Das Breslauer Arzneibuch R. 291 der Stadtbibliothek : 1. Teil: Text

Die Hs. R 291 der Breslauer Stadtbibliothek umfaßt neben vorliegendem Arzneibuche noch eine wohl aus dem XIII. Jahrhundert stammende Pergamenthandschrift. ..

Mindfulness-based cognitive therapy in obsessive-compulsive disorder – A qualitative study on patients’ experiences

BACKGROUND: Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is the first-line treatment for patients with obsessive-compulsive disorder (OCD). However, not all of them achieve remission on a longterm basis. Mindfulness-based cognitive therapy (MBCT) represents a new 8-week group therapy program whose effectiveness has been demonstrated in various mental disorders, but has not yet been applied to patients with OCD. The present pilot study aimed to qualitatively assess the subjective experiences of patients with OCD who participated in MBCT. METHOD: Semi-structured interviews were conducted with 12 patients suffering from OCD directly after 8 sessions of a weekly MBCT group program. Data were analyzed using a qualitative content analysis. RESULTS: Participants valued the treatment as helpful in dealing with their OCD and OCD-related problems. Two thirds of the patients reported a decline in OCD symptoms. Benefits included an increased ability to let unpleasant emotions surface and to live more consciously in the present. However, participants also discussed several problems. CONCLUSION: The data provide preliminary evidence that patients with OCD find aspects of the current MBCT protocol acceptable and beneficial. The authors suggest to further explore MBCT as a complementary treatment strategy for OCD

No Talking, Just Writing! Efficacy of an Internet-Based Cognitive Behavioral Therapy with Exposure and Response Prevention in Obsessive Compulsive Disorder

Background: Many patients with obsessive-compulsive disorder (OCD) do not receive first-line treatment according to the current guidelines (cognitive behavioral therapy with exposure and response prevention, CBT with ERP) due to barriers to treatment. Internet-based therapy is designed to overcome these barriers. The present study evaluates the efficacy of an Internet-based writing therapy with therapeutic interaction based on the concept of CBT with ERP for patients with OCD. Methods: Thirty-four volunteers with OCD according to DSM-IV-criteria were included in the trial and randomized according to a waiting-list control design with follow-up measures at 8 weeks and 6 months. The intervention consisted of 14 sessions, either starting directly after randomization or with an 8-week delay. Main outcome measure was the change in the severity of OCD symptoms (Yale-Brown Obsessive Compulsive Scale Self- Rating, Y-BOCS SR, and Obsessive-Compulsive Inventory-Revised, OCI-R). Results: Obsessive-compulsive symptoms were significantly improved in the treatment group compared to the waiting-list control group with large effect sizes of Cohen's d = 0.82 (Y-BOCS SR) and d = 0.87 (OCI-R), using an intention-to-treat analysis. This effect remained stable at 6-month follow-up. Only 4 participants (12%) dropped out prematurely from the study. Of the 30 completers, 90% rated their condition as improved and would recommend the program to their friends. Conclusions: Internet-based writing therapy led to a significant improvement of obsessive-compulsive symptoms. Even though replications with larger sample sizes are needed, the results support the notion that Internet-based approaches have the potential for improving the treatment situation for patients with OCD

Funktionalitäten von Essstörungen - Ergebnisse einer Analyse im stationären Setting

Introduction: Symptoms of mental disorders can serve different functions. The affected person frequently does not perceive the symptomatology as solely aversive;thus, the attitude towards therapy can be ambivalent. This survey aimed at identifying intrapsychic and interpersonal functions of eating disorders (EDs). Method: Functions of EDs were analyzed for 37 in-patients with anorexia nervosa (AN) or bulimia nervosa (BN), using a pilot questionnaire that consisted of an open introductory and concluding question each and an assessment of 18 defined functions. Qualitative content analysis was applied to classify the free-text answers. Frequency distributions were calculated, and mean values for AN and BN were compared. Results: Intrapsychic functions were more frequently ascribed to EDs than interpersonal functions. The most prominent functions were emotion regulation, gaining safety and control, and establishing content and structure. The introductory question returned establishing closeness and a feeling of security as the most frequently mentioned interpersonal functions;the answers to the concluding question suggest that EDs serve as a cry for help. The only significant difference between patients with AN and BN with regard to the functions of EDs was ED as a cry for help. Conclusions: A multitude of functions of EDs were registered. Intrapsychic functions, and particularly emotion regulation, are highly relevant. The results highlight the importance of specifically targeting functions in disorder-specific psychotherapy

First-line therapy for post-traumatic stress disorder : a systematic review of cognitive behavioural therapy and psychodynamic approaches

Background: Despite evidence supporting cognitive behavioural therapy (CBT) based interventions as the most effective approach for treating posttraumatic stress disorder (PTSD) in randomised control trials, alternative treatment interventions are often used in clinical practice. Psychodynamic (PDT) based interventions are one example of such preferred approaches, this is despite comparatively limited available evidence supporting their effectiveness for treating PTSD. Aims: Existing research exploring effective therapeutic interventions for PTSD includes trauma-focused CBT involving exposure techniques. The present review sought to establish the treatment efficacy of CBT and PDT approaches, and considers the potential impact of selecting PDT-based techniques over CBT-based techniques for the treatment of PTSD.Results: The evidence reviewed provided examples supporting PDT-based therapy as an effective treatment for PTSD, but confirmed CBT as more effective in the treatment of this particular disorder. Comparable dropout rates were reported for both treatment approaches, suggesting that relative dropout rate should not be a pivotal factor in the selection of a PDT approach over CBT for treatment of PTSD.Conclusion/Implications: The need to routinely observe evidence-based recommendations for effective treatment of PTSD is highlighted and factors undermining practitioner engagement with CBT-based interventions for the treatment of PTSD are identified