Therapeutic Change Research Articles

Pushing the limit to reach meaningful change: the impact of intensity-driven exercise on clinical outcomes for individuals with Parkinson’s disease. A single-subject design

Purpose Parkinson’s disease creates an inability to perform previous learned autonomic tasks, such as walking, which worsens with disease progression. Recommendations to incorporate exercise at moderate to high intensities for this population has been established but there is limited knowledge about its impact on clinical based outcomes. The purpose of this research is to investigate the effectiveness of a 6-week intensity-driven walking program on clinical-based outcomes in individuals with PD. Materials/Methods Five individuals with PD were recruited for this single-subject withdrawal design (A-B-A-B) study. 6-minute walk performance and other core neurological measures of gait were collected. Intervention phases incorporated a 30-minute individualized intensity-driven treadmill walking program practiced at 65% or more of ones maximum heart rate. Increased treadmill speed, incline, and resistance were manipulated to reach the target heart rate zone. Results 6-minute walk test within condition visual analysis demonstrated a therapeutic change during intervention phases and a countertherapeutic change during withdraw periods for all 5 individuals. An abrupt therapeutic effect was demonstrated for all individuals between conditions with the percent of nonoverlapping data ranging from 70-90%. Band method analysis revealed a range of 9-19 sessions two standard deviations above baseline mean performances for all individuals. Conclusion To achieve sufficient walking performance, gait practiced at higher intensity levels may provide the optimal solution as an adjunct to standard care for individuals with PD who want to improve their walking.

Re-learning from teaching: a personal reflection on Jeremy Safran's legacy.

Jeremy Safran's pedagogical style was singular in its emphasis on experiential learning through role-plays, use of session video recordings, and his full-hearted embrace of therapists' subjectivity as a tool for therapeutic change. This paper is a personal reflection on the author's experiences as Jeremy Safran's student and how they have translated into her own teaching and supervision. She shares how teaching has been a means of reconnecting with her experiences learning from Jeremy, and the ways in which she tries to carry forward his unique contributions to the next generation of students and trainees.

Emotion Regulation, Relationship and Therapeutic Change in Analytical Psychology and Contemporary Psychodynamic Approaches.

All contemporary psychotherapies agree that (failing) emotion regulation is central to psychological disorders and that psychotherapy is about improving emotion regulation. In his research on the "emotion-laden" complex Jung put an emphasis on the role of failing emotion regulation in contributing to psychological disorders as well as to change in the process of psychotherapy, but he left this field of research and took a very different direction in favour of his archetype concept. Psychodynamic approaches generally argue that changes in emotion regulation are accomplished through corrective emotional experiences in the therapeutic relationship. Insights from affective neurosciences and attachment research have had a major influence on how the therapeutic relationship is constructed in contemporary psychodynamic approaches. There is a lack of similar developments in analytical psychology, which leads to substantial differences between the models of Jungian psychotherapy in contrast to other contemporary psychodynamic approaches. The implications of these differences for the practice of psychotherapy and especially the role of the therapeutic relationship are pointed out.

Neurodynamics of Relational Aesthetic Engagement in Creative Arts Therapies

Aesthetic experiences, emerging saliently in the arts, play a pivotal role in transformative learning and creative processes that elicit physiological, affective, and cognitive responses associated with mental health indices. Interactions between subjects and aesthetic objects (e.g., visual artwork, music, and moving bodies) often entail elements of surprise and uncertainty that drive the inference of the hidden causes in the subject’s internal and external environment. These generate dynamics that align with the action-oriented Predictive Processing framework of brain function. Creative Arts Therapies (CATs) harness these dynamics by cultivating relational engagement using the arts modalities, prompting affective and cognitive processing. In this manuscript, we offer a review and conceptual analysis of recent empirical findings and theoretical premises that underpin aesthetic experiences and their relation to the psychotherapeutic use of the arts with a broad spectrum of populations and mental health conditions. We present a neuroscience-based approach to aesthetic intra- and inter-personal experiences, integrating therapeutic change factors of externalization-concretization, embodiment, and symbolization with functional network configurations, and interpersonal brain-to-brain coupling, to support predictive processing, learning, and creativity. Present and future interdisciplinary collaborations are underlined to elucidate the neurodynamic mechanisms driving psychological transformations, bridging neuroaesthetics and CATs.

