Background: Patients diagnosed as having somatization disorder (SD) who present with a lifetime history of multiple, medically unexplained physical symptoms represent a significant challenge to health care providers. To date, no... more
Background: Patients diagnosed as having somatization disorder (SD) who present with a lifetime history of multiple, medically unexplained physical symptoms represent a significant challenge to health care providers. To date, no psychotherapeutic or pharmacologic intervention has been found to produce clinically meaningful improvement in symptoms or functioning of patients with SD. We examined the efficacy of cognitivebehavioral therapy (CBT) for SD. Methods: Eighty-four participants meeting criteria for SDwererandomlyassignedto1of2conditions:(1)standard medical care augmented by a psychiatric consultation intervention or (2) a 10-session, manualized, individually administered CBT regimen added to the psychiatric consultation intervention. Assessments were conductedatbaselineand3,9,and15monthsafterbaseline.Theprimaryoutcomemeasurewastheseverityscale of the Clinical Global Impression Scale for Somatization Disorder (CGI-SD). Secondary outcome measures were responder status as determined by clinical ratings, selfreported measures of physical functioning and somatic symptoms, and health care utilization assessed via medical records. Results: Fifteen months after baseline, somatization symptoms were significantly less severe in the group treated with CBT (0.84 points on the CGI-SD 7-point scale)(P.001).PatientstreatedwithCBTalsoweresignificantly more likely to be rated as either very much improved or much improved than patients treated with only augmented standard medical care (40% [n=17] vs 5% [n=2]).Cognitive-behavioraltherapywasassociatedwith greater improvements in self-reported functioning and somatic symptoms and a greater decrease in health care costs. Conclusion: For patients diagnosed as having SD, CBT may produce clinical benefits beyond those that result from the current state-of-the-art treatment. Arch Intern Med. 2006;166:1512-1518
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Research Interests: Psychology, Clinical Psychology, Cognitive Behavioral Therapy, Medicine, Humans, and 10 moreCognitive Therapy, Psychosocial, Somatization, International Classification of Diseases, Psychotherapist, Somatoform disorders, Somatization Disorder, Psychiatric Clinics of North America, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Psychology, Cognitive Science, Behavior, Stress Management, Treatment Outcome, and 14 moreMedicine, Humans, Female, Cognitive Therapy, Male, Cognitive behavior therapy, Follow-up studies, Somatization, Middle Aged, Somatoform disorders, Somatization Disorder, Physical Function, Severity of Illness Index, and Disability Evaluation
Research Interests: Psychology, Anxiety Disorders, Medicine, Comorbidity, Humans, and 15 moreMajor Depressive Disorder, Behavior Therapy, Female, Psychosomatics, Cognitive Therapy, Sleep disorders, Male, Relaxation, Cognitive Behavioral Treatment Method, Recurrence, Clinical Sciences, Aged, Middle Aged, Parkinson Disease, and Combined Modality Therapy
This chapter provides an overview of the treatment of somatoform and related disorders. A brief history of the disorder is provided, along with a sociocultural framework in which to conceptualize somatization. The epidemiology of... more
This chapter provides an overview of the treatment of somatoform and related disorders. A brief history of the disorder is provided, along with a sociocultural framework in which to conceptualize somatization. The epidemiology of somatoform disorders is discussed. Empirical research evaluating psychosocial treatments for somatoform disorders, including the functional somatic syndromes, is reviewed and critiqued. The rather substantial assortment of treatment options available to clinicians is compared and contrasted, and their level of empirical support evaluated. The limitations of the empirical literature, as well as the treatment implications that can be drawn, are discussed.
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... and extensive medical treatment (Smith, Monson y Ray, 1986; Barsky, Orav y Bates, 2005; Dickinson et al., 2003; Fink, Sorensen, Engberg, Holm y ... These forms are analogous to dysfunctional thought records used with depressed... more
... and extensive medical treatment (Smith, Monson y Ray, 1986; Barsky, Orav y Bates, 2005; Dickinson et al., 2003; Fink, Sorensen, Engberg, Holm y ... These forms are analogous to dysfunctional thought records used with depressed patients (Beck, Rush, Shaw y Emery, 1979). ...
