Treatment Options For Depression Research Articles

Neurosteroids and translocator protein 18kDa (TSPO) ligands as novel treatment options in depression.

Recently, the gamma-aminobutyric acid (GABA) system has come into focus for the treatment of anxiety, postpartum depression, and major depressive disorder. Endogenous 3α-reduced steroids such as allopregnanolone are potent positive allosteric modulators of GABAA receptors and have been known for decades. Current industry developments and first approvals by the U.S. food and drug administration (FDA) for the treatment of postpartum depression with exogenous analogues of these steroids represent a major step forward in the field. 3α-reduced steroids target both synaptic and extrasynaptic GABAA receptors, unlike benzodiazepines, which bind to synaptic receptors. The first FDA-approved 3α-reduced steroid for postpartum depression is brexanolone, an intravenous formulation of allopregnanolone. It has been shown to provide rapid relief of depressive symptoms. An orally available 3α-reduced steroid is zuranolone, which also received FDA approval in 2023 for the treatment of postpartum depression. Although a number of studies have been conducted, the efficacy data were not sufficient to achieve approval of zuranolone in major depressive disorder by the FDA in 2023. The most prominent side effects of these 3α-reduced steroids are somnolence, dizziness and headache. In addition to the issue of efficacy, it should be noted that current data limit the use of these compounds to two weeks. An alternative to exogenous 3α-reduced steroids may be the use of substances that induce endogenous neurosteroidogenesis, such as the translocator protein 18kDa (TSPO) ligand etifoxine. TSPO has been extensively studied for its role in steroidogenesis, in addition to other functions such as anti-inflammatory and neuroregenerative properties. Currently, etifoxine is the only clinically available TSPO ligand in France for the treatment of anxiety disorders. Studies are underway to evaluate its antidepressant potential. Hopefully, neurosteroid research will lead to the development of fast-acting antidepressants.

Neurosteroids and translocator protein 18kDa (TSPO) ligands as novel treatment options in depression.

Recently, the gamma-aminobutyric acid (GABA) system has come into focus for the treatment of anxiety, postpartum depression, and major depressive disorder. Endogenous 3α-reduced steroids such as allopregnanolone are potent positive allosteric modulators of GABAA receptors and have been known for decades. Current industry developments and first approvals by the U.S. food and drug administration (FDA) for the treatment of postpartum depression with exogenous analogues of these steroids represent a major step forward in the field. 3α-reduced steroids target both synaptic and extrasynaptic GABAA receptors, unlike benzodiazepines, which bind to synaptic receptors. The first FDA-approved 3α-reduced steroid for postpartum depression is brexanolone, an intravenous formulation of allopregnanolone. It has been shown to provide rapid relief of depressive symptoms. An orally available 3α-reduced steroid is zuranolone, which also received FDA approval in 2023 for the treatment of postpartum depression. Although a number of studies have been conducted, the efficacy data were not sufficient to achieve approval of zuranolone in major depressive disorder by the FDA in 2023. The most prominent side effects of these 3α-reduced steroids are somnolence, dizziness and headache. In addition to the issue of efficacy, it should be noted that current data limit the use of these compounds to two weeks. An alternative to exogenous 3α-reduced steroids may be the use of substances that induce endogenous neurosteroidogenesis, such as the translocator protein 18kDa (TSPO) ligand etifoxine. TSPO has been extensively studied for its role in steroidogenesis, in addition to other functions such as anti-inflammatory and neuroregenerative properties. Currently, etifoxine is the only clinically available TSPO ligand in France for the treatment of anxiety disorders. Studies are underway to evaluate its antidepressant potential. Hopefully, neurosteroid research will lead to the development of fast-acting antidepressants.

