Disorders - Depressive Disorders
Daya, Z., Hearn, J. H.
INTRODUCTION: Mindfulness-based interventions (MBIs) have gained popularity in medical education. A systematic review was conducted to determine the effectiveness of MBIs for reducing psychological distress in undergraduate medical students.
METHODS: A search protocol was conducted using online databases Embase, PubMed, PsycINFO, and MEDLINE. Articles were required to meet the following criteria to be included: (1) describe a MBI or use of mindfulness exercises as part of an intervention, (2) include at least one of: stress, burnout, fatigue, or depression, as an outcome, (3) include quantitative outcomes, and (4) published in English in a peer-reviewed journal.
RESULTS: Twelve articles were reviewed. Seven studies reported improvements in at least one targeted outcome. Four of seven studies exploring the impact on stress reported improvements. Five articles studying depression reported reductions. One study exploring burnout reported a decrease on a single subscale. Only one study measured the impact on fatigue (no change reported). Half of studies reviewed included predominantly female samples.
CONCLUSIONS: Mixed evidence was found for the use of MBIs for reducing psychological distress in undergraduate medical students. Future work should aim to clarify the impact of mindfulness on burnout and fatigue, and explore the replicability of improvements in male medical students alone.
Medical Teacher, 40(2) : 146-153
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Geipel, J., Koenig, J., Hillecke, T. K., Resch, F., Kaess, M.
BACKGROUND: Existing systematic reviews provide evidence that music therapy is an effective intervention in the treatment of children and adolescents with psychopathology. The objective of the present review was to systematically review and quantify the effects of music-based interventions in reducing internalizing symptoms (i.e., depression and anxiety) in children and adolescents using a meta-analytical approach.
METHODS: Databases and journals were systematically screened for studies eligible for inclusion in meta-analysis on the effects of music-based interventions in reducing internalizing symptoms. A random-effect meta-analysis using standardized mean differences (SMD) was conducted.
RESULTS: Five studies were included. Analysis of data from (randomized) controlled trials, yielded a significant main effect (Hedge's g = -0.73; 95%CI [-1.42;-0.04], Z = 2.08, p = 0.04, k = 5), indicating a greater reduction of internalizing symptoms in youth receiving music-based interventions (n = 100) compared to different control group interventions (n = 95).
LIMITATIONS: The existing evidence is limited to studies of low power and methodological quality. Included studies were highly heterogeneous with respect to the nature of the intervention, the measurements applied, the samples studied, and the study design.
CONCLUSIONS: Findings indicate that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents. While these results are encouraging with respect to the application of music-based intervention, rigorous research is necessary to replicate existing findings and provide a broader base of evidence. More research adopting well controlled study designs of high methodological quality is needed.
Journal of Affective Disorders, 225 : 647-656
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Hollenbaugh, K. M. H., Lenz, A.
This meta-analysis evaluated the effectiveness of dialectical behavior therapy for adolescents in reducing symptoms of depression, anxiety, self-injury, and suicide risk. Twelve between-group studies (N = 834) were chosen that met the inclusion criteria. Results revealed small-to-medium Hedges's g effect sizes for all 4 symptoms compared with control and alternative treatment groups. However, the small number of effect sizes available for each analysis limited the generalizability of the findings. Implications and suggestions for future research are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Counseling & Development, 96(2) : 119-131
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Dialectical behavioural therapy (DBT)
Loechner, J., Starman, K., Galuschka, K., Tamm, J., Schulte-Korne, G., Rubel, J., Platt, B.
