Psychological intervention for postpartum depression: A systematic review and network meta-analysis.

Depression and anxiety are among the most prevalent mental health problems globally, with psychotherapy serving as a first-line treatment. Initial symptom severity, prior treatment history, waiting time, and session frequency may influence treatment effectiveness in routine care. We analyzed session-by-session data from clients receiving a seven-session cognitive-behavioral therapy (CBT) program for depression (N=2627) or anxiety (N=3929) in primary care. Symptoms were assessed using the PHQ-9 and GAD-7 at each session. The magnitude and rate of change were examined using pre-post comparisons and linear mixed models. Clients showed significant reductions in both depressive (mean change -4.45 PHQ-9 points, 95% CI -4.69, -4.22) and anxiety symptoms (mean change -4.36 GAD-7 points, 95% CI -4.54, -4.17). Higher initial symptom severity was associated with faster reductions, while prior psychiatric care or previous very long-term psychotherapy were associated with smaller pre-post gains. Waiting time and session frequency were not consistently related to outcomes. In routine CBT, clients with higher baseline severity benefited substantially, supporting equitable access to CBT regardless of initial symptom level. Clinical improvement was driven by the total number of attended treatment sessions rather than by the rate of attendance (i.e., the number of sessions per unit of time). This supports flexible scheduling without compromising outcomes. Longer waiting times did not systematically predict poorer results, suggesting that client- versus system-driven delays may have distinct implications. Considering prior treatment history may help tailor interventions for individuals with more persistent or treatment-resistant symptom patterns.

Poor sleep is common in people with multiple sclerosis (PwMS). Previous systematic reviews have evaluated intervention effectiveness to improve sleep in PwMS using questionnaires, but no review has comprehensively examined whether sleep interventions improve activity monitor measured sleep outcomes in PwMS. Adhering to the PRISMA guidelines, we searched PubMed, EMBASE, and PsycINFO databases to identify randomized controlled trials, quasi-experimental and cohort studies published from inception to October 2025. A random-effects model was used to estimate the pooled intervention effects of sleep interventions on objective sleep outcomes. Ten studies were included in the review for narrative synthesis, with five eligible for quantitative meta-analysis. Six sleep parameters were assessed via activity monitors: total sleep time, sleep efficiency, total time in bed, sleep onset latency, wake after sleep onset, and frequency of awakenings. Sleep interventions utilised included physical activity, mindfulness, cognitive behavioral therapy (CBT), melatonin, eszopiclone and transcranial direct current stimulation (tDCS). Only sleep efficiency improved following mindfulness interventions. The median length of actigraph wear time was 7 days (range 4 nights to 16 weeks). Study quality appraisal scores ranged from moderate to high, suggesting a low risk of bias. Activity monitors have been used to assess sleep intervention effectiveness in PwMS in studies assessing physical activity, mindfulness and CBT. Objective improvements in sleep were reported following mindfulness and only using one measure (sleep efficiency). However, the small number of included studies limits definitive conclusions. Future trials should consider a wider range of outcome measures and longer time horizons.

Tinnitus is a highly prevalent and challenging neurotologic condition affecting over 740 million individuals worldwide. Despite the growing number of studies, treatment approaches remain fragmented and inconsistent. This umbrella review aims to aggregate results from systematic review to comprehensively synthesize the available evidence. Following PRISMA guidelines, we systematically searched CINAHL, COCHRANE Library, PubMed, and Scopus through April 2025. Systematic reviews with meta-analyses of primary tinnitus interventions were included. Outcomes focused on validated measures of tinnitus severity, distress, loudness, and quality of life. Study quality was assessed using AMSTAR-2. A total of 44 systematic reviews were included, covering 7 intervention domains. Cognitive behavioral therapy (CBT), hearing aids, tinnitus retraining therapy (TRT), and sound/music therapy consistently improved tinnitus-related outcomes (eg, THI reductions up to -14.50, P < .001). Cochlear implantation yielded the largest effects (eg, THI -29.97) but is reserved for patients with moderate-to-profound sensorineural hearing loss who are not adequately helped by hearing aids. Neuromodulation and acupuncture showed modest or inconsistent benefits with high heterogeneity. This umbrella review provides the current and comprehensive analysis of tinnitus treatments. CBT, hearing aids, TRT, and sound/music therapy show consistent benefit. Cochlear implantation offers the greatest effect in patients with moderate-to-profound hearing loss unresponsive to hearing aids. Other therapies show mixed evidence. These findings offer a much-needed evidence framework to guide treatment decisions and future research.