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Research Interests: Cognitive Behavioral Therapy, Treatment Outcome, Anxiety, Humans, Female, and 13 moreCognitive Therapy, Male, Depressive Disorder, Aged, Middle Aged, Adult, Randomized Controlled Trial, ANXIETY, Parkinson´s Disease, American J of Psychiatry, Parkinson Disease, Psychology and Cognitive Sciences, and Medical and Health Sciences
The present study was conducted to examine the feasibility and effect of an individual cognitive‐behavioral treatment (CBT) for depression that was modified to meet the unique needs of the PD patient and incorporated a separate social... more
The present study was conducted to examine the feasibility and effect of an individual cognitive‐behavioral treatment (CBT) for depression that was modified to meet the unique needs of the PD patient and incorporated a separate social support intervention for caregivers. Fifteen PD patients with Major Depressive Disorder participated in the study with a caregiver. Patients received 10–14 sessions of modified individual CBT. Caregivers attended 3–4 psychoeducational sessions, occurring separately from the patients treatment sessions, which focused on strategies for offering appropriate support, and ways to respond to the patients' negative thoughts in a targeted manner. Patients experienced a significant reduction in depressive symptoms and negative cognitions, and an increased perception of social support over the course of treatment. Gains were maintained at 1‐month follow‐up. In conclusion, individual CBT, when modified appropriately, may be a feasible and effective option for PD depression. Larger, randomized controlled trials are needed to further evaluate the efficacy of this intervention and to identify specific mechanisms of change. © 2007 Movement Disorder Society
Research Interests: Psychology, Clinical Psychology, Cognitive Behavioral Therapy, Cognitive Science, Cognition, and 15 moreMedicine, Movement disorders, Humans, Female, Cognitive Therapy, Male, Cognitive behavior therapy, Caregivers, Clinical Sciences, Aged, Middle Aged, Pilot study, Randomized Controlled Trial, Pilot Projects, and Parkinson Disease
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Research Interests: Psychology, Clinical Psychology, Cognitive Science, Cognition, Medicine, and 15 moreHumans, Female, Male, Attitude, Depressive Disorder, Differential Diagnosis, Pessimism, Clinical Sciences, Ego, Self Assessment, Adult, Depressive Symptoms, Psychological Models, Psychiatric Status Rating Scales, and Personality Inventory
The Food and Drug Administration approved the use of buspirone for generalized anxiety disorder (GAD) in 1986. Since then, numerous studies have examined the efficacy and safety of buspirone for patients with not only generalized feelings... more
The Food and Drug Administration approved the use of buspirone for generalized anxiety disorder (GAD) in 1986. Since then, numerous studies have examined the efficacy and safety of buspirone for patients with not only generalized feelings of anxiety, but also panic disorder, major depressive disorder, obsessive-compulsive disorder, body dysmorphic disorder, social phobia, posttraumatic stress disorder, selective serotonin reuptake inhibitor-induced adverse events, dementia, behavioral disturbances, attention deficit-hyperactivity disorder, and tobacco dependency. Although relatively few placebo-controlled trials have been conducted on patients with problems other than GAD, an ever-growing body of research suggests future directions for the use of buspirone. This article reviews the body of research relating to new uses for buspirone.
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Patients presenting with somatoform or factitious disorders often incur excessive health-care charges and fail to respond to standard treatment. The purpose of this chapter is to examine evidence-based treatments for somatoform and... more
Patients presenting with somatoform or factitious disorders often incur excessive health-care charges and fail to respond to standard treatment. The purpose of this chapter is to examine evidence-based treatments for somatoform and factitious disorders. Also, an overview of the diagnostic criteria and demographic and clinical characteristics of the disorders is provided. A review of the published literature indicates that cognitive behavior therapy (CBT) has been empirically supported for somatization, hypochondriasis, body dysmorphic disorder as well as for two related conditions, irritable bowel syndrome and chronic fatigue syndrome; however, there is little data on the impact of treatment on health-care utilization, especially when the cost of CBT is factored in to the equation. Too few methodologically sound studies have been published on the treatment of conversion disorder, of pain disorder, or of factitious disorder to make any conclusions. Keywords: somatoform disorders; factitious disorders; somatization; hypochondriasis; body dysmorphic disorder; irritable bowel syndrome; chronic fatigue syndrome; fibromyalgia; cognitive behavior therapy; treatment
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This chapter provides an overview of the treatment of somatoform and related disorders. A brief history of the disorder is provided, along with a sociocultural framework in which to conceptualize somatization. The epidemiology of... more
This chapter provides an overview of the treatment of somatoform and related disorders. A brief history of the disorder is provided, along with a sociocultural framework in which to conceptualize somatization. The epidemiology of somatoform disorders is discussed. Empirical research evaluating psychosocial treatments for somatoform disorders, including the functional somatic syndromes, is reviewed and critiqued. The rather substantial assortment of treatment options available to clinicians is compared and contrasted, and their level of empirical support evaluated. The limitations of the empirical literature, as well as the treatment implications that can be drawn, are discussed.
