Effects of an Online Imagery-Based Treatment Program in Patients with Workplace-Related Posttraumatic Stress Disorder: A Pilot Study

Efficacy and acceptability of music therapy for post-traumatic stress disorder: a systematic review and meta-analysis of randomized controlled trials

Background: Music therapy is increasingly examined in randomized controlled trials (RCTs) and shows potential in treating post-traumatic stress disorder (PTSD).Objective: This systematic review and meta-analysis critically evaluates the current clinical evidence supporting the efficacy and acceptability of music therapy for PTSD.Method: RCTs comparing music therapy in addition to care as usual (CAU) versus either CAU alone or CAU combined with standard psychotherapy/pharmacotherapy for PTSD were retrieved from major English - and Chinese-language databases. Standardized mean differences (SMDs) for post-treatment PTSD symptom scores and risk differences (RDs) for retention rates upon treatment completion were calculated to assess the efficacy and acceptability of music therapy, respectively. The Cochrane risk of bias (RoB) tool 2.0 and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) were used to assess the RoB of included studies and certainty of the evidence, respectively.Results: Nine studies, incorporating 527 PTSD patients, were included, all with high RoB. The post-treatment PTSD symptom scores were significantly lower in the music therapy group than the inactive control group (SMD = -1.64, P < .001), but comparable between the music therapy group and the active control group (SMD = -0.28, P = .330). The retention rates did not differ significantly between the music therapy group and both control groups (RD = 0.03, P = .769; RD = 0.16, P = .829). The GRADE rated certainty level of evidence as low.Conclusions: Although meta-analytic findings suggest that music therapy is effective in reducing post-traumatic symptoms in individuals with PTSD, with its therapeutic effect comparable to that of standard psychotherapy, the low level of certainty limits its generalizability. More methodologically stringent studies are warranted to strengthen the clinical evidence for the efficacy and acceptability of music therapy for PTSD.

P4 suicidality screener: Literature synthesis and results from two randomized trials

OBJECTIVE

To synthesize the literature on use of the P4 suicidality screener since its introduction in 2010 and to summarize results from 2 randomized clinical trials.

METHOD

A PubMed search was conducted from 2010 to 2023 to retrieve studies reporting on use of the P4. Also, data was extracted from the CAMMPS and SCOPE trials in which the P4 was periodically administered over 12 months when the 9th item of the PHQ-9 was endorsed.

RESULTS

A total of 21 research studies using the P4 were found, of which 12 provided some data on P4 findings. Additionally, another 7 protocol papers reported intended use of the P4 as a study measure. In our 2 trials, the 9th item was endorsed 259 (12.5%) times in 2068 administrations of the PHQ-9. Higher risk suicidal ideation was identified in 4.1% (12/294) of CAMMPS participants and 2.8% (7/250) of SCOPE participants. No suicide attempts occurred over the 12 months in either trial.

CONCLUSIONS

The P4 has had moderate use as a brief suicidality screener and is an efficient way to identify the small proportion of depressed patients with higher risk suicidality. Studies comparing the P4 with other common suicidality screeners would further inform use.

Three months-longitudinal changes in relative telomere length, blood chemistries, and self-report questionnaires in meditation practitioners compared to novice individuals during midlife

Aging accelerates during midlife. Researches have shown the health benefits of mind-body intervention (MBI). However, whether MBI is involved with aging process has not been well understood. In this study, we approach to examine the relations of MBI with this process by investigating an aging marker of the peripheral blood, blood chemistry, and self-report questionnaires. A quasi-experimental design was applied. Experienced MBI practitioners participated in a 3-month intensive meditation training, while the age, gender-matched MBI-naïve controls led a normal daily life. Measurements were taken at before and after the 3 months for relative telomere length (RTL), blood chemistry, and self-report questionnaires including items about sleep quality, somatic symptoms, depression, anxiety, stress, emotional intelligence (EI), and self-regulation. For RTL, the repeated measures analysis of variance showed a significant group*time interaction (P = .013) with a significant post hoc result (P = .030) within the control group: RTL was significantly reduced in the control while it was maintained in the meditation group. In repeated measures analysis of variance for blood chemistries, there were significant group differences between the groups in glucose and total protein. In the post hoc comparison analysis, at post measurements, the meditation group exhibited significantly lower values than the control group in both glucose and total protein. There were significant group-wise differences in the correlations of RTL with triglyceride (TG), high-density lipoprotein (HDL), glutamic oxaloacetic transaminase and glutamic pyruvic transaminase. Any of self-report results did not show significant changes in group*time interaction. However, there were group differences with significant (P < .05) or a tendency (.05 < P < .1) level. There were significant improvements in depression, stress and EI as well as tendencies of improvement in sleep quality and anxiety, in the meditation group compared to the control group. Our results suggest that meditation practice may have a potential to modify aging process in molecular cellular level combined with changes in psychological dimension.

Digital interventions for subjective and objective social isolation among individuals with mental health conditions: a scoping review

BACKGROUND

Social isolation encompasses subjective and objective concepts. Both are associated with negative health consequences and are more prevalent among people with mental health problems than among the general population. To alleviate social isolation, digital interventions have potential as accessible alternatives or adjuncts to face-to-face interventions. This scoping review aimed to describe the types of digital interventions evaluated for feasibility, acceptability and effectiveness in alleviating social isolation among individuals with mental health problems, and to present an overview of the quantitative evidence yielded to inform future intervention design.

METHODS

We searched five electronic databases for quantitative and mixed methods studies published between January 2000 and July 2020. Studies were included if they evaluated digital interventions for individuals with mental health conditions, had subjective and/or objective social isolation as their primary outcome, or as one of their outcomes if no primary outcome was specified. Feasibility studies were included if feasibility outcomes were the primary outcomes and social isolation was among their secondary outcomes. A narrative synthesis was conducted to present our findings. The protocol was registered on Open Science Framework (doi: https://doi.org/10.17605/OSF.IO/CNX8A ).

RESULTS

Thirty-two studies were included for our review: 16 feasibility studies, seven single-group studies and nine effectiveness trials. There was great variation in the interventions, study designs and sample populations. Interventions included web-based programmes, phone-based programmes, blended interventions, socially assistive robots and virtual reality interventions. Many were feasibility studies, or otherwise not fully powered to detect an effect if one were present, thus preventing clear conclusions about clinical effectiveness. Satisfactory feasibility outcomes indicated potential for future trials to assess these interventions.

CONCLUSION

Our scoping review identified a range of digital approaches utilized to alleviate social isolation among individuals with mental health disorders. Conclusions regarding clinical effectiveness cannot be reached due to variability of approaches and lack of large-scale randomized controlled trials. To make clear recommendations for digital social isolation interventions, future research needs to be based on rigorous methods and larger samples. Future studies should also focus on utilizing theory-driven approaches and improving existing approaches to advance the field.

Reduced Pain by Mind-Body Intervention Correlates with Improvement of Shoulder Function in People with Shoulder Pain: A Randomized Controlled Trial

Meditation and acupressure-like stimulations have been shown to relieve pain. The aim of this study was to determine whether a short bout of mind-body intervention combined with meditation and acupressure-like stimulation was able to alleviate shoulder pain and improve its function in a short time window. Sixty-five adults with shoulder pain were recruited and randomly classified into two groups. One group participated in an intervention which consisted of acupressure-like stimulation and meditation over a 5 min period. The other group was instructed to rest during this time. A visual analog scale (VAS) pain score and objective constant scores were measured before and after intervention to determine shoulder pain and range of motion (ROM), respectively. A two-way repeated measures analysis of variance with Bonferroni correction and a regression analysis were performed. VAS pain, objective constant score, flexion, abduction, and external rotation score showed significant interactions between time and group. The pain intensity was significantly reduced, while flexion and abduction were significantly improved, in the experimental group compared to the control group, after the intervention. In addition, the change of flexion negatively correlated with the change of pain intensity in the experimental group, but not in the control group. These results show that a short-term application of mind-body intervention significantly alleviates shoulder pain and improves shoulder movement, suggesting its potential use as a therapy for people with shoulder pain.