Clinical Application and Feasibility of Capsule Endoscopy in Children at a Medical Center in Central Taiwan

Background/PurposeCapsule endoscopy (CE) is a noninvasive examination for excellent visualization of small bowel mucosal lesions. We aimed to evaluate the clinical efficacy and safety of CE in pediatric patients. MethodsFrom April 2014 to December 2022, CE procedures performed in children younger than 18 years of age at Taichung Veteran General Hospital were analyzed retrospectively. ResultsAmong 136 procedures, the completion rate was 95.6% (n=130), with a median age of 14 years old. Suspicion or evaluation of inflammatory bowel diseases (IBD) (41%) was the most common indication for CE. Other common indications of CE were chronic unexplained abdominal pain (35%) and obscure gastrointestinal bleeding or iron deficiency anemia (21%). No procedure-related complications occurred. The diagnosis of those patients with incomplete study were CD with small bowel stricture, graft-versus-host disease and duodenal ulcers. A total of 86 CE procedures showed positive findings, and the overall diagnostic yield rate was 63.2%. Small bowel ulcers (65.12%) were the most common findings. Overall, 26.5% of CE examinations resulted in a new diagnosis and 44.9% of CE exams led to a change in therapy. For patients with IBD, CE findings resulted in an even higher therapeutic change rate of 48.1%. ConclusionsCE is a safe and feasible diagnostic method to study the small intestine in children, especially for IBD. Incomplete study could be an indicator of positive finding and can potentially be a guide to identify the site of possible strictures.

Differential posttraumatic stress disorder symptom cluster response to stellate ganglion block: secondary analysis of a randomized controlled trial

Empirically supported treatments for posttraumatic stress disorder (PTSD) exist, but research suggests these therapies are less effective, acceptable, and feasible to deliver to active duty service members (SMs) compared to civilians. Stellate ganglion block (SGB) procedure, in which a local anesthetic is injected around the cervical sympathetic chain or stellate ganglion to temporarily inhibit sympathetic nervous activity, is gaining popularity as an alternative PTSD treatment in military settings. However, it is unknown whether certain PTSD symptoms are more responsive to SGB than others. The current study involved a secondary analysis of data collected from a previous randomized controlled trial of SGB compared to sham (normal saline) injection (N = 113 SMs). PTSD symptoms were assessed via clinical interview and self-report at baseline and 8 weeks post-SGB or sham. Logistic regression analyses showed that the marked alterations in arousal and reactivity PTSD symptom cluster demonstrated the greatest symptom severity reductions after SGB, relative to sham. The reexperiencing cluster also showed pronounced response to SGB in clinician-rated but not self-reported outcomes. Post-hoc item-level analyses suggested that arousal and reactivity cluster findings were driven by reductions in hypervigilance, concentration difficulties, and sleep disturbance, whereas clinician-rated reexperiencing cluster findings were driven by reductions in physiological reactions to trauma cues, emotional reactions to trauma cues, and intrusions. Our findings align with a burgeoning literature positioning SGB as a potential novel or adjunctive PTSD treatment. Results could guide future hypothesis-driven research on mediators of therapeutic change during SGB for PTSD symptoms in SMs.

Pattern transitions in diary data of MDD patients: a mixed-methods multiple case study of psychotherapy dynamics.

