Disorders - depressive disorders
Dray, J., Bowman, J., Campbell, E., Freund, M., Wolfenden, L., Hodder, R. K., McElwaine, K., Tremain, D., Bartlem, K., Bailey, J., Small, T., Palazzi, K., Oldmeadow, C., Wiggers, J.
Objective To examine the effect of universal, school-based,
resilience-focused interventions on mental health problems in children and adolescents. Method Eligible studies were randomized controlled trials
(RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and
included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015.
Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing
problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child:
5-10 years; adolescent: 11-18 years), length of follow-up (short: post-<=12 months; long: >12 months), and gender (narrative). Results A total of 57
included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were
effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general
psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological
distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up,
interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes),
interventions were effective for internalizing problems. Conclusion The findings may suggest most promise for using universal resilience-focused
interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-
behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups,
the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what
intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains
an important area for future research. Systematic review protocol and registration Systematic Review of Universal Resilience Interventions Targeting
Child and Adolescent Mental Health in the School Setting; http://dx.doi.org/10.1186/s13643-015-0172-6; PROSPERO CRD42015025908. Copyright © 2017
American Academy of Child and Adolescent Psychiatry
Journal of the
American Academy of Child & Adolescent Psychiatry, 56(10) : 813-824
- Year: 2017
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Bernecker, S. L., Coyne, A. E., Constantino,
M. J., Ravitz, P.
The
efficacy of interpersonal psychotherapy (IPT) to treat depression and other disorders is well established, yet it remains unknown which patients will
benefit more from IPT than another treatment. This review summarizes 46 years of clinical trial research on patient characteristics that moderate the
relative efficacy of IPT vs. different treatments. Across 57 studies from 33 trials comparing IPT to pharmacotherapy, another psychotherapy, or
control, there were few consistent indicators of when IPT would be more or less effective than another treatment. However, IPT may be superior to
school counseling for adolescents with elevated interpersonal conflict, and to minimal controls for patients with severe depression. Cognitive-
behavioral therapy may outpace IPT for patients with avoidant personality disorder symptoms. There was some preliminary evidence that IPT is more
beneficial than alternatives for patients in some age groups, African-American patients, and patients in an index episode of depression. The included
studies suffered from several limitations and high risk of Type I and II error. Obstacles that may explain the difficulty in identifying consistent
moderators, including low statistical power and heterogeneity in samples and treatments, are discussed. Possible remedies include within-subjects
designs, manipulation of single treatment ingredients, and strategies for increasing power such as improving measurement. Copyright © 2017 Elsevier
Ltd
Clinical Psychology Review, 56 : 82-93
- Year: 2017
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT)
Chi, X., Bo, A., Liu, T., Zhang, P., Chi, I.
This systematic review and meta-analysis
evaluated the effects of mindfulness-based stress reduction (MBSR) for intervention in youth depression. Electronic databases and references in
articles were searched. Randomized controlled trials evaluating MBSR and reporting outcomes for depressive symptoms among youth aged 12- 25 years
were included. Two reviewers independently conducted title and abstract screening, full text screening, data extraction, and risk of bias assessment.
Standardized mean differences with 95% confidence interval were calculated to represent intervention effects. Ten randomized controlled trials
featuring 985 participants were included in the meta-analysis. Effect-size estimates suggested that MBSR was moderately effective at the end of
intervention (SMD = -.52) and slightly effective at short-term follow-up (SMD = -.24) and long-term follow-up (SMD = -.15). In conclusion, MBSR is
effective in reducing youth depression, although the long-term effect appears weak.
