Body, Mind & Spirit Articles and Latest News

Headache with medication overuse: treatment strategies and proposals of relapse prevention.

Neurol Sci. 2008 Apr;29(2):93-8

Authors: Grazzi L, Andrasik F, Usai S, Bussone G

The diagnosis of medication overuse headache (MOH) is clinically important, because patients rarely respond to preventive medications whilst overusing acute medications. Properly treating medication overuse and preventing relapse require recognition of the different factors that contribute to its development and perpetuation, including some behaviours and psychological elements that are important in sustaining the overuse of medication. This article reviews current clinical experiences of MOH patients treated with different approaches. Moreover, initial outcomes and long-term durability of treatments are discussed.

PMID: 18483706 [PubMed - indexed for MEDLINE]

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Athletic trainers’ and physical therapists’ perceptions of the effectiveness of psychological skills within sport injury rehabilitation programs.

J Athl Train. 2008 May-Jun;43(3):258-64

Authors: Hamson-Utley JJ, Martin S, Walters J

CONTEXT: Psychological skills are alleged to augment sport-injury rehabilitation; however, implementation of mental imagery within rehabilitation programs is limited. OBJECTIVE: To examine attitudes of athletic trainers (ATs) and physical therapists (PTs) on the effectiveness of mental imagery, goal setting, and positive self-talk to improve rehabilitation adherence and recovery speed of injured athletes. DESIGN: The ATs and PTs were contacted via electronic or physical mailings to complete a single administration survey that measured their beliefs about the effectiveness of psychological skills for increasing adherence and recovery speed of injured athletes undergoing rehabilitation. SETTING: Professional member databases of the National Athletic Trainers’ Association and the American Physical Therapy Association. PATIENTS OR OTHER PARTICIPANTS: Of the 1000 ATs and 1000 PTs who were selected randomly, 309 ATs (age = 34.18 +/- 8.32 years, years in profession = 10.67 +/- 7.34) and 356 PTs (age = 38.58 +/- 7.51 years, years in profession = 13.18 +/- 6.17) responded. MAIN OUTCOME MEASURE(S): The Attitudes About Imagery (AAI) survey measures attitudes about psychological skills for enhancing adherence and recovery speed of injured athletes. The AAI includes demographic questions and 15 items on a 7-point Likert scale measuring attitudes about the effectiveness of mental imagery, self-talk, goal setting, and pain control on rehabilitation adherence and recovery speed of injured athletes. Test-retest reliability ranged from .60 to .84 and Cronbach alphas ranged from .65 to .90. We calculated 1-way analyses of variance to determine whether differences existed in attitudes as a result of the professionals’ education, training experience, and interest. RESULTS: Mean differences were found on attitudes about effectiveness of psychological skills for those who reported formal training and those who reported interest in receiving formal training (P < .05). In addition, ATs held more positive attitudes than PTs on 9 of 15 AAI items (P < .05). CONCLUSIONS: Overall, ATs and PTs held positive attitudes on the effectiveness of psychological skills to augment the rehabilitation process. Clinical implications regarding the use of mental skills are discussed.

PMID: 18523575 [PubMed - indexed for MEDLINE]

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Bariatric surgery in adolescents.

J Sch Health. 2008 Aug;78(8):452-4

Authors: Hyman B, Kooi K, Ficklen D

PMID: 18651933 [PubMed - indexed for MEDLINE]

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Social skills treatment for people with severe, chronic acquired brain injuries: a multicenter trial.