Effects of psilocin and psilocybin on human 5-HT4 serotonin receptors in atrial preparations of transgenic mice and humans

Several fungi belonging to the genus Psilocybe, also called “magic mushrooms”, contain the hallucinogenic drugs psilocybin and psilocin. They are chemically related to serotonin (5-HT). In addition to being abused as drugs, they are now also being discussed or used as a treatment option for depression. Here, we hypothesized that psilocybin and psilocin may act also on cardiac serotonin receptors and studied them in vitro in atrial preparations of our transgenic mouse model with cardiac myocytes-specific overexpression of the human 5-HT4 receptor (5-HT4-TG) as well as in human atrial preparations. Both psilocybin and psilocin enhanced the force of contraction in isolated left atrial preparations from 5-HT4-TG, increased the beating rate in isolated spontaneously beating right atrial preparations from 5-HT4-TG and augmented the force of contraction in the human atrial preparations. The inotropic and chronotropic effects of psilocybin and psilocin at 10 µM were smaller than that of 1 µM 5-HT on the left and right atria from 5-HT4-TG, respectively. Psilocybin and psilocin were inactive in WT. In the human atrial preparations, inhibition of the phosphodiesterase III by cilostamide was necessary to unmask the positive inotropic effects of psilocybin or psilocin. The effects of 10 µM psilocybin and psilocin were abrogated by 10 µM tropisetron or by 1 µM GR125487, a more selective 5-HT4 receptor antagonist. In summary, we demonstrated that psilocin and psilocybin act as agonists on cardiac 5-HT4 receptors.

Metabolic Status Influences Probiotic Efficacy for Depression-PRO-DEMET Randomized Clinical Trial Results.

Probiotics may represent a safe and easy-to-use treatment option for depression or its metabolic comorbidities. However, it is not known whether metabolic features can influence the efficacy of probiotics treatments for depression. This trial involved a parallel-group, prospective, randomized, double-blind, controlled design. In total, 116 participants with depression received a probiotic preparation containing Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 or placebo over 60 days. The psychometric data were assessed longitudinally at five time-points. Data for blood pressure, body weight, waist circumference, complete blood count, serum levels of C-reactive protein, cholesterol, triglycerides, and fasting glucose were measured at the beginning of the intervention period. There was no advantage of probiotics usage over placebo in the depression score overall (PRO vs. PLC: F(1.92) = 0.58; p = 0.45). However, we found a higher rate of minimum clinically important differences in patients supplemented with probiotics than those allocated to placebo generally (74.5 vs. 53.5%; X2(1,n = 94) = 4.53; p = 0.03; NNT = 4.03), as well as in the antidepressant-treated subgroup. Moreover, we found that the more advanced the pre-intervention metabolic abnormalities (such as overweight, excessive central adipose tissue, and liver steatosis), the lower the improvements in psychometric scores. A higher baseline stress level was correlated with better improvements. The current probiotic formulations may only be used as complementary treatments for depressive disorders. Metabolic abnormalities may require more complex treatments. ClinicalTrials.gov identifier: NCT04756544.

Chronometric TMS-fMRI of personalized left dorsolateral prefrontal target reveals state-dependency of subgenual anterior cingulate cortex effects.

Transcranial magnetic stimulation (TMS) applied to a left dorsolateral prefrontal cortex (DLPFC) area with a specific connectivity profile to the subgenual anterior cingulate cortex (sgACC) has emerged as a highly effective non-invasive treatment option for depression. However, antidepressant outcomes demonstrate significant variability among therapy plans and individuals. One overlooked contributing factor is the individual brain state at the time of treatment. In this study we used interleaved TMS-fMRI to investigate the influence of brain state on acute TMS effects, both locally and remotely. TMS was performed during rest and during different phases of cognitive task processing. Twenty healthy participants were included in this study. In the first session, imaging data for TMS targeting were acquired, allowing for identification of individualized targets in the left DLPFC based on highest anti-correlation with the sgACC. The second session involved chronometric interleaved TMS-fMRI measurements, with 10 Hz triplets of TMS administered during rest and at distinct timings during an N-back task. Consistent with prior findings, interleaved TMS-fMRI revealed significant BOLD activation changes in the targeted network. The precise timing of TMS relative to the cognitive states during the task demonstrated distinct BOLD response in clinically relevant brain regions, including the sgACC. Employing a standardized timing approach for TMS using a task revealed more consistent modulation of the sgACC at the group level compared to stimulation during rest. In conclusion, our findings strongly suggest that acute local and remote effects of TMS are influenced by brain state during stimulation. This study establishes a basis for considering brain state as a significant factor in designing treatment protocols, possibly improving TMS treatment outcomes.

