Consensus Statement on Management of Intersex Disorders

PEDIATRICS, Journal Year: 2006, Volume and Issue: 118(2), P. e488 - e500

Published: Aug. 1, 2006

The birth of an intersex child prompts a long-term management strategy that involves myriad professionals working with the family. There has been progress in diagnosis, surgical techniques, understanding psychosocial issues and recognizing accepting place patient advocacy. Lawson Wilkins Paediatric Endocrine Society (LWPES) European for Endocrinology (ESPE) considered it timely to review disorders from broad perspective, data on longer term outcome formulate proposals future studies. methodology comprised establishing number groups whose membership was drawn 50 international experts field. prepared prior written responses defined set questions resulting evidence based literature. At subsequent gathering participants, framework consensus document agreed. This paper constitutes its final form.

Language: Английский

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Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women

JAMA, Journal Year: 2007, Volume and Issue: 297(8), P. 820 - 820

Published: Feb. 27, 2007

Context

The prevalence of posttraumatic stress disorder (PTSD) is elevated among women who have served in the military, but no prior study has evaluated treatment for PTSD this population. Prior research suggests that cognitive behavioral therapy a particularly effective PTSD.

Objective

To compare prolonged exposure, type therapy, with present-centered supportive intervention,

Design, Setting, and Participants

A randomized controlled trial female veterans (n=277) active-duty personnel (n=7) recruited from 9 VA medical centers, 2 readjustment counseling 1 military hospital August 2002 through October 2005.

Intervention

Participants were randomly assigned to receive exposure (n = 141) or 143), delivered according standard protocols 10 weekly 90-minute sessions.

Main Outcome Measures

Posttraumatic symptom severity was primary outcome. Comorbid symptoms, functioning, quality life secondary outcomes. Blinded assessors collected data before after at 3- 6-month follow-up.

Results

Women received experienced greater reduction symptoms relative (effect size, 0.27;P .03). group more likely than longer meet diagnostic criteria (41.0% vs 27.8%; odds ratio, 1.80; 95% confidence interval, 1.10-2.96;P .01) achieve total remission (15.2% 6.9%; 2.43; 1.10-5.37;P .01). Effects consistent over time longitudinal analyses, although cross-sectional analyses most differences occurred immediately treatment.

Conclusions

Prolonged an personnel. It feasible implement across range clinical settings.

Trial Registration

clinicaltrials.gov Identifier:NCT00032617

Language: Английский

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Decreased risk of suicides and attempts during long‐term lithium treatment: a meta‐analytic review

Bipolar Disorders, Journal Year: 2006, Volume and Issue: 8(5p2), P. 625 - 639

Published: Oct. 1, 2006

Objectives: To update and extend comparisons of rates suicides suicide attempts among patients with major affective disorders versus without long‐term lithium treatment. Methods: Broad searching yielded 45 studies providing suicidal acts during treatment, including 34 also We scored study quality, tested between‐study variance, examined on off by meta‐analytic methods to determine risk ratios (RRs) 95% confidence intervals (CI). Results: In 31 suitable for meta‐analysis, involving a total 85,229 person‐years risk‐exposure, the overall was five times less lithium‐treated subjects than those not treated (RR = 4.91, CI 3.82–6.31, p < 0.0001). Similar effects were found other methods, as well completed attempted suicide, bipolar mood disorder patients. Studies higher quality ratings, randomized, controlled trials, involved shorter exposures somewhat lesser superiority. Omitting one very large or lithium‐discontinuation had little effect results. The incidence‐ratio attempts‐to‐suicides increased 2.5 lithium‐treatment, indicating reduced lethality acts. There no indication bias toward reporting positive findings, nor outcomes significantly influenced publication‐year size. Conclusions: Risks consistently lower, approximately 80%, treatment an average 18 months. These benefits sustained in randomized open clinical trials.