Quality of Life Research, 26 (1 Supplement 1) : 11
- Year: 2017
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Conejo-Ceron, S., Moreno-Peral, P., Rodriguez-Morejon,
A., Motrico, E., Navas-Campana, D., Rigabert, A., Martin-Perez, C., Rodriguez-Bayon, A., Ballesta-Rodriguez, M. I., Luna, J. D., Garcia-Campayo, J., Roca, M., Bellon,
J. A.
PURPOSE:
Although evidence exists for the efficacy of psychosocial interventions to prevent the onset of depression, little is known about its prevention in
primary care. We aimed to evaluate the effectiveness of psychological and educational interventions to prevent depression in primary care.\rMETHODS:
We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs) examining the effect of psychological and
educational interventions to prevent depression in nondepressed primary care attendees. We searched MEDLINE, PsycINFO, Web of Science, OpenGrey
Repository, Cochrane Central Register of Controlled Trials, and other sources up to May 2016. At least 2 reviewers independently evaluated the
eligibility criteria, extracted data, and assessed the risk of bias. We calculated standardized mean differences (SMD) using random-effects models.
\rRESULTS: We selected 14 studies (7,365 patients) that met the inclusion criteria, 13 of which were valid to perform a meta-analysis. Most of the
interventions had a cognitive-behavioral orientation, and in only 4 RCTs were the intervention clinicians primary care staff. The pooled SMD was -
0.163 (95%CI, -0.256 to -0.070; P = .001). The risk of bias and the heterogeneity (I2 = 20.6%) were low, and there was no evidence of
publication bias. Meta-regression detected no association between SMD and follow-up times or SMD and risk of bias. Subgroup analysis suggested
greater effectiveness when the RCTs used care as usual as the comparator compared with those using placebo.\rCONCLUSIONS: Psychological and
educational interventions to prevent depression had a modest though statistically significant preventive effect in primary care. Further RCTs using
placebo or active comparators are needed.
Annals of Family
Medicine, 15(3) : 262-271
- Year: 2017
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Psychoeducation, Other service delivery and improvement
interventions
Xu, L., Liu,
H.
This study tested the efficacy of an 8-weeks Rational Emotive Behavior Therapy (REBT) programme on adjusted
irrational beliefs and mental symptoms. The sample of 60 female college students was randomly assigned to a REBT (n = 25) and non-REBT group (n =
35). We expected increase mental symptoms in the non-REBT group, but not in the REBT group, due to the REBT programme intervention. According to our
data, adjusted irrational beliefs increased in the REBT group but remained unchanged in the non-REBT group. Even a REBT programme intervention of 8-
sessions can protect female college students from an increase in mental symptoms during the university period. Copyright © 2018, Anka Publishers. All
rights reserved.
NeuroQuantology, 15(4) : 156-161
- Year: 2017
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Whittaker, R., Stasiak, K., McDowell, H., Doherty, I., Shepherd, M., Chua, S., Dorey, E., Parag, V., Ameratunga, S., Rodgers, A., Merry, S.
BACKGROUND: Depression often starts in adolescence making it
an ideal time to intervene. We developed a universal cognitive behavioural therapy-based programme (MEMO CBT) to be delivered via multimedia mobile
phone messages for teens.\rMETHODS: We conducted a prospective multicentre, randomised, placebo-controlled superiority trial in 15 high schools in
Auckland, New Zealand, comparing MEMO CBT with a control programme [MEMO control] matched for intensity and type of message but with alternative
content not targeting depression. The primary outcome was the change in score on the Children's Depression Rating Scale-Revised from baseline to 12
months. Secondary outcomes included the change in scores in the self-reported Reynold's Adolescent Depression Rating Scale-Second Edition, the Moods
and Feelings Questionnaire, suicidal ideation using selected items from the Youth Risk Behaviour Survey, the Pediatric Quality of Life questionnaire,
12-month period prevalence of the diagnosis of depressive disorder using the Kiddie-Schedule for Affective Disorders and Schizophrenia, and
students' ratings of their satisfaction with the programme.\rRESULTS: Eight hundred and fifty-five students (13-17 years old, mean 14.3 years) were
randomly assigned to MEMO CBT (426) or to MEMO Control (429). Participants (68% female) had a mean CDRS-R at baseline of 21.5 (SD: 5). Overall 394
(93%) from the intervention group and 392 (91%) from the control group were followed up at 12 months. At the end of the intervention (approximately 9
weeks) the mean CDRS-R scores were 20.8 in the intervention group versus 20.4 in the control group, and at 12 months they were 22.4 versus 22.4 (p
value for difference in change from baseline = 0.3). There was no obvious association between the amount of the intervention viewed by participants
and outcomes.\rCONCLUSIONS: There was no evidence of benefit from the mobile phone CBT intervention compared with a control programme. Universal
depression prevention remains a challenge.
