Kyrou, I., Christou, A., Panagiotakos, D., Stefanaki, C., Skenderi, K., Katsana, K., Tsigos, C.

Effects of a hops (Humulus lupulus L.) dry extract supplement on self-reported depression, anxiety and stress levels in apparently healthy young adults: a randomized, placebo-controlled, double-blind, crossover pilot study

OBJECTIVE: The Humulus lupulus L. plant (hops) is used as a herbal medicinal product for anxiety/mood disorders. Our aim was to study the effects of a hops dry extract on self-reported depression, anxiety and stress levels in young adults.\rDESIGN: Apparently healthy young adults from our university completed the Depression Anxiety Stress Scale-21 (DASS-21) and those reporting at least mild depression, anxiety and stress were invited to complete the study intervention. This followed a randomized (1:1), placebo-controlled, double-blind, crossover design with two 4-week intervention periods (Melcalin hops or placebo; two 0.2 gr capsules once daily) separated by a 2-week wash-out. Anthropometric measurements, DASS-21 assessments and measurements of morning cortisol plasma levels were performed at the beginning and the end of the 4-week treatment periods.\rRESULTS: 36 participants (Females/Males: 31/5; age: 24.7+/-0.5 years) completed the study intervention (attrition: 6/42). No significant changes in body weight and composition or morning circulating cortisol were noted with the hops or placebo. Significantly decreased DASS-21 anxiety, depression and stress scores were documented with hops (9.2+/-7.3 vs. 5.1+/-5.9, 11.9+/-7.9 vs. 9.2+/-7.4, and 19.1+/-8.1 vs. 11.6+/-8.1; all p values <0.05), which were significantly greater compared to those caused by the placebo (all p values <0.05). \rCONCLUSION: In otherwise healthy young adults reporting at least mild depression, anxietyand stress symptoms, daily supplementation with a hops dry extract can significantly improve all these symptoms over a 4-week period. These beneficial effects agree with the indication of hops for anxiety/mood disorders and restlessness, as approved by the German Commission E.

Hormones, 16(2) : 171-180

Linke, J., Wessa, M.

Mental Imagery Training Increases Wanting of Rewards and Reward Sensitivity and Reduces Depressive Symptoms

High reward sensitivity and wanting of rewarding stimuli help to identify and motivate repetition of pleasant activities. This behavioral activation is thought to increase positive emotions. Therefore, both mechanisms are highly relevant for resilience against depressive symptoms. Yet, these mechanisms have not been targeted by psychotherapeutic interventions. In the present study, we tested a mental imagery training comprising eight 10-minute sessions every second day and delivered via the Internet to healthy volunteers (N = 30, 21 female, mean age of 23.8 years, Caucasian) who were preselected for low reward sensitivity. Participants were paired according to age, sex, reward sensitivity, and mental imagery ability. Then, members of each pair were randomly assigned to either the intervention or wait condition. Ratings of wanting and response bias toward probabilistic reward cues (Probabilistic Reward Task) served as primary outcomes. We further tested whether training effects extended to approach behavior (Approach Avoidance Task) and depressive symptoms (Beck Depression Inventory). The intervention led to an increase in wanting (p < .001, eta²_p= .45) and reward sensitivity (p = .004, eta²_p= .27). Further, the training group displayed faster approach toward positive edibles and activities (p = .025, eta²_p= .18) and reductions in depressive symptoms (p = .028, eta²_p= .16). Results extend existing literature by showing that mental imagery training can increase wanting of rewarding stimuli and reward sensitivity. Further, the training appears to reduce depressive symptoms and thus may foster the successful implementation of exsiting treatments for depression such as behavioral activation and could also increase resilience against depressive symptoms.

Behavior Therapy, 48(5) : 695-706

Lisinski, A., Hieronymus, F., Nilsson, S., Eriksson, E.

