Disorders - depressive disorders
Cuijpers,
P., Cristea, I. A., Ebert, D. D., Koot, H. M., Auerbach, R., Bruffaerts, R, Kessler, R. C.
Background: Expanded efforts to detect and treat depression among
college students, a peak period of onset, have the potential to bear high human capital value from a societal perspective because depression
increases college withdrawal rates. However, it is not clear whether evidence-based depression therapies are as effective in college students as in
other adult populations. The higher levels of cognitive functioning and IQ and higher proportions of first-onset cases might lead to treatment
effects being different among college students relative to the larger adult population. Methods: We conducted a metaanalysis of randomized trials
comparing psychological treatments of depressed college students relative to control groups and compared effect sizes in these studies to those in
trials carried out in unselected populations of depressed adults. Results: The 15 trials on college students satisfying study inclusion criteria
included 997 participants. The pooled effect size of therapy versus control was g = 0.89 (95% CI: 0.66~1.11; NNT = 2.13) with moderate heterogeneity
(I2 = 57; 95% CI: 23~72). None of these trials had low risk of bias. Effect sizes were significantly larger when students were not remunerated (e.g.
money, credit), received individual versus group therapy, and were in trials that included a waiting list control group. No significant difference
emerged in comparing effect sizes among college students versus adults either in simple mean comparisons or in multivariate metaregression analyses.
Conclusions: This metaanalysis of trials examining psychological treatments of depression in college students suggests that these therapies are
effective and have effect sizes comparable to trials carried out among depressed adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
(journal abstract).
Depression & Anxiety, 33(5) : 400-
414
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Cuijpers, P., Donker,
T., Weissman, M. M., Ravitz, P., Cristea, I. A.
OBJECTIVE: Interpersonal psychotherapy (IPT) has been developed for the treatment of
depression but has been examined for several other mental disorders. A comprehensive meta-analysis of all randomized trials examining the effects of
IPT for all mental health problems was conducted.\rMETHOD: Searches in PubMed, PsycInfo, Embase, and Cochrane were conducted to identify all trials
examining IPT for any mental health problem.\rRESULTS: Ninety studies with 11,434 participants were included. IPT for acute-phase depression had
moderate-to-large effects compared with control groups (g=0.60; 95% CI=0.45-0.75). No significant difference was found with other therapies
(differential g=0.06) and pharmacotherapy (g=-0.13). Combined treatment was more effective than IPT alone (g=0.24). IPT in subthreshold depression
significantly prevented the onset of major depression, and maintenance IPT significantly reduced relapse. IPT had significant effects on eating
disorders, but the effects are probably slightly smaller than those of cognitive-behavioral therapy (CBT) in the acute phase of treatment. In anxiety
disorders, IPT had large effects compared with control groups, and there is no evidence that IPT was less effective than CBT. There was risk of bias
as defined by the Cochrane Collaboration in the majority of studies. There was little indication that the presence of bias influenced outcome.
\rCONCLUSIONS: IPT is effective in the acute treatment of depression and may be effective in the prevention of new depressive disorders and in
preventing relapse. IPT may also be effective in the treatment of eating disorders and anxiety disorders and has shown promising effects in some
other mental health disorders.
American
Journal of Psychiatry, 173(7) : 680-7
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT)
Cuijpers, Pim, Ebert, David D., Acarturk, Ceren, Andersson, Gerhard, Cristea, Ioana A.
Personalized medicine is aimed at identifying which characteristics of an
individual predict the outcome of a specific treatment, in order to get a better match between the individual and the treatment received. We
conducted a systematic review and meta-analysis of randomized trials comparing two psychotherapies directly in a group of depressed patients with a
specific characteristic. We focused on the six most examined types of psychotherapy for adult depression. Our searches resulted in 41 studies with
2,741 patients who met inclusion criteria. These 41 studies examined 27 specific characteristics of patients. Power calculations indicated that we
would need 4 studies for each characteristic to find a clinically relevant effect size set at g = 0.50 and 16 studies for an effect size of 0.24.
