Disorders - depressive disorders
Browning, Mhem, Shin, S., Drong, G., McAnirlin, O., Gagnon, R. J., Ranganathan, S., Sindelar, K., Hoptman, D., Bratman, G. N., Yuan, S., Prabhu, V. G., Heller, W.
Exposure to natural environments offers an array of mental health benefits. Virtual reality provides simulated
experiences of being in nature when outdoor access is limited. Previous studies on virtual nature have focused mainly on single \"doses\" of virtual
nature. The effects of repeated exposure remain poorly understood. Motivated by this gap, we studied the influence of a daily virtual nature
intervention on symptoms of anxiety, depression, and an underlying cause of poor mental health: rumination. Forty college students (58% non-Hispanic
White, median age = 19) were recruited from two U.S. universities and randomly assigned to the intervention or control group. Over several weeks,
anxious arousal (panic) and anxious apprehension (worry) decreased with virtual nature exposure. Participants identifying as women, past VR users,
experienced with the outdoors, and engaged with the beauty in nature benefited particularly strongly from virtual nature. Virtual nature did not help
symptoms of anhedonic depression or rumination. Further research is necessary to distinguish when and for whom virtual nature interventions impact
mental health outcomes.
Scientific reports, 13(1) : 1239
- Year: 2023
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Other complementary & alternative
interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Bohr,
Y., Litwin, L., Hankey, J. R., McCague, H., Singoorie,
C., Lucassen, M. F. G., Shepherd, M., Barnhardt, J.
BACKGROUND: Inuit youth in Northern Canada show considerable resilience in the face of extreme
adversities. However, they also experience significant mental health needs and some of the highest adolescent suicide rates in the world.
Disproportionate rates of truancy, depression, and suicide among Inuit adolescents have captured the attention of all levels of government and the
country. Inuit communities have expressed an urgent imperative to create, or adapt, and then evaluate prevention and intervention tools for mental
health. These tools should build upon existing strengths, be culturally appropriate for Inuit communities, and be accessible and sustainable in
Northern contexts, where mental health resources are often scarce.\rOBJECTIVE: This pilot study assesses the utility, for Inuit youth in Canada, of a
psychoeducational e-intervention designed to teach cognitive behavioral therapy strategies and techniques. This serious game, SPARX, had previously
demonstrated effectiveness in addressing depression with Maori youth in New Zealand.\rMETHODS: The Nunavut Territorial Department of Health sponsored
this study, and a team of Nunavut-based community mental health staff facilitated youth's participation in an entirely remotely administered pilot
trial using a modified randomized control approach with 24 youths aged 13-18 across 11 communities in Nunavut. These youth had been identified by the
community facilitators as exhibiting low mood, negative affect, depressive presentations, or significant levels of stress. Entire communities,
instead of individual youth, were randomly assigned to an intervention group or a waitlist control group.\rRESULTS: Mixed models (multilevel
regression) revealed that participating youth felt less hopeless (P=.02) and engaged in less self-blame (P=.03), rumination (P=.04), and
catastrophizing (P=.03) following the SPARX intervention. However, participants did not show a decrease in depressive symptoms or an increase in
formal resilience indicators.\rCONCLUSIONS: Preliminary results suggest that SPARX may be a good first step for supporting Inuit youth with skill
development to regulate their emotions, challenge maladaptive thoughts, and provide behavioral management techniques such as deep breathing. However,
it will be imperative to work with youth and communities to design, develop, and test an Inuit version of the SPARX program, tailored to fit the
interests of Inuit youth and Elders in Canada and to increase engagement and effectiveness of the program.\rTRIAL REGISTRATION: ClinicalTrials.gov
NCT05702086; https://www.clinicaltrials.gov/ct2/show/NCT05702086.
JMIR Serious Games, 11 : e38493
- Year: 2023
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Blanco, I., Boemo, T., Martin-Garcia, O., Koster, E. H., De-Raedt, R., Sanchez-Lopez, A.
