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Digital mental health interventions (DMHI) may offer scalable treatment for common mental health conditions. However, many commercially available apps have not been subjected to rigorous evaluation of effectiveness, particularly among users experiencing clinically significant symptomatology. We examined depression and anxiety symptom outcomes associated with a top-rated, commercially available self-guided DMHI based on cognitive behavioral therapy ("Sanvello") relative to waitlist control. This preregistered web-based, 2-arm, parallel-group randomized trial enrolled U.S. adults with self-reported elevated symptoms of depression and/or anxiety. Those assigned to the treatment condition were provided 8 weeks of access to Sanvello. Co-primary outcomes of depression (Patient Health Questionnaire [PHQ-9]) and anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]) severity were assessed at baseline and 2, 4, 6, and 8 weeks. Intention-to-treat analyses included 280 participants (mean age 32.47 ± 9.32 years; 86.1 % women). Generalized linear mixed models showed a significant improvement in depression (F (4,779) = 6.51, p <.001) and anxiety (F (4,907) = 3.28, p =.01) associated with the DMHI over time. The intervention was also associated with a greater proportion of participants exhibiting depression response (25 [45.5 %] vs 26 [16.9 %]) and remission (10 [18.2 %] vs 7 [4.5 %]) on the PHQ-9, and anxiety response (31 [44.9 %] vs 39 [22.8 %]) and remission (20 [29.0 %] vs 27 [15.8 %]) on the GAD-7, relative to waitlist. Findings may not represent people with serious mental illness, suicidality, or the broader population of DMHI users. A commercially available, self-guided DMHI was effective at improving symptoms in individuals experiencing depression or anxiety. ClinicalTrials.gov [ NCT05373329 ] • Depression symptoms improved among those assigned to a commercially-available app. • Anxiety symptoms improved among those assigned to a commercially-available app. • App assignment was associated with a treatment response (50 % PHQ-9 reduction) among 45.5 % of those with depression. • App assignment was associated with a treatment response (50 % GAD-7 reduction) among 44.9 % of those with anxiety. [ABSTRACT FROM AUTHOR]

Diabetes in children is a chronic condition that involves rigorous blood sugar management to prevent complications. The psychological stress associated with this disease can worsen the general condition and oral health of diabetic children, causing xerostomia, oral infections and gum disease. This study explores the effectiveness of stress management strategies, including relaxation techniques, psychological counseling, family support, and behavioral interventions such as cognitive behavioral therapy (CBT) and mindfulness. Research shows that these methods reduce anxiety, improve blood sugar control and adherence to treatment, thus contributing to better oral health and an improved overall quality of life. The integrated approach to psychological stress is essential in the holistic treatment of diabetic children, to prevent long-term complications and promote healthy living.

Despite the growing recognition of mental health challenges among university students, the effectiveness and adaptability of Cognitive Behavioral Therapy (CBT) in these settings, particularly in terms of diverse delivery methods and their impact on outcomes, remains underexplored. This Systematic Literature Review (SLR) rigorously evaluates the efficacy of CBT in reducing stress among university students, utilizing the PRISMA 2020 framework. The review analyzes 27 carefully selected articles, focusing on objective analysis, diverse delivery methods, session and treatment duration, various CBT interventions, and the applied skills and strategies. The findings confirm CBT as an exceptionally effective stress management tool, noted for its adaptability and versatility. The study underscores the importance of online CBT and emphasizes the need for interventions tailored to the diverse needs of students, enhancing their mental well-being. In light of these findings, future research should investigate the mediators and moderators that affect the effectiveness of CBT, assess the long-term impact on academic and mental health outcomes, and explore the sustainability of these interventions. This study contributes to CBT's theoretical and practical understanding in higher education settings. It lays the groundwork for future explorations to optimize mental health interventions for university students. [ABSTRACT FROM AUTHOR]

Avoidant/restrictive food intake disorder (ARFID) and gastrointestinal (GI)-related somatic symptom and related disorders (SSRDs) commonly co-occur, and both are associated with confusion in the process of accessing treatment. Furthermore, health professionals report low confidence in providing care for these conditions. Using a life history methodology, we explored the journeys of children and their parents with the diagnosis and treatment of ARFID and/or SSRDs and examined themes in barriers and facilitators to care. Six families with children (4 boys and 2 girls; 8–14 years old) with a diagnosis of ARFID and/or GI-related SSRD were recruited from a pediatric tertiary-level hospital. Interviews were conducted with four parents alone, and two parent-child dyads. Participants provided rich histories of the child's health journeys with variation in the development of ARFID and GI-related SSRDs and subsequent management. Diagnostic uncertainty, the emotional impact of this journey on families, and systemic barriers to accessing treatment were themes of the healthcare narratives. Validating the emotional impacts of the healthcare journey and building trust may be helpful to address the diagnostic uncertainty that families experience. Strategies to support adaptation of cognitive-behavioral approaches for with children with complex ARFID and/or SSRDs are discussed. [ABSTRACT FROM AUTHOR]

Background: Mahana™ IBS is a Food and Drug Administration‐cleared prescription mobile application designed to deliver 3 months of gut‐directed cognitive behavioral therapy (CBT) to adults ≥22 years old with irritable bowel syndrome (IBS). We assessed whether gut‐directed CBT delivered digitally improved outcomes in IBS management. Methods: We studied users who had a dispensed physician prescription for Mahana™ IBS between August 2021 and August 2023. The primary outcome was change in IBS symptom severity (IBS‐SSS) score. Key Results: For the 843 patients, 324 (38%) completed half of the program up to session 5, and 162 (19%) of participants completed the full program up to session 10. Median age was 41 years, median IBS‐SSS was 270 (moderate severity), IBS‐mixed subtype was most common (23%) followed by IBS‐C (20%) and IBS‐D (19%). The change in IBS‐SSS was −81.0 (p = < 0.001) after session 5 and − 104.4 (p = < 0.001) after session 10. In multivariate analyses, a higher baseline IBS‐SSS (OR 1.59; 95% CI 1.26–2.01) and high baseline Perceived Stress Scale (PSS) score predicted non‐response (OR 0.95; 95% CI 0.91–0.98) while older age (OR 1.10 per decade; 95% CI 1.01–1.20), prescription source from a healthcare provider (as opposed to third party telehealth encounter, OR 1.48; 95% CI 1.07–2.05), and payment for the app (OR 1.93; 95% CI 1.41–2.63) predicted adherence. Conclusions & Inferences: Use of a digital mobile application for gut‐directed CBT improved symptoms of IBS. Digital health applications have the potential to democratize CBT and allow integrated care to scale for patients with IBS. [ABSTRACT FROM AUTHOR]

