Disorders - anxiety disorders
Silk, J.S., Tan, P.Z., Ladouceur, C.D., Meller, S., Siegle, G.J., McMakin, D.L., etal.
This study compared individual cognitive behavioral therapy (CBT) and a supportive child-centered therapy (CCT) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1-year follow-up, as well as on real-world measures of emotional functioning. Youth (N = 133; ages 9-14) with anxiety disorders (generalized, separation, and/or social anxiety) were randomized using a 2:1 ratio to CBT (n = 90) or CCT (n = 43), which served as an active comparison. Treatment response and recovery at posttreatment and 1-year follow-up were assessed by Independent Evaluators, and youth completed ecological momentary assessment of daily emotions throughout treatment. The majority of youth in both CBT and CCT were classified as treatment responders (71.1% for CBT, 55.8% for CCT), but youth treated with CBT were significantly more likely to fully recover, no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual symptoms (66.7% for CBT vs. 46.5% for CCT). Youth treated with CBT also reported significantly lower negative emotions associated with recent negative events experienced in daily life during the latter stages of treatment relative to youth treated with CCT. Furthermore, a significantly higher percentage of youth treated with CBT compared to CCT were in recovery at 1-year follow-up (82.2% for CBT vs. 65.1% for CCT). These findings indicate potential benefits of CBT above and beyond supportive therapy on the breadth, generalizability, and durability of treatment-related gains. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Clinical Child and Adolescent Psychology, 47(4) : 542-554
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Belousova, N. A., Maltsev, V. P., Korchemkina, Y. V.
Problem and objective. The design of an individual educational trajectory with due account for the individual characteristics of cognitive processes is relevant in modern education. The objective of the study was to organize the students' cognitive activity in the conditions of the examination load, taking into account the psychophysiological profile as a criterion of health preservation. Materials and methods. The study involved 114 first-year female students aged 17-18 studying at the Faculty of Training Elementary School Teachers of the South Ural State Humanitarian and Pedagogical University in Chelyabinsk. The general sample was randomly differentiated into the main group (Group 1, n=61), for which the program "Design of Students' Educational Trajectory Based on the Psychophysiological Profile" was implemented, and the control group (Group 2, n=53), where traditional tests were performed. The diagnostics of the level of mental performance by the parameters of a simple visual-motor reaction was performed using a hardware-software package "Biomysh"(Biomouse) (Neurolab, Moscow). The situational and trait anxiety was assessed. The mathematical-statistical analysis was conducted with the use of Microsoft Excel and Statistica v. 7.0. Results. The population of students at the control stage of the study was characterized by an average level of mobility of nervous processes, an optimal speed of the nervous system, a moderate degree of trait and state anxiety. Upon the program completion, the students of the main group noted an increase in the average group indicator of the CNS reaction stability at high values of the reaction stability and reliability of the activity. No significant differences in the mean values of sensorimotor reactions of students in the studied groups have been identified. The indicators of state anxiety had a regular increase in mean values in both groups, but an increase in the mean value of the control group by an indicator of state anxiety was 3.5 times higher than that in the main group. Conclusion. Task scheduling with the use of the program "Design of Students' Educational Trajectory Based on the Psychophysiological Profile" makes it possible to improve academic performance with relatively constant rates of state and trait anxiety, and thus to ensure students' stable psychoemotional state as one of the conditions for health preservation. Copyright © 2018, Pharmainfo Publications. All rights reserved.
Journal of Pharmaceutical Sciences and Research, 10(10) : 2616-2620
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Ahlen, J., Hursti, T., Tanner, L., Tokay, Z., Ghaderi, A.
