Disorders - Anxiety Disorders
Daros, A. R., Haefner, S. A., Asadi, S., Kazi, S., Rodak, T., Quilty, L. C.
Difficulties in applying emotional regulation (ER) skills are associated with depression and
anxiety symptoms, and are common targets of treatment. This meta-analysis examined whether improvements in ER skills were associated with
psychological treatment outcomes for depression and/or anxiety in youth. A multivariate, random-effects meta-analysis was run using metafor in R.
Inclusion criteria included studies that were randomized controlled trials (RCTs) of a psychological intervention for depression and/or anxiety in
patients aged 14-24, were peer reviewed, were written in English, measured depression and/or anxiety symptoms as an outcome and measured ER as an
outcome. Medline, Embase, APA PsycInfo, CINAHL and The Cochrane Library were searched up to 26 June 2020. Risk of bias (ROB) was assessed using the
Cochrane Collaboration Risk of Bias 2.0 tool. The meta-analysis includes 385 effect sizes from 90 RCTs with total N = 11,652. Psychological
treatments significantly reduced depression, anxiety, emotion dysregulation (k = 13, Hedges' g = 0.54, P < 0.001, 95% confidence interval (CI) =
0.30-0.78) and disengagement ER (k = 83, g = 0.24, 95% CI = 0.15-0.32, P < 0.001); engagement ER also increased (k = 82, g = 0.26, 95% CI = 0.15-
0.32, P < 0.001). Improvements in depression and anxiety were positively associated with improved engagement ER skills, reduced emotion dysregulation
and reduced disengagement ER skills. Sensitivity considered study selection and publication bias. Longer treatments, group formats and cognitive-
behavioural orientations produced larger positive associations between improved ER skills and reduced symptoms. ER skill improvement is linked to
depression and anxiety across a broad range of interventions for youth. Limitations of the current study include reliance on self-report measures,
content overlap between variables and inability to test the directionality of associations.
, 5(10) : 1443-1457
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Dark-Freudeman, A., Jones, C., Terry, C.
OBJECTIVES: University students experience heightened levels of stress and are seeking mental health services with increasing
frequency. Mindfulness-based interventions (MBIs) may be an effective resource for managing stress. The present study examined the effectiveness of
an MBI in reducing stress, anxiety, and rumination compared to active and traditional control conditions. METHOD(S): Undergraduate students at a
southeastern university participated in either a 4-week MBI, active control, or traditional control condition. Measures were collected pre- and
post-intervention. Result(s): Overall the MBI had a significant impact on perceived stress over and above both traditional and active control
conditions. The MBI also had a significant impact on trait mindfulness and anxiety compared to the traditional control condition. No significant
differences were observed for rumination. Conclusion(s): The MBI significantly impacted trait mindfulness, perceived stress, and state anxiety. MBIs
may be a useful approach to successfully alleviating stress in a highly stressed population.
Journal of American college health : J of ACH, : 1-10
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Mindfulness based
therapy, Other complementary & alternative
interventions
Correll, C. U., Cortese, S., Croatto, G., Monaco, F., Krinitski, D., Arrondo, G., Ostinelli, E., Zangani, C., Fornaro, M., Estrade, A., Fusar-Poli, P., Carvalho, A. F., Solmi, M.
