Cognitive and emotional variables predicting treatment outcome of cognitive behavior therapies for patients with medically unexplained symptoms: A meta-analysis

Sarter, Lena; Heider, Jens; Kirchner, Lukas; Schenkel, Sandra; Witthöft, Michael; Rief, Winfried; Kleinstäuber, Maria

doi:10.1016/j.jpsychores.2021.110486

Cited by 31 publications

(16 citation statements)

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“…Therefore, the multi-unit comprehensive intervention system provided by Echo-APP may have better applicability. It is possible to improve the overall treatment effect through targeted intervention for different symptoms, which has been verified in other studies [ 37 , 38 ]. Although the results are promising, this work is a preliminary study, and further standardized evaluation of Echo-APP is still needed, and a multicenter randomized controlled clinical study is required to explore the efficacy and adverse reactions of Echo-APP.…”

Section: Discussionsupporting

confidence: 56%

Virtual Digital Psychotherapist App–Based Treatment in Patients With Methamphetamine Use Disorder (Echo-APP): Single-Arm Pilot Feasibility and Efficacy Study

Chen

et al. 2023

JMIR Mhealth Uhealth

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Background Substance use disorder is one of the severe public health problems worldwide. Inequitable resources, discrimination, and physical distances limit patients’ access to medical help. Automated conversational agents have the potential to provide in-home and remote therapy. However, automatic dialogue agents mostly use text and other methods to interact, which affects the interaction experience, treatment immersion, and clinical efficacy. Objective The aim of this paper is to describe the design and development of Echo-APP, a tablet-based app with the function of a virtual digital psychotherapist, and to conduct a pilot study to explore the feasibility and preliminary efficacy results of Echo-APP for patients with methamphetamine use disorder. Methods Echo-APP is an assessment and rehabilitation program developed for substance use disorder (SUD) by a team of clinicians, psychotherapists, and computer experts. The program is available for Android tablets. In terms of assessment, the focus is on the core characteristics of SUD, such as mood, impulsivity, treatment motivation, and craving level. In terms of treatment, Echo-APP provides 10 treatment units, involving awareness of addiction, motivation enhancement, emotion regulation, meditation, etc. A total of 47 patients with methamphetamine dependence were eventually enrolled in the pilot study to receive a single session of the Echo-APP–based motivational enhancement treatment. The outcomes were assessed before and after the patients’ treatment, including treatment motivation, craving levels, self-perception on the importance of drug abstinence, and their confidence in stopping the drug use. Results In the pilot study, scores on the Stages of Change Readiness and Treatment Eagerness Scale and the questionnaire on motivation for abstaining from drugs significantly increased after the Echo-APP–based treatment (P<.001, Cohen d=–0.60), while craving was reduced (P=.01, Cohen d=0.38). Patients’ baseline Generalized Anxiety Disorder-7 assessment score (β=3.57; P<.001; 95% CI 0.80, 2.89) and Barratt Impulsiveness Scale (BIS)–motor impulsiveness score (β=–2.10; P=.04; 95% CI –0.94, –0.02) were predictive of changes in the patients’ treatment motivation during treatment. Moreover, patients’ baseline Generalized Anxiety Disorder-7 assessment score (β=–1.607; P=.03; 95% CI –3.08, –0.14), BIS—attentional impulsivity score (β=–2.43; P=.004; 95% CI –4.03, –0.83), and BIS—nonplanning impulsivity score (β=2.54; P=.002; 95% CI 0.98, 4.10) were predictive of changes in craving scores during treatment. Conclusions Echo-APP is a practical, accepted, and promising virtual digital psychotherapist program for patients with methamphetamine dependence. The preliminary findings lay a good foundation for further optimization of the program and the promotion of large-scale randomized controlled clinical studies for SUD.

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Section: Discussionsupporting

confidence: 56%

Virtual Digital Psychotherapist App–Based Treatment in Patients With Methamphetamine Use Disorder (Echo-APP): Single-Arm Pilot Feasibility and Efficacy Study

Chen

et al. 2023

JMIR Mhealth Uhealth

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“…Psikoterapiler bu hastaların tedavisinde önemli bir yer tutmaktadır. Bilişsel davranışçı terapi (BDT) en çok kanıt bulunan yöntemdir [21]. Hastalar arası değişiklikler olabilse de tedavi; psikoeğitim, sorun çözme eğitimi, iletişim becerileri, davranışsal aktivasyon, bilişsel yeniden yapılandırma ve gevşeme egzersizlerini içermektedir [1,5] Farmakoterapide ilk seçenek, inen ağrı yolaklarındaki analjezik etkisi, depresyon, anksiyete bozuklukları, travma sonrası stres bozukluğu gibi komorbid tablolarda iyileşme sağlaması gibi nedenlerle antidepresan grubu ilaçlardır [22][23][24].…”

Section: Olgu Sunumuunclassified

Sağlık sisteminde ihmal edilen bir konu 'Bedensel Belirti Bozukluğu': Bir olgu sunumu

