Hypnotic versus active cognitive strategies for alleviation of procedural distress in pediatric oncology patients. Psychotherapy in functional dyspepsia. A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer. Pilot Study of a Brief Behavioral Intervention for Dyspnea in Patients With Advanced Lung Cancer. A randomized controlled trial of psychotherapy in patients with chronic functional dyspepsia. Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: a controlled clinical trial Cognitive behaviour therapy reduces dyspnoea ratings in patients with chronic obstructive pulmonary disease (COPD) Treating Nonulcer Dyspepsia Considering Both Functional Disorders of the Digestive System and Psychiatric Conditions The effects of guided imagery relaxation in people with COPD. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial Guided Imagery and Relaxation in Conventional Colorectal Resections: A Randomized, Controlled, Partially Blinded Trial Psychophysiologic treatment for patients with medically unexplained symptoms: a randomized controlled trial. A randomized comparison of group cognitive–behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis Comparison of psychosocial outcomes in head and neck cancer patients receiving a coping strategies intervention and control subjects receiving no intervention. The acceptability, feasibility, and efficacy (phase I/II study) of the OVERcome (Olive Oil, Vaginal Exercise, and MoisturizeR) intervention to improve dyspareunia and alleviate sexual problems in women with breast cancer. Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. A randomized trial of the effect of training in relaxation and guided imagery techniques in improving psychological and quality-of-life indices for gynecologic and breast brachytherapy patients.
This study provided a differential comparison of the efficacy of st and ardized instruction in hypnosis or active cognitive strategy for provision of relief from procedurally induced pain and anxiety . Subjects were instructed to self-direct in the use of strategies during medical procedures . Twenty pediatric oncology patients participated in the study . They were not informed that hypnosis was one of the strategies . Subjects were screened for hypnotizability and r and omly assigned to treatments . Demographic data were collected . Pre- strategy training observations were made during a Bone Marrow Aspiration or Lumbar Puncture ( BMA/LP ) using visual analog scales , the McGill Pain Question naire , State-Trait Anxiety Inventory , pulse and temperature readings , and interview . Following strategy training , data were collected during a second BMA/LP using the same measures as employed pre-intervention . Results indicated that both strategies were effective in providing pain reduction . Neither technique provided for anxiety reduction . Hypnotizability scale scores failed to correlate with degree of pain reduction Patients with functional dyspepsia were assigned at r and om to cognitive psychotherapy ( 10 sessions of 50 min duration , n = 50 ) or to a control group ( no treatment , n = 50 ) . Before treatment all patients were assessed on psychological , somatic and lifestyle factors . If allocated to the therapy group all patients were also asked to define the main problems they wanted to discuss in therapy ( ' target complaints ' ) . The patients were evaluated at the end of therapy ( after 4 months ) and at 1 yr follow-up . Outcome measures were dyspeptic symptoms , scores on ' target complaints ' and psychological parameters . Both groups showed improvement in dyspeptic and psychological parameters after 1 yr . The improvement in the control group was attributed to a non- specific effect of increased interest and attention . The therapy group showed greater reduction than the control group on dyspeptic symptoms [ days of epigastric pain ( p = 0.050 ) , nausea ( p = 0.024 ) , heartburn ( p = 0.021 ) , diarrhoea ( p = 0.002 ) and constipation ( p = 0.047 ) ] ; and on scores on ' target complaints ' ( p = 0.001 ) Fifty-four pediatric cancer patients were studied to determine the relative efficacy of two forms of behavioral intervention for reducing chemotherapy-related distress . Following baseline assessment , subjects were r and omly assigned to receive either hypnosis , non-hypnotic distraction/relaxation , or attention placebo ( control ) during the subsequent identical chemotherapy course . Observational and interview measures of anticipatory and postchemotherapy nausea , vomiting , distress , and functional disruption served as outcome data . Results indicated that treatment condition was the single best predictor of change from baseline to intervention , with children in the hypnosis group reporting the greatest reduction of both anticipatory and postchemotherapy symptoms . The cognitive distraction/relaxation intervention appeared to have a maintenance effect in which symptoms did not get much worse or much better , while children in the control group had symptoms that consistently became worse over time . Emetic potential of the chemotherapy and the prophylactic use of antiemetics each appeared to contribute to the overall severity of symptoms . While the efficacy of hypnosis in the management of chemotherapy distress is supported , the complexities of interacting biologic and psychologic factors are highlighted CONTEXT Dyspnea is a common symptom in patients with advanced cancer