Talking treatment in general.
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26 to 50 of 1,623Omega-3 fatty acids and supportive psychotherapy for perinatal depression: a randomized placebo-controlled study.
Background: Perinatal major depressive disorder (MDD), including antenatal and postpartum depression, is common and has serious consequences. This study was designed to investigate the feasibility, safety, and efficacy of omega-3 fatty acids for perinatal depression in addition to supportive psychotherapy.
Methods: Perinatal women with MDD were randomized to eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), 1.9g/day, or placebo for 8weeks. A manualized supportive psychotherapy was provided to all subjects. Symptoms were assessed with the Hamilton Rating Scale for Depression (HAM-D) and Edinburgh Postnatal Depression Scale (EPDS) biweekly.
Results: Fifty-nine women enrolled; N = 51 had two data collection points that allowed for evaluation of efficacy. Omega-3 fatty acids were well tolerated. Participants in both groups experienced significant decreases in EPDS and HAM-D scores (p<.…
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A Systematic Review and Meta-Analysis: Psychotherapy Interventions for Reducing Suicidal Thoughts and Behaviors Among Black Youth.
Objective: Suicides continue to increase among youth, with substantial disparities among Black youth. Culturally responsive evidence-based interventions for Black youth are urgently needed to disrupt these inequities. This study aimed to identify evidence-based psychotherapy interventions for suicidal thoughts and behaviors among Black youth and examine how existing intervention manuals have integrated culturally relevant content to Black youth.
Method: Literature searches were conducted to identify relevant articles comparing the effectiveness of interventions for suicidal thoughts and behaviors in study populations including >30% Black youth and youth participants up to age 25. Published articles and therapy manuals were analyzed on cultural adaptation and on 7 content domains for cultural adaptation. Meta-analysis used a random-effects model and explored potential moderators.
Results:…
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Stoffers-Winterling JM, Storebø OJ, Kongerslev MT, Faltinsen E, Todorovac A, Sedoc Jørgensen M, Sales CP, Edemann Callesen H, Pereira Ribeiro J, Völlm BA, Lieb K, Simonsen E (2022)meta-analysisMEDLINE-indexed journal, not yet read by usThe British journal of psychiatry : the journal of mental science75 citations Psychotherapies for borderline personality disorder: a focused systematic review and meta-analysis.
Background: A recently updated Cochrane review supports the efficacy of psychotherapy for borderline personality disorder (BPD).
Aims: To evaluate the effects of standalone and add-on psychotherapeutic treatments more concisely.
Method: We applied the same methods as the 2020 Cochrane review, but focused on adult samples and comparisons of active treatments and unspecific control conditions. Standalone treatments (i.e. necessarily including individual psychotherapy as either the sole or one of several treatment components) and add-on interventions (i.e. complementing any ongoing individual BPD treatment) were analysed separately. Primary outcomes were BPD severity, self-harm, suicide-related outcomes and psychosocial functioning. Secondary outcomes were remaining BPD diagnostic criteria, depression and attrition.
Results: Thirty-one randomised controlled trials totalling 1870 participant…
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Dropout from randomised controlled trials of psychological treatments for depression in children and youth: a systematic review and meta-analyses.
Background: Depression is a prevalent and disabling condition in youth. Treatment efficacy has been demonstrated for several therapeutic modalities. Acceptability of treatments is also important to explore and was addressed by investigating treatment dropout using meta-analyses.
Methods: A systematic search was conducted using MEDLINE, CINAHL and PsycARTICLES databases. Peer-reviewed randomised controlled trials investigating psychotherapy treatment of depression in children and youth (aged up to and including 18 years) were included. Proportion meta-analyses were used to calculate estimated dropout rates; odds ratios assessed whether there was greater dropout from intervention or control arms and meta-regressions investigated for associations between dropout, study and treatment characteristics.
Results: Thirty-seven studies were included (N=4343). Overall estimate of dropout from activ…
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The Effect of Concurrent Depression on PTSD Outcomes in Trauma-Focused Psychotherapy: A Meta-Analysis of Randomized Controlled Trials.