Journal of Child Psychology & Psychiatry & Allied Disciplines, 58(9) : 1014-
1022
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Wilkes, C., Kydd, R., Sagar, M., Broadbent, E.
BACKGROUND AND
OBJECTIVES: Slumped posture is a diagnostic feature of depression. While research shows upright posture improves self-esteem and mood in healthy
samples, little research has investigated this in depressed samples. This study aimed to investigate whether changing posture could reduce negative
affect and fatigue in people with mild to moderate depression undergoing a stressful task.\rMETHODS: Sixty-one community participants who screened
positive for mild to moderate depression were recruited into a study purportedly on the effects of physiotherapy tape on cognitive function. They
were randomized to sit with usual posture or upright posture and physiotherapy tape was applied. Participants completed the Trier Social Stress Test
speech task. Changes in affect and fatigue were assessed. The words spoken by the participants during their speeches were analysed.\rRESULTS: At
baseline, all participants had significantly more slumped posture than normative data. The postural manipulation significantly improved posture and
increased high arousal positive affect and fatigue compared to usual posture. The upright group spoke significantly more words than the usual posture
group, used fewer first person singular personal pronouns, but more sadness words. Upright shoulder angle was associated with lower negative affect
and lower anxiety across both groups.\rLIMITATIONS: The experiment was only brief and a non-clinical sample was used.\rCONCLUSIONS: This preliminary
study suggests that adopting an upright posture may increase positive affect, reduce fatigue, and decrease self-focus in people with mild-to-moderate
depression. Future research should investigate postural manipulations over a longer time period and in samples with clinically diagnosed
depression.
Journal of Behavior Therapy &
Experimental Psychiatry, 54 : 143-149
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Weersing, V. R., Brent, D. A., Rozenman, M. S., Gonzalez, A., Jeffreys, M., Dickerson, J. F., Lynch, F. L., Porta, G., Iyengar, S.
Importance: Anxiety and depression affect 30% of youth but
are markedly undertreated compared with other mental disorders, especially in Hispanic populations.\rObjective: To examine whether a pediatrics-based
behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health
care.\rDesign, Setting, and Participants: This 2-center randomized clinical trial with masked outcome assessment conducted between brief behavioral
therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8.0-16.9 years) from 9 pediatric clinics in San Diego, California, and
Pittsburgh, Pennsylvania, recruited from October 6, 2010, through December 5, 2014. Youths who met DSM-IV criteria for full or probable diagnoses of
separation anxiety disorder, generalized anxiety disorder, social phobia, major depression, dysthymic disorder, and/or minor depression; lived with a
consenting legal guardian for at least 6 months; and spoke English were included in the study. Exclusions included receipt of alternate treatment for
anxiety or depression, presence of a suicidal plan, bipolar disorder, psychosis, posttraumatic stress disorder, substance dependence, current abuse,
intellectual disability, or unstable serious physical illness.\rInterventions: The BBT consisted of 8 to 12 weekly 45-minute sessions of behavioral
therapy delivered in pediatric clinics by master's-level clinicians. The ARC families received personalized referrals to mental health care and
check-in calls to support accessing care from master's-level coordinators.\rMain Outcomes and Measures: The primary outcome was clinically
significant improvement on the Clinical Global Impression-Improvement scale (score <=2). Secondary outcomes included the Pediatric Anxiety Rating
Scale, Children's Depression Rating Scale-Revised, and functioning.\rResults: A total of 185 patients were enrolled in the study (mean [SD] age,
11.3 [2.6] years; 107 [57.8%] female; 144 [77.8%] white; and 38 [20.7%] Hispanic). Youths in the BBT group (n=95), compared with those in the ARC
group (n=90), had significantly higher rates of clinical improvement (56.8% vs 28.2%; chi21=13.09, P<.001; number needed to treat, 4), greater
reductions in symptoms (F2,146=5.72; P=.004; Cohen f=0.28), and better functioning (mean [SD], 68.5 [10.7] vs 61.9 [11.9]; t156=3.64; P<.001; Cohen
d=0.58). Ethnicity moderated outcomes, with Hispanic youth having substantially stronger response to BBT (76.5%) than ARC (7.1%) (chi21=14.90;
P<.001; number needed to treat, 2). Effects were robust across sites.\rConclusions and Relevance: A pediatric-based brief behavioral intervention for
anxiety and depression is associated with benefits superior to those of assisted referral to outpatient mental health care. Effects were especially
strong for Hispanic participants, suggesting that the protocol may be a useful tool in addressing ethnic disparities in care.\rTrial Registration:
clinicaltrials.gov Identifier: NCT01147614.
