Bridging the gap: low intensity collaborative care for patients with recent cardiac events can improve mental health and quality of life

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There are many interfaces in mental health services, such as the one between physical and mental health. Where there are interfaces, there are inevitably gaps for patients to fall through. Consequently opportunities are missed to treat mental health problems in those with physical health problems. There is mounting evidence for the effectiveness of Collaborative Care (CC) [read the full story...]

RCT shows CBT is more effective than psychoanalytic psychotherapy for treating bulimia nervosa, but that’s only half the story

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I had actually heard about this Danish study, published recently by Poulsen et al. (2014) in the American Journal of Psychiatry, before it landed in my inbox. The findings are interesting because they highlight the debate surrounding the comparative efficacy of psychological treatments. What is most striking though, is how the study itself challenges the [read the full story...]

CBT is more cost-effective than SSRI alone as treatment for panic disorder

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In addition to its impact on quality of life, panic disorder can have a number of costly consequences such as lost productivity – particularly if also associated with agoraphobia. Cost-effectiveness is therefore an important consideration in choosing the optimal treatment for panic disorder, which might improve value via the cost side of the equation. A recent [read the full story...]

Off to a good start. Are self-help interventions effective for people with comorbid physical and mental health problems?

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The ideal treatment for common mental health problems in those with chronic physical illness would have to be reliable, easy to deliver, inexpensive and accessible by a group of people whose physical impairment may affect treatment adherence. NICE guidelines (CG90 Depression; the treatment and management of depression in adults) recommend self-help interventions (SHIs) based on [read the full story...]

Is the Dodo finally dead?

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There’s been a lot of chatter here in the woodlands about the role of cognitive behavioural therapy (CBT) in psychosis – what do service users think of it? Can it be used in place of antipsychotics for some people? Outside of the woodlands, CBT for psychosis has also been generating a lot of attention: Does [read the full story...]

Does group CBT treatment reduce social anxiety disorder? Possibly, perhaps, maybe not!

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Social Anxiety Disorder used to be called Social Phobia and is generally regarded as the most prevalent form of common anxiety disorder. Estimates of lifetime prevalence vary but according to a US study, 12% of adults in the US will have social anxiety disorder at some point in their lives (Kessler et al, 2005). According [read the full story...]

CBT and motivational interviewing are effective treatments for comorbid alcohol use disorders and depression, says new meta-analysis

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Alcohol use disorder is frequently comorbid with major depressive disorder, and the disease burden associated with this dual diagnosis is considerably greater than that attributed to each disorder in isolation. This creates a problem for clinicians who are trying to treat depressed problem drinkers, because many services are set up to deal with only one [read the full story...]

Service user perspectives on individual CBT for psychosis

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I have been procrastinating about writing this blog for a while. This is, in part, caused by hesitancy about involving myself in the CBT for psychosis (CBTp) debate. Regular readers of the Mental Elf will be aware that in recent months Jauhar and colleagues presented results of a meta-analysis that called into question the effectiveness [read the full story...]

The dark side of universal prevention: Limited effectiveness and harmful effects of classroom-based CBT in preventing adolescent depression

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Depression is a common problem in adolescence, with statistics showing that around 20% of young people will go through at least one clinically depressive episode by the age of 18 years. Given the significant impairment and deleterious consequences of depression, sustained efforts have been dedicated to preventive and early intervention. In a recent large trial [read the full story...]

Psychosis and schizophrenia in adults: updated NICE guidance for 2014

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While the organisation’s name may change frequently, currently National Institute for Health and Care Excellence (NICE), its role remains constant – to provide clear published guidance on the role of treatment options within the NHS. The publication of new NICE guidance represents a significant event as clinical recommendations shape the nature of provided care nationally [read the full story...]