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A meta-analysis of the effects of internet- and computer-based cognitive-behavioral treatments for anxiety.

J Clin Psychol. 2009 Jan;65(1):53-75

Authors: Reger MA, Gahm GA

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 conduct analyses by diagnostic group; there was preliminary support for the use of ICT for panic disorder and phobia. Large, well-designed, placebo-controlled trials are needed to confirm and extend the results of this meta-analysis.

PMID: 19051274 [PubMed - indexed for MEDLINE]

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Cost-effectiveness and cost-utility of cognitive therapy, rational emotive behavioral therapy, and fluoxetine (Prozac) in treating depression: a randomized clinical trial.

J Clin Psychol. 2009 Jan;65(1):36-52

Authors: Sava FA, Yates BT, Lupu V, Szentagotai A, David D

Cost-effectiveness and cost-utility of cognitive therapy (CT), rational emotive behavioral therapy (REBT), and fluoxetine (Prozac) for major depressive disorder (MDD) were compared in a randomized clinical trial with a Romanian sample of 170 clients. Each intervention was offered for 14 weeks, plus three booster sessions. Beck Depression Inventory (BDI) scores were obtained prior to intervention, 7 and 14 weeks following the start of intervention, and 6 months following completion of intervention. CT, REBT, and fluoxetine did not differ significantly in changes in the BDI, depression-free days (DFDs), or Quality-Adjusted Life Years (QALYs). Average BDI scores decreased from 31.1 before treatment to 9.7 six months following completion of treatment. Due to lower costs, both psychotherapies were more cost-effective, and had better cost-utility, than pharmacotherapy: median $26.44/DFD gained/month for CT and $23.77/DFD gained/month for REBT versus $34.93/DFD gained/month for pharmacotherapy, median $/QALYs=$1,638, $1,734, and $2,287 for CT, REBT, and fluoxetine (Prozac), respectively.

PMID: 19051275 [PubMed - indexed for MEDLINE]

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Hypercaloric diets differing in fat composition have similar effects on serum leptin and weight gain in female subjects with anorexia nervosa.

Nutr Res. 2009 Jan;29(1):1-7

Authors: Mauler B, Dubben S, Pawelzik M, Pawelzik D, Weigle DS, Kratz M

Weight regain in subjects with anorexia nervosa is associated with an increase in serum leptin concentrations that is hypothesized to impair full weight restoration. As diets rich in n-3 polyunsaturated fatty acids (PUFA) have been described to lower serum leptin concentrations, we tested the hypothesis that consumption of a hypercaloric diet rich in n-3 PUFA is associated with an attenuated increase in serum leptin and a higher efficiency of body weight gain in subjects with anorexia nervosa. Twenty-five female subjects with anorexia nervosa were enrolled into this controlled dietary intervention study. Four subjects discontinued therapy or participation in the study prematurely, and six were excluded. 15 subjects completed the study. Subjects consumed hypercaloric diets rich in either saturated fatty acids (SFA, n = or n-3 PUFA (n = 7) for 5 weeks. Primary endpoints were the change in serum leptin concentrations and body weight gain relative to energy consumed. Serum leptin concentrations increased distinctly throughout the study (P < .001), and to a similar extend in both groups [+2.9 (SD 2.4) vs. +2.8 (SD 3.4) ng/mL in the SFA- and n-3 PUFA group, respectively; P = .487]. The efficiency of body weight gain also did not differ significantly between groups, with a body weight gain of 63.1 (SD 12.4) vs. 79.2 (SD 26.0) g per 4.2 MJ (1000 kcal) consumed in the SFA- and n-3 PUFA group, respectively (P = .132). Hypercaloric diets rich in either SFA or n-3 PUFA do not differ in their effects on serum leptin concentrations and the efficiency of body weight gain in female subjects with anorexia nervosa.

PMID: 19185771 [PubMed - indexed for MEDLINE]

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High court rejects challenge to NICE guidelines on chronic fatigue syndrome.

BMJ. 2009;338:b1110

Authors: Dyer C

PMID: 19293228 [PubMed - indexed for MEDLINE]

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An overview and history of interpersonal psychotherapy.

Nurs Stand. 2009 Mar 4-10;23(26):44-9

Authors: Sloan G, Hobson J, Leighton J, McFarlane B, Law R

Interpersonal psychotherapy is regarded as an effective psychotherapy particularly in the treatment of depression and has been around for more than 20 years. However, there is a paucity of information and discussion in the nursing literature. This article provides an overview of interpersonal psychotherapy, including its origins and historical background. This is followed by a description of the model and its application in patients with major depression.

PMID: 19323110 [PubMed - in process]

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The response of mental health professionals to clients seeking help to change or redirect same-sex sexual orientation.

BMC Psychiatry. 2009 Mar 26;9(1):11

Authors: Bartlett A, Smith G, King M

ABSTRACT: BACKGROUND: We know very little about mental health practitioners’ views on treatments to change sexual orientation. Our aim was to survey a representative sample of professional members of the main United Kingdom psychotherapy and psychiatric organisations about their views and practices concerning such treatments. METHODS: We sent postal questions to mental health professionals who were members of British Psychological Society, the British Association for Counselling and Psychotherapy, the United Kingdom Council for Psychotherapy and the Royal College of Psychiatrists. Participants were asked to give their views about treatments to change homosexual desires and describe up to six patients each, whom they have treated in this way. RESULTS: Of 1848 practitioners contacted, 1406 questionnaires were returned and 1328 could be analysed. Although only 55 (4%) of therapists reported that they would attempt to change a client’s sexual orientation if one consulted asking for such therapy, 222 (17%) reported having assisted at least one client/patient to reduce or change his or her homosexual or lesbian feelings. 413 patients were described by these 222 therapists: 213 (52%) were seen in private practice and 117 (28%) were not followed up beyond the period of treatment. Counselling was the commonest (66%) treatment offered and there was no sign of a decline in treatments in recent years. 159 (72%) of the 222 therapists who had provided such treatment considered that a service should be available for people who want to change their sexual orientation. Client/patient distress and client/patient autonomy were seen as reasons for intervention; therapists paid attention to religious, cultural and moral values causing internal conflict. CONCLUSIONS: A significant minority of mental health professionals are attempting to help lesbian, gay and bisexual clients to become heterosexual. Given lack of evidence for the efficacy of such treatments, this is likely to be unwise or even harmful.

PMID: 19323803 [PubMed - as supplied by publisher]

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Levels and effects of different forms of anxiety during pregnancy after a prior miscarriage.

Eur J Obstet Gynecol Reprod Biol. 2009 Jan;142(1):23-9

Authors: Fertl KI, Bergner A, Beyer R, Klapp BF, Rauchfuss M

OBJECTIVES: The aim of the study was to assess the current level of pregnancy-related fear and state anxiety in pregnant women who experienced prior miscarriages and to explore the impact of higher levels of anxiety during the first trimester on the following course and outcome of the pregnancy. STUDY DESIGN: One hundred forty-three pregnant women who had experienced prior miscarriage (sporadic or recurrent) were measured during each trimester and postpartum. Three independent control groups consisting of pregnant women without a history of miscarriage were recruited. For assessment, a battery of questionnaires including the STAI-state scale and various instruments were administered to record pregnancy-related fear, complications during pregnancy, the course of delivery and the health status of the neonate. Correlations, univariate logistic regression modelling, and ANOVA statistics including post hoc tests were conducted. RESULTS: Compared to women without miscarriages, women with prior miscarriage had higher levels of pregnancy-related fear and state anxiety during the first trimester. The level of anxiety differed between pregnant women with a single as compared to those with recurrent miscarriage. Early pregnancy-related fear significantly correlated with complications during pregnancy and delivery. This effect was not found for state anxiety. CONCLUSIONS: This study suggests that miscarriages may lead to higher levels of pregnancy-related fear and state anxiety. In particular, pregnancy-related fear may have a negative impact on the course of pregnancy and delivery. Thus, interventions to reduce pregnancy-related fear are highly recommended.

PMID: 18986753 [PubMed - indexed for MEDLINE]

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Perception and reality changes following the Fascia Congress.

J Bodyw Mov Ther. 2008 Jan;12(1):1-2

Authors: Chaitow L

PMID: 19083649 [PubMed - indexed for MEDLINE]

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Perspective: assume a spherical cow: the role of free or mobile electrons in bodywork, energetic and movement therapies.

J Bodyw Mov Ther. 2008 Jan;12(1):40-57

Authors: Oschman JL

Biomedical research has led to the hypothesis that inflammation is the culprit behind almost every modern chronic illness. Hence there is interest in techniques that can resolve acute and chronic inflammation. A natural method involves connecting the human body to the earth (earthing). When done during sleep, earthing normalizes the daily cortisol rhythm, improves sleep and reduces pain and inflammation. Direct electrical connection with the earth enables diurnal (daily) electrical rhythms and electrons to flow from the earth to the body. Electrons are thought to act as natural anti-oxidants by neutralizing positively charged inflammatory free radicals. This concept requires a revision of an old idea in physiology: the human body and the cells within it are best described as volume conductors, in which charge is only conducted by dissolved electrolytes. The discussion relates to the term, “ungrounded,” widely used by practitioners of bodywork, energetic and movement therapies.

PMID: 19083655 [PubMed - indexed for MEDLINE]

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Biochemistry and bodywork.

J Bodyw Mov Ther. 2008 Apr;12(2):95

Authors: Chaitow L

PMID: 19083661 [PubMed - in process]

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