Search Results (124)

Background: Depression that is resistant to two or more adequate treatment trials—treatment-resistant depression (TRD)—is a prevalent clinical challenge. Although psychotherapies have been recommended by clinical guidelines as an alternative or adjunctive treatment strategy, the effectiveness of psychotherapy in individuals with TRD has not yet been evaluated through meta-analytic methods, primarily due to a limited number of trials. This highlights the necessity of personalized research targeting this specific population. This systematic review and meta-analysis aimed to summarize the evidence on psychotherapy in treating TRD. Methods: A systematic search was conducted following the Guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were included if they quantitatively examined the efficacy of psychotherapy on depression symptoms in individuals diagnosed with depression who had not responded to at least two prior treatments (i.e., pharmacotherapy and/or psychotherapy). Results: A total of 12 studies were included. The quality of evidence was evaluated as being globally moderate. When pooling all psychotherapies, a small-to-moderate, but significant, effect on depressive symptoms was observed compared to the control group (SMD = −0.49, CI = −0.63; −0.34). The observed effect remained unchanged after removing the outlier (SMD = −0.47, CI = −0.62; −0.32). When examining depressive symptoms by type of psychotherapy, Mindfulness-Based Cognitive Therapy (SMD = −0.51, CI = −0.76; −0.25), Cognitive Behavioral Therapy (SMD = −0.53, CI = −0.92; −0.14), and Cognitive Therapy (SMD = −0.51, CI = −1.01; −0.01) showed a moderately significant effect on depressive symptoms compared to the control group. Conclusions: Although this potentially represents the first meta-analysis in this area, the number of studies specifically addressing this complex population remains limited, and the existing literature is still in its early stages. Research focusing on TRD is notably sparse compared to the broader body of work on depression without treatment resistance. Consequently, it was not possible to conduct meta-analyses by type of psychotherapy across all treatment modalities and by type of control group. Due to several study limitations, there is currently limited evidence available about the effectiveness of psychotherapy for TRD, and further trials are needed. Beyond the treatments usually offered for depression, it is possible that TRD requires a personalized medicine approach. Full article

Background/Objectives: Since breast cancer (BC) survival rates have increased to 91% at 5 years and 80% at 15 years postdiagnosis, there is a growing awareness of the importance of addressing the long-term well-being of patients. Consequently, integrative oncology, which combines standard therapies with complementary approaches (nutrition, mind–body practices, and lifestyle modifications), has emerged as a patient-centred model aimed at improving symptom management, treatment adherence, and overall quality of life (QoL). This study aims to demonstrate how integrative therapies can benefit body composition, phase angle, and fluid and electrolyte balance through bioelectrical impedance analysis (BIA). Methods: This study considers a patient who underwent BC surgery and was enrolled in the AMICO clinic for anamnesis, as well as their oncological pathology data, assessment of QoL, and BIA. The breast surgeon specialising in integrative oncology therapies prescribed the patient curcumin and polydatin, moderate physical activity, a balanced diet, and Qigong sessions. The patient underwent monitoring through haematochemical analysis, BIA, and a QoL questionnaire, with follow-up every four months. Results: Between 4 and 12 months, fat mass (FM) and body mass index (BMI) markedly decreased, whereas fat-free mass (FFM), total body water (TBW), and skeletal muscle mass (SMM) increased progressively. Moreover, the improvements in the Na/K ratio and phase angle (PhA) suggest a shift toward better electrolyte and fluid balance and enhanced cellular integrity and membrane function. Equally outstanding were her psychological benefits in terms of mood, sleep, anxiety, and melancholy. Conclusions: Patient progress in body composition, metabolic function, pain management, and psychological status measured during the 12-month follow-up demonstrates the potential benefits of an integrative approach to supportive cancer care. Full article

Background/Objectives: With the rapid progression of technology, applications have been proposed as a promising alternative to conventional psychotherapeutic treatment. Nonetheless, research on unguided self-help applications for binge eating remains scarce, with most existing studies utilizing cognitive behavioral therapy (CBT) principles. Therefore, this paper presents the protocol for a randomized controlled trial designed to evaluate the efficacy and acceptability of eMOTE, a standalone application designed specifically for women in Portugal who binge eat. eMOTE, adapted from dialectical behavior therapy (DBT), is unique in that it focuses on teaching emotion regulation skills while also integrating core CBT strategies. Methods: At least 68 females who self-report binge eating episodes will be randomized into an intervention group with access to eMOTE for eight weeks or a delayed waitlist, which will have access to eMOTE after the T1 assessment. Assessments will be conducted at baseline (T0), post-intervention (T1), and at 2-month follow-up (T2). The primary outcomes will include objective and subjective binge eating frequency and binge eating symptomatology, while secondary outcomes will assess global levels of ED psychopathology, shape concern, weight concern, eating concern, dietary restraint, compensatory behaviors, mindfulness, emotion regulation difficulties, intuitive eating, psychological distress, and body mass index. Conclusions: This study will contribute to the limited literature on the use of smartphone technology as an alternative to traditional psychotherapy. Furthermore, this standalone application will offer insights into the use of emotion regulation and food monitoring components designed for adult females experiencing binge eating episodes. Full article

Myeloproliferative neoplasms (MPNs) are chronic blood cancers characterized by overproduction of blood cells, leading to increased thrombotic and ischemic risk. Patients frequently experience symptoms including fatigue, abdominal discomfort, and complications from thrombotic events, which significantly impact the quality of life (QoL). Many patients inquire about complementary and integrative medicine (CIM) approaches, including nutritional interventions and supplements, creating opportunities for healthcare providers to engage in meaningful discussions guided by the principle of safety. This review examines the current evidence for integrative approaches in MPN management, focusing on nutrition, microbiota, supplements, mind–body techniques, and acupuncture. We analyze the available data on anti-inflammatory interventions, QoL improvement strategies, and treatment tolerance enhancement. The review provides clinicians with evidence-based guidance for safely integrating complementary therapeutic approaches with conventional MPN treatment. This integrative approach represents an opportunity to develop more comprehensive and personalized therapeutic paradigms in hematology while ensuring that complementary interventions serve as adjuncts to evidence-based medical treatment. Full article

Background/Objectives: Although Tai Chi has shown potential benefits for managing chronic pain, its clinical effectiveness specifically for knee pain remains inconclusive. Methods: We systematically searched ten electronic databases for randomized controlled trials (RCTs) investigating the effects of Tai Chi on knee pain. Results: This systematic review and meta-analysis included 11 RCTs involving 706 participants; among them, three studies (n = 169) were eligible for meta-analysis. A comprehensive search of ten electronic databases was conducted up to March 2025. The included RCTs were conducted in the United States (n = 5), China (n = 3), South Korea (n = 2), and Turkey (n = 1). Compared to health education, Tai Chi significantly improved knee pain, as measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score (mean difference (MD) = −0.60; 95% CI: −6.52 to −3.28; p < 0.00001) and the Visual Analogue Scale (VAS) (MD = −1.44; 95% CI: −1.95 to −0.93; p < 0.00001). Tai Chi also significantly improved knee function compared to health education (WOMAC function score—MD = −13.49; 95% CI: −17.11 to −9.87; p < 0.00001). Four RCTs comparing Tai Chi with no intervention reported favorable effects on knee pain and function; however, a meta-analysis was not possible due to limited data. In contrast, two studies comparing Tai Chi with active controls, such as physical therapy and resistance training, found no significant differences in pain or functional outcomes. Two studies reported increased knee pain during initial Tai Chi sessions, but no adverse events occurred after postural corrections. Conclusions: While Tai Chi appears promising for knee pain management, further large-scale, high-quality RCTs with rigorous methodology are needed to establish definitive evidence. Full article