Many patients who experience significant health anxiety and somatisation, and who also over-utilise medical services, are unresponsive to standard medical care.1 Cognitive behavioural therapy (CBT) has been shown to provide modest... more
Many patients who experience significant health anxiety and somatisation, and who also over-utilise medical services, are unresponsive to standard medical care.1 Cognitive behavioural therapy (CBT) has been shown to provide modest reductions in symptomatology and healthcare utilisation in these patients.1 Relaxation training (RT) also has been shown to benefit this population, but has been less widely studied.1
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Research Interests: Psychology, Primary Care, Anxiety Disorders, Psychometrics, Primary Health Care, and 15 moreMedicine, Humans, Female, Psychosomatics, Male, Depressive Disorder, Differential Diagnosis, Health Status, Clinical Sciences, Questionnaires, Adult, Predictive value of tests, Severity of Illness Index, Psychiatric Status Rating Scales, and Patient Health Questionnaire
Objective Sleep disturbances have been reported to be one of the most troubling manifestations of menopause. While hormone replacement therapy (HRT) has historically been considered a first-line treatment for menopausal insomnia, many... more
Objective Sleep disturbances have been reported to be one of the most troubling manifestations of menopause. While hormone replacement therapy (HRT) has historically been considered a first-line treatment for menopausal insomnia, many women are now seeking alternative treatments due to concerns about the risks and side-effects of HRT. The goal of this study was to evaluate the effect of ramelteon, a selective melatonin receptor agonist, for the treatment of menopausal insomnia. Study design A total of 20 healthy peri- and postmenopausal women with insomnia participated in this six-week, prospective, open-label trial of ramelteon (8 mg) at an academic medical centre. Participants completed sleep–wake diaries on a daily basis for six weeks. Self-report measures of sleep impairment, daytime functioning, quality of life and mood were also completed on a bi-weekly basis. Results Significant improvements in latency to sleep onset, total sleep time and sleep efficiency were observed in dia...
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Research Interests: Psychology, Cognitive Science, Depression, Medicine, Executive Function, and 15 moreHumans, Female, Cognitive Therapy, Male, Psychosocial, Clinical Sciences, Aged, Middle Aged, Adult, Short Term Memory, Neurosciences, Parkinson Disease, Severity of Illness Index, Psychiatric Status Rating Scales, and Neuropsychological Tests
Background: Parkinson’s disease (PD) is frequently complicated by co-occurring psychiatric problems such as depression and anxiety that negatively affect the course and management of the illness. Yet, in most cases, these psychiatric... more
Background: Parkinson’s disease (PD) is frequently complicated by co-occurring psychiatric problems such as depression and anxiety that negatively affect the course and management of the illness. Yet, in most cases, these psychiatric comorbidities are neither recognized nor treated to remission. The primary purpose of this study was to identify and describe barriers to mental health care utilization for people with PD. Secondary objectives included the assessment of attitudes and preferences regarding the need for mental health services in the PD community and the acceptability of telehealth interventions as a method for improving access and quality of care. Methods: A total of 769 people with PD completed an anonymous cross-sectional questionnaire assessing barriers to mental health care utilization in this medical population. Respondents were drawn from a national sample. Results: Commonly endorsed barriers to mental health care utilization in PD reflect the patients’ incomplete u...
