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Background and Purpose: Fatigue is a common and disabling symptom in multiple sclerosis (MS). Educational interventions have shown potential to reduce fatigue. The aim was to systematically review the current best evidence on patient education programmes for MS‐related fatigue. Methods: This was a systematic review and meta‐analysis following Cochrane methodology. A systematic search was conducted in eight databases (September 2023). Moreover, reference lists and trial registers were searched and experts in the field were contacted. Randomized controlled trials were included evaluating patient education programmes for people with MS with the primary aim of reducing fatigue. Results: In total, 1176 studies were identified and assessed by two independent reviewers; 15 studies (1473 participants) were included. All interventions provided information and education about different aspects of MS‐related fatigue with different forms of application, some with components of psychological interventions. Amongst those, the most frequently applied were cognitive behavioural therapy (n = 5) and energy‐conservation‐based approaches (n = 4). Studies differed considerably concerning mode of intervention delivery, number of participants and length of follow‐up. Interventions reduced fatigue severity (eight studies, n = 878, standardized mean difference −0.28; 95% confidence interval −0.53 to −0.03; low certainty) and fatigue impact (nine studies, n = 824, standardized mean difference −0.21; 95% confidence interval −0.42 to 0.00; moderate certainty) directly after the intervention. Mixed results were found for long‐term effects on fatigue, for secondary endpoints (depressive symptoms, quality of life, coping) and for subgroup analyses. Conclusion: Educational interventions for people with MS‐related fatigue may be effective in reducing fatigue in the short term. More research is needed on long‐term effects and the importance of specific intervention components, delivery and context. [ABSTRACT FROM AUTHOR]

The article discusses the concept of combination treatment in managing migraine, which involves using two or more acute or preventive treatments simultaneously. It emphasizes the importance of clear terminology to enhance communication and implementation of treatment strategies, especially in regions with diverse practices. The text highlights the need for a standardized lexicon among clinicians and researchers to improve patient care and reduce ambiguity in the field. The authors suggest a stepwise approach to combining treatments, starting with identifying a baseline treatment and layering subsequent treatments based on individual patient characteristics and disease burden. [Extracted from the article]

This analysis was part of the Pain and Smoking Study (PASS), a randomized trial of a cognitive behavioral intervention (CBI) for Veterans with chronic pain who smoke. The objective of this study was to examine factors associated with participation in the walking component of the intervention. Demographics and clinical characteristics were obtained at baseline. Completion of two or more CBI counseling sessions was required to be included in analyses. Average daily step counts obtained via pedometer in the prior week were recorded in up to three telephone counseling sessions. Participants were then categorized as "sedentary" (≤ 4999 daily steps) or "not sedentary" (≥ 5000 daily steps). Multivariable logistic regression was used to model variance in activity categorization. Overall, 91.0% of participants were men, 70.5% were white, mean age was 58.4 years, mean BMI was 28.6, median pack years was 20.5, and 43.8% were depressed. Veterans reported moderate pain intensity (4.9/10) and pain interference (5.4/10). Pain locations included: lower extremity (67.4%), back (53.4%) and upper extremity (28.1%). Median daily steps were 2491 [IQR: 1720–3550] (sedentary) (n = 65), 7307 [IQR: 5952–8533] (not sedentary) (n = 24), and 3196 [IQR: 2237–5067] (overall) (n = 89). Veterans with older age (odds ratio (OR): 1.10, 95% confidence interval (CI): 1.04, 1.17) and presence of LE pain (OR: 5.98, 95% CI: 1.82, 19.65) had increased odds of being "sedentary." Integrated smoking cessation and chronic pain self-management interventions that include a walking component may need to consider the impact of age and pain location on participation. Trial registration: The trial is registered at www.ClinicalTrials.gov (NCT02971137). First posted on November 22, 2016. [ABSTRACT FROM AUTHOR]

Mental illness substantially contributes to the global burden of disease, with anxiety high in prevalence. The increase of mobile technology, mental health apps have potential to lessen this burden. However, within apps, the use of evidence-based interventions, such as cognitive behavioural therapy (CBT) are limited. Regardless, many commercially available mental health apps are highly rated by users, highlighting the need to understand what makes mental health apps valuable to the user. The contribution of this study was to uncover apps that support generalised anxiety disorder (GAD) and worry with a CBT basis, explore app functionality, and user experience. Firstly, by identifying apps that support GAD and worry and included CBT. Secondly, by identifying and analysing therapeutic and engagement functions within the apps, and finally, by thematically analysing user reviews. Six apps were identified to support GAD and worry that purported to be CBT-based. However, CBT therapeutic features and engagement features were minimally present in the apps. User reviews yielded 112 comments about the apps and key themes were identified about the app users' global experiences with the app, and about the combination of technological (e.g., useability, reliability) and therapeutic experiences (e.g., learning and using skills). Future development of quality apps to support GAD and worry must consider the empirical standing of both therapeutic and technology aspects, to provide efficacious and engaging interventions. [ABSTRACT FROM AUTHOR]

Objective: The current guidelines and canonical norms of diagnosis or treatment for Post-traumatic stress disorder (PTSD) with sleep disorder are still conflicting and have not yet reached a consensus. This study aimed to unravel the most effective countermeasures between two categories (psychotherapy and pharmacotherapy) put forward by the National Institute for Health and Clinical Excellence (NICE) and World Federation of Societies of Biological Psychiatry (WFSBP) respectively to treat PTSD individuals co-exist with sleep disorders. Methods: Four databases, including PubMed, EMBASE, Cochrane Library, and APA PsyNet, were searched from inception to February 02, 2023. Results: Twenty articles with 24 Randomized controlled trials (RCTs) and a total number of 1,647 participants were included. As demonstrated in the network meta-analysis comparison results, CBT-I (standardized mean differences (SMD) =-1.51,95% confidence interval (CI):-2.55 to -0.47), CBT-I plus IRT (SMD=-1.71, 95%CI:-3.39, -0.03), prazosin (SMD=-0.87, 95%CI:-1.59 to -0.16) and hydroxyzine (SMD=-1.06, 95%CI: -1.94 to -0.19) significantly reduced PTSD symptoms compared with placebo. In contrast to placebo, CBT-I (SMD=-5.61, 95%CI:-8.82 to -2.40) significantly improved sleep quality. For nightmare severity, IRT (SMD=-0.65, 95%CI:-1.00 to -0.31), prazosin (SMD=-1.20, 95%CI:-1.72 to -0.67) and hydroxyzine (SMD=-0.98,95%CI:-1.58 to -0.37) significantly reduced nightmare severity in comparison with placebo. Conclusions: This study suggested that under most circumstances, psychotherapy namely CBT-I had a favorable profile, but pharmacotherapy with prazosin was effective in managing nightmare severity. The sole avail of CBT-I was recommended to improving sleep quality while CBT-I and CBT-I plus IRT showed excellent management of PTSD symptom severity. Exposure to CBT-I is recommended for depression. The relevant clinical guidelines for the management of individuals with PTSD and sleep disorders may regard this as a reference. PROSPERO: CRD42023415240. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is the most common complication of pregnancy, affecting an estimated 16.7% of live births worldwide, which translates to approximately 21 million cases annually. Although poor sleep quality is a prevalent concern in this population, most existing studies predominantly focus on the impact of sleep disorders on GDM, rather than directly assessing sleep quality in women diagnosed with GDM. This study aimed to investigate sleep quality and its associated factors specifically among women with GDM. Methods: We originally aimed to include 287 women with GDM; ultimately, 618 were invited, of whom 393 participated in the survey through a convenience sampling method at the obstetric clinics of four general tertiary hospitals in Chongqing, China, from June to August 2022. Data were collected utilizing sociodemographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Scale, and the Pregnancy-related Anxiety Scale (PrAS). We employed linear regression analysis to identify factors associated with sleep quality. Results: The PSQI score of participants was (5.83 ± 3.41). Notably, 43.77% of participants reported an actual sleep duration of less than 8 h per night, whereas 45.55% experienced poor sleep quality. Worrying during the day about your inability to fall asleep (β = 0.204, P < 0.01), body image concern (β = 0.159, P < 0.01), going to bed thirsty (β = 0.160, P < 0.01), educational attainment (β=-0.150, P < 0.01), avoidance (β = 0.124, P < 0.01), sleep disturbed by bed partner's sleep (β = 0.126, P < 0.01), and worrying as you prepare for bed about your inability to fall asleep (β = 0.137, P < 0.05) significantly affected the sleep quality of participants. Conclusions: The study revealed a high prevalence of insufficient sleep duration and poor sleep quality among women with GDM, which was significantly influenced by inadequate sleep hygiene habits and pregnancy-related anxiety. These findings enhance our understanding of the factors affecting sleep quality in this population and underscore the necessity for healthcare professionals to timely identify sleep disorders. Implementing appropriate interventions, such as the development of educational programs focused on sleep hygiene and body image acceptance through cognitive behavioral therapy, could enhance the quality of care for women with GDM. [ABSTRACT FROM AUTHOR]

