107 research outputs found
The effectiveness of psychological interventions for obsessive-compulsive disorders: A meta-analysis of randomized controlled trials
No full textObsessive-compulsive disorders (OCD) rank as the tenth leading cause of disability worldwide(Fontenelle, Mendlowicz, & Versiani, 2006). It is associated with considerable loss of quality of life in patients, excessive healthcare costs, and premature mortality (Fontenelle et al., 2006; Macy et al., 2013). Various psychological interventions are available for people with OCD, however, there are few meta-analyses investigating the effectiveness of the variety of psychological interventions for OCD. Recent meta-analyses primarily focused on comparisons between exposure with response prevention (ERP) and control groups. The primary outcome was the Obsessive-Compulsive Scale (Y-BOCS). Results have shown that ERP is more effective than control groups (Ferrando & Selai, 2021; J. E. Reid et al., 2021). Few meta-analyses have compared a broad variety of psychological interventions to a control group in treating OCD. Moreover, the previously published meta-analyses on psychological interventions for OCD only included trials conducted in western countries, which has possibly led to missing high-quality studies published in other, non-English languages. The purpose of this meta-analysis is to investigate the effectiveness of a broad variety of psychological interventions for OCD, with consideration of any outcome measuring symptoms of OCD and extended with Chinese databases
The effect of psychological treatment for obsessive-compulsive disorder on depression, anxiety, and quality of life: A meta-analysis of randomized controlled trials
No full textObsessive-compulsive disorder (OCD) is characterized by persistent and recurrent obsessions and/or compulsions that are time-consuming and cause clinically significant distress/anxiety, or impairment in social, occupational, or other important areas of functioning [1]. While reducing OCD symptom severity remains the primary focus of treatment, there has been increasing research on quality of life (QoL) in recent years due to its critical role in the assessment and treatment of OCD [2]. According to the International Classification of Diseases, 10th Edition, health is defined as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." This definition implies that expert-rated illness severity is related to QoL but does not fully capture subjective well-being [3]. For instance, a reduction in OCD symptom severity does not necessarily correspond to an improvement in QoL. Furthermore, previous studies have suggested that there were negative associations between depression, anxiety (frequently co-occur with OCD), and QoL[4, 5]. However, there are no comprehensive studies that investigate them simultaneously. Therefore, our aim is to study depression, anxiety, and QoL outcomes in psychological treatments for OCD, and to analyze their interrelationships as well as their associations with OCD symptom severity through a meta-analysis
User profile of an online cognitive behavioral therapy self-help platform in Turkey
No full textOnline mental health self-help services are of societal importance and increasingly popular. Therefore, we have developed an online platform offering free self-help to the Turkish public with modules based on Cognitive Behavioral Therapy (CBT) targeting depression, anxiety, and stress respectively. The main purpose of this study is to describe the user profile of this platform. A pre-intervention self-report assessment including general demographic information and the Brief Symptom Inventory questionnaire during October 2020 until September 2022. 8331 participants completed the assessment and created an account out of the 11.228 users who registered during a two-year period, of which 8.331 (74%) completed the assessment and created an account. The majority of these users were female (76.17%), highly educated (82%), single (68%) and actively studying or working (84%). Slightly more than half (57%) of the platform user had not received psychological assistance before, while those who did receive previous assistance indicate to have benefitted from that (74%). The psychological symptoms of users are widely distributed, encompassing a broad range of user profiles. Approximately half of all users actively used the platform, while the other half did not complete any module. Among active users, the course “coping with depressive mood” was the most popular (41.45%), followed by “coping with anxiety” (37.25%) and “coping with stress” (21.30%). Offering a free online CBT self-help platform to the Turkish public seems feasible, with strong uptake among both man and woman struggling with a variety of psychological symptoms. Further research is needed to assess user satisfaction and change in symptoms over time during platform use by means of a feasibility trial.</p
Effectiveness of a guided internet-based intervention for procrastination among university students – A randomized controlled trial study protocol
No full textProcrastination is a widespread problem that is highly prevalent among the young adult population and is associated with several negative consequences. However, current evidence on the effectiveness of e-health interventions for procrastination either lack a comparison to an inactive control, do not include a student population or are of poor quality. This protocol describes the design of a trial that will overcome these limitations and examine the effectiveness of a guided internet-based intervention (GetStarted) to reduce problematic procrastinating behaviors in college students compared to a waitlist control. This study will be a two-armed randomized controlled trial with a calculated sample size of N = 176. Participants will be students from seven universities in the Netherlands. The intervention group will receive a four-week e-coach-guided intervention for procrastination. The waitlist control group will get access to treatment four weeks after randomization. Assessments will take place at baseline, post-test (4 weeks post-baseline) and follow-up (6 months post-baseline). Data will be analyzed with an intent-to-treat principle. The primary outcome is change in procrastination behaviors measured on the Irrational Procrastination scale (IPS). Secondary outcomes are depression, anxiety, stress, and quality of life. Additionally, sociodemographic characteristics of the participants, satisfaction with treatment, program usability, satisfaction with e-coach and treatment adherence will be examined as potential moderators. The results from this study can build evidence for the effectiveness of a guided internet-based intervention for treating procrastination in college students. Should it be effective, GetStarted could provide a flexible, low-intense and cost-effective treatment for procrastination and prevent common mental health problems in college students. Trial registration: This trial is registered at ClinicalTrials.gov Protocol Registration and Results System (Trial number: NCT05478096)
The predictive specificity of psychological vulnerability markers for the course of affective disorders
No full textHigh scores on markers of psychological vulnerability have been associated with a worse course of affective disorders. However, little is known about the specificity of those associations in predicting the course of different depressive and anxiety disorders. We examined the impact of psychological vulnerability on the short- and long-term course of depressive and anxiety disorders. Participants from the Netherlands Study of Depression and Anxiety with a current diagnosis of depression or anxiety (n = 1256) were reassessed after 2 and 6 years. Diagnostic status and chronic duration (>85% of the time) of symptoms were the outcomes. Predictors were neuroticism, extraversion, locus of control, cognitive reactivity (rumination and hopelessness reactivity), worry and anxiety sensitivity. High neuroticism, low extraversion and external locus of control predicted chronicity of various affective disorders. Rumination, however, predicted chronicity of depressive but not anxiety disorders. Worry specifically predicted chronicity of GAD and anxiety sensitivity predicted chronicity of panic disorder and social anxiety disorder. These patterns were present both at short-term and at long-term, without losing predictive accuracy. Psychological vulnerabilities that are theoretically specific to certain disorders indeed selectively predict the course of these disorders. General markers of vulnerability predicted the course of multiple affective disorders. This pattern of results supports the notion of specific as well as transdiagnostic predictors of the course of affective disorders and is consistent with hierarchical models of psychopathology
The effectiveness and acceptability of different treatment formats of cognitive behavioral therapy for obsessive-compulsive disorders: a systematic review and network meta-analysis
No full textCognitive behavioral therapy (CBT) is an evidence-based therapeutic intervention for obsessive-compulsive disorders (OCD)(Olatunji et al., 2013; Öst et al., 2015). CBT treatment is generally delivered individually or in a group. However more recently, family-based treatment and guided self-help as well as unguided self-help interventions are also common. Until now, it remains unknown if the format in which CBT is delivered is associated with treatment effects. So far there are only meta-analyses done within one of the CBT formats. In this network meta-analysis, we will pool all available information from a set of related studies in one analysis. In this way, we investigate the effectiveness and acceptability of different CBT treatment delivery formats by combining direct and indirect evidence
Psychotherapies for Obsessive-Compulsive Disorder: A Network Meta-analysis
No full textObsessive-compulsive disorder (OCD) is widely recognized as a dilatating and chronic disorder (Abramowitz & Jacoby, 2014), significantly affecting individuals with OCD and their families (Steketee, 1997; Stengler-Wenzke et al., 2006). Conventional psychotherapies, such as exposure and response prevention (ERP; Lindsay et al., 1997; Mancebo et al., 2021), cognitive therapy (CT; Alcolado & Radomsky, 2016; van Balkom et al., 1998), and cognitive-behavior therapy (CBT; Baruah et al., 2018; Fals-Stewart & Schafer, 1992; Mancebo et al., 2021) combining both ERP and CT, are available. Prior investigations comparing the efficacy of ERP, CT, and CBT have yielded inconsistent results; while one meta-analytic study reported similar effects of ERP, CT, and CBT (Rosa-Alcázar et al., 2008), another one suggested that CT had a lesser effect than