The co-occurrence of depression with posttraumatic stress disorder (PTSD) is common and associated with greater severity and impairment than PTSD alone, but the effects on PTSD treatment outcomes are unclear. This study investigated the impact of baseline depression on PTSD symptom change and dropout in a meta-analysis of 44 randomized controlled trials (N = 4,866) of trauma-focused psychotherapies for PTSD. Analyses included 107 active (k = 71) and control (k = 36) conditions. Baseline depression was indexed within samples as (a) continuous symptom severity (e.g., Beck Depression Inventory), standardized across depression measures and (b) proportion of patients with comorbid depressive disorder diagnosis. Among active conditions reporting continuous depression scores (k = 62), greater depression severity predicted smaller PTSD treatment effect sizes (ß = -.36, p = .002), but not dropout…
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Impact of comorbid personality disorders on psychotherapy for post-traumatic stress disorder: systematic review and meta-analysis.
Background: Although personality disorders are common in PTSD patients, it remains unclear to what extent this comorbidity affects PTSD treatment outcome. Objective: This constitutes the first meta-analysis investigating whether patients with and without comorbid personality disorders can equally benefit from psychotherapy for PTSD. Method: A systematic literature search was conducted in PubMed, EMBASE, PsychINFO and Cochrane databases from inception through 31 January 2020, to identify clinical trials examining psychotherapies for PTSD in PTSD patients with and without comorbid personality disorders (PROSPERO reference CRD42020156472). Results: Of the 1830 studies identified, 12 studies reporting on 918 patients were included. Effect sizes were synthesized using a random-effects model. Patients with comorbid personality disorders did not have significantly higher baseline PTSD severity …
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The applied implications of epigenetics in anxiety, affective and stress-related disorders - A review and synthesis on psychosocial stress, psychotherapy and prevention.
Mental disorders are highly complex and multifactorial in origin, comprising an elaborate interplay of genetic and environmental factors. Epigenetic mechanisms such as DNA modifications (e.g. CpG methylation), histone modifications (e.g. acetylation) and microRNAs function as a translator between genes and the environment. Indeed, environmental influences such as exposure to stress shape epigenetic patterns, and lifetime experiences continue to alter the function of the genome throughout the lifespan. Here, we summarize the recently burgeoning body of research regarding the involvement of aberrant epigenetic signatures in mediating an increased vulnerability to a wide range of mental disorders. We review the current knowledge of epigenetic changes to constitute useful markers predicting the clinical response to psychotherapeutic interventions, and of psychotherapy to alter - and potentia…
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Enduring effects of psychological treatments for anxiety disorders: meta-analysis of follow-up studies.
Background: It is a widespread opinion that after treatment with psychotherapy, patients with anxiety disorders maintain their gains beyond the active treatment period, whereas patients treated with medication soon experience a relapse after treatment termination. AimsWe aimed to provide evidence on whether enduring effects of psychotherapy differ from control groups.
Method: We searched 93 randomised controlled studies with 152 study arms of psychological treatment (cognitive-behavioural therapy or other psychotherapies) for panic disorder, generalised anxiety disorder and social anxiety disorder that included follow-up assessments. In a meta-analysis, pre-post effect sizes for end-point and all follow-up periods were calculated and compared with control groups (medication: n = 16 study arms; pill and psychological placebo groups: n = 17 study arms).
Results: Gains with psychotherapy we…
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A new therapy for each patient: Evidence-based relationships and responsiveness.
In this study, we introduce the journal issue devoted to evidence-based responsiveness and frame it within the work of the third interdivisional APA Task Force on Evidence-Based Relationships and Responsiveness. We summarize the meta-analytic results and clinical practices on the adaptations of psychotherapy to multiple transdiagnostic characteristics of the patient, including attachment style, culture (race/ethnicity), gender identity, coping style, therapy preferences, reactance level, religion and spirituality, sexual orientation, and stages of change. We then discuss the clinical and research process of determining what works, and what does not work, for whom. The limitations of the Task Force's work are outlined and frequently asked questions are addressed. The article closes with the Task Force's formal conclusions and 28 recommendations and with some reflections on fitting psychot…
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Long-term efficacy of psychotherapy for posttraumatic stress disorder: A meta-analysis of randomized controlled trials.
Psychotherapies are well established as efficacious acute interventions for posttraumatic stress disorder (PTSD). However, the long-term efficacy of such interventions and the maintenance of gains following termination is less understood. This meta-analysis evaluated enduring effects of psychotherapy for PTSD in randomized controlled trials (RCTs) with long-term follow-ups (LTFUs) of at least six months duration. Analyses included 32 PTSD trials involving 72 treatment conditions (N=2935). Effect sizes were significantly larger for active psychotherapy conditions relative to control conditions for the period from pretreatment to LTFU, but not posttreatment to LTFU. All active interventions demonstrated long-term efficacy. Pretreatment to LTFU effect sizes did not significantly differ among treatment types. Exposure-based treatments demonstrated stronger effects in the posttreatment to LTF…
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Systematic review and meta-analysis of dropout rates in individual psychotherapy for generalized anxiety disorder.
Background: Despite being a relatively prevalent and debilitating disorder, Generalized Anxiety Disorder (GAD) is the second least studied anxiety disorder and among the most difficult to treat. Dropout from psychotherapy is concerning as it is associated with poorer outcomes, leads to service inefficiencies and can disproportionately affect disadvantaged populations. No study to date has calculated a weighted mean dropout rate for GAD and explored associated correlates.
Methods: A systematic review was conducted using PsycINFO, Medline and Embase databases, identifying studies investigating individual psychotherapies for adults with GAD. Forty-five studies, involving 2224 participants, were identified for meta-analysis.
Results: The weighted mean dropout rate was 16.99% (95% confidence interval 14.42%-19.91%). The Q-statistic indicated significant heterogeneity among studies. Moderator …
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Amoroso T, Workman M (2016)meta-analysisMEDLINE-indexed journal, not yet read by usJournal of psychopharmacology (Oxford, England)57 citations Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy.
Since the wars in Iraq and Afghanistan, posttraumatic stress disorder (PTSD) has become a major area of research and development. The most widely accepted treatment for PTSD is prolonged exposure (PE) therapy, but for many patients it is intolerable or ineffective. ±3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy (MDMA-AP) has recently re-emerged as a new treatment option, with two clinical trials having been published and both producing promising results. However, these results have yet to be compared to existing treatments. The present paper seeks to bridge this gap in the literature. Often the statistical significance of clinical trials is overemphasized, while the magnitude of the treatment effects is overlooked. The current meta-analysis aims to provide a comparison of the cumulative effect size of the MDMA-AP studies with those of PE. Effect sizes were calculated fo…
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Parikh SV, Quilty LC, Ravitz P, Rosenbluth M, Pavlova B, Grigoriadis S, Velyvis V, Kennedy SH, Lam RW, MacQueen GM, Milev RV, Ravindran AV, Uher R, CANMAT Depression Work Group (2016)meta-analysisMEDLINE-indexed journal, not yet read by usCanadian journal of psychiatry. Revue canadienne de psychiatrie204 citations Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments.
Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) has revised its 2009 guidelines for the management of major depressive disorder (MDD) in adults by updating the evidence and recommendations. The target audiences for these 2016 guidelines are psychiatrists and other mental health professionals.
Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. "Psychological Treatments" is the second of six sections of the 2016 guidelines.
Results: Evidence-informed responses were developed for 25 questions under 5 broad categories: 1) patient characteristics relevant to using psychological interventions; 2) therapist…
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Dropout from individual psychotherapy for major depression: A meta-analysis of randomized clinical trials.
Dropout from mental health treatment poses a substantial problem, but rates vary substantially across studies and diagnoses. Focused reviews are needed to provide more detailed estimates for specific areas of research. Randomized clinical trials involving individual psychotherapy for unipolar depression are ubiquitous and important, but empirical data on average dropout rates from these studies is lacking. We conducted a random-effects meta-analysis of 54 such studies (N=5852) including 80 psychotherapy conditions, and evaluated a number of predictors of treatment- and study-level dropout rates. Our overall weighted dropout estimates were 19.9% at the study level, and 17.5% for psychotherapy conditions specifically. Therapy orientation did not significantly account for variance in dropout estimates, but estimates were significantly higher in psychotherapy conditions with more patients of…
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Cahill K, Lancaster T (2014)meta-analysisMEDLINE-indexed journal, not yet read by usThe Cochrane database of systematic reviews124 citations Workplace interventions for smoking cessation.
Background: The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation.
Objectives: 1. To categorize workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking.2. To collect and evaluate data on costs and cost effectiveness associated with workplace interventions.
Search methods: We searched the Cochrane Tobacco Addiction Group Specialized Register (July 2013), MEDLINE (1966 - July 2013), EMBASE (1985 - June 2013), and PsycINFO (to June 2013), amongst others. We searched abstracts from international conferences on tobacco and the bibliographies of identified studies and reviews for additional references.
Selection criteria: We selected interventions conducted in the workplace to promote smoking cessation. We included only randomized and q…
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Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults.
Background: Post-traumatic stress disorder (PTSD) is a distressing condition, which is often treated with psychological therapies. Earlier versions of this review, and other meta-analyses, have found these to be effective, with trauma-focused treatments being more effective than non-trauma-focused treatments. This is an update of a Cochrane review first published in 2005 and updated in 2007.
Objectives: To assess the effects of psychological therapies for the treatment of adults with chronic post-traumatic stress disorder (PTSD).
Search methods: For this update, we searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR-Studies and CCDANCTR-References) all years to 12th April 2013. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to d…
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Lancaster T, Stead LF (2005)meta-analysisMEDLINE-indexed journal, not yet read by usThe Cochrane database of systematic reviews303 citations Individual behavioural counselling for smoking cessation.
Background: Individual counselling from a smoking cessation specialist may help smokers to make a successful attempt to stop smoking.
Objectives: The objective of the review is to determine the effects of individual counselling.
Search strategy: We searched the Cochrane Tobacco Addiction Group Specialized Register for studies with counsel* in any field. Date of the most recent search: December 2004.
Selection criteria: Randomized or quasi-randomized trials with at least one treatment arm consisting of face-to-face individual counselling from a healthcare worker not involved in routine clinical care. The outcome was smoking cessation at follow up at least six months after the start of counselling.
Data collection and analysis: Both authors extracted data. The intervention and population, method of randomization and completeness of follow up were recorded.
Main results: We identified 21 tr…
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Promoting resilience in adolescents and young adults with cancer: Results from the PRISM randomized controlled trial.
Background: Adolescents and young adults (AYAs) with cancer are at risk for poor psychosocial outcomes. This study aimed to determine whether a novel intervention targeting resilience resources would improve patient-reported resilience, quality of life, and psychological distress.
Methods: In this parallel, phase 2 randomized controlled trial, English-speaking AYAs (12-25 years old) with cancer were randomized to the Promoting Resilience in Stress Management (PRISM) intervention or usual care (UC). PRISM is a brief, skills-based intervention targeting stress management, goal setting, cognitive reframing, and meaning making. Participants completed surveys at enrollment and 6 months. Mixed effects regression models evaluated associations between PRISM and the primary outcome (10-item Connor-Davidson Resilience Scale scores) and secondary outcomes (generic and cancer-related quality of life…
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Nadkarni A, Weiss HA, Weobong B, McDaid D, Singla DR, Park AL, Bhat B, Katti B, McCambridge J, Murthy P, King M, Wilson GT, Kirkwood B, Fairburn CG, Velleman R, Patel V (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usPLoS medicine56 citations Sustained effectiveness and cost-effectiveness of Counselling for Alcohol Problems, a brief psychological treatment for harmful drinking in men, delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial.
Background: Counselling for Alcohol Problems (CAP), a brief intervention delivered by lay counsellors, enhanced remission and abstinence over 3 months among male primary care attendees with harmful drinking in a setting in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of CAP over 12 months, and the effects of the hypothesized mediator 'readiness to change' on clinical outcomes.
Methods and findings: Male primary care attendees aged 18-65 years screening with harmful drinking on the Alcohol Use Disorders Identification Test (AUDIT) were randomised to either CAP plus enhanced usual care (EUC) (n = 188) or EUC alone (n = 189), of whom 89% completed assessments at 3 months, and 84% at 12 months. Primary outcomes were remission and mean standard ethanol consumed in the past 14 days, and the proposed mediating variable was readiness t…
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Patel V, Weiss HA, Chowdhary N, Naik S, Pednekar S, Chatterjee S, De Silva MJ, Bhat B, Araya R, King M, Simon G, Verdeli H, Kirkwood BR (2010)randomised controlled trialMEDLINE-indexed journal, not yet read by usLancet (London, England)469 citations Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial.
Background: Depression and anxiety disorders are common mental disorders worldwide. The MANAS trial aimed to test the effectiveness of an intervention led by lay health counsellors in primary care settings to improve outcomes of people with these disorders.
