CBT and its family of structured treatments.
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876 to 900 of 2,546A meta-analysis of cognitive therapy for worry in generalized anxiety disorder.
We report a meta- and primary data-analysis investigating the efficacy of cognitive therapy (CT) for pathological worry in adults with GAD that includes an analysis of primary data not reported in previous meta-analyses. Eligible studies included those whose participants met the criteria for a diagnosis of GAD and those that used the PSWQ as an outcome measure. All eligible studies used a randomized controlled design. Analyses included a random-effects meta-analysis of between-study effect sizes and hierarchical linear models of both within study change over time and primary recovery data. The results show that CT was effective in reducing pathological worry when compared with non-therapy controls (d=1.81), and gains were largely maintained at follow-up. The magnitude of effects reported was larger than previously found, suggesting an increased efficacy of newer forms of CT. However, we …
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Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia.
Background: Cognitive impairments, particularly memory problems, are a defining feature of the early stages of Alzheimer's disease (AD) and vascular dementia. Cognitive training and cognitive rehabilitation are specific interventional approaches designed to address difficulties with memory and other aspects of cognitive functioning. The present review is an update of previous versions of this review.
Objectives: The main aim of the current review was to evaluate the effectiveness and impact of cognitive training and cognitive rehabilitation for people with mild Alzheimer's disease or vascular dementia in relation to important cognitive and non-cognitive outcomes for the person with dementia and the primary caregiver in the short, medium and long term.
Search methods: The CDCIG Specialized Register, ALOIS, which contains records from MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS and many othe…
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Cognitive rehabilitation for spatial neglect following stroke.
Background: Unilateral spatial neglect causes difficulty attending to one side of space. Various rehabilitation interventions have been used but evidence of their benefit is lacking.
Objectives: To assess whether cognitive rehabilitation improves functional independence, neglect (as measured using standardised assessments), destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with neglect measured immediately post-intervention and at longer-term follow-up; and to determine which types of interventions are effective and whether cognitive rehabilitation is more effective than standard care or an attention control.
Search methods: We searched the Cochrane Stroke Group Trials Register (last searched June 2012), MEDLINE (1966 to June 2011), EMBASE (1980 to June 2011), CINAHL (1983 to June 2011), PsycINFO (1974 to June 2011), UK National Research …
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Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials.
Background: Psychiatric patients have more physical health problems and much shorter life expectancies compared to the general population, due primarily to premature cardiovascular disease. A multi-causal model which includes a higher prevalence of risk factors has provided a valid explanation. It takes into consideration not only risks such as gender, age, and family history that are inherently non-modifiable, but also those such as obesity, smoking, diabetes, hypertension, and dyslipidemia that are modifiable through behavioural changes and improved care. Thus, it is crucial to focus on factors that increase cardiovascular risk. Obesity in particular has been associated with both the lifestyle habits and the side effects of antipsychotic medications. The present systematic review and meta-analysis aims at collecting and updating available evidence on the efficacy of non-pharmacological…
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Cognitive-behavioral and pharmacological interventions for premenstrual syndrome or premenstrual dysphoric disorder: a meta-analysis.
The current meta-analysis investigates the efficacy of psychotherapeutic interventions and psychopharmacotherapy for premenstrual syndrome (PMS) and premenstrual dysphoric disorder. Based on a multiple-phase literature search, controlled trials were selected according to a priori defined inclusion criteria. Data were extracted on the basis of a standardized coding scheme. The standardized weighted mean difference (random effects model) was used as effect size index. Dependent on outcome, 22 included studies obtained small to medium effect sizes for cognitive-behavioral interventions (range: d(+) = 0.24-0.70) and for serotonergic antidepressants (range: d(+) = 0.29-0.58), at post-assessment. Follow-ups were performed only in studies of cognitive-behavioral interventions (range: d(+) = 0.46-0.74). There was no evidence of a publication bias. For both cognitive-behavioral interventions and …
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Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review.
