Changes In Depressive Symptoms Research Articles

Longitudinal Change in Appearance-Related Social Media Consciousness and Depressive Symptoms: A Within-Person Analysis during Early-to-Middle Adolescence.

Online appearance preoccupation may put adolescents at risk of developing mental health challenges, perhaps especially during early-to-middle adolescence. A random intercept cross-lagged panel model assessed within-person associations between appearance-related social media consciousness and depressive symptoms over three time-points with three months between waves. The sample (n = 1594) included U.S. adolescents aged 11-15 (Mage = 13; 47% girls, 46% boys, 7% another gender; 37% Latine, 33% White, 18% Black, 7% Asian). Within-person increases in appearance-related social media consciousness were associated with subsequent increases in depressive symptoms, but not vice versa. There was no evidence of gender differences and results were robust to controlling for both time on social media and offline self-objectification. Thus, online appearance concerns precede mental health challenges during early and middle adolescence.

Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review.

There is high evidence that chronic exercise benefits overall depression severity in older adults. However, late-life depression is characterized by considerable heterogeneity in clinical manifestation emphasizing the need for more individualized exercise intervention programs. Therefore, the objective of the proposed review is to investigate the effects of chronic exercise on overall depression severity and on different symptoms of depression in randomized controlled trials (RCTs) including older adults with a mean age of at least 60 years, and by considering the moderating effects of intervention characteristics and individual characteristics. This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). We will use the Population-Intervention-Comparator-Outcomes-Study design (PICOS) criteria for study inclusion and will search the following database sources for relevant RCTs: Web of Science, Academic Search Complete, CINAHL, APA Psycinfo, SPORTDiscuss, Cochrane. Two independent reviewers will conduct the study selection, data extraction, and quality assessment. Disagreement will be solved by a third reviewer. Primary outcome will be changes in overall depression severity and secondary outcomes will encompass changes in symptoms of depression as defined by the DSM-5, such as sleep quality, fatigue, anxiety, mood, apathy, changes in weight, information processing speed, and executive functions, from baseline until the end of the intervention and to any available intermediary measurement or follow up. Meta-analysis will be undertaken to synthesize the effects of chronic exercise on primary and secondary outcomes. Subgroup analysis will investigate the moderating effects of intervention characteristics (frequency, intensity, duration, type of exercise, cognitive demand, social interactions, exercise supervision, behavioral change techniques, compliance, study design, dropout-rate, type of control group) and individual characteristics (age, sex, education, functional capacity, global cognition, population) on primary and secondary outcomes. Additionally, we plan to assess quality of evidence and publication bias, and to carry out sensitivity analysis. The results of the proposed review are anticipated to have a substantial impact on research and clinical practice. On the one hand, the review's conclusions could form the foundation for developing evidence-based recommendations for individualized exercise programs that alleviate depression in older adults. On the other hand, by revealing research gaps, the review results could encourage the formulation of research questions for further RCTs. This protocol has been published in the Prospero repository (PROSPERO 2022 CRD42022361418, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361418).

Functional impairment of chronic migraine with medication overuse: Secondary analysis from the Medication Overuse Treatment Strategy (MOTS) trial.

