Symptomatic Treatment of Agoraphobia and Social Phobias: A Follow-up Study

1975 ◽  
Vol 127 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Peter Tyrer ◽  
Derek Steinberg
Keyword(s):  
Personality Disorder ◽  
Social Adjustment ◽  
Prolonged Treatment ◽  
Comparable Efficacy ◽  
List Type ◽  
Behaviour Therapy ◽  
Double Blind ◽  
Social Phobias ◽  
One Year

Summary1.Twenty-six out of 28 out-patients with agoraphobia and social phobias who had originally been treated with phenelzine or placebo in a double-blind clinical trial were followed up for a mean period of one year. During the follow-up period patients received further pharmacotherapy or behaviour therapy, except that those patients originally receiving placebo were not allowed therapy with monoamine oxidase inhibitors.2.Ratings of phobic and additional symptoms, social adjustment and degree of personality disorder were made after one year by one of the authors (D.S.) who had no prior knowledge of the treatment each patient had received.3.There were no significant differences in any of the ratings between the patients of the two groups, but those originally receiving placebo had more additional treatment in the follow-up period. Patients continuing to receive phenelzine frequently experienced a return of symptoms if the drug was withdrawn before six months treatment had elapsed.4.Degree of personality disorder showed a significant negative correlation (p = –0.6) with improvement in the phenelzine group but not in those receiving placebo originally.5.Improvement in social adjustment items was less than improvement in symptoms at follow-up. The implications of this are discussed.6.The results suggest that phenelzine is of comparable efficacy to other symptomatic treatments for agoraphobia and social phobias, but that it acts mainly by symptom suppression. Prolonged treatment in patients with personality disorders is not indicated, for improvement is less likely and the dangers of dependence are greater.

Clomipramine and Exposure for Obsessive-Compulsive Rituals: 1

1980 ◽  
Vol 136 (1) ◽  
pp. 1-25 ◽  
Author(s):  
I. M. Marks ◽  
R. S. Stern ◽  
D. Mawson ◽  
J. Cobb ◽  
R. McDonald
Keyword(s):  
Social Adjustment ◽  
Depressed Mood ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Exposure In Vivo ◽  
One Year ◽  
Interactional Effect

SummaryForty chronic obsessive-compulsive ritualizers were randomly assigned to treatment with oral clomipramine or placebo for 8 months. During weeks 4 to 7 these two groups were each randomly split into treatment by relaxation or by exposure in vivo, and during weeks 7 to 10 all patients had exposure in vivo. Double blind assessments were made at weeks 4, 7, 10, 18, 36, 62 and 114.Results are reported to one year. Clomipramine produced significant improvement in rituals, mood and social adjustment, but only in those patients who initially had depressed mood. The clomipramine effect was maximum from weeks 10 to 18 and diminished thereafter. On stopping clomipramine patients often relapsed and improved again on restarting the drug. Relaxation produced little change. Exposure produced significant lasting improvement in rituals, but less change in mood; improvement generalized to social adjustment at follow-up. Clomipramine plus exposure had a slight additive but not interactional effect. Clomipramine enhanced compliance both with exposure and with relaxation.Clomipramine is useful for compulsive ritualizers with depressed mood, but may need continuation for over a year and combination with exposure in vivo. Exposure in vivo remains the treatment of choice for rituals without depressed mood.

Fluoxetine and Fluvoxamine Combined with Individual Cognitive-Behaviour Therapy in Binge Eating Disorder: A One-Year Follow-Up Study

2001 ◽  
Vol 70 (6) ◽  
pp. 298-306 ◽  
Author(s):  
Valdo Ricca ◽  
Edoardo Mannucci ◽  
Barbara Mezzani ◽  
Sandra Moretti ◽  
Milena Di Bernardo ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
Follow Up Study ◽  
Cognitive Behaviour ◽  
One Year

Controlled Evaluation of Intravenous Drugs in the Specific Desensitization of Phobias

1973 ◽  
Vol 18 (1) ◽  
pp. 47-53 ◽  
Author(s):  
J. Trevor Silverstone ◽  
M.R. Salkind
Keyword(s):  
Normal Saline ◽  
Rating Scales ◽  
Behaviour Therapy ◽  
Social Phobias ◽  
General Anxiety ◽  
Drug Of Choice ◽  
End Of Treatment ◽  
Specific Phobias ◽  
Controlled Evaluation