Background: Self-help interventions for psychiatric disorders represent an increasingly popular alternative to therapist-administered psychological therapies, offering the potential of increased access to cost-effective treatment.
Aims: To determine the efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders.
Method: Randomised controlled trials (RCTs) of self-help interventions for anxiety disorders were identified by searching nine online databases. Studies were grouped according to disorder and meta-analyses were conducted where sufficient data were available. Overall meta-analyses of self-help v. waiting list and therapist-administered treatment were also undertaken. Methodological quality was assessed independently by two researchers according to criteria set out by the Cochrane Collaboration.
Results: Thirty-one RCTs met inclusion criteria fo…
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Effects of an Internet-based prevention programme for eating disorders in the USA and Germany--a meta-analytic review.
A cross-cultural comparison of a cognitive-behavioural, Internet-based, 8-week prevention programme for eating disorders (StudentBodies™) evaluated in the USA and in Germany was performed. Six US and four German randomized controlled trials with a total (N) of 990 female high school and college students were included in the review. Two of the US and two of the German trials explicitly addressed high risk samples in a selective prevention approach. Effect sizes for main outcomes (disordered eating, weight and shape concerns) were calculated at postintervention and at follow-up. The intervention was associated with moderate improvements in eating disorder-related attitudes, especially reductions of negative body image and the desire to be thin. The reported effects remained significant at follow-up. No clear differences between US and German samples could be found on any of the outcome mea…
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Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study.
Background: Cognitive remediation is frequently based on computerized training methods that target different cognitive deficits. The aim of this article was to assess the efficacy of computer-assisted cognitive remediation (CACR) in schizophrenia and to determine whether CACR enables selective treatment of specific cognitive domains.
Method: A meta-analysis was performed on 16 randomized controlled trials evaluating CACR. The effect sizes of differences between CACR and control groups were computed and classified according to the cognitive domain assessed. The possible influences of four potential moderator variables were examined: participants' age, treatment duration, weekly frequency, and control condition type. To test the domain-specific effect, the intended goal of each study was determined and the effect sizes were sorted accordingly. The effect sizes of the cognitive domains expl…
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Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors--a meta-analysis.
Objective: To evaluate the effect of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life (HRQoL) outcomes in breast cancer patients and survivors.
Methods: A meta-analysis was carried out to quantify the effects of behavioral and exercise interventions on fatigue, depression, anxiety, body-image, stress and HRQoL. Summary effect sizes and standard errors were calculated. The presence of publication bias was explored and sensitivity analyses were performed to identify possible sources of heterogeneity.
Results: In total, 56 studies were included. Statistically significant results were found for the effect of behavioral techniques on fatigue (ES -0.158; 95% CI -0.233 to -0.082, p<0.001), depression (ES -0.336; 95% CI -0.482 to -0.190, p<0.001), anxiety (ES -0.346; 95% CI -0.538 to -0.154, p<0.001) and stress (ES -0.159; 95% CI -0.310 t…
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The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis.
Background: Mindfulness-based cognitive therapy (MBCT) is a group-based clinical intervention program designed to reduce relapse or recurrence of major depressive disorder (MDD) by means of systematic training in mindfulness meditation combined with cognitive-behavioral methods.
Objective: By means of a meta-analysis to evaluate the effect of MBCT for prevention of relapse or recurrence among patients with recurrent MDD in remission.
Method: Electronic databases were searched and researchers were contacted for further relevant studies. Studies were coded for quality. Meta-analyses were performed by means of the Cochrane Collaboration Review Manager 5.1.
Results: Six randomized controlled trials with a total of 593 participants were included in the meta-analysis. MBCT significantly reduced the risk of relapse/recurrence with a risk ratio of 0.66 for MBCT compared to treatment as usual or …
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Cognitive intervention for persons with mild cognitive impairment: A meta-analysis.
