cognitive behavioural therapy, CBT

  • 文章类型: Randomized Controlled Trial
    目的是评估怀孕期间压力管理认知行为疗法(CBT)对随后的童年对出生时的毛发皮质醇以及6个月大的神经发育和毛发皮质醇浓度的影响。研究样本包括48名孕妇,分为两组:治疗组(TG)的24名妇女和接受标准妊娠护理的24名妇女(对照组;CG)。为了测试治疗效果,对头发皮质醇浓度和心理压力的评估,在治疗前后进行了精神病理学症状和弹性分析。他们头发中的皮质醇水平是在怀孕期间和出生时的婴儿获得的。出生六个月后,从头发中采集皮质醇样本,并根据Bayley-III试验评估婴儿的神经发育。治疗后,TG减轻了心理压力和精神病理学症状。另一方面,CG在干预前后增加了皮质醇浓度,在TG中保持稳定。此外,结果显示,TG婴儿出生时皮质醇浓度较低,6个月时认知和运动发育得分明显较高。这些发现支持,为孕妇提供心理护理可能不仅对这些妇女的精神状态有好处,但也可能有利于其后代的神经发育。本文受版权保护。保留所有权利。
    The objective was to evaluate the effects of a stress management cognitive behavioural therapy followed during pregnancy on subsequent childhood on hair cortisol at birth and on neurodevelopment and Hair Cortisol Concentrations (HCC) at 6 months of age. The study sample included 48 pregnant women, divided into two groups: 24 women in the Therapy Group (TG) and 24 women who received standard pregnancy care (control group (CG); CG). To test the therapy efficacy, an evaluation of the HCC and psychological stress, psychopathological symptomatology and resilience was conducted before and after the treatment. The level of cortisol in their hair was obtained during pregnancy and that of their babies at birth. Six months after birth, a cortisol sample was taken from the hair and the babies\' neurodevelopment was evaluated based on a Bayley-III test. The TG presented reductions in psychological stress and psychopathological symptomatology after treatment. On the other hand, the CG increased their cortisol concentrations between the pre and post intervention, remaining stable in the TG. Moreover, results showed that TG babies had lower cortisol concentrations at birth and obtained significantly higher cognitive and motor development scores at 6 months. These findings support that providing psychological care to pregnant women may not only have a benefit on these women\'s mental state, but may also benefit the neurodevelopment of their offspring.
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  • 文章类型: Journal Article
    溃疡性结肠炎和克罗恩病是炎症性肠病的主要形式。两者都代表胃肠道的慢性炎症,随着时间的推移,患者之间和个体内部的炎症和症状负担表现出异质性。最佳管理依赖于临床医生与患者合作理解和定制基于证据的干预措施。此16岁以上成人炎症性肠病管理指南由代表英国医生(英国胃肠病学会)的利益相关者制定,外科医生(大不列颠和爱尔兰结肠病学协会),专科护士(皇家护理学院),儿科医生(英国儿科胃肠病学会,肝病学和营养学),营养师(英国饮食协会),放射科医师(英国胃肠道和腹部放射学学会),全科医生(胃肠病学初级保健协会)和患者(克罗恩病和结肠炎英国)。对88247份出版物进行了系统审查,并进行了涉及81名多学科临床医生和患者的Delphi共识程序,以制定168项基于证据和专家意见的药理学建议。非药物和手术干预,以及在溃疡性结肠炎和克罗恩病的管理中提供最佳服务。提供了关于适应症的全面最新指导,开始和监测免疫抑制疗法,营养干预,pre,围手术期及术后管理,以及多学科团队的结构和功能以及初级和二级保健之间的整合。提出了20项研究重点,以告知未来的临床管理,在客观衡量优先重要性的同时,由2379名来自溃疡性结肠炎和克罗恩病患者的电子调查回复确定,包括患者,他们的家人和朋友。
    Ulcerative colitis and Crohn\'s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn\'s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn\'s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn\'s disease, including patients, their families and friends.
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