Mixed-methods approaches promise a deep understanding of psychotherapeutic processes. This study uses qualitative and quantitative data from daily diary entries and daily self-assessments during inpatient treatment. The aim of the study is to get an insight into the similarities and differences between both types of data and how they represent self-organized pattern transitions in psychotherapy. While a complete correlation of results is not expected, we anticipate observing amplifying and subsidiary patterns from both perspectives. Daily, five MDD patients wrote diaries and completed self-assessments using the Therapy Process Questionnaire, a questionnaire for monitoring the change dynamics of psychotherapy. The data were collected using the Synergetic Navigation System, an online tool for real-time monitoring. Diary entries of the patients described their experiences in everyday life. The qualitative text analysis was conducted using Mixed Grounded Theory, which provided categories representing the patients' ongoing experiences of transformation and stagnation. The time series data was analyzed using the dynamic complexity algorithm and the pattern transition detection algorithm. Results from qualitative and quantitative analyses were combined and compared. Following the process of data triangulation, the leading perspective came from the theory of self-organization. In addition to presenting the overall results for all five patients, we delve into two specific case examples in greater detail. Specific and highly diversified diary entries of 5 patients were classified into the categories of perceived pattern stability, noticing improvement, broadening the perspective, critical instability, and experiencing moments of Kairos. Patients reported problems not only related to their disorder (e.g., lack of energy and hopelessness) but also to phases and steps of change, which could be related to the theory of self-organization (e.g., problem attractors, critical fluctuations, pattern transitions, and Kairos). Qualitative and quantitative analysis provide important supplementary results without being redundant or identical. Data triangulation allows for a comprehensive and multi-perspective understanding of therapeutic change dynamics. The different topics expressed in the diary entries especially help to follow micro-psychological processes, which are far from being a simple reaction to interventions. The way patients experience themselves being in stability or instability and stagnation or transformation is surprisingly close to the general features of self-organizing processes in complex systems.

"Finding my voice again" - women's experiences of psychological therapy in perinatal secondary care settings: a qualitative study.

Although women often experience mental health comorbidities in the perinatal period, the evidence-base for psychological therapy across diagnostic boundaries in the perinatal period remains limited. As there is a need to understand experiences of therapy, irrespective of diagnosis, to inform intervention provision, the aims of this study were to explore women's experiences of psychological therapy for perinatal mental health difficulties and to identify the mechanisms that women attributed to the most significant therapeutic change for themselves and/or the mother-infant relationship. Semi-structured interviews were conducted with 16 women who received therapy within specialist perinatal community mental health settings in the Northwest of England, the UK. Interview data were analysed using reflexive thematic analysis. One overarching theme entitled participant life stories were at the heart of therapy was identified alongside three other main themes: 1.) We're in this together - therapeutic bond and establishing a coherent sense of self, 2.) Surfing the urge to 'fix' feelings - Sitting with emotions improved regulation and 3.) Seeing myself in a new light - Shifting self-blame to self-compassion enhanced self-efficacy. Theme 1 consisted of three subthemes. Participants described the quality of the therapeutic relationship as the fundamental foundation to (re)connecting with their needs, values and boundaries, which improved their sense of agency, self-esteem, therapeutic engagement and self-understanding. Shifting emotional avoidance to emotional engagement improved their self-regulation. Considering alternative factors that could have contributed to their experiences helped them to defuse self-blame and enhance self-compassion. Finally, changes in their mental health led to positive relational changes in their relationship with their infant and improved communication with partners. Sensitivity, engagement and responsivity experienced in the therapist-woman relationship was reported to be mirrored in the mother-infant relationship. Developing a coherent sense of self and self-regulation skills both appeared to heighten women's self-compassion and empathy for their infants, which also seemed to improve their ability to tolerate uncertainty and mixed emotions within themselves and their infants. The mechanisms of change in the perinatal period are important to consider at a stakeholder, therapist and service management level to parsimoniously and best meet the needs of women and the mother-infant relationship.