Chronic migraine exerts substantial negative impacts on daily functioning. Efforts to manage impaired functioning may result in medication overuse, which contributes to the worsening profile and chronification of migraine. The Migraine Functional Impact Questionnaire (MFIQ) is a recently developed measure assessing the impact of migraine on physical, social, and emotional function. The objective of this analysis was to assess changes in MFIQ scores following initiation or modification of migraine preventive medication and determine if changes in function are associated with changes in other aspects of migraine burden, such as headache frequency, headache intensity, and symptoms of anxiety and depression. This is a secondary analysis of data from the Medication Overuse Treatment Strategy (MOTS) trial, a prospective pragmatic clinical trial that investigated two treatment strategies for those with chronic migraine and medication overuse. Data from both treatment arms were pooled and analyzed using a pre-post design. Prior to and 12 weeks following initiation or modification of migraine preventive medication, participants completed a series of questionnaires that captured migraine characteristics, medication use, migraine-related physical impairment (MFIQ), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire 9 [PHQ-9]) symptoms. Changes from baseline in all measures were assessed using the paired t-test. Relationships between changes in MFIQ scores and other measures were assessed using linear regression. Multivariable modeling was performed to determine which additional variables contributed to the change in MFIQ beyond that already explained by an individual variable. Model terms were selected by using elastic net regularization. Only those participants who completed the baseline and 12-week MFIQ were included in this analysis. Of the 537 patients, 88.2% were female, and the average age was 45 years (standard deviation 13). The mean frequency of days with moderate-to-severe headache improved 39.2% from 13.5 per 30 days at baseline to 8.1 per 30 days at week 12. The mean MFIQ Usual Activities Global score improved by 15.0 points (on a 100-point scale). All five domains (Usual Activities Global, Usual Activities, Social Function, Emotional Function, Physical Function) of the MFIQ improved by a mean of at least 13.0 points. Changes in PHQ-9 score, followed by changes in headache frequency, had the strongest associations with change in all domains of the MFIQ. The negative impact of chronic migraine with medication overuse on physical, social, and emotional functioning substantially lessened following initiation or modification of migraine preventive medication. Improved functioning, as measured by the MFIQ, was most strongly associated with reductions in depression scores and headache frequency, highlighting the importance of recognizing and monitoring changes in depressive symptoms, in addition to headache frequency and functional impairment, when evaluating response to preventive medications.

Trajectories of Gender Identity and Depressive Symptoms in Youths

Concerns about the mental health of youths going through gender identity transitions have received increased attention. There is a need for empirical evidence to understand how transitions in self-reported gender identity are associated with mental health. To examine whether and how often youths changed self-reported gender identities in a longitudinal sample of sexual and gender minority (SGM) youths, and whether trajectories of gender identity were associated with depressive symptoms. This cohort study used data from 4 waves (every 9 months) of a longitudinal community-based study collected in 2 large cities in the US (1 in the Northeast and 1 in the Southwest) between November 2011 and June 2015. Eligible participants included youths who self-identified as SGM from community-based agencies and college groups for SGM youths. Data analysis occurred from September 2022 to June 2023. Gender identity trajectories and gender identity variability. The Beck Depression Inventory for Youth (BDI-Y) assessed depressive symptoms. Gender identity variability was measured as the number of times participants' gender identity changed. Hierarchical linear models investigated gender identity trajectories and whether gender identity variability was associated with depressive symptoms over time. Among the 366 SGM youths included in the study (mean [SD] age, 18.61 [1.71] years; 181 [49.4%] assigned male at birth and 185 [50.6%] assigned female at birth), 4 gender identity trajectory groups were identified: (1) cisgender across all waves (274 participants ), (2) transgender or gender diverse (TGD) across all waves (32 participants), (3) initially cisgender but TGD by wave 4 (ie, cisgender to TGD [28 participants]), and (4) initially TGD but cisgender by wave 4 (ie, TGD to cisgender [32 participants]). One in 5 youths (18.3%) reported a different gender identity over a period of approximately 3.5 years; 28 youths varied gender identity more than twice. The cisgender to TGD group reported higher levels of depression compared with the cisgender group at baseline (Β = 4.66; SE = 2.10; P = .03), but there was no statistical difference once exposure to lesbian, gay, bisexual, and transgender violence was taken into account (Β = 3.31; SE = 2.36; P = .16). Gender identity variability was not associated with within-person change in depressive symptoms (Β = 0.23; SE = 0.74; P = .75) or the level of depressive symptoms (Β = 2.43; SE = 2.51; P = .33). These findings suggest that gender identity can evolve among SGM youths across time and that changes in gender identity are not associated with changes in depressive symptoms. Further longitudinal work should explore gender identity variability and adolescent and adult health.

Temporal Changes in Depressive Symptoms Among Goodville Farm Game Players: A 6-Week Observational Study.

