Cognitive Behavioral Therapy For Patients Research Articles

Long-term effectiveness of web-based cognitive behavioral therapy for patients with eating disorders.

To evaluate the long-term effectiveness of a web-based therapist-delivered cognitive behavioral therapy (CBT) for patients with eating disorders (ED). We used follow-up data from a randomized controlled trial that evaluated a web-based CBT on ED psychopathology and related health, compared to a waiting list control (WL) condition. As participants of the WL condition started the intervention after their waiting period, follow-up data included participants from both groups. The primary outcome was change from baseline, at 3, 6, and 12-month intervals in ED psychopathology, analyzed using mixed models for repeated measures. Secondary outcomes included body dissatisfaction, BMI, physical health, mental health, self-esteem, quality of life, and social functioning. The population comprised 212 participants in total, in three subgroups: bulimia nervosa (BN; n = 44), binge eating disorder (BED; n = 83), and ED not otherwise specified (EDNOS; n = 85). Treatment effects were sustained during follow-up, with generally large effect sizes for the reduction of ED psychopathology and body dissatisfaction, and small to moderate effect sizes for physical and mental health, self-esteem, social functioning, and quality of life. Most effects were found for all three subgroups, except for long-term improvements in self-esteem and quality of life among participants with BN and EDNOS. This study showed long-term sustainability of treatment effects up to 1-year post-treatment of a web-based therapist-delivered CBT for patients with various ED. Level IV, evidence obtained from multiple time series analysis, with intervention. NTR2415-Dutch Trial Registry ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2415 ).

Subcallosal Cingulate Resting State Connectivity Responses to Cognitive Behavioral Therapy in Depression

Aberrant activity of the subcallosal cingulate cortex (SCC) is a common theme across pharmacologic treatment efficacy prediction studies. The functioning of the SCC in psychotherapeutic interventions is relatively understudied, as are functional differences among SCC subdivisions. We conducted functional connectivity analyses on resting-state fMRI data (rsFC), collected before and after cognitive behavioral therapy in patients with major depressive disorder (MDD), using seeds from three subdivisions of the SCC.

Effects of cognitive behavioral therapy for patients with rheumatoid arthritis: a systematic review and meta-analysis

ABSTRACT This study aimed to assess the effects of cognitive behavioral therapy on the psychological and physiological health of rheumatoid arthritis patients. An extensive literature search was conducted, using the PubMed, Web of Science, Cochrane Library, Embase, CNKI Scholar, WanFang, and VIP databases, from inception to December2018. The quality of the studies was evaluated by 2 independent authors, according to the basic criteria provided by the Cochrane Handbook for evaluating randomized trials. Meta-analysis was performed with Review Manager 5.3. Six randomized controlled trials met the inclusion criteria of the current study. Using standard mean differences (SMD) and 95% confidence intervals (CI), our results showed that cognitive behavioral therapy could significantly reduce levels of anxiety (SMD = −0.30, 95% CI [−0.52, −0.09], P= 0.005) and depression (SMD = −0.48, 95% CI [−0.70, −0.27], P< 0.00001), and relieve fatigue symptoms (SMD = −0.35, 95% CI [−0.60, −0.10], P= 0.006) in rheumatoid arthritis patients.This is the first known assessment of the efficacy of cognitive behavioral therapy on rheumatoid arthritis patients using meta-analysis. Large-scale randomized controlled trials need to be implemented to further explore this issue.

The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis.

Background Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conducted this meta-analysis of randomized controlled trials to assess the clinical effectiveness and safety of CBT-I for insomnia comorbid with depression. Data Sources. Seven electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science Technology Journal Database, SinoMed Database, PubMed, the Cochrane Library, and EMBASE, as well as grey literature, were searched from the beginning of each database to July 1, 2019. Study Eligibility Criteria. Randomized controlled trials that compared CBT-I to no treatment or hypnotics (zopiclone, estazolam, and benzodiazepine agonist) for insomnia comorbid with depression and reported both insomnia scales and depression scales. Study Assessment and Synthesis Methods. Cochrane Reviewer's Handbook was used for evaluating the risk of bias of included studies. Review Manager 5.3 software was used for meta-analysis. Online GRADEpro was used to assess the quality of evidence. Results The pooled data showed that CBT-I was superior to no treatment for insomnia, while it was unsure whether CBT-I was better than no treatment for depression. And the effectiveness of CBT-I was comparable to hypnotics for both insomnia and depression. CBT-I was likely to be safe due to its noninvasive nature. The methodological quality varied across these trials. The evidence quality varied from moderate to very low, and the recommendation level was low. Conclusions Currently, findings support that CBT-I seems to be effective and safe for insomnia comorbid with depression to improve the insomnia condition, while it is unsure whether CBT-I could improve depression condition. More rigorous trials are needed to confirm our findings.

