Mindfulness-based narrative therapy for depression in cancer patients

Case Study: An Integrative Modification of Gut-Directed Hypnotherapy for a Patient with Intermittent Flares of Long-Standing Irritable Bowel Syndrome

This article presents a case of a patient whose treatment for irritable bowel syndrome (IBS) involved a modification of gut-directed hypnotherapy (GDH). It was delivered in a nonstandard schedule and integrated concepts from other therapeutic modalities, primarily mindfulness meditation and narrative therapy. A review of the literature on GDH and prior modifications, as well as other iterations of integrative hypnosis, will be provided. Along with describing the case, a rationale for the treatment and examples of the modification will be presented.

Actor-partner effects of wellbeing, hope and self-esteem on depression in stroke survivor-caregiver dyads: A randomized controlled trial

BACKGROUND

Stroke is a disabling, long-term condition that challenges the mental and physical health of stroke-survivors concurrently with their primary family-caregivers (dyad). However, there has been a lack of emphasis on this dyadic need. Thus, this study aims to investigate the impacts of two interventions on hope, self-esteem and hedonic wellbeing on depression among the stroke-survivor-caregiver dyad.

METHODS

This randomized-controlled-trial applied the actor-partner interdependence model to 100 randomly-selected dyads (N = 200) of stroke-survivors, mean (SD) age was 73.63(7.22) and family-caregivers, mean (SD) age was 62.49(14.44) years, recruited from Hong Kong hospitals and rehabilitation centres. The intervention was eight-weekly two-hour narrative therapy group sessions (n = 54 dyads), compared with the current model of psychoeducational group to each dyad as needed. Outcomes were collected via questionnaires and interviews, at four time-points: baseline (T₁), during-intervention (T₂) (1-month), immediately post-intervention (T₃) (2-months) and follow-up (T₄) (6-months).

RESULTS

The results demonstrated that there are actor effects on stroke-survivors (β = -0.353, p < 0.05) and caregivers (β = -0.383, p < 0.05), where higher levels of hedonic wellbeing were associated with fewer depressive symptoms. Partner effects were observed as caregivers' depressive symptoms were possessing a significant negative relationship with stroke survivors' wellbeing (β = -0.387, p < 0.05). Those stroke survivors in the intervention group had a significantly higher level of self-esteem associated with lower levels of depression (β = -0.314, p < 0.05).

CONCLUSIONS

Improving hope, self-esteem and wellbeing through narrative therapy significantly mediates depressive symptoms, strengthening the dyadic support of stroke survivors and family caregivers.

Narrative therapy for depression and anxiety among children with imprisoned parents: A randomised pilot efficacy trial

This study aimed to determine the efficacy of narrative group therapy in reducing depression and anxiety among children with imprisoned parents. The study design was a randomised clinical trial with an experimental group, and waiting list group as the control group. Eighty-five children with imprisoned parents were selected by convenience sampling method. They were randomly assigned to the experimental and control groups. The experimental group received the narrative group therapy while the control group did not. The research measurement instrument comprised the Children's Depression Inventory (CDI) and the Revised Children's Manifest Anxiety Scale (RCMAS). Analysis of univariate covariance (ANCOVA) and independent t-test was employed to test the study hypothesis. The findings showed that depression and anxiety reduced among children with imprisoned parents with a high effect size (anxiety = 0.90 and depression = 3.05). Thus, the principle and techniques of narrative therapy and the benefits of group therapy reduced depression and anxiety among children with imprisoned parents. Therefore, this study showed that this intervention can be useful for children with imprisoned parents.

Depression in older patients with advanced colorectal cancer is closely connected with immunosuppressive acidic protein

Colorectal cancer (CRC) is one of the most common tumors. CRC patients are susceptible to suffering from depression. Whether the immune system of CRC patients with depression is impaired or stimulated is controversial. Possible reasons for this conflict are the involvement of confounding factors, such as the age of the patient, the stage of the CRC and the types of treatment in previous studies. To demonstrate clearly the relationship between depression and the immune system in the context of CRC, the present study included only older patients with advanced CRC who received only chemotherapy, and the study adopted immunosuppressive acidic protein (IAP) as an immune parameter for the first time. A total of 56 older patients with advanced CRC completed the Zung Self-Rating Depression Scale (SDS) and were divided into two groups according to SDS scores. The patients exhibiting depression were treated with fluoxetine until their symptoms remitted. The serum levels of IAP and the percentages of CD3-positive (CD3+), CD4+, CD8+ T lymphocytes and CD56+ natural killer (NK) cells and Neutrophil-lymphocyte ratio (NLR) were calculated at the time of enrollment and once the symptoms remitted. Correlation analyses revealed that the SDS score was positively associated with serum IAP levels but negatively associated with CD3 and CD4 levels. Among the depressed and non-depressed patients, serum IAP levels and the percentages of CD3 and CD4 cells were dramatically different. After the depression symptoms were treated, the IAP levels dramatically decreased, while the levels of CD3, CD4, CD8 and CD56 were unchanged. All of above suggested that IAP was closely correlated with depression and might be a relatively objective parameter for predicting depression.