JAMA Psychiatry, 74(6) : 571-
578
- Year: 2017
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Sun, Q., Cui, C., Fu, Y., Ma, S., Li, H.
The purpose of this study was to
investigate the correlation between brain-derived neurotrophic factor (BDNF) in serum and depression in children, and explore the effects of
different nursing protocols on patients with low levels of BDNF. We recruited 128 children with depression and 50 healthy subjects. Compared with
healthy controls, the mRNA and protein levels of BDNF in serum were lower in children with depression (p<0.01). We selected 60 depressed children
with low BDNF and randomly divided them in two groups: comprehensive nursing (n=30) and regular nursing (n=30). Compared to healthy children, there
was a significant increase in Hamilton depression (HAMD) scores in patients with depression in childhood (p<0.01). After treatment, BDNF protein
expression was higher in the comprehensive nursing group than that in the regular nursing group (p<0.05). Also, the HAMD score in the comprehensive
nursing group was significantly lower than that in the regular nursing group (p<0.05). Compliance to treatment and quality of life after treatment
improved in the comprehensive nursing group compared with the regular nursing group (p<0.05). Overall, a decrease in BDNF expression is closely
correlated with depression, and comprehensive nursing care can significantly ameliorate the depression symptoms in pediatric patients, increase the
BDNF expression, and improve compliance and quality of life. These results provide theoretical and practical significance for clinical nursing care
of patients with depression in childhood. Copyright © 2017, Spandidos Publications. All rights reserved.
Experimental and Therapeutic
Medicine, 14(4) : 2947-2952
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Thurman, T. R., Luckett, B. G., Nice, J., Spyrelis, A., Taylor, T. M.
Background Bereavement increases children's risk for
psychological disorders, highlighting the need for effective interventions, especially in areas where orphanhood is common. We aimed to assess the
effects of an eight-session support group intervention on the psychological health of bereaved female adolescents in South Africa. Methods This
randomised controlled trial enrolled female adolescents at 11 schools in three peri-urban towns of Free State province, South Africa. 453 bereaved
ninth-grade students aged 13-17 years who had expressed interest in taking part in the group were randomly assigned (1:1) to receive the intervention
or to be waitlisted for programme enrolment after the study period and serve as the control group. The intervention, Abangane (\"friends\" in
isiZulu), is a locally derived, curriculum-based support group focused on coping with loss incorporating indigenous stories and cognitive behavioural
therapy components. Weekly group sessions were facilitated by trained social workers or social auxiliary workers from a local non-profit
organisation. The primary outcomes included indicators of grief and depression as reported by adolescents and behavioural problems reported by their
caregivers. Grief was measured with three scales: the grief subscale of the Core Bereavement Items to assess normative grief; and the Intrusive Grief
Thoughts Scale and the Inventory of Complicated Grief-Revised for Children to assess maladaptive grief symptoms in the past 4 weeks. Depression
symptoms in the past 7 days were measured with the Center for Epidemiological Studies-Depression Scale for Children. Caregivers completed the Brief
Problem Monitor-Parent Form to report on adolescent's behaviour in the previous 4 weeks. Analysis was intention to treat. This study is registered
with ClinicalTrials.gov, number NCT02368808. Findings Between Sept 30, 2014, and Feb 5, 2015, eligible female participants were identified, of whom
226 were assigned to the intervention, Abangane, and 227 were assigned to the waitlisted control group. Analysis included 382 adolescents who
completed both surveys (193 participants assigned to Abangane and 189 assigned to waitlist). At follow up, the intervention group had significantly
lower scores for primary outcomes, including intrusive grief (p=0.000, Cohen's d=-0.21), complicated grief (p=0.015, d=-0.14), and depression
