text,pmid,Nomic Topic: specific,Nomic Topic: medium,Nomic Topic: broad,pm5,X position,Y position,id_
"It's complicated: The relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression.

Many attempts have been made to discover and characterize the mechanisms of change in psychotherapies for depression, yet no clear, evidence-based account of the relationship between therapeutic procedures, psychological mechanisms, and symptom improvement has emerged. Negatively-biased thinking plays an important role in the phenomenology of depression, and most theorists acknowledge that cognitive changes occur during successful treatments. However, the causal role of cognitive change procedures in promoting cognitive change and alleviating depressive symptoms has been questioned. We describe the methodological and inferential limitations of the relevant empirical investigations and provide recommendations for addressing them. We then develop a framework within which the possible links between cognitive procedures, cognitive change, and symptom change can be considered. We conclude that cognitive procedures are effective in alleviating symptoms of depression and that cognitive change, regardless of how it is achieved, contributes to symptom change, a pattern of findings that lends support to the cognitive theory of depression.",25595660,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.962875366210938,-2.6749556064605713,CDH8
"Testing the relationship between a self-management intervention for recurrent depression and health outcomes.

Depression is a leading cause of disability globally. It is a recurrent chronic illness that affects over three million people worldwide. Self-management has been found to positively impact depression outcomes but few techniques or interventions are theory-based and can be used either with or without the support of mental health care providers. This study aimed to test the relationship between a self-management intervention called the Self-Regulated Illness Management of Depression (SRIM-D) intervention and specific health outcomes (depression, self-efficacy, social support and quality of life). SRIM-D was developed using metacognition and self-regulation theories. Twenty-three individuals with major depressive disorder (MDD) participated in the study. Individuals over 21 years of age without a diagnosis of bipolar disorder, current substance abuse problem or suicidal ideations who suffered from MDD (BDI-II < 19) were considered for the study. The intervention was delivered over three consecutive weeks of 1 ½ hour sessions by two PhD prepared nurses with psychiatric experience. Participants were given a workbook manual with corresponding power point presentations conferring information about depression, and were led through a series of workbook activities designed to teach the self-regulation process as applied to their recurrent depression. Health outcomes were assessed via self-report survey prior to and six-month post-intervention. Six months post-intervention depressive symptoms decreased significantly (M = 6.62, SD = 14.76, t(15) = 5.60, p < .0001). Self-efficacy (M = 161.67, SD = 25.27); t(20) = -2.89, p < .01) and quality of life (13.25, SD = 3.61; t(19) = 2.62, p > .01) both improved significantly. Social support had a negligible, insignificant decrease from pre-intervention (M = 53.05, SD = 19.81) to six months post-intervention (M = 42.14, SD = 19.53). Overall, the SRIM-D intervention improved health outcomes in this study. The intervention demonstrated applicability to people with recurrent, chronic depression who might or might not have access to care.",30389064,Major Depressive Disorder,Anxiety Treatment,Mental Health,9215,9.85058307647705,-3.944957971572876,BD2g
"The effects of the psychoeducation on cognitive distortions, negative automatic thoughts and dysfunctional attitudes of patients diagnosed with depression.

There are many studies showing a positive relationship between depression level and cognitive distortions in the literature. The study was carried out to determine the effects of cognitive behavioral therapy-based psychoeducation on cognitive distortions, negative automatic thoughts and dysfunctional attitudes of patients diagnosed with depression. This study was designed as a two-group pre-posttest study. The study sample composed of a total of 60 patients (30 patients in the treatment group and 30 patients in the control group) who met the eligibility criteria. The data have been collected by using The Personal Information Form, Automatic Thoughts Questionnaire, The Dysfunctional Attitude Scale and Interpersonal Cognitive Distortions Scale. Psychoeducation was provided in the form of individual training once a week in total of eight sessions. For the pretest, assumption and schemas that make people predispose to depression, dysfunctional attitudes and cognitive distortions in interpersonal relationships were seen frequently to be above average in all patients. It was determined that patients in the treatment group used significantly less dysfunctional attitudes and to had lower negative automatic thoughts and interpersonal cognitive distortions compared with patients in the control group in posttest (p < 0.05). Consequently, cognitive behavioral therapy-based psychoeducation has become considerably effective in decreasing the use of negative automatic thoughts, interpersonal cognitive distortions and dysfunctional attitudes in patients with depression. cognitive behavioral therapy-based psychoeducation should be thought of as a treatment component due to its effectiveness in nursing care of depressed patients.",34154459,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,13.435047149658203,-1.4282559156417847,AUbE
"Acute phase cognitive therapy for recurrent major depressive disorder: who drops out and how much do patient skills influence response?

The aims were to predict cognitive therapy (CT) noncompletion and to determine, relative to other putative predictors, the extent to which the patient skills in CT for recurrent major depressive disorder predicted response in a large, two-site trial. Among 523 outpatients aged 18e70, exposed to 12e14 weeks of CT, 21.6% dropped out. Of the 410 completers, 26.1% did not respond. To predict these outcomes, we conducted logistic regression analyses of demographics, pre-treatment illness characteristics and psychosocial measures, and midtreatment therapeutic alliance. The 17-item Hamilton Rating Scale for Depression (HRSD17) scores at entry predicted dropout and nonresponse. Patients working for pay, of non-Hispanic white race, who were older, or had more education were significantly more likely to complete. Controlling for HRSD17, significant predictors of nonresponse included: lower scores on the Skills of Cognitive Therapy-Observer Version (SoCT-O), not working for pay, history of only two depressive episodes, greater pre-treatment social impairment. Midphase symptom reduction was a strong predictor of final outcome. These prognostic indicators forecast which patients tend to be optimal candidates for standard CT, as well as which patients may benefit from changes in therapy, its focus, or from alternate modalities of treatment. Pending replication, the findings underscore the importance of promoting patients’ understanding and use of CT skills, as well as reducing depressive symptoms early. Future research may determine the extent to which these findings generalize to other therapies, providers who vary in competency, and patients with other depressive subtypes or disorders.",23485420,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.121797561645508,-1.1973696947097778,Cgwg
"Psychotherapy for depression among advanced, incurable cancer patients: A systematic review and meta-analysis.

There is a high prevalence of depressive disorder and depressive symptoms among advanced, incurable cancer patients. Patients commonly report a preference for non-pharmacological treatments such as psychotherapy over pharmacological treatments for depression. The objective of this review was to investigate the effectiveness of psychotherapy for the treatment of depression in people with advanced, incurable cancer via a meta-analysis of randomized controlled trials (RCTs). We searched research databases and clinical trial registries for studies published prior to June 2015. No language restrictions were applied when selecting studies. Cochrane Collaboration meta-analysis review methodology was used. All relevant RCTs comparing psychotherapy with control conditions on depression outcomes for adults with advanced cancer were eligible for inclusion. We calculated pooled effect sizes using Hedges g and a standardized mean difference (SMD) of change between baseline and post-treatment scores. Quality of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Of 13 studies included in the review, 12 reported data suitable for meta-analysis. Psychotherapy was associated with moderate decrease in depression score (SMD -0.67, 95% confidence interval -1.06 to -0.29, P=0.0005). Few studies focused on people with clinically diagnosed depression. Overall, quality of evidence across the included studies was rated as low, and heterogeneity was high. Low quality evidence suggests that psychotherapy is moderately more effective for the amelioration of symptoms of depression among advanced, incurable cancer patients than the control conditions. There is insufficient high-quality evidence supporting the effectiveness of psychotherapy for patients with clinically diagnosed depression.",28453966,Major Depressive Disorder,Anxiety Treatment,Mental Health,2474,6.423740863800049,-1.9551056623458862,BdT5
"Construing and body dissatisfaction in chronic depression: A study of body psychotherapy.

The frequent association of depression with somatic symptoms suggests that body psychotherapy may be an appropriate therapeutic intervention for people with chronic depression. Using a subset of twenty-three participants from a randomized controlled trial that had demonstrated the effectiveness of such an intervention in reducing depressive symptoms, the present study investigated whether it may also impact aspects of construing which have been associated with depression. Patients presenting with chronic depression were randomly allocated to a treatment group or a waiting list group, which received body psychotherapy after a period on a waiting list. Correlations between repertory grid, questionnaire, and visual analogue measures indicated that depression and bodily dissatisfaction were associated with features of the content and structure of construing. There were no significant changes while patients were on the waiting list, but during treatment reduction in depression and bodily dissatisfaction, together with increase in self-esteem and quality of life, were accompanied by an increase in the salience of construing of the bodily self.",30551334,Major Depressive Disorder,Anxiety Treatment,Mental Health,26910,-1.040195107460022,-3.963686227798462,BByX
"Examining cognitive-behavioral therapy change mechanisms for decreasing depression, weight, and insulin resistance in adolescent girls at risk for type 2 diabetes.

Depression in adolescence is linked to risk for type 2 diabetes (T2D). In this secondary data analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) to a control program to ameliorate insulin resistance via reducing depression symptoms, we examine which CBT change mechanisms (e.g., behavioral activation, cognitive restructuring) contributed to decreased depression and subsequent improvements in body mass index (BMI), percent body fat, and insulin resistance. Girls 12-17y with overweight/obesity and family history of T2D were randomized to six-week group CBT (n = 61) or health education (HealthEd; n = 58). At baseline and post-treatment, adolescents completed questionnaires assessing activities, thoughts, and depression symptoms. At baseline, post-treatment, and one-year, BMI was calculated and insulin outcomes were derived from two-hour oral glucose tolerance testing. At baseline and one-year, percent body fat was assessed with dual-energy x-ray absorptiometry. Indirect effects of CBT components were tested on one-year changes in BMI, percent body fat, and insulin indices through decreases in depression symptoms during treatment. Intervention was tested as a moderator. In CBT, but not HealthEd, there was an indirect effect of increased physical activity during treatment on decreased one-year BMI via reductions in depression symptoms during treatment. Also, there were conditional indirect effects in CBT of increased pleasantness of physical and social activity during treatment on decreased one-year BMI via decreased depression symptoms during treatment. Behavioral activation may be a useful intervention to decrease depression and reduce excess weight gain in the targeted prevention of T2D in at-risk adolescent girls. NCT01425905, clinicaltrials.gov.",35367918,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,2.4813122749328613,-2.383371591567993,fUs
"Randomized controlled pilot trial of supportive text messages for patients with depression.

Depression is projected to be the primary cause of disability worldwide by 2030. In a recent survey, the most commonly cited unmet need among 42.4% of depressed Albertans was the lack of sufficient, accessible, and affordable counselling. Our aim was to test the efficacy of a supportive text messaging mobile health intervention in improving treatment outcomes in depressed patients. We performed a single-rater-blinded randomized trial involving 73 patients with Major Depressive Disorder. Patients in the intervention group (n = 35) received twice-daily supportive text messages for 3 months while those in the control group (n = 38) received a single text message every fortnight thanking them for participating in the study. The primary outcome of this study was: ""Mean changes in the BDI scores from baseline"". After adjusting for baseline BDI scores, a significant difference remained in the 3 month mean BDI scores between the intervention and control groups: (20.8 (SD = 11.7) vs. 24.9 (SD = 11.5), F (1, 60) = 4.83, p = 0.03, ηp2 = 0.07). The mean difference in the BDI scores change was significant with an effect size (Cohen's d) of 0.67. Furthermore, after adjusting for baseline scores, a significant difference remained in the 3 month mean self-rated VAS scores (EQ-5D-5 L scale) between the intervention and control groups, 65.7 (SD = 15.3) vs. 57.4 (SD = 22.9), F (1, 60) =4.16, p = 0.05, ηp2 = 0.065. The mean difference in change mean self-rated VAS scores was also statistically significant with an effect size (Cohen's d) of 0.51. Our findings suggest that supportive text messages are a potentially useful psychological intervention for depression, especially in underserved populations. Further studies are needed to explore the implications of our findings in larger clinical samples. ClinicalTrials.gov NCT02327858 . Registered 24 December 2014.",28768493,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,5.574865818023682,-7.479974269866943,BY6h
"Computer-assisted cognitive behavioral therapy for pregnant women with major depressive disorder.

Pregnant women with major depressive disorder (MDD) report that psychotherapy is a more acceptable treatment than pharmacotherapy. However, although results of several studies suggest that psychotherapy is an effective treatment for pregnant women, logistical barriers-including cost and traveling for weekly visits-can limit real-world utility. We hypothesized that computer-assisted cognitive behavior therapy (CCBT) would be both acceptable and would significantly decrease depressive symptoms in pregnant women with MDD. As a preliminary test of this hypothesis, we treated 10 pregnant women with MDD using a standardized CCBT protocol. The pilot results were very promising, with 80% of participants showing treatment response and 60% showing remission after only eight sessions of CCBT. A larger, randomized controlled trial of CCBT in pregnant women with MDD is warranted.",25268672,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.894294023513794,-5.615664958953857,CHrF
"Feasibility and efficacy of an internet treatment for postnatal depression utilising a behavioural activation approach.

",24598825,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,4.282281398773193,-5.43374490737915,CRS+
"A Web-Based Cognitive Behavior Therapy Intervention to Improve Social and Occupational Functioning in Adults With Type 2 Diabetes (The SpringboarD Trial): Randomized Controlled Trial.

Depressive symptoms are common in people with type 2 diabetes mellitus (T2DM). Effective depression treatments exist; however, access to psychological support is characteristically low. Web-based cognitive behavioral therapy (CBT) is accessible, nonstigmatizing, and may help address substantial personal and public health impact of comorbid T2DM and depression. The aim of this study was to evaluate the Web-based CBT program, myCompass, for improving social and occupational functioning in adults with T2DM and mild-to-moderate depressive symptoms. myCompass is a fully automated, self-guided public health treatment program for common mental health problems. The impact of treatment on depressive symptoms, diabetes-related distress, anxiety symptoms, and self-care behavior was also examined. Participants with T2DM and mild-to-moderate depressive symptoms (N=780) were recruited online via Google and Facebook advertisements targeting adults with T2DM and via community and general practice settings. Screening, consent, and self-report scales were all self-administered online. Participants were randomized using double-blind computerized block randomization to either myCompass (n=391) for 8 weeks plus a 4-week tailing-off period or an active placebo intervention (n=379). At baseline and postintervention (3 months), participants completed the Work and Social Adjustment Scale, the primary outcome measure. Secondary outcome measures included the Patient Health Questionnaire-9 item, Diabetes Distress Scale, Generalized Anxiety Disorder Questionnaire-7 item, and items from the Self-Management Profile for Type 2 Diabetes. myCompass users logged in an average of 6 times and completed an average of .29 modules. Healthy Lifestyles users logged in an average of 4 times and completed an average of 1.37 modules. At baseline, mean scores on several outcome measures, including the primary outcome of work and social functioning, were near to the normal range, despite an extensive recruitment process. Approximately 61.6% (473/780) of participants completed the postintervention assessment. Intention-to-treat analyses revealed improvement in functioning, depression, anxiety, diabetes distress, and healthy eating over time in both groups. Except for blood glucose monitoring and medication adherence, there were no specific between-group effects. Follow-up analyses suggested the outcomes did not depend on age, morbidity, or treatment engagement. Improvement in social and occupational functioning and the secondary outcomes was generally no greater for myCompass users than for users of the control program at 3 months postintervention. These findings should be interpreted in light of near-normal mean baseline scores on several variables, the self-selected study sample, and sample attrition. Further attention to factors influencing uptake and engagement with mental health treatments by people with T2DM, and the impact of illness comorbidity on patient conceptualization and experience of mental health symptoms, is essential to reduce the burden of T2DM. Australian New Zealand Clinical Trials Registry ACTRN12615000931572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368109&isReview=true (Archived by WebCite at http://www.webcitation.org/7850eg8pi).",31115345,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.2353363037109375,-2.519444465637207,A6IM
"The effect of psychotherapy on anxiety, depression, and quality of life in patients with diabetic retinopathy: A protocol for systematic review and network meta-analysis.

Diabetic retinopathy (DR) is one of the common microvascular complications in diabetic patients, which is characterized by progressive development and often leads to irreversible visual impairment. More seriously, DR patients suffer great psychological stress due to impaired visual function and reduced self-care ability such as anxiety and depression, which seriously affect the quality of life of patients. In recent years, various psychological therapies have been applied to alleviate anxiety, depression, and quality of life in DR patients, which have achieved positive results. However, the effectiveness and safety of different psychological therapies are unclear. This study aims to assess the effects of psychotherapy on anxiety, depression, and quality of life in DR patients through a network meta-analysis. All randomized controlled trials (RCTs) on the effects of psychotherapy on anxiety, depression, and quality of life in patients with DR published before 30 November 30, 2021, will be searched in the PubMed, EMBASE, Cochrane Register of Controlled Trials, Web of Science, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Wanfang, and China Biomedical Literature Database. There will have no restrictions on publication status and language. Two researchers will be independently responsible for RCT screening, data extraction, and quality evaluation. All statistical analyses will be performed using Stata 14.0 and R 4.1.2. The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. This study will provide comprehensive and reliable evidence-based references for elucidating the efficacy of psychotherapy on anxiety, depression, and quality of life in DR patients. Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. DOI 10.17605/OSF.IO/K8T27.",34941170,Major Depressive Disorder,Anxiety Treatment,Mental Health,21283,3.547173023223877,-1.9124140739440918,wUQ
"Internet Cognitive Behavioral Therapy for Women With Postnatal Depression: A Randomized Controlled Trial of MumMoodBooster.

There are few published controlled trials examining the efficacy of Internet-based treatment for postnatal depression (PND) and none that assess diagnostic status (clinical remission) as the primary outcome. This is despite the need to improve treatment uptake and accessibility because fewer than 50% of postnatally depressed women seek help, even when identified as depressed. In a randomized controlled trial (RCT), we aimed to test the efficacy of a 6-session Internet intervention (the MumMoodBooster program, previously evaluated in a feasibility trial) in a sample of postnatal women with a clinical diagnosis of depression. The MumMoodBooster program is a cognitive behavioral therapy (CBT) intervention, is highly interactive, includes a partner website, and was supported by low-intensity telephone coaching. This was a parallel 2-group RCT (N=43) comparing the Internet CBT treatment (n=21) to treatment as usual (n=22). At baseline and at 12 weeks after enrollment, women's diagnostic status was assessed by telephone with the Standardized Clinical Interview for DSM-IV (SCID-IV) and symptom severity with the Beck Depression Inventory (BDI-II). Depression symptoms were measured repeatedly throughout the study period with the Patient Health Questionnaire (PHQ-9). At the end of the study, 79% (15/19) of women who received the Internet CBT treatment no longer met diagnostic criteria for depression on the SCID-IV (these outcome data were missing for 2 intervention participants). This contrasted with only 18% (4/22) remission in the treatment as usual condition. Depression scores on the BDI-II showed a large effect favoring the intervention group (d=.83, 95% CI 0.20-1.45). Small to medium effects were found on the PHQ-9 and on measures of anxiety and stress. Adherence to the program was very good with 86% (18/21) of users completing all sessions; satisfaction with the program was rated 3.1 out of 4 on average. Our results suggest that our Internet CBT program, MumMoodBooster, is an effective treatment option for women clinically diagnosed with PND. This is one of only two controlled evaluations of specialized online psychological treatment among women clinically diagnosed with PND. MumMoodBooster appears to be a feasible, effective treatment option, which is potentially accessible to large numbers of women in metropolitan, rural, and remote areas. Future work might be focused profitably on establishing comparability with face-to-face treatments and purely self-guided delivery. We have commenced a larger RCT comparing MumMoodBooster with face-to-face CBT. Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000113752; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363561 (Archived by WebCite® at http://www.webcitation.org/6f64kuyLf).",26952645,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.9434564113616943,-5.550495147705078,Bv/J
"Six-months outcomes of a randomised trial of supportive text messaging for depression and comorbid alcohol use disorder.

We have previously reported that supportive text messages delivered twice daily for three months have the potential to provide personalised support for patients with depression and co-morbid Alcohol Use Disorder (AUD). In this study we report the six months outcomes. Participants (n=54) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were randomised to receive daily twice supportive text messages (n=26) or a fortnightly thank you text message (n=28) for three months. Primary outcome measures at six months were Beck's Depression Inventory (BDI-II) scores and Cumulative Abstinence Duration (CAD). NCT0137868. Unlike at three months, there was no statistically significant difference in six months BDI-II scores between the intervention (n=24) and control (n=24) groups; 13.28 (SD=8.7) vs. 15.08 (SD=11.37) respectively after adjusting for the baseline scores, F (1, 45)=0.192, p=0.66. There was also no significant difference in CAD between the text message group and the control group: 84.14 days (9.20) vs. 74.73 days (28.97), t=1.422, df=41, p=0.16. However, patients in the intervention group had significantly higher days to first drink compared to those in the control group: 119.9 (47.7) vs. 62.4 (44.9), t=2.99, df=22, p=0.01. Limitations of the study include the small sample size and the potential for loss of rater blinding. The effects of supportive text message intervention were not sustained beyond the period that the patients were receiving the intervention.",23800443,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,5.044760227203369,-8.14214038848877,CcM+
"Development and reach of a web-based cognitive behavioural therapy programme to reduce symptoms of depression and diabetes-specific distress.

There is an urgent need for more effective and efficient depression treatments in diabetes. We developed a diabetes-specific version of the Dutch web-based 'Coping with Depression' (CWD) course. Here, we report on the development, reach, patients' reasons for choosing our intervention and their characteristics. The CWD programme was amended for use in diabetes patients with co-morbid depression. Data were collected using a telephone interview, self-report questionnaires, and medical records. Adding diabetes-specific topics to an effective web-based depression programme resulted in an 8-lesson intervention (""www.diabetergestemd.nl""), with minimal guidance by coaches. In the framework of a randomised trial, the intervention attracted serious interest of 540 patients. After screening, 255 depressed diabetes patients were enrolled. Less than half had a history of depression treatment; 80% reported the diabetes-specific approach to be an important reason for signing up. We successfully developed a diabetes-specific version of the web-based CWD course, which attracted a large group of patients. Our results affirm the importance of addressing diabetes-specific issues in the context of depression treatment. Our intervention could be implemented on a large scale at low costs, and may serve as a model on how to develop other illness-specific online self-help interventions.",20619577,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.3761682510375977,-2.625232219696045,DIQZ
"Is Cognitive Behavioural Therapy focusing on Depression and Anxiety Effective for People with Long-Term Physical Health Conditions? A Controlled Trial in the Context of Type 2 Diabetes Mellitus.

It is unclear as to the extent to which psychological interventions focusing specifically on depression and anxiety are helpful for people with physical health conditions, with respect to mood and condition management. To evaluate the effectiveness of a modified evidence-based psychological intervention focusing on depression and anxiety for people with type 2 diabetes mellitus (T2DM), compared with a control intervention. Clients (n = 140) who experienced mild to moderate depression and/or anxiety and had a diagnosis of T2DM were allocated to either diabetes specific treatment condition (n = 52) or standard intervention (control condition, n = 63), which were run in parallel. Each condition received a group intervention offering evidence-based psychological interventions for people with depression and anxiety. Those running the diabetes specific treatment group received additional training and supervision on working with people with T2DM from a clinical health psychologist and a general practitioner. The diabetes specific treatment intervention helped patients to link mood with management of T2DM. Both conditions demonstrated improvements in primary outcomes of mood and secondary outcome of adjustment [95% confidence interval (CI) between 0.25 and 5.06; p < 0.05 in all cases]. The diabetes specific treatment condition also demonstrated improvements in secondary outcomes of self-report management of T2DM for diet, checking blood and checking feet, compared with the control condition (95% CIs between 0.04 and 2.05; p < 0.05 in all cases) and in glycaemic control (95% CI: 0.67 to 8.22). The findings also suggested a non-significant reduction in NHS resources in the diabetes specific treatment condition. These changes appeared to be maintained in the diabetes specific treatment condition. It is concluded that a modified intervention, with input from specialist services, may offer additional benefits in terms of improved diabetic self-management and tighter glycaemic control.",28849755,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.3692612648010254,-2.630833387374878,BX0K
"Contingency management improves outcomes in cocaine-dependent outpatients with depressive symptoms.

Despite depressive symptoms being very common among patients seeking treatment for cocaine dependence, few studies have examined the effects of depressive symptoms on cocaine outpatient treatment outcomes, and there is even less research in the context of Contingency Management (CM). The purpose of this study was to assess the main and interactive effects of co-occurring depressive symptoms on CM outcomes. Cocaine-dependent individuals (N = 108) were randomized to Community Reinforcement Approach (CRA) or CRA plus CM in two outpatient community clinical settings. Participants were categorized according to depression symptoms, self-reported by means of the BDI at treatment entry. Outcome measures included treatment retention and documented cocaine abstinence over a 6-month treatment period. Depressive symptoms were more commonly found in females and in unemployed participants, and were associated with more drug-related, social, and psychiatric problems at treatment entry. Individuals with baseline depressive symptoms had poorer treatment outcomes than patients without depressive symptoms. The addition of CM to CRA made the program more effective than with CRA alone, regardless of depressive symptoms. CM was associated with better abstinence treatment outcomes, while the interaction between unemployment and depressive symptoms was associated with negative retention treatment outcomes. This study supports the efficacy of CM for cocaine-dependent outpatients with and without depressive symptoms, and highlights its importance for improving treatment for unemployed and depressed cocaine-dependent individuals.",24080020,Major Depressive Disorder,Anxiety Treatment,Mental Health,4603,3.7913897037506104,-11.209863662719727,CYEm
"The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials.

Non-pharmacological approaches to the treatment of depression and anxiety are of increasing importance, with emerging evidence supporting a role for lifestyle factors in the development of these disorders. Observational evidence supports a relationship between habitual diet quality and depression. Less is known about the causative effects of diet on mental health outcomes. Therefore a systematic review was undertaken of randomised controlled trials of dietary interventions that used depression and/or anxiety outcomes and sought to identify characteristics of programme success. A systematic search of the Cochrane, MEDLINE, EMBASE, CINAHL, PubMed and PyscInfo databases was conducted for articles published between April 1971 and May 2014. Of the 1274 articles identified, seventeen met eligibility criteria and were included. All reported depression outcomes and ten reported anxiety or total mood disturbance. Compared with a control condition, almost half (47%) of the studies observed significant effects on depression scores in favour of the treatment group. The remaining studies reported a null effect. Effective dietary interventions were based on a single delivery mode, employed a dietitian and were less likely to recommend reducing red meat intake, select leaner meat products or follow a low-cholesterol diet. Although there was a high level of heterogeneity, we found some evidence for dietary interventions improving depression outcomes. However, as only one trial specifically investigated the impact of a dietary intervention in individuals with clinical depression, appropriately powered trials that examine the effects of dietary improvement on mental health outcomes in those with clinical disorders are required.",25465596,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,0.3432534337043762,-1.710431694984436,CE8Z
"Role of Mediators in Reducing Antepartum Depressive Symptoms in Rural Low-Income Women Receiving a Culturally Tailored Cognitive Behavioral Intervention.

Although cognitive behavioral interventions (CBIs) have demonstrated effectiveness for reducing depressive symptoms in the general population, the mechanism for reducing antepartum depressive symptoms (APDS) in rural low-income and minority women is unknown. This study tested the hypothesis that reducing stress and negative thinking, enhancing self-esteem, and increasing social-support will mediate the effect of a CBI on reducing APDS in rural low-income and minority women. Our findings show that CBI may work through reducing stress and negative thinking and enhancing self-esteem, but not social support. The findings also suggest that mental health care providers should emphasize these activities to reduce antepartum depressive symptoms.",27740883,Major Depressive Disorder,Anxiety Treatment,Mental Health,118,4.0593671798706055,-5.4937310218811035,BmBX
"What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes.

Cognitive Behavior Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT) have shown to be effective interventions for treating depressive symptoms in patients with diabetes. However, little is known about which intervention works best for whom (i.e., moderators of efficacy). The aim of this study was to identify variables that differentially predicted response to either CBT or MBCT (i.e., prescriptive predictors). The sample consisted of 91 adult outpatients with type 1 or type 2 diabetes and comorbid depressive symptoms (i.e., BDI-II ≥ 14) who were randomized to either individual 8-week CBT (n = 45) or individual 8-week MBCT (n = 46). Patients were followed for a year and depressive symptoms were measured at pre-treatment, post-treatment, and at 9-months follow-up. The predictive effect of demographics, depression related characteristics, and disease specific characteristics on change in depressive symptoms was assessed by means of hierarchical regression analyses. Analyses showed that education was the only factor that differentially predicted a decrease in depressive symptoms directly after the interventions. At post-treatment, individuals with higher educational attainment responded better to MBCT, as compared to CBT. Yet, this effect was not apparent at 9-months follow-up. This study did not identify variables that robustly differentially predicted treatment effectiveness of CBT and MBCT, indicating that both CBT and MBCT are accessible interventions that are effective for treating depressive symptoms in broad populations with diabetes. More research is needed to guide patient-treatment matching in clinical practice.",28662208,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,3.615568161010742,-2.392101287841797,Bacs
"Psychological and pharmacological interventions for depression in patients with diabetes mellitus: an abridged Cochrane review.

To summarize and critically evaluate the effectiveness of psychological and pharmacological interventions for depression in patients with both diabetes and depression. Randomized controlled trials investigating psychological and pharmacological interventions for depression in adults with diabetes and depression were included. A comprehensive search of primary studies according to Cochrane were conducted. Primary outcomes were depression and glycaemic control. Further, treatment adherence, diabetes complications, mortality, healthcare costs and quality of life were investigated. Two reviewers identified primary studies and extracted data independently. Random-effects model meta-analyses were conducted to compute overall estimates of treatment outcomes. The database search resulted in 3963 references, of which 19 trials were included. Randomized controlled trials of psychological interventions showed positive effects on short- and medium-term depression severity [standardized mean difference short-term range -1.47; -0.14, n = 7; medium-term standardized mean difference -0.42 (95% CI -0.70 to -0.14), n = 3] and depression remission [odds ratio short term 2.88 (95% CI 1.58-5.25), n = 4; odds ratio medium term 2.49 (95% CI 1.44-4.32), n = 2]. Effects on glycaemic control in psychological intervention trials varied substantially (standardized mean difference range -0.97 to 0.47, n = 4). Selective serotonin reuptake inhibitors showed a moderate beneficial effect on short-term depression severity [standardized mean difference -0.39 (95% CI -0.64 to -0.13], n = 5) and depression remission [odds ratio 2.52 (95% CI 1.11-5.75), n = 2]. Glycaemic control improved in randomized controlled trials comparing selective serotonin reuptake inhibitors with placebo at the end of treatment [standardized mean difference -0.38 (95% CI -0.64 to -0.12), n = 5]. Psychological and pharmacological interventions positively affect depression outcomes in patients with diabetes at the end of treatment. Furthermore, short-term glycaemic control improved moderately in pharmacological trials. Most outcomes have not been investigated sufficiently. Moreover, there is a lack of follow-up data for pharmacological trials limiting the evidence on the sustainability of treatment effects.",24673571,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.2428152561187744,-2.359248161315918,CQL2
"Psychosocial factors associated with treatment outcomes in women with obesity and major depressive disorder who received behavioral activation for depression.

Behavioral activation is an empirically supported treatment for depression, but much is unknown about factors associated with treatment response. The present study aimed to determine whether baseline levels and subsequent changes in psychosocial factors were associated with improvement in depression in women with comorbid obesity who received behavioral activation treatment for depression and a lifestyle intervention. Multilevel modeling was used to estimate the associations between psychosocial factors and change in depression scores during the first 10 weeks of treatment and associations between changes in psychosocial factors from baseline to 6-month follow-up and change in depression over the same time period. No baseline psychosocial factors were associated with depression improvement during treatment (p=0.110-0.613). However, greater improvement in hedonic capacity (p=0.001), environmental reward (p=0.004), and social impairment (p=0.012) were associated with greater reductions in depression over 6 months. Findings highlight the differential relationship specific psychosocial factors have with depression treatment outcomes.",30467656,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,1.0135703086853027,-2.5403342247009277,BC3s
"Web-Based Cognitive Behavior Therapy for Depression in People With Diabetes Mellitus: A Randomized Controlled Trial.

Depression is twice as common in diabetes mellitus (DM) as the general population and is associated with adverse health outcomes, but access to evidence-based therapies such as cognitive behavioral therapy (CBT) is limited in routine diabetes care. Past research has shown that generic Internet-based cognitive behavioral therapy (iCBT) is an effective treatment for depression in the general population, but it has never been evaluated in people with comorbid depression and DM. The aim of our study was to examine the efficacy of a generic 6-lesson iCBT delivered over 10 weeks in people with major depressive disorder (MDD) and DM. Participants with comorbid MDD and DM (type 1 or 2) were recruited online and randomized to an iCBT program with therapist support provided by phone and email (n=42) or a treatment as usual (TAU, n=49) control group. Outcomes were assessed through Web-based self-report questionnaires and the trial was Web-based with no face-to-face components. Primary outcomes were self-reported depression (patient health questionnaire-9, PHQ-9), diabetes-related distress (problem areas in diabetes, PAID), and self-reported glycemic control (hemoglobin A1c, HbA1c). Secondary outcomes were general distress (Kessler 10-item psychological distress scale, K-10) and disability (short form 12-item, SF-12), generalized anxiety (generalized anxiety disorder 7-item, GAD-7), and somatization (PHQ-15). The iCBT group was assessed at 3 months. A total of 27 participants (66%; 27/41) completed the iCBT program. Analyses indicated between-group superiority of iCBT over TAU at posttreatment on PHQ-9 (g=0.78), PAID (g=0.80), K-10 (g=1.06), GAD-7 (g=0.72), and SF-12 mental well-being scores (g=0.66), but no significant differences in self-reported HbA1c levels (g=0.14), SF-12 physical well-being, or PHQ-15 scores (g=0.03-0.21). Gains were maintained at 3-month follow-up in the iCBT group, and the 87% (27/31) of iCBT participants who were interviewed no longer met criteria for MDD. Clinically significant change following iCBT on PHQ-9 scores was 51% (21/41) versus 18% (9/49) in TAU. iCBT for depression is an efficacious, accessible treatment option for people with diabetes. Future studies should explore whether tailoring of iCBT programs improves acceptability and adherence, and evaluate the long-term outcomes following iCBT. Australian and New Zealand Clinical Trials Registry (ACTRN): 12613001198718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365208&isReview=true (Archived by WebCite at http://www.webcitation.org/6qCR8Fi9V).",28506956,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.365818977355957,-2.3721723556518555,Bcii
"Pilot study of psychotherapeutic text messaging for depression.

Background Text messaging services could increase access to psychotherapeutic content for individuals with depression by avoiding barriers to in-person psychotherapy such as cost, transportation, and therapist availability. Determining whether text messages reflecting different psychotherapeutic techniques exhibit differences in acceptability or effectiveness may help guide service development. Objectives We aimed to determine: (1) the feasibility of delivering a psychotherapy-based text messaging service to people with depression identified via the internet, (2) whether there is variation in satisfaction with messages according to the type of psychotherapeutic technique they represent, and (3) whether symptoms of depression vary according to receipt of each message type and participants' satisfaction with the messages they received. Methods For this study 190 US adults who screened positive for a major depressive episode (Patient Health Questionnaire (PHQ-9) score ≥10) were recruited from online advertisements. Participants received a daily psychotherapy-based text message 6 days per week for 12 weeks. Text messages were developed by a team of psychiatrists, psychologists, and social workers to reflect three psychotherapeutic approaches: acceptance and commitment therapy (ACT), behavioural activation, and cognitive restructuring. Each week the message type for the week was randomly assigned from one of the three types, allowing for repeats. Participants were asked daily to rate each message. On the 7th day of each week, participants completed a two-item depression screener (PHQ-2). Web-based surveys at baseline, 6, and 12 weeks were used as the primary measure of depressive symptoms (PHQ-9). Results Of the 190 participants enrolled, 85 (45%) completed the 6-week web survey and 67 (35%) completed the 12-week survey. The mean baseline PHQ-9 score was 19.4 (SD 4.2) and there was a statistically significant mean improvement in PHQ-9 scores of -2.9 (SD 6.0; p<0.001) at 6 weeks and -4.8 (SD 6.6; p<0.001) at 12 weeks. Mean satisfaction ratings did not vary across message types. There was generally no association between the number of weeks in which participants received a given message type and PHQ-9 scores at follow-up. However, among individuals with more severe depression at baseline (PHQ-9≥20; n=30), the number of weeks of behavioural activation messages received was associated with less symptom improvement (ρ=0.37; p=0.04) at 12 weeks. Participants who gave higher satisfaction ratings to messages regardless of type had greater reductions in PHQ-9 scores at 6 weeks. Conclusions Study participants exhibited borderline clinically significant improvement in depressive symptoms at 12 weeks suggesting the effects of the intervention, if any, were small. Although there was no overall variation in changes in PHQ-9 according to users' exposure to the three message types, effectiveness among severely depressed participants could potentially be improved by tailoring towards fewer behavioural activation messages. Controlled studies to determine effectiveness of texting interventions such as this one are indicated considering that even small effects may be cost effective given the low cost of delivering text messages.",27450571,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,6.151444435119629,-7.035689353942871,Bpjp
"The effectiveness of telephone-delivered psychological therapies for depression and anxiety: A systematic review.

Objectives The telephone is increasingly used to deliver psychological therapies for common mental health problems. This review addressed the following question: are evidence-based psychological therapies for adults with depression and/or anxiety effective in reducing psychological symptoms when delivered over the telephone? Method A systematic search for articles published over a 25-year period (January 1991-May 2016) was performed using the databases PsycINFO, PubMed and Web of Science. Citation searches, manual searches of bibliographies of relevant papers, and hand searches of key journals were also conducted. The quality of the studies included for review was assessed using the Effective Public Health Practice Project Quality Assessment Tool. Results Fourteen studies met inclusion criteria for the review. Ten reported findings from telephone treatment for depression and four for anxiety. Nine studies used randomised controlled designs, two used quasi-experimental designs and three used uncontrolled designs. Thirteen studies reported reductions in symptoms of depression or anxiety. Cohen's d ranged from 0.25-1.98 (median=0.61) for controlled studies and from 1.13-1.90 (median=1.26) for uncontrolled studies. Only four studies reported clinically significant change. Conclusions The findings indicate that telephone-delivered interventions show promise in reducing symptoms of depression and anxiety. Further research is required to establish the types of interventions that are most effective and the characteristics of clients who find them beneficial.",28038505,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.021164894104004,-3.4855518341064453,BixF
"A Machine Learning Approach to Understanding Patterns of Engagement With Internet-Delivered Mental Health Interventions.

The mechanisms by which engagement with internet-delivered psychological interventions are associated with depression and anxiety symptoms are unclear. To identify behavior types based on how people engage with an internet-based cognitive behavioral therapy (iCBT) intervention for symptoms of depression and anxiety. Deidentified data on 54 604 adult patients assigned to the Space From Depression and Anxiety treatment program from January 31, 2015, to March 31, 2019, were obtained for probabilistic latent variable modeling using machine learning techniques to infer distinct patient subtypes, based on longitudinal heterogeneity of engagement patterns with iCBT. A clinician-supported iCBT-based program that follows clinical guidelines for treating depression and anxiety, delivered on a web 2.0 platform. Log data from user interactions with the iCBT program to inform engagement patterns over time. Clinical outcomes included symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalized Anxiety Disorder-7 [GAD-7]); PHQ-9 cut point greater than or equal to 10 and GAD-7 scores greater than or equal to 8 were used to define depression and anxiety. Patients spent a mean (SD) of 111.33 (118.92) minutes on the platform and completed 230.60 (241.21) tools. At baseline, mean PHQ-9 score was 12.96 (5.81) and GAD-7 score was 11.85 (5.14). Five subtypes of engagement were identified based on patient interaction with different program sections over 14 weeks: class 1 (low engagers, 19 930 [36.5%]), class 2 (late engagers, 11 674 [21.4%]), class 3 (high engagers with rapid disengagement, 13 936 [25.5%]), class 4 (high engagers with moderate decrease, 3258 [6.0%]), and class 5 (highest engagers, 5799 [10.6%]). Estimated mean decrease (SE) in PHQ-9 score was 6.65 (0.14) for class 3, 5.88 (0.14) for class 5, and 5.39 (0.14) for class 4; class 2 had the lowest rate of decrease at -4.41 (0.13). Compared with PHQ-9 score decrease in class 1, the Cohen d effect size (SE) was -0.46 (0.014) for class 2, -0.46 (0.014) for class 3, -0.61 (0.021) for class 4, and -0.73 (0.018) for class 5. Similar patterns were found across groups for GAD-7. The findings of this study may facilitate tailoring interventions according to specific subtypes of engagement for individuals with depression and anxiety. Informing clinical decision needs of supporters may be a route to successful adoption of machine learning insights, thus improving clinical outcomes overall.",32678450,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.433419227600098,-2.5489864349365234,Alrn
"Positive cognitive behavior therapy in the treatment of depression: A randomized order within-subject comparison with traditional cognitive behavior therapy.

Previous research suggests that a stronger focus on positive emotions and positive mental health may improve efficacy of Cognitive Behavior Therapy (CBT). Objectives were to compare differential improvement of depressive symptoms (primary outcome), positive affect, and positive mental health indices during positive CBT (P-CBT; CBT in a solution-focused framework, amplified with optional positive psychology exercises) versus traditional, problem-focused CBT (T-CBT). Forty-nine patients with major depressive disorder (recruited in an outpatient mental health care facility specialized in mood disorders) received two treatment blocks of eight sessions each (cross-over design, order randomized). Intention-To-Treat mixed regression modelling indicated that depressive symptoms improved similarly during the first, but significantly more in P-CBT compared to T-CBT during the second treatment block. Rate of improvement on the less-frequently measured secondary outcomes was not significantly different. However, P-CBT was associated with significantly higher rates of clinically significant or reliable change for depression, negative affect, and happiness. Effect sizes for the combined treatment were large (pre-post Cohen's d = 2.71 for participants ending with P-CBT, and 1.85 for participants ending with T-CBT). Positive affect, optimism, subjective happiness and mental health reached normative population averages after treatment. Overall, findings suggest that explicitly focusing on positive emotions efficiently counters depressive symptoms.",30897464,Major Depressive Disorder,Anxiety Treatment,Mental Health,14639,11.31410026550293,-2.853168487548828,A9EQ
"Use of mental health telemetry to enhance identification and predictive value of early changes during augmentation treatment of major depression.

Standard clinical trial methodology in depression does not allow for careful examination of early changes in symptom intensity. The purpose of this study was to use daily ""Mental Health Telemetry"" (MHT) to prospectively record change in depressive and anxiety symptoms for depressed patients receiving augmentation treatment, and determine the extent and predictive capacity of early changes. We report results of a 6-week, open-label study of the addition of quetiapine XR (range, 50-300 mg) for adult patients (n = 26) with major depressive disorder who were nonresponsive to antidepressant treatment. In addition to regular study visits, all participants completed daily, wirelessly transmitted self-report ratings of symptoms on a Smartphone. Daily and 3-day moving average mean scores were calculated, and associations between early symptom change and eventual response to treatment were determined. Improvement in depressive and anxiety symptoms was identified as early as day 1 of treatment. Of the total decline in depression severity over 6 weeks, 9% was present at day 1, 28% at day 2, 39% at days 3 and 4, 65% at day 7, and 80% at day 10. Self-report rating of early improvement (≥20%) in depressive symptoms at day 7 significantly predicted responder status at week 6 (P = 0.03). Clinician-rated depressive and anxiety symptoms only became significantly associated with responder status at day 14. In conclusion, very early changes in depressive symptoms were identified using MHT, early changes accounted for most of total change, and MHT-recorded improvement as early as day 7 significantly predicted response to treatment at study end point.",24100787,Major Depressive Disorder,Anxiety Treatment,Mental Health,11774,7.672751426696777,-5.606497764587402,CXyI
"Which patients benefit specifically from short-term psychodynamic psychotherapy (STPP) for depression? Study protocol of a systematic review and meta-analysis of individual participant data.

Short-term psychodynamic psychotherapy (STPP) is an empirically supported treatment that is often used to treat depression. However, it is largely unclear if certain subgroups of depressed patients can benefit specifically from this treatment method. We describe the protocol for a systematic review and meta-analysis of individual participant data (IPD) aimed at identifying predictors and moderators of STPP for depression efficacy. We will conduct a systematic literature search in multiple bibliographic databases (PubMed, PsycINFO, Embase.com, Web of Science and Cochrane's Central Register of Controlled Trials), 'grey literature' databases (GLIN and UMI ProQuest) and a prospective trial register (http://www.controlled-trials.com). We will include studies reporting (a) outcomes on standardised measures of (b) depressed (c) adult patients (d) receiving STPP. We will next invite the authors of these studies to share the participant-level data of their trials and combine these data to conduct IPD meta-analyses. The primary outcome for this study is post-treatment efficacy as assessed by a continuous depression measure. Potential predictors and moderators include all sociodemographic variables, clinical variables and psychological patient characteristics that are measured before the start of treatment and are assessed consistently across studies. One-stage IPD meta-analyses will be conducted using mixed-effects models. Institutional review board approval is not required for this study. We intend to submit reports of the outcomes of this study for publication to international peer-reviewed journals in the fields of psychiatry or clinical psychology. We also intend to present the outcomes at international scientific conferences aimed at psychotherapy researchers and clinicians. The findings of this study can have important clinical implications, as they can inform expectations of STPP efficacy for individual patients, and help to make an informed choice concerning the best treatment option for a given patient. CRD42017056029.",29463590,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.214606285095215,-4.19091272354126,BPwT
"Preventive cognitive therapy could be a viable and effective addition to antidepressant medication in preventing relapse or recurrence in major depressive disorder.

",30530763,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.237079620361328,-1.0185000896453857,BCCn
"Efficacy of depression treatments for immigrant patients: results from a systematic review.

The unprecedented rates of global migration present unique challenges to mental health services in migrant receiving countries to provide efficacious and culturally salient treatment for mental health conditions including depression. This review aimed to identify and evaluate the effectiveness of depression interventions specifically directed towards first-generation immigrant populations. We conducted a systematic review of original research published between 2000 and 2013 that investigated depression interventions in first generation immigrants. Fifteen studies were included; the majority focused on Latino immigrants living in the United States (US). Twelve studies investigated the use of psychotherapies; the remainder examined collaborative care models and physical exercise-based interventions. Cognitive Behavioral Therapy and Behavioral Activation tended to improve depressive symptoms, especially when culturally adapted to suit clients while Problem Solving Therapy improved depressive symptomology with and without adaptations. Collaborative care and exercise did not significantly improve depressive symptoms. Depression may be effectively treated by means of psychotherapies, especially when treatments are culturally adapted. However the reviewed studies were limited due to methodological weaknesses and were predominantly undertaken in the US with Latino patients. To improve generalizability, future research should be undertaken in non-US settings, amongst diverse ethnic groups and utilize larger sample sizes in either randomized clinical trials or observational cohort studies.",24930429,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.762407302856445,-6.3371663093566895,CMnF
"Perceptions of and Opinions on a Computerized Behavioral Activation Program for the Treatment of Depression in Young People: Thematic Analysis.

Depression is one of the leading causes of illness and disability in young people, with approximately 20% having experienced a depressive episode by the age of 18 years. Behavioral activation (BA), a National Institute for Health and Care Excellence-recommended treatment for adults with depression, has shown preliminary support for its use with young people. BA may have the potential to be adapted and delivered in a computerized format to address the barriers often associated with young people accessing support. Despite the benefits of adopting computerized therapy delivery, the limited effectiveness of some programs has been attributed to a failure to tailor interventions to patients and practices. Therefore, while developing new treatments, it is important that target users be involved in the intervention design. This qualitative study aims to explore the views and preferences of young people and health care professionals regarding the development of a new computerized BA therapy for young people with low mood or depression, to ensure that the therapy was suitable for the target user. Semistructured focus groups and individual interviews were conducted with young people (those with experience in accessing support and those without) and health care professionals regarding the development of a new computerized BA therapy for young people with low mood or depression. The data were analyzed using thematic analysis. A total of 27 individuals, comprising both health care professionals and young people, participated in this study. Vital information pertaining to the important components of a new therapy, including its presentation, delivery, and content, was collected. Variations in perspectives highlighted the need to adopt a systemic approach in therapy development by considering the opinions of young people with and without experience in accessing mental health support and health care professionals.",33847594,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.567611694335938,-2.064854860305786,AX6E
"Theory-specific patient change processes and mechanisms in different cognitive therapies for depression.

This study aimed to identify differential patient change processes and mechanisms associated with long-term outcome in exposure-based cognitive therapy (EBCT) and cognitive-behavioral therapy (CBT) for depression. We drew on a randomized controlled trial in which 149 patients were randomly assigned to either EBCT or CBT, with the treatments showing comparable efficacy at 12-month follow-up (grosse Holtforth et al., 2019). Based on Doss's (2004) 4-step model of psychotherapy change and using sequential multilevel structural equation models, we tested putative theory-based change processes and mechanisms for both treatments. Specifically, we examined emotional processing and cognitive restructuring during treatment as hypothesized change processes of EBCT and CBT, respectively. Furthermore, as potential change mechanisms during follow-up, we examined theory-relevant mechanisms for each treatment, preselected via multilevel models. Although the full serial mediational pathways were not supported, EBCT fostered greater during-treatment increases in emotional processing and higher self-efficacy during follow-up than CBT, both of which associated with better long-term depression outcome. Unexpectedly, cognitive restructuring change did not differ between EBCT and CBT. Across both CBT and EBCT, greater during-treatment increases in cognitive restructuring related to lower cognitive-behavioral avoidance and greater self-efficacy across follow-up, which associated with lower long-term depression. Results suggest that therapists might improve long-term depression outcome by fostering both emotional processing (via emotion-focused techniques as included in EBCT) and cognitive restructuring (by using general CBT techniques included in both treatments), which operate either directly or through varied treatment-common mechanisms (e.g., greater self-efficacy and reduced cognitive-behavioral avoidance). (PsycInfo Database Record (c) 2020 APA, all rights reserved).",32338931,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.742729187011719,-2.387723207473755,Ap/U
"Effectiveness of Smartphone-Based Cognitive Behavioral Therapy Among Patients With Major Depression: Systematic Review of Health Implications.

Depression is often associated with rapid changes in mood and quality of life that persist for a period of 2 weeks. Despite medical innovations, there are problems in the provision of care. Long waiting times for treatment and high recurrence rates of depression cause enormous costs for health care systems. At the same time, comprehensive limitations in physical, psychological, and social dimensions are observed for patients with depression, which significantly reduce their quality of life. In addition to patient-specific limitations, undersupply and inappropriate health care have been determined. For this reason, new forms of care are discussed. Smartphone-based therapy is considered to have great potential due to its reach and easy accessibility. Low socioeconomic groups, which are always difficult to reach for public health interventions, can now be accessed due to the high dispersion of smartphones. There is still little information about the impact and mechanisms of smartphone-based therapy on depression. In a systematic literature review, the health implications of smartphone-based therapy were presented in comparison with standard care. The objective of this review was to identify and summarize the existing evidence regarding smartphone-based cognitive behavioral therapy for patients with depression and to present the health implications of smartphone-based cognitive behavioral therapy of considered endpoints. A systematic literature review was conducted to identify relevant studies by means of inclusion and exclusion criteria. For this purpose, the PubMed and Psyndex databases were systematically searched using a search syntax. The endpoints of depressive symptoms, depression-related anxiety, self-efficacy or self-esteem, and quality of life were analyzed. Identified studies were evaluated for study quality and risk of bias. After applying the inclusion and exclusion criteria, 8 studies were identified. The studies examined in this review reported contradictory results regarding the investigated endpoints. In addition, due to clinical and methodological heterogeneity, it was difficult to derive evident results. All included studies reported effects on depressive symptoms. The other investigated endpoints were only reported by isolated studies. Only 50% (4/8) of the studies reported effects on depression-related anxiety, self-efficacy or self-esteem, and quality of life. No clear implications of smartphone-based cognitive behavioral therapy could be established. Evidence for the treatment of depression using smartphone-based cognitive behavioral therapy is limited. Additional research projects are needed to demonstrate the effects of smartphone-based cognitive behavioral therapy in the context of evidence-based medicine and to enable its translation into standard care. Participatory technology development might help to address current problems in mobile health intervention studies.",33565989,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.657093524932861,-5.591211795806885,AbFM
"Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: phase II trial.

Although cognitive-behavioural therapy (CBT) is an effective treatment for depression, less than half of patients achieve satisfactory symptom reduction during treatment. Targeting known psychopathological processes such as rumination may increase treatment efficacy. The aim of this study was to test whether adding group rumination-focused CBT (RFCBT) that explicitly targets rumination to routine medical management is superior to adding group CBT to routine medical management in treating major depression. A total of 131 outpatients with major depression were randomly allocated to 12 sessions group RFCBT v. group CBT, each in addition to routine medical management. The primary outcome was observer-rated symptoms of depression at the end of treatment measured on the Hamilton Rating Scale for Depression. Secondary outcomes were rumination at post-treatment and depressive symptoms at 6 months follow-up (Trial registered: NCT02278224). RFCBT significantly improved observer-rated depressive symptoms (Cohen's d 0.38; 95% CI 0.03-0.73) relative to group CBT at post-treatment on the primary outcome. No post-treatment differences were found in rumination or in depressive symptoms at 6 months follow-up, although these secondary analyses may have been underpowered. This is the first randomized controlled trial providing evidence of benefits of RFCBT in major depression compared with CBT. Group RFCBT may be a beneficial alternative to group CBT for major depression.",30630555,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.236287117004395,-1.3881380558013916,BApW
"Mechanistic pathways of change in twice weekly versus once weekly sessions of psychotherapy for depression.

Recently, we showed that twice weekly sessions of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression lead to better and faster treatment outcomes compared to once weekly sessions (Bruijniks et al., 2020). The present study investigated which pathways of change may account for the effects of different session frequencies. The sample consisted of 200 patients who were randomized to CBT weekly, CBT twice weekly, IPT weekly, or IPT twice weekly. Outcome and therapy processes were measured at baseline, two weeks and monthly up to month 6 after the start of treatment. Latent change score models investigated temporal relations between change in therapy processes and change in depression and tested whether change in the therapy processes mediated the effect of session frequency on change in depression. IPT skills mediated the relation between session frequency and change in depression. A decrease in depression was related to subsequent improvement in CBT skills and subsequent decrease in motivation for therapy. The development of IPT skills may explain why a twice weekly higher session frequency is more effective in reducing depression compared to a once-weekly session frequency. Future studies should disentangle the causal effects of therapy process change throughout the course of therapy.",35176678,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.902750015258789,-3.698728322982788,mwE
"Effect of Cognitive Behavioral Therapy Versus Interpersonal Psychotherapy in Patients with Major Depressive Disorder: A Meta-analysis of Randomized Controlled Trials.

Practice guidelines have recommended cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) as the treatment of choice for major depression disorder (MDD). However, whether one therapy is better than the other remains inconclusive. The aim of this study was to compare the treatment efficacy of the two treatment approaches for MDD. Using the terms ""cognitive behavior therapy or cognitive therapy or CBT or CT or cognitive behavioral therapy"" and ""interpersonal psychotherapy or IPT,"" we systematically searched PubMed, Psyclnfo and Chinese National Knowledge Infrastructure databases up to February 2017. The language was restricted to be English and Chinese. Therapeutic outcomes, characteristics, and research quality were then extracted and analyzed independently. In accessing the included studies, we followed the criteria suggested by the Cochrane Handbook for Systematic Reviews of Interventions. Data for 946 patients from 10 randomized controlled trials were included in the study. Methodological quality was not optimal in most trials. Meta-analysis showed a mean difference (MD) of -1.31, 95% confidence interval (CI) (-2.49, -0.12) (P < 0.05) in favor of CBT according to the Beck Depression Inventory (BDI), and however, we did not found any statistically significant difference between CBT and IPT on the Hamilton Rating Scale for depression (HRSD) (MD -0.90, 95% CI [-2.18, 0.38]). Subgroup analyses for the studies in which patients were treated only by psychotherapy (MD -1.26, 95% CI [-2.78, 0.35]) and for those which offered more sessions of therapies (MD -0.82, 95% CI [-2.23, 0.59]) showed there was no significant difference between CBT and IPT according to BDI. Differences in treatment efficacy seem to vary according to different outcome measures. CBT shows an advantage over IPT for MDD according to BDI, and there is no significant difference between the two according to HRSD. These results should be interpreted with caution.",29176143,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.348847389221191,-2.88346266746521,BTmL
"[Psychotherapy of chronic depression: contributions of CBASP by McCullough].

Chronic depression is a frequent disorder and is usually treated using traditional approaches. These approaches rarely take into account the psychopathological specificities of the chronic evolution of the disorder. The present article aims at presenting the specific psychopathological nature of chronic depression and puts forward a treatment model that is particularly adapted to these specificities. The treatment model, Cognitive Behavioral Analysis System of Psychotherapy (CBASP; according to McCullough) is based on two theoretical models: the developmental theory by J. Piaget and the interpersonal model by D. Kiesler. According to McCullough, the cognitive affective functioning of chronically depressed patients is comparable with the one of a child who has not reached the Piagetian stage of logical operations. Their thinking is global, pre-logical and presents with monologues, instead of internal dialogues. These patients are incapable of effective controlling and regulating of emotions and of constructive accommodation of established schemas, when confronted with novel experiences. Finally, these patients are unaware of their interpersonal effects on the environment they unwillingly have. The latter are conceptualized using Kiesler's conceptualization of psychopathology. According to this model, the patient sends implicit relational ""messages"" provoking interpersonal ""pulls"" in the interaction partner (e.g., the therapist). These pulls are assessed and may be graphically represented using a Circumplex Model, also called the Kiesler-circle, and is the basis of the case conceptualization in the psychotherapy with chronically depressed patients. CBASP has developed based on the clinical implications of these models and combines them in an original fashion. Two lines of intervention result from the models: (1) situational analysis, which analyzes the links between behavior in a particular situation and the person's goal or desire related to the particular situation, and (2) interpersonal techniques based on the notions of transference and counter-transference. On one hand, situational analysis follows several steps linking the patient's behavior with his/her desired outcome, which is compared to the real outcome in the situation. The patient's interpretations are amended in a second step, using the desired outcome as an anchor. On the other hand, interpersonal techniques imply the therapist's stance of disciplined personal involvement, meaning a controlled way of therapist self-disclosure facing the patient, with the aim of experiencing by the patient, that his/her behavior does not remain without specific, immediate and authentic consequences in the environment. This experience by the patient should allow him/her to (re-)establish the perceived functionality of the patient's behavior in interpersonal encounters. We underline the relevance of the approach by citing several empirical studies which have established the efficacy of the model, in specific clinical conditions that are the combined treatment with anti-depressant medication, a sufficient number of sessions and in the case of early trauma as etiological factor of the chronic depression. We discuss the application of CBASP to other clinical diagnoses, such as borderline and avoidant personality disorder as well as disorders related to substance abuse and thus argue in favor of CBASP as a central model in the treatment of various mental illnesses.",23107463,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.421677589416504,-1.5563396215438843,CmZD
"Psychotherapy Versus Pharmacotherapy of Depression: What's the Evidence?

Depression may be treated by psychotherapy or pharmacotherapy or their combination. There is an ongoing debate whether one of these approaches is possibly superior. A recent meta-analysis reported results in favour of pharmacotherapy. Individual studies and meta-analyses on the comparative efficacy of psychotherapy vs. pharmacotherapy were reviewed. Evidence suggests that psychotherapy and pharmacotherapy are equally efficacious in the short-term, but psychotherapy is superior in the long-term. For the recently stated hypothesis that pharmacotherapy is superior to psychotherapy in studies without a pill placebo condition, which implies equally including a positive expectancy effect for both pharmacotherapy and psychotherapy no evidence was found. Depression may be treated by psychotherapy or pharmacotherapy with equivalent results in the short-term and advantages for psychotherapy in the long-term. As the rates of response and remission are still limited in both treatments, further improvement of treatments is required.",27439555,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.282947540283203,-2.2696681022644043,Bpsr
"Behavioural therapies versus other psychological therapies for depression.

Behavioural therapies represent one of several categories of psychological therapies that are currently used in the treatment of depression. However, the effectiveness and acceptability of behavioural therapies for depression compared with other psychological therapies remain unclear. 1. To examine the effects of all BT approaches compared with all other psychological therapy approaches for acute depression.2. To examine the effects of different BT approaches (behavioural therapy, behavioural activation, social skills training and relaxation training) compared with all other psychological therapy approaches for acute depression.3. To examine the effects of all BT approaches compared with different psychological therapy approaches (CBT, third wave CBT, psychodynamic, humanistic and integrative psychological therapies) for acute depression. We searched the Cochrane Depression Anxiety and Neurosis Group Trials Specialised Register (CCDANCTR, 31/07/2013), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE, (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. Randomised controlled trials that compared behavioural therapies with other psychological therapies for acute depression in adults. Two or more review authors independently identified studies, assessed trial quality and extracted data. We contacted study authors for additional information. Twenty-five trials involving 955 participants compared behavioural therapies with one or more of five other major categories of psychological therapies (cognitive-behavioural, third wave cognitive-behavioural, psychodynamic, humanistic and integrative therapies). Most studies had a small sample size and were assessed as being at unclear or high risk of bias. Compared with all other psychological therapies together, behavioural therapies showed no significant difference in response rate (18 studies, 690 participants, risk ratio (RR) 0.97, 95% confidence interval (CI) 0.86 to 1.09) or in acceptability (15 studies, 495 participants, RR of total dropout rate 1.02, 95% CI 0.65 to 1.61). Similarly, in comparison with each of the other classes of psychological therapies, low-quality evidence showed better response to cognitive-behavioural therapies than to behavioural therapies (15 studies, 544 participants, RR 0.93, 95% CI 0.83 to 1.05) and low-quality evidence of better response to behavioural therapies over psychodynamic therapies (2 studies, 110 participants, RR 1.24, 95% CI 0.84 to 1.82).When compared with integrative therapies and humanistic therapies, only one study was included in each comparison, and the analysis showed no significant difference between behavioural therapies and integrative or humanistic therapies. We found low- to moderate-quality evidence that behavioural therapies and other psychological therapies are equally effective. The current evidence base that evaluates the relative benefits and harms of behavioural therapies is very weak. This limits our confidence in both the size of the effect and its precision for our key outcomes related to response and withdrawal. Studies recruiting larger samples with improved reporting of design and fidelity to treatment would improve the quality of evidence in this review.",24129886,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.939188957214355,-2.4981868267059326,CXVh
"[CBASP as an Inpatient Concept for Treatment-Resistant Chronic Depression: A Pilot Study of the Relationship between Adverse Effects and Treatment Outcome].

Inpatient psychotherapy might trigger adverse effects among others due to short but intensive treatment. Thus, in this pilot study, certain adverse effects of the multidisciplinary inpatient Cognitive Behavioral Analysis System of Psychotherapy (CBASP) for treatment-resistant chronically depressed patients as well as their relationship to treatment outcome (response-, remission-, and relapse-rates) are examined. 50 patients with treatment-resistant and chronic depression completed the structured 12-weeks inpatient treatment program. Adverse effects were assessed by 1) deterioration of depressive symptoms (measured by the Hamilton Depression Rating Scale, HDRS) at discharge and 2) a self-report questionnaire measuring Adverse Effects of Inpatient Psychotherapy (ADEFIP), which were filled out 6 to 12 months after discharge by the patients. After 12 weeks of treatment, 84% could be classified as responder, of whom 44% fulfilled the remission criterion. 16% were Non-Responder. According to HDRS, none of the patients showed objective deterioration of the depressive symptoms. Six months after discharge, 40% of the responders suffered from relapse. Concerning the ADEFIP, 66% of the patients reported transient deterioration of symptoms. These patients were less likely to achieve remission. Over 50% reported interpersonal conflicts with treatment team members or other patients without any relation to outcome. Finally, more than half of the patients reported significant changes in social relationships after discharge. These patients were less likely to relapse. Overall, 94% of the patients reported at least one of the in this study assessed adverse effects. Despite some limitations, this pilot study suggests that the CBASP inpatient program could indeed cause adverse effects. However, only subjective transient deterioration appeared to have a negative impact on the individual treatment outcome in the short-term. Results encourage further research concerning adverse treatment effects in the context of short- and long-term treatment outcome investigating how relevant adverse effects are.",30286506,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.306632995605469,-1.7871731519699097,BFO8
"Dynamic prediction of psychological treatment outcomes: development and validation of a prediction model using routinely collected symptom data.

Common mental disorders can be effectively treated with psychotherapy, but some patients do not respond well and require timely identification to prevent treatment failure. We aimed to develop and validate a dynamic model to predict psychological treatment outcomes, and to compare the model with currently used methods, including expected treatment response models and machine learning models. In this prediction model development and validation study, we obtained data from two UK studies including patients who had accessed therapy via Improving Access to Psychological Therapies (IAPT) services managed by ten UK National Health Service (NHS) Trusts between March, 2012, and June, 2018, to predict treatment outcomes. In study 1, we used data on patient-reported depression (Patient Health Questionnaire 9 [PHQ-9]) and anxiety (Generalised Anxiety Disorder 7 [GAD-7]) symptom measures obtained on a session-by-session basis (Leeds Community Healthcare NHS Trust dataset; n=2317) to train the Oracle dynamic prediction model using iterative logistic regression analysis. The outcome of interest was reliable and clinically significant improvement in depression (PHQ-9) and anxiety (GAD-7) symptoms. The predictive accuracy of the model was assessed in an external test sample (Cumbria Northumberland Tyne and Wear NHS Foundation Trust dataset; n=2036) using the area under the curve (AUC), positive predictive values (PPVs), and negative predictive values (NPVs). In study 2, we retrained the Oracle algorithm using a multiservice sample (South West Yorkshire Partnership NHS Foundation Trust, North East London NHS Foundation Trust, Cheshire and Wirral Partnership NHS Foundation Trust, and Cambridgeshire and Peterborough NHS Foundation Trust; n=42 992) and compared its performance with an expected treatment response model and five machine learning models (Bayesian updating algorithm, elastic net regularisation, extreme gradient boosting, support vector machine, and neural networks based on a multilayer perceptron algorithm) in an external test sample (Whittington Health NHS Trust; Barnet Enfield and Haringey Mental Health Trust; Pennine Care NHS Foundation Trust; and Humber NHS Foundation Trust; n=30 026). The Oracle algorithm trained using iterative logistic regressions generalised well to external test samples, explaining up to 47·3% of variability in treatment outcomes. Prediction accuracy was modest at session one (AUC 0·59 [95% CI 0·55-0·62], PPV 0·63, NPV 0·61), but improved over time, reaching high prediction accuracy (AUC 0·81 [0·77-0·86], PPV 0·79, NPV 0·69) as early as session seven. The performance of the Oracle model was similar to complex (eg, including patient profiling variables) and computationally intensive machine learning models (eg, neural networks based on a multilayer perceptron algorithm, extreme gradient boosting). Furthermore, the predictive accuracy of a more simple dynamic algorithm including only baseline and index-session scores was comparable to more complex algorithms that included additional predictors modelling sample-level and individual-level variability. Overall, the Oracle algorithm significantly outperformed the expected treatment response model (mean AUC 0·80 vs 0·70, p<0·0001]). Dynamic prediction models using sparse and readily available symptom measures are capable of predicting psychotherapy outcomes with high accuracy. University of Sheffield.",33766287,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,11.371594429016113,-1.637191891670227,AY0s
"Task shifting interpersonal counseling for depression: a pragmatic randomized controlled trial in primary care.

Task shifting approaches (rational redistribution of tasks among health workforce teams) to train lay professionals to assist with integrating mental health treatment in primary care has been recommended to close the mental health treatment gap for depression in low- and middle-income countries. This study aims to examine the a new model for depression care in a low-resource environment compared to enhanced treatment at usual (E-TAU). We trained non-specialist community health workers (local lay employees of the public health system) to provide Interpersonal Counseling (IPC) to treat depressive symptoms in the Brazilian, São Paulo city, family health strategy (FHS). We conducted a randomized controlled trial involving 86 patients with a current major depressive disorder or dysthymia (based on DSM-IV) recruited from an FHS clinic. Participants were randomized to IPC intervention (n = 43) or E-TAU (n = 43). Participants allocated to IPC received 3-4 sessions provided by community health workers; research psychologists followed the E-TAU participants to facilitate their referral to specialized mental health care within the public system. Reduction of depressive symptoms was assessed using the Hamilton Rating Scale (HDRS-17) and the Patient Health Questionnaire (PHQ-9); minor psychiatric symptomatology (including depression, anxiety and somatoform symptoms) were measured using the Self Reporting Questionnaire (SRQ); and functioning was measured by the Clinical Global Impression Scale over a 2-month period. Intention-to-treat analysis showed significant improvement on symptoms for both groups over 2 months, without significant differences between them. Per-protocol analysis showed significant better HDRS-17 outcomes for the IPC group. Training non-specialist community health workers in low- and middle-income countries to provide IPC could be a successful strategy in reducing the burden of depression and also potentially a low-cost and effective alternative to specialist-led services that might not be possible in low income settings. Brazilian Clinical Trials, number RBR-5qhmb5 (trial url: http://www.ensaiosclinicos.gov.br/rg/RBR-5qhmb5/) , retrospectively registered after May 1, 2013.",28637449,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,9.188321113586426,-6.7503767013549805,Baz4
"Individual patient data meta-analysis of combined treatments versus psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for adult depression: a protocol.

There are many proven treatments (psychotherapy, pharmacotherapy or their combination) for the treatment of depression. Although there is growing evidence for the effectiveness of combination treatment (psychotherapy + pharmacotherapy) over pharmacotherapy alone, psychotherapy alone or psychotherapy plus pill placebo, for depression, little is known about which specific groups of patients may respond best to combined treatment versus monotherapy. Conventional meta-analyses techniques have limitations when tasked with examining whether specific individual characteristics moderate the effect of treatment on depression. Therefore, this protocol outlines an individual patient data (IPD) meta-analysis to explore which patients, with which clinical characteristics, have better outcomes in combined treatment compared with psychotherapy (alone or with pill placebo), pharmacotherapy and pill placebo. Study searches are completed using an established database of randomised controlled trials (RCTs) on the psychological treatment of adult depression that has previously been reported. Searches were conducted in PubMed, PsycInfo, Embase and the Cochrane Central Register of Controlled Trials. RCTs comparing combination treatment (psychotherapy + pharmacotherapy) with psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for the treatment of adult depression will be included. Study authors of eligible trials will be contacted and asked to contribute IPD. Conventional meta-analysis techniques will be used to examine differences between studies that have contributed data and those that did not. Then, IPD will be harmonised and analysis using multilevel regression will be conducted to examine effect moderators of treatment outcomes. Study results outlined above will be published in peer-reviewed journals. Study results will contribute to better understanding whether certain patients respond best to combined treatment or other depression treatments and provide new information on moderators of treatment outcome that can be used by patients, clinicians and researchers. CRD42016039028.",28193851,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.341909408569336,-0.8902202844619751,Bg16
"Adherence, flexibility, and outcome in psychodynamic treatment of depression.

This study examined the relationship between adherence flexibility early in treatment and outcome within psychodynamic psychotherapy of depression. For this purpose, we used multilevel modeling (MLM) to examine the relationship between adherence to global psychodynamic-interpersonal (PI) technique early in treatment with outcome, the impact of flexibly incorporating some limited cognitive-behavioral (CB) interventions, as well the role of therapist effects. Our sample included 46 outpatients who were consecutively enrolled in individual psychodynamic psychotherapy, received a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association [APA], 1994) Axis I diagnosis of a depressive spectrum disorder, and were assessed pre- and posttreatment through self-report of depressive symptoms. Psychotherapy sessions were videotaped and 3rd and 9th sessions were independently rated on the Comparative Psychotherapy Process Scale (CPPS) for use of PI and CB techniques, with excellent interrater reliability (intraclass correlation coefficient [ICC] > .75). Mean technique ratings across the two early treatment sessions (3rd and 9th) were calculated. Our findings suggest that flexibly incorporating a limited amount of CB strategies early in psychodynamic therapy for depression can add some benefit to the unique positive relationship between PI adherence and outcome. Implications for clinical work and future research directions are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",30035588,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,11.480246543884277,-3.7848243713378906,BImH
"A Comparative Effectiveness Trial of Depression Collaborative Care: Subanalysis of Comorbid Anxiety.

The purpose of this exploratory subanalysis was to compare the effects of two depression quality improvement approaches on clinical outcomes and service utilization for individuals with comorbid depression/anxiety. This study used data from Community Partners in Care (CPIC), a cluster-randomized comparative effectiveness trial (N = 1,018; depression = 360; comorbid depression/anxiety = 658). Each intervention arm received the same quality improvement materials, plus either technical support (Resources for Services, RS) or support for collaborative implementation planning (Community Engagement and Planning, CEP). For the comorbid depression/anxiety subgroup, the collaborative planning arm was superior at improving mental health-related quality of life and mental wellness, as well as decreasing behavioral hospitalizations and homelessness risk at 6 months. The effects were not significant at 12 months. A collaborative planning process versus technical support for depression quality improvement can have short-term effects on mental wellness and social determinants of health among those with comorbid depression/anxiety.",30226112,Major Depressive Disorder,Anxiety Treatment,Mental Health,3572,8.268719673156738,-5.876424789428711,BGCb
"Effective maNagement of depression among patients witH cANCEr (ENHANCE): a protocol for a hybrid systematic review and network meta-analysis of randomised controlled trials of interventions for depressive symptoms.

Depression is common among patients with cancer and is associated with lower treatment participation, lower satisfaction with care, poorer quality of life, greater symptom burden and higher healthcare costs. Various types of interventions (e.g. pharmacological, psychotherapy) are used for the treatment of depression. However, evidence for these among patients with cancer is limited. Furthermore, the relative effectiveness and acceptability of different approaches are unknown because a direct comparison between all available treatments has not been carried out. We will address this by conducting a network meta-analysis (NMA) of interventions for depression among people with cancer using a hybrid overview of reviews and systematic review methodology. We will search for and extract data from systematic reviews of randomised controlled trials (RCTs) of depression interventions for patients with cancer from inception, before performing a supplemental search for more recent RCTs. We will include RCTs comparing pharmacological, psychotherapy, exercise, combination therapy, collaborative care or complementary and alternative medicine interventions with pill placebo, no treatment, waitlist, treatment as usual or minimal treatment control groups, or directly in head-to-head trials, among adults who currently have cancer or have a history of any cancer and elevated depressive symptoms (scores above a cut-off on validated scales or meeting diagnostic criteria). Our primary outcomes will be change in depressive symptoms (standardised mean difference) and intervention acceptability (% who withdrew). Our secondary outcomes will be 6-month change in depressive symptoms, health-related quality of life, adverse events and mortality. We will independently screen for eligibility, extract data and assess risk of bias using the RoB 2 tool. We will use frequentist random-effects multivariate NMA in Stata, rankograms and surface under the cumulative ranking curves to synthesise evidence and obtain a ranking of intervention groups. We will explore heterogeneity and inconsistency using local and global measures and evaluate the credibility of results using the Confidence in NEtwork Meta-Analysis (CINeMA) framework. Our findings will provide the best available evidence for managing depression among patients with cancer. Such information will help to inform clinical guidelines, evidence-based treatment decisions and future research by identifying gaps in the current literature. Submitted to PROSPERO (record number: 290145), awaiting registration.",36371235,Major Depressive Disorder,Anxiety Treatment,Mental Health,14383,6.510644435882568,-2.758444309234619,Bao
"Internet-delivered interpersonal psychotherapy versus internet-delivered cognitive behavioral therapy for adults with depressive symptoms: randomized controlled noninferiority trial.

Face-to-face cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are both effective treatments for depressive disorders, but access is limited. Online CBT interventions have demonstrated efficacy in decreasing depressive symptoms and can facilitate the dissemination of therapies among the public. However, the efficacy of Internet-delivered IPT is as yet unknown. This study examines whether IPT is effective, noninferior to, and as feasible as CBT when delivered online to spontaneous visitors of an online therapy website. An automated, 3-arm, fully self-guided, online noninferiority trial compared 2 new treatments (IPT: n=620; CBT: n=610) to an active control treatment (MoodGYM: n=613) over a 4-week period in the general population. Outcomes were assessed using online self-report questionnaires, the Center for Epidemiological Studies Depression scale (CES-D) and the Client Satisfaction Questionnaire (CSQ-8) completed immediately following treatment (posttest) and at 6-month follow-up. Completers analyses showed a significant reduction in depressive symptoms at posttest and follow-up for both CBT and IPT, and were noninferior to MoodGYM. Within-group effect sizes were medium to large for all groups. There were no differences in clinical significant change between the programs. Reliable change was shown at posttest and follow-up for all programs, with consistently higher rates for CBT. Participants allocated to IPT showed significantly lower treatment satisfaction compared to CBT and MoodGYM. There was a dropout rate of 1294/1843 (70%) at posttest, highest for MoodGYM. Intention-to-treat analyses confirmed these findings. Despite a high dropout rate and lower satisfaction scores, this study suggests that Internet-delivered self-guided IPT is effective in reducing depressive symptoms, and may be noninferior to MoodGYM. The completion rates of IPT and CBT were higher than MoodGYM, indicating some progress in refining Internet-based self-help. Internet-delivered treatment options available for people suffering from depression now include IPT. International Standard Randomized Controlled Trial Number (ISRCTN): 69603913; http://www.controlled-trials.com/ISRCTN69603913 (Archived by WebCite at http://www.webcitation.org/6FjMhmE1o).",23669884,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.83801555633545,-3.140263319015503,CeFl
"Narrative therapy vs. cognitive-behavioral therapy for moderate depression: empirical evidence from a controlled clinical trial.

Systematic studies of the efficacy of Narrative Therapy (NT) for depression are sparse. To evaluate the efficacy of individual NT for moderate depression in adults compared to Cognitive-Behavioral Therapy (CBT). Sixty-three depressed clients were assigned to either NT or CBT. The Beck Depression Inventory-II (BDI-II) and Outcome Questionnaire-45.2 (OQ-45.2) were used as outcome measures. We found a significant symptomatic reduction in both treatments. Group differences favoring CBT were found on the BDI-II, but not on the OQ-45.2. Pre- to post-treatment effect sizes for completers in both groups were superior to benchmarked waiting-list control groups.",24479576,Major Depressive Disorder,Anxiety Treatment,Mental Health,24336,11.17731761932373,-2.8434484004974365,CS0U
"Enduring effects of Preventive Cognitive Therapy in adults remitted from recurrent depression: A 10 year follow-up of a randomized controlled trial.

Prevention of recurrence is a challenge in the management of major depressive disorder (MDD). The long-term effects of Preventive Cognitive Therapy (PCT) in preventing recurrence in MDD are not known. A RCT comparing the addition of PCT to Treatment As Usual (TAU), versus TAU including patients with recurrent depression who were in remission at entry (N=172). PCT consisted of eight weekly group sessions. TAU involved standard treatment. Primary outcome is time to first recurrence of a depressive episode as assessed by blinded interviewers over 10 years based on DSM-IV-TR criteria. Also over 10 years, the protective effect of PCT was dependent on the number of previous episodes a patient experienced. The protective effect intensified with the number of previous depressive episodes (Cox regression; p=.004, Hazard ratio=.576, 95% CI=.396-.837) and is mainly established within the first half of the 10 year follow-up period. For patients with more than three previous episodes (52% of the sample), PCT significantly increased the median survival time (713.0 days) versus patients that received TAU (205.0 days). No enduring effects were found on secondary outcomes. Dropout rates were relatively high for secondary outcomes, but relatively low for the primary outcome. Results were comparable after multiple imputation. PCT in remitted patients with multiple prior episodes has long-term preventive effects on time to recurrence. To reduce recurrence rates, booster sessions might be necessary. A personalized medicine approach might be necessary to reduce recurrence rates even further.",26188380,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.37532901763916,-1.0301309823989868,B6s0
"Social cognition and interaction training for major depression: A preliminary study.

The present work investigated the efficacy of social cognition and interaction training (SCIT) for patients with major depression. Thirty first-episode patients with major depression who received the SCIT plus the treatment-as-usual (i.e., SCIT + TAU group) were compared with twenty-nine patients who only received treatment-as-usual (i.e., TAU group). Patients received SCIT showed a significantly greater improvement on emotion perception, theory of mind, and attributional styles from baseline to follow-up assessments, with a significant reduction of severity of depressive symptoms, compared to those in TAU group. The preliminary findings indicate that SCIT is a feasible and promising method to improve social cognition for patients with major depression.",30551340,Major Depressive Disorder,Anxiety Treatment,Mental Health,3821,14.184274673461914,-1.0470261573791504,BByS
"A community-based group-guided self-help intervention for low mood and stress: study protocol for a randomized controlled trial.

Depression is a mental health condition which affects millions of people each year, with worldwide rates increasing. Cognitive behavioral therapy (CBT) is recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of depression. However, waiting lists can cause delays for face-to-face therapy. Also a proportion of people decline to present for help through the health service - the so-called treatment gap. Self-referral to CBT using community-based group interventions delivered by a voluntary sector organization may serve to resolve this problem. The aim of this randomized controlled trial (RCT) is to determine the efficacy of such a guided CBT self-help course, the 'Living Life to the Full' (LLTTF) classes delivered by the charity Action on Depression (AOD). The primary outcome is level of depression at 6 months assessed using the patient health questionnaire-9 (PHQ9) depression scale. Secondary measures include levels of anxiety and social functioning. Participants with symptoms of low mood will be recruited from the community through newspaper adverts and also via the AOD website. Participants will receive either immediate or delayed access to guided CBT self-help classes - the eight session LLTTF course. The primary endpoint will be at 6 months at which point the delayed group will be offered the intervention. Levels of depression, anxiety and social functioning will be assessed and an economic analysis will be carried out. This RCT will test whether the LLTTF intervention is effective and/or cost-effective. If the LLTTF community-based classes are found to be cost effective, they may be helpful as both an intervention for those already seeking care in the health service, as well as those seeking help outside that setting, widening access to psychological therapy. Current Controlled Trials ISRCTN86292664.",24252475,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.954787254333496,-3.11989164352417,CV1x
"Development of a patient-report measure of psychotherapy for depression.

Despite clear indications of need to improve depression treatment, practical tools that efficiently measure psychotherapy are not available. We developed a patient-report measure of psychotherapy for depression that assesses Cognitive Behavioral (CBT), Interpersonal (IPT), and Psychodynamic therapies. 420 patients with depression from a large managed behavioral health care organization completed the measure. The three subscales measuring CBT, IPT, and Psychodynamic Therapy showed good internal consistency, appropriate item-total correlations, and were supported by a 3-factor structure. Our results suggest that a patient questionnaire is a promising approach for assessing psychotherapy in quality improvement interventions.",19757020,Major Depressive Disorder,Anxiety Treatment,Mental Health,4830,11.71043872833252,-3.3992180824279785,DQvf
"The use and helpfulness of self-management strategies for depression: The experiences of patients.

To explore which of 50 self-management strategies are actually used and which are perceived as most helpful by patients in their day-to-day management of depression, in order to empower patients and promote active engagement in their own care. Retrospective study using an online self-report survey to assess the use and perceived helpfulness of 50 previously identified self-management strategies in 193 participants who recently recovered from a major depressive episode. Forty-five of the 50 strategies were used by at least half of all participants and about one third of all participants perceived almost 50% of all strategies as (very) helpful. The most used strategies, such as 'finding strategies to create pleasurable distractions', 'engaging in leisure activities' or 'identifying the cause of the depression', were not always perceived as most helpful. In addition, the perceived most helpful strategies, such as 'completing treatment' and 'leaving the house regularly' were not always the most used ones. Patients use and perceive a wide range of self-management strategies as helpful to recover from their depression. Patients use and perceive strategies about engagement in treatment and physical activities as being most helpful. These finding may contribute to the further development and implementation of self-management programs for the prevention or the rehabilitation of depression.",30359444,Major Depressive Disorder,Anxiety Treatment,Mental Health,9215,10.359878540039062,-3.024596691131592,BEP5
"Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial.

Individuals with a history of recurrent depression have a high risk of repeated depressive relapse or recurrence. Maintenance antidepressants for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to medication. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce risk of relapse or recurrence compared with usual care, but has not yet been compared with maintenance antidepressant treatment in a definitive trial. We aimed to see whether MBCT with support to taper or discontinue antidepressant treatment (MBCT-TS) was superior to maintenance antidepressants for prevention of depressive relapse or recurrence over 24 months. In this single-blind, parallel, group randomised controlled trial (PREVENT), we recruited adult patients with three or more previous major depressive episodes and on a therapeutic dose of maintenance antidepressants, from primary care general practices in urban and rural settings in the UK. Participants were randomly assigned to either MBCT-TS or maintenance antidepressants (in a 1:1 ratio) with a computer-generated random number sequence with stratification by centre and symptomatic status. Participants were aware of treatment allocation and research assessors were masked to treatment allocation. The primary outcome was time to relapse or recurrence of depression, with patients followed up at five separate intervals during the 24-month study period. The primary analysis was based on the principle of intention to treat. The trial is registered with Current Controlled Trials, ISRCTN26666654. Between March 23, 2010, and Oct 21, 2011, we assessed 2188 participants for eligibility and recruited 424 patients from 95 general practices. 212 patients were randomly assigned to MBCT-TS and 212 to maintenance antidepressants. The time to relapse or recurrence of depression did not differ between MBCT-TS and maintenance antidepressants over 24 months (hazard ratio 0·89, 95% CI 0·67-1·18; p=0·43), nor did the number of serious adverse events. Five adverse events were reported, including two deaths, in each of the MBCT-TS and maintenance antidepressants groups. No adverse events were attributable to the interventions or the trial. We found no evidence that MBCT-TS is superior to maintenance antidepressant treatment for the prevention of depressive relapse in individuals at risk for depressive relapse or recurrence. Both treatments were associated with enduring positive outcomes in terms of relapse or recurrence, residual depressive symptoms, and quality of life. National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, and NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.",25907157,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.878238677978516,-0.7749736309051514,B+oI
"Using shame resilience to decrease depressive symptoms in an adult intensive outpatient population.

The author explores the results of a 12-session therapy to address shame resilience as a mediator of empathy in the treatment of depression. Two instruments (the Beck Depression Inventory-II and the Test of Self-Conscious Awareness 3S) were used as pre-, mid-, and posttest measures given to a group (n=20) in an intensive outpatient program receiving an intervention to increase shame resilience. A statistical decline in depressive symptoms at both mid- and posttest was noted. Adding shame resilience therapy to traditional psychotherapy may be useful to improve patient adherence and alliance but further evidence is needed.",31612527,Major Depressive Disorder,Anxiety Treatment,Mental Health,13372,17.664234161376953,-7.903809547424316,Azbn
"Effectiveness of a minimal psychological intervention to reduce mild to moderate depression and chronic fatigue in a working population: the design of a randomized controlled trial.

In a working population, common mental complaints like depressed mood and chronic fatigue are highly prevalent and often result in further deterioration of mental health and consequently absence from work. In a large occupational health setting, we will evaluate the (cost-) effectiveness of a Minimal Psychological Intervention (MPI), in reducing symptoms of depression and chronic fatigue in a working population. The MPI is also evaluated regarding its appreciation by worker, nurse, and occupational health physician (process evaluation). The tailor-made intervention is administered by nurses, who are trained in the principles of cognitive behavioural therapy and self-management. The presented WoPaCoM study (Work Participation of Workers with Common Mental complaints) is a two-armed randomized controlled trial, comparing MPI with usual care. A total number of 124 workers suffering from (chronic) mental fatigue or mild to moderate depression will be included. A stratified and block randomization will be applied, stratifying by customer organisation, income, and gender, using a block size of four. It will include a baseline measurement and subsequently follow up measurements after 4, 6 and 12 months. The primary outcome measures are symptoms of either fatigue (using the Checklist Individual Strength) and/or depression (using the Beck Depression Inventory) and secondary outcome measures include sickness absence, self efficacy, costs and quality of life. Analysis will include both univariate and multivariate techniques and data will be analysed according to the intention to treat principle. Patient recruitment in an occupational setting proves to be complicated and time consuming. Shift work for instance proved to be an obstacle for making appointments for consultation with the nurse. Furthermore, economic developments might have created job insecurity which negatively influenced participation in the study, with workers being anxious to be detected as having psychological problems. Additionally, long-term follow-up in a working population is time-consuming and continuously engages occupational health staff and administrative personnel to control the process of data gathering. However, if the intervention proves to be effective, occupational medicine will have a manageable option for treatment of workers who are at risk of loss of productivity or sickness absence. Nederlands Trialregister NTR3162.",23402525,Major Depressive Disorder,Anxiety Treatment,Mental Health,2307,9.325797080993652,-3.8854947090148926,CiBU
"Non-pharmacological treatment of depressive disorders: a review of evidence-based treatment options.

The primary goals of this paper are to describe the collection and evaluation of various nonpharmacological treatment options for depressive disorders and to establish a basis for the development of a standard for the treatment of patients with depressive disorders. To identify evidence-based treatment elements, a comprehensive investigation of national and international guidelines was conducted. The extracted guidelines were then assessed with regard to aspects of methodological quality and evidence-based treatment elements. In a further step, specific and systematic literature searches for residual treatment elements were conducted. For the corresponding literature search, a hierarchical approach was chosen in which current guidelines were reviewed first and systematic reviews and meta-analyses second. Psychopharmacological treatments were excluded from the analysis because this is covered by specific guidelines. The treatment elements with an adequate level of evidence were identified as follows: psychotherapeutic interventions, marital/couples/family therapy and counseling, inclusion of family members, psycho-education, exercise, problem solving therapy, guided self-help and behavioral activation treatments. Further evidence-based methods include diagnostic treatment elements, participative decision-making, development of the therapeutic alliance, Cognitive Behavioral Analysis System for Psychotherapy, computerized cognitive behavior therapy, psychopharmacological therapy, combined psychopharmacological and psychotherapeutic therapy, electroconvulsive therapy, phototherapy, sleep deprivation, repetitive trans-cranial magnetic stimulation (rTMS) and acupuncture. In summary, using a hierarchical approach, it was possible to assign different levels of evidence to the various treatment options for depression.",22353197,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,9.739048957824707,-1.2027174234390259,CxFD
"Prevention of relapse/recurrence in major depressive disorder with either mindfulness-based cognitive therapy or cognitive therapy.

Both Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Therapy (CT) enhance self-management of prodromal symptoms associated with depressive relapse, albeit through divergent therapeutic procedures. We evaluated rates of relapse in remitted depressed patients receiving MBCT and CT. Decentering and dysfunctional attitudes were assessed as treatment-specific process markers. Participants in remission from Major Depressive Disorder (MDD; N = 166) were randomized to 8 weeks of either MBCT (N = 82) or CT (N = 84) and were followed for 24 months, with process markers measured every 3 months. Attendance in both treatments was high (6.3/8 session) and treatment fidelity and competence were evaluated. Relapse was defined as a return of symptoms meeting the criteria for major depression on Module A of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID). Intention-to-treat analyses indicated no differences between MBCT and CT in either rates of relapse to MDD or time to relapse across 24 months of follow up. Both groups experienced significant increases in decentering and participants in CT reported greater reductions in dysfunctional attitudes. Within both treatments, participants who relapsed evidenced lower decentering scores than those who stayed well over the follow up. This is the first study to directly compare relapse prophylaxis following MBCT and CT directly. The lack of group differences in time to relapse supports the view that both interventions are equally effective and that increases in decentering achieved via either treatment are associated with greater protection. These findings lend credence to Teasdale et al.'s (2002) contention that, even though they may be taught through dissimilar methods, CT and MBCT help participants develop similar metacognitive skills for the regulation of distressing thoughts and emotions. (PsycINFO Database Record",29265831,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.004033088684082,-0.833250880241394,BSa8
"[Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-Study].

Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-StudyObjectives: Depression is one of the most common disorders with a rate of recurrence between 60-75 %. The effectiveness of psychodynamic therapy is well-proven, but there is still a lack of studies proving the long-term effectiveness of inpatient treatment on depressive symptom load. Methods: After psychodynamic inpatient treatment in a psychodynamically oriented psychosomatic hospital unit, the reduction in general and depressive symptom load (e. g. BDI, HAMD, SCL-90-R) was evaluated by a six-month follow up design. The study was set up as naturalistic multicenter intervention study including a female follow-up sample (N = 291; age 25-45 years). Results: The symptom improvement reached by the inpatient treatment remained stable at the follow-up survey. Patients treated with antidepressant medication showed stronger depressive symptom load at discharge and follow-up survey compared to patients without antidepressant medication. Sociodemographic variables and a comorbid personality disorder were not associated with increased drop-out rates, but depressive symptom load and a premature ending of the treatment. Conclusions: The obtained results demonstrate the long-term effectiveness of inpatient psychodynamic psychotherapy. Further studies about the influence of post-hospital psychotherapy and medical treatment as well as patient satisfaction seem necessary.",31154929,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,11.013416290283203,-2.881458044052124,A5l2
"Efficacy and acceptability of adjunctive psychological and pharmacological interventions for treatment-resistant depression: protocol for a systematic review and network meta-analysis.

Major depressive disorder (MDD) is a common debilitating illness worldwide. The vast majority of patients with MDD will not achieve remission with first-line treatment and despite the availability of different treatment modalities, at least one-third of patients experience treatment-resistant depression (TRD). There continues to be a paucity of research focused on treatment options for patients with TRD thus treatment decisions are largely based on patient and clinician preference as opposed to evidence-based practice. Herein we propose a systematic review and network meta-analysis (NMA) of available pharmacological and psychological augmentation treatments for TRD, to inform evidence-based management of TRD. We plan to conduct a search of electronic databases (MEDLINE and ISIWEB) of all dates from inception for randomised controlled trials of pharmacological and psychological augmentation interventions for adults with TRD. Articles for review will be included based upon consensus from two authors. Pharmaceutical companies will be contacted for access to any unpublished data. An NMA will compare the effectiveness pharmacological adjunctive agents for TRD using preanalysis/postanalysis, assuming consistency and transitivity. This project does not require research ethics board approval. The dissemination plan is to present findings at international scientific meetings and publishing results in a peer-reviewed academic journal. CRD42019132588.",31092667,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.716209411621094,-0.6727926731109619,A6b7
"Randomized trial of a computer-tailored intervention for patients with depression.

PURPOSE. Examine the efficacy of a computer-tailored intervention (CTI) based on the transtheoretical model (TTM) for reducing depression, an increasingly important component of health promotion programs. DESIGN. Pretest-posttest randomized trial. Setting . Participants were recruited and treated at home after being identified in two primary care clinics in Eastern Massachusetts and Chicago, Illinois. SUBJECTS. A total of 350 adults experiencing at least mild symptoms of depression but not involved in or planning to seek treatment for depression. INTERVENTION. A print manual and three CTI reports tailored to stage of change for using effective methods to prevent or reduce depression, other TTM variables, level of depression, and behavior. . Pre-post changes and reliable and clinically significant change on the Beck Depression scale II and pre-post changes on the 20-item Medical Outcomes Study Short Form survey-based measure of physical functioning at 9 months' follow-up. ANALYSIS. t-tests and χ(2) tests. Complete-case analysis and two intention-to-treat analyses-assumption of no change and multiple imputation (MI)-are reported. Exploratory analyses examined whether the effects of the intervention on depression were moderated by five subject characteristics: baseline level of depression, baseline level of physical functioning, baseline stage of change for preventing or managing depression, age, and education. RESULTS. Complete-case and intention-to-treat analyses showed that the intervention group experienced significantly greater improvements in depression (d = .220-.355); results for physical functioning were weaker (d = .150-.309) and did not reach statistical significance in the MI analysis. The effects of the intervention on reliable and clinically significant change in depression were largest among participants who were experiencing moderate depression (d = .363-.519) or severe depression (d = .603-.718) or who were in the precontemplation or contemplation stage (d = .573-.856) at baseline.",22040388,Major Depressive Disorder,Anxiety Treatment,Mental Health,7525,10.624322891235352,-3.209146499633789,C1mC
"Effects of Group Psychological Counseling on Nonsuicidal Self-Injury (NSSI) Behaviors of College Students with Depression.

The depression of college students requires psychological intervention based on clinical drug treatment. Group psychological counseling is an effective psychological intervention. This study aims to explore the effect of group psychological counseling on negative emotions and Nonsuicidal Self-injury (NSSI) behaviors of college students with depression. A total of 84 students with depression by screening diagnosis at Qingdao University in March 2018 were divided into the control group (n=42) and the intervention group (n=42). Students in the control group only received drug therapy, whereas the intervention group underwent group psychological counseling intervention based on drug therapy. A comparison between depression, self-injury behaviors, and sense of life purpose of the two groups before and after the intervention was performed. The post-test Self-Rating Depression Scale (SDS) standard score of students in both groups was significantly lower than the pre-test SDS standard score (P<0.05). The SDS standard scores of the post-test and the trace test in the intervention group were significantly lower than those in the control group (P<0.05). Compared with the pre-test value, the total scores in the Meaning in Life Questionnaire (MLQ) of the post-test in both groups significantly increased. The intervention group received significantly higher scores in the MLQ of the post-test and trace test compared with the control group (P<0.05). Both groups also received significantly higher scores in the post-test in the Quality System Audit (QSA) compared with the pre-test (P<0.05). The intervention group also received higher scores on the post-test and trace test in some dimensions in the QSA compared with those of the control group (P<0.05). Group psychological counseling intervention for college students with depression can alleviate their depressive symptoms, improve their sense of life meaning, reduce the risk of suicide, and control their NSSI behaviors.",35772132,Major Depressive Disorder,Anxiety Treatment,Mental Health,3932,11.261494636535645,-4.663937568664551,Rsw
"Exploring the Relationship Between Usage and Outcomes of an Internet-Based Intervention for Individuals With Depressive Symptoms: Secondary Analysis of Data From a Randomized Controlled Trial.

Internet interventions can easily generate objective data about program usage. Increasingly, more studies explore the relationship between usage and outcomes, but they often report different metrics of use, and the findings are mixed. Thus, current evaluations fail to demonstrate which metrics should be considered and how these metrics are related to clinically meaningful change. This study aimed to explore the relationship between several usage metrics and outcomes of an internet-based intervention for depression. This is a secondary analysis of data from a randomized controlled trial that examined the efficacy of an internet-based cognitive behavioral therapy for depression (Space from Depression) in an adult community sample. All participants who enrolled in the intervention, regardless of meeting the inclusion criteria, were included in this study. Space from Depression is a 7-module supported intervention, delivered over a period of 8 weeks. Different usage metrics (ie, time spent, modules and activities completed, and percentage of program completion) were automatically collected by the platform, and composite variables from these (eg, activities per session) were computed. A breakdown of the usage metrics was obtained by weeks. For the analysis, the sample was divided into those who obtained a reliable change (RC)-and those who did not. Data from 216 users who completed pre- and posttreatment outcomes were included in the analyses. A total of 89 participants obtained an RC, and 127 participants did not obtain an RC. Those in the RC group significantly spent more time, had more log-ins, used more tools, viewed a higher percentage of the program, and got more reviews from their supporter compared with those who did not obtain an RC. Differences between groups in usage were observed from the first week in advance across the different metrics, although they vanished over time. In the RC group, the usage was higher during the first 4 weeks, and then a significant decrease was observed. Our results showed that specific levels of platform usage, 7 hours total time spent, 15 sessions, 30 tools used, and 50% of program completion, were associated with RC. Overall, the results showed that those individuals who obtained an RC after the intervention had higher levels of exposure to the platform. The usage during the first half of the intervention was higher, and differences between groups were observed from the first week. This study also showed specific usage levels associated with outcomes that could be tested in controlled studies to inform the minimal usage to establish adherence. These results will help to better understand how to use internet-based interventions and what optimal level of engagement can most affect outcomes. ISRCTN Registry ISRCTN03704676; http://www.isrctn.com/ISRCTN03704676. RR2-10.1186/1471-244X-14-147.",31373272,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.156241416931152,-3.6272807121276855,A2nb
"Internet-delivered treatment: its potential as a low-intensity community intervention for adults with symptoms of depression: protocol for a randomized controlled trial.

Depression is a high prevalence disorder, displaying high rates of lifetime incidence, early age onset, high chronicity, and role impairment. In Ireland 12-month prevalence of depression has been reported to be 10.3%. A large percentage of affected individuals have no medical diagnosis nor seek treatment. Cognitive Behavior Therapy (CBT) has established itself as an option for the treatment of depression. Many Irish adults with depression find it difficult to access evidence-based CBT, this is due to several factors, like stigma and costs. However, systematic factors including the shortage of trained professionals and the relative underdevelopment of services also make access difficult.Stepped-care can increase access to evidence-based CBT. One option is tailored internet-delivered treatment programs. Preliminary research from Ireland needs now to include large-scale studies on effectiveness. Thus the current study seeks to examine the potential of an internet-delivered low-intensity treatment for symptoms of depression in an Irish adult community sample. The study is a randomized controlled trial of an online CBT (iCBT) program for the treatment of adults with depressive symptoms. The trial will include an active treatment group and a waiting-list control group. The active condition will consist of 8 weekly modules of iCBT, with post-session feedback support. Participants in the waiting list will receive access to the treatment at week 8. Participants will complete the Beck Depression Inventory (BDI-II) and eligibility criteria will also apply. Primary outcomes are depressive symptoms. Secondary outcomes include quality of life indicators, significant events and satisfaction with online treatment. Data will be collected at baseline and at post-treatment, week 8, and at follow-up week 20 (3-months) and week 32 (6-months). Analysis will be conducted on the intention-to-treat basis. The study seeks to evaluate the effectiveness of an online delivered treatment for depression in a community sample of Irish adults with symptoms of depression. The study will be a first contribution and depending on the sample recruited the results may be generalizable to people with similar difficulties in Ireland and may therefore give insight into the potential of low-intensity interventions for Irish people with depressive symptoms. Current Controlled Trials ISRCTN03704676. DOI: 10.1186/ISRCTN03704676.",24886179,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.459816932678223,-2.910918951034546,CNNH
"[Response and remission in psychotherapy research].

Treatment effects of psychotherapy are usually studied using analysis of mean differences, tests of significance and effect size measures. These strategies, however, do not answer the question of how large the proportion of patients is who responded to treatment or who even reached remission. This article compares 2 competing methods of response and remission analysis: The Reliable Change Index (RCI) according to Jacobson et al. and the method of percent symptom reduction (PSR). We applied both methods using a sample of 338 patients with DSM-IV major depressive disorder. A pre-post treatment effect of Cohen's d=1,16 (intention-to-treat) resulted for the Beck Depression Inventory (BDI), corresponding to response rates of 54-65% and remission rates of 42-48%. We demonstrate that the PSR method had some important advantages over the RCI. It is recommended to classify patients as responders in depression psychotherapy if they improve at least 50%.",20645238,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.05281925201416,-2.090890407562256,DH0l
"Evaluating telehealth lifestyle therapy versus telehealth psychotherapy for reducing depression in adults with COVID-19 related distress: the curbing anxiety and depression using lifestyle medicine (CALM) randomised non-inferiority trial protocol.

There is increasing recognition of the substantial burden of mental health disorders at an individual and population level, including consequent demand on mental health services. Lifestyle-based mental healthcare offers an additional approach to existing services with potential to help alleviate system burden. Despite the latest Royal Australian New Zealand College of Psychiatrists guidelines recommending that lifestyle is a 'first-line', 'non-negotiable' treatment for mood disorders, few such programs exist within clinical practice. Additionally, there are limited data to determine whether lifestyle approaches are equivalent to established treatments. Using an individually randomised group treatment design, we aim to address this gap by evaluating an integrated lifestyle program (CALM) compared to an established therapy (psychotherapy), both delivered via telehealth. It is hypothesised that the CALM program will not be inferior to psychotherapy with respect to depressive symptoms at 8weeks. The study is being conducted in partnership with Barwon Health's Mental Health, Drugs & Alcohol Service (Geelong, Victoria), from which 184 participants from its service and surrounding regions are being recruited. Eligible participants with elevated psychological distress are being randomised to CALM or psychotherapy. Each takes a trans-diagnostic approach, and comprises four weekly (weeks 1-4) and two fortnightly (weeks 6 and 8) 90-min, group-based sessions delivered via Zoom (digital video conferencing platform). CALM focuses on enhancing knowledge, behavioural skills and support for improving dietary and physical activity behaviours, delivered by an Accredited Exercise Physiologist and Accredited Practising Dietitian. Psychotherapy uses cognitive behavioural therapy (CBT) delivered by a Psychologist or Clinical Psychologist, and Provisional Psychologist. Data collection occurs at baseline and 8weeks. The primary outcome is depressive symptoms (assessed via the Patient Health Questionnaire-9) at 8weeks. Societal and healthcare costs will be estimated to determine the cost-effectiveness of the CALM program. A process evaluation will determine its reach, adoption, implementation and maintenance. If the CALM program is non-inferior to psychotherapy, this study will provide the first evidence to support lifestyle-based mental healthcare as an additional care model to support individuals experiencing psychological distress. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12621000387820 , Registered 8 April 2021.",35346115,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,9.996410369873047,-3.6462347507476807,gSM
"In cognitive therapy for depression, early focus on maladaptive beliefs may be especially efficacious for patients with personality disorders.

Patients with major depressive disorder (MDD) and a comorbid personality disorder (PD) have been found to exhibit relatively poor outcomes in cognitive therapy (CT) and other treatments. Adaptations of CT focusing heavily on patients' core beliefs have yielded promising findings in the treatment of PD. However, there have been no investigations that have specifically tested whether increased focus on maladaptive beliefs contributes to CT's efficacy for these patients. CT technique use from an early CT session was assessed for 59 patients (33 without PD, 26 with PD-predominantly Cluster C) who participated in a randomized controlled trial for moderate to severe MDD. Scores were calculated for directive CT techniques (CT-Concrete) and a set of belief-focused items (CT-Belief) as rated by the Collaborative Study Process Rating Scale. Robust regressions were conducted to estimate relations between scores on each of these measures and change in depressive and PD symptoms. A PD status by CT-Belief use interaction tested the hypothesis that therapist use of CT-Belief techniques would exhibit a stronger association with symptom change in the PD group relative to the non-PD group. As hypothesized, a significant interaction between PD status and use of CT-Belief techniques emerged in the prediction of depressive and PD symptom change. Among PD patients, higher early CT-Belief interventions were found to predict significantly greater improvement. CT-Belief use did not predict greater symptom change among those without PD. Early focus on CT-Belief interventions may facilitate changes in depression and PD symptoms for patients with MDD-PD comorbidity.",26727410,Major Depressive Disorder,Anxiety Treatment,Mental Health,1989,12.31802749633789,-2.5448923110961914,BzFF
"Personalized ESM monitoring and feedback to support psychological treatment for depression: a pragmatic randomized controlled trial (Therap-i).

Major depressive disorder (MDD) is a highly prevalent mental disorder with large disease burden, high levels of relapse or persistence, and overall suboptimal outcomes of protocolized pharmacological and psychotherapeutic treatments. There is an urgent need to improve treatment effectiveness, possibly through systematic treatment personalization. In psychotherapeutic treatments this can be achieved by case conceptualization. To support this process, we developed the Therap-i module, which consists of personalized Experienced Sampling Methodology (ESM) and feedback. The Therap-i module is integrated into outpatient psychotherapeutic treatment as usual (TAU) for depression. The study aim is to investigate the efficacy of the Therap-i module in decreasing symptomatology in unresponsive or relapsing patients diagnosed with MDD. We hypothesize that the Therap-i module will contribute to TAU by i) decreasing depressive symptoms, and ii) improving general functioning, therapeutic working alliance, and illness perception. This paper provides details of the study rationale, aims, procedures, and a discussion on potential pitfalls and promises of the module. Patients diagnosed with MDD (n=100) will enrol in a pragmatic two-armed randomized controlled trial. Randomization is stratified according to the patient's treatment resistance level assessed with the Dutch Method for quantification of Treatment Resistance in Depression (DM-TRD). All fill-out the Inventory of Depressive Symptomatology Self Report (IDS-SR), Outcome Questionnaire (OQ-45), Illness Perception Questionnaire Mental Health (IPQ-MH), and Work Alliance Inventory Self Report (WAI-SR). In the intervention arm, through close collaboration between patient, clinician, and researcher, a personalized ESM diary is developed based on the patient's case conceptualization. During the ESM monitoring period (8weeks, 5 assessments/day), patients receive feedback three times, which is discussed among the abovementioned three parties. Both patients and clinicians will evaluate the Therap-i module. Data collection is ongoing. This is the first study in which personalized ESM and feedback is integrated in outpatient psychotherapeutic TAU for depression. The labour intensive procedure and methodological pitfalls are anticipated challenges and were taken into account when designing the study. When hypotheses are confirmed, the Therap-i module may advance treatment for depression by providing insights into personalized patterns driving or perpetuating depressive complaints. Trial NL7190 (NTR7381) , registered prospectively 03-08-2018.",33691647,Major Depressive Disorder,Anxiety Treatment,Mental Health,9713,10.26027774810791,-3.244041681289673,AZll
"An open trial of group metacognitive therapy for depression in Norway.

Preliminary data support the implementation of individual metacognitive therapy (MCT) for depression. Given the focus of MCT on transpersonal processes, we hypothesized that this treatment should translate well to a group format. In this study, the effects and feasibility associated with group MCT for depression are reported. Eleven patients who were consecutively referred by general practitioners to a specialist psychiatric practice in Norway participated in an open trial of the effects and feasibility associated with group MCT for depression. All of the patients met the DSM-IV criteria for major depressive disorder (MDD) and were monitored in a baseline period before attending 90-min weekly treatment sessions of group MCT for 10 weeks. The primary symptom outcome measure was severity of depression whilst secondary outcome measures included levels of anxiety, rumination and metacognitive beliefs. We also assessed recovery rates and changes in comorbid Axis I and Axis II diagnoses. Large clinically significant improvements across all measures were detected at post-treatment and these were maintained at follow-up. Based on objectively defined recovery criteria, all patients were classified as recovered at post-treatment and 91% at 6 months follow-up. The intervention was also associated with significant reductions in comorbid diagnoses. These preliminary data indicate that group MCT in the treatment of depression is effective, well accepted and it extends clinical application of MCT for depression to group formats as a potential cost-effective intervention.",25124119,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.253527641296387,-1.5161699056625366,CJzh
"Efficacy of hypnotherapy compared to cognitive behavioral therapy for mild to moderate depression - Results of a randomized controlled rater-blind clinical trial.

Methodologically well-designed RCTs concerning the efficacy of Hypnotherapy in the treatment of Major Depression are lacking. The aim of this study was to determine whether Hypnotherapy (HT) is not inferior to Cognitive Behavioral Therapy (CBT), the gold-standard psychotherapy, in the percentage reduction of depressive symptoms, assessed in mild to moderate Major Depression (MD). This study reports the main results of a monocentric two-armed randomized-controlled rater-blind clinical trial. A total of 152 patients with MD were randomized to either CBT or HT receiving outpatient individual psychotherapy with 16 to 20 sessions for the duration of six months. The primary outcome was the mean percentage improvement in depressive symptoms assessed with the Montgomery-Asberg Depression Rating Scale (MADRS) before and after treatment. The difference in the mean percentage symptom reduction between HT and CBT was 2.8 (95% CI=-9.85 to 15.44) in the Intention-to-treat sample and 4.0 (95% CI=-9.27 to 17.27) in the Per Protocol sample (N=134). Concerning the pre-specified non-inferiority margin of -16.4, both results confirm the non-inferiority of HT to CBT. The results for the follow-ups six and twelve months after the end of the treatment support the primary results. For ethical reasons the trial did not include a control group without treatment; therefore we can only indirectly conclude that both treatment conditions are effective. This is the first study to demonstrate that HT was not inferior to CBT in MD, while employing rigorous methodological standards.",33725616,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.230992317199707,-1.9505671262741089,AZUb
"Plasticity-augmented psychotherapy for refractory depressive and anxiety disorders.

Psychotherapy and pharmacotherapy have been the mainstays of treatment for depression and anxiety disorders during the last century. However, treatment response has not improved in the last few decades, with only half of all patients responding satisfactorily to typical antidepressants. To fulfill the needs of the remaining patients, new treatments with better efficacy are in demand. The addition of psychotherapy to antidepressant treatment has been shown to be superior to pharmacotherapy alone. However, the time costs of psychotherapy limit its use for clinicians and patients. Advancements in neuroscience have contributed to an improved understanding of the pathogenesis of depressive and anxiety disorders. In particular, recent advances in the field of fear conditioning have provided valuable insight into the treatment of refractory depressive and anxiety disorders. In this review, we studied the reconsolidation-updating paradigm and the concept of epigenetic modification, which has been shown to permanently attenuate remote fear memory. This has implications for drug-augmented, e.g. antidepressant and valproic acid, psychotherapy. Future research on more sophisticated psychotherapy techniques will increase the desirability of this treatment modality for both clinicians and patients.",27072378,Major Depressive Disorder,Anxiety Treatment,Mental Health,4883,11.9835844039917,-0.9963569641113281,BuUN
"Acceptance and commitment therapy for the treatment of depression in persons with physical disability: a randomized controlled trial.

To evaluate the effectiveness of acceptance and commitment therapy (ACT) on depressive symptoms in physically disabled persons. Randomized controlled trial. State welfare organization in Kamyaran, Kurdistan, Iran. Fifty-two physically disabled participants with a primary diagnosis of depression were randomly assigned to either ACT or control groups. Participants in the ACT group (n=23) received eight weekly 90-minute group sessions based on standard ACT protocol for depression. Participants in the control group (n=29) received psychoeducation regarding depression. Measures were recorded at baseline, eight weeks (end of treatment), and 16weeks (follow-up). The outcomes were the change in the depressive symptoms, measured by Beck Depression Inventory-II (BDI-II), psychological flexibility, emotion regulation, and psychological well-being measured by Acceptance and Action Questionnaire-II (AAQ-II), Emotion Regulation Questionnaire (ERQ), and Scales of Psychological Well-Being (SPWB), respectively. After eight weeks, significant changes in depressive symptoms was observed in the experimental group (ACT -10.39±0.79 vs control 0.66±0.68, P<0.001). Compared to the control group, the experimental group also showed significant improvement in psychological flexibility (ACT 8.13±0.52 vs control -0.03±0.51, P<0.001), adaptive emotion regulation strategies (ACT 10.74±0.62 vs control 0.03±1.03, P<0.001), and psychological well-being (ACT 66.95±4.01 vs control -1.90±1.04, P<0.001). Compared with control group, ACT significantly reduced the participants' depression, and changed psychological flexibility, emotion regulation, and psychological well-being in persons with physical disability.",32476482,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,7.902917861938477,-1.65216064453125,AoLj
"Effects of a group-based lifestyle medicine for depression: A pilot randomized controlled trial.

Given the growing evidence that a range of lifestyle factors are involved in the etiology of depression, a 'lifestyle medicine' approach can be potentially safe and cost-effective to prevent or treat depression. To examine the effects and acceptability of a group-based, integrative lifestyle medicine intervention as a standalone treatment for managing depressive symptoms, a pilot randomized controlled trial (RCT) was conducted in a Chinese adult population in 2018. Participants (n = 31) with PHQ-9 score above the cut-off of ≥ 10, which was indicative of moderate to severe depression, were recruited from the general community in Hong Kong and randomly assigned to lifestyle medicine group (LM group) or care-as-usual group (CAU group) in a ratio of 1:1. Participants in the LM group received 2-hour group sessions once per week for six consecutive weeks, which covered diet, exercise, mindfulness, psychoeducation, and sleep management. Linear mixed-effects model analyses showed that the LM group had a significant reduction in PHQ-9 scores compared to the CAU group at immediate posttreatment and 12-week posttreatment follow-up (d = 0.69 and 0.73, respectively). Moreover, there were significantly greater improvements in anxiety, stress, and insomnia symptoms (measured by DASS-21 and ISI) at all time points in the LM group (d = 0.42-1.16). The results suggests that our 6-week group-based, integrative lifestyle intervention program is effective in lowering depressive, anxiety, stress, and insomnia symptoms in the Chinese population. Further studies in clinical populations with a larger sample size and longer follow-up are warranted.",34624047,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,8.837838172912598,-1.4750452041625977,9Yo
"Increasing the acceptance of internet-based mental health interventions in primary care patients with depressive symptoms. A randomized controlled trial.

Internet-based interventions (IBI) are effective in treating depression. However, uptake rates in routine care are still limited. Hence, this study aimed to (1) assess the acceptance of IBIs in primary care patients with depressive symptoms and to (2) examine the effects of a brief acceptance facilitating intervention in the form of an informational video on patients' acceptance of IBIs. Primary care patients (N=128) with Minor or Major Depression were randomly assigned to an intervention (IG) or control group (CG). Patients in the IG were shown a brief informational video about IBIs before receiving a questionnaire that assessed their acceptance of IBIs and other secondary outcomes. Patients of the CG filled out the questionnaire immediately. Baseline acceptance of IBIs in the CG was high for 6.3%, moderate for 53.1% and low for 40.6% of patients. Acceptance of IBIs was significantly higher in the IG when compared to the CG (d=.71, 95%-CI:.09-2.91). Except for social influence and the general attitude towards psychological treatment, all secondary outcomes were also significantly improved (e.g. effort- (d=.40) and performance-expectancy: d=.65; knowledge about Internet interventions d=.35). Depression of the participants was only assessed using a self-report measure (PHQ-9). Primary care patients' acceptance of IBIs for depressive symptoms was low but could be increased significantly using a brief acceptance facilitating intervention on the basis of an informational video. Future studies should further examine the potential of acceptance facilitating interventions for patients and health care providers to exploit the public health impact of IBIs.",25682378,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.045389175415039,-3.358013153076172,CB3Y
"Therapist competence in cognitive therapy for depression: predicting subsequent symptom change.

The efficacy of cognitive therapy (CT) for depression has been well established. Measures of the adequacy of therapists' delivery of treatment are critical to facilitating therapist training and treatment dissemination. While some studies have shown an association between CT competence and outcome, researchers have yet to address whether competence ratings predict subsequent outcomes. In a sample of 60 moderately to severely depressed outpatients from a clinical trial, we examined competence ratings (using the Cognitive Therapy Scale) as a predictor of subsequent symptom change. Competence ratings predicted session-to-session symptom change early in treatment. In analyses focused on prediction of symptom change following 4 early sessions through the end of 16 weeks of treatment, competence was shown to be a significant predictor of evaluator-rated end-of-treatment depressive symptom severity and was predictive of self-reported symptom severity at the level of a nonsignificant trend. To investigate whether competence is more important to clients with specific complicating features, we examined 4 patient characteristics as potential moderators of the competence-outcome relation. Competence was more highly related to subsequent outcome for patients with higher anxiety, an earlier age of onset, and (at a trend level) patients with a chronic form of depression (chronic depression or dysthymia) than for those patients without these characteristics. Competence ratings were not more predictive of subsequent outcomes among patients who met (vs. those who did not meet) criteria for a personality disorder (i.e., among personality disorders represented in the clinical trial). These findings provide support for the potential utility of CT competence ratings in applied settings.",20515218,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.80394172668457,-3.1480462551116943,DJ0j
"Effectiveness of peer-delivered interventions for severe mental illness and depression on clinical and psychosocial outcomes: a systematic review and meta-analysis.

To evaluate the effectiveness of peer-delivered interventions in improving clinical and psychosocial outcomes among individuals with severe mental illness (SMI) or depression. Systematic review and meta-analysis of randomised controlled trials comparing a peer-delivered intervention to treatment as usual or treatment delivered by a health professional. Random effect meta-analyses were performed separately for SMI and depression interventions. Fourteen studies (10 SMI studies, 4 depression studies), all from high-income countries, met the inclusion criteria. For SMI, evidence from three high-quality superiority trials showed small positive effects favouring peer-delivered interventions for quality of life (SMD 0.24, 95 % CI 0.08-0.40, p = 0.003, I (2) = 0 %, n = 639) and hope (SMD 0.24, 95 % CI 0.02-0.46, p = 0.03, I (2) = 65 %, n = 967). Results of two SMI equivalence trials indicated that peers may be equivalent to health professionals in improving clinical symptoms (SMD -0.14, 95 % CI -0.57 to 0.29, p = 0.51, I (2) = 0 %, n = 84) and quality of life (SMD -0.11, 95 % CI -0.42 to 0.20, p = 0.56, I (2) = 0 %, n = 164). No effect of peer-delivered interventions for depression was observed on any outcome. The limited evidence base suggests that peers may have a small additional impact on patient's outcomes, in comparison to standard psychiatric care in high-income settings. Future research should explore the use and applicability of peer-delivered interventions in resource poor settings where standard care is likely to be of lower quality and coverage. The positive findings of equivalence trials demand further research in this area to consolidate the relative value of peer-delivered vs. professional-delivered interventions.",24632847,Major Depressive Disorder,Anxiety Treatment,Mental Health,13374,7.349299907684326,-7.517522811889648,CQwq
"[Implementation of a Web-Based Self-Help Intervention for Mood Enhancement during Waiting Times for Outpatient Psychotherapy - A Qualitative Study Exploring Participants' Perspectives].

In Germany, waiting times for outpatient psychotherapy are on average 5 months long. Guided web-based interventions can be implemented to reduce depressive symptoms during waiting times. The study aims to explore how patients experience the usage of a web-based intervention for mood enhancement. Patients on the waiting lists of cooperating outpatient clinics were invited to participate in the study and apply a web-based intervention for mood enhancement. Eleven participating patients were interviewed about their experiences with the intervention. The data was analyzed based on the Grounded-Theory methodology. Three categories could be derived from the data: prior expectations, experiences with the intervention and factors influencing adherence. The web-based intervention was experienced very differently and was associated with both positive and negative experiences. The participants could be grouped into 3 user types. Not all patients report positive experiences with the intervention and some fail to adhere. In order to prepare patients adequately, they should be informed about the application and goals of the intervention in advance. Interventions should be implemented in accordance with the individual's need of support in order to enhance adherence and allow positive experiences.",33063305,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.12253189086914,-3.192847490310669,Ag7E
"Ten month outcome of cognitive behavioural therapy v. interpersonal psychotherapy in patients with major depression: a randomised trial of acute and maintenance psychotherapy.

Cognitive behaviour therapy (CBT) and interpersonal psychotherapy (IPT) are the most studied psychotherapies for treatment of depression, but they are rarely directly compared particularly over the longer term. This study compares the outcomes of patients treated with CBT and IPT over 10 months and tests whether there are differential or general predictors of outcome. A single centre randomised controlled trial (RCT) of depressed outpatients treated with weekly CBT or IPT sessions for 16 weeks and then 24 weeks of maintenance CBT or IPT. The principle outcome was depression severity measured using the MADRS. Pre-specified predictors of response were in four domains: demographic depression, characteristics, comorbidity and personality. Data were analysed over 16 weeks and 40 weeks using general linear mixed effects regression models. CBT was significantly more effective than IPT in reducing depressive symptoms over the 10 month study largely because it appeared to work more quickly. There were no differential predictors of response to CBT v. IPT at 16 weeks or 40 weeks. Personality variables were most strongly associated with overall outcome at both 16 weeks and 40 weeks. The number of personality disorder symptoms and lower self-directness and reward dependence scores were associated with poorer outcome for both CBT and IPT at 40 weeks. CBT and IPT are effective treatments for major depression over the longer term. CBT may work more quickly. Personality variables are the most relevant predictors of outcome.",28485261,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.182353019714355,-2.6272757053375244,Bc3H
"Recent Developments in the Treatment of Depression.

The cognitive and behavioral interventions can be as efficacious as antidepressant medications and more enduring, but some patients will be more likely to respond to one than the other. Recent work has focused on developing sophisticated selection algorithms using machine-learning approaches that answer the question, ""What works best for whom?"" Moreover, the vast majority of people suffering from depression reside in low- and middle-income countries where access to either psychotherapy or medications is virtually nonexistent. Great strides have been made in training nonspecialist providers (known as task sharing) to overcome this gap. Finally, recent work growing out of evolutionary psychology suggests that antidepressant medications may suppress symptoms at the expense of prolonging the underlying episode so as to increase the risk of relapse whenever someone tries to stop. We address each of these developments and their cumulative implications.",30824244,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.962815284729004,-1.5874547958374023,A+EP
"Mixed Methods Analysis of Implementation of Interpersonal Psychotherapy (IPT) for Major Depressive Disorder in Prisons in a Hybrid Type I Randomized Trial.

This article describes a mixed methods evaluation of implementation of interpersonal psychotherapy (IPT) in the first fully-powered trial of any treatment for major depressive disorder in an incarcerated population. Assessments in this Hybrid Type I trial included surveys of prison providers and administrators (n=71), measures of feasibility and acceptability to prison patients (n=90), and a planned document review (n=460) to assess potential determinants of implementation. Quantitative and qualitative results indicated that IPT was a good fit for prisoners, and that prisoners and providers were enthusiastic about IPT. Providers were open to feedback, open to learning evidence-based practices, and committed to helping their clients. Limited treatment staff and variable supervision and collegial support may pose implementation challenges. For widespread prison implementation, scalable models for ongoing IPT training and supervision are needed.",31797190,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.691937446594238,-3.5452206134796143,Aw1P
"NICE recommendations for psychotherapy in depression: Of limited clinical utility.

In 2009/10 NICE partially updated its guidelines on the treatment and management of depression in adults. Due to methodological shortcomings the recommendations for psychotherapy must be treated with caution. Despite recognising the heterogeneous and comorbid nature of depression, and the limitations of depression as a unitary diagnostic category, NICE treats depression as if it were a unitary entity differentiated only by severity. The guidance ignores important aetiological factors such as trauma, loss and maltreatment, personality and interpersonal difficulties. It excludes the largest naturalistic studies on clinical populations treated in the National Health Service on the grounds that they are observational studies conducted in heterogeneous groups with mixed neurotic disorders. It unquestioningly accepts that the ""brand"" of psychotherapy has construct validity, and ignores psychotherapy process research indicating significant commonalities, and overlap, between treatment modalities and evidence that individual practitioner effects are larger than the differences between treatment modalities. It fails to consider patient differences and preferences, which are known to influence uptake, completion and response. It takes an exclusively short-term perspective on a chronic relapsing disorder. It does not consider the evidence for longer-term treatments. It is of special concern that NICE misrepresents the findings of its own systematic review by implying that CBT and IPT are superior treatments. NICE's systematic review actually found no evidence of superiority between CBT, IPT, psychodynamic psychotherapy, or counselling. Based on the exclusion of much clinically relevant research demonstrating the effectiveness of psychodynamic psychotherapy and counselling many commentators have alleged a bias towards CBT in the guidance. With regard to service delivery NICE proposes the replacement of psychiatric assessment and individualised treatment plans, with an unproven stepped-care model. These clinical and theoretical limitations, perceived bias in the selection of studies, neglect of patient differences, preferences and values, misrepresentation of results of the systematic review, and the proposal for an unproven service delivery model together seriously undermine the validity of the guidance. The guidance, lacking validity is of questionable use, it undermines patient autonomy, professional expertise and, ultimately, patient welfare.",26480223,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.603962898254395,-2.483933210372925,B2aV
"[Reconsidering Morita Therapy for Depression].

The author outlined Morita therapy-based living-guidance (yojo) and inpatient treatment for depressed patients. He further discussed commonalities and differences between Morita therapy and ""the third generation"" of cognitive-behavioral therapies, such as behavioral activa- tion (BA) and mindfulness-based cognitive therapy (MBCT). Both Morita therapy and BA share at least a common view that it is effective to activate patients' constructive behavior at a certain point in depression treatment. In a corresponding manner, as MBCT emphasizes the ""being"" mode and Morita therapy, ""arugamama, or being as is,"" they both state that the turn- ing point to break the vicious cycle (or ""doing"" mode) is accepting thoughts and emotions as they are. However, Morita therapists, compared with BA therapists, seem to pay more attention to the necessity of resting and appropriate timing for introducing behavioral activation. MBCT has patients concentrate their attention on their own aspirations and bodily sensations (medita- tion), while in Morita therapy, their attentions are naturally diverted through the practice of daily life. Besides the differences of cultural backgrounds, there seem to be differences in depression models between Morita therapy and ""the third generation"" of CBT. In the BA model, the cause of depression lies in a lack of positive reinforcement, and negative reinforcement resulting from the avoidance of the experience of discomfort. The cognitive theory of depression places the model of the vicious cycle among the elements of cognition, emotion, and behavior. In this regard, MBCT shares a common assumption regarding the pathogenesis of depression with conventional cognitive therapy. As BA and MBCT are based on psychological models of depression, both treatments have been primarily practiced by clinical psychologists. On the other hand, medical doctors mainly offer a psychotherapeutic approach with medication treat- ments for depressive patients in Japan. In this context, the practice of treating depression is based primarily on medical models of endogenous depression. This is also true of Morita ther- apy, but in a broad sense. While those who follow medical models in a narrow sense try to identify the cause of illness and then to remove it, Morita therapists pay more attention to the recovery process rather than the pathogeneses of depression and attempt to promote patients' natural healing-power. Therefore, it may be more appropriate to refer to the model used in Morita therapy as ""a resilience model"".",30620826,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.390246391296387,-1.533940076828003,BAyN
"Dynamic interpersonal therapy for moderate to severe depression: a pilot randomized controlled and feasibility trial.

Improving Access to Psychological Therapies (IAPT) services treat most patients in England who present to primary care with major depression. Psychodynamic psychotherapy is one of the psychotherapies offered. Dynamic Interpersonal Therapy (DIT) is a psychodynamic and mentalization-based treatment for depression. 16 sessions are delivered over approximately 5 months. Neither DIT's effectiveness relative to low-intensity treatment (LIT), nor the feasibility of randomizing patients to psychodynamic or cognitive-behavioural treatments (CBT) in an IAPT setting has been demonstrated. 147 patients were randomized in a 3:2:1 ratio to DIT (n = 73), LIT (control intervention; n = 54) or CBT (n = 20) in four IAPT treatment services in a combined superiority and feasibility design. Patients meeting criteria for major depressive disorder were assessed at baseline, mid-treatment (3 months) and post-treatment (6 months) using the Hamilton Rating Scale for Depression (HRSD-17), Beck Depression Inventory-II (BDI-II) and other self-rated questionnaire measures. Patients receiving DIT were also followed up 6 months post-completion. The DIT arm showed significantly lower HRSD-17 scores at the 6-month primary end-point compared with LIT (d = 0.70). Significantly more DIT patients (51%) showed clinically significant change on the HRSD-17 compared with LIT (9%). The DIT and CBT arms showed equivalence on most outcomes. Results were similar with the BDI-II. DIT showed benefit across a range of secondary outcomes. DIT delivered in a primary care setting is superior to LIT and can be appropriately compared with CBT in future RCTs.",31084635,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.751483917236328,-3.594146490097046,A6i+
"A comparison of the effects of sudden gains and depression spikes on short- and long-term depressive symptoms in a randomized controlled trial of behavioral activation and cognitive behavioural therapy.

The aim of this study was to examine the effects of sudden gains and depression spikes in a randomized controlled trial of cognitive behavioral therapy (CBT) and behavioral activation (BA) for depression (COBRA trial). This is a secondary analysis of 300 adults with major depressive disorder (MDD) who received CBT (n = 156) or BA (n = 144) (Richards et al., 2016). The Patient Health Questionnaire (PHQ-9) and Structured Clinical Interview Schedule (SCID) were used to measure depression symptoms at 6-, 12-, and 18-month follow-up. One-hundred and ten (37%) individuals experienced sudden gains, and 77 (26%) experienced depression spikes. There were no differences in rates of gains or spikes between treatments. Individuals with sudden gains had lower PHQ-9 scores across follow-up and were less likely to meet SCID criteria than those without a sudden gain. Generalized estimating equation (GEE) models demonstrated that individuals who had a sudden gain and were in CBT had lower PHQ-9 scores at 6 and 18 months than those in BA. Conversely, individuals who had a depression spike and were in CBT had higher PHQ-9 scores across follow-up compared to those without a depression spike and also a greater chance of meeting SCID criteria for MDD at 18 months than those who received BA. The short- and long-term impact of discontinuous change varied by type of treatment package. Identifying strategies within treatment packages and client processes that are associated with gains and spikes may help to inform treatment planning and clinical decision-making. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",35025537,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.03713607788086,-2.6462817192077637,s+w
"The Synergistic Process of Improvement in Cognitive Behavioral Therapy for Major Depression.

There is a substantial lack of qualitative research concerning individual cognitive behavioral therapy (CBT) for patients with major depressive disorder (MDD). In the present study, we wanted to explore how patients suffering from MDD experience improvement in CBT. Patients with MDD (N = 10) were interviewed at therapy termination with semi-structured qualitative interviews. The transcripts were analyzed using a thematic analysis approach. We identified three elements that were relevant to the process of improvement for all patients: the therapeutic relationship, the therapeutic interventions and increased insight. There is a dynamic interrelationship and synergy between these elements that may explain why patients considered the same elements as helpful, but often in different ways and at different stages of therapy. Highlighting the synergies and interrelationship between the elements that patients experience as helpful, may help therapists to learn from and utilize these experiences. This is a reminder of the importance of always being attentive to the individual processes of patients.",33652563,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.447104454040527,-3.042811155319214,AaAe
"Patient motivation for participating in clinical trials for depression: validation of the motivation for clinical trials inventory-depression.

The motivation for clinical trials inventory-depression (MCTI-D) was developed and evaluated for assessing motivations to participate in clinical trials on depression. Sixty-four participants completed the MCTI-D: 40 individuals expressing interest in participating in a randomized clinical trial (RCT); and 24 clinic patients receiving traditional care for depression. Content validity was supported by feedback derived from a panel of experts in depression research and respondents completing the measure. The motivation most frequently endorsed for participating in an RCT was the desire to help others and/or to further science. The potential stigma associated with seeing a psychiatrist was reported to have the least influence. Patients expressed a greater likelihood to participate in RCTs that involved psychotherapy than in experimental medication or placebo-controlled trials. Data from the MCTI-D may provide useful information for depression researchers to consider as possible influences on patients' decisions about whether or not they will participate.",19901843,Major Depressive Disorder,Anxiety Treatment,Mental Health,1983,10.627915382385254,-2.233599901199341,DQHD
"Efficacy of metacognitive therapy in improving mental health: A meta-analysis of single-case studies.

Metacognitive therapy and one of its treatment components, the attention training technique, are increasingly being delivered to improve mental health. We examined the efficacy of metacognitive therapy and/or attention training technique on mental health outcomes from single-case studies. A total of 14 studies (53 patients) were included. We used the d-statistic for multiple baseline data and the percentage change index to compute the effect sizes. Metacognitive therapy has a large effect on depression, anxiety, other psychopathological symptoms, and all outcomes together. Effect sizes were significantly moderated by the number of sessions, the severity and duration of symptoms, and patient gender, but not by study quality or attention training technique when used as a stand-alone treatment. At the follow-up, 77.36% of the individuals were considered recovered or had maintained improvement. Metacognitive therapy and attention training technique strongly contribute to improving mental health outcomes. This study effectively informs evidence-based practice in the clinical milieu.",29266265,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,14.96293830871582,-1.316861867904663,BSZ/
"Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse/recurrence: the PREVENT trial.

Depression is a common and distressing mental health problem that is responsible for significant individual disability and cost to society. Medication and psychological therapies are effective for treating depression and maintenance anti-depressants (m-ADM) can prevent relapse. However, individuals with depression often express a wish for psychological help that can help them recover from depression in the long-term. We need to develop psychological therapies that prevent depressive relapse/recurrence. A recently developed treatment, Mindfulness-based Cognitive Therapy (MBCT, see http://www.mbct.co.uk) shows potential as a brief group programme for people with recurring depression. In two studies it has been shown to halve the rates of depression recurring compared to usual care.This trial asks the policy research question, is MBCT superior to m-ADM in terms of: a primary outcome of preventing depressive relapse/recurrence over 24 months; and, secondary outcomes of (a) depression free days, (b) residual depressive symptoms, (c) antidepressant (ADM) usage, (d) psychiatric and medical co-morbidity, (e) quality of life, and (f) cost effectiveness? An explanatory research question asks is an increase in mindfulness skills the key mechanism of change? The design is a single blind, parallel RCT examining MBCT vs. m-ADM with an embedded process study. To answer the main policy research question the proposed trial compares MBCT plus ADM-tapering with m-ADM for patients with recurrent depression. Four hundred and twenty patients with recurrent major depressive disorder in full or partial remission will be recruited through primary care. Depressive relapse/recurrence over two years is the primary outcome variable. The explanatory question will be addressed in two mutually informative ways: quantitative measurement of potential mediating variables pre/post-treatment and a qualitative study of service users' views and experiences. If the results of our exploratory trial are extended to this definitive trial, MBCT will be established as an alternative approach to maintenance anti-depressants for people with a history of recurrent depression. The process studies will provide evidence about the effective components which can be used to improve MBCT and inform theory as well as other therapeutic approaches. ISRCTN26666654.",20961444,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.09619426727295,-0.8079646229743958,DEXV
"Comparative effects of group metacognitive therapy versus behavioural activation in moderately depressed students.

The high incidence and prevalence rates of depression among students identify them as a vulnerable population and make the case for the development of cost-effective treatments. We aimed to examine the comparative effects of brief group metacognitive therapy (MCT) versus behavioural activation (BA) treatments for depression, anxiety, and emotion regulation in university students. All participants (25 women, 16 men; age range: 18-30 years) fulfilled criteria for major depression and were randomly assigned to MCT (n=15), BA (n=15), or a wait-list control group (n=15). The treatment groups received 8 weekly MCT or BA sessions. Scores on the Beck Depression Inventory, Beck Anxiety Inventory, and Cognitive Emotion Regulation Questionnaire were used as outcome measures. This pilot study showed that both treatments were equally effective for depressive and anxiety symptoms. However, therapeutic techniques differed with regards to their effects on specific facets of emotion regulation, such as Positive Reappraisal and Catastrophizing, with MCT being more effective compared to BA. BA also showed a stronger relapse at follow-up with regards to Acceptance and Refocus on Planning. Results suggest that groups MCT and BA may be implemented as cost-effective treatments for students with moderate depression.",26439473,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.913215637207031,-1.9145795106887817,B3Aw
"Couple therapy for depression.

Relationship problems and depression often influence one another in a bidirectional, recursive fashion. Results from several clinical trials have demonstrated that couple therapy is effective in improving depression and reducing relationship problems. In this article, we describe an approach to working with depression in partnered individuals who are also unhappy in their relationship. This cognitive-behavior approach strives to (a) eliminate major stressors and reestablish positive activities in the relationship, (b) improve communication and problem solving in the relationship, and (c) solidify gains made in therapy and prevent relapse. The typical course of therapy is described and demonstrated in a case illustration. Couple therapy is a promising treatment for depressed individuals in distressed relationships.",22499085,Major Depressive Disorder,Anxiety Treatment,Mental Health,3806,13.897451400756836,-6.734903335571289,Cu06
"Integrative medicine for treating depression: an update on the latest evidence.

Integrative medicine (IntM) is a growing medical trend combining conventional medical approaches with evidence-based complementary therapies to promote well-being. Over half of individuals with depression use some form of IntM for symptom management. The purpose of the current study was to critically review the scientific evidence for IntM techniques in treating adult unipolar depression. We examined randomized controlled trials, systematic reviews, and meta-analyses published in the last one to three years using PsychINFO, PubMed, and Cochrane Library databases. The strongest evidence currently exists for mindfulness-based interventions and St. John's Wort (SJW) as monotherapies, and there is relatively strong evidence to support the use of omega-3 fatty acids and exercise as adjunct therapies. However, there remains an overall lack of methodologically rigorous research to support the efficacy of many other IntM techniques. Providers should be aware that many patients use IntM techniques for depression treatment and inquire regularly about such use.",23943471,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,8.905038833618164,-1.1003214120864868,CaB+
"Temporal and specific pathways of change in cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression.

The present study investigated the specific and temporal role of putative mechanisms of change in cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD). 200 patients were randomized to CBT weekly, CBT twice weekly, IPT weekly or IPT twice weekly. Outcome and putative mechanisms of change (i.e., dysfunctional thinking, behavioral activation, CBT skills, IPT skills, therapeutic alliance, compliance, motivation) were measured multiple times up to six months after the start of treatment. Latent change score models were used to investigate temporal relations and test mediation. Explorative analyses tested whether baseline working memory moderated the effect of mechanism change on outcome change. CBT skills and dysfunctional thinking mediated the relation between treatment modality and changes in depression. In both treatments, IPT skills and behavioral activation were related to subsequent change in depression while a decrease in depression led to subsequent improvement in therapeutic alliance and a decrease in autonomous motivation. Change in compliance was unrelated to change in depression. Baseline working memory was related to therapy skill improvement. CBT skill improvement seems a specific mechanism of change leading to subsequent decrease in depression in CBT. Changes in IPT skills acted as a non-specific mechanism, subsequently reducing depression regardless of treatment modality. The specific role of cognitive change and behavioral activation remains unclear. Future studies should investigate the specificity and direction of the potential mechanisms of change throughout the course of therapy and investigate whether these mechanistic pathways differ between individuals.",35228163,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.629993438720703,-3.0319409370422363,k6U
"Feasibility randomized controlled trial of cognitive and behavioral interventions for depression symptoms in patients accessing drug and alcohol treatment.

Depressed mood often co-exists with frequent drug and alcohol use. This trial examined the feasibility of screening, recruitment, randomization and engagement of drug and alcohol users in psychological interventions for depression symptoms. A total of 50 patients involved in community drugs and alcohol treatment (CDAT) were randomly allocated to behavioral activation delivered by psychological therapists (n = 23) or to cognitive behavioral therapy based self-help introduced by CDAT workers (n = 27). We examined recruitment and engagement rates, as well as changes in depression (PHQ-9) symptoms and changes in percent days abstinent (PDA within last month) at 24 weeks follow-up. The ratio of screened to recruited participants was 4 to 1, and the randomization schedule successfully generated 2 groups with comparable characteristics. Follow-up was possible with 78% of participants post-treatment. Overall engagement in psychological interventions was low; only 42% of randomized participants attended at least 1 therapy session. Patients offered therapy appointments co-located in CDAT clinics were more likely to engage with treatment (odds ratio = 7.14, p = .04) compared to those offered appointments in community psychological care clinics. Intention-to-treat analyses indicated no significant between-group differences at follow-up in mean PHQ-9 change scores (p = .59) or in PDA (p = .08). Overall, it was feasible to conduct a pragmatic trial within busy CDAT services, maximizing external validity of study results. Moderate and comparable improvements in depression symptoms over time were observed for participants in both treatment groups.",25819701,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,10.83206558227539,-2.789501905441284,B/4q
"Outcomes of acute phase cognitive therapy in outpatients with anxious versus nonanxious depression.

Compared to nonanxious depressed patients, anxious depressed patients respond less to pharmacotherapy, prompting consideration of alternate treatments. Based on the transdiagnostic principles of cognitive therapy (CT), we predicted that anxious depressed patients would respond as well to CT as nonanxious depressed patients. Adults (n = 523) with recurrent major depressive disorder received 12-14 weeks of CT as part of the Continuation Phase Cognitive Therapy Relapse Prevention Trial. Anxious depressed patients (n = 264; 50.4%) were compared to nonanxious depressed patients (n = 259; 49.6%) on demographic variables, initial severity, attrition, and rates and patterns of response and remission. Anxious depressed patients presented with greater illness severity and had significantly lower response (55.3 vs. 68.3%) and remission rates (26.9 vs. 40.2%) based on clinician-administered measures. By contrast, smaller between-group differences for attrition, and for response (59.1 vs. 64.9%) and remission (41.7 vs. 48.7%) rates on self-report measures were not significant. Further, anxious depressed patients had greater speed of improvement on self-reported anxiety symptom severity and clinician-rated depressive and anxiety symptom severity measures. Consistent with prior reports, anxious depressed patients presented with greater severity and, following CT, had lower response and remission rates on clinician-administered scales. However, anxious depressed patients improved more rapidly and response and remission rates on self-report measures were not significantly different from nonanxious depressed patients. Our findings suggest that anxious depressed patients may simply need additional time or more CT sessions to reach outcomes fully comparable to those of less anxious patients.",22398963,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,11.348138809204102,-1.3340458869934082,CwXl
"Network meta-analysis of randomised trials of pharmacological, psychotherapeutic, exercise and collaborative care interventions for depressive symptoms in patients with coronary artery disease: hybrid systematic review of systematic reviews protocol.

Depression is common in patients with coronary artery disease (CAD) and is associated with poorer outcomes and higher costs. Several randomised controlled trials (RCTs) targeting depression, of various modalities (including pharmacological, psychotherapeutic and other approaches), have been conducted and summarised in pairwise meta-analytic reviews. However, no study has considered the cumulative evidence within a network, which can provide valuable indirect comparisons and information about the relative efficacy of interventions. Therefore, we will adopt a review of review methodology to develop a network meta-analysis (NMA) of depression interventions for depression in CAD. We will search relevant databases from inception for systematic reviews of RCTs of depression treatments for people with CAD, supplementing this with comprehensive searches for recent or ongoing studies. We will extract data from and summarise characteristics of individual RCTs, including participants, study characteristics, outcome measures and adverse events. Cochrane risk of bias ratings will also be extracted or if not present will be conducted by the authors. RCTs that compare depression treatments (grouped as pharmacological, psychotherapeutic, combined pharmacological/psychotherapeutic, exercise, collaborative care) to placebo, usual care, waitlist control or attention controls, or directly in head-to-head comparisons, will be included. Primary outcomes will be the change in depressive symptoms (summarised with a standardised mean difference) and treatment acceptability (treatment discontinuation: % of people who withdrew). Secondary outcomes will include change in 6-month depression outcomes, health-related quality of life (HRQoL), mortality, cardiovascular morbidity, health services use and adverse events. Secondary analyses will form further networks with individual anti-depressants and psychotherapies. We will use frequentist, random effects multivariate network meta-analysis to synthesise the evidence for depression intervention and to achieve a ranking of treatments, using Stata. Rankograms and surface under the cumulative ranking curves will be used for treatment ranking. Local and global methods will evaluate consistency. GRADE will be used to assess evidence quality for primary outcomes. The present review will address uncertainties about the evidence in terms of depression management in CAD and may allow for a ranking of treatments, including providing important information for future research efforts. PROSPERO CRD42018108293.",30878039,Major Depressive Disorder,Anxiety Treatment,Mental Health,14383,9.147992134094238,-1.4102261066436768,A9V8
"Network analyses reveal which symptoms improve (or not) following an Internet intervention (Deprexis) for depression.

Depression is a heterogeneous collection of symptoms. Prior meta-analyses using symptom sum scores have shown the Internet intervention, Deprexis, to be an efficacious treatment for depression. However, no prior research has investigated how Deprexis (or any other Internet intervention for depression) impacts specific symptoms of depression. The current study utilizes symptom-level analyses to examine which symptoms are directly, indirectly, or minimally influenced by treatment. Network analysis and mean-level approaches examined which symptoms, assessed by the Quick Inventory of Depression Symptoms, were affected by an 8-week course of Deprexis compared with a waitlist in a nationally recruited sample from the United States (N=295). Deprexis directly improved the symptoms of sadness and indecision. Changes in these symptoms, in turn, was associated with a change in early insomnia, middle insomnia, self-dislike, fatigue, anhedonia, suicidality, slowness, and agitation. All of these symptoms (except for agitation and early insomnia) show decreases with Deprexis compared with a waitlist after correcting for multiple comparisons. Six additional symptoms, particularly the somatic symptoms, were not impacted by Deprexis compared with a waitlist. In this sample, the efficacy of Deprexis was due to its direct impact on sadness and indecision. Examining the treatment-related change in specific symptoms may facilitate a more nuanced understanding of how a treatment works compared with examining symptom sum scores. Symptom-level approaches may also identify symptoms that do not improve and provide important direction for future treatment development.",31710772,Major Depressive Disorder,Anxiety Treatment,Mental Health,20347,10.233399391174316,-2.7592625617980957,AyDe
"Long-term outcomes of acute treatment with cognitive therapy v. interpersonal psychotherapy for adult depression: follow-up of a randomized controlled trial.

Although equally efficacious in the acute phase, it is not known how cognitive therapy (CT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) compare in the long run. This study examined the long-term outcomes of CT v. IPT for MDD. One hundred thirty-four adult (18-65) depressed outpatients who were treated with CT (n = 69) or IPT (n = 65) in a large open-label randomized controlled trial (parallel group design; computer-generated block randomization) were monitored across a 17-month follow-up phase. Mixed regression was used to determine the course of self-reported depressive symptom severity (Beck Depression Inventory II; BDI-II) after treatment termination, and to test whether CT and IPT differed throughout the follow-up phase. Analyses were conducted for the total sample (n = 134) and for the subsample of treatment responders (n = 85). Furthermore, for treatment responders, rates of relapse and sustained response were examined for self-reported (BDI-II) and clinician-rated (Longitudinal Interval Follow-up Evaluation; LIFE) depression using Cox regression. On average, the symptom reduction achieved during the 7-month treatment phase was maintained across follow-up (7-24 months) for CT and IPT, both in the total sample and in the responder sample. Two-thirds (67%) of the treatment responders did not relapse across the follow-up period on the BDI-II. Relapse rates assessed with the LIFE were somewhat lower. No differential effects between conditions were found. Patients who responded to IPT were no more likely to relapse following treatment termination than patients who responded to CT. Given that CT appears to have a prophylactic effect following successful treatment, our findings suggest that IPT might have a prophylactic effect as well.",29792234,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.567484855651855,-2.9078328609466553,BLY1
"Exploring Outcomes Related to Anxiety and Depression in Completers of a Randomized Controlled Trial of Complicated Grief Treatment.

The present study examines a more fine-grained analysis of anxiety-related and depression-related outcomes amongst a sample of treatment completers who were assigned to complicated grief treatment (CGT) (n = 35) or interpersonal psychotherapy (IPT) (n = 34) in a previously reported randomized controlled trial. We examined effects of antidepressant use and measures of anxiety and depression, focusing especially on guilt related to the death or deceased and grief-related avoidance in order to further understand the differential effectiveness of CGT and IPT amongst participants who received the full course of treatment. Analyses showed that CGT produced greater reductions in anxiety and depressive symptoms including negative thoughts about the future and grief-related avoidance. CGT's advantage over IPT in lowering depression was most pronounced amongst those not taking antidepressants. Our results further elucidate CGT effects and support the idea that CG and major depressive disorder are distinct conditions. Targeted treatment for complicated grief (CG) produces benefits in associated mood and anxiety symptoms and CG symptoms. Amongst patients with CG, interpersonal psychotherapy seems relatively ineffective in ameliorating depressive symptoms. Grief-related depressive symptoms may not respond to standard treatments unless CG symptoms are also addressed. Reducing grief-related symptoms, such as anxieties about the future, guilt related to the death or deceased and avoidance of reminders of the loss may be important aspects in reducing CG.",25529554,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.954565048217773,-9.043004989624023,CEDF
"Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials.

Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach. Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data. A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29-0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit-risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration. Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.",27649340,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.483922958374023,-3.240736722946167,BnCF
"The Effects of Group Art Therapy on the Primary Family Caregivers of Hospitalized Patients with Brain Injuries in South Korea.

This study examined the effects of group art therapy on depression, burden, and self-efficacy in primary family caregivers of patients with brain injuries. This was a quasi-experimental, nonequivalent control group and a pre- and post-test design. This study was carried out in one national rehabilitation hospital targeting 41 primary family caregivers of patients with brain injuries. Group art therapy intervention was carried out three days per week comprising 12 sessions over four consecutive weeks. The experimental group (n = 20) received group art therapy, whereas the control group (n = 21) did not. We used a time difference method to minimize the risk of contaminating the control group by sampling sequentially. For depression, although there was a significant difference after the intervention (t = 3.296, p = 0.004), the mean difference score was not statistically significant between the experimental group and the control group (t = 0.861, p = 0.395). The experimental group showed a significantly greater decrease in burden (t = 2.462, p = 0.020) and significantly greater improvement in self-efficacy (t = -6.270, p < 0.001) than the control group. Group art therapy may be an effective nursing intervention for primary family caregivers of patients with brain injuries.",34065044,Major Depressive Disorder,Anxiety Treatment,Mental Health,23662,10.517213821411133,-5.36865758895874,AVb7
"Treatment selection using prototyping in latent-space with application to depression treatment.

Machine-assisted treatment selection commonly follows one of two paradigms: a fully personalized paradigm which ignores any possible clustering of patients; or a sub-grouping paradigm which ignores personal differences within the identified groups. While both paradigms have shown promising results, each of them suffers from important limitations. In this article, we propose a novel deep learning-based treatment selection approach that is shown to strike a balance between the two paradigms using latent-space prototyping. Our approach is specifically tailored for domains in which effective prototypes and sub-groups of patients are assumed to exist, but groupings relevant to the training objective are not observable in the non-latent space. In an extensive evaluation, using both synthetic and Major Depressive Disorder (MDD) real-world clinical data describing 4754 MDD patients from clinical trials for depression treatment, we show that our approach favorably compares with state-of-the-art approaches. Specifically, the model produced an 8% absolute and 23% relative improvement over random treatment allocation. This is potentially clinically significant, given the large number of patients with MDD. Therefore, the model can bring about a much desired leap forward in the way depression is treated today.",34767577,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,12.333690643310547,-1.1505999565124512,3k8
"A randomized controlled trial of Mindfulness-Based Cognitive Therapy (MBCT) versus treatment-as-usual (TAU) for chronic, treatment-resistant depression: study protocol.

Major depression is a common psychiatric disorder, frequently taking a chronic course. Despite provision of evidence-based treatments, including antidepressant medication and psychological treatments like cognitive behavioral therapy or interpersonal therapy, a substantial amount of patients do not recover. Mindfulness-Based Cognitive Therapy (MBCT) has been found to be effective in reducing relapse in recurrent depression, as well as lowering symptom levels in acute depression. The effectiveness of MBCT for chronic, treatment-resistant depression has only be studied in a few pilot trials. A large randomized controlled trial is necessary to examine the effectiveness of MBCT in reducing depressive symptoms in chronic, treatment-resistant depression. A randomized-controlled trial is conducted to compare MBCT with treatment-as-usual (TAU). Patients with chronic, treatment-resistant depression who have received antidepressant medication and cognitive behavioral therapy or interpersonal therapy are included. Assessments take place at baseline and post intervention/TAU-period. The primary outcome are depressive symptoms. Secondary outcomes are: remission rates, quality of life, rumination, mindfulness skills and self-compassion. Patients in the TAU condition are offered to participate in the MBCT after the post TAU-period assessment. From all completers of the MBCT (MBCT condition and patients participating after the TAU-period), follow-up assessments are taken at three and six months after the completion of the MBCT. This trial will result in valuable information about the effectiveness of MBCT in chronic, treatment-resistant depressed patients who previously received antidepressant medication and psychological treatment. trialregister.nl NTR4843, registered 14th October 2014.",26553106,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.929213523864746,-0.6749023199081421,B1ZW
"Effects of Group-Focused Cognitive-Behavioral Coaching Program on Depressive Symptoms in a Sample of Inmates in a Nigerian Prison.

This study investigated the effects that a group-focused cognitive-behavioral coaching program had on depressive symptoms of a sample of inmates from Nsukka Prisons, Enugu State, Nigeria. The design of the study was pretest-posttest control group . The participants were 30 male inmates, experiencing high levels of depressive symptoms, and randomly assigned to treatment and control groups. The primary outcome measure was depression symptoms as measured using Beck's Depression Inventory. Repeated-measures ANOVA and the Mann-Whitney U Test were used for data analysis. Results show that exposing inmates to the group-focused cognitive-behavioral coaching program significantly reduced the depressive symptoms of inmates in the treatment group compared with those in the control group. Our results support the use of cognitive-behavioral coaching interventions designed to assist the severely depressed inmates in Nigeria. Further studies should be conducted both in other states of Nigeria and in other countries.",28073322,Major Depressive Disorder,Anxiety Treatment,Mental Health,20390,10.66227912902832,-2.520789384841919,BiXm
"Automated Text Messaging as an Adjunct to Cognitive Behavioral Therapy for Depression: A Clinical Trial.

Cognitive Behavioral Therapy (CBT) for depression is efficacious, but effectiveness is limited when implemented in low-income settings due to engagement difficulties including nonadherence with skill-building homework and early discontinuation of treatment. Automated messaging can be used in clinical settings to increase dosage of depression treatment and encourage sustained engagement with psychotherapy. The aim of this study was to test whether a text messaging adjunct (mood monitoring text messages, treatment-related text messages, and a clinician dashboard to display patient data) increases engagement and improves clinical outcomes in a group CBT treatment for depression. Specifically, we aim to assess whether the text messaging adjunct led to an increase in group therapy sessions attended, an increase in duration of therapy attended, and reductions in Patient Health Questionnaire-9 item (PHQ-9) symptoms compared with the control condition of standard group CBT in a sample of low-income Spanish speaking Latino patients. Patients in an outpatient behavioral health clinic were assigned to standard group CBT for depression (control condition; n=40) or the same treatment with the addition of a text messaging adjunct (n=45). The adjunct consisted of a daily mood monitoring message, a daily message reiterating the theme of that week's content, and medication and appointment reminders. Mood data and qualitative responses were sent to a Web-based platform (HealthySMS) for review by the therapist and displayed in session as a tool for teaching CBT skills. Intent-to-treat analyses on therapy attendance during 16 sessions of weekly therapy found that patients assigned to the text messaging adjunct stayed in therapy significantly longer (median of 13.5 weeks before dropping out) than patients assigned to the control condition (median of 3 weeks before dropping out; Wilcoxon-Mann-Whitney z=-2.21, P=.03). Patients assigned to the text messaging adjunct also generally attended more sessions (median=6 sessions) during this period than patients assigned to the control condition (median =2.5 sessions), but the effect was not significant (Wilcoxon-Mann-Whitney z=-1.65, P=.10). Both patients assigned to the text messaging adjunct (B=-.29, 95% CI -0.38 to -0.19, z=-5.80, P<.001) and patients assigned to the control conditions (B=-.20, 95% CI -0.32 to -0.07, z=-3.12, P=.002) experienced significant decreases in depressive symptom severity over the course of treatment; however, the conditions did not significantly differ in their degree of symptom reduction. This study provides support for automated text messaging as a tool to sustain engagement in CBT for depression over time. There were no differences in depression outcomes between conditions, but this may be influenced by low follow-up rates of patients who dropped out of treatment.",28483742,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,10.327168464660645,-3.4377083778381348,Bc3z
"The effect of adding psychodynamic therapy to antidepressants in patients with major depressive disorder. A systematic review of randomized clinical trials with meta-analyses and trial sequential analyses.

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Psychodynamic therapy may be a treatment option for depression, but the effects have only been limitedly assessed in systematic reviews. Using Cochrane systematic review methodology, we compared the benefits and harms of psychodynamic therapy versus 'no intervention' or sham for major depressive disorder. We accepted any co-intervention, including antidepressants, as long as it was delivered similarly in both intervention groups. Trials were identified by searching the Cochrane Library's CENTRAL, MEDLINE via PubMed, EMBASE, Psychlit, Psyc Info, and Science Citation Index Expanded until February 2010. Two authors independently extracted data. We evaluated risk of bias to control for systematic errors. We conducted trial sequential analysis to control for random errors. We included five trials randomizing a total of 365 participants who all received antidepressants as co-intervention. All trials had high risk of bias. Four trials assessed 'interpersonal psychotherapy' and one trial 'short psychodynamic supportive psychotherapy'. Meta-analysis showed that psychodynamic therapy significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference -3.01 (95% confidence interval -3.98 to -2.03; P<0.00001), no significant heterogeneity between trials) compared with 'no intervention'. Trial sequential analysis confirmed this result. Our results are based on few trials with high risk of bias and a limited number of participants so our results may be questionable. Adding psychodynamic therapy to antidepressants might benefit depressed patients, but the possible treatment effect measured on the Hamilton Rating Scale for Depression is small.",21501877,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.934982299804688,-2.8445520401000977,C9R4
"Is it magic? An exploratory randomized controlled trial comparing imagery rescripting and cognitive restructuring in the treatment of depression.

To investigate whether working with intrusive images and the use of imagery processes would be beneficial to treating depression, an imagery-based intervention (imagery rescripting, IR) was compared with a more commonly used verbal-based technique (cognitive restructuring, CR). The study aimed not only to test the efficacy of IR as a brief modular treatment for depression, but to explore whether such experiential use of imagery would alleviate the abstract-evaluative, verbal processes of rumination and worry. Forty-one participants diagnosed with clinical depression and who also reported intrusive images underwent one assessment session of imagery properties before they were randomly assigned to an IR group or to an active control group of CR. They then received three weekly sessions of treatment, and outcomes were measured before and after treatment, as well as at two-month follow-up. The results showed that IR was equally if not more effective than CR in alleviating depression. Significant differential reductions in rumination, worry and experiential avoidance between treatments added support to the technique's experiential nature, and possibly, a defusing out of an abstract-evaluative mode of processing. Only self-report measures were used, with a small number of treatment sessions by one clinician. The findings support the therapeutic potential of imagery modalities in the treatment of depression, which compared to cognitive restructuring, appear to bring about more significant emotional change with time (clinical trial registered at the Joint CUHK-NTEC CREC Ref. No. 2015.458).",35121250,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,15.745488166809082,-0.8996971845626831,pEw
"Patient predictors of response to cognitive behaviour therapy and schema therapy for depression.

Few studies have examined differential predictors of response to psychotherapy for depression. Greater understanding about the factors associated with therapeutic response may better enable therapists to optimise response by targeting therapy for the individual. The aim of the current exploratory study was to examine patient characteristics associated with response to cognitive behaviour therapy and schema therapy for depression. Participants were 100 outpatients in a clinical trial randomised to either cognitive behaviour therapy or schema therapy. Potential predictors of response examined included demographic, clinical, functioning, cognitive, personality and neuropsychological variables. Individuals with chronic depression and increased levels of pre-treatment negative automatic thoughts had a poorer response to both cognitive behaviour therapy and schema therapy. A treatment type interaction was found for verbal learning and memory. Lower levels of verbal learning and memory impairment markedly impacted on response to schema therapy. This was not the case for cognitive behaviour therapy, which was more impacted if verbal learning and memory was in the moderate range. Study findings are consistent with the Capitalisation Model suggesting that therapy that focuses on the person's strengths is more likely to contribute to a better outcome. Limitations were that participants were outpatients in a randomised controlled trial and may not be representative of other depressed samples. Examination of a variety of potential predictors was exploratory and requires replication.",29325436,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.263631820678711,-2.6023383140563965,BRmg
"A supported self-help for recurrent depression in primary care; An economic evaluation alongside a multi-center randomised controlled trial.

Major depression is a prevalent mental disorder with a high risk of relapse or recurrence. Only few studies have focused on the cost-effectiveness of interventions aimed at the prevention of relapse or recurrence of depression in primary care. To evaluate the cost-effectiveness of a supported Self-help Preventive Cognitive Therapy (S-PCT) added to treatment-as-usual (TAU) compared with TAU alone for patients with a history of depression, currently in remission. An economic evaluation alongside a multi-center randomised controlled trial was performed (n = 248) over a 12-month follow-up. Outcomes included relapse or recurrence of depression and quality-adjusted-life-years (QALYs) based on the EuroQol-5D. Analyses were performed from both a societal and healthcare perspective. Missing data were imputed using multiple imputations. Uncertainty was estimated using bootstrapping and presented using the cost-effectiveness plane and the Cost-Effectiveness Acceptability Curve (CEAC). Cost estimates were adjusted for baseline costs. S-PCT statistically significantly decreased relapse or recurrence by 15% (95%CI 3;28) compared to TAU. Mean total societal costs were €2,114 higher (95%CI -112;4261). From a societal perspective, the ICER for relapse or recurrence was 13,515. At a Willingness To Pay (WTP) of 22,000 €/recurrence prevented, the probability that S-PCT is cost-effective, in comparison with TAU, is 80%. The ICER for QALYs was 63,051. The CEA curve indicated that at a WTP of 30,000 €/QALY gained, the probability that S-PCT is cost-effective compared to TAU is 21%. Though ultimately depending on the WTP of decision makers, we expect that for both relapse or recurrence and QALYs, S-PCT cannot be considered cost-effective compared to TAU.",30566441,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.034734725952148,-1.9883381128311157,BBk1
"A systematic review and meta-analysis on the efficacy of Internet-delivered behavioral activation.

Behavioral activation (BA) is an evidence-based treatment for depression which has attracted interest and started to accumulate evidence for other conditions when delivered face-to-face. Due to its parsimoniousness, it is suitable to be delivered via the Internet. The goal of this systematic review and meta-analysis was to examine evidence from randomized controlled trials (RCTs) to determine the efficacy of Internet-based BA and assess the quality of this evidence. Studies were identified from electronic databases (EMBASE, ISI Web of Knowledge, Medline, CINHAL, PsychINFO, Cochrane) and reference lists of included studies. Two reviewers independently screened articles for inclusion and extracted data. They assessed the quality of evidence for each outcome using The Grading of Recommendations Assessment, Development and Evaluation framework. Nine RCTs on different forms of depression were included with 2157 adult participants. Random effects meta-analyses showed that in non-clinical settings, guided Internet-based BA was non-inferior to other forms of behavioral therapy and mindfulness (mainly very low to low quality evidence) and superior to physical activity (very low quality evidence), psychoeducation/treatment as usual (moderate quality evidence) and waitlist (low quality evidence) at reducing depression and anxiety outcomes at post-treatment and short follow-up. The poor quality of some of the findings means that results should be cautiously interpreted. Evidence for the efficacy of Internet-based BA as a treatment for depression is promising. However, high quality studies with longer follow-ups are needed to increase confidence in findings and determine its efficacy in clinical settings and other conditions.",29649708,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.354823112487793,-2.041379928588867,BNUT
"Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents.

Depressive disorders are common in children and adolescents and, if left untreated, are likely to recur in adulthood. Depression is highly debilitating, affecting psychosocial, family and academic functioning. To evaluate the effectiveness of psychological therapies and antidepressant medication, alone and in combination, for the treatment of depressive disorder in children and adolescents. We have examined clinical outcomes including remission, clinician and self reported depression measures, and suicide-related outcomes. We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) to 11 November 2011. This register contains reports of relevant randomised controlled trials (RCTs) from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). RCTs were eligible for inclusion if they compared i) any psychological therapy with any antidepressant medication, or ii) a combination of psychological therapy and antidepressant medication with a psychological therapy alone, or an antidepressant medication alone, or iii) a combination of psychological therapy and antidepressant medication with a placebo or 'treatment as usual', or (iv) a combination of psychological therapy and antidepressant medication with a psychological therapy or antidepressant medication plus a placebo.We included studies if they involved participants aged between 6 and 18 years, diagnosed by a clinician as having Major Depressive Disorder (MDD) based on Diagnostic and Statistical Manual (DSM) or International Classification of Diseases (ICD) criteria. Two review authors independently selected studies, extracted data and assessed the quality of the studies. We applied a random-effects meta-analysis, using the odds ratio (OR) to describe dichotomous outcomes, mean difference (MD) to describe continuous outcomes when the same measures were used, and standard mean difference (SMD) when outcomes were measured on different scales. We included ten studies, involving 1235 participants in this review. Studies recruited participants with different severities of disorder and with a variety of comorbid disorders, including anxiety and substance use disorder, therefore limiting the comparability of the results. Regarding the risk of bias in studies, half the studies had adequate allocation concealment (there was insufficient information to determine allocation concealment in the remainder), outcome assessors were blind to the participants' intervention in six studies, and in general, studies reported on incomplete data analysis methods, mainly using intention-to-treat (ITT) analyses. For the majority of outcomes there were no statistically significant differences between the interventions compared. There was limited evidence (based on two studies involving 220 participants) that antidepressant medication was more effective than psychotherapy on measures of clinician defined remission immediately post-intervention (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.27 to 0.98), with 67.8% of participants in the medication group and 53.7% in the psychotherapy group rated as being in remission. There was limited evidence (based on three studies involving 378 participants) that combination therapy was more effective than antidepressant medication alone in achieving higher remission from a depressive episode immediately post-intervention (OR 1.56, 95% CI 0.98 to 2.47), with 65.9% of participants treated with combination therapy and 57.8% of participants treated with medication, rated as being in remission. There was no evidence to suggest that combination therapy was more effective than psychological therapy alone, based on clinician rated remission immediately post-intervention (OR 1.82, 95% CI 0.38 to 8.68).Suicide-related Serious Adverse Events (SAEs) were reported in various ways across studies and could not be combined in meta-analyses. However suicidal ideation specifically was generally measured and reported using standardised assessment tools suitable for meta-analysis. In one study involving 188 participants, rates of suicidal ideation were significantly higher in the antidepressant medication group (18.6%) compared with the psychological therapy group (5.4%) (OR 0.26, 95% CI 0.09 to 0.72) and this effect appeared to remain at six to nine months (OR 1.27, 95% CI 0.68 to 2.36), with 13.6% of participants in the medication group and 3.9% of participants in the psychological therapy group reporting suicidal ideation. It was unclear what the effect of combination therapy was compared with either antidepressant medication alone or psychological therapy alone on rates of suicidal ideation. The impact of any of the assigned treatment packages on drop out was also mostly unclear across the various comparisons in the review.Limited data and conflicting results based on other outcome measures make it difficult to draw conclusions regarding the effectiveness of any specific intervention based on these outcomes. There is very limited evidence upon which to base conclusions about the relative effectiveness of psychological interventions, antidepressant medication and a combination of these interventions. On the basis of the available evidence, the effectiveness of these interventions for treating depressive disorders in children and adolescents cannot be established. Further appropriately powered RCTs are required.",23152255,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.55380916595459,-1.9209377765655518,Clv0
"Multiple-therapy-resistant major depressive disorder: a clinically important concept.

Many novel therapeutic options for depression exist that are either not mentioned in clinical guidelines or recommended only for use in highly specialist services. The challenge faced by clinicians is when it might be appropriate to consider such 'non-standard' interventions. This analysis proposes a framework to aid this decision.Declaration of interestIn the past 3 years R.H.M.W. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending advisory boards) from various pharmaceutical companies including Astra Zeneca, Cyberonics, Eli Lilly, Janssen, LivaNova, Lundbeck, MyTomorrows, Otsuka, Pfizer, Roche, Servier, SPIMACO and Sunovion. D.M.B.C. has received fees from LivaNova for attending an advisory board. In the past 3 years A.J.C. has received fees for lecturing from Astra Zeneca and Lundbeck; fees for consulting from LivaNova, Janssen and Allergan; and research grant support from Lundbeck.In the past 3 years A.C. has received fees for lecturing from pharmaceutical companies namely Lundbeck and Sunovion. In the past 3 years A.L.M. has received support for attending seminars and fees for consultancy work (including advisory board) from Medtronic Inc and LivaNova. R.M. holds joint research grants with a number of digital companies that investigate devices for depression including Alpha-stim, Big White Wall, P1vital, Intel, Johnson and Johnson and Lundbeck through his mindTech and CLAHRC EM roles. M.S. is an associate at Blueriver Consulting providing intelligence to NHS organisations, pharmaceutical and devices companies. He has received honoraria for presentations and advisory boards with Lundbeck, Eli Lilly, URGO, AstraZeneca, Phillips and Sanofi and holds shares in Johnson and Johnson. In the past 3 years P.R.A.S. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending an advisory board) from life sciences companies including Corcept Therapeutics, Indivior and LivaNova. In the past 3 years P.S.T. has received consultancy fees as an advisory board member from the following companies: Galen Limited, Sunovion Pharmaceuticals Europe Ltd, myTomorrows and LivaNova. A.H.Y. has undertaken paid lectures and advisory boards for all major pharmaceutical companies with drugs used in affective and related disorders and LivaNova. He has received funding for investigator initiated studies from AstraZeneca, Eli Lilly, Lundbeck and Wyeth.",30517072,Major Depressive Disorder,Anxiety Treatment,Mental Health,20849,10.003899574279785,-0.8536079525947571,BCP0
"[The efficiency of psychological educational programs under depressive disorders].

The psychological educational programs make possible to increase level of awareness of depression in patients with depressive conditions and to enhance coping of patients with symptoms of disease. In scientific publications, the experience of application of both full-time group and individual and nonresident psychological educational programs is exposed The result of implementation of these programs consists in decreasing of expression depression symptoms, increasing of number of remissions, increasing of commitment to pharmaceutical treatment and decreasing of rate of refusals of treatment and increasing of rate of seeking of professional medical care in case of exacerbation of disease. The psychological educational programs ameliorate socialfunctioning, work capacity, quality of life and life satisfaction in patients.",26012276,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.7744140625,-3.154146671295166,B9MX
"Targeted prescription of cognitive-behavioral therapy versus person-centered counseling for depression using a machine learning approach.

Depression is a highly common mental disorder and a major cause of disability worldwide. Several psychological interventions are available, but there is a lack of evidence to decide which treatment works best for whom. This study aimed to identify subgroups of patients who respond differentially to cognitive-behavioral therapy (CBT) or person-centered counseling for depression (CfD). This was a retrospective analysis of archival routine practice data for 1,435 patients who received either CBT (N = 1,104) or CfD (N = 331) in primary care. The main outcome was posttreatment reliable and clinically significant improvement (RCSI) in the PHQ-9 depression measure. A targeted prescription algorithm was developed in a training sample (N = 1,085) using a supervised machine learning approach (elastic net with optimal scaling). The clinical utility of the algorithm was examined in a statistically independent test sample (N = 350) using chi-square analysis and odds ratios. Cases in the test sample that received their model-indicated ""optimal"" treatment had a significantly higher RCSI rate (62.5%) compared to those who received the ""suboptimal"" treatment (41.7%); χ2(df = 1) = 4.79, p = .03, OR = 2.33 (95% CI [1.09, 5.02]). Targeted prescription has the potential to make best use of currently available evidence-based treatments, improving outcomes for patients at no additional cost to psychological services. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",31841021,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,10.876381874084473,-2.889798879623413,AwN1
"Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: A randomized controlled trial.

Bouldering has shown promising results in the treatment of various health problems. In previous research, bouldering psychotherapy (BPT) was shown to be superior to a waitlist control group and to physical exercise with regard to reducing symptoms of depression. The primary aim of this study was to compare group BPT with group cognitive behavioural psychotherapy (CBT) to test the hypothesis that BPT would be equally as effective as CBT. We conducted a randomized, controlled, assessor-blinded non-inferiority trial in which 156 outpatients meeting the criteria of a depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were randomly assigned to one of the two intervention groups (CBT: N=77, BPT: N=79). Intervention groups were manualized and treated for 10weeks with a maximum of 11 participants and two therapists. The primary outcome was depressive symptom severity assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Patient Health questionnaire (PHQ-9) at the beginning and end of the treatment phase as well as one year after the end of treatment. In both groups, depressive symptoms improved significantly by an average of one severity level, moving from moderate to mild depressive symptoms after therapy (MADRS difference scores: BPT -8.06, 95% CI [-10.85, -5.27], p<.001; CBT -5.99, 95% CI [-8.55, -3.44], p<.001). The non-inferiority of BPT in comparison with CBT was established on the basis of the lower bound of the 95% confidence interval falling above all of the predefined margins. BPT was found to be effective in both the short (d=0.89) and long term (d=1.15). Group BPT was found to be equally as effective as group CBT. Positive effects were maintained until at least 12months after the end of therapy. Thus, BPT is a promising approach for broadening the therapeutic field of therapies for depression. Physical activity is effective in the treatment of depression and current guidelines explicitly recommend it as a complementary method for the treatment of depression. Nevertheless, body-related interventions are still underrepresented in current treatments for depression. Bouldering psychotherapy (BPT) combines physical activity with psychotherapeutic content. Its concept relies on proven effective factors from CBT such as exposure training, problem solving and practicing new functional behaviours and is thus an enrichment and implementation of CBT methods on the bouldering wall. The positive effect of group bouldering psychotherapy (BPT) in reducing depressive symptoms in outpatients with depression is not inferior to the effect of group cognitive behavioural therapy (CBT). Additionally the 10-weeks BPT-programme significantly improved symptoms of anxiety and interpersonal sensitivity as well as health-related quality of life, coping, body image, self-efficacy, and global self-esteem.",34791669,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,9.85693359375,-2.271352767944336,2h4
"Therapist use of Socratic questioning predicts session-to-session symptom change in cognitive therapy for depression.

Socratic questioning is a key therapeutic strategy in cognitive therapy (CT) for depression. However, little is known regarding its relation to outcome. In this study, we examine therapist use of Socratic questioning as a predictor of session-to-session symptom change. Participants were 55 depressed adults who participated in a 16-week course of CT (see Adler, Strunk, & Fazio, 2015). Socratic questioning was assessed through observer ratings of the first three sessions. Socratic ratings were disaggregated into scores reflecting within-patient and between-patient variability to facilitate an examination of the relation of within-patient Socratic questioning and session-to-session symptom change. Because we examined within-patient variability in Socratic questioning, the identification of such a relation cannot be attributed to any stable patient characteristics that might otherwise introduce a spurious relation. Within-patient Socratic questioning significantly predicted session-to-session symptom change across the early sessions, with a one standard deviation increase in Socratic-Within predicting a 1.51-point decrease in BDI-II scores in the following session. Within-patient Socratic questioning continued to predict symptom change after controlling for within-patient ratings of the therapeutic alliance (i.e., Relationship and Agreement), suggesting that the relation of Socratic questioning and symptom change was not only independent of stable characteristics, but also within-patient variation in the alliance. Our results provide the first empirical support for a relation of therapist use of Socratic questioning and symptom change in CT for depression.",25965026,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.203145027160645,-3.019224166870117,B903
"Norwegian general practitioners' perspectives on implementation of a guided web-based cognitive behavioral therapy for depression: a qualitative study.

Previous research suggests that Internet-based cognitive behavioral therapy (ICBT) has a positive effect on symptoms of depression. ICBT appears to be more effective with therapist support, but it is unclear what this support should comprise. General practitioners (GPs) have positive attitudes toward ICBT. However, ICBT is rarely used in regular care in general practice. More research is warranted to integrate the potential of ICBT as part of regular care. The aim of this study was to explore aspects perceived by GPs to affect the implementation of guided ICBT in daily practice. Understanding their perspectives may contribute to improving the treatment of depression in the context of general practice. A training package (3-day course) introducing a Norwegian translation of the ICBT program MoodGYM was developed and presented to GPs in Norway. Following training, GPs were asked to include guided ICBT in their regular care of patients with symptoms of depression by providing brief, face-to-face follow-up consultations between modules. We interviewed 11 GPs who had taken the course. Our interview guide comprised open questions that encouraged GPs to frame their responses using examples from their experiences when implementing ICBT. Thematic analysis was chosen to explore patterns across the data. An overall belief that ICBT would benefit both the patients' health and the GPs' own work satisfaction prompted the GPs to take the ICBT course. ICBT motivated them to invest time and effort in improving treatment. The most important motivating aspects in MoodGYM were that a program based on cognitive behavioral therapy could add a structured agenda to their consultations and empower depressed patients. Organizational aspects, such as a lack of time and varied practice, inhibited the use of ICBT. Inadequate knowledge, recalling the program, and changing own habits were also challenging. The GPs were ambivalent about whether ICBT had a negative impact on the doctor-patient interaction in the module follow-ups. Generally, GPs made an effort to recommend MoodGYM, but the expected module follow-ups were often not provided to patients and instead the GPs returned to standard treatment. GPs' feedback in the present study contribute to our understanding of the challenges of changing treatment for depression. Our findings indicated that recommending ICBT could add to the GP's toolkit. Offering training and highlighting the following aspects may increase recommendation of ICBT by GPs: (1) ICBT is theory-based and credible, (2) ICBT increases the GPs' work satisfaction by having a tool to offer, and (3) ICBT facilitates empowerment of patients in their own health. In addition, the present study also indicated that complex aspects must be accommodated before module follow-ups can be incorporated into GPs' treatment of depression.",25208886,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.724849700927734,-2.8354454040527344,CIk1
"Study protocol: a dissemination trial of computerized psychological treatment for depression and alcohol/other drug use comorbidity in an Australian clinical service.

The rise of the internet and related technologies has significant implications for the treatment of complex health problems, including the combination of depression and alcohol/other drug (AOD) misuse. To date, no research exists to test the real world uptake of internet and computer-delivered treatment programs in clinical practice. This study is important, as it is the first to examine the adoption of the SHADE treatment program, a DVD-based psychological treatment for depression and AOD use comorbidity, by clinicians working in a publicly-funded AOD clinical service. The study protocol that follows describes the methodology of this dissemination trial. 19 clinicians within an AOD service on the Central Coast of New South Wales, Australia, will be recruited to the trial. Consenting clinicians will participate in a baseline focus group discussion designed to explore their experiences and perceived barriers to adopting innovation in their clinical practice. Computer comfort and openness to innovation will also be assessed. Throughout the trial, current, new and wait-list clients will be referred to the research program via the clinical service, which will involve clients completing a baseline and 15-week follow-up clinical assessment with independent research assistants, comprising a range of mental health and AOD measures. Clinicians will also complete session checklists following each clinical session with a client, outlining the extent to which the SHADE computer program was used. Therapeutic alliance will be measured at intake and discharge from both the clinician and client perspectives. This study will provide comprehensive data on the factors associated with the adoption of an innovative, computer-delivered evidence-based treatment program, SHADE, by clinicians working in an AOD service. The results will contribute to the development of a model of dissemination of SHADE, which could be applied to a range of technological innovations. Australian Clinical Trial Registration Number: ACTRN12611000382976.",22770390,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.738359451293945,-3.8632493019104004,CrMw
"A naturalistic trial of brief psychodynamic therapy for recurrent major depression.

We examined disposition, course, and outcome for 100 outpatients offered short-term individual dynamic therapy as a primary treatment for recurrent major depression. Evaluations using the Hamilton Rating Scale for Depression (HAM-D) were conducted regularly during the year after referral. Patients failing to show a response (50% decrease in pre-treatment HAM-D scores) were referred for consultation regarding ""augmentation"" of therapy with antidepressant medication. Nineteen referrals failed to meet inclusion-exclusion criteria, reflecting therapist overestimation of the severity of patients' depressive symptoms; referring therapists also missed other salient clinical issues. Fourteen patients completed assessments but did not start therapy; ""decliners"" were more likely to report previous admissions and thus may have opted for hospitalization. Sixty-seven patients started therapy; 18 dropped out (26.9%). Of the 49 therapy completers, 23 (46.9%) did not receive augmented treatment; 20 (40.8%) demonstrated evidence of recovery during the year while 3 (6.1%) did not. Of the 26 patients (53.1%) prescribed antidepressants, 16 (32.7%) demonstrated evidence of recovery and 10 (20.4%) did not. Patient clusters also showed distinct trajectories of change on the HAM-D over the year after referral. Patients who received augmented treatment but showed no evidence of recovery scored significantly higher on indices of alexithymia. Clinical implications of the findings are considered.",23216401,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.416815757751465,-2.3593342304229736,Ck04
"Integrating Patients' Expectations into the Management of Their Depression: Report of a Symposium at the European College of Neuropsychopharmacology Congress.

A symposium held at the 31st European College of Neuropsychopharmacology congress in October 2018 in Barcelona, Spain discussed patients' expectations of treatment of their depression and how these can be integrated into patient management. Since treatment non-compliance is a major problem in patients suffering from depression, it is important to identify patients' expectations to improve treatment compliance and in turn efficacy. Currently, there is no established protocol for choosing the right antidepressant therapy, and physicians need to tailor the choice based on the type of depression, its predominant symptoms, medical and psychiatric history of patients, and their previous response to, and adverse events with, treatment. Treatment strategies also need to be adapted to each patient's personality/persona and their personal beliefs, and patients need to be aware of the potential for drug-associated adverse events such as emotional blunting, sexual dysfunction and loss of functional outcomes, as the expectation of these events may limit their impact on treatment discontinuation. Also, placebo effects remain frequent with treatment, and there is currently no agreed method for predicting response to therapy. Of the available methods to determine treatment response, pharmacogenetic testing has limited value while functional imaging may be valuable, but is not practical in routine clinical practice. Online cognitive behavioural therapy (CBT) represents a new option in the clinical management of patients with depression, particularly for patients who may not be able to access direct interaction with a psychotherapist because of the severity of their condition, their geographic location or socioeconomic situation. Online CBT can act as an adjunct to drug treatment and face-to-face psychotherapy, rather than as the sole form of treatment to aid in identifying a patient's needs, thus meeting the treatment gap and improving compliance and efficacy.Funding: Servier.",31399884,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.192983627319336,-2.283608913421631,A2QX
"Sudden gains and large intersession improvements in internet-based psychodynamic treatment (IPDT) for depressed adolescents.

Objective: Sudden gains (SGs) have often been found associated with better treatment outcome across different psychiatric disorders. However, no studies have evaluated SGs in internet-based treatment targeting adolescent depression. Method: The sample consisted of 66 adolescents diagnosed with major depressive disorder, attending psychodynamic internet-based treatment. Effects of SGs were evaluated at posttreatment and 6-month follow-up. We also evaluated effects of large intersession improvements (LIIs; sudden and relatively large gains, between sessions, without the stability criterion). Effects of SGs and LIIs early in treatment were also investigated. Results: A total of 17 patients (25.75%) experienced an SG. The effect of having an SG or early SG was non-significant after treatment (d=0.48) and at follow-up (d = 0.66). However, having an LII was related to better outcome after treatment (d=0.97) and at follow-up (d=0.76). Early LIIs were associated with significantly better results at end of treatment (d=0.72). Conclusions: The original criteria of SGs might be overly conservative and thus miss important improvements in depression. Relatively large intersession gains, regardless of stability, seem to be predictive of outcome.",32799772,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.917989730834961,-2.9039459228515625,AkKI
"Neuman Systems Model With Depressed Patients: A Randomized Controlled Trial.

To determine the effect of the coping with depression program, based on the Neuman systems model, on the coping strategies, self-esteem, and depression levels of depressed patients, a randomized controlled study was conducted. Two groups-intervention and control-were formed in the study. For the intervention group, individual psychoeducation based on the Neuman systems model and involving cognitive behavioral therapy techniques (coping with depression program) was administered at six sessions. Psychoeducation based on the Neuman systems model was effective in decreasing the level of depression, increasing the level of self-esteem, increasing problem-solving skills, encouraging individuals to seek social support for coping strategies, and decreasing the use of avoidance strategy.",32180528,Major Depressive Disorder,Anxiety Treatment,Mental Health,14949,11.512138366699219,-2.719071865081787,Ar2t
"Explaining variability in therapist adherence and patient depressive symptom improvement: The role of therapist interpersonal skills and patient engagement.

Understanding why therapists deviate from a treatment manual is crucial to interpret the mixed findings on the adherence-outcome association. The current study aims to examine whether therapists' interpersonal behaviours and patients' active engagement predict treatment outcome and therapist adherence in cognitive behaviour therapy (CBT) and mindfulness-based cognitive therapy (MBCT) for depressive symptoms. In addition, the study explores rater's explanations for therapist nonadherence at sessions in which therapist adherence was low. Study participants were 61 patients with diabetes and depressive symptoms who were randomized to either CBT or MBCT. Depressive symptoms were assessed by the Beck Depression Inventory-II. Therapist adherence, therapist interpersonal skills (i.e., empathy, warmth, and involvement), patients' active engagement, and reasons for nonadherence were assessed by two independent raters (based on digital video recordings). Therapist adherence, therapists' interpersonal skills, and patients' active engagement did not predict posttreatment depressive symptom reduction. Patients' active engagement was positively associated with therapist adherence in CBT and in MBCT. This indicates that adherence may be hampered when patients are not actively engaged in treatment. Observed reasons for nonadherence mostly covered responses to patient's in-session behaviour. The variety of reasons for therapist nonadherence might explain why therapist adherence was not associated with outcomes of CBT and MBCT.",30199135,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.863797187805176,-3.2981045246124268,BGZP
"A web-delivered care management and patient self-management program for recurrent depression: a randomized trial.

OBJECTIVE This study assessed the impact of an Internet-delivered care management and patient self-management program, eCare for Moods, on patients treated for recurrent or chronic depression. METHODS Patients with recurrent or chronic depression were randomly assigned to eCare (N=51) or usual specialty mental health care (N=52). The 12-month eCare program integrates with ongoing depression care, links to patients' electronic medical records, and provides clinicians with panel management and decision support. Participants were interviewed at baseline and six, 12, 18, and 24 months after enrollment. Telephone interviewers blind to treatment used a timeline follow-back method to estimate depression severity on a 6-point scale for each of the 105 study weeks (including the baseline). Differences between groups in weekly severity over two years were examined by generalized estimating equations. RESULTS Participants in eCare experienced more reduction in depressive symptoms (estimate=-.74 on the 6-point scale over two years; 95% confidence interval [CI]=-1.38 to -.09, p=.025) and were less often depressed (-.24 over two years; CI=-.46 to -.03, p=.026). At 24 months, 43% of eCare and 30% of usual-care participants were depression free; the number needed to treat to attain one additional depression-free participant was 8. eCare participants had other favorable outcomes: improved general mental health (p=.002), greater satisfaction with specialty care (p=.003) and with learning new coping skills (p&lt;.001), and more confidence in managing depression (p=.006). CONCLUSIONS Internet-delivered care management can help improve outcomes of patients treated for recurrent or chronic depression.",22983558,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,10.10982894897461,-3.7060890197753906,CoK3
"The Effectiveness of an Intensive Inpatient Psychotherapy Program for Chronic Depression: A naturalistic comparison with wait list.

Patients with chronic depression (CD) typically have an early symptom onset, more psychiatric comorbidities, more treatment attempts, and more frequent and longer inpatient hospitalizations than patients with major depressive disorders. The main purpose of this study was to investigate the effectiveness of an intensive inpatient psychotherapy program for patients with chronic depression (CD). The primary research question was whether two intensive psychodynamic inpatient treatments, affect phobia therapy (APT) and VITA, were superior to an outpatient wait list condition, receiving treatment as usual (TAU), at completion of treatment. To investigate if a potential difference between the intensive treatment and the wait list control group was dependent on a specific psychotherapeutic model, the study contrasted two therapies with similar intensity, but different theoretical rationales. Two hundred eighty patients with CD were included in a naturalistic study. Patients were assessed at four time points; assessment, start of therapy, end of therapy and 1-year follow-up. Three comparisons were performed with patients matched across groups; Intensive inpatient treatment program (APT + VITA) vs wait list during treatment, APT vs VITA during treatment and APT vs VITA during follow-up. The outcome measure was the BDI-II. Intensive inpatient treatment program vs. wait list showed a significant difference in favor of the intensive treatment. No significant differences were found between APT and VITA during therapy or follow-up; but both groups had large effect sizes during treatment, which were maintained during follow-up. The intensive inpatient psychotherapy program showed superior effect on chronic depression over an outpatient wait list condition receiving treatment as usual (TAU), but no significant differences were found between the two intensive inpatient psychodynamic treatments. The results provide support for the effectiveness of an intensive inpatient psychotherapy program in treatment of chronic and severe disorders, such as CD, which could be of benefit for policymakers and the health care sector as they are allocating recourses efficiently. This study has been retrospectively registered on ClinicalTrials.gov (NCT05221567) on February 3rd, 2022.",36451114,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,10.93001937866211,-2.6637392044067383,vA
"Response shifts in mental health interventions: an illustration of longitudinal measurement invariance.

The efficacy of treatments for depression is often measured by comparing observed total scores on self-report inventories, in both clinical practice and research. However, the occurrence of response shifts (changes in subjects' values, or their standards for measurement) may limit the validity of such comparisons. As most psychological treatments for depression are aimed at changing patients' values and frame of reference, response shifts are likely to occur over the course of such treatments. In this article, we tested whether response shifts occurred over the course of treatment in an influential randomized clinical trial. Using confirmatory factor analysis, measurement models underlying item scores on the Beck Depression Inventory (Beck & Beamesderfer, 1974) of the National Institute of Mental Health Treatment of Depression Collaborative Research Program (Elkin, Parloff, Hadley, & Autry, 1985) were analyzed. Compared with before treatment, after-treatment item scores appeared to overestimate depressive symptomatology, measurement errors were smaller, and correlations between constructs were stronger. These findings indicate a response shift, in the sense that participants seem to get better at assessing their level of depressive symptomatology. Comparing measurement models of patients receiving psychotherapy and medication suggested that the aforementioned effects were more apparent in the psychotherapy groups. Consequently, comparisons of observed total scores on self-report inventories may yield confounded measures of treatment efficacy.",23339313,Major Depressive Disorder,Anxiety Treatment,Mental Health,17729,11.15186595916748,-2.3286848068237305,Ci/P
"Effectiveness of a brief psychological mindfulness-based intervention for the treatment of depression in primary care: study protocol for a randomized controlled clinical trial.

Depressive symptoms are quite prevalent in Primary Care (PC) settings. The treatment as usual (TAU) in PC is pharmacotherapy, despite the high relapse rates it produces. Many patients would prefer psychotherapy, but specialized services are overloaded. Studies that apply Mindfulness-Based Interventions (MBIs) for the treatment of depression have obtained significant improvements. Brief low-intensity approaches delivered from PC could be a promising approach. This study aims to compare a low-intensity mindfulness intervention for the treatment of depression in PC using different intervention formats - a face-to-face MBI delivered in a group and the same MBI individually applied on the Internet - to a control group that will receive PC medical treatment as usual. A randomized controlled clinical trial will be conducted in PC, with about 120 depressed patients allocated (1:1:1) to three groups: ""face-to-face MBI+TAU"", ""Internet-delivered MBI+TAU"", and ""TAU alone"". The MBI programs will be composed of four modules. The primary outcome will be depressive symptoms, measured through the Beck Depression Inventory, assessed at pre- and post-treatment and 6- and 12-month follow-ups. Other outcomes will be mindfulness, happiness, affectivity, quality of life, and the use of healthcare services. Intention-to-treat analysis using linear mixed models adjusted for baseline scores and routine sociodemographic analysis that could show baseline differences will be conducted. Per-protocol secondary outcome analyses will also be performed. This is the first Spanish RCT to apply a low-intensity face-to-face MBI (plus TAU) to treat depression in PC settings compared to TAU (alone). Moreover, this study will also make it possible to evaluate the same MBI program (plus TAU), but Internet-delivered, considering their cost-effectiveness. Positive results from this RCT might have an important impact on mental health settings, helping to decrease the overload of the system and offering treatment alternatives beyond antidepressant medication through high-quality, flexible PC interventions. Clinical Trials.gov NCT03034343 . Trial Registration date 24 January 2017, retrospectively registered.",31619196,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.927310943603516,-2.0597634315490723,AzV3
"Improving the efficiency of psychological treatment using outcome feedback technology.

This study evaluated the impact of applying computerized outcome feedback (OF) technology in a stepped care psychological service offering low and high intensity therapies for depression and anxiety. A group of therapists were trained to use OF based on routine outcome monitoring using depression (PHQ-9) and anxiety (GAD-7) measures. Therapists regularly reviewed expected treatment response graphs with patients and discussed cases that were ""not on track"" in clinical supervision. Clinical outcomes data were collected for all patients treated by this group (N = 594), six months before (controls = 349) and six months after the OF training (OF cases = 245). Symptom reductions in PHQ-9 and GAD-7 were compared between controls and OF cases using longitudinal multilevel modelling. Treatment duration and costs were compared using MANOVA. Qualitative interviews with therapists (N = 15) and patients (N = 6) were interpreted using thematic analysis. OF technology was generally acceptable and feasible to integrate in routine practice. No significant between-group differences were found in post-treatment PHQ-9 or GAD-7 measures. However, OF cases had significantly lower average duration and cost of treatment compared to controls. After adopting OF into their practice, this group of therapists attained similar clinical outcomes but within a shorter space of time and at a reduced average cost per treatment episode. We conclude that OF can improve the efficiency of stepped care.",29024821,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,8.743358612060547,-5.96162748336792,BVtk
"Time to improve and recover from depressive symptoms and interpersonal problems in a clinical trial.

Results from an earlier clinical trial comparing narrative therapy with cognitive-behavioural therapy (Lopes et al., 2013) suggested that narrative therapy is efficacious for depression. However, there were significant differences in symptom reduction on the Beck Depression Inventory-II, favouring cognitive-behavioural therapy, if dropouts were included in the analysis, suggesting that time to recovery or improvement would differ in both treatments. Contrarily, results showed that treatment assignment was not a predictor for differential effect. Using a survival analytic approach, it was found that four sessions were necessary for 50% improvement and 16 sessions for 50% recovery. Additionally, depressive symptoms changes occurred significantly faster than interpersonal changes, again regardless of treatment assignment. These results support previous findings of the dose-response literature and of the phase model of change, with the advantage of being specific to psychotherapy with depressive clients.",24166937,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.601082801818848,-3.3775508403778076,CW0v
"Urinary catecholamine levels and response to group cognitive behaviour therapy in depression.

The aim was to investigate whether high catecholamine (CA) excreters would respond less well to a group cognitive behaviour therapy (CBT) treatment for depression than others. A sample of 70 adults with depression symptoms participated in a 12-week course of group CBT. Participants' 24 hour urinary catecholamine levels at pre-therapy and post-therapy were used to classify them as High (N = 10); Low (N = 33) or Mixed (N = 27) according to a cut-off one standard deviation above a published mean for healthy adults. Beck Depression Inventory (BDI) and cognitions questionnaire (Automatic Thoughts Questionnaire; Beck Hopelessness Scale and Dysfunctional Attitudes Scale) were used. Repeated measures ANOVA analyses showed an equal rate of mood improvement in all three groups over the course of CBT, despite the fact that the High excreters were on average more depressed throughout the study. Changes in depression symptoms were mirrored by improvements in cognitive measures in the three catecholamine groups. This study indicates that adults showing a biological marker of depression (elevated catecholamine levels) are equally able to benefit from CBT treatment as adults without this marker.",20338081,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.35763168334961,-2.6569058895111084,DMYw
"A ruffled mind makes a restless pillow: reducing depression incidence and severity with dCBT-I.

",32805031,Major Depressive Disorder,Anxiety Treatment,Mental Health,358,14.724982261657715,-1.5716116428375244,AkFx
"Is It All about the Higher Dose? Why Psychoanalytic Therapy Is an Effective Treatment for Major Depression.

Empirical evidence for the effectiveness of long-term psychodynamic psychotherapy (LTPP) in patients with mood disorders is growing. However, it is unclear whether the effectiveness of LTPP is due to distinctive features of psychodynamic/psychoanalytic techniques or to a higher number of sessions. We tested these rival hypotheses in a quasi-experimental study comparing psychoanalytic therapy (i.e., high-dose LTPP) with psychodynamic therapy (i.e., low-dose LTPP) and cognitive-behavioural therapy (CBT) for depression. Analyses were based on a subsample of 77 subjects, with 27 receiving psychoanalytic therapy, 26 receiving psychodynamic therapy and 24 receiving CBT. Depressive symptoms, interpersonal problems and introject affiliation were assessed prior to treatment, after treatment and at the 1-, 2- and 3-year follow-ups. Psychoanalytic techniques were assessed from three audiotaped middle sessions per treatment using the Psychotherapy Process Q-Set. Subjects receiving psychoanalytic therapy reported having fewer interpersonal problems, treated themselves in a more affiliative way directly after treatment and tended to improve in depressive symptoms and interpersonal problems during follow-up as compared with patients receiving psychodynamic therapy and/or CBT. Multilevel mediation analyses suggested that post-treatment differences in interpersonal problems and introject affiliation were mediated by the higher number of sessions, and follow-up differences in depressive symptoms were mediated by the more pronounced application of psychoanalytic techniques. We also found some evidence for indirect treatment effects via psychoanalytic techniques on changes in introject affiliation during follow-up. These results provide support for the prediction that both a high dose and the application of psychoanalytic techniques facilitate therapeutic change in patients with major depression. Psychoanalytic therapy is an effective treatment for major depression, especially in the long run. The differential effectiveness of psychoanalytic therapy cannot be fully explained by its higher dose. Distinctive features of psychoanalytic technique (e.g., focusing on patients' dreams, fantasies, sexual experiences or childhood memories) may play an important role in establishing sustained therapeutic change.",25196642,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.913212776184082,-4.0316643714904785,CIui
"Cost-effectiveness of Community-Based Depression Interventions for Rural and Urban Adults With Type 2 Diabetes: Projections From Program ACTIVE (Adults Coming Together to Increase Vital Exercise) II.

We estimated the cost-effectiveness of the Program ACTIVE (Adults Coming Together to Increase Vital Exercise) II community-based exercise (EXER), cognitive behavioral therapy (CBT), and EXER+CBT interventions in adults with type 2 diabetes and depression relative to usual care (UC) and each other. Data were integrated into the Michigan Model for Diabetes to estimate cost and health outcomes over a 10-year simulation time horizon from the health care sector and societal perspectives, discounting costs and benefits at 3% annually. Primary outcome was cost per quality-adjusted life-year (QALY) gained. From the health care sector perspective, the EXER intervention strategy saved $313 (USD) per patient and produced 0.38 more QALY (cost saving), the CBT intervention strategy cost $596 more and gained 0.29 more QALY ($2,058/QALY), and the EXER+CBT intervention strategy cost $403 more and gained 0.69 more QALY ($585/QALY) compared with UC. Both EXER and EXER+CBT interventions dominated the CBT intervention. Compared with EXER, the EXER+CBT intervention strategy cost $716 more and gained 0.31 more QALY ($2,323/QALY). From the societal perspective, compared with UC, the EXER intervention strategy saved $126 (cost saving), the CBT intervention strategy cost $2,838/QALY, and the EXER+CBT intervention strategy cost $1,167/QALY. Both EXER and EXER+CBT interventions still dominated the CBT intervention. In comparison with EXER, the EXER+CBT intervention strategy cost $3,021/QALY. Results were robust in sensitivity analyses. All three Program ACTIVE II interventions represented a good value for money compared with UC. The EXER+CBT intervention was highly cost-effective or cost saving compared with the CBT or EXER interventions.",33608260,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,9.332182884216309,-3.2083873748779297,Aajy
"Internet-delivered cognitive control training as a preventive intervention for remitted depressed patients: Protocol for a randomized controlled trial.

Preventing recurrence of depression forms an important challenge for current treatments. Cognitive control impairments often remain present during remission of depression, putting remitted depressed patients at heightened risk for new depressive episodes by disrupting emotion regulation processes. Importantly, research indicates that cognitive control training targeting working memory functioning shows potential in reducing maladaptive emotion regulation and depressive symptomatology in clinically depressed patients and at-risk student samples. The current study aims to test the effectiveness of cognitive control training as a preventive intervention in a remitted depressed sample, exploring effects of cognitive control training on rumination and depressive symptomatology, along with indicators of adaptive emotion regulation and functioning. We present a double blind randomized controlled design. Remitted depressed adults will complete 10 online sessions of a cognitive control training targeting working memory functioning or a low cognitive load training (active control condition) over a period of 14 days. Effects of training on primary outcome measures of rumination and depressive symptomatology will be assessed pre-post training and at three months follow-up, along with secondary outcome measure adaptive emotion regulation. Long-term effects of cognitive control training on broader indicators of functioning will be assessed at three months follow-up (secondary outcome measures). This study will provide information about the effectiveness of cognitive control training for remitted depressed adults in reducing vulnerability for depression. Furthermore, this study will address key questions concerning the mechanisms underlying the effects of cognitive control training, will take into account the subjective experience of the patients (including a self-report measure for cognitive functioning), and explore whether these effects extend to broad measures of functioning such as Quality of Life and disability. This study is registered with ClinicalTrials.Gov, number NCT02407652 .",26055122,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.498756408691406,-0.6497660279273987,B8k6
"Predictors of response in the treatment of moderate depression.

To identify neurocognitive and sociodemographic variables that could be associated with clinical response to three modalities of treatment for depression, as well as variables that predicted superior response to one treatment over the others. The present study derives from a research project in which depressed patients (n=272) received one of three treatments - long-term psychodynamic psychotherapy (n=90), fluoxetine therapy (n=91), or a combination thereof (n=91) - over a 24-month period. Sociodemographic variables were not found to be predictive. Six predictive neurocognitive variables were identified: three prognostic variables related to working memory and abstract reasoning; one prescriptive variable related to working memory; and two variables found to be moderators. The results of this study indicate subgroups of patients who might benefit from specific therapeutic strategies and subgroups that seem to respond well to long-term psychodynamic psychotherapy and combined therapy. The moderators found suggest that abstract reasoning and processing speed may influence the magnitude and/or direction of clinical improvement.",27901214,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.966156005859375,-1.7910456657409668,BkBh
"Enduring effects of evidence-based psychotherapies in acute depression and anxiety disorders versus treatment as usual at follow-up--a longitudinal meta-analysis.

This meta-analysis examined the enduring efficacy of evidence-based psychotherapies (EBP) in comparison to treatment as usual (TAU) by examining effects from termination to follow-up for acute anxiety and depression in an adult outpatient population. It was hypothesized that EBPs might extend their efficacy at follow-up assessment (Tolin, 2010). Longitudinal multilevel meta-analyses were conducted that examined the magnitude of difference between EBP and TAU. Targeted (disorder-specific) outcomes were examined, along with dropout rates at follow-up assessments. A total of 15 comparisons (including 30 repeated effect sizes [ES]) were included in this meta-analysis (average of 8.9 month follow-up). Small to moderate ES differences were found to be in favor of EBPs at 0-4 month assessments (Hedges' g=0.40) and up to 12-18 month assessments (g=0.20), indicating no extended efficacy at follow-up. However, the TAU-conditions were heterogeneous, ranging from absence of minimal mental health treatment to legitimate psychotherapeutic interventions provided by trained professionals, the latter of which resulted in smaller ES differences. Furthermore, samples where substance use comorbidities were not actively excluded indicated smaller ES differences. TAU-conditions produced slightly higher dropout rates than EBP-conditions. Findings indicate small and no extended superiority of EBP for acute depression and anxiety disorders in comparison to TAU at follow-up assessment. There are a limited number of studies investigating the transportability and lasting efficacy of EBP compared to TAU, especially to TAU with equivalent conditions between treatment groups.",24927168,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.987714767456055,-3.0040435791015625,CMqM
"The process of change in cognitive therapy for depression: predictors of early inter-session symptom gains.

Although cognitive therapy for depression is an efficacious treatment, questions about the aspects of the therapy that are most critical to successful implementation remain. In a sample of 60 cognitive therapy patients with moderate to severe depression, we examined three aspects of therapists' adherence to cognitive therapy techniques, the patients' facilitation or inhibition of these techniques, and the therapeutic alliance as predictors of session-to-session symptom improvement across the first five therapy sessions. Two elements of therapist adherence (viz., cognitive methods and negotiating content/structuring sessions) emerged as the strongest predictors of symptom improvement. Patient facilitation or inhibition of therapist adherence also predicted subsequent symptom change. Neither adherence to behavioral methods/homework nor the therapeutic alliance was a significant predictor in parallel analyses. Although alliance scores did not predict subsequent symptom change, they were significantly predicted by prior symptom change. These findings support the model of change that motivates cognitive therapy for depression, and they highlight the potential role of patient facilitation of therapists' adherence in treatment response.",20362978,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.914651870727539,-3.2531769275665283,DMHm
"Effects of Intensive Short-Term Dynamic Psychotherapy on Depressive Symptoms and Executive Functioning in Major Depression.

This study examined the efficacy of intensive short-term dynamic psychotherapy (ISTDP) on depressive symptoms and executive functioning in patients with major depression. We examined pretest, posttest, and follow-up depression scores as well as pretest-posttest executive functioning scores between 16 participants receiving ISTDP and 16 allocated to wait-list control. Participants in each group were matched according to age, sex, and educational level. Mixed-models analyses demonstrated significant interaction effects of group and time on depression scores when the group ISTDP was compared with the wait-list control group; participants receiving ISTDP had significantly reduced depression severity both after treatment and at follow-up. Next, a series of hierarchical regression models demonstrated modest improvements on most tests of executive functioning in participants receiving ISTDP. Depressed patients receiving ISTDP show a sustained reduction in depression severity after treatment and after 12-month follow-up and improvements in executive functioning after treatment compared with a wait-list control.",27065106,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.14255428314209,-4.063261032104492,BuZk
"Effectiveness of psychotherapy for treatment-resistant depression: a meta-analysis and meta-regression.

Despite substantial advances in treatment and management strategies for major depression, less than 50% of patients respond to first-line antidepressant treatment or psychotherapy. Given the growing number of controlled studies of psychotherapy for treatment-resistant depression (TRD) and the preference for psychotherapy of depressed subjects as a treatment option, we conducted a meta-analysis and meta-regression analysis to investigate the effectiveness of psychotherapy for TRD. Seven different psychotherapies were studied in 21 trials that included a total of 25 comparisons. In three comparisons of psychotherapy v. treatment as usual (TAU) we found no evidence to conclude that there is a significant benefit of psychotherapy as compared with TAU. In 22 comparisons of add-on psychotherapy plus TAU v. TAU only, we found a moderate general effect size of 0.42 (95% CI 0.29-0.54) in favor of psychotherapy plus TAU. The meta-regression provided evidence for a positive association between baseline severity as well as group v. individual therapy format with the treatment effect. There was no evidence for publication bias. Most frequent investigated treatments were cognitive behavior therapy, interpersonal psychotherapy, mindfulness-based cognitive therapy, and cognitive behavioral analysis system of psychotherapy. Our meta-analysis provides evidence that, in addition to pharmacological and neurostimulatory treatments, the inclusion of add-on of psychotherapy to TAU in guidelines for the treatment of TRD is justified and will provide better outcomes for this difficult-to-treat population.",30139408,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.490532875061035,-2.2761919498443604,BHJv
"Effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression: a study protocol for a systematic review and meta-analysis of randomised controlled trials.

Many studies have explored the impact of lifestyle interventions on depression. However, little is known about the effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression. Our objective is to assess the effectiveness of complex multiple-risk lifestyle interventions in reducing depressive symptoms in the adult population by the acquisition of at least two healthy habits-healthy diet, physical activity and/or smoking cessation. For such purpose, a systematic review and meta-analysis of randomised controlled trials will be conducted. MEDLINE (through Ovid and PubMed), Scopus, Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO, OpenGrey Register (System for Information on Grey Literature in Europe) and the International Clinical Trials Registry Platform will be searched for relevant articles. Additionally, a supplementary manual search will be performed using lists of references, references to expert authors and other systematic reviews and/or meta-analyses. Study selection, data extraction (target habits, country, target populations, conditions and statistical data to name a few) and assessment of the risk of bias will be performed separately by two independent researchers. The primary outcome measure will be the reduction of depression symptoms, as measured by validated instruments. We will calculate pooled standardised mean differences and 95% CIs using random-effect models. Heterogeneity, sensitivity and publication bias will be assessed, and sub-group analysis will be performed. Heterogeneity will be explored by random-effects meta-regression analysis. Ethical approval is not required for this study. The results of this systematic review and meta-analysis will be presented in relevant conferences and published in a peer-review journal. The findings of this study could have important clinical and scientific implications for the improvement of symptoms of depression. CRD42018100253; Pre-results.",30878992,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,9.149064064025879,-1.9843776226043701,A9Uh
"Economic evaluation of a dietary intervention for adults with major depression (the ""SMILES"" trial).

Recently, the efficacy of dietary improvement as a therapeutic intervention for moderate to severe depression was evaluated in a randomised controlled trial. The SMILES trial demonstrated a significant improvement in Montgomery-Åsberg Depression Rating Scale scores favouring the dietary support group compared with a control group over 12 weeks. We used data collected within the trial to evaluate the cost-effectiveness of this novel intervention. In this prospective economic evaluation, sixty-seven adults meeting DSM-IV criteria for a major depressive episode and reporting poor dietary quality were randomised to either seven sessions with a dietitian for dietary support or to an intensity matched social support (befriending) control condition. The primary outcome was Quality Adjusted Life Years (QALYs) as measured by the AQoL-8D, completed at baseline and 12 week follow-up (endpoint) assessment. Costs were evaluated from health sector and societal perspectives. The time required for intervention delivery was costed using hourly wage rates applied to the time in counselling sessions. Food and travel costs were also included in the societal perspective. Data on medications, medical services, workplace absenteeism and presenteesim (paid and unpaid) were collected from study participants using a resource-use questionnaire. Standard Australian unit costs for 2013/2014 were applied. Incremental cost-effectiveness ratios (ICERs) were calculated as the difference in average costs between groups divided by the difference in average QALYs. Confidence intervals were calculated using a non-parametric bootstrap procedure. Compared with the social support condition, average total health sector costs were $856 lower (95% CI -1247 to -160) and average societal costs were $2591 lower (95% CI -3591 to -198) for those receiving dietary support. These differences were driven by lower costs arising from fewer allied and other health professional visits and lower costs of unpaid productivity. Significant differences in mean QALYs were not found between groups. However, 68 and 69% of bootstrap iterations showed the dietary support intervention was dominant (additional QALYs at less cost) from the health sector and societal perspectives. This novel dietary support intervention was found to be likely cost-effective as an adjunctive treatment for depression from both health sector and societal perspectives. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000251820 . Registered on 29 February 2012.",29783983,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,8.870222091674805,-3.2276337146759033,BLfx
"Protocol for a randomized controlled dismantling study of an internet-based intervention for depressive symptoms: exploring the contribution of behavioral activation and positive psychotherapy strategies.

There are evidence-based interventions for depression that include different components. However, the efficacy of their therapeutic components is unknown. Another important issue related to depression interventions is that, up to now, their therapeutic components have only focused on reducing negative symptoms rather than on improving positive affect and well-being. Because the low levels of positive affect are more strongly linked to depression than to other emotional disorders, it is important to include this variable as an important treatment target. Positive psychotherapeutic strategies (PPs) could help in this issue. The results obtained so far are consistent and promising, showing that Internet-based interventions are effective in treating depression. However, most of them are also multi-component, and it is important to make progress in investigating what each component contributes to the intervention. The current study will be a three-armed, simple-blinded, randomized controlled clinical trial with a dismantling design. 192 participants will be randomly assigned to: a) an Internet-based Global Protocol condition, which includes traditional therapeutic components of evidence-based treatments for depression (Motivation for change, Psychoeducation, Cognitive Therapy, Behavioral Activation (BA), Relapse Prevention) and PPs component, offering strategies to enhance positive mood and promote psychological strengths; b) an Internet-based BA Protocol condition (without the PPs component), and c) an Internet-based PPs Protocol condition (without the BA component). Primary outcome measures will be the BDI-II and PANAS. Secondary outcomes will include other variables such as depression, anxiety and stress, quality of life, resilience, and wellbeing related measures. Treatment acceptance and usability will also be measured. Participants will be assessed at pre-, post-treatment, 3-, 6- and 12- month follow- ups. The data will be analyzed based on the Intention-to-treat principle. Per protocol analyses will also be performed. To the best of our knowledge, this is the first randomized dismantling intervention study for depression with the aim of exploring the contribution of a PPs component and the BA component in an Internet-based intervention. The three protocols are online interventions, helping to reach many people who need psychological treatments and otherwise would not have access to them. Clinicalstrials.gov as NCT03159715 . Registered 19 May 2017.",31053067,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.40212631225586,-2.9007108211517334,A7AB
"The relationship between the therapeutic alliance and treatment outcome in two distinct psychotherapies for chronic depression.

This study tested whether the quality of the patient-rated working alliance, measured early in treatment, predicted subsequent symptom reduction in chronically depressed patients. Secondarily, the study assessed whether the relationship between early alliance and response to treatment differed between patients receiving cognitive behavioral analysis system of psychotherapy (CBASP) vs. brief supportive psychotherapy (BSP). 395 adults (57% female; Mage = 46; 91% Caucasian) who met criteria for chronic depression and did not fully remit during a 12-week algorithm-based, open-label pharmacotherapy trial were randomized to receive either 16-20 sessions of CBASP or BSP in addition to continued, algorithm-based antidepressant medication. Of these, 224 patients completed the Working Alliance Inventory-Short Form at Weeks 2 or 4 of treatment. Blind raters assessed depressive symptoms at 2-week intervals across treatment using the Hamilton Rating Scale for Depression. Linear mixed models tested the association between early alliance and subsequent symptom ratings while accounting for early symptom change. A more positive early working alliance was associated with lower subsequent symptom ratings in both the CBASP and BSP, F(1, 1236) = 62.48, p < .001. In addition, the interaction between alliance and psychotherapy type was significant, such that alliance quality was more strongly associated with symptom ratings among those in the CBASP treatment group, F(1, 1234) = 8.31, p = .004. The results support the role of the therapeutic alliance as a predictor of outcome across dissimilar treatments for chronic depression. Contrary to expectations, the therapeutic alliance was more strongly related to outcome in CBASP, the more directive of the 2 therapies.",23339536,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,13.73406982421875,-6.459906578063965,Ci+4
"A randomised controlled trial of Intensive Short-Term Dynamic Psychotherapy for treatment resistant depression: the Halifax Depression Study.

While short-term psychodynamic psychotherapies have been shown effective for major depression, it is unclear if this could be a treatment of choice for depressed patients, many of whom have chronic and complex health issues, who have not sufficiently responded to treatment. This superiority trial used a single blind randomised parallel group design to test the efficacy of time-limited Intensive Short-Term Dynamic Psychotherapy (ISTDP) for treatment resistant depression (TRD). Patients referred to secondary care community mental health teams (CMHT) who met DSM-IV criteria for major depressive episode, had received antidepressant treatment ≥6 weeks, and had Hamilton Depression Rating Scale (HAM-D) scores of ≥16 were recruited. The effects of 20 sessions of ISTDP were judged through comparison against secondary care CMHT treatment as usual (TAU). The primary outcome was HAM-D scores at 6 months. Secondary outcomes included the Patient Health Questionnaire (PHQ-9) self-report measures for depression and dichotomous measures of both remission (defined as HAM-D score ≤7) and partial remission (defined as HAM-D score ≤12). Sixty patients were randomised to 2 groups (ISTDP=30 and TAU=30), with data collected at baseline, 3, and 6 months. Multi-level linear regression modelling showed that change over time on both depression scales was significantly greater in the ISTDP group in comparison to TAU. Statistically significant between-group treatment differences, in the moderate to large range, favouring ISTDP, were observed on both the observer rated (Cohen's d=0.75) and self-report measures (Cohen's d=0.85) of depression. Relative to TAU, patients in the ISTDP group were significantly more likely after 6 months to achieve complete remission (36.0% vs. 3.7%) and partial remission (48.0% vs. 18.5%). It is unclear if the results are generalizable to other providers, geographical locations and cultures. Time-limited ISTDP appears an effective treatment option for TRD, showing large advantages over routine treatment delivered by secondary care services.",28266318,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.082511901855469,-4.07242488861084,Bf7Y
"ACP Journal Club. In treatment-resistant depression, adding cognitive-behavioral therapy to usual care was cost-effective at 1 y.

",24935507,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,10.697021484375,-2.7248103618621826,CMhc
"Facebook enhances antidepressant pharmacotherapy effects.

Treatment-resistant major depressive disorder (TR-MDD) is a complex condition, with very low remission rates. In recent years some studies have been conducted on the implementation of cognitive behavioral therapy and psychodynamic psychotherapy interventions via the Internet to MDD patients, and results have been promising. However, there have been no studies in patients with TR-MDD nor with the use of Facebook with the psychiatrist as ""friend."" 60 TR-MDD patients were randomized to one of three groups: Facebook group with psychiatrist as ""friend,"" Facebook group without psychiatrist as ""friend,"" and control group (no Facebook use). Both Facebook groups spent at least 1 hour/day on Facebook, 7 days/week, during the 3 months. All patients maintained their usual pharmacotherapy. All participants were evaluated at baseline and at 1, 2, and 3 months for depressive symptoms using HAD17 and BDI-II. Results show that both Facebook groups had a decrease on HADM17 and BDI-II scores as well as higher remission and response rates than the control group, with better results if the psychiatrist was a ""friend"" on Facebook. Therefore, in TR-MDD, Facebook can be used as an effective enhancement therapy, adjuvant to pharmacological therapy with regular consultations, especially if the psychiatrist is the patient's online ""friend.""",24574930,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.735976219177246,-1.7634154558181763,CRo6
"Journal Watch review of Short-term dynamic psychotherapy versus pharmacotherapy for major depressive disorder: a randomized, placebo-controlled trial.

",24610762,Major Depressive Disorder,Anxiety Treatment,Mental Health,8564,11.4976806640625,-3.085325002670288,CRJ2
"Randomized Trial of Interpersonal Psychotherapy and Cognitive Behavioral Therapy for Major Depressive Disorder in a Community-Based Psychiatric Outpatient Clinic.

Interpersonal psychotherapy (IPT) and cognitive behavioral therapy (CBT) are both evidence-based treatments for major depressive disorder (MDD). Several head-to-head comparisons have been made, mostly in the United States. In this trial, we compared the two treatments in a small-town outpatient psychiatric clinic in Sweden. The patients had failed previous primary care treatment and had extensive Axis-II comorbidity. Outcome measures were reduction of depressive symptoms and attrition rate. Ninety-six psychiatric patients with MDD (DSM-IV) were randomized to 14 sessions of CBT (n = 48) or IPT (n = 48). A noninferiority design was used with the hypothesis that IPT would be noninferior to CBT. A three-point difference on the Beck Depression Inventory-II (BDI-II) was used as noninferiority margin. IPT passed the noninferiority test. In the ITT group, 53.5% (23/43) of the IPT patients and 51.0% (24/47) of the CBT patients were reliably improved, and 20.9% (9/43) and 19.1% (9/47), respectively, were recovered (last BDI score <10). The dropout rate was significantly higher in CBT (40%; 19/47) compared to IPT (19%; 8/43). Statistically controlling for antidepressant medication use did not change the results. IPT was noninferior to CBT in a sample of depressed psychiatric patients in a community-based outpatient clinic. CBT had significantly more dropouts than IPT, indicating that CBT may be experienced as too demanding. Since about half the patients did not recover, there is a need for further treatment development for these patients. The study should be considered an effectiveness trial, with strong external validity but some limitations in internal validity.",27029912,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.368879318237305,-3.2603042125701904,Bu7A
"A positive psychology intervention for patients with bipolar depression: a randomized pilot trial.

Background: There are few effective treatments for bipolar depression, a common and debilitating illness.Aims: We aimed to examine the feasibility and preliminary efficacy of a four-week, telephone-delivered positive psychology (PP) intervention for patients with bipolar depression.Methods: Twenty-five patients hospitalized for bipolar depression were randomized to receive a PP (n=14) or control condition (CC; n=11) intervention. Following discharge, participants completed weekly exercises and phone calls with a study trainer. PP intervention feasibility was assessed by the number of exercises completed, and acceptability was examined on five-point Likert-type scales of ease and utility. Between-group differences on psychological constructs at 4 and 8 weeks post-enrollment were assessed using mixed effects regression models.Results: Participants in the PP group completed an average of three out of four PP exercises and found PP exercises to be subjectively helpful, though neither easy nor difficult. Compared to CC, the PP intervention led to trends towards greater improvements in positive affect and optimism at follow-up, with large effect sizes (modified Cohen's d=0.95-1.24). PP had variable, non-significant effects on negative psychological constructs.Conclusions: Larger, randomized trials are needed to further evaluate the efficacy of this intervention in this high-risk population.",30366513,Major Depressive Disorder,Anxiety Treatment,Mental Health,12459,11.318174362182617,-0.6976633667945862,BEK1
"Couple and family interventions for depressive and bipolar disorders: Evidence base update (2010-2019).

This article systematically reviews the evidence base for couple and family interventions for depressive and bipolar disorders published from 2010 to 2019. Included in the review were intervention studies on depression for couples (n = 6), depression for families (n = 13), and bipolar for families (n = 5); zero studies on couple interventions for bipolar were located. Well-established interventions include cognitive and/or behavioral couple and family interventions for depression and psychoeducational family interventions for bipolar. Attachment-based couple and family interventions for depression are probably efficacious. Finally, family psychoeducation for depression is possibly efficacious, and integrative couple interventions and family play-based interventions for depression are experimental. Couple and family interventions also improved relationship dynamics, which is noteworthy since poor relationships are associated with non-remission, relapse, and recurrence of depressive and bipolar symptoms. Future research is needed on couple interventions for bipolar disorders and interventions for minoritized populations.",34750834,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,11.822545051574707,-1.0704268217086792,4Oc
"[Family psychoeducation for affective disorders].

The aim of this article was to examine the evidence of family psychoeducation (FPE) for affective disorders. Evidence indicates that FPE can be an effective supplement to the standard treatment of patients with affective disorders. FPE can effectively reduce the patients' risk of relapse and reduce the burden experienced by the relatives. However, current studies are very heterogeneous and therefore difficult to compare. Up to this point the evidence regarding the effect of FPE on unipolar depression is still very sparse and further research is needed.",28504623,Major Depressive Disorder,Anxiety Treatment,Mental Health,1033,10.995941162109375,-3.5643908977508545,BclE
"Interventions to improve return to work in depressed people.

Work disability such as sickness absence is common in people with depression. To evaluate the effectiveness of interventions aimed at reducing work disability in employees with depressive disorders. We searched CENTRAL (The Cochrane Library), MEDLINE, Embase, CINAHL, and PsycINFO until April 4th 2020. We included randomised controlled trials (RCTs) and cluster-RCTs of work-directed and clinical interventions for depressed people that included days of sickness absence or being off work as an outcome. We also analysed the effects on depression and work functioning. Two review authors independently extracted the data and rated the certainty of the evidence using GRADE. We used standardised mean differences (SMDs) or risk ratios (RR) with 95% confidence intervals (CI) to pool study results in studies we judged to be sufficiently similar. MAIN RESULTS: In this update, we added 23 new studies. In total, we included 45 studies with 88 study arms, involving 12,109 participants with either a major depressive disorder or a high level of depressive symptoms. Risk of bias The most common types of bias risk were detection bias (27 studies) and attrition bias (22 studies), both for the outcome of sickness absence. Work-directed interventions Work-directed interventions combined with clinical interventions A combination of a work-directed intervention and a clinical intervention probably reduces days of sickness absence within the first year of follow-up (SMD -0.25, 95% CI -0.38 to -0.12; 9 studies; moderate-certainty evidence). This translates back to 0.5 fewer (95% CI -0.7 to -0.2) sick leave days in the past two weeks or 25 fewer days during one year (95% CI -37.5 to -11.8). The intervention does not lead to fewer persons being off work beyond one year follow-up (RR 0.96, 95% CI 0.85 to 1.09; 2 studies, high-certainty evidence). The intervention may reduce depressive symptoms (SMD -0.25, 95% CI -0.49 to -0.01; 8 studies, low-certainty evidence) and probably has a small effect on work functioning (SMD -0.19, 95% CI -0.42 to 0.06; 5 studies, moderate-certainty evidence) within the first year of follow-up. Stand alone work-directed interventions A specific work-directed intervention alone may increase the number of sickness absence days compared with work-directed care as usual (SMD 0.39, 95% CI 0.04 to 0.74; 2 studies, low-certainty evidence) but probably does not lead to more people being off work within the first year of follow-up (RR 0.93, 95% CI 0.77 to 1.11; 1 study, moderate-certainty evidence) or beyond (RR 1.00, 95% CI 0.82 to 1.22; 2 studies, moderate-certainty evidence). There is probably no effect on depressive symptoms (SMD -0.10, 95% -0.30 CI to 0.10; 4 studies, moderate-certainty evidence) within the first year of follow-up and there may be no effect on depressive symptoms beyond that time (SMD 0.18, 95% CI -0.13 to 0.49; 1 study, low-certainty evidence). The intervention may also not lead to better work functioning (SMD -0.32, 95% CI -0.90 to 0.26; 1 study, low-certainty evidence) within the first year of follow-up. Psychological interventions A psychological intervention, either face-to-face, or an E-mental health intervention, with or without professional guidance, may reduce the number of sickness absence days, compared with care as usual (SMD -0.15, 95% CI -0.28 to -0.03; 9 studies, low-certainty evidence). It may also reduce depressive symptoms (SMD -0.30, 95% CI -0.45 to -0.15, 8 studies, low-certainty evidence). We are uncertain whether these psychological interventions improve work ability (SMD -0.15 95% CI -0.46 to 0.57; 1 study; very low-certainty evidence). Psychological intervention combined with antidepressant medication Two studies compared the effect of a psychological intervention combined with antidepressants to antidepressants alone. One study combined psychodynamic therapy with tricyclic antidepressant (TCA) medication and another combined telephone-administered cognitive behavioural therapy (CBT) with a selective serotonin reuptake inhibitor (SSRI). We are uncertain if this intervention reduces the number of sickness absence days (SMD -0.38, 95% CI -0.99 to 0.24; 2 studies, very low-certainty evidence) but found that there may be no effect on depressive symptoms (SMD -0.19, 95% CI -0.50 to 0.12; 2 studies, low-certainty evidence). Antidepressant medication only Three studies compared the effectiveness of SSRI to selective norepinephrine reuptake inhibitor (SNRI) medication on reducing sickness absence and yielded highly inconsistent results. Improved care Overall, interventions to improve care did not lead to fewer days of sickness absence, compared to care as usual (SMD -0.05, 95% CI -0.16 to 0.06; 7 studies, moderate-certainty evidence). However, in studies with a low risk of bias, the intervention probably leads to fewer days of sickness absence in the first year of follow-up (SMD -0.20, 95% CI -0.35 to -0.05; 2 studies; moderate-certainty evidence). Improved care probably leads to fewer depressive symptoms (SMD -0.21, 95% CI -0.35 to -0.07; 7 studies, moderate-certainty evidence) but may possibly lead to a decrease in work-functioning (SMD 0.5, 95% CI 0.34 to 0.66; 1 study; moderate-certainty evidence). Exercise Supervised strength exercise may reduce sickness absence, compared to relaxation (SMD -1.11; 95% CI -1.68 to -0.54; one study, low-certainty evidence). However, aerobic exercise probably is not more effective than relaxation or stretching (SMD -0.06; 95% CI -0.36 to 0.24; 2 studies, moderate-certainty evidence). Both studies found no differences between the two conditions in depressive symptoms. A combination of a work-directed intervention and a clinical intervention probably reduces the number of sickness absence days, but at the end of one year or longer follow-up, this does not lead to more people in the intervention group being at work. The intervention may also reduce depressive symptoms and probably increases work functioning more than care as usual. Specific work-directed interventions may not be more effective than usual work-directed care alone. Psychological interventions may reduce the number of sickness absence days, compared with care as usual. Interventions to improve clinical care probably lead to lower sickness absence and lower levels of depression, compared with care as usual. There was no evidence of a difference in effect on sickness absence of one antidepressant medication compared to another. Further research is needed to assess which combination of work-directed and clinical interventions works best.",33052607,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,8.402995109558105,-4.471158504486084,AhB0
"Evaluating the perceived utility of an artificial intelligence-powered clinical decision support system for depression treatment using a simulation center.

Aifred is a clinical decision support system (CDSS) that uses artificial intelligence to assist physicians in selecting treatments for major depressive disorder (MDD) by providing probabilities of remission for different treatment options based on patient characteristics. We evaluated the utility of the CDSS as perceived by physicians participating in simulated clinical interactions. Twenty physicians who were either staff or residents in psychiatry or family medicine completed a study in which they had three 10-minute clinical interactions with standardized patients portraying mild, moderate, and severe episodes of MDD. During these scenarios, physicians were given access to the CDSS, which they could use in their treatment decisions. The perceived utility of the CDSS was assessed through self-report questionnaires, scenario observations, and interviews. 60% of physicians perceived the CDSS to be a useful tool in their treatment-selection process, with family physicians perceiving the greatest utility. Moreover, 50% of physicians would use the tool for all patients with depression, with an additional 35% noting that they would reserve the tool for more severe or treatment-resistant patients. Furthermore, clinicians found the tool to be useful in discussing treatment options with patients. The efficacy of this CDSS and its potential to improve treatment outcomes must be further evaluated in clinical trials.",34953204,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,11.524822235107422,-1.5542529821395874,v5g
"Predicting outcome of Internet-based treatment for depressive symptoms.

In this study we explored predictors and moderators of response to Internet-based cognitive behavioral therapy (CBT) and Internet-based problem-solving therapy (PST) for depressive symptoms. The sample consisted of 263 participants with moderate to severe depressive symptoms. Of those, 88 were randomized to CBT, 88 to PST and 87 to a waiting list control condition. Outcomes were improvement and clinically significant change in depressive symptoms after 8 weeks. Higher baseline depression and higher education predicted improvement, while higher education, less avoidance behavior and decreased rational problem-solving skills predicted clinically significant change across all groups. No variables were found that differentially predicted outcome between Internet-based CBT and Internet-based PST. More research is needed with sufficient power to investigate predictors and moderators of response to reveal for whom Internet-based therapy is best suited.",23848944,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.97860336303711,-2.646240711212158,Cbe8
"Effect of a Web-Based Guided Self-help Intervention for Prevention of Major Depression in Adults With Subthreshold Depression: A Randomized Clinical Trial.

Evidence-based treatments for major depressive disorder (MDD) are not very successful in improving functional and health outcomes. Attention has increasingly been focused on the prevention of MDD. To evaluate the effectiveness of a web-based guided self-help intervention for the prevention of MDD. Two-group randomized clinical trial conducted between March 1, 2013, and March 4, 2015. Participants were recruited in Germany from the general population via a large statutory health insurance company (ie, insurance funded by joint employer-employee contributions). Participants included 406 self-selected adults with subthreshold depression (Centre for Epidemiologic Studies Depression Scale score ≥16, no current MDD according to Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition, Text Revision] criteria). All participants had unrestricted access to usual care (visits to the primary care clinician) and were randomized to either a web-based guided self-help intervention (cognitive-behavioral and problem-solving therapy supported by an online trainer; n=202) or a web-based psychoeducation program (n=204). The primary outcome was time to onset of MDD in the intervention group relative to the control group over a 12-month follow-up period as assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6- and 12-month follow-up, covering the period to the previous assessment. Among 406 randomized patients (mean age, 45 years; 73.9% women), 335 (82%) completed the telephone follow-up at 12 months. Fifty-five participants (27%) in the intervention group experienced MDD compared with 84 participants (41%) in the control group. Cox regression analyses controlling for baseline depressive symptom severity revealed a hazard ratio of 0.59 (95% CI, 0.42-0.82; P=.002) at 12-month follow-up. The number needed to treat to avoid 1 new case of MDD was 5.9 (95% CI, 3.9-14.6). Among patients with subthreshold depression, the use of a web-based guided self-help intervention compared with enhanced usual care reduced the incidence of MDD over 12 months. Further research is needed to understand whether the effects are generalizable to both first onset of depression and depression recurrence as well as efficacy without the use of an online trainer. German Clinical Trial Registry Identifier: DRKS00004709.",27139058,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.296076774597168,-2.9803221225738525,BtWT
"Clinical study results from a randomized controlled trial of cognitive behavioural guided self-help in patients with partially remitted depressive disorder.

Cognitive behavioural guided self-help has been shown to be effective in mild and moderate depressive disorder. It is not known, however, if it is effective in individuals with partially remitted depressive disorder, which is a serious clinical problem in up to 50-60% of treated patients. This study is the first one to examine the clinical benefit of this intervention in this patient population. For the purpose of this study, a single-blind, randomized controlled design was used. We randomized 90 individuals with partially remitted depressive disorder either to cognitive behavioural guided self-help plus psychopharmacotherapy (n = 49) or psychopharmacotherapy alone (n = 41). They were clinically assessed at regular intervals with ratings of depressive symptoms and stress-coping strategies over a 3-week run-in period and a 6-week treatment period. After 6 weeks, intention-to-treat analysis (n = 90) showed that patients treated with cognitive behavioural guided self-help plus psychopharmacotherapy did not have significantly lower scores on the Hamilton Rating Scale of Depression (17-item version; HRSD-17) and on the Beck Depression Inventory (BDI) compared to patients treated with psychopharmacotherapy alone. When negative stress-coping strategies were considered, there was a significant difference between the two groups at the end of treatment with respect to the BDI but not to the HRSD-17. Guided self-help did not lead to a significant reduction in symptom severity in patients with partially remitted depressive disorder after a 6-week intervention. However, the intervention leads to a reduction of negative stress-coping strategies. Cognitive behavioural guided self-help did not significantly improve depressive symptoms measured with the Hamilton Rating Scale of Depression (17-item version; HRSD-17) in patients with partially remitted depressive disorder. Improvements were found in reducing negative stress-coping strategies for those allocated to the cognitive behavioural guided self-help, which significantly improved Beck Depression Inventory but not HRSD-17. These findings suggest that cognitive behavioural guided self-help may offer some assistance in managing negative stress-coping strategies.",23681925,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.725622177124023,-2.80642032623291,Cd67
"Benefits of Individualized Feedback in Internet-Based Interventions for Depression: A Randomized Controlled Trial.

Even though there is an increasing number of studies on the efficacy of Internet-based interventions (IBI) for depression, experimental trials on the benefits of added guidance by clinicians are scarce and inconsistent. This study compared the efficacy of semistandardized feedback provided by psychologists with fully standardized feedback in IBI. Participants with mild-to-moderate depression (n = 1,089, 66% female) from the client pool of a health insurance company participated in a cognitive-behavioral IBI targeting depression over 6 weeks. Individuals were randomized to weekly semistandardized e-mail feedback from psychologists (individual counseling; IC) or to automated, standardized feedback where a psychologist could be contacted on demand (CoD). The contents and tasks were identical across conditions. The primary outcome was depression; secondary outcomes included anxiety, rumination, and well-being. Outcomes were assessed before and after the intervention and 3, 6, and 12 months later. Changes in outcomes were evaluated using latent change score modeling. Both interventions yielded large pre-post effects on depression (Beck Depression Inventory-II: dIC = 1.53, dCoD = 1.37; Patient Health Questionnaire-9: dIC = 1.20, dCoD = 1.04), as well as significant improvements of all other outcome measures. The effects remained significant after 3, 6, and 12 months. The groups differed with regard to attrition (IC: 17.3%, CoD: 25.8%, p = 0.001). Between-group effects were statistically nonsignificant across outcomes and measurement occasions. Adding semistandardized guidance in IBI for depression did not prove to be more effective than fully standardized feedback on primary and secondary outcomes, but it had positive effects on attrition.",29306945,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.231146812438965,-3.13447904586792,BR2C
"Initial open trial of a computerized behavioral activation treatment for depression.

This article presents preliminary findings from use of a novel computer program that implements an evidence-based psychological intervention to treat depression based on behavioral activation (BA) therapy. The program is titled ""Building a Meaningful Life Through Behavioral Activation"". The findings derive from an open trial with moderate to severely depressed individuals (N = 15) in an Intention to Treat sample. Hierarchical linear modeling (HLM) analyses revealed significant change over time on Beck Depression Inventory-Second Edition (BDI-II) scores, Revised Hamilton Depression Rating Scale scores, and significant contribution to BDI-II score variance by participant age over time, change over time in negative automatic thoughts, and change over time in BA scores. Piecewise HLM analyses revealed that significant change over time was associated uniquely with active treatment and not during 3 weeks of baseline measurement. In addition to treatment-associated significant change on all dependent measures over time, effect sizes were in the moderate to large range. Limitations are small sample size, nonrandomized control, research-recruited patients instead of purely treatment-seeking patients, possible rating bias by independent assessors who had knowledge that participants had received active treatment in this open trial, and the influence of additional services received in the post acute-treatment phase by some participants could have contributed to maintenance of gains reported for that period.",22987916,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.448654174804688,-1.8789626359939575,CoFs
"Cognitive behavioural therapy or antidepressants for acute depression?

",26646303,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.680218696594238,-2.0861289501190186,B0I1
"Is behavioural activation effective in the treatment of depression in young people? A systematic review and meta-analysis.

Depression is currently the leading cause of illness and disability in young people. Evidence suggests that behavioural activation (BA) is an effective treatment for depression in adults but less research focuses on its application with young people. This review therefore examined whether BA is effective in the treatment of depression in young people. A systematic review (International Prospective Register of Systematic Reviews reference: CRD42015020453), following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, was conducted to examine studies that had explored behavioural interventions for young people with depression. The electronic databases searched included the Cochrane Library, EMBASE, MEDLINE, CINAHL Plus, PsychINFO, and Scopus. A meta-analysis employing a generic inverse variance, random-effects model was conducted on the included randomized controlled trials (RCTs) to examine whether there were overall effects of BA on the Children's Depression Rating Scale - Revised. Ten studies met inclusion criteria: three RCTs and seven within-participant designs (total n = 170). The review showed that BA may be effective in the treatment of depression in young people. The Cochrane risk of bias tool and the Moncrieff scale used to assess the quality of the included studies revealed a variety of limitations within each. Despite demonstrating that BA may be effective in the treatment of depression in young people, the review indicated a number of methodological problems in the included studies meaning that the results and conclusions should be treated with caution. Furthermore, the paucity of studies in this area highlights the need for further research. Currently BA is included within National Institute for Health and Clinical Excellence (NICE, 2009) guidelines as an evidence-based treatment for depression in adults with extensive research supporting its effectiveness. It is important to investigate whether it may also be effective in treating young people. Included studies reported reductions in depression scores across a range of measures following BA. BA may be an effective treatment of depression in young people.",28299896,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.493450164794922,-2.0205955505371094,Bfb7
"The D*Phase-study: study protocol for a pragmatic two-phased, randomised controlled (non-inferiority) trial that addresses treatment non-response and compares cognitive behavioural therapy and short-term psychodynamic supportive psychotherapy for major depression.

Several evidence-based psychotherapeutic treatment options are available for depression, but the treatment results could be improved. The D*Phase study directly compares short-term psychodynamic supportive psychotherapy (SPSP) and cognitive behavioural therapy (CBT) for Major Depressive Disorder (MDD). The objectives are 1. to investigate if, from a group level perspective, SPSP is not inferior to CBT in the treatment of major depressive disorder, 2. to build a model that may help predict the optimal type of treatment for a specific individual; and 3. to determine whether a change of therapist or a change of therapist and treatment method are effective strategies to deal with non-response. Furthermore (4.), the effect of the therapeutic alliance, treatment integrity and therapist allegiance on treatment outcome will be investigated. In this pragmatic randomised controlled trial, 308 patients with a primary diagnosis of MDD are being recruited from a specialised mental health care institution in the Netherlands. In the first phase, patients are randomised 1:1 to either SPSP or CBT. In case of treatment non-response, a second phase follows in which non-responders from treatment phase one are randomised 1:1:1 to one of three groups: continuing the initial treatment with the same therapist, continuing the initial treatment with another therapist or continuing the other type of treatment with another therapist. In both treatment phases, patients are offered sixteen twice-weekly psychotherapy sessions. The primary outcome is an improvement in depressive symptoms. Process variables, working alliance and depressive symptoms, are frequently measured. Comprehensive assessments take place before the start of the first phase (at baseline), in week one, two and four during the treatment, and directly after the treatment (week eight). While the naturalistic setting of the study involves several challenges, we expect, by focusing on a large and diverse number of research variables, to generate important knowledge that may help enhance the effect of psychotherapeutic treatment for MDD. The study was registered on 26 August 2016 with the Netherlands Trial Register, part of the Dutch Cochrane Centre (NL5753), https://www.trialregister.nl/trial/5753.",33947374,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.899944305419922,-2.9770421981811523,AW2s
"Disseminating self-help: positive psychology exercises in an online trial.

The recent growth of positive psychology has led to a proliferation in exercises to increase positive thoughts, behaviors, and emotions. Preliminary evidence suggests that these exercises hold promise as an approach for reducing depressive symptoms. These exercises are typically researched in isolation as single exercises. The current study examined the acceptability of several multi-exercise packages using online dissemination. The purpose of this study was to investigate methods of dissemination that could increase the acceptability and effectiveness of positive psychology exercises. To achieve this goal, we compared the use of positive psychology exercises when delivered in packages of 2, 4, or 6 exercises. Self-help-seeking participants enrolled in this study by visiting an online research portal. Consenting participants were randomly assigned to receive 2, 4, or 6 positive psychology exercises (or assessments only) over a 6-week period. These exercises drew from the content of group positive psychotherapy. Participants visited an automated website that distributed exercise instructions, provided email reminders, and contained the baseline and follow-up assessments. Following each exercise, participants rated their enjoyment of the exercise, answered how often they had used each technique, and completed outcome measures. In total, 1364 individuals consented to participate. Attrition rates across the 2-, 4-, and 6-exercise conditions were similar at 55.5% (181/326), 55.8% (203/364), and 52.7% (168/319) respectively but were significantly greater than the attrition rate of 42.5% (151/355) for the control condition (χ(2)(3) = 16.40, P < .001). Participants in the 6-exercise condition were significant more likely than participants in the 4-exercise condition to use both the third (F(1,312) = 5.61, P = .02) and fourth (F(1,313 )= 6.03, P = .02) exercises. For 5 of the 6 exercises, enjoyment was related to continued use of the exercise at 6-week follow-up (r's = .12 to .39). All conditions produced significant reductions in depressive symptoms (F(1,656) = 94.71, P < .001); however, a significant condition by time interaction (F(3,656) = 4.77, P = .003) indicated that this reduction was larger in the groups that received 2 or 4 exercises compared with the 6-exercise or control condition. Increasing the number of exercises presented to participants increased the use of the techniques and did not increase dropout. Participants may be more likely to use these skills when presented with a variety of options. Increasing the number of exercises delivered to participants produced a curvilinear relationship with those in the 2- and 4-exercise conditions reporting larger decreases in depressive symptoms than participants in the 6-exercise or control conditions. Although research generally offers a single exercise to test isolate effects, this study supports that studying variability in dissemination can produce important findings.",22732765,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.49659538269043,-3.9152169227600098,CrsO
"Group person-based cognitive therapy for chronic depression: a pilot randomized controlled trial.

This pilot randomized controlled trial (RCT) assesses Person-Based Cognitive Therapy (PBCT), an integration of cognitive therapy and mindfulness, as a treatment for chronic depression. Twenty-eight participants with chronic depression were randomly allocated to treatment as usual (TAU) or PBCT group plus TAU. Assessments of depression (Beck Depression Inventory, BDI-II) and mindfulness (Southampton Mindfulness Questionnaire) were conducted before and after therapy. Intention-to-treat analysis found significant group by time interactions for both depression and mindfulness. Secondary analyses showed depression and mindfulness scores significantly improved for PBCT participants but not for TAU participants, with 64% of PBCT participants showing reliable improvement in depression, compared with 0% of TAU participants. PBCT is a promising treatment for chronic depression. Findings suggest a full RCT would be warranted.",22803939,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.917071342468262,-1.0018701553344727,CqtR
"Pilot feasibility study of a brief, tailored mobile health intervention for depression among patients with chronic pain.

This pilot feasibility study investigated a brief, tailored mobile health intervention to provide brief treatment and motivate further depression treatment seeking among patients with comorbid chronic pain. The computer tablet intervention was delivered in a hospital clinic using a blended motivational interviewing and cognitive behavioral therapy approach. Individuals were at least age 18, and screened positive for depression during a visit for chronic pain. Participants completed assessments before the intervention and at two-week follow-up. The 64 participants were most often over 50 years old, female, and Caucasian. Participant ratings demonstrated an increase in interest to seek depression treatment and willingness to make life changes to mitigate symptoms. A significant reduction in mean depression score and non-significant reductions on both measures of disability were observed. This intervention was feasible and acceptable, demonstrated promise in reducing depression and increasing treatment interest, and should be tested in a trial.",24313728,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,8.268071174621582,-5.416474342346191,CVDw
"Positive psychotherapy for depression and self-efficacy in undergraduate nursing students: A randomized, controlled trial.

Nursing students across the globe experience depressive symptoms, and many interventions have been used to alleviate their depression. However, few interventions focus on students' personal strengths and advantages. The aim of the present study was to explore the effects of an 8-week group positive psychotherapy (PPT) programme on depression and self-efficacy in full-time undergraduate nursing students. A randomized, controlled trial was conducted for 76 nursing students (34 in the experimental group, 42 in the control group). The Beck Depression Inventory-II and the General Self-Efficacy Scale were used to collect data prior to, immediately after PPT, 3 months', and 6 months' post-PPT. Repeated-measures analysis of variance indicated that the intervention significantly alleviated depression and improved self-efficacy (each P < 0.05); the effect of time and time-group interaction was also significant (each P < 0.05). The findings suggest that PPT could significantly relieve depressive symptoms and improve self-efficacy. We recommend that PPT is effective in alleviating depression and improving self-efficacy in undergraduate nursing students. Academic mental health nurses should appreciate the value of PPT and consider incorporating it in psychological support methods in order to facilitate nursing students' mental health.",27633932,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.045547485351562,-3.3094911575317383,BnOe
"Comparison of cognitive-behaviour therapy with psychoanalytic and psychodynamic therapy for depressed patients - a three-year follow-up study.

The study investigates the effectiveness of long-term psychotherapies. Cognitive-behaviour therapy was compared with psychoanalytic and psychodynamic therapy in the treatment of patients with a primary diagnosis of unipolar depression. In a prospective, quasi-experimental design 100 patients were compared at pre- and post-treatment and three-year follow-up. Outcome measures were the Beck Depression Inventory and Global Severity Index for measuring symptoms, the Inventory of Interpersonal Problems and the Social Support Questionnaire for measurement of social-interpersonal functioning, and the INTREX Introject Questionnaire for measuring personality structure. Comparative effectiveness of the experimental groups was analyzed using mixed models. We found significant outcome differences between psychoanalytic therapy and cognitive-behaviour therapy in depressive and global psychiatric symptoms, partly social-interpersonal and personality structure at three-year follow-up. Psychodynamic therapy was superior to cognitive-behaviour therapy in the reduction of interpersonal problems. Psychoanalytic therapy shows significantly longer-lasting effects compared to cognitive-behaviour therapy three years after termination of treatment, which is discussed as a dose-effect.",22987495,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.716745376586914,-3.0708751678466797,CoGh
"[Quality of life and symptoms in patients with chronic depression and anxiety after a self-management training: a randomised controlled trial].

Evidence-based interventions aimed at patient rehabilitation are not readily available in outpatient mental health care for patients with chronic anxiety and/or depression. To evaluate the effects that the program 'Rehabilitation through self-management' had on the life and symptoms of patients who had received this programme for six months in an outpatient mental health care setting. As part of a randomised controlled trial, patients were assigned to receive the programme (intervention group) or care as usual (control group). After six months we evaluated the change in the quality of life (World Health Organisation Quality of Life assessment, Brief version (WHOQOL-BREF)) and the change in anxiety symptoms (Beck Anxiety Inventory (BAI)) and depressive symptoms (Patient Health Questionnaire (PHQ-9)) using linear mixed models analysis. We included 141 patients from 12 participating mental health care institutions. We found no significant difference between the quality of life or symptoms of patients in the intervention group and those in the control groups. Differences in change scores on the WHOQOL-BREF, BAI and PHQ-9 were 0.74 (p=0.63), 0.39 (p=0.81) and -0.07 (p=0.95) respectively. Higher scores on the BAI and PHQ-9 had a negative influence on the effect of the intervention. After six months the programme had no significant effect on patients' quality of life or symptoms. These results reflect the chronicity of symptoms and the relation between symptoms and the quality of life in this patient population.",27397802,Major Depressive Disorder,Anxiety Treatment,Mental Health,8813,9.929712295532227,-3.099797248840332,BqND
"Predicting optimal interventions for clinical depression: Moderators of outcomes in a positive psychological intervention vs. cognitive-behavioral therapy.

Identifying differences in the clinical response to specific interventions is an important challenge in the field of Clinical Psychology. This is especially true in the treatment of depression where many treatments appear to have comparable outcomes. In a controlled trial, we compared a positive psychology group intervention, the Integrative Positive Psychological Intervention for Depression (IPPI-D; n = 62) to a cognitive-behavioral therapy group intervention (CBT; n = 66) for depression. No statistically or clinically-significant differences between the treatments were found, but a slight advantage was observed, on average, for IPPI-D. The aim of the present study was to identify and combine moderators of the differential efficacy of these two psychological interventions for clinical depression. For this purpose, a secondary analysis using the Personalized Advantage Index (PAI) was performed to identify the intervention predicted to produce the better outcome for each patient. Six of the 21 potential moderators were found to predict differential efficacy between the treatments. IPPI-D was predicted to be the optimal treatment for 73% of the sample. Baseline features that characterized these individuals were: mental and physical comorbidity, prior antidepressant medication, higher levels of negative thoughts, and higher personal growth. The 27% who were predicted to achieve better outcomes in CBT than in IPPI-D tended to have these baseline features: no comorbidities, no prior antidepressant medication, lower levels of negative thoughts, and lower personal growth.",31395363,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.371411323547363,-2.6187851428985596,A2UU
"[Evidence-based treatment of depression: what does the new S3- and national healthcare guideline Unipolar Depression really recommend?].

The paper reflects central recommendations and methodological issues of the new German guidelines for the treatment of depression, as discussed in the article New German Guidelines for the Treatment of Depression - The Central Role of Psychotherapy (Schauenburg et al. 2009). Members of the steering group for these guidelines disagree with the authors' description in several points, especially with reference to the efficacy of pharmacotherapy with antidepressants and psychotherapy, as well as the relationship between both strategies of therapy and their combination in diverse phases of treatment (acute/maintenance). Furthermore, we try to clarify some misunderstandings in matters of the guideline's methodology which arose in the paper cited.",21243603,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.937243461608887,-1.5579338073730469,DBGG
"Relapses in recurrent depression 1 year after maintenance cognitive-behavioral therapy: the role of therapist adherence, competence, and the therapeutic alliance.

The prevention of relapse in recurrent depression is considered a central aim in cognitive-behavioral therapy, given the high risk of relapse. In this study, patients with recurrent major depressive disorder (currently remitted) received 16 sessions of Maintenance Cognitive-Behavioral Therapy (M-CBT) over a period of 8 months, in order to prevent relapse. Therapist adherence and competence, as well as the therapeutic alliance, were investigated as predictors for reducing the risk of recurrence in depression. Videotapes of 80 participants were analyzed in order to evaluate therapist adherence and competence. Additionally, the therapeutic alliance was assessed by questionnaire. No associations were found between therapist adherence or competence, and the risk of relapse 1 year after treatment. By contrast, the therapeutic alliance was a significant predictor of the time to relapse. Moreover, we found that the number of previous depressive episodes (≥ 5 vs. ≤ 4) was a significant moderator variable. This indicates that the alliance-outcome relationship was particularly important when patients with five or more previous depressive episodes were taken into account, in comparison to patients with four or fewer episodes. For the psychotherapeutic treatment of recurrent depression and the prevention of relapse, sufficient attention should be paid to the therapeutic alliance.",23806623,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,10.225056648254395,-0.8697031140327454,CcHS
"Web-Based Therapist Training in Interpersonal Psychotherapy for Depression: Pilot Study.

Training mental health professionals to deliver evidence-based therapy (EBT) is now required by most academic accreditation bodies, and evaluating the effectiveness of such training is imperative. However, shortages of time, money, and trained EBT clinician teachers make these challenges daunting. New technologies may help. The authors have developed the first empirically evaluated comprehensive Internet therapist training program for interpersonal psychotherapy (IPT). The aim of this study was to examine whether (1) the training protocol would increase clinicians' knowledge of IPT concepts and skills and (2) clinicians would deem the training feasible as measured by satisfaction and utility ratings. A total of 26 clinicians enrolled in the training, consisting of (1) a Web-based tutorial on IPT concepts and techniques; (2) live remote training via videoconference, with trainees practicing IPT techniques in a role-play using a case vignette; and (3) a Web-based portal for therapists posttraining use to help facilitate implementation of IPT and maintain adherence over time. Trainees' knowledge of IPT concepts and skills improved significantly (P<.001). The standardized effect size for the change was large: d=2.53, 95% CI 2.23-2.92. Users found the technical features easy to use, the content useful for helping them treat depressed clients, and felt the applied training component enhanced their professional expertise. Mean rating of applied learning was 3.9 (scale range from 1=very little to 5=a great deal). Overall satisfaction rating was 3.5 (range from 1=very dissatisfied to 4=very satisfied). Results support the efficacy and feasibility of this technology in training clinicians in EBTs and warrant further empirical evaluation.",28716769,Major Depressive Disorder,Anxiety Treatment,Mental Health,4830,11.250068664550781,-4.195793151855469,BZpj
"Problem-Solving Education to Prevent Depression Among Low-Income Mothers: A Path Mediation Analysis in a Randomized Clinical Trial.

Although problem solving has been an important component of successful depression prevention and treatment interventions, evidence to support problem solving's mechanism of action is sparse. To understand the mechanism of an efficacious depression prevention intervention, problem-solving education (PSE). A multivariate path analysis was embedded within a randomized efficacy trial (February 15, 2011, to May 9, 2016). Participants were mothers with depressed mood, anhedonia, or depression history (but not in current major depressive episode) at 1 of 6 Head Start agencies. Participants were followed up for 12 months with serial assessments of potential intervention mediators and depressive symptoms. Problem-solving education (n=111) and usual Head Start services (n=119). Primary outcomes were depressive symptom elevations, which were measured bimonthly. Eight plausible intervention mediators were assessed: problem-solving ability; mastery; self-esteem; perceived stress; behavioral activation; and avoidant, problem-focused, and social coping. Among 230 participants, 152 (66.1%) were Hispanic; mean (SD) age was 31.4 (7.3) years. Based on associations with either PSE participation or depressive symptom outcomes, problem-solving ability, perceived stress, behavioral activation, and problem-focused coping were included in a parsimonious, multivariate path model. In this model, only perceived stress was associated with both PSE participation and depressive symptoms. Participants in the PSE group had adjusted standardized perceived stress change scores that were 11% lower than controls (95% CI, -0.19 to -0.03), and improvement in perceived stress generated an adjusted rate ratio (aRR) of 0.42 (95% CI, 0.33-0.53) for depressive symptom elevations. Participants in the intervention group also had standardized behavioral activation change scores 15% greater than controls (95% CI, 0.01-0.30) and problem-focused coping change scores 17% greater than controls (95% CI, 0.03-0.31); however, changes in these constructs were not associated with a differential rate of depressive symptom elevations. The direct effect of PSE on depressive symptom elevations (aRR, 0.72; 95% CI, 0.52-0.97) was greater than the mediated effect explained by improvement in perceived stress (aRR, 0.91; 95% CI, 0.85-0.98). Problem-solving education is efficacious in preventing depressive symptoms and appears to work by decreasing perceived stress; however, the mechanism for much of PSE's impact on depression remains unexplained. These results can be used to simplify the intervention model in preparation for effectiveness testing. ClinicalTrials.gov Identifier: NCT01298804.",30646083,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.844746589660645,-3.0301787853240967,BAbo
"Relapses in recurrent depression 1 year after psychoeducational treatment: the role of therapist adherence and competence, and the therapeutic alliance.

Psychoeducation has proved to be an effective treatment method for the prevention of relapse in recurrent depression. However, little is known about the processes which could account for the effects of psychoeducational treatment. In this study, patients with recurrent depression (currently remitted) received, over a period of 8 months, 16 sessions of psychoeducational treatment, in order to prevent relapse. Therapist adherence and competence, and the therapeutic alliance, were investigated as predictors of reducing the recurrence risk in depression. Videotapes of 43 participants in a psychoeducational treatment for depression were analyzed, in order to evaluate therapist adherence and competence. Additionally, the therapeutic alliance was assessed by means of a questionnaire. One year after treatment, no associations were found between therapist adherence or competence and the risk of relapse. The patients' view of the therapeutic alliance was moderately associated with the time to relapse. However, the correlation disappeared when controlled for the number of previous depressive episodes. The latter was the most important predictor of time to relapse, explaining 15% of variance.",21851988,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,10.423795700073242,-1.1246216297149658,C4gG
"Association between patients' feedback comments and depressive mood, satisfaction, homework conducted, and dropouts during self-guided smartphone cognitive behavioral therapy.

",30968499,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,8.053277969360352,-5.347328186035156,A8Fu
"Long-term effects of cognitive therapy on biological rhythms and depressive symptoms: A randomized clinical trial.

To evaluate the effect of cognitive therapy on biological rhythm and depressive and anxious symptoms in a twelve-month follow-up period. In addition, correlations between the reduction of depression and anxiety symptoms and the regulation of biological rhythm were observed. This was a randomized clinical trial with young adults from 18 to 29 years of age who were diagnosed with depression. Two models of psychotherapy were used: Cognitive Behavioral Therapy (CBT) and Narrative Cognitive Therapy (NCT). Biological rhythm was assessed with the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Severity of depressive and anxious symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS), respectively. The sample included 97 patients who were divided within the protocols of psychotherapy. There was a significant reduction in depressive and anxious symptoms (p<0.001) and an increase on regulation of biological rhythm (p<0.05) at the twelve-month follow-up. Moreover, we showed a positive correlation between the reduction of depressive symptoms and regulation of biological rhythm (r=0.638; p<0.001) and between the reduction of anxious symptoms and regulation of biological rhythm (r=0.438; p<0.001). Both models showed that cognitive therapy was effective on the reduction of depressive and anxious symptoms and on the regulation of biological rhythm at a twelve-month follow-up evaluation. This study highlights the association between biological rhythm and symptoms of depression and anxiety. We did not assess genetic, hormonal or neurochemical factors and we did not include patients under pharmaceutical treatment or those with severe symptomatology.",26300329,Major Depressive Disorder,Anxiety Treatment,Mental Health,12222,11.602581977844238,-1.3621338605880737,B5Ga
"The Cost-Effectiveness of Cognitive Behavioral Therapy Versus Second-Generation Antidepressants for Initial Treatment of Major Depressive Disorder in the United States: A Decision Analytic Model.

Most guidelines for major depressive disorder recommend initial treatment with either a second-generation antidepressant (SGA) or cognitive behavioral therapy (CBT). Although most trials suggest that these treatments have similar efficacy, their health economic implications are uncertain. To quantify the cost-effectiveness of CBT versus SGA for initial treatment of depression. Decision analytic model. Relative effectiveness data from a meta-analysis of randomized controlled trials; additional clinical and economic data from other publications. Adults with newly diagnosed major depressive disorder in the United States. 1 to 5 years. Health care sector and societal. Initial treatment with either an SGA or group and individual CBT. Costs in 2014 U.S. dollars, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. In model projections, CBT produced higher QALYs (3 days more at 1 year and 20 days more at 5 years) with higher costs at 1 year (health care sector, $900; societal, $1500) but lower costs at 5 years (health care sector, -$1800; societal, -$2500). In probabilistic sensitivity analyses, SGA had a 64% to 77% likelihood of having an incremental cost-effectiveness ratio of $100 000 or less per QALY at 1 year; CBT had a 73% to 77% likelihood at 5 years. Uncertainty in the relative risk for relapse of depression contributed the most to overall uncertainty in the optimal treatment. Long-term trials comparing CBT and SGA are lacking.",31658472,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.198378562927246,-2.8196115493774414,Ayy+
"Low-Intensity Guided Help Through Mindfulness (LIGHTMIND): study protocol for a randomised controlled trial comparing supported mindfulness-based cognitive therapy self-help to supported cognitive behavioural therapy self-help for adults experiencing depression.

Depression has serious personal, family and economic consequences. It is estimated that it will cost £12.15 billion to the economy each year in England by 2026. Improving access to psychological therapies (IAPT) is the National Health Service talking therapies service in England for adults experiencing anxiety or depression. Over 1 million people are referred to IAPT every year, over half experiencing depression. Where symptoms of depression are mild to moderate, people are typically offered cognitive behavioural therapy (CBT) self-help (CBT-SH) supported by a psychological well-being practitioner. The problem is that over half of people who complete treatment for depression in IAPT remain depressed despite receiving National Institute of Health and Care Excellent recommended treatment. Furthermore, less than half of IAPT service users complete treatment. This study seeks to investigate the effectiveness of an alternative to CBT-SH. Mindfulness-based cognitive therapy (MBCT) differs from CBT in focus, approach and practice, and may be more effective with a higher number of treatment completions. This is a definitive randomised controlled trial comparing supported MBCT self-help (MBCT-SH) with CBT-SH for adults experiencing mild to moderate depression being treated in IAPT services. We will recruit 410 participants experiencing mild to moderate depression from IAPT services and randomise these to receive either an MBCT-based self-help workbook or a CBT-based self-help workbook. Participants will be asked to complete their workbook within 16weeks, with six support sessions with a psychological well-being practitioner. The primary outcome is depression symptom severity on treatment completion. Secondary outcomes are treatment completion rates and measures of generalized anxiety, well-being, functioning and mindfulness. An exploratory non-inferiority analysis will be conducted in the event the primary hypothesis is not supported. A semi-structured interview with participants will guide understanding of change processes. If the findings from this randomised controlled trial demonstrate that MBCT-SH is more effective than CBT-SH for adults experiencing depression, this will provide evidence for policy makers and lead to changes to clinical practice in IAPT services, leading to greater choice of self-help treatment options and better outcomes for service users. If the exploratory non-inferiority analysis is conducted and this indicates non-inferiority of MBCT-SH in comparison to CBT-SH this will also be of interest to policy makers when seeking to increase service user choice of self-help treatment options for depression. Current Controlled Trial registration number: ISRCTN 13495752. Registered on 31 August 2017 (www.isrctn.com/ISRCTN13495752).",32366320,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.400762557983398,-2.337014675140381,Apoz
"The more it is needed, the less it is wanted: attitudes toward face-to-face intervention among depressed patients undergoing online treatment.

Many individuals suffering from depression do not actively seek treatment. Self-help strategies represent low-threshold treatment options that are particularly relevant for milder cases. The present study addressed two important issues: (1) we examined depressed individuals' motives and attitudes that may represent barriers to face-to-face treatment; (2) we examined if the participation in an online treatment program facilitates or compromises their willingness to undergo face-to-face treatment. We recruited 210 participants with depression for a trial on the efficacy of an online treatment program for depression. Participants were randomly allocated either to a self-help treatment (Deprexis) or to a wait-list control group. All participants filled out a newly developed 42-item questionnaire called Psychotherapy Expectations, Concerns, and Hopes Inventory (PECHI). The scale measures attitudes toward face-to-face treatment and was administered at baseline and 8 weeks later. Principal component analysis of the PECHI revealed five dimensions: hope for symptomatic improvement, fear of poor alliance with the therapist, skill acquisition, skepticism and resentment of psychotherapy, and self-stigma. Attitudes toward treatment were stable over time and neither modulated by group status nor by self-reported or objective symptom decline. Correlation analyses revealed that current levels of depression and well-being were potent predictors of attitudes toward treatment, suggesting that when the patient feels more depressed, doubts about the effectiveness of therapy emerge more strongly. To conclude, results suggest that Deprexis neither promotes nor reduces negative attitudes toward psychotherapy, nor does it increase barriers to enter face-to-face treatments. An alarming paradox emerged: when a depressed person is in greatest need of help, motivation to seek face-to-face treatment is lowest.",22930656,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.02096939086914,-3.3876116275787354,Co82
"Stress, depression, and the therapeutic alliance as mediators on the outcome of brief psychodynamic-interpersonal psychotherapy for multisomatoform disorder.

The aim of this study was to identify and explore mediators of psychodynamic-interpersonal psychotherapy (PIT) on treatment outcome in multisomatoform disorders (MSD). Data from 164 patients with MSD who took part in a randomized control trial of PIT (n=88) vs. enhanced medical care (EMC; n=76) were re-analyzed. A parallel mediation analysis was performed to investigate whether the beneficial effect of PIT vs. EMC on physical quality of life (physical component summary (PCS) of the SF-36 Health Survey) nine months post-treatment is mediated by post-treatment scores of stress, depression, and therapeutic alliance. The potential mediators were operationalized with the Helping Alliance Questionnaire (HAQ; therapeutic alliance), the Patient Health Questionnaire (PHQ)-stress module (perceived stress) and the PHQ-depression module (PHQ-9; depression). Stress partially mediated the effect of PIT vs. EMC on the follow-up outcome. PIT (as compared to EMC) led to lower post-treatment stress-levels, which in turn led to higher physical quality of life at follow-up. Neither depression nor the alliance had a mediating effect. Stress mediated the outcome of PIT for MSD. Future studies are needed to extend the scope of research regarding which specific psychotherapeutic mechanisms of change are beneficial in PIT treatment of MSD patients.",33550930,Major Depressive Disorder,Anxiety Treatment,Mental Health,1685,13.961884498596191,-6.129648685455322,AbPp
"Competitive memory training (COMET) for treating low self-esteem in patients with depressive disorders: a randomized clinical trial.

Self-esteem is a major concern in mood disorders. Low self-esteem is a symptom of depressive disorders and is considered by some to be a predictor for relapse, whereas high self-esteem seems to buffer against depression. Recently, Competitive Memory Training (COMET) has shown to be effective for the enhancement of self-esteem in several psychopathological conditions. The current study assesses whether COMET is also an effective intervention for patients with depressive disorders. Sixty-one patients with depressive disorders who were already in therapy in an outpatient mental health institution were randomly assigned to either eight group sessions of COMET in addition to their regular therapy (COMET + therapy as usual [TAU]: the experimental group) or to 8 weeks of ongoing regular therapy (TAU only: the control group). These latter (control) patients received COMET after their TAU only period. All patients in both groups that completed COMET were contacted 3 and 6 months later to assess whether the effects of COMET had remained stable. Compared to the patients who received TAU only, patients in the COMET + TAU condition showed significant improvement with large effect sizes on indices of self-esteem, depression, and depressive rumination. The therapeutic effects of COMET + TAU remained stable after 3 and 6 months on all outcome measures or improved even further. COMET for low self-esteem seems to be an efficacious trans-diagnostic intervention that can relatively easily be added to the regular treatment of patients with depressive disorders.",22495940,Major Depressive Disorder,Anxiety Treatment,Mental Health,14949,13.461437225341797,-1.0560637712478638,Cu3j
"Treating prolonged grief disorder: a randomized clinical trial.

Prolonged grief disorder (PGD) is a potentially disabling condition that affects approximately 10% of bereaved people. Grief-focused cognitive behavior therapy (CBT) has been shown to be effective in treating PGD. Although treatments for PGD have focused on exposure therapy, much debate remains about whether exposure therapy is optimal for PGD. To determine the relative efficacies of CBT with exposure therapy (CBT/exposure) or CBT alone for PGD. A randomized clinical trial of 80 patients with PGD attending the outpatient University of New South Wales Traumatic Stress Clinic from September 17, 2007, through June 7, 2010. All patients received 10 weekly 2-hour group therapy sessions that consisted of CBT techniques. Patients also received 4 individual sessions, in which they were randomized to receive exposure therapy for memories of the death or supportive counseling. Measures of PGD by clinical interview and self-reported measures of depression, cognitive appraisals, and functioning at the 6-month follow-up. Intention-to-treat analyses at follow-up indicated a significant quadratic time×treatment condition interaction effect (B [SE], 0.49 [0.16]; t120.16=3.08 [95% CI, 0.18-0.81]; P=.003), indicating that CBT/exposure led to greater PGD reductions than CBT alone. At follow-up, CBT/exposure led to greater reductions in depression (B [SE], 0.35 [0.12]; t112.65=2.83 [95% CI, 0.11-0.60]; P=.005), negative appraisals (B [SE], 0.68 [0.25]; t109.98=2.66 [95% CI, 0.17-1.18]; P=.009), and functional impairment (B [SE], 0.24 [0.08]; t111.40=3.01 [95% CI, 0.08-0.40]; P=.003) than CBT alone. In terms of treatment completers, fewer patients in the CBT/exposure condition at follow-up (14.8%) met criteria for PGD than those in the CBT condition (37.9%) (odds ratio, 3.51; 95% CI, 0.96-12.89; χ2=3.81; P=.04). Including exposure therapy that promotes emotional processing of memories of the death is an important component to achieve optimal reductions in PGD severity. Facilitating emotional responses to the death may promote greater changes in appraisals about the loss, which are associated with symptom reduction. Promotion of emotional processing techniques in therapies to treat patients with PGD is needed. anzctr.org.au Identifier: ACTRN12609000229279.",25338187,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.918041229248047,-9.114676475524902,CGwB
"Does pretreatment severity moderate the efficacy of psychological treatment of adult outpatient depression? A meta-analysis.

It is widely believed that psychological treatment has little effect on more severely depressed patients. This study assessed whether pretreatment severity moderates psychological treatment outcome relative to controls by means of meta-analyses. We included 132 studies (10,134 participants) from a database of studies (www.evidencebasedpsychotherapies.org) in which the effects of psychological treatment on adult outpatients with a depressive disorder or an elevated level of depressive symptoms were compared with a control condition in a randomized controlled trial. Two raters independently extracted outcome data and rated study characteristics. We conducted metaregression analyses assessing whether mean pretreatment depression scores predicted psychological treatment versus control condition posttreatment effect size and subgroup analyses summarizing the results of studies reporting within-study analyses of depression severity and psychological treatment outcome. Psychological treatment was found to be consistently superior to control conditions (d = 0.40-0.88). We found no indication that pretreatment mean depression scores predicted psychological treatment versus control condition posttreatment effect size, even after adjusting for relevant study characteristics. However, among the smaller subset of studies that reported within-study severity analyses, posttreatment effect sizes were higher for high-severity patients (d = 0.63) than for low-severity patients (d = 0.22) when psychological treatment was efficacious relative to a more stringent control. Contrary to conventional wisdom, our findings suggest that when compared with control conditions, psychological treatment might be more efficacious for high-severity than for low-severity patients. Because the number of studies reporting within-study severity analyses is small, we recommend that future studies routinely report tests for Severity × Treatment interactions.",20873902,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.332205772399902,-2.7011523246765137,DFQJ
"Helpful self-management strategies to cope with enduring depression from the patients' point of view: a concept map study.

Despite the development of various self-management programmes that attempt to ameliorate symptoms of patients with chronic major depressive disorder (MDD), little is known about what these patients perceive as helpful in their struggle during daily live. The present study aims to explore what patients believe they can do themselves to cope with enduring MDD besides professional treatment, and which self-management strategies patients perceive as being most helpful to cope with their MDD. We used concept mapping, a method specifically designed for the conceptualisation of a specific subject, in this case patients' point of view (n = 25) on helpful self-management strategies in their coping with enduring MDD. A purposive sample of participants was invited at the Academic Medical Center and through requests on several MDD-patient websites in the Netherlands. Participants generated strategies in focus group discussions which were successively clustered on a two-dimensional concept map by hierarchical cluster analysis. Fifty strategies were perceived as helpful. They were combined into three meta-clusters each comprising two clusters: A focus on the depression (sub clusters: Being aware that my depression needs active coping and Active coping with professional treatment); An active lifestyle (sub clusters: Active self-care, structure and planning and Free time activities) and Participation in everyday social life (sub clusters: Social engagement and Work-related activities). MDD patients believe they can use various strategies to cope with enduring MDD in daily life. Although current developments in e-health occur, patients emphasise on face-to-face treatments and long-term relations, being engaged in social and working life, and involving their family, friends, colleagues and clinicians in their disease management. Our findings may help clinicians to improve their knowledge about what patients consider beneficial to cope with enduring MDD and to incorporate these suggested self-management strategies in their treatments.",25495848,Major Depressive Disorder,Anxiety Treatment,Mental Health,9215,9.752531051635742,-3.322882652282715,CEhv
"Predicting outcome in computerized cognitive behavioral therapy for depression in primary care: A randomized trial.

To explore pretreatment and short-term improvement variables as potential moderators and predictors of 12-month follow-up outcome of unsupported online computerized cognitive behavioral therapy (CCBT), usual care, and CCBT combined with usual care for depression. Three hundred and three depressed patients were randomly allocated to (a) unsupported online CCBT, (b) treatment as usual (TAU), or (c) CCBT and TAU combined (CCBT&TAU). Potential predictors and moderators were demographic, clinical, cognitive, and short-term improvement variables. Outcomes were the Beck Depression Inventory-II score at 12 months of follow-up and reliable change. Those with higher levels of extreme (positive) responding had a better outcome in CCBT compared with TAU, whereas those having a parental psychiatric history or a major depressive disorder diagnosis had a better outcome in CCBT&TAU compared with TAU. Predictors regardless of treatment type included current employment, low pretreatment illness severity, and short-term improvement on clinical variables. Optimistic patients, holding approach-oriented coping strategies, might benefit most from CCBT, whereas CCBT&TAU might be the most suitable option for those with more severe vulnerability characteristics. Those with the least impairment improve the most, regardless of treatment type.",20350029,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.253267288208008,-2.703500270843506,DMR/
"Finally moving beyond the horse race: CBT and psychodynamic therapy equally effective for depression.

",25326494,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.98205280303955,-2.6606943607330322,CG4z
"Comparison of non-directive counselling and cognitive behaviour therapy for patients presenting in general practice with an ICD-10 depressive episode: a randomized control trial.

Most evidence in the UK on the effectiveness of brief therapy for depression concerns cognitive behaviour therapy (CBT). In a trial published in 2000, we showed that non-directive counselling and CBT were equally effective in general practice for patients with depression and mixed anxiety and depression. Our results were criticized for including patients not meeting diagnostic criteria for a depressive disorder. In this reanalysis we aimed to compare the effectiveness of the two therapies for patients with an ICD-10 depressive episode. Patients with an ICD-10 depressive episode or mixed anxiety and depression were randomized to counselling, CBT or usual general practitioner (GP) care. Counsellors provided nondirective, interpersonal counselling following a manual that we developed based on the work of Carl Rogers. Cognitive behaviour therapists provided CBT also guided by a manual. Modelling was carried out using generalized estimating equations with the multiply imputed datasets. Outcomes were mean scores on the Beck Depression Inventory, Brief Symptom Inventory, and Social Adjustment Scale at 4 and 12 months. A total of 134 participants were randomized to CBT, 126 to counselling and 67 to usual GP care. We undertook (1) an interaction analysis using all 316 patients who were assigned a diagnosis and (2) a head-to-head comparison using only those 130 (41%) participants who had an ICD-10 depressive episode at baseline. CBT and counselling were both superior to GP care at 4 months but not at 12 months. There was no difference in the effectiveness of the two psychological therapies. We recommend that national clinical guidelines take our findings into consideration in recommending effective alternatives to CBT.",24103190,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,11.081745147705078,-2.2900993824005127,CXvU
"Comparing human and automated support for depression: Fractional factorial randomized controlled trial.

Web-based interventions for people with depressive symptoms are needed and show promising effects. However, it is a consistent finding that human support is needed and this makes implementation costly. This study investigates the adherence and effectiveness of a human-supported and automated-supported web-based intervention for people with mild to moderate depressive symptomatology, and studies the impact of four persuasive technology components. People with mild to moderate depressive symptoms according to the Center of Epidemiological Studies depression scale self-report questionnaire were included, but no diagnosis was made for the study. Participants (n = 239) were randomized into one of eight intervention arms, where each level of each component is present in half of the intervention arms. On clinical outcomes, there was a significant interaction effect between support condition and time, but there was no difference on the extent of improvement from baseline to follow-up, only a difference in the time-path of improvement. Effect sizes from baseline to follow-up were 0.89 for automated and 1.00 for human support. There was no significant difference on adherence between support condition. We conclude that an automated-supported web-based intervention for treatment of depression with persuasive technology may achieve similar adherence and effectiveness as the same intervention with human support.",26196078,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.90106201171875,-3.4466640949249268,B6lu
"Long-term results of a web-based guided self-help intervention for employees with depressive symptoms: randomized controlled trial.

Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms via the Internet before they report sick from work could be beneficial and cost saving. In this study, we tested the effectiveness over the period of 1 year of a Web-based guided self-help intervention, called Happy@Work, for employees with depressive symptoms who were not on sick leave. A two-arm randomized controlled trial comparing a worker-directed, Web-based, guided self-help intervention to care as usual (CAU) was carried out. We recruited employees from 6 companies via the company's Intranet and by putting up posters. The inclusion criteria were elevated depressive symptoms as measured by a score ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D) and not being on sick leave. The intervention contained 6 lessons and consisted of problem-solving treatment and cognitive therapy. Participants were asked to submit weekly assignments via the website after completion of a lesson and they received feedback from a coach via the website. Self-report questionnaires on depressive symptoms (CES-D; primary outcome), burnout (Maslach Burnout Inventory, MBI), work performance (Health and Work Performance Questionnaire, HPQ), duration of absenteeism, and anxiety (Hospital Anxiety and Depression Scale, HADS; secondary outcomes), were completed at baseline, posttreatment, and at 6-, and 12-month follow-up. Several subgroup and per-protocol analyses were performed. A total of 231 employees were randomized to either the intervention group (n=116) or to CAU (n=115). Completion of assessments varied between 54%-74%. Improvement in depressive symptoms between baseline and posttreatment was shown in all participants and these effects sustained over time. However, there were no differences between the 2 groups (adjusted regression coefficient=0.46, 95% CI -2.11 to 3.03, P=.72; Cohen's d=0.05). Differences between groups were also not significant for the secondary outcomes. No subgroups were identified to show differences between the groups, nor did we find a between-group effect in the per-protocol analyses. This study showed that a worker-directed, Web-based, guided self-help intervention was not more effective than CAU in reducing depressive symptoms among employees with depressive symptoms who were not on sick leave over the period of 1 year. An intervention for this specific target group might not be necessary because the recovery in the CAU group was comparable to the intervention group and sustained over a 12-month period. Nederlands Trial Register (NTR): NTR2993; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2993 (Archived by WebCite at http://www.webcitation.org/6PL9pFC0n).",25008127,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.597088813781738,-3.90256667137146,CLgn
"Feasibility and outcome of metacognitive therapy for major depressive disorder: a pilot study.

Several studies have shown the effectiveness of Metacognitive Therapy (MCT) in treating different mental disorders. Most of these studies were performed in English speaking countries using the original English version of the manual. Our study aimed to examine the feasibility of the translated MCT manual in a sample of German patients with major depressive disorder. Twenty outpatients (6 male, 14 female, mean age 42.1y) with major depressive disorder were included. The main outcome was drop-out rate and satisfaction with the treatment; secondary outcomes were changes in metacognitive beliefs assessed with the metacognitive questionnaire 30 (MCQ-30), and symptom reduction measured with the Beck Depression Inventory-2 sum score (BDI-2). No drop-outs during the treatment and the follow-up phase were observed. Patients and therapists were highly satisfied with MCT treatment. The MCQ-30 significantly declined over the treatment course, paralleled by a significant reduction of the BDI-2 sum scores (from 29±8.6 at T0 to 8.4±9.6 at the end of treatment). The average treatment duration was 10±4 sessions. Applying the German version of the manual for Metacognitive Therapy proved to be feasible in the treatment of depressed patients in an outpatient setting. The treatment was well tolerated by German patients. Outcome in terms of reduction of depressive symptoms was good. Remarkable is the comparably short treatment duration which should be investigated further in future studies. German Clinical Trials Register (DRKS): DRKS00023644, 17.11.2020 (retrospectively registered).",33243217,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.410324096679688,-1.643959403038025,Ae0x
"Two Trajectories of Depressive Symptom Reduction Throughout Behavioral Activation Teletherapy Among Underserved, Ethnically Diverse, Primary Care Patients: A VitalSign6 Report.

While prior research has investigated trajectories of depressive symptom change throughout psychotherapy, such work has not been conducted exclusively among underserved patients receiving brief Behavioral Activation (BA) teletherapy, intervention modifications that should reduce barriers to therapy initiation and engagement. The current project used cluster analysis to determine discrete groups of symptom change among patients receiving an 8-session BA teletherapy intervention, and analyzed whether demographic and clinical characteristics were associated with group membership. Data from 105 patients referred from charity primary care clinics and receiving at least two therapy sessions were analyzed. Patients were predominantly female and Latina. The 9-item Patient Health Questionnaire (PHQ-9) was the outcome. Two categories were determined: a larger group (N = 61) demonstrating initially less severe symptoms and experiencing a gradual recovery, and a smaller group beginning with more severe symptoms, and experiencing a steeper recovery. In both groups, a majority of participants experienced at least a 5-point drop in depressive symptoms, while in the latter group, a majority of patients achieved depressive symptom remission (PHQ-9 < 5). Monolingual Spanish speakers were more likely to be in the former group, but no other demographic or clinical characteristics were associated with group membership. In both groups, a majority of the symptom reduction occurred by sessions 4-6. Therefore, two categories of depressive symptom change, slow responders and rapid responders, occur among patients receiving a brief BA teletherapy intervention. No demographic differences aside from primary language, nor any clinical characteristics, distinguish group membership, suggesting similar patterns of symptom reduction among a primarily underserved sample.",33051037,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.682770729064941,-2.3878889083862305,AhC+
"Investigating patient-specific mechanisms of change in SET vs. EFT for depression: study protocol for a mechanistic randomized controlled trial.

Major depressive disorder (MDD) is the leading cause of disability worldwide and one of the most heterogeneous mental health disorders. Although there are effective treatments for MDD, about 50% of patients do not respond to treatment. One of the greatest challenges in improving current treatments is identifying the mechanisms responsible for therapeutic change in MDD. The proposed study aims to identify patient-specific mechanisms of change in two treatments for MDD by investigating whether subpopulations of patients differ in the mechanisms of change that operate when receiving a given treatment. Based on theories of targeting weakness and building on strength, we will examine whether the mechanism of change operating when a treatment is provided depends on whether the treatment targets the patient's strength or weakness. To test our hypothesis that two treatments, supportive-expressive treatment (SET) and emotion-focused treatment (EFT), differ in their mechanisms of change and to explore whether focusing on the patient's strength or weakness will result in better treatment outcome, we conduct a mechanistic randomized controlled trial. One hundred and twenty-four individuals diagnosed with MDD are randomized to 16 sessions of either SET or EFT. The two treatments are theorized to differ in their main mechanism of change: SET places emphasis on insight as its main mechanism of change, and EFT places emphasis on emotional processing. Both can serve as strength- or weakness-focused treatments, based on the patient's baseline levels of insight and emotional processing. The primary outcome is the Hamilton Rating Scale for Depression. Additional measures include self-report measures and clinical interviews, hormonal, motion, acoustic, physiological, and neuroimaging assessments, performance on cognitive tasks, and narrative material (collected from the sessions and interviews). The RCT will expand our understanding of mechanisms of change in psychotherapy, from one-size-fits-all to patient-specific mechanisms of change. By informing therapists about which of the two approaches is most effective with patients based on their baseline characteristics, the RCT will contribute to progress toward personalized treatment. clinicaltrials.gov Identifier: NCT04576182 submitted on October 1st 2020. The Israel Science Foundation. Trial status: Recruitment is ongoing.",34078324,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.442522048950195,-1.6232099533081055,AVVI
"Telephone-administered psychotherapy in combination with antidepressant medication for the acute treatment of major depressive disorder.

Telephone-administered psychotherapies (T-P) provided as an adjunct to antidepressant medication may improve response rates in major depressive disorder (MDD). The goal of this study was to compare telephone-administered social rhythm therapy (T-SRT) and telephone-administered intensive clinical management (T-ICM) as adjuncts to antidepressant medication for MDD. A secondary goal was to compare T-P with Treatment as Usual (TAU) as adjunctive treatment to medication for MDD. 221 adult out-patients with MDD, currently depressed, were randomly assigned to 8 sessions of weekly T-SRT (n=110) or T-ICM (n=111), administered as an adjunct to agomelatine. Both psychotherapies were administered entirely by telephone, by trained psychologists who were blind to other aspects of treatment. The 221 patients were a posteriori matched with 221 depressed outpatients receiving TAU (controls). The primary outcome measure was the percentage of responders at 8 weeks post-treatment. No significant differences were found between T-SRT and T-ICM. But T-P was associated with higher response rates (65.4% vs 54.8%, p=0.02) and a trend toward higher remission rates (33.2% vs 25.1%; p=0.06) compared to TAU. Short term study. This study is the first assessing the short-term effects of an add-on, brief, telephone-administered psychotherapy in depressed patients treated with antidepressant medication. Eight sessions of weekly telephone-delivered psychotherapy as an adjunct to antidepressant medication resulted in improved response rates relative to medication alone.",26480205,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.33979606628418,-2.6667275428771973,B2aj
"Mechanisms of change in cognitive therapy for major depressive disorder in the community mental health setting.

This study examined the relation of change in theory-relevant cognitive variables to depressive symptom change over the course of cognitive therapy, as well as the specificity of change mechanisms to cognitive therapy as compared with dynamic therapy. There were 237 adult outpatients who were randomized to either cognitive (n = 119) or dynamic (n = 118) therapy for major depressive disorder in a community mental health setting. Assessments of compensatory skills (Ways of Responding Community Version and Self-Report Version), dysfunctional attitudes (Dysfunctional Attitudes Scale), and depressogenic schemas (Psychological Distance Scaling Task) were obtained at baseline and months 1, 2, and 5 following baseline. Primary outcome was measured using the Hamilton Rating Scale for Depression. Across both therapy conditions, change in all 3 cognitive domains was associated with concurrent change in depressive symptoms. After controlling for other cognitive variables, increased interconnectedness of the positive achievement-related schema was significantly associated with concurrent symptom change in cognitive (rp = .26, p < .001) but not dynamic therapy (rp = .08, p = .29). Increases in positive compensatory skills were associated with subsequent change in depressive symptoms in cognitive therapy (rp = -.36, p = .003), but not in dynamic therapy (rp = .11, p = .386). Results provide support for the compensatory skills model of cognitive therapy (CT) within a community mental health setting. Additional research is necessary to understand other possible mechanisms of change in CT in the community setting. (PsycINFO Database Record",28406648,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.914916038513184,-2.734792709350586,Bd/y
"Comparative effectiveness of medication versus cognitive-behavioral therapy in a randomized controlled trial of low-income young minority women with depression.

To examine whether there are latent trajectory classes in response to treatment and whether they moderate the effects of medication versus psychotherapy. Data come from a 1-year randomized controlled trial of 267 low-income, young (M = 29 years), minority (44% Black, 50% Latina, 6% White) women with current major depression randomized to antidepressants, cognitive-behavioral therapy (CBT), or referral to community mental health services. Growth mixture modeling was used to determine whether there were differential effects of medication versus CBT. Depression was measured via the Hamilton Depression Rating Scale (Hamilton, 1960). We identified 2 latent trajectory classes. The first was characterized by severe depression at baseline. At 6 months, mean depression scores for the medication and CBT groups in this class were 13.9 and 14.9, respectively (difference not significant). At 12 months, mean depression scores were 16.4 and 11.0, respectively (p for difference = .04). The second class was characterized by moderate depression and anxiety at baseline. At 6 months, mean depression scores for the medication and CBT groups were 4.4 and 6.8, respectively (p for difference = .03). At 12 months, the mean depression scores were 7.1 and 7.8, respectively, and the difference was no longer significant. Among depressed women with moderate baseline depression and anxiety, medication was superior to CBT at 6 months, but the difference was not sustained at 1 year. Among women with severe depression, there was no significant treatment group difference at 6 months, but CBT was superior to medication at 1 year.",23088620,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.285199165344238,-2.542785882949829,Cmqc
"Looking beyond depression: a meta-analysis of the effect of behavioral activation on depression, anxiety, and activation.

Depression is a prevalent and impairing condition. Behavioral activation (BA) is a parsimonious, cost-effective, and easily disseminated psychological intervention for depression. The current meta-analysis expands on the existing literature supporting the efficacy of BA for depression by examining the effects of BA on additional relevant outcomes for patients with depression, namely the reduction in anxiety symptoms and increase in activation. Randomized controlled trials of BA for depression compared to active and inactive control were identified via a systematic review. Effect sizes using Hedges's g were calculated for each outcome compared to both active and inactive control using random effects models. Subgroup analyses were used to examine the inclusion of a discussion of values as a moderator of depression symptom outcome in BA. Twenty-eight studies were included. Meta-analyses of symptom change between groups from baseline-to-post intervention indicated that BA outperformed inactive control conditions for improvements in depression (g = 0.83), anxiety (g = 0.37), and activation (g = 0.64). The difference between BA and active control conditions was not significant for improvements in depression (g = 0.15), anxiety (g = 0.03), and activation (g = 0.04). There was no evidence for a discussion of values augmenting BA efficacy. Study quality was generally low, and there was evidence of publication bias. In addition to improving depression, BA shows efficacy for reducing symptoms of anxiety and increasing activation. BA may not offer better outcomes relative to other active interventions. There is room for improvement in the quality of research in this area.",32138802,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.605962753295898,-2.027146100997925,AsXo
"Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial.

Depression is one of the more severe and serious health problems because of its morbidity, disabling effects and for its societal and economic burden. Despite the variety of existing pharmacological and psychological treatments, most of the cases evolve with only partial remission, relapse and recurrence.Cognitive models have contributed significantly to the understanding of unipolar depression and its psychological treatment. However, success is only partial and many authors affirm the need to improve those models and also the treatment programs derived from them. One of the issues that requires further elaboration is the difficulty these patients experience in responding to treatment and in maintaining therapeutic gains across time without relapse or recurrence. Our research group has been working on the notion of cognitive conflict viewed as personal dilemmas according to personal construct theory. We use a novel method for identifying those conflicts using the repertory grid technique (RGT). Preliminary results with depressive patients show that about 90% of them have one or more of those conflicts. This fact might explain the blockage and the difficult progress of these patients, especially the more severe and/or chronic. These results justify the need for specific interventions focused on the resolution of these internal conflicts. This study aims to empirically test the hypothesis that an intervention focused on the dilemma(s) specifically detected for each patient will enhance the efficacy of cognitive behavioral therapy (CBT) for depression. A therapy manual for a dilemma-focused intervention will be tested using a randomized clinical trial by comparing the outcome of two treatment conditions: combined group CBT (eight, 2-hour weekly sessions) plus individual dilemma-focused therapy (eight, 1-hour weekly sessions) and CBT alone (eight, 2-hour group weekly sessions plus eight, 1-hour individual weekly sessions). Participants are patients aged over 18 years meeting diagnostic criteria for major depressive disorder or dysthymic disorder, with a score of 19 or above on the Beck depression inventory, second edition (BDI-II) and presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct) as assessed using the RGT. The BDI-II is the primary outcome measure, collected at baseline, at the end of therapy, and at 3- and 12-month follow-up; other secondary measures are also used. We expect that adding a dilemma-focused intervention to CBT will increase the efficacy of one of the more prestigious therapies for depression, thus resulting in a significant contribution to the psychological treatment of depression. ISRCTN92443999; ClinicalTrials.gov Identifier: NCT01542957.",23683841,Major Depressive Disorder,Anxiety Treatment,Mental Health,26910,11.036469459533691,-2.285848379135132,Cd41
"Benefits of Sequentially Adding Cognitive-Behavioral Therapy or Antidepressant Medication for Adults With Nonremitting Depression.

Adults with major depressive disorder frequently do not achieve remission with an initial treatment. Addition of psychotherapy for patients who do not achieve remission with antidepressant medication alone can target residual symptoms and protect against recurrence, but the utility of adding antidepressant medication after nonremission with cognitive-behavioral therapy (CBT) has received little study. The authors aimed to evaluate the acute and long-term outcomes resulting from both sequences of combination treatments. Previously untreated adults with major depression who were randomly assigned to receive escitalopram, duloxetine, or CBT monotherapy and completed 12 weeks of treatment without achieving remission entered an additional 12 weeks of combination treatment. For patients who did not achieve remission with CBT, escitalopram was added (CBT plus medication group) to their treatment, and for those who did not achieve remission with an antidepressant, CBT was added (medication plus CBT group) to their treatment. Patients who responded to the combination treatment entered an 18-month follow-up phase to assess risk of recurrence. A total of 112 patients who did not achieve remission with a monotherapy entered combination treatment (41 who responded to monotherapy but did not achieve remission and 71 who did not respond to monotherapy). Overall, remission rates after subsequent combination therapy were significantly higher among patients who responded to monotherapy but did not achieve remission (61%) than among patients who did not respond to monotherapy (41%). Among patients who responded to monotherapy but did not achieve remission, the remission rate in the CBT plus medication group (89%) was higher than in the medication plus CBT group (53%). However, among patients whose depression did not respond to monotherapy, rates of response and remission were similar between the treatment arms. Higher levels of anxiety, both prior to monotherapy and prior to beginning combination treatment, predicted poorer outcomes for both treatment groups. The order in which CBT and antidepressant medication were sequentially combined did not appear to affect outcomes. Addition of an antidepressant is an effective approach to treating residual symptoms for patients who do not achieve remission with CBT, as is adding CBT after antidepressant monotherapy. Patients who do not respond to one treatment modality warrant consideration for addition of the alternative modality.",30764648,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.37190055847168,-1.1840903759002686,A+3m
"Individual participant data (IPD) meta-analysis of psychological relapse prevention interventions versus control for patients in remission from depression: a protocol.

Psychological interventions and antidepressant medication can be effective interventions to prevent depressive relapse for patients currently in remission of depression. Less is known about overall factors that predict or moderate treatment response for patients receiving a psychological intervention for recurrent depression. This is a protocol for an individual participant data (IPD) meta-analysis which aims to assess predictors and moderators of relapse or recurrence for patients currently in remission from depression. Searches of PubMed, PsycINFO, Embase and Cochrane Central Register of Controlled Trials were completed on 13 October 2019. Study extractions and risk of bias assessments have been completed. Study authors will be asked to contribute IPD. Standard aggregate meta-analysis and IPD analysis will be conducted, and the outcomes will be compared with assess whether results differ between studies supplying data and those that did not. IPD files of individual data will be merged and variables homogenised where possible for consistency. IPD will be analysed via Cox regression and one and two-stage analyses will be conducted. The results will be published in peer review journals and shared in a policy briefing as well as accessible formats and shared with a range of stakeholders. The results will inform patients and clinicians and researchers about our current understanding of more personalised ways to prevent a depressive relapse. No local ethics approval was necessary following consultation with the legal department. Guidance on patient data storage and management will be adhered to. CRD42019127844.",32060157,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.207995414733887,-1.21957266330719,AtVm
"Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis.

Depression is a common, disabling condition for which psychological treatments are recommended. Behavioural activation has attracted increased interest in recent years. It has been over 5 years since our meta-analyses summarised the evidence supporting and this systematic review updates those findings and examines moderators of treatment effect. Randomised trials of behavioural activation for depression versus controls or anti-depressant medication were identified using electronic database searches, previous reviews and reference lists. Data on symptom level and study level moderators were extracted and analysed using meta-analysis, sub-group analysis and meta-regression respectively. Twenty six randomised controlled trials including 1524 subjects were included in this meta-analysis. A random effects meta-analysis of symptom level post treatment showed behavioural activation to be superior to controls (SMD -0.74 CI -0.91 to -0.56, k = 25, N = 1088) and medication (SMD -0.42 CI -0.83 to-0.00, k = 4, N = 283). Study quality was low in the majority of studies and follow- up time periods short. There was no indication of publication bias and subgroup analysis showed limited association between moderators and effect size. The results in this meta-analysis support and strengthen the evidence base indicating Behavioural Activation is an effective treatment for depression. Further high quality research with longer term follow-up is needed to strengthen the evidence base.",24936656,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.574858665466309,-2.078096866607666,CMgZ
"Is there a dose-effect relationship between the number of psychotherapy sessions and improvement of social functioning?

OBJECTIVES AND DESIGN This study describes a randomized controlled trial which aimed to evaluate whether 16 sessions of psychotherapy combined with pharmacotherapy is more effective in relieving depression and improving social functioning than 8 sessions of psychotherapy combined with pharmacotherapy. METHODS. Randomized controlled trial comparing two treatment conditions with different psychotherapy dosages in out-patients with major depression. All patients studied had a baseline score of at least 14 points on the 17-item Hamilton Depression Rating Scale (HDRS). The two conditions consisted of 8- or 16-session short psychodynamic supportive psychotherapy, both in combination with pharmacotherapy. Efficacy was assessed using the 17-item HDRS, the clinical global impression of severity and of improvement, the depression subscale of the Ninety Symptom Checklist, the Quality of Life Depression Scale, and the Groningen Social Disability Schedule. RESULTS. Social functioning improved significantly in both groups. No significant differences were found between 8 and 16 sessions with regard to social functioning. A significant advantage is found for patients in remission on 5 of the 11 dimensions in social functioning over patients not in remission. CONCLUSIONS. At the end of treatment, no clear differences are found between 8 or 16 sessions of psychotherapy - both combined with pharmacotherapy - with regard to severity of depression and social functioning. It is thus still unknown if patients with major depression show more improvement in social functioning and less symptoms of depression after 16 sessions of combined therapy than after 8 sessions. Currently, it seems that for major depression 8 sessions of combined therapy are equally effective as 16 sessions.",21810106,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.698748588562012,-3.532097339630127,C5I9
"A Randomized Survey of the Public's Expectancies and Willingness to Participate in Clinical Trials of Antidepressants Versus Psychotherapy for Depression.

Expectancies and treatment preferences are known to affect the outcomes of patients enrolled in clinical trials for depression, but there is little research on their influence when the public is considering participation in these trials. We conducted an online survey (May 2013) in which participants (N = 615) were randomly assigned to read hypothetical descriptions of clinical trials for depression based on 1 of the following study designs: medication versus placebo, medication versus medication, psychotherapy versus placebo, or psychotherapy versus psychotherapy. Afterward, individuals rated willingness to participate in the trial, logic and credibility of the treatments, and expected success and improvement in symptoms. There were no differences in expectancies for ratings of credibility and logic or success and improvement among clinical trial designs. However, self-reported willingness to participate in the study was rated significantly higher in the 2 psychotherapy trial designs (active-comparator and placebo-controlled) compared with the active-comparator medication design (P < .05). Psychiatric treatment history, general treatment preferences, and depression severity were positively correlated with willingness to participate primarily in the active-comparator medication design. Consistent with the broader treatment preference literature, individuals reported a greater willingness to participate in psychotherapy compared with antidepressant studies. Thus, people's perceptions of different treatments are likely to influence not only the outcomes of clinical trials for depression but also decisions to participate in these trials in the first place.",27247843,Major Depressive Disorder,Anxiety Treatment,Mental Health,8564,9.89639663696289,-2.4473187923431396,BsA2
"Dismantling the relative effectiveness of core components of cognitive behavioural therapy in preventing depression in adolescents: protocol of a cluster randomized microtrial.

Both depressive disorder and subclinical depressive symptoms during adolescence are a major public health concern. Therefore, it is important that depression is detected at an early stage and is treated preventively. Prevention based on the principles of Cognitive Behavioural Therapy (CBT) has proven to be the most effective, however research has mainly focused on the effectiveness of ""prevention packages"" consisting of multiple CBT-components, rather than on the distinct CBT-components. This study will evaluate the relative effectiveness of four core components of CBT (cognitive restructuring (CR), behavioural activation (BA), problem solving (PS) and relaxation (RE)). In addition the relative (cost-)effectiveness of four different sequences of these components will be evaluated: (1) CR - BA - RE - PS, (2) BA - CR - RE - PS, (3) PS - GA - CR - RE and (4) RE - PS - BA - CR. We will perform a non-blinded multisite cluster randomized prevention microtrial with four parallel conditions consisting of the four sequences. The four sequences of components will be offered in groups of high school students with elevated depressive symptoms. For each CBT-component a module of three sessions is developed. Assessments will be conducted at baseline, after each CBT-component, prior to each session, at post-intervention and at 6-month follow-up. Potential moderators and mediators will be evaluated exploratively to shed light on for whom the (sequences of) CBT-components are most effective and how effects are mediated. The potential value of the study is insight in the relative effectiveness of the four most commonly used CBT-components and four different sequences, and possible moderators and mediators in the prevention of depression among adolescents. This knowledge can be used to optimize and personalize CBT-programs. The study is registered in the Dutch Trial Register (Trial NL5584 / NTR6176) on October 13, 2016.",31248384,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.162001609802246,-2.988860845565796,A4V7
"Empirically supported methods of short-term psychodynamic therapy in depression - towards an evidence-based unified protocol.

There is evidence that psychotherapy is helpful in depressive disorders, with no significant differences between psychotherapies. For psychodynamic therapy (PDT) various models prove to be efficacious. Thus, the evidence for PDT is ""scattered"" between different forms of PDT, also implying problems in training of psychotherapy and in transferring research to clinical practice. A unified protocol based on empirically-supported methods of PDT in depression may contribute to solve these problems Systematic search for randomized controlled trials fulfilling the following criteria: (a) individual psychodynamic therapy (PDT) of depressive disorders, (b) treatment manuals or manual-like guidelines, (c) PDT proved to be efficacious compared to control conditions, (d) reliable measures for diagnosis and outcome, and (f) adult patients. Fourteen RCTs fulfilled the inclusion criteria. By a systematic review of the applied methods of PDT seven treatment components were identified. A high consistency between components was found. The components were conceptualized in the form of seven interrelated treatment modules. A unified psychodynamic protocol for depression may enhance the empirical status of PDT, facilitate both the training in psychotherapy and the transfer of research to clinical practice and may have an impact on the health care system.",25194781,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.754581451416016,-4.379326820373535,CIwc
"Can personalized treatment prediction improve the outcomes, compared with the group average approach, in a randomized trial? Developing and validating a multivariable prediction model in a pragmatic megatrial of acute treatment for major depression.

Clinical trials have traditionally been analysed at the aggregate level, assuming that the group average would be applicable to all eligible and similar patients. We re-analyzed a mega-trial of antidepressant therapy for major depression to explore whether a multivariable prediction model may lead to different treatment recommendations for individual participants. The trial compared the second-line treatment strategies of continuing sertraline, combining it with mirtazapine or switching to mirtazapine after initial failure to remit on sertraline among 1,544 patients with major depression. The outcome was the Personal Health Questionnaire-9 (PHQ-9) at week 9: the original analyses showed that both combining and switching resulted in greater reduction in PHQ-9 by 1.0 point than continuing. We considered several models of penalized regression or machine learning. Models using support vector machines (SVMs) provided the best performance. Using SVMs, continuing sertraline was predicted to be the best treatment for 123 patients, combining for 696 patients, and switching for 725 patients. In the last two subgroups, both combining and switching were equally superior to continuing by 1.2 to 1.4 points, resulting in the same treatment recommendations as with the original aggregate data level analyses; in the first subgroup, however, switching was substantively inferior to combining (-3.1, 95%CI: -5.4 to -0.5). Stronger predictors are needed to make more precise predictions. The multivariable prediction models led to improved recommendations for a minority of participants than the group average approach in a megatrial.",32664003,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.911894798278809,-0.9521442651748657,Al2z
"Narrative therapy with an emotional approach for people with depression: Improved symptom and cognitive-emotional outcomes.

Narrative therapy is a useful approach in the treatment of depression that allows that person to 're-author' his/her life stories by focusing on positive interpretations, and such focus on positive emotions is a crucial component of treatment for depression. This paper evaluates narrative therapy with an emotional approach (NTEA) as a therapeutic modality that could be used by nurses for persons with depression. A nurse-administered NTEA intervention for people with depression appears effective in increasing cognitive-emotional outcomes, such as hope, positive emotions and decreasing symptoms of depression. Thus, NTEA can be a useful nursing intervention strategy for people with depression. Narrative therapy, which allows a person to 're-author' his/her life stories by focusing on positive interpretations, and emotion-focused therapy, which enables the person to realize his/her emotions, are useful approaches in the treatment of depression. Narrative therapy with an emotional approach (NTEA) aims to create new positive life narratives that focus on alternative stories instead of negative stories. The purpose of this study was to evaluate the effects of the NTEA programme on people with depression utilizing a quasi-experimental design. A total of 50 patients (experimental 24, control 26) participated in the study. The experimental group completed eight sessions of the NTEA programme. The effects of the programme were measured using a self-awareness scale, the Nowotny Hope Scale, the Positive Affect and Negative Affect Scale, and the Center for Epidemiological Studies-Depression Scale. The two groups were homogeneous. There were significant differences in hope, positive and negative emotions, and depression between the experimental and control group. The results established that NTEA can be a useful nursing intervention strategy for people with depression by focusing on positive experiences and by helping depressed patients develop a positive identity through authoring affirmative life stories.",25753316,Major Depressive Disorder,Anxiety Treatment,Mental Health,24336,13.282059669494629,-6.804440975189209,CA1y
"A randomized controlled trial on the effectiveness of a rumination-focused group treatment for residual depression.

The maintenance of residual symptoms following acute treatment is common and is associated with poor long-term prognosis. This study investigates whether a cognitive-behavioral group treatment is effective in reducing residual depression by targeting depressive rumination. Participants (N=60) were randomly assigned to either the group treatment or a wait-list control condition. Treatment significantly improved depressed mood, rumination, perceived control over rumination and dysfunctional metacognitive beliefs compared with the wait condition. Treatment gains were maintained over the follow-up period of 1 year. Attrition was low and treatment satisfaction was high. Eight individuals suffered from a depressive relapse/recurrence in the year following treatment. The results indicate that cognitive-behavioral group therapy for depressive rumination is effective and well accepted by patients suffering from residual depression.",23962173,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.12775993347168,-1.2258684635162354,CZw0
"Behavioral activation with mindfulness in treating subthreshold depression in primary care: A cost-utility and cost-effectiveness analysis alongside a randomized controlled trial.

This study aimed to assess the cost-utility and cost-effectiveness of group-based behavioral activation with mindfulness (BAM) versus care as usual (CAU) for treating subthreshold depression in primary care. Adults aged 18 years or older with subthreshold depression were randomized into two arms and were followed up for 12 months. BAM group was provided with eight 2-h weekly treatment by trained allied healthcare workers. CAU group could access to usual medical care but did not receive extra interventions. The health service cost in the past 12 months was self-reported by the participants. Quality-adjusted Life Years (QALYs) and clinical outcome (incidence of major depressive disorder progression) were measured. Willingness-to-pay ratio for cost-utility analysis (CUA) and cost-effectiveness analysis (CEA) was US$50,000 per QALY and US$20,000 per prevented major depression case, respectively. These ratios were used in the cost-effective acceptability curve analyses to estimate the probability of cost-effectiveness of the estimated incremental cost effectiveness ratios (ICER) of BAM versus CAU. A total of 115 and 116 participants were included in the BAM group and CAU respectively. The estimated CUA ICER was US5,979 per QALY and had a probability of 0.93 that BAM was cost-effective when compared to CAU. Furthermore, when compared to CAU, BAM was cost-effective in preventing progression of major depression: the estimated CEA ICER was US$1046 per preventable case of major progression with a probability of 0.99 to be cost-effective. Group-based BAM is considered as a cost-effective alternative treatment for treating subthreshold depression by preventing major depressive disorder.",33086144,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.91219711303711,-1.8983005285263062,Agoq
"Trajectories of depression in psychotherapy: How client characteristics predict clinical improvement.

The current study aims to ascertain the trajectories of psychotherapy clients' symptom change and identify client factors that predict treatment outcome. We conducted a latent growth mixture model (LGMM) to identify the change trajectories of 44 clients' depression scores during psychotherapy. Client characteristics were then explored to determine whether any were associated with change trajectories. We examined whether the number of physician visits and/or client self-concealment scores predict 63 clients' improvement after controlling for initial symptom severity. Two trajectories of clients' symptom change were identified: nonimprovers (52.3%) and improvers (47.7%). Nonimprovers had higher levels of self-concealment and baseline depression than improvers. The number of physician visits was associated with higher depression scores at baseline and greater clinical improvement during psychotherapy. Clients showed distinct trajectories of symptom change in psychotherapy. Early identification of clients at risk for treatment failure may increase the probability of therapeutic success.",33538344,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.387944221496582,-3.553597927093506,Abat
"Affect regulation training reduces symptom severity in depression - A randomized controlled trial.

Deficits in general emotion regulation skills have been shown to be associated with various mental disorders. Thus, general affect-regulation training has been proposed as promising transdiagnostic approach to the treatment of psychopathology. In the present study, we aimed to evaluate the efficacy of a general affect-regulation as a stand-alone, group-based treatment for depression. For this purpose, we randomly assigned 218 individuals who met criteria for major depressive disorder (MDD) to the Affect Regulation Training (ART), to a waitlist control condition (WLC), or to a condition controlling for common factors (CFC). The primary outcome was the course of depressive symptom severity as assessed with the Hamilton Rating Scale for Depression and the Beck Depression Inventory. Multi-level analyses indicated that participation in ART was associated with a greater reduction of depressive symptom severity than was participation in WLC (d = 0.56), whereas the slight superiority of ART over CFC (d = 0.25) was not statistically significant. Mediation analyses indicated that changes in emotion regulation skills mediated the differences between ART/CFC and WLC. Thus, the findings provide evidence for enhancing emotion regulation skills as a common mechanism of change in psychological treatments for depression. The study was registered with ClinicalTrials.gov (NCT01330485) and was supported by grants from the German Research Association (DFG; BE 4510/3-1; HI 456/6-2). Future research should compare the (cost-) efficacy of ART with that of disorder-specific interventions.",31465443,Major Depressive Disorder,Anxiety Treatment,Mental Health,7324,15.353261947631836,-2.5049381256103516,A1ZQ
"[Depression and Comorbid Personality Disorder - Effectiveness of Psychodynamic Inpatient Psychotherapy].

Objectives Depression is one of the most common illnesses. The effectiveness of psychodynamic psychotherapy on depressive symptom load has been demonstrated. However, for patients suffering from comorbid personality disorder (PD) a decreased benefit has been reported, as well as fewer rates of remission and extended duration of remission. However, findings are inconsistent. The objective of this study was to determine potential differences in therapy-outcome comparing female patients with and without comorbid PD. Method Including female inpatients aged between 25-45 years (N=377) in a psychodynamic treatment, the dissenting outcome on depressive symptom load (among others BDI; HAMD) as well as psychodynamic variables (IPO) by patients with and without comorbid PD were analysed within a naturalistic multicenter intervention study (STOP-D). Data were collected in 15 psychodynamically oriented psychosomatic hospital units in Germany, based on self- and external-assessment instruments. Results Under comparable therapy-doses, female patients with and without comorbid PD benefit significantly from psychodynamic inpatient treatment. By equivalent baseline severity of clinical symptoms patients without comorbid PD show larger effect sizes in all inventories than patients with comorbid PD. Discussion Although the benefit is lower for depressed patients with comorbid personality disorder, the positive effect of inpatient psychodynamic psychotherapy is statistically and clinically significant in both groups. Influences of further comorbid symptoms and confounding symptoms between depression and PD, which were difficult to control, are possible. Further studies are necessary. Conclusion Although patients with comorbid PD benefit significantly from the inpatient treatment, a special therapeutic design seems to be indicated for these patients.",28511242,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,11.90524673461914,-3.376521348953247,Bcfq
"Internet-based treatment of depressive symptoms in a Kurdish population: A randomized controlled trial.

Kurdish immigrants in Sweden have a doubled risk of mental health problems, and refugee and immigrant populations underutilize mental health services. The present study investigated the efficacy of culturally adapted guided internet-based cognitive behavior therapy (ICBT) for depressive symptoms in a Kurdish population. We included 50 individuals who were randomized to either an 8-week treatment or a wait-list. The Beck Depression Inventory-II was the primary outcome measure, and measures of anxiety and insomnia were secondary outcomes. Depressive symptoms were significantly reduced (intention-to-treat analysis) in the treatment group, with a between-group effect size at posttreatment of Cohen's d=1.27. Moderate to large between-group effects were also observed on all secondary outcome measures. Treatment effects were sustained at 11-month follow-up. The results provide preliminary support for culturally adapted ICBT as a complement to other treatment formats for treating symptoms of depression in a Kurdish population.",30702758,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.612001419067383,-2.93373966217041,A/oN
"Predictors of remission in depression to individual and combined treatments (PReDICT): study protocol for a randomized controlled trial.

Limited controlled data exist to guide treatment choices for clinicians caring for patients with major depressive disorder (MDD). Although many putative predictors of treatment response have been reported, most were identified through retrospective analyses of existing datasets and very few have been replicated in a manner that can impact clinical practice. One major confound in previous studies examining predictors of treatment response is the patient's treatment history, which may affect both the predictor of interest and treatment outcomes. Moreover, prior treatment history provides an important source of selection bias, thereby limiting generalizability. Consequently, we initiated a randomized clinical trial designed to identify factors that moderate response to three treatments for MDD among patients never treated previously for the condition. Treatment-naïve adults aged 18 to 65 years with moderate-to-severe, non-psychotic MDD are randomized equally to one of three 12-week treatment arms: (1) cognitive behavior therapy (CBT, 16 sessions); (2) duloxetine (30-60 mg/d); or (3) escitalopram (10-20 mg/d). Prior to randomization, patients undergo multiple assessments, including resting state functional magnetic resonance imaging (fMRI), immune markers, DNA and gene expression products, and dexamethasone-corticotropin-releasing hormone (Dex/CRH) testing. Prior to or shortly after randomization, patients also complete a comprehensive personality assessment. Repeat assessment of the biological measures (fMRI, immune markers, and gene expression products) occurs at an early time-point in treatment, and upon completion of 12-week treatment, when a second Dex/CRH test is also conducted. Patients remitting by the end of this acute treatment phase are then eligible to enter a 21-month follow-up phase, with quarterly visits to monitor for recurrence. Non-remitters are offered augmentation treatment for a second 12-week course of treatment, during which they receive a combination of CBT and antidepressant medication. Predictors of the primary outcome, remission, will be identified for overall and treatment-specific effects, and a statistical model incorporating multiple predictors will be developed to predict outcomes. The PReDICT study's evaluation of biological, psychological, and clinical factors that may differentially impact treatment outcomes represents a sizeable step toward developing personalized treatments for MDD. Identified predictors should help guide the selection of initial treatments, and identify those patients most vulnerable to recurrence, who thus warrant maintenance or combination treatments to achieve and maintain wellness.",22776534,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.78080940246582,-1.1041737794876099,CrFw
"A cluster randomized controlled trial of an online psychoeducational intervention for people with a family history of depression.

People with a family history of major depressive disorder (MDD) or bipolar disorder (BD) report specific psychoeducational needs that are unmet by existing online interventions. This trial aimed to test whether an interactive website for people at familial risk for depression (intervention) would improve intention to adopt, or actual adoption of, depression prevention strategies (primary outcome) and a range of secondary outcome measures. In this cluster randomised trial, primary care practises were randomised to either provide the link to the intervention or the control website. Primary health care attendees were invited by letter to opt into this study if they had at least one first-degree relative with MDD or BD and were asked to complete online questionnaires at baseline and 2-week follow-up. Twenty general practices were a randomized, and 202 eligible patients completed both questionnaires. Thirty-nine (19.3%) of participants were male and 163 (80.7%) female. At follow-up, compared to controls, the intervention group: (i) were more likely to intend to undergo, or to have actually undergone, psychological therapies (OR=5.83, 95% CI: 1.58-21.47, p=.008); (ii) had better knowledge of depression risk factors and prevention strategies (mean difference=0.47, 95% CI: 0.05-0.88, p=.029); and (iii) were more likely to accurately estimate their lifetime risk of developing BD (mean difference=11.2, 95% CI: -16.52- -5.73, p<.001). There were no statistically significant between-group differences in change from baseline to follow up for any of the remaining outcome measures (Patient Health Questionnaire, Perceived Devaluation-Discrimination Questionnaire and Perceived Risk of Developing MDD). The opt-in nature of the study may have led to participation bias, e.g. underrepresentation of males, and hence may limit generalisability to the broader population at familial risk for depression. This is the first website internationally focusing specifically on informational needs of those at familial risk of depression. Our interactive website can play an important role in improving the outcomes of individuals at familial risk for depression. Testing the intervention in other settings (e.g. psychology, psychiatry, genetic counselling) appears warranted. The study was prospectively registered with the Australian and New Zealand Clinical Trials Group (Registration no: ACTRN12613000402741 ).",30654777,Major Depressive Disorder,Anxiety Treatment,Mental Health,26524,10.713804244995117,-3.067965507507324,BATo
"A pilot study of interpersonal psychotherapy for alcohol-dependent women with co-occurring major depression.

Co-occurring major depression is prevalent among alcohol-dependent women and is a risk factor for poor treatment outcomes. This uncontrolled pilot study tested the feasibility, acceptability, and initial effects of interpersonal psychotherapy (IPT) for women with co-occurring alcohol dependence and major depression (AD-MD) in an outpatient community addiction treatment program. Fourteen female patients with concurrent diagnoses of alcohol dependence and major depression participated. Assessments were conducted at baseline, midtreatment (8 and 16 weeks), posttreatment (24 weeks), and follow-up (32 weeks). Participants attended a mode of 8 out of 8 possible sessions of IPT in addition to their routine addiction care, and reported high treatment satisfaction on the Client Satisfaction Questionnaire-8. Women's drinking behavior, depressive symptoms, and interpersonal functioning improved significantly over the treatment period and were sustained at follow-up. These preliminary findings suggest that IPT is a feasible, highly acceptable adjunctive behavioral intervention for AD-MD women.",23844953,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.580143928527832,-3.697808265686035,CbiF
"The effect of psychotherapy for depression on improvements in social functioning: a meta-analysis.

Patients with depression often report impairments in social functioning. From a patient perspective, improvements in social functioning might be an important outcome in psychotherapy for depression. Therefore, it is important to examine the effects of psychotherapy on social functioning in patients with depression. We conducted a meta-analysis on studies of psychotherapy for depression that reported results for social functioning at post-treatment. Only studies that compared psychotherapy to a control condition were included (31 studies with 2956 patients). The effect size of psychotherapy on social functioning was small to moderate, before [Hedges' g = 0.46, 95% confidence interval (CI) 0.32-0.60] and after adjusting for publication bias (g = 0.40, 95% CI 0.25-0.55). Univariate moderator analyses revealed that studies using care as usual as a control group versus other control groups yielded lower effect sizes, whereas studies conducted in the USA versus other countries and studies that used clinician-rated instruments versus self-report yielded higher effect sizes. Higher quality studies yielded lower effect sizes whereas the number of treatment sessions and the effect size of depressive symptoms were positively related to the effect size of social functioning. When controlling for these and additional characteristics simultaneously in multivariate meta-regression, the effect size of depressive symptoms, treatment format and number of sessions were significant predictors. The effect size of social functioning remained marginally significant, indicating that improvements in social functioning are not fully explained by improvements in depressive symptoms. Psychotherapy for depression results in small to moderate improvements in social functioning. These improvements are strongly associated with, but not fully explained by, improvements in depressive symptoms.",24472135,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.363104820251465,-2.088489532470703,CS4+
"Training in and implementation of Acceptance and Commitment Therapy for depression in the Veterans Health Administration: therapist and patient outcomes.

The U.S. Department of Veterans Affairs has implemented a national dissemination and training initiative to promote the availability of Acceptance and Commitment Therapy for depression (ACT-D). This paper reports on therapist and patient outcomes associated with competency-based training in and implementation of ACT-D. Therapist and patient outcomes were assessed on eleven cohorts of therapists (n = 391) and their patients (n = 745). Three-hundred thirty four therapists successfully completed all requirements of the Training Program. Ninety-six percent of therapists achieved competency by the end of training, compared to 21% at the outset of training. Mixed effects model analysis indicated therapists' overall ACT-D competency scores increased from 76 to 112 (conditional SD = 6.6), p < 0.001. Moreover, training was associated with significantly increased therapist self-efficacy and positive attitudes toward ACT-D. Therapeutic alliance increased significantly over the course of therapy. Mixed effects model analysis revealed that mean BDI-II scores decreased from 30 at baseline assessment to 19 (conditional SD = 5.6) at final assessment, t(367) = -20.3, p < 0.001. Quality of life scores also increased. Training in and implementation of ACT-D in the treatment of Veterans is associated with significant increases in therapist competency and robust improvements in patient outcomes.",23851161,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.36116886138916,-1.6137738227844238,CbcU
"Cognitive bias modification to prevent depression (COPE): study protocol for a randomised controlled trial.

Depression is a leading cause of disability worldwide and, although efficacious treatments are available, their efficacy is suboptimal and recurrence of symptoms is common. Effective preventive strategies could reduce disability and the long term social and health complications associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel, simple, and safe intervention that addresses attentional and interpretive biases associated with anxiety, dysphoria, and depression. The primary aim of this trial is to determine if CBM decreases the one-year onset of a major depressive episode among adults with subsyndromal depression. This randomised controlled trial will recruit 532 adults with subsyndromal symptoms of depression living in the Australian community (parallel design, 1:1 allocation ratio). Participants will be free of clinically significant symptoms of depression and of psychotic disorders, sensory and cognitive impairment, and risky alcohol use. The CBM intervention will target attentional and interpretive biases associated with depressive symptoms. The sessions will be delivered via the internet over a period of 52 weeks. The primary outcome of interest is the onset of a major depressive episode according the DSM-IV-TR criteria over a 12-month period. Secondary outcomes of interest include change in the severity of depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9), use of antidepressants or benzodiazepines, and changes in attention and interpretive biases. The assessment of outcomes will take place 3, 6, 9, and 12 months after randomisation and will occur via the internet. We propose to test the efficacy of an innovative intervention that is well grounded in theory and for which increasing empirical evidence for an effect on mood is available. The intervention is simple, inexpensive, easy to access, and could be easily rolled out into practice if our findings confirm a role for CBM in the prevention of depression. Australian and New Zealand Clinical Trials Registry ACTRN12613001334796. Date: 5th December 2013.",25012399,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.206585884094238,-1.4193896055221558,CLcu
"[Psychodynamically oriented inpatient psychotherapy of depressive disorders - First findings from a naturalistic, multicenter study].

While the general effectiveness of psychodynamic psychotherapy in both outpatient and inpatient treatment has been proven, few studies document the effectiveness of clinical inpatient treatment of depression through psychodynamic psychotherapy. This paper presents first results of a naturalistic multicenter intervention study. Included were female inpatients suffering from depressive symptoms who had been admitted to 15 psychodynamically oriented psychosomatic hospital units (N = 487). The mean duration of treatment was 61.8 days. Data were acquired at admission (T1) and discharge (T2). Our findings support previous evidence and show that psychodynamically oriented inpatient psychotherapy of depressive disorders is efficient. High pre-post effect sizes were documented in all psychometric instruments used (BDI, HAM-D, SCL-90-R, BSS, GAF). Initial subgroup comparisons reveal that the benefits for patients with comorbid personality disorder are significantly lower than for depressed patients without comorbid personality disorder. Psychodynamic inpatient psychotherapy, as practiced under naturalistic conditions, is an effective treatment of depression. Predictors of therapeutic effects within different therapeutic settings, however, remain unclear. The sustainability of the therapeutic effects found and their impact on psychodynamic relevant constructs have still to be proven.",25831982,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,11.474922180175781,-3.1161575317382812,B/tI
"Prevention of violent revictimization in depressed patients with an add-on internet-based emotion regulation training (iERT): study protocol for a multicenter randomized controlled trial.

Psychiatric patients are at high risk of becoming victim of a violent crime compared to the general population. Although most research has focused on patients with severe mental illness, depressed patients have been demonstrated to be prone to victimization as well. Victimization is associated with more severe symptomatology, decreased quality of life, and high risk of revictimization. Hence, there is a strong need for interventions that focus on preventing violent revictimization. Since emotion dysregulation is associated with both victimization and depression, we developed an internet-based Emotion Regulation Training (iERT) to reduce revictimization in depressed patients. This study aims to evaluate the clinical and cost-effectiveness of iERT added to Treatment As Usual (TAU) in reducing incidents of violent revictimization among depressed patients with a recent history of victimization. Furthermore, this study aims to examine secondary clinical outcomes, and moderators and mediators that may be associated with treatment outcomes. In a multicenter randomized controlled trial with parallel group design, patients with a major depressive disorder and a history of violent victimization over the past three years (N=200) will be allocated to either TAU + iERT (N=100) or TAU only (N=100), based on computer-generated stratified block randomization. Assessments will take place at baseline, 8 weeks, 14 weeks, and 6 months after start of treatment, and 12, 24, and 36 months after baseline. The primary outcome measure is the total number of violent victimization incidents at 12 months after baseline, measured with the Safety Monitor: an adequate self-report questionnaire that assesses victimization over the preceding 12 months. Secondary outcome measures and mediators include emotion dysregulation and depressive symptomatology. An economic evaluation with the societal perspective will be performed alongside the trial. This study is the first to examine the effectiveness of an intervention aimed at reducing violent revictimization in depressed patients. If effective, iERT can be implemented in mental health care, and contribute to the well-being of depressed patients. Furthermore, the results will provide insight into underlying mechanisms of revictimization. The study is registered at the Netherlands Trial Register ( NTR5822 ). Date of registration: 4 April 2016.",29394919,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,16.103723526000977,-8.902975082397461,BQrk
"Cognitive behavioral intervention in the Chinese cultural context: a case report.

Depression is predicted to become the world's second leading cause of disability by 2020 according to the World Health Organization. Cognitive behavioral intervention (CBI), recognized as a viable and effective treatment for depression, is becoming more widely used among Chinese clients. However, information about the application of this Western approach in the Chinese population is very limited. This paper discusses adaptations of CBI protocols for Chinese patients, considering the major Chinese cultural characteristics of predestination, losing face, avoiding conflict, and Yin-Yang balance (PLAY) for persons with depression. Illustrated is the application of the PLAY protocol in the actual case of a 35-year-old woman with depression. Implications for integrating Chinese cultural characteristics with CBI are discussed. There is evidence for adaptations of CBI for enhancing its effectiveness among Chinese people within their cultural context. Since there are limited studies on cultural-sensitive CBI for Chinese people, the conclusions drawn from this study are only preliminary. Further studies that verify the findings reported in this paper are necessary.",23857732,Major Depressive Disorder,Anxiety Treatment,Mental Health,21796,10.962263107299805,-3.922579526901245,CbXM
"Negative and Positive Affect Regulation in a Transdiagnostic Internet-Based Protocol for Emotional Disorders: Randomized Controlled Trial.

Emotional disorders (EDs) are among the most prevalent mental disorders. Existing evidence-based psychological treatments are not sufficient to reduce the disease burden of mental disorders. It is therefore essential to implement innovative solutions to achieve a successful dissemination of psychological treatment protocols, and in this regard, the use of information and communication technologies such as the internet can be very useful. Furthermore, the literature suggests that not everyone with an ED receives the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which attempts to address the underlying processes common to EDs. Most of these transdiagnostic interventions focus primarily on downregulating negative affectivity (NA), and less attention has been paid to strengths and the upregulation of positive affectivity, despite its importance for well-being and mental health. This study aims to evaluate the efficacy of a transdiagnostic internet-based treatment for EDs in a community sample. A 3-armed randomized controlled trial was conducted. A total of 216 participants were randomly assigned to a transdiagnostic internet-based protocol (TIBP), a TIBP+ positive affect (PA) component, or a waiting list (WL) control group. The treatment protocol contained core components mainly addressed to downregulate NA (ie, present-focused emotional awareness and acceptance, cognitive flexibility, behavioral and emotional avoidance patterns, and interoceptive and situational exposure) as well as a PA regulation component to promote psychological strengths and enhance well-being. Data on depression, anxiety, quality of life, neuroticism and extraversion, and PA/NA before and after treatment were analyzed. Expectations and opinions of treatment were also analyzed. Within-group comparisons indicated significant pre-post reductions in the two experimental conditions. In the TIBP+PA condition, the effect sizes were large for all primary outcomes (d=1.42, Beck Depression Inventory [BDI-II]; d=0.91, Beck Anxiety Inventory [BAI]; d=1.27, Positive and Negative Affect Schedule-Positive [PANAS-P]; d=1.26, Positive and Negative Affect Schedule-Negative [PANAS-N]), whereas the TIBP condition yielded large effect sizes for BDI-II (d=1.19) and PANAS-N (d=1.28) and medium effect sizes for BAI (d=0.63) and PANAS-P (d=0.69). Between-group comparisons revealed that participants who received one of the two active treatments scored better at posttreatment than WL participants. Although there were no statistically significant differences between the two intervention groups on the PA measure, effect sizes were consistently larger in the TIBP+PA condition than in the standard transdiagnostic protocol. Overall, the findings indicate that EDs can be effectively treated with a transdiagnostic intervention via the internet, as significant improvements in depression, anxiety, and quality of life measures were observed. Regarding PA measures, promising effects were found, but more research is needed to study the role of PA as a therapeutic component. ClinicalTrials.gov NCT02578758; https://clinicaltrials.gov/ct2/show/NCT02578758. RR2-10.1186/s12888-017-1297-z.",33522977,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,11.863181114196777,-2.5599822998046875,Abmo
"Negative mood regulation as a mechanism of change in cognitive therapy for depression.

The present study investigates the effects of negative mood regulation expectancies (NMRE) on symptom severity of depression in 2 cognitive therapies for depression. The sample included the first 146 consecutively recruited patients from a randomized controlled trial. Patients received 22 sessions of either cognitive-behavioral therapy or exposure-based cognitive therapy. They completed the Beck Depression Inventory and Negative Mood Regulation Scale at baseline and treatment termination, as well as after Sessions 7 and 14. Multilevel modeling was applied. We found a significant between-patient effect of NMRE on symptom severity of depression, when NMRE within-patient effects were set to random. There was no significant interactive effect of the between-patient NMRE with type of treatment. However, a significant moderation effect of the within-patient NMRE effect by treatment condition on depression severity was detected, with patients receiving cognitive-behavioral therapy benefiting more from improvements in NMRE. Together, these results empirically support NMRE as a relevant mechanism of change in cognitive therapy for depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).",34881923,Major Depressive Disorder,Anxiety Treatment,Mental Health,7324,14.28036117553711,-1.249841332435608,yzc
"A computer-assisted depression intervention in primary care.

The clinical benefit for depression of an interactive computer-assisted cognitive-behavioral program on CD-ROM, the Wellness Workshop (WW), was evaluated in a randomized controlled trial. A total of 191 individuals referred by primary-care physicians were randomly assigned to a control group, where physician-directed treatment as usual (TAU) was provided, or to a treatment group, where TAU was supplemented with the WW CD-ROM, delivered by mail (WW+TAU). Data were collected at baseline, at 6 weeks' post-intervention, and at a 6-month follow-up assessment. Participants were given a strong incentive by a reimbursement of $75 for completion of each assessment. Measures included symptom ratings obtained via structured clinical diagnostic interviews, as well as a battery of self-report questionnaires on symptoms specifically targeted by the intervention. Analysis of results demonstrated evidence for skill acquisition for improving dysfunctional thinking and reducing anxiety. Among those who met diagnostic criteria for depression, WW+TAU participants were three times more likely to remit at 6 weeks' post-test than TAU participants. The evidence supports the conclusion that the WW intervention added benefit to traditional care for depression. No placebo comparison group was included and the WW+TAU participants received slightly more attention (a supportive telephone contact, ≤ 5 min from a psychologist 2 weeks after receiving the program). Overall, the findings add support to the accumulating evidence for the potential clinical benefit of computer-assisted behavioral health interventions.",20961474,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.409905433654785,-2.905026435852051,DEXQ
"Sudden gains in behavioural activation for depression.

Sudden gains have been linked to improved outcomes in cognitive behaviour therapy for depression. The relationship between sudden gains and outcome is less clear in other treatment modalities, including interpersonal psychotherapy and supportive expressive therapy, which may indicate different mechanisms of change between treatment modalities. The current study examined sudden gains in adults meeting diagnostic criteria for depression (N = 40) offered up to 12 sessions of behavioural activation treatment. Sudden gains were found in 42.5% of the sample. Sudden gains occurred early (median pre-gain session 2) and were related to outcome: those who experienced a sudden gain had significantly lower post-treatment scores on the PHQ-9. Furthermore, the proportion meeting the reliable and clinically significant change criteria at end of treatment was higher in the sudden gain group. These findings highlight the importance of understanding the mechanisms by which sudden gains relate to therapy outcome in behavioural activation.",25049140,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.156213760375977,-3.0662057399749756,CK7V
"Psychological training to improve psychosocial function in patients with major depressive disorder: A randomised clinical trial.

Cognitive and emotional remediation training for depression (CERT-D): a randomised controlled trial to improve cognitive, emotional and functional outcomes in depression The aim of the current study was to evaluate an experimental treatment designed to improve psychosocial function in patients with Major Depressive Disorder (MDD) by reinforcing cognitive, emotional, and social-cognitive abilities. Participants (N = 112) with current or lifetime MDD were recruited to participate in a randomised, blinded, controlled trial. Exclusion criteria included diagnosis of a substance abuse disorder, bipolar disorder organic, eating disorders, or illness which affect cognitive function. The treatment involved repeated cognitive training designed to improve cognitive, emotional, and social-cognitive abilities. In training sessions, the principles of cognitive training were applied across cognitive, emotional, and social domains, with participants completing repeated mental exercises. Exercises included critically analysing interpretations of social interactions (e.g., body language), exploring emotional reactions to stimuli, and completing game-like cognitive training tasks. Training sessions placed great emphasis on the application of trained cognitive, emotional, and social cognitive skills to psychosocial outcomes. Outcomes demonstrated significant improvement in psychosocial function, symptom severity, self-reported cognition, and social-cognition. Our findings demonstrate the efficacy of multi-domain cognitive training to improve psychosocial functioning in individuals with MDD. We suggest that the present treatment could be deployed at a lower cost and with minimal training in comparison to established psychological therapies.",33853014,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.303924560546875,-0.6380323171615601,AX2K
"The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review.

This systematic review describes a comparison between several standard treatments for major depressive disorder (MDD) in adult outpatients, with a focus on interpersonal psychotherapy (IPT). Systematic searches of PubMed and PsycINFO studies between January 1970 and August 2012 were performed to identify (C-)RCTs, in which MDD was a primary diagnosis in adult outpatients receiving individual IPT as a monotherapy compared to other forms of psychotherapy and/or pharmacotherapy. 1233 patients were included in eight eligible studies, out of which 854 completed treatment in outpatient facilities. IPT combined with nefazodone improved depressive symptoms significantly better than sole nefazodone, while undefined pharmacotherapy combined with clinical management improved symptoms better than sole IPT. IPT or imipramine hydrochloride with clinical management showed a better outcome than placebo with clinical management. Depressive symptoms were reduced more in CBASP (cognitive behavioral analysis system of psychotherapy) patients in comparison with IPT patients, while IPT reduced symptoms better than usual care and wait list condition. The differences between treatment effects are very small and often they are not significant. Psychotherapeutic treatments such as IPT and CBT, and/or pharmacotherapy are recommended as first-line treatments for depressed adult outpatients, without favoring one of them, although the individual preferences of patients should be taken into consideration in choosing a treatment.",23312024,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.2705717086792,-3.2144277095794678,CjaT
"Does daily Naikan therapy maintain the efficacy of intensive Naikan therapy against depression?

Naikan Therapy, which has been applied to treating patients with various mental difficulties, can be classified into two major categories: intensive Naikan therapy, which lasts for seven days in a Naikan center or a clinical institute secluded from the outside world for the purpose of deep introspection, and daily Naikan therapy, which can be integrated into regular daily activities. The aim of this research is to evaluate daily Naikan therapy as a maintenance treatment for depression. Forty-seven patients, who were diagnosed as having major depressive disorder using DSM-IV criteria and who practiced intensive Naikan therapy participated in the present study. Two groups of patients were compared: 24 patients who conducted daily Naikan therapy and 23 patients who did not, after practicing intensive Naikan therapy. To evaluate efficacy, the Beck Depression Inventory was used as a primary outcome measure for the assessment of depression. The State-Trait Anxiety Inventory and the Cornell Medical Index were also used as secondary outcome measures to evaluate anxiety and psychosomatic conditions before, immediately after and three months after intensive Naikan therapy. Significant between-group differences were obtained in the time course change of depression, anxiety and psychosomatic scores within three months following the completion of intensive Naikan therapy. The current study indicates that conducting daily Naikan therapy is effective for maintaining the psychological and psychosomatic state at 3 months following the intensive Naikan therapy, while a lack of therapy may allow the patients to exacerbate their conditions to the level they held before practicing intensive Naikan therapy.",20416025,Major Depressive Disorder,Anxiety Treatment,Mental Health,13332,10.3328218460083,-2.104419469833374,DLU0
"Updating the Evidence and Recommendations for Short-Term Psychodynamic Psychotherapy in the Treatment of Major Depressive Disorder in Adults.

",28055257,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.632607460021973,-3.7982819080352783,Bimj
"Internet-based treatment of major depression for patients on a waiting list for inpatient psychotherapy: protocol for a multi-centre randomised controlled trial.

Major depressive disorder (MDD) is a prevalent and severe disorder. Although effective treatments for MDD are available, many patients remain untreated, mainly because of insufficient treatment capacities in the health care system. Resulting waiting periods are often associated with prolonged suffering and impairment as well as a higher risk of chronification. Web-based interventions may help to alleviate these problems. Numerous studies provided evidence for the efficacy of web-based interventions for depression. The aim of this study is to evaluate a new web-based guided self-help intervention (GET.ON-Mood Enhancer-WL) specifically developed for patients waiting to commence inpatient therapy for MDD. In a two-armed randomised controlled trial (n=200), the web-based guided intervention GET.ON-Mood Enhancer-WL in addition to treatment as usual (TAU) will be compared with TAU alone. The intervention contains six modules (psycho education, behavioural activation I & II, problem solving I & II, and preparation for subsequent inpatient depression therapy). The participants will be supported by an e-coach, who will provide written feedback after each module. Inclusion criteria include a diagnosis of MDD assessed with a structured clinical interview [SCID] and a waiting period of at least three weeks before start of inpatient treatment. The primary outcome is observer-rated depressive symptom severity (HRSD24). Further (explorative) questions include whether remission will be achieved earlier and by more patients during inpatient therapy because of the web-based preparatory intervention. If GET.ON-Mood Enhancer-WL is proven to be effective, patients may start inpatient therapy with reduced depressive symptom severity, ideally leading to higher remission rates, shortened inpatient therapy, reduced costs, and decreased waiting times. German Clinical Trial Registration (DRKS): DRKS00004708.",24279841,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.29362678527832,-3.010995626449585,CVh6
"Patients' interpersonal problems as moderators of depression outcomes in a randomized controlled trial comparing mindfulness-based cognitive therapy and a group version of the cognitive-behavioral analysis system of psychotherapy in chronic depression.

Interpersonal problems were examined as moderators of depression outcomes between mindfulness-based cognitive therapy (MBCT) and cognitive behavioral analysis system of psychotherapy (CBASP) in patients with chronic depression. Patients received treatment-as-usual and, in addition, were randomized to 8-weeks of MBCT (n=34) or 8-weeks of CBASP (n=34). MBCT and CBASP were given in a group format. The Hamilton depression rating scale (HAM-D) was the primary and the Beck Depression Inventory (BDI-II) the secondary outcome. The subscales of the Inventory of interpersonal problems (IIP-32) were moderators. Multilevel models were performed. Higher scores on the ""vindictive/self-centered"" subscale were associated with a better outcome in MBCT than in CBASP (HAM-D: p<.01; BDI-II: p<.01). Higher scores on the ""nonassertive"" subscale were associated with a better outcome in CBASP than in MBCT (HAM-D: p<.01; BDI-II: p<.01). If these results can be replicated in larger trials, MBCT should be preferred to CBASP in chronically depressed patients being vindictive/self-centered, whereas CBASP should be preferred to MBCT in chronically depressed patients being nonassertive.",31997369,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.402945518493652,-2.166687250137329,AuLg
"Efficacy of psychological interventions for young adults with mild-to-moderate depressive symptoms: A meta-analysis.

