Day: January 4, 2024

Categories : Pain ManagementTags :

Two Types of CBT are Equally Effective in Treating Fibromyalgia

On By ModernMedia
Photo by Andrea Piacquadio

There does not appear to be any profound differences between so-called exposure-based CBT and traditional CBT in the treatment of fibromyalgia, according to a study led by researchers at Karolinska Institutet. Both forms of treatment produced a significant reduction in symptoms in people affected by the disease. The study, one of the largest to date to compare different treatment options for fibromyalgia, is published in the journal PAIN.

About 2–4% of people live with fibromyalgia, a long-term pain syndrome that causes great suffering for patients through widespread pain, fatigue, and stiffness in the body. There is no cure for fibromyalgia and existing drugs often have insufficient effect, raising the need for more effective treatment methods.

Cognitive behavioural therapy (CBT) has shown some effect, but there is a lack of trained CBT practitioners. There is also a lack of knowledge about which form of CBT is most effective.

The study compared two different forms of internet-delivered cognitive behavioral therapy in terms of how well they reduce the symptoms and functional impact of fibromyalgia.

In brief, exposure-based CBT involves the participant systematically and repeatedly approaching situations, activities, and stimuli that the patient has previously avoided because the experiences are associated with pain, psychological discomfort, or symptoms such as fatigue and cognitive problems.

In traditional CBT, the participant is presented with several different strategies to work on during treatment, such as relaxation, activity planning, physical exercise, or strategies for managing negative thoughts and improving sleep.

The study showed that traditional CBT was by and large equivalent to the newer treatment form of exposure-based CBT.

“This result was surprising because our hypothesis, based on previous research, was that the new exposure-based form would be more effective. Our study shows that the traditional form can provide an equally good result and thus contributes to the discussion in the field,” says Maria Hedman-Lagerlöf, licensed psychologist and researcher at the Center for Psychiatry Research at the Department of Clinical Neuroscience, Karolinska Institutet.

The randomized study involved 274 people with fibromyalgia, who were randomly assigned to be treated with traditional or exposure-based CBT.

The treatments were delivered entirely online and all participants had regular contact with their therapist.

Participants answered questions about their mood and symptoms before, during, and after treatment.

After the 10-week treatment, 60% of those who received exposure-based CBT and 59% of those who received traditional CBT reported that their treatment had helped them.

“The fact that both treatments were associated with a significant reduction in the participants’ symptoms and functional impairment and that the effects were sustained for 12 months after completion of the treatment, indicates that the internet as a treatment format can be of great clinical benefit for people with fibromyalgia,” says Maria Hedman-Lagerlöf. “This is good news because it enables more people to access treatment.”

The study is the second largest to compare different psychological treatment options for fibromyalgia, according to the researchers.

“Our study is also one of the first to compare with another active, established psychological treatment,” says Maria Hedman-Lagerlöf.

Source: Karolinska Institutet

Categories : Mental HealthTags :

Losing a Parent in Childhood and Separation Anxiety in Women

On By ModernMedia
Photo by Joice Kelly on Unsplash

Women who lost a parent as children may be more likely to experience separation anxiety with romantic partners during adulthood, according to a study published in Stress and Health. In addition to feeling distressed when separated from their partners, these women may also experience anxious attachment, or worry that significant others will not be available at times of need.

The study included 60 women who lost one or both parents in their youth and 60 who had living parents. Based on participants’ answers to questionnaires, women who lost a parent reported higher levels of anxious attachment and adult separation anxiety from a partner. The groups did not differ, however, in terms of avoidant attachment, or the desire to maintain autonomy and emotional distance from their parents during childhood and from their partners during adulthood.

In women who lost a parent, adult separation anxiety and anxious attachment peaked in the initial five years of romantic relationships and gradually declined after a decade.

“A future study is suggested to delve into how the duration of a romantic relationship impacts separation anxiety and anxious attachment among women who have experienced early parental loss in childhood,” said corresponding author Ora Peleg, PhD, of the Max Stern Yezreel Valley College and the Academic College Emek Yezreel, in Israel.

Source: Wiley

Categories : Mental Health Surgeries & ProceduresTags :

No Mental Health Benefit from Bariatric Surgery for Young Patients

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Sleeve gastrectomy. Credit: Scientific Animations CC4.0

Young people who have had surgery for obesity do not improve their mental health despite significant and permanent weight loss. At the same time, bariatric surgery also increases the risk of early alcohol problems. This is according to the largest long-term study of young people who have undergone bariatric surgery, the results of which were published in Lancet Child and Adolescent Health.

The researchers studied mental health problems – before and after surgery – among all young people in Sweden who underwent bariatric surgery between 2007 and 2017. The study was conducted using register data, which enabled the scope of the study and facilitated comparisons with other groups in society. 

The study recruited 1554 adolescents (< 21 years) with severe obesity underwent bariatric surgery between 2007 and 2017, 1169 (75%) of whom were female. At time of surgery, the mean age was 19·0 years [SD 1·0], and the mean BMI was 43·7 kg/m2 (SD 5·5). They were matched with 15 540 adolescents from the general population.

It was found that young people who underwent surgery were more likely to have received treatment and medication for mental health problems already five years before the surgery.

