The Effect of Computerized Cognitive Behavioral Therapy on People's Anxiety and Depression During the 6 Months of Wuhan's Lockdown of COVID-19 Epidemic: A Pilot Study

The Effectiveness of Cognitive-Behavioral Therapy Courses in Improving the Emergency Medicine Residents and Interns' Ability to Regulate their Emotions in Threatening or Stressful Events

Background

Given that the duties of an emergency medicine (EM) specialist are much more complicated than the other health care professionals, inexperience, weakness or inability to make appropriate decisions, and lack of control over their emotions and stress can lead to medical errors. This study aimed at determining the effect of cognitive-behavioral therapy (CBT) of emotion regulation on the EM assistants' and interns' level of satisfaction and cognitive control of anger and stress.

Materials and Methods

In this study, 25 EM residents and interns were trained in the virtual CBT course while 19 ones were not given any training in the control group and Cognitive Emotion Regulation Questionnaire (CERQ) were filled before and after the training intervention.

Results

After the training intervention, the dimensions of catastrophizing and other blame in the experimental group with the means of 3.84 ± 1.40 and 3.16 ± 0.94 respectively were significantly lower than these dimensions in the control group with the means of 5.68 ± 1.76 and 4.73 ± 1.15, respectively (P value < 0.05). Moreover, the refocus on planning in the experimental group with the means of 8.40 ± 1.53 was significantly higher than in the control group with the means of 7.00 ± 2.05 (P value < 0.05).

Conclusion

CBT method used in this study may be effective in controlling the emotions of EM interns and residents. CBT may help them to regulate anger and stress and have the ability to control their emotions during or after the experience of threatening or stressful events.

The Effect of Internet-Based Cognitive Behavioral Therapy on Major Depressive Disorder: Randomized Controlled Trial

BACKGROUND

Many people living with major depressive disorder (MDD) in China do not receive treatment owing to a lack of mental health services, along with significant stigma toward mental illness. Internet-based cognitive behavioral therapy (ICBT) has been proposed to increase access to mental health care for people with MDD.

OBJECTIVE

The aims of this study were to (1) evaluate the efficacy of ICBT for depressive symptoms in patients with MDD; (2) evaluate the effect of ICBT on anxiety symptoms, nonspecific psychological distress, general self-efficacy, depression stigma, social function, and health-related quality of life (HRQoL); and (3) explore the acceptability of and satisfaction with the ICBT program among participants.

METHODS

Patients with MDD were enrolled and randomized to the ICBT group or the waiting-list control (WLC) group. The ICBT group received ICBT delivered through a WeChat mini-program with general support by nonspecialists. Participants in the 2 groups were self-evaluated online at baseline and posttreatment for changes in the primary outcome (ie, depressive symptoms) and secondary outcomes (ie, anxiety symptoms, nonspecific psychological distress, general self-efficacy, depression stigma, social functional impairment, and HRQoL). Changes in outcomes were measured by changes in overall scores on respective scales, and response and remission rates were calculated based on depressive symptoms. The acceptability of and satisfaction with the ICBT program were measured by treatment adherence and participants' feelings (ie, modules seriously completed, perceived benefit, and satisfaction).

RESULTS

We included 40 patients who were randomly assigned to the ICBT group and 44 who were assigned to the WLC group. Compared with the WLC group, the ICBT group had fewer depressive symptoms, fewer anxiety symptoms, less nonspecific psychological distress, and greater general self-efficacy. Moreover, the ICBT group had higher response (18/31, 58%) and remission rates (17/31, 55%). The adherence rate in the ICBT group was 78% (31/40), and the majority of participants who completed all ICBT modules were satisfied with the ICBT program.

CONCLUSIONS

ICBT demonstrated greater improvements in depressive symptoms, anxiety symptoms, nonspecific psychological distress, and general self-efficacy among selected patients with MDD in comparison with the findings in waiting-list controls. The ICBT program in this study had good acceptability and satisfaction among participants.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR2100046425); https://tinyurl.com/bdcrj4zv.

The effect of cognitive behavior therapy on anxiety and depression during COVID-19 pandemic: a systematic review and meta-analysis

BACKGROUND

The global spread of coronavirus has caused many physical and mental health problems throughout the world. Depression and anxiety are among the issues that people are experiencing abundantly, along with other mental health disorders, during this period. Cognitive behavior therapy (CBT) is one of the approaches that is effective on improving most of the psychological issues including depression and anxiety. The objective of this systematic review and meta-analysis was to assess the effects of CBT on depression and anxiety during COVID-19 pandemic period.

METHODS

English databases such as Cochrane, PubMed, Google Scholar, Web of Science and Persian databases such as SID, MagIran and IranDoc were searched with a time limit of 2019 to 2022. Two researchers independently evaluated the quality of the entered studies based on Cochrane handbook. Subgroup analysis was conducted separately on the basis of being infected with coronavirus, not being infected with coronavirus, and having a history of depression or anxiety before the intervention and internet-based CBT for depression and anxiety. Meta-analysis results were reported using standardized mean difference (SMD) and 95% confidence interval (95% CI). Heterogeneity of studies was analyzed by means of I² index; and in the case of heterogeneity presence, random effects model was used instead of fixed effects model. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used for evaluating the quality of evidence.

RESULTS

Totally, 2015 articles were analyzed of which 11 articles entered meta-analysis. The overall results of meta-analysis showed that mean score of anxiety in the group receiving CBT was significantly lower than the control group (SMD: - 0.95, 95% CI - 1.29 to - 0.62; P < 0.00001, I² = 94%). In addition, mean score of depression in the intervention group was significantly lower than the control group (SMD: - 0.58; 95% CI - 1.00 to - 0.16, P < 0.00001, I² = 94%). In addition, the results of subgroup meta-analysis showed that internet-based CBT was effective in reducing of depression (SMD - 0.35; 95% CI - 0.50 to - 0.20; P < 0.00001; I² = 0%) and anxiety (SMD - 0.90; 95%CI - 1.47 to - 0.33; P = 0.002; I² = 94%). The evidence about the effectiveness of CBT on depression and anxiety compared with control group on the basis of GRADE approach had low quality.

CONCLUSIONS

Meta-analysis results showed that CBT reduced the mean scores of anxiety and depression significantly during COVID-19 pandemic period. Due to the low quality of evidence, conducting more randomized controlled trials with rigorous design is suggested. Prospero registration This systematic review has been registered in Prospero (ID: CRD42021277213).

The effect of cognitive-behavioral therapy on death anxiety and depression in patients with heart failure: A quasi-experimental study

PURPOSE

In this study, the effect of cognitive-behavioral therapy (CBT) on death anxiety and depression was investigated in patients with heart failure.

DESIGN AND METHODS

In this quasi-experimental study, 66 patients with heart failure were randomly assigned to intervention (n = 33) and control (n = 33) groups. Data collection was done using a demographic questionnaire, Templer death anxiety scale, and Beck depression inventory.

FINDINGS

It was found that the overall scores of death anxiety and depression in posttest were significantly lower than those at the follow-up stage in the intervention group.

PRACTICE IMPLICATIONS

CBT could significantly reduce death anxiety and depression in patients with heart failure. Therefore, it is recommended to equip nurses with CBT trainings to manage patients with heart failure better.