Recently published controlled studies comparing electroconvulsive therapy (ECT) with other treatments for depression offer the opportunity to perform a meta-analysis of ECT in depression. Fifteen studies were identified which fulfilled the inclusion criteria. From these controlled trials, 20 effect sizes of ECT were calculated. The speed of action during the course and the efficacy after a full course of ECT were explored. The efficacy of sine wave and brief pulse machines were compared. The comparison between ECT and four other comparative treatments was made. Predictive variables were explored using homogeneity tests. ECT was shown to be superior after a full course. The funnel plot showed the absence of publication bias. There was no exaggeration of effect size in the lower quality trials. No evidence was found for a superior speed of action of ECT or for a difference in efficacy between sine wave and brief pulse stimulation. ECT was shown to be superior to medication and simulated ECT. Some evidence was found that psychosis predicted better response to ECT.
Over 50% of ambulatory patients show clinical improvement after treatment in a short-term schema therapy group. Other Directedness seems to be a predictor of schema group therapy success. More randomized controlled trial studies and prediction and mediation studies on (short-term) schema group therapy are sorely needed.
Psychologists are subject to multiple competing emotional demands that increase the risk of burnout. Research has demonstrated that burnout arises from both organizational and personal factors, including psychologists' personal beliefs and coping. Preliminary research indicates that early maladaptive schemas (EMS) are associated with high burnout, yet, to date, the role of EMS and associated coping responses (maladaptive coping modes [MCM]) in predicting high burnout amongst psychologists has not been investigated. Four hundred forty-three psychologists completed a self-report online questionnaire comprising the Maslach Burnout Inventory-emotional exhaustion scale (EE), Young Schema Questionnaire, and Schema Mode Inventory. The two most common EMS amongst psychologists were unrelenting standards and self-sacrifice. There was substantial indication of burnout, with 18.3% in the high range and 29.6% in the moderate range of EE. The most common MCM were detached protector and detached self-soother. Controlling for demographics and job demands, EMS accounted for an additional 18% variance in EE. MCM accounted for an additional 6% beyond the variance explained by demographics, job demands, and EMS. Practical recommendations are suggested to reduce psychologist burnout.
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