Disorders - depressive disorders
Sharpley, A. L., Hockney, R., McPeake, L., Geddes, J. R., Cowen, P. J.
Background Clinical mood disorders often become clinically manifest in the later teenage years and early
twenties and can be associated with a poor long-term prognosis. The primary prevention of these disorders would therefore have great public health
value. Nutritional supplements are a feasible intervention for primary prevention and several epidemiological studies have indicated links between
low folate status and depressive symptomatology in the general population. Method A randomised, double blind, parallel group, placebo-controlled
trial in which participants, aged 14-24 years, at increased familial risk of mood disorder, were randomised to folic acid (2.5 mg daily) or identical
placebo liquid for a maximum of 36 months. Primary outcome data (the onset of a DSM-IV mood disorder) were collected from 112 participants; 56 per
group. Results The incidence of mood disorder in the folic acid and placebo groups were 14.3% and 17.9% respectively, a non-significant difference.
However, there was post-hoc evidence that folic acid delayed the time to onset of mood disorder in those participants who became unwell. Limitations
Small sample size and rate of onset of mood disorders lower than expected. Conclusions Although long term folic acid supplementation was well
tolerated, with high levels of adherence, there was no evidence that it reduced the incidence of mood disorder compared to those taking placebo.
(copyright) 2014 Elsevier B.V.
Journal of Affective Disorders, 167 : 306-311
- Year: 2014
- Problem: Bipolar Disorders, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Shirk, S. R., DePrince, A. P., Crisostomo, P. S., Labus, J.
Four clinical trials have shown that
a history of interpersonal trauma is associated with diminished response to cognitive-behavioral therapy (CBT) for adolescent depression. An
efficacious CBT protocol for adolescent depression was modified to address cognitive deficits and distortions associated with interpersonal trauma.
Initial feasibility, acceptability, and treatment impact of the modified treatment (m-CBT) were evaluated in a randomized effectiveness trial
conducted in community clinics. Clients were 43 referred adolescents with a depressive disorder and a history of interpersonal trauma. Adolescents
either received m-CBT or usual care (UC) therapy. Results indicated that m-CBT was delivered with good fidelity by community clinicians, but that
number of sessions completed was attenuated in both m-CBT and UC. Adolescents reported high levels of treatment satisfaction and acceptability for
the new treatment. There were significant reductions in depressive symptoms over time, but no differences in outcomes between groups. Although the
new treatment produced promising results, it did not outperform UC. Implications for treatment development are considered. (copyright) 2013 American
Psychological Association.
Psychotherapy, 51(1) : 167-179
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Spence, S. H., Sawyer, M.
G., Sheffield, J., Patton, G., Bond, L., Graetz, B., Kay, D.
To date, universal, school-based interventions have produced limited success in the long-term prevention of depression
in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention
for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of
secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based
intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but
significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention
group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family
relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also
found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables
that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of
universal versus targeted approaches to the prevention of depression. (copyright) 2014 by the authors; licensee MDPI, Basel, Switzerland.
International Journal
of Environmental Research & Public Health, 11(5) : 5113-5132
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Zhou, X., Michael, K. D., Liu, Y., Del-Giovane, C., Qin,
B., Cohen, D., Gentile, S., Xie, P.
Background: Current guidelines for treatment-resistant depression in adolescents remain inadequate. This study
aimed to systematically review the management of treatment-resistant depression in adolescent patients. Methods: We conducted an electronic database
search of PUBMED, EMBASE, Cochrane, Web of Science and PsycINFO for studies with adolescent treatment-resistant depression published up to January
2014. Treatment-resistant depression was defined as failure to respond to at least one course of psychological or pharmacological treatment for
depression with an adequate dosage, duration, and appropriate compliance during the current illness episode. The Cochrane risk-of-bias method was
used to assess the quality of randomized controlled trials. A meta-analysis of all active treatments was conducted. Results: Eight studies with 411
depressed adolescents that fit predetermined criteria investigated pharmacological treatments and psychotherapies. Six were open-label studies, and
two were randomized controlled trials. The overall response rate for all active treatments investigated was 46% (95% CI 33 to 59; N = 411) with a
moderately high degree of heterogeneity (I2 = 76.1%, 95% CI = 47%-86%). When only the two randomized trials were included, the overall response rate
of active treatment was 53% (95% CI = 38-67; N = 347). In these randomized trials, SSRI therapy plus CBT was significantly more effective than SSRI
therapy alone, while amitriptyline was not more effective than placebo. Conclusions: Approximately half of the adolescents who presented with
treatment-refractory depression responded to active treatment, which suggests that practitioners should remain persistent in managing these
challenging cases. The combination of antidepressant medication and psychotherapy should be recommended for adolescents who present with treatment-
resistant depression.
BMC Psychiatry, 14(1) :
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Treatment resistant/treatment refractory
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants
Spielmans, G. I., Gerwig, K.
