Disorders - depressive disorders
Hothi, H., Bedard, C., Ceccacci, A., DiRezze, B., Kwan, M. Y. W.
PURPOSE: The objective of this meta-analysis was to provide a quantitative synthesis of the
effects of studies evaluating developmentally appropriate programs or interventions for transition-age youth with mental health disorders. METHOD(S):
Studies, between January 1992 and March 2021, were included if they contained a sample population with a median age between 12 and 25years and with a
mental health disorder and described the results of health interventions addressing aspects of developmental transitions. Independent reviewers
screened study texts and assessed the risk of bias. Random effects meta-analysis was used to pool data on standardized mean differences. RESULT(S):
Under neurodevelopmental studies (6), the effect size of interventions measuring social outcomes was 1.00 (95% CI: -0.01 to 2.00), parental stress
levels was -0.10 (95% CI:-0.74 to 0.55), autism symptoms was -0.40 (95% CI: -1.58 to 0.78), and self-determination was 0.16 (95% CI:-0.38 to 0.70).
Under mental illness studies (3), the effect size of interventions measuring adolescent depressive symptoms was 0.48 (95% CI: 0.01 to 0.96) and
parental depressive symptoms was 1.09 (95% CI: 0.20 to 1.97). CONCLUSION(S): There is no effect of interventions except on parental depressive
symptoms under mental illness studies. Further research with comparable outcomes and assessments is needed.Implications for
rehabilitation:Interventions for youth with mental health disorders should be developmentally appropriate and incorporate elements to assist youth in
multiple aspects of their lives.The following approaches should be considered in interventions: skills training, prevocational/vocational guidance, a
client-centered approach, and/or an ecological/experiential approach.Intervention researchers and practitioners should incorporate similar outcome
assessment tools and measures in order to allow for valid comparisons between intervention effectiveness.
, : 1-11
- Year: 2021
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Hoare, E., Collins,
S., Marx, W., Callaly, E., Moxham-Smith, R., Cuijpers, P., Holte, A., Nierenberg, A. A., Reavley, N., Christensen, H., Reynolds, C. F. 3rd., Carvalho, A. F., Jacka, F., Berk, M.
Depression is a disabling, highly prevalent, frequently chronic, and difficult-to-treat
disorder with an immense cognitive, social, and economic burden. Given that many of the advances in other non-communicable disorders like cancer have
been in prevention rather than treatment, the prevention of depression is currently an unmet public health priority. We sought to provide an overview
of the meta-analytic literature through conducting a systematic umbrella review of universally delivered preventive interventions for depression. The
search was conducted on March 18, 2021 utilising the following databases (all accessed through EBSCOHost); Allied and Complementary Medicine
Database, CINAHL Complete, Global Health, Health Source: Nursing/Academic Edition, MEDLINE Complete and APA PsychArticles. The following search terms
related to depression, prevention, and trial study design. Two authors independently screened articles and a third resolved discrepancies.
Eligibility criteria sought to identify meta-analyses that investigated the prevention of depression (i.e., reduced incidence) through intervention
studies that were universal, in that they were designed to be delivered to entire populations Six meta-analyses on psychological interventions, two
school-based meta-analyses, and one eHealth meta-analysis were included in this umbrella review. Findings indicated that all identified studies were
of good quality and one was of fair quality. One previous meta-review that examined physical activity to prevent depression was included in results,
comprising eight meta-analyses. Preventive interventions have primarily and successfully utilized psychological therapeutic components, delivered at
the school, community, and workplace settings. Both school- and eHealth-based interventions hold some utility for depression prevention. There is
meta-analytic evidence that physical activity is efficacious for depression prevention. However, universal prevention is inconsistently defined.
There is a pressing need for well-designed randomized controlled preventative interventions for depression before recommendations can be universally
accepted with convincing level of evidence.
