Disorders - Depressive Disorders
Qin, B., Zhang, Y., Zhou, X., Cheng, P., Liu, Y., Chen, J., Fu, Y., Luo, Q., Xie, P.
Purpose A meta-analysis comparing the efficacy and acceptability of selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) in depressed children, adolescents, and young adults was performed. Methods A comprehensive literature search of the PubMed, Cochrane, Embase, Web of Science, and PsycINFO databases was conducted from 1970 to December 2013. Only clinical trials that randomly assigned one SSRI or TCA to patients aged 7 to 25 years who met the diagnostic criteria for unipolar depressive disorder were included. Primary efficacy was determined by the pooling of standardized mean differences (SMDs) calculated from the difference in the reduction in mean depression rating scale scores for the 2 antidepressants. Acceptability was determined by pooling the risk ratios (RRs) of dropouts for all reasons and for adverse effects as well as the suicide-risk outcome. Findings Five trials with a total of 422 patients were considered to be eligible for inclusion. SSRIs were significantly more effective than TCAs in primary efficacy (SMD = -0.52; 95% CI, -0.81 to -0.24; P = 0.0003). Patients taking SSRIs had a significantly greater response to depressive symptoms than patients taking TCAs (RR = 1.55; 95% CI, 1.04 to 2.29; P = 0.03). On an individual SSRI basis, fluoxetine had a significantly greater efficacy than TCAs (SMD = -0.82; 95% CI, -1.34 to -0.29; P = 0.003). On an individual TCA basis, only imipramine was not significantly worse than SSRIs (SMD = -0.27; 95% CI, -0.56 to 0.02; P = 0.06). Significantly more patients taking TCAs discontinued treatment than patients taking SSRIs (35.8% vs 25.1%; RR = 0.70; 95% CI, 0.52 to 0.93; P = 0.02). Implications SSRI therapy has a superior efficacy and is better tolerated compared with TCA therapy in young patients. (copyright) 2014 Elsevier HS Journals, Inc. All rights reserved.
Clinical Therapeutics, 36(7) : 1087-1095.e4
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants
Reyes-Portillo, J. A., Mufson, L., Greenhill, L. L., Gould, M. S., Fisher, P. W., Tarlow, N., Rynn, M. A.
Results Of the 14,001 citations initially identified, 25 articles met inclusion criteria for Web-based interventions. These described 9 programs, of which 8 were Internet based and 1 was a mobile application. No Web-based interventions for suicide prevention were identified. Of the randomized controlled trials (n = 14) and open trials (n = 3) identified, 10 reported significant postintervention reductions in symptoms of depression and/or anxiety or improvements in diagnostic ratings, with small to large effect sizes. Many of these studies also reported significant improvements at follow-up. The methodological quality of the studies varied. Many programs were limited by their small sample sizes and use of waitlist or no-treatment control groups.
Conclusion There is limited evidence for the effectiveness of Web-based interventions for youth depression and anxiety. Additional research and program development are needed to fill the current gaps in the literature.
Objective To review published reports on Web-based treatment and prevention programs for depression, anxiety, and suicide prevention in children, adolescents, and emerging adults.
Method A systematic search of the PsycINFO, PubMed, Medline, and Web of Science databases was conducted in December 2013. Programs were classified according to evidence-base level (Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and Of Questionable Efficacy).
Journal of the American Academy of Child & Adolescent Psychiatry, 53(12) : 1254-1270.e5
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Rice, S., Goodall, J., Hetrick, S., Parker, A., Gilbertson, T., Amminger, P., Davey, C., McGorry, P., Gleeson, J., Alvarez-Jimenez, M.
The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a remitting and increasingly severe course. Given this, the development of cost-effective, acceptable and population focused treatment and relapse prevention interventions for depression is of critical importance. This study reports on a systematic review of the research literature for standard (e.g., RCT) online intervention approaches (Section 1), and second-generation social networking interventions (Section 2). Section 1 yielded 101 study abstracts, of which 15 met the review inclusion criteria. Section 2 yielded 358 abstracts, of which 22 studies met the inclusion criteria. All Section 1 studies were based on a cognitive behavioural framework, and all but one reported positive results. Results for Section 2 were less consistent; eight of the 16 social networking studies reported positive results for depression related outcomes. The remaining studies were either mixed or negative. Findings for online support groups tended to be more positive, however, noteworthy risks were identified. There was significantly less methodological rigor for studies included in Section 2. Findings highlight that online interventions with a broad cognitive behavioural focus appear to be effective in reducing depression symptomology in young people. Further research is required into the effectiveness of online interventions delivering cognitive behavioural sub-components (e.g., problem solving therapy). Evidence for the use of social networking was less compelling, though limited by a lack of well designed studies and social networking interventions. A range of future social networking therapeutic opportunities are highlighted.
