Reduction In Distress Research Articles

Social and non-social cognitive behavioural therapy strategies for depression: findings from the MoodMission smartphone application

ABSTRACT Objective Cognitive behavioural therapy (CBT) is an evidence-based treatment of depression that can include strategies with a social component. Mental health apps (MHapps) are widely used amongst individuals with depression to access CBT strategies. Despite the research on CBT, it is not clear whether there is a difference in the correlation of CBT strategies for depression with a social component or not. Using MoodMission, an empirically validated MHapp that recommends CBT strategies (termed “Missions”), this study investigated whether social or non-social CBT strategies would correlate with participants’ ratings of helpfulness and distress reduction. Method A total of 4,107 participants who completed at least one social or non-social Mission and baseline 9-item Patient Health Questionnaire (PHQ-9) were included. Multilevel modelling with 2-levels was used, with level 1 entered as the fixed effect between Mission type in predicting subjective helpfulness and distress reduction, and level 2 entered as the random effects of participant covariates of age, gender, and PHQ-9 scores. Results Findings indicated that Missions without a social component was a significant positive predictor in distress reduction, but there was no significant difference in predicting subjective helpfulness. Conclusion These findings suggest that individuals with depression using MHapps could benefit from engaging in non-social CBT strategies for the reduction of subjective distress, more so than social CBT strategies. Study limitations included the self-report study design, subjective outcome measures, and a higher representation of female (80.6%) participants. Further research is required to investigate the clinical significance of these findings with a more representative sample.

Adaptation of a psycho-educational group programme to improve coping in dementia caregiving: a feasibility study with mixed-methods.

As the number of people living with dementia rapidly increases worldwide, the support provided by their informal caregivers remains key to the sustainability of most healthcare systems, this voluntary contribution representing 40% of the costs of dementia worldwide. Informal caregiving in dementia, however, is linked to long periods of chronic stress with frequent and serious negative consequences on the health and quality of life of the caregiver. A psycho-educational group intervention focusing on coping with the daily stress of dementia caregiving ("Learning to feel better… to help better"), developed in French-speaking Canada and showing broad effects on quality of life, was selected with the aim of 1) adapting it to a new cultural context (French-speaking Switzerland) based on identified facilitators and barriers, using a participative approach; and 2) conducting a feasibility study to evaluate whether the adapted programme showed similar or improved feasibility and effects compared to the original Canadian programme. A mixed-methods concurrent nested design was used to evaluate the feasibility and the effects on five quantitative core outcomes. Additional qualitative data helped document in depth the acceptability and impact of the intervention. We shortened the programme from 30 to 21h in total, which resulted in increased accessibility, in terms of facilitated recruitment of participants and inclusion of a broader range of informal caregivers. There were significant reductions in subjective burden (effect size: d = -0.32) and psychological distress (d = -0.48), as well as decreases in the stress reactions of informal caregivers related to the behaviour problems of the persons with dementia (d = -0.57). The qualitative results emphasized the usefulness of providing informal caregivers with structured procedures for efficiently tackling everyday challenges, and of enabling learning through a variety of channels and activities. Substantial improvements are associated with this 21-h group intervention, organised in 7 sessions of 3h each, focused on learning more efficient strategies to cope with the daily stress of dementia caregiving. This intervention empowered informal caregivers to master their daily challenges with more confidence, satisfaction and calm. ISRCTN13512408 (registration date 17.05.2021, retrospectively registered).

Comfort Terminal Care in the intensive care unit: recommendations for practice

The Working Group on Ethics in Anesthesia and Intensive Care Medicine of the Austrian Society for Anesthesiology Resuscitation and Intensive Care Medicine (ÖGARI) already developed documentation tools for the adaption of therapeutic goals 10years ago. Since then the practical implementation of Comfort Terminal Care in the daily routine in particular has raised numerous questions, which are discussed in this follow-up paper and answered in an evidence-based manner whenever possible. The practical implementation of pain therapy and reduction of anxiety, stress and respiratory distress that are indicated in the context of Comfort Terminal Care are described in more detail. The measures that are not (or no longer) indicated, such as oxygen administration and ventilation as well as the administration of fluids and nutrition, are also commented on. Furthermore, recommendations are given regarding monitoring, (laboratory) findings and drug treatment and the importance of nursing actions in the context of Comfort Terminal Care is mentioned. Finally, the support for the next of kin and the procedure in the time after death are presented. Achange in treatment goals with atimely switch to Comfort Terminal Care enables good and humane care for seriously ill patients and their relatives at the end of life and the appreciation of their previous life with the possibility of positive experiences until the end.