Journal of Psychiatric Research, 144 : 483-
493
- Year: 2021
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any)
Herres, J., James, K. M., Bounoua, N., Ewing,
E. S. K., Kobak, R., Diamond, G. S.
Although
treatments for youth at risk for suicide have been successful, they are not similarly effective for everyone. Anxiety may interfere with
adolescents' ability to engage with therapy and explain why some adolescents do not respond as well as others to treatment. The current study tested
whether an anxiety diagnosis predicted treatment outcome among a sample of adolescents with suicidal ideation and depressive symptoms participating
in either attachment-based family therapy or family-enhanced nondirective supportive therapy (N = 129; Mage = 14.87, SD = 1.68; 81.9%
female). The data set that the current study used had a high representation of Black/African American adolescents (48.8% of sample), which is
valuable, as few studies have included adequate representation of this population. A significant indirect effect (.88; 95% confidence interval [.01,
2.64]) showed that across both treatment conditions, participants who met criteria for an anxiety disorder had greater difficulties engaging in
goal-directed behavior midtreatment, and these difficulties, in turn, predicted more posttreatment suicidal ideation. The effect of anxiety on
treatment outcome via difficulties with goal-directed behavior was nonspecific to the treatment condition. However, attachment-based family therapy
was superior to family-enhanced nondirective supportive therapy in improving this aspect of emotion regulation among adolescents who did not have
anxiety. In addition, difficulties with goal-directed behavior on treatment outcome were worse for adolescents' who reported greater attachment
avoidance to their parents. Future research should test whether targeting goal-directed behavior and attachment avoidance would result in better
treatment outcome for adolescents with suicidal ideation and anxiety. Copyright © 2021. American Psychological Association
Psychotherapy, 58(4) : 523-532
- Year: 2021
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Supportive
therapy
Gupta, V., Singh, S., Gupta, P. K., Kar, S. K.
Transcranial Magnetic Stimulation (TMS), a form of Non-Invasive Brain Stimulation
(NIBS), has gained popularity in the last couple of decades. It is approved for treating depression in adults and is under investigation in pediatric
depression. This paper aims to evaluate Transcranial Magnetic Stimulation (TMS) studies in pediatric depression and provide a narrative overview by
reviewing the research databases (PubMed, Science Direct, and Cochrane Library). Recent evidence suggests that in pediatric patients of treatment-
resistant depression, repetitive Transcranial Magnetic Stimulation (rTMS) of the frequency of 10 Hz when applied to the left dorsolateral prefrontal
cortex (DLPFC), can lead to remission, improvement in depressive symptoms, or decrease in recurrence of episodes. Existing literature also suggests
that TMS's adverse effects in the pediatric population are minimal and comparable to those in the adult population. However, the limitations of
existing studies, including lack of double-blind sham-controlled randomized trials or RCTs (only one RCT exists to date), small sample sizes, absence
of long term follow-ups, and lack of homogenous age distribution, render the evidence insufficient for approval of TMS use in pediatric depression.
This review suggests that although there is a scope of TMS use in pediatric depression, more proof is required to establish and quantify its efficacy
and standardize its dosing regimens. Copyright © 2021, Indian Association for Child and Adolescent Mental Health. All rights reserved.
Journal of Indian Association for Child and Adolescent Mental Health, 17
(3) : 154-166
- Year: 2021
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Treatment resistant/treatment refractory
-
Treatment and intervention: Biological Interventions
(any), Transcranial magnetic stimulation
(TMS)
Goldston, D. B.
Depression, suicidal behaviors and substance use problems frequently co-occur, and treatment for youth with these co-occurring problems
is often fragmented and challenging. An integrated cognitive-behavioral treatment approach that builds upon a relapse prevention framework and
applies common core skills, language, and approach for treating these related problems may be clinically beneficial. Following a description of the
integrated approach, we present results of a pilot trial (n = 13) to examine the acceptability and feasibility of the Cognitive-Behavioral Therapy-
Relapse Prevention (CBT-RP) intervention plus enhanced treatment as usual (TAU) compared to enhanced TAU alone. The feasibility of the CBT-RP + TAU
intervention was reflected by high rates of retention (86%). The acceptability was reflected in positive evaluations regarding the helpfulness of the
intervention by adolescents and families. The majority of youth in both CBT-RP + TAU and TAU alone groups evidenced reductions in depression and
suicide ideation from study entry to Week 20. Patterns of reduction were more consistent, however, for youth receiving CBT-RP + TAU, and reductions
were slower to emerge for some youth receiving TAU alone. Reductions in alcohol and marijuana problems were similar, but half of the youth in TAU
alone (and none in the CBT-RP + TAU group) had emergency department visits related to psychiatric crises or substance-related problems. These
findings, although based on a small sample, underscore the feasibility and acceptability of an integrated cognitive-behavioral relapse prevention
approach for youth with depression, suicide attempt histories, and substance use problems. Copyright © 2021 Society of Clinical Child & Adolescent
Psychology.