Background: Recent meta-analyses of
the efficacy of second-generation antidepressants for youth have concluded that such drugs possess a statistically significant advantage over placebo
in terms of clinician-rated depressive symptoms. However, no meta-analysis has included measures of quality of life, global mental health, self-
esteem, or autonomy. Further, prior meta-analyses have not included self-reports of depressive symptoms. Methods: Studies were selected through
searching Medline, PsycINFO, and the Cochrane Central Register for Controlled Trials databases as well as GlaxoSmithKline's online trial registry.
We included self-reports of depressive symptoms and pooled measures of quality of life, global mental health, self-esteem, and autonomous functioning
as a proxy for overall well-being. Results: We found a nonsignificant difference between second-generation antidepressants and placebo in terms of
self-reported depressive symptoms (k = 6 trials, g = 0.06, p = 0.36). Further, pooled across measures of quality of life, global mental health,
self-esteem, and autonomy, antidepressants yielded no significant advantage over placebo (k = 3 trials, g = 0.11, p = 0.13). Discussion: Though
limited by a small number of trials, our analyses suggest that antidepressants offer little to no benefit in improving overall well-being among
depressed children and adolescents. (copyright) 2014 S. Karger AG, Basel.
Psychotherapy & Psychosomatics, 83(3) : 158-
164
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Zaunmuller, L., Lutz, W., Strauman, T. J.
METHOD: Participants (N = 92) who
reported either low or high levels of dysphoric symptoms were randomly assigned to the restructuring microintervention, a control intervention or a
no-intervention condition. We obtained recordings of event-related potentials (ERPs) as well as mood self-ratings during an experimental session
immediately after the psychotherapeutic microintervention and the control intervention in which a set of negatively valenced pictures (IAPS) was
presented with different instructions.\rRESULTS: Whereas the restructuring intervention group and the control intervention group reported both
increases in positive and decreases in negative affect from pre- to post-intervention, the three groups differed significantly on ERP measures.
\rCONCLUSIONS: Findings provide support for current models of mechanisms of action in cognitive therapies.\rOBJECTIVE: Psychotherapy for depression
emphasizes techniques that can help individuals regulate their moods. The present study investigated the affective impact and electrocortical
correlates of cognitive restructuring, delivered as a 90-minute psychotherapeutic microintervention in a dysphoric sample.
Psychotherapy Research, 24(5) : 550-
564
- Year: 2014
- 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)
Sandler, I., Wolchik, S. A., Cruden, G., Mahrer, N. E., Ahn, S., Brincks, A., Brown, C. H.
This review presents findings from an overview of meta-analyses of the effects of
prevention and promotion programs to prevent mental health, substance use, and conduct problems. The review of 48 meta-analyses found small but
significant changes that reduce depression, anxiety, antisocial behavior, and substance use. Furthermore, the results were sustained over time.
Meta-analyses often found that the effects were heterogeneous. A conceptual model is proposed to guide the study of moderators of program effects in
future meta-analyses, and methodological issues in synthesizing findings across preventive interventions are discussed.;
Annual Review of
Clinical Psychology, 10 : 243-273
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Riper, H., Andersson, G., Hunter, S. B., de-Wit, J., Berking, M., Cuijpers, P.
Background and Aims: To review published studies on the effectiveness
of combining cognitive-behavioural therapy (CBT) and motivational interviewing (MI) to treat comorbid clinical and subclinical alcohol use disorder
(AUD) and major depression (MDD) and estimate the effect of this compared with usual care.; Methods: We conducted systematic literature searches in
PubMed, PsycINFO and Embase up to June 2013 and identified additional studies through cross-references in included studies and systematic reviews.
Twelve studies comprising 1721 patients met our inclusion criteria. The studies had sufficient statistical power to detect small effect sizes.;
Results: CBT/MI proved effective for treating subclinical and clinical AUD and MDD compared with controls, with small overall effect sizes at post-
treatment [g=0.17, confidence interval (CI)=0.07-0.28, P<0.001 for decrease of alcohol consumption and g=0.27, CI: 0.13-0.41, P<0.001 for decrease of
symptoms of depression, respectively]. Subgroup analyses revealed no significant differences for both AUD and MDD. However, digital interventions
showed a higher effect size for depression than face-to-face interventions (g=?0.73 and g=0.23, respectively, P=0.030).; Conclusions: Combined
cognitive-behavioural therapy and motivational interviewing for clinical or subclinical depressive and alcohol use disorders has a small but
clinically significant effect in treatment outcomes compared with treatment as usual.; © 2013 The Authors. Addiction published by John Wiley & Sons
Ltd on behalf of Society for the Study of Addiction.
Addiction (Abingdon,
England), 109(3) : 394-406
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy
Sadr-
Mohammadi, R., Kalantari, M., Molavi, H.
Objective: The aim was to
investigate the efficacy of life skills training on subjective well-being (SWB) among high school females. Method(s): The population study comprised
all female high school of Rafsanjan, Iran, in 2008-2009. Thirty students with the lowest scores according to the Molavi's SWB questionnaire were
considered eligible. At the next stage, the required sample of 30 students were selected randomly and divided into two groups of experimental (15
subjects) and control (15 subjects). Then, life skills training sessions were started for the experimental group (eight sessions in a 4-week period).
