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Background: Naltrexone may improve success in primary care treatment of alcohol dependence (AD). This study tests naltrexone and primary care management (PCM) vs naltrexone and cognitive behavior therapy (CBT) and tests naltrexone maintenance among patients who respond to an initial course of naltrexone combined with PCM vs CBT., Methods: A nested sequence of 3 randomized trials was conducted. In study 1, 197 subjects with AD participated in a 10-week comparison of PCM and naltrexone (50 mg/d) vs CBT and naltrexone (50 mg/d). In study 2, 53 PCM responders from study 1 continued in a 24-week placebo-controlled study of maintenance naltrexone. In study 3, 60 CBT responders from study 1 continued in a 24-week placebo-controlled study of maintenance naltrexone and CBT., Results: Study 1: No difference in the response to treatment; 84.1% (74/88) of the PCM patients and 86.5% (77/89) of the CBT patients avoided persistent heavy drinking. Percentage of days abstinent (PDA) declined over time for PCM vs CBT (P =.03). Study 2: Higher response maintenance for PCM and naltrexone (21/26, 80.8%) vs PCM and placebo (14/27, 51.9%; P =.03) and PDA declined more for the placebo group (P =.02). Study 3: The differences between naltrexone vs placebo on maintenance of response (25/30, 83.3% vs 21/30, 70.0%) or PDA did not reach statistical significance., Conclusions: Naltrexone yielded comparable results during the initial 10 weeks of treatment when combined with PCM or CBT. Maintenance of improvement was enhanced by continued naltrexone treatment in the PCM but not in the CBT arm.

Selective mutism (SM) is a complex anxiety-related disorder, primarily prevalent in girls, and usually diagnosed in early childhood. The main diagnostic features include persistent failure to speak in some social situations, where there is an expectation for speaking, despite normal or near-normal speech in other social settings. AD, an abandoned girl, about 3-year-old, from a child care institute was referred for a medical examination to a tertiary care pediatric hospital. The major complaints were poor appetite, failure to speak to others, and excessive aloofness. She had no major behavioral difficulties, was cooperative, and complied with all verbal instructions. She would use gestures to communicate. The child was diagnosed with SM and a comprehensive individualized therapeutic plan was implemented. The management plan focused on enhancing attachment, cognitive stimulation, and language skills. As a first step, AD was enrolled in a day care center. An enabling and enriching environment was provided with plentiful opportunities for play and interaction with peers. Defocused communication that involved sitting alongside the child rather than face to face, creating joint attention using tasks that the child enjoyed, not asking direct questions, giving the child adequate time to reply, and continuing with the conversation even if she did not respond verbally was used as the primary treatment strategy. Collaborative teams including pediatricians and mental health professionals can play an integral role in early diagnosis and in overseeing the challenging path of overcoming SM in young children from adverse circumstances.

Introduction Tinnitus can be distressing, and it affects the quality of life (QoL) through psychological and cognitive impairments. Cognitive behavioral therapy (CBT) and notched sound therapy (NST) are tinnitus management approaches aiming to reduce symptoms and improve QoL via two different mechanisms. The CBT attains the cognitive principle, whereas the NST initiates tinnitus habituation.

Background Gambling disorder (GD) has become a wide concern in Indonesia, as many negative consequences arise from this psychiatric condition. Prompt treatment with an appropriate method of delivery is required to achieve optimal outcomes in GD patients. This protocol paper outlines a study to determine the effectiveness, acceptability, and feasibility of internet-based cognitive behavioral therapy (iCBT) in treating GD in Indonesia. Methods This non-randomized pilot and feasibility study will recruit 20 people with GD. All participants will receive the iCBT intervention through self-learning videos and guided weekly group sessions. The effectiveness of the intervention will be assessed at baseline (week 0), post- treatment completion (week 10), and 6 weeks post-treatment (week 16). The outcomes measured will be the change in gambling symptoms, gambling urges, cognitive distortions, readiness to change, emotional problems, and quality of life of the participants. Discussion The feasibility of iCBT for GD patients in Indonesia will be assessed by this study. The study’s results will give an indication of the acceptability of the intervention and the feasibility of a subsequent conclusive trial. The delivery of iCBT may help to address the issue of treatment access in an extensive geographical region and provide immediate implications as a treatment resource for GD in practice.

Introduction: Cardiovascular diseases are among the most lethal physical diseases of the 21st century, posing a greater threat to human life than any other disease and problem. This research compared the effectiveness of mindfulness-based stress reduction and emotion-focused therapy on the cognitive flexibility of cardiovascular patients in Isfahan City.Methods: The research was conducted using a quasi-experimental design with a pre-test-post-test and a three-month follow-up with a control group. The statistical population included 380 male cardiovascular patients admitted to Shahid Chamran Cardiovascular Hospital in Isfahan in the winter of 2023. Forty-five patients were selected by purposive sampling and randomly assigned to two experimental groups and one control group. Patients in the first experimental group received eight 90-minute sessions of mindfulness-based stress reduction, while those in the second experimental group received eight 90-minute sessions of emotion-focused therapy. The measurement tools were the Cognitive Flexibility Questionnaire (Dennis & Vanderwaal, 2010) and a short clinical interview. Research data were analyzed through mixed variance analysis using SPSS version 24 software.Results: The results showed that both intervention methods increased the average cognitive flexibility and its components, including alternatives, control, and alternatives for human behaviors of patients (P≥0.01). No significant difference was observed between the effectiveness of the two methods (P≤0.01).Conclusion: According to the research results, it is possible to use the intervention method of mindfulness-based stress reduction program and emotion-focused therapy to improve the cognitive flexibility of cardiovascular patients.

Abstract Intensive lifestyle interventions are effective in preventing T2DM, but evidence is lacking for high cardiometabolic individuals in hospital settings. We evaluated a hospital-based, diabetes prevention program integrating cognitive behavioral therapy (CBT) for individuals with prediabetes. This matched cohort assessed individuals with prediabetes receiving the prevention program, which were matched 1:1 with those receiving standard care. The year-long program included five in-person sessions and several online sessions covering prediabetes self-management, dietary and behavioral interventions. Kaplan–Meier and Cox regression models estimated the 60-month T2DM incidence rate. Of 192 patients, 190 joined the prevention program, while 190 out of 10,260 individuals were in the standard-care group. Both groups had similar baseline characteristics (mean age 58.9 ± 10.2 years, FPG 102.3 ± 8.2 mg/dL, HbA1c 5.9 ± 0.3%, BMI 26.2 kg/m2, metabolic syndrome 75%, and ASCVD 6.3%). After 12 months, the intervention group only showed significant decreases in FPG, HbA1c, and triglyceride levels and weight. At 60 months, the T2DM incidence rate was 1.7 (95% CI 0.9–2.8) in the intervention group and 3.5 (2.4–4.9) in the standard-care group. After adjusting for variables, the intervention group had a 0.46 times lower risk of developing diabetes. Therefore, healthcare providers should actively promote CBT-integrated, hospital-based diabetes prevention programs to halve diabetes progression.

