Non-pharmacological Interventions For Depression Research Articles

Non-Pharmacological Interventions for Depression and Anxiety in Parkinson's Disease.

Non-Pharmacological Interventions for Depression and Anxiety in Parkinson's Disease.

Non-pharmacological interventions for depression in patients with heart failure: a systematic review

Non-pharmacological interventions for depression in patients with heart failure: a systematic review

Erratum to “Non-pharmacological interventions for depression among survivors of adverse childhood experiences: A meta-analysis” [J. Behav. Cogn. Therapy 31(4) (2021) 349–362

Erratum to “Non-pharmacological interventions for depression among survivors of adverse childhood experiences: A meta-analysis” [J. Behav. Cogn. Therapy 31(4) (2021) 349–362

Cognitive Changes in Older Adults Following a Stepped Care Intervention for Late-life Depression

ObjectivesVulnerable older adults, such as physically impaired or care-dependent individuals, are vastly underrepresented in psychotherapy research. Improving their inclusion in randomized controlled trials is necessary to determine the effectiveness of psychotherapy in this population. This study is the first to systematically evaluate strategies to recruit home-living vulnerable older adults with clinically significant depression into a large randomized controlled psychotherapy trial. Potential participants were approached directly (self-referral) or via cooperation with gatekeepers (gatekeeper-referral).MethodsThe initiator of the first contact with the study team and successful recruitment strategies were recorded. Referral strategies were compared with respect to number of inquiries and inclusion rates; study personnel’s time investment; and participant characteristics (sociodemographics, functional and cognitive status, depression and anxiety scores).ResultsMost of the N=197 participants were included via gatekeeper-referral (80.5%, 95%CI=[74.9%,86.1%], but time investment for gatekeeper-referrals was five times higher than for self-referral by media reports. Clinical psychologists and medical practitioners referred the largest proportion of participants (32.3% each) and referral by medical practitioners led to highest inclusion rates (55.6%; χ²(3)=8.964, p<.05). Most participants were referred from a hospital setting (50.3%), whereas referral numbers by medical practices were low (15.9%). Participants who initiated the first contact themselves had higher inclusion rates and were less functionally and cognitively impaired.ConclusionsIncluding home-living vulnerable older adults into psychotherapy trials requires simultaneous implementation of diverse recruitment strategies. Medical practitioners and psychologists, especially in hospitals, are the most effective recruitment strategy, but self-referral via media is most cost-efficient in terms of time investment.

Cognitive Changes in Older Adults Following a Stepped Care Intervention for Late-life Depression

Older adults with depression may manifest cognitive decline and treating depression may maintain or improve cognition. However, cognitive outcomes could be overlooked in non-pharmacological interventions for depression. This analysis investigated cognitive changes in a stepped-care intervention (Clinical Trial ID: NCT03593889) and the potential association with individual depressive symptom change. The community-dwelling older adults at risk of or with depressive symptoms without significant cognitive impairment (n=802) were assigned to intervention group (n=644) and control group (n=138). Depressive symptoms and cognitive functions were measured using Patient Health Questionnaire-9 and Cognitive Montreal Assessment-5 minutes protocol, respectively. Paired-t-Test showed significant improvements in overall cognition and attention in both intervention and control groups, but the improvements of language fluency (Intervention: MD=-0.51 p<0.01; control: MD=0.14, p=0.500) and orientation (Intervention: MD=-0.22 p<0.05; control: MD=-0.11, p=0.229) only displayed in intervention group. As control group had better cognition at baseline, linear mixed-effects model analysis was used to compare between-group difference. Intervention group had no significant cognitive improvement after adjusting the covariates but a potential improvement in language fluency (Coef. =0.442, SE=0.247, p=0.074). A linear regression analysis in intervention group indicated that reduction of concentration problem (β=0.106, p<0.05) and retardedness (β=0.117, p<0.01) under the symptomatology of depression were associated with the improvement of language fluency. In this group of older persons without significant cognitive impairment, there is no clear evidence of global cognitive benefits in a stepped care depression intervention, although there may be improvements in certain cognitive domains, which may be related to improvements in cognitive aspects of depression.

