Efficacy Trial of a Brief Cognitive-Behavioral Depression Prevention Program for High-Risk Adolescents: Effects at 1- and 2-Year Follow-Up

ERIC Educational Resources Information Center

Stice, Eric; Rohde, Paul; Gau, Jeff M.; Wade, Emily

2010-01-01

Objective: To evaluate the effects of a brief group cognitive-behavioral (CB) depression prevention program for high-risk adolescents with elevated depressive symptoms at 1- and 2-year follow-up. Method: In this indicated prevention trial, 341 at-risk youths were randomized to a group CB intervention, group supportive expressive intervention, CB…

Prevention of adolescent depression in the Spanish-speaking world.

PubMed

Horn, Andrea B; Cañizares, Catalina; Gómez, Yvonne

2014-05-27

This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America. The main goal of this paper is to make the studies and movements of the Spanish-speaking literature in this field accessible to the non-Spanish-speaking part of the research community. Therefore, after an introduction referring to possible cultural differences regarding depression in general and epidemiological basics, several programs are introduced. In total 11 programs will be shortly presented and discussed. After revising the programs it can be concluded that in the Spanish-speaking world many programs have been developed and conducted following current state of the art-approaches for adolescent depression prevention. Further research is needed especially targeting possible cultural and contextual aspects of prevention measures and their efficacy and efficiency.

Prevention of Adolescent Depression in the Spanish-Speaking World

PubMed Central

Horn, Andrea B.; Cañizares, Catalina; Gómez, Yvonne

2014-01-01

This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America. The main goal of this paper is to make the studies and movements of the Spanish-speaking literature in this field accessible to the non-Spanish-speaking part of the research community. Therefore, after an introduction referring to possible cultural differences regarding depression in general and epidemiological basics, several programs are introduced. In total 11 programs will be shortly presented and discussed. After revising the programs it can be concluded that in the Spanish-speaking world many programs have been developed and conducted following current state of the art-approaches for adolescent depression prevention. Further research is needed especially targeting possible cultural and contextual aspects of prevention measures and their efficacy and efficiency. PMID:24871258

A Qualitative Investigation of Adolescents’ Perceived Mechanisms of Change from a Universal School-Based Depression Prevention Program

PubMed Central

Shochet, Ian; Montague, Roslyn; Smith, Coral; Dadds, Mark

2014-01-01

A recent meta-analysis provides evidence supporting the universal application of school-based prevention programs for adolescent depression. The mechanisms underlying such successful interventions, however, are largely unknown. We report on a qualitative analysis of 109 Grade 9 students’ beliefs about what they gained from an evidence-based depression prevention intervention, the Resourceful Adolescent Program (RAP-A). Fifty-four percent of interviewees articulated at least one specific example of program benefit. A thematic analysis of responses revealed two major themes, improved interpersonal relationships and improved self-regulation, both stronger than originally assumed. A more minor theme also emerged—more helpful cognitions. It is postulated that both improved interpersonal relationships and improved self-regulation are likely to enhance one another, and more helpful cognitions may express its contribution through enhanced self-regulation. These findings broaden our understanding of the impact of depression prevention programs, beginning to illuminate how such programs benefit participants. PMID:24859679

Evaluation of a School-Based Depression Prevention Program among Adolescents from Low-Income Areas: A Randomized Controlled Effectiveness Trial

PubMed Central

Kindt, Karlijn C. M.; Kleinjan, Marloes; Janssens, Jan M. A. M.; Scholte, Ron H. J.

2014-01-01

A randomized controlled trial was conducted among a potential high-risk group of 1,343 adolescents from low-income areas in The Netherlands to test the effectiveness of the depression prevention program Op Volle Kracht (OVK) as provided by teachers in a school setting. The results showed no main effect of the program on depressive symptoms at one-year follow-up. A moderation effect was found for parental psychopathology; adolescents who had parents with psychopathology and received the OVK program had less depressive symptoms compared to adolescents with parents with psychopathology in the control condition. No moderating effects on depressive symptoms were found for gender, ethnical background, and level of baseline depressive symptoms. An iatrogenic effect of the intervention was found on the secondary outcome of clinical depressive symptoms. Based on the low level of reported depressive symptoms at baseline, it seems that our sample might not meet the characteristics of a high-risk selective group for depressive symptoms. Therefore, no firm conclusions can be drawn about the selective potential of the OVK depression prevention program. In its current form, the OVK program should not be implemented on a large scale in the natural setting for non-high-risk adolescents. Future research should focus on high-risk participants, such as children of parents with psychopathology. PMID:24837666

A randomized controlled trial testing the effectiveness of a universal school-based depression prevention program 'Op Volle Kracht' in the Netherlands.

PubMed

Tak, Yuli R; Van Zundert, Rinka Mp; Kuijpers, Rowella Cwm; Van Vlokhoven, Boukje S; Rensink, Hettie Fw; Engels, Rutger Cme

2012-01-10

The incidence of depressive symptoms increases during adolescence, from 10.0% to 24.5% at age 11 to 15, respectively. Experiencing elevated levels of depressive symptoms increases the risk of a depressive disorder in adulthood. A universal school-based depression prevention program Op Volle Kracht (OVK) was developed, based on the Penn Resiliency Program, aimed at preventing the increase of depressive symptoms during adolescence and enhancing positive development. In this study the effectiveness of OVK will be tested and possible mediators of program effects will be focus of study as well. The effectiveness of OVK will be tested in a randomized controlled trial with two conditions, intervention (OVK) and control condition (care as usual). Schools are randomly assigned to research conditions. OVK will be incorporated in the school curriculum, maximizing program attendance. OVK consists of 16 lessons of 50 min, given by trained psychologists to groups of 11-15 students. OVK contains Cognitive Behavioral Therapy, social skills training, problem solving and decision making. Outcomes are measured at 6, 12, 18 and 24 months follow up, to monitor long term program effects. Primary outcome is level of depressive symptoms, secondary outcomes are: anxiety, hopelessness, cognitive bias, substance use, truancy, life satisfaction, coping, self-efficacy, optimism, happiness, friendship, school performance and school attitude. The questionnaires for students will be administered in the school setting. Parents will complete a questionnaire at baseline only. In this paper the study into the effectiveness of the depression prevention program OVK was described. It is expected that OVK will prevent the increase in depressive symptoms during adolescence and enhance positive development in the intervention condition, compared to the control condition. If OVK will be effective, it can be implemented in the school context by which numerous adolescents can be reached. Netherlands Trial Register (NTR): NTR2879.

Training School Personnel to Implement a Universal School-Based Prevention of Depression Program under Real-World Conditions

ERIC Educational Resources Information Center

Harnett, P.H.; Dadds, M.R.

2004-01-01

The present study evaluated the impact of a universal prevention of depression program [the Resourceful Adolescent Program (RAP)] when implemented under real-world conditions in a school setting. Prior research has found the RAP program to be beneficial for high-school students when the program was implemented by university staff selected,…

A Randomized Placebo-Controlled Trial of a School-Based Depression Prevention Program.

ERIC Educational Resources Information Center

Merry, Sally; McDowell, Heather; Wild, Chris J.; Bir, Julliet; Cunliffe, Rachel

2004-01-01

Objective: To conduct a placebo-controlled study of the effectiveness of a universal school-based depression prevention program. Method: Three hundred ninety-two students age 13 to 15 from two schools were randomized to intervention (RAP-Kiwi) and placebo programs run by teachers. RAP-Kiwi was an 11-session manual-based program derived from…

The Effectiveness of a School-Based Adolescent Depression Education Program

ERIC Educational Resources Information Center

Swartz, Karen L.; Kastelic, Elizabeth A.; Hess, Sally G.; Cox, Todd S.; Gonzales, Lizza C.; Mink, Sallie P.; DePaulo, J. Raymond, Jr.

2010-01-01

In an effort to decrease the suicide rate in adolescents, many interventions have focused on school-based suicide prevention programs. Alternatively, depression education in schools might be effective in decreasing the morbidity, mortality, and stigma associated with adolescent depression. The Adolescent Depression Awareness Program (ADAP)…

Cost-effectiveness of a program to prevent depression relapse in primary care.

PubMed

Simon, Gregory E; Von Korff, Michael; Ludman, Evette J; Katon, Wayne J; Rutter, Carolyn; Unützer, Jürgen; Lin, Elizabeth H B; Bush, Terry; Walker, Edward

2002-10-01

Evaluate the incremental cost-effectiveness of a depression relapse prevention program in primary care. Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks later. Those recovered from the current episode but at high risk for relapse (based on history of recurrent depression or dysthymia) were offered randomization to usual care or a relapse prevention intervention. The intervention included systematic patient education, two psychoeducational visits with a depression prevention specialist, shared decision-making regarding maintenance pharmacotherapy, and telephone and mail monitoring of medication adherence and depressive symptoms. Outcomes in both groups were assessed via blinded telephone assessments at 3, 6, 9, and 12 months and health plan claims and accounting data. Intervention patients experienced 13.9 additional depression-free days during a 12-month period (95% CI, -1.5 to 29.3). Incremental costs of the intervention were $273 (95% CI, $102 to $418) for depression treatment costs only and $160 (95% CI, -$173 to $512) for total outpatient costs. Incremental cost-effectiveness ratio was $24 per depression-free day (95% CI, -$59 to $496) for depression treatment costs only and $14 per depression-free day (95% CI, -$35 to $248) for total outpatient costs. A program to prevent depression relapse in primary care yields modest increases in days free of depression and modest increases in treatment costs. These modest differences reflect high rates of treatment in usual care. Along with other recent studies, these findings suggest that improved care of depression in primary care is a prudent investment of health care resources.

Effectiveness of depression and anxiety prevention in adolescents with high familial risk: study protocol for a randomized controlled trial.

PubMed

Rasing, Sanne P A; Creemers, Daan H M; Janssens, Jan M A M; Scholte, Ron H J

2013-11-22

Depression and anxiety disorders during adolescence can have detrimental consequences. Both disorders are related to negative outcome in various areas during adolescence and are also predictive of depression and anxiety disorders later in life. Especially parental psychopathology and being female are risk factors that increase the probability of developing one of these disorders during adolescence. Research has shown that prevention programs have promising results, especially for adolescents who have these risk factors. Therefore, in this study, we will focus on the effectiveness of a prevention program 'A jump forward' that has been developed for adolescent girls with a familial risk of depression and/or anxiety. We designed a randomized controlled trial to test the effectiveness of an indicated and selective prevention program aimed at depression and anxiety in adolescent girls. Adolescents aged between 11 and 15 years old with depressive and/or anxiety symptoms and with parents who show indicators of parental psychopathology will be randomly assigned to the experimental (N = 80) or control groups (N = 80). Participants in the experimental group will follow a preventive intervention, consisting of six sessions of 90 minutes each. All participants will complete baseline, intervention phase 1 (after session 2), intervention phase 2 (after session 4), post-intervention, 6 month follow-up, and 12 month follow-up assessments. Furthermore, parents will be asked to complete assessments at baseline, post-intervention, and 12-month follow-up. Primary outcome will be depressive symptoms. Secondary outcomes will be anxiety symptoms, suicidal ideation, response style, negative cognitive errors, parental emotional support and parental control, parental psychopathology, parenting stress and adolescents' depression and anxiety symptoms according to the parents. This paper described the study designed to evaluate a program for preventing depression and/or anxiety in high-risk adolescents over a 12-month follow-up period. If the program showed to be effective in reducing symptoms of depression and anxiety and preventing adolescents from developing clinical levels of these disorders, our results would be relevant to practice. Thus, the intervention could be used on a large scale. Moreover, this study aims to contribute to the evidence-based prevention of depression and anxiety of adolescents. Dutch Trial Register NTR3720.

Evaluation of a multimodal school-based depression and suicide prevention program among Dutch adolescents: design of a cluster-randomized controlled trial.

PubMed

Gijzen, Mandy W M; Creemers, Daan H M; Rasing, Sanne P A; Smit, Filip; Engels, Rutger C M E

2018-05-10

Since 2010, suicide has been the most important cause of mortality in youth aged 15 to 29 years in the Netherlands. Depression is an important risk factor for suicidal behaviors (i.e., suicide ideation, deliberate self-harm, planning, and suicide attempts) in adolescents. Adolescents who develop depressive symptoms, are also at risk for adult depression. This developmental continuity is especially noticeable in adolescents compared to other age groups; therefore, it is necessary to develop preventive strategies for teens. This study will test a multimodal school-based approach to suicide and depression prevention, which integrates universal and targeted approaches and includes various stakeholders (schools, adolescents, parents, and mental health professionals) simultaneously. We will perform a cluster randomized controlled trial (RCT) with an intervention and control condition to test the effectiveness of a school-based multimodal stepped-prevention program for depression and suicidal behaviors in adolescents. Adolescents in their second year of secondary education will participate in the study. The participants in the intervention condition will receive the entire multimodal stepped-preventive program comprising early screening and detection of suicidal behaviors and depressive symptoms, a safety net consisting of gatekeepers at school, followed by universal and indicated prevention. The participants in the control condition will undergo only the screening and the safety net of gatekeepers at schools. They will complete assessments at baseline, post-intervention, and 6, 12, and 24-month follow-up. Primary outcome will be suicidal behaviors measured at 12-months follow-up. Additionally, the present study will identify mechanisms that mediate and moderate the program effects and test the effect of the program on various secondary outcomes. If the school-based multimodal stepped-prevention program proves to be effective, it could be implemented in schools on a large scale. The study is registered in the Dutch Trial Register ( NTR6622 ).

Understanding adolescent response to a technology-based depression prevention program.

PubMed

Gladstone, Tracy; Marko-Holguin, Monika; Henry, Jordan; Fogel, Joshua; Diehl, Anne; Van Voorhees, Benjamin W

2014-01-01

Guided by the Behavioral Vaccine Theory of prevention, this study uses a no-control group design to examine intervention variables that predict favorable changes in depressive symptoms at 6- to 8-week follow-up in at-risk adolescents who participated in a primary care, Internet-based prevention program. Participants included 83 adolescents from primary care settings ages 14 to 21 (M = 17.5, SD = 2.04), 56.2% female, with 41% non-White. Participants completed self-report measures, met with a physician, and then completed a 14-module Internet intervention targeting the prevention of depression. Linear regression models indicated that several intervention factors (duration on website in days, the strength of the relationship with the physician, perceptions of ease of use, and the perceived relevance of the material presented) were significantly associated with greater reductions in depressive symptoms from baseline to follow-up. Automatic negative thoughts significantly mediated the relation between change in depressive symptoms scores and both duration of use and physician relationship. Several intervention variables predicted favorable changes in depressive symptom scores among adolescents who participated in an Internet-based prevention program, and the strength of two of these variables was mediated by automatic negative thoughts. These findings support the importance of cognitive factors in preventing adolescent depression and suggest that modifiable aspects of technology-based intervention experience and relationships should be considered in optimizing intervention design.

Prevention and Intervention of Depression in Asian-American Adolescents

ERIC Educational Resources Information Center

Dieu, Kim

2016-01-01

Depression is one of the most common psychological disorders experienced by adolescents. Research has shown depression rates are higher in Asian-American adolescents when compared to their European-American counterparts. This paper will investigate possible programs for preventing and responding to Asian-American youths' depression through a…

Teachers or Psychologists: Who Should Facilitate Depression Prevention Programs in Schools?

PubMed Central

Wahl, Melanie S.; Adelson, Jill L.; Patak, Margarete A.; Pössel, Patrick; Hautzinger, Martin

2014-01-01

The current study evaluates a depression prevention program for adolescents led by psychologists vs. teachers in comparison to a control. The universal school-based prevention program has shown its efficacy in several studies when implemented by psychologists. The current study compares the effects of the program as implemented by teachers versus that implemented by psychologists under real-life conditions. A total of 646 vocational track 8th grade students from Germany participated either in a universal prevention program, led by teachers (n = 207) or psychologists (n = 213), or a teaching-as-usual control condition (n = 226). The design includes baseline, post-intervention, and follow-up (at 6 and 12 months post-intervention). The cognitive-behavioral program includes 10 sessions held in a regular school setting in same-gender groups and is based on the social information-processing model of social competence. Positive intervention effects were found on the change in girls’ depressive symptoms up to 12 months after program delivery when the program was implemented by psychologists. No such effects were found on boys or when program was delivered by teachers. The prevention program can successfully be implemented for girls by psychologists. Further research is needed for explanations of these effects. PMID:24837667

Depression Prevention for Early Adolescent Girls

PubMed Central

Chaplin, Tara M.; Gillham, Jane E.; Reivich, Karen; Elkon, Andrea G. L.; Samuels, Barbra; Freres, Derek R.; Winder, Breanna; Seligman, Martin E. P.

2015-01-01

Given the dramatic increase in depression that occurs during early adolescence in girls, interventions must address the needs of girls. The authors examined whether a depression prevention program, the Penn Resiliency Program, was more effective for girls in all-girls groups than in co-ed groups. Within co-ed groups, the authors also tested whether there were greater effects for boys than for girls. Participants were 208 11- to 14-year-olds. Girls were randomly assigned to all-girls groups, co-ed groups, or control. Boys were assigned to co-ed groups or control. Students completed questionnaires on depressive symptoms, hopelessness, and explanatory style before and after the intervention. Girls groups were better than co-ed groups in reducing girls’hopelessness and for session attendance rates but were similar to co-ed groups in reducing depressive symptoms. Co-ed groups decreased depressive symptoms, but this did not differ by gender. Findings support prevention programs and suggest additional benefits of girls groups. PMID:26139955

The effect of a depression prevention program on negative cognitive style trajectories in early adolescents.

PubMed

Kindt, Karlijn C M; Kleinjan, Marloes; Janssens, Jan M A M; Scholte, Ron H J

2016-10-01

As restructuring a negative cognitive style is a central skill taught in many depression prevention programs, we tested whether a universal prevention program evoked a change in negative cognitive style in adolescents. In addition, we examined distinct developmental trajectories of negative cognitive styles and assessed whether research condition (intervention versus control) predicted these trajectories. Young adolescents (n = 1343; Mean age = 13.4 years; SD = 0.77; 52.3% girls) were randomly allocated to a cognitive behavioral therapy (CBT)-based depression prevention program or a care as usual control condition. A negative cognitive style was assessed at baseline, post-treatment and 6- and 12-months follow-up. Adolescents who received the intervention did not differ in their negative cognitive style from the control group at any time-point. We found four distinctive trajectories of negative cognitive style: normative, increasing, decreasing and stable high, which were not predicted by intervention condition and were not moderated by gender. Yet, the results revealed a trend, which indicated that adolescents who followed the program tended to show an increasing than a normative developmental pattern. We concluded that the CBT-based depression prevention program did not reduce or prevent an increase in negative cognitive style. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial

PubMed Central

La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn

2016-01-01

Background Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the development and initial evaluation of a transdiagnostic school-based preventive intervention for adolescents with elevated symptoms of social anxiety and/or depression and elevated peer victimization. We modified Interpersonal Psychotherapy-Adolescent Skills Training for depression, incorporating strategies for dealing with social anxiety and peer victimization. Objective Our open trial assessed the feasibility, acceptability, and preliminary benefit of the modified program (called UTalk) for adolescents at risk for SAD or depression and who also reported peer victimization. Method Adolescents (N=14; 13–18 years; 79% girls; 86% Hispanic) were recruited and completed measures of peer victimization, social anxiety, and depression both pre- and post-intervention and provided ratings of treatment satisfaction. Independent evaluators (IEs) rated youths’ clinical severity. The intervention (3 individual and 10 group sessions) was conducted weekly during school. Results Regarding feasibility, 86% of the adolescents completed the intervention (M attendance=11.58 sessions). Satisfaction ratings were uniformly positive. Intention-to-treat analyses revealed significant declines in adolescent- and IE-rated social anxiety and depression and in reports of peer victimization. Additional secondary benefits were observed. Conclusions Although further evaluation is needed, the UTalk intervention appears feasible to administer in schools, with high satisfaction and preliminary benefit. Implications for research on the prevention of adolescent SAD and depression are discussed. PMID:27857509

The Prevention of Depression in 8- to 9-Year-Old Children: A Pilot Study

ERIC Educational Resources Information Center

Rooney, Rosanna; Roberts, Clare; Kane, Robert; Pike, Lisbeth; Winsor, Amber; White, Julia; Brown, Annette

2006-01-01

The outcomes of a new universal program aimed at preventing depressive symptoms and disorders in 8- to 9-year-old children are presented. The Positive Thinking Program is a mental health promotion program based on cognitive and behavioural strategies. It is designed to meet the developmental needs of children in the middle primary school Years 4…

Postpartum Depression Prevention for Reservation-Based American Indians: Results from a Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Ginsburg, Golda S.; Barlow, Allison; Goklish, Novalene; Hastings, Ranelda; Baker, Elena Varipatis; Mullany, Britta; Tein, Jenn-Yun; Walkup, John

2012-01-01

Background: Postpartum depression is a devastating condition that affects a significant number of women and their offspring. Few preventive interventions have targeted high risk youth, such as American Indians (AIs). Objective: To evaluate the feasibility of a depression prevention program for AI adolescents and young adults. Methods: Expectant AI…

Influence of General Self-Efficacy on the Effects of a School-Based Universal Primary Prevention Program of Depressive Symptoms in Adolescents: A Randomized and Controlled Follow-up Study

ERIC Educational Resources Information Center

Possel, Patrick; Baldus, Christiane; Horn, Andrea B.; Groen, Gunter; Hautzinger, Martin

2005-01-01

Background: Depressive disorders in adolescents are a widespread and increasing problem. Prevention seems a promising and feasible approach. Methods: We designed a cognitive-behavioral school-based universal primary prevention program and followed 347 eighth-grade students participating in a randomized controlled trial for three months. Results:…

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives

PubMed Central

Eisen, Jeffrey C.; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy

2013-01-01

Objective: To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. Method: The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). Results: While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Conclusion: Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. Trial Registration: ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912 PMID:24800110

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives.

PubMed

Eisen, Jeffrey C; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy; Van Voorhees, Benjamin W

2013-01-01

To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912.

Reduced substance use as a secondary benefit of an indicated cognitive-behavioral adolescent depression prevention program.

