Disorders - depressive disorders
O'Callaghan, Paul, McMullen, John, Shannon, Ciaran, Rafferty, Harry, Black, Alastair
Objective: To assess the efficacy of trauma-focused cognitive behavioral therapy (TF-
CBT) delivered by nonclinical facilitators in reducing posttraumatic stress, depression, and anxiety and conduct problems and increasing prosocial
behavior in a group of war-affected, sexually exploited girls in a single-blind, parallel-design, randomized,+ controlled trial.; Method: Fifty-two
12- to 17-year-old, war-affected girls exposed to rape and inappropriate sexual touch in the Democratic Republic of Congo were screened for trauma,
depression and anxiety, conduct problems, and prosocial behavior. They were then randomized to a 15 session, group-based, culturally modified TF-CBT
(n = 24) group or a wait-list control group (n = 28). Primary analysis, by intention-to-treat, involving all randomly assigned participants occurred
at pre- and postintervention and at 3-month follow-up (intervention group only).; Results: Compared to the wait list control, the TF-CBT group
experienced significantly greater reductions in trauma symptoms (F(1,49) = 52.708, p<0·001, ?(p)2 = 0.518). In addition, the TF-CBT group showed a
highly significant improvement in symptoms of depression and anxiety, conduct problems, and prosocial behavior. At 3-months follow-up the effect size
(Cohen's d) for the TF-CBT group was 2.04 (trauma symptoms), 2.45 (depression and anxiety), 0.95 (conduct problems), and-1.57 (prosocial behavior).;
Conclusions: A group-based, culturally modified, TF-CBT intervention delivered by nonclinically trained Congolese facilitators resulted in a large,
statistically significant reduction in posttraumatic stress symptoms and psychosocial difficulties among war-affected girls exposed to rape or sexual
violence. Clinical trial registration information-An RCT of TF-CBT with sexually-exploited, war-affected girls in the DRC;
http://clinicaltrials.gov/; NCT01483261.; Copyright © 2013 American Academy of Child & Adolescent Psychiatry. Published by Elsevier Inc. All rights
reserved.
Journal of the
American Academy of Child & Adolescent Psychiatry, 52(4) : 359-369
- Year: 2013
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
O'Leary-Barrett, M., Topper, L., Al-
Khudhairy, N., Pihl, R.
O., Castellanos-Ryan, N., Mackie, C. J., Conrod, P. J.
Objective To assess the 2-year impact of teacher-delivered, brief, personality-targeted interventions on internalizing and
externalizing symptoms in an adolescent U.K. sample. Method This cluster-randomized trial was run in 19 London schools (N = 1,024 adolescents).
Trained school-based professionals delivered two 90-minute, CBT-based group interventions targeting 1 of 4 personality-risk profiles: anxiety
sensitivity, hopelessness, impulsivity, or sensation seeking. Self-report depression, anxiety, and conduct disorder symptoms were assessed at 6-month
intervals. Results Interventions were associated with significantly reduced depressive, anxiety, and conduct symptoms (p <.05) over 2 years in the
full sample, reduced odds of severe depressive symptoms (odds ratio [OR] = 0.74, CI = 0.58-0.96), and conduct problems (OR = 0.79, CI = 0.65-0.96),
and a nonsignificant reduction in severe anxiety symptoms (OR = 0.79, CI = 0.59-1.05). Evaluating a priori personality-specific hypotheses revealed
strong evidence for impulsivity-specific effects on severe conduct problems, modest evidence of anxiety sensitivity-specific effects on severe
anxiety, and no evidence for hopelessness-specific effects on severe depressive symptoms. Conclusions Brief, personality-targeted interventions
delivered by educational professionals can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years, as well as
personality-specific intervention effects in youth most at risk for a particular problem, particularly for youth with high levels of impulsivity.
Clinical trial registration information - Adventure: The Efficacy of Personality-Targeted Interventions for Substance Misuse and Other Risky
Behaviors as Delivered by Educational Professionals; http://clinicaltrials.gov; NCT00776685.
Journal of the
American Academy of Child & Adolescent Psychiatry, 52(9) : 911-920
- Year: 2013
- 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
Mogoase, C., Brailean, A., David, D.
It has been shown recently that a specific intervention designed to modify the overgeneralization
bias [i.e.; concreteness training (CNT)] can decrease depressive symptoms. The intervention, however, involves multiple components (e.g.; relaxation,
problem solving), so it is not clear if the increase in concrete processing is the crucial mechanism in ameliorating depressive symptoms. Using a
dismantling design, this online study examined whether targeting only concrete processing in the absence of a therapeutic context reduces depressive
symptoms. Forty-two stable dysphoric participants were randomly allocated to either a waiting list or a 7-days concreteness training condition.