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Research Interests: Psychology, Depression, Treatment Outcome, Medicine, Humans, and 12 moreFemale, Clinical, Ethnic Groups, Middle Aged, Adult, Sexual Function, Clinical Psychopharmacology, Serotonin Uptake Inhibitors, Psychiatric Status Rating Scales, bupropion, Psychology and Cognitive Sciences, and Medical and Health Sciences
A randomized controlled trial was conducted to assess the efficacy of an individually administered form of cognitive behavioral treatment for fibromyalgia. In an additive design, 76 patients diagnosed with fibromyalgia were randomly... more
A randomized controlled trial was conducted to assess the efficacy of an individually administered form of cognitive behavioral treatment for fibromyalgia. In an additive design, 76 patients diagnosed with fibromyalgia were randomly assigned to either the experimental treatment (affective-cognitive behavioral therapy, 10 individual sessions, one per week) administered concurrently with treatment-as-usual or to an unaugmented treatment-as-usual condition. Statistical analysis conducted at the end of treatment (3 months after the baseline assessment) and at a followup (9 months after the baseline assessment) indicated that the patients receiving the experimental treatment reported less pain and overall better functioning than control patients, both at posttreatment and at followup. The implications of these findings for future research are discussed.
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... Fatigue Syndrome 321 Ruud CW Vermeulen 5.15 Does Neurasthenia Really Exist in this Century? 323 Edmond Chiu CHAPTER 6 FACTITIOUS PHYSICAL DISORDERS 325 Factitious Physical Disorders: A Review 325 Stuart ...
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Somatization disorder is a distressing, disabling, and costly disorder. A short-term treatment manual, applying cognitive behavioral techniques to the maladaptive behaviors and thoughts associated with somatization disorder, was... more
Somatization disorder is a distressing, disabling, and costly disorder. A short-term treatment manual, applying cognitive behavioral techniques to the maladaptive behaviors and thoughts associated with somatization disorder, was developed. The present case report examines the effectiveness of this 10-session treatment with a 38-year-old woman diagnosed with somatization disorder. The results show an improvement in the patient’s physical and emotional distress at termination, 6-month follow-up, and 12-month follow-up assessments.
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BackgroundHot flashes are one of the most troubling manifestations of menopause, affecting about 80% of women. Due to recent controversies about hormone replacement therapy (HRT), many women are seeking alternative treatments. The use of... more
BackgroundHot flashes are one of the most troubling manifestations of menopause, affecting about 80% of women. Due to recent controversies about hormone replacement therapy (HRT), many women are seeking alternative treatments. The use of antidepressants to treat hot flashes and other menopausal symptoms has been an active area of investigation. However, the majority of past research in this area has included women with significant medical or psychiatric histories that may influence treatment response. This was the first study to examine the impact of escitalopram on hot flashes, mood, sleep, and quality of life in a healthy sample of non-depressed menopausal women.MethodsTwenty-five menopausal women, with no significant psychiatric or medical history, were enrolled. All women were treated with escitalopram (10-20mg flexibly dosed) for 8 weeks. The active treatment phase was preceded by a single blind placebo lead-in period.ResultsOver the course of the study, women reported significant decreases in both hot flash frequency and severity and improvements in dysphoria, anxiety, quality of life, and sleep.ConclusionsThese preliminary findings suggest that escitalopram may be a feasible and effective option for treating hot flashes and other menopausal symptoms in healthy women who might not ordinarily consider antidepressant treatment.
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Despite the demonstrated efficacy of psychosocial approaches to schizophrenia treatment that include a psychoeducational component, such as illness management, the implementation of these approaches into routine mental health treatment... more
Despite the demonstrated efficacy of psychosocial approaches to schizophrenia treatment that include a psychoeducational component, such as illness management, the implementation of these approaches into routine mental health treatment has been slow. The authors sought to examine the efficacy of a comprehensive, modularized, psychoeducational program called Team Solutions, which was designed to educate patients with major mental illnesses about their illness and how to manage it. Team Solutions was chosen for study because it is available over the Internet and other venues at no cost and is used by mental health agencies across the United States and Canada. Seventy-one persons with schizophrenia or schizoaffective disorder from three day treatment settings participated in this randomized, single-blind study. Participants were randomly assigned to attend one of two interventions: the Team Solutions intervention, which consisted of participating in a 24-week psychoeducational group fo...