Aim of the Study: The primary objective was to evaluate the potential impact of the Goodville farm game on depressive symptoms. Methods: The Goodville game, characterized by its unique farming features, incorporates elements of emotional well-being and various mental health assessment tools, enabling players to monitor and improve their emotional state. Using self-reported Patient Health Questionnaire-8 (PHQ-8) data from 1717 US and UK players, changes were monitored weekly over a 6-week period. The study focused on the game's ability to integrate emotional well-being elements and various mental health assessments to facilitate self-monitoring and improvement of players' emotional states. Results: There was a significant overall time effect (F = 154.498, df = 1711, P < 0.001), indicating a moderate-to-large effect size, with progressive decreases in PHQ-8 scores throughout the period. About 60% of players reported reduced depressive symptom severity, with around 35% experiencing complete symptom relief. More significant improvements were observed in players with higher initial severity. No correlations were found between symptom changes and demographic data or the number of active playing days. Conclusion: Goodville demonstrates potential as a digital mental health intervention in reducing depressive symptoms through its specific characteristics designed to improve emotional well-being. The study emphasizes the need to consider baseline severity and highlights the therapeutic promise of authentic farming game features. Despite the absence of a control group, the findings contribute meaningful insights into digital interventions for mental health care and set a direction for future studies to validate and expand upon these results.

Efficacy of systemic therapy on adults with depressive disorders: A meta-analysis

Objective This meta-analysis evaluates the efficacy of systemic therapy approaches on adult clients with depressive disorders. Methods The illness-specific systematic review updates a previous meta-analysis on the efficacy of systemic therapy on psychiatric disorders in adulthood. It integrates the results of 30 randomized controlled trials (RCTs) comparing systemic psychotherapy for depression with an untreated control group or alternative treatments. Studies were identified through systematic searches in relevant electronic databases and cross-referencing. A random-effects model calculated weighted mean effect sizes for each type of comparison (alternative treatments, control group with no alternative treatment/waiting list) on two outcomes (depressive symptoms change, drop-out rates). Results On average, systemic interventions show larger improvements in depressive symptoms compared to no-treatment controls at post-test (g = 1.09) and follow-up (g = 1.23). Changes do not significantly differ when comparing systemic interventions with alternative treatments (post-test g = 0.25; follow-up g = 0.09). Results also vary, in part, by participant age, publication year, and active control condition. Conclusion This meta-analysis indicates the potential benefits of systemic interventions for adult patients with depression. Future randomized clinical trials in this area should enhance study quality and include relational and other relevant outcome measures.

Multipanel Approach including miRNAs, Inflammatory Markers, and Depressive Symptoms for Metabolic Dysfunction-Associated Steatotic Liver Disease Diagnosis during 2-Year Nutritional Intervention

Metabolic dysfunction-associated fatty liver disease (MASLD), with a prevalence of 30% of adults globally, is considered a multifactorial disease. There is a lack of effective non-invasive methods for accurate diagnosis and monitoring. Therefore, this study aimed to explore associations between changes in circulating miRNA levels, inflammatory markers, and depressive symptoms with hepatic variables in MASLD subjects and their combined potential to predict the disease after following a dietary intervention. Biochemical markers, body composition, circulating miRNAs and hepatic and psychological status of 55 subjects with MASLD with obesity and overweight from the FLiO study were evaluated by undergoing a 6-, 12- and 24-month nutritional intervention. The highest accuracy values of combined panels to predict the disease were identified after 24 months. A combination panel that included changes in liver stiffness, high-density lipoprotein cholesterol (HDL-c), body mass index (BMI), depressive symptoms, and triglycerides (TG) yielded an AUC of 0.90. Another panel that included changes in hepatic fat content, total cholesterol (TC), miR15b-3p, TG, and depressive symptoms revealed an AUC of 0.89. These findings identify non-invasive biomarker panels including circulating miRNAs, inflammatory markers, depressive symptoms and other metabolic variables for predicting MASLD presence and emphasize the importance of precision nutrition in MASLD management and the sustained adherence to healthy lifestyle patterns.

