Change in quality of life and their predictors in the long-term follow-up after group cognitive behavioral therapy for social anxiety disorder: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Social anxiety disorder (SAD) is one of the most common anxiety disorders. The efficacy of cognitive behaviour therapy (CBT) has been examined but to date its effects on Quality of Life (QoL) have not been appropriately evaluated especially in the long term.</p> <p>The study aimed to examine, in the long term, what aspects of Quality of Life (QoL) changed among social anxiety disorder (SAD) patients treated with group cognitive behaviour therapy (CBT) and what predictors at baseline were associated with QoL.</p> <p>Methods</p> <p>Outpatients diagnosed with SAD were enrolled into group CBT, and assessed at follow-ups for up to 12 months in a typical clinical setting. QoL was evaluated using the Short Form 36. Various aspects of SAD symptomatology were also assessed. Each of the QoL domains and scores on symptomatology were quantified and compared with those at baseline. Baseline predictors of QoL outcomes at follow-up were investigated.</p> <p>Results</p> <p>Fifty-seven outpatients were enrolled into group CBT for SAD, 48 completed the whole program, and 44 and 40 completed assessments at the 3-month and 12-month follow-ups, respectively. All aspects of SAD symptomatology and psychological subscales of the QoL showed statistically significant improvement throughout follow-ups for up to 12 months. In terms of social functioning, no statistically significant improvement was observed at either follow-up point except for post-treatment. No consistently significant pre-treatment predictors were observed.</p> <p>Conclusions</p> <p>After group CBT, SAD symptomatology and some aspects of QoL improved and this improvement was maintained for up to 12 months, but the social functioning domain did not prove any significant change statistically. Considering the limited effects of CBT on QoL, especially for social functioning, more powerful treatments are needed.</p

Design and performance of hybrid constructed wetland systems for high-content wastewater treatment in the cold climate of Hokkaido, northern Japan

The performance of six multistage hybrid constructed wetland systems was evaluated. The systems were designed to treat four kinds of high-content wastewater: dairy wastewater (three systems, average inflow content 2,400-5,000 mg.COD l(-1), 3-6 years of operation); pig farm wastewater, including liquid food washing wastewater (one system, 9,500 mg.COD l(-1), 3 years); potato starch processing wastewater (one system, 20,000-60,000 mg.COD l(-1), 3 years); and wastewater containing pig farm swine urine (one system, 6,600 mg.COD l(-1), 2.8 years) (COD chemical oxygen demand). The systems contained three or four vertical (V) flow beds with self-priming siphons and surface partitions and no or one horizontal (H) flow bed (three to five beds). In some V flow beds, treated effluents were recirculated (Vr) through the inlet to improve performance. Mean annual temperature was 5-8 degrees C at all locations. To overcome clogging due to the high load in a cold climate, we applied a safety bypass structure and floating cover material to the V flow beds. Calculated average oxygen transfer rates (OTRs) increased proportionally with the influent load, and the OTR value was Vr > V > H. The relations of load-OTR, COD-ammonium, and a Arrhenius temperature-dependent equation enable the basic design of a reed bed system

Cognitive-behavioral therapy modifies the naturalistic course of social anxiety disorder: findings from an ABA design study in routine clinical practices

AIMS: While randomized evidence appears to have established efficacy of cognitive-behavioral therapy (CBT) and some pharmacotherapy for social anxiety disorder (SAD), their real-world effectiveness has been called into question by long-term naturalistic cohort studies of patients with SAD as they show very low probability of recovery and sustained social dysfunctions despite some drug and psychological therapies. METHOD: The present study examines the effectiveness of group CBT for SAD in real-world settings (n=62) by examining the course of patients' symptomatology and social functions through approximately 6 months on the waiting list, through 6 months receiving the manualized group CBT intervention consisting of 16 2-h sessions, and for 12 months after the treatment. RESULTS: We found: (i) that the patients with SAD changed little or possibly worsened through the 6 months on the waiting list, although two in three of them were on antidepressants, benzodiazepines or both; (ii) that both their symptomatology and social function improved significantly and substantively through the group CBT; and (iii) that this improvement was maintained through the 3- and 12-month follow ups. CONCLUSIONS: We can implement and must disseminate evidence-based, effective CBT for more patients with SAD to lessen their suffering and stop the perpetuation of their symptoms.Toshi A. Furukawa, Yumi Nakano, Tadashi Funayama, Sei Ogawa, Tetsuji Ietsugu, Yumiko Noda, Junwen Chen, Norio Watanabe, Tatsuo Akech

Morphology of the vas deferens in an ethanol-drinking strain of rats (UChA and UChB)

Chronic alcoholism alters reproduction and therefore may be responsible for alterations of vas deferens, which are the subject of this analysis in UCh ethanol-drinking rats. The proximal and distal segments of the vas deferens of 20 animals were submitted to macroscopic, light microscopy, electron microscopy and morphometric analysis. The UCh rats showed atrophy of the epithelium of the vas deferens and alterations of the hypothalamus-pituitary axis. Ethanol induces changes in the epithelium of the vas deferens and hypothalamus-pituitary axis of UCh rats