Top-tier evidence on the safety/tolerability
of 80 medications in children/adolescents with mental disorders has recently been reviewed in this jour-nal. To guide clinical practice, such data
must be combined with evidence on efficacy and acceptability. Besides medications, psychosocial inter-ventions and brain stimulation techniques are
treatment options for children/adolescents with mental disorders. For this umbrella review, we systematically searched network meta-analyses (NMAs)
and meta-analyses (MAs) of randomized controlled trials (RCTs) evaluating 48 medications, 20 psychosocial interventions, and four brain stimulation
techniques in children/adolescents with 52 different mental disorders or groups of mental disorders, reporting on 20 different efficacy/acceptability
outcomes. Co-primary outcomes were disease-specific symptom reduction and all-cause discontinuation (\"acceptability\"). We included 14 NMAs and 90
MAs, reporting on 15 mental disorders or groups of mental disorders. Overall, 21 medications outperformed placebo regarding the co-primary outcomes,
and three psychosocial interventions did so (while seven outperformed waiting list/no treatment). Based on the meta-analytic evidence, the most
convincing efficacy profile emerged for amphetamines, methylphenidate and, to a smaller extent, behavioral therapy in attention-deficit/hyperactivity
disorder; aripiprazole, risperidone and several psychosocial interventions in autism; risperidone and behavioral interventions in disruptive behavior
disorders; several antipsychotics in schizophrenia spectrum disorders; fluoxetine, the combination of fluoxetine and cognitive behavioral therapy
(CBT), and interpersonal therapy in depression; aripiprazole in mania; fluoxetine and group CBT in anxiety disorders; fluoxetine/selective serotonin
reuptake inhibitors, CBT, and behavioral therapy with exposure and response prevention in obsessive-compulsive disorder; CBT in post-traumatic stress
disorder; imipramine and alarm behavioral intervention in enuresis; behavioral therapy in encopresis; and family therapy in anorexia nervosa. Results
from this umbrella review of interventions for mental disorders in children/adolescents provide evidence-based information for clinical decision
making.Copyright © 2021 World Psychiatric Association
World Psychiatry, 20(2) : 244-
275
- Year: 2021
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Bipolar Disorders, Depressive Disorders, Anorexia Nervosa, Psychosis Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Cooper, M., Stafford, M. R., Saxon, D., Beecham, J., Bonin, E. M., Barkham, M., Bower, P., Cromarty, K., Duncan, C., Pearce, P., Rameswari, T., Ryan, G.
Background: About one in seven adolescents have a mental health disorder in England, UK. School counselling is one of
the most common means of trying to address such a problem. We aimed to determine the effectiveness and cost-effectiveness of school-based humanistic
counselling (SBHC) for the treatment of psychological distress in young people in England, UK. Method(s): We did a two-arm, individually randomised
trial in 18 secondary state-funded schools across the Greater London area of the UK. Participants were randomly assigned (1:1) using a centrally
secure randomisation procedure with random permuted blocks to either SBHC plus schools' pastoral care as usual (PCAU), or PCAU alone. Participants
were pupils aged 13-16 years who had moderate-to-severe levels of emotional symptoms (measured by a score of >=5 on the Strengths and Difficulties
Questionnaire Emotional Symptoms scale) and were assessed as competent to consent to participate in the trial. Participants, providers, and assessors
(who initially assessed and enrolled participants) were not masked but testers (who measured outcomes) were masked to treatment allocation. The
primary outcome was psychological distress at 12 weeks (Young Person's Clinical Outcomes in Routine Evaluation measure [YP-CORE]; range 0-40),
analysed on an intention-to-treat basis (with missing data imputed). Costs were assessed at 24 weeks (Client Service Receipt Inventory and service
logs). The trial was registered with ISRCTN, number ISRCTN10460622. Finding(s): 329 participants were recruited between Sept 29, 2016, and Feb 8,
2018, with 167 (51%) randomly assigned to SBHC plus PCAU and 162 (49%) to PCAU. 315 (96%) of 329 participants provided data at 12 weeks and scores
were imputed for 14 participants (4%). At baseline, the mean YP-CORE scores were 20.86 (SD 6.38) for the SBHC plus PCAU group and 20.98 (6.41) for
the PCAU group. Mean YP-CORE scores at 12 weeks were 16.41 (SD 7.59) for the SBHC plus PCAU group and 18.34 (7.84) for the PCAU group (difference
1.87, 95% CI 0.37-3.36; p=0.015), with a small effect size (0.25, 0.03-0.47). Overall costs at 24 weeks were 995.20 (SD 769.86) per pupil for the
SBHC plus PCAU group and 612.89 (1224.56) for the PCAU group (unadjusted difference 382.31, 95% CI 148.18-616.44; p=0.0015). The probability of SBHC
being more cost-effective reached 80% at a willingness to pay of 390 for a 1-point improvement on the YP-CORE. Five serious adverse events occurred
for four participants in the SBHC plus PCAU group, all involving suicidal intent. Two serious adverse events occurred for two participants in the
PCAU group, one involving suicidal intent. Interpretation(s): The addition of SBHC to PCAU leads to small reductions in psychological distress, but
at an additional economic cost. SBHC is a viable treatment option but there is a need for equally rigorous evaluation of alternative interventions.
Funding(s): This work was supported by the Economic and Social Research Council (grant reference ES/M011933/1). Copyright © 2021 The Author(s).
Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
The Lancet Child and Adolescent Health, 5
(3) : 178-189
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type:
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Cohen Kadosh, K., Basso, M., Knytl, P., Johnstone, N., Lau, J. Y. F., Gibson, G. R.
The human gut microbiome influence on brain function and
mental health is an emerging area of intensive research. Animal and human research indicates adolescence as a sensitive period when the gut-brain
axis is fine-tuned, where dietary interventions to change the microbiome may have long-lasting consequences for mental health. This study reports a
systematic review and meta-analysis of microbiota-targeted (psychobiotics) interventions on anxiety in youth, with discussion of a consultation on
the acceptability of psychobiotic interventions for mental health management amongst youth with lived experience. Six databases were searched for
controlled trials in human samples (age range: 10-24 years) seeking to reduce anxiety. Post intervention outcomes were extracted as standard mean
differences (SMDs) and pooled based on a random-effects model. 5416 studies were identified: 14 eligible for systematic review and 10 eligible for
meta-analysis (total of 324 experimental and 293 control subjects). The meta-analysis found heterogeneity I2 was 12% and the pooled SMD
was -0.03 (95% CI: -0.21, 0.14), indicating an absence of effect. One study presented with low bias risk, 5 with high, and 4 with uncertain risk.
Accounting for risk, sensitivities analysis revealed a SMD of -0.16 (95% CI: -0.38, 0.07), indicative of minimal efficacy of psychobiotics for
anxiety treatment in humans. There is currently limited evidence for use of psychobiotics to treat anxiety in youth. However, future progress will
require a multidisciplinary research approach, which gives priority to specifying mechanisms in the human models, providing causal understanding, and
addressing the wider context, and would be welcomed by anxious youths. Copyright © 2021, The Author(s).
Translational
Psychiatry, 11(1) :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Chen, X., Zhang, B., Jin, S. X., Quan, Y. X., Zhang, X. W., Cui, X. S.
BACKGROUND: Recently, mindfulness interventions have been extensively applied in the field of
nursing education. However, no consensus has been reached on whether these interventions can reduce anxiety and depression in nursing students.
\rOBJECTIVE: This meta-analysis was designed to determine the effect of mindfulness interventions on levels of depression, anxiety, stress and
mindfulness for nursing students.\rDESIGN: Meta-analysis of randomized controlled trials.\rMETHODS: The following Chinese and English databases were
searched for relevant articles: Pubmed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wanfang. The
search encompassed the establishment of these databases up until January 2020. Two reviewers separately entered the data into Review Manager Software
5.3.\rRESULTS: A total of 10 randomized controlled trials (RCTs) were reviewed. It was found that mindfulness interventions significantly lowered
levels of depression (SMD = -0.42, 95% CI:-0.56 to -0.28, P < 0.001), anxiety (SMD = -0.32, 95% CI:-0.47 to -0.17, P < 0.001) and stress (SMD = -
0.50, 95% CI:-0.65 to -0.35, P < 0.001) in nursing students. Furthermore, the interventions raised levels of mindfulness in this group (SMD = 0.54,
95% CI:0.33-0.75, P < 0.001).\rCONCLUSIONS: Mindfulness interventions can significantly reduce nursing students' negative emotions, helping them to
manage their stress and anxiety. College nursing educators should consider adopting mindfulness interventions in nursing education to promote the
mental health of students.
Nurse Education
Today, 98 : 104718
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy, Acceptance & commitment therapy
(ACT)
Chen, J., Sang, G., Zhang,
Y., Jiang, A.
Background: The World Health Organization has declared the Corona Virus Disease 2019 (COVID-19) epidemic as a public health emergency of
international concern. Given the sudden infection from and extensive dispersion of COVID-19 and the absence of specific drugs, those infected are in
danger if they are not treated in time. Consequently, COVID-19 has become an important factor influencing adolescents' mental health. The purpose of
this study is to explore the intervention effect of the integration model on the negative emotions of adolescents during the COVID-19 epidemic.
