title: Hypnosis-based psychodynamic treatment in ALS: a longitudinal study on patients and their caregivers.
abstract: BACKGROUND
  Evidence of psychological treatment efficacy is strongly needed in ALS, particularly regarding long-term effects.
  
  
  METHODS
  Fifteen patients participated in a hypnosis treatment and self-hypnosis training protocol after an in-depth psychological and neurological evaluation. Patients' primary caregivers and 15 one-by-one matched control patients were considered in the study. Measurements of anxiety, depression and quality of life (QoL) were collected at the baseline, post-treatment, and after 3 and 6 months from the intervention. Bayesian linear mixed-models were used to evaluate the impact of treatment and defense style on patients' anxiety, depression, QoL, and functional impairment (ALSFRS-r), as well as on caregivers' anxiety and depression.
  
  
  RESULTS
  The statistical analyses revealed an improvement in psychological variables' scores immediately after the treatment. Amelioration in patients' and caregivers' anxiety as well as caregivers' depression, were found to persist at 3 and 6 months follow-ups. The observed massive use of primitive defense mechanisms was found to have a reliable and constant buffer effect on psychopathological symptoms in both patients and caregivers. Notably, treated patients decline in ALSFRS-r score was observed to be slower than that of control group's patients.
  
  
  CONCLUSIONS
  Our brief psychodynamic hypnosis-based treatment showed efficacy both at psychological and physical levels in patients with ALS, and was indirectly associated to long-lasting benefits in caregivers. The implications of peculiar psychodynamic factors and mind-body techniques are discussed. Future directions should be oriented toward a convergence of our results and further psychological interventions, in order to delineate clinical best practices for ALS.
authors.affiliation: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors.forename: Johann R
authors.initials: JR
authors.lastname: Kleinbub
authors.affiliation: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy ; Center for Cognitive Neuroscience, University of Padova Padova, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Palmieri
authors.affiliation: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Broggio
authors.affiliation: Department of Psychology, Catholic University of Milan Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pagnini
authors.affiliation: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Benelli
authors.affiliation: Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Sambin
authors.affiliation: Department of Neurosciences, University of Padova Padova, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Sorarù
keywords: ALSFRS-r; amyotrophic lateral sclerosis (ALS); anxiety; defense mechanisms; depression; hypnosis; psychodynamic intervention; quality of life