“Although mental illness generally increases between the ages of 15 and 21, for this group the need for treatment increased faster than for young people in general”, says Kajsa Järvholm, Associate Professor of Psychology at Lund University.

Unfortunately, this pattern continued even after obesity surgery; the young people who had the surgery continued to have a greater need for mental health treatment than their peers. 

“Obesity surgery has very positive effects on weight, blood sugar and blood pressure control, but when it comes to mental health, it does not get better or worse after bariatric surgery”, says Martin Neovius, Professor of Clinical Epidemiology at Karolinska Institutet.

Additional findings from the new study include an increase in dependency diagnoses, particularly on alcohol, in the surgical group, both in comparison to pre-surgery and to young people in general.

The study is the largest long-term study in the world of young people who have had obesity surgery.

Source: Karolinska Institutet

Categories : Environmental EffectsTags :

Air Conditioning Kept Heat-related Deaths Down in Spain – for Those who Could Afford it

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Photo by Fandy Much

Air conditioning and heating systems have contributed considerably to reducing mortality linked to extreme temperatures in Spain, according to a new observational study. The findings, published in Environment International, provide valuable insights for designing policies to adapt to climate change.

Rising temperatures but lower mortality

Spain, like many parts of the world, has experienced rising temperatures in recent decades, with the average annual mean temperature increasing at an average rate of 0.36°C per decade.

The warming trend is even more pronounced in the summer months (0.40°C per decade). Surprisingly, this increase in temperature has coincided with a progressive reduction in mortality associated with heat.

In addition, cold-related mortality has also decreased.

“Understanding the factors that reduce susceptibility to extreme temperatures is crucial to inform health adaptation policies and to combat the negative effects of climate change,” says first author of the study, Hicham Achebak, researcher at ISGlobal and Inserm (France) and holder of a Marie Sklodowska-Curie Postdoctoral Fellowship from the European Commission.

Effective societal adaptations

In this study led by the Barcelona Institute for Global Health (ISGlobal), Achebak and colleagues analysed the demographic and socioeconomic factors behind the observed reduction in heat and cold-related mortality, despite rising temperatures.

They found that the increase in air conditioning (AC) prevalence in Spain was associated with a reduction in heat-related mortality, while the rise in heating prevalence was associated with a decrease in cold-related mortality.

Specifically, AC was found to be responsible for about 28.6% of the decline in deaths due to heat and 31.5% of the decrease in deaths due to extreme heat between the late 1980s and the early 2010s.

Heating systems contributed significantly, accounting for about 38.3% of the reduction in cold-related deaths and a substantial 50.8% decrease in extreme cold-related fatalities during the same period.

The decrease in mortality due to cold would have been larger had there not been a demographic shift towards a higher proportion of people aged over 65, who are more susceptible to cold temperatures.

The authors conclude that the reduction in heat-related mortality is largely the result of the country’s socioeconomic development over the study period, rather than specific interventions such as heat-wave warning systems.

Four decades of data

For the statistical analysis, the research team collected data on daily mortality (all causes) and weather (temperature and relative humidity) for 48 provinces in mainland Spain and the Balearic Islands, between January 1980 and December 2018.

These data were then linked to 14 indicators of context (demographic and socioeconomic variables such as housing, income and education) for these populations over the same period.

Implications for climate adaptation

The results of the study extend previous findings on heat-related mortality in Spain and underscore the importance of air conditioning and heating as effective adaptation measures to mitigate the effects of heat and cold.

“However, we observed large disparities in the presence of AC across provinces. AC is still unaffordable for many Spanish households,” says Achebak.

The authors also point out that the widespread use of AC could further contribute to global warming depending on the source of electricity generation, which is why other cooling strategies, such as expanding green and blue spaces in cities, are also needed.

“Our findings have important implications for the development of adaptation strategies to climate change. They also inform future projections of the impact of climate change on human health,” concludes Joan Ballester, ISGlobal researcher and study coordinator.

Source: Barcelona Institute for Global Health (ISGlobal)

Categories : Neurodegenerative Diseases NeurologyTags :

Could Stimulating Gamma Brain Waves Help Treat Alzheimer’s?

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Photo by JD Mason on Unsplash

A review in the Journal of Internal Medicine explores the potential of non-invasive interventions such as light, sound, and magnets to stimulate gamma brain waves for the treatment of Alzheimer’s disease. Such strategies may be beneficial because Alzheimer’s disease is characterised by reduced fast brain oscillations in the gamma range (30–100Hz).

The authors note that recent studies reveal that it is feasible and safe to induce 40Hz brain activity in patients with Alzheimer’s disease through a range of methods. Also, preliminary evidence suggests that such treatment can yield beneficial effects on brain function, disease pathology, and cognitive function in patients.

Various cells in the brain beyond neurons, including microglial cells, astrocytes and vascular cells, seem to be involved in mediating these effects.

“We found that increased gamma activity elicited by the non-invasive 40Hz sensory stimulation profoundly alters the cellular state of various glial cell types,” said corresponding author Li-Huei Tsai, PhD, of MIT. “We are actively investigating the mechanism by which the 40Hz brain activity recruits diverse cell types in the brain to provide neuroprotective effects.”

Source: Wiley