A Pilot Study of Group Mindfulness-Based Cognitive Therapy (MBCT) for Combat Veterans With Posttraumatic Stress Disorder (PTSD).
A Pilot Study of Group Mindfulness-Based Cognitive Therapy (MBCT) for Combat Veterans with Posttraumatic Stress Disorder (PTSD).
Depress Anxiety. 2013 Apr 17;
King AP, Erickson TM, Giardino ND, Favorite T, Rauch SA, Robinson E, Kulkarni M, Liberzon I
BACKGROUND: “Mindfulness-based” interventions show promise for stress reduction in general medical conditions, and initial evidence suggests that they are accepted in trauma-exposed individuals. Mindfulness-based cognitive therapy (MBCT) shows substantial efficacy for prevention of depression relapse, but it has been less studied in anxiety disorders. This study investigated the feasibility, acceptability, and clinical outcomes of an MBCT group intervention adapted for combat posttraumatic stress disorder (PTSD). METHODS: Consecutive patients seeking treatment for chronic PTSD at a VA outpatient clinic were enrolled in 8-week MBCT groups, modified for PTSD (four groups, n = 20) or brief treatment-as-usual (TAU) comparison group interventions (three groups, n = 17). Pre and posttherapy psychological assessments with clinician administered PTSD scale (CAPS) were performed with all patients, and self-report measures (PTSD diagnostic scale, PDS, and posttraumatic cognitions inventory, PTCI) were administered in the MBCT group. RESULTS: Intent to treat analyses showed significant improvement in PTSD (CAPS (t(19) = 4.8, P < .001)) in the MBCT condition but not the TAU conditions, and a significant Condition × Time interaction (F[1,35] = 16.4, P < .005). MBCT completers (n = 15, 75%) showed good compliance with assigned homework exercises, and significant and clinically meaningful improvement in PTSD symptom severity on posttreatment assessment in CAPS and PDS (particularly in avoidance/numbing symptoms), and reduced PTSD-relevant cognitions in PTCI (self blame). CONCLUSIONS: These data suggest group MBCT as an acceptable brief intervention/adjunctive therapy for combat PTSD, with potential for reducing avoidance symptom cluster and PTSD cognitions. Further studies are needed to examine efficacy in a randomized controlled design and to identify factors influencing acceptability and efficacy. HubMed – depression
Predictors of anxiety and depression in Egyptian thalassemic patients: A single center study.
Int J Hematol. 2013 Apr 18;
Yahia S, El-Hadidy MA, El-Gilany AH, Anwar R, Darwish A, Mansour AK
Thalassemic patients are vulnerable to emotional and behavioral problems. Each patient age group exhibits problems unique to that stage of development, and although up to 80 % of thalassemic patients are likely to have psychological disorders, e.g., anxiety and depression, predictors of these disorders remain poorly understood. The present study was designed to assess the prevalence of anxiety and depression in a sample of Egyptian thalassemic patients and to identify predictors of these psychiatric disorders. A case-control study was conducted in 218 thalassemic patients, with 244 healthy subjects as a control. All patients and control subjects were subjected to thorough evaluation of medical history and clinical examination, and examined by a psychiatrist using the clinician version of the structured clinical interview for DSM-IV (SCID-CV), hospital anxiety and depression scale and Coopersmith self-esteem inventory. Abnormal and borderline anxieties were reported by 36.7 and 20.6 % of thalassemic patients, respectively, while abnormal and borderline depressions were reported by 32.1 and 16.1 % of patients, respectively. Hospitalization, low self-esteem, diabetes mellitus and heart failure were independent predictors of anxiety. The independent predictors of depression were heart failure, hospitalization, diabetes mellitus, short stature and delayed puberty. Thalassemic patients were more vulnerable to anxiety and depression, indicating that screening and management for such psychiatric disorders should be considered in treating all such patients. HubMed – depression
[The relationship between adverse childhood experiences and mental health in adulthood. A systematic literature review.]
Tijdschr Psychiatr. 2013; 55(4): 259-268
De Venter M, Demyttenaere K, Bruffaerts R
BACKGROUND: Traumatic childhood experiences are important societal problems and have far-reaching mental and somatic consequences. There is a considerable amount of literature concerning the relationship between adverse childhood experiences (aces) and anxiety, depression and substance abuse in adulthood. AIM: To integrate systematically all available research data on this relationship. METHOD: We studied the literature via PubMed and Psycinfo using the search terms ‘aces’, ‘anxiety’, ‘depression’, ‘substance abuse’, and ‘impact’. RESULTS: 65 publications were included in our study. Child abuse, substance abuse and parents’ divorce were found to be very frequent risk factors. On average, the occurrence of emotional, sexual and physical child abuse was the most important risk factor for the development of depression. The greatest risk factors for anxiety disorders were sexual child abuse and family violence. Strong correlations were also found between family violence or physical neglect and substance abuse. CONCLUSION: Strong correlations were shown to exist between various aces and later symptoms or diagnoses of depressive and anxiety disorders in persons abusing drugs or alcohol. It seems to be mainly child abuse and family violence which have a major impact on the future mental health of victims. HubMed – depression
[Defence style and therapeutic technique as predictors of the outcome of psychodynamic psychotherapy in depression.]
Tijdschr Psychiatr. 2013; 55(4): 247-257
Hendriksen M, Dekker JJ, de Jonghe FE, Gijsbers van Wijk CM, Peen J, Van HL
BACKGROUND: In psychodynamic psychotherapy it is assumed that insight-fostering interventions lead to better results when used with patients who have relatively strong personality structures. AIM: To investigate to what extent the use of supportive or insight-fostering interventions is determined by sociodemographic variables, the severity, duration and recurrence of depression and defence style and to find out whether the type of intervention used can predict the treatment outcome of psychotherapy in depression. METHOD: The study-group consisted of 147 depressed patients with or without a comorbid personality disorder who had been treated with supportive PsychoDynamic Therapy (pdt) with or without medication and for whom the Therapist Evaluation Form (tef) was available. On the tef the therapist assessed the patients’ defence style and the therapeutic technique that was used. The most important outcome measure was the Hamilton Depression Rating Scale (ham-d). RESULTS: No correlation was found between technique used and sociodemographic characteristics or the severity and duration of the depression. Insight-fostering interventions were related to better treatment outcomes. Not only age and educational level but also defence style turned out to be confounding variables in the relationship between technique and outcome. We found no interaction between treatment success and insight-fostering interventions in patients who used mature defence styles. CONCLUSION: In our study it was defence style as evaluated by the therapist rather than the technique used which was the strongest independent predictor of a successful outcome. This indicates that patients with primitive defence styles may also benefit from insight-fostering interventions. HubMed – depression
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