Disorders - Depressive Disorders
Topper, M., Emmelkamp, P. M., Watkins, E., Ehring, T.
BACKGROUND: This randomized controlled trial evaluated the efficacy of a preventive intervention for anxiety disorders and depression by targeting excessive levels of repetitive negative thinking (RNT; worry and rumination) in adolescents and young adults.
METHODS: Participants (N = 251, 83.7% female) showing elevated levels of RNT were randomly allocated to a 6-week cognitive-behavioral training delivered in a group, via the internet, or to a waitlist control condition. Self-report measures were collected at pre-intervention, post-intervention, 3 m and 12 m follow-up.
RESULTS: Both versions of the preventive intervention significantly reduced RNT (d = 0.53 to 0.89), and symptom levels of anxiety and depression (d = 0.36 to 0.72). Effects were maintained until 12 m follow-up. The interventions resulted in a significantly lower 12 m prevalence rate of depression (group intervention: 15.3%, internet intervention: 14.7%) and generalized anxiety disorder (group intervention: 18.0%, internet intervention: 16.0%), compared to the waitlist (32.4% and 42.2%, respectively). Mediation analyses demonstrated that reductions in RNT mediated the effect of the interventions on the prevalence of depression and generalized anxiety disorder.
CONCLUSIONS: Results provide evidence for the efficacy of this preventive intervention targeting RNT and support a selective prevention approach that specifically targets a known risk factor to prevent multiple disorders.
Behaviour Research & Therapy, 90 : 123-136
- Year: 2017
- Problem: Anxiety Disorders (any), 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)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Trebaticka, J., Hradecna, Z., Bohmer, F., Vavakova, M., Waczulikova, I., Garaiova, I., Luha, J., Skodacek, I., Suba, J., Durackova, Z.
Background: The prevalence of mood disorders in children is a growing global concern. Omega-3 fatty acids (FA) are emerging as a promising adjuvant therapy for depressive disorder (DD) in paediatric patients. The primary objective of this pilot, single-centre, randomized, double-blind controlled study was to compare the efficacy of an Omega-3 FA fish oil emulsion with a control oil emulsion alongside standard treatment for depressive symptoms in children and adolescents suffering from depressive disorder (DD) and mixed anxiety depressive disorder (MADD). Methods: 38 children (12 patients were treated and diagnosed for at least 1 month before enrolment, 26 patients were first-time diagnosed as DD) aged 11-17 years were randomised 1:1 to the intervention (Omega-3 FA, 19 patients) or active comparator (Omega-6 FA, 19 patients) groups. Children's depression inventory (CDI) ratings were performed at baseline, every 2 weeks for a 12-week intervention period and at 4-week post-intervention. 35 patients (17 in Omega-3 and 18 in Omega-6 groups) who completed the whole intervention period were evaluated. Patients from Omega-3 group were stratified according to diagnosis into two subgroups (DD-10/17 and mixed anxiety depressive disorder (MADD)-7/17 patients) and in the Omega-6 group into DD-10/18 and MADD-8/18 patients. Groups were evaluated separately. Differences between-groups were tested with the Student's t test or non-parametric Mann-Whitney U test. Two-way ANOVA with repeated measures and Friedman test were used to analyse the Treatment effect for response in CDI score. p < 0.05 was considered significant in all statistical analyses. Results: Significant reductions in CDI scores in 35 analysed patients who completed 12 weeks intervention were observed after 12 weeks of intervention only in the Omega-3 group (p = 0.034). After stratification to depressive disorder and mixed anxiety depressive disorder subgroups, the DD subgroup receiving the Omega-3 FA fish oil showed statistically greater improvement (score reduction after 8 week treatment of -9.1 CDI, p = 0.0001) when compared to the MADD subgroup (score reduction after 8 week treatment -4.24 CDI, p = 0.271). Conclusions: CDI scores were reduced in the Omega-3 group and the depression subgroup had greater improvement than the mixed depressive/anxiety group. An Omega-3 fatty acid rich fish oil emulsion may be an effective adjuvant supplement during the treatment of depressive disorders in children. Trial registration ISRCTN81655012. Copyright © 2017 The Author(s).
