Disorders - Depressive Disorders
Garrido, Sandra, Schubert, Emery, Bangert, Daniel
Background: Music is used in a variety of health contexts for mood regulation purposes. However, while research demonstrates that self-selected music is most effective in using music to alter mood in a positive direction, some people, particularly those with tendencies to depression, may incline towards music that perpetuates a negative mood. Methods: Participants were randomly assigned to Happy and Sad music groups and listened to a prescribed playlist for four weeks. Pre- and post- mood measures were taken as well as diaries of mood responses, which were analysed both qualitatively and quantitatively. Results: No long-term mood effects were observed. The affective impact was less positive for people with high scores in rumination. However, the diary-taking exercise raised participant awareness of mood impacts and increased deliberateness of music use in some participants. Conclusions: Researcher-selected music is limited in effectiveness to a single listening session even where playlists are carefully designed to appeal to the sample. However, consciousness-raising programs may be effective in changing the long-term listening habits of people who for whom music choice is sub-optimal as a coping strategy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
The Arts in Psychotherapy, 51 : 46-53
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Gest, S., Holtmann, M., Bogen, S., Schulz, C., Pniewski, B., Legenbauer, T.
Chronotherapeutics such as wake therapy and bright light therapy are well-established methods in treating adults with depressive disorders and are additionally beneficent for sleep regulation. Few studies concerning chronotherapeutics in juvenile depression exist, though the established treatments are insufficient and sleep disorders often co-occur. In this study, we investigate the impact of two types of chronotherapeutics on depressive symptoms and sleep behavior in a juvenile setting. Juvenile inpatients (n = 62) with moderate to severe depressive symptoms took part in either a combined setting consisting of one night wake therapy followed by 2 weeks bright light therapy or in a setting of bright light therapy alone. Depressive symptoms, general psychopathology, clinical impression and sleep behavior were measured before (T1), directly after (T2) and 2 weeks after intervention (T3). Depressive symptoms decreased while sleep quality increased in both groups. The bright light therapy alone group showed further improvement at T3 in regards to depressive symptoms. Correlation analyses indicated significant negative correlations between sleep quality and awaking after restorative sleep with the depressive symptoms. However, only awaking after restorative sleep had a predictive impact on treatment outcome. The present study provides first evidence for a positive impact of chronotherapeutic interventions on treatment outcome in depressed juvenile inpatients. Bright light therapy seems to stabilize and further enhance reduction of depressive symptoms during follow-up, whereas one night wake therapy does not have an additional long-lasting impact on depressive symptoms and sleep parameters.
European Child & Adolescent Psychiatry, 25(2) : 151-61
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Bright light therapy
Goossens, F. X., Lammers, J., Onrust, S. A., Conrod, P. J., de-Castro, B. O., Monshouwer, K.
Problematic substance use and mental health problems often co-occur in adolescents. Effective school-based interventions that are brief and target multiple problems are promising in the field of health promotion. Preventure is a brief, school-based, selective preventive intervention, tailored to four personality profiles. Preventure has already proved effective on alcohol outcomes. Previous trials also reveal effects on several mental health outcomes, yet the evidence for these outcomes is limited. This study presents the results of the Dutch Preventure Trial, on a range of mental health outcomes. In a cluster RCT, including 699 high risk students (mean age 14 years), the intervention effects on mental health problems at 2, 6, and 12 months post intervention were tested in the total high risk population and in four specific personality groups. No significant intervention effects were found on 22 from the 24 tests. A positive intervention effect on anxiety was found in the anxiety sensitivity personality group at 12-month follow-up, and a negative intervention effect on depression was found at 12-month follow-up in the negative thinking group. In post hoc growth curve analyses these effects were not found. This study found no convincing evidence for the effectiveness of Preventure in The Netherlands on mental health problems. This finding is not in line with the results of an earlier effectiveness study in the UK. This highlights the need for more research into the knowledge transfer model of interventions, to ensure that interventions are effective in a variety of circumstances.
European Child & Adolescent Psychiatry, 25(6) : 639-648
- Year: 2016
- 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)
, Motivational interviewing, includes Motivational Enhancing Therapy
Gruhn, M. A., Forehand, R., Compas, B.