Only 3 patient characteristics were found to have sufficient power and to significantly moderate treatment outcomes. Cognitive-behavioral therapy was
found to be more effective than other therapies in older adults (g = 0.29), in patients with comorbid addictive disorders (g = 0.31), and in
university students (g = 0.46). Risk of bias was considerable in most of the included studies. It was estimated that it will take another 326 years
to have sufficient statistical power for showing an effect size of g = 0.50 of the 27 characteristics, and 1,372 years to show an effect size of
0.24. Although several dozens of studies have compared the effects of psychotherapies in specific target groups, we will need to develop more
powerful alternatives to comparative outcome studies in order to identify personalized treatments for depression. (PsycINFO Database Record (c) 2017
APA, all rights reserved)
Behavior
Therapy, 47(6) : 966-980
- Year: 2016
- 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)
Das, J. K., Salam, R. A., Lassi, Z. S., Khan, M. N., Mahmood,
W., Patel, V., Bhutta, Z. A.
Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these
disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on
mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the
following categories for reporting the findings: school-based interventions (n = 12); community-based interventions (n = 6); digital platforms (n =
8); and individual-/family-based interventions (n = 12). Evidence from school-based interventions suggests that targeted group-based interventions
and cognitive behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: -.16; 95% confidence interval [CI]:
-.26 to -.05) and anxiety (SMD: -.33; 95% CI: -.59 to -.06). School-based suicide prevention programs suggest that classroom-based didactic and
experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57-2.45) and knowledge of suicide prevention (SMD: .72; 95% CI:
.36-1.07) with no evidence of an effect on suicide-related attitudes or behaviors. Community-based creative activities have some positive effect on
behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports Internet-based
prevention and treatment programs for anxiety and depression; however, more extensive and rigorous research is warranted to further establish the
conditions. Among individual- and family-based interventions, interventions focusing on eating attitudes and behaviors show no impact on body mass
index (SMD: -.10; 95% CI: -.45 to .25); Eating Attitude Test (SMD: .01; 95% CI: -.13 to .15); and bulimia (SMD: -.03; 95% CI: -.16 to .10). Exercise
is found to be effective in improving self-esteem (SMD: .49; 95% CI: .16-.81) and reducing depression score (SMD: -.66; 95% CI: -1.25 to -.08) with
no impact on anxiety scores. Cognitive behavioral therapy compared to waitlist is effective in reducing remission (odds ratio: 7.85; 95% CI: 5.31-
11.6). Psychological therapy when compared to antidepressants have comparable effect on remission, dropouts, and depression symptoms. The studies
evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions,
and outcomes; hence, meta-analysis could not be conducted in most of the included reviews. Future trials should also focus on standardized
interventions and outcomes for synthesizing the exiting body of knowledge. There is a need to report differential effects for gender, age groups,
socioeconomic status, and geographic settings since the impact of mental health interventions might vary according to various contextual factors.
(PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Adolescent Health, 59(4,
Suppl) : S49-S60
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any), Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any), Technology, interventions delivered using technology (e.g. online, SMS)
Devenish, B., Berk, L., Lewis, A. J.
