Disorders - Depressive Disorders
Malik, K., Ibrahim, M., Bernstein, A., Venkatesh, R. K., Rai, T., Chorpita, B., Patel, V.
BACKGROUND: Psychological interventions such as behavioral activation
(BA) that focus on overt behaviors rather than complex cognitive skills may be developmentally well-suited to address youth mental health problems.
The current systematic review synthesized evidence on the characteristics, effectiveness and acceptability of behavioral activation (BA) to examine
its role as a potential 'active ingredient' for alleviating depression and anxiety among young people aged 14 to 24 years.\rMETHODS: Evidence
across the following sources were synthesized: (i) randomized control trials (RCT) evaluating interventions where BA has been used as a standalone
intervention or as part of a multicomponent intervention, (ii) qualitative studies examining the acceptability of BA as an intervention or as a
coping strategy among young people with lived experiences. Consultations with a youth advisory group (YAG) from India were used to draw inferences
from existing evidence and identify future research priorities.\rRESULTS: As part of the review, 23 RCTs were identified; three studies examined BA
as a standalone intervention, and the remaining studies examined multicomponent intervention where BA was a constituent element. The intervention
protocols varied in composition, with the number of intervention elements ranging between 5 to 18. There was promising but limited evidence in
standalone interventions for thse effectiveness of BA for depression. The impact of BA in multicomponent interventions was difficult to evaluate in
the absence of focal assessment of activation outcomes. Evidence from 37 additional qualitative studies of youth lived experience literature,
corroborated by the YAG inputs, indicated that young people preferred using behavioral strategies similar to BA to cope with depression in their own
life. Themes indicated that the activities that are important to an individual and their socio-contextual factors need to be considered in the
planning and implementing BA intervention. Evidence for the use of BA in anxiety was limited across data sources.\rCONCLUSIONS: Overall, there was
preliminary empirical evidence for the effectiveness and acceptability of BA for youth depression. Further research is needed to examine the
components and mechanisms that contribute to its effectiveness as an active intervention ingredient for depression and anxiety.
BMC
psychology, 9(1) : 150
- 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), Cognitive & behavioural therapies (CBT)
Malik,
K.
Background Psychosocial interventions for adolescent mental health problems are effective, but evidence on their longer-term outcomes is
scarce, especially in low-resource settings. We report on the 12-month sustained effectiveness and costs of scaling up a lay counselor-delivered,
transdiagnostic problem-solving intervention for common adolescent mental health problems in low-income schools in New Delhi, India. Methods and
findings Participants in the original trial were 250 school-going adolescents (mean [M] age = 15.61 years, standard deviation [SD] = 1.68), including
174 (69.6%) who identified as male. Participants were recruited from 6 government schools over a period of 4 months (August 20 to December 14, 2018)
and were selected on the basis of elevated mental health symptoms and distress/functional impairment. A 2-arm, randomized controlled trial design was
used to examine the effectiveness of a lay counselor-delivered, problem-solving intervention (4 to 5 sessions over 3 weeks) with supporting printed
booklets (intervention arm) in comparison with problem solving delivered via printed booklets alone (control arm), at the original endpoints of 6 and
12 weeks. The protocol was modified, as per the recommendation of the Trial Steering Committee, to include a post hoc extension of the follow-up
period to 12 months. Primary outcomes were adolescent-reported psychosocial problems (Youth Top Problems [YTP]) and mental health symptoms (Strengths
and Difficulties Questionnaire [SDQ] Total Difficulties scale). Other self-reported outcomes included SDQ subscales, perceived stress, well-being,
and remission. The sustained effects of the intervention were estimated at the 12-month endpoint and over 12 months (the latter assumed a constant
effect across 3 follow-up points) using a linear mixed model for repeated measures and involving complete case analysis. Sensitivity analyses
examined the effect of missing data using multiple imputations. Costs were estimated for delivering the intervention during the trial and from
modeling a scale-up scenario, using a retrospective ingredients approach. Out of the 250 original trial participants, 176 (70.4%) adolescents
participated in the 12-month followup assessment. One adverse event was identified during follow-up and deemed unrelated to the intervention.