Compared with the control group, concrete processing training resulted in a significant increase in the concreteness of thinking. No significant
differences in autobiographical memory specificity, depressive symptoms, or rumination, however, were obtained post-intervention between the two
groups. These findings suggest that concrete processing can be trained, but training effects may not generalize to untrained cognitive contents. The
effectiveness of CNT as a standalone treatment for depression may be limited. (copyright) 2012 Springer Science+Business Media New York.
Cognitive Therapy & Research, 37(4) : 704-712
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Parks, A. C., Szanto, R. K.
The current article discusses the potential utility of self-help books as a means of disseminating positive psychological
interventions, and presents data comparing a positive psychology-based self-help book with a cognitive-behavioral self-help book and a self-
monitoring control condition. We studied college freshmen (N=58), and argue that this population is a particularly appropriate target for well-being
intervention. Outcome measures included both indices of efficacy (depressive symptoms and life satisfaction) and effectiveness (e.g. the extent to
which participants found their assigned activities to be meaningful). The two book groups outperformed the control and were equivalently efficacious
at reducing depressive symptoms; on life satisfaction, positive self-help outperformed cognitive-behavioral, but only at 6-month follow-up. Positive
self-help was also superior to cognitive-behavioral self-help on indices of effectiveness. Possibilities for future directions are discussed, with an
emphasis on the realities of practical dissemination to both college students, and to the general public. (copyright) 2013 by Sociedad Chilena de
Psicologia Clinica.
Terapia
Psicologica, 31(1) : 141-148
- Year: 2013
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Positive
psychology, Self-help
Lampe, L., Coulston, C. M., Berk, L.
Objective: To be used in conjunction with 'Pharmacological management of unipolar depression' [Malhi et al. Acta Psychiatr Scand
2013;127(Suppl. 443):6-23] and 'Lifestyle management of unipolar depression' [Berk et al. Acta Psychiatr Scand 2013;127(Suppl. 443):38-54]. To
provide clinically relevant recommendations for the use of psychological treatments in depression derived from a literature review. Method: Medical
databases including MEDLINE and PubMed were searched for pertinent literature, with an emphasis on recent publications. Results: Structured
psychological treatments such as cognitive behaviour therapy and interpersonal therapy (IPT) have a robust evidence base for efficacy in treating
depression, even in severe cases of depression. However, they may not offer benefit as quickly as antidepressants, and maximal efficacy requires
well-trained and experienced therapists. These therapies are effective across the lifespan and may be preferred where it is desired to avoid
pharmacotherapy. In some instances, combination with pharmacotherapy may enhance outcome. Psychological therapy may have more enduring protective
effects than medication and be effective in relapse prevention. Newer structured psychological therapies such as mindfulness-based cognitive therapy
and acceptance and commitment therapy lack an extensive outcome literature, but the few published studies yielding positive outcomes suggest they
should be considered options for treatment. Conclusion: Cognitive behaviour therapy and IPT can be effective in alleviating acute depression for all
levels of severity and in maintaining improvement. Psychological treatments for depression have demonstrated efficacy across the lifespan and may
present a preferred treatment option in some groups, for example, children and adolescents and women who are pregnant or postnatal. (copyright) 2013
John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
Acta Psychiatrica Scandinavica, 127(SUPPL. 443) : 24-
37
- Year: 2013
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
McCarty, C.
A., Violette, H. D., Duong, M. T., Cruz, R. A., McCauley, E.
This study was conducted to compare the outcomes of a group-based cognitive-behavioral preventive intervention
(Positive Thoughts and Actions [PTA]) tailored to youth in middle school with a brief, individually administered supportive intervention (Individual
Support Program [ISP]). A randomized, controlled trial was conducted with 120 early adolescents (72 girls, 48 boys; age = 11-15 years) who had
elevated depressive symptoms and were selected from a school-based population. Measures of internalizing problems, externalizing problems, personal
adjustment, school problems, and interpersonal relations were obtained from parents, youth, and/or teachers at preintervention (Time 1) and
postintervention (Time 2, 5-7 months after preintervention). General linear model repeated measures analyses yielded a significant Group null Time
interaction on youth-reported, but not parent-reported, depressive symptoms and internalizing symptoms. Youth in the PTA group showed greater
decreases following intervention compared to youth who received ISP, yielding effect sizes (Cohen's d) of 0.36 for depressive symptoms, 95% CI
[-.02,.73], and 0.44, 95% CI [.05,.82], for internalizing symptoms. PTA youth also showed improvements in their personal adjustment (sense of
inadequacy, self-esteem), and parent-reported social skills, but no differences emerged between groups for externalizing symptoms, school problems,
or interpersonal relationships. Cognitive-behavioral preventive interventions in which youth engage in personal goal-setting and practice social-
emotional skills, such as PTA, may be beneficial for the reduction of depressive symptoms over and above general support and empathy. (copyright)
2013 Copyright Taylor and Francis Group, LLC.
Journal of Clinical Child & Adolescent Psychology, 42(4) : 554-
563
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Supportive
therapy
Melnyk, B. M., Jacobson, D., Kelly, S., Belyea, M., Shaibi, G., Small, L., O'Haver, J., Marsiglia, F. F.