PubMed

Rohde, Paul; Stice, Eric; Gau, Jeff M; Marti, C Nathan

2012-09-01

Our first aim was to test whether a group cognitive-behavioral (CB) depression prevention program reduces substance use escalation over 2-year follow-up relative to two active comparison interventions and a brochure assessment control. Our second aim examined whether reductions in depressive symptoms mediate intervention effects, as posited by the affect-regulation model of substance use. In this indicated prevention trial, 341 high school adolescents at risk for depression because of the presence of elevated depressive symptoms were randomized to a Group CB intervention, group supportive-expressive group intervention, CB bibliotherapy, or educational brochure control condition. Participants in Group CB had significantly lower rates of substance use compared with brochure control participants at both 1- and 2-year follow-up and lower substance use at 2-year follow-up relative to bibliotherapy participants; no other condition differences were significant. Mediational analyses suggested that reductions in depressive symptoms from baseline to posttest accounted for changes in substance use over 2 years for participants in Group CB relative to brochure control participants but did not mediate effects relative to those receiving bibliotherapy. Results suggest that a secondary benefit of this CB group indicated depression prevention program is lower rates of long-term substance use. Findings supported the hypothesis that, relative to a nonactive comparison condition, reductions in depressive symptoms mediated the effects of Group CB prevention on substance use escalation. PsycINFO Database Record (c) 2012 APA, all rights reserved.

School-Based Prevention of Depressive Symptoms: A Randomized Controlled Study of the Effectiveness and Specificity of the Penn Resiliency Program

ERIC Educational Resources Information Center

Gillham, Jane E.; Reivich, Karen J.; Freres, Derek R.; Chaplin, Tara M.; Shatte, Andrew J.; Samuels, Barbra; Elkon, Andrea G. L.; Litzinger, Samantha; Lascher, Marisa; Gallop, Robert; Seligman, Martin E. P.

2007-01-01

The authors investigated the effectiveness and specificity of the Penn Resiliency Program (PRP; J. E. Gillham, L. H. Jaycox, K. J. Reivich, M. E. P. Seligman, & T. Silver, 1990), a cognitive-behavioral depression prevention program. Children (N = 697) from 3 middle schools were randomly assigned to PRP, Control (CON), or the Penn Enhancement …

Translating basic psychopathology research to preventive interventions: A tribute to John Abela

PubMed Central

Garber, Judy; Korelitz, Katherine E.; Larkin, Silvia Samanez

2012-01-01

This paper highlights how the many important contributions of John R. Z. Abela’s research program can inform the development and implementation of interventions for preventing depression in youth. Abela provided evidence of multiple vulnerabilities to depression including cognitive (e.g., inferential style, dysfunctional attitudes, ruminative response style), interpersonal (e.g., reassurance seeking, attachment, dependency), personality (e.g., neuroticism, self-criticism), and contextual (e.g., stress, parental depression). He introduced important methodological advances to the study of the hopelessness model of depression, especially in children, including the “weakest link” approach, cognitive priming, and idiographic measurement of stress. We briefly review what is currently known about the prevention of depression regarding intervention targets, content, outcomes, effect sizes, moderators, mediators, specificity, and durability. Next, we summarize several of Abela’s contributions that are most relevant to the prevention of depression. We describe the implications of Abela’s work for the development, implementation, and testing of programs aimed at preventing depression, and discuss important challenges such as the transfer of training to and the personalization of interventions so as to capitalize on individuals’ strengths versus compensate for their weaknesses. PMID:22891820

Developing a Culturally Appropriate Depression Prevention Program: Opportunities and Challenges

ERIC Educational Resources Information Center

Cardemil, Esteban V.; Kim, Saeromi; Davidson, Tatiana; Sarmiento, Ingrid A.; Ishikawa, Rachel Zack; Sanchez, Monica; Torres, Sandra

2010-01-01

This paper describes the experiences of the first author and his colleagues in the development and implementation of a depression prevention program that specifically targets Latina mothers. Building on the earlier papers that highlight the underutilization of mental health services by Latinos in general, this paper will make the case that the…

A Pilot Randomised Controlled Trial of a School-Based Resilience Intervention to Prevent Depressive Symptoms for Young Adolescents with Autism Spectrum Disorder: A Mixed Methods Analysis

ERIC Educational Resources Information Center

Mackay, Bethany A.; Shochet, Ian M.; Orr, Jayne A.

2017-01-01

Despite increased depression in adolescents with Autism Spectrum Disorder (ASD), effective prevention approaches for this population are limited. A mixed methods pilot randomised controlled trial (N = 29) of the evidence-based Resourceful Adolescent Program-Autism Spectrum Disorder (RAP-A-ASD) designed to prevent depression was conducted in…

[Vulnerability to depression in children and adolescents: update and perspectives].

PubMed

Purper-Ouakil, D; Michel, G; Mouren-Siméoni, M-C

2002-01-01

Depression in children and adolescents is associated with poor psychosocial functioning, high psychiatric comorbidity, risk of recurrent episodes or onset of bipolar disorder. These findings emphasize the importance of early identification of children and adolescents having elevated risk for future depression and further development, evaluation and greater availability of prevention strategies. Our review aims an update about depressive vulnerability in children and adolescents in the perspective of better identification of at-risk populations and targeting of prevention programs. Psychopathology, in particular anxiety and disruptive disorders are well identified risk-factors for later depression. Subclinical depressive symptomatology, also termed "demoralization", also identifies high-risk populations, likely to become incident cases of depression. It is still unclear whether this condition is prodromal depression, a specific clinical entity or the expression of biological and/or cognitive vulnerability. Familial risk for depressive disorders involves both genetic and psychosocial factors. Marital discord, poor communication and dysfunctional parenting practices are often present in families with affective disorders and can be implicated in increased depressive vulnerability in the offspring. Research on individual vulnerability in children and adolescents has focused on temperamental and cognitive characteristics. Temperament traits describe individual differences in reactivity and behavior. High emotionality, defined as the tendency to become upset easily and intensely has been associated with an increased risk for subsequent major depression. However, as the majority of high scorers will not become depressive cases, emotionality should not be the only criterion for selection of at-risk populations. Cognitive style including poor self esteem, low social competence and negative attributions are also associated with increased likelihood of depressive symptoms, but their predictive value for the onset of clinical depressive episodes needs further investigation. Familial and individual vulnerability is likely to heighten the depressogenic impact of life events and psycho-social adversity. Prevention interventions have been developed in the United States for children and adolescents at-risk for depression. In France, clinicians witness growing demands from families with affective illness concerned with risk of parent-child transmission of depressive vulnerability, prevention and early identification of symptoms. To meet this kind of emerging needs and to prevent family dysfunction, a preventive program targets offspring of depressed parents and uses clinician-based family approaches. Family and individual sessions aim a better understanding of illness experience and encourage the parents to identify and foster resilience in their children. Another type of preventive intervention focuses on children and adolescents with subclinical depressive symptoms, eventually associated with behavioral problems ou high level of parental conflict, recruited in school settings. These school-based interventions combine cognitive and social problem-solving techniques. Both familial and school-based preventive interventions have proven applicable and promising in high-risk children and adolescents. Perspectives are more systematic identification of risk groups, including youngsters with past or current non affective symptoms who might benefit from depression prevention, long-term evaluation and cross-cultural applications of prevention programs.

Outcomes of Community-Based Screening for Depression and Suicide Prevention among Japanese Elders

ERIC Educational Resources Information Center

Oyama, Hirofumi; Fujita, Motoi; Goto, Masahiro; Shibuya, Hiroshi; Sakashita, Tomoe

2006-01-01

Purpose: In this study we evaluate outcomes of a community-based program to prevent suicide among elderly individuals aged 65 and older. Design and Methods: We used a quasi-experimental design with intervention and referent municipalities. The program included a 7-year implementation of depression screening with follow-up by general practitioners…

Effect of a Cognitive-Behavioral Prevention Program on Depression 6 Years After Implementation Among At-Risk Adolescents: A Randomized Clinical Trial.

PubMed

Brent, David A; Brunwasser, Steven M; Hollon, Steven D; Weersing, V Robin; Clarke, Gregory N; Dickerson, John F; Beardslee, William R; Gladstone, Tracy R G; Porta, Giovanna; Lynch, Frances L; Iyengar, Satish; Garber, Judy

2015-11-01

Adolescents whose parents have a history of depression are at risk for developing depression and functional impairment. The long-term effects of prevention programs on adolescent depression and functioning are not known. To determine whether a cognitive-behavioral prevention (CBP) program reduced the incidence of depressive episodes, increased depression-free days, and improved developmental competence 6 years after implementation. A 4-site randomized clinical trial compared the effect of CBP plus usual care vs usual care, through follow-up 75 months after the intervention (88% retention), with recruitment from August 2003 through February 2006 at a health maintenance organization, university medical centers, and a community mental health center. A total of 316 participants were 13 to 17 years of age at enrollment and had at least 1 parent with current or prior depressive episodes. Participants could not be in a current depressive episode but had to have subsyndromal depressive symptoms or a prior depressive episode currently in remission. Analysis was conducted between August 2014 and June 2015. The CBP program consisted of 8 weekly 90-minute group sessions followed by 6 monthly continuation sessions. Usual care consisted of any family-initiated mental health treatment. The Depression Symptoms Rating scale was used to assess the primary outcome, new onsets of depressive episodes, and to calculate depression-free days. A modified Status Questionnaire assessed developmental competence (eg, academic or interpersonal) in young adulthood. Over the 75-month follow-up, youths assigned to CBP had a lower incidence of depression, adjusting for current parental depression at enrollment, site, and all interactions (hazard ratio, 0.71 [95% CI, 0.53-0.96]). The CBP program's overall significant effect was driven by a lower incidence of depressive episodes during the first 9 months after enrollment. The CBP program's benefit was seen in youths whose index parent was not depressed at enrollment, on depression incidence (hazard ratio, 0.54 [95% CI, 0.36-0.81]), depression-free days (d = 0.34, P = .01), and developmental competence (d = 0.36, P = .04); these effects on developmental competence were mediated via the CBP program's effect on depression-free days. The effect of CBP on new onsets of depression was strongest early and was maintained throughout the follow-up period; developmental competence was positively affected 6 years later. The effectiveness of CBP may be enhanced by additional booster sessions and concomitant treatment of parental depression. clinicaltrials.gov Identifier:NCT00073671.

Acceptability and Preliminary Outcomes of a Peer-Led Depression Prevention Intervention for African American Adolescents and Young Adults in Employment Training Programs

ERIC Educational Resources Information Center

Tandon, Darius; Mendelson, Tamar; Mance, GiShawn

2011-01-01

This study examines the acceptability and preliminary outcomes from an open trial of a depression prevention intervention for low-income African American adolescents and young adults in employment training programs. The sample (N=42) consisted of predominately African American adolescents and young adults (mean age=19.1) exhibiting subclinical…

Evaluation of a School-Based Program Aimed at Preventing Depressive Symptoms in Adolescents

ERIC Educational Resources Information Center

Garmy, Pernilla; Jakobsson, Ulf; Carlsson, Katarina Steen; Berg, Agneta; Clausson, Eva K.

2015-01-01

The aim of this pilot study was to evaluate the implementation of a universal school-based cognitive behavioral program whose target is to prevent depressive symptoms in adolescents. The study had a quasi-experimental design with pretest, posttest, and a 1-year follow-up and provides an illustrative calculation for the implementation costs of the…

Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

PubMed

Kim, Jong-Pill; Yang, Jinhyang

The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

Parenting Resilient Kids (PaRK), an online parenting program to prevent anxiety and depression problems in primary school-aged children: Study protocol for a randomised controlled trial.

PubMed

Fernando, Luwishennadige Madhawee N; Sim, Wan Hua; Jorm, Anthony F; Rapee, Ron; Lawrence, Katherine A; Yap, Marie B H

2018-04-19

Preventive efforts targeting childhood anxiety and depression symptoms have the potential to alter the developmental trajectory of depression and anxiety disorders across the lifespan. Substantial previous research suggests that modifiable parenting factors such as parental aversiveness and over-involvement are associated with childhood anxiety, depressive and internalising symptoms, indicating that parents can play a critical role in prevention. The Parenting Resilient Kids study is a new evidence-based online parenting program designed to prevent anxiety and depression problems in primary school-aged children by reducing family-based risk factors and enhancing protective factors through increased positive interactions between parent and child. The current study is a parallel group superiority randomised controlled trial with parent-child dyads randomised to the intervention or active-control group in a 1:1 ratio. The intervention group will receive the Parenting Resilient Kids program consisting of a feedback report on parenting behaviours and up to 12 interactive online modules personalised based on responses to the parent survey. The active-control group will receive a standardised package of online educational materials about child development and wellbeing. The trial website is programmed to run a stratified random allocation sequence (based on parent gender) to determine group membership. We aim to recruit 340 parent-child dyads (170 dyads per group). We hypothesise that the intervention group will show greater improvement in parenting risk and protective factors from baseline to 3-month follow-up (primary outcome), which will in turn mediate changes in child depressive and anxiety symptoms from baseline to 12 and 24 months (co-primary outcomes). We also hypothesise that the intervention group will show greater benefits from baseline to 3-, 12- and 24-month follow-up, with regard to: child depressive and anxiety symptoms (co-primary outcomes); and child and parent health-related quality of life, and overall family functioning (secondary outcomes). This randomised controlled trial will examine the efficacy of the Parenting Resilient Kids program as a preventive intervention for anxiety and depression symptoms in primary school-aged children, as well as changes in child and parent health-related quality of life. Findings from this study will examine design features that render web-based prevention programs effective and the extent to which parents can be engaged and motivated to change through a minimally guided parenting program. Australian New Zealand Clinical Trials Registry (ANZCTR): Trial ID ACTRN12616000621415 Registered on 13 May 2016. Updated on 3 March 2017.

Prevention of Recurrence of Major Depression among Emerging Adults by a Group Cognitive-Behavioral/Interpersonal Intervention

PubMed Central

Sheets, Erin S.; Craighead, Linda Wilcoxon; Brosse, Alisha L.; Hauser, Monika; Madsen, Joshua W.; Craighead, W. Edward

2012-01-01

Background Among the most serious sequelae to an initial episode of Major Depressive Disorder (MDD) during adolescence is the significant increase in the probability of recurrence. This study reports on an integrated CBT/IPT program, provided in a group format, that was developed to decrease the rate of MDD recurrence in emerging adults. Methods Participants were 89 young adults who were not depressed at study entry but had experienced MDD during adolescence. Participants were assigned to a CBT/IPT prevention program or to an assessment only control condition and were followed through the first 2 years of college. Results Risk for MDD recurrence was reduced more than 50% for the prevention program participants compared to assessment only controls. The intervention also conferred beneficial effects on academic performance for those students who completed the majority of the group sessions. Limitations The study included a self-selected sample of emerging adults who were aware of their history of depression. Due to the small sample size, it will be important to evaluate similar interventions in adequately-powered trials to determine if this is a replicable finding. Conclusions With 51% of the assessment only participants experiencing a MDD recurrence during the first 2 years of college, these findings support the need for programs designed to prevent MDD recurrence in young adults. The current program, based on IPT and CBT principles, appears to reduce the rate of MDD recurrence among previously depressed emerging adults. PMID:23021821

The Role of Parent Depressive Symptoms in Positive and Negative Parenting in a Preventive Intervention

PubMed Central

Forehand, Rex; Thigpen, Jennifer C.; Parent, Justin; Hardcastle, Emily J.; Bettis, Alexandra; Compas, Bruce E.

2012-01-01

This study examined the role of parent depressive symptoms as a mediator of change in behaviorally observed positive and negative parenting in a preventive intervention program. The purpose of the program was to prevent child problem behaviors in families with a parent who has current or a history of major depressive disorder. One hundred and eighty parents and one of their 9-to-15-year old children served as participants and were randomly assigned to a family group cognitive-behavioral (FGCB) intervention or a written information (WI) comparison condition. At two months after baseline, parents in the FGCB condition had fewer depressive symptoms than those in the WI condition and these symptoms served as a mediator for changes in negative, but not positive, parenting at 6 months after baseline. The findings indicate that parent depressive symptoms are important to consider in family interventions with a parent who has current or a history of depression. PMID:22612463

Evaluation of a Group Cognitive-Behavioral Depression Prevention Program for Young Adolescents: A Randomized Effectiveness Trial

ERIC Educational Resources Information Center

Gillham, Jane E.; Reivich, Karen J.; Brunwasser, Steven M.; Freres, Derek R.; Chajon, Norma D.; Kash-MacDonald, V. Megan; Chaplin, Tara M.; Abenavoli, Rachel M.; Matlin, Samantha L.; Gallop, Robert J.; Seligman, Martin E. P.

2012-01-01

Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). We…

Brief Cognitive-Behavioral Depression Prevention Program for High-Risk Adolescents Outperforms Two Alternative Interventions: A Randomized Efficacy Trial

ERIC Educational Resources Information Center

Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.

2008-01-01

In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater…

Preventing Depression among Adolescent Girls: Pathways toward Effective and Sustainable Programs

ERIC Educational Resources Information Center

Wolfe, Vicky Veitch; Dozois, David J. A.; Fisman, Sandra; DePace, JoAnne

2008-01-01

Up to 25% of adolescent girls experience an episode of major depression, at least twice the rate found with adolescent boys. In addition to reducing the suffering associated with depression, prevention efforts with this high-risk population have the potential to avert short- and long-term functional impairment, reduce the risk of associated mental…

HIV/AIDS preventive self-efficacy, depressive symptoms, and risky sexual behavior in adolescents: a cross-sectional questionnaire survey.

PubMed

Lee, Yi-Hui; Salman, Ali; Fitzpatrick, Joyce J

2009-05-01

High incidence rates of HIV/AIDS infections among youth draw attention to the need for emphasizing the reduction of risky sexual behavior, a major contributor to the spread of HIV/AIDS. Few researchers have examined the relationship between self-efficacy for HIV/AIDS preventions, depressive symptoms, and adolescent risky sexual behavior. This insufficient understanding limits nurses' ability to provide effective programs for reducing adolescents' risky sexual behaviors. This study was conducted to investigate the relationships among HIV/AIDS preventive self-efficacy, depressive symptoms, and risky sexual behavior in Taiwanese adolescents. A cross-sectional, correlational study. Seven vocational high schools located in a metropolitan area in southern Taiwan. A convenience sample of 16-18-year-old vocational high school Taiwanese adolescents (n=734) participated in this study. Several self-administrated questionnaires, including HIV/AIDS Preventive Self-efficacy scale, the Center for Epidemiological Studies-Depression scale, Safe Sex Behavior Questionnaire, and a form for demographic data, were used to collect data. Taiwanese adolescents who had higher HIV/AIDS preventive self-efficacy scores had less overall risky sexual behavior. Adolescents who had less depressive symptoms had higher HIV/AIDS preventive self-efficacy. More depressive symptoms were correlated to more risky sexual behavior. Improving Taiwanese adolescents' HIV/AIDS preventive self-efficacy could be useful to reduce risky sexual behaviors in this population. Results of this study may assist nurses in understanding factors related to adolescents HIV/AIDS related risky sexual behavior and its' preventions. However, future longitudinal studies are needed to clarify whether depressive symptoms is a major influential factor that might interfere with the effectiveness of HIV/AIDS prevention programs.

Cost-effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: design of a cluster-randomized controlled trial.

PubMed

van Dijk, Susan E M; Pols, Alide D; Adriaanse, Marcel C; Bosmans, Judith E; Elders, Petra J M; van Marwijk, Harm W J; van Tulder, Maurits W

2013-05-07

Co-morbid major depression is a significant problem among patients with type 2 diabetes mellitus and/or coronary heart disease and this negatively impacts quality of life. Subthreshold depression is the most important risk factor for the development of major depression. Given the highly significant association between depression and adverse health outcomes and the limited capacity for depression treatment in primary care, there is an urgent need for interventions that successfully prevent the transition from subthreshold depression into a major depressive disorder. Nurse led stepped-care is a promising way to accomplish this. The aim of this study is to evaluate the cost-effectiveness of a nurse-led indicated stepped-care program to prevent major depression among patients with type 2 diabetes mellitus and/or coronary heart disease in primary care who also have subthreshold depressive symptoms. An economic evaluation will be conducted alongside a cluster-randomized controlled trial in approximately thirty general practices in the Netherlands. Randomization takes place at the level of participating practice nurses. We aim to include 236 participants who will either receive a nurse-led indicated stepped-care program for depressive symptoms or care as usual. The stepped-care program consists of four sequential but flexible treatment steps: 1) watchful waiting, 2) guided self-help treatment, 3) problem solving treatment and 4) referral to the general practitioner. The primary clinical outcome measure is the cumulative incidence of major depressive disorder as measured with the Mini International Neuropsychiatric Interview. Secondary outcomes include severity of depressive symptoms, quality of life, anxiety and physical outcomes. Costs will be measured from a societal perspective and include health care utilization, medication and lost productivity costs. Measurements will be performed at baseline and 3, 6, 9 and 12 months. The intervention being investigated is expected to prevent new cases of depression among people with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression, with subsequent beneficial effects on quality of life, clinical outcomes and health care costs. When proven cost-effective, the program provides a viable treatment option in the Dutch primary care system. Dutch Trial Register NTR3715.

Implementing Suicide Prevention Programs: Costs and Potential Life Years Saved in Canada.

PubMed

Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique

2015-09-01

Little is known about the costs and effects of suicide prevention programs at the population level. We aimed to determine (i) the costs associated with a suicide death and using prospective values (ii) the costs and effects of transferring, into a Canadian context, the results of the European Nuremberg Alliance against Depression (NAD) trial with the addition of 4 community-based suicide prevention strategies. These included the training of family physicians in the detection and treatment of depression, population campaigns aimed at increasing awareness about depression, the training of community leaders among first responders and follow-up of individuals who attempted suicide. This study includes a prospective value implementation study design. Using published data and information from interviews with Canadian decision makers, we assessed the costs of a suicide death in the province of Quebec and the costs of potentially implementing the NAD multi-modal suicide prevention programs, and the incremental cost-effectiveness ratio (ICER), from a health care system and societal perspective, associated with the NAD program while considering the friction cost method (FCM) and human capital approach (HCA) (discounted at 3%.) The costs considered included those incurred for the suicide prevention program and direct medical and non-medical costs as well as those related to a police investigation and funeral costs. Indirect costs associated with loss of productivity and short term disability were also considered. Sensitivity analyses were also carried out. Costs presented were in 2010 dollars. The annual total cost of implementing the suicide prevention programs in Quebec reached CAD23,982,293. The most expensive components of the program included the follow-up of individuals who had attempted suicide and psychotherapy for bereaved individuals. These accounted for 39% and 34% of total costs. The ICER associated with the implementation of the programs reached on average CAD3,979 per life year saved. Suicide prevention programs such as the NAD trial are cost-effective and can result in important potential cost-savings due to averted suicide deaths and reduced life years lost. Implementation of suicide prevention programs at the population level in Canada is cost-effective. Community mental health programs aimed at increasing awareness and the treatment of depression and better follow-up of high risk individuals for suicide are associated with a minimal per capita investment. These programs can result in important potential cost-savings due to averted suicide deaths and decreased disability due to depression. Additional research should focus on whether the outcomes of multi-modal suicide programs are specific or synergistic and most effective for which population subgroups. This may help inform how best to invest resources for the highest return.

Integrating a suicide prevention program into the primary health care network: a field trial study in Iran.