Psychological interventions are commonly used to treat mild-to-moderate depression, but their efficacy in young adults has not been exhaustively addressed. This meta-analysis aims to establish it in comparison to no treatment, wait-list, usual treatment, passive interventions, and other bona-fide treatments. The search was conducted in Scopus, MEDLINE, PsycINFO, ClinicalTrials.gov, the ISRCTN Registry, Cochrane CENTRAL, Clarivate BIOSIS Previews and the METAPSY database, retrieving studies from the start of records to April 2020. Eligibility criteria included samples of 16-30 years experiencing mild-to-moderate depressive symptoms and participating in randomized controlled trials (RCTs), non-RCTs, or pre-post studies measuring depressive symptomatology and featuring psychological treatments. Up to 45 studies met criteria, consisting of 3,947 participants, assessed using the Quality Assessment Tool for Quantitative Studies and their results meta-analyzed assuming random effects. Psychological interventions proved to be efficacious in RCTs compared to no treatment (g = -0.68; 95% CI = -0.87, -0.48) and wait-list (g = -1.04; 95% CI = -1.25, -0.82), while depressive symptoms also improved in pre-post studies (g = -0.99; 95% CI = -1.32, -0.66). However, intervention efficacy was similar to usual care, passive, and bona-fide comparators. The heterogeneity found, a likely reporting bias and the low quality of most studies must be considered when interpreting these results. Psychological treatments are efficacious to reduce depressive symptoms in young adults, but comparable to other interventions in the mild-to-moderate range. Moderators like depression severity or therapist involvement significantly influenced their efficacy, with results encouraging clinicians to adopt flexible and personalized approaches.",35793580,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.37619686126709,-2.5526764392852783,Q6E
"Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: a randomized pilot study.

This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM + EFT). MM followed the Texas Medication Algorithm Project guidelines. Fifteen EFT sessions were delivered following the EFT treatment manual. The primary outcome was severity of depressive symptoms (assessed by the 30-item Inventory of Depressive Symptomatology-Clinician Rated version [IDS-C(30) ] administrated by evaluators blinded to cell assignment). Secondary outcome was relationship quality as assessed by the Quality of Marriage Index. Results from assessments at intake, termination, and two posttreatment follow-ups were analyzed using growth analysis techniques. IDS-C(30) scores improved over 6 months of treatment, regardless of the treatment assignment, and women receiving MM + EFT experienced significantly more improvement in relationship quality compared with women in MM. Because relationship discord after depression treatment predicts worse outcome, interventions improving relationship quality may reduce depression relapse and recurrence. Testing this hypothesis in larger samples with longer follow-up could contribute to knowledge on the mechanisms involved in determining the course of depressive illness.",22765322,Major Depressive Disorder,Anxiety Treatment,Mental Health,3806,14.709487915039062,-6.859973430633545,CrQb
"A review of empirically supported psychological therapies for mood disorders in adults.

The mood disorders are prevalent and problematic. We review randomized controlled psychotherapy trials to find those that are empirically supported with respect to acute symptom reduction and the prevention of subsequent relapse and recurrence. We searched the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to identify appropriate articles. One hundred twenty-five studies were found evaluating treatment efficacy for the various mood disorders. With respect to the treatment of major depressive disorder (MDD), interpersonal psychotherapy (IPT), cognitive behavior therapy (CBT), and behavior therapy (BT) are efficacious and specific and brief dynamic therapy (BDT) and emotion-focused therapy (EFT) are possibly efficacious. CBT is efficacious and specific, mindfulness-based cognitive therapy (MBCT) efficacious, and BDT and EFT possibly efficacious in the prevention of relapse/recurrence following treatment termination and IPT and CBT are each possibly efficacious in the prevention of relapse/recurrence if continued or maintained. IPT is possibly efficacious in the treatment of dysthymic disorder. With respect to bipolar disorder (BD), CBT and family-focused therapy (FFT) are efficacious and interpersonal social rhythm therapy (IPSRT) possibly efficacious as adjuncts to medication in the treatment of depression. Psychoeducation (PE) is efficacious in the prevention of mania/hypomania (and possibly depression) and FFT is efficacious and IPSRT and CBT possibly efficacious in preventing bipolar episodes. The newer psychological interventions are as efficacious as and more enduring than medications in the treatment of MDD and may enhance the efficacy of medications in the treatment of BD.",20830696,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.43705940246582,-2.1145262718200684,DF42
"Neurobiological and pharmacological arguments for customization of cognitive behavioral psychotherapy in the treatment of major depressive disorder.

Depression represents a public health issue because it significantly increases the risk of disabilities and premature mortality, decreases the quality of life, and increases the costs of care. The incomplete remissions favor the aggravation of neurobiological dysfunctions and pathogenesis of severe somatic comorbidities. The etiopathogenic mechanisms of depression are complex and involve multisystemic risk factors (genetic, neuroanatomic, neurobiochemical, neuroendocrine and psychosocial). Cognitive behavioral therapy (CBT) is used in all the stages of depression, as independent therapeutic method or as support of pharmacotherapy. This study has evaluated the therapeutic response of depression in M (medication) group with 136 patients under pharmacotherapy, compared with P (psychotherapy and medication) group with 137 patients treated simultaneously with medication and CBT, and the factors that can improve therapeutic management. Patients with depression had predominantly a reactive onset, recurrent evolution of at least four episodes, and frequent somatic comorbidities. After treatment, a significant improvement of depressive symptomatology was recorded especially in M group (72.06%), compared to P group (88.32%), p<0.01, as well as a significant difference in regaining functional skills (69.12% - M group, 93.43% - P group; p<0.001). The therapeutic response was significantly correlated with age (p<0.01), social-economical involvement and education level. CBT demonstrated efficiency in the treatment of major depressive disorder in association with pharmacotherapy. The therapeutic approach should rely on the pathogenic biological models that would highlight the prediction indicators for the therapeutic response and for the evolution of depression, as well as considering the psychological profile of each patient.",35263410,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.030061721801758,-2.0730459690093994,jdE
"Optimizing Treatment of Complicated Grief: A Randomized Clinical Trial.

To our knowledge, this is the first placebo-controlled randomized clinical trial to evaluate the efficacy of antidepressant pharmacotherapy, with and without complicated grief psychotherapy, in the treatment of complicated grief. To confirm the efficacy of a targeted complicated grief treatment (CGT), determine whether citalopram (CIT) enhances CGT outcome, and examine CIT efficacy without CGT. Included in the study were 395 bereaved adults who met criteria for CG recruited from March 2010 to September 2014 from academic medical centers in Boston, Massachusetts; New York, New York; Pittsburgh, Pennsylvania; and San Diego, California. Co-occurring substance abuse, psychosis, mania, and cognitive impairment were exclusionary. Study participants were randomized using site-specific permuted blocks stratified by major depression into groups prescribed CIT (n=101), placebo (PLA; n=99), CGT with CIT (n=99), and CGT with PLA (n=96). Independent evaluators conducted monthly assessments for 20 weeks. Response rates were compared under the intention-to-treat principle, including all randomized participants in a logistic regression with inverse probability weighting. All participants received protocolized pharmacotherapy optimized by flexible dosing, psychoeducation, grief monitoring, and encouragement to engage in activities. Half were also randomized to receive manualized CGT in 16 concurrent weekly sessions. Complicated grief-anchored Clinical Global Impression scale measurments every 4 weeks. Response was measured as a rating of ""much improved"" or ""very much improved."" Of the 395 study participants, 308 (78.0%) were female and 325 (82.3%) were white. Participants' response to CGT with PLA vs PLA (82.5% vs 54.8%; relative risk [RR], 1.51; 95% CI, 1.16-1.95; P=.002; number needed to treat [NNT], 3.6) suggested the efficacy of CGT, and the addition of CIT did not significantly improve CGT outcome (CGT with CIT vs CGT with PLA: 83.7% vs 82.5%; RR, 1.01; 95% CI, 0.88-1.17; P=.84; NNT, 84). However, depressive symptoms decreased significantly more when CIT was added to treatment (CGT with CIT vs CGT with PLA: model-based adjusted mean [standard error] difference, -2.06 [1.00]; 95% CI, -4.02 to -0.11; P=.04). By contrast, adding CGT improved CIT outcome (CIT vs CGT with CIT: 69.3% vs 83.7%; RR, 1.21; 95% CI, 1.00-1.46; P=.05; NNT, 6.9). Last, participant response to CIT was not significantly different from PLA at week 12 (45.9% vs 37.9%; RR, 1.21; 95% CI, 0.82-1.81; P=.35; NNT, 12.4) or at week 20 (69.3% vs 54.8%; RR, 1.26; 95% CI, 0.95-1.68; P=.11; NNT, 6.9). Rates of suicidal ideation diminished to a substantially greater extent among participants receiving CGT than among those who did not. Complicated grief treatment is the treatment of choice for CG, and the addition of CIT optimizes the treatment of co-occurring depressive symptoms. clinicaltrials.gov Identifier: NCT01179568.",27276373,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.776042938232422,-9.084640502929688,Brpb
"Challenges and Solutions for Depression Prevention Research: Methodology for a Depression Prevention Trial for Older Adults with Knee Arthritis and Emotional Distress.

To describe the methodology, challenges, and baseline characteristics of a prevention development trial entitled ""Reducing Pain, Preventing Depression."" A sequential multiple assignment randomized trial (SMART) compared sequences of cognitive behavioral therapy (CBT) and physical therapy for knee pain and prevention of depression and anxiety. Participants were randomized to CBT, physical therapy, or enhanced usual care and followed for 12 months for new-episode depression or anxiety. Participants were age≥60 with knee osteoarthritis and subsyndromal depression, defined as 9-item Patient Health Questionnaire (PHQ-9) score≥1 (which included the endorsement of one of the cardinal symptoms of depression [low mood or anhedonia]) and no diagnosis of major depressive disorder per the Structured Clinical Interview for DSM-IV. Depression and anxiety severity and characterization of new episodes were assessed with the PHQ-9, Generalized Anxiety Disorder-7, and the PRIME-MD. Knee pain was characterized with the Western Ontario McMaster Arthritis Index. Response was defined as at least ""Very Much Better"" on a Patient Global Impression of Change. At baseline there were 99 patients with an average age of 71; 61.62% were women and 81.8% white. The average PHQ-9 was 5.6 and average Generalized Anxiety Disorder-7, was 3.2. Most were satisfied with the interventions and study procedures. The challenges and solutions described here will also be used in a confirmatory clinical trial of efficacy. A SMART design for depression and anxiety prevention, using both CBT and physical therapy, appears to be feasible and acceptable to participants. The methodologic innovations of this project may advance the field of late-life depression and anxiety prevention.",26809601,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,5.520793437957764,-0.05188531056046486,ByBk
"Biological markers evaluated in randomized trials of psychological treatments for depression: a systematic review and meta-analysis.

Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding. We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression. Fifty-one trials (5123 participants) and a pooled analysis were included. Biological markers were outcomes in 43 studies and predictors of treatment response in 9. At post-treatment, psychotherapy could not be distinguished from control conditions for glycaemic control (Hb1AC), 7 trials, Hedges' g= -.01, 95% CI -0.30 to 0.29, I2=65% and cortisol concentration after-wake, 5 trials, Hedges' g= -.19, 95% CI -0.45 to 0.06, I2=0%. Follow-up results were similar. For the other biological domains (immunological, neurobiological, inflammatory, weight, blood pressure), overall findings were mixed and often inconsistent. Few trials investigated prediction of response, with only neuroimaging markers showing promise. Across domains, we found limited evidence that benefits of psychological treatments for depression translate to biological outcomes.",30922979,Major Depressive Disorder,Anxiety Treatment,Mental Health,23879,5.934162616729736,6.166418552398682,A8te
"The applicability of bright light therapy in adults with moderate, severe or profound intellectual disabilities: a brief report.

Bright light therapy (BLT) is effective in the treatment of depression in the general population. It may be a good treatment option for adults with intellectual disabilities (ID) too. However, its applicability and effectiveness are not studied in groups of adults with ID, yet. Our aim was to study the applicability of BLT in adults with ID. Bright light therapy was offered for 2 weeks, using a 10 000 lux light box, to 14 adults with moderate, severe or profound ID. Applicability of BLT and change in depressive symptoms were studied with questionnaires. Bright light therapy was successfully applied for ≥10 days in 10 participants. It was also applicable in participants with rather severe challenging behaviour. Before BLT, nine participants scored above the cut-off score of the ADAMS' depressive mood subscale. After BLT, six of them scored below cut-off. Bright light therapy is applicable in adults with moderate, severe of profound ID. Its effectiveness as a treatment for depression in adults with ID should be further studied.",28224667,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.0573906898498535,5.020613670349121,Bgft
"Treatment expectations for cognitive-behavioral therapy and light therapy for seasonal affective disorder: Change across treatment and relation to outcome.

To examine the dynamic relationship between treatment expectations and treatment outcome over the course of a clinical trial for winter seasonal affective disorder (SAD). Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern (N = 177) were randomized to 6 weeks of group-delivered cognitive-behavioral therapy for SAD (CBT-SAD) or light therapy (LT). The majority were female (83.6%) and white (92.1%), with a mean age of 45.6 years. Treatment expectations for CBT-SAD and LT were assessed using a modification of the Treatment Expectancy and Credibility Survey (Borkovec & Nau, 1972). Depression severity was assessed using the Beck Depression Inventory-Second Edition (Beck, Steer, & Brown, 1996). All measures were administered at pretreatment, midtreatment, and posttreatment. As treatment progressed, expectations for the treatment received increased across time steeply in CBT-SAD patients and moderately in LT patients. Collapsing across time, patients with higher treatment expectations had lower depression severity than those with lower treatment expectations. In a cross-lagged panel path analysis, there was a significant effect of treatment expectations at midtreatment on depression severity at posttreatment among CBT-SAD patients. Treatment expectations changed across treatment, affected outcome, and should be assessed and monitored repeatedly throughout treatment. Findings suggest that treatment expectations at midtreatment are a mechanism by which CBT-SAD reduces depression, which should be replicated in SAD samples and examined for generalizability to nonseasonal depression. These findings underscore the importance of further research examining treatment expectations in mediating CBT's effects in depression and other types of psychopathology. (PsycINFO Database Record",27281373,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.052788257598877,4.803585529327393,BrmA
"Improvement in depression scores after 1 hour of light therapy treatment in patients with seasonal affective disorder.

The purpose of this study was to investigate possible rapid effects of light therapy on depressed mood in patients with seasonal affective disorder. Participants received 1 hour of bright light therapy and 1 hour of placebo dim red light in a randomized order crossover design. Depressed mood was measured at baseline and after each hour of light treatment using two self-report depression scales (Profile of Mood States-Depression-Dejection [POMS-D] subscale and the Beck Depression Inventory II [BDI-II]). When light effects were grouped for the two sessions, there was significantly greater reduction in self-report depression scores by -1.3 (p = 0.02) on the BDI-II and -1.2 (p = 0.02) on the POMS-D. A significant but modest improvement was detected after a single active light session. This is the first study, to our knowledge, to document an immediate improvement with light treatment using a placebo-controlled design with a clinical sample of depressed individuals.",22210362,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.100324630737305,5.062994956970215,CzOR
"Light therapy for seasonal affective disorder in a clinical office setting.

To determine predictors of response to light therapy (LT) for seasonal affective disorder, winter version, in a clinical office setting for patients with a spectrum of seasonality defined by the Seasonal Pattern Assessment Questionnaire (SPAQ). A retrospective review was done of charts of 51 patients who had been treated with a 1-week light therapy intervention. Patient self-rated scales applied in a standard manner were used to measure clinical progress. The Beck Depression Inventory (BDI) with added atypical features was used as the primary outcome variable. Sleep patterns were analyzed and the effect of psychotropic medications on outcome was determined. Seven point scales were used to assess expected response and global response. The importance of having LT set up and available in an office setting was evaluated. Retrospective degree of disability was measured based on the SPAQ degree of problem. The severity of the depressive episode was determined based on BDI score at entry. Seasonality (how a patient's symptoms vary as a function of the season of the year), degree of disability based on the SPAQ, and severity of depressive episode at entry based on the BDI predicted response to LT. Greater severity at baseline based on BDI score predicted less chance of attaining full remission within 7 days of treatment compared with patients with lower severity scores at entry on the BDI. Sleep patterns relative to a fixed treatment time of 7 AM did not predict LT response. Light therapy was effective on its own, and the results were mixed as to whether adding LT to an existing antidepressant medication produced superior results. Degree of seasonality can be used as a predictor of response to LT and may be clinically useful when suggesting that patients consider a trial of LT.",21107143,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.9791250228881836,4.798640727996826,DC90
"Circadian reinforcement therapy in combination with electronic self-monitoring to facilitate a safe post-discharge period of patients with depression by stabilizing sleep: protocol of a randomized controlled trial.

The transition phase from inpatient to outpatient care for patients suffering from Major Depressive Disorder represents a vulnerable period associated with a risk of depression worsening and suicide. Our group has recently found that the sleep-wake cycle in discharged depressive patients became irregular and exhibited a drift towards later hours, associated with worsening of depression. In contrast, an advancement of sleep phase has earlier been shown to have an antidepressant effect. Thus, methods to prevent drift of the sleep-wake cycle may be promising interventions to prevent or reduce worsening of depression after discharge. In this trial, we apply a new treatment intervention, named Circadian Reinforcement Therapy (CRT), to patients discharged from inpatient psychiatric wards. CRT consists of a specialized psychoeducation on the use of regular time signals (zeitgebers): daylight exposure, exercise, meals, and social contact. The aim is to supply stronger and correctly timed zeitgebers to the circadian system to prevent sleep drift and worsening of depression. The CRT is used in combination with an electronic self-monitoring system, the Monsenso Daybuilder System (MDB). By use of the MDB system, all patients self-monitor their sleep, depression level, and activity (from a Fitbit bracelet) daily. Participants can inspect all their data graphically on the MDB interface and will have clinician contact. The aim is to motivate patients to keep a stable sleep-wake cycle. In all, 130 patients referred to an outpatient service will be included. Depression rating is blinded. Patients will be randomized 1:1 to a Standard group or a CRT group. The intervention period is 4 weeks covering the transition phase from inpatient to outpatient care. The primary outcome is score change in interviewer rated levels of depression on the Hamilton Depression Rating Scale. A subset of patients will be assessed with salivary Dim Light Melatonin Onset (DLMO) as a validator of circadian timing. The trial was initiated in 2016 and will end in 2020. If the described intervention is beneficial it could be incorporated into usual care algorithms for depressed patients to facilitate a better and safer transition to outpatient treatment. Posted prospectively at ClinicalTrials.gov at February 10, 2016 with identifier NCT02679768 .",31023274,Major Depressive Disorder,Anxiety Treatment,Mental Health,1888,-4.360010147094727,4.659811496734619,A7Xw
"Effectiveness of light therapy for depression among active duty service members: A nonrandomized controlled pilot trial.

The authors investigated the potential effectiveness of light therapy as an augmentation treatment for depression among active duty service members. This pilot study recruited active duty service members deployed to an area of combat operations. Enrollment was offered to service members scoring 50 or greater on the Zung Self-Rating Depression Scale. The authors implemented a systematic sampling technique randomly assigning the first subject and then alternating each subsequent subject to either a reference group which received the usual standard of care plus light therapy at 10,000 lux or a control group which received the usual standard of care and light therapy at 50 lux. Both groups received 90 min light sessions for five days. The study was conducted at Walter Reed Army Medical Center's Psychiatry Continuity Service. Zung Self-Rating Depression Scale collected at baseline, after five consecutive daily light sessions, and one week later. A repeated measures analysis of variance (RM ANOVA) was conducted to examine the change in Zung Depression results which showed a significant main effect for time F(2, 21)=5.05, p<0.02, indicating that depression scores reduced over time for both participant groups. Post hoc comparisons (with Bonferroni correction) demonstrated that the post-treatment Zung score was significantly lower indicating less depression than the baseline Zung score (p<0.004) and there was a statistical trend (p<0.05) for depression scores to be reduced halfway through the study in the treatment group. The post hoc analysis hints at the possibility of a reduction in depression during the active phase of light treatment.",21641522,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.285120487213135,4.824662208557129,C7df
"PURLs: Light therapy for nonseasonal major depressive disorder?

While bright light therapy already has a place in the treatment of seasonal affective disorder, a recent trial spotlights its utility beyond the winter months.",27565102,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.1665730476379395,4.923902988433838,BoHA
"Wake and light therapy for moderate-to-severe depression - a randomized controlled trial.

To examine the efficacy of using wake and light therapy as a supplement to standard treatment of hospitalized patients with depression. In this randomized, controlled study, 64 patients with moderate-to-severe depression were allocated to standard treatment or to the intervention, which additionally consisted of three wake therapy sessions in one week, 30-min daily light treatment and sleep time stabilization over the entire nine-week study period. Patients in the wake therapy group had a significant decrease in depressive symptoms in week one as measured by HAM-D17 , 17.39 (CI 15.6-19.2) vs. 20.19 (CI 18.3-22.09) (P = 0.04), whereas no statistically significant differences were found between the groups in weeks two to nine. At week nine, the wake therapy group had a significantly larger increase in general self-efficacy (P = 0.001), and waking up during nights was a significantly less frequent problem (1.9 times vs. 3.2) (P = 0.0008). In most weeks, significantly fewer patients in the wake therapy group slept during the daytime, and if they slept, their naps were shorter (week three: 66 min vs. 117 min P = 0.02). The antidepressant effect initially achieved could not be maintained during the nine-week study period. However, sleep and general self-efficacy improved.",28422269,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.467483043670654,4.756155967712402,Bdwy
"Feasibility of an Internet-based positive psychological intervention for hemodialysis patients with symptoms of depression.

Depression is a pervasive psychological issue facing hemodialysis (HD) patients. Novel technology-based treatment strategies that deploy psychology-based interventions have not been the focus for therapy and few published studies exist. The aim of the current trial is to determine the feasibility and acceptability of an Internet-based positive psychological intervention in HD patients with comorbid depressive symptoms. HD patients (n = 14) with elevated symptoms of depression were enrolled in a single-arm pre-post trial with clinical assessments at baseline and immediately post intervention. Chairside during regularly scheduled HD treatment, patients utilized a web browser to complete online modules promoting skills for increasing positive emotion over a 5-week period using Apple IPads. Targeted skills included noting of daily positive events, gratitude, positive reappraisal, acts of kindness, and mindfulness/meditation. Twelve of 14 patients completed the program for an 85.7% retention rate. Participants felt satisfied with each session and offered consistently positive feedback. On average, participants visited the website 3.5 times per week. Significant improvements were evident for depressive symptoms (15.3 vs. 10.9; p = 0.04), as per the Center for Epidemiological Studies Depression Scale. An innovative Internet-based positive psychological intervention represents a feasible and useful therapeutic option for HD patients with depressive symptoms.",30277449,Major Depressive Disorder,Anxiety Treatment,Mental Health,2177,4.4438018798828125,-0.6170154809951782,BFWw
"Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder: Acute Outcomes.

Whereas considerable evidence supports light therapy for winter seasonal affective disorder (SAD), data on cognitive-behavioral therapy for SAD (CBT-SAD) are promising but preliminary. This study estimated the difference between CBT-SAD and light therapy outcomes in a large, more definitive test. The participants were 177 adults with a current episode of major depression that was recurrent with a seasonal pattern. The randomized clinical trial compared 6 weeks of CBT-SAD (N=88) and light therapy (N=89). Light therapy consisted of 10,000-lux cool-white florescent light, initiated at 30 minutes each morning and adjusted according to a treatment algorithm based on response and side effects. CBT-SAD comprised 12 sessions of the authors' SAD-tailored protocol in a group format and was administered by Ph.D. psychologists in two 90-minute sessions per week. Outcomes were continuous scores on the Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD Version (SIGH-SAD, administered weekly) and Beck Depression Inventory-Second Edition (BDI-II, administered before treatment, at week 3, and after treatment) and posttreatment remission status based on cut points. Depression severity measured with the SIGH-SAD and BDI-II improved significantly and comparably with CBT-SAD and light therapy. Having a baseline comorbid diagnosis was associated with higher depression scores across all time points in both treatments. CBT-SAD and light therapy did not differ in remission rates based on the SIGH-SAD (47.6% and 47.2%, respectively) or the BDI-II (56.0% and 63.6%). CBT-SAD and light therapy are comparably effective for SAD during an acute episode, and both may be considered as treatment options.",25859764,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.885728120803833,4.747181415557861,B/Ua
"Cognitive behavioral therapy more effective than light therapy for relieving seasonal depression.

",20217958,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.9856457710266113,4.822982311248779,DM+y
"Effect of self-care counselling on depression and anxiety in women with endometriosis: a randomized controlled trial.

Considering the prevalence of endometriosis and consequent depression and anxiety as well as the resultant effects on the body, mind, and quality of life of patients, this study aimed to determine the effects of self-care counselling on depression and anxiety (primary outcome) and on quality of life (secondary outcome) among women with endometriosis. This randomized controlled clinical trial was conducted on 76 women with endometriosis who were treated at Al-Zahra Teaching and Treatment Center of Tabriz within the 2015-2019 period. The random blocking method was employed to divide the patients into intervention (counselling) and control groups. In the intervention group, seven self-care group counselling sessions were held on a weekly basis. The control group received routine care. A sociodemographic questionnaire, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory (STAI) and the SF-36 Quality of Life Questionnaire were completed by the researcher through an interview before and 4 weeks after the intervention. There was no significant difference between the intervention and control groups in terms of sociodemographic characteristics (p>0.05). After the intervention, the mean scores of state anxiety (mean difference: -0.12, 95% confidence interval: -9.6 to -14.4, p<0.001) and trait anxiety (mean difference: -10.9: 95% confidence interval: -9.1 to -12.7, p=0.001) were significantly lower in the counselling group than those of the control group. The mean score of depression was lower in the counselling group than in the control group; however, it was not significant (p =0/565). The mean score of quality of life for physical health (mean difference=17.2, 95% confidence interval: 13.8 to 20.5, p<0.001) and for mental health (mean difference=12.0, 95% confidence interval: 9.0 to 14.9, p <0.001) were significantly higher in the counselling group than in the control group. Self-care counselling affects the anxiety and quality of life of women with endometriosis. Therefore, in addition to other therapies, this method is proposed to improve quality of life and mental health of patients with endometriosis. IRCT Registration Number: IRCT 20111219008459N13, registered on February 10, 2019 ( https://irct.ir/user/trial/35915 ).",32727601,Major Depressive Disorder,Anxiety Treatment,Mental Health,1409,-5.601122856140137,-2.205620765686035,AlFC
"Tobacco use does not influence the response to non-pharmacologic depression treatment: A secondary analysis of the Regassa randomized controlled trial.

Behavioural interventions show promising results among patients with mild- to moderate depression. However, whether tobacco use moderates the effects of these interventions is not known. In the present study, we examined whether patients suffering from mild-to-moderate depression differed in their response to prescribed physical exercise or internet-based cognitive behavioural therapy (ICBT) according to their current tobacco use. We conducted a secondary analysis of data from 740 participants in a multicentre randomised controlled trial comparing physical exercise, internet-based cognitive behavioural therapy and treatment as usual (Regassa study). Information on current daily tobacco use was self-reported at baseline. Linear and logistic regression were used to examine the treatments' effect (reduction in depression score) in the subgroups of tobacco users (n=154) and non-users (n=586). We found that baseline tobacco use did not significantly moderate the association between treatment type and post-treatment depression severity. Both interventions (exercise and ICBT) resulted in a reduction of depression scores that was similar among non-users and users of tobacco, albeit formally statistically significant only among non-users. Physical exercise on prescription and ICBT can be used in the clinical management of depressed patients, with similar prognostic advantage among tobacco users and non-users.",29395870,Major Depressive Disorder,Anxiety Treatment,Mental Health,5333,-5.589028835296631,-8.890168190002441,BQqk
"Technology-Delivered Psychotherapeutic Interventions in Improving Depressive Symptoms Among People with HIV/AIDS: A Systematic Review and Meta-analysis of Randomised Controlled Trials.

With the increasing popularity of advanced technology, technology-delivered psychotherapeutic interventions (TPIs) may play a promising role in improving depressive symptoms among PLWHA. However, its effectiveness remains unclear. We aimed to synthesise the evidence of the effectiveness of TPIs in improving depressive symptoms of PLWHA using a meta-analytic approach. Seven databases were systematically searched for randomised controlled trials (RCTs) from the inception until August 14, 2018. Random-effects meta-analysis was adopted to assess effect size. Cochran's Q test and I2 were used to investigate the problem of heterogeneity. Sensitivity, subgroup analyses and meta-regression were performed. Of the 43,048 records identified, 14 RCTs were included. The meta-analysis revealed a small effect on reducing depressive symptom scores (d=0.23, 95% CI -0.39 to -0.06) after TPIs. Random-effects meta-regression showed that publication year was a significant moderator (p=0.013), whereby the latest trials had larger effect size in reducing the depressive symptoms than earlier trials. Our review suggested a possible future approach of utilising TPIs by means of mobile applications and internet-based interventions for PLWHA to reduce their depressive symptoms. This review highlighted the essential key features in designing future TPIs. The overall low-quality evidence suggested the need to conduct further high-quality.",31587115,Major Depressive Disorder,Anxiety Treatment,Mental Health,4671,5.055753231048584,-15.497786521911621,Azxc
"Open-label, randomized, parallel-group controlled clinical trial of massage for treatment of depression in HIV-infected subjects.

The study objectives were to determine whether massage therapy reduces symptoms of depression in subjects with human immunodeficiency virus (HIV) disease. Subjects were randomized non-blinded into one of three parallel groups to receive Swedish massage or to one of two control groups, touch or no intervention for eight weeks. The study was conducted at the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center in Los Angeles, California, which provided primary clinical care in an institutional setting. Study inclusion required being at least 16 years of age, HIV-seropositive, with a diagnosis of major depressive disorder. Subjects had to be on a stable neuropsychiatric, analgesic, and antiretroviral regimen for >30 days with no plans to modify therapy for the duration of the study. Approximately 40% of the subjects were currently taking antidepressants. All subjects were medically stable. Fifty-four (54) subjects were randomized, 50 completed at least 1 week (intent-to-treat; ITT), and 37 completed the study (completers). Swedish massage and touch subjects visited the massage therapist for 1 hour twice per week. The touch group had a massage therapist place both hands on the subject with slight pressure, but no massage, in a uniform distribution in the same pattern used for the massage subjects. The primary outcome measure was the Hamilton Rating Scale for Depression score, with the secondary outcome measure being the Beck Depression Inventory. For both the ITT and completers analyses, massage significantly reduced the severity of depression beginning at week 4 (p ≤ 0.04) and continuing at weeks 6 (p ≤ 0.03) and 8 (p ≤ 0.005) compared to no intervention and/or touch. The results indicate that massage therapy can reduce symptoms of depression in subjects with HIV disease. The durability of the response, optimal ""dose"" of massage, and mechanisms by which massage exerts its antidepressant effects remain to be determined.",23098696,Major Depressive Disorder,Anxiety Treatment,Mental Health,9426,5.129024028778076,-15.604212760925293,CmhQ
"Effects of a cognitive behavioral self-help program and a computerized structured writing intervention on depressed mood for HIV-infected people: a pilot randomized controlled trial.

The aim of the present study was to examine whether low-resource, cost-effective intervention programs can be effective in improving depressed mood in people with HIV. The efficacy of a cognitive-behavioral self-help program (CBS) and a computerized structured writing intervention (SWI) were tested in a pilot randomized controlled trial. Participants were members of a patient organization. They completed a pretest and posttest. The questionnaire included the HADS. Participants were randomly allocated to CBS (n=24), SWI (n=25) or a waiting list condition (WLC, n=24). To evaluate changes in the continuous outcome measure, a 3 x 2 (group x time) repeated measures ANCOVA was performed. Also, an ANCOVA was performed using change scores. Respondents who followed the CBS improved significantly compared to the WLC. However, for people in the SWI condition no significant improvement on depression was found. This pilot study suggests that a low-resource, cost-effective CBS program seems to be effective in reducing depressed mood in people living with HIV. Because self-help programs can be delivered through regular mail or the internet, a high number of people could be reached while overcoming geographical and social barriers to treatment.",19781889,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,5.157516956329346,-15.622279167175293,DQot
"Effectiveness of a healthy lifestyle promotion program as adjunctive teletherapy for treatment-resistant major depression during COVID 19 pandemic: A randomized clinical trial protocol.

Treatment-resistant depression (TRD) has a high prevalence and can be exacerbated by poor physical health and economic hardships, which have become common stressors during the current COVID-19 pandemic. The therapeutic approaches used to treat these patients are not always available, may be not be accepted by some patients, and often require face-to-face interactions. The main aim of this study will be to evaluate the effectiveness of an Internet-based adjuvant lifestyle-based intervention for patients with TRD. This will be a parallel, randomized, and controlled clinical trial. A total of 180 patients with TRD will be randomly allocated (1:1:1) to 1 of 3 groups: treatment prescribed by the mental health team and written suggestions for lifestyle changes (placebo control group); treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week mindfulness-based cognitive therapy program (active control group); or treatment prescribed by the mental health team, written suggestions for lifestyle changes, and an 8-week lifestyle change promotion program (intervention group). We will perform this study during the COVID-19 pandemic, and will administer interventions by teletherapy, and contact participants by telephone calls, text messages, and/or teleconferences. We will collect patient data using questionnaires administered at baseline, immediately after the intervention, and after 6 and 12 months. The primary outcome will be score on the Beck Depression Inventory-II. The secondary outcomes will be score on the Clinical Global Impressions Scale (used to quantify and track patient progress and treatment response over time) and health-related quality of life measured using the European Quality of Life-5 Dimensions Questionnaire. Patients with TRD are especially vulnerable when face-to-face psychotherapy is unavailable. The main strength of the proposed study is the novelty of the intervention to be used as an adjuvant therapy. Our results may provide guidance for treatment of patients with TRD in future situations that require lockdown measures. NCT04428099.",33157937,Major Depressive Disorder,Anxiety Treatment,Mental Health,32061,12.890520095825195,-15.126029968261719,Af11
"Videoconferencing Psychotherapy and Depression: A Systematic Review.

Introduction:Depression is the leading cause of disability in the world. Despite the prevalence of depression, a small proportion of individuals seek mental health services. A cost-effective method for increasing access to mental health services is the implementation of telemental-health programs. This review aims to summarize the state of the field on the efficacy and effectiveness of videoconferencing psychotherapy (VCP) for the treatment of depression.Materials and Methods:Systematic literature searches were performed using PsychINFO, PubMed, and EMBASE. Specific inclusion criteria were used to identify controlled and uncontrolled studies evaluating VCP for the treatment of depression. Data extraction included study assessment quality, research design, sample size, intervention details, outcome results, intervention effect size, and statistical differences between VCP and in-person (IP) therapy.Results:Of the 1,424 abstracts screened, 92 articles were critically reviewed. Thirty-three articles were included in the review, with 14 randomized controlled studies, 4 controlled nonrandomized studies, and 15 uncontrolled studies. Sample size ranged from 1 to 243 participants. Twenty-one studies reported statistically significant reductions in depressive symptoms following VCP, and the median effect size for studies ranged from medium to the very large range. Most controlled studies reported no statistical differences between VCP and IP groups receiving the same intervention.Conclusions:VCP for the treatment of depression is a promising method for delivering mental health services. More rigorous research is needed to evaluate VCP on depression in various contexts and participants.",30048211,Major Depressive Disorder,Anxiety Treatment,Mental Health,10069,12.653449058532715,-13.409462928771973,BIa6
"Unobserved heterogeneity in response to treatment for depression through videoconference.

This study examined treatment response heterogeneity in a recent randomized controlled trial of treatment for depression using videoconferencing technology compared to traditional in-office care. Growth mixture modeling was used to identify subgroups of individuals in the trial based on treatment response trajectories. Demographic and baseline characteristics were included to identify correlates of subgroup membership. There were two subgroups based on the trajectories of the Beck Hopelessness Scale. The first subgroup had less symptom severity at baseline, and there was no meaningful difference between the two treatment modalities in change over time. The second subgroup had higher symptom severity at baseline, and individuals who engaged in treatment through the videoconference modality had less symptom improvement than those who underwent the in-office modality. Older participants with higher loneliness and anxiety scores at baseline were more likely to be in the second group. Treatment of depression using videoconferencing to deliver care to an individual's home offers opportunities for improved access to services, especially among those who are unwilling or unable to seek in-person treatment. However, videoconferencing may not be appropriate for everyone. An individual's symptom level, age, and comorbidities are important clinical considerations when selecting an appropriate treatment modality. (PsycINFO Database Record",28604014,Major Depressive Disorder,Anxiety Treatment,Mental Health,10069,12.614402770996094,-13.915122032165527,BbSS
"Tai chi treatment for depression in Chinese Americans: a pilot study.

This study examined the feasibility, safety, and efficacy of using tai chi for treating major depressive disorder. Thirty-nine Chinese Americans with major depressive disorder were randomized into a 12-wk tai chi intervention or a waitlisted control group in a 2:1 ratio. The key outcome measurement was the 17-item Hamilton Rating Scale for Depression. Positive response was defined as a decrease of 50% or more on the 17-item Hamilton Rating Scale for Depression, and remission was defined as a score of 7 or lower on the 17-item Hamilton Rating Scale for Depression. Of the participants (n = 39), 77% were women, and mean (SD) age was 55 (10) years. There were 26 (67%) participants in the tai chi intervention group and 13 (33%) in the control group. Of the participants in the tai chi group, 73% completed the intervention; no adverse events were reported. We observed trends toward improvement in the tai chi intervention group, compared with the control group, in positive treatment-response rate (24% vs. 0%) and remission rate (19% vs. 0%), although the differences in our small sample did not reach statistical significance. A randomized controlled trial of tai chi is feasible and safe in Chinese American patients with major depressive disorder. These promising pilot study results inform the design of a more definitive trial.",22790795,Major Depressive Disorder,Anxiety Treatment,Mental Health,7596,8.126255989074707,1.5236656665802002,Cq3g
"Effects of a cognitive-behavioral self-help program on depressed mood for people with peripheral arterial disease.

The aim of the present study was to examine whether a new low-cost psychological self-help intervention program with minimal coaching could be effective in improving depressed mood in people with peripheral arterial disease (PAD). Thirteen persons with PAD and depressive symptoms participated in the self-help program, grounded in cognitive-behavioral therapy. They completed pre-test, post-test and follow-up questionnaires, including the PHQ-9, to measure symptoms of depression. To evaluate changes in depression scores from pre- to post-test to follow-up measurement, non-parametric repeated measures Wilcoxon signed rank tests were performed. The results showed that participants' depression scores significantly improved from pre-test to post-test and that there was no relapse from post-test to follow-up. The cognitive-behavioral self-help intervention could be an effective tool in people with PAD, to reduce symptoms of depression.",23104185,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,6.669517517089844,0.1943473517894745,CmcO
"Neurofeedback training in major depressive disorder: A systematic review of clinical efficacy, study quality and reporting practices.

Major depressive disorder (MDD) is the leading cause of disability worldwide. Neurofeedback training has been suggested as a potential additional treatment option for MDD patients not reaching remission from standard care (i.e., psychopharmacology and psychotherapy). Here we systematically reviewed neurofeedback studies employing electroencephalography, or functional magnetic resonance-based protocols in depressive patients. Of 585 initially screened studies, 24 were included in our final sample (N = 480 patients in experimental and N = 194 in the control groups completing the primary endpoint). We evaluated the clinical efficacy across studies and attempted to group studies according to the control condition categories currently used in the field that affect clinical outcomes in group comparisons. In most studies, MDD patients showed symptom improvement superior to the control group(s). However, most articles did not comply with the most stringent study quality and reporting practices. We conclude with recommendations on best practices for experimental designs and reporting standards for neurofeedback training.",33587957,Major Depressive Disorder,Anxiety Treatment,Mental Health,6667,16.16238784790039,4.278450965881348,Aaz4
"Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments.

The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. ""Complementary and Alternative Medicine Treatments"" is the fifth of six sections of the 2016 guidelines. Evidence-informed responses were developed for 12 questions for 2 broad categories of complementary and alternative medicine (CAM) interventions: 1) physical and meditative treatments (light therapy, sleep deprivation, exercise, yoga, and acupuncture) and 2) natural health products (St. John's wort, omega-3 fatty acids; S-adenosyl-L-methionine [SAM-e], dehydroepiandrosterone, folate, Crocus sativus, and others). Recommendations were based on available data on efficacy, tolerability, and safety. For MDD of mild to moderate severity, exercise, light therapy, St. John's wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments. Adjunctive exercise and adjunctive St. John's wort are second-line recommendations for moderate to severe MDD. Other physical treatments and natural health products have less evidence but may be considered as third-line treatments. CAM treatments are generally well tolerated. Caveats include methodological limitations of studies and paucity of data on long-term outcomes and drug interactions.",27486153,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,7.758924961090088,-0.13327111303806305,BpFG
"A randomised control trial of an Internet-based cognitive behaviour treatment for mood disorder in adults with chronic spinal cord injury.

Prospective parallel waitlist randomised controlled trial. Evaluate the feasibility and effectiveness of an Internet-based psychological intervention treating comorbid mood disorder in adults with spinal cord injury (SCI). Improved mood and satisfaction with life were primary outcomes. Victoria, Australia. Electronic Personal Administration of Cognitive Therapy (ePACT). Depression, Anxiety and Stress Scale-Short Form (DASS21), Personal Well-being Index, Helplessness subscale of the Spinal Cord Lesion Emotional Well-being Scale v1 Australia, at each time point.Participant qualifying criteria:Adults (18-70 years), chronic SCI, attend SCI review clinic at Austin or Caulfield Hospital and score above normative threshold of the Depression, Anxiety and Stress Scale-Short Form (DASS21). Forty-eight participants completed Time 2 post intervention (n=23) or time equivalent for waitlist control group (n=25) telephone interviews. The measures were repeated a third time (Time 3) for a small subgroup (n=12) at 6 months post intervention within the study implementation time frame. Univariate within group analyses revealed significant improvement in mood in the intervention group at Time 2: (lower depression (effect size (ES)=0.4), anxiety (ES=0.4) and stress (ES=0.3)) and higher satisfaction with life (ES=0.2). Waitlist control group improved in depression only (ES=0.3) by Time 2. Multilevel variance components analyses, although not as positive, were still encouraging. Improvement in mood symptoms was maintained in the small group reinterviewed at Time 3. Although Internet-based interventions for mental health issues in SCI not a solution for all, our results indicate that they are a potentially valuable addition to the currently available options.",26690861,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,6.693901538848877,0.1336604207754135,Bziq
"A quick behavioral dichotic word test is prognostic for clinical response to cognitive therapy for depression: A replication study.

There are no commonly used clinical indicators of whether an individual will benefit from cognitive therapy (CT) for depression. A prior study found right ear (left hemisphere) advantage for perceiving dichotic words predicted CT response. This study replicates this finding at a different research center in clinical trials that included clinically representative samples and community therapists. Right-handed individuals with unipolar major depressive disorder who subsequently received 12-14 weeks of CT at the University of Pittsburgh were tested on dichotic fused words and complex tones tests. Responders to CT showed twice the mean right ear advantage in dichotic fused words performance than non-responders. Patients with a right ear advantage greater than the mean for healthy controls had an 81% response rate to CT, whereas those with performance lower than the mean for controls had a 46% response rate. Individuals with a right ear advantage, indicative of strong left hemisphere language dominance, may be better at utilizing cognitive processes and left frontotemporal cortical regions critical for success of CT for depression. Findings at two clinical research centers suggest that verbal dichotic listening may be a clinically disseminative brief, inexpensive and easily automated test prognostic for response to CT across diverse clinical settings.",27992766,Major Depressive Disorder,Anxiety Treatment,Mental Health,4097,14.000883102416992,0.499327689409256,BjNS
"Targeting Cognitive Control Deficits With Neuroplasticity-Based Computerized Cognitive Remediation in Patients With Geriatric Major Depression: A Randomized, Double-Blind, Controlled Trial.

Late life major depression (LLD) is often accompanied by cognitive deficits. When patients have specific deficits in cognitive control functions (CCD), they are not only distressing and debilitating, they often predict poor clinical outcomes such as reduced response to SSRI/SNRI antidepressants, increased disability, suicide and all-cause mortality. We recently reported that in an open label trial, our treatment designed to target these specific CCD with neuroplasticity-based computerized cognitive remediation (nCCR) improved depression and CCD in patients who failed to remit with conventional antidepressant treatment. This study tested the hypothesis that in patients with LLD who have failed at least one trial of an SSRI/SNRI antidepressant at an adequate dose for at least 8 weeks, nCCR will improve both depressive symptoms and the CCD associated with poor antidepressant response (i.e. semantic strategy, inhibition of prepotent responses) more than an active control group. Participants were randomized (1:1) to receive either 30 hours/ 4 weeks of neuroplasticity based computerized cognitive remediation (nCCR) designed to target CCD, or the active control condition matched for duration, engagement, reward, computer presentation, and contact with study staff. All participants and raters were blinded. Mixed effects model analysis the time effect (week) (F(1,71.22)=25.2, p<0.0001) and treatment group X time interaction (F(1,61.8)=11.37, p=.002) reached significance indicating that the slope of decline in MADRS was steeper in the nCCR-GD group. Further, the nCCR group improved their semantic clustering strategy(t(28)=9.5; p=.006), as well as performance on the Stroop interference condition, and cognitive flexibility (Trails B). Further, results transferred to memory performance, which was not a function trained by nCCR. clinicaltrials.gov.",32591170,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.302785873413086,1.1571412086486816,Amwu
"Winning The Game Against Depression: A Systematic Review of Video Games for the Treatment of Depressive Disorders.

To review the evidence about video game-based therapeutic intervention for people diagnosed with depressive disorders. Psychotherapy has been proved to reduce depressive symptoms and is a key element in the treatment of depressive disorders. However, geographical, economical and stigmatized concerns are barriers to access to psychotherapy. New technologies and videos games can overcome some of these barriers by providing teleconferencing evidence-based therapy as time as they may offer an interactive entertainment. Overall, video game-based interventions were useful and effective in reducing symptoms of depressive disorders. Seven of the studies were published in the last 5 years, which reflects the increased research interest in video game-based interventions for depression. Overall, when adherence was reported, rates of acceptability and feasibility were high.",35113313,Major Depressive Disorder,Anxiety Treatment,Mental Health,9531,12.805047035217285,-0.3188380300998688,pWY
"Mindfulness-Based Cognitive Therapy for Patients With Depression Decreases the Need for Outpatient Visits.

To determine if the use of mindfulness-based cognitive therapy (MBCT) in patients with a history of 2 or more episodes of major depressive disorder and other mood disorders will decrease the need for medication management and other interventions and will also decrease the need for outpatient services and the overall cost of treatment. The study patients completed MBCT group sessions between January 1, 2010, and December 31, 2013. Patients who had 2 or more episodes of major depressive disorder (recurrent MDD) were categorized into a group. The remaining patients with other mood disorders were placed in a comparison group. The mean differences in drug treatments and hospital utilizations between the recurrent MDD and nonrecurrent MDD group were compared. Wald P values and 95% CIs were obtained for both adjusted and unadjusted estimated mean differences. Covariates were adjusted for age at start of MBCT, gender, and race/ethnicity. The final sample consisted of 142 patients (93 recurrent MDD and 49 others). There was no significant difference in the effect of MBCT on medication changes between recurrent MDD patients and nonrecurrent MDD patients. Recurrent MDD patients who participated in MBCT experienced reduction in all calls and visits (P = .0068) and less psychiatric visits (P = .0026) in the year after MBCT when compared with the visits before the intervention. This study evaluated the effectiveness of MBCT in reducing the need for additional psychiatric services. The study evaluated patients who received MBCT over 3 years and demonstrated that MBCT decreased the need for care regardless of medication changes. The results raise the question of whether MBCT allows patients to respond to situations more skillfully or if MBCT itself decreases depressive symptoms. The limitations of this study include a small sample size, patient selection, and its design as a retrospective study. However, this study may have implications as a treatment strategy that may be generalizable to other clinics and patient populations.",27828695,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.691168785095215,-0.5049477219581604,Bk9o
"Efficacy and acceptability of next step treatment strategies in adults with treatment-resistant major depressive disorder: protocol for systematic review and network meta-analysis.

For major depression, a one-size-fits-all treatment does not exist. Patients enter a 'trial-and-change' algorithm in which effective therapies are subsequently applied. Unfortunately, an empirically based order of treatments has not yet been determined. There is a magnitude of different treatment strategies while clinical trials only compare a small number of these. Network meta-analyses (NMA) might offer a solution, but so far have been limited in scope and did not account for possible differences in population characteristics that arise with increasing levels of treatment-resistance, potentially violating the transitivity assumption. We; therefore, present a protocol for a systematic review and NMA aiming at summarising and ranking treatments for treatment-resistant depression (TRD) while covering a broad range of therapeutic options and accounting for possible differences in population characteristics at increasing levels of treatment-resistance. Randomised controlled trials will be included that compared next-step pharmacological, neuromodulation or psychological treatments for treatment-resistant depression (TRD; ie, failure to respond to ≥1 adequate antidepressant drug trial(s) in the current episode) to each other or to a control condition. Primary outcomes will be the proportion of patients who responded to (efficacy) and dropped out of (acceptability) the allocated treatment. A random effects NMA will be conducted, synthesising the evidence for each outcome and determining the differential efficacy of treatments. Heterogeneity in treatment nodes will be reduced by considering alternative geometries of the network structure and by conducting a meta-regression examining different levels of TRD. Local and global methods will be applied to evaluate consistency. The Cochrane Risk of Bias 2 tool, Confidence in Network Meta-Analysis and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework will be used to assess risk of bias and certainty. This review does not require ethical approval.",35437250,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.419953346252441,-0.4667164087295532,c9k
"Distance delivery of mindfulness-based cognitive therapy for depression: project UPLIFT.

This study evaluated the efficacy of a newly developed, home-based depression intervention for people with epilepsy. Based on mindfulness-based cognitive therapy (MBCT), the eight-session, weekly intervention was designed for group delivery via the Internet or telephone. Forty participants were randomly assigned to intervention or waitlist. Depressive symptoms and other outcomes were measured at baseline, after intervening in the intervention group (~8 weeks), and after intervening in the waitlist group (~16 weeks). Depressive symptoms decreased significantly more in the intervention group than the waitlist group; Internet and telephone did not differ. This effect persisted over the 8 weeks when those waitlisted received the intervention. Knowledge/skills increased significantly more in the intervention than the waitlist group. All other changes, though not significant, were in the expected direction. Findings indicate that distance delivery of group MBCT can be effective in reducing symptoms of depression in people with epilepsy. Directions for future research are proposed.",20851055,Major Depressive Disorder,Anxiety Treatment,Mental Health,4276,9.75358772277832,-0.5484302639961243,DFkw
"Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: a 5-year controlled clinical trial.

The aim of this research, which represents an additional and longer follow-up to a previous trial, was to evaluate a 5-year follow-up study of a combined treatment (pharmacological+psychoeducational and cognitive-behavioral therapy) as compared with a standard pharmacological treatment in patients with refractory bipolar disorder. Forty patients were randomly assigned to either an Experimental group-under combined treatment - or a Control group - under pharmacological treatment. Data were analyzed by analysis of variance (ANOVA), with repeated measures at different evaluation time points. Between-group differences were significant at all evaluation time points after treatment. Experimental group had less hospitalization events than Control group in the 12-month evaluation (P=0.015). The Experimental group showed lower depression and anxiety in the 6-month (P=0.006; P=0.019), 12-month (P=0.001; P<0.001) and 5-year (P<0.001, P<0.001) evaluation time points. Significant differences emerged in mania and misadjustment already in the post-treatment evaluation (P=0.009; P<0.001) and were sustained throughout the study (6-month: P=0.006, P<0.001; 12-month: P<0.001, P<0.001; 5-year: P=0.004, P<0.001). After 5-year follow-up, 88.9% of patients in the Control group and 20% of patients in the Experimental group showed persistent affective symptoms and/or difficulties in social-occupational functioning. A combined therapy is long-term effective for patients with refractory bipolar disorder. Suggestions for future research are commented.",23276524,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,11.830350875854492,-0.22811684012413025,Cj6h
"The Impact of Treatments for Depression on the Dynamic Network Structure of Mental States: Two Randomized Controlled Trials.

Evidence is growing that vulnerability to depression may be characterized by strong negative feedback loops between mental states. It is unknown whether such dynamics between mental states can be altered by treatment. This study examined whether treatment with imipramine or treatment with Mindfulness-Based Cognitive Therapy (MBCT) reduces the connectivity within dynamic networks of mental states in individuals with depressive symptoms. In the Imipramine trial, individuals diagnosed with major depression were randomized to imipramine treatment or placebo-pill treatment (n=50). In the Mind-Maastricht trial, individuals with residual depressive symptoms were randomized to Mindfulness-Based Cognitive Therapy (MBCT) or to a waiting-list control condition (n=119). Lagged associations among mental states, as assessed with the Experience Sampling Method (ESM), were estimated at baseline and post-intervention. The results show that few of the dynamic network connections changed significantly over time and few of the changes after MBCT and imipramine treatment differed significantly from the control groups. The decrease in average node connectivity after MBCT did not differ from the decrease observed in the waiting-list control group. Our findings suggest that imipramine treatment and MBCT do not greatly change the dynamic network structure of mental states, even though they do reduce depressive symptomatology.",28425449,Major Depressive Disorder,Anxiety Treatment,Mental Health,20347,13.52103328704834,1.7933790683746338,Bdtj
"Psychological interventions for difficult-to-treat depression.

Mindfulness-based cognitive therapy (MBCT) may be helpful in preventing relapse in those with three or more depressive episodes. Recent research suggests it may also benefit those who have experienced fewer previous episodes of depression. If confirmed, this raises challenges of how MBCT is offered, accessed and supported.",23028083,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.414155960083008,-0.4977109730243683,Cniv
"Therapeutic options in treatment-resistant depression.

The phenomenon of treatment-resistant depression (TRD), described as the occurrence of an inadequate response after an adequate treatment with antidepressant agents (in terms of dose, duration, and adherence), is very common in clinical practice. It has been broadly defined in the context of unipolar major depression, but alternative definitions for bipolar depression have also been suggested. In both cases, there is a remarkable lack of consensus amongst professionals concerning its operative definition. A relatively wide variety of treatment options for unipolar TRD are available, whilst the evidence is very scanty for bipolar TRD. TRD is associated to poor clinical, functional, and social outcomes. Several novel therapeutic options are currently being investigated as promising alternatives, targeting the neurotransmitter system outside of the standard monoamine hypothesis. Augmentation or combination with lithium or atypical antipsychotics appears as a valid option for both conditions, and the same occurs with electroconvulsive therapy. Other non-pharmacological strategies such as deep brain stimulation may be promising alternatives for the future. The use of cognitive behaviour therapy is recommended for unipolar TRD, but there is no evidence supporting its use in bipolar TRD.",21623700,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.793753623962402,-0.23961606621742249,C7qm
"Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy for Depressive Disorders.

Recently, the importance of cognitive behavioral therapy (CBT) in the treatment of depression is gradually emerging. Particularly, mindfulness meditation has various approaches related to dialectical behavioral therapy (DBT), acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), and evidence has been provided that they alleviate depressive symptoms. In particular, as MBCT increases the level of evidence in the treatment of repetitive depressive disorders, guidelines are being recommended to prevent recurrence. Mindfulness may also contribute to improving the patient's symptoms as well as improving the therapeutic relationship with the therapist. For both mindful patients and therapists, positive awareness of internal experiences can be a good way to enrich the mind and overcome depressive disorders.",33834406,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.292378425598145,-0.45086002349853516,AYE7
"Pharmacological and Non-Pharmacological Interventions for Depression after Moderate-to-Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

The objective of this study was to systematically review the literature and perform a meta-analysis of randomized controlled trials (RCTs) on the effectiveness of pharmacological and non-pharmacological interventions for depression in patients with moderate-to-severe traumatic brain injury. Databases searched were: Embase, PubMed, PsycInfo, Cochrane Central, Web of Science, and Google Scholar. Depression score on a self-report questionnaire was the outcome measure. Outcomes were collected at baseline and at the first follow-up moment. Data extraction was executed independently by two researchers. Thirteen RCTs were identified: five pharmacological and eight non-pharmacological. Although not all individual studies had significant results, the overall standardized mean difference (SMD) was -0.395, p≤0.001, indicating that interventions improved the depression scores in patients with TBI. The difference in effectiveness between pharmacological interventions and non-pharmacological interventions was not significant (ΔSMD: 0.203, p=0.238). Further subdivision into methylphenidate, sertraline, psychological, and other interventions showed a significant difference in effectiveness between methylphenidate (ΔSMD: -0.700, p=0.020) and psychological interventions (reference). This difference was not found if other depression outcomes in four of the included studies were analyzed. The SMD of low-quality studies did not differ significantly from moderate- and high-quality studies (ΔSMD: 0.321, p=0.050). Although RCTs targeting interventions for depression after TBI are scarce, both pharmacological and non-pharmacological interventions appear to be effective in treating depressive symptoms/depression after moderate-to-severe TBI. There is a need for high-quality RCTs in which the add-on effects of pharmacological and non-pharmacological interventions are investigated.",32041474,Major Depressive Disorder,Anxiety Treatment,Mental Health,11272,14.13006591796875,4.737232685089111,AtnR
"Reinforcement Learning in Patients With Mood and Anxiety Disorders vs Control Individuals: A Systematic Review and Meta-analysis.

Computational psychiatry studies have investigated how reinforcement learning may be different in individuals with mood and anxiety disorders compared with control individuals, but results are inconsistent. To assess whether there are consistent differences in reinforcement-learning parameters between patients with depression or anxiety and control individuals. Web of Knowledge, PubMed, Embase, and Google Scholar searches were performed between November 15, 2019, and December 6, 2019, and repeated on December 3, 2020, and February 23, 2021, with keywords (reinforcement learning) AND (computational OR model) AND (depression OR anxiety OR mood). Studies were included if they fit reinforcement-learning models to human choice data from a cognitive task with rewards or punishments, had a case-control design including participants with mood and/or anxiety disorders and healthy control individuals, and included sufficient information about all parameters in the models. Articles were assessed for inclusion according to MOOSE guidelines. Participant-level parameters were extracted from included articles, and a conventional meta-analysis was performed using a random-effects model. Subsequently, these parameters were used to simulate choice performance for each participant on benchmarking tasks in a simulation meta-analysis. Models were fitted, parameters were extracted using bayesian model averaging, and differences between patients and control individuals were examined. Overall effect sizes across analytic strategies were inspected. The primary outcomes were estimated reinforcement-learning parameters (learning rate, inverse temperature, reward learning rate, and punishment learning rate). A total of 27 articles were included (3085 participants, 1242 of whom had depression and/or anxiety). In the conventional meta-analysis, patients showed lower inverse temperature than control individuals (standardized mean difference [SMD], -0.215; 95% CI, -0.354 to -0.077), although no parameters were common across all studies, limiting the ability to infer differences. In the simulation meta-analysis, patients showed greater punishment learning rates (SMD, 0.107; 95% CI, 0.107 to 0.108) and slightly lower reward learning rates (SMD, -0.021; 95% CI, -0.022 to -0.020) relative to control individuals. The simulation meta-analysis showed no meaningful difference in inverse temperature between patients and control individuals (SMD, 0.003; 95% CI, 0.002 to 0.004). The simulation meta-analytic approach introduced in this article for inferring meta-group differences from heterogeneous computational psychiatry studies indicated elevated punishment learning rates in patients compared with control individuals. This difference may promote and uphold negative affective bias symptoms and hence constitute a potential mechanistic treatment target for mood and anxiety disorders.",35234834,Major Depressive Disorder,Anxiety Treatment,Mental Health,9603,15.231244087219238,0.3273790776729584,kpE
"Systematic review of randomized controlled trials of candidate treatments for cognitive impairment in depression and methodological challenges in the field.

Cognitive impairment is a core feature of Major Depressive Disorder (MDD) but treatments targeting cognition are lacking. Numerous pre-clinical and clinical studies have investigated potential cognition treatments, but overall the evidence is conflicting. We conducted a systematic search following the PRISMA guidelines on PubMed and PsychInfo to evaluate the extant evidence and methodological challenges in randomized controlled trials (RCTs) of biological, psychological and behavioural candidate treatments targeting cognition in MDD. Inclusion criteria were RCTs with a placebo control assessing potential pro-cognitive effects of candidate treatments in MDD. Two independent authors reviewed the studies and assessed their risk of bias with the Cochrane Collaboration׳s Risk of Bias tool. Twenty-eight eligible studies (24 biological and four psychological or behavioural studies) were identified. Cognition was the primary treatment target in ten (36%) trials and an additional treatment outcome together with mood symptoms in 18 (64%) trials. The risk of bias was high or unclear in 93% of trials due to potential selective outcome reporting or 'pseudospecificity' (unspecific cognitive improvement due to reduced depression severity), and/or insufficient details on how the allocation sequence was generated or how blinding was maintained. Several promising treatments were identified, including vortioxetine, erythropoietin, transcranial direct current stimulation and cognitive remediation. However, several common methodological challenges may impede advances in the field. In particular, future trials should select one cognitive composite score as primary outcome, screen for cognitive impairment before inclusion of participants and address 'pseudospecificity' issues. Together, these strategies may improve the success of future cognition trials in MDD.",27745932,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.654356956481934,0.14097420871257782,Bl8r
"Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled trial.

Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. Our aim was to investigate whether the addition of MBCT to mADM is a more effective prevention strategy than mADM alone. This study is one of two multicenter randomised trials comparing the combination of MBCT and mADM to either intervention on its own. In the current trial, recurrently depressed patients in remission who had been using mADM for 6 months or longer (n=68), were randomly allocated to either MBCT+mADM (n=33) or mADM alone (n=35). Primary outcome was depressive relapse/recurrence within 15 months. Key secondary outcomes were time to relapse/recurrence and depression severity. Analyses were based on intention-to-treat. There were no significant differences between the groups on any of the outcome measures. The current study included patients who had recovered from depression with mADM and who preferred the certainty of continuing medication to the possibility of participating in MBCT. Lower expectations of mindfulness in the current trial, compared with the parallel trial, may have caused selection bias. In addition, recruitment was hampered by the increasing availability of MBCT in the Netherlands, and even about a quarter of participants included in the trial who were allocated to the control group chose to get MBCT elsewhere. For this selection of recurrently depressed patients in remission and using mADM for 6 months or longer, MBCT did not further reduce their risk for relapse/recurrence or their (residual) depressive symptoms.",26318271,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.819652557373047,-0.44586649537086487,B43R
"[Ten years of cognitive control training for depression: an overview of findings and challenges].

2007 marks a shift in scientific literature on the cognitive vulnerabilities of depression. Preceded by a vast amount of studies exploring neuroplasticity and cognitive transfer effects, Siegle e.a. (Cognit Ther Res 2007; 31: 235-62) published the findings of a proof-of-principle study in which cognitive control training (cct) was applied to treat depression. This denotes an evolution towards clinically oriented cct studies targeting reduction of the vulnerability mechanisms of depression. Following this publication, several studies tested the effects of cct on emotional vulnerability. These studies show great variability. <br/> AIM: This article provides an overview summarizing the findings of cct for depression published in the last 10 years.<br/> METHOD: The results of a recently conducted systematic review were reviewed, with a particular interest in clinical implications and challenges.<br/> RESULTS: cct shows beneficial effects on indicators of depression vulnerability (e.g., stress reactivity, rumination, symptomatology). Associated literature underlines the importance of intensive training procedures, use of an affective task context and task motivation.<br/> CONCLUSION: cct shows potential as a clinical intervention for depression. However, several questions still need to be addressed before implementation into clinical practice is warranted.",29943798,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.296371459960938,-0.5830498337745667,BJ1A
"The effect of early cognitive behavior therapy for first-episode treatment-naive major depressive disorder.

Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders. Cognitive behavioral therapy (CBT) has been widely applied in MDD treatment, yet mechanistic understanding toward CBT remains limited. Twenty-two MDD patients and twenty-seven matched healthy controls were enrolled. Patients with MDD were given structural early CBT treatment once a week for 6 weeks. Cognitive reconstruction, emotional transformation and behavioral training were included in the treatment process. Local and long-range brain functional connectivity densities (FCD) were obtained to identify abnormal connectivity of MDD by using resting-state functional magnetic resonance imaging (RS-fMRI). After CBT treatment, MDD patients showed increased FCD in the bilateral dorsolateral prefrontal cortex (dlPFC). Functional connectivity (FC) was used to further explore the role of dlPFC in CBT. The results revealed that by the completion of CBT treatment course, the FC between the dlPFC and hippocampus was enhanced. Cognitive behavioral therapy played significant role in alleviating depressive symptoms of MDD patients, evidenced by improved brain connectivity between dlPFC and hippocampus. Further study of dlPFC pathophysiology is needed to better understand these abnormalities in patients with depressive symptoms and the effect of early CBT treatment.",35398109,Major Depressive Disorder,Anxiety Treatment,Mental Health,3407,13.926593780517578,0.9203214049339294,eTg
"Change in negative attention bias mediates the association between attention bias modification training and depression symptom improvement.

Attention bias modification training (ABMT) is purported to reduce depression by targeting and modifying an attentional bias for sadness-related stimuli. However, few tests of this hypothesis have been completed. The present study examined whether change in attentional bias mediated a previously reported association between ABMT condition (active ABMT, sham ABMT, assessments only; N = 145) and depression symptom change among depressed adults. The preregistered, primary measure of attention bias was a discretized eye-tracking metric that quantified the proportion of trials where gaze time was greater for sad stimuli than neutral stimuli. Contemporaneous longitudinal simplex mediation indicated that change in attentional bias early in treatment partially mediated the effect of ABMT on depression symptoms. Specificity analyses indicated that in contrast to the eye-tracking mediator, reaction time assessments of attentional bias for sad stimuli (mean bias and trial level variability) and lapses in sustained attention did not mediate the association between ABMT and depression change. Results also suggested that mediation effects were limited to a degree by suboptimal measurement of attentional bias for sad stimuli. When effective, ABMT may improve depression in part by reducing an attentional bias for sad stimuli, particularly early on during ABMT. (PsycInfo Database Record (c) 2021 APA, all rights reserved).",34807657,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,16.004520416259766,-0.225302055478096,1yc
"Predictors of treatment response to cognitive-behavioral therapy for depression in Parkinson's disease.

The purpose of this study was to examine predictors of treatment response to cognitive-behavioral therapy (CBT) for depression in Parkinson's disease (PD). The sample comprised 80 depressed (DSM-IV criteria) adults with PD (60% male) and their caregivers who participated in an National Institutes of Health-sponsored randomized-controlled trial of CBT vs. clinical monitoring from April 2007 until July 2010. Individually administered CBT was provided to people with PD for 10 weeks, modified to address the unique needs of the medical population, and supplemented with up to 4 separate caregiver educational sessions. Treatment response was defined a priori as a rating of depression much improved or very much improved on the Clinical Global Impression-Improvement Scale or ≥ 50% reduction in the baseline Hamilton Depression Rating Scale score. It was hypothesized (a priori) that caregiver participation in treatment, motor disability, psychiatric comorbidity, and executive functioning would be significant predictors of response to CBT at end-of-treatment (Week 10) and short-term follow-up (Week 14). At Week 10, caregiver participation was the only significant predictor of treatment response in the CBT group. At Week 14, both caregiver participation and executive functioning predicted response to CBT. Treatment group, baseline depression severity, executive functioning, motor disability, psychiatric comorbidity, marital status, and caregiver burden were also related to change in depression scores, for all participants, in secondary and exploratory models. Caregiver participation may enhance acute treatment response to psychosocial interventions for depression in PD. Further research is needed to extend and replicate these findings.",22409644,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.449267387390137,13.72350025177002,CwLU
"Computerized cognitive training and functional recovery in major depressive disorder: A meta-analysis.

Depression is common, frequently resistant to antidepressant treatment, and associated with impairments in cognition and everyday functioning. Computerized cognitive training (CCT) paradigms offer potential to improve cognition, mood and everyday functioning, but their effectiveness is not well established. The goal of this article was to conduct a systematic review and meta-analysis to determine the efficacy of CCT in depressive disorders. A search was conducted to identify high quality randomized controlled CCT trials per PRISMA guidelines using PsycINFO and MEDLINE with the keywords ""Cognitive training"" or ""Cognitive remediation"" or ""Cognitive rehabilitation"" and ""Depression"". 9 randomized trials for depressed adults met inclusion criteria. Effect sizes (Hedge's g) were calculated for key outcome measures of mood symptom severity, daily functioning, and cognition. A 3-level Bayesian hierarchical linear model was used to estimate effect sizes for each domain and study. Publication bias was assessed using Classic Fail Safe N's and homogeneity was evaluated using Q and I(2) indexes. Significant small-moderate effects for Symptom Severity (0.43) and Daily Functioning (0.72), and moderate-large effects for Attention (0.67), Working Memory (0.72), and Global Functioning (1.05) were found. No significant effects were found for Executive Functioning or Verbal Memory. Moderator variable analysis revealed decreased effect of CCT with age. Gender and concurrent medication treatment did not affect the results. Small sample size, short duration, pseudo-specificity, and high heterogeneity for Verbal Memory measures. CCT is associated with improvement in depressive symptoms and everyday functioning, though produces inconsistent effects on cognition.",26437233,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.821429252624512,-0.5433728098869324,B3DX
"Characteristics of psychological interventions that improve depression in people with coronary heart disease: a systematic review and meta-regression.

Despite previous intervention trials, it is unclear which psychological treatments are most effective for people with coronary heart disease (CHD). We have conducted a systematic review with meta-regression to identify the characteristics of psychological interventions that improve depression and depressive symptoms among people with CHD. Searches of multiple electronic databases up to March 2012 were conducted, supplemented by hand-searching of identified reviews and citation tracing of eligible studies. Studies were included if they reported a randomized controlled trial of a psychological intervention for people with CHD and included depression as an outcome. Data on main effects and characteristics of interventions were extracted from eligible studies. Standardized mean differences (SMDs) were calculated for each study and pooled using random-effects models. Random-effects multivariate meta-regression was performed to identify treatment characteristics associated with improvements in depression. Sixty-four independent treatment comparisons were identified. Psychological interventions improved depression, although the effect was small (SMD=0.18, p<.001). Problem solving (SMD=0.34), general education (SMD=0.19), skills training (SMD=0.25), cognitive-behavioral therapy (CBT; SMD=0.23), and relaxation (SMD=0.15) had small effects on CHD patients who were recruited irrespective of their depression status. Among high-quality trials of depressed CHD patients, only CBT showed significant but small effects (SMD=0.31). When entered into multivariable analysis, no individual treatment component significantly improved depression. CBT and problem solving should be considered for inclusion in future treatment developments and randomized controlled trials. However, the effects are small in magnitude, and there is room to develop new interventions that may be more effective.",23324874,Major Depressive Disorder,Anxiety Treatment,Mental Health,2285,7.170677661895752,-0.14844679832458496,CjNZ
"Symptom specificity in the acute treatment of Major Depressive Disorder: a re-analysis of the treatment of depression collaborative research program.

Antidepressant medications, Cognitive-Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are equally efficacious in the acute treatment of Major Depressive Disorder (MDD). Nevertheless, remission rates remain unacceptably low. Examining the differential time course of remission of specific symptom clusters across treatments may provide a basis for assigning patients to treatments that have the highest chance of being effective. This study re-analyzed data from the NIMH Treatment of Depression Collaborative Research Project (TDCRP), which included 250 adult outpatients with MDD randomized to 16 weeks of CBT, IPT, imipramine+clinical management (IMI-CM), or pill placebo (PLA-CM). We derived four symptom factors from the 23-item Hamilton Depression Rating Scale, and three symptom factors from the Beck Depression Inventory. Within-subject hierarchical regression models were specified to examine the linear and quadratic patterns of symptom remission over five assessment points. IMI-CM produced a more rapid rate of remission than CBT or IPT for both the somatic/vegetative and cognitive-affective symptoms of MDD. There were no statistically significant differences in the rates of improvement of any of the symptom factors between the IMI-CM and PLA-CM groups. Some core symptoms of depression were excluded due to low factor loadings. Past research has argued that the CBT arm in the TDCRP may have been weak. We failed to find evidence that treatments act preferentially on specific symptom clusters. Therefore, the symptoms of MDD may be inter-dependent when it comes to their courses of remission in treatment.",22252094,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.01559829711914,-0.5966544151306152,Cyix
"Attention bias modification in depression: A randomized trial using a novel, reward-based, eye-tracking approach.

Biased attention to negative information is a mechanism for risk and relapse in depression. Attentional bias modification (ABM) paradigms manipulate attention away from negative information to reduce this bias. ABM results have been mixed due to inconsistent methodologies and stimuli design. This randomized controlled trial used a novel approach to modifying attentional bias. An eye tracker manipulated stimuli in response to participants' fixations to preferentially reward attention to positive stimuli by obscuring or enhancing image quality of negative and positive stimuli, respectively. Participants with major depressive disorder completed three 35-min sessions of active (n = 20) or sham (n = 20) ABM training. Attentional bias, memory for emotional words, and mood were assessed pre- and post-training. Training reduced negative attentional bias; relative to sham, active training participants focused significantly more on positive compared to negative stimuli in a free-viewing eye-tracker task (p = .038, ηp2 = 0.109) and, at trend, disengaged from sad information more quickly in a computerized task (p = .052, ηp2 = 0.096). Active training participants remembered more happy than sad words in an emotional word learning task, indicating a distal transfer of training to emotional memory (p = .036, ηp2 = 0.11). Training did not significantly affect mood in the one-week trial. Future studies should build on this proof-of-principle study with larger sample sizes and more intensive treatment to explore which mechanisms of training may lead to improvements in mood. Attention biases in depression are modifiable through reward-based, eye-tracking training. These data suggest generalizability of training to other cognitive faculties - recall for affective information.",33202263,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.97055721282959,-0.3728463351726532,AfU2
"Psychosocial interventions to improve mental health in adults with vision impairment: systematic review and meta-analysis.

To systematically assess the literature on psychosocial interventions to improve mental health (i.e. depression, anxiety, mental fatigue, loneliness, psychological stress and psychological well-being) in visually impaired adults (≥18 years). The databases Medline, Embase and Psychinfo were searched for relevant studies, which were categorised into randomised controlled trials (RCTs), non-RCTs and before and after comparisons (BA). The Cochrane Collaboration Risk of Bias Tool was used to assess study quality. Standardised mean differences (SMD) were calculated to quantitatively summarise the outcomes of the RCTs and non-RCTs in a meta-analysis. Meta-regression was used to explore sources of heterogeneity in the data. The search identified 27 papers (published between 1981 and 2015), describing the outcomes of 22 different studies (14 RCTs, four non-RCTs, and four BAs). Pooled analyses showed that interventions significantly reduced depressive symptoms (SMD -0.30, 95% confidence interval (CI) -0.60 to -0.01), while effects on anxiety symptoms, mental fatigue, psychological stress and psychological well-being were non-significant. Meta-regression analyses showed homogeneity in effect sizes across a range of intervention, population, and study characteristics. Only a higher age of participants was associated with less effective results on depressive symptoms (b = 0.03, 95% CI 0.01 to 0.05), psychological stress (b = 0.07, 95% CI 0.01 to 0.13) and psychological well-being (b = -0.03, 95% CI -0.05 to 0.01). However, after removing a clear outlier the overall effect on depressive symptoms and the influence of age on depressive symptoms and psychological stress were no longer significant, while the influence of age on psychological well-being remained. There is currently only limited evidence for the effectiveness of psychosocial interventions in the field of low vision. More well-designed trials are needed with specific attention for interventions tailored to the needs of elderly patients.",27580757,Major Depressive Disorder,Anxiety Treatment,Mental Health,3755,8.272879600524902,1.6768975257873535,Bn3x
"Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants.

Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial. Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences. This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT. Netherlands Trial Register (NTR): NTR1907.",21226937,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.105589866638184,-0.5219951868057251,DBRl
"Effects of psychotherapy in combination with pharmacotherapy, when compared to pharmacotherapy only on blood pressure, depression, and anxiety in female patients with hypertension.

We investigated effects of metacognitive detached mindfulness therapy and stress management training on hypertension and symptoms of depression and anxiety, as compared to a control condition. A total of 45 female patients (mean age: M=36.49years) were randomly assigned to one of three conditions: metacognitive detached mindfulness therapy, stress management training, and the control condition. Blood pressure and symptoms of depression and anxiety decreased from baseline to post-test, to follow-up. Group comparisons showed that blood pressure and symptoms of depression and anxiety decreased more in psychotherapeutic groups than in the control group. Psychotherapeutic treatment of hypertension reduced blood pressure and symptoms of depression and anxiety. Positive effects were observable at follow-up 8weeks later.",25293966,Major Depressive Disorder,Anxiety Treatment,Mental Health,21737,8.039841651916504,0.07054265588521957,CHWw
"Auditory-verbal declarative and operating memory among patients suffering from depressive disorders - preliminary study.

Dysfunctions of auditory-verbal declarative and working memory are observed in patients with depressive disorders (DD). The authors wanted to see, whether antidepressive therapy improved the efficiency of cognitive processes among patients suffering from DD and determine possible associations between auditory-verbal declarative and working memory performance, evaluated before treatment vs. remission degree after treatment. The study was carried out in 87 subjects, patients with depressive disorders (n=30, DD) and healthy subjects (n=57, CG, control group). The AVLT (Auditory Verbal Learning Test) and the Stroop Test were used. CG obtained higher results vs. DD-I (the evaluation started on the therapy onset) in the Stroop Test-RCNb (Reading Colour Names in Black)/time, NCWd (Naming Colour of Word - Different)/time, NCWd/errors, AVLT: the number of words after 30 minutes. CG demonstrated higher results than DD-II (following eight weeks of pharmacological treatment) in RCNb/time, NCWd/time, AVLT: the number of words in the first trial, the number of words after 30 minutes. Compared to DD-I, DD-II achieved better results in NCWd/errors. No statistically significant differences were observed in both tests between the patients with remission and without remission. Statistical analysis revealed the lack of significant dependences among HDRS after treatment and cognitive functions before treatment. Depressive disorders are associated with deteriorated efficiency of auditory-verbal declarative and working memory. No improvement was observed in the efficiency of auditory-verbal declarative or working memory after 8-week therapy. The performance level of cognitive processes before pharmacotherapy has no effect on the intensity of depression symptoms after therapy.",21163755,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.824457168579102,1.074971318244934,DCKA
"Cognitive-emotional training as an intervention for major depressive disorder.

There is an urgent need for more effective treatments for major depressive disorder (MDD). As understanding of the cognitive and affective neuroscience underlying psychiatric disorders expands, so do opportunities to develop interventions that capitalize on the capacity for brain plasticity. Cognitive training is one such strategy. In this article, we report a proof-of-concept study of a novel cognitive-emotional training exercise designed to enhance cognitive control for emotional information processing and targeting components of the neural networks that have been implicated in MDD. Twenty-one participants with MDD in a current episode were randomly assigned to one of the two treatment conditions: 11 participating in a cognitive-emotional training paradigm (emotional faces memory task (EFMT)) involving eight sessions over 4 weeks, and 10 participating in an active control condition (control training, CT). Assessments of MDD symptoms, negative affective bias in cognitive processing, and neurocognition (attention and working memory) were administered at baseline and after 4 weeks. Participants in the EFMT group exhibited a greater reduction in MDD symptoms compared to the CT group, and 6 of the 11 EFMT participants achieved clinical response (≥ 50% reduction in symptoms). EFMT participants also exhibited changes in negative affective bias in the hypothesized direction whereas the CT participants did not. Both groups exhibited similar, small improvements in attention and working memory. Cognitive-emotional training may represent a feasible and effective intervention strategy for MDD. This proof-of-concept study highlights the need for future studies to fully understand the effectiveness, and mechanisms of effect, of these training strategies.",24753225,Major Depressive Disorder,Anxiety Treatment,Mental Health,3407,13.86983871459961,-0.09578580409288406,CPBK
"Psychological therapies for the management of co-morbid depression following a spinal cord injury: a systematic review.

The evidence about psychological therapies used to manage co-morbid depression after a spinal cord injury is presented here. A comprehensive search of five electronic databases identified nine studies (participants, n = 591) meeting inclusion criteria. Pooled statistical analyses were conducted in combination with narrative synthesis. Overall, multimodal cognitive behavioural therapy was found to be moderately effective (standardised mean difference = -0.52; 95% confidence interval = -0.85, -0.19). Activity scheduling, psychoeducation, problem solving and cognitive therapy may be particularly beneficial therapies within cognitive behavioural therapy. Further high-quality randomised controlled trials are needed to better substantiate these findings.",23988680,Major Depressive Disorder,Anxiety Treatment,Mental Health,4322,6.496414661407471,-0.04250264912843704,CZaq
"Hypnotically catalyzing experiential learning across treatments for depression: actions can speak louder than moods.

A number of psychotherapeutic approaches for the treatment of major depression have received empirical support in the literature, most notably cognitive-behavioral and interpersonal therapies. Recent studies have shown the therapeutic value of the behavioral activation component of such interventions. Depressed individuals actively learning and applying new skills on their own behalf is widely considered a critical component of recovery. This article describes the use of hypnosis to catalyze experiential learning and to encourage behavioral activation in the depressed client by directly addressing and transforming cognitive and perceptual patterns that can impede such behavioral activation, especially global thinking and ruminative coping styles.",20390690,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.782143592834473,0.7356978058815002,DLu/
"Complementary and alternative medicine for the treatment of depressive disorders in women.

Complementary and alternative medicine (CAM) therapies are commonly practiced in the United States and are used more frequently among women than men. This article reviews several CAM treatments for depressive disorders in women, with a focus on major depressive disorder across the reproductive life cycle. The CAM therapies selected for this review (ie, S-adenosylmethionine, omega-3 fatty acids, St John's wort, bright light therapy, acupuncture, and exercise) were based on their prevalence of use and the availability of randomized, placebo-controlled data. Further study is necessary to delineate the role of specific CAM therapies in premenstrual syndrome, premenstrual dysphoric disorder, antepartum and postpartum depression, lactation, and the menopausal transition.",20385346,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,6.923666954040527,0.011530517600476742,DLzq
"Mirroring everyday clinical practice in clinical trial design: a new concept to improve the external validity of randomized double-blind placebo-controlled trials in the pharmacological treatment of major depression.

Randomized, double-blind, placebo-controlled trials constitute the gold standard in clinical research when testing the efficacy of new psychopharmacological interventions in the treatment of major depression. However, the blinded use of placebo has been found to influence clinical trial outcomes and may bias patient selection. To improve clinical trial design in major depression so as to reflect clinical practice more closely we propose to present patients with a balanced view of the benefits of study participation irrespective of their assignment to placebo or active treatment. In addition every participant should be given the option to finally receive the active medication. A research agenda is outlined to evaluate the impact of the proposed changes on the efficacy of the drug to be evaluated and on the demographic and clinical characteristics of the enrollment fraction with regard to its representativeness of the eligible population. We propose a list of measures to be taken to improve the external validity of double-blind, placebo-controlled trials in major depression. The recommended changes to clinical trial design may also be relevant for other psychiatric as well as medical disorders in which expectations regarding treatment outcome may affect the outcome itself.",22747667,Major Depressive Disorder,Anxiety Treatment,Mental Health,8564,7.880980491638184,1.2805132865905762,CrhM
"A randomised controlled trial of psychotherapy and cognitive remediation to target cognition in mood disorders.

To examine the impact of a treatment package combining Interpersonal and Social Rhythm Therapy (IPSRT) and cognitive remediation (CR), vs IPSRT alone, on cognition, functioning, and mood disturbance outcomes in mood disorders. A pragmatic randomised controlled trial in adults with bipolar disorder (BD) or major depressive disorder (MDD), recently discharged from mental health services in Christchurch, New Zealand, with subjective cognitive difficulties. Individuals were randomised to a 12-month course of IPSRT with CR (IPSRT-CR), or without CR (IPSRT). In IPSRT-CR, CR was incorporated into therapy sessions from approximately session 5 and continued for 12 sessions. The primary outcome was change in Global Cognition (baseline to 12 months). Sixty-eight individuals (BD n = 26, MDD n = 42; full/partial remission n = 39) were randomised to receive IPSRT-CR or IPSRT (both n = 34). Across treatment arms, individuals received an average of 23 IPSRT sessions. Change in Global Cognition did not differ between arms from baseline to treatment-end (12 months). Psychosocial functioning and longitudinal depression symptoms improved significantly more in the IPSRT compared with IPSRT-CR arm over 12 months, and all measures of functioning and mood symptoms showed moderate effect size differences favouring IPSRT (0.41-0.60). At 18 months, small to moderate, non-significant benefits (0.26-0.47) of IPSRT vs IPSRT-CR were found on functioning and mood outcomes. Combining two psychological therapies to target symptomatic and cognitive/functional recovery may reduce the effect of IPSRT, which has implications for treatment planning in clinical practice and for CR trials in mood disorders.",34800298,Major Depressive Disorder,Anxiety Treatment,Mental Health,6095,12.02395248413086,-0.5867130160331726,2Eg
"What role for cognitive remediation in the treatment of depressive symptoms? A superiority and noninferiority meta-analysis for clinicians.

Cognitive remediation (CR) is a promising technique in the treatment of the cognitive dimension of depression. The present study evaluated the potential of CR in treating depressive symptoms and provides practical information about its usefulness in clinical settings. We performed two meta-analyses of published randomized (and nonrandomized) clinical trials, comparing CR to control conditions in subjects with current depressive symptomatology. The superiority meta-analysis aimed to determine the superiority of CR when compared with placebo/waiting list interventions and its efficacy when used as an augmentation therapy. The noninferiority meta-analysis determined whether CR had noninferior efficacy compared with standard antidepressant interventions. CR was found to significantly improve depressive symptomatology in the superiority meta-analysis (CR: n=466, control n=478). Moreover, CR seemed to be noninferior to standard antidepressant interventions (CR: n=230, control n=235). CR was more effective when addressing hot (vs. cold) cognition, when involving younger patients (i.e., <30 years), and in the case of mild-moderate (vs. severe) depression. CR should be considered an augmentation treatment to improve treatment outcomes in depressed subjects, especially among young individuals. Interventions addressing hot cognition seem to be the most promising.",35536033,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.68327522277832,-0.2926560342311859,Zsc
"Telephone-administered psychotherapy for depression in MS patients: moderating role of social support.

Depression is common in individuals with multiple sclerosis (MS). While psychotherapy is an effective treatment for depression, not all individuals benefit. We examined whether baseline social support might differentially affect treatment outcome in 127 participants with MS and depression randomized to either Telephone-administered Cognitive-Behavioral Therapy (T-CBT) or Telephone-administered Emotion-Focused Therapy (T-EFT). We predicted that those with low social support would improve more in T-EFT, since this approach emphasizes the therapeutic relationship, while participants with strong social networks and presumably more emotional resources might fare better in the more structured and demanding T-CBT. We found that both level of received support and satisfaction with that support at baseline did moderate treatment outcome. Individuals with high social support showed a greater reduction in depressive symptoms in the T-CBT as predicted, but participants with low social support showed a similar reduction in both treatments. This suggests that for participants with high social support, CBT may be a more beneficial treatment for depression compared with EFT.",19941048,Major Depressive Disorder,Anxiety Treatment,Mental Health,1826,17.174087524414062,11.90407943725586,DP14
"Cognitive-behavioral therapy for patients with Parkinson's disease and comorbid major depressive disorder.

Depression has been recognized as a common feature of Parkinson's disease (PD), and is the most prevalent psychiatric disorder in PD patients. The authors sought to determine whether cognitive-behavioral therapy (CBT) is effective in the treatment of depression within the context of PD (dPD). The authors enrolled 8 depressed PD patients into an open treatment study of 12 weeks of individual CBT treatment. There was a significant linear decrease in mean Hamilton Rating Scale for Depression (17-item) scores over Weeks 0 to 12, and 57% of patients (4/7) met criteria for remission at endpoint. This uncontrolled study suggests that CBT may be effective in treating dPD and may be an alternative or adjunct to pharmacological treatment.",20332287,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.455429077148438,13.67676067352295,DMdQ
"Psychological interventions for depression in adolescent and adult congenital heart disease.

Adult and adolescent congenital heart disease is increasing in prevalence as better medical care means more children are surviving to adulthood. People with chronic disease often also experience depression. There are several non-pharmacological treatments that might be effective in treating depression and improving quality of life for adults and young adults with congenital heart disease. The aim of this review was to assess the effects of treatments such as psychotherapy, cognitive behavioural therapies and talking therapies for treating depression in this population. To update the previous review on the effects (both harms and benefits) of psychological interventions for treating depression in young adults and adults with congenital heart disease. Psychological interventions include cognitive behavioural therapy, psychotherapy, or 'talking/counselling' therapy for depression. We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (Issue 1, 2013), MEDLINE (OVID, 1946 to January week 4 2013), EMBASE (OVID, 1980 to 2013 week 05), PsycINFO (OVID, 1806 to January week 5 2013), the Database of Abstracts of Reviews of Effectiveness (DARE) on The Cochrane Library (Issue 1, 2013), BIOSIS (Thomson Reuters, 1969 to 21 February 2013), and CINAHL (January 1980 to February 2013) on 5 February 2013. We did not search abstracts from national and international cardiology and psychology conferences and dissertation abstracts for this update. No language restrictions were applied. Randomised controlled trials comparing psychological interventions with no intervention for people over 15 years with depression who have congenital heart disease. Two review authors independently screened titles and abstracts of studies that were potentially relevant to the review. We rejected studies that were clearly ineligible. Two review authors independently assessed the abstracts or full papers for inclusion criteria. We sought further information from the authors where papers contained insufficient information to make a decision about eligibility. We did not identify any randomised controlled trials that met the inclusion criteria. Depression is common in people with congenital heart disease and can exacerbate the physical consequences of the illness. There are effective pharmacological and non-pharmacological treatments for depression, but we have not been able to identify any trials showing the effectiveness of non-pharmacological treatments. A well-designed randomised controlled trial is needed to assess the effects of psychological interventions for depression in congenital heart disease.",24163137,Major Depressive Disorder,Anxiety Treatment,Mental Health,4560,8.183333396911621,0.5051268339157104,CW4w
"Positive memory enhancement training for individuals with major depressive disorder.

When in a negative mood state, individuals with major depressive disorder (MDD) may have difficulties recalling positive autobiographical memories in a manner that repairs that negative mood. Using cognitive bias modification techniques, investigators have successfully altered different aspects of cognition among individuals with MDD. However, little has been done to investigate the modification of positive autobiographical memory recall. This study examined the impact of a novel positive memory enhancement training (PMET) on the memories and subjective affective experiences of individuals with MDD (N = 27). Across a series of trials, participants first recalled a sad memory to elicit a negative mood state. They then recalled a happy memory and completed procedures to elicit a vivid, here-and-now quality of the memory. PMET procedures were hypothesized to promote mood repair via the recall of increasingly vivid and specific positive memories. PMET participants demonstrated improved memory specificity and greater perceived ability to ""relive"" positive memories. The procedures also repaired mood; PMET participants' affect following recall of positive memories did not differ from control participants' affect following recall of neutral memories. Results provide preliminary support for PMET as a method to improve the quality of positive memories and facilitate emotion regulation in MDD.",28826327,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,15.1918363571167,0.0632467195391655,BYJ/
"Effectiveness of digital interventions for people with comorbid heavy drinking and depression: A systematic review and narrative synthesis.

Heavy drinking and depression frequently co-occur and make a substantial contribution to the global non-communicable disease burden. Positive evidence exists for the use of digital interventions with these conditions alone, but there has been limited assessment of combined approaches. A systematic review of the effectiveness of combined digital interventions for comorbid heavy drinking and major depression in community-dwelling populations. Electronic databases were searched to October 2021 for randomised controlled trials that evaluated any personalised digital intervention for comorbid heavy drinking and depression. Primary outcomes were changes in quantity of alcohol consumed and depressive symptoms. Two reviewers independently assessed study eligibility, extracted data, and undertook risk of bias assessment. Due to the limited number and heterogeneity of studies identified, meta-analysis was not possible, therefore data were synthesised narratively. Of 898 articles identified, 24 papers were reviewed in full, five of which met the inclusion criteria (N = 1503 participants). Three utilised web-based intervention delivery; two computer programmes delivered in a clinic setting. All involved multi-component interventions; treatment length varied from one to ten sessions. Four studies found no evidence for the superiority of combined digital interventions for comorbid heavy drinking and depression over therapist-delivered approaches, single condition interventions (including online), or assessment-only controls. Positive impacts of integrated online therapy compared to generalist online health advice were reported in a fifth study, but not maintained beyond the 1-month follow-up. Few eligible, heterogeneous studies prevented meta-analysis. Limited evidence exists of the effectiveness of combined digital interventions for comorbid heavy drinking and depression in community dwelling populations.",34801605,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,4.372190475463867,-8.760971069335938,198
"Cognitive-behavioral therapies for depression and substance use disorders: An overview of traditional, third-wave, and transdiagnostic approaches.

The co-occurrence of depression and substance use disorders (SUD) is highly prevalent and associated with poor treatment outcomes for both disorders. As compared to individuals suffering from either disorder alone, individuals with both conditions are likely to endure a more severe and chronic clinical course with worse treatment outcomes. Thus, current practice guidelines recommend treating these co-occurring disorders simultaneously. The overarching aims of this narrative are two-fold: (1) to provide an updated review of the current empirical status of integrated psychotherapy approaches for SUD and depression comorbidity, based on models of traditional cognitive-behavioral therapy (CBT) and newer third-wave CBT approaches, including acceptance- and mindfulness-based interventions and behavioral activation (BA); and (2) to propose a novel theoretical framework for transdiagnostic CBT for SUD-depression, based upon empirically grounded psychological mechanisms underlying this highly prevalent comorbidity. Traditional CBT approaches for the treatment of SUD-depression are well-studied. Despite advances in the development and evaluation of various third-wave psychotherapies, more work needs to be done to evaluate the efficacy of such approaches for SUD-depression. Informed by this summary of the evidence, we propose a transdiagnostic therapy approach that aims to integrate treatment elements found in empirically supported CBT-based interventions for SUD and depression. By targeting shared cognitive-affective processes underlying SUD-depression, transdiagnostic treatment models have the potential to offer a novel clinical approach to treating this difficult-to-treat comorbidity and relevant, co-occurring psychiatric disturbances, such as posttraumatic stress.",27494547,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,4.601159572601318,-8.971076965332031,Bo/H
"Psychological interventions for co-occurring depression and substance use disorders.

Comorbid depression and substance use disorders are common and have poorer outcomes than either disorder alone. While effective psychological treatments for depression or substance use disorders are available, relatively few randomised controlled trials (RCTs) have examined the efficacy of these treatments in people with these comorbid disorders. To assess the efficacy of psychological interventions delivered alone or in combination with pharmacotherapy for people diagnosed with comorbid depression and substance use disorders. We searched the following databases up to February 2019: Cochrane Central Register of Controlled Trials, PubMed, Embase, CINAHL, Google Scholar and clinical trials registers. All systematic reviews identified, were handsearched for relevant articles. The review includes data from RCTs of psychological treatments for people diagnosed with comorbid depression and substance use disorders, using structured clinical interviews. Studies were included if some of the sample were experiencing another mental health disorder (e.g. anxiety); however, studies which required a third disorder as part of their inclusion criteria were not included. Studies were included if psychological interventions (with or without pharmacotherapy) were compared with no treatment, delayed treatment, treatment as usual or other psychological treatments. We used standard methodological procedures expected by Cochrane. Seven RCTs of psychological treatments with a total of 608 participants met inclusion criteria. All studies were published in the USA and predominately consisted of Caucasian samples. All studies compared different types of psychological treatments. Two studies compared Integrated Cognitive Behavioural Therapy (ICBT) with Twelve Step Facilitation (TSF), another two studies compared Interpersonal Psychotherapy for Depression (IPT-D) with other treatment (Brief Supportive Therapy (BST) or Psychoeducation). The other three studies compared different types or combinations of psychological treatments. No studies compared psychological interventions with no treatment or treatment as usual control conditions. The studies included a diverse range of participants (e.g. veterans, prisoners, community adults and adolescents). All studies were at high risk of performance bias, other main sources were selection, outcome detection and attrition bias. Due to heterogeneity between studies only two meta-analyses were conducted. The first meta-analysis focused on two studies (296 participants) comparing ICBT to TSF. Very low-quality evidence revealed that while the TSF group had lower depression scores than the ICBT group at post-treatment (mean difference (MD) 4.05, 95% confidence interval (CI) 1.43 to 6.66; 212 participants), there was no difference between groups in depression symptoms (MD 1.53, 95% CI -1.73 to 4.79; 181 participants) at six- to 12-month follow-up. At post-treatment there was no difference between groups in proportion of days abstinent (MD -2.84, 95% CI -8.04 to 2.35; 220 participants), however, the ICBT group had a greater proportion of days abstinent than the TSF group at the six- to 12-month follow-up (MD 10.76, 95% CI 3.10 to 18.42; 189 participants). There were no differences between the groups in treatment attendance (MD -1.27, 95% CI -6.10 to 3.56; 270 participants) or treatment retention (RR 0.95, 95% CI 0.72 to 1.25; 296 participants). The second meta-analysis was conducted with two studies (64 participants) comparing IPT-D with other treatment (Brief Supportive Psychotherapy/Psychoeducation). Very low-quality evidence indicated IPT-D resulted in significantly lower depressive symptoms at post-treatment (MD -0.54, 95% CI -1.04 to -0.04; 64 participants), but this effect was not maintained at three-month follow-up (MD 3.80, 95% CI -3.83 to 11.43) in the one study reporting follow-up outcomes (38 participants; IPT-D versus Psychoeducation). Substance use was examined separately in each study, due to heterogeneity in outcomes. Both studies found very low-quality evidence of no significant differences in substance use outcomes at post-treatment (percentage of days abstinent, IPD versus Brief Supportive Psychotherapy; MD -2.70, 95% CI -28.74 to 23.34; 26 participants) or at three-month follow-up (relative risk of relapse, IPT-D versus Psychoeducation; RR 0.67, 95% CI 0.30 to 1.50; 38 participants). There was also very low-quality evidence for no significant differences between groups in treatment retention (RR 1.00, 95% CI 0.81 to 1.23; 64 participants). No adverse events were reported in any study. The conclusions of this review are limited due to the low number and very poor quality of included studies. No conclusions can be made about the efficacy of psychological interventions (delivered alone or in combination with pharmacotherapy) for the treatment of comorbid depression and substance use disorders, as they are yet to be compared with no treatment or treatment as usual in this population. In terms of differences between psychotherapies, although some significant effects were found, the effects were too inconsistent and small, and the evidence of too poor quality, to be of relevance to practice.",31769015,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,4.582886695861816,-8.365621566772461,AxQC
"A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial).

The possible therapeutic impact of dietary changes on existing mental illness is largely unknown. Using a randomised controlled trial design, we aimed to investigate the efficacy of a dietary improvement program for the treatment of major depressive episodes. 'SMILES' was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length. Depression symptomatology was the primary endpoint, assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) at 12 weeks. Secondary outcomes included remission and change of symptoms, mood and anxiety. Analyses utilised a likelihood-based mixed-effects model repeated measures (MMRM) approach. The robustness of estimates was investigated through sensitivity analyses. We assessed 166 individuals for eligibility, of whom 67 were enrolled (diet intervention, n=33; control, n=34). Of these, 55 were utilising some form of therapy: 21 were using psychotherapy and pharmacotherapy combined; 9 were using exclusively psychotherapy; and 25 were using only pharmacotherapy. There were 31 in the diet support group and 25 in the social support control group who had complete data at 12 weeks. The dietary support group demonstrated significantly greater improvement between baseline and 12 weeks on the MADRS than the social support control group, t(60.7)=4.38, p<0.001, Cohen's d=-1.16. Remission, defined as a MADRS score <10, was achieved for 32.3% (n=10) and 8.0% (n=2) of the intervention and control groups, respectively (χ 2 (1)=4.84, p=0.028); number needed to treat (NNT) based on remission scores was 4.1 (95% CI of NNT 2.3-27.8). A sensitivity analysis, testing departures from the missing at random (MAR) assumption for dropouts, indicated that the impact of the intervention was robust to violations of MAR assumptions. These results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000251820 . Registered on 29 February 2012.",28137247,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,0.5158877968788147,-1.8902982473373413,Bhgm
"Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up.

Preliminary data suggest that psilocybin-assisted treatment produces substantial and rapid antidepressant effects in patients with major depressive disorder (MDD), but little is known about long-term outcomes. This study sought to examine the efficacy and safety of psilocybin through 12months in participants with moderate to severe MDD who received psilocybin. This randomized, waiting-list controlled study enrolled 27 patients aged 21-75 with moderate to severe unipolar depression (GRID-Hamilton Depression Rating Scale (GRID-HAMD)⩾17). Participants were randomized to an immediate or delayed (8weeks) treatment condition in which they received two doses of psilocybin with supportive psychotherapy. Twenty-four participants completed both psilocybin sessions and were followed through 12months following their second dose. All 24 participants attended all follow-up visits through the 12-month timepoint. Large decreases from baseline in GRID-HAMD scores were observed at 1-, 3-, 6-, and 12-month follow-up (Cohen d=2.3, 2.0, 2.6, and 2.4, respectively). Treatment response (⩾50% reduction in GRID-HAMD score from baseline) and remission were 75% and 58%, respectively, at 12months. There were no serious adverse events judged to be related to psilocybin in the long-term follow-up period, and no participants reported psilocybin use outside of the context of the study. Participant ratings of personal meaning, spiritual experience, and mystical experience after sessions predicted increased well-being at 12months, but did not predict improvement in depression. These findings demonstrate that the substantial antidepressant effects of psilocybin-assisted therapy may be durable at least through 12months following acute intervention in some patients.",35166158,Major Depressive Disorder,Anxiety Treatment,Mental Health,10742,-0.910304605960846,-8.081269264221191,nOc
"The Effects of Psilocybin in Adults with Major Depressive Disorder and the General Population: Findings from Neuroimaging Studies.

The use of psilocybin as treatment for major depressive disorder (MDD) has been examined as a promising alternative to traditional first-line options. We reviewed existing literature to provide a synthesis of the extant neuroimaging observations with psilocybin, and to identify putative therapeutic targets for target engagement studies with psilocybin, and potentially other psychedelics. We assessed neuroimaging observations with psilocybin among participants with MDD and healthy populations. A systematic search was conducted on PubMed, Google Scholar and PsycINFO from database inception to November 17th, 2021. The study quality (i.e., risk of bias) was assessed using the revised Cochrane risk-of-bias tool for randomized trials. A total of ten studies evaluated psilocybin in healthy populations and three studies assessed psilocybin in MDD participants using neuroimaging techniques. Following psilocybin administration, a decrease in amygdala activity and a reduction in depressive symptoms was observed in two studies. Changes in functional connectivity and activation of prefrontal limbic structures, specifically the ventral medial prefrontal cortex and amygdala, was seen in healthy populations. There was high heterogeneity in methodology (e.g., dosing schedule and imaging methods) amongst included studies. Longitudinal studies are needed to further elucidate psilocybin treatment for MDD, its long-term effects and the possibility of sustained therapeutic effects.",35580433,Major Depressive Disorder,Anxiety Treatment,Mental Health,10742,-0.8991020321846008,-7.902785778045654,YWE
"Internet and Face-to-face Cognitive Behavioral Therapy for Postnatal Depression Compared With Treatment as Usual: Randomized Controlled Trial of MumMoodBooster.

Previous research has confirmed that symptoms of postnatal depression (PND) can be ameliorated through internet-delivered psychological interventions. Advantages of internet-delivered treatment include anonymity, convenience, and catering to women who are unable to access face-to-face (FTF) treatments. To date, no research has examined the efficacy of such interventions compared directly with FTF treatments in women clinically diagnosed with PND. This study aims to compare the efficacy of one of the first web-based cognitive behavioral therapy (CBT) interventions (internet CBT+coach calls) for PND (MumMoodBooster [MMB]) with FTF-CBT in a randomized controlled trial (RCT). In this study, 116 postnatal women with a Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) diagnosis of major or minor depression were randomized to MMB (39/116, 33.6%), FTF-CBT (39/116, 33.6%), or a treatment-as-usual (TAU) control condition (38/116, 32.8%). Diagnostic status was determined at baseline and at 21-week follow-up using the Structured Clinical Interview for the DSM-IV. Severity of anxiety and depressive symptoms was evaluated using the Depression Anxiety Stress Scales and the revised Beck Depression Inventory at baseline, 12-week follow-up (after treatment), and 21-week follow-up. Of the 116 participants, 107 (92.2%) had a diagnosis of major depression at baseline. Rates of remission from a major or minor depressive episode at 21 weeks in both the FTF-CBT and MMB groups were superior to that of the TAU group (56.6% and 47.7% less likely to be depressed, respectively) and they were not significantly different from each other. Although remission rates differed between TAU and FTF-CBT, growth models showed that, in terms of symptom reduction across time, the FTF-CBT treatment was not significantly better than TAU. By comparison, MMB was statistically superior to both TAU and FTF-CBT in reducing symptoms of depression, anxiety, and stress from baseline to the 21-week follow-up (large and moderate effect sizes). Thus, after 21 weeks, the average symptom scores for depression and anxiety of women receiving MMB were approximately half those of women in both the TAU and FTF-CBT groups. In this RCT, MMB was at least as effective as FTF-CBT in achieving remission from a diagnosed PND episode. MMB was superior to TAU and FTF-CBT in encouraging and maintaining reduction of symptom severity over the 21-week follow-up for depressed postnatal women. These findings replicate results of prior studies on MMB that showed clinically significant improvements in depressive symptoms, and they provide direct empirical support that internet-delivered treatment for depressed postnatal women is a viable alternative to FTF treatment. The generalizability of the results needs to be examined in future research, as RCTs of internet-based versus FTF treatments necessarily involve a subset of people who are willing to undertake either modality of treatment. Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000881730; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364683&isReview=true.",34889742,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.96968674659729,-5.841147422790527,yeU
"Long-term impact of a behavioral weight management program on depression and anxiety symptoms: 5-year follow-up of the WRAP trial.

Behavioral weight management programs may support short-term mental health; however, limited evidence reports the long-term impacts. This study investigated the impact of behavioral weight management programs on depression and anxiety symptoms at 5years from baseline. The Weight loss Referrals for Adults in Primary care (WRAP) trial randomized 1267 adults with BMI ≥28kg/m2 to a brief intervention (BI) or commercial behavioral weight management program (WW; formerly Weight Watchers) for 12 or 52weeks (CP12 and CP52, respectively). Linear regression was used to separately compare 5-year changes in depression and anxiety symptoms (by Hospital Anxiety and Depression Scale) between randomized groups, adjusting for baseline depression/anxiety symptoms, gender, and research center. A total of 643 (51%) participants attended the 5-year study follow-up visit. There was no evidence of a difference between the randomized groups for 5-year changes in depression (BI: -0.08±3.29; CP12: 0.02±3.01; CP52: -0.09±3.41) or anxiety (BI: 0.16±3.50; CP12: -0.05±3.55; CP52: -0.66±3.59) symptoms. This study found no evidence that commercial weight management programs differed in 5-year changes in depression and anxiety symptoms, compared with BI. These are average effects; some individuals experienced increases or decreases in symptoms. Future research should investigate who is at most risk of mental health declines and investigate how to support them. Future trials should transparently report long-term mental health outcomes to strengthen understanding.",36300839,Major Depressive Disorder,Anxiety Treatment,Mental Health,1506,0.858727753162384,-2.8994140625,C1Y
"Treatment of depressive symptoms in patients with breast cancer: A randomized controlled trial comparing cognitive therapy and bright light therapy.

This randomized controlled trial (RCT), conducted in patients with breast cancer, aimed to compare the effects of cognitive therapy (CT), bright light therapy (BLT), and a waiting-list control condition (WLC) on depressive symptoms. Sixty-two women were randomly assigned to an 8-week CT (n = 25), BLT (n = 26), or WLC (n = 11). Participants completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), the Beck Depression Inventory-II (BDI-II), and the Hamilton Depression Rating Scale (HDRS) at pre- and posttreatment (and postwaiting for WLC), as well as 3 and 6 months later. At posttreatment, CT patients had a significantly greater reduction of depressive symptoms than WLC on the HADS-D and the BDI-II. BLT patients had a greater reduction of depressive symptoms than WLC on the HADS-D only. After WLC participants were reassigned to CT or BLT, a superiority of CT over BLT was found on the BDI-II at posttreatment. Patients of both active conditions showed a good sustainment of treatment gains at follow-ups. Although replication with larger samples is needed, these results confirm the efficacy of CT for depression in the context of breast cancer and suggest that BLT could be of some utility when CT is not available or desired. (PsycINFO Database Record",29172605,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,5.709430694580078,-2.608825922012329,BTq/
"Web-Based Intervention to Reduce Substance Abuse and Depression: A Three Arm Randomized Trial in Mexico.

Web-based cognitive-behavioral interventions to reduce substance use can be a useful low-cost treatment for a large number of people, and an attractive option in countries where a greater availability of treatment is needed. To evaluate the feasibility and initial effectiveness of a web-based cognitive-behavioral intervention for the reduction of substance use and depression compared with treatment as usual, with and without a printed self-help manual. Individuals seeking outpatient treatment for substance use were randomly assigned to one of the following: (1) the web-based Help Program for Drug Abuse and Depression (n = 23); (2) an in-person session with an addiction therapist and use of the Alcohol, Smoking, and Substance Involvement Screening Test Self-Help Strategies guide, followed by treatment as usual (n = 25), or (3) treatment ordinarily offered in the participating treatment centers (n = 26). The study took place in 2013-2014 (trial registration: ISRCTN25429892), and participants completed baseline, posttreatment, and 1-month follow-up evaluation interviews. Treatment retention and data availability were comparable in all three conditions. A reduction was observed from baseline to follow-up in average days of use [F(1,28) = 29.70, p < 0.001], severity of use [F(2,28) = 143.66, p < 0.001], and depressive symptomatology [F = (4)16.40, p < 0.001], independent of the type of treatment provided. The findings suggest that the web-based intervention to reduce substance abuse is feasible, although it is not more effective than other intervention modalities; its effectiveness must be evaluated in a larger sample. Attrition was a main limitation; future studies must improve retention and assess cost-effectiveness.",29768070,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,4.520610332489014,-8.824180603027344,BLuG
"Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (P<0.001), whereas these differences were non-significant in the control group (P=0.123). After the treatment, the glycated hemoglobin reduction in the intervention group was greater than that of the control group (t=2.438, P=0.016). The combination of Twenty-four Move Shadow Boxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.",26057313,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.5313870906829834,-2.1200926303863525,B8ik
"Effectiveness of Psychological Interventions on Depression in Patients After Breast Cancer Surgery: A Meta-analysis of Randomized Controlled Trials.

The present study assessed the effectiveness of individually delivered cognitive behavioral therapy (CBT) interventions in improving depression in patients with breast cancer. A systematic search of Medline (Ovid), PubMed, Cochrane Library, China National Knowledge Infrastructure database, WANFANG, and the VIP database. Quality assessment of included studies was conducted by 2 reviewers independently using the Jadad scale. The pooled effect of the mean difference in the baseline and post-treatment depressive scores was analyzed using different outcome measuring instruments (Self-rating Depression Scale, Hospital Anxiety and Depression Scale, and Hamilton Depression Rating Scale) separately. Thirteen studies involving 966 patients were included. The pooled standardized mean difference (SMD) comparing the intervention groups to the control groups was -0.87 (95% confidence interval [CI], -1.03 to -0.71; overall effect Z, 10.84; P < .0001) in the Self-rating Depression Scale subgroup, which indicated a large effect size based on Cohen's d value (Cohen's d, -0.87). The SMD was -0.50 (95% CI, -0.98 to -0.02; overall effect Z, 20.6; P = .04) in the Hospital Anxiety and Depression Scale subgroup, which indicated a moderate effect size (Cohen's d, -0.50). Finally, the SMD was -2.61 (95% CI, -4.07 to -1.14; overall effect Z, 3.49; P = .0005) in the Hamilton Depression Rating Scale subgroup, which indicated a very large effect size (Cohen's d, -2.61). The overall effect size of the individually delivered CBT in improving depression in breast cancer patients was large. Also, no evidence was found of statistical heterogeneity. The present meta-analysis showed significant efficacy for individually delivered CBT in the reduction of depression in patients after breast cancer surgery. However, further well-designed randomized controlled trials with large sample sizes are needed to provide more valid and reliable results on the long-term outcomes.",28040415,Major Depressive Disorder,Anxiety Treatment,Mental Health,8627,6.111183166503906,-2.759026288986206,BivX
"Psilocybin with psychological support for treatment-resistant depression: six-month follow-up.

Recent clinical trials are reporting marked improvements in mental health outcomes with psychedelic drug-assisted psychotherapy. Here, we report on safety and efficacy outcomes for up to 6 months in an open-label trial of psilocybin for treatment-resistant depression. Twenty patients (six females) with (mostly) severe, unipolar, treatment-resistant major depression received two oral doses of psilocybin (10 and 25 mg, 7 days apart) in a supportive setting. Depressive symptoms were assessed from 1 week to 6 months post-treatment, with the self-rated QIDS-SR16 as the primary outcome measure. Treatment was generally well tolerated. Relative to baseline, marked reductions in depressive symptoms were observed for the first 5 weeks post-treatment (Cohen's d = 2.2 at week 1 and 2.3 at week 5, both p < 0.001); nine and four patients met the criteria for response and remission at week 5. Results remained positive at 3 and 6 months (Cohen's d = 1.5 and 1.4, respectively, both p < 0.001). No patients sought conventional antidepressant treatment within 5 weeks of psilocybin. Reductions in depressive symptoms at 5 weeks were predicted by the quality of the acute psychedelic experience. Although limited conclusions can be drawn about treatment efficacy from open-label trials, tolerability was good, effect sizes large and symptom improvements appeared rapidly after just two psilocybin treatment sessions and remained significant 6 months post-treatment in a treatment-resistant cohort. Psilocybin represents a promising paradigm for unresponsive depression that warrants further research in double-blind randomised control trials.",29119217,Major Depressive Disorder,Anxiety Treatment,Mental Health,10742,-1.050047516822815,-7.99308443069458,BUcW
"Internet-based Cognitive-behavioral therapy (CBT) for depressive symptomatology in individuals with type 1 diabetes (WEB_TDDI1 study): A randomized controlled trial protocol.

Professionals need adequate tools to help patients with diabetes and depression. Although web programs integrating cognitive-behavioral therapy with diabetes education have shown good results, no similar approach has been performed as yet in Spain. The objective is to develop an Internet-based program for the treatment of mild-moderate depressive symptomatology in individuals with type 1 diabetes (WEB_TDDI1 study) based on Cognitive-behavioral therapy (CBT) and assess its results. A 2-arm randomized controlled trial will be conducted. Adults with type 1 diabetes and mild-moderate depressive symptoms will be screened to participate in the study and randomly assigned to either the treatment group (TG) that will use a Web-based application for a specific 9-week intervention in depression and type 1 diabetes or the control group (CG) that will be on the waiting list during that time. Data on the primary variable (depressive symptoms) and secondary variables (treatment-related distress, anxiety, fear of hypoglycemia, quality of life, treatment adherence, coping strategies and glycemic control) will be collected from the TG at the beginning/baseline, at the end of treatment and at 3, 6 and 12 months after treatment. The CG will be assessed at the beginning and at the end of the TG intervention. On completion of the program by the TG, the treatment will then be carried out in the CG. The new web application developed is expected to be effective for the treatment of mild-moderate depressive symptoms in adults with type 1 diabetes, reducing depressive symptoms and improving the rest of the analyzed variables. Registry: NCT03473704 (March 21, 2018); ClinicalTrials.gov.",36126050,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.2598493099212646,-2.6823136806488037,G7k
"The effectiveness of cognitive behavioural therapy for depressed patients with diabetes: A systematic review.

Depression is common among patients with diabetes, who have a higher risk of diabetes-related complications such as diabetic retinopathy, nephropathy, neuropathy and macrovascular complications. The aim of the systematic review is to determine whether cognitive behavioural therapy is effective in reducing depressive symptoms and improving glycaemic control among depressed diabetic patients. The results reveal diversified application of cognitive behavioural therapy. All studies reported that cognitive behavioural therapy had a positive impact on depressive symptoms; three found an improvement in glycated haemoglobin, and one demonstrated improved self-efficacy and self-concept related to successful diabetes management. There is a need for controlled studies with larger sample sizes and long-term follow-up.",28810481,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.3869946002960205,-2.2933712005615234,BYXM
"Mediation analyses of Internet-facilitated cognitive behavioral intervention for maternal depression.

This study evaluated the putative mediating mechanisms of an Internet-facilitated cognitive-behavioral therapy (CBT) intervention for depression tailored to economically disadvantaged mothers of preschool-age children. The CBT mediators were tested across two previously published randomized controlled trials which included the same measures of behavioral activation, negative thinking, and savoring of positive events. Trial 1 included 70 mothers with elevated depressive symptoms who were randomized to either the eight-session, Internet-facilitated intervention (Mom-Net) or to treatment as usual. Trial 2 included 266 mothers with elevated depressive symptoms who were randomized to either Mom-Net or to a motivational interviewing and referral to services condition. Simple mediation models tested each putative mediator independently followed by tests of multiple mediation that simultaneously included all three mediators in the model to assess the salient contributions of each mediator. The pattern of results for the mediating effects were systematically replicated across the two trials and suggest that behavioral activation and negative thinking are salient mediators of the Mom-Net intervention; significant mediating effects for savoring were obtained only in the simple mediation models and were not obtained in the multiple mediation models.",30311850,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,4.26978874206543,-5.677560806274414,BE4i
"Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial.

Mobile phone text message technology has the potential to improve outcomes for patients with depression and co-morbid Alcohol Use Disorder (AUD). To perform a randomised rater-blinded trial to explore the effects of supportive text messages on mood and abstinence outcomes for patients with depression and co-morbid AUD. Participants (n=54) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were randomised to receive twice daily supportive text messages (n=26) or a fortnightly thank you text message (n=28) for three months. Primary outcome measures were Beck's Depression Inventory (BDI-II) scores and Cumulative Abstinence Duration (CAD) in days at three months. NCT0137868. There was a statistically significant difference in three month BDI-II scores between the intervention and control groups; 8.5 (SD=8.0) vs. 16.7 (SD=10.3) respectively after adjusting for the baseline scores, F (1, 49)=9.54, p=0.003, η(p)(2)=0.17. The mean difference in change BDI-II scores was -7.9 (95% CI -13.06 to -2.76, Cohen'sd=0.85). There was a trend for a greater CAD in the text message group than the control group: 88.3 (SD=6.2) vs. 79.3 (SD=24.1), t=1.78, df=48, p=0.08. Limitations of the study include the small sample size, the potential for loss of rater blinding and the lack of long term follow-up to determine the longer term effects of the intervention. Supportive text messages have the potential to improve outcomes for patients with comorbid depression and alcohol dependency syndrome.",22464008,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,5.192074775695801,-8.28969669342041,CvVq
"Cognitive-Behavioural therapy and interpersonal psychotherapy for the treatment of post-natal depression: a narrative review.

Post-natal Depression (PND) is a depressive disorder that causes significant distress or impairment on different levels in the individual's life and their families. There is already evidence of the efficacy of psychological treatments for PND. We conducted a narrative review and researched the literature for identifying systematic reviews and studies for the best psychological treatments of PND, and examined what parameters made those treatments successful. We searched 4 electronic databases. We included reviews and randomised controlled clinical trials for our research. We excluded other types of studies such as case studies and cohort studies. We followed a specific search strategy with specific terms and a selection process. We identified risk of bias in reviews and studies, and identified their limitations. We synthesized the data based on particular information, including: name of the authors, location, research type, target, population, delivery, outcome measures, participants, control groups, types of intervention, components of treatments, providers, experimental conditions amongst others. We found 6 reviews and 15 studies which met our inclusion criteria focusing on Cognitive Behavioural Therapy (CBT) for PND. Among the main findings we found that CBT can be delivered on an individual basis or within a group. It can be effective in the short-term, or up to six months post-intervention. CBT can be delivered by professionals or experts, but can also be practiced by non-experts. We found 7 components of CBT, including psychoeducation, cognitive restructuring, and goal setting. We also researched whether virtual reality (VR) has ever been used for the treatment of PND, and found that it has not. From our review, we have concluded that CBT is an effective treatment for PND. We have explored the utility of VR as a possible therapeutic modality for PND and have decided to run a pilot feasibility study as a next step, which will act as the foundational guide for a clinical trial at a later stage.",29914574,Major Depressive Disorder,Anxiety Treatment,Mental Health,118,3.8422977924346924,-5.425754547119141,BKMf
"Effect of a Digital Intervention on Depressive Symptoms in Patients With Comorbid Hypertension or Diabetes in Brazil and Peru: Two Randomized Clinical Trials.

Depression is a leading contributor to disease burden globally. Digital mental health interventions can address the treatment gap in low- and middle-income countries, but the effectiveness in these countries is unknown. To investigate the effectiveness of a digital intervention in reducing depressive symptoms among people with diabetes and/or hypertension. Participants with clinically significant depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score ≥10) who were being treated for hypertension and/or diabetes were enrolled in a cluster randomized clinical trial (RCT) at 20 sites in São Paulo, Brazil (N=880; from September 2016 to September 2017; final follow-up, April 2018), and in an individual-level RCT at 7 sites in Lima, Peru (N=432; from January 2017 to September 2017; final follow-up, March 2018). An 18-session, low-intensity, digital intervention was delivered over 6 weeks via a provided smartphone, based on behavioral activation principles, and supported by nurse assistants (n=440 participants in 10 clusters in São Paulo; n=217 participants in Lima) vs enhanced usual care (n=440 participants in 10 clusters in São Paulo; n=215 participants in Lima). The primary outcome was a reduction of at least 50% from baseline in PHQ-9 scores (range, 0-27; higher score indicates more severe depression) at 3 months. Secondary outcomes included a reduction of at least 50% from baseline PHQ-9 scores at 6 months. Among 880 patients cluster randomized in Brazil (mean age, 56.0 years; 761 [86.5%] women) and 432 patients individually randomized in Peru (mean age, 59.7 years; 352 [81.5%] women), 807 (91.7%) in Brazil and 426 (98.6%) in Peru completed at least 1 follow-up assessment. The proportion of participants in São Paulo with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 40.7% (159/391 participants) in the digital intervention group vs 28.6% (114/399 participants) in the enhanced usual care group (difference, 12.1 percentage points [95% CI, 5.5 to 18.7]; adjusted odds ratio [OR], 1.6 [95% CI, 1.2 to 2.2]; P=.001). In Lima, the proportion of participants with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 52.7% (108/205 participants) in the digital intervention group vs 34.1% (70/205 participants) in the enhanced usual care group (difference, 18.6 percentage points [95% CI, 9.1 to 28.0]; adjusted OR, 2.1 [95% CI, 1.4 to 3.2]; P<.001). At 6-month follow-up, differences across groups were no longer statistically significant. In 2 RCTs of patients with hypertension or diabetes and depressive symptoms in Brazil and Peru, a digital intervention delivered over a 6-week period significantly improved depressive symptoms at 3 months when compared with enhanced usual care. However, the magnitude of the effect was small in the trial from Brazil and the effects were not sustained at 6 months. ClinicalTrials.gov: NCT02846662 (São Paulo) and NCT03026426 (Lima).",33974019,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,3.748901128768921,-2.675711154937744,AWhA
"Digitalized Cognitive Behavioral Interventions for Depressive Symptoms During Pregnancy: Systematic Review.

Studies have shown a high prevalence of depression during pregnancy, and there is also evidence that cognitive behavioral therapy (CBT) is one of the most effective psychosocial interventions. Emerging evidence from randomized controlled trials (RCTs) has shown that technology has been successfully harnessed to provide CBT interventions for other populations. However, very few studies have focused on their use during pregnancy. This approach has become increasingly important in many clinical areas due to the COVID-19 pandemic, and our study aimed to expand the knowledge in this particular clinical area. Our systematic review aimed to bring together the available research-based evidence on digitalized CBT interventions for depression symptoms during pregnancy. A systematic review of the Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, Embase, PsycINFO, Scopus, ClinicalTrials.gov, and EBSCO Open Dissertations databases was carried out from the earliest available evidence to October 27, 2021. Only RCT studies published in English were considered. The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-analyses) guidelines were followed, and the protocol was registered on the Prospective Register of Systematic Reviews. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. The review identified 7 studies from 5 countries (the United States, China, Australia, Norway, and Sweden) published from 2015 to 2021. The sample sizes ranged from 25 to 1342 participants. The interventions used various technological elements, including text, images, videos, games, interactive features, and peer group discussions. They comprised 2 guided and 5 unguided approaches. Using digitalized CBT interventions for depression during pregnancy showed promising efficacy, with guided intervention showing higher effect sizes (Hedges g=1.21) than the unguided interventions (Hedges g=0.14-0.99). The acceptability of the digitalized CBT interventions was highly encouraging, based on user feedback. Attrition rates were low for the guided intervention (4.5%) but high for the unguided interventions (22.1%-46.5%). A high overall risk of bias was present for 6 of the 7 studies. Our search only identified a small number of digitalized CBT interventions for pregnant women, despite the potential of this approach. These showed promising evidence when it came to efficacy and positive outcomes for depression symptoms, and user feedback was positive. However, the overall risk of bias suggests that the efficacy of the interventions needs to be interpreted with caution. Future studies need to consider how to mitigate these sources of biases. Digitalized CBT interventions can provide prompt, effective, evidence-based interventions for pregnant women. This review increases our understanding of the importance of digitalized interventions during pregnancy, including during the COVID-19 pandemic. PROSPERO International Prospective Register of Systematic Reviews CRD42020216159; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216159.",35195532,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,4.13593053817749,-5.764870643615723,l8U
"Chewing gum may be an effective complementary therapy in patients with mild to moderate depression.

Previous studies indicated that chewing gum may relieve stress and depression. There have, however, not been a significant number of studies on clinical usage of chewing gum. In the present study, 30 patients with mild to moderate depression were given either medication combined with chewing gum, or medication only, for 6 weeks. Turkish adaptation of Hamilton Rating Scale for Depression (HAM-D) was used to measure depression levels. Assessments were conducted by the same physician both before, and after treatment. The physician who was responsible for the assessment was not aware of the group allocation. Changes in main HAM-D scores and each item were analyzed by independent samples t test and Chi-Square test, respectively. Those patients who were administrated chewing gum responded better to the treatment than patients who took medication only. The most beneficial effect of chewing gum was observed on the gastrointestinal symptoms, e.g. loss of appetite, and flatulence among others. These results indicate that chewing gum may not be directly effective on depressed mood; however, it may reduce the symptoms originating from depression.",23415985,Major Depressive Disorder,Anxiety Treatment,Mental Health,17469,1.1643757820129395,-1.9669831991195679,Ch0E
"Understanding the functionality of depression among Australian breast cancer patients: implications for cognitive and behavioural interventions.

Depression in breast cancer (BCa) patients can reduce quality of life, relationships and treatment compliance, thus constituting a major target for cognitive behavioural (CBT) interventions. Although CBT treatments, which are built upon consideration of the roles of antecedents and consequences for depressive behaviour, are effective, the nature of those antecedents which trigger depression among BCa patients has received relatively little attention. Hypotheses were (1) to determine if BCa patients were experiencing either or both of punishment type I and II and (2) to identify if these aspects of punishment were related to overall depression. Two hundred fifty-three BCa patients completed a standardised depression scale, and data were factor analysed. Components were interpreted for their relationship to punishment type I or II. Two major components emerged: (1) loss of previously available sources of personal or social reinforcement (i.e. punishment type II or negative punishment) and (2) behavioural, emotional and cognitive responses to those losses. These two components represent the total symptomatology of major depressive episode from DSM-IV-TR. These findings support the application of a functional analytic model of depression within CBT assessment and treatment procedures with BCa patients.",20446075,Major Depressive Disorder,Anxiety Treatment,Mental Health,2474,6.24113130569458,-2.568559169769287,DK1B
"A psychoeducational intervention (SWEEP) for depressed women with diabetes.

Clinically significant depression is present in 25 % of individuals with type 2 diabetes, its risk being doubled in women. To examine the effectiveness of the Study of Women's Emotions and Evaluation of a Psychoeducational (SWEEP), a group therapy for depression treatment based on cognitive behavioral therapy principles that was developed for women with type 2 diabetes was conducted. Women with significantly elevated depression symptoms (Center for Epidemiologic Studies Depression Scale ≥16) were randomized to SWEEP (n = 38) or usual care (UC, n = 36). Multilevel modeling indicated that SWEEP was more effective than UC in reducing depression (mean difference of -15 vs. -7, p < .01), decreasing trait anxiety (mean difference of -15 vs. -5, p < .01), and improving anger expression (mean difference of -12 vs. -5, p < .05). Although SWEEP and UC had improvements in fasting glucose (mean difference of -24 vs. -1 mg/dl) and HbA1c (mean difference of -0.4 vs. -0.1 %), there were no statistically significant differences between groups. SWEEP was more effective than UC for treating depressed women with type 2 diabetes. Addition of group therapy for depression meaningfully expands the armamentarium of evidence-based treatment options for women with diabetes.",22777878,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.5575063228607178,-2.3550901412963867,CrES
"Psychological and pharmacological interventions for depression in patients with diabetes mellitus and depression.

Depression occurs frequently in patients with diabetes mellitus and is associated with a poor prognosis. To determine the effects of psychological and pharmacological interventions for depression in patients with diabetes and depression. Electronic databases were searched for records to December 2011. We searched CENTRAL in The Cochrane Library, MEDLINE, EMBASE, PsycINFO, ISRCTN Register and clinicaltrials.gov. We examined reference lists of included RCTs and contacted authors. We included randomised controlled trials (RCTs) investigating psychological and pharmacological interventions for depression in adults with diabetes and depression. Primary outcomes were depression and glycaemic control. Secondary outcomes were adherence to diabetic treatment regimens, diabetes complications, death from any cause, healthcare costs and health-related quality of life (HRQoL). Two review authors independently examined the identified publications for inclusion and extracted data from included studies. Random-effects model meta-analyses were performed to compute overall estimates of treatment outcomes. The database search identified 3963 references. Nineteen trials with 1592 participants were included. Psychological intervention studies (eight trials, 1122 participants, duration of therapy three weeks to 12 months, follow-up after treatment zero to six months) showed beneficial effects on short (i.e. end of treatment), medium (i.e. one to six months after treatment) and long-term (i.e. more than six months after treatment) depression severity (range of standardised mean differences (SMD) -1.47 to -0.14; eight trials). However, between-study heterogeneity was substantial and meta-analyses were not conducted. Short-term depression remission rates (OR 2.88; 95% confidence intervals (CI) 1.58 to 5.25; P = 0.0006; 647 participants; four trials) and medium-term depression remission rates (OR 2.49; 95% CI 1.44 to 4.32; P = 0.001; 296 participants; two trials) were increased in psychological interventions compared to usual care. Evidence regarding glycaemic control in psychological intervention trials was heterogeneous and inconclusive. QoL did not improve significantly based on the results of three psychological intervention trials compared to usual care. Healthcare costs and adherence to diabetes and depression medication were examined in only one study and reliable conclusions cannot be drawn. Diabetes complications and death from any cause have not been investigated in the included psychological intervention trials.With regards to the comparison of pharmacological interventions versus placebo (eight trials; 377 participants; duration of intervention three weeks to six months, no follow-up after treatment) there was a moderate beneficial effect of antidepressant medication on short-term depression severity (all studies: SMD -0.61; 95% CI -0.94 to -0.27; P = 0.0004; 306 participants; seven trials; selective serotonin reuptake inhibitors (SSRI): SMD -0.39; 95% CI -0.64 to -0.13; P = 0.003; 241 participants; five trials). Short-term depression remission was increased in antidepressant trials (OR 2.50; 95% CI 1.21 to 5.15; P = 0.01; 136 participants; three trials). Glycaemic control improved in the short term (mean difference (MD) for glycosylated haemoglobin A1c (HbA1c) -0.4%; 95% CI -0.6 to -0.1; P = 0.002; 238 participants; five trials). HRQoL and adherence were investigated in only one trial each showing no statistically significant differences. Medium- and long-term depression and glycaemic control outcomes as well as healthcare costs, diabetes complications and mortality have not been examined in pharmacological intervention trials. The comparison of pharmacological interventions versus other pharmacological interventions (three trials, 93 participants, duration of intervention 12 weeks, no follow-up after treatment) did not result in significant differences between the examined pharmacological agents, except for a significantly ameliorated glycaemic control in fluoxetine-treated patients (MD for HbA1c -1.0%; 95% CI -1.9 to -0.2; 40 participants) compared to citalopram in one trial. Psychological and pharmacological interventions have a moderate and clinically significant effect on depression outcomes in diabetes patients. Glycaemic control improved moderately in pharmacological trials, while the evidence is inconclusive for psychological interventions. Adherence to diabetic treatment regimens, diabetes complications, death from any cause, health economics and QoL have not been investigated sufficiently. Overall, the evidence is sparse and inconclusive due to several low-quality trials with substantial risk of bias and the heterogeneity of examined populations and interventions.",23235661,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.229104995727539,-2.370824098587036,CkiC
"Treatment of depressed mothers in home visiting: impact on psychological distress and social functioning.

Depression is prevalent in mothers receiving home visiting. Little is known about the impact of treatment on associated features of maternal depression in this population. The purpose of this study was to examine the impact of a novel, adapted treatment for depressed mothers in home visiting on psychological distress and social functioning. In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat depressed mothers in home visiting. A randomized clinical trial design was used in which subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3 months postpartum were randomized into IH-CBT and ongoing home visiting (n = 47) or standard home visiting (SHV; n = 46) in which they received home visitation alone and could obtain treatment in the community. Measures of psychological distress, social support, and social network were measured at pre-treatment, post-treatment, and three-month follow-up. Clinical features of depression and home visiting parameters were examined as potential moderators. Subjects receiving IH-CBT reported decreased psychological distress at post-treatment (ES = 0.77) and follow-up (ES = 0.73). Examination of types of psychological distress indicated broad improvements at both time points. Those receiving IH-CBT reported increased social support over time relative to those in the SHV condition. Effect sizes were modest at post-treatment (ES = 0.38) but increased at follow-up (ES = 0.65). Improvements were seen in affiliative and belonginess aspects of social support, in contrast to tangible support which was statistically non-significant. Findings were not moderated by clinical features of depression or home visiting parameters. No group differences were found in size of and involvement with social networks. IH-CBT is effective in reducing psychological distress and improving perceived social support in depressed mothers receiving home visiting. To the extent that mothers are better adjusted and feel socially supported, they are more available to their children and more amenable to home visiting services. IH-CBT is a feasible, readily adopted treatment that is compatible with multiple home visiting models. As a result it is a promising approach to help depressed mothers in home visiting. Additional interventions may be needed to support depressed mothers in building sizable and stable social networks.",23623623,Major Depressive Disorder,Anxiety Treatment,Mental Health,8308,4.166754722595215,-5.546135902404785,Cexq
"Cancer patients with major depressive disorder: testing a biobehavioral/cognitive behavior intervention.

In this Phase II trial, we evaluated a novel psychological treatment for depressed patients coping with the stresses of cancer. Effectiveness of a combined biobehavioral intervention (BBI) and cognitive behavior therapy (CBT) was studied. Participants were 36 cancer survivors (mean age = 49 years; 88% Caucasian; 92% female) diagnosed with major depressive disorder. A single group pre-post design was used. Treatment consisted of up to 20 individual 75-min combined BBI/CBT sessions. Outcomes were change in interviewer (Hamilton Rating Scale for Depression; Williams, 1988) and self-rated depressive symptoms (Beck Depression Inventory-Second Edition; Beck, Steer, & Brown, 1996) as well as change in cancer relevant symptoms (Fatigue Symptom Inventory [Hann et al., 1998] and Brief Pain Questionnaire [Daut, Cleeland, & Flanery, 1983]) and quality of life (Medical Outcomes Study Short Form-36; Ware et al., 1995). Mixed-effects modeling, a reliability change index, and generalized linear models were used. All analyses were intent-to-treat. Depressive symptoms significantly improved. In addition, 19 of 21 study completers met criteria for remission. Significant improvements were also noted in fatigue and mental health quality of life. Both concurrent anxiety disorders and high levels of cancer stress (Impact of Events Scale; Horowitz, Wilner, & Alvarez, 1979) were each associated with beginning and concluding treatment with greater depressive symptoms. CBT components were successfully incorporated into a previously efficacious intervention for reducing cancer stress. The BBI/CBT intervention warrants further research in evaluating its efficacy compared with well-established treatments for depression.",21341891,Major Depressive Disorder,Anxiety Treatment,Mental Health,8627,6.2561116218566895,-2.7194204330444336,C/ni
"A randomised, controlled trial of a dietary intervention for adults with major depression (the ""SMILES"" trial): study protocol.

Despite increased investment in its recognition and treatment, depression remains a substantial health and economic burden worldwide. Current treatment strategies generally focus on biological and psychological pathways, largely neglecting the role of lifestyle. There is emerging evidence to suggest that diet and nutrition play an important role in the risk, and the genesis, of depression. However, there are limited data regarding the therapeutic impact of dietary changes on existing mental illness. Using a randomised controlled trial design, we aim to investigate the efficacy and cost-efficacy of a dietary program for the treatment of Major Depressive Episodes (MDE). One hundred and seventy six eligible participants suffering from current MDE are being randomised into a dietary intervention group or a social support group. Depression status is assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Non Patient Edition) (SCID-I/NP). The intervention consists of 7 individual nutrition consulting sessions (of approximately 60 minutes), delivered by an Accredited Practising Dietitian (APD). Sessions commence within one week of baseline assessment. The intervention focuses on advocating a healthy diet based on the Australian Dietary Guidelines and the Dietary Guidelines for Adults in Greece. The control condition comprises a befriending protocol using the same visit schedule and length as the diet intervention. The study is being conducted at two locations in Victoria, Australia (a metropolitan and regional centre). Data collection occurs at baseline (pre-intervention), 3-months (post-intervention) and 6- months. The primary endpoint is MADRS scores at 3 months. A cost consequences analysis will determine the economic value of the intervention. If efficacious, this program could provide an alternative or adjunct treatment strategy for the management of this highly prevalent mental disorder; the benefits of which could extend to the management of common co-morbidities including cardiovascular disease (CVD), obesity, and type 2 diabetes. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000251820.",23587364,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,0.3623877763748169,-1.5311836004257202,CfSA
"Comment on Tovote et al. Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes care 2014;37:2427-2434.

",25715430,Major Depressive Disorder,Anxiety Treatment,Mental Health,670,3.756693124771118,-2.4042911529541016,CBaA
"Nutrition-focused group intervention with a strength-based counseling approach for people with clinical depression: a study protocol for the Food for Mind randomized controlled trial.

Depression is a highly prevalent mental disorder with major public health effects globally. It impairs the quality of life and reduces the ability to work and function, leading to increasing costs of sick leaves and disability pensions. Current treatment strategies focus on biological and psychological pathways while understating the role of lifestyle factors. Epidemiological studies have shown convincing evidence of an inverse relationship between diet quality and depression. However, only limited data are available on the therapeutic effects of diet quality improvement on depression. Using a randomized controlled trial design, our primary aim is to investigate the effectiveness and cost-effectiveness of a behavioral nutrition group intervention compared to a social support intervention in the treatment of depression. Participants (N=144, aged 20-65 years) with a diagnosis of moderate or severe depression recruited in collaboration with outpatient care units will be randomized into two arms: Food for Mind (FM) nutrition intervention (n=72) or Bring Good Mood (BGM) social support control group (n=72). Both arms will be provided with 6 group sessions over an 8-week period. FM involves improving diet quality by applying strength-based behavioral nutrition counseling and activities facilitated by a registered dietitian. The control arm comprises a befriending protocol. During the interventions, all participants will continue their treatment for depression as usual. Longitudinal data are collected at baseline, at 8 weeks, and at 6- and 12-month follow-ups. Depressive symptoms, diet quality, eating behavior, ability to work and function, and quality of life are assessed by self-reported questionnaires. A treatment expectancy questionnaire will be administered at baseline and an acceptability questionnaire at 8 weeks. The Center for Epidemiologic Studies Depression Scale is used as the primary endpoint at 1 year. The results will be analyzed with linear mixed-effects models. Economic evaluation includes both cost-effectiveness and cost-utility analysis. Two incremental cost-effectiveness ratios will be calculated to evaluate the incremental cost per QALY and the incremental cost per improvement in CES-D. If the intervention proves to be cost-effective and acceptable, it be can be implemented in healthcare to support the treatment of depression. ClinicalTrials.gov NCT03904771 . Retrospectively registered on 5 April 2019.",34001230,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,0.3537900149822235,-1.7968289852142334,AWMI
"Web-based depression treatment for type 1 and type 2 diabetic patients: a randomized, controlled trial.

Comorbid depression is common in patients with type 1 and type 2 diabetes, adversely affecting quality of life, diabetes outcomes, and mortality. Depression can be effectively treated with cognitive behavior therapy (CBT). The Internet is a new and attractive method for delivering CBT intervention on a large scale at relatively low costs. This study evaluated the effectiveness of Web-based CBT for depression treatment in adults with type 1 or type 2 diabetes, with minimal guidance. A randomized controlled trial was conducted in the Netherlands in 255 adult diabetic patients with elevated depressive symptoms. Primary outcomes were depressive symptoms. Secondary outcomes were diabetes-specific emotional distress and glycemic control. Assessments were at baseline, after treatment, and at the 1-month follow-up. The Web-based CBT was effective in reducing depressive symptoms by intention-to-treat analyses (P = 0.04, d = 0.29; clinical improvement 41% vs. 24% P < 0.001) and by per-protocol analyses (P < 0.001, d = 0.70; clinical improvement, 56% vs. 24% P < 0.001). The intervention reduced diabetes-specific emotional distress (P = 0.03) but had no beneficial effect on glycemic control (P > 0.05). Web-based CBT depression treatment is effective in reducing depressive symptoms in adults with type 1 and type 2 diabetes. In addition, the intervention reduces diabetes-specific emotional distress in depressed patients.",21216855,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.453707456588745,-2.5354721546173096,DBaf
"A randomized trial of interpersonal psychotherapy, problem solving therapy, and supportive therapy for major depressive disorder in women with breast cancer.

Breast cancer (BC) is a risk factor for major depressive disorder (MDD), yet little research has tested the efficacy of different psychotherapies for depressed women with BC. This study, the largest to date, compared outcomes of three evidence-based, 12-week therapies in treating major depressive disorder among women with breast cancer. This randomized trial compared interpersonal psychotherapy (IPT), problem solving therapy (PST), and brief supportive psychotherapy (BSP). Conducted at the outpatient clinic of the New York State Psychiatric Institute/Columbia University, the trial offered bilingual treatment by treatment-specific psychotherapists supervised by treatment experts. The primary outcome was change in the Hamilton Depression Rating Scale (HAM-D) at 12 weeks. Secondary outcomes included other validated patient-reported outcomes for depression and quality of life. Of 179 women with breast cancer screening positive for depression at the Columbia Cancer Center, 134 eligible patients signed informed treatment consent. Half of patients were Hispanic and economically disadvantaged. Most women had stage I (35.2%) or II (36.9%) BC; 9% had stage IV. The three brief psychotherapies showed similar improvements on the HAM-D, with large pre-post effect sizes (d~1.0); a priori defined response rates were 35% for IPT, 50% for PST and 31% for BSP, and remission rates 25%, 30% and 27%, respectively. The three treatments also showed similar improvements in the Quality of Life Enjoyment and Satisfaction Questionnaire. Dropout was high, ranging from 37 to 52% across treatments. Predictors of dropout included having<16 years of education and annual family income <$20,000. Among patients who completed treatment, all three psychotherapies were associated with similar, meaningful improvements in depression. Physical distance between the oncology and psychiatric treatment sites might have contributed to high dropout. This study suggests various psychotherapy approaches may benefit patients with breast cancer and major depression.",30343455,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,5.721256256103516,-2.875659704208374,BEds
"Is cognitive behavioral therapy a better choice for women with postnatal depression? A systematic review and meta-analysis.

The present study evaluated the combined effectiveness of cognitive behavioral therapy (CBT) for postnatal depression. A systematic search was conducted across databases including PubMed, Embase, and the Cochrane library to identify the randomized controlled trials (RCTs) that assessing CBT versus control for postnatal depression until March 2017. Data was extracted by two reviewers, independently. The Review Manager 5.3 and Stata 11.0 were used to calculate the synthesized effect of CBT on depression, and anxiety. A total of 20 RCTs involving 3623 participants were included. The results of meta-analysis showed that CBT was associated with a better Edinburgh Postnatal Depression Scale (EPDS) than control in short-term (mean difference = -2.86, 95% CI: -4.41--1.31; P<0.05) and long-term (mean difference = -1.68, 95% CI: -1.81-1.56; P<0.05). CBT also improved short-term (mean difference = -6.30, 95% CI: -11.32--1.28; P<0.05) and long-term (mean difference = -4.31, 95% CI: -6.92--1.70; P<0.05) Beck Depression Inventory (BDI). Subgroup analysis based on intervention types showed that in-home and telephone-based therapy exhibited significant reductions in EPDS scores (P<0.05 for all). CBT significantly improved the short-term [odds ratio (OR) = 6.57, 95% CI: 1.84-23.48; P<0.05] and long-term (OR = 2.00, 95% CI: 1.61-2.48; P<0.05) depressive symptomatology as compared to control. CBT also reduced the score of Depression Anxiety Stress Scales (DASS), though without significance. In conclusion, CBT effectively improved the symptoms and progression of postnatal depression.",30321198,Major Depressive Disorder,Anxiety Treatment,Mental Health,118,3.700082302093506,-5.490866661071777,BEwU
"Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial.

Depression is a common comorbidity of diabetes, undesirably affecting patients' physical and mental functioning. Psychological interventions are effective treatments for depression in the general population as well as in patients with a chronic disease. The aim of this study was to assess the efficacy of individual mindfulness-based cognitive therapy (MBCT) and individual cognitive behavior therapy (CBT) in comparison with a waiting-list control condition for treating depressive symptoms in adults with type 1 or type 2 diabetes. In this randomized controlled trial, 94 outpatients with diabetes and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ≥14) were randomized to MBCT (n = 31), CBT (n = 32), or waiting list (n = 31). All participants completed written questionnaires and interviews at pre- and postmeasurement (3 months later). Primary outcome measure was severity of depressive symptoms (BDI-II and Toronto Hamilton Depression Rating Scale). Anxiety (Generalized Anxiety Disorder 7), well-being (Well-Being Index), diabetes-related distress (Problem Areas In Diabetes), and HbA1c levels were assessed as secondary outcomes. Results showed that participants receiving MBCT and CBT reported significantly greater reductions in depressive symptoms compared with patients in the waiting-list control condition (respectively, P = 0.004 and P < 0.001; d = 0.80 and 1.00; clinically relevant improvement 26% and 29% vs. 4%). Both interventions also had significant positive effects on anxiety, well-being, and diabetes-related distress. No significant effect was found on HbA1c values. Both individual MBCT and CBT are effective in improving a range of psychological symptoms in individuals with type 1 and type 2 diabetes.",24898301,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,3.3450732231140137,-2.3096392154693604,CNDd
"Is group cognitive behaviour therapy for postnatal depression evidence-based practice? A systematic review.

There is evidence that psychological therapies including cognitive behaviour therapy (CBT) may be effective in reducing postnatal depression (PND) when offered to individuals. In clinical practice, this is also implemented in a group therapy format, which, although not recommended in guidelines, is seen as a cost-effective alternative. To consider the extent to which group methods can be seen as evidence-based, we systematically review and synthesise the evidence for the efficacy of group CBT compared to currently used packages of care for women with PND, and we discuss further factors which may contribute to clinician confidence in implementing an intervention. Seventeen electronic databases were searched. All full papers were read by two reviewers and a third reviewer was consulted in the event of a disagreement on inclusion. Selected studies were quality assessed, using the Cochrane Risk of Bias Tool, were data extracted by two reviewers using a standardised data extraction form and statistically synthesised where appropriate using the fixed-effect inverse-variance method. Seven studies met the inclusion criteria. Meta-analyses showed group CBT to be effective in reducing depression compared to routine primary care, usual care or waiting list groups. A pooled effect size of d = 0.57 (95% CI 0.34 to 0.80, p < 0.001) was observed at 10-13 weeks post-randomisation, reducing to d = 0.28 (95% CI 0.03 to 0.53, p = 0.025) at 6 months. The non-randomised comparisons against waiting list controls at 10-13 weeks was associated with a larger effect size of d = 0.94 (95% CI 0.42 to 1.47, p < 0.001). However due to the limitations of the available data, such as ill-specified definitions of the CBT component of the group programmes, these results should be interpreted with caution. Although the evidence available is limited, group CBT was shown to be effective. We argue, therefore, that there is sufficient evidence to implement group CBT, conditional upon routinely collected outcomes being benchmarked against those obtained in trials of individual CBT, and with other important factors such as patient preference, clinical experience, and information from the local context taken into account when making the treatment decision.",24283266,Major Depressive Disorder,Anxiety Treatment,Mental Health,118,3.9148311614990234,-5.547522068023682,CVe8
"Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: randomized trial.

Major depression is the most common psychiatric disorder among breast cancer patients and is associated with substantial impairment. Although some research has explored the utility of psychotherapy with breast cancer patients, only 2 small trials have investigated the potential benefits of behavior therapy among patients with well-diagnosed depression. In a primarily Caucasian, well-educated sample of women (age = 55.4 years, SD = 11.9) diagnosed with breast cancer and major depression (n = 80), this study was a randomized clinical trial testing the efficacy of 8 sessions of behavioral activation treatment for depression (BATD) compared to problem-solving therapy. Primary outcome measures assessed depression, environmental reward, anxiety, quality of life, social support, and medical outcomes. Across both treatments, results revealed strong treatment integrity, excellent patient satisfaction with treatment protocols, and low patient attrition (19%). Intent-to-treat analyses suggested both treatments were efficacious, with both evidencing significant pre-post treatment gains across all outcome measures. Across both treatments, gains were associated with strong effect sizes, and based on response and remission criteria, a reliable change index, and numbers-needed-to-treat analyses, approximately ¾ of patients exhibited clinically significant improvement. No significant group differences were found at posttreatment. Treatment gains were maintained at 12-month follow-up, with some support for stronger maintenance of gains in the BATD group. BATD and problem-solving interventions represent practical interventions that may improve psychological outcomes and quality of life among depressed breast cancer patients. Study limitations and future research directions are discussed.",21988544,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,6.194228172302246,-2.779690742492676,C2ZN
"Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial.

Major depressive disorder (MDD) is a substantial public health burden, but current treatments have limited effectiveness and adherence. Recent evidence suggests that 1 or 2 administrations of psilocybin with psychological support produces antidepressant effects in patients with cancer and in those with treatment-resistant depression. To investigate the effect of psilocybin therapy in patients with MDD. This randomized, waiting list-controlled clinical trial was conducted at the Center for Psychedelic and Consciousness Research at Johns Hopkins Bayview Medical Center in Baltimore, Maryland. Adults aged 21 to 75 years with an MDD diagnosis, not currently using antidepressant medications, and without histories of psychotic disorder, serious suicide attempt, or hospitalization were eligible to participate. Enrollment occurred between August 2017 and April 2019, and the 4-week primary outcome assessments were completed in July 2019. A total of 27 participants were randomized to an immediate treatment condition group (n = 15) or delayed treatment condition group (waiting list control condition; n = 12). Data analysis was conducted from July 1, 2019, to July 31, 2020, and included participants who completed the intervention (evaluable population). Two psilocybin sessions (session 1: 20 mg/70 kg; session 2: 30 mg/70 kg) were given (administered in opaque gelatin capsules with approximately 100 mL of water) in the context of supportive psychotherapy (approximately 11 hours). Participants were randomized to begin treatment immediately or after an 8-week delay. The primary outcome, depression severity was assessed with the GRID-Hamilton Depression Rating Scale (GRID-HAMD) scores at baseline (score of ≥17 required for enrollment) and weeks 5 and 8 after enrollment for the delayed treatment group, which corresponded to weeks 1 and 4 after the intervention for the immediate treatment group. Secondary outcomes included the Quick Inventory of Depressive Symptomatology-Self Rated (QIDS-SR). Of the randomized participants, 24 of 27 (89%) completed the intervention and the week 1 and week 4 postsession assessments. This population had a mean (SD) age of 39.8 (12.2) years, was composed of 16 women (67%), and had a mean (SD) baseline GRID-HAMD score of 22.8 (3.9). The mean (SD) GRID-HAMD scores at weeks 1 and 4 (8.0 [7.1] and 8.5 [5.7]) in the immediate treatment group were statistically significantly lower than the scores at the comparable time points of weeks 5 and 8 (23.8 [5.4] and 23.5 [6.0]) in the delayed treatment group. The effect sizes were large at week 5 (Cohen d=2.5; 95% CI, 1.4-3.5; P<.001) and week 8 (Cohen d=2.6; 95% CI, 1.5-3.7; P<.001). The QIDS-SR documented a rapid decrease in mean (SD) depression score from baseline to day 1 after session 1 (16.7 [3.5] vs 6.3 [4.4]; Cohen d=2.6; 95% CI, 1.8-3.5; P<.001), which remained statistically significantly reduced through the week 4 follow-up (6.0 [5.7]; Cohen d=2.3; 95% CI, 1.5-3.0; P<.001). In the overall sample, 17 participants (71%) at week 1 and 17 (71%) at week 4 had a clinically significant response to the intervention (≥50% reduction in GRID-HAMD score), and 14 participants (58%) at week 1 and 13 participants (54%) at week 4 were in remission (≤7 GRID-HAMD score). Findings suggest that psilocybin with therapy is efficacious in treating MDD, thus extending the results of previous studies of this intervention in patients with cancer and depression and of a nonrandomized study in patients with treatment-resistant depression. ClinicalTrials.gov Identifier: NCT03181529.",33146667,Major Depressive Disorder,Anxiety Treatment,Mental Health,10742,-0.9493383169174194,-8.060894012451172,Af+e
"Treatment response in type 2 diabetes patients with major depression.

Major depression is more prevalent in patients with type 2 diabetes mellitus (T2DM) than in general population. Comparing psychotherapeutic and pharmacological treatment responses could help to inform the choice between available treatment options. Thirty-four patients with T2DM and major depression detected by using the Hospital Anxiety-Depression Scale (HADS), the Montgomery-Äsberg Depression Rating Scale (MADRS) and a structured interview (Mini-International Neuropsychiatric Interview) were randomized to undergo Interpersonal Psychotherapy (IPT) or treatment with sertraline in a 3-month acute intervention course in addition to a 3-month continuation format. Provided that the initial MADRS score was not reduced ≥25% at week 6, these early non-responding patients continued treatment in a sequential add-on combined format. Psychological adjustment to diabetes, attachment style, diabetes self-efficacy, quality of life and HbA1c were also evaluated along intervention. Out of 22 early-responding patients (11 for each treatment type), 16 had clinically significant improvements (<50% initial MADRS score) at endpoint with 11 reaching remission (MADRS scores ≤8), and with no significant differences between IPT and sertraline. Within sequential add-on treatment, out of eight patients, only three of them achieved a clinically significant improvement and only one reached remission. These preliminary results suggested that IPT may be an option to treat major depression in T2DM against medical care with sertraline. Early non-responding patients likely need alternative or longer treatment interventions. Limitations of this study relate to small sample and absence of a control group, which was difficult to implement due to ethical restrictions. Findings suggest that Interpersonal Psychotherapy is a useful tool to treat major depression in type 2 diabetes patients. A significant number of type 2 diabetes patients with major depression do not achieve depression remission irrespective of the type of treatment. Further clinical research should focus on addictive effects of psychotherapy and psychopharmacology in the treatment of depressed patients with chronic somatic diseases.",22962030,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.3153903484344482,-1.6458244323730469,CodY
"Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial.

Antidepressant medication (ADM) is efficacious in the treatment of depression, but not all patients achieve remission and fewer still achieve recovery with ADM alone. To determine the effects of combining cognitive therapy (CT) with ADM vs ADM alone on remission and recovery in major depressive disorder (MDD). A total of 452 adult outpatients with chronic or recurrent MDD participated in a trial conducted in research clinics at 3 university medical centers in the United States. The patients were randomly assigned to ADM treatment alone or CT combined with ADM treatment. Treatment was continued for up to 42 months until recovery was achieved. Antidepressant medication with or without CT. Blind evaluations of recovery with a modified version of the 17-item Hamilton Rating Scale for Depression and the Longitudinal Interval Follow-up Evaluation. Combined treatment enhanced the rate of recovery vs treatment with ADM alone (72.6% vs 62.5%; t451=2.45; P=.01; hazard ratio [HR], 1.33; 95% CI, 1.06-1.68; number needed to treat [NNT], 10; 95% CI, 5-72). This effect was conditioned on interactions with severity (t451=1.97; P=.05; NNT,5) and chronicity (χ2=7.46; P=.02; NNT,6) such that the advantage for combined treatment was limited to patients with severe, nonchronic MDD (81.3% vs 51.7%; n=146; t145 = 3.96; P=.001; HR, 2.34; 95% CI, 1.54-3.57; NNT, 3; 95% CI, 2-5). Fewer patients dropped out of combined treatment vs ADM treatment alone (18.9% vs 26.8%; t451=-2.04; P=.04; HR, 0.66; 95% CI, 0.45-0.98). Remission rates did not differ significantly either as a main effect of treatment or as an interaction with severity or chronicity. Patients with comorbid Axis II disorders took longer to recover than did patients without comorbid Axis II disorders regardless of the condition (P=.01). Patients who received combined treatment reported fewer serious adverse events than did patients who received ADMs alone (49 vs 71; P=.02), largely because they experienced less time in an MDD episode. Cognitive therapy combined with ADM treatment enhances the rates of recovery from MDD relative to ADMs alone, with the effect limited to patients with severe, nonchronic depression. clinicaltrials.gov Identifier: NCT00057577.",25142196,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.509232521057129,-1.6778241395950317,CJiS
"Baseline Depression Severity as Moderator of Depression Outcomes Between Cognitive Behavioral Therapy vs Pharmacotherapy: An Individual Patient Data Meta-analysis.

Current guidelines recommend treating severe depression with pharmacotherapy. Randomized clinical trials as well as traditional meta-analyses have considerable limitations in testing for moderators of treatment outcomes. To conduct a systematic literature search, collect primary data from trials, and analyze baseline depression severity as a moderator of treatment outcomes between cognitive behavioral therapy (CBT) and antidepressant medication (ADM). A total of 14 902 abstracts were examined from a comprehensive literature search in PubMed, PsycINFO, EMBASE, and Cochrane Registry of Controlled Trials from 1966 to January 1, 2014. Randomized clinical trials in which CBT and ADM were compared in patients with a DSM-defined depressive disorder were included. Study authors were asked to provide primary data from their trial. Primary data from 16 of 24 identified trials (67%), with 1700 outpatients (794 from the CBT condition and 906 from the ADM condition), were included. Missing data were imputed with multiple imputation methods. Mixed-effects models adjusting for study-level differences were used to examine baseline depression severity as a moderator of treatment outcomes. Seventeen-item Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI). There was a main effect of ADM over CBT on the HAM-D (β=-0.88; P=.03) and a nonsignificant trend on the BDI (β=-1.14; P=.08, statistical test for trend), but no significant differences in response (odds ratio [OR], 1.24; P=.12) or remission (OR, 1.18; P=.22). Mixed-effects models using the HAM-D indicated that baseline depression severity does not moderate reductions in depressive symptoms between CBT and ADM at outcome (β=0.00; P=.96). Similar results were seen using the BDI. Baseline depression severity also did not moderate the likelihood of response (OR, 0.99; P=.77) or remission (OR, 1.00; P=.93) between CBT and ADM. Baseline depression severity did not moderate differences between CBT and ADM on the HAM-D or BDI or in response or remission. This finding cannot be extrapolated to other psychotherapies, to individual ADMs, or to inpatients. However, it offers new and substantial evidence that is of relevance to researchers, physicians and therapists, and patients.",26397232,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.080202102661133,-2.3283209800720215,B3tJ
"A Novel Approach to Depression Care: Efficacy of an Adapted Interpersonal Therapy in a Large, Urban Primary Care Setting.

The Collaborative Care Model (CoCM), in which social workers, primary care physicians, and a consulting psychiatrist work as a team, is an established approach to the treatment of common mental health conditions in primary care settings. Following implementation of a CoCM depression care program at our hospital-based academic primary care practice, we observed a low rate of retention with the use of problem solving therapy/behavioral activation (PST/BA). Our aim in this study was to evaluate the effectiveness of interpersonal psychotherapy (IPT), an evidence-based, flexible strategy that focuses on the relationship between depression and interpersonal challenges, compared to PST/BA. In 2015, most patients enrolled in our CoCM received PST/BA. In 2016, most patients received IPT. Patients who were enrolled and discharged from our CoCM depression care program in the years 2015 and 2016 and received either PST/BA or IPT, were included. Our primary measure was the difference in change in PHQ-9 score between the PST/BA and the IPT groups. Secondary outcomes included the difference in the change in GAD-7 score and measures of glycemic and blood pressure control between the two groups. Two hundred thirty four patients were included in our analysis. One hundred sixty five received PST/BA and 69 received IPT. There was no difference between groups in baseline demographics or measures of depression, anxiety, presence of hypertension, or presence of prediabetes/diabetes. Our primary analysis demonstrated a greater decrease in PHQ-9 score in patients receiving IPT (9.93) compared to those receiving PST/BA (5.41) (p <0.0001). The proportion of patients achieving a clinical response (PHQ-9<10) was also greater in the IPT group (71%) compared to the PST/BA group (44%). In a CoCM depression care program, IPT was a more effective strategy in improving depression symptoms as measured by PHQ-9 scores than PST/BA.",32449131,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,8.52935791015625,-6.37148904800415,Aoj8
"Self-help interventions for symptoms of depression, anxiety and psychological distress in patients with physical illnesses: a systematic review and meta-analysis.

Psychological distress, depression and anxiety are common in most physical diseases, and self-help interventions, if effective, might be an important approach to improve outcomes as they are inexpensive to provide to large numbers of patients. The primary aim of this review was to assess randomised controlled trials examining the impact of self-help interventions on symptoms of depression, anxiety and psychological distress in patients with physical illness. Systematic searches of electronic databases resulted in twenty-five eligible studies for meta-analysis (n=4211). The results of the primary meta-analyses revealed a significant improvement in depression symptoms, in favour of the intervention group (SMD=-0.13, 95% CI: -0.25, -0.02, p=0.02, I(2)=50%). There were no significant differences in symptoms of anxiety (SMD=-0.10, 95% CI: -0.24, 0.05, p=0.20, I(2)=63%) or psychological distress (SMD=-0.14, 95% CI: -0.40, 0.12, p=0.30, I(2)=72%) between intervention and control conditions. Several subgroup and sensitivity analyses improved effect sizes, suggesting that optimal mental health outcomes may be obtained in patients without neurological conditions, and with interventions based on a therapeutic model (such as cognitive behavioural therapy), and with stress management components. This review demonstrates that with appropriate design and implementation, self-help interventions may potentially improve symptoms of depression in patients with physical conditions.",24508685,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.06984806060791,-3.3243589401245117,CSY0
"Letter to the Editor: Mechanisms of change in an internet-based therapy for depression - a comment on Van der Zanden et al.

",25229946,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.255602836608887,-3.7567670345306396,CIQ8
"Prognosis moderates the engagement-outcome relationship in unguided cCBT for depression: A proof of concept for the prognosis moderation hypothesis.

Understanding how treatments work is a goal of psychotherapy research, however the strength of relationships between therapy processes and outcomes is inconsistent. DeRubeis, Cohen, et al. (2014) proposed that process-outcome relationships are moderated by patient characteristics. These ""patient response patterns"" (PRPs) indicate individuals' responsiveness to the active ingredients of treatment. Given the same quality of therapy, one individual may receive more benefit than another depending on their PRP. The ""prognosis moderation hypothesis"" states that PRPs can be defined by pretreatment prognostic indicators. Medium prognosis groups (""pliant-like"") will have stronger process-outcome relationships than good (""easy-like"") or poor (""challenging-like"") groups. N = 190 individuals received unguided computerized CBT. They were 58% women, aged 44.7 years. Engagement with the cCBT program was the process variable. PRPs were defined by predicted scores from a prognostic regression model. Outcomes were BDI scores at 3, 6, and 12 months. ""Easy-like,"" ""pliant-like"" and ""challenging-like"" groups were created and the engagement-outcome relationship was assessed as a function of group. Engagement-outcome correlations by PRP were: easy-like, r = -.27 (p < .05); pliant-like, r = -.36 (p < .01); and challenging-like, r = .05 (p = .70). The pliant-like group was found to be the only moderator of the engagement-outcome relationship. Results were similar at 6 months but faded at 12. The engagement-outcome relationship varied as a function of prognosis, providing support for the prognosis moderation hypothesis. The ""pliant-like"" group appeared most sensitive to treatment procedures. Future research is needed to refine the methods for identifying PRPs. (PsycINFO Database Record",28150952,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.250953674316406,-2.4106011390686035,BhWz
"Behavioural activation therapy for depression in adults with non-communicable diseases.

Depression is common in people with non-communicable diseases (NCDs) such as cardiovascular disease, diabetes, cancer, and chronic respiratory conditions. The co-existence of depression and NCDs may affect health behaviours, compliance with treatment, physiological factors, and quality of life. This in turn is associated with worse outcomes for both conditions. Behavioural activation is not currently indicated for the treatment of depression in this population in the UK, but is increasingly being used to treat depression in adults. To examine the effects of behavioural activation compared with any control group for the treatment of depression in adults with NCDs. To examine the effects of behavioural activation compared with each control group separately (no treatment, waiting list, other psychological therapy, pharmacological treatment, or any other type of treatment as usual) for the treatment of depression in adults with NCDs. We searched CCMD-CTR, CENTRAL, Ovid MEDLINE, Embase, four other databases, and two trial registers on 4 October 2019 to identify randomised controlled trials (RCTs) of behavioural activation for depression in participants with NCDs, together with grey literature and reference checking. We applied no restrictions on date, language, or publication status to the searches. We included RCTs of behavioural activation for the treatment of depression in adults with one of four NCDs: cardiovascular disease, diabetes, cancer, and chronic respiratory conditions. Only participants with a formal diagnosis of both depression and an NCD were eligible. Studies were included if behavioural activation was the main component of the intervention. We included studies with any comparator that was not behavioural activation, and regardless of reported outcomes. We used standard methodological procedures expected by Cochrane, including independent screening of titles/abstracts and full-text manuscripts, data extraction, and risk of bias assessments in duplicate. Where necessary, we contacted study authors for more information. We included two studies, contributing data from 181 participants to the analyses. Both studies recruited participants from US hospital clinics; one included people who were recovering from a stroke and the other women with breast cancer. For both studies, the intervention consisted of eight weeks of face-to-face behavioural therapy, with one study comparing to poststroke treatment as usual and the other comparing to problem-solving therapy. Both studies were at risk of performance bias and potential conflict of interest arising from author involvement in the development of the intervention. For one study, risks of selection bias and reporting bias were unclear and the study was judged at high risk of attrition bias. Treatment efficacy (remission) was greater for behavioural activation than for comparators in the short term (risk ratio (RR) 1.53, 95% confidence interval (CI) 0.98 to 2.38; low-certainty evidence) and medium term (RR 1.76, 95% CI 1.01 to 3.08; moderate-certainty evidence), but these estimates lacked precision and effects were reduced in the long term (RR 1.42, 95% CI 0.91 to 2.23; moderate-certainty evidence). We found no evidence of a difference in treatment acceptability in the short term (RR 1.81, 95% CI 0.68 to 4.82) and medium term (RR 0.88, 95% CI 0.25 to 3.10) (low-certainty evidence). There was no evidence of a difference in depression symptoms between behavioural activation and comparators (short term: MD -1.15, 95% CI -2.71 to 0.41; low-certainty evidence). One study found no difference for quality of life (short term: MD 0.40, 95% CI -0.16 to 0.96; low-certainty evidence), functioning (short term: MD 2.70, 95% CI -6.99 to 12.39; low-certainty evidence), and anxiety symptoms (short term: MD -1.70, 95% CI -4.50 to 1.10; low-certainty evidence). Neither study reported data on adverse effects. Evidence from this review was not sufficient to draw conclusions on the efficacy and acceptability of behavioural activation for the treatment of depression in adults with NCDs. A future review may wish to include, or focus on, studies of people with subthreshold depression or depression symptoms without a formal diagnosis, as this may inform whether behavioural activation could be used to treat mild or undiagnosed (or both) depressive symptoms in people with NCDs. Evidence from low-resource settings including low- and middle-income countries, for which behavioural activation may offer a feasible alternative to other treatments for depression, would be of interest.",32841367,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.261309623718262,-2.0800087451934814,Ajrk
"Assessing the efficacy of a culturally adapted cognitive behavioural internet-delivered treatment for depression: protocol for a randomised controlled trial.

Depression is the principal cause of disability in the world. High prevalence rates of depression in general populations and college students have been found worldwide and in various cultural groups. Low-intensity cognitive behavioural internet-delivered treatment has demonstrated efficacy in high-income-countries (HICs). However little is known of their potential for adaptation and efficacy in low and middle-income countries. Study (1) involves the cultural adaptation of the Space from Depression cognitive-behaviour internet-delivered programme with an asynchronous support for depressive symptoms. This includes initial researcher/clinician adaptation and the integration of cultural assessment feedback of the programme by a panel of experts and users through the theoretically-based Cultural Relevance Questionnaire (CRQ). Study (2) describes the implementation of the culturally adapted intervention using a randomised controlled trial methodology. The efficacy trial will include an active treatment group and a waiting-list control group of participants meeting eligibility criteria (mild to moderate depression symptoms). The active condition will consist of 7 weekly modules of internet-delivered cognitive behavioural therapy (iCBT) Space from Depression, with post-session feedback support. The primary outcome will be the Patient Health Questionnaire (PHQ-9). The study also involves collection of client reported significant events and client satisfaction with the internet-delivered treatment. Data will be collected at baseline and at post-treatment (week 7), and at follow-up (week 20/3 months). Analysis will be conducted on the intention-to-treat basis. The study seeks to establish a theoretically robust methodology for culturally adapting internet-delivered interventions for mental health disorders and to evaluate the efficacy of a culturally adapted internet-delivered treatment for depression in Colombia, with support. The study will be a first contribution to a method for culturally adapting internet-delivered interventions and also a first to examine the efficacy of such an adapted intervention in Latin America. Clinical trials NCT03062215. Retrospectively registered 14th February 2017.",29482586,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.496081352233887,-3.6485960483551025,BPd8
"Couple therapy for depression.

Couple therapy for depression has the twofold aim of modifying negative interaction patterns and increasing mutually supportive aspects of intimate relationships, changing the interpersonal context of depression. Couple therapy is included in several guidelines among the suggested treatments for depression. 1. The main objective was to examine the effects of couple therapy compared to individual psychotherapy for depression.2. Secondary objectives were to examine the effects of couple therapy compared to drug therapy and no/minimal treatment for depression. The Cochrane Common Mental Disorders Group Controlled Trials Register (CCMDCTR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid) were searched to 19 February 2018. Relevant journals and reference lists were checked. Randomised and quasi-randomised controlled trials examining the effects of couple therapy versus individual psychotherapy, drug therapy, or no treatment/minimal treatment for depression were included in the review. We considered as primary outcomes the depressive symptom level, the depression persistence, and the dropouts; the relationship distress level was a secondary outcome. We extracted data using a standardised spreadsheet. Where data were not included in published papers, we tried to obtain the data from the authors. We synthesised data using Review Manager software version 5.3. We pooled dichotomous data using the relative risk (RR), and continuous data calculating the standardised mean difference (SMD), together with 95% confidence intervals (CIs). We employed the random-effects model for all comparisons and also calculated a formal test for heterogeneity, the natural approximate Chi2 test. We included fourteen studies from Europe, North America, and Israel, with 651 participants. Eighty per cent of participants were Caucasian. Therefore, the findings cannot be considered as applicable to non-Western countries or to other ethnic groups in Western countries. On average, participants had moderate depression, preventing the extension of results to severely depressed patients. Almost all participants were aged between 36 and 47 years.There was no evidence of difference in effect at the end of treatment between couple therapy and individual psychotherapy, either for the continuous outcome of depressive symptoms, based on nine studies with 304 participants (SMD -0.17, 95% CI -0.44 to 0.10, low-quality evidence), or the proportion of participants remaining depressed, based on six studies with 237 participants (RR 0.94, 95% CI 0.72 to 1.22, low-quality evidence). Findings from studies with 6-month or longer follow-up confirmed the lack of difference between the two conditions.No trial gave information on harmful effects. However, we considered rates of treatment discontinuation for any reason as a proxy indicator of adverse outcomes. There was no evidence of difference for dropout rates between couple therapy and individual psychotherapy, based on eight studies with 316 participants (RR 0.85, 95% CI 0.51 to 1.41, low-quality evidence).Few data were available for the comparison with drug therapy. Data from a small study with 12 participants showed no difference for the continuous outcome of depressive symptoms at end of treatment (SMD -0.51, 95% CI -1.69 to 0.66, very low-quality evidence) and at 6-month follow-up (SMD -1.07, 95% CI -2.45 to 0.31, very low-quality evidence). Data on dropouts from two studies with 95 participants showed a clear advantage for couple therapy (RR 0.31, 95% CI 0.15 to 0.61, very low-quality evidence). However, this finding was heavily influenced by a single study, probably affected by a selection bias favouring couple therapy.The comparison between couple therapy plus drug therapy and drug therapy alone showed no difference in depressive symptom level, based on two studies with 34 participants (SMD -1.04, 95% CI -3.97 to 1.89, very low-quality evidence) and on dropouts, based on two studies with 45 participants (RR 1.03, 95% CI 0.07 to 15.52, very low-quality evidence).The comparison with no/minimal treatment showed a large significant effect favouring couple therapy both for depressive symptom level, based on three studies with 90 participants: (SMD -0.95, 95% CI -1.59 to -0.32, very low-quality evidence) and persistence of depression, based on two studies with 65 participants (RR 0.48, 95% CI 0.32 to 0.70, very low-quality evidence). No data were available for dropouts for this comparison.Concerning relationship distress, the comparison with individual psychotherapy showed that couple therapy appeared more effective in reducing distress level at the end of treatment, based on six studies with 187 participants (SMD -0.50, CI -0.97 to -0.02, very low-quality evidence) and the persistence of distress, based on two studies with 81 participants (RR 0.71, 95% CI 0.51 to 0.98, very low-quality evidence). The quality of evidence was heavily affected by substantial heterogeneity (I2 = 59%). In the analysis restricted to studies including only distressed couples, no heterogeneity was found and the effect in distress level at the end of treatment was larger (SMD -1.10, 95% CI -1.59 to -0.61). Very few data on this outcome were available for other comparisons.We assessed the certainty of the evidence using the GRADE system. The results were weakened by the low quality of evidence related to the effects on depressive symptoms, in comparison with individual psychotherapy, and by very low quality evidence for all other comparisons and for the effects on relationship distress. Most studies were affected by problems such as the small number of cases, performance bias, assessment bias due to the non-blinding outcome assessment, incomplete outcome reporting and the allegiance bias of investigators. Heterogeneity was, in particular, a problem for data about relationship distress. Although there is suggestion that couple therapy is as effective as individual psychotherapy in improving depressive symptoms and more effective in improving relations in distressed couples, the low or very low quality of the evidence seriously limits the possibility of drawing firm conclusions. Very few data were available for comparisons with no/minimal treatment and drug therapy. Future trials of high quality should test in large samples with a long follow-up of the effects of couple therapy in comparison to other interventions in discordant couples with a depressed partner, considering the role of relationship quality as a potential effect mediator in the improvement of depression.",29882960,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,13.957051277160645,-6.648636341094971,BKnE
"Clinical- and cost-effectiveness of a technology-supported and solution-focused intervention (DIALOG+) in treatment of patients with chronic depression-study protocol for a multi-site, cluster randomised controlled trial [TACK].

Many with an acute depressive disorder go on to develop chronic depression, despite ongoing care. There are few specifically designed interventions to treat chronic depression. DIALOG+, a technology-assisted intervention based on the principles of solution-focused therapy, may be beneficial. It has been shown to be effective as a treatment for patients with psychotic disorders, especially in regards to increasing quality of life. DIALOG+ was designed to be flexibly applied and not diagnosis-specific, aiming to structure communication and generate a personally-tailored care plan. This cluster randomised controlled trial (RCT) is part of a programme of research to adapt and test DIALOG+ for patients with chronic depression. Patients will be eligible for the trial, if they have exhibited symptoms of depression or non-psychotic low mood for at least 2years, have regular contact with a clinician and have a low subjective quality of life and moderate depressive symptoms. Clinicians, who routinely see eligible patients, will be recruited from a number of sites across NHS England. Clusters will have between 1 and 6 patients per clinician and will be randomised in a 1:1 ratio to either the intervention (DIALOG+) or active control group (treatment as usual + DIALOG scale). Clinicians in the intervention group are trained and asked to deliver the intervention regularly for 12months. Active control participants receive treatment as usual and are asked to rate their satisfaction with areas of life and treatment on the DIALOG scale at the end of the clinical session. Approximately 112 clinician clusters will be recruited to reach a total patient sample size of 376. Clinical and social outcomes including costs are assessed at baseline and 3, 6 and 12 months post randomisation. The primary outcome will be subjective quality of life at 12months. This definitive multi-site, cluster RCT aims to evaluate the clinical- and cost-effectiveness of DIALOG+ for people with chronic depression. If shown to be effective for this patient population it could be used to improve outcomes of mental health care on a larger scale, ensuring that patients with complex and co-morbid diagnoses can benefit. ISRCTN11301686 . Registered on 13 Jun 2019.",35346348,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.277968406677246,-4.1980299949646,gRk
"Estimating outcome probabilities from early symptom changes in cognitive therapy for recurrent depression.

Acute-phase cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD) producing benefits comparable to pharmacotherapy, but not all patients respond or remit. The purpose of the current analyses was to estimate CT patients' probability of nonresponse and remission from symptom improvement early in treatment. Data from 2 clinical trials of acute-phase CT for recurrent depression were pooled for analysis (N = 679). Adult outpatients received 16- or 20-session CT protocols. Symptoms were measured repeatedly with the clinician-report Hamilton Rating Scale for Depression (HRSD) and Inventory of Depressive Symptomatology-Self-Report (IDS-SR). Outcomes at exit from CT were nonresponse (<50% reduction in HRSD scores) and remission (no MDD and HRSD score ≤6). The nonresponse rate was 45.7%, and the remission rate was 33.4%. In logistic regression models, improvements on the HRSD or IDS-SR from intake to CT Sessions 3, 5, 7, 9, or 11 significantly predicted both outcomes, with prediction gaining in accuracy in later sessions. Clinician and self-report assessments yielded similar results. Prediction of outcomes replicated across data sets. Patients with no symptom improvement by CT Session 9 (Week 5) had ≤10% probability of remission and >75% probability of nonresponse. Outcomes of CT for depression are predictable from early symptom changes. Clinicians may find nonresponse and remission probability estimates useful in the informed consent process and in choosing whether to continue, augment, or switch treatments for CT patients with recurrent MDD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",31008632,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.138676643371582,-1.2528754472732544,A7kY
"Personality difficulties and response to community-based psychological treatment for anxiety and depression.

Previous research suggests that comorbid personality disorder may be associated with a less favourable treatment outcome for individuals with depression and anxiety disorder. However, little is known about whether personality difficulties are associated with treatment outcomes within Improving Access to Psychological Therapies (IAPT) services-the largest platform for treating depression and anxiety in England, UK. Secondary aims were to investigate i) whether individual personality difficulties are associated with treatment outcome and ii) whether findings are moderated by treatment type. The sample included 3,689 adults who accessed community-based psychological treatment (cognitive behavioural therapy, emotional skills training, or other psychological therapy) for depression and/or anxiety disorder. Associations between personality difficulties (assessed with the Standardised Assessment of Personality-Abbreviated Scale (SAPAS)) and treatment outcomes (recovery and reliable improvement in depression/anxiety symptom scores, assessed using questionnaire-based measures) were investigated using logistic/linear regression. Personality difficulties were associated with a reduced likelihood of recovery (adjusted OR per unit increase on SAPAS: depression=0.87, 95%CI 0.84, 0.91; anxiety=0.86, 95%CI 0.82, 0.90) and reliable improvement (adjusted OR per unit increase on SAPAS: depression=0.88, 95%CI 0.84, 0.92; anxiety=0.85, 95%CI 0.82, 0.89). Those with three or more difficulties were over 30% less likely to recover/reliably improve. Personality difficulties data were collected via self-report and were not available for all participants. Patients with personality difficulties have a less favourable response to psychological treatment for depression/anxiety disorder. If replicated, the findings highlight a major challenge to the way community-based psychological therapy services in England (IAPT services) are presently constituted.",33074146,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,13.775415420532227,-3.624835252761841,AgyB
"Update to the study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment depressive relapse/recurrence: the PREVENT trial.

Depression is a common and distressing mental health problem that is responsible for significant individual disability and cost to society. Medication and psychological therapies are effective for treating depression and maintenance anti-depressants (m-ADM) can prevent relapse. However, individuals with depression often express a wish for psychological help that can help them recover from depression in the long-term. A recently developed treatment, mindfulness-based cognitive therapy (MBCT), shows potential as a brief group program for people with recurring depression.This trial asks the policy research question; is MBCT with support to taper/discontinue antidepressant medication (MBCT-TS) superior to m-ADM in terms of: a primary outcome of preventing depressive relapse/recurrence over 24 months; and secondary outcomes of (a) depression free days, (b) residual depressive symptoms, (c) antidepressant medication (ADM) usage, (d) psychiatric and medical co-morbidity, (e) quality of life, and (f) cost effectiveness? An explanatory research question also asks whether an increase in mindfulness skills is the key mechanism of change.The design is a single-blind, parallel randomized controlled trial examining MBCT-TS versus m-ADM with an embedded process study. To answer the main policy research question the proposed trial compares MBCT-TS with m-ADM for patients with recurrent depression. Four hundred and twenty patients with recurrent major depressive disorder in full or partial remission will be recruited through primary care. Depressive relapse/recurrence over two years is the primary outcome variable. Analyses will be conducted following CONSORT standards and overseen by the trial's Data Monitoring and Safety Committee. Initial analyses will be conducted on an intention-to-treat basis, with subsequent analyses being per protocol. The explanatory question will be addressed in two mutually informative ways: quantitative measurement of potential mediating variables pre- and post-treatment and a qualitative study of service users' views and experiences. If the results of our exploratory trial are extended to this definitive trial, MBCT-TS will be established as an alternative approach to maintenance antidepressants for people with a history of recurrent depression. The process studies will provide evidence about the effective components which can be used to improve MBCT and inform theory as well as other therapeutic approaches. Trial registered 7 May 2009; ISRCTN26666654.",24916319,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.803488731384277,-0.7033079862594604,CMy8
"Discovering Common Elements of Empirically Supported Self-Help Interventions for Depression in Primary Care: a Systematic Review.

Although the efficacy of self-help cognitive-behavioral therapy (CBT) for depression has been well established, its feasibility in primary care settings is limited because of time and resource constraints. The goal of this study was to identify common elements of empirically supported (i.e., proven effective in controlled research) self-help CBTs and frameworks for effective use in practice. Randomized controlled trials (RCTs) for self-help CBTs for depression in primary care were systematically identified in Pubmed, PsycINFO, and CENTRAL. The distillation and matching model approach was used to abstract commonly used self-help techniques (practice elements). Study contexts associated with unique combinations of intervention elements were explored, including total human support dose (total face-to-face, telephone, and personalized email contact time recommended by the protocol), effective symptom domain (depression vs. general psychological distress), and severity of depression targeted by the study. Relative contribution to intervention success was estimated for individual elements and human support by conditional probability (CP, proportion of the number of times each element appeared in a successful intervention to the number of times it was used in the interventions identified by the review). Twenty-one interventions (12 successful) in 20 RCTs and 21 practice elements were identified. Cognitive restructuring, behavioral activation, and homework assignment were elements appearing in > 80% of successful interventions. The dose of human support was positively associated with the proportion of interventions that were successful in a significant linear fashion (CPs: interventions with no support, 0.20; 1-119 min of support, 0.60; 120 min of support, 0.83; p = 0.042). In addition, human support increased the probability of success for most of the extracted elements. Only social support activation, homework assignment, and interpersonal skills were highly successful (CPs ≥ 0.60) when minimal support was provided. These findings suggest that human support is an important component in creating an evidence-informed brief self-help program compatible with primary care settings.",33564943,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.627589225769043,-2.646268606185913,AbGD
"Longitudinal social-interpersonal functioning among higher-risk responders to acute-phase cognitive therapy for recurrent major depressive disorder.

Social-interpersonal dysfunction increases disability in major depressive disorder (MDD). Here we clarified the durability of improvements in social-interpersonal functioning made during acute-phase cognitive therapy (CT), whether continuation CT (C-CT) or fluoxetine (FLX) further improved functioning, and relations of functioning with depressive symptoms and relapse/recurrence. Adult outpatients (N=241) with recurrent MDD who responded to acute-phase CT with higher risk of relapse (due to unstable or partial remission) were randomized to 8 months of C-CT, FLX, or pill placebo plus clinical management (PBO) and followed 24 additional months. We analyzed repeated measures of patients' social adjustment, interpersonal problems, dyadic adjustment, depressive symptoms, and major depressive relapse/recurrence. Large improvements in social-interpersonal functioning occurring during acute-phase CT (median d=1.4) were maintained, with many patients (median=66%) scoring in normal ranges for 32 months. Social-interpersonal functioning did not differ significantly among C-CT, FLX, and PBO arms. Beyond concurrently measured residual symptoms, deterioration in social-interpersonal functioning preceded and predicted upticks in depressive symptoms and major depressive relapse/recurrence. Results may not generalize to other patient populations, treatment protocols, or measures of social-interpersonal functioning. Mechanisms of risk connecting poorer social-interpersonal functioning with depression were not studied. Average improvements in social-interpersonal functioning among higher-risk responders to acute phase CT are durable for 32 months. After acute-phase CT, C-CT or FLX may not further improve social-interpersonal functioning. Among acute-phase CT responders, deteriorating social-interpersonal functioning provides a clear, measurable signal of risk for impending major depressive relapse/recurrence and opportunity for preemptive intervention.",27104803,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.375763893127441,-1.622043490409851,Bt1y
"Cost-effectiveness of family psychoeducation to prevent relapse in major depression: results from a randomized controlled trial.

Family psychoeducation is a relatively simple and straightforward intervention whose prophylactic effectiveness and cost-effectiveness is well-established for schizophrenia. We have recently demonstrated its effectiveness for unipolar depression, but its cost-effectiveness has never been examined. We hereby report a cost-effectiveness analysis alongside a randomized controlled trial in order to assess its cost-effectiveness for preventing relapse/recurrence in depression. Fifty-seven patients diagnosed with major depression and undergoing its maintenance treatment, and their primary family members were randomized to treatment as usual (TAU) only or to TAU plus family psychoeducation, which consisted of four 2-hour multiple-family sessions consisting of didactic lectures about depression (30 minutes) and group discussion and problem solving (60-90 minutes). The economic analyses were undertaken from the perspective of the National Health Insurance (NHI), assuming the most reasonable price of US$50 per psychoeducation session per patient. The main outcome measures included relapse-free days and direct costs to the NHI. The intervention group enjoyed 272 (SD: 7.1) relapse-free days, while the control group spent 214 (SD: 90.8) relapse-free days (Cox proportional hazard ratio=0.17, 95%CI: 0.04 to 0.75, p=0.002). Cost-effectiveness acceptability curves suggested that the family psychoeducation has 90% or more chances of being cost-effective if the decision-maker is prepared to pay US$20 for one additional relapse-free day. This cost-effectiveness finding was robust when the price for family psychoeducation ranged between 50% to 150% of the baseline scenario in sensitivity analyses. If a relapse-free day is considered to be worth $30 or more, all the pricing scenarios have a close to 100% probability of being cost-effective. Family psychoeducation is effective in the relapse prevention of depression and is highly likely to be cost-effective if a relapse-free day is valued as US$20 or more. UMIN-CTR (UMIN000005555).",22583708,Major Depressive Disorder,Anxiety Treatment,Mental Health,1033,10.814703941345215,-3.534818649291992,Ctih
"The influence of patients' preference/attitude towards psychotherapy and antidepressant medication on the treatment of major depressive disorder.

Preferences and attitudes patients hold towards treatment are important, as these can influence treatment outcome. In depression research, the influence of patients' preference/attitudes on outcome and dropout has mainly been studied for antidepressant medication, and less for psychological treatments. We investigated the effects of patients' preference and attitudes towards psychological treatment and antidepressant medication on treatment outcome and dropout, and tested specificity of effects. Data are based on a randomized trial testing the effectiveness of behavioural activation (BA) vs antidepressant medication (ADM) for major depression (MDD) in Iran. Patients with MDD (N = 100) were randomized to BA (N = 50) or ADM (N = 50). Patients' preference/attitudes towards psychotherapy and ADM were assessed at baseline and associated with dropout and treatment outcome using logistic regression and multilevel analysis. High scores on psychotherapy preference/attitude and low scores on ADM preference/attitude predicted dropout from ADM, while no association between dropout and preference/attitude was found in BA. Psychotherapy preference/attitude moderated the differential effect of BA and ADM on one outcome measure, but the association disappeared after one year. Because in Iran most patients have only access to ADM, offering a psychological treatment for depression could attract especially those patients that prefer this newly available treatment. Patients' preferences and attitudes towards depression treatments influence dropout from ADM, and moderate the short-term difference in effectiveness between BA and ADM. The fact that dropout from BA was not affected by preference/attitude speaks for its acceptability among patients.",24172145,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.041475296020508,-2.808652639389038,CWwG
"The efficacy and acceptability of psychological interventions for depression: where we are now and where we are going.

Depression is an eminently treatable disorder, although estimates of treatment efficacy have been inflated by publication bias. Patients with less severe depressions respond to even nonspecific interventions, whereas patients with more severe depressions require treatments that mobilize specific mechanisms. The cognitive and behavior therapies can be as efficacious as medications in the treatment of severe depression and have an enduring effect that medications lack. Medications may interfere with those enduring effects when added in combination and may prolong the life of the underlying episode when used alone. Thus the cognitive behavioral interventions might be the optimal first-line treatments for depression.",26310321,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.084692001342773,-1.793989896774292,B49e
"The SMILES trial: do undisclosed recruitment practices explain the remarkably large effect?

The SMILES trial showed substantial improvement of depressive symptoms following seven consultations on healthy dieting. The very large effect size on depression reduction seems remarkable and we suggest that selectively induced expectancy and a loss of blinding have contributed to the observed effect.",30591065,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,11.396658897399902,-2.863156318664551,BBNe
"Positive imagery training increases positive self-referent cognition in depression.

Depressed adults often show a bias towards negative self-referent processing at the expense of positive self-referent processing. The current study assessed whether a mental imagery intervention (Positive Self Reference Training-PSRT) delivered via the Internet could improve self-referent processing and depressive symptomatology among adults with moderate or greater depression symptoms. Participants were recruited via online methods and randomly assigned to one of two computerized interventions: active PSRT (n=44) or control training (NTC; n=43). The PSRT involved visualizing the self in response to different positive cues (e.g., an achievement) every other day for two weeks. The NTC provided neutral cues about objects. Self-referential processing of positive and negative adjectives and depression symptoms were measured at baseline, one week, and two weeks after initiating training. Over those two weeks, PSRT participants showed a greater increase in positive self-referent processing than did NTC participants. Negative self-referent processing and symptoms of depression declined comparably in both groups. Similarly, for both groups, increase in positive and decrease in negative self-referent processing was associated with a greater reduction in depression. These results indicate that mental imagery has the potential to improve self-referential processing, especially for positive stimuli, which may, in turn, help reduce depressive symptomatology.",30321746,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,14.432812690734863,-0.7055168747901917,BEvu
"The six cycles maintenance model: Growing a ""vicious flower"" for depression.

Cognitive behavioural models of anxiety disorders often include visual representations of feedback loops that maintain the disorder. Cognitive therapy for depression is the prototype for therapy for many other disorders, and there is now good evidence for factors that maintain depression, yet there is still no accepted diagrammatic form of the maintenance model. To develop a simple, clinically acceptable and empirically based version of the ""vicious flower"" for depression. Current theoretical developments in depression (Differential activation and Beck's concept of modes) and empirical findings on maintenance factors were reviewed. A model was developed based on clinical utility and current knowledge of the processes and maintenance factors in depression. This model was tested for its usefulness with a small sample of IAPT trainees. The model contained 6 cycles comprising 2 cognitive cycles (automatic negative thinking and rumination/self-attacking), 2 behavioural cycles (withdrawal/avoidance and unhelpful behaviour), a mood/emotion cycle, and a motivation/physical symptoms cycle. Students found it a very useful tool for understanding maintenance factors. This diagrammatic maintenance model of depression, like similar ""vicious flowers"" for anxiety, may be helpful in conceptualization, socialization and treatment planning as well as teaching CBT.",19925693,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.007652282714844,-0.9263157844543457,DP9n
"A systematic meta-review of patient-level predictors of psychological therapy outcome in major depressive disorder.

Psychological therapies are effective for treating major depressive disorder, but current clinical guidelines do not provide guidance on the personalization of treatment choice. Established predictors of psychotherapy treatment response could help inform machine learning models aimed at predicting individual patient responses to different therapy options. Here we sought to comprehensively identify known predictors. EMBASE, Medline, PubMed, PsycINFO were searched for systematic reviews with or without meta-analysis published until June 2020 to identify individual patient-level predictors of response to psychological treatments. 3113 abstracts were identified and 300 articles assessed. We qualitatively synthesized our findings by predictor category (sociodemographic; symptom profile; social support; personality features; affective, cognitive, and behavioural; comorbidities; neuroimaging; genetics) and treatment type. We used the AMSTAR 2 to evaluate the quality of included reviews. Following screening and full-text assessment, 27 systematic reviews including 12 meta-analyses were eligible for inclusion. 74 predictors emerged for various psychological treatments, primarily cognitive behavioural therapy, interpersonal therapy, and mindfulness-based cognitive therapy. A paucity of studies examining predictors of psychological treatment outcome, as well as methodological heterogeneities and publication biases limit the strength of the identified predictors. The synthesized predictors could be used to supplement clinical decision-making in selecting psychological therapies based on individual patient characteristics. These predictors could also be used as a priori input features for machine learning models aimed at predicting a given patient's likelihood of response to different treatment options for depression, and may contribute toward the development of patient-specific treatment recommendations in clinical guidelines.",36029877,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.903055191040039,-1.9841471910476685,J04
"Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomised controlled trial.

Depression is a highly prevalent disorder, causing a large burden of disease and substantial economic costs. Web-based self-help interventions seem promising in promoting mental health. To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control condition (Netherlands Trial Register NTR1296). Adults with depressive symptoms from the general population were randomised to ACT (n = 82), expressive writing (n = 67) or waiting-list control (n = 87). The main outcome was reduction in depressive symptoms assessed with the Center for Epidemiological Studies - Depression scale. Significant reductions in depressive symptoms were found following the ACT intervention, compared with the control group (Cohen's d = 0.56) and the expressive writing intervention (d = 0.36). The effects were sustained at 6-month and 12-month follow-up. Acceptance and commitment therapy as a web-based public mental health intervention for adults with depressive symptoms can be effective and applicable.",26250745,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.876591205596924,-1.6983850002288818,B5yy
"An economic evaluation of an augmented cognitive behavioural intervention vs. computerized cognitive training for post-stroke depressive symptoms.

Stroke survivors encounter emotional problems in the chronic phase after stroke. Post-stroke depressive symptoms have major impact on health-related quality of life (HRQol) and lead to increased hospitalization and therefore substantial healthcare costs. We present a cost-effectiveness and cost-utility evaluation of a cognitive behavioural therapy augmented with occupational and movement therapy to support patients with a stroke with depressive symptoms in goal-setting and goal attainment (augmented CBT) in comparison with a computerized cognitive training program (CogniPlus) as a control intervention. A trial-based economic evaluation was conducted from a societal perspective with a time horizon of 12 months. Stroke patients (aged 18+ years) with signs of depression (Hospital Anxiety and Depression Scale (HADS) - subscale depression>7) were eligible to participate. Primary outcomes were the HADS and Quality Adjusted Life Years (QALYs) based on the three-level five-dimensional EuroQol (EQ-5D-3 L). Missing data were handled through mean imputation (costs) and multiple imputation (HADS and EuroQol), and costs were bootstrapped. Sensitivity analyses were performed to test robustness of baseline assumptions. Sixty-one patients were included. The average total societal costs were not significantly different between the control group (€9,998.3) and the augmented CBT group (€8,063.7), with a 95 % confidence interval (-5,284, 1,796). The augmented CBT intervention was less costly and less effective from a societal perspective on the HADS, and less costly and slightly more effective in QALYs, in comparison with the control treatment. The cost-effectiveness and cost-utility analyses provided greater effects and fewer costs for the augmented CBT group, and fewer effects and costs for the HADS. Based on a willingness to pay (WTP) level of €40,000 per QALY, the augmented CBT intervention had a 76 % chance of being cost-effective. Sensitivity analyses showed robustness of results. The stroke-specific augmented CBT intervention did not show convincing cost-effectiveness results. In addition to other literature, this study provided new insights into the potential cost-effectiveness of an adjusted cognitive behavioural therapy intervention. However, as our study showed a 76 % chance of being cost-effective for one outcome measure (QALY) and did not provide convincing cost-effectiveness results on the HADS we recommend further research in a larger population.",26715040,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.377263069152832,-2.4485936164855957,BzPq
"The potential of predictive analytics to provide clinical decision support in depression treatment planning.

To review progress developing clinical decision support tools for personalized treatment of major depressive disorder (MDD). Over the years, a variety of individual indicators ranging from biomarkers to clinical observations and self-report scales have been used to predict various aspects of differential MDD treatment response. Most of this work focused on predicting remission either with antidepressant medications versus psychotherapy, some antidepressant medications versus others, some psychotherapies versus others, and combination therapies versus monotherapies. However, to date, none of the individual predictors in these studies has been strong enough to guide optimal treatment selection for most patients. Interest consequently turned to decision support tools made up of multiple predictors, but the development of such tools has been hampered by small study sample sizes. Design recommendations are made here for future studies to address this problem. Recommendations include using large prospective observational studies followed by pragmatic trials rather than smaller, expensive controlled treatment trials for preliminary development of decision support tools; basing these tools on comprehensive batteries of inexpensive self-report and clinical predictors (e.g., self-administered performance-based neurocognitive tests) versus expensive biomarkers; and reserving biomarker assessments for targeted studies of patients not well classified by inexpensive predictor batteries.",29076894,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.463680267333984,-1.3046038150787354,BVBA
"Cognitive reactivity as outcome and working mechanism of mindfulness-based cognitive therapy for recurrently depressed patients in remission.

Major depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitive therapy (MBCT) with treatment-as-usual (TAU) on cognitive reactivity in recurrently depressed patients (N=115). Depressive symptoms, cognitive reactivity, and mindfulness skills were assessed pre and post treatment. Patients in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group (d=.51). The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminary evidence that cognitive reactivity is a working mechanism of MBCT.",28278742,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.826617240905762,-0.6646351218223572,Bfuu
"Effectiveness of Peer-Supported Computer-Based CBT for Depression Among Veterans in Primary Care.

This study tested whether computerized cognitive-behavioral therapy for depression supported by a peer specialist with lived experience of depression (PS-cCBT) improves mental health-related outcomes for primary care patients. In the U.S. Department of Veterans Affairs, primary care patients with a new diagnosis of depression (N=330) were randomly assigned to 3 months of PS-cCBT or a usual-care control condition. Linear mixed-effects models were used to assess differences in depression symptoms, general mental health status, quality of life, and mental health recovery measured at baseline and 3 and 6 months. In adjusted analyses, participants who received PS-cCBT experienced 1.4 points' (95% confidence interval [CI]=0.3-2.5, p=0.01) greater improvement in depression symptoms on the Quick Inventory of Depression Symptomatology-Self Report at 3 months, compared with the control group, but no significant difference was noted at 6 months. PS-cCBT recipients also had 2.6 points' (95% CI=0.5-4.8, p=0.02) greater improvement in quality of life at 3 months on the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form and greater improvement in recovery on the Recovery Assessment Scale at 3 months (3.6 points; 95% CI=0.9-6.2, p=0.01) and 6 months (4.5 points; 95% CI=1.2-7.7, p=0.01). PS-cCBT is an effective option for improving short-term depression symptoms and longer-term recovery among primary care patients newly diagnosed as having depression.",31931686,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.83984661102295,-2.838007926940918,AvAP
"Acceptability of online self-help to people with depression: users' views of MoodGYM versus informational websites.

Little is known about the factors that influence acceptability of and adherence to online psychological interventions. Evidence is needed to guide further development of promising programs. Our goal was to investigate users' views of two online approaches to self-help for depression: computerized cognitive behavior therapy (cCBT) and informational websites, in a workplace context. Computerized CBT offers an inexpensive and accessible alternative to face-to-face therapy, and employers have an interest in reducing the working time lost to depression or stress. Yet little is known about how employees, who have actual experience of using online approaches, judge the intervention as a process. The qualitative data reported here were collected within an online randomized controlled trial whose participants had diagnosable depression. The experimental intervention was a 5-week cCBT program called MoodGYM, and the control condition was five informational websites about mental health. Data were collected via online questionnaires. There was no evidence of the superiority of either in terms of treatment outcomes. In parallel, using brief rating scales and open-ended questions designed for this purpose, we examined the relative acceptability of each approach over time, including perceptions of cCBT compared to seeing a health care professional. At least 60% of participants held online therapy to be at least as acceptable as seeing a professional about mental health issues, and they were more likely to retain this opinion over time if they used the interactive program, MoodGYM, rather than informational websites alone. Barriers to cCBT use fell into four categories: intrinsic, intrapersonal problems; extrinsic technical problems; generic issues mostly pertaining to perceptions of cCBT; and specific issues about the intervention or control condition. These indicate strategies for improving engagement. As first-aid for mild to moderate mental health problems, evidence-based computerized approaches have broad acceptability. This could be increased by attending to the barriers noted here and by proactively managing users' expectations at individual and organizational levels. The findings have implications for occupational health providers and others addressing the needs of working-age adults with depression. They also raise methodological issues for online research. International Standard Randomized Controlled Trial Number (ISRCTN): 24529487; http://www.controlled-trials.com/ISRCTN24529487 (Archived by Webcite at http://www.webcitation.org/6O8cCL4mh).",24681717,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.202884674072266,-3.6223256587982178,CQEV
"Lifestyle medicine for depression: A meta-analysis of randomized controlled trials.

The treatment effect of multi-component LM interventions on depressive symptoms has not yet been examined. We systematically searched six databases from inception to February 2020 to identify randomized controlled trials (RCTs) involving any multi-component LM interventions (physical activity, nutritional advice, sleep management, and/or stress management) on depressive symptoms relative to care as usual (CAU), waitlist (WL), no intervention (NI), or attention control (AC) comparisons. Fifty studies with 8,479 participants were included. Multi-component LM interventions reduced depressive symptoms significantly relative to the CAU (p >.001; d = 0.20) and WL/NI (p > .01; d = 0.22) comparisons at immediate posttreatment. However, no significant difference was found when compared with AC. The intervention effects were maintained in the short-term (1- to 3-month follow-up) relative to the CAU comparison (p > .05; d = 0.25), but not in the medium- and long-term. The moderator analyses examining the effect of multi-component LM interventions compared with CAU suggested that the number of lifestyle factors adopted was a significant moderator. Although disease type was not a significant moderator, there was a tendency that the clinical effect of multi-component LM interventions was stronger (d = 0.45) in those diagnosed with major depression. No publication bias was detected. Low number of RCTs available in some subgroup analyses prevented from finding meaningful effects. Results may not be extended to major depression, because data on secondary depression were captured. Multi-component LM interventions appeared to be effective in mitigating depressive symptoms; however, the magnitude of the clinical effect was small. Future research is needed to assess more comprehensive and individualized LM interventions which have a greater emphasis on motivational and compliance aspects and focus solely on individuals with depression.",33609955,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.129944801330566,-1.5771069526672363,AaiZ
"Organized Self-Management Support Services for Chronic Depressive Symptoms: A Randomized Controlled Trial.

This study aimed to determine whether a self-management support service was more effective than treatment as usual in reducing depressive symptoms and major depressive episodes and increasing personal recovery among individuals with chronic or recurrent depressive symptoms. The study was a randomized controlled trial of a self-management support service consisting of depression self-management training, recovery coaching, and care coordination. The 18-month intervention included regular telephone or in-person contacts with a care manager and a structured group program co-led by a professional therapist and a trained peer specialist. Intervention (N=150) and control (N=152) participants ages ≥ 18 with chronic or recurrent depressive symptoms were recruited from five clinics in Seattle, Washington. Outcome measures included the Hopkins Symptom Checklist depression scale, the Recovery Assessment Scale, the Patient-Rated Global Improvement scale, and the percentage of participants with a major depressive episode. Interviewers were masked to treatment condition. Repeated-measures estimates of the long-term effect of the intervention versus usual care (average of the six-, 12-, and 18-month outcomes adjusted for age, gender, and site) indicated that intervention participants had less severe symptoms (p=.002) and higher recovery scores (p=.03), were less likely to be depressed (odds ratio [OR]=.52, p=.001), and were more likely to be much improved (OR=1.96, p=.001). These findings support providing regular outreach care management and a self-care group offering a combined behavioral and recovery-oriented approach for people with chronic or recurrent depressive symptoms.",26278222,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,10.028034210205078,-3.15777850151062,B5bM
"Family psychoeducation for major depression: randomised controlled trial.

The value of family psychoeducation for schizophrenia has been well established, and indications for its use have recently expanded to include bipolar affective disorder. However, no study to date has adequately examined its use in depression. To examine family psychoeducation in the maintenance treatment of depression and to investigate the influence of the family's expressed emotion (EE) on its effectiveness. Of 103 patients diagnosed with major depression and their primary family members, 57 pairs provided written informed consent. The pairs were randomly allocated to the intervention (n = 25) or control (n = 32). One family in the intervention group and two in the control group withdrew their consent after randomisation. The intervention group underwent four psychoeducation sessions consisting of didactic lectures about depression and group problem-solving focusing on how to cope in high-EE situations. Patients did not attend these sessions. Patients in both the intervention and control groups received treatment as usual. The families' EE levels were evaluated through Five-Minute Speech Samples. The primary outcome was relapse. Time to relapse was statistically significantly longer in the psychoeducation group than in the control group (Kaplan-Meier survival analysis, P = 0.002). The relapse rates up to the 9-month follow-up were 8% and 50% respectively (risk ratio 0.17, 95% CI 0.04-0.66; number needed to treat 2.4, 95% CI 1.6-4.9). In Cox proportional hazard analysis, baseline EE did not moderate the effectiveness of the intervention. Family psychoeducation is effective in the prevention of relapse in adult patients with major depression.",21343330,Major Depressive Disorder,Anxiety Treatment,Mental Health,1033,11.238710403442383,-4.163461208343506,C/mO
"Use of Computer and Mobile Technologies in the Treatment of Depression.

Major depression (MDD) is a common and disabling disorder. Research has shown that most people with MDD receive either no treatment or inadequate treatment. Computer and mobile technologies may offer solutions for the delivery of therapies to untreated or inadequately treated individuals with MDD. The authors review currently available technologies and research aimed at relieving symptoms of MDD. These technologies include computer-assisted cognitive-behavior therapy (CCBT), web-based self-help, Internet self-help support groups, mobile psychotherapeutic interventions (i.e., mobile applications or apps), technology enhanced exercise, and biosensing technology.",28499574,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.963900566101074,-3.6332662105560303,Bcp3
"Creative, Person-Centered Narrative Psychopharmacotherapy of Depression.

Depression as a multifactorial, polygenic mental disorder with thousands faces, poorly defined endophenotypes and characterized with high rate of morbidity, comorbidity, disability, mortality, and treatment failures, remains a relentless illness with heavy burden on patients, their families, and society. Therapeutic outcome of depression needs to be significantly improved and overcome the 65% barrier. The best treatments are those that utilize and integrate multiple modalities. The time is ripe for psychiatry to find its transdisciplinary integrative soul and increase treatment effectiveness. Creation and fostering hope, meaning, personal responsibility, spirit of optimism, and commitment can significantly contribute to overall positive response to pharmacotherapy, but in the other way round drug treatment can also contribute to creation and fostering hope, meaning, personal responsibility, spirit of optimism, and commitment. This chapter addresses the concept of creative person-centered narrative psychopharmacotherapy (CP-CNP) as a transdisciplinary integrative strategy for improvement of the therapeutic effectiveness in patients with depression.",33834413,Major Depressive Disorder,Anxiety Treatment,Mental Health,23726,12.158824920654297,-7.619348049163818,AYE0
"Enhancing inpatient psychotherapeutic treatment with online self-help: study protocol for a randomized controlled trial.

Depression is one of the most debilitating and costly mental disorders. There is increasing evidence for the efficacy of online self-help in alleviating depression. Knowledge regarding the options of combining online self-help with inpatient psychotherapy is still limited. Therefore, we plan to evaluate an evidence-based self-help program (deprexis®; Gaia AG, Hamburg, Germany) to improve the efficacy of inpatient psychotherapy and to maintain treatment effects in the aftercare period. Depressed patients (n=240) with private internet access aged between 18 and 65 are recruited during psychosomatic inpatient treatment. Participants are randomized to an intervention or control group at the beginning of inpatient treatment. The intervention group (n=120) is offered an online self-help program with 12 weekly tasks, beginning during the inpatient treatment. The control group (n=120) obtains access to an online platform with weekly updated information on depression for the same duration. Assessments are conducted at the beginning (T0) and the end of inpatient treatment (T1), at the end of intervention (T2) and 6 months after randomization (T3). The primary outcome is the depression score measured by the Beck Depression Inventory-II at T2. Secondary outcome measures include anxiety, self-esteem, quality of life, dysfunctional cognitions and work ability. We expect the intervention group to benefit from additional online self-help during inpatient psychotherapy and to maintain the benefits during follow-up. This could be an important approach to develop future concepts of inpatient psychotherapy. ClinicalTrials.gov Identifier: NCT02196896 (registered on 16 July 2014).",25872505,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.86757755279541,-3.313316822052002,B/JD
"Effect of a cognitive behavioral self-help intervention on depression, anxiety, and coping self-efficacy in people with rheumatic disease.

The aim of this study was to investigate whether a new cognitive-behavioral self-help program with minimal coaching could improve psychological well-being (depression, anxiety, and coping self-efficacy) in people with rheumatic disease and depressive symptoms. In total, 82 persons with a rheumatic disease enrolled in a randomized controlled trial were allocated to either a group receiving the self-help program or a waiting list control condition group. For both groups, measurements were done at baseline, posttest, and followup. The outcome measures were the depression and anxiety scales of the Hospital Anxiety and Depression Scale and an adaptation of the Generalized Self-Efficacy Scale. Repeated-measures analyses of covariance were performed to evaluate changes in outcome measures from pretest to posttest and from posttest to followup. The results showed that the self-help program was effective in reducing symptoms of depression and anxiety and in strengthening coping self-efficacy. The positive effects remained after a followup period of 2 months. This cost-effective program could very well be used as a first step in a stepped care approach or as one of the treatment possibilities in a matched care approach.",23281332,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.158578872680664,-2.9807939529418945,Cj0/
"Are all psychotherapies equally effective in the treatment of adult depression? The lack of statistical power of comparative outcome studies.

More than 100 comparative outcome trials, directly comparing 2 or more psychotherapies for adult depression, have been published. We first examined whether these comparative trials had sufficient statistical power to detect clinically relevant differences between therapies of d=0.24. In order to detect such an effect size, power calculations showed that a trial would need to include 548 patients. We selected 3 recent meta-analyses of psychotherapies for adult depression (cognitive behaviour therapy (CBT), interpersonal psychotherapy and non-directive counselling) and examined the number of patients included in the trials directly comparing other psychotherapies. The largest trial comparing CBT with another therapy included 178 patients, and had enough power to detect a differential effect size of only d=0.42. None of the trials in the 3 meta-analyses had enough power to detect effect sizes smaller than d=0.34, but some came close to the threshold for detecting a clinically relevant effect size of d=0.24. Meta-analyses may be able to solve the problem of the low power of individual trials. However, many of these studies have considerable risk of bias, and if we only focused on trials with low risk of bias, there would no longer be enough studies to detect clinically relevant effects. We conclude that individual trials are heavily underpowered and do not even come close to having sufficient power for detecting clinically relevant effect sizes. Despite this large number of trials, it is still not clear whether there are clinically relevant differences between these therapies.",26984413,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.552071571350098,-2.4936089515686035,Bvkg
"Efficacy and process of cognitive bibliotherapy for the treatment of depression in jail and prison inmates.

The purpose of this two-study project was to determine the effects of cognitive bibliotherapy for the treatment of depressive symptoms in jail and prison inmates. Participants in both samples were randomly assigned to either a treatment group that received the 4-week bibliotherapy program or a delayed-treatment control group. In the jail sample, which served as a pilot study for the more detailed prison study, the treatment group showed greater improvement on the A. T. Beck and R. A. Steer Beck Depression Inventory, 1993, Psychological Corporation, San Antonio, TX and the DAS (M. M. Weissman, & A. T. Beck Development and validation of the Dysfunctional Attitudes Scale: A preliminary investigation; paper presented at the meeting of the American Educational Research Association, November, 1978, Toronto, ON, Canada). In the prison sample, results indicated that the treatment group showed greater improvement on the HRSD (M. Hamilton, Development of a rating scale for primary depressive illness, British Journal of Social & Clinical Psychology, Vol. 6, 1967, pp. 278-296) and the A. T. Beck, R. A. Steer, & G. K. Brown Beck Depression Inventory (2nd ed.), 1996, Psychological Corporation, San Antonio, TX. Approximately half of the treated participants achieved clinically significant change. Analyses of the follow-up data revealed maintenance of treatment gains in the prison and jail samples. In the prison study, significant changes were also observed on a general measure of psychological distress. Overall, results suggest that cognitive bibliotherapy may be efficacious for depressed inmates.",23834667,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.726958274841309,-3.0946130752563477,Cbre
"Brief dynamic therapy and depression severity: a single-blind, randomized study.

Brief dynamic therapy (BDT) has been shown to be effective in treating depressive disorders. Nevertheless, whether its effect is related to the severity of depression is still unknown. The aim of this study was to analyze whether the efficacy of BDT is related to severity of depressive symptoms in patients with mild to moderate unipolar depressive disorders. A randomized clinical trial compared BDT with brief supportive psychotherapy (BSP) in 88 outpatients with depressive disorders. Two subgroups of patients were considered for statistical analysis: with mild depressive disorders (HAM-D17 baseline score: 8-13) and with moderate depressive disorders (HAM-D17 baseline score: 14-18). Patients were assessed at start of treatment (baseline-T0), at the end of treatment (T1) and at 6-month follow-up (T2). In the subgroup of patients with mild depressive disorders, no statistically significant differences emerged between the two treatments on all efficacy measures. In the subgroup of patients with moderate depressive disorders, the remission rates of patients treated with BDT were higher than those of patients treated with BSP at 6 month of follow-up (90.5% vs. 34.8%: p<.005). The sample size was relatively small; a longer follow-up period should be considered to assess the efficacy of BDT in terms of prevention of recurrences. The efficacy of BDT in treating depressive disorders is higher in moderate than in mild depression.",23174499,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.796883583068848,-3.3846001625061035,ClZw
"Indoor rock climbing (bouldering) as a new treatment for depression: study design of a waitlist-controlled randomized group pilot study and the first results.

Depression is one of the most common diseases in industrialised nations. Physical activity is regarded as an important part of therapeutic intervention. Rock climbing or bouldering (rock climbing to moderate heights without rope) comprises many aspects that are considered useful, but until now, there has been hardly any research on the effects of a bouldering group intervention on people with depression. The purpose of this controlled pilot study was twofold: first, to develop a manual for an eight-week interventional program that integrates psychotherapeutic interventions in a bouldering group setting and second, to assess the effects of a bouldering intervention on people with depression. The intervention took place once a week for three hours across a period of eight weeks. Participants were randomly assigned to the two groups (intervention vs. waitlist). The intervention group began the bouldering therapy immediately after a baseline measurement was taken; the waitlist participants began after an eight-week period of treatment as usual. On four measurement dates at eight-week intervals, participants completed the Beck Depression Inventory II (BDI-II), the symptom checklist-90-R (SCL-90), the questionnaire on resources and self-management skills (FERUS), and the attention test d2-R. A total of 47 participants completed the study, and the data were analysed with descriptive statistics. Cohen's d was calculated as a measure of the effect size. For the primary hypothesis, a regression analysis and the Number Needed to Treat (NNT) (improvement of at least 6 points on the BDI-II) were calculated. After eight weeks of intervention, results indicated positive effects on the measures of depression (primary hypothesis: BDI-II: Cohen's d = 0.77), this was supported by the regression analysis with ""group"" as the only significant predictor of a change in depression (p =.007). The NNT was four. These findings provide the first evidence that therapeutic bouldering may offer an effective treatment for depression. Further research is required. Current controlled trials, ISRCTN17623318 , registered on July 15(th) 2015.",26302900,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,9.107630729675293,-2.2026925086975098,B5D8
"Effectiveness of eHealth-based cognitive behavioural therapy on depression: A systematic review and meta-analysis.

To systematically appraise the effects of eHealth cognitive behavioural therapy on depression and anxiety severity, quality of life, adherence and attrition rates observed in adults with clinically diagnosed depression. eHealth-based cognitive behavioural therapy is an increasingly popular intervention on depression, but current reviews investigating the effects of eHealth interventions on depression are not exclusive to the clinically depressed. A systematic review and meta-analysis. Following the PRISMA guidelines, a systematic search of randomised controlled trials related to eHealth cognitive behavioural therapy published from inception from six databases and three trial registries was undertaken. A total of 15 studies were included in this systematic review. The meta-analysis revealed that, when compared to passive comparators, eHealth cognitive behavioural therapy had a statistically significant effect on depression (d = -0.62, 95% CI: -0.96 to -0.28, p = .0003) and anxiety severity (d = -0.65, 95% CI: -1.10 to -0.21, p = .004) but not for quality of life (d = 0.30, 95% CI: -0.09 to 0.07, p = .13). When compared to active comparators, a statistically significant effect on depression (d = -0.31, 95% CI: -0.55 to -0.07, p = .01) and anxiety severity (d = -0.50, 95% CI: -0.81 to -0.19, p = .002) was observed, but not for quality of life (d = 0.22, 95% CI: -0.04 to 0.48, p = .10). Weighted averages for adherence and attrition rates were low. eHealth cognitive behavioural therapy showed effectiveness in reducing depression and anxiety severity, but not quality of life. Further research is required to culturally adapt CBT interventions and explore the long-term benefits of eHealth cognitive behavioural therapy. The use of eHealth-based cognitive behavioural therapy could potentially bridge treatment gaps and serve as an adjunct to active treatment plans or an alternative for those without access to treatment.",35060252,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.807601928710938,-2.9739420413970947,rjU
"The Mereology of Depression-Networks of Depressive Symptoms during the Course of Psychotherapy.

(1) Background: Research has shown that it is important to examine depressive symptoms in the light of the mereology (the ratio between one symptom and the whole disorder). The goal of this study was to examine changes in the symptom interrelations of patients undergoing cognitive behavioral therapy treatment (CBT) via network analyses. (2) Method: Outpatients with depressive symptoms (N = 401) were assessed with the Beck Depression Inventory three times (pretreatment, after 12 sessions, and post-treatment) during CBT. Gaussian graphical models were used to estimate the relationships among symptoms. (3) Results: The severity of depressive symptoms significantly decreased over the course of therapy, but connectivity in the networks significantly increased. Communities of symptoms changed during treatment. The most central and predictable symptom was worthlessness at baseline and after 12 sessions, and loss of energy and self-dislike at post-treatment. (4) Conclusion: The results indicate that the severity of depressive symptoms decreased during cognitive behavior therapy, while network connectivity increased. Furthermore, the associations among symptoms and their centrality changed during the course of therapy. Future studies may investigate individual differences and their impact on the planning of psychotherapeutic treatment.",35742380,Major Depressive Disorder,Anxiety Treatment,Mental Health,20347,12.560992240905762,-1.3552027940750122,Sxg
"Behavioural Activation for Depression in Informal Caregivers: A Systematic Review and Meta-Analysis of Randomised Controlled Clinical Trials.

Carers experience significant physical and psychological burden and are at increased risk of experiencing clinical depression. Although several psychological treatments have been shown to be effective for preventing and treating depression in carers, most are complex, costly, and not easily accessible to family carers. In this paper, we review evidence of effectiveness of Behavioural Activation (BA) for depressive symptoms in informal caregivers and report on its quality. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL and Online trial registers for randomised controlled clinical trials of BA for carers. Twelve trials met inclusion criteria and eleven were included in the meta-analyses. BA reduced depressive symptoms for carers (standardised mean difference (SMD) -0.68; confidence interval (CI) -1.14 to -0.22) at post intervention (4-14 weeks) and in the long term (l year; SMD -0.99; CI -1.26 to -0.71). BA decreased risk of a diagnosis of major depression (Odds Ratio 0.35; CI 0.19 to 0.67), and reduced negative affect (SMD -0.53; 95% CI -0.83 to -0.23), and caregiver burden (SMD -0.32; CI -0.55 to -0.09) at post-treatment. Quality of evidence was moderate and there was no evidence of publication bias. There was high heterogeneity in the studies included. BA is effective in reducing depressive symptoms post-treatment and long-term (1 year) and decreases odds of a diagnosis of major depression in informal caregivers. Our review provides further evidence that BA is an effective psychological intervention, which is potentially highly scalable across many settings, populations and cultures (Registration: PROSPERO-CRD42019138860).",32663948,Major Depressive Disorder,Anxiety Treatment,Mental Health,38,10.580162048339844,-2.3449742794036865,Al3N
"Psychosocial preventive interventions to reduce depressive symptoms in low-SES women at risk: a meta-analysis.

Women who have low socioeconomic status (SES) or live in disadvantaged circumstances are a vulnerable group at risk for depression. Little is known about the efficacy of preventive interventions to reduce depressive symptoms in low-SES women. The aim of this study is to provide an overview of controlled outcome studies and to investigate the overall efficacy and moderators of interventions targeted at reducing depressive symptoms in this population. A systematic review and meta-analysis were conducted for 14 studies (N = 1396). The effect size of the studies was computed for outcomes assessing changes in depressive symptom levels using the standardized mean difference effect size. Study, target population, and intervention descriptors expected to influence effect size were analyzed using univariate subgroup and metaregression techniques with mixed-effects statistical models. The estimated overall effect size of 0.31 was significant; study sample characteristics, intervention characteristics and the research design of the studies did not moderate intervention effects. Limitations to this study are the relatively limited number of well controlled studies that could be included in the analyses. A number of promising programs have been developed specifically for low-SES women, a population at high risk for developing major depression. On average these programs were found to reduce the level of depressive symptoms, with more than half of the studies showing medium to large effect sizes. This indicates that considerable mental health benefits can be gained among disadvantaged women.",20346517,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.74710464477539,-4.951314449310303,DMVD
"Evaluating the efficacy and cost-effectiveness of web-based indicated prevention of major depression: design of a randomised controlled trial.

Major depressive disorder (MDD) imposes a considerable disease burden on individuals and societies. Web-based interventions have shown to be effective in reducing depressive symptom severity. However, it is not known whether web-based interventions may also be effective in preventing the onset of MDD. The aim of this study is to evaluate the (cost-) effectiveness of an indicated web-based guided self-help intervention (GET.ON Mood Enhancer Prevention) on the onset of MDD. A randomised controlled trial (RCT) will be conducted to compare the (cost-) effectiveness of the GET.ON Mood Enhancer Prevention training with a control condition exclusively receiving online-based psychoeducation on depression. Adults with subthreshold depression (N = 406) will be recruited from the general population and randomised to one of the two conditions. The primary outcome is time to onset of MDD within a 12-months follow-up period. MDD will be assessed according to DSM-IV criteria as assessed by the telephone-administered Structured Clinical Interview for DSM-IV (SCID). Time to onset of MDD will be assessed using life charts. Secondary outcomes include changes on various indicators of depressive symptom severity, anxiety and quality of life from baseline to post-treatment, to a 6-month and a 12-month follow up. Additionally, an economic evaluation using a societal perspective will be conducted to examine the intervention's cost-effectiveness. This is one of the first randomised controlled trials that examines the effect of an indicated guided self-help web-based intervention on the incidence of major depression. If shown to be effective, the intervention will contribute to reducing the disease burden due to MDD in the general population. German Clinical Trial Registration DRKS00004709.",24485283,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.05859661102295,-3.001843214035034,CSv2
"Help-seeking characteristics of Chinese- and English-speaking Australians accessing Internet-delivered cognitive behavioural therapy for depression.

Internet treatments may overcome barriers and improve access to mental health services for people who do not access professional help. It may be particularly beneficial for Chinese Australians, a group that tends to delay and underutilize face-to-face treatments. This study explored the appeal of Internet therapy to Chinese- and English-speaking Australians with depression who accessed Internet-delivered cognitive behavioural therapy (iCBT) programs. Data collected from previous randomised controlled trials of iCBT depression programs were used. Using a matched samples design, 55 Chinese- and 55 English-speaking iCBT participants with depression were matched on age, gender, and depression screener scores. They were compared on their symptom severity, previous help-seeking patterns, and reasons for seeking Internet treatment. The Chinese-speaking participants had significantly milder depressive symptoms and were less likely to have previously sought professional help compared to the English-speaking participants (all ps < 0.05). Both groups endorsed similar number of reasons for seeking iCBT, and the most common reasons related to reduced structural barriers. However, the Chinese-speaking participants were more likely to seek iCBT due to lack of knowledge about face-to-face treatment (p = 0.005), while the English-speaking participants were more likely to report not benefiting from traditional help (p = 0.030). The attraction of iCBT appears to be the reduction of structural barriers to treatment. iCBT may reduce treatment delay and increase access to Chinese Australians who have not sought professional help. English-speaking Australians are seeking iCBT as an additional means of getting help.",25193374,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.317548751831055,-4.760774612426758,CIyO
"Third-wave cognitive therapy versus mentalisation-based treatment for major depressive disorder: a randomised clinical trial.

To compare the benefits and harms of third-wave cognitive therapy versus mentalisation-based therapy in a small sample of depressed participants. The trial was conducted at an outpatient psychiatric clinic for non-psychotic patients in Roskilde, Denmark. 44 consecutive adult participants diagnosed with major depressive disorder. 18weeks of third-wave cognitive therapy (n=22) versus 18weeks of mentalisation-based treatment (n=22). The primary outcome was the Hamilton Rating Scale for Depression (HDRS) at end of treatment (18weeks). Secondary outcomes were: remission (HDRS <8), Beck's Depression Inventory, Symptom Checklist 90 Revised and The WHO-Five Well-being Index 1999. The trial inclusion lasted for about 2years as planned but only 44 out of the planned 84 participants were randomised. Two mentalisation-based participants were lost to follow-up. The unadjusted analysis showed that third-wave participants compared with mentalisation-based participants did not differ significantly regarding the 18weeks HDRS score (12.9 vs 17.0; mean difference -4.14; 95% CI -8.30 to 0.03; p=0.051). In the analysis adjusted for baseline HDRS score, the difference was favouring third-wave cognitive therapy (p=0.039). At 18weeks, five of the third-wave participants (22.7%) were in remission versus none of the mentalisation-based participants (p=0.049). We recorded no suicide attempts or suicides during the intervention period in any of the 44 participants. No significant differences were found between the two intervention groups on the remaining secondary outcomes. Third-wave cognitive therapy may be more effective than mentalisation-based therapy for depressive symptoms measured on the HDRS. However, more randomised clinical trials are needed to assess the effects of third-wave cognitive therapy and mentalisation-based treatment for depression. Registered with Clinical Trials government identifier: NCT01070134.",25138802,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.958187103271484,-2.1741626262664795,CJlP
"Economic Evaluation of an Internet-Based Preventive Cognitive Therapy With Minimal Therapist Support for Recurrent Depression: Randomized Controlled Trial.

Major depressive disorder (MDD) is highly recurrent and has a significant disease burden. Although the effectiveness of internet-based interventions has been established for the treatment of acute MDD, little is known about their cost effectiveness, especially in recurrent MDD. Our aim was to evaluate the cost effectiveness and cost utility of an internet-based relapse prevention program (mobile cognitive therapy, M-CT). The economic evaluation was performed alongside a single-blind parallel group randomized controlled trial. Participants were recruited via media, general practitioners, and mental health care institutions. In total, 288 remitted individuals with a history of recurrent depression were eligible, of whom 264 were randomly allocated to M-CT with minimal therapist support added to treatment as usual (TAU) or TAU alone. M-CT comprised 8 online lessons, and participants were advised to complete 1 lesson per week. The economic evaluation was performed from a societal perspective with a 24-month time horizon. The health outcomes were number of depression-free days according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV) criteria assessed with the Structured Clinical Interview for DSM-IV axis I disorders by blinded interviewers after 3, 12, and 24 months. Quality-adjusted life years (QALYs) were self-assessed with the three level version of the EuroQol Five Dimensional Questionnaire (EQ-5D-3L). Costs were assessed with the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness (TiC-P). Incremental cost-effectiveness ratios were calculated and cost-effectiveness planes and cost-effectiveness acceptability curves were displayed to assess the probability that M-CT is cost effective compared to TAU. Mean total costs over 24 months were €8298 (US $9415) for M-CT and €7296 (US $8278) for TAU. No statistically significant differences were found between M-CT and TAU regarding depression-free days and QALYs (P=.37 and P=.92, respectively). The incremental costs were €179 (US $203) per depression-free day and €230,816 (US $261,875) per QALY. The cost-effectiveness acceptability curves suggested that for depression-free days, high investments have to be made to reach an acceptable probability that M-CT is cost effective compared to TAU. Regarding QALYs, considerable investments have to be made but the probability that M-CT is cost effective compared to TAU does not rise above 40%. The results suggest that adding M-CT to TAU is not effective and cost effective compared to TAU alone. Adherence rates were similar to other studies and therefore do not explain this finding. The participants scarcely booked additional therapist support, resulting in 17.3 minutes of mean total therapist support. More studies are needed to examine the cost effectiveness of internet-based interventions with respect to long-term outcomes and the role and optimal dosage of therapist support. Overall, more research is needed on scalable and cost-effective interventions that can reduce the burden of recurrent MDD. Netherlands Trial Register NTR2503; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2503 (Archived by WebCite at http://www.webcitation.org/73aBn41r3).",30478021,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.939266204833984,-2.560901403427124,BCsl
"[Day-clinic and Inpatient Psychotherapy of Depression (DIP-D)--Secondary Outcomes and Follow-up Results of a Randomized-Controlled Pilot Trial].

Depressions are frequent disorders in psychosomatic medicine and psychotherapy. However, there are only few controlled studies comparing different levels of care for depressed patients. Especially the efficacy of day-clinic psychotherapy for depression remains understudied. The pilot study aims to close this gap by examining the feasibility of a randomized-controlled trial comparing day-clinic and inpatient psychotherapy for depression in a routine hospital setting. The current paper adds the secondary outcome measures on patient self-reported symptoms and interpersonal problems. In addition, findings of a 6-month follow-up are analyzed. Overall, 44 patients were recruited and randomly allocated to either day clinic or inpatient psychotherapy for 8 weeks. Depressive symptoms and interpersonal problems decreased during treatment, and follow-up scores stayed below intake scores. There were no differences between the treatment groups in this pilot study. For the future, it is desirable to compare randomized patients with those patients who received their preferred treatment option. Although the findings need to be replicated in larger samples, they appear promising for day-clinic psychotherapy. The better understanding of differential effectiveness of different levels of care of patient subgroups remains an important goal.",25927239,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,10.669429779052734,-3.0916619300842285,B+WD
"The contribution of active medication to combined treatments of psychotherapy and pharmacotherapy for adult depression: a meta-analysis.

Although there is sufficient evidence that combined treatments of psychotherapy and pharmacotherapy are more effective for depression in adults than each of the treatments alone, it remains unclear what the exact contribution of active medication is to the overall effects of combined treatments. This paper examines the contribution of active medication to combined psychotherapy and pharmacotherapy treatments. Meta-analysis of randomised controlled trials comparing the combination of psychotherapy and pharmacotherapy with the combination of psychotherapy and placebo. Sixteen identified studies involving 852 patients met our inclusion criteria. The standardised mean difference indicating the differences between the combination of psychotherapy and pharmacotherapy and the combination of psychotherapy and placebo was 0.25 (95% CI: 0.03-0.46), which corresponds to a numbers-needed-to-be-treated of 7.14. No significant differences between subgroups of studies were found. Active medication has a small but significant contribution to the overall efficacy of combined treatments.",19922522,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.640301704406738,-1.139304757118225,DP/P
"Second-generation antidepressants and cognitive-behavioural therapy are both viable choices for initial treatment of major depression.

",27581690,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.607823371887207,-0.6879240274429321,Bn2+
"A randomized effectiveness trial of interpersonal psychotherapy for depressed women with sexual abuse histories.

Many depressed women seen in community mental health centers (CMHCs) have histories of childhood sexual abuse and are economically disadvantaged. Randomized trials are needed to test the effectiveness of evidence-based interventions in this population and setting. This study compared interpersonal psychotherapy with usual care psychotherapy among women in a CMHC. Among 1,100 women seeking treatment in a CMHC, 230 (21%) had major depression and histories of childhood sexual abuse. Seventy women with major depression and sexual abuse before age 18 were randomly assigned to interpersonal psychotherapy (N=37) or usual care psychotherapy (N=33). Staff clinicians provided all treatments. Participants were assessed at study entry and at ten, 24, and 36 weeks after random assignment. Generalized estimating equations were used to examine change over time. Compared with women assigned to usual care, women who received interpersonal psychotherapy had greater reductions in depressive symptoms (Hamilton Rating Scale, p=.05, d=.34; Beck Depression Inventory-II, p=.01, d=.29), posttraumatic stress disorder symptoms (p=.04, d=.76), and shame (p=.002, d=.38). Interpersonal psychotherapy and usual care yielded comparable improvements in social and mental health-related functioning. Interpersonal psychotherapy compared favorably to usual care psychotherapy in a CMHC in improving psychiatric symptoms and reducing shame among sexually abused women. However, there is a critical need for continued research to develop more effective treatments for the social and psychiatric sequelae of interpersonal trauma and socioeconomic disadvantage.",21459988,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.558259963989258,-3.9923617839813232,C97U
"Effectiveness of cognitive-behavioral treatment for major depressive disorder in a university psychology clinic.

Major Depressive Disorder (MDD) is the most prevalent mental disorder in our environment, and one of the main causes of disability. While several empirically supported treatments (ESTs) for MDD exist, some doubts have been cast on the applicability--in time, components, and effectiveness--of these ESTs in routine clinical practice. A few attempts have been made to contrast the effectiveness of ESTs, but usually the precise components of the treatment developed are not considered in detail. The purpose of this study is to analyze the components of an EST-based treatment on a sample of 69 MDD cases from a University Psychology Clinic, and to benchmark them against the results of published efficacy studies on ESTs (behavioral activation, cognitive therapy, interpersonal therapy). Results show that treatments delivered at this clinical facility are similar in components, length, and effectiveness (in effect size, completers and improved ratio) to the benchmarked studies. Cognitive restructuring is the most frequent component of the delivered treatments. Therapy results show a 3.12 effect size, and a 55.1% improved ratio over initial sample, an 80% of completers. Results and limitations of the current study, especially those related to sample and center characteristics, are discussed.",23156941,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.971168518066406,-1.9621533155441284,ClrB
"Journal Watch review of Comparison of cognitive-behavioral therapy with psychoanalytic and psychodynamic therapy for depressed patients: a three-year follow-up study.

",24610764,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.381078720092773,-2.9445507526397705,CRJ0
"The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.

The effects of non-directive supportive therapy (NDST) for adult depression have been examined in a considerable number of studies, but no meta-analysis of these studies has been conducted. We selected 31 studies on NDST from a comprehensive database of trials, examining psychotherapies for adult depression, and conducted meta-analyses in which NDST was compared with control groups, other psychotherapies and pharmacotherapy. We found that NDST is effective in the treatment of depression in adults (g=0.58; 95% CI: 0.45-0.72). NDST was less effective than other psychological treatments (differential effect size g=-0.20; 95% CI: -0.32 to -0.08, p<0.01), but these differences were no longer present after controlling for researcher allegiance. We estimated that extra-therapeutic factors (those processes operating in waiting-list and care-as-usual controls) were responsible for 33.3% of the overall improvement, non-specific factors (the effects of NDST compared with control groups) for 49.6%, and specific factors (the effects of NDST compared with other therapies) for 17.1%. NDST has a considerable effect on symptoms of depression. Most of the effect of therapy for adult depression is realized by non-specific factors, and our results suggest that the contribution of specific effects is limited at best.",22466509,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.0042142868042,-1.7326812744140625,CvTG
"Differential role of CBT skills, DBT skills and psychological flexibility in predicting depressive versus anxiety symptom improvement.

Studies have reported associations between cognitive behavioral therapy (CBT) skill use and symptom improvement in depressed outpatient samples. However, little is known regarding the temporal relationship between different subsets of therapeutic skills and symptom change among relatively severely depressed patients receiving treatment in psychiatric hospital settings. Adult patients with major depression (N = 173) receiving combined psychotherapeutic and pharmacological treatment at a psychiatric hospital completed repeated assessments of traditional CBT skills, DBT skills and psychological flexibility, as well as depressive and anxiety symptoms. Results indicated that only use of behavioral activation (BA) strategies significantly predicted depressive symptom improvement in this sample; whereas DBT skills and psychological flexibility predicted anxiety symptom change. In addition, a baseline symptom severity X BA strategies interaction emerged indicating that those patients with higher pretreatment depression severity exhibited the strongest association between use of BA strategies and depressive symptom improvement. Findings suggest the importance of emphasizing the acquisition and regular use of BA strategies with severely depressed patients in short-term psychiatric settings. In contrast, an emphasis on the development of DBT skills and the cultivation of psychological flexibility may prove beneficial for the amelioration of anxiety symptoms.",27057997,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.738663673400879,-2.805673599243164,BuhH
"Melancholic and atypical depression as predictor and moderator of outcome in cognitive behavior therapy and pharmacotherapy for adult depression.

Melancholic and atypical depression are widely thought to moderate or predict outcome of pharmacological and psychological treatments of adult depression, but that has not yet been established. This study uses the data from four earlier trials comparing cognitive behavior therapy (CBT) versus antidepressant medications (ADMs; and pill placebo when available) to examine the extent to which melancholic and atypical depression moderate or predict outcome in an ""individual patient data"" meta-analysis. We conducted a systematic search for studies directly comparing CBT versus ADM, contacted the researchers, integrated the resulting datasets from these studies into one big dataset, and selected the studies that included melancholic or atypical depressive subtyping according to DSM-IV criteria at baseline (n = 4, with 805 patients). After multiple imputation of missing data at posttest, mixed models were used to conduct the main analyses. In none of the analyses was melancholic or atypical depression found to significantly moderate outcome (indicating a better or worse outcome of these patients in CBT compared to ADM; i.e., an interaction), predict outcome independent of treatment group (i.e., a main effect), or predict outcome within a given modality. The outcome differences between patients with melancholia or atypical depression versus those without were consistently very small (all effect sizes g < 0.10). We found no indication that melancholic or atypical depressions are significant or relevant moderators or predictors of outcome of CBT and ADM.",27921338,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.111099243164062,-1.735866665840149,Bjxb
"Efficacy of inpatient psychotherapy for major depressive disorder: a meta-analysis of controlled trials.

This meta-analysis investigates the efficacy of inpatient psychotherapy in major depressive disorders compared to control conditions. In total, 14 studies were entered into the meta-analysis with a total of 1.080 patients. Primary outcome was the standardized mean differences in self-rated depression outcomes. A priori planned subgroup analyses included the influence of different control conditions: (a) no psychiatric inpatient treatment (e.g., waitlist control), (b) treatment as usual (TAU; e.g., non-manualized clinical management), (c) TAU determined by study design (manualized/'placebo' control condition), as well as number of sessions and influence of self- vs. clinician ratings. The meta-analysis of 19 available comparisons resulted in a moderate pooled effect size showing a small and statistically significant benefit of the psychotherapeutic intervention over control conditions (g = 0.24, P < 0.001, I2 = 0%). This corresponds to a number needed to treat of 7.4. The effects of the interventions were stable over 12-month follow-up (g = 0.21, P < 0.01, I2 = 30%). Comparisons with waitlist or non-standardized control treatments tended to be associated with larger effect sizes than standardized control treatments. Despite some limitations (small number of studies), this meta-analysis provides evidence for a small but sustained effect of inpatient psychotherapy in patients with major depressive disorders.",30520019,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.914175033569336,-2.7525556087493896,BCNW
"Psychological interventions to reduce suicidality in high-risk patients with major depression: a randomized controlled trial.

Positive psychological constructs have been associated with reduced suicidal ideation, and interventions to cultivate positive feelings have the potential to reduce suicide risk. This study compares the efficacy of a 6-week, telephone-based positive psychology (PP) intervention against a cognition-focused (CF) control intervention among patients recently hospitalized for depression and suicidal ideation or behavior. A total of 65 adults with a current major depressive episode reporting suicidal ideation or a recent suicide attempt were enrolled from participating in-patient psychiatric units. Prior to discharge, participants were randomized to the PP (n = 32) or CF (n = 33) intervention. In both interventions, participants received a treatment manual, performed weekly PP (e.g. gratitude letter) or CF (e.g. recalling daily events) exercises, and completed weekly one-on-one telephone sessions over 6 weeks. Between-group differences in hopelessness (primary outcome), depression, suicidality and positive psychological constructs at 6 and 12 weeks were tested using mixed-effects models accounting for intensity of post-hospitalization psychiatric treatment. Compared with PP, the CF intervention was associated with significantly greater improvements in hopelessness at 6 weeks (β = -3.15, 95% confidence interval -6.18 to -0.12, effect size = -0.84, p = 0.04), but not 12 weeks. Similarly, the CF intervention led to greater improvements in depression, suicidal ideation, optimism and gratitude at 6 and 12 weeks. Contrary to our hypothesis, the CF intervention was superior to PP in improving hopelessness, other suicide risk factors and positive psychological constructs during a key post-discharge period among suicidal patients with depression. Further study of this CF intervention is warranted in populations at high suicide risk.",27876105,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,15.311491012573242,-8.300612449645996,BkVr
"Treating depression and substance use: a randomized controlled trial.

Few integrated substance use and depression treatments have been developed for delivery in outpatient substance abuse treatment settings. To meet the call for more ""transportable"" interventions, we conducted a pilot study to test a group cognitive-behavioral therapy (CBT) for depression and substance use that was designed for delivery by outpatient substance abuse treatment counselors. Seventy-three outpatient clients were randomized to usual care enhanced with group CBT or usual care alone and assessed at three time points (baseline and 3 and 6 months postbaseline). Our results demonstrated that the treatment was acceptable and feasible for delivery by substance abuse treatment staff despite challenges with recruiting clients. Both depressive symptoms and substance use were reduced by the intervention but were not significantly different from the control group. These results suggest that further research is warranted to enhance the effectiveness of treatment for co-occurring disorders in these settings.",22301087,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,11.078836441040039,-2.781487226486206,Cx29
"Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial.

Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov:NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n= 249), were randomly allocated to either discontinue (n= 128) or continue (n= 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT.",26892847,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.826323509216309,-0.6707791686058044,Bw0S
"Web-Based Positive Psychology Interventions: A Reexamination of Effectiveness.

Seligman, Steen, Park, and Peterson (2005) suggested that positive psychology interventions (PPIs) contain specific, powerful, therapeutic ingredients that effect greater increases in happiness and reductions in depression than a placebo control. This study reexamined the three PPIs that Seligman et al. found to be most effective when delivered over the internet. Three PPIs and a placebo control, identical with the interventions used by Seligman et al., were examined in a web-based, randomized assignment design. Mixed-design analysis of variance and multilevel modeling showed that all interventions, including the placebo, led to significant increases in happiness and reductions in depression. The effects of PPIs were indistinguishable from those of the placebo control. Using web-based delivery, both PPIs and theoretically neutral placebos can increase happiness and reduce depression in self-selected populations. Possible explanations include that non-specific factors common to most therapeutic treatments are responsible for the observed changes, or that cultural or other context-related variables operate to account for the divergent findings.",27377826,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,11.042716979980469,-3.7686755657196045,BqcO
"How individuals change during internet-based interventions for depression: A randomized controlled trial comparing standardized and individualized feedback.

Standardized and individualized Internet-based interventions (IBI) for depression yield significant symptom improvements. However, change patterns during standardized or individualized IBI are unknown. Identifying subgroups that experience different symptom courses during IBI and their characteristics is vital for improving response. Mildly to moderately depressed individuals according to self-report (N = 1,089) were randomized to receive module-wise feedback that was either standardized or individualized by a counselor within an otherwise identical cognitive-behavioral IBI for depression (seven modules over six weeks). Depressive symptoms were assessed at baseline and before each module (Patient Health Questionnaire; PHQ-9). Other individual characteristics (self-report) and the presence of an affective disorder (structured clinical interview) were assessed at baseline. Growth mixture modeling was used to identify and compare subgroups with discernable change patterns and associated client variables across conditions. Model comparisons suggest equal change patterns in both conditions. Across conditions, a group of immediate (62.5%) and a group of delayed improvers (37.5%) were identified. Immediate improvers decreased their PHQ-9 score by 5.5 points from pre to post, with 33% of improvement occurring before treatment commenced. Delayed improvers were characterized by stable symptom severity during the first two modules and smaller overall symptom decrease (3.4 points). Higher treatment expectations, a current major depressive disorder (interview), and lower social support were associated with delayed improvement. Internet-based interventions for depression with individualized and with standardized feedback lead to comparable patterns of change. Expectation management and bolstering of social support are promising strategies for individuals that are at risk for delayed improvement.",31777204,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.34520435333252,-3.196457624435425,AxJN
"Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd.",28488378,Major Depressive Disorder,Anxiety Treatment,Mental Health,1989,11.84752082824707,-2.336719274520874,Bcz+
"Effects of an internet-based cognitive behavioral therapy (iCBT) intervention on improving depressive symptoms and work-related outcomes among nurses in Japan: a protocol for a randomized controlled trial.

Depression is a major problem among nurses; hence, it is important to develop a primary prevention strategy to manage depression among nurses. This randomized controlled trial (RCT) study aims to investigate the effects of a newly developed internet-based cognitive behavioral therapy (iCBT) program on depressive symptoms, measured at baseline and three- and six-month follow-ups, among nurses in Japan. Nurses working at three university hospitals, one public hospital, and twelve private hospitals who meet inclusion criteria will be recruited and randomized either to the intervention group or the control group (planned N=525 for each group). The newly developed iCBT program for nurses consists of six modules, which cover different components of cognitive behavioral therapy (CBT); transactional stress model (in module 1), self-monitoring skills (in module 2), behavioral activation skills (in module 3), cognitive restructuring skills (in modules 4 and 5), relaxation skills (in module 5), and problem-solving skills (in module 6). Participants in the intervention group will be asked to read these modules within 9 weeks. The primary outcome will be depressive symptoms as assessed by the Beck Depression Inventory-II (BDI-II) at baseline, three-, and six-month follow-ups. The greatest strength of this study is that it is the first RCT to test the effectiveness of the iCBT program in improving depressive symptoms among nurses. A major limitation is that all measurements, including major depressive episodes, are self-reported and may be affected by situational factors at work and participants' perceptions. This trial was registered at the University Hospital Medical Information Network clinical trials registry (UMIN-CTR; ID= UMIN000033521 ) (Date of registration: August 1, 2018).",31391029,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.933085441589355,-2.542255401611328,A2XU
"Supported self-help to prevent relapse or recurrence of depression: Who benefits most?

This study aimed to identify subgroups for whom supported self-help preventive cognitive therapy (S-PCT) is more (cost)effective than treatment as usual (TAU) in preventing relapse and recurrence of major depression. We conducted a randomized controlled trial in which 248 remitted, recurrently depressed participants were randomized to S-PCT (n = 124) or TAU (n = 124). Clinical outcome was relapse or recurrence of major depressive disorder (SCID-I). We tested the moderating effects on relapse or recurrence of age, gender, education level, residual depressive symptoms, number of previous episodes, age of onset, antidepressant medication, somatization, and self-efficacy with logistic regression analyses adjusted for baseline values of depressive symptoms. We examined moderating effects on costs using linear regression analyses adjusted for baseline costs. A stratified cost-effectiveness analysis was performed to tease out differences in cost-effectiveness between subgroups. We found no moderating effect on relapse or recurrence for any of the potential moderators. For costs, the number of previous depressive episodes was identified as a moderator. At a willingness-to-pay of 16,000€, the probability that S-PCT was cost-effective compared to TAU was 95% for participants with 2-3 episodes and 11% for participants with ≥4 episodes. Participants and counselors were not blinded. The study was primarily designed to assess the (cost)effectiveness of S-PCT and not to conduct moderation analyses. S-PCT was effective in preventing relapse or recurrence of depressive disorders in a broad range of participants, but is more likely to be cost-effective in participants with 2-3 episodes than ≥4 episodes. This indicates that S-PCT can best be offered to participants with fewer previous depressive episodes.",31301621,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.207144737243652,-0.8386212587356567,A3l2
"Dropout rates in clinical trials of smartphone apps for depressive symptoms: A systematic review and meta-analysis.

Low engagement and attrition from app interventions is an increasingly recognized challenge for interpreting and translating the findings from digital health research. Focusing on randomized controlled trials (RCTs) of smartphone apps for depressive symptoms, we aimed to establish overall dropout rates, and how this differed between different types of apps. A systematic review of RCTs of apps targeting depressive symptoms in adults was conducted in May 2019. Random-effects meta-analysis were applied to calculate the pooled dropout rates in intervention and control conditions. Trim-and-fill analyses were used to adjust estimates after accounting for publication bias. The systematic search retrieved 2,326 results. 18 independent studies were eligible for inclusion, using data from 3,336 participants randomized to either smartphone interventions for depression (n = 1,786) or control conditions (n = 1,550). The pooled dropout rate was 26.2%. This increased to 47.8% when adjusting for publication bias. Study retention rates did not differ between depression vs. placebo apps, clinically-diagnosed vs. self-reported depression, paid vs. unpaid assessments, CBT vs. non-CBT apps, or mindfulness vs. non-mindfulness app studies. Dropout rates were higher in studies with large samples, but lower in studies offering human feedback and in-app mood monitoring. High dropout rates present a threat to the validity of RCTs of mental health apps. Strategies to improve retention may include providing human feedback, and enabling in-app mood monitoring. However, it critical to consider bias when interpreting results of apps for depressive symptoms, especially given the strong indication of publication bias, and the higher attrition in larger studies.",31969272,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.482564449310303,-5.969541549682617,Auih
"Self-monitoring and personalized feedback based on the experiencing sampling method as a tool to boost depression treatment: a protocol of a pragmatic randomized controlled trial (ZELF-i).

Depression is a leading cause of disability worldwide. To reduce the societal burden and improve quality of life for individual patients, treatments for depression need to be optimized. There is a particular need for person-tailored interventions that reinforce self-management of patients. Systematic self-monitoring and personalized feedback through the Experience Sampling Method (ESM) could provide such a person-tailored, empowering intervention that enhances treatment outcomes. The primary aim of this study is to investigate the efficacy of self-monitoring and personalized feedback as an add-on tool in the treatment of depressive complaints in a natural setting. The ZELF-i study is a pragmatic multi-site randomized controlled trial (RCT). We aim to recruit 150 individuals with depressive symptoms aged between 18 and 65 years, who have an intake for outpatient basic or specialized treatment at a mental health care organization in the North of the Netherlands. After the intake, participants will be randomly allocated to one of three study arms: two experimental groups engaging in 28 days of systematic self-monitoring (5 times per day) and receiving weekly personalized feedback on positive affect and activities (""Do""-module) or on negative affect and thinking patterns (""Think""-module), and a control group receiving no additional intervention. Self-report inventories of depressive symptoms, psychosocial functioning and feelings of empowerment will be administered before and after the intervention period, and at follow-up measurements at 1, 2, 3 and 6 months. The patient-experienced utility of the intervention will be investigated by a combination of quantitative and qualitative research methods. The present study is the first to examine the effects of add-on self-monitoring and personalized feedback on depressive complaints in clinical practice. It is also the first to evaluate two different ESM modules targeted at both of depression's core symptoms. Lastly, it is the first study that uses a combination of qualitative and quantitative methods to evaluate the patient-experienced utility of ESM with personalized feedback as an intervention for depression. Results of the present study may improve treatment for depression, if the intervention is found to be effective. Dutch Trial Register, NTR5707 , registered prospectively 1 February 2016.",30176845,Major Depressive Disorder,Anxiety Treatment,Mental Health,9713,9.97765064239502,-3.730389356613159,BGrk
"Brief multifamily Psychoeducation for family members of patients with chronic major depression: a randomized controlled trial.

Major depressive disorder (MDD) is a common and often chronic problem. Patients with chronic MDD often have negative impacts on the health of their families. Family psychoeducation is recognized as part of the optimal treatment for patients with psychotic disorder, and has been shown to reduce the rate of relapse in individuals with schizophrenia and to reduce the burden on their caregivers. Thus, we predict that family psychoeducation has the potential to reduce the burden on the caregivers of patients with chronic MDD. In the present study, we aimed to investigate the effects of brief multifamily psychoeducation (BMP) on the mental health status of family members of patients with chronic MDD. We conducted a clinical trial consisting of 49 chronic MDD patients and their families. Each family was randomly assigned to either the BMP intervention group or the control group. The intervention group received four BMP sessions, once every two weeks for eight weeks. The control group received one counseling session administered by a nurse. All patients received standard treatment administered by physicians. The primary outcome measurement was the Kessler Screening Scale for Psychological Distress (K6) score of family members at 16- weeks after the first BMP session. Secondary outcomes were depressive symptoms of both family members and patients at multiple time points, as well as family functioning as evaluated by the patients. Intention-to-treat analyses were conducted. There was no statistically significant effect of BMP on K6 scores at 16- weeks (mean difference 1.17, 95% confidence interval: -0.63 to 2.98, P=0.19). Exploratory analyses revealed that BMP reduced depressive symptoms in family members at 8- weeks (difference=-3.37, 95%CI -6.32 to -0.43, P=0.02) and improved family functioning at multiple time points (Role; 8 W, difference=-0.13, 95%CI -0.26 to -0.00, P=0.04, Affective Responsiveness; 8 W, difference=-0.24, 95%CI -0.43 to -0.05, P=0.01, 32 W, difference=-0.22, 95%CI -0.41 to -0.03, P=0.02, Behavior Control; 16 W, difference=-0.17, 95%CI -0.34 to -0.00, P=0.04). Four BMP sessions did not significantly reduce the psychological distress of family members of patients with chronic MDD. Clinical Trials. gov NCT01734291 , retrospectively registered (Registration date: November 21, 2012).",29929495,Major Depressive Disorder,Anxiety Treatment,Mental Health,1033,10.960796356201172,-3.8347134590148926,BKCI
"The clinical effectiveness of evidence-based interventions for depression: a pragmatic trial in routine practice.

Controversy persists about how effectively empirically-supported treatments for major depression work in actual clinical practice as well as how patients choose among them. We examined the acute phase effectiveness of cognitive therapy (CT), interpersonal psychotherapy (IPT), and combined psychotherapy-pharmacotherapy (PHT) in a naturalistic setting, allowing patients their choice of treatment. The study compared CT (n=63), IPT (n=56), CT-PHT (n=34), and IPT-PHT (n=21) for 174 subjects with major depression in a secondary care mood disorders clinic. Patient preference, rather than randomization, determined treatment selection. The Beck Depression Inventory-II (BDI) was the primary outcome variable. Exclusion criteria were minimal. All treatments were associated with a reduction in depressive symptoms, with a 35% remission rate by week 26. Overall improvement was well within ranges reported in efficacy trials. On average, treatment effects of the different interventions straddled the same range, but moderation analyses revealed that BDI scores dropped faster in the first 16 weeks in patients who received CT alone than patients who received CT and pharmacotherapy, a pattern not found in patients who received IPT (with or without pharmacotherapy). Limitations consist of a modest sample size, choice of treatment was made by participants which may have been influenced by many sources, and the absence of a non-active control group. This study supports the effectiveness of empirically-supported antidepressant treatments selected by patients in routine settings, and provides an indication that speed of therapeutic response may vary amongst treatments.",22985486,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.082015037536621,-2.6442697048187256,CoIW
"How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study.

Depression and anxiety disorders are relapse-prone conditions, even after successful treatment with pharmacotherapy or psychotherapy. Cognitive behavioural therapy (CBT) is known to prevent relapse, but there is little evidence of the durability of remission after low intensity forms of CBT (LiCBT). This study aimed to examine relapse rates 12 months after completing routinely-delivered LiCBT. A cohort of 439 LiCBT completers with remission of symptoms provided monthly depression (PHQ-9) and anxiety (GAD-7) measures during 12 months after treatment. Survival analysis was conducted to model time-to-relapse while controlling for patient characteristics. Overall, 53% of cases relapsed within 1 year. Of these relapse events, the majority (79%) occurred within the first 6 months post-treatment. Cases reporting residual depression symptoms (PHQ-9 = 5 to 9) at the end of treatment had significantly higher risk of relapse (hazard ratio = 1.90, p < 0.001). The high rate of relapse after LiCBT highlights the need for relapse prevention, particularly for those with residual depression symptoms.",28437680,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.629980087280273,-2.2207112312316895,Bdi3
"Sudden gains and patterns of symptom change in cognitive-behavioral therapy for treatment-resistant depression.

The sudden gain (SG; large symptom improvements in one between-session interval) has been identified as a consistent predictor of better outcomes at posttreatment and over follow-up in cognitive-behavioral therapy (CBT) for depression. Other defined trajectories of symptom change in CBT, including linear (consistent changes in depression), log-linear (symptom change concentrated in early or late sessions), one-step (substantial change in depression symptoms between two adjacent sessions), and cubic (symptom decrease, increase, and decrease), also predict better treatment outcomes. We explored whether these patterns of symptom change occurred and predicted outcome in a sample of 156 adults with treatment-resistant depression who participated in a randomized controlled trial of CBT as an adjunct to pharmacotherapy (Wiles et al., 2013). Depression symptoms were assessed weekly with the Beck Depression Inventory-II. Multilevel modeling revealed that both SGs and having a defined trajectory predicted lower depression severity at 6- and 12-month follow-up, even controlling for baseline depression symptoms, early slopes of change, and symptom variability. These findings highlight the importance of examining longitudinal data and the robustness of the sudden gain pattern. They further suggest that having a defined symptom trajectory might confer its own advantages in predicting depression outcomes. Clinicians could use weekly depression scores to identify these key patterns of change to guide treatment decisions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).",31894993,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.19710636138916,-2.8295679092407227,Avhn
"Optimal duration of combined psychotherapy and pharmacotherapy for patients with moderate and severe depression: a meta-analysis.

To investigate the most effective duration of combined psychotherapy and pharmacotherapy for achieving remission and preventing relapse in depressive patients as compared to pharmacotherapy alone. A systematic review of English articles using PubMed, EMBASE, Web of Science, the Cochrane Library, and PsychINFO was performed in September 2009. Clinical studies comparing pharmacotherapy alone with pharmacotherapy in combination with a psychological intervention for depression treatment that reported response, remission or relapse as outcomes were included in the analysis. For each of the studies, clinical binary outcomes such as response, remission or relapse were extracted. All pooled analyses were based on random-effects models. Twenty-one article describing the influence of additional psychotherapy on remission and 15 articles reporting the influence on relapse in depression were included in the analysis. Patients receiving combined treatment experienced remission more often than those receiving pharmacotherapy alone, with the highest odds ratio OR, 2.36; 95% CI, 1.58-3.55 observed at 4months after commencing the treatment. Patients receiving pharmacotherapy alone also demonstrated a higher risk for relapse compared to those receiving combined treatment. We restricted our search to only English language publications. Studies investigating relapse or recurrence rates are often of small size. Pharmacotherapy enhanced with psychotherapy is associated with a higher probability of remission and a lower risk of relapse, as compared to antidepressants alone for depression treatment. Receiving psychotherapy in both the acute and continuation phases is the most effective option. Further research is needed to investigate the influence of additional psychotherapy on different patients.",20950863,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.83260440826416,-0.7188830971717834,DEiV
"ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: an 18-month follow-up.

The aim of the present study was to investigate two interventions based on Acceptance and Commitment Therapy (ACT) for depressive symptoms: A face-to-face treatment (ACT group) was compared to a guided self-help treatment delivered via the Internet consisting of two assessment sessions (pre and post) and an ACT-based Internet program (iACT). Outpatients experiencing at least mild depressive symptoms were randomized to either approach. The iACT treatment group received access to an ACT-based Internet program and supportive web-based contact over a period of 6 weeks. The face-to-face group received ACT-based treatment once a week over the same period of time. In both groups, the results showed a significant effect on depression symptomatology, and general wellbeing after treatment and at the 18-month follow-up. However, the data indicated that the iACT group changed differently regarding depressive symptoms and wellbeing as compared to the face-to face ACT group. Results showed large pre-treatment to 18-month follow-up within-group effect sizes for all symptom measures in the iACT treatment group (1.59-2.08), and for most outcome measures in the face-to-face ACT group (1.12-1.37). This non-inferiority study provides evidence that guided Internet-delivered ACT intervention can be as effective as ACT-based face-to-face treatment for outpatients reporting depressive symptoms, and it may offer some advantages over a face-to-face intervention.",25127179,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,8.276286125183105,-1.9449045658111572,CJwv
"The relationship between clients' depression etiological beliefs and psychotherapy orientation preferences, expectations, and credibility beliefs.

The purpose of this study was to examine the relationship between clients' etiological beliefs for depression and treatment preferences, credibility beliefs, and outcome expectations for five different depression treatments-behavioral activation, cognitive therapy, interpersonal psychotherapy, pharmacotherapy, and psychodynamic psychotherapy. Adult psychotherapy clients (N = 98) were asked to complete an online survey that included the Reasons for Depression Questionnaire, a brief description of each of the five treatment options, and credibility, expectancy, and preference questions for each option. On average, the participating clients rated pharmacotherapy as significantly less credible, having a lower likelihood of success, and being less preferred than the four types of psychotherapy. In general, interpersonal psychotherapy was also rated more negatively than the other types of psychotherapy. However, these findings depended somewhat on whether the participating client was personally experiencing depression. Credibility beliefs, outcome expectations, and preferences for pharmacotherapy were positively associated with biological beliefs for depression; however, the other hypothesized relationships between etiological beliefs and treatment attitudes were not supported. Although the study is limited based on the specific sample and treatment descriptions that were used, the results may still have implications for psychotherapy research, training, and practice. (PsycINFO Database Record",27642759,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.659825325012207,-4.016264915466309,BnG6
"Therapeutic effect of dynamic interpersonal group psychotherapy for taiwanese patients with depressive disorder.

This study investigated the therapeutic effects of dynamic interpersonal group psychotherapy (DIGP) for the depressed in Taiwan. A 16-session DIGP was held weekly, and participants were evaluated with the Hamilton Depression Rating Scale, Taiwanese Depression Questionnaire, and World Health Organization Quality of Life-BREF before and after DIGP. Compared with control group, the patients treated with DIGP showed significant improvement in severity of their depression, especially in the somatic subscale and quality of life regarding psychological health. We found that focusing on repairing interpersonal interaction in DIGP would improve the social interaction problems of Chinese with depressive disorder.",25188566,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.10222339630127,-3.8570380210876465,CI26
"The MARIGOLD study: Feasibility and enhancement of an online intervention to improve emotion regulation in people with elevated depressive symptoms.

This manuscript describes the first two phases of pilot testing MARIGOLD, an online self-guided positive emotion skills intervention for adults with elevated depressive symptoms, along with enhancements to overcome retention and adherence problems reported in previous research. Adults with elevated depressive symptoms were recruited online and assessed at baseline, post-intervention, 1- and 3-month follow-up. Phase 1 participants (n = 58) were randomized to MARIGOLD, daily emotion reporting, or waitlist. Phase 2 participants (n = 79) were randomized to MARIGOLD plus one enhancement: online discussion board (ODB), virtual badges (VB), or facilitator contact (FC). Post-intervention interviews assessed acceptability. Intention-to-treat analyses examined retention, adherence, and preliminary efficacy. In both phases, retention and adherence did not differ between groups. MARIGOLD skills were highly acceptable, but qualitative results indicate web-based features (e.g., log-in, ODB, VB) require refinement prior to larger testing. Neither phase demonstrated between-group differences in preliminary efficacy. In Phase 1 within-group analyses, MARIGOLD and emotion reporting control demonstrated a similar pattern of findings (stable depressive symptoms, increased positive emotion, decreased negative emotion and stress), whereas the waitlist group significantly increased in depressive mood. Most Phase 2 within-group analyses demonstrated the expected pattern of results (i.e., decreases in PHQ-8 and negative emotion, increases in positive emotion). However, CES-D scores were stable in FC; perceived stress was stable in FC and ODB. This pilot study is not powered to evaluate efficacy. Positive emotion skills, plus enhancements for web-based, self-guided delivery, warrant additional study in people with elevated depressive symptoms.",31302525,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.33283805847168,-2.7561376094818115,A3k2
"Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta-analysis.

Various control conditions have been employed in psychotherapy trials, but there is growing suspicion that they may lead to different effect size estimates. The present study aims to examine the differences among control conditions including waiting list (WL), no treatment (NT) and psychological placebo (PP). We comprehensively searched for all randomized controlled trials (RCTs) comparing cognitive-behaviour therapies (CBT) against various control conditions in the acute phase treatment of depression, and applied network meta-analysis (NMA) to combine all direct and indirect comparisons among the treatment and control arms. We identified 49 RCTs (2730 participants) comparing WL, NT, PP and CBT. This network of evidence was consistent, and the effect size estimates for CBT were substantively different depending on the control condition. The odds ratio of response for NT over WL was statistically significant at 2.9 (95% CI: 1.3-5.7). However, the quality of evidence, including publication bias, was less than ideal and none of the preplanned sensitivity analyses limiting to high-quality studies could be conducted, while findings of significant differences did not persist in post hoc sensitivity analyses trying to adjust for publication bias. There may be important differences in control conditions currently used in psychotherapy trials.",24697518,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.752166748046875,-1.43424391746521,CP12
"Adverse events during a disorder-specific psychotherapy compared to a nonspecific psychotherapy in patients with chronic depression.

A recent trial comparing Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and supportive psychotherapy in chronic depression found CBASP to be more effective in treating depressive symptoms. We aimed to evaluate adverse events that occurred during this trial. A randomized trial of chronically depressed outpatients was performed. The treatment included 32 sessions of CBASP or supportive psychotherapy. Therapists asked patients about adverse events and their intensity in each session using a standardized checklist. We analyzed the mean number of (severe) adverse events per patient up to Session 32 with gamma frailty recurrent event models. Two hundred and sixty patients were included in the analyses (66% female, mean age 45 years). Patients in the supportive psychotherapy group reported less severe adverse events in general, and less severe adverse events related to personal life and to occupational life than patients in the CBASP group. Less adverse events related to suicidal thoughts were reported in the CBASP compared with the supportive psychotherapy group. Differences in the adverse events profile may be explained by the treatment elements. Adverse events related to personal and occupational life for example might be considered a necessary and expected yet temporary adverse treatment outcome of an effective CBASP treatment.",31576565,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.191326141357422,-1.9359910488128662,Az7B
"The effects of blinding on the outcomes of psychotherapy and pharmacotherapy for adult depression: A meta-analysis.

Randomized trials with antidepressants are often run under double blind placebo-controlled conditions, whereas those with psychotherapies are mostly unblinded. This can introduce bias in favor of psychotherapy when the treatments are directly compared. In this meta-analysis, we examine this potential source of bias. We searched Pubmed, PsycInfo, Embase and the Cochrane database (1966 to January 2014) by combining terms indicative of psychological treatment and depression, and limited to randomized trials. We included 35 trials (with 3721 patients) in which psychotherapy and pharmacotherapy for adult depression were directly compared with each other. We calculated effect sizes for each study indicating the difference between psychotherapy and pharmacotherapy at post-test. Then, we examined the difference between studies with a placebo condition and those without in moderator analyses. We did not find a significant difference between the studies with and those without a placebo condition. The studies in which a placebo condition was included indicated no significant difference between psychotherapy and pharmacotherapy (g=-0.07; NNT=25). Studies in which no placebo condition was included (and patients and clinicians in both conditions were not blinded), resulted in a small, but significant difference between psychotherapy and pharmacotherapy in favor of pharmacotherapy (g=-0.13; NNT=14). Studies comparing psychotherapy and pharmacotherapy in which both groups of patients (and therapists) are not blinded (no placebo condition is included) result in a very small, but significantly higher effect for pharmacotherapy.",26169475,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.545031547546387,-1.1684614419937134,B69l
"Does Publication Bias Inflate the Apparent Efficacy of Psychological Treatment for Major Depressive Disorder? A Systematic Review and Meta-Analysis of US National Institutes of Health-Funded Trials.

The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression. We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972-2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6%) of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges' g = 0.20; CI95% -0.11~0.51; k = 6) to published studies (g = 0.52; 0.37~0.68; k = 20) reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70) by 25%. Moreover, these findings may overestimate the ""true"" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively. The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression.",26422604,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.22142219543457,-3.9777209758758545,B3Qr
"Relapse and recurrence prevention in depression: current research and future prospects.

There is a growing body of literature which indicates that acute phases of psychotherapy are often ineffective in preventing relapse and recurrence in major depression. As a result, there is a need to develop and evaluate therapeutic approaches which aim to reduce the risk of relapse. This article provides a review of the empirical studies which have tested the prophylactic effects of therapy (cognitive-behavioral, mindfulness-based, and interpersonal psychotherapy) targeting relapse and recurrence in major depression. For definitional clarity, relapse is defined here as a return to full depressive symptomatology before an individual has reached a full recovery, whereas recurrence in defined as the onset of a new depressive episode after a full recovery has been achieved. Psychotherapeutic efforts to prevent relapse and recurrence in depression have been effective to varying degrees, and a number of variables appear to moderate the success of these approaches. A consistent finding has been that preventive cognitive-behavioral and mindfulness-based therapies are most effective for patients with three or more previous depressive episodes, and alternative explanations for this finding are discussed. It is noted, however, that a number of methodological limitations exist within this field of research, and so a set of hypotheses that may guide future studies in this area is provided.",22020371,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.365135192871094,-0.699309766292572,C16+
"[A Group Cognitive-Behavioural Intervention to Prevent Depression Relapse in Individuals Having Recently Returned to Work: Protocol and Feasibility].

Workplace depression is one of the major causes for sick leave and loss of productivity at work. Many studies have investigated factors predicting return to work for people with depression, including studies evaluating return to work programs and organizational factors. Yet, a paucity of studies have targeted the prevention of depressive relapses at work, even though more than half of those having had a depression will have a depressive relapse in the near future.Objectives This article describes a research protocol involving a novel group intervention based on cognitive behavioural principles with the aim to optimize return to work and diminish risk of depressive relapses.Method This pilot study follows a randomized controlled trial design, with half the participants (N=25) receiving the group intervention and the other half (N=25) receiving usual services. The theoretical and empirical underpinnings of the intervention are described, along with a detailed presentation of the intervention and of the study's objectives. The group intervention consists of 8 sessions whereby Cognitive behavioural therapy (CBT) principles and techniques are applied to the following themes: (1) Coping with stress at work; (2) Recognizing and modifying my dysfunctional beliefs linked to work; (3) Overcoming obstacles linked to work functioning and maintaining work; (4) Negotiating needed work adjustments with the support of the immediate supervisor; (5) Finding my strengths and competencies related to work; (6) Accepting criticism and asserting myself appropriately at work; (7) Uncovering my best coping strategies for work.Results Qualitative information pertaining to the first two cohorts' participants' subjective appreciation of the group experience revealed that the intervention was perceived as very useful by all, with group support, namely harmony and interpersonal support, as well as CBT strategies being mentioned specifically.Conclusion Finally, the potential relevance of the group intervention will be brought forward.",29267415,Major Depressive Disorder,Anxiety Treatment,Mental Health,2307,8.915915489196777,-4.197856426239014,BSY2
"Intensity of Treatment as Usual and Its Impact on the Effects of Face-to-Face and Internet-Based Psychotherapy for Depression: A Preregistered Meta-Analysis of Randomized Controlled Trials.

Treatment as usual (TAU) is the most frequently used control group in randomized trials of psychotherapy for depression. Concerns have been raised that the heterogeneity of treatments in TAU leads to biased estimates of psychotherapy efficacy and to an unclear difference between TAU and control groups like waiting list (WL). We investigated the impact of control group intensity (i.e., amount and degree to which elements of common depression treatments are provided) on the effects of face-to-face and internet-based psychotherapy for depression. We conducted a preregistered meta-analysis (www.osf.io/4mzyd). We included trials comparing psychotherapy with TAU or WL in patients with symptoms of unipolar depression. Six indicators were used to assess control group intensity. Standardized mean difference (SMD) of psychotherapy and control in depressive symptoms at treatment termination. We included 89 trials randomizing 14,474 patients to 113 psychotherapy conditions and 89 control groups (TAU in 42 trials, WL in 47 trials). Control group intensity predicted trial results in preregistered (one-sided ps < 0.042) and exploratory analyses. Psychotherapy effects were significantly smaller (one-sided p = 0.002) in trials with higher intensity TAU (SMD = 0.324, CI 0.209 to 0.439) than in trials with lower intensity TAU (SMD = 0.628, CI 0.455 to 0.801). Psychotherapy effects against lower intensity TAU did not differ from effects against WL (two-sided p = 0.663). Our results suggest that variation in TAU intensity impacts the outcome of trials. More scrutiny in the design of control groups for clinical trials is recommended.",35158363,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.808188438415527,-2.7655835151672363,niE
"Randomized trial of Internet-based relapse prevention for partially remitted depression.

To investigate whether Internet-based cognitive behaviour therapy (CBT) can prevent relapse in persons with partially remitted major depression after previous treatment. Seventy-one women and 13 men (N = 84) with partially remitted major depression after treatment were randomly assigned to either 10 weeks of Internet-based CBT or to a control group. Self-help material was used in combination with e-mail contact with a personal therapist. Monthly self-ratings of depressive symptoms were made, and diagnostic interviews were conducted before and after the treatment period, as well as 6 months later. Significantly fewer participants in the CBT group experienced relapse (4/38 or 10.5%) compared with those in the control group (14/37 or 37.8%). The difference in relapse rates between groups occurred early in the study period and was still apparent after 6 months. A trend towards a larger reduction in depressive symptoms was observed at post-treatment in the participants who received CBT compared with controls. Reduction in depressive symptoms reduced the risk of relapse. A trend towards a higher remission rate was found in the CBT group at the 6 month follow-up. Internet-based CBT seems promising in preventing relapse in persons with partially remitted major depression after previous treatment.",21401534,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.005454063415527,-2.168890953063965,C+xX
"Computer-Assisted Cognitive-Behavior Therapy for Depression in Primary Care: Systematic Review and Meta-Analysis.

To examine evidence for the effectiveness of computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care and assess the impact of therapist-supported CCBT versus self-guided CCBT. A search for randomized studies of CCBT compared to control groups for treating depression in primary care settings was conducted using Ovid MEDLINE, PsycINFO, PubMed, and Scopus. We extracted the following information from the studies that met inclusion criteria: mean depression rating scale scores before and after treatment, number of patients, type of control group and CCBT program, therapist support time and method of support, and treatment completion rate. Meta-analyses compared differences between posttreatment mean scores in each condition, as well as mean scores at follow-up. Study quality and possible bias also were assessed. Eight studies of CCBT for depression in primary care met inclusion criteria. The overall effect size was g = 0.258, indicating a small but significant advantage for CCBT over control conditions. Therapist support was provided in 4 of the 8 studies. The effect size for therapist-supported CCBT was g = 0.372-a moderate effect. However, the effect size for self-guided CCBT was g = 0.038, indicating little effect. Implementation of therapist-supported CCBT in primary care settings could enhance treatment efficiency, reduce cost, and improve access to effective treatment for depression. However, evidence to date suggests that self-guided CCBT offers no benefits over usual primary care.",29570963,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.70462417602539,-2.7524240016937256,BONy
"Effectiveness of CBT and its modifications for prevention of relapse/recurrence in depression: A systematic review and meta-analysis of randomized controlled trials.

CBT and its modifications are effective for depression, but its efficacy for preventing depressive relapse/recurrence remains unclear. A systematic review and meta-analysis was conducted scrutinizing the efficacy of CBT and its modifications for preventing depressive relapse/recurrence in randomized controlled trials. The retrieval database included PubMed, Web of Science, MEDLINE, and three major Chinese databases (CNKI, VIP, Wanfang), and the retrieval period was from January 1, 2009, to July 1, 2022. Data were analyzed by RevMan 5.4 and Stata 16. A total of 28 randomized controlled trials with 3938 participants were included. The relapse/recurrence rates in CBT and its modifications and the control group were 31.6 % and 41.3 %, respectively; CBT and its modifications significantly reduced the risk of developing a new depressive episode (RR, 0.73, 95%CI, 0.64-0.83). Stratified by follow-up time, both CBT and its modifications significantly reduced the relapse/recurrence of depression at ≤12 months (RR, 0.61, 95%CI, 0.47-0.79) and > 12 months (RR, 0.74, 95%CI, 0.59-0.93) compared with other active treatments. The beneficial effects of CBT and its modifications alone in reducing depressive relapse/recurrence were equivalent to those of antidepressant medication alone (RR, 1.01, 95 % CI, 0.79-1.28). Meta-regression results showed that the intervention method (P = 0.005) was one of the sources of heterogeneity. Further subgroup analysis is limited by the literature. CBT and its modifications are reliable interventions for preventing relapse/recurrence in patients with depression. Further research is needed to determine the specific conditions for CBT and its applications in clinical practice.",36162683,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.556180953979492,-1.5421695709228516,GD8
"Is there an excess of significant findings in published studies of psychotherapy for depression?

Many studies have examined the efficacy of psychotherapy for major depressive disorder (MDD) but publication bias against null results may exist in this literature. However, to date, the presence of an excess of significant findings in this literature has not been explicitly tested. We used a database of 1344 articles on the psychological treatment of depression, identified through systematic search in PubMed, PsycINFO, EMBASE and the Cochrane database of randomized trials. From these we identified 149 studies eligible for inclusion that provided 212 comparisons. We tested for an excess of significant findings using the method developed by Ioannidis and Trikalinos (2007), and compared the distribution of p values in this literature with the distribution in the antidepressant literature, where publication bias is known to be operating. The average statistical power to detect the effect size indicated by the meta-analysis was 49%. A total of 123 comparisons (58%) reported a statistically significant difference between treatment and control groups, but on the basis of the average power observed, we would only have expected 104 (i.e. 49%) to do so. There was therefore evidence of an excess of significance in this literature (p = 0.010). Similar results were obtained when these analyses were restricted to studies including a cognitive behavioural therapy (CBT) arm. Finally, the distribution of p values for psychotherapy studies resembled that for published antidepressant studies, where publication bias against null results has already been established. The small average size of individual psychotherapy studies is only sufficient to detect large effects. Our results indicate an excess of significant findings relative to what would be expected, given the average statistical power of studies of psychotherapy for major depression.",25062429,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.23444938659668,-1.6642836332321167,CKwJ
"Economic evaluation of audio based resilience training for depression in primary care.

Although there is some evidence on the effectiveness and cost-effectiveness of computerised cognitive behavioural therapy (CCBT) for treating anxiety and depression in primary care, alternative low-cost psychosocial interventions have not been investigated. The cost-effectiveness of an audio based resilience training (Positive Mental Training, PosMT) was examined using a decision model. Patient level cost and effectiveness data from a trial comparing a CCBT treatment and usual care and effectiveness data from a study on PosMT were used to inform this. Net benefits of CCBT and PosMT were approximately equal in individuals with 'moderate' depression at baseline and markedly in favour of PosMT for the 'severe' depression subgroup. With only four observations in the 'mild' depression category for PosMT, the existing evidence base remains unaltered. Efficacy data for the PosMT arm was derived from a study using a partially randomised preference design and the model structure contains simplifications due to lack of data availability. PosMT may represent good value for money in treatment of depression for certain groups of patients. More research in this area may be warranted.",23489394,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.47883129119873,-2.7386627197265625,CgsW
"Implementation of psychological therapies for anxiety and depression in routine practice: two year prospective cohort study.

Worldwide, health systems are improving access to empirically supported psychological therapies for anxiety and depression. Evaluations of this effort are limited by the cross sectional nature of studies, short implementation periods, poor data completeness rates and lack of clinically significant and reliable change metrics. Assess the impact of implementing stepped care empirically supported psychological therapies by measuring the prospective outcomes of patients referred over a two year period to one Improving Access to Psychological Therapies service in the UK. We collected demographic, therapeutic and outcome data on depression (PHQ-9) and anxiety (GAD-7) from 7859 consecutive patients for 24 months between 1st July 2006 and 31st August 2008, following up these patients for a further one year. 4183 patients (53%) received two or more treatment sessions. Uncontrolled effect size for depression was 1.07 (95% CI: 0.88 to 1.29) and for anxiety was 1.04 (0.88 to 1.23). 55.4% of treated patients met reliable improvement or reliable and clinically significant change criteria for depression, 54.7% for anxiety. Patients received a mean of 5.5 sessions over 3.5h, mainly low-intensity CBT and phone based case management. Attrition was high with 47% of referrals either not attending for an assessment or receiving an assessment only. Recovery rates for patients receiving stepped care empirically supported treatments for anxiety and depression in routine practice are 40 to 46%. Only half of all patients referred go on to receive treatment. Further work is needed to improve routine engagement of patients with anxiety and depression.",21501876,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,10.766660690307617,-3.595845937728882,C9R5
"Standardized Treatment Strategy for Depressive Disorder.

The treatment strategies of depressive disorder include pharmacological treatment, psychotherapy, and physical therapy (electroconvulsive therapy [ECT], transcranial magnetic stimulation [TMS], etc.). The updated CANMAT guidelines recommended the most second-generation antidepressants as first-line treatments for patients with a major depressive disorder (MDD) of moderate or greater severity. Before antidepressant treatment, comprehensive assessment and safety monitoring are necessary. The application of measurement-based care in the diagnosis and treatment of depression would better ensure that enough dosage and response of antidepressant is achieved at each key point, and the final outcome of disease is improved. It is recommended that antidepressant is used with monotherapy in patients with depression. Antidepressants of different types and different mechanisms could be combined to improve the efficacy for patients with treatment-resistant depression (TRD). To prevent the relapse and recurrence of disease, the long-term treatment comprised of acute treatment, consolidation treatment, and maintenance treatment must be considered for all patients.",31784964,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.770127296447754,-0.9418604969978333,AxCA
"A Systematic Review and Bayesian Network Meta-Analysis Investigating the Effectiveness of Psychological Short-Term Interventions in Inpatient Palliative Care Settings.

This paper reviews and summarises the evidence of short-term psychosocial interventions (up to 12 sessions delivered within less than eight weeks) on anxiety, depression, and emotional distress in palliative patients in inpatient settings. We screened publications from the following five databases, Embase, PubMed, PsycINFO, Web of Science, and CINAHL, from their inception to 10 September 2021. The eligible studies included controls receiving standard palliative care, actively treated controls, and wait-list controls. Nine studies met the eligibility criteria and reported the effects of five psychosocial interventions in a total of N = 543 patients. We followed PRISMA-guidelines for outcome reporting and the Cochrane Risk of Bias Assessment Tool for assessing study quality. This paper used the network meta-analysis to compare multiple treatments by providing greater statistical power and the cross-validation of observed treatment effects, using the R package BUGSnet. Compared to control groups, the following psychosocial interventions in inpatient settings showed to be superior: life review interventions were the best ranked treatment for improving anxiety and distress, while the top ranked treatment for reducing depression was outlook intervention. The short-term psychosocial interventions investigated in this meta-analysis, especially life review intervention, are feasible and can potentially improve anxiety, depression, and distress in palliative inpatients and should therefore be offered in inpatient settings.",35805365,Major Depressive Disorder,Anxiety Treatment,Mental Health,9176,7.631441116333008,-2.9836745262145996,Qfs
"Staging Treatment Intensity and Defining Resistant Depression: Historical Overview and Future Directions.

To review existing staging models and definitions of treatment-resistant depression (TRD) and offer future directions within the context of up-to-date evidence. A PubMed search was conducted on February 25, 2018, for articles in English on TRD staging or definition using the following keywords: depressive disorder, treatment-resistant OR treatment resistant depression cross-referenced with staging OR degree OR level OR definition. Relevant cross-references from identified articles were also included. A total of 18 articles were identified that included a proposed TRD staging model, a proposed TRD definition, empirical work to support a model or definition, or any combination thereof. Included articles were summarized in chronological order in terms of the date the TRD staging model (and accompanying TRD definition if applicable) was first proposed. Findings from validation studies pertaining to staging or definition were then synthesized. Five staging models were identified. Strengths identified across staging models include rigorous assessment of adequacy of treatment, differentiation of resistance versus symptom return, assignment of equal weights to different pharmacotherapies, and accounting for augmentation. Future considerations should include differential weighting to specific augmentation agents based on available evidence, added weight to electroconvulsive therapy and ketamine treatments, and the addition of evidence-based psychotherapies. Dichotomous versus continuous approaches to TRD diagnosis were considered, with the latter (beginning with 1 failed trial) best explaining available data from large trials. The most up-to-date evidence in the literature should guide future research in the definition and staging of TRD.",31163105,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.15822696685791,-0.682348906993866,A5d+
"Effectiveness of a web-based cognitive behavioural intervention for subthreshold depression: pragmatic randomised controlled trial.

Research on the effectiveness of treatments for subthreshold depression (sD) is still scarce. The aim of the study was to evaluate the efficacy of a web-based guided self-help intervention (GET.ON Mood Enhancer) in the treatment of sD. Participants with sD (n = 406) recruited from the general population via a large health insurance company were randomly allocated to a web-based cognitive behavioural intervention or to enhanced care-as-usual. The primary outcome was the reduction in depressive symptom severity as measured with the Center for Epidemiological Studies Depression Scale at post-treatment and at 6-month follow-up. Participants in the intervention group showed a significantly greater pre-post reduction in depressive symptom severity (d = 1.06; 95% CI: 0.86-1.27) compared to the control condition (d = 0.29; 95% CI: 0.10-0.49). The corresponding between-group effect size was d = 0.69 (95% CI: 0.49-0.89). At 6-month follow-up the effect was reduced to d = 0.28 (95% CI: 0.09-0.48) but was still statistically significant (F1, 403 = 9.240, p = 0.003). This study lends support to the idea that problem solving coupled with behavioural activation is an effective treatment for sD. In addition, the delivery of this intervention over the Internet might be a promising strategy for the dissemination of psychological interventions for sD on a large scale.",26398885,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.250741958618164,-2.7463300228118896,B3rs
"Symptom Severity at Week 4 of Cognitive-Behavior Therapy Predicts Depression Remission.

Early response has been shown to predict psychotherapy outcome. We examined the strength of the relationship between early response and remission in 82 patients who received naturalistic cognitive-behavior therapy in a private practice setting, and 158 patients who received protocol cognitive therapy in a research setting. We predicted that the relationship between early response and remission would be substantial enough to guide clinical decision making in both samples, and that a simple model of severity at Week 4 of treatment would predict remission as effectively as a more complex change score. Logistic regressions showed that a simple model based on the Week 4 Beck Depression Inventory (BDI) score was as predictive of remission as more complex models of early change. A receiver operating characteristics analysis showed that BDI score at Week 4 was substantially predictive of remission in both the naturalistic and research protocol samples; the area under the curve was .80 and .84 in the naturalistic and protocol samples, respectively. To guide clinical decision making, we identified threshold scores on the BDI corresponding to various negative predictive values (probability of nonremission when nonremission is predicted). Our results indicate that depressed patients who remain severely depressed at Week 4 of cognitive therapy are unlikely to reach remission at the end of relatively brief (maximum 20 sessions) treatment. We discuss implications of our findings for clinical decision making and treatment development.",31208688,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.13900089263916,-2.0663704872131348,A41/
"The more I got, the less I need? Efficacy of Internet-based guided self-help compared to online psychoeducation for major depressive disorder.

This study's aims were to compare the efficacy and negative effects of guided Internet-based cognitive behavior therapy (iCBT) and online psychoeducation (OPE) in people with major depression. A total of 131 individuals were randomized. Assessments took place at baseline (T1), six weeks (T2), and three months (T3). The primary endpoint was change in observer-based depression severity from T1 to T2. Potential negative effects were analyzed in terms of suicidal ideations, symptom deterioration, attitudes toward seeking further help, and other adverse events. iCBT (n = 65) and OPE (n = 66) both reduced depressive symptoms from T1 to T2, with large changes observed for iCBT and medium for OPE (iCBT: Cohen's d = 1.09; OPE: d = 0.60). Differences between groups were significant at the primary endpoint (d = 0.36, p = 0.028). OPE continued to have a positive effect from post-treatment to follow-up, while the effect of iCBT remained stable, with differences between groups not being significant anymore at follow-up. Participants who had undergone prior psychotherapy benefited from both treatments; but for those without prior psychotherapy, iCBT was superior also at follow-up. In the iCBT group 26.2% of the participants reported at least one side-effect. The history of psychotherapy was imbalanced between the groups. Some negative effects were assessed in the iCBT group only. Both iCBT and OPE were effective in reducing depressive symptoms, but with iCBT having a more rapid effect. iCBT was specifically superior in those with no prior history of psychotherapy. Negative effects occurred frequently and should be considered when implementing iCBT. German clinical trials register: DRKS00005025.",30611913,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.704009056091309,-3.0466549396514893,BA63
"Psychological management of unipolar depression.

To be used in conjunction with 'Pharmacological management of unipolar depression' [Malhi et al. Acta Psychiatr Scand 2013;127(Suppl. 443):6-23] and 'Lifestyle management of unipolar depression' [Berk et al. Acta Psychiatr Scand 2013;127(Suppl. 443):38-54]. To provide clinically relevant recommendations for the use of psychological treatments in depression derived from a literature review. Medical databases including MEDLINE and PubMed were searched for pertinent literature, with an emphasis on recent publications. Structured psychological treatments such as cognitive behaviour therapy and interpersonal therapy (IPT) have a robust evidence base for efficacy in treating depression, even in severe cases of depression. However, they may not offer benefit as quickly as antidepressants, and maximal efficacy requires well-trained and experienced therapists. These therapies are effective across the lifespan and may be preferred where it is desired to avoid pharmacotherapy. In some instances, combination with pharmacotherapy may enhance outcome. Psychological therapy may have more enduring protective effects than medication and be effective in relapse prevention. Newer structured psychological therapies such as mindfulness-based cognitive therapy and acceptance and commitment therapy lack an extensive outcome literature, but the few published studies yielding positive outcomes suggest they should be considered options for treatment. Cognitive behaviour therapy and IPT can be effective in alleviating acute depression for all levels of severity and in maintaining improvement. Psychological treatments for depression have demonstrated efficacy across the lifespan and may present a preferred treatment option in some groups, for example, children and adolescents and women who are pregnant or postnatal.",23586874,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.594131469726562,-2.347052812576294,CfSz
"Effectiveness of an internet intervention (Deprexis) for depression in a united states adult sample: A parallel-group pragmatic randomized controlled trial.

To examine the effectiveness of an Internet intervention for depression with a randomized, controlled trial in a large sample of adults recruited from the United States. The current study examines the effectiveness of Deprexis, an Internet treatment for depression that was provided with relatively minimal support. There were 376 treatment-seeking adults (mean age = 32 years; 74% female; 77% Caucasian, 7% Asian, 7% multiple races, 4% African American, and 11% Hispanic/Latino) with elevated depression (Quick Inventory of Depressive Symptoms-Self-Report [QIDS-SR] > = 10) who were randomized to receive an 8-week course of treatment immediately (n = 285) or after an 8-week delay (n = 91; i.e., waitlist control). Intention-to-treat analyses indicated that treatment was associated with greater reduction in self-reported symptoms of depression (effect size d = .80) and 12 times greater likelihood of experiencing at least 50% symptom improvement compared with waitlist control. Similar effects were observed for several secondary outcomes, such as interviewer-rated depression symptoms, well-being, and depression-related disability. Treatment effects for symptoms of social anxiety, panic, and traumatic intrusions were relatively small. Results suggest that Deprexis can produce symptomatic improvement among depressed adults recruited from the United States. Additional research is needed that examines whether improvements are maintained over time and who is particularly likely to respond to this form of treatment. (PsycINFO Database Record",28230390,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.327900886535645,-3.1273889541625977,BgcJ
"Outcome, costs and patient engagement for group and individual CBT for depression: a naturalistic clinical study.

This naturalistic study was undertaken in routine settings and compared the clinical effectiveness, costs, treatment preference, attrition and patient satisfaction of Group and Individual CBT. No significant differences were found in depressive and distress symptoms between group and individual CBT at post-treatment and follow-up. Individual CBT was 1.5 times more expensive to provide than Group CBT and the wider costs of other supports were similar between study arms suggesting a cost-effectiveness advantage for Group CBT. Patients preferred individual treatment at baseline but, despite this, there were no between-group differences in attrition or satisfaction. A larger RCT study is needed, but running CBT groups for depression could be considered more frequently by clinicians.",21406135,Major Depressive Disorder,Anxiety Treatment,Mental Health,13595,10.031427383422852,-2.6877312660217285,C+ta
"[Psychotherapy of depressive disorders: Evidence in chronic depression and comorbidities].

Psychotherapy has been shown to be an effective treatment option for depressive disorders; however, its effectiveness varies depending on patient and therapist characteristics and the individual form of the depressive disorder. The aim of this article is to present the current evidence for psychotherapeutic antidepressive treatments for patients with chronic and treatment-resistant depression as well as for patients with mental and somatic comorbidities. During the revision of the currently valid German S3- and National Disease Management Guideline (NDMG) on unipolar depression published in 2015, a comprehensive and systematic evidence search including psychotherapy for specific patient groups was conducted. The results of this search along with a systematic update are summarized. Psychotherapy has been shown to be effective in reducing depressive symptoms in patients suffering from chronic and treatment-resistant depression and in patients with mental and somatic comorbidities. The evidence is insufficient particularly for patients with mental comorbidities. Based on the current evidence and clinical expertise the NDMG recommends psychotherapy alone or in combination with pharmacotherapy to treat most of these depressive patient groups. Evidence gaps were identified, which highlight the need for further research.",29404648,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.468273162841797,-2.112682819366455,BQkW
"A randomized-controlled trial of cognitive-behavioral therapy for depression with integrated techniques from emotion-focused and exposure therapies.

Emotional processing (EP) is hypothesized to be a key mechanism of change in psychotherapy that may enhance its long-term efficacy. To study the effects of fostering EP in psychotherapy for depression, this randomized-controlled clinical trial compares the efficacy and pattern of change of a cognitive-behavioral therapy that integrates emotion-focused techniques within an exposure framework (Exposure-Based Cognitive Therapy for depression; EBCT-R) to a standard cognitive-behavioral therapy (CBT). One hundred and forty-nine depressed outpatients were randomized to a maximum of 22 sessions of manualized EBCT-R (N=77) or CBT (N=72). Primary outcomes were self-reported and clinician-rated depressive symptoms at posttreatment and 12-month follow-up. Secondary outcomes were self-esteem, interpersonal problems, and avoidance thoughts and behaviors. Depressive symptoms improved significantly over therapy in both treatments, with large within-group effect sizes for CBT (d=-1.95) and EBCT-R (d=-1.77). The pattern of depression change during treatment did not differ between treatments. Symptom relief lasted over 12 months and did not differ between EBCT-R and CBT. Results suggest that both treatments produced significant short- and long-term improvement in depression symptoms, but the integration of emotion-focused techniques within an exposure framework did not have added benefit. ClinicalTrials.gov Identifier: NCT01012856 Clinical or methodological significance of this article: This trial compares cognitive-behavioral therapy (CBT) with a similarly structured CBT that was designed to foster emotional processing by integrating emotion-focused techniques within an exposure framework. Results indicate that this form of assimilative integration did not improve outcomes at 12-month follow-up.",29130400,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,13.873594284057617,-5.401600360870361,BURF
"Pragmatic psychodynamic psychotherapy for a patient with depression and breast cancer: functional MRI evaluation of treatment effects.

Time-limited psychodynamic psychotherapy is garnering empirical support as an intervention for clinical depression. However, research is needed to examine the efficacy of psychodynamic approaches among patients presenting with diverse psychiatric and medical problems. This case study examined the efficacy of eight sessions of pragmatic psychodynamic psychotherapy (PPP) in treating a woman with major depression and breast cancer. Pre- to posttreatment assessment indicated significant reductions in depression and weekly assessment indicated increased environmental reward was associated with reduced depression. Secondary aims involved piloting a functional magnetic resonance imaging (fMRI) task as a neurobiological indicator of depression attenuation as a function of PPP. This assessment was conducted to explore alternative means of evaluating treatment responsiveness and addressing the problem of arbitrary metrics in measuring change. Clinical and assessment implications are discussed, with a focus on innovative approaches to evaluate treatment outcome and behavioral and neurobiological mechanisms of change associated with PPP.",24236354,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.318346977233887,-4.150100231170654,CWDT
"What might affect acceptability of online positive psychology interventions for depression: a qualitative study on patient expectations'.

Positive psychology interventions are brief self-adminstered exercises designed to promote positive emotions, behaviours, or thoughts. They are potentially effective for reducing depression and are considered suitable for online dissemination to people with depression and related conditions, as they are assumed to be more acceptable than traditional symptom-focused approaches. However, there is little investigation into perceived acceptability and potential factors that might affect it. This might limit the development and evaluation of effective interventions. Semi-structured interviews with patients with depression and/or anxiety (n=18) and professionals, including GPs and psychologists (n=5) were conducted on their perceptions of a proposed online intervention using positive psychology. Thematic analysis, according to Braun and Clarke, was used to identify meaningful patterns in the data. Four key themes were identified. The fit between the positive psychological approach and the patient's context, including their personality, symptoms and other treatments, was important in determining acceptability. Social aspects of interventions were thought to facilitate acceptability, as long as these were balanced. Support was identified as important in facilitating intervention suitability, although it was not without limitations. Finally, participants identified how design features can enhance acceptability. The findings suggest that positive psychology interventions might not be acceptable to all and that specific exercises might be more or less appropriate to deliver online. Design aspects can help to facilitate acceptability, beyond the psychological content. These findings may inform the design of future online psychology interventions for people with depression and anxiety, which can then be evaluated in future research.",30053854,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.829190254211426,-4.205277919769287,BIWm
"[The efficacy of psychological treatments for depression: a review of recent research findings].

Psychological treatments for depression have been shown to be effective, but there is room for improvement. To summarise new research findings concerning the efficacy of psychological treatments for depression, as reported in a recent dissertation. Four systematic reviews and meta-analyses and one randomised clinical trial are described. As has been shown in the case of patients treated with antidepressants, the efficacy of psychological treatments for depression when compared to strict control conditions, might be greater in patients with more severe depressive symptoms than in patients with milder symptoms. The efficacy of psychological treatments for depression when compared to control conditions is overestimated as a result of systematic publication of positive findings, as has been reported with regard to antidepressant medication too. There is increasing academic support for the efficacy of brief psychodynamic therapy for depression and there are no differences in the efficacy of short-term psychodynamic supportive psychotherapy and cognitive behavioural therapy for depression. Certain patient characteristics were found to be related to the differential efficacy of these two types of psychological treatments, but further validation is needed. A large number of patients with depression who seek help from second-line psychiatric clinics in the Netherlands fail to achieve remission following psychological treatment, irrespective of whether that treatment is combined with antidepressants. Improved efficacy of psychological treatments for depression is urgently needed and can be facilitated by means of high quality research.",25070570,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.396693229675293,-2.3521575927734375,CKlL
"Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer.

Cancer patients are at increased risk for depression compared with individuals with no cancer diagnosis, yet few interventions target depressed cancer patients. Efficacy of psychotherapeutic and pharmacologic interventions for depression in cancer patients who met an entry threshold for depressive symptoms was examined by meta-analysis. Five electronic databases were systematically reviewed to identify randomized controlled trials meeting the selection criteria. Effect sizes were calculated using Hedges' g and were pooled to compare pre- and postrandomization depressive symptoms with a random effects model. Subgroup analyses tested moderators of effect sizes, such as comparison of different intervention modalities, with a mixed effects model. All statistical tests were two-sided. Ten randomized controlled trials (six psychotherapeutic and four pharmacologic studies) met the selection criteria; 1362 participants with mixed cancer types and stages had been randomly assigned to treatment groups. One outlier trial was removed from analyses. The random effects model showed interventions to be superior to control conditions on reducing depressive symptoms postintervention (Hedges' g = 0.43, 95% confidence interval = 0.30 to 0.56, P < .001). In the four psychotherapeutic trials with follow-up assessment, interventions were more effective than control conditions up to 12-18 months after patients were randomly assigned to treatment groups (P < .001). Although each approach was more effective than the control conditions in improving depressive symptoms (P < .001), subgroup analyses showed that cognitive behavioral therapy appeared more effective than problem-solving therapy (P = .01), but not more effective than pharmacologic intervention (P = .07). Our findings suggest that psychological and pharmacologic approaches can be targeted productively toward cancer patients with elevated depressive symptoms. Research is needed to maximize effectiveness, accessibility, and integration into clinical care of interventions for depressed cancer patients.",22767203,Major Depressive Disorder,Anxiety Treatment,Mental Health,2474,6.590893745422363,-2.7115318775177,CrOU
"Rapid Evidence Review of Digital Cognitive-Behavioral Therapy for Adolescents With Depression.

We conducted a rapid evidence review to explore the benefits and harms of digital cognitive-behavioral therapy (dCBT) and the barriers to and facilitators of implementing dCBT for adolescents. We searched MEDLINE, PsycINFO, CENTRAL through December 6, 2021, for controlled trials conducted in settings highly applicable to the United States. Additionally, we searched relevant systematic reviews for eligible studies. Results were summarized qualitatively. We included 12 trials (n = 1,575) that examined the effects of nine dCBT programs. Overall, dCBT was slightly superior to comparators in improving depression symptoms immediately post-intervention, but not at a longer follow-up. The use of dCBT did not appear to result in an increased risk for suicidal attempts or ideation; however, the number of events was very small. Potential barriers to implementing/maintaining dCBT are challenges engaging/retaining patients, developing infrastructure, and training therapists to facilitate dCBT. Data on harms or unintended negative consequences were not reported in the included studies. A limited body of evidence suggests that dCBT programs might outperform control interventions for reducing depressive symptoms immediately post-intervention, but not at a longer follow-up. The safety of dCBT programs for adolescents with depression is understudied.",35256238,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.7406587600708,-2.984490156173706,jwM
"Do Patients at Sites With High RCT Enrollment Propensity Have Better Outcomes?

Concerns about randomized controlled trial (RCT) generalizability typically center on characteristics of RCT patient participants. Possibly there are RCT site characteristics that distinguish RCT outcomes from those that can be expected in non-RCT settings. To examine whether site propensity toward RCT enrollment is associated with recovery outcomes for patients and whether the association differs between patients who participate in a RCT compared with those who remain in an observational (OBS) treatment environment. Study participants with acute bipolar depression from The Systematic Treatment Enhancing Program for Bipolar Disorder acute depression pharmacotherapy RCT (N=337) and OBS treatment arm (N=1581). A longitudinal OBS study comparing the likelihood of recovery in the RCT to the OBS arm, allowing effect modification by site high RCT enrollment propensity (defined as >the median) and other predictors over a 6-month follow-up period. Non-RCT participants who received care in sites with high RCT enrollment propensity had a higher probability of recovering from their bipolar-depression episode compared with participants from low propensity sites [odds ratio (95% confidence interval)=2.13 (1.28-3.55)]. RCT enrollment propensity was not associated with recovery outcomes for RCT participants [1.03 (0.35-3.03)]. Sites with high propensity to enroll patients in RCTs appear to have unobserved characteristics, which play a significant role in outcomes for non-RCT patients. For RCT participants in low-enrollment sites, possibly RCT protocols, which proscribe care delivery and monitoring, attenuate this effect. These results have implications for future research to improve outcomes in nonresearch care settings.",26465127,Major Depressive Disorder,Anxiety Treatment,Mental Health,25280,10.223986625671387,-4.983537673950195,B2m3
"Journal Watch review of The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial.

",24610763,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.307389259338379,-2.5805282592773438,CRJ1
"Psychoeducation for major depressive disorders: a randomised controlled trial.

Various psychological therapies have been shown to be effective for the treatment of mood disorders. Among them, family psychoeducation has demonstrated efficacy in reducing symptom severity and extending the time to relapse. We tested the efficacy of adding psychoeducation focussed on how to deal with the family's expressed emotion to treatment as usual (TAU) to prevent relapse among patients with remitted major depression. A total of 34 patients with major depressive disorders in full or partial remission were randomised to receive either group psychoeducation over six sessions, each consisting of a didactic lecture and group problem-solving (n=19), plus TAU or TAU alone (n=15). The primary outcome was relapse by Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria. Masked raters administered the Hamilton Rating Scale for Depression-17 (HRSD-17). As many as 18 patients in the intervention group and 14 patients in the control group completed the study. Time to relapse was significantly longer in the intervention group than in the control group, with a risk ratio (RR) of relapse by 9 months of 0.12. At 9 months, there was a significantly greater decrease in the HRSD-17 score in the intervention group than in the control group. We demonstrated the effectiveness of patient psychoeducation on the course and outcome of major depressive disorders.",23835139,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,10.667619705200195,-3.181323528289795,Cbq0
"Is adding CBT effective for treatment-resistant depression?

",23469720,Major Depressive Disorder,Anxiety Treatment,Mental Health,11495,10.599461555480957,-1.6788548231124878,Cg/1
"The effects of brief individual cognitive behavioural therapy for depression and homesickness among international students in Malaysia.

Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression. The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression. Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores. The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months. Overall, homesickness is considered a normal reaction. Brief individual CBT for depression is effective in reducing homesickness and depression among international students.",28618312,Major Depressive Disorder,Anxiety Treatment,Mental Health,15604,11.413902282714844,-3.3277626037597656,BbGM
"Effectiveness of case management-based aftercare coordination by phone for patients with depressive and anxiety disorders: study protocol for a randomized controlled trial.

Depressive and anxiety disorders are highly prevalent, but only a small percentage (approximately 50%) of patients receive appropriate treatment. Relevant barriers include communication and coordination gaps between different providers that result from the lack of integration between different care-giving systems. Aftercare following inpatient treatment represents one of these gaps because systematic follow-up care does not exist. Case management-based aftercare coordination by phone might be a promising approach to overcoming this gap and improving long-term treatment outcomes. Case management is a patient-centered and situation-based approach comprising systematic tracking and support of patients by a case manager. The aim of this study is to evaluate the effectiveness of aftercare coordination by phone for patients with depressive and anxiety disorders. The effectiveness of aftercare coordination will be investigated in a prospective randomized controlled trial in four psychotherapeutic inpatient routine care units (St. Franziska-Stift Bad Kreuznach, MediClin Seepark Klinik Bad Bodenteich, Segeberger Kliniken Gruppe Bad Segeberg and Luisenklinik Bad Dürrheim). The patients receiving aftercare coordination (intervention group; IG) will be compared with those who receive treatment as usual (TAU control group; CG). Eligible patients will be required to have a diagnosis of an anxiety and/or depressive disorder and a recommendation for follow-up outpatient psychotherapy. The aftercare coordination consists of six phone contacts at intervals of two weeks that are performed by therapists in the inpatient units. The patients will complete questionnaires at discharge (t1), 3 months after discharge (i.e., at the end of the intervention (t2)) and 9 months after discharge (t3). The primary outcome will be change in symptom severity from t1 to t3, the secondary outcomes will be health-related quality of life and the proportion of patients who manage to begin outpatient psychotherapy by t3. This study will determine whether case management-based aftercare coordination by phone is an adequate approach for overcoming treatment barriers in the clinical pathways of patients with depressive and anxiety disorders. If proven effective, an accessible supplementary treatment approach that will help to maintain and even improve long-term treatment outcomes will be made available for patients following inpatient treatment. ClinicalTrials.gov: ( NCT02044913 ).",25897757,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,9.51172161102295,-3.734419345855713,B+wO
"Internet-Based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-analysis.

Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depression using patient-level information. We searched PubMed, Embase, PsycInfo, and Cochrane Library to identify randomized clinical trials (RCTs) published up to January 1, 2019. Eligible RCTs were those comparing guided or unguided iCBT against each other or against any control intervention in individuals with depression. Available individual patient data (IPD) was collected from all eligible studies. Depression symptom severity was assessed after treatment, 6 months, and 12 months after randomization. We conducted a systematic review and IPD network meta-analysis and estimated relative treatment effect sizes across different patient characteristics through IPD network meta-regression. Patient Health Questionnaire-9 (PHQ-9) scores. Of 42 eligible RCTs, 39 studies comprising 9751 participants with depression contributed IPD to the IPD network meta-analysis, of which 8107 IPD were synthesized. Overall, both guided and unguided iCBT were associated with more effectiveness as measured by PHQ-9 scores than control treatments over the short term and the long term. Guided iCBT was associated with more effectiveness than unguided iCBT (mean difference [MD] in posttreatment PHQ-9 scores, -0.8; 95% CI, -1.4 to -0.2), but we found no evidence of a difference at 6 or 12 months following randomization. Baseline depression was found to be the most important modifier of the relative association for efficacy of guided vs unguided iCBT. Differences between unguided and guided iCBT in people with baseline symptoms of subthreshold depression (PHQ-9 scores 5-9) were small, while guided iCBT was associated with overall better outcomes in patients with baseline PHQ-9 greater than 9. In this network meta-analysis with IPD, guided iCBT was associated with more effectiveness than unguided iCBT for individuals with depression, benefits were more substantial in individuals with moderate to severe depression. Unguided iCBT was associated with similar effectiveness among individuals with symptoms of mild/subthreshold depression. Personalized treatment selection is entirely possible and necessary to ensure the best allocation of treatment resources for depression.",33471111,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.676885604858398,-2.7730164527893066,AcJw
"A German climbing study on depression: a bouldering psychotherapeutic group intervention in outpatients compared with state-of-the-art cognitive behavioural group therapy and physical activation - study protocol for a multicentre randomised controlled trial.

Besides classical approaches for treating depression, physical activity has been demonstrated to be an effective option. Bouldering psychotherapy (BPT) combines psychotherapeutic interventions with action-oriented elements from the field of climbing. The aim of this study is to investigate the effectiveness of BPT compared with a home-based exercise program (EP - active control group, superiority trial) and state-of-the-art cognitive behavioural therapy (CBT - non-inferiority trial). The study is being conducted as a multicentre randomised controlled intervention trial at three locations in Germany. Participants are being randomised into three groups: BPT, CBT, or EP, each with a 10-week treatment phase. A power analysis indicated that about 240 people should initially be included. The primary outcome of the study is the Montgomery and Asberg Depression Rating Scale (MADRS) directly after the intervention. Additional measurement points are located three, six, and 12months after the end of the intervention. The data are being collected via computer-assisted telephone interviews. Statistical analyses comprise regression analyses to test for the superiority of BPT over EP. To test for the non-inferiority of BPT and CBT, a non-inferiority margin of 1.9 points in the Patient Health Questionnaire (PHQ-9) and two non-inferiority margins for the MADRS (half of the two smallest Cohen's d values from the current meta-analyses) was predefined. The mean difference between CBT and EP is being used as a supplementary equivalence margin. This is the first study to investigate the effect of a bouldering psychotherapy (BPT) on outpatients' depressive symptoms compared with mere physical activity (superiority analysis) and state-of-the-art cognitive behavioural therapy (CBT, non-inferiority analysis). Methodological strengths of the study are the elaborated, multicentred, randomised, controlled design. Assessors are blinded with regard to group allocation which leads to high objectivity. The study is conducted in a naturalistic setting, which leads to high external validity. Methodological limitations might be the clinical heterogeneity of the sample, which may dilute the intervention effects. ISRCTN12457760 (Registration date: 26 July 2017, retrospectively registered).",31101097,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,9.189820289611816,-2.164161443710327,A6UN
"Back to basics: could behavioural therapy be a good treatment option for youth depression? A critical review.

Recent findings from systematic reviews and primary research studies have shown more modest effects of cognitive behavioural therapy (CBT) for youth depression than previously shown, highlighting the need to further enhance the effectiveness of this intervention, or components of this intervention. Therefore, the aim of this review is to summarize the work that has been done to identify the different components of CBT and their varying effectiveness for young people with depression. Narrative overview of English language reviews/meta-analyses and primary intervention studies retrieved from searches of computerized databases as well as ancestry searches. Reviews of intervention studies of adults as well as young people with depression have shown that behavioural approaches are equally as effective as cognitive approaches in reducing depression symptoms. Post-hoc analyses of large studies in youth depression have also shown that behavioural approaches might be more suitable for young people. Behaviourally based approaches appear promising in treating youth depression; however, further research is required. This research will represent an essential step towards refining interventions for youth depression, and enabling interventions to be targeted to particular subgroups, to optimize their effectiveness.",24698212,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,11.073833465576172,-2.95512318611145,CP0+
"Predictors and moderators of response to internet-delivered Interpersonal Psychotherapy and Cognitive Behavior Therapy for depression.

By identifying which predictors and moderators lead to beneficial outcomes, accurate selection of the best initial treatment will have significant benefits for depressed individuals. An automated, fully self-guided randomized controlled internet-delivered noninferiority trial was conducted comparing two new interventions (Interpersonal Psychotherapy [IPT; n=620] and Cognitive Behavioral Therapy [CBT; n=610]) to an active control intervention (MoodGYM; n=613) over a period of 4 weeks to spontaneous visitors of an internet-delivered therapy website (e-couch). A range of putative predictors and moderators (socio-demographic characteristics [age, gender, marital status, education level], clinical characteristics [depression/anxiety symptoms, disability, quality of life, medication use], skills [mastery and dysfunctional attitudes] and treatment preference) were assessed using internet-delivered self-report measures at baseline and immediately following treatment and at six months follow-up. Analyses were conducted using Mixed Model Repeated Measures (MMRM). Female gender, lower mastery and lower dysfunctional attitudes predicted better outcome at post-test and/or follow-up regardless of intervention. No overall differential effects for condition on depression as a function of outcome were found. However, based on time-specific estimates, a significant interaction effect of age was found. For younger people, internet-delivered IPT may be the preferred treatment choice, whereas older participants derive more benefits from internet-delivered CBT programs. Although the sample of participants was large, power to detect moderator effects was still lacking. Different e-mental health programs may be more beneficial for specific age groups. The findings raise important possibilities for increasing depression treatment effectiveness and improving clinical practice guidelines for depression treatment of different age groups.",23953024,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.040285110473633,-2.811113119125366,CZ4V
"Effectiveness of a self-management training for patients with chronic and treatment resistant anxiety or depressive disorders on quality of life, symptoms, and empowerment: results of a randomized controlled trial.

Anxiety and depressive disorders are common mental disorders. A substantial part of patients does not achieve symptomatic remission after treatment in specialized services. Current care as usual (CAU) for these patients consists of long-term supportive contacts. Termination of CAU is often not considered to be an option due to persistent symptoms, a low level of functioning, and the absence of further treatment options. A new intervention, ZemCAD, offers a program focused on rehabilitation and self-management, followed by referral back to primary care. This multicenter randomized controlled trial was carried out in twelve specialized outpatient mental health care services in the Netherlands. Consenting and eligible patients were invited for the MINI interview and the baseline questionnaire. Assessments were done at 6 (T1), 12 (T2) and 18 (T3) months post baseline. We used linear mixed model analysis (LMM) to ascertain the effectiveness of the ZemCAD group relative to the CAU group on quality of life, symptom severity and empowerment. In total 141 patients were included. The results at 18-month follow-up regarding to quality of life and symptom severity, showed no significant differences between the ZemCAD group and the CAU group, except on the 'social relationships'-domain (d=0.37). With regard to empowerment a significant difference between both groups was observed in the total empowerment score and one empowerment dimension (d=0.45 and d=0.39, respectively). After the ZemCAD intervention, more patients went from specialized outpatient mental health services back to a less specialized health care setting with less intensive treatment, such as primary care. The findings in this study suggest that patients with chronic and treatment-resistant anxiety and depression using the ZemCAD intervention improve on empowerment but not on symptom severity or quality of life. Since little is known about the effects of rehabilitation and self-management in patients with chronic and treatment resistant anxiety and depressive disorders, this is a first attempt to provide a proof-of-concept study in this under-researched but important field. Netherlands Trial Register: NTR3335 , registered 7 March 2012.",30691421,Major Depressive Disorder,Anxiety Treatment,Mental Health,7056,10.023863792419434,-3.3465118408203125,A/yW
"Predicting remission after internet-delivered psychotherapy in patients with depression using machine learning and multi-modal data.

This study applied supervised machine learning with multi-modal data to predict remission of major depressive disorder (MDD) after psychotherapy. Genotyped adult patients (n=894, 65.5% women, age 18-75 years) diagnosed with mild-to-moderate MDD and treated with guided Internet-based Cognitive Behaviour Therapy (ICBT) at the Internet Psychiatry Clinic in Stockholm were included (2008-2016). Predictor types were demographic, clinical, process (e.g., time to complete online questionnaires), and genetic (polygenic risk scores). Outcome was remission status post ICBT (cut-off ≤10 on MADRS-S). Data were split into train (60%) and validation (40%) given ICBT start date. Predictor selection employed human expertise followed by recursive feature elimination. Model derivation was internally validated through cross-validation. The final random forest model was externally validated against a (i) null, (ii) logit, (iii) XGBoost, and (iv) blended meta-ensemble model on the hold-out validation set. Feature selection retained 45 predictors representing all four predictor types. With unseen validation data, the final random forest model proved reasonably accurate at classifying post ICBT remission (Accuracy 0.656 [0.604, 0.705], P vs null model = 0.004; AUC 0.687 [0.631, 0.743]), slightly better vs logit (bootstrap D=1.730, P=0.084) but not vs XGBoost (D=0.463, P=0.643). Transparency analysis showed model usage of all predictor types at both the group and individual patient level. A new, multi-modal classifier for predicting MDD remission status after ICBT treatment in routine psychiatric care was derived and empirically validated. The multi-modal approach to predicting remission may inform tailored treatment, and deserves further investigation to attain clinical usefulness.",36050305,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.520415306091309,-0.9803868532180786,JLo
"Acceptance and Commitment Therapy (ACT) to reduce depression: A systematic review and meta-analysis.

The aim of this study is to investigate the effectiveness of ACT on depression reduction and further examine the relationship between different follow-up periods, different degree of depression, and different age of patients through subgroup analysis. Relevant electronic databases were searched from Jan 2010 to Aug 2018, including CNKI, WANFANG, PubMed, EMBASE, Cochrane Library, PsycINFO. Two reviewers independently screened for eligible studies, extracted data, and assessed risk of bias of the included studies. The Cochrane Collaboration's bias assessment tool was used to evaluate the risk of bias for included studies, and Review Manager 5.3 Software for the meta-analysis RESULTS: 18 studies with 1,088 participants were included in the review. Four studies were rated as high-quality studies, and the remaining 14 studies were rated as moderate quality studies. ACT significantly reduced depression as compared with the control group [SMD = 0.59, 95% CI (0.38, 0.81)]. The subgroup analysis found a significant difference between ACT and control group after post-intervention, three months follow up, mild depression group and adults group, [SMD= 0.62, 95% CI (0.35, 0.90), [SMD= 0.55, 95% CI (0.23, 0.87)], [SMD= 0.65, 95% CI (0.40, 0.91)], [SMD= 0.52, 95% CI (0.33, 0.71)] respectively. The heterogeneity between included studies results in heterogeneity of the results. Most of the specific methods for random sequence generation and allocation concealment were not clear. The search results had limitations since only the published studies in Chinese and English were searched and lacked a search for gray and paper documents. The current study suggested that ACT was significantly for reducing depressive symptoms compared with the control group, especially at three months of follow-up, adult group and mild depression. More research is needed to investigate the difference effects for minor group, moderate and severe depression and long-term follow-up.",31563072,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,7.889865398406982,-1.7804203033447266,A0FE
"Psychological treatment of depression in institutional settings: A meta-analytic review.

Many depressed patients are treated in institutional settings. The number of studies focusing on psychotherapies for depressed patients in institutional settingsis limited, and only a few up-to-date meta-analyses have integrated the results of these studies. We conducted a meta-analysis of 32 randomized trials with 37 comparisons between psychotherapy and control conditions, examining the effects of psychotherapy for adult patients in institutional settings with depressive disorders. We found that psychotherapy had a significant, small to moderate effect on depressive symptoms (g=0.42; 95% CI: 0.29~0.56), with low to moderate heterogeneity (I2=33; 95% CI: 0~55). The effects remained small but significant after adjustment for publication bias (g=0.27; 95% CI: 0.12~0.42) and in the studies with low risk of bias (g=0.32; 95% CI: 0.11~0.52). The effects were largely retained at 9 to 15 months follow-up and still significant, again after adjustment for publication bias and in studies with low risk of bias. We found no significant difference across types of institutional settings, including psychiatric inpatient settings and nursing homes, although no studies with a low risk of bias were available in nursing homes. We included different types of institutional settings, although we did not find a significant difference between settings. The number of studies was small and risk of bias was high in a considerable number of trials. This meta-analysis provides evidence for a small to moderate and sustained effect of psychotherapy in patients in institutional settings with depression.",33773217,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.494743347167969,-2.5598418712615967,AYvE
"Individual differences in response to once versus twice weekly sessions of CBT and IPT for depression.

The Personalized Advantage Index (PAI) is a method to guide treatment selection by investigating which of two or more treatments is optimal for a given individual. Recently, it was shown that, on average, twice-weekly sessions of psychotherapy for depression lead to better outcomes compared to once-weekly sessions. The present study applied the PAI method to assess if subgroups of patients may have a differential response to psychotherapy frequency. Data came from a clinical trial (n = 200) randomizing depressed patients into different session frequencies: weekly sessions versus twice-weekly sessions. Machine-learning techniques were used to select pretreatment variables and develop a multivariable prediction model that calculated each patient's PAI. Differences in observed depression post-treatment scores (Beck Depression Inventory-II [BDI-II]) were tested between patients that received their PAI-indicated versus non-indicated session frequency. Between-group effect sizes (Cohen's d) were reported. We identified prognostic indicators generally associated with lower post-treatment BDI-II regardless of treatment assignment. In addition, we identified specific demographic and psychometric features associated with differential response to weekly- versus twice-weekly therapy sessions. Observed post-treatment BDI-II scores were significantly different between individuals receiving the PAI-indicated versus non-indicated session frequency (d = .37). Although a higher session frequency is more effective on average, different session frequencies seem beneficial for different patients. Future studies should externally validate these findings before they can be generalized to other settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",35225634,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.580883026123047,-2.649028778076172,lDo
"Defined symptom-change trajectories during acute-phase cognitive therapy for depression predict better longitudinal outcomes.

Acute-phase cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but responders experience varying post-acute outcomes (e.g., relapse vs. recovery). Responders' symptom-change trajectories during response to acute-phase CT may predict longer term outcomes. We studied adult outpatients (N = 220) with recurrent MDD who responded to CT but had residual symptoms. Responders with linear (steady improvement), log-linear (quicker improvement earlier and slower later), one-step (a single, relatively large, stable improvement between adjacent assessments), or undefined (not linear, log-linear, or one-step) symptom trajectories were assessed every 4 months for 32 additional months. Defined (linear, log-linear, one-step) versus undefined acute-phase trajectories predicted lower depressive symptoms (d = 0.36), lower weekly probability of being in a major depressive episode (OR = 0.46), higher weekly probabilities of remission (OR = 1.93) and recovery (OR = 2.35), less hopelessness (d = 0.41), fewer dysfunctional attitudes (d = 0.31), and better social adjustment (d = 0.32) for 32 months after acute-phase CT. Differences among defined trajectory groups were nonsignificant. Responding to acute-phase CT with a defined trajectory (orderly pattern) of symptom reduction predicts better longer term outcomes, but which defined trajectory (linear, log-linear, or one-step) appears unimportant. Frequent measurement of depressive symptoms to identify un/defined CT response trajectories may clarify need for continued clinical monitoring and treatment.",27591917,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.06863784790039,-1.1533102989196777,BnvS
"Using moderator-based algorithms and electronic medical records to achieve optimal outcomes in depression.

Moderator-based treatment algorithms for depression are available to assist clinicians by providing a highly structured approach for the monitoring and assessment of medication efficacy and risks. Algorithm-based treatment strategies provide consistent care and improve outcomes, and patients treated with measurement-based care experience greater reduction of symptoms, faster remission rates, and better overall efficacy than care as usual. Additionally, electronic medical records have the potential to provide interactive guidance on optimal treatment choices during patient follow-up visits. This Webcast focuses on evaluating predictors of treatment response within the context of using algorithms and integrating this information into clinical practice via electronic medical records.",21824453,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.207880020141602,-1.883784294128418,C46L
"Evidence-based treatments for depression and anxiety versus treatment-as-usual: a meta-analysis of direct comparisons.

The aim of this study was to examine the relative efficacy of evidence-based treatments (EBTs) versus treatment-as-usual (TAU) in routine care for anxiety and depression in adults. A computerized search of studies that directly compared an EBT with a TAU was conducted. Meta-analytic methods were used to estimate effectiveness of EBTs relative to TAU and to model how various confounding variables impacted the results of this comparative research. A total of 14 studies were included in the final meta-analysis. There was significant heterogeneity in the TAU conditions, which ranged from unknown and/or minimal mental health treatment to psychotherapeutic interventions provided by trained professionals. Although the effect for EBT vs. TAU was significantly greater than zero, the effect for EBT vs. TAUs that were psychotherapeutic interventions was not statistically different from zero. Heterogeneity of TAU conditions in this meta-analysis highlight the importance of clarifying the research questions being asked when investigating and drawing conclusions from EBT-TAU comparisons. Researchers need to clarify if they are comparing an EBT to psychotherapeutic services in routine care or to minimal mental health services. Extant research on EBT versus TAU reveals that there is insufficient evidence to recommend the transportation of EBTs for anxiety and depression to routine care, particularly when the routine care involves psychotherapeutic services.",21996291,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.07370376586914,-2.8175206184387207,C2St
"Evaluation of the online-based self-help programme ""Selfapy"" in patients with unipolar depression: study protocol for a randomized, blinded parallel group dismantling study.

Patients with mild to moderate depressive symptoms can have limited access to regular treatment; to ensure appropriate care, low-threshold treatment is needed. Effective online interventions could increase the supply of low-threshold treatment. Further research is needed to evaluate the effectiveness of online interventions. This study aims to evaluate the online-based self-help programme ""Selfapy"" on a sample of depressive subjects and compares the impact of the programme's unaccompanied version with its therapeutic accompanied version. A sample of 400 subjects that have a mild to severe depressive episode (Becks Depression Inventory - II and Hamilton Depression Scale) will be used. Subjects are randomly assigned to immediate access to an unaccompanied course (no support from psychologist via weekly phone calls), immediate access to an accompanied course (support from a psychologist via weekly phone calls) or a waiting list control group (access to the intervention after 24weeks). The intervention will last for a period of 12weeks. Depressive symptoms as a primary parameter, as well as various secondary parameters, such as life satisfaction, therapeutic relationships, social activation, self-esteem, attitudes towards Internet interventions and drop-out rates, are recorded at four different points in time: at baseline (T1), 6weeks after the start of the intervention (T2), 12weeks after the start of the intervention (T3) and 3months after completion of the treatment follow-up (T4). This randomized and controlled, blinded study will make use of a ""dismantled"" approach to adequately compare the accompanied and unaccompanied versions of the intervention. Positive and meaningful results are expected that could influence the acceptance and implementation of online interventions. German Clinical Trials Register DRKS00017191. Registered on 14 June 2019.",33836810,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.908882141113281,-3.590717315673828,AYCQ
"Arts for the Blues - a new creative psychological therapy for depression: a pilot workshop report.

Research over the last decade has identified both strengths and limitations in the use of routinely prescribed psychological therapies for depression. More recently, a focus on how creative art therapies and 'arts on prescription' are developing a growing recognition of their potential additional therapeutic mechanisms for depression. In an attempt to develop a new therapeutic intervention for depression, this research aligned both the evidence base surrounding the arts on prescription movement, collating these with client-reported helpful factors and preferences for therapeutic interventions. We developed a framework for a new pluralistic 'meta-approach' of therapy for depression, based on; an interdisciplinary thematic synthesis of active ingredients, considered specific features implemented in therapy, and client-reported helpful factors considered to be the broad features or experiences in therapy from both talking therapies and creative approaches. This framework contributed to the development of a pilot workshop entitled Arts for the Blues - A New Creative Psychological Therapy for Depression. An outline of, and evaluation from this workshop is presented in this article. Workshop participants were recruited via a voluntary workshop taking place at a North West Higher Education Institution Arts and Health conference ( N=15). The workshop was evaluated using quantitative measures, with results indicating around a 70% overall satisfaction, followed up with qualitative commentary around areas of good practice and areas for development. These included the positive reflection on the application of creative arts and the multimodal nature of the approach, while others reflected on the potential overwhelming nature of utilising multimodal methods for individuals with depression. Overall feedback from the pilot workshop is discussed in relation to prior research, giving credence to the potential for incorporating arts into therapy.",30950682,Major Depressive Disorder,Anxiety Treatment,Mental Health,16932,10.781096458435059,-5.491374492645264,A8Te
"Computer-Assisted Cognitive-Behavior Therapy for Depression: A Systematic Review and Meta-Analysis.

To evaluate the efficacy of computer-assisted forms of cognitive-behavior therapy for major depressive disorder (MDD) and examine the role of clinician support and other factors that might affect outcomes. Ovid MEDLINE, PsycINFO, PubMed, and Scopus from their beginnings to July 18, 2016. Keywords were ""randomized, controlled trials of computer-assisted cognitive-behavior therapy for depression"" and ""randomized, controlled trials of mobile apps for cognitive-behavior therapy of depression."" Of 223 studies identified in the search, 183 were excluded yielding a sample of 40 randomized, controlled investigations of computer-assisted cognitive-behavior therapy (CCBT) for depression. Data were abstracted independently by two authors, and consensus was reached by discussion with a third author. The overall mean effect size for CCBT compared to control conditions was g = 0.502, a moderately large effect. Studies that provided support from a clinician or other person yielded significantly larger effects (g = 0.673) than studies in which no support was provided (g = 0.239). Completion rate and study setting also influenced outcomes. Lower mean effect sizes were observed in studies with lower completion rates and in studies conducted in primary care practices. CCBT with a modest amount of support from a clinician or other helping person was found to be efficacious with relatively large mean effect sizes on measures of depressive symptoms. Self-guided CCBT for depression was considerably less effective. Future research should focus on enhancing the implementation of CCBT, including evaluating the amount and type of support needed for effective delivery, methods to improve engagement with computer-assisted therapies, and ways to improve treatment outcome in primary care settings.",30900849,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.712350845336914,-2.787003517150879,A9B3
"Is psychotherapy effective? A re-analysis of treatments for depression.

AimsThe aim of this study was to reanalyse the data from Cuijpers et al.'s (2018) meta-analysis, to examine Eysenck's claim that psychotherapy is not effective. Cuijpers et al., after correcting for bias, concluded that the effect of psychotherapy for depression was small (standardised mean difference, SMD, between 0.20 and 0.30), providing evidence that psychotherapy is not as effective as generally accepted. The data for this study were the effect sizes included in Cuijpers et al. (2018). We removed outliers from the data set of effects, corrected for publication bias and segregated psychotherapy from other interventions. In our study, we considered wait-list (WL) controls as the most appropriate estimate of the natural history of depression without intervention. The SMD for all interventions and for psychotherapy compared to WL controls was approximately 0.70, a value consistent with past estimates of the effectiveness of psychotherapy. Psychotherapy was also more effective than care-as-usual (SMD = 0.31) and other control groups (SMD = 0.43). The re-analysis reveals that psychotherapy for adult patients diagnosed with depression is effective.",30058524,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.821310997009277,-2.6445372104644775,BIRl
"Side effects of the metacognitive training for depression compared to a cognitive remediation training in patients with depression.

Although awareness of side effects over the course of psychotherapy is growing, side effects are still not always reported. The purpose of the present study was to examine side effects in a randomized controlled trial comparing Metacognitive Training for Depression (D-MCT) and a cognitive remediation training in patients with depression. 84 patients were randomized to receive either D-MCT or cognitive remediation training (MyBrainTraining) for 8 weeks. Side effects were assessed after the completion of each intervention (post) using the Short Inventory of the Assessment of Negative Effects (SIAN) and again 6 months later (follow-up) using the Negative Effects Questionnaire (NEQ). D-MCT and MyBrainTraining did not differ significantly in the number of side effects. At post assessment, 50% of the D-MCT group and 59% of the MyBrainTraining group reported at least one side effect in the SIAN. The most frequently reported side effect was disappointment in subjective benefit of study treatment. At follow-up, 52% reported at least one side effect related to MyBrainTraining, while 34% reported at least one side effect related to the D-MCT in the NEQ. The most frequently reported side effects fell into the categories of ""symptoms"" and ""quality"". Our NEQ version was missing one item due to a technical error. Also, allegiance effects should be considered. The sample size resulted in low statistical power. The relatively tolerable number of side effects suggests D-MCT and MyBrainTraining are safe and well-received treatment options for people with depression. Future studies should also measure negative effects to corroborate our results.",33846503,Major Depressive Disorder,Anxiety Treatment,Mental Health,8827,12.296830177307129,-1.4421617984771729,AX62
"Who Benefits Most from Adding Technology to Depression Treatment and How? An Analysis of Engagement with a Texting Adjunct for Psychotherapy.

Introduction: Cognitive behavioral therapy (CBT) is an established treatment for depression, but its success is often impeded by low attendance. Supportive text messages assessing participants' mood in between sessions might increase attendance to in-clinic CBT, although it is not fully understood who benefits most from these interventions and how. This study examined (1) user groups showing different profiles of study engagement and (2) associations between increased response rates to mood texts and psychotherapy attendance. Methods: We included 73 participants who attended Group CBT (GCBT) in a primary care clinic and participated in a supportive automated text-messaging intervention. Using unsupervised machine learning, we identified and characterized subgroups with similar combinations of total texting responsiveness and total GCBT attendance. We used mixed-effects models to explore the association between increased previous week response rate and subsequent week in-clinic GCBT attendance and, conversely, response rate following attendance. Results: Participants could be divided into four clusters of overall study engagement, showing distinct profiles in age and prior texting knowledge. The response rate to texts in the week before GCBT was not associated with GCBT attendance, although the relationship was moderated by age; there was a positive relationship for younger, but not older, participants. Attending GCBT was, however, associated with higher response rate the week after an attended session. Conclusion: User groups of study engagement differ in texting knowledge and age. Younger participants might benefit more from supportive texting interventions when their purpose is to increase psychotherapy attendance. Our results have implications for tailoring digital interventions to user groups and for understanding therapeutic effects of these interventions.",32213012,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,10.472759246826172,-3.0400729179382324,Arem
"[Technology-Based Psychological Interventions (TBIs) for Bridging Waiting Periods and Aftercare for People with Depressive Disorders: The Current State of Research].

Our goal was to present current research on the effectiveness, acceptance and safety of technology-based psychological interventions (TBIs) for bridging waiting periods (e.g., for outpatient psychotherapy) and aftercare of people with depressive disorders and to derive implications for future research. In this systematic review of 83 studies, the use of TBIs in people with diagnosed depression was analyzed. Among these, only a few studies were identified as those applying TBIs for bridging waiting periods (n=1) and aftercare (n=4). The narrative summary of results suggests the effectiveness of TBIs for aftercare. However, very few data are available on TBIs regarding their acceptance, safety and use for bridging waiting periods. The current evidence base is insufficient for recommending the use of TBIs for bridging waiting periods and for aftercare. Further randomized controlled trials capturing effectiveness, acceptance, safety, and the potential for implementation of TBIs under real-world care conditions are needed.",34488236,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.140103340148926,-3.5356059074401855,AQyP
"Interpersonal accuracy of interventions and the outcome of cognitive and interpersonal therapies for depression.

The purpose of the current investigation was to examine the interpersonal accuracy of interventions in cognitive therapy and interpersonal therapy as a predictor of the outcome of treatment for patients with major depressive disorder. The interpersonal accuracy of interventions was rated using transcripts of treatment sessions for 72 patients who were being treated with cognitive or interpersonal therapy for major depressive disorder through the National Institute of Mental Health Treatment of Depression Collaborative Research Program (Elkin et al., 1989). Interpersonal accuracy of interventions was assessed by first identifying core conflictual relationship themes for each patient and then by having judges rate therapist intervention statements for the extent to which each statement addressed each component of the patient-specific interpersonal theme. Using early-in-treatment sessions, statistically significant interactions of interpersonal accuracy of interventions and treatment group in relation to outcome were evident. These findings included significant interactions of treatment group with accuracy of interventions in the prediction of subsequent change of depressive symptoms and social adjustment from Week 4 to Week 16, with higher levels of interpersonal accuracy associated with relatively poorer outcomes for patients receiving cognitive therapy but relatively better outcomes for patients in interpersonal therapy. The process of interpersonal and cognitive therapies may differ in important ways. Accurately addressing interpersonal themes may be particularly important to the process of interpersonal therapy but not cognitive therapy.",20515217,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,13.594411849975586,-5.084903717041016,DJ0k
"The Effectiveness of Problem-Solving Therapy for Primary Care Patients' Depressive and/or Anxiety Disorders: A Systematic Review and Meta-Analysis.

There is increasing demand for managing depressive and/or anxiety disorders among primary care patients. Problem-solving therapy (PST) is a brief evidence- and strength-based psychotherapy that has received increasing support for its effectiveness in managing depression and anxiety among primary care patients. We conducted a systematic review and meta-analysis of clinical trials examining PST for patients with depression and/or anxiety in primary care as identified by searches for published literature across 6 databases and manual searching. A weighted average of treatment effect size estimates per study was used for meta-analysis and moderator analysis. From an initial pool of 153 primary studies, 11 studies (with 2072 participants) met inclusion criteria for synthesis. PST reported an overall significant treatment effect for primary care depression and/or anxiety (d = 0.673; P < .001). Participants' age and sex moderated treatment effects. Physician-involved PST in primary care, despite a significantly smaller treatment effect size than mental health provider only PST, reported an overall statistically significant effect (d = 0.35; P = .029). Results from the study supported PST's effectiveness for primary care depression and/or anxiety. Our preliminary results also indicated that physician-involved PST offers meaningful improvements for primary care patients' depression and/or anxiety.",29330248,Major Depressive Disorder,Anxiety Treatment,Mental Health,20534,10.305273056030273,-2.3558349609375,BRic
"Self-reported versus clinician-rated symptoms of depression as outcome measures in psychotherapy research on depression: a meta-analysis.

It is not well-known whether self-report measures and clinician-rated instruments for depression result in comparable outcomes in research on psychotherapy. We conducted a meta-analysis in which randomized controlled trials were included examining the effects of psychotherapy for adult depression. Only studies were included in which both a self-report and a clinician-rated instrument were used. We calculated the effect size (Hedges' g) based on the self-report measures, the effect size based on the clinician-rated instruments, and the difference between these two effect sizes (Deltag). A total of 48 studies including a total of 2462 participants was included in the meta-analysis. The differential effect size was Deltag=0.20 (95% CI: 0.10-0.30), indicating that clinician-rated instruments resulted in a significantly higher effect size than self-report instruments from the same studies. When we limited the effect size analysis to those studies comparing the HRSD with the BDI, the differential effect was somewhat smaller, but still statistically significant (Deltag=0.15; 95% CI: 0.03-0.27). This meta-analysis has made it clear that clinician-rated and self-report measures of improvement following psychotherapy for depression are not equivalent. Different symptoms may be more suitable for self-report or ratings by clinicians and in clinical trials it is probably best to include both.",20619943,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.979957580566406,-1.3272013664245605,DIP6
"[Evidence for the Efficacy of Behavioral Activation against Depressive Disorder: A Literature Review].

A growing body of evidence suggests the significant efficacy of behavioral activation therapy (BA) for the treatment of depression, although BA had formerly been regarded as only a part of the techniques for cognitive-behavioral treatment (CBT). The aim of this article is to review the effectiveness, indications, and limitations of BA for the psychosocial treatment of depression. The research group of Washington University in St. Louis, who previously suggested the marked efficacy of BA based on component analysis of CBT, performed a large-scale study to compare the effect of BA and cognitive therapy (CT) or antidepressant medication on the acute phase of depression. As the results, BA was superior to CT and comparable to antidepressant medication in acute-phase treatment for a subgroup of patients with relatively severe depression. Moreover, a long-term follow-up study revealed a benefit of BA compared to pharmacological treatment in regard to the persistence of the effect and cost-effectiveness. More recently, a number of meta-analyses have indicated no significant difference among BA and other psychotherapies regarding their efficacy for the treatment of depression. Because BA does not require patients or therapists to learn complex skills and is also time-efficient, it is recommended as the first-line treatment for mild or moderate depression. However, further studies are needed to consider indications, the timing of induction, and variation in BA techniques if it is applied for the treatment of depression in a general clinical setting in Japan.",26514045,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.613645553588867,-1.943221926689148,B17s
"Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression: study protocol for a randomised controlled superiority trial.

Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients present with residual symptoms by the end of treatment. A common residual symptom is rumination, a process of recurrent negative thinking and dwelling on negative affect. Rumination has been demonstrated as a major factor in vulnerability to depression, predicting the onset, severity, and duration of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more effective in treating depression and reducing relapse than standard cognitive behavioural therapy. This study is a two-arm pragmatic randomised controlled superiority trial comparing the effectiveness of group-based rumination-focused cognitive behaviour therapy with the effectiveness of group-based cognitive behavioural therapy for treatment of depression. One hundred twenty-eight patients with depression will be recruited from and given treatment in an outpatient service at a psychiatric hospital in Denmark. Our primary outcome will be severity of depressive symptoms (Hamilton Rating Scale for Depression) at completion of treatment. Secondary outcomes will be level of rumination, worry, anxiety, quality of life, behavioural activation, experimental measures of cognitive flexibility, and emotional attentional bias. A 6-month follow-up is planned and will include the primary outcome measure and assessment of relapse. The clinical outcome of this trial may guide clinicians to decide on the merits of including rumination-focused cognitive behavioural therapy in the treatment of depression in outpatient services. ClinicalTrials.gov Identifier: NCT02278224 , registered 28 Oct. 2014.",26260780,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.051679611206055,-1.6439286470413208,B5pD
"Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions.

Due to long waiting periods for outpatient psychotherapy and the high resource requirements of inpatient treatment, there is a need for alternative treatment programs for patients with depressive disorders. Thus, we investigated the effectiveness of the ""Bielefeld Outpatient Intensive Treatment Program of Depression"" (BID) in comparison with a typical inpatient treatment program by using a prospective quasi-experimental observational study. We assumed (i) that both complex programs are effective in pre-post analyses after 6 weeks and (ii) that inpatient treatment is more effective compared with the outpatient program. Four hundred patients with depressive psychopathology - a majority with depressive episodes (ICD-10 F3X) - took part in the BID and 193 in the inpatient program. Different self- (i.e., BDI) and expert measures (i.e., MADRS) of psychopathology at baseline (t1) and 6 weeks later (t2) were applied to examine treatment effects. Treatment effects were high in separate analyses of both groups with Cohen's d ranging from 1.10 to 1.76., while ANOVA comparative analyses did not reveal any significant differences between both treatment settings nor did a set of independent covariates analyzed here. Response rates of BDI (p=.002) and MADRS (p=.001) were higher in the outpatient group. Results indicate BID not to be inferior compared to an inpatient program, although diverging pathways to treatment, higher rates of clinical recurrent depressive disorders and severe episodes as well as lower rates of employment and partnership in the inpatient treatment group have to be considered. Outpatient intensive treatment programs may represent a solution for patients needing more than a treatment session once per week but less than a complex inpatient or day clinic program.",31791279,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.20595932006836,-2.74916410446167,Aw7e
"Culturally adapted psychotherapies for depressed adults: A systematic review and meta-analysis.