Background: Although
obesity and mental health disorders are two major public health problems in adolescents that affect academic performance, few rigorously designed
experimental studies have been conducted in high schools. Purpose: The goal of the study was to test the efficacy of the COPE (Creating Opportunities
for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program, versus an attention control program (Healthy
Teens) on: healthy lifestyle behaviors, BMI, mental health, social skills, and academic performance of high school adolescents immediately after and
at 6 months post-intervention. Design: A cluster RCT was conducted. Data were collected from January 2010 to May of 2012 and analyzed in 2012-2013.
Setting/participants: A total of 779 culturally diverse adolescents in the U.S. Southwest participated in the trial. Intervention: COPE was a
cognitive-behavioral skills-building intervention with 20 minutes of physical activity integrated into a health course, taught by teachers once a
week for 15 weeks. The attention control program was a 15-session, 15-week program that covered common health topics. Main outcome measures: Primary
outcomes assessed immediately after and 6 months post-intervention were healthy lifestyle behaviors and BMI. Secondary outcomes included mental
health, alcohol and drug use, social skills, and academic performance. Results: Post-intervention, COPE teens had a greater number of steps per day
(p=0.03) and a lower BMI (p=0.01) than did those in Healthy Teens, and higher average scores on all Social Skills Rating System subscales (p-values
<0.05). Teens in the COPE group with extremely elevated depression scores at pre-intervention had significantly lower depression scores than the
Healthy Teens group (p=0.02). Alcohol use was 12.96% in the COPE group and 19.94% in the Healthy Teens group (p=0.04). COPE teens had higher health
course grades than did control teens. At 6 months post-intervention, COPE teens had a lower mean BMI than teens in Healthy Teens (COPE=24.72, Healthy
Teens=25.05, adjusted M=-0.34, 95% CI=-0.56, -0.11). The proportion of those overweight was significantly different from pre-intervention to 6-month
follow-up (chi-square=4.69, p=0.03), with COPE decreasing the proportion of overweight teens, versus an increase in overweight in control
adolescents. There also was a trend for COPE Teens to report less alcohol use at 6 months (p=0.06). Conclusions: COPE can improve short- and more
long-term outcomes in high school teens. (copyright) 2013 American Journal of Preventive Medicine.
American Journal of Preventive Medicine, 45(4) : 407-415
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Physical activity, exercise
Muriungi, S.
K., Ndetei, D. M.
Objective. To determine the effectiveness of psycho-education on symptom severity in depression, hopelessness, suicidality,
anxiety and risk of substance abuse among para-medical students at Kenya Medical Training College (KMTC). Methodology. A clinical trial drew
experimental (N=1 181) and control (N=1 926) groups from different KMTC campuses. Self-administered questionnaires were used to collect data: the
researcher-designed social demographic questionnaire was used at baseline only, while Beck's Depression Inventory, Beck's Hopelessness Scale,
Beck's Suicide Ideation Scale, Beck's Anxiety Inventory and World Health Organization alcohol, smoking and substance involvement screening test
(ASSIST) (for drug abuse) were used for baseline, mid-point and end-point assessments at 3-month intervals. The experimental group received a total
of 16 hours of structured psycho-education. All study participants gave informed consent. Results. Overall, there was no significant reduction in
symptom severity between the experimental and control groups at 3 months (p>0.05) but there was a significant difference at 6 months (p<0.05).
Conclusion. Psycho-education was effective in reducing the severity of symptoms of depression, hopelessness, suicidality, anxiety and risk of
substance abuse at 6 months.
South African Journal of Psychiatry, 19(2) : 41-
50
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Lewandowski, R. E., Acri, M.C., Hoagwood, K.
E., Olfson, M., Clarke, G., Gardner, W., Scholle, S. H., Byron, S., Kelleher, K., Pincus, H. A., Frank, S., Horwitz, S. M.,
Adolescent depression is a prevalent and disabling
condition resulting in emotional suffering and social and educational dysfunction. Care for adolescent depression is suboptimal and could be improved
through the development and use of quality indicators (QIs). This article reports on the development of a care pathway and QIs for the primary and
specialty care management of adolescent depression from case identification through symptom remission. It presents evidence from a review of
adolescent clinical practice guidelines and research literature to support QIs at critical nodes in the pathway, and describes implications for
practice based on existing evidence. Barriers to measure development are identified, including gaps in empirical evidence, and a research agenda is
suggested. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)
Pediatrics, 132(4) : e996-
e1009
- Year: 2013
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement
Lewis, K. M., Dubois, D. L., Bavarian, N., Acock, A., Silverthorn, N., Day, J., Ji, P., Vuchinich, S., Flay, B. R.