Cognitive-enhanced eHealth psychosocial stepped intervention for managing breast cancer-related cognitive impairment: Protocol for a randomized controlled trial.

Breast cancer often leads to cancer-related cognitive impairment (CRCI), which includes both objective and subjective cognitive deficits. While psychosocial interventions benefit quality of life and distress reduction, their impact on cognitive deficits is uncertain. This study evaluates the integration of a cognitive module into a digital psychosocial intervention for breast cancer patients. In this randomized controlled trial (RCT), 88 recently diagnosed breast cancer (BC) patients will receive the ICOnnecta't program (control group) - a digital stepped intervention addressing a variety of psychosocial needs. The experimental group (n = 88) will receive ICOnnecta't plus a cognitive module. Assessments at baseline, 3, 6, and 12 months will measure the interventions' impact on cognition, emotional distress, medication adherence, quality of life, post-traumatic stress, work functioning and healthcare experience. Feasibility and cost-utility analyses will also be conducted. The cognitive module includes three levels. The first level contains a cognitive screening using FACT-Cog Perceived Cognitive Impairment (PCI). Patients with PCI <54 progress to a cognitive psychoeducational campus (Level 2) with content on cognitive education, behavioural strategies and mindfulness. Patients with persistent or worsened PCI (≥6) after 3 months move to Level 3, an online cognitive training through CogniFit software delivered twice a week over 12 weeks. This study assesses whether integrating a cognitive module into a digital psychosocial intervention improves objective and subjective cognition in breast cancer patients. Secondary outcomes explore cognitive improvement's impact on psychosocial variables. The research will contribute to testing efficacious approaches for detecting and addressing cognitive dysfunction in breast cancer patients. ClinicalTrials.gov, NCT06103318. Registered 26 October 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06103318?term=serra-blasco&draw=2&rank=4.

Mindful awareness and resilience skills for adolescents (MARS-A): a mixed-methods study of a mindfulness-based intervention for a heterogeneous adolescent clinical population.

Mindful Awareness and Resilience Skills for Adolescents (MARS-A) is a mindfulness-based intervention adapted for the adolescent population. While previous studies have explored the benefits of MARS-A in various single-diagnosis populations, the aim of this study was to assess MARS-A for a heterogenous clinical adolescent population with mental health and/or chronic diagnoses, focusing on the underlying suffering present in all these conditions rather than its effects on a single diagnosis itself. Qualitative data was collected through interviews to understand post-intervention participant perspectives and experiences. Quantitative data was collected through measures to investigate preliminary secondary outcomes. After participating in MARS-A, participants reported qualitative benefits in enhanced well-being, including coping with difficult emotions and managing sleep and/or pain. Quantitative results showed a reduction in functional disability, psychological distress, perceived stress, and depressive symptoms; increase in positive affect; and benefit in coping with pain and chronic conditions. MARS-A shows great potential in a heterogeneous clinical adolescent population.

A State-Wide Initiative to Improve Health System Responses to People With Borderline Personality Disorder Symptoms in Crisis: A Retrospective Audit.

Gold Card SA is a four-session structured psychological intervention offered soon after an acute crisis presentation to people with symptoms characteristic of borderline personality disorder. This study describes individual and system-level outcomes from a large-scale health-care improvement initiative to implement Gold Card SA across South Australia. An uncontrolled pre-post study design was utilized examining service user (n = 332) patient-reported outcome measures and hospital service utilization records (6 months before and after Gold Card SA). Mixed-effects negative binomial regression analysis revealed a significant decrease in rates of service utilization across emergency department presentations (63%), mental health-related inpatient admissions (65%), and bed days (82%). Linear mixed-effect regression indicated large reductions in borderline symptoms and nonspecific psychological distress, and small to moderate improvements in psychosocial functioning. People presenting with or experiencing borderline personality disorder symptoms may benefit from a brief crisis intervention embedded within a stepped care model.