The aim of the present research was
to develop and test the efficacy of a novel online contingent attention training (i.e., OCAT) to modify attention and interpretation biases, improve
emotion regulation, and reduce emotional symptom levels in the face of major stressors. Two proof-of-principle studies were carried out. In study 1,
64 undergraduates who were about to start a major stressful period (i.e., final exams) were randomized to undergo 10 days of active OCAT or a sham-
control training. Emotion regulation (habitual use of rumination and reappraisal) and symptom levels (depression and anxiety) were assessed before
and after the intervention. In study 2, the same 2 x 2 mixed design was used with 58 individuals from the general population undergoing a major
stressful situation (the lockdown period at the beginning of the COVID-19 pandemic in 2020). In both studies, the OCAT group showed significant
improvements on attention towards negative information and interpretation biases in comparison to the sham-control group. Additionally, changes in
cognitive biases transferred to reductions of participants' use of rumination and anxiety symptom levels. These results show preliminary evidence
regarding the efficacy of the OCAT to target attention and interpretation biases as well as to improve emotion regulation processes and to buffer
against the effects of major stressors. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Cognitive Research: Principles and Implications, 8(1) : ArtID
28
- Year: 2023
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Birrell, L., Teesson, M., Furneaux-Bate, A., Newton, N., Slade, T., Chapman,
C., Olsen, N., Bryant, Z., Mewton, L., Healy, A.
Introduction: Substance use, depression, and anxiety frequently cooccur and are the leading causes of disability amongst young people
globally. New scalable transdiagnostic strategies are needed. While intervention in the teenage years is critical, the durability of effects into
young adulthood is unclear. This presentation will examine the sustainability of combined mental health and substance use schoolbased intervention
across the transition from adolescence to adulthood. Method(s): A multicentre, cluster-randomized controlled trial was conducted in 2014 with 6386
students (mean age: 13.5 years) from 71 secondary schools in Australia. Schools were randomly assigned to one of four intervention conditions: (1)
Climate Schools-Substance Use, focusing on substance use only; (2) Climate Schools-Mental Health, focusing on depression and anxiety only; (3)
Climate Schools- Combined (CSC), focusing on substance use, depression, and anxiety; or (4) active control. The CSC long-term follow-up study extends
the follow-up period to 6 years post-baseline. Primary outcomes were self-reported alcohol use, depression, and anxiety. Multilevel mixedeffects
regression and generalized mixed-effects models were used to assess outcomes. Result(s): 1877 participants (mean age 20-years; 63% female) completed
a long-term assessment occasion. Six years after inclusion in a multi-site RCT, adolescents who had received the CSC program reported reduced odds of
drinking alcohol (OR 0.22; CI 0.08, 0.61) and reduced odds of binge drinking (OR 0.12; CI 0.05, 0.33) however, we found no significant difference in
other outcomes. Conclusion(s): Long-term assessment of school-based programs is vital to determine the durability across the critical transition
period transition from adolescence to early adulthood.
Early Intervention in Psychiatry, 17(Supplement 1) : 18-
19
- Year: 2023
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Birrell, L., Chapman, C., Nguyen, A., Spallek, S., Furneaux-Bate, A., Debenham, J., Newton, N.
Aims: Whilst mental health apps and online programs have proliferated there is a lack of evidence-based online interventions aiming to
upskill adolescents around supporting peers in relation to mental health and/or substance use at the early stage of symptom presentation We developed
and trialled the 'Mind your Mate' program, a brief classroom lesson and smartphone app for adolescents (aged 15- 16 years) targeting peer support
and early help-seeking for anxiety depression, and substance use. It was collaboratively design with young people, researchers and school staff
Method: A cluster RCT was conducted between 2020 and 2022 with 166 students (mean age: 15.3 years) from 12 secondary schools in Australia. Schools
were randomly assigned to one of two conditions: (1) Mind your Mate intervention group; or (2) active control. Students completed a self-report
survey at baseline, and at 6- and 12-month follow-up (83% followed-up at 12-months). Primary outcomes were self-reported depression (PHQ-A), anxiety
(GAD-7), substance use knowledge (MHLQ) and help-seeking (AHSQ). Multilevel mixedeffects regression and generalized mixed-effects models assessed
outcomes over time, relative to control Results: Compared to control, a decreasing trajectory of depression symptoms was observed in the Mind your
Mate intervention condition (b = -1.86 [3.73-0.02], p = .05). No significant differences were observed in relation to other outcomes. Preliminary
analyses demonstrate an app registration rate of 48%, with the most accessed features being the education modules and mood tracking Conclusion(s):
Results show promising impact on adolescent depression symptoms. Potential reasons for null results will be explored in the presentation.
Early Intervention in Psychiatry, 17(Supplement
1) : 217
- Year: 2023
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement
interventions
Bian, C.,
Background: Interpersonal psychotherapy (IPT) has been widely used for depression.
However, current studies of IPT have been restricted to depressive symptoms, and the results for improving social functioning were controversial.
Methods: A comprehensive literature search of randomized controlled trials (RCTs) was conducted through eleven databases. Data analysis was performed
by RevMan5.3, and effects were summarized by using a random effects model of mean differences with 95 % confidence intervals. Results: From 2443
records, eleven studies met inclusion and exclusion criteria were used for meta-analysis. The results showed that IPT had significant effects on
improving social functioning (SMD:
, 320 : 230-240
- Year: 2023
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT)
Bhattacharya, S., Kennedy, M., Miguel, C., Troger, A., Hofmann, S.
G., Cuijpers, P.
BACKGROUND: There is emerging evidence to suggest that Cognitive Behavioral Therapy for depression may have a secondary effect on self-
esteem, but less is known about non-CBT based interventions. To examine this, we had two main aims; (1) to meta-analyze psychotherapy effects on (i)
depression and (ii) self-esteem, and (2) to investigate the relationship between reductions in depression symptoms and improvements in self-esteem.
\rDESIGN: A systematic review and meta-analysis.\rMETHODS: Following the PRISMA guidelines, we conducted a meta-analysis of randomized control trials
of psychotherapy for adult depression, which included a self-esteem outcome at post-treatment. Nineteen studies with a total of 3423 participants met
the inclusion criteria. For each comparison between psychotherapy and a control condition, we calculated Hedges' g both for depression and self-
esteem and pooled them in two separate meta-analyses. Furthermore, meta-regression was used to explore the association between the effect of
psychotherapy for depression and its effect on self-esteem.\rRESULTS: The effects on depression were large and significant (Hedges' g = -0.95; [95 %
CI: -1.27, -0.63]). We found evidence of smaller, albeit still moderate, effects on self-esteem (Hedges'g = 0.63; [95 % CI:0.32, 0.93]), with
sustained effects at 6-12 months (Hedges'g = 0.70; [95 % CI: -0.03, 1.43]). We also found a strong inverse association between the effects of
psychotherapy for depression and self-esteem (beta = -0.60, p < 0.001).\rLIMITATIONS: Heterogeneity was very high (I2 = 97 %), and out of
19 trials, only 6 trials were rated as having a low risk of bias.\rCONCLUSIONS: The results suggest that psychotherapy for depression may improve
self-esteem to a moderate degree.
, 325 : 572-581
- Year: 2023
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Bhatt, M. P., Guryan, J., Pollack, H. A., Castrejon, J. C., Clark, M., Delgado-Sanchez, L., Lin, P., Lubell, M., Pinto Poehls, C., Shaver, B., Sumners, M.
This study explores whether a school-based group counseling program for adolescent
girls, implemented at scale, can mitigate trauma-related mental health harms. In a randomized trial involving 3749 Chicago public high school girls,
we find that participating in the program for 4 months induces a 22% reduction in posttraumatic stress disorder symptoms and find significant
decreases in anxiety and depression. Results surpass widely accepted cost-effectiveness thresholds, with estimated cost-utility well below $150,000
per quality adjusted life year. We find suggestive evidence that effects persist and may even increase over time. Our results provide the first
efficacy trial of such a program specifically designed for girls, conducted in America's third largest city. These findings suggest the promise of
school-based programs to mitigate trauma-related harms.
Science Advances, 9(23) : eabq2077
- Year: 2023
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Benjet, C., Zainal, N. H., Albor, Y., Alvis-Barranco, L., Carrasco-Tapias,
N., Contreras-Ibanez, C. C., Cudris-Torres, L., de la Pena, F. R., Gonzalez, N., Guerrero-Lopez, J. B., Gutierrez-Garcia, R. A., Jimenez-Perez, A. L., Medina-Mora, M. E., Patino, P., Cuijpers, P., Gildea, S.
