Orthodontic osteodilated arch treatment represents a pivotal approach in dental orthodontics to address dental crowding and misalignment. Integrating cognitive behavioral therapy (CBT) into comprehensive nursing interventions (CNI) aims to address these issues holistically. This editorial explores the effectiveness of CBT-based CNI in improving patient outcomes in orthodontic care. Innovations in remote CBT delivery, such as virtual reality, have also shown potential in reducing pain, anxiety, and depression, emphasizing CBT's adaptability in orthodontic settings. The findings underscore the importance of integrating psychological support into orthodontic care to enhance patient adherence, satisfaction, and overall treatment success. The editorial advocates for a holistic approach that combines psychological and physiological care, highlighting the transformative potential of CBT-based interventions in orthodontic treatment.

BackgroundChronic lower back pain condition (CLBP) was reported with a significantly higher disability levels and fear-avoidance beliefs than their asymptomatic counterparts. However, the anecdotal evidence is there to support whether kinesiophobia had impacted the level of lumbar position sense among CLBP. The aim of the study was to analyze the relation between kinesiophobia, and lumbar position sense in patients with CLBP and asymptomatic individual.MethodsThis is part of a major case-control study proceeded with 200 patients with CLBP and 400 controls. Kinesiophobia, and lumbar position sense were assessed with Tampa Scale for Kinesiophobia, and lumbar re-positioning test, respectively. Functional ability was measured with a patient- specific Functional Scale in patients with CLBP. Regression models was administered to explore the complex relation between kinesiophobia, and lumbar position sense.ResultsKinesiophobia was reported high among patients with CLBP (30%) than in controls (11%) with the mean difference of 6.49 ± 0.52, d = 1.07 and lumbar position sense (0.09) were positively correlated with kinesiophobia.Discussion and conclusionAlthough a higher rate of kinesiophobia was reported among patients with CLBP when compared to controls, majority of cases with CLBP did not report Kinesiophobia. Further, Kinesiophobia was found to influence lumbar position sense among patients with CLBP.ClinicalTrials.gov Identifier: NCT05079893 Registered on 14/10/2021.

Tokophobia affects up to 14% of pregnant women globally and is linked to high cesarean rates, particularly in Egypt. This study evaluated the efficacy of a culturally adapted Internet-based Cognitive Behavioral Therapy program on fear of childbirth and maternal self-efficacy among Egyptian pregnant women.

A randomized controlled trial was conducted in Damanhur City, Egypt, involving 96 pregnant women with moderate to severe tokophobia. Participants were randomly assigned to an intervention group (n = 48) receiving a six-week program via WhatsApp or a control group (n = 48) receiving routine antenatal care. The intervention included cognitive restructuring, exposure therapy, relaxation techniques, and psychoeducation grounded in Bandura's Self-Efficacy Theory. Outcomes were assessed using the Childbirth Attitude Questionnaire and Childbirth Self-Efficacy Inventory at baseline and post-intervention.

Post-intervention, the intervention group demonstrated a significant reduction in fear of childbirth scores (mean decrease: 14.32 ± 5.55; p < 0.001) and an increase in maternal self-efficacy (mean increase: 38.3 ± 35.7; p < 0.001). Large effect sizes were observed for both fear reduction (η²=0.876) and self-efficacy enhancement (η²=0.600). The control group showed no significant changes.

The culturally adapted Internet-based Cognitive Behavioral Therapy program significantly reduced tokophobia and enhanced maternal self-efficacy, supporting its integration into perinatal care. These findings align with Bandura's Self-Efficacy Theory and suggest the potential of digital interventions in improving psychological outcomes, especially in resource-limited settings.

Integrating the program into routine antenatal care could provide accessible, cost-effective support for women experiencing tokophobia, potentially reducing unnecessary cesarean sections and informing health policy regarding the effectiveness of the ICBT program. Future research should assess long-term outcomes and generalizability in diverse populations.

The study was registered on ClinicalTrials.gov under the identifier (NCT06640608) on October 15, 2024.

Background/Objectives: Sleep disturbance is often observed in the context of chronic pain. We hypothesize that, by providing an immersive Virtual Reality (VR) experience with a serious game to chronic pain patients an hour before bedtime, attention can be diverted from the pain condition, consequently leading to improved sleep quality. The aim is to evaluate the efficacy of VR compared to usual care in reducing the number of awakenings during the night and increasing sleep efficiency in patients suffering from painful diabetic polyneuropathy (PDPN). Methods: Eight patients with PDPN were randomized to either two weeks of VR or two weeks of usual care, followed by a cross-over. The primary outcome measurements were sleep efficiency and number of awakenings during the night. As secondary outcomes, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression, pain intensity, side effects and impression of change were evaluated. Results: Data of seven patients were analysed. Actigraphy data, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression and pain intensity scores did not differ between usual care and VR. As for impression of change, more patients improved after VR compared to usual care (V = 21, p = 0.03). Conclusions: A 2-week period of pain neuroscience education through VR did not result in increased sleep efficiency or fewer awakenings compared to usual care in patients with PDPN. These pilot results indicate that patients subjectively experience an improvement, yet this is not substantiated by either self-reported or objective measurements.

To explore the experiences of patients with chronic low back pain (CLBP) plus comorbid depressive symptoms who received a remote synchronous videoconference group form of Acceptance and Commitment Therapy (ACT) or Behavioral Activation Treatment for Depression (BATD).

A qualitative study (IMPACT-Q) was nested within a randomized controlled trial (RCT) designed to assess the efficacy and the cost-utility/cost-effectiveness of two therapies in the management of CLBP and depression. Fifty-five patients with CLBP plus depression were selected from the RCT. Twelve focus group sessions, each approximately 60-90 min long, were audio-recorded, transcribed verbatim, and analyzed by six coders through a thematic analysis (deductive and inductive) based on a descriptive phenomenological approach.

Patients perceived behavioral, affective, and cognitive improvements after completing group sessions. Overall, psychotherapy was perceived as a safe and non-judgmental place to express emotions and feel understood. The main barriers reported were lack of human contact and loss of social interaction. In contrast, ease of access, flexibility in the ability to connect from anywhere, avoidance of the need to travel, and savings in time and money were key facilitators to increase attendance and adherence to therapy.

This study provided support for the acceptability of videoconference-delivered ACT or BATD in patients with CLBP plus comorbid depressive symptoms.

Central post-stroke pain (CPSP) poses a multifaceted challenge in medical practice, necessitating a thorough and multidisciplinary approach for its diagnosis and treatment. This review examines current methods for addressing CPSP, highlighting both pharmacological and non-pharmacological therapies. It covers the mechanisms and clinical effectiveness of these treatments in managing CPSP and emphasizes the importance of personalized treatment plans, given the varied causes of CPSP.

Recent advancements have illuminated diverse treatment modalities for CPSP. Pharmacotherapy spans from conventional analgesics to anticonvulsants and antidepressants, tailored to mitigate the neuropathic characteristics of CPSP. Non-pharmacological interventions, including physical therapy and psychological strategies, are pivotal in managing CPSP's chronic nature. For cases resistant to standard treatments, advanced interventions such as nerve blocks and surgical procedures like deep brain stimulation (DBS) or motor cortex stimulation (MCS) are considered. Additionally, innovative technologies such as neuromodulation techniques and personalized medicine are emerging as promising avenues to enhance therapeutic outcomes and improve quality of life for individuals grappling with CPSP.

Modern approaches in managing CPSP require an interdisciplinary and patient-centric approach. Customizing treatment plans to address the specific etiology and symptoms of CPSP is crucial. Pharmacotherapy remains fundamental, encompassing medications such as anticonvulsants and antidepressants tailored to manage neuropathic pain. Integrating non-pharmacological interventions is crucial for providing comprehensive care. Additionally, investigating innovative technologies and personalized medicine presents promising opportunities to enhance treatment results and elevate the quality of life for those suffering from CPSP. Ultimately, an integrated approach that acknowledges the multifaceted nature of CPSP is essential for effective management and patient well-being.

The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy in the treatment of vasomotor, sexual dysfunction, and recurrent depression in postmenopausal women.

This prospective, open study evaluated 112 postmenopausal women with vasomotor symptoms. Sexual dysfunction has cultural, social, biological, and emotional issues and divided into two groups: G1, without depression (n=65) and G2, with recurrent depression (n=47). The subjects underwent 12 sessions of in-person cognitive behavioral therapy and 12 sessions of home-based activity over a period of 6 months. They were evaluated at 3 months following the completion of therapy. Depression, memory, and attention-related functions, as well as climactic symptoms, were assessed using a questionnaire.

In the depression questionnaire, the G1 group had a lower initial score than the G2 group (p<0.01). Following 6 months of therapy, both groups had similar improved scores. In the depression questionnaire, the women in group G1 had higher baseline values. In the assessment of vasomotor symptoms, the values in both groups were similar and showed an improvement in vasomotor symptoms after 24 weeks of treatment, but these effects disappeared after the follow-up of 48 weeks in the G2 group. Both groups improved the sexual dysfunction after 24 weeks.

Cognitive behavioral therapy may be effective in reducing vasomotor symptoms and ameliorate the sexual dysfunction and recurrent depression in postmenopausal women after 24 weeks of treatment.

Chronic pain and depression are frequently comorbid conditions associated with significant health care and social costs. This study examined the cost-utility and cost-effectiveness of videoconference-based group forms of Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD), as a complement to treatment-as-usual (TAU), for patients with chronic low back pain (CLBP) plus depressive symptoms, compared to TAU alone. A trial-based economic evaluation (n = 234) was conducted from a governmental and health care perspective with a time horizon of 12 months. Primary outcomes were the Brief Pain Inventory-Interference Scale (BPI-IS) and Quality Adjusted Life Year. Compared to TAU, ACT achieved a significant reduction in total costs (d = .47), and BATD achieved significant reductions in indirect (d = .61) and total costs (d = .63). Significant improvements in BPI-IS (d = .73 and d = .66, respectively) and Quality Adjusted Life Year scores (d = .46 and d = .28, respectively) were found in ACT and BATD compared to TAU. No significant differences in costs and outcomes were found between ACT and BATD. In the intention-to-treat analyses, from the governmental and health care perspective, no significant differences in cost reduction and incremental effects were identified in the comparison between ACT, BATD, and TAU. However, in the complete case analysis, significant incremental effects of ACT (∆BPI-IS = -1.57 and -1.39, respectively) and BATD (∆BPI-IS = -1.08 and -1.04, respectively) compared with TAU were observed. In the per-protocol analysis, only the significant incremental effects of ACT (∆BPI-IS = -1.68 and -1.43, respectively) compared to TAU were detected. In conclusion, ACT and BATD might be efficient options in the management of CLBP plus comorbid depression symptoms as compared to usual care. However, no clear difference was found in the comparison between the 2 active therapies regarding cost-effectiveness or cost-utility. PERSPECTIVE: The economic evaluation of psychological therapies for the management of complex conditions can be used in decision-making and resource allocation. This study provides evidence that ACT and BATD are more effective and involve a greater reduction in costs than usual care in the management of CLBP plus comorbid depressive symptoms. TRIAL NUMBER: NCT04140838.