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Tuesday, July 30, 2013
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Thursday, June 27, 2013
What If a Sugar Pill Was Just as Effective As Psychotherapy? | World ...
A placebo is simply something used in research to act as a treatment equivalent, so as to not bias either the research subjects or the researchers themselves in how they perceive and react to the experimental treatment. In research on drugs, this often means giving one group of patients pills that look just like the medicine being studied, but lacking any active ingredient.
In recent years, new research has emerged looking solely at the studies that were used to gain FDA approval of antidepressant medications (some of which were never published). When taken together, the studies found that antidepressant medications may not be as effective as previously thought (but what any patient who?s ever tried them could?ve told us decades ago). This recent research found effect sizes of just 0.31.
Which got some researchers to wonder? If antidepressant drug treatment effect sizes might be lower than we had thought, could the same be true for psychotherapy effect sizes too?
Could, in fact, a sugar pill offer as much change in one?s depression as months or years of intensive psychotherapy?
A research study?s effect sizes tell us how different the treatment group is from the control group ? the folks taking placebos. A larger effect size means the treatment really worked, a small effect size tells us the treatment isn?t that much different from a sham treatment.
The studies re-examing the data on antidepressants demonstrated new effect sizes that were smaller than we thought they would be. We thought antidepressants had an effect size of anywhere from 0.60 to 0.40. Now we find out their effect size might be as little as 0.31 ? a significant difference.
This means that antidepressants ? as a class of drugs ? simply aren?t as effective as most of us once thought.
?C?mon Doc? Surely psychotherapy ? which seeks to make real changes to a person?s thoughts and belief processes ? couldn?t fare any worse when compared to a sugar pill, could it??
Answering this question is tricky, because there are so few studies that have been conducted comparing psychotherapy treatment with a pill placebo control group. That?s because a pill isn?t really equivalent to psychotherapy as a treatment method. It?s like comparing apples to oranges, so in psychotherapy research, the control group is most often what?s called a ?wait list? control group.
But you can look at studies that examined an antidepressant medication, a pill placebo, and a psychotherapy treatment group. And there just so happens to be a few such studies out there.
Cuijpers et al. (2013) combed the psychological and psychiatric research literature and found ten studies that compared psychotherapies with pill placebo. In total, 1,240 patients were included in these studies. They pooled the data and ran their statistical meta-analyses on the resulting data.
Here?s what they found:
At the end of clinical trials, the effect size for psychotherapy compared to pill placebo was g = 0.25.
If we translate that into practical terms of Number Needed to Treat (NNT), 7.14 psychotherapy patients had to be treated in order to get assured of getting one who did better than getting a pill placebo.
Patients in the psychotherapy conditions scored 2.66 points lower on the Hamilton depression rating scale than those assigned to pill placebo. These differences are well within the range of the differences found between antidepressants and pill placebo in the FDA registered trials.
Essentially, when compared to pill placebo, psychotherapy did as well or, if you?d like, as poorly as an antidepressant. So, inferring that psychotherapy is the preferred treatment based simply on the basis of the small differences between antidepressants and pill placebos is not warranted.
In other words, when we look at what limited data we have ? and 10 studies of just over 1,000 patients over the course of 20 years isn?t a lot ? psychotherapy doesn?t really come out ahead of antidepressant medications.
In fact, according to this one study, it?s actually worse than antidepressants (0.25 versus 0.31), and really not much better than a person taking a sugar pill for treatment (because these effect sizes are so small, they suggest there?s not a significant difference between the placebo and treatment groups).
James Coyne suggests, ?both sides should recognize that neither psychotherapy nor meidcation [sic] have the efficacy that we would like to obtain from them in treating depression.? No new antidepressant medication breakthroughs are on the horizon, he notes, nor have any new psychotherapies taken hold in the past twenty or thirty years.
Which leaves us with the knowledge that while the treatments we have may not be as effective as we would like them to be, they remain the best tools we have to combat depression. What research can?t capture or comment upon is the amount of trial-and-error effort that goes into finding the right, effective treatment for each individual. A process that ? while frustrating ? usually results in the person suffering from depression to find some relief and hope.
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For a very lengthy, in-depth discussion of these issues, see: Is psychotherapy for depression any better than a sugar pill?
Reference
P. Cuijpers, E. H. Turner, D. C. Mohr, S. G. Hofmann, G. Andersson, M. Berking and J. Coyne. Comparison of psychotherapies for adult depression to pill placebo control groups: a meta-analysis. Psychological Medicine, available on CJO2013. doi:10.1017/S0033291713000457.
Footnotes:?
Dr. John Grohol is the founder & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.Like this author?
Catch up on other posts by John M. Grohol, Psy.D. (or subscribe to their feed).
????Last reviewed: By John M. Grohol, Psy.D. on 26 Jun 2013
????Published on PsychCentral.com. All rights reserved.
APA Reference
Grohol, J. (2013). What If a Sugar Pill Was Just as Effective As Psychotherapy?. Psych Central. Retrieved on June 26, 2013, from http://psychcentral.com/blog/archives/2013/06/26/what-if-a-sugar-pill-was-just-as-effective-as-psychotherapy/
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Friday, June 21, 2013
Surprise! You Still Get Six More Days To Apply To Disrupt SF Battlefield
Procrastination is a bitch. We get it. That’s why the new deadline to apply to TechCrunch Disrupt Battlefield?San Francisco, our preeminent startup competition, is this coming Monday, June 24. In case you miss the thousands of posts we do about these things: Applications to the 2013 TechCrunch SF Disrupt Startup Battlefield are now open?and will close at midnight on Monday. We want to break the all-time application record of 1043 from this past Spring in NY, so muster up the courage Tributes! We review applications on a rolling basis, so it?s to your advantage to submit as soon as you can. Due to strong demand, we are unable to review applications more than once, so please don’t submit a draft application before you are ready. All submissions are confidential unless otherwise permitted by applicants on the application form. More boilerplate notes:?PowerPoint slides and video demos are optional but highly encouraged — Show don’t tell. We reserve the right not to review applications without video demos based on application volume. We look forward to reviewing your application. And may the odds be ever in your favor.Source: http://feedproxy.google.com/~r/Techcrunch/~3/X-2S22eG6dQ/
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Thursday, June 20, 2013
Wimbledon Launches Its First iPad App
Showing further commitment to social technologies (following their plans to use Twitter's mirror), Wimbledon has just announced the launch of?its first ever iPad app. This year, you will be able to interact with the tournament in a whole new way, including 360? photo and video view, as well as the option to use pinch and zoom to home in on the action.
It's also made it easy to follow your favourite players, using colour-coded drop pins on a real-time map view of the courts and match alerts so you can easily follow live games.The app has been produced in collaboration with IBM, as part of the ongoing partnership between the two.
The Wimbledon app is a lot more than just offering users an alternative place to follow the tournament and seems to have been designed with a second screen experience in mind. The content available within the app serves the viewer who already has one eye on the TV screen, and wants to get more information on upcoming games or additional stats when they're watching.
The app gives you everything you need when simply watching the matches live is no longer enough and this complements the live viewing experience.
comments powered bySource: http://feedproxy.google.com/~r/SimplyZesty/~3/e0N7kCZujUE/Wimbledon-launch-first-iPad-app
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Santander says does not need to make new bad debt provisions
By Christian Lowe and Jana Mlcochova PRAGUE (Reuters) - It was a moment of high drama: the Czech prime minister stood up in parliament to try to salvage a political career torpedoed by the arrest of an aide, and Foreign Minister Karel Schwarzenberg, sitting next to him, had dozed off. Schwarzenberg's habit of napping has, instead of being a liability, made him popular among Czechs fed up with their political class and its endemic corruption, and desperate for someone who breaks the mould. ...
Source: http://news.yahoo.com/santander-says-does-not-bad-debt-provisions-100655795.html
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Wednesday, June 19, 2013
Naked Mole Rat Cancer Prevention Trick - Business Insider
The bucktoothed, wrinkled naked mole rat may hold the secret to beating cancer in humans.
After all, the ugly creature?can live for up to thirty years (other rodents live about a tenth of that) and they are unusually resistant to cancer.
This resistance could be due to a molecule in the mole rats' connective tissues, according to a study published in the journal Nature on June 19.
Magic molecule?
This key molecule is called hyaluronan. It exists in long chains around cells holding them together in tissues. The hyaluronan chains found in mole rats are many times larger than the kinds found in shorter-lived mammals, like mice and humans.
The researchers think the long chains stop healthy cells from becoming cancer cells.
When Andrei Seluanov, of the University of Rochester, tried growing naked mole rat cells in the lab, they kept turning into a gooey, slow-moving syrup ? not normal.
The substance was so thick it was clogging the drains in his lab, he told Nature News.
Strange cells
Seluanov wildly guessed that this clumping might have something to do with the mole rats' weirdness. He saw that when injected into mice the cells didn't grow tumors, but they did when they were stopped from making hyaluronan.
That was pretty strong proof.
These findings could lead to treatments for humans in the future, Seluanov told Nature News, though it will probably be a few years still.
Naked mole rats probably didn't evolve long chain hyaluronan to fight cancer, but to help squeeze through the tiny underground tunnels that these animals burrow through. Up to 80 bald and almost-blind individuals huddle into their insect-like colonies (dominated by one breeding queen) in low-oxygen conditions.
Source: http://www.businessinsider.com/naked-mole-rat-cancer-prevention-trick-2013-6
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