There is current debate about the effectiveness and generalizability of evidence-based psychological therapies in treatment of depression for diverse ethno-cultural groups. This has led to increasing interest in culturally adapted psychotherapies (CAPs). Studies on CAPs for face-to-face treatment of depressed adults were identified using nine electronic database searches. Data on the process of adaptation was analysed using thematic analysis and treatment efficacy was assessed through meta-analysis of Randomized Controlled Trials. Fifteen studies were included in the review, of which eight were included in a meta-analysis. Cognitive Behavioural Therapy and Behavioural Activation were commonly selected approaches for CAPs, mainly based on their strong evidence base for effectiveness. Twelve studies reported the adaptation process that follows all or some phases recommended by the Medical Research Council Framework for developing complex interventions. A meta-analysis of 16 RCTs, which included eight studies from the current review and eight studies from an earlier review (Chowdhary et al. (2014), demonstrated a statistically significant benefit in favour of CAPs, reducing symptom burden [standardized mean difference -0.63, 95% confidence interval -0.87 to -0.39]. Subgroup analysis showed a larger effect when the intervention was for the majority ethnic group in a population, rather than a minority group. Some studies did not report all relevant information, and in the subgroup analysis only three studies were of minority groups. CAPs were confirmed to be more efficacious than control treatments. This supports the continued development and evaluation of culturally adapted psychotherapies for depression.",32979561,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.578119277954102,-5.560977458953857,Ah75
"Patients' experiences of helpfulness in guided internet-based treatment for depression: qualitative study of integrated therapeutic dimensions.

Quantitative research on Internet-based cognitive behavioral therapy (ICBT) has collected substantial evidence for the effectiveness of this treatment approach on health outcomes. Less is known about how patients find ICBT to be generally meaningful and helpful for treating depression. To explore patients' experiences of being in ICBT treatment with a focus on the treatment dimensions that they considered helpful. Choosing a phenomenological-hermeneutical approach, 14 patients were interviewed with semistructured qualitative interviews to elicit their understanding of using ICBT. The patients took part in a clinical trial using ICBT with MoodGYM, which also featured brief consultations with a clinical psychologist. The interviews were transcribed and analyzed according to the chosen methodology and organized into significant themes. The phenomenological-hermeneutical analysis identified 5 themes relating overall to the meaning of this mode of treatment in terms of helpfulness. Two related to treatment in general: (1) taking action to address one's problems and (2) the value of talking to a professional. The next two themes specifically addressed guided self-help using the MoodGYM program: (3) acquiring relevant knowledge, and (4) restructuring the new knowledge acquired through ICBT. A fifth theme concerned (5) actual changes in patients' perceptions and interactions, related to either the self-help material or the face-to-face consultations with the therapist. Three important dimensions were made explicit: the active engagement of the patient, the guidance of the therapist, and the content of the treatment program. The findings pointed to (1) the role of MoodGYM as a source of new knowledge providing patients with a structured approach to work with their depression, (2) the patient's role as the primary agent of change through adapting relevant knowledge from MoodGYM to their situation, and (3) the dialogue with the therapist as a trusting relationship in which to share thoughts and feelings, receive feedback and advice, and to assist the patient in making use of the MoodGYM content.",23786763,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.516709327697754,-2.901690721511841,CcZx
"Treating chronic symptoms of depression in the virtual clinic: findings on chronicity of depression in patients treated with internet-based computerized cognitive behaviour therapy for depression.

",21720195,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.025712013244629,-2.906017303466797,C6Wh
"Relapse rates after psychotherapy for depression - stable long-term effects? A meta-analysis.

Depression is the most common mental disorder. Effective psychotherapeutic treatments for depression exist; however, data on their long-term effectiveness beyond a time span of two years is still scarce. Our aim was to perform a meta-analysis, investigating (a) overall rates of relapse more than two years after psychotherapy (meta-analysis 1), and (b) if psychotherapy has more enduring effects than non-psychotherapeutic comparison conditions (e.g. pharmacotherapy, treatment as usual), again beyond a time span of two years post-therapy (meta-analysis 2). We searched electronic databases Medline, PsycINFO and the COCHRANE Library. Main selection criteria were (i) RCT of psychotherapy with follow-up interval of more than 2 years, (ii) primary diagnosis of depression, assessed by observer ratings, (iii) report of relapse at follow-up. We identified 11 studies, 6 of which included a non-psychotherapeutic comparison condition. Together they comprised long-term data of 966 patients. Mean follow-up duration was 4.4 years. The overall relapse rate at long-term follow-up was 0.39 (95% CI 0.29, 0.50). Psychotherapy resulted in significantly less relapses (53.1% vs. 71.1%, OR 0.51; 95% CI 0.32, 0.82, p=0.005) than comparison treatments. This finding corresponded to a number needed to treat (NNT) of 5.55. Results can only be preliminary as data was sparse and studies differed methodologically. Heterogeneity in the first meta-analysis was high (I(2)=82%). Results indicated publication bias. The relapse rate more than two years after psychotherapy is relatively high, but significantly lower compared to non-psychotherapeutic treatments. Multiannual follow-ups should routinely be included in future psychotherapy RCTs.",25043322,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.422361373901367,-1.0907903909683228,CLAd
"Does Internet-based cognitive behavioral therapy (iCBT) prevent major depressive episode for workers? A 12-month follow-up of a randomized controlled trial.

In this study we investigated whether an Internet-based computerized cognitive behavioral therapy (iCBT) program can decrease the risk of DSM-IV-TR major depressive episodes (MDE) during a 12-month follow-up of a randomized controlled trial of Japanese workers. Participants were recruited from one company and three departments of another company. Those participants who did not experience MDE in the past month were randomly allocated to intervention or control groups (n = 381 for each). A 6-week, six-lesson iCBT program was provided to the intervention group. While the control group only received the usual preventive mental health service for the first 6 months, the control group was given a chance to undertake the iCBT program after a 6-month follow-up. The primary outcome was a new onset of DSM-IV-TR MDE during the 12-month follow-up, as assessed by means of the web version of the WHO Composite International Diagnostic Interview (CIDI), version 3.0 depression section. The intervention group had a significantly lower incidence of MDE at the 12-month follow-up than the control group (Log-rank χ2 = 7.04, p < 0.01). The hazard ratio for the intervention group was 0.22 (95% confidence interval 0.06-0.75), when estimated by the Cox proportional hazard model. The present study demonstrates that an iCBT program is effective in preventing MDE in the working population. However, it should be noted that MDE was measured by self-report, while the CIDI can measure the episodes more strictly following DSM-IV criteria.",25562115,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.892911911010742,-2.863466501235962,CDli
"Practice of therapy acquired regulatory skills and depressive relapse/recurrence prophylaxis following cognitive therapy or mindfulness based cognitive therapy.

To investigate whether usage of treatment-acquired regulatory skills is associated with prevention of depressive relapse/recurrence. Remitted depressed outpatients entered a 24-month clinical follow up after either 8 weekly group sessions of cognitive therapy (CT; N = 84) or mindfulness-based cognitive therapy (MBCT; N = 82). The primary outcome was symptom return meeting the criteria for major depression on Module A of the SCID. Factor analysis identified three latent factors (53% of the variance): decentering (DC), distress tolerance (DT), and residual symptoms (RS), which were equivalent across CT and MBCT. Latent change score modeling of factor slopes over the follow up revealed positive slopes for DC (β = .177), and for DT (β = .259), but not for RS (β = -.017), indicating posttreatment growth in DC and DT, but no change in RS. Cox regression indicated that DC slope was a significant predictor of relapse/recurrence prophylaxis, Hazard Ratio (HR) = .232 90% Confidence Interval (CI) [.067, .806], controlling for past depressive episodes, treatment group, and medication. The practice of therapy-acquired regulatory skills had no direct effect on relapse/recurrence (β = .028) but predicted relapse/recurrence through an indirect path (β = -.125), such that greater practice of regulatory skills following treatment promoted increases in DC (β = .462), which, in turn, predicted a reduced risk of relapse/recurrence over 24 months (β = -.270). Preventing major depressive disorder relapse/recurrence may depend upon developing DC in addition to managing residual symptoms. Following the acquisition of therapy skills during maintenance psychotherapies, DC is strengthened by continued skill utilization beyond treatment termination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",30431297,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.845206260681152,-0.6823543906211853,BDSM
"Effects of a cognitive behavioral self-help program on depressed mood for people with acquired chronic physical impairments: a pilot randomized controlled trial.

Aim was to examine whether a new cognitive-behavioral self-help intervention program was effective in improving depressed mood in people with acquired chronic physical impairments. Participants were 32 persons with acquired chronic physical impairments and depressive symptoms, who were randomly allocated to the Cognitive-Behavioral Self-help program (CBS) or the Waiting List Control group (WLC). Depression scores were assessed at three measurement moments: at pretest, immediately after completion of the intervention (posttest), and again two months later (follow-up). To evaluate changes in depression scores, Repeated Measures ANCOVA's were performed. It was shown that respondents who followed the CBS significantly improved compared to the WLC after completion of the program, and that this positive effect remained at 2-months follow-up. A cognitive-behavioral self-help intervention can be an effective tool to reduce depressive symptoms in people with physical impairments. A self-help program may prove to be more cost-effective for individuals and for the health care system as a whole. In addition, because a self-help intervention program can be delivered through mail or internet, a high number of people could be reached while overcoming geographical and social barriers to treatment.",21195575,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.225972175598145,-2.8352298736572266,DBty
"Randomized Controlled Trial of a Computerized Interactive Media-Based Problem Solving Treatment for Depression.

This study evaluated the efficacy of an interactive media-based, computer-delivered depression treatment program (imbPST) compared to a no-treatment control condition (NTC) in a parallel-group, randomized, controlled trial conducted in an outpatient psychiatric research clinic. 45 adult participants with major depressive disorder or dysthymia were randomized to receive either 6 weekly sessions of imbPST or no treatment (No Treatment Control; NTC). The primary outcome measure was the Beck Depression Inventory II (BDI-II). There was a significant Group x Time interaction effect [F (1.73, 43)= 58.78; p<.001; η2=.58, Cohens d=1.94], such that the patients receiving imbPST had a significantly greater reduction in depressive symptoms compared to the patients in the NTC condition. Participants in the imbPST group improved their depression symptoms significantly from moderate (BDI-II=21.9±4.20) to mild levels of depression (BDI-II=17.9±4.0) after receiving 3 weekly sessions of imbPST (p<0.001), and progressed to still milder levels of depression after six weekly sessions (BDI-II=14.5±3.7, p<0.001). NTC participants showed no significant reduction in BDI-II scores (BDI-II=21.8±4.2 pre, BDI-II=21.5±5.2 post, N.S.). Additionally, 40% of the imbPST group showed a clinically significant and reliable change in depression levels while none of the NTC group met this criterion. imbPST participants rated the program highly usable on the system usability scale (SUS) after the first session (SUS Session 1=74.6±7.2) and usability scores increased significantly by the last session (SUS Session 6=85.4±5.6). We conclude that imbPST is an effective, engaging, and easily used depression treatment program that warrants further evaluation with heterogeneous depressed populations in a stand-alone, self-administered fashion.",28390503,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.556995391845703,-2.9968113899230957,BeO7
"A mixed methods exploration of ""Creativity in Mind"", an online creativity-based intervention for low mood and anxiety.

Within the current context of a global pandemic, the value of the Internet has been greatly elevated for many people. This study is an investigation into a 30-day online intervention called Creativity in Mind (CIM). To provide a preliminary indication of the relationship between participation in CIM and change in mood symptoms and wellbeing. A co-produced mixed methods design was used to evaluate CIM. Data was obtained from 55 participants. Each day for 30days participants received a predetermined creative challenge that they were encouraged to complete and share within the group. Measures of mood and wellbeing were collected at three time points, including a 3-month follow-up. Qualitative interviews were undertaken with 18 participants and analysed using framework analysis. Scores on mood and wellbeing measures showed an overall significant improvement following completion of the programme. However, only a small number of participants demonstrated clinically significant improvement (14%) or deterioration (5%). The qualitative data indicated that CIM was experienced positively, with some negative emotions arising from the volume of interactions and negative comparisons made between participants. Preliminary results demonstrate that the pattern of clinically significant change across individual participants was comparable to other psychological therapy.",34006165,Major Depressive Disorder,Anxiety Treatment,Mental Health,16932,10.631736755371094,-4.041082859039307,AWJL
"A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression.

Internet-delivered treatments for depression have proved successful, with supported programs offering the potential for improved adherence and outcomes. Internet interventions are particularly interesting in the context of increasing access to interventions, and delivering interventions population-wide. The study was a randomized controlled trial of an 7-module internet-delivered cognitive behavioral therapy (iCBT) program for adults with depressive symptoms (n = 96) compared to a waiting-list control group (n = 92). Participants received weekly support from a trained supporter. The primary outcome was depressive symptoms as measured by the Beck Depression Inventory (BDI-II). The program was made available nationwide from an established and recognized charity for depression. For the treatment group, post-treatment effect sizes reported were large for the primary outcome measure (d = 0.91). The between-group effects were moderate to large and statistically significant for the primary outcomes (d = 0.50) favoring the treatment group. Gains were maintained at 6-month follow-up. The study has demonstrated the efficacy of the internet-delivered Space from Depression treatment. Participants demonstrated reliable and statistically significant changes in symptoms from pre-to post-intervention. The study supports a model for delivering online depression interventions population-wide using trained supporters. Current Controlled Trials ISRCTN03704676. http://dx.doi.org/10.1186/ISRCTN03704676.",26523885,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.051125526428223,-3.2073757648468018,B1xN
"Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care.

Depression is one of the most common mental disorders and will become one of the leading causes of disability in the world. Internet-based CBT programs for depression have been classified as ""well established"" following the American Psychological Association criteria for empirically supported treatments. The aim of this study is to analyze the cost effectiveness at 12-month follow-up of the Internet-based CBT program ""Smiling is fun"" with (LITG) and without psychotherapist support (TSG) compared to usual care. The perspective used in our analysis is societal. A sample of 296 depressed patients (mean age of 43.04 years; 76% female; BDI-II mean score = 22.37) from primary care services in four Spanish regions were randomized in the RCT. The complete case and intention-to-treat (ITT) perspectives were used for the analyses. The results demonstrated that both Internet-based CBT interventions exhibited cost utility and cost effectiveness compared with a control group. The complete case analyses revealed an incremental cost-effectiveness ratio (ICER) of €-169.50 and an incremental cost-utility ratio (ICUR) of €-11389.66 for the TSG group and an ICER of €-104.63 and an ICUR of €-6380.86 for the LITG group. The ITT analyses found an ICER of €-98.37 and an ICUR of €-5160.40 for the TSG group and an ICER of €-9.91 and an ICUR of €496.72 for the LITG group. In summary, the results of this study indicate that the two Internet-based CBT interventions are appropriate from both economic and clinical perspectives for depressed patients in the Spanish primary care system. These interventions not only help patients to improve clinically but also generate societal savings. clinicaltrials.gov NCT01611818.",28241025,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.739640235900879,-2.7598061561584473,BgR0
"Early changes, attrition, and dose-response in low intensity psychological interventions.

To investigate if early symptom changes in brief low intensity psychological interventions (guided self-help and psycho-education using cognitive behavioural therapy principles) are predictive of final treatment outcome. Retrospective cohort data analysis. Clinical records for 1,850 patients who screened positive for depression and/or an anxiety disorder were analysed. Reliable and clinically significant improvement (RCSI) on depression (Patient Health Questionnaire-9: PHQ-9) or anxiety (generalized anxiety disorder-7: GAD-7) outcome measures after treatment was the primary outcome. Change scores ≥6 on PHQ-9 and ≥5 on GAD-7 were taken as indicative of reliable improvement (RI). The model assumed that RI in the earliest treatment sessions would be predictive of RCSI post-treatment. Predictive accuracy was assessed by calculating the area under the curve (AUC), as well as positive and negative predictive values. Diagnostic odds ratios were also estimated, adjusting for confounders such as baseline severity, use of medication, and pre-treatment symptom change. The AUC estimates for session-to-session change scores ranged between .62 and .88, indicative of modest to high predictive reliability. Predictive accuracy was higher for patients who had four or more treatment sessions, with more than 70% of patients with RCSI being accurately identified as early as sessions 1-3. Attrition rates were significantly associated with poor outcomes. Results suggest that at least four therapy sessions are necessary to achieve more than 50% RCSI rates, and the dose-response effect appears to decline in treatments longer than six sessions. Patients showing RI early in treatment were at least twice as likely to fully recover compared to those without early RI.",24117962,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,11.568041801452637,-3.3971304893493652,CXha
"A prospective study of existential issues in therapeutic horticulture for clinical depression.

Two studies with single-group design (Study 1 N = 18, Study 2 N = 28) addressed whether horticultural activities ameliorate depression severity and existential issues. Measures were obtained before and after a 12-week therapeutic horticulture program and at 3-month follow-up. In both studies, depression severity declined significantly during the intervention and remained low at the follow-up. In both studies the existential outcomes did not change significantly; however, the change that did occur during the intervention correlated (rho > .43) with change in depression severity. Participants' open-ended accounts described the therapeutic horticulture experience as meaningful and influential for their view of life.",21208054,Major Depressive Disorder,Anxiety Treatment,Mental Health,7384,9.253085136413574,-3.04003643989563,DBjy
"Is interpersonal counselling (IPC) sufficient treatment for depression in primary care patients? A pilot study comparing IPC and interpersonal psychotherapy (IPT).

Psychotherapeutic treatment is underused in primary care, where even short-term psychotherapy can be perceived as too lengthy and labour-intensive. We tested here for the first time the preliminary efficacy of seven sessions of interpersonal counselling (IPC) by comparison with sixteen sessions of interpersonal psychotherapy (IPT) in regular clinical settings. Patients seeking treatment for the first time who met the DSM-IV criteria for major depressive disorder (MDD, mild/moderate) were randomized to either IPC (n=20) or IPT (n=20). The efficacy of the treatments was assessed using the 34-item Clinical Outcomes in Routine Evaluation (CORE-OM) scale and the Beck Depression Inventory (BDI) scale. 90% of the patients completed all the treatment sessions. IPC delivered by psychiatric nurses in primary care proved equally as effective as IPT delivered by psychotherapists/psychologists in secondary care. The pre-treatment to 12-month follow-up within-group effect sizes were large: 1.52 (CORE-OM) and 1.41 (BDI) in the IPC group and 1.58 (CORE-OM) and 1.40 (BDI) in the IPT group. At the 12-month follow-up 59% of the patients in the IPC group and 63% in the IPT group were classified as recovered on the CORE-OM scale, with corresponding remission rates of 61% for both groups on the BDI scale. The small sample size limited the power to detect differences between the groups and the naturalistic settings may have confounded the results. This clinical trial suggests that IPC is an appropriate and even sufficient first-phase intervention for handling previously untreated mild to moderate depression in primary health care.",26432031,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.227578163146973,-3.4605023860931396,B3Hs
"Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial.

Up to 70% of adolescents with moderate to severe unipolar major depression respond to psychological treatment plus Fluoxetine (20-50 mg) with symptom reduction and improved social function reported by 24 weeks after beginning treatment. Around 20% of non responders appear treatment resistant and 30% of responders relapse within 2 years. The specific efficacy of different psychological therapies and the moderators and mediators that influence risk for relapse are unclear. The cost-effectiveness and safety of psychological treatments remain poorly evaluated. Improving Mood with Psychoanalytic and Cognitive Therapies, the IMPACT Study, will determine whether Cognitive Behavioural Therapy or Short Term Psychoanalytic Therapy is superior in reducing relapse compared with Specialist Clinical Care. The study is a multicentre pragmatic effectiveness superiority randomised clinical trial: Cognitive Behavioural Therapy consists of 20 sessions over 30 weeks, Short Term Psychoanalytic Psychotherapy 30 sessions over 30 weeks and Specialist Clinical Care 12 sessions over 20 weeks. We will recruit 540 patients with 180 randomised to each arm. Patients will be reassessed at 6, 12, 36, 52 and 86 weeks. Methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, research assessors independent of treatment team and blind to randomization, analysis by intention to treat, data management using remote data entry, measures of quality assurance, advanced statistical analysis, manualised treatment protocols, checks of adherence and competence of therapists and assessment of cost-effectiveness. We will also determine whether time to recovery and/or relapse are moderated by variations in brain structure and function and selected genetic and hormone biomarkers taken at entry. The objective of this clinical trial is to determine whether there are specific effects of specialist psychotherapy that reduce relapse in unipolar major depression in adolescents and thereby costs of treatment to society. We also anticipate being able to utilise psychotherapy experience, neuroimaging, genetic and hormone measures to reveal what techniques and their protocols may work best for which patients. Current Controlled Trials ISRCTN83033550.",21752257,Major Depressive Disorder,Anxiety Treatment,Mental Health,5034,10.886210441589355,-3.0560853481292725,C54Q
"[Treatments for depression in consultation-liaison psychiatry: From theory to practice].

Treatments for depression include an adapted lifestyle, physical activity, psychotherapies, antidepressant and mood stabilizing drugs, neuromodulation, chronotherapy, spa treatments. Drug treatments used for major depressive episode are antidepressants and mood stabilizers. For a mild episode, psychotherapy is indicated. It should be combined with an antidepressant (serotonin reuptake inhibitor) for moderate and severe episodes. Suicide risk assessment is essential throughout the depressive episode. It is recommended to monitor at the start of antidepressant treatment for suicidal behavior, a change in mood suggesting an underlying bipolar disorder. The effectiveness of the treatment is evaluated after 4 to 8 weeks. The total duration of antidepressant treatment for an EDC is between 6 months and 1 year after remission, in order to prevent relapses. The use of liaison psychiatry, a real healthcare system within the general hospital, is strongly recommended for better screening and treatment of depression, thus reducing the length of hospital stays, improving the prognosis of depression. The aim of this article is to provide clinicians with a summary of validated data on the efficacy/tolerance of treatment for depression, and to suggest practical action to be taken on the main daily clinical situations: treating comorbid conditions, taking into account interactions drugs, manage the serotonin syndrome, lead to withdrawal from antidepressants, manage treatment in the elderly.",34256970,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.554726600646973,-1.0626410245895386,ATST
"The efficacy of a behavioral activation intervention among depressed US Latinos with limited English language proficiency: study protocol for a randomized controlled trial.

Major depressive disorder is highly prevalent among Latinos with limited English language proficiency in the United States. Although major depressive disorder is highly treatable, barriers to depression treatment have historically prevented Latinos with limited English language proficiency from accessing effective interventions. The project seeks to evaluate the efficacy of behavioral activation treatment for depression, an empirically supported treatment for depression, as an intervention that may address some of the disparities surrounding the receipt of efficacious mental health care for this population. Following a pilot study of behavioral activation treatment for depression with 10 participants which yielded very promising results, the current study is a randomized control trial testing behavioral activation treatment for depression versus a supportive counseling treatment for depression. We are in the process of recruiting 60 Latinos with limited English language proficiency meeting criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th and 5th Edition for participation in a single-center efficacy trial. Participants are randomized to receive 10 sessions of behavioral activation treatment for depression (n=30) or 10 sessions of supportive counseling (n=30). Assessments occur prior to each session and at 1 month after completing treatment. Intervention targets include depressive symptomatology and the proposed mechanisms of behavioral activation treatment for depression: activity level and environmental reward. We will also examine other factors related to treatment outcome such as treatment adherence, treatment satisfaction, and therapeutic alliance. This randomized controlled trial will allow us to determine the efficacy of behavioral activation treatment for depression in a fast-growing, yet highly underserved population in US mental health services. The study is also among the first to examine the effect of the proposed mechanisms of change of behavioral activation treatment for depression (that is, activity level and environmental reward) on depression over time. To our knowledge, this is the first randomized controlled trial to compare an empirical-supported treatment to a control supportive counseling condition in a sample of depressed, Spanish-speaking Latinos in the United States. Clinical Trials Register: NCT01958840; registered 8 October 2013.",24938081,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.474811553955078,-5.858597278594971,CMfH
"Efficacy of peer support interventions for depression: a meta-analysis.

To assess the efficacy of peer support for reducing symptoms of depression. Medline, PsycINFO, CINAHL and CENTRAL databases were searched for clinical trials published as of April 2010 using Medical Subject Headings and free text terms related to depression and peer support. Two independent reviewers selected randomized controlled trials (RCTs) that compared a peer support intervention for depression to usual care or a psychotherapy control condition. Meta-analyses were conducted to generate pooled standardized mean differences (SMD) in the change in depressive symptoms between study conditions. Seven RCTs of peer support vs. usual care for depression involving 869 participants were identified. Peer support interventions were superior to usual care in reducing depressive symptoms, with a pooled SMD of -0.59 (95% CI, -0.98 to -0.21; P=.002). Seven RCTs with 301 total participants compared peer support to group cognitive behavioral therapy (CBT). There was no statistically significant difference between group CBT and peer interventions, with a pooled SMD of 0.10 (95% CI, -0.20 to 0.39, P=.53). Based on the available evidence, peer support interventions help reduce symptoms of depression. Additional studies are needed to determine effectiveness in primary care and other settings with limited mental health resources.",21353125,Major Depressive Disorder,Anxiety Treatment,Mental Health,13374,8.894681930541992,-3.6549155712127686,C/dq
"Effectiveness of positive psychotherapy for young adults with depressive Symptoms.

To analyse the level of happiness and depressive symptoms before and after positive psychotherapy.. The experimental study was conducted from February 2018to March 2018 in Shahpur Sadar town of Sargodha district in the Punjab province of Pakistan at Govt. College, and comprised female young adults with depressive symptoms. The participants were subjected to 8 sessions (one baseline and seven other) of group positive psychotherapy. On the basis of repeated measure design, data was collected using the depression subscale of Depression Anxiety Stress Scale-21, Positive Psychotherapy Inventory, and Values in Action Inventory before, during and after therapy administration. SPSS 23 was used for data analysis. Of the 250 subjects assessed, 30(12%) aged 18-20 years were selected for therapy sessions as they had some level of depression; 15(50%) mild and 15(50%) moderate. Mean happiness level increased with each session from baseline value of 20.63±4.61 to post-therapy 50.67±4.63 (p<0.05). Depression level decreased from baseline value of 15.47±3.42 with each session to post-therapy 4.53±1.10 (p<0.05). Positive psychotherapy sessions were found to be effective in decreasing depression among female young adults.",32400741,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.196149826049805,-3.4655392169952393,ApNe
"Morita therapy for depression and anxiety (Morita Trial): study protocol for a pilot randomised controlled trial.

Morita Therapy, a psychological therapy for common mental health problems, is in sharp contrast to established western psychotherapeutic approaches in teaching that undesired symptoms are natural features of human emotion rather than something to control or eliminate. The approach is widely practiced in Japan, but untested and little known in the UK. A clinical trial of Morita Therapy is required to establish the effectiveness of Morita Therapy for a UK population. However, a number of methodological, procedural and clinical uncertainties associated with such a trial first require addressing. The Morita Trial is a mixed methods study addressing the uncertainties associated with an evaluation of Morita Therapy compared with treatment as usual for depression and anxiety. We will undertake a pilot randomised controlled trial with embedded qualitative study. Sixty participants with major depressive disorder, with or without anxiety disorders, will be recruited predominantly from General Practice record searches and randomised to receive Morita Therapy plus treatment as usual or treatment as usual alone. Morita Therapy will be delivered by accredited psychological therapists. We will collect quantitative data on depressive symptoms, general anxiety, attitudes and quality of life at baseline and four month follow-up to inform future sample size calculations; and rates of recruitment, retention and treatment adherence to assess feasibility. We will undertake qualitative interviews in parallel with the trial, to explore people's views of Morita Therapy. We will conduct separate and integrated analyses on the quantitative and qualitative data. The outcomes of this study will prepare the ground for the design and conduct of a fully-powered evaluation of Morita Therapy plus treatment as usual versus treatment as usual alone, or inform a conclusion that such a trial is not feasible and/or appropriate. We will obtain a more comprehensive understanding of these issues than would be possible from either a quantitative or qualitative approach alone. Current Controlled Trials ISRCTN17544090 registered on 23 July 2015.",27009046,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.967638969421387,-2.246354103088379,BvOw
"Attitudes and Preferences towards Self-help Treatments for Depression in Comparison to Psychotherapy and Antidepressant Medication.

Self-help is an effective treatment for depression. Less is known, however, about how acceptable people find different self-help treatments for depression. To investigate preferences and attitudes toward different self-help treatments for depression in comparison to psychotherapy and antidepressants. N = 536 people who were not actively seeking treatment for depression were randomly assigned to read about one of five treatment options (bibliotherapy, Internet-based self-help, guided self-help, antidepressants, or psychotherapy) before rating how acceptable they found the treatment. Participants also ranked the treatments in order of preference. Psychotherapy and guided self-help were found to be the most acceptable and preferred treatment options. Antidepressants and bibliotherapy were found to be the least acceptable treatments, with antidepressants rated as the most likely to have side effects. Preference data reflected the above findings - psychotherapy and guided self-help were the most preferred treatment options. The findings highlight differences in attitudes and preferences between guided and unguided self-help interventions; and between self-help interventions and psychotherapy. Future research should focus on understanding why unguided self-help interventions are deemed to be less acceptable than guided self-help interventions for treating depression.",25697236,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.46861457824707,-2.77177357673645,CBro
"Insight as a mechanism of change in dynamic therapy for major depressive disorder.

This study aimed to investigate change in insight into maladaptive interpersonal patterns over the course of psychotherapy, as well as the specificity of insight as a change mechanism in dynamic treatments. A total of 100 patients received up to 16 sessions of either cognitive or dynamic therapy for major depressive disorder in a randomized clinical trial. Assessments of insight (Insight into Conflictual Relationship Patterns scale) and depression severity (Hamilton Depression Inventory) took place at the beginning of treatment, at month 2, and month 5. Patient insight significantly improved over the course of dynamic treatments. Gains in insight from the beginning to month 2 of treatment were a significant predictor of decreases of depressive symptoms from month 2 to month 5 of treatment in the dynamic, but not in the cognitive treatment group, despite a nonsignificant interaction. Results provide support for insight as a change factor in dynamic therapies. Better self-understanding of dysfunctional interaction patterns could help patients to find more adaptive ways of behaving, to form more satisfying relationships, and to improve their depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).",33970657,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,15.320450782775879,-2.1420488357543945,AWkO
"The cost-effectiveness of cognitive behavioural therapy for the depression in Latinos.

",25204033,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.356818199157715,-3.5836141109466553,CIoO
"PSYCHOLOGICAL TREATMENT OF DEPRESSION IN COLLEGE STUDENTS: A METAANALYSIS.

Expanded efforts to detect and treat depression among college students, a peak period of onset, have the potential to bear high human capital value from a societal perspective because depression increases college withdrawal rates. However, it is not clear whether evidence-based depression therapies are as effective in college students as in other adult populations. The higher levels of cognitive functioning and IQ and higher proportions of first-onset cases might lead to treatment effects being different among college students relative to the larger adult population. We conducted a metaanalysis of randomized trials comparing psychological treatments of depressed college students relative to control groups and compared effect sizes in these studies to those in trials carried out in unselected populations of depressed adults. The 15 trials on college students satisfying study inclusion criteria included 997 participants. The pooled effect size of therapy versus control was g = 0.89 (95% CI: 0.66∼1.11; NNT = 2.13) with moderate heterogeneity (I(2) = 57; 95% CI: 23∼72). None of these trials had low risk of bias. Effect sizes were significantly larger when students were not remunerated (e.g. money, credit), received individual versus group therapy, and were in trials that included a waiting list control group. No significant difference emerged in comparing effect sizes among college students versus adults either in simple mean comparisons or in multivariate metaregression analyses. This metaanalysis of trials examining psychological treatments of depression in college students suggests that these therapies are effective and have effect sizes comparable to trials carried out among depressed adults.",26682536,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.419325828552246,-3.468287944793701,BzrI
"Changes in depressed patients' self-statements.

Objective: Individuals' use of self-statements reflecting self-criticism, a sense of inadequacy, and low self-worth has been linked to the incidence, severity, and recurrence of major depressive disorder [de Graaf, L. E., Huibers, M. J. H., Cuijpers, P., & Arntz, A. (2010). Minor and major depression in the general population: Does dysfunctional thinking play a role? Comprehensive Psychiatry, 51(3), 266-274. doi:10.1016/j.comppsych.2009.08.006; Riso, L. P., du Toit, P. L., Blandino, J. A., Penna, S., Dacey, S., Duin, J. S.,…Ulmer, C. S. (2003). Cognitive aspects of chronic depression. Journal of Abnormal Psychology, 112(1), 72-80. doi:10.1037/0021-843X.112.1.72]. The present study used an observer-rated measure, the Structural Analysis of Social Behavior [Benjamin, L. S. (1974). Structural Analysis of Social Behavior. Psychological Review, 81(5), 392-425. doi:10.1037/h0037024], to examine patients' self-directed communication over the course of psychotherapy.Method: Self-talk in early and late therapy sessions was examined using cases (N=44) from the cognitive therapy arm of Jacobson and colleagues' component study of cognitive therapy for depression [Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K.,…Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295-304. doi:10.1037/0022-006x.64.2.295, Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K.,…Prince, S. E. (2000). A component analysis of cognitive-behavioral treatment for depression. Prevention & Treatment, 3(1). doi:10.1037/1522-3736.3.1.323a]. We identified changes at treatment termination, and used hierarchical multiple regression to examine whether improvements in patient self-talk influenced treatment outcome up to 24 months post-termination.Results: Trends indicate that patients used friendlier and less critical self-statements at the end of treatment. Decreased self-critical behaviour was associated with fewer symptoms at the end of treatment and up to one year later; increased self-acceptance was linked to symptom improvement a year and a half after termination.Conclusion: Consistent with cognitive theory, reduced self-criticism was associated with better treatment outcomes. Longer-term improvement was linked to the development of friendlier and more accepting self-referential behaviour.",30422103,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,13.49139404296875,-3.734039783477783,BDaO
"The Significance of Understanding Body Language in Depressed Patients within the Context of Creative Psychopharmacotherapy.

Since it is generally known that the human body is the best image of the human soul, this paper aims to explain how important body language is when diagnosing psychiatric diagnosis ""depression"". It is important to point out the importance of other alternative approaches in the treatment of depression when standard psychopharmacotherapy is not enough. Body language is a powerful form of non-verbal communication that provides important traces of intentions, emotions, and motivations in other people. In everyday life, we collect information about what people think and feel by their body posture, manners, and gestures. Evaluations of clinical depression are traditionally based on verbal information. However, non-verbal expressive behavior, related to reflexive feedback of a person, may reveal negative emotional or social processes that are not fully controlled by patients therapy, along with other artistic therapies (art therapy, drama therapy, and music therapy are other artistic therapies that are applied in Great Britain) offers an attractive opportunity for patients because it enables them to work on those issues that are placed on non-verbal and pre-verbal level. Creative psychofarmacotherapy is the concept that involves creativity as its main means. In this context, the importance of physical activity and body movements will be emphasized in the treatment of depression, when regular psychopharmacotherapy is not sufficient. To conclude, the patient has the right to actively take part in creating a therapeutic relationship and responsibly contributes to overcoming psychopathology. The importance of physical activities and body movements is emphasized in the treatment of depressive people. Studies have shown that the anti-depressive effect of physical activity is increased with simultaneous use of antidepressants, as well as that movement therapy and music therapy, together with regular pharmacotherapeutic methods, help with fast recovery and that they can be used in a creative approach to problem-solving.",35354170,Major Depressive Disorder,Anxiety Treatment,Mental Health,16932,8.884001731872559,-1.7951130867004395,f6M
"Effectiveness of psycho-educational intervention in improving outcome of unipolar depression: results from a randomised clinical trial.

Depressive disorders are one of the leading components of the global burden of disease with a prevalence of up to 14% in the general population. Numerous studies have demonstrated that pharmacotherapy combined with non-pharmacological measures offer the best treatment approach. Psycho-education as an intervention has been studied mostly in disorders such as schizophrenia and dementia, less so in depressive disorders. The present study aimed to assess the impact of psycho-education of patients and their caregivers on the outcome of depression. A total of 80 eligible depressed subjects were recruited and randomised into 2 groups. The study group involved an eligible family member and all were offered individual structured psycho-educational modules. Another group (controls) received routine counselling. The subjects in both groups also received routine pharmacotherapy and counselling from the treating clinician and were assessed at baseline, 2, 4, 8, and 12 weeks using the Hamilton Depression Rating Scale (HDRS), Global Assessment of Functioning (GAF), and Psychological General Well-Being Index (PGWBI). Results from both groups were compared using statistical methods including Chi-square test, Fisher's exact test, Student's t test, Pearson's correlation coefficient, as well as univariate and multiple regression analyses. Baseline socio-demographic and assessment measures were similar in both groups. The study group had consistent improvement in terms of outcome measures with HDRS, GAF, and PGWBI scores showing respective mean change of -15.08, 22, and 60 over 12 weeks. The comparable respective changes in the controls were -8.77, 18.1, and 43.25. Structured psycho-education combined with pharmacotherapy is an effective intervention for people with depressive disorders. Psycho-education optimises the pharmacological treatment of depression in terms of faster recovery, reduction in severity of depression, and improvement in subjective wellbeing and social functioning.",25829103,Major Depressive Disorder,Anxiety Treatment,Mental Health,26524,10.649392127990723,-3.2936689853668213,B/vL
"Applying the unified protocol to a single case of major depression with schizoid and depressive personality traits.

The study presents the use of the Unified Protocol (UP) in a case of a male diagnosed with major depressive disorder and schizoid and depressive personality traits. The therapeutic focus of UP is to identify maladaptive behaviors of emotion regulation and to train new regulation strategies such as cognitive re-appraisal or emotional exposure exercises. This is a single-case research study. The intervention was carried out in twenty 1-hour sessions for 6 months. After treatment completion, follow-ups were conducted at three, six, and twelve months. The results of the 12-month follow-up revealed a clinically significant change in depressive symptomatology (RCI BDI-II = -5.51), negative affect (RCI NEGATIVE PANAS = -3.61), quality of life (RCIICV-Sp = 4.61) and schizoid (RCIMCMI-III-Schizoid = -4.36) and depressive (RCIMCMI-III-Depressive = -5.24) personality traits. Schizoid and depressive personality traits did not interfere with the application, course, and compliance with treatment. These results are discussed with regard to similar studies, also based on the use of the UP to work on emotion regulation in the treatment of emotional disorders with clinical comorbidity. The training of emotion regulation strategies through UP could be an effective proposal to treat emotional disorders with pathological personality traits comorbidity.",30353835,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,12.141266822814941,-2.8858938217163086,BEUy
"Predicting Outcome in Internet-Based Cognitive Behaviour Therapy for Major Depression: A Large Cohort Study of Adult Patients in Routine Psychiatric Care.

Although the effectiveness of therapist-guided internet-based cognitive behaviour therapy (ICBT) for treating depression has been well documented, knowledge of outcome predictors and risk factors associated with lower treatment response is limited, especially when the treatment has been conducted within a naturalistic clinical setting. Identification of such factors is important for clinicians when making treatment recommendations. Data from a large cohort (N = 1738) of adult outpatients having been treated with ICBT for depression at an outpatient psychiatric clinic were analysed. A multilevel modelling approach was used to identify patient and treatment variables associated with the speed of recovery during treatment using weekly measurements of the Montgomery Åsberg Depression Rating Scale Self-Rated (MADRS-S). Adhering to the treatment, perceiving it as credible and working full-time emerged as predictors of a faster pace of recovery and were also associated with a lower level of depression at the end of treatment. Higher pre-treatment depression and sleep problems were associated with a greater improvement rate, but predicted higher depression after treatment. Having a history of psychotropic medication was associated with both slower improvement and higher post-treatment depression. Perceived credibility of ICBT is a strong predictor of treatment response. Assessing patient beliefs and expectations may be a useful aid for clinicians when identifying those who are more or less likely to benefit from ICBT. Helping patients improve expectations prior to treatment may be an important goal for clinicians during the initial assessment phase.",27618548,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.229964256286621,-2.8900256156921387,BnbG
"The impact of psychotherapy, pharmacotherapy, and their combination on quality of life in depression.

Quality of life (QOL) is known to be negatively affected during the course of major depressive disorder. Various studies have documented the benefits of pharmacotherapy or psychotherapy alone on QOL in depression, with few studies examining combined treatment. This review will examine the evidence for the impact of each modality, as well as their combination, on QOL in depression. Using the key terms depression, depress*, major depress*, quality of life, antidepressant*, and psychotherapy, MEDLINE and PsycINFO searches were conducted to identify treatment-outcome studies that used known QOL measurements over the past twenty-six years (1984 to 2010). Significant improvements in depressive symptomatology and QOL measurements were found with pharmacotherapy, psychotherapy, and their combination, with some studies showing greater improvement following combined treatment than with either intervention alone. Substantial evidence suggests that psychotherapy, pharmacotherapy, and their combination have favorable effects on QOL in depression. While some studies have shown that combined therapy is superior than either of the two forms alone in improving QOL, additional research is needed to elucidate this effect. QOL measurement is an important dimension of treatment-outcome assessment in patients with depression.",22098324,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.834168434143066,-1.3555443286895752,C0yc
"Long-term Follow-up of a Randomized Clinical Trial Assessing the Efficacy of a Brief Cognitive-Behavioral Depression Prevention Intervention for Caregivers with Elevated Depressive Symptoms.

To evaluate the efficacy of a cognitive-behavioral intervention for the prevention of depression in caregivers with elevated depressive symptoms through 12 months of follow-up. Randomized controlled trial. Community in Galicia (Spain). 170 caregivers with elevated depressive symptoms. Caregivers were randomized to a cognitive-behavioral intervention (N=88), administered to groups of five participants in five weekly 90-min sessions, or to a usual care control group (N=82). Major depressive episodes (according to the Structured Clinical Interview for Axis I Disorders of the DSM-IV), depressive symptoms, emotional distress, caregiver burden, pleasant activities, depressive thoughts, social contacts. Trained blinded interviewers conducted assessments at 1, 3, 6, and 12 months of follow-up. At the 12-month follow-up, there was a lower incidence of major depressive episodes in the intervention group compared with the control group (3.4% versus 22.0%). The relative risk was 0.15 (95% CI: 0.05-0.51) and the number needed to treat was 5 (95% CI: 3-11). The time of delay of the depressive episode onset in the intervention group was significant. Caregivers with good compliance to the intervention had a lower incidence of depression. The effects of the intervention on depressive symptoms, emotional distress, and caregiver burden were maintained for 12 months. Younger caregivers were more likely to benefit from the intervention. The change in depressive thoughts mediated the reduction in depressive symptoms. Depressive episodes can be successfully prevented in caregivers, with long-term effects.",27067068,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.919322967529297,-2.718601703643799,BuY6
"Do improved patient recall and the provision of memory support enhance treatment adherence?

Patient adherence to psychosocial treatment is an important but understudied topic. The aim of this study was to examine whether better patient recall of treatment contents and therapist use of memory support (MS) were associated with better treatment adherence. Data were drawn from a pilot randomized controlled trial. Participants were 48 individuals (mean age = 44.27 years, 29 females) with Major Depressive Disorder randomized to receive either Cognitive Therapy (CT) with an adjunctive Memory Support Intervention (CT + Memory Support) or CT-as-usual. Therapist and patient ratings of treatment adherence were collected during each treatment session. Patient recall was assessed at mid-treatment. Therapist use of MS was manually coded for a random selection of sessions. Patient recall was significantly associated with better therapist and patient ratings of adherence. Therapist use of Application, a specific MS strategy, predicted higher therapist ratings of adherence. Attention Recruitment, another specific MS strategy, appeared to attenuate the positive impact of session number on patient ratings of adherence. Treatment groups, MS summary scores and other specific MS strategies were not significantly associated with adherence. The measure for treatment adherence is in the process of being formally validated. Results were based on small sample. These results support the importance of patient recall in treatment adherence. Although collectively the effects of MS on treatment adherence were not significant, the results support the use of certain specific MS strategy (i.e., application) as a potential pathway to improve treatment adherence. Larger-scale studies are needed to further examine these constructs.",27614662,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.287430763244629,-0.8522272109985352,BneH
"Risk factors for relapse and recurrence of depression in adults and how they operate: A four-phase systematic review and meta-synthesis.

To review and synthesise prognostic indices that predict subsequent risk, prescriptive indices that moderate treatment response, and mechanisms that underlie each with respect to relapse and recurrence of depression in adults. Childhood maltreatment, post-treatment residual symptoms, and a history of recurrence emerged as strong prognostic indicators of risk and each could be used prescriptively to indicate who benefits most from continued or prophylactic treatment. Targeting prognostic indices or their ""down-stream"" consequences will be particularly beneficial because each is either a cause or a consequence of the causal mechanisms underlying risk of recurrence. The cognitive and neural mechanisms that underlie the prognostic indices are likely addressed by the effects of treatments that are moderated by the prescriptive factors. For example, psychosocial interventions that target the consequences of childhood maltreatment, extending pharmacotherapy or adapting psychological therapies to deal with residual symptoms, or using cognitive or mindfulness-based therapies for those with prior histories of recurrence. Future research that focuses on understanding causal pathways that link childhood maltreatment, or cognitive diatheses, to dysfunction in the neocortical and limbic pathways that process affective information and facilitate cognitive control, might result in more enduring effects of treatments for depression.",30075313,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.954977989196777,-0.8518908023834229,BICK
"Behavioral activation versus physical activity via the internet: A randomized controlled trial.

A major problem today is that only about fifty percent of those affected by depression seeks help. One way to reach more sufferers would be by offering easily accessible internet based treatments. The purpose of this study was to compare/evaluate four therapist supported internet administered treatments. Two hundred eighty six participants were included. The treatment period lasted twelve weeks, consisting of the following treatments: 1) physical activity without treatment rational, 2) physical activity with treatment rational, 3) behavioral activation without treatment rational and 4) behavioral activation with treatment rational. All groups (including a control-group) showed a significant decrease in depressive symptoms. When the treatment groups were pooled and compared to the control group, there were significant differences from pretest to posttest (Hedges gav treatment =1.01, control group =0.47). This held true also when each of the four treatment groups was compared to the control group, with one exception: Physical activity without treatment rationale. The differences between how many modules the participants completed could indicate that there are other factors than the treatments that caused the symptom reduction, however, the dose-response analysis did not detect any significant differences on account of modules completed. The results support the positive effects of internet administered treatments for depression, and highlights the importance of psychoeducation, which tends to affect both the treatment outcome and the probability of remaining in treatment. These aspects need to be considered when developing and conducting new treatments for depression, since they would increase the likelihood of positive treatment outcomes.",28319696,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.845362663269043,-2.6564738750457764,BfQ7
"Perceptions of Cognitive-Behavioral Therapy and Antidepressant Medication for Depression After Brief Psychoeducation: Examining Shifts in Attitudes.

The majority of people with depression in the United States either never seek treatment or gravitate exclusively to antidepressant medication (ADM), despite the existence of other effective treatments, such as cognitive-behavioral therapy (CBT). Reluctance to use psychotherapy is partly due to lack of appropriate mental health literacy and perceptions of low treatment acceptability (appropriateness for a given problem) and credibility (treatment logicalness, and whether the patient expects improvement). In the current investigation, we examined whether providing psychoeducation about CBT for depression would change participant perceptions of the treatment's acceptability and credibility. We recruited 554 (female n = 314; 57%) participants across two online studies, and assessed their baseline perceptions of CBT and ADM using modified Treatment Acceptability (TAAS) and Treatment Credibility and Expectancy (CEQ) scales. Participants were subsequently presented with evidence-based, expert-vetted psychoeducational materials describing CBT and ADM, and were asked to recomplete the TAAS and CEQ. In Study 1, participants endorsed significantly higher CBT-CEQ (credibility/expectancy) scores postpsychoeducation. In Study 2, participants endorsed significantly lower CBT-TAAS (acceptability), and among those with no exposure to depression treatments, endorsed significantly higher CBT-CEQ scores postpsychoeducation. In both studies, there were no perceptual changes of ADM after the psychoeducation. Finally, in Study 2, endorsement of a biological model of depression and depressive symptoms were negatively predictive of CBT's acceptability and credibility and expectancy postpsychoeducation. Perceptions of credibility and expectancy of CBT for depression appear malleable even after exposure to brief psychoeducation, whereas shifting perceptions of CBT's acceptability may require more extensive intervention.",31422843,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.279169082641602,-2.348186492919922,A16+
"Precision medicine for long-term depression outcomes using the Personalized Advantage Index approach: cognitive therapy or interpersonal psychotherapy?

Psychotherapies for depression are equally effective on average, but individual responses vary widely. Outcomes can be improved by optimizing treatment selection using multivariate prediction models. A promising approach is the Personalized Advantage Index (PAI) that predicts the optimal treatment for a given individual and the magnitude of the advantage. The current study aimed to extend the PAI to long-term depression outcomes after acute-phase psychotherapy. Data come from a randomized trial comparing cognitive therapy (CT, n = 76) and interpersonal psychotherapy (IPT, n = 75) for major depressive disorder (MDD). Primary outcome was depression severity, as assessed by the BDI-II, during 17-month follow-up. First, predictors and moderators were selected from 38 pre-treatment variables using a two-step machine learning approach. Second, predictors and moderators were combined into a final model, from which PAI predictions were computed with cross-validation. Long-term PAI predictions were then compared to actual follow-up outcomes and post-treatment PAI predictions. One predictor (parental alcohol abuse) and two moderators (recent life events; childhood maltreatment) were identified. Individuals assigned to their PAI-indicated treatment had lower follow-up depression severity compared to those assigned to their PAI-non-indicated treatment. This difference was significant in two subsets of the overall sample: those whose PAI score was in the upper 60%, and those whose PAI indicated CT, irrespective of magnitude. Long-term predictions did not overlap substantially with predictions for acute benefit. If replicated, long-term PAI predictions could enhance precision medicine by selecting the optimal treatment for a given depressed individual over the long term.",31753043,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.271139144897461,-2.0771474838256836,AxeW
"Cognitive-Behavioral Therapy for Depression Using Mind Over Mood: CBT Skill Use and Differential Symptom Alleviation.

Cognitive-behavioral therapy (CBT) for depression is highly effective. An essential element of this therapy involves acquiring and utilizing CBT skills; however, it is unclear whether the type of CBT skill used is associated with differential symptom alleviation. Outpatients (N = 356) diagnosed with a primary mood disorder received 14 two-hour group sessions of CBT for depression, using the Mind Over Mood protocol. In each session, patients completed the Beck Depression Inventory and throughout the week they reported on their use of CBT skills: behavioral activation (BA), cognitive restructuring (CR), and core belief (CB) strategies. Bivariate latent difference score (LDS) longitudinal analyses were used to examine patterns of differential skill use and subsequent symptom change, and multigroup LDS analyses were used to determine whether longitudinal associations differed as a function of initial depression severity. Higher levels of BA use were associated with a greater subsequent decrease in depressive symptoms for patients with mild to moderate initial depression symptoms relative to those with severe symptoms. Higher levels of CR use were associated with a greater subsequent decrease in depressive symptoms, whereas higher levels of CB use were followed by a subsequent increase in depressive symptoms, regardless of initial severity. Results indicated that the type of CBT skill used is associated with differential patterns of subsequent symptom change. BA use was associated with differential subsequent change as a function of initial severity (patients with less severe depression symptoms demonstrated greater symptom improvement), whereas CR use was associated with symptom alleviation and CB use with an increase in subsequent symptoms as related to initial severity.",28077219,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.422979354858398,-2.678755044937134,BiUF
"Cross-trial prediction in psychotherapy: External validation of the Personalized Advantage Index using machine learning in two Dutch randomized trials comparing CBT versus IPT for depression.

Objective: Optimizing treatment selection may improve treatment outcomes in depression. A promising approach is the Personalized Advantage Index (PAI), which predicts the optimal treatment for a given individual. To determine the generalizability of the PAI, models needs to be externally validated, which has rarely been done. Method: PAI models were developed within each of two independent trials, with substantial between-study differences, that both compared CBT and IPT for depression (STEPd: n=151 and FreqMech: n=200). Subsequently, both PAI models were tested in the other dataset. Results: In the STEPd study, post-treatment depression was significantly different between individuals assigned to their PAI-indicated treatment versus those assigned to their non-indicated treatment (d=.57). In the FreqMech study, post-treatment depression was not significantly different between patients receiving their indicated treatment versus those receiving their non-indicated treatment (d=.20). Cross-trial predictions indicated that post-treatment depression was not significantly different between those receiving their indicated treatment and those receiving their non-indicated treatment (d=.16 and d=.27). Sensitivity analyses indicated that cross-trial prediction based on only overlapping variables didn't improve the results. Conclusion: External validation of the PAI has modest results and emphasizes between-study differences and many other challenges.",32964809,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.328368186950684,-2.2796897888183594,AiH+
"The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation.

Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate. To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare. The treatment was developed in three stages using a variety of methods: (a) identifying potential strategies; (b) developing a theoretical framework; and (c) evaluating the acceptability, feasibility and effectiveness of the psychological treatment. The Healthy Activity Program (HAP) is delivered over 6-8 sessions and consists of behavioral activation as the core psychological framework with added emphasis on strategies such as problem-solving and activation of social networks. Key elements to improve acceptability and feasibility are also included. In an intention-to-treat analysis of a pilot randomised controlled trial (55 participants), the prevalence of depression (Beck Depression Inventory II ⩾19) after 2 months was lower in the HAP than the control arm (adjusted risk ratio = 0.55, 95% CI 0.32-0.94,P= 0.01). Our systematic approach to the development of psychological treatments could be extended to other mental disorders. HAP is an acceptable and effective brief psychological treatment for severe depression delivered by lay counsellors in primary care.",26494875,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,10.410921096801758,-4.043026447296143,B2Li
"Reply to the Letter by Singer, Mitter, and Porsch Related to Our Paper ""Benefits of Individualized Feedback in Internet-Based Interventions for Depression: A Randomized Controlled Trial"".

",30273930,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.327746391296387,-3.3018593788146973,BFZI
"Two-year outcome of internet-based relapse prevention for partially remitted depression.

The objective of the study was to investigate the long-term effects of internet-based relapse prevention for sufferers of partially remitted depression. Eighty-four individuals with partially remitted unipolar depression were randomized to either internet-based CBT (iCBT) or to a control group. After the ten week intervention period the participants were followed for 24 months and diagnostic interviews conducted to detect relapse. The intervention and monthly self-ratings of depressive symptoms were administered via an internet-based platform that ensured secure communication with all participants. Significantly fewer participants in the iCBT group had experienced a relapse compared with those in the control group two years after the internet-based intervention. The relapse rate in the iCBT group was 13.7% (CI 95%=2.5-24.9) and in the control group it was 60.9% (CI 95%=44.8-77). Furthermore, a significantly larger proportion of the iCBT group experienced remission two years after the intervention compared with the control group. Internet-based CBT seems promising for preventing relapse in sufferers of partially remitted depression.",24021360,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.747970581054688,-2.509773015975952,CY8G
"A Reply to ""Effectiveness of an individually-tailored computerised CBT programme (Deprexis) for depression: A meta-analysis"" by Twomey and colleagues [Psychiatry Res. 256 (2017) 371-377].

",29046227,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.70424747467041,-3.0836455821990967,BVbg
"Evolutionary cognitive therapy versus standard cognitive therapy for depression: a protocol for a blinded, randomized, superiority clinical trial.

Depression is estimated to become the leading cause of disease burden globally by 2030. Despite existing efficacious treatments (both medical and psychotherapeutic), a large proportion of patients do not respond to therapy. Recent insights from evolutionary psychology suggest that, in addition to targeting the proximal causes of depression (for example, targeting dysfunctional beliefs by cognitive behavioral therapy), the distal or evolutionary causes (for example, inclusive fitness) should also be addressed. A randomized superiority trial is conducted to develop and test an evolutionary-driven cognitive therapy protocol for depression, and to compare its efficacy against standard cognitive therapy for depression. Romanian-speaking adults (18 years or older) with elevated Beck Depression Inventory (BDI) scores (>13), current diagnosis of major depressive disorder or major depressive episode (MDD or MDE), and MDD with comorbid dysthymia, as evaluated by the Structured Clinical Interview for DSM-IV (SCID), are included in the study. Participants are randomized to one of two conditions: 1) evolutionary-driven cognitive therapy (ED-CT) or 2) cognitive therapy (CT). Both groups undergo 12 psychotherapy sessions, and data are collected at baseline, mid-treatment, post-treatment, and the 3-month follow-up. Primary outcomes are depressive symptomatology and a categorical diagnosis of depression post-treatment. This randomized trial compares the newly proposed ED-CT with a classic CT protocol for depression. To our knowledge, this is the first attempt to integrate insights from evolutionary theories of depression into the treatment of this condition in a controlled manner. This study can thus add substantially to the body of knowledge on validated treatments for depression. Current Controlled Trials ISRCTN64664414The trial was registered in June 2013. The first participant was enrolled on October 3, 2012.",24641778,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.960088729858398,-2.2655410766601562,CQoa
"Ten year revision of the brief behavioral activation treatment for depression: revised treatment manual.

Following from the seminal work of Ferster, Lewinsohn, and Jacobson, as well as theory and research on the Matching Law, Lejuez, Hopko, LePage, Hopko, and McNeil developed a reinforcement-based depression treatment that was brief, uncomplicated, and tied closely to behavioral theory. They called this treatment the brief behavioral activation treatment for depression (BATD), and the original manual was published in this journal. The current manuscript is a revised manual (BATD-R), reflecting key modifications that simplify and clarify key treatment elements, procedures, and treatment forms. Specific modifications include (a) greater emphasis on treatment rationale, including therapeutic alliance; (b) greater clarity regarding life areas, values, and activities; (c) simplified (and fewer) treatment forms; (d) enhanced procedural details, including troubleshooting and concept reviews; and (e) availability of a modified Daily Monitoring Form to accommodate low literacy patients. Following the presentation of the manual, the authors conclude with a discussion of the key barriers in greater depth, including strategies for addressing these barriers.",21324944,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.508788108825684,-1.9879449605941772,C/2Y
"Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression: randomized controlled trial design and protocol.

Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The major contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Accordingly, efforts to reduce the disabling effects of this chronic condition should shift to preventing recurrence, especially in patients at high risk of recurrence. Given its high prevalence and the fact that interventions are necessary during the remitted phase, new approaches are needed to prevent relapse in depression. The best established effective and available psychological intervention is cognitive therapy. However, it is costly and not available for most patients. Therefore, we will compare the effectiveness and cost-effectiveness of self-management supported by online CT accompanied by SMS based tele-monitoring of depressive symptomatology, i.e. Mobile Cognitive Therapy (M-CT) versus treatment as us usual (TAU). Remitted patients (n = 268) with at least two previous depressive episodes will be recruited and randomized over (1) M-CT in addition to TAU versus (2) TAU alone, with follow-ups at 3, 12, and 24 months. Randomization will be stratified for number of previous episodes and type of treatment as usual. Primary outcome is time until relapse/recurrence over 24 months using DSM-IV-TR criteria as assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). For the economic evaluation the balance between costs and health outcomes will be compared across strategies using a societal perspective. Internet-based interventions might be helpful in empowering patients to become their own disease managers in this lifelong recurrent disorder. This is, as far as we are aware of, the first study that examines the (cost) effectiveness of an E-mental health program using SMS monitoring of symptoms with therapist support to prevent relapse in remitted recurrently depressed patients. Netherlands Trial Register (NTR): NTR2503.",21235774,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.408690452575684,-1.4553508758544922,DBMl
"The implementation and adherence to evidence-based protocols for psychotherapy for depression: the perspective of therapists in Dutch specialized mental healthcare.

Although psychotherapy is an effective treatment for depression, a large number of patients still do not receive care according to the protocols that are used in clinical trials. Instead, patients often receive a modified version of the original intervention. It is not clear how and when treatment protocols are used or modified in the Dutch specialized mental health care and whether these changes lead to suboptimal adherence to treatment protocols. In the context of an ongoing multicenter trial that investigates whether twice-weekly sessions of protocolized interpersonal psychotherapy (IPT) and cognitive behavioral therapy (CBT) for depression lead to better treatment outcomes compared to once-weekly sessions, two focus groups using semi-structured interviews were organized. Aims were to increase insight in the adherence to and modifications of CBT and IPT protocols in the Dutch specialized mental health care for depression. Participants were fifteen therapists from seven mental health locations part of five mental health organizations. Verbatim transcripts were coded and analyzed using qualitative software. Three themes emerged: modification as the common practice, professional and patient factors influencing the adherence to protocols and organizational boundaries and flexibility. Treatment modification appeared to happen on a frequent basis, even in the context of a trial. Definitions of treatment modifications were multiple and varied from using intuition to flexible use of the same protocol. Therapist training and supervision, the years of work experience and individual characteristics of the therapist and the patient were mentioned to influence the adherence to protocols. Modifications of the therapists depended very much on the culture within the mental health locations, who differed in terms of the flexibility offered to therapists to choose and modify treatment protocols. Not all treatment modifications were in line with existing evidence or guidelines. Regular supervision, team meetings and a shared vision were identified as crucial factors to increase adherence to treatment protocols, whereas additional organizational factors, among which a change of mindset, may facilitate adequate implementation.",29898692,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.840574264526367,-2.858543634414673,BKZm
"Changing thought patterns may help overcome depression. Focusing on how patients think rather than how they behave helps patients with even severe depression.

",20799426,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.104632377624512,-1.9313284158706665,DGYu
"Comparing Cognitive, Metacognitive, and Acceptance and Commitment Therapy Models of Depression: a Longitudinal Study Survey.

This study analyzed the interrelationships between key constructs of cognitive therapy (CT; depressogenic schemas), metacognitive therapy (MCT; dysfunctional metacognitive beliefs), and acceptance and commitment therapy (ACT; psychological inflexibility) in the prediction of depressive symptoms. With a lapse of nine months, 106 nonclinical participants responded twice to an anonymous online survey containing the following questionnaires: the Depression subscale of the Depression Anxiety and Stress Scales (DASS), the Dysfunctional Attitude Scale Revised (DAS-R), the Positive beliefs, Negative beliefs and Need to control subscales of the Metacognitions Questionnaire-30 (MCQ-30), and the Acceptance and Action Questionnaire - II (AAQ-II). Results showed that when controlling for baseline levels of depressive symptoms and demographic variables, psychological inflexibility longitudinally mediated the effect of depressogenic schemas (path ab = .023, SE = .010; 95% BC CI [.008, .048]) and dysfunctional metacognitive beliefs on depressive symptoms (positive metacognitive beliefs: path ab = .052, SE = .031; 95% BC CI [.005, .134]; negative metacognitive beliefs: path ab = .087, SE = .049; 95% BC CI [.016, .214]; need to control: path ab = .087, SE = .051; 95% BC CI [.013, .220]). Results are discussed emphasizing the role of psychological inflexibility in the CT and MCT models of depression.",26076977,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,11.88667106628418,-1.904390811920166,B8Qq
"Factors contributing to symptom change in standardized and individualized Internet-based interventions for depression: A randomized-controlled trial.

Research suggests 4 categories of outcome predictors in face-to-face therapy (i.e., treatment expectations, extratherapeutic factors, relationship factors, and factors specific to a treatment approach/technique). However, it is unclear whether these factors are relevant in standardized and individualized Internet-based interventions. To investigate this question, a secondary analysis of data from 1,089 mildly to moderately depressed adults undergoing 6 weeks of cognitive-behavioral Internet-based intervention for depression randomized to receive either weekly written feedback individualized by a counselor or automated and fully standardized feedback was performed. The following variables corresponding to the 4 categories were tested regarding associations with depressive symptom change during multiple treatment periods within a multigroup structural equation model: (a) outcome expectations, (b) extratherapeutic stressors and stress change during treatment, (c) midtreatment working alliance (task/goal and bond), and (d) uptake of treatment-specific components (logins and specific tool use). Results suggest similar regressive associations across treatment conditions: Previous symptom change was the most important predictor for subsequent symptom developments. Stress at baseline and the uptake of specific treatment components only played a minor role, and stronger task/goal ratings were associated with later symptom improvements. Early symptom improvements predicted stronger midtreatment task/goal and bond ratings, whereas only stronger task/goal ratings were associated with later symptom improvements. Outcome expectations were only indirectly related with symptom change mediated through goal/task ratings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",32134320,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.934288024902344,-3.1031641960144043,AsZs
"A 3.5-year follow-up of Internet-delivered cognitive behavior therapy for major depression.

Internet-delivered cognitive behavior therapy (ICBT) for major depression has been tested in several trials, but only with follow-ups up to 1.5 years. The aim of this study was to evaluate the outcome of ICBT 3.5 years after treatment completion. A total of 88 people with major depression were randomized to either guided self-help or e-mail therapy in the original trial. One-third was initially on a waiting-list. Treatment was provided for eight weeks and in this report long-term follow-up data were collected. Also included were data from post-treatment and six-month follow-up. A total of 58% (51/88) completed the 3.5-year follow-up. Analyses were performed using a random effects repeated measures piecewise growth model to estimate trajectory shape over time and account for missing data. Results Results showed continued lowered scores on the Beck Depression Inventory (BDI). No differences were found between the treatment conditions. A large proportion of participants (55%) had sought and received additional treatments in the follow-up period. A majority (56.9%) of participants had a BDI score lower than 10 at the 3.5-year follow-up. People with mild to moderate major depression may benefit from ICBT 3.5-years after treatment completion.",21957933,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.500941276550293,-2.680304527282715,C23Z
"Telephone-based mutual peer support for depression: a pilot study.

To evaluate the acceptability, feasibility and depression-related outcomes of a telephone-based mutual peer support intervention for individuals with continued depressive symptoms in specialty mental health treatment. Participants were depressed patients with continued symptoms or functional impairment treated at one of the three outpatient mental health clinics. Participants were partnered with another patient, provided with basic communication skills training, and asked to call their partner at least once a week using a telephone platform that recorded call initiation, frequency and duration. Depression symptoms, quality of life, disability, self-efficacy, overall mental and physical health and qualitative feedback were collected at enrolment, 6 weeks and 12 weeks. Fifty-four participants enroled in the 12-week intervention and 32 participants (59.3%) completed the intervention. Participants completing the study averaged 10.3 calls, with a mean call length of 26.8 min. The mean change in BDI-II score from baseline to study completion was -4.2 (95% CI: -7.6, -0.8; p<0.02). Measures of disability, quality of life and psychological health also improved. Qualitative assessments indicated that participants found meaning and support through interactions with their partners. Telephone-based mutual peer support is a feasible and acceptable adjunct to specialty depression care. Larger trials are needed to determine efficacy and effectiveness of this intervention.",20634226,Major Depressive Disorder,Anxiety Treatment,Mental Health,13374,9.831385612487793,-3.319767475128174,DH/1
"Metacognitive therapy in treatment-resistant depression: a platform trial.

Patients with treatment-resistant depression received up to 8 sessions of metacognitive therapy (MCT) targeting attentional control, rumination, worry, and metacognitive beliefs. A baseline period was followed by weekly sessions with follow-up assessments at 6 and 12 months post treatment. Large and statistically significant improvements occurred in all symptom measures at post treatment and were maintained over follow-up. Two out of 3 process measures significantly improved at post treatment and all of these measures were improved at follow-up. Treatment was associated with similar response rates on the BDI and Hamilton rating scale. Using liberal criteria 80% of completers were classified as recovered at post treatment and 70% at follow-up on the BDI. In the intention to treat sample 66.6% were recovered at post treatment and 58.3% at follow-up. More stringent criteria showed 60% recovery rates at post treatment and at 12 m. The results suggest that MCT could be a brief and effective treatment and they provide a precedent for more definitive randomized controlled trials.",22498310,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.237117767333984,-1.3795431852340698,Cu1X
"Efficacy of intensive short-term dynamic psychotherapy in mood disorders: A critical review.

Intensive Short-Term Dynamic Psychotherapy (ISTDP) is an intervention introduced by Davanloo in order to treat anxiety, mood and somatic symptom, and personality disorders. It is a brief intervention aiming to identify and process painful or forbidden emotions and consequently to override symptoms and self-destructive tendencies. In this review we examine the efficacy of ISTDP on symptoms in patients with Major Depressive Disorder (MDD) and Bipolar Disorder (BD). A thorough search of articles in Pubmed, PsycINFO, Isi Web of Knowledge was carried out in order to obtain available studies of ISTDP for BD and MDD. We included all studies conducted on patients with a diagnosis of MDD or BD and who received ISTDP. Eight studies were included. These were two randomized controlled trials and six observational studies. Overall the results of the included manuscripts suggest a positive effect of ISTDP on depressive symptoms for patients affected by mood disorders. Furthermore, they suggest ISTDP may be cost-effective through reducing doctor visits and hospitalizations in follow-up. Most studies had small samples and consisted of non-randomized trials. These are preliminary positive results on the effectiveness of this approach for the treatment of depressive symptoms. They have to be confirmed by studies with larger sample sizes and by comparing this technique with other psychological treatments such as cognitive-behavioral therapy.",32560931,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.407676696777344,-4.380080223083496,AnKH
"One-Year Follow-Up of the Effectiveness of Cognitive Behavioral Group Therapy for Patients' Depression: A Randomized, Single-Blinded, Controlled Study.

The aim of the study was to investigate the long-term (one year) effectiveness of a 12-session weekly cognitive behavior group therapy (CBGT) on patients with depression. This was a single-blind randomized controlled study with a 2-arm parallel group design. Eighty-one subjects were randomly assigned to 12 sessions intervention group (CBGT) or control group (usual outpatient psychiatric care group) and 62 completed the study. The primary outcome was depression measured with Beck Depression Inventory (BDI-II) and Hamilton Rating Scale for Depression (HRSD). The secondary outcomes were automatic thoughts measured by automatic thoughts questionnaire (ATQ). Both groups were evaluated at the pretest (before 2 weeks), posttest (after 12 therapy sessions), and short- (3 months), medium- (6 months), and long-term (12 months) follow-up. After receiving CBGT, the experimental group had a statistically significant reduction in the BDI-II from 40.30 at baseline to 17.82 points at session eight and to 10.17 points at postintervention (P < 0.001). Similar effects were seen on the HRSD. ATQ significantly decreased at the 12th session, 6 months after sessions, and 1 year after the sessions ended (P < 0.001). We concluded that CBGT is effective for reducing depression and continued to be effective at 1 year of follow-up.",26380359,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.290404319763184,-2.679410696029663,B373
"Evaluating an e-mental health program (""deprexis"") as adjunctive treatment tool in psychotherapy for depression: design of a pragmatic randomized controlled trial.

Major depressive disorder (MDD) places a significant disease burden on individuals as well as on societies. Several web-based interventions for MDD have shown to be effective in reducing depressive symptoms. However, it is not known whether web-based interventions, when used as adjunctive treatment tools to regular psychotherapy, have an additional effect compared to regular psychotherapy for depression. This study is a currently recruiting pragmatic randomized controlled trial (RCT) that compares regular psychotherapy plus a web-based depression program (""deprexis"") with a control condition exclusively receiving regular psychotherapy. Adults with a depressive disorder (N = 800) will be recruited in routine secondary care from therapists over the course of their initial sessions and will then be randomized within therapists to one of the two conditions. The primary outcome is depressive symptoms measured with the Beck Depression Inventory (BDI-II) at three months post randomization. Secondary outcomes include changes on various indicators such as anxiety, somatic symptoms and quality of life. All outcomes are again assessed at the secondary endpoint six months post randomization. In addition, the working alliance and feasibility/acceptability of the treatment condition will be explored. This is the first randomized controlled trial to examine the feasibility/acceptability and the effectiveness of a combination of traditional face-to-face psychotherapy and web-based depression program compared to regular psychotherapeutic treatment in depressed outpatients in routine care. ISRCTN20165665.",25298158,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.165596008300781,-2.752286195755005,CHSk
"Behavioral and cognitive intervention strategies delivered via coached apps for depression: Pilot trial.

Depression is common in primary care settings, but barriers prevent many primary care patients from initiating treatment. Smartphone apps stand as a possible means to overcome such barriers. However, there is limited evidence to understand the use and efficacy of these apps. The purpose of the current study was to pilot an evaluation of the usage and efficacy of apps for depression based upon behavioral or cognitive intervention skills, compared to a wait-list control. Thirty adults with depression were randomized to the use of either a behavioral app (Boost Me) or a cognitive app (Thought Challenger) or to a wait-list control. Boost Me and Thought Challenger participants received 6 weeks of the respective intervention along with weekly coaching sessions, with a 4-week follow-up period; wait-list control participants received no interventions for 10 weeks. A repeated-measures analysis of variance was conducted to examine depression over time and across treatment groups; t tests compared app usage across groups. Depression scores changed significantly over time (p < .001), with group differences occurring between Thought Challenger and wait-list control participants (p = .03). Boost Me was used significantly more than was Thought Challenger (p = .02); however, there was no evidence to suggest correlations between usage and changes in depression (ps > .05). The present study provides initial support that intervention strategies for depression delivered via apps with human support can impact symptoms and may promote continued use over 6 weeks. This pilot also demonstrates the feasibility of future research regarding the delivery of behavioral and cognitive intervention strategies via apps. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",30407055,Major Depressive Disorder,Anxiety Treatment,Mental Health,1427,7.387396812438965,-6.199214458465576,BDnT
"Cognitive bibliotherapy for mild depressive symptomatology: randomized clinical trial of efficacy and mechanisms of change.

It has been increasingly recognized that subthreshold depression is associated with considerable personal, social and economic costs. However, there is no accepted definition or clear-cut treatment for subthreshold depression. Cognitive bibliotherapy is a promising approach, but further research is necessary in order to assess its clinical efficacy and key mechanisms of change. This study aimed to investigate the efficacy of bibliotherapy for subthreshold depression and test whether maladaptive cognitions mediate the effects of bibliotherapy on depressive symptoms. A total of 96 young adults with subthreshold depression were randomized in one of the following treatment conditions: immediate treatment, delayed treatment, placebo and no treatment. The main outcome was represented by depressive symptoms assessed before, during and immediately after the treatment, as well as at 3-month follow-up. Automatic thoughts, dysfunctional attitudes and irrational beliefs were also assessed throughout the study, and we investigated their involvement as mediators of bibliotherapy effects on depressive symptoms. The results indicated that cognitive bibliotherapy resulted in statistically and clinically significant changes both in depressive symptoms and cognitions, which were maintained at follow-up. In contrast, placebo was only associated with a temporary decrease in depressive symptoms, without significant cognitive changes. No changes in symptoms or cognitions were found in the delayed treatment and no treatment groups. We also found that automatic thoughts significantly mediated the effect of bibliotherapy on depressive symptoms. This study provided compelling evidence for the efficacy of cognitive bibliotherapy in subthreshold depression and showed that changes in automatic thoughts mediated the effect of bibliotherapy on depressive symptoms. Cognitive bibliotherapy is an effective treatment of subthreshold depression. Changing automatic thoughts is important, as they mediate the bibliotherapy effect on depressive symptoms. Cognitive bibliotherapy is a potential alternative or adjunct to psychotherapy for mildly depressed adults.",22941790,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.941910743713379,-2.891017436981201,CoyH
"Selecting the optimal treatment for a depressed individual: Clinical judgment or statistical prediction?

Optimizing treatment selection is a way to enhance treatment success in major depressive disorder (MDD). In clinical practice, treatment selection heavily depends on clinical judgment. However, research has consistently shown that statistical prediction is as accurate - or more accurate - than predictions based on clinical judgment. In the context of new technological developments, the current aim was to compare the accuracy of clinical judgment versus statistical predictions in selecting cognitive therapy (CT) or interpersonal psychotherapy (IPT) for MDD. Data came from a randomized trial comparing CT (n=76) with IPT (n=75) for MDD. Prior to randomization, therapists' recommendations were formulated during multidisciplinary staff meetings. Statistical predictions were based on Personalized Advantage Index models. Primary outcomes were post-treatment and 17-month follow-up depression severity. Secondary outcome was treatment dropout. Individuals receiving treatment according to their statistical prediction were less depressed at post-treatment and follow-up compared to those receiving their predicted non-indicated treatment. This difference was not found for recommended versus non-recommended treatments based on clinical judgment. Moreover, for individuals with an IPT recommendation by therapists, higher post-treatment and follow-up depression severity was found for those that actually received IPT compared to those that received CT. Recommendations based on statistical prediction and clinical judgment were not associated with differences in treatment dropout. Information on the clinical reasoning behind therapist recommendations was not collected, and statistical predictions were not externally validated. Statistical prediction outperforms clinical judgment in treatment selection for MDD and has the potential to personalize treatment strategies.",33049433,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.36123275756836,-1.5903005599975586,AhEZ
"Cognitive behaviour therapy via the internet for depression: a useful strategy to reduce suicidal ideation.

Depression is a major risk factor for suicide. Given the strong association between depression and suicide, treatment for depression should be a fundamental component of suicide prevention. Currently it is not. This study aims to demonstrate the usefulness of internet-delivered cognitive behavioural therapy (iCBT) for depression as a means of reducing suicide ideation. The sample comprised 484 patients who were prescribed iCBT for depression by their primary care physician. The outcomes of interest were major depression, as indexed by the PHQ-8, and suicidal ideation as measured by question 9 of the PHQ-9. Marginal models were used to appropriately analyse available data without biasing parameter estimates. Following iCBT for depression, suicidal ideation and depression decreased in parallel over time. The prevalence of suicidal ideation reduced from 50% at baseline to 27% after treatment, whilst the prevalence of major depression reduced from 70% to 30%. Depression scores and suicidal ideation decreased after treatment regardless of demographic or clinical variables of interest. This is a naturalistic study; randomisation and scientific control were not possible. The current study demonstrates the usefulness of iCBT for depression as a means of reducing suicidal ideation which can be implemented on a large scale without enacting major structural change at the societal level. These findings need to be replicated in randomised controlled trials.",25233243,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,15.299314498901367,-8.063590049743652,CIOO
"[Update on Current Care Guideline: Depression].

Treatment of depression is based on comprehensive diagnostic, clinical and psychosocial evaluation. Brief psychotherapies (cognitive, interpersonal, psychodynamic or problem-solving) are effective in mild to moderate depression; antidepressants in mild to severe, and electroconvulsive therapy in severe or psychotic. Combining antidepressants and psychotherapy is more effective than either alone. After the acute phase, antidepressants should be continued for six months to prevent relapses, and maintenance treatment considered after three lifetime episodes. Primary care is responsible for treatment of mild to moderate depressions; developing psychiatric consultation services and use of nurse case managers are recommended.",26245079,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.74207592010498,-1.1199216842651367,B532
"Life Adaptation Skills Training (LAST) for persons with depression: A randomized controlled study.

To investigate the efficacy of the ""Life Adaptation Skills Training (LAST)"" program for persons with depression. Sixty-eight subjects with depressive disorder were recruited from psychiatric outpatient clinics in Taipei city and were randomly assigned to either an intervention group (N=33), or a control group (N=35). The intervention group received 24-sessions of the LAST program, as well as phone contact mainly related to support for a total of 24 times. The control group only received phone contact 24 times. The primary outcome measure utilized was the World Health Organization Quality of Life-BREF-Taiwan version. Secondary outcome measures included the Occupational self-assessment, the Mastery scale, the Social support questionnaire, the Beck anxiety inventory, the Beck depression inventory-II, and the Beck scale for suicide ideation. The mixed-effects linear model was applied to analyze the incremental efficacy of the LAST program, and the partial eta squared (ηp(2)) was used to examine the within- and between- group effect size. The subjects who participated in the LAST program showed significant incremental improvements with moderate to large between-group effect sizes on their level of anxiety (-5.45±2.34, p<0.05; ηp(2)=0.083) and level of suicidal ideation (-3.09±1.11, p<0.01; ηp(2)=0.157) when compared to the control group. The reduction of suicidal ideations had a maintenance effect for three months after the end of intervention (-3.44±1.09, p<0.01), with moderate between-group effect sizes (ηp(2)=0.101). Both groups showed significant improvement on overall QOL, overall health, physical QOL, psychological QOL, level of anxiety, and level of depression. The within-group effect sizes achieved large effects in the intervention group (ηp(2)=0.328-0.544), and were larger than that of the control group. A small sample size in the study, a high dropout rate, lower compliance rates for the intervention group, and lacking of true control group. The occupation-based LAST program, which focuses on lifestyle rearrangement and coping skills enhancement, could significantly improve the level of anxiety and suicidal ideations for persons with depression.",26162281,Major Depressive Disorder,Anxiety Treatment,Mental Health,8813,9.9694242477417,-2.8913393020629883,B7F8
"Rational-emotive and cognitive-behavior therapy (REBT/CBT) versus pharmacotherapy versus REBT/CBT plus pharmacotherapy in the treatment of major depressive disorder in youth; a randomized clinical trial.

Major depressive disorder is a highly prevalent and debilitating condition in youth, so developing efficient treatments is a priority for mental health professionals. Psychotherapy (i.e., cognitive behavioral therapy/CBT), pharmacotherapy (i.e., SSRI medication), and their combination have been shown to be effective in treating youth depression; however, the results are still mixed and there are few studies engaging multi-level analyses (i.e., subjective, cognitive, and biological). Therefore, the aims of this randomized control study (RCT) were both theoretical - integrating psychological and biological markers of depression in a multi-level outcome analysis - and practical - testing the generalizability of previous results on depressed Romanian youth population. Eighty-eight (N=88) depressed Romanian youths were randomly allocated to one of the three treatment arms: group Rational Emotive Behavior Therapy (REBT)/CBT (i.e., a form of CBT), pharmacotherapy (i.e., sertraline), and group REBT/CBT plus pharmacotherapy. The results showed that all outcomes (i.e., subjective, cognitive, and biological) significantly change from pre to post-treatment under all treatment conditions at a similar rate and there were no significant differences among conditions at post-test. In case of categorical analysis of the clinical response rate, we found a non-significant trend favoring group REBT/CBT therapy. Results of analyses concerning outcome interrelations are discussed.",25500320,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,10.98999309539795,-2.4669101238250732,CEco
"Patient experiences of psychological therapy for depression: a qualitative metasynthesis.

Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those affected by depression to have an impact on the treatments and services they are offered. This review aims to seek a comprehensive understanding of patient experiences of psychological therapies for depression using a systematic and rigorous approach to review and synthesis of qualitative research. PsychINFO, PsychARTICLES, MEDLINE, and CINAHL were searched for published articles using a qualitative approach to examine experiences of psychological therapies for depression. All types of psychological therapy were included irrespective of model or modes of delivery (e.g. remote or in person; group or individual). Each article was assessed following guidance provided by the Critical Appraisal Skill Programme tool. Articles were entered in full into NVIVO and themes were extracted and synthesized following inductive thematic analysis. Thirty-seven studies, representing 671 patients were included. Three main themes are described; the role of therapy features and setting; therapy processes and how they impact on outcomes; and therapy outcomes (benefits and limitations). Subthemes are described within these themes and include discussion of what works and what's unhelpful; issues integrating therapy with real life; patient preferences and individual difference; challenges of undertaking therapy; influence of the therapist; benefits of therapy; limits of therapy and what happens when therapy ends. Findings point to the importance of common factors in psychotherapies; highlight the need to assess negative outcomes; and indicate the need for patients to be more involved in discussions and decisions about therapy, including tailoring therapy to individual needs and taking social and cultural contexts into account.",32552748,Major Depressive Disorder,Anxiety Treatment,Mental Health,11153,10.09779167175293,-3.1263606548309326,AnRW
"Chatbot-Delivered Psychotherapy for Adults With Depressive and Anxiety Symptoms: A Systematic Review and Meta-Regression.

Although psychotherapy is a well-established treatment for depression and anxiety, chatbot-delivered psychotherapy is an emerging field that has yet to be explored in depth. This review aims to (a) examine the effectiveness of chatbot-delivered psychotherapy in improving depressive symptoms among adults with depression or anxiety, and (b) evaluate the preferred features for the design of chatbot-delivered psychotherapy. Eight electronic databases were searched for relevant randomized controlled trials. Meta-analysis and random effects meta-regression was conducted using Comprehensive Meta-Analysis 3.0 software. Overall effect was measured using Hedges's g and determined using z statistics at significance level p < .05. Assessment of heterogeneity was done using χ2 and I2 tests. A meta-analysis of 11 trials revealed that chatbot-delivered psychotherapy significantly improved depressive symptoms (g = 0.54, 95% confidence interval [-0.66, -0.42], p < .001). Although no significant subgroup differences were detected, results revealed larger effect sizes for samples of clinically diagnosed anxiety or depression, chatbots with an embodiment, a combination of types of input and output formats, less than 10 sessions, problem-solving therapy, off-line platforms, and in different regions of the United States than their counterparts. Meta-regression did not identify significant covariates that had an impact on depressive symptoms. Chatbot-delivered psychotherapy can be adopted in health care institutions as an alternative treatment for depression and anxiety. More high-quality trials are warranted to confirm the effectiveness of chatbot-delivered psychotherapy on depressive symptoms. PROSPERO registration number: CRD42020153332.",35227408,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.343935012817383,-2.4725377559661865,k9g
"Therapeutic horticulture in clinical depression: a prospective study of active components.

This paper is a report of a study conducted to assess change in depression severity, perceived attentional capacity and rumination (brooding) in individuals with clinical depression during a therapeutic horticulture programme and to investigate if the changes were mediated by experiences of being away and fascination. Individuals with clinical depression suffer from distortion of attention and rumination. Interventions can help to disrupt maladaptive rumination and promote restoration of depleted attentional capacity. A single-group study was conducted with a convenience sample of 28 people with clinical depression in 2009. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, and at 3-month follow-up. Assessment instruments were the Beck Depression Inventory, Attentional Function Index, Brooding Scale, and Being Away and Fascination subscales from the Perceived Restorativeness Scale. Mean Beck Depression Inventory scores declined by 4.5 points during the intervention (F = 5.49, P = 0.002). The decline was clinically relevant for 50% of participants. Attentional Function Index scores increased (F = 4.14, P = 0.009), while Brooding scores decreased (F = 4.51, P = 0.015). The changes in Beck Depression Inventory and Attentional Function Index scores were mediated by increases in Being Away and Fascination, and decline in Beck Depression Inventory scores was also mediated by decline in Brooding. Participants maintained their improvements in Beck Depression Inventory scores at 3-month follow-up. Being away and fascination appear to work as active components in a therapeutic horticulture intervention for clinical depression.",20626473,Major Depressive Disorder,Anxiety Treatment,Mental Health,7384,9.471216201782227,-2.998947858810425,DIIH
"Behavioural activation therapy to improve participation in adults with depression following brain injury: A single-case experimental design study.

Following brain injury, the risk of depression increases. There are few studies of non-pharmacological interventions for this problem. Behavioural Activation (BA) could help because it has been demonstrated to be as effective as cognitive-behaviour therapy but is less cognitively demanding and more suitable for people with brain impairment. The current study evaluated BA using a multiple-baseline design across behaviours with replication. Three male participants with clinically significant depressive symptoms (two with traumatic brain injury aged 26 and 46, one who experienced strokes in infancy, aged 26) engaged in a 10-14-week trial of BA focusing on three activity domains: physical, social and functional activities. Participants completed an online form three times a day which recorded activity participation and responses to a single-item mood scale. There was little evidence in support of BA for increasing participation. There was also a lack of change in average mood, but some positive effects were found on measures of depression symptoms and quality of life in these participants. Various factors affected participation which might have been mitigated by extended treatment contact, greater use of prompts or electronic aids or the addition of other therapy modes.",31793383,Major Depressive Disorder,Anxiety Treatment,Mental Health,11272,10.48756217956543,-1.7355856895446777,Aw5R
"Counselling versus low-intensity cognitive behavioural therapy for persistent sub-threshold and mild depression (CLICD): a pilot/feasibility randomised controlled trial.

Persistent depressive symptoms below the threshold criteria for major depression represent a chronic condition with high risk of progression to a diagnosis of major depression. The evidence base for psychological treatments such as Person-Centred Counselling and Low-Intensity Cognitive Behavioural Therapy for sub-threshold depressive symptoms and mild depression is limited, particularly for longer-term outcomes. This study aimed to test the feasibility of delivering a randomised controlled trial into the clinical and cost effectiveness of Low-Intensity Cognitive Behavioural Therapy versus Person-Centred Counselling for patients with persistent sub-threshold depressive symptoms and mild depression. The primary outcome measures for this pilot/feasibility trial were recruitment, adherence and retention rates at six months from baseline. An important secondary outcome measure was recovery from, or prevention of, depression at six months assessed via a structured clinical interview by an independent assessor blind to the participant's treatment condition. Thirty-six patients were recruited in five general practices and were randomised to either eight weekly sessions of person-centred counselling each lasting up to an hour, or up to eight weeks of cognitive-behavioural self-help resources with guided telephone support sessions lasting 20-30 minutes each. Recruitment rate in relation to the number of patients approached at the general practices was 1.8 %. Patients attended an average of 5.5 sessions in both interventions. Retention rate for the 6-month follow-up assessments was 72.2 %. Of participants assessed at six months, 71.4 % of participants with a diagnosis of mild depression at baseline had recovered, while 66.7 % with a diagnosis of persistent subthreshold depression at baseline had not developed major depression. There were no significant differences between treatment groups for both recovery and prevention of depression at six months or on any of the outcome measures. It is feasible to recruit participants and successfully deliver both interventions in a primary care setting to patients with subthreshold and mild depression; however recruiting requires significant input at the general practices. The evidence from this study suggests that short-term Person-Centred Counselling and Low-Intensity Cognitive Behaviour Therapy are potentially effective and their effectiveness should be evaluated in a larger randomised controlled study which includes a health economic evaluation. Current Controlled Trials ISRCTN60972025 .",26275718,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.878800392150879,-2.9026150703430176,B5dw
"Effect of telephone-administered vs face-to-face cognitive behavioral therapy on adherence to therapy and depression outcomes among primary care patients: a randomized trial.

Primary care is the most common site for the treatment of depression. Most depressed patients prefer psychotherapy over antidepressant medications, but access barriers are believed to prevent engagement in and completion of treatment. The telephone has been investigated as a treatment delivery medium to overcome access barriers, but little is known about its efficacy compared with face-to-face treatment delivery. To examine whether telephone-administered cognitive behavioral therapy (T-CBT) reduces attrition and is not inferior to face-to-face CBT in treating depression among primary care patients. A randomized controlled trial of 325 Chicago-area primary care patients with major depressive disorder, recruited from November 2007 to December 2010. Eighteen sessions of T-CBT or face-to-face CBT. The primary outcome was attrition (completion vs noncompletion) at posttreatment (week 18). Secondary outcomes included masked interviewer-rated depression with the Hamilton Depression Rating Scale (Ham-D) and self-reported depression with the Patient Health Questionnaire-9 (PHQ-9). Significantly fewer participants discontinued T-CBT (n = 34; 20.9%) compared with face-to-face CBT (n = 53; 32.7%; P = .02). Patients showed significant improvement in depression across both treatments (P < .001). There were no significant treatment differences at posttreatment between T-CBT and face-to-face CBT on the Ham-D (P = .22) or the PHQ-9 (P = .89). The intention-to-treat posttreatment effect size on the Ham-D was d = 0.14 (90% CI, -0.05 to 0.33), and for the PHQ-9 it was d = -0.02 (90% CI, -0.20 to 0.17). Both results were within the inferiority margin of d = 0.41, indicating that T-CBT was not inferior to face-to-face CBT. Although participants remained significantly less depressed at 6-month follow-up relative to baseline (P < .001), participants receiving face-to-face CBT were significantly less depressed than those receiving T-CBT on the Ham-D (difference, 2.91; 95% CI, 1.20-4.63; P < .001) and the PHQ-9 (difference, 2.12; 95% CI, 0.68-3.56; P = .004). Among primary care patients with depression, providing CBT over the telephone compared with face-to-face resulted in lower attrition and close to equivalent improvement in depression at posttreatment. At 6-month follow-up, patients remained less depressed relative to baseline; however, those receiving face-to-face CBT were less depressed than those receiving T-CBT. These results indicate that T-CBT improves adherence compared with face-to-face delivery, but at the cost of some increased risk of poorer maintenance of gains after treatment cessation. clinicaltrials.gov Identifier: NCT00498706.",22706833,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.665128707885742,-3.244753360748291,CsE/
"Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help.

Internet-delivered self-help for depression with therapist guidance has shown efficacy in several trials. Results from meta-analyses suggest that guidance is important and that self-help programs without support are less effective. However, there are no direct experimental comparisons between guided and unguided internet-based treatments for depression. The present study compared the benefits of a 10-week web-based unguided self-help treatment with the same intervention complemented with weekly therapist support via e-mail. A waiting-list control group was also included. Seventy-six individuals meeting the diagnostic criteria of major depression or dysthymia were randomly assigned to one of the three conditions. The Beck Depression Inventory (BDI-II) was used as the primary outcome measure. Secondary outcomes included general psychopathology, interpersonal problems, and quality of life. Sixty-nine participants (91%) completed the assessment at posttreatment and 59 (78%) at 6-month follow-up. Results showed significant symptom reductions in both treatment groups compared to the waiting-list control group. At posttreatment, between-group effect sizes on the BDI-II were d = .66 for unguided self-help versus waiting-list and d = 1.14 for guided self-help versus waiting-list controls. In the comparison of the two active treatments, small-to-moderate, but not statistically significant effects in favor of the guided condition were found on all measured dimensions. In both groups, treatment gains were maintained at 6-month follow-up. The findings provide evidence that internet-delivered treatments for depression can be effective whether support is added or not. However, all participants were interviewed in a structured diagnostic telephone interview before inclusion, which prohibits conclusions regarding unguided treatments that are without any human contact.",22060248,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.085173606872559,-3.1665306091308594,C1SK
"Well-being Therapy in Depressive Disorders.

A specific brief psychotherapeutic intervention aimed at empowering psychological well-being, the so-called Well-Being Therapy (WBT), has been manualized in 2016 by Giovanni Fava and has shown to be effective in randomized controlled trials. WBT is based on the multidimensional model of psychological well-being developed by Marie Jahoda which encompasses environmental mastery, personal growth, purpose in life, autonomy, self-acceptance, positive relations with others, and balance of psychic forces. WBT aims at promoting the achievement of an optimal-balanced functioning between the dimensions of psychological well-being, and such a balance is subsumed under the rubric of euthymia. There are evidences that WBT may be a suited clinical approach for second- or third-line treatment of depressive disorders with particular reference to decreasing vulnerability to relapse and modulating psychological well-being and mood. It has been also proposed a role of WBT in depressive disorders in clinical conditions such as treatment resistance, loss of antidepressant clinical efficacy, persistent post-withdrawal disorders, trauma exposure, and medical disease comorbidity. The present chapter provides an overview of the possible applications of WBT as treatment of depressive disorders.",33834409,Major Depressive Disorder,Anxiety Treatment,Mental Health,16319,11.0634126663208,-4.044022083282471,AYE4
"A feasibility randomised controlled trial of a brief early intervention for adolescent depression that targets emotional mental images and memory specificity (IMAGINE).

Brief, evidence-based interventions for adolescent depression are urgently required, particularly for school-settings. Cognitive mechanisms research suggests dysfunctional mental imagery and overgeneral memory could be promising targets to improve mood. This feasibility randomised controlled trial with parallel symptomatic groups (n = 56) compared a novel imagery-based cognitive behavioural intervention (ICBI) to non-directive supportive therapy (NDST) in school settings. Blind assessments (of clinical symptoms and cognitive mechanisms) took place pre-intervention, post-intervention and follow-up three months later. The trial aimed to evaluate the feasibility and acceptability of the methodology and interventions, and estimate the likely range of effects of the intervention on self-reported depression. The pre-defined criteria for proceeding to a definitive RCT were met: full recruitment occurred within eleven months; retention was 89%; ICBI acceptability was above satisfactory; and no harm was indicated. Intention-to-treat analysis found large effects in favour of ICBI (relative to NDST) at post-intervention in reducing depressive symptoms (d = -1.34, 95% CI [-1.87, -0.80]) and improving memory specificity (d = 0.79 [0.35, 1.23]), a key cognitive target. The findings suggest that ICBI may not only improve mood but also strengthen abilities associated with imagining and planning the future, critical skills at this life stage. A fully powered evaluation of ICBI is warranted. Trial Registration: https://www.isrctn.com/; ISRCTN85369879.",34098409,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,14.576573371887207,-1.446649193763733,AVGA
"Comparative Effectiveness of Cognitive Therapy and Dynamic Psychotherapy for Major Depressive Disorder in a Community Mental Health Setting: A Randomized Clinical Noninferiority Trial.

Dynamic psychotherapy (DT) is widely practiced in the community, but few trials have established its effectiveness for specific mental health disorders relative to control conditions or other evidence-based psychotherapies. To determine whether DT is not inferior to cognitive therapy (CT) in the treatment of major depressive disorder (MDD) in a community mental health setting. From October 28, 2010, to July 2, 2014, outpatients with MDD were randomized to treatment delivered by trained therapists. Twenty therapists employed at a community mental health center in Pennsylvania were trained by experts in CT or DT. A total of 237 adult outpatients with MDD seeking services at this site were randomized to 16 sessions of DT or CT delivered across 5 months. Final assessment was completed on December 9, 2014, and data were analyzed from December 10, 2014, to January 14, 2016. Short-term DT or CT. Expert blind evaluations with the 17-item Hamilton Rating Scale for Depression. Among the 237 patients (59 men [24.9%]; 178 women [75.1%]; mean [SD] age, 36.2 [12.1] years) treated by 20 therapists (19 women and 1 man; mean [SD] age, 40.0 [14.6] years), 118 were randomized to DT and 119 to CT. A mean (SD) difference between treatments was found in the change on the Hamilton Rating Scale for Depression of 0.86 (7.73) scale points (95% CI, -0.70 to 2.42; Cohen d, 0.11), indicating that DT was statistically not inferior to CT. A statistically significant main effect was found for time (F1,198=75.92; P=.001). No statistically significant differences were found between treatments on patient ratings of treatment credibility. Dynamic psychotherapy and CT were discriminated from each other on competence in supportive techniques (t120=2.48; P=.02), competence in expressive techniques (t120=4.78; P=.001), adherence to CT techniques (t115=-7.07; P=.001), and competence in CT (t115=-7.07; P=.001). This study suggests that DT is not inferior to CT on change in depression for the treatment of MDD in a community mental health setting. The 95% CI suggests that the effects of DT are equivalent to those of CT. clinicaltrials.gov Identifier: NCT01207271.",27487573,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.153374671936035,-2.687008857727051,BpD4
"Behavioral activation treatment for major depression: A randomized trial of the efficacy of augmentation with cognitive control training.

Major depressive disorder (MDD) is associated with hypoactivation of the dorsolateral prefrontal cortex, a brain region involved in emotion regulation and basic cognitive control processes. Recent studies have indicated that computerized interventions designed to activate this region may reduce depressive and ruminative symptoms. In this double-blind randomized controlled trial, we tested whether one such program, called Cognitive Control Training (CCT), enhanced treatment outcomes when used in adjunct to brief behavior therapy for MDD. Thirty-four adults with MDD were randomly assigned to complete four sessions of either computerized CCT or a control task, concurrently with four sessions of Brief Behavioral Activation Therapy for Depression (BATD). Post-treatment and one-month follow-up assessments were conducted, with self-reported depressive symptoms as the primary outcome and clinician-rated depressive symptoms and self-reported rumination as secondary outcomes. In both intent-to-treat and completer analyses, depressive symptoms and rumination decreased significantly over the course of treatment in both treatment conditions. There were no significant differences in treatment outcome depending on the augmentation condition. The sample size was small, hindering secondary analyses and identification of potential predictors or moderators of treatment effect. Results demonstrate substantial clinical benefit following four sessions of BATD; however, adjunctive CCT did not enhance outcomes. This study and other recent research suggest that the effects of CCT may not be as robust as previously indicated, highlighting the need for continued investigation of the conditions under which CCT may be effective.",28068613,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.698684692382812,-1.1625136137008667,Bibq
"The effects of cognitive-behavior therapy for depression on repetitive negative thinking: A meta-analysis.

It is not clear if treatments for depression targeting repetitive negative thinking (RNT: rumination, worry and content-independent perseverative thinking) have a specific effect on RNT resulting in better outcomes than treatments that do not specifically target rumination. We conducted a systematic search of PsycINFO, PubMed, Embase and the Cochrane library for randomized trials in adolescents, adults and older adults comparing CBT treatments for (previous) depression with control groups or with other treatments and reporting outcomes on RNT. Inclusion criteria were met by 36 studies with a total of 3307 participants. At post-test we found a medium-sized effect of any treatment compared to control groups on RNT (g = 0.48; 95% CI: 0.37-0.59). Rumination-focused CBT: g = 0.76, <0.01; Cognitive Control Training: g = 0.62, p < .01; CBT: g = 0.57, p < .01; Concreteness training: g = 0.53, p < .05; and Mindfulness-based Cognitive Therapy: g = 0.42, p < .05 had medium sized and significantly larger effect sizes than other types of treatment (i.e., anti-depressant medication, light therapy, engagement counseling, life review, expressive writing, yoga) (g = 0.14) compared to control groups. Effects on RNT at post-test were strongly associated with the effects on depression severity and this association was only significant in RNT-focused CBT. Our results suggest that in particular RNT-focused CBT may have a more pronounced effect on RNT than other types of interventions. Further mediation and mechanistic studies to test the predictive value of reductions in RNT following RNT-focused CBT for subsequent depression outcomes are called for.",29699700,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.391703605651855,-1.8329559564590454,BMoS
"A comparison of cognitive-behavioral therapy, antidepressants, their combination and standard treatment for Chinese patients with moderate-severe major depressive disorders.

No study has examined the effect of cognitive-behavioral therapy (CBT) on moderate-severe major depressive disorders (MDD) in China. The objective of this study was to evaluate the effect of CBT, antidepressants alone (MED), combined CBT and antidepressants (COMB) and standard treatment (ST; i.e., receiving psycho-educational intervention and/or medication treatment determined by treating psychiatrists) on depressive symptoms and social functioning in Chinese patients with moderate-severe MDD. A total of 180 patients diagnosed with MDD according to ICD-10 were randomly allocated to one of the four treatment regimens for a period of 6 months. Depressive symptoms were measured using the Hamilton Rating Scale for Depression (HAMD) and the Quick Inventory of Depressive Symptomatology-Self-Report (C-QIDS-SR). Remission threshold was defined as a C-QIDS-SR total score of <5. Social functioning was evaluated with the Work and Social Adjustment Scale (WSAS). All outcome measures were evaluated at entry, and at 3- and 6-months follow-up. At the 6-months assessment, the remission rates in the whole sample (n=96), the MED, the CBT, the COMB and the ST groups were 54.2%, 48%, 75%, 53.5% and 50%, respectively. Following the treatment periods, there was no significant difference in any of the study outcomes between the four groups. However, the CBT showed the greatest effect in the HAMD total score with the effect size=0.94, whereas the ST has only a moderate effect size in the WSAS total score (effect size=0.47). The findings support the feasibility and effectiveness of CBT as a psychosocial intervention for Chinese patients with moderate-severe MDD. We also found that single treatment using MED or CBT performed equally well as the combined CBT-antidepressant treatment in controlling the remission. The study provided important knowledge to inform the mental health care planning in China.",24140226,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.72120189666748,-1.9034992456436157,CXKv
"Continuous and dichotomous outcomes in studies of psychotherapy for adult depression: a meta-analytic comparison.

In treatment research on depressive disorders, outcomes can be based on continuous outcomes but also on dichotomous outcomes. Although it is possible to convert the two types of outcomes to each other, it has not been tested whether this results in systematic differences. We selected studies on psychotherapy for adult depression from an existing database, in which both continuous and dichotomous outcomes were presented. We calculated effect sizes using both types of outcomes, and compared the results. Although there were considerable differences between the two types of outcomes in individual studies, both types of outcomes resulted in very similar pooled effect sizes. The pooled effect size based on the continuous outcome were somewhat more conservative (d=0.59; OR=2.92) than the one based on the dichotomous outcome (d=0.64; OR=3.17). Heterogeneity was higher in the analyses based on the continuous outcomes than in those based on the dichotomous outcomes. Sensitivity analyses and subgroup analyses confirmed that the pooled effect sizes were very similar, that the effect sizes were somewhat smaller when the continuous outcomes are used, and that heterogeneity was higher in the analyses based on the continuous outcomes. Overall, the two types of outcomes result in comparable pooled effect sizes and can both be used in meta-analyses. However, the results of the two types of outcomes should not be used interchangeably, because there may be systematic differences in heterogeneity and subgroup analyses.",20149928,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.495283126831055,-1.798313021659851,DN5H
"[Treatment of a depressive disorder according to Functional Analytic Psychotherapy].

Treatment of a depressive disorder according to Functional Analytic Psychotherapy. This paper presents the analysis and treatment of a depressive disorder according to Functional Analytic Psychotherapy. This form of psychotherapy, which is based on the principles of radical behaviorism, makes functional use of verbal behavior, and is structured upon a therapeutic relationship that pays special attention to natural reinforcement and emphasises the events that may arise in the clinical context, and relates them to a natural context, shaping, and functional equivalence. The paper describes the case of a 40-year-old woman with major depressive disorder, and the functional conceptualization of the case according to this psychotherapy. The different phases of the treatment are described (17 sessions in total), with examples of the therapeutic relationship and of how the results were maintained in the long term. In addition to solving problems and making changes in the patient's daily life, the initial BDI-II score (29) dropped to 6 points after seven months, and remained at 8 points in the follow-up after 17 months.",20100433,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,10.573283195495605,-1.7415292263031006,DOiJ
"Beneficial effects of training in self-distancing and perspective broadening for people with a history of recurrent depression.

Cognitive training designed to recalibrate maladaptive aspects of cognitive-affective processing associated with the presence of emotional disorder can deliver clinical benefits. This study examined the ability of an integrated training in self-distancing and perspective broadening (SD-PB) with respect to distressing experiences to deliver such benefits in individuals with a history of recurrent depression (≥3 prior episodes), currently in remission. Relative to an overcoming avoidance (OA) control condition, SD-PB: a) reduced distress to upsetting memories and to newly encountered events, both during training when explicitly instructed to apply SD-PB techniques, and after-training in the absence of explicit instructions; b) enhanced capacity to self-distance from and broaden perspectives on participants' experiences; c) reduced residual symptoms of depression. These data provide initial support for SD-PB as a low-intensity cognitive training providing a spectrum of cognitive and affective benefits for those with recurrent depression who are at elevated risk of future episodes.",28525796,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.359184265136719,-0.8425057530403137,BcV7
"Somebody to lean on: Social relationships predict post-treatment depression severity in adults.

Supportive social relationships can help protect against depression, but few studies have examined how social relationships influence the response to depression treatment. We examined longitudinal associations between the availability of social relationships and depression severity following a 12-week intervention. In total, 946 adults aged 18-71 years with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12 weeks. The interventions included internet-based cognitive behavioural therapy (ICBT), 'usual care' (CBT or supportive counselling) and exercise. The primary outcome was the change in depression severity. The availability of social relationships were self-rated and based on the Interview Schedule for Social Interaction (ISSI). Prospective associations were explored using and logistic regression models. Participants with greater access to supportive social relationships reported larger improvements in depression compared to those with 'low' availability of relationships (β= -3.95, 95% CI= -5.49, -2.41, p< .01). Binary logistic models indicated a significantly better 'treatment response' (50% score reduction) in those reporting high compared to low availability of relationships (OR= 2.17, 95% CI= 1.40, 3.36, p< .01). Neither gender nor the type of treatment received moderated these effects. In conclusion, social relationships appear to play a key role in recovery from depression.",28131948,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.21897029876709,-2.7262115478515625,Bhjx
"Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis.

To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits. All relevant RCTs from a database of randomized controlled and comparative studies examining the effects of psychotherapy for adult depression (http://www.evidencebasedpsychotherapies.org), electronic databases (MEDLINE, EMBASE, PSYCINFO, AMED, CINAHL and CENTRAL) to June 2011, and bibliographies of all relevant articles. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTION: Adult patients with major depression, randomly assigned to CBT versus minimal/no treatment or care-as-usual. Three teams of reviewers, independently and in duplicate, completed title and abstract screening, full text review and data extraction. We performed an individual patient data meta-analysis to summarize data. Of 92 eligible trials, 70 provided author contact information; of these 56 (80%) were successfully contacted to establish if they captured receipt of benefits as a baseline characteristic; 8 recorded benefit status, and 3 enrolled some patients in receipt of benefits, of which 2 provided individual patient data. Including both patients receiving and not receiving disability benefits, 2 trials (227 patients) suggested a possible reduction in depression with CBT, as measured by the Beck Depression Inventory, mean difference [MD] (95% confidence interval [CI]) = -2.61 (-5.28, 0.07), p = 0.06; minimally important difference of 5. The effect appeared larger, though not significantly, in those in receipt of benefits (34 patients) versus not receiving benefits (193 patients); MD (95% CI) = -4.46 (-12.21, 3.30), p = 0.26. Our data does not support the hypothesis that CBT has smaller effects in depressed patients receiving disability benefits versus other patients. Given that the confidence interval is wide, a decreased effect is still possible, though if the difference exists, it is likely to be small.",23209672,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.183594703674316,-2.7124359607696533,Ck6t
"Do sociodemographic variables moderate effects of an internet intervention for mild to moderate depressive symptoms? An exploratory analysis of a randomised controlled trial (EVIDENT) including 1013 participants.

To explore the moderating effects of sociodemographic variables on treatment benefits received from participating in an internet intervention for depression. Randomised, assessor-blind, controlled trial. Online intervention, with participant recruitment using multiple settings, including inpatient and outpatient medical and psychological clinics, depression online forums, health insurance companies and the media (eg, newspaper, radio). The EVIDENT trial included 1013 participants with mild to moderate depressive symptoms. The intervention group subjects (n=509) received an online intervention (Deprexis) in addition to care as usual (CAU), while 504 participants received CAU alone. To explore subgroup differences, moderating effects were investigated using linear regression models based on intention-to-treat analyses. Moderating effects included sex, age, educational attainment, employment status, relationship status and lifetime frequency of episodes. The primary endpoint was change in self-rated depression severity measured by the Patient Health Questionnaire-9 (PHQ-9), comparing baseline versus 12-week post-test assessment. Secondary outcome measures were the Hamilton Rating Scale for Depression and the Quick Inventory of Depressive Symptoms each at 12 weeks and at 6 and 12 months, and PHQ-9 at 6 and 12 months, respectively. In this article, we focus on the primary outcome measure only. Between-group differences were observed in post-test scores, indicating the effectiveness of Deprexis. While the effects of the intervention could be demonstrated across all subgroups, some showed larger between-group differences than others. However, after exploring the moderating effects based on linear regression models, none of the selected variables was found to be moderating treatment outcomes. Our findings suggest that Deprexis is equally beneficial to a wide range of people; that is, participant characteristics were not associated with treatment benefits. Therefore, participant recruitment into web-based psychotherapeutic interventions should be broad, while special attention may be paid to those currently under-represented in these interventions. NCT01636752.",33500282,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.450531005859375,-3.1979262828826904,Ab08
"Efficacy of metacognitive therapy for prolonged grief disorder: protocol for a randomised controlled trial.

Studies of effective psychotherapy for individuals suffering from the effects of prolonged grief disorder (PGD) are scarce. This paper describes the protocol for an evaluation of a metacognitive therapy programme designed specifically for PGD, to reduce the psychological distress and loss of functioning resulting from bereavement. The proposed trial comprises three phases. Phase 1 consists of a review of the literature and semistructured interviews with key members of the target population to inform the development of a metacognitive therapy programme for Prolonged Grief. Phase 2 involves a randomised controlled trial to implement and evaluate the programme. Male and female adults (N=34) will be randomly assigned to either a wait list or an intervention group. Measures of PGD, anxiety, depression, rumination, metacognitions and quality of life will be taken pretreatment and posttreatment and at the 3-month and 6-month follow-up. The generalised linear mixed model will be used to assess treatment efficacy. Phase 3 will test the social validity of the programme. This study is the first empirical investigation of the efficacy of a targeted metacognitive treatment programme for PGD. A focus on identifying and changing the metacognitive mechanisms underpinning the development and maintenance of prolonged grief is likely to be beneficial to theory and practice. Ethics approval was obtained from Curtin University Human Research Ethics Committee (Approval number HR 41/2013.) ACTRN12613001270707.",26646828,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.929336547851562,-9.234685897827148,B0II
"Well-being therapy in depression: New insights into the role of psychological well-being in the clinical process.

A specific psychotherapeutic strategy for increasing psychological well-being and resilience, well-being therapy (WBT), has been developed and validated in a number of randomized controlled trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continued growth and development, the belief that life is purposeful and meaningful, the possession of quality relations with others, the capacity to manage effectively one's life, and a sense of self-determination. The evidence supporting the use of WBT and its specific contribution when it is combined with other psychotherapeutic techniques is still limited. However, the insights gained by the use of WBT may unravel innovative approaches to assessment and treatment of mood and anxiety disorders, to be confirmed by controlled studies, with particular reference to decreasing vulnerability to relapse and modulating psychological well-being and mood. An important characteristic of WBT is self-observation of psychological well-being associated with specific homework. Such perspective is different from interventions that are labeled as positive but are actually distress oriented. Another important feature of WBT is the assumption that imbalances in well-being and distress may vary from one illness to another and from patient to patient. Customary clinical taxonomy and evaluation do not include psychological well-being, which may demarcate major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same diagnosis.",28419611,Major Depressive Disorder,Anxiety Treatment,Mental Health,16319,11.053871154785156,-3.6953284740448,Bdza
"We cannot change the past, but we can change its meaning. A randomized controlled trial on the effects of self-help imagery rescripting on depression.

Imagery rescripting is a psychotherapeutic technique that aims to ameliorate negative emotions by altering (i.e., rescripting) inner representations of negative memories and images. Although the treatment was initially developed for traumatized individuals, face-to-face interventions have yielded promising results for patients with other diagnoses as well. The present study explored the feasibility and efficacy of the approach when used as a self-help intervention for depression. A total of 127 individuals with diagnosed depression were randomly allocated to either a wait-list control condition or received a brief or long version of a manual teaching imagery rescripting. Six weeks after inclusion, patients were invited to participate in the post assessment. The Beck Depression Inventory (BDI-II) served as the primary outcome (registered at ClinicalTrials.gov (NCT03299127). The long version was superior to the wait-list control condition on the BDI-II, self-esteem, and quality of life at a medium effect size. No effects emerged for anxiety. No significant between-group differences were found for the brief version. Moderation analyses indicated that the self-help approach seems particularly beneficial for those scoring high on symptoms, willingness to change, and expectancy (baseline). Most patients indicated they would use the technique in the future. The efficacy of imagery rescripting was confirmed when applied via self-help. Use of the long form of the manual is recommended. Future studies are needed to ascertain whether treatment effects are sustained over time.",29597112,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,15.923786163330078,-1.013444423675537,BN6s
"Causal explanations of depression on perceptions of and likelihood to choose cognitive behavioural therapy and antidepressant medications as depression treatments.

This research examined whether people's causal explanations of depression were associated with acceptability and efficacy-related treatment perceptions and likelihood to choose cognitive behavioural therapy (CBT) and antidepressant medication (ADM) as depression treatments. A cross-sectional internet-based design was used. A general population sample was used over a clinical sample to study those who had not yet chosen to enter treatment. A total of 422 individuals were recruited through a crowdsourcing platform to complete an online survey. Measures included perceived causes of depression, perceived acceptability, efficacy and choice likelihood for ADM and CBT, and demographics. Those with biological causal explanations of depression were more favourable towards ADM on all three perceptual measures of acceptability, efficacy and likelihood to choose ADM as a treatment for depression. Personality/character-related causal explanations of depression were positively related to perceived efficacy and likelihood to choose CBT as a depression treatment. Those endorsing environmental stress causes of depression were more likely to choose CBT as a treatment for depression. Results indicated that people's beliefs about the causes of depression were related to their perceptions of and likelihoods to choose ADM and CBT as depression treatments. Provides evidence of how different causal explanations of depression influence sufferers' likelihoods to choose ADM and CBT as possible treatments for their depression. Provides support for exploring potential patients' causal explanations about depression prior to recommending a treatment regimen.",32755009,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.957728385925293,-3.019439935684204,AkuX
"The effects of psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size.

No meta-analytical study has examined whether the quality of the studies examining psychotherapy for adult depression is associated with the effect sizes found. This study assesses this association. We used a database of 115 randomized controlled trials in which 178 psychotherapies for adult depression were compared to a control condition. Eight quality criteria were assessed by two independent coders: participants met diagnostic criteria for a depressive disorder, a treatment manual was used, the therapists were trained, treatment integrity was checked, intention-to-treat analyses were used, N >or= 50, randomization was conducted by an independent party, and assessors of outcome were blinded. Only 11 studies (16 comparisons) met the eight quality criteria. The standardized mean effect size found for the high-quality studies (d=0.22) was significantly smaller than in the other studies (d=0.74, p<0.001), even after restricting the sample to the subset of other studies that used the kind of care-as-usual or non-specific controls that tended to be used in the high-quality studies. Heterogeneity was zero in the group of high-quality studies. The numbers needed to be treated in the high-quality studies was 8, while it was 2 in the lower-quality studies. We found strong evidence that the effects of psychotherapy for adult depression have been overestimated in meta-analytical studies. Although the effects of psychotherapy are significant, they are much smaller than was assumed until now, even after controlling for the type of control condition used.",19490745,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.59151554107666,-2.3183789253234863,DRUK
"Internet-based psychological treatments for depression.

Major depression is highly prevalent, and is associated with high societal costs and individual suffering. Evidence-based psychological treatments obtain good results, but access to these treatments is limited. One way to solve this problem is to provide internet-based psychological treatments, for example, with therapist support via email. During the last decade, internet-delivered cognitive-behavioral therapy (ICBT) has been tested in a series of controlled trials. However, the ICBT interventions are delivered with different levels of contact with a clinician, ranging from nonexisting to a thorough pretreatment assessment in addition to continuous support during treatment. In this review, the authors have found an evidence for a strong correlation between the degree of support and outcome. The authors have also reviewed how treatment content in ICBT varies among treatments, and how various therapist factors may influence outcome. Future possible applications of ICBT for depression and future research needs are also discussed.",22853793,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.712272644042969,-2.9137954711914062,CqCt
"Overcoming Depression with Dance Movement Therapy: A Case Report.

In our society that sets high standards of perfection to be ok and wins, the depressed is commonly considered as an outsider, a marginalized person unable to be in line with standards and rhythms fast and competitive of the time we live. So the social stigma against people who suffer from mood disorders is a very powerful factor that negatively affects the healing of patient. He is often isolated from the others for the fear of being judged ""fool, crazy or dangerous"" or discriminated and emarginated for his mental health problem. For this reason, a cornerstone of depression rehabilitation is the bringing out of the patient from his isolation, the reintegration of user in the social context with the increase and the improvement in the quality of interpersonal relationships in the family and in the external context. So in this way is possible an increase in the tone of mood and a reduction of the symptoms of depression. The method used in our project is the dance movement therapy. In particular, dancing the ""Bachata"" and later more spontaneous dance becomes a rehabilitation tool to express emotions through the body and to open to the world, on the territory, overcoming the fear of being judged by others, the prejudice and the social stigma about mental illness. This work presents the results of a case report of a depressed patient treated with dance movement therapy.",30439838,Major Depressive Disorder,Anxiety Treatment,Mental Health,21751,8.556478500366211,-1.0809366703033447,BDQK
"Psychosocial functioning in patients with Treatment-Resistant Depression after group cognitive behavioral therapy.

Although patients with Treatment Resistant Depression (TRD) often have impaired social functioning, few studies have investigated the effectiveness of psychosocial treatment for these patients. We examined whether adding group cognitive behavioral therapy (group-CBT) to medication would improve both the depressive symptoms and the social functioning of patient with mild TRD, and whether any improvements would be maintained over one year. Forty-three patients with TRD were treated with 12 weekly sessions of group-CBT. Patients were assessed with the Global Assessment of Functioning scale (GAF), the 36-item Short-Form Health Survey (SF-36), the Hamilton Rating Scale for Depression (HRSD), the Dysfunctional Attitudes Scale (DAS), and the Automatic Thought Questionnaire-Revised (ATQ-R) at baseline, at the termination of treatment, and at the 12-month follow-up. Thirty-eight patients completed treatment; five dropped out. For the patients who completed treatment, post-treatment scores on the GAF and SF-36 were significantly higher than baseline scores. Scores on the HRSD, DAS, and ATQ-R were significantly lower after the treatment. Thus patients improved on all measurements of psychosocial functioning and mood symptoms. Twenty patients participated in the 12-month follow-up. Their improvements for psychosocial functioning, depressive symptoms, and dysfunctional cognitions were sustained at 12 months following the completion of group-CBT. These findings suggest a positive effect that the addition of cognitive behavioural group therapy to medication on depressive symptoms and social functioning of mildly depressed patients, showing treatment resistance.",20230649,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.459900856018066,-1.7791577577590942,DMys
"A randomized controlled trial evaluating a manualized TeleCoaching protocol for improving adherence to a web-based intervention for the treatment of depression.

Web-based interventions for depression that are supported by coaching have generally produced larger effect-sizes, relative to standalone web-based interventions. This is likely due to the effect of coaching on adherence. We evaluated the efficacy of a manualized telephone coaching intervention (TeleCoach) aimed at improving adherence to a web-based intervention (moodManager), as well as the relationship between adherence and depressive symptom outcomes. 101 patients with MDD, recruited from primary care, were randomized to 12 weeks moodManager+TeleCoach, 12 weeks of self-directed moodManager, or 6 weeks of a waitlist control (WLC). Depressive symptom severity was measured using the PHQ-9. TeleCoach+moodManager, compared to self-directed moodManager, resulted in significantly greater numbers of login days (p = 0.01), greater time until last use (p = 0.007), greater use of lessons (p = 0.03), greater variety of interactive tools used (p = 0.02), but total instances of tool use did not reach statistical significance. (p = 0.07). TeleCoach+moodManager produced significantly lower PHQ-9 scores relative to WLC at week 6 (p = 0.04), but there were no other significant differences in PHQ-9 scores at weeks 6 or 12 (ps>0.20) across treatment arms. Baseline PHQ-9 scores were no significantly related to adherence to moodManager. TeleCoach produced significantly greater adherence to moodManager, relative to self-directed moodManager. TeleCoached moodManager produced greater reductions in depressive symptoms relative to WLC, however, there were no statistically significant differences relative to self-directed moodManager. While greater use was associated with better outcomes, most users in both TeleCoach and self-directed moodManager had dropped out of treatment by week 12. Even with telephone coaching, adherence to web-based interventions for depression remains a challenge. Methods of improving coaching models are discussed. Clinicaltrials.gov NCT00719979.",23990896,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.340778350830078,-3.0860800743103027,CZY9
"Enhancing Social Interaction in Depression (SIDE study): protocol of a randomised controlled trial on the effects of a Cognitively Based Compassion Training (CBCT) for couples.

Positive social interactions (PSIs) and stable relationships can exert substantial benefits on health. However, patients suffering from depression benefit less from these health-promoting effects. Moreover, relationship quality and even partners' health has been found to be negatively affected by depressive symptomatology, which may result in overall impairments in social functioning of a romantic couple. Psychobiological research indicates that these impairments may be accompanied by a maladaptive regulation of the patient's neuroendocrine response to external stressors. Concerning the improvement of social functioning, first studies showed promising results of ""Cognitively Based Compassion Training (CBCT®)"". However, randomised trials are still scarce. Previous programmes did not involve participation of the patient's romantic partner. Therefore, the present study aims to investigate whether a CBCT® programme adapted for couples (CBCT®-fC) can improve depressive symptoms, distress, social interaction skills and the neurobiological regulation of stress. Couples with the female partner suffering from depression will be invited to participate in a pre-to-post intervention assessment on two consecutive days, respectively, involving a standardised PSI task, eye-tracking, ECG recordings, saliva-sampling, blood-sampling and questionnaire data. After baseline assessment, participating couples will be randomised to either a 10week CBCT®-fC or to a treatment as usual control condition. The primary endpoint is the reduction of depressive symptoms measured by the Hamilton Depression Rating Scale. Secondary outcomes encompass self-rated depression (Beck Depression Inventory), attention towards the partners face during PSI (eye tracking), stress-related biomarkers (cortisol, α-amylase, interleukin (IL)-1ß/IL-6, heart rate variability), methylation of oxytocin-receptor-genes and serotonin-transporter-genes and self-ratings of psychological constructs such as relationship quality and empathy. Ethical approval has been obtained by the Ethics Committee of the Medical Faculty Heidelberg. Results will be presented in international, peer-reviewed journals and on conferences in the field of clinical psychology and psychiatry. NCT03080025.",30287601,Major Depressive Disorder,Anxiety Treatment,Mental Health,25220,13.09310531616211,-2.2043297290802,BFN6
"Adjuvant occupational therapy improves long-term depression recovery and return-to-work in good health in sick-listed employees with major depression: results of a randomised controlled trial.

To evaluate whether adjuvant occupational therapy (OT) can improve the effectiveness of treatment-as-usual (TAU) in sick-listed employees with major depression. In total, 117 employees sick-listed for a median duration of 4.8 months (IQR=2.6 to 10.1 months) because of major depression were randomised to TAU (n=39) or adjuvant OT (TAU+OT; n=78). OT (18 sessions) focussed on a fast return to work (RTW) and improving work-related coping and self-efficacy. The primary outcome was work participation (hours of absenteeism+duration until partial/full RTW). Secondary outcomes were depression, at-work functioning, and health-related functioning. Intermediate outcomes were work-related, coping and self-efficacy. Blinded assessments occurred at baseline and 6, 12 and 18 months follow-up. The groups did not significantly differ in their overall work participation (adjusted group difference=-1.9, 95% CI -19.9 to +16.2). However, those in TAU+OT did show greater improvement in depression symptoms (-2.8, -5.5 to -0.2), an increased probability of long-term symptom remission (+18%, +7% to +30%), and increased probability of long-term RTW in good health (GH) (+24%, 12% to 36%). There were no significant group differences in the remaining secondary/intermediate outcomes. In a highly impaired population, we could not demonstrate significant benefit of adjuvant OT for improving overall work participation. However, adjuvant OT did increase long-term depression recovery and long-term RTW in GH (ie, full RTW while being remitted, and with better work and role functioning). TRIAL REGISTRATION DUTCH TRIAL REGISTER: NTR2057.",23117218,Major Depressive Disorder,Anxiety Treatment,Mental Health,2307,8.840909004211426,-4.065690517425537,CmP4
"Multimodal e-mental health treatment for depression: a feasibility trial.

Internet interventions for depression have shown less than optimal adherence. This study describes the feasibility trial of a multimodal e-mental health intervention designed to enhance adherence and outcomes for depression. The intervention required frequent brief log-ins for self-monitoring and feedback as well as email and brief telephone support guided by a theory-driven manualized protocol. The objective of this feasibility trial was to examine if our Internet intervention plus manualized telephone support program would result in increased adherence rates and improvement in depression outcomes. This was a single arm feasibility trial of a 7-week intervention. Of the 21 patients enrolled, 2 (9.5%) dropped out of treatment. Patients logged in 23.2 ± 12.2 times over the 7 weeks. Significant reductions in depression were found on all measures, including the Patient Health Questionnaire depression scale (PHQ-8) (Cohen's d = 1.96, P < .001), the Hamilton Rating Scale for Depression (d = 1.34, P < .001), and diagnosis of major depressive episode (P < .001). The attrition rate was far lower than seen either in Internet studies or trials of face-to-face interventions, and depression outcomes were substantial. These findings support the feasibility of providing a multimodal e-mental health treatment to patients with depression. Although it is premature to make any firm conclusions based on these data, they do support the initiation of a randomized controlled trial examining the independent and joint effects of Internet and telephone administered treatments for depression.",21169164,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.861775398254395,-3.634066343307495,DCGI
"Effectiveness of psychological and educational interventions for the prevention of depression in the workplace: A systematic review and meta-analysis.

Objectives Psychological and educational interventions for the prevention of depression have a small-to-moderate effect. However, little is known about their effectiveness in the workplace. We aimed to evaluate the effectiveness of such interventions through a systematic review and meta-analysis of randomized controlled trials (RCT). Methods We searched PubMed, PsycINFO, EMBASE, CENTRAL, CIS-DOC and Open Grey for RCT. Search was supplemented with manual searches of reference lists of relevant meta-analyses and trials. We included RCT that assessed either the incidence of depression or the reduction of depressive symptoms, which excluded participants with baseline depression. Measurements were required to have been made using validated instruments and participants recruited in the workplace. Independent evaluators selected studies, evaluated risk bias (Cochrane Collaboration's tool) and extracted from RCT. The combined OR was estimated using the fixed-effects model. Heterogeneity was measured by I 2and Cochrane's Q. Results Of the 1963 abstracts reviewed, 69 were selected for review in fulltext. Only three RCT met our inclusion criteria, representing 1246 workers from three different countries and continents. The combined odds ratio was 0.25 [95% confidence interval (CI) 0.11-0.60, P=0.002]; I 2=0% and Q=0.389 (P=0.823). The risk of bias was low in one RCT and moderate and high in the other two, respectively. Conclusion Psychological or educational interventions in the workplace may prevent depression, although the quality of evidence was low.",30500058,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.29637336730957,-3.590485095977783,BCe0
"The perniciousness of perfectionism in group therapy for depression: A test of the perfectionism social disconnection model.

Half a century of theoretical accounts, case histories, and evidence implies perfectionism limits the success of psychotherapy and makes it hard for people to participate in and benefit from close relationships. Likewise, intimate relationships are crucial determinants of the success of treatment. However, the extent to which specific types of relationships explain why perfectionism leads to a poorer treatment outcome is unclear. We addressed this by, first, testing whether the perfectionism traits of self-oriented, other-oriented, and socially prescribed perfectionism hindered symptom reduction in group psychotherapy for depression and, second, assessing the mediating role of romantic love, friendships, and familial love on the effects of perfectionism traits on change in depression. Psychiatric patients (N = 156) enrolled in short-term postdischarge group cognitive-behavioral therapy for residual depression completed measures of perfectionism at pretreatment; of romantic love, friendships, and familial love at posttreatment; and of depression at pre- and posttreatment. Multilevel modeling showed that other-oriented and socially prescribed perfectionism were associated with lower posttreatment reductions in depression over treatment, and path analysis revealed that self-oriented, other-oriented, and socially prescribed perfectionism indirectly predicted lower posttreatment reductions in depression through a perceived lack of quality friendships. Results lend credence and coherence to the perfectionism social disconnection model in a clinical context and underscore the importance of taking extratherapeutic social disconnection into account when treating perfectionistic patients. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",31999191,Major Depressive Disorder,Anxiety Treatment,Mental Health,16100,15.265085220336914,-3.473905563354492,AuKp
"The process of change in psychotherapy for depression: helping clients to reformulate the problem.

There is increasing interest in mental health nurses delivering structured short-term evidence-based psychotherapies such as cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT); however, while there is evidence of the efficacy of psychotherapy for depression, there is limited understanding of the treatment processes. Data were drawn from audio tapes of CBT and IPT sessions for treatment of depression. The transcripts of the initial, middle and final psychotherapy sessions of 40 clients were analysed. A thematic analysis was conducted to identify what was occurring in the sessions, how the client was describing psychotherapy and how the client was describing improvement or lack of improvement in depressive symptoms. There were differences in descriptions of therapy and the experience of depression between clients who responded and those who did not respond to therapy that were related to improvement in symptoms but not to the specific therapy. These differences were in the client's engagement with the language of therapy, sense of optimism about the particular model of psychotherapy, ability to examine their own role in the problem and desire to engage with new ways of being in their lives. Clients who responded to CBT or IPT had flexibility to develop new ways of thinking and acting, the ability to accept responsibility for their role in the identified problem and were willing to risk change.",22070862,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.9645414352417,-3.467266082763672,C1Lg
"Analysis of Clinical Trial Exit Interview Data in Patients with Treatment-Resistant Depression.

Clinical outcome assessments may not fully capture patients' perspectives of treatment benefit or tolerability. Incorporating individual exit interviews might enhance the description of the patient experience of drug effects. The objective of this study was to evaluate the patient treatment experience in a clinical trial of treatment-resistant depression utilizing exit interview methodology. Individual patient interviews were conducted with subjects exiting two phase II clinical trials involving investigational agents for treatment-resistant depression. Interviews included standardized questions about patients' perceptions of health changes and interest in continued use of the investigational agent. Constant comparative analysis of blinded data was used to identify, code, and categorize the data followed by a subsequent analysis of unblinded data to evaluate any potential treatment differences. Ninety subjects completed exit interviews across the two trials. Most subjects (90%, Trial 2001; 74%, Trial 2002) reported at least one health change. Most subjects rated these changes to be at least moderately important, with most being rated ""very important"" to ""extremely important."" After unblinding, participants receiving active therapy alone reported most of the positive health changes (80% of overall positive changes in Trial 2001, 89% in Trial 2002), whereas patients taking placebo alone reported the majority of negative health changes (57% in Trial 2002). Positive changes included not only anticipated changes in mood but also potential cognitive benefits such as mental alertness, improved sleep, and better concentration. Standardized interview data provided direct patient insight into the treatment experience from the patient perspective. Data from these interviews assisted in phase III endpoint selection by providing data on relevant concepts in the target treatment-resistant depression population receiving a new treatment, thus enabling the selection of tools to capture noted treatment effects and, by eliminating irrelevant constructs or measures, thereby reducing data ""noise."" ClinicalTrials.gov NCT01640080; NCT01627782.",31270774,Major Depressive Disorder,Anxiety Treatment,Mental Health,5977,10.434320449829102,-1.813625693321228,A4CK
"Breathing exercise combined with cognitive behavioural intervention improves sleep quality and heart rate variability in major depression.

The aim of this study was to investigate the effects of a cognitive behavioural intervention combined with a breathing relaxation exercise on sleep quality and heart rate variability in patients with major depression. Depression is a long-lasting illness with significant effects not only in individuals themselves, but on their family, work and social relationships as well. Cognitive behavioural therapy is considered to be an effective treatment for major depression. Breathing relaxation may improve heart rate variability, but few studies have comprehensively examined the effect of a cognitive behavioural intervention combined with relaxing breathing on patients with major depression. An experimental research design with a repeated measure was used. Eighty-nine participants completed this study and entered data analysed. The experimental group (n = 43) received the cognitive behavioural intervention combined with a breathing relaxation exercise for four weeks, whereas the control group (n = 46) did not. Sleep quality and heart rate variability were measured at baseline, posttest1, posttest2 and follow-up. Data were examined by chi-square tests, t-tests and generalised estimating equations. After adjusting for age, socioeconomic status, severity of disease and psychiatric history, the quality of sleep of the experimental group improved, with the results at posttest achieving significance. Heart rate variability parameters were also significantly improved. This study supported the hypothesis that the cognitive behavioural intervention combined with a breathing relaxation exercise could improve sleep quality and heart rate variability in patients with major depression, and the effectiveness was lasting. The cognitive behavioural intervention combined with a breathing relaxation exercise that included muscle relaxation, deep breathing and sleep hygiene could be provided with major depression during hospitalisation. Through group practice and experience sharing, participants could modulate their heart rate variability and share feeling about good sleep as well relaxation.",26404039,Major Depressive Disorder,Anxiety Treatment,Mental Health,12837,8.046710968017578,-0.9340161681175232,B3jI
"Predicting post treatment client satisfaction between behavioural activation for depression delivered either in-person or via home-based telehealth.

Treatment engagement, adherence, cancellations and other patient-centric data are important predictors of treatment outcome. But often these data are only examined retrospectively. In this investigation, we analysed data from a clinical trial focused on innovative delivery of depression treatment to identify which patients are likely to prefer either in-home or in-person treatment based on pre-treatment characteristics. Patient satisfaction was assessed in a trial of individuals with depression treated using identical behavioural activation therapy protocols in person or through videoconferencing to the home (N=87 at post treatment: 42 in-person and 45 in-home participants). The Client Satisfaction Questionnaire was administered at the end of the treatment. A Tobit regression model was used to assess moderation using treatment assignment. Regression lines were generated to model treatment satisfaction as a function of treatment assignment and to identify whether and where the groups intersected. We examined the distributions of the contributing moderators to the subsets of participants above and below the intersection point to identify differences. While no significant differences in patient satisfaction were observed between the two groups, or between patients receiving treatment by different providers, baseline characteristics of the sample could be used to differentiate those with a preference for traditional, in-office care from those preferring in-home care. Participants who were more likely to prefer in-home care were characterized by larger proportions of veterans and lower-ranked enlisted service members. They also had more severe symptoms at baseline and less formal education. Understanding client reactions when selecting treatment modality may allow for a more satisfying patient experience.",29976097,Major Depressive Disorder,Anxiety Treatment,Mental Health,10069,10.669180870056152,-2.980578660964966,BJYU
"The influence of depressive symptoms on the effectiveness of a short-term group form of Schema Cognitive Behavioural Therapy for personality disorders: a naturalistic study.

This naturalistic study examined the outcomes of Short-Term Schema Cognitive Behavioural Therapy in groups with personality disorders, and with high and low severity of depressive symptoms. Assessments were made at baseline, at mid-treatment (week 10), at treatment termination (week 20) and at three-month follow-up (week 32) of 225 patients with personality disorders and high severity of depressive symptoms (PD-Hi) and patients with low severity of depressive symptoms (PD-Lo). The assessments focused on symptom (Symptom Checklist-90) and schema severity (Young Schema Questionnaire) and coping styles (Utrecht Coping List). We also measured the rate of symptom remission. The data obtained were subjected to multilevel analysis. Psychiatric symptoms and maladaptive schemas improved in both patient groups. Effect sizes were moderate, and even small for the coping styles. Symptom remission was achieved in the minority of the total sample. Remission in psychiatric symptomatology was seen in more PD-Lo patients at treatment termination. However, the difference in levels of remission between the two patient groups was no longer apparent at follow-up. A short-term form of schema therapy in groups proved to be an effective approach for a broad group of patients with personality disorders. However, the majority of patients did not achieve symptom remission. Not applicable.",32487119,Major Depressive Disorder,Anxiety Treatment,Mental Health,423,17.55243492126465,-5.998376846313477,AoDy
"Systematic review and meta-analysis of collaborative care interventions for depression in patients with cancer.

Previous systematic reviews have found limited evidence for the effectiveness of pharmacological and psychological interventions for the management of depression in patients with cancer. This paper provides the first meta-analysis of newer collaborative care interventions, which may include both types of treatment, as well as integrated delivery and follow-up. Meta-analyses of pharmacological and psychological interventions are included as a comparison. A search of MEDLINE, EMBASE, PsycINFO, and the Cochrane Library from July 2005 to January 2015 for randomized controlled trials of depression treatments for cancer patients diagnosed with a major depressive disorder, or who met a threshold on a validated depression rating scale was conducted. Meta-analyses were conducted using summary data. Key findings included eight reports of four collaborative care interventions, eight pharmacological, and nine psychological trials. A meta-analysis demonstrated that collaborative care interventions were significantly more effective than usual care (standardized mean difference = -0.49, p = 0.003), and depression reduction was maintained at 12 months. By comparison, short-term (up to 12 weeks), but not longer-term effectiveness was demonstrated for both pharmacological and psychological interventions. Collaborative care interventions have newly emerged as multidisciplinary care delivery models, which may result in more long-term depression remission. This review also updates previous findings of modest evidence for the effectiveness of both pharmacological and psychological interventions for threshold depression in cancer patients. Research designs focusing on combined treatments and delivery systems may best further the limited evidence-base for the management of depression in cancer.",27643388,Major Depressive Disorder,Anxiety Treatment,Mental Health,2474,7.102115154266357,-3.036686658859253,BnGz
"Negative effects of psychotherapies for adult depression: A meta-analysis of deterioration rates.

The risk for deterioration in patients receiving psychotherapy for adult depression has not been examined extensively and it is not clear whether psychotherapy reduces this risk or may even increase it in some patients. We conducted a meta-analysis of trials comparing these psychotherapies with control conditions that report deterioration rates. We used an existing database of randomized trials on psychotherapies for adult depression which was updated up to 1/1/2017, through systematic searches in bibliographic databases. We included trials that reported clinically significant deterioration rates. We included 18 studies with 23 comparisons between therapy and control groups. The pooled risk ratio of deterioration was 0.39 (95% CI: 0.27∼0.57), indicating that patients in the psychotherapy groups have a 61% lower chance to deteriorate than patients in the control groups. We found that 20 patients need to be treated with psychotherapy in order to avoid one case of deterioration, compared to the control conditions. The median deterioration rate in the therapy groups was 4%, and in some studies more than 10%, indicating that clinicians should always be aware of the risk of deterioration. The results should be considered with caution because most studies had at least some risk of bias. Only 6% of all trials comparing psychotherapy with a control condition reported deterioration rates, using different ways to define deterioration which made pooling the prevalence rates across treatments and control groups impossible. Psychological treatments of adult depression may reduce the risk for deterioration, compared to control groups, but this should be considered with caution because of the small proportion of studies reporting deterioration rates.",30005327,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.696405410766602,-2.517775774002075,BJBm
"Therapeutic Alliance, Client Need for Approval, and Perfectionism as Differential Moderators of Response to eHealth and Traditionally Delivered Treatments for Comorbid Depression and Substance Use Problems.

This study sought to undertake an exploratory analysis of the impact of therapeutic alliance and dysfunctional attitudes (perfectionism and need for approval) on outcomes for participants receiving therapist-delivered and eHealth interventions for comorbid depression and alcohol/cannabis use problems. These factors have been shown in previous research to moderate response to psychological treatment for depression and related disorders. Participants (N = 274) with concurrent depression and alcohol/cannabis misuse were randomized to 10 sessions of therapist-delivered cognitive behavior therapy/motivational interviewing (CBT/MI), computer-delivered CBT/MI with brief therapist assistance (SHADE CBT/MI), or supportive counseling (PCT). Follow-up occurred at 3, 6, and 12 months post-baseline. Exploratory moderator analyses examined changes in depression, alcohol use, and cannabis use over the 3-12-month follow-up timepoints, adjusting for baseline, as a function of treatment allocation, and the hypothesized moderators of therapeutic alliance, perfectionism, and need for approval. The sample size and number of comparisons in the analysis mean that the results are considered preliminary and need replication in larger trials. The analysis revealed that ""client initiative,"" a subscale of therapeutic alliance, moderated change in depression scores between 3- and 12-month follow-up for the PCT group, with higher scores associated with decreases in depression over time. Higher therapeutic ""bond"" early in treatment for SHADE CBT/MI participants was associated with reduced cannabis use over time. Participants with higher ""perfectionism"" scores at baseline who received therapist CBT/MI reported increases in depression over the follow-up period, but reductions in depression if they received SHADE CBT/MI. Therapist CBT/MI participants high on ""need for approval"" at baseline reported better alcohol use outcomes over time. The preliminary nature of these results do not justify firm conclusions. However, the specific variables of perfectionism, need for approval, and client initiative show promise as moderators of treatment efficacy for comorbid depression and alcohol/cannabis use problems. Further research is justified to determine whether these factors can assist in tailoring the modality and strategies offered in the delivery of psychotherapy to this population.",28819922,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,13.715890884399414,-6.176857948303223,BYOt
"A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments.

No recent meta-analysis has examined the effects of cognitive-behavioural therapy (CBT) for adult depression. We decided to conduct such an updated meta-analysis. Studies were identified through systematic searches in bibliographical databases (PubMed, PsycINFO, Embase, and the Cochrane library). We included studies examining the effects of CBT, compared with control groups, other psychotherapies, and pharmacotherapy. A total of 115 studies met inclusion criteria. The mean effect size (ES) of 94 comparisons from 75 studies of CBT and control groups was Hedges g = 0.71 (95% CI 0.62 to 0.79), which corresponds with a number needed to treat of 2.6. However, this may be an overestimation of the true ES as we found strong indications for publication bias (ES after adjustment for bias was g = 0.53), and because the ES of higher-quality studies was significantly lower (g = 0.53) than for lower-quality studies (g = 0.90). The difference between high- and low-quality studies remained significant after adjustment for other study characteristics in a multivariate meta-regression analysis. We did not find any indication that CBT was more or less effective than other psychotherapies or pharmacotherapy. Combined treatment was significantly more effective than pharmacotherapy alone (g = 0.49). There is no doubt that CBT is an effective treatment for adult depression, although the effects may have been overestimated until now. CBT is also the most studied psychotherapy for depression, and thus has the greatest weight of evidence. However, other treatments approach its overall efficacy.",23870719,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.050206184387207,-2.481330394744873,CbIx
"An Internet-based intervention to promote mental fitness for mildly depressed adults: randomized controlled trial.

Depression is a worldwide problem warranting global solutions to tackle it. Enhancing well-being has benefits in its own right and could be a good strategy for preventing depression. Providing well-being interventions via the Internet may have synergetic effects. Psyfit (""mental fitness online"") is a fully automated self-help intervention to improve well-being based on positive psychology. This study examines the clinical effects of this intervention. We conducted a 2-armed randomized controlled trial that compared the effects of access to Psyfit for 2 months (n=143) to a waiting-list control condition (n=141). Mild to moderately depressed adults in the general population seeking self-help were recruited. Primary outcome was well-being measured by Mental Health Continuum-Short Form (MHC-SF) and WHO Well-being Index (WHO-5); secondary outcomes were depressive symptoms, anxiety, vitality, and general health measured by Center for Epidemiological Studies Depression Scale (CES-D), Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), and Medical Outcomes Study-Short Form (MOS-SF) vitality and general health subscales, respectively. Online measurements were taken at baseline, 2 months, and 6 months after baseline. The dropout rate was 37.8% in the Psyfit group and 22.7% in the control group. At 2-month follow-up, Psyfit tended to be more effective in enhancing well-being (nonsignificantly for MHC-SF: Cohen's d=0.27, P=.06; significantly for WHO-5: Cohen's d=0.31, P=.01), compared to the waiting-list control group. For the secondary outcomes, small but significant effects were found for general health (Cohen's d=0.14, P=.01), vitality (d=0.22, P=.02), anxiety symptoms (Cohen's d=0.32, P=.001), and depressive symptoms (Cohen's d=0.36, P=.02). At 6-month follow-up, there were no significant effects on well-being (MHC-SF: Cohen's d=0.01, P=.90; WHO-5: Cohen's d=0.26, P=.11), whereas depressive symptoms (Cohen's d=0.35, P=.02) and anxiety symptoms (Cohen's d=0.35, P=.001) were still significantly reduced compared to the control group. There was no clear dose-response relationship between adherence and effectiveness, although some significant differences appeared across most outcomes in favor of those completing at least 1 lesson in the intervention. This study shows that an online well-being intervention can effectively enhance well-being (at least in the short-term and for 1 well-being measure) and can help to reduce anxiety and depression symptoms. Further research should focus on increasing adherence and motivation, reaching and serving lower-educated people, and widening the target group to include people with different levels of depressive symptoms. Netherlands Trial Register (NTR) number: NTR2126; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2126 (archived by WebCite at http://www.webcitation.org/6IIiVrLcO).",24041479,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.0327730178833,-3.6794121265411377,CYoS
"Group cognitive behavioural therapy can reduce stigma and improve treatment compliance in major depressive disorder patients.

The stigma of mental disorders and poor treatment compliance can deprive patients with major depressive disorder (MDD) of receiving standard treatment. This study aimed to clarify whether MDD patients' stigma and treatment non-compliance issues can be mitigated using group cognitive behavioural therapy (GCBT). Eighty-eight participants with first-episode MDD were randomly divided into GCBT groups (GCBTs) and control groups (Cs). The Hamilton Rating Scale for Depression (HRSD-24), Morisky Medication Adherence Scale (MMAS-8™) and Stigma Scale (SS) were used to evaluate the therapeutic effect on all participants before and after receiving GCBT. Data were assessed at baseline and post-treatment. At the baseline, there were no significant differences (in terms of the demographic data of the participants and the scores on HRSD-24, MMAS-8™ and SS) between the two groups. After 8 weeks of GCBT, there were significant differences in HRSD-24 (P <.01), MMAS-8™ (P <.01), SS (P <.01), treatment compliance (P <.01) and therapeutic effect evaluation based on rate of deduction (P <.05) between the two groups. GCBT can reduce patients' sense of stigma, improve treatment compliance, effectively alleviate depressive symptoms and promote the recovery of MDD patients.",31264787,Major Depressive Disorder,Anxiety Treatment,Mental Health,585,10.892069816589355,-2.2340409755706787,A4Hr
"Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: effects at 1- and 2-year follow-up.

To evaluate the effects of a brief group cognitive-behavioral (CB) depression prevention program for high-risk adolescents with elevated depressive symptoms at 1- and 2-year follow-up. In this indicated prevention trial, 341 at-risk youths were randomized to a group CB intervention, group supportive expressive intervention, CB bibliotherapy, or educational brochure control condition. Significantly greater reductions in depressive symptoms were shown by group CB participants relative to brochure control participants by 1-year follow-up and bibliotherapy participants by 1- and 2-year follow-up but not relative to supportive expressive participants. Supportive expressive participants showed greater symptom reduction than CB bibliotherapy participants did at 2-year follow-up. Risk for onset of major or minor depression over the 2-year follow-up was significantly lower for group CB participants (14%; odds ratio = 2.2) and CB bibliotherapy participants (3%; odds ratio = 8.1) than for brochure controls (23%). Results indicate that this group CB intervention reduces initial symptoms and risk for future depressive episodes, although both supportive expressive therapy and CB bibliotherapy also produce intervention effects that persist long term. Indeed, CB bibliotherapy emerged as the least expensive method of reducing risk for future episodes of depression.",20873893,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.316415786743164,-3.165891647338867,DFQS
"Effectiveness of cognitive-behavioural therapy plus pharmacotherapy in inpatient treatment of depressive disorders.

Meta-analyses show benefits for patients from a combination of medication and cognitive-behavioural psychotherapy. However, it is still unclear whether or not additional cognitive-behavioural therapy (CBT) also produces a better treatment outcome in a naturalistic psychiatric setting. Two-hundred six consecutively registered acute psychiatric inpatients with a unipolar depressive disorder were treated with additional CBT. This combined therapy was then compared with psychiatric primary care in an inpatient setting (clinical management). In addition to pharmacological treatment, 105 of the 206 patients also received symptom-focused CBT after hospitalization. Seventeen-item Hamilton Rating Scale for Depression (HAMD, primary outcome criterion), Beck Depression Inventory (BDI), Dysfunctional Attitude Scale, Clinical Global Impression Scale and the Global Assessment of Functioning were performed with all patients. Patients who were treated with additional CBT revealed a considerably greater reduction of depressive symptoms than in patients who received inpatient primary care only (HAMD: -22.21 versus -19.86, p = 0.027; BDI: 14.99 versus 11.36, p = 0.031). Moreover, remission rates were significantly higher (HAMD: 72% to 51%, p = 0.045; BDI: 58.8% versus 43.1%, p = 0.044) in the combined treatment group than in the primary care only group. The naturalistic design and the inconsistent pharmacological treatment are design flaws. The results show that additional cognitive-behavioural treatment of depressive disorders notably improves outcome over standard procedure in acute psychiatric treatment. There is a need for treatment strategies to accompany medication. In the Sequenced Treatment Alternatives to Relieve Depression trial (STAR*D), only 33% of the patients reached remission criteria after the first antidepressant treatment step and only 50% after the second step. The strict inclusion criteria of randomized controlled trials often render their patient populations unrepresented. For an accurate view of treatment effectiveness, their results need to be complemented with results gained from trials in clinical practice. Additional cognitive-behavioural treatment notably improves treatment outcomes compared with standard treatments in the acute psychiatric treatment of depressive disorders. The results of this study under naturalistic conditions are an important addition to findings from randomized and controlled studies.",22095701,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.098211288452148,-2.640756368637085,C00L
"Acceptance-based Behavior Therapy for Depression With Psychosis: Results From a Pilot Feasibility Randomized Controlled Trial.

Acceptance-based depression and psychosis therapy (ADAPT), a mindfulness/acceptance-based behavioral activation treatment, showed clinically significant effects in the treatment of depression with psychosis in a previous open trial. The goal of the current study was to further test the feasibility of ADAPT to determine the utility of testing it in a future clinical trial, following a stage model of treatment development. Feasibility was determined by randomizing a small number of patients (N=13) with comorbid depression and psychosis to medication treatment as usual plus enhanced assessment and monitoring versus ADAPT for 4 months of outpatient treatment. Both conditions were deemed acceptable by patients. Differences in between-subjects effect sizes favored ADAPT posttreatment and were in the medium to large range for depression, psychosocial functioning, and experiential avoidance (ie, the target mechanism). Thus ADAPT shows promise for improving outcomes compared with medications alone and requires testing in a fully powered randomized trial.",26352221,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.005904197692871,-1.6367896795272827,B4Xy
"User Acceptance of Computerized Cognitive Behavioral Therapy for Depression: Systematic Review.

Computerized cognitive behavioral therapy (cCBT) has been proven to be effective in depression care. Moreover, cCBT packages are becoming increasingly popular. A central aspect concerning the take-up and success of any treatment is its user acceptance. The aim of this study was to update and expand on earlier work on user acceptance of cCBT for depression. This paper systematically reviewed quantitative and qualitative studies regarding the user acceptance of cCBT for depression. The initial search was conducted in January 2016 and involved the following databases: Web of Science, PubMed, the Cochrane Library, and PsycINFO. Studies were retained if they described the explicit examination of the user acceptance, experiences, or satisfaction related to a cCBT intervention, if they reported depression as a primary outcome, and if they were published in German or English from July 2007 onward. A total of 1736 studies were identified, of which 29 studies were eligible for review. User acceptance was operationalized and analyzed very heterogeneously. Eight studies reported a very high level of acceptance, 17 indicated a high level of acceptance, and one study showed a moderate level of acceptance. Two qualitative studies considered the positive and negative aspects concerning the user acceptance of cCBT. However, a substantial proportion of reviewed studies revealed several methodical shortcomings. In general, people experience cCBT for depression as predominantly positive, which supports the potential role of these innovative treatments. However, methodological challenges do exist in terms of defining user acceptance, clear operationalization of concepts, and measurement.",28903893,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.700392723083496,-3.0257694721221924,BXDy
"Large-scale study suggests specific indicators for combined cognitive therapy and pharmacotherapy in major depressive disorder.

",25142013,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.085370063781738,-0.6839526891708374,CJiq
"Long-term efficacy of metacognitive therapy and cognitive behaviour therapy for depression.

To examine the two-year outcomes for depression, anxiety, cognitive and global social functioning after cognitive behavioural therapy (CBT) and metacognitive therapy (MCT) for depression. Participants were 31 adults with a diagnosis of major depressive disorder in a randomised pilot study comparing MCT and CBT. Therapy modality differences in change in depression and anxiety symptoms, dysfunctional attitudes, metacognitions, rumination, worry and global social functioning were examined at the two-year follow-up for those who completed therapy. Significant improvements, with large effect sizes, were evident for all outcome variables. There were no significant differences in outcome between CBT and MCT. The greatest change over time occurred for depression and anxiety. Large changes were evident for metacognitions, rumination, dysfunctional attitudes, worry and global social functioning. Sixty-seven percent had not experienced a major depression and had been well during all of the past year, prior to the follow-up assessment. The finding at end treatment, of no modality specific differences, was also evident at two-year follow-up. Although CBT and MCT targeted depression, improvements were much wider, and although CBT and MCT take different approaches, both therapies produced positive change over time across all cognitive variables. CBT and MCT provide treatment options, that not only improve the longer-term outcome of depression, but also result in improvements in anxiety, global social functioning and cognitive status.",34250846,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,11.887136459350586,-1.7701297998428345,ATXz
"[Evidence-based treatments in the rehabilitation of patients with depression--a literature review].

In recent years, the importance of guidelines has increased continuously. This development also occurs in the field of rehabilitative health care, where process guidelines are being designed for various indicational groups to ensure quality standards and improvements. The primary goal of this paper is to collect and evaluate the evidence for various treatment options for depressive disorders in order to establish a basis for the current development of a process guideline for the rehabilitation of patients with depressive disorders. In order to identify evidence based treatment elements, first a comprehensive investigation of national and international guidelines was conducted. Thirteen selected guidelines were then assessed with regard to aspects of methodological quality and evidence-based treatment elements. In a further step, literature searches were conducted for residual treatment elements, which were identified on the basis of the Classification of Therapeutic Services (KTL) 2007. For the literature search, a hierarchical approach was chosen: At first, meta-analyses and systematic reviews were viewed. In case when there was still a lack of evidence for specific, potentially relevant treatment elements, the search was expanded to the level of primary studies. All selected reviews and primary studies then underwent a standardized assessment especially regarding methodological quality and evidence grades were allocated to treatments. Thereby, the following treatment elements with an adequate level of evidence were identified: Psychotherapeutic interventions, marital/couples/family therapy and counselling, inclusion of family members, psycho education and exercise, problem solving therapy, guided self-help, and behavioural activation treatments. On the basis of this complementary literature search, various other evident interventions could be identified within the following areas: relaxation techniques, improvement of social competence, occupational therapy, art therapies (music, movement/dance therapies), body-oriented therapies and massage therapy. In summary, using this hierarchical approach, it was possible to assign different levels of evidence to the various treatment elements for depression. Based on the results of this literature search, a next step in the development of a process guideline for the rehabilitative treatment of patients with depression will be the integration of experts in the field of rehabilitation.",20013572,Major Depressive Disorder,Anxiety Treatment,Mental Health,11412,9.696310043334961,-1.5259206295013428,DPe5
"A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials of Clinical Emotional Freedom Techniques (EFT) for the Treatment of Depression.

Among a group of therapies collectively known as energy psychology (EP), emotional freedom techniques (EFT) is the most widely practiced. Clinical EFT is an evidence-based practice combining elements of cognitive and exposure therapies with the manual stimulation of acupuncture points (acupoints). Lacking is a recent quantitative meta-analysis that enhances understanding of the variability and clinical significance of outcomes after clinical EFT treatment in reducing depression. All studies (2005-2015) evaluating EFT for sufferers of depression were identified by electronic search; these included both outcome studies and randomized controlled trials (RCTs). Our focus was depressive symptoms as measured by a variety of psychometric questionnaires and scales. We used meta-analysis to calculate effect sizes at three time points including posttest, follow-ups less than 90 days, and follow-ups more than 90 days. In total, 20 studies were qualified for inclusion, 12 RCTs and 8 outcome studies. The number of participants treated with EFT included N = 461 in outcome studies and N = 398 in RCTs. Clinical EFT showed a large effect size in the treatment of depression in RCTs. At posttest, Cohen׳s d for RCTs was 1.85 and for outcome studies was 0.70. Effect sizes for follow-ups less than 90 days were 1.21, and for ≥ 90 days were 1.11. EFT were more efficacious than diaphragmatic breathing (DB) and supportive interview (SI) in posttest measurements (P = .06 versus DB, P < .001 versus SI), and sleep hygiene education (SHE) at follow-up (P = .036). No significant treatment effect difference between EFT and eye movement desensitization and reprocessing (EMDR) was found. EFT were superior to treatment as usual (TAU), and efficacious in treatment time frames ranging from 1 to 10 sessions. The mean of symptom reductions across all studies was -41%. The results show that Clinical EFT were highly effective in reducing depressive symptoms in a variety of populations and settings. EFT were equal or superior to TAU and other active treatment controls. The posttest effect size for EFT (d = 1.31) was larger than that measured in meta-analyses of antidepressant drug trials and psychotherapy studies. EFT produced large treatment effects whether delivered in group or individual format, and participants maintained their gains over time. This meta-analysis extends the existing literature through facilitation of a better understanding of the variability and clinical significance of depression improvement subsequent to EFT treatment.",27843054,Major Depressive Disorder,Anxiety Treatment,Mental Health,3392,17.466623306274414,-8.931075096130371,BkxL
"Visualizing the evolution of evidence: Cumulative network meta-analyses of new generation antidepressants in the last 40years.

It is often challenging to present the available evidence in a timely and comprehensible manner. We aimed to visualize the evolution of evidence about antidepressants for depression by conducting cumulative network meta-analyses (NMAs) and to examine whether it could have helped the selection of optimal drugs. We built a Shiny web application that performs and presents cumulative NMAs based on R netmeta. We used a comprehensive dataset of double-blind randomized controlled trials of 21 antidepressants in the acute treatment of major depression. The primary outcomes were efficacy (treatment response) and acceptability (all-cause discontinuation), and treatment effects were summarized via odds ratios. We evaluated the confidence in evidence using the CINeMA (Confidence in Network Meta-Analysis) framework for a series of consecutive NMAs. Users can change several conditions for the analysis, such as the period of synthesis, among the others. We present the league tables and two-dimensional plots that combine efficacy, acceptability and level of confidence in the evidence together, for NMAs conducted in 1990, 1995, 2000, 2005, 2010, and 2016. They reveal that through the past four decades, newly approved drugs often showed initially exaggerated results, which tended to diminish and stabilize after approximately a decade. Over the years, the drugs with relative superiority changed dramatically; but as the evidence network grew larger and better connected, the overall confidence improved. The Shiny app visualizes how evidence evolved over years, emphasizing the need for a careful interpretation of relative effects between drugs, especially for the potentially amplified performance of newly approved drugs. HIGHLIGHTS: Network meta-analysis is considered to be a proper way of demonstrating the available evidence, since it allows comparisons between multiple interventions, and has been proved to be statistically powerful. It is challenging to present the voluminous results of NMA in an efficient and comprehendible manner. Evidence evolution based on the relatively new method NMA has not been investigated yet. The results of NMA should not only include the effects but also the confidence in the evidence, which can help interpret the findings appropriately. Effective use of rapidly developing statistical analysis and presentation tools such as Shiny package in R, may facilitate and simplify the visualization of NMA output. We should stay conservative towards new drugs, as their performance was often shown to be exaggerated initially, and it took time to become stable.",32352639,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,12.38820743560791,-3.2927637100219727,Ap0R
"Differential effects of treatments for chronic depression: a latent growth model reanalysis.

Psychotherapy-pharmacotherapy combinations are frequently recommended for the treatment of chronic depressive disorders. Our aim in this novel reanalysis of archival data was to identify patient subgroups on the basis of symptom trajectories and examine the clinical significance of the resultant classification on basis of differential treatment effects to psychotherapy (cognitive behavioral analysis system of psychotherapy), pharmacotherapy (nefazodone), and their combination. We selected data for 504 patients diagnosed with chronic depression from archival data of a clinical trial (N = 681) and analyzed treatment courses (as assessed by the Hamilton Rating Scale for Depression) using growth mixture models, a contemporary exploratory analysis technique. Three patient subgroups were identified from the typical patterns of change of depression severity during 12-week acute-phase treatment. Within these patient subgroups, differential treatment effects were evident: combination treatment clearly outperformed the 2 monotherapies in the largest patient subgroup, characterized by moderate depression severity, but not in the remaining 2 subgroups, characterized by low and severe depression at baseline. Patient characteristics prior to initiation of treatment enabled allocation of 61% of patients to these subgroups. Research on patient subgroups with different change patterns may support classifications of patients that indicate which treatment is most effective for which type of patient.",20515216,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.113959312438965,-1.1847591400146484,DJ0l
"An evaluation of the effectiveness of recruitment methods: the staying well after depression randomized controlled trial.

Randomized controlled trials (RCTs) are widely accepted as being the most efficient way of investigating the efficacy of psychological therapies. However, researchers conducting RCTs commonly report difficulties in recruiting an adequate sample within planned timescales. In an effort to overcome recruitment difficulties, researchers often are forced to expand their recruitment criteria or extend the recruitment phase, thus increasing costs and delaying publication of results. Research investigating the effectiveness of recruitment strategies is limited, and trials often fail to report sufficient details about the recruitment sources and resources utilized. We examined the efficacy of strategies implemented during the Staying Well after Depression RCT in Oxford to recruit participants with a history of recurrent depression. We describe eight recruitment methods utilized and two further sources not initiated by the research team and examine their efficacy in terms of (1) the return, including the number of potential participants who contacted the trial and the number who were randomized into the trial; (2) cost-effectiveness, comprising direct financial cost and manpower for initial contacts and randomized participants; and (3) comparison of sociodemographic characteristics of individuals recruited from different sources. Poster advertising, web-based advertising, and mental health worker referrals were the cheapest methods per randomized participant; however, the ratio of randomized participants to initial contacts differed markedly per source. Advertising online, via posters, and on a local radio station were the most cost-effective recruitment methods for soliciting participants who subsequently were randomized into the trial. Advertising across many sources (saturation) was found to be important. It may not be feasible to employ all the recruitment methods used in this trial to obtain participation from other populations, such as those currently unwell, or in other geographical locations. Recruitment source was unavailable for participants who could not be reached after the initial contact. Thus, it is possible that the efficiency of certain methods of recruitment was poorer than estimated. Efficacy and costs of other recruitment initiatives, such as providing travel expenses to the in-person eligibility assessment and making follow-up telephone calls to candidates who contacted the recruitment team but could not be screened promptly, were not analysed. Website advertising resulted in the highest number of randomized participants and was the second cheapest method of recruiting. Future research should evaluate the effectiveness of recruitment strategies for other samples to contribute to a comprehensive base of knowledge for future RCTs.",24686105,Major Depressive Disorder,Anxiety Treatment,Mental Health,14108,8.339717864990234,-6.862320899963379,CP/m
"The treatment of chronic depression with cognitive behavioral analysis system of psychotherapy: a systematic review and meta-analysis of randomized-controlled clinical trials.

Chronic depression is a severe and disabling condition. Compared to an episodic course, chronic depression has been shown to be less responsive to psychopharmacological and psychological treatments. The cognitive behavioral analysis system of psychotherapy (CBASP) has been developed as a specific psychotherapy for chronic depression. However, conflicting results concerning its efficacy have been reported in randomized-controlled trials (RCT). Therefore, we aimed at examining the efficacy of CBASP using meta-analytical methods. Randomized-controlled trials assessing the efficacy of CBASP in chronic depression were identified by searching electronic databases (PsycINFO, PubMed, Scopus, Cochrane Central Register of Controlled Trials) and by manual searches (citation search, contacting experts). Searching period was restricted from the first available entry to October 2015. Identified studies were systematically reviewed. The standardized mean difference Hedges' g was calculated from posttreatment and mean change scores. The random-effects model was used to compute combined overall effect sizes. A risk of publication bias was addressed using fail-safe N calculations and trim-and-fill analysis. Six studies comprising 1.510 patients met our inclusion criteria. The combined overall effect sizes of CBASP versus other treatments or treatment as usual (TAU) pointed to a significant effect of small magnitude (g = 0.34-0.44, P < 0.01). In particular, CBASP revealed moderate-to-high effect sizes when compared to TAU and interpersonal psychotherapy (g = 0.64-0.75, P < 0.05), and showed similar effects when compared to antidepressant medication (ADM) (g = -0.29 to 0.02, ns). The combination of CBASP and ADM yielded benefits over antidepressant monotherapy (g = 0.49-0.59, P < 0.05). The small number of included studies, a certain degree of heterogeneity among the study designs and comparison conditions, and insufficient data evaluating long-term effects of CBASP restrict generalizability yet. We conclude that there is supporting evidence that CBASP is effective in the treatment of chronic depression.",27247856,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.156280517578125,-1.7177265882492065,BsAt
"Optimizing psychotherapy dosage for comorbid depression and personality disorders (PsyDos): a pragmatic randomized factorial trial using schema therapy and short-term psychodynamic psychotherapy.

Patients with comorbid depression and personality disorders suffer from a heavy disease burden while tailored treatment options are limited, accounting for a high psychological and economic burden. Little is known about the effect of treatment dosage and type of psychotherapy for this specific co-morbid patient population, in terms of treatment-effect and cost-effectiveness. This study aims to compare treatment outcome of 25 versus 50 individual therapy sessions in a year. We expect the 50-session condition to be more effective in treating depression and maintaining the effect. Secondary objectives will be addressed in order to find therapy-specific and non-specific mechanisms of change. In a mono-center pragmatic randomized controlled trial with a 2×2 factorial design, 200 patients with a depressive disorder and personality disorder(s) will be included. Patients will be recruited from a Dutch mental health care institute for personality disorders. They will be randomized over therapy dosage (25 vs 50 sessions in a year) and type of therapy (schema therapy vs short-term psychodynamic supportive psychotherapy). The primary clinical outcome measure will be depression severity and remission. Changes in personality functioning and quality of life will be investigated as secondary outcomes. A priori postulated effect moderators and mediators will be collected as well. All patients are assessed at baseline and at 1, 2, 3, 6, 9-12 months (end of therapy) and at follow up (6 and 12 months after end of treatment). Alongside the trial, an economic evaluation will be conducted. Costs will be collected from a societal perspective. This trial will be the first to compare two psychotherapy dosages in patients with both depression and personality disorders. Insight in the effect of treatment dosage for this patient group will contribute to both higher treatment effectiveness and lower costs. In addition, this study will contribute to the limited evidence base on treating patients with both depression and personality disorders. Understanding the processes that account for the therapeutic changes could help to gain insight in what works for whom. This trial has been registered on July 20th 2016, Netherlands Trial Register, part of the Dutch Cochrane Centre ( NTR5941 ).",30086730,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.316126823425293,-2.9514076709747314,BH3u
"Efficacy of computer- and/or internet-based cognitive-behavioral guided self-management for depression in adults: a systematic review and meta-analysis of randomized controlled trials.

Depression is a worldwide disease. CBT-based self-help treatment allows patients with mild to moderate depression symptoms to improve their depression or to bridge the waiting- or pandemic period until they receive further clinical treatment. This systematic review and meta-analysis aims to explore the efficacy, acceptability and improvement in quality of life of computer-delivered and/or internet-based CBT self-help interventions with minimal guidance (up to 10 min) for depression. The second aim was to compare the effectiveness of reducing depression symptoms at post-treatment of treatment by the type of minimal guidance: (1) e-mail, (2) telephone calls, (3) e-mail and telephone together, or (4) face-to-face. The Cochrane depression, anxiety, and neurosis review group's specialized register electronic searches, grey literature, reference lists and correspondence were used to search for published and unpublished RCTs that reported efficacy of computer- and/or internet-based CBT self-help treatments for depression with minimal guidance up to 10 min per week. Methodological quality of included studies was evaluated with Cochrane Collaboration tools for assessing risk of bias. The meta-analysis was accomplished using the RevMen software. In total, 2809 study abstracts were checked for eligibility. Out of these, 19 studies (21 samples) with a total of 3226 participants were included. The results showed that concerning efficacy, the treatment group is superior to the control group with a medium to large effect size of 0.65. Also, treatment groups with combined guidance by e-mail and telephone calls together had greater effects (SMD -0.76) than groups with other types of minimal guidance (guided by e-mail SMD -0.63; guided face to-face SMD - 0.66; guided by telephone calls SMD -0.49). Findings showed also, that iCBT with minimal guidance had small but statistically significant effect size of 0.28 in improving quality of life. Moreover, there were higher drop-out rates in the treatment condition (RR 1.36) than in the control groups. The results of this meta-analysis support the efficacy of computer- and/or internet-based CBT self-help programs with minimal weekly guidance up to only 10 min for improving depression symptoms at post-treatment for adults. In addition, the results are pointing towards two practical implications. Firstly, depressed persons can use self-help treatment with minimal guidance at home to improve their symptoms or to bridge the waiting time - or pandemic period - before they receive professional face-to-face treatment. Secondly, it can help clinicians to make the decision about using CBT-based self-help treatments for patients that do not need urgent professional treatment, or to combine it with face-to-face therapy.",36424570,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.451215744018555,-3.1553759574890137,Aq4
"Non-pharmacological strategies for treatment of inpatient depression.

To examine the evidence for non-pharmacological interventions in the treatment of moderate to severe depression in an inpatient setting. An integrative review of original research papers was conducted. The electronic databases CINAHL, MEDLINE and PsychINFO were searched using the following search terms: depression, psychosocial, psychosocial intervention, therapy, and inpatient. Twelve studies were identified in the search for non-psychopharmacological interventions for depression commenced in an inpatient setting. The interventions included psychotherapies, behavioural activation, and chronotherapeutic interventions (controlled exposure to environmental stimuli). These studies suggest it is possible to engage severely depressed inpatients in structured interventions in an inpatient environment. The majority of studies reported favourable outcomes for the interventions compared to a control, but methodological issues were common. A diverse range of treatment strategies has been identified in this review. These studies provide evidence that non-pharmacological treatments for depression can be given to enhance outcomes and that research can be undertaken in inpatient settings. Whilst the evidence base has limitations, this review also highlights therapeutic and research opportunities in this area.",25648143,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.068599700927734,-1.4742017984390259,CCWk
"Metta-based group meditation and individual cognitive behavioral therapy (MeCBT) for chronic depression: study protocol for a randomized controlled trial.

Depression is a widespread disorder with severe impacts for individuals and society, especially in its chronic form. Current treatment approaches for persistent depression have focused primarily on reducing negative affect and have paid little attention to promoting positive affect. Previous studies have shown that metta meditation increases positive affect in chronically depressed patients. Results from previous trials provide evidence for the efficacy of a stand-alone metta meditation group treatment in combination with mindfulness-based approaches. Further research is needed to better understand the implementation of meditation practice into everyday life. Therefore, mindfulness and metta meditation in a group setting are combined with individual cognitive behavioral therapy (CBT) into a new, low-intensity, cost-effective treatment (""MeCBT"") for chronic depression. In this single-center, randomized, observer-blinded, parallel-group clinical trial we will test the efficacy of MeCBT in reducing depression compared to a wait-list control condition. Forty-eight participants in a balanced design will be allocated randomly to a treatment group or a wait-list control group. Metta-based group meditation will be offered in eight weekly sessions and one additional half-day retreat. Subsequent individual CBT will be conducted in eight fortnightly sessions. Outcome measures will be assessed at four time points: before intervention (T0); after group meditation (T1); after individual CBT (T2); and, in the treated group only, at 6-month follow-up (T3). Changes in depressive symptoms (clinician rating), assessed with the Quick Inventory of Depressive Symptoms (QIDS-C) are the primary outcome. We expect a significant decline of depressive symptoms at T2 compared to the wait-list control group. Secondary outcome measures include self-rated depression, mindfulness, benevolence, rumination, emotion regulation, social connectedness, social functioning, as well as behavioral and cognitive avoidance. We will explore changes at T1 and T2 in all these secondary outcome variables. To our knowledge this is the first study to combine a group program focusing on Metta meditation with state-of-the art individual CBT specifically tailored to chronic depression. Implications for further refinement and examination of the treatment program are discussed. ISRCTN, ISRCTN97264476. Registered 29 March 2018 (applied on 14 December 2017)-retrospectively registered.",31907002,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.857007026672363,-0.8171695470809937,AvWf
"National dissemination of interpersonal psychotherapy for depression in veterans: therapist and patient-level outcomes.

To evaluate the effects of training in and delivery of interpersonal psychotherapy (IPT) for depression throughout the U.S. Department of Veterans Affairs health care system on therapists' competency and patients' clinical outcomes. Participants included 124 therapists and 241 veteran patients. Therapists participated in a 3-day workshop followed by 6 months of weekly group consultation. Therapy session tapes were rated by expert IPT training consultants using a standardized competency rating form. Patient outcomes were assessed with the Beck Depression Inventory-II and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed with the Working Alliance Inventory-Short Revised. Of the 124 therapists receiving IPT training, 115 (93%) completed all training requirements. Therapist competence in IPT increased from their 1st patient to their 2nd for both initial (d = 0.36) and intermediate (d = 0.24) treatment phases. Of the 241 veteran patients treated with IPT, 167 (69%) completed ≥ 12 sessions. Intent-to-treat analyses indicated large overall reductions in depression (d = 1.26) and significant improvements in quality of life (d = 0.57 to 0.86) and the therapeutic alliance (d = 0.50 to 0.83). National IPT training in the VA health care system was associated with significant increases in therapist competencies to deliver IPT, as well as large overall reductions in depression and improvements in quality of life among veterans, many of whom presented with high levels of depression. RESULTS support the feasibility and effectiveness of broad dissemination of IPT in routine clinical settings.",25045906,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.524460792541504,-3.545586347579956,CK+j
"The portfolio method as management support for patients with major depression.

To describe how patients with major depression in psychiatric outpatient care use the portfolio method and whether the method helps the patients to understand their depression. Major depressive disorder is an increasing problem in society. Learning about one's depression has been demonstrated to be important for recovery. If the goal is better understanding and management of depression, learning must proceed on the patient's own terms, based on the patient's previous understanding of their depression. Learning must be aligned with patient needs if it is to result in meaningful and useful understanding. Each patient's portfolio consisted of a binder. Inside the binder, there was a register with predetermined flaps and questions. The patients were asked to work with the questions in the sections that built the content in the portfolio. Individual interviews with patients (n = 5) suffering from major depression according to Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) (American Psychiatric Association 1994) were repeatedly conducted between April 2008 and August 2009 in two psychiatric outpatient clinics in western Sweden. Data were analysed using latent content analysis. The results showed that the portfolio was used by patients as a management strategy for processing and analysis of their situation and that a portfolio's structure affects its usability. The patients use the portfolio for reflection on and confirmation of their progress, to create structure in their situation, as a management strategy for remembering situations and providing reminders of upcoming activities. Using a clearly structured care portfolio can enable participation and patient learning and help patients understand their depression. The portfolio method could provide a tool in psychiatric nursing that may facilitate patient understanding and increase self-efficacy.",24127874,Major Depressive Disorder,Anxiety Treatment,Mental Health,5984,10.186206817626953,-2.393019914627075,CXXe
"Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions.

The World Health Organization estimates that during a given 12-month period, approximately 34 million people suffering from major depressive disorder go untreated in Europe and the Americas alone. Barriers to treatment include geographic distance, lack of mental health insurance, prohibitive cost of treatment, long wait-lists, and perceived stigma. Over the past two decades, Internet-based cognitive-behavioral therapy (iCBT) programs have proliferated. A growing body of research supports the efficacy of iCBT for depression and other psychiatric conditions, and these programs may help address barriers that hinder access to effective treatment. The present review describes common iCBT programs along with the evidence base supporting their efficacy in reducing symptoms of depression, reviews research on moderators of treatment response, and provides suggestions for future directions in research and care.",28475503,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.434232711791992,-2.7783236503601074,BdBz
"BE-ACTIV for depression in nursing homes: primary outcomes of a randomized clinical trial.

To report the primary outcomes of a cluster randomized clinical trial of Behavioral Activities Intervention (BE-ACTIV), a behavioral intervention for depression in nursing homes. Twenty-three nursing homes randomized to BE-ACTIV or treatment as usual (TAU); 82 depressed long-term care residents recruited from these nursing homes. BE-ACTIV participants received 10 weeks of individual therapy after a 2-week baseline. TAU participants received weekly research visits. Follow-up assessments occurred at 3- and 6-month posttreatment. BE-ACTIV group participants showed better diagnostic recovery at posttreatment in intent-to-treat analyses adjusted for clustering. They were more likely to be remitted than TAU participants at posttreatment and at 3-month posttreatment but not at 6 months. Self-reported depressive symptoms and functioning improved in both groups, but there were no significant treatment by time interactions in these variables. BE-ACTIV was superior to TAU in moving residents to full remission from depression. The treatment was well received by nursing home staff and accepted by residents. A large proportion of participants remained symptomatic at posttreatment, despite taking one or more antidepressants. The results illustrate the potential power of an attentional intervention to improve self-reported mood and functioning, but also the difficulties related to both studying and implementing effective treatments in nursing homes.",24691156,Major Depressive Disorder,Anxiety Treatment,Mental Health,7503,10.568787574768066,-1.9976871013641357,CP6z
"The role of mentalization in the psychoanalytic treatment of chronic depression.

Mentalization has been proposed as a key concept in understanding therapeutic change in patients with Borderline Personality Disorder (BPD). However, little is known about mentalization in chronic depression. This study investigated the role of mentalization in the long-term psychoanalytic treatment of chronic depression. Mentalization measured with the Reflective Functioning Scale (RFS) was examined in patients with chronic depression (n = 20) in long-term psychoanalytic treatment and compared to healthy controls (n = 20). Results show that global RF scores did not differ significantly between patients and controls. However, depressed patients tended to have lower RF scores concerning issues of loss. Furthermore, RF was unrelated to symptoms and distress as assessed by the Beck Depression Inventory (BDI) and the SCL-90. RF did not predict therapeutic outcome as measured with the BDI but predicted changes in general distress after 8 months of psychoanalytic treatment as measured by the SCL-90. Moreover, correlations between RF and the Helping Alliance Questionnaire indicated that patients with higher RF were able to establish a therapeutic alliance more easily compared to patients with low RF.",21463170,Major Depressive Disorder,Anxiety Treatment,Mental Health,423,15.867953300476074,-6.239154815673828,C93i
"The efficacy of short-term psychodynamic psychotherapy for depression: a meta-analysis.

It remains largely unclear, firstly whether short-term psychodynamic psychotherapy (STPP) is an effective treatment for depression, and secondly, which study, participant, or intervention characteristics may moderate treatment effects. The purpose of this study is to assess the efficacy of STPP for depression and to identify treatment moderators. After a thorough literature search, 23 studies totaling 1365 subjects were included. STPP was found to be significantly more effective than control conditions at post-treatment (d=0.69). STPP pre-treatment to post-treatment changes in depression level were large (d=1.34), and these changes were maintained until 1-year follow-up. Compared to other psychotherapies, a small but significant effect size (d=-0.30) was found, indicating the superiority of other treatments immediately post-treatment, but no significant differences were found at 3-month (d=-0.05) and 12-month (d=-0.29) follow-up. Studies employing STPP in groups (d=0.83) found significantly lower pre-treatment to post-treatment effect sizes than studies using an individual format (d=1.48). Supportive and expressive STPP modes were found to be equally efficacious (d=1.36 and d=1.30, respectively). We found clear indications that STPP is effective in the treatment of depression in adults. Although more high-quality RCTs are necessary to assess the efficacy of the STPP variants, the current findings add to the evidence-base of STPP for depression.",19766369,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.035782814025879,-3.951418876647949,DQsm
"Efficacy and moderators of psychological interventions in treating subclinical symptoms of depression and preventing major depressive disorder onsets: protocol for an individual patient data meta-analysis of randomised controlled trials.

The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately subgroups and moderator effects. The aim of the present study is, therefore, to examine the short-term and long-term as well as moderator effects of psychological interventions compared with control groups in adults with subthreshold depression on depressive symptom severity, treatment response, remission, symptom deterioration, quality of life, anxiety and the prevention of major depressive disorder (MDD) onsets on individual patient level and study level using an individual patient data meta-analysis approach. Systematic searches in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials were conducted. We will use the following types of outcome criteria: (A) onset of major depression; (B) time to major depression onset; (C) observer-reported and self-reported depressive symptom severity; (D) response; (E) remission; (F) symptom deterioration; (G) quality of life, (H) anxiety; and (I) suicidal thoughts and behaviours. Multilevel models with participants nested within studies will be used. Missing data will be handled using a joint modelling approach to multiple imputation. A number of sensitivity analyses will be conducted in order test the robustness of our findings. The investigators of the primary trials have obtained ethical approval for the data used in the present study and for sharing the data, if this was necessary, according to local requirements and was not covered from the initial ethic assessment.This study will summarise the available evidence on the short-term and long-term effectiveness of preventive psychological interventions for the treatment of subthreshold depression and prevention of MDD onset. Identification of subgroups of patients in which those interventions are most effective will guide the development of evidence-based personalised interventions for patients with subthreshold depression. CRD42017058585.",29549201,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.663058280944824,-2.2566540241241455,BOhD
"The influence of family therapy on psychological stress and social adaptability of depressed patients.

with the increase of study and life pressure, the number of depressed college students showed an increasing trend year by year, and the drug treatment alone could not achieve a comprehensive recovery of depression patients, so it was more necessary to pay attention to the spiritual treatment. this research aimed to better understand the relationship between college students' depression and life events, social support, psychological pressure, and coping style, and the influence of systematic family therapy on depression degree, psychological stress, and social adaptability of college students with depression. in this study, 105 college students with depression were selected as the research object, and healthy college students were taken as the control group. Through questionnaire, the differences in life events, social support, psychological stress, and coping styles between the groups were compared. The correlation between the degree of depression and various variables were analyzed, and the impact path of each variable on depression was analyzed using the path analysis model. Depression patients were then divided into a conventional group treating with conventional medications and an observation group treating with systematic family interventions. Differences in Hamilton Depression Scale-17, (HAMD-17), CPSS, and Social Adaptive Functioning Evaluation (SAFE) scores were compared and analyzed between the two groups before treatment (T1), during the treatment (T2), and after treatment(T3). there were significant differences in scores of life events, social support, psychological stress, and coping styles between the healthy control group and the depressed patients (P < 0.05). There was an obvious correlation between different depression degrees and life events, social support, psychological stress, and coping styles (P < 0.05). Life events, social support, and psychological stress had a direct and significant impact on depression (0.250, 0.218, and 0.392; P < 0.05), and they also had an indirect and significant impact on depression through coping styles (P < 0.05). The systematic family treatment model could significantly reduce HAMD-17 and CPSS scores (P < 0.05), and significantly improve SAFE scores (P < 0.05). adverse life events, lack of social support, excessive psychological stress, and negative coping styles can aggravate college students' depression. Systematic family therapy can improve the degree of depression, reduce the psychological stress, and enhance the social adaptability of college students with depression.",34120939,Major Depressive Disorder,Anxiety Treatment,Mental Health,32004,11.559436798095703,-3.5855205059051514,AUyV
"Are self-managed online interventions for depression effective in improving behavioral activation? A secondary analysis of a cluster-randomized controlled trial.

Online interventions can effectively improve depressive symptoms. They often include behavioral activation (BA) techniques, but research on the effects on behavioral activation is scarce. This study aims to examine short- and long-term effects of online interventions on behavioral activation in routine care. This study is a secondary analysis of a pragmatic cluster-randomized controlled trial (@ktiv) with a sample of N = 647 GP patients with mild to moderate depression. The intervention group (IG) received treatment-as-usual (TAU) and adjunct access to an online intervention; the control group (CG) received TAU. BA was assessed in terms of the frequency and enjoyment of pleasant activities at baseline, after six weeks and after six months. Intention-to-treat analyses were performed via multilevel mixed linear regression. The frequency of pleasant activities was significantly higher in the IG than in the CG six months after baseline (t(1406) = 2.25, p = .024). The enjoyment of pleasant activities was significantly higher in the IG than in the CG both six weeks (t(1405) = 2.11, p = .035) and six months after baseline (t(1405) = 3.44, p = .001). Initial depressive symptoms significantly moderated the treatment effect on the enjoyment but not the frequency of pleasant activities. BA measures have not been validated in a clinical context. GP patients with mild to moderate depressive symptoms profited from access to an online adjunct intervention in terms of improved behavioral activation. The findings emphasize the usefulness of online interventions as supportive options in mental health care.",35460734,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.890276908874512,-2.272360324859619,cGg
"A latent trajectory analysis of inpatient depression treatment.

Patients seeking psychotherapy may progress through treatment in varying ways. Modeling multiple treatment trajectories through growth mixture modeling provides a comprehensive way of understanding a patient population. Multiple trajectories may additionally help researchers describe complexities within a patient population, such as those with severe and persistent disorders and comorbid symptoms, to understand characteristics of patients that may be struggling during treatment. We analyzed the depression symptom outcome measures (PHQ-9) for 246 patients receiving inpatient depression treatment. We constructed a growth mixture model of depression symptom changes, allowing the number of treatment trajectories to emerge through the data, and utilized goodness-of-fit indices to select the superior model. Results indicated three classes was the best fitting model, with patients either (a) patients started above the clinical cutoff score for depression and had significant linear change over time, ending therapy just above the clinical cutoff-""Improvement-leveling off-improvement""; (b) patients started therapy well above the clinical cutoff, showed symptom alleviation at the beginning of therapy before the trajectory started to level off-""High symptom pressure""; or (c) patients started therapy just below the clinical cutoff, had steady change throughout therapy, ending well below the clinical cutoff-""continuous improvement."" Implications of the study may include altering the length of treatment based on patient presenting symptoms in order to best serve patients and utilize hospital resources. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",35049322,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.646112442016602,-2.444681406021118,r2g
"The effect of core clinician interpersonal behaviours on depression.

It is well-established that core clinician interpersonal behaviours are important when treating depression, but few studies have evaluated whether outcome is determined by clinicians׳ general behaviour rather than by the perception of the individual being treated. In the NIMH TDCRP, 157 patients rated their clinician׳s genuineness, positive regard, empathy and unconditional regard during cognitive behavioural therapy, interpersonal therapy or clinical management with placebo. The association between averaged ratings for each of 27 clinicians and their patients׳ self- and observer-rated depression outcomes was evaluated, adjusting for the deviation of individual patient ratings from the average for their clinician and other potential confounders. Clinicians in the clinical management condition were rated on average as less genuine and less empathic than those in the psychotherapy conditions. Clinicians׳ average genuineness, positive regard and empathy were significantly associated with lower depression severity during treatment, but not with recovery from depression, after adjusting for the deviation of the individual patient׳s rating of their clinician from the average for that clinician, treatment condition and baseline depression severity. Clinician unconditional regard was not significantly associated with outcome. Using averaged ratings of clinician behaviour likely reduced statistical power. Clinicians׳ ability to demonstrate genuineness, positive regard and empathy may represent a stable personal characteristic that influences the treatment of depression beyond the individual clinician-patient relationship or an individual patient׳s perception of their clinician. However, clinicians׳ ability to demonstrate these behaviours may be poorer when delivering an intervention without a specific rationale or treatment techniques.",24955562,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,13.824728012084961,-5.519330024719238,CMPs
"The Ghent Psychotherapy Study (GPS) on the differential efficacy of supportive-expressive and cognitive behavioral interventions in dependent and self-critical depressive patients: study protocol for a randomized controlled trial.

Major depressive disorder is a leading cause of disease burden worldwide, indicating the importance of effective therapies. Outcome studies have shown overall efficacy of different types of psychotherapy across groups, yet large variability within groups. Although patient characteristics are considered crucial in understanding outcome, they have received limited research attention. This trial aims at investigating the interaction between therapeutic approach (pre-structured versus explorative) and the personality style of patients (dependent versus self-critical), which is considered a core underlying dimension of depressive pathology. This study is a pragmatic stratified (dependent and self-critical patients) parallel trial with equal randomization (allocation 1:1) conducted in Flanders, Belgium. One hundred and four patients will be recruited and randomized to either 16-20 sessions of cognitive behavioral therapy for depression (pre-structured approach) or 16-20 sessions of short-term psychodynamic psychotherapy for depression (explorative approach) conducted by trained psychotherapists in private practices. The primary outcome is the severity of depression as measured by the Hamilton Rating Scale for Depression at completion of therapy. Secondary outcome measures include self-reported depressive and other symptoms, interpersonal functioning, idiosyncratic complaints, and the presence of the diagnosis of depression. Additional measures include biological measures, narrative material (sessions, interviews), and health care costs. This trial presents the test of an often-described, yet hardly investigated interaction between important personality dimensions and therapeutic approach in the treatment of depression. Results could inform therapists on how to match psychotherapeutic treatments to specific personality characteristics of their patients. Isrctn.com, ISRCTN17130982 . Registered on 2 February 2015.",28292331,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.189691543579102,-2.557765007019043,BfhU
"Feasibility Study of Stress Management and Resiliency Training (SMART) in Patients With Major Depressive Disorder.

Stress is associated with the onset, maintenance, and recurrence of depression. This study investigated the feasibility of stress management and resiliency training (SMART) for enhancing resiliency in a group of patients with major depressive disorder. In an open-label study, patients with major depressive disorder were invited to participate in an adjunctive 8-week group therapy of SMART (from June 2017 to June 2018) that encompassed attention training and practice of gratitude, compassion, higher meaning, acceptance, and forgiveness. The primary outcome measure was baseline-to-endpoint change in resilience as measured by the Connor Davidson Resilience Scale (CD-RISC). Secondary outcome measures included baseline-to-endpoint change in stress using the Perceived Stress Scale (PSS) and in depression using the 17-item Hamilton Depression Rating Scale (HDRS-17) and 9-item Patient Health Questionnaire (PHQ-9). Twenty-three participants enrolled in the study (mean ± SD age = 46 ± 13 years, female = 91%). Baseline ratings of mood were of mild-to-moderate symptom severity (mean HDRS-17 score = 14.5 and PHQ-9 score = 12), resilience (mean CD-RISC score = 53.8), and perceived stress (mean PSS score = 23.5). Of the participants, 74% were study completers (attended ≥ 6 sessions). In an intention-to-treat analysis, at study endpoint there was a significant improvement in resilience (mean CD-RISC score = 61.1, P = .03), reduction in perceived stress (mean PSS score = 19.4, P = .002), and improvement in depression (mean HDRS-17 score = 9.1 and PHQ-9 score = 7.6, both P < .001). A resilience training program focused on wellness is feasible for patients who are currently symptomatic with major depressive disorder. A larger randomized controlled trial is needed to establish efficacy of this intervention and explore the long-term impact of stress management and resilience training in depression. ClinicalTrials.gov identifier: NCT03275961.",32369689,Major Depressive Disorder,Anxiety Treatment,Mental Health,5785,9.036996841430664,-2.3984971046447754,Apms
"Affective Control Training (AffeCT) reduces negative affect in depressed individuals.

Depression is the leading cause of disability worldwide, with prevalence rates rising. Despite the scale of the problem, available pharmacological and psychological interventions only have limited efficacy. The National Institute of Health's Science of Behaviour Change framework proposes to address this issue by capitalising on insights from basic science to identify mechanisms that can be targeted by novel interventions. The current study evaluated the potential of a computerized programme aimed at improving affective control, a mechanistic target involved in both risk and maintenance of depression. In a first phase the cognitive profiles of 48 depressed individuals (mean age: 39 years, 75 % female) were compared to cognitive functioning in 16 never-depressed individuals (mean age: 31 years, 56 % female). The sole index of functioning that differed between diagnostic groups was reaction time across negative and positively valanced trials on an affective Stroop task (d = 0.58). This index was then used to evaluate an affective control training (AffeCT) against a placebo training. Results showed no significant changes on tasks that showed no differences with never-depressed individuals in Phase I. However, compared to placebo training, AffeCT led to significantly greater improvement in the target index, affective Stroop performance (d = 1.17). Importantly, AffeCT led to greater reductions in negative affect as measured by the Positive Affect and Negative Affect Schedule compared to the placebo training (d = 0.98). This proof-of-concept study shows promising benefits of AffeCT on depressed individuals' affect, but not depressive symptoms. It further supports the utility of the Science of Behaviour Change framework, highlighting the need for determining meaningful assays of target mechanisms when evaluating novel interventions.",35792299,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.663318634033203,-0.884190022945404,Q9c
"A Randomized Comparison of Medication and Cognitive Behavioral Therapy for Treating Depression in Low-Income Young Minority Women.

BACKGROUND Longitudinal data arise frequently in biomedical science and health studies where each subject is repeatedly measured over time. We compared the effectiveness of medication and cognitive behavioral therapy on depression in predominantly low-income young minority women. MATERIAL AND METHODS The treatment effects on patients with low-level depression may differ from the treatment effects on patients with high-level depression. We used a quantile regression model for longitudinal data analysis to determine which treatment is most beneficial for patients at different stress levels over time. RESULTS The results confirm that both treatments are effective in reducing the depression score over time, regardless of the depression level. CONCLUSIONS Compared to cognitive behavioral therapy, treatment with medication more often effective, although the size of the effect differs. Thus, no matter how severe a patient's depression symptoms are, antidepressant medication is effective in decreasing depression symptoms.",27981956,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.575642585754395,-2.030398368835449,BjUk
"Universality of interpersonal psychotherapy (IPT) problem areas in Thai depressed patients.

Many studies have shown the efficacy of interpersonal psychotherapy (IPT) on depression; however, there are limited studies concerning the universality of the IPT problem areas in different countries. This study identifies whether the interpersonal problem areas defined in the IPT manual are endorsed by Thai depressed patients. The Thai Hamilton Rating Scale for Depression (Thai HRSD) and Thai Interpersonal Questionnaire were used to assess 90 depressed and 90 non-depressed subjects in King Chulalongkorn Memorial Hospital, during July 2007 - January 2008. The association between interpersonal problem areas/sociodemographic variables and depressive disorder were analyzed by chi-square test. A multivariable analysis was performed by using logistic regression to identify the remaining factors associated with depressive disorder. Most of the subjects were young to middle-aged females living in Bangkok and the Central Provinces. All four interpersonal problem areas (grief, interpersonal role disputes, role transitions, and interpersonal deficits) were increased in the depressed subjects as compared to the non-depressed subjects, as were the sociodemographic variables (low education, unemployment, low income, and having a physical illness). Logistic regression showed that all interpersonal problem areas still remained problems associated with depression (grief: adjusted OR = 6.01, 95%CI = 1.93 - 18.69, p < 0.01; interpersonal role disputes: adjusted OR = 6.01, 95%CI = 2.18 - 16.52, p < 0.01; role transitions: adjusted OR = 26.30, 95%CI = 7.84 - 88.25, p < 0.01; and interpersonal deficits: adjusted OR = 2.92, 95%CI = 1.12 - 7.60, p < 0.05). All four interpersonal problem areas were applicable to Thai depressed patients.",20964850,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.607129096984863,-3.9581315517425537,DEUE
"Smartphone-Supported versus Full Behavioural Activation for Depression: A Randomised Controlled Trial.

There is need for more cost and time effective treatments for depression. This is the first randomised controlled trial in which a blended treatment--including four face-to-face sessions and a smartphone application--was compared against a full behavioural treatment. Hence, the aim of the current paper was to examine whether a blended smartphone treatment was non-inferior to a full behavioural activation treatment for depression. This was a randomised controlled non-inferiority trial (NCT01819025) comparing a blended treatment (n=46) against a full ten-session treatment (n=47) for people suffering from major depression. Primary outcome measure was the BDI-II, that was administered at pre- and post-treatment, as well as six months after the treatment. Results showed significant improvements in both groups across time on the primary outcome measure (within-group Cohen's d=1.35; CI [-0.82, 3.52] to d=1.47; CI [-0.41, 3.35]; between group d=-0.13 CI [-2.37, 2.09] and d=-0.10 CI [-2.53, 2.33]). At the same time, the blended treatment reduced the therapist time with an average of 47%. We could not establish whether the blended treatment was non-inferior to a full BA treatment. Nevertheless, this study points to that the blended treatment approach could possibly treat nearly twice as many patients suffering from depression by using a smartphone application as add-on. More studies are needed before we can suggest that the blended treatment method is a promising cost-effective alternative to regular face-to-face treatment for depression. Cognitive Behavioral Therapy Treatment of Depression With Smartphone Support NCT01819025.",26010890,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.668309211730957,-5.336205959320068,B9OH
"Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression.

Depression is a common, debilitating and costly disorder. The best-evidenced psychological therapy - cognitive-behavioural therapy (CBT) - is complex and costly. A simpler therapy, behavioural activation (BA), may be an effective alternative. To determine the clinical effectiveness and cost-effectiveness of BA compared with CBT for depressed adults at 12 and 18 months' follow-up, and to investigate the processes of treatments. Randomised controlled, non-inferiority trial stratified by depression severity, antidepressant use and recruitment site, with embedded process evaluation; and randomisation by remote computer-generated allocation. Three community mental health services in England. Adults aged ≥18 years with major depressive disorder (MDD) recruited from primary care and psychological therapy services. BA delivered by NHS junior mental health workers (MHWs); CBT by NHS psychological therapists. Primary: depression severity (as measured via the Patient Health Questionnaire-9; PHQ-9) at 12 months. Secondary: MDD status; number of depression-free days; anxiety (as measured via the Generalised Anxiety Disorder-7); health-related quality of life (as measured via the Short Form questionnaire-36 items) at 6, 12 and 18 months; and PHQ-9 at 6 and 18 months, all collected by assessors blinded to treatment allocation. Non-inferiority margin was 1.9 PHQ-9 points. We undertook intention-to-treat (ITT) and per protocol (PP) analyses. We explored cost-effectiveness by collecting direct treatment and other health- and social-care costs and calculating quality-adjusted life-years (QALYs) using the EuroQol-5 Dimensions, three-level version, at 18 months. We recruited 440 participants (BA, n=221; CBT, n=219); 175 (79%) BA and 189 (86%) CBT participants provided ITT data and 135 (61%) BA and 151 (69%) CBT participants provided PP data. At 12 months we found that BA was non-inferior to CBT {ITT: CBT 8.4 PHQ-9 points [standard deviation (SD) 7.5 PHQ-9 points], BA 8.4 PHQ-9 points (SD 7.0 PHQ-9 points), mean difference 0.1 PHQ-9 points, 95% confidence interval (CI) -1.3 to 1.5 PHQ-9 points, p=0.89; PP: CBT 7.9 PHQ-9 points (SD 7.3 PHQ-9 points), BA 7.8 PHQ-9 points (SD 6.5 PHQ-9 points), mean difference 0.0 PHQ-9 points, 95% CI -1.5 to 1.6 PHQ-9 points, p=0.99}. We found no differences in secondary outcomes. We found a significant difference in mean intervention costs (BA, £975; CBT, £1235; p<0.001), but no differences in non-intervention (hospital, community health, social care and medication costs) or total (non-intervention plus intervention) costs. Costs were lower and QALY outcomes better in the BA group, generating an incremental cost-effectiveness ratio of -£6865. The probability of BA being cost-effective compared with CBT was almost 80% at the National Institute for Health and Care Excellence's preferred willingness-to-pay threshold of £20,000-30,000 per QALY. There were no trial-related adverse events. In this pragmatic trial many depressed participants in both groups were also taking antidepressant medication, although most had been doing so for a considerable time before entering the trial. Around one-third of participants chose not to complete a PP dose of treatment, a finding common in both psychotherapy trials and routine practice. We found that BA is as effective as CBT, more cost-effective and can be delivered by MHWs with no professional training in psychological therapies. Settings and countries with a paucity of professionally qualified psychological therapists, might choose to investigate the delivery of effective psychological therapy for depression without the need to develop an extensive and costly professional infrastructure. Current Controlled Trials ISRCTN27473954.",28857042,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.434112548828125,-2.3929286003112793,BXtA
"How specific is cognitive change? A randomized controlled trial comparing brief cognitive and mindfulness interventions for depression.

Objective: There is a debate in psychotherapy research as to whether different kinds of psychotherapy work through specific mechanisms of change. Particularly, it is questioned whether cognitive change is specific to cognitive therapy. This study aimed to answer this question by comparing a brief cognitive intervention with an active comparison intervention (i.e., brief mindfulness-based intervention) and by following strict methodological guidelines. Method: 72 currently depressed outpatients were randomized to either cognitive intervention (n=39) or mindfulness-based intervention (n=33). Automatic thoughts (negative self-statements, well-being, and self-confidence), dysfunctional attitudes (performance evaluation and approval by others) and depressive symptoms were assessed before and six times during treatment. Within-person and between-person mediation effects were analyzed using multilevel structural equation modeling. Results: There was no difference in cognitive change between the interventions. Negative self-statements and performance evaluations were significant mediators of the within-person effect of time on depressive symptoms, while the three other cognitive variables did not change. Conversely, change in depressive symptoms also mediated within-person cognitive change. Conclusion: Cognitive change seems to be a general rather than a specific mechanism of change. However, the mutual impact of cognitive and depressive change does not support a unidirectional causal model.",31694478,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.718217849731445,-2.1497769355773926,AyTF
"Web-based interventions for comorbid depression and chronic illness: a systematic review.

Web-based interventions offer potential benefits for managing and treating depression in the context of chronic physical illness, however their use with this population has yet to be quantitatively assessed. The present systematic review examined the biopsychosocial data from 11 independent studies (N=1348 participants), including randomised controlled and quasi-experimental designs most commonly performed with diabetes and multiple sclerosis. Study quality was evaluated using the Downs and Black (1998) index, with most studies being statistically underpowered although internal validity was demonstrated. Treatment outcomes were quantified using Cohen's d effect sizes. Results indicated significant short-term improvements in depression severity (d w=0.36, CI=0.20-0.52, p<0.01), in addition to quality of life, problem-solving skills, functional ability, anxiety and pain-related cognitions (d range=0.23 to 1.10). Longer-term outcomes could not be determined based on the limited data. Further robust studies are required before wider adoption of web techniques takes place.",25712111,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.760130882263184,-3.6137337684631348,CBc3
"Treatment of depressive symptoms in diverse, rural, and vulnerable older adults.

We examined the effects of home-delivered cognitive-behavior therapy (CBT) on depressive symptoms among rural, diverse, and vulnerable older adults. Furthermore, we differentiated depression into its two salient aspects: psychological and somatic. Data came from a randomized controlled experiment of CBT on 134 individuals residing in rural Alabama. Cognitive-behavior therapy resulted in significantly lower depressive symptom severity scores. When depressive symptoms were categorized as psychological or somatic, CBT was found to significantly improve the former but not the latter. Notably, there was a trend toward somatic symptom improvement. Cognitive-behavior therapy can be an effective treatment for depression in a hard-to-reach group of older adults. Home delivery affords advantages but is also an expensive delivery modality. Diverse older adults responded to the CBT intervention.",23893503,Major Depressive Disorder,Anxiety Treatment,Mental Health,19717,10.663466453552246,-2.1162827014923096,Cax5
"Indicated cognitive behavioral group depression prevention compared to bibliotherapy and brochure control: acute effects of an effectiveness trial with adolescents.

We tested whether a brief cognitive behavioral (CB) group and bibliotherapy prevention reduce major depressive disorder (MDD) onset, depressive symptoms, and secondary outcomes relative to brochure controls in adolescents with self-reported depressive symptoms when school personnel recruit participants and deliver the intervention. Three hundred seventy-eight adolescents (M age = 15.5 years, SD = 1.2; 68% female, 72% White) with elevated self-assessed depressive symptoms were randomized to a 6-session CB group, minimal contact CB bibliotherapy, or educational brochure control. Participants were assessed at pretest, posttest, and 6-month follow-up. CB group participants showed a significantly lower risk for major depressive disorder onset (0.8%), compared to both CB bibliotherapy (6.3%) and brochure control (6.5%; hazard ratio = 8.1 and 8.3, respectively). Planned contrasts indicated that CB group resulted in lower depressive symptom severity than brochure control at posttest (p = .03, d = 0.29) but not 6-month follow-up; differences between CB group and bibliotherapy were nonsignificant at posttest and 6-month follow-up. Condition effects were nonsignificant for social adjustment and substance use. The finding that a brief CB group intervention delivered by real-world providers significantly reduced MDD onset relative to both brochure control and bibliotherapy is very encouraging, although effects on continuous outcome measures were small or nonsignificant and approximately half the magnitude of those found in efficacy research, potentially because the present sample reported lower initial depression.",24099432,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.23868179321289,-3.009638786315918,CXza
"Exploring sudden gains in behavioral activation therapy for Major Depressive Disorder.

Understanding the onset and course of sudden gains in treatment provides clinical information to the patient and clinician, and encourages clinicians to strive for these sudden clinical gains with their patients. This study characterizes the occurrence of sudden gains with Behavioral Activation (BA; Martell, Addis, & Jacobson, 2001), and the extent to which pre-treatment dysfunctional depressive thinking predicts sudden gains during treatment. We enrolled a sample of adults (n = 42) between ages 18-65 diagnosed with primary Major Depressive Disorder. All participants completed a 16-week course of BA, with clinical and self-report assessments at pre-, mid- and post-treatment. Results indicated that sudden gain and non-sudden gain participants showed differential improvement across treatment. No significant effects emerged for the dysfunctional cognitive style as a predictor of sudden gain status. Sudden gains may result from interaction of non-specific factors with the BA techniques implemented during early phases of therapy.",22336434,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.83494758605957,-2.453294515609741,CxU5
"A lifetime approach to major depressive disorder: The contributions of psychological interventions in preventing relapse and recurrence.

Major depressive disorder (MDD) is highly disabling and typically runs a recurrent course. Knowledge about prevention of relapse and recurrence is crucial to the long-term welfare of people who suffer from this disorder. This article provides an overview of the current evidence for the prevention of relapse and recurrence using psychological interventions. We first describe a conceptual framework to preventive interventions based on: acute treatment; continuation treatment, or; prevention strategies for patients in remission. In brief, cognitive-behavioral interventions, delivered during the acute phase, appear to have an enduring effect that protects patients against relapse and perhaps others from recurrence following treatment termination. Similarly, continuation treatment with either cognitive therapy or perhaps interpersonal psychotherapy appears to reduce risk for relapse and maintenance treatment appears to reduce risk for recurrence. Preventive relapse strategies like preventive cognitive therapy or mindfulness based cognitive therapy (MBCT) applied to patients in remission protects against subsequent relapse and perhaps recurrence. There is some preliminary evidence of specific mediation via changing the content or the process of cognition. Continuation CT and preventive interventions started after remission (CBT, MBCT) seem to have the largest differential effects for individuals that need them the most. Those who have the greatest risk for relapse and recurrence including patients with unstable remission, more previous episodes, potentially childhood trauma, early age of onset. These prescriptive indications, if confirmed in future research, may point the way to personalizing prevention strategies. Doing so, may maximize the efficiency with which they are applied and have the potential to target the mechanisms that appear to underlie these effects. This may help make this prevention strategies more efficacious.",25754289,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.352560997009277,-0.8381688594818115,CA0b
"The SMILES trial: an important first step.

The SMILES trial was the first intervention study to test dietary improvement as a treatment strategy for depression. Molendijk et al. propose that expectation bias and difficulties with blinding might account for the large effect size. While we acknowledge the issue of expectation bias in lifestyle intervention trials and indeed discuss this as a key limitation in our paper, we observed a strong correlation between dietary change and change in depression scores, which we argue is consistent with a causal effect and we believe unlikely to be an artefact of inadequate blinding. Since its publication, our results have been largely replicated and our recent economic evaluation of SMILES suggests that the benefits of our approach extend beyond depression. We argue that the SMILES trial should be considered an important, albeit preliminary, first step in the field of nutritional psychiatry research.",30591059,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,9.680486679077148,-2.756213665008545,BBNf
"The effects of progress monitoring on subsequent readmission to psychiatric care: a six-month follow-up.

Monitoring patient progress and providing feedback to clinicians and patients about progress during therapy reduce depressive symptoms at treatment completion. However, the effects of feedback on patient outcomes following treatment completion are unknown. Accordingly, the current study aimed to examine the effect of feedback on readmission to psychiatric hospital following completion of a group psychotherapy program. This naturalistic historical follow-up study compared the risk of readmission to a psychiatric hospital for two patient cohorts examined by Newnham et al. (2010a,b); the first cohort received feedback (n=408) during a group psychotherapy program, whereas the second cohort did not receive feedback (n=439). The sample included inpatients and day patients, with primarily depressive and anxiety disorders who routinely completed the World Health Organization's Wellbeing Index. Feedback was associated with fewer readmissions over the six months following completion of the therapy program for patients who, at the point of feedback, were on track to make clinically meaningful improvement by treatment termination. The findings suggest feedback could result in cost saving and is associated with improved outcomes following treatment completion for patients deemed on track during therapy.",22244373,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,8.433526992797852,-5.950203895568848,CyrH
"How much psychotherapy is needed to treat depression? A metaregression analysis.

Although psychotherapies are effective in the treatment of adult depression it is not clear how this treatment effect is related to amount, frequency and intensity of therapy. To fill this gap in knowledge, the present metaregression analysis examined the association between the effects of psychotherapy for adult depression and several indicators of amount, frequency and intensity of therapy. The analysis included 70 studies (92 comparisons) with 5403 patients, in which individual psychotherapy was compared with a control group (e.g. waiting list, care-as-usual). There was only a small association between number of therapy sessions and effect size, and this association was no longer significant when the analysis adjusted for other characteristics of the studies. The multivariable analyses also found no significant association with the total contact time or duration of the therapy. However, there was a strong association between number of sessions per week and effect size. An increase from one to two sessions per week increased the effect size with g=0.45, while keeping the total number of treatment sessions constant. More research is needed to establish the robustness of this finding. Based on these findings, it may be advisable to concentrate psychotherapy sessions within a brief time frame.",23528438,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.770940780639648,-2.722526788711548,CgMf
"Interpersonal Psychotherapy for Mental Health Problems: A Comprehensive Meta-Analysis.

Interpersonal psychotherapy (IPT) has been developed for the treatment of depression but has been examined for several other mental disorders. A comprehensive meta-analysis of all randomized trials examining the effects of IPT for all mental health problems was conducted. Searches in PubMed, PsycInfo, Embase, and Cochrane were conducted to identify all trials examining IPT for any mental health problem. Ninety studies with 11,434 participants were included. IPT for acute-phase depression had moderate-to-large effects compared with control groups (g=0.60; 95% CI=0.45-0.75). No significant difference was found with other therapies (differential g=0.06) and pharmacotherapy (g=-0.13). Combined treatment was more effective than IPT alone (g=0.24). IPT in subthreshold depression significantly prevented the onset of major depression, and maintenance IPT significantly reduced relapse. IPT had significant effects on eating disorders, but the effects are probably slightly smaller than those of cognitive-behavioral therapy (CBT) in the acute phase of treatment. In anxiety disorders, IPT had large effects compared with control groups, and there is no evidence that IPT was less effective than CBT. There was risk of bias as defined by the Cochrane Collaboration in the majority of studies. There was little indication that the presence of bias influenced outcome. IPT is effective in the acute treatment of depression and may be effective in the prevention of new depressive disorders and in preventing relapse. IPT may also be effective in the treatment of eating disorders and anxiety disorders and has shown promising effects in some other mental health disorders.",27032627,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.33624267578125,-3.703434467315674,Bu3o
"A parallel group randomised open blinded evaluation of Acceptance and Commitment Therapy for depression after psychosis: Pilot trial outcomes (ADAPT).

Depression is one of the major contributors to poorer quality of life amongst individuals with psychosis and schizophrenia. The study was designed as a Pilot Trial to determine the parameters of a larger, definitive pragmatic multi-centre randomised controlled trial of Acceptance and Commitment Therapy for depression after psychosis (ACTdp) for individuals with a diagnosis of schizophrenia who also meet diagnostic criteria for major depression. Participants were required to meet criteria for schizophrenia and major depression. Blinded follow-ups were undertaken at 5-months (end of treatment) and at 10-months (5-months posttreatment). Primary outcomes were depression as measured by the Calgary Depression Scale for Schizophrenia (CDSS) and the Beck Depression Inventory (BDI). A total of 29 participants were randomised to ACTdp + Standard Care (SC) (n=15) or SC alone (n=14). We did not observe significant differences between groups on the CDSS total score at 5-months (Coeff=-1.43, 95%CI -5.17, 2.32, p=0.45) or at 10-months (Coeff=1.8, 95%CI -2.10, 5.69, p=0.36). In terms of BDI, we noted a statistically significant effect in favour of ACTdp+SC at 5-months (Coeff=-8.38, 95%CI -15.49, -1.27, p=0.02) but not at 10-months (Coeff=-4.85, 95%CI -12.10, 2.39, p=0.18). We also observed significant effects on psychological flexibility at 5-months (Coeff=-8.83, 95%CI -14.94, -2.71, p<0.01) but not 10-months (Coeff=-4.92, 95%CI -11.09, 1.25, p=0.11). In this first RCT of a psychological therapy with depression as the primary outcome, ACT is a promising intervention for depression in the context of psychosis. A further large-scale definitive randomised controlled trial is required to determine effectiveness. ISRCTN: 33306437.",27894822,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,7.942473888397217,-1.6709458827972412,BkGY
"Using problem solving therapy to treat veterans with subsyndromal depression: a pilot study.

We conducted a pilot study comparing problem solving therapy for primary care (PST-PC) to a dietary education control condition in middle-aged and older veterans with symptoms of emotional distress and subsyndromal depression. This was a two-site study at the VA Pittsburgh Healthcare System and Philadelphia VA Medical Center. Participants included veterans >50 years of age referred from primary care clinics who were eligible if they obtained a pre-screen score >11 on the Centers for Epidemiologic Studies Depression (CES-D) scale. Exclusions were a DSM-IV Major Depressive Episode within the past year, active substance abuse/dependence within 1 month, current antidepressant therapy, and a Mini mental status exam score <24. Participants were randomized to receive one of two interventions--either PST-PC or an attention control condition consisting of dietary education (DIET)--each consisting of six to eight sessions within a 4-month period. Of 45 individuals randomized, 23 (11 PST-PC and 12 DIET) completed treatment. Using regression models in completers that examined outcomes at end of treatment while controlling for baseline scores, there were significant differences between treatment groups in SF-36 mental health component scores but not in depressive symptoms (as assessed with either the 17-item Hamilton Rating Scale for Depression or the Beck Depression Inventory), social problem solving skills, or physical health status (SF-36 physical health component score). These pilot study findings suggest that a six-to-eight session version of PST-PC may lead to improvements in mental health functioning in primary care veterans with subsyndromal depressive symptoms.",24789736,Major Depressive Disorder,Anxiety Treatment,Mental Health,20534,10.083215713500977,-2.512197256088257,COjk
"Detecting critical decision points in psychotherapy and psychotherapy + medication for chronic depression.

We sought to quantify clinical decision points for identifying depression treatment nonremitters prior to end-of-treatment. Data came from the psychotherapy arms of a randomized clinical trial for chronic depression. Participants (n = 352; 65.6% female; 92.3% White; mean age = 44.3 years) received 12 weeks of cognitive behavioral analysis system of psychotherapy (CBASP) or CBASP plus an antidepressant medication. In half of the sample, receiver operating curve analyses were used to identify efficient percentage of symptom reduction cut points on the Inventory of Depressive Symptoms-Self-Report (IDS-SR) for predicting end-of-treatment nonremission based on the Hamilton Rating Scale for Depression (HRSD). Sensitivity, specificity, predictive values, and Cohen's kappa for identified cut points were calculated using the remaining half of the sample. Percentage of IDS-SR symptom reduction at Weeks 6 and 8 predicted end-of-treatment HRSD remission status in both the combined treatment (Week 6 cut point = 50.0%, Cohen's κ = .42; Week 8 cut point = 54.3%, Cohen's κ = .45) and psychotherapy only (Week 6 cut point = 60.7%, Cohen's κ = .41; Week 8 cut point = 48.7%, Cohen's κ = .49). Status at Week 8 was more reliable for identifying nonremitters in psychotherapy-only treatment. Those with chronic depression who will not remit in structured, time-limited psychotherapy for depression, either with therapy alone or in combination with antidepressant medication, are identifiable prior to end of treatment. Findings provide an operationalized strategy for designing adaptive psychotherapy interventions.",23750462,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.877413749694824,-1.8052220344543457,Cc72
"Competitive Memory Training for treating depression and rumination in depressed older adults: a randomized controlled trial.

Although rumination is an important mediator of depressive symptoms, there is insufficient proof that an intervention that specifically targets rumination ameliorates the clinical condition of, depressed patients. This study investigates whether a time-limited cognitive behavioral intervention (Competitive Memory Training, or COMET for depressive rumination) is an effective treatment for depression and rumination. This intervention was tested in older adult depressed outpatients. A total of 93 patients (aged ≥ 65 years with major depression and suffering from rumination) were treated in small groups according to the COMET protocol in addition to their regular treatment. Patients were randomized to two treatment conditions: 7 weeks of COMET + treatment-as-usual (TAU) versus TAU only. COMET + TAU showed a significant improvement in depression and rumination compared with TAU alone. This study shows that the transdiagnostic COMET protocol for depressive rumination might also be successful in treating depression and rumination in older adults.",21784413,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,14.894916534423828,-1.0386253595352173,C5fs
"Psychological treatments for persistent depression: A systematic review and meta-analysis of quality of life and functioning outcomes.

[Correction Notice: An Erratum for this article was reported in Vol 59(3) of Psychotherapy (see record 2022-94545-001). In the article, there were errors in the abstract. The confidence interval in the sentence Quality of life at follow-up: pooled g = 0.21 should appear as follows: 95% CI, 0.10-0.32. In the sentence The psychological interventions were associated with improvements in patients' functioning at end-of-treatment, the pooled g should appear as g = 0.35. The confidence interval in the sentence Functioning at follow-up resulted in: pooled g = 0.33 should appear as follows: 95% CI, 0.15-0.51. Figure 5 also has been corrected. All versions of this article have been corrected.] To date it is unclear whether psychological therapies have potential to improve quality of life and functioning in patients with persistent depression. This meta-analysis examines the effect of psychological therapies for improving quality of life and functioning in patients with persistent forms of depression. Data sources include Medline and Meta-Analytic Psychotherapy Database (METAPSY), searched 07/2021. Eligible studies were randomized controlled trials where participants had major depressive disorder on entry and met criteria for a persistent form of depression, for example, chronic, treatment resistant or recurrent depression. Standardized mean differences (Hedge's g) were calculated in random-effects meta-analyses. Fourteen studies met inclusion criteria (N = 1898). Psychological interventions were associated with improvements in patients' quality of life at the end of treatment: pooled g = 0.24 (95% confidence intervals [CIs] 0.13-0.34); low to moderate levels of heterogeneity (I² = 0% [95% CI 0%-41.2%]). Quality of life at follow-up: pooled g = 0.21 (95% CI 0.01-0.32); low to high levels of heterogeneity considering the wide CI for I² (I² = 10.36% [95% CI 0%-77.5%]). The psychological interventions were associated with improvements in patients' functioning at end of treatment: pooled g = 0.34 (95% CI 0.21-0.48); low to high levels of heterogeneity considering the wide CI for I² (I² = 0% [95% CI 0%-81.7%]). Functioning at follow-up resulted in: pooled g = 0.33 (95% CI 0.15-0.50); low to high levels of heterogeneity considering the wide CI for I² (I² = 0% [95% CI 0%-86.2%]). This meta-analysis highlights the potential benefits of psychological therapies for improving quality of life and functioning in patients with persistent depression, with strongest long-term effects for mindfulness-based cognitive therapy, interpersonal therapy in combination with antidepression medication, and long-term psychoanalytic psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",35758983,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.3514404296875,-2.271359443664551,SNg
"Treating co-occurring depression and anxiety: modeling the dynamics of psychopathology and psychotherapy using the time-varying effect model.

We demonstrate the utility of the time-varying effect model (TVEM) for the analysis of psychotherapy data, with the aim of elucidating complex patterns of change over time and dynamic associations between constructs of interest. Specifically, we examine the association between depression and co-occurring anxiety in a sample of adults treated with interpersonal psychotherapy (IPT) for depression or a variant designed to address both depression and co-occurring anxiety (IPT-PS, IPT for depression with panic and anxiety symptoms). Seventy-eight (82% female) adult outpatients with major depression and co-occurring anxiety were assessed at each of 16 outpatient treatment sessions using the Hamilton rating scales for depression and anxiety. On average, depressive symptoms declined in a quadratic form over the course of treatment. While the association between anxiety and depression was modest early in treatment, it strengthened over the middle and latter treatment phases. Finally, exploratory analyses suggest that while IPT and IPT-PS were similarly effective in reducing depressive symptoms, IPT-PS may be more effective at uncoupling the association between core anxiety and depressive symptoms. Findings point to the utility of the TVEM for psychotherapy research and the importance of assessing anxiety in the course of treating depression, especially following the initial phase of treatment (i.e., after Session 5).",24041230,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.126312255859375,-2.391184091567993,CYov
"Editorial: Room for Improvement in the Treatment of Youth Depression.

Psychotherapy has been studied for decades and is often used to treat youths with depression. How well does it work? Eckshtain et al.1 answered this question with a thoughtful, complex meta-analysis of 53 psychotherapy trials. Psychotherapy was significantly superior relative to control groups. More revealingly, treatment effects were small to moderate (g = .49) compared with no treatment, small (g = .29) compared with a broad range of usual care interventions, and middling and statistically insignificant (g = .16) relative to placebo interventions (nearly all placebo psychotherapies merely controlling for therapist attention; only one study used pill placebo). I describe these findings in the context of research on both psychotherapy and antidepressant medications. The current meta-analysis and a wider body of research provide guidance for both clinicians and researchers.",31150752,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,10.869155883789062,-2.876634359359741,A5pX
"Delivering problem-solving treatment in low-vision rehabilitation: A pilot feasibility study.

To explore the feasibility and preliminary effectiveness of Problem-Solving Treatment for Primary Care (PST-PC) delivered by low-vision rehabilitation (LVR) practitioners to adult clients with depressive symptoms. A single-group pre/postintervention study. Eighteen adult LVR clients with depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score of ≥5) received 6-8 weekly telephone sessions of PST-PC delivered by expertly trained practitioners (n = 14). Feasibility was determined via participating client and practitioner recruitment and intervention retention rates. Depressive symptoms (PHQ-9), health-related quality of life (HRQoL; Assessment of QoL Instrument-7D), and confidence in one's ability to cope using problem-solving strategies (Coping Self-Efficacy Scale) were assessed using pre/posttelephone assessments. Participating client recruitment and retention rates were 71% and 40%, respectively. Seventy percent of practitioners completed supervised training in PST-PC and demonstrated satisfactory levels of fidelity and competency. Postintervention, we observed a 53% improvement in depressive symptoms (p < .001), a 23% improvement in HRQoL (p = .001), and an 18% improvement in participants' confidence to use problem-focused coping strategies (p = .001). Telephone-PST-PC delivered by a trained LVR practitioner may be an effective intervention for clients of LVR services who exhibit depressive symptoms. A randomized controlled trial is now needed to confirm these preliminary findings and establish longer-term effectiveness. (PsycINFO Database Record",30113197,Major Depressive Disorder,Anxiety Treatment,Mental Health,20534,9.374093055725098,-1.05564284324646,BHgD
"Community-Based Multi-Site Randomized Controlled Trial of Behavioral Activation for Patients with Depressive Disorders.

Behavioral activation (BA) is a beneficial and relatively cost-effective treatment option for depression. This study utilized a pragmatic randomized controlled research design to investigate whether BA, as compared with treatment as usual (TAU), led to superior treatment effects, when delivered in community mental health settings by retrained community mental health professionals. Patients with depressive disorders (n=64) were randomly assigned to a 10-session BA (n=31) or TAU (n=33) group. The depressive symptoms and behavioral engagement were assessed at the baseline, post-treatment, and a six-month follow-up. Results showed that, as compared to the TAU group, the BA group had: (1) a reduction in depression severity, as evidenced by large effect sizes and greater response rates, and (2) an increase in behavioral engagement. However, the post-treatment gains were not maintained at the six-month follow-up. The implications and limitations of the study are also discussed (KCT0004098, June 27, 2019, retrospectively registered).",33864548,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.403122901916504,-2.0656254291534424,AXtA
"Efficacy of a Guided Web-Based Self-Management Intervention for Depression or Dysthymia: Randomized Controlled Trial With a 12-Month Follow-Up Using an Active Control Condition.

An increasing number of studies suggest that web-based interventions for patients with depression can reduce their symptoms and are expected to fill currently existing treatment gaps. However, evidence for their efficacy has mainly been derived from comparisons with wait-list or treatment as usual controls. In particular, designs using wait-list controls are unlikely to induce hope and may even have nocebo effects, making it difficult to draw conclusions about the intervention's efficacy. Studies using active controls are rare and have not yielded conclusive results. The main objective of this study is to assess the acute and long-term antidepressant efficacy of a 6-week, guided, web-based self-management intervention building on the principles of cognitive behavioral therapy (iFightDepression tool) for patients with depression compared with web-based progressive muscle relaxation as an active control condition. A total of 348 patients with mild-to-moderate depressive symptoms or dysthymia (according to the Mini International Neuropsychiatric Interview) were recruited online and randomly assigned to 1 of the 2 intervention arms. Acute antidepressant effects after 6 weeks and long-term effects at 3-, 6-, and 12-month follow-up were studied using the Inventory of Depressive Symptomatology-self-rating as a primary outcome parameter and change in quality of life (Short Form 12) and user satisfaction (client satisfaction questionnaire) as secondary outcome parameters. Treatment effects were assessed using mixed model analyses. Over the entire observation period, a greater reduction in symptoms of depression (P=.01) and a greater improvement of life quality (P<.001) was found in the intervention group compared with the active control group. Separate tests for each time point revealed significant effects on depressive symptoms at the 3-month follow-up (d=0.281; 95% CI 0.069 to 0.493), but not after 6 weeks (main outcome:d=0.192; 95% CI -0.020 to 0.404) and 6 and 12 months. The intervention was significantly superior to the control condition with respect to user satisfaction (25.31 vs 21.97; t259=5.804; P<.01). The fact that antidepressant effects have been found for a guided self-management tool in comparison with an active control strengthens the evidence base for the efficacy of web-based interventions. The antidepressant effect became most prominent at the 3-month follow-up. After 6 weeks of intervention, significant positive effects were observed on life quality but not on depressive symptoms. Although the effect size of such web-based interventions on symptoms of depression might be smaller than that suggested by earlier studies using wait-list control conditions, they can be a cost-effective addition to antidepressants and face-to-face psychotherapy. International Clinical Trials Registry Platform ICTRP080-15-09032015; https://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00009323.",32673233,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.980188369750977,-3.0500919818878174,Alvd
"Amelioration of Child Depression Through Behavioral Parent Training: A Preliminary Study.

Child depression is an impairing condition for which tested treatments have shown relatively modest mean effects. One possible explanation is that the treatments have generally adopted an individual child focus, without addressing the dysfunctional parent-child interactions that often accompany child depression. The present study provides preliminary evidence bearing on this hypothesis, using data from a treatment outcome study in which clinically referred children with a depression diagnosis could receive individual cognitive behavioral therapy (CBT) focusing on the depression or behavioral parent training (BPT) focusing on comorbid conduct problems. Among children in the study who met criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed.) depressive disorders, we identified two groups, matched on gender and age: 15 who received only CBT focused on child depression and 15 who received only BPT focused on child conduct problems. Children were 7 to 13, 20 of whom were male, and race included Caucasian (17), Latino (5), African American (2), and multirace (6). Measures assessed depressive diagnoses and symptoms, as well as parenting stress. Analyses focused on whether BPT alone might lead to reduced depression, and if so how that reduction would compare to the depression reduction achieved through CBT that focused on depression. Both groups showed significant reductions from pre- to post-treatment in depressive diagnoses and depression symptoms, and there were no BPT versus CBT group differences at post-treatment. BPT that focuses on child conduct problems, with no emphasis on depression treatment, may produce significant depression reduction in comorbid children who meet criteria for depressive disorders.",26135915,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,11.57358455657959,-3.31728196144104,B7c+
"The influence of patients' attributions of the immediate effects of treatment of depression on long-term effectiveness of behavioural activation and antidepressant medication.

Patients' attributions of effects of treatment are important, as these can affect long-term outcome. Most studies so far focused on the influence of attributions to medication for anxiety and depression disorders. We investigated the effects of patients' attributions made after acute treatment on the long-term outcome of antidepressant medication (ADM) and psychological treatment (behavioural activation, BA). Data are based on a randomized trial testing the effectiveness of BA vs. ADM for major depression (MDD) in Iran. Patients with MDD (N = 100) were randomized to BA (N = 50) or ADM (N = 50). Patients' attributions were assessed at post-test (after completion of the treatments). Scores on an attribution questionnaire were factor analysed, and factor scores were retained as predictors of depressive symptoms at 1-year follow-up. Regression analysis was used to test whether attributions predicted depressive symptoms at 1-yr follow-up, controlling for symptom level, condition, and their interaction at post-test. Belief in coping efficacy was the only attribution factor significantly predicting 1-year HRSD scores, controlling for condition, post-test HRSD and their interaction. It also mediated the condition differences at follow-up. Credit to self was the single attribution factor that predicted BDI follow-up scores, controlling for condition, posttest BDI, and their interaction. It partially mediated the condition differences on the BDI at follow-up. Attribution to increased coping capacities and giving credit to self appear essential. In the long-term (at 1 year follow-up), the difference in outcome between BA and ADM (with BA being superior to ADM) is at least partially mediated by attributions.",25898343,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.326920509338379,-2.1547224521636963,B+vm
"Attachment style as a moderating influence on the efficacy of cognitive-behavioral and interpersonal psychotherapy for depression: A failure to replicate.

Research on aptitude-treatment interactions, or patient characteristics that are associated with better outcome in one treatment than another, can help assign patients to the treatments that will be most personally effective. Theory and one past study suggest that adult attachment style might influence whether depressed patients respond better to cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT). Spurred by inconsistency in past aptitude-treatment interaction research in general, as well as concerns about the reproducibility of psychological research, we sought to replicate and extend the previous study that showed that high attachment avoidance was associated with greater depression reduction in CBT than in IPT and to improve upon that study methodologically. Using longitudinal hierarchical linear modeling, the present study examined whether, among 69 adults randomly assigned to CBT or IPT, rate of change in severity of depression symptoms was predicted by treatment condition, attachment style, and their interaction. We also conducted regression analyses to determine whether posttreatment depression was predicted by the same variables. As expected, CBT and IPT were equivalent in efficacy; however, unlike in the previous trial, there were no moderation effects of attachment. Interestingly, in some analyses, anxious attachment was associated with more positive outcomes and avoidant attachment with more negative outcomes across both treatments. The findings highlight the need for researchers to attempt replications of past studies using methods that might elucidate the reasons for discrepancies in results, and they also suggest that alternative approaches to aptitude-treatment interaction research may be more fruitful.",26726822,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,15.892067909240723,-6.138232231140137,BzF0
"Patient experiences with group behavioural activation in a partial hospital program.

Behavioural activation (BA) is an evidence-based treatment for depression that has been primarily delivered in individual out-patient treatment. Prior research supports a positive participant experience in individual therapy; however, less is known about the patient experience in group therapy, which is common in acute psychiatric settings. The present study examined the patient experience of Brief Behavioral Activation Treatment for Depression (BATD) delivered in group acute psychiatric treatment. We used thematic analysis to extract themes from feedback surveys administered as part of quality improvement practice at a partial hospital program. Survey questions explored what patients learned, liked, disliked and thought could be improved in the BATD groups. Three individuals independently coded survey responses and collaboratively developed categories and themes. Themes included several helpful content areas (e.g. value-driven activities, increasing motivation, goal setting, activity scheduling, cognitive behavioural model, self-monitoring) and learning methods (e.g. group format, experiential exercises, worksheets). Patients also identified unhelpful content (e.g. specific focus on depression and listing activities by mood). There was mixed feedback regarding the repetition of material and balance of lecture versus group participation. Overall, these findings suggest a mostly positive patient experience of group-delivered BATD and support the acceptability of group-delivered BATD as a component of short-term intensive treatment.",32843123,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.370647430419922,-2.0168163776397705,AjqF
"Efficacy of extended clinical management, group CBT, and group plus individual CBT for major depression: Results of a two-year follow-up study.

Cognitive therapy has gained prominence in the treatment of major depression, however, little is known about its long-term benefits when delivered during inpatient treatment or combined with outpatient treatment with severely ill inpatients (HAM-D > 20). To evaluate this question, we conducted a randomized controlled trial investigating the efficacy of extended clinical management (E-CM), psychoeducational cognitive behavioural group therapy (PCBT-G) or PCBT-G and 16 outpatient individual treatment sessions (PCBT-G+I). All patients were treated with pharmacotherapy. 177 inpatients with DSM-IV major depression were randomized either to E-CM or PCBT-G or PCBT-G+I. Outcome measures were collected in the hospital at pre- and posttreatment and following discharge into the community every six months for two years. We compared the study groups on symptom changes, psychosocial functioning, knowledge about depression and rehospitalization. All three treatment interventions are equally effective at reducing depressive symptoms and increasing psychosocial functioning at posttreatment. There was significant group by time interaction for knowledge about depression in favor of PCBT-G and PCBT-G+I over E-CM. We did not find significantly lower rehospitalisation rates at the two-year follow-up for PCBT-G+I compared to E-CM, however, comparing PCBT-G to E-CM. We conclude that with cognitive psychoeducational group therapy a successful, in the long-term other interventions superior psychological intervention for major depression is available as gains were sustained for two years following discharge from the hospital. More research is needed to evaluate the long-term impact of group treatment starting in inpatient treatment.",29940521,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.416333198547363,-2.586303234100342,BJ3B
"Predicting response to cognitive therapy and interpersonal therapy, with or without antidepressant medication, for major depression: a pragmatic trial in routine practice.

Identifying patient characteristics that predict response within treatments (prognostic) or between treatments (prescriptive) can inform clinical decision-making. In this study, we sought to identify predictors of response to evidence-based treatments in a sample of depressed patients seeking help in routine practice. Data come from a pragmatic trial of 174 patients with major depression who received an evidence-based treatment of their own choice: cognitive therapy (CT), interpersonal therapy (IPT), antidepressant medication (ADM) alone or in combination with either of the two psychotherapies. Patient characteristics measured at baseline were examined to see if they predicted subsequent response as measured with the Beck Depression Inventory (BDI) over the course of 26 weeks of treatment, using mixed regression modeling. Higher agoraphobia scores at baseline predicted more change in depression scores across treatments, irrespective of the treatment received. Physical functioning moderated the response to treatment: patients with high physical functioning fared better in combined treatment than patients with low physical functioning, whereas physical functioning did not predict a differential response in the psychotherapy group. Moreover, the lowest levels of physical functioning predicted an increase of depressive symptoms in combined treatment. A relatively small sample size, and selection of several predictors that were less theory-driven, which hampers the translation to clinical practice. If replicated, the prognostic and prescriptive indices identified in this study could guide decision-making in routine practice. Development of more uniform requirements for the analysis and reporting of prediction studies is recommended.",24060588,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.1680269241333,-1.986111044883728,CYWW
"Recent trends in the treatment of prolonged grief.

Treatment for prolonged grief has been controversial. However, recent studies have clarified several key issues, offering important guidance to clinicians. This review summarizes the most recent evidence on the efficacy of grief treatments, moderators of treatment response, and new treatment approaches. Recent research findings highlight that grief therapy is efficacious when targeted to adult and child grievers with persistent and elevated levels of distress. However, when grief therapy is applied as a universal intervention, it has minimal to no benefits, either for adults or for children. Earlier intervention for children is associated with greater efficacy. In recent studies, therapies employing cognitive-behavioral techniques, such as cognitive restructuring and exposure, have shown particularly robust effects in ameliorating grief symptoms. Other intervention approaches, including pharmacotherapy, internet-based, family-based, and preventive, have shown initial promise, but insufficient data exist to validate their efficacy to date. Prolonged grief, a pattern of persistent and elevated distress following a loss, is increasingly recognized as an independent form of psychopathology that is responsive to treatment. Therapies that employ cognitive-behavioral techniques are efficacious in ameliorating the symptoms of prolonged grief and should be more widely used. However, grief therapy should not be deployed as a blanket intervention for all grievers. Antidepressant medication may serve a useful adjunctive role in grief therapy completion and in reducing bereavement-related depression.",22156937,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.654787063598633,-9.015580177307129,Cz7L
"Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial.

This study further evaluates the efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). A diagnostically heterogeneous clinical sample of 37 patients with a principal anxiety disorder diagnosis was enrolled in a randomized controlled trial (RCT) involving up to 18 sessions of treatment and a 6-month follow-up period. Patients were randomly assigned to receive either immediate treatment with the UP (n=26) or delayed treatment, following a 16-week wait-list control period (WLC; n=11). The UP resulted in significant improvement on measures of clinical severity, general symptoms of depression and anxiety, levels of negative and positive affect, and a measure of symptom interference in daily functioning across diagnoses. In comparison, participants in the WLC condition exhibited little to no change following the 16-week wait-list period. The effects of UP treatment were maintained over the 6-month follow-up period. Results from this RCT provide additional evidence for the efficacy of the UP in the treatment of anxiety and comorbid depressive disorders, and provide additional support for a transdiagnostic approach to the treatment of emotional disorders.",22697453,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,12.104143142700195,-2.9850878715515137,CsNL
"Effectiveness of Cisual Messages to Promote Help-Seeking for Depression.

In order to develop more persuasive messaging to promote help-seeking for depression, we created six, differently designed visual messages and tested their effectiveness with possible audience members. Different visual designs brought differences in emotional responses to the message and willingness to use the message. Help-seeking intentions for depression increased significantly after exposure to either the plain text message or the visual messages.",31438441,Major Depressive Disorder,Anxiety Treatment,Mental Health,16050,10.747759819030762,-6.117672920227051,A1ti
"Comparability of Patients in Trials of eHealth and Face-to-Face Psychotherapeutic Interventions for Depression: Meta-synthesis.

Depressive disorders (DDs) are a public health problem. Face-to-face psychotherapeutic interventions are a first-line option for their treatment in adults. There is a growing interest in eHealth interventions to maximize accessibility for effective treatments. Thus, the number of randomized controlled trials (RCTs) of eHealth psychotherapeutic interventions has increased, and these interventions are being offered to patients. However, it is unknown whether patients with DDs differ in internet-based and face-to-face intervention trials. This information is essential to gain knowledge about eHealth trials' external validity. We aimed to compare the baseline characteristics of patients with DDs included in the RCTs of eHealth and face-to-face psychotherapeutic interventions with a cognitive component. In this meta-epidemiological study, we searched 5 databases between 1990 and November 2017 (MEDLINE, Embase, PsycINFO, Google Scholar, and the database of Cuijpers et al). We included RCTs of psychotherapeutic interventions with a cognitive component (eg, cognitive therapy, cognitive behavioral therapy [CBT], or interpersonal therapy) delivered face-to-face or via the internet to adults with DDs. Each included study had a matching study for predefined criteria to allow a valid comparison of characteristics and was classified as a face-to-face (CBT) or eHealth (internet CBT) intervention trial. Two authors selected the studies, extracted data, and resolved disagreements by discussion. We tested whether predefined baseline characteristics differed in face-to-face and internet-based trials using a mixed-effects model and testing for differences with z tests (statistical significance set at .05). For continuous outcomes, we also estimated the difference in means between subgroups with 95% CI. We included 58 RCTs (29 matching pairs) with 3846 participants (female: n=2803, 72.9%) and mean ages ranging from 20-74 years. White participants were the most frequent (from 63.6% to 100%). Other socioeconomic characteristics were poorly described. The participants presented DDs of different severity measured with heterogeneous instruments. Internet CBT trials had a longer depression duration at baseline (7.19 years higher, CI 95% 2.53-11.84; 10.0 vs 2.8 years; P=.002), but the proportion of patients with previous depression treatment was lower (24.8% vs 42%; P=.04). Subgroup analyses found no evidence of differences for the remaining baseline characteristics: age, gender, education, living area, depression severity, history of depression, actual antidepressant medication, actual physical comorbidity, actual mental comorbidity, study dropout, quality of life, having children, family status, and employment. We could not compare proficiency with computers due to the insufficient number of studies. The baseline characteristics of patients with DDs included in the RCTs of eHealth and face-to-face psychotherapeutic interventions are generally similar. However, patients in eHealth trials had a longer duration of depression, and a lower proportion had received previous depression treatment, which might indicate that eHealth trials attract patients who postpone earlier treatment attempts. PROSPERO CRD42019085880; https://tinyurl.com/4xufwcyr.",36103217,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.864672660827637,-3.019754409790039,Hl0
"Process-oriented dynamic group psychotherapy for depression as a teaching modality in a family medicine residency program- A pilot study.

Background and Objectives This pilot study provides a description and evaluation of process-oriented dynamic group psychotherapy for depression as a teaching modality for family medicine residents. The main purpose of using this modality was to teach family medicine residents a variety of psychological clinical skills. A secondary benefit of this modality was to provide in-house, primary care treatment to depressed patients, although the efficacy of this was not evaluated in the present study. Methods A 10-item, self-report, Likert-type questionnaire was administered to a convenience sample of family medicine residents who had participated in the program. Results Completed questionnaires were received from 100% of the family medicine resident participants. Responses to the questionnaires indicate that the residents felt they acquired a variety of clinical skills from the training modality, to include developing active listening and interviewing skills; methods to improve the doctor-patient relationship; increased skills in empathy, intuitive processes, and emotional support; a depth understanding of how intra-psychic conflicts and interpersonal problems contribute to depression; how to give effective feedback that promotes behavioral change; and how to place interventions at the appropriate level of change. Eighty-eight percent of residents indicated they would recommend this learning modality to a family medicine physician colleague. Conclusions The family medicine residents' responses to the questionnaires indicate that they perceived process-oriented dynamic group psychotherapy for depression as a constructive and beneficial modality for both patient care and learning a variety of clinical skills.",28486880,Major Depressive Disorder,Anxiety Treatment,Mental Health,26266,10.163047790527344,-6.573939323425293,Bc1T
"A pilot randomised controlled trial of metacognitive therapy for prolonged grief.

Prolonged grief disorder is associated with significant distress and impairment and thus efforts to improve treatments are essential. The present pilot study tested the efficacy and feasibility of group Metacognitive Grief Therapy (MCGT) designed specifically for prolonged grief symptomatology to reduce the psychological distress and impaired function resulting from bereavement. Twenty-two bereaved adult participants with prolonged grief symptomatology were randomised to a wait-list control (n=10) or an intervention condition (n=12) with a 3-month and 6-month follow-up. The wait-list control group was offered treatment after the post-test assessment. Participants attended six group MCGT sessions that ran for 2hours per week. A primary outcome measure of prolonged grief symptomatology and secondary outcome measures of depression, anxiety, rumination, metacognitive beliefs and quality of life were taken pretreatment and post-treatment for both groups and at the 3-month and 6-month follow-up for the intervention group. A Generalised Linear Mixed Model was used to assess treatment efficacy. Post-treatment intent-to-treat analyses showed MCGT reduced prolonged grief symptomatology (Cohen's d=1.7), depression (d=1.3), anxiety (d=0.8), stress (d=1.0), rumination (d=0.9) and increased quality of life (d=0.6), and these effects were maintained at the 3-month and 6-month follow-ups. No prepost between-group differences were found in metacognitive beliefs. However, a large significant effect was identified at the 3-month and 6-month follow-ups (d=1.0). The results show promise for the utility of group MCGT for reducing psychological distress and promoting quality of life. Additionally, the results underscore the need for a full randomised controlled trial of group MCGT, which may be an important addition to the treatment armamentarium available to support people with prolonged grief. ACTRN12613001270707; Results. ORIGINAL PROTOCOL: BMJ Open 2015;5:e007221. doi:10.1136/bmjopen-2014-007221.",30782672,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.836997985839844,-9.160528182983398,A+ok
"Performance improvement CME: improving outcomes in depression.

Performance Improvement CME (PI CME) is an educational activity in which clinicians retrospectively assess their current clinical practice, choose areas for improvement and implement interventions based on treatment guidelines and health care standards, and then re-evaluate their clinical practice to assess the improvements made. This PI CME focuses on improving the detection and initial treatment of depression, enhancing patients' treatment response, and preventing relapse and recurrence.",20797375,Major Depressive Disorder,Anxiety Treatment,Mental Health,4408,9.781039237976074,-2.57739520072937,DGbi
"The impact of internet-based cognitive behavioral therapy and depressive symptoms on self-care behavior in patients with heart failure: A secondary analysis of a randomised controlled trial.

Patients with chronic heart failure may require treatment of depressive symptoms to improve self-care behaviour. To investigate the impact of internet-based cognitive behavioral therapy (CBT) on self-care behaviour in heart failure patients, and to study the association between changes in depressive symptoms and changes in self-care behaviour. A secondary analysis of data collected in a pilot randomized controlled study. 50 heart failure patients with depressive symptoms were recruited from four hospitals in Sweden. Patients were randomized to nine weeks of internet-based CBT (n = 25) or to an active control group participating in an online discussion forum (n = 25). In week two and three, those in the internet-based CBT group worked with psychoeducation about heart failure and depression, emphasizing heart failure self-care. During the same weeks those in the on-line discussion forum specifically discussed heart failure self-care. Patient Health Questionnaire-9 was used to measure depressive symptoms at baseline and at the nine-week follow-up. The European Heart Failure Self-care Behaviour Scale-9 was used to measure self-care behaviour (i.e., the summary score and the subscales autonomous based, provider based and consulting behaviour) at baseline, and at the three-week and nine-week follow-ups. No significant differences were found in self-care between the patients in the internet-based CBT and the patients in the online discussion group at the three- and nine-week follow-up. Within-group analysis of the changes in the European Heart Failure Self-care Behaviour Scale showed that from baseline to week three, the summary score increased significantly for the online discussion group (p = 0.04), but not for the internet-based CBT group (p = 0.15). At the nine-week follow-up, these scores had decreased. Similarly, consulting behaviour improved at week three for the online discussion group (p = 0.04), but not for the internet-based CBT group (p = 0.22). Provider-based adherence at the nine-week follow-up had increased from baseline in the internet-based CBT group (p = 0.05) whereas it had decreased in the on-line discussion group. Improvement in symptoms of depression was significantly associated with improvement in autonomy-based self-care (r = 0.34, p = 0.03). Improvement in depressive symptoms was associated with improved autonomous-based self-care. ICBT for depression in HF may benefit aspects of self-care that are vital to improve symptoms and prognosis.",31727306,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.488007545471191,-1.9043755531311035,Ax1e
"The relation between changes in patients' interpersonal impact messages and outcome in treatment for chronic depression.

Interpersonal theories posit that chronically depressed individuals have hostile and submissive styles in their social interactions, which may undermine their interpersonal effectiveness and maintain their depression. Recent findings support this theory and also show that patients' interpersonal impact messages, as perceived by their psychotherapists, change in theoretically predicted ways following cognitive-behavioral analysis system of psychotherapy (CBASP) alone or with medication. This study extended these previous findings by examining whether such changes were associated with their depression change and response status. Data derived from a large clinical trial for chronic depression compared the efficacy of CBASP, nefazodone, and their combination. To assess patients' impact messages, CBASP clinicians completed the Impact Message Inventory (IMI; Kiesler & Schmidt, 1993) following an early and late session. Our subsample (N = 259) consisted of patients in the CBASP and combined conditions who had depression severity data for at least 1 post-randomization visit and whose clinicians completed at least 1 IMI rating. We used hierarchical linear modeling (HLM) to calculate IMI change scores and to model depression change. We used HLM and logistic regression to test our predictor questions. As hypothesized, decreases in patients' hostile-submissive impact messages were significantly associated with depression reduction (γ = 0.27, 95% CI [0.11, 0.43], p < .01) and favorable treatment response (B = -0.05, 95% CI [-0.09, -0.01], p = .03), regardless of treatment condition. The findings support CBASP theory, suggesting that interpersonal change is related to depression reduction among chronically depressed patients.",22545738,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,13.463486671447754,-4.542464256286621,CuGa
"Cognitive behavioural therapy for the treatment of late life depression: study protocol of a multicentre, randomized, observer-blinded, controlled trial (CBTlate).

Late-life depression (LLD) is one of the most prevalent mental disorders in old age. It is associated with various adverse outcomes and frequent use of health care services thereby remaining a serious public health concern. Compared with depression in early adulthood, most treatment options of LLD are less effective. Psychotherapy may be particularly beneficial for LLD due to specific psychological conditions in old age and a low risk of side effects. Although cognitive behavioural therapy (CBT) is highly established and effective in depression in young and mid-life there is only a limited number of small studies on CBT in LLD. An LLD-specific CBT has not yet been compared to an active, but unspecific supportive psychological intervention in a multicentre trial. Here we present the design of the CBTlate trial, which is a multicentre, randomized, observer-blinded, active-controlled, parallel group trial. CBTlate aims at including 248 patients with LLD of both genders at 7 sites in Germany. The purpose of the study is to test the hypothesis that a 15-session individually-delivered CBT specific for LLD is of superior efficacy in reducing symptoms of depression in comparison with a supportive unspecific intervention (SUI) of the same quantity. The intervention includes 8weeks of individual treatment sessions twice per week and a follow-up period of 6months after randomization. The primary end point is the severity of depression at the end of treatment measured by the self-rated 30-item Geriatric Depression Scale (GDS). Secondary endpoints include depressive symptoms at week 5 and at follow-up (6months after randomization). Additional secondary endpoints include the change of depressive symptoms assessed with a clinician-rating-scale and a patient reported outcome instrument for major depressive disorder, anxiety symptoms, sleep, cognition, quality of life, and overall health status from baseline to end-of treatment and to end of follow-up. Add-on protocols include MRI and the collection of blood samples. This study is the first multicentre trial of a specific CBT intervention for LLD compared to an unspecific supportive psychological intervention administered in a specialist setting. It has important implications for developing and implementing efficient psychotherapeutic strategies for LLD and may be a significant step to broaden treatment options for people suffering from LLD. ClinicalTrials.gov (NCT03735576, registered on 24 October 2018); DRKS (DRKS00013769, registered on 28 June 2018).",31881995,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,10.226563453674316,-2.108191967010498,Avqp
"[IDEM-depression: Characteristics and evaluation of an open group that combines psychoeducation and cognitive-behavior therapy].

Depression is a highly prevalent mental illness that is associated with high rates of morbidity and functional impairment. At the psychiatric unit of the University Hospital of Strasbourg, France, we have developed an open group that combines psychoeducation and cognitive-behavior therapy (CBT), the information, discovery, exchange and mobilization for depression group (IDEM-depression). IDEM-depression is composed of 17 thematic, structured, and independent sessions, which address different aspects of depression (i.e., rumination, pharmacological treatments). Because of its flexible format, patients with varying degrees of depression severity (from remission up to severe depressive symptoms) and whose depression might be bipolar or unipolar, are able to participate in the group. Thus, the group is well suited to a large number of patients with major depression. In the present study we aimed at describing the IDEM-depression group and presenting results regarding patients' overall satisfaction, assessed via two self-report questionnaires (the Client Satisfaction Questionnaire, the CSQ-8, and the IDEM ad hoc questionnaire), as well as its effect on mood following each session assessed via a visual analog scale (VAS) ranging from 0 up to 100. Sixty-five patients participated in 50 sessions of the IDEM-depression group in two hospitals in Alsace. 61% of the patients had bipolar disorder, and 41% of them were inpatients. Sessions took place on a weekly basis, lasted 2hours and were proposed by a CBT-trained clinical psychologist. Patients were asked to fill-out the VAS at the beginning and at the end of each session. Moreover, they were asked to fill-out the CSQ-8 and the IDEM ad hoc questionnaire when they left the group. Other than one session (""yoga and mindfulness""), all the sessions (16 out of 17) were structured on a Powerpoint© presentation. During the first hour information was given regarding the topic (i.e., rumination), and a shared CBT conceptualization of the topic was formulated by the participants and the psychologist. For most sessions, the first hour was therefore communication and information-based, whereas during the second hour participants were asked to participate in in-session behavioral experiments and/or to evaluate specific aspects of their behavior (thoughts, emotions, activity, mindful behavior) during the last few days. The therapist manual and the slides for each session are available via e-mail to the first author. Regarding the results, self-reported mood on the VAS was compared between the onset (225 VAS) and the end (225 VAS) of each session. Overall, results suggest that self-reported mood is significantly improved following the participation in sessions (t=-5. 87, P<0.001). Moreover, mean results on the CSQ-8 suggest that patients are highly satisfied with the group (M=24.46, SD=6.42). Among them, 82% reported a moderate-high satisfaction with the group. On the IDEM ad hoc questionnaire, patients reported an overall high satisfaction level regarding (i) the content of sessions, (ii) the duration of sessions, (iii) the frequency of sessions, (iv) how much they felt they could express themselves during sessions. In the qualitative comments of this questionnaire, patients reported that the group helped them to gain an understanding of the mechanisms involved in depression; to feel less isolated and guilty; and to learn about specific psychotherapeutic tools (i.e., mindfulness) and to try to implement them. Our results suggest that an IDEM-depression group is well suited to a wide-array of clinical pictures associated with depression (varying severity, bipolar or unipolar, inpatients and outpatients). This is probably due to its open-group format which is particularly well-adapted to the dynamic symptomatology associated with major depression, and may stimulate decentering in patients who have different levels of severity of symptoms but participate in the same session. Moreover, its impact on mood improvement, and the high satisfaction level reported by patients, seem to be related to its CBT and psychoeducation-based content on the one hand, which has shown its efficacy in depression. On the other hand, IDEM's structured open-group format might have also contributed to the improvement in mood and the overall good satisfaction reported by patients, through the social support provided by the group, improved feeling of self-efficiency, and its effect on stigmatization. Thus, IDEM-depression group is an efficacious, flexible, low-cost, and easy to implement (in different clinical settings) psychotherapeutic option for major depression.",28029354,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,10.453374862670898,-3.1668293476104736,Bi3Y
"Two-Year Follow-Up after Treatment with the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for Early-Onset Chronic Depression.

Evidence on the long-term efficacy of psychotherapeutic approaches for chronic depression is scarce. To evaluate the effects of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared to Supportive Psychotherapy (SP) 1 year and 2 years after treatment termination. In this study, we present 1- and 2-year follow-up assessments of a prospective, multicenter, evaluator-blinded, randomized clinical trial of outpatients with early-onset chronic major depression (n = 268). The initial treatment included 32 sessions of CBASP or SP over 48 weeks. The primary outcome was the rate of ""well weeks"" (Longitudinal Interval Follow-Up Evaluation; no/minimal symptoms) after 1 year and 2 years. The secondary outcomes were, among others, clinician- and self-rated depressive symptoms, response/remission rates, and quality of life. Of the 268 randomized patients, 207 (77%) participated in the follow-up. In the intention-to-treat analysis, there was no statistically significant difference between CBASP and SP patients in experiencing well weeks (CBASP: mean [SD] of 48.6 [36.9] weeks; SP: 39.0 [34.8]; rate ratio 1.26, 95% CI 0.99-1.59, p = 0.057, d = 0.18) and in remission rates (CBASP: 1 year 40%, 2 years 40.2%; SP: 1 year 28.9%, 2 years 33%) in the 2 years after treatment. Statistically significant effects were found in favor of CBASP 1 year after treatment termination regarding the rate of well weeks, self-rated depressive symptoms, and depression-related quality of life. CBASP lost its superiority over SP at some point between the first and the second year. This suggests the necessity of maintenance treatment for early-onset chronically depressed patients remitted with CBASP during the acute therapy phase, as well as the sequential integration of other treatment strategies, including medication for those who did not reach remission.",31121581,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.310832023620605,-1.8381824493408203,A6Cp
"Cognitive and psychodynamic mechanisms of change in treated and untreated depression.

Two patient-level mechanisms of change, defenses, and cognition were tested over 3 time points in 65 depressed adults, approximately half receiving treatment. Early changes in automatic thoughts and immature defenses were associated with symptom change from time-one to time-three. The directionality of early automatic thought change predicting symptom change was partially supported, but immature defense change occurs simultaneously with, or after, symptom change. Given the convergent evidence of cognitive change as a mediator of depression reduction, all depression therapies should consider how they address depressive cognition. To build a more complete understanding of how to ameliorate depression, future studies should continue to include constructs from multiple theories and have measures of therapy process in addition to patient level mechanisms.",19902488,Major Depressive Disorder,Anxiety Treatment,Mental Health,15500,12.370348930358887,-2.549649477005005,DQGu
"Sudden gains in Cognitive Therapy and Interpersonal Psychotherapy for adult depression.

We examined the rates, baseline predictors and clinical impact of sudden gains in a randomized comparison of individual Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for adult depression. 117 depressed outpatients received 16-20 sessions of either CT or IPT. Session-by-session symptom severity was assessed using the BDI-II. Sudden gains were examined using the original criteria as defined by Tang and DeRubeis (1999b). Furthermore, we examined whether the duration of the between-session interval at which sudden gains were recorded affected the results. There were significantly more patients with sudden gains in CT (42.2%) as compared to IPT (24.5%). The difference appeared to be driven by the criterion representing the stability of the gain. No between-group differences were found with regard to the magnitude, timing and predictors of the gains. Those with sudden gains were less depressed at post-treatment and follow-up. After controlling for the duration of the between-session interval, the difference in rates between the two conditions became a non-significant trend. Other sudden gains characteristics were similar to those observed when allowing for longer intervals as well. The current study indicates differences in occurrence of sudden gains in two treatment modalities that overall showed similar results, which might reflect different mechanisms of change.",26803276,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.972652435302734,-2.844434976577759,ByHI
"Indicated Prevention Interventions in the Workplace for Depressive Symptoms: A Systematic Review and Meta-analysis.

Depressive symptoms are highly prevalent and cause substantive morbidities and loss of functioning among employees. Depression may be prevented at its early stages. However, there is a paucity of information regarding indicated preventive interventions for depression among employees. The objective of this review is to examine the effectiveness of indicated interventions for the reduction of depressive symptoms in the workplace. A systematic review and meta-analysis of articles published between January 2000 and September 2017 was conducted using major electronic databases, including PubMed/MEDLINE, PsycINFO, EMBASE, SOCINDEX, and ABI/ProQuest. Studies were selected based on a set of predefined inclusion criteria. Primary outcome measures were depressive symptomatology, and the interventions were preventive in nature. Studies were pooled based on the intervention type and the effect size was measured using the standardized mean difference. A computer and hand search of the literature yielded 4,462 papers, from which 16 trials were identified to be suitable for meta-analysis. Eight of 16 studies reported significant effects for workplace preventive interventions targeting depressive symptoms in which six were cognitive behavioral therapy (CBT)-based interventions and two were non-CBT-based interventions. Small to medium effect sizes were found for both CBT- and non-CBT-based interventions (standardized mean difference= -0.44, 95% CI= -0.61, -0.26, I2=62.1% and standardized mean difference= -0.32, 95% CI= -0.59, -0.06, I2=58%, respectively). This review demonstrates that indicated interventions can significantly reduce the level of depressive symptoms among workers. The implementation of evidence-based workplace interventions should consequently be considered to prevent the development of depressive symptoms among employees.",30573152,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,9.264647483825684,-4.23811674118042,BBeT
"The effects of psychotherapy on depression among racial-ethnic minority groups: a metaregression analysis.

Several psychotherapies have been found to be effective in the treatment of depression among adults. However, little is known about whether effectiveness differs by racial-ethnic minority group. The authors conducted a meta-analysis to assess the relative effects of psychotherapy for persons from racial-ethnic minority groups, by examining whether a sample's racial-ethnic minority proportion was a moderator of the effect size of psychotherapy. Eligible studies were identified with an existing database of randomized controlled trials (RCTs) on the psychological treatment of depression among adults. The analysis included all studies in which the effect of psychotherapy for adults with a depressive disorder or symptomatology was compared with a control condition in an RCT. Only studies that reported the overall racial-ethnic minority proportion of the sample or the studies reporting specific racial-ethnic backgrounds of participants were included. A total of 56 RCTs reported the proportion of participants from racial-ethnic minority groups (with 77 comparisons between psychotherapy treatment and control groups). An overall moderate effect size (g=.50) in favor of psychotherapy was found. No significant moderating effect of race-ethnicity was found in bivariate and multivariate analyses. Results suggest that psychotherapy is equally effective regardless of care seekers' race-ethnicity. Future research should focus on filling in the gap between effective mental health care and the delivery of these services.",24535615,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.729961395263672,-6.0915093421936035,CSA8
"The impact of providing personalized depression risk information on self-help and help-seeking behaviors: Results from a mixed methods randomized controlled trial.

To evaluate the impact of providing personalized depression risk information on self-help and help-seeking behaviors among individuals who are at high risk of having a major depressive episode (MDE). In a mixed methods randomized controlled trial, participants who were at high risk of having a MDE, were recruited from across Canada, and were randomized into intervention (n=358) and control (n=354) groups. Participants in the intervention group received their personalized depression risk estimated by sex-specific risk prediction models for MDE. All participants were assessed at baseline, 6 and 12 months. Repeated measure mixed effects modeling showed significant between group differences in self-help scores. In the complete case analysis, the between group difference in mean self-help change score was 1.13 at 12 months (effect size = 0.16). Among participants who reported ""fair"" or ""poor health,"" the between group difference in mean self-help change score was 2.78 at 12 months (effect size = 0.35). The qualitative data revealed three themes and the findings are consistent with the quantitative results. Providing personalized depression risk information has a positive impact on self-help in high-risk individuals, particularly in those with poor health.",34196445,Major Depressive Disorder,Anxiety Treatment,Mental Health,13413,11.092761993408203,-2.932272434234619,AT9b
"Mentalization and Depression: Theoretical Concepts, Treatment Approaches and Empirical Studies - an Overview.

Objectives: The aim of this article is to outline the relevance of mentalization for the understanding of the dynamics and the psychotherapeutic treatment of depression, and to systematically review the literature on mentalization as it relates to the diagnosis of depression and the evaluation of depression treatment. Methods: The first part of the article consists of an overview of the theory of mentalization and its relevance for depression and its treatment. For the second part, a literature research was conducted in Scopus and PubMed to retrieve and then manually select empirical studies on depression and mentalization, focusing on studies applying the Reflective Functioning Scale based on the Adult Attachment Interview. Results: For our review, 15 studies were selected. These suggest that severe chronic and/ or treatment resistant depression is related to more pronounced mentalizing deficits. With respect to psychotherapy process and outcome, mentalization is a specific focus of psychodynamic therapy approaches, and proves to be an important mediating and moderating variable. Conclusion: Mentalization with its linkages to attachment theory offers rich possibilities for an in-depth understanding of the dynamics of depression and resulting mentalization based approaches to the treatment of the disorder. The small number of studies and their heterogeneous design allow only preliminary assumptions on the difference between severe, chronic and milder or episodic courses of depression with respect to mentalizing deficits and urge for further research.",31154932,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,15.093360900878906,-6.046370029449463,A5lz
"Cognitive control interventions for depression: A systematic review of findings from training studies.

There is a strong interest in cognitive control training as a new intervention for depression. Given the recent promising meta-analytical findings regarding the effects of cognitive training on cognitive functioning and depressive symptomatology, the current review provides an in-depth discussion of the role of cognitive control in depression. We consider the state-of-the-art research on how manipulation of cognitive control may influence cognitive and depression-related outcomes. Evidence for the effectiveness of cognitive control training procedures are discussed in relation to three stages of depression (at-risk, clinically depressed, remission) as well as the training approach that was deployed, after which the putative theoretical mechanisms are discussed. Finally, we provide ways in which cognitive control training can be utilized in future research.",28273486,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.099089622497559,-0.8969226479530334,Bf0L
"Personalized Psychotherapy for Adult Depression: A Meta-Analytic Review.

Personalized medicine is aimed at identifying which characteristics of an individual predict the outcome of a specific treatment, in order to get a better match between the individual and the treatment received. We conducted a systematic review and meta-analysis of randomized trials comparing two psychotherapies directly in a group of depressed patients with a specific characteristic. We focused on the six most examined types of psychotherapy for adult depression. Our searches resulted in 41 studies with 2,741 patients who met inclusion criteria. These 41 studies examined 27 specific characteristics of patients. Power calculations indicated that we would need 4 studies for each characteristic to find a clinically relevant effect size set at g = 0.50 and 16 studies for an effect size of 0.24. Only 3 patient characteristics were found to have sufficient power and to significantly moderate treatment outcomes. Cognitive-behavioral therapy was found to be more effective than other therapies in older adults (g = 0.29), in patients with comorbid addictive disorders (g = 0.31), and in university students (g = 0.46). Risk of bias was considerable in most of the included studies. It was estimated that it will take another 326 years to have sufficient statistical power for showing an effect size of g = 0.50 of the 27 characteristics, and 1,372 years to show an effect size of 0.24. Although several dozens of studies have compared the effects of psychotherapies in specific target groups, we will need to develop more powerful alternatives to comparative outcome studies in order to identify personalized treatments for depression.",27993344,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.605657577514648,-2.3711438179016113,BjME
"Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis.

The aim of this review is to establish the effectiveness of psychological relapse prevention interventions, as stand-alone interventions and in combination with maintenance antidepressant treatment (M-ADM) or antidepressant medication (ADM) discontinuation for patients with remitted anxiety disorders or major depressive disorders (MDD). A systematic review and a meta-analysis were conducted. A literature search was conducted in PubMed, PsycINFO and Embase for randomised controlled trials (RCTs) comparing psychological relapse prevention interventions to treatment as usual (TAU), with the proportion of relapse/recurrence and/or time to relapse/recurrence as outcome measure. Thirty-six RCTs were included. During a 24-month period, psychological interventions significantly reduced risk of relapse/recurrence for patients with remitted MDD (RR 0.76, 95% CI: 0.68-0.86, p<0.001). This effect persisted with longer follow-up periods, although these results were less robust. Also, psychological interventions combined with M-ADM significantly reduced relapse during a 24-month period (RR 0.76, 95% CI: 0.62-0.94, p = 0.010), but this effect was not significant for longer follow-up periods. No meta-analysis could be performed on relapse prevention in anxiety disorders, as only two studies focused on relapse prevention in anxiety disorders. In patients with remitted MDD, psychological relapse prevention interventions substantially reduce risk of relapse/recurrence. It is recommended to offer these interventions to remitted MDD patients. Studies on anxiety disorders are needed. PROSPERO 2018: CRD42018103142.",35960783,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.064949035644531,-0.7296461462974548,Lq8
"Pragmatic Quasi-Experimental Controlled Trial Evaluating the Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders.

Depression is a major problem in youth mental health. Current treatment is on average effective, but adolescents are hesitant to seek help. Blended treatment could lower the barriers to seeking treatment. Evidence on effectiveness is, however, scarce. The present pragmatic quasi-experimental controlled trial aimed to compare the outcomes of blended cognitive behavioral therapy (CBT) to face-to-face CBT and treatment as usual. A total of 129 adolescents with clinical depression (82.2% female), aged 13-22 (M = 16.60, SD = 2.03) received blended CBT, face-to-face CBT or treatment as usual. Clinical diagnosis, depressive symptoms, and secondary outcomes were assessed at baseline, post-intervention, and six-months follow-up. Participants receiving blended CBT were, compared to participants receiving face-to-face CBT and treatment as usual, evenly likely to be in remission from their depressive disorder at post-intervention and at six-month follow-up. Depressive symptoms decreased significantly over time in all three conditions, and changes were not significantly different between conditions. Other secondary outcomes (suicide risk, internalizing and externalizing symptoms, severity of depression, and global functioning) did not differ between treatment conditions at post-intervention and six-month follow-up. Since there was no evidence for favorable outcomes for face-to-face therapies above blended CBT, blended CBT may also be an effective treatment format in clinical practice.",33802913,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.93048095703125,-2.9315035343170166,AYZp
"Protocol for a randomised controlled trial investigating self-help email messages for sub-threshold depression: the Mood Memos study.

Sub-threshold depression is common, impairs functioning, and increases the risk of developing major depression. Although psychological treatments have been investigated for sub-threshold depression, they are costly. A less costly alternative could be an educational health promotion campaign about effective self-help for depression symptoms. The aim of the study is to test the efficacy of a low-cost email-based mental health promotion campaign in changing self-help behaviour and preventing more severe depression in adults with sub-threshold depression. The project is a randomised controlled trial of an automated preventive email-intervention aimed at people with sub-threshold depression. Adults aged 18+ with sub-threshold depression (as measured with the Patient Health Questionnaire-9), who are not already receiving professional treatment for depression, are eligible for admission to the study. Internet users will sign up via the study website http://www.moodmemos.com and be randomly allocated to receive emails twice weekly for six weeks containing either self-help coping advice or general information about depression as a control. Outcomes will be assessed at the start, midpoint, and end of the intervention, as well as six months later. Outcomes assessed include symptoms, incidence of major depression, psychological distress, social and occupational functioning, coping strategies, and coping self-efficacy. The primary hypothesis is that the Mood Memo emails containing coping strategies will reduce depression symptoms and be better at preventing major depression than the control emails that contain general information about depression. Promotion of actions an individual can take to prevent physical disease is a technique often used in public health. This study applies this approach to mental health, and explores whether a low-cost, easily disseminated email-based campaign can improve self-help coping behaviour and prevent depression in adults with sub-threshold depression. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12609000925246.",21226960,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.363950729370117,-3.113597869873047,DBRh
"Predictors of Depression Treatment Response in an Intensive CBT Partial Hospital.

Despite the effectiveness of cognitive behavioral therapy (CBT) for depression, a significant number of patients do not respond. Data examining predictors of treatment response in settings in which CBT is delivered naturalistically are lacking. Treatment outcome data collected at a CBT-based partial hospital (n = 956) were used to examine predictors of two types of treatment response: (a) a reliable and clinically significant change in depressive symptoms and (b) a self-rating of ""very much"" or ""much"" improved. In multiple logistic regression models, we examined predictors of response in the total sample and separately for patients with a primary diagnosis of major depressive disorder (MDD) versus patients with other primary diagnoses. In the total sample, higher treatment outcome expectations and fewer past hospitalizations predicted clinically significant improvement in depression symptoms, and higher treatment expectations and ethnoracial minority background predicted global improvement. In patients with primary MDD, higher treatment outcome expectations and being referred from the community (vs. inpatient hospitalization) predicted better depression response, and higher treatment outcome expectations predicted global improvement. In patients with other primary diagnoses, higher treatment outcome expectations and fewer borderline personality disorder traits predicted depression reduction, and higher treatment outcome expectations, less relationship difficulty, and female gender predicted global improvement. Results are generally consistent with data from randomized controlled trials on longer term outpatient CBT. Interventions that increase treatment expectancy and modifications to better target men may enhance treatment outcome. Future research should include objective outcome measures and examine mechanisms underlying treatment response.",26934333,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.204300880432129,-2.5891573429107666,BwP9
"The treatment of nonmelancholic depression: when antidepressants fail, does psychotherapy work?

Treatment-resistant depression (TRD) is used as a descriptive or diagnostic term and has generated many management guidelines weighting antidepressant (AD) therapy, but which may be an inappropriate paradigm for the nonmelancholic disorders where psychotherapy may be a more salient modality. This study sought to evaluate the effectiveness of psychological therapy in patients whose nonmelancholic depressive condition had been resistant to at least 2 ADs. Principal analyses compared 32 patients, diagnosed with a nonmelancholic depression who received 12 weeks of psychological therapy, with a small control group. Comparative analyses failed to find a distinct therapeutic effect, leading to an extension study pursuing candidate explanatory factors for this lack of response, including psychosocial factors. While our sample showed a 41% response and 22% remission rate to psychotherapy, their improvement pattern was similar to the control group, thus arguing against any specific therapeutic benefit. Explanatory factors nominated by the treating psychologist weighted personality issues for 35% of the patients, distal stressors for 22%, and comorbid anxiety conditions for 18%. When sample members were compared with an age- and sex-matched sample of patients with nonmelancholic depression who improved distinctly during a similar 12-week period, rates of such putative personality, stress, and anxiety risk factors did not differ, arguing against the likelihood of these factors compromising improvement. Patients with nonmelancholic TRD also failed to demonstrate a clear response to a psychotherapeutic approach, while our pursuit of clinically explanatory variables was not supported empirically.",25004496,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.215323448181152,-0.8229790329933167,CLkK
"Universal Access to Cognitive Behavioral Therapy and Antidepressants Is Necessary for All Patients With Major Depressive Disorder.

",31658468,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.854961395263672,-0.8692991733551025,Ayy/
"Psychotherapy versus second-generation antidepressants in the treatment of depression: a meta-analysis.

Most meta-analyses have concluded that psychotherapy and pharmacotherapy yield roughly similar efficacy in the short-term treatment of depression, with psychotherapy showing some advantage at long-term follow-up. However, a recent meta-analysis found that selective serotonin reuptake inhibitors medications were superior to psychotherapy in the short-term treatment of depression. To incorporate results of several recent trials into the meta-analytic literature, we conducted a meta-analysis of trials which directly compared psychotherapy to second-generation antidepressants (SGAs). Variables potentially moderating the quality of psychotherapy or medication delivery were also examined, to allow the highest quality comparison of both types of intervention. Bona fide psychotherapies showed equivalent efficacy in the short-term and slightly better efficacy on depression rating scales at follow-up relative to SGA. Non-bona fide therapies had significantly worse short-term outcomes than medication (d = 0.58). No significant differences emerged between treatments in terms of response or remission rates, but non-bona fide therapies had significantly lower rates of study completion than medication (odds ratio = 0.55). Bona fide psychotherapy appears as effective as SGAs in the short-term treatment of depression, and likely somewhat more effective than SGAs in the longer-term management of depressive symptoms.",21346483,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.404362678527832,-1.834847331047058,C/j3
"Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial.

Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England. Adolescent patients (aged 11-17 years) with a diagnosis of DSM IV major depressive disorder were randomly assigned (1:1:1), via a web-based randomisation service, to receive cognitive behavioural therapy (CBT) or short-term psychoanalytical therapy versus a reference brief psychological intervention. Randomisation was stochastically minimised by age, sex, self-reported depression sum score, and region. Patients and clinicians were aware of group allocation, but allocation was concealed from outcome assessors. Patients were followed up and reassessed at weeks 6, 12, 36, 52, and 86 post-randomisation. The primary outcome was self-reported depression symptoms at weeks 36, 52, and 86, as measured with the self-reported Mood and Feelings Questionnaire (MFQ). Because our aim was to compare the two psychological therapies with the brief psychosocial intervention, we first established whether CBT was inferior to short-term psychoanalytical psychotherapy for the same outcome. Primary analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN83033550. Between June 29, 2010, and Jan 17, 2013, we randomly assigned 470 patients to receive the brief psychosocial intervention (n=158), CBT (n=155), or short-term psychoanalytical therapy (n=157); 465 patients comprised the intention-to-treat population. 392 (84%) patients had available data for primary analysis by the end of follow-up. Treatment fidelity and differentiation were established between the three interventions. The median number of treatment sessions differed significantly between patients in the brief psychosocial intervention group (n=6 [IQR 4-11]), CBT group (n=9 [5-14]), and short-term psychoanalytical therapy group (n=11 [5-23]; p<0·0001), but there was no difference between groups in the average duration of treatment (27·5 [SD 21·5], 24·9 [17·7], 27·9 [16·8] weeks, respectively; Kruskal-Wallis p=0·238). Self-reported depression symptoms did not differ significantly between patients given CBT and those given short-term psychoanalytical therapy at weeks 36 (treatment effect 0·179, 95% CI -3·731 to 4·088; p=0·929), 52 (0·307, -3·161 to 3·774; p=0·862), or 86 (0·578, -2·948 to 4·104; p=0·748). These two psychological treatments had no superiority effect compared with brief psychosocial intervention at weeks 36 (treatment effect -3·234, 95% CI -6·611 to 0·143; p=0·061), 52 (-2·806, -5·790 to 0·177; p=0·065), or 86 (-1·898, -4·922 to 1·126; p=0·219). Physical adverse events (self-reported breathing problems, sleep disturbances, drowsiness or tiredness, nausea, sweating, and being restless or overactive) did not differ between the groups. Total costs of the trial interventions did not differ significantly between treatment groups. We found no evidence for the superiority of CBT or short-term psychoanalytical therapy compared with a brief psychosocial intervention in maintenance of reduced depression symptoms 12 months after treatment. Short-term psychoanalytical therapy was as effective as CBT and, together with brief psychosocial intervention, offers additional patient choice for psychological therapy, alongside CBT, for adolescents with moderate to severe depression who are attending routine specialist CAMHS clinics. National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, and the Department of Health.",27914903,Major Depressive Disorder,Anxiety Treatment,Mental Health,5034,11.162537574768066,-2.847057580947876,Bj2x
"An open trial of a new acceptance-based behavioral treatment for major depression with psychotic features.

Research suggests that cognitive and behavioral therapies produce significant benefits over medications alone in the treatment of severe, nonpsychotic major depression or primary psychotic disorders such as schizophrenia. However, previous research has not demonstrated the efficacy of psychotherapy for major depression with psychotic features. In this initial treatment development study, we conducted an open trial of a new behavioral intervention that combines elements of behavioral activation and acceptance and commitment therapy for depression and psychosis. Fourteen patients with major depressive disorder with psychotic features were provided with up to 6 months of Acceptance-Based Depression and Psychosis Therapy (ADAPT) in combination with pharmacotherapy. Patients reported a high degree of treatment credibility and acceptability. Results showed that patients achieved clinically significant and sustained improvements through posttreatment follow-up in depressive and psychotic symptoms, as well as psychosocial functioning. In addition, the processes targeted by the intervention (e.g., acceptance, mindfulness, values) improved significantly over the course of treatment, and changes in processes were correlated with changes in symptoms. Results suggest that ADAPT combined with pharmacotherapy is a promising treatment approach for psychotic depression that should be tested in a future randomized trial.",23223385,Major Depressive Disorder,Anxiety Treatment,Mental Health,19615,8.691648483276367,-1.7188687324523926,Ckto
"Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression: results from a multicenter randomized controlled trial.

Recent studies have suggested that therapeutic climbing/bouldering may have positive effects on perceived self-efficacy. Nevertheless, there is still an urgent need for high-quality studies, as many existing studies have suffered from methodological problems. Therefore, the current work was aimed at investigating the effect of a manualized bouldering psychotherapy (BPT) on perceived self-efficacy in people with depression, compared with a home-based physical exercise program (EP) and state-of-the-art cognitive behavioral group therapy (CBT). In a prospective, multicenter, randomized controlled trial, 233 people with depression were randomly assigned to one group (BPT, EP, or CBT). Perceived self-efficacy was assessed at baseline (t0) and directly after the 10-week intervention period (t1) with the GSE. In addition, depression was assessed with the PHQ-9 and the MADRS. We computed t tests, analyses of variance (ANOVAs), confounder-adjusted hierarchical regression analyses, mediation analyses, and several sensitivity analyses. BPT participants showed a significantly larger increase in perceived self-efficacy on the GSE compared with the EP (an increase of 3.04 vs. 1.26 points, p=.016, Cohen's d=0.39). In the confounder-adjusted hierarchical multiple regression analysis, group allocation (BPT vs. EP) was found to be the only significant predictor of the postintervention GSE score (β=.16, p=.014) besides the baseline GSE score (β=.69, p<.001). No differences were found between BPT and CBT participants regarding the effect on perceived self-efficacy. Only in the CBT group, the relationship between depression at baseline and postintervention was partially mediated (23%) by perceived self-efficacy. Participation in the manualized BPT in a group setting leads to a clinically relevant enhancement of perceived self-efficacy in people with depression. This effect is superior to that of physical exercise alone. The results provide also initial indications that BPT is comparable to CBT in enhancing perceived self-efficacy, suggesting a strong case for a broader use of BPT as a supplement to existing health services. Future studies should focus on the modes of action of BPT and its effect on perceived self-efficacy in people with other mental or physical disorders. Trial registration ISRCTN12457760, registered partly retrospectively, 26 July 2017.",34446114,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,8.850847244262695,-2.048495292663574,ARNd
"Therapeutic Alliance in Technology-Based Interventions for the Treatment of Depression: Systematic Review.

There is growing evidence that technology-based interventions (TBIs) are effective for the treatment of depression. As TBIs are gaining acceptance, a question arises whether good therapeutic alliance, considered a key aspect of psychotherapy, can be established without or with minimal face-to-face contact or rather changes if blended concepts are applied. While therapeutic alliance has been studied extensively in the context of face-to-face therapy, only few studies have reviewed evidence on alliance ratings in TBIs. The purpose of this study was to examine therapeutic alliance in technology-based psychological interventions for the treatment of depression. We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, PSYNDEX, CINAHL, clinical trial registers, and sources of grey literature for randomized controlled trials on TBIs in the treatment of adults with unipolar depression. All publications were selected according to prespecified criteria. Data were extracted by two independent reviewers. A total of eight out of 98 studies (9.5%) included in the review on TBIs for depression considered therapeutic alliance as part of their evaluation. The available data covered eight different treatment conditions, including four stand-alone treatments (face-to-face psychotherapy, email, telephone, and internet program) and four combined treatments (face-to-face psychotherapy plus a smartphone app and an internet program combined with face-to-face psychotherapy, treatment as usual, or email/telephone). On average, patients rated the alliance positively across all groups. Importantly, no relevant group differences regarding therapeutic alliance sum scores were found in any of the studies. Five studies investigated the relationship between patients' alliance ratings and treatment outcome, revealing mixed results. Our results suggest that it is possible to establish a positive therapeutic alliance across a variety of different TBIs for depression, but this is based on a small number of studies. Future research needs to determine on what basis therapeutic alliance is formed in settings that do not allow for additional nonverbal cues, perhaps with adapted instruments to measure therapeutic alliance. PROSPERO International Prospective Register of Systematic Reviews CRD42016050413; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42016050413). RR2-10.1136/bmjopen-2018-028042.",32525484,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,12.574685096740723,-5.959927558898926,AnlN
"Cognitive change in cognitive-behavioural therapy v. pharmacotherapy for adult depression: a longitudinal mediation analysis.

Although cognitive-behavioural therapy (CBT) is a well-established treatment for adult depression, its efficacy and efficiency may be enhanced by better understanding its mechanism(s) of action. According to the theoretical model of CBT, symptom improvement occurs via reductions in maladaptive cognition. However, previous research has not established clear evidence for this cognitive mediation model. The present study investigated the cognitive mediation model of CBT in the context of a randomized controlled trial of CBT v. antidepressant medication (ADM) for adult depression. Participants with major depressive disorder were randomized to receive 16 weeks of CBT (n = 54) or ADM (n = 50). Depression symptoms and three candidate cognitive mediators (dysfunctional attitudes, cognitive distortions and negative automatic thoughts) were assessed at week 0 (pre-treatment), week 4, week 8 and week 16 (post-treatment). Longitudinal associations between cognition and depression symptoms, and mediation of treatment outcome, were evaluated in structural equation models. Both CBT and ADM produced significant reductions in maladaptive cognition and depression symptoms. Cognitive content and depression symptoms were moderately correlated within measurement waves, but cross-lagged associations between the variables and indirect (i.e. mediated) treatment effects were non-significant. The results provide support for concurrent relationships between cognitive and symptom change, but not the longitudinal relationships hypothesized by the cognitive mediation model. Results may be indicative of an incongruence between the timing of measurement and the dynamics of cognitive and symptom change.",30560738,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.6919527053833,-2.7634074687957764,BBpS
"The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis.

A meta-analysis examining temporal changes (time trends) in the effects of cognitive behavioral therapy (CBT) as a treatment for unipolar depression was conducted. A comprehensive search of psychotherapy trials yielded 70 eligible studies from 1977 to 2014. Effect sizes (ES) were quantified as Hedge's g based on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). Rates of remission were also registered. The publication year of each study was examined as a linear metaregression predictor of ES, and as part of a 2-way interaction with other moderators (Year × Moderator). The average ES of the BDI was 1.58 (95% CI [1.43, 1.74]), and 1.69 for the HRSD (95% CI [1.48, 1.89]). Subgroup analyses revealed that women profited more from therapy than did men (p < .05). Experienced psychologists (g = 1.55) achieved better results (p < .01) than less experienced student therapists (g = 0.98). The metaregressions examining the temporal trends indicated that the effects of CBT have declined linearly and steadily since its introduction, as measured by patients' self-reports (the BDI, p < .001), clinicians' ratings (the HRSD, p < .01) and rates of remission (p < .01). Subgroup analyses confirmed that the declining trend was present in both within-group (pre/post) designs (p < .01) and controlled trial designs (p = .02). Thus, modern CBT clinical trials seemingly provided less relief from depressive symptoms as compared with the seminal trials. Potential causes and possible implications for future studies are discussed. (PsycINFO Database Record",25961373,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.845052719116211,-2.4637651443481445,B94o
"Replicating patient-level moderators of CBT and IPT's comparative efficacy for depression.

Although evidence-based psychotherapies, such as cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT), produce comparable average outcomes, it is plausible that some patients who possess one or more specific characteristics may respond better to one over the other. Addressing this what works best for whom question, researchers have tested the moderating influence of patient characteristics on comparative treatment effects (viz. aptitude-treatment interactions [ATIs]). However, few ATIs have emerged or replicated, thereby providing little treatment-selection guidance. Informed by a systematic review of patient ATIs in trials that compared CBT versus IPT for depression (Bernecker et al., 2017), this study aimed to replicate (a) significant ATIs previously established in a single study; and (b) significant ATIs previously examined twice, with only one study demonstrating a moderating effect. Data derived from a trial in which adult outpatients with major depression were randomly assigned to 16 weeks of CBT (n = 41) or IPT (n = 39). Patient characteristics were measured at baseline, and patients rated their depression throughout treatment. Multilevel models revealed one ATI replication; for patients with more self-sacrificing interpersonal problems, CBT outperformed IPT; the reverse was true for patients with fewer such problems. Other moderators either failed to replicate or directionally contradicted prior research. Results help inform optimal treatment matching for some patients, which reflects a type of psychotherapy personalization. However, they also highlight limitations of traditional ATI research and suggest that different methods are needed to inform responsive personalization efforts more expansively and reliably. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",36048042,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.165632247924805,-2.9687869548797607,JQw
"Treatment-specific changes in decentering following mindfulness-based cognitive therapy versus antidepressant medication or placebo for prevention of depressive relapse.

To examine whether metacognitive psychological skills, acquired in mindfulness-based cognitive therapy (MBCT), are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT's effectiveness. This study, embedded within a randomized efficacy trial of MBCT, was the first to examine changes in mindfulness and decentering during 6-8 months of antidepressant treatment and then during an 18-month maintenance phase in which patients discontinued medication and received MBCT, continued on antidepressants, or were switched to a placebo. In total, 84 patients (mean age = 44 years, 58% female) were randomized to 1 of these 3 prevention conditions. In addition to symptom variables, changes in mindfulness, rumination, and decentering were assessed during the phases of the study. Pharmacological treatment of acute depression was associated with reductions in scores for rumination and increased wider experiences. During the maintenance phase, only patients receiving MBCT showed significant increases in the ability to monitor and observe thoughts and feelings as measured by the Wider Experiences (p < .01) and Decentering (p < .01) subscales of the Experiences Questionnaire and by the Toronto Mindfulness Scale. In addition, changes in Wider Experiences (p < .05) and Curiosity (p < .01) predicted lower Hamilton Rating Scale for Depression scores at 6-month follow-up. An increased capacity for decentering and curiosity may be fostered during MBCT and may underlie its effectiveness. With practice, patients can learn to counter habitual avoidance tendencies and to regulate dysphoric affect in ways that support recovery.",22409641,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.03718090057373,-0.7131957411766052,CwLW
"Immediate and long-term effectiveness of adding an Internet intervention for depression to routine outpatient psychotherapy: Subgroup analysis of the EVIDENT trial.

To examine immediate and long-term effectiveness of an adjunctive Internet intervention for depression in a large sample of patients undergoing routine psychotherapy. The current study evaluated a subgroup of patients from the Evident trial, a randomized investigation of a 12-week minimally guided Internet intervention (Deprexis) for the treatment of mild to moderate depression. 340 adults (mean age = 43.3 years; 71.7 % female) of the original sample received routine outpatient psychotherapy during the trial period, resulting in a standard psychotherapy group (n = 174) and an augmented therapy group (n = 166). Outcomes were assessed at baseline, post-treatment and 6-month follow-up. Intention-to-treat analyses indicated that combined treatment led to a greater reduction in symptoms of depression (effect size d = 0.32; p = .002), improved therapeutic progress (d = 0.36; p = .003), and higher mental health-related quality of life (d = 0.34; p = .004). There was no intervention effect on physical health-related quality of life. The same pattern was found at 6-month follow-up, and adjunctive treatment also resulted in increased rates of clinical improvement. Treatment success was independent from therapeutic orientation of combined face-to-face therapy. Results indicate that the adjunctive use of the investigated intervention can produce additional and lasting effects in routine outpatient psychotherapy for mild to moderate levels of depression. The study adds to the ongoing evidence on augmented effects of blended treatment. Future studies should investigate different types of blends in diverse populations by means of change-sensitive assessment strategies.",32663998,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.096966743469238,-3.1411330699920654,Al22
"[What is the contribution of clinical practice recommendations concerning the prevention of depressive recurrences?].

Depression has to be managed using a combination of data-driven evidence and clinical experience. Recommendations for clinical practice are various and heterogeneous, depending on their objectives. The identification of their differences can provide informations on the difficulties that we can have in treating depressed patients. Treatment guidelines for depression support both early vigorous treatment, and continued therapy after the acute phase. In recurrent depression, maintenance antidepressant therapy and regular monitoring is advised, but pharmacological strategies should be tailored to the individual for treatment that matches the phase of illness. Psychological strategies and more specifically Cognitive Behavioral Therapy should be developed to prevent relapse specifically. Relapse prevention involves putting supports in place to help the patient stay well and to reduce the likelihood of future illness. It includes developing a plan for managing early relapse symptoms and to identify potential high-risk situations. But, a large proportion of people with a depressive disorder do not receive minimally adequate treatment. Improving the concordance of everyday practice with clinical recommendations should be an important goal for clinicians.",21211637,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.210694313049316,-0.9522595405578613,DBew
"Psychological interventions to prevent the onset of depressive disorders: A meta-analysis of randomized controlled trials.

Depressive disorders are common and have a considerable impact on patients and societies. Several treatments are available, but their effects are modest and reduce the burden only to a limited extent. Preventing the onset of depressive disorders may be one option to further reduce the global disease burden. We conducted a meta-analysis of randomized controlled trials in participants without a diagnosis of depression at baseline, who were assigned to a preventive psychological intervention, or a care-as-usual, or comparable control group and in which incident cases of depression at follow-up were ascertained with a diagnostic interview. Our systematic searches resulted in 50 trials (14,665 participants) with relatively high quality, in high risk groups of all ages. The psychological interventions were mostly based on cognitive behavioral interventions. One year after the preventive interventions, the relative risk of developing a depressive disorder was RR = 0.81 (95% CI: 0.72-0.91), indicating that those who had received the intervention had 19% less chance to develop a depressive disorder. Given the average control event rate of 30%, twenty-one people had to participate in the intervention to prevent one depressive disorder compared to people in the control conditions. Prevention is a promising approach to reduce the global disease burden of depression in addition to treatments.",33333441,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.551579475402832,-2.551797389984131,Adwy
"Cognitive behavioural therapy (CBT), third-wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents.

Depression is common in young people. It has a marked negative impact and is associated with self-harm and suicide. Preventing its onset would be an important advance in public health. This is an update of a Cochrane review that was last updated in 2011. To determine whether evidence-based psychological interventions (including cognitive behavioural therapy (CBT), interpersonal therapy (IPT) and third wave CBT)) are effective in preventing the onset of depressive disorder in children and adolescents. We searched the specialised register of the Cochrane Common Mental Disorders Group (CCMDCTR to 11 September 2015), which includes relevant randomised controlled trials from the following bibliographic databases: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched conference abstracts and reference lists of included trials and reviews, and contacted experts in the field. We included randomised controlled trials of an evidence-based psychological prevention programme compared with any comparison control for young people aged 5 to 19 years, who did not currently meet diagnostic criteria for depression. Two authors independently assessed trials for inclusion and rated their risk of bias. We adjusted sample sizes to take account of cluster designs and multiple comparisons. We contacted trial authors for additional information where needed. We assessed the quality of evidence for the primary outcomes using GRADE. We included 83 trials in this review. The majority of trials (67) were carried out in school settings with eight in colleges or universities, four in clinical settings, three in the community and four in mixed settings. Twenty-nine trials were carried out in unselected populations and 53 in targeted populations.For the primary outcome of depression diagnosis at medium-term follow-up (up to 12 months), there were 32 trials with 5965 participants and the risk of having a diagnosis of depression was reduced for participants receiving an intervention compared to those receiving no intervention (risk difference (RD) -0.03, 95% confidence interval (CI) -0.05 to -0.01; P value = 0.01). We rated this evidence as moderate quality according to the GRADE criteria. There were 70 trials (73 trial arms) with 13,829 participants that contributed to the analysis for the primary outcome of depression symptoms (self-rated) at the post-intervention time point, with results showing a small but statistically significant effect (standardised mean difference (SMD) -0.21, 95% CI -0.27 to -0.15; P value < 0.0001). This effect persisted to the short-term assessment point (up to three months) (SMD -0.31, 95% CI -0.45 to -0.17; P value < 0.0001; 16 studies; 1558 participants) and medium-term (4 to 12 months) assessment point (SMD -0.12, 95% CI -0.18 to -0.05; P value = 0.0002; 53 studies; 11,913 participants); however, the effect was no longer evident at the long-term follow-up. We rated this evidence as low to moderate quality according to the GRADE criteria.The evidence from this review is unclear with regard to whether the type of population modified the overall effects; there was statistically significant moderation of the overall effect for depression symptoms (P value = 0.0002), but not for depressive disorder (P value = 0.08). For trials implemented in universal populations there was no effect for depression diagnosis (RD -0.01, 95% CI -0.03 to 0.01) and a small effect for depression symptoms (SMD -0.11, 95% CI -0.17 to -0.05). For trials implemented in targeted populations there was a statistically significantly beneficial effect of intervention (depression diagnosis RD -0.04, 95% CI -0.07 to -0.01; depression symptoms SMD -0.32, 95% CI -0.42 to -0.23). Of note were the lack of attention placebo-controlled trials in targeted populations (none for depression diagnosis and four for depression symptoms). Among trials implemented in universal populations a number used an attention placebo comparison in which the intervention consistently showed no effect. Overall the results show small positive benefits of depression prevention, for both the primary outcomes of self-rated depressive symptoms post-intervention and depression diagnosis up to 12 months (but not beyond). Estimates of numbers needed to treat to benefit (NNTB = 11) compare well with other public health interventions. However, the evidence was of moderate to low quality using the GRADE framework and the results were heterogeneous. Prevention programmes delivered to universal populations showed a sobering lack of effect when compared with an attention placebo control. Interventions delivered to targeted populations, particularly those selected on the basis of depression symptoms, had larger effect sizes, but these seldom used an attention placebo comparison and there are practical difficulties inherent in the implementation of targeted programmes. We conclude that there is still not enough evidence to support the implementation of depression prevention programmes.Future research should focus on current gaps in our knowledge. Given the relative lack of evidence for universal interventions compared with attention placebo controls and the poor results from well-conducted effectiveness trials of universal interventions, in our opinion any future such trials should test a depression prevention programme in an indicated targeted population using a credible attention placebo comparison group. Depressive disorder as the primary outcome should be measured over the longer term, as well as clinician-rated depression. Such a trial should consider scalability as well as the potential for the intervention to do harm.",27501438,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.100854873657227,-3.4301376342773438,Bo53
"Recruitment to online therapies for depression: pilot cluster randomized controlled trial.

Raising awareness of online cognitive behavioral therapy (CBT) could benefit many people with depression, but we do not know how purchasing online advertising compares to placing free links from relevant local websites in increasing uptake. To pilot a cluster randomized controlled trial (RCT) comparing purchase of Google AdWords with placing free website links in raising awareness of online CBT resources for depression in order to better understand research design issues. We compared two online interventions with a control without intervention. The pilot RCT had 4 arms, each with 4 British postcode areas: (A) geographically targeted AdWords, (B) adverts placed on local websites by contacting website owners and requesting links be added, (C) both interventions, (D) control. Participants were directed to our research project website linking to two freely available online CBT resource sites (Moodgym and Living Life To The Full (LLTTF)) and two other depression support sites. We used data from (1) AdWords, (2) Google Analytics for our project website and for LLTTF, and (3) research project website. We compared two outcomes: (1) numbers with depression accessing the research project website, and then chose an onward link to one of the two CBT websites, and (2) numbers registering with LLTTF. We documented costs, and explored intervention and assessment methods to make general recommendations to inform researchers aiming to use similar methodologies in future studies. Trying to place local website links appeared much less cost effective than AdWords and although may prove useful for service delivery, was not worth pursuing in the context of the current study design. Our AdWords intervention was effective in recruiting people to the project website but our location targeting ""leaked"" and was not as geographically specific as claimed. The impact on online CBT was also diluted by offering participants other choices of destinations. Measuring the impact on LLTTF use was difficult as the total number using LLTTF was less than 5% of all users and record linkage across websites was impossible. Confounding activity may have resulted in some increase in registrations in the control arm. Practitioners should consider online advertising to increase uptake of online therapy but need to check its additional value. A cluster RCT using location targeted adverts is feasible and this research design provides the best evidence of cost-effectiveness. Although our British pilot study is limited to online CBT for depression, a cluster RCT with similar design would be appropriate for other online treatments and countries and our recommendations may apply. They include ways of dealing with possible contamination (buffer zones and AdWords techniques), confounding factors (large number of clusters), advertising dose (in proportion to total number of users), record linkage (landing within target website), and length of study (4-6 months). clinicaltrials.gov (Registration No. NCT01469689); http://clinicaltrials.gov/ct2/show/NCT01469689 (Archived by WebCite at http://www.webcitation.org/6EtTthDOp).",23462072,Major Depressive Disorder,Anxiety Treatment,Mental Health,21154,10.148069381713867,-3.830627918243408,ChFz
"Reflective functioning as predictor of working alliance and outcome in the treatment of depression.

Although considerable attention has been paid to the concept of mentalization in psychotherapy, there is little research on mentalization as predictor of psychotherapy process and outcome. Using data from a randomized controlled trial of cognitive-behavioral therapy and interpersonal psychotherapy for depression, we studied mentalization in 85 outpatients with major depressive disorder (MDD) according to the Diagnostic and Statistical Manual of Mental Disorders. It was hypothesized that patients showing lower capacity for mentalization would experience poorer quality of alliance and worse outcome. Depressive symptoms were measured each session using the Beck Depression Inventory-II. Mentalization was measured as reflective functioning (RF) on a slightly shortened version of the Adult Attachment Interview. A measure of depression-specific reflective functioning (DSRF), measuring mentalization about depressive symptoms, was also used. The Working Alliance Inventory-Short Form Revised was completed after each session by both therapist and patient. Longitudinal multilevel modeling was used to analyze data. The patients had on average very low RF (M = 2.62, SD = 1.22). Lower pretreatment RF/DSRF predicted significantly lower therapist-rated working alliance during treatment. RF did not affect patient-rated alliance, but lower DSRF predicted lower patient-rated alliance across treatment. Patients with higher RF/DSRF had better outcomes on self-rated depression. The findings showed lower than normal capacity for mentalization in patients with MDD. Lower RF/DSRF predicted worse treatment outcome. More research is needed to understand how RF affects psychotherapy response and how RF is affected after recovery from depression.",26594944,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,15.39499282836914,-5.878112316131592,B009
"Economic evidence for the clinical management of major depressive disorder: a systematic review and quality appraisal of economic evaluations alongside randomised controlled trials.

The aim of this systematic review of economic evaluations alongside randomised controlled trials (RCTs) was to provide a comprehensive overview of the evidence concerning cost-effectiveness analyses of common treatment options for major depression. An existing database was used to identify studies reporting cost-effectiveness results from RCTs. This database has been developed by a systematic literature search in the bibliographic databases of PubMed, PsychINFO, Embase and Cochrane library from database inception to December 2014. We evaluated the quality of economic evaluations using a 10-item short version of the Drummond checklist. Results were synthesised narratively. The risk of bias of the included RCTs was assessed, based on the Cochrane risk of bias assessment tool. Fourteen RCTs were included from the 5580 articles screened on titles and abstracts. The methodological quality of the health economic evaluations was relatively high and the majority of the included RCTs had low risk of bias in most of Cochrane items except blinding of participants and personnel. Cognitive behavioural therapy was examined in seven trials as part of a variety of treatment protocols and seems cost-effective compared with pharmacotherapy in the long-term. However cost-effectiveness results for the combination of psychotherapy with pharmacotherapy are conflicting and should be interpreted with caution due to limited comparability between the examined trials. For several treatments, only a single economic evaluation was reported as part of a clinical trial. This was the case for comparisons between different classes of antidepressants, for several types of psychotherapy (behavioural activation, occupational therapy, interpersonal psychotherapy, short-term psychotherapy, psychodynamic psychotherapy, rational emotive behavioural therapy, solution focused therapy), and for transcranial magnetic stimulation v. electroconvulsive therapy. The limited evidence base for these interventions means generalisations, based on economic evaluation alongside clinical trials, cannot easily be made. There is some economic evidence underpinning many of the common treatment options for major depression. Wide variability was observed in study outcomes, probably attributable to differences in population, interventions or follow-up periods. For many interventions, only a single economic evaluation alongside clinical trials was identified. Thus, significant economic evidence gaps remain in the area of major depressive disorder.",27328966,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.267245292663574,-3.3858816623687744,BrBA
"Tavistock Adult Depression Study (TADS): a randomised controlled trial of psychoanalytic psychotherapy for treatment-resistant/treatment-refractory forms of depression.

Long-term forms of depression represent a significant mental health problem for which there is a lack of effective evidence-based treatment. This study aims to produce findings about the effectiveness of psychoanalytic psychotherapy in patients with treatment-resistant/treatment-refractory depression and to deepen the understanding of this complex form of depression. Patients with treatment resistant/treatment refractory depression. Current major depressive disorder, 2 years history of depression, a minimum of two failed treatment attempts, ≥14 on the HRSD or ≥21 on the BDI-II, plus complex personality and/or psycho-social difficulties. Moderate or severe learning disability, psychotic illness, bipolar disorder, substance dependency or receipt of test intervention in the previous two years. Pragmatic, randomised controlled trial with qualitative and clinical components. 18 months of weekly psychoanalytic psychotherapy, manualised and fidelity-assessed using the Psychotherapy Process Q-Sort. Treatment as usual, managed by the referring practitioner. GP referrals from primary care. HRSD (with ≤14 as remission). depression severity (BDI-II), degree of co-morbid disorders Axis-I and Axis-II (SCID-I and SCID-II-PQ), quality of life and functioning (GAF, CORE, Q-les-Q), object relations (PROQ2a), Cost-effectiveness analysis (CSRI and GP medical records). 2 years. Plus: a). Qualitative study of participants' and therapists' problem formulation, experience of treatment and of participation in trial. (b) Narrative data from semi-structured pre/post psychodynamic interviews to produce prototypes of responders and non-responders. (c) Clinical case-studies of sub-types of TRD and of change. TRD needs complex, long-term intervention and extended research follow-up for the proper evaluation of treatment outcome. This pushes at the limits of the design of randomised therapeutic trials. We discuss some of the consequent problems and suggest how they may be mitigated.",22686185,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,10.852807998657227,-2.16359543800354,CsZH
"Impact of resilience on the improvement of depressive symptoms after cognitive therapies for depression in a sample of young adults.

Few studies have evaluated positive measures for therapeutic response. Thus, the objective of this study was to assess the effects of resilience on severity of depressive and anxious symptoms after brief cognitive psychotherapy for depression. This was a clinical follow-up study nested in a randomized clinical trial of cognitive therapies. The Resilience Scale was applied at baseline. The Hamilton Anxiety Rating Scale (HARS) and the Hamilton Depression Rating Scale (HDRS) were used at baseline, post-intervention, and at six-month follow-up. Sixty-one patients were assessed at baseline, post-intervention and at six-month follow-up. Resilience scores were significantly different between baseline and post-intervention assessments (p<0.001), as well as at baseline and at six-month follow-up (p<0.001). We observed a weak negative correlation between baseline resilience scores and HDRS scores at post-intervention (r=-0.295, p=0.015) and at six-month follow-up (r=-0.354, p=0.005). Furthermore, we observed a weak negative correlation between resilience scores and HARS scores at post-intervention (r=-0.292, p=0.016). Subjects with higher resilience scores at baseline showed a lower severity of symptoms at post-intervention and at six-month follow-up.",30304118,Major Depressive Disorder,Anxiety Treatment,Mental Health,5785,13.178600311279297,-4.523611068725586,BE+3
"Guided, internet-based, rumination-focused cognitive behavioural therapy (i-RFCBT) versus a no-intervention control to prevent depression in high-ruminating young adults, along with an adjunct assessment of the feasibility of unguided i-RFCBT, in the REducing Stress and Preventing Depression trial (RESPOND): study protocol for a phase III randomised controlled trial.

Depression is a global health challenge. Prevention is highlighted as a priority to reduce its prevalence. Although effective preventive interventions exist, the efficacy and coverage can be improved. One proposed means to increase efficacy is by using interventions to target specific risk factors, such as rumination. Rumination-focused CBT (RFCBT) was developed to specifically target depressive rumination and reduces acute depressive symptoms and relapse for patients with residual depression in a randomised controlled trial. Preliminary findings from a Dutch randomised prevention trial in 251 high-risk 15- to 22-year-old subjects selected with elevated worry and rumination found that both supported internet-RFBCT and group-delivered RFCBT equally reduced depressive symptoms and the onset of depressive cases over a period of 1 year, relative to the no-intervention control. A phase III randomised controlled trial following the Medical Research Council (MRC) Complex Interventions Framework will extend a Dutch trial to the United Kingdom, with the addition of diagnostic interviews, primarily to test whether guided internet-RFCBT reduces the onset of depression relative to a no-intervention control. High-risk young adults (aged 18 to 24 years), selected with elevated worry/rumination and recruited through university and internet advertisement, will be randomised to receive either guided internet-RFCBT, supported by clinical psychologists or mental health paraprofessionals, or a no-intervention control. As an adjunct arm, participants are also randomised to unguided internet-RFCBT self-help to provide an initial test of the feasibility and effect size of this intervention. While participants are also randomised to unguided internet-RFCBT, the trial was designed and powered as a phase III trial comparing guided internet-RFCBT versus a no-intervention control. In the comparison between these two arms, the primary outcomes are as follows: a) onset of major depressive episode over a 12-month period, assessed with a Structured Clinical Interview for Diagnosis at 3 months (post-intervention), 6 months and 15 months after randomisation. The following secondary outcomes will be recorded: the incidence of generalized anxiety disorder, symptoms of depression and anxiety, and levels of worry and rumination, measured at baseline and at the same follow-up intervals. In relation to the pilot investigation of unguided internet-RFCBT (the adjunct intervention arm), we will assess the feasibility and acceptability of the data-collection procedures, levels of attrition, effect size and acceptability of the unguided internet-RFCBT intervention. Widespread implementation is necessary for effective prevention, suggesting that the internet may be a valuable mode of delivery. Previous research suggests that guided internet-RFCBT reduces incidence rates relative to controls. We are also interested in developing and evaluating an unguided version to potentially increase the availability and reduce the costs. Current Controlled Trials ISRCTN12683436 . Date of registration: 27 October 2014.",26725476,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,14.900275230407715,-1.7127090692520142,BzGe
"Pilot randomised controlled trial of Help4Mood, an embodied virtual agent-based system to support treatment of depression.

Help4Mood is an interactive system with an embodied virtual agent (avatar) to assist in self-monitoring of patients receiving treatment for depression. Help4Mood supports self-report and biometric monitoring and includes elements of cognitive behavioural therapy. We aimed to evaluate system use and acceptability, to explore likely recruitment and retention rates in a clinical trial and to obtain an estimate of potential treatment response with a view to conducting a future randomised controlled trial (RCT). We conducted a pilot RCT of Help4Mood in three centres, in Romania, Spain and Scotland, UK. Patients with diagnosed depression (major depressive disorder) and current mild/moderate depressive symptoms were randomised to use the system for four weeks in addition to treatment as usual (TAU) or to TAU alone. Twenty-seven individuals were randomised and follow-up data were obtained from 21 participants (12/13 Help4Mood, 9/14 TAU). Half of participants randomised to Help4Mood used it regularly (more than 10 times); none used it every day. Acceptability varied between users. Some valued the emotional responsiveness of the system, while others found it too repetitive. Intention to treat analysis showed a small difference in change of Beck Depression Inventory II (BDI-2) scores (Help4Mood -5.7 points, TAU -4.2). Post-hoc on-treatment analysis suggested that participants who used Help4Mood regularly experienced a median change in BDI-2 of -8 points. Help4Mood is acceptable to some patients receiving treatment for depression although none used it as regularly as intended. Changes in depression symptoms in individuals who used the system regularly reached potentially meaningful levels.",26453910,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.864989280700684,-3.097806453704834,B2y/
"The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis update.

The efficacy of short-term psychodynamic psychotherapy (STPP) for depression is debated. Recently, a number of large-scale and high-quality studies have been conducted. We examined the efficacy of STPP by updating our 2010 meta-analysis. After a thorough literature search, 54 studies (33 randomized clinical trials) totaling 3946 subjects were included. STPP was significantly more effective than control conditions at post-treatment on depression, general psychopathology and quality of life measures (d=0.49 to 0.69). STPP pre-treatment to post-treatment changes (d=0.57 to 1.18) indicated significant improvements on all outcome measures, which either significantly improved further (d=0.20 to 1.04) or were maintained from post-treatment to follow-up. No significant differences were found between individual STPP and other psychotherapies at post-treatment (d=-0.14) and follow-up (d=-0.06) in analyses that were adequately powered to detect a clinically relevant difference. STPP was significantly more efficacious than other psychotherapies on anxiety measures at both post-treatment (d=0.35) and follow-up (d=0.76). We found clear indications that STPP is effective in the treatment of depression in adults. Although more high-quality studies are needed, particularly to assess the efficacy of STPP compared to control conditions at follow-up and to antidepressants, these findings add to the evidence-base of STPP for depression.",26281018,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.214093208312988,-4.1175994873046875,B5Yp
"Psychosocial remediation in depressive disorders: A systematic review.

Social functioning impairment has been described in several psychiatric illness, including depressive disorders. It is associated with a deterioration in global functioning and quality of life, thus there is a growing interest in psychosocial functioning remediation interventions. This systematic review aims to review all psychotherapeutic, pharmacological and biological social functioning interventions in depressive disorders. A systematic search was conducted on PubMed, PsycINFO and Scopus from the first articles to 2019 following the PRISMA guidelines. 72 original papers were extracted from an initial number of 1827, based on the selected eligibility criteria. A growing body of research was observed in the last 10 years, with most studies showing a low level of scientific evidence. The main diagnosis found was major depressive disorder and the principal social cognition domains assessed were emotional processing and attributional style. The type of intervention most found was the pharmacological one, followed by psychotherapeutic interventions classified as ""non-specific. The efficacy of treatments showed an improvement in depressive symptoms and positive results for emotional processing and attributional style. Because there is a lack of well-controlled designs and really few interventions focusing on its remediation, and low homogeneity on the assessment of social aspects across, a comparison of results and the extraction of general conclusions is quite difficult. Although a promising body of literature has been developed in recent years on the improvement of psychosocial functioning in patients with depressive disorders, more studies are needed to clarify relevant aspects in this area.",33991945,Major Depressive Disorder,Anxiety Treatment,Mental Health,3821,12.583281517028809,-0.7635638117790222,AWTa
"Differential efficacy of cognitive behavioral therapy and psychodynamic therapy for major depression: a study of prescriptive factors.

Minimal efficacy differences have been found between cognitive behavioral therapy (CBT) and psychodynamic therapies for depression, but little is known about patient characteristics that might moderate differential treatment effects. We aimed to generate hypotheses regarding such potential prescriptive factors. We conducted post-hoc model-based recursive partitioning analyses alongside a randomized clinical trial comparing the efficacy of CBT and short-term psychodynamic supportive psychotherapy (SPSP). Severely depressed patients received additional antidepressant medication. We included 233 adults seeking treatment for a major depressive episode in psychiatric outpatient clinics, who completed post-treatment assessment. Post-treatment mean Hamilton Depression Rating Scale scores constituted the main outcome measure. While treatment differences (CBT v. SPSP) were minimal in the total sample of patients (d = 0.04), model-based recursive partitioning indicated differential treatment efficacy in certain subgroups of patients. SPSP was found more efficacious among moderately depressed patients receiving psychotherapy only who showed low baseline co-morbid anxiety levels (d = -0.40) and among severely depressed patients receiving psychotherapy and antidepressant medication who reported a duration of the depressive episode of ⩾1 year (d = -0.31), while CBT was found more efficacious for such patients reporting a duration <1 year (d = 0.83). Our findings are observational and need validation before they can be used to guide treatment selection, but suggest that knowledge of prescriptive factors can help improve the efficacy of psychotherapy for depression. Depressive episode duration and co-morbid anxiety level should be included as stratification variables in future randomized clinical trials comparing CBT and psychodynamic therapy.",26750445,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.120908737182617,-2.45827317237854,ByyW
"Does recruitment source moderate treatment effectiveness? A subgroup analysis from the EVIDENT study, a randomised controlled trial of an internet intervention for depressive symptoms.

This study aims to examine whether the effects of internet interventions for depression generalise to participants recruited in clinical settings. This study uses subgroup analysis of the results of a randomised, controlled, single-blind trial. The study takes place in five diagnostic centres in Germany. A total of 1013 people with mild to moderate depressive symptoms were recruited from clinical sources as well as internet forums, statutory insurance companies and other sources. This study uses either care-as-usual alone (control) or a 12-week internet intervention (Deprexis) plus usual care (intervention). The primary outcome measure was self-rated depression severity (Patient Health Questionnaire-9) at 3 months and 6 months. Further measures ranged from demographic and clinical parameters to a measure of attitudes towards internet interventions (Attitudes towards Psychological Online Interventions Questionnaire). The recruitment source was only associated with very few of the examined demographic and clinical characteristics. Compared with participants recruited from clinical sources, participants recruited through insurance companies were more likely to be employed. Clinically recruited participants were as severely affected as those from other recruitment sources but more sceptical of internet interventions. The effectiveness of the intervention was not differentially associated with recruitment source (treatment by recruitment source interaction=0.28, p=0.84). Our results support the hypothesis that the intervention we studied is effective across different recruitment sources including clinical settings. ClinicalTrials.gov NCT01636752.",28710212,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.419147491455078,-3.23732328414917,BZxa
"Web-Based Cognitive Behavioral Therapy Blended With Face-to-Face Sessions for Major Depression: Randomized Controlled Trial.

Meta-analyses of several randomized controlled trials have shown that cognitive behavioral therapy (CBT) has comparable efficacy to antidepressant medication, but therapist availability and cost-effectiveness is a problem. This study aimed to evaluate the effectiveness of Web-based CBT blended with face-to-face sessions that reduce therapist time in patients with major depression who were unresponsive to antidepressant medications. A 12-week, assessor-masked, parallel-group, waiting- list controlled, randomized trial was conducted at 3 medical institutions in Tokyo. Outpatients aged 20-65 years with a primary diagnosis of major depression who were taking ≥1 antidepressant medications at an adequate dose for ≥6 weeks and had a 17-item GRID-Hamilton Depression Rating Scale (HAMD) score of ≥14 were randomly assigned (1:1) to blended CBT or waiting-list groups using a computer allocation system, stratified by the study site with the minimization method, to balance age and baseline GRID-HAMD score. The CBT intervention was given in a combined format, comprising a Web-based program and 12 45-minute face-to-face sessions. Thus, across 12 weeks, a participant could receive up to 540 minutes of contact with a therapist, which is approximately two-thirds of the therapist contact time provided in the conventional CBT protocol, which typically provides 16 50-minute sessions. The primary outcome was the alleviation of depressive symptoms, as measured by a change in the total GRID-HAMD score from baseline (at randomization) to posttreatment (at 12 weeks). Moreover, in an exploratory analysis, we investigated whether the expected positive effects of the intervention were sustained during follow-up, 3 months after the posttreatment assessment. Analyses were performed on an intention-to-treat basis, and the primary outcome was analyzed using a mixed-effects model for repeated measures. We randomized 40 participants to either blended CBT (n=20) or waiting-list (n=20) groups. All patients completed the 12-week treatment protocol and were included in the intention-to-treat analyses. Participants in the blended CBT group had significantly alleviated depressive symptoms at week 12, as shown by greater least squares mean changes in the GRID-HAMD score, than those in the waiting list group (-8.9 points vs -3.0 points; mean between-group difference=-5.95; 95% CI -9.53 to -2.37; P<.001). The follow-up effects within the blended CBT group, as measured by the GRID-HAMD score, were sustained at the 3-month follow-up (week 24) and posttreatment (week 12): posttreatment, 9.4 (SD 5.2), versus follow-up, 7.2 (SD 5.7); P=.009. Although our findings warrant confirmation in larger and longer term studies with active controls, these suggest that a combined form of CBT is effective in reducing depressive symptoms in patients with major depression who are unresponsive to antidepressant medications. University Hospital Medical Information Network Clinical Trials Registry: UMIN000009242; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000010852 (Archived by WebCite at http://www.webcitation. org/729VkpyYL).",30249583,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.478849411010742,-3.0479588508605957,BFtw
"Cost effectiveness of guided Internet-based interventions for depression in comparison with control conditions: An individual-participant data meta-analysis.

There is limited evidence on the cost effectiveness of Internet-based treatments for depression. The aim was to evaluate the cost effectiveness of guided Internet-based interventions for depression compared to controls. Individual-participant data from five randomized controlled trials (RCT), including 1,426 participants, were combined. Cost-effectiveness analyses were conducted at 8 weeks, 6 months, and 12 months follow-up. The guided Internet-based interventions were more costly than the controls, but not statistically significant (12 months mean difference = €406, 95% CI: - 611 to 1,444). The mean differences in clinical effects were not statistically significant (12 months mean difference = 1.75, 95% CI: - .09 to 3.60 in Center for Epidemiologic Studies Depression Scale [CES-D] score, .06, 95% CI: - .02 to .13 in response rate, and .00, 95% CI: - .03 to .03 in quality-adjusted life-years [QALYs]). Cost-effectiveness acceptability curves indicated that high investments are needed to reach an acceptable probability that the intervention is cost effective compared to control for CES-D and response to treatment (e.g., at 12-month follow-up the probability of being cost effective was .95 at a ceiling ratio of 2,000 €/point of improvement in CES-D score). For QALYs, the intervention's probability of being cost effective compared to control was low at the commonly accepted willingness-to-pay threshold (e.g., at 12-month follow-up the probability was .29 and. 31 at a ceiling ratio of 24,000 and 35,000 €/QALY, respectively). Based on the present findings, guided Internet-based interventions for depression are not considered cost effective compared to controls. However, only a minority of RCTs investigating the clinical effectiveness of guided Internet-based interventions also assessed cost effectiveness and were included in this individual-participant data meta-analysis.",29329486,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.624131202697754,-3.2648720741271973,BRjZ
"Psychotherapies for adult depression: recent developments.

Much has been learned from the 400 randomized trials on psychotherapies for adult depression that have been conducted, but much is also still unknown. In this study some recent attempts to further reduce the disease burden of depression through psychotherapies are reviewed. In the past, many new psychotherapies have promised to be more effective than existing treatments, usually without success. We describe recent research on two new therapies, acceptance and commitment therapy and cognitive bias modification, and conclude that both have also not shown to be more effective than existing therapies. A growing number of studies have also focused on therapies that may be successful in further reducing the disease burden, such as treatments for chronic depression and relapse prevention. Other studies are aimed at scaling up psychological services, such as the training of lay health counselors in low-income and middle-income countries, telephone-based, and internet-based therapies. Psychotherapies are essential tools in the treatment of adult depression. Randomized trials have shown that these treatments are effective, and by focusing on key issues, such as chronic depression, relapse, and scaling them up, psychotherapies contribute more and more to the reduction of the disease burden of depression.",25415495,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.727131843566895,-2.265277147293091,CFu2
"A four-session acceptance and commitment therapy based intervention for depressive symptoms delivered by masters degree level psychology students: a preliminary study.

Depressive symptoms are one of the main reasons for seeking psychological help. Shorter interventions using briefly trained therapists could offer a solution to the ever-rising need for early and easily applicable psychological treatments. The current study examines the effectiveness of a four-session Acceptance and Commitment Therapy (ACT) based treatment for self-reported depressive symptoms administered by Masters level psychology students. This paper reports the effectiveness of a brief intervention compared to a waiting list control (WLC) group. Participants were randomized into two groups: ACT (n = 28) and waiting list (n = 29). Long-term effects were examined using a 6-month follow-up. The treatment group's level of depressive symptoms (Beck Depression Inventory) decreased by an average of 47%, compared to an average decrease of 4% in the WLC group. Changes in psychological well-being in the ACT group were better throughout, and treatment outcomes were maintained after 6 months. The posttreatment ""between-group"" and follow-up ""with-in group"" effect sizes (Cohen's d) were large to medium for depressive symptoms and psychological flexibility. The results support the brief ACT-based intervention for sub-clinical depressive symptoms when treatment was conducted by briefly trained psychology students. It also contributes to the growing body of evidence on brief ACT-based treatments and inexperienced therapists.",24229795,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,7.985076427459717,-1.7250958681106567,CWHJ
"Behavioral activation versus treatment as usual in naturalistic sample of psychiatric patients with depressive symptoms: a benchmark controlled trial.

More systematic use of evidence-based brief therapies is needed in the treatment of depression within psychiatric care. The aim of this study was to explore the impact of behavioral activation therapy (BA) for patients with depressive symptoms in a routine clinical setting of secondary psychiatric care. The BA-treated intervention group (n =242) comprised patients with depressive symptoms (Beck Depression Inventory (BDI) score ≥ 17 at baseline). The control group (n =205) patients received treatment as usual in the same catchment area. The groups were matched at baseline using BDI and Alcohol Use Disorders Identification Test scores and inpatient/outpatient status. The groups were compared at 6-, 12- and 24-month follow-up points on functional outcome (Global Assessment of Functioning scale), service use, dropout and deaths. The Montgomery-Åsberg Depression Rating Scale was used to assess depressive symptoms in the intervention group. The estimated difference in GAF score between intervention and control group patients was significant at 12- and 24-months follow-up points in favor of intervention group (GAF score difference 4.85 points, p =0.006 and 5.71 points, p =0.005, respectively; estimate for patient group 2.26, p =0.036). The rates of dropout, mortality and service use were similar between the groups. Among the intervention group patients, the estimated improvement in MADRS score compared to baseline was statistically significant throughout the follow-up (p <0.001 at all follow-up points). The systematic use of BA among secondary psychiatric care depressive patients provides encouraging results despite the patients had various comorbid non-psychotic disorders. ClinicalTrials.gov , Identifier NCT02520271, Release Date: 06/27/2015, retrospectively registered.",30049272,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.604479789733887,-2.0200300216674805,BIZy
"[The efficacy of psychopharmacotherapy of late onset depression: the optimization of treatment duration].

To analyze possibilities of using different methods to increase the efficacy of psychopharmacotherapy of late onset depression, in particular to increase treatment duration. The study included 378patients, aged from 50 to 82 years (mean age 60.6±8.4). Patients were stratified into groups with short (4--8 weeks), moderate (12 weeks) and long (20-34 weeks) duration of psychopharmacotherapy. Treatment effect was much lower after <8 weeks of treatment compared with that after 12 weeks (the comparison of these groups was not available because the initial samples were not). To the 24th week, 63.9% of the patients responded to treatment, 43.4% achieved remission. Partial response and stable positive dynamics to the 12th week (about ½ of the patients achieved remission) were predictors of response with treatment duration <24 weeks. Based on the results obtained, the authors developed algorithms for choosing treatment tactics in patients with late onset depression in dependence of the results of the first 12 weeks of psychopharmacotherapy.",27240043,Major Depressive Disorder,Anxiety Treatment,Mental Health,21353,10.112010955810547,-0.6244969367980957,BsH+
"Whole-body cryotherapy - promising add-on treatment of depressive disorders.

New, effective biological interventions for treatment of depressive episodes and recurrent depression are still needed. Whole-body cryotherapy (WBC), which is a treatment using cryogenic temperature, is a novel therapeutic modality in neurology and rheumatology. The objective of this study was to determine the efficacy and safety of WBC as an add-on treatment for depressive episode. 30 adults diagnosed with depressive episode were recruited to an observational, prospective study. 21 participants (17 women, 81%), mean age 46.1 (±16.7), completed the whole study procedure. The Hamilton Depression Rating Scale and the Beck Depression Inventory were used to assess the severity of depressive symptoms. Additionally, quality of life and anhedonia were assessed with the WHOQoL-BREF and the SHAPS. Participants undertook 10, 2-minute (from - 110 C to - 135 degrees C) WBC sessions within two weeks. Patients after WBC sessions showed significant improvement in the form of a reduction in total scores in scales assessing depressive symptoms: the HDRS (p< 0.00001) between T1 (16.94±4.3) and T4 (4.50±4.2) and the BDI-II (T1: 13.48±4.6; T4: 6.14±6.7, p<0.03), lower anhedonialevelon SHAPS (p =0.011) and higher quality of lifein thefollowing domains: physical health (p =0.024), psychological health (p =0.016) and environmental domain (p =0.003). Pre/post comparison of self-report well-being measured by the VAS scale showed a significant increase (p< 0.00001). It was shown that WBC have no effect on the level of cytokines, NO, hsCRP, ESR and TAS in blood (p> 0.05). WBC proved to be an effective, safe, and tolerable add-on intervention in patients with depressive episode. Further randomized controlled trials should be conducted.",31955185,Major Depressive Disorder,Anxiety Treatment,Mental Health,17550,21.494596481323242,11.359715461730957,Autp
"A new approach on stress-related depression and anxiety: Neuro-Psycho- Physical-Optimization with Radio Electric Asymmetric-Conveyer.

Chronic social stress is an important factor responsible for the worsening of depressive disorders in humans. In this study we present the relational Neuro-Psycho-Physical Optimization (NPPO) with Radio Electric Asymmetric Conveyer (REAC-CRM) as the treatment to tackle the unconscious dysfunction adjustments carried out by the central nervous system as a response to environmental stresses. Psychological stress was measured in a group of 888 patients using the Psychological Stress Measure (PSM) test, a self-administered questionnaire. Data were collected immediately before and after the 4-wk therapy cycle. The detection of anxiety and depression clusters by PSM test has been based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, APA, 2000) criteria. Six hundred and eighty eight patients (212 males, 476 females, average PSM test total scores 107.9 +/- 23.13) were treated with REAC-CRM therapy; 200 (64 males, 136 females, average PSM test total scores 107.86 +/- 25.80) were treated with ""placebo REAC-CRM therapy""and used as control. This study showed a significant reduction in scores measuring subjective perceptions of stress in the patients treated with a cycle of REAC-CRM therapy. At the end-point the number of patients reporting symptoms of stress-related anxiety and depression on the PSM test was significantly reduced (P<0.001); in the placebo group no significant difference was highlighted. NPPO therapy with a cycle of REAC-CRM was shown to reduce subjective perceptions of stress measured by the PSM test and in particular, symptoms of stress-related anxiety and depression.",20716819,Major Depressive Disorder,Anxiety Treatment,Mental Health,12534,20.89621925354004,12.481643676757812,DGxk
"Clinical efficacy of trauma-focused psychotherapies in treatment-resistant depression (TRD) in-patients: A randomized, controlled pilot-study.

In major depressive disorder (MDD) patients, life stress events represent a risk factor for a severe, early-onset, treatment-resistant and chronic endophenotype. Treatment-resistant depression (TRD) patients who have experienced traumatic events could benefit from evidence-based trauma-focused psychotherapies. Because this topic has never been investigated, the aim of this pilot trial was to evaluate whether trauma-focused cognitive-behavioural therapy (TF-CBT) and/or eye movement desensitization and reprocessing (EMDR) can help achieve depressive symptom remission in TRD patients. We carried out a single-blind randomized controlled trial with TRD patients and we compared EMDR (N = 12) with TF-CBT (N = 10). Patients received 3 individual sessions per week over a period of 8 weeks. The symptomatological assessments were performed at 4 timepoints: baseline (T0), 4 (T4), 8 (T8) and 12 (T12) weeks. After 24 weeks, a clinical interview was carried out by phone. All TRD patients showed a significant improvement in depressive symptomatology; however, post hoc comparisons showed a significant difference between the two treatment groups, with lower depressive symptom scores in the EMDR than in the TF-CBT group at the follow-up (T12). This effect was partly maintained at 24 weeks. This pilot study suggests that evidence-based trauma-focused psychotherapies, particularly EMDR, can represent effective interventions to treat TRD patients.",30711853,Major Depressive Disorder,Anxiety Treatment,Mental Health,3392,19.200096130371094,-10.648452758789062,A/f3
"Vegetative symptoms and behaviour of the therapy-accompanying dog of a chronically suicidal patient.

We herein present a 51-year-old single female inpatient with treatment-resistant recurrent depressive disorder. Her most recent depressive episode has been severe and followed a chronic course, lasting for longer than 2years. During the exacerbation of the patient's suicidal thoughts and plans, we repeatedly and independently observed vegetative and behavioural changes of the therapy-accompanying dog of the patient. Our findings suggest a role for dog-assisted therapy for augmenting treatment as well as for enhancing and developing novel adjunctive strategies for risk assessment in patients with chronic depression and suicidality. Possible social-biological mechanisms and underpinnings are discussed, by drawing on the available literature and comparative psychology. Collaboration with animal behaviourists and animal welfare scientists, in order to improve behavioural and physiological data interpretation and humaneness of dog-assisted therapy, is emphasised as a crucial component of future research.",30150341,Major Depressive Disorder,Anxiety Treatment,Mental Health,9250,21.01072120666504,-8.16156005859375,BG/Q
"Guided self-help for depression in autistic adults: the ADEPT feasibility RCT.

Co-occurring depression frequently occurs in autism. Evidence-based psychological interventions have been successfully adapted to treat co-occurring anxiety, but there is little evidence about the usefulness of adapted cognitive-behavioural therapy for depression. To the authors' knowledge, to date there have been no randomised trials investigating the usefulness of low-intensity cognitive-behavioural therapy for depression in autism. The objectives of the study were to (1) develop a low-intensity psychological intervention for depression adapted for autism, (2) assess the feasibility and patient and therapist acceptability of the intervention, (3) estimate the rates of recruitment and retention for a full-scale randomised controlled trial and (4) identify an appropriate measure of depression to be used in a full-scale randomised controlled trial. The study comprised a randomised controlled trial (n=70) with a nested qualitative evaluation (n=21). Seventy eligible and consenting participants were randomly allocated to guided self-help or to treatment as usual. Adult autism services in two NHS regions. Adults with a diagnosis of autism spectrum disorder with depression, that is, a Patient Health Questionnaire-9 items score of ≥10. People who had attended more than six sessions of cognitive-behavioural therapy in the previous 6 months were excluded. The low-intensity intervention (guided self-help) comprised materials for nine individual sessions, based on behavioural activation adapted for autism, facilitated by therapist guides (coaches) who were graduate-level psychologists who attended training and regular supervision. Treatment as usual was standard NHS care for depression. Outcomes were measured 10, 16 and 24 weeks post randomisation using self-report and interview measures of depression, anxiety, obsessive-compulsive symptoms, social function and quality of life, and a health-care and service use questionnaire. As this was a feasibility study also designed to identify the most appropriate measure of depression, it was not possible to specify the primary outcome measure or outcome point a priori. The aims of the study were met in full. The guided self-help intervention was feasible and well received by participants and coaches. The majority of allocated participants attended the intervention in full. The most practical outcome point was determined to be 16 weeks. There were differential rates of attrition across the treatment groups: 86% of the guided self-help group remained in the study at 24 weeks, compared with 54% of treatment as usual group. The qualitative study suggested that guided self-help had enhanced credibility with participants at the point of randomisation. Inter-rater reliability of the interview measure of depression was less than adequate, limiting the conclusions that can be drawn from the prespecified sensitivity to change analyses. The intervention was feasible and well received. Although this feasibility study was not a fully powered trial, it provided some evidence that the guided self-help intervention was effective in reducing depressive symptoms. A full-scale clinical effectiveness and cost-effectiveness trial of the intervention is warranted. Improvements to the intervention materials as a result of qualitative interviews. Stakeholder consultation to consider future trial design, consider strategies to improve retention in a treatment as usual arm and select a self-report measure of depression to serve as the primary outcome measure. Current Controlled Trials ISRCTN54650760. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 68. See the NIHR Journals Library website for further project information. This study was also supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol.",31856942,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,22.00430679321289,-3.3232421875,Av/5
"Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting.

Depression is a severe mental disorder that challenges mental health systems worldwide as the success rates of all established treatments are limited. Eye Movement Desensitization and Reprocessing (EMDR) therapy is a scientifically acknowledged psychotherapeutic treatment for PTSD. Given the recent research indicating that trauma and other adverse life experiences can be the basis of depression, the aim of this study was to determine the effectiveness of EMDR therapy with this disorder. In this study, we recruited a group of 16 patients with depressive episodes in an inpatient setting. These 16 patients were treated with EMDR therapy by reprocessing of memories related to stressful life events in addition to treatment as usual (TAU). They were compared to a group of 16 controls matched regarding diagnosis, degree of depression, sex, age and time of admission to hospital, which were receiving TAU only. Sixty-eight percent of the patients in the EMDR group showed full remission at end of treatment. The EMDR group showed a greater reduction in depressive symptoms as measured by the SCL-90-R depression subscale. This difference was significant even when adjusted for duration of treatment. In a follow-up period of more than 1 year the EMDR group reported less problems related to depression and less relapses than the control group. EMDR therapy shows promise as an effective treatment for depressive disorders. Larger controlled studies are necessary to replicate our findings.",26085967,Major Depressive Disorder,Anxiety Treatment,Mental Health,3392,20.067428588867188,-10.928872108459473,B8JN
"Relationships among alexithymia, therapeutic alliance, and psychotherapy outcome in major depressive disorder.

Previous studies have found that alexithymia predicts process and outcome of psychodynamic psychotherapy across a range of psychiatric disorders. There is preliminary evidence that alexithymia may exert its effects on outcome through the therapist. Other studies have found that alexithymia does not influence outcome of cognitive-behavioral therapy (CBT). The aim of the current study was to investigate the capacity of alexithymia to predict therapist- and patient-rated therapeutic alliance and response to CBT and interpersonal psychotherapy (IPT) for major depressive disorder. A total of 75 adults with major depressive disorder were randomized to receive weekly sessions of manualized individual CBT or IPT for a period of 16 weeks. Pre-treatment alexithymia exhibited a positive direct effect on depression change, and a negative indirect effect on depression change via patient-rated alliance at week 13. There was no mediating role of therapist-rated alliance. Although these findings are preliminary, they suggest that pre-treatment alexithymia has meaningful links to psychotherapy process and outcome, and that nuanced analyses incorporating intervening variables are necessary to elucidate the nature of these links.",28456025,Major Depressive Disorder,Anxiety Treatment,Mental Health,4158,21.564634323120117,-7.146777629852295,BdSD
"BEAT-IT: Comparing a behavioural activation treatment for depression in adults with intellectual disabilities with an attention control: study protocol for a randomised controlled trial.

Depression appears to be more enduring amongst people with intellectual disabilities, suggesting that it is a more chronic problem or more poorly managed in this population. This is not helped by a lack of evidence about the effectiveness of psychological therapies for people who have intellectual disabilities and depression. Behavioural activation, which aims to counteract depression by increasing individuals' level of meaningful activity and their exposure to positive reinforcers, has proven to be as effective as cognitive behavioural therapy in the general population. Given that this therapy makes fewer communicative demands and focuses on activity, it was thought that behavioural activation would be both accessible and apt for people with intellectual disabilities, who are often socially marginalised. This study is a multi-centre single-blind randomised controlled trial of behavioural activation versus a self-help attention control intervention for depression in adults with mild/moderate intellectual disabilities. The study has an internal pilot in one centre, to establish that recruitment can be built up and sustained at the required level, before being rolled out across the other sites. One hundred sixty-six participants will be randomly assigned to the behavioural activation or self-help interventions, which will be delivered to individuals with mild to moderate intellectual disabilities, accompanied by someone who provides them with regular support. Both interventions are manualised and will be delivered over a period of approximately 4 months. The primary outcome measure will be the Glasgow Depression Scale, a self-report measure which is completed at baseline and 4 and 12 months post-randomisation. Secondary outcomes include measures of participants' activity levels, proxy reports of depressive symptoms, and cost-effectiveness. The study will provide evidence about the effectiveness of behavioural activation for depression, adapted for people who have mild/moderate intellectual disabilities, and will inform the delivery of psychological therapies to people with intellectual disabilities in practice. Date trial registered: Nov. 13, 2012; trial registration number: ISRCTN 09753005.",26714891,Major Depressive Disorder,Anxiety Treatment,Mental Health,4378,20.560688018798828,-4.639288902282715,BzPz
"Mechanisms of change in group therapy for treatment-seeking university students.

The present study examined mechanisms of change in dialectical behavior therapy (DBT) skills group and positive psychotherapy (PPT) group intervention, two treatments that have previously been shown to be effective at reducing symptoms of BPD and depression over a 12-week treatment protocol within the context of a college counseling center (Uliaszek et al., 2016). The present study is secondary data analysis of that trial. We hypothesized that change in dysfunctional coping skills use would be a specific mechanism for DBT, while change in functional coping skills use and therapeutic alliance would be mechanisms of change for both treatments. Fifty-four participants completed self-report and interview-based assessments at pretreatment, weeks 3, 6, 9, and posttreatment. Path models examined the predictive power of the mechanisms in predicting outcome; the moderating effect of group membership was also explored. Dysfunctional coping skills use across the course of treatment was a significant mechanism of change for BPD and depression for the DBT group, but not the PPT group. Conversely, therapeutic alliance was a significant mechanism of change for the PPT group, but not the DBT group. Findings highlight the importance of each mechanism during mid-to late-treatment specifically.",30077803,Major Depressive Disorder,Anxiety Treatment,Mental Health,423,18.999624252319336,-6.722315311431885,BH/k
"A feasibility study of behavioural activation for depressive symptoms in adults with intellectual disabilities.

Important work has been carried out adapting cognitive behavioural therapy for people with intellectual disabilities. However, there is a lack of alternative psychological therapies available for people with intellectual disabilities and emotional difficulties. Behavioural activation for depression is less reliant on verbal communication and focuses on increasing purposeful activity and reducing avoidance. This feasibility study involved the development and piloting of an adapted manual of behavioural activation for people with intellectual disabilities. The intervention consisted of 10-12 sessions and a key adaptation was that the therapist worked with the clients alongside a significant other in their life, either a paid carer or family member. Baseline, post-intervention (3 months after entering the study) and 6-month quantitative follow-up data were obtained. Primary outcome data were gathered, concerning depressive symptoms, participants' levels of activity and general well-being. Twenty-three adults with intellectual disabilities with symptoms of depression were recruited from specialist health services. In terms of acceptability, the behavioural activation intervention was well received and only two individuals dropped out, with a further two lost to follow-up. The main measures of depression appeared to be sensitive to change. Pre- to post-intervention data showed a significant reduction in self-report of depressive symptoms with a strong effect size (r = 0.78), that was maintained at follow-up (r = 0.86). Positive change was also obtained for informant reports of depressive symptoms from pre- to post-intervention, with a strong effect size (r = 0.7). Once again, this positive change was maintained at follow-up (r = 0.72). The study suggested that behavioural activation may be a feasible and worthwhile approach to tackling depression in people with intellectual disabilities. However, a randomised controlled trial would be required to establish its effectiveness, with more sensitive measurement of change in activity.",25496397,Major Depressive Disorder,Anxiety Treatment,Mental Health,4378,20.515474319458008,-4.639725685119629,CEgz
"Effect of the EMDR psychotherapeutic approach on emotional cognitive processing in patients with depression.

The current investigation, framed within the emotional cognitive science field, was conducted with three patients with major depression. They participated in a therapeutic process which involved EMDR (Eye Movement Desensitization and Reprocessing). Data were obtained in the clinical practice through a longitudinal one subject study design, including: emotional valence identification within affective priming experiments; and depressive emotional representation studies, the data of which was analyzed using multidimensional scaling. The first ones had the purpose of observing the therapeutic impact over the emotional cognitive bias mechanism regarding depresogenic words related to traumatic experiences; and the second, to analyze modifications on depressive schemata. The results showed that EMDR had a positive effect both on emotional cognitive processing and on long-term memory conceptual organization. In the discussion section, interesting remarks are made on the incorporation of emotional cognitive science tools to the EMDR clinical practice.",20480706,Major Depressive Disorder,Anxiety Treatment,Mental Health,3392,20.036163330078125,-10.858970642089844,DKU2
"Comparison of behavioural activation with guided self-help for treatment of depression in adults with intellectual disabilities: a randomised controlled trial.