Background/Objectives: A history of cancer has been linked to stress and concerns about its recurrence. We aimed to test the benefits of an evidence-based self-help stress reduction method, the Clinical Emotional Freedom Technique (EFT), in survivors of cutaneous melanoma, and to contrast its effects on wellbeing and perceptions of cancer recurrence when delivered in a group versus individual instruction setting. Methods: This study was preregistered at clinicaltrials.gov (NCT05421988, 3 April 2022). Fifty-three patients aged 18 and above, diagnosed with melanoma (stage T1a–T2a) at least 6 months prior, and not in active treatment were recruited from a private skin cancer clinic. After consent, all participants were randomized in one step into three condition groups: Group EFT (G-EFT; n = 16), Individual EFT (I-EFT; n = 18), and a waiting-list control condition (CC; n = 19). G-EFT and I-EFT participants attended weekly treatment sessions for four weeks. Perceptions of cancer recurrence and wellbeing measures were obtained pre- and post-intervention and at three-months follow-up using online questionnaires. Subjective units of distress (SUDs) were recorded by the EFT instructor at the beginning and end of each session. Results: Two-way repeated measures ANOVAs revealed significant improvements from pre- to post-intervention in both EFT conditions in terms of participants’ understanding of how to prevent recurrence and in their spiritual wellbeing. No statistically significant effects were found for fear of recurrence, recurrence perceptions, and affect. Significant decreases in SUD scores were observed in both EFT conditions. Over 80% of the experimental conditions’ participants reported positive changes and satisfaction. Conclusions: The findings provide support for offering EFT instruction as a non-pharmacological and noninvasive self-help method to ameliorate the stress of cancer diagnosis and treatment, and for its similar effectiveness in either a group or individual format. Full article

Complementary medicines (CMs) are widely used worldwide, with usage rates ranging from 24% to 71.3%. Despite their popularity, many CMs lack robust scientific support and can potentially lead to adverse health effects. Limited research exists on CMs-related adverse events and the role of CMs’ labels in conveying crucial information to consumers. This cross-sectional study investigated the usage, consumer perspectives, and influence of labels specifically on product-based CMs, including nutritional supplements, vitamins, minerals, probiotics, prebiotics, and herbal medicines. Practitioner-led therapies and mind-body practices were outside the scope of this research. Data were collected through an online questionnaire and analyzed using descriptive statistics and correlation analysis. The study enrolled 125 participants who were current CMs users. Pharmacies and supermarkets were the primary sources for CMs procurement. Participants’ perceptions of CMs effectiveness and safety were positively correlated. Label warnings prompted participants to seek additional information, but consultation with healthcare professionals was infrequent. Adverse reactions were reported by 18.5% of participants, with self-management approaches being common. Label warnings play a significant role in prompting consumers to seek more information about CMs. However, the limited engagement of healthcare professionals, especially pharmacists, suggests an opportunity for improved consumer education and pharmacist involvement in CMs-related discussions. Addressing these aspects can lead to safer CMs practices and informed decision-making among consumers. Full article

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the Abstracts from the 2025 Annual Conference, titled “Responding to the Human Experience of Cancer and Caring for the Soul: Building on 40 years of global leadership in psychosocial oncology”. The 40th Annual CAPO Conference was held in Toronto from 23 April 2025 to 25 April 2025. In an era marked by the rapid advancement of biologically focused precision medicine, it is imperative to redirect our attention towards the human experience of illness and the soul of medicine. Biomedicine has conceptualized illness in ways that have proved profoundly productive from a curative and biological point of view. But it cannot—and it does not pretend to—illuminate the experience of living with it. (Hurwitz 2009). This conference aims to delve into the intricate interplay between cutting-edge biomedical technologies inclusive of artificial intelligence and big data and the deeply personal narratives of individuals navigating illness. By shifting the focus from mere disease pathology to encompassing the holistic human experience, we aspire to foster a more compassionate and patient-centered approach to healthcare with psychosocial support at the core of humanistic care that can improve survival and well-being in all aspects of a whole-person approach to illness. Through interdisciplinary dialogue and introspection, we endeavor to illuminate the profound connection between mind, body, and spirit in the practice of medicine, reaffirming the timeless significance of empathy, understanding, and human connection in healing and psychosocial aspects of care as fundamental to living well with cancer. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinicians, researchers, educators in cancer care, community-based organizations and patient representatives. Patients, caregivers and family members presented abstracts that speak to their role in managing cancer experiences and care. Over two hundred (200) abstracts were submitted for presentation as symposia, 20-minute oral presentations, 10-minute oral presentations, 90-minute workshops and poster presentations. We congratulate all the presenters on their research work and contribution. Full article

