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Background Patients with unipolar depressive disorder are frequently hospitalized, and the period following discharge is a high-risk-period. Smartphone-based treatments are receiving increasing attention among researchers, clinicians, and patients. We aimed to investigate whether a smartphone-based monitoring and treatment system reduces the rate and duration of readmissions, more than standard treatment, in patients with unipolar depressive disorder following hospitalization. Methods We conducted a pragmatic, investigator-blinded, randomized controlled trial. The intervention group received a smartphone-based monitoring and treatment system in addition to standard treatment. The system allowed patients to self-monitor symptoms and access psycho-educative information and cognitive modules. The patients were allocated a study-nurse who, based on the monitoring data, guided and supported them. The control group received standard treatment. The trial lasted six months, with outcome assessments at 0, 3, and 6 months. Results We included 120 patients with unipolar depressive disorder (ICD-10). Intention-to-treat analyses showed no statistically significant differences in time to readmission (Log-Rank p=0.9) or duration of readmissions (B=-16.41,95%CI:-47.32;25.5,p=0.3) (Primary outcomes). There were no differences in clinically rated depressive symptoms (p=0.6) or functioning (p=0.1) (secondary outcomes). The intervention group had higher levels of recovery (B=7,29, 95%CI:0.82;13,75,p=0.028) and a tendency towards higher quality of life (p=0.07), wellbeing (p=0,09) satisfaction with treatment (p=0.05) and behavioral activation (p=0.08) compared with the control group (tertiary outcomes). Limitations Patients and study-nurses were unblinded to allocation. Conclusions We found no effect of the intervention on primary or secondary outcomes. In tertiary outcomes, patients in the intervention group reported higher levels of recovery compared to the control group.

The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT.Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies.

In 1989 an investigation by questionnaire, comprising psychologists and physicians employed at all psychiatric wards in Denmark, concerning individual, supportive psychotherapy for adult psychiatric inpatients was carried out. The questionnaire was answered by 41%. In this group supportive psychotherapy constituted a large amount of the daily work, most therapists were psychoanalytically oriented, and their psychotherapies implied many directive, reality-oriented techniques as well as interpretation. The level of psychotherapeutic education was high, and a need for further education in supportive psychotherapy of psychiatric inpatients was expressed.

I artiklen gennemgås historiske faser og ideologier i behandling af angsttilstande. Der tages udgangspunkt i oprettelsen af den første neuroseklinik i dansk psykiatri i 1961 og dermed den psykoanalytiske neuroselære. Herefter gennemgås centrale aspekter af indlæringsteoriens forståelse og behandling af angstneurosen, der aldrig slog igennem i Danmark. 1980’erne kaldes en intermediær fase, og dens revolutioner på angstområdet gennemgås med hovedvægt på navneskiftet fra angstneurose til panikangst og den øgede empiriske forskning. Faserne herefter er domineret af to kognitivt adfærdsterapeutiske retninger, der er stærkt nytænkende og principielt evidensbaserede. Disse leder frem til de nyeste faser, henholdsvis emotionsreguleringsforskningen og neurobiologisk funderet forståelse af angsttilstandene. Artiklen slutter i den Klinik for angstlidelser i dagens psykiatri, hvor forfatteren er leder, og udstikker nogle retningslinier for arbejdet her under forudsætning af ønsket om at bevare kliniker forsker-konceptet og levere evidensbaseret behandling.

Rosenberg, N.K. & Waersted, A.: The pathomimic syndrome. Self-mutilation in nonpsychotic persons with normal intelligence. Nordisk Psykologi, 1986, 38 (2), 92–106. The paper describes the pathomimic syndrome: self-mutilation and denial in non- psychotic persons with normal intelligence. Patients with self-inflicted dermatological diseases and hair-diseases are considered. The syndrome is elucidated through a review of the available literature and preliminary results of the authors' own psychological investigation of pathomimic patients. In particular, the psychoanalytically oriented borderline theories are found to highlight important psychodynamic aspects of pathomimia. Therapeutically patients are at present very difficult to handle.

Rehabilitation in Denmark has until recently primarily been undertaken as Rehabilitation Medicine. The main treatment offered to patients with central nervous system disturbances has been physiatry and occupational therapy. The physical treatment has been efficient, but belief in radical changes or improvement has been lacking. Rest has been considered the basis for recovery. The prevailing theory has been that since neurons in the central nervous system do not regenerate, the loss of damaged tissue is irreversible. If improvement is possible, it will occur spontaneously within the first year. Consequently, the number of rehabilitation beds for the brain damaged population has been rather few, and the possibilities for treatment sparse.