Child and Adolescent Psychiatry and Mental Health, 11 (1) (no pagination)(30) :
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Fish oil (Omega-3 fatty acids)
, Omega 3 fatty acids (e.g. fish oil, flax oil)
Sekizaki, R., Nemoto, T., Tsujino, N., Takano, C., Yoshida, C., Yamaguchi, T., Katagiri, N., Ono, Y., Mizuno, M.
Aim: Preventive intervention and treatment using internet-based cognitive behaviour therapy (iCBT) can be easily administered to school students, as they are quite familiar with internet tools. This study aims to investigate the effectiveness and contribution of iCBT to mental healthcare in a school setting. Methods: Eighty Japanese high school boys who were participating in a sports specialist course were enrolled in this study. The participants were randomly assigned to either the iCBT intervention group or the control group. Both programmes were administered for 4 weeks. To evaluate the effects, physical and mental health problems and self-efficacy were assessed. Results: The mean number of times that the iCBT website was accessed during the intervention period was 16.9, and the mean access frequency (percentage of the number of times the website was accessed during the intervention period) was 40.1% in the iCBT group. A statistically significant interaction between group and time in favour of the iCBT group was observed based on the Kessler-6 (K6) scale for depression and anxiety. Conclusions: The results suggest that a school mental healthcare programme using iCBT is suitable for students and useful for coping with stress and reducing depressed mood and anxiety in young people, especially athletes, who are regarded as needing special mental health support. Copyright © 2017 Wiley Publishing Asia Pty Ltd.
Early Intervention in Psychiatry., :
- Year: 2017
- Problem: Anxiety Disorders (any), 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)
Saravanan, C., Alias, A., Mohamad, M.
BACKGROUND: Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression.
METHOD: The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression.
RESULTS: Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores.
LIMITATION: The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months.
CONCLUSION: Overall, homesickness is considered a normal reaction. Brief individual CBT for depression is effective in reducing homesickness and depression among international students.
Journal of Affective Disorders, 220 : 108-116
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Rosenblum, K. L., Muzik, M., Morelen, D. M., Alfafara, E. A., Miller, N. M., Waddell, R. M., Schuster, M. M., Ribaudo, J.
We conducted a study to evaluate the effectiveness of Mom Power, a multifamily parenting intervention to improve mental health and parenting among high-risk mothers with young children in a community-based randomized controlled trial (CB-RCT) design. Participants (N = 122) were high-risk mothers (e.g., interpersonal trauma histories, mental health problems, poverty) and their young children (age <6 years), randomized either to Mom Power, a parenting intervention (treatment condition), or weekly mailings of parenting information (control condition). In this study, the 13-session intervention was delivered by community clinicians trained to fidelity. Pre- and post-trial assessments included mothers' mental health symptoms, parenting stress and helplessness, and connection to care. Mom Power was delivered in the community with fidelity and had good uptake (>65%) despite the risk nature of the sample. Overall, we found improvements in mental health and parenting stress for Mom Power participants but not for controls; in contrast, control mothers increased in parent-child role reversal across the trial period. The benefits of Mom Power treatment (vs. control) were accentuated for mothers with interpersonal trauma histories. Results of this CB-RCT confirm the effectiveness of Mom Power for improving mental health and parenting outcomes for high-risk, trauma-exposed women with young children. ClinicalTrials.gov Identifier: NCT01554215. Copyright © 2017, Springer-Verlag Wien.
Archives of Women's Mental Health, 20(5) : 673-686
- Year: 2017
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, 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, Other service delivery and improvement interventions
Saelid, G. A., Nordahl, H. M.