Objective: It is essential to determine detailed studies to understand the effectiveness, mechanisms, moderators, and cost-effectiveness of psychological intervention programs on psychological well-being in visually impaired people. Methods: This systematic review focused on studies that evaluated the interventions to promote psychological, emotional, and social well-being. The data were collected by... [ABSTRACT FROM AUTHOR]

Diabetes in children is a chronic condition that involves rigorous blood sugar management to prevent complications. The psychological stress associated with this disease can worsen the general condition and oral health of diabetic children, causing xerostomia, oral infections and gum disease. This study explores the effectiveness of stress management strategies, including relaxation techniques, psychological counseling, family support, and behavioral interventions such as cognitive behavioral therapy (CBT) and mindfulness. Research shows that these methods reduce anxiety, improve blood sugar control and adherence to treatment, thus contributing to better oral health and an improved overall quality of life. The integrated approach to psychological stress is essential in the holistic treatment of diabetic children, to prevent long-term complications and promote healthy living. [ABSTRACT FROM AUTHOR]

Adolescent depression presents a significant global mental health concern, exerting profound impacts on various facets of young people's lives. Cognitive Behavioral Therapy (CBT) has emerged as a leading intervention for tackling adolescent depression, grounded in principles derived from cognitive theory. This review delves into the effectiveness, mechanisms, and outcomes of CBT in addressing adolescent depression, synthesizing findings from a range of empirical studies including randomized controlled trials, meta-analyses, and systematic reviews. The review underscores the consistent efficacy of CBT in diminishing depressive symptoms among adolescents, elucidating mechanisms such as cognitive restructuring and behavioral activation that underpin its therapeutic effects. Additionally, CBT yields favorable outcomes beyond mere symptom reduction, encompassing enhancements in social connections and academic performance. Nonetheless, challenges such as limited accessibility and hurdles in engaging adolescents persist in CBT implementation. To surmount these obstacles, forthcoming research ought to concentrate on devising innovative delivery approaches, such as internet-based interventions and school-centered programs. In essence, CBT stands as a pivotal component in the treatment of adolescent depression, furnishing a holistic framework to address the intricate interplay of cognitive, emotional, and behavioral elements, thereby fostering the mental well-being of adolescents on a global scale.

This study evaluated the effect of cognitive behavioral therapy (CBT) on the academic stress of rural community secondary school economic students. The study adopted the pre-test, post-test randomized control trial experimental design. The economics academic stress questionnaire (EASQ) was used for data collection using 168 secondary school economics students sampled from rural community schools in Southeast Nigeria. The instrument was validated by three experts in the area of the study and the internal consistency reliability index of the items was estimated as 0.83 using the Cronbach Alpha method. A pre-treatment assessment (pre-test) was conducted using the EASQ to collect baseline data. After that, the experimental group was exposed to 60 min of the CBT program once a week for 8 weeks. The data collected were analysed using mixed-design repeated analysis of variance. The findings of the study revealed that CBT had a significant effect on the management of academic stress among rural community secondary schools economics students. Based on the findings of the study, it can be concluded that the use of CBT intervention will be helpful in the management of academic stress among rural community secondary school economics students. The implication of that is that CBT intervention is effective in the reduction of psychological problems and discomfort among students in order to improve their academic achievement. [ABSTRACT FROM AUTHOR]

Objectives: Test anxiety has a negative impact on college students' academic performance and mental health. This study evaluated the effects of a group program integrating Compassionate Mind Training (CMT) with Cognitive Behavioral Therapy (CBT) on test anxiety and a range of secondary outcomes. It was hypothesized that a 6-week program would reduce test anxiety and improve a range of mental health outcomes, compared to a wait-list condition. Method: A total of 64 college students (M = 20.26, SD = 1.63 years) with test anxiety (Test Anxiety Index greater than 49) were randomly assigned to either a 6-week intervention or wait-list control group. Participants completed a series of self-reports questionnaires before the intervention, after the intervention, and at a 4-month post-intervention follow-up. Results: The intervention significantly reduced test anxiety and improved self-compassion, the perceived ability to manage negative emotions, and general anxiety levels, with these effects persisting at the follow-up assessment. Moreover, the intervention group of participants experienced a further significant reduction in test anxiety and a significant improvement in subjective well-being 4 months after intervention. Conclusions: This study provides preliminary evidence supporting the efficacy of an integrated CMT with CBT group program for alleviating test anxiety. Preregistration: This study is not preregistered. [ABSTRACT FROM AUTHOR]

In Asia, the availability of school counselors is significantly lower than global standards recommend, particularly in elementary education settings. This shortage is exacerbated by rising mental health concerns among young students, particularly those with emotional disorders. Considering the critical gap in the provision of mental health services in Asia, this paper studies a digital intervention approach with an AI-driven supportive system developed by adopting OpenAI to enhance the effectiveness of counseling in elementary education. Twenty-two students with ADHD, autism spectrum disorder, and emotional disorders undergoing counseling at a primary school in Taiwan were recruited as participants for a three-month experiment, with the five Social-Emotional competencies as dependent variables. The treatment group utilized the proposed system with a digital journaling platform to help students reflect on their emotions, thoughts, and actions after counseling sessions, fostering an ongoing dialogue with their counselors through the system. Conversely, the control group received standard counseling without integrating the use of the proposed platform. The results of a two-factor mixed design ANOVA revealed that students who did not use the supportive system showed significant improvement in self-awareness. In contrast, students who went through the new model demonstrated significant changes in all competencies. These findings highlight the value of the proposed intervention approach for students with emotional disorders and suggest broader applications for AI technologies in school counseling, offering valuable insights for educators and policymakers.

