7 research outputs found
Using neurobiological measures to predict and assess trauma-focused psychotherapy outcome in youth with posttraumatic stress disorder
In this thesis we examined different predictive neurobiological measures of traumafocused psychotherapy response and investigated the biological mechanisms underlying trauma-focused psychotherapy response in youth with PTSD. Our results suggest that activity of the major neuroendocrine stress response systems and brain functional connectivity before treatment are indeed associated with trauma-focused treatment response. Moreover, trauma-focused psychotherapy response seems to be related to longitudinal changes in autonomic nervous system activity during stress and brain structure. Together, these findings improve our understanding of the relationship between neurobiological measures and traumafocused psychotherapy response in youth with PTSD. However, these insights have currently limited to no clinical value because the current state of evidence does not support implementation of neurobiological biomarkers for treatment selection and necessary trials of (augmentation) treatments targeting neurobiological mechanisms related to treatment response have not been performed yet. The way forward now, is to perform individual prediction studies in less heterogeneous patient samples and to perform developmentally informed long-term studies examining (neuro) developmental trajectories related to PTSD and treatment response. These studies are necessary to address whether neurobiological measures can eventually improve treatment outcome and reduce the burden of PTSD in affected youth
'Rapid speed of response to ECT in bipolar depression: A chart review
Objective: To validate a faster speed of response to electroconvulsive therapy (ECT) for bipolar depression (BPD) compared to major depressive disorder (MDD) Method: Retrospective chart review on an ECT cohort in an academic hospital setting. Speed of response was defined by the number of ECT treatments needed for response or remission. Results: Sixty-four depressed patients were included, of whom 53 (MDD: 40, BPD: 13) could be analyzed. The bipolar group responded faster with a mean difference of 3.3 fewer ECT treatments to meet response criteria (MDD 10.4 vs. BPD 7.1, p = 0.054). When using mixed effects regression models for the response/remitter group (n = 35), a faster response for the bipolar group (AIC 252.83 vs 258.55, χ2 = 11.72, p = 0.008) was shown. Other factors, such as psychotic features or comorbidity, did not influence the speed of response. Conclusion: This chart review of an ECT cohort in an naturalistic academic hospital setting shows an evident and clinically relevant faster speed of response in bipolar depression
Pretreatment cortisol predicts trauma-focused psychotherapy response in youth with (partial) posttraumatic stress disorder
Trauma-focused psychotherapy response in youth with posttraumatic stress disorder is associated with changes in insula volume
Using neurobiological measures to predict and assess trauma-focused psychotherapy outcome in youth with posttraumatic stress disorder
In this thesis we examined different predictive neurobiological measures of traumafocused psychotherapy response and investigated the biological mechanisms underlying trauma-focused psychotherapy response in youth with PTSD. Our results suggest that activity of the major neuroendocrine stress response systems and brain functional connectivity before treatment are indeed associated with trauma-focused treatment response. Moreover, trauma-focused psychotherapy response seems to be related to longitudinal changes in autonomic nervous system activity during stress and brain structure. Together, these findings improve our understanding of the relationship between neurobiological measures and traumafocused psychotherapy response in youth with PTSD. However, these insights have currently limited to no clinical value because the current state of evidence does not support implementation of neurobiological biomarkers for treatment selection and necessary trials of (augmentation) treatments targeting neurobiological mechanisms related to treatment response have not been performed yet. The way forward now, is to perform individual prediction studies in less heterogeneous patient samples and to perform developmentally informed long-term studies examining (neuro) developmental trajectories related to PTSD and treatment response. These studies are necessary to address whether neurobiological measures can eventually improve treatment outcome and reduce the burden of PTSD in affected youth
Using neurobiological measures to predict and assess trauma-focused psychotherapy outcome in youth with posttraumatic stress disorder
In this thesis we examined different predictive neurobiological measures of traumafocused psychotherapy response and investigated the biological mechanisms underlying trauma-focused psychotherapy response in youth with PTSD. Our results suggest that activity of the major neuroendocrine stress response systems and brain functional connectivity before treatment are indeed associated with trauma-focused treatment response. Moreover, trauma-focused psychotherapy response seems to be related to longitudinal changes in autonomic nervous system activity during stress and brain structure. Together, these findings improve our understanding of the relationship between neurobiological measures and traumafocused psychotherapy response in youth with PTSD. However, these insights have currently limited to no clinical value because the current state of evidence does not support implementation of neurobiological biomarkers for treatment selection and necessary trials of (augmentation) treatments targeting neurobiological mechanisms related to treatment response have not been performed yet. The way forward now, is to perform individual prediction studies in less heterogeneous patient samples and to perform developmentally informed long-term studies examining (neuro) developmental trajectories related to PTSD and treatment response. These studies are necessary to address whether neurobiological measures can eventually improve treatment outcome and reduce the burden of PTSD in affected youth