Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Randomized Controlled Trial

There are few effective treatments for body dysmorphic disorder (BDD) and a pressing need to develop such treatments. We examined the feasibility, acceptability, and efficacy of a manualized modular cognitive-behavioral therapy for BDD (CBT-BDD). CBT-BDD utilizes core elements relevant to all BDD patients (e.g., exposure, response prevention, perceptual retraining) and optional modules to address specific symptoms (e.g., surgery seeking).     

ON THE PRESCRIBING ANALYST

The value of medication for some patients in psychoanalysis serves to highlight the potential challenges of the medical analyst and invites exploration into possible motivations for assuming the prescribing role. Prescribing medication is one way in which the medical analyst integrates the dual identities of physician and analyst while dealing with significant cultural influences and intrapsychic tensions. Technical challenges posed by assuming the prescribing role are explored, as are the potential benefits of split treatment. The educational implications of this argument are discussed in relation to identity formation for candidates who are physicians.     

Associations among depressive symptoms,well-being,patient involvement,provider cultural competency,and treatment nonadherence: An exploratory study among university student-patients

Many students on US university campuses are underserved and undertreated for common mental health and medical conditions. The limited extent to which university students seek psychological and medical care when they need it has long been a problem. Among those who do seek care, treatment adherence appears to be an issue as well. However, few studies have examined factors that may be related to treatment nonadherence in university student-patients. The present survey study examined often-understudied constructs (i.e. patient involvement, treatment nonadherence, and provider cultural competency) in 243 university student-patients. Specifically, using a correlational research design, we examined the relations among depressive symptoms, well-being, patient involvement, cultural competency, and treatment nonadherence. Using multiple linear regression analysis, we also explored the extent to which the exploratory variables predicted treatment nonadherence separately and jointly. The current study revealed two important findings. First, all four factors – depressive symptoms, well-being, patient involvement, and cultural competency – were related to nonadherence to treatment. Second, depressive symptoms and patient involvement explained unique variance in nonadherence to treatment. The findings suggest that increased awareness of and attention to depressive symptoms and patient involvement may have important relevance for engendering healthy campuses and for reducing nonadherence in student-patients. Implications and directions for future research are proffered.     

癌痛规范化治疗的制约因素分析

癌痛严重影响中晚期癌症患者生活质量,通过使用第三阶梯强阿片类止痛药物,绝大部分患者疼痛能得到很好的控制。微观上,癌痛治疗的疗效与患者及医务人员的认识程度密切相关,也与医院麻醉科等其他科室的参与程度有关。宏观上,社会人文、经济、政策管理等方面的不足都制约着癌痛规范化治疗的有效实施。癌痛的规范化治疗是一项管理措施,需要进行疼痛评估、家庭支持及宗教组织的参与帮助等。我们国家在文化、经济、教育等各个方面取得长足进步时,癌痛治疗会更加规范、合理、人性化。     

冠心病介入治疗指南与医生的理解、掌握与运用的冲突和平衡

介入治疗是冠心病治疗的重要手段,介入治疗时机、方式、介入手术和外科手术以及内科治疗的选择,是关系到患者生命的首要问题。现从循证医学及冠心病治疗指南与医生的理解、掌握与运用的角度,探讨有利于患者的医疗行为。在临床工作中寻求医生对指南的理解、运用的一致和平衡。     

阿尔茨海默病的非药物干预与照料

目前阿尔茨海默病尚无根治性的治疗方法,药物治疗基本上是针对临床症状的对症治疗,只能在一定时期内起到改善或延缓疾病发展的作用。非药物治疗包括心理、社会、环境等综合干预,通过多重感官刺激、身体和智能锻炼、芳香治疗、感觉刺激、个性化音乐等方法,配合药物治疗以期尽可能长地保持阿尔茨海默病患者的功能水平,延迟日常生活能力的下降,减轻照料者负担,从而改善阿尔茨海默病患者及其家属的生活质量。对照料者的培训是非药物治疗的重要环节,照料的质量直接影响患者及家属的情绪和生活质量。     

关于抑郁症状的动力学探索及其心理治疗策略

心理因素是导致个体陷入抑郁症状,并难以获得彻底痊愈的根本原因。从心理层面深入探索抑郁发生的病理机制,无疑有利于创新抑郁症状的心理治疗策略,并提升抑郁症状的心理干预效果。本文从动力学的角度,分析了个体的趋利避害机制、压抑机制及效能机制在其抑郁发生过程中的内在动因,初步建构了抑郁发生及其交互作用的模式,并从心理极限的拓展、消极认知的突破和负性精神交互作用的阻断三个方面,努力探索抑郁症状的动力学辅导思路。