Promoting Teachers’ Wellbeing Using a Compassionate Mind Training Intervention: Exploring Mechanisms of Change

Abstract Objectives The current study aimed to examine the mechanisms of change of a compassionate mind training intervention for teachers (CMT-T). In particular, we examined whether changes in the three flows of compassion, fears of compassion, and emotions at work (safe, drive, and threat) mediated the effects of the CMT-T in burnout, depression, anxiety, and stress, and in overall positive affect. Methods As part of a two-arm randomized controlled trial and a stepped-wedge design, the study included all participants who completed the 8-week CMT-T intervention either at Time 1 or at Time 2 (n = 103). At pre- and post-intervention, participants completed measures of compassion, fears of compassion, emotional climate in the workplace, burnout, psychopathological symptoms, and positive affect. Results Mediation analyses revealed that increases in the flows of compassion and reductions in fears of compassion from others mediated the effects of CMT-T on teachers' depression, anxiety, stress, and burnout levels. In the case of the reduction in stress symptoms from pre- to post-intervention, compassion for self, fears of self-compassion, and fears of receiving compassion from others emerged as significant mediators of this change. The three flows of compassion and fears of compassion (for self and from others) were significant mediators of the impact of CMT-T on changes in teachers’ anxiety levels from baseline to post-intervention. A decrease in fears of compassion from others and an increase in drive emotions mediated changes in depressive symptoms following CMT-T. Concerning burnout, all flows of compassion and fear of compassion from others mediated the changes from baseline to post-intervention. Changes in positive affect following CMT-T were mediated by increases in the flows of compassion, and emotions related to soothing-safeness and drive systems in the workplace. Serial mediational models showed that the effect of CMT-T on teachers’ burnout was partially mediated by reductions in fears of compassion (for self and from others) and stress. Conclusions CMT-T effectively improves teachers’ wellbeing and reduces burnout and psychological distress through the cultivation of their ability to experience, direct, and be open to compassion, and the strengthening of the soothing-safeness and the drive systems in the school context. Preregistration The study was registered at ClinicalTrials.gov: identifier, NCT05107323; Compassionate Schools: Feasibility and Effectiveness Study of a Compassionate Mind Training Program to Promote Teachers Wellbeing.

High-definition transcranial direct current stimulation (HD-tDCS) in major depressive disorder with anxious distress—a study protocol for a double-blinded randomized sham-controlled trial

BackgroundComorbid anxiety disorders and anxious distress are highly prevalent among individuals with major depressive disorder (MDD). The presence of the DSM-5 anxious distress specifier (ADS) has been associated with worse treatment outcomes and chronic disease course. Few studies have evaluated the therapeutic effects of High-definition transcranial direct current stimulation (HD-tDCS) on depressive and anxiety symptoms among MDD patients with ADS. The current randomized controlled trial aims to assess the efficacy of HD-tDCS as an augmentation therapy with antidepressants compared to sham-control in subjects of MDD with ADS.MethodsMDD patients with ADS will be recruited and randomly assigned to the active HD-tDCS or sham HD-tDCS group. In both groups, patients will receive the active or sham intervention in addition to their pre-existing antidepressant therapy, for 2 weeks with 5 sessions per week, each lasting 30 min. The primary outcome measures will be the change of depressive symptoms, clinical response, and the remission rate as measured with the 17-item Hamilton Depression Rating Scale (HDRS-17) before and after the intervention and at the 2nd and 6th week after the completed intervention. Secondary outcome measures include anxiety symptoms, cognitive symptoms, disability assessment, and adverse effects.DiscussionThe HD-tDCS applied in this trial may have treatment effects on MDD with ADS and have minimal side effects.Trial registrationThe trial protocol is registered with www.chictr.org.cn under protocol registration number ChiCTR2300071726. Registered 23 May 2023.

Neuronavigated Right Orbitofrontal 20 Hz Theta Burst Transcranial Magnetic Stimulation Augmentation for Obsessive-Compulsive Disorder with Comorbid Depression and Anxiety Disorders: An Open-Label Study.

