| 1. |
- Andersson, Evelyn, et al.
(författare)
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Genetic Polymorphisms in Monoamine Systems and Outcome of Cognitive Behavior Therapy for Social Anxiety Disorder
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:11
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe role of genetics for predicting the response to cognitive behavior therapy (CBT) for social anxiety disorder (SAD) has only been studied in one previous investigation. The serotonin transporter (5-HTTLPR), the catechol-o-methyltransferase (COMT) val158met, and the tryptophan hydroxylase-2 (TPH2) G-703Tpolymorphisms are implicated in the regulation of amygdala reactivity and fear extinction and therefore might be of relevance for CBT outcome. The aim of the present study was to investigate if these three gene variants predicted response to CBT in a large sample of SAD patients.MethodParticipants were recruited from two separate randomized controlled CBT trials (trial 1: n = 112, trial 2: n = 202). Genotyping were performed on DNA extracted from blood or saliva samples. Effects were analyzed at follow-up (6 or 12 months after treatment) for both groups and for each group separately at post-treatment. The main outcome measure was the Liebowitz Social Anxiety Scale Self-Report.ResultsAt long-term follow-up, there was no effect of any genotype, or gene × gene interactions, on treatment response. In the subsamples, there was time by genotype interaction effects indicating an influence of the TPH2 G-703T-polymorphism on CBT short-term response, however the direction of the effect was not consistent across trials.ConclusionsNone of the three gene variants, 5-HTTLPR, COMTval158met and TPH2 G-703T, was associated with long-term response to CBT for SAD.
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| 2. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Effects of Internet-delivered cognitive behaviour therapy for anxiety and mood disorders
- 2007
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Ingår i: Review series. Psychiatry. - 1401-9302. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- The Internet has revolutionized access to health information and made communication over long distances easier. This article reviews the use of the Internet for delivery of cognitive behaviour therapy. As a starting point the concept of guided self-help is introduced. We next present the treatment approach and different protocols briefly. Next, Swedish studies on panic disorder, social phobia, and depression are summarized using meta-analytic techniques. Implementation in regular clinical setting is discussed with a focus on efficacy versus effectiveness, training of therapist, combined treatments and cost-effectiveness. We conclude that Internet treatment is likely to become a treatment option for suitable patients in the future.
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| 3. |
- Andersson, Gerhard, et al.
(författare)
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History and current status of ICBT
- 2016
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Ingår i: Guided internet-based treatments in psychiatry. - Cham : Springer. - 9783319060828 - 9783319060835 ; , s. 1-16
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Bokkapitel (refereegranskat)abstract
- We begin this chapter with a discussion of the history of ICBT and its roots in bibliotherapy and computerised CBT. We then provide a brief description of one way of administering guided ICBT, including the role of the therapist and data security issues. This description is followed by examples of conditions that are not covered later in the book, such as specific phobias and addictions. We end this chapter with a discussion of technical developments, cost-effectiveness and implementation.
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| 4. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Internet Interventions for Adults with Anxiety and Mood Disorders : A Narrative Umbrella Review of Recent Meta-Analyses
- 2019
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Ingår i: Canadian journal of psychiatry. - : SAGE Publications. - 0706-7437 .- 1497-0015. ; 64:7, s. 465-470
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Forskningsöversikt (refereegranskat)abstract
- Internet-delivered cognitive behaviour therapy (ICBT) has existed for 20 years and there are now several controlled trials for a range of problems. In this paper, we focused on recent meta-analytic reviews of the literature and found moderate to large effects reported for panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, and major depression. In total, we reviewed 9 recent meta-analytic reviews out of a total of 618 meta-analytic reviews identified using our search terms. In these selected reviews, 166 studies were included, including overlap in reviews on similar conditions. We also covered a recent review on transdiagnostic treatments and 2 reviews on face-to-face v. internet treatment. The growing number of meta-analytic reviews of studies now suggests that ICBT works and can be as effective as face-to-face therapy.
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| 5. |
- Andersson, Gerhard, et al.
(författare)
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Paniksyndrom : ond cirkel av feltolkade kroppsliga signaler
- 2011
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Ingår i: Läkartidningen. - : Läkartidningen förlag AB. - 0023-7205 .- 1652-7518. ; 108:14, s. 795-797
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Tidskriftsartikel (refereegranskat)abstract
- Attacker av intensiv rädsla utan tydlig yttre orsak som leder till rädsla för nya attacker – det kännetecknar paniksyndrom. Evidensbaserade behandlingsalternativ finns, och det finns inget skäl att avvakta med behandling.
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| 6. |
- Andersson, Gerhard, et al.
(författare)
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Paniksyndrom - ond cirkel av feltolkade kroppsliga signaler
- 2011
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 108:14, s. 795-797
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Tidskriftsartikel (refereegranskat)abstract
- Paniksyndrom kännetecknas av plötsliga, oväntade panikattacker med rädsla för nya attacker eller konsekvenser av dem. En andel patienter har även agorafobi. Olika förklaringsmodeller har förts fram för att beskriva hur paniksyndrom uppstår och vidmakthålls. Flera behandlingar för paniksyndrom finns, och bland dem är det psykologisk behandling i form av kognitiv beteendeterapi (KBT) eller läkemedelsbehandling (i första hand selektiva serotoninåterupptagshämmare) som rekommenderas och som har stöd i forskningen. I Sverige har Internetbaserad KBT för paniksyndrom utvecklats och prövats med framgång. I valet av behandling bör patientens preferenser vägas in.