Early Intervention in Psychiatry, 8 : 74
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
, Relapse prevention
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Weitkamp, K., Daniels, J. K., Hofmann, H., Timmermann, H., Romer, G., Wiegand-Grefe, S.
This waitlist-controlled field study aimed to evaluate the effectiveness of psychoanalytic short- and long-term psychotherapy for children and adolescents by using a prospective design. The presented analyses focus on the self- and parent-reported levels of depression and the therapists' ratings of the patients' level of functioning. Thirty-five children and adolescents (aged 4-21 years) and their parents who entered psychoanalytic therapy in private practices in northern Germany participated in this ongoing study. At the time of data analysis, the wait-list control group comprised 17 patients. Data were collected from therapists, parents, and from the patients themselves. Questionnaires were administered at the beginning and the end of treatment, as well as up to 5 points in time during therapy. Follow-up took place at 6 and 12 months after therapy. Depression levels were measured with the self- and parent-reported screening questionnaire Child Depression Inventory, and quality of life with the KIDSCREEN. Patients received, on average, 97 sessions of therapy (range: 25-205). Overall, patients showed pronounced impairments at the commencement of outpatient therapy. At the end of therapy, there was a significant reduction in depression in the treatment group (parent report: d = 0.88, p <.001; patient report d = 0.68, p (less-than or equal to).003). The wait-list control group, which received minimal treatment, displayed a slight, but not statistically significant, symptom improvement in the patient report (d = 0.07, p (less-than or equal to).503), but a significant improvement in the parent report (d = 0.49, p (less-than or equal to).008). The results suggest that psychoanalytic therapy is successful in alleviating depressive pathology and improving quality of life for a significant number of depressed children and adolescents. (copyright) 2013 American Psychological Association.
Psychotherapy, 51(1) : 138-147
- Year: 2014
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Psychodynamic/Psychoanalysis
Wild, K., Scholz, M., Ropohl, A., Brauer, L., Paulsen, F., Burger, P. H. M.
Burnout and stress-related mental disorders (depression, anxiety) occur in medical students and physicians with a significantly higher prevalence than in the general population. At the same time, the learning of coping mechanisms against stress is still not an integral part of medical education. In this pilot study we developed an elective course for learning relaxation techniques and examined the condition of the students before and after the course. 42 students participated in the semester courses in 2012 and 2013 as well as in a survey at the start and end of each course. The students were instructed in autogenic training (AT) and progressive muscle relaxation according to Jacobsen (PMR) with the goal of independent and regular exercising. At the beginning and the end of the semester/course the students were interviewed using standardized, validated questionnaires on burnout (BOSS-II) and anxiety (STAI-G), depression (BDI), quality of life (SF-12) and sense of coherence (SOC-L9). We compared the results of our students participating in Relacs with results from eight semester medical students (n=88), assessed with the same questionnaires at similar points of time within their semester. Participating students showed a significant decline in cognitive and emotional burnout stress and in trait anxiety. Furthermore, they showed a reduction in state anxiety and a conspicuous decrease in mean depression. The sense of coherence increased at the same time. A comparative cohort of medical students of 8th semester students, showed lower values for the specified measurement parameters at the beginning, but showed no progressive changes. Our course introducing AT and PMR led to a significant reduction of burnout and anxiety within the participating group of medical students. Even the course attendance for just one semester resulted in significant improvements in the evaluated parameters in contrast to those students who did not attend the course.
PLoS ONE, 9(12) :
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Relaxation
Taspinar, B., Aslan, U. B., Agbuga, B., Taspinar, F.