Research Interests: Psychology, Health Promotion, Health Behavior, Schizophrenia, Health Education, and 13 moreGroup Psychotherapy, Humans, Program Development, Female, Male, Patient Compliance, Aged, Middle Aged, Adult, Public health systems and services research, Psychiatric Services, Psychotic Disorders, and attitude to health
Despite the demonstrated efficacy of psychosocial approaches to schizophrenia treatment that include a psychoeducational component, such as illness management, the implementation of these approaches into routine mental health treatment... more
Despite the demonstrated efficacy of psychosocial approaches to schizophrenia treatment that include a psychoeducational component, such as illness management, the implementation of these approaches into routine mental health treatment has been slow. The authors sought to examine the efficacy of a comprehensive, modularized, psychoeducational program called Team Solutions, which was designed to educate patients with major mental illnesses about their illness and how to manage it. Team Solutions was chosen for study because it is available over the Internet and other venues at no cost and is used by mental health agencies across the United States and Canada. Seventy-one persons with schizophrenia or schizoaffective disorder from three day treatment settings participated in this randomized, single-blind study. Participants were randomly assigned to attend one of two interventions: the Team Solutions intervention, which consisted of participating in a 24-week psychoeducational group fo...
Research Interests: Psychology, Health Promotion, Health Behavior, Schizophrenia, Health Education, and 13 moreGroup Psychotherapy, Humans, Program Development, Female, Male, Patient Compliance, Aged, Middle Aged, Adult, Public health systems and services research, Psychiatric Services, Psychotic Disorders, and attitude to health
Despite the demonstrated efficacy of psychosocial approaches to schizophrenia treatment that include a psychoeducational component, such as illness management, the implementation of these approaches into routine mental health treatment... more
Despite the demonstrated efficacy of psychosocial approaches to schizophrenia treatment that include a psychoeducational component, such as illness management, the implementation of these approaches into routine mental health treatment has been slow. The authors sought to examine the efficacy of a comprehensive, modularized, psychoeducational program called Team Solutions, which was designed to educate patients with major mental illnesses about their illness and how to manage it. Team Solutions was chosen for study because it is available over the Internet and other venues at no cost and is used by mental health agencies across the United States and Canada. Seventy-one persons with schizophrenia or schizoaffective disorder from three day treatment settings participated in this randomized, single-blind study. Participants were randomly assigned to attend one of two interventions: the Team Solutions intervention, which consisted of participating in a 24-week psychoeducational group fo...
Research Interests: Psychology, Health Promotion, Health Behavior, Schizophrenia, Health Education, and 13 moreGroup Psychotherapy, Humans, Program Development, Female, Male, Patient Compliance, Aged, Middle Aged, Adult, Public health systems and services research, Psychiatric Services, Psychotic Disorders, and attitude to health
ABSTRACT
Research Interests:
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that... more
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that needs to be addressed in order to improve the management of this nonmotor complication in PD. The purpose of this study was to examine the feasibility and effect of telephone-based CBT for dPD. Twenty-one depressed people with PD participated in a National Institutes of Health-sponsored uncontrolled pilot trial of telephone-based CBT in an academic medical center from October 2009 to February 2011. The Hamilton Depression Rating Scale was the primary outcome. Treatment was provided to people with PD for 10 weeks, modified for delivery over the phone, and supplemented with 4 separate phone-based caregiver educational sessions. Assessments were completed at baseline and 5 (midpoint), 10 (end-of-treatment), and 14 weeks (follow-up) post-enrollment. Twenty (95%) people with PD completed the study treatment. Phone-based CBT was associated with significant improvements in depression, anxiety, negative thoughts, and coping. Mean Hamilton Depression Rating Scale change from baseline to week 10 was 7.91 points (P < .001, Cohen d = 1.21). Telephone-based CBT may be a feasible and helpful approach for treating dPD and warrants further exploration in randomized-controlled trials. Results were comparable to those observed in the few in-person cognitive-behavioral treatment studies for dPD conducted to date.
