1. |
- Andersson, Gerhard, et al.
(author)
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6 Internet-supported versus face-to-face cognitive behavior therapy for depression
- 2016
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In: Expert Review of Neurotherapeutics. - : TAYLOR & FRANCIS LTD. - 1473-7175 .- 1744-8360. ; 16:1, s. 55-60
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Research review (peer-reviewed)abstract
- Major depression and depressive symptoms are highly prevalent and there is a need for different forms of psychological treatments that can be delivered from a distance at a low cost. In the present review the authors contrast face-to-face and Internet-delivered cognitive behavior therapy (ICBT) for depression. A total of five studies are reviewed in which guided ICBT was directly compared against face-to-face CBT. Meta-analytic summary statistics were calculated for the five studies involving a total of 429 participants. The average effect size difference was Hedges g=0.12 (95% CI: -0.06-0.30) in the direction of favoring guided ICBT. The small difference in effect has no implication for clinical practice. The overall empirical status of clinician-guided ICBT for depression is commented on and future challenges are highlighted. Among these are developing treatments for patients with more severe and long-standing depression and for children, adolescents and the elderly. Also, there is a need to investigate mechanisms of change.
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- Andersson, Gerhard
(author)
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Internet-based cognitive-behavioral self help for depression
- 2006
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In: Expert Review of Neurotherapeutics. - : Informa UK Limited. - 1473-7175 .- 1744-8360. ; 6:11, s. 1637-1642
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Journal article (peer-reviewed)abstract
- Depression is a common condition that can be treated in many different ways. Accumulating evidence suggests that self help, based on cognitive-behavioral principles, is an evidence-based treatment for mild-to-moderate depression. Self help commonly requires some form of guidance, but can still be cost effective and the results are often similar to what can be observed in face-to-face therapy. Recently, the possibility of administering cognitive-behavioral treatment via the internet has been explored. There are several advantages to using the internet, the main one being that it bridges distances and is readily available for an increasing number of people in the world. While few controlled studies have examined the effects of internet-delivered self help for depression, the results are promising for applications that involve brief therapist input. Future possible applications of internet-based self help are discussed. © 2006 Future Drugs Ltd.
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3. |
- Andersson, Gerhard, et al.
(author)
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Long-term effects of internet-supported cognitive behaviour therapy
- 2018
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In: Expert Review of Neurotherapeutics. - : Informa UK Limited. - 1473-7175 .- 1744-8360. ; 18:1, s. 21-28
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Research review (peer-reviewed)abstract
- Introduction: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer.Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8–15 weeks). The pre-to follow-up effect size was Hedge’s g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%. Treatment seeking in the follow-up period was not documented and few studies mentioned negative effects.Expert commentary: While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects. Long-term follow-up data should be collected for more conditions and new technologies like smartphone-delivered treatments.
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4. |
- Andersson, Gerhard
(author)
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The latest developments with internet-based psychological treatments for depression
- 2024
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In: Expert Review of Neurotherapeutics. - : TAYLOR & FRANCIS LTD. - 1473-7175 .- 1744-8360. ; 24:2, s. 171-176
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Research review (peer-reviewed)abstract
- IntroductionInternet-based psychological treatments for depression have been around for more than 20 years. There has been a continuous line of research with new research questions being asked and studies conducted.Areas coveredIn this paper, the author reviews studies with a focus on papers published from 2020 and onwards based on a Medline and Scopus search. Internet-based cognitive behavior therapy (ICBT) programs have been developed and tested for adolescents, older adults, immigrant groups and to handle a societal crisis (e.g. COVID-19). ICBT works in regular clinical settings and long-term effects can be obtained. Studies on different treatment orientations and approaches such as acceptance commitment therapy, unified protocol, and tailored treatments have been conducted. Effects on quality-of-life measures, knowledge acquisition and ecological momentary assessment as a research tool have been reported. Factorial design trials and individual patient data meta-analysis are increasingly used in association with internet intervention research. Finally, prediction studies and recent advances in artificial intelligence are mentioned.Expert opinionInternet-delivered treatments are effective, in particular if therapist guidance is provided. More target groups have been covered but there are many remaining challenges including how new tools like artificial intelligence will be used when treating depression.
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5. |
- Archer, Trevor, 1949
(author)
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Neurodegeneration in schizophrenia.
- 2010
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In: Expert review of neurotherapeutics. - : Informa UK Limited. - 1744-8360 .- 1473-7175. ; 10:7, s. 1131-41
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Journal article (peer-reviewed)abstract
- The neurodegenerative aspect of schizophrenia presupposes gene-environmental interactions involving chromosomal abnormalities and obstetric/perinatal complications that culminate in predispositions that impart a particular vulnerability for drastic and unpredictable precipitating factors, such as stress or chemical agents. The notion of a neurodevelopmental progression to the disease state implies that early developmental insults, with neurodegenerative proclivities, evolve into structural brain abnormalities involving specific regional circuits and neurohumoral agents. This neurophysiological orchestration is expressed in the dysfunctionality observed in premorbid signs and symptoms arising in the eventual diagnosis, as well as the neurobehavioral deficits reported from animal models of the disorder. The relative contributions of perinatal insults, neonatal ventral hippocampus lesion, prenatal methylazoxymethanol acetate and early traumatic experience, as well as epigenetic contributions, are discussed from a neurodegenerative view of the essential neuropathology. It is implied that these considerations of factors that exert disruptive influences upon brain development, or normal aging, operationalize the central hub of developmental neuropathology around which the disease process may gain momentum. Nonetheless, the status of neurodegeneration in schizophrenia is somewhat tenuous and it is possible that brain imaging studies on animal models of the disorder, which may describe progressive alterations to cortical, limbic and ventricular structures similar to those of schizophrenic patients, are necessary to resolve the issue.