OBJECTIVE: Given
depression is a significant risk factor for suicidal behaviour, it is possible that interventions for depression may also reduce the risk of suicide
in adolescents. The purpose of this literature review is to determine whether psychological interventions aimed to prevent and/or treat depression in
adolescents can also reduce suicidality.\rMETHODS: We conducted a systematic review of psychological interventions aimed to prevent and/or treat
depression in adolescents in which outcomes for suicidality were reported, using five databases: PsycINFO, Embase, Medline, CINAHL and Scopus. Study
quality was assessed using the Cochrane Collaboration's tool for assessing risk of bias.\rRESULTS: A total of 35 articles pertaining to 12 treatment
trials, two selective prevention trials and two universal prevention trials met inclusion criteria. No studies were identified that used a no-
treatment control. In both intervention and active control groups, suicidality decreased over time; however, most structured psychological depression
treatment interventions did not outperform pharmaceutical or treatment as usual control groups. Depression prevention studies demonstrated small but
statistically significant reductions in suicidality.\rLIMITATIONS: Analysis of study quality suggested that at least 10 of the 16 studies have a high
risk of bias. Conclusive comparisons across studies are problematic due to differences in measures, interventions, population differences and control
groups used.\rCONCLUSIONS: It is unclear whether psychological treatments are more effective than no treatment since no study has used a no-treatment
control group. There is evidence to suggest that Cognitive Behavioural Therapy interventions produce pre-post reductions in suicidality with moderate
effect sizes and are at least as efficacious as pharmacotherapy in reducing suicidality; however, it is unclear whether these effects are sustained.
There are several trials showing promising evidence for family-based and interpersonal therapies, with large pre-post effect sizes, and further
evaluation with improved methodology is required. Depression prevention interventions show promising short-term effects.\rCopyright © The Royal
Australian and New Zealand College of Psychiatrists 2016.
Australian & New Zealand Journal of Psychiatry, 50(8) : 726-40
- Year: 2016
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any)
Forman-Hoffman, V., McClure, E., McKeeman, J., Wood, C.
T., Middleton, J. C., Skinner, A. C., Perrin, E. M., Viswanathan, M.
Background: Major depressive disorder (MDD) is common among
children and adolescents and is associated with functional impairment and suicide. Purpose: To update the 2009 U.S. Preventive Services Task Force
(USPSTF) systematic review on screening for and treatment of MDD in children and adolescents in primary care settings. Data Sources: Several
electronic searches (May 2007 to February 2015) and searches of reference lists of published literature. Study Selection: Trials and recent
systematic reviews of treatment, test-retest studies of screening, and trials and large cohort studies for harms. Data Extraction: Data were
abstracted by 1 investigator and checked by another; 2 investigators independently assessed study quality. Data Synthesis: Limited evidence from 5
studies showed that such tools as the Beck Depression Inventory and Patient Health Questionnaire for Adolescents had reasonable accuracy for
identifying MDD among adolescents in primary care settings. Six trials evaluated treatment. Several individual fair-and goodquality studies of
fluoxetine, combined fluoxetine and cognitive behavioral therapy, escitalopram, and collaborative care demonstrated benefits of treatment among
adolescents, with no associated harms. Limitation: The review included only English-language studies, narrow inclusion criteria focused only on MDD,
high thresholds for quality, potential publication bias, limited data on harms, and sparse evidence on long-term outcomes of screening and treatment
among children younger than 12 years. Conclusion: No evidence was found of a direct link between screening children and adolescents for MDD in
primary care or similar settings and depression or other health-related outcomes. Evidence showed that some screening tools are accurate and some
treatments are beneficial among adolescents (but not younger children), with no evidence of associated harms.
Annals of Internal Medicine, 164(5) : 342-349
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any), Other Psychological Interventions
Forti Buratti, M. A., Saikia, R., Wilkinson, E. L., Ramchandani, P. G.
The objective of this study was to evaluate the efficacy of psychological treatments for
depression in pre-adolescent children, a disorder affecting 1 - 2 % of children in this age range. A systematic review of studies of psychological
interventions to treat depressive disorder in pre-adolescent children (aged up to 12-years-old) was carried out. The primary outcome was level of
depressive symptoms. Studies were found using Medline, PsycINFO, EMBASE and Web of Knowledge databases and selected on several criteria. Only
randomised controlled trials were included. Where individual studies covered a broader age range (usually including adolescents up to age 18 years),
authors of those studies were contacted and requested to provide individual patient level data for those aged 12 years and younger. 2822 abstracts
were reviewed, and from these 124 full text articles were reviewed, yielding 7 studies for which we were able to access appropriate data for this
review. 5 of these studies evaluated cognitive behaviour therapy (CBT). Combined results from these studies suggest that there is a lack of evidence
that CBT is better than no treatment [standard mean difference -0.342 (95 % confidence interval -0.961, 0.278)], although the number of participants
included in the trials was relatively small. The evidence for efficacy of family therapy and psychodynamic therapy is even more limited. The very
limited number of participants in randomised controlled trials means that there is inconclusive evidence for the psychological treatment of
depression in children aged 12 years and below. Given the prevalence and significant impact of this disorder, there is an urgent need to establish
the effectiveness or otherwise of psychological intervention.