(p=0.009, d=-0.21) relative to the waitlisted group, while core bereavement scores were similar between groups (p=0.269). Caregivers in the
intervention group reported lower levels of behavioural problems among adolescents (p=0.017, d=-0.31). Interpretation Short-term, structured,
theory-based support groups with contextually relevant content show promise in mitigating psychological and behavioural problems among bereaved
adolescents. Abangane is replicable in resource limited settings, using freely available curriculum materials, existing programme structures, and
appropriately trained personnel to implement it. Funding US Agency for International Development Southern Africa. Copyright © 2017 The Author(s).
Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
The Lancet Global
Health, 5(6) : e604-e614
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions
Thurman, T. R., Nice,
J., Taylor, T. M., Luckett, B.
Background: Children and adolescents affected by HIV are at elevated risk of depression, yet research on related interventions in this
population is scarce in sub-Saharan Africa. This study sought to examine the effects of interpersonal psychotherapy for groups (IPTG) on depressive
symptomology among orphaned and vulnerable adolescents in South Africa. Method: A cluster randomized controlled trial wherein adolescents ages 14-17
enrolled in community-based programming for HIV-affected and vulnerable families were randomly assigned by geographic cluster to participate in a 16
-session IPTG intervention or the standard of care (n = 489). Baseline and postintervention surveys conducted with enrollees included standardized
depression screening. Utilizing an intent-to-treat design, mixed effects models were performed to examine treatment effects for all participants and
potential moderators including gender and baseline depression level (Clinical Trials registration: ClinicalTrials.gov NCT02386878). Results: While
23% of adolescents in the intervention group did not attend any IPTG sessions, average attendance was 12 out of 16 possible sessions among
participants. The intervention was not associated with changes in depression symptomology. Conclusions: Results underscore the importance of
mitigating participation barriers prior to intervention roll-out and the need for increased evidence for psychological health interventions to
mitigate depression among orphaned and vulnerable adolescents. This intervention and the study selectively targeted at-risk adolescents versus using
diagnostic mental health criteria for enrollment; more research is needed to identify the potential benefits and disadvantages of these approaches.
Copyright © 2017 Association for Child and Adolescent Mental Health
Child and
Adolescent Mental Health, 22(4) : 224-231
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT)
Tighe, J., Shand, F., Ridani,
R., Mackinnon, A., De-La-Mata, N., Christensen, H.
OBJECTIVES: Rates of youth suicide in
Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage
is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to
individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal
ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia.\rSETTING: Remote and very remote communities
in the Kimberley region of North Western Australia.\rPARTICIPANTS: Indigenous Australians aged 18-35 years.\rINTERVENTIONS: 61 participants were
recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and
then received the app for the following 6 weeks.\rPRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the Depressive Symptom Inventory-
Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient
Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11).\rRESULTS: Although
preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were
not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and
statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist
participants improved after 6 weeks of app use.\rCONCLUSIONS: Apps for suicide prevention reduce distress and depression but do not show significant
reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities
is via appropriately designed self-help apps.\rTrial registration number: actrn12613000104752.
BMJ
Open, 7(1) : e013518
- Year: 2017
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)