Our study aimed at evaluating FRIENDS for Life, an intervention to prevent anxiety and depression in Swedish school children. A total of 695 children between the ages of 8 and 11 were recruited from 17 schools in Stockholm, Sweden, and cluster-randomized to either the intervention or control group. Teachers in the intervention group received a full day of training and administered FRIENDS for Life in their classrooms. We assessed the children's anxiety and depressive symptoms, general mental health, and academic performance at pre- and post-intervention as well as at the 12-month follow-up. A multi-informant approach was used with data collected from children, parents, and teachers. Assessment was done with the Spence Children's Anxiety Scale, Children's Depression Inventory, and the Strengths and Difficulties Questionnaire. Children's baseline symptoms, gender, and age as well as their teacher's use of supervision were examined as moderators of effect. Our study found no short- or long-term effects of the intervention for any outcome with regard to the entire sample. We found an enhanced effect of the intervention regarding children with elevated depressive symptoms at baseline. We found a decrease in anxiety symptoms among children whose teachers attended a larger number of supervision sessions, compared to children whose teachers attended fewer supervised sessions or the control group. Mediation analyses showed that this effect was driven by change in the last phase of the intervention, suggesting that supervision might play an important role in enhancing teachers' ability to administer the intervention effectively.
Prevention science : the official journal of the Society for Prevention Research, 19(2) : 147-158
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Dong, G. J., Cao, D., Dong, Y., Zhang, J., Wang, F. C.
Objective: To explore the therapeutic effects of scalp acupuncture on sleep disorder induced by pre-examination anxiety in the undergraduates. Method(s): A total of 60 undergraduates with sleep disorder induced by the final examination anxiety were randomized into three groups, named a control group (20 cases), a traditional acupuncture group (20 cases) and a scalp acupuncture group (20 cases). In the control group, no any treatment was given. In the traditional acupuncture group, acupuncture was given at Sishencong (EX-HN1), bilateral Shenmen (HT 7) and bilateral Sanyinjiao (SP 6). The needles were manipulated with the even-needling technique and retained for 30 min. In the scalp acupuncture group, acupuncture was applied to upper-middle line of occiput (MS 12), middle line of vertex (MS 5) and middle line of forehead (MS 1). The needles were manipulated with the even-needling technique and retained for 30 min. The treatment was given once a day and 5 treatments made one course. There were 2 days at interval among the courses. The therapeutic effects were analyzed statistically after 4 courses of treatment. Before and after treatment, the Hamilton anxiety scale (HAMA) and the Pittsburgh sleep quality index (PSQI) were adopted to evaluate the conditions of pre-examination anxiety and sleep in the patients. Result(s): In comparison of PSQI score, compared with those before treatment, the score in the scalp acupuncture group (12.95 +/- 1.76 vs 15.95 +/- 1.82) and in the traditional acupuncture group (13.75 +/- 1.62 vs 15.75 +/- 1.86) after 1-week of treatment were reduced (both P < 0.05). Compared with control group, the score in the scalp acupuncture group (12.95 +/- 1.76 vs15.78 +/- 2.02) and in the traditional acupuncture group (13.75 +/- 1.62 vs 15.78 +/- 2.02) were better (both P < 0.05). The difference was not significant between the scalp acupuncture group and the traditional acupuncture group (P > 0.05). In 2 and 4 weeks of treatment, as well as 1 week after treatment termination, compared with the control group at the same time point, the scores in the scalp acupuncture group (in 2-week treatment: 8.95 +/- 1.88 vs 15.94 +/- 1.89, in 4-week treatment: 5.95 +/- 1.05 vs 16.5 +/- 1.95, 1 week after treatment termination: 4.7 +/- 0.77 vs 9.78 +/- 2.10) and the traditional acupuncture group (in 2-week treatment: 11.15 +/- 1.31 vs 15.94 +/- 1.89, in 4-week treatment: 8.05 +/- 0.89 vs 16.5 +/- 1.95, 1 week after treatment termination: 6.25 +/- 0.85 vs 9.78 +/- 2.10) were all lower (all P < 0.05) separately. The scores in the scalp acupuncture group were superior to the traditional acupuncture group (all P < 0.05). In comparison of HAMD score, compared with those before treatment, the score in the scalp acupuncture group (22.4 +/- 5.31 vs 25.2 +/- 6.18) and in the traditional acupuncture group (22.4 +/- 5.31 vs 25 +/- 5.97) after 1-week of treatment were reduced (both P < 0.05). Compared with control group, the score in the scalp acupuncture group (22.4 +/- 5.31 vs 23.28 +/- 5.53) and in the traditional acupuncture group (22.4 +/- 5.31 vs 23.28 +/- 5.53) were better (both P < 0.05). The difference was not significant between the scalp acupuncture