Disorders - depressive disorders
Kauer, S. D., Reid, S. C., Crooke, A. H., Khor, A., Hearps, S. J., Jorm, A. F., Sanci, L., Patton, G.
The stepped-care approach, where people with early symptoms of depression are stepped up from low-intensity interventions to higher-level interventions as needed, has the potential to assist many people with mild depressive symptoms. Self-monitoring techniques assist people to understand their mental health symptoms by increasing their emotional self-awareness (ESA) and can be easily distributed on mobile phones at low cost. Increasing ESA is an important first step in psychotherapy and has the potential to intervene before mild depressive symptoms progress to major depressive disorder. In this secondary analysis we examined a mobile phone self-monitoring tool used by young people experiencing mild or more depressive symptoms to investigate the relationships between self-monitoring, ESA, and depression. We tested two main hypotheses: (1) people who monitored their mood, stress, and coping strategies would have increased ESA from pretest to 6-week follow-up compared with an attention comparison group, and (2) an increase in ESA would predict a decrease in depressive symptoms. We recruited patients aged 14 to 24 years from rural and metropolitan general practices. Eligible participants were identified as having mild or more mental health concerns by their general practitioner. Participants were randomly assigned to either the intervention group (where mood, stress, and daily activities were monitored) or the attention comparison group (where only daily activities were monitored), and both groups self-monitored for 2 to 4 weeks. Randomization was carried out electronically via random seed generation, by an in-house computer programmer; therefore, general practitioners, participants, and researchers were blinded to group allocation at randomization. Participants completed pretest, posttest, and 6-week follow-up measures of the Depression Anxiety Stress Scale and the ESA Scale. We estimated a parallel process latent growth curve model (LGCM) using Mplus to test the indirect effect of the intervention on depressive symptoms via the mediator ESA, and calculated 95% bias-corrected bootstrapping confidence intervals (CIs). Of the 163 participants assessed for eligibility, 118 were randomly assigned and 114 were included in analyses (68 in the intervention group and 46 in the comparison group). A parallel process LGCM estimated the indirect effect of the intervention on depressive symptoms via ESA and was shown to be statistically significant based on the 95% bias-corrected bootstrapping CIs not containing zero (-6.366 to -0.029). The proportion of the maximum possible indirect effect estimated was (kappa)(2 )=.54 (95% CI .426-.640). This study supported the hypothesis that self-monitoring increases ESA, which in turn decreases depressive symptoms for young people with mild or more depressive symptoms. Mobile phone self-monitoring programs are ideally suited to first-step intervention programs for depression in the stepped-care approach, particularly when ESA is targeted as a mediating factor. ClinicalTrials.gov NCT00794222; http://clinicaltrials.gov/ct2/show/NCT00794222 (Archived by WebCite at http://www.webcitation.org/65lldW34k).
Journal of Medical Internet Research, 14(3) : e67
- Year: 2012
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Kaviani, H., Hatami, N., Javaheri, F.
Aim. Employing an experimental, randomized-controlled design, we examined the impact of mindfulness-based cognitive therapy (MBCT) on mental health and quality of life in a sub-clinically depressed population. Method/Material. The participants were randomly assigned either to receive MBCT or remain in a waiting list control group. A series of two-way ANOVA with repeated measures detected if MBCT training would result in a decline in anxiety/depression levels, cognitive distortions, and also enhance quality life over five assessment points, namely, pre-test, session 4, session 8, first follow-up (1 month) and second follow-up (6 months). Results. The findings showed that MBCT was influential to help sub-clinical participants to deal with their anxiety and depressive feelings, and experience improved quality of life before in MBCT group, during and after stressful circumstances. Negative automatic thoughts and dysfunctional attitudes were also systematically reduced. Discussion. This study provides empirical evidence for the effectiveness of MBCT in a new cultural setting, and extends our knowledge about the effectiveness and generalizability of the MBCT in real-life stressful situations. Conclusion. The findings provide the first evidence that MBCT might be a useful intervention for enhancing quality of life in sub-clinical populations.
Psychoterapia, (1) : 21-28
- Year: 2012
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Hetrick, S. E., McKenzie, J. E., Cox, G. R., Simmons, M. B., Merry, S. N.
