Reduction In Depression Scores Research Articles

Integrative Community Therapy - interventive strategies in the reduction of depression symptoms in adolescents: A quasi-experimental study.

This study aimed to evaluate the effects of Integrative Community Therapy on depression symptoms in adolescents in the school context. This is a quantitative, quasi-experimental, pre-, and post-test study that compared depression scores before and after the Integrative Community Therapy intervention was applied, conducted with 56 adolescent students. The guidelines recommended by the Standards for Quality Improvement Reporting Excellence were used to present this study. The instruments used for data collection were the following: Participants' characterization, Economic Classification, and the Children's Depression Inventory. This depression inventory was applied before and after the intervention was carried out. Most of the participants presented depressive symptoms (53.6%). Girls presented higher depression scores and were more likely to develop depression; to be working proved to be a protective factor for depression and adolescents with depression symptoms presented a higher proportion of suicidal ideation. The analysis of the depression variable indicated a reduction of the scores in the post-intervention period; however, in the gender analysis, there was a reduction in the depression scores only for the girls. The Integrative Community Therapy was an effective intervention in reducing depression scores, being a relevant strategy for healthcare services and schools in assisting adolescents to deal with their emotions, mitigate psycho-emotional suffering, and contribute as a support tool in the context of vulnerabilities inherent to the process of becoming an adolescent.

Integrating a problem-solving intervention with routine care to improve psychosocial functioning among mothers of children with sickle cell disease: A randomized controlled trial.

ObjectiveTo assess the feasibility of a problem-solving skills training intervention in improving psychological outcomes in mothers of infants with sickle cell disease (SCD).Design and methodsThis parallel randomized controlled trial recruited 64 babies with SCD, 6 to 12 months of age, and their mothers. Baseline measurements assessed mothers’ coping and problem-solving skills, depression, and parental stress before random assignment to intervention or control groups (n = 32 each). Problem-solving skills intervention was delivered through 6 monthly sessions, when babies attended for routine penicillin prophylaxis. All measurements were repeated for both groups at the end of the intervention period. Intention to treat analysis used repeated measures mixed models with the restricted estimation maximum likelihood approach.ResultsThe problem-solving intervention had no significant effect on mothers’ problem-solving skills (adjusted treatment effect: -1.69 points (95% CI:-5.62 to 2.25)), coping behaviours (adjusted treatment effect: 0.65 points (95% CI:- -7.13 to 8.41)) or depressive symptoms (adjusted treatment effect: -0.41 (95% CI: -6.00 to 5.19)). It reduced mothers’ level of difficulty in managing stressful events by 9.5 points (95% CI (-16.86 to -2.16); effect size: 0.21 SD). In the subgroup of mothers at risk of depression (n = 31 at baseline), the intervention reduced depression scores with treatment effect of 10.4 points (95%CI: -18.83 to -1.88; effect size: 0.67 SD).ConclusionThis problem-solving skills intervention study suggests feasibility and possible efficacy in improving some maternal outcomes. Further refinement and culturally appropriate adaptations of the intervention could lead to stronger effects.

Cochrane in CORR®: Psychological Interventions to Foster Resilience in Healthcare Professionals.

Cochrane in CORR®: Psychological Interventions to Foster Resilience in Healthcare Professionals.

089 Impact of A Single Sleep Education Session on Beliefs and Attitudes Among People with Excessive Daytime Sleepiness: A Pilot Study