Arch Phys Med Rehabil. 2008 Sep;89(9):1648-59

Authors: McDonald S, Tate R, Togher L, Bornhofen C, Long E, Gertler P, Bowen R

OBJECTIVE: To determine whether social skills deficits including unskilled, inappropriate behavior, problems reading social cues (social perception), and mood disturbances (such as depression and anxiety) could be remediated after severe traumatic brain injuries. DESIGN: Randomized controlled trial comparing a social skills program with social activity alone or with waitlist control. Several participants were reassigned after randomization. SETTING: Hospital outpatient and community facilities. PARTICIPANTS: Fifty-one outpatients from 3 brain injury units in Sydney, Australia, with severe, chronic acquired brain injuries were recruited. A total of 39 people (13 in skills training, 13 in social activity, 13 in waitlist) completed all phases of the study. INTERVENTION: Twelve-week social skills treatment program encompassing weekly 3-hour group sessions focused on shaping social behavior and remediating social perception and 1-hour individual sessions to address psychologic issues with mood, self-esteem, etc. MAIN OUTCOME MEASURES: Primary outcomes were: (1) social behavior during encounters with a confederate as rated on the Behaviorally Referenced Rating System of Intermediary Social Skills-Revised (BRISS-R), (2) social perception as measured by The Awareness of Social Inference Test, and (3) depression and anxiety as measured by the Depression, Anxiety and Stress Scale. Secondary outcomes were: relative report on social behavior and participation using: the Katz Adjustment Scale-R1; the Social Performance Survey Schedule; the La Trobe Communication Questionnaire; and the Sydney Psychosocial Reintegration Scale (both relative and self-report). RESULTS: Repeated-measures analysis of variance indicated that social activity alone did not lead to improved performance relative to waitlist (placebo effect) on any outcome variable. On the other hand, the skills training group improved differentially on the Partner Directed Behavior Scale of the BRISS-R, specifically the self-centered behavior and partner involvement behavior subscales. No treatment effects were found for the remaining primary outcomes (social perception, emotional adjustment) or for secondary outcome variables (relative and self-report measures of social function). CONCLUSIONS: This study suggested that treatment effects after social skills training in people with severe, chronic brain injuries are modest and are limited to direct measures of social behavior.

PMID: 18760150 [PubMed - indexed for MEDLINE]

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[Schizophrenia and psychosis–prevention and outcome]

Ugeskr Laeger. 2008 Sep 8;170(37):2872-4

Authors: Nordentoft M

Schizophrenia is described as developing through a premorbid phase, a prodromal phase, and a subsequent phase with psychotic symptoms. In the first phase, the only possible intervention is a reduction of the use of cannabis during adolescence. In the prodromal phase, intervention with cognitive behavioural treatment and antipsychotic treatment may postpone or inhibit transition to psychosis. Long duration of untreated psychosis is related to poor outcome. Early detection programmes can reduce the duration of untreated psychosis. There is good evidence that interventions during the early phase of psychotic symptoms are effective in improving several outcomes.

PMID: 18796281 [PubMed - indexed for MEDLINE]

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[Integrative treatment in psychiatric hospitals brings long-term improvements to local outpatient treatment structures]

Versicherungsmedizin. 2008 Sep 1;60(3):122-7

Authors: Banger M

In the future, a range of outpatient solutions with services provided by different partners will have to be developed for highly complex psychiatric cases. The programme expenses will be covered by different institutions. Taking the example of the Department of Addiction and Psychotherapy of the Rhine state hospital in Bonn, three integrative projects are presented, which have had a secondary, lasting effect on local outpatient treatment structures. Besides the excellent clinical cooperation between the different institutions involved, an important element of all three projects has been the intensive cooperation between all three sponsors. For the future, it will be necessary to create financial incentives for the participants in addition to promoting integrative approaches. Much creative management is also needed on the part of the psychiatric hospital in order to fulfil its role as a centre of competence for psychiatric problems.

PMID: 18807343 [PubMed - in process]

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A systematic review of the efficacy of non-pharmacological treatments for depression on glycaemic control in type 2 diabetics.

J Clin Nurs. 2008 Oct;17(19):2524-30

Authors: Wang MY, Tsai PS, Chou KR, Chen CM

Aims and objectives. This paper reported a systematic review of three randomised controlled clinical trials evaluating the efficacy of non-pharmacological treatment of depression on glycaemic control in individuals with type 2 diabetes. Background. Depression is associated with poor adherence to self-care regimen in individuals with diabetes. A significant relationship between depression and poor glycaemic control has also been suggested. Hence, the management of depression becomes an important aspect of diabetes care. Design. Systematic review. Methods. Cochrane library, Pubmed, MEDLINE, EBM review, ProQuest Medical Bundle and SCOPUS databases were searched using the following medical subject headings or key words - depression, mood disorder, depressive symptoms, diabetes mellitus, glycaemic control, glycated haemoglobin, glucose, psychological therapy, psychotherapy, non-pharmacological therapy and cognitive behaviour therapy. The publication date was limited from 1996-2007. Studies were selected if they used a randomised controlled trial design, were written in English, used non-pharmacological treatments for treating depression, included individuals with type 2 diabetes mellitus as participants and included depressive symptoms and glycaemic control (determined by haemoglobin A(1)C) as outcomes. Results. Non-pharmacological treatments of depression reduce depressive symptoms in diabetic patients. However, cognitive behaviour therapy did not improve glycaemic control. The treatment effect sizes for glycaemic control in the two collaborative-care programmes were also small. Conclusions. The available evidence indicated that non-pharmacological treatment of depression had limited effect on glycaemic control in individuals with type 2 diabetes. Relevance to clinical practice. The depression-focused interventions might not achieve optimal diabetes-related outcomes. The beneficial effect of psychological treatment for glycaemic control may be strengthened by employing treatments tailored to each individual’s diabetes self-care needs in addition to depression management.

PMID: 18808619 [PubMed - in process]

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Breath Alcohol Level and Plasma Amino Acids: A Comparison between Older and Younger Chronic Alcohol-Dependent Patients.

Alcohol Alcohol. 2008 Sep 22;

Authors: Walter H, Schlaff WB, Lesch OM, Vitek L, Zima T, Hartl D, Dvorak A, Gutierrez-Lobos K, Thau K, De Witte P

AIM: The aim of the present study is to examine the distribution of plasma excitatory and inhibitory amino acids, according to the age and current breath alcohol levels (BrAl+/-), of alcohol-dependent patients. Participants and METHODS: 78 alcohol-dependent patients (mean age = 46.2 +/- 11 years, men/women = 54/24) were clinically tested, including the determination of the major excitatory as well as inhibitory amino acids. The independent variables were gender, age and current alcohol consumption measured with the breath alcohol level (BrAl +/- status). RESULTS: In comparison to BrAl negatives, BrAl positives had higher plasma levels of glutamic acid (P = 0.01) and proline (P = 0.026), and lower levels of aminobutyric acid (P = 0.002), serine (P = 0.031) and urea (P = 0.01). In the BrAl positives, no age effect was found related to the plasma amino acids. In contrast, the BrAl negatives displayed age-related differences. The older (>/=50 years) BrAl negative patients had higher plasma levels of cystine, tyrosine, citrulline and urea, and lower histidine levels, compared to the younger group (<50 years). In general, differences in plasma levels of certain amino acids were dependent on gender, BrAl status, age and biochemical markers (GGT, MCV) of alcohol abuse. CONCLUSIONS: Abstaining patients (BrAl-/) display age-related differences in AAs’ distribution, while active drinking (BrAl+/) seems to even out those differences, underpinning the hypothesis that drinking mimics changes seen with advanced age.

PMID: 18809690 [PubMed - as supplied by publisher]

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Comparison of combined psycho- and pharmacotherapy with monotherapy in anxiety disorders: controversial viewpoints and clinical perspectives.

J Neural Transm. 2008 Sep 23;

Authors: Zwanzger P, Diemer J, Jabs B

Anxiety disorders are among the most frequent psychiatric disorders. Experimental evidence supports both psychotherapy as well as pharmacotherapy as effective treatments. There is, however, a controversy concerning the efficacy of a combination of both approaches. While some studies suggest that combined treatment enhances efficacy, others report conflicting results. This article traces the positions in this debate. We present the results from two recent meta-analyses and discuss implications for clinical practice and further research. We suggest that a research strategy that strives to establish differential indications based on patient characteristics should be preferred over attempts to reach a global judgement of the question, which appears too simplistic given the complexity of the issue.

PMID: 18810307 [PubMed - as supplied by publisher]

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The Obsessive-Compulsive Inventory-Revised (OCI-R): validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders.

J Anxiety Disord. 2008 May;22(4):734-49

Authors: Gönner S, Leonhart R, Ecker W

The OCI-R is a psychometrically sound and valid self-report scale measuring the major symptoms of OCD on six dimensions: Checking, Washing, Ordering, Hoarding, Obsessing, and Neutralizing. Information is needed on its ability to discriminate OCD from depression. In this study, reliability and convergent, divergent, and known-groups validity of an authorized German version were examined in 381 patients with OCD, other anxiety and depressive disorders. Confirmatory factor analyses replicated the original six-factor structure in each sample. Moreover, results indicated good convergent, divergent, and known-groups validity for the full scale and the subscales in each sample, only a slight construct overlap between OCD and depression, anxiety, pathological worry, and perfectionism, and the relationships of the subscales with obsessive-compulsive personality features supported its construct validity. Previous findings for the original scale were replicated and extended in a different cultural context. However, the domains Neutralizing and Obsessions need further development.

PMID: 17913454 [PubMed - indexed for MEDLINE]

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