M., Kazdin,
A. E., Kennedy, C. J., Luedtke, A., Sampson, N. A., Petukhova, M. V., Kessler, R. C.
Importance: Guided internet-
delivered cognitive behavioral therapy (i-CBT) is a low-cost way to address high unmet need for anxiety and depression treatment. Scalability could
be increased if some patients were helped as much by self-guided i-CBT as guided i-CBT.\rObjective: To develop an individualized treatment rule using
machine learning methods for guided i-CBT vs self-guided i-CBT based on a rich set of baseline predictors.\rDesign, Setting, and Participants: This
prespecified secondary analysis of an assessor-blinded, multisite randomized clinical trial of guided i-CBT, self-guided i-CBT, and treatment as
usual included students in Colombia and Mexico who were seeking treatment for anxiety (defined as a 7-item Generalized Anxiety Disorder [GAD-7] score
of >=10) and/or depression (defined as a 9-item Patient Health Questionnaire [PHQ-9] score of >=10). Study recruitment was from March 1 to October
26, 2021. Initial data analysis was conducted from May 23 to October 26, 2022.\rInterventions: Participants were randomized to a culturally adapted
transdiagnostic i-CBT that was guided (n = 445), self-guided (n = 439), or treatment as usual (n = 435).\rMain Outcomes and Measures: Remission of
anxiety (GAD-7 scores of <=4) and depression (PHQ-9 scores of <=4) 3 months after baseline.\rResults: The study included 1319 participants (mean [SD]
age, 21.4 [3.2] years; 1038 women [78.7%]; 725 participants [55.0%] came from Mexico). A total of 1210 participants (91.7%) had significantly higher
mean (SE) probabilities of joint remission of anxiety and depression with guided i-CBT (51.8% [3.0%]) than with self-guided i-CBT (37.8% [3.0%]; P =
.003) or treatment as usual (40.0% [2.7%]; P = .001). The remaining 109 participants (8.3%) had low mean (SE) probabilities of joint remission of
anxiety and depression across all groups (guided i-CBT: 24.5% [9.1%]; P = .007; self-guided i-CBT: 25.4% [8.8%]; P = .004; treatment as usual: 31.0%
[9.4%]; P = .001). All participants with baseline anxiety had nonsignificantly higher mean (SE) probabilities of anxiety remission with guided i-CBT
(62.7% [5.9%]) than the other 2 groups (self-guided i-CBT: 50.2% [6.2%]; P = .14; treatment as usual: 53.0% [6.0%]; P = .25). A total of 841 of 1177
participants (71.5%) with baseline depression had significantly higher mean (SE) probabilities of depression remission with guided i-CBT (61.5%
[3.6%]) than the other 2 groups (self-guided i-CBT: 44.3% [3.7%]; P = .001; treatment as usual: 41.8% [3.2%]; P < .001). The other 336 participants
(28.5%) with baseline depression had nonsignificantly higher mean (SE) probabilities of depression remission with self-guided i-CBT (54.4% [6.0%])
than guided i-CBT (39.8% [5.4%]; P = .07).\rConclusions and Relevance: Guided i-CBT yielded the highest probabilities of remission of anxiety and
depression for most participants; however, these differences were nonsignificant for anxiety. Some participants had the highest probabilities of
remission of depression with self-guided i-CBT. Information about this variation could be used to optimize allocation of guided and self-guided i-CBT
in resource-constrained settings.\rTrial Registration: ClinicalTrials.gov Identifier: NCT04780542.
JAMA
Psychiatry, 80(8) : 768-777
- Year: 2023
- 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), Technology, interventions delivered using technology (e.g. online, SMS)
Belmans, E., De Vuyst, H. J., Takano, K., Raes,
F.
BACKGROUND AND
OBJECTIVES: Individuals at risk for depression exhibit a decreased ability to disengage from negative memory retrieval during times of mental
distress, partly because they have difficulty retrieving positive memories to repair sad mood. In this study, we tested whether this persistent
tendency for negative memory retrieval could be reduced in adolescents through repeated practice to retrieve positive autobiographical memories,
namely Positive Memory Specificity Training (PMST). Further, we examined the impact of this intervention on secondary outcomes, including depressive
symptoms, emotion regulation strategies, and fear of positive emotions.\rMETHODS: Adolescents (n = 68) between 16 and 18 years old were randomly
allocated to either PMST or bogus control training. Persistent negative memory retrieval was assessed following the training using a behavioral
decision-making task (Emotional Reversal Learning Task). Additionally, participants completed self-report measurements (e.g., depressive symptoms)
before and two weeks after the training.\rRESULTS: We found preliminary supportive evidence for a significant training effect such that adolescents
following PMST showed less persistence in negative memory retrieval compared to those in the control group. Only for anhedonia a significant training
effect was found, indicating a possible adverse effect of the intervention.\rLIMITATIONS: The primary outcome was assessed only at post-intervention
to prevent a potential learning effect due to repeated measurements. We cannot exclude the possibility that baseline individual differences
contaminated our results. To examine possible adverse effects of PMST, larger sample are needed.\rCONCLUSIONS: PMST may help to reduce persistent
negative memory retrieval in adolescents. Recommendations for future studies are addressed.