Purpose We examined the
effects of Positive Action (PA), a school-based social-emotional learning and health promotion program, on the emotional health of predominately
low-income and ethnic minority urban youth. Methods The study was a matched-pair, cluster-randomized controlled trial involving 14 Chicago public
schools. Outcomes were assessed over a 6-year period of program implementation for a cohort of youth in each school, followed from grades 3 to 8.
Youth reported on their emotional health (positive affect, life satisfaction, depression, anxiety) and social-emotional and character development.
Growth-curve and structural-equation modeling analyses assessed overall program effects on the emotional health outcomes as well as mediation of
these effects via the program's impact on youths' social-emotional and character development. Results Students in PA schools, compared with those
in control schools, had more favorable change over the course of the study in positive affect (standardized mean difference effect size [ES] =.17)
and life satisfaction (ES =.13) as well as significantly lower depression (ES = -.14) and anxiety (ES = -.26) at study end point. Program effects for
positive affect, depression, and anxiety were mediated by more favorable change over time in social-emotional and character development for students
in PA schools. Conclusions Results suggest that universal, school-based programs can benefit the emotional health of youth in low-income, urban
settings. The modest magnitude of effects over an extended period of program implementation, however, reflects the challenges of both mounting
interventions and offsetting formidable risks for mental health problems in such environments. (copyright) 2013 Society for Adolescent Health and
Medicine. All rights reserved.
Journal of Adolescent Health, 53(6) : 706-
711
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Lee, R. S. C., Redoblado-Hodge, M. A., Naismith, S. L., Hermens, D. F., Porter, M. A., Hickie, I. B.
Background: Cognitive remediation
(CR) is an effective treatment for several psychiatric disorders. To date, there have been no published studies examining solely first-episode
psychiatric cohorts, despite the merits demonstrated by early intervention CR studies. The current study aimed to assess the effectiveness of CR in
patients with a first-episode of either major depression or psychosis. Method: Fifty-five patients (mean age=22.8 years, S.D.=4.3) were randomly
assigned to either CR (n = 28) or treatment as usual (TAU; n = 27). CR involved once-weekly 2-h sessions for a total of 10 weeks. Patients were
comprehensively assessed before and after treatment. Thirty-six patients completed the study, and analyses were conducted using an intent-to-treat
(ITT) approach with all available data. Results: In comparison to TAU, CR was associated with improved immediate learning and memory controlling for
diagnosis and baseline differences. Similarly, CR patients demonstrated greater improvements than TAU patients in psychosocial functioning
irrespective of diagnosis. Delayed learning and memory improvements mediated the effect of treatment on psychosocial functioning at a marginal level.
Conclusions: CR improves memory and psychosocial outcome in first-episode psychiatric out-patients for both depression and psychosis. Memory
potentially mediated the functional gains observed. Future studies need to build on the current findings in larger samples using blinded allocation
and should incorporate longitudinal follow-up and assessment of potential moderators (e.g. social cognition, self-efficacy) to examine sustainability
and the precise mechanisms of CR effects respectively. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Psychological Medicine, 43(6) : 1161-1173
- Year: 2013
- Problem: Depressive Disorders, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), First episode (psychosis only)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy
Kuyken, W., Weare, K., Ukoumunne, O. C., Vicary, R., Motton, N., Burnett, R., Cullen, C., Hennelly, S., Huppert, F.
Background: Mindfulness-based approaches for adults are effective at enhancing mental health, but few controlled trials have
evaluated their effectiveness among young people. Aims: To assess the acceptability and efficacy of a schools-based universal mindfulness
intervention to enhance mental health and well-being. Method: A total of 522 young people aged 12-16 in 12 secondary schools either participated in
the Mindfulness in Schools Programme (intervention) or took part in the usual school curriculum (control). Results: Rates of acceptability were high.
Relative to the controls, and after adjusting for baseline imbalances, children who participated in the intervention reported fewer depressive
symptoms post-treatment (P = 0.004) and at follow-up (P = 0.005) and lower stress (P = 0.05) and greater well-being (P = 0.05) at follow-up. The
degree to which students in the intervention group practised the mindfulness skills was associated with better well-being (P50.001) and less stress
(P = 0.03) at 3-month follow-up. Conclusions: The findings provide promising evidence of the programme's acceptability and efficacy.
British Journal of
Psychiatry, 203(2) : 126-131
- Year: 2013
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy