Benzodiazepines and Therapeutic Counselling: Report from a Who Collaborative Study

ISBN-13: 9783642737145 / Angielski / Miękka / 2011 / 135 str.

World Health Organization

Opis

This book describes a unique study on the usefulness of benzodiazepine tranquilizers given in conjunction with and compared to therapeutic counselling for the treatment of minor psychiatric disorders. International collaboration under the sponsorship of the WHO made this first cross-cultural comparative study possible. Important methodological findings about measurement instruments, as well as data about the effects of different treatments, resulted from the study. It also demonstrated the possibility of using quantitative scientific methods to measure milder forms of psychiatric disorders and their changes.

Spis treści

1 Introduction.- 1.1 Review of the Mental Health Programme of the World Health Organization (WHO).- 1.2 Related Efforts of the Organization.- 1.3 Reasons for Undertaking a Study Using Benzodiazepines.- 1.4 Acknowledgement.- 2 Literature Review.- 2.1 Literature on Cross-Cultural Comparisons of Effectiveness of Psychotropic Drugs.- 2.2 Literature on Cross-Cultural Comparisons of Psychotherapy.- 2.3 Literature on Methodological Issues Involved in the Conduct of Comparative Studies.- 2.4 Literature About Administrative/Procedural Aspects of Multicentric Trials.- 3 Aims of the Study.- 4 Description of Materials and Methods.- 4.1 Design of the Study.- 4.2 Description of Centres at Which the Study Took Place.- 4.2.1 Description of Research Centre and Study Area of Bombay.- 4.2.2 Description of Research Centre and Study Area of Ibadan.- 4.2.3 Description of Research Centre and Study Area of London.- 4.2.4 Description of Research Centre and Study Area of Tokyo.- 4.3 Description of Samples and Manner of Selection.- 4.3.1 Description of Samples.- 4.3.2 Manner of Selection of Patients for the Study.- 4.4 Description of Instruments Used for Assessment and Training of Research Workers.- 4.4.1 General Health Questionnaire (GHQ).- 4.4.2 Present State Examination (PSE).- 4.4.3 Rating Scale for Side Effects (RSSE).- 4.4.4 General Practitioner’s Rating-Need for Treatment Scale.- 4.4.5 Demographic Description.- 4.4.6 Brief Life Events Questionnaire (BLEQ).- 4.4.7 Personal Treatment Record.- 4.4.8 Audit of Counselling.- 4.5 Treatments.- 4.5.1 Choice of Drugs and Dosage.- 4.5.2 Counselling.- 5 Results.- 5.1 Assessment of the Value of Instruments Used.- 5.2 Overall Comparisons Among Centres.- 5.2.1 Comparison of GHQ Total Scores at the Start of the Trial.- 5.2.2 Comparison of GHQ Scores Between Weeks 0 and 2.- 5.2.3 Comparison of GHQ Scores Between Weeks 0 and 6.- 5.2.4 Comparison of GHQ Scores Between Weeks 6 and 12.- 5.3 Within-Centre Comparisons (Between Methods and Treatments).- 5.3.1 Comparisons on Total GHQ Scores Between Weeks 0, 2 and 6.- 5.3.2 Comparisons on Total GHQ Scores Between Weeks 6 and 12.- 5.4 GHQ Factor Scores, Weeks 0 to 2 to 6.- 5.4.1 GHQ Factor B (Anxiety and Insomnia).- 5.4.2 GHQ Factor C (Social Dysfunction).- 5.5 Comparison of Scores on Present State Examination.- 5.5.1 Comparison on PSE Total Scores Between Weeks 0 and 6.- 5.5.2 Comparison of PSE Syndromal Scores (Weeks 0 to 6).- 5.6 Treatment-Emergent Symptoms.- 5.7 Physical Measurements.- 5.8 Brief Life Events Questionnaire.- 5.9 General Summary: Effects of Drugs and Counselling.- 6 Results: Analysis of Counselling.- 6.1 Difference Among Centres in Amount of Counselling.- 6.1.1 Total Interview Time.- 6.1.2 Number of Sessions of Counselling.- 6.2 Differences Among Centres in Methods of Counselling.- 6.3 Problem Areas Considered at Interview.- 6.4 Final Audit of Counselling.- 6.4.1 Final Audit of Items.- 6.4.2 Overall Evaluation of Counselling.- 7 Discussion.- 7.1 Indirect Evaluation of Treatments.- 7.2 Evaluation of Treatments with Scales.- 7.2.1 Effects of Treatments to Week 6.- 7.2.2 Effects of Treatments to Weeks 6 to 12.- 7.3 General Improvement.- 7.4 Effects of the Study on Participating Centres.- 7.5 Methodological Limitations.- 7.6 Further Work.- 8 Conclusions.- References.- Appendix A: Description of Research Centres and Study Areas.- Appendix B: Data Collection Forms.