Background: About 20–30% of older adults (≥ 65 years old) experience one or more falls each year, and falls are associated with substantial burden to the health care system, individuals, and families from resulting injuries, fractures, and reduced functioning and quality of life. Many interventions for preventing falls have been studied, and their effectiveness, factors relevant to their implementation, and patient preferences may determine which interventions to use in primary care. The aim of this set of reviews was to inform recommendations by the Canadian Task Force on Preventive Health Care (task force) on fall prevention interventions. We undertook three systematic reviews to address questions about the following: (i) the benefits and harms of interventions, (ii) how patients weigh the potential outcomes (outcome valuation), and (iii) patient preferences for different types of interventions, and their attributes, shown to offer benefit (intervention preferences). Methods: We searched four databases for benefits and harms (MEDLINE, Embase, AgeLine, CENTRAL, to August 25, 2023) and three for outcome valuation and intervention preferences (MEDLINE, PsycINFO, CINAHL, to June 9, 2023). For benefits and harms, we relied heavily on a previous review for studies published until 2016. We also searched trial registries, references of included studies, and recent reviews. Two reviewers independently screened studies. The population of interest was community-dwelling adults ≥ 65 years old. We did not limit eligibility by participant fall history. The task force rated several outcomes, decided on their eligibility, and provided input on the effect thresholds to apply for each outcome (fallers, falls, injurious fallers, fractures, hip fractures, functional status, health-related quality of life, long-term care admissions, adverse effects, serious adverse effects). For benefits and harms, we included a broad range of non-pharmacological interventions relevant to primary care. Although usual care was the main comparator of interest, we included studies comparing interventions head-to-head and conducted a network meta-analysis (NMAs) for each outcome, enabling analysis of interventions lacking direct comparisons to usual care. For benefits and harms, we included randomized controlled trials with a minimum 3-month follow-up and reporting on one of our fall outcomes (fallers, falls, injurious fallers); for the other questions, we preferred quantitative data but considered qualitative findings to fill gaps in evidence. No date limits were applied for benefits and harms, whereas for outcome valuation and intervention preferences we included studies published in 2000 or later. All data were extracted by one trained reviewer and verified for accuracy and completeness. For benefits and harms, we relied on the previous review team's risk-of-bias assessments for benefit outcomes, but otherwise, two reviewers independently assessed the risk of bias (within and across study). For the other questions, one reviewer verified another's assessments. Consensus was used, with adjudication by a lead author when necessary. A coding framework, modified from the ProFANE taxonomy, classified interventions and their attributes (e.g., supervision, delivery format, duration/intensity). For benefit outcomes, we employed random-effects NMA using a frequentist approach and a consistency model. Transitivity and coherence were assessed using meta-regressions and global and local coherence tests, as well as through graphical display and descriptive data on the composition of the nodes with respect to major pre-planned effect modifiers. We assessed heterogeneity using prediction intervals. For intervention-related adverse effects, we pooled proportions except for vitamin D for which we considered data in the control groups and undertook random-effects pairwise meta-analysis using a relative risk (any adverse effects) or risk difference (serious adverse effects). For outcome valuation, we pooled disutilities (representing the impact of a negative event, e.g. fall, on one's usual quality of life, with 0 = no impact and 1 = death and ~ 0.05 indicating important disutility) from the EQ-5D utility measurement using the inverse variance method and a random-effects model and explored heterogeneity. When studies only reported other data, we compared the findings with our main analysis. For intervention preferences, we used a coding schema identifying whether there were strong, clear, no, or variable preferences within, and then across, studies. We assessed the certainty of evidence for each outcome using CINeMA for benefit outcomes and GRADE for all other outcomes. Results: A total of 290 studies were included across the reviews, with two studies included in multiple questions. For benefits and harms, we included 219 trials reporting on 167,864 participants and created 59 interventions (nodes). Transitivity and coherence were assessed as adequate. Across eight NMAs, the number of contributing trials ranged between 19 and 173, and the number of interventions ranged from 19 to 57. Approximately, half of the interventions in each network had at least low certainty for benefit. The fallers outcome had the highest number of interventions with moderate certainty for benefit (18/57). For the non-fall outcomes (fractures, hip fracture, long-term care [LTC] admission, functional status, health-related quality of life), many interventions had very low certainty evidence, often from lack of data. We prioritized findings from 21 interventions where there was moderate certainty for at least some benefit. Fourteen of these had a focus on exercise, the majority being supervised (for > 2 sessions) and of long duration (> 3 months), and with balance/resistance and group Tai Chi interventions generally having the most outcomes with at least low certainty for benefit. None of the interventions having moderate certainty evidence focused on walking. Whole-body vibration or home-hazard assessment (HHA) plus exercise provided to everyone showed moderate certainty for some benefit. No multifactorial intervention alone showed moderate certainty for any benefit. Six interventions only had very-low certainty evidence for the benefit outcomes. Two interventions had moderate certainty of harmful effects for at least one benefit outcome, though the populations across studies were at high risk for falls. Vitamin D and most single-component exercise interventions are probably associated with minimal adverse effects. Some uncertainty exists about possible adverse effects from other interventions. For outcome valuation, we included 44 studies of which 34 reported EQ-5D disutilities. Admission to long-term care had the highest disutility (1.0), but the evidence was rated as low certainty. Both fall-related hip (moderate certainty) and non-hip (low certainty) fracture may result in substantial disutility (0.53 and 0.57) in the first 3 months after injury. Disutility for both hip and non-hip fractures is probably lower 12 months after injury (0.16 and 0.19, with high and moderate certainty, respectively) compared to within the first 3 months. No study measured the disutility of an injurious fall. Fractures are probably more important than either falls (0.09 over 12 months) or functional status (0.12). Functional status may be somewhat more important than falls. For intervention preferences, 29 studies (9 qualitative) reported on 17 comparisons among single-component interventions showing benefit. Exercise interventions focusing on balance and/or resistance training appear to be clearly preferred over Tai Chi and other forms of exercise (e.g., yoga, aerobic). For exercise programs in general, there is probably variability among people in whether they prefer group or individual delivery, though there was high certainty that individual was preferred over group delivery of balance/resistance programs. Balance/resistance exercise may be preferred over education, though the evidence was low certainty. There was low certainty for a slight preference for education over cognitive-behavioral therapy, and group education may be preferred over individual education. Conclusions: To prevent falls among community-dwelling older adults, evidence is most certain for benefit, at least over 1–2 years, from supervised, long-duration balance/resistance and group Tai Chi interventions, whole-body vibration, high-intensity/dose education or cognitive-behavioral therapy, and interventions of comprehensive multifactorial assessment with targeted treatment plus HHA, HHA plus exercise, or education provided to everyone. Adding other interventions to exercise does not appear to substantially increase benefits. Overall, effects appear most applicable to those with elevated fall risk. Choice among effective interventions that are available may best depend on individual patient preferences, though when implementing new balance/resistance programs delivering individual over group sessions when feasible may be most acceptable. Data on more patient-important outcomes including fall-related fractures and adverse effects would be beneficial, as would studies focusing on equity-deserving populations and on programs delivered virtually. Systematic review registration: Not registered. [ABSTRACT FROM AUTHOR]

Background: Mindfulness‐based cognitive therapy (MBCT) is effective in reducing depressive symptoms in patients with major depressive disorder (MDD). Understanding for whom and how MBCT works may allow for improvements in treatment allocation and effectiveness. In this study, our aim was to investigate depressive rumination, content‐independent perseverative thinking, mindfulness skills, and self‐compassion as potential moderators and mediators of MBCT. Methods: In this non‐randomized controlled trial, patients with persistent (n = 53) or recurrent MDD with (n = 31) or without (n = 51) a current depressive episode were assigned to an intervention (MBCT plus treatment as usual [TAU], n = 94) or control group (TAU only, n = 40) based on the time between the date of inclusion and the start of MBCT. Assessments were carried out before, halfway, and after 8 weeks of MBCT + TAU or TAU. Latent growth models were employed to examine moderation, while cross‐lagged structural equation models were used to assess the mediating effects of several possible mediators of MBCT‐induced change in depressive symptoms and overall functional impairment. Results: MBCT + TAU was more effective in reducing depressive symptoms (and overall functional impairment than TAU with a medium [d = −0.54] and small [d = 0.44] effect size, respectively). Higher baseline levels of rumination and perseverative thinking and lower levels of self‐compassion moderated the effect of MBCT on depressive symptoms and overall functional impairment. Task‐based negative intrusive thoughts moderated the effects of MBCT on overall functional impairment. No mediators were established, particularly due to a lack of effect of MBCT on all assessed mediators at mid‐treatment. For interpretative purposes, a sample split (based on Johnson–Newman values) showed moderate‐to‐large effects in depressive symptom reduction for those with high rumination, high perseverative thinking, and low self‐compassion, while negative‐to‐small nonsignificant effects were found for the opposite traits. Conclusion: In the future, MBCT allocation based on levels of rumination and self‐compassion might lead to a more efficient reduction in depressive symptoms. Directions for mediation analysis within the context of MBCT for depression are discussed. Preregistration: This study was initially preregistered in the Dutch National Trial Register (NL7842). However, due to the NTR no longer being available since June 2022, the trial was reregistered at ClinicalTrials.gov (NCT05802966, dd 09‐Apr‐2023). The statistical analysis plan was adjusted after the start of the trial but before the finalization of data collection (NCT05802966; ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

Background: Technology-enabled services (TES; clinical services that include both technology-driven [e.g., personal sensing technologies] and person-powered support elements) may address gaps in depression and anxiety treatments in healthcare settings. The current study: (1) developed a TES tailored for Primary Care patients with depression and/or anxiety, and (2) conducted a pilot randomized controlled trial to assess the efficacy of the TES compared to a digital psychoeducation control app. Methods: Participants were randomized to either: (1) TES: the "Vira" smartphone app (Ksana Health Inc.), informed by behavioral activation and using passive sensing technology to provide behavioral "insights" and target behaviors associated with mental health symptoms, alongside lay-provider coaching, or (2) Control: the Mood Education mobile app (ME), containing static psychoeducational resources designed to target mental health symptoms. Both apps collected usage data. Participants completed assessments on depression (PHQ-9), anxiety (GAD-7), health-related quality of life (PedsQL), and engagement (TWEETs) at baseline, mid-treatment (week 4), end-of-treatment (week 8), and post-treatment (week 12). Results: Participants (N = 130) were randomized to receive either the TES (Vira; Mage= 30) or ME (Mage= 33). Linear mixed-effects models determined significant improvements in PHQ-9 and GAD-7 scores for participants across both conditions (ps < 0.001). There was no interactive effect of intervention and time for the PHQ-9 (p =.90) nor the GAD-7 (p =.49). Adjusting for baseline differences and randomization strata, TES participants reported a greater change in a quality of life rating of Physical Functioning (PedsQL) across time (p =.018). TES participants also reported higher levels of engagement and demonstrated higher app usage. However, adjusting for baseline symptom severity, neither app usage nor coach interaction frequency moderated outcomes (ps ≥ 0.2). Conclusions: While the TES demonstrated superior engagement, improvements in depressive and anxious symptoms for both conditions speak to the potential benefit of both TES and low-intensity psychoeducation treatments in care settings. Future research is needed to better understand which patients might differentially benefit from TESs and broader personal sensing technologies over low-intensity treatments. Trial registration: ClinicalTrials.gov NCT05406791. [ABSTRACT FROM AUTHOR]