The potential for synergistic effect of non-invasive brain stimulation and cognitive behavioural therapy for depressive and cognitive outcomes in major depressive disorder: A scoping review.

Cognitive-behavioural therapy (CBT) and mindfulness-based interventions (MBI) can reduce depressive symptoms and anxiety in people with multiple sclerosis (pwMS). Yet, psychotherapy remains underutilized by pwMS. To evaluate whether cognitive dysfunction is linked to psychotherapy use in pwMS. In a consecutive sample of 253 pwMS who received psychiatric treatment at a Canadian neuropsychiatry clinic, cognitive impairment (CI) was defined as scores >1.5 SD below normative data on >2 Minimal Assessment of Cognitive Function in MS tests. Prior psychiatric treatment use was stratified into medications alone, evidence-based psychotherapies (CBT or MBI), or supportive/unspecified psychotherapies. Covariates included age, sex, education, employment, Expanded Disability Status Scale (EDSS) scores, disease duration, subtype, disease-modifying therapy use, and Hospital Anxiety and Depression Scale scores. Multinomial logistic regression models were undertaken to evaluate the relationship between CI and prior psychiatric treatment use, adjusting for covariates. Mean age was 43.3 years, 73.5% were female, median EDSS was 2.0, 51.0% had CI, and 36.0% had received CBT or MBI. Controlling for confounding variables, CI was associated with reduced use of evidence-based psychotherapy (OR=0.34, 95%CI[0.15-0.79], p = 0.012), but not supportive/unspecified psychotherapy (OR=0.79, 95%CI[0.37-1.71], p = 0.55). Among pwMS, cognitive dysfunction is independently connected to decreased use of evidence-based psychotherapies.

Perinatal depression is more prevalent in low- and middle-income countries (LMICs) than in high-income countries, reflecting greater exposure to physical, psychosocial, and environmental adversities. It can have lasting consequences for the woman, her child, and wider family. Despite its high burden, access to appropriate mental health care for perinatal depression remains extremely limited in most LMICs. In this narrative review, we conducted a search of PubMed and Google Scholar from 2015 to 2024 (with the addition of other key articles based on authorship team consensus) for recent and policy-relevant systematic reviews, meta-analyses, key individual studies, and practice guidelines to provide an overview of identification, treatment, and prevention of perinatal depression in LMICs. Regarding identification, brief screening measures have been adapted and validated in LMICs, but there have been few studies testing the feasibility and effectiveness of screening programs. Cognitive behavioral therapy and interpersonal therapy have demonstrated effectiveness for perinatal depression in meta-analyses that include LMIC studies, particularly when adapted into brief, structured formats and delivered by nonspecialist providers through task-sharing models. Regarding prevention, evidence from a range of studies supports universal delivery of low-intensity psychosocial interventions during routine perinatal care and psychological interventions for women with elevated symptoms or known risk factors. Multiple barriers to implementation of effective perinatal depression interventions at scale in LMICs remain, including financial and human resource constraints, high service user to provider ratios, and underdeveloped referral pathways. Responses include delivery of interventions by peers rather than health workers and use of digital technologies.

Pain duration as a staging variable: A conceptual framework for testing depression-pathway interventions in dementia risk.

Efficacy of non-pharmacological therapies on depression, anxiety, and glycemic control in type 2 diabetes: A systematic review and network meta-analysis.

At least a third of U.S. adults with ADHD do not access recommended treatments (medication or cognitive behavioral therapy [CBT]), and those receiving treatment face barriers (e.g., inconsistent availability of medication). We investigated systemic inequities in CBT access for adults with ADHD versus psychiatric diagnoses with similar prevalence. We accessed and extracted publicly available listings from the Psychology Interjurisdictional Compact (PSYPACT) provider directory (N = 12,898) in April 2025. Only 26.4% of PSYPACT providers explicitly offer any services for adult ADHD. They were nearly three times more likely to treat adult depression (69.2%) and anxiety (74.0%). CBT for adult ADHD was offered by just 21.3% of providers. U.S. psychologists are chief CBT providers for adult mental disorders; however, they systemically underserve adults with ADHD. Contributors to this inequity must be identified to advance adult ADHD care, as untreated ADHD is a costly public health burden.

