Disorders - Depressive Disorders
Rohde, P., Stice, E., Shaw, H., Gau, J. M.
Objective: The main goal of this study was to evaluate the long-term effects of a brief group cognitive-behavioral (CB) adolescent depression indicated prevention program through 2-year follow-up, relative to CB bibliotherapy and brochure control, when high school personnel recruited students and delivered the program. Method: Three hundred seventy-eight adolescents (M age = 15.5, SD = 1.2; 68% female, 72% White) with elevated self-assessed depressive symptoms who were randomized to CB group, CB bibliotherapy, or educational brochure control were assessed at pretest, posttest, and 6-, 12-, 18-, and 24-month follow-up. Results: By 2 years postintervention, CB group participants showed significantly lower major depressive disorder (MDD) onset versus CB bibliotherapy (10% vs. 25%, respectively; hazard ratio = 2.48, p = .006), but the incidence difference relative to brochure controls (17%) was nonsignificant; MDD incidence for bibliotherapy and brochure controls did not differ. Although CB group participants showed lower depressive symptoms at posttest versus brochure controls, there were no effects for this outcome or for social adjustment or substance use over 2-year follow-up. Moderator analyses suggested that participants with higher baseline depressive symptoms showed greater long-term symptom reductions in the CB group intervention versus bibliotherapy. Conclusions: The evidence that a brief CB group intervention delivered by real-world providers significantly reduced MDD onset versus CB bibliotherapy is potentially encouraging. However, the lack of MDD prevention effects relative to brochure control and lack of long-term symptom effects (though consistent with results from other depression prevention trials), suggest that the delivery of the CB group should be refined to strengthen its effectiveness. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Journal of Consulting & Clinical Psychology, 83(4) : 736-747
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Self-help
Varigonda, A. L., Jakubovski, E., Taylor, M. J., Freemantle, N., Coughlin, C., Bloch, M.H.
Objective: Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for pediatric major depressive disorder (MDD). We conducted a meta-analysis to examine the following: the time-course of response to SSRIs in pediatric depression; whether higher doses of SSRIs are associated with an improved response in pediatric depression; differences in efficacy between SSRI agents; and whether the time-course and magnitude of response to SSRIs is different in pediatric and adult patients with MDD. Method: We searched PubMed and CENTRAL for randomized controlled trials comparing SSRIs to placebo for the treatment of pediatric MDD. We extracted weekly symptom data from trials to characterize the trajectory of pharmacological response to SSRIs. Pooled estimates of treatment effect were calculated based on standardized mean differences between treatment and placebo groups. Results: The meta-analysis included 13 pediatric MDD trials with a total of 3,004 patients. A logarithmic model indicating that the greatest benefits of SSRIs occurred early in treatment best fit the longitudinal data (log[week] = 0.10, 95% CI = 0.06-0.15, p < .0001). There were no significant differences based on maximum SSRI dose or between particular SSRI agents. SSRIs were demonstrated to have a smaller benefit in pediatric compared to adult MDD. Conclusion: Treatment gains in pediatric MDD are greatest early in treatment and are, on average, minimal after 4 weeks of SSRI pharmacotherapy in pediatric MDD. Further research is needed using individual patient data to examine the power of early SSRI response (e.g., 2-4 weeks) to predict outcomes in short-term pharmacological trials. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of the American Academy of Child & Adolescent Psychiatry, 54(7) : 557-564
- Year: 2015
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
Vallury, K. D., Jones, M., Oosterbroek, C.
Background: People living in rural and remote communities have greater difficulty accessing mental health services and evidence-based therapies, such as cognitive behavior therapy (CBT), than their urban counterparts. Computerized CBT (CCBT) can be used to effectively treat depression and anxiety and may be particularly useful in rural settings where there are a lack of suitably trained practitioners.; Objective: To systematically review the global evidence regarding the clinical effectiveness and acceptability of CCBT interventions for anxiety and/or depression for people living in rural and remote locations.; Methods: We searched seven online databases: Medline, Embase Classic and Embase, PsycINFO, CINAHL, Web of Science, Scopus, and the Cochrane Library. We also hand searched reference lists, Internet search engines, and trial protocols. Two stages of selection were undertaken. In the first, the three authors screened citations. Studies were retained if they reported the efficacy, effectiveness or acceptability of CCBT for depression and/or anxiety disorders, were peer reviewed, and written in English. The qualitative data analysis software, NVivo 10, was then used to run automated text searches for the word "rural," its synonyms, and stemmed words. All studies identified were read in full and were included in the study if they measured or meaningfully discussed the efficacy or acceptability of CCBT among rural participants.; Results: A total of 2594 studies were identified, of which 11 met the selection criteria and were included in the review. The studies that disaggregated efficacy data by location of participant reported that CCBT was equally effective for rural and urban participants. Rural location was found to both positively and negatively predict adherence across studies. CCBT may be more acceptable among rural than urban participants - studies to date showed that rural participants were less likely to want more face-to-face contact with a practitioner and found that computerized delivery addressed confidentiality concerns.; Conclusions: CCBT can be effective for addressing depression and anxiety and is acceptable among rural participants. Further work is required to confirm these results across a wider range of countries, and to determine the most feasible model of CCBT delivery, in partnership with people who live and work in rural and remote communities.;
Journal of Medical Internet Research, 17(6) : e139-e139
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
Swain, J., Hancock, K., Dixon, A., Bowman, J.
