Analysis of the Role of Cognitive Behavioral Therapy on Self-Care in Thyroid Cancer Patients

Objective:To explore the effect of cognitive behavioral therapy on self-care in thyroid cancer patients.Methods:A total of 144 thyroid cancer patients treated at the Affiliated Hospital of Hebei University from January 2022 to August 2023 were selected as research subjects.Using the random number table method,they were divided into a control group and an experimental group,each consisting of 72 cases.The control group received routine nursing intervention,while the experimental group received cognitive behavioral therapy based on standard nursing practices.The self-care ability(self-concept,self-efficacy,self-care skills,health knowledge level),coping style(confrontation,avoidance,and surrender),and quality of life(psychological function,social function,material life,physical function)of both groups before and after the intervention were compared.Results:In comparison to the pre-intervention period,the experimental group exhibited significantly higher self-care ability,quality of life,and confrontation scores after the intervention,as opposed to the control group.Additionally,the avoidance and surrender scores were lower in the experimental group than in the control group,with these differences proving to be statistically significant(P<0.01).Conclusion:The application of cognitive behavioral therapy can enhance the self-care ability of thyroid cancer patients,aid in better disease coping,and improve their overall quality of life.This approach is deserving of further promotion.

Evaluation of a culturally adapted cognitive behavior therapy-based,third-wave therapy manual

BACKGROUND Recommendations for psychotherapy have evolved over the years,with cognitive behavioral therapy(CBT)taking precedence since its inception within clinical guidelines in the United Kingdom and United States.The use of CBT for severe mental illness is now more common globally.AIM To investigate the feasibility and acceptability of a culturally adapted,CBT-based,third-wave therapy manual using the Comprehend,Cope,and Connect approach with individuals from a diverse population presenting to primary and secondary healthcare services.METHODS A pilot study was used to assess the feasibility and acceptability of the manualised intervention.Outcome measures were evaluated at baseline,post-intervention and 12 wk-follow up.32 participants with mental health conditions aged 20-53 years were recruited.Assessments were completed at three time points,using Clinical Outcomes in Routine Evaluation(CORE),Hospital Anxiety and Depression Scale(HADS),Bradford Somatic Inventory and World Health Organization Disability Assessment Schedule 2.0(WHODAS).The Patient Experience Questionnaire was completed post-treatment.RESULTS Repeated measures of analysis of variance associated with HADS depression,F(2,36)=12.81,P<0.001,partialη^(2)=0.42 and HADS anxiety scores,F(2,26)=9.93,P<0.001,partialη^(2)=0.36;CORE total score and WHODAS both showed significant effect F(1.25,18.72)=14.98,P<0.001,partialη^(2)=0.5.and F(1.29,14.18)=6.73,P<0.001,partialη^(2)=0.38 respectively.CONCLUSION These results indicate the effectiveness and acceptability of the culturally adapted,CBT-based,third-wave therapy manual intervention among minoritized groups with moderate effect sizes.Satisfaction levels and acceptability were highly rated.The viability and cost-effectiveness of this approach should be explored further to support universal implementation across healthcare systems.

Effect of cognitive behavior therapy training and psychological nursing on the midwifery process in the delivery room

BACKGROUND The severe physical and psychological impact of pain on the physical and mental health of women during labor leads to increased risks and complications during childbirth,presenting a major public health concern.Some studies have shown that cognitive behavioral therapy(CBT)has a positive effect on maternal psychology during delivery,reducing stress and shortening labor time.Thus,CBT training for mothers and delivery room staff may be beneficial in minimizing complications and adverse effects during natural birth.AIM To investigate the clinical effects of CBT training and psychological care during delivery,and their therapeutic effects on women in labor.METHODS This study used a retrospective analysis and included 140 mothers admitted to the maternity ward between January 2021 and January 2023.The study subjects were randomized into two groups:control(n=70)and observation(n=70).Routine care,CBT training,and psychological care were provided to mothers in both groups.Psychological status scores,delivery time,and satisfaction with care pre-and post-delivery were compared,and the incidence of complications after receiving care was analyzed between the two groups.RESULTS Although the psychological state of both groups improved significantly in the late stages of labor,the psychological state scores of the mothers in the observation group were significantly lower than those of the mothers in the control group(P<0.05).The duration of labor and incidence of complications in the observation group were significantly lower than those in the control group(P<0.05).The mothers in the observation group were significantly more satisfied with nursing care during the course of labor than those in the control group(P<0.05).CONCLUSION CBT training and psychological care for mothers in the midwifery process can effectively improve anxiety and depression,shorten labor duration,reduce postnatal complications,and improve nursing satisfaction and nurse-patient relationships.Its clinical application is effective and has popularization value,providing a new way to protect maternal mental health.

