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Filter by:Health Literacy is the ability to understand health information and to use that information to make good decisions about health and medical care. Health informatin can overwhelm even people with advanced literacy skills. About one third of the adult population in the United States has limited health literacy.
Mirtazapine is a non-SSRI (selective serotonin reuptake inhibitor) medication with a unique structure and mechanism of action. Recent study results suggest that mirtazapine may be more effective and faster acting than other antidepressants. Levels of alcohol use have been shown to be associated with levels of depressive symptoms among comorbid populations. Our own recent open label pilot study suggested robust within-group efficacy for mirtazapine for decreasing both the drinking and the depressive symptoms of persons with co-occurring alcohol dependence/major depressive disorder (AD/MDD). However, no placebo control group was employed in that study, so between-group efficacy versus placebo could not be assessed. The current grant submission proposes to conduct a first double-blind, placebo-controlled study to evaluate the efficacy of mirtazapine versus placebo for decreasing the alcohol use and depressive symptoms of persons with comorbid AD/MDD. If the results of this proposed double-blind pilot trial are promising, then the effect sizes found in this proposed study will be used to help design an adequately-powered R01 treatment trial to definitively test the efficacy of mirtazapine in this comorbid population.
The purpose of the study is to examine how well two types of treatment follow up work compared to one another: 1. standard community follow up 2. medication monitoring plus tailored case management follow up. A child's participation will involve 3 months of treatment consisting of medication and psychological, behavioural, and academic interventions tailored to their individual needs. Following this treatment, the child will be randomly assigned to receive two years of either community follow up or medication monitoring plus tailored case management follow up delivered by the study team. During both types of follow up, at 6 month intervals, the parent and child will be asked to complete interviews with our study personnel and comprehensive assessments pertaining to ADHD symptoms and various other areas of functioning. Parents will also be asked to obtain information from the child's teacher regarding the child's functioning at 6 month intervals during the school year.
Children with dyslexia show a variety of comorbid disorders like behavior and adaptive disorders, hyperkinetic and anxiety disorders. Raising and educating a child with dyslexia is a challenging task for parents. Studies show that parents of children with dyslexia suffer under depressive symptoms and higher parenting stress. In order to support the child's academic development many parents of children with dyslexia practice reading and writing more often and show controlling and maladaptive behavior. As a result learning motivation of the child decreases and later homework situations are influenced in a negative way. Consequently, it is necessary to provide parent training on appropriate behavior with homework and academic exercises, in order to raise parent's competences, reduce parenting stress and promote learning motivation of the child. In the German-speaking area there is a lack of elaborated and evaluated programs for parents of dyslexic children. Therefore, a group program that especially addresses the needs of these parents was devised. The study aims at evaluating the effects of the parent training. We hypothesize that the treatment reduces parenting stress and raises competences of the parents. Forty-one mothers of third graders with dyslexia were randomly assigned to the group-based parent training program (N=25) or a waiting list control group (N=16). Only children who performed in the normal range on the test measuring cognitive abilities (IQ > 70) and who scored below average in at least one test measuring reading or writing (T-Score < 40) were included. Children with significant deficits in hearing or vision, pervasive developmental disorder or genetic disorders were excluded. Data of children and their mothers were collected prior to intervention, directly after intervention and three months after intervention. For investigating training effects at all time points parenting stress and competences in supporting academic development, mastering homework situations and attachment to the child were measured. Parents of the waiting list control group had the possibility to take part in the parent training after the follow-up was completed. The intervention program consists of five two-hour sessions held biweekly. The training lasts about 10 weeks. It is designed for group sizes of three to ten persons. It follows a cognitive-behavioral approach. The training aims at knowledge transfer about dyslexia, raising parent's empathy for the child's difficulties in reading and writing, promoting parent's competencies and self-efficacy in handling dyslexia within the family context and during homework situations, sensitization for opportunities of integrating reading and writing into daily life and reduction of parental stress. The main topics covered are requirements and phases of acquisition of written language, the causes of dyslexia, helpful strategies for managing homework and exercises, facilitation of literacy in everyday life and dealing with dyslexia. Methods used are brief lectures, example cases, group discussions and practice, as well as homework tasks. Written handouts summarizing important topics are given at every session. A benefit of enrolling in the study is that parents get information concerning the academic development of their children. At the moment it is not sure whether parents profit from participating in the training because effects have not been investigated yet. The study takes place at the University of Heidelberg (Children's Hospital) and the Early Intervention Centre in Heidelberg. The study started in January 2012 and is expired to end in October 2014. Participants have been recruited two times, at the beginning of a school year. The timeline for every study flow was similar. Pretests took place in September and October; parent training started in December and lasted until February. Post-Test took place in February and March. Follow-Up measurements were realized from June to July. The study is funded by the Günter Reimann-Dubbers foundation of Heidelberg. The main contact for the study is Bettina Multhauf (M.Sc. Psych.), e-mail: fruehinterventionszentrum@googlemail.com
Premenstrual Dysphoric Disorder (PMDD) is characterized by affective instability and irritability, diagnosed in 5% of reproductive-age women. Although causing severe insult to patients' functioning and quality of life, ~40% do not respond to conventional treatment options. In this study, the investigators aim to examine a novel therapeutic approach for the treatment of affective instability in PMDD: brain-guided training (i.e.NeuroFeedBack, NF) probed by prefrontal EEG alpha asymmetry. PMDD patients will be randomly assigned to either a real or sham EEG-NF protocol, and undergo simultaneous fMRI-EEG scans before and after training period. Comprehensive psychological assessment will be performed for outcome measure. The investigators hypothesize that EEG-NF treatment will enhance affective stability, thus improving patients' daily lives.
The main objective of this exploratory 8-week pilot study is to evaluate the safety and efficacy of buspirone for the treatment of anxiety in youth (ages 6-17 years) with autism spectrum disorders. The study results will be used to generate hypothesis for a larger randomized controlled clinical trials with explicit hypotheses and sufficient statistical power.
Binge Eating Disorder (BED) affects as many as 3% of women and men in Ontario, 8% of obese individuals, and 30% to 50% of those participating in weight loss programs. BED, the most common eating disorder, is characterized by over-eating with loss of control (i.e., binge eating), but with no purging (e.g., vomiting).Our previous research indicates that the total health care costs for women with BED is 36% higher than the Canadian average for women of a similar age, and that health care costs significantly decreased following intensive treatment at our Centre. The main goal of our study is to inform the development of a stepped care approach to the treatment of BED. Stepped care involves providing easily accessible low intensity treatment first, and then providing more expensive intensive treatment second, if necessary. The second goal is to assess if a second more intensive step of treatment provides added value. Although stepped care for BED is suggested by a number of clinicians and researchers, no study adequately tests predictors of who might benefit from minimal treatment alone and who would require the more intensive second step. The results of this study will guide decision making regarding who benefits from stepped care, and will help to increase the accessibility, availability, and cost effectiveness of psychological treatments for BED.
Evidence-based clinical treatments for common mental disorders, such as CBT and/or pharmacotherapy, have resulted in significant and sustained improvement in clinical symptoms. However, the individual-focused treatments rarely have sickness absence as a target of intervention or evaluate work-related outcomes, such as return to work. A recent review of the evidence for managing stress at work showed that individual interventions give effects on mental health measures but did not impact absenteeism at work. The purpose of this study is to examine the efficacy and cost-effectiveness of two different rehabilitation models, one based on psychotherapy and the other on workplace-interventions, when these are offered as standalone interventions and in combination for patients with adjustment, anxiety and depressive disorders.
The Physical Activity and Nutrition in Children (PANIC) Study is a single-centre controlled trial on the effects of a combined physical activity and dietary intervention on cardiometabolic risk factors and other health outcomes in a population sample of children from the city of Kuopio, Finland. The study provides novel scientific information for the identification of cardiometabolic diseases and other chronic diseases since fetal period and for the prevention of these chronic diseases since childhood. The main hypothesis of the PANIC study is that individuals at increased risk of cardiometabolic diseases and other chronic diseases can be identified in childhood and that it is possible to start the prevention of these chronic diseases by a long-term physical activity and dietary intervention since childhood.
The current trial aims to investigate the impact of continuous feedback on dropout and outcome in group therapy. The hypothesis is that continuous feedback to patient and therapist on treatment progress and alliance will 1) increase adherence and 2) increase treatment outcome.