Team Intervention and Cognitive Behavioral Therapy for Patients with Chronic Physical Disorders

Team Intervention and Cognitive Behavioral Therapy for Patients with Chronic Physical Disorders

Competing indirect effects in a comparative psychotherapy trial for generalized anxiety disorder.

In a randomized trial for generalized anxiety disorder, cognitive-behavioral therapy (CBT) and CBT integrated with motivational interviewing (MI) promoted comparable worry reduction at posttreatment, whereas MI-CBT outperformed CBT over 12-month follow-up (Westra, Constantino, & Antony, 2016). Secondary analyses revealed competing mediators of the long-term treatment effect: MI-CBT related to lower patient resistance to the treatment, which promoted lower follow-up worry, whereas CBT related to greater increases in patient friendly submissiveness (FS), or compliance, which also promoted lower follow-up worry (that suppressed an even greater long-term advantage of MI-CBT). In this study, we tested these competing, though theoretically consistent, variables as mediators of the nonsignificant treatment effect on posttreatment worry, as there could also be treatment-specific means to arriving to these comparable ends. Eighty-five patients received 15 sessions of MI-CBT or CBT. Therapists rated patient FS through treatment, observers rated resistance at midtreatment, and patients rated worry at posttreatment. Bootstrap analyses indicated that MI-CBT patients exhibited less resistance, which promoted lower posttreatment worry, whereas CBT patients had greater increases in FS, which also promoted lower worry. CBT and MI-CBT achieved comparable posttreatment outcomes through separate indirect paths that each conferred an advantage for one treatment over the other (and had canceled out a direct treatment effect immediately after therapy). The composite trial findings have significance for understanding different pathways to personal change in both the short- and long terms, and for the importance of testing indirect effects both when direct treatment effects do and do not emerge. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The impact of internet-based cognitive behavioral therapy and depressive symptoms on self-care behavior in patients with heart failure: A secondary analysis of a randomised controlled trial

BackgroundPatients with chronic heart failure may require treatment of depressive symptoms to improve self-care behaviour. ObjectivesTo investigate the impact of internet-based cognitive behavioral therapy (CBT) on self-care behaviour in heart failure patients, and to study the association between changes in depressive symptoms and changes in self-care behaviour. DesignA secondary analysis of data collected in a pilot randomized controlled study. Setting50 heart failure patients with depressive symptoms were recruited from four hospitals in Sweden. MethodsPatients were randomized to nine weeks of internet-based CBT (n = 25) or to an active control group participating in an online discussion forum (n = 25). In week two and three, those in the internet-based CBT group worked with psychoeducation about heart failure and depression, emphasizing heart failure self-care. During the same weeks those in the on-line discussion forum specifically discussed heart failure self-care. Patient Health Questionnaire-9 was used to measure depressive symptoms at baseline and at the nine-week follow-up. The European Heart Failure Self-care Behaviour Scale-9 was used to measure self-care behaviour (i.e., the summary score and the subscales autonomous based, provider based and consulting behaviour) at baseline, and at the three-week and nine-week follow-ups. ResultsNo significant differences were found in self-care between the patients in the internet-based CBT and the patients in the online discussion group at the three- and nine-week follow-up. Within-group analysis of the changes in the European Heart Failure Self-care Behaviour Scale showed that from baseline to week three, the summary score increased significantly for the online discussion group (p = 0.04), but not for the internet-based CBT group (p = 0.15). At the nine-week follow-up, these scores had decreased. Similarly, consulting behaviour improved at week three for the online discussion group (p = 0.04), but not for the internet-based CBT group (p = 0.22). Provider-based adherence at the nine-week follow-up had increased from baseline in the internet-based CBT group (p = 0.05) whereas it had decreased in the on-line discussion group. Improvement in symptoms of depression was significantly associated with improvement in autonomy-based self-care (r = 0.34, p = 0.03). ConclusionImprovement in depressive symptoms was associated with improved autonomous-based self-care. ICBT for depression in HF may benefit aspects of self-care that are vital to improve symptoms and prognosis.