Study 329 suggests paroxetine to exert an antidepressant effect in children and adolescents [conference abstract]

Introduction: Treatment with SSRIs in adolescent depression is a controversial subject. In a recent paper in BMJ [1], Le Noury and co-workers reanalysed the results of a previously published clinical trial (Study 329) [2] addressing the tolerability and efficacy of paroxetine in adolescent depression. Noting that paroxetine did not outperform placebo with respect to the primary effect variable, the total score of the Hamilton depression rating scale (HDRS 17-sum), they concluded that paroxetine did not show efficacy. In order to shed further light on this issue, we have undertaken additional analyses of the data from Study 329. Method: Patient-level data from the trial in question were provided by GlaxoSmithKline. Effect sizes and p-values for the difference between paroxetine and placebo were assessed using linear mixed models in SAS 9.4 for each individual HDRS17 item. The model included treatment, time and the interaction between treatment and time as fixed factors, and the baseline value on the corresponding measure as a covariate. This was done in (i) in all subjects, (ii) after excluding subjects reporting <1 on the item in question at baseline and (iii) after also excluding those below age 13. Results: As stated in the original report by Keller and co-workers, paroxetine outperformed placebo with respect to reduction in depressed mood, the effect size being relatively large (0.61, p < 0.001). In addition, there was a significant effect on guilt (ES 0.42, p = 0.01). After exclusion of subjects displaying baseline rating <1 for the item in question, no further differences were revealed between the groups. However, after exclusion also of subjects <13 years of age, significant reductions in depressed mood (ES 0.71, p < 0.001), guilt (ES 0.64, p = 0.006), psycho-motor retardation (ES 0.42, p = 0.04), and psychic anxiety (ES 0.43, p = 0.03) as well as in HDRS17-sum (ES 0.39, p = 0.003), were revealed. Conclusion: We have recently reported that SSRIs of ten outperform placebo in reducing important items in the HDRS17, even when no significant difference is found with respect to HDRS17-sum [3]. This re-analysis of trial 329 yielded very similar results, again depressed mood being the item showing the highest effect size. While the Hamilton depression rating scale has been criticized when used in adult depression trials, our results suggest this scale being a suboptimal measure for detecting an antidepressant signal also in the young. Moreover, leaving the formal aspect that HDRS17-sum was named primary effect parameter in Study 329 aside, the results do not support the conclusion by Le Noury and co-workers that paroxetine lacks efficacy in adolescent depression, at least not in children aged 13 and above. The outcome suggests that one, when re-evaluating trials regarding the possible efficacy of SSRIs in the young, should not feel restricted by what was named primary efficacy parameter in the protocol, but rather explore any item deemed scientifically relevant. Moreover, the age factor should be taken into consideration when conducting such analyses.

European Neuropsychopharmacology, 27 (Supplement 4) : S1114- S1115

Lopez-Rodriguez, M. M., Baldrich-Rodriguez, I., Ruiz-Muelle, A., Cortes-Rodriguez, A. E., Lopezosa-Estepa, T., Roman, P.

Effects of Biodanza on Stress, Depression, and Sleep Quality in University Students

BACKGROUND: The existing literature shows dance to be an innovative and successful form of stress management. Previous research indicates that Biodanza is able to increase well-being and personal resources and prevent stress. However, Biodanza has not yet been empirically tested as a possible therapy for application outside the clinical context in young adults with perceived stress.\rOBJECTIVES: This study aimed to determine the effectiveness of Biodanza in reducing symptoms of perceived stress and depression and in promoting sleep quality in young adults, comparing the changes with those observed in a control group. \rDESIGN: Randomized controlled trial.\rSETTINGS/LOCATION: This study was carried out at the Faculty of Health Sciences of the University of Almeria.\rSUBJECTS: One hundred and twenty-one university students with perceived stress were randomly placed into either a Biodanza group or a wait-list control group.\rINTERVENTION: Study participants attended Biodanza sessions for 90min a week, over a period of 4 weeks.\rOUTCOME MEASURES: Depression, perceived stress, and sleep quality were assessed both before and after intervention.\rRESULTS: Ninety-five participants completed the program and were included in the statistical analysis. Significant differences in perceived stress [t (93)=2.136; p=0.015] and depression [t (93)=2.738; p=0.000] were observed after the Biodanza period. Pre/post analysis found that Biodanza also had a significant effect on depression (Cohen d=1.88; p<0.05) and perceived stress (Cohen d=0.79; p<0.05).\rCONCLUSION: The Biodanza program is an effective stress management strategy for students. The results of this study showed Biodanza to have a positive effect on perceived stress and depression in young adults. This demonstrates how artistic, collaborative, and psychophysical interventions are an effective means of preventing and managing these problems in university students.

