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Biomedical subjects

Scott Stuart

Publications and source records attributed to Scott Stuart.

7 recordsLinked to original sources
PubMed2006

Interpersonal psychotherapy for depression? The need to define its ecological niche.

BACKGROUND: Interpersonal psychotherapy (IPT) has long been viewed as an efficacious treatment for depression, with a large number of published studies allowing its efficacy and utility to be considered closely. METHODS: We review original studies and the one published meta-analysis of controlled efficacy trials, examining acute-phase and prophylactic studies, comparison studies with cognitive behaviour therapy, and studies evaluating its efficacy in combination with pharmacotherapy. RESULTS: We highlight difficulties in evaluating any psychotherapy, particularly when tested as having universal application for varying depressive conditions, but do identify circumstances where IPT may have specific salience. CONCLUSIONS: As for other treatments, IPT is unlikely to be a universal therapy for depression. This review offers suggestions as to where its preferential utility may lie, and argues for modified research paradigms to assist definition of its therapeutic niche.

Antidepressive Agents↗
PubMed2006

Interpersonal psychotherapy for somatizing patients.

The interpersonal model is important for understanding somatizing behavior. According to this model, somatizing behavior is a form of interpersonal communication driven by insecure attachment. Interpersonal psychotherapy (IPT) is a time-limited, manual-based treatment designed to relieve symptoms and improve interpersonal functioning. Based on our experience using IPT with somatizing patients, we recommend a series of strategies for its successful implementation. These strategies include an emphasis on the therapeutic alliance within a bilaterally negotiated treatment contract, and aiming for improvement in interpersonal functioning rather than for alleviation of physical symptoms. Specific techniques include the use of bridging metaphors, communication analysis, and genuine positive reinforcement. With a focus on communication in a time-limited frame, fostered by a strong collaborative relationship, IPT appears to be a promising method of reducing somatizing behavior. We urge further research on the efficacy of this form of therapy.

Adaptation, Psychological↗
PubMed2006

Distinguishing between hypochondriasis and somatization disorder: a review of the existing literature.

A valid classification is important for further understanding of the somatoform disorders. The main disorders in this grouping - somatization disorder and hypochondriasis - have lengthy historical traditions and are defined in a contrasting manner. Various authors point to distinguishing demographic and clinical features, but there have been few direct comparisons of patients with these disorders. A review of the literature indicates those domains where differences are most likely to be found. Research assessing these may serve to refine and validate these key somatoform categories and/or dimensions.

Diagnosis, Differential↗
PubMed2005

Interpersonal psychotherapy for depressed women with sexual abuse histories: a pilot study in a community mental health center.

Depression among women with childhood sexual abuse histories has a chronic and treatment-refractory course, and is accompanied by high rates of comorbid illness and adult trauma exposures. Reducing the disproportionate burden of serious mental illness among depressed, traumatized women must be a priority in community mental health settings. Effective treatments are needed. The feasibility and effects of interpersonal psychotherapy (IPT) for women with major depression and childhood trauma histories were tested. Twenty-five women in a community mental health center were enrolled in a 16-session course of IPT. Symptoms, functioning, and feasibility (e.g., participation rates) were measured at baseline, 10 weeks, 24 weeks, and 36 weeks. Fifteen of the 25 participants completed eight or more sessions. Significant improvements in depression and psychological functioning, but not in social functioning, were observed. Although a 16-session course of IPT appears feasible and promising, modifications may be needed to reduce barriers to care and enhance treatment potency.

Adaptation, Psychological↗
PubMed2002

Hypochondriasis and fear of death.

Although fear of death has been linked to hypochondriasis, the relationship of this fear to the disorder has received little study. To address this deficiency, we administered a fear of death scale along with measures of hypochondriasis, including the Whiteley Index and Somatic Symptom Inventory, to 162 general medical outpatients. Partial correlations, controlling for age, between the fear of death scale and both the Whiteley Index and Somatic Symptom Inventory were strongly positive. A factor analysis of the fear of death scale yielded three dimensions-fear of dying, loss of meaning, and fear of separation-that were also highly correlated with hypochondriasis. Fear of death and hypochondriasis showed comparable relationships to age and gender as well as to personality dimensions measured by the NEO Five-Factor Inventory. Fear of death appears to be an integral part of hypochondriasis. Its presence lends support to three models of hypochondriasis-the perceptual, existential, and interpersonal-that correspond to the dimensions of fear of death.

Ambulatory Care↗
PubMedDate not supplied

Childhood antecedents of hypochondriasis.

According to the interpersonal model of hypochondriasis, early environmental adversity may give rise to attachment insecurity that finds adult expression in care-seeking behavior. To identify antecedents of this disturbance, we interviewed general medicine patients and obtained from them self-reports of traumatic events, adverse circumstances, and symptoms experienced in childhood. Patients who met DSM-III-R criteria for hypochondriasis more often reported traumatic events and circumstances, including serious illness or injury. Among all patients, the level of hypochondriacal symptoms in adulthood was correlated with poor health, hypochondriacal worry, and separation anxiety in childhood. These findings are consistent with a growing literature that links childhood adversity to adult hypochondriasis; they support the interpersonal model.

Adult↗