Psychological therapies are first-line interventions for depression, but existing provision is not accessible for many adults with intellectual disabilities. We investigated the clinical and cost-effectiveness of a behavioural activation intervention (BeatIt) for people with intellectual disabilities and depression. BeatIt was compared with a guided self-help intervention (StepUp). We did a multicentre, single-blind, randomised, controlled trial with follow-up at 4 months and 12 months after randomisation. Participants aged 18 years or older, with mild to moderate intellectual disabilities and clinically significant depression were recruited from health and social care services in the UK. The primary outcome was the Glasgow Depression Scale for people with a Learning Disability (GDS-LD) score at 12 months. Analyses were done on an intention-to-treat basis. This trial is registered with ISCRTN, number ISRCTN09753005. Between Aug 8, 2013, and Sept 1, 2015, 161 participants were randomly assigned (84 to BeatIt; 77 to StepUp); 141 (88%) participants completed the trial. No group differences were found in the effects of BeatIt and StepUp based on GDS-LD scores at 12 months (12·03 [SD 7·99] GDS-LD points for BeatIt vs 12·43 [SD 7·64] GDS-LD points for StepUp; mean difference 0·26 GDS-LD points [95% CI -2·18 to 2·70]; p=0·833). Within-group improvements in GDS-LD scores occurred in both groups at 12 months (BeatIt, mean change -4·2 GDS-LD points [95% CI -6·0 to -2·4], p<0·0001; StepUp, mean change -4·5 GDS-LD points [-6·2 to -2·7], p<0·0001), with large effect sizes (BeatIt, 0·590 [95% CI 0·337-0·844]; StepUp, 0·627 [0·380-0·873]). BeatIt was not cost-effective when compared with StepUp, although the economic analyses indicated substantial uncertainty. Treatment costs were only approximately 3·6-6·8% of participants' total support costs. No treatment-related or trial-related adverse events were reported. This study is, to our knowledge, the first large randomised controlled trial assessing individual psychological interventions for people with intellectual disabilities and mental health problems. These findings show that there is no evidence that BeatIt is more effective than StepUp; both are active and potentially effective interventions. National Institute for Health Research.",29153873,Major Depressive Disorder,Anxiety Treatment,Mental Health,4378,21.114604949951172,-4.123349666595459,BT+e
"Rational emotive health therapy for the management of depressive symptoms among parents of children with intellectual and reading disabilities in English language.

There is little data in developing countries such as Nigeria with regard to the impact of caring for their children with intellectual and reading disability (IRD) on the quality of life of the parents and the risk of psychopathology. The main objective of the study was to assess the level of psychopathology, i.e., depression among parents of children with intellectual and reading disabilities. This was pretest/posttest control group design with 198 parents (99 fathers/99 mothers) of 100 children with the diagnosis of IRD. The measures used in this study for data collection was Beck Depression Inventory (BDI). Repeated measures analysis of variance (ANOVA) was employed for data analysis. Result obtained showed a significant high proportion of depressive symptoms among parents of children with intellectual and reading disabilities at initial assessment. Furthermore, the REHT intervention resulted in a significant reduction in depression of parents in treatment group as compared to those in the control group. The presence of a child with intellectual and reading disabilities does not cause parents to become depressed but irrational beliefs about their children's mental and reading deficiencies may contribute to unhealthy thinking and feelings about the future of their children. REHT is very effective in assisting depressed parents of children with intellectual and reading disabilities to think rationally about their children and work towards overcoming disability-related as well as behavior-related irrational beliefs. The mental health providers, therapists and counselors should apply the REHT in managing people with psychological distress especially parents of children with intellectual and reading disabilities who may have psychological diagnosis of depression.",35960096,Major Depressive Disorder,Anxiety Treatment,Mental Health,2500,20.50224494934082,-4.725162506103516,Lso
"EMDR as a treatment for long-term depression: A feasibility study.

Current treatments for long-term depression - medication and psychotherapy - are effective for some but not all clients. New approaches need to be developed to complement the ones already available. This study was designed to test the feasibility of using an effective post-traumatic stress disorder treatment for people with long-term depression. A single-case experimental design with replications was undertaken as a feasibility study of eye movement desensitization and reprocessing (EMDR) in treating long-term depression. Thirteen people with recurrent and/or long-term depression were recruited from primary care mental health services and given standard protocol EMDR for a maximum of 20 sessions. Levels of depression were measured before and after treatment and at follow-up, clients also rated their mood each day. Eight people engaged with the treatment; seven of these had clinically significant and statistically reliable improvement on the Hamilton Rating Scale for Depression. Daily mood ratings were highly variable both during baseline and intervention. EMDR is a feasible treatment for recurrent and/or long-term depression. Research on treatment efficacy and effectiveness is now required. EMDR may be an effective treatment for depression. EMDR could be considered if first-line approaches (CBT and counselling) have been tried and failed. EMDR may be particularly helpful for service users with a history of trauma.",28834138,Major Depressive Disorder,Anxiety Treatment,Mental Health,3392,19.674835205078125,-10.776444435119629,BYCi
"Refractory depression: mechanisms and evaluation of radically open dialectical behaviour therapy (RO-DBT) [REFRAMED]: protocol for randomised trial.

Only 30-40% of depressed patients treated with medication achieve full remission. Studies that change medication or augment it by psychotherapy achieve only limited benefits, in part because current treatments are not designed for chronic and complex patients. Previous trials have excluded high-risk patients and those with comorbid personality disorder. Radically Open Dialectical Behaviour Therapy (RO-DBT) is a novel, transdiagnostic treatment for disorders of emotional over-control. The REFRAMED trial aims to evaluate the effectiveness and cost-effectiveness of RO-DBT for patients with treatment-resistant depression. REFRAMED is a multicentre randomised controlled trial, comparing 7months of individual and group RO-DBT treatment with treatment as usual (TAU). Our primary outcome measure is depressive symptoms 12months after randomisation. We shall estimate the cost-effectiveness of RO-DBT by cost per quality-adjusted life year. Causal analyses will explore the mechanisms by which RO-DBT is effective. The National Research Ethics Service (NRES) Committee South Central - Southampton A first granted ethical approval on 20 June 2011, reference number 11/SC/0146. ISRCTN85784627.",26187121,Major Depressive Disorder,Anxiety Treatment,Mental Health,423,19.40134048461914,-6.934896945953369,B6uJ
"Do anxiety and depression symptoms moderate the effect of motivational enhancement therapy as a pretreatment to dialectical behaviour therapy skills training? A follow-up analysis of a pilot randomised controlled trial for youth.

We conducted a follow-up analysis of a pilot randomised controlled trial to examine whether baseline depression and anxiety symptoms moderated the impact of a motivational enhancement therapy (MET) pretreatment to dialectical behaviour therapy skill training (DBT-ST) for EA experiencing emotion dysregulation. All participants completed a 12-week DBT-ST group intervention and participants in the MET/DBT-ST condition also completed a 4-week group MET pretreatment. Nineteen MET/DBT-ST participants and 26 DBT-ST only participants completed the treatment as per protocol. Baseline anxiety and depression symptoms moderated the impact of the MET pretreatment for participants' reductions in emotion dysregulation and psychological distress, respectively, at a 3-month follow-up: participants with more severe baseline symptoms benefited more from the pretreatment. However, baseline symptoms did not moderate the effect of MET immediately after treatment. These results identified for whom MET is most effective as a pretreatment for DBT-ST amongst a heterogenous sample of EA in a real-world setting.",34816601,Major Depressive Disorder,Anxiety Treatment,Mental Health,18764,19.250919342041016,-6.883119583129883,1dE
"Farm animal-assisted intervention: relationship between work and contact with farm animals and change in depression, anxiety, and self-efficacy among persons with clinical depression.

Fourteen adults with clinical depression participated twice a week in a 12-week farm animal-assisted intervention consisting of work and contact with dairy cattle. Each participant was video-recorded twice during the intervention, and the recordings were categorized with respect to various work tasks and animal and human contact. Levels of anxiety and depression decreased and self-efficacy increased during the intervention. Interaction with farm animals via work tasks showed a greater potential for improved mental health than via sole animal contact, but only when progress in working skills was achieved, indicating the role of coping experiences for a successful intervention.",21767251,Major Depressive Disorder,Anxiety Treatment,Mental Health,7384,20.50853729248047,-8.118083000183105,C5tE
"Behavioural activation versus guided self-help for depression in adults with learning disabilities: the BeatIt RCT.

Depression is the most prevalent mental health problem among people with learning disabilities. The trial investigated the clinical effectiveness and cost-effectiveness of behavioural activation for depression experienced by people with mild to moderate learning disabilities. The intervention was compared with a guided self-help intervention. A multicentre, single-blind, randomised controlled trial, with follow-up at 4, 8 and 12 months post randomisation. There was a nested qualitative study. Participants were recruited from community learning disability teams and services and from Improving Access to Psychological Therapies services in Scotland, England and Wales. Participants were aged ≥18 years, with clinically significant depression, assessed using the Diagnostic Criteria for Psychiatric Disorders for use with Adults with Learning Disabilities. Participants had to be able to give informed consent and a supporter could accompany them to therapy. BeatIt was a manualised behavioural activation intervention, adapted for people with learning disabilities and depression. StepUp was an adapted guided self-help intervention. The primary outcome measure was the Glasgow Depression Scale for people with a Learning Disability (GDS-LD). Secondary outcomes included carer ratings of depressive symptoms and aggressiveness, self-reporting of anxiety symptoms, social support, activity and adaptive behaviour, relationships, quality of life (QoL) and life events, and resource and medication use. There were 161 participants randomised (BeatIt, n=84; StepUp, n=77). Participant retention was strong, with 141 completing the trial. Most completed therapy (BeatIt: 86%; StepUp: 82%). At baseline, 63% of BeatIt participants and 66% of StepUp participants were prescribed antidepressants. There was no statistically significant difference in GDS-LD scores between the StepUp (12.94 points) and BeatIt (11.91 points) groups at the 12-month primary outcome point. However, both groups improved during the trial. Other psychological and QoL outcomes followed a similar pattern. There were no treatment group differences, but there was improvement in both groups. There was no economic evidence suggesting that BeatIt may be more cost-effective than StepUp. However, treatment costs for both groups were approximately only 4-6.5% of the total support costs. Results of the qualitative research with participants, supporters and therapists were in concert with the quantitative findings. Both treatments were perceived as active interventions and were valued in terms of their structure, content and perceived impact. A significant limitation was the absence of a treatment-as-usual (TAU) comparison. Primary and secondary outcomes, economic data and qualitative results all clearly demonstrate that there was no evidence for BeatIt being more effective than StepUp. Comparisons against TAU are required to determine whether or not these interventions had any effect. Current Controlled Trials ISRCTN09753005.",30265239,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,20.52381706237793,-4.6163716316223145,BFhN
"Do we need both cognitive and behavioural components in interventions for depressed mood in people with mild intellectual disability?

A growing literature suggests that people with mild intellectual disability (ID) who have depressed mood may benefit from cognitive-behavioural interventions. There has been some speculation regarding the relative merit of the components of this approach. The aim of this study was to compare (i) cognitive strategies; (ii) behavioural strategies; and (iii) combined cognitive-behavioural (CB) strategies on depressed mood among a sample of 70 individuals with mild ID. Staff from three participating agencies received training in how to screen individuals with mild ID for depressive symptoms and risk factors for depression. Depressive symptoms and negative automatic thoughts were assessed prior to and at the conclusion of the intervention, and at 6-month follow-up. The interventions were run in groups by the same therapist. A post-intervention reduction in depression scores was evident in participants of all three interventions, with no significant difference between groups. A significant reduction in negative automatic thoughts post-intervention was evident in the CB combination group and was maintained at follow-up. Examination of clinical effectiveness suggests some advantage of the CB combination in terms of improvement and highlights the possible short term impact of behavioural strategies in comparison with the longer-term potential of cognitive strategies. The findings support the use of group cognitive-behavioural interventions for addressing symptoms of depression among people with ID. Further research is necessary to determine the effectiveness of components.",24372867,Major Depressive Disorder,Anxiety Treatment,Mental Health,4378,20.764446258544922,-4.768417835235596,CUJb
"Psilocybin-assisted therapy for the treatment of resistant major depressive disorder (PsiDeR): protocol for a randomised, placebo-controlled feasibility trial.

Psilocybin-assisted therapy may be a new treatment for major depressive disorder (MDD), with encouraging data from pilot trials. In this trial (short name: PsiDeR) we aimed to test the feasibility of a parallel-group, randomised, placebo-controlled design. The primary outcomes in this trial are measures of feasibility: recruitment rates, dropout rates and the variance of the primary outcome measure of depression. We are recruiting up to 60 participants at a single centre in London, UK who are unresponsive to, or intolerant of, at least two evidence-based treatments for MDD. Participants are randomised to receive a single dosing session of 25mg psilocybin or a placebo. All participants receive a package of psychological therapy. The primary outcome measure for depression is the Montgomery Asberg Depression Rating Scale collected by blinded, independent raters. The primary endpoint is at 3 weeks, and the total follow-up is 6 weeks. With further informed consent, this study collects neuroimaging and omics data for mechanism and biomarker analyses and offers participants an open label extension consisting of a further, open label dose of 25mg of psilocybin. All participants will be required to provide written informed consent. The trial has been authorised by the National Research Ethics Committee (20-LO/0206), Health Research Authority (252750) and Medicine's and Healthcare Products Regulatory Agency (CTA 14523/0284/001-0001) in the UK. Dissemination of results will occur via a peer-reviewed publication and other relevant media. EUDRACT2018-003573-97; NCT04959253.",34853114,Major Depressive Disorder,Anxiety Treatment,Mental Health,10742,-1.0396524667739868,-8.060301780700684,0FU
"Psilocybin reduces symptoms in treatment resistant depression, trial results show.

",36411539,Major Depressive Disorder,Anxiety Treatment,Mental Health,10742,-0.9566987156867981,-8.016169548034668,A2M
"Additive effectiveness of contingency management on cognitive behavioural treatment for smokers with depression: Six-month abstinence and depression outcomes.

Depression and smoking co-occur at high rates and there is a lack of evidence on the efficacy of treatments specifically tailored to this population. This randomized controlled trial sought to compare the effectiveness of cognitive behavioural treatment (CBT) combined with behavioural activation (BA) and the same treatment protocol plus contingency management (CM). A sample of 120 adult smokers (70.8%: females) with severe depressive symptoms were randomly allocated to: CBT + BA (n = 60) or CBT + BA + CM (n = 60). Smoking and depression outcomes were reported at end of treatment, 1-, 2-, 3-, and 6-month follow-ups. Self-reported smoking status was biochemically verified, and depression was assessed using the Beck Depression Inventory-II. At end of treatment, the overall quit rate was 69.2% (83/120). CM showed an additive effect on CBT + BA in enhancing abstinence rates. The significant effect of group [F(1,155) = 9.55, p = .0024], time [F(4,96) = 7.93, p < .0001], and group by time interaction [F(4,96) = 6.12, p = .0002], indicated that CM is more effective for generating longer durations of abstinence beyond those of CBT+BA. All treatment conditions equally promoted sustained reductions in depression across time [F(1,111) = 0.53, p = .4665]. A greater number of days of continuous abstinence and lower depressive symptoms mutually influenced each other. Depressed smokers achieve high cessation rates without suffering negative mood changes. Quitting smoking is not detrimental and adding CM to CBT + BA enhances long-lasting abstinence rates while promoting large depression improvements.",31491583,Major Depressive Disorder,Anxiety Treatment,Mental Health,5333,-5.452387809753418,-9.13538932800293,A1CG
"The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials.

Poor diet can be detrimental to mental health. However, the overall evidence for the effects of dietary interventions on mood and mental well-being has yet to be assessed. We conducted a systematic review and meta-analysis examining effects of dietary interventions on symptoms of depression and anxiety. Major electronic databases were searched through March 2018 for all randomized controlled trials of dietary interventions reporting changes in symptoms of depression and/or anxiety in clinical and nonclinical populations. Random-effects meta-analyses were conducted to determine effect sizes (Hedges' g with 95% confidence intervals [CI]) for dietary interventions compared with control conditions. Potential sources of heterogeneity were explored using subgroups and meta-regression analyses. Results: Sixteen eligible randomized controlled trials (published in English) with outcome data for 45,826 participants were included; the majority of which examined samples with nonclinical depression (n = 15 studies). Nonetheless, dietary interventions significantly reduced depressive symptoms (g = 0.162, 95% CI = 0.055 to 0.269, p = 0.003). Similar effects were observed among high-quality trials (g = 0.171, 95% C.I.=0.057 to 0.286, p=0.003) and when compared with both inactive (g = 0.114, 95% C.I.=0.008 to 0.219, p=0.035) and active controls (g = 0.224, 95% C.I.= 0.052 to 0.397, p = 0.011). No effect of dietary interventions was observed for anxiety (k = 11, n = 2270, g = 0.085, 95% C.I. = -0.031 to 0.202, p=0.151). Studies with female samples observed significantly greater benefits from dietary interventions, for symptoms of both depression and anxiety. Dietary interventions hold promise as a novel intervention for reducing symptoms of depression across the population. Future research is required to determine the specific components of dietary interventions that improve mental health, explore underlying mechanisms, and establish effective schemes for delivering these interventions in clinical and public health settings. PROSPERO Online Protocol: CRD42018091256.",30720698,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,0.44000276923179626,-1.6363519430160522,A/X1
"Efficacy of a fasting-mimicking diet in functional therapy for depression: A randomised controlled pilot trial.

This randomized controlled trial examined the efficacy of adding a fasting-mimicking diet to a structured psychotherapy protocol for treating depression. Of 20 patients with depression, 10 were randomly assigned to psychotherapy and dieting (i.e., experimental group) and the other 10 to psychotherapy only (i.e., control group). Patients in both groups received 20 individual sessions of functional therapy along with nutrition consultation. Patients in the control group were instructed to maintain their usual daily diets. Both treatments were effective in reducing depression as well as increasing self-esteem and quality of life. The experimental group showed improved self-esteem and psychological quality of life as well as a reduction in their mean body mass index, in comparison to the control group. The study revealed initial evidence of the efficacy of combining psychotherapy with a fasting-mimicking diet to treat depression and its correlates.",32394438,Major Depressive Disorder,Anxiety Treatment,Mental Health,17326,-0.11126353591680527,-1.4571466445922852,ApRm
"Electroacupuncture and cognitive behavioural therapy for sub-syndromal depression among undergraduates: a controlled clinical trial.

Individuals with sub-syndromal depression (SSD) are at increased risk of incident depressive disorders; however, the ideal therapeutic approach to SSD remains unknown. To evaluate the effects of electroacupuncture (EA) and cognitive behavioural therapy (CBT), alone or in combination, on depressive symptoms. Undergraduate students with SSD were recruited and allocated to one of four groups based on their preferences: EA (n=6), CBT (n=10), EA+CBT (n=6), and untreated control (n=11) groups. Six weeks of treatment were provided in the first three groups. Clinical outcomes were measured using the 17-item Hamilton Depression (HAMD-17) rating scale, Center for Epidemiologic Depression (CES-D) scale, WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire, and clinical remission rate. All 33 subjects were included in an intent-to-treat analysis. Statistically significant improvements in HAMD-17, CES-D, and WHOQOL-BREF scores and a higher remission rate were found in the EA, CBT, and EA+CBT intervention groups compared with the control group (all p<0.05). No significant differences were found between the three intervention groups. HAMD-17 factor score analysis revealed that EA reduced sleep disturbance scores more than CBT or EA+CBT (p<0.05), and CBT reduced retardation scores more than EA (p<0.01). EA+CBT reduced anxiety/somatisation scores more than EA or CBT (p<0.05) and retardation scores more than EA (p<0.05). Early intervention may alleviate depressive symptoms in SSD. EA and CBT may have differential effects on certain symptoms. Combination therapy targeting both physical and psychological symptoms may represent an ideal strategy for SSD intervention. However, randomised trials with larger sample sizes are needed. ChiCTR-TRC-10000889; Results.",27083200,Major Depressive Disorder,Anxiety Treatment,Mental Health,13436,-3.418024778366089,9.353373527526855,BuK2
"Light therapy for preventing seasonal affective disorder.

Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This review - one of four reviews on efficacy and safety of interventions to prevent SAD - focuses on light therapy as a preventive intervention. Light therapy is a non-pharmacological treatment that exposes people to artificial light. Mode of delivery (e.g. visors, light boxes) and form of light (e.g. bright white light) vary. To assess the efficacy and safety of light therapy (in comparison with no treatment, other types of light therapy, second-generation antidepressants, melatonin, agomelatine, psychological therapies, lifestyle interventions and negative ion generators) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD. A search of the Specialised Register of the Cochrane Depression, Anxiety and Neuorosis Review Group (CCDANCTR) included all years to 11 August 2015. The CCDANCTR contains reports of relevant randomised controlled trials derived from EMBASE (1974 to date), MEDLINE (1950 to date), PsycINFO (1967 to date) and the Cochrane Central Register of Controlled Trails (CENTRAL). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Knowledge, The Cochrane Library and the Allied and Complementary Medicine Database (AMED) (to 26 May 2014). We also conducted a grey literature search and handsearched the reference lists of all included studies and pertinent review articles. For efficacy, we included randomised controlled trials on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. For adverse events, we also intended to include non-randomised studies. We intended to include studies that compared any type of light therapy (e.g. bright white light, administered by visors or light boxes, infrared light, dawn stimulation) versus no treatment/placebo, second-generation antidepressants (SGAs), psychological therapies, melatonin, agomelatine, lifestyle changes, negative ion generators or another of the aforementioned light therapies. We also planned to include studies that looked at light therapy in combination with any comparator intervention and compared this with the same comparator intervention as monotherapy. Two review authors screened abstracts and full-text publications against the inclusion criteria. Two review authors independently abstracted data and assessed risk of bias of included studies. We identified 2986 citations after de-duplication of search results. We excluded 2895 records during title and abstract review. We assessed 91 full-text papers for inclusion in the review, but only one study providing data from 46 people met our eligibility criteria. The included randomised controlled trial (RCT) had methodological limitations. We rated it as having high risk of performance and detection bias because of lack of blinding, and as having high risk of attrition bias because study authors did not report reasons for dropouts and did not integrate data from dropouts into the analysis.The included RCT compared preventive use of bright white light (2500 lux via visors), infrared light (0.18 lux via visors) and no light treatment. Overall, both forms of preventive light therapy reduced the incidence of SAD numerically compared with no light therapy. In all, 43% (6/14) of participants in the bright light group developed SAD, as well as 33% (5/15) in the infrared light group and 67% (6/9) in the non-treatment group. Bright light therapy reduced the risk of SAD incidence by 36%; however, the 95% confidence interval (CI) was very broad and included both possible effect sizes in favour of bright light therapy and those in favour of no light therapy (risk ratio (RR) 0.64, 95% CI 0.30 to 1.38). Infrared light reduced the risk of SAD by 50% compared with no light therapy, but in this case also the CI was too broad to allow precise estimations of effect size (RR 0.50, 95% CI 0.21 to 1.17). Comparison of both forms of preventive light therapy versus each other yielded similar rates of incidence of depressive episodes in both groups (RR 1.29, 95% CI 0.50 to 3.28). The quality of evidence for all outcomes was very low. Reasons for downgrading evidence quality included high risk of bias of the included study, imprecision and other limitations, such as self rating of outcomes, lack of checking of compliance throughout the study duration and insufficient reporting of participant characteristics.Investigators provided no information on adverse events. We could find no studies that compared light therapy versus other interventions of interest such as SGA, psychological therapies, melatonin or agomelatine. Evidence on light therapy as preventive treatment for patients with a history of SAD is limited. Methodological limitations and the small sample size of the only available study have precluded review author conclusions on effects of light therapy for SAD. Given that comparative evidence for light therapy versus other preventive options is limited, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences.",26558494,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.1122565269470215,4.990193843841553,B1Ug
"The effect of bright light therapy on depressive symptoms in adults with intellectual disabilities: Results of a multicentre randomized controlled trial.

Although a large number of adults with intellectual disabilities have depressive symptoms, non-pharmacological treatments are scarce. The present authors investigated whether bright light therapy (BLT) is effective in decreasing depressive symptoms compared to care as usual. This multicentre randomized controlled trial consisted of three study groups (10,000 lux BLT, dim light BLT and a no-BLT group). Participants received BLT for 30 min in the morning (14 consecutive days), additional to their regular care. Primary outcome was as follows: depressive symptoms measured with the ADAMS Depressive Mood subscale 1 week after the end of BLT (same time period in the no-BLT group). Forty-one participants were included in our trial. In both BLT groups, a significant decrease in depressive symptoms was seen. No significant differences were found between 10,000 lux BLT and no-BLT (p = .199) and no significant differences between dim light BLT and no-BLT (p = .451). A minimum amount of side effects and no adverse events were reported. In both BLT interventions, a decrease in depressive symptoms was seen. With 10,000 lux BLT, depressive symptoms decreased even below the clinical cut-off point, which makes BLT a promising intervention for clinical practice.",32583931,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.1141357421875,5.10475492477417,Am3z
"The effects of a psychoneuroimmunology (PNI) based lifestyle intervention in modifying the progression of depression in clinically depressed adults.

Uncontrolled stress can lead to poorly controlled upsurges of cortisol and deregulation of the hypothalamus pituitary-adrenal axis (HPA), thereby leading to major depression. Psychoneuroimmunology (PNI) is the area of medicine dealing with the bidirectional pathways connecting the influences of brain, neuroendocrine, and immune system. Individual PNI-based lifestyle interventions such as humor and guided imagery have been shown to modulate the stress response. However, researchers have not examined the composite effect of a PNI-based lifestyle intervention among clinically depressed adults. This randomized interventional study examined the composite effect(s) of a PNI-based lifestyle intervention: progressive muscle relaxation, spiritual guided imagery, and humor as an adjunct therapy to modifying the progression of depression. Forty-one participants recruited from doctors' offices in San Bernardino and Riverside counties in Southern California, were randomized into two groups: treatment (N = 20) and control (N = 21). For a period of three weeks, participants in the treatment group listened to a 12-minute progressive muscle relaxation and spiritual guided imagery CD daily and watched 10 minutes of humorous DVDs. Participants in both groups were also receiving cognitive behavioral therapy and pharmacotherapy. Depression, spirituality, humor, and stress were assessed at baseline and week 3. Depression significantly decreased from severe to mild from baseline to week 3 in the treatment group. Spirituality significantly increased in the treatment group but remained unchanged in the controls. These findings offer depressed patients alternative approaches to preventing complications and managing their illness in the context of whole-person lifestyle optimization and integration of mind-body-spirit.",22409094,Major Depressive Disorder,Anxiety Treatment,Mental Health,13905,6.261728763580322,6.615869998931885,CwMJ
"A systematic review and meta-analysis of randomized controlled trials of cognitive behavioral therapy for hemodialysis patients with depression.

The aim of this meta-analysis was to examine the efficacy of cognitive behavioral therapy (CBT) for hemodialysis patients with comorbid depression and to identify which other aspects, including anxiety and quality of life, can be improved through intervention. A systematic literature review was performed using multiple databases (PubMed, EMBase, PsycINFO, CENTRAL). The inclusion criteria included randomized controlled trials (RCTs) of CBT conducted in hemodialysis patients with depression. Study reporting quality was assessed with the Cochrane tool and Review Manager version 5.3 was used to obtain pooled results. Eight RCTs, with a total sample size of 540 participants, met the inclusion criteria. Compared with control groups, the CBT groups had statistically significant improvements in depression (standardized mean differences [SMD] = -0.68, 95% confidence interval [CI] (-0.94 to -0.42), P < .001), anxiety (SMD = -0.99, 95%CI (-1.99 to 0.00), P = .05) and quality of life (SMD = 0.34, 95%CI (0.13 to 0.54), P < .001). The results of this meta-analysis showed that CBT could have an effective role in reducing symptoms of depression and anxiety as well as improving quality of life in hemodialysis patients with comorbid depression.",31525637,Major Depressive Disorder,Anxiety Treatment,Mental Health,2177,4.175146102905273,-0.4905119240283966,A0kM
"Psychological therapies for preventing seasonal affective disorder.

Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions. To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second-generation antidepressants, light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving person-centred outcomes among adults with a history of SAD. We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non-randomised studies. We planned to include studies that compared psychological therapy versus no treatment, or any other type of psychological therapy, light therapy, second-generation antidepressants, melatonin, agomelatine or lifestyle changes. We also planned to compare psychological therapy in combination with any of the comparator interventions listed above versus no treatment or the same comparator intervention as monotherapy. Two review authors screened abstracts and full-text publications against the inclusion criteria, independently extracted data, assessed risk of bias, and graded the certainty of evidence. We identified 3745 citations through electronic searches and reviews of reference lists after deduplication of search results. We excluded 3619 records during title and abstract review and assessed 126 articles at full-text review for eligibility. We included one controlled study enrolling 46 participants. We rated this RCT at high risk for performance and detection bias due to a lack of blinding.The included RCT compared preventive use of mindfulness-based cognitive therapy (MBCT) with treatment as usual (TAU) in participants with a history of SAD. MBCT was administered in spring in eight weekly individual 45- to 60-minute sessions. In the TAU group participants did not receive any preventive treatment but were invited to start light therapy as first depressive symptoms occurred. Both groups were assessed weekly for occurrence of a new depressive episode measured with the Inventory of Depressive Syptomatology-Self-Report (IDS-SR, range 0-90) from September 2011 to mid-April 2012. The incidence of a new depressive episode in the upcoming winter was similar in both groups. In the MBCT group 65% of 23 participants developed depression (IDS-SR ≥ 20), compared to 74% of 23 people in the TAU group (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.30; 46 participants; very low quality-evidence).For participants with depressive episodes, severity of depression was comparable between groups. Participants in the MBCT group had a mean score of 26.5 (SD 7.0) on the IDS-SR, and TAU participants a mean score of 25.3 (SD 6.3) (mean difference (MD) 1.20, 95% CI -3.44 to 5.84; 32 participants; very low quality-evidence).The overall discontinuation rate was similar too, with 17% discontinuing in the MBCT group and 13% in the TAU group (RR 1.33, 95% CI 0.34 to 5.30; 46 participants; very low quality-evidence).Reasons for downgrading the quality of evidence included high risk of bias of the included study and imprecision.Investigators provided no information on adverse events. We could not find any studies that compared psychological therapy with other interventions of interest such as second-generation antidepressants, light therapy, melatonin or agomelatine. The evidence on psychological therapies to prevent the onset of a new depressive episode in people with a history of SAD is inconclusive. We identified only one study including 46 participants focusing on one type of psychological therapy. Methodological limitations and the small sample size preclude us from drawing a conclusion on benefits and harms of MBCT as a preventive intervention for SAD. Given that there is no comparative evidence for psychological therapy versus other preventive options, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences and other preventive interventions that are supported by evidence.",31124141,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.9339144229888916,4.776185989379883,A5/2
"Supporting antidepressant discontinuation: the development and optimisation of a digital intervention for patients in UK primary care using a theory, evidence and person-based approach.

We aimed to develop a digital intervention to support antidepressant discontinuation in UK primary care that is scalable, accessible, safe and feasible. In this paper, we describe the development using a theory, evidence and person-based approach. Intervention development using a theory, evidence and person-based approach. Primary Care in the South of England. Fifteen participants with a range of antidepressant experience took part in 'think aloud' interviews for intervention optimisation. Our digital intervention prototype (called 'ADvisor') was developed on the basis of a planning phase consisting of qualitative and quantitative reviews, an in-depth qualitative study, the development of guiding principles and a theory-based behavioural analysis. Our optimisation phase consisted of 'think aloud' interviews where the intervention was iteratively refined. The qualitative systematic review and in-depth qualitative study highlighted the centrality of fear of depression relapse as a key barrier to discontinuation. The quantitative systematic review showed that psychologically informed approaches such as cognitive-behavioural therapy were associated with greater rates of discontinuation than simple advice to reduce. Following a behavioural diagnosis based on the behaviour change wheel, social cognitive theory provided a theoretical basis for the intervention. The intervention was optimised on the basis of think aloud interviews, where participants suggested they like the flexibility of the system and found it reassuring. Changes were made to the tone of the material and the structure was adjusted based on this qualitative feedback. 'ADvisor' is a theory, evidence and person-based digital intervention designed to support antidepressant discontinuation. The intervention was perceived as helpful and reassuring in optimisation interviews. Trials are now needed to determine the feasibility, clinical and cost-effectiveness of this approach.",32152159,Major Depressive Disorder,Anxiety Treatment,Mental Health,4928,5.4048004150390625,2.0282835960388184,AsL9
"Outcome Variation in the Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder.

",26844797,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.8707830905914307,4.732735633850098,Bxh4
"The long-term effects of psychotherapy added to pharmacotherapy on morning to evening diurnal cortisol patterns in outpatients with major depression.

Psychotherapy added to pharmacotherapy results in greater improvement in clinical outcomes than does pharmacotherapy alone. However, few studies examined how psychotherapy coupled with pharmacotherapy could produce a long-term protective effect by improving the psychobiological stress response. The researchers recruited 63 subjects with major depressive disorder (MDD) in an outpatient department of psychiatry at a general hospital. The randomly assigned subjects formed 2 groups: 29 in combined therapy (COMB) and 34 in monotherapy (MT). The COMB included 8 weekly body-mind-spirit group psychotherapy sessions added to pharmacotherapy. MT consisted of pharmacotherapy only. The outcome measures, collected at the subjects' homes, included the Beck Depression Inventory II (BDI-II), the State Trait Anxiety Inventory (STAI) and salivary cortisol on awakening, 45 min after awakening, and at 12.00, 17.00 and 21.00 h. Evaluation of outcome measures was at baseline condition, and at months 2 (end of additional psychotherapy), 5 and 8. While the decreases in symptoms of depression were similar between COMB and MT (p > 0.05), the reductions in anxiety state were greater in COMB than in MT during the 8-month follow-up (p < 0.05). A steeper diurnal cortisol pattern more likely occurred in COMB than in MT in the 3 follow-up periods (p < 0.05, p <0.001 and p < 0.01). The superior outcomes of group psychotherapy added to pharmacotherapy for MDD outpatients could relate to decreasing the anxiety state and to producing long-term impacts on positive stress endocrine outcomes seen as a steeper diurnal cortisol pattern.",21389753,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,5.242313385009766,4.114980697631836,C+9S
"Bright Light Therapy to Treat Depression in Individuals with Mild/Moderate or Severe Dementia.

This secondary analysis examined whether the benefits of bright light therapy on depression are greater in persons with mild/moderate or severe dementia. Exploratory analyses were also conducted to determine if bright light treatment targets different depressive symptom clusters based on dementia severity. Analyses using total scores from the instruments, Depressive Symptom Assessment for Older Adults and the Cornell Scale for Depression in Dementia, showed that bright light exposure is an equally effective intervention for depression in persons with both mild/moderate and severe dementia. Analyses of individual depressive subscales revealed that for disagreeable behavior and sleep impairment, bright light therapy appears to have greater benefits in persons with severe dementia than for those with mild/moderate dementia. Overall, this investigation supports the use of bright light therapy to treat depression regardless of dementia severity.",29509051,Major Depressive Disorder,Anxiety Treatment,Mental Health,8268,-4.28318977355957,5.220767021179199,BPE1
"Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis (HD) patients.

",20224588,Major Depressive Disorder,Anxiety Treatment,Mental Health,2177,3.830848217010498,-0.5966719388961792,DM4s
"Adjunctive Bright Light Therapy for Non-Seasonal Major Depressive Disorder: A Randomized Controlled Trial.

This double-blind, randomized controlled trial assessed bright light therapy (BLT) augmentation efficacy compared with placebo light in treating non-seasonal major depressive disorder. The study participants belonged to a subtropical area (24.5°-25.5°N) with extensive daylight and included outpatients who had received stable dosages and various regimens of antidepressive agents for 4 weeks before enrollment. The outcomes were the 17-item Hamilton Depression Rating Scale, Montgomery-Asberg Depression Rating Scale, and Patient Health Questionnaire-9, which were assessed at weeks 1, 2, and 4. A total of 43 participants (mean age 45 years, ranging from 22-81) were randomized into the BLT [n = 22] and placebo light groups [n = 21]. After a 4-week administration of morning light therapy (30 min/day), depressive symptoms did not reduce significantly, which might be due to the small sample size. Nonetheless, this study had some strengths because it was conducted in warmer climates, unlike other studies, and examined diverse Asians with depression. Our findings suggest that several factors, such as poor drug response, different antidepressive regimens, duration of BLT, and daylength variability (i.e., natural daylight in the environment) may influence the utility of add-on BLT. Researchers may consider these important factors for future non-seasonal depression studies in subtropical environments.",36231728,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.295690536499023,5.05418062210083,ERU
"Patterns of depressive symptom remission during the treatment of seasonal affective disorder with cognitive-behavioral therapy or light therapy.

To elucidate mechanisms related to remission in winter seasonal affective disorder (SAD), we explored the course of individual depressive symptom offset across two distinct treatment modalities that show comparable outcomes at treatment endpoint: cognitive-behavioral therapy for SAD (CBT-SAD) and light therapy (LT). One hundred seventy-seven adults with SAD in a depressive episode were randomized to 6-weeks of CBT-SAD (n = 88) or LT (n = 89). Symptoms were assessed via the 29-item Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD Version (SIGH-SAD) at pretreatment and weekly during treatment. Survival analyses were conducted for the 17 SIGH-SAD items endorsed by more than 40 participants at pretreatment. Within each of the included symptoms, data from participants who endorsed the symptom at pretreatment and who had 3 or fewer weeks missing were included. For most (13/17; 76%) symptoms, CBT-SAD and LT did not differ in time to remission. However, for four symptoms (early insomnia, psychic anxiety, hypersomnia, and social withdrawal), LT led to symptom remission more quickly than CBT-SAD. Symptom remission progressed comparably across CBT-SAD and LT for most symptoms. Despite the fact that the two treatments led to similar remission rates and improvements at treatment endpoint, for early insomnia, psychic anxiety, hypersomnia, and social withdrawal, LT led to symptom remission faster than CBT-SAD. These results suggest different mechanisms and pathways to the same therapeutic end. Speedier remission of early insomnia and hypersomnia is consistent with the theory that SAD is related to a pathological circadian phase-shift that can be corrected with LT.",29659120,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.930729866027832,4.771790981292725,BNLP
"Do psychological interventions reduce depression in hemodialysis patients?: A meta-analysis of randomized controlled trials following PRISMA.

Depression is highly prevalent in hemodialysis patients and results in poor patient outcomes. Although psychological interventions are being developed and used for these patients, there is uncertainty regarding the effectiveness of these interventions. The purpose of this meta-analysis is to evaluate the effects of psychological interventions on depression treatment in hemodialysis patients. All randomized controlled trials (RCTs) relevant to the depression treatment of hemodialysis patients through psychological interventions were retrieved from the following databases: Embase, Pubmed, PsycINFO, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. The reference lists of identified RCTs were also screened. The Cochrane risk of bias tool was used to evaluate the quality of the studies, RevMan (5.3) was used to analyze the data, and the evidence quality of the combined results was evaluated using GRADE (3.6.1). Eight RCTs were included. The combined results showed that psychological interventions significantly reduced the scores of the Beck Depression Inventory (P<0.001) and interdialysis weight gain (P<0.001). However, due to the high heterogeneity, effect size combinations of sleep quality and quality of life were not performed. Psychological interventions may reduce the degree of depression and improve fluid intake restriction adherence. More rigorously designed research is needed.",27559971,Major Depressive Disorder,Anxiety Treatment,Mental Health,2177,3.864185094833374,-0.4977080523967743,BoKn
"Chronotherapy for the rapid treatment of depression: A meta-analysis.

Chronotherapy (sleep deprivation, sleep phase shifting and/or the use of bright light) combines non-invasive and non-pharmacological interventions that may act rapidly against depressive symptoms. However, to date no meta-analysis has been conducted to examine their effectiveness. We carried out meta-analysis of 16 studies (four randomised controlled trials and 12 open-label case series) with between-subject comparisons between experimental and control conditions for RCTs and within-subject comparisons between baseline and follow-up for all studies. Overall chronotherapy was generally superior to other therapies such as psychotherapy, antidepressants, exercise or light therapy alone after 5-7 days. For RCTs, chronotherapy was favoured (Hedge's g = 0.62, 95% CI 0.23-1.01) compared to control treatments such as antidepressants and exercise. 33.0% of patients were responders after 5-7 days in the chronotherapy group and 1.5% of patients in the control condition (OR = 7.58, 95% CI 2.03-28.28). For the case series, large effect sizes were found by 5-7 days (g = 1.78, 95% CI 1.49-2.07). In the case series, 61.6% of patients were classed as responders. The number of RCTs included in this meta-analysis was small, and the potential for risk of bias could not be ascertained accurately. One specific limitation is that studies nearly all included in-patients and the results may not be generalisable to out-patients, and nearly all the subjects lacked credibility ratings before receiving treatment. Chronotherapy appears to be effective and well-tolerated in depressed patients. Nevertheless, further clinical and cost effectiveness studies are needed.",31606606,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.612339973449707,4.902225971221924,Azgc
"Clinical Remission of Treatment-Resistant Depression, Polysubstance Abuse, and Antidepressant Discontinuation Syndrome Through Engagement of Lifestyle Interventions.

This case illustrates the relationship between gut, hormonal, and brain function in that dietary changes, mindfulness interventions, and detoxification led to resolution of disabling psychiatric symptoms and protracted psychotropic medication withdrawal symptoms. A 50-year-old partnered, unemployed, Caucasian female with a history of major depressive disorder, multiple suicide attempts, extensive trauma and abuse, and substance abuse presented for outpatient management. The patient reported limited benefit from over two decades of conventional treatment with psychotropic medications. She presented with depression and symptoms of protracted withdrawal after self-discontinuation of multiple psychiatric medications and was prescribed a dietary, detoxification, and supplementation regimen by the primary author. Additional lifestyle interventions implemented included daily meditation, dry-skin brushing, and coffee enemas. This case exemplifies dramatic clinical remission after cessation of medication treatment and engagement of lifestyle interventions, which include dietary change, meditation, and detoxification. As such, when limited results are achieved by psychotropic medication, tapering combined with dietary interventions as the first-line therapy should be considered. This case is also evidence of the role of lifestyle interventions in treating protracted withdrawal symptoms associated with discontinuing psychotropic medications.",33186128,Major Depressive Disorder,Anxiety Treatment,Mental Health,931,5.826731204986572,2.0568056106567383,AffY
"[Wake therapy for major depression].

Patients admitted with depression are highly tormented and many are suicidal. Standard treatment does not offer full effect until after several weeks. Wake therapy is a method that may reduce depressive symptoms within days. In this paper, the literature regarding wake therapy is reviewed. The response rates in wake therapy are high, but the effect is often transitory. However, recent studies indicate that wake therapy in combination with other chronotherapeutic interventions, e.g. light therapy, can produce a rapid and sustained antidepressant effect.",26376242,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.530873775482178,4.721048355102539,B3/U
"Effectiveness of a Guided Internet- and Mobile-Based Intervention for Patients with Chronic Back Pain and Depression (WARD-BP): A Multicenter, Pragmatic Randomized Controlled Trial.

There is neither strong evidence on effective treatments for patients with chronic back pain (CBP) and depressive disorder nor sufficiently available mental health care offers. The aim is to assess the effectiveness of internet- and mobile-based interventions (IMI) as a scalable approach for treating depression in a routine care setting. This is an observer-masked, multicenter, pragmatic randomized controlled trial with a randomization ratio of 1:1.Patients with CBP and diagnosed depressive disorder (mild to moderate severity) were recruited from 82 orthopedic rehabilitation clinics across Germany. The intervention group (IG) received a guided depression IMI tailored to CBP next to treatment-as-usual (TAU; including medication), while the control group (CG) received TAU. The primary outcome was observer-masked clinician-rated Hamilton depression severity (9-week follow-up). The secondary outcomes were: further depression outcomes, pain-related outcomes, health-related quality of life, and work capacity. Biostatistician blinded analyses using regression models were conducted by intention-to-treat and per protocol analysis. Between October 2015 and July 2017, we randomly assigned 210 participants (IG, n = 105; CG, n = 105), mostly with only a mild pain intensity but substantial pain disability. No statistically significant difference in depression severity between IG and CG was observed at the 9-week follow-up (β = -0.19, 95% CI -0.43 to 0.05). Explorative secondary depression (4/9) and pain-related (4/6) outcomes were in part significant (p < 0.05). Health-related quality of life was significantly higher in the IG. No differences were found in work capacity. The results indicate that an IMI for patients with CBP and depression in a routine care setting has limited impact on depression. Benefits in pain and health-related outcomes suggest that an IMI might still be a useful measure to improve routine care.",33321501,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,6.134027004241943,0.32514601945877075,Ad4d
"Creatine for the Treatment of Depression.

Depressed mood, which can occur in the context of major depressive disorder, bipolar disorder, and other conditions, represents a serious threat to public health and wellness. Conventional treatments are not effective for a significant proportion of patients and interventions that are often beneficial for treatment-refractory depression are not widely available. There is, therefore, an immense need to identify novel antidepressant strategies, particularly strategies that target physiological pathways that are distinct from those addressed by conventional treatments. There is growing evidence from human neuroimaging, genetics, epidemiology, and animal studies that disruptions in brain energy production, storage, and utilization are implicated in the development and maintenance of depression. Creatine, a widely available nutritional supplement, has the potential to improve these disruptions in some patients, and early clinical trials indicate that it may have efficacy as an antidepressant agent.",31450809,Major Depressive Disorder,Anxiety Treatment,Mental Health,7741,2.511305570602417,8.431551933288574,A1ip
"Cognitive predictors and moderators of winter depression treatment outcomes in cognitive-behavioral therapy vs. light therapy.

There is no empirical basis for determining which seasonal affective disorder (SAD) patients are best suited for what type of treatment. Using data from a parent clinical trial comparing light therapy (LT), cognitive-behavioral therapy (CBT), and their combination (CBT + LT) for SAD, we constructed hierarchical linear regression models to explore baseline cognitive vulnerability constructs (i.e., dysfunctional attitudes, negative automatic thoughts, response styles) as prognostic and prescriptive factors of acute and next winter depression outcomes. Cognitive constructs did not predict or moderate acute treatment outcomes. Baseline dysfunctional attitudes and negative automatic thoughts were prescriptive of next winter treatment outcomes. Participants with higher baseline levels of dysfunctional attitudes and negative automatic thoughts had less severe depression the next winter if treated with CBT than if treated with LT. In addition, participants randomized to solo LT who scored at or above the sample mean on these cognitive measures at baseline had more severe depressive symptoms the next winter relative to those who scored below the mean. Baseline dysfunctional attitudes and negative automatic thoughts did not predict treatment outcomes in participants assigned to solo CBT or CBT + LT. Therefore, SAD patients with extremely rigid cognitions did not fare as well in the subsequent winter if treated initially with solo LT. Such patients may be better suited for initial treatment with CBT, which directly targets cognitive vulnerability processes.",24211338,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.894071102142334,4.675876140594482,CWVB
"A sham-controlled randomized trial of adjunctive light therapy for non-seasonal depression.

The aim of the study was to examine the efficacy and safety of morning bright light therapy (BLT) in the treatment of patients with a current major depressive episode (MDE) in bipolar and unipolar disorder without a seasonal pattern. It was a randomized, sham-controlled trial. Adults, ages 18-70 years were randomized to treatment either with BLT or a sham negative ion generator (as a placebo control). The subjects were required to be on a stable and therapeutic dose of psychotropic medication for at least 4 weeks prior to enrollment and their treatment had to be insufficiently effective. Their clinical state was monitored at the baseline and at the end of treatment. The Hamilton Depression Rating Scale-21 items (HDRS-21), Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI-II), Clinical Global Impression-Severity (CGI-S) and Patient Global Impression (PGI) were used. The results were analyzed with an intention-to-treat (ITT) analysis. Ninety-five patients were enrolled (50 diagnosed with bipolar disorder and 45 with unipolar depression). Fifty-two patients were randomized to treatment with BLT and forty-three were in the placebo group (ITT population). Eighty-three subjects completed the study. There were 12 dropouts (5 in the light group and 7 in the placebo group). After 14 days of treatment, a significant improvement was found in all groups (p<0.001). The subjects treated with BLT did not significantly differ in terms of improvement in HDRS-21 scores at the endpoint when compared to patients treated with placebo (p=0.2). However, further analysis demonstrated significantly higher response (50% v. 27.9%, p=0.02) and remission rates (28.8% v. 11.6%, p=0.04) among patients treated with morning BLT when compared to placebo group. It should be noted that in the population of drug-resistant patients, BLT was more efficacious than placebo. There were no statistically significant differences between unipolar and bipolar disorders (p=0.4). Although overall improvement in HDRS-21 scores were not superior in the BLT group, both response and remission rates were significantly higher among patients treated with BLT relative to those receiving the sham intervention. BLT was also more efficacious than placebo in the population of patients with drug-resistant depression. Further studies to define the subpopulation of patients with non-seasonal depression who may benefit the most from BLT are needed.",27267951,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.190454483032227,5.07024621963501,Brvo
"Therapeutic Potential of Conjugated siRNAs for the Treatment of Major Depressive Disorder.

",27909316,Major Depressive Disorder,Anxiety Treatment,Mental Health,4605,4.552191734313965,8.415764808654785,Bj7i
"The duration of light treatment and therapy outcome in seasonal affective disorder.

Seasonal affective disorder (SAD) is characterized by recurrent episodes of major depression with a seasonal pattern, treated with light therapy (LT). Duration of light therapy differs. This study investigates retrospectively whether a single week of LT is as effective as two weeks, whether males and females respond differently, and whether there is an effect of expectations as assessed before treatment. 83 women, and 25 men received either one-week (n=42) or two weeks (n=66) of LT were included in three studies. Before LT, patients׳ expectations on therapy response were assessed. Depression severity was similar in both groups before treatment (F(1,106)=0.19ns) and decreased significantly during treatment (main effect ""time"" F(2,105)=176.7, p<0.001). The speed of therapy response differs significantly in treatment duration, in favor of 1 week (F(2,105)=3.2, p=0.046). A significant positive correlation between expectations and therapy response was found in women (ρ=0.243, p=0.027) and not in men (ρ=-0.154,ns). When expectation was added as a covariate in the repeated-measures analysis it shows a positive effect of the level of expectation on the speed of therapy response (F(2,104)=4.1, p=0.018). A limitation is the retrospective design. There is no difference between 1 and 2 weeks of LT in overall therapy outcome, but the speed of therapy response differed between 1 week LT and 2 weeks LT. Together with the significant correlation between expectations and therapy response in women, we hypothesize that expectations play a role in the speed of therapy response.",25012451,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.0484700202941895,4.813969135284424,CLb+
"Applying experimental therapeutics to examine cognitive and chronological vulnerabilities as mediators of acute outcomes in cognitive-behavioral therapy and light therapy for winter depression.

We applied the experimental therapeutics approach to test whether acute treatment outcomes for winter seasonal affective disorder (SAD) are mediated by a cognitive mechanism in cognitive-behavioral therapy (CBT-SAD) versus a chronobiologic mechanism in light therapy (LT). Currently depressed adults with major depression, recurrent with seasonal pattern (N = 177; 83.6% female, 92.1% non-Hispanic White, M age = 45.6) were randomized to 6 weeks of LT or group CBT-SAD. SAD symptoms were assessed weekly on the Structured Clinical Interview for the Hamilton Rating Scale for Depression-SAD Version. At pre-, mid-, and posttreatment, participants completed measures of general depressogenic cognitions (Dysfunctional Attitudes Scale; DAS); SAD-specific negative cognitions (Seasonal Beliefs Questionnaire; SBQ); chronotype (Morningness-Eveningness Questionnaire; MEQ); and depressive symptoms (Beck Depression Inventory-Second Edition). Parallel-process growth models showed evidence for hypothesized mechanisms. For SAD-specific negative cognitions (SBQ), both symptom measures showed (1) an effect of treatment group on the slope of the mediator, with CBT-SAD demonstrating greater decreases, and (2) an effect of the slope of the mediator on the slope of the outcome. These effects held for the SBQ but not the broader measure of depressogenic cognitions (DAS). For the chronotype measure (MEQ), treatment assignment affected change, whereby LT was associated with reduced ""eveningness,"" but this was unrelated to change in symptoms. CBT-SAD promoted decreases in SAD-specific negative cognitions, and these changes were related to decreases in symptoms. Consistent with the theory that LT corrects misaligned circadian rhythms, LT reduced eveningness, but this did not correspond to symptom improvement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",32700956,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.052850246429443,4.768383502960205,AlaM
"Bright Light Therapy as Augmentation of Pharmacotherapy for Treatment of Depression: A Systematic Review and Meta-Analysis.

Bright light therapy has demonstrated efficacy and is an accepted treatment for seasonal depression. It has been suggested that bright light therapy may have efficacy in nonseasonal depressions. Also, there is evidence that bright light therapy may improve responsiveness to antidepressant pharmacotherapy. We searched PubMed/MEDLINE, PsycINFO, PsycARTICLES, CINAHL, EMBASE, Scopus, and Academic OneFile for English-language literature published between January 1998 and April 2016, using the keywords bright light therapy AND major depression, bright light therapy AND depress*, bright light therapy AND bipolar depression, bright light therapy AND affective disorders, circadian rhythm AND major depression, circadian rhythm AND depress*, and circadian rhythm AND affective disorder. Studies that reported randomized trials comparing antidepressant pharmacotherapy with bright light therapy ≥ 5,000 lux for ≥ 30 minutes to antidepressant pharmacotherapy without bright light therapy for the treatment of nonseasonal depression were included. Studies of seasonal depression were excluded. Following review of the initial 112 returns, 2 of the authors independently judged each trial, applying the inclusionary and exclusionary criteria. Ten studies were selected as meeting these criteria. Subjects in these studies were pooled using standard techniques of meta-analysis. Ten studies involving 458 patients showed improvement using bright light therapy augmentation versus antidepressant pharmacotherapy alone. The effect size was similar to that of other accepted augmentation strategies, roughly 0.5. Analysis of pooled data from randomized trials provides evidence for the efficacy of use of bright light therapy ≥ 5,000 lux for periods ≥ 30 minutes when used as augmentation to standard antidepressant pharmacotherapy in the treatment of major depressive disorder and bipolar depression without a seasonal pattern.",27835725,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.21638822555542,4.980947017669678,Bk4M
"Is there a difference in clinical efficacy of bright light therapy for different types of depression? A pilot study.

There is growing interest in the possible applications of Bright Light Therapy (BLT). BLT might be a valid alternative or add-on treatment for many other psychiatric disorders beyond seasonal affective disorder. This pilot study aims to examine whether the efficacy of Bright Light Therapy (BLT) is similar for different subtypes of mood disorders. Participants were 48 newly admitted outpatients with major depressive disorder with either melancholic features (n=20) or atypical features (n=28). Morning BLT was administered daily for 30 min at 5.000-10.000 lx on working days for up to 3 consecutive weeks. Participants' depressive symptoms improved significantly after BLT (p<.05, d=-.53). The effects of BLT remained stable across a 4 week follow-up. There were no significant differences in efficacy of BLT between groups (p>.05). No effect of seasonality on the improvement in depressive symptoms after BLT was found, (p=.781). The study had a small sample size and lacked a control condition. This pilot study provides preliminary evidence that BLT could be a promising treatment for depression, regardless of the melancholic or atypical character of the depressive symptoms.",23972661,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.1009650230407715,5.057251930236816,CZnp
"Efficacy of Benson's Relaxation Technique on Anxiety and Depression among Patients Undergoing Hemodialysis: A Systematic Review.

This study aimed to evaluate the efficacy of Benson's relaxation technique on anxiety and depression among patients undergoing hemodialysis. A systematic review of randomized controlled trials was conducted. Searching databases included EBSCO Host, PubMed, ProQuest, Science Direct, Sage Journals, Ovid, and Google Scholar from January 2000 to September 2020. Five randomized controlled trials were identified. Findings revealed a statistically significant decrease in anxiety score. Concerning depression; one RCT showed a statistically significant decrease and two RCTs revealed a non-significant difference in depression level. The overall quality of the RCTs was not high. Despite that the RCTs showed benefits of BRT in managing anxiety. However, this is not the same for depression. The lack of high-quality scientific evidence supporting its retinue use indicates that additional well designed randomized controlled trials in multiple countries are warranted to support the efficacy of Benson's relaxation technique on anxiety and depression among patients undergoing hemodialysis.",34159828,Major Depressive Disorder,Anxiety Treatment,Mental Health,20722,3.848207473754883,-0.29255250096321106,AUW7
"Evaluation of self-esteem and depression symptoms in depressed and nondepressed subjects treated with onabotulinumtoxinA for glabellar lines.

Botulinum toxin type A (BoNT-A) injection has become the most popular cosmetic nonsurgical procedure, and it has been suggested that BoNT-A injections may improve emotional states when frown lines are treated. To evaluate symptoms of depression and self-esteem before and after onabotulinumtoxinA (ONA) injections in the glabella in subjects with and without depression. Twenty-five subjects with depression were allocated into one group and 25 subjects without depression were matched to those according to demographic characteristics. The Beck Depression Inventory (BDI) and Rosenberg Self-Esteem Scale (RSES) were used to assess depression symptoms and self-esteem, respectively. Patients were assessed up to 12 weeks after the intervention. Patients with depression had significant improvement in depression symptoms after ONA injections. The maximum effect occurred within the first 8 weeks after treatment. A significant reduction from baseline in BDI score and significant improvement in self-esteem were also observed in patients with depression. This research presents new data regarding BoNT-A as a potential treatment to improve depression symptoms in patients with Major Depressive Disorder. Self-esteem scores alone cannot explain the improvement in depression symptoms.",23465042,Major Depressive Disorder,Anxiety Treatment,Mental Health,7125,-5.435906410217285,-0.6019735932350159,ChDq
"Effects of Nursing Interventions on Depression of Patients With Rheumatoid Arthritis: A Meta-Analysis of Randomized Controlled Trials.

Previous randomized controlled trials have led to conflicting findings regarding the effects of nursing interventions on depression of patients with rheumatoid arthritis (RA). The purpose of this study was to use the meta-analytic approach to resolve these discrepancies. We performed a systematic search of publications using MEDLINE, EMBASE, the Cochrane Library, and manual searches without language restrictions. Studies that met the following criteria were included: (1) randomized controlled trials; (2) duration of intervention≥4 weeks; (3) comparative control group; (4) adults with RA; (5) published studies in any language since reception; and (6) psychological symptoms assessed. We extracted relative risks (RRs) and 95% confidence internals (CIs) and pooled them using a random effect model. We carried out sensitivity analysis and assessed heterogeneity and publication bias. A total of 14 studies, including 1803 patients, were eligible for inclusion in the review. Depression symptom was assessed by questionnaires. In the pooled analysis, nursing interventions, including exercise training, medication guide, health education and psychotherapy were associated with the remission of depression (RR: -0.67; 95% CI: -0.89 to -0.46; P<0.01) with significant heterogeneity between studies (P<0.01). Nursing interventions may be important adjunctive therapies in the medical management of RA patients.",27888965,Major Depressive Disorder,Anxiety Treatment,Mental Health,4559,4.913862228393555,-0.5211455225944519,BkMf
"[Triple Chronotherapy approach for reducing depressive symptoms and suicidal intent in hospitalized patients: Study protocol of a Randomized Controlled Trial].

Depressive disorders are a relevant burden for public health due to their prevalence and high levels of associated disability and mortality. Recent studies suggest that the combination of multiple chronotherapuetic interventions may reveal effective in the rapid improvement of depressive symptoms. This paper describes the protocol of a study that aims to test the efficacy of a triple chronotherapy intervention (combined total sleep deprivation, light therapy and sleep phase advance) in the improvement of depressive symptoms in individuals diagnosed with unipolar or bipolar depression. A randomized controlled trial will be conducted in patients hospitalized with a unipolar or bipolar depression at the Servizio Psichiatrico di Diagnosi e Cura inpatient unit of the San Paolo - ASST Santi Paolo e Carlo Hospital in Milan, Italy. Individuals will be randomly assigned to the intervention (triple chronotherapy add-on to standard pharmacological treatment) or to the ""control"" group (standard pharmacological treatment). Enrolment began in December 2018 and will end in October 2020, or at any earlier point in which the expected sample size will be reached. The study protocol has already been approved by the local ethics committee and is registered as EudraCT 2019-000892-18. Outcome analyses aim to verify whether triple chronotherapy produces a rapid and stable improvement in depressive symptoms in individuals hospitalized for an acute unipolar or bipolar depressive episode.",32594675,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.373157978057861,5.004329681396484,AmtC
"Bringing light into darkness: A multiple baseline mixed methods case series evaluation of Augmented Depression Therapy (ADepT).

Two core features of depression are elevations in negative valence system (NVS) functioning and reductions in positive valence system (PVS) functioning. Existing psychological treatments have focused on the NVS and neglected the PVS, which may contribute to sub-optimal outcomes. The present mixed methods multiple randomised baseline case series preliminarily evaluates Augmented Depression Therapy (ADepT), a novel depression treatment targeting PVS and NVS disturbance, that aims both to reduce depression and enhance wellbeing. Eleven clinically depressed participants were recruited. Intensive time series analyses showed that 7/11 participants improved on both wellbeing and depression. Reliable and clinically significant improvement was observed for 9/11 participants on at least one of these outcomes (and also across a range of other PVS and NVS outcomes). Group level analyses showed significant pre to post change on all outcomes. Benchmarking analyses indicated these effect sizes were at least comparable (and for some PVS outcomes superior) to existing treatments. Gains were largely sustained over one-year follow-up. Qualitative interviews indicated ADepT was feasible and acceptable. These findings provide preliminary support for ADepT as a novel depression treatment. Further evaluation, directly comparing ADepT to existing treatments using randomised controlled trial designs, is now required.",31310929,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,-4.324349403381348,4.922276973724365,A3dk
"A modified Mediterranean dietary intervention for adults with major depression: Dietary protocol and feasibility data from the SMILES trial.

The SMILES trial was the first randomized controlled trial (RCT) explicitly designed to evaluate a dietary intervention, conducted by qualified dietitians, for reducing depressive symptomatology in adults with clinical depression. Here we detail the development of the prescribed diet (modified Mediterranean diet (ModiMedDiet)) for individuals with major depressive disorders (MDDs) that was designed specifically for the SMILES trial. We also present data demonstrating the extent to which this intervention achieved improvements in diet quality. The ModiMedDiet was designed using a combination of existing dietary guidelines and scientific evidence from the emerging field of nutritional psychiatric epidemiology. Sixty-seven community dwelling individuals (Melbourne, Australia) aged 18 years or over, with current poor quality diets, and MDDs were enrolled into the SMILES trial. A retention rate of 93.9 and 73.5% was observed for the dietary intervention and social support control group, respectively. The dietary intervention (ModiMedDiet) consisted of seven individual nutrition counselling sessions delivered by a qualified dietitian. The control condition comprised a social support protocol matched to the same visit schedule and length. This manuscript details the first prescriptive individualized dietary intervention delivered by dietitians for adults with major depression. Significant improvements in dietary quality were observed among individuals randomized to the ModiMedDiet group. These dietary improvements were also found to be associated with changes in depressive symptoms. The ModiMedDiet, a novel and individually tailored intervention designed specifically for adults with major depression, can be effectively implemented in clinical practice to manage this highly prevalent and debilitating condition. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000251820. Registered 29 February 2012.",28424045,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,-0.19671492278575897,10.274169921875,Bdu9
"Role of magnesium supplementation in the treatment of depression: A randomized clinical trial.

Current treatment options for depression are limited by efficacy, cost, availability, side effects, and acceptability to patients. Several studies have looked at the association between magnesium and depression, yet its role in symptom management is unclear. The objective of this trial was to test whether supplementation with over-the-counter magnesium chloride improves symptoms of depression. An open-label, blocked, randomized, cross-over trial was carried out in outpatient primary care clinics on 126 adults (mean age 52; 38% male) diagnosed with and currently experiencing mild-to-moderate symptoms with Patient Health Questionnaire-9 (PHQ-9) scores of 5-19. The intervention was 6 weeks of active treatment (248 mg of elemental magnesium per day) compared to 6 weeks of control (no treatment). Assessments of depression symptoms were completed at bi-weekly phone calls. The primary outcome was the net difference in the change in depression symptoms from baseline to the end of each treatment period. Secondary outcomes included changes in anxiety symptoms as well as adherence to the supplement regimen, appearance of adverse effects, and intention to use magnesium supplements in the future. Between June 2015 and May 2016, 112 participants provided analyzable data. Consumption of magnesium chloride for 6 weeks resulted in a clinically significant net improvement in PHQ-9 scores of -6.0 points (CI -7.9, -4.2; P<0.001) and net improvement in Generalized Anxiety Disorders-7 scores of -4.5 points (CI -6.6, -2.4; P<0.001). Average adherence was 83% by pill count. The supplements were well tolerated and 61% of participants reported they would use magnesium in the future. Similar effects were observed regardless of age, gender, baseline severity of depression, baseline magnesium level, or use of antidepressant treatments. Effects were observed within two weeks. Magnesium is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated without the need for close monitoring for toxicity.",28654669,Major Depressive Disorder,Anxiety Treatment,Mental Health,20870,-1.274657130241394,11.334087371826172,BajW
"Effects of Curcumin on Depression and Anxiety: A Narrative Review of the Recent Clinical Data.

Depressive and anxiety disorders affect a significant proportion of the global population and constitute one of the highest disease burdens worldwide. Conventional pharmacological treatments are traditionally the first line of therapy for individuals affected by these conditions although these are only successful approximately half of the time and are often associated with undesirable side effects. This review describes the use of the natural substance curcumin as a potential alternative treatment of these mental disorders. With this in mind, we analyzed the effects of curcumin in eight clinical studies of depression and five studies of anxiety and assessed these using psychiatric symptom scores and molecular biomarker readouts.",34331697,Major Depressive Disorder,Anxiety Treatment,Mental Health,22611,-0.12137065082788467,15.504376411437988,ASc9
"Preventing the recurrence of depression with a Mediterranean diet supplemented with extra-virgin olive oil. The PREDI-DEP trial: study protocol.

The role of dietary patterns in the prevention of unipolar depression has been analyzed in several epidemiological studies. The primary aims of this study are to determine the effectiveness of an extra-olive oil-enriched Mediterranean diet in reducing the recurrence of depression and improving the symptoms of this condition. Multicenter, two-arm, parallel-group clinical trial. Arm 1, extra-virgin olive oil Mediterranean diet; Arm 2, control group without nutritional intervention. Dieticians are in charge of the nutritional intervention and regular contact with the participants. Contacts are made through our web platform ( https://predidep.es/participantes/ ) or by phone. Recurrence of depression is assessed by psychiatrists and clinical psychologists through clinical evaluations (semi-structured clinical interviews: Spanish SCID-I). Depressive symptoms are assessed with the Beck Depression Inventory. Information on quality of life, level of physical activity, dietary habits, and blood, urine and stool samples are collected after the subject has agreed to participate in the study and once a year. To the best of our knowledge, the PREDI-DEP trial is the first ongoing randomized clinical trial designed to assess the role of the Mediterranean diet in the prevention of recurrent depression. It could be a cost-effective approach to avoid recurrence and improve the quality of life of these patients. The study has been prospectively registered in the U.S. National Library of Medicine ( https://clinicaltrials.gov ) with NCT number: NCT03081065.",30744589,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,-0.007805819157510996,10.667318344116211,A/DM
"Evaluating the combination of a Brief Motivational Intervention plus Cognitive Behavioral Therapy for Depression and heavy episodic drinking in college students.

[Correction Notice: An Erratum for this article was reported in Vol 34(2) of Psychology of Addictive Behaviors (see record 2020-16883-001). In the original article the order of authorship was incorrect. The correct second and third authors should appear instead as Brian Borsari and Jennifer E. Merrill.] Heavy episodic drinking (HED) and depressive symptoms often co-occur among college students and are associated with significant impairment. However, evidence-based treatments for these common co-occurring conditions are not available for college students. The current study compared the effectiveness of a treatment combining Cognitive-Behavioral Therapy for Depression and Brief Motivational Interviewing (CBT-D + BMI) versus Cognitive-Behavioral Therapy for Depression (CBT-D) alone among 94 college students with HED and depressive symptoms. Both treatment programs were associated with significant reductions of similar magnitude in HED, alcohol-related problems (ARP), and depressive symptoms at the end of treatment and at the 1-month follow-up assessment. Moderation analyses indicated that, among college students with fewer depressive symptoms at baseline, CBT-D was associated with greater sustained reduction in heavy drinking relative to CBT-D + BMI at the 1-month follow-up. Although the study did not include a no-treatment condition, the magnitude of improvement during treatment in both groups was greater than what is expected with passage of time. Although clinicians in college counseling centers may lack specialty training for co-occurring conditions, CBT-D is widely implemented in college settings. Our findings suggest that CBT-D may reduce both depressive symptoms and HED in college students and may be used to address a significant public health problem. (PsycINFO Database Record (c) 2020 APA, all rights reserved).",31855009,Major Depressive Disorder,Anxiety Treatment,Mental Health,1063,2.918941020965576,-8.161025047302246,AwCB
"Effectiveness of text messaging interventions for the management of depression: A systematic review and meta-analysis.

Depression is a leading cause of human disability. Telemedicine-based interventions using text messaging are currently being trialled for the management of community-based clients with clinical depression. However, little is known about the effectiveness of such methods. We searched the databases PubMed, Embase, Informit, Cochrane Central Register of Controlled Trials, PsycINFO and Scopus for randomised controlled trials (RCTs) published between January 2000 and April 2019. Studies comparing text messaging interventions to a comparator group for patients with depression were included in the review. Articles were assessed for quality using the Joanna Briggs Institute critical appraisal checklist for RCTs. Nine RCTs (945 patients: 764 adults and 181 adolescents) were included in the systematic review. Five studies used text messaging as the only intervention, whilst the remaining combined text messaging with other treatment modalities such as behavioural activation or cognitive behavioural therapy. A meta-analysis was conducted on seven selected RCTs (845 patients: 664 adults and 181 adolescents). The standardised mean reduction in depression due to text messaging interventions was 0.23 (95% confidence interval: -0.02 to 0.48). There was evidence of heterogeneity in treatment effect between studies. There is marginal evidence supporting text messaging interventions as an effective treatment modality for people living with clinical depression. However, further research is needed to determine how best to utilise text-message interventions alongside other conventional forms of health services delivery.",31631764,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,5.751525402069092,-7.606429100036621,AzKY
"Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: outcomes to 36-months.

Integrated psychological treatment addressing co-existing alcohol misuse and depression has not been compared with single-focused treatment. This trial evaluates changes over 36 months following randomization of 284 outpatients to one of four motivational interviewing and cognitive-behavior therapy (MICBT) based interventions: (1) brief integrated intervention (BI); or BI plus 9 further sessions with (2) an integrated-, (3) alcohol-, or (4) depression-focus. Outcome measures included changes in alcohol consumption, depression (BDI-II: Beck Depression Inventory) and functioning (GAF: Global Assessment of Functioning), with average improvements from baseline of 21.8 drinks per week, 12.6 BDI-II units and 8.2 GAF units. Longer interventions tended to be more effective in reducing depression and improving functioning in the long-term, and in improving alcohol consumption in the short-term. Integrated treatment was at least as good as single-focused MICBT. Alcohol-focused treatment was as effective as depression-focused treatment at reducing depression and more effective in reducing alcohol misuse. The best approach seems to be an initial focus on both conditions followed by additional integrated- or alcohol-focused sessions.",24210534,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,3.782574415206909,-8.470279693603516,CWWP
"[Treatment of depression complicated by abuse and dependence on alcohol].

To evaluate the efficacy of different treatment regimens of depression complicated by abuse and dependence on alcohol and to identify the most effective tactics of treatment. One hundred patients with depression were studied. Examination of patients was conducted using clinical-psychopathological method, the MADRS (at admission, on the 1st, 2nd, 4th and 6th week of treatment) and CGI scale (in the beginning of treatment and on 6th week). Data analysis using standard statistical indicators was performed. In accordance with the therapeutic tactics, patients were stratified into three groups: patients, treated with a combination of antidepressants, antipsychotics and mood stabilizers (group 1); antidepressants and antipsychotics (group 2); antidepressants and mood stabilizers (group 3). In group 1, a reduction in MADRS scores was significantly higher compared to other groups (8.53 points, p≤0.01). On the 6th week, 50% of the patients showed complete or almost complete remission, and the state of 44.7% patients was classified as 'mild disorders'. In group 3, serious condition remained in 16.7% of patients by the end of the 6th week. By the 6th week of treatment, 39.5% of patients of group 1 had 'very significant improvement'. The least treatment efficacy was noted in group 3. The use of the combination of antidepressants, antipsychotics and mood stabilizers demonstrates the greatest efficacy in terms of reduction of depressive symptoms.",28805761,Major Depressive Disorder,Anxiety Treatment,Mental Health,6986,3.4936141967773438,-8.240553855895996,BYcK
"Clinical outcomes of an integrated treatment for depression and substance use disorders.

The authors compared longitudinal treatment outcomes for depressed substance-dependent veterans (N = 206) assigned to integrated cognitive-behavioral therapy plus standard pharmacotherapy (ICBT + P) or 12-step facilitation therapy plus standard pharmacotherapy (TSF + P). Drug and alcohol involvement and depressive symptomology were measured at intake and at 3-month intervals during treatment and up to 1 year posttreatment. Participants in both treatment conditions showed decreased depression and substance use from intake. ICBT + P participants maintained improvements in substance involvement over time, whereas TSF + P participants had more rapid increases in use in the months following treatment. Decreases in depressive symptoms were more pronounced for TSF + P than ICBT + P in the 6 months posttreatment. Within both treatment groups, higher attendance was associated with improved substance use and depression outcomes over time. Initial levels of depressive symptomology had a complex predictive relationship with long-term depression outcomes. Early treatment response predicted long-term substance use outcomes for a portion of the sample. Although both treatments were associated with improvements in substance use and depression, ICBT + P may lead to more stable substance use reductions compared with TSF + P.",20853931,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,5.038732528686523,-8.736876487731934,DFhb
"Interpersonal psychotherapy versus brief supportive therapy for depressed infertile women: first pilot randomized controlled trial.

Infertility is strongly associated with depression, yet treatment research for depressed infertile women is sparse. This study tested for the first time the feasibility and preliminary efficacy of interpersonal psychotherapy (IPT), the evidence-based antidepressant intervention with the greatest peripartum research support, as treatment for depressed women facing fertility problems. Patients who met DSM-IV criteria for major depressive disorder of at least moderate severity were randomized to either 12 sessions of IPT (n=15) or brief supportive psychotherapy (BSP; n=16), our control intervention. Eighty percent of IPT and 63 % of BSP patients completed the 12 sessions of therapy. Patients in both treatments improved. IPT produced a greater response rate than BSP, with more than two-thirds of women achieving a >50 % reduction in scores on the Montgomery-Åsberg Depression Rating Scale (MADRS). IPT also tended to have lower posttreatment scores on the Beck Depression Inventory, Clinical Global Impression-Severity Scale, and anxiety subscale of the Hamilton Depression Rating Scale, with between-group effect sizes ranging from 0.61 to 0.76. Gains persisted at 6-month follow-up. This pilot trial suggests that IPT is a promising treatment for depression in the context of infertility and that it may fare better than a rigorous active control condition. Should subsequent randomized controlled trials support these findings, this will inform clinical practice and take an important step in assuring optimal care for depressed women struggling with infertility.",22526405,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,4.4965105056762695,-5.648606777191162,CuZ3
"Do Nonsuicidal Severely Depressed Individuals with Diabetes Profit from Internet-Based Guided Self-Help? Secondary Analyses of a Pragmatic Randomized Trial.

Diabetes mellitus type 1 and type 2 are linked to higher prevalence and occurrences of depression. Internet-based depression- and diabetes-specific cognitive behavioral therapies (CBT) can be effective in reducing depressive symptom severity and diabetes-related emotional distress. The aim of the study was to test whether disease-specific severity indicators moderate the treatment outcome in a 6-week minimally guided web-based self-help intervention on depression and diabetes (GET.ON Mood Enhancer Diabetes (GET.ON M.E.D.)) and to determine its effectiveness in a nonsuicidal severely depressed subgroup. Randomized controlled trial- (RCT-) based data (N = 253) comparing GET.ON M.E.D. to an online psychoeducation control group was used to test disease-specific severity indicators as predictors/moderators of a treatment outcome. Changes in depressive symptom severity and treatment response were examined in a nonsuicidal severely depressed subgroup (CES - D > 40; N = 40). Major depressive disorder diagnosis at the baseline (p prf6 = 0.01), higher levels of depression (Beck Depression Inventory II; p prpo = 0.00; p prf6 = 0.00), and lower HbA1c (p prpo = 0.04) predicted changes in depressive symptoms. No severity indicator moderated the treatment outcome. Severely depressed participants in the intervention group showed a significantly greater reduction in depressive symptom severity (d prpo = 2.17, 95% Confidence Interval (CI): 1.39-2.96) than the control condition (d prpo = 0.92; 95% CI: 0.001-1.83), with a between-group effect size of d prpo = 1.05 (95% CI: 0.11-1.98). Treatment response was seen in significantly more participants in the intervention (4/20; 20%) compared to the control group (0/20, 0%; χ 2(2)(N = 40) = 4.44; p < 0.02). At the 6-month follow-up, effects were maintained for depressive symptom reduction (d pr6f = 0.71; 95% CI: 0.19-1.61) but not treatment response. Disease-specific severity indicators were not related to a differential effectiveness of guided self-help for depression and diabetes. Clinical meaningful effects were observed in nonsuicidal severely depressed individuals, who do not need to be excluded from web-based guided self-help. However, participants should be closely monitored and referred to other treatment modalities in case of nonresponse.",31218230,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,3.488736391067505,-2.3230140209198,A4vb
"Metabolic variables associated with response to cognitive behavioural therapy for depression in females: A Canadian biomarker integration network for depression (CAN-BIND) study.

Cognitive behavioural therapy (CBT) is an established first-line treatment for depression; however, it remains unclear which factors predict a positive outcome with this approach. Prior work suggests that co-morbid obesity predicts a poorer response to antidepressant medication. The current study examined whether there is an association between weight parameters and improvement of depressive symptoms with CBT. This was a secondary analysis of data from the ""Clinical and Biological Markers of Response to Cognitive Behavioural Therapy for Depression - 6"" (CANBIND-6; https://clinicaltrials.gov/ct2/show/NCT02883257) study. Adult participants (n = 41) with a diagnosis of Major Depressive Disorder (MDD) or Persistent Depressive Disorder (PDD) were recruited from an outpatient tertiary psychiatric centre in Canada. Participants completed 20 individual sessions of CBT over 16 weeks. The primary measure for treatment outcome was the Montgomery-Åsberg Depression Rating Scale (MADRS) total score at week 16. Thirty-seven participants completed assessments pre and post CBT. Baseline weight parameters were not correlated with treatment response to CBT in the entire group. There was a significant sex*waist circumference (WC) (B:-1.34; p = 0.004) and sex*body mass index (BMI) interaction (B:-2.03; p:0.009). In female participants, baseline waist circumference, but not BMI, significantly predicted week 16 MADRS after controlling for age and baseline MADRS (B:0.422 p:0.049). The major limitation of our preliminary finding is the small sample size. Our preliminary findings suggest that higher waist circumference may be associated with a better treatment response to CBT for depression in females. This result could be of clinical relevance and warrants further investigation in larger and independent samples.",34419752,Major Depressive Disorder,Anxiety Treatment,Mental Health,12829,1.8665821552276611,-2.210256576538086,ARdL
"Momentary assessment technology as a tool to help patients with depression help themselves.

Given high relapse rates and residual symptoms in depression, new strategies to increase treatment effectiveness are required. A promising avenue is to investigate how electronic momentary assessment technology may contribute to clinical assessment and interventions in depression. A literature search was conducted focusing on the potential contribution of momentary assessments to clinical applications in depression. Momentary assessments are able to reveal subtle, small but repetitive and relevant patterns of emotional expression that predict future course of depression. A momentary assessment tool may expose manageable pieces of daily life behaviour contributing to the depressive experience that patients can influence. The use of this explicit knowledge of daily life experience is understudied with regard to its contribution to diagnostic assessment, monitoring of treatment effects and feedback interventions in depressed patients. The clinical application of momentary assessments may stimulate a shift from passive consumption of treatment to an active role for patients in their recovery and increased patient ownership. The precise, prospective and fine-grained information that momentary assessment technology provides may contribute to clinical practice in various ways. Future studies should examine the clinical impact of its use and the feasibility of its implementation in mental health care.",21838742,Major Depressive Disorder,Anxiety Treatment,Mental Health,9713,5.983076095581055,-5.746291160583496,C4ua
"Group treatment for depression in mothers of young children compared to standard individual therapy.

Studies on specific psychotherapy for depressed mothers of small children are rare. The aim of the present study was to investigate the effectiveness of a newly developed cognitive-behavioral group intervention for depressed mothers compared to standard individual therapy. In a naturalistic design, 31 mothers suffering from depressive disorders with children aged ≤4 years who had consecutively been admitted to our specialized clinic for mentally ill mothers were assigned to the group treatment, and the following 21 were admitted to the control group receiving standard individual therapy. The group treatment consisted of 12 group sessions and 1 couple session and was administered to five consecutive groups. Participants completed interviews and questionnaires - the Beck Depression Inventory and the Symptom Checklist- 90-R - before and 3 months after therapy. The treatment group and the control group showed a significant improvement in their depression, with no significant differences between the two treatment strategies. The women in group therapy, however, required fewer antidepressants, and group treatment was observed to be more effective in reducing anger and hostility. This form of group treatment for depressed women in early motherhood may have some important advantages over individual therapy; effects were small, however, and should be replicated in a further study.",22947881,Major Depressive Disorder,Anxiety Treatment,Mental Health,118,4.131399631500244,-5.422367095947266,CosW
"Long-term effects of individual mindfulness-based cognitive therapy and cognitive behavior therapy for depressive symptoms in patients with diabetes: a randomized trial.

",25832365,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,3.8277981281280518,-2.2856357097625732,B/sy
"The Combination of Cognitive-Behavioural Therapy with Virtual Reality for the Treatment of Postnatal Depression in a Brief Intervention Context: A Single-Case Study Trial.

Postnatal depression (PND) is a mood disorder with potentially devastating effects to the individual on many levels. It can affect cognitive functioning, motivation, and self-esteem. The person can socially withdraw from their immediate familial or social circle. It can affect bonding and quality time between the mother and baby. There are many effective therapeutic treatments used for the treatment of PND such as cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT). This study using a single-case study trial with 15 participants investigates the clinical usefulness of combining CBT with virtual reality (VR). Results show that the combination of CBT with VR is an effective treatment for PND. In addition, VR can enhance awareness, decision-making, and self-appreciation within the individual and can also have real-life applications. This study also shows that the combination of VR and CBT is feasible, while the use of such a technology is well accepted.",34457218,Major Depressive Disorder,Anxiety Treatment,Mental Health,18764,3.838285207748413,-5.61000919342041,ARGy
"A randomized trial of telephonic counseling plus walking for depressed diabetes patients.

Patients with diabetes and depression often have self-management needs that require between-visit support. This study evaluated the impact of telephone-delivered cognitive behavioral therapy (CBT) targeting patients' management of depressive symptoms, physical activity levels, and diabetes-related outcomes. Two hundred ninety-one patients with type 2 diabetes and significant depressive symptoms (Beck Depression Inventory scores ≥ 14) were recruited from a community-based, university-based, and Veterans Affairs health care systems. A manualized telephone CBT program was delivered weekly by nurses for 12 weeks, followed by 9 monthly booster sessions. Sessions initially focused exclusively on patients' depression management and then added a pedometer-based walking program. The primary outcome was hemoglobin A1c levels measured at 12 months. Blood pressure was a secondary outcome; levels of physical activity were determined by pedometer readings; depression, coping, and health-related quality of life were measured using standardized scales. Baseline A1c levels were relatively good and there was no difference in A1c at follow-up. Intervention patients experienced a 4.26 mm Hg decrease in systolic blood pressure relative to controls (P=0.05). Intervention patients had significantly greater increases in step counts (mean difference, 1131 steps/d; P=0.0002) and greater reductions in depressive symptoms (58% remitted at 12 mo vs. 39%; P=0.002). Intervention patients also experienced relative improvements in coping and health-related quality of life. This program of telephone-delivered CBT combined with a pedometer-based walking program did not improve A1c values, but significantly decreased patients' blood pressure, increased physical activity, and decreased depressive symptoms. The intervention also improved patients' functioning and quality of life.",21478777,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.40326189994812,-2.51601243019104,C9qD
"Nonpharmacologic treatments for depression related to reproductive events.

There is a growing body of evidence suggesting that nonpharmacological interventions have an appropriate place in the treatment of major depressive disorders (MDDs) as both stand-alone and supplemental treatments. Because women may be reluctant to use psychotropic medications due to strong values or treatment preferences during specific reproductive events, clinicians need to be able to offer empirically based alternatives to medication. In this review, we present recent findings from studies of acupuncture, bright light therapy, electroconvulsive therapy, omega fatty acid supplementation, physical activity, and psychosocial intervention for women experiencing depressive symptoms in the contexts of menstruation, pregnancy, postpartum, and menopause.",25308394,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,3.144857406616211,-5.225442886352539,CHIs
"A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression.

This study aims to evaluate the effects of Group Cognitive Behavioral Therapy (GCBT) in treating major depression in Chinese women with breast cancer. Sixty-two breast cancer patients diagnosed with major depression were randomly assigned to GCBT group (N=31) or a waiting list control group provided with an educational booklet (N=31). The primary outcome measure was the 17-Item Hamilton Depression Rating Scale (17-HAMD). The second outcome measures were Self-Rating Anxiety Scale, Functional Assessment of Cancer Therapy - Breast and Self-Esteem Scale (SES). Assessments were carried out at completion of the study and six-month afterwards. Patients in the GCBT group had a significant reduction in the 17-HAMD mean score by 9 points (p<0.001), more than any reduction among patients in the control group from baseline to the end of therapy and a significant 7 points (p<0.001) more reduction from baseline to six-month follow-up. GCBT also yielded significantly greater improvement than the control group with regard to quality of life (QoL; p<0.01) and self-esteem (p<0.05). No significant differences were found between groups on improving anxiety (p>0.05). The results of this trial suggest that GCBT is effective for treating major depression, as well as for improving QoL and self-esteem in breast cancer patients. Chictr.org ChiCTR-TRC-11001689.",23646866,Major Depressive Disorder,Anxiety Treatment,Mental Health,8627,6.031307220458984,-2.6438493728637695,Cebj
"Cognitive Behavioral Therapy Versus Sertraline in Patients With Depression and Poorly Controlled Diabetes: The Diabetes and Depression (DAD) Study: A Randomized Controlled Multicenter Trial.

This study compared the long-term efficacy of a diabetes-specific cognitive behavioral group therapy (CBT) with sertraline in patients with diabetes and depression who initially responded to short-term depression treatment. A randomized controlled single-blind trial was conducted in 70 secondary care centers across Germany comparing 12 weeks of CBT with sertraline in 251 patients with type 1 or 2 diabetes (mean HbA1c 9.3%, 78 mmol/mol) and major depression (Structured Clinical Interview for DSM-IV [SCID]). After 12 weeks, treatment responders (≥50% reduction Hamilton Depression Rating Scale [HAMD-17]) were included in the 1-year study phase where CBT patients were encouraged to use bibliotherapy and sertraline patients received continuous treatment. We analyzed differences for HbA1c (primary outcome) and reduction (HAMD-17) or remission (SCID) of depression from baseline to the 1-year follow-up using ANCOVA or logistic regression analysis. After 12 weeks, 45.8% of patients responded to antidepressant treatment and were included in the 1-year study phase. Adjusted HbA1c mean score changes from baseline to the end of the long-term phase (-0.27, 95% CI -0.62 to 0.08) revealed no significant difference between interventions. Depression improved in both groups, with a significant advantage for sertraline (HAMD-17 change: -2.59, 95% CI 1.15-4.04, P < 0.05). Depression improved under CBT and sertraline in patients with diabetes and depression, with a significant advantage for sertraline, but glycemic control remained unchanged. CBT and sertraline as single treatment are insufficient to treat secondary care diabetes patients with depression and poor glycemic control.",25690005,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.9621543884277344,-2.245471239089966,CBwj
"Interventions that may reduce depressive symptoms among prostate cancer patients: a systematic review and meta-analysis.

Prostate cancer patients are at increased risk of depression yet there is no standard intervention to address this. The purpose of this meta-analysis is to examine the efficacy of interventions in reducing depressive symptoms in men with prostate cancer. Searches for studies were conducted in four databases and by hand. Randomized controlled trials of any intervention relative to control for depression in prostate cancer patients at any stage of their cancer treatment were included. We identified 11 studies that randomized men with prostate cancer to either an intervention meant to improve some aspect of quality of life or control and reported depressive symptoms scores before and after the intervention or control condition. Two of these were not used in our meta-analysis either for concerns about quality or for lack of depression scores. The interventions identified in the remaining nine articles were exercise (four), information (three), psychotherapy or peer support (three), massage therapy (one), and medication (one). Several publications included more than one type of intervention. A meta-analysis of all studies showed that an intervention of some types significantly improved depressive symptom scores relative to the control condition (improvement in depression score by -0.86 unit (95% CI: -1.42, -0.31)). Isolating the peer support/psychotherapy studies also showed significant improvement (improvement in depression score by -1.09 unit (95% CI: -2.05, -0.13)). Treatments to improve depressive symptoms in men with prostate cancer may be effective, with the best evidence supporting the use of peer support/psychotherapy.",25753507,Major Depressive Disorder,Anxiety Treatment,Mental Health,20102,5.63374137878418,-2.910830497741699,CA1q
"Trajectories of long-term outcomes for postnatally depressed mothers treated with group interpersonal psychotherapy.

There is evidence that psychological treatments for postnatal depression are effective in the short-term; however, whether the effects are enduring over time remains an important empirical question. The aim of this study was to investigate the depressive symptoms and interpersonal functioning of participants in a randomised controlled trial (RCT) of group interpersonal psychotherapy (IPT-G) at 2 years posttreatment. The study also examined long-term trajectories, such as whether participants maintained their recovery status, achieved later recovery, recurrence or persistent symptoms. Approximately 2 years posttreatment, all women in the original RCT (N=50) were invited to participate in a mailed follow-up. A repeated measures analysis of variance assessed differences between the treatment and control conditions on depression and interpersonal scores across five measurement occasions: baseline, mid-treatment, end of treatment and 3-month and 2-year follow-up. Chi-square tests were used to analyse the percentage of participants in the four recovery categories. Mothers who received IPT-G improved more rapidly in the short-term and were less likely to develop persistent depressive symptoms in the long-term. Fifty seven percent of IPT-G mothers maintained their recovery over the follow-up period. Overall, IPT-G participants were significantly less likely to require follow-up treatment. Limitations include the use of self-report questionnaires to classify recovery. The positive finding that fewer women in the group condition experienced a persistent course of depression highlights its possible enduring effects after treatment discontinuation. Further research is needed to improve our long-term management of postnatal depression for individuals who are vulnerable to a recurrent or chronic trajectory.",22532053,Major Depressive Disorder,Anxiety Treatment,Mental Health,118,4.368955135345459,-5.6327643394470215,CuUD
"Effects of cognitive behavioral coaching on depressive symptoms in a sample of type 2 diabetic inpatients in Nigeria.

Depression is one of the mental health problems confronting those with diabetes mellitus and may result from self-defeating thoughts and lifestyles. Therefore, the aim of this study was to investigate the effects of cognitive behavioral coaching (CBC) program on depressive symptoms in a sample of the Type 2 diabetic inpatients in Onitsha metropolis of Anambra State, Nigeria. The design of the study was pretest-post-test randomized control group design. The participants were 80 Type 2 diabetic inpatients randomly assigned to the treatment and control groups. The primary outcome measures were Beck's Depression Inventory-II and a Diabetic Inpatient's Depressive Symptoms Observation Checklist. Mean, standard deviation, repeated measures analysis of covariance, and partial eta squared were used for data analysis. The results revealed that the baseline of depressive symptoms was similar between the control and treatment groups of the Type 2 diabetic inpatients. But, exposing the Type 2 diabetic inpatients to a cognitive behavioral coaching program significantly reduced the depressive symptoms in the treatment group compared to those in the control group at the end of the intervention. The effects of cognitive behavioral coaching program on the depressive symptoms of those in the treatment group remained consistent at a 6 month follow-up meetings compared to the control group. Given the potential benefits of a cognitive behavioral coaching program, clinicians and mental health professionals are urged to support and implement evidence-based cognitive-behavioral coaching interventions aimed at promoting diabetic inpatients' wellbeing in the Nigerian hospitals.",27495071,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.430022716522217,-2.3920602798461914,Bo+t
"Change Mechanisms in Brief Interpersonal Psychotherapy for Women With Perinatal Depression: Qualitative Study.

Brief interpersonal psychotherapy (IPT-B) has been shown to be effective in treating perinatal depression and in preventing depressive relapse among socioeconomically disadvantaged women. Yet, it is unclear how IPT-B alleviates depression. Previous research has suggested four possible change mechanisms derived from IPT's interpersonal model: decreasing interpersonal stress, facilitating emotional processing, improving interpersonal skills, and enhancing social support. This study explored how women who received IPT-B or enhanced maternity support services (MSS-Plus) evaluated their respective experiences. A qualitative study was conducted with 16 women who had been recruited from public health clinics to participate in a larger, randomized controlled trial of women with major depression or dysthymia and who had been assigned to receive IPT-B or MSS-Plus. The sample was 63% non-Hispanic White, had an average age of 31.6 years, and was balanced in intervention group assignment, posttraumatic stress disorder status, and depression improvement. Telephone interviews included semistructured, open-ended questions eliciting participants' experiences with depression treatment. Predetermined, conceptually derived codes were based on the four postulated IPT change mechanisms. Thematic coded excerpts were collected and discussed. Excerpts lent support to the role of IPT-B in helping women decrease their interpersonal stress; identify, reflect on, and regulate their emotions; and improve their social skills. Evidence for increasing social support was mixed but highlighted the importance of the therapeutic relationship. Including qualitative findings into training in public health and other clinical settings will help illuminate the role of the provider in facilitating the change mechanisms that may lead to improved mental health among clients.",33745285,Major Depressive Disorder,Anxiety Treatment,Mental Health,2855,4.216925621032715,-5.617824554443359,AZFF
"Non-pharmacological therapies for depressive symptoms in breast cancer patients: Systematic review and meta-analysis of randomized clinical trials.

Depressive symptoms are common comorbidities among breast cancer (BC) patients. Non-pharmacological therapies (NPTs) such as exercise and psychotherapy may reduce depressive symptoms; however, the evidence is inconclusive. The objective of this study is to evaluate if NPTs reduce depressive symptoms among BC patients. A systematic review and meta-analysis of randomized clinical trials (RCTs) of NPTs for BC patients were performed. A literature search was conducted from eight databases in English, Portuguese and Spanish from 2006 to 2017. Inclusion criteria were: RCTs that evaluated depressive symptoms as a primary or secondary outcome that did not include pharmacological interventions and did include a non-intervened control group, with at least 30 participants in non-terminal BC stage with no current psychiatric illness. A meta-analysis for each NPT was performed with DerSimonian and Laird's method for the random effects model. Sensitivity analyses were conducted. Heterogeneity and publication bias were assessed. A total of 41 eligible RCTs were identified. Overall, NPTs significantly reduced depressive symptoms (Summary standardized mean difference (SMD) = -0.516; 95%CI: -0.814, -0.218; I2 = 96.2). Of the types of NPTs, psychotherapy significantly reduced depressive symptoms (Summary SMD = -0.819; 95% CI: -1.608, -0.030; I2 = 91.53). A significant difference emerged for Mindfulness (Summary SMD = -0.241; 95% CI: -0.412, -0.070; I2 = 28.6%) and yoga (Summary SMD = -0.305; 95% CI: -0.602, -0.007; I2 = 41.0%) when the heterogeneity was reduced. No evidence of publication bias was observed. Psychotherapy and mind-body therapies may reduce depressive symptoms in women with BC. Laughter and couples therapy warrant attention in future studies.",30776733,Major Depressive Disorder,Anxiety Treatment,Mental Health,8627,6.277127265930176,-2.0959694385528564,A+tR
"Discontinuation of antidepressants during attempts to conceive: a pilot trial of cognitive behavioral therapy for the prevention of recurrent depression.

Many women discontinue antidepressants (ADs) when trying to conceive, although risk of depressive relapse is high. We examined the feasibility and potential clinical effect of cognitive behavioral therapy for the prevention of recurrence (CBT-PR) for women with a history of recurrent major depressive disorder (MDD) who planned to discontinue maintenance AD treatment for pregnancy. This was an open preliminary study of CBT-PR in women (N = 12) planning or early in pregnancy with remitted MDD on maintenance ADs with a plan to discontinue ADs for pregnancy. Participants received 12 sessions of CBT-PR during the acute phase and optional monthly booster sessions during follow-up. Participants were assessed monthly during the acute phase and then twice additionally during follow-up by an independent rater using mood scales (depression module of the Mini-International Neuropsychiatric Interview and Montgomery-Åsberg Depression Rating Scale); pregnancy status was also assessed. Over the 24 weeks of the trial, 75% (n = 9) of participants did not restart ADs and did not relapse to depression. Of the 3 who reintroduced AD, 2 experienced a depressive relapse, whereas one did not meet full criteria for MDD. Adherence to the intervention was very good with all participants completing all therapy sessions and assessments. Cognitive behavioral therapy for the prevention of recurrence seems feasible and may provide protection for women with recurrent depression on ADs who discontinue their medication while trying to conceive. The extent to which euthymia is sustainable with CBT-PR requires further study; the results of which may broaden treatment choices for women in anticipation of and during pregnancy.",24911438,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,2.8498806953430176,-5.055656909942627,CM3k
"Reanalysis of efficacy of interpersonal psychotherapy for antepartum depression versus parenting education program: initial severity of depression as a predictor of treatment outcome.

Interpersonal psychotherapy (IPT) is supported by substantial empirical evidence as a treatment for depression. Surprisingly, our recently reported randomized, single-blind, controlled clinical trial found no significant difference between interpersonal psychotherapy for antepartum depression (IPT-P) and a parenting education program (PEP) control condition for the treatment of prenatal depression. Because depression severity has been found to influence treatment response in antidepressant treatment trials, the current study reassessed IPT-P outcomes, limiting analyses to women with moderate depressive symptoms. For this reanalysis, 75 of the 110 study participants who met DSM-IV criteria for major depressive disorder and scored ≥ 16 on the 17-item Hamilton Depression Rating Scale (HDRS-17) from 2005 through 2011 were classified as moderately depressed. Linear mixed models were used to examine the longitudinal treatment response on the HDRS-17, the Edinburgh Postnatal Depression Scale (EPDS), and the Clinical Global Impressions Improvement (CGI-I) and Severity (CGI-S) scales. Although the longitudinal analysis did not reveal a significant interaction of treatment group and visit (ie, treatment response variation), the IPT-P group had significantly lower HDRS-17 and EPDS depression ratings than the PEP group at week 8 (respectively, P = .008 and P = .046); these scores remained low but lost significance versus those for the PEP group at week 12 due to attrition and smaller sample size. For the CGI ratings, the longitudinal analysis revealed significant interaction of treatment groups and visits for the CGI-I (P = .021) and CGI-S (P = .005) ratings. Post hoc analysis showed significant illness improvement and less illness severity for the IPT-P group as measured by the CGI ratings at weeks 8 (P = .007 and P = .003, respectively) and 12 (P = .003 and P = .012, respectively), whereas the PEP group remained relatively unchanged during the study. The results of this reanalysis indicate that among women with moderate levels of depression severity, IPT-P is markedly more effective than PEP. The significance of baseline severity level in depression is important in treatment trial outcomes and considerably more important in determining treatment decisions for pregnant depressed women. ClinicalTrials.gov identifier: NCT00251043.",27137422,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,4.216333866119385,-5.510450839996338,BtY5
"Group meta-cognitive therapy and depression in women with breast cancer: a randomized controlled trial.

Breast cancer is one of the most common cancers in Iranian women. They will experience a mental health problem like depression before, during or after treatment. This study aimed to determine the effectiveness of group metacognitive therapy on depression, cognitive-emotional regulation, and meta-cognitive beliefs in women with breast cancer. In this randomized controlled clinical trial, a total of 24 depressed patients with breast cancer were randomly allocated to experimental and control groups. The experimental group received meta-cognitive therapy in 8 weekly sessions, but the control group received treatment as usual. Beck Depressive Inventory, cognitive emotion regulation questionnaire, and meta-cognitions questionnaire were completed before, after and one month after the intervention. Data were analyzed using Wilcoxon and Chi-square tests. The mean score of depression in the experimental group was reduced from 21.6±4.83 in the pre-test to 13.83±8.12 in one-month follow-up (p=0.16); however, there was no significant difference in the control group. The mean score of cognitive emotion regulation did not show a significant change in the two groups during the study and follow-up period. The mean score of meta-cognitive beliefs reached 68.75±15.74 from 79.51±10.72 in the experimental group during the follow-up period (p=0.006); however, there was no significant difference in the control group in the score of metacognitive beliefs. These findings support the efficacy of meta-cognitive therapy as a viable psychosocial intervention in depressed patients with breast cancer. Trial registration IRCT201606288473N5. Registered on: 05/09/2016 https://www.irct.ir/trial/8946 .",33736617,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,5.995110988616943,-2.7533066272735596,AZMF
"Behavioral activation and problem-solving therapy for depressed breast cancer patients: preliminary support for decreased suicidal ideation.

Major depressive disorder (MDD) is the most common psychiatric disorder in breast cancer patients. The prevalence of suicidal ideation in breast cancer patients is considerable, and relative to the general population, the prevalence of completed suicide is elevated, particularly in cancer patients with MDD. A major component of suicide prevention is effective treatment of MDD. Although some research has explored the utility of psychotherapy with breast cancer patients, only three trials have explored the benefits of behavior therapy in patients with well-diagnosed MDD and there has been no systematic investigation of the potential benefits of psychotherapy toward reducing suicidal ideation in breast cancer patients. As a follow-up to a recently completed randomized trial, this study examined the efficacy of 8 weeks of behavioral activation treatment for depression (BATD) and problem-solving therapy (PST) in reducing depression and suicidal ideation, as well as increasing hopefulness in breast cancer patients with MDD (n = 80). Across both treatments, GEE analyses revealed decreased depression and suicidal ideation and increased hopefulness at posttreatment, results that were maintained at 12-month follow-up. Moreover, follow-up patient contact at approximately 2 years posttreatment yielded no indication of completed suicide. Although these data are preliminary, BATD and PST may represent practical approaches to decrease suicidal ideation in depressed breast cancer patients.",23990646,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,5.953022003173828,-2.855212688446045,CZZB
"Cognitive behavioural therapy on improving the depression symptoms in patients with diabetes: a meta-analysis of randomized control trials.

This meta-analysis was performed to evaluate the effect of cognitive behavioural therapy (CBT) in improving the depression symptoms of patients with diabetes. Literature search was conducted in PubMed and Embase up to October 2016 without the initial date. The pooled SMD (standard mean difference) and its 95% confidence interval (CI) were calculated by Revman 5.3. Subgroup analyses were performed by type of diabetes and evaluation criteria of depression. A total of five randomized control trials involving 834 patients with diabetes mellitus (including 417 patients in CBT group and 417 patients in control group) were included in this meta-analysis. The pooled estimates indicated significant improvement of depression by CBT compared with routine approaches in overall outcomes (SMD =-0.33, 95% CI =-0.46 to -0.21, P<0.00001), post-intervention outcomes (SMD =-0.43, 95% CI =-0.73 to -0.12, P=0.006) and outcomes after 12 months intervention (SMD =-0.38, 95% CI = -0.54 to -0.23, P<0.0001). Subgroup analyses showed that the results were not influenced by the type of diabetes. However, the effect of CBT on improving the depression symptoms disappeared when only using CES-D (Centre for Epidemiological Studies scale for Depression) to evaluate depression.",28183873,Major Depressive Disorder,Anxiety Treatment,Mental Health,3829,3.513838291168213,-2.298011541366577,Bg+o
"Behavior therapy for depressed breast cancer patients: predictors of treatment outcome.

Major depressive disorder (MDD) is the most common psychiatric disorder among breast cancer patients and is associated with substantial functional impairment. Although several outcome studies have explored the utility of psychotherapy for breast cancer patients with subsyndromal depression symptoms, only a few clinical trials have explored the efficacy of behavior therapy for patients with well-diagnosed MDD. An additional limitation of this research is that little is known about factors that best predict treatment outcome. In the context of a recent randomized trial of behavior activation and problem-solving therapy for depressed breast cancer patients (n = 80; Hopko et al., 2011), this study explored predictors of treatment outcome with selected demographic (age, education, marital status, occupational status), psychosocial (pretreatment depression and environmental reward, coexistent anxiety disorders, social support, history of psychotherapy) and cancer-related variables (cancer stage, duration of cancer diagnosis, and cancer treatment). Positive treatment outcome as defined by Beck Depression Inventory-II (Beck et al., 1996) response and remission criteria was associated with being married, increased social support, not actively undergoing cancer treatment during psychotherapy, and having a history of psychotherapy. The efficacy of behavior therapy for depressed breast cancer patients may depend on several patient variables. Implications for the provision of behavior therapy for breast cancer patients are discussed.",25111433,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,5.974844932556152,-2.759201765060425,CJ+/
"Cognitive-behavioral therapy for depression in Parkinson's disease: a randomized, controlled trial.

Despite the negative effects of depression in Parkinson's disease, there is currently no evidence-based standard of care. The purpose of this study was to examine the efficacy of individually administered cognitive-behavioral therapy (CBT), relative to clinical monitoring (with no new treatment), for depression in this medical population. Eighty depressed (based on DSM-IV criteria) patients with Parkinson's disease participated in a randomized, controlled trial of CBT relative to clinical monitoring (1:1 ratio) in an academic medical center from April 2007 to July 2010. All patients continued to maintain stable medication regimens under the care of their personal physicians. The 17-item Hamilton Depression Rating Scale (HAM-D) total score was the primary outcome. CBT was modified to meet the unique needs of the Parkinson's disease population and provided for 10 weeks. Assessments were completed by blind raters at baseline and 5 (midpoint), 10 (end of treatment), and 14 weeks (follow-up evaluation) postrandomization. The CBT group reported greater reductions in depression (change in HAM-D score) than the clinical monitoring group. At week 10, the mean HAM-D score change was 7.35 for CBT relative to 0.05 for clinical monitoring. CBT was also superior to clinical monitoring on several secondary outcomes (i.e., Beck Depression Inventory scores, anxiety, quality of life, coping, Parkinson's disease symptom ratings). There were more treatment responders in the CBT group than the clinical monitoring group (56% versus 8%, respectively). CBT may be a viable approach for the treatment of depression in Parkinson's disease. Further research is needed to replicate and extend these findings.",21676990,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.326070785522461,13.96530532836914,C6/K
"Personalized Telemedicine for Depression in Parkinson's Disease: A Pilot Trial.

High rates of depression are observed in Parkinson's disease, and limited access to care complicates management. The purpose of this pilot project was to evaluate the feasibility and impact of a personalized cognitive-behavioral telemedicine program for depression in Parkinson's disease (dPD). Thirty-four individuals with dPD and their carepartners participated in this pilot study. A 10-module self-help workbook, tailored to the unique needs of the dPD population, was created to be used as either a stand-alone intervention, with minimal therapist support, or a supplement to formal telephone-administered cognitive-behavioral therapy sessions. Improvements in depression, anxiety, quality of life, sleep, negative thoughts, and caregiver burden were observed over the course of the 4-month study, independent of treatment modality (guided self-help vs formal telephone-based psychotherapy). Future research will utilize randomized controlled designs and continue to focus on delivery models that can improve access to this and other evidence-based mental health interventions for dPD.",29945467,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.230301856994629,13.752079963684082,BJzq
"Telephone-based cognitive-behavioral therapy for depression in Parkinson disease.

Although face-to-face cognitive-behavioral therapy (CBT) was found to be beneficial for the treatment of depression in Parkinson disease (dPD) in a recent randomized-controlled trial, access to care was identified as a critical issue that needs to be addressed in order to improve the management of this nonmotor complication in PD. The purpose of this study was to examine the feasibility and effect of telephone-based CBT for dPD. Twenty-one depressed people with PD participated in a National Institutes of Health-sponsored uncontrolled pilot trial of telephone-based CBT in an academic medical center from October 2009 to February 2011. The Hamilton Depression Rating Scale was the primary outcome. Treatment was provided to people with PD for 10 weeks, modified for delivery over the phone, and supplemented with 4 separate phone-based caregiver educational sessions. Assessments were completed at baseline and 5 (midpoint), 10 (end-of-treatment), and 14 weeks (follow-up) post-enrollment. Twenty (95%) people with PD completed the study treatment. Phone-based CBT was associated with significant improvements in depression, anxiety, negative thoughts, and coping. Mean Hamilton Depression Rating Scale change from baseline to week 10 was 7.91 points (P < .001, Cohen d = 1.21). Telephone-based CBT may be a feasible and helpful approach for treating dPD and warrants further exploration in randomized-controlled trials. Results were comparable to those observed in the few in-person cognitive-behavioral treatment studies for dPD conducted to date.",22228827,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.415767669677734,13.712159156799316,Cy75
"A systematic review and meta-analysis of cognitive behavioral and psychodynamic therapy for depression in Parkinson's disease patients.

Numerous practice guidelines have recommended cognitive behavioral therapy (CBT) and psychodynamic therapy as a treatment of choice for depression in Parkinson's disease (PD). However, no recent meta-analysis has examined the effects of brief psychotherapy (which includes both CBT and psychodynamic therapy) for adult depression in PD. We decided to conduct such a systematic review and meta-analysis. We included randomized controlled trials (RCTs) examining the effects of brief psychotherapy compared with control groups, other support nursing, or pharmacotherapy. The quality of included studies was strictly evaluated. Twelve studies including 766 patients met all inclusion criteria. The result showed that brief psychotherapy could evidently improve the HAMD (p < 0.00001) and Moca scale (p = 0.006). There was no statistical significance in PDQ-39 scale (p = 0.31). In the subgroup analysis by types of brief psychotherapy, the efficacy of psychodynamic psychotherapy was better than CBT (SMD = -2.02 vs SMD = -0.90) for the outcome measure according to HAMD scale. Meanwhile, we found brief psychotherapy in China was more effective than in US (SMD = -1.54 vs SMD = -1.23), and in low quality studies was more efficacious than in high quality studies (SMD = -1.50 vs SMD = -1.33). Time of brief psychotherapy treatment above 6 weeks was superior to studies with less than 6 weeks treatment. We found brief psychotherapy is probable effective in the management of depression in PD patients. But one reason to undermine the validity of findings is high clinical heterogeneity and low methodological quality of the included trials.",25724804,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.557193756103516,13.80859088897705,CBSA
"Cognitive behavioral therapy for depression and anxiety of Parkinson's disease: A systematic review and meta-analysis.

To systematically evaluate the effects of cognitive behavioral therapy on anxiety and depression symptoms of patients with Parkinson's disease. Four electronic databases (MEDLINE, EMBASE, CINAHL and the Cochrane Library) to May 2019 were searched. The outcome measure of interest was anxiety and depression. Randomized controlled trials or quasi-experimental studies were included in our review. The included individual study's risk of bias were assessed with the Cochrane Collaboration's tool. And the meta-analyses were performed. A total of 7 studies were included in the meta-analysis with 191 patients. Meta-analysis indicated observed beneficial effects of cognitive behavioral therapy in the reduction of anxiety and depression for individuals with Parkinson's disease. This meta-analysis revealed that cognitive behavioral therapy is effective in relieving depression and anxiety of patients with Parkinson's disease. Medical workers could apply cognitive behavioral therapy into daily routine cares for patients with Parkinson's disease. More studies with high quality and follow-up assessment on this topic are still required.",32379650,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.209904670715332,13.790761947631836,Apem
"The relationship between telephone-administered cognitive-behavioral therapy for depression and neuropsychological functioning in Parkinson's disease.

",24763770,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.415877342224121,13.685028076171875,CO4D
"Dismantling mindfulness-based cognitive therapy for recurrent depression implicates lack of differential efficacy for mindfulness training.

",25043437,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.676106452941895,-0.2833079397678375,CLAQ
"Goal management training as a cognitive remediation intervention in depression: A randomized controlled trial.

Major depressive disorder (MDD) is associated with deficits in executive functioning (EF) that may have a detrimental effect on everyday functioning. Despite this, there are no established cognitive remediation interventions available targeting EF in MDD. Hence, the primary aim of the present pre-registered randomized controlled trial was to evaluate the effectiveness of Goal Management Training (GMT), a metacognitive and strategy-based cognitive remediation intervention to improve EF in MDD. Sixty-three participants with current or previous mild or moderate MDD and self-reported executive deficits were included and randomized to nine sessions of either GMT (two hours, once weekly; n = 35) or computerized cognitive training (one hour, twice weekly; n = 28). Assessments were conducted at baseline (T1), immediately following training (T2), and at six-month follow-up (T3). The primary outcome measure was The Behavior Rating Inventory of Executive Function - Adult version, pertained to daily life EF. Secondary outcome measures included additional EF assessments (performance-based measures and questionnaires), and depressive symptom severity. Forty-three participants completed treatment. Both groups improved following training, and linear mixed model analyses revealed no statistically significant differences between the groups for any outcome measure. Additional exploratory within-group analyses revealed a statistically significant reduction of everyday executive dysfunction and reduced depressive symptoms at the six-month follow-up in GMT only. The study was single-blind, and the sample size was modest. Our findings indicate comparable improvements in everyday and performance-based measures of EF, in addition to reductions in depressive symptoms following both GMT and CCT.",32734919,Major Depressive Disorder,Anxiety Treatment,Mental Health,11311,13.749250411987305,4.35560417175293,Ak/b
"A Novel Methodology to Estimate the Treatment Effect in Presence of Highly Variable Placebo Response.

One of the main reasons for the inefficiency of multicenter randomized clinical trials (RCTs) in depression is the excessively high level of placebo response. The aim of this work was to propose a novel methodology to analyze RCTs based on the assumption that centers with high placebo response are less informative than the other centers for estimating the 'true' treatment effect (TE). A linear mixed-effect modeling approach for repeated measures (MMRM) was used as a reference approach. The new method for estimating TE was based on a nonlinear longitudinal modeling of clinical scores (NLMMRM). NLMMRM estimates TE by associating a weighting factor to the data collected in each center. The weight was defined by the posterior probability of detecting a clinically relevant difference between active treatment and placebo at that center. Data from five RCTs in depression were used to compare the performance of MMRM with NLMMRM. The results of the analyses showed an average improvement of ~15% in the TE estimated with NLMMRM when the center effect was included in the analyses. Opposite results were observed with MMRM: TE estimate was reduced by ~4% when the center effect was considered as covariate in the analysis. The novel NLMMRM approach provides a tool for controlling the confounding effect of high placebo response, to increase signal detection and to provide a more reliable estimate of the 'true' TE by controlling false negative results associated with excessively high placebo response.",25895454,Major Depressive Disorder,Anxiety Treatment,Mental Health,8564,7.853076457977295,1.3972445726394653,B+yk
"Mental Imagery Training Increases Wanting of Rewards and Reward Sensitivity and Reduces Depressive Symptoms.

High reward sensitivity and wanting of rewarding stimuli help to identify and motivate repetition of pleasant activities. This behavioral activation is thought to increase positive emotions. Therefore, both mechanisms are highly relevant for resilience against depressive symptoms. Yet, these mechanisms have not been targeted by psychotherapeutic interventions. In the present study, we tested a mental imagery training comprising eight 10-minute sessions every second day and delivered via the Internet to healthy volunteers (N = 30, 21 female, mean age of 23.8 years, Caucasian) who were preselected for low reward sensitivity. Participants were paired according to age, sex, reward sensitivity, and mental imagery ability. Then, members of each pair were randomly assigned to either the intervention or wait condition. Ratings of wanting and response bias toward probabilistic reward cues (Probabilistic Reward Task) served as primary outcomes. We further tested whether training effects extended to approach behavior (Approach Avoidance Task) and depressive symptoms (Beck Depression Inventory). The intervention led to an increase in wanting (p < .001, η2p= .45) and reward sensitivity (p = .004, η2p= .27). Further, the training group displayed faster approach toward positive edibles and activities (p = .025, η2p= .18) and reductions in depressive symptoms (p = .028, η2p= .16). Results extend existing literature by showing that mental imagery training can increase wanting of rewarding stimuli and reward sensitivity. Further, the training appears to reduce depressive symptoms and thus may foster the successful implementation of exsiting treatments for depression such as behavioral activation and could also increase resilience against depressive symptoms.",28711118,Major Depressive Disorder,Anxiety Treatment,Mental Health,9603,14.979536056518555,-0.3652496933937073,BZwO
"Efficacy of bio- and neurofeedback for depression: a meta-analysis.

For many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase. Two different strings were considered for each of the two objectives of the study: A first group comprising studies patients with major depressive disorder (MDD) and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions. In the first group of studies including patients with MDD, the within-group analyses yielded an effect size of Hedges' g = 0.717, while the between-group analysis an effect size of Hedges' g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of randomized controlled trials (RCTs) in comparison to non RCTs, whereas the type of neurofeedback, trial design, year of publication, number of sessions, age, sex and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges' g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables. Heart rate variability (HRV) biofeedback and neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.",34776024,Major Depressive Disorder,Anxiety Treatment,Mental Health,6667,11.215486526489258,1.4119138717651367,3Ks
"Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia.

Loss of pleasure or interest in activities (i.e., anhedonia) is a risk factor for suicidality, treatment nonresponse, and relapse. Extant treatments that focus on reducing negative affect have limited effects upon positive affect (a core feature of anhedonia). We investigated whether a novel intervention aimed at increasing reward sensitivity was more efficacious for positive affect than a cognitive-behavior treatment aimed at reducing threat sensitivity, in individuals with clinically severe symptoms of depression or anxiety, and functional impairment. The Treatment for Affective Dimensions trial was offered in a 2-site randomized study at outpatient treatment centers in Los Angeles and Dallas. Ninety-six patients were randomized to 15 weekly, individual sessions of Positive Affect Treatment (PAT) or Negative Affect Treatment (NAT). The primary outcome was improvement in positive affect (Positive and Negative Affect Schedule-Positive) from pretreatment to 6-month follow-up (6MFU). Secondary outcomes were improvements in negative affect (Positive and Negative Affect Schedule-Negative), suicidal ideation, and symptoms (Depression Anxiety Stress Scales). PAT resulted in greater improvements in positive affect, p = .009, d = .52, and higher positive affect at 6MFU, p = .002, d = .67, than NAT. Participants in PAT also reported lower negative affect, p = .033, d = .52, and lower symptoms of depression, p = .035, d = .34, anxiety, p < .018, d = .30, and stress, p = .006, d = .43 at 6MFU. Finally, probability of suicidal ideation at 6MFU was lower in PAT than NAT (1.7% vs. 12.0%), p < .001. Compared to NAT, PAT demonstrated better outcomes (at 6MFU) on positive affect, depression, anxiety, stress, and suicidal ideation, for patients with symptomatic pretreatment levels of these outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",30998048,Major Depressive Disorder,Anxiety Treatment,Mental Health,9603,14.889663696289062,0.23583872616291046,A7uE
"Using attentional bias modification as a cognitive vaccine against depression.

Negative attentional biases are thought to increase the risk of recurrence in depression, suggesting that reduction of such biases may be a plausible strategy in the secondary prevention of the illness. However, no previous study has tested whether reducing negative attentional bias causally affects risk factors for depressive recurrence. The current experimental medicine study reports the effects of a computerized attentional bias modification (ABM) procedure on intermediate measures of the risk of depressive recurrence (residual depressive symptoms and the cortisol awakening response) in patients with recurrent depression. Sixty-one patients with at least two previous episodes of depression who were currently in remission were randomized to receive either an active (positive) or placebo computer-based ABM regime. The ABM regime presented either pictures of faces or words. Residual depressive symptoms, measured using the Beck Depression Inventory and the cortisol awakening response were measured immediately before and after completion of the bias modification and then again after 4 weeks' follow-up. Positive, face-based ABM reduced both measures of recurrence risk (Beck Depression Inventory and cortisol awakening response). This effect occurred during the month following completion of bias modification. Word-based modification did not influence the outcome measures. Positive face-based ABM was able to reduce intermediate measures of recurrence risk in previously depressed patients. These results suggest that ABM may provide a ""cognitive vaccine"" against depression and offer a useful strategy in the secondary prevention of the illness.",22579509,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.92056941986084,-0.39302876591682434,CtnM
"The effects of Pythagorean Self-Awareness Intervention on patients with major depressive disorder: A pilot randomized controlled trial.

Stress plays an important role in major depressive disorder (MDD). Thus, a variety of stress management programs have been developed for people with this diagnosis. This is a pilot randomized clinical trial which implemented a holistic stress management program, Pythagorean Self-Awareness Intervention (PSAI) in adults with MDD, aiming to evaluate the effectiveness of PSAI compared to standard care for reduction of depressive symptoms (primary aim), improving mental health and quality of life (secondary aims). A total of 69 participants were randomized to an intervention group (N = 34), who received the usual care provided for patients with major depression and attended the PSAI program, and a control group (N = 35), who received the usual care only. Measurements were taken in both groups before and after the intervention and included: 1. Self-report questionnaires for measuring depressive symptoms, healthy lifestyle, perceived stress, anxiety, positive and negative affect and sleep quality, 2 Cognitive function assessment tools, 3. Hair and salivary cortisol. The intervention group demonstrated significantly greater reductions in depressive symptoms, negative affect, perceived stress, sleep quality and significantly greater increase in visual memory and healthy lifestyle compared to the control group. In addition, the intervention group demonstrated a significant reduction in first morning salivary cortisol, indicating a reduction in diurnal stress levels, while no significant change of salivary cortisol was observed in the control group. Finally, none of the study's groups demonstrated a significant change in hair cortisol concentration. In conclusion, PSAI can be applied to adults suffering from MDD with significant benefits for their mental health and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04536714.",33894540,Major Depressive Disorder,Anxiety Treatment,Mental Health,16839,8.632156372070312,0.008105608634650707,AXYW
"How to determine whether conceptual endophenotypes can improve clinical outcomes in patients suffering from major depression: An exploratory approach.

Depression is a complex mental health disorder, resulting in a high degree of disability. Since symptom constellation, course, and outcome are heterogeneous in these patients, current research initiatives are striving to establish stratified diagnostic and treatment approaches. In the past two decades, Dirk Hellhammer and his team introduced Neuropattern, a new diagnostic concept, which is based on conceptual endophenotypes of the stress response network. We explore how to use this concept in clinical practice in order to ultimately determine whether it brings any value over standard care. In view of the novelty of the concept and the difficulties dealing with such a concept at a practical level, it was necessary to initiate an exploratory study to determine key factors for planning future clinical trials. We report results and knowledge gained from an exploratory single-site study investigating the use and potential benefits of Neuropattern in standard care. Inpatients (ICD-10 diagnosis F32, F33; Nö=ö178) were allocated to either treatment as usual (standard group, SG) or a novel Neuropattern oriented exploratory treatment (intervention group, IG). Symptom severity was assessed with psychometric tests at admission to hospital, during the first six weeks, and upon discharge from the hospital. In addition, direct and indirect costs were assessed for the 3-month-intervals prior to and after the hospital stay. Compared to the SG, depression scores of patients in the IG showed a faster decline once psychotherapeutic and pharmacological treatment were based on an individualized explanatory model. The patients in the IG with an F33 diagnosis showed a more pronounced reduction of depression severity during the stay in the hospital and a stronger and quicker reduction of general symptom severity. Comparing the average depression scores at the start of the study and after six weeks, symptom severity was reduced in all Neuropattern groups. Some limitations of the study have to be mentioned: The study was not blinded, was single-site, included highly depressed inpatients only, and was conducted for no longer than 8 months. The results highlight some important issues regarding taking the Neuropattern approach to the bedside and researching its efficacy and effectiveness to support personalized treatments in clinical care.",30954330,Major Depressive Disorder,Anxiety Treatment,Mental Health,16008,12.499391555786133,0.8265244960784912,A8Pn
"Study protocol for a randomised, controlled platform trial estimating the effect of autobiographical Memory Flexibility training (MemFlex) on relapse of recurrent major depressive disorder.

Major depressive disorder (MDD) is a chronic condition. Although current treatment approaches are effective in reducing acute depressive symptoms, rates of relapse are high. Chronic and inflexible retrieval of autobiographical memories, and in particular a bias towards negative and overgeneral memories, is a reliable predictor of relapse. This randomised controlled single-blind trial will determine whether a therapist-guided self-help intervention to ameliorate autobiographical memory biases using Memory Flexibility training (MemFlex) will increase the experience of depression-free days, relative to a psychoeducation control condition, in the 12 months following intervention. Individuals (aged 18 and above) with a diagnosis of recurrent MDD will be recruited when remitted from a major depressive episode. Participants will be randomly allocated to complete 4weeks of a workbook providing either MemFlex training, or psychoeducation on factors that increase risk of relapse. Assessment of diagnostic status, self-report depressive symptoms, depression-free days and cognitive risk factors for depression will be completed post-intervention, and at 6 and 12 months follow-up. The cognitive target of MemFlex will be change in memory flexibility on the Autobiographical Memory Test- Alternating Instructions. The primary clinical endpoints will be the number of depression-free days in the 12 months following workbook completion, and time to depressive relapse. Ethics approval has been granted by the NHS National Research Ethics Committee (East of England, 11/H0305/1). Results from this study will provide a point-estimate of the effect of MemFlex on depressive relapse, which will be used to inform a fully powered trial evaluating the potential of MemFlex as an effective, low-cost and low-intensity option for reducing relapse of MDD. NCT02614326.",29382674,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,14.012519836425781,-0.047670938074588776,BQ10
"Improving study design for antidepressant effectiveness assessment.

Antidepressants effectiveness in major depressive disorder (MDD) is still questioned because the extrapolation of randomized controlled trial (RCT) results to ""real life"" settings is problematic. The application of the RCT paradigm in a disorder of this type, where global care plays a central role, raises questions regarding the internal and external validity of this type of study. Outcome measurement, attrition rates, the ability of the double-blind design to control for expectations, placebo response, the representativeness of trial participants and publication bias are major methodological pitfalls. This review discusses these issues. It is illustrated using original data and proposes some alternatives for assessing antidepressant effectiveness via different approaches. Some are easy to implement, such as ecological measures, qualitative approaches, improvement of analytical strategy and improvement of blinding procedures. Some are sophisticated, involving temporary deception to deal with the confounding effect of expectations, and they raise ethical issues. Others resort to external validity, this being the case in observational studies. But all are necessary to explore antidepressant effectiveness.",24038333,Major Depressive Disorder,Anxiety Treatment,Mental Health,8564,8.090689659118652,0.9961655735969543,CYrf
"Comparative effectiveness of continuation and maintenance treatments for persistent depressive disorder in adults.

Persistent depressive disorder (PDD) is defined as a depressive disorder with a minimum illness duration of two years, including four diagnostic subgroups (dysthymia, chronic major depression, recurrent major depression with incomplete remission between episodes, and double depression). Persistent forms of depression represent a substantial proportion of depressive disorders, with a lifetime prevalence ranging from 3% to 6% in the Western world. Growing evidence indicates that PDD responds well to several acute interventions, such as combined psychological and pharmacological treatments. Yet, given the high rates of relapse and recurrences of depression following response to acute treatment, long-term continuation and maintenance therapy are of great importance. To date, there has been no evidence synthesis available on continuation and maintenance treatments of PDDs. To assess the effects of pharmacological and psychological (either alone or combined) continuation and maintenance treatments for persistent depressive disorder, in comparison with each other, placebo (drug/attention placebo/non-specific treatment control), and treatment as usual (TAU). Continuation treatments are defined as treatments given to currently remitted people (remission is defined as depressive symptoms dropping below case level) or to people who previously responded to an antidepressant treatment. Maintenance therapy is given during recovery (which is defined as remission lasting longer than six months). We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 28 September 2018. An earlier search of these databases was also conducted for RCTs via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 Dec 2015). In addition we searched grey literature resources as well as the international trial registers ClinicalTrials.gov and ICTRP to 28 September 2018. We screened reference lists of included studies and contacted the first author of all included studies. We included randomized (RCTs) and non-randomized controlled trials (NRCTs) in adults with formally diagnosed PDD, receiving pharmacological, psychological, or combined continuation and maintenance interventions. Two review authors independently selected studies and extracted and analyzed data. The primary efficacy outcome was relapse/recurrence rate of depression. The primary acceptance outcome was dropout due to any reason other than relapse/recurrence. We performed random-effects meta-analyses using risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI). We included 10 studies (seven RCTs, three NRCTs) involving 840 participants in this review, from which five studies investigated continuation treatments and five studies investigated maintenance treatments. Overall, the included studies were at low-to-moderate risk of bias. For the three NRCTs, the most common source of risk of bias was selection of reported results. For the seven RCTs, the most common sources of risk of bias was non-blinding of outcome assessment and other bias (especially conflict of interest due to pharmaceutical sponsoring).Pharmacological continuation and maintenance therapiesThe most common comparison was antidepressant medication versus tablet placebo (five studies). Participants taking antidepressant medication were probably less likely to relapse or to experience a recurrent episode compared to participants in the placebo group at the end of the intervention (13.9% versus 33.8%, RR 0.41, 95% CI 0.21 to 0.79; participants = 383; studies = 4; I² = 54%, moderate quality evidence). Overall dropout rates may be similar between participants in the medication and placebo group (23.0% versus 25.5%, RR 0.90, 95% CI 0.39 to 2.11; RCTs = 4; participants = 386; I² = 64%, low quality evidence). However, sensitivity analyses showed that the primary outcome (rate of relapse/recurrence) showed no evidence of a difference between groups when only including studies with low risk of bias.None of the studies compared pharmacological or psychological treatments versus TAU.Psychological continuation and maintenance therapiesOne study compared psychological therapies versus attention placebo/non-specific control. One study compared psychotherapy with medication. The results of the studies including psychotherapy might indicate that continued or maintained psychotherapy could be a useful intervention compared to no treatment or antidepressant medication. However, the body of evidence for these comparisons was too small and uncertain to draw any high quality conclusions.Combined psychological and pharmacological continuation and maintenance therapiesThree studies compared combined psychological and pharmacological therapies with pharmacological therapies alone. One study compared combined psychological and pharmacological therapies with psychotherapeutic therapies alone. However, the body of evidence for these comparisons was too small and uncertain to draw any high quality conclusionsComparison of different antidepressant medications Two studies reported data on the direct comparison of two antidepressants. However, the body of evidence for this comparison was too small and uncertain to draw any high quality conclusions. Currently, it is uncertain whether continued or maintained pharmacotherapy (or both) with the reviewed antidepressant agents is a robust treatment for preventing relapse and recurrence in people with PDD, due to moderate or high risk of bias as well as clinical heterogeneity in the analyzed studies.For all other comparisons, the body of evidence was too small to draw any final conclusions, although continued or maintained psychotherapy might be effective compared to no treatment. There is need for more high quality trials of psychological interventions. Further studies should address health-related quality of life and adverse events more precisely, as well as assessing follow-up data.",31106850,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.416007041931152,-0.518546998500824,A6O9
"Pivotal moments and changes in the Bonny Method of Guided Imagery and Music for patients with depression.

To explore pivotal moments and changes during the Bonny Method of Guided Imagery and Music from the perspective of patients with depression. Depression has been described as an extremely difficult experience for people and is characterised by emotional distress and suffering. As depression progresses, symptoms increase and gradually influence all aspects of the lives of those affected. Few studies have been undertaken into the essence of inner and pivotal experiences during Guided Imagery and Music in patients with depression. A qualitative research design and discovery-oriented approach were used as the method of both data gathering and textual analysis. This study conducted semi-structured interviews with five patients with depression after each of eight sessions of the Bonny Method of Guided Imagery and Music. Each session took place in a music therapy laboratory. Forty transcripts were organised into categories and analysed according to the discovery-oriented approach of Mahrer and Boulet, considering the dimensions of the Bonny Method of Guided Imagery and Music. Results. Nine patients with depression were recruited from a medical centre in southern Taiwan from 2004-2005. Five successfully completed eight Bonny Method of Guided Imagery and Music sessions. There were 141 statements coded into 10 subthemes and three themes describing pivotal moments: pushing aside the barrier, gaining new insight, moving forward. Each category was supported by three-four themes. The analysis also yielded three meaningful moments: releasing mind-body rigidity, awareness and inspiration, acceptance and inner transformation. Patients described personal emotional, cognitive and behavioural transformation during the Bonny Method of Guided Imagery and Music experiences. The discovery-oriented approach fulfilled the aim of gaining a valuable understanding of the psychological growth experiences of patients with depression during the Bonny Method of Guided Imagery and Music. Patients with depression particularly need comfort and caring. It is important that nurses offer interventions as adjuvants to medication. This study supports the feasibility of incorporating the Bonny Method of Guided Imagery and Music into the nursing management of patients with depression. Future studies are suggested to examine the interactive process of music stimulus and the multidimensional nature of imagery.",20492059,Major Depressive Disorder,Anxiety Treatment,Mental Health,4698,10.282572746276855,1.1725735664367676,DKKH
"Deficits of cognitive restructuring in major depressive disorder: Measured by textual micro-counseling dialogues.

Cognitive restructuring is an important strategy in cognitive behavioral therapy (CBT). The present study aimed to observe cognitive restructuring in major depressive disorder (MDD) patients using textual micro-counseling dialogue situations. A set of textual micro-counseling dialogues was used to trigger cognitive restructuring in 25 MDD patients and 27 healthy adults. The participants read descriptions (""problems"") and explanations (""solutions"") for psychologically distressing situations. High-, low-, and zero-restructuring solutions were randomly matched to the problems. The participants evaluated the adaptability and emotional valence of the problems and the insightfulness, adaptability, novelty, and emotional valence of the solutions. Insightfulness ratings for high-restructuring solutions were significantly higher relative to those of low-restructuring solutions in healthy adults, while adaptability ratings for low-restructuring solutions were significantly higher relative to those of high-restructuring solutions in MDD patients. Insightfulness ratings for the solutions were significantly predicted by novelty and adaptability in healthy adults and emotional valence in MDD patients. Lower insightfulness in high-restructuring solutions and higher adaptability in low-restructuring solutions in MDD patients may reflect deficits in cognitive control.",27086227,Major Depressive Disorder,Anxiety Treatment,Mental Health,7324,12.63514232635498,0.0007096044137142599,BuHw
"Pharmacological targeting of cognitive impairment in depression: recent developments and challenges in human clinical research.

Impaired cognition is often overlooked in the clinical management of depression, despite its association with poor psychosocial functioning and reduced clinical engagement. There is an outstanding need for new treatments to address this unmet clinical need, highlighted by our consultations with individuals with lived experience of depression. Here we consider the evidence to support different pharmacological approaches for the treatment of impaired cognition in individuals with depression, including treatments that influence primary neurotransmission directly as well as novel targets such as neurosteroid modulation. We also consider potential methodological challenges in establishing a strong evidence base in this area, including the need to disentangle direct effects of treatment on cognition from more generalised symptomatic improvement and the identification of sensitive, reliable and objective measures of cognition.",36396622,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.852147102355957,0.805931031703949,BFU
"The Efficacy of Psychological Interventions on Health-Related Quality of Life for Patients With Heart Failure and Depression: A Systematic Review.

Depression is prevalent among adults with chronic heart failure (CHF) and is associated with higher rates of morbidity and mortality and higher healthcare costs. The aim of this study was to explore the efficacy of psychological interventions in reducing depression and improving quality of life and clinical outcomes (mortality, hospitalization) among adults with CHF. This study performed a systematic review involving searches of 6 databases (MEDLINE, CINAHL, EMBASE, PsycINFO, ASSIA, and SSCI), the Cochrane library, and gray literature, completed in January 2020. Experimental and nonexperimental quantitative studies of psychological interventions for adults with CHF were included. Each study was quality appraised, and key data were extracted and tabled. Overall findings are presented as a narrative synthesis. Nine studies met eligibility. Study authors sampled 757 participants and evaluated 4 psychological interventions: cognitive behavioral therapy alone or combined with exercise, mindfulness-based psychoeducation, coping skills training, and innovative holistic meditation. Cognitive behavioral therapy was significantly associated with improved depression and quality of life, and reduced hospitalization risk. Mindfulness-based psychoeducation, holistic meditation, and coping skills training positively impacted depression and quality of life. Coping skills training also reduced hospitalization and mortality risks. Although this review indicates that psychological interventions can be beneficial to adults with CHF who have depression, the overall weight of evidence contains a number of biases. Larger, higher-powered studies are needed to confirm or refute these findings and to better understand how specific intervention and sample characteristics relate to outcomes.",33394624,Major Depressive Disorder,Anxiety Treatment,Mental Health,8489,7.255792140960693,-0.3169112205505371,AdD/
"Mindfulness-based cognitive therapy (MBCT) versus the health-enhancement program (HEP) for adults with treatment-resistant depression: a randomized control trial study protocol.

Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. Up to 40% of patients with depression are unresponsive to at least two trials of antidepressant medication and thus have ""treatment-resistant depression"" (TRD). There is an urgent need for cost-effective, non-pharmacologic, evidence-based treatments for TRD. Mindfulness-Based Cognitive Therapy (MBCT) is an effective treatment for relapse prevention and residual depression in major depression, but has not been previously studied in patients with TRD in a large randomized trial. The purpose of this study was to evaluate whether MBCT is an effective augmentation of antidepressants for adults with MDD who failed to respond to standard pharmacotherapy. MBCT was compared to an active control condition, the Health-Enhancement Program (HEP), which incorporates physical activity, functional movement, music therapy and nutritional advice. HEP was designed as a comparator condition for mindfulness-based interventions to control for non-specific effects. Originally investigated in a non-clinical sample to promote stress reduction, HEP was adapted for a depressed population for this study. Individuals age 18 and older with moderate to severe TRD, who failed to respond to at least two trials of antidepressants in the current episode, were recruited to participate. All participants were taking antidepressants (Treatment as usual; TAU) at the time of enrollment. After signing an informed consent, participants were randomly assigned to either MBCT or HEP condition. Participants were followed for 1 year and assessed at weeks 1-7, 8, 24, 36, and 52. Change in depression severity, rate of treatment response and remission after 8 weeks were the primary outcomes measured by the clinician-rated Hamilton Depression Severity Rating (HAM-D) 17-item scale. The participant-rated Quick Inventory of Depression Symptomology (QIDS-SR) 16-item scale was the secondary outcome measure of depression severity, response, and remission. Treatment-resistant depression entails significant morbidity and has few effective treatments. We studied the effect of augmenting antidepressant medication with MBCT, compared with a HEP control, for patients with TRD. Analyses will focus on clinician and patient assessment of depression, participants' clinical global impression change, employment and social functioning scores and quality of life and satisfaction ratings. ClincalTrials.gov identifier: NCT01021254.",24612825,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.627667427062988,-0.41356411576271057,CRGy
"Telephone and in-person cognitive behavioral therapy for major depression after traumatic brain injury: a randomized controlled trial.

Major depressive disorder (MDD) is prevalent after traumatic brain injury (TBI); however, there is a lack of evidence regarding effective treatment approaches. We conducted a choice-stratified randomized controlled trial in 100 adults with MDD within 10 years of complicated mild to severe TBI to test the effectiveness of brief cognitive behavioral therapy administered over the telephone (CBT-T) (n = 40) or in-person (CBT-IP) (n = 18), compared with usual care (UC) (n = 42). Participants were recruited from clinical and community settings throughout the United States. The main outcomes were change in depression severity on the clinician-rated 17 item Hamilton Depression Rating Scale (HAMD-17) and the patient-reported Symptom Checklist-20 (SCL-20) over 16 weeks. There was no significant difference between the combined CBT and UC groups over 16 weeks on the HAMD-17 (treatment effect = 1.2, 95% CI: -1.5-4.0; p = 0.37) and a nonsignificant trend favoring CBT on the SCL-20 (treatment effect = 0.28, 95% CI: -0.03-0.59; p = 0.074). In follow-up comparisons, the CBT-T group had significantly more improvement on the SCL-20 than the UC group (treatment effect = 0.36, 95% CI: 0.01-0.70; p = 0.043) and completers of eight or more CBT sessions had significantly improved SCL-20 scores compared with the UC group (treatment effect = 0.43, 95% CI: 0.10-0.76; p = 0.011). CBT participants reported significantly more symptom improvement (p = 0.010) and greater satisfaction with depression care (p < 0.001), than did the UC group. In-person and telephone-administered CBT are acceptable and feasible in persons with TBI. Although further research is warranted, telephone CBT holds particular promise for enhancing access and adherence to effective depression treatment.",25072405,Major Depressive Disorder,Anxiety Treatment,Mental Health,11272,13.912336349487305,4.853017330169678,CKkF
"Contemporary methods of improving cognitive dysfunction in clinical depression.

Cognitive dysfunction is prevalent in patients with major depressive disorder (MDD), with deficits observed across several domains (e.g., executive function, memory, attention). While depression alone is disabling, patients with cognitive deficits typically experience greater functional impairments, poorer clinical recovery, and reduced quality of life. Consequently, it is imperative to elucidate recent advances in our understanding of the treatment of cognitive dysfunction in MDD. Areas covered: This review spans psychological, physical, and pharmacological treatment approaches for cognitive dysfunction in depression. Where possible, the authors summarise where treatments have demonstrated efficacy in improving specific cognitive domains (e.g., attention), and highlight the differential mechanisms which underpin cognitive improvement. In addition, the roles of adjunctive cognitive treatments (e.g., exercise), and the possible side effects and drawbacks of specific treatments are explored. Expert opinion: Psychological treatments typically confer cognitive improvement alongside functional and/or clinical recovery; however, the efficacy of cognitive training and cognitive behavioral therapy to longitudinal cognitive improvement remains to be established. Recently developed pharmacological agents may improve cognition by reducing low-grade inflammation and promoting neurogenesis; however, the pro-cognitive effects of typical antidepressants are limited. Integrated approaches which emphasize cognitive recovery alongside clinical and functional improvement may be key to advancing patient outcomes.",31020872,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.891876220703125,0.31536564230918884,A7aM
"Psychological and pharmacological interventions for depression in patients with coronary artery disease.

Depression occurs frequently in individuals with coronary artery disease (CAD) and is associated with a poor prognosis. To determine the effects of psychological and pharmacological interventions for depression in CAD patients with comorbid depression. We searched the CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL databases up to August 2020. We also searched three clinical trials registers in September 2021. We examined reference lists of included randomised controlled trials (RCTs) and contacted primary authors. We applied no language restrictions. We included RCTs investigating psychological and pharmacological interventions for depression in adults with CAD and comorbid depression. Our primary outcomes included depression, mortality, and cardiac events. Secondary outcomes were healthcare costs and utilisation, health-related quality of life, cardiovascular vital signs, biomarkers of platelet activation, electrocardiogram wave parameters, non-cardiac adverse events, and pharmacological side effects. Two review authors independently examined the identified papers for inclusion and extracted data from the included studies. We performed random-effects model meta-analyses to compute overall estimates of treatment outcomes. Thirty-seven trials fulfilled our inclusion criteria. Psychological interventions may result in a reduction in end-of-treatment depression symptoms compared to controls (standardised mean difference (SMD) -0.55, 95% confidence interval (CI) -0.92 to -0.19, I2 = 88%; low certainty evidence; 10 trials; n = 1226). No effect was evident on medium-term depression symptoms one to six months after the end of treatment (SMD -0.20, 95% CI -0.42 to 0.01, I2 = 69%; 7 trials; n = 2654). The evidence for long-term depression symptoms and depression response was sparse for this comparison. There is low certainty evidence that psychological interventions may result in little to no difference in end-of-treatment depression remission (odds ratio (OR) 2.02, 95% CI 0.78 to 5.19, I2 = 87%; low certainty evidence; 3 trials; n = 862). Based on one to two trials per outcome, no beneficial effects on mortality and cardiac events of psychological interventions versus control were consistently found. The evidence was very uncertain for end-of-treatment effects on all-cause mortality, and data were not reported for end-of-treatment cardiovascular mortality and occurrence of myocardial infarction for this comparison. In the trials examining a head-to-head comparison of varying psychological interventions or clinical management, the evidence regarding the effect on end-of-treatment depression symptoms is very uncertain for: cognitive behavioural therapy compared to supportive stress management; behaviour therapy compared to person-centred therapy; cognitive behavioural therapy and well-being therapy compared to clinical management. There is low certainty evidence from one trial that cognitive behavioural therapy may result in little to no difference in end-of-treatment depression remission compared to supportive stress management (OR 1.81, 95% CI 0.73 to 4.50; low certainty evidence; n = 83). Based on one to two trials per outcome, no beneficial effects on depression remission, depression response, mortality rates, and cardiac events were consistently found in head-to-head comparisons between psychological interventions or clinical management. The review suggests that pharmacological intervention may have a large effect on end-of-treatment depression symptoms (SMD -0.83, 95% CI -1.33 to -0.32, I2 = 90%; low certainty evidence; 8 trials; n = 750). Pharmacological interventions probably result in a moderate to large increase in depression remission (OR 2.06, 95% CI 1.47 to 2.89, I2 = 0%; moderate certainty evidence; 4 trials; n = 646). We found an effect favouring pharmacological intervention versus placebo on depression response at the end of treatment, though strength of evidence was not rated (OR 2.73, 95% CI 1.65 to 4.54, I2 = 62%; 5 trials; n = 891). Based on one to four trials per outcome, no beneficial effects regarding mortality and cardiac events were consistently found for pharmacological versus placebo trials, and the evidence was very uncertain for end-of-treatment effects on all-cause mortality and myocardial infarction. In the trials examining a head-to-head comparison of varying pharmacological agents, the evidence was very uncertain for end-of-treatment effects on depression symptoms. The evidence regarding the effects of different pharmacological agents on depression symptoms at end of treatment is very uncertain for: simvastatin versus atorvastatin; paroxetine versus fluoxetine; and escitalopram versus Bu Xin Qi. No trials were eligible for the comparison of a psychological intervention with a pharmacological intervention. In individuals with CAD and depression, there is low certainty evidence that psychological intervention may result in a reduction in depression symptoms at the end of treatment. There was also low certainty evidence that pharmacological interventions may result in a large reduction of depression symptoms at the end of treatment. Moderate certainty evidence suggests that pharmacological intervention probably results in a moderate to large increase in depression remission at the end of treatment. Evidence on maintenance effects and the durability of these short-term findings is still missing. The evidence for our primary and secondary outcomes, apart from depression symptoms at end of treatment, is still sparse due to the low number of trials per outcome and the heterogeneity of examined populations and interventions. As psychological and pharmacological interventions can seemingly have a large to only a small or no effect on depression, there is a need for research focusing on extracting those approaches able to substantially improve depression in individuals with CAD and depression.",34910821,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,7.164898872375488,0.053192246705293655,xmk
"Attention Bias Modification training in individuals with depressive symptoms: A randomized controlled trial.

Negative attentional biases are often considered to have a causal role in the onset and maintenance of depressive symptoms. This suggests that reduction of such biases may be a plausible strategy in the treatment of depressive symptoms. The present clinical randomized controlled trial examined long-term effects of a computerized attention bias modification (ABM) procedure on individuals with elevated depressive symptoms. In a double-blind study design, 77 individuals with ongoing mild to severe symptoms of depression were randomly assigned to one of three conditions: 1) ABM training (n = 27); 2) placebo (n = 27); 3) assessment-only (n = 23). In both the ABM and placebo conditions, participants completed 8 sessions of 216-trials (1728 in total) during a 2-week period. Assessments were conducted at pre-training and post-training (0, 2, 4, 8-week, 3, 7-month follow-ups). Change in depressive symptoms and restoration of asymptomatic level were the primary outcome measures. In the ABM, but not the other two conditions, significant reductions in depressive symptoms were found at post-training and maintained during the 3-month follow-up. Importantly, more participants remained asymptomatic in the ABM condition, as compared to the other two conditions, from post-training to 7-month follow-up. ABM also significantly reduced secondary outcome measures including rumination and trait anxiety, and notably, the ABM effect on reducing depressive symptoms was mediated by rumination. Generalization of the findings may be limited because the present sample included only college students. The ABM effect on reducing depressive symptoms was maintained for at least 3-month duration in individuals with elevated depressive symptoms, and these results suggest that ABM may be a useful tool for the prevention of depressive symptoms. CLINICALTRIALS.GOV: NCT01628016.",25245928,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.537033081054688,-0.2572876811027527,CICK
"Positive online attentional training as a means of modifying attentional and interpretational biases among the clinically depressed: An experimental study using eye tracking.

The present study examined the effectiveness of online positive attention bias modification training (ABMT) in inducing positive attention and positive interpretational biases in depressed individuals. Clinically depressed individuals (n = 60) were randomly assigned to one of two conditions of 14-day online ABMT. In the positive ABMT condition, a probe replaced positive stimuli in 100% of trials. In the control condition, the probe replaced positive stimuli in 50% of trials. Before and after training, we recorded eye movements during the completion of a Scrambled Sentence Task in which participants created positive or negative sentences. Participants also completed measures of symptoms of depression and anxiety. After training, participants in the positive ABMT condition fixated longer on positive keywords than participants in the control group and experienced a significant reduction in anxiety. These findings suggest that positive AMBT can promote positive attention bias among clinically depressed individuals.",29542816,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,16.109045028686523,-0.08847256749868393,BOmw
"Integrated traditional and Western medicine for treatment of depression based on syndrome differentiation: a meta-analysis of randomized controlled trials based on the Hamilton depression scale.

To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale (HAMD) following syndrome differentiation of depression. We searched six English and Chinese electronic databases for randomized clinical trials (RCTs) on integrated traditional and Western medicine for treatment of depression. Two authors extracted data and independently assessed the trial quality. RevMan 5 software was used for data analyses with an effect estimate presented as weighted mean difference (WMD) with a 95% confidence interval (CI). Seven RCTs with 576 participants were identified for this review. All trials were eligible for the meta-analysis and were evaluated as unclear or having a risk of bias. Meta-analysis showed, compared with Western medicine alone, integrated traditional and Western medicine based on syndrome differentiation could improve the effect of treatment represented by the HAMD [WMD = -2.39, CI (-2.96,-1.83), Z = 8.29, P < 0.00001]. There were no reported serious adverse effects that were related to integrated traditional and Western medicine based therapies in these trials. Integrated traditional and Western medicine based therapies for the syndrome differentiation of depression significantly improved the HAMD, illustrating that combining therapies from integrated traditional and Western medicine for treatment of depression is better than Western medicine alone. However, further large, rigorously designed trials are warranted due to the insufficient methodological rigor seen in the trials included in this study.",22594094,Major Depressive Disorder,Anxiety Treatment,Mental Health,8951,8.229068756103516,-0.22962172329425812,CtZ7
"Translational approaches in treatment-resistant depression based on animal model.

An intensively researched and yet poorly understood phenomenon, both at clinical and neurobiological level, is the determinism of treatment-resistant depression. Even more controversial are the stages of approaching therapeutically this pathology because there are no evidence-based recommendations stating that a pharmacological agent is superior to another, on medium and long-term. Due to the lack of ""golden standard"" approaches, physician's experience, therapeutic alliance and a close monitoring stand as the most useful good practices in the treatment of resistant depression. The neurobiology of this pathology is incompletely characterized, and the current paper will present data derived from single-photon emission computed tomography as arguments for a better understanding of the treatment-resistance in major depression. These data have been compared with the existing data in the literature and arguments in favor of using this investigational method have been formulated. All the three cases presented are patients diagnosed with treatment-resistant major depression, each case with its own psychiatric and somatic background, and therefore with its own therapeutic approach. In all these cases, structured interviews and psychometric scales were applied in order to allow a flexible pharmacological regimen, adjusted to the patient's dynamic needs. Measurements for health-related quality of life were considered necessary for treatment-resistant depression monitoring because low values registered in this domain have important prognostic significance. Translational studies on animal models of depression support the existence of cerebral structural dysfunctions or lesions which can be correlated with clinical and neuroimaging data, allowing for the formulation of neurobiological and psychopharmacological models for treatment-resistant depression.",30534840,Major Depressive Disorder,Anxiety Treatment,Mental Health,5984,9.741024017333984,-0.30388984084129333,BCA2
"Psychological and Psychosocial Interventions for Depression and Anxiety in Patients With Age-Related Macular Degeneration: A Systematic Review.

To review the current literature on psychosocial and psychological interventions to prevent and treat depression and anxiety in patients with age-related macular degeneration (AMD). The authors conducted a systematic review of literature evaluating psychosocial and psychological interventions for depression and anxiety in patients with AMD. Primary searches of PubMed, Cochrane library, EMBASE, Global Health, Web of Science, EBSCO, and Science Direct were conducted to include all articles published up to April 21, 2018. Of a total of 398 citations retrieved, the authors selected 12 eligible studies published between 2002 and 2016. The authors found nine randomized controlled trials (RCT), and three non-randomized intervention (NRI) studies. RCT studies suggested that interventions using group self-management techniques and individual behavioral activation plus low vision rehabilitation can be effective to treat and prevent depression in patients with AMD, and one study suggested that a stepped-care intervention using cognitive-behavioral techniques can be effective to manage anxiety and depression over time. NRI studies highlighted a positive effect of self-help and emotion-focused interventions to reduce depression. Clinical practice with patients with AMD can rely on some tailored cognitive-behavioral therapeutic protocols to improve patients' mental health, but further clinical trials will generate the necessary evidence-based knowledge to improve those therapeutic techniques and offer additional tailored interventions for patients with AMD.",31005495,Major Depressive Disorder,Anxiety Treatment,Mental Health,3755,8.473114967346191,1.858075737953186,A7nf
"Efficacy versus effectiveness: a direct comparison of the outcome of treatment for mild to moderate depression in randomized controlled trials and daily practice.

Results from randomized controlled trials (RCTs) are considered to give the most reliable information on treatment outcome (efficacy). Yet, the generalizability of efficacy results to daily practice (effectiveness) might be diminished by the design of RCTs. The STAR*D trial approached daily practice as much as possible, but still has some properties of an RCT. In this study, we compare results from treatment of major depressive disorder (MDD) in routine clinical practice to those of RCTs and STAR*D. Effectiveness in routine clinical practice was compared with efficacy results from 15 meta-analyses on antidepressant, psychotherapeutic and combination treatment and results from STAR*D. Data on daily practice patients and treatments were derived from a routine outcome monitoring (ROM) system. Treatment outcome was defined as proportion of remitters (MADRS ≤10) and within-group effect size. From ROM, 598 patients suffering from a MDD episode according to the MINI-plus were included. Remission percentages were lower in routine practice than in meta-analyses for all treatment modalities (32 vs.40-74%). Differences were less explicit for antidepressants (21 vs. 34-47%) than for individual psychotherapy (27 vs. 34-58%; effect size 0.85 vs. 1.71) and combination therapy (21 vs. 45-63%), since only 60% of the meta-analyses for antidepressants showed significant differences with ROM, while for psychotherapy and combination treatment almost all meta-analyses showed significant differences. No differences in effectiveness were found between routine practice and STAR*D (antidepressants 27 vs. 28%; individual psychotherapy 27 vs. 25%; combination treatment 21 vs. 23%, respectively). Effectiveness of treatment for mild-to-moderate MDD in daily practice is similar to STAR*D and significantly lower than efficacy results from RCTs.",22584117,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,8.15955638885498,0.8640075325965881,CtiA
"A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression.

Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD. This single-site, randomized controlled trial compared 8-week courses of MBCT and the Health Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD. The primary outcome was change in depression severity, measured by percent reduction in the total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission. We enrolled 173 adults; mean length of a current depressive episode was 6.8 years (SD = 8.9). At the end of 8 weeks of treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction in the HAM-D17 (36.6 vs. 25.3%; p = 0.01) and a significantly higher rate of treatment responders (30.3 vs. 15.3%; p = 0.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4 vs. 13.9%; p = 0.15). In these models, state anxiety, perceived stress and the presence of personality disorder had adverse effects on outcomes. MBCT significantly decreased depression severity and improved treatment response rates at 8 weeks but not remission rates. MBCT appears to be a viable adjunct in the management of TRD.",26808973,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.576131820678711,-0.49494755268096924,ByCN
"Cognitive bias modification as an add-on treatment in clinical depression: Results from a placebo-controlled, single-blinded randomized control trial.

Only 60% of depressed patients respond sufficiently to treatment, so there is a dire need for novel approaches to improve treatment effects. Cognitive Bias Modification (CBM) may be an effective and easily implemented computerized add-on to treatment-as-usual. Therefore, we investigated the effects of a positivity-attention training and a positivity-approach training compared to control trainings. In a blinded randomized-controlled design, 139 depressed inpatients received either the CBM Attention Dot-Probe Training (DPT) or the CBM Approach-Avoidance Training (AAT), next to treatment as usual. N = 121 finished all four training sessions. Both trainings had an active and a control condition. In both active conditions, patients were trained to preferentially process generally positive pictures over neutral pictures. Depressive symptom severity was assessed before and after CBM, and positivity bias was measured at the start and end of each session. Clinician-rated depressive symptom severity decreased more in patients who received the active condition of the DPT or the AAT compared to patients in the control conditions. Significant change in positivity bias was found for the DPT (not the AAT), but did not mediate the effect of the training on depressive symptoms. The results suggest that both types of CBM (i.e., DPT and AAT) may provide a fitting add-on treatment option for clinical depression. The working mechanisms and optimal dose of CBM trainings, plus their possible combination, should be examined in more detail.",29908472,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.215291976928711,-0.4895995855331421,BKSv
"Randomised controlled cognition trials in remitted patients with mood disorders published between 2015 and 2021: A systematic review by the International Society for Bipolar Disorders Targeting Cognition Task Force.

Cognitive impairments are an emerging treatment target in mood disorders, but currently there are no evidence-based pro-cognitive treatments indicated for patients in remission. With this systematic review of randomised controlled trials (RCTs), the International Society for Bipolar Disorders (ISBD) Targeting Cognition Task force provides an update of the most promising treatments and methodological recommendations. The review included RCTs of candidate pro-cognitive interventions in fully or partially remitted patients with major depressive disorder or bipolar disorder. We followed the procedures of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 2020 statement. Searches were conducted on PubMed/MEDLINE, PsycInfo, EMBASE and Cochrane Library from January 2015, when two prior systematic reviews were conducted, until February 2021. Two independent authors reviewed the studies with the Revised Cochrane Collaboration's Risk of Bias tool for Randomised trials. We identified 16 RCTs (N = 859) investigating cognitive remediation (CR; k = 6; N = 311), direct current or repetitive magnetic stimulation (k = 3; N = 127), or pharmacological interventions (k = 7; N = 421). CR showed most consistent cognitive benefits, with two trials showing improvements on primary outcomes. Neuromodulatory interventions revealed no clear efficacy. Among pharmacological interventions, modafinil and lurasidone showed early positive results. Sources of bias included small samples, lack of pre-screening for objective cognitive impairment, no primary outcome and no information on allocation sequence masking. Evidence for pro-cognitive treatments in mood disorders is emerging. Recommendations are to increase sample sizes, pre-screen for impairment in targeted domain(s), select one primary outcome, aid transfer to real-world functioning, investigate multimodal interventions and include neuroimaging.",35174594,Major Depressive Disorder,Anxiety Treatment,Mental Health,6095,12.93313980102539,0.024909136816859245,m2o
"A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD): Results of an Observer-Blinded, Multicenter, Randomized Trial in Depressed Patients With Coronary Artery Disease.

Depression predicts adverse prognosis in patients with coronary artery disease (CAD), but previous treatment trials yielded mixed results. We tested the hypothesis that stepwise psychotherapy improves depressive symptoms more than simple information. In a multicenter trial, we randomized 570 CAD patients scoring higher than 7 on the Hospital Anxiety and Depression Scale-depression subscale to usual care plus either one information session (UC-IS) or stepwise psychotherapy (UC-PT). UC-PT patients received three individual psychotherapy sessions. Those still depressed were offered group psychotherapy (25 sessions). The primary outcome was changed in the Hospital Anxiety and Depression Scale-depression scores from baseline to 18 months. Preplanned subgroup analyses examined whether treatment responses differed by patients' sex and personality factors (Type D). The mean (standard deviation) depression scores declined from 10.4 (2.5) to 8.7 (4.1) at 18 months in UC-PT and from 10.4 (2.5) to 8.9 (3.9) in UC-IS (both p < .001). There was no significant group difference in change of depressive symptoms (group-by-time effect, p = .90). Preplanned subgroup analyses revealed no differences in treatment effects between men versus women (ptreatment-by-sex interaction = .799) but a significant treatment-by-Type D interaction on change in depressive symptoms (p = .026) with a trend for stronger improvement with UC-PT than UC-IS in Type D patients (n = 341, p = .057) and no such difference in improvement in patients without Type D (n = 227, p = .54). Stepwise psychotherapy failed to improve depressive symptoms in CAD patients more than UC-IS. The intervention might be beneficial for depressed CAD patients with Type D personality. However, this finding requires further study. www.clinicaltrials.gov NCT00705965; www.isrctn.com ISRCTN76240576.",27187851,Major Depressive Disorder,Anxiety Treatment,Mental Health,2285,7.006778717041016,0.1452331244945526,BstS
"Cognitive training interventions and depression in mild cognitive impairment and dementia: a systematic review and meta-analysis of randomized controlled trials.

Depression is common in people with cognitive impairment but the effect of cognitive training in the reduction of depression is still uncertain. The purpose of this paper is to evaluate the effect of cognitive training interventions in the reduction of depression rating scale score in people with cognitive impairment. Literature searches were conducted via OVID databases. Randomized controlled trials (RCTs) evaluated the effect of cognitive training interventions for the reduction of depression rating scale score in people with mild cognitive impairment (MCI) or dementia were included. Mean difference (MD) with 95% confidence interval (CI) was used to combine the results of Geriatric Depression Scale (GDS). Standardized mean difference (SMD) was used to combine the results of different depression rating scales. Subgroup analyses were conducted according to the types of cognitive training and severity of cognitive impairment, i.e. MCI and dementia. A total of 2551 people with MCI or dementia were extracted from 36 RCTs. The baseline mean score of GDS-15 was 4.83. Participants received cognitive training interventions had a significant decrease in depression rating scale score than the control group (MD of GDS-15=-1.30, 95% CI=-2.14--0.47; and SMD of eight depression scales was -0.54 (95% CI=-0.77--0.31). In subgroup analyses, the effect size of computerized cognitive training and cognitive stimulation therapy were medium-to-large and statistically significant in the reduction of depression rating scale score. Cognitive training interventions show to be a potential treatment to ameliorate depression in people with cognitive impairment.",32378715,Major Depressive Disorder,Anxiety Treatment,Mental Health,11554,11.901243209838867,4.418894290924072,Apft
"Longitudinal effects of cognitive behavioral therapy for depression on the neural correlates of emotion regulation.

Cognitive behavioral therapy (CBT) is effective for a substantial minority of patients suffering from major depressive disorder (MDD), but its mechanism of action at the neural level is not known. As core techniques of CBT seek to enhance emotion regulation, we scanned 31 MDD participants prior to 14 sessions of CBT using functional magnetic resonance imaging (fMRI) and a task in which participants engaged in a voluntary emotion regulation strategy while recalling negative autobiographical memories. Eighteen healthy controls were also scanned. Twenty-three MDD participants completed post-treatment fMRI scanning, and 12 healthy volunteers completed repeat scanning without intervention. Better treatment outcome was associated with longitudinal enhancement of the emotion regulation-dependent BOLD contrast within subgenual anterior cingulate, medial prefrontal cortex, and lingual gyrus. Baseline emotion regulation-dependent BOLD contrast did not predict treatment outcome or differ between MDD and control groups. CBT response may be mediated by enhanced downregulation of neural activity during emotion regulation; brain regions identified overlap with those found using a similar task in a normative sample, and include regions related to self-referential and emotion processing. Future studies should seek to determine specificity of this downregulation to CBT, and evaluate it as a treatment target in MDD.",29128142,Major Depressive Disorder,Anxiety Treatment,Mental Health,3407,14.215919494628906,0.6743897795677185,BUTs
"Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis.

Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to non-specific controls at post-treatment (k = 10, d = 0.71, 95% confidence interval [CI] [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [-0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [-0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [-0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.",30732534,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.644792556762695,-0.47370678186416626,A/OZ
"Cognitive remediation as a treatment for major depression: A rationale, review of evidence and recommendations for future research.

There is considerable literature regarding the effectiveness of cognitive remediation (CR) in schizophrenia and in conditions such as stroke and traumatic brain injury. Patients with major depressive disorder (MDD) present with significant cognitive impairment which in many cases may not resolve with treatment. Neurobiological data suggest that this may relate to underlying dysfunction of pre-frontal cortical areas of the brain and their connections with limbic structures. There has been limited research into specific CR to activate these areas and target impaired cognitive function in MDD. We therefore review current evidence, examine the theoretical basis for and present a rationale for research into CR in MDD. In addition, we will examine important methodological issues in developing such an approach. Based on preliminary studies using CR-based techniques, data from CR in schizophrenia, data regarding baseline and residual cognitive impairment in depression, and knowledge of the neurobiology of MDD, we examine the possible utility of CR strategies in the treatment of MDD and make recommendations for research in this area. A small number of previous studies have examined specific CR in MDD. The studies are small and inconclusive. However, data on the neuropsychological function and neurobiology of MDD suggest that this is an approach that deserves further attention and research. Further research is required in carefully selected populations, using well-defined CR techniques and some form of comparator treatment.",23956342,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.910178184509277,0.3781326711177826,CZ06
"A cluster randomized controlled platform trial comparing group MEmory specificity training (MEST) to group psychoeducation and supportive counselling (PSC) in the treatment of recurrent depression.

Impaired ability to recall specific autobiographical memories is characteristic of depression, which when reversed, may have therapeutic benefits. This cluster-randomized controlled pilot trial investigated efficacy and aspects of acceptability, and feasibility of MEmory Specificity Training (MEST) relative to Psychoeducation and Supportive Counselling (PSC) for Major Depressive Disorder (N = 62). A key aim of this study was to determine a range of effect size estimates to inform a later phase trial. Assessments were completed at baseline, post-treatment and 3-month follow-up. The cognitive process outcome was memory specificity. The primary clinical outcome was symptoms on the Beck Depression Inventory-II at 3-month follow-up. The MEST group demonstrated greater improvement in memory specificity relative to PSC at post-intervention (d = 0.88) and follow-up (d = 0.74), relative to PSC. Both groups experienced a reduction in depressive symptoms at 3-month follow-up (d = 0.67). However, there was no support for a greater improvement in depressive symptoms at 3 months following MEST relative to PSC (d = -0.04). Although MEST generated changes on memory specificity and improved depressive symptoms, results provide no indication that MEST is superior to PSC in the resolution of self-reported depressive symptoms. Implications for later-phase definitive trials of MEST are discussed.",29587159,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,14.350537300109863,-0.28450608253479004,BOA7
"Cognitive behavioral therapy for depression improves pain and perceived control in cardiac surgery patients.

Depression after cardiac surgery (CS) is associated with increased pain and decreased sleep quality. While cognitive behavioral therapy (CBT) aimed at depression is effective in relieving depressive symptoms after cardiac surgery, little is known about its ability to ameliorate other common postoperative problems that affect recovery and quality of life. The purpose of this study was to evaluate the effects of CBT for depression on pain severity, pain interference, sleep, and perceived control in patients recovering from CS. Depressed patients recovering from CS were randomized to receive either eight weeks of CBT or usual care. At baseline and post-intervention, patients completed questionnaires for depressive symptoms, pain, sleep, and perceived control. Group comparisons were conducted using t-tests or chi square analysis. Repeated measures analysis was used to assess the effect of the intervention in changes over time. The sample (n=53) included 16.9% women and had a mean age of 67.8±9.2 years. CBT for depression increased perceived control (p<0.001) and decreased pain interference (p=0.02) and pain severity (p=0.03). Group effects remained significant (p<0.05) for perceived control and pain interference and a trend was observed for pain severity (p<0.10) after controlling for variables that differed at baseline. There were no group differences in sleep disturbance over time. A depression-focused CBT intervention yields benefits in other common postoperative problems, specifically improved perceived control and decreased pain in depressed cardiac surgery patients.",26115954,Major Depressive Disorder,Anxiety Treatment,Mental Health,7940,6.477941989898682,-0.043317556381225586,B7tX
"Feasibility and acceptability of group music therapy vs wait-list control for treatment of patients with long-term depression (the SYNCHRONY trial): study protocol for a randomised controlled trial.

Depression is of significant global concern. Despite a range of effective treatment options it is estimated that around one in five diagnosed with an acute depressive episode continue to experience enduring symptoms for more than 2 years. There is evidence for effectiveness of individual music therapy for depression. However, no studies have as yet looked at a group intervention within an NHS context. This study aims to assess the feasibility of conducting a randomised controlled trial of group music therapy for patients with long-term depression (symptom durations of 1 year or longer) within the community. This is a single-centre randomised controlled feasibility trial of group music therapy versus wait-list control with a nested process evaluation. Thirty participants will be randomised with unbalanced allocation (20 to receive the intervention immediately, 10 as wait-list controls). Group music therapy will be offered three times per week in a community centre with a focus on songwriting. Data will be collected post-intervention, 3 and 6 months after the intervention finishes. We will examine the feasibility of recruitment processes including identifying the number of eligible participants, participation and retention rates and the intervention in terms of testing components, measuring adherence and estimation of the likely intervention effect. A nested process evaluation will consist of treatment fidelity analysis, exploratory analysis of process measures and end-of-participation interviews with participants and referring staff. Whilst group music therapy is an option in some community mental health settings, this will be the first study to examine group music therapy for this particular patient group. We will assess symptoms of depression, acceptability of the intervention and quality of life. We anticipate potential challenges in the recruitment and retention of participants. It is unclear whether offering the intervention three times per week will be acceptable to participants, particularly given participants' enduring symptoms and impact upon motivation. This study will provide data to inform both development of the intervention and to assess and inform the design of a full trial. ISRCTN.com, ISRCTN18164037 . Registered on 26 September 2016.",28356125,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.377352714538574,1.1448861360549927,Bevr
"The generalizability of psychotherapy efficacy trials in major depressive disorder: an analysis of the influence of patient selection in efficacy trials on symptom outcome in daily practice.

Treatment guidelines for major depressive disorder (MDD) are based on results from randomized clinical trials, among others in psychotherapy efficacy trials. However, patients in these trials differ from routine practice patients since trials use stringent criteria for patient selection. It is unknown whether the exclusion criteria used in psychotherapy efficacy trials (PETs) influence symptom outcome in clinical practice. We first explored which exclusion criteria are used in PETs. Second, we investigated the influence of commonly used exclusion criteria on symptom outcome in routine clinical practice. We performed an extensive literature search in PubMed, PsycInfo and additional databases for PETs for MDD. From these, we identified commonly used exclusion criteria. We investigated the influence of exclusion criteria on symptom outcome by multivariate regression models in a sample of patients suffering from MDD according to the MINIplus from a routine clinical practice setting (n=598). Data on routine clinical practice patients were gathered through Routine Outcome Monitoring. We selected 20 PETs and identified the following commonly used exclusion criteria: 'a baseline severity threshold of HAM-D≤14', 'current or past abuse or dependence of alcohol and/or drugs' and 'previous use of medication or ECT'. In our routine clinical practice sample of patients suffering from MDD (n=598), presence of 'current or past abuse of or dependence on alcohol and/or drugs' had no significant influence on outcome.'Meeting a baseline severity threshold of HAM-D≤14' and 'previous use of medication or ECT' were associated with better outcome, but the explained variance of the models was very small (R2=2-11%). The most consistently used exclusion criteria are not a major threat to the generalizability of results found in PETs. However, PETs do somewhat improve their results by exclusion of patients with minor depression and patients who used antidepressants prior to psychotherapy.",23137143,Major Depressive Disorder,Anxiety Treatment,Mental Health,8564,9.681655883789062,-0.6118943691253662,Cl+A
"The impact of executive function on response to cognitive behavioral therapy in late-life depression.

Late-life depression (LLD) is a common and debilitating condition among older adults. Cognitive behavioral therapy (CBT) has strong empirical support for the treatment of depression in all ages, including in LLD. In teaching patients to identify, monitor, and challenge negative patterns in their thinking, CBT for LLD relies heavily on cognitive processes and, in particular, executive functioning, such as planning, sequencing, organizing, and selectively inhibiting information. It may be that the effectiveness of CBT lies in its ability to train these cognitive areas. Participants with LLD completed a comprehensive neuropsychological battery before enrolling in CBT. The current study examined the relationship between neuropsychological function prior to treatment and response to CBT. When using three baseline measures of executive functioning that quantify set shifting, cognitive flexibility, and response inhibition to predict treatment response, only baseline Wisconsin Card Sort Task performance was associated with a significant drop in depression symptoms after CBT. Specifically, worse performance on the Wisconsin Card Sort Task was associated with better treatment response. These results suggest that CBT, which teaches cognitive techniques for improving psychiatric symptoms, may be especially beneficial in LLD if relative weaknesses in specific areas of executive functioning are present.",26230057,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,11.997995376586914,0.9639489650726318,B6HT
"Attentional bias modification in depression through gaze contingencies and regulatory control using a new eye-tracking intervention paradigm: study protocol for a placebo-controlled trial.

Attentional biases, namely difficulties both to disengage attention from negative information and to maintain it on positive information, play an important role in the onset and maintenance of the disorder. Recently, researchers have developed specific attentional bias modification (ABM) techniques aimed to modify these maladaptive attentional patterns. However, the application of current ABM procedures has yielded, so far, scarce results in depression due, in part, to some methodological shortcomings. The aim of our protocol is the application of a new ABM technique, based on eye-tracker technology, designed to objectively train the specific attentional components involved in depression and, eventually, to reduce depressive symptoms. Based on sample size calculations, 32 dysphoric (BDI ≥13) participants will be allocated to either an active attentional bias training group or a yoked-control group. Attentional training will be individually administered on two sessions in two consecutive days at the lab. In the training task series of pairs of faces (i.e. neutral vs. sad; neutral vs. happy; happy vs. sad) will be displayed. Participants in the training group will be asked to localize as quickly as possible the most positive face of the pair (e.g., the neutral face in neutral vs. sad trials) and maintain their gaze on it for 750 ms or 1500 ms, in two different blocks, to advance to the next trial. Participants' maintenance of gaze will be measured by an eye-tracking apparatus. Participants in the yoked-control group will be exposed to the same stimuli and the same average amount of time than the experimental participants but without any instruction to maintain their gaze or any feedback on their performance. Pre and post training measures will be obtained to assess cognitive and emotional changes after the training. The findings from this research will provide a proof-of-principle of the efficacy of eye-tracking paradigms to modify attentional biases and, consequently, to improve depressed mood. If the findings are positive, this new training approach may result in the improvement of cognitive bias modification procedures in depression. This trial was retrospectively registered on July 28, 2016 with the ClinicalTrials.gov NCT02847793 registration number and the title 'Attentional Bias Modification Through Eye-tracker Methodology (ABMET)'.",27931196,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.608438491821289,-0.0025625708512961864,BjpW
"Symptom severity moderates the outcome of attention bias modification for depression: An exploratory study.

A recent meta-analysis has questioned the relevance of attention bias modification (ABM) for depression outcomes. However, there might be patient characteristics not yet accounted for, that are relevant to the outcome. In the context of personalized treatment, the lack of moderator studies have limited the potential for matching ABM-treatment to individual patient characteristics. Subjects (N = 301) were randomly assigned 1:1 to receive either active or placebo Attention Bias Modification (ABM) twice daily for 14 days in a double-blind design (placebo n = 148; ABM n = 153). The outcome was change in symptoms based on the Hamilton Depression Rating Scale (HDRS). Moderator variables were self-reported depression (Beck Depression Inventory-II; BDI-II), anxiety (Beck Anxiety Inventory; BAI) and attentional bias (AB) assessed at baseline. This trial was registered with ClinicalTrials.gov, number NCT02658682. Only BAI (p for interaction = .01, Bootstrap 95% CI [0.046, 0.337]) moderated the effects of ABM on change in clinician rated depressive symptoms. Interactions were significant for BAI scores ≥8. The relative effect of the intervention increased with the highest symptom load. ABM was not effective in patients with the lowest symptom load. Future research should validate this finding and continue investigating moderators of the ABM-intervention to further enhance personalization of treatment to individual symptom characteristics.",33984807,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.81069564819336,-0.320729523897171,AWZP
"Comparative effectiveness of non-pharmacological interventions for depressive symptoms in mild cognitive impairment: systematic review with network meta-analysis.

Depressive symptoms are common among mild cognitive impairment (MCI) patients. It is unknown how different the effects on depressive symptoms are among various pharmacological MCI interventions. This systematic review aimed to evaluate the comparative effectiveness of non-pharmacological MCI interventions on depressive symptoms among MCI patients. A systematic review and network meta-analysis was conducted on randomized controlled trials (RCT) comparing the effect of different non-pharmacological MCI interventions on changes in depressive symptoms among MCI patients. RCTs were identified from MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, and PsycARTICLES. Results were summarized as standardized mean differences (SMD) and 95% confidence intervals (CI). The surface under the cumulative ranking (SUCRA) was used to rank the effect of different interventions. Twenty-two RCTs were included in the network meta-analysis. Compared with non-active control, cognition-based intervention (SMD=-0.25, 95% CI: -0.46, -0.04) and physical exercise (SMD=-0.33, 95% CI: -0.56, -0.10) had significant positive effects to reduce depressive symptoms. Health education, psychosocial intervention, and the combination of physical exercise and cognition-based intervention had non-significant overall effects. The SUCRA demonstrated that physical exercise had the highest SUCRA for the reduction in depression symptoms (0.815). In subgroup analysis, health education, cognition-based intervention, physical exercise, and the combination of physical exercise and cognition-based intervention showed significant longer-term effects (6-12months). Physical exercise and cognition-based intervention were effective interventions for depressive symptoms in MCI patients. This study can provide additional evidence for healthcare providers to make decisions for selecting available and appropriate interventions for MCI patients.",34841997,Major Depressive Disorder,Anxiety Treatment,Mental Health,14383,8.70815658569336,-0.4605979025363922,0lE
"The Impact of One-Time Relaxation Training on Attention Efficiency Measured by Continuous Performance Test in Depressive Disorders.

Introduction: People with depression often complain of dysfunction in cognitive processes, particularly attention. Pharmacotherapy is one of the most commonly used methods of treating depressive disorders and related attention difficulties. Patients also benefit from various forms of psychotherapy and frequently support themselves with alternative therapeutic methods. The purpose of this study was to examine whether a 15-min-long relaxation training session could improve the efficiency of attention and perceptiveness in individuals diagnosed with depressive disorders. Methods: Forty-two individuals participated in the study, including 20 individuals diagnosed with recurrent depressive disorder (rDD) and 22 healthy subjects (comparison group, CG). The so-called continuous performance test in the Polish version (Attention and Perceptiveness Test, APT) was applied in the study. In the first stage, the participants completed the 6/9 version of the APT test and then took part in a 15-min relaxation training session (autogenic training developed by the German psychiatrist Johannes Heinrich Schultz). The next step of the study was to perform APT again (parallel version-3/8). Results: The analyses showed statistically significant differences (p &lt; 0.001) in the results obtained in the two versions of APT between the studied groups (rDD versus CG) in terms of the perceptual speed index. These differences were seen both before and after the introduction of the relaxation training. There was a statistically significant difference in the value of the perceptual speed index before and after the applied relaxation training for the subjects with depression (p = 0.004) and for the whole study group (p = 0.008). A significant correlation of illness symptom severity with decreased attentional efficiency was observed in the rDD group (perceptual speed index)-both before (r = -0.864; p &lt; 0.001) and after the relaxation training (r = -0.785; p &lt; 0.001). Conclusions: The continuous performance test (APT) is a reliable indicator of impaired attention efficiency among patients with depressive symptoms compared to healthy subjects. 15-min-long one-time relaxation exercise has a beneficial effect on attention efficiency measured by APT in people with depression.",35682056,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,15.565672874450684,-0.13184303045272827,U3E
"Effects of reminiscence interventions on psychosocial outcomes: a meta-analysis.

This study integrated results from controlled trials of reminiscence interventions. Meta-analysis was used to aggregate results from 128 studies on 9 outcome VARIABLES. Compared to non-specific changes in control-group members, moderate improvements were observed at posttest with regard to ego-integrity (g=0.64) and depression (g=0.57 standard deviation units). Small effects were found on purpose in life (g=0.48), death preparation (g=0.40), mastery (g=0.40), mental health symptoms (g=0.33), positive well-being (g=0.33), social integration (g=0.31), and cognitive performance (g=0.24). Most effects were maintained at follow-up. We observed larger improvements of depressive symptoms in depressed individuals (g=1.09) and persons with chronic physical disease (g=0.94) than in other individuals, and in those receiving life-review therapy (g=1.28) rather than life-review or simple reminiscence. Moderating effects of the control condition were also detected. Reminiscence interventions affect a broad range of outcomes, and therapeutic as well as preventive effects are similar to those observed in other frequently used interventions.",22304736,Major Depressive Disorder,Anxiety Treatment,Mental Health,14606,10.593515396118164,3.176440954208374,Cxzd
"The use of cognitive bias modification and imagery in the understanding and treatment of depression.

Cognitive models of depression form the natural link between neurobiological and social accounts of the illness. Interest in the role of cognition in depression has recently been stimulated by the advent of simple, computer-based ""cognitive bias modification"" (CBM) techniques which are able to experimentally alter cognitive habits in clinical and non-clinical populations. In this chapter, we review recent work which has used CBM techniques to address questions of aetiology and treatment in depression with a particular focus on the interface with neurobiological and social processes relevant to the illness. We find that there are early signs that CBM may be a useful tool in exploring the aetiology of depression, particularly in regard to the neural and genetic factors which influence susceptibility to the illness and response to treatment. There is also early evidence suggesting that CBM has promise in the treatment and prevention of depression. This work suggests that the beneficial effects of CBM are mediated by the interaction between cognitive functioning and environmental and social information. In summary, by providing a method for altering habitual cognitive function in experimental and clinical settings CBM techniques have begun to further the understanding of and the treatment for depression.",22566082,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,14.695819854736328,-0.5462527871131897,CtzW
"Intervention methods for improving reduced heart rate variability in patients with major depressive disorder: A systematic review and meta-analysis.

Several studies have demonstrated that patients with major depressive disorder (MDD) commonly show reductions in heart rate variability (HRV) parameters. Thus, interventions for the improvement of low HRV may be advantageous in treating MDD. This systematic review and meta-analysis aimed to explore the improvement effects of current clinical treatments on low HRV in patients with MDD. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the PubMed, EMBASE, PsycINFO, and CNKI databases were searched for relevant literature. Interventional studies of patients with confirmed MDD, which included baseline and post-intervention data and at least one HRV parameter as an outcome indicator, were included for meta-analysis. Twenty-one studies were included in the review. Several studies affirmed the role of psychotherapy in improving low HRV in patients with MDD showing a significant increase in high-frequency and low-frequency power after psychotherapy in the meta-analysis. However, both pharmacotherapy studies and physiotherapy studies included in the meta-analysis showed significant heterogeneity. The main limitation of this study was the relatively small samples for the meta-analysis, and more high-quality randomized controlled trials in this field are wanted. Psychotherapy was effective for improving low HRV in patients with MDD. However, the effect of pharmacotherapy or physical therapy on low HRV in MDD remains unclear. Regarding research methods, it is necessary to formulate and standardize operational guidelines for future HRV measurements.",36183449,Major Depressive Disorder,Anxiety Treatment,Mental Health,12837,11.406886100769043,1.3939276933670044,Fd0
"Active versus receptive group music therapy for major depressive disorder-A pilot study.

To compare the effects of 1) active group music therapy and 2) receptive group music therapy to group counseling in treatment of major depressive disorder (MDD). On top of standard care, 14 MDD outpatients were randomly assigned to receive 1) active group music therapy (n=5), 2) receptive group music therapy (n=5), or 3) group counseling (n=4). There were 12 one-hour weekly group sessions in each arm. Participants were assessed at baseline, 1 month (after 4 sessions), 3 months (end of interventions), and 6 months. Primary outcomes were depressive scores measured by Montgomery-Åsberg Depression Rating Scale (MADRS) Thai version. Secondary outcomes were self-rated depression score and quality of life. At 1 month, 3 months, and 6 months, both therapy groups showed statistically non-significant reduction in MADRS Thai scores when compared with the control group (group counseling). The reduction was slightly greater in the active group than the receptive group. Although there were trend toward better outcomes on self-report depression and quality of life, the differences were not statistically significant. Group music therapy, either active or receptive, is an interesting adjunctive treatment option for outpatients with MDD. The receptive group may reach peak therapeutic effect faster, but the active group may have higher peak effect. Group music therapy deserves further comprehensive studies.",27261995,Major Depressive Disorder,Anxiety Treatment,Mental Health,4698,10.347311019897461,-0.037781570106744766,Br03
"Computerized Memory Specificity Training (c-MeST) for major depression: A randomised controlled trial.

Given modest response and high relapse after treatment for Major Depressive Episodes (MDE), the development and refinement of treatments to target cognitive vulnerabilities is indicated. Memory Specificity Training (MeST) remediates deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial aimed to assess the efficacy of an online, computerized version of MeST (c-MeST) for MDE. Adults (N = 245, 88.4% female; M age = 46.4) with a current MDE were randomised to the c-MeST program or wait-list control group. Significantly fewer participants in the c-MeST group, relative to control, met criteria for an MDE at one-month follow-up (35.7% c-MeST vs. 60.6% control), but not at other time-points. The c-MeST group, relative to the control group, scored significantly higher on memory specificity at all time-points following baseline (d = 0.53-0.93), and lower on depressive symptoms at one (d = 0.57) and three-month follow-up (d = 0.67). Changes in memory specificity mediated the effect of c-MeST on depressive symptoms at follow-up. c-MeST can improve memory specificity and depressive symptoms in people with an MDE, and may speed the rate of recovery. Future studies can further examine the mechanisms through which this occurs.",33291054,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,14.237733840942383,-0.1436711847782135,AeOV
"Cognitive Remediation for Outpatients With Recurrent Mood Disorders: A Feasibility Study.

Current first-line treatments for mood disorders often improve mood symptoms but do little to reduce cognitive and functional impairment. This 10-week, uncontrolled, feasibility study evaluated a cognitive remediation (CR) intervention for individuals with recurrent mood disorders. Adults with recurrent major depressive disorder or bipolar disorder, who had recently been treated and discharged from specialized mental health services, were eligible for inclusion. Twenty patients completed the CR intervention, which involved weekly individual sessions with a therapist, as well as the practice of computerized CR exercises between sessions. The study assessed the acceptability of the assessment and treatment as well as outcomes in terms of mood symptoms, general functioning, and cognitive functioning. Patients reported that they were generally satisfied with the CR intervention and were close to reaching the recommended amount of practice between therapist-led sessions. The retention rate from baseline to posttreatment was 87%. When within-group effects were examined, large effect sizes over time (>0.9) were seen for 2 cognitive variables that measured executive function: Category Switching-Total Words and Total Switching Score. Findings from the current feasibility study will inform the development of a large randomized controlled trial of an adapted version of the CR intervention for mood disorders assessed in this preliminary study, with the goal of translating the intervention into clinical practice.",32692124,Major Depressive Disorder,Anxiety Treatment,Mental Health,6095,13.366820335388184,-0.4169946014881134,Alg6
"Neurocognitive Remediation Therapy for Depression: A Feasibility Study and Randomized Controlled Pilot Protocol Testing.

Major depression is the most prevalent psychiatric disorder with high relapse rates. When mood can improve or fully recover, the neurocognitive difficulties associated with depression often persist, preventing complete functional recovery. They have also been shown to predict relapse. The efficacy of neurocognitive remediation therapy (NCRT) to rehabilitate cognition has been demonstrated in several clinical populations but randomized controlled trials (RCTs) have not been conducted in depression. The present study aimed to test the feasibility and to conduct a pilot protocol testing for an RCT of computerized NCRT for inpatients with major depressive episode. The feasibility assessment demonstrated excellent acceptance of randomization and very satisfactory recruitment and compliance rates. The RCT procedures' assessment was overall consistent with a successful pilot study with the condition of protocol modification in terms of resources. Preliminary outcome data suggested specific NCRT efficacy to improve targeted neurocognitive processes in depression.",26153888,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.167973518371582,-0.0023109361063688993,B7NW
"The effects of hypnotherapy compared to cognitive behavioral therapy in depression: a NIRS-study using an emotional gait paradigm.

Hypnotherapy (HT) is a promising approach to treating depression, but so far, no data are available on the neuronal mechanisms of functional reorganization after HT for depressed patients. Here, 75 patients with mild to moderate depression, who received either HT or Cognitive Behavioral Therapy (CBT), were measured before and after therapy using functional near-infrared spectroscopy. We investigated the patients' cerebral activation during an emotional human gait paradigm. Further, rumination was included as predictor. Our results showed a decrease of functional connectivity (FC) between two regions that are crucial to emotional processing, the Extrastriate Body Area (EBA) and the Superior Temporal Sulcus (STS). This FC decrease was traced back to an activation change throughout therapy in the right STS, not the EBA and was only found in the HT group, depending on rumination: less ruminating HT patients showed a decrease in right STS activation, while highly ruminating patients showed an increase. We carefully propose that this activation change is due to the promotion of emotional experiences during HT, while in CBT a focus lay on activating behavior and changing negative cognitions. HT seemed to have had differential effects on the patients, depending on their rumination style: The increase of right STS activation in highly ruminating patients might mirror the improvement of impaired emotional processing, whilst the decrease of activation in low ruminating patients might reflect a dismissal of an over-compensation, associated with a hyperactivity before therapy. We conclude that HT affects emotional processing and this effect is moderated by rumination.",35113202,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.778342247009277,0.6114069223403931,pWo
"Cognitive Impairment Along the Course of Depression: Non-Pharmacological Treatment Options.

Major Depressive Disorder (MDD) is one of the most common psychiatric disorders, with a large global impact on both the individual and the society. In this narrative review, we summarize neurocognitive deficits during acute and (partially) remitted states of depression. Furthermore, we outline the potential negative effect of cognitive impairment (CI) on functional recovery, and discuss the role of several variables in the development of CI for MDD patients. Though there is cumulating evidence regarding persistent CI in unipolar depression, research on treatment options specific for this patient group is still scarce. Hence the central aim of our review is to present non-pharmacological interventions, which are thought to reduce CI in affected MDD patients. We discuss cognitive remediation therapy (CRT), physical exercise, yoga, mindfulness-based therapy, and modern neuromodulation approaches like neurostimulation and neurofeedback training. In conclusion, we propose future directions for research on CI in depression. Looking further ahead, we suggest creative interventional designs that include a direct comparison of different non-pharmacological treatment approaches on neurocognition and functional outcome of MDD. Furthermore, additive and synergistic effects of CRT with other treatment approaches should be examined and compared to create multimodal and even personalized intervention programs.",30184551,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.8941011428833,0.22803951799869537,BGkk
"Remission prognosis for cognitive therapy for recurrent depression using the pupil: utility and neural correlates.

Although up to 60% of people with major depressive disorder respond to cognitive therapy (CT) in controlled trials, clinicians do not routinely use standardized assessments to inform which patients should receive this treatment. Inexpensive, noninvasive prognostic indicators could aid in matching patients with appropriate treatments. Pupillary response to emotional information is an excellent candidate, reflecting limbic reactivity and executive control. This study examined 1) whether pretreatment assessment of pupillary responses to negative information were associated with remission in CT and 2) their associated brain mechanisms. We examined whether pretreatment pupillary responses to emotional stimuli were prognostic for remission in an inception cohort of 32 unipolar depressed adults to 16 to 20 sessions of CT. Twenty patients were then assessed on the same task using functional magnetic resonance imaging. Pupillary responses were assessed in 51 never-depressed controls for reference. Remission was associated with either low initial severity or the combination of higher initial severity and low sustained pupillary responses to negative words (87% correct classification of remitters and nonremitters, 93% sensitivity, 80% specificity; 88% correct classification of high-severity participants, p < .01, 90% sensitivity, 92% specificity). Increased pupillary responses were associated with increased activity in dorsolateral prefrontal regions associated with executive control and emotion regulation. For patients with higher severity, disruptions of executive control mechanisms responsible for initiating emotion regulation, which are indexed by low sustained pupil responses and targeted in therapy, may be key to remitting in this intervention. These mechanisms can be measured using inexpensive noninvasive psychophysiological assessments.",21447417,Major Depressive Disorder,Anxiety Treatment,Mental Health,16413,13.213056564331055,-0.3048935830593109,C+Hp
"[Reducing depressive symptoms in patients with dementia].

This comment is a reflection on the article 'Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis' of Jennifer Watt et al. (BMJ 2021;372:n532). Although 256 RCTs were included, only 10 interventions were more effective than treatment as usual for the treatment of depressive symptoms in persons with dementia. Effective interventions were almost all psychosocial treatments, only acetylcholinesterase inhibitors in combination with cognitive stimulation was more effective than treatment as usual. Only 22 RCTs were aimed at patients with a depressive disorder and no NMA was possible, also because of the heterogeneity between these studies. The authors did not present data about some important transivity assumptions, as for example antidepressant dose, treatment duration or depression severity. The NMA did result in evidence suggesting which psychosocial interventions may be the best choice in dementia patients with depressive symptoms. Conflict of interest and financial support: none declared.",34854612,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.812447547912598,3.5533535480499268,0Ag
"Leveraging CAM to treat depression and anxiety.

Conventional medications and psychotherapy are still first-line treatments, but certain complementary and alternative strategies have value as adjunctive measures.",32555752,Major Depressive Disorder,Anxiety Treatment,Mental Health,5316,7.175083637237549,-0.10979189723730087,AnOV
"Mindfulness-based cognitive therapy versus psychoeducational intervention in bipolar outpatients with sub-threshold depressive symptoms: a randomized controlled trial.

The presence of depressive subsyndromal symptoms (SS) in bipolar disorder (BD) increases the risk of affective relapse and worsens social, cognitive functioning, and quality of life. Nonetheless, there are limited data on how to optimize the treatment of subthreshold depressive symptoms in BD. Mindfulness-Based Cognitive Therapy (MBCT) is a psychotherapeutic intervention that has been shown effective in unipolar depression. The assessment of its clinical effectiveness and its impact on biomarkers in bipolar disorder patients with subsyndromal depressive symptoms and psychopharmacological treatment is needed. A randomized, multicenter, prospective, versus active comparator, evaluator-blinded clinical trial is proposed. Patients with BD and subclinical or mild depressive symptoms will be randomly allocated to: 1) MBCT added to psychopharmacological treatment; 2) a brief structured group psychoeducational intervention added to psychopharmacological treatment; 3) standard clinical management, including psychopharmacological treatment. Assessments will be conducted at screening, baseline, post-intervention (8 weeks) and 4 month follow-up post-intervention. The aim is to compare MBCT intervention versus a brief structured group psychoeducation. Our hypothesis is that MBCT will be more effective in reducing the subsyndromal depressive symptoms and will improve cognitive performance to a higher degree than the psychoeducational treatment. It is also hypothesized that a significant increase of BDNF levels will be found after the MBCT intervention. This is the first randomized controlled trial to evaluate the effects of MBCT compared to an active control group on depressive subthreshold depressive symptoms in patients with bipolar disorder. ClinicalTrials.gov: NCT02133170. Registered 04/30/2014.",25124510,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.256030082702637,-0.11038526147603989,CJyw
"Personalized machine learning of depressed mood using wearables.

Depression is a multifaceted illness with large interindividual variability in clinical response to treatment. In the era of digital medicine and precision therapeutics, new personalized treatment approaches are warranted for depression. Here, we use a combination of longitudinal ecological momentary assessments of depression, neurocognitive sampling synchronized with electroencephalography, and lifestyle data from wearables to generate individualized predictions of depressed mood over a 1-month time period. This study, thus, develops a systematic pipeline for N-of-1 personalized modeling of depression using multiple modalities of data. In the models, we integrate seven types of supervised machine learning (ML) approaches for each individual, including ensemble learning and regression-based methods. All models were verified using fourfold nested cross-validation. The best-fit as benchmarked by the lowest mean absolute percentage error, was obtained by a different type of ML model for each individual, demonstrating that there is no one-size-fits-all strategy. The voting regressor, which is a composite strategy across ML models, was best performing on-average across subjects. However, the individually selected best-fit models still showed significantly less error than the voting regressor performance across subjects. For each individual's best-fit personalized model, we further extracted top-feature predictors using Shapley statistics. Shapley values revealed distinct feature determinants of depression over time for each person ranging from co-morbid anxiety, to physical exercise, diet, momentary stress and breathing performance, sleep times, and neurocognition. In future, these personalized features can serve as targets for a personalized ML-guided, multimodal treatment strategy for depression.",34103481,Major Depressive Disorder,Anxiety Treatment,Mental Health,9713,12.632482528686523,-0.3318823277950287,AVA0
"Short and long-term treatment outcomes of stepwise psychopharmacotherapy based on early clinical decision in patients with depressive disorders.

To investigate the effects of stepwise pharmacotherapy based on early clinical decision-making on short- and long-term treatment outcomes in outpatients with depressive disorders in a naturalistic one-year prospective design. Patients were recruited at a University hospital in South Korea from March 2012 to April 2017. At baseline, 1262 patients received antidepressant monotherapy. For patients with an insufficient response or uncomfortable side effects, next treatment steps (1, 2, 3, and 4 or over) with alternative strategies (switching, augmentation, combination, and mixtures of these approaches) were administered considering measurements and patient preference at every 3 weeks in the acute treatment phase (3, 6, 9, and 12 weeks) (N=1246), and at every 3 months in the continuation treatment phase (6, 9, and 12 months) (N=1015). Remission was defined as a Hamilton Depression Rating Scale score of ≤ 7. Remission was more frequently achieved with increasing treatment steps and advanced treatment strategies over the treatment period, while the superior effect of treatment Step 4 or over no longer persisted in the continuation treatment phase. Augmentation + combination strategy was associated with the best outcome, with least benefit associated with a switching strategy compared to monotherapy continuation. Adverse events were more frequent with increasing treatment steps and advanced treatment strategies, while numbers of visits did not statistically differ by treatment steps or strategies. The lack of a comparison group without early clinical decision due to the descriptive nature of study design limits to prove directly the study question. A stepwise pharmacotherapy approach based on early clinical decision-making in the light of measurements and patient preference could enhance both short- and long-term treatment outcomes in depressive disorders.",32469822,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,9.549711227416992,-0.5214362740516663,AoSh
"Digital Therapeutics to Enhance Cognition in Major Depression: How Can We Make the Cognitive Gains Translate Into Functional Improvements?

",35775161,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.771321296691895,-0.15021371841430664,Rj4
"Interpersonal and Social Rhythm Therapy for Patients With Major Depressive Disorder.

This study aimed to conduct a safety analysis among patients with major depressive disorder receiving interpersonal and social rhythm therapy (IPSRT) with and without cognitive remediation. This preliminary safety analysis of the outcomes of patients with major depressive disorder was part of a larger randomized controlled trial (RCT) in which patients with bipolar disorder and major depressive disorder received IPSRT; half were randomly assigned to receive additional cognitive remediation. The study focused on patients with major depressive disorder because IPSRT had not been trialed with this group; their outcomes were compared with those of patients with bipolar disorder. Data from the first 30 RCT participants were used to examine whether the intervention had adverse effects, whether mood symptoms and functioning improved over 12 months, and whether there was a signal of benefit. Mood symptoms were measured at baseline and 12 months with the Longitudinal Interval Follow-Up Evaluation and the Quick Inventory of Depressive Symptoms-Self-Reported; functioning was measured with the Social Adjustment Scale. A total of 63% (N=19) of participants were diagnosed with bipolar disorder and 27% (N=11) with major depressive disorder. No adverse effects were found for those with major depressive disorder, and improvements were seen in mean depressive and functioning scores at 12 months compared with baseline, with moderate to large effect sizes. IPSRT may be a clinically effective intervention for patients with major depressive disorder. Outcomes related to cognitive functioning and the effects of cognitive remediation will be reported at the end of the trial.",31752508,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,11.961491584777832,-0.40174558758735657,AxfF
"Treat the brain and treat the periphery: toward a holistic approach to major depressive disorder.

The limited medication for major depressive disorder (MDD) against an ever-rising disease burden presents an urgent need for therapeutic innovations. During recent years, studies looking at the systems regulation of mental health and disease have shown a remarkably powerful control of MDD by systemic signals. Meanwhile, the identification of a host of targets outside the brain opens the way to treat MDD by targeting systemic signals. We examine these emerging findings and consider the implications for current thinking regarding MDD pathogenesis and treatment. We highlight the opportunities and challenges of a periphery-targeting strategy and propose its incorporation into a holistic approach.",25849660,Major Depressive Disorder,Anxiety Treatment,Mental Health,5528,10.00584602355957,-0.44433191418647766,B/cw
"Depressive mood in adults with spinal cord injury as they transition from an inpatient to a community setting: secondary analyses from a clinical trial.

Prospective cohort controlled trial design. (i) To investigate mood benefits of adding group cognitive behaviour therapy (group-CBT) to standard spinal cord injury (SCI) inpatient rehabilitation (SR) that included access to antidepressant medication and individually delivered CBT on demand. (ii) To determine whether those with elevated depressive mood during inpatient rehabilitation significantly improve. SCI rehabilitation and community settings in New South Wales, Australia. Participants included 50 adults with SCI who completed SCI rehabilitation that included group-CBT compared with 38 participants who also completed SCI rehabilitation that did not contain group-CBT. Comprehensive assessment occurred after admission, within 2 weeks of discharge and 12 months post-injury. Multivariate repeated measures analyses were conducted to examine differences between groups and over time. The addition of group-CBT to SR did not result in significant improvement in mood. However, participants with clinically elevated depressive mood assessed during inpatient rehabilitation experienced significant reductions in depressive mood when assessed in the community regardless of CBT dosage. Anxiety correlated with mood while no sociodemographic/injury factors correlated with mood at any time period except education level. There were no mood advantages over time of adding group-CBT to inpatient SCI rehabilitation that contains individually delivered CBT on demand and access to antidepressant medication. However, findings showed those with elevated depressive mood during inpatient rehabilitation significantly improved when assessed in the community; however, their levels of depressive mood remain high. Future research should investigate the efficacy of providing individual preferences for managing depression in people with SCI.",28462933,Major Depressive Disorder,Anxiety Treatment,Mental Health,4322,6.834822654724121,0.1521419733762741,BdML
"Comparative efficacy and acceptability of traditional Chinese medicine for adult major depression: A protocol for network meta-analysis.

Major depression disorder (MDD) is a severe health threat characterized by persistent depression, loss of interests, lack of initiative, and even suicidal tendencies. Traditional Chinese medicine (TCM) is well tolerated and effective in treating adult MDD. However, research on the evaluation of efficacy and acceptability of different TCM strategies for adult MDD is insufficient. Consequently, it is high time to evaluate the efficacy of TCM strategies for adult MDD. Meanwhile, the acceptability of different TCM strategies is worth exploring. Comprehensively and systematically retrieve the literature in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure Database (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and Chinese BioMedical Literature Database (CBM). The literature search will focus on randomized controlled trials (RCTs) with TCM in adult MDD. Two reviewers will search the literature and extract relevant data back-to-back. Once mismatched outcomes appear, arbitration will be conducted by a third reviewer. Based on the Bayesian framework, data analysis is carried out with STATA and WinBUGS software. Heterogeneity, transitivity, consistency test, bias risk assessment, subgroup and sensitivity analysis, evidence quality evaluation will be performed accordingly. The efficacy and acceptability of different TCM strategies for adults with MDD will be compared and sorted. The study will facilitate the treatment options of adults MDD according to the supporting evidence. INPLASY2020100028.",33217832,Major Depressive Disorder,Anxiety Treatment,Mental Health,14383,8.387622833251953,0.19264942407608032,AfJQ
"Utilizing placebos to leverage effects of cognitive-behavioral therapy in patients with depression.

Patients with depression often experience difficulties with completing homework assignments during cognitive-behavioral therapy (CBT). In the present study, we investigated the effects of a specific placebo which aimed at improving the practice of a daily relaxation exercise during a four-week outpatient program. A total of 126 patients diagnosed with major depressive disorder were randomly assigned to one of three groups: 'Coping with Depression' course, 'Coping with Depression' course with additional daily placebo treatment, and waiting-list group. The placebo (sunflower oil) was introduced as a natural medicine to help the patients focus on their inner strengths and to mobilize their bodies' natural healing powers. The placebo was taken orally before the daily relaxation exercise. The placebo improved homework quantity and quality (both p < .001). The placebo group practiced more often and experienced greater relaxation effects than the no-placebo group. Additionally, the placebo group showed a greater reduction of depression symptoms (p < .001). The primary limitation of the study is the lack of a psychophysiological measure of relaxation. Placebos can be used to leverage CBT effects in patients with depression.",33065817,Major Depressive Disorder,Anxiety Treatment,Mental Health,2814,7.757640361785889,1.4675862789154053,Ag48
"A Pilot, Randomized Controlled Study of Tai Chi With Passive and Active Controls in the Treatment of Depressed Chinese Americans.

This pilot, randomized clinical trial investigates the effectiveness of tai chi as the primary treatment for Chinese Americans with major depressive disorder (MDD). 67 Chinese Americans with DSM-IV MDD and no treatment for depression were recruited between March 2012 and April 2013 and randomized (1:1:1) into a tai chi intervention, an education program, or a waitlisted group for 12 weeks. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS₁₇); positive response for this outcome was defined as a decrease in total score of 50% or more, and remission was defined as HDRS₁₇ ≤ 7. Participants (N = 67) were 72% female with a mean age of 54 ± 13 years. No serious adverse events were reported. After the end of the 12-week intervention, response rates were 25%, 21%, and 56%, and remission rates were 10%, 21%, and 50% for the waitlisted, education, and tai chi intervention groups, respectively. The tai chi group showed improved treatment response when compared to both the waitlisted group (odds ratio [OR] = 2.11; 95% CI, 1.01-4.46) and to the education group (OR = 8.90; 95% CI, 1.17-67.70). Tai chi intervention showed significantly improved remission rate over the waitlisted group (OR = 3.01; 95% CI, 1.25-7.10), and a trend of improved remission compared to the education group (OR = 4.40; 95% CI, 0.78-24.17). As the primary treatment, tai chi improved treatment outcomes for Chinese Americans with MDD over both passive and active control groups. ClinicalTrials.gov identifier: NCT01619631.",28570792,Major Depressive Disorder,Anxiety Treatment,Mental Health,7596,8.316754341125488,1.5398896932601929,Bbwr
"Effectiveness of an Adjunctive Psychotherapeutic Intervention Developed for Enhancing the Placebo Effect of Antidepressants Used within an Inpatient-Treatment Program of Major Depression: A Pragmatic Parallel-Group, Randomized Controlled Trial.

",32069467,Major Depressive Disorder,Anxiety Treatment,Mental Health,2814,8.495497703552246,0.40138596296310425,AtL0
"The Current Evidence Levels for Biofeedback and Neurofeedback Interventions in Treating Depression: A Narrative Review.

This article is aimed at showing the current level of evidence for the usage of biofeedback and neurofeedback to treat depression along with a detailed review of the studies in the field and a discussion of rationale for utilizing each protocol. La Vaque et al. criteria endorsed by the Association for Applied Psychophysiology and Biofeedback and International Society for Neuroregulation & Research were accepted as a means of study evaluation. Heart rate variability (HRV) biofeedback was found to be moderately supportable as a treatment of MDD while outcome measure was a subjective questionnaire like Beck Depression Inventory (level 3/5, ""probably efficacious""). Electroencephalographic (EEG) neurofeedback protocols, namely, alpha-theta, alpha, and sensorimotor rhythm upregulation, all qualify for level 2/5, ""possibly efficacious."" Frontal alpha asymmetry protocol also received limited evidence of effect in depression (level 2/5, ""possibly efficacious""). Finally, the two most influential real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback protocols targeting the amygdala and the frontal cortices both demonstrate some effectiveness, though lack replications (level 2/5, ""possibly efficacious""). Thus, neurofeedback specifically targeting depression is moderately supported by existing studies (all fit level 2/5, ""possibly efficacious""). The greatest complication preventing certain protocols from reaching higher evidence levels is a relatively high number of uncontrolled studies and an absence of accurate replications arising from the heterogeneity in protocol details, course lengths, measures of improvement, control conditions, and sample characteristics.",33613671,Major Depressive Disorder,Anxiety Treatment,Mental Health,6667,16.344619750976562,4.6058759689331055,Aafa
"Closed Loop Device May Alleviate Treatment-Resistant Depression.

",34751728,Major Depressive Disorder,Anxiety Treatment,Mental Health,8212,9.90350341796875,-0.516502857208252,4K8
"Individual music therapy for depression: randomised controlled trial.

Music therapy has previously been found to be effective in the treatment of depression but the studies have been methodologically insufficient and lacking in clarity about the clinical model employed. Aims To determine the efficacy of music therapy added to standard care compared with standard care only in the treatment of depression among working-age people. Participants (n = 79) with an ICD-10 diagnosis of depression were randomised to receive individual music therapy plus standard care (20 bi-weekly sessions) or standard care only, and followed up at baseline, at 3 months (after intervention) and at 6 months. Clinical measures included depression, anxiety, general functioning, quality of life and alexithymia. ISRCTN84185937. Participants receiving music therapy plus standard care showed greater improvement than those receiving standard care only in depression symptoms (mean difference 4.65, 95% CI 0.59 to 8.70), anxiety symptoms (1.82, 95% CI 0.09 to 3.55) and general functioning (-4.58, 95% CI -8.93 to -0.24) at 3-month follow-up. The response rate was significantly higher for the music therapy plus standard care group than for the standard care only group (odds ratio 2.96, 95% CI 1.01 to 9.02). Individual music therapy combined with standard care is effective for depression among working-age people with depression. The results of this study along with the previous research indicate that music therapy with its specific qualities is a valuable enhancement to established treatment practices.",21474494,Major Depressive Disorder,Anxiety Treatment,Mental Health,4698,10.242881774902344,1.8771480321884155,C9ua
"Pharmacotherapy for Depression Posttraumatic Brain Injury: A Meta-analysis.

To examine the effectiveness of pharmacotherapy for the treatment of depression following traumatic brain injury (TBI). Systematic review and meta-analysis. Multiple electronic databases were searched to identify relevant studies examining effectiveness of pharmacotherapy for depression post-TBI. Clinical trials evaluating the use of pharmacotherapy in individuals with depression at baseline and using standardized assessments of depression were included. Data abstracted included sample size, antidepressant used, treatment timing/duration, method of assessment, and results pertaining to impact of treatment. Study quality was assessed using a modified Jadad scale. Nine studies met criteria for inclusion. Pooled analyses based on reported means (standard deviations) from repeated assessments of depression showed that, over time, antidepressant treatment was associated with a significant effect in favor of treatment (Hedges g = 1.169; 95% confidence interval, 0.849-1.489; P < .001). Similarly, when limited to placebo-controlled trials, treatment was associated with a significant reduction in symptoms (standardized mean difference = 0.84; 95% confidence interval, 0.314-1.366; P = .002). Pharmacotherapy after TBI may be associated with a reduction in depressive symptomatology. Given limitations within the available literature, further well-powered, placebo-controlled trials should be conducted to confirm the effectiveness of antidepressant therapy in this population.",26479398,Major Depressive Disorder,Anxiety Treatment,Mental Health,11272,13.92198657989502,4.690445423126221,B2bG
"Longitudinal course of cognitive function across treatment in patients with MDD: A meta-analysis.

The longitudinal change of cognitive function across psychological treatment remains unclear. The aim of this meta-analysis was to synthesize results from longitudinal studies of cognitive deficits in MDD patients across treatment to examine change and determine domains that are most sensitive to change. A literature search was conducted using PsycINFO, MEDLINE, Science direct, and Google scholar databases. The main analysis included 16 studies and examined the change of cognitive function in 859 patients with MDD by calculating overall test-retest effect sizes (Hedges' g) and using a random effects model. Further analyses were conducted on studies of MDD patients that included a healthy control group, and effect sizes were compared. The effect size estimates suggest significant small improvements in all cognitive measures (g = 0.17-0.35). Studies including healthy controls revealed no significant differences in cognitive function between MDD patients and healthy controls, except for the improvements in verbal memory. Moderator analyses revealed that mean age influenced change in some cognitive domains. The change in depression severity did not affect the results. Treatments differed with regard to the type and duration of psychological intervention and the influence of additional pharmacological treatment could not be controlled. Due to the small number of included studies, the results should be regarded as preliminary. Cognitive abilities improved during treatments, which included psychological interventions. The improvements may be due to practice effects rather than cognitive recovery, except for verbal memory.",30753954,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.023355484008789,0.9499648809432983,A+/F
"Effect of psychological interventions on depressive symptoms in long-term rehabilitation after an acquired brain injury: a systematic review and meta-analysis.

To summarize empirical studies on the effectiveness of psychological interventions in long-term rehabilitation after an acquired brain injury (ABI) in reducing depressive symptoms. A systematic literature search was conducted on MEDLINE, PsycINFO, Embase, and CINAHL to identify articles published between January 1990 and October 2011. Search terms included the 3 concepts (1) ""brain injur*"" or ""stroke,"" (2) ""psychotherap*"" or ""therapy"" or ""intervention"" or ""rehabilitation,"" and (3) ""depress*."" Studies evaluating psychological interventions in patients after ABI were included. Time since injury was on average more than 1 year. Trials reported data on validated depression questionnaires before and after the psychological intervention. Two independent reviewers extracted information from the sample, the intervention, and the outcome of the included studies and calculated effect sizes (ESs) from depression questionnaires. Thirteen studies were included in a pre-post analysis. Seven studies were eligible for a meta-analysis of ESs in active interventions and control conditions. Pre-post ESs were significant in 4 of 13 studies. The overall ES of .69 (95% confidence interval [CI], .29-1.09) suggests a medium effectiveness of psychological interventions on depressive symptoms compared with control conditions. Moderator analysis of the number of sessions and adequate randomization procedure did not show significant ES differences between strata. Studies with adequate randomization did not, however, suggest the effectiveness of psychological interventions on depressive symptoms after ABI. Psychological interventions are a promising treatment option for depressive symptoms in long-term rehabilitation after ABI. Since only a few adequately randomized controlled trials (RCTs) exist, more RCTs are required to confirm this initial finding.",23439410,Major Depressive Disorder,Anxiety Treatment,Mental Health,866,14.091390609741211,4.9040632247924805,ChbM
"Improving outcome for mental disorders by enhancing memory for treatment.

Patients exhibit poor memory for treatment. A novel Memory Support Intervention, derived from basic science in cognitive psychology and education, is tested with the goal of improving patient memory for treatment and treatment outcome. Adults with major depressive disorder (MDD) were randomized to 14 sessions of cognitive therapy (CT)+Memory Support (n = 25) or CT-as-usual (n = 23). Outcomes were assessed at baseline, post-treatment and 6 months later. Memory support was greater in CT+Memory Support compared to the CT-as-usual. Compared to CT-as-usual, small to medium effect sizes were observed for recall of treatment points at post-treatment. There was no difference between the treatment arms on depression severity (primary outcome). However, the odds of meeting criteria for 'response' and 'remission' were higher in CT+Memory Support compared with CT-as-usual. CT+Memory Support also showed an advantage on functional impairment. While some decline was observed, the advantage of CT+Memory Support was evident through 6-month follow-up. Patients with less than 16 years of education experience greater benefits from memory support than those with 16 or more years of education. Memory support can be manipulated, may improve patient memory for treatment and may be associated with an improved outcome.",27089159,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.741704940795898,-0.35007748007774353,BuEe
"Impact of pharmacological and psychological treatment methods of depressive and anxiety disorders on cognitive functioning.

Anxiety and depressive disorders are characterized by a number of clinical symptoms like decreased mood, apathy, anhedonia and anxiety. An important element of the clinical picture is also neurocognitive impairment. The most common treatment methods for depression and anxiety are pharmacology, psychotherapy or a combination of both methods. The data from literature show that those treatment methods lead to an improvement of clinical symptoms, but they exert a possible impact on cognitive functions. However the study results referring both to the role of pharmacological treatment and psychotherapy in this domain are still inconsistent. There is an increasing number of accessible data confirming the positive effects of those clinical interventions on cognitive functioning of anxiety and depressive patients, but the interpretation is complicated because of differences in methodology as well as examined sample size and their characteristics. More studies are then needed to describe this phenomenon.",25078256,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.63611125946045,-0.16222405433654785,CKfZ
"Response to Individualized Homeopathic Treatment for Depression in Climacteric Women with History of Domestic Violence, Marital Dissatisfaction or Sexual Abuse: Results from the HOMDEP-MENOP Study.

Although individualized homeopathic treatment is effective for depression in climacteric women, there is a lack of well-designed studies of its efficacy for depression in battered women or in post-traumatic stress disorder. The aim of this study was to assess the association between individualized homeopathic treatment or fluoxetine and response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. One hundred and thirty-three Mexican climacteric women with moderate-to-severe depression enrolled in the HOMDEP-MENOP Study (a randomized, placebo-controlled, double-blind, double-dummy, three-arm trial, with a 6-week follow-up study) were evaluated. Domestic violence, marital dissatisfaction and sexual abuse were assessed at baseline. Response to depression treatment was defined by a decrease of 50% or more from baseline score of Hamilton scale. Association between domestic violence, sexual abuse, and marital dissatisfaction and response to depression treatment was analyzed with bivariate analysis in the three groups. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Homeopathy versus placebo had a statistically significant association with response to depression treatment after adjusting for sexual abuse (OR [95% CI]: 11.07 [3.22 to 37.96]), domestic violence (OR [95% CI]: 10.30 [3.24 to 32.76]) and marital dissatisfaction (OR [95% CI]: 8.61 [2.85 to 25.99]). Individualized homeopathic treatment is associated with response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. Further studies should be conducted to evaluate its efficacy specifically for post-traumatic stress disorder in battered women. CLINICALTRIALS. NCT01635218,: URL: http://clinicaltrials.gov/ct2/show/NCT01635218?term=depression+homeopathy&rank=1.",29871025,Major Depressive Disorder,Anxiety Treatment,Mental Health,2846,7.519725322723389,-0.264925092458725,BKwr
"Establishing the dose of memory support to improve patient memory for treatment and treatment outcome.

Patient memory for the contents of treatment sessions is poor and this is associated with worse treatment outcome. Preliminary findings indicate that treatment provider use of memory support can be helpful in enhancing patient memory for treatment and improving outcome. The development of a novel Memory Support Intervention is currently underway. A key step in this process is to establish the dose of memory support that treatment providers deliver in treatment-as-usual, as well as the optimal dose of memory support needed to maximize patient memory for treatment points and outcomes. Forty-two adults with major depressive disorder (MDD) were randomized to receive either cognitive therapy plus memory support (CS + Memory Support; n = 22) or cognitive therapy as-usual (CT-as-usual; n = 20). Patients completed a free recall of treatment points task at post-treatment. Outcome measures were administered at baseline and post-treatment. Treatment providers delivering CT-as-usual used, on average, 8.39 instances of memory support and 3.40 different types of memory support per session. Receiver Operating Characteristics (ROC) analyses using the combined sample indicate that 12.45 instances of memory support and 3.88 to 4.13 different types of memory support are needed to maximize patient recall and functional outcome. Dosing recommendations were established using a limited sample of participants receiving cognitive therapy for MDD. Treatment providers appear to deliver a suboptimal amount of memory support. Delivering the optimal dose of memory support could improve treatment outcome.",31733608,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.736529350280762,-0.23130522668361664,AxwD
"A randomized, controlled proof-of-concept trial evaluating durable effects of memory flexibility training (MemFlex) on autobiographical memory distortions and on relapse of recurrent major depressive disorder over 12 months.

Low-intensity psychological interventions that target cognitive risk factors for depressive relapse may improve access to relapse prevention programs and thereby reduce subsequent risk. This study provides the first evaluation of an autobiographical memory-based intervention for relapse prevention, to establish whether memory-training programs that are efficacious for acute depression may also aid those currently in remission. We also provide the longest follow-up to-date of the effects of autobiographical memory training on autobiographical memory processes themselves. This pre-registered randomized-controlled proof-of-concept trial (N = 74) compared an autobiographical Memory Flexibility (MemFlex) intervention to Psychoeducation about cognitive-behavioral mechanisms which maintain depression. Both interventions were primarily self-guided, and delivered via paper workbooks completed over four weeks. The key cognitive outcome was ability to retrieve and alternate between specific and general autobiographical memories. Co-primary clinical outcomes were time until depressive relapse and depression-free days in the twelve-months following intervention. Results indicated a small-moderate effect size (d = 0.35) in favor of MemFlex for the cognitive outcome. A small Hazard Ratio (1.08) was observed for time until depressive relapse, along with a negligible effect size for depression-free days (d = 0.11). Although MemFlex produced long-term improvement in memory retrieval skills, there was little support for MemFlex as a relapse prevention program for depression.",33691266,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,13.736030578613281,-0.38646358251571655,AZl/
"Depressed patients treated by homeopaths: a randomised controlled trial using the ""cohort multiple randomised controlled trial"" (cmRCT) design.

Despite controversy regarding homeopathy, some patients consult homeopaths for depression. Evidence is required to determine whether this is an effective, acceptable and safe intervention for these patients. A pragmatic trial using the ""cohort multiple randomised controlled trial"" design was used to test the effectiveness of adjunctive treatment by homeopaths compared to usual care alone, over a period of 12 months in patients with self-reported depression. One third of patients were randomly selected for an offer of treatment provided by a homeopath. The primary outcome measure was the Patient Health Questionnaire (PHQ-9) at 6 months. Secondary outcomes included depression scores at 12 months; and the Generalised Anxiety Disorder (GAD-7) outcome at 6 and 12 months. The trial over-recruited by 17% with a total of 566 patients. Forty percent took up the offer and received treatment. An intention-to-treat analysis of the offer group at 6 months reported a 1.4-point lower mean depression score than the no offer group (95% CI 0.2, 2.5, p=0.019), with a small standardized treatment effect size (d=0.30). Using instrumental variables analysis, a moderate treatment effect size in favour of those treated was found (d=0.57) with a between group difference of 2.6 points (95% CI 0.5, 4.7, p=0.018). Results were maintained at 12 months. Secondary analyses showed similar results. Similar results were found for anxiety (GAD-7). No evidence suggested any important risk involved with the intervention. This trial provides preliminary support for both the acceptability and the effectiveness of treatment by a homeopath for patients with self-reported depression. Our results provide support for further pragmatic research to provide more precise estimates of treatment effect. ISRCTN registry, ISRCTN02484593 . Registered on 7 January 2013.",28666463,Major Depressive Disorder,Anxiety Treatment,Mental Health,13889,7.864701271057129,-0.49232810735702515,BaY1
"Cognitive Control Deficits in Depression: A Novel Target to Improve Suboptimal Outcomes in Childhood.

Cognitive control deficits are one of three primary endophenotypes in depression, and the enhanced targeting of these deficits in clinical and research work is expected to lead to improved depression outcomes. Cognitive control is a set of self-regulatory processes responsible for goal-oriented behavior that predicts clinical/functional outcomes across the spectrum of brain-based disorders. In depression, cognitive control deficits emerge by the first depressive episode, persist during symptom remission, and worsen over the course of depression. In addition, the presence of these deficits predicts a poor response to evidence-based depression treatments, including psychotherapy and antidepressant medication. This is particularly relevant to childhood depression, as 1%-2% of children are diagnosed with depression, yet there are very limited evidence-based treatment options. Cognitive control deficits may be a previously underaddressed factor contributing to poor outcomes, although there remains a dearth of research examining the topic. The investigators describe the prior literature on cognitive control in depression to argue for the need for increased focus on this endophenotype. They then describe cognitive control-focused clinical and research avenues that would likely lead to improved treatments and outcomes for this historically undertreated aspect of childhood depression.",34261346,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.945780754089355,0.007447558455169201,ATP1
"Performance benefits of depression: sequential decision making in a healthy sample and a clinically depressed sample.

Previous research reported conflicting results concerning the influence of depression on cognitive task performance. Whereas some studies reported that depression enhances performance, other studies reported negative or null effects. These discrepant findings appear to result from task variation, as well as the severity and treatment status of participant depression. To better understand these moderating factors, we study the performance of individuals-in a complex sequential decision task similar to the secretary problem-who are nondepressed, depressed, and recovering from a major depressive episode. We find that depressed individuals perform better than do nondepressed individuals. Formal modeling of participants' decision strategies suggested that acutely depressed participants had higher thresholds for accepting options and made better choices than either healthy participants or those recovering from depression.",21500878,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,14.609138488769531,0.40999463200569153,C9Tt
"Implementation of a manual-based training of humor abilities in patients with depression: a pilot study.

Humor and laughter can positively influence mood, promote optimism and lead to a change of perspective. Six patients with major depression participated in a group training program specifically designed to enhance humor abilities. After 8 weeks of training, short-term mood improvement was observed and the patients considered themselves more capable of using humor as a coping strategy. Acquired humor skills also helped to sustain the patients' motivation throughout the training period. In light of these encouraging findings, further studies to compare the effectiveness of the humor training with the effectiveness of other types of intervention and to assess its potential long-term effects seem warranted.",21071099,Major Depressive Disorder,Anxiety Treatment,Mental Health,7015,10.399740219116211,0.20468707382678986,DDb5
"Current Research on Complementary and Alternative Medicine (CAM) in the Treatment of Major Depressive Disorder: An Evidence-Based Review.

Complementary and alternative medicine (CAM) encompasses a wide range of different non-mainstream therapies that have been increasingly used for treatment or adjunctive treatment of various ailments with mood disorders and ""depressive difficulties"" being two of the commonly CAM (self-)medicated conditions. We focus specifically on clinically diagnosed (in line with the standard criteria) depressive disorders, primarily major depressive disorder (MDD), and overview evidence of efficacy/safety of a range of CAM modalities addressing exclusively randomized controlled trials (RCTs) and systematic reviews/meta-analyses of RCTs. The list of addressed CAM interventions is not exhaustive: due to space limitation, addressed are interventions with at least a few conducted RCTs in the specific clinical conditions. We try to provide numerical and meaningful data as much as it is possible and to (a) indicate situations in which the reported data/estimates might have been ""too enthusiastic"" and (b) warn about heterogeneity of results that, together with other possible limitations (various biases and imprecision), results in uncertainty about the effects.",33834410,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,7.181572437286377,-0.09513668715953827,AYE3
"Cognitive behavioral therapy for post-stroke depression: A meta-analysis.

Cognitive behavioral therapy (CBT) has been widely used for post-stroke depression (PSD), but the findings have been inconsistent. This is a meta-analysis of randomized controlled trials (RCTs) of CBT for PSD. Both English (PubMed, PsycINFO, Embase) and Chinese (WanFang Database, Chinese National Knowledge Infrastructure and SinoMed) databases were systematically searched. Weighted and standardized mean differences (WMDs/SMDs), and the risk ratio (RR) with their 95% confidence intervals (CIs) were calculated using the random effects model. Altogether 23 studies with 1,972 participants with PSD were included and analyzed. Of the 23 RCTs, 39.1% (9/23) were rated as high quality studies, while 60.9% (14/23) were rated as low quality. CBT showed positive effects on PSD compared to control groups (23 arms, SMD = -0.83, 95% CI: -1.05 to -0.60, P < 0.001). Both CBT alone (7 arms, SMD = -0.76, 95% CI: -1.22 to -0.29, P = 0.001) and CBT with antidepressants (14 arms, SMD = -0.95, 95% CI: -1.20 to -0.71, P < 0.00001) significantly improved depressive symptoms in PSD. CBT had significantly higher remission (6 arms, RR = 1.76, 95% CI: 1.37-2.25, P < 0.00001) and response rates (6 arms, RR = 1.41, 95% CI: 1.22-1.63, P < 0.00001), with improvement in anxiety, neurological functional deficits and activities of daily living. CBT effects were associated with sample size, mean age, proportion of male subjects, baseline depression score, mean CBT duration, mean number of CBT sessions, treatment duration in each session and study quality. Although this meta-analysis found positive effects of CBT on depressive symptoms in PSD, the evidence for CBT is still inconclusive due to the limitations of the included studies. Future high-quality RCTs are needed to confirm the benefits of CBT in PSD.",29704854,Major Depressive Disorder,Anxiety Treatment,Mental Health,5810,12.846290588378906,5.628276348114014,BMiq
"Relaxation techniques for depressive disorders in adults: a systematic review and meta-analysis of randomised controlled trials.

Objectives: The aim of this study was to identify, evaluate, and synthesise existing randomised controlled trials (RCTs) that examined the effect of relaxation techniques in the treatment of patients with depressive disorders.Methods: A systematic review of the literature was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines.Results: Nine studies were finally included in this meta-analysis. It was found that relaxation techniques might effectively reduce depressive symptoms among adults with depression (standardised mean difference (SMD) -0.42, 95% CI -0.72 to -0.11, p = 0.008).Conclusions: Relaxation techniques are cost-effective, safe, and low-risk techniques that can be easily taught and used. Consequently, they have several benefits if practised regularly daily for more than an 8-week period.KEY POINTS/HIGHLIGHTSThe implication of this study for practice is that these relaxation techniques, cost-effective, safe, and low-risk techniques that can be easily taught and used.Consequently, practitioners will access benefits if practised regularly daily for more than an 8-week period.The relaxation technique is not complex, does not need any special device or place, does not need any change in lifestyle and is easily learned.",32425133,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.22189998626709,-0.5452700853347778,Ao3f
"Relapse/Recurrence Prevention in Major Depressive Disorder: 26-Month Follow-Up of Mindfulness-Based Cognitive Therapy Versus an Active Control.

We conducted a 26-month follow-up of a previously reported 12-month study that compared mindfulness-based cognitive therapy (MBCT) to a rigorous active control condition (ACC) for depressive relapse/recurrence prevention and improvements in depressive symptoms and life satisfaction. Participants in remission from major depression were randomized to an 8-week MBCT group (n = 46) or the ACC (n = 46). Outcomes were assessed at baseline; postintervention; and 6, 12, and 26 months. Intention-to-treat analyses indicated no differences between groups for any outcome over the 26-month follow-up. Time to relapse results (MBCT vs. ACC) indicated a hazard ratio = .82, 95% CI [.34, 1.99]. Relapse rates were 47.8% for MBCT and 50.0% for ACC. Piecewise analyses indicated that steeper declines in depressive symptoms in the MBCT vs. the ACC group from postintervention to 12 months were not maintained after 12 months. Both groups experienced a marginally significant rebound of depressive symptoms after 12 months but were still improved at 26 months compared to baseline (b = -4.12, p <= .008). Results for life satisfaction were similar. In sum, over a 26-month follow-up, MBCT was no more effective for preventing depression relapse/recurrence, reducing depressive symptoms, or improving life satisfaction than a rigorous ACC. Based on epidemiological data and evidence from prior depression prevention trials, we discuss the possibility that both MBCT and ACC confer equal therapeutic benefit. Future studies that include treatment as usual (TAU) control conditions are needed to confirm this possibility and to rule out the potential role of time-related effects. Overall findings underscore the importance of comparing MBCT to TAU as well as to ACCs.",30146148,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.756421089172363,-0.4516895115375519,BHDK
"Psychological and pharmacological interventions for depression in patients with coronary artery disease.

Depression occurs frequently in patients with coronary artery disease (CAD) and is associated with a poor prognosis. To determine the effects of psychological and pharmacological interventions for depression in CAD patients with comorbid depression. CENTRAL, DARE, HTA and EED on The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, ISRCTN Register and CardioSource Registry were searched. Reference lists of included randomised controlled trials (RCTs) were examined and primary authors contacted. No language restrictions were applied. RCTs investigating psychological and pharmacological interventions for depression in adults with CAD and comorbid depression were included. Primary outcomes were depression, mortality and cardiac events. Secondary outcomes were healthcare costs and health-related quality of life (QoL). Two reviewers independently examined the identified papers for inclusion and extracted data from included studies. Random effects model meta-analyses were performed to compute overall estimates of treatment outcomes. The database search identified 3,253 references. Sixteen trials fulfilled the inclusion criteria. Psychological interventions show a small beneficial effect on depression compared to usual care (range of SMD of depression scores across trials and time frames: -0.81;0.12). Based on one trial per outcome, no beneficial effects on mortality rates, cardiac events, cardiovascular hospitalizations and QoL were found, except for the psychosocial dimension of QoL. Furthermore, no differences on treatment outcomes were found between the varying psychological approaches. The review provides evidence of a small beneficial effect of pharmacological interventions with selective serotonin reuptake inhibitors (SSRIs) compared to placebo on depression outcomes (pooled SMD of short term depression change scores: -0.24 [-0.38,-0.09]; pooled OR of short term depression remission: 1.80 [1.18,2.74]). Based on one to three trials per outcome, no beneficial effects regarding mortality, cardiac events and QoL were found. Hospitalization rates (pooled OR of three trials: 0.58 [0.39,0.85] and emergency room visits (OR of one trial: 0.58 [0.34,1.00]) were reduced in trials of pharmacological interventions compared to placebo. No evidence of a superior effect of Paroxetine (SSRI) versus Nortriptyline (TCA) regarding depression outcomes was found in one trial. Psychological interventions and pharmacological interventions with SSRIs may have a small yet clinically meaningful effect on depression outcomes in CAD patients. No beneficial effects on the reduction of mortality rates and cardiac events were found. Overall, however, the evidence is sparse due to the low number of high quality trials per outcome and the heterogeneity of examined populations and interventions.",21901717,Major Depressive Disorder,Anxiety Treatment,Mental Health,2285,7.148543834686279,0.2519448399543762,C3sa
"Efficacy of a psychological online intervention for depression in people with epilepsy: a randomized controlled trial.

Depression is the most prevalent psychiatric disorder in persons with epilepsy (PWEs). Despite its major impact on quality of life and risk of suicide, most PWEs are not treated for depression. A current challenge in mental health care is how to close this treatment gap and increase access to psychological services. Psychological online interventions (POIs) have shown efficacy in improving depression among individuals without neurologic disorders. This pilot study aimed to assess the feasibility and efficacy of a psychological online intervention for depression (Deprexis) in PWEs who have symptoms of depression. Participants with self-reported epilepsy and subjective complaints of depressive symptoms were randomized to an intervention condition (Deprexis) or to a waiting list control (WLC) condition. After 9 weeks, participants were invited to complete an online reassessment. Relative to the waiting list group, program users experienced a significant symptom decline on the Beck Depression Inventory - I (BDI-I, primary outcome) with a moderate effect size in the complete observations analysis and a small effect size in the intention-to-treat analysis. Furthermore, there was a significant improvement with a moderate effect size on the ""energy/fatigue"" subscale of the Quality of Life In Epilepsy Inventory - 31 (QOLIE-31). The results of this trial suggest that POIs may be a feasible and beneficial tool for PWEs who have comorbid depressive symptoms.",25410633,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,15.244057655334473,9.894454002380371,CFyS
"Attentional bias modification reduces clinical depression and enhances attention toward happiness.

Difficulty in clinical antidepressant treatment leads to the pursuit of alternative treatments, such as cognitive-behavior therapy (CBT). CBT combined with regular antidepressants have indicated an optimal therapeutic effect in clinic. Attentional bias is important in the occurrence and remission of depression, however, few studies have explored the effect of attentional bias modification (ABM) on depression, and inconsistent results have been obtained due to the heterogeneity in the targeted populations, training tasks, strategies, and materials. Hence, the current study aimed to explore the therapeutic effect of ABM on depression in clinical depression. Study I was designed to explore the optimal training methods regarding task (dot-probe vs. cue-target), material (faces vs. self-referent words), and strategy (mixed ABM toward positive and away from negative stimuli vs. positive ABM toward positive stimuli) in unselected undergraduates once daily for 10 days (N = 309). Study II was carried out to observe the effect of 10 days ABM toward positive and away from negative faces (based on Study I) on clinical depression (N = 32). Depression level was assessed via a self-reporting questionnaire and a structured interview, while attentional bias was tested by cue-target task and attention to positive and negative inventory (APNI). In unselected undergraduates (Study I), two strategies significantly reduced the self-reporting depression scores: mixed ABM toward positive stimuli and away from negative stimuli with emotional faces, and positive ABM toward positive materials only with self-referent words. In patients with major depressive disorder (MDD) (Study II), the mixed ABM with emotional faces resulted in enhanced attentional bias toward happy materials in the cue-target task and APNI, which predicted a delayed depression reduction in clinical depression at the one-month follow-up investigation. Our finding confirms the literature and broadens the knowledge with the evidence of the optimal therapeutic effect of ABM combined with regular antidepressants in clinical depression. The findings that a quick enhancement in positive attentional bias, predicting a later therapeutic effect on clinical depression reduction, indicate a potential mechanism that could underlie the therapeutic process of ABM in depression. The findings that two training strategies are effective in depression reduction suggest that different strategies should be utilized to treat different types of depression. This study offers a potential way to cure depression and could be further practiced in clinic.",30551021,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.63846492767334,-0.04018903896212578,BBzD
"Recovery from recurrent depression: Randomized controlled trial of the efficacy of mindfulness-based compassionate living compared with treatment-as-usual on depressive symptoms and its consolidation at longer term follow-up.

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to reduce depressive symptoms in patients with recurrent or chronic depression. However, sequential, follow-up interventions are needed to further improve outcome for this group of patients. One possibility is to cultivate mechanisms thought to support recovery from depression, such as (self-)compassion. The current study examined the efficacy of mindfulness-based compassionate living (MBCL) in recurrently depressed patients who previously received MBCT, and consolidation effects of MBCL at follow-up. Part one is a randomized controlled trial (RCT) comparing MBCL in addition to treatment as usual (TAU) with TAU alone. The primary outcome measure was severity of depressive symptoms. Possible mediators and moderators of treatment outcome were examined. Part two is an uncontrolled study of both intervention- and control group on the consolidation of treatment effect of MBCL over the course of a 6-months follow-up period. Patients were recruited between July 2013 and December 2014 (N = 122). MBCL participants (n = 61) showed significant improvements in depressive symptoms (Cohen's d = 0.35), compared to those who only received TAU (n = 61). The results at 6-months follow-up showed a continued improvement of depressive symptoms. As MBCL was not compared with an active control condition, we have little information about the possible effectiveness of non-specific factors. MBCL appears to be effective in reducing depressive symptoms in a population suffering from severe, prolonged, recurrent depressive symptoms. To optimise the (sequential) treatment trajectory, replication of the study in a prospective sequential trial is needed. Registered at ClinicalTrials.gov:NCT02059200.",32421612,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.656990051269531,-0.5951237678527832,Ao61
"Executive Functioning at Baseline Prospectively Predicts Depression Treatment Response.

Existing cognitive and clinical predictors of treatment response to date are not of sufficient strength to meaningfully impact treatment decision making and are not readily employed in clinical settings. This study investigated whether clinical and cognitive markers used in a tertiary care clinic could predict response to usual treatment over a period of 4 to 6 months in a sample of 75 depressed adults. Patients (N = 384) were sequentially tested in 2 half-day clinics as part of a quality improvement project at an outpatient tertiary care center between August 2003 and September 2007; additional subjects evaluated in the clinic between 2007 and 2009 were also included. Diagnosis was according to DSM-IV-TR criteria and completed by residents and attending faculty. Test scores obtained at intake visits on a computerized neuropsychological screening battery were the Parametric Go/No-Go task and Facial Emotion Perception Task. Treatment outcome was assessed using 9-item Patient Health Questionnaire (PHQ-9) self-ratings at follow-up (n = 75). Usual treatment included psychotropic medication and psychotherapy. Decline in PHQ-9 scores was predicted on the basis of baseline PHQ-9 score and education, with neuropsychological variables entered in the second step. PHQ-9 scores declined by 46% at follow-up (56% responders). Using 2-step multiple regression, baseline PHQ-9 score (P ≤ .05) and education (P ≤ .01) were significant step 1 predictors of percent change in PHQ-9 follow-up scores. In step 2 of the model, faster processing speed with interference resolution (go reaction time) independently explained a significant amount of variance over and above variables in step 1 (12% of variance, P < .01), while other cognitive and affective skills did not. This 2-step model accounted for 28% of the variance in treatment change in PHQ-9 scores. Processing speed with interference resolution also accounted for 12% variance in treatment and follow-up attrition. Use of executive functioning assessments in clinics may help identify individuals with cognitive weaknesses at risk for not responding to standard treatments.",28196313,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.749532699584961,0.842861533164978,Bg0P
"Added value of Mindfulness-Based Cognitive Therapy for Depression: A Tree-based Qualitative Interaction Analysis.

To identify moderators of treatment effect for Mindfulness-Based Cognitive Therapy (MBCT) versus Treatment As Usual (TAU) in depressed patients. An individual patient data-analysis was performed on three randomized-controlled trials, investigating the effect of MBCT + TAU versus TAU alone (N = 292). Patients were either in (partial) remission, currently depressed or had chronic, treatment-resistant depression. Outcomes were depressive symptoms and quality of life. The QUalitative INteraction Trees (QUINT) method was used to identify subgroups that benefited more from either condition. MBCT + TAU outperformed TAU in reducing depressive symptoms. For both conditions, the effect of baseline depressive symptoms on post-treatment depressive symptoms was curvilinear. QUINT analyses revealed that MBCT + TAU was more beneficial than TAU for patients with an earlier onset and higher rumination levels in terms of depressive symptom reduction and for patients with a lower quality of life in terms of improving quality of life. The results suggest that MBCT might be more beneficial for those with earlier onset and higher levels of rumination and for patients with a lower quality of life. Sophisticated analytical techniques such as QUINT can be used in future research to improve personalized assignment of MBCT to patients. Long-term outcome could also be integrated in this.",31557693,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.387947082519531,-0.40910038352012634,A0J+
"Randomized trial of telephone versus in-person delivery of a brief psychosocial intervention in post-stroke depression.

A psychosocial behavioral intervention delivered in-person by advanced practice nurses has been shown effective in substantially reducing post-stroke depression (PSD). This follow-up trial compared the effectiveness of a shortened intervention delivered by either telephone or in-person to usual care. To our knowledge, this is the first of current behavioral therapy trials to expand the protocol in a new clinical sample. 100 people with Geriatric Depression Scores ≥ 11 were randomized within 4 months of stroke to usual care (N = 28), telephone intervention (N = 37), or in-person intervention (N = 35). Primary outcome was response [percent reduction in the Hamilton Depression Rating Scale (HDRS)] and remission (HDRS score < 10) at 8 weeks and 12 months post treatment. Intervention groups were combined for the primary analysis (pre-planned). The mean response in HDRS scores was 39% reduction for the combined intervention group (40% in-person; 38% telephone groups) versus 33% for the usual care group at 8 weeks (p = 0.3). Remission occurred in 37% in the combined intervention groups at 8 weeks versus 27% in the control group (p = 0.3) and 44% intervention versus 36% control at 12 months (p = 0.5). While favouring the intervention, these differences were not statistically significant. A brief psychosocial intervention for PSD delivered by telephone or in-person did not reduce depression significantly more than usual care. However, the comparable effectiveness of telephone and in-person follow-up for treatment of depression found is important given greater accessibility by telephone and mandated post-hospital follow-up for comprehensive stroke centers. Clinical Trial Registration URL: https://register.clinicaltrials.gov , unique identifier: NCT01133106, Registered 5/26/2010.",29017589,Major Depressive Disorder,Anxiety Treatment,Mental Health,5810,12.618507385253906,6.0416364669799805,BVzS
"Talking bodies: nonverbal behavior in the assessment of depression severity.

Evaluations of clinical depression are traditionally based on verbal information. Nonverbal expressive behavior, however, being associated with a person's reflexive responses, may reveal negative emotional or social processes that are not under complete control of the patients. However, investigations of nonverbal behavior in the evaluation of depressed patients are still scarce. This study examines the nonverbal behaviors of a group of Brazilian patients, associating their nonverbal behavior with severity of depression. Forty depressed patients were evaluated at baseline (T0) and after a two-week transcranial direct current stimulation treatment (T1), according to rating scales and through a 21-category Ethogram for assessment of the frequency of nonverbal behaviors displayed during an interview. Behaviors that were related to negative feelings and social disinterest decreased with corresponding clinical improvement and were associated with increased severity of symptoms at T0 and greater negative affect and dissatisfaction at T1. Pro-social behaviors were associated with milder symptoms at T0 and increased after treatment. Facial, head and hand expressive movements stood out as important indicators because of their associations with severity of depression. Duration of behaviors was not assessed and there was not a healthy control group with which to compare the findings. These results support the usefulness of nonverbal behavior as an evaluation technique in the assessment of clinical depression.",23706840,Major Depressive Disorder,Anxiety Treatment,Mental Health,21572,15.054998397827148,-0.16524328291416168,CdjY
"CBT and positive psychology interventions for clinical depression promote healthy attentional biases: An eye-tracking study.

Although there is a growing interest in the role of attentional biases in depression, there are no studies assessing changes in these biases after psychotherapeutic interventions. We used a validated eye-tracking procedure to assess pre-post therapy changes in attentional biases toward emotional information (i.e., happy, sad, and angry faces) when presented with neutral information (i.e., neutral faces). The sample consisted of 75 participants with major depression or dysthymia. Participants were blindly assigned to one of two 10 weekly sessions of group therapy: a cognitive behavior therapy intervention (N = 41) and a positive psychology intervention (N = 34). Both treatments were equally efficacious in improving depressive symptoms (p = .0001, η² = .68). A significant change in attentional performance after therapy was observed irrespective of the intervention modality. Comparison of pre-post attentional measures revealed a significant reduction in the total time of fixations (TTF) looking at negative information (i.e., sad and angry faces) and a significant increase in the TTF looking at positive information (i.e., happy faces)-all p < .02. Findings reveal for the first time that psychotherapeutic interventions are associated with a significant change in attentional biases as assessed by a direct measure of attention. Furthermore, these changes seem to operate in the same direction typically found in healthy populations (i.e., a bias away from negative information and a parallel bias toward positive information). These findings illustrate the importance of considering attentional biases as clinical markers of depression and suggest the viability of modifying these biases as a potential tool for clinical change.",30028564,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.454740524291992,-0.142246276140213,BIsu
"Depression treated by homeopaths: a study protocol for a pragmatic cohort multiple randomised controlled trial.

The most commonly recommended treatments for depression are psychological/psychotherapeutic treatments, and antidepressant drugs. However, 38 percent of patients with depression do not use these recommended treatments. Some patients seek homeopathic treatment for depression, but insufficient evidence exists to conclude as to the effectiveness, cost-effectiveness and safety of treatment by homeopaths for patients with depression. The aim of this trial is to evaluate the acceptability and comparative clinical and cost-effectiveness of the offer of adjunctive treatment provided by homeopaths for patients with self-reported depression. This pragmatic randomised controlled trial is embedded within the population based South Yorkshire Cohort (SYC) of whom nine percent self-report long-term depression. The SYC is designed to facilitate 'cohort multiple' randomised controlled trials (cmRCT). A self-completed questionnaire will be used to both screen and collect baseline data from potential trial participants. The primary outcome is PHQ-9. One-hundred-and-sixty-two participants will be randomly selected to the intervention group (Offer of treatment by a homeopath). The results of the Offer and the No Offer groups will be compared at 6 and 12 months using both an intention to treat (ITT) and complier average causal effect (CACE) analysis. Cost-effectiveness analysis will involve calculation of quality adjusted life year (QALY). In order to help interpret the quantitative findings a selection of up to 30 patients in the offer group will be invited to participate in qualitative interviews after the first consultation and after a minimum of 6 months. Interviews will be assessed by two researchers and results will be analysed using thematic analysis. Triangulation will be used to combine results from qualitative and quantitative methodologies at the interpretation stage, to see if results agree, offer complementary information on the same issue or contradict each other.",24685421,Major Depressive Disorder,Anxiety Treatment,Mental Health,2846,7.9680495262146,-0.5263241529464722,CQAe
"Treatment of atypical depression: post-hoc analysis of a randomized controlled study testing the efficacy of sertraline and cognitive behavioural therapy in mildly depressed outpatients.

Atypical features are common among depressed primary care patients, but clinical trials testing the efficacy of psychopharmacological and/or psychotherapeutic treatment are lacking. This paper examines the efficacy of sertraline and cognitive behavioural therapy (CBT) among depressed patients with atypical features. Analyses involve a double-blind comparison of sertraline versus placebo (N=47) and a single-blind comparison between CBT versus a guided self-help group (GSG) (N=48), with primary efficacy endpoints being the Inventory of Depressive Symptomatology (IDS(C)) and Hamilton Depression Scale (HAMD-17). In intent-to-treat (ITT) analyses, the decrease on the IDS(C) scale (and HAMD-17) was greater after CBT compared to GSG: p=0.01 (HAMD-17: p=0.01). The difference between selective serotonin reuptake inhibitors (SSRI) versus placebo was not significant: p=0.22 (HAMD-17: p=0.36). The number of cases in each treatment group was small, thereby limiting statistical power. Patients medicated with sertraline were 10 to 15 years younger than those included in the other groups of treatment. CBT may be an effective alternative to GSG for mildly depressed patients with atypical features. Although SSRI were not superior to placebo, it would be premature to rule out SSRI as efficacious in atypical depression.",20965118,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,7.035833358764648,2.000392436981201,DETk
"Autobiographical memory style and clinical outcomes following mindfulness-based cognitive therapy (MBCT): An individual patient data meta-analysis.

The ability to retrieve specific, single-incident autobiographical memories has been consistently posited as a predictor of recurrent depression. Elucidating the role of autobiographical memory specificity in patient-response to depressive treatments may improve treatment efficacy and facilitate use of science-driven interventions. We used recent methodological advances in individual patient data meta-analysis to determine a) whether memory specificity is improved following mindfulness-based cognitive therapy (MBCT), relative to control interventions, and b) whether pre-treatment memory specificity moderates treatment response. All bar one study evaluated MBCT for relapse prevention for depression. Our initial analysis therefore focussed on MBCT datasets only(n = 708), then were repeated including the additional dataset(n = 880). Memory specificity did not significantly differ from baseline to post-treatment for either MBCT and Control interventions. There was no evidence that baseline memory specificity predicted treatment response in terms of symptom-levels, or risk of relapse. Findings raise important questions regarding the role of memory specificity in depressive treatments.",35121385,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.397567749023438,-0.000343846419127658,pD8
"Do distance-delivery group interventions improve depression in people with epilepsy?

About one-third of people with epilepsy experience comorbid depression. The present study examined outcomes of a distance-delivery group intervention program designed to improve emotional well-being. Participants were 55 adults with epilepsy and self-reported depressive symptoms who were randomly assigned to take part in either a mindfulness-based cognitive behavioral therapy (CBT) program (UPLIFT, n = 20), an epilepsy information and self-management program (EpINFO, n = 24) that served as an active control group, or a wait-list control (WLC) group (n = 11). The Quick Inventory of Depressive Symptomatology (QIDS), Neurological Disorders Depression Inventory for Epilepsy (NDDIE), and the psychological health subscale of the World Health Organization Quality of Life (WHOQOL-BREF) scale were used to assess depression and psychological quality of life before and after treatment, and at short-term (six months) and long-term follow-up (one year) upon program completion. From pre- to posttreatment, a main effect of time was found, with participants in both the UPLIFT and EpINFO groups having reported to a similar degree a significant decrease in depressive symptoms and improved psychological health, improvements that were not seen in the WLC group. The time by group interaction effect was not significant. The effects seen at posttreatment in the UPLIFT and EpINFO groups remained at six months and one year after treatment. These data suggest that distance-delivery group intervention programs are effective at improving depression and psychological quality of life, with the EpINFO program offering benefits similar to the UPLIFT program.",31374471,Major Depressive Disorder,Anxiety Treatment,Mental Health,4276,15.22716236114502,9.475801467895508,A2mA
"Behavioral evidence for an impairment of affective theory of mind capabilities in chronic depression.

The only treatment specifically developed for chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), is based amongst others on the hypothesis that chronically depressed patients (CD) show considerable deficits of affective theory of mind (ToM) capabilities. Data are scarce, however, and it remains unclear if ToM deficits are specific or if they arise from global cognitive deficits associated with depression. This study investigates the specific deficits of affective ToM abilities in CD. ToM abilities were assessed in 26 medication-free CD and 26 matched healthy controls (HC) by means of a previously established false-belief ToM cartoon task. Since the task allowed an intern control for cognitive factors - operationalized in a visuospatial ToM task - it was possible to investigate specific affective ToM deficits. As hypothesized, the CD showed a significant specific slowdown of affective ToM compared to cognitive ToM (3rd person perspective) when compared to HC. Simultaneously, we observed a general deterioration of all ToM functions in CD. This study provides evidence that CD have a mentalization deficit, specifically for affective ToM functions. This deficit is combined with a general deterioration of ToM functions, most likely attributable to frequently described cognitive deficits in depression.",26278924,Major Depressive Disorder,Anxiety Treatment,Mental Health,3821,14.206347465515137,-0.304166316986084,B5ai
"Better to give than to take? Interactive social decision-making in severe major depressive disorder.

Although recent studies focusing on major depressive disorder (MDD) suggest altered social decision-making, studies using the Ultimatum Game (UG) in patients with severe, clinical MDD do not exist. Moreover, all aforementioned studies so far focused on responder behavior and thus fairness considerations; to this date, no one investigated social interactive behavior which involves proposer behavior possibly requiring second-order mentalizing as well. Thirty-nine MDD patients and 22 healthy controls played a modified UG, both in the roles of responder and proposer against the same partner. MDD patients accepted both fair and unfair offers as many times as the healthy controls in their role as responder. Importantly, however, in the role of proposer MDD patients offered significantly more than the control group did. Most patients were treated with psychotropic medication. Responder behavior demonstrates that MDD patients are capable of making social decisions on fairness considerations in the same way as healthy controls do. The observed proposer behavior, however, could indicate that MDD patients are more focused on avoiding rejection. These findings provide unique evidence that social decision-making--as studied in a realistic context--is disturbed in MDD.",22240086,Major Depressive Disorder,Anxiety Treatment,Mental Health,11498,14.947344779968262,0.3532179594039917,Cyu4
"Application of the Gradient Boosted method in randomised clinical trials: Participant variables that contribute to depression treatment efficacy of duloxetine, SSRIs or placebo.

Randomised, placebo-controlled trials of treatments for depression typically collect outcomes data but traditionally only analyse data to demonstrate efficacy and safety. Additional post-hoc statistical techniques may reveal important insights about treatment variables useful when considering inter-individual differences amongst depressed patients. This paper aims to examine the Gradient Boosted Model (GBM), a statistical technique that uses regression tree analyses and can be applied to clinical trial data to identify and measure variables that may influence treatment outcomes. GBM was applied to pooled data from 12 randomised clinical trials of 4987 participants experiencing an acute depressive episode who were treated with duloxetine, an SSRI or placebo to predict treatment remission. Additional analyses were conducted on the same dataset using the logistic regression model for comparison between these two methods. With GBM, there were noticeable differences between treatments when identifying which and to what extent variables were associated with remission. A single logistic regression only revealed a decreasing or increasing relationship between predictors and remission while GBM was able to reveal a complex relationship between predictors and remission. These analyses were conducted post-hoc utilising clinical trials databases. The criteria for constructing the analyses data were based on the characteristics of the clinical trials. GBM can be used to identify and quantify patient variables that predict remission with specific treatments and has greater flexibility than the logistic regression model. GBM may provide new insights into inter-individual differences in treatment response that may be useful for selecting individualised treatments. IMPACT clinical trial number 3327; IMPACT clinical trial number 4091; IMPACT clinical trial number 4689; IMPACT clinical trial number 4298; NCT00071695; NCT00062673; NCT00036335; NCT00067912; NCT00073411; NCT00489775; NCT00536471; NCT00666757 (note that trials with IMPACT numbers predate mandatory clinical trial registration requirements).",25080392,Major Depressive Disorder,Anxiety Treatment,Mental Health,7679,10.229650497436523,-0.5872249007225037,CKdh
"Reducing Readmission of Hospitalized Patients With Depressive Symptoms: A Randomized Trial.

To determine if hospitalized patients with depressive symptoms will benefit from post-discharge depression treatment with care transition support. This is a randomized controlled trial of hospitalized patients with patient health questionnaire-9 score of 10 or more. We delivered the Re-Engineered Discharge (RED) and randomized participants to groups receiving RED-only or RED for Depression (RED-D), a 12-week post-discharge telehealth intervention including cognitive behavioral therapy, self-management support, and patient navigation. Primary outcomes were hospital readmission and reutilization rates at 30 and 90 days post discharge. We randomized 709 participants (353 RED-D, 356 RED-only). At 90 days, 265 (75%) intervention participants had received at least 1 RED-D session (median 4). At 30 days, the intention-to-treat analysis showed no differences between RED-D vs RED-only in hospital readmission (9% vs 10%, incidence rate ratio [IRR] 0.92 [95% CI, 0.56-1.52]) or reutilization (27% vs 24%, IRR 1.14 [95% CI, 0.85-1.54]). The intention-to-treat analysis also showed no differences at 90 days in readmission (28% vs 21%, IRR 1.30 [95% CI, 0.95-1.78]) or reutilization (70% vs 57%, IRR 1.22 [95% CI, 1.01-1.49]). In the as-treated analysis, each additional RED-D session was associated with a decrease in 30- and 90-day readmissions. At 30 days, among 104 participants receiving 3 or more sessions, there were fewer readmissions (3% vs 10%, IRR 0.30 [95% CI, 0.07-0.84]) compared with the control group. At 90 days, among 109 participants receiving 6 or more sessions, there were fewer readmissions (11% vs 21%, IRR 0.52 [95% CI, 0.27-0.92]). Intention-to-treat analysis showed no differences between study groups on secondary outcomes. Care transition support and post-discharge depression treatment can reduce unplanned hospital use with sufficient uptake of the RED-D intervention.",35606137,Major Depressive Disorder,Anxiety Treatment,Mental Health,492,6.552230358123779,-8.377991676330566,Xco
"Exploring the impact of a complex intervention for women with depression in contexts of adversity: A pilot feasibility study of COURRAGE-plus in South Africa.

Depression is a leading cause of disease burden worldwide but is often undertreated in low- and middle-income countries. Reasons behind the treatment gap vary, but many highlight a lack of interventions which speak to the socio-economic and structural realties that are associated to mental health problems in many settings, including South Africa. The COURRAGE-PLUS intervention responds to this gap, by combining a collective narrative therapy (9weeks) intervention, with a social intervention promoting group-led practical action against structural determinants of poor mental health (4weeks), for a total of 13 sessions. The overall aim is to promote mental health, while empowering communities to acknowledge, and respond in locally meaningful ways to social adversity linked to development of mental distress. To pilot and evaluate the effectiveness of a complex intervention - COURRAGE-PLUS on symptoms of depression as assessed by the Patient Health Questionnaire (PHQ-9) among a sample of women facing contexts of adversity in Gauteng, South Africa. PHQ-9 scores were assessed at baseline, post collective narrative therapy (midline), and post social intervention (endline). Median scores and corresponding interquartile ranges were computed for all time points. Differences in scores between time points were tested with a non-parametric Friedman test. The impact across symptom severities was compared descriptively to identify potential differences in impact across categories of symptom severity within our sample. Participants' (n=47) median depression score at baseline was 11 (IQR=7) and reduced to 4 at midline (IQR=7) to 0 at endline (IQR = 2.5). The Friedman test showed a statistically significant difference between depression scores across time points, χ2(2)=49.29, p<.001. Median depression scores were reduced to 0 or 1 Post-Intervention across all four severity groups. COURRAGE-PLUS was highly effective at reducing symptoms of depression across the spectrum of severities in this sample of women facing adversity, in Gauteng, South Africa. Findings supports the need for larger trials to investigate collective narrative storytelling and social interventions as community-based interventions for populations experiencing adversity and mental distress.",33855902,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,8.786360740661621,-6.917415142059326,AX0X
"Positive strategies men regularly use to prevent and manage depression: a national survey of Australian men.

Men are at greater risk than women of dying by suicide. One in eight will experience depression--a leading contributor to suicide--in their lifetime and men often delay seeking treatment. Previous research has focused on men's use of unhelpful coping strategies, with little emphasis on men's productive responses. The present study examines the positive strategies men use to prevent and manage depression. A national online survey investigated Australian men's use of positive strategies, including 26 strategies specifically nominated by men in a previous qualitative study. Data were collected regarding frequency of use or openness to using untried strategies, depression risk, depression symptoms, demographic factors, and other strategies suggested by men. Multivariate regression analyses explored relationships between regular use of strategies and other variables. In total, 465 men aged between 18 and 74 years participated. The mean number of strategies used was 16.8 (SD 4.1) for preventing depression and 15.1 (SD 5.1) for management. The top five prevention strategies used regularly were eating healthily (54.2 %), keeping busy (50.1 %), exercising (44.9 %), humour (41.1 %) and helping others (35.7 %). The top five strategies used for management were taking time out (35.7 %), rewarding myself (35.1 %), keeping busy (35.1 %), exercising (33.3 %) and spending time with a pet (32.7 %). With untried strategies, a majority (58 %) were open to maintaining a relationship with a mentor, and nearly half were open to using meditation, mindfulness or gratitude exercises, seeing a health professional, or setting goals. In multivariate analyses, lower depression risk as measured by the Male Depression Risk Scale was associated with regular use of self-care, achievement-based and cognitive strategies, while lower scores on the Patient Health Questionnaire-9 was associated with regular use of cognitive strategies. The results demonstrate that the men in the study currently use, and are open to using, a broad range of practical, social, emotional, cognitive and problem-solving strategies to maintain their mental health. This is significant for men in the community who may not be in contact with professional health services and would benefit from health messages promoting positive strategies as effective tools in the prevention and management of depression.",26573270,Major Depressive Disorder,Anxiety Treatment,Mental Health,7271,10.98786449432373,-6.998238563537598,B1G0
"The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review.

Cultural adaptations of evidence-based psychological treatments (PTs) are important to enhance their universal applicability. The aim of this study was to review systematically the literature on adaptations of PTs for depressive disorders for ethnic minorities in Western countries and for any population in non-Western countries to describe the process, extent and nature of the adaptations and the effectiveness of the adapted treatments. Controlled trials were identified using database searches, key informants, previous reviews and reference lists. Data on the process and details of the adaptations were analyzed using qualitative methods and meta-analysis was used to assess treatment effectiveness. Twenty studies were included in this review, of which 16 were included in the meta-analysis. The process of adaptation was reported in two-thirds of the studies. Most adaptations were found in the dimensions of language, context and therapist delivering the treatment. The meta-analysis revealed a statistically significant benefit in favor of the adapted treatment [standardized mean difference (SMD) -0.72, 95% confidence interval (CI) -0.94 to -0.49]. Cultural adaptations of PTs follow a systematic procedure and lead primarily to adaptations in the implementation of the treatments rather than their content. Such PTs are effective in the treatment of depressive disorders in populations other than those for whom they were originally developed.",23866176,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,11.220773696899414,-7.219106674194336,CbOP
"Psychological treatments for depression and anxiety disorders in low- and middle- income countries: a meta-analysis.

The objective of this meta-analysis was to determine the efficacy of psychological treatments for depression and anxiety disorders in low- and middle- income countries (LAMIC). Meta-analysis of randomized controlled trials on psychological treatment of depression and anxiety disorders in low-and middle income countries using an existing database (www.evidencebasedpsychotherapies.org), PubMed, Embase, Psychinfo, Dissertation Abstracts International and the Cochrane Central Register of Controlled Trials were searched for studies published in all languages. Additional studies were identified from reference lists of found studies. Randomized controlled trials in which a psychological intervention for anxiety or depression was compared to a control condition (care-as-usual, waiting list, placebo, or another control group) were included. The randomized controlled trials needed to be conducted in a LAMI country (classification of LAMI countries according to the World Bank's list of economies) to be eligible for inclusion in the meta-analysis. Psychological treatments were defined as interventions in which the core element of treatment consisted of verbal communication between a therapist and a patient. Seventeen studies met our inclusion criteria, with a total of 3,010 participants. The mean standardized difference between the treatment and control groups at post-test was 1.02 (95% CI: 0.76∼1.28) which corresponds well with the effects found in high-income countries. These results indicate that psychological treatments of depression and anxiety disorders are also effective in LAMI countries, and may encourage global dissemination of these interventions.",21863204,Major Depressive Disorder,Anxiety Treatment,Mental Health,17770,9.96879768371582,-6.189516544342041,C4VM
"The feasibility, acceptability, and outcomes of PRIME-D: A novel mobile intervention treatment for depression.

Despite decades of research and development, depression has risen from the fifth to the leading cause of disability in the United States. Barriers to progress in the field are (1) poor access to high-quality care; (2) limited mental health workforce; and (3) few providers trained in the delivery of evidence-based treatments (EBTs). Although mobile platforms are being developed to give consumers greater access to high-quality care, too often these tools do not have empirical support for their effectiveness. In this study, we evaluated PRIME-D, a mobile app intervention that uses social networking, goal setting, and a mental health coach to deliver text-based, EBT's to treat mood symptoms and functioning in adults with depression. Thirty-six adults with depression remotely participated in PRIME-D over an 8-week period with a 4-week follow-up, with 83% retained over the 12-week course of thestudy. On average, participants logged into the app 5 days/week. Depression scores (PHQ-9) significantly improved over time (over 50% reduction), with coach interactions enhancing these effects. Mood-related disability (Sheehan Disability Scale (SDS)) also significantly decreased over time with participants no longer being impaired by their mood symptoms. Overall use of PRIME-D predicted greater gains in functioning. Improvements in mood and functioning were sustained over the 4-week follow-up. Results suggest that PRIME-D is a feasible, acceptable, and effective intervention for adults with depression and that a mobile service delivery model may address the serious public health problem of poor access to high-quality mental health care.",28419621,Major Depressive Disorder,Anxiety Treatment,Mental Health,1427,7.234925270080566,-6.02640438079834,BdzY
"Effectiveness of psychological treatments for depression and alcohol use disorder delivered by community-based counsellors: two pragmatic randomised controlled trials within primary healthcare in Nepal.

Evidence shows benefits of psychological treatments in low-resource countries, yet few government health systems include psychological services.AimEvaluating the clinical value of adding psychological treatments, delivered by community-based counsellors, to primary care-based mental health services for depression and alcohol use disorder (AUD), as recommended by the Mental Health Gap Action Programme (mhGAP). Two randomised controlled trials, separately for depression and AUD, were carried out. Participants were randomly allocated (1:1) to mental healthcare delivered by mhGAP-trained primary care workers (psychoeducation and psychotropic medicines when indicated), or the same services plus individual psychological treatments (Healthy Activity Program for depression and Counselling for Alcohol Problems). Primary outcomes were symptom severity, measured using the Patient Health Questionnaire - 9 item (PHQ-9) for depression and the Alcohol Use Disorder Identification Test for AUD, and functional impairment, measured using the World Health Organization Disability Assessment Schedule (WHODAS), at 12 months post-enrolment. Participants with depression in the intervention arm (n = 60) had greater reduction in PHQ-9 and WHODAS scores compared with participants in the control (n = 60) (PHQ-9: M = -5.90, 95% CI -7.55 to -4.25, β = -3.68, 95% CI -5.68 to -1.67, P &lt; 0.001, Cohen's d = 0.66; WHODAS: M = -12.21, 95% CI -19.58 to -4.84, β = -10.74, 95% CI -19.96 to -1.53, P= 0.022, Cohen's d = 0.42). For the AUD trial, no significant effect was found when comparing control (n = 80) and intervention participants (n = 82). Adding a psychological treatment delivered by community-based counsellors increases treatment effects for depression compared with only mhGAP-based services by primary health workers 12 months post-treatment.Declaration of interestNone.",30678744,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,9.500247955322266,-6.592336654663086,A/9z
"Discharge management strategies and post-discharge care interventions for depression - Systematic review and meta-analysis.

Patients with depression require treatment continuity when discharged from inpatient care. Interventions aimed at optimizing transition into outpatient care may be effective in preventing symptom deterioration and readmission. We aimed to evaluate the effectiveness of care transition interventions for patients with depression after psychiatric hospitalization. Systematic review and random-effects meta-analysis of controlled trials. Primary outcomes were readmissions and symptoms of depression. The control condition was treatment as usual. We included 16 publications reporting the results of 13 different studies. Studies were heterogeneous concerning patient selection and interventional approach. Effects on readmissions and depression symptoms were non-significant in meta-analysis of 8 studies/710 patients and 7 studies/592 patients, respectively. Overall risk ratio for readmission during follow-up was 0.65 (95% CI [0.42;1.01], p=0.06), standardized mean difference for depression symptoms was -0.09 (95% CI [-0.37;0.19], p=0.53). Subgroup analyses indicated no preference for a specific interventional strategy. Data point to considerable risk for selection and publication bias. Included studies are heterogeneous; subgroups are often small and may not attain the power to detect effects. Reasonable classification of interventions into groups of comparable approaches was a challenge and may be arbitrary in some cases. This systematic review and meta-analysis could not identify any convincingly effective interventional transition approach for patients with depression after psychiatric hospitalization. Current evidence regarding discharge management for depression is limited, heterogeneous and potentially prone to bias. Interventions might be more appropriate for patients with other diagnoses than depression. Further high-quality randomized studies are required.",28734149,Major Depressive Disorder,Anxiety Treatment,Mental Health,8131,7.060309886932373,-8.476685523986816,BZa5
"Patterns of practice in community mental health treatment of adult depression.

Community mental health therapists often endorse an eclectic orientation, but few studies reveal how therapists utilize elements of evidence-based psychotherapies. This study aimed to characterize treatment as usual patterns of practice among therapists treating depressed adults in community mental health settings. Therapists (N=165) from the USA's largest not-for-profit provider of community-based mental health services completed surveys assessing their demographics and practice element use with depressed adult clients. Specifically, therapists indicated whether they utilized each of 45 unique practice elements from the following evidence-based psychotherapies: Acceptance and Commitment Therapy, Behavioral Activation, Brief Psychodynamic Therapy, Cognitive Behavioral Therapy (CBT), Interpersonal Therapy, Mindfulness-Based CBT, Problem-Solving Therapy, and Self-Control Therapy. Principal component analysis was employed to identify practice patterns. The principal component analysis included 31 practice elements and revealed a three-factor model with distinct patterns of practice that did not align with traditional evidence-based practice approaches, including: (i) Planning, Practice, and Monitoring; (ii) Cognitive, Didactic, and Interpersonal; and (iii) Between Session Activities. Therapist-reported practice patterns confirmed an eclectic approach that brought together elements from theoretically distinct evidence-based psychotherapies. Future research is needed to explore how these patterns of practice relate to client outcomes to inform focused training and/or de-implementation efforts.",28327079,Major Depressive Disorder,Anxiety Treatment,Mental Health,4830,8.990245819091797,-6.378822326660156,BfJm
"The effect of depression and anxiety symptom severity on clinical outcomes and app use in digital mental health treatments: Meta-regression of three trials.

A large number of trials have consistently shown that guided digital mental health treatments (DMHTs) are effective for depression and anxiety. As DMHTs are adopted by healthcare organizations, payers, and employers, they are often considered most appropriate for people with mild-to-moderate levels of symptom severity. Thus, the aim of this study was to examine the effects of symptom severity on depression and anxiety outcomes and app use across three trials of a guided DMHT, IntelliCare. Participants were categorized into mild, moderate, moderately severe, and severe symptom severity groups on depression and anxiety. All symptom severity groups showed significant reductions in depression and anxiety in a clear ordinal pattern, with the mild symptom severity group showing the smallest changes and the severe symptom group showing the largest improvements. Those with the lowest levels of educational attainment showed the largest symptom improvement. Baseline symptom severity was not significantly related to app use. App use was significantly related to depression and anxiety outcomes. These findings suggest that depression and anxiety symptom severity is not useful in determining who should be referred to a guided DMHT.",34600398,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.697011470794678,-6.396502494812012,+Yw
"A therapist-guided smartphone app for major depression in young adults: A randomized clinical trial.

Meru Health Program (MHP) is a therapist-guided, 8-week intervention for depression delivered via smartphone. The aim was to test its efficacy in patients with clinical depression in a Finnish university student health service. Patients (n=124, women 72.6%, mean age 25y) were stratified based on antidepressant status, and randomized into intervention group receiving MHP plus treatment as usual (TAU), and control group receiving TAU only. Depression, measured by the Patient Health Questionnaire-9 (PHQ-9) scale, was the primary outcome. After baseline (T0), follow-ups were at mid-intervention (T4), immediately post-intervention (T8); 3 months (T20), and 6 months (T32) post-intervention. The intervention group and control group did not have significant differences in depression outcomes throughout end of treatment and follow-up. Among secondary outcomes, increase in resilience (d=0.32, p=0.03) and mindfulness (d=0.57, p=0.002), and reduction in perceived stress (d=-0.52, p=0.008) were greater in MHP+TAU versus TAU at T32; no differences were found in anxiety, sleep disturbances, and quality of life between groups. Post-hoc comparisons of patients on antidepressants showed significantly greater reduction in depression at T32 for MHP+TAU versus TAU (d=-0.73, p=0.01); patients not on antidepressants showed no between-group differences. Limitations include unknown characteristics of TAU, potential bias from patients and providers not being blinded to treatment group, and failure to specify examination of differences by antidepressant status in the protocol. Most outcomes, including depression, did not significantly differ between MHP+TAU and TAU. Exploratory analysis revealed intervention effect at the end of the 6-month follow-up among patients on antidepressant medication.",33743385,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.307009696960449,-6.169233798980713,AZGq
"Depression's moderation of the effectiveness of intensive case management with substance-dependent women on temporary assistance for needy families: outpatient substance use disorder treatment utilization and outcomes.

Intensive case management (ICM) is effective for facilitating entry into and retention in outpatient substance use disorder treatment (OSUDT) for low-income substance-dependent women; however, no studies have specifically examined the moderating impact of depressive symptoms on ICM. The purpose of this study was to investigate whether depressive symptoms moderated ICM's effect on OSUDT engagement, attendance, and outcomes for substance-dependent women on Temporary Assistance for Needy Families (TANF). It was hypothesized that highly depressed women would demonstrate worse outcomes on all indicators. Logistic regression and generalized estimating equations were used to determine depression's moderating impact on ICM in a secondary analysis of data from a randomized controlled trial comparing the effectiveness of ICM to usual care provided by local public assistance offices in Essex County, NJ. Substance-dependent women (N = 294) were recruited while being screened for TANF eligibility and were followed for 24 months. Findings revealed that high levels of depressive symptoms moderated the effectiveness of ICM in unexpected directions for two outcome variables. Subjects with high levels of depressive symptoms in ICM were (a) significantly more likely to engage in at least one treatment program than those in usual care and (b) associated with the fewest mean drinks per drinking day across the 24-month follow-up period. Independent effects for high levels of depressive symptoms and ICM were also found to positively influence engagement, attendance, and percentage days abstinent. ICM is effective for substance-dependent women with a broad spectrum of depressive symptoms in enhancing OSUDT utilization and outcomes.",21388603,Major Depressive Disorder,Anxiety Treatment,Mental Health,14973,7.178793907165527,-8.220061302185059,C++Y
"Reducing depressive symptoms through behavioral activation in churches: A Hybrid-2 randomized effectiveness-implementation design.

Rural African Americans are disproportionately exposed to numerous stressors such as poverty that place them at risk for experiencing elevated levels of depressive symptoms. Effective treatments for decreasing depressive symptoms exist, but rural African Americans often fail to receive adequate and timely care. Churches have been used to address physical health outcomes in rural African American communities, but few have focused primarily on addressing mental health outcomes. Our partnership, consisting of faith community leaders and academic researchers, adapted an evidence-based behavioral activation intervention for use with rural African American churches. This 8-session intervention was adapted to include faith-based themes, Scripture, and other aspects of the rural African American faith culture (e.g. bible studies) This manuscript describes a Hybrid-II implementation trial that seeks to test the effectiveness of the culturally adapted evidence-based intervention (Renewed and Empowered for the Journey to Overcome in Christ: REJOICE) and gather preliminary data on the strategies necessary to support the successful implementation of this intervention in 24 rural African American churches. This study employs a randomized one-way crossover cluster design to assess effectiveness in reducing depressive symptoms and gather preliminary data regarding implementation outcomes, specifically fidelity, associated with 2 implementation strategies: training only and training+coaching calls. This project has the potential to generate knowledge that will lead to improvements in the provision of mental health interventions within the rural African American community. Further, the use of the Hybrid-II design has the potential to advance our understanding of strategies that will support the implementation of and sustainability of mental health interventions within rural African American faith communities. NCT02860741. Registered August 5, 2016.",29170075,Major Depressive Disorder,Anxiety Treatment,Mental Health,10324,11.418641090393066,-6.24964714050293,BTuZ
"Association of Task-Shared Psychological Interventions With Depression Outcomes in Low- and Middle-Income Countries: A Systematic Review and Individual Patient Data Meta-analysis.

Task sharing, the training of nonspecialist workers with no formal experience in counseling, is a promising strategy for addressing the large gap in treatment for depression in low- and middle-income countries (LMICs). To examine the outcomes and moderators of task-shared psychological interventions associated with depression severity, response, and remission. Systematic literature searches in PubMed, Embase, PsycINFO, and Cochrane Library up to January 1, 2021. Randomized clinical trials (RCTs) of task-shared psychological interventions compared with control conditions for adults with depressive symptoms in LMICs were included. Two researchers independently reviewed the titles, abstracts, and full text of articles from an existing generic meta-analytic database that includes all RCTs on psychotherapy for depression. A systematic review and individual patient data (IPD) meta-analysis was used to estimate the outcomes of task-shared psychological interventions across patient characteristics using mixed-effects models. Procedures for abstracting data and assessing data quality and validity followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Primary outcome was reduction in depression symptom severity measured by the 9-item Patient Health Questionnaire (PHQ-9). Response and remission rates were also estimated. Of 13 eligible trials, 11 (4145 participants) contributed IPD. Task-shared psychological interventions were associated with a greater decrease in depressive symptom severity than control conditions (Hedges g, 0.32; 95% CI, -0.26 to -0.38). Participants in the intervention groups had a higher chance of responding (odds ratio, 2.11; 95% CI, 1.60 to 2.80) and remitting (odds ratio, 1.87; 95% CI, 1.20 to 1.99). The presence of psychomotor symptoms was significantly associated with the outcomes of task-shared psychological interventions (β [SE], -1.21 [0.39]; P=.002). No other significant associations were identified. Heterogeneity among the trials with IPD was 74% (95% CI, 53%-86%). In this meta-analysis of IPD, task-shared psychological interventions were associated with a larger reduction in depressive symptom severity and a greater chance of response and remission than control conditions. These findings show potential for the use of task-sharing of psychological interventions across different groups of patients with depression. Further research would help identify which people are most likely to benefit and strengthen larger-scale implementation of this strategy to address the burden of depression in LMICs.",35319740,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,8.777130126953125,-6.336533546447754,hN4
"Blue-Light Therapy for Seasonal and Non-Seasonal Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

To determine the efficacy and safety of blue-light therapy in seasonal and non-seasonal major depressive disorder (MDD), by comparison to active and inactive control conditions. We searched Web of Science, EMBASE, Medline, PsycInfo, and Clinicaltrials.gov through January 17, 2022, for randomized controlled trials (RCTs) using search terms for blue/blue-enhanced, light therapy, and depression/seasonal affective disorder. Two independent reviewers extracted data. The primary outcome was the difference in endpoint scores on the Structured Interview Guide for the Hamilton Depression Rating Scale - Seasonal Affective Disorder (SIGH-SAD) or the Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression Supplement (SIGH-ADS) between blue light and comparison conditions. Secondary outcomes were response (≥ 50% improvement from baseline to endpoint on a depression scale) and remission rates (endpoint score in the remission range). Of 582 articles retrieved, we included nine RCTs (n=347 participants) assessing blue-light therapy. Seven studies had participants with seasonal MDD and two studies included participants with non-seasonal MDD. Four studies compared blue light to an inactive light condition (efficacy studies), and five studies compared it to an active condition (comparison studies). For the primary outcome, a meta-analysis with random-effects models found no evidence for the efficacy of blue-light conditions compared to inactive conditions (mean difference [MD]=2.43; 95% confidence interval [CI], -1.28 to 6.14, P=0.20); however, blue-light also showed no differences compared to active conditions (MD=-0.11; 95% CI, -2.38 to 2.16, P=0.93). There were no significant differences in response and remission rates between blue-light conditions and inactive or active light conditions. Blue-light therapy was overall well-tolerated. The efficacy of blue-light therapy in the treatment of seasonal and non-seasonal MDD remains unproven. Future trials should be of longer duration, include larger sample sizes, and attempt to better standardize the parameters of light therapy.",35522196,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.221261501312256,5.050936698913574,aI4
"Getting depression clinical practice guidelines right: time for change?

As part of a series of papers ['Chronobiology of mood disorders' Malhi & Kuiper. Acta Psychiatr Scand 2013;128(Suppl. 444):2-15; and 'It's time we managed depression: The emerging role of chronobiology' Malhi et al. Acta Psychiatr Scand 2013;128(Suppl. 444):1] examining chronobiology in the context of depression, this article examines recent western clinical practice guidelines (CPGs) for the treatment of depression with respect to the recommendations they make, in particular as regards chronobiological treatments, and briefly considers the implications of their methodology and approach. Five international treatment guidelines, which had been published in the past 5 years, were identified, representing North American and European views. Chosen guidelines were reviewed by the authors, and the relevant recommendations were distributed for discussion and subsequent synthesis. Most current guidelines do not address chronobiology in detail. Chronotherapeutic recommendations are tentative, although agomelatine is considered as an option for major depression and bright light therapy for seasonal affective disorder. Sleep deprivation is not routinely recommended. Recommendations are limited by the lack of reliable therapeutic markers for chronotherapeutics. Current evidence supports use of light therapy in seasonal depression, but in non-seasonal depression there is insufficient evidence to support reliance on chronotherapeutics over existing treatment modalities.",23909694,Major Depressive Disorder,Anxiety Treatment,Mental Health,18329,-4.721242904663086,5.070958137512207,Cai9
"Predictors of response to combined wake and light therapy in treatment-resistant inpatients with depression.

There is growing evidence for combined chronotherapeutic interventions as adjunctive treatments for major depression. However, as the treatments can be demanding, we need to identify predictors of response. This study aimed to describe predictors of response, remission and deterioration in the short-term phase, as well as predictors of long-term response. The predictors investigated were gender, type of depression, severity of depression, treatment resistance, quetiapine use, general self-efficacy, educational level and positive diurnal variation. Follow-up data from 27 inpatients with moderate-to-severe depression participating in a chronotherapeutic intervention were analysed. As a supplement to standard treatment, they completed 3 wake therapy sessions in the first week, 30 min daily light treatment and sleep-time stabilisation in the entire 9-week study period. Patients had a significant decrease of depressive symptoms during the first 6 days measured by HAM-D6. At Day 6, 41% of the patients responded to the treatment and 19% fulfilled the criteria of remission. Deterioration by the end of wake therapy sessions was however not uncommon. In the short-term phase, mild degree of treatment resistance was associated with remission and low educational level associated with deterioration. Positive diurnal variation (mood best in the evening) was a predictor of both short-term and long-term response to combined wake and light therapy. Furthermore, patients with evening chronotypes (measured with morningness-eveningness score) were more responsive. Our results suggest that targeting the combined chronotherapeutic intervention at patients with positive diurnal variation and evening types is a viable option.",29750548,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.039108753204346,5.082730770111084,BL7n
"Light therapy for preventing seasonal affective disorder.

Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This review - one of four reviews on efficacy and safety of interventions to prevent SAD - focuses on light therapy as a preventive intervention. Light therapy is a non-pharmacological treatment that exposes people to artificial light. Mode of delivery and form of light vary. To assess the efficacy and safety of light therapy (in comparison with no treatment, other types of light therapy, second-generation antidepressants, melatonin, agomelatine, psychological therapies, lifestyle interventions and negative ion generators) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD. We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. For efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. For adverse events, we also intended to include non-randomised studies. We intended to include studies that compared any type of light therapy (e.g. bright white light, administered by visors or light boxes, infrared light, dawn stimulation) versus no treatment/placebo, second-generation antidepressants, psychological therapies, melatonin, agomelatine, lifestyle changes, negative ion generators or another of the aforementioned light therapies. We also planned to include studies that looked at light therapy in combination with any comparator intervention. Two review authors screened abstracts and full-text publications, independently abstracted data and assessed risk of bias of included studies. We identified 3745 citations after de-duplication of search results. We excluded 3619 records during title and abstract review. We assessed 126 full-text papers for inclusion in the review, but only one study providing data from 46 people met our eligibility criteria. The included RCT had methodological limitations. We rated it as having high risk of performance and detection bias because of lack of blinding, and as having high risk of attrition bias because study authors did not report reasons for dropouts and did not integrate data from dropouts into the analysis.The included RCT compared preventive use of bright white light (2500 lux via visors), infrared light (0.18 lux via visors) and no light treatment. Overall, white light and infrared light therapy reduced the incidence of SAD numerically compared with no light therapy. In all, 43% (6/14) of participants in the bright light group developed SAD, as well as 33% (5/15) in the infrared light group and 67% (6/9) in the non-treatment group. Bright light therapy reduced the risk of SAD incidence by 36%; however, the 95% confidence interval (CI) was very broad and included both possible effect sizes in favour of bright light therapy and those in favour of no light therapy (risk ratio (RR) 0.64, 95% CI 0.30 to 1.38; 23 participants, very low-quality evidence). Infrared light reduced the risk of SAD by 50% compared with no light therapy, but the CI was also too broad to allow precise estimations of effect size (RR 0.50, 95% CI 0.21 to 1.17; 24 participants, very low-quality evidence). Comparison of both forms of preventive light therapy versus each other yielded similar rates of incidence of depressive episodes in both groups (RR 1.29, 95% CI 0.50 to 3.28; 29 participants, very low-quality evidence). Reasons for downgrading evidence quality included high risk of bias of the included study, imprecision and other limitations, such as self-rating of outcomes, lack of checking of compliance throughout the study duration and insufficient reporting of participant characteristics.Investigators provided no information on adverse events. We could find no studies that compared light therapy versus other interventions of interest such as second-generation antidepressants, psychological therapies, melatonin or agomelatine. Evidence on light therapy as preventive treatment for people with a history of SAD is limited. Methodological limitations and the small sample size of the only available study have precluded review author conclusions on effects of light therapy for SAD. Given that comparative evidence for light therapy versus other preventive options is limited, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences.",30883670,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.034333229064941,4.947038173675537,A9QU
"Light therapy in non-seasonal depression: An update meta-analysis.

The effect of light therapy in treating seasonal affective disorder has been demonstrated amongst previous studies. However, the effect of light therapy in treating non-seasonal depression remains unclear. This meta-analysis aimed to determine the efficacy of light therapy in non-seasonal depression. We searched for randomized controlled trials (RCTs) in the PubMed, Web of Science, Chinese National Knowledge Infrastructure, and Chinese Biomedical Database up to February 2020. The pooled post-trial standardized mean difference in depression scores with corresponding 95% confidence intervals was calculated to evaluate the efficacy of light therapy in non-seasonal depression. A total of 23 RCTs with 1120 participants were included. The meta-analysis demonstrated the light therapy was significantly more effective than comparative treatments. Subgroup analyses revealed that none of the factors explained the significantly heterogeneity. Light therapy has a statistically significant mild to moderate treatment effect in reducing depressive symptoms, can be used as a clinical therapy in treating non-seasonal depression. But the quality of evidence is still low, more well-designed studies with larger sample size and high quality are needed to confirm the efficiency of light therapy in treating non-seasonal depression.",32622169,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.175727367401123,4.974920272827148,AmXi
"Portable light therapy in the treatment of unipolar non-seasonal major depressive disorder: study protocol for the LUMIDEP randomised controlled trial.

Major depressive disorder (MDD) affects more than 264 million people worldwide and is associated with an impaired quality of life as well as a higher risk of mortality. Current routine treatments demonstrate limited effectiveness. Light therapy (LT) on its own or in combination with antidepressant treatments could be an effective treatment, but the use of conventional LT devices use is restrictive. Portable LT devices allow patients to continue with their day-to-day activities and therefore encourage better treatment compliance. They have not been evaluated in MDD. The study is a single-centre, double-blind, randomised controlled trial assessing the efficacy of LT delivered via a portable device in addition to usual care (medical care and drug treatment) for inpatients and outpatients with unipolar non-seasonal MDD. Over the course of 8 weeks, patients use the device daily for 30 min at medium intensity as soon as possible after waking up and preferably between 07:00 and 09:00. All patients continue their usual care with their referring physician. N=50 patients with MDD are included. The primary outcome measure is depressive symptom severity assessed using the Montgomery-Åsberg Depression Rating Scale between baseline and the eighth week. Secondary outcome measures are sleep quality assessed using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale and anxiety level assessed on the Hamilton Anxiety Rating Scale, between baseline and week 8. Further parameters relating to cognitive function are measured at baseline and after the intervention. An ancillary study aims to evaluate the impact of MDD on the retina and to follow its progression. Main limitations include risk of discontinuation or non-adherence and bias in patient selection. The study protocol was approved by Ile de France X's Ethics Committee (protocol number 34-2018). Findings will be published in peer-reviewed journals. NCT03685942.",34244279,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.180314540863037,4.999765396118164,ATc0
"Experiences of wake and light therapy in patients with depression: A qualitative study.

Wake therapy can reduce depressive symptoms within days, and response rates are high. To sustain the effect, it is often combined with light therapy. Few studies have focussed on factors related to patients' adherence to the regime, and none has used qualitative methods to examine their experience of these combined interventions. Therefore, the aim of the present study was to illuminate patients' experiences with wake and light therapy and factors related to adherence. Thirteen inpatients with depression were included. They participated in an intervention consisting of three wake therapies during the first week, 30 min of daily light treatment for the entire 9 weeks, and ongoing psychoeducation regarding good sleep hygiene. Patients kept a diary, and individual semistructured interviews were conducted. Data were analysed using qualitative content analysis. The participants' overall experience with the treatment was positive. Some experienced a remarkable and rapid antidepressant effect, whereas others described more long-term benefits (e.g. improved sleep and diurnal rhythm). Yet recovery was fragile, and patients were only cautiously optimistic. Social support was important for maintaining the motivation to stay awake and receive daily light therapy. Overall, participants found the treatment worthwhile and would recommend it to others with depression. The study revealed a lack of knowledge among participants about the connection between regular sleep patterns and depression. In conclusion, this study provides insight into patients' experiences, and knowledge that can contribute to guidelines for future adherence-promoting organization of wake and light therapy.",27804203,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.342954158782959,4.796211242675781,BlRX
"Cognitive and behavioral predictors of light therapy use.

Although light therapy is effective in the treatment of seasonal affective disorder (SAD) and other mood disorders, only 53-79% of individuals with SAD meet remission criteria after light therapy. Perhaps more importantly, only 12-41% of individuals with SAD continue to use the treatment even after a previous winter of successful treatment. Participants completed surveys regarding (1) social, cognitive, and behavioral variables used to evaluate treatment adherence for other health-related issues, expectations and credibility of light therapy, (2) a depression symptoms scale, and (3) self-reported light therapy use. Individuals age 18 or older responded (n = 40), all reporting having been diagnosed with a mood disorder for which light therapy is indicated. Social support and self-efficacy scores were predictive of light therapy use (p's<.05). The findings suggest that testing social support and self-efficacy in a diagnosed patient population may identify factors related to the decision to use light therapy. Treatments that impact social support and self-efficacy may improve treatment response to light therapy in SAD.",22720089,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.9834961891174316,4.798213005065918,Cr3z
"Elucidating treatment targets and mediators within a confirmatory efficacy trial: study protocol for a randomized controlled trial of cognitive-behavioral therapy vs. light therapy for winter depression.

This study is a confirmatory efficacy trial of two treatments for winter seasonal affective disorder (SAD): SAD-tailored group cognitive-behavioral therapy (CBT-SAD) and light therapy (LT). In our previous efficacy trial, post-treatment outcomes for CBT-SAD and LT were very similar, but CBT-SAD was associated with fewer depression recurrences two winters later than LT (27.3% in CBT-SAD vs. 45.6% in LT). CBT-SAD engaged and altered a specific mechanism of action, seasonal beliefs, which mediated CBT-SAD's acute antidepressant effects and CBT-SAD's enduring benefit over LT. Seasonal beliefs are theoretically distinct from LT's assumed target and mechanism: correction of circadian phase. This study applies the experimental therapeutics approach to determine how each treatment works when it is effective and to identify the best candidates for each. Biomarkers of LT's target and effect include circadian phase angle difference and the post-illumination pupil response. Biomarkers of CBT-SAD's target and effect include decreased pupillary and sustained frontal gamma-band EEG responses to seasonal words, which are hypothesized as biomarkers of seasonal beliefs, reflecting less engagement with seasonal stimuli following CBT-SAD. In addition to determining change mechanisms, this study tests the efficacy of a ""switch"" decision rule upon recurrence to inform clinical decision-making in practice. Adults with SAD (target N =160) will be randomzied to 6-weeks of CBT-SAD or LT in winter 1; followed in winter 2; and, if a depression recurrence occurs, offered cross-over into the alternate treatment (i.e., switch from LT➔CBT-SAD or CBT-SAD➔LT). All subjects will be followed in winter 3. Biomarker assessments occur at pre-, mid-, and post-treatment in winter 1, at winter 2 follow-up (and again at mid-/post-treatment for those crossed-over), and at winter 3 follow-up. Primary efficacy analyses will test superiority of CBT-SAD over LT on depression recurrence status (the primary outcome). Mediation analyses will use parallel process latent growth curve modeling. Consistent with the National Institute of Mental Health's priorities for demonstrating target engagement at the level of Research Domain Criteria-relevant biomarkers, this work aims to confirm the targets and mechanisms of LT and CBT-SAD to maximize the impact of future dissemination efforts. ClinicalTrials.gov identifier: NCT03691792 . Registered on October 2, 2018.",35550645,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.904658079147339,4.7679548263549805,ZQ0
"Bright white light therapy in depression: A critical review of the evidence.

Light therapy is an accepted treatment option, at least for seasonal affective disorder (SAD). Our aim was to critically evaluate treatment effects of bright white light (BWL) on the depressive symptoms in both SAD and non-seasonal depression. The systematic review was performed according to the PRISMA guidelines. PubMed, Embase, and PsycINFO were searched (December 1974 through June 2014) for randomized controlled trials published in peer-reviewed journals. Study quality was assessed with a checklist developed by the Swedish Council on Technology Assessment in Health Care. Only studies with high or medium quality were used in the meta-analyses. Eight studies of SAD and two studies of non-seasonal depression met inclusion and quality criteria. Effects on SAD were estimated in two meta-analyses. In the first, week by week, BWL reached statistical significance only at two and three weeks of treatment (Standardized Mean Difference, SMD: -0.50 (-CI 0.94, -0.05); -0.31 (-0.59, -0.03) respectively). The second meta-analysis, of endpoint data only, showed a SMD of -0.54 (CI: -0.95, -0.13), which indicates an advantage for BWL. No meta-analysis was performed for non-seasonal depression due to heterogeneity between studies. This analysis is restricted to short-term effects of BWL measured as mean changes in scores derived from SIGH-SAD, SIGH-SAD self-report, or HDRS rating scales. Most studies of BWL have considerable methodological problems, and the results of published meta-analyses are highly dependent on the study selection. Even though quality criteria are introduced in the selection procedures of studies, when the results are carefully scrutinized, the evidence is not unequivocal.",25942575,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.008892059326172,5.097436904907227,B+Hg
"Dynamic LED-light versus static LED-light for depressed inpatients: study protocol for a randomised clinical study.

Retrospective studies conducted in psychiatric inpatient wards have shown a relation between the intensity of daylight in patient rooms and the length of stay, pointing to an antidepressant effect of ambient lighting conditions. Light therapy has shown a promising antidepressant effect when administered from a light box. The emergence of light-emitting diode (LED) technology has made it possible to build luminaires into rooms and to dynamically mimic the spectral and temporal distribution of daylight. The objective of this study is to investigate the antidepressant efficacy of a newly developed dynamic LED-lighting system installed in an inpatient ward. In all, 150 inpatients with a major depressive episode, as part of either a major depressive disorder or as part of a bipolar disorder, will be included. The design is a two-arm 1:1 randomised study with a dynamic LED-lighting arm and a static LED-lighting arm, both as add-on to usual treatment in an inpatient psychiatric ward. The primary outcome is the baseline adjusted score on the 6-item Hamilton Depression Rating Scale at week 3. The secondary outcomes are the mean score on the Suicidal Ideation Attributes Scale at week 3, the mean score on the 17-item Hamilton Depression Rating Scale at week 3 and the mean score on the World Health Organisation Quality of Life-BREF (WHOQOL-BREF) at week 3. The spectral distribution of daylight and LED-light, with a specific focus on light mediated through the intrinsically photosensitive retinal ganglion cells, will be measured. Use of light luminaires will be logged. Assessors of Hamilton Depression Rating Scale scores and data analysts will be blinded for treatment allocation. The study was initiated in May 2019 and will end in December 2021. No ethical issues are expected. Results will be published in peer-reviewed journals, disseminated electronically and in print and presented at symposia. NCT03821506; Pre-results.",31988225,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.4639177322387695,4.968323230743408,AuTT
"100,000 lumens to treat seasonal affective disorder: A proof of concept RCT of Bright, whole-ROom, All-Day (BROAD) light therapy.

Seasonal affective disorder (SAD) is common and debilitating. The standard of care includes light therapy provided by a light box; however, this treatment is restrictive and only moderately effective. Advances in LED technology enable lighting solutions that emit vastly more light than traditional light boxes. Here, we assess the feasibility of BROAD (Bright, whole-ROom, All-Day) light therapy and get a first estimate for its potential effectiveness. Patients were randomly assigned to a treatment for 4 weeks; either a very brightly illuminated room in their home for at least 6h per day (BROAD light therapy) or 30min in front of a standard 10,000 lux SAD light box. Feasibility was assessed by monitoring recruitment, adherence, and side effects. SAD symptoms were measured at baseline and after 2 and 4 weeks, with the Hamilton Depression Rating Scale-Seasonal Affective Disorders 29-items, self-report version. All 62 patients who started treatment were available at 4-week follow-up and no significant adverse effects were reported. SAD symptoms of both groups improved similarly and considerably, in line with previous results. Exploratory analyses indicate that a higher illuminance (lux) is associated with a larger symptom improvement in the BROAD light therapy group. BROAD light therapy is feasible and seems similarly effective as the standard of care while not confining the participants to 30min in front of a light box. In follow-up trials, BROAD light therapy could be modified for increased illuminance, which would likely improve its effectiveness.",35981135,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.0261077880859375,5.058592796325684,LAY
"Prospective, Open Trial of Adjunctive Triple Chronotherapy for the Acute Treatment of Depression in Adolescent Inpatients.

The aim of this pilot study was to explore the feasibility and proof of concept of triple chronotherapy (TCT) as a nonpharmacological adjunctive treatment in the acute management of depression in the adolescent population. Thirty-one adolescents with nonpsychotic moderate-to-severe depression were included in the study. The 4-day TCT intervention comprised one night of sleep deprivation followed by 3 days of sleep phase advancement and daily bright light therapy. Primary outcomes were feasibility and depression, as measured by the Hamilton Depression Scale-17 (HAMD-17). Secondary outcomes included severity of illness, anxiety, self-harm, insomnia, and suicidality. Twenty-nine (94%) adolescents completed the 4-day TCT intervention. Twenty-six (84%) of the 31 enrolled patients experienced a reduction in depressive symptoms of at least 50% from baseline; 24 (77%) achieved remission, defined as a HAMD-17 score less than 8. The mean depression score was severe before the start of the intervention ( \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland, xspace}\\usepackage{amsmath, amsxtra}\\usepackage{upgreek}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document} $$\\overline X$$ \\end{document} =21.8±3.8) and dropped below the remission threshold by day 4 ( \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland, xspace}\\usepackage{amsmath, amsxtra}\\usepackage{upgreek}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document} $$\\overline X$$ \\end{document} =4.4±5.1; p<0.001); the mean depression score was mild at 1 week (n=17; \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland, xspace}\\usepackage{amsmath, amsxtra}\\usepackage{upgreek}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document} $$\\overline X$$ \\end{document} =9.3±5.2; p<0.001) and 1 month (n=10, \\documentclass{aastex}\\usepackage{amsbsy}\\usepackage{amsfonts}\\usepackage{amssymb}\\usepackage{bm}\\usepackage{mathrsfs}\\usepackage{pifont}\\usepackage{stmaryrd}\\usepackage{textcomp}\\usepackage{portland, xspace}\\usepackage{amsmath, amsxtra}\\usepackage{upgreek}\\pagestyle{empty}\\DeclareMathSizes{10}{9}{7}{6}\\begin{document} $$\\overline X$$ \\end{document} =7.8±5.2; p<0.001). Severity of illness scores according to the Clinical Global Impressions severity subscale improved from a mean of 5.3 at baseline to 3.1 following the TCT intervention (p<0.0001); the effect was sustained through the 1-week postdischarge and the 1-month follow-up. Secondary outcomes showed significant improvement following the 4-day TCT intervention; improvement was sustained through the 1-week and 1-month follow-up periods. This pilot study determined TCT to be a feasible, safe, rapid, and potentially effective adjunctive treatment for depression in the adolescent population.",30388037,Major Depressive Disorder,Anxiety Treatment,Mental Health,12626,-4.457151889801025,4.939521789550781,BD3h
"Cognitive-behavioral therapy vs. light therapy for preventing winter depression recurrence: study protocol for a randomized controlled trial.

Seasonal affective disorder (SAD) is a subtype of recurrent depression involving major depressive episodes during the fall and/or winter months that remit in the spring. The central public health challenge in the management of SAD is prevention of winter depression recurrence. Light therapy (LT) is the established and best available acute SAD treatment. However, long-term compliance with daily LT from first symptom through spontaneous springtime remission every fall/winter season is poor. Time-limited alternative treatments with effects that endure beyond the cessation of acute treatment are needed to prevent the annual recurrence of SAD. This is an NIMH-funded R01-level randomized clinical trial to test the efficacy of a novel, SAD-tailored cognitive-behavioral group therapy (CBT) against LT in a head-to-head comparison on next winter outcomes. This project is designed to test for a clinically meaningful difference between CBT and LT on depression recurrence in the next winter (the primary outcome). This is a concurrent two-arm study that will randomize 160 currently symptomatic community adults with major depression, recurrent with seasonal pattern, to CBT or LT. After 6 weeks of treatment in the initial winter, participants are followed in the subsequent summer, the next winter, and two winters later. Key methodological issues surround timing study procedures for a predictably recurrent and time-limited disorder with a focus on long-term outcomes. The chosen design answers the primary question of whether prior exposure to CBT is associated with a substantially lower likelihood of depression recurrence the next winter than LT. This design does not test the relative contributions of the cognitive-behavioral treatment components vs. nonspecific factors to CBT's outcomes and is not adequately powered to test for differences or equivalence between cells at treatment endpoint. Alternative designs addressing these limitations would have required more patients, increased costs, and reduced power to detect a difference in the primary outcome. Clinicaltrials.gov identifier NCT01714050.",23514124,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.9993929862976074,4.760571002960205,CgZb
"Examining the efficacy of d-cycloserine to augment therapeutic learning in depression.

Despite advances in individual and combined treatments for major depression, issues with non-response and partial-response remain relatively common, motivating the search for new treatment strategies. This study aims to develop one such novel treatment. In this proof-of-concept study, we are investigating whether the treatment enhancing effects of d-cycloserine (DCS) administration can be extended outside the extinction-learning paradigms where they have been primarily examined. Using uniform delivery of cognitive behavioral therapy (CBT) content via computer-administered interventions for depression, we are assessing the value of pre-session administrations of DCS for retention of therapeutic learning. Recall of this information is evaluated in conjunction with performance on standardized tests of memory recall with both emotional and non-emotional stimuli. Specifically, in a randomized, double-blind trial we will compare the benefits of two pre-session administrations of DCS augmentation to those achieved by similar administrations of modafinil or placebo. Because modafinil is associated with a number of discriminable effects in addition to cognitive enhancement (e.g., feelings of vigor, alertness, positive mood); whereas these effects would not be expected with DCS, we will assess drug context effects in relation to memory augmentation effects.",27094721,Major Depressive Disorder,Anxiety Treatment,Mental Health,2176,0.19370321929454803,6.995800971984863,Bt+9
"A multicenter randomized controlled trial for bright light therapy in adults with intellectual disabilities and depression: Study protocol and obstacle management.

Due to the limited cognitive and communicative abilities of adults with intellectual disabilities (ID), current treatment options for depression are often limited to lifestyle changes and pharmacological treatment. Bright light therapy (BLT) is an effective intervention for both seasonal and non-seasonal depression in the general population. BLT is an inexpensive, easy to carry out intervention with minimal side effects. However, knowledge on its anti-depressant effect in adults with ID is lacking. Obstacles in realizing a controlled intervention study in this particular study population may have contributed to this lack. To study the effect of BLT on depression in this population, it is necessary to successfully execute a multicenter randomized controlled trial (RCT). Therefore, the study protocol and the management of anticipated obstacles regarding this trial are presented.",27912106,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.127743244171143,5.021820545196533,Bj5G
"The Efficacy of Light Therapy in the Treatment of Seasonal Affective Disorder: A Meta-Analysis of Randomized Controlled Trials.

Bright light therapy (BLT) has been used as a treatment for seasonal affective disorder (SAD) for over 30 years. This meta-analysis was aimed to assess the efficacy of BLT in the treatment of SAD in adults. We performed a systematic literature search including randomized, single- or double-blind clinical trials investigating BLT (≥1,000 lx, light box or light visor) against dim light (≤400 lx) or sham/low-density negative ion generators as placebo. Only first-period data were used from crossover trials. The primary outcome was the post-treatment depression score measured by validated scales, and the secondary outcome was the rate of response to treatment. A total of 19 studies finally met our predefined inclusion criteria. BLT was superior over placebo with a standardized mean difference of -0.37 (95% CI: -0.63 to -0.12) for depression ratings (18 studies, 610 patients) and a risk ratio of 1.42 (95% CI: 1.08-1.85) for response to active treatment (16 studies, 559 patients). We found no evidence for a publication bias, but moderate heterogeneity of the studies and a moderate-to-high risk of bias. BLT can be regarded as an effective treatment for SAD, but the available evidence stems from methodologically heterogeneous studies with small-to-medium sample sizes, necessitating larger high-quality clinical trials.",31574513,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.179300785064697,5.012004375457764,Az8K
"Moderators of Cognitive Therapy and Bright Light Therapy Effects on Depressive Symptoms in Patients with Breast Cancer.

Cognitive therapy (CT) and bright light therapy (BLT) have been found to be effective to treat depressive symptoms in breast cancer patients. No study has investigated the baseline patients' characteristics that are associated with better outcomes with CT vs. BLT in this population. This study aimed to assess, in breast cancer patients, the moderating role of eight clinical variables on the effects of CT and BLT on depressive symptoms. This is a secondary analysis of a randomized controlled trial conducted in 59 women who received an 8-week CT or BLT and completed questionnaires evaluating depression and possible moderating variables. Patients benefited more from BLT when they had no prior history of major depressive disorder, higher depression scores on the Hospital Anxiety and Depression Scale (HADS-D) at baseline, a greater initial preference for BLT, and when they received BLT during spring or summer. Patients benefited more from CT when they had a lower initial preference for receiving CT, higher depression scores on the HADS-D, and seasonal depressive symptoms. Although replication is needed, findings of this study suggest the existence of different profiles of patients more likely to benefit from CT and BLT. NCT01637103 https://clinicaltrials.gov/ct2/show/NCT01637103.",31264101,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-4.134138107299805,4.938052177429199,A4In
"Outcomes One and Two Winters Following Cognitive-Behavioral Therapy or Light Therapy for Seasonal Affective Disorder.

The central public health challenge for winter seasonal affective disorder (SAD) is recurrence prevention. Preliminary studies suggest better long-term outcomes following cognitive-behavioral therapy tailored for SAD (CBT-SAD) than light therapy. The present study is a large, randomized head-to-head comparison of these treatments on outcomes one and two winters after acute treatment. Community adults with major depression, recurrent with seasonal pattern (N=177) were followed one and two winters after a randomized trial of 6 weeks of CBT-SAD (N=88) or light therapy (N=89). Prospective follow-up visits occurred in January or February of each year, and major depression status was assessed by telephone in October and December of the first year. The primary outcome was winter depression recurrence status on the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version (SIGH-SAD). Other outcomes were depression severity on the SIGH-SAD and the Beck Depression Inventory-Second Edition (BDI-II), remission status based on severity cutoff scores, and major depression status from tracking calls. The treatments did not differ on any outcome during the first year of follow-up. At the second winter, CBT-SAD was associated with a smaller proportion of SIGH-SAD recurrences (27.3% compared with 45.6%), less severe symptoms on both measures, and a larger proportion of remissions defined as a BDI-II score ≤8 (68.3% compared with 44.5%) compared with light therapy. Nonrecurrence at the next winter was more highly associated with nonrecurrence at the second winter among CBT-SAD participants (relative risk=5.12) compared with light therapy participants (relative risk=1.92). CBT-SAD was superior to light therapy two winters following acute treatment, suggesting greater durability for CBT-SAD.",26539881,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.9441819190979004,4.878134250640869,B1l/
"Effectiveness of Light Therapy in Cognitively Impaired Persons: A Metaanalysis of Randomized Controlled Trials.

To explore the effects of light therapy on behavioral disturbances (BDs), sleep quality, and depression. Meta-analysis of randomized controlled trials. PubMed, Cochrane Library, Medline, EMBASE, Web of Science, and clinicaltrials.gov of selected randomized controlled trials and previous systematic reviews were searched. Cognitively impaired persons. Information was extracted on study characteristics, quality assessment, and outcomes. Outcome measures included BDs, sleep quality, and depression. Nine randomized controlled trials were examined. The results showed that light therapy has a moderate effect on BD (g = -0.61) and depression (g = -0.58) and a small effect on total sleep time at night (g = 0.25). Subgroup analysis indicated that a light intensity of 2,500 lux or greater has a greater effect on depression than an intensity of less than 2,500 lux (P = .03), and the low risk of bias in blinding was superior to the RCTs deemed to be of high or unclear risk of bias in blinding in terms of BD (P = .02). Light therapy can relieve BD, improve sleep quality, and alleviate symptoms of depression for cognitively impaired persons.",28734045,Major Depressive Disorder,Anxiety Treatment,Mental Health,8268,-4.575506687164307,4.984788417816162,BZbJ
"The Findings of a Cochrane Meta-Analysis of Couple Therapy in Adult Depression: Implications for Research and Clinical Practice.

The association between depressive symptoms and distressed intimate relationships supported the assumption that couple therapy, by focusing on the interpersonal context of depression, might be more effective as a treatment for depression than individual psychotherapy or drug therapy. This issue was addressed by a Cochrane meta-analysis assessing the evidence from clinical trials of couple therapy for depression in comparison with individual psychotherapy, drug therapy, and no/minimal intervention, including fourteen studies with 651 participants. No study was found free of bias and the quality of the evidence was low, with major problems of small sample sizes, missing outcome data, selective reporting, lack of information on random sequence generation and allocation concealment, recruitment of people not representative of clinical practice, and allegiance bias. The meta-analysis showed that both couple therapy and individual psychotherapy improved depressive symptoms at end of treatment and after 6 months or longer, with moderate effect sizes, without any difference between the two treatments. Couple therapy was more effective in reducing couple distress. This effect was larger in studies with distressed couples only and should be considered as relevant in its own right. Couple therapy is a viable option for the treatment of a depressed partner, especially in discordant couples. Future research should address several issues left open to provide a sound empirical foundation for clinical practice.",32294797,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,13.8863525390625,-6.209634780883789,AqlP
"Reconceptualization innovative moments as a predictor of symptomatology improvement in treatment for depression.

In previous studies, reconceptualization innovative moments were associated with successful psychotherapy. Reconceptualization has two components-(a) a positive temporal contrast between the past self and the present self (contrasting self [CS]) and (b) a description of how and/or why this change has occurred (change process [CP])-from the perspective of the client. The aim of this study is to analyse if CS and CP have the same association with outcomes as reconceptualization. Sixteen cases of clients with major depression (305 sessions) were analysed. Longitudinal regression models were used to explore if proportions of CS, CP, and reconceptualization predicted outcome measures and if outcome measures predicted CS, CP, and reconceptualization. Reconceptualization is less frequent than CS and CP taken separately, but reconceptualization was a better predictor of treatment outcomes than were its separate components. Moreover, symptom improvement did not predict reconceptualization. The construction of new meanings is important in improving depressive symptomatology. Psychotherapists can elicit these new meanings in their regular practice by posing questions that may help clients to conceptualize what is changing in themselves (CS) and questions of how this change is occurring (CP). The construction of an integrative account of these new meanings is associated with psychotherapeutic gains, and thus, reconceptualizing change could improve symptoms of depression.",29989260,Major Depressive Disorder,Anxiety Treatment,Mental Health,24336,13.64049243927002,-6.2833051681518555,BJNX
"Adding cognitive therapy to antidepressant medications decreases suicidal ideation.

Psychotherapy for depression and antidepressant medications have both been associated with decreases in suicidal ideation. Studies have not examined whether adding psychotherapy to antidepressant medications further reduces suicidal ideation relative to medications alone in adults. Participants (N = 452) were randomized to 7 months of treatment with antidepressant medications or combined treatment with both medications and cognitive therapy for depression. We examined change in the suicide items from the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) across treatment using Bayesian generalized linear mixed models for non-continuous outcomes. Suicidal ideation decreased across treatment. When measured with the BDI, participants receiving both cognitive therapy and antidepressant medications showed 17% greater reductions in suicidal ideation relative to those receiving medications alone; this effect remained significant when controlling for depression severity. While the same pattern was observed when suicidal ideation was measured with the HDRS, the effect was smaller (7%) and not statistically significant. When BDI and HDRS scores were combined, participants receiving both therapy and medications showed 9% greater reductions in suicidal ideation relative to those receiving medications alone; this effect was marginally significant when controlling for depression severity. This is a secondary analysis of a randomized clinical trial designed to treat depression, in which suicidal ideation was assessed using single-item measures. Adding cognitive therapy to antidepressant medications may reduce suicidal ideation to a greater extent than medications alone. Pending replication, combination treatment may be preferred for individuals with suicidal ideation. clinicaltrials.gov Identifier: NCT00057577.",33326891,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,15.623579978942871,-7.548546314239502,Ad0+
"Couple-based Intervention for Depression: An Effectiveness Study in the National Health Service in England.

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple-based treatment for depression (BCT-D) provided in London services that are part of the ""Improving Access to Psychological Therapies"" (IAPT) program in England. Twenty-three therapists in community clinics were trained in BCT-D during a 5-day workshop, followed by monthly group supervision for 1 year. The BCT-D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT-D. Eighty-five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT-D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT-D, although they were not the focus of treatment. BCT-D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT-D in routine clinical settings.",29205325,Major Depressive Disorder,Anxiety Treatment,Mental Health,3806,13.968053817749023,-6.512287616729736,BTLR
"Cognitive therapy and interpersonal psychotherapy reduce suicidal ideation independent from their effect on depression.

Clinical guidelines suggest that psychological interventions specifically aimed at reducing suicidality may be beneficial. We examined the impact of two depression treatments, cognitive therapy (CT) and interpersonal psychotherapy (IPT) on suicidal ideation (SI) and explored the temporal associations between depression and SI over the course of therapy. Ninety-one adult (18-65) depressed outpatients from a large randomized controlled trial who were treated with CT (n=37) and IPT (n=54) and scored at least ≥1 on the Beck Depression Inventory II (BDI-II) suicide item were included. Linear (two-level) mixed effects models were used to evaluate the impact of depression treatments on SI. Mixed-effects time-lagged models were applied to examine temporal relations between the change in depressive symptoms and the change in SI. SI decreased significantly during treatment and there were no differential effects between the two intervention groups (B=-0.007, p=.35). Depressive symptoms at the previous session did not predict higher levels of SI at the current session (B=0.016, p=.16). However, SI measured at the previous session significantly predicted depressive symptoms at the current session (B=2.06, p<.001). Both depression treatments seemed to have a direct association with SI. The temporal association between SI and depression was unidirectional with SI predicting future depressive symptoms during treatment. Our findings suggest that it may be most beneficial to treat SI first.",33755280,Major Depressive Disorder,Anxiety Treatment,Mental Health,16717,15.621800422668457,-7.766044616699219,AY9t
"The relationship between the therapeutic alliance and clinical outcomes in cognitive behaviour therapy for adults with depression: A meta-analytic review.

Research consistently provides evidence for the relationship between the therapeutic alliance (TA) and outcome across various therapies and presenting problems. Depression is considered the leading cause of disability worldwide, and there is substantial evidence for the efficacy for Cognitive Behaviour Therapy (CBT) in its treatment. At present, there is lack of clarity specifically about the relationship between the TA and outcome in CBT for depression. The present review is the first meta-analytic review to explore this relationship and also considering moderators. Within a random-effects model, an overall mean effect size of r = 0.26 (95% CI [.19-.32]) was found, indicating that the TA was moderately related to outcome in CBT for depression. The mean TA-outcome correlation is consistent with existing meta-analysis that looked across a broad range of presenting problems and psychological therapies. A secondary exploratory analysis of moderators suggested the TA-outcome relationship varied according to the TA rater, where the relationship was weaker for therapist raters compared with clients and observer raters. Additionally, the results indicated that the TA-outcome relationship marginally increased over the course of CBT treatment. The results of the meta-analysis are discussed in reference to the wider body of research, methodological limitations, clinical implications, and future directions for research.",29484770,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,13.971667289733887,-6.14941930770874,BPb3
"A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder.

This trial assessed the feasibility, acceptability, tolerability, and efficacy of an Internet-based therapist-assisted cognitive-behavioral indicated prevention intervention for prolonged grief disorder (PGD) called Healthy Experiences After Loss (HEAL). Eighty-four bereaved individuals at risk for PGD were randomized to either an immediate treatment group (n = 41) or a waitlist control group (n = 43). Assessments were conducted at four time-points: prior to the wait-interval (for the waitlist group), pre-intervention, post-intervention, 6 weeks later, and 3 months later (for the immediate group only). Intent-to-treat analyses indicated that HEAL was associated with large reductions in prolonged grief (d = 1.10), depression (d = .71), anxiety (d = .51), and posttraumatic stress (d = .91). Also, significantly fewer participants in the immediate group met PGD criteria post-intervention than in the waitlist group. Pooled data from both groups also yielded significant reductions and large effect sizes in PGD symptom severity at each follow-up assessment. The intervention required minimal professional oversight and ratings of satisfaction with treatment and usability of the Internet interface were high. HEAL has the potential to be an effective, well-tolerated tool to reduce the burden of significant pre-clinical PGD. Further research is needed to refine HEAL and to assess its efficacy and mechanisms of action in a large-scale trial.",25113524,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.882051467895508,-9.306636810302734,CJ8o
"Moderation of the Alliance-Outcome Association by Prior Depressive Episodes: Differential Effects in Cognitive-Behavioral Therapy and Short-Term Psychodynamic Supportive Psychotherapy.

Prior studies have suggested that the association between the alliance and depression improvement varies as a function of prior history of depression. We sought to replicate these findings and extend them to short-term psychodynamic supportive psychotherapy (SPSP) in a sample of patients who were randomized to one of these treatments and were administered the Helping Alliance Questionnaire (N=282) at Week 5 of treatment. Overall, the alliance was a predictor of symptom change (d=0.33). In SPSP, the alliance was a modest but robust predictor of change, irrespective of prior episodes (d=0.25-0.33). By contrast, in CBT, the effects of the alliance on symptom change were large for patients with 0 prior episodes (d=0.86), moderate for those with 1 prior episode (d=0.49), and small for those with 2+ prior episodes (d=0.12). These findings suggest a complex interaction between patient features and common vs. specific therapy processes. In CBT, the alliance relates to change for patients with less recurrent depression whereas other CBT-specific processes may account for change for patients with more recurrent depression.",28711109,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,13.738304138183594,-6.067614555358887,BZwW
"Mechanisms of change in brief couple therapy for depression.

The goal of the present study was to investigate potential mechanisms of previously documented treatment effects for a brief, 5-session, problem-focused couple therapy for depression in a sample of 35 depressed women and their nondepressed husbands. The primary treatment effects were reducing women's depressive symptoms and their husbands' psychological distress and depression-specific burden. Secondarily, treatment resulted in increased relationship satisfaction for both partners. Given these significant treatment changes observed in 5 sessions, we sought to examine the mechanisms of change by testing the following three factors as potential mediators: (a) negative behaviors and attitudes toward depression, (b) support provision, and (c) empathic communication towards the depressed female partners. Women's depression and husbands' depression-specific burden were alleviated by positive changes in their illness-related attitudes and behaviors. Improvements in women's marital satisfaction were also mediated by positive change in their illness-related attitudes and behaviors, along with perceptions of increased positivity and support from their husbands. Findings highlight the importance of targeting specific treatment agents in a brief couple therapy for depression such as psychoeducation about depression and support-building to increase partners' understanding and acceptance of the illness, and teaching communication skills to reduce negative behaviors and criticism that are replaced by more empathic communication towards the depressed individual.",24680234,Major Depressive Disorder,Anxiety Treatment,Mental Health,3806,13.982954978942871,-6.647826671600342,CQFr
"Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression.

Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited. Explicit attachment styles, levels of attachment anxiety and attachment avoidance, as well as implicit relational self-esteem and implicit relational anxiety were assessed in 67 patients with major depressive disorder (MDD) receiving Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT). ANOVA and hierarchical regression analyses were performed to investigate the predictive power of explicit and implicit attachment measures on treatment outcome. Explicit attachment avoidance at pre-treatment significantly predicted reduction of depressive symptoms following treatment. Reductions in attachment anxiety and avoidance from pre- to post-treatment predicted better treatment outcomes. Neither one of the implicit measures, nor change in these measures from pre- tot post-treatment significantly predicted treatment outcome. Our findings show that attachment avoidance as well as reductions in avoidant and anxious attachment predict symptom reduction after psychological treatment for depression. Future research should use larger sample sizes to further examine the role of attachment orientation as moderator and mediator of treatment outcome. clinicaltrials.gov; NCT01517503.",32264845,Major Depressive Disorder,Anxiety Treatment,Mental Health,5412,15.750999450683594,-6.292791366577148,Aq6q
"Randomized controlled trial of emotionally focused couple therapy compared to treatment as usual for depression: Outcomes and mechanisms of change.

This randomized controlled trial examined the effectiveness of Emotionally Focused Therapy (EFT) for depression and relationship satisfaction versus usual care (i.e., couple therapy other than EFT), and explored mechanisms of change. Mixed model trajectory analyses of 16 couples indicated EFT was associated with greater improvement in relationship satisfaction among men and women. Men receiving EFT reported greater improvements in depressive symptoms compared to usual care. Unified structural equation modeling revealed changes in relationship satisfaction preceded changes in depressive symptoms in one cluster of partners, while changes in depression preceded changes in relationship satisfaction in a second cluster. Two other clusters reported simultaneous changes in satisfaction and depression. This study provides encouraging results on the effectiveness of EFT for depression, and insight into mechanisms of change.",30105808,Major Depressive Disorder,Anxiety Treatment,Mental Health,3806,14.859857559204102,-6.933865070343018,BHlt
"Psychological distress following a motor vehicle crash: preliminary results of a randomised controlled trial investigating brief psychological interventions.

The preliminary results of a randomised controlled trial are presented. The aim of the trial is to determine the efficacy, feasibility and acceptability of email-delivered psychological interventions with telephone support, for adults injured in a motor vehicle crash engaged in seeking compensation. The primary intention for this preliminary analysis was to investigate those who were psychologically distressed and to stop the trial midway to evaluate whether the safety endpoints were necessary. The analysis included 90 adult participants randomised to one of three groups, who were assessed at baseline and post-intervention at 3 months. Cognitive behaviour therapy (CBT) or healthy lifestyle interventions were delivered over 10 weeks, involving fortnightly emailed modules plus clinically focussed telephone support, with the aim of reducing psychological distress. An active waiting list of control subjects received non-clinically focussed telephone contact over the same period along with claim-related reading material. Depression Anxiety Stress Scales (DASS) and Impact of Events Scale (Revised) (IES-R) were used to assess psychological distress. Psychiatric interviews were used to diagnose major depressive disorder and post-traumatic stress disorder. Aspects of acceptability and feasibility were also assessed. For those diagnosed with depression at baseline in the CBT group, psychological distress reduced by around 16%. For those with depression in the healthy lifestyle group, distress increased marginally. For those in the control group with depression, distress also decreased (by 18% according to DASS-21 and 1.2% according to IES-R). For those without depression, significant reductions in distress occurred, regardless of group (P<.05). The results suggest that for those with depression, a healthy lifestyle intervention is contraindicated, necessitating the cessation of recruitment to this intervention. The interventions were reported as acceptable by the majority and the data indicated that the study is feasible. CBT with telephone support reduced psychological distress in physically injured people with depression who are engaged in seeking compensation. However, time plus fortnightly telephone contact with claim-related reading material may be sufficient to reduce distress in those who are depressed. For those who were not depressed, time plus telephone support is most likely sufficient enough to assist them to recover. The trial will continue with further recruitment to only the CBT and control groups, over longer follow-up periods. Australian and New Zealand Clinical Trials Registry: Preventing psychological distress following a motor vehicle accident; ACTRN12615000326594 . Registered on 9 April 2015.",29945650,Major Depressive Disorder,Anxiety Treatment,Mental Health,12002,17.37416648864746,-10.239322662353516,BJzb
"Treating prolonged grief disorder with prolonged grief-specific cognitive behavioral therapy: study protocol for a randomized controlled trial.

Prolonged grief disorder (PGD) has emerged as a well-defined and relatively common mental disorder that will be included in the upcoming revision of the International Classification of Diseases. Recent trials with grief-specific, mostly cognitive behavioral interventions for patients with a clinically relevant diagnosis of PGD showed large effect sizes. However, a small trial suggested that non-specific behavioral activation might suffice to improve PGD. So, more evidence for the relative efficacy of grief-specific treatments is needed, as is more research on the predictors of treatment success. The purpose of the proposed trial is to evaluate a newly developed and successfully pilot-tested, prolonged grief-specific, integrative cognitive behavioral therapy (PG-CBT) compared to an active yet unspecific treatment, present-centered therapy (PCT). In a multicenter, randomized controlled trial with 204 adults with a primary diagnosis of PGD, PG-CBT is compared to PCT, assuming the superiority of PG-CBT. Both treatments consist of 20 to 24 individual sessions, with an overall treatment length of about 6 months. The primary outcome, grief symptom severity, is assessed by blinded interviewers 12 months after randomization. Secondary outcomes are grief symptom severity at post treatment, in addition to self-reported overall mental health symptoms, depressive and somatoform symptoms at post treatment and 12 months post randomization. Possible moderators and mediators of treatment success are also explored. The trial is designed to avoid bias as much as possible (stratified randomization performed independently, blinded outcome assessment, intention-to-treat-analysis, balanced treatment dose, continuous supervision, control for allegiance effects) thereby enhancing internal validity. At the same time, some aspects of the trial will ensure clinical relevance (recruiting at outpatient clinics that are part of routine health care and keeping exclusion criteria to a minimum). Since the trial is powered adequately for the primary outcome, all secondary analyses including moderator analyses are exploratory by nature. The results will extend the knowledge on efficacious treatment of PGD and its predictors. German Clinical Trials Register, ID: DRKS00012317 . Registered on 6 September 2017.",29678193,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.988508224487305,-9.177594184875488,BM7C
"Treatment efficacy and effectiveness in adults with major depressive disorder and childhood trauma history: a systematic review and meta-analysis.

Childhood trauma is a common and potent risk factor for developing major depressive disorder in adulthood, associated with earlier onset, more chronic or recurrent symptoms, and greater probability of having comorbidities. Some studies indicate that evidence-based pharmacotherapies and psychotherapies for adult depression might be less efficacious in patients with a history of childhood trauma than patients without childhood trauma, but findings are inconsistent. Therefore, we examined whether individuals with major depressive disorder, including chronic forms of depression, and a reported history of childhood trauma, had more severe depressive symptoms before treatment, had more unfavourable treatment outcomes following active treatments, and were less likely to benefit from active treatments relative to a control condition, compared with individuals with depression without childhood trauma. We did a comprehensive meta-analysis (PROSPERO CRD42020220139). Study selection combined the search of bibliographical databases (PubMed, PsycINFO, and Embase) from Nov 21, 2013, to March 16, 2020, and full-text randomised clinical trials (RCTs) identified from several sources (1966 up to 2016-19) to identify articles in English. RCTs and open trials comparing the efficacy or effectiveness of evidence-based pharmacotherapy, psychotherapy, or combination intervention for adult patients with depressive disorders and the presence or absence of childhood trauma were included. Two independent researchers extracted study characteristics. Group data for effect-size calculations were requested from study authors. The primary outcome was depression severity change from baseline to the end of the acute treatment phase, expressed as standardised effect size (Hedges' g). Meta-analyses were done using random-effects models. From 10505 publications, 54 trials met the inclusion criteria, of which 29 (20 RCTs and nine open trials) contributed data of a maximum of 6830 participants (age range 18-85 years, male and female individuals and specific ethnicity data unavailable). More than half (4268 [62%] of 6830) of patients with major depressive disorder reported a history of childhood trauma. Despite having more severe depression at baseline (g=0·202, 95% CI 0·145 to 0·258, I2=0%), patients with childhood trauma benefitted from active treatment similarly to patients without childhood trauma history (treatment effect difference between groups g=0·016, -0·094 to 0·125, I2=44·3%), with no significant difference in active treatment effects (vs control condition) between individuals with and without childhood trauma (childhood trauma g=0·605, 0·294 to 0·916, I2=58·0%; no childhood trauma g=0·178, -0·195 to 0·552, I2=67·5%; between-group difference p=0·051), and similar dropout rates (risk ratio 1·063, 0·945 to 1·195, I2=0%). Findings did not significantly differ by childhood trauma type, study design, depression diagnosis, assessment method of childhood trauma, study quality, year, or treatment type or length, but differed by country (North American studies showed larger treatment effects for patients with childhood trauma; false discovery rate corrected p=0·0080). Most studies had a moderate to high risk of bias (21 [72%] of 29), but the sensitivity analysis in low-bias studies yielded similar findings to when all studies were included. Contrary to previous studies, we found evidence that the symptoms of patients with major depressive disorder and childhood trauma significantly improve after pharmacological and psychotherapeutic treatments, notwithstanding their higher severity of depressive symptoms. Evidence-based psychotherapy and pharmacotherapy should be offered to patients with major depressive disorder regardless of childhood trauma status. None.",36156242,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,17.31732940673828,-7.111081600189209,GJw
"Randomized Controlled Trial of the Marriage Checkup: Depression Outcomes.

The association between relationship functioning and depressive symptoms is well established. This study examined the effects of the Marriage Checkup, a brief two-session Assessment and Feedback relationship intervention, on depressive symptoms. Two hundred and nine married couples participated in the Marriage Checkup and were randomized into Treatment (N = 108) and Waitlist-Control Conditions (N = 101). Compared to the control condition, intervention participants reported significant improvements in depressive symptoms (d = 0.55), with an even greater effect for those who were reporting more severe baseline depression symptoms (d = 0.67). These outcomes are comparable to those within long-term individual psychotherapy, couple therapy, and pharmacology trials, making this the briefest intervention to date to demonstrate significant improvements in depressive symptoms. Clinical implications are discussed.",31584721,Major Depressive Disorder,Anxiety Treatment,Mental Health,3806,14.161942481994629,-6.160430908203125,Az0H
"Behavioural activation and trial-based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial.

The suicidality spectrum is a clinical challenge because of the difficulty of its management and its association with mortality. Few studies have investigated psychotherapies for reducing the components of suicidality. In this study, we compared the effect of behavioural activation (BA), trial-based cognitive therapy (TBCT) - both added to antidepressant (AD) treatment - and treatment as usual (TAU) in mitigating suicidal ideation in patients with major depressive disorder (MDD). A post hoc study was conducted with data from a randomized clinical trial. Secondary analyses compared the treatments using scores from the items that evaluated suicidal ideation with the HAM-D (HAM-D-3) and BDI (BDI-9). A composite measurement was constructed by summing the scores from the two items (HAM-D-3 plus BDI-9). Seventy-six patients were analysed (BA + AD = 24; TBCT + AD = 26 and TAU = 26). In HAM-D-3, the BA + AD group showed a statistically greater reduction than the TAU group. In BDI-9, the three groups did not show significant differences. In the HAM-D-3 plus BDI-9, TBCT + AD reduced ideations more than the TAU group. There were no differences among the psychotherapies in any of the measures. Sensitivity analyses showed improvement in suicidal ideation in both psychotherapies compared to TAU. This is one of the few studies that evaluated the effect of BA and TBCT in lowering suicidal ideation. Adding these therapies to ADs seems to decrease suicidal ideation. We suggest the possible beneficial effects of BA and TBCT in the management of suicidal ideation in patients with recurrent MDD. Our findings need further studies to confirm these results.",34617303,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,14.895915985107422,-7.514260292053223,9tg
"Effectiveness of an inpatient group therapy for comorbid complicated grief disorder.

We investigated whether inpatients suffering from comorbid complicated grief disorder benefited from an additional manualized nine-session group intervention. For this purpose, 50 patients participating in the additional complicated grief intervention were compared with 22 control patients who received treatment as usual. After grief intervention, we found large effect sizes with regard to improvement in complicated grief symptoms. Because we found no differences regarding overall mental distress and depressive symptoms (between the two groups), the grief intervention seems to be highly specific.",21331975,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.770828247070312,-9.094544410705566,C/wr
"Efficacy of an outpatient treatment for prolonged grief disorder: a randomized controlled clinical trial.

Abnormal forms of grief, currently referred to as complicated grief or prolonged grief disorder, have been discussed extensively in recent years. While the diagnostic criteria are still debated, there is no doubt that prolonged grief is disabling and may require treatment. To date, few interventions have demonstrated efficacy. We investigated whether outpatients suffering from prolonged grief disorder (PGD) benefit from a newly developed integrative cognitive behavioural therapy for prolonged grief (PG-CBT). A total of 51 patients were randomized into two groups, stratified by the type of death and their relationship to the deceased; 24 patients composed the treatment group and 27 patients composed the wait list control group (WG). Treatment consisted of 20-25 sessions. Main outcome was change in grief severity; secondary outcomes were reductions in general psychological distress and in comorbidity. Patients on average had 2.5 comorbid diagnoses in addition to PGD. Between group effect sizes were large for the improvement of grief symptoms in treatment completers (Cohen׳s d=1.61) and in the intent-to-treat analysis (d=1.32). Comorbid depressive symptoms also improved in PG-CBT compared to WG. The completion rate was 79% in PG-CBT and 89% in WG. The major limitations of this study were a small sample size and that PG-CBT took longer than the waiting time. PG-CBT was found to be effective with an acceptable dropout rate. Given the number of bereaved people who suffer from PGD, the results are of high clinical relevance.",25082115,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.985260009765625,-9.231730461120605,CKbu
"An Evaluation of the Effectiveness of Evidence-Based Psychotherapies for Depression to Reduce Suicidal Ideation among Male and Female Veterans.

Although most suicide-related deaths occur among male veterans, women veterans are dying by suicide in increasing numbers. Identifying and increasing access to effective treatments is imperative for Department of Veterans Affairs suicide prevention efforts. We examined the impact of evidence-based psychotherapies for depression on suicidal ideation and the role of gender and treatment type in patients' responses to treatment. Clinicians receiving case consultation in interpersonal psychotherapy, cognitive-behavioral therapy for depression, and acceptance and commitment therapy for depression submitted data on depressive symptoms and suicidal ideation while treating veterans with depression. Suicidal ideation was reduced across time in all three treatments. A main effect for wave was associated with statistically significant decreases in severity of suicidal ideation, χ2 (2) = 224.01, p = .0001, and a subsequent test of the Gender × Wave interaction was associated with differentially larger decreases in ideation among women veterans, χ2 (2) = 9.26, p = .001. Within gender-stratified subsamples, a statistically significant Treatment × Time interaction was found for male veterans, χ2 (4) = 16.82, p = .002, with levels of ideation significantly decreased at waves 2 and 3 in interpersonal psychotherapy and cognitive-behavioral therapy for depression relative to acceptance and commitment therapy for depression; the Treatment × Wave interaction within the female subsample was not statistically significant, χ2 (4) = 3.41, p = .492. This analysis demonstrates the efficacy of each of the three tested evidence-based psychotherapies for depression as a means of decreasing suicidal ideation, especially in women veterans. For male veterans, decreases in suicidal ideation were significantly greater in interpersonal psychotherapy and cognitive-behavioral therapy for depression relative to acceptance and commitment therapy for depression.",31253233,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,15.664275169372559,-8.530019760131836,A4Ry
"A randomized clinical trial of a brief, problem-focused couple therapy for depression.

The aim of this study was to evaluate a brief couple therapy for depression targeted for mildly discordant or nondiscordant couples struggling with the negative impact of depression. Subjects included women with major depression or dysthymia who had husbands without clinical depression. Thirty-five couples were randomly assigned to the 5-week intervention (n=18) or a waitlist control group (n=17), and followed up 1 and 3 months later. Results showed a significant effect of treatment in reducing women's depressive symptoms, with 67% of women improved and 40% to 47% recovered at follow-up, compared to only 17% improved and 8% recovered among women in the control group. Treatment was also effective in secondarily improving women's marital satisfaction, reducing husbands' levels of psychological distress and depression-specific burden, and improving both partners' understanding and acceptance of depression. The treatment was implemented in five 2-hour sessions, representing an efficient, cost-effective approach. Findings support the growing utility of brief, problem-focused couple interventions that simultaneously target depression, relational functioning, and psychological distress experienced by the loved ones of depressed persons.",21035609,Major Depressive Disorder,Anxiety Treatment,Mental Health,3806,13.87387752532959,-6.164382457733154,DD+4
"Review: No reliable evidence of the effect of psychotherapy upon suicide risk in people with depression.

",23585196,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,14.611604690551758,-7.638728141784668,CfU1
"Schema therapy for chronic depression: Results of a multiple single case series.

The aim of this study was to test the effects of individual schema therapy (ST) for patients with chronic depression. Using a multiple-baseline single case series design, patients with chronic major depressive disorder (N = 25) first entered a 6-24 weeks baseline phase; this phase functioned as a no-treatment control condition. Then, patients started a 12 week exploration phase during which symptoms and underlying schemas were explored; this phase functioned as an attention control condition. Next, patients received up to 65 sessions of individual ST. The Beck Depression Inventory II (BDI-II) and the Quick Inventory of Depressive Symptomatology (QIDS) were the primary outcome measures. The BDI-II was assessed once a week during all phases of the study resulting in 100 repeated assessments per participant on average. Mixed regression analysis was used to contrast change in symptoms during the intervention with change in symptoms during the baseline and exploration control phases. When compared to the no-treatment control period, the intervention had a significant, large effect on depressive symptoms (Cohen's d BDI-II = 1.30; Cohen's d QIDS = 1.22). Effects on secondary continuous outcomes were moderate to large. The small sample size and lack of a control group. These findings provide evidence that ST might be an effective treatment for patients with chronic depression.",26780673,Major Depressive Disorder,Anxiety Treatment,Mental Health,23813,18.015216827392578,-5.985973834991455,ByZ1
"Predictors of prolonged grief in an internet-based grief therapy for people bereaved by suicide.

Internet-based cognitive-behavioural grief therapy (ICBGT) has proven to be effective for people bereaved by suicide, however the extent to which patients can benefit from therapy seems to differ. This study investigates predictors of initial grief as well as change in grief severity following treatment in an ICBGT for people bereaved by suicide. Data was gathered from a randomized control trial including 57 people participating in a 5-week intervention. Change in grief symptoms was calculated using absolute change scores of grief. In order to examine best overall combination of independent variables, best subset regressions were conducted. Higher levels of pre-test grief were associated with worse sleep quality (β = 0.32, p = .002), lower self-esteem (β = -0.37, p = .002), lower support seeking (β = -0.38, p = .006), and a higher need for social support (β = 0.28, p = .028). A greater reduction in grief severity was associated with higher self-efficacy (β = -0.49, p = .001), higher attachment anxiety (β = -0.31, p = .017) and higher pre-test grief symptoms (β = -0.39, p = .006). Attention should be paid to the intensity of grief, the attachment style and a positive self-image, as these variables seem to influence the extent, to which patients' symptoms of PGD subside following ICBGT. To specifically target factors of patients that require improvement, further studies are needed.",35278780,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.75621223449707,-9.029888153076172,izc
"Efficacy of an Internet-based cognitive-behavioural grief therapy for people bereaved by suicide: a randomized controlled trial.

Background: The loss of a loved one due to suicide can be a traumatic event associated with prolonged grief and psychological distress. Objective: This study examined the efficacy of an Internet-based cognitive-behavioural grief therapy (ICBGT) specifically for people bereaved by suicide. Methods: In a randomized controlled trial, 58 participants with prolonged grief disorder (PGD) symptoms who had lost a close person to suicide were randomly allocated either to the intervention group (IG) or waitlist-control group (WCG). The 5-week intervention comprised ten writing assignments in three phases: self-confrontation, cognitive restructuring, and social sharing. Symptoms of PGD, common grief reactions after suicide, depression, and general psychopathology were assessed at pre-, post-test and follow-up. Results: Between-group effect sizes were large for the improvement of PGD symptoms in treatment completers (dppc2 = 1.03) and the intent-to-treat analysis (dppc2 = 0.97). Common grief reactions after suicide and depressive symptoms also decreased in the IG compared to the WCG (moderate to large effects). The results are stable over time. Only for general psychopathology, there was no significant time by group interaction effect found. Conclusions: The ICBGT represents an effective treatment approach for people suffering from PGD symptoms after bereavement by suicide. Considering the effect sizes, the small treatment dose, duration, and the stability of the results, the ICBGT constitutes an appropriate alternative to face-to-face grief interventions.",34992754,Major Depressive Disorder,Anxiety Treatment,Mental Health,1231,17.517024993896484,-9.218599319458008,uMQ
"The Association of Therapeutic Alliance With Long-Term Outcome in a Guided Internet Intervention for Depression: Secondary Analysis From a Randomized Control Trial.