that interferes with functional ability and quality of life ( QOL ) . Although few evidence -based treatments for dyspnea exist , prior studies show support for nonpharmacological interventions that include elements of cognitive-behavioral therapy . OBJECTIVES To examine the feasibility and utility of delivering a brief behavioral intervention for dyspnea in patients with lung cancer . METHODS For this single-group pilot study , eligible patients included those with advanced lung cancer ( Stage III or IV non-small cell or extensive-stage small cell lung cancer ) receiving outpatient cancer treatment who reported at least moderate breathlessness . The manualized intervention consisted of two sessions in which nurse practitioners taught participants breathing and relaxation techniques within the infusion clinic and encouraged home practice . Participants completed measures of breathlessness ( Modified Medical Research Council Dyspnea Scale ) , QOL ( Functional Assessment of Cancer Therapy-Lung Trial Outcome Index ) , and anxiety and depression symptoms ( Hospital Anxiety and Depression Scale ) at baseline and within six weeks after enrollment . RESULTS Of the 32 patients enrolled in the study ( 56.3 % females ; mean age 63.34 [ SD ] = 7.96 years ) , 84.4 % ( N = 27 ) completed all study procedures . Comparing the baseline to post assessment s , we found significant improvements in Modified Medical Research Council Dyspnea Scale ( P < 0.001 ) , Functional Assessment of Cancer Therapy-Lung Trial Outcome Index ( P = 0.01 ) , and Hospital Anxiety and Depression Scale-depression subscale ( P < 0.001 ) scores . CONCLUSION In this sample of patients with advanced lung cancer and dyspnea , we observed a high completion rate for the two-session behavioral intervention . Patients also reported improvements in dyspnea , QOL , and mood . Follow-up r and omized controlled trials are needed to examine the efficacy of brief behavioral interventions for cancer-related dyspnea BACKGROUND & AIMS This study aim ed to determine whether brief psychodynamic-interpersonal ( PI ) psychotherapy is more efficacious than a psychological control for patients with chronic , intractable functional dyspepsia ( FD ) , and whether patients with abnormal gastric function respond differently than those with normal gastric function . METHODS Ninety-five consecutive patients with chronic symptoms of FD who had failed to respond to conventional pharmacologic treatments were approached . Thirty-seven received  PI psychotherapy , and 36 the control condition ( supportive therapy ) . Patients completed self-report question naires before and after treatment and 12 months later . The patients ' gastroenterologists , who were blind to the study groups , conducted independent ratings before and after treatment . Forty-nine patients also underwent a radioisotope gastric emptying study . An intention-to-treat analysis was used with baseline scores as covariates . RESULTS At the end of treatment , there were significant advantages for PI psychotherapy compared with controls for the gastroenterologists ' ( P = 0.002 ) and patients ' total symptom score ( P = 0.015 ) . One year after treatment , the symptomatic scores were similar . However , a sub analysis showed that PI therapy was superior to the control condition at 1 year , when patients with severe heartburn were excluded . There was no difference in outcome between patients with normal and abnormal gastric emptying . CONCLUSIONS PI therapy may have both short- and long-term effects in patients with dyspepsia , but further evaluation is required . Its cost-effectiveness needs to be determined & NA ; Few controlled clinical trials have tested the efficacy of psychological techniques for reducing cancer pain or post‐chemotherapy nausea and emesis . In this study , 67 bone marrow transplant patients with hematological malignancies were r and omly assigned to one of four groups prior to beginning transplantation conditioning : hypnosis training (HYP);cognitive behavioral coping skills training (CB);therapist contact control ( TC ) ; ortreatment as usual ( TAU ; no treatment control ) . Patients completed measures of physical functioning ( Sickness Impact Profile ; SIP ) and psychological functioning ( Brief Symptom Inventory ; BSI ) , which were used as covariates in the analyses . Biodemographic variables included gender , age and a risk variable based on diagnosis and number of remissions or relapses . Patients in the HYP , CB and TC groups met with a clinical psychologist for two pre‐transplant training sessions and ten in‐hospital “ booster ” sessions during the course of transplantation . Forty‐five patients completed the study and provided all covariate data , and 80 % of the time series outcome data . Analyses of the principal study variables indicated that hypnosis was effective in reducing reported oral pain for patients undergoing marrow transplantation . Risk , SIP , and BSI pre‐transplant were found to be effective predictors of inpatient physical symptoms . Nausea , emesis and opioid use did not differ significantly between the treatment groups . The cognitive behavioral intervention , as applied in this study , was not effective in reducing the symptoms measured There is evidence that psychological factors contribute to the perception of increased difficulty of breathing in patients with chronic obstructive pulmonary disease ( COPD ) , and