Subjects and methods: Adolescents were randomly selected from five middle schools in Zhejiang Province of China from May 2020 to July 2020. First,
the Self-rating Anxiety Scale, Positive and Negative Affect Scale, and Psychological Well-Being Scale were used for measurement. Then, 72 patients
with moderate and severe anxiety symptoms were chosen as the research objects, and the intervention and comparison time was determined to be eight
weeks. The subjects were randomly divided into the experiment group (35 members) and the control group (34 members). The integration model was
employed on the experiment group. Result(s): Grade, physical condition, and sleep time are important factors influencing the anxiety level of
adolescents during the COVID-19 period, and the anxiety risk of adolescents is higher during their third year of junior high school. After the
intervention, the SAS score of the experiment group is lower than that of the control group, and the decrease in the SAS score is higher in the
experiment group than in the control group (P<0.01). Moreover, the positive emotion score of the experiment group is higher than that of the control
group, and the negative emotion score of the former is lower than that of the latter. The variances in the positive and negative emotion scores are
higher in the experiment group than in the control group (P<0.01). The variance in the overall well-being index is also greater in the experiment
group than in the control group (P<0.01). Conclusion(s): The intervention using the integrated model can significantly reduce negative emotions such
as anxiety, increase positive emotions, and improve the overall well-being of adolescents during the epidemic period. Copyright © Medicinska naklada
- Zagreb, Croatia
Psychiatria Danubina, 33(1) : 86-
94
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any), Mindfulness based
therapy, Meditation, Physical activity, exercise, Technology, interventions delivered using technology (e.g. online, SMS)
Chaudhary, S., Khanna, S., Maurya, U. K., Shenoy, S.
Background: A new conception is emerging by acknowledging that right breathing volume
is elemental for good health, based on the devotional work of Russian scientist Konstantin Buteyko. Buteyko breathing technique (BBT) is committed to
reduce pulmonary ventilation which raises the levels of carbon dioxide in the body. Thus, it increases oxygen delivery to the tissues and cells.
Objective(s): To analyse the effectiveness of the Buteyko Breathing Technique on physiological and psychological parameters of football players.
Methodology: 40 male footballers were included in the study and randomly divided into two groups. Group A (n=20) received 6 weeks BBT (5
sessions/week) where as Group B (n=20) continued with regular training. Resting Heart Rate (RHR), Resting Blood Pressure (RBP), VO2max, Control Pause
Test and Anxiety were measured at the beginning and after the completion of the protocol in both the groups. Result(s): Paired t test revealed a
significant decrease in RHR, and Anxiety by 5.76% and 12.4% respectively. Resting Systolic and diastolic blood pressure decreased by 4.26% and 5%
respectively, whereas massive improvement was seen in Control Pause by 134.2% and VO2max by 15.54% in Group A. No significant change was seen in
group B. Conclusion(s): BBT was found to be useful technique to enhance endurance of the players as it has showed a positive improvement in cardio
respiratory parameters. This technique was also helpful in reducing anxiety. Copyright © 2021 Ubiquity Press. All rights reserved.
European Journal of Molecular and Clinical Medicine, 8(2) : 1790-
1800
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Meditation
Carter, T., Pascoe, M., Bastounis, A., Morres, I.
D.,
Background: There is emerging evidence that physical activity can have
beneficial effects on anxiety. A comprehensive synthesis of the evidence of the anxiolytic effects of physical activity from randomised controlled
trials (RCTs) in children and young people (CYP) is warranted. Method(s): A search of 13 databases was conducted to identify RCTs testing the effects
of physical activity on anxiety symptoms in children and young people (up to 25 years). Screening, data extraction and risk of bias assessment (using
the Cochrane Collaboration tool for assessing risk of bias) were independently undertaken by two study authors. The primary analysis used a random
effects model to compare the effect of physical activity interventions to no intervention or minimal intervention control conditions on state
anxiety, assessed using validated, self-report measures. Result(s): Of the 3590 articles retrieved, 22 RCTs were included, with nine included in the
primary meta-analysis. The overall standardised mean difference was 0.54 (95% CI -0.796, -0.28), representing a moderate improvement in state
anxiety, compared to no intervention or minimal intervention control conditions. Physical activity was also found to produce significantly superior
effects on state anxiety when compared to a time and attention-controlled group. Limitation(s): The studies are of low quality overall, and there are
a limited number of studies included in the meta-analyses therefore limiting the precision of results. Conclusion(s): Physical activity may be a
useful approach to addressing anxiety symptoms in children and young people, however, further trials of clinical populations are required to
determine the effectiveness of physical activity as a treatment of anxiety disorders. Copyright © 2021
, 285 : 10-
21
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Byrne, G., Connon, G., Martin, E., McHugh, S., Power, L.
Parent-led cognitive behavioural
therapy for child anxiety disorders have garnered a growing evidence base. However, it is unclear how such approaches translate into routine clinical
practice. The current study aims to evaluate the effectiveness of an 8-session treatment (From Timid to Tiger) in reducing child anxiety and
behavioural difficulties, as well as family accommodation. The parents of 71 children (aged 4-11) were assigned to the treatment or a waitlist
control. Parent report measures were completed pre-treatment, at treatment-end, and at 3-month follow-up. Parents assigned to the waitlist were
assessed 8 weeks after the initial assessment. Findings indicated that parents who attended the group reported significant reductions in child
anxiety and behavioural difficulties. In addition, the parents in the treatment group reported a reduction in family accommodation compared to those
in the waitlist. The current control trial provides tentative evidence of the use and effectiveness of such parent-led approaches in addressing child
anxiety difficulties commonly seen in routine clinical practice. PRACTITIONER POINTS: Parent-led approaches are effective treatments in managing
child anxiety difficulties. Very little research to date has assessed the effectiveness of such approaches in routine clinical practice. The From
Timid to Tiger program is a brief parent-led CBT intervention. The programme was effective in reducing child anxiety and behavioural difficulties.
Parents also reported a reduction in behaviours related to family accommodation. Such programmes show promise and can be used in routine clinical
practice. Copyright © 2021 British Psychological Society.
The British journal of clinical
psychology., 07 :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Bultas, M. W., Boyd,
E., McGroarty, C.
BACKGROUND: Nursing
students report increasing levels of stress and anxiety related to academic performance. Mindfulness programs have been found to reduce stress, yet
such programs have been identified as a time-burden for students. This study evaluated the integration of a brief preexamination mindfulness
reflective intervention for nursing students. Perceived stress, anxiety, resilience, and acceptability were evaluated.\rMETHOD: A mixed-methods
experimental design with random assignment was used. Forty-nine nursing students were randomized to either an intervention group (N = 25) who
participated in the brief preexamination mindfulness intervention or a control group (N = 24) who took their examinations without any intervention.
Self-report tools measured stress, resilience, and mindfulness. Qualitative responses were collected.\rRESULTS: Outcomes revealed decreased feelings
of helplessness and anxiety in the intervention group. Although students had positive views of mindfulness, barriers were indicated.\rCONCLUSION:
Brief preexamination mindfulness interventions provide students with anxiety-reducing options. [J Nurs Educ. 2021;60(11):625-628.].
Journal of Nursing Education, 60(11) : 625-628
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Brent, D. A.
Objectives: To report on the 32-week outcome of the
Brief Behavioral Therapy (BBT) for Pediatric Anxiety and Depression in Primary Care clinical trial. Method(s): A total of 185 youths aged 8 to 17
years with anxiety and/or depression identified through 9 pediatric primary care (PPC) settings in San Diego and Pittsburgh were randomized to
receive Assisted Referral to Care (ARC) or up to 12 sessions of BBT over 16 weeks. The primary outcome was clinical response across anxiety and
depression, defined as a Clinical Global Impressions-Improvement Score of <=2. Secondary outcomes included interview-rated functioning, depression,
and anxiety. Here, we report on outcomes at 32 weeks after randomization. All analyses with primary outcomes are corrected for multiple comparisons
using the false discovery rate procedure. Result(s): At 32 weeks, BBT was superior to ARC with respect to response (67.5% versus 43.1%, q = 0.03,
number needed to treat [NNT] = 5) and functioning (d = 0.49, q = 0.04). BBT was superior to ARC with respect to its impact on anxiety (f = 0.21) but
not depressive symptoms (f = 0.05). These findings persisted after controlling for the number of sessions received. Ethnicity moderated the impact of
BBT on outcome (NNT for Hispanic youths = 2), because of a much lower response rate to ARC in Hispanic than in non-Hispanic youths (16.7% versus
49.2%, p = 0.04). Conclusion(s): BBT is a promising intervention that can be effectively delivered in PPC and may be particularly effective for
Hispanic patients. Further work is indicated to improve its impact on depressive symptoms and to test BBT against other treatments delivered in
pediatric primary care. AD, DDD, TREAT Copyright © 2021
Journal of the American Academy of Child and Adolescent Psychiatry, 60(10
Supplement) : S117
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Other service delivery and improvement
interventions