Research Interests: Depression, Telemedicine, Humans, Face to Face, Female, and 19 moreFeasibility Studies, Cognitive Therapy, Male, Cognitive behavior therapy, Follow-up studies, Cognitive Behavioral Treatment Method, Clinical Sciences, Aged, Middle Aged, Randomized Controlled Trial, Telephone, Access to Care, Pilot Projects, Neurosciences, National Institute of Health, Parkinson Disease, Psychiatric Status Rating Scales, Randomized Controlled Trials as Topic, and Hamilton Depression Rating Scale
Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and... more
Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and clinical characteristics of each somatoform disorder and to examine the research assessing the efficacy of cognitive behavioral therapy (CBT) for each disorder. The review shows that CBT has received some empirical support for somatization, hypochondriasis, and body dysmorphic disorder. However, there are few data on the impact of treatment on health care use, especially when the cost of CBT is factored into the equation. Too few methodologically sound studies have been published on the treatment of conversion disorder or of pain disorder to make any conclusions.
Research Interests:
ABSTRACT
Research Interests:
Minority women often have a unique set of beliefs and expectations about medical treatment. At this time, there is a dearth of research looking at how depressed minority women respond to pharmacological interventions for the sexual... more
Minority women often have a unique set of beliefs and expectations about medical treatment. At this time, there is a dearth of research looking at how depressed minority women respond to pharmacological interventions for the sexual concomitants of depression. This was the first study to examine the impact of a medication switch, from a selective serotonin reuptake inhibitor to bupropion SR, on the sexual functioning of depressed minority women. Eighteen minority women (5 Hispanic, 10 African American, 2 Asian American, and 1 Native American), who were experiencing poor tolerability and/or lack of efficacy on an adequate trial of a selective serotonin reuptake inhibitor for depression, along with low sexual desire, were enrolled in this prospective open-label study. The selective serotonin reuptake inhibitor and bupropion SR were cross-tapered with a target dose of 150 to 300 mg of bupropion SR. The patients were followed for 10 weeks, and measures of sexual functioning and depression (Hamilton Rating Scale for Depression) were administered in an academic medical setting. Data were collected from July 2003 to December 2004. In the group as a whole, there were significant improvements in desire (F1,17 = 34.86, P < 0.001), arousal (F1,17 = 25.99, P < 0.001), and orgasm (F1,17 = 20.16, P < 0.001), on the Changes in Sexual Functioning Questionnaire. African-American women demonstrated the greatest improvement in depression (F1,16 = 9.55, P = 0.006), desire (F1,16 = 8.62, P = 0.01), and arousal (F1,16 = 8.83, P = 0.009) after the medication switch. Overall, this intervention appeared to be an effective treatment of low sexual desire in a diverse group of depressed minority women. The majority of women successfully completed the trial and planned to continue using bupropion SR after their participation in the study.
Research Interests:
ABSTRACT
Research Interests:
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that... more
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that needs to be addressed in order to improve the management of this nonmotor complication in PD. The purpose of this study was to examine the feasibility and effect of telephone-based CBT for dPD. Twenty-one depressed people with PD participated in a National Institutes of Health-sponsored uncontrolled pilot trial of telephone-based CBT in an academic medical center from October 2009 to February 2011. The Hamilton Depression Rating Scale was the primary outcome. Treatment was provided to people with PD for 10 weeks, modified for delivery over the phone, and supplemented with 4 separate phone-based caregiver educational sessions. Assessments were completed at baseline and 5 (midpoint), 10 (end-of-treatment), and 14 weeks (follow-up) post-enrollment. Twenty (95%) people with PD completed the study treatment. Phone-based CBT was associated with significant improvements in depression, anxiety, negative thoughts, and coping. Mean Hamilton Depression Rating Scale change from baseline to week 10 was 7.91 points (P < .001, Cohen d = 1.21). Telephone-based CBT may be a feasible and helpful approach for treating dPD and warrants further exploration in randomized-controlled trials. Results were comparable to those observed in the few in-person cognitive-behavioral treatment studies for dPD conducted to date.