Despite the availability of pharmacotherapy and psychotherapy for treating obsessive-compulsive disorder (OCD), alternative approaches need to be explored due to the high likelihood of treatment resistance. Neuronavigated 20 Hz theta burst stimulation (TBS-20 Hz), targeting the bilateral dorsolateral prefrontal cortex (DLPFC) augmented with the right orbitofrontal cortex (ROFC), was tested for treating OCD comorbid with depression and anxiety disorders. A retrospective chart review was performed on fourteen patients treated for moderate-to-severe OCD in a private outpatient clinic. Twelve patients had comorbid major depressive disorder (MDD), and thirteen patients had either generalized anxiety disorder (GAD) or panic disorder (PD). Patients completed the Y-BOCS-SR, BDI-II, and BAI rating scales weekly, which were used to measure the changes in OCD, depression, and anxiety symptoms, respectively. Neuronavigated TBS-20 Hz was sequentially applied to the right DLPFC (RDLPFC), left DLPFC (LDLPFC), and ROFC. A total of 64% (9/14) of patients achieved remission from OCD (Y-BOCS-SR ≤ 14) in an average of 6.1 weeks of treatment (SD = 4.0). A total of 58% (7/12) of patients remitted from MDD (BDI < 13) in an average of 4.1 weeks (SD = 2.8), and 62% (8/13) of patients remitted from GAD/PD (BAI < 8) in an average of 4.3 weeks (SD = 2.5). The neuronavigated TBS-20 Hz sequential stimulation of RDLPFC and LDLPFC, followed by ROFC, significantly reduced OCD, MDD, and GAD/PD symptoms. Randomized sham controls are warranted to validate these results.

Pentoxifylline as a Novel Add-on Therapy for Major Depressive Disorder in Adult Patients: A Randomized, Double-Blind, Placebo-Controlled Trial.

Evidence indicates an association between immune dysregulation and major depressive disorder (MDD). Pentoxifylline (PTX), a phosphodiesterase inhibitor, has been shown to reduce pro-inflammatory activities. The aim of this study was to evaluate changes in depressive symptoms and pro-inflammatory markers after administration of PTX as an adjunctive agent to citalopram in patients with MDD. One hundred patients were randomly assigned to either citalopram (20 mg/day) plus placebo (twice daily) (n=50) or citalopram (20 mg/day) plus PTX (400 mg) (twice daily) (n=50). The Hamilton Depression Rating Scale-17 (HAM-D-17) scores at baseline, weeks 2, 4, 6, 8, 10, and 12 and serum levels of interleukin1-β (IL-1-β), tumor necrosis factor-α, C-reactive protein, IL-6, serotonin, IL-10, and brain-derived neurotrophic factor (BDNF) at baseline and week 12 were evaluated. HAM-D-17 score in the PTX group significantly reduced in comparison to the control group after weeks 4, 6, 8,10, and 12 ((LSMD): - 2.193, p=0.021; - 2.597, p=0.036; - 2.916, p=0.019; - 4.336, p=0.005; and - 4.087, p=0.008, respectively). Patients who received PTX had a better response (83%) and remission rate (79%) compared to the placebo group (49% and 40%, p=0.006 and p=0.01, respectively). Moreover, the reduction in serum concentrations of pro-inflammatory factors and increase in serotonin and BDNF in the PTX group was significantly greater than in the placebo group (p<0.001). These findings support the safety and efficacy of PTX as an adjunctive antidepressant agent with anti-inflammatory effects in patients with MDD.

Bidirectional relationship between intraindividual changes in behavioral activation and intraindividual changes in postpartum depressive symptoms: A random intercept cross-lagged panel model.