Cognitive training for persons with mild cognitive impairment (MCI) has become a hot topic. However to date it remains controversial whether persons with MCI can really benefit from cognitive intervention. We aim to further investigate this by using meta-analysis of seventeen clinical studies of cognitive intervention for MCI. The results demonstrate that after training, patients with MCI improve significantly both in overall cognition and overall self-ratings. Specifically, persons with MCI obtain moderate benefits in language, self-rated anxiety and functional ability, and receive mild benefits in episodic memory, semantic memory, executive functioning/working memory, visuo-spatial ability, attention/processing speed, MMSE, self-rated memory problem, quality of life, activities of daily life and self-rated depression. The results also suggest that persons with MCI benefit from the cogn…
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The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.
Objective: Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples.
Method: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions.
Results: Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges's g = 0.63) and mood symptoms (Hedges's g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was asso…
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Interventions for reducing adolescent alcohol abuse: a meta-analytic review.
Objective: To assess the effectiveness of substance abuse interventions for their ability to reduce adolescent alcohol use.
Data sources: MEDLINE; PsycINFO; ERIC; Wilson Social Science Abstracts; Criminal Justice Abstracts; Social Work Abstracts; Social Science Citation Index; Dissertations Abstracts International; National Criminal Justice Research Service; Social, Psychological, Criminological, Educational Trials Register; and the PsiTri databases from 1960 through 2008.
Study selection: Of 64 titles and abstracts identified, 16 studies and 26 outcomes constituted the sample. The researchers calculated Hedges g effect sizes and used a random-effects model to calculate adjusted pooled effect sizes. Heterogeneity was explored using stratified analyses. Main Exposure Completion of a substance abuse intervention that aimed to reduce or eliminate alcohol consumption.
Main outcome measures: …
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Psychological treatment of panic disorder with or without agoraphobia: a meta-analysis.
Although the efficacy of psychological treatment for panic disorder (PD) with or without agoraphobia has been the subject of a great deal of research, the specific contribution of techniques such as exposure, cognitive therapy, relaxation training and breathing retraining has not yet been clearly established. This paper presents a meta-analysis applying random- and mixed-effects models to a total of 65 comparisons between a treated and a control group, obtained from 42 studies published between 1980 and 2006. The results showed that, after controlling for the methodological quality of the studies and the type of control group, the combination of exposure, relaxation training, and breathing retraining gives the most consistent evidence for treating PD. Other factors that improve the effectiveness of treatments are the inclusion of homework during the intervention and a follow-up program a…
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Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder.
Objective: The aim of this study was to compute and compare mean effects of various treatments for binge eating disorder.
Method: A total of 38 studies with 1973 participants fulfilled the defined inclusion criteria. Effect sizes, odds ratios, and simple rates were integrated in fixed and random (mixed) effects categorical models.
Results: From randomized controlled trials, psychotherapy and structured self-help, both based on cognitive behavioral interventions, were found to have large effects on the reduction of binge eating. Regarding pharmacotherapy, mainly comprising antidepressants, randomized controlled trials revealed medium effects for the reduction of binge eating. Uncontrolled studies on weight-loss treatments demonstrated moderate reductions of binge eating. Combination treatments did not result in higher effects compared with single-treatment regimens. Except for weight-loss…
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Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD).
Background: PTSD is an anxiety disorder related to exposure to a severe psychological trauma. Symptoms include re-experiencing the event, avoidance and arousal as well as distress and impairment resulting from these symptoms. Guidelines suggest a combination of both psychological therapy and pharmacotherapy may enhance treatment response, especially in those with more severe PTSD or in those who have not responded to either intervention alone.
Objectives: To assess whether the combination of psychological therapy and pharmacotherapy provides a more efficacious treatment for PTSD than either of these interventions delivered separately.
Search strategy: Searches were conducted on the trial registers kept by the CCDAN group (CCDANCTR-Studies and CCDANCTR-References) to June 2010. The reference sections of included studies and several conference abstracts were also scanned.