Objectives: Physical activity has a positive effect on people's mental health and well-being. The aim of this study was to compare the effects of hatha yoga and resistance exercises on mental health and well-being in sedentary adults. Design: Randomized controlled study. Methods: Fifty-one participants aged mean (SD) 25.6 (5.7) years were randomly divided into three groups: Hatha Yoga Group, Resistance Exercise Group and Control Group. The Hatha Yoga Group and Resistance Exercise Group participated in sessions three days per week for 7 weeks and the Control Group did not participate in any sessions. All the subjects were evaluated through the Rosenberg Self-Esteem Scale, Beck Depression Inventory, Body Cathexis Scale, Nottingham Health Profile and Visual Analog Scale for fatigue pre-and post-session. Results: Significant improvements were found in terms of all outcome measures in the Hatha Yoga Group and the resistance exercise group. No improvements were found in the Control Group. Hatha yoga more improved the dimensions fatigue, self-esteem, and quality of life, whilst resistance exercise training more improved body image. Hatha yoga and resistance exercise decreased depression symptoms at a similar level. Conclusion: The results indicated that hatha yoga and resistance exercise had positive effects on mental health and well-being in sedentary adults. Hatha yoga and resistance exercise may affect different aspects of mental health and well-being. (copyright) 2014 Elsevier Ltd.
Complementary Therapies in Medicine, 22(3) : 433-440
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Mind-body exercises (e.g. yoga, tai chi, qigong)
, Physical activity, exercise
Wahl, M. S., Adelson, J. L., Patak, M. A., Possel, P., Hautzinger, M.
The current study evaluates a depression prevention program for adolescents led by psychologists vs. teachers in comparison to a control. The universal school-based prevention program has shown its efficacy in several studies when implemented by psychologists. The current study compares the effects of the program as implemented by teachers versus that implemented by psychologists under real-life conditions. A total of 646 vocational track 8th grade students from Germany participated either in a universal prevention program, led by teachers (n = 207) or psychologists (n = 213), or a teaching-as-usual control condition (n = 226). The design includes baseline, post-intervention, and follow-up (at 6 and 12 months post-intervention). The cognitive-behavioral program includes 10 sessions held in a regular school setting in same-gender groups and is based on the social information-processing model of social competence. Positive intervention effects were found on the change in girls' depressive symptoms up to 12 months after program delivery when the program was implemented by psychologists. No such effects were found on boys or when program was delivered by teachers. The prevention program can successfully be implemented for girls by psychologists. Further research is needed for explanations of these effects. (copyright) 2014 by the authors; licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research & Public Health, 11(5) : 5294-5316
- Year: 2014
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other service delivery and improvement interventions
Stasiak, K., Hatcher, S., Frampton, C., Merry, S. N.
Background: Depressive disorder is common in adolescents and largely untreated. Computers offer a way of increasing access to care. Computerized therapy is effective for depressed adults but to date little has been done for depressed adolescents.; Aims: The objective of this study was to examine the feasibility, acceptability, and effects of The Journey, a computerized cognitive behavioural therapy (cCBT) program for depressed adolescents.; Method: Thirty-four adolescents (mean age 15.2 years, SD = 1.5) referred by school counsellors were randomly assigned to either cCBT or a computer-administered attention placebo program with psychoeducational content (CPE). Participants completed the intervention at school. Data were collected at baseline, post-intervention and at a 1-month follow-up. The primary outcome measure was the Child Depression Rating Scale Revised (CDRS-R); secondary outcome measures were: RADS-2; Pediatric Quality of Life Inventory; Adolescent Coping Scale (short form); response and remission rates on CDRS-R. Completion rates and self-reported satisfaction ratings were used to assess feasibility and acceptabililty of the intervention.; Results: Ninety-four percent of cCBT and 82% of CPE participants completed the intervention. Eighty-nine percent liked The Journey a lot or thought it was "okay" and 89% of them would recommend it for use with others as is or after some improvement. Adolescents treated with cCBT showed greater symptom improvement on CDRS-R than those treated with CPE program (mean change on cCBT = 17.6, CI = 14.13-21.00; CPE = 6.06, CI = 2.01-10.02; p< .001).; Conclusions: It is feasible, acceptable and efficacious to deliver computerized CBT to depressed adolescents in a school setting. Generalizability is limited by the size of the study.;
Behavioural & Cognitive Psychotherapy, 42(4) : 385-401
- Year: 2014
- 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)
, Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Torkan, H., Blackwell, S. E., Holmes, E. A., Kalantari, M., Neshat-Doost, H. T., Maroufi, M., Talebi, H.