A Matter of Dis/Embodied Non/Relating in Art Psychotherapy Practices

Embodied practices in arts therapies are frequently constructed upon the premise of developmental psychotherapies. This paper problematises some of the key concepts commonly used in arts therapies and explores a new intra-active framework for becoming. Relationality, boundaries and the context of change processes are revisited to investigate modelling an approach that decentres human subjectivity and considers the relevance of embodiment and the environment in relation to therapeutic change. Intersections between art, developmental psychotherapies, arts therapies and aesthetics form the basis of retheorising the dynamic relations of art-therapist-patient.

Psychedelic-assisted psychotherapy: where is the psychotherapy research?

Psychedelic-assisted psychotherapy (PAP) has emerged as a potential treatment for a variety of mental health conditions, including substance use disorders and depression. Current models of PAP emphasize the importance of psychotherapeutic support before, during, and after ingestion of a psychedelic to maximize safety and clinical benefit. Despite this ubiquitous assumption, there has been surprisingly little empirical investigation of the "psychotherapy" in PAP, leaving critical questions about the necessary and sufficient components of PAP unanswered. As clinical trials for psychedelic compounds continue the transition from safety- and feasibility-testing to evaluating efficacy, the role of the accompanying psychotherapy must be better understood to enhance scientific understanding of the mechanisms underlying therapeutic change, optimize clinical outcomes, and inform cost-effectiveness. The present paper first reviews the current status of psychotherapy in the PAP literature, starting with recent debates regarding "psychotherapy" versus "psychological support" and then overviewing published clinical trial psychotherapy models and putative models informed by theory. We then delineate lessons that PAP researchers can leverage from traditional psychotherapy research regarding standardizing treatments (e.g., publish treatment manuals, establish eligibility criteria for providers), identifying mechanisms of change (e.g., measure established mechanisms in psychotherapy), and optimizing clinical trial designs (e.g., consider dismantling studies, comparative efficacy trials, and cross-lagged panel designs). Throughout this review, the need for increased research into the psychotherapeutic components of treatment in PAP is underscored. PAP is a distinct, integrative, and transdisciplinary intervention. Future research designs should consider transdisciplinary research methodologies to identify best practices and inform federal guidelines for PAP administration.

#2776 Monoclonal gammopathies and amyloidosis unit (UGAM-A): importance of the nephrologist in the multidisciplinary approach

Abstract Background and Aims The Monoclonal Gammopathies and Amyloidosis Unit (UGAM-A) is a multidisciplinary hospital subcommittee that discusses complex cases in relation to the diagnosis and treatment of patients with blood dyscrasia and amyloidosis. Method Retrospective observational study of the cohort of patients presented at UGAM-A The data were extracted from the minutes of the UGAM-A for the period Jan/18-Dec/22. Results 81 patients were assessed with a median age of 69 years, 52 men (64.2%). HT 58 (71.6%), DM 22 (27.2%), cardiovascular disease 14 (17.3%), Neoplasm 12 (14.8%). 56 patients (69.1%) had renal damage at the time of assessment, 54 with CKD criteria, with a mean creatinine of 1.7 ± 1.0 mg/dl and proteinuria of 1.3 ± 1.7 g/mg. Cardiac involvement was found in 19 patients. There were 37 (45.7%) diagnostic changes after assessment by the UGAM. A total of 22 (27.2%) therapeutic modifications, initiation or change were made. 17 (77.3%) occurred in patients with renal involvement. There were 10 (12.3%) treatment changes, with 22.7% of them improving renal function vs. 7% in the group with no change in treatment (p = 0.04). 8 (9.9%) patients required SDB, with a median time to onset of 452d. A total of 25 (30.9%) patients died, with a median time of 370d, with 12 being the most common cardiac cause, followed by infectious 8. Conclusion Nephrologists should be involved in the complex clinical cases that accompany hematologic diagnoses. In our study, almost 80% of patients had renal involvement concomitant with haematological pathology. The role of the nephrologist is fundamental in clarifying mechanisms of kidney damage and enhancing the initiation of treatment even when they do not meet criteria from the haematological point of view, so that more than 77% of the therapeutic actions took place in patients with renal involvement.

