Disorders - Depressive Disorders
Shirk, S. R., DePrince, A. P., Crisostomo, P. S., Labus, J.
Four clinical trials have shown that a history of interpersonal trauma is associated with diminished response to cognitive-behavioral therapy (CBT) for adolescent depression. An efficacious CBT protocol for adolescent depression was modified to address cognitive deficits and distortions associated with interpersonal trauma. Initial feasibility, acceptability, and treatment impact of the modified treatment (m-CBT) were evaluated in a randomized effectiveness trial conducted in community clinics. Clients were 43 referred adolescents with a depressive disorder and a history of interpersonal trauma. Adolescents either received m-CBT or usual care (UC) therapy. Results indicated that m-CBT was delivered with good fidelity by community clinicians, but that number of sessions completed was attenuated in both m-CBT and UC. Adolescents reported high levels of treatment satisfaction and acceptability for the new treatment. There were significant reductions in depressive symptoms over time, but no differences in outcomes between groups. Although the new treatment produced promising results, it did not outperform UC. Implications for treatment development are considered. (copyright) 2013 American Psychological Association.
Psychotherapy, 51(1) : 167-179
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Spence, S. H., Sawyer, M. G., Sheffield, J., Patton, G., Bond, L., Graetz, B., Kay, D.
To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of universal versus targeted approaches to the prevention of depression. (copyright) 2014 by the authors; licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research & Public Health, 11(5) : 5113-5132
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Zhou, X., Michael, K. D., Liu, Y., Del-Giovane, C., Qin, B., Cohen, D., Gentile, S., Xie, P.
Background: Current guidelines for treatment-resistant depression in adolescents remain inadequate. This study aimed to systematically review the management of treatment-resistant depression in adolescent patients. Methods: We conducted an electronic database search of PUBMED, EMBASE, Cochrane, Web of Science and PsycINFO for studies with adolescent treatment-resistant depression published up to January 2014. Treatment-resistant depression was defined as failure to respond to at least one course of psychological or pharmacological treatment for depression with an adequate dosage, duration, and appropriate compliance during the current illness episode. The Cochrane risk-of-bias method was used to assess the quality of randomized controlled trials. A meta-analysis of all active treatments was conducted. Results: Eight studies with 411 depressed adolescents that fit predetermined criteria investigated pharmacological treatments and psychotherapies. Six were open-label studies, and two were randomized controlled trials. The overall response rate for all active treatments investigated was 46% (95% CI 33 to 59; N = 411) with a moderately high degree of heterogeneity (I2 = 76.1%, 95% CI = 47%-86%). When only the two randomized trials were included, the overall response rate of active treatment was 53% (95% CI = 38-67; N = 347). In these randomized trials, SSRI therapy plus CBT was significantly more effective than SSRI therapy alone, while amitriptyline was not more effective than placebo. Conclusions: Approximately half of the adolescents who presented with treatment-refractory depression responded to active treatment, which suggests that practitioners should remain persistent in managing these challenging cases. The combination of antidepressant medication and psychotherapy should be recommended for adolescents who present with treatment-resistant depression.
BMC Psychiatry, 14(1) :
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Treatment resistant/treatment refractory
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Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants
Spielmans, G. I., Gerwig, K.
Background: Recent meta-analyses of the efficacy of second-generation antidepressants for youth have concluded that such drugs possess a statistically significant advantage over placebo in terms of clinician-rated depressive symptoms. However, no meta-analysis has included measures of quality of life, global mental health, self-esteem, or autonomy. Further, prior meta-analyses have not included self-reports of depressive symptoms. Methods: Studies were selected through searching Medline, PsycINFO, and the Cochrane Central Register for Controlled Trials databases as well as GlaxoSmithKline's online trial registry. We included self-reports of depressive symptoms and pooled measures of quality of life, global mental health, self-esteem, and autonomous functioning as a proxy for overall well-being. Results: We found a nonsignificant difference between second-generation antidepressants and placebo in terms of self-reported depressive symptoms (k = 6 trials, g = 0.06, p = 0.36). Further, pooled across measures of quality of life, global mental health, self-esteem, and autonomy, antidepressants yielded no significant advantage over placebo (k = 3 trials, g = 0.11, p = 0.13). Discussion: Though limited by a small number of trials, our analyses suggest that antidepressants offer little to no benefit in improving overall well-being among depressed children and adolescents. (copyright) 2014 S. Karger AG, Basel.