group and the traditional acupuncture group (P > 0.05). In 2 and 4 weeks of treatment, as well as 1 week after treatment termination, compared with the control group at the same time point, the scores in the scalp acupuncture group (in 2-week treatment: 18.5 +/- 4.56 vs 24.22 +/- 5.22, in 4-week treatment: 5.8 +/- 3.52 vs 21.22 +/- 6.7,1 week after treatment termination: 4.55 +/- 2.72 vs 11.78 +/- 9.36) and the traditional acupuncture group (in 2-week treatment: 17.5 +/- 4.59 vs 24.22 +/- 5.22, in 4-week treatment: 6.95 +/- 3.33 vs 21.22 +/- 6.7, 1 week after treatment termination: 5.8 +/- 2.76 vs 11.78 +/- 9.36) were all lower (all P < 0.05) separately. The scores in the scalp acupuncture group were superior to the traditional acupuncture group (all P < 0.05). In 4-week treatment and 1 week after treatment termination, compared with control group, the total effective rates in the traditional acupuncture group (in 4-week treatment: 95% vs 11%, 1 week after treatment termination: 100% vs 83.33%, both P < 0.05) and the scalp acupuncture group (in 4-week treatment: 95% vs 11%, 1 week after treatment termination: 100% vs 83.33%, both P < 0.05) were better and the difference was not significant between the traditional acupuncture group and the scalp acupuncture group (both P > 0.05). Conclusion(s): Both scalp acupuncture and traditional acupuncture therapies are effective on sleep disorder induced by pre-examination anxiety in the undergraduates. The scalp acupuncture therapy achieves the better effects on the instant relief of symptoms. Copyright © 2018
World Journal of Acupuncture - Moxibustion, 28(3) : 156-160
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Acupuncture, acupressure
Cardamone-Breen, M. C., Jorm, A. F., Lawrence, K. A., Rapee, R. M., Mackinnon, A. J., Yap, M. B. H.
BACKGROUND: Depression and anxiety disorders are significant contributors to burden of disease in young people, highlighting the need to focus preventive efforts early in life. Despite substantial evidence for the role of parents in the prevention of adolescent depression and anxiety disorders, there remains a need for translation of this evidence into preventive parenting interventions. To address this gap, we developed a single-session, Web-based, tailored psychoeducation intervention that aims to improve parenting practices known to influence the development of adolescent depression and anxiety disorders. OBJECTIVE(S): The aim of this study was to evaluate the short-term effects of the intervention on parenting risk and protective factors and symptoms of depression and anxiety in adolescent participants. METHOD(S): We conducted a single-blind, parallel group, superiority randomized controlled trial comparing the intervention with a 3-month waitlist control. The intervention is fully automated and consists of two components: (1) completion of an online self-assessment of current parenting practices against evidence-based parenting recommendations for the prevention of adolescent depression and anxiety disorders and (2) an individually tailored feedback report highlighting each parent's strengths and areas for improvement based on responses to the self-assessment. A community sample of 349 parents, together with 327 adolescents (aged 12-15 years), were randomized to either the intervention or waitlist control condition. Parents and adolescents completed online self-reported assessments of parenting and adolescent symptoms of depression and anxiety at baseline, 1-month (parent-report of parenting only), and 3-month follow-up. RESULT(S): Compared with controls, intervention group parents showed significantly greater improvement in parenting risk and protective factors from baseline to 1-month and 3-month follow-up (F2,331.22=16.36, P<.001), with a small to medium effect size at 3-month follow-up (d=0.33). There were no significant effects of the intervention on adolescent-report of parenting or symptoms of depression or anxiety in the adolescents (all P>.05). CONCLUSION(S): Findings suggest that a single-session, individually tailored, Web-based parenting intervention can improve parenting factors that are known to influence the development of depression and anxiety in adolescents. However, our results do not support the effectiveness of the intervention in improving adolescent depression or anxiety symptoms in the short-term. Long-term studies are required to adequately assess the relationship between improving parenting factors and adolescent depression and anxiety outcomes. Nonetheless, this is a promising avenue for the translation of research into a low-cost, sustainable, universal prevention approach. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12615000247572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12615000247572 (Archived by WebCite at http://www.webcitation.org/6v1ha19XG) Copyright ©Mairead C Cardamone-Breen, Anthony F Jorm, Katherine A Lawrence, Ronald M Rapee, Andrew J Mackinnon, Marie Bee Hui Yap. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2018.