TASLI¹,

Hocaoğlu²

2022

Pamukkale Medical Journal

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ÖzBedensel belirti bozukluğu, kişinin ciddi bir hastalığa sahip olduğuna dair sanrısal olmayan düşüncelerinin altı ay ya da daha uzun süre devam etmesi durumudur. Özellikle kadın cinsiyet, düşük sosyoekonomik düzeye sahip bireylerde görüldüğü belirtilmiştir. Bedensel belirti bozukluğunun sosyal, kültürel ve psikolojik yönleri mevcuttur. Bedensel belirti bozukluk tanılı bireyler, sağlık hizmetlerine çok sık başvurma eğilimindedir. Bu hastalar psikiyatrik destek almaktan kaçınırken, daha çok genel tıbbi hizmetlere yönelirler. Birinci basamak sağlık hizmetlerine başvuruların yarısından fazlasını bedensel belirtilere sahip bireylerin oluşturduğu gösterilmiştir. Bu hastaların tanı ve ayırıcı tanısında güçlükler yaşanmakta olup, hastalara çok sayıda girişimsel ve girişimsel olmayan tetkikler uygulanmaktadır. Sağlık sistemi için önemli bir ekonomik maliyete de yol açan bu durum sıklıkla hastaların tanısının atlanmasına ve tedavinin gecikmesine neden olmaktadır. Mevcut durum hekimler için hayal kırıklığı, çaresizlik gibi duygulara yol açarken hastalarda da hekimlere ve sağlık sistemine karşı memnuniyetsizliğe neden olur. Bedensel belirti bozukluğu önemli derecede yaşam kalitesinde bozulmaya, yeti yitimine yol açan bir ruhsal bozukluktur. Genel toplumda oldukça yaygın görüldüğü bildirilen bedensel belirti bozukluğunun etiyolojisi, tanı ve tedavi yaklaşımları tam olarak bilinmemektedir. BBB depresyon, anksiyete bozuklukları ile eş tanılı durumlara da neden olmaktadır. Bu nedenle BBB erken tanı ve tedavisi önem arz etmektedir. Biz de yazıda son beş yıl içinde ağrı yakınması nedeni 230'dan fazla hekim başvurusu olan bir 51 yaşındaki erkek hastayı sunuyoruz. Ağrı yakınması nedeni ile başvurduğu sağlık kurumlarında hastaya çok sayıda girişimsel ve girişimsel olmayan tıbbi tetkik uygulanmış olması dikkat çekici bir durumdur. Hastanın belirgin düzeyde iş, ekonomik ve sosyal yaşamındaki işlev kaybı da mevcuttur. Bedensel belirti bozukluğu tanısı konusundaki farkındalığın artması hastaların yaşam kalitesini arttıracak, sağlık sistemi üzerinde olumlu katkılar sağlayacaktır.

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“…CBT targets cognitions and behaviours associated with IBS symptoms, and can include relaxation strategies and psychoeducation (Sugaya et al, 2021). However, a recent meta‐analysis indicated that patients with comorbid anxiety or depression were less likely to benefit from CBT (Sarter et al, 2021) and few, if any, studies have focused on the unique symptom management experiences and needs of patients with IBS who have concurrent symptoms of anxiety and/or depression.…”

Section: Introductionmentioning

confidence: 99%

Symptom management needs of patients with irritable bowel syndrome and concurrent anxiety and/or depression: A qualitative study

Kamp

Morgan

Yoo

et al. 2022

Journal of Advanced Nursing

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Aims To understand the experiences and needs of symptom management among individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. Design This study used a qualitative descriptive research design. Methods Individuals with a diagnosis of irritable bowel syndrome and concurrent symptoms of anxiety and/or depression participated were recruited through an online ResearchMatch and a listserv. Semi‐structured interviews focused on symptoms and experiences with symptom management interventions conducted from June to August 2020. Interviews were transcribed and data were analysed based on thematic analysis. Results Twelve individuals participated in this study; all reported current irritable bowel syndrome and anxiety/depression symptoms. The data analysis cumulated with three themes related to symptom management: (a) irritable bowel syndrome negatively impacts physical and mental well‐being; (b) a trial and error approach to symptom management; and (c) challenges with healthcare professionals supporting symptom management including negative interactions with healthcare professionals and lack of nutritional expertize and support. Conclusion There is a need for individualized approaches which consider patients' current symptoms of anxiety and depression, previous experiences with the trial‐and‐error process and consideration for intervention delivery methods. Impact There is a limited qualitative research focusing on the experiences of individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. This research highlights the need for individualized approaches to enhance symptom management that acknowledges patients' psychological state and past negative experiences with providers and prior dietary regimens.

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Cognitive and emotional variables predicting treatment outcome of cognitive behavior therapies for patients with medically unexplained symptoms: A meta-analysis

Cited by 31 publications

References 62 publications

Virtual Digital Psychotherapist App–Based Treatment in Patients With Methamphetamine Use Disorder (Echo-APP): Single-Arm Pilot Feasibility and Efficacy Study

Virtual Digital Psychotherapist App–Based Treatment in Patients With Methamphetamine Use Disorder (Echo-APP): Single-Arm Pilot Feasibility and Efficacy Study

Sağlık sisteminde ihmal edilen bir konu 'Bedensel Belirti Bozukluğu': Bir olgu sunumu

Symptom management needs of patients with irritable bowel syndrome and concurrent anxiety and/or depression: A qualitative study

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