Evidence was found for intervention effects on both SDQ Total Difficulties and YTP at 12 months (YTP: adjusted mean difference [AMD] = -0.75, 95%
confidence interval [CI] = -1.47, -0.03, p = 0.04; SDQ Total Difficulties: AMD = -1.73, 95% CI = -3.47, 0.02, p = 0.05), with stronger effects over
12 months (YTP: AMD = -0.98, 95% CI = -1.51, -0.45, p < 0.001; SDQ Total Difficulties: AMD = -1.23, 95% CI = -2.37, -0.09; p = 0.03). There was also
evidence for intervention effects on internalizing symptoms, impairment, perceived stress, and well-being over 12 months. The intervention effect was
stable for most outcomes on sensitivity analyses adjusting for missing data; however, for SDQ Total Difficulties and impairment, the effect was
slightly attenuated. The per-student cost of delivering the intervention during the trial was $3 United States dollars (USD; or $158 USD per case)
and for scaling up the intervention in the modeled scenario was $4 USD (or $23 USD per case). The scaling up cost accounted for 0.4% of the per-
student school budget in New Delhi. The main limitations of the study's methodology were the lack of sample size calculations powered for 12-month
follow-up and the absence of cost-effectiveness analyses using the primary outcomes. Copyright © 2021 Malik et al. This is an open access article
distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are credited.
PLoS Medicine, 18(9) (no
pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Problem solving therapy (PST)
Ma, L., Huang, C., Tao, R., Cui, Z., Schluter, P.
Objective: This meta-analysis examines the effect of online guided self-help interventions for depressive symptoms among college students.
Method(s): We searched studies through PubMed, Embase, Web of Science, PsycINFO, and Cochrane Central. Effect estimates were reported as standardized
mean differences (SMD) and data were pooled using random-effects models. Subgroup analyses were conducted to investigate the differential effects of
these interventions by sample type, level of contact, use of incentive, length of intervention, and program content. Result(s): 24 comparisons (n =
3074) deriving from 19 trials were included in the meta-analysis. Intervention participants (n = 1620) indicated significant reductions in depressive
symptoms at post-intervention compared to non-active control conditions (n = 1454). The weighted effect size was 0.46 (95% CI: 0.28-0.64), which
dropped to 0.36 (95% CI: 0.26-0.45) after an outlier was removed. Subgroup analyses showed that the effects were significant among interventions
using both selective and universal samples; among interventions of shorter (<=4 weeks), moderate (4-8 weeks), and greater length (>=8 weeks); among
interventions with high, moderate, and low levels of contact; among interventions with and without incentive; and among interventions employing
cognitive-behavioral therapy (CBT) and third-wave CBT. Conclusion(s): This meta-analysis reinforces evidence to support the effectiveness of online
guided self-help interventions in reducing depressive symptoms among college students. However, because of the generally variable and limited quality
of current evidence, further research applying rigorous methods is needed to confirm and extend the findings of this meta-analysis. Copyright ©
2021
Internet Interventions, 25 (no
pagination) :
- Year: 2021
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Mindfulness based
therapy, Acceptance & commitment therapy
(ACT), Self-help, Physical activity, exercise, Technology, interventions delivered using technology (e.g. online, SMS)
Luo, L., Song, N., Yang, H., Huang, J., Zhou, L., Zhang, L.
Objective: To explore the effects of using RPE exercise intensity monitoring methods and 12-week mid- and low-intensity team
aerobic training on anxiety, depression and sleep quality of depressed middle school students after the COVID-19 epidemic. Method(s): All study
participants were all from a boarding middle school in Chongqing, China. All study participants were screened by the self-rating depression scale and
reached the diagnostic criteria for depression. The study subjects were divided into a control group (N = 35) and an exercise group (N = 34). The
exercise group performed 30-min night aerobic running four times a week. Use the Borg 6-20 rating of perceived exertion scale (RPE) as a monitoring
tool for exercise intensity, and control the exercise intensity at RPE = 11-14. And the control group studied and lived normally. The experiment
lasted 12 weeks in total. After the experiment, there were 34 people in the control group and 23 people in the exercise group. The subjects'
anxiety, depression and Pittsburgh sleep quality were scored before and after the experiment. Result(s): After intervention, the depression index (p
< 0.01) of the exercise group was significantly lower than that of the control group. Conclusion(s): Using the RPE exercise intensity monitoring
method for 12 weeks of mid- and low-intensity team aerobic training can improve the depressive symptoms of depressed middle school students, and it
is beneficial to improve the students' mental health. © Copyright © 2021 Luo, Song, Yang, Huang, Zhou and Zhang.
Frontiers in Psychiatry, 12 (no
pagination) :
- Year: 2021
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Lowe, C., Wuthrich, V. M.
Typically students in their final year of
school report high levels of anxiety, depression and stress. This study evaluated Study without Stress, a group cognitive behavioural program to
reduce student stress. Fifty-six final year students (77% female) from four Australian secondary schools were randomly allocated to Study without
Stress delivered by school staff, or to an 8-week usual care condition. Changes in self-reported stress, anxiety, depression, self-efficacy, and
teacher reported emotional problems were assessed pre to post-treatment using intent-to-treat analyses. Maintenance of changes were examined 3-months
later. Compared to usual care, Study without Stress led to significant reductions in self-reported stress and distress, and increases in self-
efficacy that were maintained over time, with no significant changes in anxiety, depression or teacher reported emotional problems. Study without
Stress is beneficial for reducing academic stress and improving self-efficacy in final year students when delivered in a school setting.
Child psychiatry and human
development, 52(2) : 205-216
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Lochner, J., Starman-Wohrle, K., Takano, K., Engelmann, L., Voggt,
A., Loy, F., Bley, M., Winogradow, D., Hammerle, S., Neumeier, E., Wermuth, I., Schmitt, K., Oort, F., Schulte-Korne, G., Platt, B.,
Objective: Parental depression is one of the biggest risk factors for
youth depression. This parallel randomized controlled trial evaluates the effectiveness of the German version of the family-group-cognitive-behavioral
(FGCB) preventive intervention for children of depressed parents. Methods: Families with (i) a parent who has experienced depression and (ii) a
healthy child aged 8 - 17 years (mean = 11.63; 53% female) were randomly allocated (blockwise; stratified by child age and parental depression) to
the 12-session intervention (EG; n = 50) or no intervention (CG; usual care; n = 50). Self-reported (unblinded) outcomes were assessed immediately
after the intervention (6 months). We hypothesized that CG children would show a greater increase in self-reported symptoms of depression (DIKJ) and
internalising/externalising disorder (YSR/CBCL) over time compared to the EG. Intervention effects on secondary outcome variables emotion regulation
(FEEL-KJ), attributional style (ASF-KJ), knowledge of depression and parenting style (ESI) were also expected. Study protocol (Belinda Platt, Pietsch,
Krick, Oort, & Schulte-Körne, 2014) and trial registration (NCT02115880) reported elsewhere. Results: We found significant intervention effects on
self-reported internalising (
Child and Adolescent Psychiatry and Mental
Health, 15 : ArtID 54
- Year: 2021
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy
Liu, W., Li, G., Wang, C., Wang, X., Yang,
L.
OBJECTIVE: The efficacy of antidepressant drugs combined with psychotherapy is controversial; hence, this meta-analysis
was conducted to assess the efficacy of the combination therapy.\rMETHODS: Relevant literature was searched in PubMed, Web of Science and Embase,
Chinese databases CNKI, and WanFang Data. We included the literature on the comparison of the sertraline combined with cognitive behavioral therapy
(CBT) and each treatment alone for adolescent depression published in 2000-2021. Meta-analysis was performed using Stata16.0 software.\rRESULTS: A
total of 421 relevant articles were retrieved, and 14 studies were finally included. In comparison with the control group (sertraline), sertraline
combined with CBT achieved higher response rate (OR = 5.07, 95% CI: 3.00, 8.58) and lower incidence of adverse reactions (OR = 0.43, 95% CI: 0.24,
0.75). Before treatment, there were no significant differences in depression score, anxiety score, and symptom self-rating scale score between the
two groups. After treatment, depression score (SMD = -2.79, 95% CI: -3.64, -1.94), anxiety score (SMD = -1.22, 95% CI: -1.96, -0.47), and symptom
self-rating scale score (SMD = -1.73, 95% CI: -3.19, -0.27) were significantly lower in the combined treatment group than in the control group.
\rCONCLUSION: Although the number of comparative trials is small, this study shows that sertraline is effective for adolescent depression, but
sertraline combined with CBT is more effective. The latter can significantly reduce the incidence of depressive symptoms, anxiety, and adverse
reactions in patients. Therefore, this combination therapy is recommended for the clinical treatment of adolescent depression.
, 2021 : 5309588
- Year: 2021
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Leech, T., Dorstyn, D., Taylor, A., Li, W.
