| 1. |
- Andersson, Gerhard, et al.
(författare)
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Delivering cognitive behavioural therapy for mild to moderate depression via the Internet : Predicting outcome at 6-month follow-up
- 2004
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Ingår i: Verhaltenstherapie (Basel). - : S. Karger AG. - 1016-6262 .- 1423-0402. ; 14:3, s. 185-189
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Mild to moderate depression has been successfully treated with cognitive-behavioural (CBT) bibliotherapy, including minimal therapist contact. More recently, the Internet has been used to deliver the treatment, with obvious gains in terms of cost reduction and increased accessibility. In the present study we analysed pre-treatment predictors of improvement following Internet-based self-help treatment of mild to moderate depression. Patients and Methods: Included were 71 participants from a randomised trial who completed a 6-month follow-up. Change indexes were calculated from the Beck Depression Inventory (BDI) and the Montgomery Åsberg Depression Rating Scale (MADRS). Results: In line with the literature on depression, the number of previous episodes of depression was negatively associated with improvement after treatment. Follow-up scores on the BDI and MADRS were associated with pre-treatment levels of depression, anxiety and low levels of quality of life. Discussion: As indicated by traditional psychotherapy studies, finding predictors of outcome is a difficult task. Patients with repeated episodes of depression might benefit less from self-help over the Internet, but as the correlation is weak, no firm conclusions can be drawn.
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| 2. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Development of a new approach to guided self-help via the Internet : The Swedish experience
- 2008
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Ingår i: Journal of technology in human services. - : Informa UK Limited. - 1522-8835 .- 1522-8991. ; 26:2-4, s. 161-181
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Tidskriftsartikel (refereegranskat)abstract
- This article describes the development and empirical status of guided Internet-delivered self-help. The treatment approach combines the benefits of bibliotherapy with book-length text materials and the support given online via web pages and e-mail. Interactive features such as online registrations, tests, and online discussion forums are also included. Cognitive behavior therapy (CBT) guided the research and clinical implementations of this approach, as it lends itself more easily to the self-help format compared with other presently available psychotherapy approaches. We include an overview of the research, current issues and research in service delivery, lessons learned through a program of research, and directions for future investigations
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| 3. |
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| 4. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Internet-based self-help for depression : randomised controlled trial
- 2005
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 187, s. 456-461
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Major depression can be treated by means of cognitive-behavioural therapy, but as skilled therapists are in short supply there is a need for self-help approaches. Many individuals with depression use the internet for discussion of symptoms and to share their experience.AIMS:To investigate the effects of an internet-administered self-help programme including participation in a monitored, web-based discussion group, compared with participation in web-based discussion group only.METHOD:A randomised controlled trial was conducted to compare the effects of internet-based cognitive-behavioural therapy with minimal therapist contact (plus participation in a discussion group) with the effects of participation in a discussion group only.RESULTS:Internet-based therapy with minimal therapist contact, combined with activity in a discussion group, resulted in greater reductions of depressive symptoms compared with activity in a discussion group only (waiting-list control group). At 6 months' follow-up, improvement was maintained to a large extent.CONCLUSIONS:Internet-delivered cognitive cognitive-behavioural therapy should be pursued further as a complement or treatment alternative for mild-to-moderate depression.
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| 5. |
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| 6. |
- Breedvelt, Josefien J. F., et al.
(författare)
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An individual participant data meta-analysis of psychological interventions for preventing depression relapse
- 2024
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Ingår i: Nature Mental Health. - 2731-6076. ; 2:2, s. 154-163
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Tidskriftsartikel (refereegranskat)abstract
- Major depressive disorder is a leading cause of disability worldwide; identifying effective strategies to prevent depression relapse is crucial. This individual participant data meta-analysis addresses whether and for whom psychological interventions can be recommended for relapse prevention of major depressive disorder. One- and two-stage individual patient data meta-analyses were conducted on 14 randomized controlled trials (N = 1,720). The relapse risk over 12 months was substantially lower for those who received a psychological intervention versus treatment as usual, antidepressant medication, or evaluation-only control (hazard ratio, 0.60; 95% confidence interval, 0.48–0.74). The number of previous depression episodes moderated the treatment effect, with psychological interventions demonstrating greater efficacy for patients with three or more previous episodes. Our results suggest that adding psychological interventions to current treatment to prevent depression relapse is recommended. For patients at lower risk of relapse, less-intensive approaches may be indicated.
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| 7. |
- Buhrman, Monica, et al.
(författare)
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Psychological treatment targeting acceptance and compassion in chronic pain patients : a randomized controlled, internet delivered, treatment trial
- 2023
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Ingår i: The Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 0749-8047 .- 1536-5409. ; 39:12, s. 672-685
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Chronic pain is often associated with suffering. Self-criticism is associated with depressive symptoms. The purpose of this study was to explore if fusing acceptance and commitment therapy (ACT) and compassion focused therapy (CFT), could improve psychological wellbeing and disability in chronic pain patients with high levels of self-criticism in comparison to a wait-list control group. Methods: Individuals with chronic pain (n=71) were randomly assigned to an 8-week internet-based intervention focused on acceptance and compassion or a wait-list condition. Primary treatments outcomes were Chronic Pain Acceptance Questionnaire, Self-Compassion Scale, and Pain Disability index. Secondary outcomes were Montgomery Åsberg Depression Rating Scale, Anxiety sensitivity index, Quality of Life Inventor, Multidimensional Pain Inventory and Perseverative Thinking Questionnaire. Results: Missing data at post-intervention was 22.5%. ITT-analyses were conducted using linear mixed-models. Results revealed significantly greater levels of acceptance and self-compassion for the treatment group, which were primary outcomes, with effect sizes ranging from small to large and these results were maintained at six-month follow-up. Rates of clinical significant improvements were also greater for the treatment group in comparison to the wait-list control group on acceptance and compassion. Results in the third primary outcome showed also improvements in disability levels. Significant differences were also found in several of the secondary outcomes, in favour for the treatment group.Discussion: Internet-based ACT with CFT components shows promise as a viable treatment option in the management of chronic pain.
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| 8. |
- Buhrman, Monica, et al.
(författare)
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Psychological Treatment Targeting Acceptance and Compassion in Patients With Chronic Pain : A Randomized Controlled, Internet-delivered, Treatment Trial
- 2023
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Ingår i: The Clinical Journal of Pain. - : Wolters Kluwer Health, Inc.. - 0749-8047 .- 1536-5409. ; 39:12, s. 672-685
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Chronic pain is often associated with lower function. Self-criticism is associated with depressive symptoms. The purpose of this study was to explore if fusing Acceptance and Commitment Therapy and compassion-focused therapy could improve psychological well-being and disability in individuals with chronic pain with high levels of self-criticism in comparison to a wait-list control group. METHODS: Individuals with chronic pain (n=71) were randomly assigned to an 8-week internet-based intervention focused on acceptance and compassion or a wait-list condition. Primary treatment outcomes were the Chronic Pain Acceptance Questionnaire, Self-Compassion Scale, and Pain Disability Index. Secondary outcomes were the Montgomery Åsberg Depression Rating Scale, Anxiety Sensitivity Index, Quality of Life Inventory, Multidimensional Pain Inventory, and Perseverative Thinking Questionnaire. RESULTS: Missing data at postintervention were 22.5%. Intention-to-treat analyses were conducted using linear mixed models. The results revealed greater levels of acceptance and self-compassion for the treatment group, which were primary outcomes, with effect sizes ranging from small to large, and these results were maintained at 6-month follow-up. The rates of clinically significant improvements were also greater for the treatment group in comparison to the wait-list control group on acceptance and compassion. The treatment group also improved in the third primary outcome, pain disability. Significant differences were found in several of the secondary outcomes, in favor of the treatment group. DISCUSSION: Internet-based Acceptance and Commitment Therapy with compassion-focused therapy components shows promise as a viable treatment option in the management of chronic pain.
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| 9. |
- Cato, Ville, et al.
(författare)
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Association between benzodiazepines and suicide risk : a matched case-control study
- 2019
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Ingår i: BMC Psychiatry. - : BMC. - 1471-244X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is unclear whether benzodiazepines increase the risk of suicide. The aim of this study was to test the hypothesis that benzodiazepines are associated with an increased risk of suicide, by comparing psychopharmacological interventions between psychiatric patients who committed suicide and a group of matched controls.Methods: The case group comprised 154 psychiatric patients (101 men, 53 women; age range: 13-96 years) who had committed suicide in orebro County, Sweden. Control psychiatric patients matched by age, sex, and main psychiatric diagnosis were selected for each case. Binary logistic regression was used to calculate odds ratios in unadjusted and adjusted models.Results: Benzodiazepine prescriptions were more common among cases than controls (65/154 [42.2%] versus 43/154 [27.9%], p = 0.009, odds ratio: 1.89 [95% CI: 1.17-3.03]). This association remained significant in a model adjusted for previous suicide attempts and somatic hospitalizations (odds ratio: 1.83 [95% CI: 1.06-3.14]). No statistically significant differences were seen between the groups in the use of any other subtype of psychopharmaceutical agent.Conclusions: These data indicate that benzodiazepine use may increase the risk of suicide. However, this study is limited by the potential for indication bias.
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| 10. |
- Edlund, Sara, 1983-
(författare)
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Calm down : strategies for emotion regulation in clinical practice
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Problems with emotion regulation are common in people who seek help from health care professionals working with problems featuring psychological factors. Two such patient groups, chronic pain patients and patients with severe anxiety, are of interest in this dissertation. Effectively regulating and increasing functional emotion regulation in these patients is often challenging for clinicians, and effective strategies are needed. One treatment that greatly emphasizes the importance of functional emotion regulation is dialectical behavior therapy (DBT). DBT has a strong empirical basis in other patients with severe problems with emotion regulation, raising the question of whether the treatment and its more specific components (e.g., validation, which means communicating understanding and acceptance) could be effec-tive in the groups of patients of interest here.Accordingly, the overall aim of this dissertation was to expand our knowledge of how to use functional emotion-regulation strategies from DBT to regulate emotions in patients with chronic pain or treatment-resistant anxiety disorders. Study I examined whether brief training was enough to increase validation in partners of people with chronic pain, and whether this was associated with better-regulated emotion in the people with chronic pain. Study II explored patient perceptions of validation and invalidation by the physician in a clinical chronic pain context. Lastly, study III investi-gated whether a more extensive treatment intervention inspired by DBT was feasible and effective in patients suffering from treatment-resistant anxiety disorders.The findings indicate that emotion-regulation strategies from DBT can be effective in regulating emotions in these patients. The dissertation also illus-trates some of the difficulties in doing this, providing important information for future work, such as suggestions for modifications that might further increase positive outcomes.
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