| 1. |
- Brådvik, Louise, et al.
(författare)
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Long-term treatment and suicidal behavior in severe depression: ECT and antidepressant pharmacotherapy may have different effects on the occurrence and seriousness of suicide attempts.
- 2006
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Ingår i: Depression and Anxiety. - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 23:Nov 28, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- Our objective in this article is to assess the relation between long-term treatments of depressive episodes and attempted or completed suicide in patients who had had a severe depression at index admission. A blind record evaluation of 96 suicides with a primary severe depression and matched controls has been performed. Out of those, 57 and 33, respectively, bad made suicide attempts. Occurrence of attempt was less common after electroconvulsive therapy (ECT). However, seriousness of suicide attempt appeared to be reduced in those with at least 4 weeks of antidepressant medication compared to no treatment and ECT The theory of a suicidal syndrome independent of depression seems supported. Continuation treatment after ECT is recommended.
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| 2. |
- Cuijpers, Pim, et al.
(författare)
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Personalized treatment of adult depression : medication, psychotherapy, or both? A systematic review
- 2012
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Ingår i: Depression and anxiety (Print). - : John Wiley & Sons. - 1091-4269 .- 1520-6394. ; 29:10, s. 855-864
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Personalized medicine aims to identify which characteristics of an individual predict the outcome of a specific treatment, in order to get a better match between the individual and the treatment received. We conducted a systematic review and meta-analysis of randomized trials comparing two treatments directly in a group of patients with a specific characteristic.METHODS: We searched relevant studies from bibliographical databases and included trials comparing (1) medication with psychotherapy, (2) medication with combined treatment, and (3) psychotherapy with combined treatment, in specific target groups (a) with a predefined sociodemographic characteristic, (b) a specific type of depression, (c) a comorbid mental or somatic disorder, or (d) from a specific setting (outpatients, primary care).RESULTS: We included 52 studies with 4,734 depressed patients. In these studies, 20 characteristics of the target groups were examined. The results showed that medication is probably the best treatment for dysthymia, and combined treatments are more effective in depressed outpatients, as well as in depressed older adults. However, in order to examine the 20 characteristics in the three categories of comparisons, 254 studies would be needed for having sufficient statistical power to show an effect size of g = 0.5. Currently, only 20.1% of these studies have been conducted.CONCLUSIONS: Although a considerable number of studies have compared medication, psychotherapy, and combined treatments, and some preliminary results are useful for deciding which treatment is best for which patient, the development of personalized treatment of depression has only just begun.
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| 3. |
- Cuijpers, Pim, et al.
(författare)
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Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression : A meta-analysis
- 2009
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 26:3, s. 279-288
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Tidskriftsartikel (refereegranskat)abstract
- Background: A large number of studies have shown that psychological treatments have significant effects on depression. Although several studies have examined the relative effects of psychological and combined treatments, this has not been studied satisfactorily in recent statistical meta-analyses. Method: We conducted a meta-analysis of randomized studies in which a psychological treatment was compared to a combined treatment consisting of the same psychological treatment with a pharmacological therapy. For each of these studies we calculated the effect size indicating the difference between the psychological and the combined treatment. Results: All inclusion criteria were met by 18 studies, with a total of 1,838 subjects. The mean effect, size indicating the difference between psychological and combined treatment was 0.35 (95% CL 0.24 similar to 0.45; P<0.001), with low heterogeneity. Subgroup analyses indicated that the difference between psychological and combined treatments was significantly smaller in studies in which cognitive behavior therapy was examined. Me also found a trend (P<0.1) indicating that the difference between psychological and combined treatment was somewhat larger in studies aimed at specific populations (older adults, chronic depression, HIV patients) than in studies with adults, and in studies in which Trycyclic antidepressants or SSRIs were examined, compared to studies in which a medication protocol or another antidepressant was used. At follow-up, no difference between psychological and combined treatments was found. Conclusion: We conclude that combined treatment is more effective than psychological treatment alone. However, it is not clear whether this difference is relevant from a clinical perspective.
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| 4. |
- Ekeblad, Annika, et al.