PubMed

Malakouti, Seyed Kazem; Nojomi, Marzieh; Poshtmashadi, Marjan; Hakim Shooshtari, Mitra; Mansouri Moghadam, Fariba; Rahimi-Movaghar, Afarin; Afghah, Susan; Bolhari, Jafar; Bazargan-Hejazi, Shahrzad

2015-01-01

To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ (2) = 14.8, P < 0.001). We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

Long-Term Effects of the Family Check-Up in Public Secondary School on Diagnosed Major Depressive Disorder in Adulthood.

PubMed

Connell, Arin M; Dishion, Thomas J

2017-03-01

Given the public health importance of depression, the identification of prevention programs with long-term effects on reducing the rate of depression is of critical importance, as is the examination of factors that may moderate the magnitude of such prevention effects. This study examines the impact of the Family Check-Up, delivered in public secondary schools beginning in sixth grade, on the development of major depression in adulthood (aged 28-30). The multilevel intervention program included (a) a universal classroom-based intervention focused on problem solving and peer relationship skills, (b) the Family Check-Up (selected), a brief assessment-based intervention designed to motivate parents to improve aspects of family functioning when warranted, and (c) family management treatment (indicated), focused on improving parenting skills. Demographic (gender and ethnicity) and baseline risk factors (family conflict, academic problems, antisocial behavior, and peer deviance) were examined as possible moderators in logistic regression analyses. Intervention effects on depression were moderated by baseline family conflict and academic performance, with stronger intervention effects for youth with low grade point averages and from low-conflict families at baseline. Such findings extend the emerging literature on prevention programs with long-term effects on depression, and highlight directions for future research to enhance such effects.

[Development and application of a multidimensional suicide prevention program for Korean elders by utilizing a community network].

PubMed

Jo, Kae Hwa; Kim, Yeong Kyeong

2008-06-01

The purpose of this study was to develop a multidimensional suicide prevention program for Korean elders by utilizing a community network and to evaluate its effect. A non-equivalent control group pretest-posttest design was used. The subjects were recruited from two different elderly institutions located in D city and K province, Korea. Nineteen subjects in the control group received no intervention and 20 subjects in the experimental group received a multidimensional suicide prevention program. There were more significant decreases in depression, suicide ideation, and increases in life satisfaction in the experimental group compared to the control group. According to the above results, the multidimensional suicide prevention program for Korean elders decreased stressful events like depression, and suicide ideation and increased life satisfaction through the community network. These findings suggest that this program can be used as an efficient intervention for elders in a critical situation.

Effectiveness Trial of an Indicated Cognitive-Behavioral Group Adolescent Depression Prevention Program versus Bibliotherapy and Brochure Control at 1- and 2-Year Follow-Up

PubMed Central

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M.

2015-01-01

Objective Evaluate the longterm effects of a brief group cognitive-behavioral (CB) adolescent depression indicated prevention program through 2-year follow-up, relative to CB bibliotherapy and brochure control, when high school personnel recruited students and delivered the program. Method 378 adolescents (M age = 15.5, SD = 1.2; 68% female, 72% White) with elevated self-assessed depressive symptoms who were randomized to CB group, CB bibliotherapy, or educational brochure control were assessed at pre, post, 6-, 12-, 18-, and 24-month follow-up. Results By 2 years post-intervention, CB group participants showed significantly lower major depressive disorder (MDD) onset versus CB bibliotherapy (10% vs. 25%, respectively; HR = 2.48, p = .006), but the incidence difference relative to brochure controls (17%) was nonsignificant; MDD incidence for bibliotherapy and brochure controls did not differ. Although CB group participants showed lower depressive symptoms at post versus brochure controls, there were no effects for this outcome or for social adjustment or substance use over 2-year follow-up. Moderator analyses suggested that participants with higher baseline depressive symptoms showed greater longterm symptom reductions in the CB group intervention versus bibliotherapy. Conclusions The evidence that a brief CB group intervention delivered by real-world providers significantly reduced MDD onset versus CB bibliotherapy is potentially encouraging. However, the lack of MDD prevention effects relative to brochure control and lack of longterm symptom effects (though consistent with results from other depression prevention trials), suggest that the delivery of CB group should be refined to strengthen its effectiveness. PMID:25894666

Effects of Three Depression Prevention Interventions on Risk for Depressive Disorder Onset in the Context of Depression Risk Factors

PubMed Central

Rohde, Paul; Stice, Eric; Gau, Jeff M.

2013-01-01

Study aims were to identify subgroups of adolescents with elevated depressive symptoms who had the highest likelihood of developing future major/minor depressive disorder on the basis of depression risk factors and participation in three depression prevention programs, with the goal of evaluating the preventive effect of indicated prevention interventions in the context of known risk factors. Adolescents (N = 341) with elevated depressive symptoms were randomized to one of four prevention intervention conditions (cognitive-behavioral group, supportive-expressive group, cognitive-behavioral bibliotherapy, educational brochure control). By 2-year follow-up, 14% showed onset of major/minor depressive disorders. Classification tree analysis (CTA) revealed that negative attributional style was the most important risk factor: youth with high scores showed a 4-fold increase in depression onset compared to youth who did not endorse this attributional style. For adolescents with negative attributional style, prevention condition emerged as the most important predictor: those receiving bibliotherapy showed a 5-fold reduction in depression disorder onset relative to adolescents in the three other intervention conditions. For adolescents who reported low negative attributional style scores, elevated levels of depressive symptoms at baseline emerged as the most potent predictor. Results implicate two key pathways to depression involving negative attributional style and elevated depressive symptoms in this population, and suggest that bibliotherapy may offset the risk conveyed by the most important depression risk factor in this sample. PMID:22932745

Effects of three depression prevention interventions on risk for depressive disorder onset in the context of depression risk factors.

PubMed

Rohde, Paul; Stice, Eric; Gau, Jeff M

2012-12-01

Study aims were to identify subgroups of adolescents with elevated depressive symptoms who had the highest likelihood of developing future major/minor depressive disorder on the basis of depression risk factors and participation in three depression prevention programs, with the goal of evaluating the preventive effect of indicated prevention interventions in the context of known risk factors. Adolescents (N = 341) with elevated depressive symptoms were randomized to one of four prevention intervention conditions (cognitive-behavioral group, supportive-expressive group, cognitive-behavioral bibliotherapy, educational brochure control). By 2-year follow-up, 14% showed onset of major/minor depressive disorders. Classification tree analysis (CTA) revealed that negative attributional style was the most important risk factor: Youth with high scores showed a 4-fold increase in depression onset compared to youth who did not endorse this attributional style. For adolescents with negative attributional style, prevention condition emerged as the most important predictor: Those receiving bibliotherapy showed a 5-fold reduction in depression disorder onset relative to adolescents in the three other intervention conditions. For adolescents who reported low negative attributional style scores, elevated levels of depressive symptoms at baseline emerged as the most potent predictor. Results implicate two key pathways to depression involving negative attributional style and elevated depressive symptoms in this population, and suggest that bibliotherapy may offset the risk conveyed by the most important depression risk factor in this sample.

Factors associated with depression detection in a New Hampshire mental health outreach program.

PubMed

Ghesquiere, Angela R; Pepin, Renee; Kinsey, Jennifer; Bartels, Stephen J; Bruce, Martha L

2017-08-16

For mental health outreach programs for older adults, accurately detecting depression is key to quality service provision. Multiple factors, including gender, cognitive impairment, or recent bereavement may affect depression detection, but this is under-studied. Therefore, we sought to both establish rates of depressive symptom detection and to examine factors associated with inaccuracies of detecting depression among participants in a mental health outreach program serving older adults. We conducted a chart review of 1126 cases in an older adult-focused mental health outreach program in New Hampshire, the Referral Education Assistance & Prevention (REAP) program. Accuracy of depression detection was identified by comparing screen-positive scores for depressive symptoms on the 15-item Geriatric Depression Scale (GDS) to depression identification by counselors on a 'presenting concerns' list. Inaccurate depression detection (positive on the GDS but depression not identified by counselors) occurred in 27.6% of cases. Multivariate regression analyses indicated that anxiety, cognitive concerns, and rurality were all associated with detection innaccuracy. This study appears to be the first to examine factors influencing depression detection in a mental health outreach program. Future efforts should help ensure that all older mental health outreach clients have depression detected at optimal rates.

Translating Basic Psychopathology Research to Preventive Interventions: A Tribute to John R. Z. Abela

ERIC Educational Resources Information Center

Garber, Judy; Korelitz, Katherine; Samanez-Larkin, Silvia

2012-01-01

This article highlights how the many important contributions of John R. Z. Abela's research program can inform the development and implementation of interventions for preventing depression in youth. Abela provided evidence of multiple vulnerabilities to depression including cognitive (e.g., inferential style, dysfunctional attitudes, ruminative…

Universal Adolescent Depression Prevention Programs: A Review

ERIC Educational Resources Information Center

Carnevale, Teresa D.

2013-01-01

Although the subject of adolescent depression has gained significant attention, little is being done in the way of primary prevention. The purpose of this article is to conduct a review of the literature through the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. This review was conducted utilizing several…

Developing an Educational Workshop on Teen Depression and Suicide: A Proactive Community Intervention.

ERIC Educational Resources Information Center

McArt, Ebba W.; Shulman, Donald A.; Gajary, Elizabeth

1999-01-01

An educational workshop was developed in Monroe County, New York on teen depression and suicide. The workshop used a proactive, preventive-educational approach, including both primary and secondary prevention modalities, directly available to teens, parents, and youth professionals. The program subsequently developed new partnerships between…

Pilot trial of a dissonance-based cognitive-behavioral group depression prevention with college students.

PubMed

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M

2016-07-01

Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = 0.64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pilot Trial of a Dissonance-Based Cognitive-Behavioral Group Depression Prevention with College Students

PubMed Central

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M.

2016-01-01

Objective Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. Method 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Results Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = .64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Conclusions Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted. PMID:27176493

Family-centered program deters substance use, conduct problems, and depressive symptoms in black adolescents.

PubMed

Brody, Gene H; Chen, Yi-fu; Kogan, Steven M; Yu, Tianyi; Molgaard, Virginia K; DiClemente, Ralph J; Wingood, Gina M

2012-01-01

The present research addressed the following important question in pediatric medicine: Can participation in a new family-centered preventive intervention, the Strong African American Families-Teen (SAAF-T) program, deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents across 22 months? Data were collected from 502 black families in rural Georgia, assigned randomly to SAAF-T or an attention control condition. The prevention condition consisted of 5 consecutive meetings at community facilities with separate, concurrent sessions for caregivers and adolescents followed by a caregiver-adolescent session in which families practiced skills they learned in the separate sessions. Adolescents self-reported conduct problem behaviors, substance use, substance use problems, and depressive symptoms at ages 16 years (pretest) and 17 years 10 months (long-term assessment). Adolescents who participated in SAAF-T evinced lower increases in conduct problem behavior, substance use, substance use problems, and depressive symptom frequencies than did adolescents in the attention control condition across the 22 months between pretest and long-term assessment. This is the first study to demonstrate efficacy in a prevention program designed to deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents. Because SAAF-T is a manualized, structured program, it can be easily disseminated to public health agencies, schools, churches, boys' and girls' clubs, and other community organizations.

Effectiveness trial of an indicated cognitive-behavioral group adolescent depression prevention program versus bibliotherapy and brochure control at 1- and 2-year follow-up.

PubMed

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M

2015-08-01

The main goal of this study was to evaluate the long-term effects of a brief group cognitive-behavioral (CB) adolescent depression indicated prevention program through 2-year follow-up, relative to CB bibliotherapy and brochure control, when high school personnel recruited students and delivered the program. Three hundred seventy-eight adolescents (M age = 15.5, SD = 1.2; 68% female, 72% White) with elevated self-assessed depressive symptoms who were randomized to CB group, CB bibliotherapy, or educational brochure control were assessed at pretest, posttest, and 6-, 12-, 18-, and 24-month follow-up. By 2 years postintervention, CB group participants showed significantly lower major depressive disorder (MDD) onset versus CB bibliotherapy (10% vs. 25%, respectively; hazard ratio = 2.48, p = .006), but the incidence difference relative to brochure controls (17%) was nonsignificant; MDD incidence for bibliotherapy and brochure controls did not differ. Although CB group participants showed lower depressive symptoms at posttest versus brochure controls, there were no effects for this outcome or for social adjustment or substance use over 2-year follow-up. Moderator analyses suggested that participants with higher baseline depressive symptoms showed greater long-term symptom reductions in the CB group intervention versus bibliotherapy. The evidence that a brief CB group intervention delivered by real-world providers significantly reduced MDD onset versus CB bibliotherapy is potentially encouraging. However, the lack of MDD prevention effects relative to brochure control and lack of long-term symptom effects (though consistent with results from other depression prevention trials), suggest that the delivery of the CB group should be refined to strengthen its effectiveness. (c) 2015 APA, all rights reserved).

A Cognitive Behavioral Depression Prevention Program for Early Adolescents

ERIC Educational Resources Information Center

Miloseva, Lence

2013-01-01

The aim of this study was to present results of our one year experience with Cognitive Behavioral Psychology Program, in order to contribute to the building of whole school approach and positive psychology preventive mental health problems model. Based on Penn Resilience program (PRP), we modify and create program for early adolescents: how to…

Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran

PubMed Central

Malakouti, Seyed Kazem; Nojomi, Marzieh; Poshtmashadi, Marjan; Hakim Shooshtari, Mitra; Mansouri Moghadam, Fariba; Rahimi-Movaghar, Afarin; Afghah, Susan; Bolhari, Jafar; Bazargan-Hejazi, Shahrzad

2015-01-01

Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. Results. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ 2 = 14.8, P < 0.001). We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Conclusion. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas. PMID:25648221

Depressive symptoms, antidepressant medication use, and new onset of diabetes in participants of the diabetes prevention program and the diabetes prevention program outcomes study.

PubMed

Marrero, David G; Ma, Yong; de Groot, Mary; Horton, Edward S; Price, David W; Barrett-Connor, Elizabeth; Carnethon, Mercedes R; Knowler, William C

2015-04-01

To assess in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study whether diagnosis of diabetes predicted elevated depressive symptoms (DS) or use of antidepressant medicine (ADM) following diagnosis; whether diabetes status or duration had significant effect on DS or ADM use; and to determine the associations between A1C, fasting plasma glucose (FPG), normalization of FPG, and DS or ADM use after diagnosis. Diabetes Prevention Program participants in three treatment arms (intensive life style, metformin, placebo) were assessed for diabetes, glucose control, ADM use, and DS, measured using the Beck Depression Inventory (BDI). Among 3234 participants, 1285 developed diabetes. Depression levels were measured before and after diabetes diagnosis. Neither DS nor use of ADM increased after diagnosis; higher FPG was associated with greater ADM use in the intensive life style arm; a 10-mg/dl rise in FPG is associated with greater odds of ADM use. Higher FPG and A1C were associated with higher BDI scores in all three arms; A 10-mg/dl rise in FPG had a 0.07 increase in BDI. A 1% higher A1c was associated with a 0.21-point increase in BDI. Normalization of FPG was associated with lower BDI. When FPG had normalized, there was a decrease of 0.30 points in the BDI score compared when FPG had not normalized. Contrary to clinical attributions, diabetes diagnosis did not show an immediate impact on BDI scores or ADM use. Higher glucose levels after diagnosis were associated with a small but significantly higher BDI score and more ADM use. DPPOS: NCT00038727; DPP: NCT00004992.

An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence.

PubMed

Dimidjian, Sona; Goodman, Sherryl H; Felder, Jennifer N; Gallop, Robert; Brown, Amanda P; Beck, Arne

2015-02-01

Pregnant women with histories of depression are at high risk of depressive relapse/recurrence during the perinatal period, and options for relapse/recurrence prevention are limited. Mindfulness-based cognitive therapy (MBCT) has strong evidence among general populations but has not been studied among at-risk pregnant women to prevent depression. We examined the feasibility, acceptability, and clinical outcomes of depression symptom severity and relapse/recurrence associated with MBCT adapted for perinatal women (MBCT-PD). Pregnant women with depression histories were recruited from obstetrics clinics in a large health maintenance organization at two sites and enrolled in MBCT-PD (N = 49). Self-reported depressive symptoms and interview-based assessments of depression relapse/recurrence status were measured at baseline, during MBCT-PD, and through 6-months postpartum. Pregnant women reported interest, engagement, and satisfaction with the program. Retention rates were high, as were rates of completion of daily homework practices. Intent to treat analyses indicated a significant improvement in depression symptom levels and an 18 % rate of relapse/recurrence through 6 months postpartum. MBCT-PD shows promise as an acceptable, feasible, and clinically beneficial brief psychosocial prevention option for pregnant women with histories of depression. Randomized controlled trials are needed to examine the efficacy of MBCT-PD for the prevention of depressive relapse/recurrence during pregnancy and postpartum.

Mediators and Moderators of a School-Based Cognitive-Behavioral Depression Prevention Program.

PubMed

Duong, Mylien T; Kelly, Brynn M; Haaland, Wren L; Matsumiya, Brandon; Huey, Stanley J; McCarty, Carolyn A

2016-10-01

This study tested potential moderators and mediators of an indicated depression prevention program for middle school students, Positive Thoughts and Actions (PTA). Participants were 120 students randomly assigned to PTA, or a brief, individually administered supportive intervention (Individual Support Program, or ISP). Youths completed measures of depressive symptoms at baseline, post-intervention, and 12-month follow-up. Hierarchical regression was used to test three moderators-ethnic minority status, gender, and baseline depressive symptoms-and three mediators representing functional outcomes targeted by PTA-parent-child communication, attitude towards school, and health behavior. Ethnic minority status did not moderate PTA effects at post-intervention but did moderate PTA effects at 12-month follow-up. At 12 months, PTA appeared to be more effective for White participants than ethnic minority youth. Follow-up analyses suggested this moderation effect was due to the tendency of ethnic minority youth, especially those with fewer symptoms at baseline, to drop out by 12 months. Neither gender nor baseline depressive symptoms moderated the effects of PTA. Although PTA improved health behavior and attitudes toward school, there was no evidence that any of these functional outcomes measured mediated the impact of PTA on depressive symptoms. Future directions are discussed.

Prevention of anxiety and depression in Chinese: a randomized clinical trial testing the effectiveness of a stepped care program in primary care.

PubMed

Zhang, De Xing; Lewis, Glyn; Araya, Ricardo; Tang, Wai Kwong; Mak, Winnie Wing Sze; Cheung, Fanny Mui Ching; Mercer, Stewart William; Griffiths, Sian Meryl; Woo, Jean; Lee, Diana Tze Fan; Kung, Kenny; Lam, Augustine Tsan; Yip, Benjamin Hon Kei; Wong, Samuel Yeung Shan

2014-12-01

Despite empirical evidence demonstrating the effectiveness of collaborative stepped care program (SCP) in Western countries, such programs have not been evaluated in the east, which has a different services system structure and cultural nuances in seeking help for mental illness. Furthermore, only a few studies have used SCP for depression and anxiety prevention. We conducted a trial to test its effectiveness in preventing major depressive disorder and generalized anxiety disorder among primary care patients with subthreshold depression and/or anxiety in Hong Kong. Subthreshold depression and/or anxiety patients were randomized into the SCP group (n=121) or care as usual (CAU) group (n=119). The SCP included watchful waiting, telephone counseling, problem solving therapy, and family doctor treatment within one year. The primary outcome was the onset of major depressive disorder or generalized anxiety disorder in 15 months. The secondary outcomes were depressive and anxiety symptoms, quality of life and time absent from work due to any illness. Survival analysis showed no differences between the SCP and CAU groups (the cumulative probability of onset at 15 month was 23.1% in the SCP group and 20.5% in the CAU group; Hazard Ratio=1.62; 95% Confidence Interval: 0.82-3.18; p=0.16). No significant differences were found in secondary outcomes. Sample size might not have been large enough. SCP did not show beneficial effect on depression/anxiety prevention compared with CAU in Hong Kong primary care. As a large majority of patients improved overtime without any intervention, we are not able to exclude the possibility that the intervention might be effective. Future studies would need to have a larger sample size and conduct on patients with more severe symptoms or perform a second screening. Copyright © 2014 Elsevier B.V. All rights reserved.

[Detection, prevention and treatment of postpartum depression: a controlled study of 859 patients].

PubMed

Chabrol, H; Teissedre, F; Saint-Jean, M; Teisseyre, N; Sistac, C; Michaud, C; Roge, B

2002-01-01

This study evaluated the clinical effectiveness of a programme aimed at detecting, preventing and treating postpartum depression. The French version of the EPDS was used to measure the intensity of postpartum blues on a sample of 859 women, during their stay at the obstetrical clinic. Subjects under treatment for psychological problems were excluded from the study. Mothers scoring 9 or above on the EPDS, which is predictive of pospartum depression, were randomly assigned to a prevention and a control group. Written informed consent was obtained from the subjects after the study procedure had been explained. The prevention group received a counselling session integrating supportive, educational and cognitive-behavioral components. Therapists included five female Master's Degree level students in psychology. All therapists participated in didactic and clinical training as wells as weekly supervision from the first author. All subjects were given a second EPDS with written instructions to complete the questionnaire during the period 4 to 6 weeks postpartum and return it for analysis. At four to 6 weeks, women in the prevention group had significant reductions in the frequency of probable depression, as defined by a score of 11 or above on the EPDS (30.2% vs 48.2%, chi 2 = 7.36, dl = 1, p = 0.0067) and in the intensity of depressive symptoms measured by the mean score on the EPDS (8.5, SD = 4 vs 10.3, SD = 4.4, t = 3.06, dl = 209, p = 0.0024). Mothers with a probable depression were interviewed at home and assessed using the MINI (Mini Neuropsychiatric Interview, Lecrubier et al., 1997) to diagnose major depressive episode, the SIGH-D (Structured Interview Guide for the Hamilton Depression Rating Scale, Williams, 1988) and the BDI (Beck Depression Inventory, Beck et al., 1988). The baseline depression rating scores, EPDS (mean = 13.6, SD = 4), BDI (mean = 15.7, SD = 5.9), HDRS (mean = 14.8, SD = 6), were consistent with moderate depression. No significant differences in baseline scores were observed between the two groups on all the rating scales (p < 0.001). Mothers with probable depression in the prevention group were offered a program of 5 to 8 home visits. Most of the mothers in the prevention group (72%) agreed to participate in the program. On the contrary, most of the mothers (83.3%) who scored below 9 on the first EPDS and 11 or above on the second, who so did not received the preventive counselling session, declined to participate. This suggests the importance of the preventive session in establishing therapeutic alliance. The home visits program integrated four components, supportive, educational, cognitive-behavioral and psychodynamic centred on the mother-infant relationship in terms of the mother's personal history. Therapist participated in clinical training and weekly supervision. Fifteen women (71.4%) in the study group demonstrated complete symptom remission, as defined by HDRS score below 7 after the intervention, compared with 4 women (10.5%) in the control group (chi 2 = 23, p < 0.0001). A clearly therapeutic response to treatment was observed in the treated group with a mean reduction in HDRS score of 9.5 (DS = 6.7) from baseline. The improvement in the women in the treated group, as measured by the mean HDRS scores was statistically greater than that in the control group (m = 5.35, SD = 3.5 vs m = 15.8, SD = 4.6, t = 8.24, dl = 52, p < 0.0001). Our results indicate that a program based on an intervention at obstetrical clinics and on home visits is efficacious and well accepted for prevention, detection and treatment of postpartum depression.

