Psychotherapy and psychosomatics
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Psychother Psychosom · Jan 2009
ReviewThe decline of pharmaceutical psychiatry and the increasing role of psychological medicine.
The increasing influence of the pharmaceutical industry on psychiatric research and practice is leading to an intellectual and clinical crisis. A narrow concept of science attempts to apply oversimplified neurobiological models to the understanding and treatment of mental disorders, and relegates psychiatrists to a marginal role. This paper reviews some emerging trends of renewal that may be subsumed under the rubric of psychological medicine: use of a multidisciplinary approach, emphasis on psychotherapeutic strategies leading to self-management, reliance on repeated assessments, integration of different treatment modalities and independence from the pharmaceutical industry. The concept of psychological medicine, defined as the clinical application of the psychosomatic approach, may provide room for innovative paths in psychiatric research and treatment.
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Psychother Psychosom · Jan 2009
Randomized Controlled Trial Comparative StudyNarrative exposure therapy versus interpersonal psychotherapy. A pilot randomized controlled trial with Rwandan genocide orphans.
The aim of the present study was to evaluate the efficacy of treatment modules for trauma spectrum disorders in a sample of Rwandan genocide orphans. ⋯ Individual NET in combination with group-based mourning comprises an effective treatment for traumatized survivors who have to bear the loss of loved ones and have been suffering from symptoms of PTSD and depression.
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Psychother Psychosom · Jan 2009
ReviewThe selection and design of control conditions for randomized controlled trials of psychological interventions.
The randomized controlled trial (RCT) provides critical support for evidence-based practice using psychological interventions. The control condition is the principal method of removing the influence of unwanted variables in RCTs. There is little agreement or consistency in the design and construction of control conditions. ⋯ The strengths and weaknesses of several categories of control conditions are examined, including the ones that are under experimental control, the ones that are under the control of clinical service providers, and no-treatment controls. Considerations in the selection of control conditions are discussed and several recommendations are proposed. The aim of this paper is to begin to define principles by which control conditions can be selected or developed in a manner that can assist both investigators and grant reviewers.
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Psychother Psychosom · Jan 2009
Conflicts of interest and disclosure in the American Psychiatric Association's Clinical Practice Guidelines.
Clinical practice guidelines (CPG) are developed, endorsed, and disseminated through professional medical organizations such as the American Psychiatric Association (APA) as the standard of care for health care providers. Because of their influence, it is critical that CPG are based on objective data, unprejudiced by stakeholder groups, and that any financial associations between authors of CPG and the pharmaceutical industry are made transparent. The present study examined the degree and type of financial ties to the pharmaceutical industry held by authors of 3 major CPG. ⋯ Ninety percent of the authors of 3 major CPG in psychiatry had financial ties to companies that manufacture drugs which were explicitly or implicitly identified in the guidelines as recommended therapies for the respective mental illnesses. None of the financial associations of the authors were disclosed in the CPG.