(författare)
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Randomized Trial of Interpersonal Psychotherapy and Cognitive Behavioral Therapy for Major Depressive Disorder in a Community-Based Psychiatric Outpatient Clinic
- 2016
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Ingår i: Depression and anxiety (Print). - : WILEY-BLACKWELL. - 1091-4269 .- 1520-6394. ; 33:12, s. 1090-1098
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundInterpersonal psychotherapy (IPT) and cognitive behavioral therapy (CBT) are both evidence-based treatments for major depressive disorder (MDD). Several head-to-head comparisons have been made, mostly in the United States. In this trial, we compared the two treatments in a small-town outpatient psychiatric clinic in Sweden. The patients had failed previous primary care treatment and had extensive Axis-II comorbidity. Outcome measures were reduction of depressive symptoms and attrition rate. MethodsNinety-six psychiatric patients with MDD (DSM-IV) were randomized to 14 sessions of CBT (n = 48) or IPT (n = 48). A noninferiority design was used with the hypothesis that IPT would be noninferior to CBT. A three-point difference on the Beck Depression Inventory-II (BDI-II) was used as noninferiority margin. ResultsIPT passed the noninferiority test. In the ITT group, 53.5% (23/43) of the IPT patients and 51.0% (24/47) of the CBT patients were reliably improved, and 20.9% (9/43) and 19.1% (9/47), respectively, were recovered (last BDI score amp;lt;10). The dropout rate was significantly higher in CBT (40%; 19/47) compared to IPT (19%; 8/43). Statistically controlling for antidepressant medication use did not change the results. ConclusionsIPT was noninferior to CBT in a sample of depressed psychiatric patients in a community-based outpatient clinic. CBT had significantly more dropouts than IPT, indicating that CBT may be experienced as too demanding. Since about half the patients did not recover, there is a need for further treatment development for these patients. The study should be considered an effectiveness trial, with strong external validity but some limitations in internal validity.
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| 5. |
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| 6. |
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| 7. |
- Halonen, Jaana, et al.
(författare)
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Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood—The 1987 Finnish Birth Cohort
- 2019
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 36:4, s. 305-312
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence.Methods: Study population consisted of the 1987 Finnish Birth Cohort. Data on parents’ psychiatric care or work disability due to mental diagnosis between 1987 and 2000 and the cohort participants’ health and social factors between 2001 and 2005 were derived from administrative national registers. From 2006 through 2015, 52,182 cohort participants were followed for admittance of psychiatric work disability due to depressive or anxiety disorders. First, we applied a pathway analysis to examine the occurrence of each path. We then used mediation analysis to assess the proportion of association between parental mental disorders and work disability mediated by offspring's health and social disadvantage.Results: The pathway model indicated that the association from parental mental disorders to offspring's work disability due to depressive or anxiety disorder is through mental disorders and social disadvantage in adolescence. Odds Ratio for the total effect of parental mental disorders on offspring's psychiatric work disability was 1.85 (95% confidence interval [CI] 1.46–2.34) in the model including offspring's mental disorders that mediated this association by 35%. Corresponding results were 1.86 (95% CI 1.47–2.35) and 28% for social disadvantage in adolescence.Conclusions: These findings suggest that intergenerational determination of work disability due to mental disorders could be addressed by actions supporting mental health and social circumstances in adolescence.
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| 8. |
- Holmquist, Sofie, et al.