Parents of children with autism spectrum disorder (ASD) face emotional and practical challenges that affect their well-being and family dynamics. Given parents' crucial role in guiding their children, interventions focused on parental support have been developed. Although group-based programs are shown to be beneficial for stress management, reductions in mental health symptoms, and parental self-efficacy, existing programs do not integrate the various essential resilience-building components (e.g., Cognitive Behavioral Therapy, Applied Behavioral Approaches, self-compassion, emotion regulation, self and stress management, and mentalization), and have rarely been evaluated qualitatively from the parents' perspective. This Immersion/Crystallization qualitative thematic approach explores the experiences of parents participating in the P-PEARL program (Parent Psychological-Educational program for Autism: Resilience and Learning) and its perceived outcomes for themselves, their children, and families. We conducted semi-structured interviews with 20 parents who participated in the intervention, and analyzed them in an iterative process of reading and re-reading the interview transcripts, followed by vertical and horizontal analysis. The analysis revealed that through the intervention, parents learned the importance of self-compassion and of integrating stress-management practices into their lives. They enhanced their understanding of their child's perspective and needs, through mentalization, allowing them to better predict triggers and stressors and manage them better. They felt that the group process fostered a sense of community, emotional support from peers with the same lived experience, and reduced feelings of isolation. The study findings suggest that the P-PEARL program holds significant potential to enhance parental resilience, emotional regulation, and reflective functioning, contributing to the growing evidence base on parent-focused interventions that support family well-being in autism. • Qualitative study of a novel parent intervention for families of young children with ASD. • The P-PEARL program combines ACT, ABA, mentalization, and self-compassion practices. • Parents reported increased emotional regulation and understanding of their child’s needs. • Group format reduced parental isolation and fostered reflective, compassionate parenting. • Findings support resilience-building frameworks in autism-focused parental interventions.

Screening-to-intervention pathway for child anxiety problems alongside usual school practice versus usual school practice only (iCATSi2i): a cluster-randomised, controlled trial in primary schools in England.

Three-day intensive group cognitive behavioral therapy for social anxiety in Chinese college students: A randomized controlled trial with an exploratory analysis of underlying mechanisms.

Obsessive-compulsive disorder (OCD) is a profoundly heterogeneous condition, encompassing a wide spectrum of symptom presentations, from contamination fears to sexual obsessions, moral scrupulosity, and pathological doubt. While cognitive-behavioral therapy (CBT) incorporating exposure and response prevention (ERP) and challenging of dysfunctional obsessive beliefs remains the gold standard treatment, a growing body of literature has drawn attention to the limitations of traditional approaches. These include high drop-out rates, partial or nonresponse, and difficulty in addressing trauma-related or value-conflicted obsessional content through traditional fear-based exposure hierarchies. Continual refinement and innovation of psychotherapeutic approaches to OCD is therefore essential, not only for enhancing clinical efficacy, but also for increasing engagement, retention and meaning in therapy. This issue of Journal of Clinical Psychology: In Session brings together five in-depth clinical case studies, each exemplifying a distinct yet complementary advance in the treatment of OCD. Taken together, these cases provide a rich, practice-based insight into the diversity, complexity, and personalization of effective therapy, challenging us to expand our understanding of what constitutes successful treatment for OCD.