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| 7. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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The use of the internet in the treatment of anxiety disorders
- 2005
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Ingår i: Current Opinion in Psychiatry. - 0951-7367 .- 1473-6578. ; 18:1, s. 73-77
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Tidskriftsartikel (refereegranskat)abstract
- Purpose of review: The aim of this article is to review the emerging literature on the use of the Internet in the treatment of anxiety disorders. The questions asked are: (1) are Internet-delivered treatments for anxiety disorders supported by the research literature? (2) what is the quality of the evidence as it stands? (3) is there any evidence to suggest that Internet interventions can be harmful? Recent findings: Recent and ongoing trials on panic disorder show that Internet-based self-help with minimal therapist contact is a promising approach in the treatment of panic disorder. However, trials have been small and there is a need for large-scale trials and studies conducted in psychiatric settings as most studies have recruited patients via advertisement. There is no evidence in the literature that Internet intervention is harmful, but most likely a stepped-care approach would be feasible to handle cases who fail to respond. Summary: Internet-delivered interventions for anxiety disorders, and in particular panic disorder, are promising. There is however a need for further research and evaluation and there is also a need to find a proper place for such interventions in the clinical management of anxiety disorders, preferably using a stepped-care approach. © 2005 Lippincott Williams & Wilkins.
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| 8. |
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| 9. |
- Bergström, Jan, 1976-, et al.
(författare)
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Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting : a randomised trial
- 2010
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Ingår i: BMC Psychiatry. - : BioMed Central Ltd. - 1471-244X. ; 10:54
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Tidskriftsartikel (refereegranskat)abstract
- Background: Internet administered cognitive behaviour therapy (CBT) is a promising new way to deliver psychological treatment, but its effectiveness in regular care settings and in relation to more traditional CBT group treatment has not yet been determined. The primary aim of this study was to compare the effectiveness of Internetand group administered CBT for panic disorder (with or without agoraphobia) in a randomised trial within a regular psychiatric care setting. The second aim of the study was to establish the cost-effectiveness of these interventions. Methods: Patients referred for treatment by their physician, or self-referred, were telephone-screened by a psychiatric nurse. Patients fulfilling screening criteria underwent an in-person structured clinical interview carried out by a psychiatrist. A total of 113 consecutive patients were then randomly assigned to 10 weeks of either guided Internet delivered CBT (n = 53) or group CBT (n = 60). After treatment, and at a 6-month follow-up, patients were again assessed by the psychiatrist, blind to treatment condition. Results: Immediately after randomization 9 patients dropped out, leaving 104 patients who started treatment. Patients in both treatment conditions showed significant improvement on the main outcome measure, the Panic Disorder Severity Scale (PDSS) after treatment. For the Internet treatment the within-group effect size (pre-post) on the PDSS was Cohen's d = 1.73, and for the group treatment it was d = 1.63. Between group effect sizes were low and treatment effects were maintained at 6-months follow-up. We found no statistically significant differences between the two treatment conditions using a mixed models approach to account for missing data. Group CBT utilised considerably more therapist time than did Internet CBT. Defining effect as proportion of PDSS responders, the cost-effectiveness analysis concerning therapist time showed that Internet treatment had superior cost-effectiveness ratios in relation to group treatment both at post-treatment and follow-up. Conclusions: This study provides support for the effectiveness of Internet CBT in a psychiatric setting for patients with panic disorder, and suggests that it is equally effective as the more widely used group administered CBT in reducing panic-and agoraphobic symptoms, as well as being more cost effective with respect to therapist time.
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| 10. |
- Hedman, Erik, et al.
(författare)
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A 5-year follow-up of internet-based cognitive behavior therapy for Social Anxiety Disorder
- 2011
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Internet-basedcognitive behavior therapy (CBT) has been shown to be a promising method todisseminate cognitive behavior therapy for social anxiety disorder (SAD).Several trials have demonstrated that Internet-based CBT can be effective forSAD in the shorter term. However, the long-term effects of Internet-based CBTfor SAD are less well known. Objective: Our objectivewas to investigate the effect of Internet-based CBT for SAD 5 years aftercompleted treatment. Method: We conducted a 5-yearfollow-up study of 80 persons with SAD who had undergone Internet-based CBT.The assessment comprised a diagnostic interview and self-report questionnaires.The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social InteractionAnxiety Scale (SIAS) and the Social Phobia Scale (SPS). Attrition rates werelow: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires. Results: Mixed-effect models analysisshowed a significant effect of time on the three social anxiety measures,LSAS-SR, SIAS, and SPS (F3,98-102 = 16.05 -29.20, P < .001)indicating improvement. From baseline to 5-year follow-up, participants’ meanscores on the LSAS-SR were reduced from 71.3 (95% confidence interval [CI]66.1-76.5) to 40.3 (95% CI 35.2 - 45.3). The effect sizes of the LSAS-SR were large (Cohen’s d range 1.30 - 1.40, 95% CI 0.77 - 1.90). Improvementsgained at the 1-year follow-up were sustained 5 years after completedtreatment. Conclusions: Internet-basedCBT for SAD is a treatment that can result in large and enduring effects. Trial registration: Clinicaltrials.govNCT01145690; http://clinicaltrials.gov/ct2/show/NCT01145690 (Archived byWebCite athttp://www.webcitation.org/5ygRxDLfK)
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