Effectiveness of cognitive behavior therapy for patients with heart failure and depression: A systematic review protocol.

The objective of this review is to determine the effectiveness of cognitive behavior therapy for patients with heart failure and depression, aged ≥18 years, in institutionalized healthcare settings. More specifically, the review aims to identify which cognitive behavior therapy strategy/strategies, including the method of delivery, is the most effective for the management of depression in hospitalized patients with heart failure. The review question is as follows: Is cognitive behavior therapy effective in reducing symptoms of depression in patients with heart failure? This systematic review will be conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness evidence. This review only includes randomized controlled trials assessing the effectiveness of cognitive behavior therapy as a treatment for depression in adults (aged ≥18 years) with heart failure, compared with usual care, which might include medications.

General change mechanisms in the early treatment phase and their associations with the outcome of cognitive behavioural therapy in patients with different levels of motivational incongruence

Early general change mechanisms (GCMs) have been shown to be associated with psychotherapy outcome but it remains unclear which specific patients benefit from which GCM. This study explored whether the patients' characteristic motivational incongruence moderates the effect of GCMs in the early treatment phase on the outcome. Three early GCMs (interpersonal experiences, intrapersonal experiences, and problem actuation) were evaluated after five therapy-preparing sessions by patients and therapists. On the basis of previous work, we assumed that the association between intrapersonal experiences and outcome is moderated by incongruence. A total of 524 patients completing outpatient cognitive behavioural therapy (CBT) were investigated. The patient-reported outcome measure was psychological symptom severity. The patients' motivational incongruence was assessed with the incongruence questionnaire short form at baseline. Results showed that therapists' ratings of all three early GCMs and patients' ratings of early problem actuation were not associated with CBT outcome. By contrast, positive patients' ratings of early interpersonal and early intrapersonal experiences were beneficial for CBT outcome (both p<.05). Only the association between patients' ratings of early intrapersonal experiences and CBT outcome was moderated by incongruence (p<.05). The higher the patients' baseline incongruence was, the more beneficial early intrapersonal experiences in the patients' perspective were for a good outcome. These findings entail that increasing early intrapersonal experiences from the patients' perspective is particularly important in patients with motivational incongruence but working on early interpersonal experiences in the patients' perspective is important in patients with all levels of incongruence to reach a good CBT outcome.

Cognitive behavioral therapy with interoceptive exposure and complementary video materials for irritable bowel syndrome (IBS): protocol for a multicenter randomized controlled trial in Japan

BackgroundThere is growing evidence of the treatment efficacy of cognitive behavioral therapy (CBT) for irritable bowel syndrome (IBS). CBT is recommended by several practice guidelines for patients with IBS if lifestyle advice or pharmacotherapy has been ineffective. Manual-based CBT using interoceptive exposure (IE), which focuses on the anxiety response to abdominal symptoms, has been reported to be more effective than other types of CBT. One flaw of CBT use in general practice is that it is time and effort consuming for therapists. Therefore, we developed a set of complementary video materials that include psycho-education and homework instructions for CBT patients, reducing time spent in face-to-face sessions while maintaining treatment effects. The purpose of this study is to examine the effects of CBT-IE with complementary video materials (CBT-IE-w/vid) in a multicenter randomized controlled trial (RCT).MethodsThis study will be a multicenter, parallel-design RCT. Participants diagnosed with IBS according to the Rome IV diagnostic criteria will be randomized to either the treatment as usual (TAU) group or the CBT-IE-w/vid + TAU group. CBT-IE-w/vid consists of 10 sessions (approximately 30 min face-to-face therapy + viewing a video prior to each session). Patients in the CBT-IE-w/vid group will be instructed to pre- view 3- to 13-min videos at home prior to each face-to-face therapy visit at a hospital. The primary outcome is the severity of IBS symptoms. All participants will be assessed at baseline, mid-treatment, post-treatment, and follow-up (3 months after post assessment). The sample will include 60 participants in each group.DiscussionTo our knowledge, this study will be the first RCT of manual-based CBT for IBS in Japan. By using psycho-educational video materials, the time and cost of therapy will be reduced. Manual based CBTs for IBS have not been widely adopted in Japan to date. If our CBT-IE-w/vid program is confirmed to be more effective than TAU, it will facilitate dissemination of cost-effective manual-based CBT in clinical settings.Trial registrationThe trial was registered to the University Hospital Medical Information Network Clinical Trial Registry: UMIN, No. UMIN000030620 (Date of registration: December 28, 2017).