European Child & Adolescent Psychiatry, : 1-10
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Hansson, A., Hansson, L., Danielsson, I., Domellof, E.
This preliminary study explored if a collaborative and
therapeutic approach (CTA) could reduce self-reported psychiatric symptoms (Beck Youth Inventories [BYI]) in children referred for neuropsychological
assessment. Participants included 11 children (M(age )= 12.4 years) receiving CTA, 11 (M(age) = 12.6 years) receiving parent support, and 9 (M(age) =
12.3 years) remaining on a waiting list. Contrary to both comparison groups, the CTA group reported fewer psychiatric symptoms on most BYI subscales
after intervention, and this decrease was sustained for the Anger and Anxiety subscales at 6-month follow-up. Findings support a potential
effectiveness of CTA in the neuropsychological assessment of children in a child psychiatric setting.
Applied Neuropsychology. Child, 5(2) : 97-
106
- Year: 2016
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Haslam, C., Cruwys, T., Haslam, S. A., Dingle, G., Chang, M. X. L.
Background Social isolation and
disconnection have profound negative effects on mental health, but there are few, if any, theoretically-derived interventions that directly target
this problem. We evaluate a new intervention, Groups 4 Health (G4H), a manualized 5-module psychological intervention that targets the development
and maintenance of social group relationships to treat psychological distress arising from social isolation. Methods G4H was tested using a non-
randomized control design. The program was delivered to young adults presenting with social isolation and affective disturbance. Primary outcome
measures assessed mental health (depression, general anxiety, social anxiety, and stress), well-being (life satisfaction, self-esteem) and social
connectedness (loneliness, social functioning). Our secondary goal was to assess whether mechanisms of social identification were responsible for
changes in outcomes. Results G4H was found to significantly improve mental health, well-being, and social connectedness on all measures, both on
program completion and 6-month follow-up. In line with social identity theorizing, analysis also showed that improvements in depression, anxiety,
stress, loneliness, and life satisfaction were underpinned by participants' increased identification both with their G4H group and with multiple
groups. Limitations This study provides preliminary evidence of the potential value of G4H and its underlying mechanisms, but further examination is
required in other populations to address issues of generalizability, and in randomized controlled trials to address its wider efficacy. Conclusions
Results of this pilot study confirm that G4H has the potential to reduce the negative health-related consequences of social disconnection. Future
research will determine its utility in wider community contexts.