(författare)
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Low physical activity as a key differentiating factor in the potential high-risk profile for depressive symptoms in older adults
- 2017
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 34:9, s. 817-825
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The identification of potential high-risk groups for depression is of importance. The purpose of the present study was to identify high-risk profiles for depressive symptoms in older individuals, with a focus on functional performance.METHODS: The population-based Healthy Ageing Initiative included 2,084 community-dwelling individuals (49% women) aged 70. Explorative cluster analysis was used to group participants according to functional performance level, using measures of basic mobility skills, gait variability, and grip strength. Intercluster differences in depressive symptoms (measured by the Geriatric Depression Scale [GDS]-15), physical activity (PA; measured objectively with the ActiGraph GT3X+), and a rich set of covariates were examined.RESULTS: The cluster analysis yielded a seven-cluster solution. One potential high-risk cluster was identified, with overrepresentation of individuals with GDS scores >5 (15.1 vs. 2.7% expected; relative risk = 6.99, P < .001); the prevalence of depressive symptoms was significantly lower in the other clusters (all P < .01). The potential high-risk cluster had significant overrepresentations of obese individuals (39.7 vs. 17.4% expected) and those with type 2 diabetes (24.7 vs. 8.5% expected), and underrepresentation of individuals who fulfilled the World Health Organization's PA recommendations (15.6 vs. 59.1% expected; all P < .01), as well as low levels of functional performance.CONCLUSIONS: The present study provided a potential high-risk profile for depressive symptoms among elderly community-dwelling individuals, which included low levels functional performance combined with low levels of PA. Including PA in medical screening of the elderly may aid in identification of potential high-risk individuals for depressive symptoms.
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| 9. |
- Iliadis, Stavros I, et al.
(författare)
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Mid-pregnancy corticotropin-releasing hormone levels in association with postpartum depressive symptoms
- 2016
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 33:11, s. 1023-1030
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Tidskriftsartikel (refereegranskat)abstract
- Background: Peripartum depression is a common cause of pregnancy and postpartum related morbidity. The production of corticotropin-releasing hormone (CRH) from the placenta alters the profile of hypothalamus-pituitary-adrenal axis hormones and may be associated with postpartum depression. The purpose of this study was to assess, in non-depressed pregnant women, the possible association between CRH levels in pregnancy and depressive symptoms postpartum.Methods: A questionnaire containing demographic data and the Edinburgh Postnatal Depression Scale was filled in gestational weeks 17 and 32, and six weeks postpartum. Blood samples were collected in week 17 for assessment of CRH. A logistic regression model was constructed, using postpartum Edinburgh Postnatal Depression Scale score as the dependent variable and log transformed CRH levels as the independent variable. Confounding factors were included in the model. Sub-analyses after exclusion of study subjects with preterm birth, small for gestational age newborns, and women on corticosteroids were performed.Results: 535 women without depressive symptoms during pregnancy were included. Logistic regression showed an association between high CRH levels in gestational week 17 and postpartum depressive symptoms, before and after controlling for several confounders (unadjusted Odds Ratio = 1.11; 95% CI 1.01 – 1.22, adjusted Odds Ratio = 1.13; 95% CI 1.02 – 1.26, per 0.1 unit increase in log corticotropin-releasing hormone). Exclusion of women with preterm birth and newborns small for gestational age as well as women who used inhalation corticosteroids during pregnancy did not alter the results.Conclusions: This study suggests an association between high CRH levels in gestational week 17 and the development of postpartum depressive symptoms, among women without depressive symptoms during pregnancy.
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| 10. |
- Johansson Niemelä, Birgitta, 1948-, et al.
(författare)
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A Clinical Report : Mental health, Self-esteem and Social Interaction in Adolescents with CL/P in the Context of Re-constructive Surgery
- 2011
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Ingår i: Depression and anxiety (Print). - 1091-4269 .- 1520-6394. ; 1:102
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Tidskriftsartikel (refereegranskat)abstract
- Background:Self-esteem in children and adolescents with deviances in function and appearance has been studied with diverse results. The effect of cleft lip/ and palate on mental health, self-esteem and social interaction were studied in the context of reconstructive surgery. Comparing parents’ and children’s’ self-esteem reports was also of interest. Exploring these differences could help the understanding of future mental health in patients with CL/P and their need for reconstructive surgery. Methods:A descriptive study within an in-patient setting, Plastic Surgery Clinic, Uppsala University Hospital. Twenty-six CL/P patients between 13 and 19 years of age and their parents answered a specific condition questionnaire specially adapted for this study and Beck’s Youth Inventories the day before reconstructive surgery. Results:Mental health was affected while self-esteem was on a median-high level for this CL/P group. Parents rated their children to have higher self-esteem as they grew older. However, females reported a diminished level from primary to secondary school age. Attention on CLP was high. Twenty-three adolescents, or 85 % of resondents, wanted to change their appearance, Conclusion:Mental health was affected by CL/P, especially for those children that had been bullied. Specifically, the wish to change appearance was associated with high level of anxiety and depression. The specific condition questionnaires proved to be more informative than the standardized measure regarding self-esteem under development for the sake of differentiating between parent-adolescent estimation of self-esteem.
