. Avery ◽  
Michelle D. Jones ◽  
Leslie K. Anderson ◽  
Christina E. Wierenga ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Emotion Dysregulation ◽  
The Impact ◽  
Over Time

Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy for Tinnitus and Hyperacusis Rehabilitation: Outcomes for Patients Treated in Routine Practice

2018 ◽  
Vol 27 (4) ◽  
pp. 547-558 ◽  
Author(s):  
Hashir Aazh ◽  
Brian C. J. Moore
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Severity Index ◽  
Self Report ◽  
Cognitive Behavioral ◽  
Routine Practice ◽  
Rehabilitation Outcomes ◽  
The United Kingdom ◽  
Before And After ◽  
Severity Index Score

Objective The aim was to assess the effectiveness of cognitive behavioral therapy (CBT) for tinnitus and/or hyperacusis delivered by audiologists working in the National Health Service in the United Kingdom. Design This was a retrospective study, based on questionnaires assessing tinnitus and hyperacusis and insomnia before and after CBT. Study Sample Data were gathered for 68 consecutive patients (average age = 52.5 years) who enrolled for CBT. Results All measures showed significant improvements after CBT. Effect sizes for patients who completed CBT were 1.13 for Tinnitus Handicap Inventory scores; 0.76 for Hyperacusis Questionnaire scores; 0.71, 0.95, and 0.93 for tinnitus loudness, annoyance, and effect on life, respectively, measured using the Visual Analog Scale; and 0.94 for the Insomnia Severity Index score. An analysis including those who dropped out also showed significant improvements for all measures. Conclusion Audiologist-delivered CBT led to significant improvements in self-report measures of tinnitus and hyperacusis handicap and insomnia. The methods described here may be used when designing future randomized controlled trials of efficacy.

scholarly journals Anomalous self-experience, body image disturbance, and eating disorder symptomatology in first-onset anorexia nervosa

2021 ◽  
Author(s):  
Lorenzo Moccia ◽  
Eliana Conte ◽  
Marianna Ambrosecchia ◽  
Delfina Janiri ◽  
Salvatore Di Pietro ◽  
...  
Keyword(s):  
Body Image ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Distribution Patterns ◽  
The Body ◽  
Body Image Disturbance ◽  
Level Of Evidence ◽  
Eating Disorder Examination ◽  
First Onset ◽  
The Impact

Abstract Purpose Anorexia nervosa-restrictive subtype (AN-R) is a life-threatening disorder relying on behavioural abnormalities, such as excessive food restriction or exercise. Such abnormalities may be secondary to an “objectified” attitude toward body image and self. This is the first study exploring the impact of anomalous self-experience (ASEs) on abnormal body image attitude and eating disorder (ED) symptomatology in individuals with AN-R at onset. Methods We recruited Italian female participants, 40 with AN-R (mean age 18.3 ± 2.3) and 45 age and educational level-matched healthy controls (HCs) (mean age 18.2 ± 2.6). ASEs, body image attitude, and ED symptom severity were assessed through the examination of anomalous self-experience (EASE), the body uneasiness test (BUT), and the eating disorder examination questionnaire (EDE-Q), respectively. We conducted multivariate analysis of variance to investigate distribution patterns of variables of interest, and mediation analysis to test the effect of ASEs and body image on ED symptomatology. Results Individuals with AN-R scored higher than HCs on the EASE (p < .0001). A direct effect of ASEs on ED severity (p = 0.009; bootstrapped LLCI = 0.067, ULCI = 0.240) was found in AN-R. After modelling the effect of abnormal body image attitude, the relationship between EASE total score and ED symptomatology was significantly mediated by BUT (p = 0.002; bootstrapped LLCI = 0.001, ULCI = 0.172). Conclusion Although the exact pathways linking AN-R to self-disorder remain to be identified, a broader exploration of transdiagnostic features in AN, including explorations of different dimensions of self-experience and intersubjectivity, may shed further light on the clinical phenomenology of the disorder. Level of evidence Level III, case–control analytic study.

scholarly journals The Effects of a Digital Well-Being Intervention on Patients With Chronic Conditions: Observational Study

10.2196/16211 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e16211 ◽  
Author(s):  
Acacia C Parks ◽  
Allison L Williams ◽  
Gina M Kackloudis ◽  
Julia L Stafford ◽  
Eliane M Boucher ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Intervention Program ◽  
Behavioral Therapy ◽  
Past Research ◽  
Well Being ◽  
Subjective Well Being ◽  
The Impact ◽  
Over Time

Background Chronic conditions account for 75% of health care costs, and the impact of chronic illness is expected to grow over time. Although subjective well-being predicts better health outcomes, people with chronic conditions tend to report lower well-being. Improving well-being might mitigate costs associated with chronic illness; however, existing interventions can be difficult to access and draw from a single theoretical approach. Happify, a digital well-being intervention program drawing from multiple theoretical traditions to target well-being, has already been established as an efficacious means of improving well-being in both distressed and nondistressed users. Objective This study aimed to compare change in well-being over time after using Happify for users with and without a chronic condition. Methods Data were obtained from Happify users, a publicly available digital well-being program accessible via website or mobile phone app. Users work on tracks addressing a specific issue (eg, conquering negative thoughts) composed of games and activities based on positive psychology, cognitive behavioral therapy, and mindfulness principles. The sample included 821 users receiving at least 6 weeks’ exposure to Happify (ranging from 42 to 179 days) who met other inclusion criteria. As part of a baseline questionnaire, respondents reported demographic information (age and gender) and whether they had any of the prespecified chronic conditions: arthritis, diabetes, insomnia, multiple sclerosis, chronic pain, psoriasis, eczema, or some other condition (450 reported a chronic condition, whereas 371 did not). Subjective well-being was assessed with the Happify Scale, a 9-item measure of positive emotionality and life satisfaction. To evaluate changes in well-being over time, a mixed effects linear regression model was fit for subjective well-being, controlling for demographics and platform usage. Results At baseline, users with a chronic condition had significantly lower subjective well-being (mean 38.34, SD 17.40) than users without a chronic condition (mean 43.65, SD 19.13). However, change trajectories for users with or without a chronic condition were not significantly different; both groups experienced equivalent improvements in well-being. We also found an effect for time from baseline (b=0.071; SE=0.010; P<.01) and number of activities completed (b=0.03; SE=0.009; P<.01), and a 2-way interaction between number of activities completed and time from baseline (b=0.0002; SE=0.00006; P<.01), such that completing more activities and doing so over increasingly longer periods produced improved well-being scores. Conclusions Data from this study support the conclusion that users with a chronic condition experienced significant improvement over time. Despite reporting lower subjective well-being on the whole, their change trajectory while using Happify was equivalent to those without a chronic condition. Consistent with past research, users who completed more activities over a longer period showed the most improvement. In short, the presence of a chronic condition did not prevent users from showing improved well-being when using Happify.

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