Journal of Affective Disorders, 194 : 188-195
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Gaete, Jorge, Martinez, Vania, Fritsch, Rosemarie, Rojas, Graciela, Montgomery, Alan A., Araya, Ricardo
Background:
Depression is a disabling condition affecting people of all ages, but generally starting during adolescence. Schools seem to be an excellent setting
where preventive interventions may be delivered. This study aimed to test the effectiveness of an indicated school-based intervention to reduce
depressive symptoms among at-risk adolescents from low-income families. Methods: A two-arm, parallel, randomized controlled trial was conducted in 11
secondary schools in vulnerable socioeconomic areas in Santiago, Chile. High-risk students in year 10 (2degree Medio) were invited to a baseline
assessment (n = 1048). Those who scored >10 (boys) and >15 (girls) in the BDI-II were invited to the trial (n = 376). A total of 342 students
consented and were randomly allocated into an intervention or a control arm in a ratio of 2:1. The intervention consisted of 8 group sessions of 45
min each, based on cognitive-behavioural models and delivered by two trained psychologists in the schools. Primary (BDI-II) and secondary outcomes
(measures of anxiety, automatic thoughts and problem-solving skills) were administered before and at 3 months post intervention. The primary outcome
was the recovery rate, defined as the proportion of participants who scored in the BDI-II <10 (among boys) and <15 (among girls) at 3 months after
completing the intervention. Results: There were 229 participants in the intervention group and 113 in the control group. At 3-month follow-up 81.4 %
in the intervention and 81.7 % in the control group provided outcome data. The recovery rate was 10 % higher in the intervention (50.3 %) than in the
control (40.2 %) group; with an adjusted OR = 1.62 (95 % CI: 0.95 to 2.77) (p = 0.08). No difference between groups was found in any of the secondary
outcomes. Secondary analyses revealed an interaction between group and baseline BDI-II score. Conclusions: We found no clear evidence of the
effectiveness of a brief, indicated school-based intervention based on cognitive-behavioural models on reducing depressive symptoms among Chilean
adolescents from low-income families. More research is needed in order to find better solutions to prevent depression among adolescents. (PsycINFO
Database Record (c) 2016 APA, all rights reserved)
BMC Psychiatry Vol 16 2016, ArtID
276, 16 :
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Garrido, Sandra, Schubert, Emery, Bangert, Daniel
Background: Music is used in a
variety of health contexts for mood regulation purposes. However, while research demonstrates that self-selected music is most effective in using
music to alter mood in a positive direction, some people, particularly those with tendencies to depression, may incline towards music that
perpetuates a negative mood. Methods: Participants were randomly assigned to Happy and Sad music groups and listened to a prescribed playlist for
four weeks. Pre- and post- mood measures were taken as well as diaries of mood responses, which were analysed both qualitatively and quantitatively.
Results: No long-term mood effects were observed. The affective impact was less positive for people with high scores in rumination. However, the
diary-taking exercise raised participant awareness of mood impacts and increased deliberateness of music use in some participants. Conclusions:
Researcher-selected music is limited in effectiveness to a single listening session even where playlists are carefully designed to appeal to the
sample. However, consciousness-raising programs may be effective in changing the long-term listening habits of people who for whom music choice is
sub-optimal as a coping strategy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
The Arts in Psychotherapy, 51 : 46-
53
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Gest, S., Holtmann, M., Bogen, S., Schulz, C., Pniewski, B., Legenbauer, T.
Chronotherapeutics such as wake therapy and bright light therapy are well-
established methods in treating adults with depressive disorders and are additionally beneficent for sleep regulation. Few studies concerning
chronotherapeutics in juvenile depression exist, though the established treatments are insufficient and sleep disorders often co-occur. In this
study, we investigate the impact of two types of chronotherapeutics on depressive symptoms and sleep behavior in a juvenile setting. Juvenile
inpatients (n = 62) with moderate to severe depressive symptoms took part in either a combined setting consisting of one night wake therapy followed
by 2 weeks bright light therapy or in a setting of bright light therapy alone. Depressive symptoms, general psychopathology, clinical impression and
sleep behavior were measured before (T1), directly after (T2) and 2 weeks after intervention (T3). Depressive symptoms decreased while sleep quality
increased in both groups. The bright light therapy alone group showed further improvement at T3 in regards to depressive symptoms. Correlation
analyses indicated significant negative correlations between sleep quality and awaking after restorative sleep with the depressive symptoms. However,
only awaking after restorative sleep had a predictive impact on treatment outcome. The present study provides first evidence for a positive impact of
chronotherapeutic interventions on treatment outcome in depressed juvenile inpatients. Bright light therapy seems to stabilize and further enhance
reduction of depressive symptoms during follow-up, whereas one night wake therapy does not have an additional long-lasting impact on depressive
symptoms and sleep parameters.
European Child & Adolescent Psychiatry, 25(2) : 151-
61
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Bright light therapy