Psychotherapy & Psychosomatics, 83(3) : 158-164
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Zaunmuller, L., Lutz, W., Strauman, T. J.
METHOD: Participants (N = 92) who reported either low or high levels of dysphoric symptoms were randomly assigned to the restructuring microintervention, a control intervention or a no-intervention condition. We obtained recordings of event-related potentials (ERPs) as well as mood self-ratings during an experimental session immediately after the psychotherapeutic microintervention and the control intervention in which a set of negatively valenced pictures (IAPS) was presented with different instructions.
RESULTS: Whereas the restructuring intervention group and the control intervention group reported both increases in positive and decreases in negative affect from pre- to post-intervention, the three groups differed significantly on ERP measures.
CONCLUSIONS: Findings provide support for current models of mechanisms of action in cognitive therapies.
OBJECTIVE: Psychotherapy for depression emphasizes techniques that can help individuals regulate their moods. The present study investigated the affective impact and electrocortical correlates of cognitive restructuring, delivered as a 90-minute psychotherapeutic microintervention in a dysphoric sample.
Psychotherapy Research, 24(5) : 550-564
- Year: 2014
- 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)
Sandler, I., Wolchik, S. A., Cruden, G., Mahrer, N. E., Ahn, S., Brincks, A., Brown, C. H.
This review presents findings from an overview of meta-analyses of the effects of prevention and promotion programs to prevent mental health, substance use, and conduct problems. The review of 48 meta-analyses found small but significant changes that reduce depression, anxiety, antisocial behavior, and substance use. Furthermore, the results were sustained over time. Meta-analyses often found that the effects were heterogeneous. A conceptual model is proposed to guide the study of moderators of program effects in future meta-analyses, and methodological issues in synthesizing findings across preventive interventions are discussed.;
Annual Review of Clinical Psychology, 10 : 243-273
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Riper, H., Andersson, G., Hunter, S. B., de-Wit, J., Berking, M., Cuijpers, P.
Background and Aims: To review published studies on the effectiveness of combining cognitive-behavioural therapy (CBT) and motivational interviewing (MI) to treat comorbid clinical and subclinical alcohol use disorder (AUD) and major depression (MDD) and estimate the effect of this compared with usual care.; Methods: We conducted systematic literature searches in PubMed, PsycINFO and Embase up to June 2013 and identified additional studies through cross-references in included studies and systematic reviews. Twelve studies comprising 1721 patients met our inclusion criteria. The studies had sufficient statistical power to detect small effect sizes.; Results: CBT/MI proved effective for treating subclinical and clinical AUD and MDD compared with controls, with small overall effect sizes at post-treatment [g=0.17, confidence interval (CI)=0.07-0.28, P<0.001 for decrease of alcohol consumption and g=0.27, CI: 0.13-0.41, P<0.001 for decrease of symptoms of depression, respectively]. Subgroup analyses revealed no significant differences for both AUD and MDD. However, digital interventions showed a higher effect size for depression than face-to-face interventions (g= 0.73 and g=0.23, respectively, P=0.030).; Conclusions: Combined cognitive-behavioural therapy and motivational interviewing for clinical or subclinical depressive and alcohol use disorders has a small but clinically significant effect in treatment outcomes compared with treatment as usual.; © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
Addiction (Abingdon, England), 109(3) : 394-406
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
Raes, F., Griffith, J. W., VanDerGucht, K., Williams, J. M. G.
This reprinted article originally appeared in Mindfulness 5, 5, 2014, pp. 477-486. Our objective was to conduct the first randomized controlled trial of the efficacy of a group mindfulness program aimed at reducing and preventing depression in an adolescent school-based population. For each of 12 pairs of parallel classes with students (age range 13-20) from five schools (N = 408), one class was randomly assigned to the mindfulness condition and one class to the control condition. Students in the mindfulness group completed depression assessments (the Depression Anxiety Stress Scales) prior to and immediately following the intervention and 6 months after the intervention. Control students completed the questionnaire at the same times as those in the mindfulness group. Hierarchical linear modeling showed that the mindfulness intervention showed significantly greater reductions (and greater clinically significant change) in depression compared with the control group at the 6-month follow-up. Cohen's d was medium sized (> .30) for both the pre-to-post and pre-to-follow-up effect for depressive symptoms in the mindfulness condition. The findings suggest that school-based mindfulness programs can help to reduce and prevent depression in adolescents. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Mindfulness, 5 : 477-486
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Gallego, J., Aguilar-Parra, J. M., Cangas, A. J., Langer, A. I., Manas, I.