Research Interests: Depression, Telemedicine, Humans, Face to Face, Female, and 19 moreFeasibility Studies, Cognitive Therapy, Male, Cognitive behavior therapy, Follow-up studies, Cognitive Behavioral Treatment Method, Clinical Sciences, Aged, Middle Aged, Randomized Controlled Trial, Telephone, Access to Care, Pilot Projects, Neurosciences, National Institute of Health, Parkinson Disease, Psychiatric Status Rating Scales, Randomized Controlled Trials as Topic, and Hamilton Depression Rating Scale
Research Interests: Health Care, Treatment Outcome, Prospective studies, Humans, Female, and 13 moreMale, Randomised Controlled Trial, Clinical Sciences, Visual Analogue Scale, Aged, Middle Aged, Adult, Adverse Event, Somatoform disorders, Triazoles, Pilot Projects, Severity of Illness Index, and Psychiatric Status Rating Scales
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that... more
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that needs to be addressed in order to improve the management of this nonmotor complication in PD. The purpose of this study was to examine the feasibility and effect of telephone-based CBT for dPD. Twenty-one depressed people with PD participated in a National Institutes of Health-sponsored uncontrolled pilot trial of telephone-based CBT in an academic medical center from October 2009 to February 2011. The Hamilton Depression Rating Scale was the primary outcome. Treatment was provided to people with PD for 10 weeks, modified for delivery over the phone, and supplemented with 4 separate phone-based caregiver educational sessions. Assessments were completed at baseline and 5 (midpoint), 10 (end-of-treatment), and 14 weeks (follow-up) post-enrollment. Twenty (95%) people with PD completed the study treatment. Phone-based CBT was associated with significant improvements in depression, anxiety, negative thoughts, and coping. Mean Hamilton Depression Rating Scale change from baseline to week 10 was 7.91 points (P < .001, Cohen d = 1.21). Telephone-based CBT may be a feasible and helpful approach for treating dPD and warrants further exploration in randomized-controlled trials. Results were comparable to those observed in the few in-person cognitive-behavioral treatment studies for dPD conducted to date.
Research Interests: Depression, Telemedicine, Humans, Face to Face, Female, and 19 moreFeasibility Studies, Cognitive Therapy, Male, Cognitive behavior therapy, Follow-up studies, Cognitive Behavioral Treatment Method, Clinical Sciences, Aged, Middle Aged, Randomized Controlled Trial, Telephone, Access to Care, Pilot Projects, Neurosciences, National Institute of Health, Parkinson Disease, Psychiatric Status Rating Scales, Randomized Controlled Trials as Topic, and Hamilton Depression Rating Scale
ABSTRACT
Research Interests:
Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and... more
Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and clinical characteristics of each somatoform disorder and to examine the research assessing the efficacy of cognitive behavioral therapy (CBT) for each disorder. The review shows that CBT has received some empirical support for somatization, hypochondriasis, and body dysmorphic disorder. However, there are few data on the impact of treatment on health care use, especially when the cost of CBT is factored into the equation. Too few methodologically sound studies have been published on the treatment of conversion disorder or of pain disorder to make any conclusions.
Research Interests:
ABSTRACT
Research Interests:
Research Interests:
Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and... more
Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and clinical characteristics of each somatoform disorder and to examine the research assessing the efficacy of cognitive behavioral therapy (CBT) for each disorder. The review shows that CBT has received some empirical support for somatization, hypochondriasis, and body dysmorphic disorder. However, there are few data on the impact of treatment on health care use, especially when the cost of CBT is factored into the equation. Too few methodologically sound studies have been published on the treatment of conversion disorder or of pain disorder to make any conclusions.