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| 11. |
- Johansson Niemelä, Birgitta, 1948-, et al.
(författare)
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Mended But Not healed : Somatic and Mental Health 10 Years after Leg Lengthening with Ilixarov
- 2014
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Ingår i: Depression and anxiety (Print). - : OMICS Publishing Group. - 1091-4269 .- 1520-6394. ; 3:2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the somatic and mental health in patients who had leg lengthening (LL) in a 10-year follow-up and to compare it with the 1 year-follow-up. Earlier studies have demonstrated severe maladaptive reactions in children and adolescents on a short term basis but also that they tolerate it without sustained psychological impact. Cohort sequential longitudinal studies, in which individuals from different age groups are followed over time, are needed to tease apart aging and cohort effects. Methods: This was a prospective study with 28 patients, mean age of 20, who had undergone leg lengthening (LL) between 1997-2005 at the Department of Pediatric Orthopedics, Uppsala University Hospital. The somatic health was studied by a structured medical assessment of the reconstructed leg and an interview focused on the patient’s experiences of surgery, outcome and function. The mental health was studied by Beck depression- and the State-Trait Anxiety Inventories and a specially designed questionnaire for patient with LLI. Results: When the patients rated their mental health, 20 were within a normal level and 7 had symptoms of depression. Patients’ self-esteem was on a median level. Those who had scored highly on the depression inventory also had high levels on both State- and Trait anxiety scale. Conclusion: One fourth of the patients reported themselves to be depressed at the 10-year follow-up, while 7% of the patients were depressed one year after LL. Self-esteem results for the cohort were on a median level, both one and ten years after LL. Interview data demonstrated that the majority of patients were preoccupied with their LLI and more psychological support during the lengthening period would have been desirable. From available data we cannot conclude that the leg lengthening per se caused the depressive symptoms in the patients.
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| 12. |
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| 13. |
- Morina, N., et al.
(författare)
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The impact of enhancing perceived self-efficacy in torture survivors
- 2018
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Ingår i: Depression and anxiety (Print). - : Blackwell Publishing Inc.. - 1091-4269 .- 1520-6394. ; 35:1, s. 58-64
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Tidskriftsartikel (refereegranskat)abstract
- Background: Perceived self-efficacy (SE) is an important factor underlying psychological well-being. Refugees suffer many experiences that can compromise SE. This study tested the impact of enhancing perceived SE on coping with trauma reminders and distress tolerance in tortured refugees. Methods: Torture survivors (N = 40) were administered a positive SE induction in which they retrieved mastery-related autobiographical memories, or a non-SE (NSE) induction, and then viewed trauma-related images. Participants rated their distress following presentation of each image. Participants then completed a frustration-inducing mirror-tracing task to index distress tolerance. Results: Participants in the SE condition reported less distress and negative affect, and improved coping in relation to viewing the trauma-related images than those in the NSE condition. The SE induction also led to greater persistence with the mirror-tracing task than the NSE induction. Conclusions: These findings provide initial evidence that promoting SE in tortured refugees can assist with managing distress from trauma reminders, and promoting greater distress tolerance. Enhancing perceived SE in tortured refugees may increase their capacity to tolerate distress during therapy, and may be a useful means to improve treatment response. © 2017 Wiley Periodicals, Inc.
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| 14. |
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| 15. |
- Pertusa, Alberto, et al.
(författare)
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Do patients with hoarding disorder have autistic traits?
