Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials.

Objectives The purpose of this study is to provide an updated systematic review to identify studies describing the prevalence of psychosis in order to explore methodological factors that could account for the variation in prevalence estimates. Methods Studies with original data related to the prevalence of psychosis (published between 1990 and 2015) were identified via searching electronic databases and reviewing manual citations. Prevalence estimates were sorted according to prevalence type (point, 12-months and lifetime). The independent association between key methodological variables and the mean effect of prevalence was examined (prevalence type, case-finding setting, method of confirming diagnosis, international classification of diseases, diagnosis category, and study quality) by meta-analytical techniques and random-effects meta-regression. Results Seventy-three primary studies were included, providing a total of 101 estimates of prevalence rates of psychosis. Across these studies, the pooled median point and 12-month prevalence for persons was 3.89 and 4.03 per 1000 respectively; and the median lifetime prevalence was 7.49 per 1000. The result of the random-effects meta-regression analysis revealed a significant effect for the prevalence type, with higher rates of lifetime prevalence than 12-month prevalence (p<0.001). Studies conducted in the general population presented higher prevalence rates than those carried out in populations attended in health/social services (p = 0.006). Compared to the diagnosis of schizophrenia only, prevalence rates were higher in the probable psychotic disorder (p = 0.022) and non-affective psychosis (p = 0.009). Finally, a higher study quality is associated with a lower estimated prevalence of psychotic disorders (p<0.001). Conclusions This systematic review provides a comprehensive comparison of methodologies used in studies of the prevalence of psychosis, which can provide insightful information for future epidemiological studies in adopting the most relevant methodological approach.

/pdf/prevalence-of-psychotic-disorders-and-its-association-with-2f127pmxb5.pdf

Prevalence of psychotic disorders and its association with methodological issues. A systematic review and meta-analyses.

A meta-analytic examination of attrition in virtual reality exposure therapy for anxiety disorders.

Background In recent years, virtual reality exposure–based cognitive behavioral therapy (VRE-CBT) has shown good treatment results in (subclinical) anxiety disorders and seems to be a good alternative to exposure in vivo in regular cognitive behavioral therapy (CBT). However, previous meta-analyses on the efficacy of VRE-CBT on anxiety disorders have included studies on specific phobias and subthreshold anxiety; therefore, these results may not be generalizable to patients with more severe and disabling anxiety disorders. Objective The objective of our study is to determine the efficacy of VRE-CBT on more severe anxiety disorders, excluding specific phobias and subthreshold anxiety disorders. Meta-analyses will be conducted to examine the efficacy of VRE-CBT versus waitlist and regular CBT. Our secondary objectives are to examine whether the efficacy differs according to the type of anxiety disorder, type of recruitment, and type of VRE-CBT (virtual reality exposure either with or without regular CBT). Furthermore, attrition in VRE-CBT and CBT will be compared. Methods Studies published until August 20, 2020, were retrieved through systematic literature searches in PubMed, PsycINFO, and Embase. We calculated the effect sizes (Hedges g) for the difference between the conditions and their 95% CIs for posttest and follow-up measurements in a random effects model. A separate meta-analysis was performed to compare attrition between the VRE-CBT and CBT conditions. Results A total of 16 trials with 817 participants were included. We identified 10 comparisons between VRE-CBT and a waitlist condition and 13 comparisons between VRE-CBT and a CBT condition. With regard to risk of bias, information on random sequence generation, allocation concealment, and risk of bias for selective outcome reporting was often absent or unclear. The mean effect size of VRE-CBT compared with waitlist (nco=10) was medium and significant, favoring VRE-CBT (Hedges g=−0.490, 95% CI −0.82 to −0.16; P=.003). The mean effect size of VRE-CBT compared with CBT (nco=13) was small and nonsignificant, favoring CBT (Hedges g=0.083, 95% CI −0.13 to 0.30; P=.45). The dropout rates between VRE-CBT and CBT (nco=10) showed no significant difference (odds ratio 0.79, 95% CI 0.49-1.27; P=.32). There were no indications of small study effects or publication bias. Conclusions The results of our study show that VRE-CBT is more effective than waitlist and as effective as CBT in the treatment of more severe anxiety disorders. Therefore, VRE-CBT may be considered a promising alternative to CBT for patients with more severe anxiety disorders. Higher-quality randomized controlled trials are needed to verify the robustness of these findings.

