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Scientific Reports Sep 2020We examined if manualized cognitive behavioral therapy (CBT) was more effective than Treatment As Usual (TAU) for clinically depressed adolescents within routine care.... (Randomized Controlled Trial)
Randomized Controlled Trial
We examined if manualized cognitive behavioral therapy (CBT) was more effective than Treatment As Usual (TAU) for clinically depressed adolescents within routine care. This multisite Randomized controlled trail included 88 clinically depressed adolescents (aged 12-21 years) randomly assigned to CBT or TAU. Multiple assessments (pre-, post treatment and six-month follow-up) were done using semi-structured interviews, questionnaires and ratings and multiple informants. The primary outcome was depressive or dysthymic disorder based on the KSADS. Completers, CBT (n = 19) and TAU (n = 26), showed a significant reduction of affective diagnoses at post treatment (76% versus 76%) and after six months (90% versus 79%). Intention-to-treat analyses on depressive symptoms showed that 41.6% within CBT and 31.8% within the TAU condition was below clinical cut-off at post treatment and after six-months, respectively 61.4% and 47.7%. No significant differences in self-reported depressive symptoms between CBT and TAU were found. No prediction or moderation effects were found for age, gender, child/parent educational level, suicidal criteria, comorbidity, and severity of depression. We conclude that CBT did not outperform TAU in clinical practice in the Netherlands. Both treatments were found to be suitable to treat clinically referred depressed adolescents. CBT needs further improvement to decrease symptom levels below the clinical cut-off at post treatment.
Topics: Adolescent; Adult; Child; Cognitive Behavioral Therapy; Humans; Netherlands; Surveys and Questionnaires; Treatment Outcome; Young Adult
PubMed: 32908173
DOI: 10.1038/s41598-020-71160-1 -
Social Psychiatry and Psychiatric... Oct 2020Putative causal relations among depressive symptoms in forms of network structures have been of recent interest, with prior studies suggesting that high connectivity of...
PURPOSE
Putative causal relations among depressive symptoms in forms of network structures have been of recent interest, with prior studies suggesting that high connectivity of the symptom network may drive the disease process. We examined in detail the network structure of depressive symptoms among participants with and without depressive disorders (DD; consisting of major depressive disorder (MDD) and dysthymia) at two time points.
METHODS
Participants were from the nationally representative Health 2000 and Health 2011 surveys. In 2000 and 2011, there were 5998 healthy participants (DD-) and 595 participants with DD diagnosis (DD+). Depressive symptoms were measured using the 13-item version of the Beck Depression Inventory (BDI). Fused Graphical Lasso was used to estimate network structures, and mixed graphical models were used to assess network connectivity and symptom centrality. Network community structure was examined using the walktrap-algorithm and minimum spanning trees (MST). Symptom centrality was evaluated with expected influence and participation coefficients.
RESULTS
Overall connectivity did not differ between networks from participants with and without DD, but more simple community structure was observed among those with DD compared to those without DD. Exploratory analyses revealed small differences between the samples in the order of one centrality estimate participation coefficient.
CONCLUSIONS
Community structure, but not overall connectivity of the symptom network, may be different for people with DD compared to people without DD. This difference may be of importance when estimating the overall connectivity differences between groups with and without mental disorders.
Topics: Depression; Depressive Disorder, Major; Dysthymic Disorder; Health Surveys; Humans; Psychiatric Status Rating Scales
PubMed: 32047972
DOI: 10.1007/s00127-020-01843-7 -
BMJ Open Feb 2021To assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
Databases including PubMed, Scopus and Web of Science were systematically searched up to February 2020 to identify relevant studies that have reported data on the prevalence of depressive symptoms, dysthymia and MDDs among homeless people.
ELIGIBILITY CRITERIA
Original epidemiological studies written in English that addressed the prevalence of depressive problems among homeless people.
DATA EXTRACTION AND SYNTHESIS
A random-effect meta-analysis was performed to pool the prevalence estimated from individual studies. Subgroup and sensitivity analyses were employed to compare the prevalence across the groups as well as to identify the source of heterogeneities. The Joanna Briggs Institute's quality assessment checklist was used to measure the study quality. Cochran's Q and the I test were used to assess heterogeneity between the studies.
RESULTS
Forty publications, including 17 215 participants, were included in the final analysis. This meta-analysis demonstrated considerably higher prevalence rates of depressive symptoms 46.72% (95% CI 37.77% to 55.90%), dysthymia 8.25% (95% CI 4.79% to 11.86%), as well as MDDs 26.24% (95% CI 21.02% to 32.22%) among homeless people. Our subgroup analysis showed that the prevalence of depressive symptoms was high among younger homeless people (<25 years of age), whereas the prevalence of MDD was high among older homeless people (>50 years of age) when compared with adults (25-50 years).
CONCLUSION
This review showed that nearly half, one-fourth and one-tenth of homeless people are suffering from depressive symptoms, dysthymia and MDDs, respectively, which are notably higher than the reported prevalence rates in the general population. The findings suggest the need for appropriate mental health prevention and treatment strategies for this population group.
Topics: Adult; Depression; Depressive Disorder, Major; Dysthymic Disorder; Ill-Housed Persons; Humans; Middle Aged; Prevalence
PubMed: 33622940
DOI: 10.1136/bmjopen-2020-040061 -
Psychiatry Research Sep 2020This study tested the hypothesis that chronic depression (CD) is more similar to depression with multiple prior episodes (ME) than to depression with few prior episodes... (Comparative Study)
Comparative Study
This study tested the hypothesis that chronic depression (CD) is more similar to depression with multiple prior episodes (ME) than to depression with few prior episodes (FE). Data from participants (n = 1013) with mild to moderate depressive symptoms (Patient Health Questionnaire [PHQ-9] score 5 - 14) who took part in a randomized control trial of an internet intervention for depression (EVIDENT trial) were re-analyzed. The MINI-interview was conducted to diagnose CD (n = 376). If CD was not diagnosed, the self-reported number of depressive episodes was used to categorize participants as having episodic depression with up to five (FE, n = 422) or more than five (ME, n = 215) prior episodes. Over a three-year period, participants were assessed repeatedly regarding the course of depression (PHQ-9, QIDS), quality of life (SF-12) and therapeutic progress (FEP-2). At baseline, most scores were different between CD and FE but comparable between CD and ME. Time to remission did not differ between CD and ME but was longer in CD compared to FE. Results suggest that ME closely resembles CD and that CD differs from FE.
Topics: Adult; Chronic Disease; Depression; Depressive Disorder, Major; Female; Humans; Male; Middle Aged; Patient Health Questionnaire; Quality of Life; Randomized Controlled Trials as Topic; Self Report; Time Factors
PubMed: 32599445
DOI: 10.1016/j.psychres.2020.113235 -
JMIR Medical Informatics Jun 2021In the era of big data, networks are becoming a popular factor in the field of data analysis. Networks are part of the main structure of BeGraph software, which is a 3D...
BACKGROUND
In the era of big data, networks are becoming a popular factor in the field of data analysis. Networks are part of the main structure of BeGraph software, which is a 3D visualization application dedicated to the analysis of complex networks.
OBJECTIVE
The main objective of this research was to visually analyze tendencies of mental health diseases in a region of Spain, using the BeGraph software, in order to make the most appropriate health-related decisions in each case.
METHODS
For the study, a database was used with 13,531 records of patients with mental health disorders in three acute medical units from different health care complexes in a region of Spain. For the analysis, BeGraph software was applied. It is a web-based 3D visualization tool that allows the exploration and analysis of data through complex networks.
RESULTS
The results obtained with the BeGraph software allowed us to determine the main disease in each of the health care complexes evaluated. We noted 6.50% (463/7118) of admissions involving unspecified paranoid schizophrenia at the University Clinic of Valladolid, 9.62% (397/4128) of admissions involving chronic paranoid schizophrenia with acute exacerbation at the Zamora Hospital, and 8.84% (202/2285) of admissions involving dysthymic disorder at the Rio Hortega Hospital in Valladolid.
CONCLUSIONS
The data analysis allowed us to focus on the main diseases detected in the health care complexes evaluated in order to analyze the behavior of disorders and help in diagnosis and treatment.
PubMed: 34132650
DOI: 10.2196/15527 -
Psychiatry and Clinical Neurosciences Aug 2019Understanding premorbid personality is important, especially when considering treatment selection. Historically, the premorbid personality of patients with major...
AIM
Understanding premorbid personality is important, especially when considering treatment selection. Historically, the premorbid personality of patients with major depression in Japan was described as Shuchaku-kishitsu [similar to Typus melancholicus], as proposed by Shimoda in the 1930s. Since around 2000, there have been increased reports in Japan of young adults with depression who have had premorbid personality differing from the traditional type. In 2005, Tarumi termed this novel condition 'dysthymic-type depression,' and more recently the condition has been called Shin-gata/Gendai-gata Utsu-byo [modern-type depression (MTD)]. We recently developed a semi-structured diagnostic interview to evaluate MTD. Development of a tool that enables understanding of premorbid personality in a short time, especially at the early stage of treatment, is desirable. The object of this study was to develop a self-report scale to evaluate the traits of MTD, and to assess the scale's psychometric properties, diagnostic accuracy, and biological validity.
METHODS
A sample of 340 participants from clinical and community settings completed measures. Psychometric properties were assessed with factor analysis. Diagnostic accuracy of the MTD traits was compared against a semi-structured interview.
RESULTS
The questionnaire contained 22 items across three subscales, thus we termed it the 22-item Tarumi's Modern-Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self-Esteem (TACS-22). Internal consistency, test-retest reliability, and convergent validity were all satisfactory. Among patients with major depression, the area under the curve was 0.757 (sensitivity of 63.1% and specificity of 82.9%) and the score was positively correlated with plasma tryptophan.
CONCLUSION
The TACS-22 possessed adequate psychometric properties and diagnostic accuracy in an initial sample of Japanese adults. Additional research on its ability to support clinical assessment of MTD is warranted.
Topics: Adolescent; Adult; Depression; Female; Humans; Male; Middle Aged; Prodromal Symptoms; Psychiatric Status Rating Scales; Psychometrics; Self Concept; Self Report; Sensitivity and Specificity; Social Behavior; Tryptophan; Young Adult
PubMed: 30900331
DOI: 10.1111/pcn.12842 -
Clinical Case Reports Sep 2021Comprehensive clinical assessment with integrated team approach is crucial in managing cases of non-organic visual loss. Apart from pharmacotherapy, psychosocial...
Comprehensive clinical assessment with integrated team approach is crucial in managing cases of non-organic visual loss. Apart from pharmacotherapy, psychosocial rehabilitation should also be adequately addressed.
PubMed: 34584704
DOI: 10.1002/ccr3.4809