Computerized ambulatory monitoring overcomes a number of methodological and conceptual challenges to studying mental disorders, however concerns persist regarding the feasibility of this approach with severe psychiatric samples and the potential of intensive monitoring to influence data quality. This multi-site investigation evaluates these issues in four independent samples. Patients with schizophrenia (n = 56), substance dependence (n = 85), anxiety disorders (n = 45), and a non-clinical sample (n = 280) were contacted to participate in investigations using computerized ambulatory monitoring. Micro-computers were used to administer electronic interviews several times per day for a one-week period. Ninety-five percent of contacted individuals agreed to participate in the study, and minimum compliance was achieved by 96% of these participants. Seventy-eight percent of all programmed assessments were completed overall, and only 1% of micro-computers were not returned to investigators. There was no evidence that missing data or response time increased over the duration of the study, suggesting that fatigue effects were negligible. The majority of variables investigated did not change in frequency as a function of study duration, however some evidence was found that socially sensitive behaviors changed in a manner consistent with reactivity.
Homework assignments are an essential part of cognitive-behavioural therapy, and are included in the majority of therapy manuals and frequently used in therapeutic practice. Despite this, little is known about problems with homework completion or possible influences on homework compliance. The aim of the present practitioner survey was to provide data on problems related to homework use and compliance. Furthermore, the relationships between different variables and homework compliance were examined. Data were collected by asking 77 cognitive-behavioural therapists to recall two individual patients. Therapists described homework tasks assigned to these patients and procedures of assignment as well as problems that arose during assignment and completion. The results suggested that problems during the assignation of a task as well as during completion regularly occur. Homework compliance was positively associated with patients' motivation for therapy, outcome at a later stage of therapy, and the provision of a written note or homework sheets on the task. Regression analyses pointed to patient variables as most crucial for homework compliance. Implications for effective homework use in clinical practice are discussed.
Parenthood is positively associated with mental health, particularly for men. Most differences can be found for depressive and substance use disorders. Partnership seems especially important for parents since it does not affect prevalence rates of mental disorders among non-parents.
The present survey assessed consumer satisfaction of patients having undergone psychotherapy for depression as well as service characteristics including treatment access, communication of diagnosis and treatment rationale, quality assurance and adverse events. The study was conducted in the form of a 15-item questionnaire that was published in one of Germany's leading health magazines. 473 persons responded (81.5% women, age range 17-83). 49.8% of the respondents reported substantial or reasonable improvement; two out of three patients stated they had been satisfied with their therapy. Improvement and satisfaction were greater in those patients who had been informed about diagnosis and treatment; they were lower when unpleasant experiences were reported. Methodological restrictions of the study are outlined and hypotheses about potential strengths and deficits in the delivery of psychotherapy for depression in Germany are proposed.
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