- 2012
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Ingår i: Depression and anxiety (Print). - Malden, USA : Wiley-Blackwell. - 1091-4269 .- 1520-6394. ; 29:3, s. 210-218
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hoarding symptoms have been described in individuals with autism spectrum disorders (ASD). Furthermore, individuals with hoarding disorder (HD) may display some ASD-like features. In order to further refine the diagnostic boundaries of HD, we examined the presence of autistic traits and theory of mind deficits in individuals with HD and of hoarding behavior in patients with ASD.Methods: Two hundred and twenty-one participants in five groups (HD, ASD, obsessive-compulsive disorder (OCD), anxiety disorders (AD), and healthy controls (HC)) were administered measures of autistic traits (Autism-Spectrum Quotient), theory of mind (eyes test-revised), and hoarding severity (saving inventory-revised; SI-R (add acronym)).Results: Hoarders displayed more autistic traits compared to healthy individuals but not to psychiatric controls. Participants with ASD had significantly higher scores on the SI-R than both psychiatric (OCD or AD) and HC groups, indicating more severe hoarding behavior, but had lower scores than participants with HD. The presence of autistic traits in individuals with HD was related to the presence of comorbid OCD, but the presence of hoarding symptoms in individuals with ASD was unrelated to comorbid OCD.Conclusions We conclude that individuals with HD do not display more autistic traits than psychiatric controls, thus supporting its status as an independent diagnostic entity. More research is needed to further understand the phenomenology and clinical relevance of hoarding symptoms in ASD.
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| 16. |
- Price, Rebecca B., et al.
(författare)
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Less is more : Patient-level meta-analysis reveals paradoxical dose-response effects of a computer-based social anxiety intervention targeting attentional bias
- 2017
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 34:12, s. 1106-1115
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Forskningsöversikt (refereegranskat)abstract
- Background: The past decade of research has seen considerable interest in computer-based approaches designed to directly target cognitive mechanisms of anxiety, such as attention bias modification (ABM).Methods: By pooling patient-level datasets from randomized controlled trials of ABM that utilized a dot-probe training procedure, we assessed the impact of training "dose" on relevant outcomes among a pooled sample of 693 socially anxious adults.Results: A paradoxical effect of the number of training trials administered was observed for both posttraining social anxiety symptoms and behavioral attentional bias (AB) toward threat (the target mechanism of ABM). Studies administering a large (>1,280) number of training trials showed no benefit of ABM over control conditions, while those administering fewer training trials showed significant benefit for ABM in reducing social anxiety (P = .02). These moderating effects of dose were not better explained by other examined variables and previously identified moderators, including patient age, training setting (laboratory vs. home), or type of anxiety assessment (clinician vs. self-report).Conclusions: Findings inform the optimal dosing for future dot-probe style ABM applications in both research and clinical settings, and suggest several novel avenues for further research.
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| 17. |
- Renna, Megan E., et al.
(författare)
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The association between anxiety, traumatic stress, and obsessive-compulsive disorders and chronic inflammation : A systematic review and meta-analysis
- 2018
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 35:11, s. 1081-1094
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Tidskriftsartikel (refereegranskat)abstract
- Background Methods Anxiety is characterized by prolonged preparation for real or perceived threat. This may manifest both as psychological and physiological activation, ultimately leading to greater risk for poor health. Chronic inflammation may play an integral role in this relationship, given the influential role that it has in chronic illness. The aim of this meta-analysis is to examine levels of chronic inflammation, measured by inflammatory cytokines and C-reactive protein, in people with anxiety disorders, PTSD (posttraumatic stress disorder), or obsessive-compulsive disorder compared to healthy controls. Several moderating variables, including specific diagnosis and depression comorbidity, were also assessed. Seventy six full-text articles were screened for eligibility with 41 studies ultimately included in analysis. Results Conclusions Results demonstrated a significant overall difference between healthy controls (HCs) and people with anxiety disorders in pro-inflammatory cytokines (P = 0.013, Hedge's g = -0.39), which appears to be largely driven by interleukin-1 beta (IL-1 beta; P = 0.009, Hedge's g = -0.50), IL-6 (P < 0.001, Hedge's g = -0.93), and tumor necrosis factor-alpha (P = 0.030, Hedge's g = -0.56). Moderation analyses revealed a moderating effect of diagnosis (P = 0.050), as only individuals with PTSD demonstrated differences in inflammation between HCs (P = 0.004, Hedge's g = -0.68). These data demonstrate the association between inflammatory dysregulation and diagnoses associated with chronic, impactful, and severe anxiety and provides insight into the way that anxiety, and in particular PTSD, is related to certain inflammatory markers. In doing so, these findings may provide an initial step in disentangling the relationship between anxiety and basic health processes.