Multicomponent programs combining therapeutic exercise, cognitive-behavioral therapy, and pain neuroscience education demonstrate overall efficacy for fibromyalgia (FM). However, a substantial proportion of patients do not achieve clinically meaningful improvement. This study aimed to identify predictors of nonresponse and to develop a prognostic classifier model. Participants (n=788) from multiple randomized controlled trials received a standardized 12-week multicomponent intervention. This secondary analysis defined nonresponse as a <20% reduction in Fibromyalgia Impact Questionnaire Revised (FIQR) scores. A machine learning approach called least absolute shrinkage and selection operator (LASSO) regularization was used to train a classifier. Model performance was assessed by external validation in a holdout sample, with the area under the curve (AUC) and mean squared error as evaluation indices. Higher baseline anxiety (B=0.010), depression (B=0.007), kinesiophobia (B=0.005), and FM severity (B=-0.004), along with lower physical function (B=-0.014), younger age (B=-0.005), and lower body mass index (B=-0.010), were associated with nonresponse. The model demonstrated adequate classification accuracy out-of-sample (AUC=0.657; 95% CI: 0.586-0.728). A prototype calculator incorporating these predictors was developed. Psychological, functional, and demographic factors were linked to nonresponse to multicomponent treatment in FM. Although predictive accuracy was limited, these findings support further validation of stratification approaches to inform treatment planning.

Affect Regulation and Cardiac Rehabilitation: Common Strategies, Their Impact on Cardiovascular Health, and Opportunities for Intervention.

Internet-Based Cognitive Behavioral Therapy for Insomnia (ICBT-I) can be leveraged to facilitate access to CBT in oncology. Nevertheless, adherence to self-guided ICBT remains low (50%-60%). The Sleep-4-All-2.0 study combined an ICBT-I (Insomnet) with phone-based guidance provided by a CBT psychologist. This study assessed: (1) the performance of this combined approach in terms of adherence and insomnia remission rates, and (2) patients' characteristics associated with better or poorer outcomes. This real-world multicenter single-arm interventional study included patients with any tumor type and with an Insomnia Severity Index (ISI) score ≥ 8. Online questionnaires were used to compare adherence, insomnia remission, and sleep perception at weeks (W) 6, 12, and 24 post-intervention. Descriptive and multivariate analyses were performed. Among 348 consenting patients, 310 (89%) initiated Insomnet and completed baseline assessment (W0). Questionnaire completion rates among initiators were 85% (263/310) at W6, 71% (219/310) at W12, and 53% (164/310) at W24. Program adherence (≥ 5/6 modules completed by W12) was 74% (230/310). Insomnia remission rates were 34%, 46%, and 50%, and insomnia was no longer a problem for 48%, 63%, and 66% in W6, 12, and 24, respectively. Unemployed patients at baseline were more likely to show a decrease in ISI scores. Patients taking a sleep medication, with high sleepiness and fatigue scores at baseline and with fewer digital skills, seem to benefit less from the intervention. ICBT-I with phone-based guidance showed satisfactory rates of adherence and insomnia remission. Implementing the program effectively requires considering patients' profiles.

Access to cognitive behavioral therapy for insomnia (CBT-I) in children and adolescents is limited. Mobile health applications (MHAs) available in app stores may provide an accessible and scalable option for delivering CBT-I. This study systematically evaluated the quality of MHAs targeting insomnia in children and adolescents and examined their evidence base and treatment components. In November 2024, a systematic search of the Google Play and Apple App Stores was conducted to identify MHAs targeting insomnia in children and adolescents. MHAs were screened for eligibility in a two-level process: first based on app store descriptions, then after downloading the MHA. Eligible MHAs were independently evaluated using the German Mobile Application Rating Scale (MARS-G), which rates MHAs from 1 (inadequate) to 5 (excellent) across the subscales engagement, functionality, aesthetics, and information. Additionally, the featured treatment components and supporting scientific evidence were assessed. Of 2341 MHAs initially identified, eight MHA products met the inclusion criteria. The overall quality was moderate (mean=3.5, SD=0.4). Among the subscales, functionality was rated highest (mean=3.8, SD=0.6), followed by aesthetics (mean=3.6, SD=0.6), engagement (mean=3.3, SD=0.4), and information (mean=3.1, SD=0.8). Sleep hygiene was the most commonly featured treatment component (seven MHA products). While scientific evidence was identified for five MHA products, none specifically evaluated insomnia in the target population. Although many MHAs claim to target sleep in children and adolescents, few incorporate CBT-I components beyond sleep hygiene. The moderate quality and limited evidence base underscore the need for theory-driven, rigorously evaluated MHAs tailored to this age group.

Adaptations to cognitive behavioural therapy for autistic children and young people with anxiety: A systematic review

Can cognitive behavioral additions improve the efficacy of self-help mindfulness intervention for depression and anxiety ?: A randomized controlled trial.