Journal of Medical Internet Research, 20(4) : e148
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Albano, A. M., Comer, J. S., Compton, S. N., Piacentini, J., Kendall, P. C., Birmaher, B., Walkup, J. T., Ginsburg, G. S., Rynn, M. A., McCracken, J., Keeton, C., Sakolsky, D. J., Sherrill, J. T.
Controlled evaluations comparing medication, cognitive-behavioral therapy (CBT), and their combination in the treatment of youth anxiety have predominantly focused on global ratings by independent evaluators. Such ratings are resource intensive, may be of limited generalizability, and do not directly inform our understanding of treatment responses from the perspective of treated families. We examined outcomes from the perspective of treated youth and parents in the Child/Adolescent Anxiety Multimodal Study. Participants (N = 488; ages 7-17 years) who had a primary diagnosis of separation, social, and/or generalized anxiety disorder were randomly assigned to a treatment condition in the Child/Adolescent Anxiety Multimodal Study trial. Linear mixed-effects and analysis of covariance models examined parent- and youth-reported anxiety symptoms, impact of anxiety, broader internalizing and externalizing psychopathology, depressive symptoms, and family burden throughout the 12-week acute treatment phase and 6-month follow-up. At Week 12, combination treatment showed superiority over placebo, sertraline, and CBT with regard to parent-reported youth anxiety symptoms, and sertraline and CBT as monotherapies showed superiority over placebo with regard to parent-reported youth anxiety. Combination therapy and sertraline also showed Week 12 superiority over placebo with regard to parent-reported internalizing psychopathology, and superiority over placebo and CBT with regard to parent-reported impact of anxiety, family burden, and youth depressive symptoms. By Week 36, parent reports of many youth outcomes were comparable across active conditions. Youth measures tracked parent measures on many outcomes. Findings were drawn on brief, readily available questionnaires that in conjunction with clinician measures can inform patient-centered care and collaborative decision making. Copyright © 2017, © 2017 Society of Clinical Child & Adolescent Psychology.
Evidence-Based Practice in Child and Adolescent Mental Health, 3(1) : 30-41
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Beute, F., de-Kort, Y. A. W.
BACKGROUND: Stress, and specifically perseverative cognition, is considered to have considerable detrimental effects on mental and physical health. Interventions that can offer temporary stress relief could, therefore, bring considerable health benefits. Previous research has pointed to stress-reducing effects of exposure to nature after acute stressors, but has not yet investigated effects in the realm of everyday life. The present pilot study explores whether an ecological momentary intervention using exposure to natural images could be effective in lowering stress and improve mood. METHOD(S): Fifteen participants (12 females) scoring above threshold on stress, depression, or anxiety completed two study periods of 6 days. They watched an urban (control) or natural slideshow twice daily. Using Ecological Momentary Assessment, effects on mood, and stress-related complaints were measured in everyday life. RESULT(S): Compliance to the study protocol was high, especially in the first week, with slightly more videos watched in the morning than in the evening. We found indications of improvements in mood, self-reported worrying (but not stress levels), and heart rate. CONCLUSION(S): The results suggest that twice-daily exposure to restorative visual content could be a viable Ecological Momentary Intervention, with the potential to reduce self-reported worry, lower autonomic activity, and increase positive affect. Copyright © 2018 The International Association of Applied Psychology.
Applied Psychology, Health and well-being. 10(2) : 236-253
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Other complementary & alternative interventions
, Technology, interventions delivered using technology (e.g. online, SMS)
Weisz, J. R., Ugueto, A. M., Herren, J., Marchette, L. K., Bearman, S. K., Lee, E. H., Thomassin, K., Alleyne, A., Cheron, D. M., Tweed, J. L., Hersh, J., Raftery-Helmer, J. N., Weissman, A. S., Jensen-Doss, A.
