Psychological medicine
-
Psychological medicine · Feb 2013
Randomized Controlled TrialCost-effectiveness and long-term effectiveness of internet-based cognitive behaviour therapy for severe health anxiety.
Severe health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety. ⋯ ICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.
-
Psychological medicine · Oct 2012
Randomized Controlled TrialImplementing a minimal intervention for chronic fatigue syndrome in a mental health centre: a randomized controlled trial.
Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) is an effective but intensive treatment, requiring trained therapists. A minimal intervention based on CBT for CFS, guided self-instruction, was shown to be an effective treatment when delivered in a tertiary treatment centre. Implementing this intervention in a community-based mental health centre (MHC) will increase the treatment capacity for CFS patients. This study evaluated the effectiveness of guided self-instruction for CFS implemented in an MHC, delivered by nurses. ⋯ Implementation of guided self-instruction in a community-based MHC was partially successful. The minimal intervention can be effectively implemented for CFS patients with physical impairments.
-
Psychological medicine · Sep 2012
Randomized Controlled Trial Multicenter StudyIncremental benefits and cost of coordinated anxiety learning and management for anxiety treatment in primary care.
Improving the quality of mental health care requires integrating successful research interventions into 'real-world' practice settings. Coordinated Anxiety Learning and Management (CALM) is a treatment-delivery model for anxiety disorders encountered in primary care. CALM offers cognitive behavioral therapy (CBT), medication, or both; non-expert care managers assisting primary care clinicians with adherence promotion and medication optimization; computer-assisted CBT delivery; and outcome monitoring. This study describes incremental benefits, costs and net benefits of CALM versus usual care (UC). ⋯ Compared with UC, CALM provides significant benefits with modest increases in health-care expenditures.
-
Psychological medicine · Mar 2012
Randomized Controlled TrialAcceptance and commitment therapy as guided self-help for psychological distress and positive mental health: a randomized controlled trial.
In order to reduce the high prevalence of depression, early interventions for people at risk of depression are warranted. This study evaluated the effectiveness of an early guided self-help programme based on acceptance and commitment therapy (ACT) for reducing depressive symptomatology. ⋯ The ACT-based self-help programme with minimal email support is effective for people with mild to moderate depressive symptomatology.
-
Psychological medicine · Jan 2012
Randomized Controlled Trial Multicenter StudyDepressive symptom dimensions and cardiac prognosis following myocardial infarction: results from the ENRICHD clinical trial.
Depression following myocardial infarction (MI) independently increases risk for early cardiac morbidity and mortality. Studies suggest that somatic, but not cognitive, depressive symptoms are responsible for the increased risk. However, the effects of somatic depressive symptoms at follow-up, after sufficient time has elapsed to allow for physical recovery from the initial infarction, are not known. Our aim was to examine the relationship between cognitive and somatic depressive symptom dimensions at baseline and 12 months post-MI and subsequent mortality and cardiovascular morbidity. ⋯ Somatic symptoms of depression at 12 months post-MI in patients at increased psychosocial risk predicted subsequent mortality. Psychosocial interventions aimed at improving cardiac prognosis may be enhanced by targeting somatic depressive symptoms, with particular attention to somatic symptom severity at 12 months post-MI.