Utilization of healthcare and prescription medicines after non-pharmacological interventions for depression - A 3-year register follow-up of an RCT in primary care

Depression is a common, recurrent disorder. There is a need for readily available treatments with few negative side effects, that demands little resources and that are effective both in the short- and long term.Our aim was to investigate the long-term effectiveness of two different interventions; physical exercise and internet-based cognitive behavioural therapy (internet-CBT), compared to usual care in patients with mild to moderate depression in a Swedish primary care setting.We performed a register-based 3-year follow-up study of participants in the randomized controlled trial REGASSA (n = 940) using healthcare utilization and dispensed medicines as outcomes.We found no difference between the three groups regarding proportion of participants consulting healthcare due to mental illness or pain during follow-up. Regarding number of consultations, there was no difference between the groups, except for consultations related to pain. For this outcome both treatment arms had significantly fewer consultations compared to usual care, during year 2–3, the risk ratio (RR) for physical exercise and internet-CBT was 0.64 (95% CI = 0.43–0.95) and 0.61 (95% CI = 0.41–0.90), respectively.A significantly lower proportion of patients in both treatment arms were dispensed hypnotics and sedatives year 2–3 compared to the usual care arm, RR for both physical exercise and internet-CBT was 0.72 (95% CI = 0.53–0.98). No other differences between the groups were found.In conclusion, considering long-term effects, both physical exercise and internet-CBT, being resource-efficient treatments, could be considered as appropriate additions for patients with mild to moderate depression in primary care settings.Trial registration: The original RCT was registered with the German Clinical Trial Register (DRKS study ID: DRKS00008745).

Non-pharmacological interventions for depression among survivors of adverse childhood experiences: A meta-analysis

Adverse childhood experiences (ACEs) are associated with various mental health problems such as depression, anxiety, drug abuse, and suicide-related behaviors. Yet, it is largely unknown if non-pharmacological interventions are beneficial in improving mental health among ACEs survivors. The purposes of the current meta-analysis were to: (1) evaluate the efficacy of non-pharmacological interventions in reducing depressive symptom severity among those exposed to ACEs, and, (2) estimate the pooled effect size of these interventions. We searched PubMed, CINAHL, and PsycINFO for randomized controlled trials of psychological interventions for depression among ACEs survivors. Two reviewers independently extracted article data and evaluated the quality of studies using the Cochrane risk-of-bias criteria. We estimated the pooled effect sizes using a random-effects model. We also performed sensitivity tests using a meta-regression and sub-group analyses. Using the pooled data of 1624 individuals from 20 unique RCTs, we found that non-pharmacological intervention had a medium to large effect size in reducing depressive symptom severity compared to control conditions (Hedges’ g = 0.714, 95% CI [0.46, 0.97]). Such efficacy was sustained over the shorter-term follow-up (0 to 6 months; Hedges’ g = 0.23, 95% CI [0.04, 0.49]). Although there was an indication that the efficacy may be sustained in the longer term (12 months or more; Hedges’ g = 0.53, 95% CI: [−0.17, 1.22]), this finding was not statistically significant. Cognitive approaches had a larger effect size than noncognitive interventions. In conclusion, non-pharmacological interventions are efficacious options for treating depression among individuals with a history of adverse childhood experiences.

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.

