@article{guingo_efficacy_2026,

title = {Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial},

author = {E. Guingo and M. H. Debeurme and R. P. Santos and S. Addab and P. Rainville and S. Bouchard and K. Chougui and A. Tsimicalis and M. -L. Nault and T. Ducruet and O. Ledjiar and M. Noel and K. St-Arneault and C. Cotes-Turpin and N. Hung and P. Ouimet and S. Parent and J. Gardner and M. Bernstein and S. Le May},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105004216228&doi=10.1111%2Fjan.16991&partnerID=40&md5=9200a82b5c9572abcc5170e9c9d6142b},

doi = {10.1111/jan.16991},

issn = {03092402 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Journal of Advanced Nursing},

volume = {82},

number = {2},

pages = {1791–1802},

abstract = {Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures. Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game. Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure. Results: A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety. Conclusion: Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older. Implication for the Professional and/or Patient Care: Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal. Impact: This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older. Reporting Method: We adhered to the CONSORT checklist for reporting results. Patient or Public Contribution: A patient partner reviewed the study design, methods and final manuscript. Trial Registration: NCT03680625. © 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.},

keywords = {Adolescent, analgesia, Anxiety, Bone Nails, Child, Children, clinical trial, comparative study, controlled study, female, human, Humans, intramedullary nailing, male, multicenter study, Pain Management, procedural pain, procedures, randomized controlled trial, Therapy, video game, Video Games, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{guingoEfficacyVirtualReality2026,

title = {Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial},

author = {E. Guingo and M. H. Debeurme and R. P. Santos and S. Addab and P. Rainville and S. Bouchard and K. Chougui and A. Tsimicalis and M. -L. Nault and T. Ducruet and O. Ledjiar and M. Noel and K. St-Arneault and C. Cotes-Turpin and N. Hung and P. Ouimet and S. Parent and J. Gardner and M. Bernstein and S. Le May},

url = {https://www.scopus.com/pages/publications/105004216228?origin=resultslist},

doi = {10.1111/jan.16991},

issn = {03092402 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Journal of Advanced Nursing},

volume = {82},

number = {2},

pages = {1791–1802},

publisher = {John Wiley and Sons Inc},

abstract = {Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures. Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game. Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure. Results: A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety. Conclusion: Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older. Implication for the Professional and/or Patient Care: Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal. Impact: This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older. Reporting Method: We adhered to the CONSORT checklist for reporting results. Patient or Public Contribution: A patient partner reviewed the study design, methods and final manuscript. Trial Registration: NCT03680625. © 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.},

keywords = {Adolescent, analgesia, Anxiety, Bone Nails, Child, Children, clinical trial, comparative study, controlled study, female, human, Humans, intramedullary nailing, male, multicenter study, Pain Management, procedural pain, procedures, randomized controlled trial, Therapy, video game, Video Games, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{guingoEfficacyVirtualReality2026a,

title = {Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial},

author = {E. Guingo and M. H. Debeurme and R. P. Santos and S. Addab and P. Rainville and S. Bouchard and K. Chougui and A. Tsimicalis and M. -L. Nault and T. Ducruet and O. Ledjiar and M. Noel and K. St-Arneault and C. Cotes-Turpin and N. Hung and P. Ouimet and S. Parent and J. Gardner and M. Bernstein and S. Le May},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105004216228&doi=10.1111%2Fjan.16991&partnerID=40&md5=9200a82b5c9572abcc5170e9c9d6142b},

doi = {10.1111/jan.16991},

issn = {03092402 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Journal of Advanced Nursing},

volume = {82},

number = {2},

pages = {1791–1802},

abstract = {Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures. Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game. Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure. Results: A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety. Conclusion: Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older. Implication for the Professional and/or Patient Care: Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal. Impact: This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older. Reporting Method: We adhered to the CONSORT checklist for reporting results. Patient or Public Contribution: A patient partner reviewed the study design, methods and final manuscript. Trial Registration: NCT03680625. © 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.},

keywords = {Adolescent, analgesia, Anxiety, Bone Nails, Child, Children, clinical trial, comparative study, controlled study, female, human, Humans, intramedullary nailing, male, multicenter study, Pain Management, procedural pain, procedures, randomized controlled trial, Therapy, video game, Video Games, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{clemmensen_study_2023,