Research status of internet-delivered cognitive behavioral therapy in cancer patients

The latest global cancer burden data released by the International Agency for Research on Cancer of the World Health Organization in 2020 shows that there were 19.29 million new cancer cases worldwide,with 4.57 million in China,ranking first.The number of cancer survivors is increasing,with a 5-year survival rate exceeding 85%,but there are emotional disorders.Cognitive behavioral therapy(CBT)can improve negative emotions and has significant effects on patients.However,there is a limited number of physicians and high costs,so internet interventions have become a solution.The feasibility of web-based interventions for breast cancer patients has been proven.Research on internet-delivered CBT is also increasing.The purpose of this study was to review the concept of web-based CBT and its application status in cancer survivors,in order to provide relevant intervention for scholars and provide reference and supplement for patients to provide psychological therapy.

Effect of cognitive behavioral group therapy on rehabilitation of community patients with schizophrenia:A short-term randomized control trial

BACKGROUND The efficacy of cognitive behavioral group therapy(CBGT)for cognitive dysfunction and negative symptoms of schizophrenia is established,but more evidence is required.AIM To assess the effectiveness of CBGT combined with mental health education as a treatment for schizophrenia compared with mental health education alone.METHODS In all,120 schizophrenia out-patients were randomized into CBGT combined with mental health education or single mental health education.The primary outcomes were positive and negative symptoms,cognitive function,excitatory factor,anxiety and depression symptom improvements on the positive and negative syndrome scale score.Secondary outcome measures included social function and drug compliance.RESULTS There were significant differences between CBGT combined with mental health education and single mental health education on measures of positive and negative symptoms,cognitive functions,excitatory factor,anxiety and depression symptoms,and social functions.No other significant difference in outcomes was observed.CONCLUSION CBGT combined with mental health education may be relevant beneficial treatment method in reducing symptoms,cognitive and social functions of patients with schizophrenia.

Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients

BACKGROUND Irritable bowel syndrome(IBS)is a common digestive system disease with a high incidence rate and is common in women.The cause of IBS remains unclear.Some studies have shown that mental and psychological diseases are independent risk factors for IBS.At present,the treatment of IBS is mainly symptomatic treatment.Clinically,doctors also use cognitive behavioral therapy to improve patients'cognitive ability to diseases and clinical symptoms.In recent years,exercise therapy has attracted more and more attention from scholars.Improving the symptoms of IBS patients through psychosomatic treatment strategy may be a good treatment method.AIM To explore the effects of an intervention of cognitive behavioral therapy combined with exercise(CBT+E)on the cognitive bias and coping styles of patients with diarrhea-predominant irritable bowel syndrome(IBS-D);and to provide a theoretical reference for the management of IBS.METHODS Sixty IBS-D patients and thirty healthy subjects were selected.The 60 IBS-D patients were randomly divided into experimental and control groups.The experimental group was treated with the CBT+E intervention,while the control group was treated with conventional drugs without any additional intervention.The cognitive bias and coping styles of the participants were evaluated at baseline and after 6 wk,12 wk and 24 wk using the Automatic Thoughts Questionnaire(ATQ),Dysfunctional Attitudes Scale(DAS)and Pain Coping Style Questionnaire(CSQ)instruments,and the intervention effect was analyzed using SPSS 17.0 statistical software.RESULTS At baseline,the scores on the various scales showed that all subjects had cognitive bias and adverse coping styles.The IBS Symptom Severity Scale(IBSSSS)scores,ATQ total scores,DAS scores and CSQ scores of the two groups were not significantly different(P>0.05).Compared with baseline,after 6 wk of the CBT+E intervention,there were significant differences in the ATQ scores,the dependence and total scores on the DAS,and the catastrophization,distraction and prayer scores on the CSQ(P<0.05).After 12 wk,there were significant differences in the scores for perfectionism on the DAS and in the scores for reinterpretation,neglect and pain behavior on the CSQ in the experimental group(P<0.05).After 24 wk,there were significant differences in the vulnerability,dependence,perfectionism,and total scores on the DAS and in the catastrophization,distraction and prayer scores on the CSQ in the experimental group(P<0.01).The IBS-SSS scores were negatively correlated with the ATQ and DAS total scores(P<0.05)but were positively correlated with the CSQ total score(P<0.05).CONCLUSION Intervention consisting of CBT+E can correct the cognitive bias of IBS-D patients and eliminate their adverse coping conditions.CBT+E should be promoted for IBS and psychosomatic diseases.

P300 change and cognitive behavioral therapy in subjects with Internet addiction disorder A 3-month follow-up study

Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls （N2： P = 0.035; P3a： P = 0.031 P3b： P = 0.043） and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b （P3a： P = 0.045; P3b： P = 0.062）. These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.

Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease:A metaanalysis

BACKGROUND Recently,the efficacy of cognitive behavioral therapy(CBT)-based intervention on health outcomes in patients with coronary heart disease(CHD)has been recognized in randomized controlled trials(RCTs),but no comprehensive systematic review has been conducted.To address this research gap,our study aimed to evaluate whether comprehensive CBT-based interventions positively affect health outcomes in CHD patients.It was hypothesized that CBT-based interventions are effective in:(1)Reducing depression,anxiety,and stress symptoms;(2)Reducing body mass index,blood pressure,and lipid levels;and(3)Improving quality of life,and exercise endurance.AIM To verify the effectiveness of CBT-based interventions on CHD patients through a meta-analysis of previous publications.METHODS Relevant RCTs published in English were obtained by searching electronic databases,including PubMed,Embase,Cochrane Central Register of Controlled Trials,Scopus,and Proquest,with the retrieval time from inception to August 2020.The primary outcomes were psychological factors(depression,anxiety,and stress symptoms),physiological factors(body mass index,blood pressure,blood lipids).The secondary outcomes included quality of life and exercise endurance.We used Review Manager 5.3 to conduct the meta-analysis and used the Physiotherapy Evidence Database tool to evaluate the quality of studies.RESULTS A total of 22 RCTs comprising 4991 patients with CHD were included in the systematic review and meta-analysis.The main analysis revealed that CBT-based intervention can reduce depression symptoms:-2.00[95%confidence interval(CI):-2.83 to-1.16,P<0.001];anxiety symptoms:-2.07(95%CI:-3.39 to-0.75,P=0.002);stress symptoms:-3.33(95%CI:-4.23 to-2.44,P<0.001);body mass index:-0.47(95%CI:-0.81 to-0.13,P=0.006);and improve physical functioning:3.36(95%CI:1.63 to 5.10,P=0.000)and mental functioning:6.91(95%CI:4.10 to 9.73,P<0.001).Moreover,subgroup analysis results showed that CBT-based interventions were more effective for symptoms of depression and anxiety in CHD patients when individual,as opposed to group treatment,and psycho-education,behavioral and cognitive strategies were applied as the core treatment approaches.CONCLUSION CBT-based interventions are effective treatment strategies for CHD patients,significantly improving their symptoms of depression,anxiety and stress,body mass index,and health-related quality of life.

Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study

Objectives:The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide.Since April 2016,Japanese national health insurance has covered nurseadministered cognitive behavioral therapy(CBT)for mood disorders.However,empirical support for nurse-led CBT for depression in Asian countries,especially in Japan,is still lacking.This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression.Methods:In this single-arm study,we evaluated the effects of a 6-week group CBT,led by trained nurses,on patients with major depression.The primary outcome was the Beck Depression Inventory-Ⅱ(BDI-Ⅱ).Assessments were conducted at the beginning and end of the intervention.Results:Of 25 participants screened,23 were eligible for the study(of these,three dropped out during the trial but were included in the analysis).Nurse-led group CBT led to significant improvements in the severity of depression(BDI-Ⅱ,P<0.001).The mean total BDI-Ⅱscore improved from 23.1(SD=7.56)to 12.4(SD=8.57),and the pre-to post-effect size was large(Cohen's d=1.33).After CBT,45%of the participants were judged to be treatment responders,and 34%met the remission criteria.Conclusions:Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting.The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice.Further controlled trials that address the limitations of this study are required.

Effectiveness of cognitive behavior therapy for sleep disturbance and glycemic control in persons with type 2 diabetes mellitus:A community-based randomized controlled trial in China

BACKGROUND Poor sleep quality is a common clinical feature in patients with type 2 diabetes mellitus(T2DM),and often negatively related with glycemic control.Cognitive behavioral therapy(CBT)may improve sleep quality and reduce blood sugar levels in patients with T2DM.However,it is not entirely clear whether CBT delivered by general practitioners is effective for poor sleep quality in T2DM patients in community settings.AIM To test the effect of CBT delivered by general practitioners in improving sleep quality and reducing glycemic levels in patients with T2DM in community.METHODS A cluster randomized controlled trial was conducted from September 2018 to October 2019 in communities of China.Overall 1033 persons with T2DM and poor sleep quality received CBT plus usual care or usual care.Glycosylated hemoglobin A1c(HbAlc)and sleep quality[Pittsburgh Sleep Quality Index(PSQI)]were assessed.Repeated measures analysis of variance and generalized linear mixed effects models were used to estimate the intervention effects on hemoglobin A1c and sleep quality.RESULTS The CBT group had 0.64,0.50,and 0.9 lower PSQI scores than the control group at 2 mo,6 mo,and 12 mo,respectively.The CBT group showed 0.17 and 0.43 lower HbAlc values than the control group at 6 mo and 12 mo.The intervention on meanΔHbAlc values was significant at 12 mo(t=3.68,P<0.01)and that meanΔPSQI scores were closely related toΔHbAlc values(t=7.02,P<0.01).Intentionto-treat analysis for primary and secondary outcomes showed identical results with completed samples.No adverse events were reported.CONCLUSION CBT delivered by general practitioners,as an effective and practical method,could reduce glycemic levels and improve sleep quality for patients with T2DM in community.

The Effect of the Group Cognitive Behavior Therapy in a Nurse’s Burnout and Intention to Resign

Purpose: The purpose of the present study was to decrease burnout and intention to resign by practicing cognitive behavioral approach to nurses of the 3 years nursing clinical experience. Methods: Nurses (N = 180) who worked at acute-care hospitals and whose clinical experience was 3 years were requested. Nurses (n = 95, male 5, female 90) who were able to do participation at all the sessions were objects. The program was created and carried out for a nurse’s burnout with reference to cognitive behavior therapy. Evaluation of intervention was asked to complete a questionnaire that measured burnout (MBI), job stressors (NJSS), automatic thoughts (the shorter version of Japanese version ATQ-R), Irrational Belief Test for Nurses (IBTN), coping measure and whether or not they had an intention to resign. Measurement was performed 3 times of a baseline, after the end of session and follow-up. Analysis of covariance which adjusted the baseline level was performed. Result: According to the results, “helplessness”, “positive thinking” and “personal accomplishment” were significant (p < 0.01). According to the results of Friedman test, significant difference was observed in “emotional exhaustion” in the group with low degree of irrational belief (p < 0.10 ) and in the group with high degree (p < 0.05). With regard to the intention to leave the job, “wants to continue working as a nurse” was significant in the group in 3 months after intervention (p < 0.05). Conclusion: It is suggested that cognitive behavioral approach appears to be effective for reducing nurse’s burnout or intention to resign in nurses of the 3 years nursing clinical experience.

Effect of cognitive behavioral therapy on anxiety and depression of infertile women: A meta-analysis

Objective:To investigate the effect of cognitive behavioral therapy on anxiety and depression in infertile women.Methods:This study was performed in 2019 by searching Google Scholar,Scopus,PubMed/MEDLINE,Cochrane library,EMBASE,Proquest,ISI Web of Science,MagIran,SID and IranMedex.Eligible studies were selected by two reviewers and outcomes of interest were extracted.The meta-analysis was performed using the random effect models.Ⅰ-square statistic test was used for heterogeneity analysis.Presence of publication bias was also checked.Results:Eleven studies were included in this review.Between-group differences(cognitive behavioral therapy and control groups)in risk ratio for infertile women's depression was d=-1.36;95%CI=-1.81,-0.90;P<0.001.For infertile women's anxiety,between-group differences in risk ratio wasd=-0.83;95%CI=-1.18,-0.47;P<0.001.Conclusions:Cognitive behavioral therapy is effective in the reduction of depression and anxiety in patients with or withoutin vitro fertilization/intracytoplasmic sperm injection treatment.However,the lack of high-quality studies makes it challenging to make a solid and precise conclusion.Well-designed studies should be undertaken in the future to confirm these results.

Mindfulness-Based Cognitive Therapy: A Case Study on Experiences of Healthy Behaviors by Clients in Psychiatric Care

The aim of the study was for the first time to investigate patients’ own experiences of developing healthy behavior in connection with their participation in Mindfulness-Based Cognitive Therapy (MBCT). Healthy behaviors were defined as those which aimed to improve the individual’s well-being and physical function. Two women, diagnosed with bipolar illness or depressive episodes, were recruited from a group of clients in psychiatric care who both had been treated according to MBCT. The two clients shared their views of what changes they experienced during the treatment in semi structured interviews. Data analysis was performed according to the Empirical Phenomenological Psychological (EPP) method. The analysis generated five main themes which were shown to create a causal chain where paths to healthy behavior contributed to a process of change which was mirrored in comprehensive distancing, which in turn facilitated a reduced tendency of illness-identity and the acquiring of new proficiencies which could be generalized to different situations in daily life which led to insights about healthier behavior.

Cognitive behavioral therapy on personality characteristics of cancer patients

BACKGROUND The main treatment methods for cancer include surgery,radiotherapy,chemotherapy,targeted drug therapy and so on.Patients often feel anger,anxiety,depression,and other negative psychological reactions in the process of treatment.AIM To explore the effects of cognitive behavioral therapy on the personality characteristics of cancer patients.METHODS According to the matching design requirements,150 cancer patients were divided into 3 groups based on sex,age,condition,and cultural background.Patients in the control group received conventional treatment.Patients in experimental group 1 received an intervention based on conventional treatment combined with cognitive behavioral therapy.Patients in experimental group 2 received family members'participation in addition to the treatment given in experimental group 1.An Eysenck personality questionnaire was used to investigate all the patients before and after the intervention,and the scores for psychosis,introversion,neuroticism,and concealment degree were analyzed.RESULTS Compared with the control group,for experimental group 1 and experimental group 2 before and after the intervention,the four dimensions of mental quality,neuroticism,introversion and concealment degree all decreased,and the difference was statistically significant(P<0.05).After the intervention,there were no obvious or statistically significant differences(P>0.05)among the control group,experimental group 1,and experimental group 2 for two personality traits,psychoticism and neuroticism,both inside and outside degree and all four dimensions.CONCLUSION Simple cognitive behavioral therapy could not change the personality characteristics of cancer patients quickly,but the patients’personality characteristics were significantly improved after treatment.

Effects of Religious vs. Conventional Cognitive-Behavioral Therapy on Inflammatory Markers and Stress Hormones in Major Depression and Chronic Medical Illness: A Randomized Clinical Trial

Background: Depressive disorder is often accompanied by physiological changes that may adversely affect the course of medical illness, including an increase in pro-inflammatory cytokines. Methods: We examine the effects of religious cognitive behavioral therapy (RCBT) vs. conventional CBT (CCBT) on pro-/anti-inflammatory indicators and stress hormones in 132 individuals with major depressive disorder (MDD) and chronic medical illness who were recruited into a multi-site randomized clinical trial. Biomarkers (C-reactive protein and pro-inflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6, IL-12-p70), anti-inflammatory cytokines (IL1ra, IL-4, IL-10), and stress hormones (urinary cortisol, epinephrine, norepinephrine) were assessed at baseline, 12 weeks, and 24 weeks. Differential effects of baseline religiosity on treatment response were also examined, along with effects of religiosity on changes in biomarkers over time independent of treatment group. Biomarker levels were log transformed where possible to normalize distributions. Mixed models were used to examine trajectories of change. Results: CRP increased and IL-4, IL-10, and epinephrine decreased over time, mostly in the opposite direction expected (except epinephrine). No significant difference between RCBT and CCBT was found on average trajectory of change in any biomarkers. Religiosity interacted with treatment group in effects on IL-6, such that CCBT was more effective than RCBT in lowering lL-6 in those with low religiosity whereas RCBT appeared to be more effective than CCBT in those with high religiosity. Higher baseline religiosity also tended to predict an increase in pro-inflammatory cytokines INF-γ and IL-12 (p70) and urinary cortisol over time. Conclusions: RCBT and CCBT had similar effects on stress biomarkers. CCBT was more effective in reducing IL-6 levels in those with low religiosity, whereas RCBT tended to be more effective in those with high religiosity. Unexpectedly, higher baseline religiosity was associated with an increase in several stress biomarkers.

Applicability Evaluation of Simplified Cognitive Behavioral Therapy

背景:我们在国内较早开展并研发了针对焦虑症的结构化认知行为治疗操作手册,本研究在前期研究基础上对简化认知行为治疗的适宜性进行评价。目的:通过多中心临床对照实验,评价简化认知行为治疗(Simplified Cognitive Behavioral Therapy,SCBT)的适宜性。方法:通过来自不同级别的精神卫生专科医疗机构和综合医院精神科等多个中心,对广泛性焦虑患者进行SCBT的临床对照研究,分为3组:SCBT组,SCBT+药物组和药物组。比较三组脱落率,接受SCBT患者对治疗满意度以及治疗师对SCBT评价。结果:(1)三组脱落率差异没有统计学意义。(2)接受SCBT的两组患者仅在治疗时间和次数上差异有统计学意义,SCBT组比SCBT+药物组患者治疗满意度高。(3)18名SCBT实施人员均认为操作手册内容容易理解、易于操作,并到达治疗目标。结论:SCBT对广泛性焦虑患者适宜性较强,有望成为在不同级别医疗机构应用推广的心理治疗方法。

Cognitive-behavioral therapy for the management of irritable bowel syndrome

Irritable bowel syndrome(IBS)is a common disorder,reported to be found in 5%-20%of the general population.Its management accounts for up to 25%of a gastroenterologist’s workload in the outpatient department,and the main symptoms are abdominal pain,bloating,and altered bowel habits.Despite a great amount of available pharmacological treatments aimed at a wide variety of gastrointestinal and brain targets,many patients have not shown adequate symptom relief.In recent years,there has been increasing evidence to suggest that psychological treatments,in particular cognitive-behavioral therapy(CBT),are effective for the management of IBS.This review discusses CBT for the management of IBS.CBT has proved to be effective in alleviating the physical and psychological symptoms of IBS and has thus been recommended as a treatment option for the syndrome.