Introduction: Persistent postural-perceptual dizziness (PPPD) is characterized by chronic subjective dizziness, phobic postural vertigo, and related disorders. For at least 3 months, it exhibits varying symptoms of vertigo, unsteadiness, or dizziness. Methods: Research articles regarding PPPD were searched by viewing the Scopus, PubMed, Medline, and Google Scholar databases online. A search strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used. Results: It presents a typical chronic vestibular system and brain malfunction that result in persistent dizziness, nonspinning vertigo, and/or unsteadiness. Persistent nonvertiginous dizziness and hypersensitivity to motion and visual stimuli are the main signs and symptoms of PPPD. These symptoms appeared either when there were no active neuro-otologic illnesses or when an episodic vestibular condition was present but could not completely account for the symptoms. Psychological mechanisms that resemble cognitive models of health anxiety and panic disorder are involved in the PPPDs development and maintenance. Conclusion: Since PPPDs diagnostic criteria only involve symptoms, the patient's clinical history is crucial in making the diagnosis. Once diagnosed, effective communication and personalized treatment plans, such as serotonergic medicines, cognitive behavioral therapy, and specialized physical therapy (vestibular rehabilitation), help manage PPPD. Since PPPD is a relatively recent clinical diagnosis, many medical practitioners who treat patients who feel dizzy are unfamiliar with it. [ABSTRACT FROM AUTHOR]

Introduction: Insomnia is one of the most prevalent, persistent, and distressing conditions associated with cancer, affecting almost half of all cancer survivors. Although cognitive-behavioral therapy for insomnia is well established as the gold-standard treatment for insomnia, its accessibility is very limited in routine care. We aim to examine the real-world effectiveness and acceptability of a digital cognitive-behavioral therapy for insomnia for cancer survivors with insomnia symptoms through a randomized controlled trial in Portugal. Methods and Analysis: Our cancer trial will test the effects and acceptability of an accessible internet-delivered self-administered cognitive-behavioral therapy for insomnia digital intervention with clinician support, OncoSleep. This online program includes six interactive, personalized weekly sessions featuring evidence-based techniques targeting psychophysiological hyperarousal and maladaptive conditioning, tailored for cancer survivors. Research study procedures include screening for eligibility in the general population and randomization into one of two arms: the digital CBT-I program or a waitlist control group. Insomnia severity (primary outcome), fatigue, sleep diary outcomes, psychological distress, and quality of life (secondary outcomes) will be assessed at baseline and post-intervention.

Background: Physical and psychological interventions could affect the quality of life (QoL) of women with infertility. The purpose of this study was to compare the effectiveness of dry cupping and counselling with the mindfulness-based cognitive therapy (MBCT) approach on fertility QoL and conception success in infertile women due to polycystic ovary syndrome (PCOS).Methods: This was a two-arm pilot randomized clinical trial from first January 2021 to the end of November 2022. In this regard, 19 women with infertility who were referred to the health centers affiliated with Shiraz University of Medical Sciences and met the inclusion criteria were enrolled in the study. Participants were randomly divided into two groups (10 in the virtual MBCT group and 9 in the cupping group). All participants completed the fertility quality of life (FertiQol) tool before the intervention and three months after the end of the intervention. In addition, after the end of the intervention, a human chorionic gonadotropin test was performed monthly for three months, too. We used ANOVA/ANCOVA and its related effect sizes, including mean difference (MD) and standard mean difference (SMD: Hedges’s g), and chi-square tests to compare the study group outcomes in Stata 14.2. P-values equal to or less than 0.10 were considered significant.Results: The intervention resulted in significant differences in the mean overall scores of FertiQol between the counseling and cupping groups (61.76±14.28 and 50.65±12.53, respectively) [P=0.091, MD=11.11 (90% CI: 0.33 to 21.89), SMD=1.07 (90%: CI 0.279 to 1.84)]. No significant difference was found in conception rates between the groups after the intervention.Conclusion: This pilot study found that MBCT improved the fertility QoL in PCOS-related infertility patients better than cupping therapy.Trial registration: IRCT201706110334452N13

Objectives: Aging is an inevitable period and the quality of life in older people has been a noteworthy issue for human societies. On the other hand, Coronavirus anxiety is one of the most important phenomena affecting the lives of older people during the Coronavirus outbreak. Therefore, the present study determined the effectiveness of cognitive-behavioral therapy on anxiety and quality of life in older people. Methods: The statistical population of the present study included older people of the 3rd district of Tehran City, Iran, in the spring of 2022. The research method was quasi-experimental, which was carried out with a pre-test post-test, and one-month follow-up plan with the experimental and control groups. A total of 40 older people were selected by convenience sampling method. The experimental group participated in eight 90-minute sessions for two months and cognitive-behavioral training techniques were presented to them, and the control group did not receive any intervention. Older people responded to the Coronavirus anxiety scale and the quality-of-life questionnaire in three stages. Results: The results of the analysis of variance test with repeated measurements showed that cognitive-behavioral therapy affects the anxiety of corona and the quality of life in older people (P

Introduction: Adolescents with post-traumatic stress disorder (PTSD) exhibit heightened sensitivity to environmental hazards, and face difficulties in emotion regulation and academic self-regulation. The present study aimed to investigate the effectiveness of trauma-focused cognitive-behavioral therapy on emotion regulation and academic self-regulation in adolescent girls with clinical symptoms of post-traumatic stress disorder following a traumatic event.Methods: The research method in this study was a quasi-experimental design with pre-test and post-test measures, including a control group. A total of 20 female students from the high school in Zahedan in the year 2021 were purposefully selected and randomly assigned to two groups: the experimental group (10 participants) and the control group (10 participants). Trauma-focused cognitive-behavioral therapy was administered to the experimental group over 11 ninety-minute sessions. The data collection tools included the Pekran et al. (2002) Academic Emotion Questionnaire, the Kiano et al. (1987) Post-Traumatic Stress Disorder (PTSD) Questionnaire, and the Zimmerman and Martinez-Pons (1986) Academic Self-Regulation Questionnaire. Data analysis involved the use of both univariate and multivariate analysis of covariance (ANCOVA).Results: The findings indicated a significant difference between the mean scores of academic emotions and academic self-regulation in the experimental and control groups at the post-test phase, with a 95% confidence level (P

Cognitive restructuring (CR) aims to get people to challenge and modify their cognitive distortions, generating alternative, more adaptive thoughts. Behavioral, emotional, and physiological responses are modified by analyzing and changing dysfunctional thoughts. The person must have the cognitive capacity to participate in the analysis of their thoughts. CR for people with depression has positive effects, although there is little research on how it should be structured and applied. CR is a thought modification technique presented in the Nursing Interventions Classification (NIC), but is not organized in a sequential approach, and there is no procedure for applying it in practice. This scoping review aims to identify the structure, contents and assessment instruments used in CR for people with depressive symptoms and to analyze the health outcomes of applying the CR technique in this population. Out of 515 articles, seven studies were included in the review, up to 2021 and without any time limitation. The studies were not guided by a consistent and sound framework of the CR technique and each study used its own framework, although they used similar techniques. We grouped CR into six steps. No specific studies were found regarding intervention by nurses. CR is effective in reducing depressive symptoms, so it is an important therapeutic tool that should be used on people with depression. With this scoping review, mental health nurses will have a more comprehensive idea of the techniques that can be used in the application of CR to patients with depressive symptoms.

The development of information dissemination is associated with significantly increased risk of health anxiety (HA) , imposing a heavy burden on individuals and society. Although there are inconsistencies between the evolution and revisions in clinical diagnosis of HA, cognitive-behavioral interventions have been recognized as effective treatments for HA. We reviewed the clinical diagnoses, measurement tools, associated factors and online cognitive-behavioral interventions of HA, then proposed that the concepts and measurement tools of HA need to be further standardized. Main difficulties are the determination of the threshold for intervention and the development of psychological interventions suitable for general practices. Online and face-to-face cognitive-behavioral interventions for HA have similar effects, but the former is more inexpensive and convenient, which deserve to be studied further.

