Introduction This study examined the effectiveness of telemedicine in providing psychotherapy to patients with medically unexplained pain (MUP) who may not have access to in-person treatment. The impact of Internet-delivered intensive short-term dynamic psychotherapy (ID-ISTDP) was investigated for MUP via video teleconferencing (Skype™). Methods A randomized, controlled trial of ISTDP, an evidence-based intervention for MUP, was conducted to compare delivery modalities on variations in MUP symptoms. Eighty-one participants with MUP were randomized to either ID-ISTDP ( n = 39) or in-person ISTDP ( n = 42). Outcome variables included the Numeric Pain Rating Scale, Depression Anxiety Stress Scale-21, Emotion Regulation Questionnaire, Mindful Attention Awareness Scale and the Quality of Life Inventory. In addition, exploratory analyses were used to examine acceptability, satisfaction and compliance in both conditions. Participants were assessed prior to intervention, immediately following the intervention, and 12 months after. Results In the intention-to-treat analysis, in-person ISTDP participants had significantly lower pain intensity than ID-ISTDP participants, both immediately following the intervention ( d = 0.97) and at the 12-month follow-up ( d = 0.82). Moreover, there were significant decreases in depression, anxiety and stress as well as a greater increase in emotion regulation functioning, mindfulness and quality of life observed in the in-person ISTDP group at the end of the intervention and 12 months after the treatment when compared to the ID-ISTDP group. Participants rated both treatment conditions as equally credible and satisfying. Conclusion ISTDP seems most effective when delivered in person in treating MUP patients with highly comorbid conditions with benefits maintained over 12 months.
Background: Obsessive-compulsive disorder (OCD) is known as a non-psychotic mental disorder resistant to treatment. It has been found that eye movement desensitization and reprocessing (EMDR) can increase the effectiveness of its standard treatments. Objectives: The current study aimed at evaluating the impact of exposure/response prevention (ERP) combined with EMDR as a treatment method on patients with OCD who had experienced stressful life events by comparison to ERP alone. Methods: The present randomized controlled trial was conducted among 60 OCD patients who experienced stressful life events and were resistant to medication treatment. The participants were randomly assigned to the ERP plus EMDR (n = 30) and ERP (n = 30) groups. The Yale-Brown Obsessive-Compulsive scale (Y-BOCS) and Beck Anxiety Inventory (BAI) were completed before and after the intervention, as well as, after a follow-up period of three months. The scores were compared using the chi‐squared test, analysis of covariance (ANCOVA), and repeated measures analysis of variance (ANOVA). Results: ANOVA results demonstrated that both treatment protocols had a significant effect on the reduction of anxiety and severity of OCD symptoms, while the results of ANCOVA showed a significantly higher effect of ERP plus EMDR compared to the ERP protocol (P = 0.001), and sample attrition was significantly higher in the ERP group (P < 0.05). Conclusions: The ERP plus EMDR protocol compared to the ERP protocol showed a higher rate of completion and efficacy in OCD treatment.
A
BSTRACT
Aims:
Suicide is a major public health problem around the world. The present study aimed to design and determine the effectiveness of a suicide intervention package for psychologists working in the primary health care system in Hormozgan Province.
Materials and Methods:
This study was conducted in two phases: qualitative and quantitative phases. In the qualitative phase, it was a thematic analysis type, and in the quantitative phase, it was quasi-experimental type with pretest–posttest in two groups of intervention and comparison. To standardize the suicide intervention package, Delphi method was used, and for quantitative content validity, content validity index (CVI) and content validity ratio (CVR) were used. In the quantitative phase of the study, the statistical population of the study included 270 people who had suicidal ideations and had no history of suicide attempt. Among them, 135 people were included in the intervention group and 135 people were included in the comparison group using a convenience sampling method. They were selected among those referred to eight comprehensive rural and urban health service centers in eight cities of Hormozgan Province. The results were analyzed by MANCOVA statistical test.
Results:
CVR was more than 0.75 and CVI was more than 0.87. In the quantitative phase, the results showed a significant difference between the means before and after the intervention for the variables of psychological distress, suicidal ideation, and hopelessness (
P
< 0.01).
Conclusion:
It seems that psychological suicide preventive interventions in the primary health care system are effective in reducing psychological distress,suicidal thoughts and hopelessness.
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