title = {Study protocol for virtual leisure investigating the effect of virtual reality-delivered stress reduction, entertainment and distraction on the use of coercion and need-based medication and patient satisfaction at a closed psychiatric intensive care unit - A mixed-methods pilot clinical trial},

author = {L. Clemmensen and G. Jørgensen and K. B. Gundersen and L. C. Smith and J. Midtgaard and S. Bouchard and C. P. Thomsen and L. Turgut and L. B. Glenthoj},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85172425765&doi=10.1136%2fbmjopen-2022-070566&partnerID=40&md5=87f1ee7c5b1f4d9245722d461eb9e6d2},

doi = {10.1136/bmjopen-2022-070566},

issn = {20446055},

year  = {2023},

date = {2023-01-01},

journal = {BMJ Open},

volume = {13},

number = {9},

publisher = {BMJ Publishing Group},

abstract = {Introduction The environment at a psychiatric inpatient ward can lead to emotional distress and behavioural deviations in vulnerable individuals potentially resulting in conflicts, increased use of need-based medication and coercive actions, along with low satisfaction with treatment. To accommodate these challenges, recreational and entertaining interventions are recommended. The tested interventions have, however, shown varying effects and demand a high degree of planning and staff involvement while being difficult to adapt to individual needs. Virtual reality (VR) may help overcome these challenges. Methods and analysis The study is a mixed-methods clinical trial with a target sample of 124 patients hospitalised at a closed psychiatric ward in the capital region of Denmark. Outcomes (eg, coercion, need-based medication and perceived stress) for a 12-month period where all patients are offered VR-based recreational experiences during their hospitalisation will be compared with outcomes for a 12-month period where VR is not offered. Feasibility and acceptability will be explored with qualitative interviews supplemented with non-participant observations and focus groups. The study began on 1 January 2023, and we expect to complete data collection by 31 December 2024. Ethics and dissemination The study is registered at Danish Data Protection Agency (j.no P-2022-466) and is approved by the Committee on Health Research Ethics of the capital region of Denmark (j.no 22013313). All patients will be required to provide informed consent. Results from this study will be disseminated via peer-reviewed journals and congress/consortium presentations. Trial registration number NCT05654740. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.},

note = {Publisher: BMJ Publishing Group},

keywords = {Anxiety disorder, article, Behavior Observation Techniques, behavioral observation, borderline state, clinical effectiveness, clinical outcome, clinical protocol, Coercion, cognitive behavioral therapy, comparative study, Denmark, Depression, feasibility study, health care need, hospital patient, human, Humans, intensive care unit, Intensive Care Units, interpersonal communication, leisure, Leisure Activities, major clinical study, neuroleptic agent, non participant observation, Patient Satisfaction, peer review, pilot study, psychiatric intensive care unit, qualitative analysis, quantitative analysis, schizophrenia spectrum disorder, semi structured interview, virtual reality, virtual reality delivered stress reduction},

pubstate = {published},

tppubtype = {article}

}

@article{savard_efficacy_2021,

title = {Efficacy of a stepped care approach to deliver cognitive-behavioral therapy for insomnia in cancer patients: A noninferiority randomized controlled trial},

author = {J. Savard and H. Ivers and M. -H. Savard and C. M. Morin and A. Caplette-Gingras and S. Bouchard and G. Lacroix},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85121217599&doi=10.1093%2fsleep%2fzsab166&partnerID=40&md5=8c3390082d345b725c47465f96bb8e44},