Poznawczo – behawioralna psychoterapia osób z PTSD po doświadczeniach przemocy ze strony partnera - przegląd programów terapii

Około 30% kobiet na całym świecie doświadcza przemocy, która stanowi naruszenie podstawowych praw człowieka i jest ważnym problemem zdrowia publicznego. Rozpowszechnienie zaburzenia stresowego pourazowego (PTSD) waha się u nich między 45%, a 84%. Celem niniejszego artykułu jest przedstawienie różnych form pomocy psychologicznej dla osób doświadczających przemocy, ze szczególnym uwzględnieniem pracy w nurcie poznawczo-behawioralnym. W artykule omówiono założenia teoretyczne, strukturę i moduły realizowane w ramach Poznawczej Terapii Traumy dla Kobiet z Zaburzeniem PTSD po Doświadczeniach Przemocy (CTT-BW) autorstwa Kubany oraz przedstawiano moduły dotyczące m.in. psychoedukacji na temat PTSD, wzmacniania umiejętności zarządzania stresem, asertywnej komunikacji, radzenia sobie z niechcianymi kontaktami z byłymi partnerami i identyfikacji potencjalnych sprawców. Terapia CTT-BW to krótkoterminowa forma pomocy, której skuteczność została potwierdzona badaniami. U 94% kobiet uczestniczących w 3–miesięcznym programie prowadzonym zgodnie z jej protokołem zaobserwowano redukcję lęku, poczucia winy i poczucia wstydu oraz zanotowano znaczący wzrost samooceny.

Effectiveness of psychological distress reduction with cognitive behavioral therapy for oncological patients: A one-year follow-up study.

11624 Background: Distress has a negative impact on medical treatment (Di Matteo, Lepper &amp; Croghan, 2006) and it is considered one of the most important indexes of psychological suffering in oncological patients (NCCN, 2015). Thus, the purpose of this study was to determine the long term effectiveness of brief Cognitive Behavioral Therapy for patients with cancer (CBT-C) compared with a control group (CG) of oncological patients without any psychotherapy intervention - at one year after a chemotherapy treatment. Methods: Participants ( n = 80; mean age = 63.3, SD = 13.4; 54 female) enrolled at the Oncology Day Hospital at the “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy who undertook (CBT-C: n = 40) or non-undertook (CG: n = 40) a psychotherapy intervention. Individual psychotherapy sessions strictly followed the IPOS guidelines (Watson &amp; Kissane, 2017). Participants were tested with the Psychological distress Inventory (PDI) at the baseline (T1; Cronbach α = .88) at the end of the chemotherapy treatment (T2; Cronbach α = .87), at the end of the psychotherapy intervention (T3; Cronbach α = .88), 6-month follow-up (T4; Cronbach α = .85), and 1-year follow-up (T5; Cronbach α = .84). Results: Multilevel growth curve modeling – controlling for age, number of sessions, type and localization of tumor – showed a sharper reduction of distress for CBT-C participants that continue after posttreatment until 1-year follow-up ( p &lt; .001); whereas for CG participants it reduced more gradually from pretreatment to 1-year follow-up ( p &lt; .001). The results revealed a significant difference between the linear slopes for each treatment condition ( p &lt; .001). The overall Hedges’ g comparing the two groups for distress reduction between pretreatment and 1-year follow-up was 2.14 (p &lt; .001) in favor of CBT-C. Conclusions: Given that psychological distress occurs frequently among oncological patients this study is into an important area of study. Results suggest that CBT-C is statistically and clinically effective in treating psychological distress 1 year after the chemotherapy treatment. These findings revealed a kind of long-term effectiveness psychological intervention able both to reduce psychological suffering and improve a better quality of life in oncological settings.

Effectiveness of Internet-Delivered Computerized Cognitive Behavioral Therapy for Patients With Insomnia Who Remain Symptomatic Following Pharmacotherapy: Randomized Controlled Exploratory Trial.