Selection criteri…
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Reger MA, Gahm GA (2009)meta-analysisMEDLINE-indexed journal, not yet read by usJournal of clinical psychology118 citations A meta-analysis of the effects of internet- and computer-based cognitive-behavioral treatments for anxiety.
Internet-and computer-based cognitive-behavioral treatments have been introduced as novel approaches to deliver standard, quality treatment that may reduce barriers to care. The purpose of this review is to quantitatively summarize the literature examining the treatment effects of Internet- or computer-based treatment (ICT) on anxiety. Nineteen randomized controlled ICT trials were identified and subjected to fixed and random effects meta-analytic techniques. Weighted mean effect sizes (Cohen's d) showed that ICT was superior to waitlist and placebo assignment across outcome measures (ds=.49-1.14). The effects of ICT also were equal to therapist-delivered treatment across anxiety disorders. However, conclusions were limited by small sample sizes, the rare use of placebo controls, and other methodological problems. In addition, the number of available studies limited the opportunity to co…
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Virtual reality exposure therapy for anxiety disorders: A meta-analysis.
There is now a substantial literature investigating virtual reality exposure therapy (VRET) as a viable treatment option for anxiety disorders. In this meta-analysis we provide effect size estimates for virtual reality treatment in comparison to in vivo exposure and control conditions (waitlist, attention control, etc.). A comprehensive search of the literature identified 13 studies (n=397) that were included in the final analyses. Consistent with prediction the primary random effects analysis showed a large mean effect size for VRET compared to control conditions, Cohen's d=1.11 (S.E.=0.15, 95% CI: 0.82-1.39). This finding was consistent across secondary outcome categories as well (domain-specific, general subjective distress, cognition, behavior, and psychophysiology). Also as expected in vivo treatment was not significantly more effective than VRET. In fact, there was a small effect s…
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Siev J, Chambless DL (2007)meta-analysisMEDLINE-indexed journal, not yet read by usJournal of consulting and clinical psychology69 citations Specificity of treatment effects: cognitive therapy and relaxation for generalized anxiety and panic disorders.
The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were conducted, for GAD and PD separately, to review the treatment outcome literature directly comparing CT with RT in the treatment of those disorders. For GAD, CT and RT were equivalent. For PD, CT, which included interoceptive exposure, outperformed RT on all panic-related measures, as well as on indices of clinically significant change. There is ample evidence that both CT and RT qualify as bona fide treatments for GAD and PD, for which they are efficacious and intended to be so. Therefore, the finding that CT and RT do not differ in the treatment of GA…
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Behavioral activation treatments of depression: a meta-analysis.
Activity scheduling is a behavioral treatment of depression in which patients learn to monitor their mood and daily activities, and how to increase the number of pleasant activities and to increase positive interactions with their environment. We conducted a meta-analysis of randomized effect studies of activity scheduling. Sixteen studies with 780 subjects were included. The pooled effect size indicating the difference between intervention and control conditions at post-test was 0.87 (95% CI: 0.60 - 1.15). This is a large effect. Heterogeneity was low in all analyses. The comparisons with other psychological treatments at post-test resulted in a non-significant pooled effect size of 0.13 in favor of activity scheduling. In ten studies activity scheduling was compared to cognitive therapy, and the pooled effect size indicating the difference between these two types of treatment was 0.02.…
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Cognitive and perceptual variables in hypochondriasis and health anxiety: a systematic review.
This review examined (a) whether hypochondriacal/health-anxious individuals hold distinct assumptions about health and illness, (b) if triggering these assumptions leads to increased hypochondriacal concerns, and (c) whether these individuals perceive their bodily sensations differently from others (i.e., experience greater somatosensory amplification). There was clear evidence that health anxiety is related dysfunctional health-related beliefs. Few studies have examined how hypochondriacal concerns are triggered, and inconsistent results emerged from those that have. Health anxiety is also associated with self-reported higher levels of somatosensory amplification. However, there was little evidence that individuals high in health anxiety are actually more accurate perceivers of the their own autonomic processes. Although the results generally supported the central tenets of the cognitiv…
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Psychological interventions for needle-related procedural pain and distress in children and adolescents.
Background: Needle-related procedures are a common source of pain and distress for children. Several psychological (cognitive-behavioral) interventions to help manage or reduce pain and distress are available; however, a previous comprehensive systematic review of the efficacy of these interventions has not been conducted.
Objectives: To assess the efficacy of cognitive-behavioral psychological interventions for needle-related procedural pain and distress in children and adolescents.
Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (Issue 4, 2005), MEDLINE (1966 to 2005), PsycINFO (1887 to 2005), EMBASE (1974 to 2005), the Cumulative Index to Nursing and Allied Health Literature (1982 to 2005), Web of Science (1980 to 2005), and Dissertation-Abstracts International (1980 to 2005). We also searched citation lists and contact…
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Mitte K (2005)meta-analysisMEDLINE-indexed journal, not yet read by usJournal of affective disorders150 citations A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia.
The efficacy of (cognitive) behavioural ((C)BT) and pharmacological therapy was investigated using meta-analytic techniques. After a comprehensive review of the literature, the results of 124 studies were included. (C)BT was more effective than a no-treatment control and a placebo control. No difference of efficacy was found when using cognitive elements compared to not using them for anxiety; for associated depressive symptoms, additional cognitive elements seems superior. Pharmacotherapy was more effective than a placebo control; there was no superiority of any drug class. Sample size was related to effect size in pharmacotherapy and publication bias was found. (C)BT was at least as effective as pharmacotherapy and depending on type of analysis even significantly more effective. There were no significant differences between (C)BT alone and a combination approach but characteristics of …
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Chum J, Kim MS, Zielinski L, Bhatt M, Chung D, Yeung S, Litke K, McCabe K, Whattam J, Garrick L, O'Neill L, Goyert S, Merrifield C, Patel Y, Samaan Z (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usEvidence-based mental health30 citations Acceptability of the Fitbit in behavioural activation therapy for depression: a qualitative study.
Introduction: Major depressive disorder is characterised by low mood and poor motivation. Literature suggests that increased physical activity has positive effects on alleviating depression. Fitness-tracking devices may complement behavioural activation (BA) therapy to improve physical activity and mental health in patients with depression.
Objectives: To understand patients' perceived benefit from the Fitbit and explore themes associated with patient experiences. To compare perceived benefit, patient factors, Fitbit usage and Beck's Depression Inventory (BDI) scores.
Methods: Semistructured interviews were conducted with patients (n=36) who completed a 28-week BA group programme in a mood disorders outpatient clinic. All patients were asked to carry a Fitbit One device. We conducted thematic analyses on the interviews and exploratory quantitative analyses on patient characteristics, Fit…
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Jahoda A, Hastings R, Hatton C, Cooper SA, Dagnan D, Zhang R, McConnachie A, McMeekin N, Appleton K, Jones R, Scott K, Fulton L, Knight R, Knowles D, Williams C, Briggs A, MacMahon K, Lynn H, Smith I, Thomas G, Melville C (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe lancet. Psychiatry49 citations Comparison of behavioural activation with guided self-help for treatment of depression in adults with intellectual disabilities: a randomised controlled trial.
Background: Psychological therapies are first-line interventions for depression, but existing provision is not accessible for many adults with intellectual disabilities. We investigated the clinical and cost-effectiveness of a behavioural activation intervention (BeatIt) for people with intellectual disabilities and depression. BeatIt was compared with a guided self-help intervention (StepUp).
Methods: We did a multicentre, single-blind, randomised, controlled trial with follow-up at 4 months and 12 months after randomisation. Participants aged 18 years or older, with mild to moderate intellectual disabilities and clinically significant depression were recruited from health and social care services in the UK. The primary outcome was the Glasgow Depression Scale for people with a Learning Disability (GDS-LD) score at 12 months. Analyses were done on an intention-to-treat basis. This trial…
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