increase morbidity . We tested the hypothesis that cognitive behaviour therapy ( CBT ) decreases ratings of perceived dyspnoea in response to resistive loading in patients with COPD . From 31 patients with COPD , 18 were r and omised to four sessions of specifically targeted CBT and 13 to routine care . Prior to r and omisation , participants were tested with an inspiratory external resistive load protocol ( loads between 5 and 45cmH2O/L/s ) . Six months later , we re-measured perceived dyspnoea in response to the same inspiratory resistive loads and compared results to measurements prior to r and omisation . There was a significant 17 % reduction in dyspnoea ratings across the loads for the CBT group , and no reduction for the routine care group . The decrease in ratings of dyspnoea suggests that CBT to alleviate breathing discomfort may have a role in the routine treatment of people with COPD Nonulcer dyspepsia ( NUD ) is a common syndrome , but the optimal treatments have yet to be established . This study was performed to determine the most effectivetreatment for NUD . Subjects were recruited through the Department of General InternalMedicine at the Kyushu University Hospital because oftheir somatic symptoms . When no organic lesions werefound , the patients were directed to consult ourdepartment ( Psychosomatic Medicine ) ; 194 consecutive NUD patients were studied . All subjects were assessedpsychiatrically with the Structured Clinical Interviewfor DSM-III-R(SCID ) . Patients with serious NUD were hospitalized , and r and omly divided into control(N = 42 ) and experimental groups ( N = 86 ) . The controlswere treated with physical treatment alone . Theexperimental group received psychiatric treatment inaddition , based on the results of SCID . The experimentalgroup showed a significant improvement compared with thecontrols ( P < 0.0001 ) . The treatment for NUD takinginto consideration both the physical and psychiatric conditions is highly effective The aim of this study was to explore the effects of guided imagery relaxation in people with chronic obstructive pulmonary disease ( COPD ) using a r and omized controlled design . Half of 26 participants were allocated to the treatment group in which six practice sessions on guided imagery were conducted , while the control group was instructed to take rest quietly during the six sessions . At the seventh session , physiological changes : partial percentage of oxygen saturation ; heart rate ; upper thoracic surface electromyography ; skin conductance ; and peripheral skin temperature were recorded during a 30-minute session with a sampling frequency of one minute . Repeated measures analysis of variance was used to explore the changes of the parameters between the groups . Mann-Whitney U test was used to compare the change of perceived dyspnoea between the groups . Results showed there was a statistically significant ( p < 0.05 ) increase in partial percentage of oxygen saturation in the treatment group , but no significant effects on the other physiological parameters . Further study exploring the psychological effects of guided imagery is suggested & NA ; Few controlled clinical trials of psychological interventions for cancer pain relief exist in spite of frequent support for their importance as adjuncts to medical treatment . This study compared oral mucositis pain levels in 4 groups of cancer patients receiving bone marrow transplants ( BMT ) : ( 1 ) treatment as usual control , ( 2 ) therapist support , ( 3 ) relaxation and imagery training , and ( 4 ) training in a package of cognitive‐behavioral coping skills which included relaxation and imagery . A total of 94 patients completed the study which involved two training sessions prior to treatment and twice a week ‘ booster ’ sessions during the first 5 weeks of treatment . Results confirmed our hypothesis that patients who received either relaxation and imagery alone or patients who received the package of cognitive‐behavioral coping skills would report less pain than patients in the other 2 groups . The hypothesis that the cognitive‐behavioral skills package would have an additive effect beyond relaxation and imagery alone was not confirmed . Average visual analogue scale ( VAS ) report of pain within the therapist support group was not significantly lower than the control group ( P = 0.103 ) nor significantly higher than the training groups . Patient reports of relative helpfulness of the interventions for managing pain and nausea matched the results of VAS reports . From these results , we conclude that relaxation and imagery training reduces cancer treatment‐related pain ; adding cognitive‐behavioral skills to the relaxation with imagery does not , on average , further improve pain relief PURPOSE The aim of this study was to investigate whether brief psychologic interventions to reduce perioperative stress may improve the postoperative course of patients undergoing abdominal surgery . METHODS We used a r and omized , controlled , partially blinded trial to evaluate the differential effectiveness of two brief psychologic interventions ( guided imagery and progressive muscle relaxation ) on analgesic requirement , pain perception , pulmonary function , duration of postoperative ileus , and fatigue after conventional resection of colorectal carcinoma in elderly cancer patients . RESULTS Sixty patients ( 20 guided imagery , 22 relaxation , 18 control ) were evaluated .  