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7. |
- Carlborg, Andreas, et al.
(author)
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Suicide in schizophrenia
- 2010
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In: Expert Review of Neurotherapeutics. - : Informa UK Limited. - 1473-7175 .- 1744-8360. ; 10:7, s. 1153-64
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Research review (peer-reviewed)abstract
- Schizophrenia is a disorder with an estimated suicide risk of 4-5%. Many factors are involved in the suicidal process, some of which are different from those in the general population. Clinical risk factors include attempted suicide, depression, male gender, substance abuse and hopelessness. Biosocial factors, such as a high intelligence quotient and high level of premorbid function, have also been associated with an increased risk of suicide in patients with schizophrenia. Suicide risk is especially high during the first year after diagnosis. Many of the suicides occur during hospital admission or soon after discharge. Management of suicide risk includes both medical treatment and psychosocial interventions. Still, risk factors are crude; efforts to predict individual suicides have not proved useful and more research is needed.
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8. |
- Cortese, Samuele, et al.
(author)
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The management of sleep disturbances in children with attention-deficit/hyperactivity disorder (ADHD) : an update of the literature
- 2024
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In: Expert Review of Neurotherapeutics. - : Expert Reviews Ltd.. - 1473-7175 .- 1744-8360. ; 24:6, s. 585-596
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Research review (peer-reviewed)abstract
- INTRODUCTION: Sleep disorders represent an important comorbidity in individuals with ADHD. While the links between ADHD and sleep disturbances have been extensively investigated, research on the management of sleep disorders in individuals with ADHD is relatively limited, albeit expanding.AREAS COVERED: The authors searched PubMed, Medline, PsycInfo, Embase+Embase Classic, Web of Sciences databases, and clinicaltrials.gov up to 4 January 2024, for randomized controlled trials (RCTs) of any intervention for sleep disorders associated with ADHD. They retained 16 RCTs (eight on pharmacological and eight on non-pharmacological interventions), supporting behavioral intervention and melatonin, and nine ongoing RCTs registered on clinicaltrials.gov. EXPERT OPINION: The pool of RCTs testing interventions for sleep disorders in individuals with ADHD is expanding. However, to inform clinical guidelines, there is a need for additional research in several areas, including 1) RCTs based on a precise phenotyping of sleep disorders; 2) pragmatic RCTs recruiting neurodevelopmental populations representative of those seen in clinical services; 3) trials testing alternative interventions (e.g. suvorexant or light therapy) or ways to deliver them (e.g. online); 4) sequential and longer-term RCTs; 5) studies testing the impact of sleep interventions on outcomes other than sleep; 6) and implementation of advanced evidence synthesis and precision medicine approaches.
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9. |
- Cyrous, Alma, et al.
(author)
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New approaches to bedside monitoring in stroke
- 2012
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In: Expert Review of Neurotherapeutics. - : Informa UK Limited. - 1473-7175 .- 1744-8360. ; 12:8, s. 915-928
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Research review (peer-reviewed)abstract
- Stroke is a common, potentially devastating disease with potential high morbidity and mortality. Recognition at the onset of acute ischemic stroke is pivotal to changing outcomes such as intravenous thrombolysis. Stroke monitoring is a burgeoning field with various methods described and newer devices that aid in detecting acute or worsening ischemia that can lead to improved bedside and intensive care unit management. This article describes various methods of bedside stroke monitoring including newer techniques of intracranial pressure monitoring using the pressure reactivity index and compensatory reserve index to detect changes in autoregulatory states, noninvasive intracranial pressure monitoring, quantitative EEG with alpha-delta ratio, transcranial Doppler, methods of arteriovenous brain oxygen monitoring such as jugular venous oxygen and near-infrared spectroscopy, invasive brain oxygen probes such as Licox™ (brain tissue O2), cerebral blood flow probe (CBF Hemedex™) and cerebral microdialysis. © 2012 Expert Reviews Ltd.
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10. |
- Dobrosavljevic, Maja, 1986-, et al.
(author)
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The diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) in older adults
- 2023
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In: Expert Review of Neurotherapeutics. - : Expert Reviews Ltd.. - 1473-7175 .- 1744-8360. ; 23:10, s. 883-893
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Research review (peer-reviewed)abstract
- INTRODUCTION: There is a striking knowledge gap on ADHD in older adults, and the diagnosis as well as treatment for ADHD in this age group.AREAS COVERED: The authors first review the literature on the prevalence, functional impairment, and health comorbidities of ADHD across the lifespan. Next, they address the diagnostic criteria for ADHD in adults according to the DSM/ICD, available screening/diagnostic tools, differential diagnosis, and the validity of diagnostic criteria for ADHD in older adults. Finally, the authors focus on empirical evidence on the prevalence rates, medication response, and safety of pharmacological treatment of ADHD in older adults, and national and international clinical guidelines on the treatment of ADHD in this age group. EXPERT OPINION: It is expected that future editions of the DSM and ICD will provide specifiers to the standard ADHD criteria, to better inform the diagnosis of ADHD in older adults. It is also expected that the increasing number of epidemiological studies will provide rigorous estimates on the prevalence, incidence, and burden of ADHD in older adults. One may expect an increasing number of RCTs assessing the efficacy/effectiveness and tolerability/safety of pharmacological as well as non-pharmacological interventions which will inform future guidelines on ADHD in older adults.
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