[Correction Notice: An Erratum for this article was
reported in Vol 128[106184] of Children and Youth Services Review (see record 2021-76648-001). The authors regret that select data in Table 1 were
misplaced (incorrect table row) for two studies. The corrected details are presented in an erratum.] Objective: Smartphone applications ('apps')
have the potential to improve the scalability of mental health interventions for young people, however, the effectiveness of stand-alone apps in
mental health management remains unclear. This systematic review, with meta-analysis, provides an up-to-date summary of the available high-quality
evidence. Methods: Eleven randomized controlled trials, involving a pooled sample of 1706 adolescents and young adults (age range 10 to 35 years),
were identified from the Cochrane Library, Embase, Google Scholar, PsycINFO and PubMed databases. The reporting quality of studies was evaluated
using the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). Hedges' g effect sizes with 95% confidence intervals, p values and heterogeneity statistics were
additionally calculated using a random effects model. Results: Study reporting quality was sound, with no trials characterized as 'high' risk. App
interventions produced significant symptom improvement across multiple outcomes, compared to wait-list or attention control conditions (depression gw
= 0.52 [CI: 0.18-0.84], p = .01, k = 8; stress gw = 0.30 [CI: 0.06-0.53], p = .02, k = 2). Longer-term benefits could not be established (k = 4),
although individual studies reported positive trends up to 6 months post. Age was not identified as a significant moderator. Conclusions: Smartphone
apps hold promise as a stand-alone self-management tool in mental health service delivery. Further controlled trials with follow-up data are needed
to confirm these findings as well as determine treatment engagement and effectiveness across diverse groups of participants. (PsycInfo Database
Record (c) 2021 APA, all rights reserved)
Children and
Youth Services Review, 127 : ArtID 106073
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, 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)
Lawrence, P. J., Parkinson,
M., Jasper, B., Creswell, C., Halligan, S. L.
Guidance is scarce on whether and how to involve parents in treatment for anxiety and depressive disorders in children and young people. We
did a scoping review of randomised controlled trials of psychological interventions for anxiety and depressive disorders in children and young
people, in which parents were involved in treatment, to identify how parents and carers have been involved in such treatments, how this relates to
both child and broader outcomes, and where research should focus. We identified 73 trials: 62 focused on anxiety and 11 on depressive disorders. How
parents were involved in treatments varied greatly, with at least 13 different combinations of ways of involving parents in the anxiety trials and
seven different combinations in the depression trials. Including parents in treatment did not impair children's and young people's outcomes, but
the wide variability in how they were involved prevents clarity about why some trials favoured parent involvement and others did not. Studies must
consider the long-term and wider benefits beyond children's and young people's mental health, such as enhanced engagement, family wellbeing, and
economic gains.
The Lancet. Psychiatry, 8(10) : 909-
918
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Krause, K. R., Courtney, D. B., Chan, B. W., Bonato, S., Aitken, M., Relihan, J., Prebeg, M., Darnay, K., Hawke, L. D.
Watson, P., Szatmari, P.
Background: Problem-solving training is a common ingredient of
evidence-based therapies for youth depression and has shown effectiveness as a versatile stand-alone intervention in adults. This scoping review
provided a first overview of the evidence supporting problem solving as a mechanism for treating depression in youth aged 14 to 24 years. Methods:
Five bibliographic databases (APA PsycINFO, CINAHL, Embase, MEDLINE, Web of Science) and the grey literature were systematically searched for
controlled trials of stand-alone problem-solving therapy; secondary analyses of trial data exploring problem-solving-related concepts as predictors,
moderators, or mediators of treatment response within broader therapies; and clinical practice guidelines for youth depression. Following the scoping
review, an exploratory meta-analysis examined the overall effectiveness of stand-alone problem-solving therapy. Results: Inclusion criteria were met
by four randomized trials of problem-solving therapy (524 participants); four secondary analyses of problem-solving-related concepts as predictors,
moderators, or mediators; and 23 practice guidelines. The only clinical trial rated as having a low risk of bias found problem-solving training
helped youth solve personal problems but was not significantly more effective than the control at reducing emotional symptoms. An exploratory meta-
analysis showed a small and non-significant effect on self-reported depression or emotional symptoms (Hedges' g = -0.34; 95% CI: -0.92 to 0.23) with
high heterogeneity. Removing one study at high risk of bias led to a decrease in effect size and heterogeneity (g = -0.08; 95% CI: -0.26 to 0.10). A
GRADE appraisal suggested a low overall quality of the evidence. Tentative evidence from secondary analyses suggested problem-solving training might
enhance outcomes in cognitive-behavioural therapy and family therapy, but dedicated dismantling studies are needed to corroborate these findings.