Predictors of rapid high weight gain in schizophrenia: Longitudinal analysis of the French FACE-SZ cohort

Metabolic syndrome (MetS) is highly prevalent in schizophrenia. However very little is known about the time course of MetS and its components. The few longitudinal studies that have been carried out had small sample sizes and a short follow-up. The aim of our study was to evaluate the prevalence of MetS and its components, at baseline and one year later, and to investigate predictors of weight gain (WG) in a cohort of individuals with schizophrenia. We followed 167 schizophrenia patients from the FACE-SZ cohort for one year. The Structured Clinical Interview for DSM-IV (SCID) was used to confirm the diagnosis of schizophrenia. Data on socio-demographic and clinical characteristics, antipsychotic treatment, and comorbidities were collected, and a blood sample was drawn.We found that the prevalence of MetS increased from 21.0% to 26.6% after one year. Patients with baseline depressive symptoms had a 4.5-fold higher risk of WG at the one-year follow-up (p = 0.02) than those without depressive symptoms, after adjusting for confounding variables. WG also correlated with high levels of metabolic parameters and peripheral inflammation. These findings highlight the need to systematically diagnose depression in Schizophrenia. Future studies should determine whether specific pharmacological and non-pharmacological interventions for depression in SZ subjects are effective in preventing rapid high weight gain.

Treatment for depression following mild traumatic brain injury in adults: A meta-analysis

Primary objective: Development of depression after TBI is linked to poorer outcomes. The aim of this manuscript is to review evidence for the effectiveness of current treatments.Research design: Two meta-analyses were undertaken to examine the effectiveness of both pharmacological and non-pharmacological interventions for depression after mild TBIMethod and procedures: PubMed, Medline, PsychInfo, Web of Science and Digital Dissertations were searched and 13 studies located. Meta Analyst Beta 3.13 was used to conduct analyses of pre- vs post-effects then to examine treatment group vs control group effects.Main outcomes and results: Studies using a pre–post design produced an overall effect size of 1.89 (95% CI = 1.20–2.58, p < 0.001), suggesting that treatments were effective; however, the overall effect for controlled trials was 0.46 (95% CI = −0.44–1.36, p < 0.001), which favoured the control rather than treatment groups.Conclusions: This study highlights the need for additional large well-controlled trials of effective treatments for depression post-TBI.

Treatment of Depression After Coronary Artery Bypass Surgery

There has been little research on the treatment of depression after coronary artery bypass surgery. To test the efficacy of 2 nonpharmacological interventions for depression after coronary artery bypass surgery compared with usual care. A 12-week, randomized, single-blind clinical trial with outcome evaluations at 3, 6, and 9 months. Outpatient research clinic at Washington University School of Medicine, St Louis, Missouri. One hundred twenty-three patients who met the DSM-IV criteria for major or minor depression within 1 year after surgery. Twelve weeks of cognitive behavior therapy or supportive stress management. Approximately half of the participants were taking nonstudy antidepressant medications. Remission of depression, defined as a score of less than 7 on the 17-item Hamilton Rating Scale for Depression. Remission of depression occurred by 3 months in a higher proportion of patients in the cognitive behavior therapy (71%) and supportive stress-management (57%) arms than in the usual care group (33%) (chi(2)(2) = 12.22, P = .002). Covariate-adjusted Hamilton scores were lower in the cognitive behavior therapy (mean [standard error], 5.5 [1.0]) and the supportive stress-management (7.8 [1.0]) arms than in the usual care arm (10.7 [1.0]) at 3 months. The differences narrowed at 6 months, but the remission rates differed again at 9 months (73%, 57%, and 35%, respectively; chi(2)(2) = 12.02, P = .003). Cognitive behavior therapy was superior to usual care at most points on secondary measures of depression, anxiety, hopelessness, stress, and quality of life. Supportive stress management was superior to usual care only on some of the measures. Both cognitive behavior therapy and supportive stress management are efficacious for treating depression after coronary artery bypass surgery, relative to usual care. Cognitive behavior therapy had greater and more durable effects than supportive stress management on depression and several secondary psychological outcomes. clinicaltrials.gov Identifier: NCT00042198.

S2-04-03: Non-pharmacological interventions for depression and anxiety

Abstract not available.