Psychological Interventions For Patients Research Articles

Investigation and analysis of depression and anxiety in patients with diabetes mellitus

Objective To investigate the status of depression and anxiety in patients with diabetes, and to provide scientific basis for the further implementation of psychological intervention in patients with diabetes. Methods A questionnaire survey was conducted in 121 hospitalized patients with diabetes by general data questionnaire, patient health questionnaire (PHQ-9) and generalized anxiety disorder scale (GAD-7). Results 51.3% of diabetic patients had different degrees of depression, 56.2% of the patients had different degrees of anxiety. Women, primary school and below, complications, no access to community health services had high level of depression and anxiety; people aged from 31 to 45 years and work people acquired high anxiety score. The level of depression and anxiety of the patients increased gradually with the course of disease. when the course lasted more than 5 years, people obtained the highest score of anxiety; when the course existed beyond 10 years, the score of depression was highest. Conclusions The prevalence of depression and anxiety in patients with diabetes should be paid attention to and early screening. Key words: Diabetes; Depression; Anxiety; Investigation and analysis

Coping mediates the influence of personality on life satisfaction in patients with rheumatic diseases.

A rheumatic disease can severely impair a person's quality of life. The degree of impairment, however, is not closely related to objective indicators of disease severity. This study investigated the influence and the interplay of core psychological factors, i.e., personality and coping, on life satisfaction in patients with rheumatic diseases. Particularly, it was tested whether coping mediates the effects of personality on life satisfaction. In a cross-sectional design, 158 patients diagnosed with a rheumatic disease completed questionnaires assessing the Big 5 personality traits (BFI-10), several disease-related coping strategies (EFK) and life satisfaction (HSWBS). Data were analyzed using a complex multiple mediation analysis with the Big 5 personality traits as predictors, coping strategies as mediators and life satisfaction as outcome. All personality traits and seven of the nine coping strategies were associated with life satisfaction (rs > |0.16|, ps ≤ 0.05). The mediation analysis revealed that personality traits had no direct, but rather indirect effects on life satisfaction through coping. Neuroticism had a negative indirect effect on life satisfaction through less active problem solving and more depressive coping (indirect effects > -0.03, ps < 0.05). Extraversion, agreeableness, and conscientiousness had positive indirect effects on life satisfaction through more active problem solving, less depressive coping and/or a more active search for social support (indirect effects > 0.06, ps < 0.05). Personality and coping play a role in adjustment to rheumatic diseases. The interplay of these variables should be considered in psychological interventions for patients with rheumatic diseases.

The neglected need for psychological intervention in patients suffering from incidentally discovered intracranial aneurysms

ObjectivesPrevious studies demonstrated a conspicuously elevated rate of psychiatric disorders in patients with incidental intracranial aneurysms. This study was designed to analyze the impact of this observation on the post-interventional rates of PTSD, depressions and anxiety disorders in this collective. MethodsPhysically unaffected iA patients with an unremarkable medical history were included in this two center study. Pre-interventional psychiatric histories, rates of post-interventional depressions, subjective trauma, PTSD, and pre-interventional fears were determined by questionnaires (Beck Depression Inventory (BDI), Impact of Event Scale (IES), civilian Post-traumatic-Stress-Disorder (PTSD) Check List (PCL-C)). Benign meningioma (M) patients served as controls. Results58M and 45 iA patients were enrolled. Significantly higher rates of PTSD, elevated trauma scores, and moderate/severe depressions (PTSD: p=0.0017; IES: p=0.0038; BDI: p=0.0301) were demonstrated in the iA collective. After excluding patients with a positive pre-interventional psychiatric history those differences were not reproducible. 70% of the iA patients reported an improvement of their unspecific pre-interventional symptoms, while 30% would have rated a psychological consultation as helpful. ConclusionThe data identifies the early psychological consultation as a relevant and by affected patients accepted treatment modification when trying to improve the outcome after treatment of incidental aneurysms.