OM Chanting Reduces Psychological Distress Level in Office Workers During Covid 19 Pandemic

Purpose: psychological stress caused due to the current COVID 19 pandemic lock down may have an adverse impact on the quality of life (QoL) in office shift workers. The purpose of the present study was to investigate the effect of OM chanting on the levels of perceived psychological stress, quality of life and sleep among office workers who are confined at home and work during the global COVID-19 pandemic. Material &amp; Methods: an online OM chanting session was conducted for 20 workers who stayed at home and worked during the pandemic lockdown. Prior to and at the end of the training all the participants finished a battery of self-reported online inventories, including the Depression, Anxiety and Stress Scale with 21 items (DASS-21) and quality of life (WHOQOL-BREF). Results: after ten days of OM chanting, all the participants stated a significant enhancement in all domains of quality of life and a reduction of psychological distress (P&lt;0.05). Conclusions: OM chanting is feasible, safe and has a positive effect on psychological quality of life of participants. Still further studies have to be done to warrant the findings with suitable study design.

Symptom Experience and Quality of Life in Colorectal Cancer Patients Undergoing Chemotherapy – A Secondary Publication

Objective: To evaluate symptom experience and quality of life (QoL) and to identify the predictors of QoL among colorectal cancer patients undergoing chemotherapy. Methods: A cross-sectional study was conducted on 107 colorectal cancer patients at a university-affiliated hospital between June 1 and July 30, 2021. Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and Memorial Symptom Assessment Scale-Short Form (MSAS-SF) were used to assess symptom experience and QoL of these patients. Data were analyzed using Pearson’s correlation, t-test, ANOVA, and hierarchical multiple regression. Results: The mean QoL score for colorectal cancer patients was 88.78 ± 20.08. The most frequently experienced physical and psychological symptoms were numbness/tingling and worrying. Physical and psychological symptoms have a significant negative association with QoL. Perceived economic status was significantly associated with QoL in patients’ general characteristics. The regression analyses showed that high psychological symptoms (β = -0.63, P &lt; 0.001), middle perceived economic status (β = -0.22, P = 0.009), and low perceived economic status (β = -0.36, P &lt; 0.001) were statistically significant in predicting patients’ low QoL. Conclusion: Symptom experience and QoL are essential variables that should be acknowledged when delivering health care to colorectal cancer patients. More attention to the reduction and comprehensive symptom management of psychological distress could improve QoL among colorectal cancer patients.

DISTRESS ASSOCIATED WITH SIDE EFFECTS OF CALCIUM CHANNEL BLOCKERS AMONG A COHORT OF NEWLY DIAGNOSED WITH HYPERTENSION

Antihypertensive therapy with calcium channel blockers (CCBs) is reported to be frequently associated with varying levels of distress due to their side effects. The severity of distress may result in patients intentionally interrupting or withdrawing from therapy. In clinical settings, distress from side effects of drug(s) are sometimes left unreported, overlooked or poorly resolved by clinicians. The aim of this study was to assess distress due to side effects of commonly prescribed CCB-based antihypertensive therapies.This was a prospective observational study among patients newly diagnosed with primary hypertension being treated with either CCB monotherapies or combination regimens as initial therapy. A total of 180 patients enrolled completed the eight week study and their data used in final analysis. The subjects were allocated into six treatment groups of 30 each and given either amlodipine 10mg, nifedipine 20mg, bendrofluthiazide (monotherapies) or their combinations with bendrofluthiazide 5mg or Lisinopril 5mg (dual therapies). The level of distress before and after initiation of therapy was compared using Students t test and P values ≤ 0.05 was considered statistically significant. Patients on dual therapies reported more side effects compared to monotherapies. The most commonly reported side effects included loss of libido (38% - 47%), pitting edema (28% - 35%), headache (26% - 36%), muscle cramps (9% - 18%) and fatigue (17% - 30%). Distress score of monotherapies (14.9) and dual therapies (15.3) was considered mild (&lt; 25 threshold). There was significant reduction in distress with bowel upset (P = 0.001), insomnia (P = &lt; 0.001), pain (P = 0.001), breathing difficulties (P = 0.009) and concentration for BDF containing regimen (P = 0.001). Distress among Lisinopril containing regimens involved appetite (P = 0.003), pain (P = 0.002) and fatigue (P = 0.003). Overall, distress due to side effects was mild for all the antihypertensive drug(s). Keywords: Antihypertensives, Calcium channel blockers, Distress, Hypertension, Nifedipine, Side effects

Effectiveness of The Seven Challenges® for adults: It’s not just because of self-disclosure

ABSTRACT This study examined the longer-term effectiveness of The Seven Challenges® Program, a comprehensive counseling program that incorporates work on drug and co-occurring problems. This study also examined the role of self-disclosure in achieving positive outcomes for adult drug court clients. Results indicated that The Seven Challenges Program elicited more self-disclosure and was more effective than standard cognitive-behavioral treatment in sustained reduction of alcohol use, mental distress, emotional problems, and behavioral issues to 6 months post-intake. Additionally, The Seven Challenges Program was effective at reducing criminal activity. Greater self-disclosure among The Seven Challenges clients accounted for their greater perceived impact of treatment, but not for the effectiveness of The Seven Challenges relative to standard cognitive-behavioral treatment. These findings strengthen the existing evidence base of the effectiveness of The Seven Challenges.

A multidimensional strategy to managing dysfunctional breathing and exercise-induced laryngeal obstruction in adolescent athletes

BackgroundExercise induced laryngeal obstruction (EILO) causes inspiratory distress in the upper airway in many adolescent athletes. The nature of EILO is not fully understood, and effective management strategies are lacking. This study aimed to assess the effectiveness of a multidimensional individually tailored intervention, including Norwegian Psychomotor Physiotherapy (NPMP), elements of cognitive behavioural therapy and a rehabilitation plan, in reducing inspiratory distress and dysfunctional breathing in adolescent athletes with EILO.MethodsA mixed methods design, which combined qualitative and quantitative research, was used. Data, including subjective experiences of respiratory distress, findings from body examinations and objective measurements of lung function and aerobic capacity were gathered before and after a five month intervention involving 18 participants.ResultsFollowing the intervention, the participants showed a reduction in respiratory distress and anxiousness associated with their breathing difficulties. Furthermore, the participants reported to be more in control of their breathing. The body assessments revealed a more functional breathing motion and improved posture, which imply that the breathing was less thoracic and more diaphragmatic in rest and exercise in all participants after the intervention.ConclusionsOur results suggest that a multidimensional individually tailored intervention, including NPMP based physiotherapy, cognitive behavioural therapy elements, and a rehabilitation plan may reduce inspiratory distress and dysfunctional breathing in athletes with EILO.Trial registrationClinicalTrials.gov Protocol Registration and Results system NCT06033755, date of registration: September12, 2023. Retrospectively registered.

Effectiveness of Cognitive Behavioral Therapy (CBT) on Psychological Distress among Mothers of Children with Autism Spectrum Disorder: The Role of Problem-Solving Appraisal.

Mothers of children with autism spectrum disorder (ASD) face considerable psychological distress. Cognitive behavioral therapy (CBT) has shown promise in reducing caregiver burden, but evidence in the Arab world is lacking. Problem-solving appraisal training may optimize CBT's benefits. This study evaluated a tailored CBT program emphasizing the role of problem-solving appraisal in managing distress through the process of CBT. Sixty mothers were randomly allocated in a 1:1 ratio to either the CBT intervention group or the control group. The CBT group received 3-month sessions incorporating problem-solving appraisal training within a CBT curriculum from October 2022 to April 2023. Problem-solving techniques are focused on equipping individuals with the skills to identify, approach, and effectively resolve problems, leading to a reduction in stress levels and an improved capacity to cope with difficult situations. All mothers completed assessments of socio-demographics such as age, level of education, marital status, occupation, and adequacy of family income, the Depression Anxiety Stress Scale (DASS-21) and the Problem-Solving Inventory (PSI) before and after the program. The CBT group showed significant pre-to-post reductions in depression, anxiety, stress, and general psychological distress compared to controls (all p < 0.05). They also exhibited significant improvements in problem-solving confidence, approach-avoidance style and personal control (all p < 0.05). The customized CBT program markedly improved psychological well-being for mothers of children with ASD in Egypt. Incorporating problem-solving techniques may optimize CBT's benefits cross-culturally. These findings have implications for the implementation of evidence-based support programs for families impacted by ASD worldwide.

Yoga as a non-pharmacologic therapy to reduce dinutuximab-induced pain in patients with neuroblastoma.

Anti-GD2 antibodies are key components of treatment for high-risk neuroblastoma; however, they cause neuropathic pain. Yoga therapy may help reduce pain and distress associated with anti-GD2 therapy. Children 3years of age or older with neuroblastoma participated in individualized yoga therapy while receiving the anti-GD2 antibody dinutuximab (DIN). Yoga therapy was deemed feasible if patients participated during 60% or more of DIN admissions. Patients and caregivers assessed pain/distress before and after yoga therapy with a distress thermometer (DT) and Wong-Baker FACES pain rating scale and completed questionnaires regarding satisfaction with yoga therapy. Therapy was deemed efficacious if there was a ≥1 point pain score change and reduction in distress after yoga. Eighteen patients were enrolled; 52 encounters (admissions for DIN) were evaluable. Ten of 18 were female, three of 18 were Hispanic, and 10/18 were White. Median age at enrollment was 5.5years (range: 3-11). Yoga therapy was feasible in 39/52 (75%) encounters. Significant reductions in caregiver-reported pain and distress and reductions in patient-reported pain and distress after yoga therapy were reported. Twelve of 18 caregivers completed questionnaires: seven agreed/strongly agreed that yoga was valuable, and nine agreed/strongly agreed to continued participation in yoga. Thirty-four of 36 clinicians reported that they would recommend yoga therapy for other patients receiving DIN. Yoga therapy was feasible during DIN therapy and may be effective in reducing DIN-associated pain and distress. Future studies are needed to evaluate changes in opioid usage with the addition of yoga therapy during anti-GD2 antibody therapy.

Enhancing Financial Stability in Ghana's Universal Banking Sector: A Governance Perspective and Practical Insights

Purpose: This study investigates the impact of corporate governance structures on financial distress within the universal banking sector in Ghana.&#x0D; Methodology: The research systematically gathers data from 19 banks spanning 10-year period. Financial distress indicators were extracted from financial statements, while corporate governance measures were obtained from annual reports. The data was analysed through regression analysis and counterfactual analysis through an endogenous switching regression model.&#x0D; Findings: Key findings reveal that profitability, liquidity, and effective risk management are critical factors influencing financial distress in both strong and weak governance environments. The results also showed that improving the strength of Corporate Governance has a positive influence on Altman Z Scores, contributing to a potential reduction in financial distress.&#x0D; Unique contributor to theory, policy and practice: The study provides valuable insights for policymakers, regulators, and banking institutions in Ghana, emphasizing the need to prioritize and strengthen governance practices for a resilient banking sector. Limitations include data unavailability, reliance on unbalanced panel data, and a narrow focus on board characteristics.

Videoconferencing During the COVID-19 Pandemic is Associated with Sleep Disruption in Young Adults.

The COVID-19 pandemic resulted in a shift to working and learning from home and a concomitant rise in the use of virtual communication technology, such as videoconferencing. The current study prospectively examined the association between videoconferencing and sleep in a sample of young adults attending a university during the pandemic. The effects of videoconferencing on health and wellness outcomes and academic performance were also evaluated. Participants completed the core Consensus Sleep Diary and reported engagement in videoconferencing, the use of electronic devices, and physical activity daily for 8 consecutive days. They also completed baseline measures of sleep, communication technology use, physical activity, and mental distress, as well as released their end-of-term GPA. Results were evaluated via multilevel modeling and path analysis. Participants with a heavier videocall volume lost 17 m of sleep and suffered nearly a 1% reduction in sleep efficiency for each additional hour of videoconferencing compared to those with a lower call volume. They also tended to spend more time awake during the night, have earlier sleep midpoints, and report worse sleep, although those trends did not reach statistical significance. For everyone, including individuals with lower videocall volume, earlier sleep midpoints, lower sleep quality, somewhat shorter sleep, and higher fatigue were reported on days with a relatively high videocall load compared to days with a low videocall load. Increased academic engagement with videoconferencing predicted lower academic performance and higher psychological distress: Both relationships were mediated by sleep. Use of videoconferencing for personal reasons, however, was directly associated with a reduction in distress. Videoconferencing is an important determinant of sleep and may impact health and wellness as well as academic outcomes in young adults. The effects of virtual communication on sleep and human behavior warrant further study in this and other populations.

Improvement in Distress Tolerance as a Mechanism of Symptom Reduction During Intensive Exposure and Response Prevention–Based Treatment for OCD

Exposure and Response Prevention (ERP) is an effective treatment for obsessive-compulsive disorder (OCD), yet the specific underlying mechanisms by which ERP improves symptoms remain unclear. Initial theories suggested that habituation to triggering events and stimuli was the key therapeutic factor in ERP, while other theories highlight the role of developing the ability to tolerate distress, rather than reduction of distress. The current study examined improvements in distress tolerance as a mechanism of OCD, anxiety, and depressive symptom reductions during an ERP-based intensive program. Participants (N = 180) completed weekly measures of distress intolerance, and symptom severity of OCD, anxiety, and depression. Using Multi-Level Structural Equation Modeling, we found that participants experienced significant weekly decreases in OCD, anxiety, and depressive symptom severity across the course of their ERP-based treatment. Weekly reductions in OCD symptom severity were partially accounted for by weekly improvements in participants’ ability to tolerate distress, particularly for obsession symptoms. This effect was also significant for anxiety and depressive symptom severity, above and beyond the effects of weekly reductions in OCD symptom severity. The current study suggests improving the ability to tolerate distress represents a transdiagnostic mechanism of symptom severity reduction in OCD, anxiety, and depressive psychopathology via intensive ERP-based psychotherapy programming. Limitations and future directions for improving treatments for OCD, anxiety, and depressive symptoms are discussed.

Open Trial of a Brief Imagery-Based Stabilization Psychotherapy for Adults with Acute Posttraumatic Stress Disorder.

Early intervention after trauma is needed for reduction in clinical distress and prevention of chronic posttraumatic stress disorder (PTSD). This study describes findings from an open pilot trial of a brief stabilization psychotherapy based on imagery techniques for adults with acute PTSD (i.e., within 3 months of onset). Four sessions of 60-minute individual psychotherapy were conducted on 18 participants with PTSD within 3 months after accidents, 15 of whom completed the treatment. The clinician-administered PTSD scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Hamilton Depression and Anxiety Rating Scales, and self-questionnaires were administered at pre-treatment, post-treatment, and 6-month follow-up. Eight (53.3%) of the 15 patients at post-treatment and 8 of the 9 patients at 6-month follow-up did not meet the DSM-5 criteria for PTSD. Reliable change of PTSD symptoms after treatment was observed in 6 of 15 (45.0%) patients at post-treatment and in 4 of 9 (45.0%) patients after 6 months. There was a significant decrease in PTSD, depression, anxiety, and impaired quality of life scores after treatment, and these gains were maintained after 6 months. No cases of exacerbated PTSD symptoms were observed among completers and non-completers. Our findings suggest that brief stabilization sessions are safe treatment options for acute PTSD (KCT0001918).

App-based support for breast cancer patients to reduce psychological distress during therapy and survivorship - a multicentric randomized controlled trial.