Rational emotive behaviour therapy (REBT) is effective in reducing distress in several target groups. No other study has tested the mental health effects on adolescents in a high school setting while expanding a Cognitive Behaviour-based therapy, REBT, into the concept of mental health literacy. The format of the ABC model, which is an important element of REBT, functioned as a working manual in and between three sessions. This study tested whether knowledge and practical use of the ABC model increased self-esteem and hope, and reduced symptoms of anxiety and depression, and dysfunctional thinking. Sixty-two high school students with subclinical levels of anxiety and depression were randomly allocated into three groups; three individual REBT sessions, or three individual attentional placebo (ATP) sessions or no sessions (control). However, dysfunctional thinking, self-esteem and hope were not measured in the control group. Repeated measures with ANOVA and t-tests were conducted. Both REBT and ATP significantly reduced symptoms of anxiety and depression, but only REBT was significantly different from the control group at the six-month follow-up. Only REBT significantly reduced dysfunctional thinking, and both REBT and ATP significantly increased self-esteem and hope. REBT had both an immediate and a long-term effect. The findings show the potential positive effects of educating well-documented psychological techniques as ordinary education in school. Further research might contribute to decide whether or not to change the school system by enclosing mental health literacy classes for all students.
Cognitive Behaviour Therapy, 46(3) : 196-210
- 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
Sandoval, L. R., Buckey, J. C., Ainslie, R., Tombari, M., Stone, W., Hegel, M. T.
This study evaluated the efficacy of an interactive media-based, computer-delivered depression treatment program (imbPST) compared to a no-treatment control condition (NTC) in a parallel-group, randomized, controlled trial conducted in an outpatient psychiatric research clinic. 45 adult participants with major depressive disorder or dysthymia were randomized to receive either 6 weekly sessions of imbPST or no treatment (No Treatment Control; NTC). The primary outcome measure was the Beck Depression Inventory II (BDI-II). There was a significant Group x Time interaction effect [F (1.73, 43)= 58.78; p<.001; eta2=.58, Cohens d=1.94], such that the patients receiving imbPST had a significantly greater reduction in depressive symptoms compared to the patients in the NTC condition. Participants in the imbPST group improved their depression symptoms significantly from moderate (BDI-II=21.9+/-4.20) to mild levels of depression (BDI-II=17.9+/-4.0) after receiving 3 weekly sessions of imbPST (p<0.001), and progressed to still milder levels of depression after six weekly sessions (BDI-II=14.5+/-3.7, p<0.001). NTC participants showed no significant reduction in BDI-II scores (BDI-II=21.8+/-4.2 pre, BDI-II=21.5+/-5.2 post, N.S.). Additionally, 40% of the imbPST group showed a clinically significant and reliable change in depression levels while none of the NTC group met this criterion. imbPST participants rated the program highly usable on the system usability scale (SUS) after the first session (SUS Session 1=74.6+/-7.2) and usability scores increased significantly by the last session (SUS Session 6=85.4+/-5.6). We conclude that imbPST is an effective, engaging, and easily used depression treatment program that warrants further evaluation with heterogeneous depressed populations in a stand-alone, self-administered fashion.
Behavior Therapy, 48(3) : 413-425
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Problem solving therapy (PST)
, Technology, interventions delivered using technology (e.g. online, SMS)
Olson, R. L., Brush, C. J., Ehmann, P. J., Alderman, B. L.
OBJECTIVE: The aim of this study was to examine the effects of an 8-week moderate-intensity aerobic exercise training intervention on cognitive control in individuals with major depressive disorder (MDD).
METHODS: Participants with a current diagnosis of MDD (n=30; 21.1+/-2.0years) were stratified by depressive symptoms and randomized to an 8-week intervention of aerobic exercise (AE) or placebo exercise (PE). AE consisted of three sessions/week of moderate-intensity exercise training while PE consisted of three sessions/week of light-intensity stretching. Cognitive control was assessed pre- and post-treatment using behavioral performance (i.e., reaction time and accuracy) and event-related potentials (i.e., N2 amplitude). Depressive symptoms and rumination were also assessed before and after the intervention.