Acceptance of the brief psychologic interventions was high and 90 percent of the patients indicated that they would recommend it to other patients . Analgesic consumption ( P = 0.6 ) and subjective pain intensity at rest ( P = 0.3 ) and while coughing ( P = 0.3 ) were not different between groups . Recovery of pulmonary function , duration of postoperative ileus , and subjective postoperative fatigue were also not influenced . When the data from intervention groups were pooled , again no benefits were detected compared with the control group . CONCLUSIONS Brief psychologic interventions such as guided imagery and relaxation yielded a very positive patient response but did not show a clinical ly relevant influence on the postoperative physiologic course of elderly patients undergoing conventional resections of colorectal cancer BACKGROUND Patients presenting with medically unexplained physical symptoms ( MUPS ) typically present with significant distress and marked impairment in functioning and pose a unique challenge to health care providers . The purpose of this study was to examine the efficacy of a psychophysiological treatment ( PT ) for MUPS . METHODS Thirty-eight participants meeting criteria for subthreshold somatization disorder ( abridged somatization ) were r and omly assigned to one of two conditions : ( 1 ) st and ard medical care augmented by a psychiatric consultation intervention ( wait-list ) or ( 2 ) a 10-session , manualized , individually-administered PT added to the psychiatric consultation intervention . Assessment s were conducted at baseline , at midpoint ( after four sessions ) , and after completing the last session . The primary outcome measure was the severity scale of the Clinical Global Impression Scale anchored for Somatic Symptoms ( CGI-SD ) . Secondary outcome measures were responder status as determined by clinical ratings , self-report measures of mental and physical functioning . RESULTS At the end of the trial , the severity ( and frequency ) of physical symptoms improved significantly more ( p<0.05 ) in the intervention group . The average improvement in the CGI-SD was 0.80 points greater in the intervention group than in the wait-list group . PT was also associated with greater improvements in self-reported functioning and depressive symptomatology . The effect sizes at the final assessment point indicate that this intervention had a robust effect on complex somatic symptom presentations . CONCLUSION For patients with high levels of MUPS ( abridged somatization ) , PT produces significant improvements in symptoms and functional status & NA ; This study compared group cognitive – behavioral therapy ( 12‐week trial ) , surface electromyographic biofeedback ( 12‐week trial ) , and vestibulectomy in the treatment of dyspareunia result ing from vulvar vestibulitis . Subjects were 78 women r and omly assigned to one of three treatment conditions and assessed at pretreatment , posttreatment and 6‐month follow‐up via gynecological examinations , structured interviews and st and ard question naires pertaining to pain ( Pain Rating Index and Sensory scale of the McGill Pain Question naire , vestibular pain index , pain during intercourse ) , sexual function ( Sexual History Form , frequency of intercourse , Information subscale of the Derogatis Sexual Functioning Inventory ) , and psychological adjustment ( Brief Symptom Inventory ) . As compared with pretreatment , study completers of all treatment groups reported statistically significant reductions on pain measures at posttreatment and 6‐month follow‐up , although the vestibulectomy group was significantly more successful than the two other groups . However , the apparent superiority of vestibulectomy needs to be interpreted with caution since seven women who had been assigned to this condition did not go ahead with the intervention . All three groups significantly improved on measures of psychological adjustment and sexual function from pretreatment to 6‐month follow‐up . Intent‐to‐treat analysis supported the general pattern of results of analysis by‐treatment‐received . Findings suggest that women with dyspareunia can benefit from both medical and behavioral interventions This feasibility study aim ed at comparing psychosocial outcomes in head and neck cancer patients receiving the Nucare program  with a group of control subjects receiving no intervention .  A prospect i ve , nonr and omized study design was used . The Nucare program , a short-term psychoeducational coping strategies intervention , was the test intervention . Control subjects were matched to intervention subjects by cancer stage and time since cancer diagnosis . Outcomes were quality of life and depressive symptoms evaluated at baseline and 3 to 4 months later . One hundred thirty-eight subjects were recruited , and outcome data were available on 101 subjects . At outcome evaluation , compared with their baseline scores , the intervention group had improved physical and social functioning , global quality of life , fatigue , sleep disturbance , and depressive symptoms ; the control group showed no changes in quality of life or depressive symptoms . The results suggest that the Nucare program may improve quality of life and reduce depressive symptoms in head and neck cancer patients INTRODUCTION Almost half of breast cancer survivors experience chronic sexual problems .  Despite the negative effects of dyspareunia on physical and overall quality of life , sexual dysfunction remains underreported and undertreated in clinical practice . This is likely due to the paucity of evidence -based interventions to improve sexual functioning . AIM The study aims to prospect ively evaluate the acceptability , feasibility , and efficacy of a novel intervention ( Olive Oil , Vaginal Exercise , and MoisturizeR [ OVERcome ] ) to improve sexual problems following breast cancer treatment . MAIN OUTCOME MEASURES Dyspareunia , sexual functioning , quality of life , distress , and pelvic floor muscles ( PFMs ) functioning were evaluated . METHODS Twenty-five women with dyspareunia were instructed to perform pelvic floor muscle ( PFM ) relaxation exercises twice/day to prevent/manage PFM overactivity , apply a polycarbophil-based vaginal moisturizer three times/week to alleviate vaginal dryness , use olive oil as a lubricant during intercourse , and complete a weekly compliance diary . PFM relaxation training was administered by a physiotherapist at weeks 0 and 4 , with follow-up at weeks 12 and 26 . At each visit , women completed vali date d self-report question naires and the physiotherapist recorded objective measures of PFM functioning . RESULTS OVERcome result ed in significant improvements in dyspareunia , sexual function , and quality of life over time ( all P<0.001 ) . PFM relaxation training was reported to be effective ( P≤0.001 ) . Maximum benefits were observed at week 12 . Most women rated PFM relaxation exercises ( 92 % ) , vaginal moisturizer ( 88 % ) , and olive oil ( 73 % ) as helpful , indicating that the intervention was acceptable . Unexpectedly , six cases ( 11 % ) of vaginal stenosis were noted during initial screening . CONCLUSIONS This novel intervention is acceptable to patients with demonstrated efficacy in improving dyspareunia and sexual function following breast cancer . Delivery of the OVERcome intervention appears feasible in a clinical setting , providing a potential treatment for this important clinical issue . The unexpected number of observed cases of stenosis further highlights the underreporting of sexual problems in this population , deserving further exploration Hypnosis was compared with nonhypnotic behavioral techniques for efficacy in reducing pain and anxiety in 27 children and adolescents during bone marrow aspiration and in 22 children and adolescents during lumbar puncture . The patients and independent observers each rated ( scale of 1 to 5 ) pain and anxiety during one to three procedures prior to intervention and one to three procedures with intervention . Prior to intervention for both groups , pain during bone marrow aspiration was rated as more severe ( P less than 0.01 ) than pain during lumbar puncture . During bone marrow aspiration pain was reduced to a large extent by hypnosis ( P less than 0.001 ) and to a smaller but significant extent by nonhypnotic techniques ( P less than 0.01 ) , and anxiety was significantly reduced by hypnosis alone ( P less than 0.001 ) . During lumbar puncture only hypnosis significantly reduced pain ( P less than 0.001 ) ; anxiety was reduced to a large degree by hypnosis ( P less than 0.001 ) and to a smaller degree by nonhypnotic techniques ( P less than 0.05 ) . Thus hypnosis was shown to be more effective than nonhypnotic techniques for reducing procedural distress in children and adolescents with cancer PURPOSE The r and omized study aim ed to determine the efficacy of psychological intervention consisting of relaxation and guided imagery to reduce anxiety and depression in gynecologic and breast cancer patients undergoing brachytherapy during hospitalization . METHODS AND MATERIAL S Sixty-six patients programmed to receive brachytherapy in two hospitals in Barcelona ( Spain ) were included in this study . The patients were r and omly allocated to either the study group ( n=32 ) or the control group ( n=34 ) . Patients in both groups received training regarding brachytherapy , but only study group patients received training in relaxation and guided imagery . After collection of sociodemographic data , all patients were given a set of question naires on anxiety and depression : the Hospital Anxiety and Depression Scale ( HADS ) , and on quality of life : Cuestionario de Calidad de Vida QL-CA-AFex ( CCV ) , prior to , during and after brachytherapy . RESULTS The study group demonstrated a statistically significant reduction in anxiety ( p=0.008 ) , depression ( p=0.03 ) and body discomfort ( p=0.04 ) compared with the control group . CONCLUSIONS The use of relaxation techniques and guided imagery is effective in reducing the levels of anxiety , depression and body discomfort in patients who must remain isolated while undergoing brachytherapy . This simple and inexpensive intervention enhances the psychological wellness in patients undergoing brachytherapy . State : This study has passed Ethical Committee review
The studies highlighted problems with recruitment and compliance .
CONCLUSIONS : There was insufficient evidence on the efficacy of psychological therapies in NUD .
OBJECTIVES : We conducted a systematic review to determine the effectiveness of psychological interventions including psychodrama , cognitive behavioral therapy , relaxation therapy , guided imagery , or hypnosis in the improvement of  dyspepsia symptoms in patients with nonulcer dyspepsia ( NUD ) .