Introduction: Identifying prognostic factors of treatment outcome may assist in customizing an intervention to a patient's needs. Hence, we conducted a secondary analysis of data from a randomized controlled trial to investigate the effectiveness of an internet-based cognitive behavioral therapy for insomnia (iCBT-I) to find patient characteristics that may predict the change of insomnia severity after treatment. Materials and methods: In this exploratory analysis involving 94 chronic insomnia patients, we examined the predictive value of several self-reported measures, medical history, and sociodemographic variables to psychological distress with separate linear regression models. The main outcome was the Insomnia Severity Index score improvement from pre- to post-treatment Results: The study found that duration of insomnia, b (SE) = −0.02 (0.01), p = 0.01, and attitudes about the expected treatment success, b (SE) = 0.80 (0.27), p = 0.004, were predictors of a better outcome. Moreover, a better outcome was associated with a lower level of the following traits: attention seeking, b (SE) = −1.06 (0.51), p = 0.04; grandiosity, b (SE) = −1.50 (0.57), p = 0.01; distractibility, b (SE) = −1.57 (0.75), p = 0.04; and rigid perfectionism, b (SE) = −1.32 (0.65), p = 0.05. Conclusion: Our results suggest that iCBT-I might be particularly beneficial for patients with higher expectations from the therapy and those who have a shorter duration of insomnia. Some pronounced personality traits, such as attention seeking, grandiosity, distractibility, and rigid perfectionism, may predict worse outcomes. However, because this was a post-hoc analysis, our results must be considered exploratory and verified in further studies. Clinical trial registration: https://clinicaltrials.gov/study/NCT04300218?cond=NCT04300218&rank=1, Identifier NCT04300218. [ABSTRACT FROM AUTHOR]

Background: Attentional bias is a salient manifestation of insomnia. Digital cognitive therapy for insomnia (dCBT-I) has been validated as effective in alleviating this cognitive dysfunction. However, the effect of dCBT-I on attentional bias among Chinese individuals with insomnia remains undiscussed. This research sought to investigate this effect via a pictorial dot-probe task. Methods: In Study 1, the pattern of attentional bias among poor sleepers (N = 52) and normal sleepers (N = 56) was assessed by the dot-probe task. In study 2, dCBT-I and conventional education were received by the experimental group (N = 42) and control group (N = 25), respectively. The dot-probe tasks and sleep quality assessments were completed at baseline and post-test. Results: The results of Study 1 indicated that poor sleepers exhibited significant attentional bias, characterized by increased attentional vigilance. Compared to normal sleepers, they showed heightened attentional vigilance toward sleep-related cues. The results of Study 2 showed that both dCBT-I and conventional education led to improvements in PSQI scores. However, only dCBT-I training alleviated attentional vigilance toward sleep-related cues. Additionally, dCBT-I was uniquely effective in reducing feelings of fatigue. Conclusions: Poor sleepers had a significant attentional bias, marked by heightened vigilance toward sleep-related cues. Digital CBT-I effectively reduced attentional vigilance and fatigue, suggesting that dCBT-I targets the cognitive distortions associated with insomnia. Trial registration: ChiCTR2100053172 (registered 13/11/2021). [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment is common in Parkinson's disease (PD) but has limited treatment options. Medication has shown some benefits but accompanied by risk of adverse events. We aimed to investigate effectiveness and feasibility of nonpharmacological interventions for people with PD and cognitive impairment on patient‐centred outcomes. Methods: Systematic searches of five databases (MEDLINE, Embase, CINAHL, PsycINFO and Web of Science) were performed for studies evaluating nonpharmacological interventions for people with PD and cognitive impairment, reporting health‐related quality of life, function (activities of daily living) or wellbeing outcomes, published up to 15 May 2023. Two reviewers independently assessed full‐text articles and one reviewer extracted data, with a second reviewer reliability checking all data extraction. Randomised controlled trials (RCTs) were synthesised through meta‐analysis using a random‐effects meta‐analysis with restricted maximum likelihood method pooled estimate and observational studies through narrative synthesis. Results: Eleven RCTs and three noncontrolled studies were included, studying a range of interventions: cognitive training, cognitive stimulation, cognitive rehabilitation, physical and cognitive exercise, goal management training, psychoeducation with mindfulness, broader rehabilitation programs and a psychological intervention. Feasibility was demonstrated. The majority showed effectiveness for their primary outcome. Meta‐analysis showed no significant improvement in HrQoL (seven RCTs: pooled effect, standardised mean difference, −0.20 [−0.57−0.18]) or function (four RCTs: 0.08 [−0.36, 0.52]), and wellbeing measurement was infrequent and indirect. Quality of evidence was judged as very low, limiting the conclusions drawn. Conclusion: Whilst nonpharmacological trials for cognitive impairment in PD have shown promise, we found no evidence of effectiveness on HrQoL, function or wellbeing. However, this is based on very low‐quality evidence from a small number of diverse studies, not powered for these outcomes. Feasibility of a range of interventions has been demonstrated in both PD‐mild cognitive impairment and PD‐dementia. There is a need for more robust, adequately powered studies. [ABSTRACT FROM AUTHOR]

Simple Summary: Insomnia is prevalent in patients with cancer, with rates ranging from 30% to 60%. Addressing insomnia remains important in this population, as it can improve patient quality of life and reduce suffering. However, inconsistent methods of defining insomnia and evaluating potential interventions renders treatment difficult. Furthermore, many factors influence insomnia's presentation, requiring a specialized and individualized approach to its management for each patient. This review sought to use thorough and strict criteria to assess current psychological intervention for insomnia. To this end, we describe current psychological treatment options for insomnia, highlight gaps in the existing research, and offer suggestions for treating insomnia in patients with cancer. Background/Objectives: Insomnia is a frequent and distressing symptom with limited treatment in patients with cancer. Among the available treatments for insomnia, psychological interventions are some of the most assessed. While studies and reviews show promise of interventions improving insomnia in patients with cancer, inconsistent approaches to operationalizing and measuring insomnia combined with the heterogeneity of available treatments render comparisons and synthetization difficult. This review sought to rigorously synthesize psychological interventions for patients with cancer and insomnia by describing current therapies, identifying gaps in the literature, and offering supportive interventions. Methods: A comprehensive search of five databases—Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, EBSCO CINAHL Plus with Full Text, and Cochrane Library—was conducted through 1 August 2024. The review included randomized trials and non-inferiority trials evaluating psychological interventions for patients with various types of cancers. Twenty-one studies were included, and study quality ranged from good to excellent, according to the PEDro scale. Results: The current evidence supports the use of cognitive behavioral therapy (CBT) to treat insomnia over and above psychoeducation alone, mindfulness-based stress reduction, Brief Behavioral Therapy, the Benson Relaxation Technique, progressive muscle relaxation, mindfulness meditation, mind-body bridging, and home-based psychological nursing. Digital, minimal, and internet-based intervention modalities are effective, though professional-delivered CBT proved most effective. Conclusions: CBT remains the most effective psychological intervention for insomnia in this population. Challenges exist regarding the implementation of CBT, so further research is warranted to identify the best psychological interventions for specific settings and subsets of patients with cancer. [ABSTRACT FROM AUTHOR]

Background: There is an increased demand for quality treatment and rehabilitation services for people who use drugs (PWUDs) in the Philippines. In response, the Philippines Government's Department of Health (DOH) has established a new residential treatment model, Intensive Treatment and Rehabilitation Program for Residential Treatment and Rehabilitation Centers (INTREPRET), and integrated it into the existing treatment service platform of 21 DOH-owned Treatment and Rehabilitation Centers (TRCs). We conducted a qualitative study to identify the changes engendered by the implementation of this treatment model. Methods: Data were collected through individual face-to-face interviews. We interviewed purposefully selected 29 patients and 35 facilitators of INTREPRET group sessions in seven TRCs. We transcribed the interview records and organized the narrative information into key themes using thematic analysis during the coding process. Results: The changes perceived by the study participants included the attitude and behavior of patients, attitude and competency of facilitators, relationship between facilitators and patients, treatment planning and review process, efficient and standardized treatment services, and monitoring mechanisms of the patient's recovery process. Participants also noted challenges in INTREPRET implementation, including family participation in therapy sessions, lack of facilitators, securing a conducive place for conducting sessions, and reproducing workbooks. Conclusions: The results imply that the introduction of INTREPRET could improve treatment service quality and the effectiveness of treatment, which were primarily associated with behavioral changes in patients, improved relationship between patients and facilitators, and INTREPRET's alignment with key international treatment standards. However, despite the positive changes perceived by the participants, certain challenges pertaining to family participation in therapy sessions and the lack of resources were identified. These criticisms must be addressed by DOH, along with an integration of INTREPRET into its policy and strategic framework, to ensure the effectiveness and sustainability of the new treatment model. [ABSTRACT FROM AUTHOR]