Effect of psychosocial interventions for depression in adults with chronic kidney disease: a systematic review and meta-analysis

BackgroundPeople with chronic kidney disease (CKD) treated with dialysis are frequently affected by depression. Psychotherapy has been reported to decrease depressive symptoms in various chronic diseases and is a potential treatment option for depression. We aimed to perform a systematic review and meta-analysis to evaluate the effect of psychotherapy on depression in adults with CKD.MethodsWe searched MEDLINE, Embase, Web of Science, and Cochrane for published studies up to October 31, 2023. Two investigators independently reviewed the included studies and extracted relevant data. Randomized controlled trials (RCTs) assessing the impact of interventions that provide psychological, emotional, or social support without the use of pharmacological substances on depressive symptoms in people with CKD were included and summarized. Scores on different tools for depressive assessment and quality of life were pooled.ResultsA total of 19 RCTs published between 2004 and 2023 were included and analyzed. The weighted mean difference (WMD) for all included studies with regard to depression was − 2.32 (95%CI=-3.83, -0.80, P = 0.003). The WMD for Beck Depression Inventory (BDI) score of depression was − 3.27 (95%CI=-7.81, 1.27, P = 0.158) with significant heterogeneity (I2 = 95.1%). Significant WMD was detected for the Hospital Anxiety and Depression Scale (HADS) tool: WMD=-1.90, 95%CI=-2.91, -0.90, P < 0.001. The WMD for all included studies regarding quality of life was 1.21 (95%CI=-0.51, 2.93, P = 0.168). The WMD for Kidney Disease Quality of Life Short Form (KDQOL-SF) score was 4.55 (95%CI = 0.50, 8.60, P = 0.028). The WMD for SF-36 score was 0.02 (95%CI=-10.33, 10.36, P = 0.998). Significant difference on outcomes of S-PRT scale was observed (WMD = 2.42, 95%CI = 1.07, 3.76, P < 0.001).ConclusionsPsychosocial interventions probably reduce the depression level among CKD patients. Preliminary evidence suggests that psychosocial interventions might be beneficial for the quality of life in CKD patients. Our results provide medical facilities with an evidence-based basis for establishing psychosocial interventions in kidney care settings.

A comprehensive overview of post-stroke depression treatment options.

Nearly one-third of all stroke patients develop depression at any time after a stroke, and its presence is associated with unfavorable outcomes. This narrative review aims to provide a synopsis of possible pharmacological and non-pharmacological treatment modalities for post-stroke depression (PSD). Several studies have demonstrated the efficacy and safety of selective serotonin reuptake inhibitors in treating the symptoms of this clinical condition. The treatment of PSD has been recently enhanced by innovative approaches, such as cognitive-behavioral therapy, virtual reality, telehealth, repetitive transcranial magnetic stimulation, and non-conventional therapies, which might improve depression treatment in stroke survivors. Future high-quality randomized controlled trials are necessary to confirm this hypothesis.

Venlafaxine combined with Sweet Dream oral liquid on patients with depression and mania

BackgroundDepression and mania are common mental illnesses. Venlafaxine combined with Sweet Dream oral liquid is widely used in the treatment of these mental diseases as a drug therapy. However, the analysis of its efficacy is relatively limited.Subjects and Methods100 middle school students diagnosed with depression and mania were recruited and randomly divided into test group and control group. The test group received Venlafaxine combined with Sweet Dream oral liquid, and the control group received placebo. SPSS23.0 software was used for data processing and statistical analysis.ResultsAfter 8 weeks of treatment, symptoms of depression and mania were improved in both test and control groups. Depressive symptom scores decreased from 32.5±6.2 to 18.3±4.9 (P&lt;0.001) in the test group and from 34.2±5.8 to 20.1±5.4 (P&lt;0.001) in the control group. The score of mania symptoms decreased from 29.7±7.1 to 15.2±4.6 (P&lt;0.001) in the test group and from 31.0±6.5 to 16.8±5.2 (P&lt;0.001) in the control group. The test group showed a significant advantage in symptom improvement.ConclusionsThe results show that Venlafaxine combined with Sweet Dream oral liquid has a significant effect on middle school students with depression and mania. It can significantly improve the symptoms of depression and mania, alleviate the condition, and improve patients’ life quality. Therefore, this drug therapy can be considered as an effective treatment option for depression and mania in middle school students.Acknowledgement Introduction of talents in small and medium-sized cities under the background of government-school-enterprise cooperation Research-A case study of “100 universities visiting Shunde” in Guangdong province (No. pdjh2022b1094); Special Funds for the Cultivation of Guangdong College Students’ Scientific and Technological Innovation. “Climbing Program” Special Funds (No. pdjh2021a1005); Guangdong Province philosophy and Social Sciences “13th five year plan” 2020 discipline co construction project (No. GD20XJY54).