Research Interests:
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that... more
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that needs to be addressed in order to improve the management of this nonmotor complication in PD. The purpose of this study was to examine the feasibility and effect of telephone-based CBT for dPD. Twenty-one depressed people with PD participated in a National Institutes of Health-sponsored uncontrolled pilot trial of telephone-based CBT in an academic medical center from October 2009 to February 2011. The Hamilton Depression Rating Scale was the primary outcome. Treatment was provided to people with PD for 10 weeks, modified for delivery over the phone, and supplemented with 4 separate phone-based caregiver educational sessions. Assessments were completed at baseline and 5 (midpoint), 10 (end-of-treatment), and 14 weeks (follow-up) post-enrollment. Twenty (95%) people with PD completed the study treatment. Phone-based CBT was associated with significant improvements in depression, anxiety, negative thoughts, and coping. Mean Hamilton Depression Rating Scale change from baseline to week 10 was 7.91 points (P < .001, Cohen d = 1.21). Telephone-based CBT may be a feasible and helpful approach for treating dPD and warrants further exploration in randomized-controlled trials. Results were comparable to those observed in the few in-person cognitive-behavioral treatment studies for dPD conducted to date.
Research Interests: Depression, Telemedicine, Humans, Face to Face, Female, and 19 moreFeasibility Studies, Cognitive Therapy, Male, Cognitive behavior therapy, Follow-up studies, Cognitive Behavioral Treatment Method, Clinical Sciences, Aged, Middle Aged, Randomized Controlled Trial, Telephone, Access to Care, Pilot Projects, Neurosciences, National Institute of Health, Parkinson Disease, Psychiatric Status Rating Scales, Randomized Controlled Trials as Topic, and Hamilton Depression Rating Scale
Minority women often have a unique set of beliefs and expectations about medical treatment. At this time, there is a dearth of research looking at how depressed minority women respond to pharmacological interventions for the sexual... more
Minority women often have a unique set of beliefs and expectations about medical treatment. At this time, there is a dearth of research looking at how depressed minority women respond to pharmacological interventions for the sexual concomitants of depression. This was the first study to examine the impact of a medication switch, from a selective serotonin reuptake inhibitor to bupropion SR, on the sexual functioning of depressed minority women. Eighteen minority women (5 Hispanic, 10 African American, 2 Asian American, and 1 Native American), who were experiencing poor tolerability and/or lack of efficacy on an adequate trial of a selective serotonin reuptake inhibitor for depression, along with low sexual desire, were enrolled in this prospective open-label study. The selective serotonin reuptake inhibitor and bupropion SR were cross-tapered with a target dose of 150 to 300 mg of bupropion SR. The patients were followed for 10 weeks, and measures of sexual functioning and depression (Hamilton Rating Scale for Depression) were administered in an academic medical setting. Data were collected from July 2003 to December 2004. In the group as a whole, there were significant improvements in desire (F1,17 = 34.86, P < 0.001), arousal (F1,17 = 25.99, P < 0.001), and orgasm (F1,17 = 20.16, P < 0.001), on the Changes in Sexual Functioning Questionnaire. African-American women demonstrated the greatest improvement in depression (F1,16 = 9.55, P = 0.006), desire (F1,16 = 8.62, P = 0.01), and arousal (F1,16 = 8.83, P = 0.009) after the medication switch. Overall, this intervention appeared to be an effective treatment of low sexual desire in a diverse group of depressed minority women. The majority of women successfully completed the trial and planned to continue using bupropion SR after their participation in the study.
Research Interests:
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that... more
Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that needs to be addressed in order to improve the management of this nonmotor complication in PD. The purpose of this study was to examine the feasibility and effect of telephone-based CBT for dPD. Twenty-one depressed people with PD participated in a National Institutes of Health-sponsored uncontrolled pilot trial of telephone-based CBT in an academic medical center from October 2009 to February 2011. The Hamilton Depression Rating Scale was the primary outcome. Treatment was provided to people with PD for 10 weeks, modified for delivery over the phone, and supplemented with 4 separate phone-based caregiver educational sessions. Assessments were completed at baseline and 5 (midpoint), 10 (end-of-treatment), and 14 weeks (follow-up) post-enrollment. Twenty (95%) people with PD completed the study treatment. Phone-based CBT was associated with significant improvements in depression, anxiety, negative thoughts, and coping. Mean Hamilton Depression Rating Scale change from baseline to week 10 was 7.91 points (P < .001, Cohen d = 1.21). Telephone-based CBT may be a feasible and helpful approach for treating dPD and warrants further exploration in randomized-controlled trials. Results were comparable to those observed in the few in-person cognitive-behavioral treatment studies for dPD conducted to date.