Language: Английский

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Post-traumatic stress disorder

Nature Reviews Disease Primers, Journal Year: 2015, Volume and Issue: 1(1)

Published: Oct. 7, 2015

Language: Английский

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Nonresponse and Dropout Rates in Outcome Studies on PTSD: Review and Methodological Considerations

Psychiatry, Journal Year: 2008, Volume and Issue: 71(2), P. 134 - 168

Published: June 1, 2008

Post-traumatic stress disorder (PTSD) represents a frequent consequence of variety extreme psychological stressors. Lists empirically supported treatments for PTSD usually include cognitive behavioral therapy (CBT) and eye movement desensitization reprocessing (EMDR), but nonresponse dropout rates in these often are high. We review the treatment 55 studies PTSD, literature predictors nonresponse, discuss methodological inconsistencies that make comparisons across difficult, outline future directions research. Dropout ranged widely may have depended, at least part, on nature study population. It was not uncommon to find as high 50%. Standard methods reporting needed outcomes. suggest guidelines collecting data help identify characteristics dropouts nonresponders.

Language: Английский

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The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study

Journal of Psychopharmacology, Journal Year: 2010, Volume and Issue: 25(4), P. 439 - 452

Published: July 19, 2010

Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA 'Ecstasy' resulted in its criminalization 1985. Over two decades later, this study is the first completed clinical trial evaluating therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory both and psychopharmacology, were randomly assigned concomitant active drug (n = 12) or inactive placebo 8) during 8-h experimental sessions. Both groups received preparatory follow-up non-drug psychotherapy. The primary outcome measure was Clinician-Administered PTSD Scale, at baseline, 4 days after each session, 2 months second session. Neurocognitive testing, blood pressure, temperature monitoring performed. After 2-month follow-up, subjects offered option re-enroll procedure open-label MDMA. Decrease Scale scores from baseline significantly greater for group than all three time points baseline. rate response 10/12 (83%) treatment versus 2/8 (25%) group. There no drug-related serious adverse events, neurocognitive effects clinically significant pressure increases. MDMA-assisted can be disorder without evidence harm, it may useful other treatments.

Language: Английский

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The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III

Social Psychiatry and Psychiatric Epidemiology, Journal Year: 2016, Volume and Issue: 51(8), P. 1137 - 1148

Published: April 22, 2016

Language: Английский

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Evidence-based clinical guidelines for immigrants and refugees

Canadian Medical Association Journal, Journal Year: 2010, Volume and Issue: 183(12), P. E824 - E925

Published: June 7, 2010

(see Appendix 2, available at [www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.090313/-/DC1][1] for summary of recommendations and clinical considerations) There are more than 200 million international migrants worldwide,[1][2] this movement people has implications individual

Language: Английский

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Pharmacotherapy for post traumatic stress disorder (PTSD)

Cochrane library, Journal Year: 2006, Volume and Issue: unknown

Published: Jan. 20, 2006

Language: Английский

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Depression and Anxiety in Heart Failure: A Review

Harvard Review of Psychiatry, Journal Year: 2018, Volume and Issue: 26(4), P. 175 - 184

Published: July 1, 2018

After participating in this activity, learners should be better able to:• Identify the relationships between depression, anxiety, and heart failure (HF).• Assess methods for accurately diagnosing depression anxiety disorders patients with HF.• Evaluate current evidence treatment of HF.In (HF), are common associated adverse outcomes such as reduced adherence to treatment, poor function, increased hospitalizations, elevated mortality. Despite impact these disorders, remain underdiagnosed undertreated HF patients.We performed a targeted literature review (1) identify associations HF, (2) examine mechanisms mediating conditions medical outcomes, (3) (4) treatments population.Both development progression including rates mortality, likely mediated through both physiologic behavioral mechanisms. Given overlap cardiac psychiatric symptoms, or can challenging. Adherence formal diagnostic criteria utilization clinical interview best courses action evaluation process. There is limited efficacy pharmacologic psychotherapy HF. However, cognitive-behavioral therapy has been shown improve mental health selective serotonin reuptake inhibitors appear safe cohort.Depression common, underrecognized, linked outcomes. Further research detection develop effective badly needed.

Language: Английский

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