An emerging body of research demonstrates the effectiveness of Acceptance and Commitment Therapy (ACT) in the treatment of adult psychopathology, with several reviews and meta-analyses attesting to its effectiveness. While there are comparatively fewer empirical studies of child populations, the past few years has seen burgeoning research interest in the utility of ACT for problems in childhood. A systematic review of the published and unpublished literature was conducted to examine the evidence for ACT in the treatment of children and to provide support for clinical decision making in this area. Searches of PsycInfo, PsycArticles, PsycExtra, Proquest and the Association for Contextual Behavioral Science databases were undertaken, as well as reference lists and citation searches conducted, up to December 2014. Broad inclusion criteria were employed to maximise review breadth. Methodological quality was assessed and a narrative synthesis approach adopted. Twenty-one studies covering a spectrum of presenting problems met inclusion criteria, with a total of 707 participants. Studies were predominantly within-group designs, with a lesser proportion of case studies/series, between-group and randomised controlled trials. The preponderance of evidence suggests ACT results in improvements in clinician, parent and self-reported measures of symptoms, quality of life outcomes and/or psychological flexibility, with many studies demonstrating further gains at follow-up assessment. However, several methodological weaknesses limit conclusions, including small samples, non-randomised designs, and few alternative treatment or control comparisons. While larger scale, methodologically rigorous trials from a broader research teams are needed to consolidate these preliminary findings, emerging evidence suggests ACT is effective in the treatment of children across a multitude of presenting problems. ACT may be a viable alternative treatment option for clinicians working with young people.
Journal of Contextual Behavioral Science, 4(2) : 73-85
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Acceptance & commitment therapy (ACT)
Yang, W., Ding, Z., Dai, T., Peng, F., Zhang, J. X.
Background and objectives: Negative attentional biases are often considered to have a causal role in the onset and maintenance of depressive symptoms. This suggests that reduction of such biases may be a plausible strategy in the treatment of depressive symptoms. The present clinical randomized controlled trial examined long-term effects of a computerized attention bias modification (ABM) procedure on individuals with elevated depressive symptoms. Methods: In a double-blind study design, 77 individuals with ongoing mild to severe symptoms of depression were randomly assigned to one of three conditions: 1) ABM training (n = 27); 2) placebo (n = 27); 3) assessment-only (n = 23). In both the ABM and placebo conditions, participants completed 8 sessions of 216-trials (1728 in total) during a 2-week period. Assessments were conducted at pre-training and post-training (0, 2, 4, 8-week, 3, 7-month follow-ups). Change in depressive symptoms and restoration of asymptomatic level were the primary outcome measures. Results: In the ABM, but not the other two conditions, significant reductions in depressive symptoms were found at post-training and maintained during the 3-month follow-up. Importantly, more participants remained asymptomatic in the ABM condition, as compared to the other two conditions, from post-training to 7-month follow-up. ABM also significantly reduced secondary outcome measures including rumination and trait anxiety, and notably, the ABM effect on reducing depressive symptoms was mediated by rumination. Limitation: Generalization of the findings may be limited because the present sample included only college students. Conclusions: The ABM effect on reducing depressive symptoms was maintained for at least 3-month duration in individuals with elevated depressive symptoms, and these results suggest that ABM may be a useful tool for the prevention of depressive symptoms. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Behavior Therapy & Experimental Psychiatry, 49(Part A) : 101-111
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Attention/cognitive bias modification
, Technology, interventions delivered using technology (e.g. online, SMS)
Waters, A. M., Groth, T. A., Sanders, M., O'Brien, R., Zimmer-Gembeck, M. J.