The negative impact of unmanaged psychological distress on quality of life and outcome in breast cancer survivors has been demonstrated. Fortunately, studies indicate that distress can effectively be addressed and even prevented using evidence-based interventions. In Germany prescription-based mobile health apps, known as DiGAs (digital health applications), that are fully reimbursed by health insurances, were introduced in 2020. In this study, the effectiveness of an approved breast cancer DiGA was investigated: The personalized coaching app PINK! Coach supports and accompanies breast cancer patients during therapy and follow-up. PINK! Coach was specifically designed for breast cancer (BC) patients from the day of diagnosis to the time of Follow-up (aftercare). The app offers individualized, evidence-based therapy and side-effect management, mindfulness-based stress reduction, nutritional and psychological education, physical activity tracking, and motivational exercises to implement lifestyle changes sustainably in daily routine. A prospective, intraindividual RCT (DRKS00028699) was performed with n = 434 patients recruited in 7 German breast cancer centers from September 2022 until January 2023. Patients with BC were included independent of their stage of diseases, type of therapy and molecular characteristics of the tumor. Patients were randomized into one of two groups: The intervention group got access to PINK! over 12 weeks; the control group served as a waiting-list comparison to "standard of care." The primary endpoint was psychological distress objectified by means of Patient Health Questionnaire-9 (PHQ-9). Subgroups were defined to investigate the app's effect on several patient groups such as MBC vs. EBC patients, patients on therapy vs. in aftercare, patients who received a chemotherapy vs. patients who did not. Efficacy analysis of the primary endpoint revealed a significant reduction in psychological distress (least squares estimate -1.62, 95% confidence interval [1.03; 2.21]; p<0.001) among intervention group patients from baseline to T3 vs, control group. Subgroup analysis also suggested improvements across all clinical situations. Patients with breast cancer suffer from psychological problems including anxiety and depression during and after therapy. Personalized, supportive care with the app PINK! Coach turned out as a promising opportunity to significantly improve psychological distress in a convenient, accessible, and low-threshold manner for breast cancer patients independent of their stage of disease (EBC/MBC), therapy phase (aftercare or therapy) or therapy itself (chemotherapy/other therapy options). The app is routinely available in Germany as a DiGA. Clinical Trial Registration: DRKS Trial Registry (DRKS00028699).

The effectiveness of Problem Management Plus at 1-year follow-up for Syrian refugees in a high-income setting.

Problem Management Plus (PM+) has been effective in reducing mental health problems among refugees at three-month follow-up, but there is a lack of research on its long-term effectiveness. This study examined the effectiveness of PM+ in reducing symptoms of common mental disorders at 12-month follow-up among Syrian refugees in the Netherlands. This single-blind, parallel, controlled trial randomised 206 adult Syrians who screened positive for psychological distress and impaired functioning to either PM+ in addition to care as usual (PM+/CAU) or CAU alone. Assessments were at baseline, 1 week and 3 months after the intervention and 12 months after baseline. Outcomes were psychological distress (Hopkins Symptom Checklist [HSCL-25]), depression (HSCL-25 subscale), anxiety (HSCL-25 subscale), posttraumatic stress disorder symptoms (PCL-5), functional impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS). In March 2019-December 2022, 103 participants were assigned to PM+/CAU and 103 to CAU of which 169 (82.0%) were retained at 12 months. Intention-to-treat analyses showed greater reductions in psychological distress at 12 months for PM+/CAU compared to CAU (adjusted mean difference -0.17, 95% CI -0.310 to -0.027; p = 0.01, Cohen's d = 0.28). Relative to CAU, PM+/CAU participants also showed significant reductions on anxiety (-0.19, 95% CI -0.344 to -0.047; p = 0.01, d = 0.31) but not on any of the other outcomes. PM+ is effective in reducing psychological distress and symptoms of anxiety over a period up to 1 year. Additional support such as booster sessions or additional (trauma-focused) modules may be required to prolong and consolidate benefits gained through PM+ on other mental health and psychosocial outcomes.

Music-based therapeutic interventions for medical school students with emotional regulation and mental health: a pre-post cohort study.

Depression and anxiety are prevalent mental health challenges among college students. Music therapy has shown effectiveness in addressing depressive symptoms and enhancing psychosomatic functioning. This study aimed to evaluate the effectiveness of a 4-step structured music therapy program in improving mood and reducing symptoms of depression and anxiety among medical school students. The self-controlled study involved 45 medical school students (21 men and 24 women) aged 18-24 years to examine the prevalence of depression and anxiety, common mental health issues among medical school students. Participants underwent psychological assessment using the Symptom Checklist-90 (SCL-90), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). An 8-week music therapy intervention, comprising four steps-sociality, interaction, music lessons, and creative expression-was administered. Before-intervention, 55.6% and 15.6% students were identified as suffering from depression and anxiety respectively. Post-intervention, significant reductions in psychological distress, particularly in the Global Severity Index (GSI) and Positive Symptom Total (PST) on the SCL-90 scale, were observed (P < 0.05). Male students exhibited notable improvements in various psychological symptoms compared to females. Junior grade students demonstrated greater improvements, and clinical medicine students exhibited significant enhancements in specific areas post-intervention. The structured music therapy program showed promising results in improving mood and regulating emotions among medical school students. Music therapy holds potential as a holistic approach to address mental health challenges in this demographic.