doi = {10.1093/sleep/zsab166},

issn = {01618105 (ISSN)},

year  = {2021},

date = {2021-01-01},

journal = {Sleep},

volume = {44},

number = {11},

publisher = {Oxford University Press},

abstract = {Study Objectives: Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia, but its accessibility is very limited in routine care. A stepped care approach has been recommended as a cost-effective way to make CBT-I more widely accessible. However, no controlled study has yet been published about the efficacy of this approach. The goal of this noninferiority randomized controlled trial (RCT) was to compare the short and long-term efficacy of a stepped care CBT-I (StepCBT-I) to a standard face-to-face CBT-I (StanCBT-I). Methods: A total of 177 cancer patients were randomized to: (1) StanCBT-I (6 face-to-face CBT-I sessions; n = 59) or (2) StepCBT-I (n = 118). In the StepCBT-I group, patients with less severe insomnia first received a web-based CBT-I (n = 65), while those with more severe insomnia received 6 face-to-face CBT-I sessions (n = 53). In both cases, patients could receive up to three booster sessions of CBT-I if they still had insomnia symptoms following this first step. Results: Results indicated that the Step-CBT-I group showed an Insomnia Severity Index score reduction and a sleep efficiency (on a sleep diary) increase that was not significantly inferior to that of StanCBT-I at all post-treatment time points. Analyses of secondary outcomes indicated significant time effects (ps <. 001) and no significant group-by-time interactions (ps from. 07 to. 91) on other sleep diary parameters, sleep medication use, depression, anxiety, fatigue, and quality of life scores. Conclusion(s): The efficacy of stepped care CBT-I is not inferior to that of a standard face-to-face intervention and is a valuable approach to making this treatment more widely accessible to cancer patients. Trial registration: ClinicalTrials.gov Identifier: NCT01864720 (https://clinicaltrials.gov/ct2/show/NCT01864720?term=Savard&draw=2&rank=6; Stepped Care Model for the Wider Dissemination of Cognitive-Behavioural Therapy for Insomnia Among Cancer Patients). © 2021 Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society.},

note = {Publisher: Oxford University Press},

keywords = {adult, Anxiety, Anxiety disorder, cancer, cancer diagnosis, cancer patient, cognitive behavioral therapy, Cognitive-behavioral therapy, comparative study, complication, controlled study, cost effectiveness analysis, Depression, disease severity, drug use, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, fatigue, female, Hospital Anxiety and Depression Scale, human, Humans, insomnia, Insomnia Severity Index, long term care, major clinical study, male, malignant neoplasm, Middle Aged, Montreal cognitive assessment, neoplasm, Neoplasms, outcome assessment, procedures, psychotropic agent, quality of life, randomized controlled trial, remission, review, Self Care, short course therapy, sleep, sleep efficiency, Sleep Initiation and Maintenance Disorders, sleep pattern, stepped care, stepped care approach, Structured Clinical Interview for DSM Disorders, therapy effect, treatment outcome, web-based intervention},

pubstate = {published},

tppubtype = {article}

}

@article{savardEfficacySteppedCare2021,

title = {Efficacy of a stepped care approach to deliver cognitive-behavioral therapy for insomnia in cancer patients: A noninferiority randomized controlled trial},

author = {J. Savard and H. Ivers and M. -H. Savard and C. M. Morin and A. Caplette-Gingras and S. Bouchard and G. Lacroix},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85121217599&doi=10.1093%2fsleep%2fzsab166&partnerID=40&md5=8c3390082d345b725c47465f96bb8e44},

doi = {10.1093/sleep/zsab166},

issn = {01618105 (ISSN)},

year  = {2021},

date = {2021-01-01},

journal = {Sleep},

volume = {44},

number = {11},

publisher = {Oxford University Press},

abstract = {Study Objectives: Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia, but its accessibility is very limited in routine care. A stepped care approach has been recommended as a cost-effective way to make CBT-I more widely accessible. However, no controlled study has yet been published about the efficacy of this approach. The goal of this noninferiority randomized controlled trial (RCT) was to compare the short and long-term efficacy of a stepped care CBT-I (StepCBT-I) to a standard face-to-face CBT-I (StanCBT-I). Methods: A total of 177 cancer patients were randomized to: (1) StanCBT-I (6 face-to-face CBT-I sessions; n = 59) or (2) StepCBT-I (n = 118). In the StepCBT-I group, patients with less severe insomnia first received a web-based CBT-I (n = 65), while those with more severe insomnia received 6 face-to-face CBT-I sessions (n = 53). In both cases, patients could receive up to three booster sessions of CBT-I if they still had insomnia symptoms following this first step. Results: Results indicated that the Step-CBT-I group showed an Insomnia Severity Index score reduction and a sleep efficiency (on a sleep diary) increase that was not significantly inferior to that of StanCBT-I at all post-treatment time points. Analyses of secondary outcomes indicated significant time effects (ps <. 001) and no significant group-by-time interactions (ps from. 07 to. 91) on other sleep diary parameters, sleep medication use, depression, anxiety, fatigue, and quality of life scores. Conclusion(s): The efficacy of stepped care CBT-I is not inferior to that of a standard face-to-face intervention and is a valuable approach to making this treatment more widely accessible to cancer patients. Trial registration: ClinicalTrials.gov Identifier: NCT01864720 (https://clinicaltrials.gov/ct2/show/NCT01864720?term=Savard&draw=2&rank=6; Stepped Care Model for the Wider Dissemination of Cognitive-Behavioural Therapy for Insomnia Among Cancer Patients). © 2021 Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society.},