Clinical scientists are calling for strong partnerships in the provision of evidence-based treatments for child mental health problems in real-world contexts. In the present study, we describe the implementation of a cognitive-behavioral intervention (CBI) to address grade 5 children's anxiety symptoms. The CBI arose from a long-standing partnership between University and Education Department stakeholders. The partnership integrates school-based, evidence-informed treatment delivery with clinical education, and also supports a school-based psychology clinic to provide assessment and treatment services to children attending schools within the catchment area and clinical training for university graduate students. Children in the active condition (. N=. 74) completed the CBI during regular class time, while children in the control condition (. N=. 77) received the standard classroom curriculum. Children's anxiety and depressive symptoms, threat interpretation biases (perceived danger and coping ability), and perceptions of their social skills were assessed before and after condition. Children in the active condition reported significant improvements in self-reported anxiety symptoms, and perceptions of their social skills and coping ability, whereas no significant differences were observed for children in the control condition from pre- to post-assessment. For a subset of children assessed 12. months after the CBI (. n=. 76), symptom improvement remained stable over time and estimates of danger and coping ability showed even greater improvement. Results demonstrate the value of strong stakeholder partnerships in innovative youth mental health services, positive child outcomes, and clinical education.
Behavior Therapy, 46(6) : 844-855
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Weissman, M. M., Wickramaratne, P., Pilowsky, D.J., Poh, E., Batten, L. A., Hernandez, M., Flament, M. F., Stewart, J. A., McGrath, P., Blier, P., Stewart, J.W.
Objective: Observational studies show that when a depressed mother's symptoms remit, her children's psychiatric symptoms decrease. Using randomized treatment assignment, the authors sought to determine the differential effects of a depressed mother's treatment on her child. Method: The study was a randomized double-blind 12-week trial of escitalopram, bupropion, or the combination of the two in depressed mothers (N=76), with independent assessment of their children (N=135; ages 7-17 years). Results: There were no significant treatment differences in mothers' depressive symptoms or remission. Children's depressive symptoms and functioning improved significantly among those whose mothers were in the escitalopram group (compared with those whose mothers were in the bupropion and combination treatment groups). Only in the escitalopram group was significant improvement of mother's depression associated with improvement in the child's symptoms. Exploratory analyses suggested that this may be due to changes in parental functioning: Mothers in the escitalopram group reported significantly greater improvement, compared with the other groups, in their ability to listen and talk to their children,who as a group reported that their mothers were more caring over the 12 weeks. Maternal baseline negative affectivity appeared to moderate the effect of maternal treatment on children, although the effect was not statistically significant. Children of mothers with low negative affectivity improved in all treatment groups. Children of mothers with high negative affectivity improved significantly only for those whose mothers were in the escitalopram group. Conclusions: The effects of the depressed mother's improvement on her children may depend on her type of treatment. Depressed mothers with high anxious distress and irritability may require medications that reduce these symptoms in order to show the effect of her remission on her children. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
The American Journal of Psychiatry, 172(5) : 450-459
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
White, D. J., Cox, K. H. M., Peters, R., Pipingas, A., Scholey, A. B.
This study explored the effects of four-week multi-vitamin and mineral (MVM) supplementation on mood and neurocognitive function in healthy, young adults. Fifty-eight healthy adults, 18 - 40 years of age (M= 25.82 years, SD = 4.87) participated in this randomised, double-blind, placebo-controlled trial, in which mood and blood biomarkers were assessed at baseline and after four weeks of supplementation. Compared to placebo, MVM supplementation was associated with significantly lowered homocysteine and increased blood B-vitamin levels (p < 0.01). MVMtreatment was also associated with significantly improved mood, as measured by reduced scores on the "depression-dejection" subscale of the Profile of Mood States (p = 0.018). These findings suggest that the four weeks of MVM supplementation may have beneficial effects on mood, underpinned by elevated B-vitamins and lowered homocysteine in healthy young adults.
Nutrients, 7(11) : 9005-9017
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Vitamins and supplements
Wiegand, S., Bianchi, W., Quinn, T. A., Best, M., Fotopoulos, T.
Context: During medical education, many students experience psychological distress, including symptoms such as fatigue, stress, and depression.; Objective: To evaluate the effect of osteopathic manipulative treatment (OMT) on self-perceived fatigue, stress, and depression in first-year osteopathic medical students.; Methods: This randomized controlled pilot study with repeated measures was conducted at the Lake Erie College of Osteopathic Medicine-Bradenton in Florida during the fall 2012 semester. First-year osteopathic medical students voluntarily enrolled in the study and were randomly assigned to directed OMT (D-OMT), nondirected OMT (ND-OMT), or control groups. The D-OMT and ND-OMT groups received treatment by osteopathic physicians weekly for 4 weeks. The control group received no treatment. All groups completed the Epworth Sleepiness Scale (ESS), the Self-Perceived Stress Scale (SPSS), and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire 9 (PHQ-9) depression scale before treatment (pretest), after 2 treatments (midtest), and after 4 treatments (posttest).; Results: All participants self-reported as white and single, with both sexes equally represented, and had an mean age of 24 years. Analysis of ESS scores revealed a statistically significant decrease in the D-OMT group from pretest and posttest scores and a statistically significant increase in the ND-OMT group from pretest to midtest but not from pretest to posttest scores. No statistically significant differences were noted in the control group scores on this measure. No statistically significant differences were seen in the SPSS or PHQ-9 scores from pretest to midtest or pretest to posttest in any of the 3 groups.; Conclusion: The D-OMT regimen used in the current study produced a statistically significant decrease in self-perceived fatigue in first-year osteopathic medical students. Osteopathic manipulative treatment represents a potential modality to reduce self-perceived distress in medical students. Further research is warranted.; © 2015 The American Osteopathic Association.