Abstract Background Recent systematic reviews have indicated that cognitive behavioral therapy (CBT) is effective in reducing anxiety symptoms for autistic and non-autistic children. However, the vast majority of CBT research for autistic youth has been implemented within university settings and primarily by mental health providers. Schools hold great promise to equitably manage the mental health symptoms of autistic youth. Although preliminary research evaluating CBT within schools has been promising, CBT has not yet been compared to another readily available school mental health program. The goal of this protocol paper is to describe a multi-site study comparing two school-based interventions, Facing Your Fears-School Based (FYF-SB) and Zones of Regulation (ZOR) via a cluster randomized controlled type 1 hybrid effectiveness-implementation trial to determine which of the two interventions will best support autistic youth with anxiety in schools. Methods Up to 100 elementary and middle schools will be randomized into FYF-SB or ZOR. Once schools are randomized, a minimum of two interdisciplinary school providers at each school will be trained to deliver either FYF-SB or ZOR over the course of 12 weeks to groups of 2–5 autistic students ages 8–14 years. Over the course of two years, a total of 200 autistic students will receive either ZOR or FYF-SB. The primary outcome of this trial is child anxiety, as rated by masked evaluators and via caregiver- and student-report, which will be measured at baseline, post-treatment, and 6-month follow-up. Semi-structured interviews will also be conducted with a purposive sample of students, caregivers, and school providers to understand the acceptability, appropriateness, and feasibility of either ZOR or FYF-SB. Stakeholder engagement is a central component of this project via two stakeholder advisory boards that will directly inform and oversee the project. Discussion Results of this study will provide evidence about the relative impact of two school-based mental health interventions on outcomes reported as meaningful by caregivers and school providers. The additional focus on evaluating factors that support the implementation of FYF-SB and ZOR will allow future studies to test targeted implementation strategies that support mental health programming uptake and implementation within public schools. Trial registration This trial is registered with clinicaltrials.gov (NCT05863520).

Abstract The use of virtual reality (VR) in telepsychiatry signifies a paradigm shift in mental health care. VR provides realistic, interactive environments for therapies like exposure therapy and cognitive behavioral therapy, resulting in reliable and reproducible scenarios that improve treatment effectiveness. This technology enhances accessibility for those with geographical or physical limitations, lowers stigma, and boosts patient engagement and adherence by making treatment activities more pleasurable and interesting. Furthermore, VR may emulate social interactions and circumstances that are difficult to replicate in typical treatment settings, providing useful practice for people with social anxiety or autism spectrum disorders (ASD). Despite its great potential, integrating VR into telepsychiatry offers problems such as high VR equipment costs, assuring clinical effectiveness and safety, and securing patient data. Future research should prioritize large-scale, randomized controlled trials to determine the efficacy of VR-based therapy, investigate long-term consequences, and offer cost-effective solutions. By tackling these issues and investing in novel research, VR has the potential to greatly improve telepsychiatry, making mental health care more effective, engaging, and easily available to people all over the world.

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effectiveness of repeated transcranial direct current stimulation (rtDCS), cognitive behavioral therapy (CBT), and their combination (rtDCS-CBT) in the treatment of cognitive dysfunction, social cognition, and depressive symptoms in women diagnosed with major depressive disorder (MDD). A total of 40 female participants with MDD were randomly assigned to one of four groups: rtDCS, CBT, rtDCS-CBT, and a control group. The participants' depressive symptoms, executive functions, and social cognition were assessed at baseline, preintervention, postintervention, and during a 1-month follow-up. The rtDCS group received 10 sessions of anodal dorsolateral and cathodal ventromedial prefrontal cortex (2 mA for 20 minutes). The CBT group received 10 sessions of traditional CBT, whereas the combined group received CBT after the tDCS sessions. The results of the analysis of variance indicated that all intervention groups demonstrated significant improvements in depressive symptoms, cognitive dysfunction, and social cognition compared with the control group (all p < 0.001). Furthermore, the rtDCS-CBT group exhibited significantly greater reductions in depressive symptoms when compared with each intervention alone (all p < 0.001). Notably, working memory improvements were observed only in the rtDCS group (p < 0.001). In conclusion, this study suggests that both CBT and tDCS, either individually or in combination, have a positive therapeutic impact on enhancing executive functions, theory of mind, and depressive symptoms in women with MDD. [ABSTRACT FROM AUTHOR]

The authors examined whether brief cognitive-behavioral therapy (bCBT) for depression, delivered by mental health providers in community-based outpatient clinics (CBOCs) of the Veterans Health Administration, improved depression outcomes and was feasible and acceptable in clinical settings. The authors used a type-2 hybrid effectiveness-implementation, patient-randomized trial to compare bCBT with enhanced usual care. Participants (N=189) with moderate symptoms of depression (Patient Health Questionnaire–9 [PHQ-9] score ≥10) were enrolled from CBOCs in the southern United States. bCBT (N=109) consisted of three to six sessions, delivered by mental health providers (N=17) as part of routine clinic practices. Providers received comprehensive training and support to facilitate bCBT delivery. Recipients of enhanced usual care (N=80) were given educational materials and encouraged to discuss treatment options with their primary care provider. The primary effectiveness outcome was PHQ-9–assessed depression symptoms posttreatment (4 months after baseline) and at 8- and 12-month follow-ups. Implementation outcomes focused on bCBT dose received, provider fidelity, and satisfaction with bCBT training and support. bCBT improved depression symptoms (Cohen's d=0.55, p<0.01) relative to enhanced usual care posttreatment, and the improvement was maintained at 8- and 12-month follow-ups (p=0.004). bCBT participants received a mean±SD of 3.7±2.7 sessions (range 0–9), and 64% completed treatment (≥3 sessions). Providers delivered bCBT with fidelity and reported that bCBT training and support were feasible and effective. bCBT had a modest treatment footprint of approximately four sessions, was acceptable to participants and providers, was feasible for delivery in CBOCs, and produced meaningful sustained improvements in depression. [ABSTRACT FROM AUTHOR]

To examine the use of cognitive behavioral therapy (CBT) in a case of co-occurring generalized anxiety disorder (GAD) and Parkinson's disease (PD). This case study refers to a male aged 75 years with a diagnosis of Idiopathic Parkinson's disease. It focuses on applying a CBT model to address the psychological difficulties with PD and GAD. This case study reveals key aspects in presentation, diagnosis, and psychological treatment between PD and GAD, and is one of few studies published in this area. Symptoms of anxiety in an older adult with PD decreased during a course of CBT. The implications of the treatment outcome of this study and further considerations of treatment plans for comorbid PD and anxiety have been discussed. Using CBT could positively impact non-motor symptoms of Parkinson's, such as sleep difficulties and speech impediments. Using CBT for the catastrophic thinking and worry content in GAD seems to act as a complementary therapy for psychological/non-motor symptoms of PD. [ABSTRACT FROM AUTHOR]

Introduction: Misophonia is a recently defined disorder characterized by distressing responses to everyday sounds, such as chewing or sniffling. Individuals with misophonia experience significant functional impairment but have limited options for evidenced-based behavioral treatment. To address this gap in the literature, the current pilot trial explored the acceptability and efficacy of a transdiagnostic cognitive-behavioral approach to treating symptoms of misophonia. Methods: This trial was conducted in two studies: In Study 1, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was delivered to eight patients in order to receive feedback to guide revisions to the treatment to suit this population. In Study 2, ten patients received the revised UP treatment to explore its acceptability and preliminary efficacy. This study used a singlecase experimental design with multiple baselines, randomizing patients to either a 2-week baseline or 4-week baseline prior to the 16 weeks of treatment, followed by four weeks of follow-up. Results: The findings from these studies suggested that patients found both the original and adapted versions of the UP to be acceptable and taught them skills for how to manage their misophonia symptoms. Importantly, the findings also suggested that the UP can help remediate symptoms of misophonia, particularly the emotional and behavioral responses. Discussion: These findings provide preliminary evidence that this transdiagnostic treatment for emotional disorders can improve symptoms of misophonia in adults. [ABSTRACT FROM AUTHOR]

A systematic review and meta-analysis was conducted where we evaluated the effects of Parent Management Training (PMT), Parent–Child Interaction Therapy (PCIT) and PMT combined with child cognitive behavioral therapy (CBT) using data from 25 RCTs on children with clinical levels of disruptive behavior (age range 2–13 years). Results showed that PMT (g = 0.64 [95% CI 0.42, 0.86]) and PCIT (g = 1.22 [95% CI 0.75, 1.69]) were more effective than waiting-list (WL) in reducing parent-rated disruptive behavior, and PMT also in improving parental skills (g = 0.83 [95% CI 0.67, 0.98]) and child social skills (g = 0.49 [95% CI 0.30, 0.68]). PCIT versus WL had larger effects in reducing disruptive behavior than PMT versus WL. In the few studies found, the addition of child CBT to PMT did not yield larger effects than PMT or WL. These results support offering PMT to children with clinical levels of disruptive behavior and highlight the additional benefits of PCIT for younger ages. [ABSTRACT FROM AUTHOR]

IntroductionMisophonia is a recently defined disorder characterized by distressing responses to everyday sounds, such as chewing or sniffling. Individuals with misophonia experience significant functional impairment but have limited options for evidenced-based behavioral treatment. To address this gap in the literature, the current pilot trial explored the acceptability and efficacy of a transdiagnostic cognitive-behavioral approach to treating symptoms of misophonia.MethodsThis trial was conducted in two studies: In Study 1, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was delivered to eight patients in order to receive feedback to guide revisions to the treatment to suit this population. In Study 2, ten patients received the revised UP treatment to explore its acceptability and preliminary efficacy. This study used a single-case experimental design with multiple baselines, randomizing patients to either a 2-week baseline or 4-week baseline prior to the 16 weeks of treatment, followed by four weeks of follow-up.ResultsThe findings from these studies suggested that patients found both the original and adapted versions of the UP to be acceptable and taught them skills for how to manage their misophonia symptoms. Importantly, the findings also suggested that the UP can help remediate symptoms of misophonia, particularly the emotional and behavioral responses.DiscussionThese findings provide preliminary evidence that this transdiagnostic treatment for emotional disorders can improve symptoms of misophonia in adults.

Obsessive–compulsive disorder (OCD) is characterized by recurring obsessions and compulsions often with severe impairment affecting 1–3% of children and adolescents. Cognitive behavioural therapy (CBT) is the therapeutic golden standard for paediatric OCD. However, face-to-face CBT is limited by accessibility, availability, and quality of delivery. Enhanced CBT (eCBT) a combination of face-to-face sessions at the clinic and treatment at home via webcam and a supportive app system aims to address some of these barriers. In this pilot study, we compared eCBT outcomes of 25 paediatric patients with OCD benchmarked against traditional face-to-face CBT (n = 269) from the Nordic Long-term OCD Treatment Study, the largest paediatric OCD CBT study to date. Pairwise comparisons showed no difference between eCBT and NordLOTS treatment outcomes. Mean estimate difference was 2.5 in favour of eCBT (95% CI − 0.3 to 5.3). eCBT compared to NordLOTS showed no significant differences between response and remission rates, suggesting similar effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: Depression is a mental disorder that causes mood disorders, which are characterized by a loss of control and a subjective experience of great discomfort. Cognitive Behavioral Therapy (CBT) seems to be effective in depression and therefore it becomes necessary to investigate its effectiveness. Aim: To investigate the effectiveness of Cognitive Behavioral Therapy (CBT) in patients with depression. By investigating the effectiveness of individual and group CBT, its effectiveness in a community context, its effectiveness in relation to the administration of pharmacotherapy and the long-term efficiency of CBT. Material and Method: A systematic review of the literature was carried out in the Pubmed, Cohrane and Scopus databases for the years 2007-2021. Key words used were the following: depression, major depressive disorder, depressive symptoms, cognitive behavioral therapy (CBT), psychotherapy, group therapy, individual therapy, antidepressants, pharmacotherapy. The criteria for the inclusion of the studies were that the writing language should be English, that the survey population should be adults, adolescents and children of all sexes suffering from depression, and the criteria for excluding studies were CBT intervention via the internet or telephone. The initial search resulted in 21.587 studies, of which 13 were included in this systematic review. Results: Cognitive Behavioral Therapy (CBT) is effective in preventing the relapse of depression, as it reduces the risk of relapse by eight times and the risk of future recurrent episodes of depression. CBT, in connection with the use of pharmacotherapy, has also had a positive effect on depression, improving physical symptoms, symptoms of depression and anxiety, quality of life and social function of patients. In addition, the effectiveness of CBT was observed to be maintained for more than 3 years. Conclusions: Cognitive Behavioral Therapy (CBT) is effective in patients with depression in both individual and group CBT sessions and in the community context. CBT in combination with pharmacotherapy is also indicated in the treatment of depression and is effective over time. [ABSTRACT FROM AUTHOR]

Plain English Summary Early management of eating disorders, including mental health and medical treatment, improves outcomes and reduces the likelihood of significant complications including death. However, access to specialized mental health treatment can be challenging, particularly for patients from marginalized identities. This study examined how insurance type affects access to recommended mental health treatment for patients with eating disorders. It included a sample of 1060 youth of diverse racial/ethnic backgrounds who presented to an adolescent medicine clinic with malnutrition secondary to disordered eating. In our sample, youth with public insurance were one third as likely to receive appropriate treatment as youth with private insurance. Additionally, Latinx and Asian patients were half as likely to receive appropriate treatment as White youth. These findings highlight the importance of not only improving access to mental health care for patients with eating disorders, but also addressing the systemic causes of disparities in care for youth of color and those with public insurance.

Purpose: Oral mucositis is a common side effect of concurrent chemoradiotherapy (CCRT). This study aimed to determine whether cognitive behavioral therapy (CBT) could help prevent oral mucositis during chemoradiation therapy for locoregional advanced nasopharyngeal carcinoma (LA-NPC). Methods and materials: Between July 15, 2020, and January 31, 2022, a randomized controlled phase II trial was conducted. Eligible patients (N=282, 18-70 years old) with pathologically diagnosed LA-NPC were randomly assigned to receive CBT or treatment as usual (TAU) during CCRT (computer-block randomization, 1:1). The primary endpoints were the incidence and latency of oral mucositis. Results: The incidence of oral mucositis was significantly lower in the CBT group (84.8%; 95% confidence interval [CI], 78.7%-90.9%) than in the TAU group (98.6%; 95% CI, 96.6%-100%; P<0.001). The median latency period was 26 days and 15 days in the CBT and TAU groups, respectively (hazard ratio, 0.16; 95% CI, 0.12-0.22; P<0.001). CBT significantly reduced ≥ grade 3 oral mucositis (71.9% vs. 22.5%, P<0.001), dry mouth (10.8% vs. 3.7%, P=0.021), dysphagia (18% vs. 5.1%, P=0.001), and oral pain (10% vs. 3.6%, P=0.034) compared with TAU. Patients receiving CBT and TAU during CCRT had similar short-term response rates. Conclusions: CBT reduced the occurrence, latency, and severity of oral mucositis in patients with LA-NPC during CCRT. [ABSTRACT FROM AUTHOR]

Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to developing CAI systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called "general" or "human-like" AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy. [ABSTRACT FROM AUTHOR]

Psoriasis is a skin disease associated with the body's immune system. Mental health is one of the accompanying diseases of psoriasis. The clinical manifestations of psoriasis allow sufferers to experience anxiety and depression. There is a significant correlation between anxiety and depression to psoriasis, therefore, an adjunctive therapy is needed in addition to pharmacological therapy. One of these is Cognitive Behavioral Therapy (CBT), which aims to overcome anxiety and depression. This literature review summarizes recent findings regarding the application of CBT in psoriasis patients. The aim of this review is to summarize the latest findings about CBT as an alternative therapy in psoriasis patients. The literature review method was carried out by conducting literature reviews from various online databases, namely NCBI, Science Direct, Elsevier, and Mendeley using predetermined criteria. The results of the literature review showed that psoriasis causes severe psychological suffering, sadness, stigmatization, and decreased health-related quality of life. Result of this review is psychotherapy can lead to positive results in the development of a patient's condition. When performed regularly, CBT can effectively treat a variety of mental health conditions in individuals experiencing mild to moderate anxiety. CBT includes psychological training, self-monitoring, cognitive reconstruction, the prevention of exposure to negative stimuli, and rigorous training. The implications of writing this review are, CBT can be included in the treatment of psoriasis to obtain faster healing results through therapy methods for anxiety and depression in psoriasis patients. [ABSTRACT FROM AUTHOR]

Games have shown successful intervention outcomes and can be used to complement the treatment of anxiety disorders. However, current serious game solutions are designed to be task-based rather than story-based. We present ReWIND, a serious role-playing game (RPG) applying cognitive behavioral therapy (CBT) to design anxiety-relevant storylines and game mechanics. ReWIND advances state-of-the-art mental health games by seamlessly integrating CBT elements and strategies into the game’s storytelling so players can learn how CBT is applied in anxiety scenarios as they play through the game. Our goal is to examine the effectiveness of ReWIND in improving cognitive emotion regulation and anxiety disorders. Through a randomized controlled trial, 40 participants were recruited, of whom half were randomly assigned to play ReWIND while the others worked on a non-game task. Anxiety and cognitive emotion regulation levels were measured before and after the interventions. Our findings show ReWIND significantly reduces the severity level of anxiety symptoms and trait anxiety levels and increases perceived control of anxiety better than the non-game task. ReWIND also obtained positive ratings for its usability and practicality in real life, helping participants to cope better with anxiety disorders.

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture.

Alcohol use disorder (AUD) is a worldwide problem for individuals of varying ages and backgrounds and is associated with the underlying cause of alcoholic liver disease, liver cirrhosis, liver cancer, or many other common diseases and health conditions. Existing treatments such as cognitive behavioral therapy (CBT) have been demonstrated as an evidence-based treatment to aid individuals struggling with AUD. However, these treatments have excessive costs and time demand with trained experts. In this paper, we examine the efficacy and long-term impacts of digitally delivered CBT and other online telehealth tools and apps for AUD patients. Results show the effectiveness in the ability of digitally delivered CBT to decrease alcohol use in AUD patients. The additional use of online technologies and smartphone apps for post-CBT care demonstrates that such computer-aided apps could have long-term effects when it is continually employed, which opens the door for AUD patients who were not seeking treatment elsewhere. Further longitudinal examination research is needed to evaluate the lasting effects in liver health and other chronic diseases associated with digitally delivered alcohol reduction for AUD patients.

IntroductionThe growing demand for mental health support has highlighted the importance of conversational agents as human supporters worldwide and in China. These agents could increase availability and reduce the relative costs of mental health support. The provided support can be divided into two main types: cognitive and emotional. Existing work on this topic mainly focuses on constructing agents that adopt Cognitive Behavioral Therapy (CBT) principles. Such agents operate based on pre-defined templates and exercises to provide cognitive support. However, research on emotional support using such agents is limited. In addition, most of the constructed agents operate in English, highlighting the importance of conducting such studies in China. To this end, we introduce Emohaa, a conversational agent that provides cognitive support through CBT-Bot exercises and guided conversations. It also emotionally supports users through ES-Bot, enabling them to vent their emotional problems. In this study, we analyze the effectiveness of Emohaa in reducing symptoms of mental distress.Methods and ResultsFollowing the RCT design, the current study randomly assigned participants into three groups: Emohaa (CBT-Bot), Emohaa (Full), and control. With both Intention-To-Treat (N=247) and PerProtocol (N=134) analyses, the results demonstrated that compared to the control group, participants who used two types of Emohaa experienced considerably more significant improvements in symptoms of mental distress, including depression (F[2,244]=6.26, p=0.002), negative affect (F[2,244]=6.09, p=0.003), and insomnia (F[2,244]=3.69, p=0.026).DiscussionBased on the obtained results and participants’ satisfaction with the platform, we concluded that Emohaa is a practical and effective tool for reducing mental distress.

Background: Eating disorders are associated with substantial morbidity and mortality that can be minimized by timely access to evidence-based treatment. However, disparate access to eating disorders treatment may contribute to significant health disparities amongst marginalized groups. This study examined the association between insurance type (public vs. private) and receipt of recommended mental health treatment in a sample of racially/ethnically diverse youth who presented to an adolescent medicine clinic with malnutrition secondary to disordered eating. Methods: A retrospective chart review was conducted for youth ages 11–25 years (N = 1060) who presented to an urban adolescent medicine specialty program between June 1, 2012 and December 31, 2019 for malnutrition secondary to disordered eating. Bivariate and logistic regression analyses examined the association between insurance type (public vs. private) and other demographic/clinical factors on receipt of recommended treatment within six months of the initial evaluation. Results: Patients with public insurance were one third as likely to receive recommended treatment as patients with private insurance (AOR = 3.23; 95% CI = 1.99, 4.52), after adjusting for demographic and clinical factors. Latinx (AOR = 0.49; 95% CI = 0.31, 0.77) and Asian (AOR = 0.55; 95% CI = 0.32, 0.94) patients were half as likely to receive recommended treatment as White patients. Conclusions: Access to evidence-based mental health treatment is a necessary first step towards health equity for individuals with eating disorders. Additional work is needed to dismantle systemic inequities that contribute to disparities in care for youth of color and those with public insurance. Plain English Summary: Early management of eating disorders, including mental health and medical treatment, improves outcomes and reduces the likelihood of significant complications including death. However, access to specialized mental health treatment can be challenging, particularly for patients from marginalized identities. This study examined how insurance type affects access to recommended mental health treatment for patients with eating disorders. It included a sample of 1060 youth of diverse racial/ethnic backgrounds who presented to an adolescent medicine clinic with malnutrition secondary to disordered eating. In our sample, youth with public insurance were one third as likely to receive appropriate treatment as youth with private insurance. Additionally, Latinx and Asian patients were half as likely to receive appropriate treatment as White youth. These findings highlight the importance of not only improving access to mental health care for patients with eating disorders, but also addressing the systemic causes of disparities in care for youth of color and those with public insurance. [ABSTRACT FROM AUTHOR]

Cortical-subcortical hyperconnectivity related to affective-behavioral integration and cortical network hypoconnectivity related to cognitive control have been demonstrated in obsessive-compulsive disorder (OCD); the study objective was to examine whether these connectivity patterns predict treatment response. Adolescents (ages 12–17) and adults (ages 24–45) were randomly assigned to 12 sessions of exposure and response prevention (ERP) or stress management therapy (SMT), an active control. Before treatment, resting-state connectivity of ventromedial prefrontal cortical (vmPFC), cingulo-opercular, frontoparietal, and subcortical regions was assessed with functional MRI. OCD severity was assessed with the Yale-Brown Obsessive Compulsive Scale before, during, and after treatment. Usable fMRI and longitudinal symptom data were obtained from 116 patients (68 female; 54 adolescents; 60 medicated). ERP produced greater decreases in symptom scores than SMT. ERP was selectively associated with less vmPFC-subcortical (caudate and thalamus) connectivity in both age groups and primarily in unmedicated participants. Greater symptom improvement with both ERP and SMT was associated with greater cognitive-control (cingulo-opercular and frontoparietal) and subcortical (putamen) connectivity across age groups. Developmental specificity was observed across ERP and SMT treatments, such that greater improvements with ERP than SMT were associated with greater frontoparietal-subcortical (nucleus accumbens) connectivity in adolescents but greater connectivity between frontoparietal regions in adults. Comparison of response-predictive connections revealed no significant differences compared with a matched healthy control group. The results suggest that less vmPFC-subcortical connectivity related to affect-influenced behavior may be important for ERP engagement, whereas greater cognitive-control and motor circuit connectivity may generally facilitate response to psychotherapy. Finally, neural predictors of treatment response may differ by age. [ABSTRACT FROM AUTHOR]

LGBTQ-affirmative cognitive-behavioral therapy (CBT) addresses minority stress to improve sexual minority individuals' mental and behavioral health. This treatment has never been tested in high-stigma contexts like China using online delivery. Chinese young sexual minority men (n = 120; ages 16–30; HIV-negative; reporting depression and/or anxiety symptoms and past-90-day HIV-transmission-risk behavior), were randomized to receive 10 sessions of culturally adapted asynchronous LGBTQ-affirmative internet-based CBT (ICBT) or weekly assessments only. The primary outcome included HIV-transmission-risk behavior (i.e., past-30-day condomless anal sex). Secondary outcomes included HIV social-cognitive mechanisms (e.g., condom use self-efficacy), mental health (e.g., depression), and behavioral health (e.g., alcohol use), as well as minority stress (e.g., acceptance concerns), and universal (e.g., emotion regulation) mechanisms at baseline and 4- and 8-month follow-up. Moderation analyses examined treatment efficacy as a function of baseline stigma experiences and session completion. Compared to assessment only, LGBTQ-affirmative ICBT did not yield greater reductions in HIV-transmission-risk behavior or social-cognitive mechanisms. However, LGBTQ-affirmative ICBT yielded greater improvements in depression (d = −0.50, d = −0.63) and anxiety (d = −0.51, d = −0.49) at 4- and 8-month follow-up, respectively; alcohol use (d = −0.40) at 8-month follow-up; and certain minority stress (e.g., internalized stigma) and universal (i.e., emotion dysregulation) mechanisms compared to assessment only. LGBTQ-affirmative ICBT was more efficacious for reducing HIV-transmission-risk behavior for participants with lower internalized stigma (d = 0.42). Greater session completion predicted greater reductions in suicidality and rumination. LGBTQ-affirmative ICBT demonstrates preliminary efficacy for Chinese young sexual minority men. Findings can inform future interventions for young sexual minority men in contexts with limited affirmative supports. • LGBTQ-affirmative internet-based CBT was tested among sexual minority men in China. • LGBTQ-affirmative ICBT yielded greater mental health effects than assessment-only. • Treatment impact on HIV risk was stronger for those with lower internalized stigma. • Identity-focused treatments might be most efficacious in high-stigma settings. [ABSTRACT FROM AUTHOR]

Anxiety disorders are common in youth, associated with impairments in daily functioning, and often persist into adulthood when untreated. Cognitive behavioral therapy (CBT) for youth anxiety is a well-established intervention and has been modified to fit several treatment settings. Despite decades of results supporting the efficacy of CBT, there is a large gap in access to this treatment and a need to consider how it can best be administered flexibly to increase uptake and personalization. We first discuss the core components of treatment for CBT through the lens of the Coping Cat treatment. Next, we review the empirical findings regarding adjustments made for CBT for youth anxiety delivered (a) in schools, (b) in community settings, (c) through telehealth, (d) through online computer programs, and (e) by caregivers at home. In each setting, we provide specific suggestions for how to implement CBT with flexibility while maintaining fidelity.

Spinal cord stimulation and virtual reality therapy are established and promising techniques, respectively, for managing chronic pain, each with its unique advantages and challenges. While each therapy has been the subject of significant research interest, the prospect of combining the two modalities to offer a synergistic effect in chronic pain therapy is still in its infancy. In this narrative review, we assess the state of the field combining virtual reality as an adjunctive therapy to spinal cord stimulation in chronic pain. We also review the broader field of virtual reality therapy for acute and chronic pain, considering evidence related to feasibility in the Canadian healthcare system from cost and patient satisfaction perspectives. While early results show promise, there are unexplored aspects of spinal cord stimulation combined with virtual reality therapy, particularly long-term effects on analgesia, anxiolysis, and implications on the effectiveness and longevity of spinal cord stimulation. The infrastructure for billing virtual reality as a consult service or therapy must also catch up if it is eventually used to supplement spinal cord stimulation for chronic pain.

Introduction: Irritable bowel syndrome and fibromyalgia share similar pathophysiologic mechanisms including sensitization of peripheral and central pain pathways, autonomic dysfunction and are often co-diagnosed. Co-diagnosed patients experience increased symptom severity, mental health comorbidities, and decreased quality of life. The role of mind-body interventions, which have significant effects on central pain syndromes and autonomic dysregulation, have not been well-described in co-diagnosed patients. The aim of this state-of-the art narrative review is to explore the relationship between irritable bowel syndrome and fibromyalgia, and to evaluate the current evidence and mechanism of action of mind-body therapies in these two conditions. Methods: The PubMed database was searched without date restrictions for articles published in English using the following keywords: fibromyalgia, irritable bowel syndrome, mind-body interventions, cognitive behavioral therapy, mindfulness based stress reduction, and yoga. Results: Mind-body interventions resulted in improved patient-reported outcomes, and are effective for irritable bowel syndrome and fibromyalgia individually. Specifically, cognitive behavioral therapy and yoga trials showed decreased symptom severity, improved mental health, sleep and quality of life for both conditions individually, while yoga trials demonstrated similar benefits with improvements in both physical outcomes (gastrointestinal symptoms, pain/tenderness scores, insomnia, and physical functioning), mental health outcomes (anxiety, depression, gastrointestinal-specific anxiety, and catastrophizing), and quality of life, possibly due to alterations in autonomic activity. Conclusion: Mind-body interventions especially CBT and yoga improve patient-reported outcomes in both irritable bowel syndrome and fibromyalgia individually. However, limited available data in co-diagnosed patients warrant high quality trials to better tailor programs to patient needs. [ABSTRACT FROM AUTHOR]

Several models have been proposed for the emergence and maintenance of obsessive-compulsive disorder (OCD). Although these models have provided important insights and inspired treatment development, no single model has yet sufficiently accounted for the complexed phenotype of the disorder. In the current paper, we propose a novel model that integrates elements from cognitive behavioral models of OCD with neurocognitive approaches to the disorder. This Reciprocal Interaction Model (RIM) for OCD is based on two assumptions: (a) similar observed symptoms can stem from different etiological processes; and (b) neuropsychological deficits (such as reduced response inhibition and overreliance on the habit formation system) and cognitive behavioral processes (such as temporary reduction in anxiety after engaging in compulsive behaviors) mutually affect each other such that abnormalities in one system influence the second system and vice-versa—creating a vicious cycle of pathological processes. Indeed, the bidirectional inhibitory connection between anxiety/obsessions and executive control is at the heart of the model. We begin by briefly reviewing the current models for OCD. We then move on to describe the RIM, the supporting evidence for the model, the model's predictions, and potential clinical implications. [ABSTRACT FROM AUTHOR]

Objective: Online treatment for binge eating disorder (BED) is an easily available option for treatment compared to most standard treatment procedures. However, little is known about how motivation types characterize this population and how these impact treatment adherence and effect in an online setting. Therefore, we aimed to investigate a sample of written motivation statements from BED patients, to learn more about how treatment and online treatment in particular, presents in this population. Methods: Using self-determination theory in a mixed methods context, we investigated which types of motivation were prevalent in our sample, how this was connected with patient sentiment, and how these constructs influence treatment and adherence. Results: Contrary to what most current literature suggests, we found that in our sample (n = 148), motivation type was not connected with treatment outcome. We did find a strong association between sentiment scores and motivation types, indicating the model is apt at detecting effects. We found that when comparing an adult and young adult population, they did not differ in motivation type and the treatment was equally effective in young adults and adults. In the sentiment scores there was a difference between sentiment score and adherence in the young adult group, as the more positive the young adults were, the less likely they were to complete the program. Discussion: Because motivation type does not influence online treatment to the same degree as it would in face-to-face treatment it indicates that the typical barriers to treatment may be less crucial in an online setting. This should be considered during intake; as less motivated patients may be able to adhere better to online treatment, because the latter imposes fewer barriers of the kind that only strong motivation can overcome. The fact that motivation type and sentiment score of the written texts are strongly associated, indicate a potential for automated models to detect motivation based on sentiment. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to systematically review the eect of cognitive behavioral therapy (CBT) in terms of improving the quality of life (QOL) and negative emotion of informal cancer caregivers. Methods: PubMed, Cochrane Library, EMBASE, Web of Science, MEDLINE, China National Knowledge Infrastructure (CNKI), and China Biology Medicine disc (CBMdisc) were searched from the database establishment to October 2021. Literature screening, data extraction, and quality evaluation were conducted based on inclusion and exclusion criteria. Stata 14.0 software was used for data analysis. Results: A total of 17 randomized controlled trials (RCTs) involving 2,348 cancer informal caregivers (CGs) were included in this study, with an overall loss rate of 13.3%. Meta-analysis showed no statistically significant dierence in the impact of CBT on QOL (SMD = 0.28, 95%CI: −0.09–0.65, P < 0.001). However, the improvement of depression in CBT intervention group was significantly better than that in control group (SMD = −0.32, 95%CI: −0.56 to −0.07, P = 0.010). The HADS subgroup showed dierences in depression scores (SMD = −0.80, 95%CI: −1.30 to −0.29, P = 0.002). The overall eect of CBT on anxiety was statistically dierent, the improvement of anxiety in CBT intervention group was significantly better than that in control group (SMD = −0.36, 95%CI: −0.720–0.004, P = 0.047). Conclusions: CBT had a positive eect on reducing depression and anxiety in informal cancer caregivers, and the eect on quality of life was not statistically significant, but showed a posititive trend. [ABSTRACT FROM AUTHOR]

Objectives: Obsessive-compulsive disorder (OCD) in childhood and adolescence often leads to significant impairment in various areas of life and has a high risk of becoming chronic. Cognitive behavioral therapy (CBT) is the recommended first-line treatment, but it is too rarely implemented in accordance with guidelines and is often not available close to the patient’s home. Importantly, internet-based CBT could help to reduce this gap in care. Having previously successfully demonstrated the feasibility of an internet-based CBT approach, we aimed to assess its effectiveness in a waiting list controlled randomized trial. Methods: Children and adolescents aged 6–18 years with a principal diagnosis of OCD received 14 sessions of therapist-delivered CBT via videoconference distributed over 16 weeks. After inclusion, participants were randomly assigned to either the treatment or waiting list group. Participants in the treatment group began treatment immediately after baseline diagnostics, and participants in the waiting list group began treatment after a 16-week waiting period. The primary outcome was a pre-post comparison of OCD symptoms as measured with the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Additionally, remission was an important outcome measure. Follow-up assessments were conducted for all measures 16 and 32 weeks after completion of treatment. Results: A total of 60 children and adolescents were included into the analyses. Over the course of the treatment, OCD symptoms according to the CY-BOCS significantly decreased in the treatment group compared to the waiting-list control group. Cohen’s d between groups was 1.63. After the patients in the waiting list group also received the treatment, the OCD symptoms decreased significantly in this group as well. This improvement of symptoms increased over the course of the follow-up assessments. Remission rate peaked at the 32-week follow-up, with 68% in the treatment group and 79% in the waiting list group. Importantly, patient satisfaction with treatment was high to very high. Conclusion: In our study, OCD symptoms decreased significantly and remission rate was high after internet-based CBT. Those effects were comparable to those found in studies of face-to-face treatment. Although further evidence is needed, these are early indications that our approach may be a viable way to provide access to adequate treatment for children and adolescents affected by OCD. [ABSTRACT FROM AUTHOR]

Abstract Objective Early marriage has many deleterious effects on the health of girls, such as sexual dissatisfaction, an inevitable result of the lack of sufficient knowledge about sexual issues at the time of the marriage. The goal of the present study was to determine the effectiveness of counseling based on functional analytic psychotherapy with enhanced cognitive therapy (FECT) on the sexual quality of life of married adolescent women. Methods This clinical trial was conducted between July and October 2019 on 150 married adolescent women who met the inclusion criteria. In the intervention group, FECTwas conducted in sixteen 90-minute sessions twice a week. The Sexual Quality of Life-Female (SQOL-F) questionnaire was used. When the study ended, the control group was given the choice of receiving the same intervention as the intervention group. Results The paired t-test showed a significant difference between the mean score of sexual quality of life before (52.33±23.09) and after (88.08±10.51) counseling in the intervention group (p

IntroductionIrritable bowel syndrome and fibromyalgia share similar pathophysiologic mechanisms including sensitization of peripheral and central pain pathways, autonomic dysfunction and are often co-diagnosed. Co-diagnosed patients experience increased symptom severity, mental health comorbidities, and decreased quality of life. The role of mind-body interventions, which have significant effects on central pain syndromes and autonomic dysregulation, have not been well-described in co-diagnosed patients. The aim of this state-of-the art narrative review is to explore the relationship between irritable bowel syndrome and fibromyalgia, and to evaluate the current evidence and mechanism of action of mind-body therapies in these two conditions.MethodsThe PubMed database was searched without date restrictions for articles published in English using the following keywords: fibromyalgia, irritable bowel syndrome, mind-body interventions, cognitive behavioral therapy, mindfulness based stress reduction, and yoga.ResultsMind-body interventions resulted in improved patient-reported outcomes, and are effective for irritable bowel syndrome and fibromyalgia individually. Specifically, cognitive behavioral therapy and yoga trials showed decreased symptom severity, improved mental health, sleep and quality of life for both conditions individually, while yoga trials demonstrated similar benefits with improvements in both physical outcomes (gastrointestinal symptoms, pain/tenderness scores, insomnia, and physical functioning), mental health outcomes (anxiety, depression, gastrointestinal-specific anxiety, and catastrophizing), and quality of life, possibly due to alterations in autonomic activity.ConclusionMind-body interventions especially CBT and yoga improve patient-reported outcomes in both irritable bowel syndrome and fibromyalgia individually. However, limited available data in co-diagnosed patients warrant high quality trials to better tailor programs to patient needs.

Background: Cognitive behavioral therapy (CBT) is an efficacious treatment for depression. CBT may in part exert its therapeutic effect by strengthening inhibitory control (IC). However, the relationship between CBT and IC has yet to be thoroughly explored; in particular, it is not clear whether IC is modulated following a course of CBT. Methods: Forty-one adults with depression were recruited to undergo sixteen weeks of CBT; data from twenty-five healthy controls were used for baseline comparisons. Participants completed an affective Go/No-go task, a measure of IC, while undergoing electroencephalography recording. Electroencephalography measures of interest were the event-related potential (ERP) N2 and P3 components. Results: At baseline, individuals with depression exhibited greater ERP amplitudes during the N2 regardless of affective condition; source reconstruction attributed this to patients exhibiting greater activity in the superior frontal gyrus, right temporal lobe, and anterior cingulate cortex (ACC). Following treatment, the ERP amplitude during the N2 component decreased for angry stimuli but increased for happy stimuli. Source reconstruction attributed ERP changes in the angry-condition to the left occipital and fusiform gyrus, and changes in the happy-condition to regions including the superior frontal gyrus and ACC. Limitations: There was no placebo-treatment group. Conclusions: Neural correlates of the affective Go/No-go task were altered in depression and were found to be selectively modulated over the course of CBT in a condition- and region-specific manner. These findings support the notion that the modulation of IC may be one of the potential therapeutic mechanisms of CBT in the treatment of depression.