Background: Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena.
Twenty-six young participants, 18-25 years, with social phobia (SP) were randomly assigned to eight 2-hour sessions of group mindfulness-based cognitive therapy (MBCT) and twelve 2-hour sessions of group cognitive-behavioral therapy (CBT) in a crossover design with participants receiving treatments in reversed order. Outcome was assessed after treatments, and at 6- and 12-month follow-ups. MBCT achieved moderate-high pre-post effect sizes (d=0.78 on a composite SP measure), not significantly different from, although numerical lower than those of CBT (d=1.15). Participants in both groups further improved in the periods following their first and second treatment until 6-months follow-up (pre-follow-up ds = 1.42 and 1.62). Thus, MBCT might be a useful, low cost treatment for SP, although, probably, less efficacious than CBT.
Generally, the results are in line with the conclusion that more disturbed patients with SP both begin and end treatment at a higher symptomatic level but with a similar degree of improvement. There is, however, little clinically or theoretically relevant knowledge to be gained from existing studies of pre-treatment patient variables as predictors of drop-out and treatment outcome in CBT for patients with SP. The field is in need of conceptual and methodological improvements if more solid findings should be hoped for.
Objectives:The MONARCA I and II trials were negative but suggested that smartphone-based monitoring may increase quality of life and reduce perceived stress in bipolar disorder (BD). The present trial was the first to investigate the effect of smartphone-based monitoring on the rate and duration of readmissions in BD. Methods: This was a randomized controlled single-blind parallel-group trial. Patients with BD (ICD-10) discharged from hospitalization in the Mental Health Services, Capital Region of Denmark were randomized 1:1 to daily smartphone-based monitoring including a feedback loop (+ standard treatment) or to standard treatment for 6 months. Primary outcomes: the rate and duration of psychiatric readmissions. Results: We included 98 patients with BD. In ITT analyses, there was no statistically significant difference in rates (hazard rate: 1.05, 95% CI: 0.54; 1.91, p = 0.88) or duration of readmission between the two groups (B: 3.67, 95% CI: −4.77; 12.11, p = 0.39). There was no difference in scores on the Hamilton Depression Rating Scale (B = −0.11, 95% CI: −2.50; 2.29, p = 0.93). The intervention group had higher scores on the Young Mania Rating Scale (B: 1.89, 95% CI: 0.0078; 3.78, p = 0.050).The intervention group reported lower levels of perceived stress (B: -7.18, 95% CI: −13.50; −0.86, p = 0.026) and lower levels of rumination (B: −6.09, 95% CI: −11.19; −1.00, p = 0.019). Conclusions: Smartphone-based monitoring did not reduce rate and duration of readmissions. There was no difference in levels of depressive symptoms. The intervention group had higher levels of manic symptoms, but lower perceived stress and rumination compared with the control group.
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