Many people with schizophrenia continue to experience symptoms despite conventional treatments being used. Alternative therapies such as hypnosis, in conjunction with conventional treatments, may be helpful. OBJECTIVES: To investigate the use of hypnosis for people with schizophrenia or schizophrenia-like illnesses compared with standard care and other interventions. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group's Register (October 2006), contacted the Cochrane Complementary Medicine Field for additional searching (January 2003), hand searched references of included or excluded studies and made personal contact with authors of relevant trials. SELECTION CRITERIA: We included all randomised or double blind controlled trials that compared hypnosis with other treatments or standard care for people with schizophrenia. DATA COLLECTION AND ANALYSIS: We reliably selected studies, quality assessed them and extracted data. We excluded data where more than 50% of participants in any group were lost to follow up. For binary outcomes we calculated a fixed effects risk ratio (RR) and its 95% confidence interval (CI). MAIN RESULTS: We included three studies (total n=149). When hypnosis was compared with standard treatment no one left the studies between 1-8 weeks (n=70, 2 RCTs, Risk Difference 0.00 CI -0.09 to 0.09). Mental state scores were unaffected (n=60, 1 RCT, MD BPRS by one week -3.6 CI -12.05 to 4.8) as were measures of movement disorders and neurocognitive function. Compared with relaxation, hypnosis was also acceptable (n=106, 3 RCTs, RR leaving the study early 2.00 CI 0.2 to 2.15) and had no discernable effect on mental state (n=60, 1 RCT, MD BPRS by one week -3.4 CI -11.4 to 4.6), movement disorders or neurocognitive function. Hypnosis was as acceptable as music (Sibelius) by four weeks (n=36, RR leaving the study early 5.0, CI 0.3 to 97.4). AUTHORS' CONCLUSIONS: The studies in this field are few, small, poorly reported and outdated. Hypnosis could be helpful for people with schizophrenia. If we are to find this out, better designed, conducted and reported randomised studies are required. This current update has not revealed any new studies in this area since 2003.

Cochrane Database Syst Rev. 2007 Oct 17 Izquierdo de Santiago A, Khan M.

RATIONALE: This study examines the effect of Skill Training In Affect Regulation (STAIR) on a cohort of 24 inpatients with Schizophrenia with histories of significant trauma and Complex PTSD. METHOD: Using a model of Trauma Healing proposed by the NYS Office of Mental Health, 24 patients underwent 12 weeks of group-based Cognitive Behavior Therapy. Treatment modalities focused on trust, safety, affect-regulation, identification of trauma triggers, and disrupting abuse-driven behaviors. A comparison group of patients received 12 weeks of supportive psychotherapy by therapists unfamiliar with Trauma Management. Treatment outcome was compared using the Modified Impact of Events, and Brief Psychiatric Rating Scales. RESULTS: Following completion of 12 weeks of therapy, only those patients undergoing therapy in Trauma Recovery showed improvement on items such as tension, excitement, hostility, suspiciousness, and anger-control. CONCLUSION: These findings are an encouraging first step in trauma recovery of patients with chronic mental illness, histories of prolonged trauma, and Complex PTSD.

Psychiatr Q. 2007 Dec;78(4):317-25. Trappler B, Newville H. SUNY Downstate, Kingsboro Psychiatric Center, Clarkson Avenue, Brooklyn, NY, 11203, USA, kbmdbtt@omh.state.ny.us.

The surgical treatment of patients with intractable epilepsy is preceded by a pre-surgical evaluation period during which intracranial EEG recordings are performed to identify the epileptogenic network and provide a functional map of eloquent cerebral areas that need to be spared to minimize the risk of post-operative deficits. A growing body of research based on such invasive recordings indicates that cortical oscillations at various frequencies, especially in the gamma range (40 to 150 Hz), can provide efficient markers of task-related neural network activity. PRINCIPAL FINDINGS: Here we introduce a novel real-time investigation framework for mapping human brain functions based on online visualization of the spectral power of the ongoing intracranial activity. The results obtained with the first two implanted epilepsy patients who used the proposed online system illustrate its feasibility and utility both for clinical applications, as a complementary tool to electrical stimulation for presurgical mapping purposes, and for basic research, as an exploratory tool used to detect correlations between behavior and oscillatory power modulations. Furthermore, our findings suggest a putative role for high gamma oscillations in higher-order auditory processing involved in speech and music perception. CONCLUSION/SIGNIFICANCE: The proposed real-time setup is a promising tool for presurgical mapping, the investigation of functional brain dynamics, and possibly for neurofeedback training and brain computer interfaces.

PLoS ONE. 2007 Oct 31;2(10):e1094. Lachaux JP, Jerbi K, Bertrand O, Minotti L, Hoffmann D, Schoendorff B, Kahane P. INSERM, U821, Lyon, F-69500, France.

The Department of Maxillofacial Surgery of the University Hospital Schleswig-Holstein/Campus Lübeck offers intraoperative hypnosis since 2002. Besides clinical evaluation by controlled studies, patients attitudes should be included in the judgement on such adjuvant procedure not established in general.70 patients of the department treated under combined local anaesthesia/hypnosis rated their individual postoperative patient satisfaction by standardised questionnaires. A control group of equal size and demographic/surgical features consisted of patients that were treated without hypnosis in the same interval.Results of the inquiry indicate that intraoperative hypnosis increases significantly postoperative satisfaction of oral and maxillofacial patients. Satisfaction is attributed decisively on the adjuvant procedure.

Mund Kiefer Gesichtschir. 2007 Oct 19 Hermes D, Trübger D, Hakim SG. Klinik für Kiefer- und Gesichtschirurgie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany, mail@dirkhermes.de.

Complementary and alternative medicine (CAM) is used by large numbers of the general public and is increasingly becoming integrated into the mainstream. An understanding of why people use CAM in general has been developed in the literature, but relatively little is known specifically about adherence to CAM. We tested hypotheses (derived from a dynamic extended version of Leventhal's common-sense model) that patients' beliefs about treatment, perceptions of illness, and treatment appraisals would predict adherence to CAM.DesignA prospective self-report questionnaire study was carried out with a 3-month follow-up period.MethodsA total of 240 patients from five CAM clinics completed self-report questionnaire measures of treatment beliefs, illness perceptions, and treatment appraisals at baseline. Three months later, they completed self-report measures of adherence to therapists' recommendations concerning attendance, remedy use, and life-style changes.ResultsLogistic regression analyses showed that positive perceptions of one's therapist and belief that mental factors do not cause illness independently predicted adherence to appointments. Positive beliefs in holistic health and finding it difficult to travel to appointments predicted adherence to remedy use. Using homeopathy was the only independent predictor of adherence to life-style changes.ConclusionsTreatment appraisals, treatment beliefs, and illness perceptions explain modest proportions of the variance in adherence to CAM. This study highlights the value of operationalizing the appraisal element of the common-sense model when investigating adherence to treatment.

Br J Health Psychol. 2007 Oct 24 Bishop FL, Yardley L, Lewith GT.

A previous design of a biofeedback system for Neurorehabilitation in an interactive multimodal environment has demonstrated the potential of engaging stroke patients in task-oriented neuromotor rehabilitation. This report explores the new concept and alternative designs of multimedia based biofeedback systems. In this system, the new interactive multimodal environment was constructed with abstract presentation of movement parameters. Scenery images or pictures and their clarity and orientation are used to reflect the arm movement and relative position to the target instead of the animated arm. The multiple biofeedback parameters were classified into different hierarchical levels w.r.t. importance of each movement parameter to performance. A new quantified measurement for these parameters were developed to assess the patient's performance both real-time and offline. These parameters were represented by combined visual and auditory presentations with various distinct music instruments. Overall, the objective of newly designed system is to explore what information and how to feedback information in interactive virtual environment could enhance the sensorimotor integration that may facilitate the efficient design and application of virtual environment based therapeutic intervention.

Conf Proc IEEE Eng Med Biol Soc. 2006;1:4925-8. Huang H, Chen Y, Xu W, Sundaram H, Olson L, Ingalls T, Rikakis T, He J. Harrington Dept. of Bioeng., Biodesign Inst., Tempe, AZ.

Adult burn patients experience pain during wound care despite pharmacological interventions. Additional nursing interventions are needed to improve pain management. A systematic review was undertaken in order to examine the implications of previous research for evidence based decisions concerning the use of non-pharmacological nursing interventions and for future research. Twenty-six studies met the inclusion criteria and were discussed. The majority of the included studies concerned behavioural nursing interventions and focussed on promotion of psychological comfort. Although 17 studies showed that the intervention had a positive effect on pain outcomes and no adverse effects of the reviewed interventions were reported, the best available evidence was found for active hypnosis, rapid induction analgesia and distraction relaxation. However, in order to reduce methodological limitations, further research is needed before well-founded evidence based decisions for nursing practice can be made. Aspects that seem important for future research, like the type of the intervention, theoretical framework, manner of giving instruction and guidance, cost, outcomes, measurement instruments and data collection points are considered.

Burns. 2007 Nov;33(7):811-27. de Jong AE, Middelkoop E, Faber AW, Van Loey NE. Burn Centre, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands. aeedejong@rkz.nl