Archives of general psychiatry
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Arch. Gen. Psychiatry · Oct 2009
Randomized Controlled Trial Multicenter StudyIncremental benefit and cost of telephone care management and telephone psychotherapy for depression in primary care.
Effectiveness of organized depression care programs is well established, but dissemination will depend on the balance of benefits and costs. ⋯ Compared with current primary care practice, a structured telephone program including care management and cognitive behavioral psychotherapy has significant clinical benefit with only a modest increase in health services cost.
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Arch. Gen. Psychiatry · Jul 2009
Randomized Controlled TrialEfficacy of an Internet-based behavioral intervention for adults with insomnia.
Insomnia is a major health problem with significant psychological, health, and economic consequences. However, availability of one of the most effective insomnia treatments, cognitive behavioral therapy, is significantly limited. The Internet may be a key conduit for delivering this intervention. ⋯ Participants who received the Internet intervention for insomnia significantly improved their sleep, whereas the control group did not have a significant change. The Internet appears to have considerable potential in delivering a structured behavioral program for insomnia.
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Arch. Gen. Psychiatry · Apr 2009
Randomized Controlled Trial Comparative StudyModulation of mediotemporal and ventrostriatal function in humans by Delta9-tetrahydrocannabinol: a neural basis for the effects of Cannabis sativa on learning and psychosis.
Cannabis sativa use can impair verbal learning, provoke acute psychosis, and increase the risk of schizophrenia. It is unclear where C. sativa acts in the human brain to modulate verbal learning and to induce psychotic symptoms. ⋯ The modulation of mediotemporal and ventrostriatal function by Delta9-THC may underlie the effects of C. sativa on verbal learning and psychotic symptoms, respectively.
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Arch. Gen. Psychiatry · Jan 2009
Randomized Controlled TrialDistinct effects of {delta}9-tetrahydrocannabinol and cannabidiol on neural activation during emotional processing.
Cannabis use can both increase and reduce anxiety in humans. The neurophysiological substrates of these effects are unknown. ⋯ Delta9-Tetrahydrocannabinol and CBD had clearly distinct effects on the neural, electrodermal, and symptomatic response to fearful faces. The effects of CBD on activation in limbic and paralimbic regions may contribute to its ability to reduce autonomic arousal and subjective anxiety, whereas the anxiogenic effects of Delta9-THC may be related to effects in other brain regions.
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Arch. Gen. Psychiatry · Jun 2008
Randomized Controlled Trial Comparative StudyTreatment of acute stress disorder: a randomized controlled trial.
Recent trauma survivors with acute stress disorder (ASD) are likely to subsequently develop chronic posttraumatic stress disorder (PTSD). Cognitive behavioral therapy for ASD may prevent PTSD, but trauma survivors may not tolerate exposure-based therapy in the acute phase. There is a need to compare nonexposure therapy techniques with prolonged exposure for ASD. ⋯ Exposure-based therapy leads to greater reduction in subsequent PTSD symptoms in patients with ASD when compared with cognitive restructuring. Exposure should be used in early intervention for people who are at high risk for developing PTSD.