Journal of the American Osteopathic Association, 115(2) : 84-93
- Year: 2015
- 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
Tang, T. C., Yang, P., Yen, C. F., Liu, T. L.
In this case-control study, we aimed to assess the intervention effects of foursession eye movement desensitization and reprocessing (EMDR) on reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in Taiwanese adolescents who experienced Typhoon Morakot. A total of 83 adolescents with posttraumatic stress disorder related to Typhoon Morakot, major depressive disorder, or current moderate or high suicide risk after experiencing Typhoon Morakot were allocated to a four-session course of EMDR (N=41) or to treatment as usual (TAU; N = 42). A multivariate analysis of covariance was performed to examine the effects of EMDR in reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in adolescents by using preintervention severity values as covariates. The multivariate analysis of covariance results indicated that the EMDR group exhibited significantly lower preintervention severity values of general anxiety and depression than did the TAU group. In addition, the preintervention severity value of disaster-related anxiety in the EMDR group was lower than that in the TAU group (p=0.05). The results of this study support that EMDR could alleviate general anxiety and depressive symptoms and reduce disaster-related anxiety in adolescents experiencing major traumatic disasters.
Kaohsiung Journal of Medical Sciences, 31(7) : 363-369
- Year: 2015
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Eye movement desensitisation and reprocessing (EMDR)
Steenbergen, L., Sellaro, R., van-Hemert, S., Bosch, J. A., Colzato, L. S.
Background: Recent insights into the role of the human microbiota in cognitive and affective functioning have led to the hypothesis that probiotic supplementation may act as an adjuvant strategy to ameliorate or prevent depression. Objective: Heightened cognitive reactivity to normal, transient changes in sad mood is an established marker of vulnerability to depression and is considered an important target for interventions. The present study aimed to test if a multispecies probiotic containing Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, and Lactococcus lactis (W19 and W58) may reduce cognitive reactivity in non-depressed individuals. Design: In a triple-blind, placebo-controlled, randomized, pre- and post-intervention assessment design, 20 healthy participants without current mood disorder received a 4-week probiotic food-supplement intervention with the multispecies probiotics, while 20 control participants received an inert placebo for the same period. In the pre- and post-intervention assessment, cognitive reactivity to sad mood was assessed using the revised Leiden index of depression sensitivity scale. Results: Compared to participants who received the placebo intervention, participants who received the 4-week multispecies probiotics intervention showed a significantly reduced overall cognitive reactivity to sad mood, which was largely accounted for by reduced rumination and aggressive thoughts. Conclusion: These results provide the first evidence that the intake of probiotics may help reduce negative thoughts associated with sad mood. Probiotics supplementation warrants further research as a potential preventive strategy for depression. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Brain, Behavior & Immunity, 48 : 258-264
- Year: 2015
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Vitamins and supplements
O'Dea, B., Calear, A. L., Perry, Y.
Purpose of review: Depression and anxiety are prevalent among adolescents; however, many young people do not seek help from professional services. This is due, in part, to the inadequacies of existing healthcare systems. This article aims to review the current evidence for e-health interventions for depression and anxiety in youth, as a potential solution to the gaps in mental health service provision. Recent findings: Five randomized controlled trials reporting on e-health interventions for youth depression or anxiety were identified. Of these, two trials focused exclusively on anxiety symptoms, and three trials examined both anxiety and depression. The majority of trials assessed online cognitive behavioral therapy and focused on prevention rather than treatment. In all but one trial, results demonstrated positive effects for the e-health interventions, relative to the control. Summary: There is growing evidence for the effectiveness of online cognitive behaviour therapy interventions for reducing the level of anxiety and depressive symptoms in adolescents aged between 12 and 18 years, when delivered in school and clinical settings, with some level of supervision. However, there are a number of gaps in the literature. More research is needed to strengthen the evidence base for prevention and treatment programs that are delivered via the internet, particularly for depression. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Current Opinion in Psychiatry, 28(4) : 336-342
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)