Cognitive bias modification paradigms training positive mental imagery and interpretation (imagery CBM-I) hold promise for treatment innovation in depression. However, depression is a global health problem and interventions need to translate across settings and cultures. The current pilot study investigated the impact of 1 week of daily imagery CBM-I in treatment-seeking individuals with major depression in outpatient psychiatry clinics in Iran. Further, it tested the importance of instructions to imagine the positive training materials. Finally, we examined the effects of this training on imagery vividness. Thirty-nine participants were randomly allocated to imagery CBM-I, a non-imagery control program, or a no treatment control group. Imagery CBM-I led to greater improvements in depressive symptoms, interpretive bias, and imagery vividness than either control condition at post-treatment (n = 13 per group), and improvements were maintained at 2-week follow-up (n = 8 per group). This pilot study provides first preliminary evidence that imagery CBM-I could provide positive clinical outcomes in an Iranian psychiatric setting, and further that the imagery component of the training may play a crucial role. (copyright) 2014 The Author(s).
Cognitive Therapy & Research, 38(2) : 132-145
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Tol, W. A., Komproe, I. H., Jordans, M. J. D., Ndayisaba, A., Ntamutumba, P., Sipsma, H., Smallegange, E. S., Macy, R. D., de-Jong, J. T. V. M.
Background: Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim). Methods: We conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention. Results: No main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes. Conclusions: Given inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings. Trial registration: The study was registered as ISRCTN42284825. (copyright) 2014 Tol et al.; licensee BioMed Central Ltd.
BMC Medicine, 12(1) :
- Year: 2014
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Other Psychological Interventions, Creative expression: music, dance, drama, art
Wijnhoven, L. A. M. W., Creemers, D. H. M., Vermulst, A. A., Scholte, R. H. J., Engels, R. C. M. E.
Depression rates rise dramatically from the early to late adolescence. Especially young adolescent girls with elevated depressive symptoms are at high risk for developing a depression during adolescence or adulthood. Therefore, the prevention of depression is important especially in this high-risk group. The aim of the present study was to examine the effectiveness of the Cognitive Behavioral Therapy (CBT) component of the depression prevention program 'Op Volle Kracht' (OVK) among Dutch adolescent girls with elevated depressive symptoms. In total, 102 adolescent girls (11-15 years) in the first and second year of secondary school participated in this study. The girls in the experimental group (n = 50) followed the eight CBT-lessons of OVK and reported depressive symptoms 1 week prior to the start of the lessons, after every lesson, at one-month and 6-months follow-up. The girls in the control group (n = 52) exclusively reported depressive symptoms at the same time points. Latent Growth Curve Modeling showed that the decrease in depressive symptoms was significantly larger for girls in the experimental group compared to the girls in the control group. Furthermore, it was found that at 6-months follow-up, the girls in the experimental group had significantly lower levels of depressive symptoms compared to the girls in the control group. These findings indicate that the CBT-component of OVK effectively reduces depressive symptoms in short term and possibly prevents the development of a clinical depression. (copyright) 2013 Springer Science+Business Media New York.
Journal of Abnormal Child Psychology, 42(2) : 217-228
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Weytens, F., Luminet, O., Verhofstadt, L. L., Mikolajczak, M.
Over the past fifteen years, positive psychology research has validated a set of happiness enhancing techniques. These techniques are relatively simple exercises that allow happiness seekers to mimic thoughts and behavior of naturally happy people, in order to increase their level of well-being. Because research has shown that the joint use of these exercises increases their effects, practitioners who want to help happiness seekers need validated interventions that combine several of these techniques. To meet this need, we have developed and tested an integrative intervention (Positive Emotion Regulation program - PER program) incorporating a number of validated techniques structured around a theoretical model: the Process Model of Positive Emotion Regulation. To test the effectiveness of this program and to identify its added value relative to existing interventions, 113 undergraduate students were randomly assigned to a 6-week positive emotion regulation pilot program, a loving-kindness meditation training program, or a wait-list control group. Results indicate that fewer participants dropped out from the PER program than from the Loving-Kindness Meditation training. Furthermore, subjects in the PER group showed a significant increase in subjective well-being and life satisfaction and a significant decrease in depression and physical symptoms when compared to controls. Our results suggest that the Process Model of Positive Emotion Regulation can be an effective option to organize and deliver positive integrative interventions. (copyright) 2014 Weytens et al.
PLoS ONE, 9(4) :
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Positive psychology, Meditation