/pdf/the-effectiveness-of-virtual-reality-exposure-based-2wrto97x.pdf

The Effectiveness of Virtual Reality Exposure–Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder: Meta-analysis

El objetivo del estudio es conocer la prevalencia de personas con problemas de salud mental en Espana y su asociacion con variables socioeconomicas, de trabajo y salud. Se trata de un estudio transversal con los datos de la Encuesta Nacional de Salud de Espana (2006) en el que participaron 29.476 personas (16 y 64 anos). El instrumento de cribado de problemas de salud mental utilizado es el General Health Questionnaire (GHQ-12). Se realizaron analisis descriptivos y de regresion logistica para verificar la asociacion entre la prevalencia de problemas de salud mental y las variables independientes. La prevalencia de problemas de salud mental es mayor en mujeres (24,6%) que en hombres (14,7%). Las variables mas asociadas a una mayor prevalencia de problemas de salud mental son estar separado o divorciado, ser inmigrante de un pais en vias de desarrollo, tener peores condiciones socioeconomicas, tener poco apoyo social (hombres OR 3,6; mujeres OR 3,3), estar desempleado o en baja laboral, tener enfermedades cronicas, estar limitado/a en la realizacion de actividades cotidianas en funcion de un problema de salud (hombres OR 7,5; mujeres OR 7,1). Estos resultados permiten la identificacion de grupos de la poblacion mas vulnerables y pueden ser de utilidad para disenar intervenciones

Prevalencia de problemas de salud mental y su asociación con variables socioeconómicas, de trabajo y salud :

http://www.uhu.es/publicaciones/ojs/index.php/amc/article/download/1058/1825

La escala de valoración del estado de ánimo (EVEA ): análisis de la estructura factorial y de la capacidad para detectar cambios en estados de ánimo

Efficacy of virtual reality exposure therapy combined with two pharmacotherapies in the treatment of agoraphobia

En este articulo se presenta un estudio de contrastacion del modelo elaborado por Michael Dugas para la prediccion del trastorno de ansiedad generalizada (TAG) y su posible relacion con otros trastornos. Para ello, se evaluo por medio de un diseno correlacional a una muestra de 300 personas en las variables de TAG  y depresion, asi como en las variables de proceso, predictoras del TAG: intolerancia hacia la incertidumbre, creencias sobre la preocupacion, orientacion pobre al problema y evitacion cognitiva. Los resultados muestran un apoyo al modelo de Dugas al mostrar como las variables de proceso predicen de manera significativa las puntuaciones en una prueba que evalua el TAG. Asimismo, las variables de proceso tambien participan en la prediccion de las puntuaciones en una escala de depresion. En ese sentido, los resultados se discuten apoyando el modelo de procesos para el TAG, pero se cuestiona que esas variables solo esten relacionadas con dicho trastorno.

La predicción del trastorno de ansiedad generalizada en función de variables de proceso

Se pretende con este estudio llevar a cabo una estimacion de la prevalencia de los trastornos mentales agrupados tanto en categorias generales como en categorias diagnosticas especificas. Se utilizo un diseno por conglomerados bietapico, llevando a cabo una seleccion aleatoria de la muestra en dos fases. La muestra en 1a fase estuvo constituida por 800 personas, mayores de 18 anos. En 2a fase se trabajo con 114 personas. Como instrumentos de evaluacion se administraron el GHQ-28 y la entrevista estructurada CIDI. Los resultados indican una prevalencia estimada del 18,42% para el total de la muestra. Se obtiene una mayor prevalencia de trastornos en las mujeres. Por categorias especificas, los trastornos de ansiedad son los mas prevalentes, seguidos por los trastornos relacionados con sustancias y de los trastornos del estado de animo. Se destaca que los trastornos relacionados con el uso de sustancias ocupan un segundo lugar, desplazando a los trastornos del estado de animo, lo que concuerda con otros estudios realizados con metodologia similar.

/pdf/prevalencia-de-los-trastornos-mentales-en-la-isla-de-399s1katpf.pdf

Prevalencia de los trastornos mentales en la isla de Tenerife

Género y uso de medicamentos ansiolíticos e hipnóticos en España

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