RESULTS: Compared with PE, the AE treatment arm was associated with an increase in N2 amplitude to incongruent flanker task trials, reflecting an increase in cognitive control processes. Symptoms of depression also decreased after AE although the treatments did not differ in their effects on rumination. Exploratory mediation analysis indicated that changes in N2 amplitude did not mediate pre-to-post treatment reductions in depressive symptoms.
CONCLUSIONS: An 8-week moderate-intensity AE program is associated with improved neural indices of conflict monitoring and reduced depressive symptoms among individuals with MDD.
SIGNIFICANCE: Future research examining the influence of exercise in combination with behavioral and pharmacological treatments for neurocognitive function in MDD is warranted.
Clinical Neurophysiology, 128(6) : 903-913
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Pandya, S. P.
Based on a one-year longitudinal study of 1,769 children from schools across countries diagnosed with depressive symptoms, this randomized, controlled, trial-based research has investigated the influences and impact on childhood depression of two kinds of spiritual programs, customized and open-ended. Results of the analysis of variance (ANOVA) and t-test showed that children had lower scores on depression scales and higher scores on the happiness scale post-intervention. Results of the logistic regression analysis and structural equation models specifically highlighted that boys, Christians, children from the middle class, and those who underwent the customized spiritual program were more likely to exhibit lower depressive symptoms and greater happiness, post-intervention. The implications of these findings for social work with depressed children have been discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Social Work in Mental Health, 15(4) : 373-396
- 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)
, Mindfulness based therapy, Meditation
Pedrelli, P.
Almost half of college students in the US report engaging in binge drinking (BD), a behavior associated with increased risk for physical injury, sexual and/or physical assault, driving while intoxicated, suicidal behavior and death. Many students report drinking heavily in order to cope with aversive mood states and BD is more frequent among students with depressive symptoms. The combination of depressive symptoms and alcohol use to cope with negative mood increases risk for negative consequences and poor long-term outcome. However, empirically supported treatments are not available for binge drinking students with concurrent depressive symptoms. The study compared the efficacy of a novel program combining an evidence-based treatment for BD, Brief Motivational Intervention, and an evidence-based treatment for depression, Cognitive Behavioral Therapy (BMI+CBT), relative to CBT alone, for binge drinking students with depressive symptoms. The study included 96 undergraduate students (67%females, age=19.9 +/- 1.3) reportingmild to severe depressive symptoms and BD who were randomized to eight therapy sessions of BMI+CBT or CBT alone. Participants completed assessmentsmeasures at baseline, at the end of treatment and one month after completion of treatment. A longitudinal mixedmodel did not find a differential effect of the two treatments on BD and depressive symptoms (F(2,53),=1.43, p > 0.05). However, there was a main effect of treatment on BD (F(2,53),=12.01, p < 0.01; treatment effect follow-up-1 d = 0.48; follow-up-2 d = 0.56), and on depressive symptoms (treatment effect follow-up-1 d = 1.15; follow-up-2 d = 1.30). In addition, a differential effect between the treatments was found on coping strategies such that participants receiving BMI+CBT reported a significant higher decrease in using avoidance behavior as a coping strategy than those in the CBT alone group (F(2,52),=7.69, p < 0.01). Baseline severity of depressive symptoms and of alcohol consumption did not predict outcome. Although the absence of a no-treatment group does not allow concluding that the gains experienced during treatment were not associated with the passage of time, the magnitude of improvement found by the study was higher than that found with passage of time (Kenney et al. 2016). Students with co-occurring depressive symptoms and BD may benefit from receiving CBT and the inclusion of BMI may not yield additional gains. Findings, also suggest that CBT+BMI and CBT may act upon different mechanisms.