Supplemental Material for Brief Psychological Intervention in Patients With Cervical Cancer: A Randomized Controlled Trial

Supplemental Material for Brief Psychological Intervention in Patients With Cervical Cancer: A Randomized Controlled Trial

The effects of a novel psychological attribution and emotional awareness and expression therapy for chronic musculoskeletal pain: A preliminary, uncontrolled trial

ObjectiveCurrent psychological and behavioral therapies for chronic musculoskeletal pain only modestly reduce pain, disability, and distress. These limited effects may be due to the failure of current therapies: a) to help patients learn that their pain is influenced primarily by central nervous system psychological processes; and b) to enhance awareness and expression of emotions related to psychological trauma or conflict.Methods: We developed and conducted a preliminary, uncontrolled test of a novel psychological attribution and emotional awareness and expression therapy that involves an initial individual consultation followed by 4 group sessions. A series of 72 patients with chronic musculoskeletal pain had the intervention and were assessed at baseline, post-treatment, and 6-month follow-up. ResultsParticipation and satisfaction were high and attrition was low. Intent-to-treat analyses found significant improvements in hypothesized change processes: psychological attributions for pain, emotional awareness, emotional approach coping, and alexithymia. Pain, interference, depression, and distress showed large effect size improvements at post-treatment, which were maintained or even enhanced at 6 months. Approximately two-thirds of the patients improved at least 30% in pain and other outcomes, and one-third of the patients improved 70%. Changes in attribution and emotional processes predicted outcomes. Higher baseline depressive symptoms predicted greater improvements, and outcomes were comparable for patients with widespread vs. localized pain.Conclusion: This novel intervention may lead to greater benefits than available psychological interventions for patients with chronic musculoskeletal pain, but needs controlled testing.

Mental status and related factors in patients with maintenance hemodialysis in Huzhou City

Objective To investigate the psychological status and related factors in patients with maintenance hemodialysis in Huzhou city. Methods 376 cases of maintenance hemodialysis were selected as the research subjects in Huzhou First People's Hospital.The anxiety and depression status in maintenance hemodialysis patients were investigated by issuing questionnaires.To study the relationship between anxiety and depression, gender, age, social support, nutritional status, complications, and in maintenance hemodialysis patients.At the same time, the quality of life was evaluated by SF-36 scale. Results Issuing 376 questionnaires, a total of 373 points, the effective recovery rate was 99.20%.In 373 patients, there were 182 patients (48.79%) with no depression, mild depression in 78 cases (20.91%), moderate depression in 59 cases (15.82%), severe depression in 54 cases (14.48%).51.21% patients had different degree of depression.Of the 373 patients, there were 123 patients (32.97%) with no anxiety, mild anxiety in 141 cases (37.80%), mild and moderate anxiety in 55 cases (14.75%), moderate anxiety in 33 cases (8.85%), severe anxiety in 21 cases (5.63%). A total of 67.03% patients had different degrees of anxiety.Huzhou city maintenance hemodialysis, female patients had depression rate of 80.70%, anxiety rate of 65.50%, which were significantly higher than the rate of depression 55.45%, anxiety rate 39.11% in male patients, the differences were statistically significant (P<0.01-0.05). In maintenance hemodialysis patients, the anxiety and depression status gradually increased with age.Severe malnutrition in maintenance hemodialysis patients, the rate of depression, anxiety rates were 80.65%, 90.32%, the rates of depression, anxiety were 44.49%, 61.81% in normal and mild malnutrition patients, the differences were statistically significant (all P<0.01). SF-36 scale showed that most of the patients with maintenance hemodialysis patients had poor quality of life, and the function was limited. Conclusion Maintenance hemodialysis patients, the general existence of anxiety and depression in the mental state in Huzhou city.Moreover, the psychological state of the patients is influenced by sex, age, nutrition status, and other factors.In clinical, it is needed to provide effective psychological intervention for patients to improve the quality of life, according to the psychological status and related factors of maintenance hemodialysis patients. Key words: Rend dialysis; Psychology, medical; Quality of life; Influence factors

Non-pharmacological interventions for people with epilepsy and intellectual disabilities.

Approximately 30% of patients with epilepsy remain refractory to drug treatment and continue to experience seizures whilst taking one or more antiepileptic drugs (AEDs). Several non-pharmacological interventions that may be used in conjunction with or as an alternative to AEDs are available for refractory patients. In view of the fact that seizures in people with intellectual disabilities are often complex and refractory to pharmacological interventions, it is evident that good quality randomised controlled trials (RCTs) are needed to assess the efficacy of alternatives or adjuncts to pharmacological interventions.This is an updated version of the original Cochrane review (Beavis 2007) published in The Cochrane Library (2007, Issue 4). To assess data derived from randomised controlled trials of non-pharmacological interventions for people with epilepsy and intellectual disabilities.Non-pharmacological interventions include, but are not limited to, the following.• Surgical procedures.• Specialised diets, for example, the ketogenic diet, or vitamin and folic acid supplementation.• Psychological interventions for patients or for patients and carers/parents, for example, cognitive-behavioural therapy (CBT), electroencephalographic (EEG) biofeedback and educational intervention.• Yoga.• Acupuncture.• Relaxation therapy (e.g. music therapy). For the latest update of this review, we searched the Cochrane Epilepsy Group Specialised Register (19 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) via CRSO (19 August 2014), MEDLINE (Ovid, 1946 to 19 August 2014) and PsycINFO (EBSCOhost, 1887 to 19 August 2014). Randomised controlled trials of non-pharmacological interventions for people with epilepsy and intellectual disabilities. Two review authors independently applied the inclusion criteria and extracted study data. One study is included in this review. When two surgical procedures were compared, results indicated that corpus callosotomy with anterior temporal lobectomy was more effective than anterior temporal lobectomy alone in improving quality of life and performance on IQ tests among people with epilepsy and intellectual disabilities. No evidence was found to support superior benefit in seizure control for either intervention. This is the only study of its kind and was rated as having an overall unclear risk of bias. The previous update (December 2010) identified one RCT in progress. The study authors have confirmed that they are aiming to publish by the end of 2015; therefore this study (Bjurulf 2008) has not been included in the current review. This review highlights the need for well-designed randomised controlled trials conducted to assess the effects of non-pharmacological interventions on seizure and behavioural outcomes in people with intellectual disabilities and epilepsy.

Psychological support needs of patients with head and neck cancer and their caregivers: A qualitative study

Objective: The aim of this study was to explore the psychological support needs of patients with head and neck cancer (HNC) and their caregivers. The appropriate timing, length, format and content of sessions were also investigated.Design: Eighty-three patients with HNC and 73 of their caregivers completed questionnaires at diagnosis. Follow-up questionnaires were mailed to patients six months later.Main outcome measures: Free text-comments to open-ended questions in the questionnaires were analysed using an inductive thematic approach with coding and theme development directed by the content of responses. This was used to determine psychological support needs both at diagnosis and at six month follow-up.Results: Patients described ‘just being there’, empathy, maintaining normality and practical support as helpful from family/friends. They desired information, honesty, positivity and empathy from clinical staff. Formal psychological support was desired by approximately 40% of patients and caregivers, particularly early after diagnosis and during treatment. Most participants desired face to face sessions, providing individualised information and coping strategies.Conclusion: The results of this study suggest that psychological interventions for patients with HNC and their caregivers should be delivered early after diagnosis in face to face sessions, presenting honest and factual information about the disease and coping strategies.

Quality effect of systemic psychological intervention for patients with craniofacial trauma before MRI scanning

Objective To investigate the psychological influence of anxiety and depression of patients with craniofacial trauma using psychological intervention before MRI scanning. Methods One hundred and forty hospitalized patients with craniofacial trauma were enrolled averagely divided into psychological experimental group and control group by time sequence. The patients of the experimental group received psychological intervention before MRI scanning, whereas the patients of the control group did not, but patients in both groups underwent routine nursing. The psychological state of all the patients were evaluated using self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Results There was no difference in either SAS or SDS between two groups before intervention (P>0.05). After intervention, the anxiety score and depression score were (38.96±10.15) and (46.86±11.25), which were lower than (43.53±9.32) and (52.51±6.80) of the control group (t=-2.776, -3.601, respectively; P<0.05). All patients in the experimental group completed examination, but two cases failed in the control group. The image quality control in the experimental group were excellent (clear and no constructed defect), and there were three cases of good image for quality control in the control group. Conclusions Psychological intervention before MRI scanning may play an important role in improving the psychological state of patients with craniofacial trauma so as to improve the cooperation of examination, completion rate and quality of image. Key words: Psychological intervention; Craniofacial trauma; Magnetic resonance imaging(MRI)

Stimulating interest: A brief introduction to drugs for ADHD

About 1-in-20 children and adolescents have attention deficit hyperactivity disorder (ADHD). Parental training and education, and psychological treatment for patients, are the usual first-line treatments for moderate ADHD. NICE recommends drugs for severe ADHD, as well as for children with moderate ADHD who refused non-drug treatment, or whose symptoms and impairment did not respond adequately to training, education and psychological treatment. The drug choice needs to be individualised, form part of a comprehensive treatment plan and carers (including school staff) need to remain alert for adverse events. This article briefly introduces the place of, and some issues surrounding, stimulants for ADHD.

The Effectiveness of Relaxation Techniques in Anxiety Disorders

The treatment of anxiety disorders is subject to multiple factors (biological and environmental), this creates a complex situation while trying to achieve effective treatment of anxiety disorders. This is the reason why in the current study, we decided to evaluate the effectiveness of specific relaxation techniques as an additional therapeutic measure. To determine whether there is therapeutic benefit in the application of relaxation techniques among patients undergoing Pharmacological and psychological anxiety disorder treatment in comparison with patients with anxiety disorders receiving only the latter. Firstly the process involved a pre and post intervention assessment using a psychometric equipment the Hamilton rating Scale for -HARS anxiety (HARS), the anxiety Inventory-STAI State (STAI-S) and Trait (STAI-T), which allowed us to perform an objective assessment of anxiety levels Significant reductions in post intervention levels were obtained in comparison with pre anxiety levels, in HARS (30.56 and 22.75), in STAI-S (64.93 and 46.62) and in STAI-T (83.75 and 63.56). Additionally the size effect (SE) was considerable, in the HARS (SE= 0,70), en STAI-S (SE=0.59) and STAI-T (SE =0.69). From the obtained results, we can affirm there are benefits of introducing therapeutic relaxation techniques as a complement to pharmacological / psychological treatment in patients with anxiety disorders. However more studies should be carried out to evaluate the maintenance of these results in the Long-term.

Patients' Outcome Expectations Matter in Psychological Interventions for Patients with Diabetes and Comorbid Depressive Symptoms.

This study examined whether patients’ expectations of treatment outcome predict treatment completion, homework compliance, and depressive symptom improvement in cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy (MBCT). Study participants were patients with diabetes and comorbid depressive symptoms who were randomized to 8 sessions of either CBT (n = 45) or MBCT (n = 46), both individually delivered. The results showed that high outcome expectations were predictive of post-treatment depressive symptoms in CBT and MBCT, but not of early and mid-treatment symptoms. Patients’ outcome expectations predicted treatment completion in CBT and MBCT as well as homework compliance in MBCT. Homework compliance did not mediate the association between patients’ outcome expectations and post-treatment depressive symptom improvement. The findings do not support the hypothesis that patients’ expectations have an immediate impact on patients’ mental state and partially support the notion that patients are less involved in treatment when they hold low expectations for improvement.

A RCT Comparing Specific Intensive Cognitive Training to Aspecific Psychological Intervention in RRMS: The SMICT Study.

Background: Specific cognitive rehabilitation in multiple sclerosis (MS) resulted to be effective compared to no treatment. So far the possible role of an aspecific psychological intervention on cognition has not been investigated.Objective: The aim of the SMICT RCT was to compare the efficacy of a specific cognitive training with an aspecific psychological intervention in relapsing-remitting MS patients.Methods: From a sample of 150 patients, with the same disability and immunomodulatory therapy, submitted to neuropsychological examination, 45 impaired in at least one test were included and 41 randomized to have either a specific cognitive training for the impaired function (22) or to an aspecific psychological intervention (19) for 4 months, starting after baseline examination. Neuropsychological tests and functional scales were administered at baseline and 1 year later.Results: After 1 year, the mean number of pathological tests was significantly lower in the specific treatment group, compared to the aspecific group. Memory and attention/speeded information processing functions were mostly improved. Depression and quality of life were not different between groups at follow up.Conclusion: Our study demonstrates that an intensive and domain specific cognitive approach results to be more effective than aspecific psychological intervention in patients with MS.

Psychometric properties of translated outcome measures of cognitive behavioural therapy for psychosis in the Chinese context

ObjectivesGrowing evidence supporting the use of Cognitive Behavioural Therapy (CBT) to improve outcomes in patients with psychosis has largely originated from American and European countries, its applicability and effectiveness in Chinese patients with psychosis is still under-explored. However, the lack of stable and reliable outcome measures to evaluate the effectiveness of CBT for patients with psychosis hinders further development of psychological intervention in patients with psychosis in the Chinese context. The present study therefore aims to translate selected outcomes measures developed in American and European countries to measure the effectiveness of CBT for psychosis into Chinese and evaluate their psychometric properties. MethodsThirty-three patients with residual psychotic symptoms were recruited in the Department of Psychiatry, Kowloon Hospital, Hong Kong. Participants were asked to complete a set of self-reported questionnaires twice with an interval of a week, including Beliefs About Voices Questionnaire-Revised (BAVQ-R), Beck Cognitive Insight Scale (BCIS) and Southampton Mindfulness Questionnaire (SMQ). ResultsThe results found that the Chinese versions of BAVQ-R, BCIS and SMQ had excellent test-retest reliability with good to acceptable internal reliability. ConclusionsGenerally, all three translated outcome measures were found to be stable and reliable, and were ready for evaluating the effectiveness of cognitive therapy for psychosis in the Chinese population. Further discussions on scoring and interpretations of the Chinese version of SMQ were made.

EHMTI-0210. Dolotest may reflect the effect of psychological treatment in patients suffering from severe headache

Patients with severe headache who undergo psychological treatment at the Danish Headache Center, a tertiary multidisciplinary treatment centre, often report positive effects on their perceived general well-being and ability to work. However there is no agreement on which quality of life (QoL) instruments are useful for monitoring outcome of psychological treatment.

Psychological interventions for patients with cancer: psychological flexibility and the potential utility of Acceptance and Commitment Therapy.

Cancer is an illness affecting patients' physical and psychosocial well-being: high numbers report problematic levels of distress at many points through diagnosis, treatment and survivorship. Conclusive evidence for the long-term benefits of psychological interventions is lacking and this may be because (1) they employ a too limited scope of underlying therapeutic model; or (2) that they are too focused on improving psychopathological outcomes. Acceptance and Commitment Therapy (ACT) may add components not emphasised elsewhere and may provide a more suitable model of adjustment and coping. Following a comprehensive literature search a theoretical and conceptual discussion of the potential for ACT-based oncology interventions is presented. Only a small number of studies have purposively studied the application of ACT within the cancer setting, but this nonetheless presents useful pilot data. The data demonstrate potential clinical- and cost-effectiveness for a range of patients, including those with psychological comorbidity. Within the context of wider cancer adjustment, ACT offers an intervention framework to appropriately build upon the strong empirical base already established for Mindfulness within this specific patient population. The evidence available suggests that the underlying framework of ACT offers an intervention model that is potentially more suited to the individualistic nature of cancer adjustment.

Brief psychological intervention after self-harm: randomised controlled trial from Pakistan

Self-harm is a major risk factor for completed suicide. To determine the efficacy of a brief psychological intervention - culturally adapted manual-assisted problem-solving training (C-MAP) - delivered following an episode of self-harm compared with treatment as usual (TAU). The study was a randomised controlled assessor-masked clinical trial (trial registration: ClinicalTrials.gov NCT01308151). All patients admitted after an episode of self-harm during the previous 7 days to the participating medical units of three university hospitals in Karachi, Pakistan, were included in the study. A total of 250 patients were screened and 221 were randomly allocated to C-MAP plus treatment as usual (TAU) or to TAU alone. All patients were assessed at baseline, at 3 months (end of intervention) and at 6 months after baseline. The primary outcome measure was reduction in suicidal ideation at 3 months. The secondary outcome measures included hopelessness, depression, coping resources and healthcare utilisation. A total of 108 patients were randomised to the C-MAP group and 113 to the TAU group. Patients in the C-MAP group showed statistically significant improvement on the Beck Scale for Suicide Ideation and Beck Hopelessness Inventory, which was sustained at 3 months after the completion of C-MAP. There was also a significant reduction in symptoms of depression compared with patients receiving TAU. The positive outcomes of this brief psychological intervention in patients attempting self-harm are promising and suggest that C-MAP may have a role in suicide prevention.

The association between muscle weakness and activity limitations in patients with Ehlers Danlos (Hypermobility Type): the impact of proprioception

The association between muscle weakness and activity limitations in patients with Ehlers Danlos (Hypermobility Type): the impact of proprioception

Evaluating the Effectiveness of Psychological Interventions in Patients with Psoriasis: A Review

Psoriasis is a common condition, often associated with substantial psychological morbidity. Stress is frequently implicated in the onset or exacerbation of psoriasis, giving rise to the possible use of psychotherapeutic modalities in treatment. This article reviewed the literature describing cases and trials of psychological interventions (i.e., psychotherapy, biofeedback, hypnosis, meditation, and emotional disclosure) in the treatment of patients with psoriasis. All six case reports/series demonstrated positive outcomes. Among the trials, seven out of 11 found significant physical improvement and four out of seven found significant psychological benefit. Psychological interventions appear to have the potential to serve as helpful adjuncts to conventional dermatological treatments, although further research is needed with emphasis on randomized controlled trials with more standardized, validated outcome measures.

Correction: Psychological Interventions for Patients with Coronary Heart Disease and Their Partners: A Systematic Review

Correction: Psychological Interventions for Patients with Coronary Heart Disease and Their Partners: A Systematic Review