OBJECTIVE: We assessed sustainability of an empirically supported, transdiagnostic youth psychotherapy program when therapist supervision was shifted from external experts to internal clinic staff.
METHOD: One hundred sixty-eight youths, aged 6-15 years, 59.5% male, 85.1% Caucasian, were treated for anxiety, depression, traumatic stress, or conduct problems by clinicians employed in community mental health clinics. In Phase 1 (2.7 years), 1 group of clinicians, the Sustain group, received training in Child STEPs (a modular transdiagnostic treatment + weekly feedback on youth response) and treated clinic-referred youths, guided by weekly supervision from external STEPs experts. In Phase 2 (2.9 years), Sustain clinicians treated additional youths but with supervision by clinic staff who had been trained to supervise STEPs. Also in Phase 2, a new group, External Supervision clinicians, received training and supervision from external STEPs experts and treated referred youths. Phase 2 youths were randomized to Sustain or External Supervision clinicians. Groups were compared on 3 therapist fidelity measures and 14 clinical outcome measures.
RESULTS: Sustain clinicians maintained their previous levels of fidelity and youth outcomes after switching from external to internal supervision; and in Phase 2, the Sustain and External Supervision groups also did not differ on fidelity or youth outcomes. Whereas all 34 group comparisons were nonsignificant, trends with the largest effect sizes showed better clinical outcomes for internal than external supervision.
CONCLUSIONS: Implementation of empirically supported transdiagnostic treatment may be sustained when supervision is transferred from external experts to trained clinic staff, potentially enhancing cost-effectiveness and staying power in clinical practice. (PsycINFO Database Record
Journal of Consulting & Clinical Psychology, 86(9) : 726-737
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
Bunnell, B. E., Mesa, F., Beidel, D. C.
Selective mutism (SM) is an anxiety disorder marked by withdrawal of speech in particular social situations. Treatment is often difficult, requiring attention to several characteristics particular to the disorder. Therapeutic tools and activities such as games and mobile applications (apps) may be particularly advantageous to behavioral therapy for SM. A 2-session hierarchy for shaping successive approximations of speech in SM was piloted with 15 children, 5 to 17 years old, who were randomly assigned to shaping while using mobile apps, other therapeutic tools/activities, and reinforcement alone. Very strong treatment gains were observed: 13 of 15 (88.7%) children completed the hierarchy during the first session and 14 (93.3%) did so during the second session, with the final child completing all but the final step (i.e., to ask and respond to at least 5 open-ended questions). Moreover, all 15 children spoke to the clinician within 59 minutes of treatment (M = 17 minutes), and 14 (93.3%) children held five, 5-minute conversations with additional unknown adults during the second session. This occurred regardless of the inclusion of therapeutic tools/activities, although preliminary patterns of responding were observed such that children shaped while using mobile apps tended to show less self-reported and physiologically measured anxious distress. The utility of therapeutic activities and mobile apps when treating SM is discussed as well as areas for future research.
Behavior Therapy, 49(6) : 966-980
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Yap, M. B. H., Mahtani, S., Rapee, R. M., Nicolas, C., Lawrence, K. A., Mackinnon, A., Jorm, A. F.
Background: Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. Objective: This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. Methods: A two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children's Anxiety Scale (anxiety symptoms). Results: Parents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-time interaction on the PRADAS, with a medium effect size, Cohen d = 0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent- and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. Conclusions: The fully automated PiP intervention showed promising short-term effects on parenting behaviors that are associated with adolescents' risk for depression and anxiety. Long-term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents' mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Medical Internet Research Vol 20(1), 2018, ArtID e17, 20(1) :
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Londono-Tobon, A., Reed, M. O., Taylor, J. H., Bloch, M. H.
Objective: School refusal is an important pediatric problem with significant negative short- A nd long-term outcomes. Specific psychosocial treatments appear effective in reducing school refusal, but many children do not respond to these treatments. Although systematic reviews have examined the efficacy of psychological interventions for school refusal, no systematic reviews on pharmacological interventions exist. Methods: We conducted a comprehensive literature search of MEDLINE, PsycINFO, Scopus, and Embase for randomized controlled trials (RCTs) or quasi-experimental pharmacologic trials in children and adolescents with school refusal reported in English or Spanish until July 1, 2017. Two authors screened study titles and abstracts for eligibility. Data regarding the population, intervention, comparison, and outcomes for each trial were extracted and reported. Effect sizes for school attendance are presented. Results: The search identified 6 articles, including 7 trials (6 RCTs and 1 open label) and 306 youths. Pharmacologic treatments investigated for school refusal included antidepressants (imipramine, clomipramine, and fluoxetine) and benzodiazepines (alprazolam). All pharmacotherapies studied had pretreatment to posttreatment improvements on school refusal, depression, and anxiety symptoms. However, included trials were severely underpowered and did not demonstrate significant improvement compared to placebo. Conclusions: Data regarding pharmacological treatments for school refusal are sparse. Most trials in this area were conducted before development of newer antidepressants, were underpowered, and have significant methodological limitations that are characteristic of the time in which they were conducted. This systematic review highlights the need for more trials with newer pharmacologic agents, larger sample sizes, and improved systematic assessments of school refusal and comorbidities. School refusal represents an important functional outcome for many children, especially those with anxiety and depression. Future pharmacologic studies of anxiety and depression in children may benefit from incorporating specific school refusal measures as secondary outcomes. Copyright © 2018, Mary Ann Liebert, Inc.
Journal of Child and Adolescent Psychopharmacology, 28(6) : 368-378
- Year: 2018
- Problem: Anxiety Disorders (any), Specific Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants, Antidepressants (any)
, Anticonvulsants/mood stabilisers (excl. lithium)
Devoe, D., Farris, M., Addington, J.
Youth at clinical high risk (CHR) for psychosis often present with symptoms of depression and anxiety, which can reduce quality of life. Therefore, the aim of this systematic review was to determine the impact of all interventions on symptoms of depression and anxiety in CHR samples. We systematically searched Embase, EBM, PsycINFO, CINAHL, and MEDLINE. Studies were selected if they reported changes in depression or anxiety symptoms in youth at CHR and included an intervention. Data was evaluated using pairwise metaanalyses, stratified by time, and reported as the standardized mean difference (SMD). Twenty-three studies met our inclusion criteria, including a total of 1,831 CHR participants. The mean age was 19.35 years and 49% were female. Interventions included family therapy, glycine, antipsychotics, cognitive remediation, however analysis could only be performed on cognitive behavioural therapy (CBT) and omega-3. CBT did not significantly improve depression at 6-months (SMD = 0.02; 95% CI = -0.25, 0.28), 12-months (SMD = -0.04; 95%CI = -0.23, 0.14), 18-months (SMD = -0.11; 95%CI = -0.41, 0.20), or at 24-48-month follow-up (SMD = -0.21; 95%CI = -0.50, 0.08). CBT did not significantly improve anxiety at 6-months (SMD = -0.10; 95% CI = -0.29, 0.08), 12-months (SMD = 0.05; 95%CI = -0.14, 0.23), 18-months (SMD = 0.09; 95%CI = -0.22, 0.39), or at 24-48-months (SMD = -0.06; 95%CI = -0.55, 0.43). Omega-3 did not significantly improve depression at 6-months (SMD = -0.46; 95CI = -1.15, 0.23) and 12-months (SMD = -0.29; 95%CI = -1.10, 0.51). In conclusion, no interventions significantly impacted symptoms of depression or anxiety in CHR samples. However, no trials in this review were designed to target and treat these symptoms and the CBT used was specifically designed to address attenuated psychotic symptoms.
Early Intervention in Psychiatry, 12 (Supplement 1) : 174
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders, Psychosis Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions, Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Cognitive remediation therapy, Family therapy, Fish oil (Omega-3 fatty acids)
, Omega 3 fatty acids (e.g. fish oil, flax oil)