Journal of Behavior Therapy & Experimental
Psychiatry, 81 : 101881
- Year: 2023
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Bell, I. H., Marx, W., Nguyen, K., Grace, S., Gleeson, J., Alvarez-Jimenez, M.
BACKGROUND: Depression and anxiety are prevalent in youth populations and typically emerge during adolescence.
Repetitive negative thinking (RNT) is a putative transdiagnostic mechanism with consistent associations with depression and anxiety. Targeting
transdiagnostic processes like RNT for youth depression and anxiety may offer more targeted, personalised and effective treatment. METHOD(S): A
meta-analysis was conducted to examine the effect of psychological treatments on RNT, depression and anxiety symptoms in young people with depression
or anxiety, and a meta-regression to examine relationships between outcomes. RESULT(S): Twenty-eight randomised controlled trials examining 17
different psychological interventions were included. Effect sizes were small to moderate across all outcomes (Hedge's g depression = -0.47, CI -0.77
to -0.17; anxiety = -0.42, CI -0.65 to -0.20; RNT = -0.45, CI -0.67 to -0.23). RNT-focused and non-RNT focused approaches had comparable effects;
however, those focusing on modifying the process of RNT had significantly larger effects on RNT than those focusing on modifying negative thought
content. Meta-regression revealed a significant relationship between RNT and depression outcomes only across all intervention types and with both
depression and anxiety for RNT focused interventions only. CONCLUSION(S): Consistent with findings in adults, this review provides evidence that
reducing RNT with psychological treatment is associated with improvements in depression and anxiety in youth. Targeting RNT specifically may not lead
to better outcomes compared to general approaches; however, focusing on modifying the process of RNT may be more effective than targeting content.
Further research is needed to determine causal pathways.
Psychological
medicine, 53(1) : 6-16
- Year: 2023
- 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)
Bell, I., Arnold, C., Gilbertson, T., D'Alfonso, S., Castagnini, E., Chen, M. N., Nicholas, J., O'Sullivan, S., Valentine, L., Alvarez-Jimenez, M.
Aims: In the ebb and flow of daily life, mental health symptoms come and go, driven by changes in mechanisms interacting with the
environment. Transdiagnostic processes underpin many of these changes. Using smartphone apps to target these processes in real time may provide more
targeted and potent intervention. A novel, personalized smartphone intervention called 'Mello' was designed to disrupt repetitive negative thinking
(RNT), a key transdiagnostic mechanism, in young people with depression and anxiety. This pilot randomized controlled trial (RCT) aimed to evaluate
the feasibility, acceptability and preliminary clinical outcomes and mechanisms of Mello. Method(s): Fifty-five young people were randomized to
receive Mello or a non-active control. Measures were completed at baseline, mid, and post intervention, assessing acceptability, feasibility and
changes in symptoms and RNT. Result(s): Mello was found to be feasible, with recruitment rates exceeding targets, 86% uptake and 94% retention.
Participants reported enjoying Mello and 96% would recommend it to others. Greater reductions in depression (Cohen's d = 0.50), anxiety (Cohen's d
= 0.61) and RNT (Cohen's d = 0.87) were observed for Mello users compared to control. Mediation analyses suggested that changes in anxiety were
accounted for by changes in RNT. Conclusion(s): Mello is a feasible and acceptable app amongst young people with depression and anxiety. Preliminary
clinical effects suggest the app can improve symptoms and this may occur via the proposed mechanism of reducing RNT. This world-first trial of a
personalized, transdiagnostic smartphone app has important implications for advancing treatment of youth mental ill-health using novel targeted
approaches.
Early Intervention in Psychiatry, 17(Supplement 1) : 198-199
- Year: 2023
- 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), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)