Full title: Self-help interventions for young people with persistent physical symptoms: A systematic review

Objective: Persistent physical symptoms are frequent among young people causing considerable social, psychological, and economic consequences. Easily accessible interventions adapted to non-specialized settings are needed. We aimed to systematically review randomized controlled trials on self-help interventions for young people with persistent physical symptoms compared to active or passive control groups. Our purpose was to 1) describe applied therapeutic approaches and content and 2) examine potential effects on symptom burden and psychosocial outcomes.

Methods: We included randomized controlled trials on minimal contact self-help interventions for young people with persistent physical symptoms. Systematic literature searches in PubMed, Cochrane Central, Embase, and PsycINFO were conducted. Study selection, data extraction and quality assessment were performed independently by two reviewers. A narrative synthesis of the effects was performed.

Results: We identified 11 studies on self-help interventions for young people. The methodological quality of the studies was generally low. Participants suffered from impairing fatigue, headache, abdominal pain, and musculoskeletal or multi-site pain. Applied therapeutic approaches were cognitive behavioral therapy, relaxation training, hypnotherapy, and written self-disclosure. Outcomes were diverse and mainly related to symptom burden, whereas psychosocial outcomes were only sporadically examined. Overall, evidence of effectiveness of self-help interventions in alleviating symptom burden was weak, and potential effects could not be linked to one specific theoretical approach.

Conclusion: Few self-help interventions of diverse content exist for young people with persistent physical symptoms. Rigorously designed studies that include recommended outcome domains assessed by aligned measures are needed to determine and compare the clinical value of such interventions.

J Psychosom Res. 2021 Jun 19;148:110553. doi: 10.1016/j.jpsychores.2021.110553.

by Joyce-Anne Locking

Every place we go, everything we do, there is always a certain atmosphere in the air. It may be tense, it may be friendly, or it may be any number of other descriptions. There are many different atmospheres in our daily lives. The highway may be crowded or clear. The house may be noisy or quiet. Our visitors may be vibrant or they may be worried about something that is bothering them. Every person we come into contact with creates an influencing atmosphere on our daily energy. If they compliment us, we feel one way. If they yell at us, we feel another way. Whatever the atmosphere, if we could paint it or draw it, what would it look like? Would the colours be vivid or pale? Would the lines be heavy or thin? Would images be large or small?

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by Tim Brunson, PhD

The first step to mastering anything is to load your brain with as much relevant information regarding that endeavor. This is especially true for mastering the game of golf. While practice appears to be the key, it takes a tremendous dedication to the sport to spend sufficient time on the golf course to attain a respectable level of expertise. So, if you are a business professional who can only play a round once or twice a week, you may find yourself constantly lagging behind many of your friends. Fortunately, there are other solutions. This is where I come in.

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For the first time, the therapeutic effects on subacute and chronic tinnitus of an inpatient multimodal treatment concept based on principles of Ericksonian hypnosis (EH) were examined by standardized criteria of the Tinnitus Questionnaire (TQ) and Health Survey (SF-36) within a controlled prospective, longitudinal study. A total of 393 patients were treated within an inpatient closed-group 28-day-setting based on a resource-oriented, hypnotherapeutic concept. The severity of tinnitus was assessed by TQ at times of admission, discharge and also at a 6- and 12-month follow-up. Health-related quality of life was evaluated before and after therapy using the SF-36. After therapy, a decrease in TQ score was seen in 90.5% of the patients with subacute tinnitus and in 88,3% of those with chronic tinnitus. Assessment of the TQ score at the end of therapy revealed highly significant improvements of 15.9/14.1 points in mean. Effect sizes in the treatment groups (0.94/0.80) were superior to those in the waiting-list controls (0.14/0.23). The TQ score remained stable in the follow-up controls. Significant improvement in health-related quality of life has been observed within the treatment groups depending on initial level of tinnitus serverity I-IV according to TQ. Using a multimodal treatment concept with emphasis on resource-activating approaches of EH the annoyance of tinnitus can be significantly reduced while health-related quality of life is enhanced within a comparatively short treatment period of 28 days.

Practice for Otorhinolaryngology and Psychotherapy, Luisenstrasse 6, 79098, Freiburg, Germany, Dr-Ross@web.de.

Eur Arch Otorhinolaryngol. 2007 May;264(5):483-8. Epub 2007 Jan 6

W J Hamel explored the effects of music therapy on the anxiety levels, heart rate and blood pressure of patients waiting for their scheduled cardiac catheterization. 101 (63 men and 38 women) patients were randomly assigned to listen to 20 minutes of pre-selected music or to a standard care control group. Measurements were taken during the waiting period and just prior to departure for the lab. The intervention group had a significant reduction in anxiety (p = 0.003) and when compared to the controls (p = 0.004). Where the heart rate and systolic blood pressure dropped in the music therapy group, it increased in the control group. This held up whether the patient was male or female, but the men as a group had higher diastolic scores than the women, and the women had higher anxiety scores than the men.

Our body's health is dependent largely upon a delicate balance of our immune system. While in some instances, such as AIDS, an immune system may be deficient, in others, such as rheumatism and various liver disorders, the system may be over active. There is considerable evidence that emotional traits, both negative and positive, my influence this balance and thus affect one's susceptibility to infection or a hyperactive immune system. Stress levels and negative moods often precede the onset of both minor and major illnesses. Fortunately, the opposite is also true.

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Over the past 20 years, there as been considerable evidence that psychological factors can play a substantive role in the development and progression of coronary artery disease. There is evidence that hypnosis can be effective in the treatment of coronary artery disease, enhancing the effect of standard cardiac rehabilitation in reducing all-cause mortality and cardiac event recurrences for up to 2 years.

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