One major predictor of depression onset is having a depressed parent. This study provides the first systematic review and meta-analysis of preventive interventions for offspring of depressed parents. We searched six literature databases and included randomized controlled trials which concerned the non-depressed offspring (aged 18 or younger) of a depressed parent, who received a preventive intervention designed to reduce the risk of depression or a comparison condition. Primary and secondary outcome measures were the severity and incidence of childhood depression. 14 publications reporting data from seven trials (n = 935 children) were included and were of relatively high quality. The effect of the interventions (versus any control condition) on depressive and internalising symptoms at post-intervention follow-up (up to four months) was small but significant [g' = - 0.20, 95% CI (- 0.34; - 0.06), p = 0.005; I2 = 0.00%]. The interventions also had a small but significant effect on depression incidence [Risk Ratio = 0.56; 95% CI(0.41;0.77); d' = - 0.42]. Intervention effects were not present in the short-term (up to 12 months post-intervention) or long-term (15-72 months post-intervention) follow-ups. Interventions targeting the offspring of depressed parents show promise not only in reducing symptoms of depression but also in preventing the onset of depression, at least immediately after the intervention. Copyright © 2017 The Authors
Clinical Psychology Review, 60 : 1-14
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Hathaway, E. E., Walkup, J. T., Strawn, J. R.
Anxiety and depressive disorders are common in the pediatric primary care setting, and respond to both psychotherapeutic and psychopharmacologic treatment. However, there are limited data regarding the optimal treatment duration. This article systematically reviews guidelines and clinical trial data related to antidepressant treatment duration in pediatric patients with depressive and anxiety disorders. The extant literature suggests 9-12 months of antidepressant treatment for youth with major depressive disorder. For generalized, separation and social anxiety disorders, 6-9 months of antidepressant treatment may be sufficient, though many clinicians extend treatment to 12 months based on extrapolation of data from adults with anxiety disorders. Such extended treatment periods may decrease the risk of long-term morbidity and recurrence; however, the goal of treatment is ultimately remission, rather than duration of antidepressant pharmacotherapy. Moreover, while evidence-based guidelines represent a starting point, appropriate treatment duration varies and patient-specific response, psychological factors, and timing of discontinuation must be considered for individual pediatric patients. Copyright © 2018 Mosby, Inc.
Current Problems in Pediatric and Adolescent Health Care, 48(2) : 31-39
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
, Relapse prevention
-
Treatment and intervention: Biological Interventions (any)
, Antidepressants (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Mychailyszyn, M. P., Elson, D. M.
Previous research has indicated that Interpersonal Psychotherapy (IPT) is generally effective for ameliorating symptoms for adults suffering from depression. Indeed, this has been demonstrated through numerous clinical and open trials, and further confirmed on a larger degree through several meta-analyses. However, no such comprehensive reviews have been conducted exclusively with adolescents, a population for which interpersonal relationships holds immense developmental importance. Therefore, a meta-analysis of the effectiveness of IPT-A, the version of IPT modified to specifically address depression in adolescents, was conducted in the present review. A total of ten studies yielding 766 participants were included in the present meta-analysis and analyzed using a standardized mean gain (SMG) effect size. The results indicate that IPT-A was significantly effective at reducing depressive symptoms in adolescents and significantly more effective than control or treatment-as-usual groups in treating depression in adolescents. IPT-A yielded an overall effect size (Hedges g) of 1.19, while the aggregate effect size for control/placebo groups was 0.58. Overall, the results of this review suggest that IPT-A holds similar promise for improving adolescent depression as the original version does for adults. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Children and Youth Services Review, 87 : 123-129
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Interpersonal therapy (IPT)
Pandey, A., Hale, D., Das, S., Goddings, A. L., Blakemore, S. J., Viner, R. M.