Abstract Introduction Excessive daytime sleepiness is associated with adverse health outcomes and substantial functional deficits. However, little is known about experiences among these individuals and whether some education about sleep health would be helpful. Methods N=28 participants with excessive daytime sleepiness (ESS>=10) but no other major medical problems were recruited from the community. The intervention was a single 2-hour sleep education workshop. Participants were randomized to either the education session or a wait-list control. Change from baseline on Epworth Sleepiness Scale (ESS), Dysfunctional Beliefs About Sleep (DBAS) scale, Fatigue Severity Scale (FSS), Insomnia Severity Index (ISI),pHQ9 depression scale, and GAD7 anxiety scale were evaluated versus controls, adjusted for age, sex, and race/ethnicity. Also,participants were asked whether they agree to a range of beliefs/attitudes about sleep before and after the session (as part of intervention or following wait list). Posttest-Pretest difference scores were compared to determine if any were changed by the session (nominal significance p<0.05). Results Compared to the wait-list control, those who received the education session did not show differences in sleepiness (4.2% reduction,p=0.73) or dysfunctional beliefs about sleep (52.1% reduction,p=0.07), but they did demonstrate a 26.5% reduction in fatigue (p=0.01), a 55.2% reduction in insomnia severity (p=0.004), a 59.1% reduction in depression score (p=0.02), and a 54.5% reduction in anxiety score (p=0.04). The single session resulted in increased agreement with the statements, “People with daytime sleepiness should discuss their problems with their doctor or health care provider” (t=-2.3,p=0.03), “I understand the basics of how sleep works” (t=-2.2,p=0.04), “I understand the basics of how sleepiness works” (t=-2.7,p=0.01), “Excessive daytime sleepiness is something that can be improved with psychological treatment” (t=-2.3,p=0.03), and “I know what to do if…” “I have trouble falling asleep” (t=-4.3,p=0.0003), “I have trouble with poor quality sleep” (t=-5.1,p=0.0001), and “I experience daytime sleepiness” (t=-3.0,p=0.007). Conclusion A brief sleep health education session improved sleep and mental health in individuals with daytime sleepiness, even if it did not improve sleepiness. Further, the session did likely provide useful educational information. Support (if any) This work was supported by Jazz Pharmaceuticals

Improvement in psychological wellbeing among adolescents with a substance use disorder attending an outpatient treatment programme.

Adolescents with substance use disorders (SUDs) exhibit high rates of comorbid psychological problems. This study aimed to examine the impact of an outpatient substance use treatment programme upon the psychological wellbeing of adolescents. A prospective study was carried out examining psychological symptoms in a group of adolescents attending the Youth Drug and Alcohol (YoDA) Addiction Service in Dublin. Participants were treated with evidenced based psychological models such as cognitive behavioural therapy, motivational interviewing and systemic family therapy. The Becks Youth Inventory was utilised to assess psychological symptoms at treatment entry and repeated three months later at follow up. Among 36 adolescents who were included in this study, poly-substance misuse was the norm. Almost three-quarter had a cannabis use disorder (CUD). There were significant reductions in mean subscale scores of depression (56.0 to 50.8, p = 0.003), anger (55.2 to 49.5, p < 0.001) and disruptive behaviour (61.6 to 56.5, p = 0.002) at follow up. Although there wasn't a statistically significant reduction in mean scores for anxiety, we observed a significant proportion of participants (p = 0.008) improving and moving out of a moderate to severe symptom range when examined by category. This was also the case for self-concept (p = 0.04). Furthermore this study revealed a positive correlation between the reduction in days of cannabis use and reduction in depressive scores (Pearson correlation 0.49, p = 0.01) among those with a CUD. The findings indicate that substance use treatment for adolescents is associated with important psychological and behavioural improvements.

A comparison of group art therapy in decreasing the depression level of leukemia pediatric patients

IntroductionCancer and its treatment often impose physical and psychological consequences. Children with cancer are not only at a risk of adverse events resulting from medical procedures but also severe effects on their social and mental health as a result of its treatment. Depression being one of the most common psychiatric disorders associated with cancer in children and adolescents. The current study aims to provide evidence of an easy and inexpensive intervention that can be used in oncology patients in a low resource setting to help maintain mental health stability in pedriatric patients..ObjectivesTo examine the effectiveness of therapeutic group art therapy, in reducing depression scores in children with cancer.MethodsThe study is quasi experimental, through convinient sampling data of fifteen children in initial stage of thier treatment were selected. They were divided into two groups experimental and controlled through random allocation. Three sessions of forty minutes of group art therapy was given in experimental group, in control normal treatment was provided excluding group art therapy. Childhood Depression Scale (CDI) was used in both group as pre and post test to determine the depression level.ResultsThe results shows a positive change in the level of depression in experimental group as compared to controlled group.ConclusionsGroup art therapy is an effective and inexpensive way of reducing depression level of paediatric leukemia patients that can be used by oncology healthcare centres worldwide with trained mental healthcare professionals in order to maintain positive treatment results of cancer.

Isotretinoin Use and Risk of Depression in Acne Vulgaris Patients in Riyadh, Saudi Arabia.

BackgroundThe association between isotretinoin administration and depression in acne patients remains controversial. We aim to estimate the prevalence of depression among patients with acne vulgaris before and after treatment with isotretinoin in Riyadh, Saudi Arabia.MethodsThis was a prospective study on patients attending the King Khalid University Hospital (KKUH), a tertiary institution, who were prescribed isotretinoin for the treatment of acne vulgaris for the first time. The Beck Depression Inventory (BDI) was used to screen for depressive symptoms. ResultsA total of 179 patients were included in the study. The patients were then divided into two groups based on the treatment modality that they received: one group taking isotretinoin and the other treatment group who used other medications, including Retin-A (tretinoin) and Tazorac (tazarotene). A total of 119 patients were in the isotretinoin group with 91.6%, 2.5%, 1.7%, and 3.4% of those patients having a normal mood, mild depression, moderate depression, and severe depression scores before starting isotretinoin treatment, respectively. After three months of treatment, 94.1%, 1.7%, 0.8%, and 2.5% of patients had normal mood, mild depression, moderate depression, and severe depression, respectively. Meanwhile, after six months of treatment, 95.8%, 0.8%, 0%, and 1.7% of patients had normal mood, mild depression, moderate depression, and severe depression, respectively. The mean BDI score at the baseline was 3.31 ± 6.98 for isotretinoin and 3.17 ± 6.27 for other treatments. Compared to the baseline, patients using the isotretinoin showed a significant reduction in depression scores at three months (2.64 ± 6.17; p-value < 0.001), six months (1.99 ± 5.08; p-value < 0.001), and across all follow-up points (p-value < 0.001). Similar results were also estimated for the other treatment group, including Retin-A (tretinoin), adapalene, benzoyl peroxide, and doxycycline; however, no significant difference was noticed between the two groups (p-value = 0.885).ConclusionIsotretinoin treatment for acne does not appear to be associated with a statistically significant increased risk of depression in our population. Therefore, more studies are needed to understand this reflection in Saudi Arabia.

Effects of Saffron Extract Supplementation on Mood, Well-Being, and Response to a Psychosocial Stressor in Healthy Adults: A Randomized, Double-Blind, Parallel Group, Clinical Trial.

Anxiety, stress, and low mood are closely related and may contribute to depressive symptoms. Among non-pharmacological solutions to improve subclinical mood symptoms and resilience to stress, natural products such as saffron—identified as promising following preliminary beneficial effects in major depressive disorder—represent a relevant strategy. This study aimed to assess the efficacy of 8 weeks' supplementation with 30 mg standardized saffron extract on emotional well-being in healthy adults with subclinical feelings of low mood and anxiety and/or stress and evaluate the acute effect of saffron in response to a lab-based psychosocial stressor. The study adopted a double-blind, randomized, parallel groups design in which 56 healthy male and female individuals (18–54 years) received either a saffron extract or a placebo for 8 weeks. Chronic effects of saffron on subjective anxiety, stress, and depressive feelings were assessed using a questionnaire battery [including Profile of Mood State-2, (POMS)] and acute effects in response to a lab-based psychosocial stressor were measured through psychological and physiological parameters. Urinary crocetin levels were quantified. Participants who received the saffron extract reported reduced depression scores and improved social relationships at the end of the study. Urinary crocetin levels increased significantly with saffron supplementation and were correlated with change in depression scores. The typical stress-induced decrease in heart rate variability (HRV) during exposure to the stressor was attenuated following acute saffron intake. Saffron extract appears to improve subclinical depressive symptoms in healthy individuals and may contribute to increased resilience against the development of stress-related psychiatric disorders.Clinical trials number: NCT03639831.

Novel treatment of opioid use disorder using ibogaine and iboga in two adults

AbstractIbogaine is a naturally occurring psychedelic medicine with anti-addictive properties. While research on ibogaine is limited, several observational studies have shown ibogaine can mitigate opioid withdrawal, as seen with reductions in clinical and subjective opioid withdrawal scores and reduced drug use severity (Noller, Frampton, &amp; Yazar-Klosinski, 2018; Brown &amp; Alper 2018). Furthermore, the psychoactive experience may help individuals to realign their values, purpose and sense of connection, as seen with post treatment reductions in depression scores (Noller et al., 2018; Mash et al., 2000).Case seriesThis case series describes two cases of individuals accessing ibogaine through private unregulated clinics in the Vancouver area to treat their opioid use disorder.ConclusionsIn case 1, the client achieved total abstinence from all opioids within 5–6 days of starting ibogaine treatment, did not experience any opioid withdrawal symptoms after ibogaine treatment and maintained abstinence from opioids for 3 years. In case 2, the patient took ibogaine/iboga in multiple treatments over a short period of time (&lt;4 months). The patient stopped all non-medical opioids after the first iboga treatment and then used ibogaine to aid with further dose reductions of her opioid agonist therapy (OAT) and has maintained abstinence from opioids for 2 years. Ibogaine offers a unique and novel therapeutic approach to treating opioid use disorder. Further studies are needed to establish the safety, risks and potential role for ibogaine as a mainstream, evidence-based addiction treatment.

Comparison of Efficacy in Depression and Stigma Reduction in Virtual In-Office Psychiatric Encounters with Virtual Out-of-Office Psychiatric Encounters among Adults in Louisiana

The primary purpose of this study was to conduct a clinical trial to compare the provision of psychiatric evaluation and medication interventions in a Virtual Out of Office format (VOO) with the provision of psychiatric evaluation and medication interventions in a Virtual in-Office psychiatric encounter (VIO) among adults in Louisiana seeking psychiatric services for the treatment of depression. This study was classified as a pretest-posttest control group noninferiority double-blind experimental design. Each patient took a self-rated instrument at baseline and at week 8. The study tested the two interventions (VOO and VIO) by way of changes in overall function, changes in perceptions of stigma, and changes in rates of presentism. The final sample was 150 total number randomly assigned and 120 eligible participants providing usable data with 75 participants in VIO treatment group and 45 participants in VOO treatment group. The Virtual-Out-of-Office (VOO) treatment level was more effective in reducing the perceived Stigma associated with receiving psychiatric treatment than for the Virtual-in- Office (VIO) treatment. The VOO group had a significant reduction in the overall Stigma score (pre-test mean=1.97, post-test mean=1.52, t=2.629, df=24, p=0.015) and the Stigma-Intrinsic sub-scale score (pre-test mean=2.02, posttest mean=1.46, t=2.697, df=24, p=0.013) in the study. The VIO group showed no significant difference in any of the Stigma scores between pre-test and post-test measurements. The Virtual-Out-of-Office (VOO) treatment level was more efficacious in treating Depression associated with receiving psychiatric treatment than for the Virtual-in- Office (VIO) treatment group. The VOO group had a significant reduction in the Depression score (pre-test mean=3.05, post-test mean=1.71, t=5.406, df=24, p ≤ 0.001) in the study. Although the VIO group showed a significant reduction in the Depression score (pre-test mean=2.89, post-test mean=2.32, t=3.265, df=46, p=0.002), the VOO group showed a substantially greater reduction in Depression scores. Both treatment groups were effective in reducing depression which is consistent with literature and the practice of treating depression.

The ASHA (Hope) Project: Testing an Integrated Depression Treatment and Economic Strengthening Intervention in Rural Bangladesh: A Pilot Randomized Controlled Trial.

