Here are two papers on mindfulness and four on sleep.  The Kuyken et al paper is important.  It compares mindfulness-based cognitive therapy (MBCT) with continuation antidepressants in the prevention of relapse in recurrent depression.  The results are great - "Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM (maintenance antidepressant) group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04).  MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains."  I have been cautious in my enthusiasm for MBCT (see previous post) but this is exactly the kind of research that we need to help clarify MBCT's potential further.  The second paper on mindfulness is lower key.  It is a mention of its potential in enhancing sexuality.  It makes sense - see last month's posts on the effects of meditation training on experiencing positive emotions - but the relevant research is still in its early stages. 

PLEASE NOTE: This blog post dates back to December 2008.  All the questionnaires on this page, updated scoring details for the IES-R, the widely used Posttraumatic Cognitions Inventory, descriptions of how to do "reliving" of the trauma, written accounts, and site visits, as well as a series of other updated PTSD-relevant questionnaires and handouts are available on the relevant "Good knowledge" page of this website - "PTSD assessment, images, memories & assessment".  Also of relevance (particularly for child abuse) is the page "Life review, traumatic memories & therapeutic writing".

Here are the two main questionnaires currently used to assess Health Anxiety Disorder - the HAI and the HAQ.  The HAI is the one recommended by the NHS Improving Access to Psychological Therapies (IAPT) initiative.  I've also added a scale put together by Adrian Wells that assesses safety behaviours and extent of disease belief.  Finally there is a classic CBT thoughts record.  I don't use these kinds of records much any more, but I've added it for 'completeness'.

Health anxiety inventory (HAI) - the 18 item (short form) HAI is the disorder specific scale recommended by the IAPT initiative.  The third page of the download gives typical scores for a Health Anxiety group, a more general anxiety group, a control group, and so on.   

Health anxiety questionnaire (HAQ) - this 21 item health anxiety questionnaire yields four subscales, which can make it easier therapeutically to target specific behaviours like reassurance seeking.  The third page of the download gives some idea of likely scores in different disorders.

Five of these six studies are from last month's American Journal of Psychiatry.  Kendler et al discuss the many similarities and only occasional differences between bereavement-related and other life event-related depression - an issue explored further in Maj's editorial.  Li et al show that depression in pregnancy (exacerbated further by stressful life events and obesity) increases the risk of preterm delivery.  Miklowitz reviews research on the value of adjunctive psychotherapy for bipolar disorder sufferers (already taking medication) and discusses the various ways it can be helpful.  Oquendo et al (in a freely viewable editorial) argue that suicidal behaviour should be placed on a "separate axis" in the next version of the DSM diagnostic system.  Finally Vertanen et al, in an interesting study, demonstrate that increased hospital overcrowding - measured by bed occupancy rates - is associated with increased use of antidepressants by hospital staff.

Kendler, K. S., J. Myers, et al. (2008). "Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events?" Am J Psychiatry 165(11): 1449-1455.  [Abstract/Full Text]  

Here are a collection of downloadable forms, questionnaires and handouts that I use when working with people struggling with obsessive compulsive disorder and body dysmorphic disorder.

Normal intrusions - a list of 52 "normal intrusive thoughts" with the percentage of 293 students (none of whom had been diagnosed with a mental health problem) who reported that they had experienced this thought.  I often hand out this leaflet to help people realize that experiencing occasional disturbing intrusive thoughts is totally normal.

OCD diagnosis & prevalence - leaflet giving DSM-IV diagnostic criteria for obsessive-compulsive disorder and some details of prevalence rates.

Here are a series of forms, questionnaires and handouts that I use regularly in my work.  The problem solving diagram is a recurring theme - both at the start of therapy and as a sheet to return to when reviewing and considering additional therapeutic options.  Other sheets are classic variants on the tools used by many cognitive behavioural therapists - with occasional alternatives and additions, that I've come up with over the years, thrown in as well.

Here are half a dozen recent studies involving cognitive therapy (CBT).  The first by Craigie et al explores the use of mindfulness-based cognitive therapy (MBCT) to treat generalized anxiety disorder (GAD).  Although, as one would expect, MBCT helped GAD sufferers, it was noteworthy that results "fall well short of outcomes achieved by past research".  This adds to my concern that mindfulness training may at times be being over-hyped - see a blog I wrote in September for for more on this.  The next study by Cuijpers et al also suggests limitations to the march of CBT with interpersonal psychotherapy looking a somewhat better candidate for prevention of depression onset.  I guess one could argue that CBT can - and probably more often should - include  behavioural interventions to promote improved relationships.  Click here for tools that can help this approach.   The third piece of research by Grey et al is exciting.  It challenges the Alice in Wonderland dodo bird suggestion that "everyone has won, and all must have prizes"

Note this list of resources has been updated ... see the "Good Knowledge" section's folder on "Social anxiety information & assessment".  It is also worth clicking on "social anxiety" in the "Tag Cloud".

The "Improving Access to Psychological Therapies" (IAPT) initiative is very ambitious and exciting.  It states its principal aim is to support English Primary Care Trusts in implementing "National Institute for Health and Clinical Excellence" (NICE) guidelines for people suffering from depression and anxiety disorders.  IAPT go on to say that "At present, only a quarter of the 6 million people in the UK with these conditions are in treatment, with debilitating effects on society."

One aspect of this carefully planned initiative is strong encouragement to assess and monitor the progress of those who are getting help.  Visiting the IAPT "Outcomes Toolkit and FAQ" web page provides access to several freely downloadable documents.  The emphasis is on good assessment measures that are free to use.  See below:

IAPT Outcomes Toolkit 2008/9 PDF - this 81 page 1.1Mb Adobe PDF is the September 08 version with amended IAPT Paper Based Data Set Questionnaires.