Biomedical subjects

J R Parkin

Publications and source records attributed to J R Parkin.

5 recordsLinked to original sources

PubMed1999

Home self-assessment and self-treatment of obsessive-compulsive disorder using a manual and a computer-conducted telephone interview: replication of a UK-US study.

BACKGROUND: This open study replicates and extends previous pilot work with BT STEPS, a self-therapy system to assess and treat obsessive-compulsive disorder (OCD) through exposure and ritual prevention. METHOD: 21 OCD patients entered this open trial, using a self-guiding manual and any Touch-Tone telephone to access computer-driven interviews via an Interactive Voice Response system. The patients also used the system to rate progress on rating scales. RESULTS: The results support those of the previous open study. Of the 21 patients, 16 (76%) completed self-assessment over a mean of 21 days. Of these, 10 patients (48%) went on to do 2 or more exposure and ritual prevention sessions over a mean of 64 days; they improved significantly on OCD symptoms, as much as is usual with serotonin reuptake inhibitor medication, and in mood and work/social adjustment. Improvement was predicted by baseline motivation and by rapid completion of self-assessment with BT STEPS, even though self-assessment alone was not therapeutic. CONCLUSION: The significant improvement in the intent-to-treat analysis was due to the subgroup of patients (48% of those who began BT STEPS) who went beyond self-assessment to do exposure and ritual prevention self-therapy at home guided by BT STEPS. A controlled trial is now needed.

Adult↗

PubMed1998

Home self-assessment of obsessive-compulsive disorder. Use of a manual and a computer-conducted telephone interview: two UK-US studies.

BACKGROUND: Two studies tested whether subjects with obsessive-compulsive disorder could successfully use BT STEPS, a computer-aided system, to perform self-assessment for self-treatment of obsessive-compulsive disorder by exposure and ritual prevention. METHOD: Subjects were given a self-guiding manual and could use a touch-tone telephone to access computer-controlled Interactive Voice Response interviews at their convenience from home. Using the BT STEPS system, patients rated themselves and worked out a plan for individually tailored self-exposure therapy. RESULTS: Outcomes were similar in the two studies. Of the 63 subjects who used BT STEPS, 84% completed the self-assessment module. Most calls were made outside usual office hours. As expected, subjects did not improve merely by completing self-assessment. However, completion of self-assessment predicted later improvement with self-exposure therapy. CONCLUSIONS: Most subjects successfully completed self-assessment using BT STEPS from their homes. DECLARATION OF INTEREST: BT STEPS is a trademark of Pfizer, Inc. I.M.M., L.B. and J.H.G. have a financial interest in BT STEPS.

Adult↗

PubMed1998

Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: an open U.S.-U.K. study.

OBJECTIVE: To evaluate the efficacy and acceptability of a self-help program for mild-to-moderate depression that combined treatment booklets and telephone calls to a computer-aided Interactive Voice Response (IVR) system. METHOD: In an open trial, 41 patients from Boston, Massachusetts; Madison, Wisconsin; and London, England, used COPE, a 12-week self-help system for depression. COPE consisted of an introductory videotape and 9 booklets accompanied by 11 telephone calls to an IVR system that made self-help recommendations to patients based on information they entered. RESULTS: All 41 patients successfully completed the self-assessment in the booklets and telephone calls; 28 (68%) also completed the 12-week self-help program. Hamilton Rating Scale for Depression (HAM-D) and Work and Social Adjustment scores improved significantly (41% and 42% mean reduction in the intent-to-treat sample, respectively, p < .001). Eighteen (64%) of the 28 completers were considered responders on the basis of > or = 50% reduction in their HAM-D scores. There was a higher percentage of completers in the pooled U.S. sites (82% vs. 43%), and U.S. completers improved more than those in the United Kingdom (73% vs. 43% were responders). Most (68%) of the calls were made outside usual office hours, Monday-Friday, 9:00 a.m. to 5:00 p.m. Expectation of effectiveness and time spent making COPE calls (more treatment modules) correlated positively with improvement over 12 weeks. Mean call length for completers was 14 minutes. CONCLUSION: A self-help system comprised of a computer-aided telephone system and a series of booklets was used successfully by people with mild-to-moderate depression. These preliminary results are encouraging for people who cannot otherwise access ongoing, in-person therapy.

Adult↗

PubMed1993

Blood-letting in bulimia nervosa.

Three cases of blood-letting in association with bulimia nervosa are reported. This association has not previously been described.

Adult↗

PubMedDate not supplied

Self-treatment for obsessive compulsive disorder using a manual and a computerized telephone interview: a U.S.-U.K. study.

Bt steps is a patient-centered behavioral therapy program that uses a manual and a computer-driven interactive voice response system to assess and treat obsessive compulsive disorder. This nine-step program contains a self-assessment module and a self-treatment module that provides teaching on exposure and ritual prevention. The patient reads about the steps in a manual and then uses a touch-tone telephone to contact the program, in which a recorded voice conducts the interview. Of 40 patients in an open 12-week trial in the United States and London, 35 completed the self-assessment module, and 17 completed at least two sessions of exposure and ritual prevention. The system produced statistically significant improvements on measures of obsessive compulsive disorder.

Adult↗