According to Lewisohn's model of depression, decreases in behavioral activation (BA) occurring after facing a vital stressor may increase the risk of depression. Transition to parenthood is a potentially stressful life event that increases the risks of postpartum depression. We aimed to (a) describe the changes in BA and depressive symptomatology between the prepartum period, 1 month, 3 months, and 6 months postpartum and (b) evaluate the bidirectionality of the relationship between intraindividual changes in BA and intraindividual changes in depressive symptoms longitudinally. Chilean pregnant women (N = 503) completed a battery of questionnaires when they were between 32 and 37 weeks of gestation and 1, 3, and 6 months after delivery. A repeated measures analysis of variance showed that BA significantly decreased from prepartum to 1 month postpartum. A random intercept cross-lagged panel model supported the bidirectional inverse relationship between intraindividual changes in BA and intraindividual changes in depressive symptoms. The effect sizes of these associations were large (βs ranging from -.141 to -.243) according to Orth et al. (2022)'s recommendations for cross-lagged effect benchmarks. This relationship showed robustness when multigroup random intercept cross-lagged panel models were conducted to adjust for several covariates (i.e., marital status, the type of health insurance, type of delivery, primiparous vs. multiparous participants, and pregnancy or delivery complication or newborn health problem). Nonetheless, reporting a previous history of major depression moderated this relationship so that intraindividual decreases in BA more likely led to intraindividual increases in depressive symptoms in people with a history of depression than in people without such a history. We discuss implications for behavioral models of depression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Changes in depressive symptoms and antibody production following influenza vaccination in adolescents and adults

ObjectivePsychological distress has been associated with dampened antibody production following vaccination. Questions remain, however, about whether psychological distress influences vaccine response uniformly across the lifespan, and whether changes in distress result in changes in antibody production across the same period. MethodsParticipants (N = 148; Mage = 32.2 years, SD = 19.7, range = 12–80 years) took part in consecutive vaccine studies during the 2017–2018 and 2018–2019 influenza seasons. Each influenza season, they reported on their depressive symptoms, provided blood samples, and received the standard influenza vaccine. Participants then provided a second blood sample one month later. Antibody titers were examined pre- and post-vaccination. ResultsAnalyses examined both within-season and across-season effects of depressive symptoms, age, and their interaction on vaccine response. Within-season analyses revealed that age predicted antibody response during both seasons (2017–2018 and 2018–2019). Neither depressive symptoms nor the interaction with age were associated with antibody response to vaccination within either season. Across the two seasons, age significantly moderated the association between change in depressive symptoms and change in antibody production. For people who were 48 or older, increases in depressive symptoms across the two seasons were associated with a less robust response to the vaccine in the second season relative to the first season. For people younger than 48, changes in depressive symptoms were not significantly related to changes in antibody production. ConclusionsThese findings highlight the important role of mental health for older adults’ vaccine response, which could have clinical relevance for protection against disease.

Rumination in patients with major depressive disorder before and after antidepressant treatment

BackgroundRumination is a maladaptive response to distress characteristic of Major Depressive Disorder (MDD). It is unclear to what degree rumination is associated with depression severity prior to treatment and how it responds to antidepressant treatment. Therefore, we evaluated the association between rumination and depression severity in 92 untreated patients with MDD and explored the changes in rumination after initiation of antidepressant medication. MethodWe measured rumination using the Rumination Response Scale (RRS) and depression severity with the Hamilton Depression Rating Scale (HDRS17 or HDRS6) before and after initiation of 12 weeks of antidepressant treatment. The association between RRS and pre-treatment HDRS17 was evaluated using a linear regression model. RRS at week 4, 8, and 12 across treatment response categories (remission vs. non-response) were evaluated using a mixed effect model. ResultsRRS was positively associated with depression severity prior to treatment at a trend level (p = 0.06). After initiation of treatment RRS decreased significantly (p < 0.0001) and remitters exhibited lower rumination compared to non-responders at week 4 (p = 0.03), 8 (p = 0.01), and 12 (p = 0.007). LimitationsThe study had no placebo group. ConclusionsAlthough pre-treatment rumination did not significantly associate with depressive symptoms, rumination was closely connected to change in depressive symptoms. Tormented patients could be reassured that rumination symptoms may be alleviated over the course of antidepressant treatment.