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| 18. |
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| 19. |
- Sigström, Robert, 1982, et al.
(författare)
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Nine-year follow-up of specific phobia in a population sample of older people
- 2016
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Ingår i: Depression and Anxiety. - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 33:4, s. 339-46
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about the long-term course of specific phobia (SP) in the general population. We examined the prevalence and course of SP and subthreshold fears in an older population followed over 9 years. METHOD: A psychiatric examination was performed in a population-based sample of 558 70-year-olds, among whom 303 dementia-free survivors were followed up at both ages 75 and 79. Fears were rated with respect to level of anxiety and social or other consequences. DSM-IV SP was diagnosed when fears were associated with prominent anxiety and had social or other consequences. All other fears were labeled subthreshold fears. RESULTS: The prevalence of SP declined from 9.9% at age 70 to 4.0% at age 79. The reason was that the prevalence of fears associated with prominent anxiety (mandatory in the diagnosis) decreased whereas the prevalence of fears that gave social or other consequences remained stable. A total of 14.5% of the population had SP at least once during the study. Among these, 11.4% had SP and 65.9% had specific fear at all three examinations. CONCLUSION: The prevalence of fears associated with prominent anxiety decreased with age, resulting in an overall decline in the prevalence of SP. SP seems to be a fluctuating disorder, and in most cases an exacerbation of chronic subthreshold fears.
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| 20. |
- Silverman, Michael E., et al.
(författare)
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The risk factors for postpartum depression : A population-based study
- 2017
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Ingår i: Depression and anxiety (Print). - Hoboken, USA : John Wiley & Sons. - 1091-4269 .- 1520-6394. ; 34:2, s. 178-187
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Tidskriftsartikel (refereegranskat)abstract
- Background: Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Only a few large population-based studies of PPD have used clinical diagnoses of depression and no study has examined how a maternal depression history interacts with known risk factors. The objective of this study was to examine the impact of a depression history on PPD and pre- and perinatal risk factors.Methods: A nationwide prospective cohort study of all women with live singleton births in Sweden from 1997 through 2008 was conducted. Relative risk (RR) of clinical depression within the first year postpartum and two-sided 95% confidence intervals were estimated.Results: The RR of PPD in women with a history of depression was estimated at 21.03 (confidence interval: 19.72-22.42), compared to those without. Among all women, PPD risk increased with advanced age (1.25 (1.13-1.37)) and gestational diabetes (1.70 (1.36-2.13)). Among women with a history of depression, pregestational diabetes (1.49 (1.01-2.21)) and mild preterm delivery also increased risk (1.20 (1.06-1.36)). Among women with no depression history, young age (2.14 (1.79-2.57)), undergoing instrument-assisted (1.23 (1.09-1.38)) or cesarean (1.64(1.07-2.50)) delivery, and moderate preterm delivery increased risk (1.36 (1.05-1.75)). Rates of PPD decreased considerably after the first postpartum month (RR = 0.27).Conclusions: In the largest population-based study to date, the risk of PPD was more than 20 times higher for women with a depression history, compared to women without. Gestational diabetes was independently associated with a modestly increased PPD risk. Maternal depression history also had a modifying effect on pre- and perinatal PPD risk factors.
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| 21. |
- Strauss, Timmy, et al.
