Mindfulness-baseret kognitiv terapi i en sundhedspsykologisk kontekst: effektstudier og kliniske betragtninger fra Enhed for Psykoonkologi og Sundhedspsykologi

Mindfulness-based cognitive therapy (MBCT) was originally developed to prevent recurrent depression, but may also be of relevance for patient groups in the field of health psychology. The present paper gives a descriptive overview of clinical trials conducted at theUnit for Psychooncology and Health Psychology (EPoS) with the overall purpose of exemplifying research-related and clinical considerations in the field. Our studies indicate that a generic application of MBCT reduces pain intensity among women treated for breast cancer,as well as depression symptoms related to spousal bereavement in old age. Furthermore, ongoing studies will yield results on the effect of disease-specific versions of MBCT adjusted to the special needs of other populations in the field of health psychology. Finally, the importance of MBCT instructor qualification is briefly discussed and specific experiencesin relation to how these qualification criteria can be met are described

VII Scandinavian Copd Research Symposium, Holmenkollen, Oslo 18th-19th November 2016

Peer reviewe

Data from: Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis

Objective: To evaluate the evidence on the efficacy of psychosocial interventions for improving pregnancy rates and reducing distress for couples in treatment with assisted reproductive technology (ART). Design: Systematic review and meta-analysis. Data sources PsycINFO, PubMed, Embase, CINAHL, Web of Science and The Cochrane Library between 1978 and April 2014. Study selection Studies were considered eligible if they evaluated the effect of any psychosocial intervention on clinical pregnancy and/or distress in infertile participants, used a quantitative approach, and were published in English. Data extraction Study characteristics and results were extracted and the methodological quality assessed. Effect sizes (Hedges g) were pooled using a random effect model. Heterogeneity was assessed using the Q statistic and I2, and publication bias evaluated using Eggers’ method. Possible moderators and mediators were explored with meta-ANOVAs and meta-regression. Results We identified 39 eligible studies (total N = 2746 men and women) assessing the effects of psychological treatment on pregnancy rates and/or adverse psychological outcomes, including depressive symptoms, anxiety, infertility stress, and marital function. Statistically significant and robust overall effects of psychosocial intervention were found for both clinical pregnancy (RR = 2.01; CI: 1.48-2.73; p<0.001) and combined psychological outcomes (Hedges g=0.59; CI: 0.38-0.80; p=0.001,). The pooled effect sizes (ES) for psychological outcomes were generally larger for women (g: 0.51-0.73) than men (0.13-0.34), but the difference only reached statistical significance for depressive symptoms (p=0.004). Meta-regression indicated that larger reductions in anxiety were associated with greater improvement in pregnancy rates (Slope: 0.19; p=0.004). No clear-cut differences were found between effects of cognitive behavioral therapy (CBT) (g=0.84), mind-body interventions (0.61), and other intervention types (0.50). Conclusion The present meta-analysis suggests that psychosocial interventions for couples in treatment for infertility, in particular CBT, could be efficacious, both in reducing psychological distress and in improving clinical pregnancy rates

Search history v7

Search history v

Figure 1 PRISMA flowchart

Figure 1 PRISMA flowchar

Nonpharmacological management of psychological distress in people with COPD

Psychological distress is prevalent in people with COPD and relates to a worse course of disease. It often remains unrecognised and untreated, intensifying the burden on patients, carers and healthcare systems. Nonpharmacological management strategies have been suggested as important elements to manage psychological distress in COPD. Therefore, this review presents instruments for detecting psychological distress in COPD and provides an overview of available nonpharmacological management strategies together with available scientific evidence for their presumed benefits in COPD. Several instruments are available for detecting psychological distress in COPD, including simple questions, questionnaires and clinical diagnostic interviews, but their implementation in clinical practice is limited and heterogeneous. Moreover, various nonpharmacological management options are available for COPD, ranging from specific cognitive behavioural therapy (CBT) to multi-component pulmonary rehabilitation (PR) programmes. These interventions vary substantially in their specific content, intensity and duration across studies. Similarly, available evidence regarding their efficacy varies significantly, with the strongest evidence currently for CBT or PR. Further randomised controlled trials are needed with larger, culturally diverse samples and long-term follow-ups. Moreover, effective nonpharmacological interventions should be implemented more in the clinical routine. Respective barriers for patients, caregivers, clinicians, healthcare systems and research need to be overcome