The present study was undertaken to compare intravenous methohexitone, given as an adjunct to the behaviour therapy of phobias, with another centrally-acting, rapidly metabolised intravenous agent, propanidid, and also with normal saline. Thirty-five patients were included in the trial, all of whom had had phobic symptoms of at least one year's duration which were seriously interfering with their lives — 15 had specific phobias, 9 had social phobias and 11 had agoraphobia. Treatment consisted of twelve weekly drug-assisted desensitization treatments, using either 1 per cent methohexitone, 2.5 per cent propanidid or normal saline. Within each diagnostic group the drugs were randomly allocated. All treatments were conducted by one of the authors and all assessments by the other (who did not know which of the three preparations the patient had received). In addition to monthly ratings of the phobic symptoms, assessments of anxiety and depression were made, using self-rating scales. Patients were followed up six months after the end of treatment. Patients with specific phobias fared best, 9 out of the 13 who completed being considered to be markedly improved. Although the numbers are small there was a suggestion that patients receiving the two active drugs did better than those on the placebo. While methohexitone and propanidid were similarly effective, recovery time was much more rapid with propanidid. No patient in the specific phobia group relapsed significantly during the six months follow-up period. Furthermore, as the phobia improved the general anxiety level fell. Few depressive symptoms arose during successful desensitization, and there was no evidence of symptom substitution. Patients with social phobias and agoraphobia did far less well. In neither case did the active drugs appear to possess any advantage over placebo. Furthermore, of the 7 patients with agoraphobia who had improved, 4 relapsed within six months. It was concluded that drug-assisted desensitization is likely to be of greatest benefit in the management of specific phobias, with propanidid being the drug of choice.

The long-term effects of homeopathic treatment of chronic headaches: one year follow-up and single case time series analysis

2001 ◽  
Vol 90 (02) ◽  
pp. 63-72 ◽  
Author(s):  
H Walach ◽  
T Lowes ◽  
D Mussbach ◽  
U Schamell ◽  
W Springer ◽  
...  
Keyword(s):  
Time Series ◽  
Single Case ◽  
Double Blind Study ◽  
Long Term Effects ◽  
Double Blind ◽  
Homeopathic Treatment ◽  
Chronic Headaches ◽  
One Year

AbstractLittle is known about long-term effects of homeopathic treatment. Following a double-blind, placebo controlled trial of classical homeopathy in chronic headaches, we conducted a 1-year observational study of 18 patients following the double-blind phase, and a complete follow-up study of all trial participants. Eighteen patients received free treatment for daily diary data (frequency, intensity, duration of headaches) over the course of 1 y. All patients enrolled in the double-blind study were sent a 6-week headache diary, a follow-up questionnaire, a personality inventory and a complaint list. Eighty-seven, of the original 98 patients enrolled returned questionnaires, 81 returned diaries. There was no additional change from the end of the trial to the one-year follow-up. The improvement seen at the end of the 12-week trial was stable after 1 y. No differential effects according to treatment after the trial could be seen. Patients with no treatment following the trial had the most improvement after 1 y. Five of 18 patients can be counted responders according to ARIMA analysis of single-case time-series. Patients with double diagnoses and longer treatment duration tended to have clearer improvements than the rest of the patients. Approximately 30% of patients in homeopathic treatment will benefit after 1 y of treatment. There is no indication of a specific, or of a delayed effect of homeopathy.

scholarly journals Topical Diltiazem Versus Topical Glyceryl Trinitrate In The Management Of Chronic Anal Fissure

JMS SKIMS ◽  
2014 ◽  
Vol 17 (2) ◽  
pp. 55-58
Author(s):  
Shams Ul Bari ◽  
Ajaz Ahmad Malik ◽  
Khurshid Alam Wani ◽  
Ajaz A Rather
Keyword(s):  
Side Effects ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
P Value ◽  
Double Blind ◽  
Surgical Methods ◽  
Significant Difference ◽  
Topical Glyceryl Trinitrate ◽  
One Year

Background: Chemical sphincterotomy is a novel way for treating patients of chronic anal fissure which avoids the risk of fecal incontinence associated with traditional surgical methods. Aims and objectives: The aim of this study was to compare the results of topical Diltiazem with topical Glyceril trinitrate in the management of chronic anal fissure. Methods: 71 patients in the age group of 15 - 61 years with chronic anal fissure were included in this prospective, randomized, double-blind trial over a period of two years with further follow up for one year. The patients were randomly allocated to either Diltiazem gel 2% (37 patients) or Glyceril trinitrate ointment 0.2% (34 patients) and were asked to use the treatment twice daily for 8 weeks. Each patient was reviewed every two weeks. Symptoms, healing, side effects and recurrence were compared using SPSS version 10 employing X2 test. A p-value below 0.05 was considered statistically significant. Results: Patients who received topical diltiazem (DTZ) showed statistically significant difference than those who were prescribed topical glyceril trinitrate in terms of symptoms, wound healing, side effects ( headaches) and recurrence (p=0.03 and 0.003 respectively). Healing occurred in 34 of 37 (92%) patients treated with Diltiazem after 6 weeks and 27 of 34 (80%) patients treated with Glyceril trinitrate after 8 weeks, which shows a significant difference in favour of Diltiazem (P < 0.001). The rest of the patients did not heal and underwent sphincterotomy (SILS). Headache occurred in all of the patients treated with Glyceril trinitrate but none of the patients treated with Diltiazem. Conclusion: Diltiazem gel was found to be better than Glyceril trinitrate ointment due to significantly higher healing rate and fewer side-effects. JMS 2014;17(2):55-58

