Disorders - Depressive Disorders
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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
LIMITATIONS: The experiment was only brief and a non-clinical sample was used.
CONCLUSIONS: 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.
Objective: To examine whether a pediatrics-based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care.
Design, 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.
Interventions: 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.
Main 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.
Results: 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.
Conclusions 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.
Trial 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.
SETTING: Remote and very remote communities in the Kimberley region of North Western Australia.
PARTICIPANTS: Indigenous Australians aged 18-35 years.
INTERVENTIONS: 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.
PRIMARY 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).
RESULTS: 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.
CONCLUSIONS: 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.
Trial 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)
Tompson, M. C., Sugar, C. A., Langer, D. A., Asarnow, J. R.
OBJECTIVE: Despite the morbidity and negative outcomes associated with early-onset depression, few studies have examined the efficacy of psychosocial treatment for depressive disorders during childhood. Integrating family in treatment could have particularly salutary effects during this developmental period. This trial compared immediate posttreatment effects of family-focused treatment for childhood depression (FFT-CD) with those of individual supportive psychotherapy (IP) for children 7 to 14 years old with depressive disorders.
METHOD: Children were randomized to 15 sessions of FFT-CD (n = 67) or IP (n = 67) over 4 months. The primary treatment outcome was adequate clinical depression response, defined as at least a 50% decrease in score on the Children's Depression Rating Scale-Revised (CDRS-R). Additional outcomes included patient-centered outcomes (parent- and child-reported treatment satisfaction), remission (defined as CDRS-R score <=28), change in continuous CDRS-R score, and change in child and parent reports of depressive and non-depressive symptoms and social adjustment.
RESULTS: Significant improvement was evident across groups for depressive and non-depressive symptoms, global response, and functioning and social adjustment. Compared with children randomized to IP, children randomized to FFT-CD showed higher rates of adequate clinical depression response (77.7% versus 59.9%; number needed to treat = 5.72; odds ratio 2.29; 95% CI 1.001-5.247; t = 1.97, p = .0498). Across treatments, families reported high satisfaction; compared with IP families, FFT-CD families reported greater knowledge and skills for managing depression. There were no significant differences between treatment arms on secondary outcomes.
CONCLUSION: Results support the value of psychosocial intervention, emphasize the important role that families play, and highlight the potential for FFT-CD for supporting recovery in children with depression. Clinical trial registration information-Systems of Support Study for Childhood Depression; http://clinicaltrials.gov; NCT01159041.
Journal of the American Academy of Child & Adolescent Psychiatry, 56(6) : 515-523
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy, Supportive therapy
Topooco, N. W., Andersson, G.
Objectives: Globally, depression is the primary cause of disability-adjusted life years among adolescents. Psychotherapeutic treatment capacities are recommended but are insufficient. Young individuals are under-represented in standard care settings for reasons of stigma and limited mental healthcare literacy. Digital interventions have the potential to increase availability of treatment and to reduce individual barriers. In this randomized controlled trial, we evaluated digital treatment based on CBT against a brief active control condition. Methods: Seventy adolescents (aged 15-19 years) presenting with depressive symptoms were randomly assigned to receive CBT (n = 35) or active control condition (n = 35). The CBT program was delivered over eight weeks and composed of text-based material and chat sessions with a psychologist. The primary outcome was self-reported depression symptoms at posttreatment, as measured with the self-reported Beck Depression Inventory (BDI-II). Assessments were made at baseline and posttreatment and are planned at 6 months and 2 years (trial currently running). Results: Preliminary results showed significant reductions in depressive symptoms after treatment, with an obtained large between-group effect [d = 0.99; CI 0.48-1.51; F(1,63) = 29.93, P < 0.001]. Participants indicated satisfaction with the CBT program on self-reported questionnaires and in written feedback. Conclusions: Digital psychological treatment for adolescents with depressive symptoms can be effective. The findings regarding participants' experiences indicate that synchronous support in digital treatment is in line with the preferences of young patients.
Journal of the American Academy of Child and Adolescent Psychiatry, 56 (10) : S299-S300
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)