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Psychotherapy

These pubmed results were generated on 2011/11/29

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St. John's wort is a plant with yellow flowers whose medicinal uses were first recorded in ancient Greece. The flowering tops of St. John's wort are used to prepare teas, tablets, and capsules containing concentrated extracts. Liquid extracts and topical preparations are also used. Today, St. John's wort is used by some for depression, anxiety, and/or sleep disorders.

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[Disease-syndrome combination clinical study on psychosomatic diseases: Yang and Yin syndrome typing for psychosomatic diseases].

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011 Oct;31(10):1304-5

Authors: Zhao ZF

PMID: 22097191 [PubMed - in process]

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Predicting the efficacy of proton pump inhibitors in patients with non-erosive reflux disease before therapy using dual-channel 24-h esophageal pH monitoring.

J Gastroenterol Hepatol. 2011 Nov 18;

Authors: Shimatani T, Sugimoto M, Nishino M, Adachi K, Furuta K, Ito M, Kurosawa S, Manabe N, Mannen K, Hongo M, Chiba T, Kinoshita Y,

Abstract
Background and Aim: We aimed to determine whether reflux- and symptom-related parameters can predict the efficacy of proton pump inhibitors (PPIs) in non-erosive reflux disease (NERD). Methods: Twenty-seven NERD patients who had experienced heartburn more than once a week within the previous month were enrolled. Intraesophageal pH before therapy was measured simultaneously at 5 and 15 cm above the esophagogastric junction (EGJ) for 24 h. The PPI rabeprazole was administered at a dose of 10 mg once daily for 4 weeks. In the event that heartburn was not relieved, the dose was increased to 10 mg twice daily for an additional 2 weeks, and again to 20 mg twice daily for another 2 weeks. Results: Univariate analysis demonstrated no significant associations between any reflux- or symptom-related parameters at either site and complete heartburn relief after 4 weeks, or cumulative complete heartburn relief after 8 weeks. However, post-hoc analysis demonstrated more satisfactory heartburn relief after 4 weeks in patients with a high symptom index compared with those with a low symptom index, at 5 cm above the EGJ (P= 0.009). Cumulative satisfactory heartburn relief after 8 weeks was also greater in patients with a high total number of acid reflux episodes compared with those with a low total number of episodes, at 15 cm above the EGJ (P= 0.037). Conclusions: Pre-therapeutic pH monitoring in the lower and mid-esophagus is useful for predicting the efficacy of PPIs in NERD patients.

PMID: 22098590 [PubMed - as supplied by publisher]

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The treatment of patients with medically unexplained physical symptoms in China: a study comparing expectations and treatment satisfaction in psychosomatic medicine, biomedicine, and traditional Chinese medicine.

Int J Psychiatry Med. 2011;41(3):229-44

Authors: Fritzsche K, Xudong Z, Anselm K, Kern S, Wirsching M, Schaefert R

Abstract
OBJECTIVE: Little is known about treatment for patients with medically unexplained symptoms (MUS) in China. This study investigates the treatment expectations and treatment satisfaction of patients with MUS in psychosomatic medicine, biomedicine, and Traditional Chinese Medicine (TCM).
METHOD: In a cross-sectional survey, n = 96 (10.3%) out of 931 participating patients were screened positive for multiple somatoform symptoms. These patients answered questionnaires concerning symptom duration, number of doctor visits, functional impairment, emotional distress, treatment expectations, treatment satisfaction, and empathy in the consultation. The physicians filled in a questionnaire about applied or recommended treatment.
RESULTS: Most of the patients from psychosomatic medicine wanted psychotherapy. In TCM, 55% of the patients had already received TCM treatment and most of them wanted to continue TCM treatment. Patients in biomedicine did not express clear expectations; most of them had had no previous treatment. A combination of treatment methods was most prevalent in biomedicine in comparison to psychosomatic medicine and TCM. The outcome from the patients’ point of view was significantly better in TCM than in psychosomatic medicine and biomedicine. Psychosomatic medicine’s strength was the empathetic physician-patient interaction.
CONCLUSIONS: From a biopsychosocial perspective, these results suggest that various treatment approaches with various emphases can be effective depending on the patient’s complaints, his illness beliefs, and what the physician offers. The results will be verified in a larger multicenter longitudinal study.

PMID: 22073762 [PubMed - in process]

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[Investigation on the behavior problems of children aged 3 to 5 years in Changsha and comparison of the norm of Conners Parent Symptom Questionnaire in Chinese and American urban children].

Zhongguo Dang Dai Er Ke Za Zhi. 2011 Nov;13(11):900-3

Authors: Guo R, Mao DA, Li JM, Luo XM, Jiang Y, Liu JH

Abstract
OBJECTIVE: To investigate the behavior problems of children aged 3 to 5 years in Changsha and to compare the differences of the results detected by the norm of Conners Parent Symptom Questionnaire (PSQ) in Chinese and American urban children.
METHODS: A total of 854 children aged 3 to 5 years were randomly sampled from 5 districts in Changsha City and their parents completed the Conners PSQ.
RESULTS: The assessment by the norm of PSQ in American urban children demonstrated that the average prevalence of behavior problems was 20.4%, with 28.1% for boys and 12.4% for girls. There were significant differences between boys and girls (P<0.01). The factor score of anxiety in girls was markedly higher than that in boys (P<0.01). Learning and psychosomatic problems were the main problems in the children. The prevalences of conduct problems and impulse-restlessness, and abnormal restlessness index detected by the norm of PSQ in Chinese urban children were higher than those detected by the American norm. The prevalences of conduct problems and psychosomatic problems in boys by the norm of PSQ in Chinese urban children were significantly lower than those detected by the American norm, while the total prevalence of behavior problems was higher than that detected by American norm. There was a poor consistency in the assessment results of most factors of the PSQ and the total prevalence of behavior problems detected by the Chinese and American norms (KappP<0.4).
CONCLUSIONS: The prevalence of behavior problems especially learning problems and psychosomatic problems in children aged 3 to 5 years is higher in Changsha. The consistency of assessment results is poor between the norms of China and America. It is recommended to use the China norm of PSQ in Chinese children aged 3 to 5 years because the Chinese norm is in line with China’s national conditions and cultural background.

PMID: 22099201 [PubMed - in process]

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Gender differences in outcomes of a multimodal pain management program.

Pain. 2011 Nov 17;

Authors: Pieh C, Altmeppen J, Neumeier S, Loew T, Angerer M, Lahmann C

Abstract
Although gender differences in pain and analgesia are well known, it still remains unclear whether men and women vary in response to multimodal pain treatment. This study was conducted to investigate whether men and women exhibited different outcomes after an intensive multimodal pain treatment program. The daily outpatient program consisted of individual treatment as well as group therapy, with a total amount of therapy of 117.5h per patient. Overall, 496 patients (254 women) completed the multimodal program. Pretreatment parameters for pain, disability due to pain, pain duration, and pain chronicity stage, as well as age or psychiatric comorbidities, did not differ between genders. The average pain, measured with a Numeric Rating Scale, decreased after treatment of -1.54 (±1.96) with a large effect size (ES) of .911 for the total sample. However, there were considerable differences in the benefit for women (-1.83±2.12; ES 1.045) compared with men (-1.23±1.74; ES .758). Consistently, women (ES .694) improved more in pain-related disabilities in daily life than men (ES .436). These distinctions are not due to differences in pain duration, received medication, psychiatric comorbidities, pain chronicity stage, or application for a disability pension. Therefore, gender differences not only refer to chronic pain prevalence, pain perception, or experimental pain measurement, but also seem to have a clinically relevant impact on the response to pain therapy.

PMID: 22100358 [PubMed - as supplied by publisher]

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Psychometric properties and population-based norms of the Life Orientation Test Revised (LOT-R).

Br J Health Psychol. 2011 Jul 21;

Authors: Glaesmer H, Rief W, Martin A, Mewes R, Brähler E, Zenger M, Hinz A

Abstract
Objectives. The relevance of the construct optimism in health psychology has been convincingly demonstrated in numerous studies. Population-based studies about dispositional optimism and the psychometric properties of the Life Orientation Test LOT-R as well as population-based norms are lacking. Design. A representative population survey in Germany was conducted to investigate psychometric properties of the LOT-R and to deliver population-based norms. Methods. A representative sample of 2,372 adults aged 18-93 years were screened using self-rating instruments. Results. The confirmatory factor analysis (CFA) confirmed two factors. Optimism and pessimism are negatively correlated (r=-.20). Indications for convergent validity were demonstrated with depression, satisfaction with life, subjective state of health and health care utilization. Optimism is more strongly related to all indicators than pessimism. Since there are only marginal age and gender differences, norm data are given for the entire population. Conclusions. Our study confirms the bi-dimensionality of the LOT-R and thus underpins that optimism and pessimism are two independent constructs rather than a single bipolar trait. Psychometric properties were found to be satisfactory. Together with the norm values reported in the paper, this instrument can, thus, be employed to measure dispositional optimism or pessimism in individual diagnostics as well as in epidemiological research.

PMID: 22106985 [PubMed - as supplied by publisher]

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Childhood trauma and health outcomes in HIV-infected patients: An exploration of causal pathways.

J Acquir Immune Defic Syndr. 2011 Nov 20;

Authors: Pence BW, Mugavero MJ, Carter TJ, Leserman J, Thielman NM, Raper JL, Proeschold-Bell RJ, Reif S, Whetten K

Abstract
OBJECTIVE: Traumatic life histories are highly prevalent in people living with HIV/AIDS (PLWHA) and predict sexual risk behaviors, medication adherence, and all-cause mortality. Yet the causal pathways explaining these relationships remain poorly understood. We sought to quantify the association of trauma with negative behavioral and health outcomes and to assess whether those associations were explained by mediation through psychosocial characteristics. METHODS: In 611 outpatient PLWHA, we tested whether trauma’s influence on later health and behaviors was mediated by coping styles, self efficacy, social support, trust in the medical system, recent stressful life events, mental health, and substance abuse. RESULTS: In models adjusting only for sociodemographic and transmission category confounders (estimating total effects), past trauma exposure was associated with 7 behavioral and health outcomes including increased odds or hazard of recent unprotected sex (OR=1.17 per each additional type of trauma, 95% CI=1.07-1.29), medication nonadherence (OR=1.13, 1.02-1.25), hospitalizations (HR=1.12, 1.04-1.22), and HIV disease progression (HR=1.10, 0.98-1.23). When all hypothesized mediators were included, the associations of trauma with health care utilization outcomes were reduced by about 50%, suggesting partial mediation (e.g., OR for hospitalization changed from 1.12 to 1.07) whereas point estimates for behavioral and incident health outcomes remained largely unchanged, suggesting no mediation (e.g., OR for unprotected sex changed from 1.17 to 1.18). Trauma remained associated with most outcomes even after adjusting for all hypothesized psychosocial mediators. CONCLUSIONS: These data suggest that past trauma influences adult health and behaviors through pathways other than the psychosocial mediators considered in this model.

PMID: 22107822 [PubMed - as supplied by publisher]

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MAO-inhibitors in Parkinson’s Disease.

Exp Neurobiol. 2011 Mar;20(1):1-17

Authors: Riederer P, Laux G

Abstract
Monoamine oxidase inhibitors (MAO-I) belong to the earliest drugs tried in Parkinson’s disease (PD). They have been used with or without levodopa (L-DOPA). Non-selective MAO-I due to their side-effect/adverse reaction profile, like tranylcypromine have limited use in the treatment of depression in PD, while selective, reversible MAO-A inhibitors are recommended due to their easier clinical handling. For the treatment of akinesia and motor fluctuations selective irreversible MAO-B inhibitors selegiline and rasagiline are recommended. They are safe and well tolerated at the recommended daily doses. Their main differences are related to (1) metabolism, (2) interaction with CYP-enzymes and (3) quantitative properties at the molecular biological/genetic level. Rasagiline is more potent in clinical practise and has a hypothesis driven more favourable side effect/adverse reaction profile due to its metabolism to aminoindan. Both selegiline and rasagiline have a neuroprotective and neurorestaurative potential. A head-to head clinical trial would be of utmost interest from both the clinical outcome and a hypothesis-driven point of view. Selegiline is available as tablet and melting tablet for PD and as transdermal selegiline for depression, while rasagiline is marketed as tablet for PD. In general, the clinical use of MAO-I nowadays is underestimated. There should be more efforts to evaluate their clinical potency as antidepressants and antidementive drugs in addition to the final proof of their disease-modifying potential. In line with this are recent innovative developments of MAO-I plus inhibition of acetylcholine esterase for Alzheimer’s disease as well as combined MAO-I and iron chelation for PD.

PMID: 22110357 [PubMed - as supplied by publisher]

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