scholarly journals Brief Intermittent Neuroleptic Prophylaxis for Selected Schizophrenic Out-patients

1989 ◽  
Vol 155 (05) ◽  
pp. 702-706 ◽  
Author(s):  
H. A. McClelland ◽  
G. Harrison ◽  
S. D. Soni
Keyword(s):  
Psychotic Symptoms ◽  
Intermittent Treatment ◽  
Double Blind ◽  
Prodromal Symptoms ◽  
Novel Approach ◽  
Depot Neuroleptic ◽  
One Year ◽  
Depot Injections ◽  
To Receive

“A study was conducted to investigate a novel approach to the prophylaxis of schizophrenic relapse. The treatment strategy comprised brief intermittent courses of neuroleptic agents begun as soon as non-psychotic symptoms believed to be early signs of relapse appeared. Fifty four stable, remitted outpatients meeting the American Psychiatric Association's DSM–III criteria for schizophrenia were randomised double blind to receive brief intermittent treatment with either active or placebo depot neuroleptic injections. Only three patients given placebo injections and two controls were admitted to hospital during one year of follow up. Eight (30%) of the patients given placebo injections and only 2 (7%) of the controls, however, had a recurrence of schizophrenic symptoms. Patients given placebo injections experienced fewer extrapyramidal side effects and showed a trend towards a reduction in tardive dyskinesia. Dysphoric and neurotic symptoms were identified before eight out of 11 relapses, and these symptoms were more frequent in patients given placebo depot injections. These results suggest a viable but not necessarily better alternative to continuous oral or depot treatment for less ill, chronic, stabilised schizophrenics based on the early treatment of putative prodromal symptoms of relapse.”

Extraoral Photobiomodulation for Prevention of Oral and Oropharyngeal Mucositis in Head and Neck Cancer Patients: Interim Analysis of A Randomized, Double-Blind, Clinical Trial

2021 ◽  
Author(s):  
Elisa Kauark-Fontes ◽  
Cesar Augusto Migliorati ◽  
Joel B Epstein ◽  
Nathaniel Simon Treister ◽  
Carolina Guimarães Bonfim Alves ◽  
...  
Keyword(s):  
Placebo Group ◽  
Double Blind ◽  
Oncological Outcomes ◽  
Double Blind Clinical Trial ◽  
First Occurrence ◽  
Anti Inflammatory ◽  
One Year ◽  
Oropharyngeal Mucositis

Abstract PurposeTo assess the safety and efficacy of prophylactic extraoral photobiomodulation (PBM) for the prevention of oral and oropharyngeal mucositis (OM) on clinical outcomes and survival in patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC).MethodsOOPSCC patients who received radiotherapy (RT) were prospectively randomized to two groups: prophylactic extraoral PBM and placebo. OM grade (NCI), pain (VAS), analgesia, and anti-inflammatory prescriptions were assessed weekly. Quality of life questionnaires (QoL) were performed at the first and last day of RT. Following RT, participants were evaluated quarterly for oncological outcomes follow-up.Results55 patients met the inclusion criteria. The first occurrence of OM was observed at week 1, for the placebo group (p = 0.014). Later OM onset and severity was observed for the PBM group, with first occurrence at week 2 (p = 0.009). No difference in severe OM incidence was observed (p > 0.05). Lower mean pain score was noted at week 7 for the PBM group (2.1) compared to placebo group (4.5) (p = 0.009). Less analgesics (week 3; p = 0.009/week 7; p = 0.02) and anti-inflammatory prescription (week 5; p = 0.0346) were observed for the PBM group. Better QoL scores were observed for the PBM group at last day of RT (p = 0.0034). No difference in overall survival among groups, was observed in one year of follow-up (p = 0.889).ConclusionProphylactic extraoral PBM can delay OM onset, reduce pain, as well as reduced analgesic and anti-inflammatory prescription requirements. Extraoral PBM was associated with better QoL. There was no evidence of PBM impact on oncological outcomes. TRN:RBR-4w4swx (date of registration: 01/20/2020)

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