Clinical practice guidelines did not recommend problem-solving training as a stand-alone treatment for youth depression, but five mentioned it as a
treatment ingredient. Conclusions: On its own, problem-solving training may be beneficial for helping youth solve personal challenges, but it may not
measurably reduce depressive symptoms. Youth experiencing elevated depressive symptoms may require more comprehensive psychotherapeutic support
alongside problem-solving training. High-quality studies are needed to examine the effectiveness of problem-solving training as a stand-alone
approach and as a treatment ingredient. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
BMC Psychiatry, 21 : ArtID
397
- Year: 2021
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Problem solving therapy (PST)
Juul, L., Brorsen, E., Gotzsche, K., Nielsen, B. L., Fjorback, L. O.
Background: In this study, we aimed to investigate the effects of a mindfulness program including
Mindfulness-Based Stress Reduction (MBSR) on the mental health of student teachers when offered at their educational institution in a real-life
context. Methods: A parallel randomized controlled trial (RCT) was conducted among selfselected student teachers at a Danish undergraduate program
for teacher education in the autumns of 2019 and 2020. Participation was not recommended in case of (1) clinical depression or a diagnosis of
psychosis or schizophrenia, (2) abuse of alcohol, drugs, and/or medicine. Randomization was performed by a Statistician who was blinded to the
identity of the students. Data was collected using selfreported questionnaires. The primary outcome was a change in perceived stress 3 months from
baseline. Secondary outcome measures were symptoms of anxiety and depression, well-being, resilience, mindfulness, and thoughts and feelings during
rest. The effects were analyzed according to the intention-to-treat principle using mixed-effect linear regression models. Mediating effects of
mindfulness skills on the mental health outcomes were explored using structural equation modeling. Results: The study group included 67 student
teachers with 34 allocated to the intervention group (median age: 25 years; women: n = 24, 71%); and 33 students (median age: 25 years; women: n =
25, 76%) allocated to a waiting list control group. At baseline, mean Perceived Stress Scale (PSS) scores were 18.88 (SD: 5.75) in the intervention
group and 17.91 (SD: 6.36) in the waiting list control group. A total of 56 students completed the questionnaire at a 3-month follow-up (28 in both
the intervention- and the control group). Statistically significant effects of the intervention were found on perceived stress, symptoms of anxiety
and depression, well-being, and on three of seven resting-state dimensions. No effects were found on resilience or mindfulness. Statistically
significant mediated effects via resting-state dimensions were found.\rConclusion The findings suggested that offering a mindfulness program at an
undergraduate program for teacher education could significantly improve the mental health among self-selected students within 3 months. Results of
mediation analysis supported the hypothesis that some of the effects might be explained by reduced distracting thoughts. Clinical Trial Registration:
[www.ClinicalTrials.gov], identifier [NCT04558099].
, 12 : ArtID 722771
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Johnston, C. S., Jasbi, P., Jin,
Y., Bauer, S., Williams, S., Fessler, S. N., Gu, H.
Daily vinegar ingestion has been linked to improved
glycemic control, but recent data suggest a separate unexplored role for vinegar in mental health. Utilizing a placebo-controlled, parallel arm study
design, this 4-week trial examined the impact of daily vinegar ingestion on mood states and urinary metabolites in healthy college students.
Participants were randomized to the vinegar group (VIN: n = 14; 1.5 g acetic acid/day as liquid vinegar) or the control group (CON: n = 11; 0.015 g
acetic acid/day as a pill) with no change to customary diet or physical activity. At baseline and at study week four, participants completed the
Profile of Mood States (POMS) and the Center for Epidemiological Studies-Depression (CES-D) questionnaires and provided a first-morning urine sample
for targeted metabolomics analyses. The change in both POMS depression scores and CES-D scores differed significantly between groups favoring
improved affect in the VIN versus CON participants after four weeks. Metabolomics analyses pre and post-intervention suggested metabolite alterations
associated with vinegar ingestion that are consistent for improved mood, including enzymatic dysfunction in the hexosamine pathway as well as
significant increases in glycine, serine, and threonine metabolism. These data warrant continued investigation of vinegar as a possible agent to
improve mood state.
Nutrients, 13(11) : 11
- Year: 2021
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements, Other complementary & alternative
interventions