Therapeutic alliance has been well established as a robust predictor of face-to-face psychotherapy outcomes. Although initial evidence positioned alliance as a relevant predictor of internet intervention success, some conceptual and methodological concerns were raised regarding the methods and instruments used to measure the alliance in internet interventions and its association with outcomes. The aim of this study was to explore the alliance-outcome association in a guided internet intervention using a measure of alliance especially developed for and adapted to guided internet interventions, showing evidence of good psychometric properties. A sample of 223 adult participants with moderate depression received an internet intervention (ie, Deprexis) and email support. They completed the Working Alliance Inventory for Guided Internet Intervention (WAI-I) and a measure of treatment satisfaction at treatment termination and measures of depression severity and well-being at termination and 3- and 9-month follow-ups. For data analysis, we used two-level hierarchical linear modeling that included two subscales of the WAI-I (ie, tasks and goals agreement with the program and bond with the supporting therapist) as predictors of the estimated values of the outcome variables at the end of follow-up and their rate of change during the follow-up period. The same models were also used controlling for the effect of patient satisfaction with treatment. We found significant effects of the tasks and goals subscale of the WAI-I on the estimated values of residual depressive symptoms (γ02=-1.74, standard error [SE]=0.40, 95% CI -2.52 to -0.96, t206=-4.37, P<.001) and patient well-being (γ02=3.10, SE=1.14, 95% CI 0.87-5.33, t198=2.72, P=.007) at the end of follow-up. A greater score in this subscale was related to lower levels of residual depressive symptoms and a higher level of well-being. However, there were no significant effects of the tasks and goals subscale on the rate of change in these variables during follow-up (depressive symptoms, P=.48; patient well-being, P=.26). The effects of the bond subscale were also nonsignificant when predicting the estimated values of depressive symptoms and well-being at the end of follow-up and the rate of change during that period (depressive symptoms, P=.08; patient well-being, P=.68). The results of this study point out the importance of attuning internet interventions to patients' expectations and preferences in order to enhance their agreement with the tasks and goals of the treatment. Thus, the results support the notion that responsiveness to a patient's individual needs is crucial also in internet interventions. Nevertheless, these findings need to be replicated to establish if they can be generalized to different diagnostic groups, internet interventions, and supporting formats.",32207689,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,13.621871948242188,-6.12001895904541,Aric
"Mood Regulation Focused CBT Based on Memory Reconsolidation, Reduced Suicidal Ideation and Depression in Youth in a Randomised Controlled Study.

Suicide attempts and suicidal ideation in adolescence are considered to be related to suicide and psychiatric adversity later in life. Secondary prevention by improving the treatment of suicidal youth is a distinct possibility. In this study, treatment with a systematised mood-regulation focused cognitive behavioural therapy (MR-CBT) (n = 15) was compared with treatment as usual (TAU) (n = 12) in a group of depressed adolescents in a clinical setting. MR-CBT focuses on mood regulation by means of counter conditioning with memory reconsolidation being the proposed mechanism of change. Subjects practice keeping emotionally positive memories to diminish the emotional impact of negative memories. Symptoms of depression were tested with a short version of the Mood and Feelings Questionnaire (SMFQ), and wellbeing with the World Health Organization 5 Wellbeing Index (WHO-5). Suicidal events were rated according to the clinical interview Columbia Suicide Severity Rating Scale (C-SSRS). Suicidal events at the end of treatment were significantly reduced in the MR-CBT group, but not in the TAU group. Depression and wellbeing improved significantly in both treatment groups. While far from conclusive, the results are encouraging enough to suggest that further studies should be undertaken to examine whether psychotherapy focusing on mood regulation for young individuals at risk might enhance secondary prevention of suicide.",29734740,Major Depressive Disorder,Anxiety Treatment,Mental Health,8140,15.403451919555664,-7.874258518218994,BMJR
"Childhood maltreatment and differential treatment response and recurrence in adult major depressive disorder.

A substantial number of patients with major depressive disorder (MDD) do not respond to treatment, and recurrence rates remain high. The purpose of this study was to examine a history of severe childhood abuse as a moderator of response following a 16-week acute treatment trial, and of recurrence over a 12-month follow-up. Participants included 203 adult outpatients with MDD (129 women; age 18-60). The design was a 16-week single-center randomized, open label trial of interpersonal psychotherapy, cognitive-behavioral therapy, or antidepressant medication, with a 12-month naturalistic follow-up, conducted at a university psychiatry center in Canada. The main outcome measure was Hamilton Depression Rating Scale scores at treatment end point. Childhood maltreatment was assessed at the completion of treatment using an interview-based contextual measure of childhood physical, sexual, and emotional abuse. Multiple imputation was adopted to estimate missing values. Patients with severe maltreatment were significantly less likely to respond to interpersonal psychotherapy than to cognitive-behavioral therapy or medication (OR = 3.61), whereas no differences among treatments were found in those with no history of maltreatment (ORs < 1.50). Furthermore, maltreatment significantly predicted a shorter time to recurrence over follow-up across treatment conditions (OR = 3.04). These findings were replicated in the sample with complete case data. Patients with a history of childhood abuse may benefit more from antidepressant medication or cognitive-behavioral therapy than from interpersonal psychotherapy. However, these patients remain vulnerable to recurrence regardless of treatment modality.",22428942,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,17.05710792541504,-7.076388835906982,Cv2Y
"Do depression treatments reduce suicidal ideation? The effects of CBT, IPT, pharmacotherapy, and placebo on suicidality.

Many well-researched treatments for depression exist. However, there is not yet enough evidence on whether these therapies, designed for the treatment of depression, are also effective for reducing suicidal ideation. This research provides valuable information for researchers, clinicians, and suicide prevention policy makers. Analysis was conducted on the Treatment for Depression Research Collaborative (TDCRP) sample, which included CBT, IPT, medication, and placebo treatment groups. Participants were included in the analysis if they reported suicidal ideation on the HRSD or BDI (score of ≥1). Multivariate linear regression indicated that both IPT (b=.41, p<.05) and medication (b =.47, p<.05) yielded a significant reduction in suicide symptoms compared to placebo on the HRSD. Multivariate linear regression indicated that after adjustment for change in depression these treatment effects were no longer significant. Moderate Cohen׳s d effect sizes from baseline to post-test differences in suicide score by treatment group are reported. These analyses were completed on a single suicide item from each of the measures. Moreover, the TDCRP excluded participants with moderate to severe suicidal ideation. This study demonstrates the specific effectiveness of IPT and medications in reducing suicidal ideation (relative to placebo), albeit largely as a consequence of their more general effects on depression. This adds to the growing body of evidence that depression treatments, specifically IPT and medication, can also reduce suicidal ideation and serves to further our understanding of the complex relationship between depression and suicide.",24953481,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,15.688197135925293,-7.849238395690918,CMRy
"Identifying the most suitable treatment for depression based on patients' attachment: study protocol for a randomized controlled trial of supportive-expressive vs. supportive treatments.

In the absence of one intervention that can cure all patients with major depressive disorder (MDD), the leading cause of disability worldwide, increased attention has been focused on selecting the best treatment based on patient characteristics. Theory-driven hypotheses for selecting the best treatments have not yet been adequately investigated. The present study tested the a priory hypothesis that attachment orientations may determine whether patients benefit more from a treatment where alliance provides a facilitative environment for the treatment to work, as in the case of supportive-expressive psychotherapy, vs. where alliance is conceptualized as an active ingredient in itself, as in the case of supportive psychotherapy. To test the hypothesis that attachment orientation moderates the effect of treatment condition on outcome, we conduct a randomized controlled trial (RCT). One hundred patients are randomized to 16 sessions of either supportive-expressive or supportive psychotherapy for MDD, conducted by experienced psychologists. The primary outcome is change in the Hamilton Rating Scale for Depression. Secondary outcome measures include self-reported depressive and other symptoms, psychological and interpersonal functioning, quality of life, and the presence of the diagnosis of depression. Additional measures include hormonal levels, motion synchrony, and acoustic attributes, performance on cognitive tasks, and narrative material (collected from the sessions and from interviews). The RCT will expand our understanding of how the outcome of treatment can be optimized by identifying the most promising role of alliance in treatment, based on patients' pre-treatment attachment orientation. Results will contribute to the ongoing theoretical debate concerning the differential efficacy of various psychotherapeutic approaches for patients with different attachment orientations. The RCT will also contribute to progress toward personalized treatment by informing therapists about which of two approaches are most effective with patients based on their attachment styles. Clinicaltrials.gov Identifier: NCT02728557 submitted on the 15.3.16. The Israel Science Foundation. Trial status: Recruitment is ongoing.",30419875,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,15.081267356872559,-6.204998016357422,BDcg
"Digging down or scratching the surface: how patients use metaphors to describe their experiences of psychotherapy.

In the present study, we wanted to explore which metaphors patients suffering from major depressive disorder (MDD) use to explain their experience of being in therapy and their improvement from depression. Patients with MDD (N=22) received either psychodynamic therapy (PDT) or cognitive behavioral therapy (CBT). They were interviewed with semi-structured qualitative interviews after ending therapy. The transcripts were analyzed using a method based on metaphor-led discourse analysis. Metaphors were organized into three different categories concerning the process of therapy, the therapeutic relationship and of improvement from depression. Most frequent were the metaphorical concepts of surface and depth, being open and closed, chemistry, tools, improvement as a journey from darkness to light and depression as a disease or opponent. Patient metaphors concerning the therapeutic experience may provide clinicians and researchers valuable information about the process of therapy. Metaphors offer an opportunity for patients to communicate nuances about their therapeutic experience that are difficult to express in literal language. However, if not sufficiently explored and understood, metaphors may be misinterpreted and become a barrier for therapeutic change. Clinical Trial gov. Identifier: NCT03022071 . Date of registration: 16/01/2017.",34706691,Major Depressive Disorder,Anxiety Treatment,Mental Health,21812,12.662323951721191,-6.938199996948242,6HY
"Narrative Changes Predict a Decrease in Symptoms in CBT for Depression: An Exploratory Study.

Innovative moments (IMs) are new and more adjusted ways of thinking, acting, feeling and relating that emerge during psychotherapy. Previous research on IMs has provided sustainable evidence that IMs differentiate recovered from unchanged psychotherapy cases. However, studies with cognitive behavioural therapy (CBT) are so far absent. The present study tests whether IMs can be reliably identified in CBT and examines if IMs and symptoms' improvement are associated. The following variables were assessed in each session from a sample of six cases of CBT for depression (a total of 111 sessions): (a) symptomatology outcomes (Outcome Questionnaire-OQ-10) and (b) IMs. Two hierarchical linear models were used: one to test whether IMs predicted a symptom decrease in the next session and a second one to test whether symptoms in one session predicted the emergence of IMs in the next session. Innovative moments were better predictors of symptom decrease than the reverse. A higher proportion of a specific type of IMs-reflection 2-in one session predicted a decrease in symptoms in the next session. Thus, when clients further elaborated this type of IM (in which clients describe positive contrasts or elaborate on changes processes), a reduction in symptoms was observed in the next session. A higher expression and elaboration of reflection 2 IMs appear to have a facilitative function in the reduction of depressive symptoms in this sample of CBT. Copyright © 2016 John Wiley & Sons, Ltd. Elaborating innovative moments (IMs) that are new ways of thinking, feeling, behaving and relating, in the therapeutic dialogue, may facilitate change. IMs that are more predictive of amelioration of symptoms in CBT are the ones focused on contrasts between former problematic patterns and new adjusted ones; and the ones in which the clients elaborate on processes of change. Therapists may integrate these kinds of questions (centred on contrasts and centred on what allowed change from the client's perspective), in the usual CBT techniques. When elaborating these IMs successfully, therapists may expect an improvement in symptoms in the next session of psychotherapy.",27766698,Major Depressive Disorder,Anxiety Treatment,Mental Health,24336,13.922202110290527,-6.81997013092041,Bltx
"A randomized controlled trial for identifying the most suitable treatment for depression based on patients' attachment orientation.

Many active treatments exist for major depressive disorder (MDD), but little is known about their differential effects for various subpopulations of patients to guide precision medicine. This is the first randomized controlled trial (RCT) designed to identify differential treatment effects based on patients' attachment orientations. We tested an a priori preregistered hypothesis of the potential moderating effect of patients' attachment orientation on the outcome of supportive therapy (ST) versus supportive-expressive therapy (SET). The RCT was conducted between 2015 and 2021. Individuals with MDD were randomly assigned to 16-week ST or SET. The predefined primary outcome measure was the Hamilton Rating Scale for Depression. Hypotheses were formulated and preregistered before data collection. One hundred patients with MDD were enrolled, 57% women, average age 31.2 (SD = 8.25). Data were analyzed using the intention-to-treat approach. Our hypothesis that attachment anxiety is a significant moderator of treatment outcome was supported (B = -0.09, p = .016): Patients with higher levels of attachment anxiety showed greater treatment efficacy following SET than ST. Although the hypothesis regarding a potential moderating effect of avoidant attachment was not supported, sensitivity analyses revealed that individuals with disorganized attachment orientation (higher scores on both anxious and avoidant attachment) benefited more from SET than from ST (B = -0.07, p = .04). The findings support the clinical utility of patients' attachment orientation in selecting the most suitable treatment for individuals and demonstrate the methodological utility of RCTs predesigned to test theoretically based models of personalized treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",35025539,Major Depressive Disorder,Anxiety Treatment,Mental Health,4896,15.521899223327637,-6.278894424438477,s+s
"Narrative flexibility in brief psychotherapy for depression.

This study aimed to further understand how narrative flexibility contributes to therapeutic outcome in brief psychotherapy for depression utilizing the Narrative-Emotion Process Coding System (NEPCS), an observational measure that identifies specific markers of narrative and emotion integration in therapy sessions. The present study investigated narrative flexibility by examining the contribution of NEPCS shifting (i.e., movement between NEPCS markers) in early, middle, and late sessions of client-centred therapy (CCT), emotion-focused therapy (EFT), and cognitive therapy (CT) and treatment outcome (recovered versus unchanged at the therapy termination). A logistic regression, with Wald tests of parameter estimates and pairwise comparisons, was used to test the study hypotheses. Results demonstrated that for recovered clients, the probability of shifting over the course of a therapy session was constant, whereas the probability of shifting declined for unchanged clients as the session progressed. There was also evidence that longer duration of time spent in any single NEPCS marker was negatively associated with shifting for both recovered and unchanged clients, although the effect was stronger for unchanged clients. The results provided preliminary support for the contribution of narrative flexibility to treatment outcomes in EFT, CCT, and CT treatments of depression.",27093498,Major Depressive Disorder,Anxiety Treatment,Mental Health,24336,13.596199035644531,-6.192406177520752,Bt/6
"Psychotherapy for the Treatment of Anxiety and Depression in Patients with Parkinson Disease: A Meta-Analysis of Randomized Controlled Trials.

Anxiety and depression are major psychiatric nonmotor symptoms (NMSs) of Parkinson disease (PD). Although several studies have investigated the effects of psychotherapeutic interventions, particularly cognitive-behavioral therapy (CBT), for alleviating anxiety and depression in patients with PD, the findings have been inconclusive because of the small sample size and the lack of a unified protocol for such treatments. Thus, the present meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effect of psychotherapy on PD-related anxiety and depression. Systematic review and meta-analysis. Relevant RCTs were extracted from PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases. This study was registered in PROSPERO under the number CRD 42020165052. The primary and secondary outcomes were changes in the anxiety score and depressive symptoms, respectively. Fourteen RCTs including 507 patients with PD were analyzed. The interventions were classified as CBT and non-CBT. CBT significantly reduced anxiety at the end of the study (standardized mean difference = -0.85, 95% confidence interval = -1.12 to -0.58, P < .001, I2 = 0%), whereas non-CBT did not. Greater heterogeneity in the effects of non-CBT treatment was observed. CBT was significantly beneficial for depression (standardized mean difference = -0.83, 95% confidence interval = -1.26 to -0.40, P < .001, I2 = 55%). Despite the greater heterogeneity in the effects, non-CBT interventions were also effective in alleviating depressive symptoms. CBT is effective for the management of anxiety and depression in patients with PD. Routine treatment for patients with this condition is strongly recommended.",33957132,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.55550765991211,13.646716117858887,AWug
"Telephone-based cognitive behavioral therapy for depression in Parkinson disease: A randomized controlled trial.

To determine whether, for patients with depression and Parkinson disease (PD), telephone-based cognitive-behavioral treatment (T-CBT) alleviates depressive symptoms significantly more than treatment as usual (TAU), we conducted a randomized controlled trial to evaluate the efficacy of a 10-session T-CBT intervention for depression in PD, compared to TAU. Seventy-two people with PD (PWP) were randomized to T-CBT + TAU or TAU only. T-CBT tailored to PWPs' unique needs was provided weekly for 3 months, then monthly during 6-month follow-up. CBT targeted negative thoughts (e.g., ""I have no control""; ""I am helpless"") and behaviors (e.g., social withdrawal, excessive worry). It also trained care partners to help PWP practice healthy habits. Blind raters assessed outcomes at baseline, midtreatment, treatment end, and 1 and 6 months post-treatment. Analyses were intent to treat. T-CBT outperformed TAU on all depression, anxiety, and quality of life measures. The primary outcome (Hamilton Depression Rating Scale score) improved significantly in T-CBT compared to TAU by treatment end. Mean improvement from baseline was 6.53 points for T-CBT and -0.27 points for TAU (p < 0.0001); gains persisted over 6-month follow-up (p < 0.0001). Improvements were moderated by a reduction in negative thoughts in the T-CBT group only, reflecting treatment target engagement. T-CBT may be an effective depression intervention that addresses a significant unmet PD treatment need and bypasses access barriers to multidisciplinary, evidence-based care. NCT02505737. This study provides Class I evidence that for patients with depression and PD, T-CBT significantly alleviated depressive symptoms compared to usual care.",32238507,Major Depressive Disorder,Anxiety Treatment,Mental Health,2024,15.306087493896484,13.788448333740234,ArKV
"Secondary outcomes of the guided self-help behavioral activation and physical activity for depression trial.

Background: This article presents secondary outcome variables from a randomized controlled trial evaluating the efficacy of two guided self-help interventions for the treatment of depression: behavioral activation (BA) and physical activity (PA). Both interventions resulted in significant reductions in depressive symptoms compared to the wait-list control group, however the mechanisms by which these interventions influenced depression were not presented. Purpose: The purpose of this paper was to compare changes in secondary outcome variables to gain insight into the mechanisms by which reactivation interventions reduce depressive symptoms. Results: Mixed-model analysis of variances (ANOVAs) revealed significant increases in life satisfaction (Main effect: F(3, 91.71)=4.63, p<0.01) and self-efficacy (Main effect: F(3, 91.32)=4.05, p<0.01) as well as significant decreases in negative affect (Main effect: F(2, 75.88)=5.24, p<0.01) and loneliness (Main effect: F(2, 71.78)=7.49, p<0.01) in both interventions at pre-, mid-, post-intervention and follow-up. The group x time interactions were not significant, suggesting that the PA and BA interventions had comparable effects over time. Conclusion: These findings provide insight into the potential mechanisms underlying the effectiveness of guided self-help PA and BA interventions on depressive symptoms.",29722574,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,10.132033348083496,-2.174769401550293,BMVK
"Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials.

Meta-analyses on psychological treatment for depression in individuals with a somatic disease are limited to specific underlying somatic diseases, thereby neglecting the generalisability of the interventions. To examine the effectiveness of cognitive-behavioural therapy (CBT) for depression in people with a diversity of somatic diseases. Meta-analysis of randomised controlled trials evaluating CBT for depression in people with a somatic disease. Severity of depressive symptoms was pooled using the standardised mean difference (SMD). Twenty-nine papers met inclusion criteria. Cognitive-behavioural therapy was superior to control conditions with larger effects in studies restricted to participants with depressive disorder (SMD = -0.83, 95% CI -1.36 to -0.31, P<0.001) than in studies of participants with depressive symptoms (SMD = -0.16, 95% CI -0.27 to -0.06, P = 0.001). Subgroup analyses showed that CBT was not superior to other psychotherapies. Cognitive-behavioural therapy significantly reduces depressive symptoms in people with a somatic disease, especially in those who meet the criteria for a depressive disorder.",20592427,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.60799789428711,-2.113438367843628,DIpu
"Psychologic Treatment of Depression Compared With Pharmacotherapy and Combined Treatment in Primary Care: A Network Meta-Analysis.

Most patients with depression are treated by general practitioners, and most of those patients prefer psychotherapy over pharmacotherapy. No network meta-analyses have examined the effects of psychotherapy compared with pharmacotherapy, combined treatment, care as usual, and other control conditions among patients in primary care. We conducted systematic searches of bibliographic databases to identify randomized trials comparing psychotherapy with pharmacotherapy, combined treatment, care as usual, waitlist, and pill placebo. The main outcome was treatment response (50% improvement of depressive symptoms from baseline to end point). A total of 58 studies with 9,301 patients were included. Both psychotherapy and pharmacotherapy were significantly more effective than care as usual (relative risk [RR] for response = 1.60; 95% CI, 1.40-1.83 and RR = 1.65; 95% CI, 1.35-2.03, respectively) and waitlist (RR = 2.35; 95% CI, 1.57-3.51 and RR = 2.43; 95% CI, 1.57-3.74, respectively) control groups. We found no significant differences between psychotherapy and pharmacotherapy (RR = 1.03; 95% CI, 0.88-1.22). The effects were significantly greater for combined treatment compared with psychotherapy alone (RR = 1.35; 95% CI, 1.00-1.81). The difference between combined treatment and pharmacotherapy became significant when limited to studies with low risk of bias and studies limited to cognitive behavior therapy. Psychotherapy is likely effective for the treatment of depression when compared with care as usual or waitlist, with effects comparable to those of pharmacotherapy. Combined treatment might be better than either psychotherapy or pharmacotherapy alone.",34180847,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.105785369873047,-2.345444917678833,AUIX
"Cost-Effectiveness of a Web-Based Program for Residual Depressive Symptoms: Mindful Mood Balance.

Mindful Mood Balance (MMB) is an effective Web-based program for residual depressive symptoms that prevents relapse among patients with partial recovery from major depressive episodes. This cost-effectiveness analysis was conducted from the health plan perspective alongside a pragmatic randomized controlled trial of MMB. Adults were recruited from behavioral health and primary care settings in a large integrated health system and randomly assigned to MMB plus usual depression care (MMB+UDC) or UDC. Patients had at least one prior major depressive episode; a current score of 5-9 on the Patient Health Questionnaire-9, indicating residual depressive symptoms; and Internet access. Program costs included recruitment, coaching, and MMB licensing. Center for Medicare and Medicaid fee schedules were applied to electronic health record utilization data for psychotropic medications and psychiatric and psychotherapy visits. Effectiveness was measured as depression-free days (DFDs), converted from PHQ-9 scores collected monthly for 1 year. Incremental cost-effectiveness ratios were calculated with various sets of cost inputs. A total of 389 patients (UDC, N=210; MMB+UDC, N=179) had adequate follow-up PHQ-9 measures for inclusion. MMB+UDC patients had 29 more DFDs during follow-up. Overall, the incremental cost of MMB+UDC was $431.54 over 12 months. Incremental costs per DFD gained ranged from $9.63 for program costs only to $15.04 when psychiatric visits, psychotherapy visits, and psychotropic medications were included. MMB offers a cost-effective Web-based program for reducing residual depressive symptoms and preventing relapse. Health systems should consider adopting MMB as adjunctive to traditional mental health care services.",34320822,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.967479705810547,-1.0245624780654907,ASlc
"I can't do it on my own: motivation to enter therapy for depression among low income, second generation, Latinas.

The purpose of this study was to explore the perspectives of 12 low income, second generation, Latinas seeking to enter therapy for depression. Qualitative data collected at the time of a diagnostic interview (SCID) using Motivational Interviewing techniques, included an assessment of the woman's motivation to enter therapy and confidence that she could follow through with treatment. Data were analyzed using Constructivist Grounded Theory and revealed six positive and six painful motivators that catalyzed the women towards treatment amidst complications related to ""self"" and ""time."" Despite demanding schedules for taking care of their families, finances, current or estranged partners, and work responsibilities, women were determined to get help for their depression.",20218772,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.081147193908691,-5.5801262855529785,DM+Z
"Psychosocial treatment approaches to difficult-to-treat depression.

Coexisting psychiatric and medical conditions, environmental and contextual factors, inadequate diagnosis and treatment, medication non-adherence, and issues such as low self-esteem, hopelessness and cognitive reactivity, can play a role in difficult-to-treat depression. A reduction in symptoms due to pharmacological treatment does not equate with full recovery, and some level of rehabilitation is often required. The evidence base for psychosocial therapies in difficult-to-treat depression is small, with the research heavily weighted toward biological treatments. Nevertheless, combining psychological treatments with pharmacotherapy is likely to improve rates of recovery in difficult-to-treat depression. Psychological therapies can be useful in modifying health beliefs, treating comorbid anxiety and other disorders, dealing with contextual factors, and activating patients to facilitate their recovery. Effective treatment requires a multidisciplinary team involving a general practitioner and psychologist, and sometimes a psychiatrist. Effective communication and active engagement of patients and families is essential.",25370289,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.46887493133545,-1.4537694454193115,CGUo
"Patterns of change and their relationship to outcome and follow-up in group and individual psychotherapy for depression.

The study explored the presence of different patterns of change in a sample of patients who received cognitive therapy for depression sequentially in two different formats: group and individual. Our hypothesis was that patients' baseline characteristics (e.g., symptom severity, self-esteem) would discriminate patterns of response to group and individual therapy. 108 adults who met criteria for depression and completed the treatments included in a randomized controlled trial (RCT) were assessed with the Beck Depression Inventory-II (BDI-II), the Clinical Outcome in Routine Evaluation-Short Form B (CORE-SFB), the Global Assessment of Functioning (GAF), and the repertory grid technique. Growth mixture modeling was carried out to identify the patterns of change. Mixed linear models and repeated measures analysis of variance were performed to compare patients' characteristics in each pattern. Multinomial logistic regression was used to compute predictive models for the patterns from patients' characteristics. Finally, hierarchical linear regression was used to establish the power of each pattern to predict treatment outcome. A 3-class solution was obtained: group therapy improvers, individual therapy improvers, and nonimprovers. Group therapy improvers started therapy with less severe levels of depression and psychological distress, higher functioning and self-esteem, lower perceived social isolation, and lower dilemmatic construction of the self than the other groups. Individual therapy improvers and nonimprovers presented similar characteristics at baseline. However, a significant proportion of nonimprovers presented a concurrent diagnosis of fibromyalgia. The greater the impairment that patients present at baseline, the more likely they are to benefit from individual therapy after group therapy. A diagnosis of fibromyalgia can be considered a risk factor for therapy failure in the treatment of depression. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",32551725,Major Depressive Disorder,Anxiety Treatment,Mental Health,26910,11.93701171875,-3.6763782501220703,AnTT
"Are Digitally Delivered Psychological Interventions for Depression the Way Forward? A Review.

Digitally delivered interventions aim to make psychological treatments more widely accessible and minimize clinician input. Although their clinical efficacy against wait-list, control conditions is well established, comparative outcome studies are a much better way to examine if psychotherapies are equally effective. Such reviews are still relatively lacking. The aim of this review was therefore to evaluate the effectiveness of digitally delivered psychological therapies over traditionally delivered (face-to-face) ones to alleviate symptoms in adults experiencing sub-threshold and clinical depression. Findings showed that digital interventions produced consistently clinically significant improvements in depressive symptoms. Moreover, the level of therapist contact or expertise did not affect much treatment effectiveness. Future research is pertinent to investigate further the influence of therapist input, the reasons for dropout, how to improve users' experience and therapeutic engagement and maintain improvements at post-treatment.",29656348,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.130199432373047,-3.4691314697265625,BNNx
"Groups 4 Health versus cognitive-behavioural therapy for depression and loneliness in young people: randomised phase 3 non-inferiority trial with 12-month follow-up.

Depression treatments are typically less effective for young people than for adults. However, treatments rarely target loneliness, which is a key risk factor in the onset, maintenance and development of depression. This study evaluated the efficacy of a novel loneliness intervention, Groups 4 Health (G4H), relative to the best-practice treatment of cognitive-behavioural therapy (CBT) in reducing loneliness and depression over a 12-month period (Australian New Zealand Clinical Trial Registry: ACTRN12618000440224). The study was a phase 3 randomised non-inferiority trial comparing G4H with dose-controlled group CBT. Participants were 174 people aged 15-25 years experiencing loneliness and clinically significant symptoms of depression, who were not in receipt of adjunct treatment. Participants were recruited from mental health services in Southeast Queensland, Australia. Randomisation was conducted using computer software. Follow-up assessments and statistical analyses were masked to allocation. Both interventions consisted of five 75 min group-based psychotherapy sessions. The primary outcomes were depression and loneliness, with a non-inferiority margin of 2.20 for depression. The trial enrolled 174 participants between 24 April 2018 and 25 May 2019, with 84 in the G4H condition and 90 in the CBT condition. All randomised participants were included in the intention-to-treat analyses (n = 174). The pre-post effect sizes for depression were dG4H = -0.71 and dCBT = -0.91. For loneliness, they were dG4H = -1.07 and dCBT = -0.89. At 12-month follow-up, the absolute difference between groups on depression was 1.176 (95% CI -1.94 to 4.29) and on loneliness it was -0.679 (95% CI -1.43 to 0.07). No adverse effects were observed. G4H was non-inferior to CBT for depression and showed a slight advantage over CBT for loneliness that emerged after treatment completion.",35049477,Major Depressive Disorder,Anxiety Treatment,Mental Health,21526,10.827466011047363,-2.7700347900390625,r1w
"Effects of an immersive psychosocial training program on depression and well-being: A randomized clinical trial.

Psychiatry stands to benefit from brief non-pharmacological treatments that effectively reduce depressive symptoms. To address this need, we conducted a single-blind randomized clinical trial assessing how a 6-day immersive psychosocial training program, followed by 10-min daily psychosocial exercises for 30 days, improves depressive symptoms. Forty-five adults were block-randomized by depression score to two arms: (a) the immersive psychosocial training program and 10-min daily exercise group (36 days total; total n = 23; depressed at baseline n = 14); or (b) a gratitude journaling control group (36 days total; total n = 22; depressed at baseline n = 13). The self-report PHQ-9 was used to assess depression levels in both groups at three time points: baseline, study week one, and study week six. Depression severity improved over time, with a significantly greater reduction in the psychosocial training program group (-82.7%) vs. the control group (-23%), p = 0.02 for baseline vs. week six. The effect size for this reduction in depression symptoms was large for the intervention group (d = -1.3; 95% CI, -2.07, -0.45; p < 0.001) and small for the control group (d = -0.3; 95% CI, -0.68, 0.03; p = 0.22). Seventy-nine percent (11/14) of depressed participants in the intervention condition were in remission (PHQ-9 ≤ 4) by week one and 100% (14/14) were in remission at week six. Secondary measures of anxiety, stress, loneliness, and well-being also improved by 15-80% in the intervention group (vs. 0-34% in the control group), ps < 0.05. Overall, this brief, immersive psychosocial training program rapidly and substantially improved depression levels and several related secondary outcomes, suggesting that immersive interventions may be useful for reducing depressive symptoms and enhancing well-being.",35429739,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.479469299316406,-2.539820432662964,dNs
"Clinical and cost-effectiveness of guided internet-based interventions in the indicated prevention of depression in green professions (PROD-A): study protocol of a 36-month follow-up pragmatic randomized controlled trial.

People in green professions are exposed to a variety of risk factors, which could possibly enhance the development of depression. Amongst possible prevention approaches, internet- and mobile-based interventions (IMIs) have been shown to be effective and scalable. However, little is known about the effectiveness in green professions. The aim of the present study is to examine the (cost-)effectiveness of a tailored IMI program for reducing depressive symptoms and preventing the onset of clinical depression compared to enhanced treatment as usual (TAU+). A pragmatic randomized controlled trial (RCT) will be conducted to evaluate a tailored and therapeutically guided preventive IMI program in comparison to TAU+ with follow-ups at post-treatment (9weeks), 6-, 12-, 24-, and 36-months. Entrepreneurs in green professions, collaborating spouses, family members and pensioners (N=360) with sufficient insurance status and at least subthreshold depression (PHQ-9≥5) are eligible for inclusion. Primary outcome is depressive symptom severity (QIDS-SR16). Secondary outcomes include incidence of depression (QIDS-SR16), quality of life (AQoL-8D) and negative treatment effects (INEP). A health-economic evaluation will be conducted from a societal perspective. The IMI program is provided by psychologists of an external service company and consists of six guided IMIs (6-8 modules, duration: 6-8weeks) targeting different symptoms (depressive mood, depressive mood with comorbid diabetes, perceived stress, insomnia, panic and agoraphobic symptoms or harmful alcohol use). Intervention choice depends on a screening of participants' symptoms and individual preferences. The intervention phase is followed by a 12-months consolidating phase with monthly contact to the e-coach. This is the first pragmatic RCT investigating long-term effectiveness of a tailored guided IMI program for depression prevention in green professions. The present trial builds on a large-scale strategy for depression prevention in green professions. The intended implementation of the IMI program with a nationwide rollout has the potential to reduce overall depression burden and associated health care costs in case of given effectiveness. German Clinical Trial Registration: DRKS00014000 . Registered on 09 April 2018.",31500602,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.620624542236328,-3.351611852645874,A059
"Is cognitive therapy enduring or antidepressant medications iatrogenic? Depression as an evolved adaptation.

Patients treated to remission with cognitive therapy are less than half as likely to relapse following treatment termination as patients treated to remission with antidepressant medications. What remains unclear is whether cognitive therapy truly is enduring or antidepressant medications iatrogenic in terms of prolonging the life of the underlying episode. Depression is an inherently temporal phenomenon and most episodes will remit spontaneously even in the absence of treatment. There is reason to believe that depression is an adaptation that evolved because it keeps organisms focused on (ruminating about) complex social issues until they can be resolved and that medications work not so much by addressing a nonexistent deficit in neurotransmitters in the synapse as by perturbing underlying regulatory mechanisms to the point that they reassert homeostatic control over those systems. If the latter is true then medications may work to suppress symptoms in a manner that leaves the underlying episode unaddressed and patients at elevated risk of relapse whenever they are taken away. Cognitive therapy is predicated on the notion that people become depressed because they misinterpret life events in a negative fashion and that helping them examine the accuracy of their beliefs will relieve their distress. Such an approach would not work if patients were not capable of thinking clearly (if their ""brains were broken"") and it is likely that cognitive therapy works by making rumination more efficient so as to facilitate the resolution of the complex social issue(s) that brought the episode about. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",33382283,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.286723136901855,-2.233783006668091,AdO2
"The effectiveness of a Supported Self-management task-shifting intervention for adult depression in Vietnam communities: study protocol for a randomized controlled trial.

Depressive disorders are one of the leading causes of disease and disability worldwide. In Vietnam, although epidemiological evidence suggests that depression rates are on par with global averages, services for depression are very limited. In a feasibility study that was implemented from 2013 to 2015, we found that a Supported Self-management (SSM) intervention showed promising results for adults with depression in the community in Vietnam. This paper describes the Mental Health in Adults and Children: Frugal Innovations (MAC-FI) trial protocol that will assess the effectiveness of the SSM intervention, delivered by primary care and social workers, to community-based populations of adults with depression in eight Vietnamese provinces. The MAC-FI program will be assessed using a stepped-wedge, randomized controlled trial. Study participants are adults aged 18 years and over in eight provinces of Vietnam. Study participants will be screened at primary care centres and in the community by health and social workers using the Self-reporting Questionnaire-20 (SRQ-20). Patients scoring >7, indicating depression caseness, will be invited to participate in the study in either the SSM intervention group or the enhanced treatment as usual control group. Recruited participants will be further assessed using the World Health Organization's Disability Assessment Scale (WHODAS 2.0) and the Cut-down, Annoyed, Guilty, Eye-opener (CAGE) Questionnaire for alcohol misuse. Intervention-group participants will receive the SSM intervention, delivered with the support of a social worker or social collaborator, for a period of 2 months. Control- group participants will receive treatment as usual and a leaflet with information about depression. SRQ-20, WHODAS 2.0 and CAGE scores will be taken by blinded outcome assessors at baseline, after 1 month and after 2 months. The primary analysis method will be intention-to-treat. This study has the potential to add to the knowledge base about the effectiveness of a SSM intervention for adult depression that has been validated for the Vietnamese context. This trial will also contribute to the growing body of evidence about the effectiveness of low-cost, task-shifting interventions for use in low-resource settings, where specialist mental health services are often limited. Retrospectively registered at ClinicalTrials.gov, identifier: NCT03001063 . Registered on 20 December 2016.",28476148,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,10.404641151428223,-3.598694086074829,BdBL
"Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to summarize the effects of forest therapy on depression and anxiety using data obtained from randomized controlled trials (RCTs) and quasi-experimental studies. We searched SCOPUS, PubMed, MEDLINE(EBSCO), Web of science, Embase, Korean Studies Information Service System, Research Information Sharing Service, and DBpia to identify relevant studies published from January 1990 to December 2020 and identified 20 relevant studies for the synthesis. The methodological quality of eligible primary studies was assessed by ROB 2.0 and ROBINS-I. Most primary studies were conducted in the Republic of Korea except for one study in Poland. Overall, forest therapy significantly improved depression (Hedges's g = 1.133; 95% confidence interval (CI): -1.491 to -0.775) and anxiety (Hedges's g = 1.715; 95% CI: -2.519 to -0.912). The quality assessment resulted in five RCTs that raised potential concerns in three and high risk in two. Fifteen quasi-experimental studies raised high for nine quasi-experimental studies and moderate for six studies. In conclusion, forest therapy is preventive management and non-pharmacologic treatment to improve depression and anxiety. However, the included studies lacked methodological rigor and required more comprehensive geographic application. Future research needs to determine optimal forest characteristics and systematic activities that can maximize the improvement of depression and anxiety.",34886407,Major Depressive Disorder,Anxiety Treatment,Mental Health,7384,8.99424934387207,-2.7387619018554688,yn8
"Autonomy and ethical treatment in depression.

Antidepressant medication and evidence-based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self-knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor-related decisions. I further argue that such an effect comprises a compelling moral reason for doctors to see evidence-based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression.",19222444,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.4038724899292,-2.532763719558716,DRie
"Mechanisms of change and heterogeneous treatment effects in psychodynamic and cognitive behavioural therapy for patients with depressive disorder: a randomized controlled trial.

Major depressive disorder (MDD) is a prevalent psychiatric condition associated with significant disability, mortality and economic burden. Cognitive behavioral therapy (CBT) and psychodynamic psychotherapy (PDT) are found to be equally effective for patients with depression. However, many patients do not respond sufficiently to either treatment. To offer individualized treatment, we need to know if some patients benefit more from one of the two therapies. At present little is known about what patient characteristics (moderators) may be associated with differential outcomes of CBT and PDT, and through what therapeutic processes and mechanisms (mediators) improvements occur in each therapy mode. Presently only theoretical assumptions, sparsely supported by research findings, describe what potentially moderates and mediates the treatment effects of CBT and PDT. The overall aim of this study is to examine theoretically derived putative moderators and mediators in CBT and PDT and strengthen the evidence base about for whom and how these treatments works in a representative sample of patients with MDD. One hundred patients with a diagnosis of MDD will be randomized to either CBT or PDT. Patients will be treated over 28 weeks with either CBT (one weekly session over 16 weeks and three monthly booster sessions) or PDT (one weekly session over 28 weeks). The patients will be evaluated at baseline, during the course of therapy, at the end of therapy, and at follow-up investigations 1 and 3 years post treatment. A large range of patient and observer rated questionnaires (specific preselected putative moderators and mediators) are included. The clinical outcome of this study may better guide clinicians when deciding what kind of treatment any individual patient should be offered. Moreover, the study aims to further our knowledge of what mechanisms lead to symptom improvement and increased psychosocial functioning. ClinicalTrials.gov Identifier: NCT03022071.",33482927,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.450348854064941,-2.7311744689941406,AcA/
"Design and rationale for a randomized controlled trial to reduce readmissions among patients with depressive symptoms.

The Re-Engineered Discharge (Project RED) reduces 30-day readmission rates by 30%. However, our data indicates that for patients displaying depressive symptoms during hospitalization, Project RED is less effective in preventing unplanned readmission. We aim to examine the effectiveness of RED-D, a modified brief Cognitive behavioral therapy (CBT) protocol delivered as a post-discharge extension of the Re-Engineered Discharge, in reducing 30-day readmissions rates and emergency department (ED) use as well as depressive symptoms for medical patients with comorbid depressive symptoms. This paper details the study design and implementation of an ongoing, federally funded randomized controlled trial of our post-discharge mental health intervention, RED-D, compared to the RED plus usual care. This research has two primary objectives: (1) to determine whether RED-D delivered telephonically by a mental health professional immediately following discharge is effective in reducing hospital readmission and emergency department use for patients displaying depressive symptoms during their inpatient stay, and (2) to examine whether this approach yields a clinically significant reduction in depressive symptoms. We intend to recruit 1200 participants randomized to our intervention, RED-D (n=600), and to RED plus usual care (n=600). Hospitalized patients with depressive symptoms are at increased risk for 30-day readmission. We aim to conduct a randomized clinical trial to evaluate the comparative effectiveness of RED-D, our post-discharge modified brief CBT intervention compared to RED alone in reducing readmissions and depressive symptoms for this at-risk population.",26343332,Major Depressive Disorder,Anxiety Treatment,Mental Health,492,10.147765159606934,-1.30336332321167,B4gS
"[Behavioral activation programs: A tool for treating depression efficiently].

Major depressive disorder (MDD) is a debilitating disorder, and its treatment often requires complex and costly psychological therapies. Behavioral activation (BA) is a simple, effective and affordable psychotherapy recommended in the treatment of MDD. (i) Explain the theoretical basis of BA and its application in clinical practice. (ii) Review the randomized controlled trials examining BA as a treatment for MDD through a systematic search of the existing literature. Medline and ClinicalTrials databases were searched with the following keywords: (""behavioral activation"" OR ""behavioural activation"") AND (""therapy"" OR ""psychotherapy""). (i) Articles describing BA's theoretical foundations and principles of therapy were selected. (ii) Randomized controlled trials studying BA as a treatment for depression were selected according to the PRISMA criteria. (i) BA is a behavioral therapy that helps patients to increase their behaviors towards rewarding and/or pleasant activities, and to decrease avoidant behaviors maintaining negative affects by negative reinforcement. BA also tends to increase behaviors towards life-goals used as positive reinforcement contingencies. BA is a brief and cost effective therapy, which can be evaluated by specific psychometric scales. (ii) BA has a strong therapeutic effect in MDD as evaluated by several randomized controlled trials of good quality. BA is a simple, affordable and effective treatment for MDD. Data is insufficient to provide proof for the interest of using commitment to life-goals as reinforcement contingencies. Behavioral inhibition is encountered amongst several psychiatric disorders and more studies should be conducted to discuss its use for other diseases such as schizophrenia or anxiety disorders.",28431689,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.391990661621094,-2.022268533706665,BdoM
"Early Improvement in Work Productivity Predicts Future Clinical Course in Depressed Outpatients: Findings From the CO-MED Trial.

Depression symptom severity, the most commonly studied outcome in antidepressant treatment trials, accounts for only a small portion of burden related to major depression. While lost work productivity is the biggest contributor to depression's economic burden, few studies have systematically evaluated the independent effect of treatment on work productivity and the relationship between changes in work productivity and longer-term clinical course. Work productivity was measured repeatedly by the Work Productivity and Activity Impairment self-report questionnaire in 331 employed participants with major depression enrolled in the Combining Medications to Enhance Depression Outcomes trial. Trajectories of change in work productivity during the first 6 weeks of treatment were identified and used to predict remission at 3 and 7 months. Participants reported reduced absence from work and increased work productivity with antidepressant treatment even after controlling for changes in depression severity. Three distinct trajectories of changes in work productivity were identified: 1) robust early improvement (24%), 2) minimal change (49%), and 3) high-impairment slight reduction (27%). Compared with other participants, those with robust improvement had 3-5 times higher remission rates at 3 months and 2-5 times higher remission rates at 7 months, even after controlling for select baseline variables and remission status at week 6. In this secondary analysis, self-reported work productivity improved in depressed patients with antidepressant treatment even after accounting for depressive symptom reduction. Early improvement in work productivity is associated with much higher remission rates after 3 and 7 months of treatment.",27523501,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,9.09408950805664,-3.117483615875244,BooO
"Non-pharmacological treatment of depression: a systematic review and evidence map.

The comparative effectiveness of non-pharmacological treatments of depression remains unclear. We conducted an overview of systematic reviews to identify randomised controlled trials (RCTs) that compared the efficacy and adverse effects of non-pharmacological treatments of depression. We searched multiple electronic databases through February 2016 without language restrictions. Pairs of reviewers determined eligibility, extracted data and assessed risk of bias. Meta-analyses were conducted when appropriate. We included 367 RCTs enrolling ∼20000 patients treated with 11 treatments leading to 17 unique head-to-head comparisons. Cognitive behavioural therapy, naturopathic therapy, biological interventions and physical activity interventions reduced depression severity as measured using standardised scales. However, the relative efficacy among these non-pharmacological interventions was lacking. The effect of these interventions on clinical response and remission was unclear. Adverse events were lower than antidepressants. The quality of evidence was low to moderate due to inconsistency and unclear or high risk of bias, limiting our confidence in findings. Non-pharmacological therapies of depression reduce depression symptoms and should be considered along with antidepressant therapy for the treatment of mild-to-severe depression. A shared decision-making approach is needed to choose between non-pharmacological therapies based on values, preferences, clinical and social context.",27836921,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.747991561889648,-1.3447965383529663,Bk21
"Prevention of Recurrence After Recovery From a Major Depressive Episode With Antidepressant Medication Alone or in Combination With Cognitive Behavioral Therapy: Phase 2 of a 2-Phase Randomized Clinical Trial.

Antidepressant medication (ADM) maintenance treatment is associated with the prevention of depressive recurrence in patients with major depressive disorder (MDD), but whether cognitive behavioral therapy (CBT) treatment is associated with recurrence prevention remains unclear. To determine the effects of combining CBT with ADM on the prevention of depressive recurrence when ADMs are withdrawn or maintained after recovery in patients with MDD. A total of 292 adult outpatients with chronic or recurrent MDD who participated in the second phase of a 2-phase trial. Participants had recovered in the first phase of the trial receiving ADM, either alone or in combination with CBT. The trial was conducted in research clinics in 3 university medical centers in the United States. Patients in phase 2 were randomized to receive maintenance of or withdrawal from ADM and were followed up for 3 years. The first and last patients entered phase 2 in August 2003 and October 2009, respectively. The last patient completed phase 2 in August 2012. Data were analyzed from December 2013 to December 2018. Maintenance of or withdrawal from treatment with ADM. Recurrence of an MDD episode using longitudinal interval follow-up evaluations; sustained recovery across both phases. A total of 292 participants (171 women, 121 men; mean [SD] age 45.1 [12.9] years) were included in analyses of depressive recurrence. Maintenance ADM yielded lower rates of recurrence compared with ADM withdrawal regardless of whether patients had achieved recovery in phase 1 with ADM alone (48.5% vs 74.8%; z=-3.16; P=.002; number needed to treat [NNT], 2.8; 95% CI, 1.8-7.0) or ADM plus CBT (48.5% vs 76.7%; z=-3.49; P<.001; NNT, 2.7; 95% CI, 1.9-5.9). Sustained recovery rates differed as a function of phase 2 condition, with maintenance ADM superior to ADM withdrawal (z=2.90; P=.004; OR, 2.54; 95% CI, 1.37-4.84; NNT, 2.3; 95% CI, 1.5-6.4). Phase 1 condition was not associated with differential rates of sustained recovery (ADM alone vs ADM plus CBT; z=0.22; P=.83; OR, 1.08; 95% CI, 0.52-2.11; NNT, 26.0; 95% CI, number needed to harm 3.2 to NNT 2.8), nor was there a significant interaction of phase 1 condition and phase 2 condition (z=0.30; P=.77; OR, 1.14; 95% CI, 0.49-2.88). Maintenance ADM treatment, but not previous exposure to CBT, was associated with reduced rates of depressive recurrence. In previous studies, when CBT has been provided without ADM, CBT has shown a preventive effect on depressive relapse. Whether CBT also has a preventive effect on depressive recurrence, or if adding ADM interferes with any such preventive effect, remains unclear. ClinicalTrial.gov identifier: NCT00057577.",31799993,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.26858901977539,-0.8368246555328369,Awzw
"Patient predictors of response to cognitive behaviour therapy and interpersonal psychotherapy in a randomised clinical trial for depression.

This study examined patient predictors of response to interpersonal psychotherapy (IPT) and cognitive behaviour therapy (CBT). Participants were 177 adults with a primary diagnosis of major depressive disorder randomised to 16 weekly sessions of either IPT or CBT. Pre and post treatment depressive symptomatology was assessed by an independent clinician with the Montgomery Asberg Depression Rating Scale. General predictors of response were perceived logic of therapy, recurrent depression and childhood reasons for depression (r² =.21). Only one differential predictor of treatment response was identified. Increasing comorbid personality disorder symptoms was associated with decreases in response to IPT but not CBT. The results indicate that attention to specific pretreatment patient factors may enhance response to psychotherapy.",20674982,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.377365112304688,-2.975454092025757,DHZV
"Interpersonal psychotherapy (IPT) in major depressive disorder.

In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.",22955493,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.77271842956543,-3.7917017936706543,CokI
"What ""good outcome"" means to patients: Understanding recovery and improvement in psychotherapy for major depression from a mixed-methods perspective.

This study explored the meaning of ""good outcome"" within and beyond the much-used statistical indices of clinical significance in standard outcome research as developed by Jacobson and Truax (1991). Specifically, we examined the experiences of patients marked as ""recovered"" and ""improved"" following cognitive-behavioral therapy and psychodynamic therapy for major depression. A mixed-methods study was conducted using data gathered in an RCT, including patients' pre-post outcome scores on the Beck Depression Inventory-II and posttreatment client change interviews. We selected 28 patients who showed recovery and 19 patients who showed improvement in self-reported depression symptoms. A grounded theory analysis was performed on patients' interviews, ultimately resulting in a conceptual model of ""good outcome."" From patients' perspectives, good outcome can be understood as feeling empowered, finding personal balance and encountering ongoing struggle, indicating an ongoing process and variation in experience. The Jacobson-Truax classification of ""good outcome"" could not account for the (more pessimistic) nuances in outcome experiences, especially for ""improved"" patients, and did not grasp the multidimensional nature of outcome as experienced by patients. It is recommended that statistical indications of clinical meaningfulness are interpreted warily and ideally contextualized within personal narratives. Further research on the phenomenon of change and good outcome is required, aiming at integrating multiple perspectives and methods accordingly the multidimensional phenomenon under study. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",31204837,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.785921096801758,-4.000942230224609,A46M
"A randomized controlled trial of IPT versus CBT in primary care: with some cautionary notes about handling missing values in clinical trials.

A randomized controlled trial is reported in which three treatments were compared for the management of depression in Primary Care. The treatments were Treatment As Usual (TAU) carried out by the General Practitioners, Cognitive-Behaviour Therapy (CBT) or Interpersonal Psychotherapy (IPT). Measurements of depressive symptomatology were taken at Baseline (Time1), at end of treatment (Time2), and at 5-month follow-up (Time3). An initial analysis of the longitudinal data revealed that there were a significant number of missing values, especially in the Time3 follow-up for the TAU group. That is, the missing data were not missing at random within the dataset, which is one of the considerations for usual procedures for replacement of missing values (RMV). The paper presents, therefore, the outcome of different approaches to RMV and their consequences for conclusions about the relative efficacy of the treatment conditions. The results showed that clients in all conditions improved significantly, with at least some analyses showing superiority of IPT and CBT at end of treatment Time 2. However, by the follow-up clients in all conditions performed equally well.",22337508,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.26075553894043,-3.201429605484009,CxTt
"The EVIDENT-trial: protocol and rationale of a multicenter randomized controlled trial testing the effectiveness of an online-based psychological intervention.

Depressive disorders are among the leading causes of worldwide disability with mild to moderate forms of depression being particularly common. Low-intensity treatments such as online psychological treatments may be an effective way to treat mild to moderate depressive symptoms and prevent the emergence or relapse of major depression. This study is a currently recruiting multicentre parallel-groups pragmatic randomized-controlled single-blind trial. A total of 1000 participants with mild to moderate symptoms of depression from various settings including in- and outpatient services will be randomized to an online psychological treatment or care as usual (CAU). We hypothesize that the intervention will be superior to CAU in reducing depressive symptoms assessed with the Personal Health Questionnaire (PHQ-9, primary outcome measure) following the intervention (12 wks) and at follow-up (24 and 48 wks). Further outcome parameters include quality of life, use of health care resources and attitude towards online psychological treatments. The study will yield meaningful answers to the question of whether online psychological treatment can contribute to the effective and efficient prevention and treatment of mild to moderate depression on a population level with a low barrier to entry. NCT01636752.",24074299,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.213861465454102,-3.2541871070861816,CYKe
"Digital tools for the assessment of pharmacological treatment for depressive disorder: State of the art.

Depression is an invalidating disorder, marked by phenotypic heterogeneity. Clinical assessments for treatment adjustments and data-collection for pharmacological research often rely on subjective representations of functioning. Better phenotyping through digital applications may add unseen information and facilitate disentangling the clinical characteristics and impact of depression and its pharmacological treatment in everyday life. Researchers, physicians, and patients benefit from well-understood digital phenotyping approaches to assess the treatment efficacy and side-effects. This review discusses the current possibilities and pitfalls of wearables and technology for the assessment of the pharmacological treatment of depression. Their applications in the whole spectrum of treatment for depression, including diagnosis, treatment of an episode, and monitoring of relapse risk and prevention are discussed. Multiple aspects are to be considered, including concerns that come with collecting sensitive data and health recordings. Also, privacy and trust are addressed. Available applications range from questionnaire-like apps to objective assessment of behavioural patterns and promises in handling suicidality. Nonetheless, interpretation and integration of this high-resolution information with other phenotyping levels, remains challenging. This review provides a state-of-the-art description of wearables and technology in digital phenotyping for monitoring pharmacological treatment in depression, focusing on the challenges and opportunities of its application in clinical trials and research.",35671641,Major Depressive Disorder,Anxiety Treatment,Mental Health,21947,10.960076332092285,-1.6221753358840942,VOQ
"Morita Therapy for depression (Morita Trial): an embedded qualitative study of acceptability.

To explore the views of UK-based recipients of Morita Therapy (MT) on the acceptability of MT. Qualitative study nested within a pilot randomised controlled trial of MT (a Japanese psychological therapy largely unknown in the UK) versus treatment as usual, using post-treatment semistructured interviews analysed with a framework approach. Participants who received MT as part of the Morita Trial, recruited for the trial from General Practice record searches in Devon, UK. Data from 16 participants were purposively sampled for analysis. We identified five themes which, together, form a model of how different participants viewed and experienced MT. Overall, MT was perceived as acceptable by many participants who emphasised the value of the approach, often in comparison to other treatments they had tried. These participants highlighted how accepting and allowing difficulties as natural phenomena and shifting attention from symptoms to external factors had facilitated symptom reduction and a sense of empowerment. We found that how participants understood and related to the principles of MT, in light of their expectations of treatment, was significantly tied to the extent to which MT was perceived as acceptable. Our findings also highlighted the distinction between MT in principle and practice, with participants noting challenges of engaging with the process of therapy such as fear and discomfort around rest, needing sufficient support from the therapist and others, and the commitment of treatment. People in the UK can accept the premise of MT, and consider the approach beneficial and novel. Therefore, proceeding to a large-scale trial of MT is appropriate with minor modifications to our clinical protocol. Participants' expectations and understandings of treatment play a key role in acceptability, and future research may investigate these potential moderators of acceptability in MT. ISRCTN17544090; Pre-results.",31147359,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.96726131439209,-2.264295816421509,A5rc
"A systematic review of depression psychotherapies among Latinos.

For decades, the literature has reported persistent treatment disparities among depressed Latinos. Fortunately, treatment development and evaluation in this underserved population has expanded in recent years. This review summarizes outcomes across 36 unique depression treatment studies that reported treatment outcomes for Latinos. Results indicated that there was significant variability in the quality of RCT and type/number of cultural adaptations. The review suggested that there might a relation between cultural adaptations with treatment outcomes; future studies are warranted to confirm this association. Cognitive Behavioral Therapy was the most evaluated treatment (CBT; n=18, 50% of all evaluations), followed by Problem Solving Therapy (PST; n=4), Interpersonal Therapy (IPT; n=4), and Behavioral Activation (BA; n=3). CBT seems to fare better when compared to usual care, but not when compared to a contact-time matched control condition or active treatment. There is growing support for PST and IPT as efficacious depression interventions among Latinos. IPT shows particularly positive results for perinatal depression. BA warrants additional examination in RCT. Although scarce, telephone and in-home counseling have shown efficacy in reducing depression and increasing retention. Promotora-assisted trials require formal assessment. Limitations and future directions of the depression psychotherapy research among Latinos are discussed.",27113679,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.73852825164795,-5.716366767883301,BtsU
"Evidence for short-term psychodynamic psychotherapy for depression.

",22697196,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.54645824432373,-4.021124362945557,CsN0
"Physical exercise and internet-based cognitive-behavioural therapy in the treatment of depression: randomised controlled trial.

Depression is common and tends to be recurrent. Alternative treatments are needed that are non-stigmatising, accessible and can be prescribed by general medical practitioners. To compare the effectiveness of three interventions for depression: physical exercise, internet-based cognitive-behavioural therapy (ICBT) and treatment as usual (TAU). A secondary aim was to assess changes in self-rated work capacity. A total of 946 patients diagnosed with mild to moderate depression were recruited through primary healthcare centres across Sweden and randomly assigned to one of three 12-week interventions (trail registry: KCTR study ID: KT20110063). Patients were reassessed at 3 months (response rate 78%). Patients in the exercise and ICBT groups reported larger improvements in depressive symptoms compared with TAU. Work capacity improved over time in all three groups (no significant differences). Exercise and ICBT were more effective than TAU by a general medical practitioner, and both represent promising non-stigmatising treatment alternatives for patients with mild to moderate depression.",26089305,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.264208793640137,-2.147416114807129,B8Fz
"Effectiveness of Internet-based cognitive behaviour therapy for depression in routine psychiatric care.

Efficacy of guided Internet-based cognitive behaviour therapy (ICBT) for depression has been demonstrated in several randomised controlled trials. Knowledge on the effectiveness of the treatment, i.e. how it works when delivered within routine care, is however scarce. The aim of this study was to investigate the effectiveness of ICBT for depression. We conducted a cohort study investigating all patients (N=1203) who had received guided ICBT for depression between 2007 and 2013 in a routine care setting at an outpatient psychiatric clinic providing Internet-based treatment. The primary outcome measure was the Montgomery Åsberg Depression Rating Scale-Self rated (MADRS-S). Patients made large improvements from pre-treatment assessments to post-treatment on the primary outcome (effect size d on the MADRS-S=1.27, 99% CI, 1.14-1.39). Participants were significantly improved in terms of suicidal ideation and sleep difficulties. Improvements were sustained at 6-month follow-up. Attrition was rather large at 6-month follow-up. However, additional data was collected through telephone interviews with dropouts and advanced statistical models indicated that missing data did not bias the findings. ICBT for depression can be highly effective when delivered within the context of routine psychiatric care. This study suggests that the effect sizes are at least as high when the treatment is delivered in routine psychiatric care by qualified staff as when delivered in a controlled trial setting.",24238951,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.73759651184082,-2.706669807434082,CV/x
"Who benefits the most from cognitive change in cognitive therapy of depression? A study of interpersonal factors.

Research suggests that decreases in negative cognitions coincide with symptom improvements over the course of cognitive therapy (CT) of depression, but the role cognitive change (CC) plays in reducing symptoms remains controversial. A total of 126 adults (mean age = 31.7, SD = 13.35; 60% female; 83% Caucasian) participated in CT for depression. Patients completed the Beck Depression Inventory-II and the Immediate Cognitive Change Scale at each session. At intake evaluation, maladaptive personality traits (Personality Inventory for DSM-5, Brief Form) and interpersonal problems (Inventory of Interpersonal Problems, Short Version) were assessed via self-report, and social skills were assessed through patients' evaluation of their performance following a series of behavioral role-plays (standardized interaction task). To rule out between-patient differences as potential confounds, our model disaggregated within- and between-patient components of CC and depression scores. Within-patient CC significantly predicted within-patient change in depressive symptoms. This relation was moderated by patients' evaluations of their social skills and patients' level of interpersonal problems, with CC predicting symptoms more robustly for patients with fewer perceived social skills and for those with greater interpersonal problems. Maladaptive personality traits did not emerge as a moderator. Additional analyses showed the relation of CC and symptom change was particularly strong among those with social anxiety disorder and among those observers rated as having lower social skills. CC in CT sessions appears to foster subsequent depressive symptom reduction, especially among patients with lower levels of self-evaluated social skills and greater interpersonal problems. (PsycINFO Database Record (c) 2020 APA, all rights reserved).",31804094,Major Depressive Disorder,Anxiety Treatment,Mental Health,21854,11.775941848754883,-2.7474284172058105,Awv1
"Culturally Adapted Cognitive-Behavioral Therapy for Chinese Americans With Depression: A Randomized Controlled Trial.

No randomized controlled trials (RCTs) for adults have compared the effectiveness of a well-specified psychotherapy and a culturally adapted version of the same treatment. This study evaluated the effectiveness of cognitive-behavioral therapy (CBT) and culturally adapted CBT (CA-CBT) in treating depressed Chinese-American adults. This RCT treated 50 Chinese Americans who met criteria for major depression and sought treatment at community mental health clinics. Screening of participants began in September 2008, and the last assessment was conducted in March 2011. Participants were stratified by whether they were already taking antidepressants when they first came to the clinic and randomly assigned to 12 sessions of CBT or CA-CBT. The study did not influence regular prescription practices. The primary outcomes were dropout rates and Hamilton Depression Rating Scale scores at baseline, session 4, session 8, and session 12. Participants in CA-CBT demonstrated a greater overall decrease in depressive symptoms compared with participants in CBT, but the groups had similarly high depression rates at week 12. Differences in dropout rates for the two groups approached, but did not meet, statistical significance (7%, CA-CBT; 26%, CBT). Chinese Americans entered this study with very severe depression. Participants in both CBT and CA-CBT demonstrated significant decreases in depressive symptoms, but the majority did not reach remission. Results suggest that these short-term treatments were not sufficient to address such severe depression and that more intensive and longer treatments may be needed. Results also indicate that cultural adaptations may confer additional treatment benefits.",26129996,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.269224166870117,-4.433038234710693,B7iO
"The clinical effectiveness and cost-effectiveness of low-intensity psychological interventions for the secondary prevention of relapse after depression: a systematic review.

Depression is the most common mental disorder in community settings and a major cause of disability across the world. The objective of treatment is to achieve remission or at least adequate control of depressive symptoms; however, even after successful treatment, the risk of relapse after remission is significant. Although the effectiveness of low-intensity interventions has been extensively evaluated to treat primary symptoms of psychological difficulties, there has been substantially less research examining the use of these interventions as a relapse prevention strategy. To systematically review the clinical effectiveness and cost-effectiveness of low-intensity psychological or psychosocial interventions to prevent relapse or recurrence in patients with depression. As the broader definition of 'low-intensity' psychological intervention is somewhat contested, the review was conducted in two parts: A, a systematic review of all evaluations of 'low-intensity' interventions that were delivered by para-professionals, peer supporters or psychological well-being practitioners as defined by the Improving Access to Psychological Therapies programme; and B, a scoping review of relevant evaluations of interventions involving qualified mental health professionals (e.g. psychiatrists, clinical psychologists, cognitive behavioural therapists) involving < 6 hours of contact per patient. Comprehensive literature searches were developed; electronic databases were searched from inception until September 2010 (including MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, EMBASE, The Cochrane Library), internet resources were used to identify guidelines on the treatment of depression, and the bibliographies of relevant reviews, guidelines and included studies were scrutinised. Two reviewers independently screened titles and abstracts; data were extracted independently by one reviewer using a standardised data extraction form and checked by another. Discrepancies were resolved by consensus, with involvement of a third reviewer when necessary. The inclusion criteria were population - adults or adolescents who had received treatment for depression; intervention - part A, low-intensity interventions, specifically any unsupported psychological/psychosocial interventions or any supported interventions that did not involve highly qualified mental health professionals, and, part B, interventions carried out by qualified mental health professionals that involved < 6 hours of contact per patient; comparator - any, including no treatment, placebo, psychological or pharmacological interventions; outcomes - relapse or recurrence, other outcomes (e.g. social function, quality of life) were recorded where reported; and study design - for clinical effectiveness, randomised, quasi-randomised and non-randomised studies with concurrent control patients. For cost-effectiveness, full economic evaluations that compared two or more treatment options and considered both costs and consequences. No studies met the main part A inclusion criteria. For the clinical effectiveness review, 17 studies (14 completed, three ongoing), reported in 27 publications, met the part B inclusion criteria. These studies were clinically and methodologically diverse, and reported differing degrees of efficacy for the evaluated interventions. One randomised controlled trial (RCT), which evaluated a collaborative care-type programme, was potentially relevant to part A; this study reported no difference between patients receiving the intervention and those receiving usual care in terms of relapse of depression over 12 months. For the cost-effectiveness review, two studies met the criteria for part B. One of these was an economic evaluation of the RCT above, which was potentially relevant to part A. This evaluation found that the intervention may be a cost-effective use of resources when compared with usual care; however, it was unclear how valid these estimates were for the NHS. Although any definition of 'brief' is likely to be somewhat arbitrary, an inclusion threshold of 6 hours contact per patient was used to select brief high-intensity intervention studies. Most excluded studies evaluated clearly resource-intensive interventions, though occasionally, studies were excluded on the basis of having only slightly more than 6 hours contact per patient. There is inadequate evidence to determine the clinical effectiveness or cost-effectiveness of low-intensity interventions for the prevention of relapse or recurrence of depression. A scoping review of brief high-intensity therapies indicates that some approaches have shown promise in some studies, but findings have not been consistent. Many uncertainties remain and further primary research is required. Careful consideration should be given to the scope of such research; it is important to evaluate the broader patient pathway accounting for the heterogeneous patient groups of interest. Future RCTs conducted in a UK primary care setting should include adult participants in remission or recovery from depression, and evaluate the quality of the intervention and consistency of delivery across practitioners where appropriate. The occurrence of relapse or recurrence should be measured using established methods, and functional outcomes as well as symptoms should be measured; data on quality of life using a generic instrument, such as the European Quality of Life-5 Dimensions (EQ-5D), should be collected. The National Institute for Health Research Health Technology Assessment programme.",22642789,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.456781387329102,-2.0191802978515625,Cs6y
"An Exploratory Brief Head-To-Head Non-Inferiority Comparison of an Internet-Based and a Telephone-Delivered CBT Intervention for Adults with Depression.

Telephone-administered psychotherapy (tCBT) and internet-based treatments (iCBT) may overcome barriers to mental health treatment. TCBT has demonstrated efficacy similar to traditional psychotherapy, however, few studies have compared iCBT to efficacious interventions. This exploratory study examined the noninferiority of iCBT relative to tCBT. We also explored pretreatment moderators of outcome and assessed treatment dropout. As a secondary exploratory analysis of a 304-participant randomized noninferiority trial, we compared iCBT, the first level of a stepped-care intervention, with tCBT on depression outcome after 5 weeks of treatment (prior to stepping). Multiple linear regression models were fit to examine moderators of 5-week depression. Differences in dropout were examined using Kaplan-Meier survival analysis. After 5 weeks of treatment, both interventions significantly reduced depression severity. The effect size difference between the two interventions was d=0.004 [90% CI=-0.19 to 0.19]; the CI did not cross the non-inferiority margin. Pretreatment depression was significantly associated with depression at week 5. The relationship between cognitive strategy usefulness and depression at week 5 differed between interventions, controlling for pretreatment depression. There was no significant difference in dropout between interventions. Given the stepped-care trial design, iCBT and tCBT could not be compared at the end of treatment or follow-up. Analyses were exploratory and should be interpreted with caution. A large sample, powered for noninferiority, found iCBT no less efficacious than tCBT at reducing depression symptoms after five weeks of treatment.",33246650,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.652139663696289,-2.8916099071502686,AexD
"Effectiveness of psychoeducation for depression: a systematic review.

Pharmacological treatment is considered indispensable to major depressive disorder. In spite of this, a significant number of patients do not respond adequately to treatment based only on medication, presenting high relapse and recurrence rates. Therefore, psychosocial interventions, such as psychoeducation, have been increasingly recognized as an essential component in the treatment of depression, associated with pharmacological strategies. Thus, the aim of the present systematic review was to evaluate the effectiveness of psychoeducation for patients with unipolar depression, analyzing the evidence from the literature. Searches were undertaken from April to October 2012 in LILACS, PsycINFO, PubMed, SCOPUS and ISI Web of Knowledge with keywords including 'psychoeducation', 'psychoeducational intervention' and 'depression', with no restriction regarding publishing dates. Fifteen studies were included in the review, 13 of which evaluated the effectiveness of psychoeducation for patients with depression: 10 papers evaluated in-person psychoeducation approaches and three papers evaluated long-distance approaches. In addition to these 13 papers, one evaluated psychoeducational interventions for patients' families and patients' responses and another evaluated psychoeducational interventions for patients' families and families' responses. Findings suggest that increased knowledge about depression and its treatment is associated with better prognosis in depression, as well as with the reduction of the psychosocial burden for the family. Psychoeducation is a psychosocial treatment that has been well documented as an adjunct to pharmacological therapy. However, there are only a few studies regarding its effectiveness on adult patients with major depressive disorder. Although the publications in this area are still very limited, the articles selected in this review suggest that psychoeducation is effective in improving the clinical course, treatment adherence, and psychosocial functioning of depressive patients.",23739312,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,10.635575294494629,-3.1811788082122803,CdGA
"Improvement in self-reported quality of life with cognitive therapy for recurrent major depressive disorder.

Major depressive disorder (MDD) is common, often recurrent and/or chronic. Theoretically, assessing quality of life (QoL) in addition to the current practice of assessing depressive symptoms has the potential to offer a more comprehensive evaluation of the effects of treatment interventions and course of illness. Before and after acute-phase cognitive therapy (CT), 492 patients from Continuation Phase Cognitive Therapy Relapse Prevention trial (Jarrett et al., 2013; Jarrett and Thase, 2010) completed the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Inventory of Depressive Symptomatology Self-report (IDS-SR) and Beck Depression Inventory (BDI); clinicians completed Hamilton Rating Scale for Depression-17-items. Repeated measures analysis of variance evaluated the improvement in QoL before/after CT and measured the effect sizes. Change analyses to assess clinical significance (Hageman and Arrindell, 1999) were conducted. At the end of acute-phase CT, a repeated measure analysis of variance produced a statistically significant increase in Q-LES-Q scores with effect sizes of 0.48-1.3%; 76.9-91.4% patients reported clinically significant improvement. Yet, only 11-38.2% QoL scores normalized. An analysis of covariance showed that change in depression severity (covariates=IDS-SR, BDI) completely accounted for the improvement in Q-LES-Q scores. There were only two time points of observation; clinically significant change analyses lacked matched normal controls; and generalizability is constrained by sampling characteristics. Quality of life improves significantly in patients with recurrent MDD after CT; however, this improvement is completely accounted for by change in depression severity. Normalization of QoL in all patients may require targeted, additional, and/or longer treatment.",25082112,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.256524085998535,-1.4859198331832886,CKbx
"Guided Internet-Based Cognitive Behavioral Therapy for Depression: Implementation Cost-Effectiveness Study.

Major depressive disorder is a chronic condition; its prevalence is expected to grow with the aging trend of high-income countries. Internet-based cognitive-behavioral therapy has proven efficacy in treating major depressive disorder. The objective of this study was to assess the cost-effectiveness of implementing a community internet-based cognitive behavioral therapy intervention (Super@, the Spanish program for the MasterMind project) for treating major depressive disorder. The cost-effectiveness of the Super@ program was assessed with the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing tool, using a 3-state Markov model. Data from the cost and effectiveness of the intervention were prospectively collected from the implementation of the program by a health care provider in Badalona, Spain; the corresponding data for usual care were gathered from the literature. The health states, transition probabilities, and utilities were computed using Patient Health Questionnaire-9 scores. The analysis was performed using data from 229 participants using the Super@ program. Results showed that the intervention was more costly than usual care; the discounted (3%) and nondiscounted incremental cost-effectiveness ratios were €29,367 and €26,484 per quality-adjusted life-year, respectively (approximately US $35,299 and $31,833, respectively). The intervention was cost-effective based on the €30,000 willingness-to-pay threshold typically applied in Spain (equivalent to approximately $36,060). According to the deterministic sensitivity analyses, the potential reduction of costs associated with intervention scale-up would reduce the incremental cost-effectiveness ratio of the intervention, although it remained more costly than usual care. A discount in the incremental effects up to 5% exceeded the willingness-to-pay threshold of €30,000. The Super@ program, an internet-based cognitive behavioral therapy intervention for treating major depressive disorder, cost more than treatment as usual. Nevertheless, its implementation in Spain would be cost-effective from health care and societal perspectives, given the willingness-to-pay threshold of €30,000 compared with treatment as usual.",33973857,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.977449417114258,-2.7442221641540527,AWhN
"The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis.

Standardised effect sizes have been criticized because they are difficult to interpret and offer little clinical information. This meta-analyses examine the extent of actual improvement, the absolute numbers of patients no longer meeting criteria for major depression, and absolute rates of response and remission. We conducted a meta-analysis of 92 studies with 181 conditions (134 psychotherapy and 47 control conditions) with 6937 patients meeting criteria for major depressive disorder. Within these conditions, we calculated the absolute number of patients no longer meeting criteria for major depression, rates of response and remission, and the absolute reduction on the BDI, BDI-II, and HAM-D. After treatment, 62% of patients no longer met criteria for MDD in the psychotherapy conditions. However, 43% of participants in the control conditions and 48% of people in the care-as-usual conditions no longer met criteria for MDD, suggesting that the additional value of psychotherapy compared to care-as-usual would be 14%. For response and remission, comparable results were found, with less than half of the patients meeting criteria for response and remission after psychotherapy. Additionally, a considerable proportion of response and remission was also found in control conditions. In the psychotherapy conditions, scores on the BDI were reduced by 13.42 points, 15.12 points on the BDI-II, and 10.28 points on the HAM-D. In the control conditions, these reductions were 4.56, 4.68, and 5.29. Psychotherapy contributes to improvement in depressed patients, but improvement in control conditions is also considerable.",24679399,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.419168472290039,-2.380368947982788,CQG0
"Effectiveness of Briefer Coping-Focused Psychotherapy for Common Mental Complaints on Work-Participation and Mental Health: A Pragmatic Randomized Trial with 2-Year Follow-Up.

Purpose The aim of this study was to assess short and long-term effectiveness of brief coping-focused psychotherapy (Brief-PsT) compared with short-term psychotherapy (Short-PsT) on work-participation (WP) and mental health. Both treatments were preceded by group education. Methods All participants were on, or at risk of, sick leave due to common mental complaints. Patients were selected for inclusion in this study based on levels of self-reported symptoms ('some' or 'seriously affected') of anxiety and depression. They were randomized to Brief-PsT (n=141) or Short-PsT with a more extended focus (n=143). Primary outcome was the transition of WP-state from baseline to 3 months follow-up. In addition, WP at 12 and 24 months follow-up were assessed. The secondary outcome, clinical recovery rate (CR-rate) was obtained from the Beck Depression and Beck Anxiety Inventories, at 2-year follow-up. In addition, self-reported mental health symptom severity, self-efficacy, subjective health complaints and life satisfaction were assessed. Results At 3 months follow-up, the increase in WP was significantly greater in Brief-PsT than in Short-PsT (p=0.039). At 3 months, 60% in Brief-PsT and 51% in Short-PsT was at work, partial or full. Thereafter, these differences diminished, 84% and 80% were at work at 2-year follow up. The 2-year follow-up of the secondary outcome measurements was completed by 53% in Brief-PsT and 57% in Short PsT. CR-rate was significantly greater in Brief-PsT compared with the Short-PsT (69% vs. 51%, p=0.024). Furthermore, there was a greater reduction in the number of subjective health complaints in Brief-PsT (4.0 vs. 1.9 p=0.012). All other measurements favoured Brief-PsT as well, but did not reach statistical significance. Conclusions Brief coping-focused psychotherapy added to group education for persons with depression or anxiety complaints seemed more effective in enhancing early work participation compared with additional short-term psychotherapy of standard duration with more extended focus. Clinical recovery rate and decline of comorbid subjective health complaints at 2-year follow-up were also in favour of the brief coping-focused program.",31222615,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.62468433380127,-4.073665142059326,A4qL
"Randomized controlled trial of interpersonal psychotherapy versus enhanced treatment as usual for women with co-occurring depression and pelvic pain.

Our study assessed the effectiveness of Interpersonal Psychotherapy (IPT) tailored for biomedical patients with depression and pain. IPT was compared to enhanced treatment as usual (E-TAU) among women with co-occurring depression and chronic pain presenting for care at a women's health or family medicine practice. We hypothesized that women presenting to urban medical practices with depression and chronic pain would benefit from IPT tailored to address their needs to a greater degree than from E-TAU. We conducted a randomized controlled psychotherapy trial of 61 women from 2 urban medical practices who met criteria for major depressive disorder and chronic pelvic pain. Participants were assigned to receive either 8 sessions of IPT or a facilitated psychotherapy referral to a community mental health center, and assessed for depression, social interactions, and pain at 0-, 12-, 24-, and 36-weeks, with score on the Hamilton Rating Scale for Depression as the primary outcome. Both intent-to-treat (ITT) and causal modeling analyses correcting for treatment attendance were conducted. ITT analyses were not significant. In causal modeling analyses, participants assigned to IPT showed significantly more improvement for depression and social interactions, but not for pain. IPT may be a viable option as part of a comprehensive treatment program for women in medical practices with depression and chronic pain. ClinicalTrials.gov, NCT00895999.",25280823,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.502264022827148,-3.8622629642486572,CHgN
"Effects of combined pharmacotherapy and psychotherapy for improving work functioning in major depressive disorder.

Major depressive disorder is associated with significant impairment in occupational functioning and reduced productivity, which represents a large part of the overall burden of depression. To examine symptom-based and work functioning outcomes with combined pharmacotherapy and psychotherapy treatment of major depressive disorder. Employed patients with a DSM-IV diagnosis of major depressive disorder were treated with escitalopram 10-20 mg/day and randomised to: (a) telephone-administered cognitive-behavioural therapy (telephone CBT) (n = 48); or (b) adherence-reminder telephone calls (n = 51). Outcomes included the Montgomery-Åsberg Depression Rating Scale (MADRS), administered by masked evaluators via telephone, and self-rated work functioning scales completed online. (Registered at clinicaltrials.gov: NCT00702598.) After 12 weeks, there were no significant between-group differences in change in MADRS score or in response/remission rates. However, participants in the telephone-CBT group had significantly greater improvement on some measures of work functioning than the escitalopram-alone group. Combined treatment with escitalopram and telephone-administered CBT significantly improved some self-reported work functioning outcomes, but not symptom-based outcomes, compared with escitalopram alone.",24029535,Major Depressive Disorder,Anxiety Treatment,Mental Health,4351,9.805835723876953,-1.2011284828186035,CYzp
"The effects of once- versus twice-weekly sessions on psychotherapy outcomes in depressed patients.

It is unclear what session frequency is most effective in cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT) for depression. Compare the effects of once weekly and twice weekly sessions of CBT and IPT for depression. We conducted a multicentre randomised trial from November 2014 through December 2017. We recruited 200 adults with depression across nine specialised mental health centres in the Netherlands. This study used a 2 × 2 factorial design, randomising patients to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II at baseline, before session 1, and 2 weeks, 1, 2, 3, 4, 5 and 6 months after start of the intervention. Intention-to-treat analyses were conducted. Compared with patients who received weekly sessions, patients who received twice weekly sessions showed a statistically significant decrease in depressive symptoms (estimated mean difference between weekly and twice weekly sessions at month 6: 3.85 points, difference in effect size d = 0.55), lower attrition rates (n = 16 compared with n = 32) and an increased rate of response (hazard ratio 1.48, 95% CI 1.00-2.18). In clinical practice settings, delivery of twice weekly sessions of CBT and IPT for depression is a way to improve depression treatment outcomes.",32029012,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.284151077270508,-2.7683873176574707,AtyD
"Effectiveness of Telephone-Administered Cognitive-Behavioral Psychotherapy for Depression With Versus Without Additional Letters: A Randomized Controlled Trial.

Background: Telephone-administered cognitive-behavioral psychotherapy (T-CBT) can effectively treat patients with depressive symptoms. Introduction: We investigated whether adding letters (via postal mail) to T-CBT reduces depressive symptoms and increases response and remission. Additionally, we assessed whether T-CBT reduced all patients' symptoms in the first depression-specific T-CBT sample in German healthcare. Materials and Methods: Primary care patients were randomized to T-CBT with versus without letters. All received 1 face-to-face and 8-12 telephone-administered sessions. An intention-to-treat sample was analyzed. Between-groups differences in symptom change and the total sample's symptom change were computed using linear mixed models with group as fixed effect, referring general practice as random effect and several covariates. Differences in response and remission were assessed using logistic regressions. Results: Fifty-nine patients were referred to T-CBT and randomized. Twenty-six patients actually participated in T-CBT with letters and 21 without letters. The groups did not differ significantly regarding symptom change (Patient Health Questionnaire [PHQ-9]) from baseline to end: T-CBT without letters showed 1.05 points greater reduction (95% confidence interval: -4.72 to 2.62; p=0.56; Cohen's d=-0.12) (adjusted mean change). The groups did not differ significantly regarding symptom change from baseline to 6-month follow-up nor odds of response or remission. The total sample's PHQ-9 showed significant adjusted mean reduction from baseline to end of T-CBT and to 6-month follow-up. Discussion: Additional letters did not lead to greater symptom reduction. Overall results for the first German T-CBT intervention for depression appear promising but require further assessment using a control condition. Conclusions: Additional letters do not appear to enhance the effectiveness of T-CBT.",31013466,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.639361381530762,-3.0266387462615967,A7gD
"The experience of participating in an internet-based cognitive behavioral therapy program among patients with cardiovascular disease and depression: a qualitative interview study.

Depression in conjunction with cardiovascular disease (CVD) is associated with worsening in CVD, higher mortality, and poorer quality of life. Despite the poor outcomes there is a treatment gap of depression in CVD patients. Recently we found that an Internet-based cognitive behavioral therapy (iCBT) tailored for CVD patients led to reduced symptoms of depression. However, we still have little knowledge about CVD patients' experiences of working with iCBT. The aim of this study was therefore to explore CVD patients' experiences of engaging in a tailored iCBT program. A qualitative interview study using inductive thematic analysis. Data was obtained from 20 patients with CVD and depressive symptoms who had participated in a randomized controlled trial (RCT) evaluating the impact of a nine-week iCBT program on depression. Three main themes emerged: (1) Taking control of the disease, (2) Not just a walk in the park, and (3) Feeling a personal engagement with the iCBT program. The first theme included comments that the tailored program gave the patients a feeling of being active in the treatment process and helped them achieve changes in thoughts and behaviors necessary to take control of their CVD. The second theme showed that patients also experienced the program as demanding and emotionally challenging. However, it was viewed as helpful to challenge negative thinking about living with CVD and to change depressive thoughts. In the third theme patients reported that the structure inherent in the program, in the form of organizing their own health and the scheduled feedback from the therapist created a feeling of being seen as an individual. The feeling of being acknowledged as a person also made it easier to continuously work with the changes necessary to improve their health. Engaging in an iCBT program tailored for patients with CVD and depression was by the patients perceived as helpful in the treatment of depression. They experienced positive changes in emotions, thoughts, and behaviors which a result of learning to take control of their CVD, being confirmed and getting support. The patients considered working with the iCBT program as demanding and emotionally challenging, but necessary to achieve changes in emotions, thoughts, and behaviors.",35468736,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.571043014526367,-2.0598888397216797,bwY
"Clinical Case Management versus Case Management with Problem-Solving Therapy in Low-Income, Disabled Elders with Major Depression: A Randomized Clinical Trial.

To test the hypotheses that (1) clinical case management integrated with problem-solving therapy (CM-PST) is more effective than clinical case management alone (CM) in reducing depressive symptoms of depressed, disabled, impoverished patients and that (2) development of problem-solving skills mediates improvement of depression. This randomized clinical trial with a parallel design allocated participants to CM or CM-PST at 1:1 ratio. Raters were blind to patients' assignments. Two hundred seventy-one individuals were screened and 171 were randomized to 12 weekly sessions of either CM or CM-PST. Participants were at least 60 years old with major depression measured with the 24-item Hamilton Depression Rating Scale (HAM-D), had at least one disability, were eligible for home-based meals services, and had income no more than 30% of their counties' median. CM and CM-PST led to similar declines in HAM-D over 12 weeks (t = 0.37, df = 547, p = 0.71); CM was noninferior to CM-PST. The entire study group (CM plus CM-PST) had a 9.6-point decline in HAM-D (t = 18.7, df = 547, p <0.0001). The response (42.5% versus 33.3%) and remission (37.9% versus 31.0%) rates were similar (χ(2) = 1.5, df = 1, p = 0.22 and χ(2) = 0.9, df = 1, p = 0.34, respectively). Development of problem-solving skills did not mediate treatment outcomes. There was no significant increase in depression between the end of interventions and 12 weeks later (0.7 HAM-D point increase) (t = 1.36, df = 719, p = 0.17). Organizations offering CM are available across the nation. With training in CM, their social workers can serve the many depressed, disabled, low-income patients, most of whom have poor response to antidepressants even when combined with psychotherapy.",25794636,Major Depressive Disorder,Anxiety Treatment,Mental Health,20534,9.928823471069336,-1.9240049123764038,CAQo
"Effectiveness of blended depression treatment for adults in specialised mental healthcare: study protocol for a randomised controlled trial.

Internet-based interventions are seen as an important potential strategy to improve accessibility and affordability of high quality treatments in mental healthcare. A growing number of studies have demonstrated the clinical efficacy of internet-based treatment for mood disorders, but scientific evidence for the application in routine specialised mental healthcare settings is limited. Also, little is known about the clinical and health-economic benefits of blended treatment, where online interventions are integrated with face-to-face treatment of depression in one treatment protocol. The primary aim of this study is to investigate the clinical and cost-effectiveness of blended Cognitive Behavioural Therapy (bCBT) for depression, as compared to treatment as usual (TAU) in specialised routine mental healthcare in the Netherlands. This trial is part of the E-COMPARED project which has a broader perspective, focussing on primary and specialised care in eight European countries. The study is a randomised controlled non-inferiority trial with two parallel conditions: bCBT and TAU. The blended treatment combines individual face-to-face CBT with CBT delivered through an Internet-based treatment platform (Moodbuster). This platform includes a mobile phone application, used for ecological momentary assessments, automated feedback and motivational messages. Weekly alternating face-to-face (10) and online (9) sessions will be delivered over a period of 19-20 weeks. TAU is defined as the routine care that subjects receive when they are diagnosed with depression in specialised mental healthcare. Adult patients≥18 years old meeting DSM-IV diagnostic criteria for major depressive disorder will be recruited within participating outpatient specialised mental healthcare clinics in the Netherlands. Measurements will be taken at baseline and at 3, 6 and 12 months follow-up. The primary outcome will be depressive symptoms, measured with the PHQ-9 and QIDS. Secondary outcomes include health-related quality of life, mastery, treatment preference, working alliance, system usability, treatment satisfaction and possible negative side-effects. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective and will include both direct and indirect healthcare costs. The results of this study will provide insight into the health and economical outcomes of blended treatment for depression and give an indication of the value of implementing blended treatment in specialised clinical settings. Netherlands Trial Register NTR4962 . Registered 05-01-2015.",27102812,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.389920234680176,-3.098438024520874,Bt3v
"Economic Evaluation of Cognitive Behavioral Therapy for Depression: A Systematic Review.

This study aimed to conduct a systematic review of cost-utility studies of internet-based and face-to-face cognitive behavioral therapy (CBT) for depression from childhood to adulthood and to examine their reporting and methodological quality. A structured search for cost-utility studies concerning CBT for depression was performed in 7 comprehensive databases from their inception to July 2020. Two reviewers independently screened the literature, abstracted data, and assessed quality using the Consolidated Health Economic Evaluation Reporting Standards and Quality of Health Economic Studies checklists. The primary outcome was the incremental cost-effectiveness ratio (ICER) across all studies. To make a relevant comparison of the ICERs across the identified studies, cost data were inflated to the year 2020 and converted into US dollars. Thirty-eight studies were included in this review, of which 26 studies (68%) were deemed of high methodological quality and 12 studies (32%) of fair quality. Despite differences in study designs and settings, the conclusions of most included studies for adult depression were general agreement; they showed that face-to-face CBT monotherapy or combination therapy compared with antidepressants and usual care for adult depression were cost-effective from the societal, health system, or payer perspective (ICER -$241 212.4/quality-adjusted life-year [QALY] to $33 032.47/QALY, time horizon 12-60 months). Internet-based CBT regardless of guided or unguided also has a significant cost-effectiveness advantage (ICER -$37 717.52/QALY to $73 841.34/QALY, time horizon 3-36 months). In addition, CBT was cost-effective in preventing depression (ICER -$23 932.07/QALY to $26 092.02/QALY, time horizon 9-60 months). Nevertheless, the evidence for the cost-effectiveness of CBT for children and adolescents was still ambiguous. Fair or high-quality evidence showed that CBT monotherapy or combination therapy for adult depression was cost-effective; whether CBT-related therapy was cost-effective for children and adolescents depression remains inconclusive.",35422392,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.073028564453125,-2.793653726577759,dbA
"Comparison of the Effects of Coaching and Receipt of App Recommendations on Depression, Anxiety, and Engagement in the IntelliCare Platform: Factorial Randomized Controlled Trial.

IntelliCare is a modular platform that includes 12 simple apps targeting specific psychological strategies for common mental health problems. This study aimed to examine the effect of 2 methods of maintaining engagement with the IntelliCare platform, coaching, and receipt of weekly recommendations to try different apps on depression, anxiety, and app use. A total of 301 participants with depression or anxiety were randomized to 1 of 4 treatments lasting 8 weeks and were followed for 6 months posttreatment. The trial used a 2X2 factorial design (coached vs self-guided treatment and weekly app recommendations vs no recommendations) to compare engagement metrics. The median time to last use of any app during treatment was 56 days (interquartile range 54-57), with 253 participants (84.0%, 253/301) continuing to use the apps over a median of 92 days posttreatment. Receipt of weekly recommendations resulted in a significantly higher number of app use sessions during treatment (overall median=216; P=.04) but only marginal effects for time to last use (P=.06) and number of app downloads (P=.08). Coaching resulted in significantly more app downloads (P<.001), but there were no significant effects for time to last download or number of app sessions (P=.36) or time to last download (P=.08). Participants showed significant reductions in the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) across all treatment arms (P s<.001). Coached treatment led to larger GAD-7 reductions than those observed for self-guided treatment (P=.03), but the effects for the PHQ-9 did not reach significance (P=.06). Significant interaction was observed between receiving recommendations and time for the PHQ-9 (P=.04), but there were no significant effects for GAD-7 (P=.58). IntelliCare produced strong engagement with apps across all treatment arms. Coaching was associated with stronger anxiety outcomes, and receipt of recommendations enhanced depression outcomes. ClinicalTrials.gov NCT02801877; https://clinicaltrials.gov/ct2/show/NCT02801877.",31464192,Major Depressive Disorder,Anxiety Treatment,Mental Health,1427,7.605169296264648,-5.8891706466674805,A1au
"Differences in depressed oncologic patients' narratives after receiving two different therapeutic interventions for depression: a qualitative study.

This study aims to explore differences in personal narratives of the experience of illness and treatment in depressed oncologic patients who received either combined treatment for depression (psychotherapy plus antidepressants) or standard treatment (antidepressants alone). We employed a qualitative research design based on grounded theory. Data were collected from eight videotaped focus groups and semi-structured interviews with a total of 28 participants. The research team reviewed interview transcripts and categorized the participants' responses using the ATLAS.ti (ATLAS.ti Scientific Software Development GmbH Hardenbergstr. 7 D-10623, Berlin) software package. Compared with patients in the standard treatment group, patients in the combined treatment group were better able to relate their experiences of physical and emotional discomfort and find meaning in the experience of illness by viewing cancer as a transformative experience. In addition, patients in the combined treatment group tended to use more active coping strategies based on acceptance of their situation and emphasized that psychotherapy had been helpful. Qualitative analysis is an efficient method of examining the meaning of quantitative results in depth, particularly patients' perspectives on quality of life. Patients undergoing combined treatment consider psychotherapy to be a helpful tool and exhibit more personal growth than do patients undergoing standard treatment.",21882288,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,8.9180908203125,-2.3861517906188965,C4AJ
"Group cognitive-behavioral therapy for clients with major depression in residential substance abuse treatment.

The BRIGHT (Building Recovery by Improving Goals, Habits, and Thoughts) study was a community-based effectiveness trial that compared residential substance abuse treatment with residential treatment plus group cognitive-behavioral therapy (CBT)for depression. This brief report focuses on the subgroup of participants with major depression. The authors used a quasi-experimental design and an intent-to-treat analysis. Out of 299 participants enrolled, 135 had major depression. Primary outcomes were change in depression symptoms, mental health functioning, and days of alcohol use and problematic substance use. At the three-month follow-up, participants with major depression reported less severe depression and better functioning, compared with participants with major depression who received usual care. At six months, functioning continued to be higher and problem substance use was lower. Group CBT was an effective treatment for major depression for clients in residential substance abuse treatment. These results extend the effectiveness of group CBT for major depression to a new setting, patient population, and type of provider.",22638007,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,11.15468692779541,-2.4408469200134277,Cs/Q
"Outcomes, skill acquisition, and the alliance: Similarities and differences between clinical trial and student therapists.

Considerable evidence from clinical trials supports the efficacy of cognitive therapy (CT) of depression. Less is known about outcomes when provided in other contexts, such as when provided by student therapists. We conducted a non-randomized comparison of student therapists vs. clinical trial therapists on change in depressive symptoms, dropout, change in CT skills, and therapeutic alliance among 100 clients with moderate to severe depression. Treatment manual and duration were the same. Clients treated by student therapists had largely comparable outcomes on depressive symptom change, therapeutic alliance, and CT skills. Results supported non-inferiority of student therapists on change in depressive symptoms, but non-inferiority was not supported when using an interviewer evaluated measure of depression. Evidence of non-inferiority was also obtained for client CT skills and therapeutic alliance. In fact, conventional superiority analyses indicated student therapists outperformed clinical trial therapists on alliance and CT skills. The rate of dropout among student therapists (30%) was numerically higher than among clinical trial therapists (17%) and our results did not support non-inferiority on dropout. CT provided by student therapists can achieve outcomes similar to those in a clinical trial, but more research about dropout is needed.",32276239,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.046342849731445,-3.065889596939087,Aqy/
"Effectiveness and acceptance of a web-based depression intervention during waiting time for outpatient psychotherapy: study protocol for a randomized controlled trial.

Due to limited resources, waiting periods for psychotherapy are often long and burdening for those in need of treatment and the health care system. In order to bridge the gap between initial contact and the beginning of psychotherapy, web-based interventions can be applied. The implementation of a web-based depression intervention during waiting periods has the potential to reduce depressive symptoms and enhance well-being in depressive individuals waiting for psychotherapy. In a two-arm randomized controlled trial, effectiveness and acceptance of a guided web-based intervention for depressive individuals on a waitlist for psychotherapy are evaluated. Participants are recruited in several German outpatient clinics. All those contacting the outpatient clinics with the wish to enter psychotherapy receive study information and a depression screening. Those adults (age≥18) with depressive symptoms above cut-off (CES-D scale >22) and internet access are randomized to either intervention condition (treatment as usual and immediate access to the web-based intervention) or waiting control condition (treatment as usual and delayed access to the web-based intervention). At three points of assessment (baseline, post-treatment, 3-months-follow-up) depressive symptoms and secondary outcomes, such as quality of life, attitudes towards psychotherapy and web-based interventions and adverse events are assessed. Additionally, participants' acceptance of the web-based intervention is evaluated, using measures of intervention adherence and satisfaction. This study investigates a relevant setting for the implementation of web-based interventions, potentially improving the provision of psychological health care. The results of this study contribute to the evaluation of innovative and resource-preserving health care models for outpatient psychological treatment. This trial has been registered on 13 February 2017 in the German clinical trials register (DRKS); registration number DRKS00010282 .",29788996,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.046235084533691,-3.2653727531433105,BLbu
"Personalized prognostic prediction of treatment outcome for depressed patients in a naturalistic psychiatric hospital setting: A comparison of machine learning approaches.

Research on predictors of treatment outcome in depression has largely derived from randomized clinical trials involving strict standardization of treatments, stringent patient exclusion criteria, and careful selection and supervision of study clinicians. The extent to which findings from such studies generalize to naturalistic psychiatric settings is unclear. This study sought to predict depression outcomes for patients seeking treatment within an intensive psychiatric hospital setting and while comparing the performance of a range of machine learning approaches. Depressed patients (N = 484; ages 18-72; 89% White) receiving treatment within a psychiatric partial hospital program delivering pharmacotherapy and cognitive behavioral therapy were split into a training sample and holdout sample. First, within the training sample, 51 pretreatment variables were submitted to 13 machine learning algorithms to predict, via cross-validation, posttreatment Patient Health Questionnaire-9 depression scores. Second, the best performing modeling approach (lowest mean squared error; MSE) from the training sample was selected to predict outcome in the holdout sample. The best performing model in the training sample was elastic net regularization (ENR; MSE = 20.49, R2 = .28), which had comparable performance in the holdout sample (MSE = 11.26; R2 = .38). There were 14 pretreatment variables that predicted outcome. To demonstrate the translation of an ENR model to personalized prediction of treatment outcome, a patient-specific prognosis calculator is presented. Informed by pretreatment patient characteristics, such predictive models could be used to communicate prognosis to clinicians and to guide treatment planning. Identified predictors of poor prognosis may suggest important targets for intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",31841022,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.774398803710938,-1.1424082517623901,AwN0
"Amelioration of mild and moderate depression through Pranic Healing as adjuvant therapy: randomised double-blind controlled trial.

Depression is a mental disorder, affecting the quality of life. Our study explores the efficacy of Pranic Healing (PH), as an adjuvant therapy in treating depression Methods: In this randomised double-blind controlled trial, 52 participants with a mean age of 34.4 years, with mild to moderate depression were assessed using the Hamilton Depression Rating (HAM-D) scale during the 5-week study. Both Medication + PH (MedPH) and Medication + Mock PH (MedMockPH) groups comprising 26 members received Pranic and mock healing lasting 20 minutes per session respectively once a week for 4 weeks, along with the antidepressant drug. The average decrease in HAM-D score in MedPH was median 11 (Interquartile Range (IQR) 7-12) and was significantly higher compared with the MedMockPH group median 6.5 (IQR 3-9). At pre-assessment, both groups had 8 cases of mild and 18 cases of moderate depression. At post-assessment, HAM-D showed that the improvement in depression category was seen in 69.2% of participants in the MedMockPH group and 100% in MedPH group. These results give first the evidence that PH can aid as an adjuvant therapy for depressed people.",28836826,Major Depressive Disorder,Anxiety Treatment,Mental Health,19115,10.088955879211426,-2.3594257831573486,BYAO
"Effectiveness of a nurse facilitated cognitive group intervention among mild to moderately-depressed-women in KwaZulu-Natal, South Africa.

The purpose of the study was to determine the effectiveness of a nurse-facilitated-cognitive-group (NFCG) intervention as an adjunct to antidepressant medication, in mild to moderately, depressed women. This was a quasi-experimental, nonequivalent, control group design study. A sample of 30 consenting participants was selected from an urban, community psychiatric clinic, and the participants were randomly allocated to the control and the intervention groups. The effectiveness of the intervention was measured using the Beck Depression Inventory (BDI). After six weeks of implementation of the NFCG intervention, there was a decrease in the BDI scores of the intervention group, and an increase in the BDI scores in the control group (CG) - but the difference in scores was not significant (Student's t-test=1.076, p=0.291). After 12 weeks of the group intervention, the BDI scores for the intervention group, showed a considerable reduction in their levels of depression, whilst the participants of the control group had a further increase in their scores. There was a statistically significant difference between the groups, with respect to the BDI scores (p<0.001). The Friedman test indicated that the mean BDI scores, were statistically significant (p<0.001) within the intervention group, meaning that the BDI scores improved, at the end of the intervention for all the participants. Analysis of the BDI scores, using the Friedman test, showed that there was no improvement in the control group (p=0.597). The NFCG intervention, as an adjunct to antidepressant medication, contributed to a reduction in depressive symptoms.",23417633,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.580730438232422,-2.9017436504364014,Chyp
"Scheduled Telephone Support for Internet Cognitive Behavioral Therapy for Depression in Patients at Risk for Dropout: Pragmatic Randomized Controlled Trial.

Therapist-supported, internet-delivered cognitive behavioral therapy (iCBT) is efficient in the treatment of depression. However, the optimal mode and intensity of therapist support remain to be identified. Scheduled telephone support (STS) may improve adherence and outcomes but, as it is time- and resource-consuming, should be reserved for patients for whom the usual support may be insufficient. This paper aims to reveal whether add-on STS for patients at risk of dropping out improves treatment adherence and symptoms in iCBT for depression. Among patients participating in an ongoing large observational routine clinical practice study of iCBT for depression delivered nationwide by Helsinki University Hospital (HUS-iCBT), those demonstrating a ≥14-day delay in initiation of treatment received invitations to this subsidiary STS study. A total of 100 consenting patients were randomly allocated to either HUS-iCBT as usual (control group, n=50) or HUS-iCBT plus add-on STS (intervention group, n=50). Proportions of those reaching midtreatment and treatment end point served as the primary outcome; secondary outcomes were change in Beck Depression Inventory (BDI)-measured depressive symptoms and time spent in treatment. Add-on STS raised the proportion of patients reaching midtreatment compared with HUS-iCBT as usual (29/50, 58% vs 18/50, 36%; P=.045) and treatment end point (12/50, 24% vs 3/50, 6%; P=.02). Change in BDI score also favored add-on STS (3.63 points vs 1.1 points; P=.049), whereas duration of treatment did not differ. Add-on STS enhances adherence and symptom improvement of patients at risk of dropping out of iCBT for depression in routine clinical practice. International Standard Randomised Controlled Trial Number (ISRCTN) 55123131; http://www.isrctn.com/ISRCTN55123131.",32706658,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.726248741149902,-2.874901056289673,AlVS
"Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis.

A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mode for depressed patients in this setting. Randomized trials comparing a psychological treatment with usual care, placebo, another psychological treatment, pharmacotherapy, or a combination treatment in adult depressed primary care patients were identified by database searches up to December 2013. We performed both conventional pairwise meta-analysis and network meta-analysis combining direct and indirect evidence. Outcome measures were response to treatment (primary outcome), remission of symptoms, post-treatment depression scores and study discontinuation. A total of 37 studies with 7,024 patients met the inclusion criteria. Among the psychological treatments investigated in at least 150 patients face-to-face cognitive behavioral therapy (CBT; OR 1.80; 95 % credible interval 1.35-2.39), face-to-face counselling and psychoeducation (1.65; 1.27-2.13), remote therapist lead CBT (1.87; 1.38-2.53), guided self-help CBT (1.68; 1.22-2.30) and no/minimal contact CBT (1.53; 1.07-2.17) were superior to usual care or placebo, but not face-to-face problem-solving therapy and face-to-face interpersonal therapy. There were no statistical differences between psychological treatments apart from face-to-face interpersonal psychotherapy being inferior to remote therapist-lead CBT (0.60; 0.37-0.95). Remote therapist-led (0.86; 0.21-3.67), guided self-help (0.93; 0.62-1.41) and no/minimal contact CBT (0.85; 0.54-1.36) had similar effects as face-to-face CBT. The limited available evidence precludes a sufficiently reliable assessment of the comparative effectiveness of psychological treatments in depressed primary care patients. Findings suggest that psychological interventions with a cognitive behavioral approach are promising, and primarily indirect evidence indicates that it applies also when they are delivered with a reduced number of therapist contacts or remotely. 01KG1012 at http://www.gesundheitsforschung-bmbf.de/de/2852.php.",26286590,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.354886054992676,-2.529998540878296,B5UJ
"Letter to the Editor: Mechanisms of change in an internet-based therapy for depression - a comment on Van der Zanden et al.: a reply.

",25302601,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.504684448242188,-3.1563761234283447,CHPD
"Brief cognitive behavioral therapy for depression among patients with alcohol dependence in Thailand.

This study evaluated the short-term efficacy of brief cognitive behavioral therapy for reducing depression among Thai general hospital patients with alcohol dependence. A quasi-experimental design was used with a control group and pretest, posttest, and follow-up assessments. Participants were patients with alcohol dependence and depression who were recruited from district and provincial hospitals in northern Thailand. Eighty (N = 80) eligible participants were purposively selected and enrolled, and then randomly assigned into two groups. One group received three weeks of brief six-session cognitive behavioral therapy as the intervention, and the other group received usual care as their treatment. Data were collected at Week 0 (pretest), Week 3 (posttest), and Week 7 (one month follow-up) and included a nine-item depression scale, with analysis through descriptive statistics and t-test. Findings indicated that the mean depression scores decreased significantly (p < .01) in both the experimental (n = 33) and control groups (n = 27) at the one month follow-up (Week 7). However, only the experimental group showed significant differences in their mean depression scores between pre- and posttest. At Week 7, the experimental group showed significantly lower mean depression scores than the control group (p < .05). In summary, the brief six-session cognitive behavioral therapy intervention yielded promising results and may benefit patients with alcohol dependence and depression who are seen in general hospital settings.",25162191,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.086213111877441,-2.8221495151519775,CJOk
"Effectiveness of an internet-based self-guided program to treat depression in a sample of Brazilian users: a study protocol.

Although psychological treatments for depressive disorders are available, they are often expensive or inaccessible for many. Web-based interventions that require minimal or no contact with therapists have been shown effective. To the best of our knowledge, no study using this treatment format has been conducted in Brazil. The Deprexis program was designed using empirically established principles of cognitive-behavioral therapy to reduce depressive symptoms. The objective of this study was to evaluate the effectiveness of Deprexis in Brazil. This randomized controlled trial will include 128 Brazilians with clinically significant depression symptoms or who have been diagnosed with depressive disorder (major depressive disorder or dysthymia), recruited over the internet (Brazilian forums, social networks, or e-mail lists). Individuals with other psychiatric diagnoses that require significant attention (e.g., bipolar disorder, psychosis) will not be included in the trial. Participants will be randomly assigned to 1) treatment as usual plus immediate access to Deprexis or 2) treatment as usual plus delayed access to Deprexis (after 8 weeks). Participants will be able to obtain other treatment types in addition to the online intervention. If found effective, this web-based intervention would increase the evidence-based care options for depression treatment in Brazil. RBR-6kk3bx, UTN U1111-1212-8998.",32159711,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.13300895690918,-3.082832098007202,AsHa
"Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial.

Depressive and adjustment disorders are highly prevalent in patients with physical diseases and are associated with poorer quality of life, increased morbidity and mortality, as well as higher healthcare costs. Access to mental health care holds strong importance for these patients, although waiting times for outpatient individual psychotherapy in Germany are often long. Attending an intervention while waiting for individual therapy could improve this problem. For this purpose, we developed an eight-session cognitive behavioral group therapy (STEpS) and tested its efficacy in a randomized controlled trial. Seventy-six patients with chronic physical diseases and comorbid depressive or adjustment disorders were randomized to either STEpS or a waiting list control group. The primary outcome was self-reported depression measured by the Hospital Anxiety and Depression Scale (HADS-D), while the secondary outcomes included global psychological distress and health-related quality of life. Data was assessed at baseline, post-treatment and 2-month follow-up and was analyzed based on intention-to-treat. Compared to the control group, the STEpS group showed significantly less depression (d=0.37; p=.009) and significantly higher quality of life (mental: d=0.47; p=.030; physical: d=0.70; p=.001) at post-treatment. The groups did not differ in global psychological distress. At 2-month follow-up, the STEpS group indicated significantly higher subjective physical health (d=0.43; p=.046), but did not differ from the control group in the remaining outcomes. STEpS proved effective in improving depression and health-related quality of life in the short term but did not reveal effects on mental outcomes at 2-month follow-up. Nonetheless, the implementation of STEpS as a waiting list intervention prior to individual therapy could help patients to handle long waiting periods in outpatient care. German Clinical Trials Register DRKS00005140 (27 August 2013).",29017481,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.927753448486328,-2.548628807067871,BVzb
"Efficacy and cost-effectiveness of a blended cognitive behavioral therapy for depression in Spanish primary health care: study protocol for a randomised non-inferiority trial.

Data from primary health care in Spain show a high prevalence of the major depressive disorder. Blended treatment (combination of face-to-face and online components) seems to be a very promising tool for the optimization and dissemination of psychological treatments in a cost-effective form. Although there is growing data that confirm the advantages of blended therapies, few studies have analyzed their application in regular clinical practice. The objective of the present paper is to describe the protocol for a clinical study aimed at exploring the clinical and cost-effectiveness of a blended cognitive behavioral therapy (b-CBT) for depression, compared to treatment as usual (TAU) in a primary health care setting. A two-arm randomised controlled non-inferiority trial will be carried out, with repeated measures (baseline, 3 months, 6 months, and 12 months) under two conditions: b-CBT and TAU. The b-CBT program will consist in three face-to-face sessions and eight online sessions. The TAU is defined as the routine care delivered by the general practitioner for the treatment of depression in primary care. The primary outcome is a symptomatic change of depressive symptoms on the patient-health questionnaire (PHQ-9). Other secondary outcomes will be considered (e.g., quality of life, treatment preference). All participants must be 18 years of age or older and meet the diagnostic criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental disorders 4th edition. 156 participants will be recruited (78 per arm). It is expected that b-CBT is clinically non-inferior when compared to TAU. This is the first study in Spain to use a b-CBT format in primary and specialized care, and this format could be an efficacious and cost-effective therapeutic strategy for the treatment of depression. ClinicalTrials.gov NCT02361684. Registered on 8 January 2015. Currently recruiting participants.",29566656,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.652231216430664,-2.9299776554107666,BOQ6
"Comparison of Clinical Significance of Cognitive-Behavioral Therapy and Psychodynamic Therapy for Major Depressive Disorder: A Randomized Clinical Trial.

The aim of this study was to evaluate the effect of two brief psychotherapy models for major depressive disorder (MDD). This is a randomized clinical trial with 247 individuals diagnosed with MDD. Supportive-expressive dynamic psychotherapy (SEDP) (18 sessions) and cognitive-behavioral therapy (CBT) (16 sessions) were the two models used in this study. Participants were evaluated at baseline, during treatment, and postintervention (last session). Clinically significant changes were found in both psychotherapy models, and CBT showed higher response rates. Regarding the Beck Depression Inventory-II [F(1,120) = 4.07, p = 0.046] and Outcome Questionnaire 45.2 [F(1.114) = 7.99, p = 0.006], CBT had a better effect than SEDP. Hence, the results obtained have contributed to literature, served to corroborate the importance and effectiveness of psychodynamic psychotherapy, as well as explored the mechanisms of change, remission, and response in the treatment of MDD, which have been ignored to a large extent.",30124572,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.222441673278809,-2.711153745651245,BHWQ
"The efficacy of behavioral activation treatment among depressed Spanish-speaking Latinos.

Major depressive disorder (MDD) is highly prevalent among U.S. Spanish-speaking Latinos, but the lack of empirically supported treatments precludes this population's access to quality mental health care. Following the promising results of an open-label trial of the Behavioral Activation Treatment for Depression (BATD) among Spanish-speaking Latinos, the authors conducted a randomized control trial (RCT; N = 46) that compared BATD to supportive counseling. Study outcomes included depression, BATD proposed mechanisms of change, and nonspecific psychotherapy factors. Relative to supportive counseling, BATD led to greater decreases in depressive symptoms over time (p = .04) and greater MDD remission at the end of treatment (p = .01). Activity level (p = .01) and environmental reward (p = .05) showed greater increases over time among those who received BATD compared to supportive counseling. Treatment adherence, therapeutic alliance, and treatment satisfaction did not differ between the groups over time (ps > 0.17). The 1-month follow-up suggested sustained clinical gains across therapies. The current study adds to a growing treatment literature and provides support that BATD is efficacious in reducing depression and increasing activity level and environmental reward in the largest, yet historically underserved U.S. ethnic minority population. This trial sets the stage for a larger RCT that evaluates the transportability and generalizability of BATD in an effectiveness trial. (PsycINFO Database Record",27054826,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.10783863067627,-4.925795078277588,BukN
"Computer-assisted cognitive-behavior therapy for depression.

This article reviews the use of computer technology in treating depression as a substitute or adjunct for standard therapy. It discusses advantages and disadvantages of introducing computer technology as a treatment option, problems and barriers to expanded use, the varieties of computer-assisted psychotherapy for major depression, and relevant research. Three specific Internet-based programs are described, assessed and compared: Good Days Ahead, Beating the Blues, and MoodGYM. The authors conclude that these and similar programs are promising. Preliminary outcome studies suggest that these programs produce outcome similar to standard therapy, although methodological shortcomings limit confidence in these findings. Suggestions are offered for practitioners considering the addition of computer assistance to their treatment of depression.",24059735,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.753629684448242,-2.9577407836914062,CYXy
"A spirituality teaching program for depression: a randomized controlled trial.

This randomized controlled trial assessed the efficacy of a Spirituality Teaching Program to treat unipolar major depression. A randomized controlled, assessor blinded trial design was used. A total of 84 individuals aged 18 years or older with unipolar major depression of mild to moderate severity were recruited in Calgary, Canada and randomized to two study arms: 1) Spirituality Teaching Program Group (8 week, home-based Spirituality Teaching Program); and 2) Waitlist Control Group (no intervention followed by Spirituality Teaching Program starting at week 9). Outcome measures (depression severity, response rate, remission rate) were assessed at baseline, 8, 16, and 24 weeks using the Hamilton Depression Rating Scale (HAM-D). The two trial groups were similar in their demographic and disease characteristics at baseline. At the 8-week point, the change in depression severity was significantly different between the two groups (change in HAM-D score: 8.5 for the Spirituality Group and 2.3 for the Waitlist Control Group, p < 0.001). The Spirituality Teaching Program Group had significantly higher response (36% vs. 4.4%, p < 0.001) and remission rates (31% vs. 4.4%, p < 0.001) than the Waitlist Control Group. The benefits remained throughout the observation period for the Spirituality Teaching Program Group participants with response rates of 56.4% at 16 weeks and 58.9% at 24 weeks. The Spirituality Program significantly reduced depression severity and increased response and remission rates. This non-drug treatment program should be investigated further as a treatment option for depression.",22439299,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.31313705444336,-4.142096042633057,CvtE
"The Feasibility and Efficacy of a Brief Integrative Treatment for Adults With Depression and/or Anxiety: A Randomized Controlled Trial.

The aim of this study was to investigate the efficacy and suitability of a brief integrative intervention, Personalized Integrative Therapy (PI Therapy), for the treatment of adult depression and/or anxiety. In this 6-week, 3-arm, parallel-group, randomized trial, PI Therapy delivered alone or with nutritional supplements (PI Therapy + Supps) was compared to cognitive behavior therapy (CBT) in 48 adults with depression and/or anxiety. All treatments were delivered as a 1-day workshop plus 6 weeks of reminder phone text messages to reinforce topics and skills covered in the workshop. Affective symptoms decreased significantly and to the same extent in all 3 conditions. At the end of treatment, 33% to 58% of participants reported levels of depressive symptoms in the normal range, and 50% to 58% reported nonclinical levels of anxiety. Compared to CBT and PI Therapy, PI Therapy + Supps was associated with significantly greater improvements in sleep quality. These findings suggest that a brief integrative intervention with or without supplements was comparable to CBT in reducing affective symptoms in adults with depression and/or anxiety. However, sleep quality improved only in the PI Therapy + Supps condition. These findings will require replication with a larger cohort.",32638615,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.65803337097168,-2.6472251415252686,AmMr
"Upregulating Positive Affectivity in the Transdiagnostic Treatment of Emotional Disorders: A Randomized Pilot Study.

Transdiagnostic cognitive-behavioral therapy for emotional disorders (ED) has proven to be effective. However, current transdiagnostic treatment protocols address only the regulation of negative affectivity, and they do not include treatment components to more directly target the regulation of positive affectivity. In this study, we propose to evaluate the preliminary efficacy and acceptability of a transdiagnostic treatment protocol for ED that includes, as an innovative feature, a specific treatment component to directly upregulate positive affectivity based on positive psychology interventions. A total of 24 participants were randomized to either a transdiagnostic treatment protocol ( n = 12) or a transdiagnostic treatment protocol with an additional component designed to regulate positive affectivity ( n = 12). Participants completed measures of anxiety, depression, positive and negative affectivity, and quality of life, as well as treatment acceptability at pre- and posttreatment and at the 3-month follow-up. Both interventions led to improvements in all measures at posttreatment, and these outcomes were maintained at the 3-month follow-up, with large effect sizes for all measures. The effect sizes for positive affect were larger in the condition that included the component to upregulate positive affectivity. Attrition rate was low, and both treatment protocols were well accepted by participants. The results obtained in this study indicate the feasibility of testing the treatment protocol in a larger, randomized, controlled trial, and they suggest the potential of including treatment components for directly upregulating positive affectivity in future research on transdiagnostic treatment protocols for ED.",29047288,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,11.929855346679688,-2.968806266784668,BVa7
"Exploring mechanisms of change in cognitive therapy and interpersonal psychotherapy for adult depression.

The present study explored the temporal relationships between change in five candidate causal mechanisms and change in depressive symptoms in a randomized comparison of individual Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for adult depression. Furthermore, hypotheses concerning the mediation of change in these treatments were tested. Patients were 151 depressed adult outpatients treated with either CT (n = 76) or IPT (n = 75). Depression severity was assessed with the BDI-II. Candidate mediators included both therapy-specific as well as common factors. Measures were taken multiple times over the course of treatment (baseline, mid-, and post-treatment). Pearson's correlations and Latent-Difference-Score models were used to examine the direct and indirect relationships between (change in) the candidate mediators and (subsequent) (change in) depression. Patients showed improvement on all measures. No differential effects in pre- to post-treatment changes were observed between the two conditions. However, change in interpersonal functioning occurred more rapidly in IPT. Only little empirical support for the respective theoretical models of change in CT and IPT was found. Future studies should pay special attention to the timing of assessments and within-patient variance.",28544896,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.641009330749512,-2.9345688819885254,BcF2
"What we know, what we do not know, and where are we heading? Efficacy and acceptability of psychological interventions for depression.

In the past several decades, increasing evidence supports the efficacy of psychotherapies for depression. The vast majority of findings from meta-analyses, randomized clinical trials (RCTs) and naturalistic studies have demonstrated that well-established psychotherapies (behavioural activation, problem-solving therapy, psychodynamic therapy, cognitive-behavioural therapy, interpersonal therapy and emotion-focused therapy) are superior to no-treatment and control conditions, and are in most cases equally effective in treating depression. However, despite this abundant support for psychotherapies, studies have also consistently shown high drop-out rates, high percentages of non-respondent patients who experience treatment failures, and mixed findings regarding the enduring effects of psychotherapy. Thus, there is a need to develop more personalised treatment models tailored to patients' needs. A new integrative sequential stepwise approach to the treatment of depression is suggested.",26411324,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.656149864196777,-2.5590054988861084,B3cQ
"The moderating effects of group cognitive-behavioral therapy for depression among substance users.

This study examined the prospective longitudinal relationship between changes in depressive symptoms on alcohol and/or drug (i.e., substance) use among addiction participants in treatment, and whether group cognitive-behavioral therapy for depression (GCBT-D) moderated the relationship. Using a quasi-experimental intent-to-treat design, 299 residential addiction treatment clients with depressive symptoms (Beck Depression Inventory-II, BDI-II scores > 17; Beck, Steer, & Brown, 1996) were assigned to either usual care (n = 159) or usual care plus a 16-session GCBT-D intervention (n = 140). Two follow-up interviews were conducted, one 3 months after the baseline interview corresponding to the end of the intervention, and then one 3 months later. Parallel-process growth modeling was used to examine changes in depressive symptoms and the associated changes in abstinence and negative consequences from substance use over time. Treatment group was included as a moderator of the association. Participants in the GCBT-D condition showed a greater increase in abstinence and greater decreases in depressive symptoms and negative consequences over time. There were significant interaction effects, such that the associations between depressive symptoms, negative consequences, and abstinence changes were larger in the usual-care condition than in the GCBT-D condition. The results suggest that the intervention may be effective by attenuating the association between depressive symptoms and substance use outcomes. These findings contribute to the emerging literature on the prospective longitudinal associations between depressive symptoms and substance use changes by being the first to examine them among a sample receiving GCBT-D in an addiction treatment setting.",22564202,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,10.984862327575684,-2.815472364425659,Ct0+
"Brief psychotherapy for depression: a systematic review and meta-analysis.

Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < or =8 sessions) for depression. We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms. We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from -0.33 to -0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES -0.42, 95% CI -0.74 to -0.10, 12 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES -0.24, 95% CI -0.42 to -0.06, 12 = 0%). Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.",22849036,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.923794746398926,-2.896312952041626,CqHC
"Meta-analyses of positive psychology interventions: The effects are much smaller than previously reported.

For at least four decades, researchers have studied the effectiveness of interventions designed to increase well-being. These interventions have become known as positive psychology interventions (PPIs). Two highly cited meta-analyses examined the effectiveness of PPIs on well-being and depression: Sin and Lyubomirsky (2009) and Bolier et al. (2013). Sin and Lyubomirsky reported larger effects of PPIs on well-being (r = .29) and depression (r = .31) than Bolier et al. reported for subjective well-being (r = .17), psychological well-being (r = .10), and depression (r = .11). A detailed examination of the two meta-analyses reveals that the authors employed different approaches, used different inclusion and exclusion criteria, analyzed different sets of studies, described their methods with insufficient detail to compare them clearly, and did not report or properly account for significant small sample size bias. The first objective of the current study was to reanalyze the studies selected in each of the published meta-analyses, while taking into account small sample size bias. The second objective was to replicate each meta-analysis by extracting relevant effect sizes directly from the primary studies included in the meta-analyses. The present study revealed three key findings: (1) many of the primary studies used a small sample size; (2) small sample size bias was pronounced in many of the analyses; and (3) when small sample size bias was taken into account, the effect of PPIs on well-being were small but significant (approximately r = .10), whereas the effect of PPIs on depression were variable, dependent on outliers, and generally not statistically significant. Future PPI research needs to focus on increasing sample sizes. A future meta-analyses of this research needs to assess cumulative effects from a comprehensive collection of primary studies while being mindful of issues such as small sample size bias.",31141537,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.901236534118652,-4.293949604034424,A5wa
"'Third wave' cognitive therapy versus mentalization-based therapy for major depressive disorder. A protocol for a randomised clinical trial.

Most interventions for depression have shown small or no effects. 'Third wave' cognitive therapy and mentalization-based therapy have both gained some ground as treatments of psychological problems. No randomised trial has compared the effects of these two interventions for patients with major depression. We plan a randomised, parallel group, assessor-blinded superiority clinical trial. During two years we will include 84 consecutive adult participants diagnosed with major depressive disorder. The participants will be randomised to either 'third wave' cognitive therapy versus mentalization-based therapy. The primary outcome will be the Hamilton Rating Scale for Depression at cessation of treatment at 18 weeks. Secondary outcomes will be the proportion of patients with remission, Symptom Checklist 90 Revised, Beck's Depression Inventory, and The World Health Organisation-Five Well-being Index 1999. Interventions for depression have until now shown relatively small effects. Our trial results will provide knowledge about the effects of two modern psychotherapeutic interventions. ClinicalTrials: NCT01070134.",23253305,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.09608268737793,-2.6214964389801025,CkPR
"Behavioral activation: Is it the expectation or achievement, of mastery or pleasure that contributes to improvement in depression?

Behavioral activation (BA) is receiving renewed interest as a stand-alone or as a component of cognitive-behavior therapy (CBT) for depression. However, few studies have examined which aspects of BA are most contributory to its efficacy. This is a secondary analysis of a 9-week randomized controlled trial of smartphone CBT for patients with major depression. Depression severity was measured at baseline and at end of treatment by the Patient Health Questionnaire-9. All aspects of behavioral activation tasks that the participants had engaged in, including their expected mastery and pleasure and obtained mastery and pleasure, were recorded in the web server. We examined their contribution to improvement in depression as simple correlations and in stepwise multivariable linear regression. Among the 78 patients who completed at least one behavioral experiment, all aspects of expected or achieved mastery or pleasure correlated with change in depression severity. Discrepancy between the expectation and achievement, representing unexpected gain in mastery or pleasure, was not correlated. In stepwise regression, expected mastery and pleasure, especially the maximum level of the latter, emerged as the strongest contributing factors. The study is observational and cannot deduce cause-effect relationships. It may be the expected and continued sense of pleasure in planning activities that are most meaningful and rewarding to individuals, and not the simple level or amount of obtained pleasure, that contributes to the efficacy of BA.",29906719,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.692166328430176,-2.0147132873535156,BKUK
"Effectiveness of preventive cognitive therapy while tapering antidepressants versus maintenance antidepressant treatment versus their combination in prevention of depressive relapse or recurrence (DRD study): a three-group, multicentre, randomised controlled trial.

Keeping individuals on antidepressants after remission or recovery of major depressive disorder is a common strategy to prevent relapse or recurrence. Preventive cognitive therapy (PCT) has been proposed as an alternative to maintenance antidepressant treatment, but whether its addition would allow tapering of antidepressants or enhance the efficacy of maintenance antidepressant treatment is unclear. We aimed to compare the effectiveness of antidepressants alone, with PCT while tapering off antidepressants, or PCT added to antidepressants in the prevention of relapse and recurrence. In this single-blind, multicentre, parallel, three-group, randomised controlled trial, individuals recruited by general practitioners, pharmacists, secondary mental health care, or media were randomly assigned (10:10:8) to PCT and antidepressants, antidepressants alone, or PCT with tapering of antidepressants, using computer-generated randomised allocation stratified for number of previous depressive episodes and type of care. Eligible participants had previously experienced at least two depressive episodes and were in remission or recovery on antidepressants, which they had been receiving for at least the past 6 months. Exclusion criteria were current mania or hypomania, a history of bipolar disorder, any history of psychosis, current alcohol or drug abuse, an anxiety disorder that requires treatment, psychological treatment more than twice a month, and a diagnosis of organic brain damage. The primary outcome was time-related proportion of individuals with depressive relapse or recurrence in the intention-to-treat population, assessed four times in 24 months. Assessors were masked to treatment allocation, whereas physicians and participants could not be masked. This trial is registered with the Netherlands Trial Register, number NTR1907. Between July 14, 2009, and April 30, 2015, 2486 participants were assessed for eligibility and 289 were randomly assigned to PCT and antidepressant (n=104), antidepressant alone (n=100), or PCT with tapering of antidepressant (n=85). The overall log-rank test was significant (p=0·014). Antidepressants alone were not superior to PCT while tapering off antidepressants in terms of the risk of relapse or recurrence (hazard ratio [HR] 0·86, 95% CI 0·56-1·32; p=0·502). Adding PCT to antidepressant treatment resulted in a 41% relative risk reduction compared with antidepressants alone (0·59, 0·38-0·94; p=0·026). There were two suicide attempts (one in the antidepressants alone group and one in the PCT with tapering of antidepressants group) and one death (in the PCT and antidepressants group) not related to the interventions during the 24 months' follow-up. Maintenance antidepressant treatment is not superior to PCT after recovery, whereas adding PCT to antidepressant treatment after recovery is superior to antidepressants alone. PCT should be offered to recurrently depressed individuals on antidepressants and to individuals who wish to stop antidepressants after recovery. The Netherlands Organisation for Health Research and Development.",29625762,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.331415176391602,-0.8976427316665649,BNkw
"The superiority of antidepressant medication to cognitive behavior therapy in melancholic depressed patients: a 12-week single-blind randomized study.

To pursue the previously long-standing but formally untested clinical view that melancholia is preferentially responsive to antidepressant medication in comparison with psychotherapy [specifically Cognitive Behavior Therapy (CBT)]. Second, to determine whether a broader action antidepressant medication sequencing regimen is superior to a Selective Serotonin Reuptake Inhibitor (SSRI) alone. We sought to recruit a large sample of participants with melancholic depression for a 12-week trial but inclusion criteria compromised recruitment and testing the second hypothesis. The first hypothesis was evaluated by comparing 18 participants receiving antidepressant medication to 11 receiving CBT. Primary study measures were the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Endogenous Subscale (HES), rated blindly, while several secondary measures also evaluated outcome. Participants receiving medication had a superior 12-week outcome to those receiving CBT, with significant differences present on primary measures as early as 4 weeks. At trial conclusion, the percentage improvement in HAM-D scores was 61.1% vs. 34.4%, respectively [Number Needed to Treat (NNT) = 3.7] and with those in receipt of medication returning non-significantly higher HAM-D responder (66.6% vs. 36.4%, NNT = 2.8) and remission (66.7% vs. 45.4%, NNT = 4.7) rates. As the sample size was small and participants evidenced only moderate levels of depression severity, the study risked being underpowered and idiosyncratic. Despite the small sample, the superiority of antidepressant medication to CBT in those with a melancholic depression was distinctive in this pilot study.",23240706,Major Depressive Disorder,Anxiety Treatment,Mental Health,12330,10.614751815795898,-1.963238000869751,Ckc2
"Culturally attuned Internet treatment for depression amongst Chinese Australians: a randomised controlled trial.

Although depression can be treated effectively with Cognitive Behaviour Therapy (CBT), only a small percentage of Chinese Australians access evidence-based treatment due to practical and cultural barriers. The present study examined the efficacy and acceptability of an Internet delivered CBT (iCBT) program to treat Chinese Australians with depression. The Chinese depression iCBT program (the Brighten Your Mood Program) is a culturally adapted version of the clinically efficacious Sadness iCBT Program. Fifty-five Chinese Australians with depression were randomly allocated to either an immediate treatment group or to a waitlist control group. Treatment consisted of an 8 week program with 6 CBT online educational lessons, homework assignments, additional resources presented in Chinese and English, and weekly telephone support with Mandarin/Cantonese-speaking support personnel. An intention-to-treat model was used for data analyses. Seventeen of twenty-five (68%) treatment group participants completed all lessons within the timeframe. Compared to controls, treatment group participants reported significantly reduced symptoms of depression on the Chinese versions of the Beck Depression Inventory (CBDI) and Patient Health Questionnaire-9 item (CB-PHQ-9). The within- and between-group effect sizes (Cohen's d) were 1.41 and 0.93 on the CBDI, and 0.90 and 0.50 on the CB-PHQ-9, respectively. Participants rated the procedure as acceptable, and gains were sustained at three-month follow-up. The study included several subclinical participants and some measures that have not been previously validated with Chinese Australians. Results provide preliminary support for the efficacy and acceptability of an iCBT program at reducing symptoms of depression in Chinese Australians.",22177742,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.974736213684082,-3.717970609664917,Czpg
"Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression.

Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse. To compare rates of relapse in depressed patients in remission receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care. Patients who met remission criteria after 8 months of algorithm-informed antidepressant treatment were randomized to receive maintenance antidepressant medication, MBCT, or placebo and were followed up for 18 months. Outpatient clinics at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and St Joseph's Healthcare, Hamilton, Ontario. One hundred sixty patients aged 18 to 65 years meeting DSM-IV criteria for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to 1 of the 3 study conditions. Patients in remission discontinued their antidepressants and attended 8 weekly group sessions of MBCT, continued taking their therapeutic dose of antidepressant medication, or discontinued active medication and were switched to placebo. Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on module A of the Structured Clinical Interview for DSM-IV. Intention-to-treat analyses showed a significant interaction between the quality of acute-phase remission and subsequent prevention of relapse in randomized patients (P = .03). Among unstable remitters (1 or more Hamilton Rating Scale for Depression score >7 during remission), patients in both MBCT and maintenance treatment showed a 73% decrease in hazard compared with placebo (P = .03), whereas for stable remitters (all Hamilton Rating Scale for Depression scores ≤7 during remission) there were no group differences in survival. For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters.",21135325,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.752910614013672,-0.6859712600708008,DCjN
"Is behavioral activation an effective and acceptable treatment for co-occurring depression and substance use disorders? A meta-analysis of randomized controlled trials.

Depression often co-occurs with substance use problems and is associated with poor treatment outcomes. While the efficacy of behavioral activation (BA) has been tested in clinical trials with substance users, outcomes have not yet been quantitatively synthesized. The study team performed a random effects meta-analysis of the randomized clinical trial evidence base. We compared outcomes for individual or group BA against passive or active controls. We also compared attendance and dropout rates. The meta-analysis used a grading of recommendations assessment, development, and evaluation (GRADE) approach to assess the quality of each meta-analytic comparison. We included five trials in the meta-analysis (N = 195). The analysis found no significant differences between BA and controls with regard to depression (Post-treatment: k = 5; N = 195; SMD: 0.19, CI -0.10 to 0.49; p = 0.20; GRADE = Low; Follow-up: k = 5; N = 195; SMD: -0.10, CI -0.51 to -0.30; p = 0.62; GRADE = Low) or substance use (post-treatment: k = 4; N = 151; SMD: 0.14, CI -0.33 to -0.6; p = 0.57, GRADE = Low; Follow-up: k = 4; N = 151; SMD: 0.17, CI -0.34 to 0.69; p = 0.51, GRADE = Low) and there was little evidence of publication bias. The average session attendance rate for BA was 72%. An average dropout rate of 35% was reported for both BA and comparator conditions. BA does not emerge as a differentially efficacious treatment for comorbid depression and substance use disorders, although it does appear to be an acceptable treatment option. Our confidence in the results are limited by the number and quality of the original studies and the possibility of the effect of small study bias. We make suggestions for improving the methodological quality and direction of future BA trials.",34146994,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.219470977783203,-2.048637628555298,AUf7
"Long-term effectiveness of two models of brief psychotherapy for depression: A three-year follow-up randomized clinical trial.

Major depressive disorder (MDD) is a disease that severely impairs psychosocial functioning and decreases the subject's quality of life. Patients who received psychotherapy have a better long-term therapeutic response than those who have only been treated with antidepressants or have not been treated. There are few studies in the literature that follow the outcomes of psychotherapeutic treatments for depression for more than two years. The aim of this study is to compare the therapeutic response of two models of brief psychotherapy for MDD treatment (Cognitive Behavioral Therapy and Short-term Psychodynamic Psychotherapy) with naturalistic controls who received treatment as usual in a three-year follow-up. This is a sample of 75 outpatients, mostly women (82.7%), with a median age of 33 (27-44). The interventions took place in 50-minute sessions once a week for 14 to 16 weeks. Outcomes were assessed at baseline and three years after the intervention. Regarding depressive symptoms, the therapeutic response was maintained three years after the conclusion of the brief models of psychotherapy. Functional capacity long-term maintenance depended not only on the intervention but also on the education level, the work situation and the severity of depressive symptoms at the beginning of the treatment.",32001003,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.501764297485352,-2.7773098945617676,AuIz
"[The psychotherapy of depressions].

The author outlines the development of views concerning depression, and delineates the evolution of the cognitive approach. The issue of cognitive approach in the Hungarian literature is shortly presented. The author states on the basis of the literature, that the monistic view of depressions is not sustainable any more. The generally accepted conceptions of cognitive therapies are summarised. He also reviews the most important other psychotherapeutic approaches in the treatment of depressions. Some important comparative studies on the basis of a dual approach are presented showing the newest trends of research. The author points out the market mechanisms behind the proliferation of new psychotherapeutic ""methods"". The importance of depressions in public health is underlined. The use of modern telecommunication techniques in psychotherapy is briefly demonstrated.",21502667,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.335165977478027,-2.113536834716797,C9RS
"Combination of pharmacotherapy and psychotherapy in the treatment of chronic depression: a systematic review and meta-analysis.

Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences. This review examined whether the combination of pharmacological treatments and psychotherapy is associated with higher effectiveness than pharmacotherapy alone via meta-analysis; and identified possible treatment effect modifiers via meta-regression-analysis. A systematic search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, ISI Web of Science, BIOSIS, PsycINFO, and CINAHL. Primary efficacy outcome was a response to treatment; primary acceptance outcome was dropping out of the study. Only randomized controlled trials were considered. We identified 8 studies with a total of 9 relevant comparisons. Our analysis revealed small, but statistically not significant effects of combined therapies on outcomes directly related to depression (BR = 1.20) with substantial heterogeneity between studies (I² = 67%). Three treatment effect modifiers were identified: target disorders, the type of psychotherapy and the type of pharmacotherapy. Small but statistically significant effects of combined therapies on quality of life (SMD = 0.18) were revealed. No differences in acceptance rates and the long-term effects between combined treatments and pure pharmacological interventions were observed. This systematic review could not provide clear evidence for the combination of pharmacotherapy and psychotherapy. However, due to the small amount of primary studies further research is needed for a conclusive decision.",22694751,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.149649620056152,-1.5744493007659912,CsQP
"Effectiveness of Web- and Mobile-Based Treatment of Subthreshold Depression With Adherence-Focused Guidance: A Single-Blind Randomized Controlled Trial.

Evidence for the impact of psychological Interventions for subthreshold depression (sD) is conflicting. Moreover, human resources to deliver such treatments are limited. This study aimed to evaluate the effectiveness of a web-based intervention with adherence-focused guidance in the treatment of sD. Participants with sD (CES-D≥ 16, no Major Depressive Disorder according to DSM-IV criteria, N = 204) recruited via a large health insurance were randomly allocated to a web-based mobile-supported cognitive-behavioral intervention or to a waitlist control condition with unrestricted access to usual care. The primary outcome was the reduction in depressive symptom severity as measured by blind diagnostic raters using the Quick Inventory of Depressive Symptomatology (QIDS) at posttreatment. There was a statistically significant between-group difference in QIDS scores at posttreatment in favor of the intervention group, F(1, 201) = 11.31, p = .001, corresponding to a medium effect size of d = 0.37 (95% CI 0.09-0.64) and a NNT of 7 (95%-CI 3.7-41.2). Significant effects in favour of the intervention group were also found for secondary outcomes such as quality of life, anxiety, and insomnia severity. Web-based self-help interventions with adherence-focused guidance could be an acceptable and effective approach to reduce a range of negative consequences associated with subclinical depression.",29405923,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.144375801086426,-3.065185308456421,BQis
"Time trends in the effects of mindfulness-based cognitive therapy for depression: A meta-analysis.

Recent studies suggest that the effects of cognitive therapies for depression show systematic changes over time. A meta-analysis was conducted to explore the temporal development of the effect of mindfulness-based cognitive therapy (MBCT) for current depression in studies that used the Beck Depression Inventory (BDI) or the Hamilton Depression Rating Scale (HDRS) as outcome measures. A systematic search of research databases yielded 20 studies that were included in the analyses. The results showed that MBCT is effective in reducing depressive symptoms. The effect sizes of studies using the BDI or the HDRS as an outcome measure were not moderated by the time of publication. Funnel plots and the trim and fill method suggested that publication bias was low. However, the number of available studies was small, and the time period investigated relatively short. The results should therefore be considered preliminary.",32319124,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.76681900024414,-0.732877254486084,AqQK
"Pilot study of treatment for major depression among women prisoners with substance use disorder.

This study, the largest randomized controlled trial of treatment for major depressive disorder (MDD) in an incarcerated population to date, wave-randomized 38 incarcerated women (6 waves) with MDD who were attending prison substance use treatment to adjunctive group interpersonal psychotherapy (IPT) for MDD or to an attention-matched control condition. Intent-to-treat analyses found that IPT participants had significantly lower depressive symptoms at the end of 8 weeks of in-prison treatment than did control participants. Control participants improved later, after prison release. IPT's rapid effect on MDD within prison may reduce serious in-prison consequences of MDD.",22694906,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.561880111694336,-3.5659751892089844,CsP+
"Combining baseline characteristics to disentangle response differences to disorder-specific versus supportive psychotherapy in patients with persistent depressive disorder.

Does the pre-treatment profile of individuals with persistent depressive disorder (PDD) moderate their benefit from disorder-specific Cognitive Behavioral System of Psychotherapy (CBASP) versus supportive psychotherapy (SP)? We investigated this question by analyzing data from a multi-center randomized clinical trial comparing the effectiveness of 48 weeks of CBASP to SP in n = 237 patients with early-onset PDD who were not taking antidepressant medication. We statistically developed an optimal composite moderator as a weighted combination of 13 preselected baseline variables and used it for identifying and characterizing subgroups for which CABSP may be preferable to SP or vice versa. We identified two distinct subgroups: 58.65% of the patients had a better treatment outcome with CBASP, while the remaining 41.35% had a better outcome with SP. At baseline, patients responding more favorably to CBASP were more severely depressed and more likely affected by moderate-to-severe childhood trauma including early emotional, physical, or sexual abuse, as well as emotional or physical neglect. In contrast, patients responding more favorably to SP had a higher pre-treatment global and social functioning level, a higher life quality and more often a recurrent illness pattern without complete remission between the episodes. These findings emphasize the relevance of considering pre-treatment characteristics when selecting between disorder-specific CBASP and SP for treating PDD. The practical implementation of this approach would advance personalized medicine for PDD by supporting mental health practitioners in their selection of the most effective psychotherapy for an individual patient.",31734568,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.387533187866211,-2.4062068462371826,Axu3
"The effects of cognitive therapy versus 'no intervention' for major depressive disorder.

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy may be an effective treatment option for major depressive disorder, but the effects have only had limited assessment in systematic reviews. We used The Cochrane systematic review methodology with meta-analyses and trial sequential analyses of randomized trials comparing the effects of cognitive therapy versus 'no intervention' for major depressive disorder. Participants had to be older than 17 years with a primary diagnosis of major depressive disorder to be eligible. Altogether, we included 12 trials randomizing a total of 669 participants. All 12 trials had high risk of bias. Meta-analysis on the Hamilton Rating Scale for Depression showed that cognitive therapy significantly reduced depressive symptoms (four trials; mean difference -3.05 (95% confidence interval (Cl), -5.23 to -0.87; P<0.006)) compared with 'no intervention'. Trial sequential analysis could not confirm this result. Meta-analysis on the Beck Depression Inventory showed that cognitive therapy significantly reduced depressive symptoms (eight trials; mean difference on -4.86 (95% CI -6.44 to -3.28; P = 0.00001)). Trial sequential analysis on these data confirmed the result. Only a few trials reported on 'no remission', suicide inclination, suicide attempts, suicides, and adverse events without significant differences between the compared intervention groups. Cognitive therapy might be an effective treatment for depression measured on Hamilton Rating Scale for Depression and Beck Depression Inventory, but these outcomes may be overestimated due to risks of systematic errors (bias) and random errors (play of chance). Furthermore, the effects of cognitive therapy on no remission, suicidality, adverse events, and quality of life are unclear. There is a need for randomized trials with low risk of bias, low risk of random errors, and longer follow-up assessing both benefits and harms with clinically relevant outcome measures.",22174786,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.961981773376465,-2.4646918773651123,CzsM
"Preventing relapse in recurrent depression using mindfulness-based cognitive therapy, antidepressant medication or the combination: trial design and protocol of the MOMENT study.

Depression is a common psychiatric disorder characterized by a high rate of relapse and recurrence. The most commonly used strategy to prevent relapse/recurrence is maintenance treatment with antidepressant medication (mADM). Recently, it has been shown that Mindfulness-Based Cognitive Therapy (MBCT) is at least as effective as mADM in reducing the relapse/recurrence risk. However, it is not yet known whether combination treatment of MBCT and mADM is more effective than either of these treatments alone. Given the fact that most patients have a preference for either mADM or for MBCT, the aim of the present study is to answer the following questions. First, what is the effectiveness of MBCT in addition to mADM? Second, how large is the risk of relapse/recurrence in patients withdrawing from mADM after participating in MBCT, compared to those who continue to use mADM after MBCT? Two parallel-group, multi-center randomized controlled trials are conducted. Adult patients with a history of depression (3 or more episodes), currently either in full or partial remission and currently treated with mADM (6months or longer) are recruited. In the first trial, we compare mADM on its own with mADM plus MBCT. In the second trial, we compare MBCT on its own, including tapering of mADM, with mADM plus MBCT. Follow-up assessments are administered at 3-month intervals for 15months. Primary outcome is relapse/recurrence. Secondary outcomes are time to, duration and severity of relapse/recurrence, quality of life, personality, several process variables, and incremental cost-effectiveness ratio. Taking into account patient preferences, this study will provide information about a) the clinical and cost-effectiveness of mADM only compared with mADM plus MBCT, in patients with a preference for mADM, and b) the clinical and cost-effectiveness of withdrawing from mADM after MBCT, compared with mADM plus MBCT, in patients with a preference for MBCT. ClinicalTrials.gov: NCT00928980.",22925198,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.111790657043457,-0.6761062741279602,CpC4
"Effectiveness of Short-Term Dynamic Group Psychotherapy in Primary Care for Patients with Depressive Symptoms.

An open prospective controlled study was designed to compare the efficacy of short-term dynamic group psychotherapy with the standard treatment in patients with depressive symptoms attended in the primary care setting. A total of 115 patients with depressive symptoms were assigned to receive psychotherapy (75min) over 9months (37 to 39 sessions) (n=70) or the standard care (n=45). Outcome measures were the differences between baseline and post-treatment in the 17-item Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A) and the Short-Form Health Survey (SF-12) questionnaire in the two study groups. At the end of dynamic group psychotherapy, statistically significant improvements in the mean scores of all questionnaires were observed, whereas in control patients, significant improvements were only observed in the HDRS-17 scale and in the Mental Component Summary score of the SF-12. The mean changes after treatment were also higher in the psychotherapy group than in controls in all outcome measures, with statistically significant differences in the mean differences in favour of the psychotherapy group. In summary, implementation of short-term dynamic group psychotherapy run by experienced psychotherapists for patients with depressive symptoms attended in routine primary care centres is feasible and effective. © 2016 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd. Short-term dynamic group psychotherapy was delivered as a non-pharmacological intervention to improve depressive symptoms. Statistically significant differences as compared with a control group were observed in 17-item Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A) and the Short-Form Health Survey (SF-12) questionnaire. Implementation of short-term dynamic group psychotherapy run by experienced psychotherapists for patients with depressive symptoms attended in routine primary care centres is feasible and effective.",27456221,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.660919189453125,-3.6511075496673584,Bpef
"Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: study protocol for a randomized controlled trial.

There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. Our study determines the efficacy of a manualized short-term psychodynamic psychotherapy and predictors of outcome by personality and quality of the therapeutic relationship. Eligible breast cancer patients with comorbid depression are assigned to short-term psychodynamic psychotherapy (up to 20+5 sessions) or to treatment as usual (augmented by recommendation for counseling center and physician information). We plan to recruit a total of 180 patients (90 per arm) in two centers. Assessments are conducted pretreatment, after 6 (treatment termination) and 12 months (follow-up). The primary outcome measures are reduction of the depression score in the Hospital Anxiety and Depression Scale and remission of depression as assessed by means of the Structured Clinical Interview for DSM IV Disorders by independent, blinded assessors at treatment termination. Secondary outcomes refer to quality of life. We investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment. ISRCTN96793588.",23217093,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.891106605529785,-3.851576089859009,Ck0A
"Cognitive restructuring, behavioral activation and cognitive-behavioral therapy in the treatment of adult depression: A network meta-analysis.

To examine if cognitive restructuring (CR), behavioral activation (BA), and cognitive-behavioral therapy (CBT) result in differential effects in the treatment of adult depression. We extracted randomized controlled trials (RCTs) from a database updated yearly from PubMed, PsycINFO, Embase, and Cochrane Library. Network and pairwise meta-analyses were conducted to investigate the effects of CR, BA, and CBT delivered in a face-to-face individual format, compared with waiting list (WL) and care-as-usual (CAU), on adult depression. The primary outcome was a standardized mean difference (SMD) in posttreatment depression severity. Tolerability of treatments and depression severity at follow-up were also assessed. A total of 45 studies with 3,382 participants were included. There was no evidence of a difference in effectiveness between CR, BA, and CBT. All three interventions were superior to CAU; SMD 0.57, 95% confidence interval [CI 0.08-1.07]; 0.52 [0.34-0.71]; 0.44 [0.28-0.60], respectively and WL 1.20 [0.69-1.70]; 1.15 [0.90-1.40]; 1.07 [0.87-1.26]. No difference in tolerability was found (risk ratio [RR] vs. CAU: 1.01 [0.04-22.81], 0.84 [0.63-1.11], and 0.96 [0.76-1.21], respectively). Metaregression and sensitivity analyses did not produce material differences. Results suggest that CR or BA alone and their combination (CBT) may be effective interventions in comparison to WL and CAU in the treatment of adult depression. There was no evidence suggesting differences in effectiveness among the three treatments. More research is needed to derive conclusions about the performance of CR. (PsycInfo Database Record (c) 2021 APA, all rights reserved).",34264703,Major Depressive Disorder,Anxiety Treatment,Mental Health,3392,10.696610450744629,-2.3814191818237305,ATNY
"Role of autobiographical memory in patient response to cognitive behavioural therapies for depression: protocol of an individual patient data meta-analysis.

Cognitive behavioural therapies (CBTs) are one of the most effective treatments for major depression. However, ~50% of individuals do not adequately respond to intervention and of those who do remit from a depressive episode, over 50% will experience later relapse. Identification of patient-level factors which moderate treatment response may ultimately help to identify cognitive barriers that could be targeted to improve treatment efficacy. This individual patient data meta-analysis explores one such potential moderator-the ability to retrieve specific, detailed memories of the autobiographical past-as cognitive-based therapeutic techniques draw heavily on the ability to use specific autobiographical information to challenge the dysfunctional beliefs which drive depression. We have formed a collaborative network which will contribute known datasets. This will be supplemented by datasets identified through literature searches in Medline, PsycInfo, Web of Science, the Cochrane Central Register of Controlled Trials and WHO trials database between December 2018 and February 2019. Inclusion criteria are delivery of a cognitive or cognitive behavioural therapy for major depression, and measurement of autobiographical memory retrieval at preintervention. Primary outcomes are depressive symptoms and clinician-rated diagnostic status at postintervention, along with autobiographical memory specificity at postintervention. Secondary outcomes will consider each of these variables at follow-up. All analyses will be completed using random-effects models employing restricted maximum likelihood estimation. Risk of bias in included studies will be measured using the Revised Cochrane Risk of Bias Tool. The findings will be published in a peer-reviewed journal. Study results will contribute to better understanding of the role of autobiographical memory in patient response to CBTs, and may help to inform personalised medicine approaches to treatment of depression. CRD42018109673.",31196907,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,11.947338104248047,-0.9437167644500732,A5BQ
"Cognitive conflict resolution during psychotherapy: Its impact on depressive symptoms and psychological distress.

The aim of this study was to assess the resolution of cognitive conflicts (CCs) within a randomized controlled trial testing the differential efficacy of group cognitive behavioral therapy (CBT) plus an individually tailored intervention module focused on CCs vs. group plus individual CBT, and to determine whether CC resolution was related to improvement in symptoms and psychological distress. The data come from 104 adults meeting criteria for major depressive disorder and/or dysthymia. Change in scores on the Beck Depression Inventory-II and Clinical Outcomes in Routine Evaluation-Outcome Measure was assessed at the end of treatment and at three-month follow-up. Outcomes were compared between those participants who resolved their CCs and those who maintained them using three-level multilevel growth models. CC resolution did not depend on treatment allocation. Participants who resolved their CCs acquired greater benefits with regards to reduction of depressive symptoms and psychological distress than those who maintained their conflicts. CC seems to be a relevant notion to take into consideration to understand symptom improvement. Further research on CC might lead to the advancement of treatments which involve conflict resolution as a change mechanism.",29173128,Major Depressive Disorder,Anxiety Treatment,Mental Health,26910,11.760266304016113,-2.386143684387207,BTp6
"The self-management of longer-term depression: learning from the patient, a qualitative study.

Depression is a common mental health condition now viewed as chronic or long-term. More than 50 % of people will have at least one further episode of depression after their first, and therefore it requires long-term management. However, little is known about the effectiveness of self-management in depression, in particular from the patients' perspective. This study aimed to understand how people with longer-term depression manage the condition, how services can best support self-management and whether the principles and concepts of the recovery approach would be advantageous. Semi-structured in depth interviews were carried out with 21 participants, recruited from a range of sources using maximum variation sampling. Interpretative Phenomenological Analysis was used by a diverse team comprised of service users, practitioners and academics. Four super-ordinate themes were found: experience of depression, the self, the wider environment, self-management strategies. Within these, several prominent sub-themes emerged of importance to the participants. These included how aspects of themselves such as hope, confidence and motivation could be powerful agents; and how engaging in a wide range of chosen activities could contribute to their emotional, mental, physical, social, spiritual and creative wellbeing. Services in general were not perceived to be useful in specifically facilitating self-management. Increased choice and control were needed and a greater emphasis on an individualised holistic model. Improved information was needed about how to develop strategies and locate resources, especially during the first episode of depression. These concepts echoed those of the recovery approach, which could therefore be seen as valuable in aiding the self-management of depression.",26205099,Major Depressive Disorder,Anxiety Treatment,Mental Health,8293,9.991888046264648,-2.9530534744262695,B6fC
"A randomized controlled trial comparing two cognitive-behavioral programs for adolescent girls with subclinical depression: A school-based program (Op Volle Kracht) and a computerized program (SPARX).

Limited research has indicated the effectiveness of the school-based Cognitive Behavioral Therapy (CBT) prevention program 'Op Volle Kracht (OVK)' and the computerized CBT program 'SPARX' in decreasing depressive symptoms. Therefore, a randomized controlled trial of the effectiveness of OVK and SPARX was conducted among Dutch female adolescents (n = 208, mean age = 13.35) with elevated depressive symptoms. Participants were randomly assigned to one of four conditions: OVK only (n = 50), SPARX only (n = 51), OVK and SPARX combined (n = 56) and a monitoring control condition (n = 51). Participants in the first three conditions received OVK lessons and/or the SPARX game. Depressive symptoms were assessed before interventions started, weekly during the interventions, and immediately after the interventions ended, with follow-up assessments at 3, 6 and 12 months. Intention to treat results showed that depressive symptoms decreased in all conditions (F(12, 1853.03) = 14.62, p < .001), with no difference in depressive symptoms between conditions. Thus, all conditions, including the monitoring control condition, were equally effective in reducing depressive symptoms. Possible explanations for the decrease of depressive symptoms in all conditions are discussed and suggestions for future research are provided. Dutch Trial Register: NTR3737.",27019280,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.676752090454102,-3.8020925521850586,BvFX
"Can non-pharmacological interventions prevent relapse in adults who have recovered from depression? A systematic review and meta-analysis of randomised controlled trials.

To identify studies of non-pharmacological interventions provided following recovery from depression, and to evaluate their efficacy in preventing further episodes. We identified relevant randomised controlled trials from searching MEDLINE, Embase, PsycINFO, CENTRAL, and ProQuest, searching reference and citation lists, and contacting study authors. We conducted a meta-analysis of relapse outcomes. There were 29 eligible trials. 27 two-way comparisons including 2742 participants were included in the primary analysis. At 12months cognitive-behavioural therapy (CBT), mindfulness-based cognitive therapy (MBCT), and interpersonal psychotherapy (IPT) were associated with a 22% reduction in relapse compared with controls (95% CI 15% to 29%). The effect was maintained at 24months for CBT, but not for IPT despite ongoing sessions. There were no 24-month MBCT data. A key area of heterogeneity differentiating these groups was prior acute treatment. Other psychological therapies and service-level programmes varied in efficacy. Psychological interventions may prolong the recovery a person has achieved through use of medication or acute psychological therapy. Although there was evidence that MBCT is effective, it was largely tested following medication, so its efficacy following psychological interventions is less clear. IPT was only tested following acute IPT. Further exploration of sequencing of interventions is needed. PROSPERO 2011:CRD42011001646.",25939032,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.170852661132812,-0.8094933032989502,B+Kt
"Problem-solving therapy for adult depression: An updated meta-analysis.

Problem-solving therapy (PST) is one of the best examined types of psychotherapy for adult depression. No recent meta-analysis has examined the effects of PST compared to control groups or to other treatments. We wanted to verify whether PST is effective, whether effects are comparable to those of other treatments, and whether we could identify the possible sources of high heterogeneity that was found in earlier meta-analyses. We conducted systematic searches in bibliographical databases, including PubMed, PsycInfo, Embase and the Cochrane database of randomized trials. We included 30 randomized controlled trials on PST (with 3530 patients), in which PST was compared to control conditions, with other therapies, and with pharmacotherapy. We could compare these 30 trials on PST also with 259 trials on other psychotherapies for adult depression. The effect size of PST versus control groups was g=0.79 (0.57-1.01) with very high heterogeneity (I2=84; 95% CI: 77-88). The effect size from the 9 studies with low risk of bias was g=0.34 (95% CI: 0.22-0.46) with low heterogeneity (I2=32; 95% CI: 0-68), which is comparable to the effects of other psychotherapies. PST was a little more effective than other therapies in direct comparisons, but that may be explained by the considerable number of studies with researcher allegiance towards PST. In meta-regression analyses of all controlled studies, no significant difference between PST and other therapies was found. PST is probably an effective treatment for depression, with effect sizes that are small, but comparable to those found for other psychological treatments of depression.",29331596,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.430961608886719,-2.3984568119049072,BRhR
"Comprehensive self-control training benefits depressed college students: A six-month randomized controlled intervention trial.

Depressive disorder was associated with dysfunctional self-regulation. The current study attempted to design and test a comprehensive self-control training (CSCT) program with an overall emphasis on behaviral activation in depressed Chinese college students. Participants included 74 students who had diagnosed with major depression, they were randomly assigned to one of the two groups: intervention group (n=37), and control group (n=37). The intervention participants received an eight-week CSCT and four-month follow-up consolidation program, as compared to the control group who received only pre-post-and-follow-up measurements. All participants measured Beck Depression Inventory (BDI-Ⅱ) and Self-control Scale (SCS) at three time points: baseline, post-training, and four-month follow-up. The dropout rates were 6 (8.1%) in the intervention group and 3 (4.1%) in the control group at the end of six-month intervention. The general linear model repeated measures analysis of variance revealed that comparing with the control group, the intervention group participants had more increase in their trait self-control score, at the meantime, their depressive symptoms had significantly improved. Univariate and logistic regression analyses revealed that participants with milder baseline depressive symptoms were more likely to benefit from CSCT interventions; depression improvement was also associated with the number of sessions attended. The main limitation was related to the small sample size which consisted of college students who were relatively young and well educated. The current study demonstrates that CSCT program could temporarily enhance self-control capacity as well as improve depressive symptoms; participants who are mildly to moderately depressed, and who could adhere to the training protocol are more likely to benefit from the intervention.",29017069,Major Depressive Disorder,Anxiety Treatment,Mental Health,13624,11.229249954223633,-3.15040922164917,BVz6
"Coach-Facilitated Web-Based Therapy Compared With Information About Web-Based Resources in Patients Referred to Secondary Mental Health Care for Depression: Randomized Controlled Trial.

Depression is a common mental disorder with a high social burden and significant impact on suicidality and quality of life. Treatment is often limited to drug therapies because of long waiting times to see psychological therapists face to face, despite several guidelines recommending that psychological treatments should be first-line interventions for mild to moderate depression. We aimed to evaluate, among patients on a waitlist to receive secondary mental health care services for depression, how effective coach-guided web-based therapy (The Journal) is, compared with an information-only waitlist control group, in reducing depression symptoms after 12 weeks. We conducted a randomized controlled trial with 2 parallel arms and a process evaluation, which included interviews with study participants. Participants assigned to the intervention group received 12 weeks of web-based therapy guided by a coach who had a background in social work. Patients in the control group receive a leaflet of mental health resources they could access. The primary outcome measure was a change in depression scores, as measured by the Patient-Health Questionnaire (PHQ-9). A total of 95 participants were enrolled (intervention, n=47; control, n=48). The mean change in PHQ-9 scores from baseline to week 12 was -3.6 (SD 6.6) in the intervention group and -3.1 (SD 6.2) in the control group, which was not a statistically significant difference with a two-sided alpha of .05 (t91=-0.37; P=.72, 95% CI -3.1 to 2.2). At 12 weeks, participants in the intervention group reported higher health-related quality of life (mean EuroQol 5 dimensions visual analogue scale [EQ-5D-VAS] score 66.8, SD 18.0) compared with the control group (mean EQ-5D VAS score 55.9, SD 19.2; t84=-2.73; P=.01). There were no statistically significant differences between the two groups in health service use following their initial consultation with a psychiatrist. The process evaluation showed that participants in the intervention group completed a mean of 5.0 (SD 2.3) lessons in The Journal and 8.8 (SD 3.1) sessions with the coach. Most participants (29/47, 62%) in the intervention group who completed the full dose of the intervention, by finishing 6 or more lessons in The Journal, were more likely to have a clinically important reduction in depressive symptoms at 12 weeks compared with the control group (Χ21=6.3; P=.01, Φ=0.37). Participants who completed the interviews reported that the role played by the coach was a major factor in adherence to the study intervention. The results demonstrate that the use of guided web-based therapy for the treatment of depression is not more effective than information-only waitlist control. However, it showed that the coach has the potential to increase adherence and engagement with web-based depression treatment protocols. Further research is needed on what makes the coach effective. ClinicalTrials.gov: NCT02423733; https://clinicaltrials.gov/ct2/show/NCT02423733.",32515740,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.158637046813965,-3.27215313911438,Antx
"Psychotherapy for major depressive disorder in Latinos.

Latino patients often prefer psychotherapy to pharmacotherapy for the treatment of depression. Psychotherapies, such as cognitive-behavioral therapy and interpersonal therapy, have been found to be effective treatments for patients with depression, particularly for Latino patients. Clinicians should be respectful of the core values of family, respect, identity, and spirituality in Latino cultures and should modify psychotherapies accordingly.",20492848,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.585593223571777,-5.8533501625061035,DKJh
"Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial.

Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach. The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD. A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL. Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations. This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.",31769377,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.96039867401123,-1.9490141868591309,AxPl
"Concentrated transdiagnostic and cross-disciplinary group treatment for patients with depression and with anxiety: a pilot study.

A number of treatment approaches have shown efficacy for depression and/or anxiety, yet there is a paucity of research on potentially cost-effective concentrated approaches. Based on our previous experience with concentrated treatment in disorders such as Obsessive-Compulsive Disorder and chronic fatigue, we proposed that this novel approach could be useful for other conditions, including depression and/or anxiety. As a pre-requisite for a future randomized controlled trial, the aim of this study was to investigate the acceptability, satisfaction and effectiveness of a transdiagnostic, interdisciplinary group treatment delivered during 5 consecutive days to groups of 6-10 patients with depression and/or anxiety. This was a non-randomized clinical intervention pilot study in line with a published protocol. Forty-two consecutively referred patients, aged 19-47 (mean age 31.7, SD=8.12) were included and completed treatment. All had a severity of their problems that entitled them to care in the specialist public mental health care. Self-reported age when the symptoms became a problem was 20.9 years. Mean number of prior treatment courses was 2.77 (SD=2.19; range 0-8). Acceptability was defined as the proportion of eligible patients who accepted and completed the treatment. Satisfaction was evaluated by Client Satisfaction Questionnaire-8. Secondary objectives were to assess the treatment effectiveness by questionnaires at pre-treatment, seven days post-treatment and three months follow-up. The treatment was highly acceptable (91.3% accepted, all completed), and patients were highly satisfied with the treatment, including the amount. Functional impairment, as measured by Work and Social Adjustment Scale (WSAS) improved significantly (p<.0005) from ""severe"" (mean 25.4 SD=6.59) to ""less severe"" (mean 13.37, SD=9.43) at 3 months follow-up. Using the Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), the effect sizes at 3 months follow-up were 1.21 for anxiety and 1.3 for depression. More than 80% reported reduced utilization of mental health care, and 67% had not used, or had used the family doctor less, for anxiety or depression. 52% had not used, or had reduced, medication for their disorder. The concentrated, interdisciplinary treatment approach yielded promising results. Long-term follow up is warranted. This study is registered in Clinical Trials, identifier NCT05234281 and approval date 09/02/2022.",36058925,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,11.05268669128418,-2.847653865814209,I3I
"Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials.

Evidence on effects of Internet-based interventions to treat subthreshold depression (sD) and prevent the onset of major depression (MDD) is inconsistent. We conducted an individual participant data meta-analysis to determine differences between intervention and control groups (IG, CG) in depressive symptom severity (DSS), treatment response, close to symptom-free status, symptom deterioration and MDD onset as well as moderators of intervention outcomes. Randomized controlled trials were identified through systematic searches via PubMed, PsycINFO, Embase and Cochrane Library. Multilevel regression analyses were used to examine efficacy and moderators. Seven trials (2,186 participants) were included. The IG was superior in DSS at all measurement points (posttreatment: 6-12 weeks; Hedges' g = 0.39 [95% CI: 0.25-0.53]; follow-up 1: 3-6 months; g = 0.30 [95% CI: 0.15-0.45]; follow-up 2: 12 months, g = 0.27 [95% CI: 0.07-0.47], compared with the CG. Significantly more participants in the IG than in the CG reached response and close to symptom-free status at all measurement points. A significant difference in symptom deterioration between the groups was found at the posttreatment assessment and follow-up 2. Incidence rates for MDD onset within 12 months were lower in the IG (19%) than in the CG (26%). Higher initial DSS and older age were identified as moderators of intervention effect on DSS. Our findings provide evidence for Internet-based interventions to be a suitable low-threshold intervention to treat individuals with sD and to reduce the incidence of MDD. This might be particularly true for older people with a substantial symptom burden.",32544912,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.32231330871582,-2.833946943283081,AnVG
"Impact of spiritual healing on moderate depression in adults: a study protocol of a pilot randomised controlled trial (RCT).

Depression is a common mental disorder and the (global) leading cause of all non-fatal burden of disease worldwide. Currently, supported treatment for depression is antidepressant medication and different psychotherapeutic interventions. Many patients experience, however, adverse effects of antidepressant medication, while at the same time the access to psychotherapeutic interventions are limited. Many patients who suffer from depression turn to complementary medicine and among those modalities often spiritual healing. There is some evidence that consulting a spiritual healer can be beneficial for patients who suffer from depression, and that spiritual healing is associated with low risk. The aim of this protocol is to conduct a pilot randomised controlled trial (RCT) (spiritual healing as addition to usual care vs usual care alone) in preparation of a larger trial in adults with moderate depression, to examine feasibility and individuals' experience of spiritual healing. This study is a pilot RCT with two parallel groups. A total of 28 adult patients with moderate depression, diagnosed by the physician and according to the Montgomery and Åsberg Depression Rating Scale criteria will be randomised to spiritual healing in addition to usual care (n=14) or usual care alone (n=14). To determine if there is a statistical indication of an effect of healing warranting a full-scale study; the separation test will be used. To investigate participants' experience with spiritual healing, a qualitative study will be included using semistructured interviews. The data will be analysed based on a direct content analysis. This protocol was approved by regional committees for medical and health research ethics by the identifier (63692). The results will be disseminated through open-access, peer-reviewed publications, in addition to stakeholders' reporting and presenting at conferences. Norwegian Centre for Research Data (845302) and clinicaltrials.gov (ID: NCT04766242).",36109024,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,11.185498237609863,-3.8897616863250732,Hck
"Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: a randomized controlled trial.

In order to reduce the high prevalence of depression, early interventions for people at risk of depression are warranted. This study evaluated the effectiveness of an early guided self-help programme based on acceptance and commitment therapy (ACT) for reducing depressive symptomatology. Participants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the self-help programme with extensive email support (n=125), the self-help programme with minimal email support (n=125) or to a waiting list control group (n=126). Participants completed measures before and after the intervention to assess depression, anxiety, fatigue, experiential avoidance, positive mental health and mindfulness. Participants in the experimental conditions also completed these measures at a 3-month follow-up. In the experimental conditions significant reductions in depression, anxiety, fatigue, experiential avoidance and improvements in positive mental health and mindfulness were found, compared with the waiting list condition (effect sizes Cohen's d=0.51-1.00). These effects were sustained at the 3-month follow-up. There were no significant differences between the experimental conditions on the outcome measures. The ACT-based self-help programme with minimal email support is effective for people with mild to moderate depressive symptomatology.",21740624,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.908216953277588,-1.7384778261184692,C6Co
"Long-term effect of combined interpersonal psychotherapy and pharmacotherapy in a randomized trial of depressed patients.

Evaluation of the long-term benefits of combined pharmacological and psychotherapeutic depression treatment and the differential impact of early childhood trauma. A randomized trial was conducted in 124 in-patients with a diagnosis of major depressive disorder comparing 5 weeks of interpersonal psychotherapy plus pharmacotherapy (IPT) with medication plus clinical management (CM). The study included a prospective, naturalistic follow-up 3, 12 and 75 months after in-patient treatment. The Hamilton Rating Scale for Depression (HRSD) served as the primary outcome measure. Patients in both treatments reduced their depressive symptoms between baseline and 5-year follow-up significantly with a faster decrease early in the follow-up phase. The time rate of change and acceleration on the HRSD was higher for patients in the combination therapy group. The contrast between the conditions at year 5 was non-significant. However, 28% of the IPT patients showed a sustained remission compared with 11% of the CM patients (P = 0.032). Early adversity was found to be a moderator of the relationship between treatment and outcome. In the long-term, a combination of psycho- and pharmacotherapy was superior in terms of sustained remission rates to standard psychiatric treatment. Early trauma should be assessed routinely in depressed patients.",21231926,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.055848121643066,-2.5054843425750732,DBO5
"Brief behavioral activation intervention for depressive symptoms: Patient satisfaction, acceptability, engagement, and treatment response.

Depressive symptoms are the most common reason for referral to integrated behavioral health providers in primary care. Although evidence-based brief psychotherapies for depression in primary care exist, treatment duration is a significant barrier to implementation. In this open trial, we examined the patient experience of receiving a brief behavioral activation intervention designed for use in primary care (BA-PC), which comprised 2 30-min appointments and 2 boosters spaced 2-3 weeks apart across 12 weeks, and its impact on depression symptoms. Participants were 22 patients recruited from primary care who reported at least moderate depressive symptoms (score ≥ 10 on the Patient Health Questionnaire-9 [PHQ-9]). Patient experiences were examined through assessing patient engagement, satisfaction, acceptability, and treatment response. Fidelity of intervention delivery in delivering the BA-PC within a 12-week period was also assessed. Participants reported a high level of satisfaction with and acceptability of the BA-PC intervention, materials, and format. Within-subject t tests revealed a significant reduction in depressive symptoms from baseline at the 12-week assessment, based on PHQ-9 total score, t(21) = 3.80, p = .001. Evidence of fidelity included 81% of patients completing the 2 BA-PC appointments, average appointment lengths of approximately 30 min, and high content fidelity within each appointment. These preliminary findings suggest that overall experience of a brief BA-PC intervention was positive, with high patient satisfaction, patient acceptability, and treatment fidelity as well as positive patient treatment response. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",30714752,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.32496452331543,-2.260502338409424,A/dT
"Extreme nonresponse to acute phase cognitive therapy for depression: an attempt to replicate and extend.

As with other interventions for major depressive disorder (MDD), cognitive therapy (CT) results in treatment failure for about half of all participants. In 2007, Coffman and colleagues in Seattle studied this topic by identifying a group of patients who demonstrated an extremely poor response to CT (i.e., posttreatment BDI score≥31). They called these patients ""extreme nonresponders"" (ENR) and described the pretreatment characteristics that predicted response status. In the current study, we attempt a replication of the Seattle study with a larger sample of adults with recurrent MDD (N=473) who received a 16-20 session (12-14week) course of CT. The rate of ENR in this large sample was only 6.3% (30/473), compared to 22.2% (10/45) in the Seattle sample. Four pretreatment measures of symptom severity and functioning differed significantly among ENR and non-ENR participants. In each case, higher symptoms or poorer functioning were associated with ENR status. However, the combination of these factors in a regression model did not predict actual ENR status with the high degree of sensitivity or specificity observed in the Seattle study. These findings suggest that extreme nonresponse to CT is not as common as previously described and, although poor outcomes are associated with pretreatment clinical status, it is difficult to predict posttreatment symptom severity with a high degree of accuracy across different research samples.",24680227,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.365781784057617,-1.1445896625518799,CQFx
"Two-way messaging therapy for depression and anxiety: longitudinal response trajectories.

Telemedicine is a strategy for overcoming barriers to access evidence-based psychotherapy. Digital modalities that operate outside session-based treatment formats, such as ongoing two-way messaging, may further address these challenges. However, no study to date has established suitability criteria for this medium. A large outpatient sample (n=10,718) engaged in daily messaging with licensed clinicians from a telemedicine provider. Patients consisted of individuals from urban and rural settings in all 50 states of the US, who signed up to the telemedicine provider. Using a longitudinal design, symptoms changes were observed during a 12week treatment course. Symptoms were assessed from baseline every three weeks using the Patient Health Questionnaire (PHQ-9) for depression, and the Generalized Anxiety Disorder (GAD-7) for anxiety. Demographics and engagement metrics, such as word count for both patients and therapists, were also assessed. Growth mixture modeling was used to tease apart symptoms trajectories, and identify predictors of treatment response. Two subpopulations had GAD-7 and PHQ-9 remission outcomes (Recovery and Acute Recovery, 30.7% of patients), while two others showed amelioration of symptoms (Depression and Anxiety Improvement, 36.9% of patients). Two subpopulations experienced no changes in symptoms (Chronic and Elevated Chronic, 32.4% of patients). Higher use of written communication, patient characteristics, and engagement metrics reliably distinguished patients with the greatest level of remission (Recovery and Acute Recovery groups). Remission of depression and anxiety symptoms was observed during delivery of psychotherapy through messaging. Improvement rates were consistent with face-to-face therapy, suggesting the suitability of two-way messaging psychotherapy delivery. Characteristics of improving patients were identified and could be used for treatment recommendation. These findings suggest the opportunity for further research, to directly compare messaging delivery with a control group of treatment as usual. Clinicaltrials.gov Identifier: NCT03699488, Retrospectively Registered October 8, 2018.",32532225,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.7135009765625,-4.072505950927734,AngO
"Improved cognitive content endures for 2 years among unstable responders to acute-phase cognitive therapy for recurrent major depressive disorder.

The cognitive model of depression suggests that cognitive therapy (CT) improves major depressive disorder (MDD) in part by changing depressive cognitive content (e.g. dysfunctional attitudes, hopelessness). The current analyses clarified: (1) the durability of improvements in cognitive content made by acute-phase CT responders; (2) whether continuation-phase CT (C-CT) or fluoxetine (FLX) further improves cognitive content; and (3) the extent to which cognitive content mediates continuation treatments' effects on depressive symptoms and major depressive relapse/recurrence. Out-patients with recurrent MDD who responded to acute-phase CT (n = 241) were randomized to 8 months of C-CT, FLX or pill placebo (PBO) and followed for an 24 additional months. Cognitive content was assessed approximately every 4 months using five standard patient-report measures. Large improvements in cognitive content made during acute-phase CT were maintained for 32 months, with 78-90% of patients scoring in normal ranges, on average. Cognitive content varied little between C-CT, FLX and PBO arms, overall. Small, transient improvements in cognitive content in C-CT or FLX compared with PBO patients did not clearly mediate the treatments' effects on depressive symptoms or on major depressive relapse/recurrence. Outpatients with recurrent MDD who respond to acute-phase CT show durable improvements in cognitive content. C-CT or FLX may not continue to improve patient-reported cognitive content substantively, and thus may treat recurrent MDD by other paths.",26098793,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.856735229492188,-1.1580612659454346,B78T
"Dance movement therapy for depression.

Depression is a debilitating condition affecting more than 350 million people worldwide (WHO 2012) with a limited number of evidence-based treatments. Drug treatments may be inappropriate due to side effects and cost, and not everyone can use talking therapies.There is a need for evidence-based treatments that can be applied across cultures and with people who find it difficult to verbally articulate thoughts and feelings. Dance movement therapy (DMT) is used with people from a range of cultural and intellectual backgrounds, but effectiveness remains unclear. To examine the effects of DMT for depression with or without standard care, compared to no treatment or standard care alone, psychological therapies, drug treatment, or other physical interventions. Also, to compare the effectiveness of different DMT approaches. The Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR-Studies and CCDANCTR-References) and CINAHL were searched (to 2 Oct 2014) together with the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov. The review authors also searched the Allied and Complementary Medicine Database (AMED), the Education Resources Information Center (ERIC) and Dissertation Abstracts (to August 2013), handsearched bibliographies, contacted professional associations, educational programmes and dance therapy experts worldwide. Inclusion criteria were: randomised controlled trials (RCTs) studying outcomes for people of any age with depression as defined by the trialist, with at least one group being DMT. DMT was defined as: participatory dance movement with clear psychotherapeutic intent, facilitated by an individual with a level of training that could be reasonably expected within the country in which the trial was conducted. For example, in the USA this would either be a trainee, or qualified and credentialed by the American Dance Therapy Association (ADTA). In the UK, the therapist would either be in training with, or accredited by, the Association for Dance Movement Psychotherapy (ADMP, UK). Similar professional bodies exist in Europe, but in some countries (e.g. China) where the profession is in development, a lower level of qualification would mirror the situation some decades previously in the USA or UK. Hence, the review authors accepted a relevant professional qualification (e.g. nursing or psychodynamic therapies) plus a clear description of the treatment that would indicate its adherence to published guidelines including Levy 1992, ADMP UK 2015, Meekums 2002, and Karkou 2006. Study methodological quality was evaluated and data were extracted independently by the first two review authors using a data extraction form, the third author acting as an arbitrator. Three studies totalling 147 participants (107 adults and 40 adolescents) met the inclusion criteria. Seventy-four participants took part in DMT treatment, while 73 comprised the control groups. Two studies included male and female adults with depression. One of these studies included outpatient participants; the other study was conducted with inpatients at an urban hospital. The third study reported findings with female adolescents in a middle-school setting. All included studies collected continuous data using two different depression measures: the clinician-completed Hamilton Depression Rating Scale (HAM-D); and the Symptom Checklist-90-R (SCL-90-R) (self-rating scale).Statistical heterogeneity was identified between the three studies. There was no reliable effect of DMT on depression (SMD -0.67 95% CI -1.40 to 0.05; very low quality evidence). A planned subgroup analysis indicated a positive effect in adults, across two studies, 107 participants, but this failed to meet clinical significance (SMD -7.33 95% CI -9.92 to -4.73).One adult study reported drop-out rates, found to be non-significant with an odds ratio of 1.82 [95% CI 0.35 to 9.45]; low quality evidence. One study measured social functioning, demonstrating a large positive effect (MD -6.80 95 % CI -11.44 to -2.16; very low quality evidence), but this result was imprecise. One study showed no effect in either direction for quality of life (0.30 95% CI -0.60 to 1.20; low quality evidence) or self esteem (1.70 95% CI -2.36 to 5.76; low quality evidence). The low-quality evidence from three small trials with 147 participants does not allow any firm conclusions to be drawn regarding the effectiveness of DMT for depression. Larger trials of high methodological quality are needed to assess DMT for depression, with economic analyses and acceptability measures and for all age groups.",25695871,Major Depressive Disorder,Anxiety Treatment,Mental Health,21751,8.75181770324707,-0.9403957724571228,CBsI
"Internet-based cognitive behavior therapy for major depressive disorder: A randomized controlled trial.

Prior research has shown that the Sadness Program, a technician-assisted Internet-based cognitive behavioral therapy (iCBT) intervention developed in Australia, is effective for treating major depressive disorder (MDD). The current study aimed to expand this work by adapting the protocol for an American population and testing the Sadness Program with an attention control group. In this parallel-group, randomized controlled trial, adult MDD participants (18-45 years) were randomized to a 10-week period of iCBT (n = 37) or monitored attention control (MAC; n = 40). Participants in the iCBT group completed six online therapy lessons, which included access to content summaries and homework assignments. During the 10-week trial, iCBT and MAC participants logged into the web-based system six times to complete self-report symptom scales, and a nonclinician technician contacted participants weekly to provide encouragement and support. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), and the secondary outcomes were the Patient Health Questionnaire-9 and Kessler-10. Intent-to-treat analyses revealed significantly greater reductions in depressive symptoms in iCBT compared with MAC participants, using both the self-report measures and the clinician-rated HRSD (d = -0.80). Importantly, iCBT participants also showed significantly higher rates of clinical response and remission. Exploratory analyses did not support illness severity as a moderator of treatment outcome. The Sadness Program led to significant reductions in depression and distress symptoms. With its potential to be delivered in a scalable, cost-efficient manner, iCBT is a promising strategy to enhance access to effective care.",28009467,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.736265182495117,-2.8972039222717285,BjAo
"Rationale and methods of the iFightDepression study: A double-blind, randomized controlled trial evaluating the efficacy of an internet-based self-management tool for moderate to mild depression.

During the last decade online interventions have emerged as a promising approach for patients with mild/moderate depressive symptoms, reaching at large populations and representing cost-effective alternatives. The main objective of this double-blind, randomized controlled trial is to examine the efficacy of an internet-based self-management tool (iFightDepression) for mild to moderate depression as an add-on to treatment as usual (TAU) versus internet-based psychoeducation plus TAU. A total of 310 participants with major depression disorder (MDD) will be recruited at four different mental-health facilities in Spain. Participants will be randomly allocated to one of two study arms: iFightDepression (iFD) tool + TAU vs. internet-based psychoeducation + TAU. Both interventions last for 8 weeks and there is a 12 weeks follow up. The primary outcome measure is changes in depressive symptoms assessed with the Hamilton Depression Rating Scale. Additionally, pre-post interventions assessments will include socio-demographic data, a brief medical and clinical history and self-reported measures of depressive symptoms, quality of life, functional impairments and satisfaction with the iFD tool. iFightDepression is an easy-prescribed tool that could increase the efficacy of conventional treatment and potentially reach untreated patients, shortening waiting lists to receive psychological treatment. Confirming the efficacy of the iFD internet-based self-management tool as an add-on treatment for individuals with mild to moderate depression will be clinically-relevant. Registration number NCT02312583 . Clinicaltrials.gov . December 4, 2014.",28420367,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.143502235412598,-2.8502302169799805,Bdyf
"'Third wave' cognitive and behavioural therapies versus treatment as usual for depression.

So-called 'third wave' cognitive and behavioural therapies represent a new generation of psychological therapies that are increasingly being used in the treatment of psychological problems. However, the effectiveness and acceptability of third-wave cognitive and behavioural therapy (CBT) approaches as treatment for acute depression remain unclear. 1. To examine the effects of all third wave CBT approaches compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.2. To examine the effects of different third wave CBT approaches (ACT, compassionate mind training, functional analytic psychotherapy, dialectical behaviour therapy, MBCT, extended behavioural activation and metacognitive therapy) compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.3. To examine the effects of all third wave CBT approaches compared with different types of comparators (treatment as usual, no treatment, waiting list, attention placebo, psychological placebo) for acute depression. We searched the Cochrane Depression Anxiety and Neurosis Group Trials Specialised Register (CCDANCTR to 01/01/12), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE, (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. An updated search of CCDANCTR restricted to search terms relevant to third wave CBT therapies was conducted in March 2013 (CCDANCTR to 01/02/13). Randomised controlled trials that compared third wave CBT therapies with control conditions for acute depression in adults. Two review authors independently identified studies, assessed trial quality and extracted data. Study authors were contacted for additional information when required. We rated the quality of evidence using GRADE methods. Four small studies (224 participants) were included in the review. Little information was provided about the process of allocating participants to groups. None of the studies used independent outcome assessors, and evidence suggested researcher allegiance towards the active treatments. The four studies examined a diversity of third wave CBT approaches (extended behavioural activation, acceptance and commitment therapy and competitive memory training) and control conditions. None of the studies conducted follow-up assessments. The results showed a significant difference in clinical response rates in favour of third wave CBT when compared with treatment as usual (TAU) conditions (three studies, 170 participants, risk ratio (RR) 0.51, 95% confidence interval (CI) 0.27 to 0.95; very low quality). No significant difference in treatment acceptability based on dropout rates was found between third wave CBT approaches and TAU (four studies, 224 participants, RR 1.01, 95% CI 0.08 to 12.30; very low quality). Both analyses showed substantial statistical heterogeneity. Very low quality evidence suggests that third wave CBT approaches appear to be more effective than treatment as usual in the treatment of acute depression. The very small number of available studies and the diverse types of interventions and control comparators, together with methodological limitations, limit the ability to draw any conclusions on their effect in the short term or over a longer term. The increasing popularity of third wave CBT approaches in clinical practice underscores the importance of completing further studies of third wave CBT approaches in the treatment of acute depression, on a short- and long-term basis, to provide evidence of their effectiveness to policy-makers, clinicians and users of services.",24142810,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.111196517944336,-2.5298256874084473,CXH9
"Email-based promotion of self-help for subthreshold depression: Mood Memos randomised controlled trial.

Subthreshold depression is common, impairs functioning and increases the risk of major depression. Improving self-help coping strategies could help subthreshold depression and prevent major depression. To test the effectiveness of an automated email-based campaign promoting self-help behaviours. A randomised controlled trial was conducted through the website: www.moodmemos.com. Participants received automated emails twice weekly for 6 weeks containing advice about self-help strategies. Emails containing general information about depression served as a control. The principal outcome was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9) (trial registration: ACTRN12609000925246). The study recruited 1326 adults with subthreshold depression. There was a small significant difference in depression symptoms at post-intervention, favouring the active group (d = 0.17, 95% CI 0.01-0.34). There was a lower, although non-significant, risk of major depression in the active group (number needed to treat (NNT) 25, 95% CI 11 to ∞ to NNT(harm) 57). Emails promoting self-help strategies were beneficial. Internet delivery of self-help messages affords a low-cost, easily disseminated and highly automated approach for indicated prevention of depression.",22442102,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.988187789916992,-3.264608383178711,Cvqi
"Individualized Treatment Strategy for Depressive Disorder.

The goal of treatment for depressive disorders is complete remission of depressive symptoms with full recovery of social function and prevention of recurrence. However, a large proportion of patients do not experience symptomatic remission after the initial treatment, with even lower rates of remission in the longer treatment term. The main objective of individualized treatment applied in psychiatry is to improve precision in disease diagnosis, prognosis, treatment choices, and treatment response. Diverse approaches and techniques, such as genomics, epigenomics, other omics, neural circuit, and artificial intelligence are related to precision psychiatry. Using biology and computational psychiatry tools to find potential biomarkers, and based on precision psychiatry, patients considered to belong to the same endophenotype will be possible to receive biomarkers-based treatment and better prognosis. Especially in the choice of intervention, individualized treatment should be considered. In this review, we present the development of precise treatment in depressive disorders and introduce advances in several domains toward precision medicine and individualized treatment. We pay particular attention to biomarkers and the development of new technologies in depressive disorders, which will help disease complete remission and functional recovery, seek better lives for patients suffered with depressive disorders.",31784966,Major Depressive Disorder,Anxiety Treatment,Mental Health,22361,10.783988952636719,-1.163608431816101,AxB+
"The efficacy of adding short-term psychodynamic psychotherapy to antidepressants in the treatment of depression: A systematic review and meta-analysis of individual participant data.

We examined the efficacy of adding short-term psychodynamic psychotherapy (STPP) to antidepressants in the treatment of depression by means of a systematic review and meta-analysis of individual participant data, which is currently considered the most reliable method for evidence synthesis. A thorough systematic literature search resulted in 7 studies comparing combined treatment of antidepressants and STPP versus antidepressant mono-therapy (n = 3) or versus antidepressants and brief supportive psychotherapy (n = 4). Individual participant data were obtained for all these studies and totaled 482 participants. Across the total sample of studies, combined treatment of antidepressants and STPP was found significantly more efficacious in terms of depressive symptom levels at both post-treatment (Cohen's d = 0.26, SE = 0.10, p = .01) and follow-up (d = 0.50, SE = 0.10, p < .001). This effect was most apparent at follow-up and in studies examining STPP's specific treatment efficacy. Effects were still apparent in analyses that controlled for risk of bias and STPP quality in the primary studies. These findings support the evidence-base of adding STPP to antidepressants in the treatment of depression. However, further studies are needed, particularly assessing outcome measures other than depression and cost-effectiveness, as well as examining the relative merits of STPP versus other psychotherapies as added to antidepressants.",32650213,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.974968910217285,-4.193046569824219,AmD0
"Preventing the development of depression at work: a systematic review and meta-analysis of universal interventions in the workplace.

Depression is a major public health problem among working-age adults. The workplace is potentially an important location for interventions aimed at preventing the development of depression, but to date, the mental health impact of universal interventions in the workplace has been unclear. A systematic search was conducted in relevant databases to identify randomized controlled trials of workplace interventions aimed at universal prevention of depression. The quality of studies was assessed using the Downs and Black checklist. A meta-analysis was performed using results from studies of adequate methodological quality, with pooled effect size estimates obtained from a random effects model. Nine workplace-based randomized controlled trials (RCT) were identified. The majority of the included studies utilized cognitive behavioral therapy (CBT) techniques. The overall standardized mean difference (SMD) between the intervention and control groups was 0.16 (95% confidence interval (CI): 0.07, 0.24, P = 0.0002), indicating a small positive effect. A separate analysis using only CBT-based interventions yielded a SMD of 0.12 (95% CI: -0.01, 0.24, P = 0.07). [corrected]. There is good quality evidence that universally delivered workplace mental health interventions can reduce the level of depression symptoms among workers. There is more evidence for the effectiveness of CBT-based programs than other interventions. Evidence-based workplace interventions should be a key component of efforts to prevent the development of depression among adults.",24886246,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,9.307119369506836,-4.111926555633545,CNM/
"Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial.

A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. However, there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists. The present article describes the protocol of a study that will examine the relative efficacy, the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for inpatients with unipolar depression. The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions). Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention-to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher. Despite the large number of studies on treatment of depression, there is a clear lack of controlled research in inpatient psychotherapy during the acute phase of a major depressive episode. Research on brief therapy is important to take into account current short lengths of stay in psychiatry. The current study has the potential to scientifically inform appropriate inpatient treatment. This study is the first to address the issue of the economic evaluation of inpatient psychotherapy. Australian New Zealand Clinical Trial Registry (ACTRN12612000909820).",23110608,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.819625854492188,-3.1467044353485107,CmWN
"Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis.

Previous meta-analyses comparing the efficacy of psychotherapeutic interventions for depression were clouded by a limited number of within-study treatment comparisons. This study used network meta-analysis, a novel methodological approach that integrates direct and indirect evidence from randomised controlled studies, to re-examine the comparative efficacy of seven psychotherapeutic interventions for adult depression. We conducted systematic literature searches in PubMed, PsycINFO, and Embase up to November 2012, and identified additional studies through earlier meta-analyses and the references of included studies. We identified 198 studies, including 15,118 adult patients with depression, and coded moderator variables. Each of the seven psychotherapeutic interventions was superior to a waitlist control condition with moderate to large effects (range d = -0.62 to d = -0.92). Relative effects of different psychotherapeutic interventions on depressive symptoms were absent to small (range d = 0.01 to d = -0.30). Interpersonal therapy was significantly more effective than supportive therapy (d = -0.30, 95% credibility interval [CrI] [-0.54 to -0.05]). Moderator analysis showed that patient characteristics had no influence on treatment effects, but identified aspects of study quality and sample size as effect modifiers. Smaller effects were found in studies of at least moderate (Δd = 0.29 [-0.01 to 0.58]; p = 0.063) and large size (Δd = 0.33 [0.08 to 0.61]; p = 0.012) and those that had adequate outcome assessment (Δd = 0.38 [-0.06 to 0.87]; p = 0.100). Stepwise restriction of analyses by sample size showed robust effects for cognitive-behavioural therapy, interpersonal therapy, and problem-solving therapy (all d>0.46) compared to waitlist. Empirical evidence from large studies was unavailable or limited for other psychotherapeutic interventions. Overall our results are consistent with the notion that different psychotherapeutic interventions for depression have comparable benefits. However, the robustness of the evidence varies considerably between different psychotherapeutic treatments.",23723742,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.394493103027344,-2.5589585304260254,CdUL
"Preventive Cognitive Therapy versus Treatment as Usual in preventing recurrence of depression: protocol of a multi-centered randomized controlled trial.

Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Therefore, part of the efforts to reduce the disabling effects of depression should focus on preventing recurrence, especially in patients at high risk of recurrence. The best established effective psychological intervention is cognitive therapy, with indications for prophylactic effects after remission. In this randomized controlled trial (cost-) effectiveness of Preventive Cognitive Therapy (PCT) after response to Acute Cognitive Therapy (A-CT) will be evaluated in comparison with Treatment As Usual (TAU). Remitted patients that responded to A-CT treatment with at least two previous depressive episodes will be recruited. Randomization will be stratified for number of previous episodes. Follow-ups are at 3, 6, 12 and 15 months. The primary outcome measure will be the time to relapse or recurrence of depression meeting DSM-IV criteria for a major depressive episode on the Structured Clinical Interview for DSM-VI Axis I Disorders (SCID-I). Costs will be measured from a societal perspective. This study is the first to examine the addition of PCT to TAU, compared to TAU alone in patients that recovered from depressive disorder with A-CT. Alongside this effect study a cost effectiveness analysis will be conducted. Furthermore, the study explores potential moderators to examine what works for whom. Netherlands Trial Register (NTR): 2599 , date of registration: 11-11-2010.",26129694,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.2154541015625,-0.9612067341804504,B7is
"Relief of chronic or resistant depression (Re-ChORD): a pragmatic, randomized, open-treatment trial of an integrative program intervention for chronic depression.

Chronic depression is a particularly disabling mood disorder and treatment outcomes are poor with either psychotherapy or pharmacotherapy alone. There is growing evidence that an integrative treatment approach may be optimal. A novel multi-modal, multi-disciplinary treatment program, Re-ChORD, was developed at the University of British Columbia and evaluated in this pilot study. Re-ChORD consisted of guidelines-based medication management, and group-based interpersonal psychotherapy and occupational therapy. A randomized, parallel-groups, open-treatment trial was conducted comparing Re-ChORD to treatment as usual (TAU). Inclusion criteria were current depression (17-item Ham-D > or = 15) and a diagnosis of a chronic depressive disorder. The primary outcome variable was clinical remission (17-item Ham-D < or = 7) at 4 month assessment. A total of 64 patients were randomised to Re-ChORD (N=34) and TAU (N=30). Under both intention to treat (ITT) and completer analyses, the remission rate was significantly higher in the Re-ChORD than TAU groups. Treatment effect size for remission was of medium magnitude (22.2% and 29.6% over TAU under ITT and completer analyses). We did not collect sufficient follow-up data to investigate maintenance of gains. Re-ChORD shares elements with other combined treatments, and the present positive findings cannot be interpreted as being specific to the Re-ChORD program. Consistent with growing evidence that integrative treatments are necessary for chronic depressive disorders, Re-ChORD was demonstrated in this pilot study to produce significantly greater rates of remission than treatment as usual. A larger-scale trial is warranted.",19896200,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.090249061584473,-0.6798982620239258,DQJh
"The effects of psychotherapies for depression on response, remission, reliable change, and deterioration: A meta-analysis.

Meta-analyses of psychotherapies usually report effects sizes, while clinicians and patients need to know the proportion of patients who benefit from therapy. We conducted a meta-analysis of therapies for depression reporting the rates of response (50% symptom reduction), remission (HAM-D <7), clinical significant deterioration for psychotherapy, and control conditions (CAU, waitlist, and pill placebo), as well as the relative risk of these outcomes and the numbers-needed-to-be-treated (NNTs). We searched bibliographic databases and included 228 randomized trials comparing psychotherapy for depression against control conditions (75 with low risk of bias). Only therapies with at least 10 trials were included. We extracted outcomes from the studies, and for those studies not reporting the outcomes, we used a validated method to estimate the rates. The overall response rate in psychotherapies at 2 (±1) months after baseline was 41% (95% CI: 38~43), 17% (15~20) for usual care (CAU), and 16% (95% CI: 14~18) for waitlist. No significant differences between types of therapy were found. The NNT for therapy versus CAU was 5.3 and versus waitlist 3.9. About one third of patients remitted after therapy compared with 7%-13% in control conditions. The rates of deterioration were 5% versus 12%-13%, respectively. Most sensitivity analyses supported the general findings. Psychotherapies for depression may be effective compared with control conditions, but more than half of patients receiving therapy do not respond and only one third remitted. More effective treatments and treatment strategies such as sequencing and combining treatments are clearly needed.",34107050,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.742476463317871,-2.3797667026519775,AU+Q
"Internet-based CBT for depression with and without telephone tracking in a national helpline: randomised controlled trial.

Telephone helplines are frequently and repeatedly used by individuals with chronic mental health problems and web interventions may be an effective tool for reducing depression in this population. To evaluate the effectiveness of a 6 week, web-based cognitive behaviour therapy (CBT) intervention with and without proactive weekly telephone tracking in the reduction of depression in callers to a helpline service. 155 callers to a national helpline service with moderate to high psychological distress were recruited and randomised to receive either Internet CBT plus weekly telephone follow-up; Internet CBT only; weekly telephone follow-up only; or treatment as usual. Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up. Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence. A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline. Controlled-Trials.comISRCTN93903959.",22140514,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.447299003601074,-3.136108160018921,C0Kv
"Psychotherapy for chronic major depression and dysthymia: a meta-analysis.

Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic depression and dysthymia. We found that psychotherapy had a small but significant effect (d=0.23) on depression when compared to control groups. Psychotherapy was significantly less effective than pharmacotherapy in direct comparisons (d=-0.31), especially SSRIs, but that this finding was wholly attributable to dysthymic patients (the studies examining dysthymia patients were the same studies that examined SSRIs). Combined treatment was more effective than pharmacotherapy alone (d=0.23) but even more so with respect to psychotherapy alone (d=0.45), although again this difference may have reflected the greater proportion of dysthymic samples in the latter. No significant differences were found in drop-out rates between psychotherapy and the other conditions. We found indications that at least 18 treatment sessions are needed to realize optimal effects of psychotherapy. We conclude that psychotherapy is effective in the treatment of chronic depression and dysthymia but probably not as effective as pharmacotherapy (particularly the SSRIs).",19781837,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.203577995300293,-1.6701003313064575,DQoz
"Efficacy of web-based self-management interventions for depressive symptoms: a meta-analysis of randomized controlled trials.

The incidence of depression is increasing worldwide. Depression can lead to poor physical health and even suicide. However, in high-income countries, only about 50% of the people with depression receive appropriate therapy, and the detection rate of depression in low- and middle-income countries is relatively lower. Web-based self-management enables remote treatment and solves the problem of insufficient psychological treatment resources. Many past studies have evaluated the effectiveness of web-based self-management of depression, but there has been no synthesis of evidence. Therefore, this study conducted a meta-analysis of the effectiveness of web-based self-management for depressive symptoms. Six electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Embase, CINAHL, and PsycINFO) were searched in September 2020. All literature referring to the effects of web-based self-management on depression were shortlisted by performing the medical subject headings (MeSH) search combined with a text word search. A total of 18 eligible randomized controlled trials were identified, and the results from 3055 participants were consolidated. The web-based self-management group exhibited a greater reduction in depressive symptoms than the control group (g=-0.46; 95% CI: 0.62,0.30), and there was no evidence of publication bias. Subgroup analysis revealed that patients with moderate-to-severe depression benefited from web-based self-management interventions. In terms of interventions, those based on cognitive behavioral therapy (CBT) were highly effective. We noted that the longer the intervention time, the better was the improvement in the status of depression. Furthermore, it was established that participants who communicated with therapists and showed greater adherence to the intervention experienced significant improvement in their symptoms. The results of the intervention group were better than those of the waiting-list, treatment-as-usual, and online psychoeducation groups. Web-based self-management is a promising therapy for depression. Future research should aim to refine these aspects of the intervention to achieve a beneficial impact.",34380440,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.004056930541992,-3.479743003845215,AR6W
"[Psychoeducation for depression--features of interventions and therapeutic competencies].

Psychoeducation is an effective treatment method for depression disorders. In the present paper, we discuss the development, measurement and validation of features and competencies in psychoeducational interventions (SK-P). 30 videos showing sessions of psychoeducation for the treatment of recurring depression constituted the basis of the assessment. The therapists were assessed by 2 independent raters in regard to their psychoeducational competencies. Factor analysis revealed a one-factor factor structure. The scale composed of 8 items had high internal consistency (α=0.92) as well as interrater reliability (ICC=0.87). Furthermore, a correlation was found between the therapists' competencies and the quality of the therapeutic relationship as seen by their patients (r=0.46). The SK-P is therefore a promising instrument for reviewing competencies of therapists treating depression with psychoeducation.",21448818,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,10.933308601379395,-3.556213140487671,C+GO
"Internet-based versus face-to-face cognitive-behavioral intervention for depression: a randomized controlled non-inferiority trial.

In the past decade, a large body of research has demonstrated that internet-based interventions can have beneficial effects on depression. However, only a few clinical trials have compared internet-based depression therapy with an equivalent face-to-face treatment. The primary aim of this study was to compare treatment outcomes of an internet-based intervention with a face-to-face intervention for depression in a randomized non-inferiority trial. A total of 62 participants suffering from depression were randomly assigned to the therapist-supported internet-based intervention group (n=32) and to the face-to-face intervention (n=30). The 8 week interventions were based on cognitive-behavioral therapy principles. Patients in both groups received the same treatment modules in the same chronological order and time-frame. Primary outcome measure was the Beck Depression Inventory-II (BDI-II); secondary outcome variables were suicidal ideation, anxiety, hopelessness and automatic thoughts. The intention-to-treat analysis yielded no significant between-group difference (online vs. face-to-face group) for any of the pre- to post-treatment measurements. At post-treatment both treatment conditions revealed significant symptom changes compared to before the intervention. Within group effect sizes for depression in the online group (d=1.27) and the face-to-face group (d=1.37) can be considered large. At 3-month follow-up, results in the online group remained stable. In contrast to this, participants in the face-to-face group showed significantly worsened depressive symptoms three months after termination of treatment (t=-2.05, df=19, p<.05). Due to the small sample size, it will be important to evaluate these outcomes in adequately-powered trials. This study shows that an internet-based intervention for depression is equally beneficial to regular face-to-face therapy. However, more long term efficacy, indicated by continued symptom reduction three months after treatment, could be only be found for the online group.",23886401,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.053486824035645,-3.500702142715454,Ca6/
"Effectiveness of Acceptance and Commitment Therapy in treating depression and suicidal ideation in Veterans.

This paper examines the effects of Acceptance and Commitment Therapy for depression (ACT-D), and the specific effects of experiential acceptance and mindfulness, in reducing suicidal ideation (SI) and depression among Veterans. Patients included 981 Veterans, 76% male, mean age 50.5 years. Depression severity and SI were assessed using the BDI-II. Experiential acceptance and mindfulness were measured with the Acceptance and Action Questionnaire-II (AAQ-II) and the Five Facet Mindfulness Questionnaire, respectively. Of the 981 patients, 647 (66.0%) completed 10 or more sessions or finished early due to symptom relief. For Veterans with SI at baseline, mean BDI-II score decreased from 33.5 to 22.9. For Veterans with no SI at baseline, mean BDI-II score decreased from 26.3 to 15.9. Mixed models with repeated measurement indicated a significant reduction in depression severity from baseline to final assessment (b = -10.52, p < .001). After adjusting for experiential acceptance and mindfulness, patients with SI at baseline demonstrated significantly greater improvement in depression severity during ACT-D treatment, relative to patients with no SI at baseline (b = -2.81, p = .001). Furthermore, increases in experiential acceptance and mindfulness scores across time were associated with a reduction in depression severity across time (b = -0.44, p < .001 and b = -0.09, p < .001, respectfully), and the attenuating effect of mindfulness on depression severity increased across time (b = -0.05, p = .042). Increases in experiential acceptance scores across time were associated with lower odds of SI across time (odds ratio = 0.97, 95% CI [0.95, 0.99], p = .016) and the attenuating effect of experiential acceptance on SI increased across time (odds ratio = 0.96, 95% CI [0.92, 0.99], p = .023). Overall the number of patients with no SI increased from 44.5% at baseline to 65% at follow-up. Veterans receiving ACT-D demonstrated decreased depression severity and decreased odds of SI during treatment. Increases in experiential acceptance and mindfulness scores were associated with reduction in depression severity across time and increases in experiential acceptance scores were associated with reductions in SI across time.",26378720,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.406881332397461,-1.575309157371521,B380
"Effectiveness and adherence of telephone-administered psychotherapy for depression: A systematic review and meta-analysis.

The aim of this systematic review was to evaluate the effectiveness of telephone-administered psychotherapy for depression in adults when compared to control conditions or other active treatments, and to determine adherence to telephone-administered psychotherapy. A bibliographic search was conducted in MEDLINE, Embase, PsycINFO, the Cochrane library, and a number of sources of grey literature. We included randomised controlled trials (RCTs) examining the impact of telephone-administered psychotherapy on depressive symptomatology. Two reviewers independently screened citations, extracted the relevant data, and assessed risk of bias using Cochrane tools. Random effects meta-analyses were used to determine the average effect of the interventions on depressive symptomatology: main analysis including randomised trials only, and several exploratory subgroup and sensitivity analyses. We identified ten trials. Telephone-administered psychotherapy showed beneficial effects on depression severity when compared to control conditions ((standardized mean difference [SMD]= -0.85 (95% CI -1.56 to -0.15)). When compared to active comparators, the meta-analysis showed a non-significant small effect size (SMD= -0.18 (95% CI -0.45 to 0.09)), in favour of telephone-administered psychotherapy. Total weighted mean adherence was 73%. Some of the included studies presented a small sample size. Due to variations in time points follow-ups among the studies, it was not possible to determine long term post intervention effects. Available evidence suggests that telephone-delivered psychotherapy may be an effective strategy to reduce depression symptoms when compared to control conditions, and shows an adequate treatment adherence. Future research is needed to determine its cost-effectiveness and long-term effects.",31539688,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.910966873168945,-3.211883306503296,A0YS
"Effects of internet-delivered behavioral activation on individuals with depressive symptoms: A systematic review and meta-analysis.

Behavioral activation is recognized as a stand-alone, evidence-based therapy for depression. Internet-delivered psychological interventions are easy to access and low cost. Therefore, it is important to determine whether internet-delivered behavioral activation (iBA) is an effective option for improving depressive symptoms and other health-related outcomes. This systematic review and meta-analysis aimed to examine the effects of iBA on individuals with depressive symptoms. A comprehensive search was conducted within four databases to identify randomized controlled trials (RCTs) that involved iBA for people with depressive symptoms. The quality of the included RCTs was assessed using the Cochrane Collaboration risk-of-bias tool. Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the type of control groups. Twenty RCTs met the eligibility criteria. Meta-analyses showed iBA had small to medium effects on depressive symptoms, anxiety, quality of life, functioning, perceived social support, and behavioral activation (BA) in people suffering from depressive symptoms at the immediate posttest and follow-up compared to control conditions. Relatively fewer studies were conducted to compare effects of iBA on outcomes other than depressive symptoms and BA process measures compared to comparison or control conditions. The overall risk of bias across the included RCTs was unclear. Further high-quality studies are needed to verify the effects of iBA on varied health outcomes and BA process measures for individuals with depressive symptoms.",35717866,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.318666458129883,-2.21916127204895,TkA
"Chronic and treatment resistant depression: diagnosis and stepwise therapy.

The 12-month prevalence of depression in Europe is approximately 7%; depression becomes chronic in 15-25% of sufferers. One-third to one-half do not respond to an initial trial of drug therapy lasting several weeks. Selective literature review, including consideration of the German National Disease Management Guideline Unipolar Depression. At the end of an initial trial of treatment with an antidepressant drug, usually lasting four weeks, its efficacy should be evaluated systematically. In case of non-response, the following options have been found useful: measurement of the serum drug level, dose escalation (but not for selective serotonin reuptake inhibitors [SSRIs]), lithium augmentation, the addition of a second-generation antipsychotic (atypical neuroleptic), and any one of several defined combinations of antidepressants. There is no empirical evidence for switching to another antidepressant. Electroconvulsive therapy is the most effective treatment for refractory depression. Cognitive behavioral therapy, interpersonal psychotherapy, psychoanalysis and psychodynamic psychotherapy have also been found useful. The cognitive behavioral analysis system of psychotherapy (CBASP) was developed specifically for the treatment of chronic depression. The structured application of treatments of documented efficacy, in a stepwise treatment algorithm that gives equal weight to drugs and psychotherapy, is the best way to prevent or overcome treatment resistance and chronification.",25467053,Major Depressive Disorder,Anxiety Treatment,Mental Health,11495,9.938980102539062,-0.7194739580154419,CE7F
"Effects of cognitive psychotherapy on the biological rhythm of patients with depression.

Stability between internal and external biological regulators are essential to stable mood states. However, the literature needs studies investigating the effect of brief psychotherapies in the biological rhythm regularization. To verify the capacity regulation of biological rhythms in two models of brief psychotherapy for the remission of depressive symptoms. We conducted a randomized clinical trial with young adults aged 18-29 years old who met diagnostic criteria for depression according to the Structured Clinical Interview for DSM (SCID). In order to evaluate the biological rhythm the Biological Rhythm of assessment in Neuropsychiatry (BRIAN) interview was used; whereas the severity of depression was assessed by the Hamilton Depression Rating Scale (HDRS). The psychotherapy models consisted of two cognitive psychotherapies: Cognitive Narrative Therapy (CNT) and Cognitive-Behavioral Therapy (CBT). The sample consisted of 97 randomized into two models of brief psychotherapy. The patients regulated the biological rhythm from baseline to post-intervention (p=.001) and follow up (p=.003). We also found a positive moderate correlation between biological rhythm regularization and remission of the depressive symptoms (r=.594; p<.001). The two models of brief psychotherapies were effective in the remission of depressive symptoms as well as the regulation of biological rhythms in the follow-up of 6 months. We did not assess genetic, hormonal and neurochemical factors. Also, we did not include patients in pharmaceutical treatment, and with severe symptomatology.",24268614,Major Depressive Disorder,Anxiety Treatment,Mental Health,12222,10.914710998535156,-1.764359712600708,CVqc
"Behavioural activation: history, evidence and promise.

Behavioural activation holds promise to reduce the global burden of depression as a treatment approach that is effective, easy to teach, scalable and acceptable to providers and patients across settings and cultures. This editorial reviews the history of behavioural activation, what it is, current evidence for its use and future directions.",22550329,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.434410095214844,-1.9211411476135254,CuBF
"Supportive monitoring and disease management through the internet: an internet-delivered intervention strategy for recurrent depression.

Major depression is a highly prevalent, disabling disorder associated with loss of quality of life and large economic burden for the society. Depressive disorders often follow a chronic or recurrent course. The risk of relapses increases with each additional episode. The internet-deliverable intervention strategy SUMMIT (SUpportive Monitoring and Disease Management over the InTernet) for patients with recurrent depression has been developed with the main objectives to prolong symptom-free phases and to shorten symptom-loaden phases. This paper describes the study design of a six-sites, three-arm, randomized clinical trial intended to evaluate the efficacy of this novel strategy compared to treatment as usual (TAU). Two hundred thirty six patients who had been treated for their (at least) third depressive episode in one of the six participating psychiatric centers were randomized into one of three groups: 1) TAU plus a twelve-month SUMMIT program participation with personal support or 2) TAU plus a twelve-month SUMMIT program participation without personal support, or 3) TAU alone. Primary outcome of this study is defined as the number of ""well weeks"" over 24months after index treatment assessed by blind evaluators based on the Longitudinal Interval Follow-Up Evaluation. If efficacious, the low monetary and nonmonetary expenditures of this automated, yet individualized intervention may open new avenues for providing an acceptable, convenient, and affordable long-term disease management strategy to people with a chronic mental condition such as recurrent depression.",23974036,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.002649307250977,-2.474017858505249,CZmD
"Exploration of a Biblical Counseling Program for Depression.

Millions of Americans experience sadness, fatigue, and sleeping difficulty. These symptoms are consistent with a diagnosis of depression, which the American Psychiatric Association (APA) categorizes as a serious medical illness. Treatments include pharmacotherapy and/or counseling, with varying outcomes. Anecdotally, positive outcomes are seen in adults with depressive symptoms seeking Biblical counseling (BC) that uses the Judeo-Christian Bible as its foundation; so, this project explored such a program. The project included a retrospective chart review and a pilot study introducing the use of the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) to identify and track depressive symptoms. Findings support further investigation into BC as a viable option.",33638814,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.88524055480957,-4.735482692718506,AaL1
"Tailored vs. standardized internet-based cognitive behavior therapy for depression and comorbid symptoms: a randomized controlled trial.

Major depression can be treated by means of cognitive behavior therapy, delivered via the Internet as guided self-help. Individually tailored guided self-help treatments have shown promising results in the treatment of anxiety disorders. This randomized controlled trial tested the efficacy of an Internet-based individually tailored guided self-help treatment which specifically targeted depression with comorbid symptoms. The treatment was compared both to standardized (non-tailored) Internet-based treatment and to an active control group in the form of a monitored online discussion group. Both guided self-help treatments were based on cognitive behavior therapy and lasted for 10 weeks. The discussion group consisted of weekly discussion themes related to depression and the treatment of depression. A total of 121 participants with diagnosed major depressive disorder and with a range of comorbid symptoms were randomized to three groups. The tailored treatment consisted of a prescribed set of modules targeting depression as well as comorbid problems. The standardized treatment was a previously tested guided self-help program for depression. From pre-treatment to post-treatment, both treatment groups improved on measures of depression, anxiety and quality of life. The results were maintained at a 6-month follow-up. Subgroup analyses showed that the tailored treatment was more effective than the standardized treatment among participants with higher levels of depression at baseline and more comorbidity, both in terms of reduction of depressive symptoms and on recovery rates. In the subgroup with lower baseline scores of depression, few differences were seen between treatments and the discussion group. This study shows that tailored Internet-based treatment for depression is effective and that addressing comorbidity by tailoring may be one way of making guided self-help treatments more effective than standardized approaches in the treatment of more severe depression. Clinicaltrials.gov NCT01181583.",22615841,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.670190811157227,-2.944742441177368,CtNv
"The process of change in cognitive therapy for depression when combined with antidepressant medication: Predictors of early intersession symptom gains.

Previous studies of cognitive therapy (CT) for depression have examined therapist adherence and the therapeutic alliance as predictors of subsequent symptom change. However, little is known about these CT process variables when CT is delivered in combination with antidepressant medication. In a sample of 176 depressed outpatients randomized to the combined condition of a clinical trial, we examined ratings of adherence and alliance as predictors of subsequent session-to-session symptom change across early CT sessions. Both adherence to Behavioral Methods/Homework and the therapeutic alliance significantly predicted session-to-session symptom change. In models in which patients' medication regimen and prior symptom change were covaried, only Behavioral Methods/Homework remained a significant predictor of subsequent symptom change. Our findings highlight the utility of Behavioral Methods/Homework in combined treatment for promoting early session-to-session symptom change.",22774791,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.945826530456543,-3.030707359313965,CrH4
"Effectiveness of cognitive-behavioural therapy for depression in advanced cancer: CanTalk randomised controlled trial.

Depression is one of the most common mental disorders in people with advanced cancer. Although cognitive-behavioural therapy (CBT) has been shown to be effective for depression in people with cancer, it is unclear whether this is the case for people with advanced cancer and depression. We sought to determine whether CBT is more clinically effective than treatment as usual (TAU) for treating depression in people with advanced cancer (trial registration number ISRCTN07622709). A multi-centre, parallel-group single-blind randomised controlled trial comparing TAU with CBT (plus TAU). Participants (n = 230) with advanced cancer and depression were randomly allocated to (a) up to 12 sessions of individual CBT or (b) TAU. The primary outcome measure was the Beck Depression Inventory-II (BDI-II). Secondary outcome measures included the Patient Health Questionnaire-9, the Eastern Cooperative Oncology Group Performance Status, and Satisfaction with Care. Multilevel modelling, including complier-average intention-to-treat analysis, found no benefit of CBT. CBT delivery was proficient, but there was no treatment effect (-0.84, 95% CI -2.76 to 1.08) or effects for secondary measures. Exploratory subgroup analysis suggested an effect of CBT on the BDI-II in those widowed, divorced or separated (-7.21, 95% CI -11.15 to -3.28). UK National Institute for Health and Care Excellence (NICE) guidelines recommend CBT for treating depression. Delivery of CBT through the Improving Access to Psychological Therapies (IAPT) programme has been advocated for long-term conditions such as cancer. Although it is feasible to deliver CBT through IAPT proficiently to people with advanced cancer, this is not clinically effective. CBT for people widowed, divorced or separated needs further exploration. Alternate models of CBT delivery may yield different results.",31566164,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,6.557925224304199,-2.6755473613739014,A0Cp
"Study protocol for a randomised controlled trial of a cognitive-behavioural prevention programme for the children of parents with depression: the PRODO trial.

Depression is one of the most common psychiatric illnesses worldwide, but is nevertheless preventable. Since the children of parents who have depression are at greatest risk of developing depression themselves, prevention programmes for this population are a major public health priority. Here we report the study protocol of a randomised controlled trial of a group-based psychological intervention for families with i) at least one parent who suffers (or has suffered) from depression and ii) at least one child who has no current or previous psychiatric diagnosis. Eligible families will be randomly allocated to receive either a German adaptation of the 12-session cognitive-behavioural Raising Healthy Children intervention (Gesund und glücklich aufwachsen; N=50), or no intervention (usual care; N=50). The primary outcome (child diagnosis of an episode of depression) will be assessed at 15-month follow-up. The secondary outcomes (child psychopathological symptoms) will be assessed immediately following completion of the intervention (6-months), as well as at 9- and 15-month follow-up. We hypothesise that children in the intervention condition, compared with those who do not receive the intervention, will show fewer symptoms of psychopathology, and be less likely to meet diagnostic criteria for a depressive episode, at follow-up. Despite their elevated risk of developing depression, there is little formal support available for the children of parents with depression. This study provides an important step in the development of more effective depression prevention measures, which are needed if the personal, social and economic burden of depression is to be reduced. Clinical Trials NCT02115880. Registered April 7 2014.",25269863,Major Depressive Disorder,Anxiety Treatment,Mental Health,6753,10.735150337219238,-2.7656872272491455,CHp4
"Immediate versus sustained effects: interrupted time series analysis of a tailored intervention.

Detailed intervention descriptions and robust evaluations that test intervention impact--and explore reasons for impact--are an essential part of progressing implementation science. Time series designs enable the impact and sustainability of intervention effects to be tested. When combined with time series designs, qualitative methods can provide insight into intervention effectiveness and help identify areas for improvement for future interventions. This paper describes the development, delivery, and evaluation of a tailored intervention designed to increase primary health care professionals' adoption of a national recommendation that women with mild to moderate postnatal depression (PND) are referred for psychological therapy as a first stage treatment. Three factors influencing referral for psychological treatment were targeted using three related intervention components: a tailored educational meeting, a tailored educational leaflet, and changes to an electronic system data template used by health professionals during consultations for PND. Evaluation comprised time series analysis of monthly audit data on percentage referral rates and monthly first prescription rates for anti-depressants. Interviews were conducted with a sample of health professionals to explore their perceptions of the intervention components and to identify possible factors influencing intervention effectiveness. The intervention was associated with a significant, immediate, positive effect upon percentage referral rates for psychological treatments. This effect was not sustained over the ten month follow-on period. Monthly rates of anti-depressant prescriptions remained consistently high after the intervention. Qualitative interview findings suggest key messages received from the intervention concerned what appropriate antidepressant prescribing is, suggesting this to underlie the lack of impact upon prescribing rates. However, an understanding that psychological treatment can have long-term benefits was also cited. Barriers to referral identified before intervention were cited again after the intervention, suggesting the intervention had not successfully tackled the barriers targeted. A time series design allowed the initial and sustained impact of our intervention to be tested. Combined with qualitative interviews, this provided insight into intervention effectiveness. Future research should test factors influencing intervention sustainability, and promote adoption of the targeted behavior and dis-adoption of competing behaviors where appropriate.",24188718,Major Depressive Disorder,Anxiety Treatment,Mental Health,18777,10.44703197479248,-3.1314868927001953,CWjV
"Using bibliotherapy to assist people to recover from depression in Thailand: Relationship between resilience, depression and psychological distress.

Thailand is experiencing a marked increase in the prevalence of depression. Self-help has an important role in helping people with depression. The aim of this study was to assess if a favourable relationship existed between resilience, depression and psychological distress in participants with depression who receive bibliotherapy in comparison with a control group. A randomized controlled trial was conducted with 56 participants with moderate depression. The intervention group received the self-help manual, whereas the control group received standard care. The findings showed a positive relationship between higher levels of resilience and lower levels of depression and psychological distress in the intervention group only, between baseline and posttest. The findings provide preliminary evidence supporting the use of bibliotherapy for individuals with depression in Thailand. Bibliotherapy can be incorporated easily into mental health nurses and other clinicians' work in promoting recovery in people with depression in the community.",24621304,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.94860553741455,-3.769221305847168,CQ90
"CBT for depression: a pilot RCT comparing mobile phone vs. computer.

This paper reports the results of a pilot randomized controlled trial comparing the delivery modality (mobile phone/tablet or fixed computer) of a cognitive behavioural therapy intervention for the treatment of depression. The aim was to establish whether a previously validated computerized program (The Sadness Program) remained efficacious when delivered via a mobile application. 35 participants were recruited with Major Depression (80% female) and randomly allocated to access the program using a mobile app (on either a mobile phone or iPad) or a computer. Participants completed 6 lessons, weekly homework assignments, and received weekly email contact from a clinical psychologist or psychiatrist until completion of lesson 2. After lesson 2 email contact was only provided in response to participant request, or in response to a deterioration in psychological distress scores. The primary outcome measure was the Patient Health Questionnaire 9 (PHQ-9). Of the 35 participants recruited, 68.6% completed 6 lessons and 65.7% completed the 3-months follow up. Attrition was handled using mixed-model repeated-measures ANOVA. Both the Mobile and Computer Groups were associated with statistically significantly benefits in the PHQ-9 at post-test. At 3months follow up, the reduction seen for both groups remained significant. These results provide evidence to indicate that delivering a CBT program using a mobile application, can result in clinically significant improvements in outcomes for patients with depression. Australian New Zealand Clinical Trials Registry ACTRN 12611001257954.",23391304,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,8.070549011230469,-5.338199138641357,CiNd
"Different control conditions can produce different effect estimates in psychotherapy trials for depression.

Control conditions' influence on effect estimates of active psychotherapeutic interventions for depression has not been fully elucidated. We used network meta-analysis to estimate the differences between control conditions. We have conducted a comprehensive literature search of randomized trials of psychotherapies for adults with depression up to January 1, 2019 in four major databases (PubMed, PsycINFO, Embase, and Cochrane). The network meta-analysis included broadly conceived cognitive behavior therapies in comparison with the following control conditions: Waiting List (WL), No Treatment (NT), Pill Placebo (PillPlacebo), Psychological Placebo (PsycholPlacebo). 123 studies with 12,596 participants were included. The I-squared was 55.9% (95% CI: 45.9%; to 64.0%) (moderate heterogeneity). The design-by-treatment global test of inconsistency was not significant (P = 0.44). Different control conditions led to different estimates of efficacy for the same intervention. WL appears to be the weakest control (odds ratio of response against NT = 1.93 (1.30 to 2.86), PsycholPlacebo = 2.03 (1.21 to 3.39), and PillPlacebo = 2.66 (1.45 to 4.89), respectively). Different control conditions produce different effect estimates in psychotherapy randomized controlled trials for depression. WL was the weakest, followed by NT, PsycholPlacebo, and PillPlacebo in this order. When conducting meta-analyses of psychotherapy trials, different control conditions should not be lumped into a single group.",33338564,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.527420043945312,-2.445319414138794,Adsz
"Psychotherapy Targeting Depression and Anxiety for Use in Palliative Care: A Meta-Analysis.

Research on the effectiveness of evidence-based practices in the treatment of depression and anxiety with palliative care populations is primarily limited to individuals having specific conditions such as cancer. This meta-analysis examined the effect of psychotherapy on depression and anxiety among individuals with any condition appropriate for palliative care. We searched PubMed, PsycINFO, Cochrane Library, and EMBASE databases until August 2017. Eligible studies were randomized controlled trials of psychotherapy that reported outcomes of depression and anxiety and included adults with serious illnesses. The current meta-analysis included 32 randomized controlled trials with 36 samples including 1536 participants undergoing psychotherapy. Overall, findings suggest that psychotherapy in palliative care populations reduced depression (large effect) and anxiety (small effect) symptoms. Psychotherapy also improved quality of life (small effect). Significant moderators of intervention effects included type of intervention and provider, number and length of treatment sessions, and sample age. Cognitive-behaviorally based and other therapies (e.g., acceptance, mindfulness) showed significant effects, as did interventions delivered by mental health providers. More treatment sessions were associated with greater effect sizes; longer sessions were associated with decreased effect sizes. As the sample age increased, the study effect size decreased. Findings suggest that psychotherapy for individuals with serious illnesses appropriate for palliative care can mitigate symptoms of depression and anxiety and improve quality of life. Methodological reporting and quality of research designs in studies of psychotherapy for palliative patient populations could be improved. Future research is needed with a broader range of patient populations.",29676960,Major Depressive Disorder,Anxiety Treatment,Mental Health,3648,7.969933986663818,-2.7772858142852783,BM8N
"Patient recall of specific cognitive therapy contents predicts adherence and outcome in adults with major depressive disorder.

The current study examined whether and which specific contents of patients' memory for cognitive therapy (CT) were associated with treatment adherence and outcome. Data were drawn from a pilot RCT of forty-eight depressed adults, who received either CT plus Memory Support Intervention (CT + Memory Support) or CT-as-usual. Patients' memory for treatment was measured using the Patient Recall Task and responses were coded into cognitive behavioral therapy (CBT) codes, such as CBT Model and Cognitive Restructuring, and non-CBT codes, such as individual coping strategies and no code. Treatment adherence was measured using therapist and patient ratings during treatment. Depression outcomes included treatment response, remission, and recurrence. Total number of CBT codes recalled was not significantly different comparing CT + Memory Support to CT-as-usual. Total CBT codes recalled were positively associated with adherence, while non-CBT codes recalled were negatively associated with adherence. Treatment responders (vs. non-responders) exhibited a significant increase in their recall of Cognitive Restructuring from session 7 to posttreatment. Greater recall of Cognitive Restructuring was marginally significantly associated with remission. Greater total number of CBT codes recalled (particularly CBT Model) was associated with non-recurrence of depression. Results highlight the important relationships between patients' memory for treatment and treatment adherence and outcome.",28822879,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.195127487182617,-0.7137769460678101,BYMl
"Quantifying and qualifying the preventive effects of acute-phase cognitive therapy: Pathways to personalizing care.

To determine the extent to which prospectively identified responders to cognitive therapy (CT) for recurrent major depressive disorder (MDD) hypothesized to be lower risk show significantly less relapse or recurrence than treated higher risk counterparts across 32 months. Outpatients (N = 523), aged 18-70, with recurrent MDD received 12-14 weeks of CT. The last 7 consecutive scores from the Hamilton Rating Scale for Depression (HRSD-17) were used to stratify or define responders (n = 290) into lower (7 HRSD-17 scores of less than or equal to 6; n = 49; 17%) and higher risk (n = 241; 83%). The lower risk patients entered the 32-month follow-up. Higher risk patients were randomized to 8 months of continuation-phase CT or clinical management plus double-blind fluoxetine or pill placebo, with a 24-month follow-up. Lower risk patients were significantly less likely to relapse over the first 8 months compared to higher risk patients (Kaplan-Meier [KM] estimates; i.e., 4.9% = lower risk; 22.1% = higher risk; log-rank χ2 = 6.83, p = .009). This increased risk was attenuated, but not completely neutralized, by active continuation-phase therapy. Over the subsequent 24 months, the lower and higher risk groups did not differ in relapse or recurrence risk. Rapid and sustained acute-phase CT remission identifies responders who do not require continuation-phase treatment to prevent relapse (i.e., return of an index episode). To prevent recurrence (i.e., new episodes), however, strategic allocation and more frequent ""dosing"" of CT and/or targeted maintenance-phase treatments may be required. Longitudinal follow-up is recommended.",26654211,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.512249946594238,-1.006832242012024,B0BR
"Evaluating an e-mental health program (""deprexis"") as adjunctive treatment tool in psychotherapy for depression: Results of a pragmatic randomized controlled trial.

Depressive disorders place a significant disease burden on individuals as well as on societies. Several web-based interventions for depression have shown to be effective in reducing depressive symptoms. However, it is not known whether web-based interventions, when used as adjunctive treatment tools to regular psychotherapy, have an additional effect compared to regular psychotherapy for depression. Adults (N = 98) with a unipolar affective disorder were recruited in routine outpatient psychotherapy practices in Germany from therapists over the course of their initial sessions and randomized within therapists to one of two active treatment conditions: regular psychotherapy or psychotherapy plus a web-based depression program (""deprexis""). Primary outcome was depressive symptoms measured with the Beck Depression Inventory (BDI-II) at 12 weeks. Secondary outcomes were anxiety symptoms, somatic symptoms and quality of life at 12 weeks and six months follow-up. The study also included an assessment of the working alliance after six and 12 weeks. The combination of psychotherapy with the web-based program was more effective than psychotherapy alone at 12 weeks, with medium between-group effect sizes on primary depressive symptoms (Cohen's d = .51) and small to medium between-group effect sizes on secondary outcomes (Cohen's d = .07-.55). Furthermore, we did not observe negative side effects in the blended format, e.g., a lower working alliance than in psychotherapy alone. The study had a smaller than planned sample size and the dropout rate at follow-up was high. This study provides first evidence that the use of a web-based program as an adjunctive tool in regular psychotherapy could be a promising option to consider in future treatment for depression.",29154168,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.132966995239258,-3.1231303215026855,BT+A
"Effectiveness of guided internet-based interventions in the indicated prevention of depression in green professions (PROD-A): Results of a pragmatic randomized controlled trial.

Major Depressive Disorder (MDD) has a major impact on public health. Reduction of depression burden in general population is of greatest importance and might be achieved by implementation of depression prevention measures into routine care. We evaluate an online prevention measure as part of a national project aiming to reduce depression in the occupational group of green professions. This two-armed pragmatic RCT (n = 360) evaluates the effectiveness of a tailored internet-based intervention (IMI) program compared to enhanced treatment as usual. The IMI program entailed access to one of six guided IMIs each focusing on different symptom areas (depressive mood with optional comorbid diabetes, perceived stress, insomnia, panic and agoraphobia and harmful alcohol consumption). Eligible were entrepreneurs, spouses, family members and pensioners in green professions with adequate insurance status and at least subthreshold depression (PHQ≥5). Primary outcome was depressive symptom severity (QIDS-SR16) at 9-weeks post-treatment (T1). Various secondary outcomes were assessed at T1. A small effect of depression reduction (d=-0.28, 95%-CI: -0.50 to -0.07) was found at T1 favouring the IMI program (β=-0.22, 95%-CI: -0.41 to -0.02, p=.033). Categorical analysis indicated a reduced risk of potential MDD with NNTB=28.11. Adherence to the IMI program at T1 was exceptionally low. Results are limited to green professions and representativeness might be restricted by self-selection of participants. Depression burden in green professions can be reduced by this online prevention measure. Yet, short-term effectiveness is restricted by low adherence rates. German Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.",33096333,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.089391708374023,-3.184033155441284,AghH
"Metacognitive Therapy versus Cognitive Behaviour Therapy in Adults with Major Depression: A Parallel Single-Blind Randomised Trial.

In the last forty years therapy outcomes for depression have remained the same with approximately 50% of patients responding to treatments. Advances are urgently required. We hypothesised that a recent treatment, metacognitive therapy (MCT), might be more effective, by targeting mental control processes that directly contribute to depression. We assessed the clinical efficacy of MCT compared to current best psychotherapy practice, CBT, in adults with major depressive disorder. A parallel randomized single-blind trial was conducted in a primary care outpatient setting. This trial is registered with the ISCRTN registry, number ISRCTN82799488. In total 174 adults aged 18 years or older meeting Diagnostic and Statistical Manual of Mental Disorders IV criteria for major depressive disorder were eligible and consented to take part. 85 were randomly allocated to MCT and 89 to CBT. Randomisation was performed independently following pre-treatment assessment and was stratified for severity of depression (low<20 vs high>=20) on the Hamilton Depression Rating Scale (HDRS) and on sex (male/female). Assessors and trial statisticians were blind to treatment allocation. Each treatment arm consisted of up to 24 sessions of up to 60minutes each, delivered by trained clinical psychologists. The co-primary outcome measures were assessor rated symptom severity on the HDRS and self-reported symptom severity on the Beck Depression Inventory II (BDI-II) at post treatment. Secondary outcomes were scores six months post treatment on these measures and a range of symptom and mechanism variables. A key trial design feature was that each treatment was implemented to maximize individual patient benefit; hence time under therapy and number of sessions delivered could vary. Treated groups in the trial were very similar on most baseline characteristics. Data were analyzed on the basis of intention to treat (ITT). No differences were found on the HDRS at post treatment or follow-up (-0.95 [-2.88 to 0.98], p=0.336; and -1.61 [-3.65 to 0.43], p=0.122), but floor effects on this outcome were high. However, a significant difference favouring MCT was found on the BDI-II at post treatment (-5.49 [95% CI -8.90 to -2.08], p=0.002), which was maintained at six-month follow-up (-4.64 [-8.21 to -1.06], p=0.011). Following MCT 74% of patients compared with 52% in CBT met formal criteria for recovery on the BDI-II at post treatment (odds-ratio=2.42 [1.20 to 4.92], p=0.014). At follow-up the proportions were 74% compared to 56% recovery (odds-ratio=2.19 [1.05 to 4.54], p=0.036). Significant differences favouring MCT, also maintained over time, were observed for most secondary outcomes. The results were robust against controlling for time under therapy and when outcomes were assessed at a common 90 day mid-term time-point. Limitations of the study include the use of only two therapists where one treated 69% of patients, possible allegiance effects as the study was conducted in an established CBT clinic and the chief investigator is the originator of MCT and group differences in time under therapy. Never the less evidence from this study suggests that MCT had considerable beneficial effects in treating depression that may exceed CBT.",32398710,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,11.978031158447266,-1.4515830278396606,ApOk
"Similar changes in cognitions following cognitive-behavioral therapy or escitalopram for major depressive disorder: Implications for mechanisms of change.

Psychosocial treatments and medications both have been shown to be effective in treating major depressive disorder. We hypothesized that cognitive-behavioral therapy (CBT) would outperform medication on measures of cognitive change. We randomized depressed individuals to 12 weeks of CBT (n = 15) or escitalopram (n = 11). In an intent-to-treat analysis (n = 26), we conducted a repeated measures analysis of variance to examine changes in depressive symptoms (ie, 17-item Hamilton Depression Rating Scale, Beck Depression Inventory), anhedonia (ie, Snaith-Hamilton Pleasure Scale), cognitive measures (ie, Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire, Perceived Stress Scale), and quality of life (ie, Quality of Life Enjoyment and Satisfaction Questionnaire) at 4 time points: baseline, week 4, week 8, and week 12. Treatment for both groups started at baseline, and patients received either 12 weeks of individual CBT or 12 weeks of escitalopram with flexible dosing (10 to 20 mg). Collapsing the escitalopram and CBT groups, there were statistically significant pre-post changes on all outcome measures. However, there were no statistically significant differences between treatment groups on any of the outcome measures, including cognitive measures across time points. Our results suggest that both CBT and escitalopram have similar effects across a variety of domains and that, in contrast to our a priori hypothesis, CBT and escitalopram were associated with comparable changes on cognitive measures.",25954938,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.536849021911621,-1.0386625528335571,B9+Q
"Development of a clinician report measure to assess psychotherapy for depression in usual care settings.

Although mental health policy initiatives have called for quality improvement in depression care, practical tools to describe the quality of psychotherapy for depression are not available. We developed a clinician-report measure of adherence to three types of psychotherapy for depression-cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. A total of 727 clinicians from a large, national managed behavioral health care organization responded to a mail survey. The measure demonstrated good psychometric properties, including appropriate item-scale correlations, internal consistency reliability, and a three-factor structure. Our results suggest that this questionnaire may be a promising approach to describing psychotherapy for depression in usual care.",20186569,Major Depressive Disorder,Anxiety Treatment,Mental Health,4830,11.255217552185059,-3.530548095703125,DNZ5
"Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach.

Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online information on depression) in addition to inpatient psychodynamic psychotherapy. Both groups had access to their respective experimental intervention for 12 weeks, regardless of inpatient treatment duration. Reduction of depressive symptoms, as measured with the Beck Depression Inventory-II, was the primary outcome at the end of the intervention (T2). Depressive symptoms were statistically significantly lower in the IG compared to the active CG at T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d = 0.38) at discharge from inpatient treatment (T1). No statistically significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. This is the first evidence for blended treatment combining online self-help with inpatient psychotherapy. The study opens new and promising avenues for increasing the efficacy of inpatient psychotherapy. Future studies should determine how integration of online self-help into the therapeutic process can be developed further.",29131090,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.182522773742676,-3.363539218902588,BUQY
"A Novel Religious/Spiritual Group Psychotherapy Reduces Depressive Symptoms in a Randomized Clinical Trial.

This randomized controlled trial aimed to examine the effect of the Happy Science doctrine-based group psychotherapy on depressive symptoms in 118 Japanese mental disorder outpatients. The treatment group (n = 58) took part in five 90-min sessions at one-week intervals, while the control group (n = 60) received standard care including medication. Depressive symptoms were assessed before the intervention, 5 weeks after the intervention, and at 3-month follow-up. Compared to the control group, the treatment group showed a significant reduction in depressive symptoms both at post-intervention and at 3-month follow-up. In conclusion, this group psychotherapy might be of benefit in treating depressive symptoms.",26320001,Major Depressive Disorder,Anxiety Treatment,Mental Health,1733,10.503984451293945,-2.6915667057037354,B41Z
"The effectiveness of group-based behavioral activation in the treatment of depression: An updated meta-analysis of randomized controlled trial.

Depression is a common mental health problem associated with significant morbidity and mortality. Amongst various psychological treatments for depression, individual behavioral activation (BA) has been shown to be effective and relatively simple in its delivery by health care providers although its effectiveness as a group based intervention requires further evidence. The objective of this study is to evaluate and update on the effectiveness of group-based BA to relieve symptoms of depression. A meta-analysis was performed and prospective randomized trials were systematically searched from the OVID databases. The trials comparing group-based BA intervention versus usual care or waitlist controls were included. Depressive symptom measured by various validated scales was the primary outcome. As the interventions can be heterogeneous across the included studies, all analyses were performed by random-effects model. Seven randomized control trials were identified from the United States, United Kingdom, Sweden and Iran from 2003 to 2013. A total of 240 subjects were randomly assigned to group-based BA, and all participants included met the criteria for moderate to severe depression at baseline with the majority of participants being females. Participants who joined the group-based BA showed lower depressive symptoms (MD of BDI-II: -6.06 (95% CI: -8.28 to -3.85 and MD of HRSD: -2.82 (95% CI: -4.62 to -1.02)) than participants randomized to the control group with usual treatment. The group-based BA also showed significant reduction in anxiety level (MD of BAI: -3.66 (95% CI: -6.11 to -1.22)) but not quality of life according to two studies. Risk of bias was evident amongst the studies as blinding of health providers and patients were not feasible in psychological studies. Group-based behavioral activation remains promising in relieving depressive symptoms for people with moderate to severe depression from this meta-analysis. Future studies should be higher quality research with larger sample size, longer follow-up periods, and synchronized clinical outcome measures. Patient feedback for group-based behavioral activation can also be further evaluated in order to ensure long term satisfaction and usage in health services.",27810717,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.396127700805664,-1.880473017692566,BlLf
"Feedback-informed treatment versus usual psychological treatment for depression and anxiety: a multisite, open-label, cluster randomised controlled trial.

Previous research suggests that the use of outcome feedback technology can enable psychological therapists to identify and resolve obstacles to clinical improvement. We aimed to assess the effectiveness of an outcome feedback quality assurance system applied in stepped care psychological services. This multisite, open-label, cluster randomised controlled trial was done at eight National Health Service (NHS) Trusts in England, involving therapists who were qualified to deliver evidence-based low-intensity or high-intensity psychological interventions. Adult patients (18 years or older) who accessed individual therapy with participating therapists were eligible for inclusion, except patients who accessed group therapies and those who attended less than two individual therapy sessions. Therapists were randomly assigned (1:1) to an outcome feedback intervention group or a treatment-as-usual control group by use of a computer-generated randomisation algorithm. The allocation of patients to therapists was quasi-random, whereby patients on waiting lists were allocated sequentially on the basis of therapist availability. All patients received low-intensity (less than eight sessions) or high-intensity (up to 20 sessions) psychological therapies for the duration of the 1-year study period. An automated computer algorithm alerted therapists in the outcome feedback group to patients who were not on track, and primed them to review these patients in clinical supervision. The primary outcome was symptom severity on validated depression (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalised Anxiety Disorder-7 [GAD-7]) measures after treatment of varying durations, which were compared between groups with multilevel modelling, controlling for cluster (therapist) effects. We used an intention-to-treat approach. This trial was prospectively registered with ISRCTN, number ISRCTN12459454. In total, 79 therapists were recruited to the study between Jan 8, 2016, and July 15, 2016, but two did not participate. Of these participants, 39 (51%) were randomly assigned to the outcome feedback group and 38 (49%) to the control group. Overall, 2233 patients were included in the trial (1176 [53%] were treated by therapists in the outcome feedback group, and 1057 [47%] by therapists in the control group). Patients classified as not on track had less severe symptoms after treatment if they were allocated to the outcome feedback group than those in the control group (PHQ-9 d=0·23, B=-1·03 [95% CI -1·84 to -0·23], p=0·012; GAD-7 d=0·19, B=-0·85 [-1·56 to -0·14], p=0·019). Supplementing psychological therapy with low-cost feedback technology can reduce symptom severity in patients at risk of poor response to treatment. This evidence supports the implementation of outcome feedback in stepped care psychological services. English NHS and Department of Health Sciences, University of York, York, UK.",29937396,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,9.042315483093262,-5.585102081298828,BJ6E
"Evaluation of the Effect of Comprehensive Nursing in Psychotherapy of Patients with Depression.

The purpose of this study is to understand the emotional experience and psychological intervention of patients with depression and to explore the intervention effect of nursing intervention in the psychological treatment of patients with depression, so as to provide clinical nursing work recommendations and provide reference for the implementation of intervention methods for patients with depression. In addition, through case analysis, this paper combines controlled trials to study the effect of comprehensive nursing in the psychotherapy of patients with depression and combines mathematical statistics to process data. Through the analysis of controlled trials, it can be known that on the basis of conventional medication, interventional guidance for patients with depression through comprehensive nursing programs can play an ideal effect in improving the depression of patients. Moreover, it can effectively improve the patient's quality of life after intervention and enhance the patient's nursing satisfaction.",34737786,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.319436073303223,-2.664280891418457,4zs
"A session-to-session examination of homework engagement in cognitive therapy for depression: Do patients experience immediate benefits?

Homework is a key component of Cognitive Therapy (CT) for depression. Although previous research has found evidence for a positive relationship between homework compliance and treatment outcome, the methods used in previous studies have often not been optimal. In this study, we examine the relation of specific aspects of homework engagement and symptom change over successive session-to-session intervals. In a sample of 53 depressed adults participating in CT, we examined the relation of observer-rated homework engagement and session-to-session symptom change across the first five sessions. Within patient (and not between patient) variability in homework engagement was significantly related to greater session-to-session symptom improvements. These findings were similar when homework engagement was assessed through a measure of general engagement with homework assignments and a measure assessing engagement in specific assignments often used in CT. Secondary analyses suggested that observer ratings of the effort patients made on homework and the completion of cognitive homework were the numerically strongest predictors of depressive symptom improvements. Patient engagement with homework assignments appears to be an important predictor of early session-to-session symptom improvements. Future research is needed to identify what therapist behaviors promote homework engagement.",26183022,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.679327011108398,-3.2365918159484863,B6xb
"[Dynamic, long-term, and institutional psychotherapy to treat persistent depressive disorders].

Major depression is a public health problem that threatens to become the second leading cause of disability in the world. In this study we show the results obtained once we applied a psychodynamic psychotherapeutic and long-term process in patients with major depressive disorder, attending a public health institution (PHI). From a list of female volunteers, we randomly selected 30 patients who met the diagnostic criteria of major depression. They were divided into 5 groups, with 6 members each. Due to the high percentage of early desertions, we had to select from the very same list other 28 depressed women. In this framework there was not a full-time psychotherapist organizing and directing the psychotherapeutic process; the patients themselves were the ones who assumed such functions. From the group of 58 patients, 26 completed the program scheduled. From this subgroup, 20 were responders and the rest, the other 6, non-responders. After the end of the psychotherapeutic process, the latter kept ingesting psychotropic drugs. If we correct the mistakes made in this first opportunity and we implement new strategies, the psychotherapeutic process can be transformed into a more institutional tool. Psychotherapy directed only to the cases difficult to solve is significantly effective, safe, cheap, and it may achieve a wide coverage.",27819782,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,10.276226997375488,-1.7416832447052002,BlDu
"Bouldering psychotherapy is more effective in the treatment of depression than physical exercise alone: results of a multicentre randomised controlled intervention study.

Recent scientific studies have suggested that climbing/bouldering is effective in alleviating depression when the comparison group was a waitlist control group, even when physical activity and other therapeutic approaches were controlled for. In the present study, we aimed to investigate the effectiveness of a manualised psychotherapeutic bouldering intervention for depressed individuals, compared with an active control group performing physical exercise alone. In a multicentre randomised controlled intervention trial, 133 outpatients with depression were assigned to either a bouldering psychotherapy (BPT) group or a home-based supervised exercise programme (EP). Severity of depression as the primary outcome was assessed at baseline and directly after a ten-week intervention period using the Montgomery-Åsberg Depression Rating Scale (MADRS). Secondary outcomes included anxiety, coping skills, self-esteem, body image, and interpersonal sensitivity. We applied t-tests to test for differences within the groups (t0 vs. t1) and between the BPT and the EP and a multiple regression analysis with the post-intervention MADRS score as the dependent variable. The robustness of estimates was investigated with a sensitivity analyses. Patients in the BPT group showed a significantly larger decrease in depression scores compared with the EP on the MADRS (drop of 8.4 vs. 3.0 points, p=.002, Cohen's d=0.55). In the confounder-adjusted regression analyses, group allocation was found to be the only significant predictor of the post-intervention MADRS score (β=-5.60, p=.001) besides the baseline MADRS score. Further significant differences in change scores between the BPT and the EP were found for anxiety (p=.046, d=0.35), body image (p=.018, d=0.42), and global self-esteem (p=.011, d=0.45). The study provides evidence that the manualised BPT is not only effective in alleviating depressive symptoms but even goes beyond the effect of mere physical exercise. Based on these findings, the BPT should be considered as a complementary therapeutic approach. Trial identification number: ISRCTN12457760: Study KuS (Klettern und Stimmung - Climbing and Mood) combined boulder and psychotherapy against depression, registered retrospectively on July 26th, 2017.",32164679,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,8.118324279785156,-1.4591469764709473,AsC2
"Therapist-rated outcomes in a randomized clinical trial comparing cognitive behavioral therapy and psychodynamic therapy for major depression.

The efficacy of psychodynamic therapy (PDT) for depression is debated due to a paucity of high-quality studies. We compared short psychodynamic supportive psychotherapy (SPSP) to cognitive behavioral therapy (CBT) in a randomized clinical trial. We used therapist-rated outcomes to examine how the course of change during treatment could be best represented and to compare treatment efficacy, hypothesizing non-significant differences. Three hundred and forty-one adults meeting DSM-IV criteria for a depressive episode and with Hamilton Depression Rating Scale (HAM-D) scores ≥14 were randomized to 16 sessions of individual manualized CBT or SPSP. Severely depressed patients (HAM-D>24) received additional antidepressant medication. After each session, therapists rated the Clinical Global Impression Scale subscales 'Severity of Illness' (CGI-S) and 'Global Improvement' (CGI-I), and the DSM-IV Axis V Global Assessment of Functioning Scale (GAF). We fitted growth curves using mixed model analyses with intention-to-treat samples. CGI-S and GAF scores during treatment were best represented by a linear symptom decrease. CGI-I scores were best represented by an S-shaped curve with relative more improvement in the first and last phases than in the middle phase of treatment. No significant post-treatment treatment differences were found. A non-significant trend for a treatment effect on CGI-S scores vanished when controlling for therapist gender and profession. Therapists were not specifically trained for CGI and GAF assessments. These findings add to the evidence-base of PDT for depression. Therapist characteristics and differences between severity and improvement measures might influence ratings and need to be taken into account when using therapist-rated outcome measures.",25240140,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.318995475769043,-2.7221312522888184,CIIQ
"Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments.

The Canadian Network for Mood and Anxiety Treatments (CANMAT) has revised its 2009 guidelines for the management of major depressive disorder (MDD) in adults by updating the evidence and recommendations. The target audiences for these 2016 guidelines are psychiatrists and other mental health professionals. Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. ""Psychological Treatments"" is the second of six sections of the 2016 guidelines. Evidence-informed responses were developed for 25 questions under 5 broad categories: 1) patient characteristics relevant to using psychological interventions; 2) therapist and health system characteristics associated with optimizing outcomes; 3) descriptions of major psychotherapies and their efficacy; 4) additional psychological interventions, such as peer interventions and computer- and technology-delivered interventions; and 5) combining and/or sequencing psychological and pharmacological interventions. First-line psychological treatment recommendations for acute MDD include cognitive-behavioural therapy (CBT), interpersonal therapy (IPT), and behavioural activation (BA). Second-line recommendations include computer-based and telephone-delivered psychotherapy. Where feasible, combining psychological treatment (CBT or IPT) with antidepressant treatment is recommended because combined treatment is superior to either treatment alone. First-line psychological treatments for maintenance include CBT and mindfulness-based cognitive therapy (MBCT). Patient preference, in combination with evidence-based treatments and clinician/system capacity, will yield the optimal treatment strategies for improving individual outcomes in MDD.",27486150,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.290206909179688,-0.73365718126297,BpFJ
"Predictors of outcome for telephone and face-to-face administered cognitive behavioral therapy for depression.

Cognitive behavioral therapy (CBT) can be delivered efficaciously through various modalities, including telephone (T-CBT) and face-to-face (FtF-CBT). The purpose of this study was to explore predictors of outcome in T-CBT and FtF-CBT for depression. A total of 325 depressed participants were randomized to receive eighteen 45-min sessions of T-CBT or FtF-CBT. Depression severity was measured using the Hamilton Depression Rating Scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9). Classification and regression tree (CART) analyses were conducted with baseline participant demographics and psychological characteristics predicting depression outcomes, HAMD and PHQ-9, at end of treatment (week 18). The demographic and psychological characteristics accurately identified 85.3% and 85.0% of treatment responders and 85.7% and 85.0% of treatment non-responders on the HAMD and PHQ-9, respectively. The Coping self-efficacy (CSE) scale predicted outcome on both the HAMD and PHQ-9; those with moderate to high CSE were likely to respond with no other variable influencing that prediction. Among those with low CSE, depression severity influenced response. Social support, physical functioning, and employment emerged as predictors only for the HAMD, and sex predicted response on the PHQ-9. Treatment delivery method (i.e. telephone or face-to-face) did not impact the prediction of outcome. Findings suggest that the predictors of improved depression are similar across treatment modalities. Most importantly, a moderate to high level of CSE significantly increases the chance of responding in both T-CBT and FtF-CBT. Among patients with low CSE, those with lower depressive symptom severity are more likely to do well in treatment.",26077620,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.05350399017334,-2.9128782749176025,B8QE
"Early response to psychological therapy as a predictor of depression and anxiety treatment outcomes: A systematic review and meta-analysis.

Previous studies indicate that early symptomatic improvement, typically observed during the first 4 weeks of psychological therapy, is associated with positive treatment outcomes for a range of mental health problems. However, the replicability, statistical significance, and magnitude of this association remain unclear. The current study reviewed the literature on early response to psychological interventions for adults with depression and anxiety symptoms. A systematic review and random effects meta-analysis were conducted, including studies found in Medline, PsychINFO, SCOPUS, Web of Science, and through reference lists and reverse citations. Twenty-five eligible studies including 11,091 patients measured early response and examined associations with posttreatment outcomes. It was possible to extract and/or calculate effect size data from 15 studies to conduct a meta-analysis. A large pooled effect size (g=0.87 [95% confidence interval: 0.63-1.10], p<.0001) indicated that early responders had significantly better posttreatment outcomes compared to cases without early response, and this effect was larger in anxiety (g=1.37) compared to depression (g=0.76) measures. Most studies were of good quality and there was no evidence of publication bias. The main limitations concerned insufficient statistical reporting in some studies, which precluded their inclusion in meta-analysis, and it was not possible to examine effect sizes according to different outcome questionnaires. There is robust and replicated evidence that early response to therapy is a reliable prognostic indicator for depression and anxiety treatment outcomes.",31233263,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.092594146728516,-2.301577091217041,A4h7
"The effect of interpersonal psychotherapy and other psychodynamic therapies versus 'treatment as usual' in patients with major depressive disorder.

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment in systematic reviews. Cochrane systematic review methodology with meta-analysis and trial sequential analysis of randomized trials comparing the effect of psychodynamic therapies versus 'treatment as usual' for major depressive disorder. To be included the participants had to be older than 17 years with a primary diagnosis of major depressive disorder. Altogether, we included six trials randomizing a total of 648 participants. Five trials assessed 'interpersonal psychotherapy' and only one trial assessed 'psychodynamic psychotherapy'. All six trials had high risk of bias. Meta-analysis on all six trials showed that the psychodynamic interventions significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference -3.12 (95% confidence interval -4.39 to -1.86;P<0.00001), no heterogeneity) compared with 'treatment as usual'. Trial sequential analysis confirmed this result. We did not find convincing evidence supporting or refuting the effect of interpersonal psychotherapy or psychodynamic therapy compared with 'treatment as usual' for patients with major depressive disorder. The potential beneficial effect seems small and effects on major outcomes are unknown. Randomized trials with low risk of systematic errors and low risk of random errors are needed.",21556370,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.218193054199219,-2.7266383171081543,C8dL
"The effectiveness of enhanced evidence-based care for depressive disorders: a meta-analysis of randomized controlled trials.

Several care models have been developed to improve treatment for depression, all of which provide ""enhanced"" evidence-based care (EEC). The essential component of these approaches is Measurement-Based Care (MBC). Specifically, Collaborative Care (CC), and Algorithm-guided Treatment (AGT), and Integrated Care (IC) all use varying forms of rigorous MBC assessment, care management, and/or treatment algorithms as key instruments to optimize treatment delivery and outcomes for depression. This meta-analysis systematically examined the effectiveness of EEC versus usual care for depressive disorders based on cluster-randomized studies or randomized controlled trials (RCTs). PubMed, the Cochrane Library, and PsycInfo, EMBASE, up to January 6th, 2020 were searched for this meta-analysis. The electronic search was supplemented by a manual search. Standardized mean difference (SMD), risk ratio (RR), and their 95% confidence intervals (CIs) were calculated and analyzed. A total of 29 studies with 15,255 participants were analyzed. EEC showed better effectiveness with the pooled RR for response of 1.30 (95%CI: 1.13-1.50, I2=81.9%, P<0.001, 18 studies), remission of 1.35 (95%CI: 1.11-1.64, I2=85.5%, P<0.001, 18 studies) and symptom reduction with a pooled SMD of -0.42 (95%CI: -0.61-(-0.23), I2=94.3%, P<0.001, 19 studies). All-cause discontinuations were similar between EEC and usual care with the pooled RR of 1.08 (95%CI: 0.94-1.23, I2=68.0%, P=0.303, 27 studies). This meta-analysis supported EEC as an evidence-based framework to improve the treatment outcome of depressive disorders.Review registration: PROSPERO: CRD42020163668.",34657142,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.902320861816406,-2.9475557804107666,78w
"Psychotherapy and depressive symptom trajectories among VA patients: Comparing dose-effect and good-enough level models.

Objective: Psychotherapy for depression is effective for many veterans, but the relationship between number of treatment sessions and symptom outcomes is not well established. The Dose-Effect model predicts that greater psychotherapeutic dose (total sessions) yields greater symptom improvement with each additional session resulting in smaller session-to-session improvement. In contrast, the Good-Enough Level (GEL) model predicts that rate of symptom improvement varies by total psychotherapeutic dose with faster improvement associated with earlier termination. This study compared the dose-effect and GEL model among veterans receiving psychotherapy for depression within the Veterans Health Administration. Method: The sample included 13,647 veterans with ≥2 sessions of psychotherapy for depression with associated Patient Health Questionnaire-9 (PHQ-9) scores in primary care (n = 7,502) and specialty mental health clinics (n = 6,145) between October 2014 and September 2018. Multilevel longitudinal modeling was used to compare the Dose-Effect and GEL models within each clinic type. Results: The GEL model demonstrated greater fit for both clinic types relative to dose-effect models. In both treatment settings, veterans with fewer sessions improved faster than those with more sessions. In primary care clinics, veterans who received 4-8 total sessions achieved similar levels of symptom response. In specialty mental health clinics, increased psychotherapeutic dose was associated with greater treatment response up to 16 sessions. Veterans receiving 20 sessions demonstrated minimal treatment response. Conclusions: These findings support the GEL model and suggest a flexible approach to determining length of psychotherapy for depression may be useful for optimizing treatment response and allocation of clinical resources. (PsycInfo Database Record (c) 2021 APA, all rights reserved).",34124925,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.91680908203125,-4.272924900054932,AUxI
"An everyday activity as a treatment for depression: the benefits of expressive writing for people diagnosed with major depressive disorder.

The benefits of expressive writing have been well documented among several populations, but particularly among those who report feelings of dysphoria. It is not known, however, if those diagnosed with Major Depressive Disorder (MDD) would also benefit from expressive writing. Forty people diagnosed with current MDD by the Structured Clinical Interview for DSM-IV participated in the study. On day 1 of testing, participants completed a series of questionnaires and cognitive tasks. Participants were then randomly assigned to either an expressive writing condition in which they wrote for 20 min over three consecutive days about their deepest thoughts and feelings surrounding an emotional event (n=20), or to a control condition (n=20) in which they wrote about non-emotional daily events each day. On day 5 of testing, participants completed another series of questionnaires and cognitive measures. These measures were repeated again 4 weeks later. People diagnosed with MDD in the expressive writing condition showed significant decreases in depression scores (Beck Depression Inventory and Patient Health Questionnaire-9 scores) immediately after the experimental manipulation (Day 5). These benefits persisted at the 4-week follow-up. Self-selected sample. This is the first study to demonstrate the efficacy of expressive writing among people formally diagnosed with current MDD. These data suggest that expressive writing may be a useful supplement to existing interventions for depression.",23790815,Major Depressive Disorder,Anxiety Treatment,Mental Health,14760,11.317754745483398,-4.069307327270508,CcV5
"Efficacy of metacognitive training for depression as add-on intervention for patients with depression in acute intensive psychiatric inpatient care: A randomized controlled trial.

Metacognitive training for depression (D-MCT) is a novel low-intensity group training for economic treatment of depression. Previous studies demonstrate its efficacy in moderately depressed outpatients. The present study evaluated efficacy and patients' perspective of the D-MCT in severely depressed psychiatric inpatients. In a randomized-controlled trial, 75 individuals with a major depressive disorder (MDD) were allocated to D-MCT versus euthymic therapy as add-on (twice a week) to cognitive-behavioural-based (CBT) inpatient-care. Depressive symptoms (HDRS, BDI), dysfunctional (meta)cognition (DAS, MCQ-30) and subjective appraisal were assessed at baseline, 4weeks (post) and 3months (follow-up). Participants in both conditions showed a large decline in depression at post and follow-up-assessment. No superior add-effect of D-MCT versus active control emerged for depression severity on top of the inpatient care. However, among patients with a diagnosis of MDD with no (vs. at least one) comorbidity, D-MCT participants showed a larger decline in depressive (meta-)cognition at follow-up with medium-to-large effect sizes. D-MCT was evaluated as superior in overall appraisal, treatment preference, motivation and satisfaction. The follow-up time interval of 3months may have been too short to detect long-term effects. There is emerging evidence that modification of (meta)cognition unfolds its full effects only with time. Effects of CBT inpatient-care on outcome parameters cannot be differentiated. Although D-MCT as an add-on was not superior in complete case analyses, results suggest greater benefit for patients with MDD and no comorbidity. D-MCT proved feasible in acute-psychiatric inpatient-care and was highly accepted by patients. Future studies should investigate the role of modified (meta)cognition on long-term treatment outcome, including dropout and relapse rates.",35274407,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.381470680236816,-1.717687964439392,jC8
"Psychoanalytic and cognitive-behavior therapy of chronic depression: study protocol for a randomized controlled trial.

Despite limited effectiveness of short-term psychotherapy for chronic depression, there is a lack of trials of long-term psychotherapy. Our study is the first to determine the effectiveness of controlled long-term psychodynamic and cognitive-behavioral (CBT) treatments and to assess the effects of preferential vs. randomized assessment. Patients are assigned to treatment according to their preference or randomized (if they have no clear preference). Up to 80 sessions of psychodynamic or psychoanalytically oriented treatments (PAT) or up to 60 sessions of CBT are offered during the first year in the study. After the first year, PAT can be continued according to the 'naturalistic' usual method of treating such patients within the system of German health care (normally from 240 up to 300 sessions over two to three years). CBT therapists may extend their treatment up to 80 sessions, but focus mainly maintenance and relapse prevention. We plan to recruit a total of 240 patients (60 per arm). A total of 11 assessments are conducted throughout treatment and up to three years after initiation of treatment. The primary outcome measures are the Quick Inventory of Depressive Symptoms (QIDS, independent clinician rating) and the Beck Depression Inventory (BDI) after the first year. We combine a naturalistic approach with randomized controlled trials(RCTs)to investigate how effectively chronic depression can be treated on an outpatient basis by the two forms of treatment reimbursed in the German healthcare system and we will determine the effects of treatment preference vs. randomization. http://www.controlled-trials.com/ISRCTN91956346.",22834725,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,10.928095817565918,-2.32651948928833,CqTW
"A machine learning ensemble to predict treatment outcomes following an Internet intervention for depression.

Some Internet interventions are regarded as effective treatments for adult depression, but less is known about who responds to this form of treatment. An elastic net and random forest were trained to predict depression symptoms and related disability after an 8-week course of an Internet intervention, Deprexis, involving adults (N = 283) from across the USA. Candidate predictors included psychopathology, demographics, treatment expectancies, treatment usage, and environmental context obtained from population databases. Model performance was evaluated using predictive R2$\\lpar R_{{\\rm pred}}^2\\rpar\\comma $ the expected variance explained in a new sample, estimated by 10 repetitions of 10-fold cross-validation. An ensemble model was created by averaging the predictions of the elastic net and random forest. Model performance was compared with a benchmark linear autoregressive model that predicted each outcome using only its baseline. The ensemble predicted more variance in post-treatment depression (8.0% gain, 95% CI 0.8-15; total $R_{{\\rm pred}}^2 \\; $= 0.25), disability (5.0% gain, 95% CI -0.3 to 10; total $R_{{\\rm pred}}^2 \\; $= 0.25), and well-being (11.6% gain, 95% CI 4.9-19; total $R_{{\\rm pred}}^2 \\; $= 0.29) than the benchmark model. Important predictors included comorbid psychopathology, particularly total psychopathology and dysthymia, low symptom-related disability, treatment credibility, lower access to therapists, and time spent using certain Deprexis modules. A number of variables predict symptom improvement following an Internet intervention, but each of these variables makes relatively small contributions. Machine learning ensembles may be a promising statistical approach for identifying the cumulative contribution of many weak predictors to psychosocial depression treatment response.",30392475,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.478747367858887,-1.0595757961273193,BDyy
"The role of early symptom trajectories and pretreatment variables in predicting treatment response to cognitive behavioral therapy.

Research has focused on 2 different approaches to answering the question, ""Which clients will respond to cognitive behavioral therapy (CBT) for depression?"" One approach focuses on rates of symptom change within the 1st few weeks of treatment, whereas the 2nd approach looks to pretreatment client variables (e.g., hopelessness) to identify clients who are more or less likely to respond. The current study simultaneously examines these 2 lines of research (i.e., early symptom change and pretreatment variables) on the prediction of treatment outcome to determine the incremental utility of each potential predictor. The sample consists of 173 clients (66.47% female, 92.49% Caucasian), 18-64 years of age (M = 27.94, SD = 11.42), receiving treatment for depression and anxiety disorders in a CBT-oriented psychology training clinic. The rate of change in depressive symptom severity from baseline over the 1st 5 treatment sessions significantly predicted treatment outcome. A contemplative orientation to change and medication status positively predicted early symptom change, whereas student status negatively predicted early symptom change. Higher levels of baseline anxiety, precontemplative readiness to change, and global functioning predicted lower levels of depressive symptom severity at termination. The findings suggest achieving rapid symptom change early in treatment may be integral to overall success. As such, therapists may wish to target factors such as readiness to change to potentially maximize rapid rate of symptom change and subsequent treatment outcome.",22730951,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.69363021850586,-3.295309066772461,CruB
"[The effectiveness of psychotherapy on depression in the long term].

Different short-term therapies, mainly with short follow-ups, seem equally effective treatments of mood disorders. The Helsinki Psychotherapy Study is the only published randomized trial on the effectiveness of short-term and long-term therapies during a longer follow-up. During a 5-year follow-up, patients' recovery from symptoms and improvement in work ability were greater in long-term therapy than in two, equally effective, short-term therapies. The short-term therapies were, however, more cost-effective, but many patients in them did not recover. More randomized clinical trials and cohort studies with long follow-ups on the efficacy, sufficiency and suitability of short- and long-term therapy are thus needed.",22428380,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.895577430725098,-4.158450126647949,Cv3t
"Defining and Predicting Patterns of Early Response in a Web-Based Intervention for Depression.

Web-based interventions for individuals with depressive disorders have been a recent focus of research and may be an effective adjunct to face-to-face psychotherapy or pharmacological treatment. The aim of our study was to examine the early change patterns in Web-based interventions to identify differential effects. We applied piecewise growth mixture modeling (PGMM) to identify different latent classes of early change in individuals with mild-to-moderate depression (n=409) who underwent a CBT-based web intervention for depression. Overall, three latent classes were identified (N=409): Two early response classes (n=158, n=185) and one early deterioration class (n=66). Latent classes differed in terms of outcome (P<.001) and adherence (P=.03) in regard to the number of modules (number of modules with a duration of at least 10 minutes) and the number of assessments (P<.001), but not in regard to the overall amount of time using the system. Class membership significantly improved outcome prediction by 24.8% over patient intake characteristics (P<.001) and significantly added to the prediction of adherence (P=.04). These findings suggest that in Web-based interventions outcome and adherence can be predicted by patterns of early change, which can inform treatment decisions and potentially help optimize the allocation of scarce clinical resources.",28600278,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.56119155883789,-2.686237335205078,BbVf
"Activity and subsequent depression levels: a causal analysis of behavioural activation group treatment with weekly assessments over 8 weeks.

Research on behavioural activation (BA) for depression assumes that increasing the rate of rewarding activities leads to reduced depressive mood. Although the efficacy of BA treatment has been convincingly demonstrated, assumptions referring to the mechanisms underlying this effect have not been tested decisively yet. The Behavioural Activation Scale for Depression and the Beck Depression Inventory II were administered over 8 weeks in 161 reliably diagnosed patients with unipolar depression who underwent BA treatment in groups. Time-lagged associations between behavioural activity on depression at subsequent assessment (1 week later) and vice versa were modelled (a) with multilevel models and (b) dynamic panel models that eliminate shared constant factors and allow for reverse causation (e.g., depression affecting subsequent activation in the model for activation on depression). Both activation and depression changed significantly (model-based within effect sizes for activation = .70 and for depression = -.75). Higher activation and lower depression predict each other over time (mixed-effects, time-lagged model), but this association disappears in dynamic causal models. Change patterns were only analysed within a time frame of 1 week; smaller time intervals were not investigated. There were no objective observational data of activity patterns. In the present study, increased behavioural activity and reduced depressive mood co-occur on the week scale. They predict each other across time, but this may be due to shared causes only.",31976588,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.767447471618652,-1.9000117778778076,AudO
"Exercise and internet-based cognitive-behavioural therapy for depression: multicentre randomised controlled trial with 12-month follow-up.

Evidence-based treatment of depression continues to grow, but successful treatment and maintenance of treatment response remains limited. To compare the effectiveness of exercise, internet-based cognitive-behavioural therapy (ICBT) and usual care for depression. A multicentre, three-group parallel, randomised controlled trial was conducted with assessment at 3 months (post-treatment) and 12 months (primary end-point). Outcome assessors were masked to group allocation. Computer-generated allocation was performed externally in blocks of 36 and the ratio of participants per group was 1:1:1. In total, 945 adults with mild to moderate depression aged 18-71 years were recruited from primary healthcare centres located throughout Sweden. Participants were randomly assigned to one of three 12-week interventions: supervised group exercise, clinician-supported ICBT or usual care by a physician. The primary outcome was depression severity assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS). The response rate at 12-month follow-up was 84%. Depression severity reduced significantly in all three treatment groups in a quadratic trend over time. Mean differences in MADRS score at 12 months were 12.1 (ICBT), 11.4 (exercise) and 9.7 (usual care). At the primary end-point the group × time interaction was significant for both exercise and ICBT. Effect sizes for both interventions were small to moderate. The long-term treatment effects reported here suggest that prescribed exercise and clinician-supported ICBT should be considered for the treatment of mild to moderate depression in adults.",27609813,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.738696098327637,-2.6329143047332764,BniV
"Long-term effects of Internet-delivered cognitive behavioral therapy for depression in primary care - the PRIM-NET controlled trial.

Internet-delivered cognitive behavioral therapy (ICBT) is recommended as an efficient treatment alternative for depression in primary care. However, only few previous studies have been conducted at primary care centers (PCCs). We evaluated long-term effects of ICBT treatment for depression compared to treatment as usual (TAU) in primary care settings. Randomized controlled trial. Patients were enrolled at16 PCCs in south-west Sweden. Patients attending PCCs and diagnosed with depression (n=90). Patients were assessed by a primary care psychologist/psychotherapist and randomized to ICBT or TAU. The ICBT included an ICBT program consisting of seven modules and weekly therapist e-mail or telephone support during the 3-month treatment period. Questionnaires on depressive symptoms (BDI-II), quality of life (EQ-5D) and psychological distress (GHQ-12) were administered at baseline, with follow-ups at 3, 6 and 12 months. Antidepressants and sedatives use, sick leave and PCC contacts were registered. Intra-individual change in depressive symptoms did not differ between the ICBT group and the TAU group during the treatment period or across the follow-up periods. At 3-month follow-up, significantly fewer patients in ICBT were on antidepressants. However, the difference leveled out at later follow-ups. There were no differences between the groups concerning psychological distress, sick leave or quality of life, except for a larger improvement in quality of life in the TAU group during the 0- to 6-month period. ICBT with weekly minimal therapist support in primary care can be equally effective as TAU among depressed patients also over a 12-month period. The trial was registered in the Swedish Registry, researchweb.org, ID number 30511.",28585868,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.598868370056152,-2.580048084259033,BbjM
"A randomised controlled trial of positive memory training for the treatment of depression within schizophrenia.

Depression is highly prevalent within individuals diagnosed with schizophrenia, and is associated with an increased risk of suicide. There are no current evidence based treatments for low mood within this group. The specific targeting of co-morbid conditions within complex mental health problems lends itself to the development of short-term structured interventions which are relatively easy to disseminate within health services. A brief cognitive intervention based on a competitive memory theory of depression, is being evaluated in terms of its effectiveness in reducing depression within this group. This is a single blind, intention-to-treat, multi-site, randomized controlled trial comparing Positive Memory Training plus Treatment as Usual with Treatment as Usual alone. Participants will be recruited from two NHS Trusts in Southern England. In order to be eligible, participants must have a DSM-V diagnosis of schizophrenia or schizo-affective disorder and exhibit at least a mild level of depression. Following baseline assessment eligible participants will be randomly allocated to either the Positive Memory Training plus Treatment as Usual group or the Treatment as Usual group. Outcome will be assessed at the end of treatment (3-months) and at 6-month and 9-month post randomization by assessors blind to group allocation. The primary outcome will be levels of depression and secondary outcomes will be severity of psychotic symptoms and cost-effectiveness. Semi-structured interviews will be conducted with all participants who are allocated to the treatment group so as to explore the acceptability of the intervention. Cognitive behaviour therapy is recommended for individuals diagnosed with schizophrenia. However, the number of sessions and length of training required to deliver this intervention has caused a limit in availability. The current trial will evaluate a short-term structured protocol which targets a co-morbid condition often considered of primary importance by service users. If successful the intervention will be an important addition to current initiatives aimed at increasing access to psychological therapies for people diagnosed with severe mental health problems. Current Controlled Trials. ISRCTN99485756 . Registered 13 March 2014.",25886265,Major Depressive Disorder,Anxiety Treatment,Mental Health,22470,11.918726921081543,-3.1180527210235596,B+8Y
"Personalized treatment of adult depression: medication, psychotherapy, or both? A systematic review.

Personalized medicine aims to identify which characteristics of an individual predict the outcome of a specific treatment, in order to get a better match between the individual and the treatment received. We conducted a systematic review and meta-analysis of randomized trials comparing two treatments directly in a group of patients with a specific characteristic. We searched relevant studies from bibliographical databases and included trials comparing (1) medication with psychotherapy, (2) medication with combined treatment, and (3) psychotherapy with combined treatment, in specific target groups (a) with a predefined sociodemographic characteristic, (b) a specific type of depression, (c) a comorbid mental or somatic disorder, or (d) from a specific setting (outpatients, primary care). We included 52 studies with 4,734 depressed patients. In these studies, 20 characteristics of the target groups were examined. The results showed that medication is probably the best treatment for dysthymia, and combined treatments are more effective in depressed outpatients, as well as in depressed older adults. However, in order to examine the 20 characteristics in the three categories of comparisons, 254 studies would be needed for having sufficient statistical power to show an effect size of g = 0.5. Currently, only 20.1% of these studies have been conducted. Although a considerable number of studies have compared medication, psychotherapy, and combined treatments, and some preliminary results are useful for deciding which treatment is best for which patient, the development of personalized treatment of depression has only just begun.",22815247,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.47542667388916,-2.0755889415740967,Cqjg
"Comparing bona fide psychotherapies of depression in adults with two meta-analytical approaches.

Despite numerous investigations, the question whether all bona fide treatments of depression are equally efficacious in adults has not been sufficiently answered. We applied two different meta-analytical techniques (conventional meta-analysis and mixed treatment comparisons). Overall, 53 studies with 3,965 patients, which directly compared two or more bona fide psychotherapies in a randomized trial, were included. Meta-analyses were conducted regarding five different types of outcome measures. Additionally, the influence of possible moderators was examined. Direct comparisons of cognitive behavior therapy, behavior activation therapy, psychodynamic therapy, interpersonal therapy, and supportive therapies versus all other respective treatments indicated that at the end of treatment all treatments but supportive therapies were equally efficacious whereas there was some evidence that supportive therapies were somewhat less efficacious than all other treatments according to patient self-ratings and clinical significance. At follow-up no significant differences were present. Age, gender, comorbid mental disorders, and length of therapy session were found to moderate efficacy. Cognitive behavior therapy was superior in studies where therapy sessions lasted 90 minutes or longer, behavior activation therapy was more efficacious when therapy sessions lasted less than 90 minutes. Mixed treatment comparisons indicated no statistically significant differences in treatment efficacy but some interesting trends. This study suggests that there might be differential effects of bona fide psychotherapies which should be examined in detail.",23840824,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.007458686828613,-2.5557777881622314,Cblw
"Drug-free options to fight depression. Cognitive behavioral therapy, exercise, and magnetic stimulation can make a difference.

",24873005,Major Depressive Disorder,Anxiety Treatment,Mental Health,1641,9.931679725646973,-1.3800867795944214,CNYp
"Economic evaluation of Internet-based problem-solving guided self-help treatment in comparison with enhanced usual care for depressed outpatients waiting for face-to-face treatment: A randomized controlled trial.

Previous studies have demonstrated the effectiveness of Internet-based interventions for depression in comparison with usual care. However, evidence on the cost-effectiveness of these interventions when delivered in outpatient clinics is lacking. The aim of this study was to estimate the cost-effectiveness of an Internet-based problem-solving guided self-help intervention in comparison with enhanced usual care for outpatients on a waiting list for face-to-face treatment for major depression. After the waiting list period, participants from both groups received the same treatment at outpatient clinics. An economic evaluation was performed alongside a randomized controlled trial with 12 months follow-up. Outcomes were improvement in depressive symptom severity (measured by CES-D), response to treatment and Quality-Adjusted Life-Years (QALYs). Statistical uncertainty around cost differences and incremental cost-effectiveness ratios were estimated using bootstrapping. Mean societal costs for the intervention group were €1579 higher than in usual care, but this was not statistically significant (95% CI - 1395 to 4382). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective in comparison with usual care was 0.57 at a ceiling ratio of €15,000/additional point of improvement in CES-D, and 0.25 and 0.30 for an additional response to treatment and an extra QALY respectively, at a ceiling ratio of €30,000. Sensitivity analysis showed that from a mental healthcare provider perspective the probability of the intervention being cost-effective was 0.68 for a ceiling ratio of 0 €/additional unit of effect for the CES-D score, response to treatment and QALYs. As the ceiling ratio increased this probability decreased, because the mean costs in the intervention group were lower than the mean costs in the usual care group. The patients in the intervention group showed low adherence to the Internet-based treatment. It is possible that greater adherence would have led to larger clinical effects. Offering an Internet-based intervention to depressed outpatients on waiting list for face-to-face treatment was not considered cost-effective in comparison with enhanced usual care from a societal perspective. There was a high probability of the intervention being cost-effective in comparison with enhanced usual care from the perspective of the mental healthcare provider.",27155071,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.343831062316895,-3.1625747680664062,BtKB
"Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth With Major Depressive Disorders: Randomized Controlled Trial.

Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth to communicate online, can strategically address depressive disorders. We performed a randomized controlled trial (RCT) that compared online mindfulness-based cognitive behavioral therapy (CBT-M) combined with standard psychiatric care to standard psychiatric care alone in youth (18-30 years old) diagnosed with major depressive disorder. Forty-five participants were randomly assigned to CBT-M and standard care (n=22) or to standard psychiatric care alone (n=23). All participants were provided standard psychiatric care (ie, 1 session per month), while participants in the experimental group received an additional intervention consisting of the CBT-M online software program. Interaction with online workbooks was combined with navigation coaching delivered by phone and secure text messaging. In a two-level linear mixed-effects model intention-to-treat analysis, significant between-group differences were found for the Beck Depression Inventory-II score (difference -8.54, P=.01), Quick Inventory of Depressive Symptoms score (difference -4.94, P=.001), Beck Anxiety Inventory score (difference -11.29, P<.001), and Brief Pain Inventory score (difference -1.99, P=.03), while marginal differences were found for the Five Facet Mindfulness Questionnaire-Nonjudging subscale (difference -2.68, P=.05). These results confirm that youth depression can be effectively treated with online CBT-M that can be delivered with less geographic restriction. Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052.",33688840,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.560540199279785,-2.882185459136963,AZn1
"Narrative therapy for adults with major depressive disorder: improved symptom and interpersonal outcomes.

This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population (61%), and clinically significant improvement (53%) were comparable to benchmark research outcomes. Post-therapy interpersonal relatedness improvement (d=.62) was less substantial than for symptoms. Three-month follow-up found maintenance of symptom, but not interpersonal gains. Benchmarking and clinical significance analyses mitigated repeated measure design limitations, providing empirical evidence to support narrative therapy for adults with major depressive disorder.",20306354,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.278882026672363,-2.607086420059204,DMjQ
"Family psychoeducation for major depressive disorder - study protocol for a randomized controlled trial.

Major depressive disorder has been shown to affect many domains of family life including family functioning. Conversely, the influence of the family on the course of the depression, including the risk of relapse, is one reason for targeting the family in interventions. The few studies conducted within this area indicate that family psychoeducation as a supplement to traditional treatment can effectively reduce the risk of relapse in patients with major depression as well as being beneficial for the relatives involved. However, the evidence is currently limited. This study will investigate the effect of family psychoeducation compared to social support on the course of the illness in patients with major depressive disorder. The study is designed as a dual center, two-armed, observer-blinded, randomized controlled trial. Relatives are randomized to participate in one of two conditions: either four sessions of manualized family psychoeducation or four sessions in a social support group led by a health care professional. Patients will not participate in the groups and will continue their treatment as usual. A total of 100 patients, each accompanied by one relative, will be recruited primarily from two outpatient clinics in the Capital Region of Denmark. The primary outcome is the occurrence of depressive relapse at 9-month follow-up defined as a score ≥7 on the Hamilton six-item subscale. Secondary outcomes will include time to relapse. It is hoped that the results from this study will help to clarify the mechanisms behind any beneficial changes due to family psychoeducation and provide information on the long-term effect of this intervention for both patient and relatives. If the results are positive, the family psychoeducation program may be suitable for implementation within a clinical setting. ClinicalTrials.gov Identifier: NCT02348827 , registered 5 January 2015.",27577267,Major Depressive Disorder,Anxiety Treatment,Mental Health,1033,10.816630363464355,-3.5994033813476562,Bn6v
"An Open Effectiveness Trial of a Multimodal Inpatient Treatment for Depression and Anxiety Among Adults With Serious Mental Illness.

This prospective open effectiveness trial examined symptom change trajectories and rates of remission from depression and anxiety in an intensive multimodal inpatient treatment for adults with serious mental illness (SMI). Patient baseline characteristics were examined as mediators/moderators of treatment response. Adult inpatients with SMI (N = 994) completed an average of 39 days of inpatient treatment. Latent growth curve (LGC) methods were used to model symptom trajectories, estimating expected remission based on individual patterns of change observed across the sample. Absolute reductions in symptoms were substantial, with large effect size improvements for both depression (d = 1.21, 95% CI [1.13, 1.29]) and anxiety (d = 1.13, 95% CI [1.05, 1.21]). For those presenting with elevated depressive symptoms (Patient Health Questionnaire-Depression ≥ 5.0; 87.5% of the sample), 46.9% evidenced remission from admission to discharge. Among patients presenting with significant anxiety (Patient Health Questionnaire-Generalized Anxiety Disorder Screener ≥ 5.0; 84.5% of the sample), 50.0% evidenced remission from admission to discharge. Mediation analyses revealed that depression and anxiety severity decreased more rapidly with increasing age and initial levels of experiential avoidance. Rates of remission of depression and anxiety were greater than anticipated in this large cohort of adult SMI inpatients and may be related to intensity and length of hospitalization.",28409715,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.597128868103027,-1.8161121606826782,Bd87
"The effect of psychotherapeutic interventions on positive and negative affect in depression: A systematic review and meta-analysis.

Depression is a mental disorder characterized by high and dysregulated negative affect in addition to diminished positive affect. To our knowledge, there has been no systematic review of the impact of psychotherapeutic interventions on these affective dimensions. Two comprehensive literature searches for all randomized controlled trials of psychotherapy in adults with depression were performed. The first from 1996 to December 31, 2014 and the second from January 1, 2015 to December 31, 2015. The primary outcome was the mean score of positive and negative affect. Depressive symptoms were measured to be included as a predictor in the meta-regression analyses. Ten studies with 793 adults with depression were included. All studies assessed positive and negative affect. Psychotherapeutic interventions resulted in significantly increased positive affect (g=0.41; 95% CI: 0.16-0.66 p=0.001), and significantly decreased negative affect (g=0.32; 95% CI: 0.15-0.78, p=0.001) in depressed adults. Because of the small number and substantial heterogeneity of the existing studies the meta-regression analyses produced conflicting results. As a consequence, we were unable to sufficiently demonstrate whether NA and depressive symptoms are in fact correlated or not. Given the small number and heterogeneity of the included studies, the findings should be considered with caution. Psychotherapeutic interventions demonstrate low to moderate effects in enhancing positive and reducing negative affect in depressed adults.",27262637,Major Depressive Disorder,Anxiety Treatment,Mental Health,23510,11.730987548828125,-2.4784834384918213,Brz9
"Effectiveness of guided self-help in decreasing expressed emotion in family caregivers of people diagnosed with depression in Thailand: a randomised controlled trial.

High expressed emotion (EE) can extend the duration of illness and precipitate relapse; however, little evidence-based information is available to assist family caregivers of individuals with depression. In the present exploratory study, we examined the effectiveness of a cognitive behaviour therapy (CBT) based guided self-help (GSH) manual in decreasing EE in caregivers of people with depression, in Thailand. A parallel group randomised controlled trial was conducted, following CONSORT guidelines, with 54 caregivers who were allocated equally to GSH or control group (standard outpatient department support). In addition, both groups were contacted weekly by telephone. EE was assessed, using the Family Questionnaire (FQ), at baseline, post-test (Week 8) and follow-up (Week 12). FQ scores at baseline indicated that both groups had similar, though moderately high level of EE. However, between baseline and post-test EE scores decreased markedly in the intervention group, but in contrast, they increased slightly in the control group. Between post-test and follow-up, little change took place in the EE scores of either group. Overall, the intervention group recipients of GSH showed a significant decrease in EE whereas the control group recipients of standard outpatient department support reported a slight increase in EE. These findings provide preliminary evidence that GSH is beneficial in reducing EE in caregivers, which is advantageous to family members with depression and caregivers. The approach may be used as an adjunct to the limited outpatient department support given to caregivers by mental health professionals and, perhaps, to caregivers who do not attend these departments. Australian and New Zealand Clinical Trials Registry https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366639. Registered 21 July 2014.",26489756,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.723666191101074,-3.4576504230499268,B2Qe
"Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents.

Depressive disorders are common in children and adolescents and, if left untreated, are likely to recur in adulthood. Depression is highly debilitating, affecting psychosocial, family and academic functioning. To evaluate the effectiveness of psychological therapies and antidepressant medication, alone and in combination, for the treatment of depressive disorder in children and adolescents. We have examined clinical outcomes including remission, clinician and self reported depression measures, and suicide-related outcomes. We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) to 11 June 2014. The register contains reports of relevant randomised controlled trials (RCTs) from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). RCTs were eligible for inclusion if they compared i) any psychological therapy with any antidepressant medication, or ii) a combination of psychological therapy and antidepressant medication with a psychological therapy alone, or an antidepressant medication alone, or iii) a combination of psychological therapy and antidepressant medication with a placebo or'treatment as usual', or (iv) a combination of psychological therapy and antidepressant medication with a psychological therapy or antidepressant medication plus a placebo.We included studies if they involved participants aged between 6 and 18 years, diagnosed by a clinician as having Major Depressive Disorder (MDD) based on Diagnostic and Statistical Manual (DSM) or International Classification of Diseases (ICD) criteria. Two review authors independently selected studies, extracted data and assessed the quality of the studies. We applied a random-effects meta-analysis, using the odds ratio (OR) to describe dichotomous outcomes, mean difference (MD) to describe continuous outcomes when the same measures were used, and standard mean difference (SMD) when outcomes were measured on different scales. We included eleven studies, involving 1307 participants in this review. We also identified one ongoing study, and two additional ongoing studies that may be eligible for inclusion. Studies recruited participants with different severities of disorder and with a variety of comorbid disorders, including anxiety and substance use disorder, therefore limiting the comparability of the results. Regarding the risk of bias in studies, just under half the studies had adequate allocation concealment (there was insufficient information to determine allocation concealment in the remainder), outcome assessors were blind to the participants' intervention in six studies, and in general, studies reported on incomplete data analysis methods, mainly using intention-to-treat (ITT) analyses. For the majority of outcomes there were no statistically significant differences between the interventions compared. There was limited evidence (based on two studies involving 220 participants) that antidepressant medication was more effective than psychotherapy on measures of clinician defined remission immediately post-intervention (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.27 to 0.98), with 67.8% of participants in the medication group and 53.7% in the psychotherapy group rated as being in remission. There was limited evidence (based on three studies involving 378 participants) that combination therapy was more effective than antidepressant medication alone in achieving higher remission from a depressive episode immediately post-intervention (OR 1.56, 95% CI 0.98 to 2.47), with 65.9% of participants treated with combination therapy and 57.8% of participants treated with medication, rated as being in remission. There was no evidence to suggest that combination therapy was more effective than psychological therapy alone, based on clinician rated remission immediately post-intervention (OR 1.82, 95% CI 0.38 to 8.68).Suicide-related Serious Adverse Events (SAEs) were reported in various ways across studies and could not be combined in meta-analyses. However, some trials measured suicidal ideation using standardised assessment tools suitable for meta-analysis. In one study involving 188 participants, rates of suicidal ideation were significantly higher in the antidepressant medication group (18.6%) compared with the psychological therapy group (5.4%) (OR 0.26, 95% CI 0.09 to 0.72) and this effect appeared to remain at six to nine months (OR 0.26, 95% CI 0.07 to 0.98), with 13.6% of participants in the medication group and 3.9% of participants in the psychological therapy group reporting suicidal ideation. It was unclear what the effect of combination therapy was compared with either antidepressant medication alone or psychological therapy alone on rates of suicidal ideation. The impact of any of the assigned treatment packages on drop out was also mostly unclear across the various comparisons in the review.Limited data and conflicting results based on other outcome measures make it difficult to draw conclusions regarding the effectiveness of any specific intervention based on these outcomes. There is very limited evidence upon which to base conclusions about the relative effectiveness of psychological interventions, antidepressant medication and a combination of these interventions. On the basis of the available evidence, the effectiveness of these interventions for treating depressive disorders in children and adolescents cannot be established. Further appropriately powered RCTs are required.",25433518,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.697434425354004,-2.0439834594726562,CFfw
"Whole-Body Hyperthermia for the Treatment of Major Depressive Disorder: A Randomized Clinical Trial.

Limitations of current antidepressants highlight the need to identify novel treatments for major depressive disorder. A prior open trial found that a single session of whole-body hyperthermia (WBH) reduced depressive symptoms; however, the lack of a placebo control raises the possibility that the observed antidepressant effects resulted not from hyperthermia per se, but from nonspecific aspects of the intervention. To test whether WBH has specific antidepressant effects when compared with a sham condition and to evaluate the persistence of the antidepressant effects of a single treatment. A 6-week, randomized, double-blind study conducted between February 2013 and May 2015 at a university-based medical center comparing WBH with a sham condition. All research staff conducting screening and outcome procedures were blinded to randomization status. Of 338 individuals screened, 34 were randomized, 30 received a study intervention, and 29 provided at least 1 postintervention assessment and were included in a modified intent-to-treat efficacy analysis. Participants were medically healthy, aged 18 to 65 years, met criteria for major depressive disorder, were free of psychotropic medication use, and had a baseline 17-item Hamilton Depression Rating Scale score of 16 or greater. A single session of active WBH vs a sham condition matched for length of WBH that mimicked all aspects of WBH except intense heat. Between-group differences in postintervention Hamilton Depression Rating Scale scores. The mean (SD) age was 36.7 (15.2) years in the WBH group and 41.47 (12.54) years in the sham group. Immediately following the intervention, 10 participants (71.4%) randomized to sham treatment believed they had received WBH compared with 15 (93.8%) randomized to WBH. When compared with the sham group, the active WBH group showed significantly reduced Hamilton Depression Rating Scale scores across the 6-week postintervention study period (WBH vs sham; week 1: -6.53, 95% CI, -9.90 to -3.16, P<.001; week 2: -6.35, 95% CI, -9.95 to -2.74, P=.001; week 4: -4.50, 95% CI, -8.17 to -0.84, P=.02; and week 6: -4.27, 95% CI, -7.94 to -0.61, P=.02). These outcomes remained significant after evaluating potential moderating effects of between-group differences in baseline expectancy scores. Adverse events in both groups were generally mild. Whole-body hyperthermia holds promise as a safe, rapid-acting, antidepressant modality with a prolonged therapeutic benefit. clinicaltrials.gov Identifier: NCT01625546.",27172277,Major Depressive Disorder,Anxiety Treatment,Mental Health,22509,9.356368064880371,-0.831875205039978,Bs7P
"Examination of the utility of psychotherapy for patients with treatment resistant depression: a systematic review.

To examine the utility of psychotherapy in managing treatment resistant depression. PubMed, PsycInfo, Embase, Cochrane Registry of Controlled Clinical Trials, article bibliographies. Eligible articles had to be in English and include English-speaking adult outpatients from general medical or mental health clinics. Studies had to be randomized clinical trials (RCT) involving at least one of the following psychotherapy modalities: cognitive therapy, interpersonal therapy, or behavior therapy. Patients were considered treatment resistant if they reported partial or no remission following treatment with an adequate antidepressant dose for ≥ 6 weeks. Exclusion criteria included receiving psychotherapy at the time of recruitment, and/or comorbid psychiatric conditions unlikely to be treated outside of specialized mental health care (e.g., severe substance abuse). Due to heterogeneity in study designs, a summary estimate of effect was not calculated. Studies were critically analyzed and a qualitative synthesis was conducted. Of 941 original titles, 13 articles evaluating 7 unique treatment comparisons were included. Psychotherapy was examined as an augmentation to antidepressants in five studies and as substitution treatment in two studies. A total of 592 patients were evaluated (Mean age ~40 y; Females = 50-85%; Caucasians ≥ 75%). The STAR*D trial used an equipoise stratified randomization design; the remaining studies were RCTs. Compared to active management, two good quality trials showed similar benefit from augmenting antidepressants with psychotherapy; one fair quality and one poor quality trial showed benefit from psychotherapy augmentation; and one good and one poor trial found similar benefit from substituting psychotherapy for antidepressants. One fair quality trial showed lithium augmentation to be more beneficial than psychotherapy. Review demonstrates the utility of psychotherapy in managing treatment resistant depression. However, evidence is sparse and results are mixed. Given that quality trials are lacking, rigorous clinical trials are recommended to guide practice. In the interim, primary care providers should consider psychotherapy when treating patients with treatment resistant depression.",21184287,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.390559196472168,-2.2545979022979736,DB5N
"[Personalised internet-based interventions for depression: with or without personal support?]

Psychological treatment of depression can be made more accessible with internet-based interventions. A large number of trials has shown that on average these interventions are more effective when some kind of personal support by a clinician is given compared to unguided interventions. In order to examine whether there are subgroups of patients for whom unguided interventions are as effective as guided interventions, we conducted an 'individual patient data' network meta-analysis in which the primary data of 36 randomised trials with 8107 patients were integrated into one dataset. We found that several patient characteristics predict the outcome. Unguided interventions were as effective as guided interventions in mild depression. These data also make it possible to predict which patient with which characteristics benefits from guided and unguided interventions. We consider this as an important step towards personalised treatment of depression.",35736386,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.91596794128418,-3.674992799758911,S/E
"Does psychological process change during psychotherapy predict long-term depression outcome after successful cognitive therapy or interpersonal psychotherapy? Secondary analysis of a randomized trial.

Objective Psychotherapies for depression are similarly effective, but the processes through which these therapies work have not been identified. We focus on psychological process changes during therapy as predictors of long-term depression outcome in treatment responders. Method: Secondary analysis of a randomized trial comparing cognitive therapy (CT) and interpersonal psychotherapy (IPT) that focuses on 85 treatment responders. Using mixed-effects models, changes during therapy (0-7 months) on nine process variables were associated with depression severity (BDI-II) at follow-up (7-24 months). Results: A decrease in dysfunctional attitudes was associated with a decrease in depression scores over time. Improved self-esteem was associated with less depression at follow-up (borderline significant). More improvement in both work and social functioning and interpersonal problems was associated with better depression outcomes in IPT relative to CT, while less improvement in work and social functioning and interpersonal problems was associated with better outcomes in CT relative to IPT. Conclusions: Less negative thinking during therapy is associated with lower depression severity in time, while changes during therapy in work and social functioning and interpersonal problems appear to predict different long-term outcomes in CT vs. IPT. If replicated, these findings can be used to guide clinical decision-making during psychotherapy.",35442870,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.772249221801758,-3.1704909801483154,cts
"The effects of cognitive therapy versus 'treatment as usual' in patients with major depressive disorder.

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy may be an effective treatment option for major depressive disorder, but the effects have only had limited assessment in systematic reviews. Cochrane systematic review methodology, with meta-analyses and trial sequential analyses of randomized trials, are comparing the effects of cognitive therapy versus 'treatment as usual' for major depressive disorder. To be included the participants had to be older than 17 years with a primary diagnosis of major depressive disorder. Altogether, we included eight trials randomizing a total of 719 participants. All eight trials had high risk of bias. Four trials reported data on the 17-item Hamilton Rating Scale for Depression and four trials reported data on the Beck Depression Inventory. Meta-analysis on the data from the Hamilton Rating Scale for Depression showed that cognitive therapy compared with 'treatment as usual' significantly reduced depressive symptoms (mean difference -2.15 (95% confidence interval -3.70 to -0.60; P<0.007, no heterogeneity)). However, meta-analysis with both fixed-effect and random-effects model on the data from the Beck Depression Inventory (mean difference with both models -1.57 (95% CL -4.30 to 1.16; P = 0.26, I(2) = 0) could not confirm the Hamilton Rating Scale for Depression results. Furthermore, trial sequential analysis on both the data from Hamilton Rating Scale for Depression and Becks Depression Inventory showed that insufficient data have been obtained. Cognitive therapy might not be an effective treatment for major depressive disorder compared with 'treatment as usual'. The possible treatment effect measured on the Hamilton Rating Scale for Depression is relatively small. More randomized trials with low risk of bias, increased sample sizes, and broader more clinically relevant outcomes are needed.",21829664,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.099615097045898,-2.6775693893432617,C42G
"Identifying relapse prevention elements during psychological treatment of depression: Development of an observer-based rating instrument.

Although observer-rated instruments assessing therapist's adherence to relapse-preventive treatments are available, they do not adequately cover specific relapse-preventive elements that focus on implementation of strategies after terminating treatment. This study describes the development of the KERI-D (Kodierbogen zur Erfassung Rückfallprophylaktischer Interventionen bei Depression/Coding System to Assess Interventions of Relapse Prevention in Depression). The KERI-D is a new observer-based rating tool for acute or continuation/maintenance-phase sessions and assesses relapse-prevention elements including implementation into patient's daily routines. The development of the KERI-D included iterative steps referring to theoretical, clinical and empirical sources. It consists of 19 content items within four categories (self-care, early warning signs, triggering events/situations, termination of therapy) and one global item. For empirical analyses, videotaped psychotherapy sessions of 36 psychotherapies were rated by three independent observers and analyzed for their psychometric properties. Most items showed moderate to good inter-rater reliability (median ICC = .80) and retest reliability (median ICC = .93). Principal-axis factor analysis revealed three subscales, and first evidence of content validity was demonstrated. No associations with clinical follow-up data were found. Analysis was limited to a relatively small sample of selected psychotherapy sessions. Evaluation of predictive validity is a desirable next step to further examine applicability and scope of the instrument. The KERI-D is the first observer-based rating instrument measuring specific relapse-prevention strategies in psychotherapy for depression. It may help to identify elements that prove effective in reducing relapse/recurrence in the long-term and thereby help to optimize effect duration of depression treatment.",29149753,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.386652946472168,-0.9698824882507324,BUCN
"The clinical effectiveness of cognitive behavior therapy and an alternative medicine approach in reducing symptoms of depression in adolescents.

The main aim of the study was to investigate the effectiveness of two psychotherapeutic approaches, cognitive behavioral therapy (CBT) and a complementary medicine method Reiki, in reducing depression scores in adolescents. We recruited 188 adolescent patients who were 12-17 years old. Participants were randomly assigned to CBT, Reiki or wait-list. Depression scores were assessed before and after the 12 week interventions or wait-list. CBT showed a significantly greater decrease in Child Depression Inventory (CDI) scores across treatment than both Reiki (p<.001) and the wait-list control (p<.001). Reiki also showed greater decreases in CDI scores across treatment relative to the wait-list control condition (p=.031). The analyses indicated a significant interaction between gender, condition and change in CDI scores, such that male participants showed a smaller treatment effect for Reiki than did female participants. Both CBT and Reiki were effective in reducing the symptoms of depression over the treatment period, with effect for CBT greater than Reiki. These findings highlight the importance of early intervention for treatment of depression using both cognitive and complementary medicine approaches. However, research that tests complementary therapies over a follow-up period and against a placebo treatment is required.",27058159,Major Depressive Disorder,Anxiety Treatment,Mental Health,12770,11.027430534362793,-2.9762988090515137,Bug8
"Preventing Depression in Adults With Subthreshold Depression: Health-Economic Evaluation Alongside a Pragmatic Randomized Controlled Trial of a Web-Based Intervention.

Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD) in people with subthreshold depression (sD). A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web-based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs) were assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6- and 12-month follow-up, covering the period to the previous assessment. Costs were self-assessed through a questionnaire. Costs measured from a societal and health care perspective were related to DFYs and quality-adjusted life years (QALYs). In total, 406 participants were enrolled in the trial. The mean treatment duration was 5.84 (SD 4.37) weeks. On average, participants completed 4.93 of 6 sessions. Significantly more DFYs were gained in the intervention group (0.82 vs 0.70). Likewise, QALY health gains were in favor of the intervention, but only statistically significant when measured with the more sensitive SF-6D. The incremental per-participant costs were €136 (£116). Taking the health care perspective and assuming a willingness-to-pay of €20,000 (£17,000), the intervention's likelihood of being cost-effective was 99% for gaining a DFY and 64% or 99% for gaining an EQ-5D or a SF-6D QALY. Our study supports guidelines recommending Web-based treatment for sD and adds that this not only restores health in people with sD, but additionally reduces the risk of developing a MDD. Offering the intervention has an acceptable likelihood of being more cost-effective than enhanced usual care and could therefore reach community members on a wider scale. German Clinical Trials Register: DRKS00004709; http://www.drks.de/DRKS00004709 (Archived by WebCite at http://www.webcitation.org/6kAZVUxy9).",28052841,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.8269624710083,-2.871487855911255,BioQ
"A comparison of transdiagnostic behavior therapy (TBT) and behavioral activation treatment for depression (BATD) in veterans with major depressive disorder.

Although frequently discussed within the scope of transdiagnostic psychotherapy protocols, limited data are available on their efficacy in patients with a principal diagnosis of major depressive disorder. The present study attempted to address that gap in the literature through a randomized clinical trial comparing transdiagnostic behavior therapy (TBT) to behavioral activation treatment for depression (BATD). Forty veterans with principal major depressive disorder were randomized into either 12 sessions of individual TBT or BATD, with symptom measures collected at baseline and posttreatment. Process variables for treatment engagement and completion also were recorded. Participants reported similar symptom improvements in depression, stress, anhedonia, and impairment across both treatments. Clinician-rated treatment improvements favored TBT. Participants in TBT also attended more appointments, canceled or missed fewer appointments, and completed the protocol at a higher rate than participants that received BATD. The present findings support TBT as an efficacious treatment for principal major depressive disorder, with potentially superior coverage of comorbid anxiety symptomatology and improved treatment adherence and completion compared to BATD. Pending replication in larger samples, TBT and other similar transdiagnostic psychotherapies should be considered for implementation across the anxiety and depressive disorders to simplify dissemination efforts for evidence-based psychotherapies and potentially improve coverage of comorbidity.",34935138,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,11.87495231628418,-2.9076714515686035,wg0
"The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials.

To review the outcomes, nature and quality of published randomised controlled trials of preventive and treatment internet interventions for depression and anxiety disorders, and to document the availability of effective interventions. Previous reviews of internet interventions for mental health and related conditions were updated using an extension of the original methodology. All studies included in the original reviews and more recent eligible trials (published before June 2009) were included, together with any trials identified from a search of the health intervention web portal Beacon and the Journal of Medical Internet Research. A total of 29 reports describing 26 trials satisfied the inclusion criteria. All trials employed a cognitive behaviour therapy intervention program. Of the 26 trials, 23 demonstrated some evidence of effectiveness relative to controls. Effect size differences ranged from 0.42 to 0.65 for depression interventions involving participants with clinically significant symptoms of depression, and 0.29 to 1.74 for anxiety interventions involving participants with a diagnosed anxiety disorder. Of the five effective English-language programs, three are available to the public without charge and two can be accessed at a small cost through health practitioner referral. Internet interventions for depression and anxiety disorders offer promise for use as self-help applications for consumers or as an adjunct to usual care.",20528707,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.653271675109863,-3.791870355606079,DJod
"Effectiveness of stress control large group psychoeducation for anxiety and depression: Systematic review and meta-analysis.

This review sought to evaluate the effectiveness of the 'Stress Control' (SC) large psychoeducational 6-session group programme developed to increase access to treatment for patients with anxiety and depression. Systematic review and meta-analysis (Prospero registration: CRD42020173676). Pre-post and post-treatment follow-up effect sizes were extracted and synthesized in a random effects meta-analysis, and variations in effect sizes were investigated via moderator analyses. Secondary analyses synthesized between-group effect sizes from controlled studies containing comparator treatments and calculated the average dropout rate. The quality of the meta-analysis was assessed using the GRADE approach. Nineteen studies with pre-post treatment outcomes were included. The average group size was N = 39, and the average dropout rate was 34%. Pooled effect sizes indicated moderate pre-post treatment reductions in anxiety (ES = 0.58; CI 0.41 to 0.75; N = 5597; Z = 7.13; p < .001), moderate reductions in depression (ES = 0.62; CI 0.44 to 0.80; N = 5538, Z = 7.30; p < .001), and large reductions in global distress (ES = 0.86; CI 0.61 to 1.11; N = 591; Z = 7.41; p < .001). At follow-up, improvements in anxiety, depression, and global distress were maintained. When SC was compared to active and passive controls, outcomes were equivalent for anxiety (ES = 0.12, 95% CI -0.25 to 0.49, Z = -0.70; p = .482) and depression (ES = 0.15, 95% CI -0.24 to 0.54, Z = 0.84; p = .401). SC appears to be a clinically effective and durable low-intensity group intervention that facilitates access to treatment for large patient numbers. However, conclusions are limited by the low methodological quality of the evidence. The stress control version of large group psychoeducation is appropriate and effective for mild-to-moderate anxiety and depression The evidence base for stress control is predominantly made up of practice-based studies Stress control needs to form one component of the overall offer made to patients presenting with mild-to-moderate anxiety and depression The competencies required to deliver such groups need better specification.",33822376,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,10.545760154724121,-2.908372402191162,AYOj
"The clinical effectiveness of an algorithm-guided treatment program for depression in specialized mental healthcare: A comparison with efficacy trials.

Doubts exist on whether effects found in randomized controlled trials (RCTs) are directly generalizable to daily clinical practice. This study aimed (a) to investigate the effectiveness of treatment options within an algorithm-guided treatment (AGT) program for depression and compare their effectiveness with outcomes of efficacy trials and (b) to assess the relation between treatment continuity and outcomes. This naturalistic study linked treatment data from January 2012 to November 2014 from a Dutch mental healthcare provider, to routine outcome monitoring (ROM) data (N = 351). Effectiveness of the treatment options (pharmacotherapy, psychotherapy and their combination) was compared to the efficacy reported in the meta-analyses. We included treatment continuity as binary variable ""early terminators versus completers of the recommended number of treatment sessions"". Remission rates for psychotherapy (38% [95% CI: 32-45]), pharmacotherapy (31% [95% CI: 22-42]) and combination therapy (46% [95% CI: 19-75]) were respectively lower, comparable, and comparable to those reported in the meta-analyses. Similarly, response rates were respectively lower (24% [95% CI: 19-30]), lower (21% [95% CI: 13-31]), and comparable (46% [95% CI: 19-75]) to meta-analyses results. A similar share of early terminators and completers achieved remission and response. A substantial proportion of patients had incomplete ROM data after data linkage. Limited set of patient characteristics to check for selection bias. Despite the more heterogeneous patient population in clinical practice, the effectiveness of an AGT program, emphasizing strict guideline adherence, approached that found in RCTs. A fixed number of treatment sessions may not suit all individual patients.",32734911,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.17599868774414,-2.4686434268951416,Ak/g
"Improving outcomes for patients with depression by enhancing antidepressant therapy with non-pharmacological interventions: a systematic review of reviews.

To analyse literature reviews reporting outcomes of non-pharmacological interventions directed at improving the treatment of depression. A review of English articles was performed in June 2009 using the following databases: PubMed, EMBASE, International Pharmaceutical Abstracts, Web of Science, PsycINFO and the Cochrane Library. Only review articles comparing traditional pharmacotherapy and interventions combining pharmacological and non-pharmacological treatments were included. Extraction of articles and quality assessment of included reviews was performed independently by two authors using the AMSTAR score. The articles in the final data set included research on psychotherapeutic, multifaceted and single-component interventions. Single-component interventions have failed to demonstrate improved outcome for patients with depression. Collaborative care and additional psychotherapy have been shown to provide more benefits for patients than pharmacotherapy alone. Both approaches have a small effect on short-term treatment, and psychotherapy is the most effective for long-term prognosis in terms of preventing relapse. Conclusions regarding the effects of adherence-improving and multifaceted interventions are fairly certain. However, the findings about the impact of combined psychotherapy and pharmacotherapy on the outcomes of depression remain tentative due to the methodological limitations of available reviews.",21600619,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.713672637939453,-1.1388736963272095,C79l
"No Sustainable Effects of an Internet-Based Relapse Prevention Program over 24 Months in Recurrent Depression: Primary Outcomes of a Randomized Controlled Trial.

",29306953,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.379725456237793,-1.754143238067627,BR19
"Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus supportive psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial.

Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD). Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA) controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically depressed patients. ClinicalTrials.gov (NCT00970437).",21849054,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.278742790222168,-2.0493037700653076,C4jk
"Effects of Early-Stage Group Psychoeducation Programme for Patients with Depression.

The purpose of this study was to examine the effect of a psychoeducational group programme on inpatients with depression. We compared the attributes and Inventory Scale for Mood and Sense of Fatigue (SMSF) scores of 45 people who participated in the programme (participation group) with those of 37 people who did not participate (control group). Further, we investigated the rate of readmission 6 months after discharge and the number of patients in the participation group who had consulted a psychiatric social worker. Statistically, there were no significant differences in the SMSF score between the two groups on admission and at the time of discharge. The programme had no effect on the readmission rate. However, the SMSF score of the participation group significantly improved from the start of the programme to patient discharge. Furthermore, improvement of depressive symptoms, feeling of recovery and adherence were found in the participation group. The programme seemed to provide a psychotherapeutic effect for the patients and promoted cooperation with occupational therapist and other specialists in the hospital. The efficacy of psychoeducation in preventing recurrence of depression remains to be demonstrated, and methods of investigating effective approaches for this purpose need to be considered in the future.",26148274,Major Depressive Disorder,Anxiety Treatment,Mental Health,12433,10.793549537658691,-3.5026538372039795,B7Sa
"How and for whom does web-based acceptance and commitment therapy work? Mediation and moderation analyses of web-based ACT for depressive symptoms.

Acceptance and Commitment Therapy (ACT) has been demonstrated to be effective in reducing depressive symptoms. However, little is known how and for whom therapeutic change occurs, specifically in web-based interventions. This study focuses on the mediators, moderators and predictors of change during a web-based ACT intervention. Data from 236 adults from the general population with mild to moderate depressive symptoms, randomized to either web-based ACT (n=82) or one of two control conditions (web-based Expressive Writing (EW; n=67) and a waiting list (n=87)), were analysed. Single and multiple mediation analyses, and exploratory linear regression analyses were performed using PROCESS and linear regression analyses, to examine mediators, moderators and predictors on pre- to post- and follow-up treatment change of depressive symptoms. The treatment effect of ACT versus the waiting list was mediated by psychological flexibility and two mindfulness facets. The treatment effect of ACT versus EW was not significantly mediated. The moderator analyses demonstrated that the effects of web-based ACT did not vary according to baseline patient characteristics when compared to both control groups. However, higher baseline depressive symptoms and positive mental health and lower baseline anxiety were identified as predictors of outcome across all conditions. Similar results are found for follow-up. The findings of this study corroborate the evidence that psychological flexibility and mindfulness are distinct process mechanisms that mediate the effects of web-based ACT intervention. The results indicate that there are no restrictions to the allocation of web-based ACT intervention and that web-based ACT can work for different subpopulations. Netherlands Trial Register NTR2736 . Registered 6 February 2011.",27215733,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.035531997680664,-1.905471920967102,BsbD
"The effect of CBT and its modifications for relapse prevention in major depressive disorder: a systematic review and meta-analysis.

The risk of relapse in major depressive disorder (MDD) is associated with high worldwide disease burden. Cognitive behavioral therapy (CBT) and its modifications might be effective in relapse prevention. The aim of this review was to evaluate the efficacy of these treatments for reducing relapse of MDD. The retrieval was performed in the databases of MEDLINE via Pubmed, EMBASE and PsycINFO via OVID, The Cochrane Library and four Chinese databases. Clinical trials registry platforms and references of relevant articles were retrieved as well. Hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to pool evidences. A total of 16 eligible trials involving 1945 participants were included. In the first 12 months, CBT was more efficacious than control in reducing the risk of developing a new episode of depression for MDD patients in remission (HR:0.50, 95%CI:0.35-0.72, I2 =11%). Mindfulness-based cognitive therapy (MBCT) was more efficacious than control only among patients with 3 or more previous depressive episodes (HR:0.46, 95%CI:0.31-0.70, I2 =38%). Besides, compared with maintenance antidepressant medication (m-ADM), MBCT was a more effective intervention (HR:0.76, 95%CI:0.58-0.98, I2 =0%). These positive effects might be only maintained at two and nearly 6 years follow up for CBT. The use of CBT for MDD patients in remission might reduce risk of relapse. Besides, the effect of MBCT was moderated by number of prior episodes and MBCT might only be effective for MDD patients with 3 or more previous episodes. Further exploration for the influence of previous psychological intervention is required.",29475431,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.355046272277832,-1.1662616729736328,BPmU
"Pharmacological Interventions versus Combined Treatment of Depression: A Prospective Study.

Depression is a common disease worldwide but still, the role of combined treatment (pharmacological and psychological interventions) needs to be clarified. The study aims to compare the effectiveness of integrated treatment versus exclusive pharmacological intervention of depression. The observational prospective study provided the collection of data relating to outpatients evaluated through the administration of the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), and the Clinical Global Impression Scale (CGI) both at T0 and at a 3-month follow up visit (T1). A statically significant association between sex (female) and psychotherapy utilization emerged. A statistically significant association between education (graduated patients) and psychotherapy use was observed. The other qualitative variables showed no statistically significance associations. No significant association between drop out and type of treatment emerged. Clinical research has not yet conclusively demonstrated the superiority of combined therapy over single treatments. As regards sex, the result is in line with the professional literature and provides support in describing how men have more stigmatizing beliefs about treatment of mental health. As regards education, graduated people present higher rates of adherence probably because they may have major introspective capacity and predisposition to communication. Limitations consist in small sample and short duration of the follow-up (3 months). The strengths, in the type of setting and the respect for routine clinical practice. Future perspective of the research could focus on application of rating instruments to highlight the variables involved in depressive disorder.",36339279,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.177125930786133,-1.904234766960144,CEU
"A randomized controlled trial of internet-based therapy in depression.

Depression is among the most prevalent disorders worldwide. In view of numerous treatment barriers, internet-based interventions are increasingly adopted to ""treat the untreated"". The present trial (registered as NCT01401296) was conducted over the internet and aimed to assess the efficacy of an online self-help program for depression (Deprexis). In random order, participants with elevated depression symptoms received program access or were allocated to a wait-list control condition. After eight weeks, participants were invited to take part in an online re-assessment. To compensate for common problems of online studies, such as low completion rates and unclear diagnostic status, reminders and incentives were used, and clinical diagnoses were externally confirmed in a subgroup of 29% of participants. Relative to the wait-list group, program users experienced significant symptom decline on the Beck Depression Inventory (BDI; primary outcome), the Dysfunctional Attitudes Scale (DAS), the Quality of Life scale (WHOQOL-BREF) and the Rosenberg Self-Esteem Scale (RSE). Compared to wait-list participants, symptom decline was especially pronounced among those with moderate symptoms at baseline as well as those not currently consulting a therapist. Completion (82%) and re-test reliability of the instruments (r = .72-.87) were good. The results of this trial suggest that online treatment can be beneficial for people with depression, particularly for those with moderate symptoms.",22677231,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.967692375183105,-3.341546058654785,Csg/
"Collaborative care for depression and anxiety problems.

Common mental health problems, such as depression and anxiety, are estimated to affect up to 15% of the UK population at any one time, and health care systems worldwide need to implement interventions to reduce the impact and burden of these conditions. Collaborative care is a complex intervention based on chronic disease management models that may be effective in the management of these common mental health problems. To assess the effectiveness of collaborative care for patients with depression or anxiety. We searched the following databases to February 2012: The Cochrane Collaboration Depression, Anxiety and Neurosis Group (CCDAN) trials registers (CCDANCTR-References and CCDANCTR-Studies) which include relevant randomised controlled trials (RCTs) from MEDLINE (1950 to present), EMBASE (1974 to present), PsycINFO (1967 to present) and the Cochrane Central Register of Controlled Trials (CENTRAL, all years); the World Health Organization (WHO) trials portal (ICTRP); ClinicalTrials.gov; and CINAHL (to November 2010 only). We screened the reference lists of reports of all included studies and published systematic reviews for reports of additional studies. Randomised controlled trials (RCTs) of collaborative care for participants of all ages with depression or anxiety. Two independent researchers extracted data using a standardised data extraction sheet. Two independent researchers made 'Risk of bias' assessments using criteria from The Cochrane Collaboration. We combined continuous measures of outcome using standardised mean differences (SMDs) with 95% confidence intervals (CIs). We combined dichotomous measures using risk ratios (RRs) with 95% CIs. Sensitivity analyses tested the robustness of the results. We included seventy-nine RCTs (including 90 relevant comparisons) involving 24,308 participants in the review. Studies varied in terms of risk of bias.The results of primary analyses demonstrated significantly greater improvement in depression outcomes for adults with depression treated with the collaborative care model in the short-term (SMD -0.34, 95% CI -0.41 to -0.27; RR 1.32, 95% CI 1.22 to 1.43), medium-term (SMD -0.28, 95% CI -0.41 to -0.15; RR 1.31, 95% CI 1.17 to 1.48), and long-term (SMD -0.35, 95% CI -0.46 to -0.24; RR 1.29, 95% CI 1.18 to 1.41). However, these significant benefits were not demonstrated into the very long-term (RR 1.12, 95% CI 0.98 to 1.27).The results also demonstrated significantly greater improvement in anxiety outcomes for adults with anxiety treated with the collaborative care model in the short-term (SMD -0.30, 95% CI -0.44 to -0.17; RR 1.50, 95% CI 1.21 to 1.87), medium-term (SMD -0.33, 95% CI -0.47 to -0.19; RR 1.41, 95% CI 1.18 to 1.69), and long-term (SMD -0.20, 95% CI -0.34 to -0.06; RR 1.26, 95% CI 1.11 to 1.42). No comparisons examined the effects of the intervention on anxiety outcomes in the very long-term.There was evidence of benefit in secondary outcomes including medication use, mental health quality of life, and patient satisfaction, although there was less evidence of benefit in physical quality of life. Collaborative care is associated with significant improvement in depression and anxiety outcomes compared with usual care, and represents a useful addition to clinical pathways for adult patients with depression and anxiety.",23076925,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,8.377614974975586,-5.48795747756958,Cm02
"Systematic review and meta-analysis of group cognitive behavioural psychotherapy treatment for sub-clinical depression.

Studies investigating effectiveness of group psychotherapy intervention in sub-threshold depression have shown varying results with differing effect sizes. A systematic review of randomised controlled trials of group psychotherapy in adults with sub-threshold depression has been conducted to present the best available evidence in relation to its effect on depressive symptomatology and prevention of incident major depression. Electronic search for RCTs and a meta-analysis using random effects models to obtain a pooled estimate. Eight studies from six clinical trials met the inclusion criteria. Group psychotherapy is an effective intervention for reducing depressive symptoms in adults with sub-threshold depression in comparison to waiting list controls (MD=-3.48, 95% CI: -5.02, -1.93). The reported benefits for group intervention in reducing depressive symptoms in comparison to other active interventions did not reach statistical significance (MD=0.37 95% CI: -1.29, 2.04). The benefit of group psychotherapy at follow-up is not maintained. Group psychotherapies do not appear to reduce the risk of incident depressive disorder during the follow up (RR=1.15 95% CI: 0.85, 1.54). Dutch studies had bigger effect sizes than studies from other countries. The quality of reporting of all the studies was suboptimal. The results of this meta-analysis show that group CBT interventions for patients with sub-threshold depression have a significant effect on depressive symptomatology at post treatment in both working age and older adult population. However it does not appear to reduce the incidence of major depressive disorders and has minimal or no effect on depressive symptomatology during follow-up.",26070412,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.586390495300293,-2.3069629669189453,B8X4
"Interpersonal psychotherapy as add-on for treatment-resistant depression: A pragmatic randomized controlled trial.

Treatment-resistant depression (TRD) is an extremely prevalent clinical condition. Although Interpersonal Psychotherapy (IPT) is an established treatment for uncomplicated depression, its effectiveness has never before been studied in patients with TRD in real-world settings. We investigate IPT as an adjunct strategy to treatment as usual (TAU) for TRD patients in a pragmatic, randomized, controlled trial. A total of 40 adult patients with TRD (satisfying the criteria for major depressive disorder despite adequate antidepressant treatment) were recruited from a tertiary care facility for this pragmatic trial and blinded to the evaluator. Patients were randomized to one of two treatment conditions: (1) TAU - pharmacotherapy freely chosen by the clinician (n=23) and (2) TAU+IPT (n=17). Assessments were performed at weeks 8, 12, 19 and 24. Changes in the estimated means of the Hamilton Depression Rating Scale score were the primary outcome measure. Secondary outcomes included patient-rated scales and quality of life scales. We used a linear mixed model to compare changes over time between the two groups. Both treatments lead to improvements in depressive symptoms from baseline to week 24 with no significant between group differences in either primary: TAU (mean difference: 4.57; CI95%: 0.59-8.55; d=0.73) vs. IPT+TAU (mean difference: 5.86, CI95%: 1.50-10.22; d=0.93) or secondary outcomes. Our relatively small sample limits our ability to detect differences between treatments. Both treatments lead to equal improvements in depressive symptoms. We found no evidence to support adding IPT to pharmacotherapy in patients with TRD. ClinicalTrials.gov-NCT01896349.",26799332,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.487531661987305,-3.6549770832061768,ByLG
"The development of a brief psychodynamic intervention (dynamic interpersonal therapy) and its application to depression: a pilot study.

This paper describes a protocol for a brief psychodynamic intervention (Dynamic Interpersonal Therapy; DIT) for use with depressed patients and a pilot study set out to test its acceptability and compatibility with session-by-session monitoring as a prelude to a future randomized controlled trial. Sixteen consecutively referred, depressed patients (aged 20-53) were offered 16 sessions of DIT. Patient outcomes were collected pre-post, and on a session-by-session basis, using the PHQ-9 and GAD-7. Therapist and supervision feedback indicates that this structured psychodynamic treatment could be effectively taught, and that the key competences involved were acquired and demonstrated in the clinical work supervised. Patients found the treatment acceptable and relevant to their problems. The treatment appeared compatible with session-by-session monitoring of symptoms of anxiety and depression. DIT was associated with a significant reduction in reported symptoms in all but one case, to below clinical levels in 70% of the patients. Random regression models revealed highly significant linear and quadratic components, confirming the decrease in reported symptom severity but cautioning about slight increase in symptoms around the ending phase of the treatment. The results suggest that DIT is promising in its acceptability and effectiveness with an unselected group of primary care patients, and is easily acquired by psychodynamically trained clinicians.",21463169,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.914877891540527,-3.9853627681732178,C93j
"Clinical relevance of findings in trials of CBT for depression.

Cognitive behavioural therapy (CBT) is beneficial in depression. Symptom scores can be translated into Clinical Global Impression (CGI) scale scores to indicate clinical relevance. We aimed to assess the clinical relevance of findings of randomised controlled trials (RCTs) of CBT in depression. We identified RCTs of CBT that used the Hamilton Rating Scale for Depression (HAMD). HAMD scores were translated into Clinical Global Impression - Change scale (CGI-I) scores to measure clinical relevance. One hundred and seventy datasets from 82 studies were included. The mean percentage HAMD change for treatment arms was 53.66%, and 29.81% for control arms, a statistically significant difference. Combined active therapies showed the biggest improvement on CGI-I score, followed by CBT alone. All active treatments had better than expected HAMD percentage reduction and CGI-I scores. CBT has a clinically relevant effect in depression, with a notional CGI-I score of 2.2, indicating a significant clinical response. The non-specific or placebo effect of being in a psychotherapy trial was a 29% reduction of HAMD.",28957788,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.252805709838867,-2.6583240032196045,BWXq
"Exploring the efficacy of psychological treatments for depression: a multiverse meta-analysis protocol.

In the past four decades, over 700 randomised controlled trials (RCTs) and 80 meta-analyses have examined the efficacy of psychological treatments for depression. Overwhelming evidence suggests that all types of psychological treatments are effective. Yet, many aspects are still unexplored. Meta-analysts could perform hundreds of potential meta-analyses with the current literature, and a comprehensive bird's-eye view of all published studies is missing. This protocol outlines how a multiverse meta-analysis can evaluate the entire body of the literature on psychological treatments of depression in a single analysis. Thereby, gaps of evidence and areas of robustness are highlighted. We will conduct systematic literature searches in bibliographical databases (PubMed, Embase, PsycINFO and Cochrane Register of Controlled Trials) up until 1 January 2021. We will include all RCTs comparing a psychological treatment with a control condition. We will include studies published in English, German, Spanish or Dutch, and exclude trials on maintenance and relapse prevention as well as dissertations. Two independent researchers will check all records. All self-reported and clinician-rated instruments measuring depression are included. We will extract information on recruitment settings, target groups, age groups, comorbidity, intervention formats, psychotherapy types, number of sessions, control conditions and country. Two independent researchers will assess risk of bias using the Cochrane Risk of Bias assessment tool. As part of the multiverse meta-analysis, unweighted, fixed effect and random effects models will be calculated. As we will not collect any primary data, an ethical approval of this protocol is not required. We will publish the results in a peer-review journal and present them at international conferences. We will follow open science practices and provide our code and data.",35078836,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.157811164855957,-2.5429391860961914,qxw
"[Psychotherapy of depressive disorders : Procedures, evidence and perspectives].

Depressive disorders are associated with a high burden of suffering and significantly reduce the well-being and the self-esteem of affected patients. Psychotherapy is one of the main treatment options for depressive disorders. The aim of this article is to present the current evidence for antidepressive psychotherapeutic treatments. During the revision of the German S3- and National Disease Management Guideline (NDMG) on unipolar depression in 2015, a comprehensive and systematic evidence search was conducted. The results of this search along with a systematic update are summarized. The most intensively investigated psychotherapeutic method is cognitive behavioral therapy (CBT), which proved to be effective in many trials. Evidence also exists for psychodynamic psychotherapy and interpersonal therapy (IPT), followed by systemic therapy and client-centered psychotherapy; however, the evidence is less robust. Psychotherapy alone or in combination with pharmacotherapy was shown to be an effective treatment option. Psychotherapy represents a key element in the treatment of depressive disorders.",29383414,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.295092582702637,-2.0305612087249756,BQ1Y
"[Movement therapy and depression--evaluation study of a disorder-oriented and an unspecific movement-therapeutic support in clinical context].

In recent years body-orientated concepts have gained more and more importance in the therapy of mental disorders. But there is still a widespread skepticism about the effectiveness of movement-therapeutic measures. In the present study the effectiveness of an unspecific versus a disorder-orientated movement-therapy was tested in the clinical setting including a 6-month catamnesis with depressive patients (n=103) with a BDI >18. The results show, at every data point, the effectiveness of the measures for all investigated parameters. Both forms of movement-orientated interventions differ only slightly with regard to the therapeutic success. The catamnesis shows a big gap between resolution and actually realized activities. On the basis of the results it can be assumed that mainly general unspecific determinants play a more important role for the therapeutic success than assumed so far.",21120790,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,10.021491050720215,-1.8132309913635254,DCv9
"The effectiveness of Culturally Sensitive Collaborative Treatment of depressed Chinese in family medicine clinics: A randomized controlled trial.

To investigate whether the Culturally Sensitive Collaborative Treatment (CSCT) would improve outcomes for patients with major depression who were managed in family medicine clinics in Taiwan. A single-blinded randomized trial was conducted in 26 family medicine clinics. Patients with major depressive disorder were consecutively randomized to either CSCT or treatment as usual (TAU). The primary outcome was the severity of depression. Secondary outcomes included treatment response, treatment remission, quality of life, and medication adherence. Outcomes were compared using hierarchical linear models (mixed-effects models) from baseline to 26-week follow-up assessments. Of the 280 patients, 141 were randomized to TAU and 139 to CSCT. Hierarchical linear modeling revealed that the CSCT group displayed significantly greater improvement in depressive symptoms over the study period when compared to the TAU group (B=-2.60, P<0.001). The odds of achieving the response, remission, and medication adherence were significantly greater for the CSCT group compared to the TAU group (odds ratio=4.65, 4.12, and 2.06, respectively; all Ps<0.05). However, both groups did not differ significantly in quality of life. CSCT is effective in improving treatment outcomes for major depression in family medicine clinics in Taiwan.",29127813,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,10.667222023010254,-4.842380046844482,BUT6
"Effect of Cognitive Behavioral Therapy on Improving the Cognitive Function in Major and Minor Depression.

The aim of this study was to investigate the effectiveness of cognitive behavioral therapy (CBT) on improving the cognitive function in minor depression (MiD) and major depression (MaD). The study will constitute a placebo-controlled single-blind parallel-group randomized controlled trial. The selected participants will be randomly allocated into one of two parallel groups with a 1:1 ratio: the CBT-based group and the general health education group. CBT significantly alleviated depressive symptoms of MiD and MaD at 12 weeks (p < 0.001), and the treatment effect was maintained for at least 12 months (p < 0.001). Interestingly, CBT significantly promotes more cognitive function of MiD and partial cognitive function of MaD at 12 weeks in the intervention group than in the control group (p < 0.01). CBT can alleviate depressive symptoms of both minor and MaDs. The effectiveness of CBT is different on improving the cognitive function in MiD and MaD.",30865075,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.223447799682617,-2.4324512481689453,A9ht
"Effectiveness of a Multimodal Digital Psychotherapy Platform for Adult Depression: A Naturalistic Feasibility Study.

Although psychotherapy is one of the most efficacious and effective treatments for depression, limited accessibility to trained providers markedly limits access to care. In an attempt to overcome this obstacle, several platforms seeking to provide these services using digital modalities (eg, video, text, and chat) have been developed. However, the use of these modalities individually poses barriers to intervention access and acceptability. Multimodal platforms, comprising those that allow users to select from a number of available modalities, may be able to provide a solution to these concerns. We aimed to investigate the preliminary effectiveness of providing psychotherapy through a multimodal digital psychotherapy platform. In addition, we aimed to examine differential responses to intervention by gender, self-reported physical health status, and self-reported financial status, as well as how prior exposure to traditional face-to-face psychotherapy affected the effectiveness of a multimodal digital psychotherapy intervention. Finally, we aimed to examine the dose-response effect. Data were collected from a total of 318 active users of BetterHelp, a multimodal digital psychotherapy platform. Data on physical health status, financial status, and prior exposure to psychotherapy were obtained using self-report measures. Effectiveness was determined by the extent of symptom severity change, which was measured using the Patient Health Questionnaire at Time 1 (time of enrollment) and Time 2 (3 months after enrollment). Intervention dosage was measured as the sum of individual therapist-user interactions across modalities. Depression symptom severity was significantly reduced after the use of the multimodal digital psychotherapy intervention (P<.001). Individuals without prior traditional psychotherapy experience revealed increased improvement after intervention (P=.006). We found no significant dose-response effect of therapy, nor significant differences in outcomes across gender, self-reported financial status, and self-reported physical health status. Users of BetterHelp experienced significantly reduced depression symptom severity after engaging with the platform. Study findings suggest that this intervention is equally effective across gender, self-reported financial status, and self-reported physical health status and particularly effective for individuals without a history of psychotherapy. Overall, study results suggest that multimodal digital psychotherapy is a potentially effective treatment for adult depression; nevertheless, experimental trials are needed. We discuss directions for future research.",30674448,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.354827880859375,-2.5981287956237793,BABX
"[Latest developments in the non-pharmacological treatment of depression - A more integrative approach].

Non-pharmacological treatments of depression have become more widespread recently, especially for mild to moderate forms of depression. These complementary approaches are particularly interesting for patients who are reluctant to start an antidepressant. Novel approaches are found in psychotherapy, alternative treatments, plant-based treatments as well as the prevention of relapse through the use of digital tools. Some are even reimbursed by health insurance. However, these approaches are currently only applicable in combination with usual treatment, pharmacological or psychotherapy, as studies have shown that their efficiency in monotherapy is still limited.",36170135,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.834647178649902,-1.3148469924926758,F2s
"The compensation and capitalization models: a test of two approaches to individualizing the treatment of depression.

Despite long-standing calls for the individualization of treatments for depression, modest progress has been made in this effort. The primary objective of this study was to test two competing approaches to personalizing cognitive-behavioral treatment of depression (viz., capitalization and compensation). Thirty-four adults meeting criteria for Major Depressive Disorder (59% female, 85% Caucasian) were randomized to 16-weeks of cognitive-behavioral treatment in which strategies used were selected based on either the capitalization approach (treatment matched to relative strengths) or the compensation approach (treatment matched to relative deficits). Outcome was assessed with a composite measure of both self-report (i.e., Beck Depression Inventory) and observer-rated (i.e., Hamilton Rating Scale for Depression) depressive symptoms. Hierarchical linear modeling revealed a significant treatment approach by time interaction indicating a faster rate of symptom change for the capitalization approach compared to the compensation approach (d = .69, p = .03). Personalizing treatment to patients' relative strengths led to better outcome than treatment personalized to patients' relative deficits. If replicated, these findings would suggest a significant change in thinking about how therapists might best adapt cognitive-behavioral interventions for depression for particular patients.",22982085,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.953934669494629,-2.3296444416046143,CoMl
"A randomized controlled trial of internet-delivered cognitive behaviour therapy to prevent the development of depressive disorders in older adults with multimorbidity.

Multimorbidity, which commonly impacts older adults is associated with higher rates of depression. We aimed to investigate whether internet delivered cognitive-behaviour therapy (iCBT) could prevent depressive disorders in older adults with multimorbidity who were not currently depressed. 302 primary care and community participants aged 65 years and over, who had multimorbidity but did not meet criteria for a depressive disorder were randomised to an intervention group who received an eight-week, five session iCBT (n = 150) or to a control group (n = 152) who received treatment as usual. Diagnostic interviews were conducted at baseline, and three and six months after the intervention period, where indicated, and the presence of depressive disorder was the primary outcome. The intention to treat, chi-square analyses indicated there were significantly fewer cases of depressive disorder in the treatment group compared to the control group by six-month follow-up (χ²(1,302) = 5.21, p = .02). The main limitations of this RCT are a short follow up period and low proportion of participants who developed depressive disorders. Participants were relatively well educated, with a majority having English as their first language. These results indicate that depressive disorder was prevented in the first six months following iCBT with three times the number of cases of depressive disorder in the control group compared to the treatment group. Further research is required to determine whether iCBT can be effective for preventing depressive disorder in this population over a longer time period.",31767215,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.51517391204834,-2.39979887008667,AxRf
"Cross-trial prediction of depression remission using problem-solving therapy: A machine learning approach.

Psychotherapy is a standard depression treatment; however, determining a patient's prognosis with therapy relies on clinical judgment that is subject to trial-and-error and provider variability. To develop machine learning (ML) algorithms to predict depression remission for patients undergoing 6 months of problem-solving therapy (PST). Using data from the treatment arm of 2 randomized trials, ML models were trained and validated on ENGAGE-2 (ClinicalTrials.gov, #NCT03841682) and tested on RAINBOW (ClinicalTrials.gov, #NCT02246413) for predictions at baseline and at 2-months. Primary outcome was depression remission using the Depression Symptom Checklist (SCL-20) score < 0.5 at 6 months. Predictor variables included baseline characteristics (sociodemographic, behavioral, clinical, psychosocial) and intervention engagement through 2-months. Of the 26 candidate variables, 8 for baseline and 11 for 2-months were predictive of depression remission, and used to train the models. The best-performing model predicted remission with an accuracy significantly greater than chance in internal validation using the ENGAGE-2 cohort, at baseline [72.6% (SD = 3.6%), p < 0.0001] and at 2-months [72.3% (5.1%), p < 0.0001], and in external validation with the RAINBOW cohort at baseline [58.3% (0%), p < 0.0001] and at 2-months [62.3% (0%), p < 0.0001]. Model-agnostic explanations highlighted key predictors of depression remission at the cohort and patient levels, including female sex, lower self-reported sleep disturbance, lower sleep-related impairment, and lower negative problem orientation. ML models using clinical and patient-reported data can predict depression remission for patients undergoing PST, affording opportunities for prospective identification of likely responders, and for developing personalized early treatment optimization along the patient care trajectory.",35398399,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.304659843444824,-1.095232605934143,eSM
"Dropout from exercise randomized controlled trials among people with depression: A meta-analysis and meta regression.

Exercise has established efficacy in improving depressive symptoms. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of this evidence base, with dropout rates varying across studies. We conducted a systematic review and meta-analysis to investigate the prevalence and predictors of dropout rates among adults with depression participating in exercise RCT's. Three authors identified RCT's from a recent Cochrane review and conducted updated searches of major electronic databases from 01/2013 to 08/2015. We included RCT's of exercise interventions in people with depression (including major depressive disorder (MDD) and depressive symptoms) that reported dropout rates. A random effects meta-analysis and meta regression were conducted. Overall, 40 RCT's were included reporting dropout rates across 52 exercise interventions including 1720 people with depression (49.1 years (range=19-76 years), 72% female (range=0-100)). The trim and fill adjusted prevalence of dropout across all studies was 18.1% (95%CI=15.0-21.8%) and 17.2% (95%CI=13.5-21.7, N=31) in MDD only. In MDD participants, higher baseline depressive symptoms (β=0.0409, 95%CI=0.0809-0.0009, P=0.04) predicted greater dropout, whilst supervised interventions delivered by physiotherapists (β=-1.2029, 95%CI=-2.0967 to -0.3091, p=0.008) and exercise physiologists (β=-1.3396, 95%CI=-2.4478 to -0.2313, p=0.01) predicted lower dropout. A comparative meta-analysis (N=29) established dropout was lower in exercise than control conditions (OR=0.642, 95%CI=0.43-0.95, p=0.02). Exercise is well tolerated by people with depression and drop out in RCT's is lower than control conditions. Thus, exercise is a feasible treatment, in particular when delivered by healthcare professionals with specific training in exercise prescription.",26551405,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,7.979788780212402,-1.4435514211654663,B1bZ
"Group therapy for mood disorders: A meta-analysis.

The addition of group psychotherapy as a specialty by the APA in 2018 creates a need for rigorous empirical reviews of group treatments for specific disorders. We conducted a meta-analysis of randomized controlled trials (RCTs) that tested the effect of group psychotherapy for mood disorders, including depression and bipolar disorder, at posttreatment and follow-up time-points, as well as rates of recovery and attrition. Major databases were searched for RCTs of group treatment for depression and bipolar disorder published from 1990 to 2018, which identified 42 studies across both disorders. Random effects meta-analyses indicated that group therapy for depression produced superior outcomes compared to waitlist control (WLC) and treatment as usual (TAU) and equivalent outcomes to medication. Similarly, group therapy for bipolar disorder produced superior outcomes to TAU. Analyses of recovery rates were conducted for depression, producing similar results to the main outcome analyses. Rates of attrition did not differ between group and comparison conditions for either disorder. These findings support group therapy for treating depression and bipolar disorder, although further research is needed comparing group treatment for bipolar disorder to medication.",32930060,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,11.479660034179688,-1.274741530418396,Aiiy
"Metacognitive therapy in recurrent depression: a case replication series in Denmark.

Metacognitive therapy (MCT) for depression is derived from the Wells and Matthews (1994) self-regulatory model, in which a Cognitive-Attentional Syndrome (CAS) is the cause of psychological disorders. MCT for depression focuses on identifying patients' CAS and helps them to stop it. The CAS consists of worry, rumination and dysfunctional coping strategies. The focus in MCT is on removing the CAS by challenging positive and negative metacognitive beliefs and eliminating dysfunctional behaviors. In this case series, MCT was delivered to four depressed Danes and treatment was evaluated in 5-11 sessions of up to one hour each. An A-B design with follow-up at 3 and 6 months was conducted and the primary outcome was Beck's Depression Inventory II (BDI-II). We measured CAS processes with the Major depressive Disorder Scale (MDD-S). The results of the case series showed clinically significant improvements in depressive symptoms, rumination and metacognitive beliefs and the effects were still present at follow-up for all patients. The small number of patients and decreasing baselines observed in some cases limits the conclusions. However, the results suggest that this treatment is feasible and was associated with large improvements in symptoms when delivered away from its point of origin and in a Danish help-seeking sample.",24256292,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,11.812273979187012,-1.4676289558410645,CVzY
"Alterations of mental defeat and cognitive flexibility during cognitive behavioral therapy in patients with major depressive disorder: a single-arm pilot study.

Mental defeat affects the occurrence and chronicity of depression and cognitive flexibility. This study aimed to examine changes in mental defeat and cognitive flexibility scores after cognitive behavioral therapy including IR. In the intervention group, patients with depression (n=18, mean age=37.89 years) received 15 cognitive behavioral therapy sessions. Patients completed the Beck Depression Inventory-II; Mental Defeat Scale; Cognitive Flexibility Scale; EuroQol five dimensions questionnaire; Patient Health Questionnaire-9 and seven-item Generalized Anxiety Disorder Scale before the intervention, after six sessions, and post-intervention. The healthy control group (n=33, mean age=37.91) completed all scales once and did not receive treatment. Post-cognitive behavioral therapy, a significant decrease was observed in Beck Depression Inventory-II, Mental Defeat Scale, Cognitive Flexibility Scale, and Patient Health Questionnaire-9 scores. Although mental defeat and cognitive flexibility did not reach the level of the healthy control group, they demonstrated improvement. Therefore, when treating depression, mental defeat and cognitive flexibility should be measured in addition to depressive symptoms. Trial registration This study was registered retrospectively in the national UMIN Clinical Trials Registry on July 25, 2016 (registration ID: UMIN000023320).",31694691,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,11.992493629455566,-1.2938185930252075,AySx
"The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis.

There is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression. One hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials. Compared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging from g = 0.31 to g = 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g = 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g = 0.32 to g = 0.39). Both interventions improved depression symptom severity more than functioning and QoL. Despite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems.",27780478,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.218329429626465,-1.7262932062149048,Bli/
"Processes of change in cognitive behavioral therapy for treatment-resistant depression: psychological flexibility, rumination, avoidance, and emotional processing.

Recent clinical research suggests that facilitating psychological flexibility and emotional processing and decreasing rumination and avoidance are important tasks of treatment for disorders characterized by entrenched patterns of psychopathology, such as major depressive disorder. The current study examined these processes as predictors of treatment outcomes in a subsample of depressed adult patients (n=49) who had not fully responded to antidepressant medication and were randomized to receive cognitive-behavioral therapy (CBT). Target variables were coded from session recordings at baseline and in the vicinity of two therapeutic transition points: a sudden gain (improvement) and a transient spike in depression symptoms, or at similar periods for those without such transitions. Results indicated that psychological flexibility during the pre-sudden gain period predicted less depression at 12-month follow-up, beyond baseline symptoms and other co-occurring processes. Interaction analyses revealed that when flexibility was low during the post-spike period, avoidance and rumination predicted higher depressive symptoms, whereas emotional processing predicted lower symptoms at the 12-month follow-up. When flexibility was high, none of these variables were associated with outcome. Together, these findings highlight psychological flexibility as a key therapeutic target in CBT for treatment-resistant depression and might have implications for relapse prevention.",31822203,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,12.001605987548828,-2.4310824871063232,Awe+
"Evidence-based, non-pharmacological treatment guideline for depression in Korea.

Although pharmacological treatment constitutes the main therapeutic approach for depression, non-pharmacological treatments (self-care or psychotherapeutic approach) are usually regarded as more essential therapeutic approaches in clinical practice. However, there have been few clinical practice guidelines concerning self-care or psychotherapy in the management of depression. This study introduces the 'Evidence-Based, Non-Pharmacological Treatment Guideline for Depression in Korea.' For the first time, a guideline was developed for non-pharmacological treatments for Korean adults with mild-to-moderate depression. The guideline development process consisted of establishing several key questions related to non-pharmacologic treatments of depression, searching the literature for studies which answer these questions, assessing the evidence level of each selected study, drawing up draft recommendation, and peer review. The Scottish Intercollegiate Guidelines Network grading system was used to evaluate the quality of evidence. As a result of this process, the guideline recommends exercise therapy, bibliotherapy, cognitive behavior therapy, short-term psychodynamic supportive psychotherapy, and interpersonal psychotherapy as the non-pharmacological treatments for adult patients with mild-to-moderate depression in Korea. Hence, it is necessary to develop specific methodologies for several non-pharmacological treatment for Korean adults with depression.",24431900,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.372114181518555,-1.2046470642089844,CTaj
"Do positive psychology exercises work? A replication of Seligman et al. (2005).

The current work replicated a landmark study conducted by Seligman and colleagues (2005) that demonstrated the long-term benefits of positive psychology exercises (PPEs). In the original study, two exercises administered over 1 week (""Three Good Things"" and ""Using your Signature Strengths in a New Way"") were found to have long-lasting effects on depression and happiness (Seligman, Steen, Park, & Peterson, 2005). These exercises were tested here using the same methodology except for improvements to the control condition, and the addition of a second ""positive placebo"" to isolate the common factor of accessing positive, self-relevant constructs. This component control design was meant to assess the effect of expectancies for success (expectancy control), as well the cognitive access of positive information about the self (positive placebo). Repeated measures analyses showed that the PPEs led to lasting increases in happiness, as did the positive placebo. The PPEs did not exceed the control condition in producing changes in depression over time. Brief, positive psychology interventions may boost happiness through a common factor involving the activation of positive, self-relevant information rather than through other specific mechanisms. Finally, the effects of PPEs on depression may be more modest than previously assumed.",24469930,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.721851348876953,-4.065370082855225,CS6v
"Cognitive-Behavioral Analysis System of Psychotherapy, Drug, or Their Combination for Persistent Depressive Disorder: Personalizing the Treatment Choice Using Individual Participant Data Network Metaregression.

Persistent depressive disorder is prevalent, disabling, and often difficult to treat. The cognitive-behavioral analysis system of psychotherapy (CBASP) is the only psychotherapy specifically developed for its treatment. However, we do not know which of CBASP, antidepressant pharmacotherapy, or their combination is the most efficacious and for which types of patients. This study aims to present personalized prediction models to facilitate shared decision-making in treatment choices to match patients' characteristics and preferences based on individual participant data network metaregression. We conducted a comprehensive search for randomized controlled trials comparing any two of CBASP, pharmacotherapy, or their combination and sought individual participant data from identified trials. The primary outcomes were reduction in depressive symptom severity for efficacy and dropouts due to any reason for treatment acceptability. All 3 identified studies (1,036 participants) were included in the present analyses. On average, the combination therapy showed significant superiority over both monotherapies in terms of efficacy and acceptability, while the latter 2 treatments showed essentially similar results. Baseline depression, anxiety, prior pharmacotherapy, age, and depression subtypes moderated their relative efficacy, which indicated that for certain subgroups of patients either drug therapy or CBASP alone was a recommendable treatment option that is less costly, may have fewer adverse effects and match an individual patient's preferences. An interactive web app (https://kokoro.med.kyoto-u.ac.jp/CBASP/prediction/) shows the predicted disease course for all possible combinations of patient characteristics. Individual participant data network metaregression enables treatment recommendations based on individual patient characteristics.",29847831,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.2515287399292,-1.9958717823028564,BLEr
"Short-Term Psychodynamic Psychotherapy with Mentalization-Based Techniques in Major Depressive Disorder patients: Relationship among alexithymia, reflective functioning, and outcome variables - A Pilot study.

In depressed patients, recent advances have highlighted impairment in mentalizing: identifying and interpreting one's own or other's mental states. Short-Term Psychodynamic Psychotherapy (STPP) has proven to be effective in reducing symptoms and improving relational/functional abilities in these subjects. Therefore, the first aim of our study was to evaluate effectiveness of STPP with Mentalization-Based Techniques (STMBP) on their clinical outcomes and the second, to investigate Reflective Functioning and alexithymia concerning treatment outcomes in depressed subjects. A baseline evaluation of reflective functioning, alexithymia and depression was conducted before an STMBP treatment. Patients were re-tested successively after 40 weeks (T1) and in a follow-up after 1 year at the end of the treatment (T2). A total of 24 patients principally diagnosed with Major Depressive Disorder (MDD) underwent a STMBP conducted by two expert therapists. Global Assessment Functioning (GAF), Toronto Alexithymia Scale-20 (TAS-20) and Hamilton Depression Rating Scale (HAM-D) data were collected at the baseline (T0) by two clinical therapists, along with RF scores rated by two trained raters. HAM-D, TAS-20 and GAF follow-ups were conducted at the end of the treatment after 40 weeks (T1) and after 1-year follow-up (T2). Results highlighted an improvement of both HAM-D and TAS-20 scores in our sample. Moreover, a negative correlation between RF and TAS-20 was found. Both HAM-D and RF at T0 influenced depressive outcomes at the end of the treatment. Results confirmed the effectiveness of STMBP in MDD, suggesting also an inverse association between RF and alexithymia. Our study demonstrates how STMBP could be effective in MDD even after 40 sessions, maintaining its effect in a 1-year follow-up. STMBP improves subjective capability of reflecting on the mental states of oneself and others. Our intervention allows patients to orientate thoughts from inside to outside, reducing negative beliefs also in absence of a pharmacological therapy (during the follow-up).",27801544,Major Depressive Disorder,Anxiety Treatment,Mental Health,4158,12.196043014526367,-3.8855552673339844,BlT3
"The Effectiveness of Internet-Based Cognitive Behavioral Therapy for the Treatment of Depression in a Large Real-World Primary Care Practice: A Randomized Trial.

PurposeThe purpose of this study was to compare the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression, to that of treatment as usual (TAU) alone. MethodsIn this study, 302 depressed adult Family Medicine outpatients were randomized to receive either TAU or additional access to Thrive, a fully automated iCBT program with three video-based modules, each containing 10 lessons using behavioral activation, cognitive restructuring, and social skills training. The primary outcome was the change in the score on an online patient health questionnaire (PHQ-9), measured at 0, 8, and 24 weeks. ResultsThe intervention group saw a relative improvement of 2.5 points in PHQ-9 scores at 8 weeks (p = 0.002, d = -0.48), was 6.0 times (p < 0.001) more likely to respond (defined as a ≥ 50% reduction in PHQ-9 score), and was 5.2 times (p = 0.04) more likely to have achieved remission (defined as a PHQ-9 score of < 5) at 8 weeks, but by 24 weeks, the control group had improved to a similar extent as the intervention group (d = -0.14). The intervention group improved in productivity at 8 weeks (p = 0.03), but by 24 weeks, the TAU group had also improved to a similar extent. No significant differences in anxiety, quality of life, or suicidal ideation were found. Patients reported high satisfaction with this iCBT tool, including ease of use, tailoring, and perceived helpfulness. However, only 43% of the intervention group and 58% of the TAU group had outcome measures at every time point. ConclusionsiCBT was associated with greater depression response and remission at 8 weeks, compared with the control group. Depression scores in the intervention group remained similar at 24 weeks, at which time the control group also showed similar rate of response and remission.",35939620,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.442591667175293,-2.9613406658172607,MYU
"The effects of fifteen evidence-supported therapies for adult depression: A meta-analytic review.

Objective: In the past decades, many different types of psychotherapy for adult depression have been developed. Method: In this meta-analysis we examined the effects of 15 different types of psychotherapy using 385 comparisons between a therapy and a control condition: Acceptance and commitment therapy, mindfulness-based cognitive behavior therapy (CBT), guided self-help using a self-help book from David Burns, Beck's CBT, the ""Coping with Depression"" course, two subtypes of behavioral activation, extended and brief problem-solving therapy, self-examination therapy, brief psychodynamic therapy, non-directive counseling, full and brief interpersonal psychotherapy, and life review therapy. Results: The effect sizes ranged from g=0.38 for the ""Coping with Depression"" course to g=1.10 for life review therapy. There was significant publication bias for most therapies. In 70% of the trials there was at least some risk of bias. After adjusting studies with low risk of bias for publication bias, only two types of therapy remained significant (the ""Coping with Depression"" course, and self-examination therapy). Conclusions: We conclude that the 15 types of psychotherapy may be effective in the treatment of depression. However, the evidence is not conclusive because of high levels of heterogeneity, publication bias, and the risk of bias in the majority of studies.",31394976,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.386232376098633,-2.312493085861206,A2Ur
"Telephone-based depression self-management in Hispanic adults with epilepsy: a pilot randomized controlled trial.

Depression is associated with adverse outcomes in epilepsy but is undertreated in this population. Project UPLIFT, a telephone-based depression self-management program, was developed for adults with epilepsy and has been shown to reduce depressive symptoms in English-speaking patients. There remains an unmet need for accessible mental health programs for Hispanic adults with epilepsy. The purpose of this study was to evaluate the feasibility, acceptability, and effects on depressive symptoms of a culturally adapted version of UPLIFT for the Hispanic community. Hispanic patients with elevated depressive symptoms (n = 72) were enrolled from epilepsy clinics in New York City and randomized to UPLIFT or usual care. UPLIFT was delivered in English or Spanish to small groups in eight weekly telephone sessions. Feasibility was assessed by recruitment, retention, and adherence rates and acceptability was assessed by self-reported satisfaction with the intervention. Depressive symptoms (PHQ-9 scores) were compared between study arms over 12 months. The mean age was 43.3±11.3, 71% of participants were female and 67% were primary Spanish speakers. Recruitment (76% consent rate) and retention rates (86-93%) were high. UPLIFT participants completed a median of six out of eight sessions and satisfaction ratings were high, but rates of long-term practice were low. Rates of clinically significant depressive symptoms (PHQ-9 ≥5) were lower in UPLIFT versus usual care throughout follow-up (63% vs. 72%, 8 weeks; 40% vs. 70%, 6 months; 47% vs. 70%, 12 months). Multivariable-adjusted regressions demonstrated statistically significant differences at 6 months (OR = 0.24, 95% CI, 0.06-0.93), which were slightly reduced at 12 months (OR = 0.30, 95% CI, 0.08-1.16). Results suggest that UPLIFT is feasible and acceptable among Hispanic adults with epilepsy and demonstrate promising effects on depressive symptoms. Larger trials in geographically diverse samples are warranted.",33963873,Major Depressive Disorder,Anxiety Treatment,Mental Health,4276,10.536917686462402,-2.5141210556030273,AWpV
"Update of Recent Literature on Remotely Delivered Psychotherapy Interventions for Anxiety and Depression.

Introduction:Anxiety and depression are harmful to individuals suffering from these disorders, their caregivers, and the economy. Remote delivery of psychotherapy has been established as a viable alternative to traditional in-person psychotherapy for treating anxiety and depression. However, literature comparing and evaluating the variety of remote delivery modalities of psychotherapy has not yet been integrated. This review examines the efficacy, practicality, and limitations of telephone, video, and online-administered psychotherapy for the treatment of anxiety and depression.Methods:A comprehensive literature search conducted using PubMed and PsycINFO included systematic reviews, randomized controlled trials, and cost-analysis studies focused on a remote delivery method of psychotherapy for anxiety and depression.Results:Overall, interventions delivered through telephone, video, and online modalities demonstrated good efficacy in treating anxiety and depression in general, and when presenting comorbid with other disorders. The literature also suggested that telehealth psychotherapy is accessible, convenient, and cost-effective. However, there is less evidence for video-delivered psychotherapy for anxiety and depression compared with telephone-administered and online-administered modalities. Despite this, overall, the efficacy and practical benefits of remote psychotherapy interventions in treating anxiety and depression across a diverse range of patient groups suggested that it is an appropriate alternative for those who cannot access in-person psychotherapy.Conclusions:Further research evaluating the efficacy and practical benefits of video-delivered psychotherapy for anxiety and depression is much needed for patients with limited access to in-person psychological care.",30300082,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.537079811096191,-3.211721181869507,BFCc
"How Effective Is Algorithm-Guided Treatment for Depressed Inpatients? Results from the Randomized Controlled Multicenter German Algorithm Project 3 Trial.

Treatment algorithms are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evaluate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder. Inpatients, aged 18 to 70 years with major depressive disorder from 10 German psychiatric departments were randomized to 5 different treatment arms (from 2000 to 2005), 3 of which were standardized stepwise drug treatment algorithms (ALGO). The fourth arm proposed medications and provided less specific recommendations based on a computerized documentation and expert system (CDES), the fifth arm received treatment as usual (TAU). ALGO included 3 different second-step strategies: lithium augmentation (ALGO LA), antidepressant dose-escalation (ALGO DE), and switch to a different antidepressant (ALGO SW). Time to remission (21-item Hamilton Depression Rating Scale ≤9) was the primary outcome. Time to remission was significantly shorter for ALGO DE (n=91) compared with both TAU (n=84) (HR=1.67; P=.014) and CDES (n=79) (HR=1.59; P=.031) and ALGO SW (n=89) compared with both TAU (HR=1.64; P=.018) and CDES (HR=1.56; P=.038). For both ALGO LA (n=86) and ALGO DE, fewer antidepressant medications were needed to achieve remission than for CDES or TAU (P<.001). Remission rates at discharge differed across groups; ALGO DE had the highest (89.2%) and TAU the lowest rates (66.2%). A highly structured algorithm-guided treatment is associated with shorter times and fewer medication changes to achieve remission with depressed inpatients than treatment as usual or computerized medication choice guidance.",28645191,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.137187004089355,-1.1714497804641724,Basd
"The effect of dance over depression.

Dance and movement therapy are consisted of music, easy exercises and sensorial stimulus and provide drugless treatment for the depression on low rates. In this study, it has been aimed to examine the effect of dance over the depression. A total of 120 healthy male and female conservatory students ranged from 20 and 24 ages volunteered to participate in this study. They were divided randomly into 1 of 2 groups: dance training group (DTG; N = 60) and control group (CG; N = 60). A dance training program was applied to the subjects three days a week (Tuesday, Thursday, and Saturday) during 12 weeks. The subjects in the control group did not participate in the training and participated only in the pre and post test measurements. Beck Depression Scale was used for the pre and post test measurements of subjects. 12 weeks of dance training has been found to be effective on the depression levels of the subjects participating in the research as the training group (p < 0.05). The depression level of males and females before training has meaningfully decreased after 12 weeks of dance training (p < 0.05). When the depression levels of the subjects participated in research as the control group were separately evaluated for males and females, no meaningful change has been found in the depression levels during 12 weeks (p > 0.05). In conclusion, it has been seen that dance affects the depression levels of university students positively and decreases their depression levels.",22053537,Major Depressive Disorder,Anxiety Treatment,Mental Health,21751,8.348291397094727,-0.6791389584541321,C1YF
"The role of outcome expectancy in therapeutic change across psychotherapy versus pharmacotherapy for depression.

Patient outcome expectancy - the belief that treatment will lead to an improvement in symptoms - is linked to favourable therapeutic outcomes in major depressive disorder (MDD). The present study extends this literature by investigating the temporal dynamics of expectancy, and by exploring whether expectancy during treatment is linked to differential outcomes across treatment modalities, for both optimistic versus pessimistic expectancy. A total of 104 patients with MDD were randomized to receive either cognitive behavioral therapy (CBT) or pharmacotherapy for 16 weeks. Outcome expectancy was measured throughout treatment using the Depression Change Expectancy Scale (DCES). Depression severity was measured using both the Hamilton Depression Rating Scale and Beck Depression Inventory-II. Latent growth curve models supported improvement in expectancy across both treatments. Cross-lagged panel models revealed that both higher optimistic and lower pessimistic expectancy at mid-treatment predicted greater treatment response in pharmacotherapy. For CBT, the associative patterns between expectancy and depression differed as a function of expectancy type; higher optimistic expectancy at pre-treatment and lower pessimistic expectancy at mid-treatment predicted greater treatment response. The sample size limited statistical power and the complexity of models that could be explored. Results suggest that outcome expectancy improved during treatment for depression. Whether outcome expectancy represents a specific mechanism for the reduction of depression warrants further investigation.",30921595,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.759450912475586,-3.328629732131958,A8u2
"Efficacy of narrative reformulation during cognitive analytic therapy for depression: Randomized dismantling trial.

Narrative reformulation (NR) is a component of cognitive analytic therapy (CAT) that is assumed to increase client engagement and improve clinical outcomes. This study set out to test these claims. A single-blind randomized and controlled dismantling trial investigated treatment outcomes for moderate to severely depressed patients receiving CAT in Primary Care. Ninety-five participants were randomized to either full-CAT (n = 52) or CAT minus narrative reformulation (CAT-NR, n = 43). Treatment duration in both arms was 8-sessions and was matched apart from the omission of the NR in the CAT-NR arm. The primary outcome measure was the Patient Health Questionnaire (PHQ-9), with secondary outcome measures of anxiety, functioning, helpfulness and the therapeutic alliance. Outcomes were assessed at screening, every treatment session and at 8-weeks follow-up. Growth curve modelling found that NR did not enhance the efficacy of CAT for depression. There were no significant differences between groups in terms of attendance, adverse events, anxiety, functioning, helpfulness or therapeutic alliance. There were large within-group effect sizes (d+ > 1.5), as CAT with or without NR produced significant reductions in depression (p < .01). The primary outcome were assessed via self-report and the follow-up period was brief. These results suggest that NR may be redundant when treating depression with CAT. Whilst a brief 8-session version of the CAT model appears suitable for treating depression in Primary Care, further research regarding the need for NR is indicated.",29990661,Major Depressive Disorder,Anxiety Treatment,Mental Health,8878,11.334514617919922,-2.387904167175293,BJMU
"Changes in well-being and quality of life in a randomized trial comparing dynamic psychotherapy and pharmacotherapy for major depressive disorder.

Major depressive disorder (MDD) is associated with a decrease in quality of life (QOL) and well-being. Therefore, researchers are increasingly complementing traditional symptom measurements with QOL and well-being assessments in order to broaden the evaluation of treatment outcomes. The current prospective study investigated the effectiveness of supportive-expressive therapy (SET), antidepressant medication (MED) and placebo (PBO) in improving QOL and well-being in patients with MDD. Data from a randomized controlled trial (trial registration: NCT00043550) comparing SET, MED and PBO for the treatment of depression (N=156) were analyzed. Outcome measures addressed patients' QOL and physical and mental well-being. Changes in outcomes were assessed across and between treatments using linear mixed models. Across treatments, patients showed significant improvement in QOL and mental and physical health measures, as well as a reduction in interpersonal distress and depressive and anxiety symptoms (p≤.002 for all measures). Those changes were not only the products of a decrease in depressive symptoms, but also predicted subsequent reduction in symptoms. No significant differences were found between the three treatment conditions. The limitation is the study's moderate sample size. Current treatments for depression significantly improve patients' QOL and well-being. No significant differences were found between the three conditions examined in this study. The current study highlights the role of well-being in predicting subsequent symptomatic change.",24176534,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.03338623046875,-1.1863023042678833,CWtO
"Psychological treatment of depression in inpatients: a systematic review and meta-analysis.

Research on psychological treatment of depression in inpatients is not conclusive, with some studies finding clear positive effects and other studies finding no significant benefit compared to usual care or structured pharmacotherapy. The results of a meta-analysis investigating how effective psychological treatment is for depressed inpatients are presented. A systematic search in bibliographical databases resulted in 12 studies with a total of 570 respondents. This set of studies had sufficient statistical power to detect small effect sizes. Psychological treatments had a small (g=0.29), but statistically significant additional effect on depression compared to usual care and structured pharmacological treatments only. This corresponded with a numbers-needed-to-be-treated of 6.17. Heterogeneity was zero in most analyses, and not significant in all analyses. There was no indication for significant publication bias. Effects were not associated with characteristics of the population, the interventions and the design of the studies. Although the number of studies was small, and the quality of many studies was not optimal, it seems safe to conclude that psychological treatments have a small but robust effect on depression in depressed inpatients. More high-quality research is needed to verify these results.",21382540,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.334575653076172,-2.879837989807129,C/Dv
"Adaptation of an internet-based depression prevention intervention for Chinese adolescents: from ""CATCH-IT"" to ""grasp the opportunity"".

There is a dearth of information on the compatibility of Western-developed, internet-based interventions that prevent onset and precipitation of depression in global settings. Recently, Project CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral, Humanistic and Interpersonal Training), an information technology-based intervention, was adapted to prevent depression in Hong Kong Chinese adolescents. This paper evaluates qualitative data from consultations to develop a revised intervention of CATCH-IT for Hong Kong youth. A theoretical thematic analysis approach was used to analyze data. Materials from three consultation trips which included focus groups (2007), an expert panel (2007), a public health campaign (2009), and a joint primary care physician-social worker review group (2010) were compiled. Authors (KS and AZ) independently reviewed the data and applied the theoretical framework of behavioral vaccines to code the data. These data were subsequently consolidated to provide a coherent narrative analysis. The cognitive behavioral therapy (CBT), behavioral activation (BA), and resiliency modules were maintained, while the interpersonal therapy (IPT) modules of CATCH-IT were excluded in the Hong Kong adaptation. Concurrent self-reports of drinking, smoking, illicit drug use and gambling behavior were added. Rather than primary care consultations, social worker consultations may be the best point of entry for intervention. Socio-cultural relevance of psychotherapeutics and delivery context of internet-based interventions will require significant adaptation for the Hong Kong setting. However, because of community engagement throughout the process of adaptation, we believe the CATCH-IT intervention can be adapted for Chinese adolescents in Hong Kong with retained fidelity. The revised intervention is called ""Grasp the Opportunity"".",23612531,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.511316299438477,-3.5886518955230713,Ce7r
"A randomized study on the effect of modified behavioral activation treatment for depressive symptoms in rural left-behind elderly.

To evaluate the effectiveness of a modified behavioral activation treatment (MBAT) intervention on reducing depressive symptoms in rural left-behind elderly. This is a randomized study registered in Chinese Clinical Trial Registry (ChiCTR-IOR-17011289). Eighty rural left-behind elderly people who had a Geriatric Depression Scale (GDS) score between 11 and 25 were randomly assigned to the intervention (n=40) and control group (n=40). The intervention group received both MBAT and regular treatment for 8 weeks while the control group received regular treatment. Both groups were assessed with the GDS, Beck Anxiety Inventory (BAI), and Oxford Happiness Questionnaire (OHQ) at baseline, immediately post-intervention, and at 3 months post-intervention. There were a total of 73 participants that completed the intervention. The scores of GDS and BAI decreased significantly, but the scores of OHQ increased significantly in the intervention group after 8 sessions of MBAT (P<.01). The reduction in depression symptoms after the intervention was maintained at the 3-month follow-up. Significant differences in GDS, BAI, and OHQ scores were observed between the intervention group and the control group (P<.01). MBAT produced a significantly greater reduction in depressive symptoms than regular care in rural left-behind elderly. Clinical or methodological significance of this article: A modified behavioral activation (BA) psychotherapy can significantly reduce the recurrence and seriousness of depression symptoms in the left-behind elderly with mild to moderate depression. This study also suggests that further study of the MBAT as an intervention will provide a direction for the management of mental health in rural left-behind elders.",28838290,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.501653671264648,-1.8403429985046387,BX+r
"Symptom-specific effectiveness of an internet-based intervention in the treatment of mild to moderate depressive symptomatology: The potential of network estimation techniques.

The internet-based intervention Deprexis® has proven to be effective in improving overall depression severity. The current pragmatic randomized controlled trial included 1013 participants with mild to moderate symptomatology and aimed to identify the symptom-specific effects of the internet-based intervention Deprexis (intervention group) in comparison to care as usual (control group). All participants -in both conditions- were permitted to use any type of treatment. Of the nine considered symptoms (assessed with the Patient Health Questionnaire), seven showed larger improvements in the intervention condition relative to care as usual (effect sizes ranging from 0.15 to 0.31). No significant differences were found for the two other symptoms. In a next step, a network was estimated including treatment condition as well as changes in all nine symptoms. The resulting network suggests that four of the seven identified symptom-specific effects were direct, whereas the three other symptom-specific effects were indirect and could be explained by effects on other symptoms. Lastly, exploratory analyses showed that the intervention was more effective in improving overall depression severity for participants with higher scores on those four symptoms that were directly affected by the intervention; consequently, the network estimation techniques showed potential in precision psychiatry.",31542565,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.351553916931152,-3.016544818878174,A0Vg
"For whom does interpersonal psychotherapy work? A systematic review.

The efficacy of interpersonal psychotherapy (IPT) to treat depression and other disorders is well established, yet it remains unknown which patients will benefit more from IPT than another treatment. This review summarizes 46years of clinical trial research on patient characteristics that moderate the relative efficacy of IPT vs. different treatments. Across 57 studies from 33 trials comparing IPT to pharmacotherapy, another psychotherapy, or control, there were few consistent indicators of when IPT would be more or less effective than another treatment. However, IPT may be superior to school counseling for adolescents with elevated interpersonal conflict, and to minimal controls for patients with severe depression. Cognitive-behavioral therapy may outpace IPT for patients with avoidant personality disorder symptoms. There was some preliminary evidence that IPT is more beneficial than alternatives for patients in some age groups, African-American patients, and patients in an index episode of depression. The included studies suffered from several limitations and high risk of Type I and II error. Obstacles that may explain the difficulty in identifying consistent moderators, including low statistical power and heterogeneity in samples and treatments, are discussed. Possible remedies include within-subjects designs, manipulation of single treatment ingredients, and strategies for increasing power such as improving measurement.",28710917,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.691543579101562,-3.6811275482177734,BZwn
"Patient learning of treatment contents in cognitive therapy.

Research has demonstrated that both memory and learning for treatment contents are poor, and that both are associated with worse treatment outcome. The Memory Support Intervention has been shown to improve memory for treatment, but it has not yet been established if this intervention can also improve learning of treatment contents. This study was designed to document the number of times participants exhibited each of the indices of learning, to examine the indices of learning and their relationship to recall of treatment points, and to investigate the association between the indices of learning and depression outcome. Adults diagnosed with major depressive disorder (N = 48) were randomly assigned to 14 sessions of cognitive therapy-as-usual (CT-as-usual) or cognitive therapy plus the Memory Support Intervention (CT + Memory Support). Measures of learning, memory, and depressive symptomatology were taken at mid-treatment, post-treatment, and at 6-month follow-up. Relative to the CT-as-usual group, participants in the CT + Memory Support group reported more accurate thoughts and applications of treatment points at mid-treatment, post-treatment, and 6-month follow-up. Patient recall was significantly correlated with application and cognitive generalization. Thoughts and application at mid-treatment were associated with increased odds of treatment response at post-treatment. The learning measure for this study has not yet been psychometrically validated. The results are based on a small sample. Learning during treatment is poor, but modifiable via the Memory Support Intervention. These results provide encouraging data that improving learning of treatment contents can reduce symptoms during and following treatment.",28869825,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.351607322692871,-1.108177900314331,BXgc
"[Cognitive behavioral therapy for depression in advanced schistosomiasis patients].

To evaluate the efficacy of cognitive behavioral therapy for depression in advanced schistosomiasis patients. A total of 60 advanced schistosomiasis patients with major depressive disorder were divided into a combination therapy group (30 cases) who received sertraline plus cognitive behavior therapy and a monotherapy group (30 cases) who received sertraline only. Before the treatment and at the 1st, 2nd, 4th, 8th week after the treatment, the efficacy and safety were assessed with the HAMD17 item score and the related factor points and TESS. The effective rate, side effect rate and relapse rate in six months were calculated and compared between the two groups. At the end of 8th week after the treatment, the total scores of HAMD, factor scores of cognitive impairment, retardation factor scores and sleep disturbance factor scores in the 2 groups were statistically decreased compared with those before the treatment (P < 0.05 or P < 0.01). The factor scores in the combined therapy group were lower than those in the monotherapy group. The effective rate in the combination therapy group was 86.7% (26/30), and it was significantly higher than that in the monotherapy group (56.7%, 17/30), (chi2 = 6.65, P < 0.05). The doses of the drug were lower in the combination therapy group than those in the monotherapy group (t = 2.25, P < 0.05). Within six months, the relapse rate was 13.3% in the combination therapy group, and it was significantly lower than that in the monotherapy group (46.7%) (chi2 = 7.937, P < 0.025). The side effect rate was 23.3% in the combination therapy group and that was 26.7% in the monotherapy group, and there was no statistically significant difference between the two groups (P > 0.05). The combination therapy (drug combined with cognitive behavioral therapy) is effective in advanced schistosomiasis patients with depression, and it also can reduce the amount of medication and the relapse.",23236802,Major Depressive Disorder,Anxiety Treatment,Mental Health,4274,10.968534469604492,-1.523921012878418,CkhC
"[Self-management interventions in the treatment of depressive disorders: ready for clinical practice?]

Only about half of those suffering from a depressive disorder seek treatment. Self-management interventions are one way to reduce this treatment gap. These interventions are mostly based on evidence-based techniques of cognitive behavioural therapy, which are taught by a computer program instead of a therapist. Numerous studies have shown the effectiveness of these interventions. However, these studies also raise a number of questions. These concern the efficacy both in the external rating and in the long-term course and the efficacy in severe depressive symptoms or in combination with antidepressant medication. Finally, the question arises as to the use of these interventions in patients in clinical practice and in people who are not particularly Internet-savvy. We addressed these questions in a large randomized study (EVIDENT study). This study investigated the efficacy of Intervention deprexis®. The results of this study are summarised in this overview and placed in the context of other interventions available in Germany.",30891718,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.970446586608887,-2.949096202850342,A9KM
"Behavioral activation in acute inpatient psychiatry: a multiple baseline evaluation.

The present study employed a multiple baseline study design with repeated measures to explore clinical outcomes, therapy mechanisms, and feasibility of Behavioral Activation for persons admitted to inpatient psychiatry. Six adult inpatients with depressive symptoms and different psychiatric disorders were randomized to different lengths of baseline standard inpatient treatment. Subsequently a 5-day, 10-session Behavioral Activation protocol was added. Daily self-report outcome and process measures were administered and supplemented with hourly self-reports and clinician assessments before and after each study phase. After a relatively stable baseline, at least four participants showed marked gradual improvements both in terms of outcome as well as activation and avoidance as Behavioral Activation was initiated. The temporal relation between process and outcome differed somewhat across metrics. In most instances however, change in activation and avoidance either coincided or preceded decreased depression. We did not include some relatively common disorders, did not control for the effects of increased attention, did not investigate treatment integrity, and did not conduct follow-up after discharge. Raters were not blind and measures were mainly focused on depressive symptoms. All received concurrent medical treatment. This preliminary study further supports the promise of Behavioral Activation as an inpatient treatment for persons with a variety of psychiatric disorders. Results also lends preliminary support for the purported mechanisms of Behavioral Activation.",25460264,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.324092864990234,-2.0289924144744873,CFCD
"Pilot randomized controlled trial of a video self-help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability.

A common setting where depression is identified and treated is in primary care, where there is a need for low-intensity and cost-effective interventions to be used as part of a stepped-care model. The current study involved a pilot, parallel-group, randomized controlled trial of a video self-help intervention for primary care patients based on acceptance and commitment therapy (ACT). The intervention, called LifeStories, consisted of storytelling vignettes of patients describing their use of ACT-consistent coping skills for depression. Primary care patients were recruited to determine feasibility, acceptability, and potential clinical effects of the intervention. Twenty-one participants were assigned to use LifeStories over a period of 4 weeks, and 19 participants were assigned to an attention-matched comparison group. Qualitative feedback indicated that participants using LifeStories found the intervention to be engaging and useful in transmitting key ACT principles. Furthermore, those receiving LifeStories rated their level of ""transportation"" or immersion in the videos higher than the control group. Both conditions showed large improvements in levels of depression at a 12-week follow-up. There were no significant differences in symptom outcomes between groups; however, because this was a pilot study, it was not powered to detect differences between interventions. Both conditions additionally showed smaller effect size changes in psychological flexibility, a key ACT mechanism. The results suggest LifeStories to be a feasible and acceptable psychological intervention that may improve depression, and further research is warranted to determine its effectiveness as part of a stepped-care approach to treating depression in primary care.",32087610,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,9.247166633605957,-2.4059643745422363,As+A
"Mediators of the impact of a home-based intervention (beat the blues) on depressive symptoms among older African Americans.

Older African Americans (N = 208) with depressive symptoms were randomly assigned to a home-based nonpharmacologic intervention (Beat the Blues, or BTB) or wait-list control group. BTB was delivered by licensed social workers and involved up to 10 home visits focused on care management, referral and linkage, depression knowledge and efficacy in symptom recognition, instruction in stress reduction techniques, and behavioral activation through identification of personal goals and action plans for achieving them. Structured interviews by assessors masked to study assignment were used to assess changes in depressive symptoms (main trial endpoint), behavioral activation, depression knowledge, formal care service utilization, and anxiety (mediators) at baseline and 4 months. At 4 months, the intervention had a positive effect on depressive symptoms and all mediators except formal care service utilization. Structural equation models indicated that increased activation, enhanced depression knowledge, and decreased anxiety each independently mediated a significant proportion of the intervention's impact on depressive symptoms as assessed with 2 different measures (PHQ-9 and CES-D). These 3 factors also jointly explained over 60% of the intervention's total effect on both indicators of depressive symptoms. Our findings suggest that most of the impact of BTB on depressive symptoms is driven by enhancing activation or becoming active, reducing anxiety, and improving depression knowledge/efficacy. The intervention components appear to work in concert and may be mutually necessary for maximal benefits from treatment to occur. Implications for designing tailored interventions to address depressive symptoms among older African Americans are discussed.",25244479,Major Depressive Disorder,Anxiety Treatment,Mental Health,20534,10.741299629211426,-2.7992465496063232,CIEB
"Effectiveness of resilience training versus cognitive therapy on reduction of depression in female Iranian college students.

Depression is the most common mental illness among women. Its prevalence in women is two to three times that of men. The purpose of the present study was to evaluate the effectiveness of resilience training on the reduction of depression in female college students. This semi-empirical study was carried out with two experimental groups and one control group. The research sample was women with symptoms of depression who were 18-22 years of age and living in a college dormitory. One experimental group was given eight 90-minute resilience training sessions, while the other received eight 90-minute cognitive therapy sessions. The control group didn't receive any interventions. The three groups under study were evaluated using the Beck II depression inventory before and after the interventions and two months after the treatment had ended. The three groups didn't have significant differences in age, marital status, or depression scores on the pretest. The resilience training group and cognitive therapy group showed a significant decrease in the average depression score from pretest to posttest and from pretest to follow-up. The main effect of groups, stage, and interaction between groups and stage also were significant (all were p < 0.001). There was no significant difference between effectiveness of resilience training and cognitive therapy on depression but there was a significant difference between these two treatment groups and the control group. The effectiveness of resilience training was just as good as the effectiveness of cognitive therapy. The effects of resilience training on depression remained stable from the posttest to the follow-up, like that of cognitive therapy.",24857532,Major Depressive Disorder,Anxiety Treatment,Mental Health,5785,11.042561531066895,-3.5457327365875244,CNlJ
"Cognitive therapy plus medication management is better than antidepressants alone for patients with severe depression.

",26109592,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.377742767333984,-1.352446436882019,B7zJ
"Self-help books for people with depression: the role of the therapeutic relationship.

In the UK, bibliotherapy schemes have become a widespread source of support for people with common mental health disorders such as depression. However, the current evidence suggests that bibliotherapy schemes that are offered without guidance are not effective. It may be possible to improve the effectiveness of self-help books by incorporating into them some of the ""common factors"" that operate in personal therapeutic encounters, for example therapist responsiveness. The aim was to test whether and to what extent authors have incorporated common factors into self-help books. A model of how common factors might be incorporated into CBT-based self-help books was developed and a sample of three books were examined against the model criteria. The sampled self-help books were found to have common factors to a greater or lesser extent, but some types of common factors were more prevalent than others. Factors addressing the development and maintenance of the therapeutic alliance were less often apparent. Self-help books have the potential to provide a valuable service to people with depression, but further work is necessary to develop them. It is suggested that future generations of self-help books should pay explicit attention to the use of common factors, in particular developing and investigating how factors such as flexibility, responsiveness and alliance-rupture repair can be woven into the text.",19995466,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.801106452941895,-3.3687708377838135,DPop
"Large reductions in depression and anxiety via low-intensity cognitive behavioural therapy delivered by novice coach.

",26764369,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,11.267157554626465,-2.483891248703003,Bym7
"Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial.

Mild to moderate depressive symptoms are common but often remain unrecognized and treated inadequately. We hypothesized that an Internet intervention in addition to usual care is superior to care as usual alone (CAU) in the treatment of mild to moderate depressive symptoms in adults. This trial was controlled, randomized and assessor-blinded. Participants with mild to moderate depressive symptoms (Patient Health Questionnaire, PHQ-9, score 5-14) were recruited from clinical and non-clinical settings and randomized to either CAU or a 12-week Internet intervention (Deprexis) adjunctive to usual care. Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The primary outcome measure was self-rated depression severity (PHQ-9). The main analysis was based on the intention-to-treat principle and used linear mixed models. A total of 1,013 participants were randomized. Changes in PHQ-9 from baseline differed signixFB01;cantly between groups (t825 = 6.12, p < 0.001 for the main effect of group). The post-assessment between-group effect size in favour of the intervention was d = 0.39 (95% CI: 0.13-0.64). It was stable at follow-up, with d = 0.32 (95% CI: 0.06-0.69). The rate of participants experiencing at least minimally clinically important PHQ-9 change at the post-assessment was higher in the intervention group (35.6 vs. 20.2%) with a number needed to treat of 7 (95% CI: 5-10). The Internet intervention examined in this trial was superior to CAU alone in reducing mild to moderate depressive symptoms. The magnitude of the effect is clinically important and has public health implications.",27230863,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.015634536743164,-3.0639233589172363,BsP4
"A randomized controlled trial of cognitive-behavioral treatment for depression versus relaxation training for alcohol-dependent individuals with elevated depressive symptoms.

A previous pilot study found positive outcomes among alcohol-dependent individuals with elevated depressive symptoms who received cognitive-behavioral treatment for depression (CBT-D; n = 19) compared with a relaxation training control (RTC; n = 16). The current study represents a replication of this pilot study using a larger sample size and a longer follow-up assessment period. Patients entering a partial hospital drug and alcohol treatment program who met criteria for alcohol dependence and elevated depressive symptoms (Beck Depression Inventory score ≥ 15) were recruited and randomly assigned to receive eight individual sessions of CBT-D (n = 81) or RTC (n = 84). There were significant improvements in depressive and alcohol use outcomes over time for all participants.Compared with RTC, the CBT-D condition had significantly lower levels of depressive symptoms, as measured by the Beck Depression Inventory, at the 6-week follow-up. However, this effect was inconsistent because there were no differences in the Modified Hamilton Rating Scale for Depression between conditions at that time point and there were no significant differences at any other follow-up. No significant between-group differences on alcohol use outcomes were found. The current findings did not replicate the positive outcomes observed in the CBT-D condition in our previous pilot study. Possible explanations for why these findings were not replicated are discussed, as are theoretical and clinical implications of using CBT-D in alcohol treatment.",21388602,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,10.724156379699707,-3.0047154426574707,C++Z
"Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.

What are the benefits and harms of second generation antidepressants and cognitive behavioral therapies (CBTs) in the initial treatment of a current episode of major depressive disorder in adults? This was a systematic review including qualitative assessment and meta-analyses using random and fixed effects models. Medline, Embase, the Cochrane Library, the Allied and Complementary Medicine Database, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature were searched from January 1990 through January 2015. The 11 randomized controlled trials included compared a second generation antidepressant CBT. Ten trials compared antidepressant monotherapy with CBT alone; three compared antidepressant monotherapy with antidepressant plus CBT. Meta-analyses found no statistically significant difference in effectiveness between second generation antidepressants and CBT for response (risk ratio 0.91, 0.77 to 1.07), remission (0.98, 0.73 to 1.32), or change in 17 item Hamilton Rating Scale for Depression score (weighted mean difference, -0.38, -2.87 to 2.10). Similarly, no significant differences were found in rates of overall study discontinuation (risk ratio 0.90, 0.49 to 1.65) or discontinuation attributable to lack of efficacy (0.40, 0.05 to 2.91). Although more patients treated with a second generation antidepressant than receiving CBT withdrew from studies because of adverse events, the difference was not statistically significant (risk ratio 3.29, 0.42 to 25.72). No conclusions could be drawn about other outcomes because of lack of evidence. Results should be interpreted cautiously given the low strength of evidence for most outcomes. The scope of this review was limited to trials that enrolled adult patients with major depressive disorder and compared a second generation antidepressant with CBT, and many of the included trials had methodological shortcomings that may limit confidence in some of the findings. Second generation antidepressants and CBT have evidence bases of benefits and harms in major depressive disorder. Available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences. Funding, competing interests, data sharing This project was funded under contract from the Agency for Healthcare Research and Quality by the RTI-UNC Evidence-based Practice Center. Detailed methods and additional information are available in the full report, available at http://effectivehealthcare.ahrq.gov/.",26645251,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.76547908782959,-2.3122658729553223,B0KX
"Lifestyle Prescription for Depression with a Focus on Nature Exposure and Screen Time: A Narrative Review.

Recent lifestyles changes have favored increased time in contact with screens and a parallel reduction in contact with natural environments. There is growing awareness that nature exposure and screen time are related to depression. So far, the roles of how these environmental lifestyles affect depressive symptoms and disorders have not been reviewed simultaneously. The aim of this review was to gather the literature regarding the role of nature exposure and screen time in depression. An emphasis was made on clinical samples of patients with well-defined depression and the different methodological approaches used in the field. A second goal was to suggest an agenda for clinical practice and research. Studies were included if they assessed depressive symptoms in patients with a clinical diagnosis of depression. An overview of the published literature was conducted using three scientific databases up to December 2021. Several interventions involving nature exposure have shown positive effects on depressive symptoms and mood-related measures. The most consistent finding suggests that walks in natural environments may decrease depressive symptoms in patients with clinical depression. Less researched interventions, such as psychotherapy delivered in a forest or access to natural environments via virtual reality, may also be effective. In contrast, fewer observational studies and no experimental research on screen time have been conducted in patients with clinical depression. Thus, recommendations for practice and research are also discussed. Scarce research, diverse interventions, and several methodological shortcomings prevent us from drawing conclusions in this area. More high-quality experimental research is needed to establish interventions with proven efficacy in clinical depression. At this stage, it is too early to formulate practice guidelines and advise the prescription of these lifestyles to individuals with depression. The present findings may serve as a basis to develop strategies based on nature exposure and screen time targeting clinical depression.",35564489,Major Depressive Disorder,Anxiety Treatment,Mental Health,7384,8.736403465270996,-2.149780035018921,Y9Y
"Depression in Visual Impairment Trial (DEPVIT): A Randomized Clinical Trial of Depression Treatments in People With Low Vision.

The purpose of this study was to compare two interventions for depression, problem solving treatment (PST) and referral to the patient's physician, with a waiting-list control group in people with sight loss and depressive symptoms. This was an assessor-masked, exploratory, multicenter, randomized clinical trial, with concurrent economic analysis. Of 1008 consecutive attendees at 14 low-vision rehabilitation centers in Britain, 43% (n = 430) screened positive for depressive symptoms on the Geriatric Depression Scale and 85 of these attendees participated in the trial. Eligible participants were randomized in the ratio 1:1:1 to PST, referral to their physician, or a waiting-list control arm. PST is a manualized talking intervention delivered by a trained therapist who teaches people over six to eight sessions to implement a seven-step method for solving their problems. Referral to the physician involved sending a referral letter to the person's physician, encouraging him or her to consider treatment according to the stepped care protocol recommended by the U.K.'s National Institute of Health and Care Excellence. The primary outcome was change in depressive symptoms (6 months after baseline) as determined by the Beck Depression Inventory. At 6 months, Beck Depression Inventory scores reduced by 1.05 (SD 8.85), 2.11 (SD 7.60), and 2.68 (SD 7.93) in the waiting-list control, referral, and PST arms, respectively. The cost per patient of the PST intervention was £1176 in Wales and £1296 in London. Depressive symptoms improved most in the PST group and least in the control group. However, the change was small and the uncertainty of the measurements relatively large.",27548898,Major Depressive Disorder,Anxiety Treatment,Mental Health,3755,9.72666072845459,-1.7368272542953491,BoTs
"Effect of a brief cognitive behavioral program on depressive symptoms among newly licensed registered nurses: An observational study.

Depressive symptoms are a serious problem in workplaces. Hospital staff members, such as newly licensed registered nurses (NLRNs), are at particularly increased risk of these symptoms owing to their limited experience. Previous studies have shown that a brief program-based cognitive behavioral therapy program (CBP) can offer effective treatment. Here, we conducted a longitudinal observational study of 683 NLRNs (CBP group, n = 522; no-CBP group, n = 181) over a period of 1 year (six times surveys were done during this period). Outcomes were assessed on the basis of surveys that covered the Beck Depression Inventory-I (BDI). The independent variables were CBP attendance (CBP was conducted 3 months after starting work), personality traits, personal stressful life events, workplace adversity, and pre-CBP change in BDI in the 3 months before CBP (ΔBDIpre-CBP). All factors were included in Cox proportional hazards models with time-dependent covariates for depressive symptoms (BDI ≥10), and we reported hazard ratios (HRs). Based on this analysis, we detected that CBP was significantly associated with benefit for depressive symptoms in all NLRNs (Puncorrected = 0.0137, HR = 0.902). To identify who benefitted most from CBP, we conducted a subgroup analysis based on the change in BDI before CBP (ΔBDIpre-CBP). The strongest association was when BDI scores were low after starting work and increased before CBP (Puncorrected = 0.00627, HR = 0.616). These results are consistent with previous findings, and indicate that CBP may benefit the mental health of NLRNs. Furthermore, selective prevention based on the pattern of BDI change over time may be important in identifying who should be offered CBP first. Although CBP is generally effective for all nurses, such a selective approach may be most appropriate where cost-effectiveness is a prominent concern.",33045002,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.681532859802246,-2.959278106689453,AhIl
"Effect of Positive Psychotherapy on Psychological Well-Being, Happiness, Life Expectancy and Depression Among Retired Teachers with Depression: A Randomized Controlled Trial.

Despite conducting numerous positive psychotherapy (PPT) tests, the effects of such activities in participants aged 50 and above have been dealt with by few studies. Therefore, the effects of PPT on psychological well-being (PWB), happiness, expectancy life (LX) and depression of retired teachers with depression, was investigated using a randomized controlled trial. In this study, 60 female teachers aged 55-80 years, who obtained the lowest scores in the Beck Depression Inventory-II (BDI-II), were randomly divided into the two PPT (n=30) and untreated groups (n=30) at the time of entering the study and 2 months later following their assessments through the Psychological Well-Being Scales-Short (PWBS-S), Oxford Happiness Inventory (OHI), Adult Hope Scale (AHS) and BDI-II. The PPT and untreated groups took part in 10 group sessions and underwent no interventions, respectively. The study was completed with a total number of 52 female teachers (n=26 per group). The PPT group showed some effectiveness on the variables of PWBS-S, OHI, AHS and BDI-II in a way that the involved retired teachers with depression increased their PWB, happiness and LE after PPT training and teachers reduced their BDI-II after intervention (p<0.05). PPT can be used in order to increase the level of PWB, happiness, and LX, along with depression symptoms decreasing amongst retired teachers with the age of 55, and also more than that.",31552541,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.887184143066406,-3.797992467880249,A0OZ
"Effects of web-based stress and depression literacy intervention on improving symptoms and knowledge of depression among workers: A randomized controlled trial.

The present randomized controlled trial aimed to examine whether a newly developed psychoeducational information website on stress and depression was effective in improving depressive symptoms at one- and four-month follow-ups among workers in Japan. Participants were recruited from registered members of a web survey site in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to intervention or control groups. Immediately after the baseline survey, the intervention group was invited to access a psychoeducational website named the ""UTSMed"" within 4 months after the baseline survey. Depressive symptoms (Beck Depression Inventory II; BDI-II) were assessed as a primary outcome, at baseline, and one- and four-month follow-ups for both intervention and control groups. The analyses were conducted separately by the three subgroups (high-risk, moderate-risk, and low-risk). A total of 1236 workers completed the baseline survey. Participants were randomly allocated to an intervention or control group (N=618 for each), with the subgroups of high-risk (7-8%), moderate-risk (47%) and low-risk (45-46%) in each group. A significant intervention effect on improving depressive symptoms (t=-2.35, P =0.02, d=-0.57) was observed at 1-month follow-up only in the high-risk subgroup. The present study did not use a stratified permuted-block randomization. A web-based psychoeducation approach may not be effective enough in improving depressive symptoms in a general population of workers, while it may be effective for workers who had recently sought help for mental health.",27280960,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.766744613647461,-3.399235963821411,BrmZ
"Optimizing the context of support of web-based self-help in individuals with mild to moderate depressive symptoms: A randomized full factorial trial.

Web-based self-help programs for individuals with depressive symptoms are efficacious. Differences in effect sizes and adherence rates might be due to contextual factors. This randomized factorial trial investigated the effects of four potentially supportive contextual factors on outcome and adherence. Two factors were provided through human contact (guidance and a diagnostic interview), and two factors were provided without human contact (a motivational interviewing module and automated emails). We recruited 316 adults with mild to moderate depressive symptoms (Patient Health Questionnaire-9 score: 5-14). All participants received access to a problem-solving therapy program. Participants were randomized across the four experimental factors (present or absent), resulting in a 16-condition design. The primary outcome was depressive symptoms 10 weeks after baseline. The secondary outcome was program adherence. Overall, results showed significant symptom reduction for the primary depression measure (Cohen's d = 0.38-0.91). Guided participants showed significantly less severe symptoms of depression at post-treatment (d = 0.15) and higher treatment adherence (d = 0.53). At follow-up, these differences were no longer present. The remaining three factors did not influence primary outcome and adherence. These findings indicate that guidance leads to a faster reduction of depressive symptoms and higher treatment adherence.",35306266,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.505297660827637,-2.9614946842193604,hu8
"The effect of cognitive-behavioral therapy as an antidepressive treatment is falling: Reply to Ljòtsson et al. (2017) and Cristea et al. (2017).

This article critically reassesses the nonlinear reanalysis by Ljótsson, Hedman, Mattsson, and Andersson (2017) and reviews Cristea et al.'s (2017) extension of our original meta-analysis (Johnsen & Friborg, 2015) reporting a decline in the effects of cognitive-behavioral therapy (CBT) for treating unipolar depression. Ljótsson et al. fitted a piecewise meta-regression model to the data, indicating a halt in the decline from the year 1995 onward, hence concluding that CBT is not gradually losing its efficacy. We reanalyzed the data for nonlinear time trends and replicated their findings for the 34 studies using the Hamilton Rating Scale for Depression as the outcome but not for the 67 studies using Beck's Depression Inventory as the outcome. The best nonlinear model was quadratic rather than flat (or linear) from 2001 onward, which opposes the conclusion by Ljótsson et al. of stability in effects. Cristea et al. identified additional studies, but their new analyses provided mixed support for a linear decline in CBT effects. They could not dismiss a decline except only in the most stringent analytic condition-namely, when analyzing only 29 randomized controlled trials based on between-groups effect sizes solely. Their study includes several questionable methodological choices, so we expand on the discussion of these disparate meta-analytic findings. Of particular concern is the tendency to downplay the fact that when looking at all of the studies together, there is a clear decline in the effects of CBT, which should concern therapy researchers within the field rather than being explained away. (PsycINFO Database Record",28230414,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.268308639526367,-2.5152759552001953,Bgb7
"Supportive-expressive dynamic psychotherapy in the community mental health system: a pilot effectiveness trial for the treatment of depression.

The goal of the current article is to present the results of a randomized pilot investigation of a brief dynamic psychotherapy compared with treatment-as-usual (TAU) in the treatment of moderate-to-severe depression in the community mental health system. Forty patients seeking services for moderate-to-severe depression in the community mental health system were randomized to 12 weeks of psychotherapy, with either a community therapist trained in brief dynamic psychotherapy or a TAU therapist. Results indicated that blind judges could discriminate the dynamic sessions from the TAU sessions on adherence to dynamic interventions. The results indicate moderate-to-large effect sizes in favor of the dynamic psychotherapy over the TAU therapy in the treatment of depression. The Behavior and Symptom Identification Scale-24 showed that 50% of patients treated with dynamic therapy moved into a normative range compared with only 29% of patients treated with TAU.",22962971,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.542534828186035,-3.4828097820281982,Coco
"[Overcoming treatment resistance in chronic depression : The role of inpatient psychotherapy].

Chronic depression poses a particular challenge for the psychiatric and psychotherapeutic care system. Owing to high rates of psychiatric comorbidities and multiple pharmacological and psychotherapeutic treatment resistance, novel treatment strategies are urgently required. In this article, we describe the clinical characteristics of chronic and treatment-resistant depression and review the pharmacological and psychotherapeutic treatment options currently available. We focus on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), the first specific psychotherapy approach to chronic depression. Finally, we discuss the role of psychotherapeutic inpatient programs and stepped care concepts in chronic and treatment-resistant depression.",26610341,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.695232391357422,-1.3958686590194702,B0mP
"Effect of a cognitive behavioural intervention on depression reduction among community-dwelling adult learners in Nigeria: Implications for adult education administration.

",31971045,Major Depressive Disorder,Anxiety Treatment,Mental Health,15858,11.113293647766113,-2.9417600631713867,AuhU
"Predictors of Response to Web-Based Cognitive Behavioral Therapy With High-Intensity Face-to-Face Therapist Guidance for Depression: A Bayesian Analysis.

Several studies have demonstrated the effect of guided Internet-based cognitive behavioral therapy (ICBT) for depression. However, ICBT is not suitable for all depressed patients and there is a considerable level of nonresponse. Research on predictors and moderators of outcome in ICBT is inconclusive. This paper explored predictors of response to an intervention combining the Web-based program MoodGYM and face-to-face therapist guidance in a sample of primary care patients with mild to moderate depressive symptoms. Participants (N=106) aged between 18 and 65 years were recruited from primary care and randomly allocated to a treatment condition or to a delayed treatment condition. The intervention included the Norwegian version of the MoodGYM program, face-to-face guidance from a psychologist, and reminder emails. In this paper, data from the treatment phase of the 2 groups was merged to increase the sample size (n=82). Outcome was improvement in depressive symptoms during treatment as assessed with the Beck Depression Inventory-II (BDI-II). Predictors included demographic variables, severity variables (eg, number of depressive episodes and pretreatment depression and anxiety severity), cognitive variables (eg, dysfunctional thinking), module completion, and treatment expectancy and motivation. Using Bayesian analysis, predictors of response were explored with a latent-class approach and by analyzing whether predictors affected the slope of response. A 2-class model distinguished well between responders (74%, 61/82) and nonresponders (26%, 21/82). Our results indicate that having had more depressive episodes, being married or cohabiting, and scoring higher on a measure of life satisfaction had high odds for positively affecting the probability of response. Higher levels of dysfunctional thinking had high odds for a negative effect on the probability of responding. Prediction of the slope of response yielded largely similar results. Bayes factors indicated substantial evidence that being married or cohabiting predicted a more positive treatment response. The effects of life satisfaction and number of depressive episodes were more uncertain. There was substantial evidence that several variables were unrelated to treatment response, including gender, age, and pretreatment symptoms of depression and anxiety. Treatment response to ICBT with face-to-face guidance may be comparable across varying levels of depressive severity and irrespective of the presence and severity of comorbid anxiety. Being married or cohabiting, reporting higher life satisfaction, and having had more depressive episodes may predict a more favorable response, whereas higher levels of dysfunctional thinking may be a predictor of poorer response. More studies exploring predictors and moderators of Internet-based treatments are needed to inform for whom this treatment is most effective. Australian New Zealand Clinical Trials Registry number: ACTRN12610000257066; https://www.anzctr.org.au/trial_view.aspx?id=335255 (Archived by WebCite at http://www.webcitation.org/6GR48iZH4).",26333818,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.142661094665527,-2.5102834701538086,B4pv
"Efficacy of a cognitive and behavioural psychotherapy applied by primary care psychologists in patients with mixed anxiety-depressive disorder: a research protocol.

In contrast with the recommendations of clinical practice guidelines, the most common treatment for anxiety and depressive disorders in primary care is pharmacological. The aim of this study is to assess the efficacy of a cognitive-behavioural psychological intervention, delivered by primary care psychologists in patients with mixed anxiety-depressive disorder compared to usual care. This is an open-label, multicentre, randomized, and controlled study with two parallel groups. A random sample of 246 patients will be recruited with mild-to-moderate mixed anxiety-depressive disorder, from the target population on the lists of 41 primary care doctors. Patients will be randomly assigned to the intervention group, who will receive standardised cognitive-behavioural therapy delivered by psychologists together with usual care, or to a control group, who will receive usual care alone. The cognitive-behavioural therapy intervention is composed of eight individual 60-minute face-to face sessions conducted in eight consecutive weeks. A follow-up session will be conducted over the telephone, for reinforcement or referral as appropriate, 6 months after the intervention, as required. The primary outcome variable will be the change in scores on the Short Form-36 General Health Survey. We will also measure the change in the frequency and intensity of anxiety symptoms (State-Trait Anxiety Inventory) and depression (Beck Depression Inventory) at baseline, and 3, 6 and 12 months later. Additionally, we will collect information on the use of drugs and health care services. The aim of this study is to assess the efficacy of a primary care-based cognitive-behavioural psychological intervention in patients with mixed anxiety-depressive disorder. The international scientific evidence has demonstrated the need for psychologists in primary care. However, given the differences between health policies and health services, it is important to test the effect of these psychological interventions in our geographical setting. NCT01907035 (July 22, 2013).",25879932,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.589401245117188,-2.676774263381958,B/Cb
"Nonpharmacological interventions for subthreshold depression in adults: A systematic review and network meta-analysis.

Subthreshold depression (StD) is very common, with an estimated global incidence of 25%, and is associated with other clinical conditions. Nonpharmacological interventions have been demonstrated to be effective, but which one is best should be further investigated. This study aims to compare and rank the efficacy of nonpharmacological interventions in adults with StD. Ten databases were searched, and comparisons were made using a random-effects network meta-analysis using the frequentist framework. The assumption of local consistency was assessed by using the node-splitting method. The surface under the cumulative ranking curve (SUCRA) was used to separately rank each intervention. A total of 32 randomized controlled trials (RCTs) were included. The results showed that psychotherapy, as an intervention class, had significantly positive effects compared to control groups (SMD = -0.78, 95% CI: -1.06, -0.49) and had the highest rank (SUCRA, 79.0%; mean rank, 1.6). Cognitive behavioral therapy (CBT), as an individual intervention, had significantly positive effects relative to all control groups and had the highest rank (SUCRA, 82.5%; mean rank, 3.1). We speculate that psychotherapy, especially CBT, may be the most effective nonpharmacological intervention to improve StD in adults. More RCTs examining the efficacy of different nonpharmacological interventions are needed.",36242840,Major Depressive Disorder,Anxiety Treatment,Mental Health,14383,10.266579627990723,-2.053595781326294,EB0
"Efficacy of Self-guided Internet-Based Cognitive Behavioral Therapy in the Treatment of Depressive Symptoms: A Meta-analysis of Individual Participant Data.

Self-guided internet-based cognitive behavioral therapy (iCBT) has the potential to increase access and availability of evidence-based therapy and reduce the cost of depression treatment. To estimate the effect of self-guided iCBT in treating adults with depressive symptoms compared with controls and evaluate the moderating effects of treatment outcome and response. A total of 13 384 abstracts were retrieved through a systematic literature search in PubMed, Embase, PsycINFO, and Cochrane Library from database inception to January 1, 2016. Randomized clinical trials in which self-guided iCBT was compared with a control (usual care, waiting list, or attention control) in individuals with symptoms of depression. Primary authors provided individual participant data from 3876 participants from 13 of 16 eligible studies. Missing data were handled using multiple imputations. Mixed-effects models with participants nested within studies were used to examine treatment outcomes and moderators. Outcomes included the Beck Depression Inventory, Center for Epidemiological Studies-Depression Scale, and 9-item Patient Health Questionnaire scores. Scales were standardized across the pool of the included studies. Of the 3876 study participants, the mean (SD) age was 42.0 (11.7) years, 2531 (66.0%) of 3832 were female, 1368 (53.1%) of 2574 completed secondary education, and 2262 (71.9%) of 3146 were employed. Self-guided iCBT was significantly more effective than controls on depressive symptoms severity (β=-0.21; Hedges g =0.27) and treatment response (β=0.53; odds ratio, 1.95; 95% CI, 1.52-2.50; number needed to treat, 8). Adherence to treatment was associated with lower depressive symptoms (β=-0.19; P=.001) and greater response to treatment (β=0.90; P<.001). None of the examined participant and study-level variables moderated treatment outcomes. Self-guided iCBT is effective in treating depressive symptoms. The use of meta-analyses of individual participant data provides substantial evidence for clinical and policy decision making because self-guided iCBT can be considered as an evidence-based first-step approach in treating symptoms of depression. Several limitations of the iCBT should be addressed before it can be disseminated into routine care.",28241179,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.658231735229492,-2.7631638050079346,BgRp
"Effectiveness comparisons of various psychosocial therapies for children and adolescents with depression: a Bayesian network meta-analysis.

The existence of depression among children or adolescents can trigger a sequence of burdens on themselves, their families and even the whole society, which cause both physical and economic impacts. Our network meta-analysis (NMA) was aimed at comparing them with each other for evaluating the optimal psychosocial therapy to help children and adolescents with depression to improve their mental health. Based on several biomedical databases, a system of search strategies was conducted for searching randomized controlled trials (RCTs) which published from their inception on October, 1st 2018 without language restriction. We carried out an expression analysis for comparing the efficacy of various psychosocial therapies using Bayesian NMA. A battery of analyses and assessments, such as conventional meta-analysis and risk of bias, were performed concurrently. Only 32 of RCTs which involved 2677 participants were eventually included in our analyses from the 19,176 of initial citation screening. In addition, in terms of various valid assessment instruments, interpersonal psychotherapy [standard mean difference (SMD)=-1.38, Credible interval (CrI) -2.5, -0.20)], computer cognitive-behavioral therapy (SMD=-1.36, CrI -2.59, -0.14), cognitive-behavioral therapy (SMD=-1.16, CrI -2.15, -0.18), had significantly better effects than the named control group. All together, these results suggest that interpersonal psychotherapy might be the best approach to improve the depressive state among children and adolescents. This study may provide an excellent resource for future endeavors to utilize psychosocial interventions and may also serve as a springboard for creative undertakings as yet unknown.",32076871,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.930625915527344,-2.7778077125549316,AtGe
"Workplace interventions to reduce depression and anxiety in small and medium-sized enterprises: A systematic review.

Depression and anxiety are the most prevalent mental health difficulties in the workplace, costing the global economy $1 trillion each year. Evidence indicates that symptoms may be reduced by interventions in the workplace. This paper is the first to systematically review psychosocial interventions for depression, anxiety, and suicidal ideation and behaviours in small-to medium-size enterprises (SMEs). A systematic search following PRISMA guidelines, registered in PROSPERO (CRD42020156275), was conducted for psychosocial interventions targeting depression, anxiety, and suicidal ideation/behaviour in SMEs. The PubMed, PsycINFO, Scopus, and two specific occupational health databases were searched, as well as four databases for grey literature, without time limit until 2nd December 2019. In total, 1283 records were identified, 70 were retained for full-text screening, and seven met the inclusion criteria: three randomised controlled trials (RCTs), three before and after designs and one non-randomised trial, comprising 5111 participants. Study quality was low to moderate according to the Quality Assessment Tool for Quantitative Studies. Five studies showed a reduction in depression and anxiety symptoms using techniques based on cognitive behavioural therapy (CBT), two reported no significant change. Low number and high heterogeneity of interventions and outcomes, high attrition and lack of rigorous RCTs. Preliminary evidence indicates CBT-based interventions can be effective in targeting symptoms of depression and anxiety in SME employees. There may be unique challenges to implementing programmes in SMEs. Further research is needed in this important area.",34082284,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,8.865490913391113,-5.306318759918213,AVRQ
"Effect of Disorder-Specific vs Nonspecific Psychotherapy for Chronic Depression: A Randomized Clinical Trial.

Chronic depression is a highly prevalent and disabling disorder. There is a recognized need to assess the value of long-term disorder-specific psychotherapy. To evaluate the efficacy of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared with that of nonspecific supportive psychotherapy (SP). A prospective, multicenter, evaluator-blinded, randomized clinical trial was conducted among adult outpatients with early-onset chronic depression who were not taking antidepressant medication. Patients were recruited between March 5, 2010, and October 16, 2012; the last patient finished treatment on October 14, 2013. Data analysis was conducted from March 5, 2014, to October 27, 2016. The treatment included 24 sessions of CBASP or SP for 20 weeks in the acute phase, followed by 8 continuation sessions during the next 28 weeks. The primary outcome was symptom severity after 20 weeks (blinded observer ratings) as assessed by the 24-item Hamilton Rating Scale for Depression (HRSD-24). Secondary outcomes were rates of response (reduction in HRSD-24 score of ≥50% from baseline) and remission (HRSD-24 score ≤8), as well as self-assessed ratings of depression, global functioning, and quality of life. Among 622 patients assessed for eligibility, 268 were randomized: 137 to CBASP (96 women [70.1%] and 41 men [29.9%]; mean [SD] age, 44.7 [12.1] years) and 131 to SP (81 women [61.8%] and 50 men [38.2%]; mean [SD] age, 45.2 [11.6] years). The mean (SD) baseline HRSD-24 scores of 27.15 (5.49) in the CBASP group and 27.05 (5.74) in the SP group improved to 17.19 (10.01) and 20.39 (9.65), respectively, after 20 weeks, with a significant adjusted mean difference of -2.51 (95% CI, -4.16 to -0.86; P=.003) and a Cohen d of 0.31 in favor of CBASP. After 48 weeks, the HRSD-24 mean (SD) scores were 14.00 (9.72) for CBASP and 16.49 (9.96) for SP, with an adjusted difference of -3.13 (95% CI, -5.01 to -1.25; P=.001) and a Cohen d of 0.39. Patients undergoing CBASP were more likely to reach response (48 of 124 [38.7%] vs 27 of 111 [24.3%]; adjusted odds ratio, 2.02; 95% CI, 1.09 to 3.73; P=.03) or remission (27 of 124 [21.8%] vs 14 of 111 [12.6%]; adjusted odds ratio, 3.55; 95% CI, 1.61 to 7.85; P=.002) after 20 weeks. Patients undergoing CBASP showed significant advantages in most other secondary outcomes. Highly structured specific psychotherapy was moderately more effective than nonspecific therapy in outpatients with early-onset chronic depression who were not taking antidepressant medication. Adding an extended phase to acute psychotherapy seems promising in this population. clinicaltrials.gov Identifier: NCT00970437.",28146251,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.204835891723633,-1.8771002292633057,BhZM
"Effectiveness and Acceptance of Technology-Based Psychological Interventions for the Acute Treatment of Unipolar Depression: Systematic Review and Meta-analysis.

Evidence on technology-based psychological interventions (TBIs) for the acute treatment of depression is rapidly growing. Despite extensive research in this field, there is a lack of research determining effectiveness and acceptance of TBIs considering different application formats in people with a formally diagnosed depressive disorder. The goal of the review was to investigate the effectiveness and acceptance of TBIs in people with diagnosed depression with particular focus on application formats (stand-alone interventions, blended treatments, collaborative and/or stepped care interventions). Studies investigating adults with diagnosed unipolar depressive disorders receiving any kind of psychotherapeutic treatment delivered (at least partly) by a technical medium and conducted as randomized controlled trials (RCTs) were eligible for inclusion. We searched CENTRAL (Cochrane Central Register of Controlled Trials; August 2020), MEDLINE, PsycINFO, PSYNDEX, CINAHL (January 2018), clinical trial registers, and sources of grey literature (January 2019). Two independent authors decided about study inclusion and extracted data. We performed random effects meta-analyses to synthesize the data. Database searches resulted in 15,546 records of which 78 completed studies were included. TBIs delivered as stand-alone interventions showed positive effects on posttreatment depression severity when compared to treatment as usual (SMD -0.44, 95% CI -0.73 to -0.15, k=10; I²=86%), attention placebo (SMD -0.51, 95% CI -0.73 to -0.30; k=12; I²=66%), and waitlist controls (SMD -1.01, 95% CI -1.23 to -0.79; k=19; I²=73%). Superior long-term effects on depression severity were shown when TBIs were compared to treatment as usual (SMD -0.24, 95% CI -0.41 to -0.07; k=6; I²=48%) attention placebo (SMD -0.23, 95% CI -0.40 to -0.07; k=7; I²=21%) and waitlist controls (SMD -0.74, 95% CI -1.31 to -0.18; k=3; I²=79%). TBIs delivered as blended treatments (providing a TBI as an add-on to face-to-face treatment) yielded beneficial effects on posttreatment depression severity (SMD -0.27, 95% CI -0.48 to -0.05; k=8; I²=53%) compared to face-to-face treatments only. Additionally, TBIs delivered within collaborative care trials were more effective in reducing posttreatment (SMD -0.20, 95% CI -0.36 to -0.04; k=2; I²=0%) and long-term (SMD -0.23, 95% CI -0.39 to -0.07; k=2; I²=0%) depression severity than usual care. Dropout rates did not differ between the intervention and control groups in any comparison (all P≥.09). We found that TBIs are effective not only when delivered as stand-alone interventions but also when they are delivered as blended treatments or in collaborative care trials for people with diagnosed depression. Our results may be useful to inform routine care, since we focused specifically on different application formats, formally diagnosed patients, and the long-term effectiveness of TBIs. PROSPERO International Prospective Register of Systematic Reviews CRD42016050413; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42016050413. RR2-10.1136/bmjopen-2018-028042.",36260395,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.052227020263672,-3.096076488494873,DsE
"Pattern of Changes during Treatment: A Comparison between a Positive Psychology Intervention and a Cognitive Behavioral Treatment for Clinical Depression.

Research on psychotherapy has traditionally focused on analyzing changes between the beginning and the end of a treatment. Few studies have addressed the pattern of therapeutic change during treatment. The aim of this study was to examine the pattern of changes in clinical and well-being variables during a cognitive behavioral therapy (CBT) program compared with an integrative positive psychology interventions program for clinical depression IPPI-D. 128 women with a diagnosis of major depression or dysthymia were assigned to the CBT or PPI group. A measure of depressive symptoms (i.e., Beck Depression Inventory) and well-being (i.e., Pemberton Happiness Index) were administered four times: at the beginning and end of the treatment, as well as during treatment (at sessions 4 and 7). Through mixed-model repeated measures ANOVAs, both depressive symptoms (p .08). The percentage of improvement in depressive symptoms in the first treatment period was higher than in the later ones (ps < .005). On the contrary, well-being showed a more gradual improvement (p = .15). These results highlight the importance of assessing the pattern of changes in symptoms and well-being separately.",29072149,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.17187213897705,-3.210920572280884,BVE7
"An online intervention for reducing depressive symptoms: secondary benefits for self-esteem, empowerment and quality of life.

Internet-based interventions are increasingly recognized as effective for the treatment and prevention of depression; however, there is a paucity of research investigating potential secondary benefits. From a consumer perspective, improvements in indicators of wellbeing such as perceived quality of life may represent the most important outcomes for evaluating the effectiveness of an intervention. This study investigated the 'secondary' benefits for self-esteem, empowerment, quality of life and perceived social support of two 12-week online depression interventions when delivered alone and in combination. Participants comprised 298 adults displaying elevated psychological distress. Participants were randomised to receive: an Internet Support Group (ISG); an automated Internet psycho-educational training program for depression; a combination of these conditions; or a control website. Analyses were performed on an intent-to-treat basis. Following the automated training program immediate improvements were shown in participants׳ self-esteem and empowerment relative to control participants. Improvements in perceived quality of life were reported 6-months following the completion of the intervention when combined with an ISG. These findings provide initial evidence for the effectiveness of this online intervention for improving individual wellbeing beyond the primary aim of the treatment. However, further research is required to investigate the mechanisms underlying improvement in these secondary outcomes.",24534125,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.984091758728027,-3.411792039871216,CSCi
"Do Cognitive Therapy Skills Neutralize Lifetime Stress to Improve Treatment Outcomes in Recurrent Depression?

Cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but not all patients respond. Past research suggests that stressful life events (SLE; e.g., childhood maltreatment, emotional and physical abuse, relationship discord, physical illness) sometimes reduce the efficacy of depression treatment, whereas greater acquisition and use of CT skills may improve patient outcomes. In a sample of 276 outpatient participants with recurrent MDD, we tested the hypothesis that patients with more SLE benefit more from CT skills in attaining response and remaining free of relapse/recurrence. Patients with more pretreatment SLE did not develop weaker CT skills, on average, but were significantly less likely to respond to CT. However, SLE predicted non-response only for patients with relatively weak skills, and not for those with stronger CT skills. Similarly, among acute-phase responders, SLE increased risk for MDD relapse/recurrence among patients with weaker CT skills. Thus, the combination of more SLE and weaker CT skills forecasted negative outcomes. These novel findings are discussed in the context of improving CT for depression among patients with greater lifetime history of SLE and require replication before clinical application.",32800302,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.624760627746582,-1.4528143405914307,AkJa
"Clinical effectiveness of cognitive behavioral therapy for depression in routine care: A propensity score based comparison between randomized controlled trials and clinical practice.

The efficacy of cognitive behavioral therapy (CBT) for the treatment of depressive disorders has been demonstrated in many randomized controlled trials (RCTs). This study investigated whether for CBT similar effects can be expected under routine care conditions when the patients are comparable to those examined in RCTs. N=574 CBT patients from an outpatient clinic were stepwise matched to the patients undergoing CBT in the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP). First, the exclusion criteria of the RCT were applied to the naturalistic sample of the outpatient clinic. Second, propensity score matching (PSM) was used to adjust the remaining naturalistic sample on the basis of baseline covariate distributions. Matched samples were then compared regarding treatment effects using effect sizes, average treatment effect on the treated (ATT) and recovery rates. CBT in the adjusted naturalistic subsample was as effective as in the RCT. However, treatments lasted significantly longer under routine care conditions. The samples included only a limited amount of common predictor variables and stemmed from different countries. There might be additional covariates, which could potentially further improve the matching between the samples. CBT for depression in clinical practice might be equally effective as manual-based treatments in RCTs when they are applied to comparable patients. The fact that similar effects under routine conditions were reached with more sessions, however, points to the potential to optimize treatments in clinical practice with respect to their efficiency.",26433763,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.129368782043457,-2.6899893283843994,B3GI
"[Resource-focused treatment for unipolar depression: a randomized controlled psychotherapy study].

Resource activation is considered to be a central mechanism in psychotherapeutic change. However, it is widely unknown whether a special focus on resource activation is associated with higher efficacy in cognitive behavioural therapy. 52 patients with unipolar depression took part in a randomized controlled study comparing cognitive behavioural therapy plus resource activation (RFCBT) with cognitive behavioural therapy (CBT) alone. Overall, treatment effects were comparable to published research. In both treatment groups patients equally improved on cognitive, emotional and interpersonal outcome measures. A combined treatment approach of cognitive behavioural therapy and resource activation was shown to be an effective treatment of unipolar depression. Yet, compared to a standard CBT-treatment an additional focus on resource was not associated with higher efficacy.",21337296,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.847983360290527,-2.5859599113464355,C/qf
"Schema therapy, motivational interviewing, and collaborative-mapping as treatment for depression among low income, second generation Latinas.

US-born Latinos report significantly more depression than foreign-born Latinos in the US, and Latinas have twice the rate of depression than Latino men. The purpose of this pilot study was to test the feasibility of an innovative, short-term program of Schema Therapy (ST) combined with Motivational Interviewing (MI) techniques to reduce depression and increase resilience among second generation Latinas of low income in the US. In addition to blending ST and MI strategies with a focus on resilience, a novel technique called collaborative-mapping was a crucial strategy within treatment. Scheduling for sessions was flexible and patients had unlimited cell phone access to the therapist outside of sessions, although few used it. A mixed linear regression model for BDI-II scores of 8 women who completed all eight 2-h sessions demonstrated that the treatment significantly decreased BDI-II scores during the course of treatment (p = .0003); the average decreasing rate in BDI-II scores was 2.8 points per visit. Depression scores remained sub-threshold for 12 months after treatment completion. Resilience scores significantly increased after treatment completion and remained high at all follow-up visits through 1 year (p < .01). Thus, this short term, customized intervention was both feasible and effective in significantly decreasing depression and enhancing resilience for this sample with effects enduring one year after treatment. This study is the first to combine ST and MI in therapy, which resulted in an appealing, desirable, and accessible depression treatment for this severely understudied, underserved sample of low income, second generation Latinas in the US.",21619859,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.336464881896973,-5.630547523498535,C7uX
"Where to go from here? An exploratory meta-analysis of the most promising approaches to depression prevention programs for children and adolescents.

To examine the overall effect of individual depression prevention programs on future likelihood of depressive disorder and reduction in depressive symptoms. In addition, we have investigated whether Cognitive Behavioural Therapy (CBT), Interpersonal Therapy (IPT) and other therapeutic techniques may modify this effectiveness. This study is based on and includes the trial data from meta-analyses conducted in the Cochrane systematic review of depression prevention programs for children and adolescents by Merry et al. (2011). All trials were published or unpublished English language randomized controlled trials (RCTs) or cluster RCTs of any psychological or educational intervention compared to no intervention to prevent depression in children and adolescents aged 5-19 years. There is some evidence that the therapeutic approach used in prevention programs modifies the overall effect. CBT is the most studied type of intervention for depression prevention, and there is some evidence of its effectiveness in reducing the risk of developing a depressive disorder, particularly in targeted populations. Fewer studies employed IPT, however this approach appears promising. To our knowledge, this is the first study to have explored how differences in the approach taken in the prevention programs modify the overall treatment effects of prevention programs for children and adolescents. More research is needed to identify the specific components of CBT that are most effective or indeed if there are other approaches that are more effective in reducing the risk of future depressive episodes. It is imperative that prevention programs are suitable for large scale roll-out, and that emerging popular modes of delivery, such as online dissemination continue to be rigorously tested.",25941844,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.219058990478516,-3.23690128326416,B+II
"Autonomous and controlled motivation and interpersonal therapy for depression: moderating role of recurrent depression.

We examined the moderating role of depression recurrence on the relation between autonomous and controlled motivation and interpersonal therapy (IPT) treatment outcome. The investigation was conducted in an out-patient mood disorders clinic of a large university-affiliated psychiatric hospital. The sample represents a subset of a larger naturalistic database of patients seen in the clinic. We examined 74 depressed out-patients who received 16 sessions of IPT. The Beck Depression Inventory-II, administered at pre-treatment and post-treatment, served as a measure of depressive severity. Measures of motivation and therapeutic alliance were collected at the third session. In the entire sample, both the therapeutic alliance and autonomous motivation predicted higher probability of achieving remission; however, the relation differed for those with highly recurrent depression compared to those with less recurrent depression. For those with highly recurrent depression, the therapeutic alliance predicted remission whereas autonomous motivation had no effect on remission. For those with less recurrent depression, both autonomous motivation and the therapeutic alliance predicted better achieving remission. Controlled motivation emerged as a significant negative predictor of remission across both groups. Taken together, these results highlight the possible use of motivation theory to inform and enrich therapeutic conceptualizations and interventions in clinical practice, but also point to the importance of modifying interventions based on the chronicity of a client's depression.",19917153,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.599170684814453,-3.589559316635132,DQA6
"Efficacy of an internet-based self-management intervention for depression or dysthymia - a study protocol of an RCT using an active control condition.

The treatment of major depressive disorder, a highly prevalent disorder associated with pronounced burden, is a large challenge to healthcare systems worldwide. Internet based self-management interventions seem to be a cost effective way to complement the treatment of depressed patients, but the accumulating evidence is mainly based on the comparison to waitlist controls and treatment as usual, which might lead to an overestimation of effects. Furthermore, studies assessing long-term effects and possible negative outcomes are still rare. The proposed study evaluates the efficacy of the German version of the iFightDepression® tool in comparison to an active control condition. A total of 360 patients with mild to moderate depressive symptoms are included into a two-armed randomized controlled trial. They receive one of two six week interventions; either the iFightDepression® tool or progressive muscle relaxation serving as the control condition. Both intervention groups receive information material, weekly tasks via the internet and regular phone calls as part of the intervention. The primary outcome is change in depressive symptoms after the intervention period, as measured with the Inventory of Depressive Symptomatology. Satisfaction with the program, usability, changes in perceived quality of life, and possible negative effects are assessed as secondary outcomes. This study represents the first randomized controlled trial on the iFightDepression® self-management tool in its German version, aiming at efficacy, but also at providing new insights into so far understudied aspects of E-mental health programs, namely the specificity of the treatment effect compared to an active control condition, it's continuity over a time course of 12months, and possible negative effects of these internet based interventions. International trial-registration took place through the ""international clinical trials registry platform"" (WHO) with the secondary ID 080-15-09032015. German Clinical Trial Registration: DRKS00009323 (DRKS.de, registered on 25 February 2016).",30871544,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.708978652954102,-3.0476949214935303,A9bv
"Internet-delivered psychotherapy for depression in adults.

The rapidly growing number of published research papers attests to the increasing interest in Internet-delivered psychotherapy (iPT). The present article reviews the current status of iPT for the treatment of adults with symptoms of depression. Randomized controlled trials have confirmed the efficacy of guided iPT in treating people with diagnosed or elevated symptoms of depression with equivalent results obtained by programs based on cognitive behavioural or problem solving models. With guidance, effect sizes are comparable to those obtained in face-to-face psychotherapy and low-intensity interventions are as effective as those with higher levels of therapist contact. On current evidence, entirely self-guided programs appear to have fewer benefits, but deliver tangible benefits to completers. Recent studies indicate the utility of iPT. Large-scale trials are needed to evaluate optimal strategies for disseminating iPT. Future studies should independently replicate findings and efforts are required to educate patients and health professionals about iPT.",20827199,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.62802791595459,-2.7977657318115234,DF7q
"Mindfulness-Based Cognitive Therapy, Acceptance and Commitment Therapy, and Positive Psychotherapy for Major Depression.

In the past two decades, newer psychotherapy treatments have emerged for the treatment of major depression. This review aimed to comprehensively synthesize the evidence for mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and positive psychotherapy (PPT) in treating a current episode of major depression. A systematic search of the Ovid MEDLINE, Embase, PsycINFO, and Cochrane databases was conducted for randomized controlled trials of MBCT, ACT, and PPT for major depression. Standardized mean differences were calculated with Hedges' g to complete random-effects meta-analysis. Heterogeneity was assessed with the Cochran Q statistic and I2 statistic. Subgroup analysis was conducted to further investigate heterogeneity. A random-effects meta-analysis of 15 studies (MBCT, N=7; ACT, N=4; PPT, N=4) revealed that all three therapies showed efficacy in reducing symptoms of depression with a small favorable effect, compared with all control conditions (N=946; Hedges' g=0.34; 95% confidence interval=0.14, 0.54; p<0.001). Cochrane's Q statistic (Q=32, df=15, p=0.007) suggested significant heterogeneity (I2=53%). A mixed-effects model test for subgroup differences showed significant differences between active controls and treatment-as-usual controls (χ2=15.3, df=1, p<0.001). Overall quality of evidence and publication bias were low. Meta-analysis shows that MBCT and ACT may be superior to inactive or treatment-as-usual controls and that PPT may be comparable to active controls for reducing symptoms of major depression after an acute course of therapy. However, the quality of the evidence was low. High-quality studies are needed to confirm the efficacy of these interventions.",32985916,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.432599067687988,-0.8401098847389221,Ah4N
"[Internet- and Mobile Based Psychotherapy for Depression].

Guided Internet- and mobile-based interventions (IMIs) are an effective and scientifically sound treatment option for depression. Meta-analyses revealed effect sizes comparable to those found for face-to-face treatment as well as pharmacotherapy. Today, most IMIs are based on cognitive behavioral therapy (CBT). While IMIs are well established in healthcare systems of many countries worldwide, Germany is still lagging behind. However, there are an increasing number of model projects trying to implement IMIs into routine healthcare for depression in Germany. Both, service providers and recipients would benefit from transparent quality assurance and data safety guidelines.",28114693,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.541251182556152,-3.9224464893341064,Bh0T
"Adjuvant Guided Exercise Therapy Versus Self-Organized Activity in Patients With Major Depression.

Exercise seems to be effective in reducing depression itself, as well as the risk of relapse. This study evaluated whether standardized guided exercise therapy (GET) in comparison with self-organized activity (SOA) is an effective augmentation therapy in depressive adults. A total of 111 inpatients (66.7% women; mean age, 45.05 ± 12.19 years) with major depression were randomly assigned to either GET or SOA. Interventions were performed three times a week, with each session lasting 50 minutes. Both GET and SOA exerted effects even after a short-term application of 6 weeks. GET was superior to SOA in reducing depression symptom severity, as measured by the Hamilton Depression Scale (p = 0.017), specifically improving suicidality (p = 0.028) as well as time (p = 0.003) and severity of diurnal variation (p = 0.027). The findings support the beneficial role of adjuvant GET in patients with major depression as a feasible treatment in a psychiatric short-term inpatient setting.",32947455,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,7.958707332611084,-1.5534709692001343,AiWw
"Effectiveness of Supplementary Cognitive-Behavioral Therapy for Pharmacotherapy-Resistant Depression: A Randomized Controlled Trial.

Antidepressant medication is efficacious in the treatment of depression, but not all patients improve with antidepressant medication alone. Despite this treatment gap, limited evidence regarding the effectiveness of supplementing psychotherapy for pharmacotherapy-resistant depression is available. Therefore, we investigated the effectiveness of supplementing usual medication management (treatment as usual [TAU]) with cognitive-behavioral therapy (CBT) in patients with pharmacotherapy-resistant depression seeking psychiatric specialty care. A 16-week assessor-masked randomized controlled trial with a 12-month follow-up was conducted in 1 university hospital and 1 psychiatric hospital from September 2008 to December 2014. Outpatients aged 20-65 years with pharmacotherapy-resistant depression (taking antidepressant medications for ≥ 8 weeks, 17-item GRID-Hamilton Depression Rating Scale [GRID-HDRS₁₇] score ≥ 16, Maudsley Staging Method for treatment-resistant depression score ≥ 3, and DSM-IV criteria for major depressive disorder) were randomly assigned (1:1) to CBT combined with TAU or to TAU alone. The primary outcome was the alleviation of depressive symptoms, as measured by change in the total GRID-HDRS₁₇ score from baseline to 16 weeks; primary analysis was done on an intention-to-treat basis. A total of 80 patients were randomized; 78 (97.5%) were assessed for the primary outcome, and 73 (91.3%) were followed up for 12 months. Supplementary CBT significantly alleviated depressive symptoms at 16 weeks, as shown by greater least squares mean changes in GRID-HDRS₁₇ scores in the intervention group than in the control group (-12.7 vs -7.4; difference = -5.4; 95% CI, -8.1 to -2.6; P < .001), and the treatment effect was maintained for at least 12 months (-15.4 vs -11.0; difference = -4.4; 95% CI, -7.2 to -1.6; P = .002). Patients with pharmacotherapy-resistant depression treated in psychiatric specialty care settings may benefit from supplementing usual medication management with CBT. UMIN Clinical Trials Registry identifier: UMIN000001218.",28252882,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.460342407226562,-2.4168410301208496,BgIr
"A systematic review of comparative efficacy of treatments and controls for depression.

Although previous meta-analyses have examined effects of antidepressants, psychotherapy, and alternative therapies for depression, the efficacy of these treatments alone and in combination has not been systematically compared. We hypothesized that the differences between approved depression treatments and controls would be small. The authors first reviewed data from Food and Drug Administration Summary Basis of Approval reports of 62 pivotal antidepressant trials consisting of data from 13,802 depressed patients. This was followed by a systematic review of data from 115 published trials evaluating efficacy of psychotherapies and alternative therapies for depression. The published depression trials consisted of 10,310 depressed patients. We assessed the percentage symptom reduction experienced by the patients based on treatment assignment. Overall, antidepressants led to greater symptom reduction compared to placebo among both unpublished FDA data and published trials (F = 38.5, df = 239, p<0.001). In the published trials we noted that the magnitude of symptom reduction with active depression treatments compared to controls was significantly larger when raters evaluating treatment effects were un-blinded compared to the trials with blinded raters (F = 2.17, df = 313, p<0.05). In the blinded trials, the combination of antidepressants and psychotherapy provided a slight advantage over antidepressants (p = 0.027) and psychotherapy (p = 0.022) alone. The magnitude of symptom reduction was greater with psychotherapies compared to placebo (p = 0.019), treatment-as-usual (p = 0.012) and waiting-list (p<0.001). Differences were not seen with psychotherapy compared to antidepressants, alternative therapies or active intervention controls. In conclusion, the combination of psychotherapy and antidepressants for depression may provide a slight advantage whereas antidepressants alone and psychotherapy alone are not significantly different from alternative therapies or active intervention controls. These data suggest that type of treatment offered is less important than getting depressed patients involved in an active therapeutic program. Future research should consider whether certain patient profiles might justify a specific treatment modality.",22860015,Major Depressive Disorder,Anxiety Treatment,Mental Health,8564,9.764206886291504,-1.4254883527755737,Cp8v
"Efficacy and cost-effectiveness of intensive short-term dynamic psychotherapy for treatment resistant depression: 18-Month follow-up of the Halifax depression trial.

Depressed patients with chronic and complex health issues commonly relapse; therefore, examining longer-term outcomes is an important consideration. For treatment resistant depression (TRD), the post-treatment efficacy of time-limited Intensive Short-Term Dynamic Psychotherapy (ISTDP) has been demonstrated but longer-term outcomes and cost-effectiveness are unclear. In this superiority trial, 60 patients referred to Community Mental Health Teams (CMHT) were randomised to 2 groups (ISTDP=30 and CMHT=30). The primary outcome was Hamilton Depression Rating scale (HAM-D) scores at 18 months. Secondary outcomes included Patient Health Questionnaire (PHQ-9) depression scores and dichotomous measure remission. A health economic evaluation examined mental health costs with quality-adjusted life years (QALYs). Statistically significant treatment differences in depression previously found at 6 months favouring ISTDP were maintained at 18-month follow-up. Group differences in depression were in the moderate to large range on both the observer rated (Cohen's d = .64) and self-report measures (Cohen's d = .70). At 18 months follow-up the remission rate in ISTDP patients was 40.0%, and 23.4% had discontinued antidepressants. Health economic analysis suggests that ISTDP was more cost-effective than CMHT at 18 months. Probabilistic analysis suggests that there is a 64.5% probability of ISTDP being cost-effective at a willingness to pay for a QALY of $25,000 compared to CMHT at 18 months. Replication of these findings is necessary in larger samples and future cost analyses should also consider indirect costs. ISTDP demonstrates long-term efficacy and cost-effectiveness in TRD.",32421603,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.545425415039062,-3.888578414916992,Ao69
"Blending online therapy into regular face-to-face therapy for depression: content, ratio and preconditions according to patients and therapists using a Delphi study.

Blending online modules into face-to-face therapy offers perspectives to enhance patient self-management and to increase the (cost-)effectiveness of therapy, while still providing the support patients need. The aim of this study was to outline optimal usage of blended care for depression, according to patients and therapists. A Delphi method was used to find consensus on suitable blended protocols (content, sequence and ratio). Phase 1 was an explorative phase, conducted in two rounds of online questionnaires, in which patients' and therapists' preferences and opinions about online psychotherapy were surveyed. In phase 2, data from phase 1 was used in face-to-face interviews with therapists to investigate how blended therapy protocols could be set up and what essential preconditions would be. Twelve therapists and nine patients completed the surveys. Blended therapy was positively perceived among all respondents, especially to enhance the self-management of patients. According to most respondents, practical therapy components (assignments, diaries and psycho-education) may be provided via online modules, while process-related components (introduction, evaluation and discussing thoughts and feelings), should be supported face-to-face. The preferred blend of online and face-to-face sessions differs between therapists and patients; most therapists prefer 75% face-to-face sessions, most patients 50 to 60%. The interviews showed that tailoring treatment to individual patients is essential in secondary mental health care, due to the complexity of their problems. The amount and ratio of online modules needs to be adjusted according to the patient's problems, skills and characteristics. Therapists themselves should also develop skills to integrate online and face-to-face sessions. Blending online and face-to-face sessions in an integrated depression therapy is viewed as a positive innovation by patients and therapists. Following a standard blended protocol, however, would be difficult in secondary mental health care. A database of online modules could provide flexibility to tailor treatment to individual patients, which asks motivation and skills of both patients and therapists. Further research is necessary to determine the (cost-)effectiveness of blended care, but this study provides starting points and preconditions to blend online and face-to-face sessions and create a treatment combining the best of both worlds.",25496393,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.18807315826416,-3.473733901977539,CEg1
"It is time to investigate integrative approaches to enhance treatment outcomes for depression?

Psychological and pharmacological interventions are the most common treatments for adult depression. While these interventions have robust evidence supporting their efficacy, there remain up to 60 percent of individuals who do not respond to treatment, or only partially respond. Unfortunately, efforts at improving outcome rates from new or modified versions of psychological or pharmacological interventions have been disappointing. It is argued that increased treatment efficacy for depression may be achieved by utilising integrative or adjunctive treatments. As depression is influenced by an array of psychological, biological, social, environmental, dietary, and lifestyle factors, it is hypothesised that treatment outcomes will only be improved when integrative interventions are utilised. The research supporting the potential of several of these factors are reviewed in this article including those associated with diet, exercise, sleep, sunshine/light, nature, herbs and nutraceuticals, social connections, meditation, religion/spirituality, and alcohol and nicotine use. It is argued that increased efforts should be directed at investigating integrative or adjunctive interventions, rather than stand-alone treatments, to enhance outcomes for depression.",31010505,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,9.149081230163574,-1.2979575395584106,A7iW
"Effectiveness of hygienic-dietary recommendations as enhancers of antidepressant treatment in patients with depression: study protocol of a randomized controlled trial.

In recent years some studies have been published supporting the efficacy of light exposure, physical activity, sleep control and a Mediterranean diet pattern on the improvement or prevention of depression. However, to our knowledge, there have been no studies using all these measures together as an adjuvant antidepressant strategy. Multicenter, randomized, controlled, two arm-parallel, clinical trial. Eighty depressed patients undergoing standard antidepressant treatment will be advised to follow four additional hygienic-dietary recommendations about exercise, diet, sunlight exposure and sleep. Outcome measures will be assessed before and after the 6 month intervention period. We expect the patients in the active recommendations group to experience a greater improvement in their depressive symptoms. If so, this would be a great support for doctors who might systematically recommend these simple and costless measures, especially in primary care. ISRCTN59506583.",20618920,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,8.387848854064941,-1.2193949222564697,DIQ/
"Therapist-guided internet-based psychodynamic therapy versus cognitive behavioural therapy for adolescent depression in Sweden: a randomised, clinical, non-inferiority trial.

Adolescent major depressive disorder (MDD) is highly prevalent and associated with lifelong adversity. Evidence-based treatments exist, but accessible treatment alternatives are needed. We aimed to compare internet-based psychodynamic therapy (IPDT) with an established evidence-based treatment (internet-based cognitive behavioural therapy [ICBT]) for the treatment of adolescents with depression. In this randomised, clinical trial, we tested whether IPDT was non-inferior to ICBT in the treatment of adolescent MDD. Eligible participants were 15-19 years old, presenting with a primary diagnosis of MDD according to DSM-5. Participants were recruited nationwide in Sweden through advertisements on social media, as well as contacts with junior and senior high schools, youth associations, social workers, and health-care providers. Adolescents who scored 9 or higher on the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR) in an initial online screening were contacted by telephone for a diagnostic assessment using the Mini International Neuropsychiatric Interview. Participants were randomly assigned to ICBT or IPDT. Both interventions comprised eight self-help modules delivered over 10 weeks on a secure online platform. The primary outcome was change in depression severity measured weekly by the QIDS-A17-SR. Primary analyses were based on an intention-to-treat sample including all participants randomly assigned. A non-inferiority margin of Cohen's d=0·30 was predefined. The study is registered at ISRCTN, ISRCTN12552584. Between Aug 19, 2019, and Oct 7, 2020, 996 young people completed screening; 516 (52%) were contacted for a diagnostic interview. 272 participants were eligible and randomly assigned to ICBT (n=136) or IPDT (n=136). In the ICBT group, 51 (38%) of 136 participants were classified as remitted, and 54 (40%) of 136 participants were classified as remitted in the IPDT group. Within-group effects were large (ICBT: within-group d=1·75, 95% CI 1·49 to 2·01; IPDT: within-group d=1·93, 1·67 to 2·20; both p<0·0001). No statistically significant treatment difference was found in the intention-to-treat analysis. Non-inferiority for IPDT was shown for the estimated change in depression during treatment (d=-0·18, 90% CI -0·49 to 0·13; p=0·34). All secondary outcomes showed non-significant between-group differences. IPDT was non-inferior to ICBT in terms of change in depression for the treatment of adolescents with MDD. This finding increases the range of accessible and effective treatment alternatives for adolescents with depression. Kavli trust.",35803894,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.66907024383545,-3.020221710205078,Qi4
"Inadequate Reporting of a Randomized Trial Comparing Cognitive-Behavioral Therapy and Psychodynamic Therapy for Depression.

",31157691,Major Depressive Disorder,Anxiety Treatment,Mental Health,12518,11.314291954040527,-3.2014570236206055,A5jT
"Early in-session cognitive-emotional problem-solving predicts 12-month outcomes in depression with personality disorder.

Therapist-patient verbalizations reveal complex cognitive-emotional linguistic data. How these variables contribute to change requires further research. Emotional-cognitive text analysis using the Ulm cycles model software was applied to transcripts of the third session of psychotherapy for 20 patients with depression and personality disorder. Results showed that connecting cycle sequences of problem-solving in the third hour predicted 12-month clinical outcomes. Therapist-patient dyads most improved spent significantly more time early in session in connecting cycles, whilst the least improved moved into connecting cycles late in session. For this particular sample, it was clear that positive emotional problem-solving in therapy was beneficial.",23962204,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.950586318969727,-3.265075206756592,CZwx
"Maintenance cognitive-behavioral therapy and manualized psychoeducation in the treatment of recurrent depression: a multicenter prospective randomized controlled trial.

This multicenter study compared the relapse and recurrence outcomes of two active treatments, maintenance cognitive-behavioral therapy (CBT) and manualized psychoeducation, both in addition to treatment as usual, in patients in remission from depression. This was a multicenter prospective randomized observer-blinded study with two parallel groups. The authors assessed 180 patients with three or more previous major depressive episodes who met remission criteria over a 2-month baseline period and who were randomly assigned to 16 sessions of either maintenance CBT or manualized psychoeducation over 8 months and then followed up for 12 months. The main outcome measure was time to first relapse or recurrence of a major depression, based on DSM-IV criteria, as assessed by blinded observers with the Longitudinal Interval Follow-Up Evaluation. Cox regression analysis showed that time to relapse or recurrence of major depression did not differ significantly between treatment conditions, but a significant interaction was observed between treatment condition and number of previous episodes (<5 or ≥5). Within the subsample of patients with five or more previous episodes, maintenance CBT was significantly superior to manualized psychoeducation, whereas for patients with fewer than five previous episodes, no significant treatment differences were observed in time to relapse or recurrence. The results indicate that maintenance CBT has significant effects on the prevention of relapse or recurrence only in patients with a high risk of depression recurrence. For patients with a moderate risk of recurrence, nonspecific effects and structured patient education may be equally effective.",23732968,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.156335830688477,-0.907924473285675,CdLa
"Efficacy of a self-help manual in increasing resilience in carers of adults with depression in Thailand.

Caring for a person with a mental illness can have adverse effects on caregivers; however, little is known about how best to help such caregivers. The aim of the present study was to examine the efficacy of a cognitive behaviour therapy-guided self-help manual in increasing resilience in caregivers of individuals with depression, in comparison to caregivers who receive routine support only. A randomized, controlled trial was conducted, following CONSORT guidelines, with 54 caregivers allocated to parallel intervention (self-help manual) (n=27) or control (standard support) (n=27) groups. Resilience was assessed at baseline, post-test (week 8), and follow up (week 12). Intention-to-treat analyses were undertaken. Repeated-measures ANOVA indicated a significant difference in resilience scores between the three time points, showing a large effect. Pairwise comparisons between intervention and control groups indicated resilience to be significantly different between baseline and post-test, and between baseline and follow up, but not between post-test and follow up. Overall, the intervention group showed a slightly greater increase in resilience over time than the control group; however, the time-group interaction was not significant. Guided self-help is helpful in improving caregivers' resilience and could be used as an adjunct to the limited support provided to carers by mental health nurses and other clinicians.",26666688,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.830912590026855,-3.5179853439331055,Bz33
"Effectiveness of a Guided Self-help Manual in Strengthening Resilience in People Diagnosed with Moderate Depression and Their Family Caregivers in Thailand: A Randomised Controlled Trial.

The growing incidence of depression in developing countries, such as Thailand, is placing increasing pressure on public mental health services, and those living in rural areas have limited access to these services. Resilience is integral to the recovery of people with depression and to caregivers. This parallel-group randomised controlled trial evaluated the effectiveness of a guided self-help manual in improving resilience in adults diagnosed with moderate depression and their primary caregivers in Thailand. Our findings provide preliminary evidence that the approach is an effective way of increasing resilience in adults with depression and their caregivers.",28471254,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,11.94551944732666,-4.543323040008545,BdF0
"Work-related treatment for major depressive disorder and incapacity to work: preliminary findings of a controlled, matched study.

The aim of this study was to compare the effectiveness of work-related cognitive-behavioral treatment (W-CBT) with that of cognitive-behavioral treatment as usual (CBT-AU) for employees on sick leave as a result of a major depressive disorder (MDD). We collected data for 26 matched outpatients at pre- and posttreatment, as well as at 1-year follow-up. Outcome measures were the days of incapacity to work (DIW) as well as self-report measures (Beck Depression Inventory [BDI], Symptom Checklist 90-R [GSI], Life Satisfaction Questionnaire [FLZ]). We analyzed data with hierarchical linear modeling in a 2-level model. Therapy effects were defined in 3 ways: effect size (ES), response (based on the reliable change index), and remission compared with the general population's symptom level. The DIW were reduced significantly after both types of treatment, but employees showed even fewer DIW after W-CBT. At follow-up, significantly more employees were working as a result of W-CBT than with CBT-AU. Significant improvements on scores of self-rating measures corresponded with moderate-to-large effect sizes for both treatment types. Approximately 2 thirds of the treated employees were categorized as unimpaired on BDI scores at posttreatment and at follow-up. At least 1 half of the employees were classified as unimpaired on GSI scores at both assessment points. In future research, a randomized controlled trial should be conducted using a larger sample size to investigate the impact of moderators (e.g., employees at different branches of the company). Findings provided support for using common CBT techniques to enhance return to work without losing expected improvements at the symptom level.",25402222,Major Depressive Disorder,Anxiety Treatment,Mental Health,2307,9.090921401977539,-4.401762008666992,CF65
"Depression subtypes and their response to cognitive behavioral therapy: A latent transition analysis.

Depression is a heterogeneous condition, with multiple possible symptom-profiles leading to the same diagnosis. Descriptive depression subtypes based on observation and theory have so far proven to have limited clinical utility. To identify depression subtypes and to examine their time-course and prognosis using data-driven methods. Latent transition analysis was applied to a large (N=8380) multi-service sample of depressed patients treated with cognitive behavioral therapy (CBT) in outpatient clinics. Patients were classed into initial latent states based on their responses to the Patient Health Questionnaire-9 of depression symptoms, and transition probabilities to other states during treatment were quantified. Qualitatively similar states were clustered into overarching depression subtypes and we statistically compared indices of treatment engagement and outcomes between subtypes using post hoc analyses. Fourteen latent states were clustered into five depression subtypes: mild (2.7%), severe (9.8%), cognitive-affective (23.7%), somatic (21.4%), and typical (42.4%). These subtypes had high temporal stability, and the most common transitions during treatment were from severe toward milder states within the same subtype. Differential response to treatment was evident, with the highest improvement rate (63.6%) observed in the cognitive-affective subtype. Replicated evidence indicates that depression subtypes are temporally stable and associated with differential response to CBT.",33960570,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,11.476478576660156,-1.0730844736099243,AWsF
"Psychodynamic guided self-help for adult depression through the internet: a randomised controlled trial.

Psychodynamic psychotherapy (PDT) is an effective treatment for major depressive disorder (MDD), but not all clients with MDD can receive psychotherapy. Using the Internet to provide psychodynamic treatments is one way of improving access to psychological treatments for MDD. The aim of this randomised controlled trial was to investigate the efficacy of an Internet-based psychodynamic guided self-help treatment for MDD. Ninety-two participants who were diagnosed with MDD according to the Mini-International Neuropsychiatric Interview were randomised to treatment or an active control. The treatment consisted of nine treatment modules based on psychodynamic principles with online therapist contact. The active control condition was a structured support intervention and contained psychoeducation and scheduled weekly contacts online. Both interventions lasted for 10 weeks. The primary outcome measure was the Beck Depression Inventory-II (BDI-II). Mixed-effects model analyses of all randomised participants showed that participants receiving Internet-based PDT made large and superior improvements compared with the active control group on the BDI-II (between-group Cohen's d = 1.11). Treatment effects were maintained at a 10-month follow-up. Internet-based psychodynamic guided self-help is an efficacious treatment for MDD that has the potential to increase accessibility and availability of PDT for MDD. Clinicaltrials.gov: NCT01324050.",22741027,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.414079666137695,-3.578244924545288,Crms
"Patient characteristics associated with retrospectively self-reported treatment outcomes following psychological therapy for anxiety or depressive disorders - a cohort of GLAD study participants.

Progress towards stratified care for anxiety and depression will require the identification of new predictors. We collected data on retrospectively self-reported therapeutic outcomes in adults who received psychological therapy in the UK in the past ten years. We aimed to replicate factors associated with traditional treatment outcome measures from the literature. Participants were from the Genetic Links to Anxiety and Depression (GLAD) Study, a UK-based volunteer cohort study. We investigated associations between retrospectively self-reported outcomes following therapy, on a five-point scale (global rating of change; GRC) and a range of sociodemographic, clinical and therapy-related factors, using ordinal logistic regression models (n=2890). Four factors were associated with therapy outcomes (adjusted odds ratios, OR). One sociodemographic factor, having university-level education, was associated with favourable outcomes (OR=1.37, 95%CI: 1.18, 1.59). Two clinical factors, greater number of reported episodes of illness (OR=0.95, 95%CI: 0.92, 0.97) and higher levels of personality disorder symptoms (OR=0.89, 95%CI: 0.87, 0.91), were associated with less favourable outcomes. Finally, reported regular use of additional therapeutic activities was associated with favourable outcomes (OR=1.39, 95%CI: 1.19, 1.63). There were no statistically significant differences between fully adjusted multivariable and unadjusted univariable odds ratios. Therapy outcome data can be collected quickly and inexpensively using retrospectively self-reported measures in large observational cohorts. Retrospectively self-reported therapy outcomes were associated with four factors previously reported in the literature. Similar data collected in larger observational cohorts may enable detection of novel associations with therapy outcomes, to generate new hypotheses, which can be followed up in prospective studies.",36401199,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,12.275115013122559,-4.3290629386901855,A/w
"Behavior change through automated e-mails: mediation analysis of self-help strategy use for depressive symptoms.

To evaluate whether automated e-mails promoting effective self-help strategies for depressive symptoms were effective in changing self-help behavior, and whether this improved depression outcomes. 568 adults with sub-threshold depression participated in a randomized controlled trial and provided complete data. A series of 12 e-mails promoting the use of evidence-based self-help strategies was compared with e-mails providing non-directive depression information. Depression symptoms were assessed with the Patient Health Questionnaire depression scale (PHQ-9) and use of self-help strategies was assessed at baseline and post-intervention. We hypothesized that those receiving the self-help e-mails would increase their use of evidence-based self-help and this would be associated with improvements in depression. Mediation analyses were conducted using a non-parametric bootstrapping procedure. Total use of the self-help strategies promoted in the e-mails significantly mediated the effect of the intervention on depressive symptoms (B = -0.75, SE = 0.16, 95% CI: -1.06 to -0.48). The direct effect of the intervention on depressive symptoms was much smaller and not significant when the mediation path was included. The majority of the individual strategies also had a significant indirect effect on depressive symptoms. In adults with sub-threshold depression, automated e-mails based on behavior change principles can successfully increase use of self-help strategies, leading to a reduction in depressive symptoms.",23262114,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.890030860900879,-3.4856784343719482,CkHQ
"Development of a Storytelling Video Self-Help Intervention Based on Acceptance and Commitment Therapy for Major Depression: Open Trial Results.

This study involved the initial development and testing of a video self-help intervention called LifeStories, which features real patients describing their use of coping strategies for depression based on Acceptance and Commitment Therapy. We conducted a baseline-controlled open trial (AB design) of 11 individuals diagnosed with major depressive disorder. Participants reported high levels of satisfaction and transportation (i.e., engagement) after watching LifeStories. No significant changes were observed during the 4-week baseline period in terms of interviewer-rated depression severity (primary outcome), but a significant and large effect size improvement was observed at Week 8 postintervention. The majority of participants (54.5%) showed a reliable and clinically significant posttreatment response. Significant improvements also were observed during the intervention period only for self-reported depressive symptoms and aspects of mindfulness (nonreactivity). Qualitative data analysis of participant interviews identified additional areas for improvement and refinement. Future testing in a randomized trial is warranted based on these encouraging results.",29090593,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,9.30268669128418,-2.1029210090637207,BU1O
"Machine learning in the prediction of depression treatment outcomes: a systematic review and meta-analysis.

Multiple treatments are effective for major depressive disorder (MDD), but the outcomes of each treatment vary broadly among individuals. Accurate prediction of outcomes is needed to help select a treatment that is likely to work for a given person. We aim to examine the performance of machine learning methods in delivering replicable predictions of treatment outcomes. Of 7732 non-duplicate records identified through literature search, we retained 59 eligible reports and extracted data on sample, treatment, predictors, machine learning method, and treatment outcome prediction. A minimum sample size of 100 and an adequate validation method were used to identify adequate-quality studies. The effects of study features on prediction accuracy were tested with mixed-effects models. Fifty-four of the studies provided accuracy estimates or other estimates that allowed calculation of balanced accuracy of predicting outcomes of treatment. Eight adequate-quality studies reported a mean accuracy of 0.63 [95% confidence interval (CI) 0.56-0.71], which was significantly lower than a mean accuracy of 0.75 (95% CI 0.72-0.78) in the other 46 studies. Among the adequate-quality studies, accuracies were higher when predicting treatment resistance (0.69) and lower when predicting remission (0.60) or response (0.56). The choice of machine learning method, feature selection, and the ratio of features to individuals were not associated with reported accuracy. The negative relationship between study quality and prediction accuracy, combined with a lack of independent replication, invites caution when evaluating the potential of machine learning applications for personalizing the treatment of depression.",35575607,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,11.977795600891113,-0.7096680402755737,Yk0
"Adherence predictors in an Internet-based Intervention program for depression.

Internet-delivered psychotherapy has been demonstrated to be effective in the treatment of depression. Nevertheless, the study of the adherence in this type of the treatment reported divergent results. The main objective of this study is to analyze predictors of adherence in a primary care Internet-based intervention for depression in Spain. A multi-center, three arm, parallel, randomized controlled trial was conducted with 194 depressive patients, who were allocated in self-guided or supported-guided intervention. Sociodemographic and clinical characteristics were gathered using a case report form. The Mini international neuropsychiatric interview diagnoses major depression. Beck Depression Inventory was used to assess depression severity. The visual analogic scale assesses the respondent's self-rated health and Short Form Health Survey was used to measure the health-related quality of life. Age results a predictor variable for both intervention groups (with and without therapist support). Perceived health is a negative predictor of adherence for the self-guided intervention when change in depression severity was included in the model. Change in depression severity results a predictor of adherence in the support-guided intervention. Our findings demonstrate that in our sample, there are differences in sociodemographic and clinical variables between active and dropout participants and we provide adherence predictors in each intervention condition of this Internet-based program for depression (self-guided and support-guided). It is important to point that further research in this area is essential to improve tailored interventions and to know specific patients groups can benefit from these interventions.",28871896,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.3611478805542,-3.3242571353912354,BXd9
"Online cognitive-based intervention for depression: exploring possible circularity in mechanisms of change.

This study investigates possible circularity in mechanisms of change in participants of Master Your Mood (MYM), a cognitive-based, online intervention for young adults with depressive symptoms. A previous study showed that MYM effectively reduced depression and anxiety and strengthened mastery. We randomized 244 participants with depressive symptoms into MYM or a wait-list control condition. We explored the circularity hypothesis by several analyses. Correlations were computed to determine the association between (change in) depression and anxiety. Path analysis mediation models were used to explore whether change in anxiety and mastery mediated the intervention effect on depression, whether depression and mastery mediated the effect on anxiety and whether depression and anxiety mediated the effect on mastery. We used linear regression to explore whether early changes in anxiety predicted later changes in depression, and whether early changes in depression predicted later changes in anxiety. Co-morbidity between depression and anxiety was high (69.2%) and the association between depression and anxiety change was strong (r = 0.677, p < 0.01). Changes in anxiety and mastery mediated change in depression (mediation proportion 44%); changes in depression mediated change in anxiety (79%) and mastery (75%). We did not find an early change in anxiety predictive for a late change in depression, and vice versa. This study appears to confirm the hypothesized circularity in the recovery process. We found high co-morbidity and strong correlation between depression and anxiety levels and bi-directional relationships between potential mediators and outcomes. Early anxiety change scores were not predictive of late depression change scores, and vice versa.",23866103,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.426383972167969,-2.4922919273376465,CbOW
"Interpersonal Psychotherapy Versus Cognitive Therapy for Depression: How They Work, How Long, and for Whom-Key Findings From an RCT.

Although the effectiveness of interpersonal psychotherapy (IPT) and cognitive therapy (CT) for major depression has been established, little is known about how and for whom they work and how they compare in the long term. The latter is especially relevant for IPT because research on its long-term effects has been limited. This overview paper summarizes findings from a Dutch randomized controlled trial on the effects and mechanisms of change of IPT versus CT for major depression. Adult outpatients with depression (N=182) were randomly assigned to CT (N=76), IPT (N=75), or a 2-month waitlist control group followed by patient's treatment of choice (N=31). The primary outcome was depression severity. Other outcomes were quality of life, social and general psychological functioning, and scores on various mechanism measures. Interventions were compared at the end of treatment and up to 17 months follow-up. On average, IPT and CT were both superior to waitlist, and their outcomes did not differ significantly from one another. However, the pathway through which change occurred appeared to differ. For a majority of participants, one of the interventions was predicted to be more beneficial than the other. No support for the theoretical models of change was found. Outcomes of IPT and CT did not appear to differ significantly. IPT may have an enduring effect not different from that of CT. The field would benefit from further refinement of study methods to disentangle mechanisms of change and from advances in the field of personalized medicine (i.e., person-specific analyses and treatment selection methods).",32122161,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.67138671875,-3.0434188842773438,AsjX
"Was Eysenck right after all? A reassessment of the effects of psychotherapy for adult depression.

In the 1950s, Eysenck suggested that psychotherapies may not be effective at all. Twenty-five years later, the first meta-analysis of randomised controlled trials showed that the effects of psychotherapies were considerable and that Eysenck was wrong. However, since that time methods have become available to assess biases in meta-analyses. We examined the influence of these biases on the effects of psychotherapies for adult depression, including risk of bias, publication bias and the exclusion of waiting list control groups. The unadjusted effect size of psychotherapies compared with control groups was g = 0.70 (limited to Western countries: g = 0.63), which corresponds to a number-needed-to-treat of 4.18. Only 23% of the studies could be considered as a low risk of bias. When adjusting for several sources of bias, the effect size across all types of therapies dropped to g = 0.31. These results suggest that the effects of psychotherapy for depression are small, above the threshold that has been suggested as the minimal important difference in the treatment of depression, and Eysenck was probably wrong. However, this is still not certain because we could not adjust for all types of bias. Unadjusted meta-analyses of psychotherapies overestimate the effects considerably, and for several types of psychotherapy for adult depression, insufficient evidence is available that they are effective because too few low-risk studies were available, including problem-solving therapy, interpersonal psychotherapy and behavioural activation.",29486804,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.707554817199707,-2.3710455894470215,BPZc
"The cost-effectiveness of depression treatment for co-occurring disorders: a clinical trial.

The authors aimed to determine the economic value of providing on-site group cognitive behavioral therapy (CBT) for depression to clients receiving residential substance use disorder (SUD) treatment. Using a quasi-experimental design and an intention-to-treat analysis, the incremental cost-effectiveness and cost-utility ratio of the intervention were estimated relative to usual care residential treatment. The average cost of a treatment episode was $908, compared to $180 for usual care. The incremental cost effectiveness ratio was $131 for each point improvement of the BDI-II and $49 for each additional depression-free day. The incremental cost-utility ratio ranged from $9,249 to $17,834 for each additional quality adjusted life year. Although the intervention costs substantially more than usual care, the cost effectiveness and cost-utility ratios compare favorably to other depression interventions. Health care reform should promote dissemination of group CBT to individuals with depression in residential SUD treatment.",24094613,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.337418556213379,-2.602224588394165,CX3q
"[Therapeutic strategy of depressive episodes. Prevention of relapse risk].

Prevention of the risk of recurrence of depressive episodes is a dynamic process that begins early in the management. Although complete remission is obtained for almost half of the treated depressive episodes, a heuristic conceptual thinking apprehends depression as a potentially chronic disorder when considering relapse and recurrence prevention. Multiple actions of care have to be initiated. They are formalised, but also adjustable to the needs of a critical management period throughout the follow-up. These actions include the prescription of an antidepressant at an effective dosage. They also consider the preventative and therapeutic impact of psychotherapy. The search for residual symptoms of depression is the rule, and addition of other medication should be considered if needed. These recommendations are evidence-based in the context of recurrence prevention. Nevertheless, many other initiatives are equally important recommendations in terms of therapeutic impact. Thus, rigorous evaluation of the initial symptomatology, promotion of information on disease, health-care advices, as well as implementation of family and other networks are good-practices. Such actions should be conducted in a relationship based on a therapeutic alliance. These elements need to be adjusted and contextualised in line with the Health System, mode of medical practice and unique style of the therapist. Proactive and sustainable implementations of these guidelines are required in the context of a unique and open therapeutic relationship for both therapist and patient.",21211636,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.283304214477539,-0.6238308548927307,DBex
"Analysis of the components of a cognitive-behavioral intervention administered via conference call for preventing depression among non-professional caregivers: a pilot study.

The primary aim was to assess the feasibility/acceptability of a preventive cognitive-behavioral intervention implemented via conference call for caregivers. The secondary aim was to conduct a preliminary assessment of the efficacy of the behavioral activation component alone compared to the complete cognitive-behavioral intervention. Sixty-one caregivers (mean age 58.4 years) were randomly assigned to a cognitive-behavioral intervention via conference call (CBC, n = 20), a behavioral activation intervention via conference call (BAC, n = 22) or a control group receiving usual care (CG, n = 19). Both interventions consisted of five 90-minute group sessions implemented weekly. Only 6.6% of caregivers discontinued the study. In the CBC and BAC groups, attendance and satisfaction with the intervention were similarly high among both groups. Homework adherence was also high in both groups. At post-treatment, there was a lower incidence of depression in the CBC and BAC groups compared to the CG (0.0% for BAC and CBC vs. 10.5% for CG). The relative risk was 0.0, and number needed to treat was 10 in both groups. Depressive symptoms were significantly reduced in the CBC and BAC groups compared to the CG (d = 2.18 and d = 2.06). The results support the feasibility of the intervention. Moreover, the BAC intervention was non-inferior to the CBC intervention for reducing depressive symptoms.",27187725,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.907184600830078,-2.726471185684204,Bstb
"Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial.

The current study examined the efficacy of an early intervention based on acceptance and commitment therapy (ACT) for depressive symptomatology. The ACT intervention is aimed at increasing the acceptance of negative thoughts and emotions and living a mindful and value-based life. Adults with mild to moderate depressive symptomatology were randomly assigned to the ACT intervention (n=49) or to a waiting list (n=44). The mean age of the participants was 49 years. The majority of the participants was female and of Dutch origin. All the participants completed measures before and after the intervention, as well as three months later at follow-up to assess depression (CES-D), anxiety (HADS-A), fatigue (CIS), alcohol use and acceptance (AAQ-II). The ACT intervention led to statistically significant reduction in depressive symptomatology (Cohen's d=.60). These reductions were maintained at the three-month follow-up. Also significant reductions in anxiety and fatigue were observed. Moreover, mediational analysis showed that the improvement of acceptance during the intervention mediated the effects of the intervention on depressive symptomatology at follow-up. These findings suggest that an early intervention based on ACT, aimed at increasing acceptance, is effective in reducing depressive symptomatology.",21074752,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.11150074005127,-1.748774766921997,DDY1
"Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: nonsignificant effects in pilot effectiveness trial with college students.

Conduct a pilot trial testing whether a brief cognitive-behavioral (CB) group reduced depressive symptoms and secondary outcomes relative to bibliotherapy and brochure controls in college students with elevated depressive symptoms. 82 college students (M age=19.0, SD=0.9; 70% female, 80% White) with elevated self-assessed depressive symptoms were randomized to a 6-session CB group, bibliotherapy, or educational brochure control condition, completing assessments at pretest, posttest, and at 6- and 12-month follow-up. Planned contrasts found no significant effects for CB group on depressive symptoms compared to either bibliotherapy or brochure controls at posttest (d=-.08 and .06, respectively) or over follow-up (d=-.04 and -.10, respectively). There were no intervention effects for social adjustment and substance use, though CB group participants had improved knowledge of CB concepts at posttest, versus brochure controls. Condition differences in major depression onset were nonsignificant but suggested support for CB interventions (CB group=7.4%, bibliotherapy=4.5%, brochure control=15.2%). Unexpectedly modest support was found for a brief CB group depression prevention intervention, compared to bibliotherapy or brochure control, when provided to self-selected college students, suggesting that alternative screening or interventions approaches are needed for this population.",24655464,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.377608299255371,-3.1388087272644043,CQeU
"Implementing multifactorial psychotherapy research in online virtual environments (IMPROVE-2): study protocol for a phase III trial of the MOST randomized component selection method for internet cognitive-behavioural therapy for depression.

Depression is a global health challenge. Although there are effective psychological and pharmaceutical interventions, our best treatments achieve remission rates less than 1/3 and limited sustained recovery. Underpinning this efficacy gap is limited understanding of how complex psychological interventions for depression work. Recent reviews have argued that the active ingredients of therapy need to be identified so that therapy can be made briefer, more potent, and to improve scalability. This in turn requires the use of rigorous study designs that test the presence or absence of individual therapeutic elements, rather than standard comparative randomised controlled trials. One such approach is the Multiphase Optimization Strategy, which uses efficient experimentation such as factorial designs to identify active factors in complex interventions. This approach has been successfully applied to behavioural health but not yet to mental health interventions. A Phase III randomised, single-blind balanced fractional factorial trial, based in England and conducted on the internet, randomized at the level of the patient, will investigate the active ingredients of internet cognitive-behavioural therapy (CBT) for depression. Adults with depression (operationalized as PHQ-9 score≥10), recruited directly from the internet and from an UK National Health Service Improving Access to Psychological Therapies service, will be randomized across seven experimental factors, each reflecting the presence versus absence of specific treatment components (activity scheduling, functional analysis, thought challenging, relaxation, concreteness training, absorption, self-compassion training) using a 32-condition balanced fractional factorial design (2IV7-2). The primary outcome is symptoms of depression (PHQ-9) at 12 weeks. Secondary outcomes include symptoms of anxiety and process measures related to hypothesized mechanisms. Better understanding of the active ingredients of efficacious therapies, such as CBT, is necessary in order to improve and further disseminate these interventions. This study is the first application of a component selection experiment to psychological interventions in depression and will enable us to determine the main effect of each treatment component and its relative efficacy, and cast light on underlying mechanisms, so that we can systematically enhance internet CBT. Current Controlled Trials ISRCTN24117387 . Registered 26 August 2014.",27716200,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.270134925842285,-3.1259682178497314,BmUo
"Publication bias in meta-analyses of the efficacy of psychotherapeutic interventions for depression.

The aim of this study was to assess whether systematic reviews investigating psychotherapeutic interventions for depression are affected by publication bias. Only homogeneous data sets were included, as heterogeneous data sets can distort statistical tests of publication bias. We applied Begg and Mazumdar's adjusted rank correlation test, Egger's regression analysis, and the trim and fill procedure to assess the presence and magnitude of publication bias in all homogeneous data sets of systematic reviews published up to September 2010. Thirty-one data sets reported in 19 meta-analyses fulfilled our inclusion criteria. Significant bias was detected in 5 (16.13%; rank correlation test) and 6 (19.35%; Egger's regression analysis) of these data sets. Applying the trim and fill procedure to amend presumably missing studies rarely changed the assessment of the efficacy of therapeutic interventions, with 2 exceptions. In 1 data set psychotherapy was no longer found to be significantly more efficacious than pharmacotherapy in reducing dropout at posttreatment when publication bias was taken into account. In the 2nd data set, after correcting for publication bias, there was no longer evidence that depressed patients without comorbid personality disorder profited more from psychotherapy and pharmacotherapy than patients with comorbid personality disorder. The results suggest that taken together, psychotherapy research for depression is only marginally affected by the selective reporting of positive outcomes. With 2 notable exceptions, correcting for publication bias did not change the evaluation of the efficacy of psychotherapeutic interventions.",23244368,Major Depressive Disorder,Anxiety Treatment,Mental Health,3327,11.727643966674805,-4.74668550491333,CkZH
"Cognitive-behavioral versus psychodynamic therapy for major depression: Secondary outcomes of a randomized clinical trial.

In a randomized clinical trial, we compared the efficacy of cognitive-behavioral therapy (CBT) and psychodynamic therapy for adult outpatient depression on measures of psychopathology, interpersonal functioning, pain, and quality of life. There were 341 Dutch adults (70.1% female, mean age = 38.9, SD = 10.3) meeting Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria for a major depressive episode and with a Hamilton Depression Rating Scale (HAM-D) score ≥14, who were randomized to 16 sessions of individual manualized CBT or short-term psychodynamic supportive psychotherapy. Severely depressed patients (HAM-D >24) received additional antidepressant medication according to a protocol. Outcome measures included the Brief Symptom Inventory, Beck Anxiety Inventory, Outcome Questionnaire, a visual analogue scale for pain, and EuroQol. Data were analyzed with mixed model analyses using intention-to-treat samples. Noninferiority margins were prespecified as Cohen's d = -0.30. Across treatment conditions, 45-60% of the patients who completed posttreatment assessment showed clinically meaningful change for most outcome measures. We found no significant differences between the treatment conditions on any of the outcome measures at both posttreatment and follow-up. Noninferiority of psychodynamic therapy to CBT was shown for posttreatment and follow-up anxiety measures as well as for posttreatment pain and quality of life measures, but could not be consistently demonstrated for the other outcomes. This is the first study that shows that psychodynamic therapy can be at least as efficacious as CBT for depression on important aspects of patient functioning other than depressive symptom reduction. These findings extend the evidence-base of psychodynamic therapy for depression, but replication is needed by means of rigorously designed noninferiority trials. (PsycINFO Database Record",28627912,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.197610855102539,-2.7943661212921143,Ba9t
"Simpler psychological treatment is as effective as CBT for depression and is cheaper, study shows.

",27458146,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.662610054016113,-2.340928077697754,Bpcp
"Guided self-help on the Internet for Turkish migrants with depression: the design of a randomized controlled trial.

The Turkish population living in The Netherlands has a high prevalence of psychological complaints and has a high threshold for seeking professional help for these problems. Seeking help through the Internet can overcome these barriers. This project aims to evaluate the effectiveness of a guided self-help problem-solving intervention for depressed Turkish migrants that is culturally adapted and web-based. This study is a randomized controlled trial with two arms: an experimental condition group and a wait list control group. The experimental condition obtains direct access to the guided web-based self-help intervention, which is based on Problem Solving Treatment (PST) and takes 6 weeks to complete. Turkish adults with mild to moderate depressive symptoms will be recruited from the general population and the participants can choose between a Turkish and a Dutch version. The primary outcome measure is the reduction of depressive symptoms, the secondary outcome measures are somatic symptoms, anxiety, acculturation, quality of life and satisfaction. Participants are assessed at baseline, post-test (6 weeks), and 4 months after baseline. Analysis will be conducted on the intention-to-treat sample. This study evaluates the effectiveness of a guided problem-solving intervention for Turkish adults living in The Netherlands that is culturally adapted and web-based. Nederlands Trial Register: NTR2303.",21047442,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.12886905670166,-3.384307384490967,DDxb
"The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis.

Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management, are part of recommended treatment; however, no systematic review has evaluated the effects of depression self-management interventions for this population. The primary objective was to examine the effect of self-management interventions on reducing depressive symptomatology in adults with chronic disease(s) and co-occurring depressive symptoms. Secondary objectives were to evaluate the effect of these interventions on improving other psychosocial and physiological outcomes (e.g., anxiety, glycemic control) and to assess potential differential effect based on key participant and intervention characteristics (e.g., chronic disease, provider). Studies comparing depression self-management interventions to a control group were identified through a) systematic searches of databases to June 2018 [MEDLINE (1946 -), EMBASE (1996 -), PsycINFO (1967 -), CINAHL (1984 -)] and b) secondary 'snowball' search strategies. The methodological quality of included studies was critically reviewed. Screening of all titles, abstracts, and full texts for eligibility was assessed independently by two authors. Data were extracted by one author and verified by a second. Fifteen studies were retained: 12 for meta-analysis and three for descriptive review. In total, these trials included 2064 participants and most commonly evaluated interventions for people with cancer (n=7) or diabetes (n=4). From baseline to <6-months (T1), the pooled mean effect size was -0.47 [95% CI -0.73, -0.21] as compared to control groups for the primary outcome of depression and-0.53 [95% CI -0.91, -0.15] at ≥ 6-months (T2). Results were also significant for anxiety (T1) and glycemic control (T2). Self-management skills of decision-making and taking action were significant moderators of depression at T1. Self-management interventions show promise in improving depression and anxiety in those with concomitant chronic physical disease. The findings may contribute to the development of future Self-management interventions and delivering evidence-based care to this population. Further high-quality RCTs are needed to identify sources of heterogeneity and investigate key intervention components.",34800995,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.696061134338379,-3.3332200050354004,2Bs
"Efficacy of hypnotherapy compared to cognitive-behavioural therapy for mild-to-moderate depression: study protocol of a randomised-controlled rater-blind trial (WIKI-D).

Despite a substantial number of studies providing evidence for the efficacy of psychological treatment for mild-to-moderate depression, maximally only 50% of participants respond to treatment, even when using gold-standard treatments such as cognitive-behavioural therapy (CBT) and interpersonal therapy. New approaches such as the 'third wave' psychotherapies have provided promising results; however, studies concerning the comparison with evidence-based treatments are lacking. This study aims to compare the efficacy of clinical hypnotherapy (HT) with gold-standard psychotherapy (CBT) in the treatment of mild-to-moderate major depressive episodes. The present study comprises a monocentric, two-armed, randomised-controlled, rater-blind (non-inferiority) clinical trial. A total of 160 participants with mild-to-moderate major depression episode will be randomly assigned to either CBT or HT involving 20 sessions of psychotherapy over a period of 24 weeks. We predict that the average improvement in the Montgomery-Åsberg Depression Rating Scale score will not be inferior in HT compared with CBT (non-inferiority hypothesis).Further outcome parameters will include the number of participants responding to treatment following the completion of treatment and 1year after. Additionally, quality of life, treatment expectations and hypnotic susceptibility before and after end of treatment will be assessed. The study protocol and the documents for the informed consent have been approved by the Ethics Committee of the University Hospital Tuebingen (061/2015B02). The results of this trial will be submitted for publication in peer-reviewed journals, and will be presented at national and international conferences. NCT02375308; Pre-results.",29196478,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.753143310546875,-1.637386441230774,BTT0
"Shape of change in internet based behavioral activation treatment for depression.

Shape of change, sudden gains and depression spikes were examined in an online 12-session Behavioral Activation (BA) treatment for depression. Client and therapist factors related to sudden gains were examined to investigate processes associated with outcome. Participants were postpartum Women with Major Depressive Disorder (n=42) who received online BA supported in 30-minute telephone sessions by a mental health worker. Depression symptoms were assessed at each session and number of sessions completed were recorded by the online program. Therapist records were rated for client stressful life event and therapist concrete focus. A quadratic pattern provided the best fit with the data; a cubic pattern was a poor fit. Sudden gains, but not depression spikes, predicted lower depression scores at 17-week outcome. Women who had higher baseline social functioning, did not experience a stressful life event during therapy, and completed more online modules, but not more telephone sessions, were more likely to have a sudden gain. A concrete therapist focus was associated with sudden gains. These results extend research on trajectories of change and sudden gains to an online BA treatment and to postpartum depression, and suggest important client and therapist factors associated with sudden gains.",28618298,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.596229553222656,-2.7384326457977295,BbGQ
"[Psychoeducation and family-related counselling in the treatment of depression].

By now psychoeducation is also recommended for the treatment of depression, due to data showing high acceptance and efficacy regarding a broad range of clinical variables. The impact of family-involvement by groups for relatives is not sufficiently studied yet, but findings concerning other severe mental diseases suggest positive effects. Self help groups are of high importance for the patients' relatives, who often need advice and support.",21043021,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,10.946681022644043,-3.3506550788879395,DD1s
"Effects of Internet-delivered cognitive behavioural therapy adapted for patients with cardiovascular disease and depression: a long-term follow-up of a randomized controlled trial at 6 and 12 months posttreatment.

Internet-based cognitive behavioural treatment (iCBT) has shown positive short-term effects on depression in patients with cardiovascular disease (CVD). However, knowledge regarding long-term effects and factors that may impact the effect of iCBT is lacking. This study therefore sought (i) to evaluate the effect of iCBT on depression in CVD patients at 6- and 12-month follow-ups and (ii) to explore factors that might impact on the effect of iCBT on change in depression at 12-month follow-up. A longitudinal follow-up study of a randomized controlled trial evaluating the effects of a 9-week iCBT programme compared to an online discussion forum (ODF) on depression in CVD patients (n = 144). After 9 weeks, those in the ODF group were offered the chance to take part in the iCBT programme. The Patient Health Questionnaire (PHQ-9) and the Montgomery-Åsberg Depression Rating Scale-self-rated version (MADRS-S) measured depression at baseline, 9 weeks, 6 months, and 12 months. Linear mixed model and multiple regression analysis were used for statistical computing. The iCBT programme significantly improved depression at 9-week follow-up and this was stable at 6- and 12-month follow-ups (PHQ-9 P = 0.001, MADRS-S P = 0.001). Higher levels of depression at baseline and a diagnosis of heart failure were factors found to impact the effect of iCBT on the change in depression. A 9-week iCBT programme in CVD patients led to long-term improvement in depression. Higher levels of depression scores at baseline were associated with improvement in depression, whereas heart failure had opposite effect. The trial is registered at ClinicalTrials.gov, NCT02778074.",35061868,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.3429536819458,-2.550408363342285,rfM
"Trajectories of change in depression symptoms and suicidal ideation over the course of evidence-based treatment for depression: Secondary analysis of a randomised controlled trial of cognitive behavioural therapy plus fluoxetine in young people.

Effective treatment of depression is a key target for suicide prevention strategies. However, only around one-third of young people with suicide risk respond to evidence-based treatments. Understanding the trajectory of suicidal ideation, as a marker of suicide risk, over the course of evidence-based treatment for depression might provide insight into more targeted and effective treatments. This is a secondary analysis of data from the multicentre Youth Depression Alleviation-Combined Treatment trial. A total of 153 young people aged 15-25years diagnosed with major depressive disorder were randomly assigned in this double-blind, placebo-controlled trial to either cognitive behavioural therapy plus fluoxetine or cognitive behavioural therapy plus placebo. Participants were assessed for depression and suicidal ideation at baseline and at weeks 4, 8 and 12. Using group-based trajectory modelling, we identified two distinct depression trajectories. The first (Improving; 54.9%; n=83) comprised those who experienced a consistent decline in depression symptoms. The second (Persisting; 45.1%; n=70) comprised those who, despite treatment, still had clinically significant levels of depression by the end of treatment. For suicidal ideation, we identified four distinct trajectories: Non-clinical (15.5%; n=20), Low Improving (47.1%; n=75), High Improving (24.8%; n=38) and High Persisting (12.7%; n=20). Treatment allocation was not significantly associated with trajectory membership for either depression or suicidal ideation. Understanding the course of depression and suicidal ideation during treatment has important implications for managing suicide risk. The findings suggest that there is an identifiable group of young people for whom enhanced psychological and/or pharmacological intervention might be required to ensure a better treatment response. Specific interventions for those with suicidal ideation may also be prudent from the outset. The Youth Depression Alleviation-Combined Treatment trial was prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12612001281886).",33722073,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,12.095917701721191,-2.925710916519165,AZXX
"Cost-effectiveness of nurse-led self-help for recurrent depression in the primary care setting: design of a pragmatic randomised controlled trial.

Major Depressive Disorder is a leading cause of disability, tends to run a recurrent course and is associated with substantial economic costs due to increased healthcare utilization and productivity losses. Interventions aimed at the prevention of recurrences may reduce patients' suffering and costs. Besides antidepressants, several psychological treatments such as preventive cognitive therapy (PCT) are effective in the prevention of recurrences of depression. Yet, many patients find long-term use of antidepressants unattractive, do not want to engage in therapy sessions and in the primary care setting psychologists are often not available. Therefore, it is important to study whether PCT can be used in a nurse-led self-help format in primary care. This study sets out to test the hypothesis that usual care plus nurse-led self-help for recurrent depression in primary care is feasible, acceptable and cost-effective compared to usual care only. Patients are randomly assigned to 'nurse-led self-help treatment plus usual care' (134 participants) or 'usual care' (134 participants). Randomisation is stratified according to the number of previous episodes (2 or 3 previous episodes versus 4 or more). The primary clinical outcome is the cumulative recurrence rate of depression meeting DSM-IV criteria as assessed by the Structured-Clinical-Interview-for-DSM-IV- disorders at one year after completion of the intervention. Secondary clinical outcomes are quality of life, severity of depressive symptoms, co-morbid psychopathology and self-efficacy. As putative effect-moderators, demographic characteristics, number of previous episodes, type of treatment during previous episodes, age of onset, self-efficacy and symptoms of pain and fatigue are assessed. Cumulative recurrence rate ratios are obtained under a Poisson regression model. Number-needed-to-be-treated is calculated as the inverse of the risk-difference. The economic evaluation is conducted from a societal perspective, both as a cost-effectiveness analysis (costs per depression free survival year) and as a cost-utility analysis (costs per quality adjusted life-year). The purpose of this paper is to outline the rationale and design of a nurse-led, cognitive therapy based self-help aimed at preventing recurrence of depression in a primary care setting. Only few studies have focused on psychological self-help interventions aimed at the prevention of recurrences in primary care patients. NTR3001 (http://www.trialregister.nl).",22677092,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.918167114257812,-2.1671688556671143,CshE
"Dilemma-focused intervention for unipolar depression: a treatment manual.

This article introduces a new treatment protocol for depression. Based on previous research which indicated the presence of cognitive conflicts in depression, this study created an intervention manual to address these conflicts. The therapy manual for depressive patients followed the guideline for inclusion in clinical trials (stage II), which has received high recognition. A preliminary version (stage I) of this manual was formulated based on other, more general dilemma-focused therapy publications, inspired by personal construct theory (PCT), and input from clinical experience. The resulting version was then applied during the 8-session format of a pilot study with patients diagnosed with major depressive disorder or dysthymia. Finally, feedback was requested from seasoned and highly respected therapists, some of whom were familiar with PCT. According to the mentioned guideline, the intervention manual selected the theoretical framework, in this case PCT, to include its conceptualization of depression and resolution of dilemmas (to foster clinical improvement) as a main treatment goal. The manual was then contrasted with psychoanalytic psychotherapy, cognitive-behavior therapy (CBT), motivational interviewing (MI), and other similar approaches such as cognitive-analytic therapy and coherence therapy. Following these conceptual clarifications, the specific interventions included in the manual were defined according to both categories: their unique and essential components and those conceived as common psychotherapeutic factors. Next, the general structure and content for each session were presented. The structure consisted of seven well-defined individual sessions with an additional session, which could complement any of the former sessions to address the patient's issues in greater depth, if needed. This Dilemma-Focused Intervention manual aimed to improve the treatment outcome for depression by offering an intervention that could be combined with other general approaches. At its present level of definition, it allows for inclusion in controlled trials (eg, the current RCT combining group CBT with this intervention). Thus, this manual added to the existing resources in psychotherapeutic research and practice for treatment of depression.",27406383,Major Depressive Disorder,Anxiety Treatment,Mental Health,26910,10.750356674194336,-2.5413737297058105,BqFn
"The clinical effectiveness of web-based cognitive behavioral therapy with face-to-face therapist support for depressed primary care patients: randomized controlled trial.

Most patients with mild to moderate depression receive treatment in primary care, but despite guideline recommendations, structured psychological interventions are infrequently delivered. Research supports the effectiveness of Internet-based treatment for depression; however, few trials have studied the effect of the MoodGYM program plus therapist support. The use of such interventions could improve the delivery of treatment in primary care. To evaluate the effectiveness and acceptability of a guided Web-based intervention for mild to moderate depression, which could be suitable for implementation in general practice. Participants (N=106) aged between 18 and 65 years were recruited from primary care and randomly allocated to a treatment condition comprising 6 weeks of therapist-assisted Web-based cognitive behavioral therapy (CBT), or to a 6-week delayed treatment condition. The intervention included the Norwegian version of the MoodGYM program, brief face-to-face support from a psychologist, and reminder emails. The primary outcome measure, depression symptoms, was measured by the Beck Depression Inventory-II (BDI-II). Secondary outcome measures included the Beck Anxiety Inventory (BAI), the Hospital Anxiety and Depression Scale (HADS), the Satisfaction with Life Scale (SWLS), and the EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D). All outcomes were based on self-report and were assessed at baseline, postintervention, and at 6-month follow-up. Postintervention measures were completed by 37 (71%) and 47 (87%) of the 52 participants in the intervention and 54 participants in the delayed treatment group, respectively. Linear mixed-models analyses revealed a significant difference in time trends between the groups for the BDI-II, (P=.002), for HADS depression and anxiety subscales (P<.001 and P=.001, respectively), and for the SWLS (P<.001). No differential group effects were found for the BAI and the EQ-5D. In comparison to the control group, significantly more participants in the intervention group experienced recovery from depression as measured by the BDI-II. Of the 52 participants in the treatment program, 31 (60%) adhered to the program, and overall treatment satisfaction was high. The reduction of depression and anxiety symptoms was largely maintained at 6-month follow-up, and positive gains in life satisfaction were partly maintained. The intervention combining MoodGYM and brief therapist support can be an effective treatment of depression in a sample of primary care patients. The intervention alleviates depressive symptoms and has a significant positive effect on anxiety symptoms and satisfaction with life. Moderate rates of nonadherence and predominately positive evaluations of the treatment also indicate the acceptability of the intervention. The intervention could potentially be used in a stepped-care approach, but remains to be tested in regular primary health care. Australian New Zealand Clinical Trials Registry: ACTRN12610000257066; http://apps.who.int/trialsearch/trial.aspx?trialid=ACTRN12610000257066 (Archived by WebCite at http://www.webcitation.org/6Ie3YhIZa).",23916965,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.329977989196777,-3.1582226753234863,Caa3
"RELATIONSHIP OF COGNITIVE BEHAVIORAL THERAPY EFFECTS AND HOMEWORK IN AN INDICATED PREVENTION OF DEPRESSION INTERVENTION FOR NON-PROFESSIONAL CAREGIVERS (.).

Activities designed to be performed outside of the intervention are considered an essential aspect of the effectiveness of cognitive-behavioral therapy. However, these have received little attention in interventions aimed at individuals with subclinical depressive symptoms who do not yet meet diagnostic criteria for depression (indicated prevention). In this study, the completion of tasks given as homework and their relationship with post-treatment depressive symptoms was with relation to an indicated prevention of depression intervention. Eighty-nine female non-professional caregivers recruited from an official registry completed an intervention involving 11 homework tasks. Tasks performed were recorded and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Among caregivers, 80.9% completed 9-11 tasks. The number of tasks performed was associated with post-treatment depressive symptoms, with 9 being optimal for clinically significant improvement. These findings highlight the relationship between homework and post-treatment depressive symptoms.",25799123,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.891918182373047,-3.40789794921875,CAMZ
"Component studies of psychological treatments of adult depression: A systematic review and meta-analysis.

A recent report from the US Institute of Medicine indicated that identifying core elements of psychosocial interventions is a key step in successfully bringing evidence-based psychosocial interventions into clinical practice. Component studies have the best design to examine these core elements. Earlier reviews resulted in heterogeneous sets of studies and probably missed many studies. We conducted a comprehensive search of component studies on psychotherapies for adult depression and included 16 studies with 22 comparisons. Fifteen components were examined of which four were examined in more than one comparison. The pooled difference between the full treatments and treatments with one component removed was g=0.21 (95% CI: 0.03∼0.39). One study had sufficient statistical power to detect a small effect size and found that adding emotion regulation skills increased the effects of CBT. None of the other studies had enough power to detect an effect size smaller than g=0.55. Only one study had low risk of bias. The currently available component studies do not have the statistical power nor the quality to draw any meaningful conclusion about key ingredients of psychotherapies for adult depression.",29115185,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.591629028320312,-2.408679723739624,BUfp
"Cognitive behavioral therapy helps depression. Research shows the approach is especially helpful for those who aren't aided by drugs.

",27024583,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.964902877807617,-2.313340187072754,BvAw
"Experiences of guided Internet-based cognitive-behavioural treatment for depression: a qualitative study.

Internet-based self-help treatment with minimal therapist contact has been shown to have an effect in treating various conditions. The objective of this study was to explore participants' views of Internet administrated guided self-help treatment for depression. In-depth interviews were conducted with 12 strategically selected participants and qualitative methods with components of both thematic analysis and grounded theory were used in the analyses. Three distinct change processes relating to how participants worked with the treatment material emerged which were categorized as (a) Readers, (b) Strivers, and (c) Doers. These processes dealt with attitudes towards treatment, views on motivational aspects of the treatment, and perceptions of consequences of the treatment. We conclude that the findings correspond with existing theoretical models of face-to-face psychotherapy within qualitative process research. Persons who take responsibility for the treatment and also attribute success to themselves appear to benefit more. Motivation is a crucial aspect of guided self-help in the treatment of depression.",21718523,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.273322105407715,-3.1556127071380615,C6X7
"Attentional Control as a Predictor of Response to Psychological Treatment for Depression and Relapse up to 1 year After Treatment: A Pilot Cohort Study.

Identifying depressed patients unlikely to reach remission and those likely to relapse after reaching remission is of great importance, but there are few pre-treatment factors that can help clinicians predict prognosis and together these explain relatively little variance in treatment outcomes. Attentional control has shown promise in studies to date, but has not been investigated prospectively in routine clinical settings with depressed patients. This study aimed to pilot the use of a brief self-report measure of attentional control in routine care and investigate the associations between attentional control, psychological treatment response and relapse to depression up to 1 year post-treatment. Depressed patients were recruited from two primary care psychological treatment (IAPT) services and completed the Attentional Control Scale (ACS) alongside routine symptom measures at every therapy session. Participants were tracked and followed up for 1 year post-treatment. Baseline ACS scores were associated with remission and residual depressive symptoms post-treatment, and relapse within 12 months of ending treatment, all independent of pre-treatment depressive symptom severity, and the latter also independent of residual symptoms. A self-report measure of attentional control can potentially be used to predict levels of depressive symptoms post-treatment and can contribute to predicting risk of relapse to depression in IAPT services, without affecting rates of therapy completion/drop-out or data completion of standard IAPT measures. However, this pilot study had a small overall sample size and a very small number of observed relapses, so replication in a larger study is needed before firm conclusions can be made.",30352633,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,10.85872745513916,-0.6820229887962341,BEWX
"Complex depression: The treatment of major depression and severe personality pathology.

The intensive treatment of a patient presenting with major depression, chronic suicidal ideation, and a borderline personality disorder with narcissistic features is described as it developed over an 18-month treatment. The treatment approach is a transdiagnostic one with an emphasis on change in the patient's representation of self and others, identity and interpersonal functioning. The intended change is not only in the reduction of depression and suicidal ideation but also an improvement in interactions with others at work and intimate relations. The combination of rich clinical information from the therapist and independent research ratings of patient progress provide a complex picture of the treatment.",30773631,Major Depressive Disorder,Anxiety Treatment,Mental Health,11672,10.903024673461914,-1.683163046836853,A+vn
"Psychotherapy or medication for depression? Using individual symptom meta-analyses to derive a Symptom-Oriented Therapy (SOrT) metric for a personalised psychiatry.

Antidepressant medication (ADM) and psychotherapy are effective treatments for major depressive disorder (MDD). It is unclear, however, if treatments differ in their effectiveness at the symptom level and whether symptom information can be utilised to inform treatment allocation. The present study synthesises comparative effectiveness information from randomised controlled trials (RCTs) of ADM versus psychotherapy for MDD at the symptom level and develops and tests the Symptom-Oriented Therapy (SOrT) metric for precision treatment allocation. First, we conducted systematic review and meta-analyses of RCTs comparing ADM and psychotherapy at the individual symptom level. We searched PubMed Medline, PsycINFO, and the Cochrane Central Register of Controlled Trials databases, a database specific for psychotherapy RCTs, and looked for unpublished RCTs. Random-effects meta-analyses were applied on sum-scores and for individual symptoms for the Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) measures. Second, we computed the SOrT metric, which combines meta-analytic effect sizes with patients' symptom profiles. The SOrT metric was evaluated using data from the Munich Antidepressant Response Signature (MARS) study (n=407) and the Emory Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study (n=234). The systematic review identified 38 RCTs for qualitative inclusion, 27 and 19 for quantitative inclusion at the sum-score level, and 9 and 4 for quantitative inclusion on individual symptom level for the HAM-D and BDI, respectively. Neither meta-analytic strategy revealed significant differences in the effectiveness of ADM and psychotherapy across the two depression measures. The SOrT metric did not show meaningful associations with other clinical variables in the MARS sample, and there was no indication of utility of the metric for better treatment allocation from PReDICT data. This registered report showed no differences of ADM and psychotherapy for the treatment of MDD at sum-score and symptom levels. Symptom-based metrics such as the proposed SOrT metric do not inform allocation to these treatments, but predictive value of symptom information requires further testing for other treatment comparisons.",32498707,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.126702308654785,-1.6296504735946655,An6z
"The Cost-effectiveness of the Online MindSpot Clinic for the Treatment of Depression and Anxiety in Australia.

The MindSpot Clinic (MindSpot) offers internet-delivered cognitive behavior therapy (iCBT) courses for people with anxiety and depressive disorders in Australia. The efficacy credentials of the courses offered at MindSpot are now well established but not the credentials of cost-effectiveness. The current study is aimed to evaluate the cost-effectiveness of the Wellbeing Course offered in MindSpot in comparison with the routine/usual care (defined as care in the absence of MindSpot) for people with symptoms of depression or/and anxiety from the perspective of Australian Department of Health. An economic model using a one-year decision-tree framework was constructed. The four health states in the model included: fully recovered; partially recovered; no improvement; and deteriorated. The probabilities between the four health states in the model were derived from a series of individual client datasets and from the Australian National Survey of Mental Health and Wellbeing. The EuroQol Five Dimension -- Five Level was used to derive the utilities, and costs were expressed in 2014 Australian dollars. Sensitivity analyses were conducted to examine the robustness of results to key model parameters. In the base case analysis, for people seeking treatment, care offered at Mindspot cost less and achieved greater benefits compared to the comparator. By adopting MindSpot, an additional 505 of fully recovered and 223 of partially recovered clients can be achieved per annum compared to routine/usual care. The result of the sensitivity analyses indicated the result of the analysis were robust. This study found that the iCBT treatments provided by MindSpot were highly cost-effective in comparison with current routine/usual care in the Australia setting. However, future research using a prospective matched comparator that comprehensively assesses all the respective costs is required to verify the current study findings.",29300702,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.30837631225586,-2.911261558532715,BR70
"Continuation of Antidepressants vs Sequential Psychological Interventions to Prevent Relapse in Depression: An Individual Participant Data Meta-analysis.

Depression frequently recurs. To prevent relapse, antidepressant medication is often taken in the long term. Sequentially delivering a psychological intervention while undergoing tapering of antidepressant medication might be an alternative to long-term antidepressant use. However, evidence is lacking on which patients may benefit from tapering antidepressant medication while receiving a psychological intervention and which should continue the antidepressant therapy. A meta-analysis of individual patient data with more power and precision than individual randomized clinical trials or a standard meta-analysis is warranted. To compare the associations between use of a psychological intervention during and/or after antidepressant tapering vs antidepressant use alone on the risk of relapse of depression and estimate associations of individual clinical factors with relapse. PubMed, the Cochrane Library, Embase, and PsycInfo were last searched on January 23, 2021. Requests for individual participant data from included randomized clinical trials (RCTs) were sent. Randomized clinical trials that compared use of a psychological intervention while tapering antidepressant medication with antidepressant monotherapy were included. Patients had to be in full or partial remission from depression. Two independent assessors conducted screening and study selection. Of 15 792 screened studies, 236 full-text articles were retrieved, and 4 RCTs that provided individual participant data were included. Time to relapse and relapse status over 15 months measured via a blinded assessor using a diagnostic clinical interview. Individual data from 714 participants (mean [SD] age, 49.2 [11.5] years; 522 [73.1%] female) from 4 RCTs that compared preventive cognitive therapy or mindfulness-based cognitive therapy during and/or after antidepressant tapering vs antidepressant monotherapy were available. Two-stage random-effects meta-analysis found no significant difference in time to depressive relapse between use of a psychological intervention during tapering of antidepressant medication vs antidepressant therapy alone (hazard ratio [HR], 0.86; 95% CI, 0.60-1.23). Younger age at onset (HR, 0.98; 95% CI, 0.97-0.99), shorter duration of remission (HR, 0.99; 95% CI, 0.98-1.00), and higher levels of residual depressive symptoms at baseline (HR, 1.07; 95% CI, 1.04-1.10) were associated with a higher overall risk of relapse. None of the included moderators were associated with risk of relapse. The findings of this individual participant data meta-analysis suggest that regardless of the clinical factors included in these studies, the sequential delivery of a psychological intervention during and/or after tapering may be an effective relapse prevention strategy instead of long-term use of antidepressants. These results could be used to inform shared decision-making in clinical practice.",34009273,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.777368545532227,-0.702570378780365,AWHK
"A manual-based phenomenological art therapy for individuals diagnosed with moderate to severe depression (PATd): A randomized controlled study.

This study investigated the effects of manual-based Phenomenological Art Therapy for individuals living with depression in addition to treatment as usual (PATd/TAU) compared with only treatment as usual (TAU) for individuals diagnosed with moderate to severe depression. 79 adults (men = 29.1%) were included in this randomized-controlled-trial (RCT), multicenter study in Sweden with an intention-to-treat design. Participants were randomized into either the PATd/TAU-group (n = 43) or TAU-group (n = 36). Data were collected at baseline and at end of treatment. The main outcomes were depression levels and self-esteem. Secondary outcomes were suicide ideation and sickness absence. The PATd/TAU-group showed a significant decrease of depression levels. The PATd/TAU-group returned to work to a higher degree than the TAU-group. Self-esteem significantly improved in both groups. Suicide ideation was unaffected. Manual-based PATd works as expected, being an effective treatment, and contributes to recovery for individuals with moderate to severe depression. This outcome needs to be confirmed and its long-term effects examined in further studies. (PsycINFO Database Record",29756790,Major Depressive Disorder,Anxiety Treatment,Mental Health,23662,11.015363693237305,-3.4303672313690186,BL2r
"Outcomes of an online computerized cognitive behavioral treatment program for treating chinese patients with depression: A pilot study.

This pilot study examined the feasibility, safety, and effectiveness of using an online computerized cognitive behavioral therapy (CBT) for treating Chinese patients with depression. Seventy-five Chinese patients with depression in outpatient clinics were randomized into a 5-week intervention. The intervention group received the Chinese translated version of MoodGYM in addition to usual treatment, and the control group continued with usual treatment. Participants completed the 20-item Center for Epidemiologic Studies Depression Scale (CES-D) pre- and post-intervention. We conducted multivariate linear regression analyses to compare the change in CES-D scores for completers after the intervention. Seventy-eight percent (n=29) of participants in the intervention group and 84% (n=32) of patients in the control group completed the post-treatment assessments, and no serious adverse events were reported. Results indicated that while both groups significantly improved at post test, the intervention group improved significantly more than the control group (t(59)=2.37, p=0.02). Computerized CBT can be a cost-effective adjunct to medication treatment, particularly in areas with limited access to mental health services. The use of online computerized CBT has been found to be effective in many studies in Western countries, but has not been studied among Chinese outpatients. This study suggests that online computerized CBT is acceptable, and that MoodGYM is a feasible and efficacious augmentative treatment, specifically when used within an outpatient clinic population. With this small sample size we were able to demonstrate that the addition of MoodGYM to usual care improved treatment outcomes for outpatients with depression in China.",29146042,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.600971221923828,-3.139167070388794,BUEc
"Efficacy of brief dynamic interpersonal therapy in patients with major depressive disorder: a prospective, multicenter randomized controlled trial protocol.

In China, psychodynamic psychotherapies are widely used as a treatment for depression. However, very few efficacy studies of psychodynamic therapies have been conducted with the Chinese population. This paper describes a study protocol of a multicenter randomized controlled trial of dynamic interpersonal psychotherapy (DIT), a brief manualized depression-focused intervention, in Chinese adults with major depressive disorder (MDD). Recruitment is planned in five hospitals. Two hundred forty patients with MDD will be randomly allocated on a 1:1:1 basis to either medication plus DIT, medication plus an active control psychotherapy, or medication alone. Patients will be assessed at baseline and at weeks 2, 4, 8, 12, and 16 during the acute treatment phase and 1, 3, 6, and 12months posttreatment. The primary outcome is change from baseline in the 17-item Hamilton Depression Rating Scale, administered by independent raters who are blind to treatment allocation. The Hamilton Anxiety Rating Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-item scale, response, remission and relapse rates, self-assessment of overall efficacy and satisfaction of patients, and side effect profiles are secondary measures. This will be the first multicentered RCT in China to assess the efficacy of a brief psychodynamic intervention for MDD. The study has the potential to inform clinical treatment guidelines for the treatment of depression in China. ChiCTR, ChiCTR1800016970 . Registered on July 5, 2018.",32703316,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.538918495178223,-3.5602402687072754,AlXf
"Training Substance Use Disorder Counselors in Cognitive Behavioral Therapy for Depression: Development and Initial Exploration of an Online Training Program.

Evidence based psychotherapies (EBPs) remain underutilized. Models for EBP training and implementation that are cost-effective, minimally disruptive, and sufficiently flexible are needed. Internet-based technology is a promising platform, but questions remain about how this technology can address the barriers to implementation. We developed and examined the implementation of an online training for the Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT) intervention-a manualized, sixteen-session group depression treatment for individuals with substance use disorders (SUDs). We explored the feasibility of replacing in-person BRIGHT training with a self-paced, online training. A highly partnered and iterative process was followed to translate the written BRIGHT manual and associated didactic training materials into a media rich, interactive, and detailed (12-16 h) online training. Subsequently, 8 volunteer counselors across 7 Veterans' Affairs SUD programs completed the training. Semi-structured interviews focused on the counselors' experiences and their plans for implementing BRIGHT groups. A template approach, using a mixture of deductive and inductive coding, was used for data analyses. The most important barrier to completing training was a lack of protected time. Most counselors were not afforded protected time and reported a sometimes frustrating and fragmented training experience. Many used personal time at work and at home to complete the work. Facilitators to completing the training included positive reactions/attitudes towards the training modules, supervisor support, counselor dedication, and strong beliefs supporting providing services for depression. Many counselors were also concerned about the feasibility of fitting 16 group sessions (2h each) into their program's clinical schedule, but many had devised potential solutions or ""work-arounds"" to accommodate or approximate the recommended treatment course (e.g., using lunch times, reducing some content/exercises). This work contributes to the literature on implementation of complex EBPs and addresses the strengths and limitations of web-based technologies in supporting the implementation of EBPs.",26219680,Major Depressive Disorder,Anxiety Treatment,Mental Health,4830,10.733696937561035,-3.565533399581909,B6QR
"Trajectories of Change in a Group Behavioral Activation Treatment for Severe, Recurrent Depression.

Depression is a common and costly problem. Behavioral Activation (BA) is an effective treatment for depression when delivered 1:1, but group treatments often do not perform as well as 1:1 treatments. One way to begin to understand how group treatments perform is to assess the process of change during treatment. This study examined trajectories of change across 10-session group BA for individuals with severe, chronic, or recurrent forms of depression. We also tested whether individuals who had associated sudden gains or depression spikes had better outcomes than those who did not have these change patterns. We examined psychological and sociodemographic predictors of the patterns of change. Participants were 104 individuals who met diagnostic criteria for major depressive disorder and participated in one of 10 BA groups, provided over a 2-year period. A linear, but not quadratic or cubic, rate of change fit the data and the effect size for the change in mood symptoms from baseline to posttreatment was large, Cohen's d = 1.25. Although 34% (26 of the 77 who provided outcome data) of individuals had a sudden gain and 10% (7/77) had a depression spike, neither sudden gains nor depression spikes predicted posttreatment outcomes. None of the demographic or psychological factors (rumination, behavioral activation) predicted the pattern of change. These results suggest that although group BA may help to reduce depressive symptoms in individuals with severe, recurrent, and/or chronic forms of depression, the overall linear pattern of change is different from quadratic patterns of change reported for 1:1 BA.",31030869,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,10.588855743408203,-1.9425435066223145,A7RB
"Five-year follow-up of first-episode depression treated with psychodynamic psychotherapy or antidepressants.

Short-term psychodynamic psychotherapy (STPP) both combined with medication and alone has been shown to be effective in major depressive disorder (MDD). However, few studies compared STTP and pharmacotherapy in monotherapy during acute phase and there is lack of data concerning the prevention of recurrences. The aim of this retrospective study was to evaluate the clinical course of patients who achieved remission from their first life-time major depressive episode after treatment with antidepressant (AD) therapy or brief dynamic therapy (BDT), a specific type of STPP, examining the recurrence rates during a 5-year treatment-free period. The analysis was conducted on 93 subjects (remitters to BDT n = 46; remitters to AD n = 47). Treatment with BDT was associated with a significantly higher proportion of patients without depressive recurrences during the observation period. Among patients who were remitters to BDT, 71.7% did not experience depressive recurrences at the end of the observation period, compared to 46.8% of those treated with pharmacotherapy. BDT may be more effective than AD pharmacotherapy in improving the long-term outcome of patients with a first major depressive episode; further studies comparing STPP and AD in terms of efficacy and cost-effectiveness are needed.",30878853,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.927584648132324,-3.627457618713379,A9Uz
"Motivational deficits differentially predict improvement in a randomized trial of self-system therapy for depression.

A randomized trial compared the time course and differential predictors of symptom improvement in 2 treatments for depression. Forty-nine adults (84% female) who were not taking antidepressant medications and met diagnostic criteria for major depressive disorder or dysthymia were randomly assigned either to cognitive-behavioral therapy (CBT) or self-system therapy (SST), a treatment that targets problems in self-regulation, the ongoing process of evaluating progress toward personal goals. Self-regulatory variables (promotion and prevention focus and goal disengagement and reengagement) were assessed as potential moderators of efficacy. At intake, most participants reported depression in the moderate to severe range and had histories of recurrent episodes and previous treatment attempts. Self-reported symptoms of depression and anxiety were assessed at each therapy session. Multilevel modeling was used to examine (a) differences in change associated with the treatment conditions and (b) moderation of treatment efficacy by pretreatment measures of self-regulatory deficits. Both treatments were effective and did not show differences in the magnitude or rate of symptom change or in dropout rates, suggesting that CBT and SST were equally effective in improving depression and anxiety. Patients with self-regulatory deficits, however, showed greater improvement in depressive symptoms with SST. Specifically, patients with low promotion focus and low goal reengagement responded better to SST, whereas patients with high prevention focus responded better to CBT. Overall, the results corroborate previous research suggesting that SST is a viable short-term treatment for depression that is particularly effective in helping patients compensate for self-regulatory deficits.",25867448,Major Depressive Disorder,Anxiety Treatment,Mental Health,14593,10.48084831237793,-2.9432356357574463,B/N3
"Predictors of patient cognitive therapy skills and symptom change in two randomized clinical trials: the role of therapist adherence and the therapeutic alliance.

Previous research has found that therapist adherence to concrete, problem-focused cognitive therapy (CT) techniques predicts depressive symptom change (e.g., Feeley, DeRubeis, & Gelfand, 1999). More recently, Strunk, DeRubeis, Chui, and Alvarez (2007) demonstrated that in-session evidence of patients' use of CT skills was related to a lower rate of relapse in the year following CT for depression. The current investigation attempts to integrate and extend these findings within 2 separate samples of patients and therapists. Drawing from the CT samples (N = 105, mean age = 40 years, female = 62%, White = 82%) of 2 published randomized clinical trials of depression treatment, we conducted analyses to examine whether therapist adherence to concrete CT techniques (Collaborative Study Psychotherapy Rating Scale) and the quality of the therapeutic alliance (Working Alliance Inventory) predict patients' use of CT skills (Performance of Cognitive Therapy Strategies) and subsequent Beck Depression Inventory symptom change. Results indicated a differential pattern of prediction in the 2 samples. In one, CT techniques exhibited a stronger association with patient CT skills and symptom change than did the alliance, whereas the reverse pattern emerged in the second sample. A baseline symptom severity × CT techniques interaction indicated that between-study differences in intake depression severity might in part explain the process-outcome differences. The present findings suggest that the nature of the therapy sample examined may moderate process-outcome findings in psychotherapy research. The implications of these results and directions for future research are discussed.",22468907,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.061923027038574,-3.1213955879211426,CvQM
"Behavioural activation interventions for depressed individuals with a chronic physical illness: a systematic review protocol.

Depression is common in people with chronic physical illness and is associated with worse medical outcomes. Cognitive behavioural therapy and problem-solving improve depression, although usually have small to moderate effects among people with chronic physical illness. Behavioural activation interventions for depression, which aim to increase positive reinforcement from the environment by encouraging individuals to increase pleasant/rewarding activities, have been reported to be equivalent to cognitive behavioural therapy. However, the effectiveness of behavioural activation interventions for depression in individuals with chronic physical illness is unclear. The aims of this systematic review are to identify the extent to which different forms of behavioural activation have been used as a treatment for depression in this population, examine the effectiveness of the interventions, and identify any adaptations which have been made specifically to the interventions for individuals with a range of chronic physical illnesses. Electronic databases will be systematically searched using terms relevant to behavioural activation and depression, and the subset of studies in people with chronic physical illnesses will be identified by manual searching. References and citations of eligible studies will be searched and experts in this field will be contacted to identify additional papers. All study designs will be included in this review to allow for a more extensive identification of the extent of different forms of behavioural activation interventions. The different forms of behavioural activation and the specific chronic physical health conditions for which this intervention has been used will be reviewed narratively. For the effectiveness of the interventions, if sufficient randomised controlled trials have been undertaken the results will be meta-analysed. Non-randomised studies will be narratively synthesised and adaptations to the interventions will also be narratively reviewed. The findings will inform the design, development and subsequent evaluation of a behavioural activation intervention for depression in people with a chronic physical illness. PROSPERO registration number: CRD42013004500.",24237689,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.11085319519043,-2.424830675125122,CWBb
"Does illness attribution affect treatment assignment in depression?

Little is known about depressed individuals' illness attributions and how these influence treatment assignment in clinical practice. The aim of the present study was to examine whether illness attribution across the domains of intraindividual, interpersonal and biological reasons was associated with treatment assignment in a naturalistic treatment setting. Illness attribution was assessed with the Reasons for Depression Questionnaire in 221 depressed individuals. Participants were assigned to either cognitive-behavioural therapy (CBT), interpersonal therapy (IPT) or psychopharmacological treatment (PHT). Depressed individuals who strongly attributed their illness to intraindividual factors were more likely to be assigned to CBT, and depressed individuals attributing their depression to biological reasons were more likely to receive in PHT. In contrast, interpersonal illness attribution was not associated with treatment assignment. Illness attribution influences treatment assignment to CBT and PHT. However, factors other than illness attribution for depression affect a treatment choice of IPT.",19911389,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.005537033081055,-3.9346683025360107,DQED
"Cognitive-behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial.

Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment. Observer-blind, parallel-group, pragmatic superiority randomised controlled trial. A total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London. Adolescents aged 11-17 years with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses. In total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up. Mean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post randomisation. There were non-inferiority effects of CBT compared with STPP [treatment effect by final follow-up=-0.578, 95% confidence interval (CI) -2.948 to 4.104; p=0.748]. There were no superiority effects for the two specialist treatments (CBT+STPP) compared with BPI (treatment effect by final follow-up=-1.898, 95% CI -4.922 to 1.126; p=0.219). At final assessment there was no significant difference in the mean depressive symptom score between treatment groups. There was an average 49-52% reduction in depression symptoms by the end of the study. There were no differences in total costs or quality-of-life scores between treatment groups and prescribing a selective serotonin reuptake inhibitor (SSRI) during treatment or follow-up did not differ between the therapy arms and, therefore, did not mediate the outcome. The three psychological treatments differed markedly in theoretical and clinical approach and are associated with a similar degree of clinical improvement, cost-effectiveness and subsequent maintenance of lowered depressive symptoms. Both STPP and BPI offer an additional patient treatment choice, alongside CBT, for depressed adolescents attending specialist Child and Adolescent Mental Health Services. Further research should focus on psychological mechanisms that are associated with treatment response, the maintenance of positive effects, determinants of non-response and whether or not brief psychotherapies are of use in primary care and community settings. Neither reason for SSRI prescribing or monitoring of medication compliance was controlled for over the course of the study, and the economic results were limited by missing data. Current Controlled Trials ISRCTN83033550. This project was funded by the National Institute for Heath Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 12. See the National Institute for Heath Research Journals Library website for further project information. Funding was also provided by the Department of Health. The funders had no role in the study design, patient recruitment, data collection, analysis or writing of the study, any aspect pertinent to the study or the decision to submit to The Lancet.",28394249,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.160430908203125,-3.135761022567749,BeLA
"Effects of online intervention for depression on mood and positive symptoms in schizophrenia.

Depression is common in schizophrenia. Whereas the improvement of mood and self-esteem represents a subjective treatment priority for many patients, depression is rarely a primary target for clinical intervention. The present trial examined whether an online intervention for depression can ameliorate depressive symptoms in schizophrenia. A total of 58 individuals with schizophrenia were invited to participate in an online survey which encompassed the Center for Epidemiologic Studies-Depression Scale (CES-D, primary outcome), the Patient-Health-Questionnaire-9 (PHQ-9) and the Paranoia Checklist. Subsequently, telephone interviews were conducted to verify diagnostic status and assess symptoms (Positive and Negative Syndrome Scale, PANSS). Participants were randomized either to the experimental condition (online depression intervention) or to a waitlist control condition. Three months after inclusion, a reassessment was carried out (self-report and telephone interview blind for group condition). The trial was registered (registration: DRKS00007888). Participants in the treatment group showed a significant decline of depressive symptoms at a medium-to-large effect size, as assessed with the CES-D and the PANSS depression item, in comparison to the waitlist control group (completer (CC) and intention-to-treat analyses (ITT)). For the PHQ-9 (CC and ITT) and the PANSS distress subscale (CC only) significance was bordered at a medium effect size. Completion at the post-assessment after three months was 84%. Depression in schizophrenia is both underdiagnosed and undertreated. To reduce the large treatment gap in the disorder, low threshold strategies are urgently needed. Online treatment and bibliotherapy may represent valuable tools to address patients' needs beyond the treatment of the core positive syndrome.",27210726,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.635419845581055,-3.4193997383117676,Bsee
"Therapists' Experiences of Psychodynamic Therapy with and without Transference Interventions for Adolescents with Depression.

Psychodynamic therapy is an effective treatment for depression. However, a large number of adolescent patients with depression do not respond and/or drop out of therapy and little is known about what therapists actually do in therapy with adolescents. Thus, more research is needed to explore the various actions that therapists do in therapy, so that therapists can tailor their therapy more specifically to each individual adolescent. The present study aimed to investigate how the experience of psychotherapists differs between two treatment modes for adolescents with depression: psychodynamic psychotherapy with and without transference interventions. In-depth interviews were conducted with six therapists. The data, which were analyzed using thematic analysis, generated three key themes: (1) The therapists experienced that transference interventions are often useful in therapies with adolescents with depression, (2) therapies without transference interventions can be challenging for therapists, but still helpful for patients, and (3) the experience contributed to the deepening recognition of therapists that they always need to adapt their techniques to the particular patient. The results enhance our knowledge of the significance of therapists' actions in therapy with adolescents. The therapists highlighted issues that are important for identifying barriers to incorporating new knowledge into clinical practice.",32605079,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.53722095489502,-3.7344563007354736,Amkz
"Diminishing Effects After Recurrent Use of Self-Guided Internet-Based Interventions in Depression: Randomized Controlled Trial.

Self-guided internet-based interventions have several advantages over guided interventions and are generally effective in treating psychiatric symptoms. We aimed to investigate whether the use of a new self-guided internet-based intervention (MOOD) would lead to a significant reduction in depressive symptoms compared with a care-as-usual (CAU) control group in a sample of individuals with depressive symptoms, most of whom had already used a different self-guided internet-based intervention in a previous trial. A total of 125 individuals were randomized to the intervention condition (MOOD) and received access to the intervention for a period of six weeks or a CAU group. After six weeks, all participants were invited to take part in the post assessment. The Beck Depression Inventory-II served as the primary outcome. Both intention-to-treat as well as per-protocol analyses indicated that the depressive symptomatology decreased in both conditions but showed no advantage for those who had used MOOD. Subsequent moderation analyses suggested that those individuals who had less experience with psychotherapy benefitted to a greater extent compared with those with more experience. Self-guided internet-based interventions are deemed a suitable first-step approach to the treatment of depression. However, our results indicate that they are more efficacious in those with less psychotherapy experience. ClinicalTrials.gov NCT03795480; http://clinicaltrials.gov/ct2/show/NCT03795480.",31579014,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.209308624267578,-3.3419315814971924,Az4W
"Long-Term Effects of a Cognitive Behavioral Conference Call Intervention on Depression in Non-Professional Caregivers.

Recent evidence supports the efficacy of conference call cognitive-behavioral interventions in preventing depression in caregivers at post-intervention, but we do not know whether the results are sustained long term. The main objective of this study was to evaluate the long-term efficacy of a cognitive-behavioral intervention administered by telephone conference call in preventing depression in caregivers with elevated depressive symptoms, comparing all components of the intervention versus only the behavioral ones. A randomized controlled trial was conducted using a dismantling strategy. At total of 219 caregivers were randomly assigned to a cognitive-behavioral conference call intervention (CBCC; n = 69), a behavioral-activation conference call intervention (BACC; n = 70), or a usual care control group (CG, n = 80). Information was collected on depressive symptoms and depression at pre-intervention and at 1, 3, 6, 12, and 36 months post-intervention. At 36 months, there was a reduction in depressive symptoms (p < 0.001) and a lower incidence of major depressive episodes in both the CBCC and BACC groups compared to CG (8.7%, 8.6%, and 33.7%, respectively). The results show that a conference call intervention was effective in the long term to prevent depression in caregivers and that the behavioral-activation component was comparable to the complete cognitive-behavioral protocol.",33187116,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.909757614135742,-2.5129551887512207,AfeX
"Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy - results from a randomized controlled trial.

Bouldering-Psychotherapy (BPT) has proven to effectively reduce depressive symptoms, but evidence on its cost-effectiveness is lacking. Corresponding information is paramount to support health policy decision making on a potential implementation of BPT in routine care. Using data from the German KuS trial BPT was compared with group Cognitive Behavioral Therapy (CBT). Severity of depression symptoms at end of the intervention was operationalized via Montgomery-Asberg Depression Rating Scale (MADRS) and Patient Health Questionnaire (PHQ-9). Adopting a societal perspective, direct medical costs and productivity loss were calculated based on standardized unit costs. To determine incremental cost-effectiveness ratios (ICER) and cost-effectiveness-acceptance curves (CEAC), adjusted mean differences (AMD) in costs (gamma-distributed model) and both effect parameters (Gaussian-distributed model) were obtained from 1000 simultaneous bootstrap replications. BPT was related to improved effects (AMDs: MADRS -2.58; PHQ-9: -1.35) at higher costs (AMD: +€ 754). No AMD was significant. ICERs amounted to €288 per MADRS-point and €550 per PHQ-9-point. For both effect parameters about 20% of bootstrap replications indicated dominance of BPT, and about 75% larger effects at higher costs. At hypothetical willingness to pay (WTP) thresholds of €241 (MADRS) and €615 (PHQ-9) per unit of change BPT had a 50% probability of being cost-effective. BPT is a promising alternate treatment strategy which - in absence of established WTP thresholds for improving symptoms of depression - cannot unambiguously be claimed cost-effective. Further studies defining subgroups that particularly benefit from BPT appear paramount to delineate recommendations for an efficient prospective roll-out to routine care.",34702280,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,9.785091400146484,-2.869028329849243,6VQ
"Faith-adapted psychological therapies for depression and anxiety: Systematic review and meta-analysis.

Incorporating faith (religious or spiritual) perspectives into psychological treatments has attracted significant interest in recent years. However, previous suggestion that good psychiatric care should include spiritual components has provoked controversy. To try to address ongoing uncertainty in this field we present a systematic review and meta-analysis to assess the efficacy of faith-based adaptations of bona fide psychological therapies for depression or anxiety. A systematic review and meta-analysis of randomised controlled trials were performed. The literature search yielded 2274 citations of which 16 studies were eligible for inclusion. All studies used cognitive or cognitive behavioural models as the basis for their faith-adapted treatment (F-CBT). We identified statistically significant benefits of using F-CBT. However, quality assessment using the Cochrane risk of bias tool revealed methodological limitations that reduce the apparent strength of these findings. Whilst the effect sizes identified here were statistically significant, there were relatively a few relevant RCTs available, and those included were typically small and susceptible to significant biases. Biases associated with researcher or therapist allegiance were identified as a particular concern. Despite some suggestion that faith-adapted CBT may out-perform both standard CBT and control conditions (waiting list or ""treatment as usual""), the effect sizes identified in this meta-analysis must be considered in the light of the substantial methodological limitations that affect the primary research data. Before firm recommendations about the value of faith-adapted treatments can be made, further large-scale, rigorously performed trials are required.",25723562,Major Depressive Disorder,Anxiety Treatment,Mental Health,1733,11.631830215454102,-4.616016387939453,CBTm
"Patient Choice in Depression Psychotherapy: Outcomes of Patient-Preferred Therapy Versus Randomly Allocated Therapy.

Patient choice is recognized as a factor that influences clinical outcomes and treatment evaluation in mental health care. However, research on how having a choice affects patients with depression has been rare. This Dutch study examined whether patients randomly selected to choose between two types of depression psychotherapy benefited more from treatment than patients randomly assigned to an intervention. Data were derived from a trial of outpatients with depression who were randomly assigned to cognitive therapy (CT), interpersonal psychotherapy (IPT), or a 2-month waitlist control condition followed by the patient's choice of CT or IPT. Treatment groups were combined into a no-choice condition (N=151), with the waitlist as the choice condition (N=31). Multilevel regression was used to compare depression severity (measured with the Beck Depression Inventory-II [BDI-II]) and general psychological distress (measured with the Brief Symptom Inventory [BSI]) posttreatment and at the 5-month follow-up. Differences in patients' pretreatment expectations, beliefs about treatment credibility, and posttreatment evaluation were examined. No significant differences in clinical outcomes were found between the choice and no-choice conditions (mean difference: BDI-II posttreatment=-0.55, 95% confidence interval [CI]=-5.25 to 4.15; follow-up=2.10, 95% CI=-4.01 to 8.20; BSI posttreatment=-1.89, 95% CI=-15.35 to 11.58; follow-up=3.13, 95% CI=-12.32 to 18.57). Patients in both groups reported comparable scores on pretreatment expectations, credibility beliefs, and posttreatment evaluation. Neither expectations nor credibility beliefs were predictive of clinical outcomes. Our findings did not support the value of patient choice. Considering the exploratory nature of the trial, future studies designed to examine the effects of choice in depression treatment are recommended.",34521212,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.431081771850586,-2.8517937660217285,AQZn
"Prevention of depression in first-year university students with high harm avoidance: Evaluation of the effects of group cognitive behavioral therapy at 1-year follow-up.

High harm avoidance (HA) scores on the temperament and character inventory appear to be a risk factor for depressive disorders and suicide. Since 2012, we have conducted group cognitive behavioral therapy (G-CBT) interventions for students at Nagasaki University with high HA and without depressive disorders, with the aim of preventing depression. Here, we report on the effects of the G-CBT at 1-year follow-up for the 2012 to 2015 period.Forty-two participants with high HA were included in the final analysis. Outcomes were measured with the Beck Depression Inventory II, Manifest Anxiety Scale, 28-item General Health Questionnaire, and Brief Core Schema Scales at baseline, and at 6-month, and 1-year follow-ups.Repeated-measures analyses of variance revealed a significant decrease in mean depressive symptom scores at the 6-month follow-up point; this decrease was maintained at 1 year. Improvements in cognitive schemas were also seen at 6 months and 1 year.We observed improvements in cognitive schemas associated with depression as a result of the G-CBT intervention, with effects maintained at 1 year post-intervention. This intervention may be effective in positively modifying the cognitions of students with HA and preventing future depression.",30383656,Major Depressive Disorder,Anxiety Treatment,Mental Health,8609,11.391473770141602,-3.438361883163452,BD7K
"Review: In acute depression, interpersonal psychotherapy is more effective than control but not other therapies.

",27538183,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.010828018188477,-2.9384515285491943,Bocb
"[Online therapy for depressive disorders : An acceptance-based analysis from the perspective of therapists].

The supply of online therapy options for mild to moderate depressive disorders has substantially risen both nationally and internationally in the past years. While the efficacy and efficiency of specific online-based therapeutic services were indicated within the framework of scientific evaluations, little is known about the acceptance of these new therapy options. In a nationwide online survey of online-based therapy options for mild to moderate depressive disorders, the attitude and stance as well as the use intention and the subjectively perceived knowledge of 657 medical practitioners and therapists, active in psychotherapeutic and psychiatric treatment were collated. The impact of the potential predictors on the use intention of online-based therapies, based on the unified theory of acceptance and use of technology, was analyzed by means of a binary logistic regression model. Besides the perceived performance and expense expectations, the supportive framework conditions, the influence of the cooperative environment, the individual technical affinity as well as the evaluation of the prospective significance of online-based therapy proved to be significantly influential predictors on the user intention. Special predictability for a positive user intention was shown related to the perceived potential of online therapy. The results underline the relevance of further evidence-basing of online therapy for mild to moderate depressive disorders. A user-oriented, participatory technology development proves to be just as relevant as a comprehensive sensitization, elucidation and education of potential users for a successful implementation.",31165209,Major Depressive Disorder,Anxiety Treatment,Mental Health,17772,9.869486808776855,-3.375746011734009,A5cj
"Behavioral activation for depression delivered by drug and alcohol treatment workers: A pilot randomized controlled trial.

One in two patients seeking help for substance use disorders (SUDs) has clinically significant depression symptoms. This co-occurrence impairs treatment outcomes, but limited evaluation of the implementation of evidence-based interventions has taken place. This pilot randomized controlled trial (RCT) assessed the feasibility and potential efficacy of a brief, protocol-driven behavioral activation (BA) intervention delivered by drug and alcohol workers in a community drug and alcohol treatment (CDAT) service. Eligible participants (n = 34) were randomly allocated to either BA (n = 17) or treatment as usual (n = 17) and assessed at baseline and 6-, 12-, and 24-week follow-up. Feasibility outcomes were participant engagement and worker protocol adherence. The primary pilot outcome was severity of depression symptoms (PHQ-9) at 12-week follow-up. Secondary outcomes included percent days abstinent (PDA) in the past month, severity of dependence (SDS), anxiety symptoms (GAD-7), and valued living (VQ) at all follow-up points. Fifty-nine percent of BA participants attended at least one session and there was 95% adherence to the treatment protocol. BA was associated with significantly reduced depression at 12-week follow-up (PHQ-9 mean difference - 5.69, 95% CI -10.07 to -1.31). BA participants had significantly greater improvements in PDA (mean difference 17.9, 95% CI 0.99 to 34.82) and VQ-Progress (mean difference 5.34, 95% CI 1.47 to 9.22) at 6-week follow-up and PDA (mean difference 27.69, 95% CI 4.44 o 50.95) at 12-week follow-up. The study found no significant between-group differences at 24-week follow-up. BA implemented by drug and alcohol treatment workers in CDAT appears feasible and may add clinical benefit to usual care for SUD patients with elevated depressive symptoms accessing CDAT. Fully powered RCTs are warranted to better investigate the replicability of these preliminary findings. Methodological limitations are discussed and suggestions for future research are provided.",35484019,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.557380676269531,-2.264214038848877,bRI
"Improving the effectiveness of psychological interventions for depression and anxiety in the cardiac rehabilitation pathway using group-based metacognitive therapy (PATHWAY Group MCT): study protocol for a randomised controlled trial.

Anxiety and depression are prevalent among cardiac rehabilitation patients but pharmacological and psychological treatments have limited effectiveness in this group. Furthermore, psychological interventions have not been systematically integrated into cardiac rehabilitation services despite being a strategic priority for the UK National Health Service. A promising new treatment, metacognitive therapy, may be well-suited to the needs of cardiac rehabilitation patients and has the potential to improve outcomes. It is based on the metacognitive model, which proposes that a thinking style dominated by rumination, worry and threat monitoring maintains emotional distress. Metacognitive therapy is highly effective at reducing this thinking style and alleviating anxiety and depression in mental health settings. This trial aims to evaluate the effectiveness and cost-effectiveness of group-based metacognitive therapy for cardiac rehabilitation patients with elevated anxiety and/or depressive symptoms. The PATHWAY Group-MCT trial is a multicentre, two-arm, single-blind, randomised controlled trial comparing the clinical- and cost-effectiveness of group-based metacognitive therapy plus usual cardiac rehabilitation to usual cardiac rehabilitation alone. Cardiac rehabilitation patients (target sample n = 332) with elevated anxiety and/or depressive symptoms will be recruited across five UK National Health Service Trusts. Participants randomised to the intervention arm will receive six weekly sessions of group-based metacognitive therapy delivered by either cardiac rehabilitation professionals or research nurses. The intervention and control groups will both be offered the usual cardiac rehabilitation programme within their Trust. The primary outcome is severity of anxiety and depressive symptoms at 4-month follow-up measured by the Hospital Anxiety and Depression Scale total score. Secondary outcomes are severity of anxiety/depression at 12-month follow-up, health-related quality of life, severity of post-traumatic stress symptoms and strength of metacognitive beliefs at 4- and 12-month follow-up. Qualitative interviews will help to develop an account of barriers and enablers to the effectiveness of the intervention. This trial will evaluate the effectiveness and cost-effectiveness of group-based metacognitive therapy in alleviating anxiety and depression in cardiac rehabilitation patients. The therapy, if effective, offers the potential to improve psychological wellbeing and quality of life in this large group of patients. UK Clinical Trials Gateway, ISRCTN74643496 , Registered on 8 April 2015.",29615092,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,7.503830432891846,-0.9064986109733582,BNtf
"Community-Based Preventive Interventions for Depression and Anxiety in Women.

Depression and anxiety are the most common mental disorders and currently, they constitute one of the main causes of disability and death. The high prevalence of psychiatric disorders and their increasing burden are noteworthy. The aim of this study is to investigate the effectiveness of community-based preventive interventions for depression and anxiety in women. We systematically searched for articles published up to the beginning of 2018, which addressed community-based preventive interventions for depression and anxiety in women. The studies were searched in PubMed, Scopus, Cochrane Library, Web of Science, PsycInfo, IranMedex, SID and EMBASE electronic databases. Articles that complied with our inclusion criteria (preventive interventions involving healthy adult women aged 18 to 65 years) were reviewed. Quality assessment of the articles was performed using standard tools. We extracted the required data and reported the results in a narrative form. Twenty-three articles were identified and entered into the final review. Depression and anxiety symptoms were decreased in more than 70% of interventions. Cognitive behavioral therapy (CBT) and exercise were the most effective interventions. In addition, computer and internet-based programs had positive outcomes in both categories of depression and anxiety. Community-based preventive programs for depression and anxiety in women had promising and positive results. CBT and exercise were the most effortless, yet the most effective interventions to apply. Computer and internet-based programs had the benefit of covering many people simultaneously. These interventions are cost-effective and feasible among Iranian women.",32126789,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.221842765808105,-3.5336849689483643,Asfs
"Manualised cognitive-behavioural therapy in treating depression in advanced cancer: the CanTalk RCT.

With a prevalence of up to 16.5%, depression is one of the commonest mental disorders in people with advanced cancer. Depression reduces the quality of life (QoL) of patients and those close to them. The National Institute for Health and Care Excellence (NICE) guidelines recommend treating depression using antidepressants and/or psychological treatments, such as cognitive-behavioural therapy (CBT). Although CBT has been shown to be effective for people with cancer, it is unclear whether or not this is the case for people with advanced cancer and depression. To assess the clinical effectiveness and cost-effectiveness of treatment as usual (TAU) plus manualised CBT, delivered by high-level Improving Access to Psychological Therapy (IAPT) practitioners, versus TAU for people with advanced cancer and depression, measured at baseline, 6, 12, 18 and 24 weeks. Parallel-group, single-blind, randomised trial, stratified by whether or not an antidepressant was prescribed, comparing TAU with CBT plus TAU. Recruitment took place in oncology, hospice and primary care settings. CBT was delivered in IAPT centres or/and over the telephone. Patients (N=230; n=115 in each arm) with advanced cancer and depression. Inclusion criteria were a diagnosis of cancer not amenable to cure, a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of depressive disorder using the Mini-International Neuropsychiatric Interview, a sufficient understanding of English and eligibility for treatment in an IAPT centre. Exclusion criteria were an estimated survival of <4 months, being at high risk of suicide and receiving, or having received in the last 2 months, a psychological intervention recommended by NICE for treating depression. (1) Up to 12 sessions of manualised individual CBT plus TAU delivered within 16 weeks and (2) TAU. The primary outcome was the Beck Depression Inventory, version 2 (BDI-II) score at 6, 12, 18 and 24 weeks. Secondary outcomes included scores on the Patient Health Questionnaire-9, the Eastern Cooperative Oncology Group Performance Status, satisfaction with care, EuroQol-5 Dimensions and the Client Services Receipt Inventory, at 12 and 24 weeks. A total of 80% of treatments (185/230) were analysed: CBT (plus TAU) (n=93) and TAU (n=92) for the BDI-II score at all time points using multilevel modelling. CBT was not clinically effective [treatment effect -0.84, 95% confidence interval (CI) -2.76 to 1.08; p=0.39], nor was there any benefit for other measures. A subgroup analysis of those widowed, divorced or separated showed a significant effect of CBT on the BDI-II (treatment effect -7.21, 95% CI -11.15 to -3.28; p<0.001). Economic analysis revealed that CBT has higher costs but produces more quality-adjusted life-years (QALYs) than TAU. The mean service costs for participants (not including the costs of the interventions) were similar across the two groups. There were no differences in EQ-5D median scores at baseline, nor was there any advantage of CBT over TAU at 12 weeks or 24 weeks. There was no statistically significant improvement in QALYs at 24 weeks. Although all participants satisfied a diagnosis of depression, for some, this was of less than moderate severity at baseline, which could have attenuated treatment effects. Only 64% (74/115) took up CBT, comparable to the general uptake through IAPT. Cognitive-behavioural therapy (delivered through IAPT) does not achieve any clinical benefit in advanced cancer patients with depression. The benefit of CBT for people widowed, divorced or separated is consistent with other studies. Alternative treatment options for people with advanced cancer warrant evaluation. Screening and referring those widowed, divorced or separated to IAPT for CBT may be beneficial. Whether or not improvements in this subgroup are due to non-specific therapeutic effects needs investigation. Current Controlled Trials ISRCTN07622709. This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 19. See the NIHR Journals Library website for further project information.",31097078,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,6.4893479347229,-2.6396212577819824,A6XZ
"Mechanisms of change in psychotherapy for depression: An empirical update and evaluation of research aimed at identifying psychological mediators.

We present a systematic empirical update and critical evaluation of the current status of research aimed at identifying a variety of psychological mediators in various forms of psychotherapy for depression. We summarize study characteristics and results of 35 relevant studies, and discuss the extent to which these studies meet several important requirements for mechanism research. Our review indicates that in spite of increased attention for the topic, advances in theoretical consensus about necessities for mechanism research, and sophistication of study designs, research in this field is still heterogeneous and unsatisfactory in methodological respect. Probably the biggest challenge in the field is demonstrating the causal relation between change in the mediator and change in depressive symptoms. The field would benefit from a further refinement of research methods to identify processes of therapeutic change. Recommendations for future research are discussed. However, even in the most optimal research designs, explaining psychotherapeutic change remains a challenge. Psychotherapy is a multi-dimensional phenomenon that might work through interplay of multiple mechanisms at several levels. As a result, it might be too complex to be explained in relatively simple causal models of psychological change.",27770716,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.992166519165039,-3.5954198837280273,BlqS
"Divergent Outcomes in Cognitive-Behavioral Therapy and Pharmacotherapy for Adult Depression.

Although the average depressed patient benefits moderately from cognitive-behavioral therapy (CBT) or pharmacotherapy, some experience divergent outcomes. The authors tested frequencies, predictors, and moderators of negative and unusually positive outcomes. Sixteen randomized clinical trials comparing CBT and pharmacotherapy for unipolar depression in 1,700 patients provided individual pre- and posttreatment scores on the Hamilton Depression Rating Scale (HAM-D) and/or Beck Depression Inventory (BDI). The authors examined demographic and clinical predictors and treatment moderators of any deterioration (increase ≥1 HAM-D or BDI point), reliable deterioration (increase ≥8 HAM-D or ≥9 BDI points), extreme nonresponse (posttreatment HAM-D score ≥21 or BDI score ≥31), superior improvement (HAM-D or BDI decrease ≥95%), and superior response (posttreatment HAM-D or BDI score of 0) using multilevel models. About 5%-7% of patients showed any deterioration, 1% reliable deterioration, 4%-5% extreme nonresponse, 6%-10% superior improvement, and 4%-5% superior response. Superior improvement on the HAM-D only (odds ratio=1.67) and attrition (odds ratio=1.67) were more frequent in pharmacotherapy than in CBT. Patients with deterioration or superior response had lower pretreatment symptom levels, whereas patients with extreme nonresponse or superior improvement had higher levels. Deterioration and extreme nonresponse and, similarly, superior improvement and superior response, both occur infrequently in randomized clinical trials comparing CBT and pharmacotherapy for depression. Pretreatment symptom levels help forecast negative and unusually positive outcomes but do not guide selection of CBT versus pharmacotherapy. Pharmacotherapy may produce clinician-rated superior improvement and attrition more frequently than does CBT.",26869246,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.001517295837402,-2.274075508117676,BxLt
"A Feasibility Study of Behavioral Activation for Major Depressive Disorder in a Community Mental Health Setting.

Behavioral activation (BA) is a well-supported treatment approach, but little research has been conducted on the effectiveness of this treatment within publicly funded community mental health settings. We examined the feasibility of conducting a randomized trial examining the effectiveness of nine sessions of BA as a treatment for major depressive disorder (MDD) in a community mental health clinic (CMHC) setting. Following adaptation of a BA manual and training of BA therapists, 80 patients seeking treatment at a CMHC were randomized, with a 3:1 randomization rate of BA to nine sessions of treatment as usual (TAU). Feasibility assessments indicated that only one eligible patient refused randomization and, of patients who attended at least one session, the median number of sessions was six for the BA group and eight for the TAU group. Of three postbaseline monthly assessments, 71.3% (171/240) were successfully obtained. On average, patients in the BA condition completed homework assignments 83.9% of the time. Treatment fidelity ratings indicated that substantially more BA techniques were delivered in the BA group compared to the TAU group (d = 2.11). Measures of BA mechanisms improved significantly over time and these changes were significantly associated with change in depressive symptoms. These results indicate that it is feasible to conduct a randomized study of BA for MDD in a CMHC setting. In addition, the study reconfirmed the potential importance of theory-relevant BA mechanism variables. Following these findings, further investigation into the effectiveness of BA in this setting is needed.",33483123,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.484273910522461,-1.95100736618042,AcAv
"Psychotherapy for depression: a randomized clinical trial comparing schema therapy and cognitive behavior therapy.

The efficacy of Cognitive Behavior Therapy (CBT) for depression has been robustly supported, however, up to fifty percent of individuals do not respond fully. A growing body of research indicates Schema Therapy (ST) is an effective treatment for difficult and entrenched problems, and as such, may be an effective therapy for depression. In this randomized clinical trial the comparative efficacy of CBT and ST for depression was examined. 100 participants with major depression received weekly cognitive behavioral therapy or schema therapy sessions for 6 months, followed by monthly therapy sessions for 6 months. Key outcomes were comparisons over the weekly and monthly sessions of therapy along with remission and recovery rates. Additional analyses examined outcome for those with chronic depression and comorbid personality disorders. ST was not significantly better (nor worse) than CBT for the treatment of depression. The therapies were of comparable efficacy on all key outcomes. There were no differential treatment effects for those with chronic depression or comorbid personality disorders. This study needs replication. This preliminary research indicates that ST may provide an effective alternative therapy for depression.",23870427,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.081384658813477,-2.495687961578369,CbJH
"Effect of treatments for depression on quality of life: a meta-analysis.

Cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are the two first-line treatments for depression, but little is known about their effects on quality of life (QOL). A meta-analysis was conducted to examine changes in QOL in adults with major depressive disorder who received CBT (24 studies examining 1969 patients) or SSRI treatment (13 studies examining 4286 patients) for their depression. Moderate improvements in QOL from pre to post-treatment were observed in both CBT (Hedges' g = .63) and SSRI (Hedges' g = .79) treatments. The effect size remained stable over the course of the follow-up period for CBT. No data were available to examine follow-ups in the SSRI group. QOL effect sizes decreased linearly with publication year, and greater improvements in depression were significantly associated with greater improvements in QOL for CBT, but not for SSRIs. CBT and SSRIs for depression were both associated with moderate improvements in QOL, but are possibly caused by different mechanisms.",28440699,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.342700958251953,-1.5237489938735962,BdgI
"Positive memory training for the treatment of depression in schizophrenia: A randomised controlled trial.

Around half of people diagnosed with schizophrenia suffer from co-morbid depression, yet there are no evidence-based psychological treatments to target this presentation. Participants were aged 18-65 years old, had a clinical diagnosis of schizophrenia or schizoaffective disorder and at least a mild level of depression. Participants were randomly assigned (1:1) to receive PoMeT or treatment as usual. PoMeT was delivered in up to 12 individual sessions within 3 months. We stratified randomisation by site and by severity of depression using randomised-permuted blocks. Assessments were carried out at baseline, 3-month, 6-month and 9-month by assessors who were blind to treatment allocation. The primary outcome was reduction in the symptoms of depression at 3-month, 6-month and 9-month as measured by the BDI-II. Analysis was by intention-to-treat with linear mixed-effects models. The trial was registered with the ISRCTN registry number 99485756. One hundred participants were randomly assigned to either PoMeT (n = 49) or treatment as usual (n = 51). The reduction in BDI-II total score at 3 months was significantly greater for PoMeT than for treatment as usual (mean difference = 4.33, SE = 2.00, 95% CI 0.38 to 8.23; p = 0.03). To our knowledge this is, to date, the largest powered randomised controlled trial focused on the psychological treatment of depression in people diagnosed with schizophrenia. Results indicate that a brief targeted intervention can reduce the symptoms of depression in the group. The main limitation of the study is the lack of an active control group which may contribute to an inflated treatment effect.",33002684,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,11.5258207321167,-3.023374080657959,Ahqi
"Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression.

Internet-delivered psychological treatment of major depression has been investigated in several trials, but the role of personalized treatment is less investigated. Studies suggest that guidance is important and that automated computerized programmes without therapist support are less effective. Individualized e-mail therapy for depression has not been studied in a controlled trial. Eighty-eight individuals with major depression were randomized to two different forms of Internet-delivered cognitive behaviour therapy (CBT), or to a waiting-list control group. One form of Internet treatment consisted of guided self-help, with weekly modules and homework assignments. Standard CBT components were presented and brief support was provided during the treatment. The other group received e-mail therapy, which was tailored and did not use the self-help texts i.e., all e-mails were written for the unique patient. Both treatments lasted for 8 weeks. In the guided self-help 93% completed (27/29) and in the e-mail therapy 96% (29/30) completed the posttreatment assessment. Results showed significant symptom reductions in both treatment groups with moderate to large effect sizes. At posttreatment 34.5% of the guided self-help group and 30% of the e-mail therapy group reached the criteria of high-end-state functioning (Beck Depression Inventory score below 9). At six-month follow-up the corresponding figures were 47.4% and 43.3%. Overall, the difference between guided self-help and e-mail therapy was small, but in favour of the latter. These findings indicate that both guided self-help and individualized e-mail therapy can be effective.",20152960,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.366042137145996,-3.093240737915039,DN21
"The cost-effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorders during a one-year follow-up.

Mood and anxiety disorders are characterized by a high and increasing prevalence, they cause a lot of costs and human suffering and there are many treatment options with differing costs. The benefits of identifying the treatments with the most favourable cost-effectiveness ratios can be substantial. However, the number of randomized trials where psychological treatments are compared with each other and where economic aspects, too, are taken into account is still relatively small. To compare the cost-effectiveness of two short-term psychotherapies in the treatment of depressive and anxiety disorders during a one-year follow-up. In the Helsinki Psychotherapy Study, 198 patients, who were 20--45 years of age and met DSM-IV criteria for anxiety or mood disorder, were randomized to short-term psychodynamic psychotherapy (SPP) or solution-focused therapy (SFT). Psychiatric symptoms were assessed at baseline and 4 times during the one-year follow-up from the start of therapy using the Beck Depression Inventory and the Symptom Check List Anxiety Scale, and 2 times using the Hamilton Depression Rating Scales and Hamilton Anxiety Rating Scales. Both direct costs (therapy sessions, outpatient visits, medication, inpatient care) and indirect costs (production losses due to work absenteeism, value of neglected household work, lost leisure time and unpaid help received) due to mental disorders were measured. Mean total costs were compared and incremental cost-effectiveness ratios analyzed. According to all 4 psychiatric outcome measures, symptoms of depression and anxiety were reduced statistically significantly in both therapy groups during the one-year follow-up. The relative changes were about the same size according to all four outcome measures. In both groups the reductions took place mainly in the first half of the follow-up. The reductions were somewhat greater with SPP, but the differences between the two groups were small and not statistically significant at any measurement point. The mean total direct costs were 1791 euros in the SPP group, being 346 euros (16%) lower than those of the SFT group, but this difference was not statistically significant either. Also the incremental cost-effectiveness ratio points calculated by 500 bootstrap iterations favoured SPP. The total indirect costs in the SPP group were, in contrast to direct costs, higher than those in the SFT group, but, again, the difference was not statistically significant. The generalization of our results may be weakened by the fact that the patients included in our study were relatively young, and the follow-up period was restricted to one year. This study suggests that there are no notable differences in cost-effectiveness between SPP and SFT. If one were obliged to choose between these two therapies our results would support the choice of SPP. However, more research with extensive data about both costs and effectiveness, compiled over a period longer than one year, are needed before any firm conclusions can be drawn about the cost-effectiveness of the two therapies compared in this study.",22611089,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.541403770446777,-4.428898811340332,CtSQ
"Sudden gains in the treatment of depression in a partial hospitalization program.

This study examines sudden gains (SGs), or rapid improvements in symptoms, among adults in treatment for depression in a partial hospitalization program (PHP). This study identifies the proportion of people who experience SGs in a PHP, when SGs occur in treatment, and the association of SGs with outcomes at the end of treatment. The sample included 664 adults consecutively admitted to a PHP program for treatment of depression. Patients were administered the 24-item Behavior and Symptom Identification Scale and the short form of the Quality of Life Enjoyment and Satisfaction Questionnaire. We conducted t tests, multiple regressions, and generalized estimating equations (GEE). Over 40% of the sample experienced SGs, and most of those who experienced SGs did so by the 2nd week of treatment. SGs were associated with significantly greater improvement in depression and quality of life scores at the end of treatment. Results of the GEE indicate that although depression scores significantly decreased for the entire sample, the SG group improved to a greater degree than the group without SGs. The proportion of SGs among people in a PHP is similar to proportions found in traditional outpatient psychotherapy, suggesting that a subset of people receiving psychotherapy may be predisposed to SGs. The timing of SGs in a PHP suggests that SGs are associated with the dose of treatment received. Future research should focus on identifying people predisposed to SGs, as well as the mechanisms by which SGs occur.",21381809,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.247980117797852,-2.8451876640319824,C/Fa
"The effects on depression of Internet-administered behavioural activation and physical exercise with treatment rationale and relapse prevention: study protocol for a randomised controlled trial.

Despite their potential as low-threshold, low-cost and high-flexibility treatments of depression, behavioural activation and physical exercise have not yet been directly compared. This study will examine the effects of these interventions, administered via the Internet. The added effect of providing a treatment rationale will also be studied, as well as a relapse prevention program featuring cognitive behavioural therapy components. This randomised controlled trial will include 500 participants meeting the diagnostic criteria for major depression, recruited in multiple cycles and randomised to either a waiting list control group with delayed treatment, or one of the four treatment groups: (1) physical exercise without a clear treatment rationale; (2) physical exercise with treatment rationale; (3) behavioural activation with treatment rationale; or (4) behavioural activation without a clear treatment rationale. Post treatment, half of the participants will be offered a relapse prevention program. Primary outcome measure will be the Patient Health Questionnaire 9-item. Secondary measures include diagnostic criteria for depression, as well as self-reported anxiety, physical activity and quality of life. Measurements - done via telephone and the Internet - will be collected pre-treatment, weekly during treatment period, immediately post treatment and then monthly during a 24-month follow-up period. The results of this study will constitute an important contribution to the body of knowledge of the respective interventions. Limitations are discussed. ClinicalTrials.gov: NCT01619930.",23374879,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.64350700378418,-2.076627731323242,Cidf
"Could Treatment Matching Patients' Beliefs About Depression Improve Outcomes?

Patients' beliefs about depression and expectations for treatment can influence outcomes of major depressive disorder (MDD) treatments. We hypothesized that patients with weaker biological beliefs (less endorsement of [a] biochemical causes and [b] need for medication) and more optimistic treatment expectations (greater improvement and shorter time to improvement), have better outcomes in cognitive therapy (CT). Outpatients with recurrent MDD who received acute-phase CT (N = 152), and a subset of partial or unstable responders (N = 51) randomized to 8 months of continuation CT or fluoxetine with clinical management, completed repeated measures of beliefs, expectations, and depression. As hypothesized, patients with weaker biological beliefs about depression, and patients who expected a shorter time to improvement, experienced greater change in depressive symptoms and more frequent response to acute-phase CT. Moreover, responders who received continuation treatment better matched to their biological beliefs (i.e., responders with weaker biological beliefs about depression who received continuation CT, or responders with stronger biological beliefs about depression who received continuation fluoxetine) had fewer depressive symptoms and less relapse/recurrence by 32 months after acute-phase CT than did responders who received mismatched continuation treatment. Specific screening and/or intervention targeting patients' biological beliefs about depression could increase CT efficacy.",31208686,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.681142807006836,-1.3624317646026611,A42B
"Short-term effects of a web-based guided self-help intervention for employees with depressive symptoms: randomized controlled trial.

Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms before sick leave via the Internet could be beneficial and cost saving. In this study, we developed and tested the effectiveness of a Web-based guided self-help course for employees with depressive symptoms. We report on the posttreatment effectiveness of the intervention. This study is a two-arm randomized controlled trial comparing a Web-based guided self-help course to care as usual (CAU). We recruited employees from 6 different companies via the companies' intranet and posters. The main inclusion criterion was elevated depressive symptoms as measured by a score of ≥16 on the Center for Epidemiological Studies Depression scale (CES-D). The intervention (Happy@Work) was based on problem-solving treatment and cognitive therapy and consisted of 6 weekly lessons. Participants were asked to submit their weekly assignment via the website after completion. They subsequently received feedback from a coach via the website. Self-report questionnaires on depressive symptoms (CES-D; primary outcome), anxiety measured by the Hospital Anxiety and Depression Scale (HADS), burnout measured by the Maslach Burnout Inventory (MBI), and work performance measured by the Health and Work Performance Questionnaire (HPQ; secondary outcomes) were completed at baseline and at posttreatment. A total of 231 employees were randomized to either the intervention group (n=116) or CAU (n=115).The posttreatment assessment was completed by 171 (74.0%) participants. Both the intervention and the CAU group showed significant improvements in the primary outcome of depressive symptoms, but no differences between the conditions was found (d=0.16, 95% CI -0.10 to 0.41, P=.29). Significant but small effects in favor of the intervention group were found for anxiety symptoms (d=0.16, 95% CI -0.09 to 0.42, P=.04) and exhaustion (d=0.17, 95% CI -0.09 to 0.43, P=.02). This study showed that a Web-based guided self-help course for employees with depressive symptoms was not more effective in reducing depressive symptoms among employees than CAU. Large improvements in depressive symptoms in the CAU group were unforeseen and potential explanations are discussed.",24800966,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.19127082824707,-4.306539058685303,COZd
"Does group cognitive-behavioral therapy module type moderate depression symptom changes in substance abuse treatment clients?

Little is known about the effect of group therapy treatment modules on symptom change during treatment and on outcomes post-treatment. Secondary analyses of depressive symptoms collected from two group therapy studies conducted in substance use treatment settings were examined (n=132 and n=44). Change in PHQ-9 scores was modeled using longitudinal growth modeling combined with random effects modeling of session effects, with time-in-treatment interacted with module theme to test moderation. In both studies, depressive symptoms significantly decreased during the active treatment phase. Symptom reductions were not significantly moderated by module theme in the larger study. However, the smaller pilot study's results suggest that future examination of module effects is warranted, given the data are compatible with differential reductions in reported symptoms being associated with attending people-themed module sessions versus thoughts-themed sessions.",24657006,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,11.177996635437012,-2.716388702392578,CQbU
"Efficacy of guided internet-assisted intervention on depression reduction among educational technology students of Nigerian universities.

The study's objective was to determine the efficacy of guided internet-assisted intervention (GIAI) on depression reduction among educational technology students of Nigerian universities. The design of the study was a 10-weeks group-randomized trial (GRT) which involved a pre-test, post-test, and follow-up assessment. A total of 192 educational technology students who were identified as having depression formed the sample of the study. Beck's Depression Inventory-II (BDI-II) was the measure used for data collection in the study. Data collected were analyzed using ANOVA with repeated measures. The initial assessment results showed that the participants in both treatment and usual-care control groups had depression. After 10-weeks participation in GIAI, the assessment results showed a significant reduction in depression among students in the treatment group when compared to those in the usual-care control group. The follow-up assessment indicated a further significant reduction in the depression among participants in the treatment group when compared to those in the usual-care control group. The authors concluded that GIAI was significantly effective in reducing depression among university students in the treatment group compared to those in the usual-care control group. Therefore, educational technologists, counselors, psychologists, health workers, and other social workers should adopt educational intervention using GIAI in helping university students undergo depression reduction.",32028389,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.931360244750977,-3.670017719268799,Atyl
"[Cognitive behavioral therapy and psychoanalysis : Effectiveness comparable in the depressive crisis ?]

Our study compares the efficacy of two therapeutic treatments, cognitive behavioral and psychoanalytic, on a depressed population hospitalized in the same institution. We recorded the degree of intensity and improvement of fifteen subjects in a depressive state followed by a psychologist trained in CBT, and recorded the same for fifteen subjects followed by a psychoanalytical psychologist, using the Montgomery-Asberg Depression Rating Scale (MADRS). Both the first and final follow-up scores were compared, and the difference between the two depression scores was calculated. At the same time, the degree of therapeutic alliance was measured using the therapeutic alliance scale, therapist version (WAI-T). The comparison of the MADRS averages and the point spread demonstrate a significant and equivalent reduction in the depressive crisis for both groups. The WAI-T scores and the comparison of the average to the overall score indicate a similar quality of alliance. These results suggest that the frame of reference is not the cornerstone of a psychotherapy's efficacy, but is rather based on the foundation of a good therapeutic alliance with benevolent neutrality, the maintenance of a good distance, the ability to maintain the frame, a sufficient management of anxiety in the face of suicidal thoughts, with a structuring implication towards the subject. This, associated with a more active relational dynamic on the part of the therapist, compared to the investment he would develop in other types of follow-ups. These results demonstrate that the collaboration between professionals using a different theoretical framework can contribute to obtaining attractive benefits for the subjects.",32958202,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.339861869812012,-3.014927864074707,AiNy
"Development, acceptability and efficacy of a standardized healthy lifestyle intervention in recurrent depression.

Research evidence on the effects of integrated multifaceted lifestyle interventions for depression is scanty. The aim of the present study is to report on the development, acceptability and efficacy of a standardized healthy lifestyle intervention, including exercise, eating habits, sleep hygiene and smoking cessation in preventing relapses. One hundred-sixty outpatients with recurrent unipolar depression or bipolar disorder were recruited after achieving full remission or recovery from the most recent depressive episode. Patients were randomized to 3-months of usual care or to an intervention aimed at promoting a healthy lifestyle (HLI), as an augmentation of pharmacological maintenance treatment. Usual care consisted of clinical management visits. At the end of the intervention, follow-up visits were scheduled at 3,6,9 and 12 months. During the intervention phase, 1 relapse occurred in the HLI group and 4 in the control group. Over the 12 months of follow-up, relapses were 5 in the HLI group and 16 in control group. Using an intent-to-treat approach, the overall percentage of relapses was 6/81 (7.4%) in the HLI group vs. 20/79 (25.3%) in the control group.. In a Kaplan-Meier survival analysis the risk of relapse was significantly lower in patients receiving the HLI intervention (log-rank test, p=0.003) over the 60 weeks of observation. The majority of patients assigned to HLI adhered to the program, and were highly motivated throughout the intervention. The retention rate was low because patients were recruited during the maintenance phase and the 1-year follow-up was relatively short to detect a long-term effect of HLI. The HLI program proved to be efficacious in preventing relapses. Given the absence of contraindications and its cost-effectiveness in routine practice, the use of HLI should be encouraged to promote the well-being of patients with recurrent depression.",26897454,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,9.951709747314453,-1.4531821012496948,BwwR
"Interpersonal psychotherapy for depression: a meta-analysis.

Interpersonal psychotherapy (IPT), a structured and time-limited therapy, has been studied in many controlled trials. Numerous practice guidelines have recommended IPT as a treatment of choice for unipolar depressive disorders. The authors conducted a meta-analysis to integrate research on the effects of IPT. The authors searched bibliographical databases for randomized controlled trials comparing IPT with no treatment, usual care, other psychological treatments, and pharmacotherapy as well as studies comparing combination treatment using pharmacotherapy and IPT. Maintenance studies were also included. Thirty-eight studies including 4,356 patients met all inclusion criteria. The overall effect size (Cohen's d) of the 16 studies that compared IPT and a control group was 0.63 (95% confidence interval [CI]=0.36 to 0.90), corresponding to a number needed to treat of 2.91. Ten studies comparing IPT and other psychological treatments showed a nonsignificant differential effect size of 0.04 (95% CI=-0.14 to 0.21; number needed to treat=45.45) favoring IPT. Pharmacotherapy (after removal of one outlier) was more effective than IPT (d=-0.19, 95% CI=-0.38 to -0.01; number needed to treat=9.43), and combination treatment was not more effective than IPT alone, although the paucity of studies precluded drawing definite conclusions. Combination maintenance treatment with pharmacotherapy and IPT was more effective in preventing relapse than pharmacotherapy alone (odds ratio=0.37; 95% CI=0.19 to 0.73; number needed to treat=7.63). There is no doubt that IPT efficaciously treats depression, both as an independent treatment and in combination with pharmacotherapy. IPT deserves its place in treatment guidelines as one of the most empirically validated treatments for depression.",21362740,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.616598129272461,-3.9155664443969727,C/Tz
"Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial.

This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales-21. Process outcomes included ACT- and RNT-related measures: general RNT, experiential avoidance, cognitive fusion, values, and generalized pliance. At the 1-month follow-up, linear mixed effects models showed that the intervention was efficacious in reducing emotional symptoms (d = 2.42, 95% confidence interval [1.64, 3.19]), with 94.12% of participants in the RNT-focused ACT condition showing clinically significant change in the Depression, Anxiety, and Stress Scales-21 total scores versus 9.09% in the WLC condition (70% vs. 8% in intention-to-treat analysis). The intervention effects were maintained at the 3-month follow-up. No adverse events were found. A very brief RNT-focused ACT intervention was highly effective in the treatment of depression and GAD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",31944806,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,7.663394927978516,-1.7178735733032227,Au3D
"THE LONG-TERM EFFICACY OF ACUTE-PHASE PSYCHOTHERAPY FOR DEPRESSION: A META-ANALYSIS OF RANDOMIZED TRIALS.

Understanding the effectiveness of treatment for depression in both the short term and long term is essential for clinical decision making. The present meta-analysis examined treatment effects on depression and quality of life in acute-phase psychotherapeutic interventions compared to no treatment control groups for adult depression at 6 months or longer postrandomization. A systematic literature search resulted in 44 randomized controlled trials with 6,096 participants. Acute-phase psychotherapy was compared to control groups at 6-month or longer postrandomization. Odds ratios of a positive outcome were calculated. Psychotherapy outperformed control groups at 6 months or longer postrandomization (OR = 1.92, 95% CI: 1.60-2.31, P < .001). Heterogeneity was moderate (I²: 65, 95% CI: 53-74, P < .001). However, effects significantly decreased with longer follow-up periods. Additionally, a small positive effect of psychotherapy was observed for quality of life, while similar effects were obtained in separate analyses of each type of psychotherapy, with the exception of nondirective supportive therapy. Studies that provided booster sessions had better treatment results compared with studies that did not provide any further sessions. Finally, we found that trials on psychotherapy aimed at major depressive disorder (MDD) had better outcomes than those that were aimed at elevated depressive symptoms. There is substantial evidence that acute-phase psychotherapy results in a better treatment effects on depression and quality of life in the long term for adult patients with depression.",27000501,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.391389846801758,-1.3509759902954102,BvVx
"Nonpharmacologic Versus Pharmacologic Treatment of Adult Patients With Major Depressive Disorder: A Clinical Practice Guideline From the American College of Physicians.

The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the comparative effectiveness of treatment with second-generation antidepressants versus nonpharmacologic treatments for major depressive disorder in adults. This guideline is based on a systematic review of published, English-language, randomized, controlled trials from 1990 through September 2015 identified using several databases and through hand searches of references of relevant studies. Interventions evaluated include psychotherapies, complementary and alternative medicines (including acupuncture, ω-3 fatty acids, S-adenosyl-L-methionine, St. John's wort [Hypericum perforatum]), exercise, and second-generation antidepressants. Evaluated outcomes included response, remission, functional capacity, quality of life, reduction of suicidality or hospitalizations, and harms. The target audience for this guideline includes all clinicians, and the target patient population includes adults with major depressive disorder. This guideline grades the evidence and recommendations using ACP's clinical practice guidelines grading system. ACP recommends that clinicians select between either cognitive behavioral therapy or second-generation antidepressants to treat patients with major depressive disorder after discussing treatment effects, adverse effect profiles, cost, accessibility, and preferences with the patient (Grade: strong recommendation, moderate-quality evidence).",26857948,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,9.049578666687012,-0.7703078389167786,BxVL
"Depression in chronic illness: does religion help?

This article examines the impact of depression on patients, reviews research on the the relationship between religious involvement and depression, and explores the potential role of religious cognitive-behavioral therapy (CBT) in the treatment of depression in chronic illness. A randomized clinical trial at Duke University is examining the effectiveness of religious CBT versus conventional secular CBT in the treatment of major depression in patints with chronic illness. A validated religious psychotherapy intervention may provide nurses new strategies for helping chronically ill patients with depression.",24592603,Major Depressive Disorder,Anxiety Treatment,Mental Health,1733,11.48661994934082,-3.579394578933716,CRYg
"Staging of unipolar depression: systematic review and discussion of clinical implications.

Staging has been increasingly used in unipolar depression since its introduction in the nineties. Several models are available, but their differential features and implications are not completely clear. We systematically reviewed: (a) staging models of longitudinal development of unipolar depression; (b) staging models of treatment-resistant unipolar depression; (c) their applications. MEDLINE, PsycINFO, EMBASE, and Web of Science were examined according to PRISMA guidelines from inception to December 2021. Search terms were: 'stage/staging', combined using the Boolean 'AND' operator with 'psychiatric disorder/mental disorder/depressive/mood disorder'. A total of 169 studies were identified for inclusion: 18 described staging models or applications, 151 described treatment-resistant staging models or applications. Staging models of longitudinal development were found to play a key role in formulating sequential treatment, with particular reference to the use of psychotherapy after pharmacotherapy. Staging methods based on treatment resistance played a crucial role in setting entry criteria for randomized clinical trials and neurobiological investigations. Staging is part of clinimetrics, the science of clinical measurements, and its role can be enhanced by its association with other clinimetric strategies, such as repeated assessments, organization of problematic areas, and evaluation of phenomena that may affect responsiveness. In research, it may allow to identify more homogeneous populations in terms of treatment history that may diminish the likelihood of spurious results in comparisons. In clinical practice, the use of staging in a clinimetric perspective allows clinicians to make full use of the information that is available for an individual patient at a specific time.",35655409,Major Depressive Disorder,Anxiety Treatment,Mental Health,19464,10.707414627075195,-0.8450438380241394,VzE
"Sudden gains in routine care cognitive behavioral therapy for depression: A replication with extensions.

Over the last decade, a substantial amount of findings have been reported on the association between sudden gains (large symptom improvements in a between-session interval) and treatment outcome. Accurate replications of previous findings are needed to tackle inconsistencies and to shed light on the clinical implications of sudden gains. This study investigates whether similar effects of sudden gains can be expected under routine care conditions, when the patients are comparable to those examined in the original study by Tang and DeRubeis (1999). Using propensity score matching (PSM), 462 patients treated with cognitive behavioral therapy (CBT) under routine conditions were matched stepwise to patients of the original study on sudden gains, a randomized controlled CBT trial (RCT). After the application of PSM, the effects of sudden gains on treatment outcome were similar to those found by Tang and DeRubeis (1999). The closer the match between the RCT and the naturalistic sample, the more similar the association between sudden gains and treatment outcome. Sudden gains seem to have a significant impact on recovery rates, even in treatments under routine care. Results suggest that one important aspect of replication success is to control for confounding baseline covariates.",27846418,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.08418083190918,-2.9404258728027344,Bku0
"Prevalence and risk factors for recurrence of depression five years after short term psychodynamic therapy.

Follow-up research concerning the efficacy of treatment for depression is scarce and varies widely in clinical and methodological terms. Aim was to conduct a five-year follow-up study of recurrence of depression after short supportive Psychodynamic Treatment (PDT) alone or in combination with pharmacotherapy. Patients who had been treated five years previously for major depressive disorder in a randomised control trial comparing short supportive PDT alone or in combination with pharmacotherapy, were traced. Patients who completed treatment were included. Recurrent episodes in the past five years were identified using CIDI. Severity of symptoms after five years was measured with the Hamilton Rating Scale for Depression and sub-scales Depression, Anxiety and Somatisation of the self-report Symptom Checklist 90. 52 (37%) patients of the original sample were localised. 42% had suffered from one or more recurrences during the follow-up period. There was no significant difference between the group who had received psychotherapy and the group who had received combined therapy during the acute phase. Young women and patients with more residual depressive symptoms and less somatic symptoms directly after treatment, were more at risk for recurrence. Relatively small study population. Furthermore it was not known if patients received other treatment during the follow-up period. The long-term efficacy of PDT (with or without antidepressants) seemed to be comparable with other psychotherapies for depression. But the high recurrence rate urges us to shift the focus of depression treatment to improving long-term outcome and to the prevention of recurrence, in particular for young women and patients with residual symptoms of depression.",21676466,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.834861755371094,-1.1977359056472778,C6/q
"Early telephone intervention for psychiatric outpatients starting antidepressant treatment.

The article addresses the hypothesis that early telephone intervention for psychiatric outpatients starting antidepressant treatment would increase compliance with pharmacological treatment and retention time in the study, and thus allow for a more favourable clinical outcome. The study focuses on 131 depressed outpatients who participated in a study aiming to obtain full remission. Patients who benefited from three early structured telephone interventions (n=81) were compared with participants who benefited from the usual care (n=50) with no clinical contact before the first clinical assessment at 2 weeks. The intervention proved to have no significant effect on treatment adherence, attrition rate, exclusion rate for adverse events or improvement of depression severity. It was nevertheless associated with increased retention time in the present study. These results suggest that motivational phone calls may reinforce adhesion in psychiatric patients and provide early opportunities to adapt treatment to individual needs. These results suggest that motivational phone calls may reinforce adhesion in psychiatric patients and provide early opportunities to adapt treatment to individual needs.",20166864,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,9.190302848815918,-4.081916332244873,DNrG
"Effectiveness of cognitive behavioural therapy augmentation in major depression treatment (ECAM study): study protocol for a randomised clinical trial.

Major depression is a serious mental disorder that causes substantial distress and impairment in individuals and places an enormous burden on society. Although antidepressant treatment is the most common therapy provided in routine practice, there is little evidence to guide second-line therapy for patients who have failed to respond to antidepressants. The aim of this paper is to describe the study protocol for a randomised controlled trial that measures the clinical effectiveness of cognitive behavioural therapy (CBT) as an augmentation strategy to treat patients with non-psychotic major depression identified as suboptimal responders to usual depression care. The current study is a 16-week assessor-blinded randomised, parallel-groups superiority trial with 12-month follow-up at an outpatient clinic as part of usual depression care. Patients aged 20-65years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Major Depressive Disorder who have experienced at least one failed trial of antidepressants as part of usual depression care, will be randomly assigned to receive CBT plus treatment as usual, or treatment as usual alone. The primary outcome is the change in clinician-rated 17-item GRID-Hamilton Depression Rating Scale (GRID-HAMD) score at 16weeks, and secondary outcomes include severity and change in scores of subjective depression symptoms, proportion of responders and remitters, safety and quality of life. The primary population will be the intention-to-treat patients. All protocols and the informed consent form comply with the Ethics Guideline for Clinical Research (Japanese Ministry of Health, Labour and Welfare). Ethics review committees at the Keio University School of Medicine and the Sakuragaoka Memorial Hospital approved the study protocol. The results of the study will be disseminated at several research conferences and as published articles in peer-reviewed journals. The study will be implemented and reported in line with the CONSORT statement. UMIN Clinical Trials Registry: UMIN000001218.",25335963,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.016969680786133,-2.775960683822632,CGxU
"Smartphone Cognitive Behavioral Therapy as an Adjunct to Pharmacotherapy for Refractory Depression: Randomized Controlled Trial.

In the treatment of major depression, antidepressants are effective but not curative. Cognitive behavioral therapy (CBT) is also effective, alone or in combination with pharmacotherapy, but accessibility is a problem. The aim is to evaluate the effectiveness of a smartphone CBT app as adjunctive therapy among patients with antidepressant-resistant major depression. A multisite, assessor-masked, parallel-group randomized controlled trial was conducted in 20 psychiatric clinics and hospitals in Japan. Participants were eligible if they had a primary diagnosis of major depression and were antidepressant-refractory after taking one or more antidepressants at an adequate dosage for four or more weeks. After a 1-week run-in in which participants started the medication switch and had access to the welcome session of the app, patients were randomized to medication switch alone or to medication switch plus smartphone CBT app via the centralized Web system. The smartphone app, called Kokoro-app (""kokoro"" means ""mind"" in Japanese), included sessions on self-monitoring, behavioral activation, and cognitive restructuring presented by cartoon characters. The primary outcome was depression severity as assessed by masked telephone assessors with the Patient Health Questionnaire-9 (PHQ-9) at week 9. The secondary outcomes included the Beck Depression Inventory-II (BDI-II) and Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER). In the total sample (N=164), 81 participants were allocated to the smartphone CBT in addition to medication change and 83 to medication change alone. In the former group, all but one participant (80/81, 99%) completed at least half, and 71 (88%) completed at least six of eight sessions. In the intention-to-treat analysis, patients allocated the CBT app scored 2.48 points (95% CI 1.23-3.72, P<.001; standardized mean difference 0.40) lower on PHQ-9 than the control at week 9. The former group also scored 4.1 points (95% CI 1.5-6.6, P=.002) lower on BDI-II and 0.76 points (95% CI -0.05 to 1.58, P=.07) lower on FIBSER. In the per-protocol sample (comfortable with the smartphone app, still symptomatic, and adherent to medication with mild or less side effects after run-in), the intervention group (n=60) scored 1.72 points (95% CI 0.25-3.18, P=.02) lower on PHQ-9, 3.2 points (95% CI -0.01 to 6.3, P=.05) lower on BDI-II, and 0.75 points (95% CI 0.03-1.47, P=.04) lower on FIBSER than the control (n=57). The treatment benefits were maintained up to week 17. This is the first study to demonstrate the effectiveness of a smartphone CBT in the treatment of clinically diagnosed depression. Given the merits of the mobile mental health intervention, including accessibility, affordability, quality control, and effectiveness, it is clinically worthwhile to consider adjunctive use of a smartphone CBT app when treating patients with antidepressant-resistant depression. Research into its effectiveness in wider clinical contexts is warranted. Japanese Clinical Trials Registry UMIN CTR 000013693; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ ctr_view.cgi?recptno=R000015984 (Archived by WebCite at http://www.webcitation.org/6u6pxVwik).",29101095,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.874766826629639,-5.727783203125,BUrz
"Pilot mixed-methods evaluation of interpersonal counselling for young people with depressive symptoms in non-specialist services.

The majority of young people receive treatment for depressive symptoms in the UK from staff with minimal specialist mental health/therapeutic training. There is no evidence to guide them as to what treatments are likely to be effective. Interpersonal counselling (IPC) is a reduced form of interpersonal psychotherapy and may be an appropriate treatment to use in this population. To test the effectiveness and acceptability of IPC delivered by youth workers to young people with primarily depressive symptoms. Youth workers received a 2-day training course in IPC, followed by regular supervision. They delivered IPC to 23 young people who they would normally see in their service, with depressive symptoms as their main problem. Symptoms were assessed by the Revised Child Depression and Anxiety Scale (RCADS). Qualitative interviews of youth workers and young people assessed acceptability. Mean (SD) RCADS depression-T scores fell from 78.2 (11.1) to 52.9 (16.8). All young people and youth workers interviewed were positive about it. Participants detailed specific advantages of IPC above standard counselling, including practical help, the use of goals, psychoeducation and integrating a self-rated questionnaire into treatment. IPC is likely to be an effective and acceptable treatment for young people with primarily depressive symptoms seen in local authority non-specialist mental health services. Further research is needed to determine if it is more effective than current treatment as usual.",30352883,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.338434219360352,-3.766035556793213,BEWB
"Efficacy of low-intensity psychological intervention applied by ICTs for the treatment of depression in primary care: a controlled trial.

Depression is one of the most common disorders in Psychiatric and Primary Care settings and is associated with significant disability and economic costs. Low-intensity psychological interventions applied by Information and Communication Technologies (ICTs) could be an efficacious and cost-effective therapeutic option for the treatment of depression. The aim of this study is to assess 3 low-intensity psychological interventions applied by ICTs (healthy lifestyle, positive affect and mindfulness) in Primary Care; significant efficacy for depression treatment has previously showed in specialized clinical settings by those interventions, but ICTs were not used. Multicenter controlled randomized clinical trial in 4 parallel groups. Interventions have been designed and on-line device adaptation has been carried out. Subsequently, the randomized controlled clinical trial will be conducted. A sample of N=240 mild and moderate depressed patients will be recruited and assessed in Primary Care settings. Patients will be randomly assigned to a) healthy lifestyle psychoeducational program+improved primary care usual treatment (ITAU), b) focused program on positive affect promotion+ITAU c) mindfulness+ITAU or d) ITAU. The intervention format will be one face to face session and four ICTs on-line modules. Patients will be diagnosed with MINI psychiatric interview. Main outcome will be PHQ-9 score. They will be also assessed by SF-12 Health Survey, Client Service Receipt Inventory, EuroQoL-5D questionnaire, Positive and Negative Affect Scale, Five Facet Mindfulness Questionnaire and the Pemberton Happiness Index. Patients will be assessed at baseline, post, 6 and 12 post-treatment months. An intention to treat and per protocol analysis will be performed. Low-intensity psychological interventions applied by Information and Communication Technologies have been not used before in Spain and could be an efficacious and cost-effective therapeutic option for depression treatment. The strength of the study is that it is the first multicenter controlled randomized clinical trial of three low intensity and self-guided interventions applied by ICTs (healthy lifestyle psychoeducational program; focused program on positive affect promotion and brief intervention based on mindfulness) in Primary Care settings. Current Controlled Trials ISRCTN82388279 . Registered 16 April 2014.",25948287,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.199535369873047,-2.897447109222412,B+Cv
"Use of Spirituality in the Treatment of Depression: Systematic Literature Review.

Spirituality has been gaining recognition as a potential treatment modality. Our paper aimed to provide a systematic overview of existing research examining the use of spirituality as a treatment method for depression. All articles published between 2000 and 2018 that scientifically evaluated therapeutic interventions with elements of spirituality were included in the review. Ten studies met the inclusion criteria. Their analysis showed that there were elements of spirituality-based treatments that were repeatedly mentioned, including gratitude, forgiveness, self-acceptance, and compassion. Most often, spirituality was used together with psychotherapy. The review also noted the emergence of digital interventions.",35226252,Major Depressive Disorder,Anxiety Treatment,Mental Health,1733,11.864981651306152,-5.092764377593994,lB8
"Using intervention mapping to deconstruct cognitive work hardening: a return-to-work intervention for people with depression.

Mental health related work disability leaves are increasing at alarming rates with depression emerging as the most common mental disorder in the workforce. Treatments are available to alleviate depressive symptoms and associated functional impacts; however, they are not specifically aimed at preparing people to return to work. Cognitive work hardening (CWH) is a novel intervention that addresses this gap in the health care system. This paper presents a theoretical analysis of the components and underlying mechanisms of CWH using Intervention Mapping (IM) as a tool to deconstruct its elements. The cognitive sequelae of depression and their relevance to return-to-work (RTW) are examined together with interpersonal skills and other work-related competencies that affect work ability. IM, a tool typically used to create programs, is used to deconstruct an existing program, namely CWH, into its component parts and link them to theories and models in the literature. CWH has been deconstructed into intervention elements which are linked to program performance objectives through underlying theoretical models. In this way, linkages are made between tools and materials of the intervention and the overall program objective of 'successful RTW for people with depression'. An empirical study of the efficacy of CWH is currently underway which should provide added insight and understanding into this intervention. The application of IM to CWH illustrates the theoretical underpinnings of the treatment intervention and assists with better understanding the linkage between intervention elements and intervention objective. Applying IM to deconstruct an existing program (rather than create a program) presents an alternate application of the IM tool which can have implications for other programs in terms of enhancing understanding, grounding in theoretical foundations, communicating program design, and establishing a basis for program evaluation and improvement.",25496395,Major Depressive Disorder,Anxiety Treatment,Mental Health,2307,8.838699340820312,-4.820727348327637,CEg0
"Computer-based psychological treatments for depression: a systematic review and meta-analysis.

The aim of the paper was to systematically review the literature on computer-based psychological treatments for depression and conduct a meta-analysis of the RCT studies, including examining variables which may effect outcomes. Database and hand searches were made using specific search terms and inclusion criteria. The review included a total of 40 studies (45 published papers), and 19 RCTs (23 published papers) were included in a standard meta-analysis. The review describes the different computer-based treatments for depression, their design, communication types employed: synchronous, asynchronous, and face-to-face (F:F); alongside various types and frequency of support delivered. The evidence supports their effectiveness and highlights participant satisfaction. However, pertinent limitations are noted. Across 19 studies the meta-analysis revealed a moderate post-treatment pooled effect size d=.56 (95% confidence interval [CI] -.71, -.41), Z=7.48, p<.001). Supported interventions yielded better outcomes, along with greater retention. The results reported statistically significant clinical improvement and recovery post-treatment. The review and meta-analysis support the efficacy and effectiveness of computer-based psychological treatments for depression, in diverse settings and with different populations. Further research is needed, in particular to investigate the influence of therapist factors in supported treatments, the reasons for dropout, and the maintenance of gains post-treatment.",22466510,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.472199440002441,-3.1143155097961426,CvTF
"Psychological interventions for depression in Chinese university students: A systematic review and meta-analysis.

University students in China are vulnerable to depression with a high estimated prevalence. It is currently unknown which types of psychological interventions are being delivered to treat depression in this population and whether they are effective. Therefore, a systematic review was conducted to address this issue. We searched records in English and Chinese databases up to January 2019. From 2,739 records, we identified 39 randomized controlled trails (RCTs) and 54 non-RCTs. A range of psychological interventions were identified including cognitive behaviour therapy, interpersonal therapy, and local interventions. Hedge's g pooled effect size of 23 comparisons from 21 RCTs (N =858) compared to a control group (N = 802) was 1.08 (95% CI: 0.72 to 1.45). Heterogeneity was moderate with I2 = 47 (95%CI: 14 to 68). Type of control group was significantly associated with the effect size (p =0.039). Comparisons between the intervention condition and the 'no intervention' condition yielded a higher effect size (Hedges' g =1.38, 95% CI: 0.89 to 1.87) than comparisons between the intervention condition and the 'usual care/control' condition (Hedges' g = 0.56, 95% CI 0.08 to 1.05). No other significant differences based on the study characteristics were observed. Publication bias and quality of inclusions. Collectively, there is evidence that psychological interventions for depression in Chinese university students are effective as compared to control groups, although the effects merit further examination by research of higher quality. Innovations in treatment delivery could facilitate wider dissemination of evidence-based interventions.",31744736,Major Depressive Disorder,Anxiety Treatment,Mental Health,17119,11.061864852905273,-3.928778648376465,Axl+
"Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment.

Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Interpersonal therapy compared with usual care reduced posttreatment major depressive disorder scores (standardized mean difference [SMD]: 0.24, 95% confidence interval [CI]: -0.47 to -0.02) and reduced relapse/recurrence in patients with major depressive disorder (relative risk [RR]: 0.41, 95% CI: 0.27-0.63). Supportive therapy compared with usual care improved major depressive disorder scores (SMD: 0.58, 95% CI: 0.45-0.72) and increased posttreatment recovery (odds ratio [OR]: 2.71, 95% CI: 1.19-6.16) in patients with major depressive disorder. CBT compared with usual care increased response (OR: 1.58, 95% CI: 1.11-2.26) and recovery (OR: 3.42, 95% CI: 1.98-5.93) in patients with major depressive disorder and decreased relapse/recurrence (RR: 0.68, 95% CI: 0.65-0.87]). For patients with generalized anxiety disorder, CBT improved symptoms posttreatment (SMD: 0.80, 95% CI: 0.67-0.93), improved clinical response posttreatment (RR: 0.64, 95% CI: 0.55-0.74), and improved quality-of-life scores (SMD: 0.44, 95% CI: 0.06-0.82). There was a significant difference in posttreatment recovery (OR: 1.98, 95% CI: 1.11-3.54) and mean major depressive disorder symptom scores (weighted mean difference: -3.07, 95% CI: -4.69 to -1.45) for patients who received individual versus group CBT. Details about the providers of psychotherapy were rarely reported in the systematic reviews we examined.In the base case probabilistic cost-utility analysis, compared with usual care, both group and individual CBT were associated with increased survival: 0.11 quality-adjusted life-years (QALYs) (95% credible interval [CrI]: 0.03-0.22) and 0.12 QALYs (95% CrI: 0.03-0.25), respectively.Group CBT provided by nonphysicians was associated with the smallest increase in discounted costs: $401 (95% CrI: $1,177 to 1,665). Group CBT provided by physicians, individual CBT provided by nonphysicians, and individual CBT provided by physicians were associated with the incremental costs of $1,805 (95% CrI: 65-3,516), $3,168 (95% CrI: 889-5,624), and $5,311 (95% CrI: 2,539-8,938), respectively. The corresponding incremental cost-effectiveness ratio (ICER) was lowest for group CBT provided by nonphysicians ($3,715/QALY gained) and highest for individual CBT provided by physicians ($43,443/QALY gained). In the analysis that ranked best strategies, individual CBT versus group CBT provided by nonphysicians yielded an ICER of $192,618 per QALY. The probability of group CBT provided by nonphysicians being cost-effective versus usual care was greater than 95% for all willingness-to-pay thresholds over $20,000 per QALY and was around 88% for individual CBT provided by physicians at a threshold of $100,000 per QALY.We estimated that adding structured psychotherapy to usual care over the next 5 years would result in a net budget impact of $68 million to $529 million, depending on a range of factors. We also estimated that to provide structured psychotherapy to all adults with major depressive disorder (alone or combined with generalized anxiety disorder) in Ontario by 2021, an estimated 500 therapists would be needed to provide group therapy, and 2,934 therapists would be needed to provide individual therapy.People with major depressive disorder and/or generalized anxiety disorder with whom we spoke reported finding psychotherapy effective, but they also reported experiencing a large number of barriers that prevented them from finding effective psychotherapy in a timely manner. Participants reported wanting more freedom to choose the type of psychotherapy they received. Compared with usual care, treatment with CBT, interpersonal therapy, or supportive therapy significantly reduces depression symptoms posttreatment. CBT significantly reduces anxiety symptoms posttreatment in patients with generalized anxiety disorder.Compared with usual care, treatment with structured psychotherapy (CBT or interpersonal therapy) represents good value for money for adults with major depressive disorder and/or generalized anxiety disorder. The most affordable option is group structured psychotherapy provided by nonphysicians, with the selective use of individual structured psychotherapy provided by nonphysicians or physicians for those who would benefit most from it (i.e., patients who are not engaging well with or adhering to group therapy).",29213344,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.012815475463867,-2.362434148788452,BTGC
"The efficacy of short-term psychodynamic psychotherapy for depressive disorders with comorbid personality disorder.

The presence of comorbid personality disorder (PD) is one of the factors that can make the treatment of depression unsuccessful. Short-term Psychodynamic Psychotherapy (STPP) has been shown efficacious in the treatment of personality and depressive disorders (DD). However, the efficacy of STPP for comorbid DD and PD has not been systematically evaluated. In this study, data from patients meeting criteria for both DD and PD participating from randomized controlled trials of STPP was collected, systematically reviewed, and meta-analyzed where possible. Eight studies were included, 6 with major depression and 2 with minor depressive disorders. Pre- to post- treatment effects sizes were large (d = 1.00-1.27), suggesting symptom improvement during STPP, and these gains were maintained in follow-ups averaging over 1.5 years. For major depression, no differences were found comparing STPP to other psychotherapies, and STPP was found superior to a wait-list condition in one study. STPP may have had an advantage over other therapy controls in treating minor depression as noted in ratings of general psychopathology. Patients with Cluster A/B and C PD were responsive to STPP, with the majority of all studied patients showing clinically significant change on self-report measures. Within the limits of this study, these findings suggest that STPP warrants consideration as a first line treatment for combined personality disorder and depression. Future research directions are proposed.",21463171,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.329564094543457,-4.0940842628479,C93h
"Effects of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder: a systematic review of randomized clinical trials with meta-analyses and trial sequential analyses.

Major depressive disorder afflicts an estimated 17% of individuals during their lifetime at tremendous suffering and cost. Cognitive therapy and interpersonal psychotherapy are treatment options, but their effects have only been limitedly compared in systematic reviews. Using Cochrane systematic review methodology we compared the benefits and harm of cognitive therapy versus interpersonal psychotherapy for major depressive disorder. Trials were identified by searching the Cochrane Library's CENTRAL, Medline via PubMed, EMBASE, Psychlit, PsycInfo, and Science Citation Index Expanded until February 2010. Continuous outcome measures were assessed by mean difference and dichotomous outcomes by odds ratio. We conducted trial sequential analysis to control for random errors. We included seven trials randomizing 741 participants. All trials had high risk of bias. Meta-analysis of the four trials reporting data at cessation of treatment on the Hamilton Rating Scale for Depression showed no significant difference between the two interventions [mean difference -1.02, 95% confidence interval (CI) -2.35 to 0.32]. Meta-analysis of the five trials reporting data at cessation of treatment on the Beck Depression Inventory showed comparable results (mean difference -1.29, 95% CI -2.73 to 0.14). Trial sequential analysis indicated that more data are needed to definitively settle the question of a differential effect. None of the included trial reported on adverse events. Randomized trials with low risk of bias and low risk of random errors are needed, although the effects of cognitive therapy and interpersonal psychotherapy do not seem to differ significantly regarding depressive symptoms. Future trials should report on adverse events.",22051174,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.21802043914795,-2.7358477115631104,C1aP
"Effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression: A systematic review of systematic reviews and meta-analyses.

To determine the effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression. Systematic review of systematic reviews and meta-analyses (SR/MA). We searched PubMed, PsycINFO, Cochrane Database of Systematic Reviews, OpenGrey, and PROSPERO from their inception until February 2014. Two reviewers independently evaluated the eligibility criteria of all SR/MA, abstracted data, and determined bias risk (AMSTAR). Twelve SR/MA (156 non-repeated trials and 56,158 participants) were included. Of these, 142 (91%) were randomized-controlled, 13 (8.3%) controlled trials, and 1 (0.6%) had no control group. Five SR/MA focused on children and adolescents, four on specific populations (women after childbirth, of low socioeconomic status, or unfavorable circumstances; patients with severe traumatic physical injuries or stroke) and three addressed the general population. Nine (75%) SR/MA concluded that interventions to prevent depression were effective. Of the 156 trials, 137 (87.8%) reported some kind of effect size calculation. Effect sizes were small in 45 (32.8%), medium in 26 (19.1%), and large in 25 (18.2%) trials; 41 (29.9%) trials were not effective. Of the 141 trials for which follow-up periods were available, only 34 (24.1%) exceeded 12 months. Psychological and/or educational interventions to prevent onset of episodes of depression were effective, although most had small or medium effect sizes.",25445331,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.748042106628418,-3.4167263507843018,CFU4
"The effects of psychotherapy for adult depression on suicidality and hopelessness: a systematic review and meta-analysis.

Although treatment guidelines suggest that suicidal patients with depression should be treated for depression with psychotherapy, it is not clear whether these psychological treatments actually reduce suicidal ideation or suicide risk. We conducted a systematic review and meta-analysis of studies on psychotherapy for depression in which outcomes on suicidality were reported. We also focused on outcomes on hopelessness because this is strongly associated with suicidal behavior in depression. Thirteen studies (with 616 patients) were included, three of which examined the effects of psychotherapy for depression on suicidal ideation and suicide risk, and eleven on hopelessness. No studies were found with suicide attempts or completed suicides as the outcome variables. The effects on suicidal ideation and suicide risk were small (g=0.12; 95% CI: -0.20-0.44) and not statistically significant. A power calculation showed that these studies only had sufficient power to find an effect size of g=0.47. The effects on hopelessness were large (g=1.10; 95% CI: 0.72-1.48) and significant, although heterogeneity was very high. Furthermore, significant publication bias was found. After adjustment of publication bias the effect size was reduced to g=0.60. At this point, there is insufficient evidence for the assumption that suicidality in depressed patients can be reduced with psychotherapy for depression. Although psychotherapy of depression may have small positive effects on suicidality, available data suggest that psychotherapy for depression cannot be considered to be a sufficient treatment. The effects on hopelessness are probably higher.",22832172,Major Depressive Disorder,Anxiety Treatment,Mental Health,93,10.681838035583496,-2.615971326828003,CqXN
"Clinical effectiveness of cognitive therapy v. interpersonal psychotherapy for depression: results of a randomized controlled trial.

Although both cognitive therapy (CT) and interpersonal psychotherapy (IPT) have been shown to be effective treatments for major depressive disorder (MDD), it is not clear yet whether one therapy outperforms the other with regard to severity and course of the disorder. This study examined the clinical effectiveness of CT v. IPT in a large sample of depressed patients seeking treatment in a Dutch outpatient mental health clinic. We tested whether one of the treatments was superior to the other at post-treatment and at 5 months follow-up. Furthermore, we tested whether active treatment was superior to no treatment. We also assessed whether initial depression severity moderated the effect of time and condition and tested for therapist differences. Depressed adults (n = 182) were randomized to either CT (n = 76), IPT (n = 75) or a 2-month waiting list control (WLC) condition (n = 31). Main outcome was depression severity, measured with the Beck Depression Inventory - II (BDI-II), assessed at baseline, 2, 3, and 7 months (treatment phase) and monthly up to 5 months follow-up (8-12 months). No differential effects between CT and IPT were found. Both treatments exceeded response in the WLC condition, and led to considerable improvement in depression severity that was sustained up to 1 year. Baseline depression severity did not moderate the effect of time and condition. Within our power and time ranges, CT and IPT appeared not to differ in the treatment of depression in the acute phase and beyond.",25640151,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.516918182373047,-3.1259984970092773,CCe3
"A Psychoanalytic-Derived Brief Psychotherapeutic Approach in the Treatment of Major Depression: Monotherapy Studies.

Over the years, short term psychodynamic therapy (STPP) has been broadly researched in order to evaluate its efficacy in the treatment of major psychiatric disorders. In particular, a consistent number of studies focused on assessing clinical outcomes of the principal psychodynamic techniques in treating depressive disorders. We conducted a narrative review in which we aimed to evaluate the efficacy of STPP in monotherapy in major depressive disorder and to assess possible features that may correlate with its clinical use. Databases searched were PubMed, Ovid, Scopus, PsycINFO and Cochrane Libraries from inception to July 2022. Our research underlined that STPP in monotherapy is particularly effective in moderately severe depression and in preventing depressive relapses. Moreover, a case-by-case evaluation of its efficacy should be performed when considering STPP for the treatment of major depression with other comorbid psychiatric conditions. Although such key points emerged from scientific evidence, STPP should be better studied in the long-term perspective; further research is needed to define the clinical scenarios in which STPP can be considered a first-line approach as monotherapy in major depressive disorder compared to medications or other types of psychotherapy.",36295496,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.13991641998291,-3.878584861755371,C5k
"Performance improvement CME: algorithms and EMRs in depression.

Major depressive disorder is difficult to treat due to its chronic and recurrent nature and the poor performance of most pharmacologic treatment options. To improve patient outcomes, clinicians should become familiar with moderators of antidepressant response, implement measurement-based care, and follow treatment algorithms. The use of electronic medical records and computerized decision support systems may improve documentation and facilitate clinicians' adherence to current standards of care. This Performance Improvement activity focuses on improving treatment outcomes for antidepressant therapy through familiarity with moderators of antidepressant response and the use of treatment algorithms, measurement-based care, and electronic medical records.",21951991,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.315086364746094,-1.6057535409927368,C28W
"Using the Personalized Advantage Index for individual treatment allocation to cognitive behavioral therapy (CBT) or a CBT with integrated exposure and emotion-focused elements (CBT-EE).

Even though different psychotherapeutic interventions for depression have shown to be effective, patients suffering from depression vary substantially in their treatment response. The goal of this study was to answer the following research questions: (1) What are the most important predictors determining optimal treatment allocation to cognitive behavioral therapy (CBT) or CBT with integrated exposure and emotion-focused elements (CBT-EE)?, and (2) Would model-determined treatment allocation using this predictive information result in better treatment outcomes? Bayesian Model Averaging (BMA) was applied to the data of a randomized controlled trial comparing the efficacy of CBT and CBT-EE in depressive outpatients. Predictions were made for every patient for both treatment conditions and an optimal versus a suboptimal treatment was identified in each case. An index comparing the two estimates, the Personalized Advantage Index (PAI), was calculated. Different predictors were found for both conditions. A PAI of 1.35 BDI-II points for the two conditions was found and 46% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Although the utility of the PAI approach must be further confirmed in prospective research, the present study study promotes the identification of specific interventions favorable for specific patients.",31507250,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.156702041625977,-2.3826897144317627,A00L
"Suicidal ideation and other persisting symptoms after CBT or antidepressant medication treatment for major depressive disorder.

Persisting symptoms after treatment for major depressive disorder (MDD) contribute to ongoing impairment and relapse risk. Whether cognitive behavior therapy (CBT) or antidepressant medications result in different profiles of residual symptoms after treatment is largely unknown. Three hundred fifteen adults with MDD randomized to treatment with either CBT or antidepressant medication in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study were analyzed for the frequency of residual symptoms using the Montgomery Asberg Depression Rating Scale (MADRS) item scores at the end of the 12-week treatment period. Separate comparisons were made for treatment responders and non-responders. Among treatment completers (n = 250) who responded to CBT or antidepressant medication, there were no significant differences in the persistence of residual MADRS symptoms. However, non-responders treated with medication were significantly less likely to endorse suicidal ideation (SI) at week 12 compared with those treated with CBT (non-responders to medication: 0/54, 0%, non-responders to CBT: 8/30, 26.7%; p = .001). Among patients who terminated the trial early (n = 65), residual MADRS item scores did not significantly differ between the CBT- and medication-treated groups. Depressed adults who respond to CBT or antidepressant medication have similar residual symptom profiles. Antidepressant medications reduce SI, even among patients for whom the medication provides little overall benefit.",30207254,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.844816207885742,-1.1991360187530518,BGSL
"Review: computerised CBT improves adult depression in the short-term, but its effect may have been overestimated previously.

",23939679,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.732236862182617,-2.4186434745788574,CaFY
"Canadian Network for Mood and Anxiety Treatments (CANMAT) consensus recommendations for functional outcomes in major depressive disorder.

Functional recovery is increasingly recognized as a priority in the treatment of major depressive disorder (MDD), by both clinicians and patients. However, symptom improvement remains the focus of traditional clinical trials for MDD and of the regulatory approval process for new medications and other interventions. Many studies have shown that functional outcomes do not always correspond to symptom-based outcomes. Representatives from clinical practice, professional societies, academia, industry, and government were invited by the Canadian Network for Mood and Anxiety Treatments to develop recommendations for the conceptualization and measurement of functional outcomes in clinical trials of MDD. Definitions and conceptual frameworks to guide assessment of functioning are described, as well as research methodology applicable to the broad spectrum of treatments for MDD. Examples are given for validated instruments, including patient-reported outcome measures. Strategies for knowledge translation and dissemination are suggested and consensus recommendations summarized. As the societal burden and financial costs of MDD continue to escalate, so does the need for evidence-based and cost-effective interventions that demonstrate improvement in functioning. Routine assessment of functional outcomes will benefit not only individuals with MDD but also diverse stakeholders concerned about the efficacy and cost-effectiveness of interventions.",25954941,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.145587921142578,-0.89486163854599,B9+N
"Interpersonal psychotherapy for Finnish community patients with moderate to severe major depression and comorbidities: a pilot feasibility study.

Interpersonal psychotherapy (IPT) has shown efficacy in randomized controlled trials. No reports exist on IPT for depressed patients with severe psychiatric comorbidities in public outpatient clinics. This pilot feasibility study assessed preliminary effectiveness and patient satisfaction with IPT for depressed patients with psychiatric comorbidities in municipal outpatient care in Turku, Finland. Because lengthy treatment strains mental healthcare resources, this trial also assessed the potential for IPT, a time-limited treatment, to discharge patients successfully. Seven clinicians in two municipal clinics were briefly trained to deliver IPT, while clinicians in two other clinics provided treatment as usual (TAU). Twenty-six patients with moderate to severe major depressive disorder received IPT for 16 weeks, and a control group (n = 20) received TAU. Seventy-six percent of patients had concurrent anxiety disorders, 73% personality disorders and 20% alcohol dependence. As 61% of patients received concurrent pharmacotherapy, the study lacked statistical power to find outcome differences between treatment groups. Depressive symptoms, social functioning and self-perceived health improved notably in both groups. The mean Hamilton Depression Rating Scale (HAMD) score decreased from 20 to 10. Using HAMD ≤ 7 as a cutoff, 28.3% of patients achieved remission. Patients receiving IPT reported significantly greater satisfaction with their treatment and were more often able to terminate treatment after 16 sessions. Both treatments were effective in this small, highly comorbid sample. Conducting IPT appeared feasible in municipal outpatient clinics and offered some advantages over TAU. It was possible to train staff quickly. These results warrant a further, larger randomized trial.",21417681,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.568242073059082,-3.532329559326172,C+kZ
"Psychological treatment of depression: results of a series of meta-analyses.

In the past few decades, a considerable number of studies have examined the effects of psychotherapies for adult depression. We described the results of a series of meta-analyses examining what this large body of research has contributed to our knowledge of these treatments of depression. We found that different types of psychotherapy are efficacious in the treatment of adult depression, including cognitive behavior therapy, interpersonal psychotherapy, problem-solving therapy, non-directive supportive therapy and behavioral activation therapy. Differences between types of psychotherapy are small. The efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of pharmacotherapy, and that combined treatment is more effective than psychotherapy alone and pharmacotherapy alone. Psychotherapy is not only effective in depressed adults in general, but also in older adults, women with postpartum depression, patients with general medical disorders, in inpatients, in primary care patients, patients with chronic depression and in subthreshold depression. We found no evidence showing that psychotherapy is less efficacious in severe depression (with mean baseline Hamilton Depression Rating Scale scores up to 31, mean Beck Depression Inventory scores up to 35.85 and mean Beck Depression Inventory-II scores up to 36.50), but effects are smaller in chronic depression. We also found that the effects of psychotherapy are probably overestimated because of publication bias and the relatively low quality of many studies in the field.",21770842,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.76612663269043,-2.557671308517456,C5px
"Computer-delivered behavioural activation and approach-avoidance training in major depression: Proof of concept and initial outcomes.

Individuals with major depressive disorder (MDD) have problems with engaging in approach behaviour to potentially rewarding encounters, which contributes to the maintenance of depressive symptoms. Approach-avoidance training (AAT) retrains implicit approach tendencies, and behavioural activation (BA) promotes explicit approach behaviour in MDD. As a novel MDD treatment strategy, this study aimed to implement a brief, computerized version of BA integrated with implicit AAT. Adults with a principal diagnosis of MDD (N = 25) were randomly assigned to complete one of two versions of AAT - approach-positive faces (n = 12) or balanced approach of positive and neutral faces (n = 13) - concurrently with self-guided BA twice weekly for 2 weeks. Outcomes included treatment completion rates; bias scores for automatic approach towards positive social cues; and symptom scales for depression, positive affect, social relationship functioning, anhedonia, and anxiety. Feasibility and acceptability of computerized BA + AAT were supported by moderate pre-treatment credibility and expectancy ratings and 80% treatment completion. Participants across both conditions displayed significant and large sized reductions in depression from pre- to post-assessment (Cohen's d = -1.23) that maintained three months later, as well as decreased anxiety and anhedonia and increased positive affect and social relationship functioning (medium to large effects). Results support the feasibility and potential efficacy of brief, computerized BA + AAT. Research is needed to determine whether AAT is additive to BA, and what AAT parameters best enhance treatment outcomes. Brief, computerized behavioral activation plus approach/avoidance training (BA + AAT) may be acceptable and beneficial for some patients with moderate-to-severe major depression. Computer-delivered BA + AAT can be implemented as a largely self-guided program for MDD and could be administered remotely and/or with minimal clinician interaction. As this was a small proof of concept study, it cannot be determined which treatment components - AAT, BA, or both - contributed to positive clinical outcomes. Because BA + AAT was implemented in a research clinic, it remains unknown what treatment engagement and response would look like in community settings.",33772806,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.568586349487305,-1.9601136445999146,AYvm
"Two forms of group therapy and individual treatment of work-related depression: a one-year follow-up study.

Patients on long-term sick-leave (> 90 days) from white collar work, with a diagnosis of work-related depression, dysthymia, or maladaptive stress reaction were randomized either to cognitive group therapy (CGT), focused psychodynamic group therapy (FGT), or to a comparison group. All patients were interviewed and responded to self-report questionnaires before the start of treatment and at 6 and 12 months. At the 12-month follow-up, 70% of the patients met the criteria for reliable change of the target symptom (depression), and the sample as a whole improved significantly on all measures used. However, there were no differences in outcome between the three treatment groups.",21985258,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,8.78459358215332,-4.120210647583008,C2cz
"Does collaborative care improve social functioning in adults with depression? The application of the WHO ICF framework and meta-analysis of outcomes.

Collaborative care has proven efficacy in improving symptoms of depression, yet patients value improvements in their social function also. We used the World Health Organisation's International classification of functioning, disability, and health (WHO ICF) to robustly identify measures of social function and explored whether collaborative care interventions improve social functioning using meta-analysis. We performed a secondary data analysis on studies identified from our previous Cochrane review of collaborative care interventions for depression and search update (December 2013). The WHO ICF framework was applied to identify studies that included self-report measures of social functioning. Outcomes were extracted at short-term (6 months) and medium-term (≥7 months) and analysed using random-effects meta-analysis. The relationship between improvements in depression outcomes and improvements in social functioning was also explored using bivarable meta-regression. Eighteen trials were identified that measured social functioning and met our remaining inclusion criteria. Collaborative care was associated with small improvements in social functioning in the short (Standardised Mean Difference, SMD=0.23, 95% confidence interval 0.12 to 0.34) and medium term (SMD=0.19, 95% confidence interval 0.09 to 0.29). Improvements in depressive symptoms were associated with moderate improvements in social function (ß=-0.55, 95% confidence interval -0.82 to -0.28) but cross-sectionally only. The small number of studies (N=18) prevented more complex analyses to explore moderators of social functioning outcomes. Collaborative care improves social functioning but the mechanisms through which this occurs are unknown. Future depression interventions need to consider a person's degree of social function equally alongside their depressive symptoms.",26476422,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,8.518417358398438,-4.99387788772583,B2dm
"Adding smartphone-based cognitive-behavior therapy to pharmacotherapy for major depression (FLATT project): study protocol for a randomized controlled trial.

Major depression is one of the most debilitating diseases in terms of quality of life. Less than half of patients suffering from depression can achieve remission after adequate antidepressant treatment. Another promising treatment option is cognitive-behavior therapy (CBT). However, the need for experienced therapists and substantive dedicated time prevent CBT from being widely disseminated. In the present study, we aim to examine the effectiveness of switching antidepressants and starting a smartphone-based CBT program at the same time, in comparison to switching antidepressants only, among patients still suffering from depression after adequate antidepressant treatment. A multi-center randomized trial is currently being conducted since September 2014. The smartphone-based CBT program, named the ""Kokoro-App,"" for major depression has been developed and its feasibility has been confirmed in a previous open study. The program consists of an introduction, 6 sessions and an epilogue, and is expected to be completed within 9 weeks by patients. In the present trial, 164 patients with DSM-5 major depressive disorder and still suffering from depressive symptoms after adequate antidepressant treatment for more than 4 weeks will be allocated to the Kokoro-App plus switching antidepressant group or the switching antidepressant alone group. The participants allocated to the latter group will receive full components of the Kokoro-App after 9 weeks. The primary outcome is the change in the total score on the Patient Health Questionnaire through the 9 weeks of the program, as assessed at week 0, 1, 5 and 9 via telephone by blinded raters. The secondary outcomes include the change in the total score of the Beck Depression Inventory-II, change in side effects as assessed by the Frequency, Intensity and Burden of Side Effects Rating, and treatment satisfaction. An effective and reachable intervention may not only lead to healthier mental status among depressed patients, but also to reduced social burden from this illness. This paper outlines the background and methods of a trial that evaluates the possible additive value of a smartphone-based CBT program for treatment-resistant depression. UMIN-CTR: UMIN000013693 (registered on 1 June 2014).",26149441,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,7.720734119415283,-5.426779270172119,B7RK
"Predictors of longitudinal outcomes after unstable response to acute-phase cognitive therapy for major depressive disorder.

After patients with major depressive disorder (MDD) respond to acute-phase cognitive therapy (CT), continuation-phase treatments may be applied to improve long-term outcomes. We clarified which CT responders experience remission, recovery, relapse, and recurrence by testing baseline demographic, clinical, and personality variables. The sample of CT responders at higher risk of relapse (N = 241) was randomized to 8 months of continuation-phase CT, double-blinded fluoxetine, or pill placebo, and followed 24 months (Jarrett & Thase, 2010). Patients with lower positive emotionality and behavioral activation at the end of acute-phase CT showed increased risk for relapse/recurrence of MDD. In addition, patients with lower positive emotionality and behavioral activation, as well as higher residual depression (including emotional, cognitive, and social facets), showed decreased probability of remission (≥6 continuous weeks of minimal or absent symptoms) after acute-phase CT. Finally, patients with greater residual depression, as well as younger age and earlier MDD onset, showed decreased probability of recovery (≥35 continuous weeks of minimal or absent symptoms) after acute-phase CT. Moderator analyses did not reveal differential prediction across the continuation phase treatment arms. These results may help clinicians gauge the prognoses and need for continuation treatment among MDD patients who respond to acute-phase CT.",25985046,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.73303508758545,-1.2061021327972412,B9kq
"The Tree Theme Method® (TTM), an occupational therapy intervention for treating depression and anxiety: study protocol of a randomized controlled trial.

Depression and anxiety disorders are increasing among the general population in the Western world. Individuals may need several kinds of treatment in order to maintain health, such as cognitive behavioural therapy (CBT) and drug treatment. However, having an everyday life that ""works"" is also important, suggesting a need for interventions based on activities that facilitate a satisfying everyday life. There is still lack of such evidence-based interventions. The Tree Theme Method(®) (TTM) is an occupational therapy intervention designed for a client-centred context in which an individual develops strategies to become an actor in his or her everyday life. Previous studies of the TTM have focused on process evaluation; therefore, further studies are needed to evaluate the method's effects. The aim of this paper is to outline an intervention that can evaluate the effects of the TTM in terms of psychological symptoms, as well as everyday occupations and well-being, in patients suffering from depression and anxiety. This randomized clinical trial includes patients from three Swedish counties randomized to either intervention or treatment as usual. Men and women aged 18-65 years who have been diagnosed with either depression or anxiety are eligible for inclusion. Data collection is carried out at baseline, and outcomes are assessed at the end of intervention, as well as at 3 months and 12 months after intervention ends. The outcomes measured are psychological symptoms, everyday activities, and health-related factors. Depression and anxiety may create difficulties for individuals in the activities of their everyday lives to the extent that they require diagnosis and intervention. Despite this reality, evidence-based interventions that focus on everyday activities are lacking. Therefore, it would be useful to design a specific method for occupational therapy intervention that does precisely that. This study provides insight into the effects of the TTM, comparing it to occupational therapy treatment as usual. ClinicalTrials.gov: NCT01980381; registered November 2013.",26552426,Major Depressive Disorder,Anxiety Treatment,Mental Health,2573,9.932156562805176,-3.087510585784912,B1aI
"Delivering happiness: translating positive psychology intervention research for treating major and minor depressive disorders.

Despite the availability of many treatment options, depressive disorders remain a global public health problem. Even in affluent nations, 70% of reported cases either do not receive the recommended level of treatment or do not get treated at all, and this percentage does not reflect cases of depression that go unreported due to lack of access to health care, stigma, or other reasons. In developing countries, the World Health Organization estimates that <10% receive proper depression care due to poverty, stigma, and lack of governmental mental health resources and providers. Current treatments do not work for everyone, and even people who achieve remission face a high risk of recurrence and residual disability. The development of low-cost effective interventions that can serve either as initial therapy for mild symptoms or as adjunctive therapy for partial responders to medication is an immense unmet need. Positive activity interventions (PAIs) teach individuals ways to increase their positive thinking, positive affect, and positive behaviors. The majority of such interventions, which have obtained medium-size effect sizes, have been conducted with nondepressed individuals, but two randomized controlled studies in patients with mild clinical depression have reported promising initial findings. In this article, the authors review the relevant literature on the effectiveness of various types of PAIs, draw on social psychology, affective neuroscience and psychophamacology research to propose neural models for how PAIs might relieve depression, and discuss the steps needed to translate the potential promise of PAIs as clinical treatments for individuals with major and minor depressive disorders.",21721928,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.638113975524902,-3.9856860637664795,C6U+
"Stage models for major depression: Cognitive behavior therapy, mechanistic treatment targets, and the prevention of stage transition.

Stage models encourage a longitudinal perspective on the care of those with major depression: supporting vigilance to the risk for stage progression and the selection of interventions to address that risk. A central goal for this article is to evaluate the role of cognitive-behavior therapy (CBT) in addressing stage progression in the treatment of major depression. We summarize the evidence supporting depression-focused CBT for: (1) preventing depression onset, (2) treating syndromal depression, (3) treating residual symptoms, (4) preventing relapse, and (5) addressing pharmacologic treatment resistance. In addition, consistent with the goal of aiding prevention and intervention development by refining mechanistic treatment targets, we evaluate the role of two specific risk-factors for stage progression: insomnia and rumination. These risk factors have a feed-forward relationship with stress, both being amplified by stress and amplifying the negative consequences of stress. Moreover, each of these risk factors predict depression stage transmissions across multiple stages, and both are modifiable with treatment. Accordingly, insomnia and rumination appear to serve as excellent mechanistic targets for the prevention of depression stage progression. These findings are discussed in relation to current limitations and future research directions for targeting these risk factors and furthering the effective treatment of depression.",35688097,Major Depressive Disorder,Anxiety Treatment,Mental Health,358,10.978865623474121,-1.4411938190460205,Uow
"Lifestyle change recommendations in major depression: Do they work?

Modifying some lifestyle factors can be useful in depression, at least as an adjuvant treatment. Combining different lifestyle interventions seems to be an adequate strategy to increase their antidepressant efficacy according with preliminary studies, but this issue has not been enough investigated. The present study is a randomized, double-blinded, multicentre, two arm-parallel clinical trials, with a 12 month follow-up. The sample consisted of 273 Primary Care patients. Four combined hygienic-dietary written recommendations were given to the patients about diet, exercise, light exposure and sleep hygiene. Both active and control interventions were associated with improvement on BDI (Beck Depression Inventory) scores. However, there were not statistically significant differences (7.0 vs. 7.6; p=0.594). We were unable to monitor whether patients carry out recommendations. Intervention could be too difficult to accomplish for depressed patients without enough support and supervision. Just giving written lifestyle recommendations are not enough for depressive patients to benefit from them, so perhaps lifestyle change recommendations work or do not work on Depression depending on how they are presented to patients and on monitoring systems of their implementation.",26025368,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,8.699780464172363,-1.379682183265686,B9Ci
"Competitive Memory Training (COMET) for low self-esteem in patients with personality disorders: a randomized effectiveness study.

Self-esteem is a major concern in the treatment of patients with personality disorders in general. In patients with borderline personality disorder, low self-esteem is associated with factors contributing to suicidal and self-injurious behaviour. At the moment there are no well-proven interventions that specifically target low self-esteem. Recently, a new approach, Competitive Memory Training or COMET, aimed at the enhancement of retrieving beneficial information from memory, appeared to be successful in addressing low self-esteem in different patient populations. To assess whether COMET for low self-esteem is also an effective intervention for patients with personality disorders. 91 patients with personality disorders who were already in therapy in a regular mental health institution were randomly assigned to either 7 group sessions of COMET in addition to their regular therapy or to 7 weeks of ongoing regular therapy. These latter patients received COMET after their “7 weeks waiting period for COMET”. All patients that completed COMET were contacted 3 months later to assess whether the effects of COMET had remained stable. Compared to the patients who received regular therapy only, patients in the COMET + regular therapy condition improved significantly and with large effect sizes on indices of self-esteem and depression. Significant differential improvements on measures of autonomy and social optimism were also in favour of COMET, but had small to intermediate effect sizes. The therapeutic effects of COMET remained stable after 3 months on three out of the four outcome measures. COMET for low self-esteem seems to be an efficacious trans-diagnostic approach that can rather easily be implemented in the treatment of patients with personality disorders.",20809991,Major Depressive Disorder,Anxiety Treatment,Mental Health,14949,12.087985038757324,-2.4238247871398926,DGNQ
"Blended vs. face-to-face cognitive behavioural treatment for major depression in specialized mental health care: study protocol of a randomized controlled cost-effectiveness trial.

Depression is a prevalent disorder, associated with a high disease burden and substantial societal, economic and personal costs. Cognitive behavioural treatment has been shown to provide adequate treatment for depression. By offering this treatment in a blended format, in which online and face-to-face treatment are combined, it might be possible to reduce the number of costly face-to-face sessions required to deliver the treatment protocol. This could improve the cost-effectiveness of treatment, while maintaining clinical effects. This protocol describes the design of a pilot study for the evaluation of the feasibility, acceptability and cost-effectiveness of blended cognitive behavioural therapy for patients with major depressive disorder in specialized outpatient mental health care. In a randomized controlled trial design, adult patients with major depressive disorder are allocated to either blended cognitive behavioural treatment or traditional face-to-face cognitive behavioural treatment (treatment as usual). We aim to recruit one hundred and fifty patients. Blended treatment will consist of ten face-to-face and nine online sessions provided alternately on a weekly basis. Traditional cognitive behavioural treatment will consist of twenty weekly sessions. Costs and effects are measured at baseline and after 10, 20 and 30 weeks. Evaluations are directed at cost-effectiveness (with depression severity and diagnostic status as outcomes), and cost-utility (with costs per quality adjusted life year, QALY, as outcome). Costs will encompass health care uptake costs and productivity losses due to absence from work and lower levels of efficiency while at work. Other measures of interest are mastery, working alliance, treatment preference at baseline, depressive cognitions, treatment satisfaction and system usability. The results of this pilot study will provide an initial insight into the feasibility and acceptability of blended cognitive behavioural treatment in terms of clinical and economic outcomes (proof of concept) in routine specialized mental health care settings, and an indication as to whether a well-powered clinical trial of blended cognitive behavioural treatment for depression in routine practice would be advisable. This will be determined based on the perspective of various stakeholders including patients, mental health service providers and health insurers. Strengths and limitations of the study are discussed. Netherlands Trial Register NTR4650 . Registered 18 June 2014.",25326035,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.801642417907715,-2.8805103302001953,CG5R
"Rationale and design of a systematic review: effectiveness and acceptance of technology-based psychological interventions in different clinical phases of depression management.

Although many effective treatment options exist, depression is still undertreated indicating gaps in the healthcare system. The complementary provision of mental healthcare through technologies (eg, computer, smartphone) has the potential to fill treatment gaps and to overcome access barriers to mental healthcare. Until now, no systematic review integrates the evidence on different technology-based psychological interventions (TBIs) concerning their effectiveness and acceptance in different clinical phases of depression management (bridging waiting periods, acute treatment and aftercare). The aim of this project is to structure evidence on TBIs regarding different phases of depression management, and to determine effectiveness and acceptance for each clinical phase considering both active (eg, face-to-face treatment) and inactive (eg, waitlist) controls as comparators. We will include studies on adults with a formal diagnosis of unipolar depression. Treatments delivered by technologies based on scientific psychological theories will be considered as experimental interventions. The primary effectiveness outcome will be depressive symptoms at study endpoint measured by symptom severity rating scales, and the primary acceptance outcome will be dropping out of the study due to any reason. We will consider only randomised controlled trials, which will be identified by key database searches (including Cochrane Central Register of Controlled Trials, Medline, PsycINFO, PSYNDEX, CINAHL) complemented through searches in clinical trial registries (eg, clinicaltrials.gov) and grey literature searches (eg, Open Grey). Two review authors will independently conduct study selection, data extraction and quality assessment of included studies (using the Cochrane Collaboration's tool for assessing risk of bias). Meta-analyses applying random-effect models as well as subgroup, meta-regression and sensitivity analyses will be performed. Ethics approval is not required for this study, as we conduct research on secondary data. We will disseminate results via peer-reviewed journal publications, presentations on conferences and via plain language summaries. CRD42016050413; Pre-results.",30918040,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.96323299407959,-3.3736071586608887,A8yX
"Effects on Daily Spiritual Experiences of Religious Versus Conventional Cognitive Behavioral Therapy for Depression.

We compared religiously integrated cognitive behavioral therapy (RCBT) versus conventional CBT (CCBT) on increasing daily spiritual experiences (DSE) in major depressive disorder and chronic medical illness. A total of 132 participants aged 18-85 were randomized to either RCBT (n = 65) or CCBT (n = 67). Participants received ten 50-min sessions (primarily by telephone) over 12 weeks. DSE was assessed using the Daily Spiritual Experiences Scale (DSES). Mixed-effects growth curve models compared the effects of treatment group on trajectory of change in DSE. Baseline DSE and changes in DSE were examined as predictors of change in depressive symptoms. DSE increased significantly in both groups. RCBT tended to be more effective than CCBT with regard to increasing DSE (group by time interaction B = -1.80, SE = 1.32, t = -1.36, p = 0.18), especially in those with low religiosity (B = -4.26, SE = 2.27, t = -1.88, p = 0.07). Higher baseline DSE predicted a decrease in depressive symptoms (B = -0.09, SE = 0.04, t = -2.25, p = 0.025), independent of treatment group, and an increase in DSE with treatment correlated with a decrease in depressive symptoms (r = 0.29, p = 0.004). RCBT tends to be more effective than CCBT in increasing DSE, especially in persons with low religiosity. Higher baseline DSE and increases in DSE over time predict a faster resolution of depressive symptoms. Efforts to increase DSE, assessed by a measure such as the DSES, may help with the treatment of depression in the medically ill.",27305903,Major Depressive Disorder,Anxiety Treatment,Mental Health,1733,11.637287139892578,-3.7426953315734863,BrSz
"Cognitive Behavioral Analysis System of Psychotherapy versus Escitalopram in Chronic Major Depression.

A specific psychotherapy for chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), was compared to escitalopram (ESC). Sixty patients with chronic major depression were randomized to 'CBASP' (22 sessions) or 'ESC plus clinical management' (ESC/CM) at two treatment sites. The primary outcome measure was the score on the Montgomery-Asberg Depression Rating Scale (MADRS) after 8 weeks of acute treatment assessed by blinded raters. In the case of nonimprovement (<20% reduction in the MADRS score), the other condition was augmented for the following 20 weeks of extended treatment. Secondary end points were, among others, depressive symptoms, remission (MADRS score of ≤9) and response rates (reduction of MADRS score of ≥50%) 28 weeks after randomization. An intent-to-treat analysis revealed that clinician-rated depression scores decreased significantly after 8 and 28 weeks with no significant differences between the groups. The response rates after 28 weeks of treatment were high (CBASP: 68.4%, ESC/CM: 60.0%), and the remission rates were moderate (CBASP: 36.8%, ESC/CM: 50.0%) with neither group being superior. Nonimprovers to the initial treatment caught up with the initial improvers in terms of depression scores and response and remission rates by the end of the treatment after being augmented with the respective other condition. CBASP and ESC/CM appear to be equally effective treatment options for chronically depressed outpatients. For nonimprovers to the initial treatment, it is efficacious to augment with medication in the case of nonresponse to CBASP and vice versa.",26022410,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.13234806060791,-2.0188841819763184,B9E0
"Do client attributes moderate the effectiveness of a group cognitive behavioral therapy for depression in addiction treatment?

The study goal was to determine whether client attributes were associated with outcomes from group cognitive behavioral therapy for depression (GCBT-D) as delivered in community-based addiction treatment settings. Data from 299 depressed residential clients assigned to receive either usual care (N=159) or usual care plus GCBT-D (N=140) were examined. Potential moderators included gender, race/ethnicity, education, referral status, and problem substance use. Study outcomes at 6 months post-baseline included changes in depressive symptoms, mental health functioning, negative consequences from substance use, and percentage of days abstinent. Initial examination indicated that non-Hispanic Whites had significantly better outcomes than other racial/ethnic groups on two of the four outcomes. After correcting for multiple testing, none of the examined client attributes moderated the treatment effect. GCBT-D appears effective; however, the magnitude and consistency of treatment effects indicate that it may be less helpful among members of racial/ethnic minority groups and is worthy of future study.",22828976,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,11.43961238861084,-2.987016201019287,CqZP
"Acceptability and Effectiveness of NHS-Recommended e-Therapies for Depression, Anxiety, and Stress: Meta-Analysis.

There is a disconnect between the ability to swiftly develop e-therapies for the treatment of depression, anxiety, and stress, and the scrupulous evaluation of their clinical utility. This creates a risk that the e-therapies routinely provided within publicly funded psychological health care have evaded appropriate rigorous evaluation in their development. This study aims to conduct a meta-analytic review of the gold standard evidence of the acceptability and clinical effectiveness of e-therapies recommended for use in the National Health Service (NHS) in the United Kingdom. Systematic searches identified appropriate randomized controlled trials (RCTs). Depression, anxiety, and stress outcomes at the end of treatment and follow-up were synthesized using a random-effects meta-analysis. The grading of recommendations assessment, development, and evaluation approach was used to assess the quality of each meta-analytic comparison. Moderators of treatment effect were examined using subgroup and meta-regression analysis. Dropout rates for e-therapies (as a proxy for acceptability) were compared against controls. A total of 24 studies evaluating 7 of 48 NHS-recommended e-therapies were qualitatively and quantitatively synthesized. Depression, anxiety, and stress outcomes for e-therapies were superior to controls (depression: standardized mean difference [SMD] 0.38, 95% CI 0.24 to 0.52, N=7075; anxiety and stress: SMD 0.43, 95% CI 0.24 to 0.63, n=4863), and these small effects were maintained at follow-up. Average dropout rates for e-therapies (31%, SD 17.35) were significantly higher than those of controls (17%, SD 13.31). Limited moderators of the treatment effect were found. Many NHS-recommended e-therapies have not been through an RCT-style evaluation. The e-therapies that have been appropriately evaluated generate small but significant, durable, beneficial treatment effects. International Prospective Register of Systematic Reviews (PROSPERO) registration CRD42019130184; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130184.",33112238,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.971565246582031,-3.2283005714416504,AgV6
"We can manage depression better with technology.

Gotzsche, in Lancet Psychiatry, argued that antidepressants produce more harm than good and should be used sparingly. Ka-range et al showed that GP prescriptions of antidepressants in Australia are continuing to rise, especially in children. A rethink about the treatment of depression is indicated. This paper provides a summary of the evidence for internet-delivered cognitive behaviour therapy, and looks at the three RACGP Handbook of Non-Drug Intervention (HANDI) recommendations for non-drug treatments for depression and arranged for the developers to comment. The systems identified by HANDI are beneficial in major depression and are supported by evidence. They have not been shown to harm or to be beneficial in depression associated with schizophrenia, bipolar disorder or substance dependence. Although little input is required from general practitioners who prescribe these courses, they may form part of a more comprehensive treatment plan. Australia is a world leader in automated internet-delivered cognitive behaviour therapy. Australian clinicians should take advantage and use these courses.",25705731,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.002571105957031,-3.0884671211242676,CBi2
"Effectiveness of cognitive behavioral group therapy for depression in routine practice.

Previous research has shown that cognitive- behavioral group therapy (group CBT) is an effective treatment for depression. However, the effectiveness of this approach in routine care needs more research. The current study retrospectively examines the outcomes of patients who received group CBT for depression at a psychiatric outpatient clinic between 2003 and 2013. Based on patient records, 143 patients were identified as having received the treatment, and 88 patients were included in the outcome analyses. The Beck Depression Inventory (BDI-II) score was the main outcome measure. The dropout rate was 17.5%. The average BDI-II score decreased from 28.5 to 18.5 from pre-treatment to post-treatment and remained stable at 3-months follow-up. The effect sizes at post-treatment and follow-up were large (d=.97 and d=1.10, respectively). At post-treatment, 44% of the patients showed a significant improvement in depression, including 30% who recovered; at follow-up, the proportions increased to 57% and 40%, respectively. No predictors of dropout or treatment response were found. Group CBT for depression can be delivered in routine care settings with good results. However, there are still many patients who drop out or do not benefit from treatment.",25330912,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.18607234954834,-2.7395710945129395,CG0y
"Augmenting Ongoing Depression Care With a Mutual Peer Support Intervention Versus Self-Help Materials Alone: A Randomized Trial.

Various models of peer support may be implemented in mental health settings. This randomized trial assessed the effectiveness of a telephone-delivered mutual peer support intervention. A total of 443 patients receiving ongoing depression treatment from the U.S. Department of Veterans Affairs were enrolled in either enhanced usual care (N=243) or the peer support intervention (N=200). Intent-to-treat analyses assessed outcomes at six months postenrollment, excluding 56 patients who experienced an unplanned telephone platform shutdown. At baseline, patients had substantial depressive symptoms, functional limitations, and low quality of life. Both groups showed significant clinical improvements at six months, with no significant differences by group. Telephone-delivered mutual peer support for patients with depression did not improve outcomes beyond those observed with enhanced usual care. Other peer support models, with more ""professionalized"" peers delivering a structured curriculum, may be more effective.",26369884,Major Depressive Disorder,Anxiety Treatment,Mental Health,13374,8.114690780639648,-4.721660137176514,B4GJ
"Rating Short-Term Psychodynamic Therapy for the Canadian Network for Mood and Anxiety Treatments Depression Guidelines.

",28055254,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.660666465759277,-4.291684150695801,Bimm
"Antidepressant and group psychosocial treatment for depression: a rater blind exploratory RCT from a low income country.

Research in the West shows that group psychological intervention together with an antidepressant treatment leads to more effective treatment of a depressive disorder. There are no treatment trials from low income countries comparing the efficacy of antidepressant treatment with a group psychological intervention. To conduct a feasibility trial to compare the efficacy of an antidepressant to a group psychosocial intervention, for low income women attending primary health care in Karachi, Pakistan. This was a preliminary RCT in an urban primary health care clinic in Karachi, Pakistan. Consecutive eligible women scoring >12 on the CIS-R and >18 on Hamilton Depression Rating Scale (HDRS) (n = 66) were randomly assigned to antidepressants or a psychosocial treatment in group settings. The primary outcome measure was HDRS score; secondary outcome measures were disability and quality of life. More than half of the patients in both groups improved (50% reduction in HDRS scores); at end of therapy at 3 months 19 (59.4%) vs 18 (56.2%), and at 6-month follow-up 21(67.7%) vs 20(62.5%) for antidepressants and psychosocial intervention respectively. Although HDRS, BDQ and EQ5-D scores all improved considerably in both groups from start to end of treatment, and these improvements were largely maintained after a further 3 months, the differences between the two treatments were not statistically significant. Psychosocial intervention was as effective as antidepressants in reducing depression and in improving quality of life and disability at the end of therapy. However, these findings need further exploration through a larger trial.",23867053,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,10.509592056274414,-2.057706356048584,CbMh
"Algorithms For Treatment of Major Depressive Disorder: Efficacy and Cost-Effectiveness.

In spite of multiple new treatment options, chronic and treatment refractory courses still are a major challenge in the treatment of depression. Providing algorithm-guided antidepressant treatments is considered an important strategy to optimize treatment delivery and avoid or overcome treatment-resistant courses of major depressive disorder (MDD). The clinical benefits of algorithms in the treatment of inpatients with MDD have been investigated in large-scale, randomized controlled trials. Results showed that a stepwise treatment regimen (algorithm) with critical decision points at the end of each treatment step based on standardized and systematic measurements of response and an algorithm-guided decision-making process increases the chances of achieving remission and optimizes prescription behaviors for antidepressants. In conclusion, research in MDD revealed that systematic and structured treatment procedures, the diligent assessment of response at critical decision points, and timely dose and treatment type adjustments make the substantial difference in treatment outcomes between algorithm-guided treatment and treatment as usual.",29986372,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.765667915344238,-1.1788783073425293,BJPW
"Evaluation of the Effectiveness of a Psychoeducational Intervention in Treatment-Naïve Patients with Antidepressant Medication in Primary Care: A Randomized Controlled Trial.

There is evidence supporting the effectiveness of psychoeducation (PE) in patients with symptoms of depression in primary care (PC), but very few studies have assessed this intervention in antidepressant-naïve patients. The aim of this study is to assess the effectiveness of a PE program in these patients, since the use of antidepressant (AD) medication may interfere with the effects of the intervention. 106 participants were included, 50 from the PE program (12 weekly 1.5-hour sessions) and 56 from the control group (CG) that received the usual care. Patients were assessed at baseline and at 3, 6, and 9 months. The main outcome measures were the Beck Depression Inventory (BDI) and remission based on the BDI. The analysis was carried out on an intention-to-treat basis. The PE program group showed remission of symptoms of 40% (P = 0.001) posttreatment and 42% (P = 0.012) at 6 months. The analysis only showed significant differences in the BDI score posttreatment (P = 0.008; effect size Cohen's d' = 0.55). The PE intervention is an effective treatment in the depressive population not treated with AD medication. Before taking an AD, psychoeducational intervention should be considered.",26380366,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,10.229482650756836,-2.5184261798858643,B372
"Quantity and quality of psychotherapy trials for depression in the past five decades.

Over the years randomized controlled trials (RCTs) of various psychotherapies for treating depression have provided evidence to demonstrate the interventions' efficacy/effectiveness. However, recent researches suggest that the quality of some RCTs were actually less than ideal, which could hence have biased their results. The present study aims to assess (1) the changes in characteristics of RCTs of psychotherapies for treating adult depression; (2) the temporal changes in their trial quality, and (3) the quality differences among different therapeutic approaches. We included 135 RCTs of psychotherapies treating adult depression published from year 1969 to 2011. Temporal changes in trials' characteristics including their quantity and quality were assessed at study-level and arm-level. Quality differences among different schools of psychotherapy were assessed at arm-level. Changes in quantity and improvements in methodological quality were found at study-level. Positive changes in trial quality at arm-level were observed in most aspects. Comparisons made across different schools of psychotherapy revealed statistically significant differences among them, with earlier behavior therapy trials doing worst and more recent third wave cognitive-behavior therapy doing best. We could not determine whether the observed changes in quality resulted from actual improvement in trial quality and/or from improved reporting. The relatively smaller number of arms for several types of interventions could weaken the representativeness when making comparisons across psychotherapeutic approaches. Our study revealed positive temporal changes in both trial quantity and quality over the past five decades and has also spotted possible areas for further improvement.",24882199,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.529297828674316,-2.4325194358825684,CNRA
"The development and validation of the Memory Support Rating Scale.

Patient memory for treatment information is poor, and worse memory for treatment information is associated with poorer clinical outcomes. Memory support techniques have been harnessed to improve patient memory for treatment. However, a measure of memory support used by treatment providers during sessions has yet to be established. The present study reports on the development and psychometric properties of the Memory Support Rating Scale (MSRS)-an observer-rated scale designed to measure memory support. Adults with major depressive disorder (MDD; N = 42) were randomized to either cognitive therapy plus memory support (CT + MS; n = 22) or cognitive therapy as-usual (CT-as-usual; n = 20). At posttreatment, patients freely recalled treatment points via the patient recall task. Sessions (n = 171) were coded for memory support using the MSRS, 65% of which were also assessed for the quality of cognitive therapy via the Cognitive Therapy Rating Scale (CTRS). A unidimensional scale composed of 8 items was developed using exploratory factor analysis, though a larger sample is needed to further assess the factor structure of MSRS scores. High interrater and test-retest reliabilities of MSRS scores were observed across 7 MSRS coders. MSRS scores were higher in the CT + MS condition compared with CT-as-usual, demonstrating group differentiation ability. MSRS scores were positively associated with patient recall task scores but not associated with CTRS scores, demonstrating convergent and discriminant validity, respectively. Results indicate that the MSRS yields reliable and valid scores for measuring treatment providers' use of memory support while delivering cognitive therapy. (PsycINFO Database Record",26389597,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.719378471374512,-0.6273049116134644,B3z/
"For whom does it work? moderators of outcome on the effect of a transdiagnostic internet-based maintenance treatment after inpatient psychotherapy: randomized controlled trial.

Recent studies provide evidence for the effectiveness of Internet-based maintenance treatments for mental disorders. However, it is still unclear which participants might or might not profit from this particular kind of treatment delivery. The study aimed to identify moderators of treatment outcome in a transdiagnostic Internet-based maintenance treatment (TIMT) offered to patients after inpatient psychotherapy for mental disorders in routine care. Using data from a randomized controlled trial (N=400) designed to test the effectiveness of TIMT, we performed secondary analyses to identify factors moderating the effects of TIMT (intervention) when compared with those of a treatment-as-usual control condition. TIMT involved an online self-management module, asynchronous patient-therapist communication, a peer support group, and online-based progress monitoring. Participants in the control condition had unstructured access to outpatient psychotherapy, standardized outpatient face-to-face continuation treatment, and psychotropic management. Self-reports of psychopathological symptoms and potential moderators were assessed at the start of inpatient treatment (T1), at discharge from inpatient treatment/start of TIMT (T2), and at 3-month (T3) and 12-month follow-up (T4). Education level, positive outcome expectations, and diagnoses significantly moderated intervention versus control differences regarding changes in outcomes between T2 and T3. Only education level moderated change differences between T2 and T4. The effectiveness of the intervention (vs control) was more pronounced among participants with a low (vs high) education level (T2-T3: B=-0.32, SE 0.16, P=.049; T2-T4: B=-0.42, SE 0.21, P=.049), participants with high (vs low) positive outcome expectations (T2-T3: B=-0.12, SE 0.05, P=.02) and participants with anxiety disorder (vs mood disorder) (T2-T3: B=-0.43, SE 0.21, P=.04). Simple slope analyses revealed that despite some subgroups benefiting less from the intervention than others, all subgroups still benefited significantly. This transdiagnostic Internet-based maintenance treatment might be suitable for a wide range of participants differing in various clinical, motivational, and demographic characteristics. The treatment is especially effective for participants with low education levels. These findings may generalize to other Internet-based maintenance treatments.",24113764,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.506613731384277,-3.3068976402282715,CXms
"Effectiveness of Supported Self-Help in Recurrent Depression: A Randomized Controlled Trial in Primary Care.

The burden and economic consequences of depression are high, mostly due to its recurrent nature. Due to current budget and time restraints, a preventive, low- cost, accessible minimal intervention is much needed. In this study, we evaluated the effectiveness of a supported self-help preventive cognitive therapy (S-PCT) added to treatment as usual (TAU) in primary care, compared to TAU alone. We conducted a randomized controlled trial among 248 patients with a history of depression, currently in full or partial remission or recovery. Participants were randomized to TAU augmented with S-PCT (n = 124) or TAU alone (n = 124). S-PCT consisted of an 8-week self-help intervention, supported by weekly telephone guidance by a counselor. The intervention included a self-help book that could be read at home. The primary outcome was the incidence of relapse or recurrence and was assessed over the telephone by the Structured Clinical Interview for DSM-IV axis 1 disorders. Participants were observed for 12 months. Secondary outcomes were depressive symptoms, quality of life (EQ-5D and SF-12), comorbid psychopathology, and self-efficacy. These secondary outcomes were assessed by digital questionnaires. In the S-PCT group, 44 participants (35.5%) experienced a relapse or recurrence, compared to 62 participants (50.0%) in the TAU group (incidence rate ratio = 0.71, 95% CI 0.52-0.97; risk difference = 14, 95% CI 2-24, number needed to treat = 7). Compared to the TAU group, the S-PCT group showed a significant reduction in depressive symptoms over 12 months (mean difference -2.18; 95% CI -3.09 to -1.27) and a significant increase in quality of life (EQ-5D) (mean difference 0.04; 95% CI 0.004-0.08). S-PCT had no effect on comorbid psychopathology, self-efficacy, and quality of life based on the SF-12. A supported self-help preventive cognitive therapy, guided by a counselor in primary care, proved to be effective in reducing the burden of recurrent depression.",28647744,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.056946754455566,-1.326411485671997,Bapa
"Behavioral activation for the treatment of atypical depression: a pilot open trial.

Psychosocial interventions for atypical depression (AD) have been relatively ignored in the clinical research literature, despite evidence that the atypical subtype of major depression is marked by earlier age of onset, longer duration of mood episode, greater symptom severity, and poorer response to pharmacologic treatment. Given the symptom profile of AD, which is characterized by mood reactivity, psychomotor slowing, and interpersonal withdrawal, the authors argue that a behavioral activation (BA) intervention may be particularly well suited to this population. As an initial exploration of this hypothesis, the current study presents preliminary outcome data from 10 outpatients with AD who participated in an open pilot trial of BA over a 16-week period. Overall, results provide encouraging preliminary support for the feasibility, acceptability, and efficacy of BA for AD, with significant reductions in depressive symptoms and associated improvements in functional impairment and BA level. Study results are discussed in the context of existing treatments for AD, and areas for future treatment development are highlighted.",21507998,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.822733879089355,-1.9381450414657593,C9Le
"One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression.

Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change. We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering, and experiential avoidance. Patients in both conditions reported significant and large reductions of depressive symptoms (d = -1.26 to -1.60) and improvement in quality of life (d = 0.91 to -1.28) 12months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression. clinicaltrials.gov; NCT01517503 . Registered 25 January 2012 - Retrospectively registered.",33446152,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,9.888362884521484,-1.7691386938095093,AcbP
"The feasibility of adapted group-based interpersonal therapy (IPT) for the treatment of depression by community health workers within the context of task shifting in South Africa.

Within the context of a large treatment gap for depression and a scarcity of specialist resources, there is a need for task shifting to scale up mental health services to address this gap in South Africa. This study assessed the feasibility of an adapted manualized version of grouped based Interpersonal Therapy (IPT) for use by supervised community health workers through a pilot study on 60 primary health care clinic users screened as having moderate to severe depression. Retention was good and participants in the group-based IPT intervention showed significant reduction in depressive symptoms on completion of the 12-week intervention as well as 24 weeks post baseline compared to the control group. Qualitative process evaluation suggests that improved social support, individual coping skills and improved personal agency assisted in the reduction of depressive symptoms.",21687982,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,11.366639137268066,-4.158951759338379,C6z4
"Group psychological therapies for depression in the community: systematic review and meta-analysis.

Psychological therapies have been shown to be effective in the treatment of depression. However, evidence is focused on individually delivered therapies, with less evidence for group-based therapies. To conduct a systematic review and meta-analysis of the efficacy of group-based psychological therapies for depression in primary care and the community. We searched MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials and the Cochrane Collaboration Depression, Anxiety and Neurosis Review Group database from inception to July 2010. The Cochrane risk of bias methodology was applied. Twenty-three studies were included. The majority showed considerable risk of bias. Analysis of group cognitive-behavioural therapy (CBT) v. usual care alone (14 studies) showed a significant effect in favour of group CBT immediately post-treatment (standardised mean difference (SMD) -0.55 (95% CI -0.78 to -0.32)). There was some evidence of benefit being maintained at short-term (SMD = -0.47 (95% CI -1.06 to 0.12)) and medium- to long-term follow-up (SMD = -0.47 (95% CI - 0.87 to -0.08)). Studies of group CBT v. individually delivered CBT therapy (7 studies) showed a moderate treatment effect in favour of individually delivered CBT immediately post-treatment (SMD = 0.38 (95% CI 0.09-0.66)) but no evidence of difference at short- or medium- to long-term follow-up. Four studies described comparisons for three other types of group psychological therapies. Group CBT confers benefit for individuals who are clinically depressed over that of usual care alone. Individually delivered CBT is more effective than group CBT immediately following treatment but after 3 months there is no evidence of difference. The quality of evidence is poor. Evidence about group psychological therapies not based on CBT is particularly limited.",22383765,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.681696891784668,-2.6303088665008545,Cwnt
"The Effect of Guided Web-Based Cognitive Behavioral Therapy on Patients With Depressive Symptoms and Heart Failure: A Pilot Randomized Controlled Trial.

Depressive symptoms, and the associated coexistence of symptoms of anxiety and decreased quality of life (QoL), are common in patients with heart failure (HF). However, treatment strategies for depressive symptoms in patients with HF still remain to be established. Internet-based cognitive behavioral therapy (ICBT), as guided self-help CBT programs, has shown good effects in the treatment of depression. Until now, ICBT has not been evaluated in patients with HF with depressive symptoms. The aims of this study were to (1) evaluate the effect of a 9-week guided ICBT program on depressive symptoms in patients with HF; (2) investigate the effect of the ICBT program on cardiac anxiety and QoL; and (3) assess factors associated with the change in depressive symptoms. Fifty participants were randomized into 2 treatment arms: ICBT or a Web-based moderated discussion forum (DF). The Patient Health Questionnaire-9 was used to measure depressive symptoms, the Cardiac Anxiety Questionnaire (CAQ) was used to measure cardiac-related anxiety, and the Minnesota Living with Heart Failure questionnaire was used to measure QoL. Data were collected at baseline and at follow-up at the end of the 9-week intervention. Intention-to-treat analysis was used, and missing data were imputed by the Expectation-Maximization method. Between-group differences were determined by analysis of covariance with control for baseline score and regression to the mean. No significant difference in depressive symptoms between the ICBT and the DF group at the follow-up was found, [F(1,47)=1.63, P=.21] and Cohen´s d=0.26. Secondary within-group analysis of depressive symptoms showed that such symptoms decreased significantly in the ICBT group from baseline to the follow-up (baseline M=10.8, standard deviation [SD]=5.7 vs follow-up M=8.6, SD=4.6, t(24)=2.6, P=.02, Cohen´s d=0.43), whereas in the DF group, there was no significant change (baseline M=10.6, SD=5.0, vs follow-up M=9.8, SD=4.3, t(24)=0.93, P=.36. Cohen´s d=0.18). With regard to CAQ and QoL no significant differences were found between the groups (CAQ [d(1,47)=0.5, P=.48] and QoL [F(1,47)=2.87, P=.09]). In the ICBT group in the CAQ subscale of fear, a significant within-group decrease was shown (baseline M=1.55 vs follow-up M=1.35, P=.04). In the ICBT group, the number of logins to the Web portal correlated significantly with improvement in depressive symptoms (P=.02), whereas higher age (P=.01) and male sex (P=.048) were associated with less change in depressive symptoms. This study is underpowered because of difficulties in the recruitment of patients. Guided ICBT adapted for persons with HF and depressive symptoms was not statistically superior to participation in a Web-based DF. However, within the ICBT group, a statically significant improvement of depressive symptoms was detected. Clinicaltrials.gov NCT01681771; https://clinicaltrials.gov/ct2/show/NCT01681771 (Archived by WebCite at http://www.webcitation.org/6ikzbcuLN).",27489077,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,8.903170585632324,-1.4182056188583374,BpCp
"A demonstration of a multi-method variable selection approach for treatment selection: Recommending cognitive-behavioral versus psychodynamic therapy for mild to moderate adult depression.

Objective: We use a new variable selection procedure for treatment selection which generates treatment recommendations based on pre-treatment characteristics for adults with mild-to-moderate depression deciding between cognitive behavioral (CBT) versus psychodynamic therapy (PDT). Method: Data are drawn from a randomized comparison of CBT versus PDT for depression (N=167, 71% female, mean-age=39.6). The approach combines four different statistical techniques to identify patient characteristics associated consistently with differential treatment response. Variables are combined to generate predictions indicating each individual's optimal-treatment. The average outcomes for patients who received their indicated treatment versus those who did not were compared retrospectively to estimate model utility. Results: Of 49 predictors examined, depression severity, anxiety sensitivity, extraversion, and psychological treatment-needs were included in the final model. The average post-treatment Hamilton-Depression-Rating-Scale score was 1.6 points lower (95%CI=[0.5:2.8]; d=0.21) for those who received their indicated-treatment compared to non-indicated. Among the 60% of patients with the strongest treatment recommendations, that advantage grew to 2.6 (95%CI=[1.4:3.7]; d=0.37). Conclusions: Variable selection procedures differ in their characterization of the importance of predictive variables. Attending to consistently-indicated predictors may be sensible when constructing treatment selection models. The small N and lack of separate validation sample indicate a need for prospective tests before this model is used.",30632922,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.032209396362305,-2.3140337467193604,BAnp
"A randomized controlled trial of an online, modular, active learning training program for behavioral activation for depression.

This randomized-controlled trial assessed the efficacy of a trainer-led, active-learning, modular, online behavioral activation (BA) training program compared with a self-paced online BA training with the same modular content. Seventy-seven graduate students (M = 30.3 years, SD = 6.09; 76.6% female) in mental health training programs were randomly assigned to receive either the trainer-led or self-paced BA training. Both trainings consisted of 4 weekly sessions covering 4 core BA strategies. Primary outcomes were changes in BA skills as measured by an objective role-play assessment and self-reported use of BA strategies. Assessments were conducted at pre-, post-, and 6-weeks after training. A series of longitudinal mixed effect models assessed changes in BA skills and a longitudinal model implemented with generalized estimating equations assessed BA use over time. Significantly greater increases in total BA skills were found in the trainer-led training condition. The trainer-led training condition also showed greater increases in all core BA skills either at posttraining, follow-up, or both. Reported use of BA strategies with actual clients increased significantly from pre- to posttraining and maintained at follow-up in both training conditions. This trial adds to the literature on the efficacy of online training as a method to disseminate BA. Online training with an active learning, modular approach may be a promising and accessible implementation strategy. Additional strategies may need to be paired with the online BA training to assure the long-term implementation and sustainability of BA in clinical practice. (PsycINFO Database Record",28726481,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.542304039001465,-2.0528690814971924,BZiB
"Relaxation Therapy for Depression: An Updated Meta-analysis.

We conducted this updated meta-analysis to evaluate the effects of relaxation therapy for depression. We searched PubMed, MEDLINE, PsycINFO, the Cochrane Library, Web of Science, and CINAHL for randomized controlled trials evaluating the effects of relaxation therapy in patients with depression. Finally, 14 studies were included in this meta-analysis. The efficacy of the intervention was evaluated using depression scale scores. We found that there was no significant difference between the effects of relaxation therapy and psychotherapy on decreasing self-rated depressive symptoms (standardized mean difference [SMD] = 0.19; 95% confidence interval [CI], -0.11 to 0.48). In addition, eight trials compared relaxation therapy with no treatment, waiting list, or minimal treatment and showed that the relaxation group reported lower levels of self-reported depression scores postintervention (SMD = -0.57; 95% CI, -0.98 to -0.15). Therefore, this meta-analysis showed that relaxation might reduce depressive symptoms, and the effect is not worse than that of psychotherapy.",32221187,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.680791854858398,-1.6366339921951294,ArXY
"[Psychotherapy for depression].

Based on empirical evidence, psychotherapeutic treatment of depression is recommended if the following methods are applied: Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), and Psychoanalytic/Short-term Psychodynamic Therapy. The empirical evidence for the efficacy of CBT and IPT is established, whereas data supporting the efficacy of psychoanalytical/psychodynamic techniques is not as well documented. In addition, considering the cost-benefit aspects of treatment, CBT and IPT are highly recommendable.",21043019,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.831690788269043,-2.6310300827026367,DD1u
"Pharmacological management of unipolar depression.

To be used in conjunction with 'Psychological management of unipolar depression' [Lampe et al. Acta Psychiatr Scand 2013;127(Suppl. 443):24-37] and 'Lifestyle management of unipolar depression' [Berk et al. Acta Psychiatr Scand 2013;127(Suppl. 443):38-54]. To provide clinically relevant recommendations for the use of pharmacological treatments in depression derived from a literature review. Using our previous Clinical Practice Guidelines [Malhi et al. Clinical practice recommendations for bipolar disorder. Acta Psychiatr Scand 2009;119(Suppl. 439):27-46] as a foundation, these clinician guidelines target key practical considerations when prescribing pharmacotherapy. A comprehensive review of the literature was conducted using electronic database searches (PubMed, MEDLINE), and the findings have been synthesized and integrated alongside clinical experience. The pharmacotherapy of depression is an iterative process that often results in partial and non-response. Beyond the initiation of antidepressants, the options within widely used strategies, such as combining agents and switching between agents, are difficult to prescribe because of the paucity of pertinent research. However, there is some evidence for second-line strategies, and a non-prescriptive algorithm can be derived that is based broadly on principles rather than specific steps. Depression is by its very nature a heterogeneous illness that is consequently difficult to treat. Invariably, situation-specific factors often play a significant role and must be considered, especially in the case of partial and non-response. Consulting with colleagues and trialling alternate treatment paradigms are essential strategies in the management of depression.",23586873,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.022993087768555,-0.722642719745636,CfS0
"Mobile Phone-Based Mood Ratings Prospectively Predict Psychotherapy Attendance.

Psychotherapy nonattendance is a costly and pervasive problem. While prior research has identified stable patient-level predictors of attendance, far less is known about dynamic (i.e., time-varying) factors. Identifying dynamic predictors can clarify how clinical states relate to psychotherapy attendance and inform effective ""just-in-time"" interventions to promote attendance. The present study examines whether daily mood, as measured by responses to automated mobile phone-based text messages, prospectively predicts attendance in group cognitive-behavioral therapy (CBT) for depression. Fifty-six Spanish-speaking Latino patients with elevated depressive symptoms (46 women, mean age=50.92years, SD=10.90years), enrolled in a manualized program of group CBT, received daily automated mood-monitoring text messages. Patients' daily mood ratings, message response rate, and delay in responding were recorded. Patients' self-reported mood the day prior to a scheduled psychotherapy session significantly predicted attendance, even after controlling for patients' prior attendance history and age (OR=1.33, 95% CI [1.04, 1.70], p=.02). Positive mood corresponded to a greater likelihood of attendance. Our results demonstrate the clinical utility of automated mood-monitoring text messages in predicting attendance. These results underscore the value of text messaging, and other mobile technologies, as adjuncts to psychotherapy. Future work should explore the use of such monitoring to guide interventions to increase attendance, and ultimately the efficacy of psychotherapy.",28711112,Major Depressive Disorder,Anxiety Treatment,Mental Health,2750,7.838912010192871,-5.562997341156006,BZwT
"Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials.

BackgroundThe influence of baseline severity has been examined for antidepressant medications but has not been studied properly for cognitive-behavioural therapy (CBT) in comparison with pill placebo.AimsTo synthesise evidence regarding the influence of initial severity on efficacy of CBT from all randomised controlled trials (RCTs) in which CBT, in face-to-face individual or group format, was compared with pill-placebo control in adults with major depression.MethodA systematic review and an individual-participant data meta-analysis using mixed models that included trial effects as random effects. We used multiple imputation to handle missing data.ResultsWe identified five RCTs, and we were given access to individual-level data (n = 509) for all five. The analyses revealed that the difference in changes in Hamilton Rating Scale for Depression between CBT and pill placebo was not influenced by baseline severity (interaction P = 0.43). Removing the non-significant interaction term from the model, the difference between CBT and pill placebo was a standardised mean difference of -0.22 (95% CI -0.42 to -0.02, P = 0.03, I2 = 0%).ConclusionsPatients suffering from major depression can expect as much benefit from CBT across the wide range of baseline severity. This finding can help inform individualised treatment decisions by patients and their clinicians.",28104735,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.91029167175293,-2.408841609954834,Bh8n
"Psychodynamic treatment of depression.

Findings reviewed in this article show that PT should be included in treatment guidelines for depression. BPT in particular has been found to be superior to control conditions, equally effective as other active psychological treatments, with treatment effects that are often maintained in the long run, conferring resistance to relapse. Moreover, BPT is as effective as pharmacotherapy in the acute treatment of mild to moderate depression, and, either as monotherapy or combined with medication, BPT is associated with better long-term outcome compared with pharmacotherapy alone. PT is accepted by many depressed patients as a viable and preferred treatment. Furthermore, LTPT and PA have shown promise in treating patients with complex psychological disorders characterized by mood problems, often with comorbid personality problems. Finally, although studies suggest that effects of PT may be achieved somewhat slower compared with other forms of psychotherapy as well as medication in the acute treatment of depression, LTPT appears to be more clinically effective and perhaps more cost effective in the long run, particularly for chronically depressed patients. As noted, these conclusions need to be interpreted within the context of important limitations. Compared with other treatments, the evidence base for PT in depression remains relatively small, despite a respectable research tradition supporting psychodynamic assumptions with regard to the causation of depression. Moreover, and perhaps most importantly, although more studies now include longer follow-up assessments, our knowledge about the long-term effects of so-called evidence-based treatments of depression remains sketchy at best. In this context, the growing evidence for the efficacy and effectiveness of LTPT is promising. Overall, it is clear that the future of the treatment of depression may lie in a combined disorder- and person-centered, tailored-made approach, which takes into account, particularly in chronic depression, the broader interpersonal context and life history of the individual. It is clear that psychodynamic therapies have an important role to play in this respect.",22370494,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.058650970458984,-2.9434993267059326,CwzH
"A self-help, positive goal-focused intervention to increase well-being in people with depression.

Self-help interventions are an accessible, first-step treatment for depression. Well-being interventions focus on increasing people's resources and bringing about positive feelings and behaviours and could enhance self-help interventions for depression by increasing well-being as well as reducing depression. The present study tested the effectiveness of a self-help, well-being intervention (Goal-setting and Planning, GAP) in both increasing well-being and reducing depression within a sample from a depression self-help organization. We used a cross-over design, with half of the participants allocated to GAP (n = 26) and half to a wait-list control group (n = 29). After 5 weeks, the wait-list control group also received GAP. Compared with wait-list controls, those allocated to GAP showed an overall positive change, with individual significant decreases in negative affect and trends towards significant decreases in depression and increases in positive affect and life satisfaction post-intervention. Within a cross-over design, the wait-list controls also received GAP. In the whole sample that received GAP, there were significant increases in positive affect and life satisfaction and significant decreases in negative affect and depression, post-intervention and at 5-week follow-up, relative to baseline. These findings demonstrate that GAP is a useful intervention for people with symptoms of depression, influencing both levels of well-being and depressive symptoms.",22610936,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.742311477661133,-3.8802289962768555,CtSc
"Frequency and change mechanisms of psychotherapy among depressed patients: study protocol for a multicenter randomized trial comparing twice-weekly versus once-weekly sessions of CBT and IPT.

Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are among the most well established therapies for the treatment of depression. However, some major questions remain unanswered. First, it is unknown what session frequency results in the most optimal (cost) effectiveness in psychotherapy. Second, the debate as to what mechanisms underlie the effect of psychotherapy has not yet been resolved. Enhancing knowledge about the optimal session frequency and mechanisms of change seems crucial in order to optimize the (cost) effectiveness of psychotherapy for depression. This study aims to compare treatment outcome of twice-weekly versus once-weekly sessions of CBT and IPT. We expect twice-weekly sessions to be more effective and lead to more rapid recovery of depressive symptoms in comparison to once-weekly sessions. Both therapy-specific and non-specific process measures will be included to unravel the mechanisms of change in psychotherapy for depression. Besides the use of self-reports and behavioral observations, this study will also examine underlying biological processes by collecting blood samples. In a multicenter randomized trial, two hundred depressed patients will be recruited from Dutch specialized mental healthcare centers and randomized into one of the following groups, all receiving a maximum of 20 sessions in different frequencies: a) twice-weekly sessions at the start of CBT, b) twice-weekly sessions at the start of IPT, c) once-weekly sessions at the start of CBT, d) once-weekly sessions at the start of IPT. Primary outcome measures are depression severity, cost-effectiveness and quality of life. Process measures include therapeutic alliance, recall, therapy-specific skills, motivation and compliance. Assessments will take place during baseline, monthly during treatment and follow-up at month 9, 12 and 24. In addition, at 12 and 24 months, the frequency of depressive episodes in the previous year will be assessed. Blood samples will be taken pre- and post-treatment. The study has been ethically approved and registered. Finding that twice-weekly sessions are more effective or lead to more rapid recovery of depressive symptoms could lead to treatment adaptations that have the potential to reduce the personal and societal burden of depression. In addition, insight into the mechanisms of change and physiological processes in psychotherapy will enable us to optimize treatments and may help to understand human functioning beyond the context of treatment. The study has been registered on October 21th, 2014 at the Netherlands Trial Register, part of the Dutch Cochrane Centre ( NTR4856 ).",26122891,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.097704887390137,-2.6287131309509277,B7lu
"The effects of social group interventions for depression: Systematic review.

There is a growing prevalence of prolonged antidepressant use globally. Social group interventions may be an effective way to manage mild to moderate depression, especially with patients seeking to discontinue antidepressant use. This systematic review evaluates studies that used social group interventions to manage depression. Studies published up to June 2019 in nine bibliographic databases were identified using search terms related to depression, social interventions, and social participation. Formal therapies for depression (cognitive behaviour therapy, music therapy) were excluded as they have been reviewed elsewhere. 24 studies met inclusion criteria; 14 RCTs, 6 non-randomised controlled trials and 4 pre-post evaluations. In total, 28 social group programs were evaluated, 10 arts-based groups, 13 exercise groups and 5 others. Programs ranged in 'dose' from 5 to 150 hours (M = 31 hours) across 4 to 75 weeks (M = 15 weeks) and produced effect sizes on depression in the small to very large range (Hedge's g = .18 to 3.19, M = 1.14). A regression analysis revealed no participant variables, study variables or intervention variables were related to effect size on depression. Risks of bias were found, primarily in the non-randomised studies, which means the findings must be regarded as preliminary until replicated. These findings indicate that social group interventions are an effective way to manage mild to moderate depression symptoms in a variety of populations. This approach may also help to prevent relapse among patients tapering off antidepressant medication.",33302192,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.418720245361328,-2.5431857109069824,AeGw
"No evidence that CBT is less effective than antidepressants in moderate to severe depression.

",27543494,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.855534553527832,-2.2501168251037598,BoXu
"A Randomized Controlled Trial in Routine Clinical Practice Comparing Acceptance and Commitment Therapy with Cognitive Behavioral Therapy for the Treatment of Major Depressive Disorder.

Since current therapies for depression are effective but not for all patients alike, we need to further improve available treatments. Existing research suggests that acceptance and commitment therapy (ACT) may effectively treat major depressive disorder (MDD). We compared ACT with cognitive behavioral therapy (CBT) for depression, testing the hypothesis that CBT would outperform ACT. We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before and after treatment and at the 6-month follow-up, assessing diagnosis, symptom levels of depression, and quality of life. After treatment, the rates of remission from depression were 75 and 80% for the ACT and CBT conditions, respectively. Patients in both conditions further reported significant and large reductions in depressive symptoms and improvement in quality of life from before to after treatment as well as at the follow-up. Our findings indicated no significant differences between the two intervention groups. Our results indicate that CBT is not more effective in treating depression than ACT. Further research is needed to investigate whether ACT and CBT work differently for different groups of patients with depression.",29566394,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,8.09179401397705,-1.6799101829528809,BORL
"The effectiveness of the cognitive behavioral analysis system of psychotherapy for chronic depression: a randomized controlled trial.

It is widely agreed that chronic depression is difficult to treat, knowledge about optimal treatment approaches is emerging. A multisite randomized controlled trial was conducted comparing the cognitive behavioral analysis system of psychotherapy (CBASP), a psychotherapy model developed specifically to treat chronic depression (n = 67) with care as usual (CAU; evidence-based treatments, n = 72) over a period of 52 weeks, with 23 sessions on average, in 3 outpatient clinics in the Netherlands. In both arms algorithm-based pharmacotherapy was provided. Patients (aged 18-65) met criteria for a DSM-IV diagnosis of major depressive disorder with diagnostic specifiers (chronic, without interepisode recovery) or with co-occurring dysthymic disorder indicating a chronic course. The Inventory for Depressive Symptomatology (IDS) Self-Report was used as the primary outcome measure. Mixed-effects linear regression analysis was used to compare the changes on the IDS scores between CBASP and CAU. The IDS was administered before treatment, and after 8, 16, 32 and 52 weeks. At week 52, patients assigned to CBASP had a greater reduction of depressive symptoms compared to patients assigned to CAU (t = -2.00, p = 0.05). However, CBASP and CAU did not differ from each other on the IDS after 8 weeks (t = 0.49, p = 0.63), 16 weeks (t = -0.03, p = 0.98) and 32 weeks (t = -0.17, p = 0.86) of treatment. This trial shows that CBASP is at least as effective as standard evidence-based treatments for chronic depression. In the long run, CBASP appears to have an added effect.",25116461,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.272944450378418,-1.8783338069915771,CJ6F
"Behavioral activation therapy for return to work in medication-responsive chronic depression with persistent psychosocial dysfunction.

Chronic depression is associated with significant impairment in work functioning, relationships, and health. Such impairment often persists following medication-induced remission of depressive symptoms. We adapted and tested Behavioral Activation therapy with a goal of return to work (BA-W) in subjects with chronic depression who had responded to medication treatment but remained unemployed. Sixteen adults aged 18-65 with DSM-IV diagnosed Dysthymic Disorder or chronic Major Depression were recruited from clinical trials taking place at the New York State Psychiatric Institute between 4/2009 and 12/2012 and enrolled in 12 weeks of individual manual-driven BA-W. Functioning was measured at intake, post-treatment and at 24 week follow-up. Eighty-seven percent (n=14) of subjects completed the full 12 weeks of BA-W. Hours of work related activity (p<.005, d=0.83), hours of paid work (p<.0003, d=0.54), and work productivity (p<.0004, d=-0.48) increased significantly over the study period. Earned income increased post-treatment (p=.068) with significant changes by 24 week follow-up (p=.011). Secondary outcomes including behavioral avoidance (p<.004, d=-0.56), and global functioning (p<.0003, d=1.42) were also significantly improved post-treatment. Effect sizes, including for outcomes with non-significant changes, were generally in the range of 0.5-0.8. This pilot study provides preliminary evidence of the efficacy of a work-targeted psychotherapy to remediate vocational impairment in subjects with chronic depression. Data suggests that further testing of BA-W using a randomized controlled trial is warranted and may represent a significant advance in treatment for the residual disability present after successful pharmacotherapy.",25464836,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.32414436340332,-2.0068116188049316,CE9Z
"NewsCAP: Cognitive behavioral therapy is as effective as antidepressants for depressive disorder.

",27875429,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.07229995727539,-2.571756601333618,BkWa
"A culturally adapted depression intervention for African American adults experiencing depression: Oh Happy Day.

The purpose of this article is to describe development of a culturally adapted depression intervention (Oh Happy Day Class, OHDC) designed for African American adults experiencing major depressive disorder (MDD). This project included 2 pilot studies testing the feasibility and acceptability of the OHDC and examining short-term effects of the OHDC in reducing symptoms of MDD. The OHDC is a 2.5-hr weekly, culturally specific, cognitive behavioral, group counseling intervention for 12 weeks. Cultural adaptations of the OHDC are based on the ecological validity and culturally sensitive framework, along with an Afrocentric paradigm. Fifty African American participants with MDD were enrolled (15 in Pilot I and 35 in Pilot II). All participants in Pilots I and II received the 12-week intervention and completed assessments at baseline, mid-intervention, end-intervention, and 3 months postintervention. General linear mixed modeling for assessment of pre-post longitudinal data analysis was conducted. Results for Pilot I showed 73% of participants completed the full OHDC, a statistically significant decline in depression symptoms from pre- to postintervention, and a 0.38 effect size. Participants were very satisfied with the OHDC. In Pilot II, 66% of participants completed the full OHDC, and there was a significant pre-post intervention decrease in depression symptoms. For men, the OHDC showed a 1.01 effect size and for women, a 0.41 effect size. Both men and women were very satisfied with the OHDC based on the satisfaction measure. These promising findings are discussed with a focus on future plans for examining efficacy of the OHDC in a large-scale, randomized, control trial.",25420141,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,11.427136421203613,-5.027052879333496,CFqp
"Efficacy of the sequential integration of psychotherapy and pharmacotherapy in major depressive disorder: a preliminary meta-analysis.

Prevention of relapse and recurrence represents an important task in the successful treatment of major depressive disorder (MDD). The aim of this meta-analysis was to examine the efficacy of the sequential integration of psychotherapy and pharmacotherapy in reducing the risk of relapse and recurrence in MDD. Keyword searches were conducted in Medline, EMBASE, PsycINFO and the Cochrane Library from inception of each database to December 2008. Randomized controlled trials examining the efficacy of the administration of psychotherapy after successful response to acute-phase pharmacotherapy in the treatment of adults with MDD were considered for inclusion in the meta-analysis. Eight high-quality studies with 442 patients in a sequential treatment arm and 433 in a control treatment arm were included. The pooled risk ratio (RR) for relapse/recurrence was 0.797 [95% confidence interval (CI) 0.659-0.964] according to the random-effects model, suggesting a relative advantage in preventing relapse/recurrence for the sequential administration of treatments compared with control conditions. Performing subgroup analyses, we found a trend favoring psychotherapy during continuation of antidepressant drugs compared to antidepressants or treatment as usual (RR 0.842, 95% CI 0.674-1.051). Patients randomized to psychotherapy while antidepressants were discontinued were significantly less likely to experience relapse/recurrence compared to controls (RR 0.650, 95% CI 0.463-0.912). We found evidence that the sequential integration of psychotherapy and pharmacotherapy is a viable strategy for preventing relapse and recurrence in MDD. In addition, our findings suggest that discontinuation of antidepressant drugs may be feasible when psychotherapy is provided.",20444307,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.062356948852539,-0.6279836893081665,DK2n
"Existential dynamic therapy (""VITA"") for treatment-resistant depression with cluster C disorder: matched comparison to treatment as usual.

Existential suffering may contribute to treatment-resistant depression. The ""VITA"" treatment model was designed for such patients with long-standing depression accompanied by existential and/or religious concerns. This naturalistic effectiveness study compared the VITA model (n = 50) with a ""treatment as usual"" comparison group (TAU; n = 50) of patients with treatment-resistant depression and cluster c comorbidity. The TAU patients were matched on several characteristics with the VITA patients. The VITA model included existential, dynamic, narrative and affect-focused components. The VITA group had significantly greater improvement on symptom distress and relational problems during treatment and from pre-treatment to 1-year follow-up. Patients in the VITA, at follow-up, were more likely to be employed and less likely be using psychotropic medications.",22690951,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,10.402456283569336,-2.358832836151123,CsTg
"Psychotherapy for depression in claimants receiving wage replacement benefits: review of the evidence.

To review the evidence on the provision of psychotherapy for claimants who are suffering from depression and receiving wage replacement benefits. A literature review was performed using PubMed and EMBASE. Results from three studies are discussed. The first is a systematic review and individual patient data meta-analysis of randomized controlled trials to assess the relative effectiveness of cognitive behavioral therapy (CBT) for depression in patients receiving disability benefits. A non-significant trend showed that the effect of CBT was greater in patients receiving benefits (34 patients) than those not receiving disability benefits (193 patients) on the Beck Depression Inventory; mean difference (95% confidence interval [CI]) = -4.46 (-12.21 to 3.30). The second study is an analysis of a large insurance administrative database consisting of 10,338 long-term disability claims for depression. Receipt of psychotherapy was associated with faster claim closure (hazard ratio = 1.42; 95% CI = 1.33 to 1.52). The third study evaluated the effectiveness of standard CBT vs work-focused CBT in 168 employees with common mental health problems (depression, anxiety and adjustment disorders). Employees receiving work-focused CBT returned to work 65 days earlier on average than those receiving standard CBT. Limited evidence shows that psychotherapy is effective in claimants suffering from depression who are in receipt of wage replacement benefits. At this time, clinicians and insurers should continue to recommend psychotherapy as a treatment management strategy for claimants with depression. Larger comparative trials, conducted in collaboration with disability insurers, will lead to increased confidence in estimates.",25004599,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.81165599822998,-3.054656744003296,CLkH
"[Effectiveness of Behavioral Activation for the Treatment of Severe Depression in Clinical Settings].

Objectives Among interventions that have been shown to be efficacious in the treatment of depression, behavioural activation (AC) is receiving increasing attention as the evidence supporting its effectiveness continues to accumulate. Although the efficacy of AC for the treatment of depression has been established through numerous randomized controlled trials, studies evaluating the effectiveness of AC when implemented in mental health settings are rare and there is insufficient supportive data. This step is, however, essential to the validity and the generalization of the treatment to the reality of clinical settings. This study focuses on AC applied to take into account the reality of clinical settings and patients seeking treatment. It evaluates the effectiveness of group-based AC for the treatment of severe depression in a clinical setting in a heterogeneous population in terms of diagnosis (unipolar and bipolar depression) and comorbidity (Axis I and II). Methods A sample of 45 participants with severe depression was recruited in a psychiatric hospital. Participants received a 10 sessions group intervention of AC. Questionnaires were administered to obtain pretreatment, post-treatment and four-week post-treatment data. The impact of the intervention was observed on measures of depression, behavioural activation, reinforcement, anxiety, social adjustment and quality of life. Various moderation effects associated with the heterogeneity of the sample were tested on the evolution of depressive symptoms. The integrity of the treatment administered by the therapists and the acceptability of the intervention by participants were also documented. Results Mixed model analyses of variance were performed to assess whether (a) AC caused a significant change at the end of treatment on depressive symptoms, behavioural activation, reinforcement, anxiety, social adjustment and quality of life and whether (b) gains were maintained after four weeks. A significant change was obtained between the pre-post measures on the average score of all these variables, with the exception of a subscale of the quality of life measure. Analyses were also performed to verify various moderating effects on the evolution of depressive symptoms, level of activation and reinforcement. No interaction effects are observed on depression, activation and reinforcement measures. There is no significant difference according to pretreatment severity category, diagnosis (unipolar vs bipolar), presence of comorbidity (other Axis I and/or Axis II disorder) or co-morbidity of Axis II disorder. As for the activation measure in people with bipolar depression versus unipolar depression, it should be noted that the result is at the threshold of statistical significance. Conclusion The results support the effectiveness of group-based AC for the treatment of severe depression in clinical settings in a heterogeneous population, as well as for the maintenance of gains after four weeks. The effectiveness of AC was also observed across all associated psychosocial measures.",33270398,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.461281776428223,-1.8141218423843384,Aefa
"Behavioral interventions for office-based care: depressive disorders.

Depressive disorders commonly are diagnosed and managed in primary care settings, and many patients prefer a nonpharmacologic approach. Traditionally, symptom reduction through pharmacotherapy has been the primary focus of management, but there is a growing acknowledgment of the need to develop modalities that prevent subsequent relapse and recurrences. Psychotherapy, including cognitive behavioral and interpersonal therapies, can have enduring effects that reduce subsequent risk in ways that drugs cannot. Although most family physicians do not provide formal psychosocial interventions for depression, brief interventions and behavioral intervention technologies, such as those that deliver care via the Internet or mobile device, are key means of increasing access to psychotherapy. For children and adolescents with mild, uncomplicated depression, physician-provided social support, encouragement, and reinforcement of adaptive behavior patterns can be as effective as cognitive behavioral therapy. In addition, a primary care physician's involvement in parent education and safety planning for suicide prevention holds promise for risk reduction. Evidence also supports the use of problem-solving therapy and components of cognitive behavioral therapy and interpersonal psychotherapy provided by primary care physicians for patients with depression.",24628012,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,10.13752269744873,-2.3706746101379395,CQ28
"Economic Evaluation of Concise Cognitive Behavioural Therapy and/or Pharmacotherapy for Depressive and Anxiety Disorders.

Depressive and anxiety disorders cause great suffering and disability and are associated with high health care costs. In a previous conducted pragmatic randomised controlled trial, we have shown that a concise format of cognitive behavioural- and/or pharmacotherapy is as effective as standard care in reducing depressive and anxiety symptoms and in improving subdomains of general health and quality of life in secondary care psychiatric outpatients. In this economic evaluation, we examined whether a favourable cost-utility of concise care compared to standard care was attained. The economic evaluation was performed alongside a pragmatic randomised controlled trial. Health-related quality of life was measured using the Short-Form (SF-36) questionnaire. Cost of healthcare utilization and productivity loss (absenteeism and presenteeism) were assessed using the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P). A cost-utility analysis, using cost-effectiveness acceptability curves, comparing differences in societal costs and Quality-Adjusted Life Years (QALYs) at 1 year was performed. One year after study entry, the difference in mean cost per patient of the two primary treatments was not significant between both groups. No significant differences in other healthcare and non- healthcare costs could be detected between patients receiving concise care and standard care. Also, QALYs were not statistically different between the groups during the study period. From both the societal and healthcare perspective, the probability that concise care is more cost-effective compared to standard care remains below the turning point of 0.5 for all acceptable values of the willingness to pay for a QALY. The economic evaluation suggests that concise care is unlikely to be cost-effective compared to standard care in the treatment for depressive- and anxiety disorders in secondary mental health care during a one year follow up period. Total costs and QALYs were not significantly different between standard and concise care, with no evidence for cost-effectiveness of concise care in the first year. The longer impact of concise care for patients with mild to moderate symptoms of depressive and/or anxiety disorders compared to standard care in secondary care needs to be further studied. This economic evaluation failed to find significant differences in cost between concise and standard care over the study period of one year. Replication of our economic evaluation might benefit from an extended follow-up period and strict adherence to the study protocol. If concise care will be found to be cost-effective in the long term, this would have major implications for recommendations how to optimize secondary mental health care in the treatment of depressive -- and anxiety disorders.",26729009,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.890181541442871,-3.2374627590179443,BzDa
"A comparison of cost-effectiveness between offering antidepressant-CBT combinations first or second, for moderate to severe depression in Japan.

It is not clear which method is more cost-effective: To initially provide all depressed patients with combination therapy (COMB; i.e. cognitive behavioural therapy plus pharmacotherapy), followed by antidepressant treatment (AD) for those still in depression; or, to first provide AD for all patients, followed by COMB for non-remission patients. The aim is to investigate whether a COMB-first strategy would be more cost-effective than an AD-first strategy, in treating depression. A Markov model was developed to perform the analysis. The primary outcome was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) at 104 weeks. Probabilistic sensitivity analysis and scenario analysis were performed, to investigate the uncertainty associated with the clinical parameters and the impact of CBT's cost on the results, respectively. The ICER per QALY at 104 week, was JPY 591,822 (USD 5,725) for moderate depression and JPY 499,487 (USD 4,832) for severe one. The scenario analysis revealed the ICER became JPY 1,147,518 (USD 11,101) for moderate and JPY 968,484 (USD 9,369) for severe when the CBT cost was set as JPY 14,400 (USD 139)(i.e. GBP 96: the unit cost of CBT in UK), which is well below the threshold recommended by NICE (i.e. GBP 20,000-30,000). This is a model-based analysis which was conducted from the health insurance perspective. Then, the analysis from the societal perspective would generate different results. The results suggest that a COMB-first strategy would be more cost effective than an AD-first strategy.",34147970,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.734427452087402,-2.9177019596099854,AUfF
"Treatment as usual (TAU) for depression: a comparison of psychotherapy, pharmacotherapy, and combined treatment at a large academic medical center.

Depression is among the most prevalent and burdensome psychiatric disorders in the United States (Kessler et al., Achieves of General Psychiatry 62:617-627, 2005). There is substantial empirical support regarding efficacy of pharmacotherapy, psychotherapy, and combined treatment (both pharmacotherapy and psychotherapy) for treating depression. However, far less is known about the effectiveness of these treatments for real-world patients treated within routine clinical care settings (Cahill et al., The British Journal of Clinical Psychology 49:421-453, 2010). This study seeks to explore the effectiveness of treatment as usual (TAU) for depression in a large cohort of psychiatric outpatients receiving psychotherapy, pharmacotherapy, or combined treatment within an academic medical center. Initial and follow-up self-report assessments were analyzed for 1,322 patients receiving treatment for depression. Using these data, we determined treatment effect sizes, rates of reliable improvement (and deterioration), and rates of clinically significant improvement for psychotherapy, pharmacotherapy, and combined care. On average, all treatments produced significant improvement with effect sizes surpassing our no-treatment benchmark. No significant between-group (treatment) differences in self-report outcomes were found. The rates of reliable change were similar for all treatment groups consistent with past research. The present findings support the effectiveness of psychotherapy, pharmacotherapy, and combined treatment as routinely provided within a large academic medical center for the treatment of real-world patients suffering with depression.",23505987,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.89085578918457,-2.796052932739258,CghJ
"Evaluation of a text-message-based maintenance intervention for Major Depressive Disorder after inpatient cognitive behavioral therapy.

High relapse rates in Major Depressive Disorder (MDD) indicate the need for interventions enhancing the sustainability of treatment outcomes. Primary aim of the present study was to evaluate the effectiveness of a text-message-based maintenance intervention for depression (TMMI-D). Additionally, we aimed to clarify whether the use of individualized messages would lead to better outcome than the use of standardized messages which focused upon adaptive ways of regulating undesired emotions. In this RCT, 226 individuals who had completed inpatient treatment for MDD were randomly allocated to a condition in which participants received TMMI-D with standardized messages targeting emotion regulation, or to a condition with individualized messages, or to a waitlist control condition. Primary outcome was depressive symptom severity assessed with the BDI-II. Multilevel analyses suggest that participants receiving TIMMI-D with standardized messages reported a significantly smaller increase of depressive symptoms during the post-treatment and follow-up interval than did patients in the waitlist control condition. Contrastingly, there was no such effect for patients who had used TIMMI-D with individualized messages. Limitations include proportions of missing data, thus, generalizing the findings of the present study might be an overestimation. Text-message-based interventions may help increase the sustainability of outcome after treatment for MDD. The unexpected superiority of the standardized over the individualized version is in line with research that points to the efficacy of interventions fostering adaptive emotion regulation as a means to treat depression (and other mental disorders).",29132073,Major Depressive Disorder,Anxiety Treatment,Mental Health,7324,10.168303489685059,-2.1859326362609863,BUPW
"Cost-utility and cost-effectiveness of internet-based treatment for adults with depressive symptoms: randomized trial.

The effectiveness of Internet-based treatments for depression has been demonstrated; their cost-effectiveness, however, has been less well researched. Evaluating the relative cost-utility and cost-effectiveness of (1) Internet-based cognitive behavioral therapy, (2) Internet-based problem-solving therapy, and (3) a waiting list for adults with depressive symptoms. A total of 263 participants with clinically significant depressive symptoms were randomized to Internet-based cognitive behavioral therapy (n = 88), Internet-based problem-solving therapy (n = 88), and a waiting list (n = 87). End points were evaluated at the 12-week follow-up. Cost-utility analysis showed that cognitive behavioral therapy and problem-solving therapy had a 52% and 61% probability respectively of being more acceptable than waiting when the willingness to pay is € 30,000 for one quality-adjusted life-year. When society is prepared to pay € 10,000 for a clinically significant change from depression, the probabilities of cognitive behavioral therapy and problem-solving therapy being more acceptable than waiting are 91% and 89%, respectively. Comparing both Internet-based treatments showed no clear preference for one or the other of the treatments. Both Internet-based treatments have a high probability of being cost-effective with a modest value placed on clinically significant change in depressive symptoms. ISRCTN16823487; http://www.controlled-trials.com/ISRCTN16823487 (Archived by WebCite at http://www.webcitation.org/5u8slzhDE).",21169166,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.633511543273926,-3.3415446281433105,DCGG
"Effectiveness of a freely available computerised cognitive behavioural therapy programme (MoodGYM) for depression: Meta-analysis.

To investigate the effectiveness of a freely available computerised cognitive behavioural therapy programme (MoodGYM) for depression (primary outcome), anxiety and general psychological distress in adults. We searched PsycINFO, CINAHL Plus, MEDLINE, EMBASE, Social Science Citation Index and references from identified papers. To assess MoodGYM's effectiveness, we conducted random effects meta-analysis of identified randomised controlled trials. Comparisons from 11 studies demonstrated MoodGYM's effectiveness for depression symptoms at post-intervention, with a small effect size ( g=0.36, 95% confidence interval: 0.17-0.56; I2=78%). Removing the lowest quality studies ( k=3) had minimal impact; however, adjusting for publication bias reduced the effect size to a non-significant level ( g=0.17, 95% confidence interval: -0.01 to 0.38). Comparisons from six studies demonstrated MoodGYM's effectiveness for anxiety symptoms at post-intervention, with a medium effect size ( g=0.57, 95% confidence interval: 0.20-0.94; I2=85%). Although comparisons from six studies did not yield significance for MoodGYM's effectiveness for general psychological distress symptoms, the small effect size approached significance ( g=0.34, 95% confidence interval: -0.04 to 0.68; I2=79%). Both the type of setting (clinical vs non-clinical) and MoodGYM-developer authorship in randomised controlled trials had no meaningful influence on results; however, the results were confounded by the type of control deployed, level of clinician guidance, international region of trial and adherence to MoodGYM. The confounding influence of several variables, and presence of publication bias, means that the results of this meta-analysis should be interpreted with caution. Tentative support is provided for MoodGYM's effectiveness for symptoms of depression and general psychological distress. The programme's medium effect on anxiety symptoms demonstrates its utility for people with this difficulty. MoodGYM benefits from its free accessibility over the Internet, but adherence rates can be problematic and at the extreme can fall below 10%. We conclude that MoodGYM is best placed as a population-level intervention that is likely to benefit a sizeable minority of its users.",27384752,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.673419952392578,-3.0194170475006104,BqXQ
"[Cognitive therapy and interpersonal psychotherapy for major depressive disorder: how do they work, how long, and for whom?]