Background: Both night-eating syndrome and binge-eating disorder are characterized by episodes of excessive food consumption, significant distress, and functional impairment related to maladaptive eating behaviors. Both types of eating disorders are associated with poorer sleep quality. Cognitive behavioral therapy has demonstrated good outcomes for binge-eating disorder; however, it is unknown if it is effective for night-eating syndrome and comorbid insomnia. Case presentation: The current paper presents a case report of a Dutch woman in her 40's receiving cognitive behavioral therapy-enhanced for night-eating syndrome, as well as binge-eating disorder. However, to tailor the intervention to her specific needs, throughout the course of treatment, cognitive behavioral therapy-insomnia interventions were also implemented. Her comorbid complaints were insomnia, childhood trauma, a depressive mood disorder, and cluster B and C personality traits. She had a history of bariatric surgery, as well as alcohol addiction, and received various treatments in the past, aiming to become abstinent from binge eating. Conclusions: Post-treatment, she was abstinent from binge eating and, her scores of various eating disorder measures were below clinical cut-points. However, it is unclear if she would show earlier symptom reduction if she received cognitive behavioral therapy-insomnia, prior to cognitive behavioral therapy-enhanced. In addition, the patient reported an increase in her depressive mood and commenced schema therapy after cognitive behavioral therapy- enhanced. Although common, the underlying cause of symptom shifts in patients with an eating disorder remains largely unknown. [ABSTRACT FROM AUTHOR]

Background and aims: Cancer and its treatments may cause neurocognitive impairments in preschool children, but there is limited research on the neurocognitive outcomes of this population. This study, which assessed the neurocognitive function of preschool children with cancer and analyzed various influencing factors of neurocognitive functioning, is of significant importance. We aimed to investigate neurocognitive function and related risk factors in preschool children with cancer to inform preventive and intervention strategies. Methods: From September 2023 to May 2024, we recruited 100 preschool children with cancer. The Chinese version of the Ages & Stages Questionnaires, the Spence Preschool Anxiety Scale Chinese Version, and the Sleep Disturbance Scale for Children were used to collected data. Binary logistic stepwise regression analysis was used to explore the influencing factors of neurocognitive function in preschool children with cancer. Results: 49% of the preschool children with cancer had abnormalities in at least one neurocognitive dimension. The majority of children had abnormalities in gross motor dimension, accounting for 30%, which was related to age and frequency of participation in neurocognitive activities. Communication dimension was related to father's education level, dietary habit, and frequency of participation in activities. Fine motor dimension was associated with age, sex, and father's education level. Problem-solving dimension was associated with age and dietary habit. Personal-social dimension was related to age and radiotherapy. Conclusions: Nearly half of preschool children with cancer experienced neurocognitive impairment. The Chinese version of the Ages & Stages Questionnaires is a simple and effective tool for screening children with possible neurocognitive impairment. It was found that children's neurocognitive function was significantly influenced by family environment, dietary habit, cognitive activities, and cancer treatment. Therefore, it is recommended to strengthen family and social support, and to formulate personalized intervention such as cognitive therapy and dietary adjustment based on children's age and family background, which are important for promoting neurocognitive recovery. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual task conditions. Design: Randomized clinical trial. Methods: The present study was registered with the ID number NCT04786132. A total of 20 healthy and physically active older adults (73.25 ± 5.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE) and closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants' ability to reposition their dominant knee at 45°. Finally, performance of the cognitive task was measured through a subscale of the Barcelona Test called "categorical evocation in associations". The EG and the CG completed 8-week training programs with two sessions, 30 min per week, of postural control and proprioception exercises. The EG additionally included music in each session. Results: The analysis using a mixed ANOVA model revealed no significant group × time interaction effects (p < 0.05) for any of the assessments. However, a significant main effect for the time factor was observed, with both the control and experimental groups showing improved outcomes in the post-intervention measurements. Specifically, significant results were found for RBOE (F (4,15) = 11.87, p < 0.001, η2p = 0.76), RBCE (F (4,15) = 11.62, p < 0.001, η2p = 0.75), and proprioception (F (1,18) = 11.53, p < 0.003, η2p = 0.39). Conclusions: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music. [ABSTRACT FROM AUTHOR]

The two-week Home Base Intensive Clinical Program (ICP) provides treatment to veterans and active duty service members suffering from primary diagnoses of posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), anxiety, or depression. First launched in 2015, this paper provides a programmatic update, including new treatment components implemented since inception, and examines outcomes for all participants who entered the program from September 2015 to July 2024 (n = 2561). The Home Base ICP provides a massed care approach through daily individual Prolonged Exposure, Cognitive Processing Therapy, Unified Protocol, or cognitive rehabilitation, along with groups targeting coping skills. Participants entering the program are provided with core group programming, as well as individualized therapy sessions tailored to their unique needs and symptom presentation. Supplemental dual recovery support is also available for all participants with co-occurring substance use or behavioral addiction concerns. Participants' support people receive education, support, and case management services. Participants have a multidisciplinary team comprising therapists, psychopharmacology providers, case managers, nurses, and wellness providers. Results demonstrate that program participants exhibited statistically significant reductions in PTSD symptoms (Cohen's d = 0.80), depression (d = 0.68), post-concussion symptoms (d = 0.71), and increased satisfaction in social roles (d = -0.65). Completion rate was 94.60% (n = 2422), suggesting that the Home Base ICP is a well-received and effective model of care for veterans and service members. [ABSTRACT FROM AUTHOR]

Introduction: Hyperacusis is common among the autistic population, with a lifetime prevalence estimated at up to 60% compared to 17.1% in those without autism. For autistic children, avoidance behaviors and distress associated with hyperacusis significantly disrupt participation in everyday routines including academic, social and leisure activities. Although hyperacusis is a significant problem for children with autism and their families, there is little research on effective interventions. This report describes the clinical case of an 11-year-old boy with autism who received a modified cognitive behavioral therapy (CBT) approach to address symptoms of hyperacusis. Case presentation: Patient A is an 11-year-old boy with autism and hyperacusis. He and his parents report difficulties tolerating loud or high-pitched sounds including whistling, fireworks, traffic and high-pitched musical instruments (e.g., the ocarina and flute). When hearing these sounds during everyday activities (e.g., celebrations and social events) he will often ask strangers to stop, cover his ears, or avoid/run away from the source of sound. A modified CBT approach was combined with exposure therapy, and sensory-based self-regulation strategies to improve tolerance and decrease distress when hearing whistling. Treatment outcomes include improved loudness discomfort levels in audiology evaluations, improved auditory domain scores on the Sensory Profile questionnaires, lower self-reported subjective units of distress scale (SUDS) ratings in response to bothersome sounds, and decreased use of noise canceling headphones during daily activities. The client and his parents also reported generalization of these improvements with other sounds (e.g., fireworks). Conclusion: The patient described in this case report showed measurable improvements in his ability to tolerate whistling, a bothersome sound encountered regularly in his daily life. Considering the high prevalence rate of hyperacusis in autism and its impact on children and family routines, stress and daily living, the development and testing of an effective treatment approach for hyperacusis is needed. The treatment plan for this case arose from the collaboration between professionals in occupational therapy, applied behavior analysis, audiology, and clinical psychology. Future studies are encouraged to determine the efficacy of this combined approach for other children with autism and hyperacusis. [ABSTRACT FROM AUTHOR]

Background and aim: Addiction problems also affect the lives of family members. This study aims to examine: (1) young adult family members' experiences with informal and professional support in coping with the impact of relatives' addiction problems and (2) how these experiences evolve over time. Method: A three-year longitudinal qualitative study. Four rounds of in-depth, semi-structured individual interviews were conducted. Thirty students aged 18–30 years, participated in the study at baseline. 93% participated in at least two interviews, and 80% participated three or four times. The Stress-Strain-Information-Coping-Support model was used, and Directed Content Analysis was applied. Findings: Five major themes were extracted from the data: (1) Informal support; (2) Educational support; (3) Healthcare support; (4) Resilience factors; and (5) Developments over time. Informal and educational support were more often described as effective than healthcare support, although the number of participants who sought healthcare support increased over time. Effective elements of support included being able to discuss their experiences with people listening without judgment or unsolicited advice and having long-term relationships of trust with people from the social environment and professionals. Participants were mainly treated with Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Learning how to distinguish between accurate and inaccurate thoughts, especially about themselves, was considered effective. Body-oriented therapy was remarkably absent. Finding effective healthcare support was often a long and winding road through various therapies and therapists. Participants were not attracted to peer group interventions but needed advice on how to deal with their relatives. They also needed recognition by their relatives for harm done. This recognition was seldom given. Conclusions: It is recommended to train educational and healthcare professionals to recognize the support needs of young people with relatives with addiction problems, to help them cope, or to refer them adequately. We also suggest broadening the scope of professional support offered to AFMs, including body-oriented and cultural interventions. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this scoping review is to provide an overview of the available evidence on the effectiveness of web-based interventions for fear of cancer recurrence (FCR) and a discussion of drawbacks and possible improvements for web-based interventions identified in the reviewed studies. These steps fulfil the aim of this review, which is to offer suggestions for developing future web-based interventions based on the reviewed studies. Methods: Five databases (PubMed, MEDLINE, EMBASE, SCOPUS and Web of Science) were searched. Original peer-reviewed articles, written in English, on web-based interventions for FCR were included for review. The data from the included studies was synthesised thematically. Results: We included 34 papers reporting on 28 interventions. Most of the studies in the papers were quantitative and mixed quantitative studies with a qualitative element, e.g. an interview post-intervention. Interventions were most commonly trialled with women breast cancer patients. Top three countries where studies were conducted were USA, Australia and the Netherlands. The most common theoretical framework for interventions is cognitive behavioural therapy (CBT), followed by mindfulness-based and mixed CBT, mindfulness, acceptance and commitment therapy (ACT), relaxation approaches. FCR was the primary focus/measure in 19 Studies, in 9 studies FCR was a secondary/related outcome/measure. Overall, the evidence of efficacy of web-based interventions on FCR is mixed. Conclusions: The existing research suggests several key points for producing more robust evidence about the effectiveness of web-based interventions for FCR. First, the studies suggest that it is a priority to better define eligibility criteria to proactively include people with higher levels of FCR. Second, there is a need for longer-term follow-up and outcome measuring period. Third, research examining the reasons for dropout from web-based interventions for FCR is critical to improve the effectiveness of web-based interventions. Fourth, while web-based interventions do not involve the costs of transportation, traveling time, space, equipment, cleaning, and other expenses, further cost utility analyses should be performed. Finally, future studies should assess how intervention accessibility, adherence, and effectiveness can be improved across different intervention designs, varying from intensive synchronous individual therapist-assisted web-based programme to blended designs combining the advantages of face-to-face and internet-based elements, to entirely self-managed programmes. Implications for cancer survivors: Developing and evaluating more accessible FCR treatments have been identified among top international FCR research priorities (Shaw et al. 2021). While there is some evidence that web-based interventions can be as effective as face-to-face interventions, currently there is a dearth of systematic data about the ways in which the web-based modality specifically can enhance supportive care for FCR. Developing knowledge about effective web-based interventions has implications for cancer survivors as they can be presented with more accessible, low-cost and low-burden options for managing fear of cancer recurrence. [ABSTRACT FROM AUTHOR]

This study aims to explore the complex and multifaceted relationship between Behavioral Activation and Behavioral Maintenance in sports participation, delving into the underlying mechanisms to provide practical insights into how individuals initiate and sustain engagement in sports activities. Utilizing a combination of convenience sampling and snowball sampling methods, 378 sports participants from over ten provinces and cities in China were selected as survey subjects, and an intermediary model concerning the activation and maintenance of sports participation behavior was constructed. Discriminant validity and mediation effect analyses were conducted using SPSS and AMOS 23.0. The results indicate that Behavioral Activation indirectly influences Behavioral Maintenance through Competence (ad = 0.39), with a 95% confidence interval [0.201, 0.642], excluding 0. Behavioral Activation also indirectly influences Behavioral Maintenance through Autonomy (be = 0.23), with a 95% confidence interval [0.109, 0.421], excluding 0. However, Behavioral Activation indirectly influences Behavioral Maintenance through Relatedness (cf. = 0.09), with a 95% confidence interval [-0.068, 0.336], which includes 0. The study reveals that both Competence and Autonomy significantly mediate the activation and maintenance of sports participation behavior among athletes. However, Relatedness does not play a significant mediating role in the activation and maintenance of sports participation behavior among the participants. [ABSTRACT FROM AUTHOR]

Background: Internet-delivered cognitive behavioural therapy (ICBT) has previously shown promise in effectively treating climate change-related distress. The aim of the present study was to investigate participants' experiences of undergoing a novel ICBT program targeting psychological symptoms associated with climate change. Methods: Telephone interviews were conducted with nine participants who had received eight weeks of ICBT for climate change-related distress. A semi-structured interview guide was used to gather information about participants' experiences of undergoing treatment. Data were transcribed and analyzed using thematic analysis. Results: The thematic analysis resulted in three overarching themes: (1) Same old feelings, brand new strategies, (2) Bumps in the road, and (3) Personalized climate engagement. Participants experienced that they had developed new coping strategies for handling their emotions, encountered challenges during the treatment period, and adapted their pro-environmental behaviour to their individual needs and circumstances. Conclusions: The results indicate that participants were able to utilize the treatment material in different ways, resulting in a variety of emotional, cognitive, and behavioural changes. While the treatment was generally described as helpful, participants also raised some concerns regarding the treatment format. These findings can inform further development of ICBT targeting psychological symptoms associated with climate change. [ABSTRACT FROM AUTHOR]

Background: Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults with mental health issues. Methods: An uncontrolled observational study utilizing secondary retrospective program data was conducted to evaluate the reach, uptake, and psychological symptom changes among participants engaging with either iCBT program. Results: Between May 2020 and September 2021, 56,769 individuals enrolled in LifeWorks AbilitiCBT, and 73,356 in MindBeacon TAiCBT. However, substantial exclusions were made: 56% of LifeWorks participants and 68% of MindBeacon participants were ineligible or failed to initiate treatment. Consequently, 25,154 LifeWorks participants and 23,795 MindBeacon participants were included in the analysis. Of these, 22% of LifeWorks and 26% of MindBeacon participants completed over 75% of iCBT treatment. On average, LifeWorks participants received 13 ± SD 7.1 therapist messages and sent 5 ± SD 10.3 messages, while MindBeacon participants received 25 ± SD 20.7 therapist messages and sent 13 ± SD 16.4 messages. LifeWorks included synchronous therapist contact averaging 1.4 ± SD 1.9 h per participant, while MindBeacon was purely asynchronous. Baseline severity of anxiety (37%) and depression symptoms (22%) was higher for LifeWorks participants compared to MindBeacon participants (24% and 10%, respectively). Clinically significant changes in anxiety and depression scores were observed: 22% of LifeWorks and 31% of MindBeacon participants exhibited reliable recovery in PHQ-9 scores, while 26% of LifeWorks and 25% of MindBeacon participants demonstrated reliable recovery in GAD-7 scores. Conclusion: In conclusion, iCBT programs show promise for engaged participants with varying levels of severity in anxiety and depression symptoms. Future iterations of iCBT should consider adopting a broad entry criterion to iCBT programming to increase accessibility, especially for those with severe symptoms, alongside integrated intake care pathways, and potential payment structure adjustments for iCBT service providers. Taken all together, these factors could temper high dropout rates post-intake assessment. This evaluation underscores the potential and value of digital mental health interventions for individuals with mild to severe anxiety or depression symptoms, emphasizing the importance of addressing participant dropout. [ABSTRACT FROM AUTHOR]

This study introduced a groundbreaking approach to address the pressing public health challenges of obesity management and its associated health implications. By establishing a clear link between obesity and various health issues, this study underscores the critical need for effective interventions. Our team developed a pioneering digital therapeutic tool through the application of advanced 3D artificial intelligence technologies. This innovative solution offers a dynamic visual representation of weight loss and health enhancement journeys for individuals with obesity. By providing a platform for users to monitor their progress in real time, digital therapeutics (DTx) foster deeper engagement and strengthen motivation towards health goals. The experimental results showed that the digital therapeutic received high scores in terms of usability, effectiveness, predictiveness and personalization, user satisfaction, and continuous usage and adherence. These findings suggest that DTx can be a valuable tool for the management and treatment of obesity. The effectiveness of this digital approach was thoroughly assessed from multiple dimensions, showing its significant potential and effectiveness in obesity management. These findings advocate ongoing research in this area, projecting that the continuous evolution of DTx will have a profound positive impact on both personal and public health outcomes. [ABSTRACT FROM AUTHOR]

Behavioral activation therapy is presented as a promising psychological intervention to enhance depression management and related symptoms by increasing engagement in rewarding activities. This study reviews three research endeavors, including randomized controlled trials and a case study. Variability in intervention duration and training approaches is noted, although typically, eight sessions per week were conducted. Therapy components range from participating in pleasurable activities to ongoing support outside sessions. The process of evidence source selection relied on identifying 327 articles across four databases, with three selected for review, utilizing the PRISMA extension for scoping reviews. This ensured rigorous eligibility criteria and a structured methodology for data collection. Overall, these findings support the effectiveness and applicability of behavioral activation therapy in treating depression in older adults. Training non-specialized healthcare personnel would improve the overall quality of medical care and facilitate the dissemination of evidence-based therapies. This, in turn, could be crucial in closing the psychotherapeutic care gap that exists in low and middle-income countries. [ABSTRACT FROM AUTHOR]

Background and aims: Giulia, an 11-year-old girl diagnosed with ligyrophobia, has been experiencing intense anxiety related to loud noises since the age of two. This case report aims to explore the efficacy of Third-Wave Cognitive Behavioral Therapy, specifically Acceptance and Commitment Therapy (ACT), in addressing Giulia's anxiety and avoidance behaviors. The primary goal is to examine the impact of ACT on reducing ligyrophobic symptoms and enhancing psychological flexibility. Methods: The therapeutic intervention spanned 24 sessions and was divided into two phases. The initial phase focused on emotional competence using characters from the movie "Inside Out," aiding Giulia in recognizing and understanding her emotions. The subsequent phase targeted the six processes of psychological inflexibility identified in ACT, fostering increased flexibility. Results: Throughout the intervention, Giulia demonstrated significant improvements in anxiety symptoms, as evidenced by a decrease in Subjective Units of Distress (SUD) scores. Avoidance behaviors also diminished, and Giulia exhibited enhanced mindfulness skills. She became more cognizant of her emotional experiences and more certain of her personal ideals as a result of the therapy. Giulia's active participation and commitment to exposure exercises led to a substantial reduction in ligyrophobic reactions. Discussion: The successful application of ACT in Giulia's case suggests that targeting psychological inflexibility through mindfulness and values clarification can be effective in treating ligyrophobia in children. The integration of metaphors and creative exercises proved valuable in engaging Giulia and fostering therapeutic progress. The findings underscore the importance of a tailored, third-wave therapeutic approach in addressing specific phobias in pediatric populations. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to review studies developing or validating a prediction model for transition to psychosis in individuals meeting At Risk Mental State (ARMS) criteria focussing on predictors that can be obtained as part of standard clinical practice. Prediction of transition is crucial to facilitating identification of patients who would benefit from cognitive behavioural therapy and, conversely, those that would benefit from less costly and less-intensive regular mental state monitoring. The review aims to determine whether prediction models rated as low risk of bias exist and, if not, what further research is needed within the field. Design: Bibliographic databases (PsycINFO, Medline, EMBASE, CINAHL) were searched using index terms relating to the clinical field and prognosis from 1994, the initial year of the first prospective study using ARMS criteria, to July 2024. Screening of titles, abstracts, and subsequently full texts was conducted by two reviewers independently using predefined criteria. Study quality was assessed using the Prediction model Risk Of Bias ASessment Tool (PROBAST). Setting: Studies in any setting were included. Primary and secondary outcome measures: The primary outcome for the review was the identification of prediction models considering transition risk and a summary of their risk of bias. Results: Forty-eight unique prediction models considering risk of transition to psychosis were identified. Variables found to be consistently important when predicting transition were age, gender, global functioning score, trait vulnerability, and unusual thought content. PROBAST criteria categorised four unique prediction models as having an overall low-risk bias. Other studies were insufficiently powered for the number of candidate predictors or lacking enough information to draw a conclusion regarding risk of bias. Conclusions: Two of the 48 identified prediction models were developed using current best practice statistical methodology, validated their model in independent data, and presented low risk of bias overall in line with the PROBAST guidelines. Any new prediction model built to evaluate the risk of transition to psychosis in people meeting ARMS criteria should be informed by the latest statistical methodology and adhere to the TRIPOD reporting guidelines to ensure that clinical practice is informed by the best possible evidence. External validation of such models should be carefully planned particularly considering generalisation across different countries. Systematic review registration: https://www.crd.york.ac.uk/PROSPEROFILES/108488%5fPROTOCOL%5f20191127.pdf , identifier CRD42018108488. [ABSTRACT FROM AUTHOR]

Introduction: Resilience is the dynamic adaptive process of maintaining or recovering mental health from stressors, such as trauma, challenging life circumstances, critical transitions, or physical illnesses. Resilience after adversity can be fostered through protective factors and the implementation of interventions that promote resilience. Hence, it is essential to investigate both protective and vulnerable factors to reduce the negative effects of unfavorable life events and increase resilience through positive risk-response interventions. Objective: To assess the effect of previous adversity, protecting factors, and resilience-promoting interventions to possess resilience after adversity in a global context. Methods: The study included English language articles sourced from PubMed, Embase, Scopus, Web of Sciences, the Cochrane Database of Systematic Reviews, Scopus, and Google Scholar published before 15 April 2024. These articles reported the effect of adversity, protecting factors, and/or resilience-promoting interventions to possess resilience after adversity in a global context without a population age limitation. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews. A weighted inverse-variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed. Results: A total of 44 articles (n = 556,920 participants) were included in this umbrella review. From the random-effects model analysis, the pooled effect of adversity on the development of resilience was 0.25 (p < 0.001). The pooled effects of adversity-protective factors and resilience-promoting interventions after adversity were 0.31 (p < 0.001) and 0.42 (p < 0.001), respectively. The pooled effects of specific adversity protective factors were 0.26, 0.09, 0.05, 0.34, 0.23, and 0.43 for the availability of support, cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, respectively. The pooled effects of specific resilience-promoting interventions were 0.30, 0.21, 0.51, and 0.52 for cognitive behavior therapy (CBT) interventions, mindfulness-based interventions, mixed interventions, and resilience-promoting interventions, respectively. Conclusion: The findings of this umbrella review revealed that people who experienced early adversity can develop resilience later in life. The study highlights the need to consider adversity protective factors, such as availability of support (family, friends, and school), cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, and resilience-promoting interventions, including CBT interventions, mindfulness-based interventions, and mixed interventions, to enhance resilience promotion programs. [ABSTRACT FROM AUTHOR]

Background: Physical activity has the potential to improve physical and mental health outcomes of persons with depression. However, feasible and acceptable strategies to integrate physical activity interventions into real-world settings are needed. Objective: To assess the feasibility and acceptability of a manualized Behavioral Activation intervention aimed to increase physical activity in persons with depression (defined as a PHQ-9 score ≥ 10). Methods: A single-arm pilot study was conducted. The intervention consisted of 8 tele-therapy sessions delivered over a 10-week period. Measures of feasibility included screening, enrollment, intervention adherence, outcome data availability, and intervention fidelity. Acceptability was assessed with a post-intervention survey and qualitatively through focus groups and interviews. Preliminary efficacy of the intervention was assessed by evaluating pre-to-post changes in physical activity and depressive symptoms. Results: All feasibility metrics exceeded predetermined feasibility goal metrics with the exception of Fitbit wear and screening rate, which was due to a greater than anticipated enrollment rate. Participants (n = 15) reported perceived benefits from the intervention and convenience in attending tele-therapy sessions. Depressive symptoms, as measured by the PHQ-9 improved (16.8 at enrollment to 10.1 post intervention, Cohen's d = 1.13). Self-reported moderate-to-vigorous physical activity (MVPA) increased from 22.0 min/week at baseline to 36.67 min/week post-intervention (d = 0.58). Physical activity as measured by the Fitbit showed little change (daily step 5543.29 during Week 1 to 6177.48 during Week 10, (d = 0.14); MVPA 21.23 min/week during Week 1 to 19.22 at Week 10 (d = 0.0.06). Conclusions: Results of the pilot study suggest the intervention is feasible to deliver and acceptable to participants. Preliminary results suggest the intervention may be effective in improving depressive symptoms and increasing self-reported physical activity. Trial registration: ClinicalTrials.gov NCT04990401, Registered July 21, 2021. [ABSTRACT FROM AUTHOR]

Introduction: The normal transition to sleep is characterized by a reduction in higher frequency activity and an increase in lower frequency activity in frontal brain regions. In sleep onset insomnia these changes in activity are weaker and may prolong the transition to sleep. Methods: Using a wearable device, we compared 30min of short duration repetitive transcranial electric stimulation (SDR-tES) at 0.75Hz, prior to going to bed, with an active control at 25Hz in the same individuals. Results: Treatment with 0.75Hz significantly reduced sleep onset latency (SOL) by 53% when compared with pre-treatment baselines and was also significantly more effective than stimulation with 25Hz which reduced SOL by 30%. Reductions in SOL with 25Hz stimulation displayed order effects suggesting the possibility of placebo. No order effects were observed with 0.75Hz stimulation. The decrease in SOL with 0.75Hz treatment was proportional to an individual's baseline wherein those suffering from the longest pre-treated SOLs realized the greatest benefits. Changes in SOL were correlated with left/right frontal EEG signal coherence around the stimulation frequency, providing a possible mechanism and target for more focused treatment. Stimulation at both frequencies also decreased perceptions of insomnia symptoms measured with the Insomnia Severity Index, and comorbid anxiety measured with the State Trait Anxiety Index. Discussion: Our study identifies a new potential treatment for sleep onset insomnia that is comparably effective to current state-of-practice options including pharmacotherapy and cognitive behavioral therapy and is safe, effective, and can be delivered in the home. [ABSTRACT FROM AUTHOR]

Studies have shown a high prevalence of trauma and PTSD among patients with severe mental illness, but relatively few studies have examined the outcomes of PTSD treatment for this patient group. The aim of this case-series was to assess the feasibility of a Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) intervention for PTSD in people with psychosis. The study examined the possibilities and obstacles when treating this population within clinical settings. Patients were selected from four community mental health centers and were screened for traumatic experiences and symptoms of PTSD. A small group of eligible participants (n=7) received manualized TF-CBT adapted for patients with psychosis. Experienced therapists received training and supervision in the intervention. Symptoms of PTSD and psychosis were assessed at baseline and post-treatment along with quality of life, level of functioning, alliance, life events, engagement, suicidal ideation and adverse events. Treatment fidelity and the different combinations of treatment modules were monitored in regard to implementation. Three cases were selected as illustrative of the different treatment courses when implementing the TF-CBT intervention within this population. Detailed case descriptions were based on quantitative ratings and the therapists' experiences with the therapy. Results from the case series highlighted issues regarding toleration of treatment, large variation in psychopathology and the task of matching treatment needs with appropriate therapeutic techniques. The complexity of the patient group may affect treatment and clinical research studies. Lessons learned from this case series can contribute to the future development implementation and evaluation of trauma treatment for patients with psychosis. [ABSTRACT FROM AUTHOR]

Background: Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition with profound public health, personal, and family consequences. ADHD requires comprehensive treatment; however, lack of communication and integration across multiple points of care is a substantial barrier to progress. Given the chronic and pervasive challenges associated with ADHD, innovative approaches are crucial. We developed the digital health intervention (DHI)—CoolTaCo [Cool Technology Assisting Co-regulation] to address these critical barriers. CoolTaCo uses Patient-Centered Digital Healthcare Technologies (PC-DHT) to promote co-regulation (child/parent), capture patient data, support efficient healthcare delivery, enhance patient engagement, and facilitate shared decision-making, thereby improving access to timely and targeted mental health intervention for children at significant risk for poor outcomes. The present paper will describe our planned protocol to evaluate the efficacy of CoolTaCo via randomized control trial (RCT). Methods/design: We will recruit 60 children (ages 8–12) with ADHD who will be randomized to either immediate (n = 30) or delayed (n = 30) treatment (i.e., a waitlist control group). Among those randomized to immediate treatment, half will be assigned to DHI (delivered via a smartwatch and smartphone application), the other half to an active control treatment as usual (TAU). Unlike the DHI group, the TAU group will receive the smartwatch with no assigned activities, applications, or interventions on the devices. The intervention period will last 16 weeks; after a participant has been in the delayed treatment group for 16 weeks and has completed the post-waiting period assessment, they will be randomly assigned to either the intervention or active control group. Thus, 30 participants will complete the intervention, and 30 will complete the active control, with half of the total sample completing a waitlist period. Discussion: Individuals with ADHD have complex needs. Despite improvement in outcomes following cognitive behavioral therapies (CBT) and pharmaceutical treatment, long-term maintenance is a challenge often not addressed by traditional medical approaches, and, as we described, ineffective approaches to information sharing across points of care create further barriers to progress. Our research will fill a significant gap in translating early treatment investments and gains into long-term, sustainable outcomes. This study was registered as a clinic trial at ClinicalTrials.gov (Digital Health Intervention for Children With ADHD, ID# NCT06456372) on 06/13/2024. [ABSTRACT FROM AUTHOR]

Here, we investigated the association of different emotion regulation (ER) indices with symptom severity across a large transdiagnostic sample of patients with emotional disorders (cross-sectional approach) and the predictive validity these ER indices have for the outcome of routine care CBT (longitudinal approach). We assessed the trait-like use of adaptive (reappraisal) and maladaptive (suppression, externalizing behaviors) ER strategies via questionnaire as well as the situational ability to regulate emotions with an experimental ER paradigm. Psychopathology was assessed dimensionally using the depression, anxiety, and stress scale. Cross-sectionally symptom severity was predicted by less trait-like use of adaptive and more trait-like use of maladaptive ER strategies, but no associations were found for situational ER ability. This association was more pronounced for depression and stress symptoms rather than anxiety symptoms. In a striking dissociation, the longitudinal analyses revealed the reverse picture: Better situational ER ability, but not trait-like use of ER strategies was associated with less symptom severity after the CBT treatment. Our data argues in favor of a distinction between trait-like and situational ER abilities in individuals with emotional disorders, highlighting challenges in applying adaptive ER strategies in daily life despite demonstrating intact ER skills in experimental settings. Our findings also inform transdiagnostic models of psychopathology and suggest that distress/depression rather than anxiety symptomatology to be driving forces for the occurrence of ER deficits across the depression/anxiety disorders spectrum. [ABSTRACT FROM AUTHOR]

Objective: Despite the widespread application of non-pharmacological therapies in treating cancer-related insomnia, a comprehensive assessment of these methods is lacking. This study aims to compare the efficacy of 11 non-pharmacological interventions for cancer-related insomnia, providing a theoretical basis for clinicians in choosing treatment methods. Methods: We searched five databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, Wiley Library, and Web of Science, for relevant randomized controlled trials. Included studies involved patients diagnosed with cancer-related insomnia, employed non-pharmacological treatments, and reported outcomes using the PSQI and ISI. Bayesian statistical methods were used for the network meta-analysis, and statistical processing was performed using Review Manager 5.4 and Stata 14.0 software. The results were thoroughly analyzed and evaluated, and publication bias was assessed using funnel plot tests. Results: Our study included 41 randomized controlled trials, comprising 11 different non-pharmacological interventions (3,541 participants), the network analysis identifying Electroacupuncture as the most effective, with a SUCRA value of 92.2% in ISI, this was followed by Professionally administered Cognitive behavioral therapy for insomnia(PCBT-I) and Mindfulness-based cognitive therapy(MBCT), with SUCRA values of 78.4 and 64.1%, respectively. Traditional Cognitive behavioral therapy for insomnia(CBT-I) and VCBT-I showed lower efficacy with SUCRA values of 55.9 and 55.2%, respectively. Exercise interventions and control groups had the lowest efficacy, with SUCRA values of 24.0 and 16.1%. Using PSQI as the outcome measure, Massage therapy ranked highest in improving sleep quality with a SUCRA value of 92.2%, followed by Professionally administered Cognitive behavioral therapy for insomnia (PCBT-I) and Electroacupuncture. League tables indicated significant improvements in sleep outcomes for Electroacupuncture and MT compared to control groups, with Electroacupuncture (EA) showing an MD of −7.80 (95% CI: −14.45, −1.15) and MT an MD of −4.23 (CI: −8.00, −0.46). Conclusion: Considering both outcome indicators, Electroacupuncture was significantly effective in alleviating the severity of insomnia, while MT was most effective in improving sleep quality. Therefore, in the non-pharmacological interventions for cancer-related insomnia, Electroacupuncture and MT May be particularly effective choices. Future research should further explore the specific mechanisms of action of these interventions and their efficacy in different patient groups. [ABSTRACT FROM AUTHOR]

Background: Sleep and mental health problems are very common in university students. The objective of this study was to assess the effectiveness of a multi-component sleep-mood intervention on improving sleep and mental health in university students with clinically significant insomnia symptoms, and to investigate possible mediators. Methods: Thirty-five participants were randomized to the Sleep Mood Intervention: Live Effectively (SMILE) intervention (n = 23), or wait-list group (n = 12). SMILE is a multi-component group therapy and includes elements of cognitive behavioral therapy for insomnia (CBT-I), mindfulness, and lifestyle modifications, in four weekly two-hour sessions. The primary outcome was insomnia severity. Secondary outcomes were severity of depression and anxiety, and quality of life (QoL). Dysfunctional beliefs and attitudes about sleep and pre-sleep arousal were assessed as mediators. Results: Intention-to-treat analysis showed significant time x treatment interaction on insomnia symptoms p =.02, partial η²= 0.15, d = 0.84 [95% CI: 0.63 to 1.14], with significantly lower insomnia severity for SMILE compared to waitlist at post-test. No significant effects were found on depression d = 0.02 [95% CI: -0.35 to 0.37], anxiety d = 0.15 [95% CI: -0.16 to 0.53], and QoL d = 0.09 [95% CI: -0.25 to 0.42]. Dysfunctional beliefs mediated the effect on insomnia severity, but pre-sleep arousal did not. Conclusions: This integrated group intervention is associated with reductions in insomnia symptoms in university students. Since no significant effects were detected on mood and QoL, future studies with larger sample size may explore the effects of this intervention on these outcomes. Trial registration: Registry: Overzicht van Medisch-wetenschappelijk Onderzoek. Registration number: NL-OMON46359. Date of registration: September 18th, 2018. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BD) is characterized by recurrent episodes of mania, hypomania, and depression and is often complicated by comorbid substance use disorders (SUDs). Up to 60% of individuals with BD experience SUDs, which exacerbate mood instability and increase the risk of rapid cycling, suicide, and poor clinical outcomes. Current treatment strategies, including lithium and valproate, show limited efficacy in treating both BD and SUD. Psychotherapeutic approaches such as cognitive behavioral therapy (CBT) offer benefits but lack a specific focus on substances such as cannabis and cocaine. Since there is still debate on how to treat this comorbidity, there is a need to find new therapeutic options; this mini-review examines the pharmacological properties of cariprazine and its emerging role in the treatment of comorbid BD and SUD. Cariprazine, an atypical antipsychotic with partial agonism at dopamine D2 and D3 receptors, has shown promise in treating both mood symptoms and cognitive dysfunction in BD. Its unique affinity for D3 receptors, which are involved in motivation and reward processing, may offer advantages in reducing drug craving. Clinical trials indicate that cariprazine effectively treats manic, depressive, and mixed episodes in BD with a favorable side effect profile, particularly at lower doses. Preliminary results suggest its potential to reduce craving and substance use in individuals with co-occurring BD and SUD. Therefore, cariprazine, with its unique pharmacodynamic mechanism, could be further studied for the treatment of BD in comorbidity with SUD. However, evidence on the role of cariprazine in the treatment of SUDs remains limited, based primarily on case reports and animal studies. Further research, including large-scale clinical trials, is needed to determine its full efficacy in this dual diagnosis. [ABSTRACT FROM AUTHOR]

This review explores the impact of cognitive behavioral therapy for insomnia (CBT-I) on menopausal women suffering from insomnia. The transition to menopause is often accompanies by sleep disturbances, which significantly affect women's quality of life. This review applies a scoping approach to evaluate randomized controlled trials (RCTs) focused on CBT-I interventions for insomnia among menopausal women. The included studies examined variations in the number of CBT-I sessions, the duration of interventions, and their delivery methods (face-to-face, online, or telephone-based). The results consistently showed that CBT-I significantly improves sleep quality and reduces insomnia severity in menopausal women. CBT-I was particularly effective compared to other interventions such as sleep restriction therapy and sleep hygiene education. Sleep quality improvements were observed to persist for up to six months after treatment. These findings support the use of CBT-I as a first-line intervention for insomnia in menopausal women, offering a sustainable solution with fewer side effects compared to pharmacological treatments. However, the review also highlights the need for further research on CBT-I's efficacy in diverse populations, as most studies focused on predominantly white and well-educated women. [ABSTRACT FROM AUTHOR]

Military combat can result in the need for comprehensive care related to both physical and psychological trauma, most commonly chronic pain and post-traumatic stress disorder (PTSD). These conditions tend to co-occur and result in high levels of distress and interference in everyday life. Thus, it is imperative to develop effective, time-efficient treatments for these conditions before they become chronic and resistant to change. We developed and pilot-tested the Pain and Trauma Intensive Outpatient Treatment (PATRIOT) Program, a brief, intensive (3 weeks, six sessions) integrated chronic pain and PTSD treatment. An overview and session-by-session outline of the PATRIOT Program is provided, followed by results from the first pilot evaluation of the PATRIOT Program's feasibility, acceptability, and preliminary efficacy in a sample of eight participating Veterans with comorbid chronic pain and PTSD. There were no treatment dropouts. At post-treatment, there were significant reductions in PTSD symptoms based on the Clinician-Administered Assessment of PTSD (CAPS). Pain and catastrophic thinking also decreased from pre- to post-treatment. With continued investigations and support, the PATRIOT Program may offer a brief, cost-effective, and more easily accessible treatment option for individuals who could benefit from learning skills to manage pain and PTSD more effectively. [ABSTRACT FROM AUTHOR]

Background: Residual symptoms in individuals with bipolar disorder (BD) in remission are common, and they contribute to significant functional impairment and distress. The incomplete efficacy of pharmacological treatments and improvements in psychotherapeutic approaches has led to renewed interest in psychotherapy for this disorder. However, there are fewer studies addressing the same. Aim: The study aims to examine brief CBT (cognitive behavior therapy) in addressing the residual symptoms in BD. Method: A two-group randomized control design with multiple assessments (pre, post, and 3-month follow-up) was adopted. The sample consisted of 30 patients each in the intervention and Treatment As Usual (TAU) groups selected from the outpatient services of a tertiary mental health hospital. The variables studied were interepisodic symtpoms, functioning, and adherence to treatment using the tools of Beck Depression Inventory-II, Young Mania Rating Scale, and Beck Anxiety Inventory. The intervention group received a brief integrated CBT of 8--10 sessions conducted weekly over 2--3 months. The TAU group received treatment as usual and brief weekly telephonic contact. Results: A significant difference was seen across the time points between the groups on all the variables. Significant changes in within group scores was noted in the intervention group on depressive and anxiety symptoms, medication adherence, and dysfunctional attitudes compared to the TAU group. However, there was no significant change in the functioning in both the groups. Larger within group effect sizes for anxiety, dysfunctional attitudes and emotion regulation, medium effect sizes for depression, and quality of life and small effect sizes for manic symptoms and medication adherence were found in the intervention group. Depression severity had a significant moderating effect on therapy outcomes. Conclusion: The study shows effectiveness of brief CBT in reducing residual symptoms in the patients with BD. A longer-term follow-up would validate the findings. [ABSTRACT FROM AUTHOR]

To synthesize the best available evidence regarding the perceptions and current clinical practices of athletic trainers (ATs) in integrating psychological skills into patient management. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL; via EBSCOhost), PsycInfo (via EBSCOhost), SPORTDiscus (via EBSCOhost), and Scopus (via Elsevier). Studies had to investigate the current clinical practices and perceptions of certified ATs in integrating psychologically informed practice for patient management. Studies that had level 4 evidence or higher were included. Studies were excluded if they were published before 1999, the primary language was not English, they involved athletic training students or other rehabilitation specialists, or they explored the athlete's and/or patient's perception of psychosocial techniques or strategies. This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement in Exercise, Rehabilitation, Sport Medicine and Sports Science guidance. A total of 1857 articles were reviewed, and 8 met inclusion criteria. Two studies had level 2a evidence, 4 studies had level 4a evidence, and 2 studies had level 4b evidence. Six studies were rated as good quality, and 2 studies were rated as lesser quality. The included studies demonstrated a high-quality body of evidence with consistent results, which strengthens the review findings. Athletic trainers have the knowledge to identify when athletes are psychologically affected by injury and can identify common psychological responses. Although ATs acknowledge the value of implementing psychosocial strategies, a lack of confidence in implementing basic or advanced techniques, feeling underprepared by their educational program, and a lack of clinical training appear to affect the use of psychosocial techniques in clinical practice and the rate of mental health recognition and referral among ATs. [ABSTRACT FROM AUTHOR]

Introduction: Depression is the most common psychiatric disorder suffered by patients with chronic kidney disease who are undergoing hemodialis. Depression can lead to decreased quality of life and increase the economic burden on the health system. CBT is a validated treatment for depression, and there has been no research yet on CBT in patients with chronic kidney disease undergoing hemodialysis in RSUD, Dr. Soetomo Surabaya. To prove the effect of CBT on the improvement of depression in patients with chronic kidney disease undergoing hemodialysis in RSUD, Dr. Soetomo Surabaya. Methods: Experimental study with use of randomized, pretest-posttest control group design. Respondents meeting the criteria were divided by random allocation, treatment by CBT for as many as 17 respondents, and even as much control as 20 respondents. The mean age of the treatment group was 37.24 and the control group was 44.45, with a range of 21–60 years old, who experienced mild and moderate depression without antidepressants. Treatment consists of 4 sessions, 45 minutes each session, once a week. Effectiveness was measured using BDI instruments. Results: There were significant differences in pre- and post-depression scores in the treatment group (p = 0.007), and there were significant differences in depression improvement between the treatment and control groups (p = 0.006). Depression improvement in the treatment group was 64.7% compared to the control group’s 25.0%. Conclusion: CBT can improve mild and moderate depression without antidepressants (NNT = 3) in patients with chronic kidney disease undergoing hemodialysis treatment at RSUD Dr. Soetomo Surabaya. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative depression is a condition of depressive effects in patients without symptoms of depressive mood that occurs a few weeks after surgery and persists for at least 2 weeks. It generally possesses the same symptoms as major depressive disorder. Review: Their difference is that surgery is the trigger of depression in postoperative depression cases. Postoperative depression is associated with increased patients’ morbidity and mortality, increased the risk of disease complications, reduced postoperative healing process, prolonged the duration of treatment, and reduced patients’ quality of life. Therefore, mental health conditions should always be assessed on patients after undergoing surgery. Postoperative depression therapy needs to consider the benefits of antidepressants and adequate pain management. Antidepressant considerations also need to consider interactions with other drugs. Psychotherapy and cognitive behavioral therapy are also useful in postoperative depression management. Conclusion: This review is aimed to give insight about postoperative depression, its importance, and how to treat it. [ABSTRACT FROM AUTHOR]

ABSTRACT: Ableism, akin to other forms of discrimination such as sexism and racism, is increasingly recognized as a pervasive societal concern directed towards individuals with disabilities. This scholarly inquiry delineates the operational definition, manifestations, and ramifications of ableism, with a specific focus on its manifestations within healthcare settings. It underscores the critical need for targeted interventions aimed at mitigating biases among healthcare professionals and promoting inclusivity within healthcare delivery systems. Utilizing insights from cognitive psychology, the study conceptualizes ableism as a cognitive distortion, explicating the mechanisms through which biases shape perceptions and recommending Cognitive Behavioral Therapy (CBT) as a promising intervention modality. The paper advocates for exploration of intersectional analyses, utilization of qualitative research methodologies, and cultivation of collaborative partnerships with disability advocacy organizations to develop more comprehensive intervention approaches. Noteworthy limitations of the current discourse include the potential for tokenistic representations and the imperative for genuine and substantive engagement with the voices and experiences of individuals with disabilities. [ABSTRACT FROM AUTHOR]

Background/Objectives: Adolescents with idiopathic scoliosis require emotional support to change their experience of their desired body shape and to feel optimistic about the cosmetic results of surgical treatment. Recently, the use of virtual reality in psychological assessment and treatment has given specialists a technology that appears particularly well-suited for addressing body image disorders. The study objectives were two-fold. Firstly, we aimed to evaluate changes within the body image of scoliosis patients pre- and postoperatively. Secondly, we aimed to investigate if differences in body image exist in scoliosis females after implementing cognitive-behavioral therapy. Methods: Thirty-six total scoliosis patients participated in the 1st and 2nd study phases. The psychotherapy took place before and after surgery and during the patient's stay in the hospital. Body image was assessed using a virtual reality-based application, "Avatar Scoliosis 3D". Results: Regarding body image dissatisfaction evaluated via virtual tasks, the difference between the desired by patients and actual (based on the radiographic parameters) body shape is significant preoperatively in both scoliosis samples: with and without therapy (p < 0.000001 and p < 0.000001, respectively). Conclusions: The results of the present study may have important implications for developing standards for body image disorder treatments in scoliosis patients. We revealed that irrespective of received therapeutic support, scoliosis patients accurately estimate their body shape pre- and postoperatively, and they feel dissatisfied with their body preoperatively but not postoperatively. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the comparative efficacy and acceptability of cognitive behavioral therapy for insomnia (CBT‐I), pharmacotherapy, and their combination in the long and short terms among adults with chronic insomnia disorder. Methods: We searched multiple databases to December 27, 2023. We included trials in hypnotic‐free adults with chronic insomnia comparing at least two of CBT‐I, pharmacotherapy, or their combination. We assessed the confidence in evidence using CINeMA. The primary outcome was long‐term remission. Secondary outcomes included all‐cause dropout and self‐reported sleep continuity measures in the long term, and the same outcomes in the short term. We performed frequentist random‐effects network meta‐analyses (CRD42024505519). Findings: We identified 13 trials including 823 randomized participants (mean age, 47.8 years; 60% women). CBT‐I was more beneficial than pharmacotherapy in the long term (median duration, 24 weeks [range, 12 to 48 weeks]; remission odds ratio, 1.82 [95% confidence interval (CI), 1.15–2.87]; [certainty of evidence: high]), while there was weaker evidence of benefit of combination against pharmacotherapy (1.71 [95% CI, 0.88–3.30: moderate]) and no clear difference of CBT‐I against combination (1.07 [95% CI, 0.63–1.80: moderate]). CBT‐I was associated with fewer dropouts than pharmacotherapy. Short‐term outcomes favored CBT‐I over pharmacotherapy except total sleep time. Given the average long‐term remission rate in the pharmacotherapy‐initiating arms of 28%, CBT‐I resulted in a long‐term remission rate of 41% (95% CI, 31%–53%) and combination 40% (95% CI, 25%–56%). Interpretation: The current study found that starting with CBT‐I for chronic insomnia leads to better outcomes than pharmacotherapy. Combination may be better than pharmacotherapy alone, but unlikely to be worth the additional burden over CBT‐I alone. [ABSTRACT FROM AUTHOR]

Background: Treatment-resistant depression (TRD) is a severe public health problem and a condition uncommonly addressed by psychological therapies. This paper presents a theoretical model, grounded in established learning principles and in the perspective of behavioral activation (BA), to explain its constitution and development. Method: A review of theoretical models and empirical research on TRD was conducted in major databases. Results: The model reflects how patients with TRD are more susceptible to becoming trapped in their condition by seeking to avoid discomfort through avoidance and escape behaviors, which increasingly drives them away from sources of positive reinforcement. Based on this model, a BA-based intervention protocol is suggested for the treatment of TRD. Through six phases (in a total of thirteen sessions), the protocol guides the intervention towards the reestablishment of personalized routines to increase the probability of reinforcement and reduce avoidance behaviors. Conclusions: Although the model holds significant potential to become an effective intervention in TRD, future research will allow the evaluation of the efficacy of the protocol as a standalone intervention. [ABSTRACT FROM AUTHOR]