Mindfulness-based cognitive therapy for seasonal affective disorder: A pilot study.

Mindfulness-based cognitive therapy for seasonal affective disorder: A pilot study.

J Affect Disord. 2014 Jul 11;168C:205-209

Authors: Fleer J, Schroevers M, Panjer V, Geerts E, Meesters Y

Abstract

BACKGROUND: The best available treatment for seasonal affective disorder (SAD) is light therapy. Yet, this treatment does not prevent recurrence of depression in subsequent seasons. The aim of the study is to gain preliminary insight in the efficacy of Mindfulness Based Cognitive Therapy (MBCT) in the prevention of SAD recurrence.

METHODS: This is a randomized controlled pilot study, in which SAD patients in remission were randomly allocated to an individual format of MBCT or a control condition (i.e. treatment as usual). MBCT was given between May and June 2011, when there was no presence of depressive symptoms. The Inventory for Depressive Symptomatology Self-Report (IDS-SR), which patients received on a weekly basis from September 2011 to April 2012, was used to assess moment of recurrence (≥20) and severity at moment of recurrence.

RESULTS: 23 SAD patients were randomized to MBCT and 23 to the control condition. Kaplan-Meier survival curve showed that the groups did not differ in moment of recurrence (χ²(1).41, p=.52). T-tests showed no group difference in mean IDS-SR scores at moment of recurrence (t(31)=-.52, p=.61).

LIMITATIONS: The results are limited by small sample size (n=46) and missing data of weekly IDS-SR assessments.

CONCLUSION: The findings of this pilot RCT suggest that individual MBCT is not effective in preventing a SAD recurrence when offered in a symptom free period (i.e. spring).

PMID: 25063959 [PubMed - as supplied by publisher]

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The Course of Sleep Problems in Patients With Heart Failure and Associations to Rehospitalizations.

The Course of Sleep Problems in Patients With Heart Failure and Associations to Rehospitalizations.

J Cardiovasc Nurs. 2014 Jun 24;

Authors: Johansson P, Broström A, Sanderman R, Jaarsma T

Abstract

INTRODUCTION:: Sleep problems are common in patients with heart failure (HF) and might be associated with patient outcomes.

AIMS:: The aim of this study was to describe the course of sleep problems in HF patients over 1 year and the association between sleep problems and rehospitalization.

METHODS:: Data from 499 HF patients (mean age, 70 years) were used in this analysis. Sleep problems were assessed with the item “Was your sleep restless” from the Center for Epidemiological Studies Depression Scale during hospitalization for HF (baseline) and after 1 year.

RESULTS:: A total of 43% of patients (n = 215) reported sleep problems at baseline, and 21% of patients (n = 105), after 1 year. Among the 215 patients with problems with sleep at baseline, 30% (n = 65) continued to have sleep problems over time. Among the 284 patients without sleep problems at baseline, 14% (n = 40) reported sleep problems after 1 year. After adjustments for potential cofounders, patients with continued sleep problems had an almost 2-fold increased risk for all-cause hospitalizations (hazard ratio, 2.1; P = .002) and cardiovascular hospitalizations (hazard ratio, 2.2; P = .004).

CONCLUSION:: One-third of HF patients with sleep problems at discharge experienced persistent sleep problems at follow-up. Continued sleep problems were associated with all-cause and cardiovascular rehospitalizations.

PMID: 24978159 [PubMed - as supplied by publisher]

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Reply to Drs. Walmsley and Casey letter.

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Reply to Drs. Walmsley and Casey letter.

J Crohns Colitis. 2013 Dec 1;7(11):932

Authors: Bennebroek Evertsz’ F, Nieuwkerk PT, Stokkers PC, Ponsioen CY, Bockting CL, Sanderman R, Sprangers MA

PMID: 23932784 [PubMed - indexed for MEDLINE]

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Development of the patient Harvey Bradshaw index and a comparison with a clinician-based Harvey Bradshaw index assessment of Crohn’s disease activity.