Objectives: In a randomized clinical trial with 180 families of parents with a history of major depressive disorder, levels of stress reactivity were examined as a mediator of the effects of a family group cognitive-behavioral (FGCB) intervention on adolescent's use of coping skills. Methods: Families were either randomized to a written information (WI) condition, or a FGCB intervention condition. The FGCB intervention is a manualized 12-session program designed to teach parenting skills to parents and facilitate the development of adaptive coping responses to stress in youth (see Compas et al., 2009). The Parental Depression version of the Responses to Stress Questionnaire (RSQ; Connor-Smith, Compas, Wadsworth, Thomsen, & Saltzman, 2000; Jaser et al., 2005, 2008) was used to assess self-reported levels of stress reactivity and three factors of coping in youth: primary control coping (e.g., problem solving), secondary control coping (e.g., positive thinking), and disengagement coping (e.g., avoidance; Connor-Smith et al., 2000). Stress reactivity, the hypothesized mediator, was assessed at 2 months, and adolescents' primary control, secondary control, and disengagement coping skills were measured at a 6-month follow-up. Results: Stress reactivity mediated the effects of the intervention on primary control coping skills (t = =2.12, p < .05) and secondary control coping skills (t = -7.90, p < .001) after adolescents completed the intervention, accounting for approximately half of the effect of the intervention on the outcomes. No significant mediating effects were found for stress reactivity and disengagement coping. Conclusions: The present study provides the first evidence of stress reactivity as a mediator within a family group cognitive-behavioral preventive intervention for families of parents with a history of major depressive disorder. Further investigation of the relations between stress reactivity and coping is vital to implementing preventive interventions targeting the reduction of mental health problems in children of depressed parents.
Journal of the American Academy of Child and Adolescent Psychiatry, 55 (10 Supplement 1) : S213
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Gunlicks-Stoessel, M., Mufson, L.
Background: Problems in adolescents' relationships with their parents are a significant risk factor for the development and maintenance of depression. The purpose of this pilot study was to examine the feasibility and acceptability of an adaptation of interpersonal psychotherapy for depressed adolescents (IPT-A) who were also experiencing problems in their relationships with parents. The adaptation includes greater and more structured parent involvement in the treatment (IPT-AP). Method: Fifteen adolescents (age 12-17) who were diagnosed with depression and were also experiencing conflictual or emotionally disengaged relationships with their parents (based on adolescent or parent report on the Conflict Behavior Questionnaire) participated in a 16 week randomized clinical trial of individually delivered IPT-A versus IPT-AP. Data regarding the feasibility and acceptability of IPT-AP were collected. Assessments of depression and family functioning were completed at baseline and weeks 4, 8, 12, and 16 by evaluators blind to treatment condition. Results: IPT-AP was feasible to implement, and adolescents and parents reported high treatment satisfaction. Adolescents demonstrated significant improvements in depressive symptoms, general functioning, and family functioning. IPT-AP was more efficacious than individual IPT-A in improving adolescents' perceptions of father-adolescent relations and mothers' perceptions of mother-adolescent relations. Conclusions: Interpersonal psychotherapy for depressed adolescents and their parents was feasible to implement and acceptable to families, indicating that a full-scale randomized controlled trial to evaluate its efficacy is warranted.
Child & Adolescent Mental Health, :
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Interpersonal therapy (IPT)
, Other service delivery and improvement interventions
Gunlicks-Stoessel, Meredith, Mufson, Laura, Westervelt, Ana, Almirall, Daniel, Murphy, Susan
This pilot study was conducted to assess the feasibility and acceptability of 4 adaptive treatment strategies (ATSs) for adolescent depression to plan for a subsequent full-scale clinical trial. The ATSs aim to address 2 questions that arise when personalizing treatment: (a) For adolescents treated with Interpersonal Psychotherapy for depressed adolescents (IPT-A; Mufson et al., 2004), at what time point should therapists make the determination that the adolescent is not likely to respond if the initial treatment plan is continued (week 4 or week 8)? (b) For adolescents who are judged to need their treatment augmented, should the therapist increase the number of IPT-A sessions or add pharmacotherapy (fluoxetine)? A 16-week pilot sequential multiple assignment randomized trial (SMART) was conducted with 32 adolescents (M age = 14.9) who had a diagnosis of major depressive disorder, dysthymic disorder, or depressive disorder not otherwise specified. Adolescents were primarily female (75%) and Caucasian (84.4%). Data regarding the feasibility and acceptability of the study and treatment procedures and treatment response rates were collected. Week 4 was the more feasible and acceptable decision point for assessing need for a change to treatment. Adolescents, parents, and therapists reported a range of attitudes about medication and more intensive therapy as treatment options. Results from the pilot study have yielded additional research questions for the full-scale SMART and will improve our ability to successfully conduct the trial. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Clinical Child and Adolescent Psychology, 45(4) : 480-494
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Service Delivery & Improvement, Psychological Interventions (any)
, Interpersonal therapy (IPT)
, Other service delivery and improvement interventions
Hallford, D. J., Mellor, D.
Psychotherapy & Psychosomatics, : 246-249
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Johnson, C., Burke, C., Brinkman, S., Wade, T.
Anxiety, depression and eating disorders show peak emergence during adolescence and share common risk factors. School-based prevention programs provide a unique opportunity to access a broad spectrum of the population during a key developmental window, but to date, no program targets all three conditions concurrently. Mindfulness has shown promising early results across each of these psychopathologies in a small number of controlled trials in schools, and therefore this study investigated its use in a randomised controlled design targeting anxiety, depression and eating disorder risk factors together for the first time. Students (M age 13.63; SD = .43) from a broad band of socioeconomic demographics received the eight lesson, once weekly.b ("Dot be") mindfulness in schools curriculum (N = 132) or normal lessons (N = 176). Anxiety, depression, weight/shape concerns and wellbeing were the primary outcome factors. Although acceptability measures were high, no significant improvements were found on any outcome at post-intervention or 3-month follow-up. Adjusted mean differences between groups at post-intervention were .03 (95% CI: -.06 to -.11) for depression, .01 (-.07 to -.09) for anxiety, .02 (-.05 to -.08) for weight/shape concerns, and .06 (-.08 to -.21) for wellbeing. Anxiety was higher in the mindfulness than the control group at follow-up for males, and those of both genders with low baseline levels of weight/shape concerns or depression. Factors that may be important to address for effective dissemination of mindfulness-based interventions in schools are discussed. Further research is required to identify active ingredients and optimal dose in mindfulness-based interventions in school settings.
Behaviour Research & Therapy, 81 : 1-11
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Hetrick, S. E., Cox, G. R., Witt, K. G., Bir, J. J., Merry, S. N.
BACKGROUND: Depression is common in young people. It has a marked negative impact and is associated with self-harm and suicide. Preventing its onset would be an important advance in public health. This is an update of a Cochrane review that was last updated in 2011.
OBJECTIVES: To determine whether evidence-based psychological interventions (including cognitive behavioural therapy (CBT), interpersonal therapy (IPT) and third wave CBT)) are effective in preventing the onset of depressive disorder in children and adolescents.
SEARCH METHODS: We searched the specialised register of the Cochrane Common Mental Disorders Group (CCMDCTR to 11 September 2015), which includes relevant randomised controlled trials from the following bibliographic databases: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched conference abstracts and reference lists of included trials and reviews, and contacted experts in the field.
SELECTION CRITERIA: We included randomised controlled trials of an evidence-based psychological prevention programme compared with any comparison control for young people aged 5 to 19 years, who did not currently meet diagnostic criteria for depression.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed trials for inclusion and rated their risk of bias. We adjusted sample sizes to take account of cluster designs and multiple comparisons. We contacted trial authors for additional information where needed. We assessed the quality of evidence for the primary outcomes using GRADE.