Employ the 5H Model, Evaluate its Efficacy, And Illustrate the Change in Elderly Depression Levels and Symptoms

Introduction: Age-related disorders include mental health. This reduction in intergenerational cohesion and filial responsibilities has caused older people's dissatisfaction, sadness, and grief. Depression and dementia impair elderly people worldwide by taking away their independence and autonomy. Methodology: The authors use the experimental approach to implement the 5H model, evaluate its efficacy, and show the change in depression levels and symptoms in Quang Ngai's elderly. The author chose 26 senior persons from Truong Quang Trong Ward and 23 from Tinh Thien Village to engage in the intervention study. The semi-experimental study compared N=60 samples (Experimental Group=30 and Control Group=30). The elderly control group receives conventional therapy according to the local program, whereas the experimental group receives community intervention. The GDS-15 and ICD-10 examined the intervention's efficacy. Results: This study found that I mild depression had a significant change post-intervention; (ii) the mean score of depression through 2 assessments (GDS-15 scale and ICD-10 clinical assessment) both showed a significant reduction; (iii) females tended to change more than males; (iv) elderly aged 60-70 were easier to change than those over 80 years old; and (v) community-based psychosocial therapy had a significant impact on depression. Conclusion: Considering the aforementioned favourable results, the Quang Ngai city depression prevention intervention program for the elderly is practical and can reduce symptoms, severity, and reverse depression. Hence, the model is applicable across Quang Ngai City.

Interpersonal sensitivity predicts slower change and less change in anxiety symptoms in cognitive behavioural therapy.

Patients in cognitive behavioural therapy (CBT) who are high in interpersonal sensitivity may have difficulty fully engaging in treatment because therapy sessions require intimate interpersonal interactions that are especially uncomfortable for these individuals. The current study tests the hypotheses that patients who are high in interpersonal sensitivity benefit less from CBT for symptoms of depression and anxiety, show a slower rate of change in those symptoms, and are more likely to drop out of treatment. Participants were 832 outpatients who received naturalistic CBT. We assessed interpersonal sensitivity before treatment began and depression and anxiety symptoms at every therapy session. We assessed early, premature, and uncollaborative termination after treatment ended. We constructed multilevel linear regression models and logistic regression models to assess the effects of baseline interpersonal sensitivity on the treatment outcome, the slope of change in depression and anxiety symptoms, and each type of dropout. Higher baseline interpersonal sensitivity was associated with a slower rate of change and less overall change in anxiety but not depressive symptoms. Baseline interpersonal sensitivity was not a predictor of dropout. Interpersonal sensitivity at baseline predicts less change and a slower rate of change in anxiety symptoms. Early detection of elevated interpersonal sensitivity can help therapists take action to address these barriers to successful treatment and help scientists build decision support tools that accurately predict the trajectory of change in anxiety symptoms for these patients.

Cancer Care Supportive Text Messaging Program (Text4Hope) for People Living With Cancer and Their Caregivers During the COVID-19 Pandemic: Longitudinal Observational Study.

Cancer is the leading cause of death in Canada, and living with cancer generates psychological demands, including depression and anxiety among cancer survivors and caregivers. Text4Hope-Cancer Care SMS text messaging-based service was provided to people with cancer and caregivers during the COVID-19 pandemic to support their mental health. The aim of this study is to examine the clinical effectiveness of and satisfaction with Text4Hope-Cancer Care in addressing mental health conditions among people living with cancer and caregivers. The study was conducted in Alberta, Canada. People who were diagnosed or receiving cancer treatment and caregivers self-subscribed to receive 3-months daily supportive cognitive behavioral therapy-based SMS text messages and a web-based survey was sent at designated time points to collect clinical and nonclinical data. The Hospital Anxiety and Depression scale (HADS) was used to examine changes in anxiety and depression symptoms after receiving the service. Satisfaction with the service was assessed using a survey with a Likert scale. Descriptive and inferential statistics were used, and test significance was considered with P≤.05. Overall, 107 individuals subscribed to the service, and 93 completed the program (completion rate 93/107, 86.9%). A significant improvement in the anxiety symptoms (HADS-Anxiety [HADS-A] subscale) was reported after 3 months of Text4Hope-Cancer Care (t11=2.62; P=.02), with medium effect size (Hedges g=0.7), but not depression symptoms (HADS-Depression [HADS-D] subscale). Subscribers expressed high satisfaction and agreed that the service has helped them to cope with mental health symptoms and improve their quality of life. Most subscribers read the SMS text messages more than once (30/30, 100%); took time to reflect or took a beneficial action after reading the messages (27/30, 90%); and highly agreed (27/30, >80%) with the value of the received supportive SMS text messages as being relevant, succinct, affirmative, and positive. All subscribers recommended SMS text messaging for stress, anxiety, and depression and for cancer care support (30/30, 100%). Text4Hope-Cancer Care was well-perceived and effectively addressed anxiety symptoms among people living with cancer and caregivers during the peak of the COVID-19 pandemic. This study provides evidence-based support and insight for policy and stakeholders to implement similar convenient, economic, and accessible mental health services that support vulnerable populations during crises. RR2-10.2196/20240.