How Preoperative Investigations Affect the Management of Bariatric Patients - Results of a Cohort Study of 897 Patients

Abstract Background Poorly defined preoperative diagnostic protocols worldwide vary in their emphasis on comprehensive investigations, with some prioritizing patient safety while others question routine procedures. Aims This study explores how diverse preoperative findings, from inflammatory processes to structural abnormalities, significantly influence patients’ management and the choice of bariatric procedures, underscoring the complexity in decision-making for individualized surgical interventions based on a cohort study's findings. Methods In a retrospective analysis of prospective data of over 1000 bariatric surgery patients from January 2017 to December 2022, we specifically included those who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). In all patients, preoperative upper endoscopy was performed, with selected candidates also undergoing additional procedures like upper GI series and esophageal manometry, especially when LSG was planned. The study primarily analyzed the impact of preoperative examinations on therapeutic approaches. Results In this study, 897 patients were included, with 741 undergoing laparoscopic LRYGB and 156 LSG. All patients underwent upper endoscopy, revealing common findings such as type C gastritis, gastroesophageal reflux disease, and detection of Helicobacter pylori. Upper endoscopy prompted a therapeutic change in 216 patients (24.3%), resulting in a number needed to screen (NNS) of 4.1, with no significant differences based on the initially scheduled procedure. Preoperatively, upper GI series were more frequently conducted before planned LSG, uncovering hiatal hernias and motility disorders. However, no change in the surgical procedure resulted from upper GI series findings. Esophageal manometry, primarily performed for LSG, indicated normal findings in 84.6%, with a procedural change in 3 patients (2.0%). Overall, 14 (1.6%) patients experienced a change in the planned procedure, with 12 changes prompted by preoperative findings and two by technical difficulties. Conclusion We recommend routine upper endoscopy for all bariatric surgery patients, with additional manometry for planned LSG. Upper GI series should be reserved for selected cases and specific clinical indications.

Treatment Engagement and Outcomes in Parent–Child Interaction Therapy with Mothers with a History of ADHD: A Case Series

Behavioral parent training is the recommended intervention for young children with disruptive behavior and/or attention-deficit/hyperactivity disorder (ADHD). Parent–child interaction therapy (PCIT) is an empirically supported behavioral parent-training program for families of children ages 3–6 years old. Behavioral parent-training programs, including PCIT, rely on parents as the primary agents of therapeutic change. Parents who face barriers to adequate engagement with these programs may also struggle to implement the changes necessary for children’s behavior to improve. Parental characteristics that may prevent treatment engagement, however, are seldom considered in the research literature or in clinical practice. The current case series describes engagement indicators in three mothers taking part in PCIT. Each mother has a history of diagnosed or suspected ADHD, and this series explores their ADHD-related symptoms as they relate to the treatment of their child’s behavior.

Effectiveness of the Therapeutic Lifestyle Change Diet Intervention to Improve Biochemical Markers of Cardiovascular Diseases in HIV-Infected Patients with Dyslipidemia

Introduction: This randomized controlled trial study aimed to investigate the effectiveness of therapeutic lifestyle change (TLC) diet intervention by the registered dietitians. Methods: Eighty-two people living with HIV (PLHIV) with dyslipidemia were randomly allocated to the intervention group as well as another 82 PLHIV with dyslipidemia to the control group. Participants in the intervention group were instructed to meet the registered dietitians every 2 weeks at weeks 0, 2, 4, 6, and 12 (a totally of 12 weeks) to receive individual medical nutrition therapy according to the TLC diet principles, while the participants in the control group only received routine health care service. Results: Triglycerides, total cholesterol, and LDL cholesterol of the intervention group were significantly lower than those of the control group at the endpoint (p < 0.05). In addition, these biomarkers and C-reactive protein of the intervention group were significantly lower when compared with their baseline (p < 0.05). The overall dietary habits of participants in the intervention group were significantly improved at the end of the study (p < 0.05). Conclusion: The medical nutrition therapy intervention based on the TLC diet is effective in improving blood lipid profiles among PLHIV with dyslipidemia.