Internet-delivered cognitive behavioural therapy programme to reduce depressive symptoms in patients with multiple sclerosis: a multicentre, randomised, controlled, phase 3 trial

Depression is three to four times more prevalent in patients with neurological and inflammatory disorders than in the general population. For example, in patients with multiple sclerosis, the 12-month prevalence of major depressive disorder is around 25% and it is associated with a lower quality of life, faster disease progression, and higher morbidity and mortality. Despite its clinical relevance, there are few treatment options for depression associated with multiple sclerosis and confirmatory trials are scarce. We aimed to evaluate the safety and efficacy of a multiple sclerosis-specific, internet-based cognitive behavioural therapy (iCBT) programme for the treatment of depressive symptoms associated with the disease. This parallel-group, randomised, controlled, phase 3 trial of an iCBT programme to reduce depressive symptoms in patients with multiple sclerosis was carried out at five academic centres with large outpatient care units in Germany and the USA. Patients with a neurologist-confirmed diagnosis of multiple sclerosis and depressive symptoms were randomly assigned (1:1:1; automated assignment, concealed allocation, no stratification, no blocking) to receive treatment as usual plus one of two versions of the iCBT programme Amiria (stand-alone or therapist-guided) or to a control condition, in which participants received treatment as usual and were offered access to the iCBT programme after 6 months. Masking of participants to group assignment between active treatment and control was not possible, although raters were masked to group assignment. The predefined primary endpoint, which was analysed in the intention-to-treat population, was severity of depressive symptoms as measured by the Beck Depression Inventory-II (BDI-II) at week 12 after randomisation. This trial is registered at ClinicalTrials.gov, NCT02740361, and is complete. Between May 3, 2017, and Nov 4, 2020, we screened 485 patients for eligibility. 279 participants were enrolled, of whom 101 were allocated to receive stand-alone iCBT, 85 to receive guided iCBT, and 93 to the control condition. The dropout rate at week 12 was 18% (50 participants). Both versions of the iCBT programme significantly reduced depressive symptoms compared with the control group (BDI-II between-group mean differences: control vs stand-alone iCBT 6·32 points [95% CI 3·37-9·27], p<0·0001, effect size d=0·97 [95% CI 0·64-1·30]; control vs guided iCBT 5·80 points [2·71-8·88], p<0·0001, effect size d=0·96 [0·62-1·30]). Clinically relevant worsening of depressive symptoms was observed in three participants in the control group, one in the stand-alone iCBT group, and none in the guided iCBT group. No occurrences of suicidality were observed during the trial and there were no deaths. This trial provides evidence for the safety and efficacy of a multiple sclerosis-specific iCBT tool to reduce depressive symptoms in patients with the disease. This remote-access, scalable intervention increases the therapeutic options in this patient group and could help to overcome treatment barriers. National Multiple Sclerosis Society (USA).

The Effect of Microglia on Depression

This paper focuses on the relationship between microglia and depression. Depression is affected by multiple structures, cells, and hormones, including the hippocampus, amygdala, hypothalamic-pituitary-adrenal axis, gut microbiota, stem cells, and glucocorticoids. This paper explores the relationship between microglia and structures, how these structural changes lead to increased concentrations of microglia leading to depression, and current treatment options for depression. Treatment options include drug therapy, electroacupuncture, and stem cell therapy. All of these treatments significantly impact the cure of depression and, at the same time, affect the overactivated microglia cells. It is concluded that the production of depression is closely related to microglial cells.

Recent Advances on Primary Sjogren's Syndrome and Depression Relationship

Primary Sjogren's syndrome is a chronic autoimmune disorder that affects the exocrine glands, leading to dryness of the eyes, mouth, and other mucous membranes. Depression is a common comorbidity in patients with primary Sjogren's syndrome, and it can have a significant impact on patients' quality of life. This review paper provides an overview of the clinical presentation and prevalence of primary Sjogren's syndrome and depression, as well as a summary of the research progress on the relationship between these two conditions. The proposed mechanisms underlying the relationship between primary Sjogren's syndrome and depression, including neuroendocrine and immune system dysregulation, proinflammatory cytokines, stress and coping mechanisms, psychological factors, and other factors, are also discussed. Additionally, various treatment options for depression in patients with primary Sjogren's syndrome are reviewed, including pharmacological and non-pharmacological interventions. While there are some limitations to the current research, understanding the relationship between primary Sjogren's syndrome and depression is important for improving the care and quality of life of patients with this condition.

Behavioural Activation versus Treatment as Usual for Depressed Older Adults in Primary Care: A Pragmatic Cluster-Randomised Controlled Trial

Introduction: Effective non-pharmacological treatment options for depression in older adults are lacking. Objective: The effectiveness of behavioural activation (BA) by mental health nurses (MHNs) for depressed older adults in primary care compared with treatment as usual (TAU) was evaluated. Methods: In this multicentre cluster-randomised controlled trial, 59 primary care centres (PCCs) were randomised to BA and TAU. Consenting older (≥65 years) adults (n = 161) with clinically relevant symptoms of depression (PHQ-9 ≥ 10) participated. Interventions were an 8-week individual MHN-led BA programme and unrestricted TAU in which general practitioners followed national guidelines. The primary outcome was self-reported depression (QIDS-SR16) at 9 weeks and 3, 6, 9, and 12-month follow-up. Results: Data of 96 participants from 21 PCCs in BA and 65 participants from 16 PCCs in TAU, recruited between July 4, 2016, and September 21, 2020, were included in the intention-to-treat analyses. At post-treatment, BA participants reported significantly lower severity of depressive symptoms than TAU participants (QIDS-SR16 difference = −2.77, 95% CI = −4.19 to −1.35), p < 0.001; between-group effect size = 0.90; 95% CI = 0.42–1.38). This difference persisted up to the 3-month follow-up (QIDS-SR16 difference = −1.53, 95% CI = −2.81 to −0.26, p = 0.02; between-group effect size = 0.50; 95% CI = 0.07–0.92) but not up to the 12-month follow-up [QIDS-SR16 difference = −0.89 (−2.49 to 0.71)], p = 0.28; between-group effect size = 0.29 (95% CI = −0.82 to 0.24). Conclusions: BA led to a greater symptom reduction of depressive symptoms in older adults, compared to TAU in primary care, at post-treatment and 3-month follow-up, but not at 6- to 12-month follow-up.

Fast and accurate assessment of depression based on voice acoustic features: a cross-sectional and longitudinal study.

Depression is a widespread mental disorder that affects a significant portion of the population. However, the assessment of depression is often subjective, relying on standard questions or interviews. Acoustic features have been suggested as a reliable and objective alternative for depression assessment. Therefore, in this study, we aim to identify and explore voice acoustic features that can effectively and rapidly predict the severity of depression, as well as investigate the potential correlation between specific treatment options and voice acoustic features. We utilized voice acoustic features correlated with depression scores to train a prediction model based on artificial neural network. Leave-one-out cross-validation was performed to evaluate the performance of the model. We also conducted a longitudinal study to analyze the correlation between the improvement of depression and changes in voice acoustic features after an Internet-based cognitive-behavioral therapy (ICBT) program consisting of 12 sessions. Our study showed that the neural network model trained based on the 30 voice acoustic features significantly correlated with HAMD scores can accurately predict the severity of depression with an absolute mean error of 3.137 and a correlation coefficient of 0.684. Furthermore, four out of the 30 features significantly decreased after ICBT, indicating their potential correlation with specific treatment options and significant improvement in depression (p < 0.05). Voice acoustic features can effectively and rapidly predict the severity of depression, providing a low-cost and efficient method for screening patients with depression on a large scale. Our study also identified potential acoustic features that may be significantly related to specific treatment options for depression.

The Effectiveness of Cognitive Behavioral Therapy for Depression Among Individuals with Diabetes: a Systematic Review and Meta-Analysis.

Depression is prevalent and common among individuals living with diabetes. The aim of this review is to systematically assess and meta-analyze the treatment effect of cognitive-behavioral therapy for depression (and other affective outcomes) among patients with diabetes. Earlier investigations found both psychosocial and pharmacological interventions, including cognitive-behavioral therapy, were promising in managing depression in patients with diabetes, though these findings remain inclusive due to poor study designs and a small number of trials included, which calls for a comprehensive systematic review and meta-analysis. A total of 33 studies (89 effect sizes) reported a moderate and statistically significant treatment effect of cognitive-behavioral therapy for depressive symptoms among individuals with diabetes (d = 0.301, 95% CI 0.115-0.487, p < 0.001). On average, cognitive-behavioral therapy was effective for psychological stress/distress outcomes but not for anxiety or physiological outcomes. The findings of the study confirmed CBT as an effective treatment option for depression among diabetes patients and identified important areas for future research.

Effects of Metabolic Syndrome and Sex on Stress Coping Strategies in Individuals with Depressive Disorder

Metabolic syndrome (MetS) is related to depression and contributes to reduced life expectancy in individuals with mental disorders. Stress coping strategies are important factors in the development and maintenance of depressive disorders and have been related to metabolic disturbances. The aim of this study was to determine whether there is a difference in the use of positive (re- and devaluation, distraction, and control) and negative stress coping strategies in relation to patients’ MetS. A sample of 363 individuals (n female = 204, n male = 159) with a diagnosis of depression was measured with the Stress Coping Style Questionnaire and the Beck Depression Inventory. In addition, we collected data on MetS (waist circumference, triglycerides, high-density lipoprotein, fasting glucose/diabetes, blood pressure/hypertonia) according to the International Diabetes Federation. A 2 × 2 design including Mets (with vs. without) and sex (female vs. male) was performed to test for differences in stress coping strategies. Individuals with depression and MetS scored higher on distraction strategies than depressed individuals without MetS (p &lt; 0.01, corrected with false discovery rate). In addition, we found sex differences in stress coping strategies indicating that women with depression scored higher on distraction strategies (p &lt; 0.001, FDR corrected), as well as negative strategies (p &lt; 0.001, FDR corrected), than men. No significant interaction between MetS and sex was found regarding the higher value of stress coping strategies. Findings suggest that individuals with depression and MetS used distraction strategies to a higher amount to cope with stress, which could be stress eating in some cases, than those without MetS. Women with depressive disorders had higher values than men on other coping strategies in our sample of individuals with depression. A better understanding of MetS and sex-specific differences in stress coping strategies might help to plan more effective preventive strategies and personalized treatment options for depression.

Cognitive Behavioral Therapy for Depression Among Chinese Diabetes Patients: A Systematic Review and Meta-Analysis

Objective: The purpose of this study was to evaluate the effectiveness of cognitive behavioral therapy (CBT) for Chinese diabetic patients suffering from depression. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we researched seven electronic databases and two professional websites. Publication bias was assessed using funnel plot. Meta-analysis was conducted using meta-regression with robust variance estimation. Results: Final analysis included a total of 23 controlled trials containing 201 effect size estimates (including 5025 participants). Subgroup analyses indicated significant treatment effects for (1) depression outcomes, anxiety outcomes, psychological stress/distress outcomes, physiological outcomes, and general wellness outcomes, (2) studies with/without manuals, (3) studies using individual-based/group-based CBT, (4) studies in person/assisted with technology, and (5) studies providers with/without training. The treatment outcomes and intervention composition (CBT only versus CBT plus other approaches) were significant moderators. Conclusions: Findings of the study suggested CBT is a promising treatment option for depression among Chinese diabetes patients.

Prevention of mania in a primigravida at ultra-high risk of postpartum recurrence.

Prevention of mania in a primigravida at ultra-high risk of postpartum recurrence.

Internet-Based Cognitive BehaviouralTherapy for Individuals With Depression and Chronic Health Conditions: A Systematic Review.