ERP (Olatunji et al., 2013). This discrepancy could potentially be attributed to the limited number of randomized controlled trials (RCTs) examining the effects of psychotherapy for OCD. The escalating number of RCTs conducted in the past decade necessitates a refreshed evaluation to determine which intervention exerts the greatest advantage in managing OCD symptoms. Moreover, in recent years, novel psychotherapies, such as acceptance and commitment therapy (ACT; Lee et al., 2023; Twohig et al., 2010) and the inference-based approach (IBA; Visser et al., 2015), have emerged as promising treatments for OCD. Nonetheless, whether these innovative therapies yield similar effects to each other/conventional approaches or offer superior treatment benefits, thus potentially warranting an update to first-line psychotherapy recommendations for OCD, remains unknown. Addressing this question is crucial for guiding clinical practice for individuals with OCD and optimizing mental health resource management. Therefore, our objective is to conduct a network meta-analysis to investigate the effectiveness and acceptability of all types of psychotherapies for OCD
Effects of psychological treatment for depression among people not actively seeking help: A meta-analysis
No full textAlthough psychological treatments have been found to be effective for depression in adults, many individuals with depression do not actively seek help. It is currently unclear whether psychological treatments are effective among those not actively seeking help. Besides, little is known about the proportion of patients who completed a screening questionnaire who end up in a clinical trial. Therefore, we conducted a meta-analysis of 52 randomized trials comparing psychotherapies for adults with a diagnosis or elevated symptoms of depression against control conditions (care-as-usual, waiting list, and other inactive treatment). Only studies recruiting participants who do not actively seek help (participants who have been recruited through screening instead of advertisements and clinical referrals) were included. To obtain an overall effect estimate of psychotherapy, we pooled all post-test differences with a random-effects model. We found that psychological treatments had a moderate to high effect on reducing depressive symptoms compared to control groups [g = 0.55; 95% confidence interval (CI) 0.41-0.69]. Heterogeneity was high (I2 = 75%; 95% CI 68-80). At 12 months' follow-up, the effects were small but significant (6-8 months: g = 0.33; 95% CI 0.14-0.52; 9-12 months: g = 0.24; 95% CI 0.11-0.37). As a secondary outcome, we found that 13% of patients who completed a screening questionnaire met the inclusion criteria for depression and agreed to be randomized in the trial. Based on the current evidence, psychological treatments for depression might be effective for depressed patients who are not actively seeking help
Effectiveness of a guided digital self-help intervention to improve sleep and the biological clock in university students – Study protocol for a randomized controlled trial
No full textBackground: Sleep problems occur in many university students which affects their mental health and daily functioning. Cognitive behavioural therapy for insomnia (CBT-I) has been proven effective in adults but research in university students, who struggle to maintain a 24-hour rhythm, is still limited. We hypothesize that a guided digital CBT-I intervention, enriched with components on the biological clock (‘i-Sleep & BioClock’) will be effective in reducing insomnia severity and improving mental health outcomes for students with sleep problems. Objectives: We aim to evaluate the effectiveness of a guided online sleep and biological clock self-help intervention in improving sleep, depression symptoms, anxiety symptoms, functioning, academic performance, and quality of life in university students at 6 weeks and 18 weeks. Methods: This is a two-arm parallel-group superiority randomized controlled trial, comparing a 5-week guided online ‘i-Sleep & BioClock’ intervention to online psychoeducation (PE). We aim to include 192 university students (Bachelor, Master, and PhD) with at least subthreshold insomnia (Insomnia Severity Index ≥10), aged ≥16, who can speak Dutch or English. We are excluding students with current risk for suicide or night shifts. The primary outcome is insomnia severity. Secondary outcomes include sleep estimates (sleep and light exposure diary), depression, anxiety, functioning, quality of life, and academic performance. The effectiveness of the intervention compared to online PE will be evaluated using linear mixed models. Discussion: The current study tests the effectiveness of an online self-help intervention for university students who suffer from sleep problems. This trial builds upon an open feasibility study and will provide evidence of an online guided self-help program for students. The findings of this study will determine the potential wider dissemination of the intervention to address the high need for available and accessible help for students experiencing insomnia. Trial registration: ClinicalTrials.Gov (NCT06023693), registered on August 3rd, 2023.</p
The effect of eye movements on craving in alcohol-dependent inpatients: a randomized controlled experiment
No full textHealth and Well-bein
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