Awareness As a Vehicle for Well-Being: College Students’ Lived Experiences Participating in a Mindfulness-Based Intervention During the COVID-19 Pandemic

ABSTRACT College students are experiencing increasing rates of mental health problems, with difficulties exacerbated by the effects of the COVID-19 pandemic. Mindfulness-Based Stress Reduction (MBSR) has demonstrated efficacy in treating psychological problems and promoting well-being within this population. Less well-understood, however, are MBSR participants’ perceptions of the mechanisms underlying this therapeutic change. The current qualitative study examined nonclinical college students’ experiences participating in a randomized controlled trial of an online adaptation of MBSR, administered during the fall 2020 COVID-19 pandemic lockdown. In-depth, semi-structured interviews were conducted with nine participants who had recently completed the MBSR course. The qualitative data were analyzed using thematic analysis. Participants described greater self-awareness, relational awareness, present-moment awareness, and body awareness as resulting in improved emotion regulation, empathy, communication, and well-being, while reducing anxiety and physical pain. These findings support and extend other theoretical models of change in mindfulness-based interventions. The results further suggest that online MBSR adaptations may be beneficial in promoting mental health for college students and that cultivating greater awareness may help in bolstering psychological well-being within this population.

Who is the Expert in Change? Exploring the Role of Therapists in Client Change Processes: A Systemic Therapy Case Study

ABSTRACT This case study focuses on the therapeutic change process, highlighting the crucial role of therapists in facilitating it. Rooted in constructivist epistemology, we employed an integrative systemic model. Our exploration centers on the presence or absence of system restructuring within the therapeutic process. We delve into the differing perceptions of change between the therapist and the client, particularly regarding the criteria for therapy discharge. A significant aspect of our analysis is the discussion on the authenticity of change. We examine the dual role of therapists as expert observers and participants in the therapy, navigating between “objective” and subjective perspectives in their interventions. This includes assessing various levels of change, first and second order. We highlight the client’s autonomy in defining the reality and authenticity of change, advocating for a balance between the therapist’s guidance and the client’s agency. Additionally, we emphasize the therapist’s need for self-reflection and adherence to ethical practices. Our study contributes to systemic therapy literature by demonstrating the effective application of an integrative approach. It reinforces the importance of collaboration in therapeutic change, offering insights into how therapists can navigate complex therapeutic dynamics.

Therapeutic Chatbots as Cognitive-Affective Artifacts

Conversational Artificial Intelligence (CAI) systems (also known as AI “chatbots”) are among the most promising examples of the use of technology in mental health care. With already millions of users worldwide, CAI is likely to change the landscape of psychological help. Most researchers agree that existing CAIs are not “digital therapists” and using them is not a substitute for psychotherapy delivered by a human. But if they are not therapists, what are they, and what role can they play in mental health care? To answer these questions, we appeal to two well-established and widely discussed concepts: cognitive and affective artifacts. Cognitive artifacts are artificial devices contributing functionally to the performance of a cognitive task. Affective artifacts are objects which have the capacity to alter subjects’ affective state. We argue that therapeutic CAIs are a kind of cognitive-affective artifacts which contribute to positive therapeutic change by (i) simulating a (quasi-)therapeutic interaction, (ii) supporting the performance of cognitive tasks, and (iii) altering the affective condition of their users. This sheds new light on why virtually all existing mental health CAIs implement principles and techniques of Cognitive Behavioral Therapy — a therapeutic orientation according to which affective change and, ultimately, positive therapeutic change is mediated by cognitive change. Simultaneously, it allows us to conceptualize better the potential and limitations of applying these technologies in therapy.

An integrative, systemic day-clinic approach for the treatment of psychiatric disorders in young adults: a detailed study of two cases

IntroductionMore than 75% of the psychiatric disorders arise before the age of 30. Adolescence and young adulthood pose numerous developmental challenges like identity development, educational and occupational concerns, gaining autonomy and boundary-setting skills. The adolescent crises, which can involve a broad spectrum of psychiatric symptoms, demands a multidisciplinary approach to diagnosis and treatment.ObjectivesOur goal is to present a best practice example of an interdisciplinary day clinic through two case presentations, aiming improving innovative strategies for assessment/treatment of psychiatric disorders in young adulthood.MethodsVia two comprehensive case presentations, we will introduce a psychotherapeutic day-clinic concept from a psychiatric training hospital in Germany.ResultsThe day clinic’s interdisciplinary team uses therapeutic approaches like dynamic, cognitive-behavioral, and systemic therapy to understand young adults beyond just their symptoms. Milieu-therapeutic methods, family constellations, socio-therapeutic approaches and non-verbal therapies are incorporated into our concept. Case 1: A 20-year-old male patient, previously diagnosed with schizophrenia, was referred due to symptoms of living in an unreal world with perceived magical abilities and family conflicts. In the evaluation the features of high-functioning autism spectrum disorder (ASD) were more prominent than the psychotic symptoms. Developmental history and diagnostic tools yielded the diagnosis of ASD. Magical abilities in an unreal world appears to align more closely with repetitive/restrictive patterns of behavior, hereby we excluded in the follow-up the diagnosis of schizophrenia. Psychoeducation, social-skills-training and family interventions helped him to comprehend his strengths and discover a clearer direction in his life.Case 2: Another 20-year-old male patient was referred with depressive symptoms, a sense of emptiness and self-mutilation. Following routine evaluation, we employed systemic methods (genogram constellations) to gain deeper insight into the patient’s psychopathology. His mother’s migration history from Thailand, coupled with unfulfilled aspirations, echoed in his recurring thought: “Where are my roots?” During follow-up, we recognized his passive stance toward therapeutic change, addressed through a systemic intervention known as ‘taking the side of non-change.’ This shifted his position from resistance to openness. Non-verbal approaches, family interventions, and corrective in-vivo experiences significantly contributed to his stabilization.ConclusionsSpecialized psychiatric centers tailored to the unique needs of young adults play a critical role in evaluating, diagnosing, and treating psychiatric crises during this developmental stage. Achieving this requires the implementation of interdisciplinary holistic therapeutic approaches.Disclosure of InterestNone Declared

Using virtual reality to understand mechanisms of therapeutic change

Using virtual reality to understand mechanisms of therapeutic change

Research Progress in the Clinical Treatment of Familial Hypercholesterolemia.

Familial hypercholesterolemia (FH) is an autosomal dominant inheritable disease with severe disorders of lipid metabolism. It is mainly marked by increasing levels of plasma total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), xanthoma, corneal arch, and early-onset coronary heart disease (CHD). The prevalence of FH is high, and it is dangerous and clinically underdiagnosed. The clinical treatment for FH includes both pharmacological and non-pharmacological treatment, of which non-pharmacological treatment mainly includes therapeutic lifestyle change and dietary therapy, LDL apheresis, liver transplantation and gene therapy. In recent years, many novel drugs have been developed to treat FH more effectively. In addition, the continuous maturity of non-pharmacological treatment techniques has also brought more hope for the treatment of FH. This paper analyzes the pathogenic mechanism and the progress in clinical treatment of FH. Furthermore, it also summarizes the mechanism and structure-activity relationship of FH therapeutic drugs that have been marketed. In a word, this article provides a reference value for the research and development of FH therapeutic drugs.