Cognitive Behavior Therapy for Heart Failure Patients with Depression

The purpose of this systematic review was to examine the effectiveness of cognitive behavior therapy (CBT) in minimizing the depressive symptoms and improving quality of life in heart failure (HF) patients with depression. This systematic review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness evidence. This review only considered randomized controlled trial, assessing the effectiveness of CBT as a treatment for depression in adults (aged above 18) with HF, compared with usual care, which may include medications. This systematic review includes five RCTs involving 379 HF patients with depression (CBT = 192;Control = 187). Two RCTs compared CBT versus usual care using BDI, and no statistically significant differences were observed in reduction of depression after three months of the intervention (MD ?0.92, 95% CI ?1.89 to ?0.05) (p = 0.06). However, a significant difference of depression level was identified between CBT and control groups in a meta-analysis of two RCTs after 6-months of intervention measured by Hamilton Depression Scale (HAM-D) (MD ?3.34, 95% CI ?5.00 to ?1.68) (p = 0.0001) with moderate heterogeneity (I2 = 43%). Quality of life was assessed at three months between intervening groups undergoing CBT and the control group with usual care in two RCTs. A statistically significant improvement was observed in the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in the CBT group compared with usual care (MD ?9.44, 95% CI ?13.02 to ?5.87) (p < 0.0001). The key finding of this review is that CBT is likely to be helpful in improving the depressive symptoms and quality of life in HF patients with depression. Moreover, long-term continued CBT sessions may help in minimizing the depression level and improving the QoL.

Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents

Purpose: This study analyzed treatment effects of cognitive behavioral therapy (CBT) group counseling intervention on HIV transmission risk behavior, depression, anxiety, and alcohol use in HIV perinatally infected adolescents attending an HIV clinical care center in Uganda, Africa. Method: A total of 186 adolescents were randomly assigned to an experimental or control arm and assigned into groups of 11 - 16 adolescents. The experimental groups received an 80-minute CBT based weekly intervention for 8 consecutive weeks, while the control groups received only standard group care. Data from self report assessments were analyzed at pre- and post-test using repeated measures of analysis of variance. The participants, analyzed by variable, included 115 for sexual behavior, 106 for depression, 88 for anxiety, and 115 for alcohol use. Results: The results from the study show a large significant difference (p = 0.006) between the experimental and control groups on the anxiety variable. There were no significant differences between the experimental and control groups on the variables of sexual behavior (p = 0.876), depression (p = 0.700), and alcohol use (p = 0.815). There was an indication of reduced levels of HIV sexual transmission risk behavior, depression, and alcohol use levels in the participants in both the experimental and control groups. Conclusions: Risky sexual behavior places HIV perinatally infected adolescents at risk of re-infection, sexually transmitted diseases, and transmitting HIV to their sexual partners. CBT group counseling intervention equipped the participating adolescents with appropriate life skills to deal with psychological distress and anxiety often seen in their lives and may be useful in routine medical care to reduce transmission risks and improve wellness and call for its incorporation into HIV preventive programs and counselor education.

The Effect of Cognitive Behavioral Therapy and Changes of Depressive Symptoms Among Thai Adult HIV-Infected Patients

Background: In Thailand, the therapeutic effect of cognitive behavioral therapy (CBT) for depression among adult HIV-infected patients has been limitedly studied. Objectives: To determine the association of CBT and changes of de-pression both immediately post treatment and at 3-month post-treatment.Materials and Methods: A prospective cohort study was conducted at the University Hospital in Thailand. Forty and eighty HIV-infected adults who voluntarily received and did not receive CBT were recruited from the immunology clinic and sexually transmitted diseases clinic between September 2010 and February 2011. Sociodemographic characteristics and medical histories of the participants were collected. A standard Thai Depression Inventory (TDI) was used for evaluation of depressive symptoms. TDI score of 21 or above was interpreted as depression. Other questionnaires included a Montreal Cognitive Assessment questionnaire, standard questionnaire for evaluating life stress event and questionnaire for HIV social support. Results: The mean ages of participants were 44.8 and 43.4 years in the CBT and non-CBT groups respectively. In both group, about half of the subjects were females. Life stress event score in CBT group was significantly higher than the non-CBT group (p <0.01). At baseline, the mean TDI scores of the CBT group and non-CBT group were 26.7 and 25.3 respectively. After adjustment for age, gender, social support, life stress event and current opportunistic infection;the mean changes of TDI scores in the CBT group were significantly higher than the non-CBT group both immediately [12.13 (95%CI ,10.00 -14.26)] (p <0.001) and at 3-month post-treatment [15.94 (95%CI, 13.69-18.18)] (p < 0.001). Conclusion: CBT is beneficial for treatment of depression among adult HIV-infected patients in Thailand. The beneficial effect of CBT was not only immediate but also sustained at 3-month post-treatment.