Depressive disorders are common in young people and are associated with significant negative impacts. Newer generation antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are often used, however evidence of their effectiveness in children and adolescents is not clear. Furthermore, there have been warnings against their use in this population due to concerns about increased risk of suicidal ideation and behaviour. To determine the efficacy and adverse outcomes, including definitive suicidal behaviour and suicidal ideation, of newer generation antidepressants compared with placebo in the treatment of depressive disorders in children and adolescents. For this update of the review, we searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) to October 2011. The CCDANCTR includes relevant randomised controlled trials from the following bibliographic databases: CENTRAL (the Cochrane Central Register of Controlled Trials) (all years), EMBASE (1974 -), MEDLINE (1950 -) and PsycINFO (1967 -). We searched clinical trial registries and pharmaceutical company websites. We checked reference lists of included trials and other reviews, and sent letters to key researchers and the pharmaceutical companies of included trials from January to August 2011. Published and unpublished randomised controlled trials (RCTs), cross-over trials and cluster trials comparing a newer generation antidepressant with a placebo in children and adolescents aged 6 to 18 years old and diagnosed with a depressive disorder were eligible for inclusion. In this update, we amended the selection criteria to include newer generation antidepressants rather than SSRIs only. Two or three review authors selected the trials, assessed their quality, and extracted trial and outcome data. We used a random-effects meta-analysis. We used risk ratio (RR) to summarise dichotomous outcomes and mean difference (MD) to summarise continuous measures. Nineteen trials of a range of newer antidepressants compared with placebo, containing 3335 participants, were included. The trials excluded young people at high risk of suicide and many co-morbid conditions and the participants are likely to be less unwell than those seen in clinical practice. We judged none of these trials to be at low risk of bias, with limited information about many aspects of risk of bias, high drop out rates and issues regarding measurement instruments and the clinical usefulness of outcomes, which were often variously defined across trials. Overall, there was evidence that those treated with an antidepressant had lower depression severity scores and higher rates of response/remission than those on placebo. However, the size of these effects was small with a reduction in depression symptoms of 3.51 on a scale from 17 to 113 (14 trials; N = 2490; MD -3.51; 95% confidence interval (CI) -4.55 to -2.47). Remission rates increased from 380 per 1000 to 448 per 1000 for those treated with an antidepressant. There was evidence of an increased risk (58%) of suicide-related outcome for those on antidepressants compared with a placebo (17 trials; N = 3229; RR 1.58; 95% CI 1.02 to 2.45). This equates to an increased risk in a group with a median baseline risk from 25 in 1000 to 40 in 1000. Where rates of adverse events were reported, this was higher for those prescribed an antidepressant. There was no evidence that the magnitude of intervention effects (compared with placebo) were modified by individual drug class. Caution is required in interpreting the results given the methodological limitations of the included trials in terms of internal and external validity. Further, the size and clinical meaningfulness of statistically significant results are uncertain. However, given the risks of untreated depression in terms of completed suicide and impacts on functioning, if a decision to use medication is agreed, then fluoxetine might be the medication of first choice given guideline recommendations. Clinicians need to keep in mind that there is evidence o an increased risk of suicide-related outcomes in those treated with antidepressant medications.
Cochrane Database of Systematic Reviews, 11 : CD004851
- Year: 2012
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Antidepressants (any)
Ingram, D., Moreno, M.
Question Among adolescents with depression, does a computerized
cognitive behavioral therapy intervention reduce
depressive symptoms as much as or more than usual treatment?
Design Multicenter, randomized controlled, noninferiority
trial.
Setting 24 primary care health centers in New Zealand.
Participants Of the 213 adolescents assessed for eligibility,
187 were randomized, 170 were assessed after intervention,
and 168 were assessed at the three-month follow-up.
Intervention 7 computerized modules of cognitive behavioral
therapy (SPARX) were completed between 4 and 7
weeks. Usual treatment utilized face-to-face counseling.
Outcomes The primary outcome was score change in children's
depression rating scale-revised. Secondary outcomes were the Reynolds adolescent depression scale-second edition,
the mood and feelings questionnaire, the pediatric quality
of life enjoyment and satisfaction questionnaire, the
Spence children's anxiety scale, the Kazdin hopelessness scale
for children, change in clinical global impression scale, and
participant satisfaction with intervention.