IMPORTANCE Childhood and adolescence self-regulation (SR) is gaining importance as a target of intervention because of mounting evidence of its positive associations with health, social and educational outcomes. OBJECTIVE To conduct a systematic review and meta-analysis of rigorously evaluated interventions to improve self-regulation in children and adolescents. DATA SOURCES Keyword searches of the PsycINFO, PubMed, EMBASE, CINAHL Plus, ERIC, British Education Index, Child Development and Adolescent Studies, and CENTRAL were used to identify all studies published through July 2016. STUDY SELECTION To be eligible for this review, studies had to report cluster randomized trials or randomized clinical trials, evaluate universal interventions designed to improve self-regulation in children and adolescents aged 0 to 19 years, include outcomes associated with self-regulation skills, and be published in a peer-reviewed journal with the full text available in English. DATA EXTRACTION AND SYNTHESIS A total of 14 369 published recordswere screened, of which 147 were identified for full-text review and 49 studies reporting 50 interventions were included in the final review. Results were summarized by narrative review and meta-analysis. MAIN OUTCOMES AND MEASURES Self-regulation outcomes in children and adolescents. RESULTS This review identified 17 cluster randomized trials and 32 randomized clinical trials evaluating self-regulation interventions, which included a total of 23 098 participants ranging in age from 2 to 17 years (median age, 6.0 years). Consistent improvement in self-regulation was reported in 16 of 21 curriculum-based interventions (76%), 4 of the 8 mindfulness and yoga interventions (50%), 5 of 9 family-based programs (56%), 4 of 6 exercise-based programs (67%), and 4 of 6 social and personal skills interventions (67%), or a total of 33 of 50 interventions (66%). Ameta-analysis evaluating associations of interventions with self-regulation task performance scores showed a positive effect of such interventions with pooled effect size of 0.42 (95%CI, 0.32-0.53). Only 24 studies reported data on distal outcomes (29 outcomes). Positive associations were reported in 11 of 13 studies (85%) on academic achievement, 4 of 5 studies on substance abuse (80%), and in all studies reporting on conduct disorders (n = 3), studies on social skills (n = 2), studies on depression (n = 2), studies on behavioral problems (n = 2), and study on school suspensions (n = 1). No effect was seen on 2 studies reporting on academic achievement, 1 study reporting on substance abuse, and 1 additional study reporting on psychological well-being. CONCLUSIONS AND RELEVANCE A wide range of interventions were successful in improving self-regulation in children and adolescents. There was improvement in distal academic, health, and behavioral outcomes in most intervention groups compared with controls. Copyright © 2018 American Medical Association. All rights reserved.
JAMA Pediatrics, 172(6) : 566-575
- Year: 2018
- Problem: Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Skills training, Other Psychological Interventions, Mindfulness based therapy, Mind-body exercises (e.g. yoga, tai chi, qigong)
, Physical activity, exercise
Purgato, M., Gross, A. L., Betancourt, T., Bolton, P., Bonetto, C., Gastaldon, C., Gordon, J., OCallaghan, P., Papola, D., Peltonen, K., Punamaki, R. L., Richards, J., Staples, J. K., Unterhitzenberger, J., van-Ommeren, M., de-Jong, J., Jordans, M. J. D., Tol, W. A., Barbui, C.
Background: Results from studies evaluating the effectiveness of focused psychosocial support interventions in children exposed to traumatic events in humanitarian settings in low-income and middle-income countries have been inconsistent, showing varying results by setting and subgroup (eg, age or gender). We aimed to assess the effectiveness of these interventions, and to explore which children are likely to benefit most. Methods: We did a systematic review and meta-analysis of individual participant data (IPD) from 3143 children recruited to 11 randomised controlled trials of focused psychosocial support interventions versus waiting list. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, PsycArticles, Web of Science, and the main local low-income and middle-income countries (LMICs) databases according to the list of databases relevant to LMIC developed collaboratively by Cochrane and WHO Library, up to November, 2016. We included randomised controlled trials that assessed the effectiveness of focused psychosocial support interventions in children exposed to traumatic events in LMICs, compared with waiting lists (eg, inactive controls). We excluded quasi-randomised trials, studies that did not focus on psychosocial support interventions, and studies that compared two active interventions without control conditions. We requested anonymised data from each trial for each of the prespecified variables for each child who was randomly assigned. The main outcomes considered were continuous scores in post-traumatic stress disorder (PTSD) symptoms, depressive symptoms, and anxiety symptoms assessed with rating scales administered immediately (0-4 weeks) after the intervention. We harmonised all individual items from rating scales using item response theory methods. This study is registered with PROSPERO, number CRD42013006960. Findings: We identified a beneficial effect of focused psychosocial support interventions on PTSD symptoms (standardised mean difference [SMD] -0.33, 95% CI -0.52 to -0.14) that was maintained at follow-up (-0.21, -0.42 to -0.01). We also identified benefits at the endpoint for functional impairment (-0.29, -0.43 to -0.15) and for strengths: coping (-0.22, -0.43 to -0.02), hope (-0.29, -0.48 to -0.09), and social support (-0.27, -0.52 to -0.02). In IPD meta-analyses focused on age, gender, displacement status, region, and household size we found a stronger improvement in PTSD symptoms in children aged 15-18 years (-0.43, -0.63 to -0.23), in non-displaced children (-0.40, -0.52 to -0.27), and in children living in smaller households (<6 members; -0.27, -0.42 to -0.11). Interpretation: Overall, focused psychosocial interventions are effective in reducing PTSD and functional impairment, and in increasing hope, coping, and social support. Future studies should focus on strengthening interventions for younger children, displaced children, and children living in larger households. Funding: European Commission FP7th Framework Programme for Research (Marie Curie International Outgoing Fellowship) and the National Institute on Aging. Copyright © 2018 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, 6(4) : e390-e400
- Year: 2018
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
Winzer, R., Lindberg, L., Guldbrandsson, K., Sidorchuk, A.
Background: Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers.Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. Material and Methods: A systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995-2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges' g) used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3-6 months, 7-12 months, and 13-18 months of post-intervention follow-up. Results: About 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7-12 months post-intervention (standardized mean difference (Hedges' g) effect size (ES) = -0.28 (95% CI [-0.49, -0.08])). Further, sustainability of symptom-reductions were evident for depression with intervention effect lasting up to 13-18 months (ES = -0.30 (95% CI [-0.51, -0.08])), for anxiety up to 7-12 months (ES = -0.27 (95% CI [-0.54, -0.01])), and for stress up to 3-6 months (ES = -0.30 (95% CI [-0.58, -0.03])). The effects of interventions to enhance positive mental health were sustained up to 3-6 months for the combined positive mental health outcomes (ES = 0.32 (95% CI [0.05, 0.59])). For enhanced active coping, sustainability up to 3-6 months was observed with a medium and significant effect (ES = 0.75 (95% CI [0.19, 1.30])). Discussion: The evidence suggests long-term effect sustainability for mental ill health preventive interventions, especially for interventions to reduce the symptoms of depression and symptoms of anxiety. Interventions to promote positive mental health offer promising, but shorter-lasting effects. Future research should focus on mental health organizational interventions to examine their potential for students in tertiary education. Copyright © 2018 Winzer et al.
PeerJ, 2018 (4) (no pagination)(e4598) :
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Psychoeducation, Mindfulness based therapy
Yuan, S., Zhou, X., Zhang, Y., Zhang, H., Pu, J., Yang, L., Liu, L., Jiang, X., Xie, P.
Background: Depression and anxiety are the most common mental disorders in children and adolescents. Bibliotherapy is a treatment using written materials for mental health problems. Its main advantages are ease of use, low cost, low staffing demands, and greater privacy. Yet few meta-analyses have focused on the effect of bibliotherapy on depression and anxiety disorders in children and adolescents. Methods: We included randomized controlled trials comparing bibliotherapy with control con-ditions for depression and anxiety in children and adolescents (aged #18 years). Five electronic databases (PubMed, Embase, Cochrane, Web of Science, and PsycINFO) were searched from inception to January 2017. Efficacy was defined as mean change scores in depression and anxiety symptoms. Acceptability was defined as the proportion of participants who discontinued the treatment. Random effects model was used. An intention-to-treat analysis was conducted. Results: Eight studies with 979 participants were selected. At posttreatment, bibliotherapy was significantly more effective than the control conditions in reducing the symptoms of depression or anxiety (standardized mean difference, -0.52; 95% confidence interval [CI], -0.89 to -0.15). Bibliotherapy did not have statistically significantly more all-cause discontinuations than controls (risk ratios, 1.66; 95% CI, 0.93 to 2.95). We also performed subgroup analyses for efficacy outcomes in different categories (types of disorder, mean age, control conditions, and parental involvement) of studies and found that bibliotherapy has been more effective in depressive adolescents. Limitations: Limited studies were eligible in this review and hence there was potential publication bias. Conclusion: According to the findings in this review, bibliotherapy may be more beneficial in treating depression in adolescents, but shows less robust effects for anxiety in children. Further well-defined clinical studies should be performed to confirm these outcomes. Copyright © 2018 Yuan et al.