keywords = {adult, Anxiety, Anxiety disorder, cancer, cancer diagnosis, cancer patient, cognitive behavioral therapy, Cognitive-behavioral therapy, comparative study, complication, controlled study, cost effectiveness analysis, Depression, disease severity, drug use, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, fatigue, female, Hospital Anxiety and Depression Scale, human, Humans, insomnia, Insomnia Severity Index, long term care, major clinical study, male, malignant neoplasm, Middle Aged, Montreal cognitive assessment, neoplasm, Neoplasms, outcome assessment, procedures, psychotropic agent, quality of life, randomized controlled trial, remission, review, Self Care, short course therapy, sleep, sleep efficiency, Sleep Initiation and Maintenance Disorders, sleep pattern, stepped care, stepped care approach, Structured Clinical Interview for DSM Disorders, therapy effect, treatment outcome, web-based intervention},

pubstate = {published},

tppubtype = {article}

}

@article{bouchard_virtual_2017,

title = {Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: A three-arm randomised controlled trial},

author = {S. Bouchard and S. Dumoulin and G. Robillard and T. Guitard and E. Klinger and H. Forget and C. Loranger and F. X. Roucaut},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85018214603&doi=10.1192%2fbjp.bp.116.184234&partnerID=40&md5=245751bf4ef3f8ae014a9c5816a585c3},

doi = {10.1192/bjp.bp.116.184234},

issn = {00071250},

year  = {2017},

date = {2017-01-01},

journal = {British Journal of Psychiatry},

volume = {210},

number = {4},

pages = {276–283},

publisher = {Royal College of Psychiatrists},

abstract = {Background: People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive-behavioural therapy (CBT), could be an answer. Aims: To show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposure in vivo. Method: Participants were randomly assigned to either VR exposure (n =17), in vivo exposure (n=22) or waiting list (n= 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. (Trial registration number ISRCTN99747069.) Results: Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists than in vivo exposure. Conclusions: Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure. Declaration of interest S.B. and G.R. are consultants to and own equity in Cliniques et Développement In Virtuo, which develops virtual environments; however, Cliniques et Développement In Virtuo did not create the virtual environments used in this study. The terms of these arrangements were reviewed and approved by Universitédu Québec en Outaouais, in accordance with its policy on conflicts of interest. © The Royal College of Psychiatrists 2017.},

note = {Publisher: Royal College of Psychiatrists},

keywords = {adult, article, avoidance behavior, clinical outcome, cognitive therapy, comparative effectiveness, comparative study, computer interface, controlled study, cost, devices, female, hospital admission, human, Humans, Implosive Therapy, in vivo study, major clinical study, male, Middle Aged, outcome assessment, Outcome Assessment (Health Care), phobia, procedures, randomized controlled trial, Social, social phobia, User-Computer Interface, virtual reality, virtual reality exposure therapy},

pubstate = {published},

tppubtype = {article}

}

@article{bouchardVirtualRealityCompared2017,

title = {Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: A three-arm randomised controlled trial},

author = {S. Bouchard and S. Dumoulin and G. Robillard and T. Guitard and E. Klinger and H. Forget and C. Loranger and F. X. Roucaut},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85018214603&doi=10.1192%2fbjp.bp.116.184234&partnerID=40&md5=245751bf4ef3f8ae014a9c5816a585c3},

doi = {10.1192/bjp.bp.116.184234},

issn = {00071250},

year  = {2017},

date = {2017-01-01},

journal = {British Journal of Psychiatry},

volume = {210},

number = {4},

pages = {276–283},

publisher = {Royal College of Psychiatrists},

abstract = {Background: People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive-behavioural therapy (CBT), could be an answer. Aims: To show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposure in vivo. Method: Participants were randomly assigned to either VR exposure (n =17), in vivo exposure (n=22) or waiting list (n= 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. (Trial registration number ISRCTN99747069.) Results: Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists than in vivo exposure. Conclusions: Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure. Declaration of interest S.B. and G.R. are consultants to and own equity in Cliniques et Développement In Virtuo, which develops virtual environments; however, Cliniques et Développement In Virtuo did not create the virtual environments used in this study. The terms of these arrangements were reviewed and approved by Universitédu Québec en Outaouais, in accordance with its policy on conflicts of interest. © The Royal College of Psychiatrists 2017.},

keywords = {adult, article, avoidance behavior, clinical outcome, cognitive therapy, comparative effectiveness, comparative study, computer interface, controlled study, cost, devices, female, hospital admission, human, Humans, Implosive Therapy, in vivo study, major clinical study, male, Middle Aged, outcome assessment, Outcome Assessment (Health Care), phobia, procedures, randomized controlled trial, Social, social phobia, User-Computer Interface, virtual reality, virtual reality exposure therapy},

pubstate = {published},

tppubtype = {article}

}

@article{cousineau_insomnia_2016,

title = {Insomnia symptoms following treatment for comorbid panic disorder with agoraphobia and generalized anxiety disorder},

author = {H. Cousineau and A. Marchand and S. Bouchard and C. Bélanger and P. Gosselin and F. Langlois and J. Labrecque and M. J. Dugas and G. Belleville},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962128029&doi=10.1097%2fNMD.0000000000000466&partnerID=40&md5=2ca2dd82c29553bd7377ba64dd5522cc},

doi = {10.1097/NMD.0000000000000466},

issn = {00223018},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Nervous and Mental Disease},

volume = {204},

number = {4},

pages = {267–273},

publisher = {Lippincott Williams and Wilkins},

abstract = {Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η2 = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.},

note = {Publisher: Lippincott Williams and Wilkins},

keywords = {adult, agoraphobia, antidepressant agent, Anxiety Disorders, anxiolytic agent, article, clinical trial, cognitive therapy, cohort analysis, Cohort Studies, Combined Modality Therapy, comorbidity, comparative study, controlled study, Depression, disease severity, female, generalized anxiety disorder, human, Humans, hypnotic agent, insomnia, major clinical study, male, Middle Aged, multicenter study, multimodality cancer therapy, nocturnal panic attack, panic, Panic Disorder, panic disorder with agoraphobia, patient worry, procedures, psychoeducation, psychology, psychotropic agent, Psychotropic Drugs, quasi experimental study, Quebec, randomized controlled trial, Sleep Initiation and Maintenance Disorders, statistical significance, treatment outcome, wakefulness, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{cousineauInsomniaSymptomsFollowing2016,

title = {Insomnia symptoms following treatment for comorbid panic disorder with agoraphobia and generalized anxiety disorder},

author = {H. Cousineau and A. Marchand and S. Bouchard and C. Bélanger and P. Gosselin and F. Langlois and J. Labrecque and M. J. Dugas and G. Belleville},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962128029&doi=10.1097%2fNMD.0000000000000466&partnerID=40&md5=2ca2dd82c29553bd7377ba64dd5522cc},

doi = {10.1097/NMD.0000000000000466},

issn = {00223018},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Nervous and Mental Disease},

volume = {204},

number = {4},

pages = {267–273},

publisher = {Lippincott Williams and Wilkins},

abstract = {Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η2 = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {adult, agoraphobia, antidepressant agent, Anxiety Disorders, anxiolytic agent, article, clinical trial, cognitive therapy, cohort analysis, Cohort Studies, Combined Modality Therapy, comorbidity, comparative study, controlled study, Depression, disease severity, female, generalized anxiety disorder, human, Humans, hypnotic agent, insomnia, major clinical study, male, Middle Aged, multicenter study, multimodality cancer therapy, nocturnal panic attack, panic, Panic Disorder, panic disorder with agoraphobia, patient worry, procedures, psychoeducation, psychology, psychotropic agent, Psychotropic Drugs, quasi experimental study, Quebec, randomized controlled trial, Sleep Initiation and Maintenance Disorders, statistical significance, treatment outcome, wakefulness, Young Adult},

pubstate = {published},

tppubtype = {article}

}