BackgroundIn reality, pharmacotherapy still remains the most common treatment for insomnia.ObjectiveThis study aimed to examine the effectiveness of our internet-delivered computerized cognitive behavioral therapy (ICBT) program as an adjunct to usual care (UC) compared with UC alone in patients with insomnia who remain symptomatic following hypnotics.MethodsWe recruited 23 patients with insomnia who remained symptomatic following pharmacologic treatment including benzodiazepines, and we conducted an exploratory randomized controlled trial. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) at week 6 of the treatment. Secondary outcomes were sleep onset latency, total sleep time, sleep efficiency, number of awakenings, refreshment and soundness of sleep, anxiety by Hospital Anxiety and Depression Scale, depression measured by the Center for Epidemiologic Studies Depression Scale, and quality of life (QOL) measured by the EuroQol-5D. All parameters were measured at weeks 0 (baseline), 6 (postintervention), and 12 (follow-up).ResultsThe adjusted mean reduction (−6.11) in PSQI at week 6 from baseline in the ICBT plus UC group was significantly (P<.001) larger than the adjusted mean reduction (0.40) in the UC alone group. Significant differences were also found in favor of ICBT plus UC for PSQI, sleep onset latency, sleep efficiency, number of awakenings, and depression at all assessment points. Refreshment, soundness of sleep, anxiety, and QOL improved by week 6 in ICBT plus UC compared with UC alone. There were no reports of adverse events in either group during the study.ConclusionsThese results indicated that our 6-week ICBT program is an effective treatment adjunct to UC for improving insomnia and related symptoms even after unsuccessful pharmacotherapy.Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry: UMIN000021509; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023545 (Archived by WebCite at http://www.webcitation. org/75tCmwnYt).

Cortisol levels before and after cognitive behavioural therapy in patients with eating disorders reporting childhood abuse: A follow-up study

The etiopathogenesis of eating disorders (EDs) is complex and still not well understood. Biological, psychological and environmental factors (e.g. childhood abuse) have all been considered to be involved in the onset and the persistence of EDs. The hypothalamic-pituitary-adrenal (HPA) axis is a relevant biological factor capable of influencing the onset and the course of EDs and not many information are available about the impact of a Cognitive Behavioral Therapy (CBT) on cortisol changes in EDs. The HPA-axis functioning has been evaluated before and after CBT in a group of patients with Anorexia Nervosa (n = 34) and Bulimia Nervosa (n = 35) according to the presence/absence of a history of sexual/physical abuse. At baseline, only patients reporting childhood abuse showed lower morning cortisol levels as compared with other patients of the same diagnostic group and Healthy Controls. After CBT, a variation of cortisol levels has been found only in patients without abuse, suggesting a role of childhood adversities in the persistence of HPA-axis alterations in Eating Disorders.

"A Pilot Study to Compare Cognitive Behavioral Therapy with Virtual Reality vs. Standard Cognitive Behavioral Therapy for Patients who Suffer from Cervical Cancer"

"A Pilot Study to Compare Cognitive Behavioral Therapy with Virtual Reality vs. Standard Cognitive Behavioral Therapy for Patients who Suffer from Cervical Cancer"

Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and psychological distress: a scoping review.

Comorbid psychological distress (i.e. insomnia and depression) is experienced by 20-40% of patients with cardiovascular disease. This has a considerable impact on their health and quality of life, leading to frequent re-hospitalisations, higher healthcare costs and a shorter life expectancy. Internet-based cognitive behavioural therapy shows great potential for treating psychological distress in cardiovascular disease. Effective and feasible treatments can, however, only benefit patients if they are fully implemented in clinical care. This scoping review aimed to explore the literature for internet-based cognitive behavioural therapy in cardiovascular disease and for strategies to implement the intervention. We searched electronic databases, journals and internet sources to find original studies about internet-based cognitive behavioural therapy in cardiovascular disease, adhering to scoping methodology guidelines. After identifying 267 titles, we screened 40 abstracts and chose 11 full-text articles for full-text screening. The results sections in four articles were searched for outcomes that related to the effectiveness and implementation of internet-based cognitive behavioural therapy by directed qualitative content analysis using an implementation framework. Three of the four articles fulfilling the inclusion criteria concerned internet-based cognitive behavioural therapy for treating mild to moderate depressive symptoms in cardiovascular disease, and none focused on insomnia. The studies showed evidence for the effectiveness of internet-based cognitive behavioural therapy, and/or described patient factors influencing clinical effectiveness. Our qualitative content analysis showed that many implementation aspects and stakeholder perspectives remain unexplored. Internet-based cognitive behavioural therapy promises to alleviate patient suffering in cardiovascular disease. There is, however, little research about internet-based cognitive behavioural therapy for cardiovascular disease, and about how this evidence-based intervention is implemented.