Journal of Alternative & Complementary Medicine, 23(7) : 558-565

Jaffery, A., Edwards, M. K., Loprinzi, P. D.

Randomized Control Intervention Evaluating the Effects of Acute Exercise on Depression and Mood Profile: Solomon Experimental Design

Mayo Clinic Proceedings, 92(3) : 480- 481

Johnson, C., Burke, C., Brinkman, S., Wade, T.

A randomized controlled evaluation of a secondary school mindfulness program for early adolescents: Do we have the recipe right yet?

OBJECTIVE: Mindfulness is being promoted in schools as a prevention program despite a current small evidence base. The aim of this research was to conduct a rigorous evaluation of the .b (\"Dot be\") mindfulness curriculum, with or without parental involvement, compared to a control condition.\rMETHOD: In a randomized controlled design, students (M_age 13.44, SD 0.33; 45.4% female) across a broad range of socioeconomic indicators received the nine lesson curriculum delivered by an external facilitator with (N = 191) or without (N = 186) parental involvement, or were allocated to a usual curriculum control group (N = 178). Self-report outcome measures were anxiety, depression, weight/shape concerns, wellbeing and mindfulness.\rRESULTS: There were no differences in outcomes between any of the three groups at post-intervention, six or twelve month follow-up. Between-group effect sizes (Cohen's d) across the variables ranged from 0.002 to 0.37. A wide range of moderators were examined but none impacted outcome.\rCONCLUSIONS: Further research is required to identify the optimal age, content and length of mindfulness programs for adolescents in universal prevention settings.\rTrial registration: actrn12615001052527.

Behaviour Research & Therapy, 99 : 37- 46

Gholami-Tahsini, Z., Makvand-Hosseini, S., Kianersi, F., Rashn, S., Majdara, E.

Biofeedback-aided relaxation training helps emotional disturbances in undergraduate students before examination

The main aim of the present research was to determine the effectiveness of biofeedback-aided relaxation training (BFRT) for alleviating symptoms of depression, anxiety, and stress for undergraduate students as they prepared for their final examinations. In a randomized controlled trial design, 29 male and female students, with heightened levels of depression, anxiety and stress scores on the Depression, Anxiety, and Stress Scale, were chosen and randomly assigned to BFRT or a no-treatment control condition. Subjects assigned to BFRT received eight sessions of BFRT spaced over 4 weeks, during which they were trained to decrease electromyography (EMG) and respiration rate (RESP) and to increase skin temperature (TEMP). Data were extracted and analyzed by GLM statistical analysis. Students receiving BFRT revealed significant reductions in symptoms when compared to the untreated controls. Those receiving BFRT also showed significant changes for the three targeted psychophysiological modalities (EMG, RESP, and TEMP). It was concluded that BFRT can be useful for reducing symptoms of emotional disturbance in undergraduate students during a particularly stressful period and that this may, in turn, help promote overall psychological health. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

Applied Psychophysiology and Biofeedback, 42(4) : 299-307

Gold, C., Saarikallio, S., Crooke, A. H. D., McFerran, K. S.

Group music therapy as a preventive intervention for young people at risk: cluster-randomized trial

Background: Music forms an important part of the lives and identities of adolescents and may have positive or negative mental health implications. Music therapy can be effective for mental disorders such as depression, but its preventive potential is unknown.\rObjective: The aim of this study was to examine whether group music therapy (GMT) is an effective intervention for young people who may be at risk of developing mental health problems, as indicated via unhealthy music use. The main question was whether GMT can reduce unhealthy uses of music and increase potentials for healthy uses of music, compared to self-directed music listening (SDML). We were also interested in effects of GMT on depressive symptoms, psychosocial well-being, rumination, and reflection.\rMethods: In an exploratory cluster- randomized trial in Australian schools, 100 students with self-reported unhealthy music use were invited to GMT (weekly sessions over 8 weeks) or SDML. Changes in the Healthy-Unhealthy Music Scale (HUMS) and mental health outcomes were measured over 3 months.\rResults: Both interventions were well accepted. No effects were found between GMT and SDML (all p > 0.05); both groups tended to show small improvements over time. Younger participants benefited more from GMT, and older ones more from SDML (p = 0.018).\rConclusions: GMT was associated with similar changes as SDML. Further research is needed to improve the processes of selecting participants for targeted interventions; to determine optimal dosage; and to provide more reliable evidence of effects of music-based interventions for adolescents.

Journal of Music Therapy, 54(2) : 133-160

Goodyer, I. M., Reynolds, S., Barrett, B., Byford, S., Dubicka, B., Hill, J., Holland, F., Kelvin, R., Midgley, N., Roberts, C., Senior, R., Target, M., Widmer, B., Wilkinson, P., Fonagy, P.

Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial

Background Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. Methods We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England. Adolescent patients (aged 11-17 years) with a diagnosis of DSM IV major depressive disorder were randomly assigned (1:1:1), via a web-based randomisation service, to receive cognitive behavioural therapy (CBT) or short- term psychoanalytical therapy versus a reference brief psychological intervention. Randomisation was stochastically minimised by age, sex, self- reported depression sum score, and region. Patients and clinicians were aware of group allocation, but allocation was concealed from outcome assessors. Patients were followed up and reassessed at weeks 6, 12, 36, 52, and 86 post-randomisation. The primary outcome was self-reported depression symptoms at weeks 36, 52, and 86, as measured with the self-reported Mood and Feelings Questionnaire (MFQ). Because our aim was to compare the two psychological therapies with the brief psychosocial intervention, we first established whether CBT was inferior to short-term psychoanalytical psychotherapy for the same outcome. Primary analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN83033550. Findings Between June 29, 2010, and Jan 17, 2013, we randomly assigned 470 patients to receive the brief psychosocial intervention (n=158), CBT (n=155), or short-term psychoanalytical therapy (n=157); 465 patients comprised the intention-to-treat population. 392 (84%) patients had available data for primary analysis by the end of follow-up. Treatment fidelity and differentiation were established between the three interventions. The median number of treatment sessions differed significantly between patients in the brief psychosocial intervention group (n=6 [IQR 4-11]), CBT group (n=9 [5-14]), and short-term psychoanalytical therapy group (n=11 [5-23]; p<0.0001), but there was no difference between groups in the average duration of treatment (27.5 [SD 21.5], 24.9 [17.7], 27.9 [16.8] weeks, respectively; Kruskal-Wallis p=0.238). Self-reported depression symptoms did not differ significantly between patients given CBT and those given short-term psychoanalytical therapy at weeks 36 (treatment effect 0.179, 95% CI -3.731 to 4.088; p=0.929), 52 (0.307, -3.161 to 3.774; p=0.862), or 86 (0.578, -2.948 to 4.104; p=0.748). These two psychological treatments had no superiority effect compared with brief psychosocial intervention at weeks 36 (treatment effect -3.234, 95% CI -6.611 to 0.143; p=0.061), 52 (-2.806, -5.790 to 0.177; p=0.065), or 86 (-1.898, -4.922 to 1.126; p=0.219). Physical adverse events (self-reported breathing problems, sleep disturbances, drowsiness or tiredness, nausea, sweating, and being restless or overactive) did not differ between the groups. Total costs of the trial interventions did not differ significantly between treatment groups. Interpretation We found no evidence for the superiority of CBT or short-term psychoanalytical therapy compared with a brief psychosocial intervention in maintenance of reduced depression symptoms 12 months after treatment. Short-term psychoanalytical therapy was as effective as CBT and, together with brief psychosocial intervention, offers additional patient choice for psychological therapy, alongside CBT, for adolescents with moderate to severe depression who are attending routine specialist CAMHS clinics. Funding National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, and the Department of Health. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license

