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Supportive Clinical Management (supportive + clinical_management)

Distribution by Scientific Domains
Medical Sciences50%

Selected Abstracts

Specialist supportive clinical management for anorexia nervosa

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 8 2006
Dip Clin Psyc, Virginia V. W. McIntosh PhD
Abstract Objective: This article presents the rationale for, and description of, a nonspecialized therapy for anorexia nervosa, called specialist supportive clinical management (SSCM). Method: Clinical management and supportive psychotherapy models of treatment are outlined. SSCM is described, as it was delivered in a clinical trial of psychotherapies for adult women with anorexia nervosa. Results: The primary focus of SSCM for anorexia nervosa is the resumption of normal eating and the restoration of weight. Therapy aims to maintain a therapeutic relationship that facilitates the return to normal eating, and to enable other life issues that may impact on the eating disorder to be addressed. Conclusion: Possible effective components of SSCM are discussed. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006; 39:625,632 [source]

A controlled evaluation of monthly maintenance interpersonal psychotherapy in late-life depression with varying levels of cognitive function

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2008
Kristen Carreira
Abstract Objective To evaluate the effect of maintenance Interpersonal Psychotherapy (IPT) on recurrence rates and time to recurrence of major depression in elderly patients with varying levels of cognitive function. Methods/Design Two-year maintenance study of monthly maintenance IPT vs supportive clinical management (CM) in remitted depressed elderly who were participants in a previously reported placebo-controlled study of maintenance paroxetine and IPT (Reynolds et al., 2006). We used Cox regression analysis to test interactions between cognitive status (Dementia Rating Scale score) and treatment (IPT, CM) with respect to recurrence of major depression. Results We observed a significant interaction between cognitive status and treatment: lower cognitive performance was associated with longer time to recurrence in IPT than in CM (58 weeks vs 17 weeks) (HR,=,1.41 [95% CI,=,1.04, 1.91], p,=,0.03). Subjects with average cognitive performance showed no effect of maintenance IPT vs CM on time to recurrence (38 vs 32 weeks, respectively). Conclusion Monthly maintenance IPT confers protection against recurrence of major depression in elders with lower cognitive functioning. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Maintenance Treatment for Old-Age Depression Preserves Health-Related Quality of Life: A Randomized, Controlled Trial of Paroxetine and Interpersonal Psychotherapy

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2007
Alexandre Y. Dombrovski MD
OBJECTIVES: To determine whether maintenance antidepressant pharmacotherapy and interpersonal psychotherapy sustain gains in health-related quality of life (HR-QOL) achieved during short-term treatment in older patients with depression. DESIGN: After open combined treatment with paroxetine and interpersonal psychotherapy, responders were randomly assigned to a two (paroxetine vs placebo) by two (monthly interpersonal psychotherapy vs clinical management) double-blind, placebo-controlled maintenance trial. HR-QOL outcomes were assessed over 1 year. SETTING: University-based clinic. PATIENTS: Of the referred sample of 363 persons aged 70 and older with major depression, 210 gave consent, and 195 started acute treatment; 116 met criteria for recovery, entered maintenance treatment, and were included in this analysis. INTERVENTIONS: Paroxetine; monthly manual-based interpersonal psychotherapy. MEASUREMENTS: Overall HR-QOL as measured using the Quality of Well-Being Scale (QWB) and six specific HR-QOL domains derived from the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) subscales. RESULTS: All domains of HR-QOL except physical functioning improved with successful acute and continuation treatment. After controlling for any effects of psychotherapy, pharmacotherapy was superior to placebo in preserving overall well-being (P=.04, effect size (r)=0.23), social functioning (P=.02, r=0.27), and role limitations due to emotional problems (P=.007, r=0.30). Interpersonal psychotherapy (controlling for the effects of pharmacotherapy) did not preserve HR-QOL better than supportive clinical management. CONCLUSION: Maintenance antidepressant pharmacotherapy is superior to placebo in preserving improvements in overall well-being achieved with treatment response in late-life depression. No such benefit was seen with interpersonal psychotherapy. [source]