MAIN RESULTS: We included 83 trials in this review. The majority of trials (67) were carried out in school settings with eight in colleges or universities, four in clinical settings, three in the community and four in mixed settings. Twenty-nine trials were carried out in unselected populations and 53 in targeted populations.For the primary outcome of depression diagnosis at medium-term follow-up (up to 12 months), there were 32 trials with 5965 participants and the risk of having a diagnosis of depression was reduced for participants receiving an intervention compared to those receiving no intervention (risk difference (RD) -0.03, 95% confidence interval (CI) -0.05 to -0.01; P value = 0.01). We rated this evidence as moderate quality according to the GRADE criteria. There were 70 trials (73 trial arms) with 13,829 participants that contributed to the analysis for the primary outcome of depression symptoms (self-rated) at the post-intervention time point, with results showing a small but statistically significant effect (standardised mean difference (SMD) -0.21, 95% CI -0.27 to -0.15; P value < 0.0001). This effect persisted to the short-term assessment point (up to three months) (SMD -0.31, 95% CI -0.45 to -0.17; P value < 0.0001; 16 studies; 1558 participants) and medium-term (4 to 12 months) assessment point (SMD -0.12, 95% CI -0.18 to -0.05; P value = 0.0002; 53 studies; 11,913 participants); however, the effect was no longer evident at the long-term follow-up. We rated this evidence as low to moderate quality according to the GRADE criteria.The evidence from this review is unclear with regard to whether the type of population modified the overall effects; there was statistically significant moderation of the overall effect for depression symptoms (P value = 0.0002), but not for depressive disorder (P value = 0.08). For trials implemented in universal populations there was no effect for depression diagnosis (RD -0.01, 95% CI -0.03 to 0.01) and a small effect for depression symptoms (SMD -0.11, 95% CI -0.17 to -0.05). For trials implemented in targeted populations there was a statistically significantly beneficial effect of intervention (depression diagnosis RD -0.04, 95% CI -0.07 to -0.01; depression symptoms SMD -0.32, 95% CI -0.42 to -0.23). Of note were the lack of attention placebo-controlled trials in targeted populations (none for depression diagnosis and four for depression symptoms). Among trials implemented in universal populations a number used an attention placebo comparison in which the intervention consistently showed no effect.
AUTHORS' CONCLUSIONS: Overall the results show small positive benefits of depression prevention, for both the primary outcomes of self-rated depressive symptoms post-intervention and depression diagnosis up to 12 months (but not beyond). Estimates of numbers needed to treat to benefit (NNTB = 11) compare well with other public health interventions. However, the evidence was of moderate to low quality using the GRADE framework and the results were heterogeneous. Prevention programmes delivered to universal populations showed a sobering lack of effect when compared with an attention placebo control. Interventions delivered to targeted populations, particularly those selected on the basis of depression symptoms, had larger effect sizes, but these seldom used an attention placebo comparison and there are practical difficulties inherent in the implementation of targeted programmes. We conclude that there is still not enough evidence to support the implementation of depression prevention programmes.Future research should focus on current gaps in our knowledge. Given the relative lack of evidence for universal interventions compared with attention placebo controls and the poor results from well-conducted effectiveness trials of universal interventions, in our opinion any future such trials should test a depression prevention programme in an indicated targeted population using a credible attention placebo comparison group. Depressive disorder as the primary outcome should be measured over the longer term, as well as clinician-rated depression. Such a trial should consider scalability as well as the potential for the intervention to do harm.
Cochrane Database of Systematic Reviews, (8) : CD003380
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Dialectical behavioural therapy (DBT)
, Interpersonal therapy (IPT)
, Mindfulness based therapy, Acceptance & commitment therapy (ACT)
, Positive psychology
Lai, E. S. Y., Kwok, C. L., Wong, P. W. C., Fu, K. W., Law, Y. W., Yip, P. S. F.
Background A pilot study about the effectiveness of a universal school-based programme, "The Little Prince is Depressed", for preventing depression in Chinese adolescents in Hong Kong was conducted and reported previously. This study used a larger sample to examine the effectiveness and sustainability of the programme. Methods This study used quasi-experimental design. Twelve schools enrolled in "The Little Prince is Depressed" programme either as an intervention or a control condition. The intervention schools carried out the 12-session programme in two phases: the professional-led first phase and the teacher-led second phase. All participants were required to complete a questionnaire at three time points measuring their (1) depressive, anxiety, and stress levels; (2) knowledge of mental health; (3) attitudes towards mental illness; (4) perceived social support; and (5) help-seeking behaviours. Results A total of 3,391 students participated in the study. The level of depressive symptoms did not reduce significantly at post-intervention; however, a delayed effect was observed at followup assessment for the participants of the teacher-led group in reducing anxiety and stress levels. Also, the knowledge of mental health and attitudes towards mental illness of the intervention-group participants significantly improved at post-test, and the outcomes were maintained at 4 to 5 months after the intervention in both the professional-led and the teacher-led conditions (p<.05). A preference among schoolchildren for whom to seek help from was identified. Conclusions The universal depression prevention programme was effective in enhancing knowledge of mental health and promoting a more positive attitude towards mental illness among adolescents in Hong Kong. In particular, the teacher-led group showed better outcomes than the professional-led group in reducing students' anxiety and stress at follow-up period. The programme can achieve sustainability in schools if teachers are provided with adequate support.
PLoS ONE, 11(2) :
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Skills training
Kondo, D. G., Forrest, L. N., Shi, X., Sung, Y. H., Hellem, T. L., Huber, R. S., Renshaw, P. F.
Major depressive disorder (MDD) often begins during adolescence and is projected to become the leading cause of global disease burden by the year 2030. Yet, approximately 40 % of depressed adolescents fail to respond to standard antidepressant treatment with a selective serotonin reuptake inhibitor (SSRI). Converging evidence suggests that depression is related to brain mitochondrial dysfunction. Our previous studies of MDD in adult and adolescent females suggest that augmentation of SSRI pharmacotherapy with creatine monohydrate (CM) may improve MDD outcomes. Neuroimaging with phosphorus-31 magnetic resonance spectroscopy (31P-MRS) can measure the high-energy phosphorus metabolites in vivo that reflect mitochondrial function. These include phosphocreatine (PCr), a substrate for the creatine kinase reaction that produces adenosine triphosphate. As part of the National Institute of Mental Health's experimental medicine initiative, we conducted a placebo-controlled dose-ranging study of adjunctive CM for adolescent females with SSRI-resistant MDD. Participants were randomized to receive placebo or CM 2, 4 or 10 g daily for 8 weeks. Pre- and post-treatment 31P-MRS scans were used to measure frontal lobe PCr, to assess CM's target engagement with cerebral energy metabolism. Mean frontal lobe PCr increased by 4.6, 4.1 and 9.1 % in the 2, 4 and 10 g groups, respectively; in the placebo group, PCr fell by 0.7 %. There was no group difference in adverse events, weight gain or serum creatinine. Regression analysis of PCr and depression scores across the entire sample showed that frontal lobe PCr was inversely correlated with depression scores (p = 0.02). These results suggest that CM achieves target engagement with brain bioenergetics and that the target is correlated with a clinical signal. Further study of CM as a treatment for adolescent females with SSRI-resistant MDD is warranted.
Amino Acids, : 1-14
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Other biological interventions
Kumar, S. S., Rajagopalan, A., Mukkadan, J. K.
Introduction: Although several methods are developed to alleviate stress among college students, logistic limitations in adopting them have limited their utility. Aim: Hence, we aimed to test a very practical approach to alleviate stress among college students by achieving vestibular stimulation using swings. Materials and Methods: In this study 60 male and female participants were randomly assigned into vestibular stimulation or control groups. Depression, anxiety, stress scores, sleep quality, heart rate, blood pressure, Autonomic functions, respiratory, haematological, cognitive function, Quality of life were recorded before and after 1st, 7th, 14th, 21st, 28th days of vestibular stimulation. Results: STAI S and STAI T scores were significantly improved on day 28th following vestibular stimulation. Diastolic and mean arterial blood pressure were significantly decreased and remained within normal limits in vestibular group on day 28th following vestibular stimulation. Postural fall in blood pressure was significantly improved on day 14 onwards, following vestibular stimulation. Respiratory rate was significantly improved on day 7 onwards, following vestibular stimulation. PSQI sleep disturbance, PSQI sleep latency, PSQI total score and bleeding time was significantly improved following vestibular stimulation. Conclusion: Our study supports the adoption of vestibular stimulation for stress management. Hence, placement of swings in college campuses must be considered, which may be a simple approach to alleviate stress among college students.
Journal of Clinical & Diagnostic Research, 10(2) : CC27-CC31
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other complementary & alternative interventions