Background Gestational diabetes mellitus (GDM) is a common complication during pregnancy. However, the adherence to individualized medical nutrition therapy (IMNT) alone among GDM women is poor and the impact of group cognitive behavioral therapy (GCBT) on their pregnancy outcomes remains unclear. Objective To examine the impact of GCBT on the pregnancy outcomes of women with GDM, and to provide reference for improving pregnancy outcomes and developing effective gestational diabetes management programme. Methods A total of 878 pregnant women with GDM who delivered and received IMNT in our hospital from 2020 to 2021 were retrospectively selected as the study subjects and divided into the observation group including 141 pregnant women with GDM who received GCBT and the control group including 737 pregnant women with GDM who did not receive GCBT. The differences in pregnancy outcomes of pregnant women with GDM between the two groups before and after propensity score matching were analyzed. Results There were 134 pregnant women with GDM in the observation group and 256 pregnant women with GDM in the control group after 1∶2 propensity score matching. The proportion of pregnant women with GDM who gained normal weight in the observation group (50.7%, 68/134) was higher than that in the control group (37.5%, 96/256) (P

Background and aims: A lack of assertiveness can worsen marital conflicts and cause psychological symptoms. The present study aimed to investigate the effects of psychodrama and cognitive behavioral therapy (CBT) on the assertiveness skills of women with marital conflicts. Methods: This quasi-experimental study was conducted on all married women with marital conflicts visiting the counseling departments of cultural centers at the Municipality of Isfahan (Iran) in 2021. Cluster sampling was employed to select 60 women, who were then assigned to three 20-member groups called CBT, psychodrama, and control using a simple random method. The participants completed the Assertion Inventory before and after the intervention and 60 days after the post-test. The repeated measures ANOVA via SPSS-22 was then used for data analysis. Results: The mean (±SD) of the post-test score of assertiveness skills in the psychodrama and CBT groups was 123.40 (±23.83) and 111.25 (±22.77), respectively, which was different from the control group (83.20 (±21.24)). According to the results, CBT and psychodrama affected the assertiveness components of women with marital conflicts instead of control cases (P

BackgroundWhile there is no cure for tinnitus, research has shown that cognitive behavioral therapy (CBT) is effective in managing clinical sequelae. Although traditional CBT is labor-intensive and costly, new online consultations may improve accessibility. Moreover, there is promise in an engaging conversational agent, or a “chatbot,” delivering CBT in a conversation-like manner and allowing users to work through complex situations with the guidance of a virtual coach. Currently, there is little research examining a possible hybrid model using iCBT and tele consultation with a psychologist.MethodsA randomized, 2 parallel-group trial was conducted to compare the clinical effectiveness of (1) iCBT delivered through a chatbot mobile app (i.e., Tinnibot only group) (2) Tinnibot combined with telepsychology (i.e., hybrid-intervention group). A total of 30 eligible adults with tinnitus were included. After an 8-week intervention period, participants were followed up for 2 months. The primary outcome measure, the Tinnitus Functional Index (TFI), and the secondary outcome measures, Hyperacusis Questionnaire (HQ), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health Questionnaire (PHQ-9), were assessed before treatment, post-treatment, and at follow-up.ResultsThe TFI decreased significantly over time in both groups, with a trend for a larger improvement in the group that received telepsychology. At post-treatment, a clinically significant improvement was observed in 42% of the Tinnibot-only group and 64% of the hybrid-intervention group. At follow-up, this was 64% for both groups. The secondary outcome measures, PHQ-9 and GAD-7 improved significantly over time, but the HQ did not.DiscussionInternet-based delivery of CBT is effective in decreasing tinnitus distress, and levels of anxiety and depression, which is more relevant today than ever in the context of a global pandemic that has challenged the delivery of face-to-face intervention. The addition of telepsychology might be beneficial, but not essential for the effectiveness of treatment. There is a need for further research to determine whether there is any relationship between the characteristics of tinnitus patients and the success of the different modes of delivery of therapy.

The present case report describes a 19-year-old male patient whose main symptoms were emotional coldness, absence of close relationships, difficulty experiencing pleasure with other people, and lack of motivation to work or to continue his studies. A schizoid personality disorder was diagnosed as a product of early maladaptive patterns such as inhibition, emotional deprivation, social isolation, and inadequacy. Likewise, a rigid and fragmented family context was evidenced, with an affective absence of parents and a focus on strict behavioral rules. The study aimed to intervene, from a cognitive clinical approach, the early maladaptive patterns and symptoms that maintained the features of schizoid personality disorder in the patient. For this purpose, cognitive behavioral therapy was carried out, with techniques such as debates, images to reparentalize, assignment of tasks, use of humor, and social skills training, among others. In conclusion, it can be stated that the early maladaptive patterns maintained the schizoid personality symptomatology. Finally, it was demonstrated through clinical and psychometric criteria that cognitive behavioral therapy decreased schizoid personality behaviors in the patient.

ObjectivesWhile the association between insomnia and traumatic brain injury (TBI) is well established, TBI rehabilitation programs that focus on sleep as a primary target are limited. Cognitive behavioral therapy for insomnia (CBTi) is an effective treatment for insomnia, however; its use within TBI clinics is relatively unknown. Therefore, our aim was to evaluate the implementation of CBTi, used in conjunction with a smartphone app for insomnia, within a US military TBI program to improve care within this setting.SettingA TBI clinic at a US military installation.MethodsMHS beneficiaries underwent 6 sessions of CBTi and a 1-month post-treatment follow up session. Data was collected at each treatment session as part of routine clinical care.ResultsA total of 69 US MHS beneficiaries seen at a TBI clinic with a diagnosis of insomnia began CBTi. Attrition rate at the end of the CBTi program and 1-month posttreatment session was 35% and 48%, respectively. Results demonstrated that sleep onset latency (SOL) and wake after sleep onset (WASO) decreased during treatment (p's < 0.001). Further, symptoms reported on the Insomnia Severity Index (ISI) improved during CBTi (p < 0.001).ConclusionFindings demonstrate how CBTi used in conjunction with a CBTi smartphone application can be used to effectively treat insomnia for MHS beneficiaries seeking care for TBIs. This evaluation provides the basis for further research on how CBTi may improve care within TBI programs.

Background Worldwide, breast cancer has become the most common malignancy, and many breast cancer survivors struggle with psychological problems in treatment and recovery. The efficacy of mindfulness-based stress reduction (MBSR) in the psychological care of breast cancer patients has been confirmed in many systematic reviews (SRs) . However, due to inconsistent outcome measures used in various SRs, the review results cannot be directly applied to clinical practice. Objective To perform an overview of the SRs of the efficacy of MBSR in breast cancer patients, providing a reference for the making of psychological care interventions for these patients. Methods PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, JBI, CNKI, Wanfang Data, and CBM were searched from inception to July 2022 for SRs of patients with breast cancer treated with MBSR. Literature screening and data extraction were performed by two researchers independently. Methodological quality was assessed using the AMSTAR 2. The standardization of reporting quality was assessed using the PRISMA checklist. Quality of evidence and strength of recommendations were assessed using the GRADE approach. The confidence of evidence from qualitative SRs was assessed using the CERQual. Results Fourteen SRs were included. The methodological quality of included SRs was generally low, with only one being of high quality and two fatally missing key items. The defects in reporting quality were mainly in study protocol registration, risk of bias assessment and funding sources. Fifteen outcomes and 73 evidence bodies (0, 31, 28 and 6 were classified as high, moderate, low, and very low quality, respectively, by the GRADE approach, and the other 8 were classified as low quality by the CERQual approach) were identified in the SRs in total. MBSR could relieve anxiety, depression, fatigue, and stress in breast cancer patients to varying degrees, whose efficacy has proven to be significant in a short-term, but is uncertain in a long-term. Conclusion Generally, SRs on MBSR improving psychological condition in breast cancer patients contain unsatisfactory quality of evidence, whose methodological quality and standardization level of reporting quality still need to be improved further. Moreover, the shorter-term effect of MBSR has been confirmed, but its long-term effect is uncertain, and requires to be evaluated by more high-quality, large-sample clinical studies.

Background: Breast cancer is the most common type of cancer among women and causes emotional and emotional problems, therefore, the present study was conducted with the aim of comparing the effectiveness of group positive behavior therapy and group cognitive behavioral therapy on the cognitive regulation of emotion in women with breast cancer. Materials and Methods: The present study was semi-experimental and the statistical population of the research was all women with breast cancer referred to Milad Hospital in Tehran in 1400, 45 of whom met the entry criteria (age range 25-55 years, one month passed from the course chemotherapy) were selected by purposive sampling and were randomly divided into two experimental groups and one control group. The experimental groups underwent cognitive-behavioral and positive therapy in 8 90-minute sessions. In order to collect information, the Garnevsky emotion regulation questionnaire was used and the data were analyzed with SPSS-20 software. Results: The results indicated a significant difference between the two treatments on the scores of cognitive regulation of emotion (P

Background and Objective: Previous studies have advanced our understanding of the impact of executive functions on eating behavior. Given the considerable evidence of executive dysfunction among obese individuals and the bidirectional relationship between cognition and obesity, it is crucial to include educational components in interventions aimed at enhancing executive functions among obese populations. This study aimed to evaluate the effectiveness of cognitive hypnotherapy in improving executive functions among women with obesity. Methods: This clinical trial enrolled 30 obese women who were randomly assigned to either an intervention or control group (n=15). The mean ages of the experimental and control groups, respectively, were 40.80±6.02 and 38.47±7.50 years, while their BMIs (kg/m2) were 33.45±3.50 and 33.12±3.47, and hypnotizability scores were 39.67±5.98 and 37.40±7.09. The intervention group received 12 sessions of 2-hour cognitive hypnotherapy. Data collection instruments included the Stanford Hypnosis Susceptibility Scale (1962), Life Experiences, Interests and Values Checklist (1998), and Cognitive Ability Questionnaire (2013). Results: The results demonstrated that cognitive hypnotherapy significantly improved executive functions (F=7.02, P≤0.01), including inhibitory control and selective attention (F=2.83, P≤0.05), decision making (F=4.13, P≤0.05), planning (F=3.32, P≤0.05), and sustained attention (F=2.83, P≤0.05) in the intervention group. Conclusion: Given the relationship between cognitive abilities, eating behaviors, and obesity, and the effectiveness of cognitive hypnotherapy in enhancing executive functions, this approach can be used to enhance cognitive functions among individuals with obesity.

Background: Wernicke encephalopathy (WE) is an acute and potentially fatal neuropsychiatric disorder resulting from thiamine deficiency: its etiology and clinical presentation can be heterogeneous and arduously recognized, especially in children and adolescents. Case presentation: An 8-year-old girl arrived to the emergency room with ataxic gait, nystagmus, and mental confusion after a 10-day history of repeated severe vomiting; her recent clinical history was characterized by restricted nutrition due to a choking phobia, which caused substantial weight loss. Brain magnetic resonance imaging revealed a bilaterally increased T2 signal in the medial areas of the thalami and cerebral periaqueductal region. Diagnosis of WE based on clinical and neuroradiological findings was established and confirmed after labwork showing low serum thiamine. Following psychiatric evaluation, the patient was also diagnosed with avoidance-restrictive food intake disorder (ARFID), which required starting cognitive behavioral therapy and introducing aripiprazole. The patient displayed improvement of the radiological findings after one month and complete resolution of her neurological symptoms and signs. Conclusions: Eating disorders like ARFID might forerun acute signs of WE; this possibility should be considered even in pediatric patients, especially when atypical neurological pictures or feeding issues come out.

Background and Objective: Gastrointestinal diseases are one of the most important and common chronic non-communicable diseases that impose a great economic burden and psychological pressure on society and the healthcare system. Considering the ambiguity in the field of cognitive etiology and treatment of irritable bowel syndrome, this study was conducted to compare the effectiveness of lifestyle-focused cognitive behavioral therapy versus semantic cognitive restructuring therapy on chronic fatigue in patients with irritable bowel syndrome. Methods: This cross-sectional study was conducted among 45 patients with irritable bowel syndrome who referred to a private clinic. Patients were assigned into 3 groups (n=15) of lifestyle-focused cognitive behavioral therapy, semantic cognitive restructuring therapy, and a control group that did not receive any cognitive therapy with a pretest-posttest design. The Multidimensional Fatigue Inventory with 5 subscales of general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue was used for data collection. The total score of the patient's fatigue intensity is obtained from 0 to 100, where a score of 20-40 indicates low fatigue, 40-60 indicates moderate fatigue, and a score above 60 indicates high fatigue in the individual. Groups were compared before, after and one month after treatment. Findings: 22 women (48.9%) and 23 men (51.1%) in the age group of 25-49 years participated in this study. The findings showed that lifestyle-focused cognitive behavioral therapy with a score of (53.53±11.12) and semantic cognitive restructuring therapy with a score of (60.40±14.57) in the post-test, and with scores (55.80±11.68 and 59.72±14.94, respectively) in the follow-up after four months were effective on chronic fatigue in patients with irritable bowel syndrome (p

Background and Objective: Type 2 diabetes is a common disease that could be prevented or managed with a healthy lifestyle. This study was conducted to determine the effects of self-healing with mindfulness-integrated cognitive behavior therapy on the health-promoting lifestyle profile of patients with type 2 diabetes. Methods: This clinical trial was done on 45 patients with type 2 diabetes who had been referred to the Sedigeh Tahereh Clinic in Isfahan (Iran) in 2021. The patients were randomly divided into 3 groups of 15 patients: a control group, a self-healing group (first intervention) and a mindfulness-integrated cognitive behavior therapy group (second intervention). Interventions for each treatment were held as a weekly 90-minute online session. Posttest was After 12 sessions and three months after the test was followed up. The research tool was a health-promoting lifestyle profile questionnaire with nutrition, exercise, health responsibility, stress management, interpersonal support and self-fulfillment components. The questionnaire was filled out by each group after the 12 sessions and three months after the last session. Results: Both the self-healing methods and the mindfulness-integrated cognitive behavior therapy increased the lifestyle scores of patients with type 2 diabetes compared to the control group (P

Aim:Dental anxiety is a common problem in pediatric dentistry and reducing it with improved communication is important. This study aimed to evaluate whether anxious children give similar answers in the dental office even though they have different cultural backgrounds and to assess the international usability of the cognitive behavioral therapy tool of the Turkish version of “Your Teeth You Are In Control” intervention including “Message to the Dentist” feedback form.Materials and Methods:Two hundred and sixty-two children aged 5-15 years attending a faculty clinic and a private dental office were included in this study. The children were asked to complete the form to report how worried they felt and the levels of pain they experienced before and after their dental treatment on a scale of 1-10 (1=the best and 10=the worst outcome). Statistical analysis was performed with IBM SPSS V23.Results:Most of the participants were worried about the needle, the dentist, and pain, respectively (38.2%, 34%, 28.2%). Most of the children raised their hand as a stop signal (94.7%). There was a statistically significant negative and weak correlation between age and anticipated pain, actual pain and anxiety scores (p=0.016, 0.003, 0.001 respectively).Conclusion:The “Message to the Dentist” feedback form and cognitive behavioral therapy resource can be used in pediatric dentistry to reduce dental anxiety in its Turkish version. It was useful to understand the sources of dental anxiety in children and this can facilitate treatment by helping pediatric dentists understand how these patients feel about dental treatment procedures and, via their efforts, to improve patient care.

This study developed an information and communication technology-based mobile application to administer cognitive behavioral therapy to community-dwelling older adults with insomnia. First, the content of the application was determined through a systematic review and preference survey. Preference data on the perception, needs, and preference for non-face-to-face service content were collected from 15 July 2021 to 31 August 2021 from 100 community-dwelling older adults aged 65 years and older. In the design stage, the structure and function of the application were determined, and an interface was designed. The application was developed in conjunction with design experts and programmers using Android Studio software (Android 9). Usability tests were conducted during the implementation stage, followed by an evaluation stage. The evaluation revealed that the application’s structure and functions should comprise sleep information, sleep-habit improvement, sleep assistance, video, real-time counseling, and exercise services. These elements were finalized after receiving the results of a preference analysis and advice from an advisory panel of experts in different fields. The developed application was rated with a score of four or higher in all areas. This study successfully developed, implemented, and evaluated a new mobile application called Smart Sleep for community-dwelling older adults with insomnia.

Background and Aim Sexual function is an important part of menopausal women's lives, and changes in it, especially during menopause, can affect their health. The aim of this study was to compare the effectiveness of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) on the sexual function of postmenopausal women. Methods & Materials This research was a quasi-experimental with pre-test, post-test and follow-up design with control group. The statistical population of the study included postmenopausal women who referred to Zanjan Health Center in 2020 to receive services. Among them, 45 were selected using the available sampling method and were randomly assigned to three groups of 15, and control group using randomly assigned block allocation method. Therapeutic sessions were held in 8 sessions and each session was held for 2 hours. Data were collected by FSFI (Female Sexual Function Index) and were analyzed using ANOVA with repeated measures analysis via SPSS software, version 24. Ethical Considerations This study was approved by the ethics committee of the Zanjan University of Medical Sciences (Code: IR.ZUMS.REC.1398.328). Results In the post-test and follow-up phase, there was a significant difference between both CBT and ACT methods compared to the control group in sexual function respectively (P0.05, F=0.494). Conclusion Cognitive-behavioral therapy and acceptance-based therapy have improved sexual function in postmenopausal women, so it is recommended that these therapies be used to improve the sexual function of postmenopausal women in health centers.

Schizophrenia is a severe mental disorder that endangers patients and their families' lives as well as the society. Over 80% of patients cannot be cured completely, one contributor to which is patients' lack of self-determined motivation for treatment. There are few studies on self-determined motivation for treatment among patients with schizophrenia in China. Self-determined motivation facilitates the development of positive emotions, behaviors and cognition, which also plays a vital role in the promotion health-related behaviors. We reviewed the latest advances in self-determined motivation towards rehabilitation treatment in schizophrenia patients, and gave a summary of the features and measurement methods regarding self-determined motivation, as well as its roles in predicting the effect of cognitive remediation, physical therapy and other types of rehabilitation treatment, and in maintaining treatment adherence. After that, we made suggestions on the problems to be solved. To improve treatment adherence and cure rate in schizophrenia patients, future studies may focus on developing appropriate interventions in accordance with the self-determined motivation of the patients.

BackgroundHigh rates of adolescent depression demand for more effective, accessible treatment options. A virtual randomized controlled trial was used to assess the feasibility and acceptability of a 5-week, self-guided, cognitive behavioral therapy (CBT)-based mobile application, Spark, compared to a psychoeducational mobile application (Active Control) as an adjunct treatment for adolescents with depression during the COVID-19 pandemic.MethodsA community sample aged 13–21, with self-reported symptoms of depression, was recruited nationwide. Participants were randomly assigned to use either Spark or Active Control (NSpark = 35; NActive Control = 25). Questionnaires, including the PHQ-8 measuring depression symptoms, completed before, during, and immediately following completion of the intervention, evaluated depressive symptoms, usability, engagement, and participant safety. App engagement data were also analyzed.Results60 eligible adolescents (female = 47) were enrolled in 2 months. 35.6% of those expressing interest were consented and all enrolled. Study retention was high (85%). Spark users rated the app as usable (System Usability Scalemean = 80.67) and engaging (User Engagement Scale-Short Formmean = 3.62). Median daily use was 29%, and 23% completed all levels. There was a significant negative relationship between behavioral activations completed and change in PHQ-8. Efficacy analyses revealed a significant main effect of time, F = 40.60, p

BackgroundThe number of adolescents with insomnia is increasing in recent years. Cognitive behavioral therapy (CBT) is traditional treatment for this disease, but has some limitations. Virtual reality technology (VRT) is a novel treatment, but there is a lack of research on its effect on this disease.ObjectiveTo explore the effect of CBT with VRT on adolescents with insomnia.MethodsAdolescents with insomnia were selected from Hangzhou Seventh People's Hospital from April 2020 to June 2021, and randomized into a control group (treated with CBT) and a test group (treated with CBT and VRT) . Sleep quality was measured in both groups at admission and four weeks after admission using the Pittsburgh Sleep Quality Index (PSQI) .Results77 patients with adolescent insomnia were initially included, 15 cases of shedding were removed (12 in the control group and 3 in the test group) , and finally 62 cases were included, including 32 in the control group and 30 in the test group. After treatment, the test group had mean lower scores of four domains (overall sleep quality, sleep latency, duration of sleep, sleep efficiency) and mean total PSQI score than that of the control group (P0.05) . The overall response rate of the test group was higher than that of the control group (P

Background and Objective: Fibromyalgia syndrome is a chronic disease with extensive musculoskeletal pain that primarily involves women and also it has negatively effects on many aspects of psychological and social life. Cognitive-behavioral therapy examines dysfunctional emotions and maladaptive cognitive behaviors, processes, and themes, and cognitive-behavioral hypnotherapy combines hypnotherapy with the methods and concepts of cognitive-behavioral therapy. The aim of this study was to compare the effectiveness of cognitive-behavioral therapy with cognitive-behavioral hypnotherapy on sexual satisfaction of women with fibromyalgia syndrome. Methods: This clinical trial study was done on 9 women with fibromyalgia syndrome who referred to rheumatology clinic in Gorgan, northern Iran in 2020. The patients were randomly divided into three groups including cognitive-behavioral therapy, combination cognitive-behavioral hypnotherapy and control group. The treatments used were performed for 8 sessions separately for 2 groups of 3 people in Pars Tavan Comprehensive Center. Control group did not receive any intervention. A multidimensional sexual satisfaction questionnaire of Roshan 2014 was used to evaluate patients. Results: Sexual satisfaction in post-test on both interventional group showed a significant improvement compared to control group (P

Multiple sclerosis is an unpredictable neurologic disease affecting 2.8 million people worldwide. Individuals with MS experience multiple physical and psychological symptoms such as depression, anxiety, fatigue, and pain that impact their general functioning and quality of life. The aim of this review is to highlight the importance of psychological interventions in reducing depression and anxiety symptoms associated with the diagnosis of multiple sclerosis. Cognitive and behavioral techniques are also useful in relieving the specific symptoms of multiple sclerosis. However, few studies have captured the psychological processes involved in reducing the symptoms of depression and anxiety, which is why greater concern is recommended in future studies in order to develop better psychological interventions tailored for patients with multiple sclerosis.

Anorexia nervosa (AN) is one among the severe psychiatric disorders of adolescence. AN in boys is often overlooked by both physicians and psychiatrists since it is predominantly seen in females. Teenagers usually get over the disorder, but in some cases, AN can cause serious complications, including chronicity and death. AN is often encountered among females and more so in the affluent class. Here, we present an 11-year-old boy belonging to a middle-class Indian family, referred for psychiatric evaluation from the pediatrics department after ruling out all medical causes for the weight loss. The patient complained of loss of appetite along with weight loss of 14 kg in the last 3 months. In-depth psychiatric evaluation revealed significant distress of gaining weight as well as an intense disgust related to his body shape. A cluster of determined food refusal and weight loss triggered the exploration of other symptoms of AN. The patient responded to antidepressants and well-planned cognitive behavioral therapy. Results were seen in the form of return to the normal range of body weight, shape, and size along with its confident acceptance.

Introduction: Asthma is a major health problem in most parts of the world. This chronic disease is influenced by psychological therapies, such as cognitive-behavioral therapy, and training, such as diaphragmatic respiratory exercises. This study aimed to compare the effectiveness of cognitive-behavioral therapy and training of diaphragmatic respiratory exercises on panic symptoms in women with asthma in Lahijan, Iran, in 2020. Material & Methods: This quasi-experimental study was conducted on two groups using a pre-test and post-test design with a control group. A total of 60 women who were referred to the clinics or hospitals in Lahijan, Iran, in 2020, were selected through the available sampling method and randomly divided into three groups of cognitive-behavioral therapy, diaphragmatic respiratory training, and control. Pre-tests were taken from the samples before the interventions. After the interventions, post-tests were administered, and the patients were followed up one month later. The data were collected using the Albani Panic Disorder Questionnaire, designed in 1996 by Barlow and Zeinberg. The obtained data were then analyzed using SPSS software (version 22) through descriptive statistics (mean±SD and variance) and inferential statistics (variance analysis and Bonferroni test). (Ethic code: IR.IAU.NAJAFABAD.REC.1399.048) Findings: The results of the study showed that cognitive-behavioral therapy at the post-test (62.43±3.96) and training of diaphragmatic respiratory exercises at the follow-up phase (55.64±2.58) were more effective in improving the panic symptoms of women with asthma (P=0.0001). Discussion & Conclusion: The use of methods, such as cognitive-behavioral therapy, and changes in the lifestyle (regular physical activity) of asthmatic patients can play a helpful role in controlling asthma panic symptoms.

Background and aims: Infertility is the inability to conceive after one-year sexual activity without contraception. It can be associated with different psychological consequences. The aim of this study was to evaluate the effects of cognitive behavioral therapy (CBT) on self-esteem among infertile couples. Methods: This randomized controlled trial was conducted in 2018 with a two-group pretest-posttest design. Participants were thirty infertile couples (60 individuals) who referred to the infertility clinic of Imam Khomeini hospital, Ahvaz, Iran. Couples with score 21 or less for the Eysenck Self-Esteem Questionnaire were randomly allocated to a 30-person control and a 30-person intervention group. Participants in the intervention group received CBT in eight sixty-minute weekly sessions, while their counterparts in the control group received no education. A demographic questionnaire and the Eysenck Self-Esteem Questionnaire were used for data collection. The data were analyzed through the SPSS software (v. 24.0) and the chi-square, independent-sample t, and paired-sample t tests. Results: There was no significant difference between the intervention and the control groups respecting the pretest mean score of self-esteem (12.93±3.31 vs. 12.8±2.58; P=0.863). The posttest mean score of self-esteem in the control group was 12.76±2.47 with no significant change compared with the pretest (P=0.907), while the mean score of self-esteem in the intervention group significantly increased to 21.43±3.54 at posttest (P

Introduction and purpose: Infertile women often use a stressful process called laboratory fertilization to fulfill their desire for childbearing. The present study aimed to determine the effect of mindfulness-based cognitive therapy training on intolerance of uncertainty in infertile women undergoing in vitro fertilization (IVF) treatment. Methods: This study was conducted using a semi-experimental approach based on a pre-test, post-test, and follow-up design with a control group. The statistical population consisted of all infertile women referred to an infertility treatment center in Mashhad, Iran. From this group, a total of 60 women with a history of infertility were selected using the available sampling method and then randomly assigned to experimental and control groups. For the experimental group, eight 2-h sessions of mindfulness training were held weekly; however, the control group did not receive any psychological services. The intolerance of uncertainty questionnaire was used to measure anxiety, and data analysis was performed by single-variable covariance using SPSS software (version 21). Results: The results indicated that there was a statistically significant difference between the experimental and the control groups in terms of intolerance of uncertainty, and mindfulness-based cognitive therapy training effectively reduced the intolerance of uncertainty (P

A global disparity exists between the burden of mental ill-health and the resources available to address this issue. Common mental disorders, such as mild-to-moderate depression, anxiety disorders and post-traumatic stress disorder, are associated with a significant decline in health and functioning and contribute significantly to the overall burden of disease. In view of a shortage of mental health professionals in most low- and middle-income countries, task sharing (task shifting) can make an important contribution to improving access to mental health services. Task sharing involves non-specialists in the delivery of health care. The use of lay health workers is premised on the assumption that the shorter training required for non professionals will allow an increase in the provision of required care without the need for an increase in resources and will strengthen and scale-up sustainable health systems. The need for low-tech support in the management of common mental disorders is widespread, and the core resource is humans trained to identify and treat those requiring mental health care. There is a strong evidence base for the effectiveness of task sharing in psychotherapy, and talk therapies, e.g. cognitive behavioral therapy, can easily be delegated to non-specialists, including non-specialist health workers, peer helpers and lay people. A (cost-) effective model of mental health care in low-resource settings as well as in high-income countries may include the medical school-based training of some psychiatrists and clinical psychologists in the treatment of referred patients with serious mental illness. These professional mental health specialists would also be trainers and supervisors of non-specialist health workers who would identify common mental health disorders and provide psychotherapy to people with these conditions in a community-based setting. Community-based generalism including task sharing rather than centralized specialism may be capable of preventing and treating many common mental disorders with minor financial expenditure.

There is growing evidence to support the potential benefit of e-Health interventions targeting psychosocial outcomes and/or pain-related psychological variables for chronic pain conditions, including fibromyalgia syndrome (FMS). This systematic review aims at providing an in-depth description of the available e-Health psychological and/or multicomponent interventions for patients with FMS. Searches were made in PubMed, Cochrane, Web of Science, and PsycINFO up to 15 May 2023, finally including twenty-six articles. The quality of the included articles was medium–high (average quality assessment score of 77.1%). 50% of studies were randomized controlled trials (RCTs) (n = 13), and the majority of them focused exclusively on adult patients with FMS (n = 23) who were predominantly female. Four categories of e-Health modalities were identified: web-based (n = 19), mobile application (m-Health) (n = 3), virtual reality (VR) (n = 2), and video consulting (n = 2). Interventions were mainly based on the cognitive behavioral therapy (CBT) approach (n = 14) and mostly involved contact with a healthcare professional through different digital tools. Overall, a growing number of psychological and multicomponent interventions have been created and delivered using digital tools in the context of FMS, showing their potentiality for improving psychosocial outcomes and pain-related psychological variables. However, some digital tools resulted as underrepresented, and the literature on this topic appears highly heterogeneous precluding robust conclusions.

A clinical case of a patient with chronic nonspecific low back pain and comorbid chronic insomnia is described, and a modern approach to the management of this patient category is shown. So-called yellow flags - factors that contribute to the central sensitization of pain - lead to chronicity of LBP. In the presented clinical case we identified the most common "yellow flags”: insomnia, pain catastrophizing, restrictive ”pain” behavior, anxiety. In practice, they often ignore the aforementioned factors, determine only the presence of back pain and prescribe analgesic therapy, which does not allow for an effective result.Insomnia is prevalent among patients with LBP, occurring in 47-64% of cases. With the COVID-19 pandemic among the population, the incidence of insomnia, anxiety and depression has increased. To date, the identification and treatment of these disorders is particularly relevant in the management of patients with chronic nonspecific LBP.The patient was treated, which included non-drug and drug methods and complied with Russian and foreign clinical guidelines on the therapy of chronic nonspecific LBP and on the therapy of chronic insomnia. Non-drug treatment consisted of educational talks, recommendations on daily activity and sleep hygiene, cognitive-behavioral therapy, mindfulness, relaxation, and therapeutic gymnastics. The listed methods were aimed at reducing pain catastrophizing, physical and social activation of the patient. The nonsteroidal anti-inflammatory drug dexketoprofen was used as pharmacotherapy according to a step-by-step regimen. After 5 days of therapy pain relief was observed, after 3 months of therapy back pain regressed, sleep normalized, mood improved. This therapeutic approach showed its effectiveness and safety in the treatment of chronic nonspecific LBP and comorbid chronic insomnia.

Low back pain is one of the most common reasons for seeking medical attention. Musculoskeletal (nonspecific) pain is the most common (90%) cause of chronic pain. Depressive and anxiety disorders, sleep disorders, mainly in the form of insomnia, which negatively affect the course of the disease, are often encountered as comorbid disorders in patients with chronic musculoskeletal low back pain (CMLBP). When managing patients, it is effective to use an integrated approach: drug therapy, kinesitherapy and psychological methods. Kinesitherapy uses various types of exercise and walking; it is important that they are performed regularly under the supervision of a specialist, excluding excessive physical and static loads. Cognitive-behavioral therapy is the most effective psychological effect in CMLBP, which should be directed not only to pain, but also to insomnia, depression and anxiety disorders. Non-steroidal anti-inflammatory drugs (NSAIDs) are used as drugs for chronic pain. It is important to take into account the presence of risk factors, concomitant diseases, interactions with other drugs. The use of etoricoxib (Arcoxia) for chronic low back pain is discussed. The author presents his own experience in managing 71 patients (average age 55) with CMLBP using kinesitherapy, psychological methods, and NSAIDs. As a result of treatment after 3 months, a significant decrease in VAS was achieved from 8 (6-8) to 2 (0-4) points (p < 0.0001), the depression decreased from 7 (5-9) to 4 (3-6) points in HADS (p = 0.002), the anxiety from 7 (5-10) to 5 (3-7) points in HADS (p = 0.0003), a decrease in disabilities according to the Oswestry question-naire from 46 (34-57.77) to 11.11 (4.44-26) percent (p < 0.0001), increase in physical activity according to IPAQ-SF from 11 (7-16) to 23 (15-26 ) points (p = 0.0002), decrease insomnia according to ISI from 12 (7-15) to 6 (2-10) points (p < 0.001), improvement in sleep quality according to PSQI from 9 (7-13) points up to 4 (2-9) points (p < 0.001). The widespread introduction of complex treatment of patients with CMLBP is of great medical and social importance.

Background and Objective: In recent years, psychological therapies increasingly used as complementary treatment of group psychotherapy. This study was done to evaluate the effectiveness of logotheraphy and cognitive-behavioral therapy on life expectancy among students with depression disorder. Methods: This clinical trial study was performed on 45 students with depression disorder whom refered to consulting center in Rasht city, north of Iran during 2018-19. Subjects were randomly divided into three groups including logotheraphy, cognitive-behavioral and control groups. At first, students who were willing to participate in this course completed Miller Hope Scale (MHS) Scale (pre-test). Then, the interventional groups were received logotheraphy and cognitive-behavioral group counseling for 10 weeks (90 minutes each session, once a week). After completing the course of treatment, all three groups were retested and one month after the post-test, a follow-up test was performed. Results: The mean score of the life expectancy of students with depression in interventional groups (logotheraphy, cognitive-behavioral) were significantly increasd in compared to controls in post-test and one month after follow up (P

Objective: Psychological wellbeing and ego-resiliency are highly affected in a chronic disease like type 2 diabetes mellitus (T2DM), where psychological interventions are considered as an option. The present study, therefore, aimed to investigate the effectiveness of cognitive-behavioral therapy (CBT) on psychological wellbeing and ego-resiliency of T2DM in Sabzevar, Iran. Materials and Methods: This experimental pretest-posttest design was conducted on T2DM patients admitted to Diabetes Center in Sabzevar, Iran. The sample included 30 patients, selected by convenient sampling, and randomly assigned into control (n=15) and experimental groups (n=15). Ryff’s Psychological Wellbeing Scale and Klohnenchr('39')s Ego-resiliency Inventory were used to collect data. CBT was conducted for the experimental group. Statistical analyses were performed in SPSS17 using ANCOVA. Results: The findings indicated that CBT had considerable impact on psychological wellbeing (and its six components: self-acceptance, personal growth, purpose in life, environmental mastery, autonomy, and positive relations with others), and ego-resiliency, in T2DM (P-value ≤ 0.01). Conclusion: The application of CBT, in T2DM patients can be an effective, applicable and promising intervention to enhance the psychological wellbeing and ego-resiliency, two highly affected constructs in chronic diseases leading to serious comorbidities for health.

Abstract Dysphagia or difficulty swallowing in childhood necessitates multi‐disciplinary evaluation and management. This case report highlights the teamwork required for diagnostic work‐up to distinguish functional dysphagia from organic and psychiatric conditions in an adolescent girl. Treatment model based on cognitive behavioral therapy is also presented.

Background and purpose: Improving quality of life is one of the goals of care that helps in preventing chronic conditions such as metabolic syndrome. The aim of this study was to determine the effect of self-management training based on group cognitive-behavioral therapy on quality of life in adults with metabolic syndrome. Materials and methods: This randomized clinical was carried out in 80 adults with metabolic syndrome in 2019. They were divided into intervention group and control group (n=40 per group) using permutation block method. The WHOQOL-BREF was administered before and three months after the intervention. Self-management trainings based on cognitive-behavioral therapy were performed twice a week in intervention group during 8 sessions of 90 minutes, while the control group received only routine care. Data were analyzed using Chi-square, independent t-test, paired t-test, and analysis of covariance. Results: The mean scores for quality of life and also dimensions of physical health, mental health, and social relations in intervention group were 42.14±5.18, 45.53±9.32, 40.38±7.44 and 43.32±6.43, respectively before the intervention that increased significantly to 56.38±7.23, 71.22±13.35, 65.29±8.56 and 48.76±6.95 after the intervention (P 0.05). Conclusion: Self-management training based on cognitive-behavioral therapy can improve the quality of life in adults with metabolic syndrome. (Clinical Trials Registry Number: IRCT20200507047343N1)

In the practice of neurologists and therapists, patients with complaints of headache, increased fatigue, and irritability are common. The most frequent causes of headaches in ambulatory patients are primary headaches (migraine and tension headaches). Lack of sleep, stress, symptoms of anxiety and depression, and abuse of analgesic drugs are the most common factors that contribute to the frequency of headaches. Magnesium deficiency is another factor, the role of which has been discussed in the frequency of primary headaches, in the development of neurotic disorders and depression. Clinical manifestations of magnesium deficiency itself usually include such nonspecific symptoms as fatigue, anxiety, irritability, numbness in the extremities, leg cramps, sleep disorders, etc.Magnesium deficiency is widespread among the population of developed countries, especially among women of reproductive age, often occurs during pregnancy, while taking oral contraceptives. Magnesium is involved in the regulation of the nervous system, neuromuscular transmission, cardiac activity, regulation of vascular tone, blood clotting and bone tissue metabolism. Magnesium deficiency is associated with diseases such as coronary heart disease, hypertension, type 2 diabetes, Alzheimer’s disease, migraine, osteoporosis, depression, neurotic disorders (panic disorder, generalized anxiety, various phobias), and fibromyalgia syndrome. Stress can lead to a decrease in magnesium levels in the body, and magnesium deficiency, in turn, reduces tolerance to stressful situations. Timely diagnosis and adequate treatment of magnesium deficiency and associated conditions represent important clinical challenges.The clinical case of a patient with neurotic disorder, headache and magnesium deficiency is presented, and the effectiveness of an interdisciplinary approach including an educational talk, adequate therapy for headache management, magnesium drug therapy and psychological methods is demonstrated. The role of magnesium deficiency in the development of various neurologic diseases is reviewed. The most effective magnesium compounds for therapy are discussed. Principles of diagnosis and treatment of patients with magnesium deficiency are presented.

Since the start of the 2019 coronavirus pandemic, interest in digital therapeutics (DTx) has increased. Temporomandibular disorder (TMD) fundamentally requires cognitive behavioral therapy (CBT), including physical self-regulation. An application that records TMD pain and parafunctional activities for CBT has recently been developed. However, evidence of the reduction of clinical symptoms in patients via repetitive software-driven CBT is lacking. The purpose of the present study was to evaluate the impact of applications that support CBT regarding the performance of CBT and the improvement of clinical symptoms in temporomandibular joint patients. From 20 October 2020 to 7 January 2021, we randomly assigned 41 participants diagnosed with TMD to control (conventional treatment) and experimental (conventional treatment + application use) groups. We randomly assigned 41 participants diagnosed with TMD to control (conventional treatment) and experimental (conventional treatment + application use) groups. Improvements regarding the number of tender points, mouth opening, visual analog scale score, pain level upon palpation, joint sound, and stress were compared between the two groups. Compared with the control group, the experimental group showed significant improvements in the number of tender points and degree of mouth opening. They also showed improvements in pain level, joint sound, and locking, although not statistically significantly, as compared with the control group. Thus, further studies with a greater sample size need to be conducted to confirm the findings. Nevertheless, our results showed that repetitive cognitive behavioral therapy using a smartphone application can be used as digital therapeutics for temporomandibular disorder patients.

BACKGROUND: Today, type 2 diabetes mellitus (DM) is one of the most common metabolic diseases that is still on the rise. Present study aimed at investigation of effectiveness of cognitive behavioral therapy (CBT) on attitudes of the patients with type II DM taking insulin towards continuity of treatment, considering the increasing trend of this disease and the necessity of providing appropriate treatment facilities. METHODS: The study was conducted in semi-experimental method based on pretest-posttest and control group design. The statistical population included all insulin-dependent patients with type II DM, who were clients of Mahdieh Hospital of Tehran, Iran, in 2014. The convenience sampling was used based on which, 30 patients with type II DM were divided into two experimental (15 subjects) and control (15 subjects) groups and they responded to the questionnaire developed by the author. Then, the experimental group members experienced eight 90-minute sessions of CBT, while the controls received no intervention. Analysis of covariance (ANCOVA) with the SPSS software was used to analyze data. RESULTS: CBT led to increased cognitive, behavioral, and affective attitudes of the patients with type II DM who were taking insulin. Given the derived F, the difference between experimental and control groups was significant in terms of cognitive, affective, and behavioral attitudes (P < 0.01). CONCLUSION: Totally, our results emphasize the role of CBT in attitudes of patients with type II DM taking insulin towards continuance of treatment.

Background and Aim: Despite numerous advances in treating various diseases and increased life expectancy, obesity will be the leading cause of hopelessness in the next 100 years. The present study aimed to compare the effects of Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Therapy (CBT) on lifestyle habits, disordered eating behavior, and health-promoting lifestyle in obese women. Methods & Materials: The statistical population consisted of all women referring to obesity clinics in district 2 of Tehran City, Iran, in 2019. Forty-Five patients were selected by convenience sampling method and replaced in 3 groups of 15 (two experimental & one control groups). The study participants were assessed using the Assessment of Life Habits Scale (LIFE-H)), the Eating Attitudes Test (EAT), and the Health Promoting Lifestyle Profile-II (HPLP-II). The ACT group underwent nine 90-minute sessions and the CBT group received eight 90-minute sessions. The control group received no training. The collected data were analyzed using Mixed Design and repeated-measures Analysis of Variance (ANOVA) in SPSS. Ethical Considerations This study was approved by the Research Ethics Committee of Islamic Azad University, Karaj Branch (Code: IR.IAU.K.REC.1398.039). Results: The present research results signified that ACT and CBT were effective on the habits of eating disorders and health-promoting lifestyles in the explored obese women. The achieved changes remained stable until the follow-up phase (P

Background and Objective: Unwanted pregnancy reduces maternal role and decreases maternal-fetal attachment. Maternal -fetal attachment is the thoughts, feelings, and behaviors that pregnant women express about their fetuses. The aim of this study was to determine the effect of midwifery counseling with cognitive-behavioral approach on maternal-fetal attachment in women with unwanted pregnancy. Materials and Methods: This randomizes clinical trial was performed on 96 pregnant women with unwanted pregnancy referred to health centers of Kazerun, Shiraz, Iran, in 2019. The experimental group received 4 training sessions based on the cognitive behavioral counseling during 4 weeks. The control group received only the routine care program. At baseline and immediately after the intervention, both groups completed the demographic and maternal-fetal attachment questionnaire. Data were analyzed using descriptive and inferential statistics (independent t-test and Chi-square test) using SPSS 21. Results: The study showed no significant difference in total score of attachment (P=0.886) before intervention between the two groups; while after the intervention a significant difference was observed in the score of attachment (P=0.001) between the two groups; that is showed effectiveness of cognitive behavior therapy on promotes on maternal-fetal attachment Conclusion: Considering the effect of cognitive-behavioral training in promoting of maternal- fetal attachment, it is recommended that this type of educational intervention be integrated into the womenchr('39')s care program with unwanted pregnancies.

Abstract Background Adolescent depression is a global mental health concern. Identification and effective prevention in an early stage are necessary. The present randomized, controlled trial aimed to examine the effectiveness of Cognitive Behavioral Therapy (CBT)-based depression prevention in adolescents with elevated depressive symptoms. This prevention approach is implemented in school communities, which allows to examine effects under real-life circumstances. Methods A total of 5222 adolescents were screened for elevated depressive symptoms in the second grade of secondary schools; 130 adolescents aged between 12 and 16 years old (M = 13.59; SD = 0.68; 63.8% girls) were randomly assigned to the experimental (OVK 2.0) or control condition (psycho-education). Self- and parent-reported depressive symptoms were assessed at pretest and post intervention, as well as 6- and 12-months follow-up. Clinical assessment of depression was assessed at pretest and 6-months follow-up. Results Intent-to-treat analyses revealed that the decrease in adolescent-rated depressive symptoms was significantly larger in the intervention condition than in the control condition. There was no significant difference in decrease of parent-rated depressive symptoms between both conditions. Conclusions Based on the findings, we recommend the implementation of screening and prevention in schools, according the basics of this study design. Since this is a new step forward, we discuss the clinical impact and challenges, as well possibilities for future research. Trial registration The study is registered in the Dutch Trial Register for RCT’s ( NTR5725 ). Date registered: 11 March 2016.