Methods: In this cluster randomised trial, primary care facilities in Goa, India, were assigned (1:1) by computer-generated randomised sequence to intervention or control (enhanced usual care) groups. All adults who screened positive for common mental disorders were eligible. The collaborative stepped-care intervention offered case management and psychosocial interventions, provided by a trained lay health counsellor, supplemented by antidepressant drugs by the primary care physician and supervision by a mental health specialist. The research assessor was masked. The primary outcome was recovery from common mental disorders as defined…
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Kleinschmitt A (2024)systematic reviewMEDLINE-indexed journal, not yet read by usTranscultural psychiatry Research on psychotherapy for refugees in Germany: A systematic review on its transdisciplinary and transregional opening.
Recently, an increasing amount of research has focused on adapting psychotherapy concepts for refugees moving to Germany. For a long time, research from disciplines like anthropology and cultural studies has problematized the eurocentrism of psychology's theoretical premises and methodologies. Currently, scholarship around Global Mental Health and decolonization emphasizes how knowledge production from various disciplines and regions relates to this topic and could contribute to improving respective approaches. Consequently, this review aims at evaluating the actual transdisciplinary and transregional opening of studies on psychotherapeutic interventions for refugees in Germany. It provides a theoretically as well as empirically informed basis for looking at disciplinary premises, practices, and boundaries as well as the regional locatedness of respective research. Fourteen relevant stud…
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A systematic review and meta-ethnography to explore people's experiences of psychotherapy for self-harm.
Background: Self-harm is a major public health concern. Lifetime prevalence is high, and rates of self-harm are rising; however, available interventions do not benefit everyone, and engagement with therapy can be low. Qualitative accounts allow for a greater understanding of what is helpful to individuals. This study aimed to synthesize the experiences of interventions for self-harm, from participants who have participated in these themselves.
Methods: Participants had self-harmed at least once and undergone an individual psychotherapeutic intervention for self-harm. Papers not written or translated to the English language were excluded. Four databases (Medline, CINAHL, Web of Science and PsycINFO) were systematically searched and each paper was assessed using the CASP quality appraisal tool. A meta-ethnographic approach to the synthesis was taken.
Results: Ten studies encompassing 104 p…
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Using Artificial Intelligence to Enhance Ongoing Psychological Interventions for Emotional Problems in Real- or Close to Real-Time: A Systematic Review.
Emotional disorders are the most common mental disorders globally. Psychological treatments have been found to be useful for a significant number of cases, but up to 40% of patients do not respond to psychotherapy as expected. Artificial intelligence (AI) methods might enhance psychotherapy by providing therapists and patients with real- or close to real-time recommendations according to the patient's response to treatment. The goal of this investigation is to systematically review the evidence on the use of AI-based methods to enhance outcomes in psychological interventions in real-time or close to real-time. The search included studies indexed in the electronic databases Scopus, Pubmed, Web of Science, and Cochrane Library. The terms used for the electronic search included variations of the words "psychotherapy", "artificial intelligence", and "emotional disorders". From the 85 full te…
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Non-pharmacological treatment of gambling disorder: a systematic review of randomized controlled trials.
Background: The main focus of the non-pharmacological treatment of Gambling Disorder (GD) is the behaviour, cognition and motivation of the patient, addressing the psychological determinants of gambling. Although there is not a gold standard non-pharmacological treatment yet, many studies already had promising results, and the outcomes were even better when pharmacotherapies were combined with psychotherapies. This review intended to synthesise the efficacy of various available non-pharmacological therapies for GD evaluated in randomized controlled trials.
Methods: A systematic search was conducted in PubMed and in Cochrane Library for randomized controlled trials. Studies were included if participants had GD as their primary diagnosis and excluded if patients had other comorbidities.
Results: From 320 records identified, 22 studies were included in the critical appraisal. They included …
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The Effect of Psychotherapy on Quality of Life in IBD Patients: A Systematic Review.
Background: Patients with inflammatory bowel disease (IBD) express a need for additional psychotherapy; however, psychological support is not incorporated in the routine care of persons with IBD. This systematic review aims to assess the effect of psychotherapy on quality of life (QoL).
Methods: A systematic search was conducted on October 7, 2019, using Embase, Medline (Ovid), PubMed, Cochrane, Web of Science, PsycInfo, and Google Scholar to collect all types of clinical trials with psychotherapeutic interventions that measured QoL in patients with IBD aged ≥18 years. Quality of evidence was systematically assessed using the Grading of Recommendations Assessment, Development, and Evaluation criteria.
Results: Out of 2560 articles, 31 studies (32 articles) were included with a total number of 2397 patients with active and inactive IBD. Of the 31 eligible studies, 11 reported a significan…
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