| 1. |
- Andersson, Gerhard, et al.
(författare)
-
The contribution of active medication to combined treatments of psychotherapy and pharmacotherapy for adult depression : a meta-analysis.
- 2010
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 121:6, s. 415-23
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Although there is sufficient evidence that combined treatments of psychotherapy and pharmacotherapy are more effective for depression in adults than each of the treatments alone, it remains unclear what the exact contribution of active medication is to the overall effects of combined treatments. This paper examines the contribution of active medication to combined psychotherapy and pharmacotherapy treatments. METHOD: Meta-analysis of randomised controlled trials comparing the combination of psychotherapy and pharmacotherapy with the combination of psychotherapy and placebo. RESULTS: Sixteen identified studies involving 852 patients met our inclusion criteria. The standardised mean difference indicating the differences between the combination of psychotherapy and pharmacotherapy and the combination of psychotherapy and placebo was 0.25 (95% CI: 0.03-0.46), which corresponds to a numbers-needed-to-be-treated of 7.14. No significant differences between subgroups of studies were found. CONCLUSION: Active medication has a small but significant contribution to the overall efficacy of combined treatments.
|
|
| 2. |
- Hedman, E., et al.
(författare)
-
Clinical and genetic outcome determinants of Internet- and group-based cognitive behavior therapy for social anxiety disorder
- 2012
-
Ingår i: Acta Psychiatrica Scandinavica. - : John Wiley and Sons. - 0001-690X .- 1600-0447. ; 126:2, s. 126-136
-
Tidskriftsartikel (refereegranskat)abstract
- Hedman E, Andersson E, Ljotsson B, Andersson G, Andersson E, Schalling M, Lindefors N, Ruck C. Clinical and genetic outcome determinants of Internet- and group-based cognitive behavior therapy for social anxiety disorder (SAD). Objective: No study has investigated clinical or genetic predictors and moderators of Internet-based cognitive behavior therapy (ICBT) compared with cognitive behavioral group therapy for (CBGT) for SAD. Identification of predictors and moderators is essential to the clinician in deciding which treatment to recommend for whom. We aimed to identify clinical and genetic (5-HTTLPR, COMTval158met, and BDNFval66met) predictors and moderators of ICBT and CBGT. Method: We performed three types of analyses on data from a sample comprising participants (N = 126) who had undergone ICBT or CBGT in a randomized controlled trial. Outcomes were i) end state symptom severity, ii) SAD diagnosis, and iii) clinically significant improvement. Results: The most stable predictors of better treatment response were working full time, having children, less depressive symptoms, higher expectancy of treatment effectiveness, and adhering to treatment. None of the tested gene polymorphisms were associated with treatment outcome. Comorbid general anxiety and depression were moderators meaning that lower levels were associated with a better treatment response in ICBT but not in CBGT. Conclusion: We conclude that demographic factors, symptom burden, adherence, and expectations may play an important role as predictors of treatment outcome. The investigated gene polymorphisms do not appear to make a difference.
|
|
| 3. |
- Holländare, Fredrik, 1972-, et al.
(författare)
-
Randomized trial of Internet-based relapse prevention for partially remitted depression
- 2011
-
Ingår i: Acta Psychiatrica Scandinavica. - : John Wiley and Sons. - 0001-690X .- 1600-0447. ; 124:4, s. 285-294
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether Internet-based cognitive behaviour therapy (CBT) can prevent relapse in persons with partially remitted major depression after previous treatment. less thanbrgreater than less thanbrgreater thanMethod: Seventy-one women and 13 men (N = 84) with partially remitted major depression after treatment were randomly assigned to either 10 weeks of Internet-based CBT or to a control group. Self-help material was used in combination with e-mail contact with a personal therapist. Monthly self-ratings of depressive symptoms were made, and diagnostic interviews were conducted before and after the treatment period, as well as 6 months later. less thanbrgreater than less thanbrgreater thanResults: Significantly fewer participants in the CBT group experienced relapse (4/38 or 10.5%) compared with those in the control group (14/37 or 37.8%). The difference in relapse rates between groups occurred early in the study period and was still apparent after 6 months. A trend towards a larger reduction in depressive symptoms was observed at post-treatment in the participants who received CBT compared with controls. Reduction in depressive symptoms reduced the risk of relapse. A trend towards a higher remission rate was found in the CBT group at the 6 month follow-up. less thanbrgreater than less thanbrgreater thanConclusion: Internet-based CBT seems promising in preventing relapse in persons with partially remitted major depression after previous treatment.
|
|
| 4. |
- Hedman, E., et al.
(författare)
-
Effectiveness of Internet-based cognitive behaviour therapy for panic disorder in routine psychiatric care
- 2013
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 128:6, s. 457-467
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectiveGuided Internet-based cognitive behaviour therapy (ICBT) for panic disorder has been shown to be efficacious in several randomized controlled trials. However, the effectiveness of the treatment when delivered within routine psychiatric care has not been studied. The aim of this study was to investigate the effectiveness of ICBT for panic disorder within the context of routine psychiatric care. MethodWe conducted a cohort study investigating all patients (n=570) who had received guided ICBT for panic disorder between 2007 and 2012 in a routine care setting at an out-patient psychiatric clinic providing Internet-based treatment. The primary outcome measure was the Panic Disorder Severity Scale-Self-report (PDSS-SR). ResultsParticipants made large improvements from screening and pretreatment assessments to posttreatment (Cohen's d range on the PDSS-SR=1.07-1.55). Improvements were sustained at 6-month follow-up. ConclusionThis study suggests that ICBT for panic disorder is as effective when delivered in a routine care context as in the previously published randomized controlled trials.
|
|
