scholarly journals Treatment of Hypochondriasis in Two Schizophrenia Patients Using Clozapine

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Antonio Tundo ◽  
Luca Proietti ◽  
Rocco de Filippis
Keyword(s):  
Therapeutic Strategy ◽  
Dosage Reduction ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Mood Stabilizer ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Alternative Interventions ◽  
Cognitive Behavioural ◽  
Obsessive Compulsive Spectrum Disorder

Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%), especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) include combining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptake inhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO in patients using clozapine so we examine these options in 2 cases and report the results. Among treatments delivered, only dosage reduction adequately worked. We recommend caution when thinking about escalating treatment and suggest trying it only when alternative interventions were not successful and weighing risk and benefits of this therapeutic strategy. Further research is needed to confirm the hypothesis that CLZ treatment induces hypochondriac symptoms, to investigate the prevalence of the phenomenon, and, mostly, to identify possible treatment strategies.

scholarly journals Clinical practice guidelines for insomnia disorder

2017 ◽  
Vol 59 (3) ◽  
pp. 45-51
Author(s):  
Lucille Malan ◽  
Nokuthula Dlamini
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Treatment Options ◽  
Early Morning ◽  
Behavioural Therapy ◽  
Pharmacological Therapy ◽  
Chronic Insomnia ◽  
First Line Therapy ◽  
Insomnia Disorder ◽  
Cognitive Behavioural ◽  
Falling Asleep

Insomnia disorder is defined as difficulty in falling asleep, maintaining sleep, and early morning awakenings. Common daytime consequences experienced are fatigue, mood instability and impaired concentration. In chronic insomnia these symptoms persist over a period of at least three months. Chronic insomnia can also be a symptom of a variety of disorders. The pathophysiology of insomnia is theorised as a disorder of nocturnal and daytime hyper-arousal as a result of increased somatic, cortical and cognitive activation. The causes of insomnia can be categorized into situational, medical, psychiatric and pharmacologically-induced. To diagnose insomnia, it is required to evaluate the daytime and nocturnal symptoms, as well as psychiatric and medical history. The Diagnostic and Statistical Manual 5 Criteria (DSM-5) also provides guidelines and criteria to be followed when diagnosing insomnia disorder. Goals of treatment for insomnia disorder are to correct the underlying sleep complaint and this, together with insomnia symptoms, their severity and duration, as well as co-morbid disorders will determine the choice of treatment. In the majority of patients, insomnia can be treated without pharmacological therapy and cognitive behavioural therapy is considered first-line therapy for all patients with insomnia. The most common pharmacological insomnia treatments include benzodiazepines and benzodiazepines receptor agonists. To avoid tolerance and dependence, these hypnotics are recommended to be used at the lowest possible dose, intermittently and for the shortest duration possible. A combination of cognitive behavioural therapy and pharmacological treatment options is recommended for chronic insomnia.

Obsessive-compulsive disorder

2015 ◽  
Author(s):  
Paul M. Salkovskis ◽  
Joan Kirk
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Experimental Studies ◽  
Behavioural Therapy ◽  
Cognitive Factors ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Behavioural Theory ◽  
Cognitive Behavioural ◽  
Negative Appraisals

Chapter 8 explores obsessive-compulsive disorder (OCD). It first outlines the nature of OCD, its prevalence, the development of current treatments, the behavioural theory of OCD and behaviour therapy in practice, deficit theories and cognitive factors, cognitive behavioural therapy (CBT) for OCD, experimental studies of normal intrusive thoughts, distorted thinking and negative appraisals, treatment implications of the cognitive behavioural theory, and strategies in the treatment of OCD.

What do you really need? Self- and partner-reported intervention preferences within cognitive behavioural therapy for reassurance seeking behaviour

2019 ◽  
Vol 48 (1) ◽  
pp. 25-37
Author(s):  
Rachael L. Neal ◽  
Adam S. Radomsky
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Theory And Practice ◽  
Obsessive Compulsive ◽  
Support Provision ◽  
Reassurance Seeking ◽  
Compulsive Disorder ◽  
Choice Preference ◽  
Cognitive Behavioural ◽  
Intervention Preferences

AbstractBackground:Reassurance seeking (RS) in obsessive compulsive disorder (OCD) is commonly addressed in cognitive behavioural therapy (CBT) using a technique called reducing accommodation. Reducing accommodation is a behaviourally based CBT intervention that may be effective; however, there is a lack of controlled research on its use and acceptability to clients/patients, and case studies suggest that it can be associated with negative emotional/behavioural consequences. Providing support to encourage coping with distress is a cognitively based CBT intervention that may be an effective alternative, but lacks evidence regarding its acceptability.Aims:This study aimed to determine whether support provision may be a more acceptable/endorsed CBT intervention for RS than a strict reducing accommodation approach.Method:Participants and familiar partners (N = 179) read vignette descriptions of accommodation reduction and support interventions, and responded to measures of perceived intervention acceptability/adhereability and endorsement, before completing a forced-choice preference task.Results:Overall, findings suggested that participants and partners gave significantly higher ratings for the support than the accommodation reduction intervention (partial η2 = .049 to .321). Participants and partners also both selected the support intervention more often than the traditional reducing accommodation intervention when given the choice.Conclusions:Support provision is perceived as an acceptable CBT intervention for RS by participants and their familiar partners. These results have implications for cognitive behavioural theory and practice related to RS.

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