Investigation of Emotional Expression Processing Following Cognitive Behavioural Therapy for Patients with Schizophrenia: An Event-Related Potentials Study

Growing evidence supports the use of cognitive behavioural therapy (CBT) for psychosis, including CBT for voices (CBTv), which targets auditory verbal hallucinations (AVH). The present study observed the effects of CBTv on electrophysiological measures of facial expression processing in patients with schizophrenia with AVH. Twenty-five patients with schizophrenia were randomly assigned to a treatment group (TG; n = 14) or a treatment as usual (TAU) group (n = 11). The TG received group CBTv for five-six months in addition to their TAU. The matched waitlist group received TAU for the five-six months. The CBTv treatment showed shorter P100 latency in response to facial expressions following treatment compared with baseline, but not the TAU group. Amount of negative content of voices and “omnipotence” of voices were modified following CBTv treatment, but not following TAU. This study provides evidence that CBTv decreases early visual information processing time as indexed by the P100 latency.

Effectiveness of Cognitive Behavioral Therapy for Depression and Anxiety in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis.

Depression and anxiety are highly prevalent in patients with cardiovascular disease (CVD) and influence their mental well-being and CVD prognosis. The primary objective was to assess the effectiveness of cognitive behavioral therapy (CBT) for depression and anxiety in patients with CVD. Secondary objectives were to assess the impact of CBT on cardiovascular mortality, cardiovascular events, patient satisfaction, and quality of life. MEDLINE, PsycINFO, CINAHL, CENTRAL, and alternative sources were searched for randomized controlled trials and observational studies with a control. Studies were required to assess CBT in coronary heart disease, acute coronary syndrome, atrial fibrillation, or postmyocardial infarction patients, with anxiety and/or depression. Studies were independently screened by two reviewers and critically appraised using the Cochrane Risk of Bias tool. The random-effects model was used to pool standardized mean differences (SMD). Twelve randomized controlled trials were included. At follow-up, depression (SMD = -0.35, 95% confidence interval [CI] = -0.52 to -0.17, p < .001, I = 59%) and anxiety (SMD = -0.34, 95% CI = -0.65 to -0.03, p = .03, I = 71%) scores were significantly lower in CBT patients compared with controls. Change in mental health quality of life (SF-12) was also significantly greater for CBT patients, compared with controls (mean difference = 3.62, 95% CI = 0.22 to 7.02, p = .04, I = 0%). No differences in patient satisfaction or cardiovascular events were evident between CBT and control groups. Among the study reports included in this meta-analysis, data specific to cardiovascular mortality were not reported. Cognitive behavioral therapy seems to be an effective treatment for reducing depression and anxiety in patients with CVD and should be considered in standard clinical care.

Cognitive-behavioural therapy in patients with inflammatory bowel diseases: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the effects of cognitive-behavioural therapy in patients with inflammatory bowel diseases. Cochrane Library, Web of Science, Pubmed, EMBASE, and CINAHL were searched up to June 2017, as well as grey literature and databases hand searches. Quality assessment, heterogeneity, sensitivity analysis, and publication bias were performed. Stata12.0 software was used for pooled estimates. Seven eligible reports were included in the final analysis. Inflammatory Bowel Disease Questionnaire score was higher in the cognitive-behavioural therapy group than in the control group at the final follow-up in inflammatory bowel disease patients (P=0.008). There was no statistically significant difference in the Crohn's Disease Activity Index (P=0.751), Simple Clinical Colitis Activity Index score (P=0.747), State Anxiety score (P=0.988), Trait Anxiety score (P=0.681), and Perceived Stress Questionnaire score (P=0.936) at the final point of follow-up. A funnel plot showed no publication bias (P=0.98). Cognitive-behavioural therapy appeared to support higher quality of life in inflammatory bowel disease patients compared with a control group at the final follow-up point but had no effect on disease activity, anxiety, or perceived stress in patients with inflammatory bowel disease. Cognitive-behavioural therapy can be an acceptable adjunctive therapy for inflammatory bowel disease patients, but the effect of cognitive-behavioural therapy is limited.

Brief cognitive-behavioural therapy for patients in the community with schizophrenia: Randomised controlled trial in Beijing, China - Expression of Concern.

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