Main Results Participants who underwent the SPARX
treatment had a nonsignificantly greater reduction in children's
depression rating scale-revised compared with the
treatment as usual group for both per protocol (2.73, CI
-0.31 to 5.77) and intention to treat analyses (1.60, CI
-1.21 to 4.41). All secondary measures demonstrated either
noninferiority or an advantage of SPARX. Remission rates
were higher in the SPARX compared with treatment as
usual group (17.3% difference, CI 1.6% to 31.8%), but
rates of response were not different between the groups
(difference 7.9%, CI -7.9% to 24%). Of the 22 total adverse
events that were possibly or probably related to the intervention,
11 were in the SPARX group and 11 were in the
treatment as usual group. Benefits were maintained at three
months after completion of the program and results were
not related to sex, age, ethnicity, or setting.
Conclusions A computerized cognitive behavioral therapy
program was as effective as treatment as usual for help
seeking adolescents with depression, significantly reducing
symptoms of depression, anxiety, and hopelessness while
increasing quality of life.
Journal of Pediatrics, 161(5) : 967-968
- Year: 2012
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Kaslow, Nadine J., Broth, Michelle Robbins, Smith, Chaundrissa Oyeshiku, Collins, Marietta H.
Emotional and behavioral symptoms and disorders are prevalent in children and adolescents. There has been a burgeoning literature supporting evidence-based treatments for these disorders. Increasingly, family-based interventions have been gaining prominence and demonstrating effectiveness for myriad childhood and adolescent disorders. This article presents the current evidence in support of family-based interventions for mood, anxiety, attention-deficit hyperactivity, disruptive behavior, pervasive developmental particularly autism spectrum, and eating disorders. This review details recent data from randomized controlled trials (RCTs) and promising interventions not yet examined using a randomized controlled methodology. It highlights the evidence base supporting various specific family-based interventions, some of which are disorder dependent. A practitioner perspective is then offered with regard to recommendations for future practice and training. The article closes with a summary and directions for future research.; © 2012 American Association for Marriage and Family Therapy.
Journal of Marital & Family Therapy, 38(1) : 82-100
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders, Anorexia Nervosa, Bulimia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., Fang, A.
Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 metaanalyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in seven of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidencebase of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomizedcontrolled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples. (copyright) Springer Science+Business Media, LLC 2012.
Cognitive Therapy & Research, 36(5) : 427-440
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Kim, Sun Mi, Han, Doug Hyun, Lee, Young Sik, Renshaw, Perry F.
The purpose of the current study was to evaluate the efficacy of cognitive behavioral therapy (CBT) in combination with bupropion for treatment of problematic on-line game play in adolescents with comorbid major depressive disorder. Sixty-five depressed adolescents with excessive on-line game play were randomly assigned to a CBT group (CBT-Med group (N = 32)) or a clinical control group (Med group (N = 33)). Measures of severity of internet use, depressive symptoms, anxiety symptoms, life satisfaction and school adaptation were assessed at baseline, after the 8 week intervention, and at the end of a 4 week follow-up post-treatment period. Young Internet Addiction Scale scores in the CBT-Med group were reduced compared to those of the Med group, but there was no significant difference in the change of depression scores between two groups. The mean anxiety scores in the CBT-Med group did not change while those in the Med group were increased. The mean life satisfaction scores in the CBT-Med group were increased compared to those of the Med group. CBT in combination with bupropion may be effective for the treatment of depressed adolescents with on-line game addiction, particularly in reducing on-line game play and anxiety, as well as in improving life satisfaction. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Computers in Human Behavior, 28(5) : 1954-1959
- Year: 2012
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other antidepressants
Kolko, D. J., Campo, J. V., Kilbourne, A. M., Kelleher, K.
