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Biomedical subjects

A Hoffart

Publications and source records attributed to A Hoffart.

At least 19 recordsLinked to original sources
PubMed2004

Short-term follow-up of adults with long standing anorexia nervosa or non-specified eating disorder after inpatient treatment.

OBJECTIVE: There are few follow-up studies on outcome for patients with long standing anorexia nervosa (AN) or non-specified eating disorder with several comorbid psychiatric disorders. Inpatient treatment is one option for these patients. The aim of this prospective study was to report one-year follow-up for a consecutive sample of these patients after an inpatient treatment program. METHOD: All 24 patients with a mean age of 28 years and mean duration of an eating disorder of 11 years were treated in a 23-week inpatient group treatment program for AN. Patients were assessed using Eating Disorder Examination interview (EDE), Eating Disorder Inventory (EDI) and Symptom Check List (SCL-90-R) at pre-treatment, post-treatment and at one year after start of treatment. At the follow-up 24 patients were personally interviewed. On admission 12 (50%) had AN, 8 (33%) non-specified eating disorder (EDNOS) and 4 (17%) bulimia nervosa (BN). All had previously suffered from AN and were clinically evaluated to have mostly anorectic psychopathology. RESULTS: Ten (42%) patients had improved at follow-up and 14 (58%) had a poor outcome. There was a moderate but significant improvement on the EDE, EDI and GSI from pre-treatment to follow-up. The improvement occurred during inpatient treatment, and no significant differences from post-treatment to follow-up were found. Patients with low weight on admission showed a significant mean weight increase of about 4 kg at the follow-up. CONCLUSIONS: At one-year follow-up there was a moderate reduction of eating disorder symptoms and general psychiatric symptoms for patients with long standing anorexic symptoms. The improvement occurred during inpatient treatment. Inpatient treatment may be a treatment option in long-time rehabilitation for some of these patients.

Adolescent↗
PubMed2001

One-year follow-up of patients treated for dental fear: effects of cognitive therapy, applied relaxation, and nitrous oxide sedation.

The effects of dental fear treatments were assessed in a 1-year follow-up study. Sixty-two patients had finished a controlled study in which they were randomly allocated to nitrous oxide sedation (NO), cognitive therapy (CT), or applied relaxation (AR). During the trial highly significant reductions in dental fear and general distress were observed. One year later a majority (95%) of the participants had attended dental treatment in general practice. On the whole, continued favorable effects with regard to dental fear and general distress were observed. Patients in the applied relaxation group evidenced the largest reductions on the dental fear measures. All patients judged the dental fear treatment to have been beneficial, and 80% judged the treatment given in the year after the dental fear treatment successful. All three treatment groups scored in the normative range for general distress both at the end of treatment and at follow-up.

Analysis of Variance↗
PubMed2001

A comparison of cognitive therapy, applied relaxation, and nitrous oxide sedation in the treatment of dental fear.

The aim of this study was to investigate the short-term efficacy of cognitive therapy and applied relaxation in dental fear treatment and to compare these methods with conventional pharmacological sedation (nitrous oxide sedation). Patients (n = 65) with severe dental fear were randomly assigned to the different treatment methods and received 10 weekly sessions of individual therapy. Dropout rates were low, and all patients who completed the therapy sessions were able to receive dental treatment. Scores on dental fear tests were significantly reduced compared with pretreatment level for all treatment groups. There were no major differences between treatment methods in this short-term perspective.

Adult↗
PubMed2000

The relationship between cognitions and panic attack intensity.

OBJECTIVE: To investigate the relationship between panic attack intensity, catastrophic belief and cognitions. METHOD: Data from 540 panic diaries were collected from 42 patients with panic disorder with agoraphobia. RESULTS: When we controlled for individual variation, effects of treatment and number of symptoms, catastrophic belief contributed significantly to more intense panic attacks (r2 change = 0.10, P<0.0001). There were no significant differences in panic attack intensity between primary and secondary cognitions. CONCLUSION: Our results indicate that catastrophic belief is a reliable predictor of panic attack intensity.

Adult↗
PubMed2000

Effects of dental fear treatment on general distress. The role of personality variables and treatment method.

This study aimed to clarify the effects of applied relaxation, cognitive therapy, and nitrous oxide sedation on dental fear and general emotional distress symptoms. Relationships among outcome measures and the Big Five personality dimensions (i.e., Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness) were also investigated. After treatment, a highly significant decline in a broad range of emotional distress symptoms as well as dental fear was found. No main treatment method effect or treatment x phase interaction effect with regard to dental fear or distress symptoms was found. Thus, the three treatment methods had highly similar effects, at least on a short-term basis. Significant correlations between neuroticism, extraversion, and agreeableness on one hand, and emotional distress symptoms on the other, were demonstrated. However, when initial symptom level was controlled for in multiple regression analysis, the statistical effects of personality variables generally disappeared.

Adult↗
PubMed1997

Interpersonal problems among patients suffering from panic disorder with agoraphobia before and after treatment.

The aim of this study was to examine interpersonal problems among panic disorder with agoraphobia patients before and after treatment. Patients (N = 46) suffering from panic disorder with moderate or severe agoraphobia and considering agoraphobia as their main problem were randomly assigned to receive either cognitive therapy or guided mastery therapy in a six-week in-patient group programme. The Inventory of Interpersonal Problems (IIP) and various symptom measures were administered at pretreatment and at one-year follow-up. Two IIP subscales were derived from factor analysis of the present data: affiliation problems and power problems. The overall pattern of results supported a state model of interpersonal problems. At pre-treatment, the scores on the affiliation problems subscale were clearly related to non-specific state characteristics, that is, to depression and general anxiety. From pre-treatment to follow-up, levels of interpersonal problems decreased significantly. Pre-treatment depression was a powerful predictor of change in interpersonal problems from pre-treatment to one-year follow-up. On the other hand, interpersonal problems at pre-treatment failed to predict the change in levels on various symptom scales.

Adult↗
PubMed1995

DSM-III-R Axis I and II disorders in agoraphobic inpatients with and without panic disorder before and after psychosocial treatment.

Panic disorder patients with agoraphobia (n = 32) and agoraphobic patients without panic disorder (n = 18) who were participants in an inpatient behavioral-psychodynamic treatment program were assessed repeatedly from pretreatment to 2-year posttreatment follow-up. At pretreatment, there were statistical trends for more of the panic with agoraphobia patients to have obsessive-compulsive disorder and alcohol abuse/dependence, and for more of the agoraphobia without panic patients to have generalized anxiety disorder and avoidant personality disorder. There was also a trend for more of the panic with agoraphobia patients to have met criteria for major depression during the 2-year follow-up period.

Adult↗
PubMed1995

Cognitive mediators of situational fear in agoraphobia.

The aim of this study was to examine cognitive mediators of situational fear in agoraphobia. Patients suffering from panic disorder with moderate or severe agoraphobia were randomly assigned to receive either cognitive therapy or guided mastery therapy in a 6-week inpatient group program. The results were consistent with a self-efficacy model of agoraphobia. Across test occasions, and when the other cognitive variables were controlled for, self-efficacy made a significant contribution to the prediction of situational fear or changes in situational fear in 5 out of 5 cases. Catastrophic beliefs were related to situational fear in 1 of the 5 cases.

Adult↗
PubMed1995

A comparison of cognitive and guided mastery therapy of agoraphobia.

The aim of this study was to compare the efficacy of cognitive and performance-based therapy of agoraphobia. Fifty-two patients suffering from panic disorder with moderate or severe agoraphobia and considering agoraphobia as their main problem were randomly assigned to receive either cognitive therapy or guided mastery therapy in a six-week inpatient group program. Significantly more of the cognitive therapy patients attained high endstate functioning, whereas the proportion of responders in the two groups did not differ. An overall test revealed no differences between the two treatment groups on the continuous outcome measures at posttreatment. As predicted from the cognitive model of panic with agoraphobia, self-efficacy scores increased with the reduction of catastrophic belief scores in the cognitive therapy group. Inconsistent with the self-efficacy model, catastrophic belief scores did not change with the increase of self-efficacy scores in the guided mastery group. Overall, the superiority of one of the treatment methods over the other was not clearly demonstrated.

Adult↗
PubMed1995

Psychoanalytical personality types and agoraphobia.

The aim of this study was to examine the relationship between psychoanalytical personality types and agoraphobia. Thirty-two panic disorder with agoraphobia patients and 18 agoraphobia without panic disorder patients attending an inpatient 11-week behavioral-psychodynamic treatment program were assessed repeatedly from pretreatment to 2 years after the end of treatment. On personality scales measuring oral, obsessive, hysterical, and reality-weak traits, there were no differences between agoraphobic patients with and without panic disorder. The examined traits correlated across the period from pretreatment to 2-year follow-up, although the potential influence of symptoms were controlled for. Higher scores on the oral scale predicted poorer course of symptoms in the year immediately after treatment. Scores on the oral scale decreased with the improvements of agoraphobic and general symptoms, but did not attain a normal level. The results supported a combined predisposition-state model for the relationship between oral traits and agoraphobia.

Adult↗
PubMed1995

Assessment of depression: comparison between Beck Depression Inventory and subscales of Comprehensive Psychopathological Rating Scale.

The purpose of this study was to investigate the relationship between self-rating and therapist rating in nonpsychotic patients with unipolar depressive disorders. We also wanted to find out whether the presence of personality disorders would influence the results. At admission and discharge 117 patients filled in the Beck Depression Inventory (BDI) and were rated by a therapist on the Comprehensive Psychopathological Rating Scale (CPRS). Based on the CPRS-scores, two indices of depression were calculated: CPRS-dep and Montgomery Asberg Depression Rating Scale (MADRS). Sixty-three patients had DSM-III-R major depression, 30 had dysthymic disorder, while 24 had no depressive disorder. Eighty suffered from one or more personality disorders, mostly within cluster C. The self rating (BDI) and therapist ratings (CPRS-dep and MADRS) were strongly intercorrelated, with a nonsignificant tendency for weaker correlations in patients with personality disorders. All scales were useful to separate depressed from non-depressed, and to discriminate between major depression and dysthymic disorder, with a tendency in favour of BDI. As cut-off scores for major depression we recommend the sum score of 23 on the BDI, and mean scores of 1 on CPRS-dep and 1.1 on MADRS on a 0-3 scale. When these values are used, 70-79% of patients are correctly classified.

Adult↗
PubMed1994

DSM-III-R Axis I and II disorders in agoraphobic patients with and without panic disorder.

Patients attending an inpatient phobia treatment program were diagnosed for DSM-III-R Axis I and II disorders, using the Structured Clinical Interview for DSM-III-R Disorders, and completed a set of self-report instruments. They were divided into 3 groups: (a) those who met the criteria for panic disorder with agoraphobia (n = 57), (b) those who met the criteria for agoraphobia without a history of panic disorder (n = 21), and (c) those who met criteria for other anxiety disorders, but not for panic/agoraphobia (n = 14). On Axis I, more of the panic with agoraphobia than of the agoraphobia without panic patients had obsessive-compulsive disorder. On Axis II, no significant differences between the agoraphobic patients with and without panic occurred. However, the number of hysterical traits was related to the presence of panic disorder among the agoraphobic patients. Avoidant and dependent traits were related to symptom severity.

Adult↗
PubMed1993

Coping strategies in major depressed, agoraphobic and comorbid in-patients: a longitudinal study.

The first aim of this study was to explore the diagnostic specificity of coping styles by comparing ways of coping in non-anxious major depressed, non-depressed agoraphobic, and both major depressed and agoraphobic (comorbid) in-patients. The second aim was to investigate whether a vulnerability model, a state model, or a combined vulnerability-state model of coping accounted best for the data. On admission and when discharged, 95 patients completed the Way of Coping Checklist and were evaluated on several symptom scales. Self-report symptom scales were completed at one-year follow-up as well. The 'purely' agoraphobic and the comorbid patients showed less seeking of social support and more wishful thinking than the major depressed patients. For the wishful thinking scale, these differences were related to differences in level of global psychopathology. Overall, the results for the seeking social support scale were consistent with a combined vulnerability-state model. The problem-focused coping and wishful thinking scores behaved mostly as state phenomena. The avoidance scores provided ambiguous evidence. In a subsample of 30 agoraphobic patients who received a combination of exposure and psychodynamic treatment, higher pre-treatment levels of seeking social support and lower pre-treatment levels of avoidance as coping both predicted a more favourable course of symptoms pertaining to fear of fear in the one-year follow-up period.

Adaptation, Psychological↗
PubMed1993

Clomipramine in the treatment of agoraphobic inpatients resistant to behavioral therapy.

BACKGROUND: Both behavior-modification methods and antidepressants have proved to be effective in the treatment of agoraphobia. The authors examined the effects of clomipramine on agoraphobia in patients who failed to respond to exposure-based behavioral treatment. METHOD: Eighteen patients with panic disorder with agoraphobia who had not responded to previous inpatient behavioral treatment were recruited to a 12-week, placebo-controlled, double-blind crossover study of clomipramine, at top doses of 150 mg/day for 3 weeks. The patients were assessed on measures of phobic avoidance, agoraphobic cognitions, panic, state and trait anxiety, subjective anxiety, and depression. RESULTS: One patient dropped out of the study after 6 weeks. On most outcome measures, the 17 study completers had significantly (p < .05) lower symptom scores at posttest in the active drug period than at posttest in the placebo period; however, the clinical gains were modest. CONCLUSION: The short-term efficacy of clomipramine for agoraphobic patients who failed to respond lastingly to behavioral treatment was demonstrated. It remains to be shown that clomipramine can lead to clinically significant and lasting benefits in these patients.

Adult↗