Depression, a debilitating disorder, is highly prevalent among low-income women in low- and middle-income countries. Standard psychotherapeutic approaches may be helpful, but low treatment uptake, low retention, and transient treatment effects reduce the benefit of therapy. This pilot randomized controlled trial examined the effectiveness and feasibility of an integrated depression treatment/economic strengthening intervention. The study took place in two villages in the Sirajganj district in rural Bangladesh. Forty-eight low-income women with depressive symptoms (Patient Health Questionnaire (PHQ-9) score ≥ 10) were recruited and randomized to intervention or control arms. The intervention included a six-month group-based, fortnightly depression management and financial literacy intervention, which was followed by a cash-transfer of $186 (equivalent to the cost of two goats) at 12 months’ follow-up. The cash transfer could be used to purchase a productive asset (e.g., agricultural animals). The control arm received no intervention. Findings showed significant reduction in depression scores in the intervention group. The mean PHQ-9 score decreased from 14.5 to 5.5 (B ± SE, −9.2 ± 0.8 95% CI −10.9, −7.5, p < 0.01) compared to no change in the control group. Most other psycho-social outcomes, including tension, self-esteem, hope, social-support, and participation in household economic decision-making, also improved with intervention. An integrated depression treatment and financial empowerment intervention was found to be highly effective among rural low-income women with depression. Next steps involve formal testing of the model in a larger trial.

The Effects of a Saffron Extract (affron®) on Menopausal Symptoms in Women during Perimenopause: A Randomised, Double-Blind, Placebo-Controlled Study.

ObjectivesThere is preliminary evidence suggesting saffron may effectively treat menopausal symptoms. The aim of this study was to examine the tolerability and efficacy of a standardised saffron extract (affron®) on menopausal complaints in perimenopausal women.MethodsIn this 12-week, parallel-group, double-blind, randomised controlled trial, 86 perimenopausal women experiencing menopausal complaints received either a placebo or 14 mg of a saffron extract (affron®), twice daily. Outcome measures included the Greene Climacteric Scale (GCS), Positive and Negative Affect Schedule (PANAS), and Short Form-36 Health Survey (SF-36).ResultsBased on data collected from 82 participants, saffron was associated with greater improvements in mood and psychological symptoms compared to the placebo. Results from the GCS revealed a significantly greater reduction in the GCS psychological score (P = 0.032), characterised by a 33% reduction in anxiety and a 32% reduction in depression scores from baseline to week 12. There was also a significantly greater reduction in the PANAS negative affect score (P = 0.043) compared to the placebo. However, compared to the placebo, saffron was not associated with greater improvements in vasomotor symptoms, somatic symptoms, or other quality of life measures. Saffron intake was well tolerated with no reported major adverse events.ConclusionsThe saffron extract, affron®, administered for 12 weeks at a dose of 14 mg twice daily was associated with greater improvements in psychological symptoms. Further studies in perimenopausal women presenting with varying severity of menopausal symptoms, using different doses of saffron will be useful to examine in future clinical trials.

Fuzzy-set qualitative comparative analysis of implementation outcomes in an integrated mental healthcare trial in South Africa

ABSTRACT Background Integrating mental health services into primary healthcare platforms is an established health systems strategy in low-to-middle-income countries. In South Africa, this was pursued through the Programme for Improving Mental Health Care (PRIME), a multi-country initiative that relied on task-sharing as a principle implementation strategy. Towards better describing the implementation processes, qualitative comparative analysis was adopted to explore causal pathways in the intervention. Objective This study aimed to explore factors that could have influenced key outcomes of an integrated mental healthcare intervention in South Africa. Methods Drawing from an embedded multiple case study design, the analysis used qualitative comparative analysis. Focusing on nine PHC clinics in the Dr Kenneth Kaunda District as cases, with depression reduction scores set as outcome measures, trial data variables were modelled in a hypothetical causal process. A fuzzy-set qualitative comparative analysis was performed by 1) developing the research questions, 2) developing the fuzzy set, 3) testing necessity and 4) testing sufficiency. These steps were undertaken collaboratively among the research team. Results The data were calibrated during several meetings among team members to gain a degree of consensus. Necessity analyses suggested that none of the causal conditions exceeded the threshold of necessity and triviality, and confirmed the inclusion of relevant variables in line with the proposed models. Sufficiency analyses produced two configurations, which were subjected to standard and specific analyses. Ultimately, the results suggested that none of the causal conditions were necessary for a reduction in depression scores to occur, while programme fidelity was identified as a sufficient condition for a reduction in scores to occur. Conclusions The study highlights the importance of understanding implementation pathways to enable better integration of mental health services within primary healthcare in low-to-middle-income settings. It underlines the importance of programme fidelity in achieving the goals of implementation.

'It makes life worthwhile!' Peer mentoring in long-term care—a feasibility study

Objectives: Loneliness and depression are of increasing concern in long-term care homes made more urgent by viral outbreak isolation protocols. An innovative program called Java Mentorship was developed that engaged community volunteers and resident volunteers (mentors) as a team. The team met weekly, received education, and provided visits and guidance in pairs to socially disengaged residents (mentees). The purpose of this study was to assess the feasibility of conducting a larger study. Method: We conducted a mixed-methods pre-post study to evaluate the program. We collected feasibility data associated with the program implementation, including assessment of the sample and ability to recruit; procedures for data collection; retention, program adherence and acceptability; and residents’ responses including loneliness, depression, purpose in life, social identity and sense of belonging outcomes. We enrolled community mentors (n = 65), resident mentors (n = 48) staff facilitators (n = 24) and mentees (n = 74) in 10 Canadian sites. Results: Most feasibility objectives were met, and adherence and acceptability were high. Some resource challenges and low retention rates among resident mentors were noted. We found a 29% reduction in depression scores (p = .048; d = .30) and 15% reduction in loneliness scores (p = .014; d = .23). Purpose in life, social identity and sense of belonging were unchanged. Interviews among participants indicated high acceptability and positive perceptions of the program. Conclusion: The study findings reveal a potential role for mentorship as a viable approach to reducing loneliness and depression in long-term care settings and lay the groundwork for future research.

Effectiveness of a brief psychoeducational intervention on postnatal depression in the slums, Nairobi: a longitudinal study.

Research has shown that postnatal depression (PND) is higher in low- and middle-income countries as compared to higher-income countries. Despite this, little is known about practical interventions in these poorly resourced countries. This research investigated the effectiveness of a brief, prophylactic and therapeutic psychoeducational intervention in a low-resourced community in Nairobi. Two closely similar Maternal and Child Health (MCH) clinics in urban slums in Nairobi were identified and randomly selected. A total of 567 mothers formed the study population. The experimental group (284) mothers received the intervention, which included psychoeducation on PND, coping skills, healthy way of mother/child interaction and infant stimulation in addition to routine treatment, while the control group (283) mothers received treatment as usual. Data was collected using a social-demographic questionnaire and the English version of Becks Depression Inventory (BDI) at baseline. At 6months, we reassessed both groups using BDI only. Within group comparison, the percentage reduction of depression was 35.6% among the experimental as compared to 2.3% in the control group. Between group comparison, the mean BDI depression score was significantly low in the experimental arm compared to the control arm at endline (p = 0.025). When all variables were adjusted, using a generalized linear model, BDI depression score reduction among the participants was significantly associated with the intervention (p = 0.040). A brief, psychoeducational intervention that targets the mother and her infant may reduce PND even in poorly resourced environments. Therefore, it can be integrated into existing MCH services.

Effect of continuous positive airway pressure on symptoms of anxiety and depression in patients with obstructive sleep apnea

PurposeThe objective was to assess the effect of continuous positive airway pressure (CPAP) on symptoms of anxiety and depression in patients with obstructive sleep apnea (OSA). We hypothesized a decrease in symptoms at follow-up, but that improvement relied on CPAP adherence.MethodsThe sample comprised 468 patients (mean age 55.5 years (SD = 12.0), 72% men) with OSA who received CPAP at a Norwegian hospital. OSA was diagnosed according to standard respiratory polygraphy. Mean baseline respiratory event index (REI) was 28.4 (SD = 20.6). Symptoms of anxiety and depression were assessed prior to CPAP treatment and at follow-up after a median of 20 weeks, range 6–52 weeks, with the Hospital Anxiety and Depression Scale (HADS). Patients were classified as CPAP adherent (≥ 4 h per night) or non-adherent (< 4 h per night).ResultsThere was a significant decrease in anxiety scores from baseline (mean = 5.16, SD = 3.94) to follow-up (mean = 4.76, SD = 3.81), p < 0.001. Similarly, depression scores decreased from baseline (mean = 4.31, SD = 3.66) to follow-up (mean = 3.89, SD = 3.69), p < 0.001. Cohen’s d (0.19 and 0.18, respectively) indicated small effect sizes. The reduction in anxiety scores did not depend on CPAP adherence (no interaction effect F(1, 466) = 0.422, p = 0.516), whereas the reduction in depression scores were seen only in the CPAP adherent group (interaction effect F(1, 466) = 7.738, p = 0.006).ConclusionsWe found a decrease in symptoms of anxiety and depression from baseline to follow-up of CPAP treatment. The improvement in symptoms of depression was depending on CPAP adherence. This underlines the importance of adherence for optimal effect of CPAP treatment.

Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Depression in Adolescence: A Systematic Review

BackgroundThere is evidence that repetitive transcranial magnetic stimulation (rTMS) is effective for treating adult depression. However, it remains unclear whether rTMS is an effective treatment for adolescent depression. This systematic review examines the existing literature on the effectiveness and acceptability of rTMS in the treatment of adolescent depression. MethodsAfter protocol registration (PROSPERO), we searched PubMed, Embase, PsycINFO, WoS and CENTRAL databases and the grey literature. We included studies that used rTMS in adolescents aged 12–25 years old who had a clinical diagnosis of depression. Study quality was assessed using the Newcastle-Ottawa Scale. ResultsFourteen studies were identified, which included 8 open-trial studies (N = 142 participants) and six studies which performed further post-hoc/follow-up analyses on these open-trial datasets. All studies suffered from multiple biases but reported that rTMS treatment reduced depression scores in adolescents. A single study on theta burst stimulation also found a positive effect. No study to date includes a sham control. Reported side effects of rTMS included scalp pain, headache and dizziness. LimitationsStudy methodologies precluded a meta-analysis. ConclusionsThe current literature signals that rTMS could reduce adolescent depressive symptoms. However, sham controlled randomized trials are needed. These findings suggest that rTMS may be a promising treatment option for adolescents with depression.

Efektifitas Musik Nature sounds dan Dzikir Terhadap Penurunan Tingkat Depresi Pasien Kanker Payudara

Depression is one of the psychological responses experienced by breast cancer patients. One of the actions to reduce the psychological impact of breast cancer patients is with music therapy. Music effects can calm the soul, provide comfort, calm, so that arises a sense of enthusiasm and positive thoughts. The music used in this study is nature sounds. This music is very close to the environment and each individual recognizes the sounds of nature so that it is more easily and efficiently applied. Natural sound music with a combination of dzikir can be used as an alternative therapy to improve the mental status of breast cancer patients who experience depression. This study aims to determine the effect of combination therapy of nature sound and dhikr on the level of depression in breast cancer patients. The method used in this study is a quasi-experimental approach with a pre-equivalent non-equivalent without control group approach, to see differences in the average level of depression before and after giving a combination of music therapy and dhikr. Giving music therapy is given with a rhythm of 60-80 bpm, stable, low frequency and relaxing melody has been done 2 times a week. The data was processed with SPSS statistical software version 20.0 with normality test and paired t test. The results showed that the majority of patients aged 36-45 years (46.7%) and undergoing 3rd cycle chemotherapy (33.3%). Natural sound music therapy and dzikir significant to reduce depression scores with p value = 0.001. In conclusion, this study proves that nature sounds music therapy effectively to reduce depression scores in breast cancer patients

Effectiveness of an 8-Week Web-Based Mindfulness Virtual Community Intervention for University Students on Symptoms of Stress, Anxiety, and Depression: Randomized Controlled Trial.

BackgroundA student mental health crisis is increasingly acknowledged and will only intensify with the COVID-19 crisis. Given accessibility of methods with demonstrated efficacy in reducing depression and anxiety (eg, mindfulness meditation and cognitive behavioral therapy [CBT]) and limitations imposed by geographic obstructions and localized expertise, web-based alternatives have become vehicles for scaled-up delivery of benefits at modest cost. Mindfulness Virtual Community (MVC), a web-based program informed by CBT constructs and featuring online videos, discussion forums, and videoconferencing, was developed to target depression, anxiety, and experiences of excess stress among university students.ObjectiveThe aim of this study was to assess the effectiveness of an 8-week web-based mindfulness and CBT program in reducing symptoms of depression, anxiety, and stress (primary outcomes) and increasing mindfulness (secondary outcome) within a randomized controlled trial (RCT) with undergraduate students at a large Canadian university.MethodsAn RCT was designed to assess undergraduate students (n=160) who were randomly allocated to a web-based guided mindfulness–CBT condition (n=80) or to a waitlist control (WLC) condition (n=80). The 8-week intervention consisted of a web-based platform comprising (1) 12 video-based modules with psychoeducation on students’ preidentified life challenges and applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided 20-minute live videoconferences. The outcomes (depression, anxiety, stress, and mindfulness) were measured via an online survey at baseline and at 8 weeks postintervention using the Patient Health Questionnaire-9 (PHQ9), the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facets Mindfulness Questionnaire Short Form (FFMQ-SF). Analyses employed generalized estimation equation methods with AR(1) covariance structures and were adjusted for possible covariates (gender, age, country of birth, ethnicity, English as first language, paid work, unpaid work, relationship status, physical exercise, self-rated health, and access to private mental health counseling).ResultsOf the 159 students who provided T1 data, 32 were males and 125 were females with a mean age of 22.55 years. Participants in the MVC (n=79) and WLC (n=80) groups were similar in sociodemographic characteristics at T1 with the exception of gender and weekly hours of unpaid volunteer work. At postintervention follow-up, according to the adjusted comparisons, there were statistically significant between-group reductions in depression scores (β=–2.21, P=.01) and anxiety scores (β=–4.82, P=.006), and a significant increase in mindfulness scores (β=4.84, P=.02) compared with the WLC group. There were no statistically significant differences in perceived stress for MVC (β=.64, P=.48) compared with WLC.ConclusionsWith the MVC intervention, there were significantly reduced depression and anxiety symptoms but no significant effect on perceived stress. Online mindfulness interventions can be effective in addressing common mental health conditions among postsecondary populations on a large scale, simultaneously reducing the current burden on traditional counseling services.Trial RegistrationISRCTN Registry ISRCTN12249616; http://www.isrctn.com/ISRCTN12249616

Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study.

IntroductionAn increasing number of young men have been found to develop nonorganic erectile dysfunction (NOED) in recent years. The NOED has been shown to respond better to cognitive behavior sex therapy (CBST) in a few past studies.AimThe present research aims to establish the efficacy of CBST as a promising treatment option in young men suffering from NOED by administering a feasibility pilot trial.Methods28 young men (M = 31 years) out of a total of 39 men (7 excluded, 4 quit treatment) diagnosed with NOED from sexual health clinics in Pakistan were recruited to receive CBST treatment (n = 13) on average twice a week for a period of 50 minutes per session for a period of 4, 6, 8, and 12 weeks for the mild, mild to moderate, moderate, and severe forms of NOED, respectively, and sildenafil citrate group (n = 15) receiving sildenafil citrate 50 mg on demand. The trial design was sequential random assignment clinical trial.Main Outcome MeasuresInternational Index of Erectile Functoning-5 and Depression Anxiety Stress Scale-21 were used before treatment, after treatment, and in follow-up as the main outcome measures.ResultsThe repeated measures analysis of covariance established a nonsignificant difference between CBST and sildenafil citrate 50 mg in NOED scores improvement, NOED severity reduction, and reduction in depression scores at posttreatment assessment. There were significant differences among different CBST modalities in improving NOED scores, reduction in NOED severity, and depression scores. There was significant difference in CBST and sildenafil citrate 50 mg in anxiety reduction at posttreatment assessment. The covariates age, age groups, and NOED duration did not significantly impact the treatment outcome for both treatment groups except age which impacted the interaction of treatment and anxiety scores.ConclusionThe CBST is an emerging and promising treatment choice in younger men suffering from NOED.Bilal A, Abbasi NuH. Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study. J Sex Med 2020;8:396–407.