Two of the problems that currently affect a large proportion of university students are high levels of anxiety and stress experienced in different situations, which are particularly high during the first years of their degree and during exam periods. The present study aims to investigate whether mindfulness training can bring about significant changes in the manifestations of depression, anxiety, and stress of students when compared to another group undergoing a physical activity program and a control group. The sample consisted of 125 students from the Bachelor of Education Program. The measuring instrument used was the Abbreviated Scale of Depression, Anxiety and Stress (DASS-21). The results indicate that the effects of reducing the identified variables were higher for the mindfulness group than for the physical education group and for the control group F(2) = 5.91, p = .004, eta2 = .106. The total scores for all variables related to the mindfulness group decreased significantly, including an important stress reduction t(29) = 2.95, p = .006, d = .667. Mindfulness exercises and some individual relaxing exercises involving Physical Education could help to reduce manifestations of stress and anxiety caused by exams in students.
The Spanish journal of psychology, 17 : E109
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Mindfulness based therapy, Physical activity, exercise
Matos, A. P., Do-Rosario-Pinheiro, M., Oliveira, S., Marques, C.
Introduction: The Parental Program for the Prevention of Depression in Adolescents (3PDA) was developed to improve the efficacy of the Program for the Prevention of Depression in Adolescents (PPDA), which include new components that enhance welfare and psychological suffering, such as emotional validation and compassion. Objectives: To describe the implementation and evaluation processes of the program, and analyze the efficacy of the 3PPDA in the results of PPDA (Arnarson &Craighead, 2009). Methods: The total sample was comprised by 42 parents of adolescents aged between 13 and 15 years, considered at risk (scores between the 75th and the 90th percentiles on the CDI) that had attended the PPDA. The sample was divided into two groups: 14 were allocated into the experimental group (parents attending the 3PDA) and 28 into the control group (parents not attending the 3PDA). The 3PDA is composed by 10 thematic sessions, during 5 weeks, 10 hours in total. To collect the data, indicators of satisfaction to assess each session were used, like asssiduity, overall satisfation and instructor-group interaction. Results: We found high values on the satisfaction indicators. The group of adolescents whose parents are not at the 3PDA have 3 times more depressive symptoms at the end of the intervention compared with the group of adolescents whose parents are at the 3PDA. Conclusions: Although the small sample of parental experimental group, the 3PDA seems to be relevant in increasing the effectiveness of PPDA.
Atencion Primaria, 46 (Supplement 5) : 8
- Year: 2014
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Zamirinejad, S., Hojjat, S. K., Golzari, M., Borjali, A., Akaberi, A.
Issues in Mental Health Nursing, 35(6) : 480-488
- Year: 2014
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Azevedo, A., Matos, A. P.
Introduction: In adolescence, depression appears to be a very impairing condition, due to its serious psychosocial consequences and recurrence (Monroe &Harkness, 2011). For this reason, it is necessary to treat it as soon as possible, using interventions effective in maintainning the therapeutic gains. We developed a new treatment composed by components of the "third generation therapies". Methods: The present pilot study of the randomized controlled trial was conducted in the Pediatric Hospital of Coimbra, Portugal, and enrolled eight severely depressed adolescents aged between 14 and 18 years. The population was identified by diagnostic interview and characterized by self-report instruments. We compared the experimental group, to which the treatment was applied, and the control group, under "treatment as usual" condition, in pre-treatment and post-treatment moments. Results: The preliminary results showed that the treatment was effective in reducing depressive symptoms, suicidal ideation and risk factors as self-criticism, and in promoting protective factors, such as self compassion. Conclusions: These preliminary data seem very promising. It is necessary to replicate them with a larger sample, which is now being enlarged. To test its capacity for maintaining treatment gains, a large follow up study is being conducted.
Atencion Primaria, 46 (Supplement 5) : 8
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions