This treatment-development study is a Stage I evaluation of an intervention that combines mindfulness meditation with cognitive-behavior therapy for insomnia (CBT-I). Thirty adults who met research diagnostic criteria for Psychophysiological Insomnia (Edinger et al., 2004) participated in a 6-week, multi-component group intervention using mindfulness meditation, sleep restriction, stimulus control, sleep education, and sleep hygiene. Sleep diaries and self-reported pre-sleep arousal were assessed weekly while secondary measures of insomnia severity, arousal, mindfulness skills, and daytime functioning were assessed at pre-treatment and post-treatment. Data collected on recruitment, retention, compliance, and satisfaction indicate that the treatment protocol is feasible to deliver and is acceptable for individuals seeking treatment for insomnia. The overall patterns of change with treatment demonstrated statistically and clinically significant improvements in several nighttime symptoms of insomnia as well as statistically significant reductions in pre-sleep arousal, sleep effort, and dysfunctional sleep-related cognitions. In addition, a significant correlation was found between the number of meditation sessions and changes on a trait measure of arousal. Together, the findings indicate that mindfulness meditation can be combined with CBT-I and this integrated intervention is associated with reductions in both sleep and sleep-related arousal. Further testing of this intervention using randomized controlled trials is warranted to evaluate the efficacy of the intervention for this population and the specific effects of each component on sleep and both psychological and physiological arousal.
To address whether switch of depression into hypomania or mania or cycle acceleration in patients with bipolar disorder is caused by antidepressants or whether this phenomenon is attributable to the natural history of bipolar disorder itself.
Method: A critical review of the literature, pointing at sources of bias that have been previously overlooked. For examining the causation in question, the Bradford–Hill criteria were applied, i.e. specificity of the potential causative agent, strength of effect, consistency in findings, dose–response relation, temporal relation with exposure to agent preceding effect and biological plausibility.
Results: There is a scarcity of randomized studies addressing the question, and the available studies all suffer from various forms of bias. However, there is some evidence suggesting that antidepressants given in addition to a mood stabilizer are not associated with an increased rate of switch when compared with the rate associated with the mood stabilizer alone.
Conclusion: When combined with a mood stabilizer, antidepressants given for acute bipolar depression seemingly do not induce a switch into hypomania or mania. Whether antidepressants may accelerate episode frequency and/or may cause other forms of destabilization in patients with bipolar disorder remain to be properly studied.
This is a companion paper to our earlier review of psychological treatments for people with personality disorder that examined the evidence from randomized controlled trials (RCTs). Here, we report on the evidence of pharmacological treatments from RCTs for people with personality disorder. As in the previous report, this paper incorporates information from an earlier review that examined the evidence to 2002, and extends it to December 2006. As in the previous paper, this review restricts itself to the findings from RCTs, and excludes evidence from other study designs; however, details of these other studies will be posted in the National Personality Disorder Institute Website (http://www.pdinstitute.org.uk).
Turning gardens into multisensory experiences ,Julie Swann Nursing & Residential Care, Vol. 8, Iss. 4, 15 Mar 2006, pp 171 – 174
Julie Swann looks beyond the provision of a basic garden in care homes and encourages the design of a safe outdoor environment that stimulates all senses. Most people enjoy gardens either actively
or passively, perhaps as a place to reflect, to reminisce, to contemplate or to simply to look out onto. A garden should be an integral, interesting part of a care home environment, no matter how small the area available.
Report:Towards Transformation“The arts transformed my life. It did, it transformed my life, but it didn’t come without a lot of hard work on my part as well…”
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The Invest to Save: Arts in Health Programme is a 3-year HM Treasury funded project aimed at strengthening the capacity of the North West Regions’, Arts and Health community through networking and training opportunities and building the evidence base as to the effectiveness of creativity, culture and the arts on health and economic outcomes.
The project is a partnership between Manchester Metropolitan University, Arts Council England, North West and the Department of Health, Public Health Team, North West.
This annual statistical report presents information on drug misuse among both adults and children. It includes a focus on young adults. The topics covered include:
prevalence of drug misuse, including the types of drugs used
trends in drug misuse over recent years
patterns of drug misuse among different groups of the population
health outcomes related to drug misuse including hospital admissions, drug treatment and deaths related to drug misuse
The bulletin also summarises government plans and targets in this area, as well as providing sources of further information and links to relevant documents. The bulletin draws together data from a variety of different sources and presents it in a user-friendly format. Most of the data contained in the bulletin have been published previously, by The NHS Information Centre, Department of Health, the Home Office, Office for National Statistics, the Health Protection Agency or the National Treatment Agency for Substance Misuse. Previously unpublished figures on drug-related admissions to hospital are presented.
“Abortion does not harm mental health” is the headline in The Times, following a recent US report of psychiatric problems that occur after abortions. The newspaper suggests that the report’s findings will hinder the latest efforts of a group of anti-abortion MPs to “make it harder for British women to obtain terminations”. These MPs have tabled an amendment to the Human Fertilisation and Embryology Bill that would require all women to be counselled about psychiatric risks before they can be cleared to have a termination. This bill is to be debated by the House of Commons in October.
The systematic review excluded unreliable research and found no “credible” evidence that single abortions directly cause more mental health problems among adults with unwanted pregnancies than in those who deliver that pregnancy. They found one well-conducted study which provided reliable evidence that there was no difference between these groups for these outcomes. The evidence regarding multiple abortions was less certain, and the interpretation of the research is complicated by the fact that the studies often did not distinguish between abortions of wanted pregnancies (e.g. detected foetal abnormalities) and unwanted pregnancies, or consider factors such as poverty and drug use that raise the likelihood both of having an abortion and suffering mental illness.