Evidence-Based Practice in Child and Adolescent Mental Health, 6(2) : 155-
172
- Year: 2021
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Goldbach, J. T., Rhoades, H., Mamey, M. R., Senese, J., Karys, P., Marsiglia, F. F.
BACKGROUND: Minority stress may lead to poorer mental health for sexual and gender minority adolescents, yet no
interventions have been tested through an RCT to address these concerns. METHOD(S): We report on an RCT of an intervention-Proud & Empowered-with
four high schools. Measures assess the intervention's impact on mental health symptoms. RESULT(S): Compared to the control, participants in the
treatment condition reported significant differences in minority stress, anxiety, and depressive symptoms. Moderation analyses showed that the
intervention significantly moderated the relationship between minority stress and PTSD (b = -1.28, p = .032), depression (b = -0.79, p = .023), and
suicidality (b = 0.14, p = .012) symptoms; those in the intervention condition had mitigated relationships between measures of stress and health
outcomes compared to those in the control condition. CONCLUSION(S): Results suggest that Proud & Empowered help reduce mental health symptoms and
exposure to minority stressors and build coping strategies. TRIAL REGISTRATION: The intervention was registered on clinicaltrials.gov on August 1,
2019 under Trial # NCT04041414 . Copyright © 2021. The Author(s).
BMC public health, 21
(1) : 2315
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Ghosh, A., Cherian, R. J., Wagle, S., Sharma, P., Kannan, K. R., Bajpai, A., Gupta, N.
Most individuals vulnerable to depression do not receive adequate or timely treatment globally. Unguided
computerized cognitive behavioral therapy (cCBT) has the potential to bridge this treatment gap. However, the real-world effectiveness of unguided
cCBT interventions, particularly in low- and middle-income countries (LMICs), remains inconclusive. In this study, we report the design and
development of a new unguided cCBT intervention, TreadWill, and its pragmatic evaluation. TreadWill was designed to be fully automated, engaging,
easy to use, and accessible in LMICs. To evaluate its effectiveness and engagement level, we performed a double-blind, fully-remote, randomized
controlled trial with 598 participants in India. The use of TreadWill significantly reduced depression-related and anxiety-related symptoms. Compared
with a plain-text version with the same therapeutic content, the full-featured version of TreadWill showed significantly higher engagement. Overall,
our study provides a new resource and evidence for the use of unguided cCBT as a scalable intervention in LMICs. Copyright The copyright holder for
this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC
4.0 International license.
medRxiv., 24 :
- Year: 2021
- 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), Technology, interventions delivered using technology (e.g. online, SMS)
Frohlich, J. R., Rapinda, K. K., Schaub, M. P., Wenger, A., Baumgartner, C., Johnson, E. A., O'Connor, R. M., Vincent, N., Blankers, M., Ebert, D.
D., Hadjistavropoulos, H. D., Mackenzie, C. S., Wardell, J. D., Augsburger, M., Goldberg, J. O., Keough, M.
T.
Objective: Many young adults struggle with comorbid alcohol misuse and emotional problems (i.e., depression and anxiety). However,
there is currently a paucity of evidence-based, integrated, accessible treatment options for individuals with these comorbidities. The main goal of
this study was to examine efficacy of a novel online, minimally guided, integrated program for comorbid alcohol misuse and emotional problems in
young adults. Method(s): The study was an open-label two-arm RCT. Participants (N = 222, Mage = 24.6, 67.6% female) were randomized to one
of two conditions: the Take Care of Me program (an 8-week, online integrated treatment condition consisting of 12 modules), or an online
psychoeducational control condition. Intervention modules incorporated content based on principles of cognitive behavioral therapy and motivational
interviewing. Participants completed assessment data at baseline, at the end of treatment (i.e., 8 weeks), and at follow-up (i.e., 24 weeks). Data
were analyzed using generalized linear mixed models. Result(s): We observed that participants in the treatment condition showed larger reductions in
depression, hazardous drinking, as well as increases in psychological quality of life and confidence at the end of treatment. We did not find group
differences on total alcohol use at follow-up, but participants in the treatment group reduced their hazardous drinking and improved their quality of
life at 24-week follow-up. Conclusion(s): Our study provides promising initial evidence for the first iteration of the comorbid alcohol misuse and
emotional problems online program. Copyright © 2021
Addictive Behaviors
Reports, 14 (no pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Fink, A., Koschutnig, K., Zussner,
T., Perchtold-Stefan, C. M., Rominger, C., Benedek, M., Papousek, I.
This study examined the effects of a two-week running intervention on depressive
symptoms and structural changes of different subfields of the hippocampus in young adults from the general population. The intervention was realized
in small groups of participants in a mostly forested area and was organized into seven units of about 60 min each. The study design included two
intervention groups which were tested at three time points and which received the intervention time-delayed: The first group between the first and
the second time point, and the second group between the second and the third time point (waiting control group). At each test session, magnetic
resonance imaging (MRI) was performed and symptoms related to depression were measured by means of the Center for Epidemiological Studies Depression
(CES-D) Scale. Results revealed a significant reduction of CES-D scores after the running intervention. The intervention also resulted in significant
increases in the volume of the hippocampus, and reductions of CES-D scores right after the intervention were associated with increases in hippocampal
volume. These findings add important new evidence on the beneficial role of aerobic exercise on depressive symptoms and related structural
alterations of the hippocampus.
, 144 : 70-
81
- Year: 2021
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
de-la-Barrera, U., Monaco, E., Postigo-Zegarra, S., Gil-Gomez, J. A., Montoya-Castilla, I.
Introduction Technologies
provide a brilliant opportunity to promote social-emotional competences, well-being and adjustment in adolescence. Game-based programmes and serious
games are digital tools that pursue an educational goal in an attractive environment for adolescents. The purpose of this study was therefore to
determine the effectiveness of emoTIC, a game-based social-emotional programme designed according to Mayer, Caruso, and Salovey's model of emotional
intelligence. Materials and methods The participants were 119 adolescents between 11 and 15 years, randomly assigned to the experimental group and
the control group. The adolescents completed questionnaires to assess their emotional intelligence, self-esteem, affect balance, difficulties,
prosocial behaviour, depression, anxiety and stress. Results The MANCOVA results showed that adolescents who completed the game-based programme had
improved self-esteem, affect balance, emotional symptoms, behavioural problems, and hyperactivity (Wilks' lambda = .77; F = 2.10; p = .035).
Hierarchical multiple regression indicated that adolescents in the experimental group had a greater change in self-esteem and affect balance
(positive beta), while their emotional problems and hyperactivity decreased (negative beta). Anxiety moderated the influence of the intervention on
self-esteem (b = .04; t = -2.55; p <= .05; LLCI = -0.43, ULCI = -0.05). Adolescents with low or medium anxiety improved their self-esteem with the
intervention, while those with high anxiety did not develop it. Conclusions The use of technology in social-emotional programmes could be the first
step in increasing adolescents' interest in emotions and emoTIC could be considered a useful programme which influences their personal, emotional
and social factors. Trial registration Clinical Trial identifier: NCT04414449. Copyright: © 2021 de la Barrera 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 ONE, 16(4 April) (no
pagination) :
- Year: 2021
- 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)
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)
Cruwys,
T.,
Background: Decades of research indicate that when social connectedness is threatened, mental health is at
risk. However, extant interventions to tackle loneliness have had only modest success, and none have been trialled under conditions of such threat.
Method: 174 young people with depression and loneliness were randomised to one of two evidence-based treatments: cognitive behaviour therapy (CBT) or
Groups 4 Health (G4H), an intervention designed to increase social group belonging. Depression, loneliness, and well-being outcomes were evaluated at
one-year follow-up; COVID-19 lockdown restrictions were imposed partway through follow-up assessments. This provided a quasi-experimental test of the
utility of each intervention in the presence (lockdown group) and absence (control group) of a threat to social connectedness. Results: At one-year
follow-up, participants in lockdown reported significantly poorer wellbeing than controls who completed follow-up before lockdown, t(152) = 2.41, p =
.017. Although both CBT and G4H led to symptom improvement, the benefits of G4H were more robust following an unanticipated threat to social
connectedness for depression (chi2(16) = 31.35, p = .001), loneliness (chi2(8) = 21.622, p = .006), and wellbeing (chi2(8) = 22.938, p = .003).
Limitations: Because the COVID-19 lockdown was unanticipated, this analysis represents an opportunistic use of available data. As a result, we could
not measure the specific impact of restrictions on participants, such as reduced income, degree of isolation, or health-related anxieties.
Conclusions: G4H delivered one year prior to COVID-19 lockdown offered greater protection than CBT against relapse of loneliness and depression
symptoms. Implications are discussed with a focus on how these benefits might be extended to other life stressors and transitions. (PsycInfo Database
Record (c) 2022 APA, all rights reserved)
, 295 : 316-
322
- Year: 2021
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions