How can technology enhance cognitive behavioral therapy: the case of pediatric obsessive compulsive disorder

Many children with mental health disorders do not receive adequate treatment due to the uneven dissemination of resources, and other barriers to treatment. In the case of pediatric obsessive compulsive disorder treatment progress is also hindered by partial or non-response to treatment in addition to poor compliance. This debate paper focuses on new technologies as a potential vehicle to address the challenges faced by traditional treatment, with special reference to cognitive behavioral therapy for pediatric obsessive compulsive disorder. We discuss the achievements and challenges that previous studies have faced, debate ways to overcome them, and we offer specific suggestions for further research in the are

Effectiveness of an online interpretation training as a pre-treatment for cognitive behavioral therapy for obsessive-compulsive disorder in youth: A randomized controlled trial

Background: Cognitive behavioral therapy (CBT) is the treatment of choice for pediatric obsessive-compulsive disorder (OCD), but not all patients profit sufficiently. Long waitlists and wide variations in improvement rates ask for new interventions. We examined the effectiveness of a Cognitive Bias Modification–Interpretation (CBM-I) training that was offered during the waiting period for CBT. We tested 1) whether the CBM-I training is an effective intervention during a waitlist period for CBT, and 2) whether augmenting CBT with CBM-I improves treatment effect. Methods: Participants (74 children with OCD, 8–18 years) were randomly assigned to either a CBM-I training or a waitlist, both followed by CBT. Results: indicated that compared to the waitlist, the CBM-I training was effective in reducing OCD severity, with a medium effect size. Patients in the CBM-I training condition started subsequent CBT with less severe OCD, and this advantage was maintained during CBT. However, the CBM-I training did not result in a faster decline of symptoms during subsequent CBT. Conclusion: These findings indicate that CBM-I training could be an easy to implement, helpful intervention during a waitlist period. However, replications in larger samples and comparisons to active control conditions are needed

Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review

Background:Obsessive-compulsive disorder (OCD) is a chronic mental health disorder characterized by recurringobsessions and compulsions affecting 1–3% of children and adolescents. Current treatment options are limited byaccessibility, availability, and quality of care. New technologies provide opportunities to address at least some ofthese challenges. This paper aims to investigate the acceptability, feasibility, and efficacy of traditional cognitivebehavioral therapy with Internet cognitive behavioral therapy (iCBT) for pediatric OCD according to PreferredReporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Method:We searched EMBASE, Medline, PsycINFO, CENTRAL, LILACS, CINAHL, and Scopus. Results include articlesfrom 1987 to March 2018. Main inclusion criteria were patients aged 4–18, primary diagnosis of OCD, and iCBT.Results:Of the 2323 unique articles identified during the initial search, six studies with a total of 96 participants metour inclusion criteria: three randomized controlled trials, one single-case multiple-baseline design, one open-label trial,and one case series. Four studies reported a significant decrease in OCD severity on the Children’sYale-BrownObsessive-Compulsive Scale (CY-BOCS) following iCBT, one study reported significant decrease in CY-BOCS scores foriCBT relative to waitlist, and the case series reported (some) symptom reduction in all participants. Six studies reportedhigh rates of feasibility, and five studies reported good acceptability of iCBT.Conclusion:At present, evidence regarding acceptability, feasibility, and efficacy of iCBT for pediatric OCD is limited.Results are promising but need to be confirmed and refined in further research

Failure of stereotactic core needle biopsy in women recalled for suspicious calcifications at screening mammography:frequency, causes, and final outcome in a multi-institutional, observational follow-up study

OBJECTIVES: We determined the failure rate of stereotactic core needle biopsy (SCNB) and its causes and final outcome in women recalled for calcifications at screening mammography. METHODS: We included a consecutive series of 624,039 screens obtained in a Dutch screening region between January 2009 and July 2019. Radiology reports and pathology results were obtained of all recalled women during 2-year follow-up. RESULTS: A total of 3495 women (19.6% of 17,809 recalls) were recalled for suspicious calcifications. SCNB was indicated in 2818 women, of whom 12 had incomplete follow-up and another 12 women refused biopsy. DCIS or invasive cancer was diagnosed in 880 of the remaining 2794 women (31.5%). SCNB failed in 62 women (2.2%, 36/2794). These failures were mainly due to a too posterior (n = 30) or too superficial location (n = 17) of the calcifications or calcifications too faint for biopsy (n = 13). Of these 62 women, 10 underwent surgical biopsy, yielding one DCIS (intermediate grade) and two invasive cancers (one intermediate grade and one high grade) and another two women were diagnosed with DCIS (both high grade) at follow-up. Thus, the malignancy rate after SCNB failure was 8.1% (5/62). Calcifications were depicted neither at SCNB specimen radiography nor at pathology in 16 women after (repeated) SCNB (0.6%, 31/2732). None of them proved to have breast cancer at 2-year follow-up. CONCLUSIONS: The failure rate of SCNB for suspicious calcifications is low but close surveillance is warranted, as breast cancer may be present in up to 8% of these women. KEY POINTS: • The failure rate of stereotactic core needle biopsy (SCNB) for calcifications recalled at screening mammography was 2.2%. • Failures were mainly due to calcifications that could not be reached by SCNB or calcifications too faint for biopsy. • The management after failed SCNB was various. At least, close surveillance with a low threshold for surgical biopsy is recommended as breast cancer may be present in up to 8% of women with SCNB failure

Pre-excited or not pre-excited?

Case ReportsJournal ArticleFLWINinfo:eu-repo/semantics/publishe

Cryotherapy in the setting of parahissian pathways: report of four cases

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