Objectives: To evaluate the feasibility and clinical benefits of an integrated mental health intervention (doctoroffice collaborative care [DOCC]) vs enhanced usual care (EUC) for children with behavioral problems. Design: Cases were assigned to DOCC and EUC using a 2:1 randomization schedule that resulted in 55 DOCC and 23 EUC cases. Setting: Preassessment was conducted in 4 pediatric primary care practices. Postassessment was conducted in the pediatric or research office. Doctor-office collaborative care was provided in the practice; EUC was initiated in the office but involved a facilitated referral to a local mental health specialist. Participants: Of 125 referrals (age range, 5-12 years), 78 children participated. Interventions: Children and their parents were assigned to receive DOCC or EUC. Main Outcome Measures: Preassessment diagnostic status was evaluated using the Schedule for Affective Disorders and Schizophrenia for School-aged Children. Preassessment and 6-month postassessment ratings of behavioral and emotional problems were collected from parents using the Vanderbilt Attention-Deficit/Hyperactivity Disorder Diagnostic Parent Rating Scale, as well as individualized goal achievement ratings forms. At discharge, care managers and a diagnostic evaluator completed the Clinical Global Impression Scale, and pediatricians and parents completed satisfaction and study feedback measures. Results: Group comparisons found significant improvements for DOCC over EUC in service use and completion, behavioral and emotional problems, individualized behavioral goals, and overall clinical response. Pediatricians and parents were highly satisfied with DOCC. Conclusion: The feasibility and clinical benefits of DOCC for behavioral problems support the integration of collaborative mental health services for common mental disorders in primary care. (copyright)2012 American Medical Association. All rights reserved.
Archives of Pediatrics & Adolescent Medicine, 166(3) : 224-231
- Year: 2012
- 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
Mason, W. Alex, Haggerty, Kevin P., Fleming, Andrew P., Casey-Goldstein, Mary
Parental depression places offspring at elevated risk for multiple, co-occurring problems. The purpose of this study was to develop and preliminarily evaluate Project Hope, a family intervention for the prevention of both depression and substance use among adolescent-aged children (M = 13.9 years) of depressed parents. The program was created by blending two empirically supported interventions: one for depression and another for substance use. Thirty families were randomly assigned to either Project Hope (n = 16) or a wait-list control condition (n = 14). Pretests, posttests (n = 29), and 5-month follow-ups (n = 28) were conducted separately with parents and youth via phone interviews. Questions asked about the family depression experience, family interactions, family management, coping, adolescent substance use beliefs and refusal skills, adolescent depression, and adolescent substance use. Project Hope was fully developed, manualized, and implemented with a small sample of targeted families. Engagement in the program was relatively high. Preliminary outcome analyses were conducted using 2 (Group) √ó3 (Time) analyses of covariance. Results provided some evidence for significant improvements among intervention compared to control participants in indicators of the family depression experience, family management, and coping, and a statistically significant decrease from pretest to posttest in alcohol quantity for intervention compared to control youth. Next steps for this program of research are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Journal of Child & Family Studies, 21(6) : 891-905
- Year: 2012
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Manani, R., Bahrami, F., Abedi, A.
Objectives: The aim of this study was to examine the effect of child centered attachment based therapy on reducing of childhood depression symptoms in early adolescent students in Isfahan (Iran). Method: This study was semi experimental and the sample was thirty fourth grade elementary students who were randomly assigned into control (n=15) and experimental (n=15) groups. The instruments were child depression inventory and inventory of parent and peer attachment. Independent variable was six group sessions of child centered attachment based therapy that was performed in experimental group along with one training group session for their mothers. Results: Data were analyzed with multivariate analysis of covariance. Results showed that child centered attachment based therapy was effective on reducing child depressive symptoms and increasing quality of parental attachment. Conclusion: These results suggest that child centered attachment based therapy has important advantages. Together with prior findings supporting efficacy of attachment based therapy in other populations with different ages, it should be considered as a promising new approach for working with depressed youth and their families.
Adolescent Psychiatry, 2(1) : 99-100
- Year: 2012
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Lubans, D. R., Plotnikoff, R. C., Lubans, N. J.
Background: Physical activity programmes have been identified as a potential strategy for improving social and emotional well-being in at-risk youth, who have a prevalence of depression and low self-esteem exceeding the general population. Methods: A systematic search of six electronic databases (EMBASE, OVID MEDLINE, PsychINFO, PubMed, Scopus and SPORTDiscus) was conducted to identify physical activity programmes designed to improve social and emotional well-being in at-risk youth. Results: The search identified 15 studies, which reported the effects of three types of physical activity programmes (i.e. outdoor adventure, sport and skill-based and physical fitness programmes) on social and emotional well-being. While many of the interventions resulted in significant positive effects, the risk of bias was high in all of the included studies. Conclusion: Due to the mixed findings and the high risk of bias, it is difficult to determine the efficacy of physical activity programmes for improving social and emotional well being in at-risk youth. (copyright) 2011 The Authors. Child and Adolescent Mental Health (copyright) 2011 Association for Child and Adolescent Mental Health.
Child & Adolescent Mental Health, 17(1) : 2-13
- Year: 2012
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Macdonald, G., Higgins, J. P., Ramchandani, P., Valentine, J. C., Bronger, L. P., Klein, P., O'Daniel, R., Pickering, M., Rademaker, B., Richardson, G., Taylor, M.
Despite differences in how it is defined, there is a general consensus amongst clinicians and researchers that the sexual abuse of children and adolescents ('child sexual abuse') is a substantial social problem worldwide. The effects of sexual abuse manifest in a wide range of symptoms, including fear, anxiety, post-traumatic stress disorder and various externalising and internalising behaviour problems, such as inappropriate sexual behaviours. Child sexual abuse is associated with increased risk of psychological problems in adulthood. Cognitive-behavioural approaches are used to help children and their non-offending or 'safe' parent to manage the sequelae of childhood sexual abuse. This review updates the first Cochrane review of cognitive-behavioural approaches interventions for children who have been sexually abused, which was first published in 2006. To assess the efficacy of cognitive-behavioural approaches (CBT) in addressing the immediate and longer-term sequelae of sexual abuse on children and young people up to 18 years of age. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2011 Issue 4); MEDLINE (1950 to November Week 3 2011); EMBASE (1980 to Week 47 2011); CINAHL (1937 to 2 December 2011); PsycINFO (1887 to November Week 5 2011); LILACS (1982 to 2 December 2011) and OpenGrey, previously OpenSIGLE (1980 to 2 December 2011). For this update we also searched ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP). We included randomised or quasi-randomised controlled trials of CBT used with children and adolescents up to age 18 years who had experienced being sexually abused, compared with treatment as usual, with or without placebo control. At least two review authors independently assessed the eligibility of titles and abstracts identified in the search. Two review authors independently extracted data from included studies and entered these into Review Manager 5 software. We synthesised and presented data in both written and graphical form (forest plots). We included 10 trials, involving 847 participants. All studies examined CBT programmes provided to children or children and a non-offending parent. Control groups included wait list controls (n = 1) or treatment as usual (n = 9). Treatment as usual was, for the most part, supportive, unstructured psychotherapy. Generally the reporting of studies was poor. Only four studies were judged 'low risk of bias' with regards to sequence generation and only one study was judged 'low risk of bias' in relation to allocation concealment. All studies were judged 'high risk of bias' in relation to the blinding of outcome assessors or personnel; most studies did not report on these, or other issues of bias. Most studies reported results for study completers rather than for those recruited.Depression, post-traumatic stress disorder (PTSD), anxiety and child behaviour problems were the primary outcomes. Data suggest that CBT may have a positive impact on the sequelae of child sexual abuse, but most results were not statistically significant. Strongest evidence for positive effects of CBT appears to be in reducing PTSD and anxiety symptoms, but even in these areas effects tend to be 'moderate' at best. Meta-analysis of data from five studies suggested an average decrease of 1.9 points on the Child Depression Inventory immediately after intervention (95% confidence interval (CI) decrease of 4.0 to increase of 0.4; I(2) = 53%; P value for heterogeneity = 0.08), representing a small to moderate effect size. Data from six studies yielded an average decrease of 0.44 standard deviations on a variety of child post-traumatic stress disorder scales (95% CI 0.16 to 0.73; I(2) = 46%; P value for heterogeneity = 0.10). Combined data from five studies yielded an average decrease of 0.23 standard deviations on various child anxiety scales (95% CI 0.3 to 0.4; I(2) = 0%; P value for heterogeneity = 0.84). No study reported adverse effects. The conclusions of this updated review remain the same as those when it was first published. The eview confirms the potential of CBT to address the adverse consequences of child sexual abuse, but highlights the limitations of the evidence base and the need for more carefully conducted and better reported trials.
Cochrane Database of Systematic Reviews, 5 : CD001930
- Year: 2012
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)