The human papillomavirus type 16 (HPV 16) is a high-risk human papillomavirus strain commonly associated with oropharyngeal cancers, including lymph node involvement. The treatment for HPV 16-related tonsil cancer, commonly involving surgery, radiation, and chemotherapy, presents significant challenges. Complications such as oral mucositis, xerostomia, dysphagia, dysgeusia, hypogeusia, impaired gustatory function, and significant weight loss frequently arise, leading to reduced nutritional intake, impaired healing, and recovery progression. These challenges underscore the need for supportive interventions to enhance rehabilitation and the post-recovery period, improve treatment tolerance, and maintain quality of life. Objective: This single-subject study examines a 67-year-old male patient diagnosed with a T1N3b (small primary tumor with advanced lump node involvement) associated with HPV 16 positivity, indicating a virus-associated oncogenesis. Methods: The patient underwent radiation therapy and chemotherapy, leading to treatment-associated side effects. After having dietary drinks for daily nourishment, the patient routinely incorporated oral bio extra virgin olive oil (BEVOO) to cope with indicated challenges. Results: Body composition and metabolic parameters showed treatment-induced declines, followed by substantial but not complete recovery during follow-up examination. Visual Analog Scale (VAS) scores reflected gradual improvements in dysphagia, xerostomia, mucositis, and subtle but ongoing enhancement of the dysgeusia, gustatory perception, and oral palatability. The BEVOO supplementation and mindfulness were associated with positive recovery trends. Additional variables could have impacted the outcomes, preceding and throughout treatment, including the patient’s cognitive and somatic health, environmental conditions, dietary habits, individual attitudes toward recovery, physical activity, and patient way of life. Conclusions: These results emphasize the need for additional research employing a comprehensive, multi-factorial framework that accounts for the complex interplay of physiological, psycho-social, and environmental contributors. More extensive, more diverse studies are essential to confirm these observations and substantiate the role of BEVOO as a supportive intervention in cancer recovery. Full article

Background/Objectives: Head and neck cancer is one of the most common cancers globally, with high mortality and significant treatment-related side effects. Conventional therapies, including surgery, radiotherapy, and chemotherapy, have improved survival but often have serious consequences for patients’ quality of life. For this reason, there is growing interest in complementary therapies such as acupuncture, herbal medicine, cannabinoids, traditional Chinese medicine, and mind-body therapies. Methods: This review was conducted through a systematic analysis of the scientific literature available on PubMed and Scopus, selecting studies about the use of alternative therapies in patients with head and neck cancer according to strict criteria. Results: Acupuncture has shown benefits in the management of xerostomia and dysphagia, while some herbal medicines have shown potential anticancer effects, although with limitations related to bioavailability. Vitamins and antioxidants showed mixed results: some studies suggest a protective effect, while others report a possible increased risk of cancer progression. Cannabinoids are a controversial topic, with possible palliative benefits but also a higher risk of head and neck cancer. Traditional Chinese medicine and mind-body therapies, such as yoga, have shown positive effects on patients’ well-being, although their direct impact on cancer progression remains uncertain. Conclusions: Alternative therapies could be a useful support in managing symptoms and improving the quality of life patients with head and neck cancer. However, solid scientific evidence on their effectiveness and safety is still lacking. Rigorous clinical studies are needed to assess their therapeutic potential and define a safe integration into multidisciplinary cancer management. Full article

Background: Musculoskeletal conditions with multisystem comorbidities present significant challenges in terms of prevention and rehabilitation. Despite advances in instrumental technologies for diagnosis and treatment, a gap remains between biomedical research and practical application. Strengthening the therapeutic alliance involves improving patients’ understanding of diagnostics and treatment, while emphasizing face-to-face interactions. A team of healthcare professionals, promoting an integrated approach combining manual and movement therapies—such as physiotherapy, chiropractic, and osteopathic care—can bridge this gap, promoting well-being through a person-centered framework. Emerging research highlights the role of cognitive, neurophysiological, and sociocultural factors in body perception and health, emphasizing the need for inclusive, culturally sensitive care within osteopathic practice. Methods: We synthesize the available evidence and expert insights to address gaps in the literature. Our approach integrates conceptual analysis with emerging research, applying Driscoll’s reflective model to generate a practical framework rooted in osteopathic principles and clinical experiences. Results: We propose an integrative model incorporating narrative-based sense-making, shared decision-making, mindfulness, and active participation. By blending historical osteopathic principles with modern evidence, the model aims to enhance health resilience, reduce unnecessary interventions, and establish a holistic framework for prevention and rehabilitation. Conclusions: Integrating diverse approaches within osteopathic care refines clinical practices, ensuring a more person-centered, culturally sensitive, and holistic approach to musculoskeletal rehabilitation. This model bridges the gap between tradition and modern evidence, enhancing therapeutic outcomes and fostering an inclusive healthcare system. Full article

Trauma can impact individuals within a generation (intragenerational) and future generations (transgenerational) through a complex interplay of biological and environmental factors. This review explores the epigenetic mechanisms that have been correlated with the effects of trauma across generations, including DNA methylation, histone modifications, and non-coding RNAs. These mechanisms can regulate the expression of stress-related genes (such as the glucocorticoid receptor (NR3C1) and FK506 binding protein 5 (FKBP5) gene), linking trauma to biological pathways that may affect long-term stress regulation and health outcomes. Although research using model organisms has elucidated potential epigenetic mechanisms underlying the intergenerational effects of trauma, applying these findings to human populations remains challenging due to confounding variables, methodological limitations, and ethical considerations. This complexity is compounded by difficulties in establishing causality and in disentangling epigenetic influences from shared environmental factors. Emerging therapies, such as psychedelic-assisted treatments and mind–body interventions, offer promising avenues to address both the psychological and potential epigenetic aspects of trauma. However, translating these findings into effective interventions will require interdisciplinary methods and culturally sensitive approaches. Enriched environments, cultural reconnection, and psychosocial interventions have shown the potential to mitigate trauma’s impacts within and across generations. By integrating biological, social, and cultural perspectives, this review highlights the critical importance of interdisciplinary frameworks in breaking cycles of trauma, fostering resilience, and advancing comprehensive healing across generations. Full article

Background/Objectives: Indigenous perspectives, which emphasize non-materialistic dimensions of healing, such as the interconnectedness of the body, mind, and spirit, align with one foundational principle of osteopathic care. Integrating these perspectives into person-centered care may enhance therapeutic effectiveness by accommodating diverse understandings of health and well-being. This perspective paper explores how various epistemological frameworks, including Indigenous non-materialistic approaches, can inform manual therapy techniques and therapeutic alliances to advance person-centered care. Methods: We synthesized the best available evidence with expert insights and interdisciplinary viewpoints to address the gaps in the scientific literature. Our approach integrates conceptual analysis and emerging research to provide a comprehensive discussion for a broad professional audience. Results: We focused on detailing the existing sociocultural and experiential frameworks available to describe patients’ bodily perceptions rather than abstract intellectual constructs. Our findings were divided into two sections. The first examines the incorporation of diverse body representations that extend beyond purely biomechanical interpretations, emphasizing the role of non-materialistic components in therapeutic processes. The second explores recent neuroscientific research on self and consciousness, demonstrating how these insights intersect with Indigenous perspectives to enrich the theoretical and practical applications of osteopathic principles in different clinical contexts. Conclusions: Epistemological flexibility has the potential to refine clinical frameworks and ensure that they reflect the full scope of osteopathic practices beyond musculoskeletal care. By integrating diverse sociocultural perspectives without reinforcing stereotypes or rigid cultural constructs, this approach clarifies the diversity of body representations in osteopathic practices, addresses gaps in academic discourse, and promotes the integration of multiple worldviews as a foundation for truly person-centered care. Full article

What is apoptosis? The Nomenclature Committee on Cell Death and numerous other pioneering cancer/p53 biologists use the terms “apoptosis” and “cell death” interchangeably, disregard the mind-numbing complexity and heterogeneity that exists within a tumor (intratumor heterogeneity), disregard the contribution of polyploid giant cancer cells (PGCCs; the root causes of therapy resistance and relapse) to this heterogeneity, and then propose novel apoptosis-stimulating anticancer strategies. This is shocking for the following three reasons. First, clinical studies reported since the 1990s have revealed that increased apoptosis in solid tumors is associated with increased tumor diversity and poor prognosis. Second, we have known for years that dying (apoptotic) cancer cells release a panel of secretions (e.g., via phoenix rising and other pathways) that promote metastatic outgrowth. Third, over a decade ago, it was demonstrated that cancer cells can recover from late stages of apoptosis (after the formation of apoptotic bodies) via the homeostatic process of anastasis, resulting in the emergence of aggressive variants. The cell surface expression of CD24 has recently been reported to be preferentially enriched in recovered (anastatic) cancer cells that exhibit tumorigenic properties. These and related discoveries outlined herein call for a paradigm shift in oncology to focus on strategies that minimize the occurrence of treacherous apoptosis and other tumor-repopulating events (e.g., therapy-induced cancer cell dormancy and reactivation). They also raise an intriguing question: is deregulated anastasis (rather than evasion of apoptosis) a hallmark of cancer? Full article

Complementary and alternative medicine (CAM) encompasses a variety of ancient therapies with origins in cultures such as those of China, Egypt, Greece, Iran, India, and Rome. The National Institutes of Health (NIH) classifies these integrative therapies into five categories: (1) mind–body therapies, (2) biological practices, (3) manipulative and body practices, (4) energy medicine, and (5) whole medical systems, including traditional Chinese medicine and Ayurvedic medicine. This review explores the role of biological practices utilizing aromatic plants, particularly through inhalation aromatherapy and massage with essential oils, as effective complementary strategies within health systems. The review compiles information on the most commonly used plants and essential oils for holistic health maintenance from a complementary and alternative perspective. Given their accessibility and relative safety compared to conventional treatments, these therapies have gained popularity worldwide. Furthermore, the integration of essential oils has been shown to alleviate various psychological and physiological symptoms, including anxiety, depression, fatigue, sleep disorders, neuropathic pain, nausea, and menopausal symptoms. Among the studied plants, lavender has emerged as being particularly notable due to its broad spectrum of therapeutic effects and its designation by the US Food and Drug Administration (FDA) as “Generally Recognized as Safe”. Other essential oils under investigation include eucalyptus, damask rose, sandalwood, vetiver, calamus, frankincense, chamomile, lemon, grapefruit, tangerine, orange, sage, rosemary, garlic, and black pepper. This study emphasizes the potential benefits of these aromatic plants in enhancing patient well-being. Additionally, it underscores the importance of conducting further research to ensure the safety and efficacy of these therapies. Full article