Although the effectiveness of cognitive therapy (ct) and interpersonal psychotherapy (ipt) for depression has been well established, little is known about how, how long and for whom they work.<br/> AIM: To summarize findings from a large rct to the (differential) effects and mechanisms of change of ct/ipt for depression.<br/> METHOD: 182 adult depressed outpatients were randomized to ct (n = 76), ipt (n = 75), or a two-month wait-list-control condition (n = 31). Primary outcome was depression severity (bdi-ii). Other outcomes were quality of life, social and general psychological functioning and various potential process measures. Interventions were compared at the end of treatment, and up to 17 months follow-up.<br/> RESULTS: Overall, ct and ipt were both superior to the wait-list, but did not differ significantly from one another. However, the pathway through which therapeutic change occurred appeared to be different for ct and ipt, and many patients were predicted to have a clinically meaningful advantage in one of the two interventions. We did not find empirical support for the theoretical models of change.<br/> CONCLUSION: (Long-term) outcomes of ct and ipt appear to not differ significantly. The field would benefit from further refinement of research methods to disentangle mechanisms of change, and from advances in the field of personalized medicine.",31907915,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.630829811096191,-2.951935291290283,AvUx
"Inpatient psychotherapy for depression in a large routine clinical care sample: A Bayesian approach to examining clinical outcomes and predictors of change.

A routinely collected dataset was analyzed (1) to determine the naturalistic effectiveness of inpatient psychotherapy for depression in routine psychotherapeutic care, and (2) to identify potential predictors of change. In a sample of 22,681 inpatients with depression, pre-post and pre-follow-up effect sizes were computed for various outcome variables. To build a probabilistic model of predictors of change, an independent component analysis generated components from demographic and clinical data, and Bayesian EFA extracted factors from the available pre-test, post-test and follow-up questionnaires in a subsample (N = 6377). To select the best-fitted model, the BIC of different path models were compared. A Bayesian path analysis was performed to identify the most important factors to predict changes. Effect sizes were large for the primary outcome and moderate for various secondary outcomes. Almost all pretreatment factors exerted significant influences on different baseline factors. Several factors were found to be resistant to change during treatment: suicidality, agoraphobia, life dissatisfaction, physical disability and pain. The strongest cross-loadings were observed from suicidality on negative cognitions, from agoraphobia on anxiety, and from physical disability on perceived disability. No causal conclusions can be drawn directly from our results as we only used cross-lagged panel data without control group. The results indicate large effects of inpatient psychotherapy for depression in routine clinical care. The direct influence of pretreatment factors decreased over the course of treatment. However, some factors appeared stable and difficult to treat, which might hinder treatment outcome. Findings of different predictors of change are discussed.",35219740,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.913324356079102,-2.330087184906006,lMw
"Outcome of Psychoanalytic and Cognitive-Behavioural Long-Term Therapy with Chronically Depressed Patients: A Controlled Trial with Preferential and Randomized Allocation.

For chronic depression, the effectiveness of brief psychotherapy has been limited. This study is the first comparing the effectiveness of long-term cognitive-behavioural therapy (CBT) and long-term psychoanalytic therapy (PAT) of chronically depressed patients and the effects of preferential or randomized allocation. A total of 252 adults met the inclusion criteria (aged 21-60 years, major depression, dysthymia, double depression for at least 24 months, Quick Inventory of Depressive Symptoms [QIDS] >9, Beck Depression Inventory II [BDI] >17, informed consent, not meeting exclusion criteria). Main outcome measures were depression self-rating (BDI) and rating (clinician-rated QIDS [QIDS-C]) by independent, treatment-blinded clinicians. Full remission rates (BDI ≤12, QIDS-C ≤5) were calculated. An independent center for data management and biostatistics analyzed the treatment effects and differences using linear mixed models (multilevel models and hierarchical models). The average BDI declined from 32.1 points by 12.1 points over the first year and 17.2 points over 3 years. BDI overall mean effect sizes increased from d = 1.17 after 1 year to d = 1.83 after 3 years. BDI remission rates increased from 34% after 1 year to 45% after 3 years. QIDS-C overall effect sizes increased from d = 1.56 to d = 2.08, and remission rates rose from 39% after 1 year to 61% after 3 years. We found no significant differences between PAT and CBT or between preferential and randomized allocation. Psychoanalytic as well as cognitive-behavioural long-term treatments lead to significant and sustained improvements of depressive symptoms of chronically depressed patients exceeding effect sizes of other international outcome studies.",30384775,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.370218276977539,-2.3999204635620117,BD5t
"What predicts outcome, response, and drop-out in CBT of depressive adults? a naturalistic study.

The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment. To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT. 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses. A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment. Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.",23211066,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,11.774556159973145,-3.1354238986968994,Ck5m
"Bibliotherapy for depression.

Bibliotherapy can be used to treat mild to moderate depression or subthreshold depressive symptoms, as a sole or supplementary therapy. Bibliotherapy is a form of guided self-help. The patient works through a structured book, independently from the doctor. The role of the doctor is to support and motivate the patient as they continue through the book and to help clarify any questions or concerns the patient may have. Relevant books can be purchased or often borrowed from a library, with limited cost and good accessibility from a patient perspective. Patients need to have a reading age above 12 years and have a positive attitude toward self-help. Bibliotherapy has NHMRC Level 1 evidence of efficacy and no serious adverse effects have been reported. This article forms part of a series on non-drug treatments, which summarise the indications, considerations and the evidence, and where clinicians and patients can find further information.",23550243,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.885102272033691,-3.375540256500244,Cf3B
"Reversals of sudden gains made during cognitive therapy with depressed adults: a preliminary investigation.

This study investigated sudden reversals during cognitive therapy (CT), through the comparison of ""in-session"" activity and ""out-of-session"" life events. The sample comprised 20 clients who experienced sudden gains during CT for depression: 10 who subsequently suffered a reversal of this gain and 10 matched clients who maintained progress. Measures of client resistance and therapist responses were scored by judges from session transcripts and clients completed measures of life events and depression at each session. This enabled the Reversal and Non-Reversal groups to be compared during pre-sudden gain, pre-reversal or matched sessions. No differences were apparent between the Reversal and Non-reversal groups or between the pre-gain and pre-reversal sessions in terms of client or therapist ""in-session"" activities. In the Reversals group, 6 out of 10 clients recovered their level of symptom improvement, following the reversal. Therapists showed higher levels of reflection and self-disclosure with clients who did not recover their symptom gain following the Reversal than with clients who did recover their symptom gain following the Reversal. The study is discussed in terms of the manner by which reversals can be more effectively measured and researched.",20406531,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.17091178894043,-2.9394710063934326,DLeK
"Efficacy of a transdiagnostic guided internet-delivered intervention for emotional, trauma and stress-related disorders in Mexican population: study protocol for a randomized controlled trial.

Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.",35941557,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.307068824768066,-2.659252643585205,MTc
"Effects of Brief Behavioural Activation on Approach and Avoidance Tendencies in Acute Depression: Preliminary Findings.

It has been suggested that the behavioural activation (BA) treatments for depression unfold their effects, at least partly, through changes in approach and avoidance tendencies. However, as yet, little research has examined the cognitive effects of these interventions. This study investigated the impact of a single session of BA on depressive symptomatology, self-reported avoidance, and behavioural approach and avoidance tendencies. Forty-six patients with a diagnosis of Major Depression were recruited from primary care psychological therapies services and block randomized to either a single session of behavioural activation (n = 22) or waiting list control (n = 24) delivered by an unblinded therapist. Self-reports of symptoms and cognitive factors were assessed before and after the one-week intervention phase. Approach and avoidance behavioural tendencies were assessed using the Approach-Avoidance Task (AAT). Data from 40 participants (n = 20 in each group) was available for analyses. Depressive symptoms significantly decreased, and activation significantly increased from before to after treatment in the treatment group, but not in the control group. Performance on the AAT showed a trend indicating increased approach to positive valence stimuli in the treatment group, but not in the control group. Mediational analyses indicated small indirect effects of self-reported change in activation as mediators of the effect of condition on symptoms. The findings suggest that a single session of BA can have significant effects on symptoms in clinically depressed patients. Results hint at the possibility that increased behavioural approach might mediate the effect of BA.",27692021,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.589411735534668,-2.0064992904663086,BmlV
"Telephone vs face-to-face cognitive behavioral therapy for depression.

",22990260,Major Depressive Disorder,Anxiety Treatment,Mental Health,16426,10.865477561950684,-2.6983604431152344,CoDi
"Psychotherapy effectiveness for major depression: a randomized trial in a Finnish community.

The purpose of this study is to assess the relative effectiveness of Interpersonal Psychotherapy (IPT), Psychoeducative Group Therapy (PeGT), and treatment as usual (TAU) for patients with Major Depressive Disorder (MDD) in municipal psychiatric secondary care in one Finnish region. All adult patients (N=1515) with MDD symptoms referred to secondary care in 2004-2006 were screened. Eligible, consenting patients were assigned randomly to 10-week IPT (N=46), PeGT (N=42), or TAU (N=46) treatment arms. Antidepressant pharmacotherapy among study participants was evaluated. The Hamilton Depression Rating scale (HAM-D) was the primary outcome measure. Assessment occurred at 1, 5, 3, 6, and 12 months. Actual amount of therapists' labor was also evaluated. All statistical analyses were performed with R software. All three treatment cells showed marked improvement at 12-month follow-up. At 3 months, 42 % in IPT, 61 % in PeGT, and 42 % in TAU showed a mean ≥50 % in HAM-D improvement; after 12 months, these values were 61 %, 76 %, and 68 %. Concomitant medication and limited sample size minimized between-treatment differences. Statistically significant differences emerged only between PeGT and TAU favoring PeGT. Secondary outcome measures (CGI-s and SOFAS) showed parallel results. All three treatments notably benefited highly comorbid MDD patients in a public sector secondary care unit. ClinicalTrials.gov NCT02314767 (09.12.2014).",27153942,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.278986930847168,-3.2818925380706787,BtLE
"An adjunctive Management of Depression Program for difficult-to-treat depressed patients and their families.

The goal of this open-label feasibility trial was to test a short-term, adjunctive intervention, the Management of Depression (MoD) Program, to determine if patients with difficult-to-treat forms of depression and their family members could learn to cope more effectively with their illness. Nineteen patients meeting The Diagnostic and Statistical Manual IV criteria for major depressive disorder, dysthymia, or chronic/recurrent depression and their family members participated in an open-label study testing the efficacy of the MoD Program. The intervention consisted of nine sessions over 16 weeks, followed by an 8-month maintenance phase. Outcome measures focused on quality of life, psychological and family functioning, and level of depression. Fourteen patients and their family members improved significantly in psychosocial and family functioning, and depression severity (all P-values <.05) by the end of the 16-week intervention. There was also significant improvement in quality of life, psychosocial and family functioning, and depression scores (all P-values<.05) for the 10 patients who completed the maintenance phase. The MoD Program is a useful adjunctive intervention that helped patients and their family members deal more effectively with their persisting depression. The disease management approach improved the patient's perceived quality of life and functioning, reduced depressive symptoms, and improved perception of their family's functioning.",20013959,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.042409896850586,-0.9849867820739746,DPet
"Dysfunctional attitudes as a moderator of pharmacotherapy and psychotherapy for chronic depression.

Individuals with chronic depression exhibit heterogeneous responses to treatment. Important individual differences may therefore exist within this particularly difficult to treat population that act as moderators of treatment response. The present study examined whether pretreatment levels of dysfunctional attitudes (DA) moderated treatment response in a large sample of chronically depressed individuals. Data were taken from the Research Evaluating the Value of Augmenting Medication with Psychotherapy (REVAMP) treatment study--a multi-site treatment and augmentation study of 808 chronically depressed individuals. REVAMP comprised two phases: 1) a 12-week open-label antidepressant trial and 2), a subsequent phase, in which phase 1 non-remitters (N = 491) were randomized to either receive an ongoing medication algorithm alone, medication plus cognitive behavioral analysis system of psychotherapy, or medication plus brief supportive psychotherapy. In phase 1, compared to the pharmacotherapy response of patients with lower DA scores, the response for patients with higher DA scores was steeper, but leveled off toward the end of the phase. In phase 2, DA predicted a differential response in the medication only arm, but not in the two psychotherapy + medication conditions. Specifically, in the phase 2 medication only condition, patients with higher DA improved while those with lower DA scores did not. These results indicate that the relation between DA and treatment response in chronic depression is complex, but suggest that greater DA may be associated with a steeper reduction and/or better response to pharmacotherapy.",23102821,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.205498695373535,-1.3923022747039795,Cmde
"The impact of brief dynamic interpersonal therapy (DIT) on veteran depression and anxiety.

A significant proportion of veterans continue to experience depression or anxiety following treatment with the empirically supported psychotherapies offered by the Veterans Health Administration. Continued development and testing of new treatments may be useful. Brief dynamic interpersonal therapy (DIT) is a short-term psychodynamic therapy developed for depression in the United Kingdom and is being disseminated as an alternative to cognitive behavioral therapy within the National Health Service. This study represents the first evaluation of DIT in the United States, implemented at a veterans affairs medical center for veterans with depression and/or anxiety. Electronic medical records of veterans receiving DIT from 2012 to 2018 at a New York-based veterans affairs medical center were reviewed. Linear mixed-effects models were used to analyze depression and anxiety scores collected at each session from the Patient Health Questionnaire and the Generalized Anxiety Disorder seven-item scale. Following DIT, patients presenting with clinically significant depression and/or anxiety reported a 46% reduction in Patient Health Questionnaire-9 scores (N = 60) and a 43% reduction in Generalized Anxiety Disorder seven-item scale scores (N = 46). Large effect sizes on both measures were found (d = 1.17, 95% CI [0.88, 1.47], p < .0001; d = 1.24, 95% CI [0.90, 1.58], p < .0001, respectively). DIT is a promising alternative to currently offered psychotherapies for veterans with depression and anxiety. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",31999192,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.994428634643555,-4.051578998565674,AuKo
"Personalising psychotherapies for depression using a novel mixed methods approach: an example from Morita therapy.

Current quantitative methods for personalising psychotherapies for depression are unlikely to be able to inform clinical decision-making for hundreds of years. Novel alternative methods to generate hypotheses for prospective testing are therefore required, and we showcase mixed methods as one such approach. By exploring patients' perspectives in depth, and integrating qualitative and quantitative data at the level of the individual, we may identify new potential psychosocial predictors of psychotherapy outcomes, potentially informing the personalisation of depression treatment in a shorter timeframe. Using Morita therapy (a Japanese psychotherapy) as an exemplar, we thus explored how Morita therapy recipients' views on treatment acceptability explain their adherence and response to treatment. The Morita trial incorporated a pilot randomised controlled trial of Morita therapy versus treatment as usual for depression, and post-treatment qualitative interviews. We recruited trial participants from general practice record searches in Devon, UK, and purposively sampled data from 16 participants for our mixed methods analysis. We developed typologies of participants' views from our qualitative themes, and integrated these with quantitative data on number of sessions attended and whether participants responded to treatment in a joint typologies and statistics display. We enriched our analysis using participant vignettes to demonstrate each typology. We demonstrated that (1) participants who could identify with the principles of Morita therapy typically responded to treatment, regardless of how many sessions they attended, whilst those whose orientation towards treatment was incompatible with Morita therapy did not respond to treatment, again regardless of treatment adherence and (2) participants whose personal circumstances impeded their opportunity to engage in Morita therapy attended the fewest sessions, though still benefitted from treatment if the principles resonated with them. We identified new potential relationships between ""orientation"" and outcomes, and ""opportunity"" and adherence, which could not have been identified using existing non-integrative methods. This mixed methods approach warrants replication in future trials and with other psychotherapies to generate hypotheses, based on typologies (or profiles) of patients for whom a treatment is more or less likely to be suitable, to be tested in prospective trials. Current Controlled Trials, ISRCTN17544090. Registered on 23 July 2015.",31915064,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.593060493469238,-2.1208138465881348,AvOW
"Economic evaluations of internet- and mobile-based interventions for the treatment and prevention of depression: A systematic review.

Internet- and mobile-based interventions (IMIs) targeting depression have been shown to be clinically effective and are considered a cost-effective complement to established interventions. The aim of this review was to provide an overview of the evidence for the cost-effectiveness of IMIs for the treatment and prevention of depression. A systematic database search was conducted (Medline, PsychInfo, CENTRAL, PSYNDEX, OHE HEED). Relevant articles were selected according to defined eligibility criteria. IMIs were classified as cost-effective if they were below a willingness-to-pay threshold (WTP) of €22,845 (£20,000) - €34,267 (£30,000) per additional quality-adjusted life year (QALY) according to the National Institute for Health and Clinical Excellence (NICE) standard. Study quality was assessed using the Consolidated Health Economic Evaluation Reporting Standard guidelines and the Cochrane Risk of Bias Tool. Of 1538 studies, seven economic evaluations of IMIs for the treatment of major depression, four for the treatment of subthreshold/minor depression and one for the prevention of depression. In six studies, IMIs were classified as likely to be cost-effective with an incremental cost-utility ratio between €3088 and €22,609. All of these IMIs were guided. Overall quality of most economic evaluations was evaluated as good. All studies showed some risk of bias. The studies used different methodologies and showed some risk of bias. These aspects as well as the classification of cost-effectiveness according to the WTP proposed by NICE should be considered when interpreting the results. Results indicate that guided IMIs for the treatment of (subthreshold) depression have the potential to be a cost-effective complement to established interventions, but more methodologically sound studies are needed.",28922737,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.496384620666504,-3.3095293045043945,BW2O
"Feasibility and Outcome of a Short-Term Group Therapy for Inpatients with Comorbid Substance Use Disorders and Depression: The InterPersonal Kiesler-Circle Training (IPKCT).

",27513671,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,11.7068452835083,-3.5366406440734863,Bovr
"The efficacy of short-term psychodynamic psychotherapy for depression: a summary of recent findings.

",20064127,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.070008277893066,-4.630327224731445,DO+L
"Treating Subthreshold Depression in Primary Care: A Randomized Controlled Trial of Behavioral Activation With Mindfulness.

We undertook a randomized controlled trial to assess the efficacy of group-based behavioral activation with mindfulness (BAM) for treating subthreshold depression in primary care in Hong Kong. We recruited adult patients aged 18 years or older with subthreshold depression from public primary care clinics and randomly assigned them to a BAM intervention group or a usual care group. The BAM group was provided with eight 2-hour weekly BAM sessions by trained allied health care workers. Patients in the usual care group received usual medical care with no additional psychological interventions. The primary outcome was depressive symptoms measured by the Beck Depression Inventory-II at 12 months. Secondary outcomes included incidence of major depressive disorder at 12 months. We assessed quality of life, activity and circumstances change, functional impairment, and anxiety at baseline, end of intervention, 5 months, and 12 months. We randomly allocated 115 patients to the BAM intervention and 116 patients to usual care. At 12 months, compared with usual care peers, BAM patients had a slightly more favorable change in levels of depressive symptoms on the Beck Depression Inventory-II (between-group mean difference in score = -3.85; 95% CI, -6.36 to -1.34; Cohen d = -0.46, 95% CI, -0.76 to -0.16). Incidence of major depressive disorder was lower with BAM (10.8% vs 26.8%, P = .01), whereas groups did not differ significantly on other secondary outcomes at 12 months. Group BAM appears to be efficacious for decreasing depressive symptoms and reducing the incidence of major depression among patients with subthreshold depression in primary care, although generalizability of our findings may be limited.",29531101,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.257081031799316,-2.3094663619995117,BOup
"The efficacy of interpersonal psychotherapy for depression among economically disadvantaged mothers.

A randomized clinical trial was conducted to evaluate the efficacy of interpersonal psychotherapy (IPT) for ethnically and racially diverse, economically disadvantaged women with major depressive disorder. Non-treatment-seeking urban women (N = 128; M age = 25.40, SD = 4.98) with infants were recruited from the community. Participants were at or below the poverty level: 59.4% were Black and 21.1% were Hispanic. Women were screened for depressive symptoms using the Center for Epidemiologic Studies Depression Scale; the Diagnostic Interview Schedule was used to confirm major depressive disorder diagnosis. Participants were randomized to individual IPT or enhanced community standard. Depressive symptoms were assessed before, after, and 8 months posttreatment with the Beck Depression Inventory-II and the Revised Hamilton Rating Scale for Depression. The Social Support Behaviors Scale, the Social Adjustment Scale-Self-Report, and the Perceived Stress Scale were administered to examine mediators of outcome at follow-up. Treatment effects were evaluated with a growth mixture model for randomized trials using complier-average causal effect estimation. Depressive symptoms trajectories from baseline through postintervention to follow-up showed significant decreases among the IPT group compared to the enhanced community standard group. Changes on the Perceived Stress Scale and the Social Support Behaviors Scale mediated sustained treatment outcome.",24229549,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.123804092407227,-3.9654691219329834,CWH5
"Positive Psychology for Overcoming Symptoms of Depression: A Pilot Study Exploring the Efficacy of a Positive Psychology Self-Help Book versus a CBT Self-Help Book.

Depression is an extremely common mental health disorder, with prevalence rates rising. Low-intensity interventions are frequently used to help meet the demand for treatment. Bibliotherapy, for example, is often prescribed via books on prescription schemes (for example 'Reading Well' in England) to those with mild to moderate symptomology. Bibliotherapy can effectively reduce symptoms of depression (Naylor et al., 2010). However, the majority of self-help books are based on cognitive behavioural therapy (CBT), which may not be suitable for all patients. Research supports the use of positive psychology interventions for the reduction of depression symptoms (Bolier et al., 2013) and as such self-help books from this perspective should be empirically tested. This study aimed to test the efficacy of 'Positive Psychology for Overcoming Depression' (Akhtar, 2012), a self-help book for depression that is based on the principles of positive psychology, in comparison with a CBT self-help book that is currently prescribed in England as part of the Reading Well books on prescription scheme. Participants (n = 115) who were not receiving treatment, but had symptoms of depression, read the positive psychology or the CBT self-help book for 8 weeks. Depression and well-being were measured at baseline, post-test and 1-month follow-up. Results suggest that both groups experienced a reduction in depression and an increase in well-being, with no differences noted between the two books. Future directions are discussed in terms of dissemination, to those with mild to moderate symptoms of depression, via books on prescription schemes.",29692281,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,11.034791946411133,-3.9258663654327393,BMu5
"Comparative outcomes among the problem areas of interpersonal psychotherapy for depression.

Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose psychotherapy focused on each problem area. Moreover, we sought to understand how the patient characteristics and interpersonal problems most closely linked to the onset of a patient's current depression contributed to IPT success. Patients meeting DSM-IV criteria for an episode of major depressive disorder (n=182) were treated with weekly IPT. Remission was defined as an average Hamilton Rating Scale for Depression 17-item score of 7 or below over 3 weeks. Personality disorders were diagnosed using the Structured Clinical Interview for DSM-IV Personality Disorders. Contrary to our prediction that patients whose treatment was focused on interpersonal deficits would take longer to remit, survival analyses indicated that patients receiving treatment focused on each of the four problem areas did not differ in their times to remission. Nor were patients in the interpersonal deficits group more likely to have an Axis II diagnosis. Patients whose treatment focused on role transitions remitted faster than those whose treatment focused on role disputes, after controlling for covariates. With skillful use of IPT strategies and tactics and with careful medication management where appropriate, patients in this study whose treatment focused on each problem area were treated with equal success by trained IPT clinicians.",20099274,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.679335594177246,-3.7863171100616455,DOjL
"Internet-Delivered Disease Management for Recurrent Depression: A Multicenter Randomized Controlled Trial.

Strategies to improve the life of patients suffering from recurrent major depression have a high relevance. This study examined the efficacy of 2 Internet-delivered augmentation strategies that aim to prolong symptom-free intervals. Efficacy was tested in a 3-arm, multicenter, open-label, evaluator-blind, randomized controlled trial. Upon discharge from inpatient mental health care, 232 adults with 3 or more major depressive episodes were randomized to 1 of 2 intervention groups (SUMMIT or SUMMIT-PERSON) or to treatment as usual (TAU) alone. Over 12 months, participants in both intervention arms received, in addition to TAU, intense monitoring via e-mail or a smartphone, including signaling of upcoming crises, assistance with personal crisis management, and facilitation of early intervention. SUMMIT-PERSON additionally offered regular expert chats. The primary outcome was 'well weeks', i.e. weeks with at most mild symptoms assessed by the Longitudinal Interval Follow-Up Evaluation, during 24 months after the index treatment. SUMMIT compared to TAU reduced the time with an unwell status (OR 0.48; 95% CI 0.23-0.98) through faster transitions from unwell to well (OR 1.44; 95% CI 0.83-2.50) and slower transitions from well to unwell (OR 0.69; 95% CI 0.44-1.09). Contrary to the hypothesis, SUMMIT-PERSON was not superior to either SUMMIT (OR 0.77; 95% CI 0.38-1.56) or TAU (OR 0.62; 95% CI 0.31-1.24). The efficacy of SUMMIT was strongest 8 months after the intervention. The fully automated Internet-delivered augmentation strategy SUMMIT has the potential to improve TAU by reducing the lifelong burden of patients with recurrent depression. The fact that the effects wear off suggests a time-unlimited extension.",26808817,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.047554016113281,-3.221261739730835,ByCV
"Psychotherapy for depression in college students: A protocol for systematic review and network meta-analysis.

Depression is a disease with a high incidence and easy to relapse. It not only affects the work and life of patients, but also brings a heavy economic burden. University is the peak of depression, and the prevalence of depression among college students is much higher than that of ordinary people. The purpose of this research is to evaluate depression symptoms, life satisfaction, self-confidence, substance use, social adjustment, and dropout rates of the use of psychological intervention for college students. We will identify relevant trials from systematic searches in the following electronic databases: PubMed, Embase, Web of Science and The Cochrane Library. We will also search Clinical Trials.gov, the WHO International Clinical Trials Registry Platform for unpublished data. Additional relevant studies will be searched through search engines (such as Google), and references included in the literature will be tracked. All relevant randomized controlled trials (RCTs) will be included. There are no date restrictions. Use Cochrane Collaboration's Risk of bias tool to conduct risk of bias analysis. Use the Grades of Recommendation, Assessment, Development, and Evaluation to assess the quality of evidence. All statistical analysis will be performed using Stata (V.15.0.) and Review Manager (V.5.2.0). A total of 6238 records were obtained by searching the database and 27 records were obtained by other sources. After removing duplicate records, there are 4225 records remaining. We excluded 3945 records through abstract and title, leaving 280 full-text articles. This will be the first study to compare the effects of different psychological treatments on depression in college students. We hope that this study will guide clinical decision-making of psychotherapy to better treat depression in college students. INPLASY202070134.",32991449,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.699353218078613,-3.4832465648651123,Ahzg
"Development and testing of a self-regulation model for recurrent depression.

Self-regulation is a strategy for self-management of depression. Study aims were to (1) describe development of an intervention based on metacognition and self-regulation, (2) test intervention feasibility and utility, and (3) determine its effectiveness in reducing depressive symptoms. The Self-Regulated Illness Management of Depression intervention was developed and taught to 22 participants with recurrent depression. There was no attrition 6 months post intervention. At 6 months, there was a significant decrease in depressive symptoms (M=10.21, standard deviation=8.0), t(18)=5.60, p<.001, and 73 percent of participants used Self-Regulated Illness Management of Depression frequently. Results indicated that Self-Regulated Illness Management of Depression was feasible and useful.",29722280,Major Depressive Disorder,Anxiety Treatment,Mental Health,9215,10.559216499328613,-3.0308573246002197,BMVS
"Cost-effectiveness analysis of internet-mediated cognitive behavioural therapy for depression in the primary care setting: results based on a controlled trial.

To perform a cost-effectiveness analysis of a randomised controlled trial of internet-mediated cognitive behavioural therapy (ICBT) compared with treatment as usual (TaU) for patients with mild to moderate depression in the Swedish primary care setting. In particular, the objective was to assess from a healthcare and societal perspective the incremental cost-effectiveness ratio (ICER) of ICBT versus TaU at 12 months follow-up. A cost-effectiveness analysis alongside a pragmatic effectiveness trial. Sixteen primary care centres (PCCs) in south-west Sweden. Ninety patients diagnosed with mild to moderate depression at the PCCs. ICERs calculated as (CostICBT-CostTaU)/(Health outcomeICBT-Health outcomeTaU)=ΔCost/ΔHealth outcomes, the health outcomes being changes in the Beck Depression Inventory-II (BDI-II) score and quality-adjusted life-years (QALYs). The total cost per patient for ICBT was 4044 Swedish kronor (SEK) (€426) (healthcare perspective) and SEK47679 (€5028) (societal perspective). The total cost per patient for TaU was SEK4434 (€468) and SEK50343 (€5308). In both groups, the largest cost was associated with productivity loss. The differences in cost per patient were not statistically significant. The mean reduction in BDI-II score was 13.4 and 13.8 units in the ICBT and TaU groups, respectively. The mean QALYs per patient was 0.74 and 0.79 in the ICBT and TaU groups, respectively. The differences in BDI-II score reduction and mean QALYs were not statistically significant. The uncertainty of the study estimates when assessed by bootstrapping indicated that no firm conclusion could be drawn as to whether ICBT treatment compared with TaU was the most cost-effective use of resources. ICBT was regarded to be as cost-effective as TaU as costs, health outcomes and cost-effectiveness were similar for ICBT and TaU, both from a healthcare and societal perspective. ID NR 30511.",29903785,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.0917329788208,-2.813981056213379,BKV+
"Treating major depression by creating positive expectations for the future: a pilot study for the effectiveness of future-directed therapy (FDT) on symptom severity and quality of life.

This nonrandomized pilot study assesses the efficacy of a new future-oriented form of therapy, known as future-directed therapy (FDT), as a treatment for patients with Major Depressive Disorder (MDD) in a naturalistic hospital-based outpatient psychiatry clinic. The study measured symptom severity of depression and anxiety, in addition to quality of life pre- and posttreatment. The study examined a new manualized treatment designed to help people anticipate a more positive future. The intervention consists of twenty 90-min group sessions administered twice a week over 10 weeks. The intervention was compared to depressed patients in the same clinic who enrolled in traditional cognitive-based group psychotherapy. Sixteen patients with MDD completed the FDT intervention as part of their outpatient treatment for depression. Seventeen patients with MDD participated in treatment as usual (TAU) cognitive-based group therapy. The Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form, self-report instruments were administered prior to and immediately after the completion of therapy. Patients treated with FDT demonstrated significant improvements in depression (P = 0.001), anxiety (P = 0.021) and quality of life (P = 0.035), and also reported high satisfaction with the therapy. Compared to the TAU group, patients treated with FDT showed greater improvements in depressive symptoms (P = 0.049). FDT may have the potential of becoming an additional treatment option for patients with MDD.",21615882,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.308090209960938,-1.1579943895339966,C7xE
"Systematic review of universal and targeted workplace interventions for depression.

Depression is increasingly being recognised as a significant mental health problem in the workplace contributing to productivity loss and economic burden to organisations. This paper reviews recently published randomised controlled trials (RCTs) of universal and targeted interventions to reduce depression in the workplace. Studies were identified through searches of EMBASE, MEDLINE/PubMed, PsycINFO, PsycARTICLES Full Text, and Global Health and Social Policy and Practice databases. Studies were included if they included an RCT of a workplace intervention for employees targeting depression as the primary outcome. Twenty-two published RCTs investigating interventions utilising various therapeutic approaches were identified. The cognitive behavioural therapy (CBT) approach is the most frequently used in the workplace, while interventions that combine different therapeutic approaches showed the most promising results. A universal intervention in the workplace that combines CBT and coping flexibility recorded the highest effect size (d=1.45 at 4 months' follow-up). Most interventions were delivered in group format and showed low attrition rates compared with other delivery formats. Although all studies reviewed were RCTs, the quality of reporting is low. Interventions using different therapeutic approaches with different modes of delivery have been used. Most of these interventions were shown to reduce depression levels among employees in the workplace, particularly those that combine more than one therapeutic approaches.",29074553,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.519685745239258,-3.941377639770508,BVCr
"Editorial: Optimizing Depression Prevention: The Way Forward?

Since the advent of cognitive-behavioral therapy (CBT) and interpersonal therapy in the 1960s and 1970s, the progress on ""talking therapies"" has been slow. An extensive review of prevention and treatment studies over the past 50 years has shown that, although the therapies are effective, for depression the effect size is moderate, even for treatment, and has not changed in 50 years,1 with some indication that efficacy may have decreased.2 The approaches used in treatment have also been the mainstay of depression prevention approaches,3,4 with evidence of a small-to-moderate reduction in depressive symptoms but with no convincing evidence of reduction in the incidence of depressive disorder in meta-analyses.3,4.",34216778,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.604146003723145,-2.4833414554595947,ATwm
"Moderators of psychological and psychoeducational interventions for the prevention of depression: A systematic review.

Psychological and psychoeducational interventions have proven to be effective in preventing depression. However, the identification of the patients that benefit the most from each type of intervention has not yet been established. A systematic review was performed of the literature on moderators of preventive psychological and psychoeducational interventions for depression in all types of population. A search was performed on PubMed, PsycINFO, Web of Science, Embase, Cochrane Central Register of Controlled Trials and OpenGrey up to July 2019. Fulfillment of eligibility criteria, data collection, and study quality assessment were assessed by two independent researchers. Outcomes were moderators of the reduction of depressive symptoms or the incidence of depression. Twenty-seven moderator effect studies performed in 19 randomized controlled trials were included. Thirty-four potential sociodemographic, clinical, interpersonal, personality and life-event moderators were evaluated. Baseline depressive symptoms, gender, age, baseline parental depression and social support were the most frequently studied potential moderators. In interventions for children and adolescents, the moderator for which evidence was strongest was having parents free of depression at baseline. Psychological and psychoeducational interventions seem to be more effective in children and adolescents who exhibit a lower use of substances and whose parents do not have symptoms of depression at baseline. In adults, a lower age was associated with greater effects of preventive interventions. ETHICS: As this systematic review is based on published data, approval from the local ethics committee was not required.",32505982,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.007631301879883,-3.059098958969116,An1Z
"Internet- and mobile-based depression interventions for people with diagnosed depression: A systematic review and meta-analysis.

To summarize and critically evaluate the effectiveness of internet- and mobile-based interventions (IMIs) for depression in adults with a diagnosed depression. Preregistered systematic review of RCTs investigating internet- and mobile-based interventions (IMIs) targeting adults with diagnosed depression. IMIs had to be compared with waitlist, attention placebo, other IMIs or other (face-to-face) therapies. A comprehensive search of primary studies was conducted. Study selection and data extraction was done by two independent researchers. Primary outcome was symptom severity of depression. Furthermore, treatment response, depression remission, treatment adherence, anxiety and quality of life were investigated. Random-effects meta-analyses were conducted where possible, as well as pre-planned subgroup and sensitivity analyses. Database search resulted in 4858 references, of which 19 studies were eligible for inclusion and provided data on 29 IMIs. IMIs showed beneficial effects on depression severity when compared to waitlist conditions at the end of treatment (pooled standardized mean difference (SMD) g = -0.90, 95% CI -1.07 to -0.73, n = 10). The comparison between different IMIs did not result in any superiority or inferiority. All IMIs reduced depression symptoms from pre- to post-treatment (within group SMD range -2.24; -0.64, n = 29) and from pre-treatment to follow-up assessments (SMD range -3.07; -0.93, n = 27). IMIs significantly reduce depression symptoms in adults with diagnosed depression at the end of treatment and at follow-up assessments when compared to waitlist conditions. These findings argue for IMIs to be recommended in depression treatment guidelines.",28715726,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.201870918273926,-3.386138916015625,BZq8
"Differences in the Effect of Internet-Based Cognitive Behavioral Therapy for Improving Nonclinical Depressive Symptoms Among Workers by Time Preference: Randomized Controlled Trial.

Previous randomized controlled trials (RCTs) have shown a significant intervention effect of internet-based computerized cognitive behavioral therapy (iCBT) on improving nonclinical depressive symptoms among healthy workers and community residents in a primary prevention setting. Time preference is one's relative valuation for having a reward (eg, money) at present than at a later date. Time preference may affect the effectiveness of cognitive behavioral therapy. This RCT aimed to test the difference of intervention effect of an iCBT program on improving nonclinical depressive symptoms between two subgroups classified post-hoc on the basis of time preference among workers in Japan. All workers in one corporate group (approximate n=20,000) were recruited. Participants who fulfilled the inclusion criteria were randomly allocated to either intervention or control groups. Participants in the intervention group completed 6 weekly lessons and homework assignments within the iCBT program. The Beck Depression Inventory-II (BDI-II) and Kessler's Psychological Distress Scale (K6) measures were obtained at baseline and 3-, 6-, and 12-month follow-ups. Two subgroups were defined by the median of time preference score at baseline. Only few (835/20,000, 4.2%) workers completed the baseline survey. Of the 835 participants, 706 who fulfilled the inclusion criteria were randomly allocated to the intervention or control group. Participants who selected irrational time preference options were excluded (21 and 18 participants in the intervention and control groups, respectively). A three-way interaction (group [intervention/control] × time [baseline/follow-up] × time preference [higher/lower]) effect of iCBT was significant for BDI-II (t1147.42=2.33, P=.02) and K6 (t1254.04=2.51, P=.01) at the 3-month follow-up, with a greater effect of the iCBT in the group with higher time preference. No significant three-way interaction was found at the 6- and 12-month follow-ups. The effects of the iCBT were greater for the group with higher time preference at the shorter follow-up, but it was leveled off later. Workers with higher time preference may change their cognition or behavior more quickly, but these changes may not persist. UMIN Clinical Trials Registry UMIN000014146; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno=R000016466 (Archived by WebCite at http://www.webcitation.org/70o2rNk2V).",30097419,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.745024681091309,-3.205059766769409,BHuR
"Progress monitoring and feedback in psychiatric care reduces depressive symptoms.

To date, the monitoring of patient progress using standardized assessments has been neglected in hospital-based psychiatric care. Findings in outpatient psychotherapy have demonstrated clinically significant benefits for providing feedback to the sizeable minority of patients who were otherwise unlikely to experience positive outcome (Lambert, 2007). However, a similar system for presenting feedback on patient progress has not yet been assessed for group therapy within psychiatric inpatient settings. The current study aimed to develop and evaluate the effectiveness of a feedback system suitable for use in psychiatric services. In a nonrandomized trial, 1308 consecutive inpatients and day patients, whose diagnoses were primarily depressive and anxiety disorders, completed the World Health Organization's Wellbeing Index (WHO-5) routinely during a ten-day cognitive behavioral therapy group. The first cohort (n=461) received treatment as usual. The second cohort (n=439) completed monitoring measures without feedback, and for patients in the third cohort (n=408), feedback on progress was provided to both clinicians and patients midway through the treatment period. Feedback was effective in reducing depressive symptoms (F(1,649)=6.29, p<.05) for those patients at risk of poor outcome, but not effective in improving wellbeing (F(1,569)=1.14, p>.05). The current findings may be generalized to patient samples that exhibit largely depressive disorders, however rigorous follow-up is warranted. Similar to outpatient settings, feedback appears to be beneficial for improving symptom outcomes but further time may be required for wellbeing to be affected.",20542574,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,8.532036781311035,-5.981299877166748,DJbo
"A qualitative study of cognitive-behavioral therapy for Iranian migrants with mild/moderate depression in Austria.

This qualitative study was carried out to investigate the effectiveness of cognitive-behavioral therapy (CBT) for Iranian migrants suffering from major depressive disorder (MDD) and living in Austria for an average of 14 years. The qualitative data were collected through interviews based on the Farsi version of the Structured Clinical Interview for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, to obtain more information from the participants, they were asked to talk in more detail about their childhood and teenage years, reasons for immigration, their lifestyle before and after immigration, and their social activities. Interviews were conducted at four time points: preintervention, postintervention, 1-month follow-up, and 6-month follow-up. Patients who did not complete the interventions were interviewed on a voluntary basis to explain their reasons. Preintervention interviews were conducted to get some useful information about participant's' expectations of psychotherapy, especially group-based cognitive-behavioral therapy (GCBT), and also to assess the reasons for depression from their own point of view. The postintervention interviews were conducted to examine the participants' psychological situations as well as the reasons for positive effects of interventions. The interviews on average lasted 50 minutes, and field notes were taken. The results of this study showed a reduction in depression symptoms after the interventions. However, the effect of treatment was not persistent. The findings suggest that the main reasons behind Iranian migrants' depression in Austria is related to their dysfunctional acculturation attitude. The effectiveness of GCBT for Iranian migrants with depression also may be related to their sociocultural background.",27294588,Major Depressive Disorder,Anxiety Treatment,Mental Health,11643,11.379732131958008,-4.273154258728027,Brbo
"Effectiveness of brief group transdiagnostic therapy for emotional disorders in primary care: A randomized controlled trial identifying predictors of outcome.

AbstractBrief transdiagnostic psychotherapy is a possible approach for emotional disorders in primary care. The objective of the present randomized controlled trial was to determine its effectiveness compared with the treatment as usual based on pharmacological interventions in patients with mild/moderate symptoms. In addition, emotional regulation strategies and cognitive factors were studied as potential predictors. Participants (N=105) were assigned to brief group therapy based on the Unified Protocol (n=53) or treatment as usual (n=52). They were assessed before and after the interventions. Mean differences and stepwise regression analyses were performed. Brief group transdiagnostic psychotherapy was more effective than medication in reducing all clinical symptoms (p=.007 for generalized anxiety; p=.000 for somatization; p=.000 for panic disorder; and p=.041 for depression) and in modifying emotional regulation strategies and cognitive processes (p=.000 for cognitive reappraisal, expressive suppression, worry, rumination, and metacognition) with moderate/high effect sizes. Besides, it was found that these variables acted as predictors of the therapeutic change. It is concluded that brief therapies could be an accurate treatment for mild/moderate emotional disorders in primary care due to their cost-effective characteristics.",34269640,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,11.72399616241455,-2.8258941173553467,ATJx
"An exploratory randomized controlled trial of body psychotherapy for patients with chronic depression.

Chronic major depressive disorder and dysthymia are associated with a high burden and substantial care costs. New and more effective treatments are required. This is the first randomized controlled trial designed to evaluate the effectiveness of Body Psychotherapy (BPT) in patients with chronic depression. Patients with chronic depressive syndromes (more than 2 years symptomatic) and a total score of ≥ 20 on the Hamilton Rating Scale for Depression (HAMD) were randomly allocated to either immediate BPT or a waiting group which received BPT 12 weeks later. BPT was manualized, delivered in small groups in 20 sessions over a 10 weeks period, and provided in addition to treatment as usual. In an intention to treat analysis, primary outcome were depressive symptoms at the end of treatment adjusted for baseline symptom levels. Secondary outcomes were self-esteem and subjective quality of life. Thirty-one patients were included and twenty-one received the intervention. At the end of treatment patients in the immediate BPT group had significantly lower depressive symptom scores than the waiting group (mean difference 8.7, 95% confidence interval 1.0-16.7). Secondary outcomes did not show statistically significant differences. When the scores of the waiting group before and after BPT (as offered after the waiting period) were also considered in the analysis, the differences with the initial waiting group remained significant. The results suggest that BPT may be an effective treatment option for patients with chronic depression. Difficulty recruiting and subsequent attrition was one of the limitations, but the findings merit further trials with larger samples and process studies to identify the precise therapeutic mechanisms.",23769289,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.02391242980957,-1.3475139141082764,CcqD
"Clinician-assisted computerised versus therapist-delivered treatment for depressive and addictive disorders: a randomised controlled trial.

To compare computer-delivered and therapist-delivered treatments for people with depression and comorbid addictive disorders. Randomised controlled clinical trial. Our study was conducted between January 2005 and August 2007 at seven study clinics in rural and urban New South Wales. Participants were 274 people who had a Beck Depression Inventory II (BDI-II) score ≥ 17 and were using alcohol and/or cannabis at harmful levels in the month before baseline. They were self-referred or referred from other sources such as outpatient drug treatment clinics, general practices and non-government support agencies. Participants were randomly allocated to receive (1) integrated cognitive behaviour therapy and motivational interviewing (CBT/MI) delivered by a therapist; (2) integrated CBT/MI delivered by computer, with brief therapist assistance at the end of each session (clinician-assisted computerised [CAC] treatment), or (3) person-centred therapy (PCT), consisting of supportive counselling given by a therapist (the control group). All three treatments were delivered according to a manual developed specifically for the study. Changes in depression, alcohol use and cannabis use at 3 months after baseline; significant predictors of change in the primary outcome variables. Compared with computer- or therapist-delivered CBT/MI, PCT was associated with significantly less reduction in depression and alcohol consumption at 3 months. CAC therapy was associated with improvement at least equivalent to that achieved by therapist-delivered treatment, with superior results as far as reducing alcohol consumption. Change in depression was significantly predicted by change in alcohol use (in the same direction) and an ability to determine primacy, irrespective of whether this was for drug use or depression. Change in alcohol use was significantly predicted by changes in cannabis use and depression, and change in cannabis use by change in alcohol use. In the regression model, treatment allocation did not independently predict change, but was associated with significant reduction in depression and alcohol use at 3 months. Over a 3-month period, CBT/MI was associated with a better treatment response than supportive counselling. CAC therapy was associated with greater reduction in alcohol use than therapist-delivered treatment. ACTRN12610000274077.",21806518,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.619781494140625,-2.8330442905426025,C5Mt
"Long-Term Outcomes of a Therapist-Supported, Smartphone-Based Intervention for Elevated Symptoms of Depression and Anxiety: Quasiexperimental, Pre-Postintervention Study.

Depression is one of the most common mental health disorders and severely impacts one's physical, psychological, and social functioning. To address access barriers to care, we developed Ascend-a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. A previous feasibility study with 102 adults with elevated depression reported that Ascend is associated with a postintervention reduction in depression symptoms. We aimed to examine whether Ascend is associated with a reduction in symptoms of anxiety, and importantly, whether reductions in symptoms of depression and anxiety are maintained up to 12-months postintervention. We assessed whether the previously reported, end-of-treatment improvements seen in the 102 adults with elevated symptoms of depression extended up to 12 months posttreatment for depression symptoms (measured by the Patient Health Questionnaire-9 [PHQ-9]) and up to 6 months posttreatment for anxiety symptoms (added to the intervention later and measured using the Generalized Anxiety Disorder-7 [GAD-7] scale). We used linear mixed effects models with Tukey contrasts to compare time points and reported intention-to-treat statistics with a sensitivity analysis. The intervention was associated with reductions in symptoms of depression that were maintained 12 months after the program (6.67-point reduction in PHQ-9 score, 95% CI 5.59-7.75; P<.001; Hedges g=1.14, 95% CI 0.78-1.49). A total of 60% of the participants with PHQ-9 scores above the cutoff for major depression at baseline (PHQ≥10) reported clinically significant improvement at the 12-month follow-up (at least 50% reduction in PHQ-9 score and postprogram score <10). Participants also reported reductions in symptoms of anxiety that were maintained for at least 6 months after the program (4.26-point reduction in GAD-7 score, 95% CI 3.14-5.38; P<.001; Hedges g=0.91, 95% CI 0.54-1.28). There is limited evidence on whether outcomes associated with smartphone-based interventions for common mental health problems are maintained posttreatment. Participants who enrolled in Ascend experienced clinically significant reductions in symptoms of depression and anxiety that were maintained for up to 1 year and 6 months after the intervention, respectively. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and anxiety.",31452521,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,8.571149826049805,-4.607820987701416,A1hC
"Efficacy of cognitive behavioural therapy delivered over the Internet for depressive symptoms: A systematic review and meta-analysis.

Introduction Cognitive behavioural therapy has been shown to improve depressive symptoms in adults with mild to moderate depression. To overcome many of the barriers associated with delivering this treatment, attempts have been made to deliver cognitive behavioural therapy via the Internet. The objective of this meta-analysis is to assess whether Internet-based cognitive behavioural therapy delivered to adults with depressive symptoms leads to a reduction in these symptoms as compared to those who receive no therapy. Methods In September 2015, the Cochrane, PubMed and PsycInfo databases were searched; studies were also found through bibliography searches. Studies were included if they were randomized controlled trials published in English between 2005-2015 conducted with adults >18 years of age experiencing mild to moderate depression where study subjects received Internet-based cognitive behavioural therapy, and the control group was placed on a wait-list. The search yielded 257 articles; 14 of these were included in the meta-analysis. Results Internet delivered cognitive behavioural therapy had a medium effect on reducing depressive symptoms at the end of the study period (standardized mean difference: 0.74, confidence interval: 0.62-0.86, p<0.001). Internet-delivered cognitive behavioural therapy also has a large sustained effect in maintaining reduction of depressive symptoms in follow-up measures done 3-6 months after the conclusion of the therapy (standardized mean difference: 0.83, confidence interval: 0.69-0.99, p<0.001). There was no publication bias and low heterogeneity. Discussion Cognitive behavioural therapy delivered over the Internet leads to immediate and sustained reduction in depressive symptoms; thus, it may be a good treatment modality for individuals unable or unwilling to access traditional face-to-face therapy.",28696153,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.480769157409668,-2.9733316898345947,BZ+k
"Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: Results of a randomized controlled trial.

For severe and chronic depression, inpatient treatment may be necessary. Current guidelines recommend combined psychological and pharmacological treatments for moderate to severe depression. Results for positive effects of combined treatment for depressed inpatients are still ambiguous. This randomised controlled trial examined the efficacy of adding an intensive and brief psychodynamic psychotherapy (IBPP) to treatment-as-usual (TAU) for inpatients with DSM-IV major depressive episode. The primary outcomes were reduction in depression severity, and response and remission rates at post-treatment, 3-month and 12-month follow-up points. A linear mixed model analysis (N=149) showed a higher reduction in the observer-rated severity of depressive symptoms at each follow-up point for the IBPP condition compared with the TAU condition (post-treatment ES=0.39, 95%CI 0.06-0.71; 3-month ES=0.46, 95%CI 0.14-0.78; 12-month ES=0.32, 95%CI 0.01-0.64). Response rate was superior in the IBPP group compared with the TAU group at all follow-up points (post-treatment OR =2.69, 95%CI 1.18-6.11; 3-month OR=3.47, 95%CI 1.47-8.25; 12-month OR=2.26, 95%CI 1.02-4.97). IBPP patients were more likely to be remitted 3 months (OR=2.82, 95%CI 1.12-7.10) and 12 months (OR=2.93, 95%CI 1.12-7.68) after discharge than TAU patients. Heterogeneous sample with different subtypes of depression and comorbidity. IBPP decreased observer-rated depression severity up to 12 months after the end of treatment. IBPP demonstrated immediate and distant treatment responses as well as substantial remissions at follow-up. IBPP appears to be a valuable adjunct in the treatment of depressed inpatients.",27894036,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.227282524108887,-3.145845651626587,BkHU
"On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis.

In recent years a large array of treatment protocols conceptualized as transdiagnostic have been developed with clinical and practical advantages compared to traditional single-disorder protocols. Within this panorama, the Transdiagnostic Unified Protocol (UP) of Emotional Disorders was developed aimed at treating the negative affective processes underlying several diagnostic categories, and accounting for the covariance of different emotional disorders. The UP has been found to efficiently target the roots of these disorders leading to a reduction in symptoms of co-occurring disorders. However, several questions have marginally addressed in the previous studies, and some UP features still remain unexplored. The present meta-analysis aims at evaluating whether the UP results to significant changes in anxiety and depression symptoms severity in children, adolescents, and adults. 19 RCTs and 13 uncontrolled pre-post trials comprising 2183 patients/clients met inclusion criteria for meta-analysis. Large to moderate combined overall effect size for both depression plus anxiety were detected in the uncontrolled pre-post studies (g = 0.756) and in RTCs studies (g = 0.452), respectively. Large effect size at pre-treatment to 3-6-month follow-up was observed for combined depression plus anxiety (g = 1.113). Subgroup analysis suggested that UP treatment does not differ across the anxiety and depression self-report measures. Moreover, UP intervention outperformed both passive and active control conditions to treat negative affective syndromes. Meta-regression confirmed the moderate effects of therapist level of experience, the sample characteristics, and the UP-protocol adaptations. The findings indicate that the manualized UP treatment has potential to contribute to improving mental health outcomes, particularly of anxiety and depression.",34098412,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,12.106389045715332,-3.1192805767059326,AVF/
"Effectiveness of a brief psychoeducational group intervention for relatives on the course of disease in patients after inpatient depression treatment compared with treatment as usual--study protocol of a multisite randomised controlled trial.

Relapses and rehospitalisations are common after acute inpatient treatment in depressive disorders. Interventions for stabilising treatment outcomes are urgently needed. Psychoeducational group interventions for relatives were shown to be suitable for improving the course of disease in schizophrenia and bipolar disorders. A small Japanese monocentre randomised controlled trial also showed promising results for depressive disorders. However, the evidence regarding psychoeducation for relatives of patients with depressive disorders is unclear. The study is conducted as a two-arm multisite randomised controlled trial to evaluate the incremental effect of a brief psychoeducational group intervention for relatives as a maintenance treatment on the course of disease compared to treatment as usual. Primary outcome is the estimated number of depression-free-days in patients within one year after discharge from inpatient treatment. 180 patients diagnosed with unipolar depressive disorders as well as one key relative per patient will be included during inpatient treatment and randomly allocated to the conditions at discharge. In the intervention group, relatives will participate in a brief psychoeducational group intervention following the patient's discharge. The intervention consists of four group sessions lasting 90 to 120 min each. Every group session contains informational parts as well as structured training in problem-solving. In both study conditions, patients will receive treatment as usual. Patients as well as relatives will be surveyed by means of questionnaires at discharge and three, six, nine and twelve months after discharge. In addition to the primary outcome, several patient-related and relative-related secondary outcomes will be considered and health economics will be investigated. Our study will provide evidence on the incremental effect of a brief psychoeducational intervention for relatives as a maintenance treatment after inpatient depression treatment. Positive results may have a major impact on health care for depression. German Clinical Trials Register (DRKS): DRKS00006819; Trial registration date: 2014 Oktober 31; Universal Trial Number (UTN): U1111-1163-5391.",26497218,Major Depressive Disorder,Anxiety Treatment,Mental Health,1033,11.048842430114746,-3.5140135288238525,B2KI
"A Propensity Score Analysis of Homework Adherence-Outcome Relations in Cognitive Behavioral Therapy for Depression.

Little is known about whether or not a consistently high level of homework adherence over the course of therapy benefits patients. This question was examined in two samples of patients who were receiving individual Cognitive Behavioral Therapy (CBT) for depression (Ns = 128 [Sequenced Treatment Alternatives to Relieve Depression: STAR-D] and 183 [Continuation Phase Cognitive Therapy Relapse Prevention: C-CT-RP]). Logistic and linear regression and propensity score models were used to identify whether or not clinician assessments of homework adherence differentiated symptom reduction and remission, as assessed by the Hamilton Depression Rating Scale-17 (HDRS-17), the Quick Inventory of Depressive Symptomatology-Self-Reported Scale (QIDS-SR), and the QIDS-Clinician Scale (QIDS-C). CBT-related response and remission were equally likely between both high and low homework adherers in both studies and in all models. But in propensity adjusted models that adjusted for session attendance, for both the STAR-D and C-CT-RP samples, greater homework adherence was significantly associated with greater response and remission from depression in the first and last 8 sessions of CBT. Our results suggest that homework adherence can account for response and remission early and late in treatment, with adequate session attendence.",30824246,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.768733024597168,-3.290881633758545,A+EN
"Effectiveness of Cognitive Behavioural Self-Help for the Treatment of Depression and Anxiety in People with Long-Term Physical Health Conditions: a Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Depression and anxiety are prevalent comorbidities in people with long-term physical health conditions; however, there is limited access to evidence-based treatments for comorbid mental health difficulties. This study is a meta-analysis examining the effectiveness of cognitive behavioural self-help for physical symptoms, depression and anxiety in people with long-term conditions. This study involves a systematic search of electronic databases supplemented by expert contact, reference and citation checking and grey literature. The meta-analysis yielded a small effect size for 11 studies reporting primary outcomes of depression (g=-0.20) and 8 studies anxiety (g=-0.21) with a large effect size (g=-1.14) for 1 study examining physical health symptoms. There were no significant moderators of the main effect. Limited evidence supports cognitive behavioural self-help for depression, anxiety and physical symptoms in people with long-term conditions. Small effect sizes for depression and anxiety may result from failure to recruit participants with clinical levels of these difficulties at baseline.",25690370,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.643497467041016,-3.011629819869995,CBwS
"Protocol registration and selective outcome reporting in recent psychiatry trials: new antidepressants and cognitive behavioural therapies.

The selective reporting of favorable outcomes has a serious influence on our evidence base. However, this problem has not yet been systematically investigated in the field of psychiatry. Our study aimed to evaluate registration and outcome reporting in randomized controlled trials (RCTs) of standard treatments for depression: cognitive behavioural therapy (CBT) or new-generation antidepressants (ADs). We searched for reports of RCTs examining the efficacy of CBT or AD for depression that were published between 2011 and 2013. We then compared their primary outcomes in the trial registries and those in publications. We identified 170 trials. Among them, 92 trials (54.1%) were registered, 43 trials (25.3%) were properly registered, and only 32 (18.8%) trials were both properly registered and reported (the primary outcomes as recorded in the registries were reported in publications). There was no statistically significant difference in the proportions of properly registered and reported trials for CBT or AD (relative risk: 0.51, 95% CI: 0.25-1.03). High impact factor journals, commercial funding, publication of protocol, and relatively large sample size were significant predictors of proper registration and reporting. The prevalence of proper registration and reporting is still very low in depression trials.",26367129,Major Depressive Disorder,Anxiety Treatment,Mental Health,3741,10.449066162109375,-5.593947887420654,B4Ho
"Psychotherapy in recurrent depression: efficacy, pitfalls, and recommendations.

Most people who seek treatment for depression experience relapse or recurrence, thus prevention represents a very important way to reduce suffering and burdens associated with this illness. Preventive psychological interventions after depression remission include maintenance psychotherapy after an initial course of psychological treatment and the sequential model, i.e. the use of psychotherapy after pharmacotherapy or the application of drug treatment after a course of psychotherapy. Maintenance psychotherapy is aimed to prolong the effects obtained in the previous treatment course. The sequential model appeared to be more effective than monotherapy or the simultaneous combination of two different interventions. The patient should be informed about the prognosis of depressive illness and treatment options. One option would be to continue with an antidepressant drug indefinitely; however, loss of clinical effect may occur. The other option would be to start working on the prevention of the next episode. Thus, a sequential approach might be proposed. It includes antidepressants in the acute phase and a short-term course of cognitive-behavioral therapy in the residual phase. This approach has been specifically applied for its preventive effects. Completing the psychotherapy course with sessions of Well-Being Therapy would be optimal to enhance psychological well-being and euthymia.",32735486,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.945565223693848,-0.9305927753448486,Ak+2
"Logo-autobiography and its effectiveness on depressed Korean immigrant women.

This study aimed to explore the effectiveness of logo-autobiography (LA) as a therapeutic modality for Korean immigrant women suffering from depression and perceiving their lives as meaningless. A nonrandomized quasi-experimental study was conducted with pretest, posttest, and a 4-week follow-up test. Forty subjects--20 with antidepressants and 20 without--were divided quarterly and assigned to the experimental group and the control group. The experimental group reported a significant lower score on depressive symptoms (F = 6.832, p = .013; F = 19.800, p ≤ .001) and a higher score on meaning of life (F = 12.294, p = .001; F = 12.232, p = .001) than did the control group immediately after completing the LA and a 4-week follow-up. The LA was more effective for the subjects in the nonmedication group than in the medication group. In conclusion, LA is effective in reducing depressive symptoms and increasing a sense of meaning in life among Korean immigrant women suffering from depression.",22802301,Major Depressive Disorder,Anxiety Treatment,Mental Health,12985,11.520090103149414,-5.588813304901123,CquP
"Morita therapy for depression in adults: A systematic review and meta-analysis.

Morita therapy is a systematic psychological therapy that aims to improve everyday functioning rather than target specific symptoms. However, there has been no systematic review evaluating the evidence of the effectiveness of Morita therapy in the treatment of depression. The aim of this study was to assess the clinical efficacy of Morita therapy in combination with pharmacotherapy in patients 18 and older who were diagnosed with current depressive disorder. A total of 840 patients with depression from 11 randomized controlled trial (RCT) studies were included in this meta-analysis after a literature search of 10 databases was performed from database inception to July 1, 2017. All the eligible studies were determined to have an unclear or high risk of bias. Morita therapy plus pharmacotherapy was significantly superior to pharmacotherapy alone in reducing depression severity. The remission rate of the Morita therapy plus pharmacotherapy group was better than that of the pharmacotherapy alone group. Morita therapy significantly reduced depression severity symptoms and improved the remission rate. Due to the relatively weak quality of the included studies, definitive conclusions cannot be made. Thus, multi-center, well-designed clinical trials with larger cohorts are urgently needed to support the clinical application of Morita therapy.",30380592,Major Depressive Disorder,Anxiety Treatment,Mental Health,13332,10.95106315612793,-1.9730567932128906,BD+U
"'Third wave' cognitive and behavioural therapies versus other psychological therapies for depression.

So-called 'third wave' cognitive and behavioural therapies represents a new generation of psychological therapies that are increasingly being used in the treatment of psychological problems. However, the effectiveness and acceptability of third wave cognitive and behavioural therapy (CBT) approaches as a treatment for depression compared with other psychological therapies remain unclear. 1. To examine the effects of all third wave CBT approaches compared with all other psychological therapy approaches for acute depression.2. To examine the effects of different third wave CBT approaches (ACT, compassionate mind training, functional analytic psychotherapy, extended behavioural activation and metacognitive therapy) compared with all other psychological therapy approaches for acute depression.3. To examine the effects of all third wave CBT approaches compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, cognitive-behavioural) for acute depression. We searched the Cochrane Depression, Anxiety and Neurosis Group Specialised Register (CCDANCTR to 01/01/12), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. An updated search of CCDANCTR restricted to search terms relevant to third wave CBT was conducted in March 2013 (CCDANCTR to 01/02/13). Randomised controlled trials that compared various third wave CBT with other psychological therapies for acute depression in adults. Two review authors independently identified studies, assessed trial quality and extracted data. Study authors were contacted for additional information where required. We rated the quality of evidence using GRADE methods. A total of three studies involving 144 eligible participants were included in the review. Two of the studies (56 participants) compared an early version of acceptance and commitment therapy (ACT) with CBT, and one study (88 eligible participants) compared extended behavioural activation with CBT. No other studies of third wave CBT were identified. The two ACT studies were assessed as being at high risk of performance bias and researcher allegiance. Post-treatment results, which were based on dropout rates, showed no evidence of any difference between third wave CBT and other psychological therapies for the primary outcomes of efficacy (risk ratio (RR) of clinical response 1.14, 95% confidence interval (CI) 0.79 to 1.64; very low quality) and acceptability. Results at two-month follow-up showed no evidence of any difference between third wave CBT and other psychological therapies for clinical response (2 studies, 56 participants, RR 0.22, 95% CI 0.04 to 1.15). Moderate statistical heterogeneity was indicated in the acceptability analyses (I(2) = 41%). Very low quality evidence suggests that third wave CBT and CBT approaches are equally effective and acceptable in the treatment of acute depression. Evidence is limited in quantity, quality and breadth of available studies, precluding us from drawing any conclusions as to their short- or longer-term equivalence. The increasing popularity of third wave CBT approaches in clinical practice underscores the importance of completing further studies to compare various third wave CBT approaches with other psychological therapy approaches to inform clinicians and policymakers on the most effective forms of psychological therapy in treating depression.",24142844,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.082138061523438,-2.259530782699585,CXH2
"One-year follow-up results of unsupported online computerized cognitive behavioural therapy for depression in primary care: A randomized trial.

To report the one-year follow-up results of computerized cognitive behavioural therapy (CCBT), offered online without professional support, for depression compared with usual GP care and a combination of both treatments. To explore potential relapse prevention effects of CCBT. 303 depressed patients were randomly allocated to (a) unsupported online CCBT (b) treatment as usual (TAU), or (c) CCBT and TAU combined. We had a 12-month follow-up period. Primary outcome measure was the Beck Depression Inventory II. Self-reported health care use was also measured. At 12 months, no statistically significant differences between the three interventions are found in the intention-to-treat population for depressive severity, reliable improvement, remission, and relapse. In the first quarter, differences in health care consumption between the three interventions are significant (i.e. less GP contacts, less antidepressant medication, and less specialist mental health care in the CCBT group), but these differences disappear over time. Unsupported online CCBT is not superior to TAU by a GP for depression. With equal effects, CCBT alone leads to less health care consumption than TAU and CCBT&TAU. Overall effects are modest in all interventions, which can be explained by the finding that the use of health care services decreases despite the lack of substantial improvements.",20723885,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.849117279052734,-2.7645835876464844,DGr9
"Internet-based behavioural activation with lay counsellor support versus online minimal psychoeducation without support for treatment of depression: a randomised controlled trial in Indonesia.

Depression is one of the leading contributors to the global burden of disease. However, treatment availability is often very poor in low-income and middle-income countries. In a randomised clinical trial, we investigated the efficacy of internet-based behavioural activation with lay counsellor support compared with online minimal psychoeducation without support for depression in Indonesia (a middle-income country). We did a community-based, two-group, randomised controlled trial in Indonesia. Eligible participants were aged 16 years or older, scored 10 or above on the Patient Health Questionnaire 9 (PHQ-9), met the criteria for major depressive disorder or persistent depressive disorder based on the Structured Clinical Interview for DSM-5, were proficient in Bahasa Indonesia, and could use the internet. Participants were randomly allocated (1:1) by a research assistant using a web-based randomisation program to online behavioural activation with lay support (termed Guided Act and Feel Indonesia [GAF-ID]) or online psychoeducation without further support. Randomisation was done within a random permuted block design and was stratified by sex and depression severity (ie, PHQ-9 10-14 vs ≥15). The primary outcome was self-reported PHQ-9 score at 10 weeks from baseline. Research assistants were masked to group allocation until after the assessment of the primary outcome. Interventions were described to participants during the consent procedure and after randomisation, but no indication was given as to which was the intervention of interest and which was the control. Analysis was by intention to treat. The trial was registered in the Netherlands Trial Register, number NTR5920. It is closed to new particpants, and follow-up has been completed. Between Sept 6, 2016, and May 1, 2017, 313 participants were enrolled and randomly assigned, 159 to the GAF-ID group and 154 to the online psychoeducation group. At 10 weeks, PHQ-9 scores were significantly lower in the GAF-ID group than in the online psychoeducation group (mean difference -1·26 points [95% CI -2·29 to -0·23]; p=0·017), and participants in the GAF-ID group had a 50% higher chance of remission at 10 weeks (relative risk 1·50 [95% CI 1·19 to 1·88]; p<0·0001). An effect size of 0·24 for the GAF-ID group compared with the control group at 10 weeks was sustained over time (effect size 0·24 at 3 months, and 0·27 at 6 months). No adverse events were reported in either group. To our knowledge, ours is the first adequately powered randomised clinical trial of an internet-based intervention for depression in a low-income or middle-income country. Online behavioural activation with lay counsellor support efficaciously reduced symptoms of depression, and could help to bridge the mental health gap in low-income and middle-income countries. Indonesia Endowment Fund for Education, University of Groningen.",30006262,Major Depressive Disorder,Anxiety Treatment,Mental Health,4436,10.12671947479248,-3.3669381141662598,BJAa
"Internet-based therapy for mild to moderate depression in Swedish primary care: short term results from the PRIM-NET randomized controlled trial.

Depression presents a serious condition for the individual and a major challenge to health care and society. Internet-based cognitive behavior therapy (ICBT) is a treatment option supported in several trials, but there is as yet a lack of effective studies of ICBT in ""real world"" primary care settings. We examined whether ICBT differed from treatment-as-usual (TAU) in reducing depressive symptoms after 3 months. TAU comprised of visits to general practitioner, registered nurse, antidepressant drugs, waiting list for, or psychotherapy, or combinations of these alternatives. Patients, aged ≥ 18 years, who tentatively met criteria for mild to moderate depression at 16 primary care centers in the south-western region of Sweden were recruited and then assessed in a diagnostic interview. A total of 90 patients were randomized to either TAU or ICBT. The ICBT treatment included interactive elements online, a workbook, a CD with mindfulness and acceptance exercises, and minimal therapist contact. The treatment period lasted for 12 weeks after which both groups were assessed. The main outcome measure was Beck Depression Inventory-II (BDI-II). Additional measures were Montgomery Åsberg Depression Rating Scale - self rating version (MADRS-S) and Beck Anxiety Inventory (BAI). The analyses revealed no significant difference between the two groups at post treatment, neither on BDI-II, MADRS-S, nor BAI. Twenty patients (56%) in the ICBT treatment completed all seven modules. Our findings suggest that ICBT may be successfully delivered in primary care and that the effectiveness, after 3 months, is at par with TAU.",24911260,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.540292739868164,-2.7219653129577637,CM3z
"Evaluation of a bibliotherapy manual for reducing psychological distress in people with depression: a randomized controlled trial.

This article reports a study to evaluate the efficacy of a self-help manual in reducing psychological distress in individuals with moderate depression. The prevalence of depression in Thailand is increasing markedly (e.g. from 56-197 per 100,000 population between 1997-2007). We conducted a randomized controlled trial with 54 outpatients with depression in Chiang Mai Province in Thailand. Participants were assigned randomly to an intervention or control group. The intervention group participants were given a self-help manual in addition to standard care and treatment while the control group received standard care and treatment. Psychological distress was measured with the Kessler Psychological Distress Scale. Data were collected between October 2007-April 2008. The findings showed statistically significant differences between both groups in their levels of psychological distress (e.g. tiredness, hopelessness, restlessness). At post-test, the distress scores of the intervention group were lower than those in the control group. Between post-test and 1-month follow-up, distress scores continued to decrease steadily in the intervention group but only decreased slightly in the control group. The findings affirm the benefits of bibliotherapy or self-help therapy in book form in helping to reduce psychological distress in people with moderate depression. The approach is easy to use and can be incorporated as an adjunct to standard care and treatment. Bibliotherapy can be used by community mental health nurses and other clinicians to reduce psychological distress and promote recovery in people with moderate depression.",22381065,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.636994361877441,-3.691671848297119,Cwqj
"

Objective: Background regarding a recent debate between Cuijpers et al. (2019a, b) and the authors (Munder et al. 2019) about the efficacy of psychotherapy for depression is given. Method: A main reason for the discrepancy in Cuijpers et al.'s and our conclusions is discussed. Results: In our view the discrepancy is due, among other things, to a blurred distinction between questions of relative and absolute efficacy of psychotherapy. Although the efficacy of psychotherapy vis-à-vis alternative treatments may be ambiguous, there can be little doubt about the benefits of psychotherapy relative to no treatment. Conclusion: We do not think that raising fundamental concerns about the value of psychotherapy is a service to the field. We argue that moving the field forward requires a focus on how psychotherapy works and how the access to psychotherapy can be increased.",31154927,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.412524223327637,-2.1907219886779785,A5l3
"Trained lay coaches and self-care cognitive-behavioral tools improve depression outcomes.

Identify the key effective components of a depression self-care intervention. Secondary analysis of data from 3 studies that demonstrated effectiveness of a similar depression self-care intervention (n = 275): 2 studies among patients with chronic physical conditions and 1 among cancer survivors. The studies used similar tools, and telephone-based lay coaching. Depression remission and reduction at 6 months were assessed with either PHQ-9 (chronic condition cohorts) or CES-D (cancer survivor cohort). Multiple logistic regression was used to analyze data when the interaction p-value with cohort was < 0.10. The 3 coached cohorts achieved better depression outcomes than usual care. The combination of coaching and joint use of 2 tools based on cognitive-behavioral therapy (CBT) was associated with depression remission and reduction among chronic condition cohorts but not among cancer survivors. Neither the number nor the length of coach calls were associated with outcomes in pooled data. Trained lay coaching and use of CBT-based self-care tools were associated with improved depression outcomes in patients with chronic conditions but not among cancer survivors. Trained lay coaching and CBT tools are key components of depression self-care interventions. Further research is needed on the effective components in cancer survivors.",35397942,Major Depressive Disorder,Anxiety Treatment,Mental Health,8878,10.372875213623047,-2.982269048690796,eUE
"Predicting Optimal Outcomes in Cognitive Therapy or Interpersonal Psychotherapy for Depressed Individuals Using the Personalized Advantage Index Approach.

Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works best for the depressed individual. In this paper, we aim to replicate a recently developed treatment selection method, using data from an RCT comparing the effects of cognitive therapy (CT) and interpersonal psychotherapy (IPT). 134 depressed patients completed the pre- and post-treatment BDI-II assessment. First, we identified baseline predictors and moderators. Second, individual treatment recommendations were generated by combining the identified predictors and moderators in an algorithm that produces the Personalized Advantage Index (PAI), a measure of the predicted advantage in one therapy compared to the other, using standard regression analyses and the leave-one-out cross-validation approach. We found five predictors (gender, employment status, anxiety, personality disorder and quality of life) and six moderators (somatic complaints, cognitive problems, paranoid symptoms, interpersonal self-sacrificing, attributional style and number of life events) of treatment outcome. The mean average PAI value was 8.9 BDI points, and 63% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Those who were randomized to their predicted optimal treatment (either CT or IPT) had an observed mean end-BDI of 11.8, while those who received their predicted non-optimal treatment had an end-BDI of 17.8 (effect size for the difference = 0.51). Depressed patients who were randomized to their predicted optimal treatment fared much better than those randomized to their predicted non-optimal treatment. The PAI provides a great opportunity for formal decision-making to improve individual patient outcomes in depression. Although the utility of the PAI approach will need to be evaluated in prospective research, this study promotes the development of a treatment selection approach that can be used in regular mental health care, advancing the goals of personalized medicine.",26554707,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.085079193115234,-2.3366923332214355,B1Xh
"Short web-based guided self-help intervention prevents the onset of a major depressive disorder in adults with subthreshold depression.

",28069609,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,10.35552978515625,-2.417623996734619,BiaW
"Depression beliefs, treatment preference, and outcomes in a randomized trial for major depressive disorder.

Previous studies suggest that individual preferences for medication- or psychotherapy-based treatments for depression may affect outcomes in clinical trials that compare these two forms of treatment. We assessed patients' beliefs about the causes of their depression, their preferred treatment, and strength of that preference in 80 patients participating in a 12-week clinical trial evaluating neuroimaging predictors of response to cognitive behavior therapy (CBT) or escitalopram. Forty-five patients expressed a preference for one of the 2 treatments, but being matched to preference did not influence remission or completion rates. Medication-preferring patients were more likely to terminate the trial early, regardless of treatment received. CBT-preferring patients rarely endorsed unknown causes for their depression, and medication-preferring patients were highly unlikely to identify pessimistic attitudes as a source of their depression. Among patients willing to be randomized to treatment, preference does not appear to strongly influence outcome. Specific preferences for CBT or medication may reflect differing conceptualizations about depressive illness, knowledge of which may enhance treatment retention and efficacy.",22118808,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.823013305664062,-2.3945884704589844,C0g9
"Acceptability and Efficacy of Group Behavioral Activation for Depression Among Adults: A Meta-Analysis.

The evidence base for behavioral activation (BA) as a front-line treatment for depression is grounded in individual delivery. No valid previous meta-analytic reviews of BA delivered in groups have been conducted. This study therefore examined the efficacy and acceptability of group BA drawn from clinical trial evidence. Randomized controlled trials of group BA were identified using a comprehensive literature search. Depression outcomes at posttreatment/follow-up, recovery and dropout rates were extracted and analyzed using a random-effects meta-analysis. Treatment moderators were analyzed using meta-regression and subgroup analyses. Nineteen trials were quantitatively synthesized. Depression outcomes postgroup BA treatment were superior to controls (SMD 0.72, CI 0.34 to 1.10, k=13, N=461) and were equivalent to other active therapies (SMD 0.14, CI -0.18 to 0.46, k=15, N=526). Outcomes were maintained at follow-up for group BA and moderators of treatment outcome were limited. The dropout rate for group BA (14%) was no different from other active treatments for depression (17%). Further research is required to refine the conditions for optimum delivery of group BA and define robust moderators and mediators of outcome. However, BA delivered in groups produces a moderate to large effect on depressive symptoms and should be considered an appropriate front-line treatment option.",31422844,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.508402824401855,-2.113879680633545,A169
"Exploring personalized psychotherapy for depression: A system dynamics approach.

Depressive disorders are the leading contributor to medical disability, yet only 22% of depressed patients receive adequate treatment in a given year. Response to treatment varies widely among individuals with depression, and poor response to one treatment does not signal poor response to others. In fact, half of patients who do not recover from a first-line psychotherapy will recover from a second option. Attempts to personalize psychotherapy to patient characteristics have produced better outcomes than usual care, but research on personalized psychotherapy is still in its infancy. The present study explores a new method for personalizing psychotherapy for depression through simulation modeling. In this study, we developed a system dynamics simulation model of depression based on one of the major mechanisms of depression in the literature and investigated the trend of depressive symptoms under different conditions and treatments. Our simulation outputs show the importance of individualized services with appropriate timing, and reveal a new method for personalizing psychotherapy to heterogeneous individuals. Future research is needed to expand the model to include additional mechanisms of depression.",36301962,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.590417861938477,-2.082029342651367,Cyk
"Effects of five-minute internet-based cognitive behavioral therapy and simplified emotion-focused mindfulness on depressive symptoms: a randomized controlled trial.

Notwithstanding a high expectation for internet-based cognitive behavioral therapy (iCBT) for reducing depressive symptoms, many of iCBT programs have limitations such as temporary effects and high drop-out rates, possibly due to their complexity. We examined the effects of a free, simplified, 5-minute iCBT program by comparing it with a simplified emotion-focused mindfulness (sEFM) exercise and with a waiting list control group. A total of 974 participants, who were recruited using the website of a market research company, were randomly assigned to the iCBT group, the sEFM group, and the control group. Those in the intervention arms performed each exercise for 5 weeks. The primary outcome measure was the Center for Epidemiological Studies Depression scale (CES-D) at postintervention. Secondary outcome measures were the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 scale (GAD-7). Intention-to-treat analyses were conducted. During postintervention assessment, there were no significant differences between the intervention arms and the control group in the CES-D, although the difference between the iCBT arm and control group was close to significance (p=0.05) in favor of iCBT. There was a significant difference in the PHQ-9 in favor of the sEFM group compared with the control group. There were no significant differences in outcome measures between the three groups at the 6-week follow-up. Although both iCBT and sEFM have the potential to temporarily reduce depressive symptoms, substantial improvements are required to enhance and maintain their effects. This trial is registered with the UMIN Clinical Trial Registry (UMIN-CTR) (ID: UMIN000015097 ) on 1 October 2014.",28259151,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.636307716369629,-2.760066032409668,BgCf
"Changes in causal attributions and relationship representations: Are they specific or common mechanisms in the treatment of depression?

The goal of the study was to examine two central theory-driven mechanisms of change, causal attributions and relational representations, to account for symptomatic improvement in psychodynamic treatment and supportive clinical management, combined with either pharmacotherapy or placebo, in a randomized control trial (RCT) for depression. We used data from an RCT for depression, which reported non-significant differences in outcome among patients (N=149) who received supportive-expressive psychotherapy (SET), clinical management combined with pharmacotherapy (CM+MED), or clinical management with placebo pill (CM+PBO) (Barber et al., 2012). Mechanism and outcome measures were administered at intake, mid-treatment, end of treatment, and at a 4-month follow-up. Improvements in causal attributions and in relational representations were found across treatments. Changes in causal attributions did not predict subsequent symptomatic level when controlling for prior symptomatic level. In contrast, decrease in negative relational representations predicted subsequent symptom reduction across all treatments, and increase in positive relational representations predicted subsequent symptom reduction only in SET. The study is limited by its moderate sample size. Additional studies are needed to examine the same questions using additional treatment orientations, such as cognitive treatments. Findings demonstrate that changes in negative relational representations may act as a common mechanism of change and precede symptom reduction across psychodynamic therapy and supportive case management combined with either pharmacotherapy or placebo, whereas an increase in positive relational representation may be a mechanism of change specific to psychodynamic therapy.",26771947,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.785505294799805,-3.6407644748687744,ByhZ
"Study protocol for pragmatic trials of Internet-delivered guided and unguided cognitive behavior therapy for treating depression and anxiety in university students of two Latin American countries: the Yo Puedo Sentirme Bien study.

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent among university students and predict impaired college performance and later life role functioning. Yet most students do not receive treatment, especially in low-middle-income countries (LMICs). We aim to evaluate the effects of expanding treatment using scalable and inexpensive Internet-delivered transdiagnostic cognitive behavioral therapy (iCBT) among college students with symptoms of MDD and/or GAD in two LMICs in Latin America (Colombia and Mexico) and to investigate the feasibility of creating a precision treatment rule (PTR) to predict for whom iCBT is most effective. We will first carry out a multi-site randomized pragmatic clinical trial (N = 1500) of students seeking treatment at student mental health clinics in participating universities or responding to an email offering services. Students on wait lists for clinic services will be randomized to unguided iCBT (33%), guided iCBT (33%), and treatment as usual (TAU) (33%). iCBT will be provided immediately whereas TAU will be whenever a clinic appointment is available. Short-term aggregate effects will be assessed at 90days and longer-term effects 12months after randomization. We will use ensemble machine learning to predict heterogeneity of treatment effects of unguided versus guided iCBT versus TAU and develop a precision treatment rule (PTR) to optimize individual student outcome. We will then conduct a second and third trial with separate samples (n = 500 per arm), but with unequal allocation across two arms: 25% will be assigned to the treatment determined to yield optimal outcomes based on the PTR developed in the first trial (PTR for optimal short-term outcomes for Trial 2 and 12-month outcomes for Trial 3), whereas the remaining 75% will be assigned with equal allocation across all three treatment arms. By collecting comprehensive baseline characteristics to evaluate heterogeneity of treatment effects, we will provide valuable and innovative information to optimize treatment effects and guide university mental health treatment planning. Such an effort could have enormous public-health implications for the region by increasing the reach of treatment, decreasing unmet need and clinic wait times, and serving as a model of evidence-based intervention planning and implementation. IRB Approval of Protocol Version 1.0; June 3, 2020. Recruitment began on March 1, 2021. Recruitment is tentatively scheduled to be completed on May 30, 2024. ClinicalTrials.gov NCT04780542 . First submission date: February 28, 2021.",35658942,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.917985916137695,-2.878861665725708,Vt0
"Happiness intervention decreases pain and depression, boosts happiness among primary care patients.

The aim of the study was to determine whether positive psychological interventions (PPIs) in a primary health care setting would improve physical and mental health over time. Most treatments for depression focus on reducing symptoms rather than on creating positive states of mental health. Empirical studies to verify the efficacy of PPIs in primary health care are needed. In a six-week pilot program, we invited patients in a primary health care setting with symptoms of depression to participate in groups designed to increase levels of happiness. The program involved interventions such as engaging in good deeds, writing gratitude letters, and introducing empirical research. Patients completed the SF12v2(®) at the beginning and end of the program and at three- and six-month follow-up. Measures included physical functioning, bodily pain, mental health, social functioning, and vitality. Patients also participated in focus groups to discuss their experiences. Of the 124 patients who enrolled in this pilot study, 75 completed the six-week program, and 35 participated in two follow-up assessments. Among the participants who remained for all follow-up assessments, scores improved from baseline to 6-month follow-up for health, vitality, mental health, and the effects of mental and physical health on daily activities. This subset of patients reported greater energy and more daily accomplishments, along with reductions in functional limitations. Improvements in mental and physical health and functioning were shown over a six-month period. The study provides a basis for the further investigation of PPIs in creating improvements for patients with depression in primary health care.",24451155,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.674859046936035,-3.889641761779785,CTJY
"Bona Fide Psychotherapy Models Are Equally Effective for Major Depressive Disorder: Future Research Directions.

",27487423,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.688650131225586,-1.7500498294830322,BpED
"Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly.

The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section on ""Special Populations"" is the sixth of six guidelines articles. Recent studies inform the treatment of MDD in children and adolescents, pregnant and breastfeeding women, women in perimenopause or menopause, and the elderly. Evidence for efficacy of treatments in these populations is more limited than for the general adult population, however, and risks of treatment in these groups are often poorly studied and reported. Despite the limited evidence base, extant data and clinical experience suggest that each of these special populations can benefit from the systematic application of treatment guidelines for treatment of MDD.",27486149,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.163599014282227,-0.6862590312957764,BpFK
"Schema therapy versus cognitive behavioral therapy versus individual supportive therapy for depression in an inpatient and day clinic setting: study protocol of the OPTIMA-RCT.

Major depressive disorder represents (MDD) a major cause of disability and disease burden. Beside antidepressant medication, psychotherapy is a key approach of treatment. Schema therapy has been shown to be effective in the treatment of psychiatric disorders, especially personality disorders, in a variety of settings and patient groups. Nevertheless, there is no evidence on its effectiveness for MDD in an inpatient nor day clinic setting and little is known about the factors that drive treatment response in such a target group. In the current protocol, we outline OPTIMA (OPtimized Treatment Identification at the MAx Planck Institute): a single-center randomized controlled trial of schema therapy as a treatment approach for MDD in an inpatient and day clinic setting. Over the course of 7 weeks, we compare schema therapy with cognitive behavioral therapy and individual supportive therapy, conducted in individual and group sessions and with no restrictions regarding concurrent antidepressant medication, thus approximating real-life treatment conditions. N=300 depressed patients are included. All study therapists undergo a specific training and supervision and therapy adherence is assessed. Primary outcome is depressive symptom severity as self-assessment (Beck Depression Inventory-II) and secondary outcomes are clinical ratings of MDD (Montgomery-Asberg Depression Rating Scale), recovery rates after 7 weeks according to the Munich-Composite International Diagnostic Interview, general psychopathology (Brief Symptom Inventory), global functioning (World Health Organization Disability Assessment Schedule), and clinical parameters such as dropout rates. Further parameters on a behavioral, cognitive, psychophysiological, and biological level are measured before, during and after treatment and in 2 follow-up assessments after 6 and 24months after end of treatment. To our knowledge, the OPTIMA-Trial is the first to investigate the effectiveness of schema therapy as a treatment approach of MDD, to investigate mechanisms of change, and explore predictors of treatment response in an inpatient and day clinic setting by using such a wide range of parameters. Insights from OPTIMA will allow more integrative approaches of psychotherapy of MDD. Especially, the identification of intervention-specific markers of treatment response can improve evidence-based clinical decision for individualizing treatment. Identifier on clinicaltrials.gov : NCT03287362 ; September, 12, 2017.",33054737,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.384114265441895,-3.263087511062622,AhAK
"Psychological therapies for treatment-resistant depression in adults.

Antidepressants are a first-line treatment for adults with moderate to severe major depression. However, many people prescribed antidepressants for depression don't respond fully to such medication, and little evidence is available to inform the most appropriate 'next step' treatment for such patients, who may be referred to as having treatment-resistant depression (TRD). National Institute for Health and Care Excellence (NICE) guidance suggests that the 'next step' for those who do not respond to antidepressants may include a change in the dose or type of antidepressant medication, the addition of another medication, or the start of psychotherapy. Different types of psychotherapies may be used for TRD; evidence on these treatments is available but has not been collated to date.Along with the sister review of pharmacological therapies for TRD, this review summarises available evidence for the effectiveness of psychotherapies for adults (18 to 74 years) with TRD with the goal of establishing the best 'next step' for this group. To assess the effectiveness of psychotherapies for adults with TRD. We searched the Cochrane Common Mental Disorders Controlled Trials Register (until May 2016), along with CENTRAL, MEDLINE, Embase, and PsycINFO via OVID (until 16 May 2017). We also searched the World Health Organization (WHO) trials portal (ICTRP) and ClinicalTrials.gov to identify unpublished and ongoing studies. There were no date or language restrictions. We included randomised controlled trials (RCTs) with participants aged 18 to 74 years diagnosed with unipolar depression that had not responded to minimum four weeks of antidepressant treatment at a recommended dose. We excluded studies of drug intolerance. Acceptable diagnoses of unipolar depression were based onthe Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) or earlier versions, International Classification of Diseases (ICD)-10, Feighner criteria, or Research Diagnostic Criteria. We included the following comparisons.1. Any psychological therapy versus antidepressant treatment alone, or another psychological therapy.2. Any psychological therapy given in addition to antidepressant medication versus antidepressant treatment alone, or a psychological therapy alone.Primary outcomes required were change in depressive symptoms and number of dropouts from study or treatment (as a measure of acceptability). We extracted data, assessed risk of bias in duplicate, and resolved disagreements through discussion or consultation with a third person. We conducted random-effects meta-analyses when appropriate. We summarised continuous outcomes using mean differences (MDs) or standardised mean differences (SMDs), and dichotomous outcomes using risk ratios (RRs). We included six trials (n = 698; most participants were women approximately 40 years of age). All studies evaluated psychotherapy plus usual care (with antidepressants) versus usual care (with antidepressants). Three studies addressed the addition of cognitive-behavioural therapy (CBT) to usual care (n = 522), and one each evaluated intensive short-term dynamic psychotherapy (ISTDP) (n = 60), interpersonal therapy (IPT) (n = 34), or group dialectical behavioural therapy (DBT) (n = 19) as the intervention. Most studies were small (except one trial of CBT was large), and all studies were at high risk of detection bias for the main outcome of self-reported depressive symptoms.A random-effects meta-analysis of five trials (n = 575) showed that psychotherapy given in addition to usual care (vs usual care alone) produced improvement in self-reported depressive symptoms (MD -4.07 points, 95% confidence interval (CI) -7.07 to -1.07 on the Beck Depression Inventory (BDI) scale) over the short term (up to six months). Effects were similar when data from all six studies were combined for self-reported depressive symptoms (SMD -0.40, 95% CI -0.65 to -0.14; n = 635). The quality of this evidence was moderate. Similar moderate-quality evidence of benefit was seen on the Patient Health Questionnaire-9 Scale (PHQ-9) from two studies (MD -4.66, 95% CI 8.72 to -0.59; n = 482) and on the Hamilton Depression Rating Scale (HAMD) from four studies (MD -3.28, 95% CI -5.71 to -0.85; n = 193).High-quality evidence shows no differential dropout (a measure of acceptability) between intervention and comparator groups over the short term (RR 0.85, 95% CI 0.58 to 1.24; six studies; n = 698).Moderate-quality evidence for remission from six studies (RR 1.92, 95% CI 1.46 to 2.52; n = 635) and low-quality evidence for response from four studies (RR 1.80, 95% CI 1.2 to 2.7; n = 556) indicate that psychotherapy was beneficial as an adjunct to usual care over the short term.With the addition of CBT, low-quality evidence suggests lower depression scores on the BDI scale over the medium term (12 months) (RR -3.40, 95% CI -7.21 to 0.40; two studies; n = 475) and over the long term (46 months) (RR -1.90, 95% CI -3.22 to -0.58; one study; n = 248). Moderate-quality evidence for adjunctive CBT suggests no difference in acceptability (dropout) over the medium term (RR 0.98, 95% CI 0.66 to 1.47; two studies; n = 549) and lower dropout over long term (RR 0.80, 95% CI 0.66 to 0.97; one study; n = 248).Two studies reported serious adverse events (one suicide, two hospitalisations, and two exacerbations of depression) in 4.2% of the total sample, which occurred only in the usual care group (no events in the intervention group).An economic analysis (conducted as part of an included study) from the UK healthcare perspective (National Health Service (NHS)) revealed that adjunctive CBT was cost-effective over nearly four years. Moderate-quality evidence shows that psychotherapy added to usual care (with antidepressants) is beneficial for depressive symptoms and for response and remission rates over the short term for patients with TRD. Medium- and long-term effects seem similarly beneficial, although most evidence was derived from a single large trial. Psychotherapy added to usual care seems as acceptable as usual care alone.Further evidence is needed on the effectiveness of different types of psychotherapies for patients with TRD. No evidence currently shows whether switching to a psychotherapy is more beneficial for this patient group than continuing an antidepressant medication regimen. Addressing this evidence gap is an important goal for researchers.",29761488,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.22288990020752,-1.7576290369033813,BLzI
"What changes in cognitive therapy for depression? An examination of cognitive therapy skills and maladaptive beliefs.

This study examined effortful cognitive skills and underlying maladaptive beliefs among patients treated with cognitive therapy (CT) for depression. Depressed patients (n=44) completed cognitive measures before and after 16 weeks of CT. Measures included an assessment of CT skills (Ways of Responding Scale; WOR), an implicit test of maladaptive beliefs (Implicit Association Test; IAT), and a self-report questionnaire of maladaptive beliefs (Dysfunctional Attitude Scale; DAS). A matched sample of never-depressed participants (n=44) also completed study measures. Prior to treatment, depressed patients endorsed significantly more undesirable cognitions on the WOR, IAT, and DAS compared with never-depressed participants. Patients displayed improvement on the WOR and DAS over the course of treatment, but showed no change on the IAT. Additionally, improvements on the WOR and DAS were each related to greater reductions in depressive symptoms. Results suggest that the degree of symptom reduction among patients participating in CT is related to changes in patients' acquisition of coping skills requiring deliberate efforts and reflective thought, but not related to reduced endorsement of implicitly assessed maladaptive beliefs.",25526838,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.674005508422852,-2.3395750522613525,CEG9
"Effectiveness of the relaxation response-based group intervention for treating depressed chinese american immigrants: a pilot study.

This study examined the feasibility, safety and efficacy of an 8-week Relaxation Response (RR)-based group. Twenty-two depressed Chinese American immigrants were recruited. Outcomes measures were response and remission rates, the Hamilton Rating Scale for Depression, Clinical Global Impressions Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, and the Multidimensional Scale of Perceived Social Support Scale. Participants (N = 22) were 82% female, mean age was 53 (± 12). After intervention, completers (N = 15) showed a 40% response rate and a 27% remission rate, and statistically significant improvement in most outcome measures. The RR-based group is feasible and safe in treating Chinese American immigrants with depression.",25198683,Major Depressive Disorder,Anxiety Treatment,Mental Health,27971,11.242860794067383,-5.090765476226807,CItU
"Low intensity vs. self-guided internet-delivered psychotherapy for major depression: a multicenter, controlled, randomized study.

Major depression will become the second most important cause of disability in 2020. Computerized cognitive-behaviour therapy could be an efficacious and cost-effective option for its treatment. No studies on cost-effectiveness of low intensity vs self-guided psychotherapy has been carried out. The aim of this study is to assess the efficacy of low intensity vs self-guided psychotherapy for major depression in the Spanish health system. The study is made up of 3 phases: 1.- Development of a computerized cognitive-behaviour therapy for depression tailored to Spanish health system. 2.- Multicenter controlled, randomized study: A sample (N=450 patients) with mild/moderate depression recruited in primary care. They should have internet availability at home, not receive any previous psychological treatment, and not suffer from any other severe somatic or psychological disorder. They will be allocated to one of 3 treatments: a) Low intensity Internet-delivered psychotherapy + improved treatment as usual (ITAU) by GP, b) Self-guided Internet-delivered psychotherapy + ITAU or c) ITAU. Patients will be diagnosed with MINI psychiatric interview. Main outcome variable will be Beck Depression Inventory. It will be also administered EuroQol 5D (quality of life) and Client Service Receipt Inventory (consume of health and social services). Patients will be assessed at baseline, 3 and 12 months. An intention to treat and a per protocol analysis will be performed. The comparisons between low intensity and self-guided are infrequent, and also a comparative economic evaluation between them and compared with usual treatment in primary. The strength of the study is that it is a multicenter, randomized, controlled trial of low intensity and self-guided Internet-delivered psychotherapy for depression in primary care, being the treatment completely integrated in primary care setting. Clinical Trials NCT01611818.",23312003,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.410118103027344,-3.057530641555786,CjaV
"Randomized controlled trial of family-focused treatment for child depression compared to individual psychotherapy: one-year outcomes.

Childhood-onset depression is associated with increased risk of recurrent depression and high morbidity extending into adolescence and adulthood. This multisite randomized controlled trial evaluated two active psychosocial treatments for childhood depression: family-focused treatment for childhood depression (FFT-CD) and individual supportive psychotherapy (IP). Aims were to describe effects through 52 weeks postrandomization on measures of depression, functioning, nondepressive symptoms, and harm events. Children meeting criteria for depressive disorders (N = 134) were randomly assigned to 15 sessions of FFT-CD or IP and evaluated at mid-treatment for depressive symptoms and fully at roughly 16 weeks (after acute treatment), 32 weeks, and 52 weeks/one year. See clinicaltrials.gov: NCT01159041. Analyses using generalized linear mixed models confirmed the previously reported FFT-CD advantage on rates of acute depression response (≥50% Children's Depression Rating Scale reduction). Improvements in depression and other outcomes were most rapid during the acute treatment period, and leveled off between weeks 16 and 52, with a corresponding attenuation of observed group differences, although both groups showed improved depression and functioning over 52 weeks. Survival analyses indicated that most children recovered from their index depressive episodes by week 52: estimated 76% FFT-CD, 77% IP. However, by the week 52 assessment, one FFT-CD child and six IP children had suffered recurrent depressive episodes. Four children attempted suicide, all in the IP group. Other indicators of possible harm were relatively evenly distributed across groups. Results indicate a quicker depression response in FFT-CD and hint at greater protection from recurrence and suicide attempts. However, outcomes were similar for both active treatments by week 52/one year. Although community care received after acute treatment may have influenced results, findings suggest the value of a more extended/chronic disease model that includes monitoring and guidance regarding optimal interventions when signs of depression-risk emerge.",31840263,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,11.711264610290527,-2.844583749771118,AwOc
"Clinical depression: an evidence-based integrative complementary medicine treatment model.

Clinical depression has a major impact on individuals and society, often presenting the clinician with a significant challenge. Recent evidence suggests that synthetic antidepressants- although effective in the treatment of severe depressed mood-may have only a weak effect against mild-moderate forms of depression. In such cases, nonpharmaceutical options may be indicated. Furthermore, research findings suggest that select natural products are effective adjuvants when combined with synthetic antidepressants. Research concerning the treatment of depression emphasizes individual monotherapies, which is often incongruent with clinical reality. In practice, clinicians often use a variety of interventions; however, this approach may not be systematic, and many interventions used may not be based on strong evidence. This article proposes an evidence-based prescriptive clinical model based on the biopsychosocial model to treat unipolar depression. The ""Antidepressant-Lifestyle- Psychological-Social (ALPS) depression treatment model"" integrates nonpharmacological interventions (such as complementary medicines, lifestyle advice, and psychosocial techniques) for use by clinicians. Initially a review of nonpharmacological mood-elevating interventions was undertaken. Evidentiary support was revealed for use of psychological techniques such as cognitive and behavioral medicine and interpersonal therapy, St John's wort, S-adenosyl methionine, and aerobic and anaerobic exercise. There were inconsistent research findings for acupuncture, omega-3 fish oils, and L-tryptophan for depressed mood. From these evidencebased interventions an integrative model was formed. Clinical recommendations in addition to a practical stepped-care decision tree are outlined. The ALPS model has the potential to improve treatment outcomes and reduce relapse rates in clinical depression and warrants research using rigorous and appropriate methodology.",22314631,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,9.111982345581055,-1.0174862146377563,CxqA
"Estimating patient-specific treatment advantages in the 'Treatment for Adolescents with Depression Study'.

The 'Treatment for Adolescents with Depression Study' (TADS, ClinicalTrials.gov, identifier: NCT00006286) was a cornerstone, randomized controlled trial evaluating the effectiveness of standard treatment options for major depression in adolescents. Whereas previous TADS analyses examined primarily effect modifications of treatment-placebo differences by various patient characteristics, less is known about the modification of inter-treatment differences, and hence, patient characteristics that might guide treatment selection. We sought to fill this gap by estimating patient-specific inter-treatment differences as a function of patients' baseline characteristics. We did so by applying the 'model-based random forest', a recently-introduced machine learning-based method for evaluating effect heterogeneity that allows for the estimation of patient-specific treatment effects as a function of arbitrary baseline characteristics. Treatment conditions were cognitive-behavioural therapy (CBT) alone, fluoxetine (FLX) alone, and the combination of CBT and fluoxetine (COMB). All inter-treatment differences (CBT vs. FLX; CBT vs. COMB; FLX vs. COMB) were evaluated across 23 potential effect modifiers extracted from previous studies. Overall, FLX was superior to CBT, while COMB was superior to both CBT and FLX. Evidence for effect heterogeneity was found for the CBT-FLX difference and the FLX-COMB difference, but not for the CBT-COMB difference. Baseline depression severity modified the CBT-FLX difference; whereas baseline depression severity, patients' treatment expectations, and childhood trauma modified the FLX-COMB difference. All modifications were quantitative rather than qualitative, however, meaning that the differences varied only in magnitude, but not direction. These findings imply that combining CBT with fluoxetine may be superior to either therapy used alone across a broad range of patients.",30856378,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,10.945823669433594,-1.6888518333435059,A9oM
"Evaluating the Effectiveness of Online Educational Modules and Interactive Workshops in Alleviating Symptoms of Mild to Moderate Depression: A Pilot Trial.

Depression is a common health concern in primary care with barriers to treatment well documented in the literature. Innovative online psychoeducational approaches to address barriers to care have been well received and can be cost effective. This pilot trial evaluated the effectiveness of an online psychoeducation curriculum intended to alleviate symptoms of depression while utilizing minimal staff resources. A small (n=29) randomized control pilot study was conducted. Online psychoeducational content was delivered in 5 to 10-minute videos over 8weeks. Participants engaged in moderated discussions on workshop topics. The Patient Health Care Questionnaire (PHQ-9) was used to measure pre/post scores. Two Likert scale questions were used to determine subjective changes in understanding of depression and coping skills. Paired T-test analysis showed an average PHQ-9 improvement of 4.37 (P=.01) in the intervention arm and 1.81 (P=.172) in the control group. No significant difference in delta PHQ-9 score was found between groups via difference in difference analysis (P=.185). Effect size was 0.59. No improvement in Likert scores for question 1 or 2 were detected by paired T test in either group. This pilot trial of interactive online psychoeducational content shows initial promise as there was a significant improvement in PHQ-9 scores within the intervention arm. The comparison of delta scores between intervention and control arms was not statistically significant although this is likely due to the underpowered nature of the pilot trial. This data trend justifies the need for a larger validation trial of this intervention.",33225804,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.8374662399292,-3.3818392753601074,AfCt
"Cognitive behavioral therapy for depressive disorders: Outcomes from a multi-state, multi-site primary care practice.

Individuals with depressive disorders often present to and seek treatment in primary care. Integrated behavioral health services within this setting can improve access to evidence-based cognitive behavioral therapy (CBT). However, limited information exists on the effectiveness of CBT for depression in primary care. Of the 1,302 participants with a primary depressive disorder referred by their primary care provider, 435 endorsed moderate to severe depression at baseline and engaged in at least one CBT session. A psychotherapy tracking database was used to collect relevant data, which included demographics, clinical characteristics, treatment outcomes, and CBT intervention use. Participants with moderate to severe depression who participated in CBT reported a significant decrease in depression and anxiety symptoms at the end of treatment (p ≤ .001, d = 0.52-0.78). Rates of reliable change, response, and remission and types of CBT interventions used differed between major and persistent depressive disorders. Multiple limitations must be noted, which are related to the naturalistic study design, inclusion and exclusion criteria, sample operationalization, symptomatic measurement, time-limited and focused assessment, data collection strategies, and psychological services. Together, these temper the conclusions that can be drawn. Significant reductions in depression and anxiety symptoms were reported by participants with depressive disorders who engaged in short-term CBT within primary care. This study indicates that CBT can be implemented within primary care and suggests that primary care patients with depression can benefit from integrated psychological services, supporting population-based models of care.",34375199,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.926888465881348,-2.8016979694366455,AR+F
"Can interpersonal psychotherapy be delivered by a community agency?

There are limited options for depressed patients to have access to evidence-based psychotherapies in the community. This pilot study explored the feasibility of delivering interpersonal psychotherapy (IPT) to clients in a community support agency. A total of 18 clients with depression completed at least eight sessions of IPT (range 8-13) and 17 completed a range of pre- and post-treatment measures. Clients had a high level of depression and were functioning poorly. All found the delivery of IPT in the community useful and would recommend therapy to others. There was a significant reduction in self-report and clinician-rated depression, and improvement in social functioning. This study supports the notion that therapy can be delivered by appropriately trained non-mental-health clinicians in the community with good effect and adds to the range of options for delivery of psychiatric care.",29409335,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.502999305725098,-3.472728729248047,BQer
"Disseminating behavioural activation for depression via online training: preliminary steps.

Despite the availability of evidence-based treatments for depression, large gaps exist between empirical research and clinical practice. To make preliminary steps toward the dissemination of Behavioural Activation (BA) via online training by examining clinicians' interest in learning BA via online training and the effects of a preliminary version of BA online training. In study 1, practising clinicians (n = 540) completed a survey that assessed attitudes towards learning BA using an online training format. In study 2, we conducted a small, pilot randomized controlled trial (n = 46) to examine preliminary efficacy of teaching BA principles and treatment strategies with a precursor version of BA online training. Study findings suggest that clinicians have interest in learning about BA via online training and that clinicians participating in BA online training evidence high satisfaction and significant gains in self-efficacy using BA and knowledge of BA terms and concepts. These results support the importance of efforts to disseminate BA and the viability of online training as an easily accessible and affordable training option.",24382130,Major Depressive Disorder,Anxiety Treatment,Mental Health,4830,10.099499702453613,-2.24958872795105,CUA3
"Web-based acceptance and commitment therapy for depressive symptoms with minimal support: a randomized controlled trial.

Low-intensity interventions for people suffering from depressive symptoms are highly desirable. The aim of the present study was to investigate the outcomes of a web-based acceptance and commitment therapy (ACT)-based intervention without face-to-face contact for people suffering from depressive symptoms. Participants (N = 39) with depressive symptoms were randomly assigned to an Internet-delivered acceptance and commitment therapy (iACT) intervention or a waiting list control condition (WLC). Participants were evaluated with standardized self-reporting measures (Beck Depression Inventory [BDI-II], Symptom Checklist-90 [SCL-90], Acceptance and Action Questionnaire [AAQ-2], Five Facet Mindfulness Questionnaire [FFMQ], Automatic Thoughts Questionnaire [ATQ], and White Bear Suppression Inventory [WBSI]) at pre- and post-measurement. Long-term effects in the iACT group were examined using a 12-month follow-up. The iACT program comprised home assignments, online feedback given by master's-level students of psychology over a 7-week intervention period, and automated email-based reminders. Significant effects were observed in favor of the iACT group on depression symptomatology (between effect sizes [ESs] at post-treatment, iACT/WLC, g = .83), psychological and physiological symptoms (g = .60), psychological flexibility (g = .67), mindfulness skills (g = .53), and frequency of automatic thoughts (g = .57) as well as thought suppression (g = .53). The treatment effects in the iACT group were maintained over the 12-month follow-up period (within-iACT ES: BDI-II, g = 1.33; SCL-90, g = 1.04; ATQF/B [Frequency/Believability], FFMQ, WBSI, AAQ-II, g = .74-1.08). The iACT participants stated that they would be happy to recommend the same intervention to others with depressive symptoms. We conclude that an ACT-based guided Internet-delivered treatment with minimal contact can be effective for people with depressive symptoms.",26253644,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.17654800415039,-1.6304651498794556,B5v8
"The origins and current status of behavioral activation treatments for depression.

The past decade has witnessed a resurgence of interest in behavioral interventions for depression. This contemporary work is grounded in the work of Lewinsohn and colleagues, which laid a foundation for future clinical practice and science. This review thus summarizes the origins of a behavioral model of depression and the behavioral activation (BA) approach to the treatment and prevention of depression. We highlight the formative initial work by Lewinsohn and colleagues, the evolution of this work, and related contemporary research initiatives, such as that led by Jacobson and colleagues. We examine the diverse ways in which BA has been investigated over time and its emerging application to a broad range of populations and problems. We close with reflections on important directions for future inquiry.",21275642,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.462618827819824,-1.9600818157196045,DAqH
"Interpersonal psychotherapy: evaluation, support, triage.

Depression is highly prevalent and debilitating among medically ill patients. As high as one third of the primary practise patients screen positive for depression symptoms and over half of the patients diagnosed with major depressive disorder are treated in primary care. However, current primary care service arrangements do not efficiently triage patients who screen positive for depression into appropriate treatments that reflect their individual needs and preferences. In this paper, we describe a tool that aims to fill the gap between screening the patients for depression and triaging them to appropriate care. This is a three-session adaptation of interpersonal psychotherapy: ipt; evaluation, support, triage (IPT-EST). We first outline IPT-EST procedures that aim to provide structure and content to primary care practitioners who identify patients with positive depression symptoms, thus assisting the practitioners to explore the patients' psychosocial triggers of depression, give basic strategies to manage these interpersonal stressors and provide decisions tools about triaging patients with severe/persistent depression into appropriate treatment.",22359316,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.656232833862305,-3.6352245807647705,Cw/R
"Behavioural activation v. antidepressant medication for treating depression in Iran: randomised trial.

Behavioural activation might be a viable alternative to antidepressant medication for major depressive disorder. To compare the effectiveness of behavioural activation and treatment as usual (TAU, antidepressant medication) for major depressive disorder in routine clinical practice in Iran. Patients with major depressive disorder (n = 100) were randomised to 16 sessions of behavioural activation (n = 50) or antidepressant medication (n = 50) (IRCT138807192573N1). The main outcome was depression, measured with the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD), assessed at 0, 4, 13 and 49 weeks. Symptom reduction was greater in the behavioural activation group than in the TAU group on both the BDI and the HRSD at 13 and 49 weeks in multilevel analysis. Baseline depression severity was a moderator, with relatively better effects for behavioural activation in individuals who were more severely depressed. Also, there was better retention in the behavioural activation than in the TAU group. Behavioural activation is a viable and effective treatment for people with major depressive disorder, especially for those who are more severely depressed, and it can successfully be disseminated into routine practice settings in a non-Western country such as Iran.",23391727,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.441366195678711,-2.1527280807495117,CiM7
"Technology-adaptable interventions for treating depression in adults with cognitive impairments: protocol for a systematic review.

Depression is a common comorbidity in individuals with cognitive impairment. Those with cognitive impairments face unique challenges in receiving the benefits of many conventional therapies for depression, and may have poorer outcomes in areas such as recovery and quality of life. However, the stigmatization of mental health disorders, cost barriers and physical disabilities may prevent these individuals from seeking mental health care. An online, self-help intervention specifically developed for adults with cognitive deficits and depression may be particularly beneficial to this population. We aim to inform the design of such an intervention through a systematic review by answering the following research question: among adults with cognitive impairment (including those with acquired brain injuries or neurodegenerative diseases), which technology-amenable interventions have been shown to effectively decrease symptoms of depression? Specifically, psychotherapeutic and/or behavioural interventions that could be delivered in a self-guided, online system will be included. Comprehensive electronic searches will be conducted in MEDLINE, EMBASE, PsycINFO and CINAHL. Additional studies will be obtained through manually searching the references of relevant systematic reviews, contacting primary authors of select articles and tracking conference proceedings and trial registries. Article titles and abstracts will be screened using predefined eligibility criteria, and then judged for their amenability to the proposed self-help, technology-based intervention. The full text of those articles with selected interventions will then be screened to determine final eligibility for inclusion. Included articles will be categorized by intervention type and assessed for risk of bias using the Cochrane Effective Practice and Organization of Care Risk of Bias tool for non-randomized trials, controlled before-after studies and interrupted time series. The primary outcome will be a change in score on a validated depression scale, and adverse events will be documented as a secondary outcome. After data extraction from selected articles, pooling of data and meta-analysis will be conducted if a sufficient pool of studies with comparable methodology and quality are identified. Alternatively, plain language summaries will be developed. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. PROSPERO CRD42014014417.",25875655,Major Depressive Disorder,Anxiety Treatment,Mental Health,11272,9.914892196655273,-3.3470046520233154,B/GL
"Multidisciplinary intervention in the treatment of mixed anxiety and depression disorder.

Depression and anxiety disorders are one of the main limiting psychopathologies in the world today. This pathology is linked to an inflammatory state and a dysregulation of both neurotransmitters and autonomic nervous system. Various treatments from psychiatric and psychological areas have shown different degrees of efficacy in their treatment, being Cognitive Behavioral Therapy one of the most successful. In addition, various interventions from other areas of knowledge are showing significant improvements in this pathology. This research aimed to analyze the psychological and physiological modifications of a multidisciplinary intervention that combines psychological treatment (Cognitive Behavioral Therapy), physical activity and nutritional intervention in a mixed anxiety and depression disorder (DSM-V). We analyzed modifications in the HAM-D depression, STAI anxiety questionnaire, subjective perceptions of anxiety, happiness, sleep and motivation and the autonomous modulation before and after a 6 multidisciplinary sessions of cognitive behavioral therapy, aerobic physical activity and nutritional intervention in a subject with a mixed anxiety and depression disorder. The results showed a reduction in the values of depression in HAM-D until the classification of non-depression, a reduction in both state and trait anxiety, an increase in the subjective perceptions of sleep, happiness and motivation and a greater parasympathetic modulation after the six intervention sessions. The combination of psychological therapy with aerobic physical activity and nutritional recommendations to treat mixed anxiety and depression disorder produced an increased parasympathetic tone and a decreased anxiety and depression symptoms in six sessions. This is a novel research that allows us to open the study of a new multidisciplinary field in the treatment of this disease that is highly present today.",32109486,Major Depressive Disorder,Anxiety Treatment,Mental Health,19217,11.198163032531738,-2.4489290714263916,Asrp
"Internet-based psychodynamic versus cognitive behaviour therapy for adolescents with depression: study protocol for a non-inferiority randomized controlled trial (the ERiCA study).

Adolescent depression is a common mental health problem and there is an urgent need for effective and accessible treatments. Internet-based interventions solve many obstacles for seeking and receiving treatment, thus increasing access to effective treatments. Internet-based cognitive behavioural therapy (ICBT) for adolescent depression has demonstrated efficacy in previous trials. In order to broaden the range of evidence-based treatments for young people, we evaluated a newly developed affect-focused Internet-based psychodynamic treatment (IPDT) in a previous study with promising results. The purpose of the planned study is to evaluate the efficacy of IPDT for adolescent depression in a non-inferiority trial, comparing it to ICBT. The study will employ a parallel randomized non-inferiority design (ratio 1:1; n = 270). Eligible participants are adolescents 15-19years suffering from depression. The primary hypothesis is that IPDT will be non-inferior to ICBT in reducing depressive symptoms from pre-treatment to end of treatment. Secondary research questions include comparing outcomes of IPDT and ICBT regarding anxiety symptoms, emotion regulation and self-compassion. Additional data will be collected to evaluate cost-effectiveness as well as investigating predictors, moderators and mediators of outcome. In addition, we will examine long-term outcome up to 1 year after end of treatment. Diagnostic interviews with MINI 7.0 will be used to establish primary diagnosis of depression as well as ruling out any exclusion criteria. Both treatments consist of eight modules over 10 weeks, complemented with therapist support through text messages and weekly chat sessions. Primary outcome measure is the Quick Inventory of Depressive Symptomatology in Adolescents Self-Rated (QIDS-A17-SR). Primary outcome will be analysed using data from all participants entering the study using a multilevel growth curve strategy based on the weekly measurements of QIDS-A17-SR. The non-inferiority margin is defined as d = 0.30. This trial will demonstrate whether IPDT is non-inferior to ICBT in the treatment of adolescent depression. The study might therefore broaden the range of evidence-based treatment alternatives for young people struggling with depression. Further analyses of data from this trial may increase our knowledge about ""what works for whom"" and the pathways of change for two distinct types of interventions. ISRCTN12552584 , Registered on 13 August 2019.",32600400,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.036117553710938,-3.0954058170318604,Amor
"[The generalisability of depression trials to clinical practice].

Evidence-based therapies for major depression, as described in the clinical guidelines, are based on results from randomised controlled trials (RCTs). So far, it is not known to what extent results of RCTs on major depression can be generalised to 'real life' clinical practice. To compare treatment results for major depression from RCTs (efficacy) and results from daily practice (effectiveness); furthermore, to assess to what extent eligibility criteria and (un)intended selection by recruitment procedures influences treatment outcomes in daily practice. In a 'real life' patient population (n=1653) suffering from major depression (established by the MINIplus) and assessed in routine outcome monitoring at baseline, we explored how many patients met the eligibility criteria for antidepressant and psychotherapy efficacy trials. Furthermore we explored to what extent RCT participants differed in socio-demographic and socio-economic status from 'daily practice' patients. 626 of the ROM patients had at least one follow-up assessment. In this follow-up group we compared the treatment outcome (assessed by the MADRS and BDI-II) to the results of 15 meta-analyses of RCTs. We also explored to what extent patient selection based on eligibility criteria and socio-demographic/socio-economic status influenced treatment outcome. Remission percentages (21-27% in ROM versus 34-58% in RCTs) and effect sizes (0.85 in ROM versus 1.71 in RCTs, within-group data) were lower in daily practice than in RCTs. ROM patients differed from RCT participants in many disease-specific and socio-economic features. These differences are due to patient selection in RCTs. However, the influence of patient selection based on eligibility criteria and socio-demographic differences in treatment outcome were very modest (explained variances 1-11%). Treatment success for major depression is lower in daily practice than in RCTs and 'real life' patients differ in many features from RCT participants. However, these differences cannot explain the difference between efficacy and effectiveness. The generalisability of the results of depression trials to daily practice might not be jeopardised by the use of eligibility criteria and recruitment procedures to the extent suggested in earlier research.",26402894,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.954463005065918,-1.7178312540054321,B3kT
"The predictive value of early response in patients with depressive disorders.

Several randomized controlled trials have identified early response to psychotherapy as a predictor for later treatment outcome among patients with depressive disorders. However, supporting evidence under routine conditions is rare. This study evaluated the predictive value of early improvement for final outcomes in psychotherapy among depressive patients in the naturalistic setting of a German university outpatient clinic. We used the method of percent symptom reduction to classify 639 patients with major depression or dysthymic disorder who underwent an average of 40.0 sessions (SD=16.3) of naturalistic cognitive-behavioral therapy (CBT) as having either an early response or an early nonresponse. Early response was a good predictor for final response and remission regarding depressive symptoms (OR=8.75 and OR=5.32, respectively), as well as overall psychological distress (OR=3.95 and OR=3.16, respectively). Early nonresponse was distinctly associated with later deterioration of both depressive (OR=9.56) and general psychological symptomatology (OR=4.92). Early response to psychotherapy has high predictive qualities for positive later treatment outcome in depressive patients under routine CBT. Therefore, early treatment effects should be considered in clinical decision-making and treatment planning in everyday clinical practice.",26776721,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,10.935644149780273,-2.1602466106414795,Byc0
"Quality of life after response to acute-phase cognitive therapy for recurrent depression.

Adults with major depressive disorder (MDD) often experience reduced quality of life (QOL). Efficacious acute-phase treatments, including cognitive therapy (CT) or medication, decrease depressive symptoms and, to a lesser degree, increase QOL. We tested longer-term changes in QOL after response to acute-phase CT, including the potential effects of continuation treatment for depression and time-lagged relations between QOL and depressive symptoms. Responders to acute-phase CT (N = 290) completed QOL and depressive symptom assessments repeatedly for 32 post-acute months. Higher-risk responders were randomized to 8 months of continuation treatment (CT, fluoxetine, or pill placebo) and then entered a 24-month follow-up. Lower-risk responders were only assessed for 32 months. On average, large gains in QOL made during acute-phase CT response were maintained for 32 months. Continuation CT or fluoxetine did not improve QOL relative to pill placebo. Controlling for residual depressive symptoms, higher QOL after acute-phase CT response was a protective factor against MDD relapse and recurrence. Higher QOL predicted subsequent reductions in depressive symptom severity, but depressive symptom severity did not predict subsequent changes in QOL. Generalization of results to other patient populations, treatments, and measures is uncertain. The clinical trial was not designed to test relations between QOL and depression. Replication is needed before clinical application of these results. Gains in QOL made during response to acute-phase CT are relatively stable and may help protect against relapse/recurrence. Continuation CT or fluoxetine may not further improve QOL among acute-phase CT responders.",32971314,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.660788536071777,-1.4850746393203735,AiCz
"Effectiveness of a self-help manual on the promotion of resilience in individuals with depression in Thailand: a randomised controlled trial.

The prevalence of depression is increasing markedly in Thailand. One way of helping people with depression is to increase their resilience; good resilience is associated with positive outcomes in depression. The purpose of this study was to examine the effectiveness of a self-help manual on the resilience levels of individuals with depression living in the community in Chiang Mai Province in northern Thailand. Fifty-six participants with a diagnosis of moderate depression were assigned randomly to either an intervention (n = 27) or control (n = 29) group by means of independent random allocation, using computer generated random numbers. Fifty-four completed the study (two were excluded shortly after baseline data collection), so an available case analysis was undertaken. The intervention group were given a self-help manual and continued to receive standard care and treatment, while the control group continued to receive standard care and treatment. Both groups were also given a short weekly telephone call from a researcher. Participants were assessed at three time points: baseline (Week 0), immediate post-test (Week 8), and follow-up (Week 12). Data were collected between October 2007 and April 2008. The findings showed statistically significant differences between the intervention and the control group, and within the intervention group, in their resilience levels. Simple main effects analyses of group within time showed a significant difference between both groups at follow-up (p = 0.001), with the intervention group having a higher resilience score than the control group. Simple main effect of time within the intervention group showed a significant increase in resilience scores from baseline to post-test time points (p < 0.001), from baseline to follow-up (p < 0.001), but not from post-test to follow-up (p = 0.298). The findings provide preliminary evidence supporting the use of bibliotherapy for increasing resilience in people with moderate depression in a Thai context. Bibliotherapy is straightforward to use, and an easily accessible addition to the standard approach to promoting recovery. It is incorporated readily as an adjunct to the work of mental health nurses and other professionals in promoting resilience and enhancing recovery in people with moderate depression in the community. http://www.ANZCTR.org.au/ACTRN12611000905965.aspx.",22339984,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.837458610534668,-3.7861454486846924,CxQ8
"Interpersonal Counseling for College Students: Pilot Feasibility and Acceptability Study.

University counseling centers struggle to meet the growing demand for mental health treatment by students in distress. More acutely distressed students typically receive priority, whereas those with mild to moderate depression often face longer wait times and fewer available therapy sessions. For this reason, interpersonal counseling for college students (IPC-C) was created as a brief manualized psychotherapy, suitable for students with mild to moderate depression, that maintains the core components of interpersonal counseling and integrates components from interpersonal psychotherapy for adolescents and other developmentally appropriate techniques. This article describes a pilot trial of IPC-C. IPC-C is delivered in three to six psychotherapy sessions focused on alleviating depressive symptoms and increasing social support. Ten participants from two university counseling centers were recruited to receive IPC-C. The inclusion criterion was a Patient Health Questionnaire-9 (PHQ-9) score of 5-14, indicating mild to moderate depression. Participants completed the PHQ-9 at each session, the College Adjustment Test at baseline and termination, and the IPC Satisfaction Scale at termination. Nine of the 10 participants completed the study, attending an average of five therapy sessions each. Participants agreed that the number of sessions was appropriate and indicated satisfaction with the IPC-C intervention. Participants exhibited significantly reduced depression severity (Cohen's d=2.45) and significantly improved college adjustment (d=0.92). In this pilot trial, IPC-C was found to be a feasible and acceptable intervention for university-based treatment of young adults with mild to moderate depressive symptoms. IPC-C holds promise as a potentially effective intervention for this population and warrants further study in a randomized trial.",34905934,Major Depressive Disorder,Anxiety Treatment,Mental Health,17119,11.249407768249512,-3.846125364303589,xyI
"An online optimism intervention reduces depression in pessimistic individuals.

Interest in online positive psychology interventions (OPPIs) continues to grow. The empirical literature has identified design factors (e.g., variety and duration of activities) and moderators (e.g., personality traits) that can influence their effectiveness. A randomized controlled trial tested an empirically informed OPPI designed to promote self-efficacy and an optimistic outlook. Pessimism was included as a trait moderator. Participants (N = 466) were English-speaking adults interested in becoming happier. They were randomly assigned to complete either an OPPI cultivating optimism or a control condition writing about daily activities for 3 weeks. Follow-up assessments occurred 1 and 2 months following the exercise period. A hierarchical linear model analysis indicated that the optimism intervention increased the pursuit of engagement-related happiness in the short term and reduced dysfunctional attitudes across follow-ups. Pessimistic individuals had more to gain and reported fewer depressive symptoms at post-test. These findings support the conclusion that empirically informed online interventions can improve psychological well-being, at least in the short run, and may be particularly helpful when tailored to the needs of the individual.",24417602,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.925261497497559,-3.9804787635803223,CTj8
"Towards personalising treatment: a systematic review and meta-analysis of face-to-face efficacy moderators of cognitive-behavioral therapy and interpersonal psychotherapy for major depressive disorder.

Consistent evidence suggests that face-to-face cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT) may be equally effective depression treatments. Current clinical research focuses on detecting the best predictors-moderators of efficacy to guide treatment personalisation. However, individual moderator studies show inconsistent findings. This systematic review and meta-analysis aimed to compare the efficacy of CBT and IPT, including combined treatment with antidepressants for depression, and evaluate the predictive power of demographic, clinical presentation and treatment characteristics moderators for both therapies. PsycArticles, PsycINFO, PubMed and Cochrane Library were systematically searched through December 2017 for studies that have assessed individuals with major depression receiving either CBT or IPT in a face-to-face format both at pre- and post-treatment. Random-effects moderator meta-analyses were conducted. In total 168 samples from 137 studies including 11 374 participants qualified for the meta-analytic review. CBT and IPT were equally effective across all but one prespecified moderators. For psychotherapy delivered without concomitant antidepressant treatment [antidepressant medications (ADMs)], CBT was superior to IPT (g = 1.68, Qbetweenp = 0.037). Within-CBT moderator analyses showed that increased CBT efficacy was associated with lower age, high initial depression severity, individual format of administration and no adjunctive ADMs. Within-IPT analyses showed comparable efficacy across all moderators. Clinical guidance around combined treatment (psychotherapy plus ADMs) should be reconsidered. CBT alone is superior to IPT alone and to combined treatment, while IPT alone is non-inferior to combined treatment. More research is needed to assess the moderating effect of older age and number of previous episodes on IPT efficacy.",31615583,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.294119834899902,-2.9182379245758057,AzZD
"The Role of Staging in Planning Psychotherapeutic Interventions in Depression.

The purpose of this critical review is to examine the role of staging in planning a psychotherapeutic intervention in depressive disorders. English-language studies concerned with staging in depressive disorders were identified in MEDLINE, PsycINFO, and Web of Science and by manual search of the literature. Selection of articles was based on their methodological quality and implications for clinical practice. Staging may allow clinicians to apply a psychotherapeutic intervention to specific phases of the development of depressive disorders: certain psychotherapeutic approaches, such as well-being therapy and mindfulness-based cognitive therapy, appear to be uniquely suited for addressing the residual phase of depression, whereas interpersonal psychotherapy has been mainly tested in the acute phase. Cognitive-behavioral treatment appears to be suitable for all phases, but with chronic or double depression, its modifications (eg, cognitive-behavioral analysis system of psychotherapy) appear to be indicated. Staging may also allow clinicians to assess past and potential resistance to treatment. Treatment options, including psychotherapy, need to be filtered by clinical judgment and patient-specific problems that take into account individual staging classifications of the depressive illness.",28297594,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.197827339172363,-1.3116154670715332,BfdP
"Effectiveness of a Guided Web-Based Intervention to Reduce Depressive Symptoms before Outpatient Psychotherapy: A Pragmatic Randomized Controlled Trial.

Psychotherapy is a first-line treatment for depression. However, capacities are limited, leading to long waiting times for outpatient psychotherapy in health care systems. Web-based interventions (WBI) could help to bridge this treatment gap. This study investigates the effectiveness of a guided cognitive-behavioral WBI in depressive patients seeking face-to-face psychotherapy. A 2-arm randomized controlled trial was conducted. Depressive patients (n = 136) recruited from the waiting lists of outpatient clinics were randomly assigned to an intervention group (IG; treatment as usual [TAU] + immediate access to WBI) or a control group (CG; TAU + access to WBI after follow-up). Depressive symptoms and secondary outcomes were assessed at baseline, 7 weeks, and 5 months after randomization. Mixed-model analyses revealed a significant group × time interaction effect on depressive symptoms (F2, 121.5 = 3.91; p < 0.05). Between-group effect sizes were d = 0.55 at 7 weeks and d = 0.52 at 5 months. The IG was superior regarding psychological symptoms and mental health quality of life but not on physical health quality of life, attitudes, motivation for psychotherapy, or subjective need and uptake of psychotherapy. Patients waiting for face-to-face psychotherapy can benefit from a WBI when compared to TAU. Despite the reduction of depressive symptoms in the IG, the uptake of subsequent psychotherapy was still high in both groups. The effects remained stable at the 5-month follow-up. However, this study could not determine the proportion of specific intervention effects vs. nonspecific effects, such as positive outcome expectations or attention. Future research should focus on the long-term effects and cost-effectiveness of WBI before psychotherapy.",33946072,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.989526748657227,-3.2750244140625,AW3g
"Cost-effectiveness analyses of augmented cognitive behavioral therapy for pharmacotherapy-resistant depression at secondary mental health care settings.

Pharmacotherapy is the primary treatment strategy in major depression. However, two-thirds of patients remain depressed after the initial antidepressant treatment. Augmented cognitive behavioral therapy (CBT) for pharmacotherapy-resistant depression in primary mental health care settings proved effective and cost-effective. Although we reported the clinical effectiveness of augmented CBT in secondary mental health care, its cost-effectiveness has not been evaluated. Therefore, we aimed to compare the cost-effectiveness of augmented CBT adjunctive to treatment as usual (TAU) and TAU alone for pharmacotherapy-resistant depression at secondary mental health care settings. We performed a cost-effectiveness analysis at 64weeks, alongside a randomized controlled trial involving 80 patients who sought depression treatment at a university hospital and psychiatric hospital (one each). The cost-effectiveness was assessed by the incremental cost-effectiveness ratio (ICER) that compared the difference in costs and quality-adjusted life years, and other clinical scales, between the groups. The ICERs were JPY -15278322 and 2026865 for pharmacotherapy-resistant depression for all samples and those with moderate/severe symptoms at baseline, respectively. The acceptability curve demonstrates a 0.221 and 0.701 probability of the augmented CBT being cost-effective for all samples and moderate/severe depression, respectively, at the threshold of JPY 4.57 million (GBP 30000). The sensitivity analysis supported the robustness of our results restricting for moderate/severe depression. Augmented CBT for pharmacotherapy-resistant depression is not cost-effective for all samples including mild depression. In contrast, it appeared to be cost-effective for the patients currently manifesting moderate/severe symptoms under secondary mental health care.",34459077,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.801891326904297,-2.632796287536621,ARGg
"Online psychological interventions to reduce symptoms of depression, anxiety, and general distress in those with chronic health conditions: a systematic review and meta-analysis of randomized controlled trials.

Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition. We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses. In total 70 eligible studies across 17 health conditions [most commonly: cancer (k = 20), chronic pain (k = 9), arthritis (k = 6) and multiple sclerosis (k = 5), diabetes (k = 4), fibromyalgia (k = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression g = 0.30 (95% CI 0.22-0.39), anxiety g = 0.19 (95% CI 0.12-0.27), and distress g = 0.36 (95% CI 0.23-0.49). Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.",32674747,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.008352279663086,-3.8911337852478027,AluY
"The Effects of Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Analysis System of Psychotherapy added to Treatment as Usual on suicidal ideation in chronic depression: Results of a randomized-clinical trial.

Suicidal ideation (SI) is common in chronic depression, but only limited evidence exists for the assumption that psychological treatments for depression are effective for reducing SI. In the present study, the effects of Mindfulness-based Cognitive Therapy (MBCT; group version) plus treatment-as-usual (TAU: individual treatment by either a psychiatrist or a licensed psychotherapist, including medication when indicated) and Cognitive Behavioral Analysis System of Psychotherapy (CBASP; group version) plus TAU on SI was compared to TAU alone in a prospective, bi-center, randomized controlled trial. The sample consisted of 106 outpatients with chronic depression. Multivariate regression analyses revealed different results, depending on whether SI was assessed via self-report (Beck Depression Inventory suicide item) or via clinician rating (Hamilton Depression Rating Scale suicide item). Whereas significant reduction of SI emerged when assessed via clinician rating in the MBCT and CBASP group, but not in the TAU group while controlling for changes in depression, there was no significant effect of treatment on SI when assessed via self-report. SI was measured with only two single items. Because all effects were of small to medium size and were independent of effects from other depression symptoms, the present results warrant the application of such psychotherapeutical treatment strategies like MBCT and CBASP for SI in patients with chronic depression.",27128357,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.074233055114746,-0.754157543182373,Btgt
"Predicting treatment effects in unipolar depression: A meta-review.

There is increasing interest in clinical prediction models in psychiatry, which focus on developing multivariate algorithms to guide personalized diagnostic or management decisions. The main target of these models is the prediction of treatment response to different antidepressant therapies. This is because the ability to predict response based on patients' personal data may allow clinicians to make improved treatment decisions, and to provide more efficacious or more tolerable medications to the right patient. We searched the literature for systematic reviews about treatment prediction in the context of existing treatment modalities for adult unipolar depression, until July 2019. Treatment effect is defined broadly to include efficacy, safety, tolerability and acceptability outcomes. We first focused on the identification of individual predictor variables that might predict treatment response, and second, we considered multivariate clinical prediction models. Our meta-review included a total of 10 systematic reviews; seven (from 2014 to 2018) focusing on individual predictor variables and three focusing on clinical prediction models. These identified a number of sociodemographic, phenomenological, clinical, neuroimaging, remote monitoring, genetic and serum marker variables as possible predictor variables for treatment response, alongside statistical and machine-learning approaches to clinical prediction model development. Effect sizes for individual predictor variables were generally small and clinical prediction models had generally not been validated in external populations. There is a need for rigorous model validation in large external data-sets to prove the clinical utility of models. We also discuss potential future avenues in the field of personalized psychiatry, particularly the combination of multiple sources of data and the emerging field of artificial intelligence and digital mental health to identify new individual predictor variables.",32437828,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,11.343802452087402,-1.1448460817337036,Aou3
"The effect of cognitive behavioral group therapy for depression: a meta-analysis 2000-2010.

The goals of the meta-analysis were to investigate the overall effectiveness of cognitive behavioral group therapy (CBGT) for depression and relapse prevention in depression from 2000 to 2010, and to investigate how the variables (episode, residual symptoms, group size, control group, group manual, therapist experience, therapy frequency, session length, and take-home assignment) of a CBGT study could affect the effect size. This study collected actual study designs sought of CBGT for depression published from 2000 to 2010. These studies were then cross-referenced using Medical Subject Headings (MeSH) with the following keywords: group therapy, cognitive therapy, cognitive behavioral therapy, cognitive behavioral group therapy, psychotherapy, depression, relapse, and recurrence. The quality of the studies was evaluated using Cochrane Collaboration Guidelines. The effect size of CBGT on depression and relapse prevention in depression used the formula devised by Hedges and Olkin (1985). The study investigated the results of 32 studies on the effect of CBGT for depression. The CBGT had an immediate (g=-0.40) and continuous effect over 6 months (g=-0.38), but no continuous effect after 6 months (g=-0.06). The CBGT lowered the relapse rate of depression (RD = 0.16). Variables significantly different from each other in terms of immediate effect were: CBGT versus usual care, therapy sessions lasting longer than 1 hour, and take-home assignments. Preintervention severity of depression and patient turnover rate were found to be significantly related to the size of the immediate effect. The relapse rate after 6 months was significantly related only to ""participants have no residual symptoms/participants did not mention residual symptoms."" Researchers and clinicians should take note that CBGT had a moderate effect on the level of depression and a small effect on the relapse rate of depression. The results of this study suggest that the patient should receive a course of therapy at least every 6 months.",22221447,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.30298900604248,-2.5504989624023438,CzCf
"Reducing the stigma of depression through neurobiology-based psychoeducation: a randomized controlled trial.

Attribution theory claims that people who are stigmatized experience more negative emotional and behavioral reactions from others when they are thought to be responsible for their problems. Accordingly, this study proposed a neurobiology-based psychoeducational intervention, which attempted to reduce people's blameworthy attitudes toward and social distance from depressed individuals. One hundred and thirty-two college students were randomly assigned to an experimental and control group. Participants in the experimental group received a 30-min lecture on neurobiology-based psychoeducation for depressive disorders, and were asked to fill out questionnaires before and 2 weeks after the intervention. The control group, with no intervention, also filled out the same questionnaires before and 2 weeks after the experiment. The main contents of the neurobiology-based psychoeducation concerned the neurotransmission processes and biological mechanisms of depression, in order to emphasize the biological attribution of depression. An ancova indicated that the neurobiology-based psychoeducational intervention significantly elevated the biological attribution of depression and reduced the social distance from depressed individuals. Psychological blameworthy attitudes toward depression, however, did not significantly change. Through a brief psychoeducation program about depression, knowledge of neuroscience could lead to positive benefits. Public awareness that depression can be effectively prevented and treated may be a way in which people can accept depressed individuals. Further studies are needed to certify the mechanisms of the effect of neurobiology-based psychoeducation.",24521323,Major Depressive Disorder,Anxiety Treatment,Mental Health,585,10.928177833557129,-4.7502570152282715,CSO4
"Interventions to reduce the impact of unemployment and economic hardship on mental health in the general population: a systematic review.

Job loss, debt and financial difficulties are associated with increased risk of mental illness and suicide in the general population. Interventions targeting people in debt or unemployed might help reduce these effects. We searched MEDLINE, Embase, The Cochrane Library, Web of Science, and PsycINFO (January 2016) for randomized controlled trials (RCTs) of interventions to reduce the effects of unemployment and debt on mental health in general population samples. We assessed papers for inclusion, extracted data and assessed risk of bias. Eleven RCTs (n = 5303 participants) met the inclusion criteria. All recruited participants were unemployed. Five RCTs assessed 'job-club' interventions, two cognitive behaviour therapy (CBT) and a single RCT assessed each of emotional competency training, expressive writing, guided imagery and debt advice. All studies were at high risk of bias. 'Job club' interventions led to improvements in levels of depression up to 2 years post-intervention; effects were strongest among those at increased risk of depression (improvements of up to 0.2-0.3 s.d. in depression scores). There was mixed evidence for effectiveness of group CBT on symptoms of depression. An RCT of debt advice found no effect but had poor uptake. Single trials of three other interventions showed no evidence of benefit. 'Job-club' interventions may be effective in reducing depressive symptoms in unemployed people, particularly those at high risk of depression. Evidence for CBT-type interventions is mixed; further trials are needed. However the studies are old and at high risk of bias. Future intervention studies should follow CONSORT guidelines and address issues of poor uptake.",27974062,Major Depressive Disorder,Anxiety Treatment,Mental Health,6549,9.555027961730957,-4.737847328186035,BjZk
"The Efficacy of Measurement-Based Care for Depressive Disorders: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objective: To determine the efficacy of measurement-based care (MBC), defined as routinely administered outcome measures with practitioner and patient review to inform clinical decision-making, for adults with depressive disorders. Data Sources: Embase, MEDLINE, PsycINFO, ClinicalTrials.gov, CNKI, and Wanfang Data were searched through July 1, 2020, using search terms for measurement-based care, depression, antidepressant or pharmacotherapy, and randomized controlled trials (RCTs), without language restriction. Study Selection: Of 8,879 articles retrieved, 7 RCTs (2,019 participants) evaluating MBC for depressive disorders, all involving pharmacotherapy, were included. Data Extraction: Two independent reviewers extracted data. The primary outcome was response rate (≥50% improvement from baseline to endpoint on a depression scale). Secondary clinical outcomes were remission rate (endpoint score in remission range), difference in endpoint severity, and medication adherence. Results: Meta-analysis with random-effects models found no significant difference between MBC and comparison groups in response rates (3 studies; odds ratio [OR]=1.66; 95% CI, 0.66-4.17; P=.279). MBC was associated with significantly greater remission rates (5 studies; OR=1.83; 95% CI, 1.12-2.97; P=.015), lower endpoint severity (5 studies; standardized mean difference=0.53; CI 0.06-0.99; P=.026), and greater medication adherence (3 studies; OR=1.68; 95% CI, 1.22-2.30; P=.001). Conclusions: Although benefits for clinical response are unclear, MBC is effective in decreasing depression severity, promoting remission, and improving medication adherence in patients with depressive disorders treated with pharmacotherapy. The results are limited by the small number of included trials, high risk of bias, and significant study heterogeneity.",34587377,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.139820098876953,-1.810368537902832,+6w
"Forecasting success: patients' expectations for improvement and their relations to baseline, process and outcome variables in group cognitive-behavioural therapy for depression.

There is growing evidence for the important role of patients' outcome expectations to the process and outcome of psychotherapy, yet its relevance to group cognitive-behavioural therapy (CBT) for depression has not been examined. In an effort to fill this void, the present study investigated expectations for improvement among 80 psychiatric outpatients attending a group CBT program for depression. The study addressed the following four questions: (1) Which baseline patient characteristics might be associated with patients' expectations for improvement? (2) Does providing a rationale and outline for treatment affect patients' expectations? (3) Are patients' expectations related to the quality of therapeutic alliance? and (4) Are patients' expectations associated with the outcome of treatment? The main findings of the study are as follows: (a) baseline symptoms of depression, quality of life and current suicidal ideations were consistently associated with outcome expectancies; (b) outcome expectancies were unrelated to treatment completion status; (c) although expectancy ratings did not change significantly for the group as a whole, there was some variability in how individual patient's expectancy ratings changed; (d) baseline expectancies were related to early-treatment alliance quality, but not to mid-treatment alliance, whereas early-treatment expectancies were significantly associated with mid-treatment alliance; and (e) baseline expectations of favourable outcome had a negative association with improvement in anxiety symptoms, yet expectancy ratings from session 3 had a positive association with improvement in quality of life and interpersonal problems. Increases in expectancy ratings were significantly related to improvement in anxiety, quality of life and interpersonal problems. Patients who present in a particularly hopeless and demoralized state are likely to have low expectations for a positive outcome of treatment. Efforts should be made in the first few sessions of therapy to mobilize patients' hope and expectation of success, for increases in one's expectations may facilitate a favourable treatment outcome. An optimistic outlook on the probability of success in treatment may contribute to the development of a strong working relationship between the patient and the therapist.",23280955,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.79912281036377,-3.761536121368408,Cj1Q
"A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression.

The aim of this meta-analysis was to systematically examine the short- and long-term effects of group Cognitive Behavioral Therapy (CBT) for adolescent depression and to examine the role of various moderators of the reported effect sizes. A comprehensive literature search of relevant randomized-controlled trials identified 23 studies containing 49 post-intervention and 56 follow-up comparisons. Standardized mean differences (SMD) were calculated both for post-intervention and follow-up. A three-level random effects approach was used to model the dependent effect sizes. Group CBT was more efficacious than control conditions both at post-intervention (SMD = -0.28, 95% CI [-0.36, -0.19]) and at follow-up (SMD = -0.21, 95% CI [-0.30, -0.11]). Having an inactive control group was associated with a larger post-intervention effect size, while having a longer follow-up duration was associated with a smaller follow-up effect size. Even though the effect sizes are low, research suggests that group CBT is a significant treatment for adolescent depression.",29957492,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.116570472717285,-3.0399909019470215,BJoV
"Effectiveness and cost effectiveness of guided online treatment for patients with major depressive disorder on a waiting list for psychotherapy: study protocol of a randomized controlled trial.

Depressive disorders are highly prevalent and result in negative consequences for both patients and society. It is therefore important that these disorders are treated adequately. However, due to increased demand for mental healthcare and subsequent increased costs, it would be desirable to reduce costs associated with major depressive disorder while maintaining or improving the quality of care within the healthcare system. Introducing evidence-based online self-help interventions in mental healthcare might be the way to maintain clinical effects while minimizing costs by reducing the number of face-to-face sessions. This study aims to evaluate the clinical and economical effects of a guided online self-help intervention when offered to patients with major depressive disorder on a waiting list for psychotherapy in specialized mental health centers (MHCs). Patients at mental health centers identified with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of major depression who are awaiting face-to-face treatment are studied in a randomized controlled trial. During this waiting list period, patients are randomized and either (1) receive an internet-based guided self-help treatment or (2) receive a self-help book. The 5-week internet-based guided self-help intervention and the self-help booklet are based on problem solving treatment. After the intervention, patients are allowed to start regular face-to-face treatment at MHCs. Costs and effects are measured at baseline, after the intervention at 6 to 8 weeks, 6 months and 12 months. The primary outcome measure is symptoms of depression. Secondary outcome measures are diagnosis of depression, number of face-to-face sessions, absence of work and healthcare uptake in general. Additional outcome measures are anxiety, insomnia, quality of life and mastery. This study evaluates the effectiveness and cost effectiveness of internet-based guided self-help in patients at specialized mental health centers. The aim is to demonstrate whether the introduction of internet-based self-help interventions in regular mental healthcare for depressive disorders can maintain clinical effects and reduce costs. Strengths and limitations of this study are discussed. Netherlands Trial Register NTR2824.",24289099,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.866028785705566,-3.1029653549194336,CVZx
"Psychological Treatment for Depressive Disorder.

Depression is highly prevalent and causes unnecessary human suffering and economic loss. Therefore, its treatment and prevention are of utmost importance. There are several advantages of using psychotherapy either by itself or combined with pharmacological treatment methods in the treatment of depression. First, it is well known that combining biological treatment with psychosocial methods increases the chances of recovery. Second, in some individuals, psychotherapy continues to be the only solution. Third, the use of antidepressants contains some safety risks and side effects, but psychotherapy does not. Fourth, clinically, depressive patients prefer psychotherapy to drug therapy. Use of a depression-focused psychotherapy alone is recommended as an initial treatment choice for patients with mild to moderate depression, with clinical evidence supporting the use of cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), psychodynamic psychotherapy (PDP), and problem-solving therapy (PST) in individual and group formats. Important developments took place within the past 20 years in the psychotherapy of depression. In the present chapter, we introduced several key issues, such as, Are all psychotherapies equally effective? Who benefits from psychotherapies? Is telepsychotherapy effective? Finally, we introduce the psychotherapy for special populations.",31784967,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.24916934967041,-2.092165946960449,AxB9
"Cost-effectiveness of Cognitive Behavioral Therapy for Depressed Youth Declining Antidepressants.

Adolescents with depression identified in primary care settings often have limited treatment options beyond antidepressant (AD) therapy. We assessed the cost-effectiveness of a brief cognitive behavioral therapy (CBT) program among depressed adolescents who declined or quickly stopped using ADs. A total of 212 youth with depression were randomly assigned to treatment as usual (TAU) or TAU plus brief individual CBT. Clinical outcomes included depression-free days (DFDs) and estimated quality-adjusted life-years (QALYs). Costs were adjusted to 2008 US dollars. Incremental cost-effectiveness ratios (ICERs) comparing CBT to TAU were calculated over 12- and 24-month follow-up periods. Youth randomly assigned to CBT had 26.8 more DFDs (P = .044) and 0.067 more QALYs (P = .044) on average compared with TAU over 12 months. Total costs were $4976 less (P = .025) by the end of the 24-month follow-up among youth randomly assigned to CBT. Total costs per DFD were -$51 (ICER = -$51; 95% confidence interval [CI]: -$394 to $9) at 12 months and -$115 (ICER = -$115; 95% CI: -$1090 to -$6) at 24 months. Total costs per QALY were -$20282 (ICER = -$20282; 95% CI: -$156741 to $3617) at 12 months and -$45792 (ICER = -$45792; 95% CI: -$440991 to -$2731) at 24 months. Brief primary care CBT among youth declining AD therapy is cost-effective by widely accepted standards in depression treatment. CBT becomes dominant over TAU over time, as revealed by a statistically significant cost offset at the end of the 2-year follow-up.",29351965,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,10.714466094970703,-2.923130989074707,BRQo
"Pilot of the brief behavioral activation treatment for depression in latinos with limited english proficiency: preliminary evaluation of efficacy and acceptability.

Latinos with limited English proficiency (LEP) experience multiple barriers to accessing efficacious mental health treatments. Using a stage model of behavior therapy research, this Stage I investigation evaluated the Brief Behavioral Activation Treatment for Depression (BATD), an intervention that may be well equipped to address existing treatment barriers. A sample of 10 Latinos with LEP and depressive symptomatology participated in a 10-session, direct (i.e., literal) Spanish-language translation of BATD, with no other cultural modifications. Participants were assessed at each session for depressive symptomatology and for the proposed BATD mechanisms: activity engagement and environmental reward. One month after treatment, participants were reassessed and interviewed to elicit feedback about BATD. Hierarchical linear model analyses were used to measure BATD outcomes. Results showed depressive symptomatology decreased (p<.001), while both activation (p=.04) and environmental reward (p=.02) increased over the course of BATD. Increases in activation corresponded concurrently with decreases in depression (p=.01), while environmental reward preceded decreases in depressive symptomatology (all p's ≤ .04). Follow-up analyses revealed sustained clinical gains in depression and activation, and an increase in environmental reward at follow-up. Participant interviews conducted 1 month after treatment conclusion indicated that BATD is an acceptable treatment for our sample of interest. Despite the limitations inherent in a study restricted to a sample of 10, preliminary outcomes of this Stage I research suggest that members of this otherwise underserved group showed improvements in depressive symptomatology and are willing to participate in and adhere to BATD. The study's positive outcomes suggest that a Stage II randomized clinical trial is a logical next step.",24411118,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.302943229675293,-4.341303825378418,CTpU
"The efficacy of psychoeducation on recurrent depression: a randomized trial with a 2-year follow-up.

The efficacy of psychoeducation is well documented in the treatment of relapse prevention of schizophrenia, and recently also in bipolar disorder; however, for recurrent depression only few controlled studies focusing on the efficacy of psychoeducation have been conducted. This randomized study tests the efficacy of treatment-as-usual supplemented with a psychoeducative programme for patients with recurrent depression, treated at Community Mental Health Centres (CMHC) in Denmark. The primary outcome measurements concern was decline in consumption of psychiatric inpatient services and decline in Beck's Depression Inventory (BDI). Eighty patients were randomized, either to the psychoeducative programme (consisting of eight sessions, each of 2hours duration) and 2-year outpatient follow-up (42 cases), or only to 2-year outpatient follow-up (38 controls). The patients were monitored during 2 years after randomization. Data were collected from interviews including BDI, drug treatment and social measurements, and register data concerning use of psychiatric services. At 2-year follow-up, a significant reduction in the consumption of psychiatric inpatient services and in BDI was found; however, it was uniform for case and control patients. Drop-out/non-compliance was significantly more frequent among patients randomized to the control group. Furthermore, during follow-up the case group got a significant stronger attachment to the Labour market than the control group. The primary hypothesis could not be confirmed. Secondary outcome measurements concerning drop-out/non-compliance and attachment to the Labour market were significantly in favour of cases.",27997274,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,10.572563171386719,-2.6146302223205566,BjJi
"Benchmarking of cognitive-behavioral therapy for depression in efficacy and effectiveness studies--how do exclusion criteria affect treatment outcome?

Little is known about how exclusion criteria applied in randomized controlled trials (RCTs) affect the transfer of psychotherapy outcome research to naturalistic settings. This study evaluated the effects of naturalistic depression therapies and benchmarked them with published RCTs. Commonly used exclusion criteria were applied to n=338 depressive patients receiving cognitive-behavioral therapy. Outcomes of the resulting subsample eligible for RCTs were compared to those reported in RCTs. Treatment outcomes of the total sample (d=1.16) and the subsample eligible for RCTs (d=1.15) were highly similar. Therapy outcome was worse than in high-quality RCTs (d=1.39). No systematic bias was demonstrated due to patient selection criteria that are typically applied in RCTs. The comparability of psychotherapies conducted in RCTs and in real-world settings might be underestimated. Conclusions concerning the improvement of therapies in naturalistic settings are discussed.",21793689,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,10.77402114868164,-2.257213592529297,C5X4
"Effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depression: a systematic review (METACHRON).

Chronic depressions represent a substantial part of depressive disorders and are associated with severe consequences. Several studies were performed addressing the effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depressions. Yet, a systematic review comparing the effectiveness of multiple treatment options and considering all subtypes of chronic depressions is still missing. Aim of this project is to summarize empirical evidence on efficacy and effectiveness of treatments for chronic depression by means of a systematic review. The primary objectives of the study are to examine, which interventions are effective; to examine, if any differences in effectiveness between active treatment options exist; and to find possible treatment effect modifiers. Psychotherapeutic, pharmacological, and combined treatments will be considered as experimental interventions and no treatment, wait-list, psychological/pharmacological placebo, treatment as usual, and other active treatments will be seen as comparators. The population of patients will include adults with chronic major depression, dysthymia, double depression, or recurrent depression without complete remission between episodes. Outcomes of the analyses are depressive symptoms, associated consequences, adverse events, and study discontinuation. Only randomized controlled trials will be considered. Given the high prevalence and serious consequences of chronic depression and a considerable amount of existing primary studies addressing the effectiveness of different treatments the present systematic review may be of high relevance. Special attention will be given to the use of current methodological standards. Findings are likely to provide crucial information that may help clinicians to choose the appropriate treatment for chronically depressed patients.",21092304,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.887980461120605,-1.680692434310913,DDKE
"Telephone cognitive-behavioral therapy for subthreshold depression and presenteeism in workplace: a randomized controlled trial.

Subthreshold depression is highly prevalent in the general population and causes great loss to society especially in the form of reduced productivity while at work (presenteeism). We developed a highly-structured manualized eight-session cognitive-behavioral program with a focus on subthreshold depression in the workplace and to be administered via telephone by trained psychotherapists (tCBT). We conducted a parallel-group, non-blinded randomized controlled trial of tCBT in addition to the pre-existing Employee Assistance Program (EAP) versus EAP alone among workers with subthreshold depression at a large manufacturing company in Japan. The primary outcomes were depression severity as measured with Beck Depression Inventory-II (BDI-II) and presenteeism as measured with World Health Organization Health and Work Productivity Questionnaire (HPQ). In the course of the trial the follow-up period was shortened in order to increase acceptability of the study. The planned sample size was 108 per arm but the trial was stopped early due to low accrual. Altogether 118 subjects were randomized to tCBT+EAP (n = 58) and to EAP alone (n = 60). The BDI-II scores fell from the mean of 17.3 at baseline to 11.0 in the intervention group and to 15.7 in the control group after 4 months (p<0.001, Effect size = 0.69, 95%CI: 0.32 to 1.05). However, there was no statistically significant decrease in absolute and relative presenteeism (p = 0.44, ES = 0.15, -0.21 to 0.52, and p = 0.50, ES = 0.02, -0.34 to 0.39, respectively). Remote CBT, including tCBT, may provide easy access to quality-assured effective psychotherapy for people in the work force who present with subthreshold depression. Further studies are needed to evaluate the effectiveness of this approach in longer terms. The study was funded by Sekisui Chemicals Co. Ltd. ClinicalTrials.gov NCT00885014.",22532849,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.329289436340332,-2.8296172618865967,CuTH
"Sampling bias in an internet treatment trial for depression.

Internet psychological interventions are efficacious and may reduce traditional access barriers. No studies have evaluated whether any sampling bias exists in these trials that may limit the translation of the results of these trials into real-world application. We identified 7999 potentially eligible trial participants from a community-based health cohort study and invited them to participate in a randomized controlled trial of an online cognitive behavioural therapy programme for people with depression. We compared those who consented to being assessed for trial inclusion with nonconsenters on demographic, clinical and behavioural indicators captured in the health study. Any potentially biasing factors were then assessed for their association with depression outcome among trial participants to evaluate the existence of sampling bias. Of the 35 health survey variables explored, only 4 were independently associated with higher likelihood of consenting-female sex (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.05-1.19), speaking English at home (OR 1.48, 95% CI 1.15-1.90) higher education (OR 1.67, 95% CI 1.46-1.92) and a prior diagnosis of depression (OR 1.37, 95% CI 1.22-1.55). The multivariate model accounted for limited variance (C-statistic 0.6) in explaining participation. These four factors were not significantly associated with either the primary trial outcome measure or any differential impact by intervention arm. This demonstrates that, among eligible trial participants, few factors were associated with the consent to participate. There was no indication that such self-selection biased the trial results or would limit the generalizability and translation into a public or clinical setting.",23092978,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.308650970458984,-3.400423288345337,Cmm2
"Effects of clay art therapy on adults outpatients with major depressive disorder: A randomized controlled trial.

Depression has become a critical global health problem, affecting millions of people. Cost-effective nonpharmacological treatment in community settings has been proposed to complement medical treatment. Short-term clay art therapy (CAT) is an alternative treatment that promotes the enhancement of various aspects of mental health for depressed individuals. One-hundred and six adults with depression were randomized into a CAT group or visual art (VA) control group for six 2.5-h weekly sessions. Intervention effects were measured using the Beck Depression Inventory, 12-Item General Health Questionnaire (Chinese version), Body-Mind-Spirit Well-Being Inventory, and 20-Item Toronto Alexithymia Scale (Chinese version) at baseline, immediately postintervention (T1), and 3-weeks postintervention (T2). Multivariate analysis of covariance results indicated a more significant time × group effect for CAT than for VA on depressive signs, general health, and body-mind-spirit well-being (all p<0.05). Significant within-groups changes were observed in these three aspects after treatment and at T2 (all p<0.001) and in alexithymia at T2 (p<0.01) in the CAT group, but the change was nonsignificant in the VA group at T1 and T2. The homogeneity of the participants affected the generalizability of the study findings. The short-term postintervention follow-up (3 weeks) presented difficulties in demonstrating the long-term effects of CAT. CAT can aid emotion regulation and benefit various aspects of mental health in adults. The short duration of the intervention suggests additional application value in treating depression. Further investigation is warranted regarding the potential effect of CAT on alleviating physical symptoms and improving social function.",28433887,Major Depressive Disorder,Anxiety Treatment,Mental Health,23662,10.464994430541992,-4.946008205413818,BdmK
"Pilot randomized controlled trial of a Spanish-language Behavioral Activation mobile app (¡Aptívate!) for the treatment of depressive symptoms among united states Latinx adults with limited English proficiency.

To address the need for disseminable, evidence-based depression treatment options for Latinx adults with limited English proficiency (LEP), our team developed ¡Aptívate!, a Spanish-language Behavioral Activation self-help mobile application. Primary aims of this study were to: 1) examine feasibility and uptake of ¡Aptívate! among depressed Latinx adults with LEP and 2) preliminarily examine ¡Aptívate! efficacy for depression treatment. Participants (N = 42) with elevated depressive symptoms were randomized 2:1:1 to: 1) ¡Aptívate! (n = 22), 2) an active control Spanish-language app (""iCouch CBT""; n = 9), or 3) Treatment As Usual (i.e., no app; n = 11). Feasibility was assessed via self-reported app utilization and app analytics data. Depressive symptoms were assessed weekly for eight weeks via self report. All ¡Aptívate! participants used the app at least once, 81.8% of participants used the app ≥8 times, and 36.4% of participants used the app ≥56 times. Weekly retention was strong: 72.7% and 50% of participants continued to use the app at one- and two-months post-enrollment, respectively. Generalized Estimating Equation models indicated a significant interaction between time and treatment, such that ¡Aptívate! participants reported significantly lower depressive symptoms over time than TAU. Depressive symptoms did not differ on average across time between the iCouch and TAU conditions, nor between iCouch and ¡Aptívate!. Limitations include small sample size, limited follow-up, and lack of analytics data for the active control condition. With further research, ¡Aptívate! may offer a feasible, efficacious approach to extend the reach of evidence-based depression treatment for Latinx adults with LEP.",30870770,Major Depressive Disorder,Anxiety Treatment,Mental Health,1427,7.618046283721924,-5.677972793579102,A9cH
"Use of a Fully Automated Internet-Based Cognitive Behavior Therapy Intervention in a Community Population of Adults With Depression Symptoms: Randomized Controlled Trial.

Although internet-based cognitive behavior therapy (iCBT) interventions can reduce depression symptoms, large differences in their effectiveness exist. The aim of this study was to evaluate the effectiveness of an iCBT intervention called Thrive, which was designed to enhance engagement when delivered as a fully automated, stand-alone intervention to a rural community population of adults with depression symptoms. Using no diagnostic or treatment exclusions, 343 adults with depression symptoms were recruited from communities using an open-access website and randomized 1:1 to the Thrive intervention group or the control group. Using self-reports, participants were evaluated at baseline and 4 and 8 weeks for the primary outcome of depression symptom severity and secondary outcome measures of anxiety symptoms, work and social adjustment, psychological resilience, and suicidal ideation. Over the 8-week follow-up period, the intervention group (n=181) had significantly lower depression symptom severity than the control group (n=162; P<.001), with a moderate treatment effect size (d=0.63). Moderate to near-moderate effect sizes favoring the intervention group were observed for anxiety symptoms (P<.001; d=0.47), work/social functioning (P<.001; d=0.39), and resilience (P<.001; d=0.55). Although not significant, the intervention group was 45% less likely than the control group to experience increased suicidal ideation (odds ratio 0.55). These findings suggest that the Thrive intervention was effective in reducing depression and anxiety symptom severity and improving functioning and resilience among a mostly rural community population of US adults. The effect sizes associated with Thrive were generally larger than those of other iCBT interventions delivered as a fully automated, stand-alone intervention. ClinicalTrials.gov NCT03244878; https://clinicaltrials.gov/ct2/show/NCT03244878.",31738173,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.681085586547852,-2.7374536991119385,AxsV
"Psychotherapy for subclinical depression: meta-analysis.

There is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder. To examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression. We conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group. The target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23-0.47; NNT = 5, 95% CI 4-8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment. Psychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.",25274315,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.541398048400879,-2.3860745429992676,CHk1
"The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial.

The efficacy of psychodynamic therapies for depression remains open to debate because of a paucity of high-quality studies. The authors compared the efficacy of psychodynamic therapy with that of cognitive-behavioral therapy (CBT), hypothesizing nonsignificant differences and the noninferiority of psychodynamic therapy relative to CBT. A total of 341 adults who met DSM-IV criteria for a major depressive episode and had Hamilton Depression Rating Scale (HAM-D) scores ≥14 were randomly assigned to 16 sessions of individual manualized CBT or short-term psychodynamic supportive therapy. Severely depressed patients (HAM-D score >24) also received antidepressant medication according to protocol. The primary outcome measure was posttreatment remission rate (HAM-D score ≤7). Secondary outcome measures included mean posttreatment HAM-D score and patient-rated depression score and 1-year follow-up outcomes. Data were analyzed with generalized estimating equations and mixed-model analyses using intent-to-treat samples. Noninferiority margins were prespecified as an odds ratio of 0.49 for remission rates and a Cohen's d value of 0.30 for continuous outcome measures. No statistically significant treatment differences were found for any of the outcome measures. The average posttreatment remission rate was 22.7%. Noninferiority was shown for posttreatment HAM-D and patient-rated depression scores but could not be demonstrated for posttreatment remission rates or any of the follow-up measures. The findings extend the evidence base of psychodynamic therapy for depression but also indicate that time-limited treatment is insufficient for a substantial number of patients encountered in psychiatric outpatient clinics.",24030613,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.26877498626709,-2.9059693813323975,CYyZ
"Patient characteristics and the therapist as predictors of depressed patients' outcome expectation over time: A multilevel analysis.

Objective: Although there is an established link between patients' early positive outcome expectation for and their actual improvement from therapy, there is little research on patients' change in outcome expectation across therapy and both patient and therapist correlates of early outcome expectation level and change. The present study examined: (i) the overall trajectory of change in patients' outcome expectation through cognitive-behavioral therapy (CBT) for depression; (ii) patient characteristics as predictors of both initial outcome expectation and change in outcome expectation; and (iii) between-therapist effects in outcome expectation change. Method: Depressed patients (N=143) received a brief course of CBT. Outcome expectation was measured at screening, pretreatment, session 7, and session 14. Results: Outcome expectation linearly increased from screening to session 14. When controlling for other patient characteristics at intake, having previous depressive episodes was negatively associated with initial outcome expectation and higher well-being was positively associated with initial outcome expectation. When controlling for early alliance and early symptom change, outcome expectation change was predicted by previous depressive episodes. Finally, therapist effects emerged in outcome expectation over time. Conclusions: Various depressed patients' characteristics predict initial outcome expectation level and change, with significant between-therapists' differences related to outcome expectation change.",29368580,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.738031387329102,-3.3475019931793213,BRCN
"Expectancy Effects in Self-Help Depression Treatment: First Evidence that the Rationale Given for an Online Study Impacts the Outcome.

Positive expectations play an important role in effective treatments for major depressive disorder (MDD). The way a study is contextualized modulates prognostic expectations. The aim of the study was to test the effect of differing information regarding the rationale given to participants for a study on depression symptoms. Sixty-nine participants with depression symptoms participated in an online study with two conditions. In random order, half were invited to participate in a treatment study and half in a cognition study. After completing the baseline assessment, participants received one of two self-help manuals. Post-assessment was conducted six weeks later. Only about 64% of the participants were reached for post-assessment, and adherence was low. However, our results offer the first evidence that stronger improvements emerged in participants who were told the trial was a treatment study compared with a cognition study. Information given about the rationale for a study could influence symptom reduction in online treatments for patients with MDD. Future (online) studies should attempt to replicate these results.",29081332,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.221994400024414,-2.9485862255096436,BU8g
"Psychotherapy, antidepressants, and their combination for chronic major depressive disorder: a systematic review.

Recommendations for treatment of chronic major depressive disorder (cMDD) are mostly based on clinical experiences and on the literature on treatment-resistant depression (TRD) but not on a systematic review of the literature. We conducted a systematic review of 10 randomized controlled trials (RCTs), with 17 comparisons between antidepressants (ADs), psychotherapy, or the combination of both interventions. The best evidence is for the combination of psychotherapy and ADs, and especially for the combination of the cognitive behavourial analysis system of psychotherapy and ADs. Evidence is very weak for both ADs alone and psychotherapy alone. Assessment of TRD was mostly absent in the studies. The best treatment for cMDD is a combination of psychotherapy and ADs. However, there is a lack of well-performed RCTs in both ADs and psychotherapy and their combination for cMDD. Therefore, the conclusions are preliminary.",23870720,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.937490463256836,-0.7189100980758667,CbIw
"Behavioral activation therapy for remediating persistent social deficits in medication-responsive chronic depression.

The purpose of this article is to explore the use of behavioral activation therapy in patients with medication-responsive chronic depression who continue to experience social and occupational deficits. The classification of chronic depression includes a variety of disorders that are both common and debilitating and that frequently leave patients socially impaired even after remission of mood symptoms. Medication is often only partially effective in remedying these social impairments. As a result, other interventions, including forms of psychotherapy, may be justified as an adjunct to medication to improve residual social impairment. Behavioral activation therapy is one such treatment that may be especially appropriate for such individuals. The authors offer a brief description of behavioral activation therapy and examine how to adapt this therapy for use in patients with medication-responsive chronic depression. Preliminary evidence suggests that the therapy can be easily implemented with few modifications to improve social and occupational difficulties.",21586994,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.433477401733398,-2.232395648956299,C8Hq
"Internet-delivered treatment for young adults with anxiety and depression: Evaluation in routine clinical care and comparison with research trial outcomes.

Mood and anxiety disorders typically emerge in adolescence and early adult life, but young adults are often reluctant to seek treatment. The Mood Mechanic course is a transdiagnostic internet-delivered psychological intervention for symptoms of depression and anxiety, targeted at people aged 18-24 years. The current study compared the efficacy of the course when delivered under strict research trial conditions (research trial; n = 192) with its effectiveness in a routine health-care setting (routine care; n = 222). Symptoms of depression, anxiety and general distress at baseline, during, and after treatment were measured by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and Kessler 10-Item Scale (K-10), respectively. Both groups showed significant symptom reductions on all measures at post-treatment and 3-month follow-up. Deterioration rates were low, within-group effect sizes were large (>1.0) and both groups reported high levels of treatment satisfaction. Patients in routine care were less likely to complete post-treatment or follow-up symptom questionnaires. The study is based on self-reported data from treatment-seeking individuals that were motivated enough to start the course, and the absence of a control group and a formal diagnosis in the routine care sample means that some caution is needed in generalising the results. The results show that the Mood Mechanic course is effective and acceptable in routine clinical care, and that online psychological interventions designed for young adults are an effective treatment option for this hard-to-reach group.",31170620,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.255080223083496,-3.5208282470703125,A5W3
"Psychopharmacology Algorithms for Major Depressive Disorder: Current Status.

Major depressive disorder (MDD) is one of the leading causes of disability worldwide, and a considerable portion of depressed patients does not respond well to available treatment strategies. Algorithm-based treatment may contribute to improving the MDD outcomes and have the potential to homogenize the pharmacological treatment of MDD patients, facilitating outcome research and cost-effectiveness analysis. This chapter provides a critical review of the available literature on the use of treatment algorithms for the management of MDD. The main available algorithms, their effectiveness, and challenges and limitations associated with their development are discussed. Finally, we provide a discussion of the future direction of algorithm-based treatments for MDD.",33834411,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.323101043701172,-0.9573020339012146,AYE2
"Morita Therapy for depression (Morita Trial): a pilot randomised controlled trial.

To address uncertainties prior to conducting a fully powered randomised controlled trial of Morita Therapy plus treatment as usual (TAU) versus TAU alone, or to determine that such a trial is not appropriate and/or feasible. Pilot parallel group randomised controlled feasibility trial. Participants aged ≥18 years with Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV major depressive disorder, with or without DSM-IV anxiety disorder(s), recruited from general practice record searches in Devon, UK. We randomised participants on a 1:1 basis stratified by symptom severity, concealing allocation using a secure independent web-based system, to receive TAU (control) or 8-12 sessions of Morita Therapy, a Japanese psychological therapy, plus TAU (intervention). Rates of recruitment, retention and treatment adherence; variance and estimated between-group differences in follow-up scores (on the Patient Health Questionnaire 9 (PHQ-9) (depressive symptoms); Generalised Anxiety Disorder Questionnaire 7 (anxiety symptoms); Short Form 36 Health Survey Questionnaire/Work and Social Adjustment Scale (quality of life); Morita Attitudinal Scale for Arugamama (attitudes)) and their correlation with baseline scores. We recruited 68 participants, 5.1% (95% CI 3.4% to 6.6%) of those invited (34 control; 34 intervention); 64/68 (94%; 95% CI 88.3% to 99.7%) provided 4-month follow-up data. Participants had a mean age of 49 years and mean PHQ-9 score of 16.8; 61% were female. Twenty-four of 34 (70.6%) adhered to the minimum treatment dose. The follow-up PHQ-9 (future primary outcome measure) pooled SD was 6.4 (95% CI 5.5 to 7.8); the magnitude of correlation between baseline and follow-up PHQ-9 scores was 0.42 (95% CI 0.19 to 0.61). Of the participants, 66.7% and 30.0% recovered in the intervention and control groups, respectively; 66.7% and 13.3% responded to treatment in the intervention and control groups, respectively. A large-scale trial of Morita Therapy would require 133 participants per group and is feasible with minor modifications to the pilot trial protocol. Morita Therapy shows promise in treating depression and may provide patients with a distinct alternative to current treatments. ISRCTN17544090; Pre-results.",30099395,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,11.07874584197998,-2.3887884616851807,BHrz
"Nonpharmacological interventions for relapse prevention in unipolar depression: A network meta-analysis.

The development of prophylactic interventions for major depressive disorder (MDD) is an important issue in clinical practice. We aimed to compare the relative efficacy of nonpharmacological interventions for relapse prevention in adult patients with MDD. Randomized controlled trials investigating nonpharmachological interventions for relapse prevention were included. A Bayesian network meta-analysis was performed. Hazard ratios are reported as effect sizes with 95% credible intervals. Global inconsistency, local inconsistency, heterogeneity, and transitivity were evaluated. Confidence for the results comparing the active treatment with control conditions or antidepressant medicine (ADM) was assessed. Thirty-six trials were included. Most nonpharmacological interventions were various forms of psychotherapy; others were noninvasive neurostimulation techniques (3 studies with electroconvulsive therapy and 1 study with transcranial magnetic stimulation). Psychotherapy as a monotherapy following ADM or psychotherapy produced significantly better outcomes than control conditions, and there was no significant difference between psychotherapy and ADM. The combination of psychotherapy and ADM was superior to either treatment alone. The results were similar for patients with at least 3 previous episodes. Neurostimulation techniques were also superior to controls, either as a monotherapy or combined with ADM. Our study provided evidence that psychotherapy as a monotherapy following ADM or psychotherapy was effective and performed as well as ADM for relapse prevention. Neurostimulation techniques also showed promising results but more studies are needed to confirm their efficacy. These findings may be informative for clinical practice and inspire future research.",33601704,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.968198776245117,-0.6849765181541443,Aaoo
"Wait-there's evidence for that? Integrative medicine treatments for major depressive disorder.

Depression is one of the most common mental health disorders and currently affects over 17 million Americans. Up to two-thirds of patients with depression in the United States will seek complementary and alternative or integrative medical treatments and thus medical providers who treat depression should understand that many integrative medical treatments have evidence of efficacy either as monotherapies or as add-on adjuncts to other treatments. This review references guidelines from the Canadian Network for Mood and Anxiety Treatments and Michigan Medicine, along with an updated literature review, to provide a framework for reviewing medications or herbal formulation, as well as other therapies, which have evidence in the treatment of depression. In general, St. John's Wort, Omega-3 Fatty Acids, S-adenosyl-L-methionine, and crocus sativus (saffron) have the highest levels of evidence in the treatment of mild-to-moderate depression. Acetyl-l-carnitine, l-methylfolate, DHEA, and lavender have a moderate level of evidence in treating depression, whereas Vitamin D, one of the most common supplements in the United States, does not have evidence in treating depression. Of the non-medication-based therapies, exercise, light therapy, yoga, acupuncture, and probiotics have evidence in the treatment of depression, whereas a full review of dietary modifications for depression was out of scope for this article.",34521233,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,8.725029945373535,-0.8581100106239319,AQZl
"Managing major depressive disorder through the use of adjunct therapies.

Although many treatments for Major Depressive Disorder (MDD) exist, only half of all patients respond to initial trial of pharmacotherapy and only a third will achieve remission with that trial. First-line therapies for the management of MDD include psychotherapy or pharmacotherapy, alone or in combination. Given the disappointing rates of response and remission to initial therapy, clinicians are looking for methods to improve the management of MDD, such as through the use of adjunct therapies. The first article in this series, by Katzman and Chokka, discusses gaps in the treatment of MDD and proposes measures to change and strengthen future practice guidelines. Epstein et al. summarize the findings of clinical studies, systematic analyses, and reviews of trials supporting the use of adjunct therapy for the treatment of MDD. Velehorschi et al. review emerging research identifying common pathophysiological processes between MDD and three of its comorbidities. Lastly, Cameron and Habert highlight the challenges that primary care physicians face in the management of MDD. Ultimately, the goal of treatment is to not only relieve symptoms of MDD, but achieve sustained remission. This supplement was written to address the issues of less than ideal outcomes and approaches to enhancing response and remission rates.",25539870,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.113870620727539,-0.7949408292770386,CD5f
"Joy Journal: A Behavioral Activation Technique Used in the Treatment of Late-Life Depression Associated With Hopelessness During the COVID-19 Pandemic.

",33411995,Major Depressive Disorder,Anxiety Treatment,Mental Health,3961,9.928274154663086,-2.0289855003356934,Ac24
"Effectiveness of psychological interventions in preventing recurrence of depressive disorder: meta-analysis and meta-regression.

Major depression is probably best seen as a chronically recurrent disorder, with patients experiencing another depressive episode after remission. Therefore, attention to reduce the risk of relapse or recurrence after remission is warranted. The aim of this review is to meta-analytically examine the effectiveness of psychological interventions to reduce relapse or recurrence rates of depressive disorder. We systematically reviewed the pertinent trial literature until May 2014. The random-effects model was used to compute the pooled relative risk of relapse or recurrence (RR). A distinction was made between two comparator conditions: (1) treatment-as-usual and (2) the use of antidepressants. Other sources of heterogeneity in the data were explored using meta-regression. Twenty-five randomised trials met inclusion criteria. Preventive psychological interventions were significantly better than treatment-as-usual in reducing the risk of relapse or recurrence (RR=0.64, 95% CI=0.53-0.76, z=4.89, p<0.001, NNT=5) and also more successful than antidepressants (RR=0.83, 95% CI=0.70-0.97, z=2.40, p=0.017, NNT=13). Meta-regression showed homogeneity in effect size across a range of study, population and intervention characteristics, but the preventive effect of psychological intervention was usually better when the prevention was preceded by treatment in the acute phase (b=-1.94, SEb=0.68, z=-2.84, p=0.005). Differences between the primary studies in methodological design, composition of the patient groups and type of intervention may have caused heterogeneity in the data, but could not be evaluated in a meta-regression owing to poor reporting. We conclude that there is supporting evidence that preventive psychological interventions reduce the risk of relapse or recurrence in major depression.",25553400,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.127697944641113,-0.9704341292381287,CDt2
"Lifestyle medicine for depression.

The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. ""Lifestyle Medicine"" provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts.",24721040,Major Depressive Disorder,Anxiety Treatment,Mental Health,20599,8.877470970153809,-1.2341532707214355,CPfa
"The connecting adolescents to reduce relapse (CARR) trial: study protocol for a randomized controlled trial comparing the efficacy of Groups 4 Health and cognitive behaviour therapy in young people.

Depression is the leading cause of disability in young people (aged 15-25) globally. Loneliness is a major factor in the development and relapse of depression in young people, yet few interventions directly address loneliness. Groups 4 Health (G4H) - a novel, theoretically derived group psychotherapy intervention - may address this disconnect. Previous trials (Phase I and Phase II) have found G4H to be efficacious in reducing symptoms of depression. However, the efficacy of G4H compared to current evidence-based treatments (Phase III) has not been investigated. This protocol details the design and methodology of the Connecting Adolescents to Reduce Relapse (CARR) trial, a randomised control trial assessing the efficacy of G4H in young people relative to cognitive behavioural therapy (CBT). The CARR trial is a two-arm non-inferiority randomised controlled trial that will compare the efficacy of G4H to the most widely used evidence-based treatment for depression, CBT, at program completion and 6- and 12-month follow up. Participants will be 200 young people (aged 15-25) with symptoms of depression and/or loneliness recruited from community and university mental health services. We hypothesise that the interventions will be comparable in reducing depression symptoms, but that G4H will be superior in reducing loneliness. Because loneliness is a primary risk factor for depression relapse in young people, we therefore expect the benefits of Groups 4 Health to be particularly apparent at 12-month follow up. This trial will be the first to evaluate an intervention that targets loneliness, in comparison to the current gold standard treatment approach - CBT. If found to be effective, this program offers a new approach to treatment and relapse prevention of depression among young people. Trial prospectively registered on ANZCTR ( ACTRN12618000440224 ), registered on 27/03/2018.",31221143,Major Depressive Disorder,Anxiety Treatment,Mental Health,21526,10.8446044921875,-3.1595377922058105,A4rj
"[Low-Intensity Interventions to Reduce Depressive Symptoms before Outpatient Psychotherapy - A Systematic Literature Review].

Psychotherapeutic resources are limited, leading to prolonged waiting periods prior to outpatient psychotherapy. Low-intensity interventions have the potential to bridge such treatment gaps. This systematic review aims to identify interventions targeting depressive symptoms implemented prior to outpatient psychotherapy, and to assess their effectiveness and acceptance. 22 studies were identified. Interventions were classified as active waiting, self-help, guided self-help, brief single-strand interventions, and low-intensity psychotherapy. Evidence of intervention effectiveness is limited; intervention acceptance varies between interventions. The resulting classification illustrates a range of innovative interventions which can be implemented into routine care depending on existing resources and preferences. Different models for the provision of low-intensity interventions are discussed.",30045413,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.473397254943848,-3.302067756652832,BIdq
"Blended care in the treatment of subthreshold symptoms of depression and psychosis in emerging adults: A randomised controlled trial of Acceptance and Commitment Therapy in Daily-Life (ACT-DL).

In this study, the feasibility and efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL), ACT augmented with a daily life application, was investigated in 55 emerging adults (age 16 to 25) with subthreshold depressive and/or psychotic complaints. Participants were randomized to ACT-DL (n = 27) or to active control (n = 28), with assessments completed at pre- and post-measurement and 6- and 12-months follow-up. It took up to five (ACT-DL) and 11 (control) months to start group-based interventions. Participants attended on average 4.32 out of 5 ACT-DL sessions. On the app, they filled in on average 69 (48%) of signal-contingent beep-questionnaires, agreed to 15 (41%) of offered beep-exercises, initiated 19 on-demand exercises, and rated ACT-DL metaphors moderately useful. Relative to active control, interviewer-rated depression scores decreased significantly in ACT-DL participants (p = .027). Decreases in self-reported depression, psychotic-related distress, anxiety, and general psychopathology did not differ between conditions. ACT-DL participants reported increased mean NA (p = .011), relative to active controls. Mean PA did not change in either group, nor did psychological flexibility. ACT-DL is a feasible intervention, although adaptations in future research may improve delivery of and compliance with the intervention. There were mixed findings for its efficacy in reducing subthreshold psychopathology in emerging adults. Dutch Trial Register no.: NTR3808.",32146218,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,7.761112689971924,-1.6431251764297485,AsQ+
"Acceptance and Commitment Therapy for Major Depressive Disorder: Insights into a New Generation of Face-to-Face Treatment and Digital Self-Help Approaches.

Major depressive disorder (MDD) represents a key contributor to the global burden of mental illness given its relatively high lifetime prevalence, frequent comorbidity, and disability rates. Evidence-based treatment options for depression include pharmacotherapy and psychotherapy, such as cognitive behavioral therapy (CBT). Beyond traditional CBT, over 15 years ago, Hayes proclaimed a new generation of contextualistic and process-orientated so-called third wave of CBT interventions, including acceptance and commitment therapy (ACT). Using mindfulness and acceptance as well as commitment and behavior change processes, the transdiagnostic ACT approach aims to increase psychological flexibility as universal mechanism of behavior change and to build a value-driven orientation in life. ACT for MDD can be provided as either stand-alone individual, group, or self-help formats (e.g., apps) or combined with other approaches like behavioral activation. To date, a steadily growing empirical support from outcome and process research suggests the efficacy of ACT, which appears to work specifically through the six proposed core processes involved in psychological flexibility, such as defusion. In view of an ongoing interest of clinicians in ""third-wave"" CBTs and the important role of clients' preferences in providing therapy choices that work, the purpose of this chapter is to give a brief overview on the application of ACT in the treatment of MDD in adults.",33834407,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.304524421691895,-1.6322834491729736,AYE6
"Internet-based behavioral activation and acceptance-based treatment for depression: a randomized controlled trial.

Internet-based cognitive behavior therapy for depression has been tested in several trials but there are no internet studies on behavioral activation (BA), and no studies on BA over the internet including components of acceptance and commitment therapy (ACT). The aim of this study was to develop and test the effects of internet-delivered BA combined with ACT against a waiting list control condition as a first test of the effects of treatment. Selection took place with a computerized screening interview and a subsequent semi-structured telephone interview. A total of 80 individuals from the general public were randomized to one of two conditions. The treatment lasted for 8 weeks after which both groups were assessed. We also included a 3 month follow-up. The treatment included interactive elements online and a CD-ROM for mindfulness and acceptance exercises. In addition, written support and feedback was given by a therapist every week. Results at posttreatment showed a large between group effect size on the Beck Depression inventory II d=0.98 (95%CI=0.51-1.44). In the treated group 25% (10/40) reached remission defined as a BDI score ≤ 10 vs. 5% (2/40) in the control group. Results on secondary measures were smaller. While few dropped out from the study (N=2) at posttreatment, the average number of completed modules was M=5.1 out of the seven modules. The study only included a waiting-list comparison and it is not possible to determine which treatment components were the most effective. We conclude that there is initial evidence that BA with components of ACT can be effective in reducing symptoms of depression.",23357657,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.52230453491211,-2.5684006214141846,Citk
"Time to remission from mild to moderate depressive symptoms: One year results from the EVIDENT-study, an RCT of an internet intervention for depression.

Internet interventions are effective in treating depressive symptoms but few studies conducted a long-term follow-up. The aim of this study was to test the effectiveness of an internet intervention in increasing the remission rate over a twelve months period. A total of 1013 participants with mild to moderate depressive symptoms were randomized to either care as usual alone or a 12-week internet intervention (Deprexis) plus usual care. Self-rated depression severity (PHQ-9) was assessed regularly over twelve months. Remission rates over time were significantly higher in the intervention group (Cox regression: hazard ratio [HR] 1.31; p = 0.009). The intervention was more effective in the subgroup not taking antidepressant medication (Cox regression: HR 1.88; p < 0.001). PHQ-change from baseline was greater in the intervention group (linear mixed model [LMM]: p < 0.001) with the between-group effect gradually decreasing from d = 0.36 at three months to d = 0.13 at twelve months (LMM: group by time interaction: p < 0.001). This internet intervention can contribute to achieving remission in people with mild to moderate depressive symptoms, especially if they are not on antidepressant medication (Trial Registration: NCT01636752).",28797829,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.059966087341309,-2.8504698276519775,BYkO
"Refractory depression - mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms.

Individuals with depression often do not respond to medication or psychotherapy. Radically open dialectical behaviour therapy (RO DBT) is a new treatment targeting overcontrolled personality, common in refractory depression. To compare RO DBT plus treatment as usual (TAU) for refractory depression with TAU alone (trial registration: ISRCTN 85784627). RO DBT comprised 29 therapy sessions and 27 skills classes over 6 months. Our completed randomised trial evaluated RO DBT for refractory depression over 18 months in three British secondary care centres. Of 250 adult participants, we randomised 162 (65%) to RO DBT. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), assessed masked and analysed by treatment allocated. After 7 months, immediately following therapy, RO DBT had significantly reduced depressive symptoms by 5.40 points on the HRSD relative to TAU (95% CI 0.94-9.85). After 12 months (primary end-point), the difference of 2.15 points on the HRSD in favour of RO DBT was not significant (95% CI -2.28 to 6.59); nor was that of 1.69 points on the HRSD at 18 months (95% CI -2.84 to 6.22). Throughout RO DBT participants reported significantly better psychological flexibility and emotional coping than controls. However, they reported eight possible serious adverse reactions compared with none in the control group. The RO DBT group reported significantly lower HRSD scores than the control group after 7 months, but not thereafter. The imbalance in serious adverse reactions was probably because of the controls' limited opportunities to report these.",31317843,Major Depressive Disorder,Anxiety Treatment,Mental Health,22849,11.160679817199707,-1.8071690797805786,A3Yn
"Effectiveness of online interventions in preventing depression: a protocol for systematic review and meta-analysis of randomised controlled trials.

Although evidence exists for the efficacy of psychosocial interventions in preventing depression, little is known about its prevention through online interventions. The objective of this study is to conduct a systematic review and meta-analysis of randomised controlled trials assessing the effectiveness of online interventions in preventing depression in heterogeneous populations. We will conduct a systematic review and meta-analysis of randomised controlled trials that will be identified through searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Australia New Zealand Clinical Trials Register . We will also search the reference lists provided in relevant studies and reviews. Experts in the field will be contacted to obtain more references. Two independent reviewers will assess the eligibility criteria of all articles, extract data and determine their risk of bias (Cochrane Collaboration Tool). Baseline depression will be required to have been discarded through standardised interviews or validated self-reports with standard cut-off points. The outcomes will be the incidence of new cases of depression and/or the reduction of depressive symptoms as measured by validated instruments. Pooled standardised mean differences will be calculated using random-effect models. Heterogeneity and publication bias will be estimated. Predefined sensitivity and subgroup analyses will be performed. If heterogeneity is relevant, random-effect meta-regression will be performed. The results will be disseminated through peer-reviewed publication and will be presented at a professional conference. Ethical assessment is not required as we will search and assess existing sources of literature. CRD42014014804; Results.",30498036,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.021343231201172,-3.5721595287323,BCgd
"Effectiveness of a transdiagnostic individually tailored Internet-based and mobile-supported intervention for the indicated prevention of depression and anxiety (ICare Prevent) in Dutch college students: study protocol for a randomised controlled trial.

Depression and anxiety are common and co-morbid disorders that affect a significant proportion of students. Innovative prevention strategies targeting both conditions are needed to reduce their health burden and costs. ICare Prevent is such an innovative strategy and contains a transdiagnostic individually tailored Internet-based and mobile-supported intervention. It addresses common risk factors of depression and anxiety as part of a large EU-funded multi-country project* (ICare). Little is known about the clinical and cost-effectiveness of this type of intervention compared to care as usual (CAU) for college students. We hypothesize that ICare Prevent will be more (cost-)effective than CAU in the reduction of symptoms of depression and anxiety. A three-arm, parallel, randomized controlled superiority trial will be conducted comparing a guided and an unguided version of ICare Prevent with a control group receiving CAU. The trial will be open-label but outcome assessors will be blinded. A total of 252 college students (age≥16 years) with subclinical symptoms of depression defined as a score≥16 on the Center for Epidemiological Studies Depression Scale (CES-D), and/or anxiety, defined as a score≥5 on the Generalized Anxiety Disorder scale (GAD-7), will be included. Those meeting diagnostic criteria for a depressive or anxiety disorder will be excluded. The primary outcome is change in disorder specific symptom severity from baseline to post-intervention. Secondary endpoints include self-reported depression and anxiety symptoms as well as time to onset of a mood or anxiety disorder until 12-month follow-up. Societal costs and quality of life will be assessed to estimate the intervention's cost-effectiveness compared to CAU. Transdiagnostic individually tailored Internet-based prevention could be a (cost-)effective approach to tackle the disease burden of depression and anxiety among college students. Dutch trial register, NTR 6562 . Registered on 6 July 2017.",29458407,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.050105094909668,-3.0126357078552246,BP1s
"Study protocol: Hybrid Type I cost-effectiveness and implementation study of interpersonal psychotherapy (IPT) for men and women prisoners with major depression.

This article describes the protocol for a Hybrid Type I cost-effectiveness and implementation study of interpersonal psychotherapy (IPT) for men and women prisoners with major depressive disorder (MDD). The goal is to promote uptake of evidence-based treatments in criminal justice settings by conducting a randomized effectiveness study that collects implementation data, including a full cost-effectiveness analysis. More than 2.3 million people are incarcerated in the United States on any given day. MDD is the most common severe mental illness among incarcerated individuals. Despite the prevalence and consequences of MDD among incarcerated populations, this study will be the first fully-powered randomized trial of any treatment for MDD in an incarcerated population. Given the politically charged nature of the justice system, advantageous health outcomes are often not enough to get an intervention implemented in prisons. To increase the policy impact of this trial, we sought advice from prison providers and administrators about outcomes that would be persuasive to policy-makers and defensible to the public. In this trial, effectiveness questions will be answered using a randomized clinical trial design comparing IPT plus prison treatment as usual (TAU) to TAU alone, with outcomes including depressive symptoms (primary), suicidality, and in prison functioning (enrollment and completion of correctional programs; disciplinary and incident reports; aggression/victimization; social support). Implementation outcomes will include cost-effectiveness; feasibility and acceptability of IPT to clients, providers, and administrators; prison provider intervention fidelity, attitudes, and competencies; and barriers and facilitators of implementation assessed through surveys, interviews, and process notes.",26845030,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.71479320526123,-3.4157285690307617,Bxhk
"An idiographic analysis of change processes in the unified transdiagnostic treatment of depression.

Idiographic research methods can provide rich information regarding the process of change in specific treatments. Adopting an idiographic, exploratory approach, this study examined (a) temporal patterns of 3 transdiagnostic change constructs (mindfulness, cognitive reappraisal, and emotion avoidance), (b) the relationships between these constructs and depression and anxiety symptom severity over time, and (c) changes in these constructs in relation to the introduction of specific transdiagnostic intervention strategies in a single case. The case was a 64-year-old, White, female patient with principal major depressive disorder and secondary generalized anxiety disorder being treated with the Unified Protocol (UP). Univariate and multivariate time series analyses were applied to symptom and change construct data. (a) Clinically significant decreases in depression and anxiety from baseline to posttreatment were observed, as well as clinically significant increases in mindfulness and reappraisal; (b) changes in mindfulness were associated with changes in depression and anxiety, and changes in mindfulness temporally preceded changes in depression and anxiety; (c) changes in reappraisal were associated with changes in depression, and changes in reappraisal temporally preceded changes in depression; (d) the UP module designed to increase present-focused emotion awareness exerted the strongest influence on mindfulness ratings, although other modules had an impact; (e) reappraisal ratings were most strongly influenced by the emotion monitoring and functional analysis module, although subsequent modules continued to have a measureable impact. Although specific to this case, these results begin to elucidate important processes of change in transdiagnostic cognitive-behavioral therapy for principal depression with comorbid anxiety.",25045911,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,12.085407257080078,-3.035156726837158,CK+e
"Effectiveness of telephone-based aftercare case management for adult patients with unipolar depression compared to usual care: A randomized controlled trial.

Patients with depression often have limited access to outpatient psychotherapy following inpatient treatment. The objective of the study was to evaluate the long-term effectiveness of a telephone-based aftercare case management (ACM) intervention for patients with depression. We performed a prospective randomized controlled trial in four psychotherapeutic inpatient care units with N = 199 patients with major depression or dysthymia (F32.x, F33.x, F34.1, according to the ICD-10). The ACM consisted of six phone contacts at two-week intervals performed by trained and certified psychotherapists. The control group received usual care (UC). The primary outcome was depressive symptom severity (BDI-II) at 9-month follow-up, and secondary outcomes were health-related quality of life (SF-8, EQ-5D), self-efficacy (SWE), and the proportion of patients initiating outpatient psychotherapy. Mixed model analyses were conducted to compare improvements between treatment groups. Regarding the primary outcome of symptom severity, the groups did not significantly differ after 3 months (p = .132; ES = -0.23) or at the 9-month follow-up (p = .284; ES = -0.20). No significant differences in health-related quality of life or self-efficacy were found between groups. Patients receiving ACM were more likely to be in outpatient psychotherapy after 3 months (OR: 3.00[1.12-8.07]; p = .029) and 9 months (OR: 4.78 [1.55-14.74]; p = .006) than those receiving UC. Although telephone-based ACM did not significantly improve symptom severity, it seems to be a valuable approach for overcoming treatment barriers to the clinical pathways of patients with depression regarding their access to outpatient psychotherapy.",29077724,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,9.670731544494629,-3.434891939163208,BVAO
"Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression.

Pharmacotherapy and psychotherapy are generally effective treatments for major depressive disorder (MDD); however, research suggests that patient preferences may influence outcomes. We examined the effects of treatment preference on attrition, therapeutic alliance, and change in depressive severity in a longitudinal randomized clinical trial comparing pharmacotherapy and psychotherapy. Prior to randomization, 106 individuals with MDD reported whether they preferred psychotherapy, antidepressant medication, or had no preference. A mismatch between preferred and actual treatment was associated with greater likelihood of attrition, fewer expected visits attended, and a less positive working alliance at session 2. There was a significant indirect effect of preference match on depression outcomes, primarily via effects of attendance. These findings highlight the importance of addressing patient preferences, particularly in regard to patient engagement, in the treatment of MDD.",20462569,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.152856826782227,-2.4393138885498047,DKk5
"Reduced Contact Cognitive-Behavioral Interventions for Adult Depression: A Review.

Depression is a highly prevalent and debilitating mental health condition. Evidence suggests that there is a widening gap between the demand for and availability of effective treatments. As such, there is a vast need for the development and dissemination of accessible and affordable treatments for depression. In the past decade, there has been a proliferation of reduced client-therapist contact protocols for depression. In this article, the authors review and compare the efficacy of reduced contact cognitive-behavioral interventions for adult depression across two degrees of therapist-client contact (i.e., no therapist-client contact versus minimal therapist-client contact interventions). The authors also discuss the methodological and theoretical limitations of this research base. The present review suggests that a) reduced contact interventions for depression can be effective in remediating the symptoms of depression; b) the effect sizes of some reduced contact protocols may approximate those reported in traditional protocols involving significantly greater client-therapist contact; and c) protocols which employ some form of client-therapist contact, on average, generate higher effect sizes than those that are purely self-help in nature. A discussion of the theoretical and applied implications of such findings, as well as areas in need of further research, is provided.",26606161,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.546171188354492,-2.917846202850342,B0qv
"Sudden gains during psychological treatments of anxiety and depression: a meta-analysis.

The present study quantitatively reviewed the literature on sudden gains in psychological treatments for anxiety and depression. The authors examined the short- and long-term effects of sudden gains on treatment outcome as well as moderators of these effects. The authors conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. The meta-analysis was based on 16 studies and included 1,104 participants receiving psychological treatment for major depressive disorder or an anxiety disorder. Effect size estimates suggest that sudden gains had a moderate effect on primary outcome measures at posttreatment (Hedges's g = 0.62) and follow-up (Hedges's g = 0.56). These effect sizes were robust and unrelated to publication year or number of treatment sessions. The effect size of sudden gains in cognitive-behavioral therapy was higher (Hedges's g = 0.75) than in other treatments (Hedges's g = 0.23). These results suggest that sudden gains are associated with short-term and long-term improvements in depression and anxiety, especially in cognitive-behavioral therapy.",22122290,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.258864402770996,-2.9546031951904297,C0cj
"The long-term effects of bibliotherapy in depression treatment: Systematic review of randomized clinical trials.

Literature shows bibliotherapy can be helpful for moderate depression treatment. The aim of this systematic review is to verify the long-term effects of bibliotherapy. After bibliographic research, we included RCTs articles about bibliotherapy programme treatment of depression published in English language between 1990 and July 2017. All RCTs were assessed with Cochrane's Risk of Bias tool. Ten articles (reporting 8 studies involving 1347 subjects) out of 306 retrieved results were included. All studies analyze the effects of bibliotherapy after follow-up periods ranging from 3months to 3years and show quiet good quality in methods and analyses. The treatment was compared to standard treatments or no intervention in all studies. After long-term period follow-ups, six studies, including adults, reported a decrease of depressive symptoms, while four studies including young people did not show significant results. Bibliotherapy appears to be effective in the reduction of adults depressive symptoms in the long-term period, providing an affordable prompt treatment that could reduce further medications. The results of the present review suggest that bibliotherapy could play an important role in the treatment of a serious mental health issue. Further studies should be conducted to strengthen the evidence of bibliotherapy's efficacy.",28993103,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.770886421203613,-3.4169492721557617,BV3O
"Dropout from individual psychotherapy for major depression: A meta-analysis of randomized clinical trials.

Dropout from mental health treatment poses a substantial problem, but rates vary substantially across studies and diagnoses. Focused reviews are needed to provide more detailed estimates for specific areas of research. Randomized clinical trials involving individual psychotherapy for unipolar depression are ubiquitous and important, but empirical data on average dropout rates from these studies is lacking. We conducted a random-effects meta-analysis of 54 such studies (N=5852) including 80 psychotherapy conditions, and evaluated a number of predictors of treatment- and study-level dropout rates. Our overall weighted dropout estimates were 19.9% at the study level, and 17.5% for psychotherapy conditions specifically. Therapy orientation did not significantly account for variance in dropout estimates, but estimates were significantly higher in psychotherapy conditions with more patients of minority racial status or with comorbid personality disorders. Treatment duration was also positively associated with dropout rates at trend level. Studies with an inactive control comparison had higher dropout rates than those without such a condition. Limitations include the inability to test certain potential predictors (e.g., socioeconomic status) due to infrequent reporting. Overall, our findings suggest the need to consider how specific patient and study characteristics may influence dropout rates in clinical research on individual therapy for depression.",26067572,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.32080078125,-5.406187534332275,B8Zj
"Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy.

In a previous clinical controlled trial (Lopes et al., 2014), narrative therapy (NT) showed promising results in ameliorating depressive symptoms with comparable outcomes to cognitive-behavioral therapy (CBT) when patients completed treatment. This paper aims to assess depressive symptoms and interpersonal problems in this clinical sample at follow-up. Using the Beck Depression Inventory-II and Outcome Questionnaire-45.2 Interpersonal Relations Scale, naturalistic prospective follow-up assessment was conducted at 21 and 31 months after the last treatment session. At follow-up, patients kept improving in terms of depressive symptoms and interpersonal problems. The odds that a patient maintained recovery from depressive symptoms at follow-up were five times higher than the odds that a patient maintained recovery from interpersonal problems. In the same way, the odds of a patient never recovering from interpersonal problems were five times higher than the odds of never recovering from depressive symptoms. The study did not control for the natural course of depression or treatment continuation. For depressed patients with greater interpersonal disabilities, longer treatment plans and alternative continuation treatments should be considered.",25082116,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.3052978515625,-2.6326916217803955,CKbt
"I didn't know cognitive therapy was deep: a case study of sudden and lasting gains in cognitive-supportive therapy of depression.

Sudden gains is a robust phenomenon that has been found to occur among a variety of psychotherapies, clinical conditions, settings, patient populations, and differing levels of therapist expertise. Sudden gains predict superior end-of-treatment outcomes and long-term maintenance of gains. While cognitive changes during the critical session appear to account for the sudden gains, the nature of these changes has not been fully explained, and no detailed reports of how therapists and patients explain these changes have been presented. This case involved a 61-year-old woman with depression, fibromyalgia, and severe osteoarthritis who, after being in psychotherapy treatment for nearly a year, achieved sudden gains after one particular psychotherapy session. The authors discuss the nature of the cognitive changes that both the patient and therapist understood to occur during that critical session and that they believed contributed to the remission of major depressive disorder over a 2-year period. This case study also explores the possible synergistic effects of medications and cognitive interventions on sudden gains. The commentary on the case links this discussion of sudden gains to an intervention created by Viederman and Perry in the 1980s called the psychodynamic life narrative, which they found could sometimes alleviate symptoms rapidly and dramatically by reframing a person's self-image during a depressive crisis, especially one related to a feeling of despair triggered by medical illness. An increased understanding of the nature of interventions that produce cognitive changes leading to immediate, dramatic, and lasting improvement could potentially contribute to the development of more effective treatments for depression and other clinical conditions.",25226201,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.13265323638916,-2.9417006969451904,CIUT
"Feasibility of a blended group treatment (bGT) for major depression: uncontrolled interventional study in a university setting.

This study investigated the feasibility of a novel blended (face-to-face and computer-based) group intervention for the reduction of depressive symptoms in major depression. Patient-centred uncontrolled interventional study. University setting in a general community sample. A multimodal recruitment strategy (public health centres and public areas) was applied. Based on independent interviews, 26 participants, diagnosed with major depressive disorder (81% female; 23% comorbidity >1 and 23% comorbidity >2), entered treatment. Acceptance and mindfulness based, as well as self-management and resource-oriented psychotherapy principles served as the theoretical basis for the low-threshold intervention. The blended format included face-to-face sessions, complemented with multimedia presentations and a platform featuring videos, online work sheets, an unguided group chat and remote therapist-patient communication. The Center for Epidemiological Studies-Depression scale and the 12-item General Health Questionnaire. Large to very large within group effect sizes were found on self-reported depression (F(2, 46.37)=25.69, p<0.001; d=1.80), general health (F(2,46.73)=11.47, p<0.001; d=1.32), personal resources (F(2,43.36)=21.17, p<0.001; d=0.90) and mindfulness (F(2,46.22)=9.40, p<0.001; d=1.12) after a follow-up period of 3months. Treatment satisfaction was high, and 69% ranked computer and multimedia use as a therapeutic factor. Furthermore, participants described treatment intensification as important advantage of the blended format. Half of the patients (48%) would have preferred more time for personal exchange. The investigated blended group format seems feasible for the reduction of depressive symptoms in major depression. The development of blended interventions can benefit from assuring that highly structured treatments actually meet patients' needs. As a next step, the intervention should be tested in comparative trials in routine care. DRKS00010894; Pre-results.",29530905,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.47354507446289,-3.14070987701416,BOu3
"Effectiveness and cost-effectiveness of telephone-based cognitive-behavioural therapy in primary care: study protocol of TIDe - telephone intervention for depression.

Despite the availability of evidence-based treatments for depression, a large proportion of patients remains untreated or adequate treatment is initiated with delay. This situation is particularly critical in primary care, where not only most individuals first seek help for their mental health problems, but also depressive disorders - particularly mild to moderate levels of severity - are highly prevalent given the high comorbidity of chronic somatic conditions and depression. Improving the access for evidence-based treatment, especially in primary care, is hence a priority challenge in the mental health care agenda. Telephone usage is widespread and has the potential of overcoming many barriers that individuals suffering from mental health problems are facing: Its implementation for treatment delivery presents an option for optimisation of treatment pathways and outcomes. This paper details the study protocol for a randomised controlled trial (RCT) evaluating the effectiveness of a telephone-administered short-term cognitive-behavioural therapy (T-CBT) for depression as compared to treatment as usual (TAU) in the Swiss primary care setting. The study aims at randomising a total of 216 mildly to moderately depressed patients, which are either identified by their General Practitioners (GPs) or who self-refer to the study programme in consultation with their GP. The trial will examine whether telephone-delivered, manualised treatment leads to clinically significant reduction in depression at follow-up. It will further investigate the cost-effectiveness and acceptability of the intervention in the primary care setting. Conducting a low-intensity treatment on the telephone allows for greater flexibility for both patient and therapist, can grant more anonymity and can thus lead to less hesitation in the patient about whether to attempt treatment or not. In order to benefit from this approach, large-scale studies need to prove superior effectiveness and cost-effectiveness of telephone-delivered therapy over routine care for patients with mild to moderate depression. ClinicalTrials.gov NCT02667366 . Registered on 3 December 2015.",28724423,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.525321960449219,-2.9456772804260254,BZjf
"Analysis of the Components of a Cognitive-Behavioral Intervention for the prevention of Depression Administered via Conference Call to Nonprofessional Caregivers: A Randomized Controlled Trial.

Effective and accessible interventions for indicated prevention of depression are necessary and lacking, especially for informal caregivers. Although telephone-based interventions could increase the accessibility for caregivers, randomized controlled trials are scarce, with no examination of prevention to date. Moreover, the efficacy of specific therapeutic components in preventive cognitive-behavioral programs is unknown. The main objective of this study was to evaluate the efficacy of a telephone-administered psychological preventive intervention in informal caregivers with high depressive symptoms. A total of 219 caregivers were randomized to a cognitive-behavioral conference call intervention (CBCC, n = 69), a behavioral-activation conference call intervention (BACC, n = 70), or a usual care control group (CG, n = 80). Both interventions consisted of five 90-minute group sessions. At the post-intervention, incidence of depression was lower in CBCC and BACC compared to CG (1.5% and 1.4% vs. 8.8%). Relative risk was 0.17 for the CBCC and 0.16 for the BACC, and the number-needed-to-treat was 14 in both groups. Depressive symptoms were significantly lower in BACC and BACC groups compared to CG (d = 1.16 and 1.29), with no significant differences between CBCC and BACC groups. The conference call intervention was effective in preventing depression and the behavioral-activation component (BACC) was comparable to the CBCC intervention.",32244970,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.534930229187012,-2.3995673656463623,ArFE
"[Short-Term Psychodynamic Therapy in Depression - An Evidence-Based Unified Protocol].

With a lifetime prevalence of about 17% depression is the most common mental disorder. Psychotherapy is efficacious in the treatment of depression, with no significant differences between different forms of psychotherapies. For psychodynamic therapy (PDT) various models proved to be efficacious in randomized controlled trials (RCTs). As a consequence the evidence for PDT is scattered between different forms or orientations of PDT entailing problems regarding psychotherapy training and the transfer of research into clinical practice. Thus, our aim was to develop a unified protocol for the dynamic treatment of depression that is based on those models of PDT that proved efficacious in randomized controlled trials (RCTs). As a first step we conducted a systematic search of RCTs investigating manualized or manual-based individual psychodynamic therapy for depressive disorders in adults that proved to be efficacious compared to comparison conditions. 11 studies fulfilled our inclusion criteria. In a second step we systematically reviewed the studies with regard to the treatment concepts they had applied. 7 highly consistent treatment components could be identified. We conceptualized them in the form of 7 interrelated treatment modules which constitute the unified psychodynamic protocol for depression. The protocol may enhance the empirical status of PDT and facilitate both psychotherapy training as well as the transfer of research to clinical practice. Through the focused use of techniques that proofed efficacious it is expected to bring more benefit to depressed patients and therefore also have a positive impact on the health care system.",26581037,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.549626350402832,-3.7945234775543213,B1AF
"Depression self-management support: a systematic review.

To systematically review empirical evidence regarding the efficacy of depression self-management support (SMS) interventions for improving depression symptomatology and preventing relapse. Pubmed and PsycINFO databases were searched for relevant articles on depression SMS interventions. Scanning of references in the articles and relevant reviews and communications with field experts yielded additional articles. Two independent reviewers analyzed the articles for inclusion and data was extracted from the selected articles. 13 papers met the inclusion criteria and reported the results of six separate studies, including three pilot studies. The results were mostly positive. A majority of the trials assessing depression severity changes found SMS to be superior to care as usual. SMS interventions were found to improve self-management behaviors and self-efficacy. Mixed results were found concerning relapse rates. Promising results were found on assessments of functional status. Based on the findings, cost-effectiveness remains unclear. SMS has been mostly examined through pilot studies with insufficient power. The results are promising, but larger randomized controlled trials are needed. SMS interventions can be administered by non-physician professionals and are well accepted by patients, but more research is needed before we can recommend implementing specific depression SMS approaches in primary care.",23414831,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,9.513579368591309,-3.72589373588562,Ch1R
"[Morita Therapy to Treat Depression: When and How to Encourage Patients to Join Activities].

The author discusses how Morita therapy is used to treat depression, illustrated with a clinical case, and makes comparisons between Morita therapy and behavioral activation (BA). The author further examines the issue of when and how to encourage patients to join activities in clinical practice in Japan. Both Morita therapy and BA share at least a common view that it is effective to activate patients' constructive behavior at a certain point in depression treatment. However, BA therapists, compared to Morita therapists, seem to pay less attention to the necessity of resting and the appropriate timing for introducing behavioral activation. There may be some contextual differences between depressive patients in Japan and those in North America. In the case of Japanese patients, exhaustion from overwork is often considered a factor triggering the development of depression. At the same time, the Morita-based pathogenic model of depression seems different from BA's model of the same disorder. BA's approach to understanding depression may be considered a psychological (behavioristic) model. In this model, the cause of depression lies in: (a) a lack of positive reinforcement, and (b) negative reinforcement resulting from avoidance of the experience of discomfort. Therefore, the basic strategy of BA is to release depressive patients from an avoidant lifestyle, which serves as a basis for negative reinforcement, and to redirect the patients toward activities which offer the experience of positive reinforcement BA is primarily practiced by clinical psychologists in the U. S. while psychiatrists prescribe medication as a medical service. On the other hand, the clinical practice of treating depression in Japan is based primarily on medical models of depression. This is also true of Morita therapy, but in a broad sense. While those who follow medical models in a narrow sense try to identify the cause of illness and then remove it, Morita therapists pay more attention to the recovery process rather than the pathogeneses of depression, and attempt to foster patients' natural healing power and resilience. Therefore, it may be more appropriate to refer to the model used in Morita therapy as ""a health-recovery model."" Moreover, the Moritian model of depression partially incorporates a psychological model because patients' dogmatic thinking (e. g., perfectionistic self-expectations and high demands on self) is regarded as a factor hindering their recovery, which Morita therapists try to modify. In conclusion, it is recommended that we reconsider the importance of incorporating psychological help which is compatible with the initial treatment principle based on resting and pharmacotherapy in clinical practice in Japan.",26514044,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.930009841918945,-1.9655823707580566,B17t
"Psychodynamic therapy for depression in women with infants and young children.

It has long been known that the rate of depression is high among women with infants and young children. In recent research a psychodynamic therapy group was found to be beneficial for a self-selected, postnatal subgroup of women who were of middle socio-economic status (SES), educated and who met DSM-IV criteria for clinical or subclinical depression. The current study sought to replicate these findings with individual psychodynamic therapy and to compare outcomes for three psychodynamic treatment conditions: individual, group, and combined individual and group. Patients began and left treatment from each of the three psychodynamic therapy conditions on a self-determined basis. Pre- and postintervention DSM-IV Global Assessment of Functioning (GAF) were obtained by reliable blind raters. A ten-variable, self-administered postintervention outcome questionnaire provided further data. Women (n = 58) in all three therapeutic conditions showed statistically significant improvement in their pre-to-post GAF and large treatment effects. On the questionnaire, they indicated that they were affected positively by all three conditions. Statistically significant differences among treatment conditions favored the individual treatment. Psychodynamic therapy appears well suited for the population of women in this study, especially when administered on an individual basis. The model employed here emphasized receiving and developing empathic emotional attunement, insight into one's relationships and early experiences, and a process for expressing feelings and resolving problems. Compared to group and combination therapies, the individual treatment may afford the greatest opportunity for receiving and developing these features and, thus, the best outcomes.",22876529,Major Depressive Disorder,Anxiety Treatment,Mental Health,118,12.155827522277832,-4.223917007446289,Cpvd
"Activation therapy for the treatment of inpatients with depression - protocol for a randomised control trial compared to treatment as usual.

Inpatients with depression have a poor long term outcome with high rates of suicide, high levels of morbidity and frequent re-admission. Current treatment often relies on pharmacological intervention and focuses on observation to maintain safety. There is significant neurocognitive deficit which is linked to poor functional outcomes. As a consequence, there is a need for novel psychotherapeutic interventions that seek to address these concerns. We combined cognitive activation and behavioural activation to create activation therapy (AT) for the treatment of inpatient depression and conducted a small open label study which demonstrated acceptability and feasibility. We propose a randomised controlled trial which will compare treatment as usual (TAU) with TAU plus activation therapy for adult inpatients with a major depressive episode. The behavioural activation component involves therapist guided re-engagement with previously or potentially rewarding activities. The cognitive activation aspect utilises computer based exercises which have been shown to improve cognitive function. The proposed randomised controlled trial will examine whether or not the addition of this therapy to TAU will result in a reduced re-hospitalisation rate at 12weeks post discharge. Subjective change in activation and objectively measured change in activity levels will be rated, and the extent of change to neurocognition will be assessed. Unique trial number: U1111-1190-9517. Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12617000024347p .",30709391,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,10.247824668884277,-2.2486770153045654,A/iW
"Improvement in Psychodynamic Psychotherapy for Depression: A Qualitative Study of the Patients' Perspective.

The patient's perspective on improvement in psychotherapy is crucial for tailoring the therapy he or she is receiving. The present study aimed at exploring the factors aiding and the patients' experiences of improvement in time-limited psychodynamic psychotherapy for depression. Semi-structured, in-depth interviews were conducted with ten adult patients who received up to 28 sessions of manualized psychodynamic psychotherapy in the Norwegian study ""Mechanisms of change in psychotherapy"" (the MOP study). The post-therapy interviews addressed the participants' experiences from therapy. The data were analyzed with thematic content analysis and hermeneutic interpretation. The analysis identified four helpful dimensions: ""Therapist activities"" comprised supporting and acknowledging, advising and offering tips for everyday life, questioning and pressuring. ""Patient activities"" included opening up, caring for oneself and showing agency. ""Facilitators"" for improvement were learning from therapy, learning to receive therapy and agreed goals. ""Achievements"" comprised new perspectives and understandings, increased self-awareness and mastery and changed thinking and feeling. Improvements from psychodynamic therapy seemed reliant on the degree to which the therapy could activate and be relevant to the patients' everyday life. Tailoring therapy for patients with depression should link the focus on symptoms and ways of thinking and feeling with their life circumstances.",32961671,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.150221824645996,-4.985451698303223,AiKM
"The efficacy of behavioural activation treatment for co-occurring depression and substance use disorder (the activate study): a randomized controlled trial.

Epidemiological studies suggest that compared with the general population, mood disorders are up to 4.7 times more prevalent in substance dependent samples. Comorbid substance use disorder (SUD) and depression has been associated with a more severe and protracted illness course and poorer treatment outcomes. Despite this, the development and assessment of behavioural interventions for treating depression among individuals with SUDs have received little empirical attention. Behavioural Activation Treatment for Depression (BATD-R) is an empirically supported treatment for depression that has shown some efficacy among substance users. This paper describes the study protocol of a parallel, single blind, randomised controlled trial to determine the efficacy and feasibility of a modified version of the BATD-R (Activate) in reducing symptoms of depression and substance dependence among individuals in residential rehabilitation (RR) and opioid substitution therapy (OST). A sample of approximately 200 individuals with depressive symptomatology in treatment for SUD will be recruited from RR and OST services in New South Wales, Australia. Dynamic random allocation following minimisation methodology will be used to assign participants to one of two groups. The control group will receive treatment as usual (TAU), which will be the model of care provided in accordance with standard practice at participating RR and OST services. The intervention group will receive Activate, comprising 10 individual 60-min therapy sessions with a psychologist employed on the research team, in addition to TAU. Data collection will occur at baseline (pre-intervention), and 3-months and 12-months post baseline. The association between depression and substance dependence has been well documented, yet practical and effective treatments are scarce. The findings of the present study will contribute significantly to understanding the types of programs that are effective in treating this comorbidity. This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000876796 . Registered on 7 August, 2013.",27391675,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.530512809753418,-2.0925092697143555,BqR1
"Sudden gains and treatment outcomes among depressed individuals in a partial hospitalization programme.

Sudden gains commonly occur among patients receiving psychotherapy for depression and have been found to consistently predict better treatment outcomes. However, the majority of prior research has examined sudden gains primarily in weekly or biweekly treatment settings. Individuals were divided into two groups: those who experienced at least one sudden gain and those who did not. Rates of sudden gain occurrence, pretreatment factors and posttreatment outcomes were examined between the two groups. Over 60% of this sample experienced at least one sudden gain, the majority of which occurred during the first 3days of treatment. Sudden gains were associated with significantly lower baseline depression and anxiety severity. Patients who experienced sudden gains reported significantly greater improvement in depressive and anxiety symptoms, coping skills, functioning, positive mental health and well-being at treatment termination. This study was conducted in a single location with a relatively homogeneous sample. Due to a lack of follow-up data, we were unable to determine if treatment outcomes were sustained after treatment termination. The assessment timeline of the depressive symptoms differs between baseline and daily scales, which may have affected the number of observed sudden gains after the initial treatment day. The proportion of sudden gains in this study is higher than those found in outpatient settings, demonstrating that this phenomenon may commonly occur among depressed patients in acute treatment. These results suggest that the mechanisms by which sudden gains occur may be reinforced by daily, intensive treatment.",35294079,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.311174392700195,-2.8649137020111084,iR8
"Adapting computerized treatments into traditional psychotherapy for depression.

Recent developments in technology have helped to improve the process of psychotherapy. Unfortunately, many therapists lack the computer skills or financial resources needed for the newest technology. Nonetheless, even basic advances in technology may help to improve the treatment of depression. The literature is reviewed for journal articles on the treatment of depression published during the past seven years in which treatments have been guided by technology. Six novel findings are summarized that may be helpful even when the therapist lacks skill or resources for advanced technology. 1) The efficient assessment of depression can be facilitated by technology, whether using standardized measures or simple daily ratings of mood. 2) Technology tools can be used to send semi-automated daily reminders to help clients develop more adaptive habits in thoughts or actions. 3) Depressed clients can begin to confront their negative view of self, often triggered by some form of loss, failure, or rejection, whether real, imagined, or anticipated. 4) Clients can confront their problems through therapeutic dialogue, whether conducted in person, over the telephone, or via video conference. 5) Clients can use writing assignments to identify, label, explore and express their thoughts and feelings. These writing assignments can be conducted via paper, email, or internet forms. 6) Clients value rapport with a therapist, and this bond seems important to ensure participation and adherence with treatment. Even low-tech therapists can strengthen the treatment of depression using basic technology tools to replace, extend, or supplement traditional sessions. However, it is important to protect the rapport needed for sustained participation in therapy.",22954823,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.839810371398926,-3.830507516860962,ColF
"EFFECTS OF RELIGIOUS VERSUS STANDARD COGNITIVE-BEHAVIORAL THERAPY ON OPTIMISM IN PERSONS WITH MAJOR DEPRESSION AND CHRONIC MEDICAL ILLNESS.

We compared the effectiveness of religiously integrated cognitive behavioral therapy (RCBT) versus standard CBT (SCBT) on increasing optimism in persons with major depressive disorder (MDD) and chronic medical illness. Participants aged 18-85 were randomized to either RCBT (n = 65) or SCBT (n = 67) to receive ten 50-min sessions remotely (94% by telephone) over 12 weeks. Optimism was assessed at baseline, 12 and 24 weeks by the Life Orientation Test-Revised. Religiosity was assessed at baseline using a 29-item scale composed of religious importance, individual religious practices, intrinsic religiosity, and daily spiritual experiences. Mixed effects growth curve models were used to compare the effects of treatment group on trajectory of change in optimism. In the intention-to-treat analysis, both RCBT and SCBT increased optimism over time, although there was no significant difference between treatment groups (B = -0.75, SE = 0.57, t = -1.33, P = .185). Analyses in the highly religious and in the per protocol analysis indicated similar results. Higher baseline religiosity predicted an increase in optimism over time (B = 0.07, SE = 0.02, t = 4.12, P < .0001), and higher baseline optimism predicted a faster decline in depressive symptoms over time (B = -0.61, SE = 0.10, t = -6.30, P < .0001), both independent of treatment group. RCBT and SCBT are equally effective in increasing optimism in persons with MDD and chronic medical illness. While baseline religiosity does not moderate this effect, religiosity predicts increases in optimism over time independent of treatment group.",26219426,Major Depressive Disorder,Anxiety Treatment,Mental Health,1733,11.415229797363281,-3.144254207611084,B6Qn
"Comparative effectiveness and acceptability of different ACT delivery formats to treat depression: A systematic review and network meta-analysis of randomized controlled trials.

Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of acute depression. However, whether ACT can be effectively delivered in individual, group, internet, and combined delivery format remain unclear. We aimed to examine the most effective delivery format for ACT via a network meta-analysis (NMA). An electronic literature search was conducted by two reviewers in the Pubmed, Cochrane library, Embase, PsycINFO, CINAHL, CNKI, Wangfang databases to identify relevant studies that were published up to March 21th, 2021. We conducted pairwise and NMA to evaluate the relative effectiveness and rank the probability of different ACT delivery formats. A series of analyses and assessments, such as the risk of bias, and GRADE were performed concurrently. A total of 23 studies were included in our analysis based on a series of rigorous screenings, which comprised 690 depressed patients. The effectiveness of individual, group, internet, and combine ACT did not differ statistically significantly from each other. Compared with control group, individual delivery format (standardized mean difference [SMD] = -1.44, confidence interval (CI) = -2.11 to -0.76 GRADE low), group delivery format (SMD = -1.34, 95 % CI = -1.91 to -0.78 GRADE moderate), and internet delivery format (SMD = -0.66, 95 % CI = -1.25 to -0.06 GRADE low) showed the largest improvement on depressive symptoms, whereas the combined group and individual ACT was less effective. In terms of acceptability (dropout for any reason), all delivery formats did not differ statistically significantly from each other. For depression symptoms, individual, group, and internet treatment formats appeared to be effective interventions. Applying effective and acceptable ACT in a range of different formats will make ACT easier to implement, disseminate, and deliver across different settings and diverse patient populations. More research is needed to verify the ACT in telephone and combined formats for the management of depression.",35764229,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,7.971072673797607,-1.773322582244873,R9s
"Transdiagnostic and Transcultural: Pilot Study of Unified Protocol for Depressive and Anxiety Disorders in Japan.

Unified protocol (UP) is a transdiagnostic cognitive behavior therapy for emotional disorders. It remains unknown whether UP is applicable for use in non-Western countries and for depressive disorders. We therefore examined its feasibility for a Japanese clinical population using this clinical trial design, which is multicentered, open-labeled, and single-armed (Clinical registry: UMIN000008322). The primary outcome was severity of anxiety symptoms, as assessed using Structured Interview Guide for the Hamilton Anxiety Rating Scale. Secondary outcomes were depressive symptoms, clinical global impression, functioning, quality of life, affectivity, emotion regulation, and adverse events. Of the 28 prospective participants, 17 were eligible and enrolled (depressive disorders=9, anxiety disorders=8). Severity of anxiety symptoms, which decreased significantly after the intervention, remained low for 3months (Hedges' g=1.29, 95% CI=0.56-2.06). Similar tendencies were observed for secondary outcome measures. No severe adverse event occurred. Two participants dropped out of the intervention. High treatment adherence and interrater reliability were confirmed. Results suggest the feasibility of UP in the Japanese context sufficient to warrant a larger clinical trial.",27157034,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,12.23642635345459,-2.9235751628875732,BtHy
"Effectiveness of a Web-Based Guided Self-help Intervention for Outpatients With a Depressive Disorder: Short-term Results From a Randomized Controlled Trial.

Research has convincingly demonstrated that symptoms of depression can be reduced through guided Internet-based interventions. However, most of those studies recruited people form the general population. There is insufficient evidence for the effectiveness when delivered in routine clinical practice in outpatient clinics. The objective of this randomized controlled trial was to study patients with a depressive disorder (as defined by the Diagnostic and Statistical Manual of Disorders, fourth edition), as assessed by trained interviewers with the Composite International Diagnostic Interview, who registered for treatment at an outpatient mental health clinic. We aimed to examine the effectiveness of guided Internet-based self-help before starting face-to-face treatment. We recruited 269 outpatients, aged between 18 and 79 years, from outpatient clinics and randomly allocated them to Internet-based problem solving therapy (n=136), with weekly student support, or to a control condition, who remained on the waitlist with a self-help booklet (control group; n=133). Participants in both conditions were allowed to take up face-to-face treatment at the outpatient clinics afterward. We measured the primary outcome, depressive symptoms, by Center for Epidemiological Studies Depression scale (CES-D). Secondary outcome measures were the Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), Insomnia Severity Index questionnaire (ISI), and EuroQol visual analog scale (EQ-5D VAS). All outcomes were assessed by telephone at posttest (8 weeks after baseline). Posttest measures were completed by 184 (68.4%) participants. We found a moderate to large within-group effect size for both the intervention (d=0.75) and the control (d=0.69) group. However, the between-group effect size was very small (d=0.07), and regression analysis on posttreatment CES-D scores revealed no significant differences between the groups (b=1.134, 95% CI -2.495 to 4.763). The per-protocol analysis (≥4 sessions completed) results were also not significant (b=1.154, 95% CI -1.978 to 7.637). Between-group differences were small and not significant for all secondary outcomes. Adherence to the intervention was low. Only 36% (49/136) received an adequate dosage of the intervention (≥4 of 5 sessions). The overall treatment satisfaction was moderate. Internet-based problem solving therapy is not more effective in reducing symptoms of depression than receiving an unguided self-help book during the waitlist period at outpatient mental health clinics. The effect sizes are much smaller than those found in earlier research in the general population, and the low rates of adherence indicate that the acceptability of the intervention at this stage of treatment for depressed outpatients is low. However, taking into account that there is much evidence for the efficacy of Internet-based treatments, it is too early to draw firm conclusions about the effectiveness of these treatments in outpatient clinics as a whole. Netherlands Trial Register NTR2824; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2824 (Archived by WebCite at http://www.webcitation/ 6g3WEuiqH).",27032449,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.094114303588867,-3.5164482593536377,Bu3w
"Patients' experiences of a computerised self-help program for treating depression - a qualitative study of Internet mediated cognitive behavioural therapy in primary care.

The objective of this study was to explore primary care patients' experiences of Internet mediated cognitive behavioural therapy (iCBT) depression treatment. Qualitative study. Data were collected from focus group discussions and individual interviews. Primary care. Data were analysed by systematic text condensation by Malterud. Thirteen patients having received iCBT for depression within the PRIM-NET study. Analysis presented different aspects of patients' experiences of iCBT. The informants described a need for face-to-face meetings with a therapist. A therapist who performed check-ups and supported the iCBT process seemed important. iCBT implies that a responsibility for the treatment is taken by the patient, and some patients felt left alone, while others felt well and secure. This was a way to work in privacy and freedom with a smoothly working technology although there was a lack of confidence and a feeling of risk regarding iCBT. iCBT is an attractive alternative to some patients with depression in primary care, but not to all. An individual treatment design seems to be preferred, and elements of iCBT could be included as a complement when treating depression in primary care. Such a procedure could relieve the overall treatment burden of depression. Key points Internet mediated cognitive behavioural therapy (iCBT) can be effective in treating depression in primary care, but patients' experiences of iCBT are rarely studied •Most patients express a need for human contact, real-time interaction, dialogue and guidance when treated for depression. •The patient's opportunity to influence the practical circumstances about iCBT is a success factor, though this freedom brings a large responsibility upon the receiver. •An individual treatment design seems to be crucial, and elements of iCBT could be included as a complement to face-to-face meetings.",28277055,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.328253746032715,-2.66611647605896,Bfwm
"Efficacy of a Transdiagnostic internet-based treatment for emotional disorders with a specific component to address positive affect: Study protocol for a randomized controlled trial.

Emotional disorders (ED) are among the most prevalent mental disorders. However, less than 50% of people suffering from ED receive the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which tries to address the underlying processes common to ED. Most of these programs focus primarily on down-regulating negative affectivity, rather than increasing strengths and up-regulating positive affectivity. The data suggest the existence of disturbances in positive affectivity in these disorders, and so new interventions focusing on these problems are greatly needed. It is also essential to provide assistance to all the people in need. Information and Communication Technologies can be very useful. This study aims to evaluate the efficacy of a transdiagnostic Internet-based treatment for ED in a community sample. The protocol includes traditional CBT components, as well as a specific component to address positive affect. We intend to test this protocol, including this specific component or not, versus a waiting list control group. Moreover, we aim to test the differential effect of this specific component, and study the effectiveness (in terms of patients' acceptance) of using a self-applied Internet-based program. This paper presents the study protocol. The study is a randomized controlled trial. 207 participants will be randomly assigned to: a)Transdiagnostic Internet-based protocol (TIBP), b)Transdiagnostic Internet-based protocol + positive affect component (TIBP + PA), or c)a Waiting List control group (WL). Primary outcomes measures will be the BDI-II, the BAI, and the PANAS. Secondary outcomes will include diagnosis-specific measures of the principal disorder. Participants' treatment acceptance will also be measured. Participants will be assessed at pre-, post-treatment, and 3- and 12- month follow-ups. The data will be analyzed based on the Intention-to-treat principle. Per protocol analyses will also be performed. To the best of our knowledge, this is the first study of a transdiagnostic Internet-based treatment for ED with a specific component to up-regulate positive affectivity. This intervention could contribute to improve the efficiency and effectiveness of current treatment programs for ED, promote the dissemination of EBTs, and help to decrease the high prevalence of ED. ClinicalTrial.gov: NCT02578758 . Registered 15 October 2015.",28424068,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.560864448547363,-2.9668169021606445,Bdu6
"Combination psychotherapy and antidepressant medication treatment for depression: for whom, when, and how.

Major depressive disorder (MDD) is among the most frequent and debilitating psychiatric disorders. Efficacious psychotherapy and antidepressant medications have been developed, and two-thirds of depressed patients respond to single-modality treatment; however, only about one-third of patients remit to single-modality treatments with no meaningful differences in outcomes between treatment types. This article describes the major clinical considerations in choosing between single-modality or combination treatments for MDD. A review of the relevant literature and meta-analyses provides suggestions for which treatment to use for which patient and when each treatment or combination should be provided. The review summarizes the moderators of single-modality and combination-treatment outcomes. We describe models of mechanisms of treatment efficacy and discuss recent treatment-specific neurobiological mechanisms of change.",24405361,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.685687065124512,-0.9655444025993347,CTuw
"Effectiveness of therapeutic milieu intervention on inpatients with depressive disorder: A feasibility study from North India.

This study examined therapeutic milieu interventions on self-esteem, socio-occupational functioning, and depressive symptoms among inpatients with depressive disorders. A pretest-posttest nonequivalent control group quasi-experimental design was adopted. Sixty participants with depression who got admitted to the general hospital psychiatric ward were assigned to a control (Treatment as Usual) group and an experimental (therapeutic milieu intervention) group nonrandomly using a convenience sampling technique. We evaluated the following outcome measures: self-esteem, socio-occupational functioning, and depressive symptoms for both groups at baseline, 4th, 8th, and 12th weeks. Therapeutic milieu interventions improved self-esteem, socio-occupational functioning, and reduced depressive symptoms. The findings provided initial evidence for practice. Psychiatric nurses can implement simple, milieu therapy interventions in any setting, which will enhance the clinical outcomes and socio-occupational functioning of depressive patients.",33476398,Major Depressive Disorder,Anxiety Treatment,Mental Health,14949,10.4664888381958,-2.8759689331054688,AcGW
"Effect of psychotherapy for depression on quality of life: meta-analysis.

Several meta-analyses have shown that psychotherapy is effective for reducing depressive symptom severity. However, the impact on quality of life (QoL) is as yet unknown. To investigate the effectiveness of psychotherapy for depression on global QoL and on the mental health and physical health components of QoL. We conducted a meta-analysis of 44 randomised clinical trials comparing psychotherapy for adults experiencing clinical depression or elevated depressive symptoms with a control group. We used subgroup analyses to explore the influence of various study characteristics on the effectiveness of treatment. We detected a small to moderate effect size (Hedges' g = 0.33, 95% CI 0.24-0.42) for global QoL, a moderate effect size for the mental health component (g = 0.42, 95% CI 0.33-0.51) and, after removing an outlier, a small but statistically significant effect size for the physical health component (g = 0.16, 95% CI 0.05-0.27). Multivariate meta-regression analyses showed that the effect size of depressive symptoms was significantly related to the effect size of the mental health component of QoL. The effect size of depressive symptoms was not related to global QoL or the physical health component. Psychotherapy for depression has a positive impact on the QoL of patients with depression. Improvements in QoL are not fully explained by improvements in depressive symptom severity.",27539296,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.172432899475098,-2.178755521774292,BobF
"Why people choose to participate in psychotherapy for depression: A qualitative study.

WHAT IS KNOWN ON THE SUBJECT?: Medication does not always resolve a serious mood episode, and there is evidence that it needs to be combined with an evidence-based psychotherapy to promote symptomatic and functional recovery. There is little known about what people with serious mood disorders want from mental health services to manage their mood. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Participants in this study wanted a framework other than the medical model for understanding and managing their mood. Their motivation to commence psychotherapy was based on a sense of having hit rock bottom and a need for understanding what was happening in order to better manage their mood. ABSTRACT: Introduction There is little known about the motivations for people to participate in psychotherapy for depression. Aim To explore why people, with a diagnosis of major depressive episode, chose to take part in a psychotherapy study and what they expected it to involve. Method This was a qualitative study of participants' motivations and understandings of psychotherapy for depression. Data were collected using semi-structured interviews and analysed using thematic analysis. Findings Eight females and eight males with an age range from 21 years to 55 years were recruited. Three themes were identified that described why participants chose to participate in psychotherapy: medication was not enough, a turning point and making sense of experience. The participants chose to participate in psychotherapy after finding that medication was insufficient and this combined with a sense of crisis motivated them to engage in psychotherapy in order to learn to manage their mood differently. Discussion The participants recognized that they wanted a framework other than a medical model with its reliance on medication, in order to make sense of their experiences and develop new self-management strategies. Implications for Practice Our study suggests that some people experiencing a serious mood disorder access psychotherapy after ""hitting rock bottom"" and finding insufficient help from medications. Mental health nurses need to be aware people do not always want a medical model approach to treatment of serious mood disorders and they need to provide the opportunity of engaging in a psychotherapeutic framework in order to better understand and manage their mood.",31957177,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.403532028198242,-2.354428768157959,AusH
"The Effect of Waiting for Inpatient Psychotherapy for Depression.

Objectives: This study aimed to investigate the effect of waiting for inpatient psychosomatic psychotherapy and the prediction of treatment outcome from the effect of waiting in depressed patients. Methods: A total of N = 519 patients were assessed for depressive symptoms before their initial intake interview, at the time of their hospital admission (on average 6 weeks after the intake), and at discharge (after eight weeks of inpatient psychotherapy). Results: There was a small to moderate reduction in depressive symptoms from intake interview to hospital admission. This effect was independent from the waiting duration. Latent change from intake interview to hospital admission was a significant moderate predictor of treatment outcome at discharge. Conclusions: Findings imply that the prospect of inpatient psychotherapy may affect patients' depression severity. Furthermore, patients who benefit more from the prospect of treatment may also achieve higher therapeutic effects.",33565372,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,10.630666732788086,-3.2145423889160156,AbFu
"Choosing between Internet-based psychodynamic versus cognitive behavioral therapy for depression: a pilot preference study.

Major depression is a world-wide problem that can be treated with various forms of psychotherapy. There is strong research support for treating major depression using cognitive behavior therapy delivered in the format of guided self-help via the Internet (ICBT). Recent research also suggests that psychodynamic psychotherapy can be delivered as guided self-help via the Internet (IPDT) and that it seem to be as effective as ICBT for mild to moderate depression. However, no head-to-head comparison between the two treatments exists. In the field of Internet interventions it is largely unexplored if treatment preference affects outcome and adherence. Participants were allocated to IPDT or ICBT based on their stated preference. More than half of the participants preferred ICBT (N = 30) over IPDT (N = 14). Differences in efficacy between treatments were explored. Correlations between strength of preference and treatment outcome, adherence to treatment and completion of the whole treatment program were explored. Data were collected before and after treatment, as well as in a 7-month follow-up. During the treatment period, both programs performed equally well in reducing symptoms. More participants who received IPDT completed the entire program. At follow-up, mixed-effects models showed that participants who chose ICBT improved more in terms of quality of life. The ICBT group also had a significant increase in participants who recovered from their depression from post-treatment to follow-up. Exploratory analyses indicated that strength of preference was correlated with adherence to treatment and completion of the whole program, and long-term outcome for the ICBT group. Few differences were found during the acute treatment phase, but the long-term effects are in favor of ICBT. Strength of preference for treatment seems to have a predictive value. Further research comparing the efficacy of ICBT and IPDT, and the effects of preference matching and strength of preference, is warranted. This trial is a continuation of the study registered as NCT01324050 at Clinicaltrials.gov.",24139066,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.69063663482666,-2.967545986175537,CXMX
"Cognitive behavioral intervention via a smartphone app for non-professional caregivers with depressive symptoms: study protocol for a randomized controlled trial.

Although major depression is a frequent disorder in non-professional caregivers and there are effective psychological interventions to prevent it, caregivers have difficulty accessing them. Interventions for depression applied through an app could improve accessibility; yet, to date, adherence to such interventions has been low. The objectives of this study are to (1) evaluate the efficacy of a cognitive behavioral depression prevention intervention administered through a smartphone app with and without telephone conference calls, (2) analyze the mediators of the change in the incidence of depression and depressive symptoms, and (3) assess adherence and satisfaction with the interventions. A randomized controlled clinical trial will be conducted. Caregivers with elevated symptoms will be randomly assigned to a cognitive behavioral intervention administered by a smartphone app (CBIA) group, a CBIA plus telephone conference calls (TCCs) group (CBIA + TCC), or an attention control group. Each condition will consist of approximately 58 participants. Both interventions will be administered in five modules through a smartphone app and the CBIA + TCC group will receive additional TCCs in group format (four sessions of 30 min each). Trained blind assessors will conduct pre-treatment, post-treatment and follow-up assessments at 1, 3, 6, and 12 months. This study will provide evidence of the efficacy of a cognitive behavioral intervention to prevent depression in caregivers with elevated depressive symptoms administered through a smartphone app and the impact of feedback applied through conference calls to increase program adherence and efficacy. If the results were favorable, it would mean that we have developed a more effective, accessible, and clinically useful preventive depression intervention than the currently available ones for many present and future caregivers. ClinicalTrials.gov: NCT03110991 . Registered 5 April 2017.",30064466,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,7.311519622802734,-5.949940204620361,BILs
"Systematic reviews of randomised clinical trials examining the effects of psychotherapeutic interventions versus ""no intervention"" for acute major depressive disorder and a randomised trial examining the effects of ""third wave"" cognitive therapy versus mentalization-based treatment for acute major depressive disorder.

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy and psychodynamic therapy may be effective treatment options for major depressive disorder, but the effects have only had limited assessment in systematic reviews. The two modern forms of psychotherapy, ""third wave"" cognitive therapy and mentalization-based treatment, have both gained some ground as treatments of psychiatric disorders. No randomised trial has compared the effects of these two interventions for major depressive disorder. We performed two systematic reviews with meta-analyses and trial sequential analyses using The Cochrane Collaboration methodology examining the effects of cognitive therapy and psycho-dynamic therapy for major depressive disorder. We developed a thorough treatment protocol for a randomised trial with low risks of bias (systematic error) and low risks of random errors (""play of chance"") examining the effects of third wave' cognitive therapy versus mentalization-based treatment for major depressive disorder. We conducted a randomised trial according to good clinical practice examining the effects of ""third wave"" cognitive therapy versus mentalisation-based treatment for major depressive disorder. The first systematic review included five randomised trials examining the effects of psychodynamic therapy versus ""no intervention' for major depressive disorder. Altogether the five trials randomised 365 participants who in each trial received similar antidepressants as co-interventions. All trials had high risk of bias. Four trials assessed ""interpersonal psychotherapy"" and one trial ""short psychodynamic supportive psychotherapy"". Both of these interventions are different forms of psychodynamic therapy. Meta-analysis showed that psychodynamic therapy significantly reduced depressive symptoms on the Hamilton Depression Rating Scale (HDRS) compared with ""no intervention"" (mean difference -3.01 (95% confidence interval -3.98 to -2.03; p = 0.00001), no significant heterogeneity between trials). Trial sequential analysis confirmed this result. The second systematic review included 12 randomised trials examining the effects of cognitive therapy versus ""no intervention"" for major depressive disorder. Altogether a total of 669 participants were randomised. All trials had high risk of bias. Meta-analysis showed that cognitive therapy significantly reduced depressive symptoms on the HDRS compared with ""no intervention"" (four trials; mean difference -3.05 (95% confidence interval, -5.23 to -0.87; p = 0.006)). Trial sequential analysis could not confirm this result. The trial protocol showed that it seemed feasible to conduct a randomised trial with low risks of bias and low risks of random errors examining the effects of ""third wave"" cognitive therapy versus mentalization-based therapy in a setting in the Danish healthcare system. It turned out to be much more difficult to recruit participants in the randomised trial than expected. We only included about half of the planned participants. The results from the randomised trial showed that participants randomised to ""third wave"" therapy compared with participants randomised to mentalization-based treatment had borderline significantly lower HDRS scores at 18 weeks in an unadjusted analysis (mean difference -4.14 score; 95% CI -8.30 to 0.03; p = 0.051). In the adjusted analysis, the difference was significant (p = 0.039). Five (22.7%) of the participants randomised to ""third wave"" cognitive therapy had remission at 18 weeks versus none of the participants randomised to mentalization-based treatment (p = 0.049). Sequential analysis showed that these findings could be due to random errors. No significant differences between the two groups was found regarding Beck's Depression Inventory (BDI II), Symptom Checklist 90 Revised (SCL 90-R), and The World Health Organization-Five Well-being Index 1999 (WHO 5). We concluded that cognitive therapy and psychodynamic therapy might be effective interventions for depression measured on HDRS and BDI, but the review results might be erroneous due to risks of bias and random errors. Furthermore, the effects seem relatively small. The trial protocol showed that it was possible to develop a protocol for a randomised trial examining the effects of ""third wave"" cognitive therapy versus mentalization-based treatment with low risks of bias and low risks of random errors. Our trial results showed that ""third wave"" cognitive therapy might be a more effective intervention for depressive symptoms measured on the HDRS compared with mentalization-based treatment. The two interventions did not seem to differ significantly regarding BDI II, SCL 90-R, and WHO 5. More randomised trials with low risks of bias and low risks of random errors are needed to assess the effects of cognitive therapy, psychodynamic therapy, ""third wave"" cognitive therapy, and mentalization-based treatment.",25283628,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.18886661529541,-2.6020162105560303,CHdt
"Acceptance and Commitment Therapy preceded by an experimental Attention Bias Modification procedure in recurrent depression: study protocol for a randomized controlled trial.

This project studies the effect of group-based Acceptance and Commitment Therapy (ACT) following Attention Bias Modification (ABM) on residual symptoms in recurrent depression. ACT is a cognitive-behavioral intervention combining acceptance and mindfulness processes with commitment and behavior-change processes. ACT enjoys modest empirical support in treating depression and has also shown promising results in secondary prevention of depression. The experimental cognitive bias modification (ABM) procedure has been shown to reduce surrogate markers of depression vulnerability in patients in remission from depression. The aim of the current project is to investigate if the effect of group-based ACT on reducing residual depressive symptoms can be enhanced by preceding it with ABM. Also, assessment of the relationship between conceptually relevant therapeutic processes and outcome will be investigated. An invitation to participate in this project was extended to 120 individuals within a larger sample who had just completed a separate randomized, multisite, clinical trial (referred to hereafter as Phase 1) in which they received either ABM (n = 60) or a control condition without bias modification (n = 60). This larger Phase-1 sample consisted of 220 persons with a history of at least two episodes of major depression who were currently in remission or not fulfilling the criteria of major depression. After its inclusion, Phase-1 participants from the Sørlandet site (n = 120) were also recruited for this study in which they received an 8-week group-based ACT intervention. Measures will be taken immediately after Phase 1, 1 month, 2 months, 6 months, and 1 year after the conclusion of Phase 1. This study sequentially combines acceptable, nondrug interventions from neuropsychology and cognitive-behavioral psychology in treating residual symptoms in depression. The results will provide information about the effectiveness of treatment and on mechanisms and processes of change that may be valuable in understanding and further developing ABM and ACT, combined and alone. ClinicalTrials.gov, Identifier: NCT02648165 . Registered on 6 January 2016.",29587807,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,7.897503852844238,-1.6704349517822266,BOAL
"Efficacy of Transdiagnostic Behavior Therapy Across the Affective Disorders.

This study supports the efficacy of transdiagnostic behavior therapy across various affective disorders, including depression and PTSD. These findings suggest a possible reduction in the number of treatment protocols providers need to learn in order to treat patients with affective disorders.",31533455,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,11.856895446777344,-2.7552108764648438,A0dv
"Specific and non-specific effects of psychotherapeutic interventions for depression: Results from a meta-analysis of 84 studies.

There is a long-standing and very active debate regarding which psychotherapeutic intervention should be used in depressive disorders. However, the effects of psychotherapies may result majorly from non-specific factors rather than from specific factors related to the type of psychotherapeutic intervention. We performed a systematic review and meta-analysis on aggregated data to understand how the effects of different psychotherapies are impacted by non-specific factors. We included randomized controlled trials that assessed the efficacy of psychotherapeutic interventions in the treatment of adult depressive disorders. The primary outcome was the change in depression score from baseline to the latest follow-up visit (i.e. response). A meta-regression was performed to predict response according to the type of intervention and non-specific factors (e.g. number of treatment sessions, length of follow-up, therapeutic allegiance of the investigator). The main analysis included 214 study arms from 84 trials. The effects of psychotherapies compared to the waiting list control condition failed to remain significant after adjusting for non-specific factors. Response increased with the number of treatment sessions (β = 0.03, 95% CI [0.01; 0.04]) and the length of follow-up (β = 0.01, 95% CI [0.00; 0.02]). Response also improved in case of presumed therapeutic allegiances among investigators (β = 0.29, 95% CI [0.07; 0.52]). Response to psychotherapies seems to be closely related to non-specific effects. The development of a well-designed trial that controls for non-specific factors might help disentangle the effects of psychotherapies.",28038336,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.468036651611328,-2.1510846614837646,BixZ
"Clinical efficacy and economic evaluation of online cognitive behavioral therapy for major depressive disorder: a systematic review and meta-analysis.

Leading cause of disability worldwide, depression is the most prevalent mental disorder with growing societal costs. As mental health services demand often outweighs provision, accessible treatment options are needed. Our systematic review and meta-analysis evaluated the clinical efficacy and economic evidence for the use of online cognitive behavioral therapy (oCBT) as an accessible treatment solution for depression. Electronic databases were searched for controlled trials published between 2006 and 2016. Of the reviewed 3,324 studies, 29 met the criteria for inclusion in the efficacy meta-analysis. The systematic review identified five oCBT economic evaluations. Therapist-supported oCBT was equivalent to face-to-face CBT at improving depressive symptoms and superior to treatment-as-usual, waitlist control, and attention control. Depression severity, number of sessions, or support did not affect efficacy. From a healthcare provider perspective, oCBT tended to show greater costs with greater benefits in the short term, relative to comparator treatments. Although efficacious, further economic evidence is required to support the provision of oCBT as a cost-effective treatment for depression. Economic evaluations that incorporate a societal perspective will better account for direct and indirect treatment costs. Nevertheless, oCBT shows promise of effectively improving depressive symptoms, considering limited mental healthcare resources.",29145746,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.421927452087402,-2.893216371536255,BUE3
"[Evaluation of behavioral and cognitive therapy in depression].

Many psychotherapeutic approaches have been developed for depression, among which behavioral and cognitive therapies have shown their effectiveness. These short-term therapies quickly improve symptoms and reduce the relapse rate by around 30%. This article reviews the main studies of behavioral and cognitive therapy in depressed patients. The results are discussed in terms of acceptability, feasibility, and efficacy. The study protocols, psychiatric symptoms, and endpoints are described. There is now a need to identify which patients are most likely to respond to these treatments.",21171253,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.978071212768555,-2.515652656555176,DCDy
"Randomized controlled trial of computerized cognitive behavioural therapy for depressive symptoms: effectiveness and costs of a workplace intervention.

Depression and anxiety are major causes of absence from work and underperformance in the workplace. Cognitive behavioural therapy (CBT) can be effective in treating such problems and online versions offer many practical advantages. The aim of the study was to investigate the effectiveness of a computerized CBT intervention (MoodGYM) in a workplace context. The study was a phase III two-arm, parallel randomized controlled trial whose main outcome was total score on the Work and Social Adjustment Scale (WSAS). Depression, anxiety, psychological functioning, costs and acceptability of the online process were also measured. Most data were collected online for 637 participants at baseline, 359 at 6 weeks marking the end of the intervention and 251 participants at 12 weeks post-baseline. In both experimental and control groups depression scores improved over 6 weeks but attrition was high. There was no evidence for a difference in the average treatment effect of MoodGYM on the WSAS, nor for a difference in any of the secondary outcomes. This study found no evidence that MoodGYM was superior to informational websites in terms of psychological outcomes or service use, although improvement to subthreshold levels of depression was seen in nearly half the patients in both groups.",23795621,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.742901802062988,-3.137427806854248,CcRg
"Early interventions in cognitive behavioral therapy for depression: A study contrasting a low-adherent and a highly adherent case.

In cognitive behavioral therapy for depression, the first sessions play a crucial role in determining treatment outcome. In the first sessions, the therapist needs to form an alliance to facilitate application of the techniques; agree with the patient on problem definition, problem solution, and goals; explain the rationale; and create confidence in therapy by producing early symptom relief. This article illustrates the cognitive behavioral therapy treatment process of two depressed clients: one for whom the treatment manual was followed neatly and one for whom the therapist chose not to adhere to the manual strictly. Both had a comparable end result in terms of symptom change and alliance scores. The existing literature shows evidence for starting off with behavioral techniques, supported by assigning and reviewing homework, structuring sessions, and negotiating goals. The cases also illustrate that there are circumstances, such as urgent financial problems, in which the therapists may need to leave the treatment manual early in the therapy process, albeit temporarily. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",30816762,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.591361045837402,-3.300729751586914,A+LK
"Inpatient treatment decreases depression but antidepressants may not contribute. A prospective quasi-experimental study.

The aim of the study is the evaluation of psychiatric-psychotherapeutic inpatient treatment utilizing a naturalistic design. In a sample of 574 consecutively admitted patients, depression (64.5%), personality disorders (19.5%), schizophrenia (4.2%), bipolar disorder (3.3%), obsessive-compulsive disorder (2.3%) or other mental disorders (6.4%) were diagnosed. All patients were treated with psychotherapy, most with antidepressants. Depression was measured using the Beck Depression Inventory-II (BDI-II). 180 patients formed a waiting list control group. The regularly discharged patients (N = 489) were asked to participate in a six-month follow-up, with 62.6% taking part. From the time of admission to discharge, there was a strong decline in depression (31.5 vs. 13.2 points on the BDI-II), as well as from admission to follow-up (31.2 vs. 18.3 points). In the control group, there was a weak symptom decline (34.6 vs. 32.1 points) until admission, which was independent of the waiting period duration. For the success of treatment, it did not matter whether the patients received antidepressants. In the follow-up, 81.0% of patients retrospectively considered psychotherapy to be important for treatment outcome, only 2.3% considered medications to be important. Psychiatric inpatient treatment reduces depression significantly at discharge and follow-up; the decrease in depression is rather due to psychotherapy than to antidepressants.",31518849,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,10.702027320861816,-3.0661401748657227,A0r0
"The influence of individual, group, and relative self-esteem on outcome for patients undergoing group cognitive-behavioural therapy treatment.

Despite a strong association between individual self-esteem and treatment outcome in group cognitive-behavioural therapy (GCBT), no study has investigated how patient outcomes might be influenced by an individual's self-esteem relative to other group members. The study comprised a retrospective examination of patients' data and used a multiple regression analysis to identify predictors of treatment outcome. Patients' pre-treatment self-esteem scores were assessed on a continuum and assigned to be low, medium, or high. Therapy groups were assigned to be either low, balanced or high self-esteem groups based on averaged self-esteem scores of participants. In this study, 3,878 patients who had completed a 10-day intensive cognitive behavioural group therapy programme at a private psychiatric facility were included in the study. The Rosenberg Self-Esteem measure was chosen to assess self-esteem. The three subscales of the Depression Anxiety Stress Scales were used as the outcome measures. Patient outcomes were influenced by pre-treatment self-esteem scores, such that higher initial self-esteem was associated with better treatment outcomes. Low group self-esteem was predictive of significantly better outcomes for depression, relative to higher self-esteem groups. Additionally, the combined influence of high individual self-esteem and low group self-esteem was associated with significantly enhanced depression improvement. High self-esteem patients perform better on outcome measures following completion of GCBT. Low self-esteem groups show greater improvement in depression symptoms. Similar results for depression are achieved when patients with high self-esteem complete treatment in low self-esteem groups.",24117916,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.208568572998047,-2.9509429931640625,CXhd
"Modelling the cost-effectiveness of pharmacotherapy compared with cognitive-behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK.

The National Institute of Health and Care Excellence (NICE) in England and Wales recommends the combination of pharmacotherapy and psychotherapy for the treatment of moderate to severe depression. However, the cost-effectiveness analysis on which these recommendations are based has not included psychotherapy as monotherapy as a potential option. For this reason, we aimed to update, augment and refine the existing economic evaluation. We constructed a decision analytic model with a 27-month time horizon. We compared pharmacotherapy with cognitive-behavioural therapy (CBT) and combination treatment for moderate to severe depression in secondary care from a healthcare service perspective. We reviewed the literature to identify relevant evidence and, where possible, synthesized evidence from clinical trials in a meta-analysis to inform model parameters. The model suggested that CBT as monotherapy was most likely to be the most cost-effective treatment option above a threshold of £ 22,000 per quality-adjusted life year (QALY). It dominated combination treatment and had an incremental cost-effectiveness ratio of £ 20,039 per QALY compared with pharmacotherapy. There was significant decision uncertainty in the probabilistic and deterministic sensitivity analyses. Contrary to previous NICE guidance, the results indicated that even for those patients for whom pharmacotherapy is acceptable, CBT as monotherapy may be a cost-effective treatment option. However, this conclusion was based on a limited evidence base, particularly for combination treatment. In addition, this evidence cannot easily be transferred to a primary care setting.",26040631,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.750930786132812,-2.7010178565979004,B8yj
"The power of belief and expectancy in understanding and management of depression.

This article examines how beliefs can influence the definition, classification, understanding, and treatment of depression. It is organized in five parts: The first part critically reviews the definition of depression; the second part explores the medicalization of depression; the third part examines the role of the pharmaceutical industry in the promotion and marketing of antidepressant medications; the fourth part surveys the psychological therapies for depression and examines the role of expectancy in outcome; and the last part looks at the mechanisms involved in the placebo effect. A list of evidence-based strategies, including hypnosis, are discussed in the context of cognitive hypnotherapy for depression to illustrate how expectancy effect can be maximized in psychotherapy.",23488252,Major Depressive Disorder,Anxiety Treatment,Mental Health,13735,10.620796203613281,-2.6050846576690674,Cgtt
"Effects, Adherence, and Therapists' Perceptions of Web- and Mobile-Supported Group Therapy for Depression: Mixed-Methods Study.

Blended group therapy (bGT) has been investigated a several times for anxiety and depression, but information on patients' adherence to and therapists' perception of the novel format is nonexistent. Furthermore, many studies investigated mainly female and highly educated populations, limiting the validity of previous findings. This study aimed to reduce the gaps and limitations of the previous findings by evaluating an integrated internet- and mobile-supported bGT format. A total of 27 patients diagnosed with major depression (14/27, 52% female and 7/27, 25.9% compulsory education) participated in a 7-week treatment at a university outpatient clinic. Furthermore, 8 novice therapists participated in semistructured interviews and a subsequent cross-validation survey. Primary symptom reduction was high (d=1.31 to 1.51) and remained stable for the follow-up period. Therapists identified advantages (eg, patient engagement, treatment intensification, and improved therapeutic relation) and disadvantages (eg, increased workload, data issues, and undesired effects) of bGT. The required online guidance time was 10.3 min per patient and week, including guidance on exercises (67% or 6.9 min) and intimate communication (33% or 3.4 min). Concerning patients' adherence to bGT, tracked completion of all Web-based and mobile tasks was high and comparable with group attendance. Results suggest high feasibility of bGT in a gender-balanced, moderately educated sample. bGT provides group therapists with tools for individual care, resulting in an optimization of the therapy process, and high completion rates of the implemented bGT elements. The limited work experience of the involved therapists restricts the study findings, and potential drawbacks need to be regarded in the development of future bGT interventions.",31066700,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.397969245910645,-2.925522565841675,A6z3
"Short-Term Psychodynamic Psychotherapy for Depression: For Whom Does It Work? A Research Perspective.

Short-term psychodynamic psychotherapy (STPP) is an empirically supported treatment for depression that is frequently applied in clinical practice. However, it remains largely unclear which patients can benefit specifically from STPP for depression, because studies often have small sample sizes and, therefore, lack statistical power to examine patient characteristics associated with differential treatment efficacy. Individual participant data (IPD) meta-analyses, which combine patient-level data from multiple studies, can help overcome this obstacle. Currently, the first IPD meta-analysis project regarding STPP for depression is being conducted. We describe this project, its progress, and first findings.",34478326,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.167680740356445,-4.284844875335693,AQ5v
"Cognitive-behavioral therapy for treatment-resistant depression in adults and adolescents: a systematic review.

To conduct a systematic review of literature on use and efficacy of cognitive-behavioral therapy (CBT) for treatment of treatment-resistant depression in adults and adolescents. We performed a systematic review according to the Prisma Guidelines of literature indexed on the PubMed, SciELO, Psychiatry Online, Scopus, PsycArticles, Science Direct and the Journal of Medical Case Reports databases. Randomized controlled trials, open studies and case reports were included in the review. The searches returned a total of 1,580 articles, published from 1985 to 2017. After applying the inclusion criteria, 17 articles were selected, their complete texts were read and 8 were included in this review. Four of these studies were randomized controlled trials with adults, one of which covered a post-study follow-up period; two were randomized controlled trials with adolescents, one of which presented follow-up data; one was an open study; and one was a case report. The studies provide good quality and robust evidence on the topic addressed. A combination of CBT with pharmacotherapy for treatment-resistant patients shows a decrease in depressive symptoms. CBT can be an effective type of therapy for adults and adolescents with treatment-resistant depression.",32130308,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.863739967346191,-2.5487592220306396,Asc0
"Immediate help through group therapy for patients with somatic diseases and depressive or adjustment disorders in outpatient care: study protocol for a randomized controlled trial.

One in three people with a chronic somatic disease suffer from a comorbid mental disorder. Most common comorbidities are depressive, anxiety and adjustment disorders. These lead to an increase in morbidity and mortality, and a deterioration of quality of life and healthcare costs. Treatment of mental disorders is of great importance, but the waiting time for outpatient individual psychotherapy can be up to six months in Germany. Group therapy has comparable treatment effects and is considerably more economic than individual therapy; however, it is still almost unused in the outpatient care system. The introduction of a stepped care approach, such as attending a group program before individual therapy, could improve this issue. For this purpose we developed a group program (STEpS), and its efficacy will be evaluated in this study. A randomized controlled trial will be conducted to evaluate the efficacy of a cognitive behavioral therapy (CBT) group program for patients with somatic diseases and depressive or adjustment disorders, compared to a wait-list control group. A total of 128 adults with any chronic somatic disease and comorbid depression or adjustment disorder will be recruited in our outpatient clinic, and will be randomly assigned to participate in the group program immediately after contacting the clinic (intervention group) or after a waiting period of four months (wait-list control group). Primary outcomes will be self-reported depressive and anxiety symptoms. Secondary outcomes will be self-reported psychological distress, changes in experience and behavior, health-related quality of life, state of self-esteem and subjective need for therapy. Assessments will take place at baseline, 10 weeks (post-treatment) and 18 weeks (follow-up) after randomization. Additionally, treatment acceptance and psychotherapeutic process will be assessed after each session. This study investigates whether the CBT group program is an effective treatment to reduce depressive and anxiety symptoms and psychological distress in these patients. If the group program is effective, it could be implemented as a treatment option prior to individual outpatient therapy. These results will contribute to improving outpatient care for mental disorders in patients with somatic diseases. German Clinical Trials Register DRKS00005140 (27 August 2013).",26116561,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.897398948669434,-2.2342331409454346,B7su
"Moderators of continuation phase cognitive therapy's effects on relapse, recurrence, remission, and recovery from depression.

About half of patients who respond to acute-phase cognitive therapy (CT) for major depressive disorder (MDD) will relapse/recur within 2 years; continuation-phase CT lowers this risk. We analyzed demographic, clinical, cognitive, social-interpersonal, and personality variables to clarify which patients continuation-phase CT helps to avoid relapse and recurrence and achieve remission and recovery. Participants had recurrent MDD, responded to acute-phase CT, were randomized to 8 months of continuation-phase CT (n = 41) or assessment control (n = 43), and were assessed 16 additional months (Jarrett et al., 2001). Consistent with an underlying risk-reduction model, continuation-phase CT was helpful for responders to acute-phase CT with greater risk and/or dysfunction as follows: Younger patients with earlier MDD onset who displayed greater dysfunctional attitudes and lower self-efficacy; personality traits suggesting low positive activation (e.g., reduced energy, enthusiasm, gregariousness); and transiently elevated depressive symptoms late in acute-phase CT and residual symptoms after acute-phase CT response. We emphasize the need for replication of these results before clinical application.",20163785,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.801544189453125,-0.8860767483711243,DNtl
"Problem-solving intervention to prevent depression in non-professional caregivers: a randomized controlled trial with 8 years of follow-up.

Studies of psychological interventions for the prevention of depression have found significant effects in the short-term, but the long-term efficacy has yet to be determined. This study evaluated the 8-year effect of a randomized controlled trial for indicated prevention of depression in female caregivers. A total of 173 non-professional female caregivers with subclinical depressive symptoms not meeting criteria for a major depressive episode (MDE) were randomized to either a brief problem-solving intervention (n = 89) or usual-care control group (n = 84). Blinded evaluators conducted an assessment at the 8-year follow-up. The primary outcome was Depression Status, defined by diagnoses of MDE since the 1-year follow-up using the Structured Clinical Interview for the Disorders of the DSM-5. The secondary outcome was current Depressive Symptom Severity. Regression analyses were conducted to evaluate the effect of the intervention on the outcomes. There were no significant differences in the Depression Status between the problem-solving (30.3%) and control groups (26.2%) (adjusted OR 1.25, 95% CI -0.58 to 2.69). Depressive Symptom Severity, however, was significantly lower in the problem-solving group compared to the control group at this follow-up, amounting to a small effect size of Cohen's d = 0.39 (adjusted B = -3.32, p = 0.018). This is the first study to assess such a long-term follow-up of intervention of indicated prevention of depression. Results seem to indicate that the protective effect of the intervention became smaller over time during follow-up. Future research should replicate these results.",31017076,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,10.78741455078125,-2.1555376052856445,A7dW
"Guided self-help concreteness training as an intervention for major depression in primary care: a Phase II randomized controlled trial.

The development of widely accessible, effective psychological interventions for depression is a priority. This randomized trial provides the first controlled data on an innovative cognitive bias modification (CBM) training guided self-help intervention for depression. One hundred and twenty-one consecutively recruited participants meeting criteria for current major depression were randomly allocated to treatment as usual (TAU) or to TAU plus concreteness training (CNT) guided self-help or to TAU plus relaxation training (RT) guided self-help. CNT involved repeated practice at mental exercises designed to switch patients from an unhelpful abstract thinking habit to a helpful concrete thinking habit, thereby targeting depressogenic cognitive processes (rumination, overgeneralization). The addition of CNT to TAU significantly improved depressive symptoms at post-treatment [mean difference on the Hamilton Rating Scale for Depression (HAMD) 4.28, 95% confidence interval (CI) 1.29-7.26], 3- and 6-month follow-ups, and for rumination and overgeneralization post-treatment. There was no difference in the reduction of symptoms between CNT and RT (mean difference on the HAMD 1.98, 95% CI -1.14 to 5.11), although CNT significantly reduced rumination and overgeneralization relative to RT post-treatment, suggesting a specific benefit on these cognitive processes. This study provides preliminary evidence that CNT guided self-help may be a useful addition to TAU in treating major depression in primary care, although the effect was not significantly different from an existing active treatment (RT) matched for structural and common factors. Because of its relative brevity and distinct format, it may have value as an additional innovative approach to increase the accessibility of treatment choices for depression.",22085757,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,10.934492111206055,-2.503803014755249,C09k
"Do scores on the Beck Depression Inventory-II predict outcome in cognitive processing therapy?

Current treatment guidelines for posttraumatic stress disorder (PTSD) recognize that severe depression may limit the effectiveness of trauma-focused interventions, making it necessary to address depression symptomatology first. However, there is a paucity of research providing specific treatment recommendations using a common depression measure like the Beck Depression Inventory-II (BDI-II). Accordingly, we examined the utility of using BDI-II cutoff scores for predicting response to cognitive processing therapy (CPT). Our sample was 757 military veterans receiving outpatient therapy at a Department of Veterans Affairs specialty clinic. At baseline, the majority of participants (58.9%) reported BDI-II scores suggestive of severe depression, and 459 (60.7%) met DSM-IV diagnostic criteria for major depressive disorder (MDD). Despite this high level of depression severity, most participants who completed therapy experienced a clinically significant reduction in symptoms (75.1%). No differences were observed across BDI-II groups on rates of clinically significant change in PTSD symptoms or on rates of treatment completion. Taken together, results suggest that CPT is an effective treatment, even in cases of severe co-occurring depression. Limitations and implications for treatment guidelines are discussed.",26010112,Major Depressive Disorder,Anxiety Treatment,Mental Health,3392,10.194854736328125,-1.2067062854766846,B9PN
"Metacognitive therapy and work-focused interventions for patients on sick leave due to anxiety and depression: study protocol for a randomised controlled wait-list trial.

Common mental disorders such as depression and anxiety are major contributors to the global burden of disease. Affected individuals suffer reduced quality of life, impaired functioning and reduced capacity to work. Maintaining employment is an important determinant for health and wellbeing, and the economic impact of depression and anxiety is a significant societal expense. Treatments providing effective symptom reduction and helping patients return to work (RTW) would thus have substantial public health benefits. The present study will explore the effectiveness of metacognitive therapy (MCT) and work-focused interventions on reducing symptoms and increasing RTW rates for patients on sick leave due to depression and anxiety. The study is a randomised controlled wait-list trial (RCT; N = 240). The intervention group will receive protocol-based MCT and work-focused interventions immediately after inclusion. The control condition is a wait-list control group. All patients will receive up to 12 weekly sessions. The study context is a Norwegian outpatient clinic part of a national programme aimed at reducing sick leave. The co-primary outcomes are change in RTW and symptoms of depression and anxiety at the end of treatment. In addition to self-report, sick leave will also be collected from national registries from 2 years prior to intervention to 4 years after intervention. Symptoms of scores will be collected by self-report at pre- and post-treatment and at 6 and 12 months follow-up after treatment. A cost-effectiveness analysis will use total cost and quality-adjusted life-years as the secondary outcomes. There is broad consensus on the importance of identifying treatment that effectively reduces depression and anxiety symptoms and aids RTW. This study is an important contribution to the field as it is the first RCT on MCT and work-focused interventions for patients on sick leave due to anxiety and depression. ClinicalTrials.gov NCT03301922 . Registered on October 4, 2017.",34838125,Major Depressive Disorder,Anxiety Treatment,Mental Health,2307,9.04265308380127,-4.099340438842773,0vw
"Positivity pays off: Clients' perspectives on positive compared with traditional cognitive behavioral therapy for depression.

[Correction Notice: An Erratum for this article was reported in Vol 57(3) of Psychotherapy (see record 2020-64984-001). In the article ""Positivity Pays Off: Clients' Perspectives on Positive Compared With Traditional Cognitive Behavioral Therapy for Depression"" by Nicole Geschwind, Emke Bosgraaf, Fredrike Bannink, and Frenk Peeters (Psychotherapy. Advance online publication. February 20, 2020. http://dx.doi.org/10.1037/pst0000288), the second to last sentence does not appear correctly and should appear instead as follows: The conclusion emerging from this study is that exploring better moments and building positivity efficiently counters depressive symptoms and builds well-being.] In this qualitative study, we explored the experiences of clients receiving cognitive behavioral therapy (CBT) for major depressive disorder. All participants received 8 sessions of traditional CBT (based on Beck, Rush, Shaw, & Emergy, 1979) and 8 sessions of positive CBT (order counterbalanced). The aim of the study was to examine clients' experience of positive CBT and to contrast this with their experience of traditional CBT. Positive CBT structurally and selectively focuses on better moments (exceptions to the problem as opposed to the problem), strengths, and positive emotions and integrates traditional CBT with solution-focused brief therapy and positive psychology. In addition to conducting interviews with 12 individuals, the second author attended all therapy sessions of 4 clients and observed biweekly supervision sessions as further methods of data collection. Qualitative analysis showed that, despite initial skepticism, clients preferred positive CBT and indicated experiencing a steeper learning curve during positive, compared with traditional, CBT for depression. The popularity of positive CBT was attributable to 4 influences: feeling good and empowered, benefitting from upward spiral effects of positive emotions, learning to appreciate baby steps, and (re)discovering optimism as a personal strength. Qualitative analysis showed that, despite better moments and building positivity efficiently counters depressive symptoms and builds well-being. Clients perceived positive CBT's upbeat tone as stimulating and as motivating for change. (PsycInfo Database Record (c) 2020 APA, all rights reserved).",32077710,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.00440502166748,-3.1629438400268555,AtFx
"Beliefs about the causes of depression and recovery and their impact on adherence, dosage, and successful tapering of antidepressants.

Continuation of antidepressant medication (ADM) after remission is widely used to prevent depressive relapse/recurrence. Little is known about predictors of ADM use in terms of adherence, dosage, and successful tapering. The current study aimed to explore beliefs about the causes of depression and recovery (i.e., causal beliefs) and to examine whether they predict ADM use. The data were drawn from a controlled trial and an extension of this trial with additional experience sampling. In total, 289 remitted patients with recurrent depression (ADM ≥ 6 months) were randomly assigned to Preventive Cognitive Therapy (PCT) with ADM tapering, PCT with maintenance ADM, or maintenance ADM alone. Adherence, ADM dosage, and causal beliefs regarding the first and last depressive episodes were explored via questionnaires. Most patients mentioned stressful life events as cause of depression, although more patients tended to endorse external causes for the first episode and internal causes for the last episode. ADM was most often mentioned as helpful during recovery from both episodes. Over half of all patients were adherent and under half of the patients in the tapering condition were able to complete the taper. Causal beliefs did not predict ADM use. The results suggest that causal beliefs play little role in the use of maintenance ADM. More information is needed on factors contributing to successful tapering. The results must be interpreted with caution as this is not a naturalistic study and the results might be biased toward a more favorable view regarding ADM.",28102582,Major Depressive Disorder,Anxiety Treatment,Mental Health,4928,9.587109565734863,-0.8091738820075989,Bh/b
"Effectiveness and cost-effectiveness of a guided Internet- and mobile-based intervention for the indicated prevention of major depression in patients with chronic back pain-study protocol of the PROD-BP multicenter pragmatic RCT.

Reducing the disease burden of major depressive disorder (MDD) is of major public health relevance. The prevention of depression is regarded as one possible approach to reach this goal. People with multiple risk factors for MDD such as chronic back pain and subthreshold depressive symptoms may benefit most from preventive measures. The Internet as intervention setting allows for scaling up preventive interventions on a public mental health level. This study is a multicenter pragmatic randomized controlled trial (RCT) of parallel design aiming to investigate the (cost-) effectiveness of an Internet- and mobile-based intervention (IMI) for the prevention of depression in chronic back pain patients (PROD-BP) with subthreshold depressive symptoms. eSano BackCare-DP is a guided, chronic back pain-specific depression prevention intervention based on cognitive behavioral therapy (CBT) principles comprising six weekly plus three optional modules and two booster sessions after completion of the intervention. Trained psychologists provide guidance by sending feedback messages after each module. A total of 406 patients with chronic back pain and without a depressive disorder at baseline will be recruited following orthopedic rehabilitation care and allocated to either intervention or treatment-as-usual (TAU). Primary patient-relevant endpoint of the trial is the time to onset of MDD measured by the telephone-administered Structured Clinical Interview for DSM (SCID) at baseline and 1-year post-randomization. Key secondary outcomes are health-related quality of life, depression severity, pain intensity, pain-related disability, ability to work, intervention satisfaction and adherence as well as side effects of the intervention. Online assessments take place at baseline and 9 weeks as well as 6 and 12 months post-randomization. Cox regression survival analysis will be conducted to estimate hazard ratio at 12-month follow-up. Moreover, an economic analysis will be conducted from a societal and public health perspective. This is the first study examining an IMI for depression prevention in a sample of chronic pain patients. If this implementation of a depression prevention IMI into orthopedic aftercare proves effective, the intervention could be integrated into routine care with minimal costs and extended for use with other chronic diseases. Results will have implications for researchers, health care providers and public health policy makers. The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (DRKS): DRKS00007960 . Registered 12 August 2015.",28109247,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.898174285888672,-2.2193944454193115,Bh4+
"Comparative efficacy and durability of continuation phase cognitive therapy for preventing recurrent depression: design of a double-blinded, fluoxetine- and pill placebo-controlled, randomized trial with 2-year follow-up.

Major Depressive Disorder (MDD) is highly prevalent and associated with disability and chronicity. Although cognitive therapy (CT) is an effective short-term treatment for MDD, a significant proportion of responders subsequently suffer relapses or recurrences. This design prospectively evaluates: 1) a method to discriminate CT-treated responders at lower vs. higher risk for relapse; and 2) the subsequent durability of 8-month continuation phase therapies in randomized higher risk responders followed for an additional 24 months. The primary prediction is: after protocol treatments are stopped, higher risk patients randomly assigned to continuation phase CT (C-CT) will have a lower risk of relapse/recurrence than those randomized to fluoxetine (FLX). Outpatients, aged 18 to 70 years, with recurrent MDD received 12-14 weeks of CT provided by 15 experienced therapists from two sites. Responders (i.e., no MDD and 17-item Hamilton Rating Scale for Depression <or=12) were stratified into higher and lower risk groups based on stability of remission during the last 6 weeks of CT. The lower risk group entered follow-up for 32 months; the higher risk group was randomized to 8 months of continuation phase therapy with either C-CT or clinical management plus either double-blinded FLX or pill placebo. Following the continuation phase, higher risk patients were followed by blinded evaluators for 24 months. The trial began in 2000. Enrollment is complete (n=523). The follow-up continues. The trial evaluates the preventive effects and durability of acute and continuation phase treatments in the largest known sample of CT responders collected worldwide.",20451668,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.707114219665527,-1.078640341758728,DKwJ
"Personalized medicine for depression: can we match patients with treatments?

Response to specific depression treatments varies widely among individuals. Understanding and predicting that variation could have great benefits for people living with depression. The authors describe a conceptual model for identifying and evaluating evidence relevant to personalizing treatment for depression. They review evidence related to three specific treatment decisions: choice between antidepressant medication and psychotherapy, selection of a specific antidepressant medication, and selection of a specific psychotherapy. They then discuss potential explanations for negative findings as well as implications for research and clinical practice. Many previous studies have examined general predictors of outcome, but few have examined true moderators (predictors of differential response to alternative treatments). The limited evidence indicates that some specific clinical characteristics may inform the choice between antidepressant medication and psychotherapy and the choice of specific antidepressant medication. Research to date does not identify any biologic or genetic predictors of sufficient clinical utility to inform the choice between medication and psychotherapy, the selection of specific medication, or the selection of a specific psychotherapy. While individuals vary widely in response to specific depression treatments, the variability remains largely unpredictable. Future research should focus on identifying true moderator effects and should consider how response to treatments varies across episodes. At this time, our inability to match patients with treatments implies that systematic follow-up assessment and adjustment of treatment are more important than initial treatment selection.",20843873,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.139500617980957,-1.4755380153656006,DFsX
"Psychodynamic technique early in treatment related to outcome for depressed patients.

We examined the relationship between psychodynamic techniques early in treatment with reliable change in depressive symptomatology. Forty-six patients admitted for individual psychodynamic psychotherapy who received a diagnosis representative of a depressive spectrum disorder were assessed pretreatment and posttreatment through self-report of depressive symptoms. Videotapes from two early treatment sessions (3rd and 9th) were independently rated on the Comparative Psychotherapy Process Scale for use of psychodynamic-interpersonal and cognitive-behavioural techniques, with excellent interrater reliability (intraclass correlation coefficient > .75). We found a significant relationship between overall use of psychodynamic technique across early treatment (r = .31, p = .036), as well as specific psychodynamic techniques delivered across early treatment, with change in patient-reported depressive symptoms. Our findings suggest that focusing on affective experiencing and expression, as well as providing interpretations are particularly helpful early in psychodynamic treatment for depression. Clinical implications and future directions are discussed.",29277973,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.990038871765137,-4.327809810638428,BSPk
"Effects of nonpharmacological interventions on depressive symptoms and depression among nursing students: A systematic review and meta-analysis.

We aim to examine whether nonpharmacological interventions could effectively improve depressive symptoms and depression to provide more treatment options for nursing students. PubMed, the Cochrane Library, EMBase, Web of Science, PsycINFO, and three Chinese electronic databases were comprehensively searched for papers that were published from January 1990 through March 2018. Quality assessment, sensitivity analysis and heterogeneity were performed. In our review, 13 controlled trials met the inclusion criteria. The meta-analysis indicated that the depressive symptoms and depression of nursing students in the intervention groups showed significantly moderate improvements compared with the control groups. Three subgroup analyses showed that mindfulness interventions and stress management programs were common and effective, short-term interventions were beneficial to depression, nonpharmacological interventions had great improvements for Asian nursing students and more rigorous researches on methodological quality are recommended. Nonpharmacological interventions can serve as promising complementary and alternative approaches in reducing the depressive symptoms and depression of nursing students.",30712730,Major Depressive Disorder,Anxiety Treatment,Mental Health,4226,8.838383674621582,-1.1322154998779297,A/et
"Effectiveness of psychological treatments for depressive disorders in primary care: systematic review and meta-analysis.

We performed a systematic review of the currently available evidence on whether psychological treatments are effective for treating depressed primary care patients in comparison with usual care or placebo, taking the type of therapy and its delivery mode into account. Randomized controlled trials comparing a psychological treatment with a usual care or a placebo control in adult, depressed, primary care patients were identified by searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO up to December 2013. At least 2 reviewers extracted information from included studies and assessed the risk of bias. Random effects meta-analyses were performed using posttreatment depression scores as outcome. A total of 30 studies with 5,159 patients met the inclusion criteria. Compared with control, the effect (standardized mean difference) at completion of treatment was -0.30 (95% CI, -0.48 to -0.13) for face-to-face cognitive behavioral therapy (CBT), -0.14 (-0.40 to 0.12) for face-to-face problem-solving therapy, -0.24 (-0.47 to -0.02) for face-to-face interpersonal psychotherapy, -0.28 (-0.44 to -0.12) for other face-to-face psychological interventions, -0.43 (-0.62 to -0.24) for remote therapist-led CBT, -0.56 (-1.57 to 0.45) for remote therapist-led problem-solving therapy, -0.40 (-0.69 to -0.11) for guided self-help CBT, and -0.27 (-0.44 to -0.10) for no or minimal contact CBT. There is evidence that psychological treatments are effective in depressed primary care patients. For CBT approaches, substantial evidence suggests that interventions that are less resource intensive might have effects similar to more intense treatments.",25583894,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.461379051208496,-2.499769687652588,CDSY
"Cognitive-behavioral group therapy in major depressive disorder with focus on self-esteem and optimism: an interventional study.

Major depressive disorder is a common psychological condition that can lead to negative individual and social consequences, the management of which is very important in treating the patients. The present study aimed to determine the effect of cognitive-behavioral group therapy on self-esteem and optimism in patients with major depressive disorder. This is a single-blinded, randomized controlled trial in which a total of 64 patients with major depressive disorder were recruited using convenience sampling and then randomly assigned to two groups of Cognitive-Behavioral Group Therapy (CBGT) and Treatment-As-Usual (TAU). Data collection tools consisted of a demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Revised Life Orientation Test (LOT-R). In the pretest stage, participants in both groups completed the above questionnaires before the intervention. Patients in the CBGT group received eight 90-min sessions of cognitive-behavioral therapy during four weeks (two sessions a week). Then participants re-completed RSES and LOT-R immediately, three months, and six months after the intervention. Data were analyzed with SPSS software version 16.0 using chi-squared test, independent-samples t-test, and repeated measures Analysis of Variance. The significance level (p-value) was considered to be less than 0.05. It was indicated that there was a statistically significant difference in the mean scores of self-esteem and optimism between the two groups immediately, three months, and six months after the intervention (p<.05). The mean scores of self-esteem and optimism in the CBGT group increased significantly after the intervention compared to before it, although these scores gradually decreased over the three measurement time points after the intervention. Based upon the results, it was concluded that the level of optimism and self-esteem increased significantly in the CBGT group after the intervention, although the levels of the above variables dropped again in the long run after the intervention due to the discontinuity of CBGT sessions. Therefore, it is necessary to take particular measures to regularly hold the sessions of CBGT for patients with major depressive disorder. IRCT20140212016564N15 , The date of registration: 20-09-2021, Retrospectively registered.",35484528,Major Depressive Disorder,Anxiety Treatment,Mental Health,14949,11.303792953491211,-2.7236545085906982,bPA
"Do guided internet-based interventions result in clinically relevant changes for patients with depression? An individual participant data meta-analysis.

Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients' groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving internet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.",29940401,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.123846054077148,-3.3090415000915527,BJ3U
"Internet-Based Psychotherapy for Adult Depression: What About the Mechanisms of Change?

Internet-based cognitive behavioral therapy for depression (iCBT) has been advanced as a valuable alternative treatment option, generating promising results. However, little is known about its underlying mechanisms of change. We aimed to provide an overview of the state of the art regarding the mechanisms of iCBT for adult depression, in the context of iCBT efficacy. We conducted a systematic qualitative review of 37 randomized clinical trials, assessed the risk of bias in the included studies, and used a systematic evaluative framework to establish the scientific status of iCBT, based on evidence regarding clinical efficacy and mechanisms of change. Findings indicated that iCBT mechanisms of change are clearly underinvestigated, although iCBT is relatively efficacious, at least in the short term. The quality of iCBT randomized clinical trials proved to be suboptimal. The iCBT theory should be clearly specified and adequately investigated to design and implement highly efficacious therapeutic packages. Without considering the iCBT mechanisms of change along with iCBT efficacy, the extent to which iCBT is an empirically validated treatment remains questionable.",27684405,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.979165077209473,-2.8689582347869873,BmrD
"Guided or self-guided internet-based cognitive-behavioural therapy (iCBT) for depression? Study protocol of an individual participant data network meta-analysis.

Although guided forms of internet-based cognitive-behavioural therapy (iCBT) result in a substantial reduction in depression, it seems that the most scalable way to deliver iCBT is without guidance. However, direct evidence on the comparison between guided and self-guided iCBT is scarce. Moreover, it is unclear which types of patients may benefit more from each of these two forms of iCBT. Network meta-analysis (NMA) using individual participant data (IPD) offers a way to assess the relative efficacy of multiple (>2) interventions. Moreover, it maximises our power to detect patient-level characteristics (covariates) that have an important effect on the efficacy of interventions. This protocol describes the procedures of an IPD-NMA, which aims at examining the relative efficacy of guided compared with self-guided iCBT and at identifying predictors and moderators of treatment outcome. We will use an existing database on psychotherapies for adult depression to identify eligible studies. This database has been updated up to 1 January 2018, through literature searches in PubMed, Embase, PsycINFO and Cochrane Library. The outcome of this IPD-NMA is reduction in depressive symptoms severity. We will fit the model in a Bayesian setting. After fitting the model, we will report the relative treatment effects for different types of patients, and we will discuss the clinical implications of our findings. Based on the results from the IPD-NMA model, we will develop and validate a personalised prediction model, aiming to provide patient-level predictions about the effects of the interventions. An ethical approval is not required for this study. The results will be published in a peer-review journal. These results will guide clinical decisions about the most efficient way to allocate iCBT resources, thereby increasing the scalability of this innovative therapeutic approach.",31171550,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.83795166015625,-2.9021711349487305,A5WH
"Evaluation of a cognitive behavioural self-help manual for reducing depression: a randomized controlled trial.

The prevalence of depression is increasing in Thailand. We used a randomized controlled trial to examine the effectiveness of a self-help programme in reducing depression in people with depression in Chiang Mai Province in Thailand. Fifty-six individuals diagnosed with moderate depression participated. They were assigned randomly to an intervention (n= 27) or control (n= 29) group. The intervention group were given a self-help manual along with standard care and treatment, while the control group continued to receive standard care and treatment. Both groups were also given a short weekly telephone call. The findings showed statistically significant differences between the groups, and within the intervention group, in their depression levels. Between baseline and post-test, a sharp decrease in depression was evident in the intervention group, whereas the level of depression increased in the control group. Between post-test and follow-up, a decrease was apparent in depression in both groups. However, the intervention group showed a much lower level of depression than the control group. The results support the use of bibliotherapy as an adjunct to mental health nurses' and other professionals' work in caring for people with moderate depression in the community. http://www.ANZCTR.org.au/ACTRN12611000905965.aspx.",22260148,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.805135726928711,-3.4908435344696045,Cyb/
"Behavioural activation treatment for depression in individuals with neurological conditions: a systematic review.

To evaluate the effectiveness of behavioural activation interventions for people with neurological conditions with comorbid depression, and explore content and adaptations. PsycINFO, MEDLINE, CINAHL, AMED, and EMBASE databases were searched on the 19 November 2019. Reference lists of selected full-texts were screened by title. We included peer-reviewed studies published in English that used behavioural activation for treatment of depression in adults with a neurological condition. Single-case reports, reviews, and grey literature were excluded. Methodological quality was assessed by two authors independently, and quality was appraised using Critical Appraisal Skills Programme checklists. From 2714 citations, 10 articles were included comprising 590 participants. Behavioural activation was used to treat depression in people with dementia (n=4), stroke (n=3), epilepsy (n=1), Parkinson's disease (n=1), and brain injury (n=1). Sample size ranged from 4 to 105 participants. There were seven randomized controlled studies; however, no studies compared behavioural activation to an alternative psychological therapy. The effect sizes varied between small and large in the studies where effect size could be calculated (d=0.24-1.7). Methodological quality of the included studies was variable. Intervention components were identifying and engaging in pleasurable activities, psychoeducation, and problem-solving. Adaptations included delivering sessions via telephone, delivering interventions via primary caregivers, and giving psychoeducation to caregivers. The effectiveness of behavioural activation in randomized controlled trials varied from small to large (d=0.24-1.7) in reducing depression. The content of behavioural activation was comparable to established treatment manuals. Adaptations appeared to support individuals to engage in therapy. PROSPERO 2018, CRD42018102604.",31875690,Major Depressive Disorder,Anxiety Treatment,Mental Health,24027,10.415603637695312,-1.8430192470550537,Avv2
"Cognitive Behavioral Analysis System of Psychotherapy versus Escitalopram in Patients with Chronic Depression: Results from a Naturalistic Long-Term Follow-Up.

",28903098,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.213459968566895,-2.164440631866455,BXEd
"Psychological treatment of depressive symptoms in patients with medical disorders: a meta-analysis.

It is widely acknowledged that the prevalence of depression in the general population is high, but that it is even higher for patients with medical disorders. Yet, the effectiveness of psychological treatments in these patient populations has not been firmly established. We conducted a meta-analysis of randomized controlled studies examining the effects of psychological treatments in patients with 1 of 10 different medical disorders and elevated levels of depression. Extensive searches were performed in PubMed, PsycINFO, Embase, and the Cochrane Central Register of Controlled Trials. We included 23 studies. The overall effect size of the 15 studies that compared psychological treatments with a waitlist or care-as-usual control group was d=1.00 [95% confidence interval (CI), 0.57-1.44] but declined to d=0.42 (95% CI, 0.27-0.58) after removing two outliers with extremely high effects. We tested the type of disorder, inclusion based on diagnostic criteria or symptoms, type of treatment, treatment format, type of control group, and intention-to-treat or completers analyses, but none of these variables were significantly associated with the effect. The four studies that compared one type of psychotherapy to another showed a positive effect of cognitive behavioral therapy and interpersonal therapy compared to supportive therapy (d=0.42; 95% CI, 0.14-0.69). There were not enough studies (n=3) to draw any conclusions about the comparison of psychotherapy to pharmacotherapy. We conclude that the effects of psychological treatment of patients with medical disorders are very similar to those found in otherwise healthy patients. Treating this comorbid depression should be one of the priorities in medical care settings.",20630260,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.218567848205566,-2.3974740505218506,DIEA
"Predictors of response to CBT and IPT for depression; the contribution of therapy process.

Little is known about the factors that contribute to a positive psychotherapy outcome. There is still considerable debate as to whether specific factors (e.g. severity of symptoms, comorbidity) or nonspecific factors (e.g. alliance, therapy process) are most important in influencing outcome. This study examined the additional contribution that therapeutic process and alliance made to previously identified specific predictors of response to CBT and IPT for depression over the course of therapy. The previously identified specific factors were belief that childhood reasons caused the depression, recurrent depression, perceptions about how logical therapy was and comorbid personality disorder symptoms. One hundred and sixty five adult outpatients with major depression were treated for depression in a randomised clinical trial examining predictors of response to Cognitive Behavior Therapy and Interpersonal Psychotherapy. All therapy sessions were audiorecorded to enable objective ratings of therapeutic process and alliance. Process factors - patient psychic distress, patient participation and patient alliance had the strongest associations with outcome. The early and middle stage of therapy process did not account for any additional variance other than that previously identified by the patient predictors, however, at the end stage of therapy process contributed a further 14%.",26432173,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.554078102111816,-2.806320905685425,B3Hj
"European Psychiatric Association Guidance on psychotherapy in chronic depression across Europe.

Patients with chronic depression (CD) by definition respond less well to standard forms of psychotherapy and are more likely to be high utilizers of psychiatric resources. Therefore, the aim of this guidance paper is to provide a comprehensive overview of current psychotherapy for CD. The evidence of efficacy is critically reviewed and recommendations for clinical applications and research are given. We performed a systematic literature search to identify studies on psychotherapy in CD, evaluated the retrieved documents and developed evidence tables and recommendations through a consensus process among experts and stakeholders. We developed 5 recommendations which may help providers to select psychotherapeutic treatment options for this patient group. The EPA considers both psychotherapy and pharmacotherapy to be effective in CD and recommends both approaches. The best effect is achieved by combined treatment with psychotherapy and pharmacotherapy, which should therefore be the treatment of choice. The EPA recommends psychotherapy with an interpersonal focus (e.g. the Cognitive Behavioural Analysis System of Psychotherapy [CBASP]) for the treatment of CD and a personalized approach based on the patient's preferences. The DSM-5 nomenclature of persistent depressive disorder (PDD), which includes CD subtypes, has been an important step towards a more differentiated treatment and understanding of these complex affective disorders. Apart from dysthymia, ICD-10 still does not provide a separate entity for a chronic course of depression. The differences between patients with acute episodic depression and those with CD need to be considered in the planning of treatment. Specific psychotherapeutic treatment options are recommended for patients with CD. Patients with chronic forms of depression should be offered tailored psychotherapeutic treatments that address their specific needs and deficits. Combination treatment with psychotherapy and pharmacotherapy is the first-line treatment recommended for CD. More research is needed to develop more effective treatments for CD, especially in the longer term, and to identify which patients benefit from which treatment algorithm.",26854984,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.747756004333496,-1.5857537984848022,BxX3
"Improving confidence for self care in patients with depression and chronic illnesses.

The aim of this study was to examine whether patients who received a multicondition collaborative care intervention for chronic illnesses and depression had greater improvement in self-care knowledge and efficacy, and whether greater knowledge and self-efficacy was positively associated with improved target outcomes. A randomized controlled trial with 214 patients with comorbid depression and poorly controlled diabetes and/or coronary heart disease tested a 12-month team-based intervention that combined self-management support and collaborative care management. At 6 and 12 month outcomes the intervention group showed significant improvements over the usual care group in confidence in ability to follow through with medical regimens important to managing their conditions and to maintain lifestyle changes even during times of stress. Improvements in self care-efficacy were significantly related to improvements in depression, and early improvements in confidence to maintain lifestyle changes even during times of stress explained part of the observed subsequent improvements in depression.",23398269,Major Depressive Disorder,Anxiety Treatment,Mental Health,1185,8.153486251831055,-4.943370819091797,CiFr
"Effectiveness of adjuvant occupational therapy in employees with depression: design of a randomized controlled trial.

Major depressive disorder is among the medical conditions with the highest negative impact on work outcome. However, little is known regarding evidence-based interventions targeting the improvement of work outcomes in depressed employees. In this paper, the design of a randomized controlled trial is presented in order to evaluate the effectiveness of adjuvant occupational therapy in employees with depression. This occupational intervention is based on an earlier intervention, which was designed and proven effective by our research group, and is the only intervention to date that specifically targets work outcome in depressed employees. In a two-arm randomized controlled trial, a total of 117 participants are randomized to either 'care as usual' or ' care as usual' with the addition of occupational therapy. Patients included in the study are employees who are absent from work due to depression for at least 25% of their contract hours, and who have a possibility of returning to their own or a new job. The occupational intervention consists of six individual sessions, eight group sessions and a work-place visit over a 16-week period. By increasing exposure to the working environment, and by stimulating communication between employer and employee, the occupational intervention aims to enhance self-efficacy and the acquisition of more adaptive coping strategies. Assessments take place at baseline, and at 6, 12, and 18-month follow-ups. Primary outcome measure is work participation (hours of absenteeism and time until work resumption). Secondary outcome measures are work functioning, symptomatology, health-related quality of life, and neurocognitive functioning. In addition, cost-effectiveness is evaluated from a societal perspective. Finally, mechanisms of change (intermediate outcomes) and potential patient-treatment matching variables are investigated. This study hopes to provide valuable knowledge regarding an intervention to treat depression, one of the most common and debilitating diseases of our time. If our intervention is proven (cost-) effective, the personal, economic, and health benefits for both patients and employers are far-reaching. NTR2057.",20849619,Major Depressive Disorder,Anxiety Treatment,Mental Health,2307,9.162047386169434,-4.316989421844482,DFmx
"Memory support strategies and bundles: A pathway to improving cognitive therapy for depression?

Therapist use of memory support (MS) alongside treatment-as-usual, with the goal of enhancing patient recall of treatment contents, has been of recent interest as a novel pathway to improve treatment outcome. The memory support intervention (MSI) involves treatment providers' using 8 specific MS strategies to promote patient memory for treatment. The present study examines to what extent therapist use of MS strategies and bundles improves patient recall of treatment contents and treatment outcome. The data were drawn from a pilot RCT reported elsewhere. Participants were 48 adults (mean age = 44.27 years, 29 females) with major depressive disorder (MDD), randomized to receive 14 sessions of either CT + Memory Support (n = 25) or CT-as-usual (n = 23). Therapist use of MS was coded using the Memory Support Rating Scale. Patient memory and treatment outcomes were assessed at baseline, midtreatment (patient recall only), posttreatment, and 6-month follow-up. Participants in CT + Memory Support received significantly higher amount of MS relative to CT-as-usual. Although not reaching statistical significance, small-to-medium effects were observed between MS strategies and patient recall in the expected direction. Although MS variables were not significantly associated with changes in continuous depressive symptoms, MS was associated with better global functioning. MS also exhibited small to medium effects on treatment response and recurrence in the expected direction but not on remission, though these effects did not reach statistical significance. These results provide initial empirical evidence supporting an active method for therapists to implement MS strategies. (PsycINFO Database Record",28221056,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.997333526611328,-0.7456872463226318,Bgiz
"The DARE study of relapse prevention in depression: design for a phase 1/2 translational randomised controlled trial involving mindfulness-based cognitive therapy and supported self monitoring.

Depression is a common condition that typically has a relapsing course. Effective interventions targeting relapse have the potential to dramatically reduce the point prevalence of the condition. Mindfulness-based cognitive therapy (MBCT) is a group-based intervention that has shown efficacy in reducing depressive relapse. While trials of MBCT to date have met the core requirements of phase 1 translational research, there is a need now to move to phase 2 translational research - the application of MBCT within real-world settings with a view to informing policy and clinical practice. The aim of this trial is to examine the clinical impact and health economics of MBCT under real-world conditions and where efforts have been made to assess for and prevent resentful demoralization among the control group. Secondary aims of the project involve extending the phase 1 agenda to an examination of the effects of co-morbidity and mechanisms of action. This study is designed as a prospective, multi-site, single-blind, randomised controlled trial using a group comparison design between involving the intervention, MBCT, and a self-monitoring comparison condition, Depression Relapse Active Monitoring (DRAM). Follow-up is over 2 years. The design of the study indicates recruitment from primary and secondary care of 204 participants who have a history of 3 or more episodes of Major Depression but who are currently well. Measures assessing depressive relapse/recurrence, time to first clinical intervention, treatment expectancy and a range of secondary outcomes and process variables are included. A health economics evaluation will be undertaken to assess the incremental cost of MBCT. The results of this trial, including an examination of clinical, functional and health economic outcomes, will be used to assess the role that this treatment approach may have in recommendations for treatment of depression in Australia and elsewhere. If the findings are positive, we expect that this research will consolidate the evidence base to guide the decision to fund MBCT and to seek to promote its availability to those who have experienced at least 3 episodes of depression. Australian New Zealand Clinical Trials Registry: ACTRN12607000166471.",22260629,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.027283668518066,-0.7574067115783691,Cybs
"World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders. part 2: maintenance treatment of major depressive disorder-update 2015.

These guidelines for the treatment of unipolar depressive disorders systematically review available evidence pertaining to the biological treatment of patients with major depression and produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians assessing and treating patients with these conditions. The relevant data have been extracted primarily from various treatment guidelines and panels for depressive disorders, as well as from meta-analyses/reviews on the efficacy of antidepressant medications and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and was then categorized into five levels of evidence (CE A-F) and five levels of recommendation grades (RG 1-5). This second part of the WFSBP guidelines on depressive disorders covers the management of the maintenance phase treatment, and is primarily concerned with the biological treatment (including pharmacological and hormonal medications, electroconvulsive therapy and other brain stimulation treatments) of adults and also, albeit to a lesser extent, children, adolescents and older adults.",25677972,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.8226318359375,-0.6535604000091553,CB7p
"Cognitive behavioral analysis system of psychotherapy versus interpersonal psychotherapy for early-onset chronic depression: a randomized pilot study.

The only psychotherapy specifically designed and evaluated for the treatment of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), has never been directly compared to another depression-specific psychological method. Thirty patients with early-onset chronic depression were randomized to 22 sessions of CBASP or Interpersonal Psychotherapy (IPT) provided in 16 weeks. Primary outcome was the score on the 24-item Hamilton Rating Scale for Depression (HRSD) assessed posttreatment by an independent blinded evaluator. Secondary endpoints were, among others, remission (HRSD≤8) rates and the Beck Depression Inventory (BDI). The study included a prospective naturalistic 12-month follow-up. Intent-to-treat analyses of covariance (ANCOVA) revealed that there was no significant difference in posttreatment HRSD scores between the CBASP and the IPT condition, but in self-rated BDI scores. We found significantly higher remission rates in the CBASP (57%) as compared to the IPT (20%) group. One year posttreatment, no significant differences were found in the self-reported symptom level (BDI) using ANCOVA. The study used only a small sample size and no placebo control. The generalizability of the results may be limited to patients with a preference for psychological treatment. While the primary outcome was not significant, secondary measures showed relevant benefits of CBASP over IPT. We found preliminary evidence that in early-onset chronic depression, an approach specifically designed for this patient population was superior to a method originally developed for the treatment of acute depressive episodes. Long-term results suggest that chronically depressed patients may need extended treatment courses.",20822814,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.257266998291016,-1.8747825622558594,DF/6
"Internet-based cognitive behavioural therapy for subthreshold depression: a systematic review and meta-analysis.

Subthreshold depression has a considerable impact on individuals' subjective well-being and psychosocial functioning and is a predictor of major depressive disorder. Internet-based cognitive behavioural treatments (iCBTs) have been used to reduce the symptoms of subthreshold depression. This meta-analysis aims to systematically review evidence indicating the efficacy of iCBT programs on the improvement of depressive symptoms in this population. Articles published from January 2005 to July 2016 were searched in the following databases: Medline, PubMed, Web of Science, ScienceDirect, PsycArticles and the Cochrane Central Register of Controlled Trials. Only randomized controlled trials comparing the efficacy of iCBT programs with control groups for participants with subthreshold depression were selected. Both quantitative and qualitative analyses were conducted to examine the efficacy of iCBT interventions. Tenarticles from 8 randomized controlled trials were identified in this systematic review. The results suggested that iCBT programs had a superior efficacy compared to results from a non-active control group at the post-intervention stage (SMD=- 0.28, CI [- 0.42, - 0.14]; I2=49 %). However, evidence on the long-term efficacy of iCBT programs is still insufficient and needs further exploration. There has been substantial evidence that iCBT intervention has a superior short-term efficacy compared to the results of control groups, while its long-term efficacy of iCBT for subthreshold depressive symptoms is inconclusive and must be examined in further research. The protocol of this review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), Protocol No. CRD42015023390 .",27769266,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.507076263427734,-2.8682618141174316,Blr6
"Efficacy of psychological pain theory-based cognitive therapy in suicidal patients with major depressive disorder: A pilot study.

The present study aimed to explore the effects of psychological pain theory-based cognitive therapy (PPTBCT) on suicide among depressed patients, compared with a control group who received usual psychological care (UPC). The sample consisted of 32 depressed patients and 32 healthy control subjects. All participants completed the Beck Scale for Suicide Ideation (BSI), Beck Depression Inventory, Three-Dimensional Psychological Pain Scale (TDPPS), and Problem Solving Inventory(PSI), and Automatic Thoughts Questionnaire (ATQ). All measures differed significantly between depressed patients and healthy controls. Then clinical participants were assigned randomly to the PPTBCT (n=19) and control (n=13) groups. During the 8-week intervention, scores related to depression, suicidal ideation, psychological pain, and automatic thoughts were decreased in both groups at the post-intervention and 4-week follow-up time points, compared with pre-intervention scores. BSI scores remained low at follow up and did not differ significantly from post-intervention scores in the PPTBCT group, but were significantly higher at follow up than at post-intervention in the control group. PPTBCT may effectively reduce suicide risk in patients with major depressive disorder, although the effects of its application need to be confirmed.",28063394,Major Depressive Disorder,Anxiety Treatment,Mental Health,20900,8.464362144470215,-0.6626533269882202,Bigh
"Effectiveness of and dropout from outpatient cognitive behavioral therapy for adult unipolar depression: a meta-analysis of nonrandomized effectiveness studies.

The primary aim of this study was to assess the overall effectiveness of and dropout from individual and group outpatient cognitive behavioral therapy (CBT) for adults with a primary diagnosis of unipolar depressive disorder in routine clinical practice. We conducted a random effects meta-analysis of 34 nonrandomized effectiveness studies on outpatient individual and group CBT for adult unipolar depressive disorder. Standardized mean gain effect sizes are reported for end-of-treatment and 6-month follow-up effects for depression severity, dysfunctional cognitions, general anxiety, psychological distress, and functional impairment. The mean dropout rate from CBT is reported. We benchmarked our results against high-quality randomized controlled trials (RCTs). Outpatient CBT was effective in reducing depressive severity in completer (d = 1.13) and intention-to-treat (ITT) samples (d = 1.06). Moderate to large posttreatment effect sizes (d = 0.67-0.88) were found for secondary outcomes. The weighted mean dropout rate was 24.63%. Posttreatment gains for depression were maintained at 6 months after completion of therapy. Effect sizes for depression were inferior to those of benchmark RCTs. Although clinical practice patients show lesser improvements in depressive symptoms than RCT patients, individual and group outpatient CBT can be effectively transported to routine clinical practice. The considerable treatment dropout rate, especially in individual CBT, must be improved. The small number of available studies and low quality of some reports stress the need for high-quality effectiveness studies.",23379264,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.101761817932129,-2.67692232131958,CiYr
"Behavioural activation for depression: efficacy, effectiveness and dissemination.

Depression being a prevalent psychobiological disorder across the world, there is a need to identify effective, evidence-based treatments that are time and cost-effective in an effort to increase the population's accessibility to treatments. Low-intensity interventions, such as guided self-help treatments, hold promise for the dissemination of evidence-based treatments. Behavioural activation, a component of cognitive-behavioural therapy, is receiving increasing attention and empirical support as a stand-alone psychological treatment for depression. This article reviews behavioural activation's theoretical foundations and efficacy in light of determining its potential as a low-intensity intervention. A systematic review of articles on low-intensity behavioural activation interventions for depression was conducted using the PsychInfo, Medline and Embase databases. Behavioural activation's potential for dissemination as a guided self-help treatment is discussed and future avenues of research are stressed. Studies on the efficacy of behavioural activation as a guided self-help treatment are very limited to date and there are significant variations among existing studies. Based on the research literature, it can be concluded that behavioural activation could be a viable option as a low-intensity guided self-help psychological treatment for mild to moderate depression. Further research is required to better understand the optimal parameters and client-therapist characteristics of this form of low-intensity intervention.",22884236,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.203526496887207,-2.053356409072876,Cpob
"Comparing the acceptability of a positive psychology intervention versus a cognitive behavioural therapy for clinical depression.

There is growing evidence on the efficacy of positive psychology interventions (PPI) to treat clinical disorders. However, very few studies have addressed their acceptability. The present study aimed to analyse 2 key components of acceptability (i.e., client satisfaction and adherence to treatment) of a new PPI programme, the Integrative Positive Psychological Intervention for Depression (IPPI-D), in comparison to a standard cognitive behavioural therapy (CBT) programme in the treatment of clinical depression. One hundred twenty-eight women with a DSM-IV diagnosis of major depression or dysthymia were allocated to a 10-session IPPI-D or CBT group intervention condition. Results showed that both interventions were highly acceptable for participants. Attendance rates were high, and there were no significant differences between conditions. However, the IPPI-D condition showed significantly higher client satisfaction than the CBT condition. Moreover, acceptability did not differ based on participants' severity of symptoms, regardless of condition. These findings encourage further investigations of the applicability of PPI in clinical settings in order to broaden the range of acceptable and suitable therapies for depressed patients. Key Practitioner Message This study sheds light on the client satisfaction and adherence to a positive intervention. For participants, positive psychology interventions (PPI) may be more satisfactory than CBT as PPI are framed within a positive mental health model and, consequently, may reduce the risk of stigmatization Because acceptability of treatments and preferences may affect the efficacy of treatments, this study provides an excellent opportunity to offer professionals more therapeutic options to tailor treatments to clients' needs and expectations.",28857393,Major Depressive Disorder,Anxiety Treatment,Mental Health,16148,10.625722885131836,-3.3202884197235107,BXsk
"Psychotherapeutic interventions for depressed, low-income women: a review of the literature.

Low-income women have very high rates of depression and also face a number of unique barriers that can prevent them from seeking, accepting, engaging in, or benefiting from psychotherapy treatment. Untreated depression often leads to deleterious psychological consequences for these women and their children, and may also diminish a woman's ability to improve her economic circumstances. We reviewed the literature on psychotherapeutic interventions for depressed, low-income women, identifying a number of practical, psychological, and cultural barriers that often prevent them from engaging in psychotherapy. Next, we assessed the degree to which established intervention programs help women overcome these barriers. The data suggest that it is quite difficult to engage depressed, low-income women in psychotherapy, but that a number of standard psychotherapy approaches do show promise. However, we found that many of the currently available interventions fail to fully address the barriers that prevent this population from engaging in treatment. Moreover, the impact these interventions have on engagement and attrition rates or clinical improvements is often inadequately reported. We provide preliminary recommendations for clinicians who work with low-income women as well as suggestions for bolstering the literature base.",20678834,Major Depressive Disorder,Anxiety Treatment,Mental Health,5074,10.561878204345703,-5.354833602905273,DHU3
"Long-term efficacy of Metacognitive Training for Depression (D-MCT): A randomized controlled trial.

The availability of treatment for depression needs to be improved. Among the barriers are the dearth of group programmes and the high demand of many programmes with regard to staff expertise. The Metacognitive Training for Depression (D-MCT) is a new, easy-to-administer, cognitive behaviour-based group intervention. In a previous 6-month trial, D-MCT was highly accepted by patients and efficacious compared to a control treatment. The aim of the current study was to examine whether the effects of the D-MCT can be sustained over 3.5 years. Long-term follow-up of a randomized controlled trial. A total of 84 patients with a confirmed diagnosis of unipolar depressive disorder were enrolled in a randomized, controlled, assessor-blind, parallel group trial comparing two interventions added to usual care: D-MCT and general health training (HT). Patients were reassessed 3.5 years after the interventions were terminated. Primary outcome was the Hamilton Depression Rating Scale. Self-assessed depressive symptom severity (BDI), dysfunctional cognitive (DAS) and metacognitive (MCQ) beliefs, self-esteem (RSE), and quality of life (WHOQOL-BREF) served as secondary outcomes. Primary intention-to-treat analyses using analysis of covariance showed negative results, and only secondary post-hoc analyses utilizing latent growth modelling demonstrated superiority of D-MCT over HT with regard to the long-term course of depressive symptom severity and cognitive and metacognitive outcomes as well as physical and psychological quality of life. Findings suggest that D-MCT may be a promising add-on treatment for unipolar depression that should be investigated in large multi-centre studies. Independent replications are needed. Clinical implications: The current study shows tentative evidence that positive effects of the D-MCT reported at the 6-month follow-up assessment were sustained over 3.5 years. Potential positive effects regard severity of depression, dysfunctional cognitive, and metacognitive beliefs as well as quality of life. If positive results are replicated with less trained therapists, D-MCT offers the possibility of providing a simple and easy-to-administer CBT-based group treatment for depression with long lasting effects. Sample size was small; a large-scale multi-centre trial would be desirable to gain high statistical power with an adequate sample size and to allow the investigation of possible allegiance effects. D-MCT was delivered as an add-on intervention and not as a stand-alone intervention.",30556583,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.234132766723633,-1.4139668941497803,BBtm
"Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial.

There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer. In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N=78) or 'treatment as usual' (control group, TAU, N=79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured Clinical Interview for DSM-IV) and reduction in depression score by at least 2 points (Hospital Anxiety and Depression Scale, HADS-D) in STPP versus TAU at treatment termination. Secondary outcomes mainly refer to quality of life (QoL). In the intention to treat (ITT) analysis, 44% of the STPP group achieved highly significantly more remission than TAU (23%). STPP treatment (OR=7.64; P<0.001) was the strongest predictor for remission post-treatment; time was also significant (OR=0.96; P<0.05). A high effect favoring STPP (d=0.82) was observed for the HADS-D score post-treatment (secondary outcome). Regarding further secondary outcomes (QoL), analyses of covariance yielded main effects for group (favoring STPP with an effect size of at least d=0.5) for global QoL, role, emotional and social functioning, pain, treatment side-effects, breast symptoms and upset by hair loss. STPP is an effective treatment of a broad range of depressive conditions in breast cancer patients improving depression and functional QoL. Findings are limited by the drop-out rate (∼1/3) and delayed post-treatment assessments. Future trials may consider stepped-care approaches, tailored to patients' needs and requirements in the acute treatment phase.",24347520,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.158445358276367,-4.179493427276611,CUfr
"Effectiveness of Group Behavioural Activation for Depression: A Pilot Study.

The evidence base for behavioural activation (BA) is mainly grounded in the individual delivery method, with much less known about the impact of group delivery. To conduct a pilot study of behavioural activation in groups (BAG) for depression delivered in a routine service setting, in order to explore acceptability, effectiveness and predictors of outcome. The manualized group treatment format was delivered in a Primary Care mental health setting, at step three of an Improving Access to Psychological Therapies (IAPT) service. BAG was facilitated by cognitive behavioural psychotherapists, and outcome measures (depression, anxiety and functional impairment) were taken at each session. Seventy-three participants were referred and treated within nine groups. BAG was an acceptable treatment generating a low drop-out rate (7%). Significant pre-post differences were found across all measures. There was a moderate to large depression effect size (d + = 0.74), and 20% met the criteria for a reliable recovery in depression. Greater severity of initial depression and attendance of at least four BAG sessions predicted better outcomes. BAG appears to be an effective depression treatment option that shows some clinical promise. Further larger and more controlled studies are nevertheless required.",28287065,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,10.480522155761719,-2.042896032333374,BfnW
"Applications of machine learning algorithms to predict therapeutic outcomes in depression: A meta-analysis and systematic review.

No previous study has comprehensively reviewed the application of machine learning algorithms in mood disorders populations. Herein, we qualitatively and quantitatively evaluate previous studies of machine learning-devised models that predict therapeutic outcomes in mood disorders populations. We searched Ovid MEDLINE/PubMed from inception to February 8, 2018 for relevant studies that included adults with bipolar or unipolar depression; assessed therapeutic outcomes with a pharmacological, neuromodulatory, or manual-based psychotherapeutic intervention for depression; applied a machine learning algorithm; and reported predictors of therapeutic response. A random-effects meta-analysis of proportions and meta-regression analyses were conducted. We identified 639 records: 75 full-text publications were assessed for eligibility; 26 studies (n=17,499) and 20 studies (n=6325) were included in qualitative and quantitative review, respectively. Classification algorithms were able to predict therapeutic outcomes with an overall accuracy of 0.82 (95% confidence interval [CI] of [0.77, 0.87]). Pooled estimates of classification accuracy were significantly greater (p < 0.01) in models informed by multiple data types (e.g., composite of phenomenological patient features and neuroimaging or peripheral gene expression data; pooled proportion [95% CI] = 0.93[0.86, 0.97]) when compared to models with lower-dimension data types (pooledproportion=0.68[0.62,0.74]to0.85[0.81,0.88]). Most studies were retrospective; differences in machine learning algorithms and their implementation (e.g., cross-validation, hyperparameter tuning); cannot infer importance of individual variables fed into learning algorithm. Machine learning algorithms provide a powerful conceptual and analytic framework capable of integrating multiple data types and sources. An integrative approach may more effectively model neurobiological components as functional modules of pathophysiology embedded within the complex, social dynamics that influence the phenomenology of mental disorders.",30153635,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,12.141090393066406,-0.7167840003967285,BG8e
"Improving the Course of Depressive Symptoms After Inpatient Psychotherapy Using Adjunct Web-Based Self-Help: Follow-Up Results of a Randomized Controlled Trial.

We recently showed in a randomized controlled trial that Web-based self-help as an adjunct improved the effectiveness of multimodal inpatient psychotherapy for depression. The aims of this study were (1) to determine whether a Web-based self-help adjunctive to multimodal inpatient psychotherapeutic treatment could also improve the course of depressive symptoms and (2) to identify predictors of residual depressive symptoms at follow-up. Overall, 229 patients were randomized either to the Web-based self-help intervention group (Deprexis) or an active control group (Web-based information about depression and depressive symptoms) in addition to multimodal inpatient psychotherapy. Participants in both groups were able to access their respective Web-based programs for 12 weeks, which meant that they typically had access after discharge from the inpatient unit (mean hospitalization duration: 40 days, T1). Follow-up was performed 6 months after study intake (T3). At follow-up, participants of the Web-based self-help group had considerably lower symptom load regarding depressive symptoms (d=0.58) and anxiety (d=0.46) as well as a better quality of life (d=0.43) and self-esteem (d=0.31) than participants of the control group. Nearly 3 times as many participants of the intervention group compared with the control group achieved remission in accordance with less deterioration. The number needed to treat based on the Beck Depression Inventory-II (BDI-II) improved over time (T1: 7.84, T2: 7.09, and T3: 5.12). Significant outcome predictors were BDI at discharge and treatment group. Web-based self-help as an add-on to multimodal inpatient psychotherapy improved the short-term course of depressive symptoms beyond termination. Residual symptoms at discharge from inpatient treatment and utilization of the Web-based self-help were the major predictors of depressive symptoms at follow-up. Challenges and barriers (eg, costs, therapists' concerns, or technical barriers) of adding Web-based interventions to inpatient treatment have to be addressed. ClinicalTrials.gov NCT02196896; https://clinicaltrials.gov/ct2/show/NCT02196896.",31651403,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,9.99995231628418,-3.257248878479004,Ay6H
"Protocol for a randomized controlled dismantling study of a brief telephonic psychological intervention applied to non-professional caregivers with symptoms of depression.

Although depression is a common problem in caregivers and there are effective cognitive-behavioral interventions for its prevention, the ability of caregivers to attend these treatments is often limited by logistics. Furthermore, the efficacy of the components of these interventions is unknown. The objectives of this study are to (a) evaluate the efficacy of a telephone-administered cognitive-behavioral intervention to prevent depression with all its components (cognitive and behavioral) and only with behavioral activation, and to (b) analyze the mediators of the change in depressive symptoms. A randomized controlled clinical trial was designed to dismantle the components of a cognitive-behavioral intervention. Caregivers with elevated depressive symptoms will be randomly assigned to a cognitive-behavioral intervention, an intervention with only the behavioral activation component, or a usual care control group. Each condition will consist of approximately 60 participants. The two interventions will consist of five sessions lasting 90 min each, applied to groups of about 5 participants at a time via conference call. Trained interviewers, blind to the experimental conditions, will conduct the assessments at the pre-treatment, post-treatment and 1-, 3-, 6- and 12-month follow-ups. This study will provide evidence of the efficacy of a cognitive-behavioral intervention to prevent depression in caregivers with elevated depressive symptoms administered via conference call, and on the impact of the behavioral activation component on the overall efficacy of the program. If we find favorable results, it would mean that we have developed a program of prevention of depression of higher clinical utility and efficacy than those currently available, which would make it possible for a large number of caregivers to have access to such resources. ClinicalTrials.gov: NCT02292394. Registered 6 November 2014.",26597295,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.64238452911377,-2.7371137142181396,B0yF
"Comparing outcomes in chronic depression following inpatient psychotherapy for patients continuing versus discontinuing antidepressant medication.

Research indicates that combination of psychotherapy and antidepressant medication (ADM) provides cumulative effects and thus outperforms monotherapy in treating chronic depression. In this quasi-experimental study, we explored symptom change for patients with chronic depression treated with ADM when presenting for a 12-week psychotherapeutic inpatient treatment programme. We compared outcomes through treatment and follow-up of patients who continued medication with those who discontinued. We also tested possible moderator effects of initial depression severity on change between the groups. Based on prior research, we hypothesized that combination treatment would yield better results (i.e., more reduction in depression). Patients (N = 112) were referred from general practitioners or local secondary health care. Outcome was measured by Beck Depression Inventory-II (BDI-II), and comparisons were carried out using multilevel modelling. Although 35 patients discontinued ADM during treatment, 77 continued. Both continuers and discontinuers had a significant treatment effect that was maintained at 1-year follow-up. There was no difference in outcome between continuers and discontinuers of ADM. Patients with severe depression had significantly more symptom improvement than patients with moderate depression, but depression severity did not affect outcomes across continuers and discontinuers of ADM differently. The results could indicate that patients had developed resistance and/or tolerance to the prophylactic effects of medication and that ADM did not contribute to the reduction of depressive symptoms. The findings may also indicate that psychotherapy alone in some instances can be a viable alternative to continued combined treatment. Clinicians should carefully assess benefits of patients' ongoing use of antidepressant medication when entering psychotherapy.",33527551,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.189434051513672,-1.034306287765503,Abit
"Teletherapy Versus In-Person Psychotherapy for Depression: A Meta-Analysis of Randomized Controlled Trials.

Introduction: The recent surge in telehealth service delivery represents a promising development in the field's ability to address access gaps in health care across underserved populations. Telehealth also carries the potential to help reduce the societal burden of mental illnesses such as major depression, which often go untreated. There is now a sufficiently large corpus of randomized controlled trials to examine the comparative effectiveness of teletherapy and in-person services meta-analytically. Methods: We searched the PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for articles from January 1, 2000 to February 1, 2021 to identify randomized head-to-head trials of video-based versus in-person delivery of psychotherapy to reduce depressive symptoms. We conducted a random-effects meta-analysis to evaluate potential differences in efficacy rates. We calculated and meta-analyzed odds ratios to examine differential attrition rates between video and in-person conditions. Finally, we conducted subgroup analyses based on the primary treatment focus (depression or another condition) of each trial. Results: Primary study analyses yielded evidence that video-based psychotherapy is roughly comparable in efficacy with in-person psychotherapy for reducing depressive symptoms (g=0.04, 95% confidence interval [CI=-0.12 to 0.20], p=0.60, I2=5%). Likewise, attrition rates between the two conditions were not significantly different (odds ratio=1.07, 95% CI=[0.78 to 1.49], p=0.63, I2=25%). Finally, we did not observe significant subgroup differences in either efficacy (p=0.38) or attrition (p=0.94). Conclusions: The present findings suggest that video-based teletherapy may be a feasible and effective alternative to in-person services for reducing depressive symptoms. Continued research on the effectiveness of telehealth in clinically depressed samples, and further elucidation of the access barriers entailed by each delivery modality, can help the field better determine which patients will derive the greatest benefit from each mode of intervention.",35007437,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.648645401000977,-3.2156388759613037,tqU
"Comparison of relaxation training with a cognitive-behavioural intervention for indicated prevention of depression in university students: a randomized controlled trial.

Although cognitive-behavioural programmes for preventing depression have produced promising findings, their administration requires extensive training. Relaxation techniques are more straightforward psychological strategies, but they have not been investigated in the prevention of depression. This trial aimed to compare the results of relaxation training (RT) with that of a cognitive-behavioural programme (CBT) for prevention of depression in university students with elevated depressive symptoms. The 133 participants (mean age 23.3 years, 82% women) were randomly assigned to CBT or RT. Both programmes were administered to groups of 5 or 6 participants in eight weekly 90-min sessions. Participants were evaluated by independent raters before, immediately after, and 3 and 6 months after taking part in the programmes. By itself, intervention type had no significant effect on either depression or anxiety scores. The scores were lower at the follow-up time points with respect to pre-intervention scores. Effect size was greatest between pre- and immediately post-intervention scores for CBT, d = 1.32, 95% CI [1.00, 1.64], and between pre- and 6-month post-intervention scores for RT, d = 0.75, 95% CI [0.47, 1.03]. Anxiety symptoms were significantly improved by both interventions at 3-month follow-up, and by CBT at 6-month follow-up also. In the medium term (3-6 months), relaxation training produced similar reductions in depressive and anxiety symptoms as a more complex cognitive-behavioural programme.",22939979,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,9.928759574890137,-1.618098258972168,Cozw
"The effect of pilot cognitive restructuring therapy intervention on depression in female cancer patients.

",26332380,Major Depressive Disorder,Anxiety Treatment,Mental Health,15858,6.466377258300781,-2.4300620555877686,B4rO
"Effectiveness of a web-based behavioural activation intervention for individuals with depression based on the Health Action Process Approach: protocol for a randomised controlled trial with a 6-month follow-up.

Behavioural activation is a highly effective treatment for depression. However, there is considerable heterogeneity of interventions grouped under the term 'behavioural activation'. A main reason for the heterogeneity is the lack of a unified theory in the intervention development: few of the established intervention manuals give a theoretical rationale for their intervention techniques. For the first time, this study will examine the effectiveness of a theory-based behavioural activation intervention (InterAKTIV) based on the Health Action Process Approach. The intervention is implemented online to ensure broad dissemination and standardisation. In a two-arm randomised controlled trial, the effectiveness of a guided web-based behavioural activation intervention for people with depression will be evaluated. Participants are recruited via the print and online media of a large German healthcare insurance company. Individuals (age 18-65), who meet criteria for major depressive episode in a clinical interview and no exclusion criteria are eligible for inclusion. A target sample of 128 participants is randomly allocated to either the intervention group (immediate access to InterAKTIV) or treatment as usual (access after follow-up assessment). The primary outcome of depressive symptom severity (Quick Inventory of Depressive Symptomatology Clinician Rating) and secondary outcomes, including behavioural activation, physical activity and motivational and volitional outcomes are assessed at baseline, post treatment and 6-month follow-up. Data will be analysed on an intention-to-treat basis with additional per-protocol analyses. This trial is approved by the ethics committee of the Albert-Ludwigs-University of Freiburg (no.: 20-1045). All participants are required to submit their informed consent online before study inclusion. The results will be submitted for publication in a peer-reviewed journal and presented at conferences. This trial was registered in the German Clinical Trials Register (DRKS): DRKS00024349 (date of registration: 29 January 2021).",35074820,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.245992660522461,-1.9253309965133667,q+U
"The Efficacy of Internal Family Systems Therapy in the Treatment of Depression Among Female College Students: A Pilot Study.

College women are vulnerable to depression due to developmental and transitional life changes. Early diagnosis and effective treatment is critically important. Empirical support exists for the effectiveness of select treatment options (i.e., antidepressant medication, cognitive-behavioral therapy [CBT], and interpersonal psychotherapy [IPT]), yet a significant percentage of those treated do not benefit. In this pilot study, Internal Family Systems (IFS) therapy was tested as an alternative approach. College women (N = 37) were randomly allocated to IFS treatment or treatment as usual (CBT or IPT). Results demonstrated a decline in depressive symptoms for both conditions and no significant differences in the magnitude or rate of change. The results provide preliminary evidence for the efficacy of IFS in the treatment of depressive symptoms.",27500908,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.526424407958984,-3.3770840167999268,Bo6b
"Goal Achievement and Goal-Related Cognitions in Behavioral Activation Treatment for Depression.

This study investigates the extent to which achieving goals during behavioral activation (BA) treatment predicts depressive symptom improvement, and whether goal-related cognitions predict goal achievement or treatment response. Patients (n = 110, mean age 37.6, 54% female) received low-intensity cognitive behavioral therapy for depression, which included setting up to three behavioral goals in each of three BA-focused sessions (i.e., 9 goals per patient). Patients completed items from the Self-Regulation Skills Battery to assess goal-related cognitions and goal achievement for these goals, and depressive symptoms were assessed weekly with the PHQ-9. Multilevel models investigated the relationships between goal-related cognitions, goal achievement and depressive symptoms. Depressive symptoms improved curve-linearly during treatment (B = 0.12, p < .001), but were not predicted by contemporaneous or time-lagged goal achievement. While cumulative goal achievement predicted end-of-treatment depressive symptoms (r = -.23; p < .01), this relationship became nonsignificant after controlling for depressive symptoms at baseline. Readiness, planning and action control predicted greater goal achievement, whereas greater goal ownership predicted less goal achievement (all p < .05). Motivation and outcome expectancy were related to subsequent, but not contemporaneous, improvements in depressive symptoms (all p < .05). This study indicates the importance of goal-related cognitions in BA treatments, and future research should investigate potential moderators of the relationships between goal-related cognitions, goal achievement, and improvements in depressive symptoms.",31422846,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.701188087463379,-2.0963189601898193,A167
"Computerised therapy for depression with clinician vs. assistant and brief vs. extended phone support: study protocol for a randomised controlled trial.

Computerised cognitive behaviour therapy (cCBT) involves standardised, automated, interactive self-help programmes delivered via a computer. Randomised controlled trials (RCTs) and observational studies have shown than cCBT reduces depressive symptoms as much as face-to-face therapy and more than waiting lists or treatment as usual. cCBT's efficacy and acceptability may be influenced by the ""human"" support offered as an adjunct to it, which can vary in duration and can be offered by people with different levels of training and expertise. This is a two-by-two factorial RCT investigating the effectiveness, cost-effectiveness and acceptability of cCBT supplemented with 12 weekly phone support sessions are either brief (5-10 min) or extended (20-30 min) and are offered by either an expert clinician or an assistant with no clinical training. Adults with non-suicidal depression in primary care can self-refer into the study by completing and posting to the research team a standardised questionnaire. Following an assessment interview, eligible referrals have access to an 8-session cCBT programme called Beating the Blues and are randomised to one of four types of support: brief-assistant, extended-assistant, brief-clinician or extended-clinician.A sample size of 35 per group (total 140) is sufficient to detect a moderate effect size with 90% power on our primary outcome measure (Work and Social Adjustment Scale); assuming a 30% attrition rate, 200 patients will be randomised. Secondary outcome measures include the Beck Depression and Anxiety Inventories and the PHQ-9 and GAD-7. Data on clinical outcomes, treatment usage and patient experiences are collected in three ways: by post via self-report questionnaires at week 0 (randomisation) and at weeks 12 and 24 post-randomisation; electronically by the cCBT system every time patients log-in; by phone during assessments, support sessions and exit interviews. The study's factorial design increases its efficiency by allowing the concurrent investigation of two types of adjunct support for cCBT with a single sample of participants. Difficulties in recruitment, uptake and retention of participants are anticipated because of the nature of the targeted clinical problem (depression impairs motivation) and of the studied interventions (lack of face-to-face contact because referrals, assessments, interventions and data collection are completed by phone, computer or post). Current Controlled Trials ISRCTN98677176.",22925596,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.694478988647461,-2.8264992237091064,CpCc
"Testing mediators of intervention effects in randomized controlled trials: An evaluation of three depression prevention programs.

Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB bibliotherapy, or assessment-only control condition. The group CB intervention reduced depressive symptoms and negative cognitions and increased pleasant activities. Change in these mediators predicted change in depression, and intervention effects became weaker controlling for change in the mediators; yet, change in depression appeared typically to occur before change in the mediators. The supportive expressive intervention reduced depressive symptoms but affected only 1 of 2 mediators (emotional expression but not loneliness). Change in emotional expression did not correlate with change in depression, and change in depression usually occurred before change in the mediators. Bibliotherapy did not significantly affect depressive symptoms or the ostensive mediators (negative cognitions and pleasant activities), and change in depression usually occurred before change in the mediators. Results imply that this procedure provides a sensitive test of mediation but yielded limited support for the hypothesized mediators, suggesting that nonspecific factors may play an important mediational role.",20350038,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.271981239318848,-3.232710838317871,DMR4
"Meta-analysis of the effects of peer-administered psychosocial interventions on symptoms of depression.

Many community mental health centers have implemented peer treatment models that employ recovered former clients as cost-efficient adjunct providers. The effectiveness of these and other peer-administered interventions (PAIs) for treating depression symptoms has not been well-established. The current study is a meta-analysis of PAIs' effects on depression symptoms. Twenty-three eligible studies were identified. Study characteristics were coded by multiple raters, random-effects models were used to compare mean effect sizes, and mixed-effects models were used to test for moderation. PAIs produced significant pre-post reductions in depression symptoms (d = .5043 [95 % CI .3675-.6412]). In direct comparisons, PAIs performed as well as non-peer-administered interventions (.0848 [-.1455-.3151]), and significantly better than no-treatment conditions (.2011 [.0104-.3918]). PAIs that involved a professional in a secondary treatment role were significantly less effective than those that were purely peer-administered, and educational/skills-based PAIs produced better outcomes than those that were mainly supportive. Follow-up data, when available, indicated that PAIs' benefits were maintained. PAIs reduce depression symptoms and warrant further study. The clinical significance of PAIs' benefits, and whether they are better suited as stand-alone or adjunct treatments, remain to be established. Implications for the roles of mental health professionals are discussed.",25861883,Major Depressive Disorder,Anxiety Treatment,Mental Health,13374,9.805702209472656,-3.1476857662200928,B/TH
"Art as a Therapeutic Tool in Depressive Disorders: a Systematic Review of the Literature.

Different alternative forms of therapy have been studied in relation to their applicability and effectiveness. The use of art therapy in the treatment of depressive disorder is an example frequently employed in several countries. The aim of this research was to identify and discuss which artistic techniques have been applied most frequently in the treatment of depressive disorders and what their main effects are. The research was conducted in the MEDLINE/PubMed, American Psychological Association (APA) and Web of Science databases. The articles were selected through the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA protocol). 14 articles were selected, among which the main techniques of art therapy used were: manual work (drawing, painting, and modeling), music, poetry, photography, theater and contemplation of art pieces. It was found that most of the researches are European and as a field of knowledge they depart mainly from medicine. Of the 14 researches of this review, only two failed in the use of art therapy techniques as a therapeutic tool. It can be understood that art therapy is a safe and reliable tool for treatment not only of depression but also of other mental disorders.",31501993,Major Depressive Disorder,Anxiety Treatment,Mental Health,23662,10.737321853637695,-5.384192943572998,A04y
"Exploring preoperational features in chronic depression.

The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) by James McCullough is the first psychotherapeutical approach specifically designed for chronic depression. Whereas its efficacy has recently been studied, empirical investigations on the underlying etiopathological hypotheses are missing. McCullough postulates that chronically depressed patients - particularly those with early onset - think preoperationally. This term was coined by J. Piaget and includes egocentrism in the views of self and others and incapacity for authentic interpersonal empathy. In accordance, empirical studies indicate a deficit in theory of mind (ToM) in depressed individuals. Sixteen patients with early onset chronic depression were compared to sixteen matched healthy controls using three measurements: 1) the Movie for the Assessment of Social Cognition (MASC) as a new video-based theory of mind test, 2) self-rated questionnaires on empathy (Interpersonal Reactivity Index (IRI), and a scale assessing individual competence in relationships), and 3) a structured evaluation by the patients' therapists. The groups did not differ in their theory of mind performance on any aspect assessed by the used test. However, patients rated their empathy in daily life as significantly inferior to healthy controls. In addition, the therapists assigned a considerable amount of preoperational behavior to their patients. No meaningful correlations between these three types of measurements were found. Small sample size, no structural assessment of possible psychopathology in the control group, control group was not rated by clinicians concerning preoperational behaviors. Lack of empathy exists in the daily life of early onset chronically depressed patients according to their own and their therapists' evaluation. However, a video-based test failed to pick up deficits in their theory of mind capacities. Further research is needed to investigate theory of mind deficits using real life interpersonal interactions demanding the patient's personal involvement.",20089311,Major Depressive Disorder,Anxiety Treatment,Mental Health,3821,11.478486061096191,-1.815039873123169,DOrb
"The Sequential Integration of Pharmacotherapy and Psychotherapy in the Treatment of Major Depressive Disorder: A Meta-Analysis of the Sequential Model and a Critical Review of the Literature.

A number of randomized controlled trials in major depressive disorder have employed a sequential model, which consists of the use of pharmacotherapy in the acute phase and of psychotherapy in its residual phase. The aim of this review was to provide an updated meta-analysis of the efficacy of this approach in reducing the risk of relapse in major depressive disorder and to place these findings in the larger context of treatment selection. Keyword searches were conducted in MEDLINE, EMBASE, PsycINFO, and Cochrane Library from inception of each database through October 2014. Randomized controlled trials examining the efficacy of the administration of psychotherapy after successful response to acute-phase pharmacotherapy in the treatment of adults with major depressive disorder were considered for inclusion in the meta-analysis. Thirteen high-quality studies with 728 patients in a sequential treatment arm and 682 in a control treatment arm were included. All studies involved cognitive-behavioral therapy (CBT). The pooled risk ratio for relapse/recurrence was 0.781 (95% confidence interval [CI]=0.671-0.909; number needed to treat=8), according to the random-effects model, suggesting a relative advantage in preventing relapse/recurrence compared with control conditions. A significant effect of CBT during continuation of antidepressant drugs compared with antidepressants alone or treatment as usual (risk ratio: 0.811; 95% CI=0.685-0.961; number needed to treat=10) was found. Patients randomly assigned to CBT who had antidepressants tapered and discontinued were significantly less likely to experience relapse/recurrence compared with those assigned to either clinical management or continuation of antidepressant medication (risk ratio: 0.674; 95% CI=0.482-0.943; number needed to treat=5). The sequential integration of CBT and pharmacotherapy is a viable strategy for preventing relapse in major depressive disorder. The current indications for the application of psychotherapy in major depressive disorder are discussed, with special reference to its integration with pharmacotherapy.",26481173,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.035510063171387,-1.1426222324371338,B2ZV
"The effect of treatment as usual on major depressive disorder: A meta-analysis.

Health-economic models are used to evaluate the long-term cost-effectiveness of an intervention and typically include treatment as usual (TAU) as comparator. Part of the data used for these models are acquired from the literature and thus valid information is needed on the effects of TAU on depression. The aim of the current meta-analysis was to examine positive and negative outcomes of major depression for patients receiving TAU. We conducted a systematic literature search in PubMed, EMBASE, PsycInfo, and the Cochrane Central Register of Controlled Trials. Eligible studies were randomized controlled trials including a TAU group for depression. The quality of the included studies was assessed using the criteria described in the ""Risk of bias assessment tool"". Four separate meta-analyses were performed to estimate remission, response, reliable change and deterioration rates at short-term (≤6 months from baseline). Thirty-eight studies including 2099 patients in the TAU were identified. Nine studies (24%) met five or six quality criteria, 17 studies (44%) met three or four quality criteria and 12 studies (32%) met one or two quality criteria. After adjusting for publication bias, the first meta-analysis (n=33) showed that 33% of the patients remitted from depression. The second meta-analysis (n=13) demonstrated that 27% of the patients responded to treatment, meaning that their depressive symptom decreased at least 50% from baseline to follow-up measurement. The third meta-analysis (n=7) indicated that 31% of the patients showed a reliable change, meaning that their depressive symptoms improved more than expected by random variation alone. Finally, 12% of the patients deteriorated, meaning that their depressive symptoms became more severe. Statistical heterogeneity was substantial in most analyses and was not fully explained by subgroup analyses. The quality of the included studies was moderate. This may result in overestimation of the true effects. The treatments labelled as TAU for depression were clinically and statistically heterogeneous. We demonstrated that a few patients benefited from TAU and a small number of patients suffered from worsened depressive symptoms at the short term. The results can be included in health-economic models that compare depression treatments to TAU.",28013125,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.8582763671875,-2.601048469543457,Bi9c
"A written self-help intervention for depressed adults comparing behavioural activation combined with physical activity promotion with a self-help intervention based upon behavioural activation alone: study protocol for a parallel group pilot randomised controlled trial (BAcPAc).

Challenges remain to find ways to support patients with depression who have low levels of physical activity (PA) to overcome perceived barriers and enhance the perceived value of PA for preventing future relapse. There is an evidence-base for behavioural activation (BA) for depression, which focuses on supporting patients to restore activities that have been avoided, but practitioners have no specific training in promoting PA. We aimed to design and evaluate an integrated BA and PA (BAcPAc) practitioner-led, written, self-help intervention to enhance both physical and mental health. This study is informed by the Medical Research Council Complex Intervention Framework and describes a protocol for a pilot phase II randomised controlled trial (RCT) to test the feasibility and acceptability of the trial methods to inform a definitive phase III RCT. Following development of the augmented written self-help intervention (BAcPAc) incorporating behavioural activation with physical activity promotion, depressed adults are randomised to receive up to 12 sessions over a maximum of 4 months of either BAcPAc or behavioural activation alone within a written self-help format, which represents treatment as usual. The study is located within two 'Improving Access to Psychological Therapies' services in South West England, with both written self-help interventions supported by mental health paraprofessionals. Measures assessed at 4, 9, and 12 month follow-up include the following: CIS-R, PHQ-9, accelerometer recorded (4 months only) and self-reported PA, body mass index, blood pressure, Insomnia Severity Index, quality of life, and health and social care service use. Process evaluation will include analysis of recorded support sessions and patient and practitioner interviews. At the time of writing the study has recruited 60 patients. The feasibility outcomes will inform a definitive RCT to assess the clinical and cost-effectiveness of the augmented BAcPAc written self-help intervention to reduce depression and depressive relapse, and bring about improvements across a range of physical health outcomes. Current Controlled Trials ISRCTN74390532, 26.03.2013.",24886116,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,10.091127395629883,-1.9488576650619507,CNNQ
"Patients' perspectives on treatment with Metacognitive Training for Depression (D-MCT): Results on acceptability.

Our understanding of how patients perceive and evaluate treatment for depression is scarce. Because dropout rates are high among individuals in treatment for depression, it is necessary to expand the focus of research to patients' perspectives on the treatment they receive. The aim of the two studies presented was to evaluate patient acceptance of Metacognitive Training for Depression (D-MCT), a highly standardized group intervention. Acceptability was evaluated in an open case series (Study 1, N = 70) and a randomized controlled trial (RCT; Study 2, N = 84). In both studies, participants rated their subjective appraisal on a 15-item questionnaire after administration of eight D-MCT modules. In Study 1, a subsample of patients also evaluated modules individually after each session. In Study 2, ratings were compared to an active control intervention (walking and psychoeducation sessions), and assessment was repeated at 6-months follow-up. High rates of acceptance of the D-MCT were demonstrated in both studies immediately after treatment (post-assessment). In addition, the RCT showed better evaluations for the D-MCT than for the control condition at post-assessment as well as at 6-months follow-up. Weekly session evaluations in Study 1 indicated good acceptance for individual modules. Evaluations could only be obtained from completers; blinding of patients and therapists was not possible. Results of the two studies suggest that D-MCT represents a promising group treatment in terms of patient acceptance and provide an example of how patients' feedback may be used to improve treatment.",28628763,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.17533016204834,-1.9108482599258423,Ba81
"Japan Unified Protocol Clinical Trial for Depressive and Anxiety Disorders (JUNP study): study protocol for a randomized controlled trial.

The unified protocol for the transdiagnostic treatment of emotional disorders is a promising treatment approach that could be applicable to a broad range of mental disorders, including depressive, anxiety, trauma-related, and obsessive-compulsive disorders. However, no randomized controlled trial has been conducted to verify the efficacy of the unified protocol on the heterogeneous clinical population with depressive and anxiety disorders. The trial was designed as a single-center, assessor-blinded, randomized, 20-week, parallel-group superiority study in order to compare the efficacy of the combination of unified protocol and treatment-as-usual versus waiting-list with treatment-as-usual for patients with depressive and/or anxiety disorders. The primary outcome was depression at 21 weeks, assessed by the 17-item version of the GRID-Hamilton Rating Scale for Depression. Estimated minimum sample size was 27 participants in each group. We will also examine the treatment mechanisms, treatment processes, and neuropsychological correlates. The results of this study will clarify the efficacy of the unified protocol for depressive and anxiety disorders, and the treatment mechanism, process, and neurological correlates for the effectiveness of the unified protocol. If its efficacy can be confirmed, the unified protocol may be of high clinical value for Japan, a country in which cognitive behavioral treatment has not yet been widely adopted. ClinicalTrials.gov NCT02003261 (registered on December 2, 2013).",26987315,Major Depressive Disorder,Anxiety Treatment,Mental Health,22726,12.021791458129883,-2.900153398513794,BviX
"Pilot trial of a dissonance-based cognitive-behavioral group depression prevention with college students.

Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = 0.64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted.",27176493,Major Depressive Disorder,Anxiety Treatment,Mental Health,15356,11.350564002990723,-3.0185225009918213,Bs30
"Processes of change in acceptance and commitment therapy and cognitive therapy for depression: a mediation reanalysis of Zettle and Rains.

Several articles have recently questioned the distinction between acceptance and commitment therapy (ACT) and traditional cognitive therapy (CT). This study presents a reanalysis of data from Zettle and Rains that compared 12 weeks of group CT with group ACT. For theoretical reasons, Zettle and Rains also included a modified form of CT that did not include distancing, and no intent-to-treat analysis was included. Particularly because that unusual third condition did somewhat better than the full CT package, it contaminated the direct comparison of ACT and CT, which has of late become theoretically interesting. In the present study, data from participants in the ACT and CT conditions were reanalyzed. ACT was shown to produce greater reductions in levels of self-reported depression using an intent-to-treat analysis. Posttreatment levels of cognitive defusion mediated this effect at follow-up. The occurrence of depressogenic thoughts and level of dysfunctional attitudes did not function as mediators. This study adds additional evidence that ACT works through distinct and theoretically specified processes that are not the same as CT.",21362745,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.751795768737793,-1.8921624422073364,C/Tu
"A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems.

To review the efficacy of non-pharmacological treatment for depression in people with depression and chronic physical health problems. Five electronic databases were searched including EMBASE, Medline and PsycINFO for randomized controlled trials (RCTs). Each paper was assessed for quality, data extracted and, where possible, the data meta-analyzed. The overall quality of each meta-analysis was assessed. 35 studies met our inclusion criteria and 22 were meta-analyzed using a random-effects model. The largest and strongest evidence base supports individual- and group-based cognitive and behavioral interventions (18 trials). The evidence was strongest for those interventions aimed solely at reducing depression in comparison to those aimed more broadly at reducing the psychosocial stress associated with having a chronic physical health problem. Overall, the efficacy of certain types of non-pharmacological interventions for people with depression and chronic physical health problems has been demonstrated. The overall impression is that their efficacy in this population is comparable to that in people with depression without chronic physical health problems but the evidence-base is currently inadequate and larger trials with long-term follow-up are required.",21665008,Major Depressive Disorder,Anxiety Treatment,Mental Health,9426,9.892141342163086,-1.9125549793243408,C7Lw
"Internet-delivered cognitive behavioural therapy for adults with mild to moderate depression and high cardiovascular disease risks: a randomised attention-controlled trial.

Mild to moderate depression is common in those with cardiovascular disease and undertreated. We aimed to evaluate the effectiveness of internet-delivered Cognitive Behaviour Therapy (iCBT) on depressive symptom severity and adherence to medical advice and lifestyle interventions in adults with mild to moderate depression and high cardiovascular disease (CVD) risks. Randomised double-blind, 12 week attention-controlled trial comparing an iCBT programme (E-couch) with an internet-delivered attention control health information package (HealthWatch, n = 282). The primary outcome was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9) (trial registration: ACTRN12610000085077). 487/562 (88%) participants completed the endpoint assessment. 383/562 (70%) were currently treated for cardiovascular disease and 314/562 (56%) had at least one other comorbid condition. In ITT analysis of 562 participants iCBT produced a greater decline in the mean PHQ-9 score compared to the attention control of 1.06 (95% CI: 0.23-1.89) points, with differences between the two arms increasing over the intervention period (time by treatment effect interaction p = .012). There were also larger improvements in adherence (2.16 points; 95% CI: 0.33-3.99), reductions in anxiety (0.96 points; 95% CI: 0.19-1.73), and a greater proportion engaging in beneficial physical activity (Odds Ratio 1.91, 95%CI: 1.01-3.61) in the iCBT participants but no effect upon disability, or walking time/day. There were no withdrawals due to study related adverse events. In people with mild to moderate depression and high levels of CVD risk factors, a freely accessible iCBT programme (http://www.ecouch.anu.edu.au) produced a small, but robust, improvement in depressive symptoms, adherence and some health behaviours. Australian and New Zealand Clinical Trials Registry ACTRN12610000085077.",23555624,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.166854858398438,-2.6358108520507812,Cfxl
"Behavioural activation therapy for depression in adults.

Behavioural activation is a brief psychotherapeutic approach that seeks to change the way a person interacts with their environment. Behavioural activation is increasingly receiving attention as a potentially cost-effective intervention for depression, which may require less resources and may be easier to deliver and implement than other types of psychotherapy. To examine the effects of behavioural activation compared with other psychological therapies for depression in adults. To examine the effects of behavioural activation compared with medication for depression in adults. To examine the effects of behavioural activation compared with treatment as usual/waiting list/placebo no treatment for depression in adults. We searched CCMD-CTR (all available years), CENTRAL (current issue), Ovid MEDLINE (1946 onwards), Ovid EMBASE (1980 onwards), and Ovid PsycINFO (1806 onwards) on the 17 January 2020 to identify randomised controlled trials (RCTs) of 'behavioural activation', or the main elements of behavioural activation for depression in participants with clinically diagnosed depression or subthreshold depression. We did not apply any restrictions on date, language or publication status to the searches. We searched international trials registries via the World Health Organization's trials portal (ICTRP) and ClinicalTrials.gov to identify unpublished or ongoing trials. We included randomised controlled trials (RCTs) of behavioural activation for the treatment of depression or symptoms of depression in adults aged 18 or over. We excluded RCTs conducted in inpatient settings and with trial participants selected because of a physical comorbidity. Studies were included regardless of reported outcomes. Two review authors independently screened all titles/abstracts and full-text manuscripts for inclusion. Data extraction and 'Risk of bias' assessments were also performed by two review authors in duplicate. Where necessary, we contacted study authors for more information. Fifty-three studies with 5495 participants were included; 51 parallel group RCTs and two cluster-RCTs. We found moderate-certainty evidence that behavioural activation had greater short-term efficacy than treatment as usual (risk ratio (RR) 1.40, 95% confidence interval (CI) 1.10 to 1.78; 7 RCTs, 1533 participants), although this difference was no longer evident in sensitivity analyses using a worst-case or intention-to-treat scenario. Compared with waiting list, behavioural activation may be more effective, but there were fewer data in this comparison and evidence was of low certainty (RR 2.14, 95% CI 0.90 to 5.09; 1 RCT, 26 participants). No evidence on treatment efficacy was available for behavioural activation versus placebo and behavioural activation versus no treatment. We found moderate-certainty evidence suggesting no evidence of a difference in short-term treatment efficacy between behavioural activation and CBT (RR 0.99, 95% CI 0.92 to 1.07; 5 RCTs, 601 participants). Fewer data were available for other comparators. No evidence of a difference in short term-efficacy was found between behavioural activation and third-wave CBT (RR 1.10, 95% CI 0.91 to 1.33; 2 RCTs, 98 participants; low certainty), and psychodynamic therapy (RR 1.21, 95% CI 0.74 to 1.99; 1 RCT,60 participants; very low certainty). Behavioural activation was more effective than humanistic therapy (RR 1.84, 95% CI 1.15 to 2.95; 2 RCTs, 46 participants; low certainty) and medication (RR 1.77, 95% CI 1.14 to 2.76; 1 RCT; 141 participants; moderate certainty), but both of these results were based on a small number of trials and participants. No evidence on treatment efficacy was available for comparisons between behavioural activation versus interpersonal, cognitive analytic, and integrative therapies. There was moderate-certainty evidence that behavioural activation might have lower treatment acceptability (based on dropout rate) than treatment as usual in the short term, although the data did not confirm a difference and results lacked precision (RR 1.64, 95% CI 0.81 to 3.31; 14 RCTs, 2518 participants). Moderate-certainty evidence did not suggest any difference in short-term acceptability between behavioural activation and waiting list (RR 1.17, 95% CI 0.70 to 1.93; 8 RCTs. 359 participants), no treatment (RR 0.97, 95% CI 0.45 to 2.09; 3 RCTs, 187 participants), medication (RR 0.52, 95% CI 0.23 to 1.16; 2 RCTs, 243 participants), or placebo (RR 0.72, 95% CI 0.31 to 1.67; 1 RCT; 96 participants; low-certainty evidence). No evidence on treatment acceptability was available comparing behavioural activation versus psychodynamic therapy. Low-certainty evidence did not show a difference in short-term treatment acceptability (dropout rate) between behavioural activation and CBT (RR 1.03, 95% CI 0.85 to 1.25; 12 RCTs, 1195 participants), third-wave CBT (RR 0.84, 95% CI 0.33 to 2.10; 3 RCTs, 147 participants); humanistic therapy (RR 1.06, 95% CI 0.20 to 5.55; 2 RCTs, 96 participants) (very low certainty), and interpersonal, cognitive analytic, and integrative therapy (RR 0.84, 95% CI 0.32 to 2.20; 4 RCTs, 123 participants). Results from medium- and long-term primary outcomes, secondary outcomes, subgroup analyses, and sensitivity analyses are summarised in the text. This systematic review suggests that behavioural activation may be more effective than humanistic therapy, medication, and treatment as usual, and that it may be no less effective than CBT, psychodynamic therapy, or being placed on a waiting list. However, our confidence in these findings is limited due to concerns about the certainty of the evidence. We found no evidence of a difference in short-term treatment acceptability (based on dropouts) between behavioural activation and most comparison groups (CBT, humanistic therapy, waiting list, placebo, medication, no treatment or treatment as usual). Again, our confidence in all these findings is limited due to concerns about the certainty of the evidence. No data were available about the efficacy of behaioural activation compared with placebo, or about treatment acceptability comparing behavioural activation and psychodynamic therapy, interpersonal, cognitive analytic and integrative therapies. The evidence could be strengthened by better reporting and better quality RCTs of behavioural activation and by assessing working mechanisms of behavioural activation.",32628293,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.548613548278809,-2.1376047134399414,AmTY
"The effectiveness of an online support group for members of the community with depression: a randomised controlled trial.

Internet support groups (ISGs) are popular, particularly among people with depression, but there is little high quality evidence concerning their effectiveness. The study aimed to evaluate the efficacy of an ISG for reducing depressive symptoms among community members when used alone and in combination with an automated Internet-based psychotherapy training program. Volunteers with elevated psychological distress were identified using a community-based screening postal survey. Participants were randomised to one of four 12-week conditions: depression Internet Support Group (ISG), automated depression Internet Training Program (ITP), combination of the two (ITP+ISG), or a control website with delayed access to e-couch at 6 months. Assessments were conducted at baseline, post-intervention, 6 and 12 months. There was no change in depressive symptoms relative to control after 3 months of exposure to the ISG. However, both the ISG alone and the combined ISG+ITP group showed significantly greater reduction in depressive symptoms at 6 and 12 months follow-up than the control group. The ITP program was effective relative to control at post-intervention but not at 6 months. ISGs for depression are promising and warrant further empirical investigation. Controlled-Trials.com ISRCTN65657330.",23285271,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.107206344604492,-3.6244935989379883,CjyN
"[Psychotherapeutic considerations regarding medication treatment for refractory cases].

The aim of this paper is to consider the psychotherapeutic approach to refractory cases in a psychiatric clinic. Although standardized, formulated psychotherapies, i. e., CBT and IPT, have a limited efficacy against antidepressant-resistant or chronic depression, psychotherapy and medication treatment may complement each other in combination. However, the first step in the psychotherapeutic consideration of refractory depression is to give up seeking ""a specific medicine"" which does not exist. On the other hand, a doctor should give his/her patient new hope for recovery and stimulate their motivation for treatment. In the dialogue between a doctor and patient, the following points are to be focused on : 1) The essential part of treatment is not medicine but the patient him-/herself. 2) Recommendation of medication should not further reduce the patient's pride. 3) It should be clear that medication treatment is a collaborative activity between patients and doctors. It is preferable for topics of an interview to extend from a reconsideration of the prescription contents to reconstruction of the daily life. It may be helpful for patients to obtain detailed advice on basic lifestyle aspects, such as sleep, meals, and daily activities.",25711120,Major Depressive Disorder,Anxiety Treatment,Mental Health,19106,10.75082015991211,-1.893512487411499,CBd5
"Group Cognitive Behavioural Analysis System of Psychotherapy (CBASP) for persistently depressed outpatients: a retrospective chart review.

Cognitive behavioural analysis system of psychotherapy (CBASP) is an effective individual treatment for persistent depressive disorder (PDD), but evidence on group treatment (Group-CBASP) is limited. Our aim was to review the effect of Group-CBASP on self-report depression severity in outpatients with PDD, overall and by age of depression-onset. A retrospective chart review study (November 2011-March 2017) in 54 patients with PDD (29 late-onset, 25 early-onset). Patients were previously treated by pharmacotherapy (92.6%), psychotherapy (98.1%) and/or electroconvulsive therapy (11.1%). Group-CBASP involved 24 weekly sessions during 6 months, followed by individual appointments over 6 months. The Inventory of Depressive Symptoms -self rating(IDS-SR) was used at baseline and after 3, 6, 9 and 12 months, computing mean differences and response rates. The mean IDS-SR score decreased significantly from 39.83 at baseline to 33.78 at 6 months: a decrease from severe to moderate depression after 24 weeks of Group-CBASP, with a medium effect size (Cohen's d = .49). At 12 months, the mean IDS-SR score was 32.81, indicating moderate symptom levels remained. At 6 and 12 months, mean IDS-SR scores were similar among late- versus early-onset patients, but at 12 months response rates were higher among late-onset patients. Although results of our study provide valuable input for future prospective studies, limitations were the use of a retrospective design and the small group size. Group-CBASP offered to an outpatient population with PDD was associated with clinically relevant decrease in self-reported symptom severity, and with sustained response particularly in patients with late onset of depression. Group-CBASP seems to be a good alternative for CBASP in individual setting. Patients with late age of depression-onset seem to benefit more from Group-CBASP. This study shows that clinical relevant effects of Group-CBASP, followed by individual contacts, remain at least for 6 months. Research on personalizing treatment strategies is needed to improve patient assignment for Group-CBASP.",32920864,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.306724548339844,-1.670955777168274,Aiq6
"The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study).

Individuals with a history of recurrent depression have a high risk of repeated depressive relapse/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial. To establish whether MBCT with support to taper and/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse/recurrence. Secondary aims examined MBCT's acceptability and mechanism of action. Single-blind, parallel, individual randomised controlled trial. UK general practices. Adult patients with a diagnosis of recurrent depression and who were taking m-ADM. Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT's acceptability and mechanism of action. The primary outcome measure was time to relapse/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities. In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation. There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse/recurrence among individuals at risk for depressive relapse/recurrence. Both treatments appear to confer protection against relapse/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group. Current Controlled Trials ISRCTN26666654. This project was funded by the NIHR Health Technology Assessment programme and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula and will be published in full in Health Technology Assessment; Vol. 19, No. 73. See the NIHR Journals Library website for further project information.",26379122,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.773306846618652,-0.8174368143081665,B38P
"Sequential Combination of Pharmacotherapy and Psychotherapy in Major Depressive Disorder: A Systematic Review and Meta-analysis.

The sequential model emerged from the awareness that the persistence of residual symptoms and the frequent occurrence of psychiatric comorbidity were both associated with poor long-term outcome of major depressive disorder (MDD). To conduct an updated meta-analysis to examine the association of the sequential combination of pharmacotherapy and psychotherapy with reduced risk of relapse and recurrence in MDD. Keyword searches were conducted in PubMed, PsycInfo, Web of Science, and the Cochrane Library from inception of each database through November 2019. Reference lists from relevant studies were examined using the following keywords: sequential treatment, drugs and psychotherapy, combined treatment, continuation or maintenance, relapse or recurrence and prevention, and depress* or major depress*, selecting adults and randomized controlled trials as additional limits. Authors of selected articles were contacted if needed. Randomized clinical trials examining the effectiveness of the sequential use of psychotherapy following response to acute-phase pharmacotherapy in the treatment of adult remitted patients with MDD were selected independently by 2 reviewers. The methods used fulfilled the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data extraction and methodologic quality assessment were conducted independently by the reviewers. Examination of the pooled results was performed based on the random-effects model. Heterogeneity between study results and likelihood of significant publication bias were assessed. Sensitivity analyses and meta-regressions were also run. The primary outcome measures were relapse or recurrence rates of MDD, as defined by study investigators, at the longest available follow-up. Seventeen randomized clinical trials met criteria for inclusion in the meta-analysis, with 1 study yielding 2 comparisons (2283 patients overall, with 1208 patients in a sequential treatment arm and 1075 in a control arm). The pooled risk ratio for relapse/recurrence of MDD was 0.84 (95% CI, 0.74-0.94), suggesting a relative advantage in preventing relapse/recurrence for the sequential combination of treatments compared with control conditions. The results of this systematic review and meta-analysis indicate that the sequential integration of psychotherapy following response to acute-phase pharmacotherapy, alone or combined with antidepressant medication, was associated with reduced risk of relapse and recurrence in MDD. The preventive value of the sequential strategy relies on abatement of residual symptoms and/or increase in psychological well-being. The steps for implementing the sequential approach in remitted patients with recurrent MDD are provided.",33237285,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,9.69122314453125,-0.6858052015304565,Ae46
"Efficacy of Internet-Delivered Psychodynamic Therapy: Systematic Review and Meta-Analysis.

Recent years have seen an increase of internet-delivered interventions based on psychodynamic treatment models. To test the efficacy of internet-delivered psychodynamic therapy (IPDT), we conducted a systematic review and meta-analysis of randomized controlled trials. Following literature searches, we identified seven studies meeting inclusion criteria. The total number of participants was 528 in the treatment group and 552 in the control conditions. We found small effects favoring IPDT compared to inactive control conditions for main outcomes (g = 0.44), depression (g = 0.46), anxiety (g = 0.20), and quality of life (g = 0.40). There was significant heterogeneity between studies for main outcomes and depression. Within-group effects ranged from Hedges's g = 0.32-0.99. The effects of IPDT were maintained or increased at follow-up. Study quality varied but was generally high. No indications of publication bias were found. In conclusion, IPDT is a promising treatment alternative, especially for depression, although the small number of studies limits the generalizability of the findings.",33779225,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,11.34791088104248,-3.263246536254883,AYr5
"A randomized controlled trial on the role of support in Internet-based problem solving therapy for depression and anxiety.

Internet-based interventions can be effective treatments for anxiety and depression. Meta-analytic evidence suggests that they should be delivered with human support to reach optimal effects. These findings have not consistently been replicated in direct comparisons of supported and unsupported interventions, however. This study examined the role of support in Internet-based problem solving treatment (PST) for symptoms of anxiety and/or depression. Adults with mild to moderate symptoms of anxiety and/or depression were recruited from the general population and randomized to: (1) PST without support (n = 107), (2) PST with support on request (n = 108), (3) PST with weekly support (n = 106), (4) no Internet-based intervention but non-specific chat or email (n = 110), or (5) waitlist control (WLC; n = 106). Primary outcomes were symptoms of anxiety (HADS) and depression (CES-D) measured at baseline and 6 weeks later. Analyses were first based on the intention-to-treat principle (ITT) and repeated with intervention completers. Only participants who received PST with weekly support improved significantly more than WLC for depressive symptoms. Results for anxiety were less robust but in favor of the weekly support condition. The results underscore the importance of structural support in Internet-based interventions for depression and anxiety.",26188373,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.085762977600098,-3.7971396446228027,B6s2
"Efficacy of ultrabrief cognitive and behavioural therapy performed by psychiatric residents on depressed inpatients.

",21968526,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.445324897766113,-2.8197524547576904,C2sv
"Opening toward life: experiences of basic body awareness therapy in persons with major depression.

Although there is a vast amount of research on different strategies to alleviate depression, knowledge of movement-based treatments focusing on body awareness is sparse. This study explores the experiences of basic body awareness therapy (BBAT) in 15 persons diagnosed with major depression who participated in the treatment in a randomized clinical trial. Hermeneutic phenomenological methodology inspired the approach to interviews and data analysis. The participants' experiences were essentially grasped as a process of enhanced existential openness, opening toward life, exceeding the tangible corporeal dimension to also involve emotional, temporal, and relational aspects of life. Five constituents of this meaning were described: vitality springing forth, grounding oneself, recognizing patterns in one's body, being acknowledged and allowed to be oneself, and grasping the vagueness. The process of enhanced perceptual openness challenges the numbness experienced in depression, which can provide hope for change, but it is connected to hard work and can be emotionally difficult to bear. Inspired by a phenomenological framework, the results of this study illuminate novel clinical and theoretical insight into the meaning of BBAT as an adjunctive approach in the treatment of depression.",25956354,Major Depressive Disorder,Anxiety Treatment,Mental Health,11656,9.10767650604248,-1.1560596227645874,B99G
"Effectiveness, relapse prevention and mechanisms of change of cognitive therapy vs. interpersonal therapy for depression: Study protocol for a randomised controlled trial.

Major depression is a common mental disorder that substantially impairs quality of life and has high societal costs. Although psychotherapies have proven to be effective antidepressant treatments, initial response rates are insufficient and the risk of relapse and recurrence is high. Improvement of treatments is badly needed. Studying the mechanisms of change in treatment might be a good investment for improving everyday mental health care. However, the mechanisms underlying therapeutic change remain largely unknown. The objective of the current study is to assess both the effectiveness of two commonly used psychotherapies for depression in terms of reduction of symptoms and prevention of relapse on short and long term, as well as identifying underlying mechanisms of change. In a randomised trial we will compare (a) Cognitive Therapy (CT) with (b) Interpersonal therapy (IPT), and (c) an 8-week waiting list condition followed by treatment of choice. One hundred eighty depressed patients (aged 18-65) will be recruited in a mental health care centre in Maastricht (the Netherlands). Eligible patients will be randomly allocated to one of the three intervention groups. The primary outcome measure of the clinical evaluation is depression severity measured by the Beck Depression Intenvory-II (BDI-II). Other outcomes include process variables such as dysfunctional beliefs, negative attributions, and interpersonal problems. All self-report outcome assessments will take place on the internet at baseline, three, seven, eight, nine, ten, eleven, twelve and twenty-four months. At 24 months a retrospective telephone interview will be administered. Furthermore, a rudimentary analysis of the cost-effectiveness will be embedded. The study has been ethically approved and registered. By comparing CT and IPT head-to-head and by investigating multiple potential mediators and outcomes at multiple time points during and after therapy, we hope to provide new insights in the effectiveness and mechanisms of change of CT and IPT for depression, and contribute to the improvement of mental health care for adults suffering from depression. The study has been registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (ISRCTN67561918).",21672217,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.895219802856445,-2.4521260261535645,C7Es
"I'm Not the Only One With Depression: Women's Perceptions of In-Person Group Formats of Depressive Symptom Interventions.

A standard format for depression management has long been the in-person group-based intervention, yet recent calls for scalable interventions have increased interest in individual online formats. However, the perspectives and preferences of women are largely missing in the literature. This secondary qualitative data analysis using a phenomenological method of inquiry explored the lived experiences of pregnant and nonpregnant women with depressive symptoms (N = 44) who participated in 2 studies involving group-based face-to-face mindful physical activity interventions for depressive symptom self-management. Four main themes emerged regarding the group format: shared experiences enhanced the feeling of safety and impact of the group interventions; group instructors played a key role in fostering a safe environment; participants wished for more group interactions; and participants preferred a synchronous group-based intervention over a technology-based or asynchronous alternative for depressive symptom management. The findings from this study suggest that women with depression enjoy synchronous group-based interventions and find them to be beneficial for the shared experiences with other women and the safe environment created by group instructors. Future research should include study designs that consider these factors in the context of hybrid or fully online intervention formats for depression management.",33528186,Major Depressive Disorder,Anxiety Treatment,Mental Health,2805,9.696880340576172,-3.3190290927886963,AbiG
"Psychoanalytic versus psychodynamic therapy for depression: a three-year follow-up study.

The aim of this study was to investigate the effectiveness of long-term psychoanalytic and psychodynamic psychotherapies. In a prospective, randomized outcome study, psychoanalytic (mean duration: 39 months, mean dose: 234 sessions) and psychodynamic (mean duration: 34 months, mean dose: 88 sessions) therapy were compared at post-treatment and at one-, two-, and three-year follow-up in the treatment of patients with a primary diagnosis of unipolar depression. All treatments were carried out by experienced psychotherapists. Primary outcome measures were the Beck Depression Inventory and the Scales of Psychological Capacities, and secondary outcome measures were the Global Severity Index of the Symptom Checklist 90-R, the Inventory of Interpersonal Problems, the Social Support Questionnaire, and the INTREX Introject Questionnaire. Interviewers at pre- and post-treatment and at one-year follow-up were blinded; at two- and three-year follow-up, all self-report instruments were mailed to the patients. Analyses of covariance, effect sizes, and clinical significances were calculated to contrast the groups. We found significant outcome differences between treatments in terms of depressive and global psychiatric symptoms, personality functioning, and social relations at three-year follow-up, with psychoanalytic therapy being more effective. No outcome differences were found in terms of interpersonal problems. We concluded that psychoanalytic therapy associated with its higher treatment dose shows longer-lasting effects.",23631544,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.668917655944824,-3.653515100479126,Ceqy
"GET.ON Mood Enhancer: efficacy of Internet-based guided self-help compared to psychoeducation for depression: an investigator-blinded randomised controlled trial.

Major depressive disorder (MDD) imposes a considerable disease burden on individuals and societies. A large number of randomised controlled trials (RCTs) have shown the efficacy of Internet-based guided self-help interventions in reducing symptoms of depression. However, study quality varies considerably. The aim of this study is to evaluate the efficacy of a new Internet-based guided self-help intervention (GET.ON Mood Enhancer) compared to online-based psychoeducation in an investigator-blinded RCT. A RCT will be conducted to compare the efficacy of GET.ON Mood Enhancer with an active control condition receiving online psychoeducation on depression (OPD). Both treatment groups will have full access to treatment as usual. Adults with MDD (n=128) will be recruited and randomised to one of the two conditions. Primary outcome will be observer-rated depressive symptoms (HRSD-24) by independent assessors blind to treatment conditions. Secondary outcomes include changes in self-reported depressive symptom severity, anxiety and quality of life. Additionally, potential negative effects of the treatments will systematically be evaluated on several dimensions (for example, symptom deteriorations, attitudes toward seeking psychological help, relationships and stigmatisation). Assessments will take place at baseline, 6 and 12 weeks after randomisation. This study evaluates a new Internet-based guided self-help intervention for depression using an active control condition (psychoeducation-control) and an independent, blinded outcome evaluation. This study will further enhance the evidence for Internet-based guided self-help interventions for MDD. German Clinical Trial Registration (DRKS): DRKS00005025.",24476555,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.305253028869629,-3.201162099838257,CS2a
"Feasibility and Preliminary Efficacy of a New Online Self-Help Intervention for Depression among Korean College Students' Families.

Applying innovative online approaches to interventions for preventing depression is necessary. Since depressive emotions are typically shared within the family, the development of interventions involving family members is critical. This study thus aimed to examine the feasibility, acceptability, and preliminary outcomes of a new online self-help intervention, MindGuide, among Korean college students' families. We developed MindGuide, which integrates cognitive behavioral therapy with mindfulness and an emotional regulation approach. A one-group pretest-posttest design was used to measure the changes in the Center for Epidemiological Studies Depression Scale, the Attitude Toward Suicide scale, and the Satisfaction With Life Scale before and after the intervention. Of the 34 families that began the program, completion rates were 88.2%, 85.3%, and 91.2% for fathers, mothers, and children, respectively. The findings indicated that the MindGuide program is feasible and acceptable for families of Korean college students. The results support the potential effect of MindGuide on reducing depression, improving positive attitudes toward suicide prevention, and enhancing family relationships in participants at risk of depression. However, future research is needed to thoroughly explore and evaluate the efficacy of the MindGuide program.",35206327,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.482365608215332,-3.1752398014068604,lpw
"Evaluating the Efficacy of Internet-Delivered Cognitive Behavioral Therapy Blended With Synchronous Chat Sessions to Treat Adolescent Depression: Randomized Controlled Trial.

Depression is a common and serious problem among adolescents, but few seek or have access to therapy. Internet-delivered cognitive behavioral therapies (ICBTs), developed to increase treatment access, show promise in reducing depression. The inclusion of coach support in treatment is desired and may be needed. The aim of this study was to determine the efficacy of an ICBT protocol blended with weekly real-time therapist sessions via chat; blended treatment, for adolescent depression, including major depressive episode (MDE). The protocol has previously been evaluated in a controlled study. In a two-arm randomized controlled trial, adolescents 15 to 19 years of age were recruited through a community setting at the national level in Sweden (n=70) and allocated to either 8 weeks of treatment or to minimal attention control. Depression was assessed at baseline, at posttreatment, and at 12 months following treatment (in the intervention group). The primary outcome was self-reported depression level as measured with the Beck Depression Inventory II at posttreatment. The intervention was offered without the need for parental consent. Over two weeks, 162 adolescents registered and completed the baseline screening. Eligible participants (n=70) were on average 17.5 years of age (SD 1.15), female (96%, 67/70), suffered from MDE (76%, 53/70), had no previous treatment experience (64%, 45/70), and reported guardian(s) to be aware about their depression state (71%, 50/70). The average intervention completion was 74% (11.8 of 16 modules and sessions). Following the treatment, ICBT participants demonstrated a significant decrease in depression symptoms compared with controls (P<.001), corresponding to a large between-group effect (intention-to-treat analysis: d=0.86, 95% CI 0.37-1.35; of completer analysis: d=0.99, 95% CI 0.48-1.51). A significant between-group effect was observed in the secondary depression outcome (P=.003); clinically significant improvement was found in 46% (16/35) of ICBT participants compared with 11% (4/35) in the control group (P=.001). The results are in line with our previous study, further demonstrating that adolescents with depression can successfully be engaged in and experience significant improvement following ICBT blended with therapist chat sessions. Findings on participants' age and baseline depression severity are of interest in relation to used study methods. ClinicalTrials.gov NCT02363205; https://clinicaltrials.gov/ct2/show/NCT02363205.",31682572,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.959125518798828,-2.962944507598877,AyeM
"Self-compassion enhances the efficacy of explicit cognitive reappraisal as an emotion regulation strategy in individuals with major depressive disorder.

Cognitive reappraisal has been shown to be an effective strategy to regulate depressed mood in healthy and remitted depressed individuals. However, individuals currently suffering from a clinical depression often experience difficulties in utilizing this strategy. Therefore, the goal of this study was to examine whether the efficacy of explicit cognitive reappraisal in major depressive disorder can be enhanced through the use of self-compassion and emotion-focused acceptance as preparatory strategies. Thereby, explicit cognitive reappraisal refers to purposefully identifying, challenging, and modifying depressiogenic cognitions to reduce depressed mood. To test our hypotheses, we induced depressed mood at four points in time in 54 participants (64.8% female; age M = 35.59, SD = 11.49 years) meeting criteria for major depressive disorder. After each mood induction, participants were instructed to either wait, or employ self-compassion, acceptance, or reappraisal to regulate their depressed mood. Depressed mood was assessed before and after each mood induction and regulation period on a visual analog scale. Results indicated that participants who had utilized self-compassion as a preparatory strategy experienced a significantly greater reduction of depressed mood during reappraisal than did those who had been instructed to wait prior to reappraisal. Participants who had used acceptance as a preparatory strategy did not experience a significantly greater reduction of depressed mood during subsequent reappraisal than those in the waiting condition. These findings provide preliminary evidence that the efficacy of explicit cognitive reappraisal is moderated by the precursory use of other emotion regulation strategies. In particular, they suggest that depressed individuals might benefit from using self-compassion to facilitate the subsequent use of explicit cognitive reappraisal.",27152671,Major Depressive Disorder,Anxiety Treatment,Mental Health,7324,9.164216041564941,-1.5078165531158447,BtL9
"[Behavioral Activation for Depression: Theory and Practice].

Behavioral activation (BA) has recently attracted marked attention. While cognitive therapy focuses on the cognitive distortion of patients with depression and asks them to change their behaviors as the process of altering the cognitive distortion, BA pays attention to behavior to avoid an unpleasant situation or social situation as a key symptom that leads to persistence of the depression. Avoidance behaviors are often seen during every process of depression, from onset to recurrence. Avoidance behaviors, a decrease in pleasant phenomena, or increase in unpleasant phenomena, result in reinforcing a depressive mood. If patients can set appropriate behavioral targets and achieve them, the beneficial behaviors will be further promoted with positive feed-back. The behavioral change, as-a consequence, will result in improvement of the mood, cognition, and depression itself. In this manuscript, the author presents two clinical cases, in which BA assisted the patients in recovering from their depression. The first case was a male in his thirties who repeatedly took sick leave from his work because of maladjustment, which resulted in persistent depression. The second case was a female in her thirties who suffered from OCD and then became maladjusted to her place of work, depressive, and emotionally unstable. In both cases, avoidant behaviors caused their conditions to persist. Appropriate activities formed by BA improved their moods, and their self-efficacies were gradually regained. It was suggested that BA is markedly effective, especially in patients whose avoidant behaviors mainly cause the persistence of their depressive symptoms.",26514042,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.81315803527832,-1.9515057802200317,B17v
"Randomized cost-effectiveness trial of group interpersonal psychotherapy (IPT) for prisoners with major depression.

This study tested the effectiveness and cost-effectiveness of interpersonal psychotherapy (IPT) for major depressive disorder (MDD) among prisoners. It is the first fully powered randomized trial of any treatment (pharmacological or psychosocial) targeting MDD among incarcerated individuals. One hundred eighty-one male (n = 117) and female (n = 64) prisoners from prison facilities in 2 states were randomized to group IPT (delivered by master's-level and nonspecialist prison counselors) for MDD plus prison treatment as usual (TAU) or to TAU alone. Participants' average age was 39 (range = 20-61); 20% were African American and 19% were Hispanic. Outcomes assessed at posttreatment and 3-month follow-up included depressive symptoms (primary; assessed using the Hamilton Rating Scale for Depression), suicidality (assessed with the Beck Scale for Suicide Ideation and Beck Hopelessness Scale), in-prison functioning (i.e., enrollment in correctional programs; discipline reports; aggression/victimization; and social support), remission from MDD, and posttraumatic stress disorder symptoms. IPT reduced depressive symptoms, hopelessness, and posttraumatic stress disorder symptoms, and increased rates of MDD remission relative to prison TAU alone. Effects on hopelessness were particularly strong. Cost per patient was $2,054 including costs for IPT training and supervision or $575 without these costs. For providers running their second or subsequent IPT group, cost per additional week in remission from MDD (relative to TAU alone) was $524 ($148 excluding training and supervision costs, which would not be needed for established programs). IPT is effective and cost-effective and we recommend its use for MDD among prisoners. It is currently the only treatment for MDD evaluated among incarcerated individuals. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",30714749,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.50238037109375,-3.7140443325042725,A/dW
"Time-intensive behavioural activation for depression: A multiple baseline study.

Depression is the second leading cause of disability, worldwide, and increasing access to its effective/preferred treatment requires more attention. Behavioural activation and time-intensive treatment delivery both show promise in this regard, yet research into their combination is limited. This study aimed to investigate the feasibility, effectiveness, and acceptability of time-intensive behavioural activation (BA) for depression METHODS: Eight adults with major depressive disorder were recruited from three outpatient IAPT services in London. The study employed a single case experimental design with multiple baselines. All participants completed time-intensive BA, consisting of up to seven twice weekly sessions with daily prompting in-between and three optional booster sessions. Idiographic, standardised and process measures of depression symptomatology were collected. Treatment recruitment and retention indicated that the intervention was feasible. Visual and statistical analyses showed that relative to baseline, 6 out of 8 participants made significant improvements in all idiographic symptoms of depression following the intervention. According to standardised measures of depression, four out of eight participants were considered treatment responders. Five participants completed follow-up measures and the majority of progress was maintained after the withdrawal of the intervention. The intervention was also considered highly acceptable by participants and therapists. Conclusions cannot be drawn about the generalizability or the long-term durability of the findings CONCLUSIONS: Overall this study provides new, but tentative evidence highlighting the potential of time-intensive BA as a feasible, effective and acceptable treatment for some adult outpatients with depression. The findings now warrant further, more rigorous evaluation of the treatment.",30641404,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.48835277557373,-1.9608261585235596,BAfD
"Treatment of depression and/or anxiety - outcomes of a randomised controlled trial of the tree theme method® versus regular occupational therapy.

Depression and anxiety disorders are a major concern in western countries, and because these often have a negative affect on everyday life interventions based on activities in everyday life are needed. The Tree Theme Method® (TTM) is a client-centred occupational therapy intervention designed to increase the ability to cope with, and to enhance satisfaction with, everyday life, both at home and at work. The aim of this study was to compare the short term outcomes of the TTM intervention with regular occupational therapy treatment for people with depression and/or anxiety disorders. This randomised controlled trial included patients from three counties in Sweden. Men and women with depression and/or anxiety disorders, ages 18 to 65, were randomised to either TTM or regular occupational therapy. Assessment data were collected at baseline and the follow-up directly after completing the intervention. Non-parametric and parametric statistical methods were used. The questionnaires were answered by 118 patients at baseline and by 107 patients after completing the intervention. No significant differences in short term outcomes were found between the groups. Both groups showed positive significant outcomes regarding almost all aspects of activities in everyday life, psychological symptoms, and health-related and intervention-related aspects. Despite the lack of differences between the groups, the positive outcomes regarding activities in everyday life, psychological symptoms, and health-related aspects after completing the intervention indicates the need for further research on the long-term perspective of TTM compared to regular occupational therapy. Clinical Trials.gov: NCT01980381 ; registered November 2013.",29792226,Major Depressive Disorder,Anxiety Treatment,Mental Health,2573,10.31662654876709,-3.4674227237701416,BLY2
"Nonpharmacological Treatment for Supporting Social Participation of Adults with Depression.

Social withdrawal is predominantly seen among adults with depression. However, a dearth of reviews exists that explore nonpharmacological treatments, especially occupational therapy (OT) interventions and their effect in promoting social participation. The aim of this research was to review what intervention programs are conducted to support the social participation of adults with depression and their effectiveness. A systematic review was performed wherein relevant articles were searched in PubMed, CINAHL, Wiley Online Library, PsycINFO, and OTseeker databases and AJOT, BJOT, SJOT, and OTMH journals. Only English articles published from January 2010 to December 2018, which tackled intervention for adults aged 20-60 years with depression, were considered. Ten out of 918 studies met the screening criteria. Among the ten studies, the effective intervention programs were categorized as either occupation-based intervention (OBI) or cognitive behavioral therapy-based intervention (CBT-BI). These programs sought the following outcomes: behavioral change in social participation (n = 4), reduction of depression or depressive symptoms (n = 13), life satisfaction (n = 4), and quality of life (QoL) (n = 1). Studies showed moderate (n = 3) to strong (n = 7) level of certainty, whereas they also revealed high to unclear (n = 3) and low (n = 7) risk of bias. Both OBI such as animal-assisted therapy and CBT-BI such as behavioral change program and health education have a strong level of certainty and low risk of bias in promoting social participation by supporting positive behavioral change and reducing depressive symptoms. Furthermore, the sport and exercise program of OBI was popular in encouraging participation and engagement with other people. Other programs were suggested for combined interventions to support social participation, life satisfaction, and QoL.",34007254,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,10.16083812713623,-2.6582610607147217,AWIj
"Bibliotherapy as a treatment for depression in primary care.

This study was designed to determine whether a physician-delivered bibliotherapy prescription would compare favorably with the prevailing usual care treatment for depression in primary care (that often involves medication) and potentially offer an alternative. Six family physicians were trained to write and deliver prescriptions for cognitive-behavioral bibliotherapy. Thirty-eight patients were randomly assigned to receive either usual care or a behavioral prescription to read the self-help book, Feeling Good (Burns, D. D. (1999). Feeling good: The new mood therapy. New York: HarperCollins). The treatment groups did not differ in terms of overall outcome variables. Patients in both treatment groups reported statistically significant decreases in depression symptoms, decreases in dysfunctional attitudes, and increases in quality of life. Although not statistically significant, the mean net medical expenses in the behavioral prescription group were substantially less. This study provided empirical evidence that a behavioral prescription for Feeling Good may be as effective as standard care, which commonly involves an antidepressant prescription.",20803165,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,10.540329933166504,-3.240831136703491,DGVK
"Identifying moderators of the adherence-outcome relation in cognitive therapy for depression.

Little is known about the influence of patients' pretreatment characteristics on the adherence-outcome relation in cognitive therapy (CT) for depression. In a sample of 57 depressed adults participating in CT, the authors examined interactions between pretreatment patient characteristics and therapist adherence in predicting session-to-session symptom change. Using items from the Collaborative Study Psychotherapy Rating Scale, the authors assessed 3 facets of therapist adherence: cognitive methods, negotiating/structuring, and behavioral methods/homework. Two graduate students rated Sessions 1-4 for adherence. Symptoms were assessed prior to each session with the Beck Depression Inventory-II. Moderators were assessed as part of patients' intake evaluations. After correcting for multiple comparisons, patient gender remained a significant moderator of the relationship between cognitive methods and next-session symptom change; cognitive methods more strongly predicted greater symptom improvement for women as compared to men. Pretreatment anxiety and number of prior depressive episodes were significant moderators of the relationship between behavioral methods/homework and next-session symptom change, with greater behavioral methods/homework predicting symptom improvement more strongly among patients high in pretreatment anxiety and among patients with relatively few prior depressive episodes. This is the first study to provide evidence of how therapist adherence is differentially related to outcome among depressed patients with different characteristics. If replicated, these findings may inform clinical decisions regarding the use of specific facets of adherence in CT for depression with specific patients.",26214542,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,11.875761985778809,-3.178527355194092,B6VB
"Four hygienic-dietary recommendations as add-on treatment in depression: a randomized-controlled trial.

Modifying diet, exercise, sunlight exposure and sleep patterns may be useful in the treatment of depression. Eighty nonseasonal depressive outpatients on anti-depressant treatment were randomly assigned either to the active or control group. Four hygienic-dietary recommendations were prescribed together. Outcome measures were blinded assessed before and after the six month intervention period. A better evolution of depressive symptoms, a higher rate of responder and remitters and a lesser psychopharmacological prescription was found in the active group. Small sample size. Lacked homogeneity concerning affective disorders (major depression, dysthimia, bipolar depression). This study suggests lifestyle recommendations can be used as an effective antidepressant complementary strategy in daily practice.",22516309,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,8.253729820251465,-1.267962098121643,Cujq
"The Appalachia Mind Health Initiative (AMHI): a pragmatic randomized clinical trial of adjunctive internet-based cognitive behavior therapy for treating major depressive disorder among primary care patients.

Major depressive disorder (MDD) is a leading cause of disease morbidity. Combined treatment with antidepressant medication (ADM) plus psychotherapy yields a much higher MDD remission rate than ADM only. But 77% of US MDD patients are nonetheless treated with ADM only despite strong patient preferences for psychotherapy. This mismatch is due at least in part to a combination of cost considerations and limited availability of psychotherapists, although stigma and reluctance of PCPs to refer patients for psychotherapy are also involved. Internet-based cognitive behaviorial therapy (i-CBT) addresses all of these problems. Enrolled patients (n = 3360) will be those who are beginning ADM-only treatment of MDD in primary care facilities throughout West Virginia, one of the poorest and most rural states in the country. Participating treatment providers and study staff at West Virginia University School of Medicine (WVU) will recruit patients and, after obtaining informed consent, administer a baseline self-report questionnaire (SRQ) and then randomize patients to 1 of 3 treatment arms with equal allocation: ADM only, ADM + self-guided i-CBT, and ADM + guided i-CBT. Follow-up SRQs will be administered 2, 4, 8, 13, 16, 26, 39, and 52 weeks after randomization. The trial has two primary objectives: to evaluate aggregate comparative treatment effects across the 3 arms and to estimate heterogeneity of treatment effects (HTE). The primary outcome will be episode remission based on a modified version of the patient-centered Remission from Depression Questionnaire (RDQ). The sample was powered to detect predictors of HTE that would increase the proportional remission rate by 20% by optimally assigning individuals as opposed to randomly assigning them into three treatment groups of equal size. Aggregate comparative treatment effects will be estimated using intent-to-treat analysis methods. Cumulative inverse probability weights will be used to deal with loss to follow-up. A wide range of self-report predictors of MDD heterogeneity of treatment effects based on previous studies will be included in the baseline SRQ. A state-of-the-art ensemble machine learning method will be used to estimate HTE. The study is innovative in using a rich baseline assessment and in having a sample large enough to carry out a well-powered analysis of heterogeneity of treatment effects. We anticipate finding that self-guided and guided i-CBT will both improve outcomes compared to ADM only. We also anticipate finding that the comparative advantages of adding i-CBT to ADM will vary significantly across patients. We hope to develop a stable individualized treatment rule that will allow patients and treatment providers to improve aggregate treatment outcomes by deciding collaboratively when ADM treatment should be augmented with i-CBT. ClinicalTrials.gov NCT04120285 . Registered on October 19, 2019.",35725644,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.347350120544434,-1.2778385877609253,TWs
"STEP.De study-a multicentre cluster-randomised effectiveness trial of exercise therapy for patients with depressive symptoms in healthcare services: study protocol.

Although exercise therapy has widely been shown to be an efficacious treatment modality for depression, evidence for its effectiveness and cost efficiency is lacking. The Sport/Exercise Therapy for Depression study is a multicentre cluster-randomised effectiveness trial that aims to compare the effectiveness and cost efficiency of exercise therapy and psychotherapy as antidepressant treatment. 480 patients (aged 18-65) with an International Classification of Diseases diagnosis associated with depressive symptoms are recruited. Up to 30 clusters (psychotherapists) are randomly assigned to allocate patients to either an exercise or a psychotherapy treatment as usual in a 2:1 ratio. The primary outcome (depressive symptoms) and the secondary outcomes (work and social adjustment, quality of life) will be assessed at six measurement time points (t0: baseline, t1: 8 weeks after treatment initiation, t2: 16 weeks after treatment initiation, t3/4/5: 2, 6, 12 months after treatment). Linear regression analyses will be used for the primary endpoint data analysis. For the secondary endpoints, mixed linear and logistic regression models with fixed and random factors will be added. For the cost efficiency analysis, expenditures in the 12 months before and after the intervention and the outcome difference will be compared between groups in a multilevel model. Recruitment start date was 1 July 2018 and the planned recruitment end date is 31 December 2020. The study protocol was approved by the ethics committee of the University of Potsdam (No. 17/2018) and the Freie Universität Berlin (No. 206/2018) and registered in the ISRCTN registry. Informed written consent will be obtained from all participants. The study will be reported in accordance with the Consolidated Standards of Reporting Trials and the Recommendations for Interventional Trials statements. The results will be published in peer-reviewed academic journals and disseminated to the public. ISRCTN28972230.",32295779,Major Depressive Disorder,Anxiety Treatment,Mental Health,6812,7.892276287078857,-1.4863477945327759,AqkZ
"The Generalizability of Randomized Controlled Trials of Self-Guided Internet-Based Cognitive Behavioral Therapy for Depressive Symptoms: Systematic Review and Meta-Regression Analysis.

Self-guided internet-based cognitive behavioral therapies (iCBTs) for depressive symptoms may substantially increase accessibility to mental health treatment. Despite this, questions remain as to the generalizability of the research on self-guided iCBT. We sought to describe the clinical entry criteria used in studies of self-guided iCBT, explore the criteria's effects on study outcomes, and compare the frequency of use of these criteria with their use in studies of face-to-face psychotherapy and antidepressant medications. We hypothesized that self-guided iCBT studies would use more stringent criteria that would bias the sample toward those with a less complex clinical profile, thus inflating treatment outcomes. We updated a recently published meta-analysis by conducting a systematic literature search in PubMed, MEDLINE, PsycINFO, and EMBASE. We conducted a meta-regression analysis to test the effect of the different commonly used psychiatric entry criteria on the treatment-control differences. We also compared the frequency with which exclusion criteria were used in the self-guided iCBT studies versus studies of face-to-face psychotherapy and antidepressants from a recently published review. Our search yielded 5 additional studies, which we added to the 16 studies identified by Karyotaki and colleagues in 2017. Few self-guided iCBT studies excluded patients with severe depressive symptoms (6/21, 29%), but self-guided iCBT studies were more likely than antidepressant (14/170, 8.2%) studies to use this criterion. However, self-guided iCBT studies did not use this criterion more frequently than face-to-face psychotherapy studies (6/16, 38%). Beyond this, we found no evidence that self-guided iCBTs used more stringent entry criteria. Strong evidence suggested that they were actually less likely to use most entry criteria, especially exclusions on the basis of substance use or personality pathology. None of the entry criteria used had an effect on outcomes. A conservative interpretation of our findings is that the patient population sampled in the literature on self-guided iCBT is relatively comparable with that of studies of antidepressants or face-to-face psychotherapy. Alternatively, studies of unguided cognitive behavioral therapy may sample from a more heterogeneous and representative patient population. Until evidence emerges to suggest otherwise, the patient population sampled in self-guided iCBT studies cannot be considered as less complex than the patient population from face-to-face psychotherapy or antidepressant studies.",30413400,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.725348472595215,-2.9938600063323975,BDhy
"Web-based cognitive behavior therapy for depression with and without telephone tracking in a national helpline: secondary outcomes from a randomized controlled trial.

An earlier report indicated that callers to a telephone counseling service benefited from the addition of an evidence-based Web intervention for depression. It is not known whether the Web intervention would also lower alcohol use and stigma, or improve quality of life and knowledge of depression and its treatments. To report the secondary outcomes of a trial of a Web-based cognitive behavior therapy (CBT) intervention for depression, including hazardous alcohol use, quality of life, stigma, depression literacy, and CBT literacy. We recruited a sample of 155 callers to Lifeline, a national telephone counseling service in Australia, who met the criteria for moderate to high psychological distress. Participants were randomly assigned to 1 of 4 conditions: (1) Web CBT plus weekly telephone tracking, (2) Web CBT only, (3) weekly telephone tracking only, and (4) neither Web CBT nor telephone tracking. Participants were assessed at preintervention, postintervention, and 6 and 12 months postintervention. At postintervention, participants who completed the Web intervention either with or without telephone support had lower levels of hazardous alcohol use (without tracking: P = .008, effect size = 0.23; with tracking: P = .003, effect size = 0.26), improved quality of life (without tracking: P = .001, effect size = 0.81; with tracking: P = .009, effect size = 0.63), and improved CBT literacy (without tracking: P = .01, effect size = 0.71; with tracking: P < .001, effect size = 0.80) compared with those who did not receive the Web intervention or telephone support. Results for quality of life and CBT literacy were maintained at 6- and 12-month's follow-up, but differences in hazardous alcohol use were not significantly different between conditions at 6 and 12 months. Although omnibus tests for depression literacy and stigma were nonsignificant, contrasts revealed that those in the Web-only condition showed significantly lower levels of stigma than participants in the control condition at postintervention. This was true for participants in the Web-only and Web plus tracking conditions at 6 months. Similarly, those in the Web-only and Web plus tracking conditions had significantly higher depression literacy at postintervention, and this was maintained in the Web-only condition at 6-months' follow-up. No significant differences were found in depression literacy and stigma between conditions at 12 months. Evidence-based Web interventions for depression can be effective not only in reducing depression symptoms but also in improving other health outcomes, including quality of life, hazardous alcohol use, and knowledge about effective strategies for depression self-management. International Standard Randomized Controlled Trial Number (ISRCTN): 93903959; http://www.controlled-trials.com/ISRCTN93903959/ (Archived by WebCite at http://www.webcitation.org/65y61nSsH).",22738715,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.373973846435547,-3.066831111907959,CroL
"The efficacy and optimal matching of an Internet-based acceptance and commitment therapy intervention for depressive symptoms among university students: A randomized controlled trial in China.

The present study tested the efficacy of an unguided internet-based Acceptance and Commitment Therapy (iACT) program for depression, and identified the psychological characteristics of participants who benefitted the most from the program. Undergraduate students with mild to severe symptoms of depression were randomized to the iACT group (n=95) or the waiting-list group (WLC group; n=87). Depressive symptoms and positive mental health were assessed at baseline (T0 ), at the end of the 6-week program (T1 ), and at a 3-month follow-up (T2 ). Compared with the WLC group, the iACT group showed significantly more improvement in depressive symptoms (d=1.27) and positive mental health (d=0.59), both at T1 and T2 . Latent Profile Analysis identified three classes of participants: Sensitive-to-Relationship, Low-Reactive-Depression, and Endogenous-Depression group. In general, the treatment was particularly suitable for the Sensitive-to-Relationship class. The iACT was effective in treating the depressive symptoms of undergraduates, especially suitable for the clients with high baseline depression, high externality, high resistance, and high sensitivity to relationships.",35191525,Major Depressive Disorder,Anxiety Treatment,Mental Health,9547,8.154237747192383,-2.0200111865997314,mHU
"Cost-Utility Analysis of Mindfulness-Based Cognitive Therapy Versus Antidepressant Pharmacotherapy for Prevention of Depressive Relapse in a Canadian Context: Analyse coût-utilité de la thérapie cognitive basée sur la pleine conscience contre la pharmacothérapie antidépressive pour prévenir la rechute de la dépression en contexte canadien.

Patients suffering from major depressive disorder (MDD) experience impaired functioning and reduced quality of life, including an elevated risk of episode return. MDD is associated with high societal burden due to increased healthcare utilization, productivity losses, and suicide-related costs, making the long-term management of this illness a priority. The purpose of this study is to evaluate the cost-effectiveness of mindfulness-based cognitive therapy (MBCT), a first-line preventative psychological treatment, compared to maintenance antidepressant medication (ADM), the current standard of care. A cost-utility analysis was conducted over a 24-month time horizon to model differences between MBCT and ADM in cost and quality-adjusted life years (QALY). The analysis was conducted using a decision tree analytic model. Intervention efficacy, utility, and costing data estimates were derived from published sources and expert consultation. MBCT was found to be cost-effective compared to maintenance ADM over a 24-month time horizon. Antidepressant pharmacotherapy resulted in 1.10 QALY and $17,255.37 per patient on average, whereas MBCT resulted in 1.18 QALY and $15,030.70 per patient on average. This resulted in a cost difference of $2,224.67 and a QALY difference of 0.08, in favor of MBCT. Multiple sensitivity analyses supported these findings. From both a societal and health system perspective, utilizing MBCT as a first-line relapse prevention treatment is potentially cost-effective in a Canadian setting. Future economic evaluations should consider combined treatment (e.g., ADM and psychotherapy) as a comparator and longer time horizons as the literature advances.",32031000,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.856088638305664,-1.688405990600586,Atw0
"A DILEMMA-FOCUSED INTERVENTION FOR DEPRESSION: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL WITH A 3-MONTH FOLLOW-UP.

Since long ago it has been asserted that internal conflicts are relevant to the understanding and treatment of mental disorders, but little research has been conducted to support the claim. The aim of this study was to test the differential efficacy of group cognitive behavioral therapy (CBT) plus an intervention focused on the dilemma(s) detected for each patient versus group individual CBT plus individual CBT for treating depression. A comparative controlled trial with a 3-month follow-up was conducted. One hundred twenty-eight adults meeting criteria for MDD and/or dysthymia, presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct, assessed by the repertory grid technique) and who had completed seven sessions of group CBT were randomly assigned to eight sessions of individual manualized CBT or dilemma-focused therapy (DFT). The Beck Depression Inventory-II was administered at baseline, at the end of therapy and after 3 months' follow-up. Multilevel mixed effects modeling yielded no significant differences between CBT and DFT with the intention-to-treat sample. Equivalent effect sizes, remission, and response rates were found with completers as well. In combination with group CBT, both individual CBT and DFT significantly reduced depressive symptoms. Both conditions obtained comparable results to those in the literature. Thus, the superiority of the adjunctive DFT was not demonstrated. Working with dilemmas can be seen as a promising additional target in the psychotherapy of depression, but further research is still required.",27103215,Major Depressive Disorder,Anxiety Treatment,Mental Health,26910,11.222182273864746,-2.244539499282837,Bt3N
"Efficacy of cognitive-behavioural therapy and other psychological treatments for adult depression: meta-analytic study of publication bias.

It is not clear whether the effects of cognitive-behavioural therapy and other psychotherapies have been overestimated because of publication bias. To examine indicators of publication bias in randomised controlled trials of psychotherapy for adult depression. We examined effect sizes of 117 trials with 175 comparisons between psychotherapy and control conditions. As indicators of publication bias we examined funnel plots, calculated adjusted effect sizes after publication had been taken into account using Duval & Tweedie's procedure, and tested the symmetry of the funnel plots using the Begg & Mazumdar rank correlation test and Egger's test. The mean effect size was 0.67, which was reduced after adjustment for publication bias to 0.42 (51 imputed studies). Both Begg & Mazumbar's test and Egger's test were highly significant (P<0.001). The effects of psychotherapy for adult depression seem to be overestimated considerably because of publication bias.",20194536,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.64284610748291,-2.2856926918029785,DNSc
"The clinical effectiveness of cognitive therapy for depression in an outpatient clinic.

Cognitive therapy (CT) has been shown to be efficacious in the treatment of depression in numerous randomized controlled trials (RCTs). However, little evidence is available that speaks to the effectiveness of this treatment under routine clinical conditions. This paper examines outcomes of depressed individuals seeking cognitive therapy at an outpatient clinic (N=217, Center for Cognitive Therapy; CCT). Outcomes were then compared to those of participants in a large NIMH-funded RCT of cognitive therapy and medications as treatments for depression. The CCT is shown to be a clinically representative setting, and 61% of participants experienced reliable change in symptoms over the course of treatment; of those, 45% (36% of the total sample) met criteria for recovery by the end of treatment. Participants at CCT had similar outcomes to participants treated in the RCT, but there was some evidence that those with more severe symptoms at intake demonstrated greater improvement in the RCT than their counterparts at CCT. The CCT may not be representative of all outpatient settings, and the structure of treatment there was considerably different from that in the RCT. Treatment fidelity was not assessed at CCT. Depressed individuals treated with cognitive therapy in a routine clinical care setting showed a significant improvement in symptoms. When compared with outcomes evidenced in RCTs, there was little evidence of superior outcomes in either setting. However, for more severe participants, outcomes were found to be superior when treatment was delivered within an RCT than in an outpatient setting. Clinicians treating such patients in non-research settings may thus benefit from making modifications to treatment protocols to more closely resemble research settings.",20080305,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.779108047485352,-2.7165400981903076,DOxD
"Feasibility study of an interactive multimedia electronic problem solving treatment program for depression: a preliminary uncontrolled trial.

Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a minimally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4weeks), and study endpoint (10weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated.",24680231,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.72896957397461,-2.766613245010376,CQFu
"An effectiveness trial of group cognitive behavioral therapy for patients with persistent depressive symptoms in substance abuse treatment.

Although depression frequently co-occurs with substance abuse, few individuals entering substance abuse treatment have access to effective depression treatment. The Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT) study is a community-based effectiveness trial that compared residential substance abuse treatment with residential treatment plus group cognitive behavioral therapy for depression delivered by substance abuse treatment counselors. We hypothesized that intervention clients would have improved depression and substance use outcomes compared with those of clients receiving usual care. A nonrandomized controlled trial using a quasi-experimental intent-to-treat design in which 4 sites were assigned to alternate between the intervention and usual care conditions every 4 months for 2½ years. Four treatment programs in Los Angeles County. We screened 1262 clients for persistent depressive symptoms (Beck Depression Inventory-II score >17). We assigned 299 clients to receive either usual care (n = 159) or usual care plus the intervention (n = 140). Follow-up rates at 3 and 6 months after the baseline interview were 88.1% and 86.2%, respectively, for usual care and 85.7% and 85.0%, respectively, for the intervention group. Sixteen 2-hour group sessions of cognitive behavioral therapy for depression. Change in depression symptoms, mental health functioning, and days of alcohol and problem substance use. Intervention clients reported significantly fewer depressive symptoms (P < .001 at 3 and 6 months) and had improved mental health functioning (P < .001 at 3 months and P < .01 at 6 months). At 6 months, intervention clients reported fewer drinking days (P < .05) and fewer days of problem substance use (P < .05) on days available. Providing group cognitive behavioral therapy for depression to clients with persistent depressive symptoms receiving residential substance abuse treatment is associated with improved depression and substance use outcomes. These results provide support for a new model of integrated care. clinicaltrials.gov Identifier: NCT01191788.",21646576,Major Depressive Disorder,Anxiety Treatment,Mental Health,7932,11.210421562194824,-3.0269241333007812,C7Zg
"Feasibility, acceptability and future adaptation of the Chinese translated Behavioural activation (C-BA) treatment for depression: A pilot study.

Although depression is prevalent among Chinese international students (CIS), only 4% of CIS seek treatment. Behavioural activation (BA) has been suggested as a culturally sensitive treatment for depression that has the potential to meet the clinical needs of CIS. The current pilot study tested the feasibility, acceptability and themes for future cultural adaptations of a Chinese translated BA treatment (C-BA) among CIS. Six CIS with elevated depressive symptoms (Beck Depression Inventory, BDI ≥14) completed a six-session individual C-BA treatment and assessments at pre- and post-treatment and a 1-month follow-up. Primary outcome measures included treatment feasibility, acceptability and qualitative interview data informing future adaption of C-BA. Exploratory analyses examined group changes in depressive symptoms over time and clinically significant symptom changes on individual levels. All participants found the treatment to be highly feasible and culturally acceptable, and were highly engaged in the treatment. Themes of future cultural adaptions were generated from the qualitative interviews. Significant decreases in depressive symptoms were observed at a one1-month post-treatment follow-up assessment. Preliminary evidence suggests that C-BA has the potential to be a culturally sensitive treatment for depression among CIS. CIS demonstrated openness to psychotherapy and high treatment engagement.",32706123,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.530601501464844,-2.172913074493408,AlV6
"Art therapy for patients with depression: expert opinions on its main aspects for clinical practice.

Art therapy is based mainly on clinical experience and is rarely described and evaluated scientifically. There is a need for further exploration of its use in patients with depression. The aim of this study was to explore what experts consider to be the main aspects of art therapy in clinical practice for patients with depression. Eighteen occupational therapists experienced and educated in art therapy participated. The experts answered three rounds of Delphi questionnaires and ranked their agreement with 74 assertions. Consensus was defined as 70% or higher. The experts agreed more on assertions about theoretical frames of reference than about clinical practice. The main aspects of art therapy were agreed to be the patients' opportunity to express themselves verbally and through making art. It was equally important that art tasks provided an opportunity to address depressive thoughts, feelings, life experiences, and physical symptoms. Experts in the field of art therapy considered that the main aspect of clinical practice in art therapy for patients with depression is that art themes should promote expression related to both to depression and personal history.",27469205,Major Depressive Disorder,Anxiety Treatment,Mental Health,2573,10.613719940185547,-5.389645099639893,BpT+
"Psychological Treatment of Depression in Primary Care: Recent Developments.

We give an overview of recent developments on psychological treatments of depression in primary care. In recent years, it has become clear that psychotherapies can effectively be delivered through e-health applications. Furthermore, several studies in low and middle income countries have shown that lay health counselors can effectively deliver psychological therapies. Behavioral activation, a relatively simple form of therapy, has been found to be as effective as cognitive behavior therapy. Treatment of subthreshold depression has been found to not only reduce depressive symptoms but also prevent the onset of major depression. In addition, therapies are effective in older adults, patients with general medical disorders and in perinatal depression. Psychological therapies are effective in the treatment of depression in primary care, have longer lasting effects than drugs, are preferred by the majority of patients, and can be applied flexibly with different formats and across different target groups.",31760505,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.511589050292969,-2.6089773178100586,AxWl
"[Behavioral activation and depression: a contextual treatment approach].

Depression is a widespread psychological disorder that affects approximately one in five North American. Typical reactions to depression include inactivity, isolation, and rumination. Several treatments and psychological interventions have emerged to address this problematic. Cognitive behavioural therapies have received increasingly large amounts of empirical support. A sub-component of cognitive behavioural therapy, behavioural activation, has been shown to in itself effectively treat symptoms of depression. This intervention involves efforts to re-activate the depressed client by having them engage in pleasant, gratifying, leisure, social, or physical activities, thereby counteracting the tendency to be inactive and to isolate oneself. Clients are guided through the process of establishing a list of potentially rewarding social, leisure, mastery-oriented or physical activities, to then establish a gradual hierarchy of objectives to be accomplished over the span of several weeks. Concrete action plans are devised, and solutions to potential obstacles are elaborated. The client is the asked to execute the targeted objective and to record their mood prior to and following the activity. Behavioural activation effectively reverses the downward spiral to depression. Interestingly, studies show that behavioural activation has a positive effect on cognitive activities. It has been shown to reduce rumination and favour cognitive restructuring, without requiring cognitively-based interventions. The advantage of this treatment is therefore that it is simpler to administer in comparison to full-packaged cognitive behavioural therapies, it requires a lesser number of sessions and can be disseminated in a low-intensity format. This article begins by summarizing the origins of the behavioural model of depression, which serves as a basis to the understanding of behavioural activation. This is followed by a detailed explanation of the different phases involved in a behavioural activation intervention. Empirical support for behavioural activation is then presented in regards to depression as well as comorbid physical and psychological health problems. The results of meta-analyses and randomized controlled trials are presented. Behavioural activation is then discussed within the framework of third-wave therapies, discussing the potential role of mindfulness in behavioural activation objectives. Specifically, it is suggested that mindfulness, although not necessarily directly addressed in behavioural activation interventions, is an integral part of this intervention as clients are asked to record their mood and activities and to become cognizant of the relationship between their symptoms of depression and the participation in activities that provide positive reinforcement. This favours self-awareness and allows clients to realize the impact of their actions on their physical and psychological states. In engaging in self-observation and self-recording, and in participating in a variety of tasks and activities, clients are indirectly encouraged to focus on the here and now rather that to succumb to the depressive tendency that is to ruminate. Suggestions are made as to how therapists can include mindfulness-based activities in the behavioural activation hierarchy. It is hypothesized that, due to the calming effect of mindfulness practices on the nervous system, incorporating mindfulness-based activities-such as yoga, tai chi, Qi Gong, or meditation-could for some people enhance the efficacy of behavioural activation interventions and foster a greater sense of well-being. The article concludes by discussing issues that should be addressed in future research. It is suggested that future studies on behavioural activation explore the impacts of incorporating mindfulness-based activities in the behavioural activation hierarchy in comparison to a traditional hierarchy limited to the accomplishment of gratifying or mastery-oriented tasks, social outings, leisure activities and physical activity.",24719008,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,10.392026901245117,-1.862418532371521,CPhE
"Effects of Scheduled Waiting for Psychotherapy in Patients With Major Depression.

The role of nonspecific factors in the outcome of psychotherapy is poorly understood. To study the effects of pretreatment expectancy of scheduled psychotherapy, we examined the effects of an agreed waiting time on the outcome of psychodynamic psychotherapy. Thirty-three treatment-naive outpatients with major depressive disorder were randomly selected to start psychotherapy either directly (DG; n = 17) or after waiting for 6 months (WG; n = 16). In WG, 18% to 60% of the total decline in symptoms took place during the waiting time. After 1 year of active psychotherapy, the anxiety score declined significantly only in WG, and the total length of treatment needed was shorter in WG. No other outcome differences between WG and DG were found. We conclude that scheduled waiting associates with a significant decline in depressive symptoms. Scheduled waiting should be regarded as a preparatory treatment and not as an inert nontreatment control.",27861459,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,10.472846984863281,-2.8883893489837646,Bkjz
"The Effectiveness of Cognitive Behavioral Therapy versus Psychoeducation in the Management of Depression among Patients Undergoing Haemodialysis.

The aim of this randomized controlled trial was to compare the effectiveness of psychoeducation versus cognitive behavioral therapy (CBT) in the management of depression among renal dialysis patients. A sample of 130 dialysis patients participated in the study and they were assigned at random to one of two therapies: psychoeducation (N = 65) or CBT (N = 65). Hamilton depression rating scale was completed by the participants in both groups prior to the therapies and after completion. Both therapies were effective in the management of depression, although psychoeducation was superior. Psychoeducation is recommended over CBT in the management of depression among renal dialysis patients.",29370555,Major Depressive Disorder,Anxiety Treatment,Mental Health,2177,10.440921783447266,-2.2839412689208984,BQ/4
"Psychological treatments for persistent depression: A systematic review and meta- analysis of quality of life and functioning outcomes: Correction to McPherson and Senra (2022).

Reports an error in ""Psychological treatments for persistent depression: A systematic review and meta-analysis of quality of life and functioning outcomes"" by Susan McPherson and Hugo Senra (Psychotherapy, Advanced Online Publication, Jun 27, 2022, np). In the article, there were errors in the abstract. The confidence interval in the sentence Quality of life at follow-up: pooled g = 0.21 should appear as follows: 95% CI, 0.10-0.32. In the sentence The psychological interventions were associated with improvements in patients' functioning at end-of-treatment, the pooled g should appear as g = 0.35. The confidence interval in the sentence Functioning at follow-up resulted in: pooled g = 0.33 should appear as follows: 95% CI, 0.15-0.51. Figure 5 also has been corrected. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2022-76312-001.) To date it is unclear whether psychological therapies have potential to improve quality of life and functioning in patients with persistent depression. This meta-analysis examines the effect of psychological therapies for improving quality of life and functioning in patients with persistent forms of depression. Data sources include Medline and Meta-Analytic Psychotherapy Database (METAPSY), searched 07/2021. Eligible studies were randomized controlled trials where participants had major depressive disorder on entry and met criteria for a persistent form of depression, for example, chronic, treatment resistant or recurrent depression. Standardized mean differences (Hedge's g) were calculated in random-effects meta-analyses. Fourteen studies met inclusion criteria (N = 1898). Psychological interventions were associated with improvements in patients' quality of life at the end of treatment: pooled g = 0.24 (95% confidence intervals [CIs] 0.13-0.34); low to moderate levels of heterogeneity (I² = 0% [95% CI 0%-41.2%]). Quality of life at follow-up: pooled g = 0.21 (95% CI 0.01-0.32); low to high levels of heterogeneity considering the wide CI for I² (I² = 10.36% [95% CI 0%-77.5%]). The psychological interventions were associated with improvements in patients' functioning at end of treatment: pooled g = 0.34 (95% CI 0.21-0.48); low to high levels of heterogeneity considering the wide CI for I² (I² = 0% [95% CI 0%-81.7%]). Functioning at follow-up resulted in: pooled g = 0.33 (95% CI 0.15-0.50); low to high levels of heterogeneity considering the wide CI for I² (I² = 0% [95% CI 0%-86.2%]). This meta-analysis highlights the potential benefits of psychological therapies for improving quality of life and functioning in patients with persistent depression, with strongest long-term effects for mindfulness-based cognitive therapy, interpersonal therapy in combination with antidepression medication, and long-term psychoanalytic psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",36037491,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.19242000579834,-2.223390817642212,Jno
"Effectiveness of interpersonal psychotherapy for community living depressed women involved with the justice system.

Despite the prevalence of depression among women in the justice system, and its potentially significant consequences, there is a dearth of studies investigating psychological treatments for depression in this context, especially outside prison. Our aim was to gather preliminary data on whether individual interpersonal psychotherapy (IPT) is an acceptable and effective treatment for depression in women at an early stage in the justice system. In this pilot study, IPT was offered to 24 depressed women following their first or second contact with the justice system. The women were assessed using a range of scales to quantify depression, anxiety, post-traumatic stress disorder (PTSD) and social support. Multilevel models were used to explore interactions between change in depression and other features given the multiplicity and complexity of problems. Details on engagement and attrition were also collected. Therapy attrition was low, despite challenging life-circumstances and depression scores followed a linear trajectory with scores significantly decreasing over the time (β = -0.59, SE = 0.07, p < 0.001). Participants with more adverse life events, attachment related anxiety and lower social support had poorer outcomes. Results are encouraging. More than half of the hard-to-reach women who were eligible did engage, and retention rates suggest the therapy was acceptable to them. Depression scores improved, and potential factors affecting treatment outcome were identified. A randomised controlled trial is now warranted, ensuring adequate supplementary support for women with dependants living on their own and without employment.",33969558,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,11.443378448486328,-3.771496534347534,AWlU
"Psychological therapies for preventing seasonal affective disorder.

Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions. To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second-generation antidepressants (SGAs), light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD. We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group Specialised Register (CCDANCTR) to 11 August 2015. The CCDANCTR contains reports of relevant randomised controlled trials from EMBASE (1974 to date), MEDLINE (1950 to date), PsycINFO (1967 to date) and the Cochrane Central Register of Controlled Trials (CENTRAL). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Knowledge, The Cochrane Library and the Allied and Complementary Medicine Database (AMED) (to 26 May 2014). We conducted a grey literature search (e.g. in clinical trial registries) and handsearched the reference lists of all included studies and pertinent review articles. To examine efficacy, we planned to include randomised controlled trials on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non-randomised studies. We planned to include studies that compared psychological therapy versus any other type of psychological therapy, placebo, light therapy, SGAs, melatonin, agomelatine or lifestyle changes. We also intended to compare psychological therapy in combination with any of the comparator interventions listed above versus the same comparator intervention as monotherapy. Two review authors screened abstracts and full-text publications against the inclusion criteria. Two review authors planned to independently extract data and assess risk of bias. We planned to pool data for meta-analysis when participant groups were similar and when studies assessed the same treatments versus the same comparator and provided similar definitions of outcome measures over a similar duration of treatment; however, we included no studies. We identified 2986 citations through electronic searches and reviews of reference lists after de-duplication of search results. We excluded 2895 records during title and abstract review and assessed 91 articles at full-text review for eligibility. We found no controlled studies on use of psychological therapy to prevent SAD and improve patient-centred outcomes in adults with a history of SAD. Presently, there is no methodologically sound evidence available to indicate whether psychological therapy is or is not an effective intervention for prevention of SAD and improvement of patient-centred outcomes among adults with a history of SAD. Randomised controlled trials are needed to compare different types of psychological therapies and to compare psychological therapies versus placebo, light therapy, SGAs, melatonin, agomelatine or lifestyle changes for prevention of new depressive episodes in patients with a history of winter-type SAD.",26560172,Major Depressive Disorder,Anxiety Treatment,Mental Health,5646,-3.8918800354003906,4.7193522453308105,B1Sg
"Predicting early dropout in online versus face-to-face guided self-help: A machine learning approach.

Early dropout hinders the effective adoption of brief psychological interventions and is associated with poor treatment outcomes. This study examined if attendance and depression treatment outcomes could be improved by matching patients to either face-to-face or computerized low-intensity psychological interventions. Archival clinical records were analysed for 85,664 patients who accessed face-to-face or computerized guided self-help (GSH). The primary outcome was early dropout (attending ≤3 sessions). Supervised machine learning analyses were applied in a training sample (n = 55,529). The trained algorithm was cross-validated in an independent test sample (n = 30,135). The clinical utility of the model was evaluated using logistic regression, chi-square tests, and sensitivity analyses in a balanced subsample. Patients who received their model-indicated treatment modality were 12% more likely to receive an adequate dose of treatment OR = 1.12 (95% CI = 1.02 to 1.24), p = .02, and the strength of this effect was larger in the balanced subsample (OR = 2.10, 95% CI = 1.65 to 2.68, p < .001). Patients had better treatment outcomes when matched to their model-indicated treatment modality. Machine learning approaches may enable services to optimally match patients to the treatment modality that maximizes attendance.",36244300,Major Depressive Disorder,Anxiety Treatment,Mental Health,24111,12.4752197265625,-5.316985130310059,D/8
"Reducing Stress and Preventing Depression (RESPOND): Randomized Controlled Trial of Web-Based Rumination-Focused Cognitive Behavioral Therapy for High-Ruminating University Students.

Prevention of depression is a priority to reduce its global disease burden. Targeting specific risk factors, such as rumination, may improve prevention. Rumination-focused Cognitive Behavioral Therapy (RFCBT) was developed to specifically target depressive rumination. The primary objective of this study was to test whether guided Web-based RFCBT (i-RFCBT) would prevent the incidence of major depression relative to usual care in UK university students. The secondary objective was to test the feasibility and estimated effect sizes of unguided i-RFCBT. To address the primary objective, a phase III randomized controlled trial was designed and powered to compare high risk university students (N=235), selected with elevated worry/rumination, recruited via an open access website in response to circulars within universities and internet advertisements, randomized to receive either guided i-RFCBT (interactive Web-based RFCBT, supported by asynchronous written Web-based support from qualified therapists) or usual care control. To address the secondary objective, participants were also randomized to an adjunct arm of unguided (self-administered) i-RFCBT. The primary outcome was the onset of a major depressive episode over 15 months, assessed with structured diagnostic interviews at 3 (postintervention), 6, and 15 months post randomization, conducted by telephone, blind to the condition. Secondary outcomes of symptoms of depression and anxiety and levels of worry and rumination were self-assessed through questionnaires at baseline and the same follow-up intervals. Participants were randomized to guided i-RFCBT (n=82), unguided i-RFCBT (n=76), or usual care (n=77). Guided i-RFCBT reduced the risk of depression by 34% relative to usual care (hazard ratio [HR] 0.66, 95% CI 0.35 to 1.25; P=.20). Participants with higher levels of baseline stress benefited most from the intervention (HR 0.43, 95% CI 0.21 to 0.87; P=.02). Significant improvements in rumination, worry, and depressive symptoms were found in the short-to-medium term. Of the 6 modules, guided participants completed a mean of 3.46 modules (SD 2.25), with 46% (38/82) being compliant (completing ≥4 modules). Similar effect sizes and compliance rates were found for unguided i-RFCBT. Guided i-RFCBT can reduce the onset of depression in high-risk young people reporting high levels of worry/rumination and stress. The feasibility study argues for formally testing unguided i-RFCBT for prevention: if the observed effect sizes are robustly replicated in a phase III trial, it has potential as a scalable prevention intervention. ISRCTN Registry ISRCTN12683436; https://www.isrctn.com/ISRCTN12683436 (Archived by WebCite at http://www.webcitation.org/77fqycyBX). RR2-10.1186/s13063-015-1128-9.",31094331,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,15.121068954467773,-1.515755534172058,A6a1
"Sudden gains in cognitive-behavior therapy for treatment-resistant depression: Processes of change.

Sudden gains were investigated in cognitive-behavioral therapy (CBT) for treatment-resistant depression (TRD). Client and therapist processes in sessions proximal to sudden gains were examined to better understand the antecedents of sudden gains and potential mechanisms linking them to outcome. Participants were 156 adults with TRD in a randomized controlled trial of CBT as an adjunct to pharmacotherapy (Wiles et al., 2013). Depression symptoms were assessed by the Beck Depression Inventory-II at each session. In a subsample of 50 clients, audio-recordings of 125 therapy sessions were rated for hope, emotional processing, and therapist competence in case-conceptualization. Sudden gains were experienced by 54% of participants. Those with gains reported significantly lower depression severity at 12-month follow-up and more remission of symptoms than those without gains. Sudden gains also predicted lower depression at follow-up, beyond the slope of linear change in symptoms across treatment. Therapists demonstrated greater competence in case conceptualization with clients who reported sudden gains, and those with gains expressed more hope in sessions prior to a gain. In addition, more hope and emotional processing in the pregain sessions predicted less depression at follow-up, controlling for depression scores in the prior session. Better therapist conceptualization skills and more client hope in the baseline and pregain sessions were also associated with more emotional processing in those same sessions. This study extends the phenomenon of sudden gains in CBT for depression to a treatment-resistant population and identified important therapy processes that predicted long-term outcomes: hope and emotional processing. (PsycINFO Database Record",27100125,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.558382987976074,-2.802917242050171,Bt6K
"Cognitive bias modification to prevent depression (COPE): results of a randomised controlled trial.

Although efficacious treatments for major depression are available, efficacy is suboptimal and recurrence is common. Effective preventive strategies could reduce disability associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel and safe intervention that attenuates biases associated with depression. This study investigated whether the delivery of a CBM programme designed to attenuate negative cognitive biases over a period of 1 year would decrease the incidence of major depression among adults with subthreshold symptoms of depression. Randomised double-blind controlled trial delivered an active CBM intervention or a control intervention over 52 weeks. Two hundred and two community-dwelling adults who reported subthreshold levels of depression were randomised (100 intervention, 102 control). The primary outcome of interest was the incidence of major depressive episode assessed at 11, 27 and 52 weeks. Secondary outcomes included onset of clinically significant symptoms of depression, change in severity of depression symptoms and change in cognitive biases. Adherence to the interventions was modest though did not differ between conditions. Incidence of major depressive episodes was low. Conditions did not differ in the incidence of major depressive episodes. Likewise, conditions did not differ in the incidence of clinically significant levels of depression, change in the severity of depression symptoms or change in cognitive biases. Active CBM intervention did not decrease the incidence of major depressive episodes as compared to a control intervention. However, adherence to the intervention programme was modest and the programme failed to modify the expected mechanism of action.",31544719,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.315675735473633,-0.8949535489082336,A0T+
"Schema therapy for patients with chronic depression: a single case series study.

This study tested the effectiveness of schema therapy (ST) for patients with chronic depression. Twelve patients with a diagnosis of chronic depression participated. The treatment protocol consisted of 60 sessions, with the first 55 sessions offered weekly and the last five sessions on a biweekly basis. A single case series A-B-C design, with 6 months follow-up was used. Baseline (A) was a wait period of 8 weeks. Baseline was followed by introduction to ST and bonding to therapist (phase B) with individually tailored length of 12-16 sessions, after which further ST was provided (phase C) up to 60 sessions (included the sessions given as introduction). Patients were assessed with Hamilton Rating Scale for Depression three times during baseline, at the end of phase B, then every 12 weeks until the end of treatment and at 6 months follow-up. Secondary outcome measures were the Hamilton Rating Scale for Anxiety and the Young Schema Questionnaire. At the end of treatment 7 patients (approximately 60%) remitted or satisfactorily responded. The mean HRSD dropped from 21.07 during baseline to 9.40 at post-treatment and 10.75 at follow-up. The effects were large and the gains of treatment were maintained at 6-month follow-up. Only one patient dropped out for reasons not related to treatment. The lack of control group, the small sample and the lack of a multiple baseline case series. This preliminary study supports the use of ST as an effective treatment for chronic depression.",24650608,Major Depressive Disorder,Anxiety Treatment,Mental Health,23813,17.639188766479492,-5.980380535125732,CQh9
"Change in defense mechanisms and coping patterns during the course of 2-year-long psychotherapy and psychoanalysis for recurrent depression: a pilot study of a randomized controlled trial.

Very little research has been conducted so far to study the potential mechanisms of change in long-term active psychological treatments of recurrent depression. The present pilot randomized controlled trial aimed to determine the feasibility of studying the change process occurring in patients during the course of 2-year-long dynamic psychotherapy, psychoanalysis, and cognitive therapy, as compared with clinical management. In total, eight outpatients presenting with recurrent depression, two patients per treatment arm, were included. All patients were randomly assigned to one of the four treatment conditions. Defense mechanisms and coping patterns were assessed using validated observer-rated methodology based on transcribed, semistructured follow-along independent dynamic interviews. The results indicated that, whereas some patients in the active treatments changed on the symptomatic levels, some others remained unchanged during the course of their 2-year-long treatment. However, with regard to potential mechanisms of change in these patients, changes in defense mechanisms and coping patterns were revealed to be important processes over time in successful therapies and, to a lesser extent, in less successful treatments. No change was found either on outcome or on the process measure for the control condition, that is, clinical management. These results are discussed along with previous data comparing change in defense mechanisms and coping during the course of treatments.",23817160,Major Depressive Disorder,Anxiety Treatment,Mental Health,15500,13.578314781188965,-4.0892767906188965,Cb8E
"Is perceived control of depression related to therapy outcome for depression? A longitudinal study.

The present study followed a group of patients over a two-year period after they had received a cognitive behavioral psychoeducational intervention targeting patients' ability to cope with depression. The main aims were to examine whether a change in both depressive symptoms and in the perceived control of depression occurred and the relationship between depressive symptoms and perceived control. Using a prospective longitudinal design, a sample of 183 patients was assessed at four time points during a two-year period. The patients showed a large reduction in depressive symptoms over the two-year period after the course ended. During the same time period, perceived controllability of depression increased. A parallel latent growth curve model showed that increased control beliefs were related to reduced depressive symptoms. The decrease in depressive symptoms over time was not dependent on the patients' initial level of depression or initial control of depression, use of medication, duration of previous depressive episodes, alcohol use or sociodemographic variables. Group interventions aimed at increasing coping skills for preventing and mastering of depression may lead to a large and stable reduction in depressive symptoms. A key factor in prevention may be to strengthen patients' perceived ability to cope with the different symptoms of depression.",34157589,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.560683250427246,-2.6489596366882324,AUYw
"Effects of intensive short-term dynamic psychotherapy on social cognition in major depression.

Background: Social cognition is commonly affected in psychiatric disorders and is a determinant of quality of life. However, there are few studies of treatment.Objective: To investigate the efficacy of intensive short-term dynamic psychotherapy on social cognition in major depression.Method: This study used a parallel group randomized control design to compare pre-test and post-test social cognition scores between depressed participants receiving ISTDP and those allocated to a wait-list control group. Participants were adults (19-40 years of age) who were diagnosed with depression. We recruited 32 individuals, with 16 participants allocated to the ISTDP and control groups, respectively. Both groups were similar in terms of age, sex and educational level.Results: Multivariate analysis of variance (MANOVA) demonstrated that the intervention was effective in terms of the total score of social cognition: the experimental group had a significant increase in the post-test compared to the control group. In addition, the experimental group showed a significant reduction in the negative subjective score compared to the control group as well as an improvement in response to positive neutral and negative states.Conclusion: Depressed patients receiving ISTDP show a significant improvement in social cognition post treatment compared to a wait-list control group.",29792087,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.490917205810547,-2.472599744796753,BLY/
"Identifying change-dropout patterns during an Internet-based intervention for depression by applying the Muthen-Roy model.

To date, only few studies have attempted to investigate non-ignorable dropout during Internet-based interventions by applying an NMAR model, which includes missing data indicators in its equations. Here, the Muthen-Roy model was used to investigate change and dropout patterns in a sample of patients with mild-to-moderate depression symptoms (N = 483) who were randomized to a 12-week Internet-based intervention (deprexis, identifier: NCT01636752). Participants completed the PHQ-9 biweekly during the treatment. We identified four change-dropout patterns: Participants showing high impairment, improvement and low dropout probability (C3, N = 134) had the highest rate of reliable change at 6- and 12-month follow-up. A further pattern was characterized by high impairment, deterioration and high dropout probability (C2, N = 32), another by low impairment, improvement and high dropout probability (C1, N = 198). The last pattern was characterized by high impairment, no change and low dropout probability (C4, N = 119). In addition to deterioration, also rapid improvement may lead to dropout as a result of a perceived ""good enough"" dosage of treatment. This knowledge may strengthen sensitivity for the mechanisms of dropout and help to consider its meaning in efforts to optimize treatment selection.",30721109,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,12.404454231262207,-4.7393693923950195,A/Xf
"It can't hurt, right? Adverse effects of psychotherapy in patients with depression.

Despite growing awareness of occasional adverse effects of psychological treatments, only a few instruments cover side effects and other unwanted effects of psychotherapy. For the present study, the Positive and Negative Effects of Psychotherapy Scale (PANEPS) was evaluated in a population of individuals with depression who had completed at least one course of face-to-face psychotherapy. A total of 135 individuals with a current or previous depressive episode as verified by a diagnostic interview filled out the online version of the PANEPS, which is designed to capture both positive and adverse events. Factor analysis yielded four dimensions: positive effects, side effects, malpractice, and unethical conduct. Internal consistency of the individual subscales was satisfactory to excellent (Cronbach's α: 0.72 and 0.92). Positive effects were reported by virtually all patients (95.6%). At the same time, approximately half of the sample noted at least one adverse event (52.6%). Among these, side effects (38.5%) and malpractice (26.7%) were significantly more prevalent than unethical conduct (8.1%). As expected, positive effects were negatively correlated with adverse events. Our results challenge the common clinical assumption that some degree of destabilization is necessary for symptom improvement. The survey was conducted anonymously, and the sample underwent diagnostic verification. The results indicate a need for improved treatment guidelines and mechanisms to monitor treatment.",30088072,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.555692672729492,-5.65255880355835,BH2/
"[Cognitive therapy of depressive rumination].

Modern approaches to the therapy of depressive ruminations are reviewed. Depressive ruminations are thought to underlie and maintain depression. The authors describe different forms of ruminations and present the analysis of depressive ruminations and the role of childhood experience in their development as well as cognitive-behavioral techniques used for their correction.",31006794,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.48401165008545,-1.3835341930389404,A7lb
"Improved emotion regulation in depression following cognitive remediation: A randomized controlled trial.

Executive functions (EFs) play a key role in emotion regulation and, related to this, depression. Cognitive remediation (CR) targeting EFs, such as Goal Management Training (GMT) and computerized cognitive training (CCT), may reduce maladaptive emotion regulation. However, the clinical potential of GMT in the context of depression and emotion regulation remains to be tested. Hence, the primary aim of the present study was to compare effects of GMT with CCT on symptoms of emotion dysregulation. The paper reports the effects of a preregistered randomized controlled trial. Sixty-three participants (18-60yrs) with active or remitted depression and EF complaints were randomized to nine sessions of GMT (n = 35) or CCT (n = 28). All were assessed at baseline, post-intervention, and at 6-month follow-up. The Ruminative Response Scale and the Difficulties in Emotion Regulation Scale were employed to assess emotion regulation. Both groups improved following the intervention on emotion regulation domains after controlling for intention-to-treat, including brooding rumination and on items reflecting non-accepting reactions to distress. Relative to CCT, the GMT-group demonstrated increased clarity of emotional responses in the per protocol analysis. Our findings demonstrate the potential of GMT and CCT in reducing maladaptive emotion regulation in depression.",34740101,Major Depressive Disorder,Anxiety Treatment,Mental Health,11311,15.081510543823242,-1.437284231185913,4tA
"What the future holds: Machine learning to predict success in psychotherapy.

Machine learning (ML) may help to predict successful psychotherapy outcomes and to identify relevant predictors of success. So far, ML applications are scant in psychotherapy research and they are typically based on small samples or focused on specific diagnoses. In this study, we predict successful therapy outcomes with ML in a heterogeneous sample in routine outpatient care. We trained established ML models (decision trees and ensembles of them) with routinely collected clinical baseline information from n = 685 outpatients to predict a successful outcome of cognitive behavioral therapy. Treatment success was defined as clinically significant change (CSC) on the Brief-Symptom-Checklist (reached by 326 patients; 48%). The best performing model (Gradient Boosting Machines) achieved a balanced accuracy of 69% (p < .001) on unseen validation data. Out of 383 variables, we identified the 16 most important predictors, which were still able to predict CSC with 67% balanced accuracy. Our study demonstrates that ML models built on data, which is typically available at the outset of therapy, can predict whether an individual will substantially benefit from the intervention. Some of the predictors were theoretically expected (e.g., level of functioning), but others need further validation (e.g., somatization). From a theoretical and practical perspective, ML is clearly an attractive addition to more established psychotherapy research methodology.",35715257,Major Depressive Disorder,Anxiety Treatment,Mental Health,10887,12.807016372680664,-1.1155521869659424,Trs
"Alleviating distressing intrusive memories in depression: a comparison between computerised cognitive bias modification and cognitive behavioural education.

Negative appraisals maintain intrusive memories and intrusion-distress in depression, but treatment is underdeveloped. This study compared the efficacy of computerised bias modification positive appraisal training (CBM) versus a therapist-delivered cognitive behavioural therapy session (CB-Education) that both aimed to target and alter negative appraisals of a negative intrusive autobiographical memory. Dysphoric participants (Mean BDI-II = 27.85; N = 60) completed baseline ratings of a negative intrusive memory, negative appraisals and the Impact of Event Scale, and were randomly allocated either one session of CBM, CB-Education, or a no intervention monitoring control condition (Control). Mood and intrusion symptoms were assessed at one week follow-up. For all groups, there were significant reductions over one week in mood (depression and anxiety), memory intrusiveness and negative appraisals. Groups differed in terms of intrusion-related distress, with the CB-Education group showing greatest reduction, followed by the CBM group. The study provides evidence for the link between maladaptive appraisals of intrusive memories and distress in depressed mood. Further, both a single session of CB-Education and (to a lesser degree) CBM are useful in reducing intrusion-related distress. This study may have been underpowered to detect differences and replication is needed with larger samples.",24685536,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,15.425027847290039,-0.8565157055854797,CQAX
"Changes in interpersonal problems in the psychotherapeutic treatment of depression as measured by the Inventory of Interpersonal Problems: A systematic review and meta-analysis.

Interpersonal problems are commonly reported by depressed patients, but the effect of psychotherapeutic treatment on them remains unclear. This paper reviews the effectiveness of psychotherapeutic interventions for depression on interpersonal problems as measured by the Inventory of Interpersonal Problems (IIP). An electronic database search identified articles reporting IIP outcome scores for individual adult psychotherapy for depression. A systematic review and, where possible, meta-analysis was conducted. Twenty-eight studies met inclusion criteria, 10 of which could be included in a meta-analysis investigating changes in the IIP after brief psychotherapy. Reasons for exclusion from the meta-analysis were too few participants with a diagnosis of depression (n=13), IIP means and SDs unobtainable (n=3) and long-term therapy (n=2). A large effect size (g=0.74, 95% CI=0.56-0.93) was found for improvement in IIP scores after brief treatment. Paucity of IIP reporting and treatment type variability mean results are preliminary. Heterogeneity for improvement in IIP after brief psychotherapy was high (I2=75%). Despite being central to theories of depression, interpersonal problems are infrequently included in outcome studies. Brief psychotherapy was associated with moderate to large effect sizes in reduction in interpersonal problems. Of the dimensions underlying interpersonal behaviour, the dominance dimension may be more amenable to change than the affiliation dimension. Yet, high pre-treatment affiliation appeared to be associated with better outcomes than low affiliation, supporting the theory that more affiliative patients may develop a better therapeutic relationship with the therapist and consequently respond more positively than more hostile patients.",28968563,Major Depressive Disorder,Anxiety Treatment,Mental Health,21854,13.54726791381836,-4.496723651885986,BWOD
"Optimizing the ingredients for imagery-based interpretation bias modification for depressed mood: is self-generation more effective than imagination alone?

Negative interpretation is thought to be crucial in the development and maintenance of depression. Recently developed cognitive bias modification paradigms, intending to change these biases towards a more optimistic interpretation tendency (CBM-I), seem to offer new promising implications for cognitive therapy innovation. This study aimed to increase our knowledge of the underlying mechanisms of action of imagery-based CBM-I in the context of depressed mood. We therefore compared the efficacy of CBM-I requiring participants to imagine standardized positive resolutions to a novel, more active training version that required participants to generate the positive interpretations themselves. Fifty-four participants were randomly allocated to (1) standardized CBM-I, (2) self-generation CBM-I or (3) a control group. Outcome measures included self-report mood measures and a depression-related interpretation bias measure. Both positive training variants significantly increased the tendency to interpret fresh ambiguous material in an optimistic manner. However, only the standardized imagery CBM-I paradigm positively influenced mood.",24113076,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.503417015075684,-1.0717931985855103,CXnh
"Metacognitive Training for Depression: Feasibility, safety and acceptability of two new treatment modules to reduce suicidality.

Recent evidence favours psychological interventions explicitly targeting suicidality; however, group treatments on suicidality are rare and are assumed to have unfavourable effects. We developed two modules specifically addressing suicidality that replace two existing modules in the Metacognitive Training for Depression (D-MCT). The aim of the current study was to examine the feasibility, safety, and acceptability of this intervention (D-MCT/S). Forty-eight inpatients with depression received eight sessions of D-MCT/S over 4 weeks in addition to standard treatment. Patients were assessed before the training, 4 and 8 weeks later regarding suicidality (primary outcome: Beck Suicide Scale [BSS]), hopelessness, depression (e.g. Hamilton Depression Rating Scale [HDRS]), dysfunctional attitudes, and self-esteem. Negative effects of the modules and subjective appraisal were assessed. Suicidality, hopelessness, and depression decreased over time. Whereas the effects on the BSS only reached trend level, a large effect was observed when the suicide item of the HDRS was used. Two of the 46 patients (4%) reported a deterioration in their symptoms, but this was not associated with the D-MCT/S. Negative effects of the general training were rather low, and acceptability was high. In general, patients evaluated the two new modules on suicidality similarly to the established modules. However, both modules were assessed as distressing by 39% of the patients. When we addressed suicidality in the D-MCT/S, we did not observe any contagious effects. In fact, the pilot versions of the two modules on suicidality are promising in terms of feasibility, safety, and acceptability. The results will be used to improve current shortcomings. The trial was registered with the German Clinical Trials Register (#DRKS-ID: DRKS00010543) on 23 August 2016.",33169467,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.430832862854004,-1.3407329320907593,AfsE
"Introducing a Group Therapy Program (PLAN D) for Young Outpatients with Derealization and Depersonalization: A Pilot Study.

Depersonalization and derealization (DD) cause significant distress and are associated with poor role and social functional outcomes. Despite the relatively high prevalence of DD symptoms and the chronic course in those suffering from a DD disorder, there still exists a need for effective interventions. Preliminary evidence indicates that cognitive behavioral therapy (CBT) delivered in an individual setting demonstrates some positive intervention effects for patients with DD regarding their symptom levels. By considering DD-specific treatment needs, a group therapy program was developed as an add-on therapy based on CBT techniques called PLAN D comprising the following elements: psychoeducation, lifestyle interventions, acceptance and mindfulness training, and new patterns of DD-related cognitions. In a pilot study, we present an 8-week group intervention for adolescents and young adults with DD disorder. To our knowledge, no standardized group intervention program for DD exists so far. Thus, this novel intervention represents a promising opportunity to positively influence long-term outcomes and course of DD.",34818653,Major Depressive Disorder,Anxiety Treatment,Mental Health,21372,16.00798797607422,-2.9286551475524902,1Wc
"Interpersonal Circumplex Profiles Of Persistent Depression: Goals, Self-Efficacy, Problems, And Effects Of Group Therapy.

We assessed severely and persistently depressed patients' interpersonal self-efficacy, problems, and goals, plus changes in interpersonal functioning and depression during 20 weeks of group therapy. Outpatients (32 female, 26 male, mean age = 45 years) completed interpersonal circumplex measures of goals, efficacy, and problems before completing 20 weeks of manualized group therapy, during which we regularly assessed depression and interpersonal style. Compared to normative samples, patients lacked interpersonal agency, including less self-efficacy for expressive/assertive actions; stronger motives to avoid conflict, scorn, and humiliation; and more problems with being too submissive, inhibited, and accommodating. Behavioral Activation and especially Cognitive Behavioral Analysis System of Psychotherapy interventions produced improvements in depression and interpersonal agency, with increases in ""agentic and communal"" efficacy predicting subsequent decreases in depression. While severely and persistently depressed patients were prone to express maladaptive interpersonal dispositions, over the course of group therapy, they showed increasingly agentic and beneficial patterns of cognitions, motives, and behaviors.",27391237,Major Depressive Disorder,Anxiety Treatment,Mental Health,21854,13.635035514831543,-5.077773094177246,BqSW
"Efficacy of Metacognitive Training for Depression: A Randomized Controlled Trial.

",27230865,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,13.149003028869629,-1.4797086715698242,BsP2
"Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial.

Deficits in emotion regulation skills are possible factors maintaining major depressive disorder (MDD). Therefore, the aim of the study was to test whether integrating a systematic emotion regulation training (ERT) enhances the efficacy of routine inpatient cognitive behavioral therapy (CBT) for MDD. In a prospective randomized controlled trial, 432 inpatients meeting criteria for MDD were assigned to receive either routine CBT or CBT enriched with an intense emotion regulation skills training (CBT-ERT). Participants in the CBT-ERT condition demonstrated a significantly greater reduction in depression (response rates - CBT: 75.5%, CBT-ERT: 84.9%; remission rates - CBT: 51.1%, CBT-ERT: 65.1%). Moreover, CBT-ERT participants demonstrated a significantly greater reduction of negative affect, as well as a greater increase of well-being and emotion regulation skills particularly relevant for mental health. Integrating strategies that target emotion regulation skills improves the efficacy of CBT for MDD.",23712210,Major Depressive Disorder,Anxiety Treatment,Mental Health,7324,14.6463623046875,-1.8474104404449463,Cdep
"Predictors of treatment attendance in cognitive and dynamic therapies for major depressive disorder delivered in a community mental health setting.

Our goal was to evaluate treatment attendance patterns, including both treatment completion and premature termination from treatment, for 2 evidence-based psychotherapies for major depressive disorder (MDD) delivered in a community mental health setting. We explored rates of premature termination across the course of treatment as well as the factors that predicted and moderated premature termination and treatment completion. This investigation included 237 patients with MDD who participated in a noninferiority trial comparing short-term dynamic psychotherapy (DT) to cognitive therapy (CT). Patients in both conditions were offered 16 sessions of treatment and had up to 5 months to complete treatment. All patients completed an extensive self-report battery at treatment baseline as well as measures of the therapeutic alliance and opinions about treatment following Session 2. Premature termination from both treatments was high with 27% of patients discontinuing treatment very early after only an intake session or a single treatment session. Patients in CT were significantly more likely to terminate treatment prematurely, χ²(3) = 14.35, p = .002. Baseline physical health functioning, subthreshold psychotic symptoms, Session 2 ratings of agreement on tasks, and Session 2 ratings of treatment sensibility all independently predicted premature termination of services. Trauma history significantly moderated very early termination of treatment, χ²(3) = 10.26, p = .017, with patients with high trauma histories more likely to complete DT but terminate prematurely from CT. Very early termination from services was higher in CT compared with DT. Including techniques to improve engagement in both therapies and matching patients to treatment based on predictors/moderators may be effective ways to optimize treatment engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).",31204838,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.74863052368164,-5.718783378601074,A46L
"The effect of strategies of personal resilience on depression recovery in an Australian cohort: a mixed methods study.

Strategies of personal resilience enable successful adaptation in adversity. Among patients experiencing depression symptoms, we explored which personal resilience strategies they find most helpful and tested the hypothesis that use of these strategies improves depression recovery. We used interview and survey data from the Diagnosis, Management and Outcomes of Depression in Primary Care 2005 cohort of patients experiencing depression symptoms in Victoria, Australia. A total of 564 participants answered a computer-assisted telephone interview question at 12 months follow-up, about what they found most helpful for their depression, stress or worries. Depressive disorder and severity were measured at annual follow-up using the Composite International Diagnostic Interview and the Patient Health Questionnaire self-rating questionnaire. Using interview responses, we categorised participants as users or not of strategies of personal resilience, specifically, drawing primarily on expanding their own inner resources or pre-existing relationships: 316 (56%) were categorised as primarily users of personal resilience strategies. Of these, 193 (61%) reported expanding inner resources, 79 (25%) drawing on relationships and 44 (14%) reported both. There was no association between drawing on relationships and depression outcome. There was evidence supporting an association between expanding inner resources and depression outcome: 25 per cent of users having major depressive disorder 1 year later compared to 38 per cent of non-users (adjusted odds ratio: 0.59, confidence interval: 0.36-0.97). This is the first study to show improved outcome for depression for those who identify as most helpful the use of personal resilience strategies. The difference in outcome is important as expanding inner resources includes a range of low intensity, yet commonly available strategies.",24966226,Major Depressive Disorder,Anxiety Treatment,Mental Health,5785,12.819448471069336,-4.813699722290039,CMFZ
"Validation of an Emotion Regulation Training Program on Mental Well-Being.

This research aimed to validate an Emotion Regulation Training program cultivating resilience, strengthening interpersonal communication, and enhancing emotional intelligence. A community sample of 104 participants were assigned to either an intervention (n=51) or nonactive control (n=53) group matched by age and gender. In addition, data were gathered via a cognitive performance test conducted pre- and postmeasurement in a subset of the larger sample (n=19 intervention, n=19 control). Results revealed reappraisal significantly increased in the intervention group, which was associated with a decrease in depressive symptomology, worry, and suppression, and a concurrent increase in overall mental well-being, supporting the validation of the Emotion Regulation Training program.",31554489,Major Depressive Disorder,Anxiety Treatment,Mental Health,7324,14.982596397399902,-2.42862606048584,A0Mm
"Depression and mentalizing: A psychodynamic therapy process study.

The present study aimed to explore the relationship between changes in depressive symptoms and the capacity to mentalize over the course of a 3-month inpatient psychodynamic therapy in a sample of 56 patients with depression. Depressive symptoms and mentalizing were assessed weekly during treatment and at 1-year follow-up with the Beck Depression Inventory and the Reflective Functioning Questionnaire (RFQ). Data were analyzed using Latent Growth Curve (LGC) modeling with structured residuals. In the total sample, depressive symptoms improved on average from baseline to the end of treatment, while mentalizing skills did not. However, individual variations were observed in mentalizing skills, with some patients improving while others did not. Within-patient residual changes in mentalizing skills did not predict residual changes in depressive symptoms. Accordingly, the results did not support mentalizing as a mechanism of change at this level. Nonetheless, between-patient effects were found, showing that patients with higher levels of mentalizing at baseline and patients whose mentalizing skills improved over the course of therapy also had greater reductions in depressive symptoms. We suggest that the presence of relatively higher mentalizing skills might be a factor contributing to moderately depressed individuals' ability to benefit from treatment, while relatively poor or absent mentalizing capacity might be part of the dynamics underlying treatment resistance in individuals with severe depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).",34351181,Major Depressive Disorder,Anxiety Treatment,Mental Health,22639,15.442063331604004,-5.683063507080078,ASOm
"Patient interpersonal and cognitive changes and their relation to outcome in interpersonal psychotherapy for depression.

Despite interpersonal psychotherapy's (IPT) efficacy for depression, little is known about its change-promoting ingredients. This exploratory study examined candidate change mechanisms by identifying whether patients' interpersonal and cognitive characteristics change during IPT and whether such changes relate to outcomes. Patients were 95 depressed adults receiving manualized IPT. We used multilevel modeling to assess the relation between change in each interpersonal and cognitive domain and outcome. Across all interpersonal and cognitive variables measured, patients showed significant improvement. Unexpectedly, reduced romantic relationship adjustment was related to posttreatment depression reduction (β = 2.028, p = .008, self-rated; β = 1.474, p = .022, clinician-rated). For the other measured domains, change was not significantly associated with outcome (though changes in some interpersonal variables evidenced a trend-level relation to outcome). Possible reciprocal influences among IPT, depression, and romantic relationship functioning are discussed, as are implications for future research.",24002972,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.782361030578613,-4.584848403930664,CZMT
"Using Artificial Intelligence to Predict Change in Depression and Anxiety Symptoms in a Digital Intervention: Evidence from a Transdiagnostic Randomized Controlled Trial.

While digital psychiatric interventions reduce treatment barriers, not all persons benefit from this type of treatment. Research is needed to preemptively identify who is likely to benefit from these digital treatments in order to redirect those people to a higher level of care. The current manuscript used an ensemble of machine learning methods to predict changes in major depressive and generalized anxiety disorder symptoms from pre to 9-month follow-up in a randomized controlled trial of a transdiagnostic digital intervention based on participants' (N=632) pre-treatment data. The results suggested that baseline characteristics could accurately predict changes in depressive symptoms in both treatment groups (r=0.482, 95% CI[0.394, 0.561]; r=0.477, 95% CI[0.385, 0.560]) and anxiety symptoms in both treatment groups (r=0.569, 95% CI[0.491, 0.638]; r=0.548, 95% CI[0.464, 0.622]). These results suggest that machine learning models are capable of preemptively predicting a person's responsiveness to digital treatments, which would enable personalized decision-making about which persons should be directed towards standalone digital interventions or towards blended stepped-care.",33278743,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,12.405426979064941,-1.2913265228271484,AeXB
"Depression and psychodynamic psychotherapy.

Depression is a complex condition, and its classical biological/psychosocial distinction is fading. Current guidelines are increasingly advocating psychotherapy as a treatment option. Psychodynamic psychotherapy models encompass a heterogeneous group of interventions derived from early psychoanalytic conceptualizations. Growing literature is raising awareness in the scientific community about the importance of these treatment options, as well as their favorable impact on post-treatment outcomes and relapse prevention. Considering the shifting paradigm regarding treatment of depressive disorder, the authors aim to provide a brief overview of the definition and theoretical basis of psychodynamic psychotherapy, as well as evaluate current evidence for its effectiveness.",28614491,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,12.502273559570312,-5.521312236785889,BbJW
"How and when immersion and distancing are useful in emotion focused therapy for depression.

Objective: The potential benefit or harm of immersion (egocentric perspective) and distancing (observer perspective) on negative experiences are unclear and have not been empirically investigated in therapy. This is a first exploratory study aimed to analyze and compare the perspectives adopted on reflection (immersion and distancing) of negative experiences across therapy and the relationship between them and depressive symptoms in contrasting therapeutic outcomes of emotion-focused therapy (EFT). Method: Three good-outcomes cases and three poor-outcomes cases of EFT, diagnosed with mild to moderate depression at the beginning of therapy, were randomly selected. Immersion and distancing on negative experiences were analyzed using the measure of immersed and distanced speech. The depressive symptoms were assessed by the Beck Depression Inventory-II. Results: Significant differences across sessions were only found in the good-outcome cases which showed a significant decrease of immersion and an increase of distancing, and this evolution pattern was found related to the reduction of symptoms. Moreover, at the beginning of therapy, distancing was higher in the poor-outcome cases rather than in the good-outcome cases. Conclusion: The progressive and significant evolution from higher immersion at the initial phase to higher distancing in the final phase may be helpful in EFT for depression.",29251176,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,14.710750579833984,-1.3066946268081665,BSma
"Latent change score modeling as a method for analyzing the antidepressant effect of a psychosocial intervention in Alzheimer's disease.

Developing and evaluating interventions for patients with age-associated disorders is a rising field in psychotherapy research. Its methodological challenges include the high between-subject variability and the wealth of influencing factors associated with longer lifetime. Latent change score modeling (LCSM), a technique based on structural equation modeling, may be well suited to analyzing longitudinal data sets obtained in clinical trials. Here, we used LCSM to evaluate the antidepressant effect of a combined cognitive behavioral/cognitive rehabilitation (CB/CR) intervention in Alzheimer's disease (AD). LCSM was applied to predict the change in depressive symptoms from baseline as an outcome of the CORDIAL study, a randomized controlled trial involving 201 patients with mild AD. The participants underwent either the CORDIAL CB/CR program or standard treatment. Using LCSM, the model best predicting changes in Geriatric Depression Scale scores was determined based on this data set. The best fit was achieved by a model predicting a decline in depressive symptoms between before and after testing. Assignment to the intervention group as well as female gender revealed significant effects in model fit indices, which remained stable at 6- and 12-month follow-up examinations. The pre-post effect was pronounced for patients with clinically relevant depressive symptoms at baseline. LCSM confirmed the antidepressant effect of the CORDIAL therapy program, which was limited to women. The effect was pronounced in patients with clinically relevant depressive symptoms at baseline. Methodologically, LCSM appears well suited to analyzing longitudinal data from clinical trials in aged populations, by accounting for the high between-subject variability and providing information on the differential indication of the probed intervention.",25833732,Major Depressive Disorder,Anxiety Treatment,Mental Health,11554,12.773114204406738,-2.525757312774658,B/q9
"When less could be more: Investigating the effects of a brief internet-based imagery cognitive bias modification intervention in depression.

Depression is a highly prevalent condition worldwide, yet multiple barriers to treatments means that the development of low intensive and easily accessible psychological interventions is crucially needed. The current study sought to investigate the efficacy of a brief, self-administered imagery cognitive bias modification (imagery CBM) procedure delivered online to a sample of 101 individuals with depressive symptoms. Compared to a closely matched control condition or a waitlist condition, imagery CBM led to greater improvements in depressive symptoms (d = 0.86, 95% CI = [0.33, 1.3] and d = 1.17, 95% CI = [0.62, 1.65]) interpretation bias and anhedonia. Despite the limitation to a two week follow-up, the study findings highlight the potential of imagery CBM as a brief, easily accessible intervention for depression that can be delivered remotely in peoples' home.",27485252,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,14.922586441040039,-0.8819437026977539,BpGY
"Assessing in-session rumination and its effects on CBT for depression.

The study evaluated if rumination of patients during therapy (i.e., in-session rumination) relates to whether or not they do less well in CBT treatment. We developed a reliably assessed in-session rumination observational measure and evaluated its relationship to depression over the course of CBT. Rated sessions came from 63 treatment-naïve patients with major depressive disorder who participated in CBT in the PReDICT study (Dunlop et al., 2017). In-session rumination was operationalized as repetitive, negative, and passive talking about depressive topics. Trained undergraduates rated the intensity and duration of in-session rumination occurring during 57 initial therapy sessions (i.e., session one) and 45 sessions in the middle of treatment (i.e., session eight). The observational ratings were sufficiently reliable (all ICCs > 0.69). Mixed model results indicated that greater intensity of in-session rumination during the initial treatment session predicted higher levels of subsequent clinician-rated depressive symptoms (p < .023). Regression results indicated that greater intensity and duration of in-session rumination at session 8 significantly predicted higher clinician-rated symptoms at end of treatment (p's < 0.02). In-session rumination intensity and duration were not, however, related to subsequent self-reported depressive symptoms. The results support efforts to identify which patients might benefit from rumination-specific interventions.",36283238,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.482077598571777,-1.5243542194366455,DLg
"An investigation of extreme responding as a mediator of cognitive therapy for depression.

Although the efficacy of Cognitive Therapy (CT) for depression is well documented, questions remain about the conditions under which CT is maximally effective, and the mechanisms by which CT is efficacious. This study examined the role of extreme responding (ER) as a mediator and predictor of relapse, as well as a predictor of acute treatment outcome. To test mediation, ER of participants in CT was compared to ER of participants receiving Behavioral Activation (BA). Results indicated that ER was not a mediator of relapse in either condition. Both CT and BA showed reductions in depression severity, however neither group showed significant changes in ER over the course of treatment. Finally, ER did not predict or moderate acute treatment outcome. The implications of these results, strengths and limitations of the current study, and future research directions are discussed.",20060516,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.616365432739258,-1.0415196418762207,DPBy
"Cognitive and Metacognitive Mechanisms of Change in Metacognitive Training for Depression.

Metacognitive Training for Depression (D-MCT), a low-threshold group intervention, has been shown to improve depressive symptoms. It aims at the reduction of depression by changing dysfunctional cognitive as well as metacognitive beliefs. The purpose of the present study was to investigate whether the mechanisms of change in D-MCT are cognitive (and thus primarily concern the content of cognition) or metacognitive in nature. Eighty-four outpatients with depression were included in a randomized controlled trial comparing D-MCT to an active control intervention. Level of depression, dysfunctional cognitive beliefs (DAS), and metacognitive beliefs (MCQ subscales: Positive Beliefs, Negative Beliefs, Need for Control) were assessed before (t0) and after treatment (t1). Severity of depression was also assessed 6 months later (t2). Linear regression analyses were used to determine whether change in depression from t0 to t2 was mediated by change in cognitive vs. metacognitive beliefs from t0 to t1. D-MCT's effect on change in depression was mediated by a decrease in dysfunctional metacognitive beliefs, particularly 'need for control'. Our findings underline that one of the key mechanisms of improvement in D-MCT is the change in metacognitive beliefs. The current study provides further support for the importance of metacognition in the treatment of depression.",28615651,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,12.426426887512207,-1.527266263961792,BbIW
"Efficacy of an internet and app-based gratitude intervention in reducing repetitive negative thinking and mechanisms of change in the intervention's effect on anxiety and depression: Results from a randomized controlled trial.

Repetitive negative thinking (RNT) has been identified as a transdiagnostic process that is involved in various forms of psychopathology, including anxiety and depression. This randomized controlled trial compared a 5-week internet and app-based gratitude intervention (intervention group; IG) with adherence-focused guidance against a wait list control group (WLG) in reducing RNT in a sample with elevated RNT. A total of 260 individuals were randomized to either the IG or the WLG. Data were collected at baseline (T1), within one week post intervention (T2), and at three (3-MFU) and six-months of follow-up (6-MFU; for IG only). The primary outcome was RNT. Secondary outcomes included other mental health outcomes and resilience factors. Participants of the IG reported significantly less RNT at T2 (d = 0.61) and 3-MFU (d = 0.75) as compared to WLG. Improvements were sustained until 6-MFU. Significant, small to moderate effect sizes were identified for most secondary outcomes at T2 and 3-MFU. Furthermore, results of mediation analyses revealed that the gratitude intervention exerts its effect on anxiety and depression by reducing the risk factor of RNT, while the mediating role of resilience was less clear. The gratitude intervention investigated in this study was found to be effective in reducing RNT. Gratitude interventions might affect mental health by two parallel pathways: increasing resources and reducing risk factors. EB 201701-03-Lehr. DRKS00011862. The trial protocol can be assessed at: https://www.drks.de/.",31202003,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.25017261505127,-1.7824052572250366,A488
"Metacognitive Training for Depression (D-MCT) reduces false memories in depression. A randomized controlled trial.

Metacognitive Training for Depression (D-MCT) is a highly standardized group program targeted at depression-related (""Beckian"") emotional as well as cognitive biases, including mood-congruent and false memory. While prior results are promising with respect to psychopathological outcomes (depression), it is unclear whether D-MCT also meets its goal of improving cognitive biases, such as false memories. In the framework of a randomized controlled trial (registered trial, DRKS00007907), we investigated whether D-MCT is superior to an active control condition (health training, HT) in reducing the susceptibility of depressed patients for false memories. False memories were examined using parallel versions of a visual variant of the Deese-Roediger McDermott paradigm. Both groups committed less false memories at post assessment after 4 weeks compared to baseline. Relative to HT, D-MCT led to a significant decrease in high-confident false memories over time. The study presents first evidence that D-MCT decreases the susceptibility of depressed patients for false memories, particularly for errors made with high confidence that are presumably the most ""toxic"" in terms of mood-congruent memory distortions.",29890366,Major Depressive Disorder,Anxiety Treatment,Mental Health,2511,13.217933654785156,-1.164792537689209,BKfy
"Sequential multiple assignment randomized trial (SMART) with adaptive randomization for quality improvement in depression treatment program.

Implementation study is an important tool for deploying state-of-the-art treatments from clinical efficacy studies into a treatment program, with the dual goals of learning about effectiveness of the treatments and improving the quality of care for patients enrolled into the program. In this article, we deal with the design of a treatment program of dynamic treatment regimens (DTRs) for patients with depression post-acute coronary syndrome. We introduce a novel adaptive randomization scheme for a sequential multiple assignment randomized trial of DTRs. Our approach adapts the randomization probabilities to favor treatment sequences having comparatively superior Q-functions used in Q-learning. The proposed approach addresses three main concerns of an implementation study: it allows incorporation of historical data or opinions, it includes randomization for learning purposes, and it aims to improve care via adaptation throughout the program. We demonstrate how to apply our method to design a depression treatment program using data from a previous study. By simulation, we illustrate that the inputs from historical data are important for the program performance measured by the expected outcomes of the enrollees, but also show that the adaptive randomization scheme is able to compensate poorly specified historical inputs by improving patient outcomes within a reasonable horizon. The simulation results also confirm that the proposed design allows efficient learning of the treatments by alleviating the curse of dimensionality.",25354029,Major Depressive Disorder,Anxiety Treatment,Mental Health,11150,12.600842475891113,-3.399339437484741,CGio
"Internet-delivered cognitive control training as a preventive intervention for remitted depressed patients: Evidence from a double-blind randomized controlled trial study.

Cognitive control impairments may place remitted depressed (RMD) patients at increased risk for developing future depressive symptomatology by disrupting emotion regulation processes. Research has shown that directly targeting cognitive control has beneficial effects on high trait ruminators and clinically depressed patients. The current study tested whether internet-delivered cognitive control training (CCT) can be used as an intervention to increase resilience to depression in RMD patients. Effects of CCT were assessed using a double-blind randomized controlled design. RMD patients performed 10 sessions of a working memory-based CCT (N = 34) or a low cognitive load training (N = 34; active control condition) over a period of 14 days. Assessments took place prior to training, immediately following 2 weeks of training, and at 3 months follow-up. Brooding and depressive symptomatology were selected as primary outcome measures, alternative indicators for emotion regulation and residual symptomatology were selected as secondary outcome measures, along with indicators of functioning. Compared to an active control condition, CCT demonstrated beneficial effects on a cognitive transfer task, brooding, depressive symptomatology, residual complaints, self-reported use of general maladaptive emotion regulation strategies, and resilience after controlling for intention to treat. Furthermore, completers of the CCT reported a reduction in experienced disability and cognitive complaints. However, no beneficial effects were found for self-reported use of adaptive emotion regulation strategies. These findings demonstrate the effectiveness of CCT as an intervention to reduce cognitive vulnerability, residual symptomatology, and foster resilience following recovery from depression. CCT thus holds potential as a preventive intervention for RMD patients. (PsycINFO Database Record",27362792,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.099553108215332,-0.7108245491981506,Bqm8
"Cognitive training for modifying interpretation and attention bias in depression: Relevance to mood improvement and implications for cognitive intervention in depression.

Depressed individuals interpret ambiguous information more negatively and this has been suggested a central component in cognitive models of depression. In this study we investigated the effectiveness of the interpretation modification training on modifying interpretation bias in depression and its association with symptoms reduction. In a double-blind, randomized controlled design, twenty-two depressed individuals (mean age=19.86, SD=1.16) were randomly assigned to the experimental and control groups. They completed 10 sessions of cognitive training with the Ambiguous Hallmark Program (AHP) over 5 weeks. Participants' interpretation bias and their depressive scores were assessed and compared before and after the intervention. Results showed that the AHP significantly decreased negative interpretation in the experimental group. Additionally, a significant decrease in the depressive scores was also observed in the intervention group compared to the control group. We also observed the transfer of learning from the AHP training to another interpretation bias task. The AHP can significantly modify negative interpretations and symptoms in depression providing preliminary supporting evidence for its clinical application especially in mild-to-moderate depression. Improved cognitive control over emotional information and unbiased attention to them could explain effects of the Interpretation modification paradigm. Further studies need to examine the efficacy of the AHP as a potential cognitive intervention in depression.",30496949,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.627363204956055,-0.9124400615692139,BChc
"Social problem solving and depressive symptoms over time: a randomized clinical trial of cognitive-behavioral analysis system of psychotherapy, brief supportive psychotherapy, and pharmacotherapy.

Depression is associated with poor social problem solving, and psychotherapies that focus on problem-solving skills are efficacious in treating depression. We examined the associations between treatment, social problem solving, and depression in a randomized clinical trial testing the efficacy of psychotherapy augmentation for chronically depressed patients who failed to fully respond to an initial trial of pharmacotherapy (Kocsis et al., 2009). Participants with chronic depression (n = 491) received cognitive-behavioral analysis system of psychotherapy (CBASP; McCullough, 2000), which emphasizes interpersonal problem solving, plus medication; brief supportive psychotherapy (BSP) plus medication; or medication alone for 12 weeks. CBASP plus pharmacotherapy was associated with significantly greater improvement in social problem solving than BSP plus pharmacotherapy, and a trend for greater improvement in problem solving than pharmacotherapy alone. In addition, change in social problem solving predicted subsequent change in depressive symptoms over time. However, the magnitude of the associations between changes in social problem solving and subsequent depressive symptoms did not differ across treatment conditions. It does not appear that improved social problem solving is a mechanism that uniquely distinguishes CBASP from other treatment approaches.",21500885,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.601588249206543,-2.3940513134002686,C9Tp
"Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression.

In mindfulness-based cognitive therapy (MBCT), it is proposed that training in mindfulness should reduce the tendency of formerly depressed patients to enter into ruminative thinking, thus reducing their risk of depressive relapse. However, data showing that rumination is associated with depressive relapse are lacking. In an uncontrolled study with 24 formerly depressed patients, rumination was assessed with the Ruminative Response Scale. To assess the occurrence of relapse or recurrence, the Structured Clinical Interview for DSM-IV was administered 12 months after the end of the MBCT. Rumination significantly decreased during the MBCT course. Post-treatment levels of rumination predicted the risk of relapse of major depressive disorder in the 12-month follow-up period even after controlling for numbers of previous episodes and residual depressive symptoms. The results provide preliminary evidence that rumination is important in the process of depressive relapse.",22903859,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,15.139143943786621,-1.3381675481796265,CpWS
"Therapeutic alliance in face-to-face and telephone-administered cognitive behavioral therapy.

Telephone-administered therapies have emerged as an alternative method of delivery for the treatment of depression, yet concerns persist that the use of the telephone may have a deleterious effect on therapeutic alliance. The purpose of this study was to compare therapeutic alliance in clients receiving cognitive behavioral therapy (CBT) for depression by telephone (T-CBT) or face-to-face (FtF-CBT). We randomized 325 participants to receive 18 sessions of T-CBT or FtF-CBT. The Working Alliance Inventory (WAI) was administered at Weeks 4 and 14. Depression was measured during treatment and over 1 year posttreatment follow-up using the Hamilton Rating Scale for Depression and Patient Health Questionnaire-9. There were no significant differences in client or therapist WAI between T-CBT or FtF-CBT (Cohen's f² ranged from 0 to .013, all ps > .05). All WAI scores predicted depression end of treatment outcomes (Cohen's f² ranged from .009 to .06, all ps < .02). The relationship between the WAI and depression outcomes did not vary by treatment group (Cohen's f² ranged from 0 to .004, ps > .07). The WAI did not significantly predict depression during posttreatment follow-up (all ps > .12). Results from this analysis do not support the hypothesis that the use of the telephone to provide CBT reduces therapeutic alliance relative to FtF-CBT.",24447003,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,13.152021408081055,-5.6104536056518555,CTNs
"The Effects of Computerized Cognitive Control Training on Community Adults with Depressed Mood.

Depression is frequently characterized by patterns of inflexible, maladaptive, and ruminative thinking styles, which are thought to result from a combination of decreased attentional control, decreased executive functioning, and increased negative affect. Cognitive Control Training (CCT) uses computer-based behavioral exercises with the aim of strengthening cognitive and emotional functions. A previous study found that severely depressed participants who received CCT exhibited reduced negative affect and rumination as well as improved concentration. The present study aimed to extend this line of research by employing a more stringent control group and testing the efficacy of three sessions of CCT over a 2-week period in a community population with depressed mood. Forty-eight participants with high Beck Depression Inventory (BDI-II) scores were randomized to CCT or a comparison condition (Peripheral Vision Training; PVT). Significant large effect sizes favoring CCT over PVT were found on the BDI-II (d = 0.73, p < .05) indicating CCT was effective in reducing negative mood. Additionally, correlations showed significant relationships between CCT performance (indicating ability to focus attention on CCT) and state affect ratings. Our results suggest that CCT is effective in altering depressed mood, although it may be specific to select mood dimensions.",24589123,Major Depressive Disorder,Anxiety Treatment,Mental Health,3407,13.073271751403809,-0.7539013028144836,CRbe
"Does cognitive behavioral therapy for depression target positive affect? Examining affect and cognitive change session-to-session.

Researchers have been interested in the role of negative affect (NA) and positive affect (PA) in cognitive behavioral therapy (CBT) for depression. We examined cognitive change (CC) and these two affect variables across the course of CBT. Patients (N = 125; M age = 31.7, SD = 13.35; 60% female; 83% Caucasian) participated in 16 weeks of CBT for depression. They completed the Beck Depression Inventory-II (BDI-II) and the Immediate Cognitive Change Scale at each session and a measure of affect before and after each session. NA decreased (rate of change p < .001, d = -1.08) and PA increased (p < .001, d = 0.53) during treatment. CC predicted next-session PA, 0.06, 95% CI [0.01, 0.11], and NA, -0.09, 95% CI [-0.14, -0.04], and was concurrently associated with change in PA, 0.36, 95% CI [0.30, 0.42], and NA, -0.32, 95% CI [-0.42, -0.26], over the course of a session. Presession PA, 0.22, 95% CI [0.17, 0.26], and NA, -0.13, 95% CI [-0.17, -0.08], predicted postsession CC, while pre to postsession change in PA, -0.05, 95% CI [-0.09, -0.002], and NA, 0.06, 95% CI [0.01, 0.11], predicted change in depressive symptoms. Although NA and PA both change in CBT, the changes in PA are more modest. Both NA and PA predict symptom change, consistent with the possibility that increasing PA may be beneficial. CC and affect change are reciprocally related, suggesting that CC may contribute to affect change, while affect may also facilitate CC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).",34591547,Major Depressive Disorder,Anxiety Treatment,Mental Health,21854,12.470608711242676,-2.0824074745178223,+wY
"Social skills training for depression and comparative efficacy research: a 30-year retrospective.

By the late 1970s it was clear that cognitive and behavioral therapies were promising alternatives to antidepressant medications for treatment of depressed outpatients. One such model of therapy, Social Skills Training, was developed by Michel Hersen and his colleagues specifically for treatment of depressed women. Professor Hersen and his colleagues obtained funding from the National Institute of Mental Health to conduct the first well-controlled randomized trial of this intervention, contrasting Social Skills Training, in combination with either placebo or active amitriptyline, against two active standards: amitriptyline alone and time-limited, psychodynamic psychotherapy in combination with placebo. The results of this study suggested that Social Skills Training (plus placebo) was at least as effective as amitriptyline alone or psychodynamic psychotherapy (plus placebo), with superior mode-specific effects on measures of social skill. The current narrative, which provides an autobiographical perspective of four critical years (1980-1984) in the early career of the author that were intertwined with the conduct and completion of this clinical trial, is an homage to Professor Hersen's talents as a supervisor, researcher, and mentor.",22718283,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,13.882076263427734,-1.1830936670303345,Cr4o
"The impact of personality disorder pathology on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder.

Despite extensive research, there is no consensus how Personality Disorders (PD) and PD features affect outcome for Major Depressive Disorder (MDD). The present study evaluated the effects of PD (features) on treatment continuation and effectiveness in Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for MDD. Depressed outpatients were randomized to CT (n=72) and IPT (n=74). Primary outcome was depression severity measured repeatedly with the Beck Depression Inventory-II (BDI-II) at baseline, three months, at the start of each therapy session, at post-treatment and monthly during five months follow-up. Comorbid PD and PD features did not affect dropout. Multilevel and Cox regression models indicated no negative effect of PD on BDI-II change and remission rates during treatment and follow-up, irrespective of the treatment received. For both therapies, higher dependent PD features predicted overall lower BDI-II scores during treatment, however this effect did not sustain through follow-up. Cluster A PD features moderated treatment outcome during treatment and follow-up: individuals with high cluster A PD features had greater BDI-II reductions over time in CT as compared to IPT. Not all therapists and participants were blind to the assessment of PD (features), and assessments were performed by one rater. Further research must investigate the state and trait dependent changes of PD and MDD over time. We found no negative impact of PD on the effectiveness and treatment retention of CT and IPT for MDD during treatment and follow-up. If replicated, cluster A PD features can be used to optimize treatment selection.",28866297,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.948064804077148,-2.6654248237609863,BXkG
"Predictors of Symptom Outcome in Interpretation Bias Modification for Dysphoria.

Interpretation Bias Modification (IBM) interventions have been effective in reducing negative interpretation biases theorized to underlie depressive psychopathology. Although these programs have been highlighted as potential short-term interventions for depression, mixed evidence has been found for their effects on depressive symptoms. There is a need to examine attitudes towards training as well as individual difference factors that may impact symptom outcomes for IBM depression interventions. Seventy-two dysphoric young adults were randomly assigned to receive either an IBM targeting negative interpretation bias in personal evaluations or interpersonal situations or a healthy video control (HVC) condition. Compared to those who received HVC, participants in the IBM condition reported lower negative interpretation bias at posttreatment. No differences between conditions were found for symptom outcomes. Greater perceived treatment credibility and expectancy were associated with better treatment outcomes for both the IBM and HVC groups. Within the IBM group, a greater tendency toward assimilation with treatment scenarios was significantly associated with better treatment outcomes for both depressive and anger symptoms. This effect was unique from treatment credibility and expectancy. Pretreatment psychological reactance did not predict treatment response for either condition. Implications and future research directions are discussed.",31030880,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.671058654785156,-0.9360945820808411,A7Q4
"Ask the doctor. I got divorced a few months ago. Recently I was diagnosed with depression. A friend suggested I try interpersonal therapy. She thinks the problem is my relationship with my former husband. I'd never heard of this type of therapy. Could you tell me more about it?

",27024340,Major Depressive Disorder,Anxiety Treatment,Mental Health,6597,12.778672218322754,-4.139647006988525,BvBF
"Comparison and change of defense mechanisms over the course of psychotherapy in patients with depression or anxiety disorder: Evidence from a randomized controlled trial.

Defense mechanisms play an important role in the development and maintenance of both health and psychopathology. Research is still in the early stages of investigating the specific relationships among diagnostic groups and defense mechanisms along with their response to different treatment types. For the present study a total of 47 outpatients diagnosed with depression or anxiety disorders were randomized to receive 25±3 sessions of cognitive-behavioral therapy with integrated elements of either emotion-focused therapy (CBT + EFT) or treatment components based on self-regulation theory (CBT + SR). An observer-rated method, the Defense Mechanism Rating Scale (DMRS) was used to code transcripts of the 1st, 8th, 16th and 24th session to assess change in defensive functioning. Over the course of therapy, overall defensive functioning (ODF) as well as adaptive defenses increased significantly, whereas maladaptive and neurotic defenses did not change. At the beginning of treatment, the proportion of adaptive defenses and ODF was significantly higher in patients diagnosed with anxiety disorders than in patients with depressive disorders. However, depressed patients exhibited greater improvement in their defensive functioning over the course of therapy. Results support the view of defense mechanisms as a useful transdiagnostic and transtheoretical concept and supports the notion that change of defense mechanisms may be a relevant mechanism of change in psychotherapy.",30986736,Major Depressive Disorder,Anxiety Treatment,Mental Health,15500,14.570101737976074,-4.7425217628479,A722
"Interpersonal clarification effects in Cognitive-Behavioral Therapy for depression and how they are moderated by the therapeutic alliance.

Although a wide body of research links depression to interpersonal deficits, Cognitive-Behavioral Therapy (CBT), considered the gold standard in the treatment of this condition, has not been developed to specifically address interpersonal difficulties. However, cognitive changes on a relational level occurring during CBT might play an important role in the treatment of depression. Interpersonal clarification refers to the process of better understanding the nature of one's interpersonal patterns during therapy. The aim of this study is to analyze the effects of interpersonal clarification in CBT and how they are moderated by the therapeutic alliance. A sample of 621 patients diagnosed with depression were treated with CBT by 126 therapists in a university outpatient clinic. Patients completed measures of interpersonal problems and depression severity at baseline, measures of symptomatic evolution before each session and process measures (assessing interpersonal clarification and alliance) after each session. Multilevel models separating between-patient (BP) and within-patient (WP) effects of interpersonal clarification, and including BP and WP alliance effects as covariates and moderators of the interpersonal clarification effects were conducted. Analyses showed both significant BP and WP effects interpersonal clarification, even when adjusting for alliance effects. Furthermore, significant interactive effects were found between outcome of WP interpersonal clarification with both BP alliance and WP alliance. Interpersonal clarification was measured with one single-item and adherence to CBT was not explicitly measured. The results present preliminary evidence for considering interpersonal clarification a meaningful change process in CBT for depression, especially in the context of a stronger therapeutic alliance.",33190117,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,13.653345108032227,-5.3831400871276855,Afb1
"The Current Research Landscape on the Artificial Intelligence Application in the Management of Depressive Disorders: A Bibliometric Analysis.

Artificial intelligence (AI)-based techniques have been widely applied in depression research and treatment. Nonetheless, there is currently no systematic review or bibliometric analysis in the medical literature about the applications of AI in depression. We performed a bibliometric analysis of the current research landscape, which objectively evaluates the productivity of global researchers or institutions in this field, along with exploratory factor analysis (EFA) and latent dirichlet allocation (LDA). From 2010 onwards, the total number of papers and citations on using AI to manage depressive disorder have risen considerably. In terms of global AI research network, researchers from the United States were the major contributors to this field. Exploratory factor analysis showed that the most well-studied application of AI was the utilization of machine learning to identify clinical characteristics in depression, which accounted for more than 60% of all publications. Latent dirichlet allocation identified specific research themes, which include diagnosis accuracy, structural imaging techniques, gene testing, drug development, pattern recognition, and electroencephalography (EEG)-based diagnosis. Although the rapid development and widespread use of AI provide various benefits for both health providers and patients, interventions to enhance privacy and confidentiality issues are still limited and require further research.",31216619,Major Depressive Disorder,Anxiety Treatment,Mental Health,5329,12.42923355102539,-0.8969888687133789,A4wS
"Interpersonal problems as predictors of therapeutic alliance and symptom improvement in cognitive therapy for depression.

The degree to which interpersonal problems of depressed patients improve over the course of cognitive therapy (CT) and relate to the quality of the therapeutic alliance and to symptom improvement, remains unclear. We analyzed data of adult outpatients (N=523) with major depressive disorder participating in a clinical trial to determine the factor structure of the Inventory of Interpersonal Problems-Circumplex (IIP-C) and to relate the observed factor scores to the quality of the therapeutic alliance and symptom improvement over the course of CT. Patients received 16-20 sessions protocol (50-60 min each) of individual CT according to the treatment manual by Beck et al. (1979). We found a three-factor structure (interpersonal distress, agency, and communion) of interpersonal problems. Interpersonal distress decreased (d=.90), but interpersonal style did not change substantively during CT (communion d=.03; agency d=.14). High initial agency scores related negatively to the therapeutic alliance (β=-.12), whereas high initial communion scores related positively to the therapeutic alliance (β=.15). Elevated pre-treatment interpersonal distress scores were related to both weaker therapeutic alliances (β=.13) and higher symptom levels throughout treatment (β=.10). All patients in this study had recurrent MDD and it is therefore uncertain whether the results would generalize to patients with other psychiatric disorders. This study supports the use of the IIP-C as a comprehensive measure of patients' interpersonal style and interpersonal distress. The IIP-C measured before CT showed some predictive validity with respect to therapeutic alliance measured at the midpoint and therapy outcome. The clinical importance of these findings is discussed.",22306232,Major Depressive Disorder,Anxiety Treatment,Mental Health,21854,13.635422706604004,-5.383232116699219,Cxxh
"Can integrating the Memory Support Intervention into cognitive therapy improve depression outcome? A randomized controlled trial.

We investigated if improving a patient's memory for the content of their treatment, via the Memory Support Intervention, improves illness course and functional outcomes. The platform for investigating this question was major depressive disorder (MDD) and cognitive therapy (CT). Adults diagnosed with MDD (N = 178) were randomly allocated to CT + Memory Support (n = 91) or CT-as-usual (n = 87). Both treatments were comprised of 20-26, 50-min sessions over 16 weeks. Blind assessments were conducted before and immediately following treatment (post-treatment) and 6 months later (6FU). Patient memory for treatment, assessed with a free recall task, was higher in CT + Memory Support for past session recall at post-treatment. Both treatment arms were associated with reductions in depressive symptoms and functional impairment except: CT + Memory Support exhibited lower depression severity at 6FU (b = -3.09, p = 0.050, d = -0.27), and greater reduction in unhealthy days from baseline to 6FU (b = -4.21, p = 0.010, d = -1.07), compared to CT-as-usual. While differences in illness course and functional outcomes between the two treatment arms were limited, it is possible that future analyses of the type of memory supports and longer follow-up may yield more encouraging outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT01790919. Registered October 6, 2016.",35963181,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.413216590881348,-0.6422930359840393,Lkc
"Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial.

About 20% of major depressive episodes become chronic and medication-refractory and also appear to be less responsive to standard cognitive-behavioural therapy (CBT). To test whether CBT developed from behavioural activation principles that explicitly and exclusively targets depressive rumination enhances treatment as usual (TAU) in reducing residual depression. Forty-two consecutively recruited participants meeting criteria for medication-refractory residual depression were randomly allocated to TAU v. TAU plus up to 12 sessions of individual rumination-focused CBT. The trial has been registered (ISRCTN22782150). Adding rumination-focused CBT to TAU significantly improved residual symptoms and remission rates. Treatment effects were mediated by change in rumination. This is the first randomised controlled trial providing evidence of benefits of rumination-focused CBT in persistent depression. Although suggesting the internal validity of rumination-focused CBT for residual depression, the trial lacked an attentional control group so cannot test whether the effects were as a result of the specific content of rumination-focused CBT v. non-specific therapy effects.",21778171,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,14.918886184692383,-1.4450663328170776,C5kX
"What Do People Really Think of Me? Evaluating Bias in Interpersonal Predictions Over the Course of Cognitive-Behavioral Therapy of Depression.

Cognitive behavioral therapy (CBT) of depression is hypothesized to achieve its effects by correcting negative biases. However, little research has tested how biases change over the course of CBT. We focus on biases in interpersonal judgments and examine whether changes in biases occur in CBT and are associated with symptom improvements. A sample of 126 adults (60% women, mean age 31.7, 83% White) participated in CBT of depression. Observers provided ratings of patients participating in two interpersonal tasks on three occasions. Patients were asked to predict observers' ratings. In a thin slice (TS) task, observers evaluated how patients came across in a brief segment in which patients talked about themselves. In a Standard Interaction Task (SIT), observers rated the social skills patients displayed in challenging role plays. The difference between patient predictions and observer ratings provided measures of bias in these interpersonal judgments. TS and SIT bias became significantly less pessimistic and more realistic over the course of CBT. Improvements in TS bias were associated with a faster reduction in symptoms, whereas there was a non-significant trend for improvement in SIT bias being associated with faster symptom reduction. Consistent with the CBT model, negative interpersonal biases became more realistic throughout a course of CBT for depression and at least some of the changes in bias were related to therapeutic outcomes. We encourage future researchers to continue examining for whom and under which conditions correcting such biases produces the greatest benefits.",34452680,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,14.85738468170166,-1.2270469665527344,ARKM
"Predictors of treatment dropout in self-guided web-based interventions for depression: an 'individual patient data' meta-analysis.

It is well known that web-based interventions can be effective treatments for depression. However, dropout rates in web-based interventions are typically high, especially in self-guided web-based interventions. Rigorous empirical evidence regarding factors influencing dropout in self-guided web-based interventions is lacking due to small study sample sizes. In this paper we examined predictors of dropout in an individual patient data meta-analysis to gain a better understanding of who may benefit from these interventions. A comprehensive literature search for all randomized controlled trials (RCTs) of psychotherapy for adults with depression from 2006 to January 2013 was conducted. Next, we approached authors to collect the primary data of the selected studies. Predictors of dropout, such as socio-demographic, clinical, and intervention characteristics were examined. Data from 2705 participants across ten RCTs of self-guided web-based interventions for depression were analysed. The multivariate analysis indicated that male gender [relative risk (RR) 1.08], lower educational level (primary education, RR 1.26) and co-morbid anxiety symptoms (RR 1.18) significantly increased the risk of dropping out, while for every additional 4 years of age, the risk of dropping out significantly decreased (RR 0.94). Dropout can be predicted by several variables and is not randomly distributed. This knowledge may inform tailoring of online self-help interventions to prevent dropout in identified groups at risk.",25881626,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,12.535035133361816,-5.5429606437683105,B/Ao
"Modification of Hostile Interpretation Bias in Depression: A Randomized Controlled Trial.

Interpretation Bias Modification (IBM) is gaining attention in the literature as an intervention that alters cognitive biases and reduces associated symptoms. Forty, primarily college-aged, non-treatment-seeking adults with major depressive disorder (MDD) were randomly assigned to receive either IBM targeting hostile interpretation bias (IBM-H) or a healthy video control (HVC) condition. Compared to those in HVC, participants in IBM-H reported more benign interpretations and fewer hostile interpretations at posttreatment. No difference in depressive interpretation bias was found between groups at posttreatment. IBM-H led to improved anger control at posttreatment and follow-up compared to HVC, though no effects of condition were found on trait anger or depressive symptoms. The IBM-H group perceived their treatment as less credible than the HVC group. For individuals with high expectancy of treatment success, IBM-H led to lower posttreatment depressive symptoms compared to HVC, while findings trended in the opposite direction for those with low expectancy of success. Overall, these preliminary findings point to boundary conditions for the efficacy of IBM protocols for anger and depression and potential improvements to be made to future IBM protocols.",29530259,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.651177406311035,-0.855944037437439,BOv3
"Assessment of Automatic Thoughts in Patients with Depressive Illness at a Tertiary Hospital in Nepal.

Cognitive functions have significant influence on psycho-social and general wellbeing. The quality, content and processing of negative thoughts initiate depressive symptoms; i.e. low mood, decreased self-worth and diminished interest in pleasurable activities. The study assessed the automatic thoughts of patients having depressive illness and evaluated and compared the changes after therapy; i.e. Psychotherapy and pharmacotherapy. Diagnosed cases of depressive illness (n=135), according to ICD-10 and study criteria, attending the out-patient clinic of Department of Psychiatry and Mental Health, Tribhuvan University Teaching Hospital, were included. Beck Depression Inventory was used to screen level of depressive symptoms. Automatic thoughts were assessed by the Automatic Thought Questionnaire-Revised before initiating therapy and after completion of therapy for comparison. Depressive patients received either of the three treatment procedures after randomization of the study sample into three different treatment groups; i.e. Cognitive behavior therapy, pharmacotherapy or combined therapy receiving both cognitive behavior therapy and pharmacotherapy. Among the total 135 patients, 53 (39.3%) had moderate, 47 (34.8%) had severe depressive and 35 (25.9%) had mild depressive symptoms before therapeutic interventions. Negative automatic thoughts were significantly present in depressed patients and reduced after all three interventions. Negative automatic thoughts of hopelessness, anxiety and inability coping were significantly reduced after therapy. Automatic negative thoughts were significantly correlated with depressive disorder. Combined therapy CBT with pharmacotherapy or CBT alone was found to be more effective in modifying automatic negative thoughts than pharmacotherapy alone, ultimately reducing depressive symptoms to a significant degree.",28746324,Major Depressive Disorder,Anxiety Treatment,Mental Health,20047,14.347986221313477,-1.9405543804168701,BZOy
"Rumination-focused cognitive behaviour therapy for non-responsive chronic depression: an uncontrolled group study.

One-third of patients with depression do not respond satisfactorily to treatment, and approximately 20% of all patients treated for depression develop a chronic depression. One approach to more effective treatment of chronic and treatment-resistant depression is to target rumination - an underlying mechanism implicated in the development and maintenance of depression. The purpose of this uncontrolled group study was to investigate the feasibility of individual rumination-focused cognitive behavioural therapy (RfCBT) for patients with chronic and treatment-resistant depression. A total of 10 patients with chronic and treatment-resistant depression were offered 12-16 individual sessions of RfCBT. The primary outcome was depressive symptoms as measured by Hamilton Depression Scale at pre-, post- and 3-month follow-up. Secondary symptoms measured included self-reported rumination and worry. There was a significant reduction in depressive symptoms (p < 0.05), rumination (p < 0.01) and worry (p < 0.5) from pre- to post-treatment. Half of the participants (n = 5) showed significant reliable change on levels of depressive symptoms post-treatment. The reduction in depressive symptoms, rumination and worry were maintained at follow-up. RfCBT was associated with significant reductions in depressive symptoms in a small sample with chronic and treatment-resistant depression. Despite limitations of being a small uncontrolled study with limited follow-up, these results are promising in a difficult to treat population. RfCBT warrants further systematic evaluation.",31625500,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.252164840698242,-1.4904767274856567,AzQ/
"Early treatment response in psychotherapy for depression and personality disorder: links with core conflictual relationship themes.

Objective: Depressed personality disorder patients showing an early rapid response (or sudden gain) in psychotherapy have better outcomes. Early responders are five times more likely to recover, despite equivalent ratings of working alliance. We explored core conflictual relationship themes (CCRTs) of early responders compared to others to further elucidate process-outcome links. Method: Patients (N=20) with diagnosed major depression and personality disorder received 16 weeks of psychodynamic therapy. Early response was defined as a 50% reduction in Beck Depression Inventory symptoms during the first six sessions. Transcripts of therapy session three for early responders (n=10) and others (n=10) were analyzed using the CCRT Leipzig/Ulm method, identifying 728 components scored by two independent judges. Results: Relationship narratives showed CCRT-wish satisfaction was lower for those not having an early response, for both CCRT ""Response of Other"" and ""Response of Self"" components. These patients told narratives of others as more unreliable, aggressive, and less supportive, with less feelings of being loved and a lower experience of being self-determined. Conclusions: Specific negative relationship patterns may inhibit the ability to benefit from both therapy and extra-therapy relationships, contributing to a slower treatment response.",31018824,Major Depressive Disorder,Anxiety Treatment,Mental Health,23894,13.33470630645752,-4.283184051513672,A7bR
"Combining imagination and reason in the treatment of depression: a randomized controlled trial of internet-based cognitive-bias modification and internet-CBT for depression.

Computerized cognitive-bias modification (CBM) protocols are rapidly evolving in experimental medicine yet might best be combined with Internet-based cognitive behavioral therapy (iCBT). No research to date has evaluated the combined approach in depression. The current randomized controlled trial aimed to evaluate both the independent effects of a CBM protocol targeting imagery and interpretation bias (CBM-I) and the combined effects of CBM-I followed by iCBT. Patients diagnosed with a major depressive episode were randomized to an 11-week intervention (1 week/CBM-I + 10 weeks/iCBT; n = 38) that was delivered via the Internet with no face-to-face patient contact or to a wait-list control (WLC; n = 31). Intent-to-treat marginal models using restricted maximum likelihood estimation demonstrated significant reductions in primary measures of depressive symptoms and distress corresponding to medium-large effect sizes (Cohen's d = 0.62-2.40) following CBM-I and the combined (CBM-I + iCBT) intervention. Analyses demonstrated that the change in interpretation bias at least partially mediated the reduction in depression symptoms following CBM-I. Treatment superiority over the WLC was also evident on all outcome measures at both time points (Hedges gs = .59-.98). Significant reductions were also observed following the combined intervention on secondary measures associated with depression: disability, anxiety, and repetitive negative thinking (Cohen's d = 1.51-2.23). Twenty-seven percent of patients evidenced clinically significant change following CBM-I, and this proportion increased to 65% following the combined intervention. The current study provides encouraging results of the integration of Internet-based technologies into an efficacious and acceptable form of treatment delivery. (PsycINFO Database Record (c) 2013 APA, all rights reserved).",23750459,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,14.79339599609375,-0.9029240012168884,Cc74
"Cognitive psychotherapy treatment decreases peripheral oxidative stress parameters associated with major depression disorder.

Studies have already pointed out the contribution of oxidative stress in the pathophysiology of major depressive disorder (MDD). The aim of the present study was to investigate the oxidative-antioxidative systems in MDD and in response to cognitive psychotherapies. Oxidative stress were analyzed in 49 MDD patients at baseline, post-treatment, and follow-up; and 49 control subjects without history of psychiatric disorders. MDD subjects presented an increase in oxidative damage related to control subjects for thiobarbituric acid reactive species (TBARS), nitric oxide, and a decrease in total thiol content. Cognitive psychotherapies were able to counteract peripheral oxidative stress in MDD patients, reducing TBARS levels (p<0.001) in the follow-up, nitric oxide (p<0.001) in the post-treatment and follow-up, and increasing the total thiol content (p<0.01) in the post-treatment and follow-up. Oxidative stress was associated with MDD and the regulation of these parameters might represent an important mechanism associated with the clinical improvement of cognitive psychotherapy.",26255227,Major Depressive Disorder,Anxiety Treatment,Mental Health,12951,3.383086919784546,8.38845157623291,B5uQ
"Cognitive behaviour therapy and inflammation: A systematic review of its relationship and the potential implications for the treatment of depression.

There is growing evidence confirming increased inflammation in a subset of adults with depression. The impact of this relationship has mostly been considered in biologically based interventions; however, it also has potential implications for psychological therapies. Cognitive behaviour therapy is the most commonly used psychological intervention for the treatment of depression with theories around its efficacy primarily based on psychological mechanisms. However, cognitive behaviour therapy may have an effect on, and its efficacy influenced by, physiological processes associated with depression. Accordingly, the purpose of this systematic review was to examine the relationship between cognitive behaviour therapy and inflammation. Studies examining the anti-inflammatory effects of cognitive behaviour therapy in people with depression and other medical conditions (e.g. cancer, diabetes and heart disease) were examined. In addition, the relationship between change in inflammatory markers and change in depressive symptoms following cognitive behaviour therapy, and the influence of pre-treatment inflammation on cognitive behaviour therapy treatment response were reviewed. A total of 23 studies investigating the anti-inflammatory effects of cognitive behaviour therapy were identified. In 14 of these studies, at least one reduction in an inflammatory marker was reported, increases were identified in three studies and no change was found in six studies. Three studies examined the relationship between change in inflammation and change in depressive symptoms following cognitive behaviour therapy. In two of these studies, change in depressive symptoms was associated with a change in at least one inflammatory marker. Finally, three studies examined the influence of pre-treatment inflammation on treatment outcome from cognitive behaviour therapy, and all indicated a poorer treatment response in people with higher premorbid inflammation. Preliminary evidence suggests inflammation should be considered within the context of cognitive behaviour therapy, although robust studies examining the relationship are sparse, and heterogeneity between studies and populations examined was high. The potential treatment implications of the bi-directional relationship between inflammation and cognitive behaviour therapy are discussed, and recommendations for future research are proposed.",28382827,Major Depressive Disorder,Anxiety Treatment,Mental Health,5528,5.0470051765441895,5.7708587646484375,BeW3
"Benefits of collaborative care for post-CABG depression are not related to adjustments in antidepressant pharmacotherapy.

To determine whether the use and adjustment of antidepressant pharmacotherapy accounted for the beneficial effects of collaborative care treatment on the improvement of mood symptoms and health-related quality of life (HRQoL) after coronary artery bypass graft (CABG) surgery. In a post-hoc analysis of data from the Bypassing the Blues (BtB) trial we tested the impact of antidepressant medication on changes in depression and HRQoL from the early postoperative period to 8-month follow-up. Two hundred fifty-nine depressed post-CABG patients scoring ≥10 on the Patient Health Questionnaire-9 were classified in four groups according to whether or not they received antidepressants at baseline and 8-months following randomization. Patients using antidepressant pharmacotherapy at baseline and follow-up tended to be younger and female (p≤0.01), but were similar in various clinical characteristics. Just 24% (63/259) of patients were on an antidepressant at baseline which increased to 36% at follow-up (94/259). Compared to other groups, patients on antidepressants at both baseline and follow-up assessment showed the smallest improvement in mood symptoms and HRQoL. While multivariate analyses confirmed that randomization to collaborative care was associated with greater improvement in mood symptoms (odds ratio [OR]=3.1; 95%-confidence interval [CI]=1.8-5.4, p<0.0001) and mental HRQoL (OR=3.6, CI=1.4-9.3, p=0.01), use of antidepressant medication had no differential impact on either measure (p=0.06 and p=0.92, respectively). The beneficial effects of collaborative care for post-CABG depression were not generated by adjustments in antidepressant medication. Clinicaltrials.gov Identifier: NCT00091962. (http://clinicaltrials.gov/ct2/show/NCT00091962?term=rollman+cabg&rank=1).",24360138,Major Depressive Disorder,Anxiety Treatment,Mental Health,7940,5.511114597320557,-0.42114225029945374,CUWK
"Comparative Efficacy of Therapies for Treatment of Depression for Patients Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial.

Although depression is common among patients receiving maintenance hemodialysis, data on their acceptance of treatment and on the comparative efficacy of various therapies are limited. To determine the effect of an engagement interview on treatment acceptance (phase 1) and to compare the efficacy of cognitive behavioral therapy (CBT) versus sertraline (phase 2) for treating depression in patients receiving hemodialysis. Multicenter, parallel-group, open-label, randomized controlled trial. (ClinicalTrials.gov: NCT02358343). 41 dialysis facilities in 3 U.S. metropolitan areas. Patients who had been receiving hemodialysis for at least 3 months and had a Beck Depression Inventory-II score of 15 or greater; 184 patients participated in phase 1, and 120 subsequently participated in phase 2. Engagement interview versus control visit (phase 1) and 12 weeks of CBT delivered in the dialysis facility versus sertraline treatment (phase 2). The primary outcome for phase 1 was the proportion of participants who started depression treatment within 28 days. For phase 2, the primary outcome was depressive symptoms measured by the Quick Inventory of Depressive Symptoms-Clinician-Rated (QIDS-C) at 12 weeks. The proportion of participants who initiated treatment after the engagement or control visit did not differ (66% vs. 64%, respectively; P = 0.77; estimated risk difference, 2.1 [95% CI, -12.1 to 16.4]). Compared with CBT, sertraline treatment resulted in lower QIDS-C depression scores at 12 weeks (effect estimate, -1.84 [CI, -3.54 to -0.13]; P = 0.035). Adverse events were more frequent in the sertraline than the CBT group. No randomized comparison was made with no treatment, and persistence of treatment effect was not assessed. An engagement interview with patients receiving maintenance hemodialysis had no effect on their acceptance of treatment for depression. After 12 weeks of treatment, depression scores were modestly better with sertraline treatment than with CBT. Patient-Centered Outcomes Research Institute, Dialysis Clinic, Kidney Research Institute, and National Institute of Diabetes and Digestive and Kidney Diseases.",30802897,Major Depressive Disorder,Anxiety Treatment,Mental Health,2177,3.962177276611328,-0.25968998670578003,A+V/
"The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review.

Depression is highly prevalent among Haemodialysis (HD) patients and is known to results in a series of adverse outcomes and poor quality of life (QoL). Although cognitive behavioural therapy (CBT) has been shown to improve depressive symptoms and QoL in other chronic illness, there is uncertainty in terms of the effectiveness of CBT in HD patients with depression or depressive symptoms. All randomised controlled trials relevant to the topic were retrieved from the following databases: CINHAL, MEDLINE, PubMed, PsycINFO and CENTRAL. The grey literature, specific journals, reference lists of included studies and trials registers website were also searched. Data was extracted or calculated from included studies that had measured depression and quality of life using valid and reliable tools -this included mean differences or standardised mean differences and 95% confidence intervals. The Cochrane risk of bias tool was used to identify the methodological quality of the included studies. Six RCTs were included with varying methodological quality. Meta-analysis was undertaken for 3 studies that employed the CBT versus usual care. All studies showed that the depressive symptoms significantly improved after the CBT. Furthermore, CBT was more effective than usual care (MD=-5.28, 95%CI -7.9 to -2.65, P=0.37) and counselling (MD=-2.39, 95%CI -3.49 to -1.29), while less effective than sertraline (MD=2.2, 95%CI 0.43 to 3.97) in alleviating depressive symptoms. Additionally, the CBT seems to have a beneficial effect in improving QoL when compared with usual care, while no significant difference was found in QoL score when compared CBT with sertraline. CBT may improve depressive symptoms and QoL in HD patients with comorbid depressive symptoms. However, more rigorous studies are needed in this field due to the small quantity and varied methodological quality in the identified studies.",32664880,Major Depressive Disorder,Anxiety Treatment,Mental Health,2177,4.040311336517334,-0.5397945642471313,Al10
"Internet Cognitive-Behavioral Therapy for Depression in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial.

To determine the efficacy of an internet-based cognitive-behavioral therapy (iCBT) program for depression in older adults with osteoarthritis (OA) of the knee and comorbid major depressive disorder (MDD). We conducted a randomized controlled trial in 69 adults (ages ≥50 years) meeting criteria for MDD and OA of the knee with 1-week postintervention (week 11) and 3-month followup (week 24) end points. Patients were allocated to either a 10-week iCBT program for depression added to treatment as usual (TAU) or to a TAU control group. Primary outcomes were depression symptoms (9-Item Patient Health Questionnaire [PHQ-9]) and psychological distress (Kessler-10 [K-10]). Secondary outcomes included arthritis self-efficacy (Arthritis Self-Efficacy Scale [ASES]), OA pain, stiffness, physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and physical and mental health (Short Form 12-Item health survey physical component and mental component summaries). Depression status was assessed by blinded diagnostic interview (the Mini-International Neuropsychiatric Interview) at intake and followup. Intent-to-treat analyses indicated between-group superiority of iCBT over TAU on the primary outcomes (PHQ-9: Hedges g = 1.01, 95% confidence interval [95% CI] 0.47, 1.54; K-10: Hedges g = 0.75, 95% CI 0.23, 1.28), at postintervention and 3-month followup (PHQ-9: Hedges g = 0.90, 95% CI 0.36, 1.44; K-10: Hedges g = 0.94, 95% CI 0.41, 1.48), and on secondary OA-specific measures (ASES: Hedges g = -0.81, 95% CI -0.29, -1.33; WOMAC: Hedges g = 0.56-0.65, 95% CI 0.04, 1.18) at the 3-month followup. The majority of iCBT participants (84%) no longer met diagnostic criteria at 3-month followup. Results support the efficacy of an iCBT program (requiring no face-to-face contact) for depression in individuals with comorbid depression and OA of the knee. Importantly, the benefits of the program extended beyond reduced depressive symptoms and distress to include increased self-efficacy and improved pain, stiffness, and physical function at followup.",28426917,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,5.564744472503662,-0.39184942841529846,BdsK
"The (cost) effectiveness of guided internet-based self-help CBT for dialysis patients with symptoms of depression: study protocol of a randomised controlled trial.

Only a minority of dialysis patients with depressive symptoms are diagnosed and receive treatment. Depressive symptoms are highly prevalent in this population and are associated with adverse clinical outcomes. Underlying factors for this undertreatment may be the lack of evidence for the safety and effectivity of antidepressant medication, the reluctance of patients to adhere to antidepressant medication, the lack of mental healthcare provision in somatic healthcare environments and end-stage renal disease (ESRD) related physical limitations that complicate face-to-face psychotherapy. Guided Internet-based self-help treatment has demonstrated to be effective for depressive symptoms in other chronic patient populations and may overcome these barriers. The aim of this study is to investigate the (cost) effectiveness of a guided Internet-based self-help intervention for symptoms of depression in dialysis patients. This study is a cluster randomized controlled trial (RCT) that investigates the effectiveness of a 5-week Internet-based self-help Problem Solving Therapy (PST) for depressive symptoms in dialysis patients. Depressive symptoms will be measured using the Beck Depression Inventory - second edition (BDI-II), with a cut-off score of ≥10. We aim to include 206 dialysis patients with depressive symptoms who will be cluster randomized to the intervention or the Care as Usual (CAU) control group. Secondary outcomes will include anxiety symptoms, quality of life, economic costs and clinical outcomes, such as inflammatory factors and hair cortisol levels. Assessments will take place at baseline (T0), 2weeks after intervention (T1) and 6months (T2), 12months (T3) and 18months (T4) after intervention. The control group will be measured at the same time points. Analysis will be based on the intention-to-treat principle. Mixed models will be used to assess the changes within each condition between pre-treatment and post-treatment. If demonstrated to be (cost) effective, Internet-based PST will offer new possibilities to treat dialysis patients with depressive symptoms and to improve their quality of care. Dutch Trial Register: Trial NL6648 (NTR6834) (prospectively registered 13th November 2017).",31775685,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,4.043089866638184,-0.2941906750202179,AxKa
"Systematic Review and Meta-analysis of Interventions for Depression and Anxiety in Persons With Rheumatoid Arthritis.

Psychiatric comorbidities, such as depression and anxiety, are very common in persons with rheumatoid arthritis (RA) and can lead to adverse outcomes. By appropriately treating these comorbidities, disease-specific outcomes and quality of life may be improved. The aim of this study was to systematically review the literature from controlled trials of treatments for depression and anxiety in persons with RA. We searched multiple online databases from inception until March 25, 2015, without restrictions on language, date, or location of publication. We included controlled trials conducted in persons with RA and depression or anxiety. Two independent reviewers extracted information including trial and participant characteristics. The standardized mean differences (SMDs) of depression or anxiety scores at postassessment were pooled between treatment and comparison groups, stratified by active versus inactive comparators. From 1291 unique abstracts, we included 8 RA trials of depression interventions (6 pharmacological, 1 psychological, 1 both). Pharmacological interventions for depression with inactive comparators (n = 3 trials, 143 participants) did not reduce depressive symptoms (SMD, -0.21; 95% confidence interval [CI], -1.27 to 0.85), although interventions with active comparators (n = 3 trials, 190 participants) did improve depressive symptoms (SMD, -0.79; 95% CI, -1.34 to -0.25). The single psychological trial of depression treatment in RA did not improve depressive symptoms (SMD, -0.44; 95% CI, -0.96 to 0.08). Seven of the trials had an unclear risk of bias. Few trials examining interventions for depression or anxiety in adults with RA exist, and the level of evidence is low to moderate because of the risk of bias and small number of trials.",28221313,Major Depressive Disorder,Anxiety Treatment,Mental Health,4559,4.876887798309326,-0.30641037225723267,BgiX
"Efficacy of psychotherapy on diurnal cortisol patterns and suicidal ideation in adjustment disorder with depressed mood.

The aims were to examine the effects of psychotherapy on depressive and anxiety symptoms, the occurrence of suicidal ideations and diurnal cortisol patterns in patients with adjustment disorder (AD) with depressed mood. Participants recruited from an outpatient department of psychiatry at a general hospital were randomly assigned to one of two groups: 34 in psychotherapy group and 37 in control group. The control group consisted of one-session psychoeducation. Psychotherapy included the eight-weekly body-mind-spirit (BMS) group psychotherapy. Measures included Beck Depression Inventory-II and State Trait Anxiety Inventory. Salivary cortisol samples were collected from the patients at their homes on awakening; 30 and 45 min after awakening; and at 1200, 1700 and 2100 h. Measurements were taken at baseline and at months 2 (end of intervention), 5, 8 and 14. There was no differential change over time between the BMS and control groups in self-reported depression or anxiety symptoms. However, suicidal ideation appeared to be reduced in the psychotherapy group. Changes in diurnal cortisol patterns were also significantly different in group × time interactions, in favor of BMS group. Psychotherapy likely provides improvements in psychobiological stress responses and decreases the occurrence of suicidal ideation in patients with AD.",24342115,Major Depressive Disorder,Anxiety Treatment,Mental Health,23529,5.171857833862305,4.335211277008057,CUmm
"The Cognitive Behavioral Treatment of Depression and Low Self-Esteem in the Context of Pediatric Chronic Fatigue Syndrome (CFS/ME): A Case Study.

Up to one in three young people with chronic fatigue syndrome (CFS/ME) also has depressive symptoms. It is not known how best to treat young people with this comorbidity. This case report seeks to describe and discuss the use of a cognitive behavioral approach for depression and low self-esteem in a 16-year-old girl with CFS/ME. Therapy was effective in remediating the young person's mood difficulties, but appeared to exacerbate their CFS/ME symptoms. Therefore, it is crucial that CFS/ME and mood treatments are designed and trialed to ensure a complementary approach. Good communication and joint working between involved professionals is also important, and ideally, treatments for mood and for CFS/ME would be provided by the same team to facilitate this.",26470755,Major Depressive Disorder,Anxiety Treatment,Mental Health,280,3.597625494003296,0.2772548794746399,B2id
"Discontinuing antidepressant medication after mindfulness-based cognitive therapy: a mixed-methods study exploring predictors and outcomes of different discontinuation trajectories, and its facilitators and barriers.

This study aimed to explore predictors and outcomes associated with different trajectories of discontinuing antidepressant medication (ADM), in recurrently depressed individuals after participation in mindfulness-based cognitive therapy (MBCT). Facilitators and barriers of discontinuation were explored qualitatively. Mixed-methods study combining quantitative and qualitative data, drawn from a randomised controlled trial. Twelve secondary and tertiary psychiatric outpatient clinics in the Netherlands. Recurrently depressed individuals (N=226) who had been using ADM for at least 6months and in partial or full remission. Regardless of trial condition, we made post-hoc classifications of patients' actual discontinuation trajectories: full discontinuation (n=82), partial discontinuation (n=34) and no discontinuation (n=110) of ADM within 6months after baseline. A subset of patients (n=15) and physicians (n=7) were interviewed to examine facilitators and barriers of discontinuation. All participants were offered MBCT, which consisted of eight weekly sessions in a group. Demographic and clinical predictors of successful discontinuation within 6 months, relapse risk within 15 months associated with different discontinuation trajectories, and barriers and facilitators of discontinuation. Of the 128 patients assigned to MBCT with discontinuation, only 68 (53%) fully discontinued ADM within 6 months, and 17 (13%) discontinued partially. Predictors of full discontinuation were female sex, being employed and lower levels of depression. Relapse risk was lower after no discontinuation (45%) or partial discontinuation (38%), compared with full discontinuation (66%) (p=0.02). Facilitators and barriers of discontinuation were clustered within five themes: (1) pre-existing beliefs about depression, medication and tapering; (2) current experience with ADM; (3) life circumstances; (4) clinical support and (5) mindfulness. Discontinuing antidepressants appears to be difficult, stressing the need to support patients and physicians in this process. MBCT may offer one of these forms of support. ClinicalTrials.gov Registry (NCT00928980); post-results.",33177138,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,5.573152542114258,2.1605913639068604,AfmK
"World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders.

This 2013 update of the practice guidelines for the biological treatment of unipolar depressive disorders was developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal has been to systematically review all available evidence pertaining to the treatment of unipolar depressive disorders, and to produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. The guidelines are intended for use by all physicians seeing and treating patients with these conditions. The 2013 update was conducted by a systematic update literature search and appraisal. All recommendations were approved by the Guidelines Task Force. This first part of the guidelines (Part 1) covers disease definition, classification, epidemiology, and course of unipolar depressive disorders, as well as the management of the acute and continuation phase treatment. It is primarily concerned with the biological treatment (including antidepressants, other psychopharmacological medications, electroconvulsive therapy, light therapy, adjunctive and novel therapeutic strategies) of adults. To date, there is a variety of evidence-based antidepressant treatment options available. Nevertheless there is still a substantial proportion of patients not achieving full remission. In addition, somatic and psychiatric comorbidities and other special circumstances need to be more thoroughly investigated. Therefore, further high-quality informative randomized controlled trials are urgently needed.",23879318,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.143916130065918,-0.5098027586936951,CbBl
"Autobiographical Memory-Based Intervention for Depressive Symptoms in Young Adults: A Randomized Controlled Trial of Cognitive-Reminiscence Therapy.

",27230870,Major Depressive Disorder,Anxiety Treatment,Mental Health,14606,11.052186012268066,2.932973861694336,BsPx
"Challenges of Treatment-resistant Depression.

Guidelines for the management of treatment-resistant depression (TRD) do not meet the criteria of evidence-based medicine and better-quality research is required to inform clinical practice. Current treatments of resistant depression remains largely empirical. There are no bench-mark antidepressants. Clear and justifiable rationale should be followed while initiating new treatment strategies; systematic planning and careful monitoring of progress implemented while new treatment components are added. Biological psychiatrists should give due importance to the non-biological aspects of depression and psychotherapists should not overlook the biological correlates. Unidimensional solution will not work for a complex illness like refractory depression and a single answer should not be sought as a cure because the aetiology of depression is multifactorial and the pathophysiology itself remains unknown. Psychopharmacological interventions are still the main stay of treatment of TRD. There are two major alternatives to pharmacotherapy: neuromodulation and psychotherapy. Alternative terminologies for TRD like MTR-MDD (Multiple Therapy Resistant-Major Depressive Disorder) are being introduced reflecting the frustrations of clinicians and patients with the conventional definition of TRD and treatment modalities.",30267518,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.840354919433594,-0.3161717355251312,BFe7
"Mindfulness-based cognitive therapy for recurrent major depression: A 'best buy' for health care?

While mindfulness-based cognitive therapy is effective in reducing depressive relapse/recurrence, relatively little is known about its health economic properties. We describe the health economic properties of mindfulness-based cognitive therapy in relation to its impact on depressive relapse/recurrence over 2years of follow-up. Non-depressed adults with a history of three or more major depressive episodes were randomised to mindfulness-based cognitive therapy+depressive relapse active monitoring (n=101) or control (depressive relapse active monitoring alone) (n=102) and followed up for 2years. Structured self-report instruments for service use and absenteeism provided cost data items for health economic analyses. Treatment utility, expressed as disability-adjusted life years, was calculated by adjusting the number of days an individual was depressed by the relevant International Classification of Diseases 12-month severity of depression disability weight from the Global Burden of Disease 2010. Intention-to-treat analysis assessed the incremental cost-utility ratios of the interventions across mental health care, all of health-care and whole-of-society perspectives. Per protocol and site of usual care subgroup analyses were also conducted. Probabilistic uncertainty analysis was completed using cost-utility acceptability curves. Mindfulness-based cognitive therapy participants had significantly less major depressive episode days compared to controls, as supported by the differential distributions of major depressive episode days (modelled as Poisson, p<0.001). Average major depressive episode days were consistently less in the mindfulness-based cognitive therapy group compared to controls, e.g., 31 and 55days, respectively. From a whole-of-society perspective, analyses of patients receiving usual care from all sectors of the health-care system demonstrated dominance (reduced costs, demonstrable health gains). From a mental health-care perspective, the incremental gain per disability-adjusted life year for mindfulness-based cognitive therapy was AUD83,744 net benefit, with an overall annual cost saving of AUD143,511 for people in specialist care. Mindfulness-based cognitive therapy demonstrated very good health economic properties lending weight to the consideration of mindfulness-based cognitive therapy provision as a good buy within health-care delivery.",27095791,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.875672340393066,-0.45216578245162964,Bt9l
"Cognitive-reminiscence therapy and usual care for depression in young adults: study protocol for a randomized controlled trial.

Depression is a common affliction for young adults, and is associated with a range of adverse outcomes. Cognitive-reminiscence therapy is a brief, structured intervention that has been shown to be highly effective for reducing depressive symptoms, yet to date has not been evaluated in young adult populations. Given its basis in theory-guided reminiscence-based therapy, and incorporation of effective therapeutic techniques drawn from cognitive therapy and problem-solving frameworks, it is hypothesized to be effective in treating depression in this age group. This article presents the design of a randomized controlled trial implemented in a community-based youth mental health service to compare cognitive-reminiscence therapy with usual care for the treatment of depressive symptoms in young adults. Participants in the cognitive-reminiscence group will receive six sessions of weekly, individual psychotherapy, whilst participants in the usual-care group will receive support from the youth mental health service according to usual procedures. A between-within repeated-measures design will be used to evaluate changes in self-reported outcome measures of depressive symptoms, psychological wellbeing and anxiety across baseline, three weeks into the intervention, post-intervention, one month post-intervention and three months post-intervention. Interviews will also be conducted with participants from the cognitive-reminiscence group to collect information about their experience receiving the intervention, and the process underlying any changes that occur. This study will determine whether a therapeutic approach to depression that has been shown to be effective in older adult populations is also effective for young adults. The expected outcome of this study is the validation of a brief, evidence-based, manualized treatment for young adults with depressive symptoms. Australian New Zealand Clinical Trials Registry ACTRN12613000084785.",24143890,Major Depressive Disorder,Anxiety Treatment,Mental Health,14606,10.679657936096191,3.0102758407592773,CXHe
"The effects of relaxation training on depression and anxiety in people living with long-term neurological conditions.

Purpose: The present study investigated the effects of a relaxation training program on self-reported depression and anxiety in participants living with long-term neurological conditions, including acquired brain injury, stroke, Parkinson's disease, and multiple sclerosis.Materials and methods: A five-session relaxation training program, plus a follow-up session was offered to people living with a long-term neurological condition as part of routine clinical practice, and was delivered in their own homes. A self-report measure (Hospital Anxiety and Depression Scale) was administered at the pre- and post-intervention time points and at follow-up, around 5weeks after the final session. Participants also completed an individual assessment of change questionnaire at follow-up, reporting on subjective views of observed changes.Results: Statistically significant improvements were found on measures of both anxiety and depression following completion of the relaxation program. Scores at follow-up (mean=5weeks) revealed the improvement was maintained for anxiety, and there was further significant improvement for depression. Reliable change analyses from pre- to post-intervention demonstrated a clinically significant decrease in anxiety scores for 47% of participants and in depression scores for 30% of participants. No clinically significant increase in depression and anxiety was identified from pre- to post-intervention, and this was generally maintained at follow-up.Conclusion: Relaxation training is proposed as a clinically effective treatment for anxiety and depression in people living with long-term neurological conditions, which could in turn lead to better functional outcomes of neurorehabilitation. The program investigated here has additional benefits of being delivered in people's own homes, which overcomes barriers to attending hospital, and is consistent with trends towards home as opposed to hospital care. This program may also be less costly to administer as it can be delivered as part of a stepped-care program by therapy assistants under supervision from qualified staff, and encourages self-management over the longer term. Design limitations may reduce the generalisability of these findings, but are clinically encouraging and should stimulate further research.Implications for RehabilitationRelaxation training…•could be offered as an effective first-line intervention, as an alternative to medication to treat anxiety and depression to people living with Long-Term Neurological Conditionsis a self-management strategy which can be taught in people's own homes, if getting out of the house is difficultcan be delivered as a stepped-care intervention via therapy assistants, helping to reduce costs and demands on rehabilitation servicesmay help to improve the functional outcomes of wider rehabilitation interventions by addressing psychological issues which can be a barrier.",30653375,Major Depressive Disorder,Anxiety Treatment,Mental Health,14391,9.47577953338623,0.006207586731761694,BAVt
"Managing depressive symptoms in people with mild cognitive impairment and mild dementia with a multicomponent psychotherapy intervention: a randomized controlled trial.

To evaluate the feasibility and effectiveness of the CORDIAL program, a psychosocial intervention consisting of cognitive behavioral therapy (CBT), cognitive rehabilitation, and reminiscence to manage depressive symptoms for people with mild cognitive impairment (MCI) or dementia. We conducted a randomized controlled trial, based on a two-group (intervention and control), pre-/post-intervention design. Participants were recruited from five different old age psychiatry and memory clinics at outpatients' hospitals. Hundred and ninety-eight people with MCI or early-stage dementia were included. The intervention group (n = 100) received 11 individual weekly sessions of the CORDIAL program. This intervention includes elements from CBT, cognitive rehabilitation, and reminiscence therapy. The control group (n = 98) received treatment-as-usual. We assessed Montgomery-Åsberg Depression Rating Scale (MADRS) (main outcome), Neuropsychiatric Inventory Questionnaire, and Quality of Life in Alzheimer's disease (secondary outcomes) over the course of 4 months and at a 10-month follow-up visit. A linear mixed model demonstrated that the depressive symptoms assessed by MADRS were significantly more reduced in the intervention groups as compared to the control group (p < 0.001). The effect persisted for 6 months after the intervention. No significant differences between groups were found in neuropsychiatric symptoms or quality of life. Our multicomponent intervention, which comprised 11 individual sessions of CBT, cognitive rehabilitation, and reminiscence therapy, reduced depressive symptoms in people with MCI and dementia.",32131911,Major Depressive Disorder,Anxiety Treatment,Mental Health,11554,10.154129981994629,3.4237186908721924,Asbw
"Effectiveness of mindfulness-based cognitive therapy against suicidal ideation in patients with depression: A systematic review and meta-analysis.

Mindfulness-based cognitive therapy (MBCT) can effectively prevent relapse of major depression, but there is currently insufficient evidence for efficacy against suicidal ideation during depressive episodes. We thus conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing MBCT to treatment as usual (TAU) for suppression of suicidal ideation in patients with current depression. We systematically searched PubMed, Embase, Cochrane, CNKI, and Wan Fang databases for RCTs published in English or Chinese between January 1, 2000, and August 30, 2021. Pooled data were compared between MBCT and TAU groups using a random-effects model. Seven RCTs with a total of 479 participants were included. Suicidal ideation and general depression scores were significantly improved following MBCT compared to TAU [Suicidal Ideation: standard mean difference (SMD) = -0.33, 95 % CI, -0.56 to -0.10; Depression: SMD = -0.96, 95%CI, -1.54 to -0.38]. Mindfulness-based cognitive therapy is an effective intervention for reducing depressive symptoms and suicidal ideation in depressed patients. This meta-analysis was conducted in accordance with PRISMA guidelines and registered at PROSPERO https://www.crd.york.ac.uk/PROSPERO/ (CRD42021285016).",36170923,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.386134147644043,-0.44704023003578186,FzA
"New modalities of assessment and treatment planning in depression: the sequential approach.

The sequential model of treatment for depression, i.e. the use of psychotherapy in patients who have remitted from a major depressive disorder after a course of pharmacotherapy, is an intensive two-stage approach that derives from the awareness that one course of treatment is unlikely to provide a solution to all the symptoms of patients. The aim of the sequential approach is to provide different types of treatment for as long as considered necessary in different phases of illness as determined by repeated assessments. The treatment strategies are chosen on the basis of the symptoms identified and not as predefined options. The sequential model emphasizes consideration of subclinical and residual symptomatology according to the organizing principles of macro-analysis (a relationship between co-occurring symptoms and problems is established on the basis of where treatment should commence in the first place). Diagnostic endpoints (i.e. DSM diagnoses), the customary guidance of treatment planning, are replaced by conceptualization of disorders as 'transfer stations', which are amenable to longitudinal verification and modification. The aim of this systematic review was to survey the literature concerned with the sequential approach to the treatment of depression. Randomized controlled trials were identified using MEDLINE and a manual search of the literature. In seven of the eight studies that were identified, the sequential use of pharmacotherapy and psychotherapy was found to improve long-term outcome after termination of treatment compared with clinical management and treatment as usual. Nevertheless, data on this approach are limited and more studies are necessary for detailing the various clinical steps associated with it. The sequential approach calls for a re-assessment of the design of comparative clinical trials. It allows randomization of patients who are already in treatment and assignment of them to treatment alternatives according to stages of development of their illness and not simply to disease classification. The model is thus more in line with the chronicity of mood disorders compared to the standard randomized controlled trial, which is based on the acute disease model.",20443645,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.3867826461792,-0.3630618155002594,DK26
"Mindfulness-based cognitive therapy for recurrent depression: A translational research study with 2-year follow-up.

While mindfulness-based cognitive therapy (MBCT) has demonstrated efficacy in reducing depressive relapse/recurrence over 12-18 months, questions remain around effectiveness, longer-term outcomes, and suitability in combination with medication. The aim of this study was to investigate within a pragmatic study design the effectiveness of MBCT on depressive relapse/recurrence over 2 years of follow-up. This was a prospective, multi-site, single-blind trial based in Melbourne and the regional city of Geelong, Australia. Non-depressed adults with a history of three or more episodes of depression were randomised to MBCT + depression relapse active monitoring (DRAM) (n=101) or control (DRAM alone) (n=102). Randomisation was stratified by medication (prescribed antidepressants and/or mood stabilisers: yes/no), site of usual care (primary or specialist), diagnosis (bipolar disorder: yes/no) and sex. Relapse/recurrence of major depression was assessed over 2 years using the Composite International Diagnostic Interview 2.1. The average number of days with major depression was 65 for MBCT participants and 112 for controls, significant with repeated-measures ANOVA (F(1, 164)=4.56, p=0.03). Proportionally fewer MBCT participants relapsed in both year 1 and year 2 compared to controls (odds ratio 0.45, p<0.05). Kaplan-Meier survival analysis for time to first depressive episode was non-significant, although trends favouring the MBCT group were suggested. Subgroup analyses supported the effectiveness of MBCT for people receiving usual care in a specialist setting and for people taking antidepressant/mood stabiliser medication. This work in a pragmatic design with an active control condition supports the effectiveness of MBCT in something closer to implementation in routine practice than has been studied hitherto. As expected in this translational research design, observed effects were less strong than in some previous efficacy studies but appreciable and significant differences in outcome were detected. MBCT is most clearly demonstrated as effective for people receiving specialist care and seems to work well combined with antidepressants.",24595511,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.743697166442871,-0.6140193939208984,CRV0
"LONG-TERM OUTCOME OF MINDFULNESS-BASED COGNITIVE THERAPY IN RECURRENTLY DEPRESSED PATIENTS WITH AND WITHOUT A DEPRESSIVE EPISODE AT BASELINE.

In a previous randomized controlled trial in patients with three or more previous depressive episodes, mindfulness-based cognitive therapy (MBCT) appeared to be equally effective in those who were depressed and those who were in remission at the start of the trial. The aim of this study is to compare the 1-year outcome of MBCT in 124 remitted and 58 depressed patients who participated in the original trial and who were all offered MBCT either immediately or after a waiting period of 3 months. The course of depressive symptoms, rumination, mindfulness skills, and quality of life over the course of treatment and the 1-year follow-up period was analyzed. Linear mixed modeling was used to compare the outcome between remitted and depressed patients at baseline. In the whole sample, levels of depression and rumination decreased and mindfulness and quality of life increased over treatment. Levels of depressive symptoms, mindfulness, and quality of life remained stable over the 1-year follow-up period. Rumination further decreased. Remitted and depressed patients at the start of the trial did not differ in terms of outcome during or after treatment. Long-term outcome after MBCT in depressed patients was comparable to those who were in remission at the start of the trial. These findings lend further support to the notion that recurrent depressed patients meeting the criteria of a depressive episode do not need to be excluded from MBCT.",25869231,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.632464408874512,-0.4580605626106262,B/Lz
"Metacognitive therapy home-based self-help for cardiac rehabilitation patients experiencing anxiety and depressive symptoms: study protocol for a feasibility randomised controlled trial (PATHWAY Home-MCT).

Anxiety and depression are common among patients attending cardiac rehabilitation services. Currently available pharmacological and psychological interventions have limited effectiveness in this population. There are presently no psychological interventions for anxiety and depression integrated into cardiac rehabilitation services despite emphasis in key UK National Health Service policy. A new treatment, metacognitive therapy, is highly effective at reducing anxiety and depression in mental health settings. The principal aims of the current study are (1) to evaluate the acceptability of delivering metacognitive therapy in a home-based self-help format (Home-MCT) to cardiac rehabilitation patients experiencing anxiety and depressive symptoms and conduct a feasibility trial of Home-MCT plus usual cardiac rehabilitation compared to usual cardiac rehabilitation; and (2) to inform the design and sample size for a full-scale trial. The PATHWAY Home-MCT trial is a single-blind feasibility randomised controlled trial comparing usual cardiac rehabilitation (control) versus usual cardiac rehabilitation plus home-based self-help metacognitive therapy (intervention). Economic and qualitative evaluations will be embedded within the trial. Participants will be assessed at baseline and followed-up at 4 and 12 months. Patients who have been referred to cardiac rehabilitation programmes and have a score of ≥8 on the anxiety and/or depression subscales of the Hospital Anxiety and Depression Scale will be invited to take part in the study and written informed consent will be obtained. Participants will be recruited from the National Health Service in the UK. A minimum of 108 participants will be randomised to the intervention and control arms in a 1:1 ratio. The Home-MCT feasibility randomised controlled trial will provide evidence on the acceptability of delivering metacognitive therapy in a home-based self-help format for cardiac rehabilitation patients experiencing symptoms of anxiety and/or depression and on the feasibility and design of a full-scale trial. In addition, it will provide provisional point estimates, with appropriately wide measures of uncertainty, relating to the effectiveness and cost-effectiveness of the intervention. ClinicalTrials.gov, NCT03129282 , Submitted to Registry: 11 April 2017.",30115112,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,7.424055099487305,-0.5710335969924927,BHeJ
"Impact of Mindfulness-Based Cognitive Therapy on Depressive Symptoms Reduction among Depressed Patients in Nigeria: A Randomized Controlled Trial.

Depression is a common mental health disease with a high risk of relapse in people with a mental health condition. Mindfulness-based cognitive therapy (MBCT) showed higher efficacy in reducing depressive symptoms and prevent relapse for depressed patients. The study examined the effectiveness of MBCT versus the control group (CG) for the depression symptom reduction. A controlled trial was used to examine the effectiveness of MBCT or CG on depressive patients in Nigeria. Out of 357 screened subjects, 101 patients were randomized to receive either MBCT (n=50) or CG (n=51) and prospectively followed for 2 months. The intervention delivered according to the published manuals, and Beck Depression Inventory (BDI) was used to assess MDD severity among the patients. All assessments were conducted at three levels (baseline, 2 and 4 months). At the end of the 8 weeks of MBCT intervention, MBCT participants did not have significantly fewer depressive symptoms compared to those in the CG. However, the MBCT group had a significant depressive symptom reduction after 2 month follow up. The findings are in line with other studies, which show MBCT significantly decreased depression severity and improved treatment response rates after 2 months follow up, confirmed MBCT viability in the management of MDD.",32996802,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.288254737854004,-0.49393776059150696,Ahvn
"Comment on ""The effects of rational emotive behavior therapy for depressive symptoms in adults with congenital heart disease.""

",35963661,Major Depressive Disorder,Anxiety Treatment,Mental Health,24560,8.753684043884277,0.534991979598999,Ljc
"Treatment effects of massage therapy in depressed people: a meta-analysis.

To systematically investigate the treatment effects of massage therapy in depressed people by incorporating data from recent studies. A meta-analysis of randomized controlled trials (RCTs) of massage therapy in depressed people was conducted using published studies from PubMed, EMBASE, PsycINFO, and CINAHL electronic database from inception until July 2008. The terms used for the search were derived from medical subheading term (MeSH) massage combined with MeSH depression. Hand searching was also checked for bibliographies of relevant articles. Retrieval articles were constrained to RCTs/clinical trials and human subjects. No language restrictions were imposed. We included 17 studies containing 786 persons from 246 retrieved references. Trials with other intervention, combined therapy, and massage on infants or pregnant women were excluded. Two reviewers independently performed initial screen and assessed quality indicators by Jadad scale. Data were extracted on publication year, participant characteristics, and outcomes by another single reviewer. All trials showed positive effect of massage therapy on depressed people. Seventeen RCTs were of moderate quality, with a mean quality score of 6.4 (SD = 0.85). The pooled standardized mean difference in fixed- and random-effects models were 0.76 (95% CI, 0.61-0.91) and 0.73 (95% CI, 0.52-0.93), respectively. Both indicated significant effectiveness in the treatment group compared with the control group. The variance between these studies revealed possible heterogeneity (tau(2) = 0.06, Cochran chi-squared(16) = 25.77, P = .06). Massage therapy is significantly associated with alleviated depressive symptoms. However, standardized protocols of massage therapy, various depression rating scales, and target populations in further studies are suggested.",20361919,Major Depressive Disorder,Anxiety Treatment,Mental Health,9426,8.148552894592285,0.5320090055465698,DMIi
"Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: a systematic review.

Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, owing to a lower side-effect burden, potential reduction of polypharmacy, and theoretical considerations that such interventions may target some of the cognitive roots of depression. We aimed to determine the state of the evidence supporting this application. Randomized controlled trials of techniques meeting the Agency for Healthcare Research and Quality definition of meditation, for participants having clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e., how they were applied) components, and trial outcomes were reviewed. 18 studies meeting the inclusion criteria were identified, encompassing 7 distinct techniques and 1173 patients. Mindfulness-Based Cognitive Therapy comprised the largest proportion of studies. Studies including patients having acute major depressive episodes (n = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (n = 8), demonstrated moderate to large reductions in depression symptoms within the group, and relative to control groups. There was significant heterogeneity of techniques and trial designs. A substantial body of evidence indicates that meditation therapies may have salutary effects on patients having clinical depressive disorders during the acute and subacute phases of treatment. Owing to methodologic deficiencies and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium.",25591492,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,8.707246780395508,-0.3224112391471863,CDL2
"Patients' Perceptions of Functional Improvement in Psychotherapy for Mood Disorders.

This study aimed to examine participants' experiences of interpersonal and social rhythm therapy, with or without cognitive remediation, and the impact of this intervention on their functioning. This qualitative study drew data from follow-up interviews of 20 participants who completed the 12-month intervention as part of a randomized controlled trial. The qualitative data were collected through semistructured interviews and were analyzed with thematic analysis. The 20 participants (11 men, 9 women, ages 22-55, median age=32) reported that interpersonal and social rhythm therapy (content and process) as an adjunct to medication, alone or in combination with cognitive remediation, was effective in improving their functioning. They described these improvements as facilitated by a new sense of control and confidence, ability to focus, new communication and problem-solving skills, and better daily routines. Participants with recurrent mood disorders described improved functioning related to therapies that formulate their mood disorder in terms of a model, such as interpersonal and social rhythm therapy with or without cognitive remediation, that provides an understandable and evidence-based rationale, facilitates a sense of control and confidence by supporting the person in undertaking practical routines that can be integrated into daily life, focuses on communication and problem-solving skills, and engenders a sense of hope by working with the person to develop self-management strategies relevant to their specific symptom experiences and the life they choose to live.",33302704,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,12.34617805480957,-0.3969205617904663,AeGV
"Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: a qualitative study with illustrative case studies.

This study aimed to describe the recovery journeys of people with a history of recurrent depression who took part in a psychosocial programme designed to teach skills to prevent depressive relapse (mindfulness-based cognitive therapy (MBCT)), alongside maintenance antidepressant medication (ADM). A qualitative study embedded within a multicentre, single blind, randomised controlled trial (the PREVENT trial). Primary care urban and rural settings in the UK. 42 people who participated in the MBCT arm of the parent trial were purposively sampled to represent a range of recovery journeys. MBCT involves eightweekly group sessions, with four refresher sessions offered in the year following the end of the programme. It was adapted to offer bespoke support around ADM tapering and discontinuation. Written feedback and structured in-depth interviews were collected in the 2years after participants undertook MBCT. Data were analysed using thematic analysis and case studies constructed to illustrate the findings. People with recurrent depression have unique recovery journeys that shape and are shaped by their pharmacological and psychological treatment choices. Their journeys typically include several over-arching themes: (1) beliefs about the causes of depression, both biological and psychosocial; (2) personal agency, including expectations about their role in recovery and treatment; (3) acceptance, both of depression itself and the recovery journey; (4) quality of life; (5) experiences and perspectives on ADM and ADM tapering-discontinuation; and (6) the role of general practitioners, both positive and negative. People with recurrent depression describe unique, complex recovery journeys shaped by their experiences of depression, treatment and interactions with health professionals. Understanding how several themes coalesce for each individual can both support their recovery and treatment choices as well as health professionals in providing more accessible, collaborative, individualised and empowering care. Clinical trial number ISRCTN26666654; post results.",32075835,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.845107078552246,-0.39058148860931396,AtHE
"Treatment for depression comorbid with dementia.

Depression is a common comorbidity in dementia. Randomised controlled studies of antidepressants do not show a significant improvement in depressive symptoms in patients with comorbid dementia and are known to lead to an increase in side effects. However, there are relatively few studies of depression in dementia, and drawing firm conclusions about the use of antidepressants is limited by the amount of data available. Furthermore, it is unclear whether data can be extrapolated from similar populations (eg, those with late-life depression) to inform pharmacotherapy in this patient group. Given the lack of effectiveness and risk of side effects associated with pharmacological treatments, psychological interventions may offer important therapeutic benefits. There is evidence for the effectiveness of individual psychological therapy, and further research will establish which psychological approach is the most effective. Some studies have shown an improvement in depressive symptoms using structured sleep hygiene programmes, exercise, arts interventions and music therapy. These studies are hampered by small data sets, and the benefits to individuals may not be well captured by standard outcome measures. At present, the best evidence for arts-based approaches is in music therapy. Depression with comorbid dementia responds well to electroconvulsive therapy and this is a useful treatment modality for those with severe or life-threatening depressive symptoms. Alternative neurostimulation techniques such as transcranial magnetic stimulation are not widely used at present and further research is needed before they can be a more widely used treatment modality.",31558560,Major Depressive Disorder,Anxiety Treatment,Mental Health,11554,10.284367561340332,3.2728524208068848,A0JG
"Neurocognitive changes in depressed patients in psychodynamic psychotherapy, therapy with fluoxetine and combination therapy.

Randomized controlled trials (RCTs) examining the efficacy of different forms of therapy for depression are relatively common. However, there are not many RCTs comparing neurocognitive effects of these treatments. Neurocognitive changes across three types of treatment for depression were compared. Long-term psychodynamic psychotherapy (LTPP) was compared with fluoxetine treatment, and their combination, in the treatment of moderate depression. A 272 adult patients with beck depression inventory (BDI) scores 20-35 were randomized to receive LTPP, fluoxetine monotherapy or their combination for a 24 months period. The Wechsler adult intelligence scale version III (WAIS-III) was the primary neuropsychological measure. Multilevel mixed model analyses indicated that there were neurocognitive changes within and between treatments, with statistically significant differences over time (p>.01). LTPP and combined treatment seemed to be more efficacious in modifying specific areas of cognition than fluoxetine alone. Sample very homogenous, threatening external validity. LTPP and its combination with fluoxetine demonstrated to be effective for specific neurocognitive increasing in patients with moderate depression. This study suggests marked differences over time in the neurocognitive effects between the three treatment forms compared. Results found here may be of clinical relevance for building bridges between pharmacotherapy and psychodynamic psychotherapy.",24103853,Major Depressive Disorder,Anxiety Treatment,Mental Health,15794,11.622693061828613,-0.4513562321662903,CXuk
"International Study to Predict Optimized Treatment for Depression (iSPOT-D), a randomized clinical trial: rationale and protocol.

Clinically useful treatment moderators of Major Depressive Disorder (MDD) have not yet been identified, though some baseline predictors of treatment outcome have been proposed. The aim of iSPOT-D is to identify pretreatment measures that predict or moderate MDD treatment response or remission to escitalopram, sertraline or venlafaxine; and develop a model that incorporates multiple predictors and moderators. The International Study to Predict Optimized Treatment - in Depression (iSPOT-D) is a multi-centre, international, randomized, prospective, open-label trial. It is enrolling 2016 MDD outpatients (ages 18-65) from primary or specialty care practices (672 per treatment arm; 672 age-, sex- and education-matched healthy controls). Study-eligible patients are antidepressant medication (ADM) naïve or willing to undergo a one-week wash-out of any non-protocol ADM, and cannot have had an inadequate response to protocol ADM. Baseline assessments include symptoms; distress; daily function; cognitive performance; electroencephalogram and event-related potentials; heart rate and genetic measures. A subset of these baseline assessments are repeated after eight weeks of treatment. Outcomes include the 17-item Hamilton Rating Scale for Depression (primary) and self-reported depressive symptoms, social functioning, quality of life, emotional regulation, and side-effect burden (secondary). Participants may then enter a naturalistic telephone follow-up at weeks 12, 16, 24 and 52. The first half of the sample will be used to identify potential predictors and moderators, and the second half to replicate and confirm. First enrolment was in December 2008, and is ongoing. iSPOT-D evaluates clinical and biological predictors of treatment response in the largest known sample of MDD collected worldwide. International Study to Predict Optimised Treatment - in Depression (iSPOT-D) ClinicalTrials.gov Identifier: NCT00693849. URL: http://clinicaltrials.gov/ct2/show/NCT00693849?term=International+Study+to+Predict+Optimized+Treatment+for+Depression&rank=1",21208417,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.625924110412598,-0.24912582337856293,DBjJ
"A Chinese Chan-based mind-body intervention for patients with depression.

Given the recent growing interest and encouraging findings in studies of alternative treatments for depression, the present randomized controlled trial study aimed to compare the effect of a newly developed Chinese Chan-based Dejian Mind-Body Intervention (DMBI) with the Cognitive Behavioral Therapy (CBT) on improving depressive symptoms in patients with depression. Seventy-five participants diagnosed with major depressive disorder were randomly assigned to receive either 10-session CBT or DMBI, or placed on a waitlist. Pre-post measurements included record of anti-depressants treatment, ratings by psychiatrists who were blinded to the experimental design and self-report on mood measures, and performance in a cognitive test tapping concentration ability. Both the CBT and DMBI groups demonstrated significantly reduced overall depressive syndrome after intervention at large effect size (0.93-1.10). Furthermore, the DMBI group (p<0.05), but not the CBT or waitlist groups, demonstrated significant reduction in intake of anti-depressants, and significant improvement in specific depression-related symptoms including difficulty in concentration (p=0.002), and problems in gastrointestinal health (p=0.02) and overall sleep quality (p<0.001). This study has provided some evidence for the short-term effect of the DMBI on Chinese population. Its long-term effect on a larger sample and on Caucasian population warrants further investigation. The present findings suggest that a Chinese Chan-based Mind-Body intervention has positive effects on improving mood and health conditions of individuals with depression.",22840618,Major Depressive Disorder,Anxiety Treatment,Mental Health,19115,9.112284660339355,-0.01787639409303665,CqO8
"Homeopathy for depression--DEP-HOM: study protocol for a randomized, partially double-blind, placebo controlled, four armed study.

Homeopathy is often sought by patients with depression. In classical homeopathy, the treatment consists of two main elements: the case history and the prescription of an individually selected homeopathic remedy. Previous data suggest that individualized homeopathic Q-potencies were not inferior to the antidepressant fluoxetine in a sample of patients with moderate to severe depression. However, the question remains whether individualized homeopathic Q-potencies and/or the type of the homeopathic case history have a specific therapeutical effect in acute depression as this has not yet been investigated. The study aims to assess the two components of individualized homeopathic treatment for acute depression, i.e., to investigate the specific effect of individualized Q-potencies versus placebo and to investigate the effect of different approaches to the homeopathic case history. A randomized, partially double-blind, placebo-controlled, four-armed trial using a 2 x 2 factorial design with a six-week study duration per patient will be performed. 228 patients diagnosed with major depression (moderate episode) by a psychiatrist will be included. The primary endpoint is the total score on the 17-item Hamilton Depression Rating Scale after six weeks. Secondary end points are: Hamilton Depression Rating Scale total score after two and four weeks; response and remission rates, Beck Depression inventory total score, quality of life and safety at two, four and six weeks. Statistical analyses will be by intention-to-treat. The main endpoint will be analysed by a two-factorial analysis of covariance. Within this model generalized estimation equations will be used to estimate differences between verum and placebo, and between both types of case history. For the first time this study evaluates both the specific effect of homeopathic medicines and of a homeopathic case taking in patients with depression. It is an attempt to deal with the challenges of homeopathic research and the results might be useful information in the current discussion about the evidence on homeopathy ClinicalTrials.gov: NCT01178255.",21320338,Major Depressive Disorder,Anxiety Treatment,Mental Health,2846,7.964931964874268,-0.43266865611076355,C/8B
"Staying well after depression: trial design and protocol.

Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group. This trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter. This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression--that in people who become suicidal when depressed.",20302615,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,10.06922721862793,-0.47443437576293945,DMnr
"What is the best sequential treatment strategy in the treatment of depression? Adding pharmacotherapy to psychotherapy or vice versa?

Insufficient response to monotreatment for depression is a common phenomenon in clinical practice. Even so, evidence indicating how to proceed in such cases is sparse. This study looks at the second phase of a sequential treatment algorithm, in which 103 outpatients with moderately severe depression were initially randomized to either short-term supportive psychodynamic therapy (PDT) or antidepressants. Patients who reported less than 30% symptom improvement after 8 weeks were offered combined treatment. Outcome measures were the Hamilton Depression Rating Scale (HAM-D), the Clinical Global Impression of Severity and Improvement, the SCL-90 depression subscale and the EuroQOL questionnaire. Despite being nonresponsive, about 40% of patients preferred to continue with monotherapy. At treatment termination, patients initially randomized to PDT had improved more than those initially receiving antidepressants, as indicated by the HAM-D and the EuroQOL, independently of whether the addition was accepted or not. Starting with psychotherapy may be preferable in mildly and moderately depressed outpatients. For patients who receive either PDT or antidepressants, combined therapy after early nonresponse seems to be helpful. Nevertheless, this sequential strategy is not always preferred by patients.",23295630,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.461896896362305,-0.4834398925304413,CjoC
"Meditation for treating adults with bipolar disorder II: A multi-city study.

There is a need to generate evidence on whether meditation's core aspect of building and nurturing calm and peace serves as a mood stabilizer for current and recurrent episodes of depression through the acute and maintenance phases of treating bipolar disorder II affected patients. A 2-year longitudinal multi-city randomized controlled trial experiment was conducted comprising 311 bipolar disorder II affected patients in the intervention and control group respectively across eight African and Asian cities. The Bipolar Depression Rating Scale (BDRS) was administered with the intervention and control groups that were equal at baseline. Meditation had a positive impact on the intervention group. Post intervention BDRS scores were significantly lower for patients from Asian cities, men, Hindus and Buddhists, middle class, and married patients as well as those who attended all the meditation rounds and regularly self-practiced. Within the BDRS outcome measure, depressive symptoms were impacted the most as compared with mixed symptoms. Meditation helped alleviate guilt, depressed mood, and helplessness-hopelessness. The meditation programme can be used as a combination therapy along with pharmacological treatment to treat mood instability and depression among patients with bipolar disorder II.",30536496,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.289241790771484,0.09674341231584549,BB/D
"Using complementary and alternative medicines for depression.

The use of complementary and alternative medicines (CAM) has increased among patients with psychiatric disorders over recent decades. Therefore, clinicians must inquire and be knowledgeable about the use of CAM therapies, not only to give their patients accurate and up-to-date information but also to know when to appropriately prescribe CAM therapies to patients. Of the available CAMs, omega-3 fatty acids, folate, SAM-e, and St John's wort are reviewed.",20923617,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,7.3630290031433105,0.04685165733098984,DE6e
"[Depression and music therapy: the receptive composite montage with a projective focus].

Depression is a frequent mood disorder that requires a consensual therapeutic arsenal combining psychotropic drugs and psychotherapies. When depression requires hospitalization, particularly in the context of a major depressive disorder, having an integrative tool that induces a state of relaxation, positive mood and anticipation within twenty minutes is useful for patients and care teams. The Receptive Projective Composite Montage is a standardized music therapy device with evaluated effectiveness that can fulfill this role.",34238497,Major Depressive Disorder,Anxiety Treatment,Mental Health,4698,10.171432495117188,1.4396179914474487,ATgv
"Complementary and alternative medicine for the treatment of major depressive disorder.

To review the clinical evidence supporting complementary and alternative medicine interventions for treating major depressive disorder. PubMed was searched from January 1966 to February 2010 using the term depressive disorder in combination with St John's wort, S-adenosylmethionine (SAM-e), exercise, acupuncture, omega-3 fatty acids, and folate. Only relevant human trials were selected. In a large meta-analysis, St John's wort was found to be equivalent to antidepressant drugs with fewer side effects. Exercise reduced depressive scores in 3 meta-analyses. Omega-3 fatty acids reduced depressive scores in a meta-analysis of 16 trials, but publication bias was identified. Oral SAM-e monotherapy reduced depressive scores in 4 of 5 small randomized controlled trials. Folate deficiency is associated with more severe and refractory depression, and supplementation reduced depressive scores in 2 of 3 randomized controlled trials. Acupuncture demonstrated limited efficacy in 1 meta-analysis and 5 other trials. St John's wort and regular exercise appear effective in the treatment of depression. Acupuncture appears ineffective for depression, but it might offer other health benefits. Other promising therapies include SAM-e, omega-3 fatty acid, and folic acid supplementation in selected patients; further study is warranted.",21673208,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,7.4735212326049805,0.31671303510665894,C7Dt
"Sequential Combination of Cognitive-Behavioral Treatment and Well-Being Therapy in Depressed Patients with Acute Coronary Syndromes: A Randomized Controlled Trial (TREATED-ACS Study).

Randomized controlled trials (RCT) of psychotherapeutic interventions have addressed depression and demoralization associated with acute coronary syndromes (ACS). The present trial introduces psychological well-being, an increasingly recognized factor in cardiovascular health, as a therapeutic target. This study was designed to determine whether the sequential combination of cognitive-behavioral therapy (CBT) and well-being therapy (WBT) may yield more favorable outcomes than an active control group (clinical management; CM) and to identify subgroups of patients at greater risk for cardiac negative outcomes. This multicenter RCT comparedCBT/WBT sequential combination versus CM, with up to 30 months of follow-up. One hundred consecutive depressed and/or demoralized patients (out of 740 initially screened by cardiologists after a first episode of ACS) were randomized to CBT/WBT associated with lifestyle suggestions (n = 50) and CM (n = 50). The main outcome measures included: severity of depressive symptoms according to the Clinical Interview for Depression, changes in subclinical psychological distress, well-being, and biomarkers, and medical complications and events. CBT/WBT sequential combination was associated with a significant improvement in depressive symptoms compared to CM. In both groups, the benefits persisted at follow-up, even though the differences faded. Treatment was also related to a significant amelioration of biomarkers (platelet count, HDL, and D-dimer), whereas the 2 groups showed similar frequencies of adverse cardiac events. Addressing psychological well-being in the psychotherapeutic approach to ACS patients with depressive symptoms was found to entail important clinical benefits. It is argued that lifestyle changes geared toward cardiovascular health may be facilitated by a personalized approach that targets well-being.",32791501,Major Depressive Disorder,Anxiety Treatment,Mental Health,19464,6.958464622497559,-0.48257017135620117,AkPq
"Group-Based Relaxation Response Skills Training for Pharmacologically-Resistant Depressed and Anxious Patients.

Drug-resistance for depression and anxiety is a major limitation in the treatment of these common disorders, and adjunct support interventions may be beneficial in the treatment of these patients. The purpose of this study was to evaluate the effects of a short-term (8 session) Relaxation Response Skills Training (RRST) programme for a population of psychiatric outpatients with anxiety and mood disorders who were unresponsive to drug treatment, and to test the feasibility of this intervention as complementary treatment for a psychiatric setting. Forty patients were measured for overall psychopathological symptoms, depression, and anxiety, and were then given an 8-week course of RRST, while continuing their pharmacological treatment. Following the RRST intervention, participants were again assessed. The results demonstrated reductions in overall symptoms (large effect size and reasonable clinically significant change), and also in depression and anxiety (medium effect sizes and clinically significant change). These results suggest that this short-term RRT offers a simple and cost-effective way to augment drug management for participants with common psychiatric disorders who are less responsive to the drug treatment.",27669887,Major Depressive Disorder,Anxiety Treatment,Mental Health,23393,9.19143295288086,-0.5832988619804382,BmyF
"Enhancing the efficacy of integrative improvisational music therapy in the treatment of depression: study protocol for a randomised controlled trial.

Depression is among the leading causes of disability worldwide. Not all people with depression respond adequately to standard treatments. An innovative therapy that has shown promising results in controlled trials is music therapy. Based on a previous trial that suggested beneficial effects of integrative improvisational music therapy (IIMT) on short and medium-term depression symptoms as well as anxiety and functioning, this trial aims to determine potential mechanisms of and improvements in its effects by examining specific variations of IIMT. A 2×2 factorial randomised controlled trial will be carried out at a single centre in Finland involving 68 adults with a diagnosis of depression (F32 or F33 in International Statistical Classification of Diseases and Related Health Problems 10th revision). All participants will receive 6weeks of bi-weekly IIMT, where they are invited to improvise music and reflect on those improvisations with a music therapist in a one-to-one setting. Potential enhancements to IIMT will include: home-based listening to recorded improvisations (LH) from IIMT sessions to facilitate integration of therapeutic processing into daily life; and resonance frequency breathing (RFB), a breathing exercise at the beginning of each session to facilitate emotional expression and processing. Participants will be randomised in a 1:1:1:1 ratio into each combination (IIMT alone or with one or both enhancements). The primary outcome is depressive symptoms measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) at 6weeks. Secondary outcomes are depressive symptoms at 6months; anxiety, quality of life, and functioning at 6weeks and 6months; and adverse events. Secondary underlying mechanisms/process variables are self-rated momentary depression level before every IIMT session; and homework compliance in IIMT + LH. Statistical analyses involve an intention-to-treat approach, using a linear mixed-effects model examining the main effects (LH vs no LH; RFB vs no RFB) and interaction effects (LH × RFB). This trial will contribute to understanding the mechanisms of IIMT and may further enhance the effectiveness of an intervention that was previously shown to be superior to standard care alone for adults with depression. ISRCTN11618310 . Registered on 26 January 2018.",31036058,Major Depressive Disorder,Anxiety Treatment,Mental Health,12837,10.211007118225098,1.1798344850540161,A7Mg
"Hypnosis in the treatment of depression: considerations in research design and methods.

Depressive disorders constitute a serious problem in the United States and around the world. The appearance of practice guidelines and lists of evidenced-based therapies suggests that adequate treatments for depression exist. However, a careful consideration of what is known and not known about the treatment of depression leaves plenty of room for improved approaches to addressing this condition. Although there has been a dearth of research on the treatment of depression using hypnosis, there are several compelling arguments for the inclusion of hypnotic approaches in the array of current strategies for dealing with depression. However, traditional ""gold-standard"" research methods, namely randomized controlled trials, have many shortcomings for identifying the potential impact of hypnosis on depression. Other strategies, notably single-case design and benchmarking approaches, may offer a more practical solution to the problem of determining ""what works for depression.""",20390688,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.598954200744629,0.7883951663970947,DLvB
"Treatment of difficult-to-treat depression - clinical guideline for selected interventions.

Difficult-to-treat-depression (DTD) is a clinical challenge. The interventions that are well-established for DTD are not suitable or effective for all the patients. Therefore, more treatment options are highly warranted. We formulated an evidence-based guideline concerning six interventions not well-established for DTD in Denmark. Selected review questions were formulated according to the PICO principle with specific definitions of the patient population (P), the intervention (I), the comparison (C), and the outcomes of interest (O), and systematic literature searches were performed stepwise for each review question to identify relevant systematic reviews/meta-analyses, and randomized controlled trials. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the methodological quality of the included studies. Clinical recommendations were formulated based on the evidence, the risk-benefit ratio, and perceived patient preferences. We found sufficient evidence for a weak recommendation of repetitive transcranial magnetic stimulation (rTMS) and cognitive behavioural analysis system of psychotherapy (CBASP). The use of bright light therapy in DTD was not sufficiently supported by the evidence, but should be considered as good clinical practice. The interventions should be considered in addition to ongoing antidepressant treatment. We did not find sufficient evidence to recommend intravenous ketamine/esketamine, rumination-focused psychotherapy, or cognitive remediation to patients with DTD. The evidence supported two of the six reviewed interventions, however it was generally weak which emphasizes the need for more good quality studies. This guideline does not cover all treatment options and should be regarded as a supplement to relevant DTD-guidelines.",34455900,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.637404441833496,-0.39583539962768555,ARHY
"Complementary and alternative medicine in major depressive disorder: the American Psychiatric Association Task Force report.

To review selected complementary and alternative medicine (CAM) treatments for major depressive disorder (MDD). Authors of this report were invited participants in the American Psychiatric Association's Task Force on Complementary and Alternative Medicine. The group reviewed the literature on individual CAM treatments for MDD, methodological considerations, and future directions for CAM in psychiatry. Individual CAM treatments were reviewed with regard to efficacy in MDD, as well as risks and benefits. Literature searches included MEDLINE and PsycINFO reviews and manual reference searches; electronic searches were limited to English-language publications from 1965 to January 2010 (but manual searches were not restricted by language). Treatments were selected for this review on the basis of (1) published randomized controlled trials in MDD and (2) widespread use with important clinical safety or public health significance relevant to psychiatric practice. An action plan is presented based on needs pertaining to CAM and psychiatry. Consensus was reached by group conferences. Written iterations were drafted and sent out among group members prior to discussion, resolution of any differences of interpretation of evidence, and final approval. A review of randomized controlled trials for commonly used CAM treatments such as omega-3 fatty acids, St John's wort (Hypericum), folate, S-adenosyl-L-methionine (SAMe), acupuncture, light therapy, exercise, and mindfulness psychotherapies revealed promising results. More rigorous and larger studies are recommended. Each CAM treatment must be evaluated separately in adequately powered controlled trials. At this time, several CAM treatments appear promising and deserve further study. The greatest risk of pursuing a CAM therapy is the possible delay of other well-established treatments. Clinical, research, and educational initiatives designed to focus on CAM in psychiatry are clearly warranted due to the widespread use of CAM therapies.",20573326,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,7.340043067932129,-0.062801793217659,DI7l
"Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects.

The present meta-analysis aimed to examine to what extent combined pharmacotherapy with psychotherapy results in a different response to treatment compared to psychotherapy or pharmacotherapy alone in adults with major depression at six months or longer postrandomization. A systematic literature search resulted in 23 randomized controlled trials with 2184 participants. Combined treatment was compared to either psychotherapy or anti-depressant medication alone in both the acute phase and the maintenance phase. Odds ratios of a positive outcome were calculated for all comparisons. In acute phase treatment, combined psychotherapy with antidepressants outperformed antidepressants alone at six months or longer postrandomization in patients with major depressive disorder (OR=2.93, 95%CI 2.15-3.99, p<0.001). Heterogeneity was zero (95%CI 0-57%, p>0.05). However, combined therapy resulted in equal response to treatment compared to psychotherapy alone at six months or longer postrandomization. As for the maintenance treatment, combined maintenance psychotherapy with antidepressants resulted in better-sustained treatment response compared to antidepressants at six months or longer postrandomization (OR=1.61, 95%CI 1.14-2.27, p<0.05). Heterogeneity was zero (95%CI 0-68%, p>0.05). Combined therapy results in a superior enduring effect compared to antidepressants alone in patients with major depression. Psychotherapy is an adequate alternative for combined treatment in the acute phase as it is as effective as combined treatment in the long-term.",26826534,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,9.589881896972656,-0.5922355651855469,Bxx2
"Outcomes of Online Mindfulness-Based Cognitive Therapy for Patients With Residual Depressive Symptoms: A Randomized Clinical Trial.

Patients with residual depressive symptoms face a gap in care because few resources, to date, are available to manage the lingering effects of their illness. To evaluate the effectiveness for treating residual depressive symptoms with Mindful Mood Balance (MMB), a web-based application that delivers mindfulness-based cognitive therapy, plus usual depression care compared with usual depression care only. This randomized clinical trial was conducted in primary care and behavioral health clinics at Kaiser Permanente Colorado, Denver. Adults identified with residual depressive symptoms were recruited between March 2, 2015, and November 30, 2018. Outcomes were assessed for a 15-month period, comprising a 3-month intervention interval and a 12-month follow-up period. Patients were randomized to receive usual depression care (UDC; n=230) or MMB plus UDC (n=230), which included 8 sessions delivered online for a 3-month interval plus minimal phone or email coaching support. Primary outcomes were reduction in residual depressive symptom severity, assessed using the Patient Health Questionaire-9 (PHQ-9); rates of depressive relapse (PHQ-9 scores ≥15); and rates of remission (PHQ-9 scores <5). Secondary outcomes included depression-free days, anxiety symptoms (General Anxiety Disorder-7 Item Scale), and functional status (12-Item Short Form Survey). Among 460 randomized participants (mean [SD] age, 48.30 [14.89] years; 346 women [75.6%]), data were analyzed for the intent-to-treat sample, which included 362 participants (78.7%) at 3 months and 330 (71.7%) at 15 months. Participants who received MMB plus UDC had significantly greater reductions in residual depressive symptoms than did those receiving UDC only (mean [SE] PHQ-9 score, 0.95 [0.39], P<.02). A significantly greater proportion of patients achieved remission in the MMB plus UDC group compared with the UDC only group (PHQ-9 score, <5: β [SE], 0.38 [0.14], P=.008), and rates of depressive relapse were significantly lower in the MMB plus UDC group compared with the UDC only group (hazard ratio, 0.61; 95% CI, 0.39-0.95; P<.03). Compared with the UDC only group, the MMB plus UDC group had decreased depression-free days (mean [SD], 281.14 [164.99] days vs 247.54 [158.32] days; difference, -33.60 [154.14] days; t=-2.33; P=.02), decreased anxiety (mean [SE] General Anxiety Disorder-7 Item Scale score, 1.21 [0.42], P=.004), and improved mental functioning (mean [SE] 12-Item Short Form Survey score, -5.10 [1.37], P<.001), but there was no statistically significant difference in physical functioning. Use of MMB plus UDC resulted in significant improvement in depression and functional outcomes compared with UDC only. The MMB web-based treatment may offer a scalable approach for the management of residual depressive symptoms. ClinicalTrials.gov identifier: NCT02190968.",31995132,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.885261535644531,-0.577133297920227,AuN7
"Do psychological interventions reduce symptoms of depression for patients with bipolar I or II disorder? A meta-analysis.

Psychological therapies may play an important role in the treatment of bipolar disorders. Several meta-analyses that examine the effectiveness of psychotherapies for patients with bipolar disorder include conclusions about the impact upon bipolar depression. However, these tend not to consider differences in depression outcome depending upon whether the therapy primarily targets acute depression, nor severity of baseline depression. This may affect the conclusions drawn about the effectiveness of these therapies for acute bipolar depression treatment. This meta-analysis explored the effectiveness of psychological therapies in reducing bipolar depression, in particular examining whether: (1) the effect of therapy is greater when baseline depressive symptoms are more severe, and (2) the effect of therapy is greater when the primary focus of the therapy is the treatment of acute bipolar depression? A systematic search was conducted using the following electronic databases; Cochrane Controlled Register of Trials (1996), MEDLINE (1966 onwards), EMBASE (1980 onwards), PsycINFO (1974 onwards), Scopus, Web of Science and Clinical Trials Registries (listed at:https://www.hhs.gov/ohrp/international/clinical-trial-registries/index.html). Eligible studies were randomized controlled trials evaluating a psychological intervention for adults diagnosed with Bipolar I or II disorder. The comparators were usual care, wait-list, placebo, active treatment control. Post-treatment depression status was required to be measured continuously using a validated self- or observer- report measure, or categorically by a validated diagnostic instrument or clinical diagnosis by a suitably qualified person. Titles and abstracts were screened, followed by full texts. Two reviewers conducted each stage until agreement was reached, and both independently extracted study information. Means, standard deviations (SDs) and number of participants were retrieved from articles and used to perform a meta-analysis. The primary outcome was depressive symptom score. The database search identified 6388 studies. After removing the duplicates, 3298 studies remained, of which, 28 studies were included in the qualitative review and 22 in the meta-analysis. Effect sizes range from -1.99 [-2.50, -1.49] to 0.89 [-0.12, 1.90]. There was low quality evidence of a significant effect on symptoms of depression for cognitive behavioral therapy and dialectical behavior therapy. Trials of psychoeducation, mindfulness-based therapy, family therapy and interpersonal and social rhythm therapy showed no evidence of any effect on depression. We found no significant relationship between baseline depression score and depression outcome post-treatment when we controlled for therapy type and comparator. The result also showed that the effect sizes for studies targeting acute depression to be tightly clustered around a small overall effect size. Some psychological therapies may reduce acute bipolar depression although this conclusion should be viewed with caution given the low quality of evidence. More research using similar therapy types and comparators is needed to better understand the relationship between depression status at baseline and outcome.",35007645,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,11.779343605041504,-0.21019399166107178,tpg
"Early cognitive behavioral therapy for depression after cardiac surgery.

Despite high rates of postcardiac surgery depression, studies of depression treatment in this population have been limited. The aim of this study was to evaluate early cognitive behavioral therapy (CBT) in a home environment in patients recovering from cardiac surgery. : From July 2006 through October 2009, we conducted a randomized controlled trial and enrolled 808 patients who were screened for depressive symptoms using the Beck Depression Inventory (BDI) in the hospital and 1 month later. Patients were interviewed using the Structured Clinical Interview for DSM-IV; those who met criteria for clinical depression (n = 81) were randomized to CBT (n = 45) or usual care (UC; n = 36). After completion of the UC period, 25 individuals were offered later CBT (UC + CBT). Main outcomes (depressive symptoms [BDI] and clinical depression [Structured Clinical Interview for DSM-IV]) were evaluated after 8 weeks using intention-to-treat principles and linear mixed models. Compared with the UC group, in the CBT group, there was greater decline in BDI scores (β = 1.41; 95% confidence interval [CI], 0.81-2.02; P = < .001) and greater remission of clinical depression (29 [64%] vs 9 [25%]; number need to treat, 2.5; 95% CI, 1.7-4.9; P < .001). Compared with the early CBT group (median time from surgery to CBT, 45.5 days) the later UC + CBT group (median time from surgery to CBT, 122 days) also experienced a reduction in BDI scores, but the group × time effect was smaller (β = 0.79; 95% CI, 0.10-1.47; P = .03) and remission rates between the 2 groups did not differ. Early home CBT is effective in depressed postcardiac surgery patients. Early treatment is associated with greater symptom reduction than similar therapy given later after surgery.",22635060,Major Depressive Disorder,Anxiety Treatment,Mental Health,7940,6.922169208526611,0.12619587779045105,CtAP
"Frequency of use and perceived helpfulness of wellness strategies for bipolar and unipolar depression.

The majority of research in mood disorders has focused on pharmacologic, psychotherapeutic, and brain stimulation interventions. Conversely, the utility of less structured interventions, such as lifestyle modifications or wellness strategies, has remained understudied. The objective of the current study is to evaluate the frequency of use and perceived helpfulness of wellness strategies for bipolar and unipolar depression. The Depression and Bipolar Support Alliance (DBSA) conducted an online survey asking participants about the use and helpfulness of wellness strategies. In total, 896 participants completed the survey (unipolar depression [n = 447] and bipolar depression [n = 449]). Wellness strategies were used by 62% and 59% of individuals with bipolar and unipolar depression, respectively. Listening to music, socializing, and adequate sleep were commonly reported wellness strategies. The majority of participants reported wellness strategies to be helpful. Use of wellness strategies was associated with greater overall perceived treatment effectiveness (P < .0001) and greater subjective helpfulness of medications (P = .039), psychotherapy (P < .0001), and peer support groups (P < .0001). Wellness strategies were commonly used by the majority of respondents. These strategies were subjectively helpful for most respondents and were associated with greater overall treatment effectiveness and increased helpfulness of medications, psychotherapy, and peer support groups. As such, wellness strategies should be considered while developing a holistic treatment plan for depression. Further research is needed to evaluate the antidepressant effects of specific wellness strategies to better understand the role of these interventions in the management of depression.",30372507,Major Depressive Disorder,Anxiety Treatment,Mental Health,831,10.916068077087402,-0.2814474105834961,BEFh
"[A phenomenological approach of treatment-resistant depressions].

Hospital practitioners are regularly facing treatment-resistant depression, which may be defined according to the clinical picture or according to the therapeutic strategy. There are different levels of resistance and different levels of evidence for this resistance. Indeed, the notions of relative and absolute resistance describe the adequacy of assigned treatment. It thus seems necessary to specify the psychopathology of treatment-resistant depression and to highlight the endogeneity phenomenon in order to solve this problem. Our work addresses the concept of endogeneity (previously clarified by Hubertus Tellenbach) and will consider its implications in the management of treatment-resistant depression. We attempt to demonstrate that the phenomenological approach is an interesting tool in clinical practice through the highlight of endogenous characteristics. The first step consists in specifying the endogenous phenomena: abolition of rhythms, loss of the forward-looking deployment, overall impression, and reversibility, spatial and temporal characteristics from the phenotype. Our phenomenological approach continues by exploring the false resistances. Hence, we take into account anxious comorbidity, medical comorbidity, addictions, personality disorders and the hypothesis of a bipolar diathesis. First of all, it is difficult to show the patient in which way their behaviour results in stagnation. Indeed, it could strengthen the internal move that leads to an imperious necessity to cope with the surroundings. The psychotherapeutic help is elaborated by specifically highlighting the pathogenic situations whilst also taking into account the difficulties of an authentic therapeutic alliance. Our approach emphasizes the endogeneity phenomenon in depression, permitting the search for an optimal therapeutic strategy. It also provides assistance in resolving false resistance or what is apparent. In cases of endogenous depression, therapeutic orientation favours pharmacological and instrumental strategies (brain stimulation). If elements of self-understanding can be given to the patient, they must show that the rigid way in which the patient appropriates the daily reports is more stressful than the choice. Therefore, the psychotherapeutic help must take into account the situation and the individual vulnerability so as to develop a suitable care.",24079991,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.08347225189209,-0.436783105134964,CYEq
"Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: a systematic review.

Depressed and anxious patients often combine complementary and alternative medicine (CAM) therapies with conventional pharmacotherapy to self-treat symptoms. The benefits and risks of such combination strategies have not been fully evaluated. This paper evaluates the risk-benefit profile of CAM augmentation to antidepressants in affective conditions. PubMed was searched for all available clinical reports published in English up to December 2012. Data were evaluated based on graded levels of evidence for efficacy and safety. Generally, the evidence base is significantly larger for depression than for anxiety disorder. In unipolar depression, there is Level 2 evidence for adjunctive sleep deprivation (SD) and Free and Easy Wanderer Plus (FEWP), and Level 3 for exercise, yoga, light therapy (LT), omega-3 fatty acids, S-adenosylmethionine and tryptophan. In bipolar depression, there is Level 1 evidence for adjunctive omega-3s, Level 2 for SD, and Level 3 for LT and FEWP. In anxiety conditions, exercise augmentation has Level 3 support in generalized anxiety disorder and panic disorder. Though mostly well-tolerated, these therapies can only be recommended as third-line interventions due to the quality of available evidence. Overall, the literature is limited. Studies often had methodological weaknesses, with little information on long-term use and on potential drug-CAM interactions. Many CAM studies were not published in English. While several CAM therapies show some evidence of benefit as augmentation in depressive disorders, such evidence is largely lacking in anxiety disorders. The general dearth of adequate safety and tolerability data encourages caution in clinical use.",23769610,Major Depressive Disorder,Anxiety Treatment,Mental Health,4064,7.124422073364258,0.17599038779735565,Ccpe
"Evidence-based hypnotherapy for depression.

Cognitive hypnotherapy (CH) is a comprehensive evidence-based hypnotherapy for clinical depression. This article describes the major components of CH, which integrate hypnosis with cognitive-behavior therapy as the latter provides an effective host theory for the assimilation of empirically supported treatment techniques derived from various theoretical models of psychotherapy and psychopathology. CH meets criteria for an assimilative model of psychotherapy, which is considered to be an efficacious model of psychotherapy integration. The major components of CH for depression are described in sufficient detail to allow replication, verification, and validation of the techniques delineated. CH for depression provides a template that clinicians and investigators can utilize to study the additive effects of hypnosis in the management of other psychological or medical disorders. Evidence-based hypnotherapy and research are encouraged; such a movement is necessary if clinical hypnosis is to integrate into mainstream psychotherapy.",20390689,Major Depressive Disorder,Anxiety Treatment,Mental Health,13735,9.690892219543457,0.5355029106140137,DLvA
"The clinical effectiveness of using a predictive algorithm to guide antidepressant treatment in primary care (PReDicT): an open-label, randomised controlled trial.

Depressed patients often do not respond to the first antidepressant prescribed, resulting in sequential trials of different medications. Personalised medicine offers a means of reducing this delay; however, the clinical effectiveness of personalised approaches to antidepressant treatment has not previously been tested. We assessed the clinical effectiveness of using a predictive algorithm, based on behavioural tests of affective cognition and subjective symptoms, to guide antidepressant treatment. We conducted a multicentre, open-label, randomised controlled trial in 913 medication-free depressed patients. Patients were randomly assigned to have their antidepressant treatment guided by a predictive algorithm or treatment as usual (TaU). The primary outcome was the response of depression symptoms, defined as a 50% or greater reduction in baseline score of the QIDS-SR-16 scale, at week 8. Additional prespecified outcomes included symptoms of anxiety at week 8, and symptoms of depression and functional outcome at weeks 8, 24 and 48. The response rate of depressive symptoms at week 8 in the PReDicT (55.9%) and TaU (51.8%) arms did not differ significantly (odds ratio: 1.18 (95% CI: 0.89-1.56), P=0.25). However, there was a significantly greater reduction of anxiety in week 8 and a greater improvement in functional outcome at week 24 in the PReDicT arm. Use of the PReDicT test did not increase the rate of response to antidepressant treatment estimated by depressive symptoms but did improve symptoms of anxiety at week 8 and functional outcome at week 24. Our findings indicate that personalisation of antidepressant treatment may improve outcomes in depressed patients.",33637837,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,10.427103996276855,-0.5301053524017334,AaMp
"Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials.

Relapse prevention in recurrent depression is a significant public health problem, and antidepressants are the current first-line treatment approach. Identifying an equally efficacious nonpharmacological intervention would be an important development. To conduct a meta-analysis on individual patient data to examine the efficacy of mindfulness-based cognitive therapy (MBCT) compared with usual care and other active treatments, including antidepressants, in treating those with recurrent depression. English-language studies published or accepted for publication in peer-reviewed journals identified from EMBASE, PubMed/Medline, PsycINFO, Web of Science, Scopus, and the Cochrane Controlled Trials Register from the first available year to November 22, 2014. Searches were conducted from November 2010 to November 2014. Randomized trials of manualized MBCT for relapse prevention in recurrent depression in full or partial remission that compared MBCT with at least 1 non-MBCT treatment, including usual care. This was an update to a previous meta-analysis. We screened 2555 new records after removing duplicates. Abstracts were screened for full-text extraction (S.S.) and checked by another researcher (T.D.). There were no disagreements. Of the original 2555 studies, 766 were evaluated against full study inclusion criteria, and we acquired full text for 8. Of these, 4 studies were excluded, and the remaining 4 were combined with the 6 studies identified from the previous meta-analysis, yielding 10 studies for qualitative synthesis. Full patient data were not available for 1 of these studies, resulting in 9 studies with individual patient data, which were included in the quantitative synthesis. Of the 1258 patients included, the mean (SD) age was 47.1 (11.9) years, and 944 (75.0%) were female. A 2-stage random effects approach showed that patients receiving MBCT had a reduced risk of depressive relapse within a 60-week follow-up period compared with those who did not receive MBCT (hazard ratio, 0.69; 95% CI, 0.58-0.82). Furthermore, comparisons with active treatments suggest a reduced risk of depressive relapse within a 60-week follow-up period (hazard ratio, 0.79; 95% CI, 0.64-0.97). Using a 1-stage approach, sociodemographic (ie, age, sex, education, and relationship status) and psychiatric (ie, age at onset and number of previous episodes of depression) variables showed no statistically significant interaction with MBCT treatment. However, there was some evidence to suggest that a greater severity of depressive symptoms prior to treatment was associated with a larger effect of MBCT compared with other treatments. Mindfulness-based cognitive therapy appears efficacious as a treatment for relapse prevention for those with recurrent depression, particularly those with more pronounced residual symptoms. Recommendations are made concerning how future trials can address remaining uncertainties and improve the rigor of the field.",27119968,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.789460182189941,-0.5061590671539307,Btnk
"Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition.

We evaluated the comparative effectiveness of mindfulness-based cognitive therapy (MBCT) versus an active control condition (ACC) for depression relapse prevention, depressive symptom reduction, and improvement in life satisfaction. Ninety-two participants in remission from major depressive disorder with residual depressive symptoms were randomized to either an 8-week MBCT or a validated ACC that is structurally equivalent to MBCT and controls for nonspecific effects (e.g., interaction with a facilitator, perceived social support, treatment outcome expectations). Both interventions were delivered according to their published manuals. Intention-to-treat analyses indicated no differences between MBCT and ACC in depression relapse rates or time to relapse over a 60-week follow-up. Both groups experienced significant and equal reductions in depressive symptoms and improvements in life satisfaction. A significant quadratic interaction (Group × Time) indicated that the pattern of depressive symptom reduction differed between groups. The ACC experienced immediate symptom reduction postintervention and then a gradual increase over the 60-week follow-up. The MBCT group experienced a gradual linear symptom reduction. The pattern for life satisfaction was identical but only marginally significant. MBCT did not differ from an ACC on rates of depression relapse, symptom reduction, or life satisfaction, suggesting that MBCT is no more effective for preventing depression relapse and reducing depressive symptoms than the active components of the ACC. Differences in trajectory of depressive symptom improvement suggest that the intervention-specific skills acquired may be associated with differential rates of therapeutic benefit. This study demonstrates the importance of comparing psychotherapeutic interventions to active control conditions.",26371618,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.857831001281738,-0.3828762471675873,B4EM
"Improving the Effectiveness of Psychological Interventions for Depression and Anxiety in Cardiac Rehabilitation: PATHWAY-A Single-Blind, Parallel, Randomized, Controlled Trial of Group Metacognitive Therapy.

Depression and anxiety in cardiovascular disease are significant, contributing to poor prognosis. Unfortunately, current psychological treatments offer mixed, usually small improvements in these symptoms. The present trial tested for the first time the effects of group metacognitive therapy (MCT; 6 sessions) on anxiety and depressive symptoms when delivered alongside cardiac rehabilitation (CR). A total of 332 CR patients recruited from 5 National Health Service Trusts across the North-West of England were randomly allocated to MCT+CR (n=163, 49.1%) or usual CR alone (n=169, 50.9%). Randomization was 1:1 via minimization balancing arms on sex and Hospital Anxiety and Depression Scale scores within hospital site. The primary outcome was Hospital Anxiety and Depression Scale total after treatment (4-month follow-up). Secondary outcomes were individual Hospital Anxiety and Depression Scales, traumatic stress symptoms, and psychological mechanisms including metacognitive beliefs and repetitive negative thinking. Analysis was intention to treat. The adjusted group difference on the primary outcome, Hospital Anxiety and Depression Scale total score at 4 months, significantly favored the MCT+CR arm (-3.24 [95% CI, -4.67 to -1.81], P<0.001; standardized effect size, 0.52 [95% CI, 0.291 to 0.750]). The significant difference was maintained at 12 months (-2.19 [95% CI, -3.72 to -0.66], P=0.005; standardized effect size, 0.33 [95% CI, 0.101 to 0.568]). The intervention improved outcomes significantly for both depression and anxiety symptoms when assessed separately compared with usual care. Sensitivity analysis using multiple imputation of missing values supported these findings. Most secondary outcomes favored MCT+CR, with medium to high effect sizes for psychological mechanisms of metacognitive beliefs and repetitive negative thinking. No adverse treatment-related events were reported. Group MCT+CR significantly improved depression and anxiety compared with usual care and led to greater reductions in unhelpful metacognitions and repetitive negative thinking. Most gains remained significant at 12 months. Study strengths include a large sample, a theory-based intervention, use of longer-term follow-up, broad inclusion criteria, and involvement of a trials unit. Limitations include no control for additional contact as part of MCT to estimate nonspecific effects, and the trial was not intended to assess cardiac outcomes. Nonetheless, results demonstrated that addition of the MCT intervention had broad and significant beneficial effects on mental health symptoms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: ISRCTN74643496.",34148379,Major Depressive Disorder,Anxiety Treatment,Mental Health,10337,7.199352264404297,-0.2911572754383087,AUew
"Clinical effectiveness, construct and assessment.

In an era of contention about the efficacy of antidepressants, the concept of clinical effectiveness has surfaced as a basic tenet of real-world practice. The concept of clinical effectiveness can lead to important insights into the treatment of depression and, by acting as an organizing concept for research, can help studies better focus on obtaining information necessary to improve clinical practice. The limitations and strengths of efficacy and effectiveness studies in psychiatry are explored, and recent effectiveness studies in psychiatry are discussed, and their implications for re-examining treatment goals and remission. Efficacy studies are invaluable for the development of new drugs, but often lack generalizability. In contrast, effectiveness studies are broader in scope and offer the potential to assess quality of life and functional change. Studies that explore the clinical effectiveness of treatments for depression can identify important treatment gaps and suggest ways to address them. Although the efficacy of an antidepressant is important, other factors such as patient adherence, safety and tolerability, and the alignment of treatment outcomes with dimensions likely to be critical to patients (quality of life and functioning) also need to be examined. Antidepressant treatment, both in clinical practice and in research, should involve clinical considerations that go beyond efficacy data. Broader issues of tolerability, safety, residual symptoms, functioning, and quality of life must also be addressed. Accomplishing this objective may involve the development of new global effectiveness measures; better outcome measures; and a broader, more patient-centered orientation towards clinical care.",21561665,Major Depressive Disorder,Anxiety Treatment,Mental Health,7794,7.985081195831299,0.8544350266456604,C8YS
"Group interpersonal and social rhythm therapy for bipolar depression.

To evaluate the feasibility of 2-week interpersonal and social rhythm therapy group (IPSRT-G) for bipolar depression. Participants with bipolar depression received two individual sessions, six IPSRT-G sessions, and a 12-week telephone call. The Inventory of Depressive Symptomatology-Clinician Rated (IDS-C), Young Mania Rating Scale (YMRS), Sheehan Disability Scale (SDS), and Clinical Global Impressions-Bipolar Version (CGI-BP) were used. IDS-C and SDS scores improved significantly at 12 weeks. YMRS and CGI-BP scores improved but did not reach statistical significance. The promising antidepressive response supports further study of IPSRT-G for bipolar depression.",25187443,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,11.744524002075195,-0.5403351783752441,CI31
"Effectiveness of mindfulness-based cognitive therapy among depressed individuals with disabilities in Nigeria: A randomized controlled trial.

The objective of this paper was to examine the efficacy of mindfulness-based cognitive therapy (MBCT) in decreasing depressive symptoms and intellectual disabilities (ID) among individuals with depression in Nigeria. In this randomized controlled trial, 101 participants with depression and ID, aged 18-60 years, who obtained 14 scores in the Beck Depression Inventory (BDI-II), scores 4 and above on Shaheen Disability Scale (SDS), were randomly assigned into the interventions (n =50) and active control group (n = 51). The MBCT group has shown a statistically significant effect on the SDS and BDI-II variables by decreasing depressive symptoms and disabilities following MBCT (p<0.05). The assessment revealed that participants reported an improvement in their experience of depression and ID. The most significant impact was in the reduced levels of ID reported. The results of the evaluation suggest that depressed people with intellectual disabilities benefit from a structured MBCT group intervention and the results are maintained at 2-months follow-up.",33421840,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.501984596252441,-0.3704945147037506,Acu9
"Relative effectiveness of augmentation treatments for treatment-resistant depression: a systematic review and network meta-analysis.

Most interventions for treatment-resistant depression (TRD) are added as augmenters. We aimed to determine the relative effectiveness of augmentation treatments for TRD. This systematic review and network meta-analysis (NMA) sought all randomized trials of pharmacological and psychological augmentation interventions for adults meeting the most common clinical criteria for TRD. The NMA compared the intervention effectiveness of depressive symptoms for TRD augmentation. Of 36 included trials, 27 were suitable for inclusion in NMA, and no psychological trials could be included in the absence of a common comparator. Antipsychotics (13 trials), mood stabilizers (three trials), NMDA-targeting medications (five trials), and other mechanisms (3 trials) were compared against placebo. NMDA treatments were markedly superior to placebo (ES=0.91, 95% CI 0.67 to 1.16) and head-to-head NMA suggested that NMDA therapies had the highest chance of being an effective treatment option compared to other pharmacological classes. This study provides the most comprehensive evidence of augmenters' effectiveness for TRD, and our GRADE recommendations can be used to guide guidelines to optimize treatment choices. Although conclusions are limited by paucity of, and heterogeneity between, trials as well as inconsistent reports of treatment safety. This work supports the use of NMDA-targeting medications such as ketamine.",32498577,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.577489852905273,-0.3556557595729828,An7I
"The use of biofeedback intervention in the improvement of depression levels: a randomised trial.

To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group. A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher's exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2. The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group. The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.",33427129,Major Depressive Disorder,Anxiety Treatment,Mental Health,12837,10.969563484191895,1.3594942092895508,Acrf
"Semantic organizational strategy predicts verbal memory and remission rate of geriatric depression.

This study tests the hypothesis that the use of semantic organizational strategy during the free-recall phase of a verbal memory task predicts remission of geriatric depression. Sixty-five older patients with major depression participated in a 12-week escitalopram treatment trial. Neuropsychological performance was assessed at baseline after a 2-week drug washout period. The Hopkins Verbal Learning Test-Revised was used to assess verbal learning and memory. Remission was defined as a Hamilton Depression Rating Scale score of ≤ 7 for 2 consecutive weeks and no longer meeting the DSM-IV-TR criteria for major depression. The association between the number of clusters used at the final learning trial (trial 3) and remission was examined using Cox's proportional hazards survival analysis. The relationship between the number of clusters utilized in the final learning trial and the number of words recalled after a 25-min delay was examined in a regression with age and education as covariates. Higher number of clusters utilized predicted remission rates (hazard ratio, 1.26 (95% confidence interval, 1.04-1.54); χ(2) =4.23, df=3, p=0.04). There was a positive relationship between the total number of clusters used by the end of the third learning trial and the total number of words recalled at the delayed recall trial (F(3,58)=7.93; p<0.001). Effective semantic strategy use at baseline on a verbal list learning task by older depressed patients was associated with higher rates of remission with antidepressant treatment. This result provides support for previous findings indicating that measures of executive functioning at baseline are useful in predicting antidepressant response.",21618287,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.281291007995605,1.2712849378585815,C7vW
"Cognitive hypnotherapy for psychological management of depression in palliative care.

The prevalence of psychiatric disorders in palliative care is well documented, yet they often remain undetected and untreated, adding further to the burden of suffering on patients who are already facing severe physical and psychosocial problems. This article will focus on depression as it represents one of the most common psychiatric disorders treated by psychiatrists and psychotherapists in palliative care. Although depression in palliative care can be treated successfully with antidepressant medication and psychotherapy, a significant number of depressives do not respond to either medication or existing psychotherapies. This is not surprising considering depression is a complex disorder. Moreover, the presentation of depression in palliative care is compounded by the severity of the underlying medical conditions. It is thus important for clinicians to continue to develop more effective treatments for depression in palliative care. This article describes cognitive hypnotherapy (CH), an evidence-based multimodal treatment for depression which can be applied to a wide range of depressed patients in palliative care. CH, however, does not represent a finished product; it is a work in progress to be empirically validated and refined by advances in cancer and clinical depression.",29307205,Major Depressive Disorder,Anxiety Treatment,Mental Health,13735,8.9552640914917,0.8168152570724487,BR1p
"The effects of rational emotive behavior therapy for depressive symptoms in adults with congenital heart disease.

Over 30% of adults with congenital heart disease (CHD) experience depression. To evaluate the effectiveness of Rational Emotive Behavior Therapy (REBT) in reducing depressive symptoms in adults with CHD. Forty-two adults with CHD were recruited from an outpatient clinic and randomized to a study group (n = 21), which comprised 8-weekly group-based counseling sessions, or a control group (n = 21), which received usual care. REBT effectiveness was examined using the Hamilton Depression Rating Scale, Beck Depression Inventory, Shorten General Attitude and Belief Scale, and salivary cortisol levels before therapy, after the last session, and at follow-up 4 weeks later. Average participant ages were 30.1 ± 7.58 and 33.3 ± 7.1 years in study and control groups, respectively; 52.4% of participants in each group were female. After REBT, depression (p < 0.001), irrational beliefs (p < 0.001), and salivary cortisol levels (p = 0.006) were significantly lower in the study group than in the control group. Effects of REBT in the study group remained consistent at the 4-week follow-up. REBT may be effective in reducing depression in adults with CHD.",34411872,Major Depressive Disorder,Anxiety Treatment,Mental Health,24560,8.96748161315918,0.6098890900611877,ARjU
"Complementary therapies for clinical depression: an overview of systematic reviews.

As clinical practice guidelines vary widely in their search strategies and recommendations of complementary and alternative medicine (CAM) for depression, this overview aimed at systematically summarising the level 1 evidence on CAM for patients with a clinical diagnosis of depression. PubMed, PsycInfo and Central were searched for meta-analyses of randomised controlled clinical trials (RCTs) until 30 June 2018. Outcomes included depression severity, response, remission, relapse and adverse events. The quality of evidence was assessed according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) considering the methodological quality of the RCTs and meta-analyses, inconsistency, indirectness, imprecision of the evidence and the potential risk of publication bias. The literature search revealed 26 meta-analyses conducted between 2002 and 2018 on 1-49 RCTs in major, minor and seasonal depression. In patients with mild to moderate major depression, moderate quality evidence suggested the efficacy of St. John's wort towards placebo and its comparative effectiveness towards standard antidepressants for the treatment for depression severity and response rates, while St. John's wort caused significant less adverse events. In patients with recurrent major depression, moderate quality evidence showed that mindfulness-based cognitive therapy was superior to standard antidepressant drug treatment for the prevention of depression relapse. Other CAM evidence was considered as having low or very low quality. The effects of all but two CAM treatments found in studies on clinical depressed patients based on low to very low quality of evidence. The evidence has to be downgraded mostly due to avoidable methodological flaws of both the original RCTs and meta-analyses not following the Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Further research is needed.",31383703,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,7.8512163162231445,-0.5007448792457581,A2dT
"Feasibility and acceptability of a Whole-Body hyperthermia (WBH) protocol.

Whole-body hyperthermia (WBH) has shown promise as a non-pharmacologic treatment for major depressive disorder (MDD) in prior trials that used a medical (infrared) hyperthermia device. Further evaluation of WBH as a treatment for MDD has, however, been stymied by regulatory challenges. We examined whether a commercially available infrared sauna device without FDA-imposed limitations could produce the degree of core body temperature (101.3°F) associated with reduced depressive symptoms in prior WBH studies. We also assessed the frequency of adverse events and the amount of time needed to achieve this core body temperature. We explored changes (pre-post WBH) in self-reported mood and affect. Twenty-five healthy adults completed a single WBH session lasting up to 110min in a commercially available sauna dome (Curve Sauna Dome). We assessed core body temperature rectally during WBH, and mood and affect at timepoints before and after WBH. All participants achieved the target core body temperature (101.3°F). On average, it took participants 82.12min (SD=11.3) to achieve this temperature (range: 61-110min), and WBH ended after a participant maintained 101.3°F for two consecutive minutes. In exploratory analyses of changes in mood and affect, we found that participants evidenced reductions (t[24]=2.03, M diff = 1.00, p=.054, 95% CI [-2.02,0.02]) in self-reported depression symptoms from 1week pre- to 1week post-WBH, and reductions (t[24]= -2.93, M diff=-1.72, p=.007, 95% CI [-2.93, -0.51]) in self-reported negative affect pre-post-WBH session. This novel WBH protocol holds promise in further assessing the utility of WBH in MDD treatment. This trial was registered at clinicaltrivals.gov (NCT04249700).",34674592,Major Depressive Disorder,Anxiety Treatment,Mental Health,22509,8.944343566894531,0.2393229752779007,7OI
"Using mechanism of action to choose medications for treatment-resistant depression.

Remission rates for depression continue to be low, and for many patients, complex treatment regimens are needed for optimal response. Many physicians do not fully understand how and why depression medications work or which ones will complement each other. This CME Webcast covers the different mechanisms of action of current pharmacotherapeutic options for depression, both monotherapy and adjunctive medications, and shows clinicians how to use their understanding of mechanisms of action to choose the most effective treatment strategy for their patients, especially those with treatment-resistant or difficult-to-treat depression.",26455685,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.352760314941406,-0.09589570015668869,B2wy
"A randomized controlled trial of cognitive control training (CCT) as an add-on treatment for late-life depression: a study protocol.

Already a major health concern, late-life depression (LLD) is expected to form an increasing problem in the aging population. Moreover, despite current treatments, LLD is associated with a poor long-term prognosis and high rate of chronicity. Treatment provision and treatment accordingly warrant improvement, where add-on treatments might contribute to the efficacy of conventional therapies. Although it is known that impaired cognitive control contributes to LDD, it is not targeted sufficiently by current interventions. Research on cognitive control training (CCT) shows promising results on depressive symptoms, cognitive performance, and overall functioning. However, further research is needed to determine the long-term effects of CCT on LLD, its cost-effectiveness, and mechanisms of change. In the current multicenter randomized controlled trial (RCT) with a between-subjects design participants aged 60years and over with a current LLD receiving treatment as usual (TAU) are randomized to add-on CCT or placebo training. Randomization is stratified by depression severity. Participants will receive eight online CCT or placebo sessions spread across four consecutive weeks. They will complete a post-training assessment after 1 month and three follow-up assessments scheduled three, six and 12months after completing the training. We expect CCT and TAU to be more (cost-)effective in reducing depressive symptoms than placebo training and TAU. Additionally, we will be looking at secondary clinical, cognitive and global functioning outcomes and likely mechanisms of change (e.g., improved cognitive functioning, reduced rumination, and improved inhibition of negative stimuli). The proposed RCT aims to contribute to the clinical and scientific knowledge on the long-term effects of CCT as an add-on treatment for LLD. Cost-effectiveness is particularly relevant considering the expected volume of the target demographic. The study will be a pragmatic trial with few inclusion restrictions, providing information on feasibility of web-based trainings in clinical settings. The outcomes are potentially generalizable to guidelines for treatment of LLD. This trial is registered in the Netherlands Trial Register (code: NL7639 ). Registered 3 april 2019.",34837976,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,11.86074447631836,-0.31724992394447327,0wQ
"Utilizing placebos to leverage the effects of cognitive-behavioral therapy in patients with depression: Rebuttal to commentary.

",33607510,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,7.656985759735107,1.5053446292877197,AakR
"[The algorithm for the biological treatment of depression in the Dutch multidisciplinary guideline on depression].

Although antidepressants are effective in the treatment of depression, nonresponse is unfortunately a recurring problem. Treatment algorithms can help the health care professional to make consecutive step-by-step choices between the different available treatment options. To update the biological algorithm in the Dutch multidisciplinary guideline on the treatment of depression. The literature was reviewed systematically. There are five steps in the algorithm: 1. Treatment starts with an SSRI, a TCA, an SNRI, mirtazapine or buproprion. 2. If there is no response after 4-10 weeks, administer another antidepressant. 3. Augment medication with lithium. 4. Administer a monoamine oxidase inhibitor. 5. Apply electroconvulsive therapy. The algorithm is certainly worth using, but its efficacy needs to be fully investigated.s.",21506078,Major Depressive Disorder,Anxiety Treatment,Mental Health,20490,9.613394737243652,-0.569238007068634,C9N6
"Cognitive hypnotherapy for major depressive disorder.

Since the publication of the special issue on cognitive hypnotherapy in the Journal of Cognitive Psychotherapy: An International Quarterly (1994), there have been major developments in the application of hypnosis to the treatment of depression. However, there is no ""one-size-fits-all"" treatment for depressive disorders as the conditions represent a complex set of heterogeneous symptoms, involving multiple etiologies. It is thus important for therapists to promote a multimodal approach to treating depressive disorders. This article describes cognitive hypnotherapy (CH), an evidence-based multimodal psychological treatment that can be applied to a wide range of depressed patients. CH combines hypnosis with cognitive behavior therapy as the latter provides the best integrative lodestone for assimilating empirically supported treatment techniques derived from various psychotherapies.",22655331,Major Depressive Disorder,Anxiety Treatment,Mental Health,13735,9.684508323669434,0.6742553114891052,Csxa
"Association between decentering and reductions in relapse/recurrence in mindfulness-based cognitive therapy for depression in adults: A randomized controlled trial.

Decentering is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind (Safran & Segal, 1990), and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The present study sought to examine the role of decentering, and other related variables, in the efficacy of Mindfulness-based cognitive therapy (MBCT) as compared to two active comparison conditions. Formerly depressed individuals (N = 227), randomly assigned to MBCT (n = 74), relaxation group therapy (RGT; n = 77) or Treatment as usual (TAU; n = 76), completed self-report measures of decentering and symptoms of depression at pre-, mid-, and posttreatment, and relapse was assessed at 3, 6, 9, and 12 months, posttreatment. With regard to the acute treatment phase, results indicated that, whereas levels of depression increased in both RGT and TAU, MBCT patients remained free from symptom gains. Moreover, gains in decentering from mid- to posttreatment predicted reductions in depression from pre- to posttreatment for MBCT and TAU, but not for RGT. Participants who experienced increases in decentering, measured from mid- to posttreatment, generally evidenced the lowest levels of relapse/recurrence (during the four follow-up assessments), largely irrespective of treatment group. However, results related to change in decentering should be considered exploratory due to small cell sizes among participants who did not experience gains in decentering. Taken together, these results suggest that decentering is a potent mechanism for reduction of relapse in major depression, albeit one that is nonspecific to MBCT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).",35343725,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.879281997680664,-0.41068148612976074,gYM
"Randomised controlled trial of Interpersonal and Social Rhythm Therapy and group-based Cognitive Remediation versus Interpersonal and Social Rhythm Therapy alone for mood disorders: study protocol.

Individuals with mood disorders frequently experience cognitive impairment, which impacts on the long-term trajectory of the disorders, including being associated with persisting difficulties in occupational and psychosocial functioning, residual mood symptoms, and relapse. Current first-line treatments for mood disorders do little to improve cognitive function. Targeting cognition in clinical research is thus considered a priority. This protocol outlines a prospectively-registered randomised controlled trial (RCT) which examines the impact of adding group-based Cognitive Remediation (CR) to Interpersonal and Social Rhythm Therapy (IPSRT-CR) for individuals with mood disorders. This is a pragmatic, two-arm, single-blinded RCT comparing IPSRT-CR with IPSRT alone for adults (n=100) with mood disorders (Major Depressive Disorder or Bipolar Disorder) with subjective cognitive difficulties, on discharge from Specialist Mental Health Services in Christchurch, New Zealand. Both treatment arms will receive a 12-month course of individual IPSRT (full dose=24 sessions). At 6 months, randomisation to receive, or not, an 8-week group-based CR programme (Action-based Cognitive Remediation - New Zealand) will occur. The primary outcome will be change in Global Cognition between 6 and 12 months (treatment-end) in IPSRT-CR versus IPSRT alone. Secondary outcomes will be change in cognitive, functional, and mood outcomes at 6, 12, 18, and 24 months from baseline and exploratory outcomes include change in quality of life, medication adherence, rumination, and inflammatory markers between treatment arms. Outcome analyses will use an intention-to-treat approach. Sub-group analyses will assess the impact of baseline features on CR treatment response. Participants' experiences of their mood disorder, including treatment, will be examined using qualitative analysis. This will be the first RCT to combine group-based CR with an evidence-based psychotherapy for adults with mood disorders. The trial may provide valuable information regarding how we can help promote long-term recovery from mood disorders. Many issues have been considered in developing this protocol, including: recruitment of the spectrum of mood disorders, screening for cognitive impairment, dose and timing of the CR intervention, choice of comparator treatment, and choice of outcome measures. Australian and New Zealand Clinical Trials Registry, ACTRN12619001080112 . Registered on 6 August 2019.",35164720,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,11.893885612487793,-0.6062061190605164,nUE
"Management of treatment-resistant depression.

Given the limitations of evidence for treatment options that are consistently effective for TRD and the possibility that TRD is in fact a form of depression that has a low probability of resolving, how can clinicians help patients with TRD? Perhaps the most important conceptual shift that needs to take place before treatment can be helpful is to accept TRD as a chronic illness, an illness similar to many others, one that can be effectively managed but that is not, at our present level of knowledge, likely to be cured. An undue focus on remission or even a 50% diminution of symptoms sets unrealistic goals for both patients and therapists and may lead to overtreatment and demoralization. The focus should be less on eliminating depressive symptoms and more on making sense of and learning to function better in spite of them. It is important to acknowledge the difficult nature of the depressive illness, to remove blame from the patient and clinician for not achieving remission, to set realistic expectations, and to help promote better psychosocial functioning even in the face of persisting symptoms. The critical element when implementing such an approach is a judicious balance between maintaining hope for improvement without setting unrealistic expectations. It is important to reemphasize that following a disease management model with acceptance of the reality of a chronic illness is not nihilistic and does not mean the abandonment of hope for improvement. The first step in treating a patient with TRD is to perform a comprehensive assessment of the patient’s past and current treatment history to ensure that evidence-based treatment trials have in fact been undertaken, and if not, such treatment trials should be implemented. If the patient continues to have significant residual symptoms, it is important to determine the impact is of these symptoms on the patient’s quality of life and ability to function. It is also important to evaluate the factors that may be contributing to the persistence of depressive symptoms such as comorbid personality disorders, somatic disorders, substance abuse, and work and interpersonal conflicts. The treatment of patients with TRD needs to move beyond attempts to modify symptoms without taking into consideration and attempting to modify the patient’s personality, coping skills, and social system. Further somatic treatment trials can be undertaken, if desired by the patient and therapist, as a small (5%–15%) percentage of patients may respond and further treatment trials, and this may engender hope. The risk with this approach is that patients and therapists may not work at disease management skills if they believe there may be a resolution of the depression if they could just find the right medication or intervention. Therapists may also feel pressured by patients, families, insurance companies, as well as their own sense of helplessness to escalate treatment in a more and more aggressive manner in an attempt to achieve an elusive remission. A disease management program can provide the therapist and patient with sufficient structure, skills, and goals to encourage ongoing treatment without resorting to unproven measures that may create more side effects and problems. It is particularly important to include the patient’s significant others in the reformulation of the patient’s problem and thereby learn how to manage the illness more effectively. Significant others and family members can be invaluable in providing support for dealing with the difficult process of acquiring a new skill set. Indeed, they spend significantly more time with the patient than does any therapist. Family members are likely to provide this kind of support only if they have been part of the assessment and treatment process. Patients with a wide range of chronic medical illnesses can and do learn to function effectively and to achieve a satisfying quality of life in spite of their illness. There is no reason to think that patients with TRD should not be able to achieve a similar level of illness management, functioning, and quality of life.",22370501,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,10.041298866271973,-0.5649755597114563,CwzB
"Mind-body medicine therapies for a range of depression severity: a systematic review.

Of the 34 million adult Americans (17%) using mind-body medicine therapies, 8 million (24%) have anxiety/depression. The evidence for using mind-body therapies to address varying depressive symptoms in populations with and without other chronic comorbidities is reviewed. Systematic literature searches of PubMed (Medline), Embase, CINAHL, and the seven databases encompassed by Current Contents, Web of Science, and Web of Knowledge were conducted. Studies designed as prospective control-comparison, adult population, English, at least 2 weeks long, sample size >30, and with primary or secondary outcome as depression measured on an established scale were included. Methodologic quality was evaluated using the modified scale for assessing scientific quality of investigations (SASQI) for Complementary and Alternative Medicine (CAM). Ninety papers of about 2900 met both inclusion and exclusion criteria; 60% of them scored a SASQI >9 and were deemed of sufficient quality to be included in the review; 74% of these selected quality papers demonstrated positive effects on the improvement of depressive symptoms. All mind-body modalities included in the study had at least one positive study. For cancer patients, several studies noted the positive effects of yoga and combination therapies on depression severity. For both diagnosed depression and fibromyalgia, several studies noted the positive effects of mindfulness on depression severity. The use of evidence-based mind-body therapies can alleviate depression severity. They could be used with established psychiatric treatments of therapy and medications. The likely long-term increased cost-effectiveness of integrating these therapies deserves further investigation.",22902090,Major Depressive Disorder,Anxiety Treatment,Mental Health,2805,8.080636024475098,-0.08993306756019592,CpYB
"Sequential Interventions for Major Depression and Heart Failure Self-Care: A Randomized Clinical Trial.

Major depression and inadequate self-care are common in patients with heart failure (HF). Little is known about how to intervene when both problems are present. This study examined the efficacy of a sequential approach to treating these problems. Stepped Care for Depression in HF was a single-site, single-blind, randomized controlled trial of cognitive behavior therapy (CBT) versus usual care (UC) for major depression in patients with HF. The intensive phase of the CBT intervention lasted between 8 and 16 weeks, depending upon the rate of improvement in depression. All participants received a tailored HF self-care intervention that began 8 weeks after randomization. The intensive phase of the self-care intervention ended at 16 weeks post-randomization. The coprimary outcome measures were the Beck Depression Inventory (version 2) and the Maintenance scale of the Self-Care of HF Index (v6.2) at week 16. One hundred thirty-nine patients with HF and major depression were enrolled; 70 were randomized to UC and 69 to CBT. At week 16, the patients in the CBT arm scored 4.0 points ([95% CI, -7.3 to -0.8]; P=0.02) lower on the Beck Depression Inventory, version 2 than those in the usual care arm. Mean scores on the Self-Care of HF Index Maintenance scale were not significantly different between the groups ([95% CI, -6.5 to 1.5]; P=0.22). CBT is more effective than usual care for major depression in patients with HF. However, initiating CBT before starting a tailored HF self-care intervention does not increase the benefit of the self-care intervention. URL: https://www. gov; Unique identifier: NCT02997865.",35973032,Major Depressive Disorder,Anxiety Treatment,Mental Health,8489,7.446229934692383,-0.28059497475624084,LR8
"Cognitive-behavioral therapy for depression in bipolar disorder: a meta-analysis.

Given the prevalence of null hypothesis significance testing, cognitive-behavioral therapy's effect on depressive symptoms of bipolar disorder is not fully understood in the absence of effect size statistics. The present study discusses the disadvantages associated with null hypothesis significance testing and seeks to overcome these shortcomings via conducting a meta-analysis which examines cognitive-behavioral therapy for depressive symptoms in persons with bipolar disorder. A systematic literature search was conducted and included articles were subject to meta-analytic procedures. With a mean weighted Cohen's d of -0.29, relative to treatment as usual, cognitive-behavioral therapy has a small effect on depressive symptoms in persons with bipolar disorder. The strengths, limitations, and need for future research are discussed.",20799127,Major Depressive Disorder,Anxiety Treatment,Mental Health,7881,11.938994407653809,-0.11480315029621124,DGZC
"Psychological treatments for depression and anxiety in dementia and mild cognitive impairment.

Experiencing anxiety and depression is very common in people living with dementia and mild cognitive impairment (MCI). There is uncertainty about the best treatment approach. Drug treatments may be ineffective and associated with adverse effects. Guidelines recommend psychological treatments. In this updated systematic review, we investigated the effectiveness of different psychological treatment approaches. Primary objective To assess the clinical effectiveness of psychological interventions in reducing depression and anxiety in people with dementia or MCI. Secondary objectives To determine whether psychological interventions improve individuals' quality of life, cognition, activities of daily living (ADL), and reduce behavioural and psychological symptoms of dementia, and whether they improve caregiver quality of life or reduce caregiver burden. We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE, Embase, four other databases, and three trials registers on 18 February 2021. We included randomised controlled trials (RCTs) that compared a psychological intervention for depression or anxiety with treatment as usual (TAU) or another control intervention in people with dementia or MCI. A minimum of two authors worked independently to select trials, extract data, and assess studies for risk of bias. We classified the included psychological interventions as cognitive behavioural therapies (cognitive behavioural therapy (CBT), behavioural activation (BA), problem-solving therapy (PST)); 'third-wave' therapies (such as mindfulness-based cognitive therapy (MBCT)); supportive and counselling therapies; and interpersonal therapies. We compared each class of intervention with control. We expressed treatment effects as standardised mean differences or risk ratios. Where possible, we pooled data using a fixed-effects model. We used GRADE methods to assess the certainty of the evidence behind each result. We included 29 studies with 2599 participants. They were all published between 1997 and 2020. There were 15 trials of cognitive behavioural therapies (4 CBT, 8 BA, 3 PST), 11 trials of supportive and counselling therapies, three trials of MBCT, and one of interpersonal therapy. The comparison groups received either usual care, attention-control education, or enhanced usual care incorporating an active control condition that was not a specific psychological treatment. There were 24 trials of people with a diagnosis of dementia, and five trials of people with MCI. Most studies were conducted in community settings. We considered none of the studies to be at low risk of bias in all domains. Cognitive behavioural therapies (CBT, BA, PST) Cognitive behavioural therapies are probably slightly better than treatment as usual or active control conditions for reducing depressive symptoms (standardised mean difference (SMD) -0.23, 95% CI -0.37 to -0.10; 13 trials, 893 participants; moderate-certainty evidence). They may also increase rates of depression remission at the end of treatment (risk ratio (RR) 1.84, 95% CI 1.18 to 2.88; 2 studies, with one study contributing 2 independent comparisons, 146 participants; low-certainty evidence). We were very uncertain about the effect of cognitive behavioural therapies on anxiety at the end of treatment (SMD -0.03, 95% CI -0.36 to 0.30; 3 trials, 143 participants; very low-certainty evidence). Cognitive behavioural therapies probably improve patient quality of life (SMD 0.31, 95% CI 0.13 to 0.50; 7 trials, 459 participants; moderate-certainty evidence) and activities of daily living at end of treatment compared to treatment as usual or active control (SMD -0.25, 95% CI -0.40 to -0.09; 7 trials, 680 participants; moderate-certainty evidence). Supportive and counselling interventions Meta-analysis showed that supportive and counselling interventions may have little or no effect on depressive symptoms in people with dementia compared to usual care at end of treatment (SMD -0.05, 95% CI -0.18 to 0.07; 9 trials, 994 participants; low-certainty evidence). We were very uncertain about the effects of these treatments on anxiety, which was assessed only in one small pilot study. Other interventions There were very few data and very low-certainty evidence on MBCT and interpersonal therapy, so we were unable to draw any conclusions about the effectiveness of these interventions. CBT-based treatments added to usual care probably slightly reduce symptoms of depression for people with dementia and MCI and may increase rates of remission of depression. There may be important effect modifiers (degree of baseline depression, cognitive diagnosis, or content of the intervention). CBT-based treatments probably also have a small positive effect on quality of life and activities of daily living. Supportive and counselling interventions may not improve symptoms of depression in people with dementia. Effects of both types of treatment on anxiety symptoms are very uncertain. We are also uncertain about the effects of other types of psychological treatments, and about persistence of effects over time. To inform clinical guidelines, future studies should assess detailed components of these interventions and their implementation in different patient populations and in different settings.",35466396,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,10.060653686523438,3.2414419651031494,b6g
"Efficacy of mindfulness-based cognitive therapy in relation to prior history of depression: randomised controlled trial.

There appears to be consensus that patients with only one or two prior depressive episodes do not benefit from treatment with mindfulness-based cognitive therapy (MBCT). To investigate whether the effect of MBCT on residual depressive symptoms is contingent on the number of previous depressive episodes (trial number NTR1084). Currently non-depressed adults with residual depressive symptoms and a history of depression (≤2 prior episodes: n = 71; ≥3 episodes: n = 59) were randomised to MBCT (n = 64) or a waiting list (control: n = 66) in an open-label, randomised controlled trial. The main outcome measured was the reduction in residual depressive symptoms (Hamilton Rating Scale for Depression, HRSD-17). Mindfulness-based cognitive therapy was superior to the control condition across subgroups (β = -0.56, P<0.001). The interaction between treatment and subgroup was not significant (β = 0.45, P = 0.16). Mindfulness-based cognitive therapy reduces residual depressive symptoms irrespective of the number of previous episodes of major depression.",22878133,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.45433235168457,-0.2356513887643814,Cpt4
"Effectiveness of an alternative intervention in the treatment of depressive symptoms.

There is a scarcity of studies in the international literature regarding alternative treatment to the pharmacological and psychotherapeutic intervention in the face of depression symptoms. This study aimed to test a protocol based on natural therapy, alternatives to pharmacological and psychotherapeutic, through Mindfulness Meditation, Reiki, Acupuncture and Auriculotherapy, to treat the symptoms of depression for those who were with no pharmacological or psychotherapeutic treatment for these symptoms. this is a randomized single-blind controlled pilot study. The final sample was 21 participants divided in two groups: experimental and control. Participants were evaluated by validated instruments during the screening process and after the intervention. The instruments were: Depression, Anxiety and Stress Scale and Beck Depression Inventory. Intervention was performed in eight sessions, during two months. All the techniques were used in the experimental group. Analysis of variance with repeated measures was used to compare pre-intervention to post-intervention moments. the result of analysis indicates a significant reduction in the symptoms of depression after the intervention among the experimental group. there is no way to determine which of the techniques used produced the most significant result. The protocol proposed in this study was effective in reducing the symptoms of depression to whom are not eligible for traditional treatment.",32871687,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.19100570678711,-0.6051424145698547,AjTw
"Patients with a preference for medication do equally well in mindfulness-based cognitive therapy for recurrent depression as those preferring mindfulness.

Previous studies have suggested that patients' treatment preferences may influence treatment outcome. The current study investigated whether preference for either mindfulness-based cognitive therapy (MBCT) or maintenance antidepressant medication (mADM) to prevent relapse in recurrent depression was associated with patients' characteristics, treatment adherence, or treatment outcome of MBCT. The data originated from two parallel randomised controlled trials, the first comparing the combination of MBCT and mADM to MBCT in patients preferring MBCT (n=249), the second comparing the combination to mADM alone in patients preferring mADM (n=68). Patients' characteristics were compared across the trials (n=317). Subsequently, adherence and clinical outcomes were compared for patients who all received the combination (n=154). Patients with a preference for mADM reported more previous depressive episodes and higher levels of mindfulness at baseline. Preference did not affect adherence to either MBCT or mADM. With regard to treatment outcome of MBCT added to mADM, preference was not associated with relapse/recurrence (χ(2)=0.07; p=.80), severity of (residual) depressive symptoms during the 15-month follow-up period (β=-0.08, p=.49), or quality of life. The group preferring mADM was relatively small. The influence of preferences on outcome may have been limited in the current study because both preference groups received both interventions. The fact that patients with a preference for medication did equally well as those with a preference for mindfulness supports the applicability of MBCT for recurrent depression. Future studies of MBCT should include measures of preferences to increase knowledge in this area.",26852095,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.820019721984863,-0.3838326930999756,Bxaj
"Mindfulness-based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta-analysis.

To perform a network meta-analysis (NMA) to compare the long-term effectiveness of mindfulness-based cognitive therapy (MBCT) with available strategies for prevention and time to depressive relapse. Seven electronic databases were searched up to June 2019. Studies evaluated MBCT for the management of depression-related outcomes and follow-up assessments occurred at 12 months or longer. Twenty-three publications were included, 17 of which were randomised controlled trials (RCTs). Data from 14 RCTs including 2077 participants contributed to meta-analysis (MA) and NMA to assess relapse of depression and 13 RCTs with 2017 participants contributed to MA and NMA for time to relapse of depression. NMAs showed statistically significant advantages for MBCT over treatment as usual (TAU) for relapse of depression (RR = 0.73, 95% CI 0.54 to 0.98) and for MBCT over TAU and placebo for time to relapse of depression (MBCT vs TAU: HR = 0.57, 95% CI 0.37 to 0.88; MBCT vs placebo: HR = 0.23, 95% CI 0.08 to 0.67). Subgroup meta-analysis of relapse of depression by previous number of depressive episodes showed similar results between subgroups. Subgroup meta-analysis by the use or not of booster sessions suggests these may lead to improved effectiveness. MBCT is more effective than TAU in the long-term in preventing relapse of depression and has statistically significant advantages over TAU and placebo for time to relapse of depression. No statistically significant differences were observed between MBCT and active treatment strategies for rate of relapse or time to relapse of depression.",33035356,Major Depressive Disorder,Anxiety Treatment,Mental Health,506,9.776678085327148,-0.5589016079902649,AhQh
"Key considerations in the pharmacological management of treatment-resistant depression.

Introduction: Treatment-resistant depression (TRD) is a complex, multifactorial, and biologically heterogeneous disorder with debilitating outcomes. Understanding individual reasons why patients do not respond to treatment is necessary for improving clinical recommendations regarding medication regimens, augmentation strategies, and alternative treatments.Areas covered: This manuscript reviews evidence-based treatment strategies for the clinical management of TRD. Current developments in the field and potential future recommendations for personalized treatment of TRD are also discussed.Expert opinion: Treatment guidelines for TRD are limited by the heterogeneous nature of the disorder. Furthermore, current strategies reflect this heterogeneity by emphasizing disease characteristics as well as drug trial response or failure. Developing robust biomarkers that could one day be integrated into clinical practice has the potential to advance specific treatment targets and ultimately improve treatment and remission outcomes.",34252320,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.984901428222656,-0.4543497860431671,ATWY
"Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: systematic review and meta-analysis.

Anxiety and depression are common in people with dementia and mild cognitive impairment (MCI), but there is uncertainty about the effectiveness of both pharmacological and psychological therapies. To evaluate the evidence of effectiveness of psychological treatments in treating depression and anxiety in people with dementia and MCI. We carried out a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological treatment versus usual care in people with dementia and MCI. Primary outcomes were symptoms of anxiety and depression. Secondary outcomes were quality of life, ability to perform daily activities, neuropsychiatric symptoms, cognition and caregivers' self-rated depressive symptoms. We included six RCTs, involving 439 participants with dementia, which used cognitive-behavioural therapy, interpersonal therapy, counselling or multimodal interventions including a specific psychological therapy. We found beneficial effects for both depression and anxiety. Overall, the quality of the evidence was moderate for depression and low for anxiety, due to the methodological limitations of the studies we identified and the limited number of trials. The evidence from six RCTs suggests that psychological treatments are effective in reducing symptoms of depression and anxiety for people with dementia. There is a need for high-quality, multicentre trials including standardised, well-defined interventions.",26429684,Major Depressive Disorder,Anxiety Treatment,Mental Health,11554,9.781379699707031,3.456799030303955,B3Jt
"Beyond Response: Aiming for Quality Remission in Depression.

To define treatment response in depression as at least a 50% reduction in total symptom severity is to accept that up to half of patients will continue to have residual symptoms, most commonly low mood/loss of interest, cognitive problems, lack of energy, and difficulty sleeping. In fact, patients' goals for treatment are to return to premorbid levels of functioning. This highlights the importance of assessing both functional outcomes and symptom improvement when evaluating the efficacy of antidepressant medication. Not all patients who achieve symptomatic response/remission will achieve a functional response/remission. In two studies (one with agomelatine and one with escitalopram), 54% of patients receiving agomelatine and 47% of those receiving escitalopram achieved a symptomatic response, and 53% of patients in each study achieved a functional response. However, 42% of patients receiving agomelatine and 35% of those receiving escitalopram had both a symptomatic and a functional response. The four symptoms of depression with the most marked effect on function are sad mood, impaired concentration, fatigue, and loss of interest. Low energy is particularly associated with poor occupational functioning, highlighting the importance of ongoing assessment of patients with depression, focusing particular attention on the symptoms that affect their ability to function, such as fatigue. Depending on the type of residual symptoms, some patients may benefit from combination therapy, such as adding dopamine modulator therapy. Antidepressant therapy is only effective if patients continue to take their medication, and high rates of early discontinuation have been reported. Therefore, when selecting treatment for depression, physicians can maximize the likelihood of adherence and persistence by taking into account both the antidepressant efficacy of treatment, its adverse effects and acceptability to patients.",35247185,Major Depressive Disorder,Anxiety Treatment,Mental Health,18329,10.16589069366455,-0.5417576432228088,kHQ
"The integrative management of treatment-resistant depression: a comprehensive review and perspectives.

Major depressive disorder is a prevalent and disabling illness. Notwithstanding numerous advances in the pharmacological treatment of depression, approximately 70% of patients do not remit after first-line antidepressant treatment. The MEDLINE/PubMed, EMBASE and ClinicalTrials.gov electronic databases were searched from inception to October 1, 2013, for randomized controlled trials (RCT), relevant open-label trials, meta-analyses and ongoing trials of pharmacological and psychotherapeutic approaches to treatment-resistant depression (TRD). Switching to a different antidepressant is a useful option following nonresponse to a first-line agent. Although widely used in clinical practice, there is limited evidence to support antidepressant combination for TRD. Notwithstanding evidence for lithium or T3 augmentation to be successful in TRD, most studies were carried out when participants were treated with tricyclic antidepressants (TCA). Of the available strategies to augment the response to new-generation antidepressants, the use of some atypical antipsychotics is best supported by evidence. Several novel therapeutic options are currently discussed. Evidence suggests that cognitive therapy (CT) is an effective strategy for TRD. The success of switching to a different antidepressant following a first-line agent is supported by evidence, but there is limited evidence for effective combination strategies. Lithium and T3 augmentation of TCA have the strongest evidence base for successful treatment of TRD. The use of augmentation of newer-generation antidepressants with atypical antipsychotics is supported by a growing evidence base. Current evidence supports CT as an effective strategy for TRD. There is a need for additional large-scale RCT of TRD. The development of new antidepressants targeting novel pathways opens a promising perspective for the management of TRD.",24458008,Major Depressive Disorder,Anxiety Treatment,Mental Health,6242,9.33661937713623,-0.23864927887916565,CTE7
"Cognitive effects of pharmacotherapy for major depressive disorder: a systematic review.

Cognitive impairment frequently accompanies major depressive disorder (MDD) and can persist during remission. This review examined pharmacotherapy effects on cognitive function in MDD. PubMed and EMBASE searches were conducted on July 30, 2013, for English language reports of cognitive assessments following pharmacologic monotherapy or augmentation therapy in MDD. A total of 43 research reports were identified (31 monotherapy [8 placebo-controlled, 11 active-comparator, 12 open-label], 12 augmentation therapy [7 placebo-controlled, 5 open-label]). Results reported in each publication were examined for open-label and placebo- or active comparator-controlled studies. Studies varied widely in terms of size (median, 50 participants; interquartile range, 21-143 participants), populations examined, duration (median, 8 weeks; interquartile range, 6-12 weeks), and neurocognitive assessments used. Most individual studies reported some benefit to cognition with pharmacotherapy, but there was no pattern of response in specific domains and only 12% of individually analyzed changes favored active treatment over placebo or untreated healthy controls. Sample weighted mean effect sizes revealed that verbal memory improved with monotherapy, while the largest treatment effect with augmentation therapy was for visual memory. Pharmacotherapy may have benefit in reducing cognitive impairment in MDD, with augmentation therapy being a potential approach for addressing cognitive deficits that persist after monotherapy has brought about clinical response or remission. However, given the wide variability in study design and treatment duration across studies, these findings should be interpreted cautiously. More definitive research is required before firm conclusions can be reached.",25099527,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.48548698425293,0.5735872983932495,CKKa
"Cognition in depression: Can we THINC-it better?

Cognitive compromise is a common experience for patients with depression and other mood disorders. Depressed patients sustain deficits in working memory and attentional distortions in emotional processing and negative attention biases, which may contribute to maintaining their depressive state. The Mood Assessment and Classification (MAC) Committee comprised academic psychiatrists with clinical expertise in the management of mood disorders. The independently convened committee met to discuss contentious aspects of mood disorders diagnosis and assessment with the express aim of informing clinical practice and future research. The Committee specifically identified cognition as an important aspect for clinicians to consider in the context of depression and mood disorders. This article highlights some of the barriers to assessment and proposes tools that have the potential to be implemented in clinical practice. The conclusions drawn within this article are based on expert opinion. We have noted the limitations of the literature that informs this opinion. As cognitive ability has been closely linked to patients' ability to achieve functional recovery, it is imperative that clinicians are able to identify patients with cognitive deficits and are equipped with tools to conduct effective cognitive assessments. Examining cognitive factors may generate a deeper understanding of the pathogenesis of depression and mood disorders which can ultimately be used to inform treatment.",28869910,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.25497055053711,0.43763813376426697,BXgR
"Effects of cognitive behavioural therapy on verbal learning and memory in major depression: Results of a randomized controlled trial.

Major depression (MD) is often accompanied by deficits in cognitive functioning. Cognitive behavioural therapy (CBT) has beneficial effects on MD. The aim of this study was to examine whether CBT affects verbal learning and memory in patients with MD and whether CBT that emphasizes exercise during behavioural activation has additional effects on verbal performance. Ninety-eight patients with MD were randomly assigned to CBT emphasizing either exercise during behavioural activation (CBT-E) or CBT emphasizing pleasurable low-energy activities (CBT-C). A passive waiting list control group was also involved (WL). Thirty nondepressed age- and sex-matched controls were included to examine potential verbal learning and memory alterations in MD at baseline. Neuropsychological measures were assessed at baseline and after 16 weeks of CBT and waiting time, respectively. Patients with MD demonstrated worse cognitive performance than healthy controls in verbal learning, recognition, and memory at baseline. After treatment, we found no improvements concerning verbal learning and memory performance compared with WL, with the exception of recognition memory. No differences were found between CBT conditions. Psychological treatments such as CBT seem to have limited influence on memory functions. Concerning recognition memory, our results contradict, in part, previous assumptions that cognitive impairments persists despite depressive symptom reduction.",30614136,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.665544509887695,-0.0913313701748848,BA5B
"Augmenting neurocognitive remediation therapy to Preventive Cognitive Therapy for partially remitted depressed patients: protocol of a pragmatic multicentre randomised controlled trial.

Major depressive disorder (MDD) affects 163 million people globally every year. Individuals who experience subsyndromal depressive symptoms during remission (ie, partial remission of MDD) are especially at risk for a return to a depressive episode within an average of 4 months. Simultaneously, partial remission of MDD is associated with work and (psycho)social impairment and a lower quality of life. Brief psychological interventions such as preventive cognitive therapy (PCT) can reduce depressive symptoms or relapse for patients in partial remission, although achieving full remission with treatment is still a clinical challenge. Treatment might be more effective if cognitive functioning of patients is targeted as well since cognitive problems are the most persisting symptom in partial remission and predict poor treatment response and worse functioning. Studies show that cognitive functioning of patients with (remitted) MDD can be improved by online neurocognitive remediation therapy (oNCRT). Augmenting oNCRT to PCT might improve treatment effects for these patients by strengthening their cognitive functioning alongside a psychological intervention. This study will examine the effectiveness of augmenting oNCRT to PCT in a pragmatic national multicentre superiority randomised controlled trial. We will include 115 adults partially remitted from MDD with subsyndromal depressive symptoms defined as a Hamilton Depression Rating Scale score between 8 and 15. Participants will be randomly allocated to PCT with oNCRT, or PCT only. Primary outcome measure is the effect on depressive symptomatology over 1 year. Secondary outcomes include time to relapse, cognitive functioning, quality of life and healthcare costs. This first dual approach study of augmenting oNCRT to PCT might facilitate full remission in partially remitted individuals as well as prevent relapse over time. Ethical approval was obtained by Academic Medical Center, Amsterdam. Outcomes will be made publicly available. NL9582.",35738653,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,12.936558723449707,-0.19246195256710052,S40
"Cognitive remediation for treatment-resistant depression: effects on cognition and functioning and the role of online homework.

Neurocognitive impairments are observed in depression and associated with poor functioning. This study examined the efficacy and the effectiveness of cognitive remediation with supplemental Internet-based homework in treatment-resistant depression. Participants were randomized to treatment or wait list control conditions. Treatment consisted of 10 weeks of weekly group sessions and daily online cognitive exercises completed at home. The participants were assessed on cognitive, mood, motivation, and functioning measures. There was a significant time by treatment interaction for attention/processing speed and verbal memory. Changes in functioning were not significant, although improved cognition predicted improvements in functioning. Number of minutes of online exercise was associated with greater cognitive improvements. Cognitive deficits are malleable with behavioral treatment in a mood disorder characterized by severe and persistent symptoms.",23896849,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.041586875915527,-0.4150494933128357,CauL
"Longitudinal Changes of Cognitive Deficits and Treatment Outcome of Cognitive Behavioral Therapy for Major Depression.

The current study examined neuropsychological changes over the course of cognitive behavioral therapy (CBT) in outpatients with major depressive disorder and the influence of cognitive deficits as predictors of clinical outcome in depression. A neuropsychological test battery was carried out on depressed outpatients (N = 54) at the beginning and at the end of CBT. Small improvements were found in divided attention, figural memory, and processing speed from pre- to posttreatment. Cognitive deficits in executive functions before treatment predicted the clinical outcome at the end of CBT. The present study reveals that attention and memory deficits are most likely to improve over the course of treatment, whereas executive functions remain stable in the long term. Depressed patients with worse executive functions at the beginning of treatment seem to benefit more from long-term CBT therapy.",33555821,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.821878433227539,0.17154057323932648,AbNV
"Neural and clinical changes of cognitive behavioural therapy versus talking control in patients with major depression: a study protocol for a randomised clinical trial.

While major depression causes substantial distress and impairment for affected individuals and society, the effectiveness of cognitive behavioural therapy (CBT) in treating the condition has been established. However, the therapeutic mechanism underlying the efficacy of CBT remains unknown. This study aimed to describe a protocol for a randomised controlled trial that will measure the CBT-induced clinical and neural changes in patients with non-psychotic major depression. The current study is a 16-week assessor-blinded, randomised, parallel-group trial with a 12-month follow-up as part of usual depression care at an outpatient clinic. Patients aged 20-69 years with major depressive disorder will be randomly assigned to receive either CBT in addition to their usual treatment or talking control in addition to their usual treatment for 16 weeks. The primary outcome is the functional changes in the brain areas that have been associated with future-oriented thinking at 16 weeks; secondary outcomes include changes in functional brain connectivity, severity and changes in the scores of objective and subjective clinical depression symptoms, proportion of responders and remitters and quality of life. The intention-to-treat analysis will be used. All protocols and the informed consent form are compliant with the Ethics Guideline for Clinical Research (Japanese Ministry of Health, Labour and Welfare). Ethical Review Committees at the Keio University School of Medicine have approved the study protocol (version 3, 11 September 2017). We will disseminate research findings to scientific and general audiences through national and international conference presentations as well as lay summaries to the general public, including mental health consumer and publications in international peer-reviewed psychiatry and brain imaging journals. UMIN Clinical Trials Registry (UMIN000018155); Pre-results.",32102803,Major Depressive Disorder,Anxiety Treatment,Mental Health,17830,12.629402160644531,-0.28963232040405273,AsxM
"How to modify persisting negative expectations in major depression? An experimental study comparing three strategies to inhibit cognitive immunization against novel positive experiences.

Research has shown that negative expectations in major depressive disorder (MDD) often persist despite positive disconfirming experiences. To explain this phenomenon, the concept of cognitive immunization has been introduced: that is, individuals with MDD reappraise disconfirming positive evidence in such a way that negative expectations are maintained. In this study, we examined whether it is possible to inhibit cognitive immunization to facilitate expectation update. We examined 113 people with MDD being treated in an inpatient psychosomatic hospital. Using a previously validated paradigm, participants worked on a standardized performance test; we examined changes in negative performance-related expectations after positive expectation-disconfirming feedback. One experimental group received additional information increasing the value of the positive feedback ('INFORMATION'). Another group was instructed to recall the feedback after completing the task ('RECALL'). In a third group, participants' attention was shifted to potential expectation-disconfirming feedback ('ATTENTION'). In addition, a control group underwent the standard procedure of the paradigm. The results showed significant group differences in the change in generalized performance expectations, with the largest changes in participants from the INFORMATION group. All experimental groups had lower values for cognitive immunization than the control group. Given that this proof-of-concept study was the first to examine strategies to inhibit cognitive immunization, the findings need to be replicated in future studies. The present study confirms that cognitive immunization in MDD can be inhibited, thus facilitating adjusting negative expectations. The most promising results were found for the INFORMATION group, providing information to emphasize the relevance of expectation-disconfirming information.",30870773,Major Depressive Disorder,Anxiety Treatment,Mental Health,13413,14.645204544067383,-0.3529675304889679,A9cE
"Memory Flexibility training (MemFlex) to reduce depressive symptomatology in individuals with major depressive disorder: study protocol for a randomised controlled trial.

Major depressive disorder (MDD) is associated with chronic biases in the allocation of attention and recollection of personal memories. Impaired flexibility in attention and autobiographical memory retrieval is seen to both maintain current symptoms and predict future depression. Development of innovative interventions to reduce maladaptive cognitive patterns and improve cognitive flexibility in the domain of memory may therefore advance current treatment approaches for depression. Memory specificity training and cognitive bias modification techniques have both shown some promise in improving cognitive flexibility. Here we outline plans for a trial of an innovative memory flexibility training programme, MemFlex, which advances current training techniques with the aim of improving flexibility of autobiographical memory retrieval. This trial seeks to estimate the efficacy of MemFlex, provide data on feasibility, and begin to explore mechanisms of change. We plan a single-blind, randomised, controlled, patient-level trial in which 50 individuals with MDD will complete either psychoeducation (n=25) or MemFlex (n=25). After completing pre-treatment measures and an orientation session, participants complete eight workbook-based sessions at home. Participants will then be assessed at post-treatment and at 3 month follow-up. The co-primary outcomes are depressive symptoms and diagnostic status at 3 month follow-up. The secondary outcomes are memory flexibility at post-treatment and number of depression free days at 3 month follow-up. Other process outcomes and mediators of any treatment effects will also be explored. This trial will establish the efficacy of MemFlex in improving memory flexibility, and reducing depressive symptoms. Any effects on process measures related to relapse may also indicate whether MemFlex may be helpful in reducing vulnerability to future depressive episodes. The low-intensity and workbook-based format of the programme may improve access to psychological therapies, and, if encouraging, the results of this study will provide a platform for later-phase trials. NCT02371291 (ClinicalTrials.gov), registered 9 February 2015.",26531124,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,13.765748977661133,-0.299464613199234,B1qC
"Reward learning impairment and avoidance and rumination responses at the end of Engage therapy of late-life depression.

This study examined the association between reward processing, as measured by performance on the probabilistic reversal learning (PRL) task and avoidance/rumination in depressed older adults treated with Engage, a psychotherapy that uses ""reward exposure"" to increase behavioral activation. Thirty older adults with major depression received 9 weeks of Engage treatment. At baseline and treatment end, the 24-item Hamilton Depression Rating Scale (HAM-D) was used to assess depression severity and the Behavioral Activation for Depression Scale (BADS) to assess behavioral activation and avoidance/rumination. Participants completed the PRL task at baseline and at treatment end. The PRL requires participants to learn stimulus-reward contingencies through trial and error, and switch strategies when the contingencies unexpectedly change. At the end of Engage treatment, the severity of depression was lower (HAM-D: t(19) = -7.67, P < .001) and behavioral activation was higher (BADS: t(19) = 2.23, P = .02) compared to baseline. Response time following all switches (r(19) = -0.63, P = .003) and error switches (r(19) = -0.57, P = .01) at baseline was negatively associated with the BADS avoidance/rumination subscale score at the end of Engage treatment. Impaired reward learning, evidenced by slower response following all switches and error switches, contributes to avoidant, ruminative behavior at the end of Engage therapy even when depression improves. Understanding reward processing abnormalities of avoidance and rumination may improve the timing and targeting of interventions for these symptoms, whose persistence compromises quality of life and increases the risk of depression relapse.",29573471,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,15.175276756286621,0.8464002013206482,BOLd
"Investigating the (cost-) effectiveness of attention bias modification (ABM) for outpatients with major depressive disorder (MDD): a randomized controlled trial protocol.

Despite the range of available, evidence-based treatment options for Major Depressive Disorder (MDD), the rather low response and remission rates suggest that treatment is not optimal, yet. Computerized attention bias modification (ABM) trainings may have the potential to be provided as cost-effective intervention as adjunct to usual care (UC), by speeding up recovery and bringing more patients into remission. Research suggests, that a selective attention for negative information contributes to development and maintenance of depression and that reducing this negative bias might be of therapeutic value. Previous ABM studies in depression, however, have been limited by small sample sizes, lack of long-term follow-up measures or focus on sub-clinical samples. This study aims at evaluating the long-term (cost-) effectiveness of internet-based ABM, as add-on treatment to UC in adult outpatients with MDD, in a specialized mental health care setting. This study presents a double-blind randomized controlled trial in two parallel groups with follow-ups at 1, 6, and 12 months, combined with an economic evaluation. One hundred twenty six patients, diagnosed with MDD, who are registered for specialized outpatient services at a mental health care organization in the Netherlands, are randomized into either a positive training (towards positive and away from negative stimuli) or a sham training, as control condition (continuous attentional bias assessment). Patients complete eight training sessions (seven at home) during a period of two weeks (four weekly sessions). Primary outcome measures are change in attentional bias (pre- to post-test), mood response to stress (at post-test) and long-term effects on depressive symptoms (up to 1-year follow-up). Secondary outcome measures include rumination, resilience, positive and negative affect, and transfer to other cognitive measures (i.e., attentional bias for verbal stimuli, cognitive control, positive mental imagery), as well as quality of life and costs. This is the first study investigating the long-term effects of ABM in adult outpatients with MDD, alongside an economic evaluation. Next to exploring the mechanism underlying ABM effects, this study provides first insight into the effects of combining ABM and UC and the potential implementation of ABM in clinical practice. Trialregister.nl, NTR5285 . Registered 20 July 2015.",27809880,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.847801208496094,-0.22232845425605774,BlM3
"Neural predictors and effects of cognitive behavioral therapy for depression: the role of emotional reactivity and regulation - CORRIGENDUM.

",34315547,Major Depressive Disorder,Anxiety Treatment,Mental Health,3407,14.324119567871094,0.6023502349853516,ASn3
"A digital intervention targeting cognitive control network dysfunction in middle age and older adults with major depression.

Nonpharmacological interventions targeting putative network mechanisms of major depressive disorder (MDD) may represent novel treatments. This mechanistic study investigates how a video game-like intervention, designed to improve cognitive control network (CCN) functioning by targeting multitasking, influences the CCN of middle-aged and older adults with MDD. The sample consisted of 34 adults aged 45-75 with SCID-defined diagnosis of MDD, Hamilton depression rating scale scores ≥20, and a deficit in cognitive control. Participants were instructed to play at home for 20-25min per day, at least 5 times per week, for 4 weeks. Evidence of target engagement was defined a priori as >2/3 of participants showing CCN improvement. CCN engagement was defined as a change in a Z score of ≥0.5 on functional magnetic resonance imaging (fMRI) in activation and functional connectivity of the CCN during task-based and resting-state fMRI, respectively. 74% of participants showed a change in activation of the CCN, and 72% showed an increase in resting-state functional connectivity. Sixty-eight percent demonstrated improved cognitive control function, measured as either improvement on sustained attention or working memory performance or reduced self-reported symptoms of apathy on the frontal systems behavioral scale (FrsBe). Participants also reported a significant reduction in mood symptoms measured by PHQ-9. A remotely deployed neuroscience-informed video game-like intervention improves both CCN functions and mood in middle-aged and older adults with MDD. This easily-disseminated intervention may rescue CCN dysfunction present in a substantial subset of middle-aged and older adults with MDD.",33947831,Major Depressive Disorder,Anxiety Treatment,Mental Health,3407,12.996516227722168,0.6344249248504639,AW2a
"A randomised controlled trial of memory flexibility training (MemFlex) to enhance memory flexibility and reduce depressive symptomatology in individuals with major depressive disorder.

Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval can thereby have a detrimental impact on mental health. This randomised controlled phase II exploratory trial (N = 60) evaluated the potential of a novel intervention drawn from basic science - an autobiographical Memory Flexibility (MemFlex) training programme - which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and diagnostic status at three-month follow-up. These effect sizes could subsequently be used to estimate sample size for a fully-powered trial. Results demonstrated small-moderate, though as expected statistically non-significant, effect sizes in favour of MemFlex for memory flexibility (d = 0.34, p = .20), and loss of diagnosis (OR = 0.65, p = .48), along with the secondary outcome of depression-free days (d = 0.36, p = .18). A smaller effect size was observed for between-group difference in self-reported depressive symptoms (d = 0.24, p = .35). Effect sizes in favour of MemFlex in this early-stage trial suggest that fully-powered evaluation of MemFlex may be warranted as an avenue to improving low-intensity treatment of depression. ClinicalTrials.gov, Identifier NCT02371291.",30199738,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,13.981350898742676,-0.10716753453016281,BGYl
"Remediation of depression-related cognitive impairment: cognitive control training as treatment augmentation.

Despite several available evidence-based interventions for major depression relapse, rates remain high and relapse prevention programs are still scarce. To increase effectiveness, novel techniques that target underlying vulnerability factors may be a promising avenue. Depression is associated with impairments in executive functioning, which is in turn associated with poor psychosocial outcomes and more Repetitive Negative Thinking (RNT), a key vulnerability factor for relapse. This paper examines deficits in cognitive control as a potentially modifiable causal mechanism for depression. Areas covered: An overview of studies on the interplay between cognitive control and RNT is presented, assessing the potential of training cognitive control in depressed individuals. Cognitive Control Training (CCT), or other techniques aimed at remediating executive functioning, provides an interesting way to examine the causal status of executive functions in depression-related symptoms, such as emotion regulation and psychosocial functioning. The clinical utility of CCT is assessed. Expert commentary: There is emerging evidence for clinical utility of CCT but more large-scale, longitudinal studies are required. The section discusses how the adaptive Paced Auditory Serial Addition Test (PASAT) can be used as a technique that can be combined with psychological as well as biological interventions, to increase overall effectiveness of treatment for depression.",30334627,Major Depressive Disorder,Anxiety Treatment,Mental Health,10927,13.43364143371582,-0.4734114706516266,BEnJ
"Cognitive Remediation Therapy for Psychotic Major Depressive Disorder.

",29902368,Major Depressive Disorder,Anxiety Treatment,Mental Health,19615,13.204402923583984,-0.3311920166015625,BKXP
"Cognitive remediation for depressed inpatients: Results of a pilot randomized controlled trial.

Neurocognitive deficits that persist despite antidepressive treatment and affect social and vocational functioning are well documented in major depressive disorder. Cognitive training approaches have proven successful in ameliorating these deficits in other psychiatric groups, but very few studies have been conducted in unipolar depressive patients by now. In contrast to previous studies solely including outpatients, effects of a cognitive remediation intervention on neurocognitive functioning of depressed inpatients were assessed by the present study. A randomized controlled trial was carried out with 46 depressed inpatients of a psychiatric hospital. Patients were randomly assigned to either a control group that received standard drug and non-drug (cognitive behavioural, occupational, sports, relaxation and music therapy) antidepressive treatment or a remediation group that additionally received 12 sessions of cognitive training for a total of 4 weeks (three sessions per week). An intent to treat analysis and a last observation carried forward method was used for data analyses. Patients of the remediation group demonstrated greater improvements in neurocognitive measures of verbal and nonverbal memory, working memory and executive function (Cohen's d effect sizes between .52 and .98). These results provide preliminary evidence that cognitive remediation interventions can be successfully applied also in psychiatric inpatients experiencing an acute depressive episode.",26706860,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.155527114868164,-0.44138434529304504,BzXF
"Attentional bias modification treatment for depression: Study protocol for a randomized controlled trial.

Theoretical models and empirical research point to negatively biased attention as a maintaining factor in depression. Although preliminary studies suggest experimentally modifying attentional biases (i.e., attentional bias modification; ABM) reduces depression symptoms and depression risk, relatively few rigorous studies with clinical samples have been completed. This clinical trial examines the impact of ABM on a sample of adults (N = 123) with elevated depression severity who also exhibit at least modest levels of negatively biased attention prior to treatment. Participants will be randomly assigned to either active ABM, placebo ABM, or an assessment-only control condition. Individuals assigned to ABM will complete 5 trainings per week (2 in-clinic, 3 brief trainings at-home) during a four-week period. Throughout this four-week period, participants will complete weekly assessments of symptom severity and putative treatment mediators measured across different levels of analysis (e.g., eye tracking, behavioral measures, and functional Magnetic Resonance Imaging). This article details the rationale and design of the clinical trial, including methodological issues that required more extensive consideration. Our findings may not only point to an easily-accessible, efficacious treatment for depression but may also provide a meaningful test of whether a theoretically important construct, negatively biased attention, maintains depression.",30416089,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.872209548950195,-0.12277037650346756,BDfZ
"Influence of Pharmacotherapy on Cognitive Functions in Depression: A Review of the Literature.

In addition to irregularities relating to the emotional sphere, the cognitive impairment in depression is a part of the clinical picture of this affective disorder. Some of the cognitive deficits may be associated with the severity of psychopathological symptoms of depression, while others are more established and can also occur during periods of remission. The participation in cognitive functioning of people with depression have a number of factors: the severity of symptoms, concurrent anxiety disorders, gender, age, education, duration of the disease, and number of previous episodes, as well as general somatic health or medication used. The pharmacological treatment may have varying impact on the different areas of cognition. Research on pharmacotherapy for depression and its impact on cognitive functioning continue and are very popular among clinicians and researchers. The relationship between antidepressants and cognitive abilities is always modulated by the type of depressive disorder, neurobiological factors, and demographic variables. This article presents a review of the studies relating to assessment of the effects of various antidepressants on cognitive abilities among patients with depression.",26599597,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.952194213867188,0.3986532986164093,B0vv
"Effects of emotion recognition training on mood among individuals with high levels of depressive symptoms: study protocol for a randomised controlled trial.

We have developed a new paradigm that targets the recognition of facial expression of emotions. Here we report the protocol of a randomised controlled trial of the effects of emotion recognition training on mood in a sample of individuals with depressive symptoms over a 6-week follow-up period. We will recruit 190 adults from the general population who report high levels of depressive symptoms (defined as a score ≥ 14 on the Beck Depression Inventory-II). Participants will attend a screening session and will be randomised to intervention or control procedures, repeated five times over consecutive days (Monday to Friday). A follow-up session will take place at end-of -treatment, 2-weeks and 6-weeks after training. Our primary study outcome will be depressive symptoms, Beck Depression Inventory- II (rated over the past two weeks). Our secondary outcomes are: depressive symptoms, Hamilton Rating Scale for Depression; anxiety symptoms, Beck Anxiety Inventory (rated over the past month); positive affect, Positive and Negative Affect Schedule (rated as 'how you feel right now'); negative affect, Positive and Negative Affect Schedule (rated as 'how you feel right now'); emotion sensitivity, Emotion Recognition Task (test phase); approach motivation and persistence, the Fishing Game; and depressive interpretation bias, Scrambled Sentences Test. This study is of a novel cognitive bias modification technique that targets biases in emotional processing characteristic of depression, and can be delivered automatically via computer, Internet or Smartphone. It therefore has potential to be a valuable cost-effective adjunctive treatment for depression which may be used together with more traditional psychotherapy, cognitive-behavioural therapy and pharmacotherapy. Current Controlled Trials: ISRCTN17767674.",23725208,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,14.796921730041504,-0.27877306938171387,CdTV
"A randomized controlled trial of gaze-contingent music reward therapy for major depressive disorder.

Heightened attention allocation toward negative-valanced information and reduced attention allocation toward positive-valanced information represent viable targets for attention bias modification in major depressive disorder. Accordingly, we conducted a randomized controlled trial testing the efficacy of a novel gaze-contingent attention bias modification procedure for major depressive disorder. Sixty patients with major depressive disorder were randomly assigned to either eight training sessions of feedback-based gaze-contingent music reward therapy designed to divert patients' gaze toward positive over sad stimuli, or to a control condition which entailed eight sessions of gaze-noncontingent music. Clinician-rated and self-reported measures of depression, and proportion of dwell-time on sad faces, were assessed pretreatment, posttreatment, and at a 3-month follow-up. Gaze-contingent music reward therapy produced a greater reduction in dwell-time on sad faces compared with the control condition, but it failed to generalize to novel faces. Both groups manifested similarly significant reductions in depression symptoms from pre- to posttreatment that were maintained at follow-up. Exploratory analyses suggest that first-episode patients may benefit more from this therapy than patients with a history of multiple episodes. Gaze-contingent music reward therapy can modify attention biases in depression, but clear differential clinical effects did not emerge. Theoretical and practical implications are discussed.",32790036,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.844612121582031,0.2035316377878189,AkRB
"Testing the efficacy of INtegral Cognitive REMediation (INCREM) in major depressive disorder: study protocol for a randomized clinical trial.

Given the limitation of pharmacological treatments to treat cognitive symptoms in patients with Major Depressive Disorder (MDD), cognitive remediation programs has been proposed as a possible procognitive intervention but findings are not conclusive. This study investigates the efficacy of an INtegral Cognitive REMediation (INCREM) that includes a combination of a Functional Remediation (FR) strategy plus a Computerized Cognitive Training (CCT) in order to improve not only cognitive performance but also the psychosocial functioning and the quality of life. A single blind randomized controlled clinical trial in 81 patients with a diagnosis of MDD in clinical remission or in partial remission. Participants will be randomized to one of three conditions: INCREM (FR+CCT), Psychoeducation plus online games and Treatment As Usual (TAU). Intervention will consist in 12 group sessions, of approximately 110min once a week. The primary outcome measure will be % of change in psychosocial functioning after treatment measured by the Functional Assessment Short Test (FAST); additionally, number of sick leaves and daily activities will also be recorded as pragmatic outcomes. To our knowledge, this is the first randomized controlled clinical trial using a combination of two different approaches (FR+CCT) to treat the present cognitive deficits and to promote their improvements into a better psychosocial functioning. Clinical Trials NCT03624621 . Date registered 10th of August 2018 and last updated 24th August 2018.",31060604,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.203047752380371,-0.13022778928279877,A65i
"Computerised memory specificity training (c-MeST) for the treatment of major depression: a study protocol for a randomised controlled trial.

Major depression is a prevalent and debilitating disorder, but many sufferers do not receive support or respond to current treatments. The development of easily accessible and low-intensity treatments that have clear cognitive mechanisms of change is indicated. Memory specificity training (MeST) is an intervention for depression that targets deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial will assess the efficacy of an online, computerised version of MeST (c-MeST). Adults aged 18 and over with a current major depressive episode (MDE) will be recruited and randomised to have access to the seven session, online c-MeST programme for 2weeks, or to a wait-list control group. The primary outcomes will be diagnostic status of MDE and self-reported depressive symptoms at postintervention. One-month and three-month follow-ups will be collected. Increases in autobiographical memory specificity will be assessed as a mediator of change, as well as other variables thought to contribute to reduced memory specificity, such as rumination and cognitive avoidance. Ethics approval has been granted by the Deakin University Human Research Ethics Committee to conduct the study (ID: 2017_168). The findings will be disseminated through scholarly publications and workshops and will inform future trials, such as with an active comparator or as an adjunct treatment. ACTRN12618000257268; Pre-results.",30819707,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,14.080466270446777,-0.30122119188308716,A+Hm
"Positivity-approach training for depressive symptoms: A randomized controlled trial.

Depression is highly comorbid and depressive symptoms are very common. Symptom severity adversely affects treatment outcome and later health status. Established interventions for depression leave ample room for improvement. Short interventions that target specific vulnerabilities emerge as plausible augmentation strategies. In this study, we tested the efficacy of a computerized general positivity-approach training and its effect on depressive symptoms. Patients (N = 240) with various diagnoses of mental disorders who received treatment-as-usual in an inpatient setting were randomly assigned to also receive either 4 sessions of a positivity-approach training or 4 sessions of sham training. Depression severity was assessed at baseline and post-treatment. Training data were analyzed for a subset of 111 patients. Depressive symptoms were reduced more after positivity-approach training than after sham training. Initial depression symptom severity moderated the intervention effects, such that approach tendencies and depression symptoms were only affected positively among patients with higher levels of initial depression symptom severity. The findings provide preliminary support for positivity-approach training as an add-on treatment option for depressive symptoms.",30439675,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,14.403057098388672,-0.576046884059906,BDQ9
"Can increased cognitive load help people with subthreshold depression to forget negative information?

Given that major depression is a global public health problem, and that sub-threshold depression (SD) has been shown to be a significant risk indicator of major depression disorder, the awareness of SD interventions has increased. The current study explored the effect of increasing cognitive load on the forgetting of unwanted and negative memories of sub-threshold depression individuals (SDs) (Study 1) and proposed a cognitive load intervention (CLI) (study 2). 53 SDs and 52 normal participants were recruited to explore the effect of cognitive load on the directed forgetting of negative items (Study 1). The treatment effect of CLI on 62 SDs was investigated. SDs completed up to 8 CLI/control sessions over an 8-week period while regularly recording their depression symptoms (Study 2). The results showed that it is more difficult for SDs to forget negative 'to-be-forgotten' items than normal controls (F (1, 99) = 27.98, p < 0.001, η2 = 0.22). In study 1, increasing cognitive load promoted directed forgetting for negative items in SDs. Study 2 showed that there were significant reductions in depression symptoms of SDs over the 8-week CLI (e.g. BDI-Ⅱ scores: F (1, 60) = 99.93, p < 0.001, η2 = 0.63). Small sample size and lack of verification by neuroimaging may limit the generalizability of these results. The study revealed that increasing cognitive load can promote SDs to forget negative information, while the CLI project effectively reduced the depression level of SDs, thus providing encouraging initial support for its use in the treatment of SD.",33581464,Major Depressive Disorder,Anxiety Treatment,Mental Health,11407,14.732131004333496,0.5598613619804382,Aa4v
"Impact of psychotherapy and antidepressive treatment on cognitive functions in patients treated for depression.

Depressive disorders are often treated with the use of antidepressants and with psychotherapy at the same time. According to the literature these two types of treatment may exert a certain influence on brain functioning. The aim of this study was to evaluate the effectiveness of different forms of therapeutic methods on the improvement of cognitive functions. 60 patients participated in the study. They were divided into 3 groups treated with pharmacotherapy, psychotherapy or both, respectively. The neuropsychological changes observed as a results of the application of these methods was assessed with the Vienna Test System (VTS). The patients recruited to the study were treated at the psychotherapeutic subdivision of a psychiatric ward. Inclusion in the study was restricted to individuals with a diagnosis of recurrent depressive disorder. The improvement in psychological tests measuring short-term memory and attention was present on average after 8 weeks of treatment and was most prominent in patients treated with both forms of therapy. The interpretation of the achieved results must be cautious because of the relatively small groups participating in the study. Further research is necessary to analyze the impact of different therapeutic forms used in the treatment of depression on cognitive processes.",22945206,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.775205612182617,0.09161367267370224,Cove
"Cognitive remediation therapy for partially remitted unipolar depression: A single-blind randomized controlled trial.

There is an urgent need for the development and evaluation of targeted interventions for cognitive impairment (CI) in patients with (partially) remitted major depressive disorder (MDD). The aim of our study was therefore to evaluate the effect of cognitive remediation therapy (CRT) on cognitive and psychosocial functioning in a sample of patients with MDD, taking into account comorbidity, psychopathology, remission status and CI profile. Furthermore, we compared a generalized training (GT) with an individualized training (IT) approach regarding their effects on cognition. Sixty-two MDD patients in partial remission with CI were randomly assigned to a control group (CG), IT or GT. Participants of GT trained six cognitive subdomains (divided attention, selective attention, alertness, working memory, planning and response inhibition), whereas participants of IT trained their three most deficient cognitive subdomains as identified at baseline. Participants of both intervention groups trained three times per week over a five-week period. Both training groups received additional 30-minute compensatory-transfer sessions once per week. Attention appeared to be the most frequently impaired cognitive domain as well as the domain which was significantly improved by CRT, with medium to large effect sizes. No difference in improvement was found between IT and GT. The analyses also revealed greater improvement in self-assessed psychosocial functioning in training participants (GT and IT combined) compared to the CG. Due to the small sample size, the present results are preliminary in nature. CRT was well accepted, and patients transferred the attentional improvement to real life, as measured by self-assessed psychosocial functioning. IT yielded no additional advantages over GT. We propose CRT as an integral part of the treatment plan for patients with depression suffering from CI.",32871662,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.285618782043457,-0.2753361761569977,AjUC
"A Systematic Review and Meta-Analysis of Cognitive Training in Adults with Major Depressive Disorder.

Major Depressive Disorder (MDD) is common and disabling, and is linked to functional impairment and increased mortality. While current treatments for MDD are moderately effective, ultimately, up to one third of patients do not achieve full remission. Interestingly, while affective symptoms of major depression typically resolve with the depressive episode, cognitive impairment frequently persists, and has been identified as one of the most prominent predictors of illness recurrence. Additionally, MDD is well-recognised as a key risk factor for further cognitive decline and dementia. Yet, available treatments for MDD do not typically address cognitive impairment. Cognitive training, represents a promising and novel therapeutic intervention in this regard. This review systematically identified and evaluated the evidence for cognitive training in adults with MDD. Following PRISMA guidelines, eligible studies were selected according to pre-defined criteria delineating our target population (adults with clinically defined MDD), parameters for cognitive training interventions (computer-or strategy-based, clinician-facilitated), and study design (controlled trials including pre-post cognitive and psychological or functional outcome data). Of 448 studies identified, nine studies met inclusion criteria. These studies were evaluated for methodological quality and risk of bias. Despite heterogeneity, qualitative and meta-analytic synthesis of study findings revealed significant improvements in cognitive and affective outcomes following cognitive training, with moderate pooled effect sizes. Unfortunately, very few studies investigated 'far transfer' to broader domains of everyday functioning. Overall, given the strong evidence for the efficacy and value of cognitive training in this context, cognitive training should be considered as a primary therapeutic intervention in the treatment of MDD.",33913064,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.941049575805664,-0.07139516621828079,AXMe
"Deep learning for the prediction of treatment response in depression.

Mood disorders are characterized by heterogeneity in severity, symptoms and treatment response. The possibility of selecting the correct therapy on the basis of patient-specific biomarker may be a considerable step towards personalized psychiatry. Machine learning methods are gaining increasing popularity in the medical field. Once trained, the possibility to consider single patients in the analyses instead of whole groups makes them particularly appealing to investigate treatment response. Deep learning, a branch of machine learning, lately gained attention, due to its effectiveness in dealing with large neuroimaging data and to integrate them with clinical, molecular or -omics biomarkers. In this mini-review, we summarize studies that use deep learning methods to predict response to treatment in depression. We performed a bibliographic search on PUBMED, Google Scholar and Web of Science using the terms ""psychiatry"", ""mood disorder"", ""depression"", ""treatment"", ""deep learning"", ""neural networks"". Only studies considering patients' datasets are considered. Eight studies met the inclusion criteria. Accuracies in prediction of response to therapy were considerably high in all studies, but results may be not easy to interpret. The major limitation for the current studies is the small sample size, which constitutes an issue for machine learning methods. Deep learning shows promising results in terms of prediction of treatment response, often outperforming regression methods and reaching accuracies of around 80%. This could be of great help towards personalized medicine. However, more efforts are needed in terms of increasing datasets size and improved interpretability of results.",33248809,Major Depressive Disorder,Anxiety Treatment,Mental Health,16008,13.088303565979004,-0.35882407426834106,AevR
"Neurofeedback Treatment on Depressive Symptoms and Functional Recovery in Treatment-Resistant Patients with Major Depressive Disorder: an Open-Label Pilot Study.

We evaluated the effects of neurofeedback as an augmentation treatment on depressive symptoms and functional recovery in patients with treatment-resistant depression (TRD). We included 24 adult patients with TRD and 12 healthy adults. 24 TRD patients were assigned to the neurofeedback augmentation group (n = 12) and the medication-only (treatment as usual [TAU]) group (n = 12). The neurofeedback augmentation group underwent combined therapy comprising medication and 12-24 sessions of neurofeedback training for 12 weeks. To assess the serum levels of brain-derived neurotrophic factor (BDNF) in both groups, pre- and post-treatment blood samples were obtained. Patients were evaluated using the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Clinical Global Impression-Severity (CGI-S), 5-level version of European Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D-5L), and Sheehan Disability Scale (SDS) at baseline, and at the 1-, 4-, and 12-week. From baseline to week 12, neurofeedback training reduced mean scores on HAM-D, BDI-II, CGI-S, and SDS, and increased mean EQ-5D-5L tariff score. In the neurofeedback augmentation group, the response and remission rates were 58.3% and 50.0%, respectively, at week 12. Changes in HAM-D, EQ-5D-5L tariff score, and SDS were significantly larger in the neurofeedback group than in the medication-only (TAU) group. No significant difference in BDNF level was found pre- vs. post-treatment in any of the groups. Despite the small sample size, these results suggest that neurofeedback treatment may be effective as an augmentation treatment, not only for depressive symptoms, but also for functional recovery, in patients with TRD. Clinical Research Information Service Identifier: KCT0004183 ClinicalTrials.gov Identifier: NCT04078438.",31674161,Major Depressive Disorder,Anxiety Treatment,Mental Health,6667,15.971480369567871,4.310145378112793,AylK
"Attentional bias training in depression: therapeutic effects depend on depression severity.

Depressed individuals show maintained attention to negative information and reduced attention for positive information. Selective biases in information processing are considered to have an important role in the origin, maintenance and recurrence of depressive episodes. In two experiments we investigated the effects of attentional bias manipulation on mood and depressive symptoms. In experiment 1 we investigated the effects of attentional bias manipulation compared to a control procedure in a sample of dysphoric students (N = 48) showing mild to severe levels of depressive symptoms. In experiment 2 we investigated the same attentional training procedure in a sample of depressed in- and outpatients (N = 35). Mild improvements on symptom severity were observed in students showing mild depressive symptoms. However, in students showing moderate to severe depressive symptoms, depressive symptoms increased after the training. No beneficial effects of training on top of therapy and/or medication were found in depressed patients. These results indicate that therapeutic effects of attentional bias modification might be dependent on depression severity.",20227062,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,15.538294792175293,-0.043797820806503296,DM28
"Randomized clinical trial of integral cognitive remediation program for major depression (INCREM).

Despite achieving clinical remission, patients with depression encounter difficulties to return to their premorbid psychosocial functioning. Cognitive dysfunction has been proposed to be a primary mediator of functional impairment. Therefore, the new non-pharmacological procognitive strategy INtegral Cognitive REMediation for Depression (INCREM) has been developed with the aim of targeting cognitive and psychosocial functioning. This is a single-blind randomized controlled clinical trial with three treatment arms. Fifty-two depressed patients in clinical remission, with psychosocial difficulties and cognitive impairment, were randomly assigned to receive INCREM intervention, Psychoeducation programme, or treatment as usual. Patients were assessed before and after the study period, and six months after. The primary outcome was the change from baseline of patients' psychosocial functioning. Changes in cognitive functioning and other variables were considered secondary outcomes. The analysis showed a significant improvement in psychosocial functioning in the INCREM group, especially six months after the intervention, compared to patients who received the psychoeducation programme. An improvement in cognitive performance was also observed in the INCREM group. This study includes a small sample size due to the anticipated end of the clinical trial because of the COVID-19 pandemic. These results provide preliminary evidence on the feasibility and potential efficacy of the INCREM program to improve not only cognitive performance but also psychosocial functioning in clinically remitted depressed patients, and such improvement is maintained six months after. It can be speculated that the maintenance is mediated by the cognitive enhancement achieved with INCREM.",35545155,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.070411682128906,-0.20117227733135223,ZcA
"The effects of autobiographical memory flexibility (MemFlex) training: An uncontrolled trial in individuals in remission from depression.

Impaired cognitive processing is a key feature of depression. Biases in autobiographical memory retrieval (in favour of negative and over-general memories) directly impact depression symptoms, but also influence downstream cognitive factors implicated in the onset and maintenance of the disorder. We introduce a novel cognitive intervention, MemFlex, which aims to correct these biases in memory retrieval and thereby modify key downstream cognitive risk and maintenance factors: rumination, impaired problem solving, and cognitive avoidance. Thirty eight adults with remitted Major Depressive Disorder completed MemFlex in an uncontrolled clinical trial. This involved an orientation session, followed by self-guided completion of six workbook-based sessions over one-month. Assessments of cognitive performance and depression symptoms were completed at pre- and post-intervention. Results demonstrated medium-sized effects of MemFlex in improving memory specificity and problem solving, and decreasing rumination, and a small effect in reducing cognitive avoidance. No significant change was observed in residual symptoms of depression. This study was an uncontrolled trial, and has provided initial evidence to support a larger-scale, randomized controlled trial. These findings provide promising evidence for MemFlex as a cost-effective, low-intensity option for reducing cognitive risk associated with depression.",27058165,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,14.276979446411133,-0.2497512400150299,Bug4
"Predictors of cognitive remediation therapy improvement in (partially) remitted unipolar depression.

There is urgent need for development and evaluation of targeted interventions for cognitive deficits in (partially) remitted major depression. Until now the analyses of the moderators of treatment efficacy were only examined in mixed samples of patients with schizophrenia, affective spectrum and schizoaffective disorders. Thus, the aim of our study was to evaluate the predictors of cognitive remediation therapy (CRT) improvement in a sample of (partially) remitted major depressive disorder patients. Reliable Change Index with corrections for practice effects was calculated for each participant as an indicator for training improvement. Thirty eight patients, who were randomized within our previously conducted CRT clinical trial, were divided into ""Improvers"" and ""Nonimprovers"" in the attention domain, to compare them on sociodemographic, psychopathological, neurocognitive, psychosocial and training factors. We detected 13 training participants who improved reliably in the attention domain. Illness duration was the only factor which significantly differentiated between Improvers and Nonimprovers. No significant differences between Improvers and Nonimprovers in terms of other clinical variables, sociodemographic and neuropsychological factors were found. Exploratory research results should be taken with caution. Focus on the attention domain could have led to a limited point of view. Our findings represent a first analysis of the predictors of cognitive remediation training improvement in (partially) remitted unipolar depression. Much more work should be done to refine cognitive treatment approaches. An initiation of cognitive training in early stages of the disease could be beneficial for the affected patients.",31846901,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.338223457336426,-0.21129654347896576,AwIr
"Digital Intervention for Cognitive Deficits in Major Depression: A Randomized Controlled Trial to Assess Efficacy and Safety in Adults.

The authors evaluated AKL-T03, an investigational digital intervention delivered through a video game-based interface, designed to target the fronto-parietal network to enhance functional domains for attentional control. AKL-T03 was tested in adult patients with major depressive disorder and a demonstrated cognitive impairment at baseline. Adults ages 25-55 years on a stable antidepressant medication regimen with residual mild to moderate depression and an objective impairment in cognition (as measured using the symbol coding test) were enrolled in a double-blind randomized controlled study. Participants were randomized either to AKL-T03 or to an expectation-matched digital control intervention. Participants were assessed at baseline and after completion of their 6-week at-home intervention. The primary outcome measure was improvement in sustained attention, as measured by the Test of Variables of Attention (TOVA). AKL-T03 (N=37) showed a statistically significant medium-effect-size improvement in sustained attention compared with the control intervention on the TOVA primary outcome (N=37) (partial eta-squared=0.11). Additionally, a composite score derived from all cognitive measures demonstrated significant improvement with AKL-T03 over the control intervention. Individual secondary and exploratory endpoints did not demonstrate statistically significant between-group differences. No serious adverse events were reported, and two patients (5.5%) in the AKL-T03 group reported an intervention-related adverse event (headache). Treatment with AKL-T03 resulted in significant improvement in sustained attention, as well as in cognitive functioning as a whole, compared with a control intervention. AKL-T03 is a safe digital intervention that is effective in the treatment of cognitive impairment associated with major depression. Further research will be needed to understand the clinical consequences of this treatment-induced change.",35410496,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,12.547261238098145,0.36690330505371094,d5Y
"Neurocognitive performance predicts treatment outcome with cognitive behavioral therapy for major depressive disorder.

The current study examined the contribution of baseline neuropsychological functioning to the prediction of antidepressant outcome with cognitive behavioral therapy (CBT) for Major Depressive Disorder (MDD). We hypothesized that depressed participants who were more neurocognitively intact and had less rigid, negative thinking would respond better to CBT. Thirty-one MDD patients completed a comprehensive neuropsychological battery before initiation of CBT. A subgroup also completed a probabilistic reversal learning task. Depression severity was assessed with the Beck Depression Inventory (BDI); rigid, negative thinking was assessed with the Dysfunctional Attitudes Scale (DAS) and the Automatic Thoughts Questionnaire (ATQ) throughout treatment. Remitters were compared to non-remitters. Paradoxically, eventual remitters performed generally worse across the neuropsychological battery considered as a whole. Univariate testing showed a significant difference on only a single measure, the Continuous Performance Test d', when corrected for multiple comparisons. Baseline rigid, negative thinking did not predict treatment outcome. Results suggest that the structure of CBT may particularly benefit individuals with mild depression-related neurocognitive difficulties during a depressive episode. Further research is needed to examine these patient characteristics and their potential contribution to the mechanisms of CBT efficacy.",30173044,Major Depressive Disorder,Anxiety Treatment,Mental Health,3858,13.207680702209473,0.5292729139328003,BGuz
"Can integrating the Memory Support Intervention into cognitive therapy improve depression outcome? Study protocol for a randomized controlled trial.

The Memory Support Intervention was developed in response to evidence showing that: (1) patient memory for treatment is poor, (2) poor memory for treatment is associated with poorer adherence and poorer outcome, (3) the impact of memory impairment can be minimized by the use of memory support strategies and (4) improved memory for treatment improves outcome. The aim of this study protocol is to conduct a confirmatory efficacy trial to test whether the Memory Support Intervention improves illness course and functional outcomes. As a ""platform"" for the next step in investigating this approach, we focus on major depressive disorder (MDD) and cognitive therapy (CT). Adults with MDD (n=178, including 20% for potential attrition) will be randomly allocated to CT+Memory Support or CT-as-usual and will be assessed at baseline, post treatment and at 6 and 12 months' follow-up (6FU and 12FU). We will compare the effects of CT+Memory Support vs. CT-as-usual to determine if the new intervention improves the course of illness and reduces functional impairment (aim 1). We will determine if patient memory for treatment mediates the relationship between treatment condition and outcome (aim 2). We will evaluate if previously reported poor treatment response subgroups moderate target engagement (aim 3). The Memory Support Intervention has been developed to be ""transdiagnostic"" (relevant to a broad range of mental disorders) and ""pantreatment"" (relevant to a broad range of types of treatment). This study protocol describes a ""next step"" in the treatment development process by testing the Memory Support Intervention for major depressive disorder (MDD) and cognitive therapy (CT). If the results are promising, future directions will test the applicability to other kinds of interventions and disorders and in other settings. ClinicalTrials.gov, ID: NCT01790919 . Registered on 6 October 2016.",29137655,Major Depressive Disorder,Anxiety Treatment,Mental Health,2055,12.40201187133789,-0.5008724927902222,BUKz
"Effects of Attentional Bias Modification on residual symptoms in depression: a randomized controlled trial.

Following treatment, many depressed patients have significant residual symptoms. However, large randomised controlled trials (RCT) in this population are lacking. When Attention bias modification training (ABM) leads to more positive emotional biases, associated changes in clinical symptoms have been reported. A broader and more transparent picture of the true advantage of ABM based on larger and more stringent clinical trials have been requested. The current study evaluates the early effect of two weeks ABM training on blinded clinician-rated and self-reported residual symptoms, and whether changes towards more positive attentional biases (AB) would be associated with symptom reduction. A total of 321 patients with a history of depression were included in a preregistered randomized controlled double-blinded trial. Patients were randomised to an emotional ABM paradigm over fourteen days or a closely matched control condition. Symptoms based on the Hamilton Rating Scale for Depression (HRSD) and Beck Depression Inventory II (BDI-II) were obtained at baseline and after ABM training. ABM training led to significantly greater decrease in clinician-rated symptoms of depression as compared to the control condition. No differences between ABM and placebo were found for self-reported symptoms. ABM induced a change of AB towards relatively more positive stimuli for participants that also showed greater symptom reduction. The current study demonstrates that ABM produces early changes in blinded clinician-rated depressive symptoms and that changes in AB is linked to changes in symptoms. ABM may have practical potential in the treatment of residual depression. ClinicalTrials.gov ID: NCT02658682 (retrospectively registered in January 2016).",31068158,Major Depressive Disorder,Anxiety Treatment,Mental Health,4146,16.159730911254883,-0.06945674121379852,A6yg
"The Efficacy of Cognitive Remediation in Depression: A Systematic Literature Review and Meta-Analysis.

Individuals with major depressive disorder often experience cognitive deficits. Cognitive remediation (CR) is an intervention aimed at improving cognition in psychiatric disorders. However, its efficacy on global and specific domains of cognition in adults with depression requires systematic investigation. Further, given individual differences in treatment outcome, moderators of CR effects in depression need to be identified. We performed a systematic review and meta-analysis of published controlled trials of CR in adults with depression. We analyzed results from eight studies to estimate the efficacy of CR on global cognition and on six cognitive domains. We also examined three potential moderators, namely session format (individual vs. group), treatment duration, and participants' age. CR was found to improve global cognition (g = 0.44), verbal memory (g = 0.60), attention/processing speed (g = 0.41), working memory (g = 0.35), and executive functioning (g = 0.30). No significant improvements emerged for visuospatial memory and verbal fluency. Furthermore, no significant moderating effect of participant's age, session duration or session format were observed. Conclusions are limited by the small number of studies, the heterogeneity in cognitive measures, and the lack of indicators of everyday functioning. Our meta-analysis supports the use of CR in improving global cognition in adults with major depressive disorder with a moderate effect size and this efficacy varies between cognitive domains.",33631438,Major Depressive Disorder,Anxiety Treatment,Mental Health,9099,13.193524360656738,-0.3217396140098572,AaR/
"Feasibility and Effectiveness of Memory Specificity Training in Depressed Outpatients: A Pilot Study.

Research has shown that depressed patients suffer from reduced autobiographical memory specificity (rAMS). This cognitive phenomenon is associated with the maintenance and recurrence of depressive symptoms. This pilot study aims to investigate the feasibility and effectiveness of a relatively new group-based intervention (Memory Specificity Training; MeST) that aims to reduce rAMS in an outpatient setting. Twenty-six depressed outpatients received MeST during the waiting period prior to psychotherapy. The Client Satisfaction Questionnaire (CSQ-8) was used to measure client satisfaction after the training. The Autobiographical Memory Test (AMT) was used to measure memory specificity before and after the training. Depressive symptoms were measured using the Beck Depression Inventory (BDI-II) and the Montgomery Asberg Depression Rating Scale (MADRS), before and after the training, and at a 3-month follow-up. Participants as well as trainers were positive about the use of MeST. Participants also showed an increase in memory specificity and a decrease in depressive symptoms. This study suggests that MeST is feasible in an outpatient setting, that it increases autobiographical memory specificity and that it may decrease depressive symptoms. A randomized controlled trial is recommended to examine MeST and its effects on autobiographical memory specificity, depressive symptoms and depressive relapse more extensively. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message: Research suggests that modification of rAMS can advance recovery and reduce the chance of developing a depression relapse. However, most existing psychotherapies for depression do not include these specific interventions. This is the first study to show that MeST in an outpatient setting is feasible and can lead to an increase in autobiographical memory specificity and that it may decrease depressive symptoms. A larger scale randomized controlled trial is required to examine whether the addition of MeST to care as usual decreases depressive symptoms more effectively than care as usual without MeST, and to examine whether subgroups of patients benefit specifically from this intervention (e.g. patients with more severely decreased memory specificity).",26620851,Major Depressive Disorder,Anxiety Treatment,Mental Health,3732,14.276869773864746,-0.21445836126804352,B0cX
"Internet-based guided self-help for glioma patients with depressive symptoms: design of a randomized controlled trial.

Among glioma patients, depression is estimated to be more prevalent than in both the general population and the cancer patient population. This can have negative consequences for both patients and their primary informal caregivers (e.g., a spouse, family member or close friend). At present, there is no evidence from randomized controlled trials for the effectiveness of psychological treatment for depression in glioma patients. Furthermore, the possibility of delivering mental health care through the internet has not yet been explored in this population. Therefore, a randomized controlled trial is warranted to evaluate the effects of an internet-based, guided self-help intervention for depressive symptoms in glioma patients. The intervention is based on problem-solving therapy. An existing 5-week course is adapted for use by adult glioma patients with mild to moderate depressive symptoms (Center for Epidemiology Studies Depression Scale score ≥12). Sample size calculations yield 126 glioma patients to be included, who are randomly assigned to either the intervention group or a waiting list control group. In addition, we aim to include 63 patients with haematological cancer in a non-central nervous system malignancy control group. Assessments take place at baseline, after 6 and 12 weeks, and after 6 and 12 months. Primary outcome measure is the change in depressive symptoms. Secondary outcome measures include health-related quality of life, fatigue, costs and patient satisfaction. In addition, all patients are asked to assign a primary informal caregiver, who does not participate in the intervention but who is asked to complete similar assessments. Their mood, health-related quality of life and fatigue is evaluated as well. This is the first study to evaluate the effects of problem-solving therapy delivered through the internet as treatment for depressive symptoms in glioma patients. If proven effective, this treatment will contribute to the mental health care of glioma patients in clinical practice. Netherlands Trial Register NTR3223.",24721108,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,10.402763366699219,7.539125919342041,CPfZ
"Pharmacological and psychotherapeutic interventions for management of poststroke depression: A Bayesian network meta-analysis of randomized controlled trials.

Poststroke depression (PSD) constitutes an important complication of stroke, leading to great disability as well as increased mortality. Since which treatment for PSD should be preferred are still matters of controversy, we are aiming to compare and rank these pharmacological and nonpharmacological interventions. We will employ a network meta-analysis to incorporate both direct and indirect evidence from relevant trials. We will search PubMed, the Cochrane Library Central Register of Controlled Trials, Embase, and the reference lists of relevant articles for randomized controlled trials (RCT) of different PSD treatment strategies. The characteristics of each RCT will be summarized, including the study characteristics, the participant characteristics, the outcome measurements, and adverse events. The risk of bias will be assessed by means of the Cochrane Collaboration's risk of bias tool. The primary outcome was change in Hamilton Depression Scale (HAMD) score. Secondary outcomes involve patient response rate (defined as at least a 50% score reduction on HAMD), and remission rate (defined as no longer meeting baseline criteria for depression). Moreover, we will assess the acceptability of treatments according to treatment discontinuation. We will perform pairwise meta-analyses by random effects model and network meta-analysis by Bayesian random effects model. Formal ethical approval is not required as primary data will not be collected. Our results will help to reduce the uncertainty about the effectiveness and safety of PSD management, which will encourage further research for other therapeutic options. The review will be disseminated in peer-reviewed publications and conference presentations. CRD42016049049.",28207523,Major Depressive Disorder,Anxiety Treatment,Mental Health,5810,12.80733585357666,6.339045524597168,Bgty
"Effects of an epilepsy-specific Internet intervention (Emyna) on depression: Results of the ENCODE randomized controlled trial.

Depression and anxiety are highly prevalent among people with epilepsy (PwE) but often remain unrecognized and treated inadequately. Effective psychosocial treatments such as cognitive behavioral therapy (CBT) are rarely available to most PwE, which is one reason electronically delivered CBT (eCBT) is regarded as promising. This study examined an eCBT intervention, termed Emyna, that was tailored to suit the needs of PwE. It includes CBT-related content on depression, stress and anxiety, seizure triggers and auras, and lifestyle habits. The trial examined the efficacy of Emyna in reducing symptoms of depression (primary outcome) and anxiety as well as improving quality of life. Participants (N = 200) with epilepsy, a diagnosis of a depressive disorder, and at least moderate depressive symptoms were randomized to Emyna or care as usual. At baseline and after 3, 6, and 9 months, participants were invited to complete online questionnaires. The primary outcome was improvement of depressive symptoms at 3 months. Relative to the control group, intervention group participants experienced significantly greater improvements in depression, anxiety, stress, social-occupational impairment, and epilepsy-related quality of life, in both intention-to-treat (ITT) and per-protocol analyses. In ITT analyses, effects of medium magnitude were observed, as measured by the Patient Health Questionnaire-9 items (Cohen d = 0.54, 95% confidence interval [CI] = 0.25-0.82, P < 0.001) and the Neurological Disorders Depression Inventory for Epilepsy (d = 0.51, 95% CI = 0.23-0.79, P < 0.01). At 3 months, intervention group participants also reported fewer illness-related days off work and fewer days hospitalized over the preceding months, compared to control group participants (P ≤ 0.05), whereas no such differences were present at baseline (P > 0.30). These findings showed that Emyna, used adjunctively to usual care, could help improve mental health, social-occupational functioning, and quality of life among PwE. The program provides an additional treatment option that could produce clinically relevant symptom reductions and reduce key cost drivers (ie, hospitalization rates and illness-related inability to work).",30802941,Major Depressive Disorder,Anxiety Treatment,Mental Health,3446,15.279706954956055,9.681734085083008,A+V1
"Cognitive-behavioral therapy for depression in patients with temporal lobe epilepsy: a pilot study.

Depression has a high prevalence among patients with temporal lobe epilepsy (TLE). A pilot study was carried out to evaluate group cognitive-behavioral therapy (CBT) as a treatment for depression in patients with TLE. Twenty-three outpatients with TLE and major depressive disorder, according to DSM-IV criteria, were enrolled and divided into two groups to receive 16 weekly sessions of CBT. The primary outcome measures were depression severity (assessed with the Beck Depression Inventory) and quality of life (measured with the Quality of Life in Epilepsy-31). Sixteen patients (70%) completed at least 80% of the sessions. From week 8, CBT had a significant positive effect on severity of depression that lasted until the end of treatment. A significant improvement in quality of life was also observed. CBT seems to be a useful intervention for treating depression and improving quality of life in patients with TLE.",22154515,Major Depressive Disorder,Anxiety Treatment,Mental Health,4276,15.323328971862793,9.572010040283203,Cz9r
"Cognitive behavioral therapy for depression in patients with temporal lobe epilepsy.

",22944340,Major Depressive Disorder,Anxiety Treatment,Mental Health,4531,15.259940147399902,9.56859016418457,CowP
"Ecosystem focused therapy in poststroke depression: a preliminary study.

Poststroke depression (PSD) occurs in the context of abrupt, often catastrophic disability that finds the patient and his or her family unprepared. We developed the ecosystem focused therapy (EFT), a systematic intervention aimed to increase the PSD patient's and his or her ecosystem's abilities to address the ""psychosocial storm"" of PSD and utilize available treatments effectively and efficiently. This is a preliminary study of its efficacy. A total of 24 PSD patients were randomly assigned to receive weekly sessions of EFT or a comparison condition consisting of systematic Education on Stroke and Depression and their treatment for 12weeks. Ecosystem Focused Therapy may be more efficacious than Education on Stroke and Depression in reducing depressive symptoms and signs, in leading to a higher remission rate, and in ameliorating disability in PSD. Reduction of disability in the early part of the trial mediated later improvement in depressive symptomatology. Similarly, reduction in depressive symptoms and signs early on mediated later improvement in disability. These encouraging findings require replication. Beyond its potential direct benefits in PSD, EFT may provide an appropriate context for efficient and timely administration of pharmacotherapy and of physical, speech, and occupational therapy thus maximizing their efficacy.",22249997,Major Depressive Disorder,Anxiety Treatment,Mental Health,5810,12.826092720031738,6.290078639984131,Cylw
"Non-pharmacological interventions for depressive disorder in patients after traumatic brain injury: A protocol for a systematic review and network meta-analysis.

Depressive disorder has gradually become one of the most commonly reported disabling psychiatric complication that occurs after traumatic brain injury (TBI). Currently classical antidepressant medications may not have the same effectiveness in patients with TBI as in patients without TBI. Non-pharmacological interventions have been considered to be effective for managing depressive symptoms or treating depressive disorder. But to date the comparative effectiveness of various types of non-pharmacological interventions has been synthesized in few studies, the evidence remains inconclusive. Thus, the purpose of this systematic review and network meta-analyses is to summarize high-quality evidence and identify the most effective non-pharmacological intervention when applied to treat the depressive disorder in patients after TBI. The comprehensive literature search in electronic database including PubMed, Ovid Medline, Cochrane Library, Web of Science database, Embase Database, China National Knowledge Infrastructure (CNKI), and Wanfang Data Chinese database from inception to the search date. Only high-quality randomized controlled trials (RCTs) that have used non-pharmacological interventions to treat depressive disorder after TBI will be considered. Two independent reviewers will identify eligible studies, extract and manage data information, and then determine methodical quality of included studies. Overall efficacy will be assessed as primary outcome. Secondary outcomes involved treatment response, remission rate, overall acceptability, tolerability of treatment, social functioning, occurrence of adverse events, and suicide-related outcome. Cochrane risk of bias assessment tool will be adopted to assess the risk of bias. Study heterogeneity will be measured by the I statistic. Traditional pairwise meta-analyses will be performed using STATA, while WinBUGS with GeMTC package of R software will be used to carry out network meta-analysis. This systematic review will examine the relative efficacy, effectiveness, safety, tolerability and acceptability of non-pharmacological interventions, and then to identify the most effective non-pharmacological intervention for depressive disorder after TBI. Our work could be used to give clinical recommendations for practice guideline developers, psychiatrist, neurologist, policymakers, researchers as well as individual with depressive disorder after TBI, and will also identify gaps in knowledge that could be the subject of future research. Neither ethics approval nor patient informed consent is necessary since this protocol was designed based on the existing literature. The results will be disseminated electronically or in print through publications in peer-reviewed scientific journal. INPLASY202080022.",32991457,Major Depressive Disorder,Anxiety Treatment,Mental Health,16172,14.050810813903809,4.894766807556152,Ahze