Psychotherapy of adjustment disorders: Current state and future directions

Domhardt, Matthias; Baumeister, Harald

doi:10.1080/15622975.2018.1467041

Cited by 42 publications

(22 citation statements)

References 83 publications

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“…Psychotherapeutic and psychopharmacological treatment options for AD have recently been summarized in three review articles (Domhardt and Baumeister, 2018;O'Donnell et al, 2018;Stein, 2018). They found that the quality of evidence has been ranked low to very low (O'Donnell et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Metacognitive Therapy for Adjustment Disorder in a Patient With Newly Diagnosed Pulmonary Arterial Hypertension: A Case Report

et al. 2020

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Adjustment disorders (ADs) belong to the worldwide most diagnosed mental disorders and are particularly frequent in patients with an underlying physical illness. Pulmonary arterial hypertension (PAH) is a severe and disabling disease, which significantly impacts on quality of life and has high mortality rates. The authors here present the case of a young female who developed a severe adjustment disorder with both anxious and depressive symptoms after a diagnosis of PAH requiring intensive care treatment due to right heart failure. Psychosocial functioning was severely impaired, and physical health reduced. Following hemodynamic stabilization and the establishment of PAH treatment, the patient was admitted to the Department of Psychiatry, Social Psychiatry and Psychotherapy and received metacognitive therapy (MCT). AD with mixed anxiety and depressed mood was diagnosed according to DSM-V criteria. At the start of treatment, she reported significant mental distress, indicated by a total sum score of the Hospital Anxiety and Depression Scale (HADS) of 20 points. The 6-min walking distance was only 358 m before the patient was exhausted. She then was treated with MCT without further psychopharmacological drugs. After only four MCT sessions, she fully remitted from AD which was accompanied by an 11-point reduction in the HADS (to 9 points). MCT specific scores also improved (MCQ-30 sum score decreased from 77 to 35). Notably, physical capacity improved as well, documented by an improved walking distance (439 m; +22%). This is the first case of a patient with AD in the context of PAH treated with MCT. The case report suggests that MCT is a possible psychotherapeutic treatment option for AD in the context of a potentially life-threatening disease. The study design does not permit an attribution of outcome to MCT but it suggests MCT is a potentially viable and acceptable treatment option.

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Section: Discussionmentioning

confidence: 99%

Metacognitive Therapy for Adjustment Disorder in a Patient With Newly Diagnosed Pulmonary Arterial Hypertension: A Case Report

et al. 2020

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“…Stepped-Care-Ansätze im eigentlichen Sinn weichen hiervon insofern ab, dass Patienten nach einem definierten Behandlungsalgorithmus nur dann die nächste, ggf. intensivere, invasivere und auch kostenintensivere Behandlung erhalten, wenn die vorherige Stufe nicht zu einer ausreichenden Behandlungsresponse führte und die weiterführende Behandlung als zielführend, potenziell wirksam und ausreichend wirtschaftlich eingestuft wird [9] [10].…”

Section: Sequenzielle Verzahnte Psychotherapieunclassified

Blended Psychotherapy – verzahnte Psychotherapie: Das Beste aus zwei Welten?

Baumeister¹,

Grässle²,

Ebert³

et al. 2018

PiD - Psychotherapie im Dialog

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Psychotherapie und Digitalisierung – zwei scheinbar unvereinbare Begriffe, die jedoch zunehmend in einem Atemzug verwendet werden. Von der „One size fits all“-Prophezeiung bis zum Untergang der Versorgung psychisch erkrankter Menschen findet eine teils hoch emotionale und oftmals wenig wissenschaftlich fundierte Diskussion statt. Verzahnte Psychotherapie kann ein Ansatz sein, der beide Welten verbindet.

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“…Digital health interventions, delivered via the Internet or mobile devices, might be a promising alternative to overcome these barriers and contribute to the extension of mental health care practices for children and adolescents with CC ( Lunkenheimer et al, 2020 ). Possible advantages of Internet- and mobile-based interventions (IMIs) might be their delivery mode irrespective of the constraints of space and time, potential anonymity and flexibility in conduct, special attractiveness for youth, potential cost-effectiveness, as well as scalability on a larger scale on a steady basis ( Andersson et al, 2019 ; Domhardt et al, 2018 ; Domhardt and Baumeister, 2018 ; Ebert et al, 2018 ). Obviously, some assets are especially important when the access to conventional mental health care services for youth with CC is even further reduced – as observed during the Covid-19 crisis ( Torous and Wykes, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…Obviously, some assets are especially important when the access to conventional mental health care services for youth with CC is even further reduced – as observed during the Covid-19 crisis ( Torous and Wykes, 2020 ). Regardless of contemporary circumstances, IMIs can be implemented as stand-alone interventions, as part of blended-therapy approaches or within a framework of stepped and collaborative care ( Andersson et al, 2019 ; Domhardt et al, 2018 ; Domhardt and Baumeister, 2018 ; Ebert et al, 2018 ; Yonek et al, 2020 ). Of note, interventions with accompanying human support evince consistently higher effect sizes than pure self-help interventions for depression and anxiety symptoms in adults ( Baumeister et al, 2014 ; Domhardt et al, 2019 ), reaching even comparable effect sizes to face-to-face psychotherapies in some instances ( Carlbring et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis

Domhardt

Schröder

Geirhos

et al. 2021

Internet Interventions

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Background Digital health interventions might extend service provisions for youth with chronic medical conditions (CC) and comorbid mental health symptoms. We aimed to comprehensively evaluate the efficacy of Internet- and mobile-based interventions (IMIs) for different psychological and disease-related outcomes in children and adolescents with CC. Method Studies were identified by systematic searches in CENTRAL, Embase, MEDLINE/PubMed and PsycINFO, complemented by searches in reference lists of eligible studies and other reviews. We included studies, when they were randomized controlled trials (RCTs) comparing the efficacy of an IMI to control conditions in improving psychological and disease-related outcomes in youth (mean age ≤ 18 years) with CC. Study selection, data extraction and risk of bias assessment were conducted independently by two reviewers. Meta-analyses were performed within a random-effects model, and Hedges' g (with 95% confidence intervals) was calculated as effect size measure. Primary outcomes were comorbid mental health symptoms (i.e., depression, anxiety and stress), as well as quality of life and self-efficacy. Results A total of 19 randomized controlled trials (2410 patients) were included in this meta-analysis. IMIs were associated with improvements in self-efficacy ( g = 0.38; 95% CI, 0.15 to 0.61; I 2 = 0) and combined disease-related outcomes ( g = −0.13; 95% CI, −0.25 to −0.01 ; I 2 = 21). Meta-analyses on other outcomes were non-significant, and some pre-planned analyses were not feasible because of a shortage of studies. Conclusion The available evidence on IMIs for improving mental and health-related outcomes in youth with CC is limited. Our findings point to a rather small benefit and limited efficacy. Future research is needed, to comprehensively assess the potential of IMIs to extend collaborative care, and to identify factors contributing to improved user-centered interventions with better treatment outcomes.

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Psychotherapy of adjustment disorders: Current state and future directions

Cited by 42 publications

References 83 publications

Metacognitive Therapy for Adjustment Disorder in a Patient With Newly Diagnosed Pulmonary Arterial Hypertension: A Case Report

Metacognitive Therapy for Adjustment Disorder in a Patient With Newly Diagnosed Pulmonary Arterial Hypertension: A Case Report

Blended Psychotherapy – verzahnte Psychotherapie: Das Beste aus zwei Welten?

Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis

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