Alcoholism: Clinical and Experimental Research, 41 (Supplement 1) : 302A
- Year: 2017
- Problem: Depressive Disorders, Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
Perry, Y., Werner-Seidler, A., Calear, A., Mackinnon, A., King, C., Scott, J., Merry, S., Fleming, T., Stasiak, K., Christensen, H., Batterham, P. J.
BACKGROUND: Depression often emerges for the first time during adolescence. There is accumulating evidence that universal depression prevention programs may have the capacity to reduce the impact of depression when delivered in the school environment.
OBJECTIVE: This trial investigated the effectiveness of SPARX-R, a gamified online cognitive behavior therapy intervention for the prevention of depression relative to an attention-matched control intervention delivered to students prior to facing a significant stressor-final secondary school exams. It was hypothesized that delivering a prevention intervention in advance of a stressor would reduce depressive symptoms relative to the control group.
METHODS: A cluster randomized controlled trial was conducted in 10 government schools in Sydney, Australia. Participants were 540 final year secondary students (mean 16.7 [SD 0.51] years), and clusters at the school level were randomly allocated to SPARX-R or the control intervention. Interventions were delivered weekly in 7 modules, each taking approximately 20 to 30 minutes to complete. The primary outcome was symptoms of depression as measured by the Major Depression Inventory. Intention-to-treat analyses were performed.
RESULTS: Compared to controls, participants in the SPARX-R condition (n=242) showed significantly reduced depression symptoms relative to the control (n=298) at post-intervention (Cohen d=0.29) and 6 months post-baseline (d=0.21) but not at 18 months post-baseline (d=0.33).
CONCLUSIONS: This is the first trial to demonstrate a preventive effect on depressive symptoms prior to a significant and universal stressor in adolescents. It demonstrates that an online intervention delivered in advance of a stressful experience can reduce the impact of such an event on the potential development or exacerbation of depression.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614000316606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365986 (Archived by WebCite at http://www.webcitation.org/ 6u7ou1aI9).
Journal of Medical Internet Research, 19(11) : e369
- 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)
Peters, W., Freeman, M. P., Kim, S., Cohen, L. S., Joffe, H.
PURPOSE/BACKGROUND: Two-thirds of women with depressive disorders report reemergence of depression premenstrually, or premenstrual exacerbation (PME), despite effective treatment of the underlying mood disorder during the remainder of the cycle. There is a paucity of studies that rigorously assess treatments targeting PME. Open-label data suggest that augmentation of antidepressants with the oral contraceptive pill (OCP) drospirenone and ethinyl estradiol (DRSP/EE) improves depressive symptoms that break through treatment premenstrually. We now report results of a randomized placebo-controlled OCP augmentation trial.
METHODS: Women with unipolar depressive disorders in remission on stable antidepressant doses with a 30% increase in Montgomery-Asberg Depression Rating Scale (MADRS) scores from the follicular to luteal phase were randomized to double-blind augmentation of antidepressant with either DRSP/EE or placebo for 2 months. The MADRS and Daily Record of Severity of Problems (DRSP) measures were anchored to the menstrual cycle phase.
FINDINGS/RESULTS: Of 32 women randomized, 25 (n = 12 DRSP/EE, n = 13 placebo) completed the trial. Premenstrual MADRS scores declined by a median of 43.6% and 38.9% (P = 0.59), and premenstrual DRSP scores declined by a median of 23.5% and 20.9% (P = 0.62) in the DRSP/EE and placebo groups, respectively. There was a trend toward greater improvement in premenstrual DRSP scores for women with fewer lifetime depressive episodes (r = -0.40, P = 0.06).
IMPLICATIONS/CONCLUSIONS: Findings from this small randomized trial suggest that OCP augmentation of antidepressants may not be effective for treating premenstrual breakthrough of depression. Future studies should target women established to have hormonal sensitivity prior to antidepressant therapy and those with fewer lifetime depressive episodes.
Journal of Clinical Psychopharmacology, 37(5) : 609-614
- Year: 2017
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions