Biomedical subjects

Lina Gega

Publications and source records attributed to Lina Gega.

6 recordsLinked to original sources

PubMed2006

Effect of referral source on outcome with cognitive-behavior therapy self-help.

Little is known about how psychiatric patients' source of referral relates to treatment outcome. This study examines the effect of referral source on clinical outcome with computer-aided cognitive-behavior therapy (CCBT) for anxiety and depressive disorders. Three hundred fifty-five referrals to a clinic that offered CCBT with brief backup from a clinician were classified into general practitioner (GP) referrals (34%), mental health (MH) professional referrals (42%), and self-referrals (SR, 24%), and compared on sociodemographic and clinical features and treatment outcome. At intake, referrals from all 3 sources had similar sociodemographic features and problem duration, but GP referrals had less comorbidity, whereas MH professional referrals were being treated for their problem more often and were less motivated to change than were SR. Among treatment completers, SRs had the least and MH professional referrals had the most impaired work/social adjustment. Each referral group improved on generic and syndrome-specific measures; however, GP referrals improved the most and MH professional referrals the least. The 3 groups received similar therapist support and were equally satisfied after treatment. We conclude that GP referrals had the best outcome with CCBT for anxiety/depressive disorders. Referral source can be important in psychotherapy research because it may affect the type of patient seen and may predict treatment outcome.

Adult↗

PubMed2005

Screening people with anxiety/depression for suitability for guided self-help.

The aim of this study was to test a questionnaire for screening people with anxiety/ depression for their suitability for certain forms of computer-guided self-help. A total of 196 referrals completed the screening questionnaire. Three clinicians each independently judged the referrals' broad problem type and suitability. Referrals were randomized to 1 of 3 clinicians for a screening interview. The results show that inter-clinician agreement was good for questionnaire-based problem type and suitability, and excellent for screening interview-based problem type and suitability. Agreement between the questionnaire and interview was good on problem type but poor on suitability. Compared with the screening interview, the questionnaire detected suitable patients well but unsuitable patients less well. In conclusion, by quickly scanning the completed questionnaire, clinicians were able sensitively to detect patients' problem types that were suitable for certain forms of self-help. Some unsuitability items need refining.

Adolescent↗

PubMed2004

Computer-aided CBT self-help for anxiety and depressive disorders: experience of a London clinic and future directions.

This article describes a broad-spectrum, computer-aided self-help clinic that raised the throughput of anxious/depressed patients per clinician and lowered per-patient time with a clinician without impairing effectiveness. Many sufferers improved by using one of four computer-aided systems of cognitive behavior therapy (CBT) self-help for phobia/panic, depression, obsessive-compulsive disorder, and general anxiety. The systems are accessible at home, two by phone and two by the Web. Initial brief screening by a clinician can be done by phone, and if patients get stuck they can obtain brief live advice from a therapist on a phone helpline. Such clinician-extender systems offer hope for enhancing the convenience and confidentiality of guided self-help, reducing the per-patient cost of CBT, and lessening stigma. The case examples illustrate the clinical process and outcomes of the computer-aided system.

Adult↗

PubMed2004

Computer-aided self-help for phobia/panic via internet at home: a pilot study.

In an open study, ten people with phobia or panic disorder who could not travel repeatedly to a therapist accessed a computer-aided exposure self-help system (FearFighter) at home on the internet with brief therapist support by telephone. They improved significantly, and their outcome and satisfaction resembled those in patients with similar disorders who used FearFighter in clinics with brief face-to-face therapist support.

Adult↗

PubMed2003

Pragmatic evaluation of computer-aided self-help for anxiety and depression.

BACKGROUND: Most anxiety/depression is not effectively treated. Aims Open evaluation of a free clinic giving immediate computer-aided cognitive-behavioural therapy (CBT) self-help plus brief advice from a therapist. METHOD: Test of outcome of self-referrals who used one of four computer-aided CBT systems for depression, phobia/panic, general anxiety or obsessive-compulsive disorder. RESULTS: The equivalent of one full-time clinician managed 355 referrals over a year. Of the 266 who had a screening interview 79% were suitable. Completers and non-completers of computer-aided CBT had similar pre-treatment features, with very chronic, moderately severe problems. Completers of the computer-aided self-help had a mean total of an hour's live therapist support over 12 weeks. They improved significantly and clinically meaningfully with three of the four systems and felt 'fairly satisfied'. Improvement resembled that in controlled and other trials of computer-aided CBT. CONCLUSIONS: Computer-aided self-help is a 'clinician extender'that greatly cuts per-patient therapist time without impairing improvement. It could reduce the per-patient cost of CBT.

Adult↗

PubMedDate not supplied

Reliability and validity of the work and social adjustment scale in phobic disorders.

The Work and Social Adjustment Scale (WSAS) is a simple widely used 5-item measure of disability whose psychometric properties need more analysis in phobic disorders. The reliability, factor structure, validity, and sensitivity to change of the WSAS were studied in 205 phobic patients (73 agoraphobia, 62 social phobia, and 70 specific phobia) who participated in various open and randomized trials of self-exposure therapy. Internal consistency of the WSAS was excellent in all phobics pooled and in agoraphobics and social phobics separately. Principal components analysis extracted a single general factor of disability. Specific phobics gave less consistent ratings across WSAS items, suggesting that some items were less relevant to their problem. Internal consistency was marginally higher for self-ratings than clinician ratings of the WSAS. Self-ratings and clinician ratings correlated highly though patients tended to rate themselves as more disabled than clinicians did. WSAS total scores reflected differences in phobic severity and improvement with treatment. The WSAS is a valid, reliable, and change-sensitive measure of work/social and other adjustment in phobic disorders, especially in agoraphobia and social phobia.

Adult↗