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Development of the patient Harvey Bradshaw index and a comparison with a clinician-based Harvey Bradshaw index assessment of Crohn’s disease activity.

J Clin Gastroenterol. 2013 Nov-Dec;47(10):850-6

Authors: Evertsz’ FB, Hoeks CC, Nieuwkerk PT, Stokkers PC, Ponsioen CY, Bockting CL, Sanderman R, Sprangers MA

Abstract

GOALS AND BACKGROUND: The objective is to develop a patient-based Harvey Bradshaw Index (P-HBI) of Crohn’s Disease (CD) activity and to compare it with the clinician-based HBI of CD activity in CD outpatients.

STUDY: Consecutive patients with CD randomly completed the P-HBI either before or after the consultation. The gastroenterologist assessed patient’s CD activity on the same day. Overall agreement between HBI and P-HBI was calculated with Spearman’s ρ and Mann-Whitney U test. Agreement regarding active disease versus remission and agreement at item level was calculated by percent agreement and Cohen’s κ.

RESULTS: One hundred eighty-one (response rate 88.3%) CD patients participated. P-HBI and HBI showed a large correlation (rs=0.82). The medians (interquartile range) of the total HBI (2; 0 to 4) and P-HBI (4; 1 to 7) were statistically significantly different (z=-8.411; P<0.001). Fortunately, in 82.6% of the cases this difference between clinicians and patients was not clinically significant (<3.2). The percentage agreement between clinician and patient, judging CD as active or as in remission, was 77%, rs=0.56, κ=0.52, indicating a moderate agreement. P-HBI and HBI on frequent extraintestinal manifestations in CD varied from less than chance (κ=-0.02) to a perfect agreement (κ=1). Patients tended to report more symptoms while completing the patient-based questionnaire compared to what they reported to the clinician during consultation.

CONCLUSIONS: The P-HBI is the first step in developing a potential promising tool given its adequate agreement with the original HBI and its feasibility, especially in patients with low scores. Future research is necessary to develop a validated patient-based version studied in several patient populations.

PMID: 23632348 [PubMed - indexed for MEDLINE]

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The patient simple clinical colitis activity index (P-SCCAI) can detect ulcerative colitis (UC) disease activity in remission: a comparison of the P-SCCAI with clinician-based SCCAI and biological markers.

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The patient simple clinical colitis activity index (P-SCCAI) can detect ulcerative colitis (UC) disease activity in remission: a comparison of the P-SCCAI with clinician-based SCCAI and biological markers.

J Crohns Colitis. 2013 Dec 1;7(11):890-900

Authors: Bennebroek Evertsz’ F, Nieuwkerk PT, Stokkers PC, Ponsioen CY, Bockting CL, Sanderman R, Sprangers MA

Abstract

AIM: To develop a patient-based Simple Clinical Colitis Activity Index (P-SCCAI) of ulcerative colitis (UC) activity and to compare it with the clinician-based SCCAI, C-reactive protein (CRP) and Physician’s Global Assessment (PGA) of UC activity. Monitoring UC activity may give patients disease control and prevent unnecessary examinations.

METHODS: Consecutive UC patients randomly completed the P-SCCAI either before or after consultation. Gastroenterologists assessed patients’ UC activity on the same day. Overall agreement between SCCAI and P-SCCAI was calculated with Spearman’s Rho and Mann-Whitney U test. Agreement regarding active disease versus remission and agreement at domain level were calculated by percent agreement and kappa (κ).

RESULTS: 149 (response rate 84.7%) UC patients participated. P-SCCAI and SCCAI showed a large correlation (rs=0.79). The medians (IQR) of the P-SCCAI (3.78;0-15) tended to be higher than those of the SCCAI (2.86;0-13), although this difference did not reach statistical significance (z=1.71| p=0.088). In 77% of the cases the difference between clinicians’ and patients’ scores was not clinically different (i.e.≤2). Percentage agreement between clinicians and patients, judging UC as active or in remission, was 87%, rs=0.66, κ=0.66, indicating a substantial agreement. In general patients tended to report more physical symptoms than clinicians. C-Reactive protein (CRP) was found to have a significant association with both P-SCCAI and SCCAI (κ=0.32, κ=0.39 respectively) as was PGA (κ=0.73 for both indices).

CONCLUSIONS: The P-SCCAI is a promising tool given its substantial agreement with the SCCAI and its feasibility. Therefore, P-SCCAI can complement SCCAI in clinical care and research.

PMID: 23269224 [PubMed - indexed for MEDLINE]

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Individual Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavior Therapy (CBT) for Treating Depressive Symptoms in Patients With Diabetes: Results of a Randomized Controlled Trial.

Individual Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavior Therapy (CBT) for Treating Depressive Symptoms in Patients With Diabetes: Results of a Randomized Controlled Trial.

Diabetes Care. 2014 Jun 4;

Authors: Tovote KA, Fleer J, Snippe E, Peeters AC, Emmelkamp PM, Sanderman R, Links TP, Schroevers MJ

Abstract

OBJECTIVE: Depression is a common comorbidity of diabetes, undesirably affecting patients’ physical and mental functioning. Psychological interventions are effective treatments for depression in the general population as well as in patients with a chronic disease. The aim of this study was to assess the efficacy of individual mindfulness-based cognitive therapy (MBCT) and individual cognitive behavior therapy (CBT) in comparison with a waiting-list control condition for treating depressive symptoms in adults with type 1 or type 2 diabetes.RESEARCH DESIGN AND METHODS: In this randomized controlled trial, 94 outpatients with diabetes and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ≥14) were randomized to MBCT (n = 31), CBT (n = 32), or waiting list (n = 31). All participants completed written questionnaires and interviews at pre- and postmeasurement (3 months later). Primary outcome measure was severity of depressive symptoms (BDI-II and Toronto Hamilton Depression Rating Scale). Anxiety (Generalized Anxiety Disorder 7), well-being (Well-Being Index), diabetes-related distress (Problem Areas In Diabetes), and HbA1c levels were assessed as secondary outcomes.RESULTS: Results showed that participants receiving MBCT and CBT reported significantly greater reductions in depressive symptoms compared with patients in the waiting-list control condition (respectively, P = 0.004 and P < 0.001; d = 0.80 and 1.00; clinically relevant improvement 26% and 29% vs. 4%). Both interventions also had significant positive effects on anxiety, well-being, and diabetes-related distress. No significant effect was found on HbA1c values.CONCLUSIONS: Both individual MBCT and CBT are effective in improving a range of psychological symptoms in individuals with type 1 and type 2 diabetes.

PMID: 24898301 [PubMed - as supplied by publisher]

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Shared Decision Making in Transplantation: How Patients See Their Role in The Decision Process of Accepting a Donor Liver.

Shared Decision Making in Transplantation: How Patients See Their Role in The Decision Process of Accepting a Donor Liver.

Liver Transpl. 2014 May 24;

Authors: Op den Dries S, Annema C, van den Berg AP, Ranchor AV, Porte RJ

Abstract

At the time of organ offer for transplantation, donor-related risks such as disease transmission and graft failure are weighed against the patient’s risk of remaining on the waiting list. The patient’s commonly inactive role in decision-making and the timing and extent of donor-specific risk information has been discussed in the medical literature. This is the first study revealing the opinion of liver patients on these issues. Forty patients listed for liver transplantation and 179 transplanted liver patients participated in an anonymous questionnaire-based survey. The majority of patients wanted to be informed about donor-related risks (59.8-74.8%). The preferred timing for being informed of donor-related risks was for 53.3% of the patients at the time of organ offer. Of these patients, 79.8% wished to be involved in decision-making on whether or not to accept a liver for transplantation, 10.6% wished to make the final decision alone and only 9.6% did not want to be involved in the decision-making process. Implementing this knowledge by standardizing the content, the manner of transfer, and the amount of information that we provide to our patients will improve opportunities for shared decision-making at different time points along the transplant allocation process. This will enable us to provide the same opportunities and care to every patient on the waiting list. Liver Transpl , 2014. © 2014 AASLD.

PMID: 24863055 [PubMed - as supplied by publisher]

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Depression screening and patient outcomes in pregnancy or postpartum: A systematic review.

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Depression screening and patient outcomes in pregnancy or postpartum: A systematic review.

J Psychosom Res. 2014 Jun;76(6):433-446

Authors: Thombs BD, Arthurs E, Coronado-Montoya S, Roseman M, Delisle VC, Leavens A, Levis B, Azoulay L, Smith C, Ciofani L, Coyne JC, Feeley N, Gilbody S, Schinazi J, Stewart DE, Zelkowitz P

Abstract

OBJECTIVE: Clinical practice guidelines disagree on whether health care professionals should screen women for depression during pregnancy or postpartum. The objective of this systematic review was to determine whether depression screening improves depression outcomes among women during pregnancy or the postpartum period.

METHODS: Searches included the CINAHL, EMBASE, ISI, MEDLINE, and PsycINFO databases through April 1, 2013; manual journal searches; reference list reviews; citation tracking of included articles; and trial registry reviews. RCTs in any language that compared depression outcomes between women during pregnancy or postpartum randomized to undergo depression screening versus women not screened were eligible.

RESULTS: There were 9,242 unique titles/abstracts and 15 full-text articles reviewed. Only 1 RCT of screening postpartum was included, but none during pregnancy. The eligible postpartum study evaluated screening in mothers in Hong Kong with 2-month-old babies (N=462) and reported a standardized mean difference for symptoms of depression at 6months postpartum of 0.34 (95% confidence interval=0.15 to 0.52, P<0.001). Standardized mean difference per 44 additional women treated in the intervention trial arm compared to the non-screening arm was approximately 1.8. Risk of bias was high, however, because the status of outcome measures was changed post-hoc and because the reported effect size per woman treated was 6-7 times the effect sizes reported in comparable depression care interventions.

CONCLUSION: There is currently no evidence from any well-designed and conducted RCT that screening for depression would benefit women in pregnancy or postpartum. Existing guidelines that recommend depression screening during pregnancy or postpartum should be re-considered.

PMID: 24840137 [PubMed - as supplied by publisher]

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Prevalence of posttraumatic stress disorder (PTSD) in women with breast cancer.

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Prevalence of posttraumatic stress disorder (PTSD) in women with breast cancer.

J Psychosom Res. 2014 Jun;76(6):485-6

Authors: Kwakkenbos L, Coyne JC, Thombs BD

PMID: 24840144 [PubMed - in process]

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Predictors of All-Cause Mortality in Patients with Stable COPD: Medical Co-morbid Conditions or High Depressive Symptoms.

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Predictors of All-Cause Mortality in Patients with Stable COPD: Medical Co-morbid Conditions or High Depressive Symptoms.

COPD. 2014 May 15;

Authors: Maters GA, de Voogd JN, Sanderman R, Wempe JB

Abstract

Abstract Co-morbid conditions are frequently found in patients with COPD. We evaluate the association of co-morbidities with mortality, in stable COPD. 224 patients, mean age 61.2 (±10.00), 48.2% female, mean FEV1 1.1 (±0.5) liters, median follow-up time 4.2 years, participated. Medical co-morbidities were scored according to the Charlson Co-morbidity Index (CCI). Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist-90 (SCL-90). The Cox proportional hazard model was used for survival analyses. In our sample, 70% of all patients have a co-morbid medical condition or high depressive symptoms. During follow-up 51% of all patients died, and those with heart failure have the highest mortality rate (75%). Age, fat-free mass and exercise capacity were predictive factors, contrary to CCI-scores and high depressive symptoms. An unadjusted association between heart failure and survival was found. Although the presence of co-morbidities, using the CCI-score, is not related to survival, heart failure seems to have a detrimental effect on survival. Higher age and lower exercise capacity or fat-free mass predict mortality.

PMID: 24831411 [PubMed - as supplied by publisher]

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