Cognitive behavioural therapy (CBT) has heightened the need for internet-delivered intervention for depression with chronic diseases than a traditionally-based treatment procedure, and the need for CBT as an internet-delivered intervention has increased because it scales down the stigma of proceeding to a therapist, saves travel time from different geographical areas, and increases access to the service. This study aimed to evaluate the contemporary evidence for the effectiveness of internet-delivered cognitive behavioural therapy (CBT) as a treatment option for depression with chronic illness (CVD, diabetes, chronic pain, cancer, and chronic obstructive pulmonary disease (COPD)) among adult populations in high-income countries. A systematic search strategy was devised based on selecting search terms, inclusion and exclusion criteria, and refinement processes. Electronic searches were conducted using databases related to healthcare and containing peer-reviewed literature: the Cumulated Index to Nursing and Allied Health Literature (CINAHL), the Excerpta Medica Database (Embase), the Medical Literature Analysis and Retrieval System Online (Medline), and PsycINFO. Key search terms were applied to all databases and combined using Boolean operators to maximise the efficiency of the search. This review included randomised controlled trials (RCTs) evaluating the adult population aged ≥18 years published from 2006-2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was employed to guide the review process. The initial search yielded 134 studies across all databases, which were refined, leading to 18 studies in the final review data set. This review suggests that internet-based CBT is an effective strategy for reducing depressive symptoms in patients with comorbid depression and chronic diseases.

Development and pilot of the Alcohol and Depression Decision-Aid for Psychological Treatments (ADDAPT)

PurposeEvidence is lacking as to the superiority of dual-focused versus single-focused approaches in treating depression and alcohol use comorbidity. Different people may also value the different features of treatment options differently, necessitating a decision-support tool. This study aims to test the acceptability, feasibility, safety and potential usefulness of the Alcohol and Depression Decision-Aid for Psychological Treatments (ADDAPT).Design/methodology/approachADDAPT was developed according to International Patient Decision-Aid Standards and in consultation with potential end users. Adults with depression and alcohol use comorbidity, who were considering/recently considered psychological treatments, were recruited via online advertisements. After clicking on the study URL, participants accessed the ADDAPT e-book and completed validated and purpose-designed questionnaires.FindingsOf the 24 participants, most would recommend ADDAPT to others (79.2% agree) and endorsed it as easy-to-use (75%), useful in decision-making (79.2%), presenting balanced (87.5%), up-to-date (91.7%), easy-to-understand (79.2%) and trustworthy information (83.3%), which did not provoke anxiety (i.e. safety; 75%). Post-use, participants felt well prepared to decide on treatment (M = 3.48/5) and demonstrated good treatment knowledge (M = 65.83%). All but one participant indicated a treatment choice supported by best available evidence, and decisional conflict scores except for the uncertainty subscale were below the threshold for decisional delay (all M < 37.5/100).Originality/valueADDAPT is the first decision-aid of its kind, with pilot findings supporting its acceptability, feasibility, safety and potential usefulness for improving decision-making quality among people considering psychological treatment options for depression and alcohol use comorbidity.

Comparative Study of the Antibacterial Activity, Total Phenolic and Total Flavonoid Content of Nine Hypericum Species Grown in Greece

Hypericum perforatum is an herb whose use dates back centuries. Extracts of the plant are available as over-the-counter treatment options for depression. The genus consists of approximately 500 species, most of which have not yet been studied. Antimicrobial resistance has reached alarming levels, indicating a post-antibiotic era as many of the available treatment options become less effective. For this reason, nine Hypericum species were studied for their antimicrobial activity and their total phenolic and flavonoid content. Extracts were tested against Gram-negative and Gram-positive bacteria. Extracts inhibited the growth of Gram-positive bacteria (Staphylococcus aureus and Enterococcus faecalis). The lowest MIC and MBC values were calculated for the extract of H. perforatum against both microorganisms tested, reaching 0.06 mg/mL for S. aureus and 0.13 mg/mL for E. faecalis. Total phenolic content was the highest in the H. perforatum extract (86 ± 12.90 mg GAE/g dry plant material). H. tetrapterum presented the highest flavonoid content, equal to 1.58 ± 0.4 mg RE/g of dry plant material. The Hypericum species studied herein are less common or have not yet been examined compared to H. perforatum; therefore, our study adds new data to the knowledge of the genus Hypericum.