(författare)
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Touch aversion in patients with interpersonal traumatization
- 2019
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Ingår i: Depression and anxiety (Print). - : WILEY. - 1091-4269 .- 1520-6394. ; 36:7, s. 635-646
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Tidskriftsartikel (refereegranskat)abstract
- Background Interpersonal touch is a key aspect of human interaction and a usually very comforting experience. For patients suffering from posttraumatic stress disorders (PTSD) caused by interpersonal traumatization, such touch is affectively ambiguous. Methods In two studies, we investigated the experience and neural processing of various types of interpersonal and impersonal touch in patients as compared with healthy controls. Results Patients strongly disliked show, interpersonal skin-to-skin stroking, while controls appreciated this kind of touch. No group differences were observed for ratings of impersonal touch. Similarly, the neural activation differed between groups for interpersonal, but not for impersonal touch. The interpersonal touch aversion in patients was accompanied by enhanced blood-oxygen-level-dependent response in the superior temporal gyrus and by a pronounced reduction of response in the hippocampus. This reduction was significantly correlated to symptoms of negative alterations and arousal within the patients. Conclusion We interpret the hippocampal suppression as an attempt to control traumatic memories, evoked by interpersonal touch. This mechanism may maintain the aversion of interpersonal touch in patients with interpersonal trauma-related PTSD.
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| 22. |
- Suppes, Trisha, et al.
(författare)
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MAINTENANCE TREATMENT WITH QUETIAPINE WHEN COMBINED WITH EITHER LITHIUM OR DIVALPROEX IN BIPOLAR I DISORDER : ANALYSIS OF TWO LARGE RANDOMIZED, PLACEBO-CONTROLLED TRIALS
- 2013
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Ingår i: Depression and anxiety (Print). - : Wiley-Blackwell. - 1091-4269 .- 1520-6394. ; 30:11, s. 1089-1098
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTo determine the efficacy and safety of quetiapine combined with lithium or divalproex for preventing mood events in patients with bipolar I disorder. In this pooled analysis of two similar long-term studies (D1447C00126 [NCT00107731] and D1447C00127 [NCT00081380]), lithium and divalproex treatment groups were analyzed separately. MethodsPatients received open-label quetiapine (400-800 mg/d) plus lithium or divalproex to achieve 12 weeks of clinical stability before being randomized to double-blind combination treatment with quetiapine (400-800 mg/d) or placebo plus lithium or divalproex for up to 104 weeks. The primary endpoint was time to first mood event postrandomization following open stabilization. ResultsOf 3,414 patients in the stabilization phase, 1,326 were randomized. There were no differences in the risk of recurrence of mood, mania, or depression between quetiapine plus lithium or quetiapine plus divalproex. Among patients co-treated with placebo and lithium, the risk of recurrence of a mania event was significantly higher than among patients co-treated with placebo and divalproex. In patients with an index episode of mania, placebo plus lithium was associated with a significantly higher risk of recurrence of a mania event than placebo plus divalproex. Safety data were generally consistent with recognized safety profiles. ConclusionsIn patients with bipolar I disorder previously stabilized on quetiapine and lithium or divalproex, maintenance therapy with quetiapine significantly increased the time to recurrence of a mood event (mania or depression) versus placebo, regardless of whether it was combined with lithium or divalproex.
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| 23. |
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| 24. |
- Tillfors, Maria, 1963-, et al.
(författare)
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Treating university students with social phobia and public speaking fears : Internet delivered self-help with or without live group exposure sessions
- 2008
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 25:8, s. 708-717
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study investigated the efficacy of an Internet-based self-help program with minimal therapist contact via e-mail for Swedish university students with social phobia and public speaking fears. The main objective was to test if the Internet-based self-help program would be more effective if five live group exposure sessions were added. METHODS: Thirty-eight students meeting the diagnostic and statistical manual of mental disorders, 4th edition criteria for social phobia were randomized into two different treatment groups: Internet delivered cognitive behavior therapy combined with five group exposure sessions (ICBT+ exp) or the Internet program alone (ICBT). RESULTS: Results were analyzed on an intention-to-treat basis. Both treatment groups showed significant improvement from pre- to post-test, and from pre-test to 1-year follow-up, on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). For both the groups, the average within-group effect sizes for the primary social anxiety scales, expressed as Cohen's d, were comparable to those seen in traditionally administered cognitive behavioral therapy both at post-test and at 1- year follow-up. CONCLUSIONS: The results suggest that the Internet-based self-help program on its own is efficient in the treatment of university students with social phobia. Adding group exposure sessions did not improve the outcome significantly.
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