Improving mental health in chronic care in general practice: study protocol for a cluster-randomised controlled trial of the Healthy Mind intervention

BackgroundMental health issues are common among patients with chronic physical conditions, affecting approximately one in five patients. Poor mental health is associated with worse disease outcomes and increased mortality. Problem-solving therapy (PST) may be a suitable treatment for targeting poor mental health in these patients. This study protocol describes a randomised controlled trial of the Healthy Mind intervention, a general practice-based intervention offering PST to patients with type 2 diabetes and/or ischaemic heart disease and poor mental well-being.MethodsA stepped-wedge cluster-randomised controlled trial with 1-year follow-up will be conducted in Danish general practice. At the annual chronic care consultation, patients with type 2 diabetes and/or chronic ischaemic heart disease will be screened for poor mental well-being. Patients in the control group will be offered usual care while patients in the intervention group will be offered treatment with PST provided by general practitioners (GPs) or general practice staff, such as nurses, who will undergo a 2-day PST course before transitioning from the control to the intervention group. The primary outcome is change in depressive symptoms after 6 and 12 months. Secondary outcomes include change in mental well-being, anxiety, and diabetes distress (patients with type 2 diabetes) after 6 and 12 months as well as change in total cholesterol levels, low-density lipoprotein (LDL) levels, and blood glucose levels (patients with diabetes) after 12 months. Process outcomes include measures of implementation and mechanisms of impact. We aim to include a total of 188 patients, corresponding to approximately 14 average-sized general practices.DiscussionThe Healthy Mind trial investigates the impact of PST treatment for patients with chronic disease and poor mental well-being in general practice. This will be the first randomised controlled trial determining the effect of PST treatment for patients with chronic diseases in general practice. The results of this study will provide relevant insights to aid GPs, and general practice staff manage patients with poor mental well-being.Trial registrationClinicalTrials.gov NCT05611112. Registered on October 28, 2022.

Patterns of depression among women post-divorce and the influential factors: Latent growth modeling

ObjectivesThe purpose of this study is to longitudinally examine the change in depressive symptoms immediately following divorce among Korean women during the COVID-19 outbreak, as well as to verify the factors affecting the change in depressive symptoms. MethodsA total of 401 women from the Korean Longitudinal Survey of Women & Families(KLoWF) were analyzed between 2012(4th wave) and 2020(8th wave). Latent Growth Modeling is utilized to assess the overall trajectory of depressive symptoms in women following divorce. ResultsIn the immediate aftermath of divorce, the level of depressive symptoms in divorced women was high, but gradually decreased over time, only to reappear later on. The factors impacting the initial depressive symptom levels among women post-divorce revealed that lower educational attainment, lower subjective economic status, and poorer subjective health status were associated with higher depressive symptom levels. Among the factors influencing the rate of change in depressive symptoms, living alone emerged as the only statistically significant factor. The depressive symptom levels of women living alone declined gradually, whereas the depressive symptom levels of women living with someone decreased more rapidly. ConclusionAs a result of this study, valuable data can be used to develop practical interventions aimed at enhancing the mental well-being of women post-divorce, particularly during challenging circumstances such as the COVID-19 outbreak.

Cognitive and interpersonal moderators of two evidence-based depression prevention programs.

To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. Two hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive-behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy-Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent-adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention. After adjusting for multiple comparisons, rumination (B = -2.02, SE = .61, p = .001, d = .47), hopelessness (B = -2.03, SE = .72, p = .005, d = .41), and conflict with father (B = 1.68, SE = .74, p = .02, d = .32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. These exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. (PsycInfo Database Record (c) 2024 APA, all rights reserved).