Groningen, Netherlands
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Bos E.H.,Center for Integrative Psychiatry | Hoenders R.,Center for Integrative Psychiatry | De Jonge P.,University of Groningen
BMJ Case Reports | Year: 2012

Time-series analysis was used to study the associations between daily weather variables and symptomatology in a man suffering from recurrent anxiety. Outcome measures were the patient 's main symptoms: anxiety and energy. Wind direction appeared to be related to the patient's energy levels; these were significantly lower when the wind blew from the southeast. This effect could not be explained by other weather parameters. Decreases in energy in turn predicted increases in anxiety. The reverse effect was observed as well, with increases in anxiety predicting decreases in energy, indicating a positive feedback loop. Copyright 2012 BMJ Publishing Group. All rights reserved.


Meijer A.,University of Groningen | Conradi H.J.,University of Groningen | Conradi H.J.,University of Amsterdam | Bos E.H.,University of Groningen | And 4 more authors.
General Hospital Psychiatry | Year: 2011

Objective: A meta-analysis of over 25 years of research into the relationship between post-myocardial infarction (MI) depression and cardiac prognosis was conducted to investigate changes in this association over time and to investigate subgroup effects. Method: A systematic literature search was performed (Medline, Embase and PsycINFO; 1975-2011) without language restrictions. Studies investigating the impact of post-MI depression on cardiovascular outcome, defined as all-cause mortality, cardiac mortality and cardiac events within 24 months after the index MI, were identified. Depression had to be assessed within 3 months after MI using established instruments. Pooled odds ratios (ORs) were calculated using a random effects model. Results: A total of 29 studies were identified, resulting in 41 comparisons. Follow-up (on average 16 months) was described for 16,889 MI patients. Post-MI depression was associated with an increased risk of all-cause mortality [(OR), 2.25; 95% confidence interval [CI], 1.73-2.93; P<.001], cardiac mortality (OR, 2.71; 95% CI, 1.68-4.36; P<.001) and cardiac events (OR, 1.59; 95% CI, 1.37-1.85; P<.001). ORs proved robust in subgroup analyses but declined over the years for cardiac events. Conclusions: Post-MI depression is associated with a 1.6- to 2.7-fold increased risk of impaired outcomes within 24 months. This association has been relatively stable over the past 25 years. © 2011 Elsevier Inc.


Sarris J.,University of Melbourne | Sarris J.,Swinburne University of Technology | Lake J.,Arizona Center for Integrative Medicine | Hoenders R.,Center for Integrative Psychiatry
Journal of Alternative and Complementary Medicine | Year: 2011

Background: Bipolar disorder (BD) is a debilitating syndrome that is often undiagnosed and undertreated. Population surveys show that persons with BD often self-medicate with complementary and alternative medicine (CAM) or integrative therapies in spite of limited research evidence supporting their use. To date, no review has focused specifically on nonconventional treatments of BD. Objectives: The study objectives were to present a review of nonconventional (complementary and integrative) interventions examined in clinical trials on BD, and to offer provisional guidelines for the judicious integrative use of CAM in the management of BD. Methods: PubMed, CINAHL, ® Web of Science, and Cochrane Library databases were searched for human clinical trials in English during mid-2010 using Bipolar Disorder and CAM therapy and CAM medicine search terms. Effect sizes (Cohen's d) were also calculated where data were available. Results: Several positive high-quality studies on nutrients in combination with conventional mood stabilizers and antipsychotic medications in BD depression were identified, while branched-chain amino acids and magnesium were effective (small studies) in attenuating mania in BD. In the treatment of bipolar depression, evidence was mixed regarding omega-3, while isolated studies provide provisional support for a multinutrient formula, n-acetylcysteine, and l-tryptophan. In one study, acupuncture was found to have favorable but nonsignificant effects on mania and depression outcomes. Conclusions: Current evidence supports the integrative treatment of BD using combinations of mood stabilizers and select nutrients. Other CAM or integrative modalities used to treat BD have not been adequately explored to date; however, some early findings are promising. Select CAM and integrative interventions add to established conventional treatment of BD and may be considered when formulating a treatment plan. It is hoped that the safety issues and clinical considerations addressed in this article may encourage the practice of safety-conscious and evidence-based integrative management of BD. © 2011 Mary Ann Liebert, Inc.


de Vries R.M.,University of Groningen | Hartogs B.M.A.,Center for Integrative Psychiatry | Morey R.D.,University of Groningen
Behavior Therapy | Year: 2015

When researchers are interested in the effect of certain interventions on certain individuals, single-subject studies are often performed. In their most simple form, such single-subject studies require that a subject is measured on relevant criterion variables several times before an intervention and several times during or after the intervention. Scores from the two phases are then compared in order to investigate the intervention effect. Since observed scores typically consist of a mixture of true scores and random measurement error, simply looking at the difference in scores can be misleading. Hence, de Vries & Morey (2013) developed models and hypothesis tests for single-subject data, quantifying the evidence in data for the size and presence of an intervention effect. In this paper we give a non-technical overview of the models and hypothesis tests and show how they can be applied on real data using the BayesSingleSub R package, with the aid of an empirical data set. © 2014.


PubMed | University of Groningen and Center for Integrative Psychiatry
Type: Journal Article | Journal: Behavior therapy | Year: 2015

When researchers are interested in the effect of certain interventions on certain individuals, single-subject studies are often performed. In their most simple form, such single-subject studies require that a subject is measured on relevant criterion variables several times before an intervention and several times during or after the intervention. Scores from the two phases are then compared in order to investigate the intervention effect. Since observed scores typically consist of a mixture of true scores and random measurement error, simply looking at the difference in scores can be misleading. Hence, de Vries & Morey (2013) developed models and hypothesis tests for single-subject data, quantifying the evidence in data for the size and presence of an intervention effect. In this paper we give a non-technical overview of the models and hypothesis tests and show how they can be applied on real data using the BayesSingleSub R package, with the aid of an empirical data set.


PubMed | University of Groningen and Center for Integrative Psychiatry
Type: | Journal: Journal of affective disorders | Year: 2016

The exact nature of the complex relationship between sleep and affect has remained unclear. This study investigated the temporal order of change in sleep and affect in participants with and without depression.27 depressed patients and 27 pair-matched healthy controls assessed their sleep in the morning and their affect 3 times a day for 30 consecutive days in their natural environment. Daily sleep quality and average positive affect (PA) and negative affect (NA) were used to examine whether changes in sleep quality preceded or followed changes in PA and NA, and whether this was different for patients and healthy controls. Second, presumptive mediating factors were investigated. We hypothesized that fatigue mediated the effect of changes in sleep quality on subsequent PA/NA, and that rumination mediated the effect of changes in PA/NA on subsequent sleep quality.Multilevel models showed that changes in sleep quality predicted changes in PA (B=0.08, p<0.001) and NA (B=-0.06, p<0.001), but not the other way around (PA: B=0.03, p=0.70, NA: B=-0.05, p=0.60). Fatigue was found to be a significant mediator of the relationship between sleep quality and PA (Indirect Effect=0.03, p<0.001), and between sleep quality and NA (Indirect Effect=-0.02, p=0.01). Rumination was not investigated because of non-significant associations between PA/NA and sleep quality. The associations were not different for patients and controls.The analyses were restricted to self-reported sleep quality, and conclusions about causality could not be drawn.Improvements in sleep quality predicted improvements in affect the following day, partly mediated by fatigue. Treatment of sleep symptoms would benefit affect in clinical care and beyond.


Hoenders H.J.R.,Center for Integrative Psychiatry | Appelo M.T.,Psycho oncology Therapy Center Het Behouden Huys | Van Den Brink E.H.,Center for Integrative Psychiatry | Hartogs B.M.A.,Center for Integrative Psychiatry | De Jong J.T.V.M.,University of Amsterdam
Journal of Alternative and Complementary Medicine | Year: 2011

Background: Complementary and alternative medicine (CAM) is subject to heated debates and prejudices. Studies show that CAM is widely used by psychiatric patients, usually without the guidance of a therapist and without the use of a solid working method, leading to potential health risks. Aim: The purpose of this study is to facilitate the judicious use of CAM alongside conventional psychiatry in an outpatient psychiatric clinic. Methods: A search was made through scientific and legal articles and discussion in focus groups. Results: In the Centre for Integrative Psychiatry (CIP) of Lentis in the Netherlands, some carefully selected CAM are offered under strict conditions, alongside conventional treatments. Because of the controversy and the potential health risks, Lentis designed a protocol that is presented. Conclusions: The CIP hopes, by using this protocol, to better serve and respect the individual needs and preferences of the diversity of psychiatric patients in our Dutch multicultural society, and better protect them from harm. © 2011, Mary Ann Liebert, Inc.


Time-series analysis was used to study the associations between daily weather variables and symptomatology in a man suffering from recurrent anxiety. Outcome measures were the patient's main symptoms: anxiety and energy. Wind direction appeared to be related to the patient's energy levels; these were significantly lower when the wind blew from the southeast. This effect could not be explained by other weather parameters. Decreases in energy in turn predicted increases in anxiety. The reverse effect was observed as well, with increases in anxiety predicting decreases in energy, indicating a positive feedback loop.


Hartogs B.M.,Center for Integrative Psychiatry
BMJ case reports | Year: 2013

A 23-year-old woman with anorexia nervosa (AN) and a strong need for control was offered an integrative treatment, empowering the patient to be an active participant and advocating shared decision-making. To emphasise this, both the therapist and patient describe their views on the therapy. The integrative treatment resulted in more psychological flexibility and behavioural improvements, as is evident from an increased weight, a decreased dietary restriction and an increased valued action. The strength of this integrative treatment is based on accepting and encouraging patient's self-chosen treatment method, within healthy limits, and thereby creating a flexible, supportive and empowering therapeutic alliance. More research is needed to test the efficacy of combining complementary therapies within conventional treatments of AN.


PubMed | Center for Integrative Psychiatry and University of Kiel
Type: Journal Article | Journal: Journal of attention disorders | Year: 2015

Patients with attention-deficit/hyperactivity disorder (ADHD) display deficits in working memory (WM) and enhanced distractibility.Evoked gamma-band response (GBR) occurs already 50 ms after stimulus onset and is modulated by attention. 16 boys with ADHD and 20 healthy controls (10-14 years) completed a WM task with distraction.Occipitally evoked 40 Hz-GBR was higher during distraction in ADHD than controls. GBR correlated negatively with interference control.These data suggest that ADHD patients are disturbed by interference on an early level of perception.

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