Neuropsychiatric Disease and Treatment, 14 : 353-365
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Self-help
Yang, L., Zhou, X., Zhou, C., Zhang, Y., Pu, J., Liu, L., Gong, X., Xie, P.
Background Few meta-analyses have focused on the effect of cognitive behavioral therapy (CBT) for depression in children. Study Selection Randomized controlled trials comparing CBT with control conditions for depression in children (<=13 years old) were included. Data Sources Seven electronic databases (PubMed, Embase, CENTRAL, Web of Science, PsycINFO, CINAHL, and LiLACS) were searched from inception to September 2015. Data Extraction and Synthesis The primary efficacy was defined as mean change scores in depressive symptoms, and the second efficacy (remission) was a score below the threshold for a diagnosis of depression, both after treatment and at the end of follow-up. We also measured acceptability by the proportion of participants who discontinued treatment up to posttreatment. Results Nine studies with 306 participants were selected for this analysis. At posttreatment, CBT was significantly more effective than control conditions in terms of primary efficacy (standardized mean difference, -0.41; 95% confidence interval [CI], -0.64 to -0.18) and secondary efficacy (odds ratio [OR], 2.16; 95% CI, 1.24 to 3.78). At follow-up, the results were consistent with those of efficacy outcomes at posttreatment, with a standardized mean difference of -0.34 and an OR of 2.04. CBT had no statistical more all-cause discontinuations than the control group (OR, 0.69; 95% CI, 0.26 to 1.82). However, subgroup analyses found that CBT was only significantly more effective than nontreatment, while it was not better than wait list or psychological placebo. Conclusions CBT seems to be more beneficial in the treatment of depression in children than nontreatment; however, this finding is limited by the small size of the trials and low literature quality. Copyright © 2016 Academic Pediatric Association
Academic Pediatrics, 17(1) : 9-16
- Year: 2017
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Yatham, S., Sivathasan, S., Yoon, R., da-Silva, T. L., Ravindran, A. V.
Background: Low and middle income countries (LMICs) not only have the majority of the world's population but also the largest proportion of youth. Poverty, civil conflict and environmental stressors tend to be endemic in these countries and contribute to significant psychiatric morbidity, including depression, anxiety and post-traumatic stress disorder (PTSD). However, mental health data from LMICs is scarce, particularly data on youth. Evaluation of such information is crucial for planning services and reducing the burden of disability. This paper reviews the published data on the prevalence and randomized trials of interventions for depression, anxiety and PTSD in youth in LMICs. Methods: PubMed and Google Scholar were searched for articles published in English up to January 2017, using the keywords: Low/middle income country, depression, anxiety, post-traumatic stress disorder, child, youth, adolescent, prevalence, treatment, intervention, and outcomes. Results: The few prevalence studies in LMICs reported rates of up to 28% for significant symptoms of depression or anxiety among youth, and up to 87% for symptoms of PTSD among youth exposed to traumatic experienences, though these rates varied widely depending on several factors, including the assessments tools used. Most rigorous interventions employed some form or variation of CBT, with mixed results. Studies using other forms of psychosocial interventions appear to be heterogeneous and less rigorous. Conclusions: The mental health burden due to depression and anxiety disorders in youth is substantial in LMICs, with high needs but inadequate services. Youth specific services for early detection and cost-effective interventions are needed. Copyright © 2017 Elsevier B.V.
Asian Journal of Psychiatry., :
- Year: 2017
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)