Acceptance and Commitment Therapy as a Treatment for Scrupulosity in Obsessive Compulsive Disorder.
Acceptance and Commitment Therapy as a Treatment for Scrupulosity in Obsessive Compulsive Disorder.
Filed under: Depression Treatment
Behav Modif. 2013 Feb 11;
Dehlin JP, Morrison KL, Twohig MP
This study evaluated acceptance and commitment therapy (ACT) for scrupulosity-based obsessive compulsive disorder (OCD). Five adults were treated with eight sessions of ACT, without in-session exposure, in a multiple baseline across participants design. Daily monitoring of compulsions and avoided valued activities were tracked throughout the study. The Obsessive Compulsive Inventory-Revised, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Penn Inventory of Scrupulosity, Beck Depression Inventory-II, Quality of Life Scale, Santa Clara Strength of Religious Faith Questionnaire, and the Acceptance and Action Questionnaire-II were completed at pretreatment, posttreatment, and 3-month follow-up. The Treatment Evaluation Inventory was completed at posttreatment. Average daily compulsions reduced as follows: pretreatment = 25.0, posttreatment = 5.6, and follow-up = 4.3. Average daily avoided valued activities reduced as follows: pretreatment = 6.0, posttreatment = 0.7, and follow-up = 0.5. Other measures showed similar patterns. Religious faith only slightly declined: 4% at posttreatment and 7% at follow-up. Treatment acceptability was high.
HubMed – depression
The relationship of C-reactive protein to obesity-related depressive symptoms: A longitudinal study.
Filed under: Depression Treatment
Obesity (Silver Spring). 2012 Oct 3;
Daly M
Obesity has been shown to produce a state of systematic low-grade inflammation that may have detrimental neuropsychiatric effects. This study examined longitudinal associations between obesity, inflammation, and depressive symptoms amongst a cohort of older English adults over 4 years of follow-up. Participants were 3891 obese and non-obese people drawn from the English Longitudinal Study of Ageing (ELSA) [aged 64.9 (SD = 8.8) years, 44.6% men]. Depressive symptoms were assessed at baseline and after 4 years of follow-up using the eight-item Centre for Epidemiological Studies – Depression Scale (CES-D). Approximately 26.3% (N = 1 025) of the sample were categorized as obese at baseline. Obesity at baseline was associated with elevated levels of depressive symptoms at follow-up (P < .001), in analyses that adjusted for depression levels at baseline and sociodemographic and background variables including the prevalence of permanent illness/disability, alcohol consumption, sedentary behavior, and smoking. In addition, C-reactive protein (CRP) concentrations at baseline were independently associated with CES-D depression scores at follow-up (P = .008) in fully adjusted analyses. Subsequent mediation analyses revealed that CRP levels explained approximately 20% of the obesity-related longitudinal change in depression scores. These data suggest that chronic inflammation may be a key determinant of depressive symptoms in obesity. HubMed – depression
Influence of body mass index on the choice of therapy for depression and follow-up care.
Filed under: Depression Treatment
Obesity (Silver Spring). 2012 Oct 3;
Boudreau DM, Arterburn D, Bogart A, Haneuse S, Theis MK, Westbrook E, Simon G
Overweight and obese patients commonly suffer from depression and choice of depression therapy may alter weight. We conducted a cohort study to investigate whether obesity is associated with treatment choices for depression; and whether obesity is associated with appropriate duration of depression treatment and receipt of follow-up visits. Adults with a diagnosis of depression between January 1, 2006 and March 31, 2010 who had 1+ new episodes of an antidepressant medication and/or psychotherapy were eligible. Medication use, encounters, diagnoses, height, and weight were collected from health plan databases. We modeled receipt of the different therapies (medication and psychotherapy) by BMI and BMI trajectory during the 9-months prior to initiation of therapy using logistic regression models that accommodated correlation within provider and adjusted for covariates. We modeled BMI via a restricted cubic spline. Fluoxetine was the reference treatment option in the medication models. Lower BMI was associated with greater use of mirtazapine, and a declining BMI prior to treatment was associated with greater odds of initiating mirtazapine and paroxetine. Higher BMI was associated with greater odds of initiating bupropion even after adjustment for smoking status. Obese patients were less likely to receive psychotherapy and less likely to receive appropriate duration (180-days) of depression treatment compared to normal weight subjects. Our study provides evidence that BMI is considered when choosing therapy but associations were weak. Our results should prompt discussion about recommending and choosing depression treatment plans that optimize depression care and weight management concurrently. Differences in care and follow-up by BMI warrant additional research.
HubMed – depression
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