Long-term effects of cognitive therapy on biological rhythms and depressive symptoms: A randomized clinical trial
JOURNAL OF AFFECTIVE DISORDERS
Authors: Mondin, Thaise Campos; Cardoso, Taiane de Azevedo; Jansen, Karen; da Silva, Giovanna Del Grande; de Mattos Souza, Luciano Dias; da Silva, Ricardo Azevedo
Abstract
Objective: To evaluate the effect of cognitive therapy on biological rhythm and depressive and anxious symptoms in a twelve-month follow-up period. In addition, correlations between the reduction of depression and anxiety symptoms and the regulation of biological rhythm were observed. Methods: This was a randomized clinical trial with young adults from 18 to 29 years of age who were diagnosed with depression. Two models of psychotherapy were used: Cognitive Behavioral Therapy (CBT) and Narrative Cognitive Therapy (NCT). Biological rhythm was assessed with the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Severity of depressive and anxious symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS), respectively. The sample included 97 patients who were divided within the protocols of psychotherapy. Results: There was a significant reduction in depressive and anxious symptoms (p < 0.001) and an increase on regulation of biological rhythm (p < 0.05) at the twelve-month follow-up. Moreover, we showed a positive correlation between the reduction of depressive symptoms and regulation of biological rhythm (r=0.638; p < 0.001) and between the reduction of anxious symptoms and regulation of biological rhythm (r=0 438; p < 0.001). Conclusion: Both models showed that cognitive therapy was effective on the reduction of depressive and anxious symptoms and on the regulation of biological rhythm at a twelve-month follow-up evaluation. This study highlights the association between biological rhythm and symptoms of depression and anxiety. Limitation: We did not assess genetic, hormonal or neurochemical factors and we did not include patients under pharmaceutical treatment or those with severe symptomatology. (C) 2015 Elsevier B.V. All rights reserved
The Parkinson Anxiety Scale (PAS): Development and Validation of a New Anxiety Scale
MOVEMENT DISORDERS
Authors: Leentjens, Albert F. G.; Dujardin, Kathy; Pontone, Gregory M.; Starkstein, Sergio E.; Weintraub, Daniel; Martinez-Martin, Pablo
Abstract
Existing anxiety rating scales have limited construct validity in patients with Parkinson's disease (PD). This study was undertaken to develop and validate a new anxiety rating scale, the Parkinson Anxiety Scale (PAS), that would overcome the limitations of existing scales. The general structure of the PAS was based on the outcome of a Delphi procedure. Item selection was based on a canonical correlation analysis and a Rasch analysis of items of the Hamilton Anxiety Rating Scale (HARS) and the Beck Anxiety Inventory (BAI) from a previously published study. Validation was done in a cross-sectional international multicenter study involving 362 patients with idiopathic PD. Patients underwent a single screening session in which the PAS was administered, along with the Hamilton Depression Rating Scale, the HARS, and the BAI. The Mini International Neuropsychiatric Interview was administered to establish Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses of anxiety and depressive disorders. The PAS is a 12-item observer or patient-rated scale with three subscales, for persistent, episodic anxiety and avoidance behavior. Properties for acceptability and reliability met predetermined criteria. The convergent and known groups validity was good. The scale has a satisfactory factorial structure. The area under the receiver operating characteristics curve and Youden index of the PAS are higher than that of existing anxiety rating scales. The PAS is a reliable and valid anxiety measure for use in PD patients. It is easy and brief to administer, and has better clinimetric properties than existing anxiety rating scales. The sensitivity to change of the PAS remains to be assessed. (C) 2014 International Parkinson and Movement Disorder Society