Control group did not receive any intervention. The method of data processing at a descriptive level was through using central tendency indicators,
dispersion, frequency, and percentage. Student's t-test was used for analysis of independent variables. Result(s): The greatest R2 (0.48)
was observed for SWB. The R2 coefficients for neurosis, stress-depression, vitality, and life determination were 0.27, 0.15, 0.20, and
0.09, respectively. Conclusion(s): Life skills training showed the greatest effect regarding SWB of the students. Copyright © 2014, Brieflands. All
rights reserved.
Iranian Journal of Psychiatry and Behavioral
Sciences, 8(2) : 63-67
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Soutullo, C., Figueroa-Quintana, A.
Major depressive
disorder (MDD) in children and adolescents is a public health problem that requires evidence-based management. Our objective is to review available
studies, with a PubMed search, and briefly summarize safety and efficacy results of (mostly SSRI) antidepressants in children and adolescents with
MDD. Fluoxetine and escitalopram are safe and effective in the treatment of MDD in children and adolescents both in reduction of symptoms, and in
remission/response rates. However, response rates are lower than for non-OCD anxiety. Sertraline also had positive results in one study that pooled
results from two studies. The number needed to treat (NNT) for MDD is 10, and the number needed to harm (NNH) for suicidality is 112. Methodological
limitations in the studies include, mainly, high placebo response rates, associated with multiple study sites, younger patients, and lower MDD
severity. Treatment should be maintained close to 1 year after remission, to prevent relapse. FDA-approved fluoxetine and escitalopram are safe and
effective in the treatment of pediatric MDD. Sertraline also has some data supporting its efficacy and safety, but is not FDA-approved. The possible
modest increase in suicidal ideation in some patients should be known by clinicians, but the risk/benefit ratio is 1 to 11.2 times favorable to using
SSRIs in moderate to severe MDD. (copyright) 2013 Springer Science+Business Media New York.
Current Psychiatry
Reports, 15(7) :
- Year: 2013
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Tetracyclic antidepressants (TECA/NSSAs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs)
Sheets, E. S., Wilcoxon-Craighead, L., Brosse, A. L., Hauser, M., Madsen, J. W., Edward-Craighead,
W.
Background: Among the most serious sequelae to an
initial episode of Major Depressive Disorder (MDD) during adolescence is the significant increase in the probability of recurrence. This study
reports on an integrated CBT/IPT program, provided in a group format, that was developed to decrease the rate of MDD recurrence in emerging adults.
Methods: Participants were 89 young adults who were not depressed at study entry but had experienced MDD during adolescence. Participants were
assigned to a CBT/IPT prevention program or to an assessment only control condition and were followed through the first 2 years of college. Results:
Risk for MDD recurrence was reduced more than 50% for the prevention program participants compared to assessment only controls. The intervention also
conferred beneficial effects on academic performance for those students who completed the majority of the group sessions. Limitations: The study
included a self-selected sample of emerging adults who were aware of their history of depression. Due to the small sample size, it will be important
to evaluate similar interventions in adequately-powered trials to determine if this is a replicable finding. Conclusions: With 51% of the assessment
only participants experiencing a MDD recurrence during the first 2 years of college, these findings support the need for programs designed to prevent
MDD recurrence in young adults. The current program, based on IPT and CBT principles, appears to reduce the rate of MDD recurrence among previously
depressed emerging adults. (copyright) 2012 Elsevier B.V. All rights reserved.
Journal of Affective Disorders, 147(1-3) : 425-
430
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Relapse prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Interpersonal therapy (IPT)
Rooney, R., Hassan, S., Kane, R., Roberts, C. M., Nesa, M.
The Aussie Optimism: Positive Thinking Skills Program (AOP-PTS) is an innovative curriculum-based mental health promotion
program based on cognitive and behavioural strategies. The program is aimed at preventing depressive and anxiety symptoms and disorders in middle
primary school children aged 9-10 years. Students from 22 low SES primary schools ( N=910) were randomly assigned to an intervention or a control
group and assessed at baseline, post-test, 6 months and 18 months. The intervention group received the program implemented by teachers and the
control group received their regular Health Education curriculum. Students completed questionnaires on depression, anxiety, and attribution style. At
risk students were further assessed with the computerised Diagnostic Interview for Children and Adolescents. Parents reported on their children's
externalising and internalising problems at home. Children in the intervention condition reported a significant pre-post reduction in depressive
symptoms, and there was a significant pre-post reduction in parent-reported emotional difficulties which was maintained at 6 month follow-up; no
changes were evident in the control group. Both groups showed significant improvements in child-reported anxiety and attribution style, and
significant improvements in parent-reported pro-social behaviours. For both groups, there were no significant post-baseline changes in incidence and
recovery rates for depression, anxiety, or internalising symptoms. These findings suggest that AOP-PTS has the potential to treat depressive
symptomatology in the immediate term but the effects were not sustained. There is also evidence of improved emotional resilience up to 6 months
following the program. Further follow-up to investigate longer term effects is needed. (copyright) 2013 Elsevier Ltd.
Behaviour Research & Therapy, 51(12) : 845-854
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions