Body, Mind & Spirit Articles and Latest News

[Chronic pain and cognitive-behavioral treatment]

Zhonghua Kou Qiang Yi Xue Za Zhi. 2006 Sep;41(9):572-4

Authors: Zhao YP, Ma XC

PMID: 17129437 [PubMed - indexed for MEDLINE]

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Does age matter? Effects of cognitive rehabilitation across the age span.

Schizophr Res. 2009 Sep;113(2-3):252-8

Authors: Wykes T, Reeder C, Landau S, Matthiasson P, Haworth E, Hutchinson C

BACKGROUND: Cognitive remediation (CR) therapy in its various disguises can be helpful for people with schizophrenia but it is not clear if patient characteristics are likely to interfere with its effectiveness. METHODOLOGY: This paper describes the assessment of one putative moderating variable, age, on the outcome of CRT in a rigorous randomised control trial with memory, cognitive flexibility and planning as primary outcomes and social behaviour, symptoms and self-esteem as secondary outcomes. Calendar age was divided into younger (< 40; N55) and older (40 or more years; N30). There were no differences between the groups at baseline in their cognitive, social or demographic data except on predicted variables. RESULTS: Younger people benefited more from cognitive remediation in two of the three cognitive domains tested. In the memory domain both groups benefited. Only negative symptoms showed a moderating effect of age on CRT, where again the younger group showed improvements in the context of CRT but the older group did not. When older people did show a cognitive advantage in memory following therapy this cognitive improvement benefited social behaviour. CONCLUSION: CRT needs some modification to increase the benefits to older participants. However, any cognitive improvements do still seem to have a beneficial effect.

PMID: 19524409 [PubMed - indexed for MEDLINE]

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Defining and predicting functional outcome in schizophrenia and schizophrenia spectrum disorders.

Schizophr Res. 2009 Sep;113(2-3):210-7

Authors: Schennach-Wolff R, Jäger M, Seemüller F, Obermeier M, Messer T, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Huff W, Heuser I, Maier W, Lemke MR, Rüther E, Buchkremer G, Gastpar M, Möller HJ, Riedel M

BACKGROUND: To assess criteria and to identify predictive factors for functional outcome. The criteria should cover all domains proposed by the Remission in Schizophrenia Working Group. METHOD: PANSS ratings were used to evaluate the symptomatic treatment outcome of 262 inpatients with schizophrenia spectrum disorders within a naturalistic multicenter trial. Functional remission was defined as a GAF score >61 (Global Assessment of Functioning Scale), SOFAS score >61 (Social and Occupational Functioning Scale) and a SF-36 mental health subscore >40 (Medical Outcomes Study-Short Form Health Survey). Multivariate logistic regression and CART analyses were used to determine valid clinical and sociodemographic predictors. RESULTS: In total, 52 patients (20%) fulfilled the criteria for functional remission, 125 patients (48%) achieved symptomatic resolution and when criteria for functional remission and symptomatic resolution were combined 33 patients (13%) achieved complete remission. Younger age, employment, a shorter duration of illness, a shorter length of current episode, less suicidality, and a lower PANSS negative and global subscore at admission were predictive of functional remission. The regression model showed a predictive value of more than 80%. CONCLUSIONS: A significant association was found between functional remission and symptomatic resolution, indicating reasonable validity of the proposed definition for functional outcome. The revealed predictors for functional treatment outcome emphasize the need for psychosocial and vocational rehabilitation in schizophrenic patients.

PMID: 19560901 [PubMed - indexed for MEDLINE]

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One- vs. five-session treatment of intra-oral injection phobia: a randomized clinical study.

Eur J Oral Sci. 2009 Jun;117(3):279-85

Authors: Vika M, Skaret E, Raadal M, Ost LG, Kvale G

The present study aimed to evaluate the effect of one and five sessions of treatment for intra-oral injection phobia in 55 subjects fulfilling the DSM-IV criteria for specific phobia. The subjects were randomly assigned to one or five sessions of cognitive behavioural therapy (CBT) performed by dentists. Assessments included behavioural tests and self-report instruments used pretreatment, post-treatment, and at 1 yr of follow-up. The dental anxiety scale (DAS), the injection phobia scale-anxiety, and the mutilation questionnaires were applied. Mean avoidance duration of intra-oral injections before treatment was 7.0 yr. The results showed that 89% of the subjects had received intra-oral injections from a regular dentist during the 1-yr follow-up. The only significant difference between the one- and the five-session groups was that the five-session group reported less anxiety (as measured using the DAS) at 1 yr of follow-up. It was concluded that both treatments performed by dentists specially trained in CBT have a significant treatment effect on the intra-oral injection phobia.

PMID: 19583756 [PubMed - indexed for MEDLINE]

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Discriminating semantic from episodic relatedness in young and older adults.

Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2009 Sep;16(5):535-62

Authors: Patterson MM, Light LL, Van Ocker JC, Olfman D

The ability of young (aged 18-30) and older (aged 60-80) adults to discriminate pre-experimental (semantic) from experimental (episodic) associations was examined. Participants studied a list containing semantically related and unrelated word pairs and then made either associative recognition (Experiments 1a and b) or semantic relatedness (Experiment 2) judgments at various response deadlines. For associative recognition judgments, both young and older adults benefited from semantic relatedness, leading to more hits for related than unrelated pairs, and at the long response deadline, older adults’ performance on those pairs matched that of young participants. Also, both young and older adults demonstrated superior discrimination for unrelated lures whose members had originally been studied in related pairs - evidence for recall-to-reject processing in both age groups. In making semantic relatedness judgments, both young and older adults showed an episodic priming effect. When older adults can rely on long-standing associations, their performance resembles that of young adults - both in associative recognition and in episodic priming.

PMID: 19590991 [PubMed - indexed for MEDLINE]

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Factors influencing the choice of new generation antipsychotic medication in the treatment of patients with schizophrenia.

Schizophr Res. 2009 Sep;113(2-3):246-51

Authors: Edlinger M, Hofer A, Rettenbacher MA, Baumgartner S, Widschwendter CG, Kemmler G, Neco NA, Fleischhacker WW

OBJECTIVE: This prospective, naturalistic study investigated the factors influencing physicians’ choice of antipsychotic drug therapy in the treatment of patients with schizophrenia. METHOD: 108 in- and outpatients treated at the Department of Psychiatry of the Medical University Innsbruck who started treatment with a new generation antipsychotic (except clozapine) were included. The following factors were investigated: sociodemographic and illness-related variables, pretreatment, the reasons for change of treatment (lack of efficacy, side effects, non-compliance), side effects of pretreatment and body-mass-index (BMI). RESULTS: Sociodemographic and most illness-related variables did not have an influence on the physicians’ choice of medication. Risperidone was more frequently prescribed in patients with severe positive symptoms than amisulpride or quetiapine. Rigidity, orthostatic dizziness and gynecomastia during pretreatment were frequently associated with starting patients on ziprasidone. In patients with diminished sexual desire ziprasidone was preferred over olanzapine. Amisulpride was used more commonly than olanzapine if patients had experienced weight gain during pretreatment. Moreover, patients who were prescribed amisulpride had a significantly higher BMI in comparison to patients who were prescribed olanzapine. The reasons for current change of treatment, as well as the drug history (total number of antipsychotic drugs prescribed during the course of the illness) did not have an influence on the physicians’ choice of antipsychotic. CONCLUSION: In summary, the data suggest that side effects have a larger influence on the choice of antipsychotic than demographic or illness-related variables, except the severity of positive symptoms.

PMID: 19595578 [PubMed - indexed for MEDLINE]

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A psychological intervention reduces inflammatory markers by alleviating depressive symptoms: secondary analysis of a randomized controlled trial.

Psychosom Med. 2009 Sep;71(7):715-24

Authors: Thornton LM, Andersen BL, Schuler TA, Carson WE

OBJECTIVES: To test experimentally whether a psychological intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflammation can contribute to depressive symptoms, although the converse remains untested. METHODS: As part of a randomized clinical trial, newly diagnosed breast cancer patients (n = 45) with clinically significant depressive symptoms were evaluated and randomized to psychological intervention with assessment or assessment only study arms. The intervention spanned 12 months, with assessments at baseline, 4, 8, and 12 months. Mixed-effects modeling tested the hypothesis that the intervention reduced self-reported depressive symptoms (Center for Epidemiological Studies Depression scale, Profile of Mood States Depression and Fatigue subscales, and Medical Outcomes Study-Short Form 36 Bodily Pain subscale) and immune cell numbers that are elevated in the presence of inflammation (white blood cell count, neutrophil count, and helper/suppressor ratio). Mediation analyses tested whether change in depressive symptoms, pain, or fatigue predicted change in white blood cell count, neutrophil count, or the helper/suppressor ratio. RESULTS: The intervention reduced significantly depressive symptoms, pain, fatigue, and inflammation markers. Moreover, the intervention effect on inflammation was mediated by its effect on depressive symptoms. CONCLUSIONS: This is the first experiment to test whether psychological treatment effective in reducing depressive symptoms would also reduce indicators of inflammation. Data show that the intervention reduced directly depressive symptoms and reduced indirectly inflammation. Psychological treatment may treat effectively depressive symptoms, pain, and fatigue among cancer patients.

PMID: 19622708 [PubMed - indexed for MEDLINE]

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Quitting smoking is easy…Mark Twain said so.

J Perianesth Nurs. 2009 Aug;24(4):260-2

Authors: Sandlin-Leming D

PMID: 19647667 [PubMed - indexed for MEDLINE]

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An individually tailored treatment programme for improved oral hygiene: introduction of a new course of action in health education for patients with periodontitis.

Int J Dent Hyg. 2009 Aug;7(3):166-75

Authors: Jönsson B, Ohrn K, Oscarson N, Lindberg P

OBJECTIVES: To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis. METHODS: Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse. RESULTS: Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period. CONCLUSION: The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.

PMID: 19659712 [PubMed - indexed for MEDLINE]

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The effect of guided imagery on the third stage of labor: a pilot study.

J Altern Complement Med. 2009 Aug;15(8):863-70

Authors: Schorn MN

OBJECTIVE: The purpose of this pilot study was to test the effects of guided imagery on blood loss during the third stage of labor. DESIGN AND SETTING: This was a three-group randomized controlled trial. Recruitment was conducted from a university nurse-midwifery practice. SUBJECTS: Sixty (60) women between pregnancy weeks 36 and 38 participated. INTERVENTIONS: The women were randomized into experimental, placebo, and control groups.Outcome measures: Intrauterine pressure catheters were used to measure uterine contraction frequency and intensity. Blood loss was measured. Analysis of variance was used to compare the three groups on continuous variables. RESULTS: Complete data were collected on 41 subjects. No significant differences were found among the groups on demographic or potentially confounding variables. CONCLUSIONS: Blood loss was nominally lower in the experimental group, but conclusions cannot be drawn due to the sample size.

PMID: 19678776 [PubMed - indexed for MEDLINE]

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