The Lancet Psychiatry, 4(2) : 109-119

Guo, Y. F., Zhang, X., Plummer, V., Lam, L., Cross, W., Zhang, J. P.

Positive psychotherapy for depression and self-efficacy in undergraduate nursing students: A randomized, controlled trial

Nursing students across the globe experience depressive symptoms, and many interventions have been used to alleviate their depression. However, few interventions focus on students' personal strengths and advantages. The aim of the present study was to explore the effects of an 8- week group positive psychotherapy (PPT) programme on depression and self-efficacy in full-time undergraduate nursing students. A randomized, controlled trial was conducted for 76 nursing students (34 in the experimental group, 42 in the control group). The Beck Depression Inventory-II and the General Self-Efficacy Scale were used to collect data prior to, immediately after PPT, 3 months', and 6 months' post-PPT. Repeated-measures analysis of variance indicated that the intervention significantly alleviated depression and improved self-efficacy (each P < 0.05); the effect of time and time-group interaction was also significant (each P < 0.05). The findings suggest that PPT could significantly relieve depressive symptoms and improve self-efficacy. We recommend that PPT is effective in alleviating depression and improving self-efficacy in undergraduate nursing students. Academic mental health nurses should appreciate the value of PPT and consider incorporating it in psychological support methods in order to facilitate nursing students' mental health.

International Journal of Mental Health Nursing, 26(4) : 375 -383

Haddock, S. A., Weiler, L. M., Trump, L. J., Henry, K. L.

The efficacy of internal family systems therapy in the treatment of depression among female college students: a pilot study

College women are vulnerable to depression due to developmental and transitional life changes. Early diagnosis and effective treatment is critically important. Empirical support exists for the effectiveness of select treatment options (i.e., antidepressant medication, cognitive-behavioral therapy [CBT], and interpersonal psychotherapy [IPT]), yet a significant percentage of those treated do not benefit. In this pilot study, Internal Family Systems (IFS) therapy was tested as an alternative approach. College women (N = 37) were randomly allocated to IFS treatment or treatment as usual (CBT or IPT). Results demonstrated a decline in depressive symptoms for both conditions and no significant differences in the magnitude or rate of change. The results provide preliminary evidence for the efficacy of IFS in the treatment of depressive symptoms.

Journal of Marital & Family Therapy, 43(1) : 131- 144

Haeffel, G. J., Hein, S., Square, A., Macomber, D., Lee, M., Chapman, J., Grigorenko, E. L.

Evaluating a social problem solving intervention for juvenile detainees: Depressive outcomes and moderators of effectiveness

This study reports findings from the administration of a social problem-solving training (SPST) intervention to juvenile detainees in the Connecticut Youth Detainee Program. SPST is a cognitive behavioral intervention that teaches children and youth how to more effectively cope with interpersonal stress and conflict. In the current study, we tested whether SPST could decrease depressive symptoms in a sample of detained adolescent offenders. The study used a randomized-control design with detention staff administering the intervention. The results showed that SPST, as a main effect, was not more effective in reducing depressive symptoms than treatment as usual. However, the effectiveness of SPST was moderated by fluid intelligence. Juvenile detainees with high intelligence scores were most likely to benefit from SPST compared to treatment as usual. It was surprising that, for those with lower intelligence scores, SPST increased depressive symptoms relative to treatment as usual. These results help fill a critical need for intervention effectiveness data on juvenile detainees and indicate that SPST may not be useful for reducing outcomes such as depression.

Development & Psychopathology, 29(3) : 1035- 1042