Preventing Adolescents' Externalizing and Internalizing Symptoms: Effects of the Penn Resiliency Program

ERIC Educational Resources Information Center

Cutuli, J. J.; Gillham, Jane E.; Chaplin, Tara M.; Reivich, Karen J.; Seligman, Martin E. P.; Gallop, Robert J.; Abenavoli, Rachel M.; Freres, Derek R.

2013-01-01

This study reports secondary outcome analyses from a past study of the Penn Resiliency Program (PRP), a cognitive-behavioral depression prevention program for middle-school aged children. Middle school students (N = 697) were randomly assigned to PRP, PEP (an alternate intervention), or control conditions. Gillham et al., (2007) reported analyses…

School-based prevention programs for depression and anxiety in adolescence: a systematic review.

PubMed

Corrieri, Sandro; Heider, Dirk; Conrad, Ines; Blume, Anne; König, Hans-Helmut; Riedel-Heller, Steffi G

2014-09-01

School-based interventions are considered a promising effort to prevent the occurrence of mental disorders in adolescents. This systematic review focuses on school-based prevention interventions on depression and anxiety disorders utilizing an RCT design, starting from the year 2000. Based on an online search (PubMed, Scirus, OVID, ISI) and bibliographic findings in the eligible articles, 28 studies providing information were reviewed. The search process ended on 2 May 2011. The majority of interventions turn out to be effective, both for depression (65%) and anxiety (73%). However, the obtained overall mean effect sizes calculated from the most utilized questionnaires can be considered rather small (CDI: -0.12; RCMAS: -0.29). The majority of the reviewed school-based interventions shows effectiveness in reducing or preventing mental disorders in adolescents. However, effect size computation revealed only small-scale effectiveness. Future studies have to consider the impact of program implementation variations. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effectiveness of the Surviving the Teens® Suicide Prevention and Depression Awareness Program: An Impact Evaluation Utilizing a Comparison Group

ERIC Educational Resources Information Center

Strunk, Catherine M.; King, Keith A.; Vidourek, Rebecca A.; Sorter, Michael T.

2014-01-01

Youth suicide is a serious public health issue in the United States. It is currently the third leading cause of death for youth aged 10 to 19. School-based prevention programs may be an effective method of educating youth and enhancing their help-seeking. Most school-based suicide prevention programs have not been rigorously evaluated for their…

Treating Depressed and Anxious Smokers in Smoking Cessation Programs

ERIC Educational Resources Information Center

Richards, C. Steven; Cohen, Lee M.; Morrell, Holly E. R.; Watson, Noreen L.; Low, Blakely E.

2013-01-01

Objective: Cigarette smoking is the leading cause of preventable death in the United States. In addition, smoking rates among depressed and anxious smokers are higher than in the population at large. Furthermore, treating depressed and anxious smokers effectively is particularly challenging because of their significant negative affect,…

[Effects of core competency support program on depression and suicidal ideation for adolescents].

PubMed

Park, Hyun Sook

2009-12-01

The purpose of this study was to evaluate the effects of a core competency support program on depression and suicidal ideation in adolescents. A quasi-experimental design was employed in this study. Participants for the study were high school students, 27 in the experimental group and 29 in the control group. Data were analyzed using the SPSS/WIN. 14.0 program with X(2) test, t-test, and ANCOVA. Participants in the core competency support program reported decreased depression scores significantly different from those in the control group. Participants in the core competency support program reported decreased suicidal ideation scores, also significantly different from those in the control group. The core competency support program was effective in decreasing depression and suicidal ideation for adolescents. Therefore, this approach is recommended as a suicide prevention strategy for adolescents.

Management of recurrent depression.

PubMed

Howell, Cate; Marshall, Charlotte; Opolski, Melissa; Newbury, Wendy

2008-09-01

Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and these principles can be applied to managing depression. This article outlines the principles of chronic disease management, including the use of management plans and a team care approach, and their application to the management of depression. Treatment approaches that systematically assist patients in managing their chronic disease are more effective than those based on acute care. Depression treatment guidelines are available, as well as primary care initiatives which facilitate comprehensive and long term mental health care, including relapse prevention strategies. A number of risk factors for depression relapse have been identified, and research has recommended that novel intensive relapse prevention programs need to be developed.

Reducing Depression Through an Online Intervention: Benefits From a User Perspective

PubMed Central

Griffiths, Kathleen M

2016-01-01

Background Internet interventions are increasingly being recognized as effective in the treatment and prevention of mental health conditions; however, the usefulness of such programs from the perspective of the participants is often not reported. Objective This study explores the experiences of participants of a 12-week randomized controlled trial of an automated self-help training program (e-couch), with and without an Internet support group, targeting depression. Methods The study comprised a community sample of 298 participants who completed an online survey both prior to and on completion of an intervention for preventing or reducing depressive symptoms. Results Overall, participants reported a high level of confidence in the ability of an online intervention to improve a person’s understanding of depression. However, confidence that a website could help people learn skills for preventing depression was lower. Benefits reported by participants engaged in the intervention included increased knowledge regarding depression and its treatment, reduced depressive symptoms, increased work productivity, and improved ability to cope with everyday stress. A minority of participants reported concerns or problems resulting from participation in the interventions. Conclusions The findings provide consumer support for the effectiveness of this online intervention. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 65657330;http://www.isrctn.com/ISRCTN65657330 (Archived by WebCite at http://www.webcitation.org/6cwH8xwF0) PMID:26747378

The effectiveness of a school-based adolescent depression education program.

PubMed

Swartz, Karen L; Kastelic, Elizabeth A; Hess, Sally G; Cox, Todd S; Gonzales, Lizza C; Mink, Sallie P; DePaulo, J Raymond

2010-02-01

In an effort to decrease the suicide rate in adolescents, many interventions have focused on school-based suicide prevention programs. Alternatively, depression education in schools might be effective in decreasing the morbidity, mortality, and stigma associated with adolescent depression. The Adolescent Depression Awareness Program (ADAP) developed a 3-hour curriculum to teach high school students about the illness of depression. The purpose of this study was to assess the effectiveness of the ADAP curriculum in improving high school students' knowledge about depression. From 2001 to 2005, 3,538 students were surveyed on their knowledge about depression before and after exposure to the ADAP curriculum. The number of students scoring 80% or higher on the assessment tool more than tripled from pretest to posttest (701 to 2,180), suggesting the effectiveness of the ADAP curriculum. Further study and replication are required to determine if improved knowledge translates into increased treatment-seeking behavior.

Effects of a randomized controlled recurrent fall prevention program on risk factors for falls in frail elderly living at home in rural communities.

PubMed

Jeon, Mi Yang; Jeong, HyeonCheol; Petrofsky, Jerrold; Lee, Haneul; Yim, JongEun

2014-11-14

Falling can lead to severe health issues in the elderly and importantly contributes to morbidity, death, immobility, hospitalization, and early entry to long-term care facilities. The aim of this study was to devise a recurrent fall prevention program for elderly women in rural areas. This study adopted an assessor-blinded, randomized, controlled trial methodology. Subjects were enrolled in a 12-week recurrent fall prevention program, which comprised strength training, balance training, and patient education. Muscle strength and endurance of the ankles and the lower extremities, static balance, dynamic balance, depression, compliance with preventive behavior related to falls, fear of falling, and fall self-efficacy at baseline and immediately after the program were assessed. Sixty-two subjects (mean age 69.2±4.3 years old) completed the program--31 subjects in the experimental group and 31 subjects in the control group. When the results of the program in the 2 groups were compared, significant differences were found in ankle heel rise test, lower extremity heel rise test, dynamic balance, depression, compliance with fall preventative behavior, fear of falling, and fall self-efficacy (p<0.05), but no significant difference was found in static balance. This study shows that the fall prevention program described effectively improves muscle strength and endurance, balance, and psychological aspects in elderly women with a fall history.

Depression in the classroom: considerations and strategies.

PubMed

Calear, Alison L

2012-01-01

Depression is a prevalent and debilitating disorder that can severely affect a young person’s social, emotional, and academic functioning. Identifying depression early is essential to reducing the impact of this disorder. Depression is treatable. However, there are a number of classroom and school supports that can be put in place to assist a young person experiencing or recovering from depression. Preventing the development of depression through effective classroom programs should be encouraged and supported within the school environment.

Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

ERIC Educational Resources Information Center

Ammerman, Robert T.; Shenk, Chad E.; Teeters, Angelique R.; Noll, Jennie G.; Putnam, Frank W.; Van Ginkel, Judith B.

2012-01-01

Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the…

Depression Awareness and Self-Management Through the Internet: Protocol for an Internationally Standardized Approach

PubMed Central

Koburger, Nicole; Larkin, Celine; Karwig, Gillian; Coffey, Claire; Maxwell, Margaret; Harris, Fiona; Rummel-Kluge, Christine; van Audenhove, Chantal; Sisask, Merike; Alexandrova-Karamanova, Anna; Perez, Victor; Purebl, György; Cebria, Annabel; Palao, Diego; Costa, Susana; Mark, Lauraliisa; Tóth, Mónika Ditta; Gecheva, Marieta; Ibelshäuser, Angela; Gusmão, Ricardo; Hegerl, Ulrich

2015-01-01

Background Depression incurs significant morbidity and confers increased risk of suicide. Many individuals experiencing depression remain untreated due to systemic and personal barriers to care. Guided Internet-based psychotherapeutic programs represent a promising means of overcoming such barriers and increasing the capacity for self-management of depression. However, existing programs tend to be available only in English and can be expensive to access. Furthermore, despite evidence of the effectiveness of a number of Internet-based programs, there is limited evidence regarding both the acceptability of such programs and feasibility of their use, for users and health care professionals. Objective This paper will present the protocol for the development, implementation, and evaluation of the iFightDepression tool, an Internet-based self-management tool. This is a cost-free, multilingual, guided, self-management program for mild to moderate depression cases. Methods The Preventing Depression and Improving Awareness through Networking in the European Union consortium undertook a comprehensive systematic review of the available evidence regarding computerized cognitive behavior therapy in addition to a consensus process involving mental health experts and service users to inform the development of the iFightDepression tool. The tool was implemented and evaluated for acceptability and feasibility of its use in a pilot phase in 5 European regions, with recruitment of users occurring through general practitioners and health care professionals who participated in a standardized training program. Results Targeting mild to moderate depression, the iFightDepression tool is based on cognitive behavioral therapy and addresses behavioral activation (monitoring and planning daily activities), cognitive restructuring (identifying and challenging unhelpful thoughts), sleep regulation, mood monitoring, and healthy lifestyle habits. There is also a tailored version of the tool for young people, incorporating less formal language and additional age-appropriate modules on relationships and social anxiety. The tool is accompanied by a 3-hour training intervention for health care professionals. Conclusions It is intended that the iFightDepression tool and associated training for health care professionals will represent a valuable resource for the management of depression that will complement existing resources for health care professionals. It is also intended that the iFightDepression tool and training will represent an additional resource within a multifaceted approach to improving the care of depression and preventing suicidal behavior in Europe. PMID:26251104

Applying Prevention and Positive Youth Development Theory to Predict Depressive Symptoms among Young People

ERIC Educational Resources Information Center

Olson, Jonathan R.; Goddard, H. Wallace

2015-01-01

The purpose of this study was to identify predictors of depressive symptoms among adolescents using concepts drawn from two theoretical models that underlie popular youth-focused programs. Specifically, we assessed the degree to which family-level risk factors increase the likelihood of depressive symptoms, and the degree to which community and/or…

Preventing Perinatal Depression through Home Visiting: The Mothers and Babies Course

ERIC Educational Resources Information Center

Perry, Deborah F.; Tandon, S. Darius; Edwards, Karen; Mendelson, Tamar

2014-01-01

Home visiting (HV) programs serve women at high risk for developing postpartum depression because of factors such as poverty and low social support. Depression poses serious threats not only to mother-child attachment and healthy infant development but also to women's ability to engage with HV services and supports. The Mothers and Babies (MB)…

Have Mental Health Education Programs Influenced the Mental Health Literacy of Those with Major Depression and Suicidal Ideation? A Comparison between 1998 and 2008 in South Australia

ERIC Educational Resources Information Center

Chamberlain, Peter N.; Goldney, Robert D.; Taylor, Anne W.; Eckert, Kerena A.

2012-01-01

Mental health literacy is the knowledge and beliefs about mental disorders that aid their recognition, management, or prevention and is considered to be an important determinant of help-seeking. This has relevance in suicide prevention, as depression, the clinical condition most frequently associated with suicidality, has been the target of…

Exercise Against Depression.

ERIC Educational Resources Information Center

Artal, Michal; Sherman, Carl

1998-01-01

Physical activity is useful for preventing and easing depression symptoms. When prescribing exercise as an adjunct to medication and psychotherapy, physicians must consider each patient's individual circumstances. Hopelessness and fatigue can make physical exercise difficult. A feasible, flexible, and pleasurable program has the best chance for…

Using the PRECEDE-PROCEED model for an online peer-to-peer suicide prevention and awareness for depression (SPAD) intervention among African American college students: experimental study.

PubMed

Shanta Bridges, Ledetra; Sharma, Manoj; Lee, Jung Hye Sung; Bennett, Russell; Buxbaum, Sarah G; Reese-Smith, Jacqueline

2018-01-01

Background: Suicide rates are high among African American students because they are at a greater risk of depression. A commonly used suicide prevention approach is the gatekeeper training. However, gatekeeper training is neither evidence-based nor has it been identified as culturally-appropriate for African American college students. Therefore, the purpose of this study was to develop and evaluate an online peer-to-peer PRECEDE-PROCEED model based depression awareness and suicide prevention program that was culturally appropriate for African American college students. Methods: The setting was a predominantly Black institution in southern USA. A pre-experimental repeated measures one group design was used to measure changes in peer educators' (n = 29) predisposing factors regarding knowledge, skills and attitudes pertaining to depression, reinforcing factors or receiving support from peers, healthcare professionals and teachers to help someone with depression, enabling factors or sureness of finding organizations to help someone with depression, and behavior for helping someone with depression at pretest, posttest and 1-month follow-up. A posttest only one group design was also used to measure effect on predisposing factors and behavior of students (n = 300) trained by peer educators. Results: There were statistically significant improvements in attitudes related to depression as disease (P = 0.003; η 2 = 0.39), attitudes about managing depression (P = 0.0001; η 2 = 0.30), skills(P = 0.0001; η 2 = 0.41), reinforcing factors (P = 0.018; η 2 = 0.13), enabling factors (P = 0.0001;η 2 = 0.31), and behavior (P = 0.016; η 2 = 0.14). Changes in knowledge about depression and attitudes about helping people with depression were not statistically significant over time for peer educators. The peer-to-peer training was not completely effective in transferring corresponding changes for students trained by peers. Conclusion: The program was effective for peer educators but peers could not significantly influence other students in all domains. This study provides a starting point toward evidencebased approaches for health promotion interventionists addressing depression awareness and suicide prevention among African American college students.

Prevention of Anxiety Symptoms in Children: Results from a Universal School-Based Trial

ERIC Educational Resources Information Center

Essau, Cecilia A.; Conradt, Judith; Sasagawa, Satoko; Ollendick, Thomas H.

2012-01-01

The present study evaluated the effectiveness of a universal school-based cognitive behavior prevention program (the FRIENDS program) for childhood anxiety. Participants were 638 children, ages 9 to 12 years, from 14 schools in North Rhine-Westphalia, Germany. All the children completed standardized measures of anxiety and depression, social and…

Fortalezas Familiares Program: Building sociocultural and family strengths in Latina women with depression and their families

PubMed Central

Valdez, Carmen R.; Abegglen, Jessica; Hauser, Claire T.

2013-01-01

The purpose of this article is to describe Fortalezas Familiares (FF; Family Strengths), a community-based prevention program designed to address relational family processes and promote wellbeing among Latino families when a mother has depression. Although depression in Latina women is becoming increasingly recognized, risk and protective mechanisms associated with children’s outcomes when a mother has depression are not well understood for Latino families. We begin by reviewing the literature on risk and protective psychosocial mechanisms by which maternal depression may affect Latino youth, using family systems theory and a developmental psychopathology framework with an emphasis on sociocultural factors shaping family processes. Next, we describe the theoretical basis and development of the FF program, a community-based 12-week intervention for Latina immigrant women with depression, other caregivers, and their children. Throughout this article, we use a case study to illustrate a Latina mother’s vulnerability to depression and the family’s response to the FF program. Recommendations for future research and practice include consideration of sociocultural processes in shaping both outcomes of Latino families and their response to interventions. PMID:24033237

Fortalezas familiares program: building sociocultural and family strengths in latina women with depression and their families.

PubMed

Valdez, Carmen R; Abegglen, Jessica; Hauser, Claire T

2013-09-01

The purpose of this article is to describe Fortalezas Familiares (FF; Family Strengths), a community-based prevention program designed to address relational family processes and promote well-being among Latino families when a mother has depression. Although depression in Latina women is becoming increasingly recognized, risk and protective mechanisms associated with children's outcomes when a mother has depression are not well understood for Latino families. We begin by reviewing the literature on risk and protective psychosocial mechanisms by which maternal depression may affect Latino youth, using family systems theory and a developmental psychopathology framework with an emphasis on sociocultural factors shaping family processes. Next, we describe the theoretical basis and development of the FF program, a community-based 12-week intervention for Latina immigrant women with depression, other caregivers, and their children. Throughout this article, we use a case study to illustrate a Latina mother's vulnerability to depression and the family's response to the FF program. Recommendations for future research and practice include consideration of sociocultural processes in shaping both outcomes of Latino families and their response to interventions. © FPI, Inc.

Effects of a Randomized Controlled Recurrent Fall Prevention Program on Risk Factors for Falls in Frail Elderly Living at Home in Rural Communities

PubMed Central

Jeon, Mi Yang; Jeong, HyeonCheol; Petrofsky, Jerrold; Lee, Haneul; Yim, JongEun

2014-01-01

Background Falling can lead to severe health issues in the elderly and importantly contributes to morbidity, death, immobility, hospitalization, and early entry to long-term care facilities. The aim of this study was to devise a recurrent fall prevention program for elderly women in rural areas. Material/Methods This study adopted an assessor-blinded, randomized, controlled trial methodology. Subjects were enrolled in a 12-week recurrent fall prevention program, which comprised strength training, balance training, and patient education. Muscle strength and endurance of the ankles and the lower extremities, static balance, dynamic balance, depression, compliance with preventive behavior related to falls, fear of falling, and fall self-efficacy at baseline and immediately after the program were assessed. Sixty-two subjects (mean age 69.2±4.3 years old) completed the program – 31 subjects in the experimental group and 31 subjects in the control group. Results When the results of the program in the 2 groups were compared, significant differences were found in ankle heel rise test, lower extremity heel rise test, dynamic balance, depression, compliance with fall preventative behavior, fear of falling, and fall self-efficacy (p<0.05), but no significant difference was found in static balance. Conclusions This study shows that the fall prevention program described effectively improves muscle strength and endurance, balance, and psychological aspects in elderly women with a fall history. PMID:25394805

Emotionally Troubled Teens' Help-Seeking Behaviors: An Evaluation of Surviving the Teens® Suicide Prevention and Depression Awareness Program

ERIC Educational Resources Information Center

Strunk, Catherine M.; Sorter, Michael T.; Ossege, Julianne; King, Keith A.

2014-01-01

Many school-based suicide prevention programs do not show a positive impact on help-seeking behaviors among emotionally troubled teens despite their being at high risk for suicide. This study is a secondary analysis of the Surviving the Teens® program evaluation to determine its effect on help-seeking behaviors among troubled youth. Results showed…

Impact of a preventive intervention for perinatal depression on mood regulation, social support, and coping.

PubMed

Mendelson, Tamar; Leis, Julie A; Perry, Deborah F; Stuart, Elizabeth A; Tandon, S Darius

2013-06-01

Perinatal depression prevention trials have rarely examined proximal outcomes that may be relevant for understanding long-term risk for depression. The Mothers and Babies (MB) Course is a cognitive-behavioral depression prevention intervention, which has been shown to prevent depressive symptoms among at-risk perinatal women of color. This study examined intervention impact on three proximal outcomes that are theoretically linked with the intervention's model of change and have been empirically linked with risk for depression: mood regulation expectancies, perceived social support, and coping. The study used data from a randomized intervention trial of the MB Course with 78 low-income, predominantly African-American perinatal women enrolled at one of four home visitation programs in Baltimore City. Mood regulation expectancies, perceived social support, and coping were assessed with self-report instruments at baseline, post-intervention, and 3- and 6-month follow-ups. The intervention group experienced 16 % greater growth in mood regulation from baseline to 6-month follow-up compared to the usual care group, suggesting a prevention effect. The pattern of findings was similar, although not statistically significant, for social support. Contrary to prediction, the control group experienced less growth in avoidant coping than the intervention group. Findings indicate the MB Course enhances mood regulation, which may facilitate prevention of depression over time. Assessment of intervention effects on proximal outcomes is beneficial for understanding how interventions may enhance protective factors relevant to successful long-term outcomes.

Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: depression and alcohol outcomes.

PubMed

Reynolds, Elizabeth K; Macpherson, Laura; Tull, Matthew T; Baruch, David E; Lejuez, C W

2011-10-01

College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students' depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time × Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions.

Parenting intervention effects on parental depressive symptoms: examining the role of parenting and child behavior.

PubMed

Wong, Jessie J; Gonzales, Nancy A; Montaño, Zorash; Dumka, Larry; Millsap, Roger E

2014-06-01

Parental depression is a major risk factor in child development. Growing research suggests parenting programs can positively impact parental depressive symptoms, although the specific mechanisms that explain these effects are unknown. The current study examined parenting mediated effects of a parenting program on mothers' and fathers' depressive symptoms, as well as the role of child behavior in linking parenting to reductions in depressive symptoms. The study samples included 494 mothers and 288 fathers of Mexican origin adolescents who participated in a randomized trial of the Bridges to High School Program/Proyecto Puentes a la Secundaria, a universal prevention and promotion intervention that included parent training but did not directly target parental depressive symptoms. Parenting mediator models tested program effects on parental depressive symptoms through changes in harsh and supportive parenting. Results showed a significant indirect intervention effect on maternal depressive symptoms through changes in mothers' harsh parenting. Next, child behavior models revealed a partial mediation effect of harsh parenting and a full mediation effect of supportive parenting on maternal depressive symptoms through mothers' reports of child externalizing symptoms. Indirect effects of fathers' harsh and supportive parenting on paternal depressive symptoms were also found through fathers' reports of child behavior. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A wakeup call to the prevention field: are prevention programs for substance use effective for girls?

PubMed

Kumpfer, Karol L; Smith, Paula; Summerhays, Julia Franklin

2008-07-01

Substance misuse in adolescent girls has increased dramatically since 1992. This article reviews trends in use rates and etiological theories tested by gender that suggest that family protective factors have more influence on girls. Next, a literature review reveals that few prevention programs have published their outcomes by gender or developed gender-specific programs. Nationwide community coalition results found positive effects on boys but increased drug use in young girls. The most effective programs are family focused targeting family bonding, supervision, and communication. Recent gender-specific prevention programs with positive results address stress, depression, social assertiveness, and body image. The authors recommend additional research testing programs by gender and also gender-specific versus generic versions of evidence-based programs to determine how to improve prevention program effectiveness for girls.

Suicide prevention program for at-risk groups: pointers from an epidemiological study.

PubMed

Maniam, T; Chinna, Karuthan; Lim, C H; Kadir, A B; Nurashikin, I; Salina, A A; Mariapun, Jeevitha

2013-01-01

The aim of this paper is to identify at-risk groups for a focused suicide prevention program for Malaysia. Data from 20,552 persons aged 16 years and above (males 45.9%), was obtained using stratified, random sampling in a national survey of psychiatric morbidity using locally validated General Health Questionnaire (GHQ-28) which included questions on suicidal ideation. The overall prevalence of suicidal ideation (SI) was 6.3%, CI 6.1-6.8 (n=1288). Logistic regression analysis was performed with age, ethnicity, gender, urban/rural residence, age group, marital status, household income, type of household, presence of chronic pain, social dysfunction, somatic, anxiety or depressive symptoms, obesity, and chronic medical illnesses as independent variables. Only Insomnia, Religion, Marital Status, Depression, Social Dysfunction and Anxiety were seen to be significant predictors. Prevalence of SI was significantly higher among Indians (11.0%, CI 9.5-12.5), especially those of the Hindu faith (12.2%, CI 10.5-14.0), Chinese (9.7%, CI 8.8-10.7) and those having depressive symptoms. In a developing country with competing priorities, prudent allocation of resources requires focusing suicide prevention efforts on treating depression in vulnerable groups. Copyright © 2013 Elsevier Inc. All rights reserved.

Can we reduce the burden of depression? The Australian experience with beyondblue: the national depression initiative.

PubMed

Hickie, Ian

2004-01-01

Throughout the Asia Pacific region, there is an urgent need to reduce the burden of depression by increasing depression awareness, reducing stigma and dismantling those social barriers that prevent full participation by people with depression. This paper describes the development and early achievements of the Australian depression initiative, beyondblue. A review of the key priorities of beyondblue and their impacts during the first three years of operation (2001-03). Key achievements include: the degree of national recognition of beyondblue; size and scope of media impact; growth in website utilisation; increased reporting of the community's recognition of people with depression; genuine reforms in life insurance and income protection; development of a new national consumer and carer organisation; establishment of major population-based preventative and early intervention programs; system-wide reform of primary care-based mental health services; national educational program uptake by general practitioners; and, development of key awareness and intervention programs for use in schools and the workplace. In its first three years of operation, beyondblue has had a major impact on depression awareness in Australia and demonstrable gains have been made in reducing stigma and major social barriers. A pre-existing national mental health policy and implementation plan, a substantial funding base and participation by key political, media and community leaders have been essential elements of its short-term success. Its longer-term impact will now depend on more sustainable community and business partnerships as well as the growth of a more influential consumer and carer voice.

Social skills and depressive symptoms across adolescence: social support as a mediator in girls versus boys.

PubMed

Nilsen, Wendy; Karevold, Evalill; Røysamb, Espen; Gustavson, Kristin; Mathiesen, Kristin S

2013-02-01

The current population-based study of Norwegian adolescents examined gender-specific patterns in the prospective association between social skills in early adolescence (age 12.5; n = 566) and changes in depressive symptoms from early to late adolescence (age 16.5; n = 375). Further, a potential mediation effect of social support (from peers, parents, and teachers) in middle adolescence (age 14.5; n = 456) was examined. The findings indicated that low levels of social skills in early adolescence predicted increases in depressive symptoms for both girls and boys. Low levels of friend support in middle adolescence mediated this relationship for girls, but not boys. The findings underline the importance of including social skills training in primary programs designed to prevent development of depression. Preventive programs should also include actions on how girls can cope with interpersonal difficulties. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Depression and Outcome of Fear of Falling in a Falls Prevention Program.

PubMed

Iaboni, Andrea; Banez, Carol; Lam, Robert; Jones, Simon A; Maki, Brian E; Liu, Barbara A; Flint, Alastair J

2015-10-01

To examine whether depression predicts less improvement in fear of falling and falls efficacy in older adults attending a falls prevention program (FPP). Using a prospective observational design in an academic medical center, the authors studied 69 nondemented adults aged 55 years or older (mean age: 77.8±8.9 years) who had experienced at least one fall in the previous year and who attended the FPP. The primary outcome variable was change in severity of fear of falling during the FPP. Secondary outcome variables were change in falls efficacy and fear-related restriction of activities during the FPP. Independent variables were baseline depressive disorders and depressive symptom severity. Twenty-one of 69 study participants (30.4%) had a depressive disorder at baseline. Depressive disorder and depressive symptoms were not associated with change in severity of fear of falling or restriction of activity. On the other hand, depressive disorder was associated with improvement in falls efficacy, although this finding was not significant in multivariate analysis. Among participants with a depressive disorder, improvement in falls efficacy was significantly correlated with improvement in depressive symptoms. There was no association between baseline depression and change in fear of falling in this FPP. The correlation between improvement in depressive symptoms and improvement in falls efficacy raises the question as to whether a cognitive-behavioral intervention that simultaneously targets both depression and falls efficacy would be a useful component of a FPP. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

75 FR 7600 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-22

... suicide prevention; perceived and personal stigma related to depression and mental health seeking; and... Project: Cross-Site Evaluation of the Garrett Lee Smith Memorial Suicide Prevention and Early Intervention... the Garrett Lee Smith Memorial Youth Suicide Prevention and Early Intervention State/Tribal Programs...

Clusters of Behaviors and Beliefs Predicting Adolescent Depression: Implications for Prevention

PubMed Central

Paunesku, David; Ellis, Justin; Fogel, Joshua; Kuwabara, Sachiko A; Gollan, Jackie; Gladstone, Tracy; Reinecke, Mark; Van Voorhees, Benjamin W.

2009-01-01

OBJECTIVE Risk factors for various disorders are known to cluster. However, the factor structure for behaviors and beliefs predicting depressive disorder in adolescents is not known. Knowledge of this structure can facilitate prevention planning. METHODS We used the National Longitudinal Study of Adolescent Health (AddHealth) data set to conduct an exploratory factor analysis to identify clusters of behaviors/experiences predicting the onset of major depressive disorder (MDD) at 1-year follow-up (N=4,791). RESULTS Four factors were identified: family/interpersonal relations, self-emancipation, avoidant problem solving/low self-worth, and religious activity. Strong family/interpersonal relations were the most significantly protective against depression at one year follow-up. Avoidant problem solving/low self-worth was not predictive of MDD on its own, but significantly amplified the risks associated with delinquency. CONCLUSION Depression prevention interventions should consider giving family relationships a more central role in their efforts. Programs teaching problem solving skills may be most appropriate for reducing MDD risk in delinquent youth. PMID:20502621

Prevention of suicidal behavior

PubMed Central

Hegerl, Ulrich

2016-01-01

More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, as well as other factors. In the vast majority of cases, suicidal behavior occurs in the context of psychiatric disorders, depression being the most important one. Improving the treatment of depression, restricting access to lethal means, and avoiding the Werther effect (imitation suicide) are central aspects of suicide prevention programs. In several European regions, the four-level intervention concept of the European Alliance Against Depression (www.EAAD.net), simultaneously targeting depression and suicidal behavior, has been found to have preventive effects on suicidal behavior. It has already been implemented in more than 100 regions in Europe. PMID:27489458

A Pilot Randomised Controlled Trial of a School-Based Resilience Intervention to Prevent Depressive Symptoms for Young Adolescents with Autism Spectrum Disorder: A Mixed Methods Analysis.

PubMed

Mackay, Bethany A; Shochet, Ian M; Orr, Jayne A

2017-11-01

Despite increased depression in adolescents with Autism Spectrum Disorder (ASD), effective prevention approaches for this population are limited. A mixed methods pilot randomised controlled trial (N = 29) of the evidence-based Resourceful Adolescent Program-Autism Spectrum Disorder (RAP-A-ASD) designed to prevent depression was conducted in schools with adolescents with ASD in years 6 and 7. Quantitative results showed significant intervention effects on parent reports of adolescent coping self-efficacy (maintained at 6 month follow-up) but no effect on depressive symptoms or mental health. Qualitative outcomes reflected perceived improvements from the intervention for adolescents' coping self-efficacy, self-confidence, social skills, and affect regulation. Converging results remain encouraging given this population's difficulties coping with adversity, managing emotions and interacting socially which strongly influence developmental outcomes.

The process of developing and implementing a telephone-based peer support program for postpartum depression: evidence from two randomized controlled trials

PubMed Central

2014-01-01

Background A randomized controlled trial evaluated the effect of telephone-based peer support on preventing postpartum depression (PPD) among high-risk mothers. The results indicated that support provided by peer volunteers may be an effective preventative strategy. The purpose of this paper is to outline the process of developing, implementing, maintaining, and evaluating the peer support program that we used in this PPD prevention trial. Methods The peer support program had been used successfully in a pilot trial and a previous breastfeeding peer support trial. Based on our experience and lessons learned, we developed a 4-phase, 12-step approach so that the peer support model could be copied and used by different health providers in various settings. We will use the PPD prevention trial to demonstrate the suggested steps. Results The trial aim to prevent the onset of PPD was established. Peer volunteers who previously experienced and recovered from self-reported PPD were recruited and attended a four-hour training session. Volunteers were screened and those identified as appropriate to provide support to postpartum mothers were selected. Women who scored more than 9 on the Edinburgh Postnatal Depression Scale within the first two weeks after childbirth were recruited to participate in the trial and proactive, individualized, telephone-based peer support (mother-to-mother) was provided to those randomized to the intervention group. Peer volunteers maintained the intervention, supported other volunteers, and evaluated the telephone-based support program. Possible negative effects of the intervention were assessed. An in-depth assessment of maternal perspectives of the program at 12 weeks postpartum was performed. Conclusions The 4-phase, 12-step approach delineated in this paper provides clear and concise guidelines for health professionals to follow in creating and implementing community-based, peer-support interventions with the potential to prevent PPD. Trial registration Current Controlled Trials ISRCTN68337727. PMID:24742217

Parents' perceptions on offspring risk and prevention of anxiety and depression: a qualitative study.

PubMed

Festen, Helma; Schipper, Karen; de Vries, Sybolt O; Reichart, Catrien G; Abma, Tineke A; Nauta, Maaike H

2014-01-01

Offspring of patients with anxiety or depression are at high risk for developing anxiety or depression. Despite the positive findings regarding effectiveness of prevention programs, recruitment for prevention activities and trials is notoriously difficult. Our randomized controlled prevention trial was terminated due to lack of patient inclusion. Research on mentally-ill parents' perceptions of offspring's risk and need for preventive intervention may shed light on this issue, and may enhance family participation in prevention activities and trials. Qualitative data were collected through semi-structured interviews with 24 parents (patients with anxiety or depression, or their partners). An inductive content analysis of the data was performed. Five research questions were investigated regarding parents' perceptions of anxiety, depression, and offspring risk; anxiety, depression, and parenting; the need for offspring intervention and prevention; and barriers to and experiences with participation in preventive research. Parental perceptions of the impact of parental anxiety and depression on offspring greatly differed. Parents articulated concerns about children's symptomatology, however, most parents did not perceive a direct link between parent symptoms and offspring quality of life. They experienced an influence of parental symptoms on family quality of life, but chose not to discuss that with their children in order to protect them. Parents were not well aware of the possibilities regarding professional help for offspring and preferred parent-focused rather than offspring-focused interventions such as parent psycho-education. Important barriers to participation in preventive research included parental overburden, shame and stigma, and perceived lack of necessity for intervention. This study highlights the importance of educating parents in adult health care. Providing psycho-education regarding offspring risk, communication in the family, and parenting in order to increase parental knowledge and parent-child communication, and decrease guilt and shame are important first steps in motivating parents to participate in preventive treatment.

Predictors of Depression Stigma in Medical Students: Potential Targets for Prevention and Education.

PubMed

Wimsatt, Leslie A; Schwenk, Thomas L; Sen, Ananda

2015-11-01

Suicide rates are higher among U.S. physicians than the general population. Untreated depression is a major risk factor, yet depression stigma presents a barrier to treatment. This study aims to identify early career indications of stigma among physicians-in-training and to inform the design of stigma-reduction programs. A cross-sectional student survey administered at a large, Midwestern medical school in fall 2009 included measures of depression symptoms, attitudes toward mental health, and potential sources of depression stigma. Principal components factor analysis and linear regression were used to examine stigma factors associated with depression in medical students. The response rate was 65.7%, with 14.7% students reporting a previous depression diagnosis. Most students indicated that, if depressed, they would feel embarrassed if classmates knew. Many believed that revealing depression could negatively affect professional advancement. Factor analyses revealed three underlying stigma constructs: personal weakness, public devaluation, and social/professional discrimination. Students associating personal weakness with depression perceived medication as less efficacious and the academic environment as more competitive. Those endorsing public stigma viewed medication and counseling as less efficacious and associated depression with an inability to cope. Race, gender, and diagnosis of past/current depression also related to beliefs about stigma. Depression measures most strongly predicted stigma associated with personal weakness and social/professional discrimination. Recommendations for decreasing stigma among physicians-in-training include consideration of workplace perceptions, depression etiology, treatment efficacy, and personal attributes in the design of stigma reduction programs that could facilitate help-seeking behavior among physicians throughout their career. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Preferred Features of E-Mental Health Programs for Prevention of Major Depression in Male Workers: Results From a Canadian National Survey.

PubMed

Wang, JianLi; Lam, Raymond W; Ho, Kendall; Attridge, Mark; Lashewicz, Bonnie M; Patten, Scott B; Marchand, Alain; Aiken, Alice; Schmitz, Norbert; Gundu, Sarika; Rewari, Nitika; Hodgins, David; Bulloch, Andrew; Merali, Zul

2016-06-06

Major depression is a prevalent mental disorder and imposes considerable burden on health and productivity. Men are not immune to major depression, yet they often delay seeking help because of perceived stigma and gender norms. E-mental health programs hold potential for early prevention of major depression. However, we have little knowledge about men's preferences for design features of e-mental health programs. The objective of this study was to (1) estimate and compare the proportions of Internet use for medical information, preferred design features, and likely use of e-mental health programs; (2) examine factors associated with the likely use of e-mental health programs; and (3) understand potential barriers to the use of e-mental health programs among Canadian working men, who were at high risk of a major depressive episode (MDE). A cross-sectional survey in 10 Canadian provinces was conducted between March and December 2015. Random digit dialing method was used through household landlines and cell phones to collect data from 511 working men who were at high risk of having an MDE and 330 working men who were at low risk of having an MDE. High-risk men were more likely to endorse the importance of accessing health resources on the Internet than low-risk men (83.4% vs 75.0%, respectively; P=.01). Of the 17 different features assessed, the top three features most likely to be used by high-risk men were: "information about improving sleep hygiene" (61.3%), "practice and exercise to help reduce symptoms of stress and depression" (59.5%), and "having access to quality information and resources about work stress issues" (57.8%). Compared with men at low risk for MDE, men at high risk for MDE were much more likely to consider using almost every one of the different design features. Differences in preferences for the design features by age among men at high risk of MDE were found only for 3 of 17 features. Differences in preferences for design features between English- and French-speaking participants were found only for 4 out of the 17 features. Analysis of qualitative data revealed that privacy issues, perceived stigma, ease of navigation, personal relevance, and lack of personal interaction, time, and knowledge were identified as barriers to the use of e-mental health programs in working men who were at high risk of MDE. E-mental health programs may be a promising strategy for prevention of depression in working men. Development of e-mental health programs should consider men's preferences and perceived barriers to enhance the acceptability of this approach.

A Web-Based Psychoeducational Intervention for Adolescent Depression: Design and Development of MoodHwb

PubMed Central

Thapar, Anita; Rice, Frances; Beeching, Harriet; Cichosz, Rachel; Mars, Becky; Smith, Daniel J; Merry, Sally; Stallard, Paul; Jones, Ian; Thapar, Ajay K; Simpson, Sharon A

2018-01-01

Background Depression is common in adolescence and leads to distress and impairment in individuals, families and carers. Treatment and prevention guidelines highlight the key role of information and evidence-based psychosocial interventions not only for individuals but also for their families and carers. Engaging young people in prevention and early intervention programs is a challenge, and early treatment and prevention of adolescent depression is a major public health concern. There has been growing interest in psychoeducational interventions to provide accurate information about health issues and to enhance and develop self-management skills. However, for adolescents with, or at high risk of depression, there is a lack of engaging Web-based psychoeducation programs that have been developed with user input and in line with research guidelines and targeted at both the individual and their family or carer. There are also few studies published on the process of development of Web-based psychoeducational interventions. Objective The aim of this study was to describe the process underlying the design and development of MoodHwb (HwbHwyliau in Welsh): a Web-based psychoeducation multimedia program for young people with, or at high risk of, depression and their families, carers, friends, and professionals. Methods The initial prototype was informed by (1) a systematic review of psychoeducational interventions for adolescent depression; (2) findings from semistructured interviews and focus groups conducted with adolescents (with depressive symptoms or at high risk), parents or carers, and professionals working with young people; and (3) workshops and discussions with a multimedia company and experts (in clinical, research, and multimedia work). Twelve interviews were completed (four each with young people, parents or carers, and professionals) and six focus groups (three with young people, one with parents and carers, one with professionals, and one with academics). Results Key themes from the interviews and focus groups were: aims of the program, design and content issues, and integration and context of the program. The prototype was designed to be person-centered, multiplatform, engaging, interactive, and bilingual. It included mood-monitoring and goal-setting components and was available as a Web-based program and an app for mobile technologies. Conclusions MoodHwb is a Web-based psychoeducational intervention developed for young people with, or at high risk of, depression and their families and carers. It was developed with user input using qualitative methods as well as user-centered design and educational and psychological theory. Further research is needed to evaluate the effectiveness of the program in a randomized controlled trial. If found to be effective, it could be implemented in health, education, youth and social services, and charities, to not only help young people but also families, carers, friends, and professionals involved in their care. PMID:29449202

Preventing Adolescent Depression with the Family Check-Up: Examining Family Conflict as a Mechanism of Change

PubMed Central

Fosco, Gregory M.; Van Ryzin, Mark J.; Connell, Arin M.; Stormshak, Elizabeth A.

2015-01-01

Family-centered prevention programs are understudied for their effects on adolescent depression, despite considerable evidence that supports their effectiveness for preventing escalation in youth problem behavior and substance use. This study was conducted with 2 overarching goals: (a) replicate previous work that has implicated the Family Check-Up (FCU), a multilevel, gated intervention model embedded in public middle schools, as an effective strategy for preventing growth in adolescent depressive symptoms and (b) test whether changes in family conflict may be an explanatory mechanism for the long-term, protective effects of the FCU with respect to adolescent depression. This trial was conducted with 593 ethnically diverse families who were randomized to intervention (offered the FCU) or middle school as usual. Complier average causal effect (CACE) analysis revealed that engagers in the FCU evidenced less growth in depressive symptoms and family conflict from 6th through 9th grade and post-hoc analyses indicated that the FCU is related to lower rates of Major Depressive Disorder. The second set of analyses examined family conflict as a mechanism of change for families who participated in the FCU. Families who reported short-term intervention benefits had significantly less escalation in family conflict over the middle school years; in turn, growth in family conflict explained risk for adolescent depressive symptoms. PMID:26414418

Preventing adolescent depression with the family check-up: Examining family conflict as a mechanism of change.

PubMed

Fosco, Gregory M; Van Ryzin, Mark J; Connell, Arin M; Stormshak, Elizabeth A

2016-02-01

Family-centered prevention programs are understudied for their effects on adolescent depression, despite considerable evidence that supports their effectiveness for preventing escalation in youth problem behavior and substance use. This study was conducted with 2 overarching goals: (a) replicate previous work that has implicated the Family Check-Up (FCU), a multilevel, gated intervention model embedded in public middle schools, as an effective strategy for preventing growth in adolescent depressive symptoms and (b) test whether changes in family conflict may be an explanatory mechanism for the long-term, protective effects of the FCU with respect to adolescent depression. This trial was conducted with 593 ethnically diverse families who were randomized to intervention (offered the FCU) or middle school as usual. Complier average causal effect (CACE) analysis revealed that engagers in the FCU evidenced less growth in depressive symptoms and family conflict from 6th through 9th grade, and post hoc analyses indicated that the FCU is related to lower rates of major depressive disorder. The second set of analyses examined family conflict as a mechanism of change for families who participated in the FCU. Families who reported short-term intervention benefits had significantly less escalation in family conflict over the middle school years; in turn, growth in family conflict explained risk for adolescent depressive symptoms. (c) 2016 APA, all rights reserved).

Associations among bullying, cyberbullying, and suicide in high school students.

PubMed

Bauman, Sheri; Toomey, Russell B; Walker, Jenny L

2013-04-01

This study examined associations among depression, suicidal behaviors, and bullying and victimization experiences in 1491 high school students using data from the 2009 Youth Risk Behavior Survey. Results demonstrated that depression mediated the association between bullying/victimization and suicide attempts, but differently for males and females. Specifically, depression mediated the link between traditional victimization and suicide attempts similarly across gender, whereas depression mediated the link between cyber victimization and suicide attempts only for females. Similarly, depression mediated the link between traditional bullying and suicide attempts for females only. Depression did not mediate the link between cyberbullying and suicide attempts for either gender. Implications of the findings are discussed, including the importance of greater detection of depression among students involved in bullying, and the need for a suicide prevention and intervention component in anti-bullying programs. Findings suggest that bullying prevention efforts be extended from middle school students to include high school students. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Longitudinal effects of hostility, depression, and bullying on adolescent smoking initiation.

PubMed

Weiss, Jie W; Mouttapa, Michele; Cen, Steven; Johnson, C Anderson; Unger, Jennifer

2011-06-01

The present study examined the associations between smoking initiation and, hostility, depressive symptoms, and bullying (bullies and bully-victims) among a culturally diverse sample of 1,771 adolescents who reported never having smoked at baseline. Data were obtained from a longitudinal school-based experimental trial of smoking prevention programs in Southern California. Annual survey was performed for students of the sixth, seventh, and eighth grades. All students in the 24 participating schools were invited to participate in the study during the sixth grade. The risk of smoking initiation was significantly higher among students who scored higher on hostility and depressive symptoms, and were bully-victims. The findings suggest that tobacco prevention programs should include strategies for managing hostile feelings and negative effect as part of the curriculum. In addition, it might be helpful to identify youth who score high on these psychosocial factors and teach them skills to handle interpersonal conflict and negative feelings to prevent their involvement in substance use. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Depressive symptoms and health-related quality of life among participants in the Pasos Adelante chronic disease prevention and control program, Arizona, 2005-2008.

PubMed

Cutshaw, Christina A; Staten, Lisa K; Reinschmidt, Kerstin M; Davidson, Christopher; Roe, Denise J

2012-01-01

Chronic diseases are the leading causes of death in the United States and have been associated with depressive symptoms and poor health-related quality of life (HRQOL). This study examined whether depressive symptoms and HRQOL indicators changed among participants in Pasos Adelante, a chronic disease prevention and control program implemented in a US-Mexico border community. Pasos Adelante was a 12-week promotora-led program that included educational sessions and walking groups. We used the Centers for Epidemiologic Studies Depression Scale (CES-D) and the Center for Disease Control's "Healthy Days" measures to measure depressive symptoms and HRQOL. We used linear mixed-effects models and general estimating equations to analyze changes in CES-D scores and HRQOL indicators from baseline to postprogram and from postprogram to 3-month follow-up. At baseline, participants had a mean of 7.1 physically unhealthy days, 7.4 mentally unhealthy days, and 3.9 days of activity limitation. The mean number of physically and mentally unhealthy days declined significantly from baseline to postprogram, but the mean number of activity limitation days did not. At baseline, 42.6% of participants reported their health as fair/poor; 20.8% of participants reported frequent mental distress, and 31.8% had a CES-D score of 16 or more. All 3 proportions declined from baseline to postprogram. No significant changes occurred between postprogram and follow-up. Participants in Pasos Adelante showed improvement in depressive symptoms and several HRQOL indicators. Future studies should use an experimental design with a comparison group to determine whether these findings can be replicated and to examine potential mediators and moderators of program effects.

Preventing Depression in Final Year Secondary Students: School-Based Randomized Controlled Trial

PubMed Central

Perry, Yael; Werner-Seidler, Aliza; Calear, Alison; Mackinnon, Andrew; King, Catherine; Scott, Jan; Merry, Sally; Fleming, Theresa; Stasiak, Karolina; Batterham, Philip J

2017-01-01

Background Depression often emerges for the first time during adolescence. There is accumulating evidence that universal depression prevention programs may have the capacity to reduce the impact of depression when delivered in the school environment. Objective This trial investigated the effectiveness of SPARX-R, a gamified online cognitive behavior therapy intervention for the prevention of depression relative to an attention-matched control intervention delivered to students prior to facing a significant stressor—final secondary school exams. It was hypothesized that delivering a prevention intervention in advance of a stressor would reduce depressive symptoms relative to the control group. Methods A cluster randomized controlled trial was conducted in 10 government schools in Sydney, Australia. Participants were 540 final year secondary students (mean 16.7 [SD 0.51] years), and clusters at the school level were randomly allocated to SPARX-R or the control intervention. Interventions were delivered weekly in 7 modules, each taking approximately 20 to 30 minutes to complete. The primary outcome was symptoms of depression as measured by the Major Depression Inventory. Intention-to-treat analyses were performed. Results Compared to controls, participants in the SPARX-R condition (n=242) showed significantly reduced depression symptoms relative to the control (n=298) at post-intervention (Cohen d=0.29) and 6 months post-baseline (d=0.21) but not at 18 months post-baseline (d=0.33). Conclusions This is the first trial to demonstrate a preventive effect on depressive symptoms prior to a significant and universal stressor in adolescents. It demonstrates that an online intervention delivered in advance of a stressful experience can reduce the impact of such an event on the potential development or exacerbation of depression. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12614000316606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365986 (Archived by WebCite at http://www.webcitation.org/ 6u7ou1aI9) PMID:29097357

Have Broad-Based Community and Professional Education Programs Influenced Mental Health Literacy and Treatment Seeking of those with Major Depression and Suicidal Ideation?

ERIC Educational Resources Information Center

Goldney, Robert D.; Fisher, Laura J.

2008-01-01

"Mental health literacy" is the knowledge and beliefs about mental disorders that aid in their recognition, management, or prevention; it is also a determinant of help seeking. As such, it is presumed to be important in community suicide prevention programs. In Australia there have been a number of government, professional, and…

Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial.

PubMed

Nakagami, Yukako; Kubo, Hiroaki; Katsuki, Ryoko; Sakai, Tomomichi; Sugihara, Genichi; Naito, Chisako; Oda, Hiroyuki; Hayakawa, Kohei; Suzuki, Yuriko; Fujisawa, Daisuke; Hashimoto, Naoki; Kobara, Keiji; Cho, Tetsuji; Kuga, Hironori; Takao, Kiyoshi; Kawahara, Yoko; Matsumura, Yumi; Murai, Toshiya; Akashi, Koichi; Kanba, Shigenobu; Otsuka, Kotaro; Kato, Takahiro A

2018-01-01

Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. Design was a single-arm study with relatively small sample size and short-term follow up. The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.

Depressive symptoms, antidepressant medication use and new onset of diabetes in participants of the Diabetes Prevention Program and the Diabetes Prevention Program Outcomes Study

PubMed Central

Marrero, David G.; Ma, Yong; de Groot, Mary; Horton, Edward S.; Price, David W.; Barrett-Connor, Elizabeth; Carnethon, Mercedes R.; Knowler, William C.

2015-01-01

Objective To assess in participants in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study (DPP/DPPOS) whether diagnosis of diabetes predicted: elevated depressive symptoms (DS) or antidepressant medicine (ADM) use after diagnosis; diabetes status or duration had significant effect on DS or ADM use; and associations between A1C, fasting plasma glucose (FPG), normalization of FPG and DS or ADM use post diagnosis. Methods DPP participants in 3 treatment arms [intensive lifestyle (ILS), metformin (MET), placebo (PLC)] were assessed semiannually or annually for diabetes, glucose control, ADM use, and DS. DS was measured using Beck Depression Inventory (BDI) questionnaire. Among the total 3234 enrolled participants, 1285 developed diabetes whose levels of depression were measured before and after their diabetes diagnosis. Results Neither DS nor ADM use increased significantly following diabetes diagnosis. After diabetes diagnosis, higher FPG was associated with greater ADM use in the ILS arm independent of potential confounders; a 10 mg/dl higher in FPG is associated with 8.8% more odds of ADM use. Higher FPG, and higher A1C were associated with higher BDI scores in all three arms. On average, a participant with 10 mg/dl higher rise in FPG had a 0.07 increase in BDI score. Similarly, 1% higher A1c was associated with a 0.21 point increase in BDI score. On contrary, normalization of FPG was associated with lower BDI scores. In participants with FPG that had normalized, there was a decrease of 0.30 points in the BDI score compared to those whose FPG had not normalized. Conclusions Contrary to clinical attributions, the diagnosis of diabetes did not show an immediate impact on BDI scores or ADM use. However, higher glucose levels after diagnosis were associated with small but significant higher BDI score and more ADM use. PMID:25775165

Increasing Self-Empowerment Related to Depression among Court-Involved Youth: The Moods Matter Project

ERIC Educational Resources Information Center

Calley, Nancy G.; Hawley, Lisa D.

2010-01-01

An empirically-guided program designed to empower at-risk youth through increased knowledge of depression and prevention resources was developed and implemented. Ninety-three court-involved adolescents participated in the "Moods Matter" project, a four-part psycho-educational group experience rooted in the principles of Rational Emotive Behavior…

Subthreshold depression in adolescence: a systematic review.

PubMed

Bertha, Eszter A; Balázs, Judit

2013-10-01

In adolescence, the number of depressive symptoms is rising notably. Individuals may have relevant depressive symptoms without meeting the full criteria of a major depressive episode (MDE), a condition referred to as subthreshold depression (sD). This article presents a review on adolescent sD examining the prevalence, the quality of life (QoL), the risk of developing MDE, and preventive programs available for adolescents living with sD. A systematic literature search from the year of the introduction of Diagnostic and Statistic Manual for Mental Disorders Fourth Edition (DSM-IV) until 2012 (18 years) was conducted with a special focus on adolescent sD. Data from 27 studies were included into this review. The results show high prevalence of sD among adolescents, with a negative impact on QoL, and provide evidence that sD is a significant risk indicator of later MDE; therefore, individuals with sD represent good targets for preventive interventions. Our review highlights the fact that sD is a significant health problem among adolescents indeed, and adolescents with sD could be a subgroup of youth, who need further help to reduce their clinically significant depressive symptoms for the successful prevention of a later MDE.

Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: a randomized effectiveness trial.

PubMed

Gillham, Jane E; Reivich, Karen J; Brunwasser, Steven M; Freres, Derek R; Chajon, Norma D; Kash-Macdonald, V Megan; Chaplin, Tara M; Abenavoli, Rachel M; Matlin, Samantha L; Gallop, Robert J; Seligman, Martin E P

2012-01-01

Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). We evaluated the effectiveness of the Penn Resiliency Program for adolescents (PRP-A), a school-based group intervention that targets cognitive behavioral risk factors for depression. We randomly assigned 408 middle school students (ages 10-15) to one of three conditions: PRP-A, PRP-AP (in which adolescents participated in PRP-A and parents were invited to attend a parent intervention component), or a school-as-usual control. Adolescents completed measures of depression and anxiety symptoms, cognitive style, and coping at baseline, immediately after the intervention, and at 6-month follow-up. PRP-A reduced depression symptoms relative to the school as usual control. Baseline levels of hopelessness moderated intervention effects. Among participants with average and high levels of hopelessness, PRP (A and AP) significantly improved depression symptoms, anxiety symptoms, hopelessness, and active coping relative to control. Among participants with low baseline hopelessness, we found no intervention effects. PRP-AP was not more effective than PRP-A alone. We found no intervention effects on clinical levels of depression or anxiety. These findings suggest that cognitive-behavioral interventions can be beneficial when delivered by school teachers and counselors. These interventions may be most helpful to students with elevated hopelessness.

Comprehensive care improves health outcomes among elderly Taiwanese patients with hip fracture.

PubMed

Shyu, Yea-Ing L; Liang, Jersey; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen

2013-02-01

Few studies have investigated the effects of care models that combine interdisciplinary care with nutrition consultation, depression management, and fall prevention in older persons with hip fracture. The purpose of this study was to compare the effects of a comprehensive care program with those of interdisciplinary care and usual care for elderly patients with hip fracture. A randomized experimental trial was used to explore outcomes for 299 elderly patients with hip fracture receiving three treatment care models: interdisciplinary care (n = 101), comprehensive care (n = 99), and usual care (n = 99). Interdisciplinary care included geriatric consultation, continuous rehabilitation, and discharge planning with post-hospital services. Comprehensive care consisted of interdisciplinary care plus nutrition consultation, depression management, and fall prevention. Usual care included only in-hospital rehabilitation without geriatric consultation, in-home rehabilitation, and home environmental assessment. Participants in the comprehensive care group had better self-care ability (odds ratio, OR = 3.19, p < .01) and less risk of depression (OR = 0.48, p < .01) than those who received usual care. The comprehensive care group had less risk of depression (OR = 0.51, p < .05) and of malnutrition (OR = 0.48, p < .05) than the interdisciplinary care group during the first year following discharge. Older persons with hip fracture benefitted more from the comprehensive care program than from interdisciplinary care and usual care. Older persons with hip fracture benefitted more from comprehensive care including interdisciplinary care and nutrition consultation, depression management, and fall prevention than simply interdisciplinary care.

Getting Real about Suicide Prevention in Schools

ERIC Educational Resources Information Center

Schiro, Theodora

2018-01-01

After her son died by suicide, Theodora Schiro vowed to raise awareness and teach others about depression and suicide. In this article, Schiro (a former teacher and principal) explains how educators can detect warning signs, devise preventative programs, and fight the stigma associated with suicide.

"She Finally Smiles … for Real": Reducing Depressive Symptoms and Bolstering Resilience Through a Camp Intervention for LGBTQ Youth.

PubMed

Gillig, Traci K; Miller, Lynn C; Cox, Courtney M

2017-11-29

While summer camps are a recognized evidence-based strategy for building social and emotional skills among youth (U.S. Centers for Disease Control and Prevention [CDC], 2009), no known studies have evaluated the effects of camp programming for LGBTQ youth in the United States. This pilot study evaluates a novel program (Brave Trails) for LGBTQ youth ages 12 to 20, using a pre-post camper survey (N = 56) and a post-camp parent survey (N = 54). Results show campers experienced increases in identity affirmation and hope and a reduction in depressive symptoms. Regression analyses found changes in identity affirmation predicted reductions in depressive symptoms and increases in resilience. Additionally, campers' experience of key camp programming features predicted changes in depressive symptoms. Findings from the parent survey were consistent with camper survey results. Theoretical and practical implications are discussed.

Preliminary Effectiveness of Surviving the Teens[R] Suicide Prevention and Depression Awareness Program on Adolescents' Suicidality and Self-Efficacy in Performing Help-Seeking Behaviors

ERIC Educational Resources Information Center

King, Keith A.; Strunk, Catherine M.; Sorter, Michael T.

2011-01-01

Background: Suicide ranks as the third leading cause of death among youth aged 15-24 years. Schools provide ideal opportunities for suicide prevention efforts. However, research is needed to identify programs that effectively impact youth suicidal ideation and behavior. This study examined the immediate and 3-month effect of Surviving the Teens[R]…

Managing workplace depression: an untapped opportunity for occupational health professionals.

PubMed

Putnam, Kelly; McKibbin, Laura

2004-03-01

Depression is one of the most prevalent and costly health issues affecting the American work force. Despite well established research demonstrating the association between employee depression and reduced on-the-job productivity, increased absenteeism, and higher health care use, most employers remain largely unresponsive to the need for company based depression initiatives. Organizational and individual barriers can prevent companies from effectively managing employee depression. Organizational barriers include information gaps, lack of data to justify increased investment in employee mental health programs, and employers' ambiguous roles in addressing depression. Individual barriers such as an inability to recognize signs and symptoms; stigma; confidentiality and privacy concerns; and unavailability of easily accessible, quality resources can keep employees who are depressed from seeking treatment. Many occupational health professionals may feel ill prepared or uncomfortable taking the lead in creating more aggressive worksite responses to depression, but they are, perhaps, in the best of all possible positions within an organization to succeed. Occupational health professionals have the credentials, credibility, training, and experience necessary to build a strong case for business leaders for why investing in workplace depression programs is so important. Occupational health professionals are the most qualified to design and deliver destigmatized, customer friendly programs and services for employees to access for help with depression, and to integrate their services with other departments such as benefits, health promotion, EAP, and human resources, to create an effective, organization-wide depression initiative.

COMBIMAN Programs (COMputerized BIomechanical MAN-Model). Version 8 (User’s Guide)

DTIC Science & Technology

1989-02-01

prgrams The guide is based on the program as of January 1989. It deals with the conventions used to develop and analyze crew stations, the generation of the...END ACTION: This is a safety to prevent ending the program if PFK 31 is accidentally depressed. Select END COMBIMAN if you intended to end the program

Moderators of two indicated cognitive-behavioral depression prevention approaches for adolescents in a school-based effectiveness trial.

PubMed

Brière, Frédéric N; Rohde, Paul; Shaw, Heather; Stice, Eric

2014-02-01

Our aim was to identify moderators of the effects of a cognitive behavioral group-based prevention program (CB group) and CB bibliotherapy, relative to an educational brochure control condition and to one another, in a school-based effectiveness randomized controlled prevention trial. 378 adolescents (M age = 15.5, 68% female) with elevated depressive symptoms were randomized in one of three conditions and were assessed at pretest, posttest, and 6-month follow-up. We tested the moderating effect of three individual (baseline depressive symptoms, negative attributional style, substance use), three environmental (negative life events, parental support, peer support), and two sociodemographic (sex, age) characteristics. Baseline depressive symptoms interacted with condition and time. Decomposition indicated that elevated baseline depressive symptoms amplified the effect of CB bibliotherapy at posttest (but not 6-month follow-up) relative to the control condition, but did not modify the effect of CB group relative to the control condition or relative to bibliotherapy. Specifically, CB bibliotherapy resulted in lower posttest depressive symptoms than the control condition in individuals with elevated, but not average or low baseline symptoms. We found no interaction effect for other putative moderators. Our findings suggest that bibliotherapy is effective only in participants who have elevated depressive symptoms at baseline. The fact that no study variable moderated the effects of CB group, which had a significant main effect in reducing depressive symptoms relative to the control condition, suggests that this indicated prevention intervention is effective for a wide range of adolescents. Copyright © 2013 Elsevier Ltd. All rights reserved.

Moderators of two Indicated Cognitive-Behavioral Depression Prevention Approaches for Adolescents in a School-Based Effectiveness Trial

PubMed Central

Brière, Frédéric N.; Rohde, Paul; Shaw, Heather; Stice, Eric

2014-01-01

Objective Our aim was to identify moderators of the effects of a cognitive behavioral group-based prevention program (CB group) and CB bibliotherapy, relative to an educational brochure control condition and to one another, in a school-based effectiveness randomized controlled prevention trial. Method 378 adolescents (M age = 15.5, 68% female) with elevated depressive symptoms were randomized in one of three conditions and were assessed at pretest, posttest, and 6-month follow-up. We tested the moderating effect of three individual (Baseline Depressive Symptoms, Negative Attributional Style, Substance Use), three environmental (Negative Life Events, Parental Support, Peer Support), and two sociodemographic (Sex, Age) characteristics. Results Baseline Depressive Symptoms interacted with Condition and Time. Decomposition indicated that elevated baseline depressive symptoms amplified the effect of CB bibliotherapy at posttest (but not 6-month follow-up) relative to the control condition, but did not modify the effect of CB group relative to the control condition or relative to bibliotherapy. Specifically, CB bibliotherapy resulted in lower posttest depressive symptoms than the control condition in individuals with elevated, but not average or low baseline symptoms. We found no interaction effect for other putative moderators. Conclusions Our findings suggest that bibliotherapy is effective only in participants who have elevated depressive symptoms at baseline. The fact that no study variable moderated the effects of CB group, which had a significant main effect in reducing depressive symptoms relative to the control condition, suggests that this indicated prevention intervention is effective for a wide range of adolescents. PMID:24418653

Campus Suicide Prevention and Intervention: Putting Best Practice Policy into Action

ERIC Educational Resources Information Center

Washburn, Cheryl A.; Mandrusiak, Michael

2010-01-01

Findings from biannual American College Health Association-National College Health Assessment surveys have highlighted the prevalence of depression, suicidal ideation, and attempted suicides on Canadian university campuses and the need for comprehensive suicide prevention programs. This article explores how one large western Canadian university…

Staying well during pregnancy and the postpartum: A pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence.

PubMed

Dimidjian, Sona; Goodman, Sherryl H; Felder, Jennifer N; Gallop, Robert; Brown, Amanda P; Beck, Arne

2016-02-01

Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their health care providers. Pregnant women with histories of depression report preference for nonpharmacological care, but few evidence-based options exist. Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general populations and indications of promise as adapted for perinatal depression (MBCT-PD). With a pilot randomized clinical trial, our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual (TAU). Pregnant adult women with depression histories were recruited from obstetric clinics at 2 sites and randomized to MBCT-PD (N = 43) or TAU (N = 43). Treatment acceptability was measured by assessing completion of sessions, at-home practice, and satisfaction. Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6 months postpartum. Consistent with predictions, MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments, and satisfaction with services was significantly higher for MBCT-PD than TAU. Moreover, at-risk women randomly assigned to MBCT-PD reported significantly improved depressive outcomes compared with participants receiving TAU, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study. MBCT-PD is an acceptable and clinically beneficial program for pregnant women with histories of depression; teaching the skills and practices of mindfulness meditation and cognitive-behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in many women's lives. (c) 2016 APA, all rights reserved).

An Evaluation of FrancoForme: A CASE-MANAGED HOME-BASED PRIMARY AND SECONDARY CARDIOVASCULAR DISEASE PREVENTION PROGRAM FOR FRENCH-SPEAKING CANADIANS.

PubMed

Prince, Stephanie A; Laflamme, Marc; Harris, Jennifer; Tulloch, Heather E; de Margerie, Michele

2017-11-01

Cardiovascular disease (CVD) is the leading cause of mortality globally. Telephone-delivered interventions targeting cardiovascular risk factors are gaining popularity. This study is an evaluation of FrancoForme, a cardiovascular risk factor reduction program for the primary and secondary prevention of CVD among French-speaking patients of Eastern Ontario. This study reports on changes in cardiovascular risk factors, weekly exercise levels, and psychosocial characteristics including anxiety, depression, and quality of life upon program completion (3 months) and at 1 year after the start of the program. Repeated-measures analysis of variance was used to compare changes in outcomes between primary prevention risk groups (low, moderate, and high risk for CVD) and the secondary prevention group (ie, cardiac rehabilitation) at baseline, 3 months and 12 months. A total of 762 patients enrolled in FrancoForme between 2008 and 2015. At 3 months, all program completers (n = 507) experienced significant reductions for all cardiovascular risk factors except diastolic blood pressure. Minutes of self-reported exercise increased significantly by an average 90 minutes per week and all psychosocial variables improved. Significant group effects were observed across several risk factors. Among 12-month responders (n = 240), exercise, high-density lipoproteins, triglycerides, cholesterol, and all psychosocial variables were improved over baseline results. FrancoForme is unique in targeting both the primary and secondary prevention of CVD and removes several of the barriers to participating in a conventional CVD prevention program for French-speaking patients. FrancoForme is successful, receiving high satisfaction rates and resulting in significant improvements in cardiovascular risk factors, exercise, anxiety, and depression, as well as quality of life.

Preferred Features of E-Mental Health Programs for Prevention of Major Depression in Male Workers: Results From a Canadian National Survey

PubMed Central

Lam, Raymond W; Ho, Kendall; Attridge, Mark; Lashewicz, Bonnie M; Patten, Scott B; Marchand, Alain; Aiken, Alice; Schmitz, Norbert; Gundu, Sarika; Rewari, Nitika; Hodgins, David; Bulloch, Andrew; Merali, Zul

2016-01-01

Background Major depression is a prevalent mental disorder and imposes considerable burden on health and productivity. Men are not immune to major depression, yet they often delay seeking help because of perceived stigma and gender norms. E-mental health programs hold potential for early prevention of major depression. However, we have little knowledge about men’s preferences for design features of e-mental health programs. Objectives The objective of this study was to (1) estimate and compare the proportions of Internet use for medical information, preferred design features, and likely use of e-mental health programs; (2) examine factors associated with the likely use of e-mental health programs; and (3) understand potential barriers to the use of e-mental health programs among Canadian working men, who were at high risk of a major depressive episode (MDE). Methods A cross-sectional survey in 10 Canadian provinces was conducted between March and December 2015. Random digit dialing method was used through household landlines and cell phones to collect data from 511 working men who were at high risk of having an MDE and 330 working men who were at low risk of having an MDE. Results High-risk men were more likely to endorse the importance of accessing health resources on the Internet than low-risk men (83.4% vs 75.0%, respectively; P=.01). Of the 17 different features assessed, the top three features most likely to be used by high-risk men were: “information about improving sleep hygiene” (61.3%), “practice and exercise to help reduce symptoms of stress and depression” (59.5%), and “having access to quality information and resources about work stress issues” (57.8%). Compared with men at low risk for MDE, men at high risk for MDE were much more likely to consider using almost every one of the different design features. Differences in preferences for the design features by age among men at high risk of MDE were found only for 3 of 17 features. Differences in preferences for design features between English- and French-speaking participants were found only for 4 out of the 17 features. Analysis of qualitative data revealed that privacy issues, perceived stigma, ease of navigation, personal relevance, and lack of personal interaction, time, and knowledge were identified as barriers to the use of e-mental health programs in working men who were at high risk of MDE. Conclusion E-mental health programs may be a promising strategy for prevention of depression in working men. Development of e-mental health programs should consider men’s preferences and perceived barriers to enhance the acceptability of this approach. PMID:27267782

Predictors of Treatment Response in Depressed Mothers Receiving In-Home Cognitive-Behavioral Therapy and Concurrent Home Visiting

ERIC Educational Resources Information Center

Ammerman, Robert T.; Peugh, James L.; Putnam, Frank W.; Van Ginkel, Judith B.

2012-01-01

Home visiting is a child abuse prevention strategy that seeks to optimize child development by providing mothers with support, training, and parenting information. Research has consistently found high rates of depression in mothers participating in home visiting programs and low levels of obtaining mental health treatment in the community.…

Influence of Conduct Problems and Depressive Symptomatology on Adolescent Substance Use: Developmentally Proximal versus Distal Effects

ERIC Educational Resources Information Center

Maslowsky, Julie; Schulenberg, John E.; Zucker, Robert A.

2014-01-01

The identification of developmentally specific windows at which key predictors of adolescent substance use are most influential is a crucial task for informing the design of appropriately targeted substance use prevention and intervention programs. The current study examined effects of conduct problems and depressive symptomatology on changes in…

A Web-Based Psychoeducational Intervention for Adolescent Depression: Design and Development of MoodHwb.

PubMed

Bevan Jones, Rhys; Thapar, Anita; Rice, Frances; Beeching, Harriet; Cichosz, Rachel; Mars, Becky; Smith, Daniel J; Merry, Sally; Stallard, Paul; Jones, Ian; Thapar, Ajay K; Simpson, Sharon A

2018-02-15

Depression is common in adolescence and leads to distress and impairment in individuals, families and carers. Treatment and prevention guidelines highlight the key role of information and evidence-based psychosocial interventions not only for individuals but also for their families and carers. Engaging young people in prevention and early intervention programs is a challenge, and early treatment and prevention of adolescent depression is a major public health concern. There has been growing interest in psychoeducational interventions to provide accurate information about health issues and to enhance and develop self-management skills. However, for adolescents with, or at high risk of depression, there is a lack of engaging Web-based psychoeducation programs that have been developed with user input and in line with research guidelines and targeted at both the individual and their family or carer. There are also few studies published on the process of development of Web-based psychoeducational interventions. The aim of this study was to describe the process underlying the design and development of MoodHwb (HwbHwyliau in Welsh): a Web-based psychoeducation multimedia program for young people with, or at high risk of, depression and their families, carers, friends, and professionals. The initial prototype was informed by (1) a systematic review of psychoeducational interventions for adolescent depression; (2) findings from semistructured interviews and focus groups conducted with adolescents (with depressive symptoms or at high risk), parents or carers, and professionals working with young people; and (3) workshops and discussions with a multimedia company and experts (in clinical, research, and multimedia work). Twelve interviews were completed (four each with young people, parents or carers, and professionals) and six focus groups (three with young people, one with parents and carers, one with professionals, and one with academics). Key themes from the interviews and focus groups were: aims of the program, design and content issues, and integration and context of the program. The prototype was designed to be person-centered, multiplatform, engaging, interactive, and bilingual. It included mood-monitoring and goal-setting components and was available as a Web-based program and an app for mobile technologies. MoodHwb is a Web-based psychoeducational intervention developed for young people with, or at high risk of, depression and their families and carers. It was developed with user input using qualitative methods as well as user-centered design and educational and psychological theory. Further research is needed to evaluate the effectiveness of the program in a randomized controlled trial. If found to be effective, it could be implemented in health, education, youth and social services, and charities, to not only help young people but also families, carers, friends, and professionals involved in their care. ©Rhys Bevan Jones, Anita Thapar, Frances Rice, Harriet Beeching, Rachel Cichosz, Becky Mars, Daniel J Smith, Sally Merry, Paul Stallard, Ian Jones, Ajay K Thapar, Sharon A Simpson. Originally published in JMIR Mental Health (http://mental.jmir.org), 15.02.2018.

Overview of Meta-Analyses of the Prevention of Mental Health, Substance Use and Conduct Problems

PubMed Central

Sandler, Irwin; Wolchik, Sharlene A.; Cruden, Gracelyn; Mahrer, Nicole E.; Ahn, Soyeon; Brincks, Ahnalee; Brown, C. Hendricks

2014-01-01

This paper presents findings from an overview of meta-analyses of the effects of prevention and promotion programs to prevent mental health, substance use and conduct problems. The review of 48 meta-analyses found small but significant effects to reduce depression, anxiety, anti-social behavior and substance use. Further, the effects are sustained over time. Meta-analyses often found that the effects were heterogeneous. A conceptual model is proposed to guide the study of moderators of program effects in future meta-analyses and methodological issues in synthesizing findings across preventive interventions are discussed. PMID:24471372

[Diagnosis and treatment of child and adolescent depression].

PubMed

Bunge, Eduardo L; Carrea, Gabriela; Tosas de Molina, Mar; Soto, Natalie

2011-01-01

The present paper reviews the available literature on the current state of knowledge regarding depression in children and adolescents. Empirically supported psychotherapeutic treatment adjustments for children are described, such as the Self-Control Therapy (CBT), Penn Prevention Program; and other treatments that are experimental phase. Similarly empirically supported psychotherapeutic treatment adjustments for adolescents are described, such as Adolescent Coping with Depression, Interpersonal Psychotherapy; and other treatments that are experimental phase as Biblotherapy and Attachment-Based Family Therapy.

A randomized clinical trial aimed at preventing poor psychosocial and glycemic outcomes in teens with type 1 diabetes (T1D)

PubMed Central

Weissberg-Benchell, Jill; Rausch, Joseph; Iturralde, Esti; Jedraszko, Aneta; Hood, Korey

2016-01-01

Adolescents with type 1 diabetes have an increased risk for a variety of emotional and behavioral challenges as well as negative diabetes outcomes. This study was designed to compare the effectiveness of a depression-prevention, resilience promotion program with an advanced diabetes education program. Each program consisted of 9 group-based sessions. There were 264 adolescents enrolled in this multi-site randomized clinical trial. The primary outcomes were depressive symptoms and glycemic control; secondary outcomes included resilience skills, diabetes management and adherence, and diabetes-specific distress. The goal of the present paper is to describe the study design, the intervention, and the baseline characteristics of the sample. Preliminary data suggests that enrollment, randomization and retention were successful. Longitudinal follow-up and examination of mechanisms of action as they relate to psychosocial and glycemic outcomes will be explored in the future. PMID:27267154

A qualitative study exploring adolescents' experiences with a school-based mental health program.

PubMed

Garmy, Pernilla; Berg, Agneta; Clausson, Eva K

2015-10-21

Supporting positive mental health development in adolescents is a major public health concern worldwide. Although several school-based programs aimed at preventing depression have been launched, it is crucial to evaluate these programs and to obtain feedback from participating adolescents. This study aimed to explore adolescents' experiences with a -based cognitive-behavioral depression prevention program. Eighty-nine adolescents aged 13-15 years were divided into 12 focus groups. The focus group interviews were analyzed using qualitative content analysis. Three categories and eight subcategories were found to be related to the experience of the school-based program. The first category, intrapersonal strategies, consisted of the subcategories of directed thinking, improved self-confidence, stress management, and positive activities. The second category, interpersonal awareness, consisted of the subcategories of trusting the group and considering others. The third category, structural constraints, consisted of the subcategories of negative framing and emphasis on performance. The school-based mental health program was perceived as beneficial and meaningful on both individual and group levels, but students expressed a desire for a more health-promoting approach.

Adaptation of the preventive intervention program for depression for use with predominantly low-income Latino families.

PubMed

D'Angelo, Eugene J; Llerena-Ouinn, Roxana; Shapiro, Rachel; Colon, Frances; Rodriguez, Paola; Gallagher, Katie; Beardslee, William R

2009-06-01

This paper describes the process for and safety/feasibility of adapting the Beardslee Preventive Intervention Program for Depression for use with predominantly low income, Latino families. Utilizing a Stage I model for protocol development, the adaptation involved literature review, focus groups, pilot testing of the adapted manual, and open trial of the adapted intervention with 9 families experiencing maternal depression. Adaptations included conducting the intervention in either Spanish or English, expanding the intervention to include the contextual experience of Latino families in the United States with special attention to cultural metaphors, and using a strength-based, family-centered approach. The families completed preintervention measures for maternal depression, child behavioral difficulties, global functioning, life stresses, and an interview that included questions about acculturative stressors, resiliency, and family awareness of parental depression. The postintervention interview focused on satisfaction, distress, benefits of the adapted intervention, and therapeutic alliance. The results revealed that the adaptation was nonstressful, perceived as helpful by family members, had effects that seem to be similar to the original intervention, and the preventionists could maintain fidelity to the revised manual. The therapeutic alliance with the preventionists was experienced as quite positive by the mothers. A case example illustrates how the intervention was adapted.

eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis.

PubMed

Deady, M; Choi, I; Calvo, R A; Glozier, N; Christensen, H; Harvey, S B

2017-08-29

Anxiety and depression are associated with a range of adverse outcomes and represent a large global burden to individuals and health care systems. Prevention programs are an important way to avert a proportion of the burden associated with such conditions both at a clinical and subclinical level. eHealth interventions provide an opportunity to offer accessible, acceptable, easily disseminated globally low-cost interventions on a wide scale. However, the efficacy of these programs remains unclear. The aim of this study is to review and evaluate the effects of eHealth prevention interventions for anxiety and depression. A systematic search was conducted on four relevant databases to identify randomized controlled trials of eHealth interventions aimed at the prevention of anxiety and depression in the general population published between 2000 and January 2016. The quality of studies was assessed and a meta-analysis was performed using pooled effect size estimates obtained from a random effects model. Ten trials were included in the systematic review and meta-analysis. All studies were of sufficient quality and utilized cognitive behavioural techniques. At post-treatment, the overall mean difference between the intervention and control groups was 0.25 (95% confidence internal: 0.09, 0.41; p = 0.003) for depression outcome studies and 0.31 (95% CI: 0.10, 0.52; p = 0.004) for anxiety outcome studies, indicating a small but positive effect of the eHealth interventions. The effect sizes for universal and indicated/selective interventions were similar (0.29 and 0.25 respectively). However, there was inadequate evidence to suggest that such interventions have an effect on long-term disorder incidence rates. Evidence suggests that eHealth prevention interventions for anxiety and depression are associated with small but positive effects on symptom reduction. However, there is inadequate evidence on the medium to long-term effect of such interventions, and importantly, on the reduction of incidence of disorders. Further work to explore the impact of eHealth psychological interventions on long-term incidence rates.

Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: A randomized effectiveness trial

PubMed Central

Gillham, Jane E.; Reivich, Karen J.; Brunwasser, Steven M.; Freres, Derek R.; Chajon, Norma D.; Megan Kash-MacDonald, V.; Chaplin, Tara M.; Abenavoli, Rachel M.; Matlin, Samantha L.; Gallop, Robert J.; Seligman, Martin E.P.

2015-01-01

Objective Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). Method We evaluated the effectiveness of the Penn Resiliency Program for adolescents (PRP-A), a school-based group intervention that targets cognitive behavioral risk factors for depression. We randomly assigned 408 middle school students (ages 10-15) to one of three conditions: PRP-A, PRP-AP (in which adolescents participated in PRP-A and parents were invited to attend a parent intervention component), or a school-as-usual control. Adolescents completed measures of depression and anxiety symptoms, cognitive style, and coping at baseline, immediately after the intervention, and at 6-month follow-up. Results PRP-A reduced depression symptoms relative to the school as usual control. Baseline levels of hopelessness moderated intervention effects. Among participants with average and high levels of hopelessness, PRP (A and AP) significantly improved depression symptoms, anxiety symptoms, hopelessness, and active coping relative to control. Among participants with low baseline hopelessness, we found no intervention effects. PRP-AP was not more effective than PRP-A alone. We found no intervention effects on clinical levels of depression or anxiety. Conclusion These findings suggest that cognitive-behavioral interventions can be beneficial when delivered by school teachers and counselors. These interventions may be most helpful to students with elevated hopelessness. PMID:22889296

Process evaluation of a stepped-care program to prevent depression in primary care: patients' and practice nurses' experiences.

PubMed

Pols, Alide D; Schipper, Karen; Overkamp, Debbie; van Dijk, Susan E; Bosmans, Judith E; van Marwijk, Harm W J; Adriaanse, Marcel C; van Tulder, Maurits W

2017-02-23

Depression is common in patients with diabetes type 2 (DM2) and/or coronary heart disease (CHD), with high personal and societal burden and may even be preventable. Recently, a cluster randomized trial of stepped care to prevent depression among patients with DM2 and/or CHD and subthreshold depression in Dutch primary care (Step-Dep) versus usual care showed no effectiveness. This paper presents its process evaluation, exploring in-depth experiences from a patient and practice nurse perspective to further understand the results. A qualitative study was conducted. Using a purposive sampling strategy, data were collected through semi-structured interviews with 24 participants (15 patients and nine practice nurses). All interviews were audiotaped and transcribed verbatim. Atlas.ti 5.7.1 software was used for coding and structuring of themes. A thematic analysis of the data was performed. The process evaluation showed, even through a negative trial, that Step-Dep was perceived as valuable by both patients and practice nurses; perceived effectiveness on improving depressive symptoms varied greatly, but most felt that it had been beneficial for patients' well-being. Facilitators were: increased awareness of mental health problems in chronic disease management and improved accessibility and decreased experienced stigma of receiving mental health care. The Patient Health Questionnaire 9 (PHQ-9), used to determine depression severity, functioned as a useful starting point for the conversation on mental health and patients gained more insight into their mental health by regularly filling out the PHQ-9. However, patients and practice nurses did not widely support its use for monitoring depressive symptoms or making treatment decisions. Monitoring mental health was deemed important in chronically ill patients by both patients and practice nurses and was suggested to start at the time of diagnosis of a chronic disease. Appointed barriers were that patients were primarily motivated to participate in scientific research rather than their intrinsic need to improve depressive symptoms. Additionally, various practice nurses preferred offering individually based therapy over pre-determined interventions in a protocolled sequence and somatic practice nurses expressed a lack of competence to recognise and treat mental health problems. This study demonstrates both the benefits and unique demands of programs such as Step-Dep. The appointed facilitators and barriers could guide the development of future studies aiming to prevent depression in similar patient groups.

Teens Engaged in Collaborative Health: The Feasibility and Acceptability of an Online Skill-Building Intervention for Adolescents at Risk for Depression.

PubMed

Lattie, Emily G; Ho, Joyce; Sargent, Elizabeth; Tomasino, Kathryn N; Smith, J D; Brown, C Hendricks; Mohr, David C

2017-06-01

There is an ongoing need for effective and accessible preventive interventions for adolescent depression and substance abuse. This paper reports on a field trial of an online indicated preventive intervention, ProjectTECH, which is based on cognitive-behavioral therapy (CBT) techniques. The study aims to gather information about the feasibility and acceptability of this program. Secondary aims of this study were to examine the impact of the program on depression symptoms, perceived stress, positive affect, and substance use and to compare differences between groups that were led by a peer versus those that were led by a licensed clinician. High school students (n = 39) were recruited primarily through social media advertisements, and assigned to four groups of 8-12 individuals to collaboratively participate in an 8 week peer network-based online preventive intervention which were led by a trained peer guide or a licensed clinician. Participants were provided with didactic lessons, CBT-based mood management tools, and peer networking features, and completed quantitative and qualitative feedback at baseline, midpoint, end of intervention, and 1 month follow up. The program attracted and retained users primarily from social media and was used frequently by many of the participants (system login M = 25.62, SD = 16.58). Participants rated the program as usable, and offered several suggestions for improving the program, including allowing for further personalization by the individual user, and including more prompts to engage with the social network. From baseline to end of intervention, significant decreases were observed in depressive symptoms and perceived stress ( p 's < .05). Significant increases in positive affect were observed from baseline to midpoint ( p < .05) and no changes were observed in substance use, although the rate of substance use was low in this sample. While this study had low power to detect group differences, no consistent differences were observed between participants in a peer-led group and those in a clinician-led group. Results of this study indicates that ProjectTECH, an indicated preventive intervention for high school-aged adolescents, demonstrates both feasibility, acceptability, and short-term, longitudinal psychological benefits for participants. Future iterations of the program may benefit from close attention to user interface design and the continued use of trained peer support guides.

Depression as a moderator of benefit from Media Smart: a school-based eating disorder prevention program.

PubMed

Wilksch, Simon M; Wade, Tracey D

2014-01-01

To investigate if baseline depression moderated response to Media Smart, an 8-lesson school-based program previously found to achieve a long-term risk reduction effect in young adolescents. 540 Grade 8 students (M age = 13.62 years, SD = .37) from 4 schools participated with 11 classes receiving the Media Smart program (126 girls; 107 boys) and 13 comparison classes receiving their normal lessons (147 girls; 160 boys). Shape and weight concern, media internalization, body dissatisfaction, dieting, ineffectiveness, and perceived pressure were the outcome variables. Moderation was indicated by significant interaction effects for group (Media Smart; Control) × moderator (high depression; low depression) × time (post-program; 6-month follow-up; 2.5-year follow-up), with baseline entered as a covariate. Such effects were found for shape and weight concern, media internalization, body dissatisfaction, ineffectiveness and perceived pressure. Post-hoc testing found high depression Media Smart participants scored significantly lower than their control counterparts at post-program on shape and weight concern, media internalization and dieting, whereas low depression Media Smart participants scored significantly lower on shape and weight concern at 2.5-year follow-up. Media Smart achieved a reduction in eating disorder risk factors for high-depression participants and a reduced rate of growth in risk factor scores for low-depression participants. Trial registry name: Australian New Zealand Clinical Trials Registry. URL: http://www.anzctr.org.au. Registration identification number: ACTRN12608000545369. Copyright © 2013 Elsevier Ltd. All rights reserved.

Combining emotion regulation and mindfulness skills for preventing depression relapse: a randomized-controlled study.

PubMed

Elices, Matilde; Soler, Joaquim; Feliu-Soler, Albert; Carmona, Cristina; Tiana, Thais; Pascual, Juan C; García-Palacios, Azucena; Álvarez, Enric

2017-01-01

Dialectical behavioral therapy (DBT) skills have become increasingly used to treat several psychiatric conditions, including major depressive disorder (MDD). The aim of the study was to investigate the efficacy of an intervention that combines emotion regulation and mindfulness skills of DBT to prevent depression relapse/recurrence. A total of 75 individuals (79% females; mean age, 52 years) with a diagnosis of MDD in complete or partial remission were recruited. Participants were randomly allocated either to an intervention combining emotion regulation and mindfulness skills (ER + M group, n  = 37) or to a psychoeducative program ( n  = 38). After the 10-week treatment period, participants were followed for 1 year. Analyses were run in per-protocol (PP) and intention-to-treat (ITT) samples. The primary outcome measure was time to depression relapse/recurrence. ER + M training was not more effective than the control intervention in preventing depression relapse. However, PP and ITT analyses showed that participants trained in ER + M presented a significant reduction in depressive symptoms and overall psychopathology. Based on the PP and ITT analyses, neither of the interventions were related with an increase in dispositional mindfulness. More studies are needed to confirm the efficacy of ER + M to decrease depressive symptoms and overall psychopathology. NCT02747134. Registered on 20 April 2016.

Men's depression and suicide literacy: a nationally representative Canadian survey.

PubMed

Oliffe, John L; Hannan-Leith, Madeline N; Ogrodniczuk, John S; Black, Nick; Mackenzie, Corey S; Lohan, Maria; Creighton, Genevieve

2016-12-01

Male suicide prevention strategies include diagnosis and effective management of men's depression. Fundamental to suicide prevention efforts is public awareness, which in turn, is influenced by literacy levels about men's depression and suicide. The aim of this study is to examine sex differences in mental health literacy with respect to men's depression and suicide among a cohort of Canadian respondents. About 901 English-speaking Canadian men and women completed online survey questionnaires to evaluate mental health literacy levels using 10-item D-Lit and 8-item LOSS questionnaires, which assess factual knowledge concerning men's depression and suicide. Statistical tests (Chi-square, z-test) were used to identify significant differences between sex sub-groups at 95% confidence. Overall, respondents correctly identified 67% of questions measuring literacy levels about male depression. Respondents' male suicide literacy was significantly poorer at 53.7%. Misperceptions were especially evident in terms of differentiating men's depressive symptoms from other mental illnesses, estimating prevalence and identifying factors linked to male suicide. Significant sex differences highlighted that females had higher literacy levels than men in regard to male depression. Implementing gender sensitive and specific programs to target and advance literacy levels about men's depression may be key to ultimately reducing depression and suicide among men in Canada.

Often Difficult--But Worth It. Collaboration among Professionals.

ERIC Educational Resources Information Center

Walker, Joyce A.

1988-01-01

A joint effort between the Minnesota Extension Service and University of Minnesota School of Medicine produced a community-based research and educational program on stress, depression, and suicide prevention. The Teens in Distress program represents a successful collaborative effort and illustrates the potential problems when Extension…

Preventing the development of depression at work: a systematic review and meta-analysis of universal interventions in the workplace

PubMed Central

2014-01-01

Background Depression is a major public health problem among working-age adults. The workplace is potentially an important location for interventions aimed at preventing the development of depression, but to date, the mental health impact of universal interventions in the workplace has been unclear. Method A systematic search was conducted in relevant databases to identify randomized controlled trials of workplace interventions aimed at universal prevention of depression. The quality of studies was assessed using the Downs and Black checklist. A meta-analysis was performed using results from studies of adequate methodological quality, with pooled effect size estimates obtained from a random effects model. Results Nine workplace-based randomized controlled trials (RCT) were identified. The majority of the included studies utilized cognitive behavioral therapy (CBT) techniques. The overall standardized mean difference (SMD) between the intervention and control groups was 0.16 (95% confidence interval (CI): 0.07, 0.24, P = 0.0002), indicating a small positive effect. A separate analysis using only CBT-based interventions yielded a significant SMD of 0.12 (95% CI: 0.02, 0.22, P = 0.01). Conclusions There is good quality evidence that universally delivered workplace mental health interventions can reduce the level of depression symptoms among workers. There is more evidence for the effectiveness of CBT-based programs than other interventions. Evidence-based workplace interventions should be a key component of efforts to prevent the development of depression among adults. PMID:24886246

Do Parent Mental Illness and Family Living Arrangement Moderate the Effects of the Aussie Optimism Program on Depression and Anxiety in Children?

PubMed

Cheng, Maryanne; Rooney, Rosanna M; Kane, Robert T; Hassan, Sharinaz; Baughman, Natalie

2018-01-01

Parent mental illness and family living arrangement are associated with depression and anxiety in children, and may influence the effects of programs that aim to prevent these disorders. This study investigated whether these family context factors moderated the intervention effects of the enhanced Aussie Optimism Positive Thinking Skills program on depression and anxiety in primary school children. The intervention was a universal, cognitive-behavioral program, with a one hour session each week for 10 weeks, delivered by trained teachers. The participants were 502 children from 13 private schools, aged 9-11, with 347 in the intervention group and 155 in the control group. There were 267 females and 235 males. Data from 502 parents was also included. A cluster randomized controlled trial design was used, including eight intervention schools and five control schools. Depression and anxiety were assessed at pre-test, post-test, and 6-months follow-up. Information on parent mental illness and family living arrangement was collected through a parent questionnaire. The data was analyzed using covariance analysis with Generalized Linear Mixed Methods. At baseline, depressive and anxiety symptoms did not differ significantly based on parent mental illness. Symptoms of depression at baseline were significantly higher for children from a higher-risk family living arrangement, but anxiety symptoms were not. Parent mental illness and family living arrangement did not moderate the effects of the program on depression and anxiety at post-test or 6-months follow-up. Parent mental illness moderated the intervention effects on negative self-esteem, an aspect of depression, at post-test, with improvements seen only for children who did not have a parent with a mental illness. The findings indicate an association between family living arrangement and depressive symptoms in children. The findings suggest that the program is effective for children regardless of parent mental illness or family living arrangement, although parent mental illness has the capacity to influence the program's outcomes.

Association between family socioeconomic status and depressive symptoms among Chinese adolescents: Evidence from a national household survey.

PubMed

Zhou, Qin; Fan, Libo; Yin, Zhichao

2018-01-01

Depression is a common mental disorder due to high risk of the adolescence development stage. Few studies discussed the association between family socioeconomic status (SES) and depression and its mechanism. We aimed to provide a national view of depressive symptoms among Chinese adolescents to explore the relationship between family SES and depressive symptoms. We used the data from the Chinese Family Panel Studies (CFPS). Family SES include family income and parents' educational attainment. Depressive symptoms were measured by the Center for Epidemiological Study Depression. Family SES was found to be significantly associated with adolescents' depressive symptoms. The study indicated that adolescents were more likely to have depressive symptoms when family income decreased. Poor self-confidence, mathematics performance, and physical health were associated with high risk for depressive symptoms. The presence of these factors greatly weakened the association between family SES and depressive symptoms. Therefore, adolescents' mental health is vulnerable and connected to family SES. Physical health, school performance, and self-confidence might be important mediators in the pathways of family SES affecting depressive symptoms. Prevention and intervention programs are important and necessary to improve the mental health of Chinese adolescents, and the effect of family SES should be considered in these programs. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient-perceived barriers to a screening program for depression: a patient opinion survey of hemodialysis patients

PubMed Central

Beanlands, Heather; Logan, Alexander; Kurdyak, Paul; Jassal, Sarbjit Vanita

2017-01-01

Abstract Background Depression is a prevalent, yet underdiagnosed, psychiatric disorder among patients with end-stage renal disease. Active case identification through routine screening is suggested; however, patient-related barriers may reduce the effectiveness of screening for, and treating, depression. This study aimed to explore the perceived barriers that limit patients from participating in screening and treatment programs for depression. Methods In a cross-sectional study of chronic maintenance hemodialysis patients, the Perceived Barriers to Psychological Treatment questionnaire, adapted to include screening, was used to measure perceived barriers. The two-item Patient Health Questionnaire was used to identify patients with depressive symptoms. Results Of 160 participants, 73.1% reported at least one barrier preventing them from participation [95% confidence interval (95% CI) 66.2–80.0%]. Patients with depressive symptoms were more likely to perceive at least one barrier to a screening program for depression compared with those without depressive symptoms (96% versus 68.9%, respectively; odds ratio = 10.8; 95% CI 1.4–82.8; P = 0.005). The association of the barrier scores with depressive symptoms remained significant after adjustment for patient’s characteristics. The most common barriers that patients expressed were concerns about the side effects of any antidepressant medications that may be prescribed (40%), concerns about having more medications (32%), feeling that the problem is not severe enough (23%) and perceiving no risk of depression (23%). Conclusions Negative perceptions about depression and its treatment among hemodialysis patients constitute an important barrier to identifying this condition and first need to be addressed before implementing a screening program in this population. PMID:29225813

Adolescents' reactions to universal and indicated prevention programs for depression: perceived stigma and consumer satisfaction.

PubMed

Rapee, Ronald M; Wignall, Ann; Sheffield, Jeanie; Kowalenko, Nick; Davis, Anna; McLoone, Jordana; Spence, Susan H

2006-06-01

There is a common view that one of the major considerations in selecting between universal and indicated interventions is the marked stigma produced by the latter. However, to date there has been no empirical examination of this assumption. The current study examined reported stigma and program satisfaction following two school-based interventions aimed at preventing depression in 532 middle adolescents. The interventions were conducted either across entire classes by classroom teachers (universal delivery) or in small high risk groups by mental health professionals (indicated delivery). The indicated delivery was associated with significantly greater levels of perceived stigma, but effect sizes were small and neither program was associated with marked stigma in absolute terms. Perceived stigma was more strongly associated with aspects of the individual including being male and showing greater externalizing symptomatology. In contrast, the indicated program was evaluated more positively by both participants and program leaders and effect sizes for these measures of satisfaction were moderate to large. The results point to the need for further empirical evaluation of both perceived stigma and program satisfaction in providing balanced considerations of the value of indicated and universal programs.

Preliminary effectiveness of surviving the teens(®) suicide prevention and depression awareness program on adolescents' suicidality and self-efficacy in performing help-seeking behaviors.

PubMed

King, Keith A; Strunk, Catherine M; Sorter, Michael T

2011-09-01

Suicide ranks as the third leading cause of death among youth aged 15-24 years. Schools provide ideal opportunities for suicide prevention efforts. However, research is needed to identify programs that effectively impact youth suicidal ideation and behavior. This study examined the immediate and 3-month effect of Surviving the Teens® Suicide Prevention and Depression Awareness Program on students' suicidality and perceived self-efficacy in performing help-seeking behaviors. High school students in Greater Cincinnati schools were administered a 3-page survey at pretest, immediate posttest, and 3-month follow-up. A total of 1030 students participated in the program, with 919 completing matched pretests and posttests (89.2%) and 416 completing matched pretests and 3-month follow-ups (40.4%). Students were significantly less likely at 3-month follow-up than at pretest to be currently considering suicide, to have made a suicidal plan or attempted suicide during the past 3 months, and to have stopped performing usual activities due to feeling sad and hopeless. Students' self-efficacy and behavioral intentions toward help-seeking behaviors increased from pretest to posttest and were maintained at 3-month follow-up. Students were also more likely at 3-month follow-up than at pretest to know an adult in school with whom they felt comfortable discussing their problems. Nine in 10 (87.3%) felt the program should be offered to all high school students. The findings of this study lend support for suicide prevention education in schools. The results may be useful to school professionals interested in implementing effective suicide prevention programming to their students. © 2011, American School Health Association.

Effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: A pragmatic cluster randomized controlled trial.

PubMed

Pols, Alide D; van Dijk, Susan E; Bosmans, Judith E; Hoekstra, Trynke; van Marwijk, Harm W J; van Tulder, Maurits W; Adriaanse, Marcel C

2017-01-01

Given the public health significance of poorly treatable co-morbid major depressive disorders (MDD) among patients with type 2 diabetes mellitus (DM2) and coronary heart disease (CHD), we need to investigate whether strategies to prevent the development of major depression could reduce its burden of disease. We therefore evaluated the effectiveness of a stepped-care program for subthreshold depression in comparison with usual care in patients with DM2 and/or CHD. A cluster randomized controlled trial, with 27 primary care centers serving as clusters. A total of 236 DM2 and/or CHD patients with subthreshold depression (nine item Patient Health Questionnaire (PHQ-9) score ≥ 6, no current MDD according to DSM-IV criteria) were allocated to the intervention group (N = 96) or usual care group (n = 140). The stepped-care program was delivered by trained practice nurses during one year and consisted of four sequential treatment steps: watchful waiting, guided self-help, problem solving treatment and referral to the general practitioner. The primary outcome was the 12-month cumulative incidence of MDD as measured with the Mini International Neuropsychiatric Interview (MINI). Secondary outcomes included severity of depression (measured by PHQ-9) at 3, 6, 9 and 12 months. Of 236 patients (mean age, 67,5 (SD 10) years; 54.7% men), 210 (89%) completed the MINI at 12 months. The cumulative incidence of MDD was 9 of 89 (10.1%) participants in the intervention group and 12 of 121 (9.9%) participants in the usual care group. We found no statistically significant overall effect of the intervention (OR = 1.21; 95% confidence interval (0.12 to 12.41)) and there were no statistically significant differences in the course or severity of depressive symptoms between the two groups. This study suggest that Step-Dep was not more effective in preventing MDD than usual care in a primary care population with DM2 and/or CHD and subthreshold depression.

Perceived parental child rearing and attachment as predictors of anxiety and depressive disorder symptoms in children: The mediational role of attachment.

PubMed

Chorot, Paloma; Valiente, Rosa M; Magaz, Ana M; Santed, Miguel A; Sandin, Bonifacio

2017-07-01

The present study aimed to examine (a) the relative contribution of perceived parental child-rearing behaviors and attachment on anxiety and depressive symptoms, and (b) the role of attachment as a possible mediator of the association between parental rearing and anxiety and depression. A sample of 1002 children (aged 9-12 years) completed a booklet of self-report questionnaires measuring parental rearing behaviors, attachment towards peers, and DSM anxiety and depressive disorder symptoms. We found that parental aversiveness, parental neglect, and fearful/preoccupied attachment, each accounted for a significant amount of the variance in both anxiety and depressive symptoms. In addition, parental overcontrol was found to account for unique variance in anxiety whereas communication/warmth accounted for a significant proportion of the variance in depression. A relevant finding was that fearful/preoccupied attachment was found to mediate the association between parental rearing behaviors and both anxiety and depression. Parental rearing behaviors and attachment to peers may act as risk factors to the development and/or maintenance of anxiety and depressive symptomatology in children. Findings may contribute to outline preventive and/or treatment programs to prevent or reduce both clinical anxiety and depression during childhood. Copyright © 2017. Published by Elsevier B.V.

MEMO--a mobile phone depression prevention intervention for adolescents: development process and postprogram findings on acceptability from a randomized controlled trial.

PubMed

Whittaker, Robyn; Merry, Sally; Stasiak, Karolina; McDowell, Heather; Doherty, Iain; Shepherd, Matthew; Dorey, Enid; Parag, Varsha; Ameratunga, Shanthi; Rodgers, Anthony

2012-01-24

Prevention of the onset of depression in adolescence may prevent social dysfunction, teenage pregnancy, substance abuse, suicide, and mental health conditions in adulthood. New technologies allow delivery of prevention programs scalable to large and disparate populations. To develop and test the novel mobile phone delivery of a depression prevention intervention for adolescents. We describe the development of the intervention and the results of participants' self-reported satisfaction with the intervention. The intervention was developed from 15 key messages derived from cognitive behavioral therapy (CBT). The program was fully automated and delivered in 2 mobile phone messages/day for 9 weeks, with a mixture of text, video, and cartoon messages and a mobile website. Delivery modalities were guided by social cognitive theory and marketing principles. The intervention was compared with an attention control program of the same number and types of messages on different topics. A double-blind randomized controlled trial was undertaken in high schools in Auckland, New Zealand, from June 2009 to April 2011. A total of 1348 students (13-17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups. Of these, 835 (97.7%) self-completed follow-up questionnaires at postprogram interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over three-quarters of participants viewed at least half of the messages and 90.7% (379/418) in the intervention group reported they would refer the program to a friend. Intervention group participants said the intervention helped them to be more positive (279/418, 66.7%) and to get rid of negative thoughts (210/418, 50.2%)--significantly higher than proportions in the control group. Key messages from CBT can be delivered by mobile phone, and young people report that these are helpful. Change in clinician-rated depression symptom scores from baseline to 12 months, yet to be completed, will provide evidence on the effectiveness of the intervention. If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage. CLINICALTRIAL: Australia New Zealand Clinical Trials Registry (ACTRN): 12609000405213; http://www.anzctr.org.au/trial_view.aspx?ID=83667 (Archived by WebCite at http://www.webcitation.org/64aueRqOb).

Baby Business: a randomised controlled trial of a universal parenting program that aims to prevent early infant sleep and cry problems and associated parental depression

PubMed Central

2012-01-01

Background Infant crying and sleep problems (e.g. frequent night waking, difficulties settling to sleep) each affect up to 30% of infants and often co-exist. They are costly to manage and associated with adverse outcomes including postnatal depression symptoms, early weaning from breast milk, and later child behaviour problems. Preventing such problems could improve these adverse outcomes and reduce costs to families and the health care system. Anticipatory guidance-i.e. providing parents with information about normal infant sleep and cry patterns, ways to encourage self-settling in infants, and ways to develop feeding and settling routines before the onset of problems-could prevent such problems. This paper outlines the protocol for our study which aims to test an anticipatory guidance approach. Methods/Design 750 families from four Local Government Areas in Melbourne, Australia have been randomised to receive the Baby Business program (intervention group) or usual care (control group) offered by health services. The Baby Business program provides parents with information about infant sleep and crying via a DVD and booklet (mailed soon after birth), telephone consultation (at infant age 6-8 weeks) and parent group session (at infant age 12 weeks). All English speaking parents of healthy newborn infants born at > 32 weeks gestation and referred by their maternal and child health nurse at their first post partum home visit (day 7-10 postpartum), are eligible. The primary outcome is parent report of infant night time sleep as a problem at four months of age and secondary outcomes include parent report of infant daytime sleep or crying as a problem, mean duration of infant sleep and crying/24 hours, parental depression symptoms, parent sleep quality and quantity and health service use. Data will be collected at two weeks (baseline), four months and six months of age. An economic evaluation using a cost-consequences approach will, from a societal perspective, compare costs and health outcomes between the intervention and control groups. Discussion To our knowledge this is the first randomised controlled trial of a program which aims to prevent both infant sleeping and crying problems and associated postnatal depression symptoms. If effective, it could offer an important public health prevention approach to these common, distressing problems. Trial registration number ISRCTN: ISRCTN63834603 PMID:22309617

Baby Business: a randomised controlled trial of a universal parenting program that aims to prevent early infant sleep and cry problems and associated parental depression.

PubMed

Cook, Fallon; Bayer, Jordana; Le, Ha N D; Mensah, Fiona; Cann, Warren; Hiscock, Harriet

2012-02-06

Infant crying and sleep problems (e.g. frequent night waking, difficulties settling to sleep) each affect up to 30% of infants and often co-exist. They are costly to manage and associated with adverse outcomes including postnatal depression symptoms, early weaning from breast milk, and later child behaviour problems. Preventing such problems could improve these adverse outcomes and reduce costs to families and the health care system. Anticipatory guidance-i.e. providing parents with information about normal infant sleep and cry patterns, ways to encourage self-settling in infants, and ways to develop feeding and settling routines before the onset of problems-could prevent such problems. This paper outlines the protocol for our study which aims to test an anticipatory guidance approach. 750 families from four Local Government Areas in Melbourne, Australia have been randomised to receive the Baby Business program (intervention group) or usual care (control group) offered by health services. The Baby Business program provides parents with information about infant sleep and crying via a DVD and booklet (mailed soon after birth), telephone consultation (at infant age 6-8 weeks) and parent group session (at infant age 12 weeks). All English speaking parents of healthy newborn infants born at > 32 weeks gestation and referred by their maternal and child health nurse at their first post partum home visit (day 7-10 postpartum), are eligible. The primary outcome is parent report of infant night time sleep as a problem at four months of age and secondary outcomes include parent report of infant daytime sleep or crying as a problem, mean duration of infant sleep and crying/24 hours, parental depression symptoms, parent sleep quality and quantity and health service use. Data will be collected at two weeks (baseline), four months and six months of age. An economic evaluation using a cost-consequences approach will, from a societal perspective, compare costs and health outcomes between the intervention and control groups. To our knowledge this is the first randomised controlled trial of a program which aims to prevent both infant sleeping and crying problems and associated postnatal depression symptoms. If effective, it could offer an important public health prevention approach to these common, distressing problems.

A web-based approach to managing stress and mood disorders in the workforce.

PubMed

Billings, Douglas W; Cook, Royer F; Hendrickson, April; Dove, David C

2008-08-01

To evaluate the effectiveness of a web-based multimedia health promotion program for the workplace, designed to help reduce stress and to prevent depression, anxiety, and substance abuse. Using a randomized controlled trial design, 309 working adults were randomly assigned to the web-based condition or to a wait-list control condition. All participants were assessed on multiple self-reported outcomes at pretest and posttest. Relative to controls, the web-based group reduced their stress, increased their knowledge of depression and anxiety, developed more positive attitudes toward treatment, and adopted a more healthy approach to alcohol consumption. We found that a brief and easily adaptable web-based stress management program can simultaneously reduce worker stress and address stigmatized behavioral health problems by embedding this prevention material into a more positive stress management framework.

Family dissolution and offspring depression and depressive symptoms: A systematic review of moderation effects.

PubMed

Di Manno, Laura; Macdonald, Jacqui A; Knight, Tess

2015-12-01

Parental separation is associated with increased risk for offspring depression; however, depression outcomes are divergent. Knowledge of moderators could assist in understanding idiosyncratic outcomes and developing appropriately targeted prevention programs for those at heightened risk of depression following parental separation. Therefore, the objective of the review was to identify and evaluate studies that examined moderators of the relationship between parental separation and offspring depression A search of scientific, medical and psychological databases was conducted in April 2015 for longitudinal research that had evaluated any moderator/s of the relationship between parental separation or divorce and offspring depression or depressive symptoms. Papers were assessed for quality by evaluating the study's sample, attrition rates, methodology and measurement characteristics. Fourteen quantitative studies from five countries assessed sixteen moderating factors of the relationship between parental separation and offspring depression or depressive symptoms. A number of factors were found to moderate this relationship, including offspring gender, age (at assessment and at depression onset), genotype, preadolescent temperament, IQ, emotional problems in childhood and maternal sensitivity. While robust longitudinal research was selected for inclusion, common issues with longitudinal studies such as low rates of participation and attrition were among the methodological concerns evident in some of the reviewed papers. The current review is the first to assess interaction effects of the relationship between parental separation and offspring depression or depressive symptoms. While further research is recommended, this assessment is critical in understanding variation in heterogeneous populations and can inform targeted policy and prevention.

A randomized controlled trial of combined exercise and psycho-education for low-SES women: short- and long-term outcomes in the reduction of stress and depressive symptoms.

PubMed

van der Waerden, Judith E B; Hoefnagels, Cees; Hosman, Clemens M H; Souren, Pierre M; Jansen, Maria W J

2013-08-01

Exercise may have both a preventive and a therapeutic impact on mental health problems. The Exercise without Worries intervention aims to reduce stress and depressive symptoms in low-SES women by means of a group-based program combining physical exercise and psycho-education. Between September 2005 and May 2008, 161 Dutch low-SES women with elevated stress or depressive symptom levels were randomly assigned to the combined exercise/psycho-education intervention (EP), exercise only (E) or a waiting list control condition (WLC). The E condition provided low to moderate intensity stretching, strength, flexibility, and body focused training as well as relaxation, while the EP program integrated the exercise with cognitive-behavioral techniques. Depressive symptoms (CES-D) and perceived stress (PSS) were measured before and immediately after the intervention and at 2, 6 and 12 month follow-up. Multilevel linear mixed-effects models revealed no differential patterns in reduction of CES-D or PSS scores between the EP, E and WLC groups on the short (post-test and 2 month follow-up) or long term (6 and 12 months follow-up). Depressive symptom outcomes were moderated by initial depressive symptom scores: women from the EP and E groups with fewer initial symptoms benefited from participation on the short term. Further, women in the EP and E groups with the lowest educational level reported more stress reduction at post-test than women with higher educational levels. In the overall target population of low-SES women, no indications were found that the Exercise without Worries course reduced depressive symptom and stress levels on the short or long term. The findings do suggest, however, that exercise alone or in combination with psycho-education may be a viable prevention option for certain groups of disadvantaged women. Especially those low-SES women with less severe initial problems or those with low educational attainment should be targeted for future depression prevention practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

A mindfulness-based stress management program and treatment with omega-3 fatty acids to maintain a healthy mental state in hospital nurses (Happy Nurse Project): study protocol for a randomized controlled trial.

PubMed

Watanabe, Norio; Furukawa, Toshi A; Horikoshi, Masaru; Katsuki, Fujika; Narisawa, Tomomi; Kumachi, Mie; Oe, Yuki; Shinmei, Issei; Noguchi, Hiroko; Hamazaki, Kei; Matsuoka, Yutaka

2015-01-31

It is reported that nursing is one of the most vulnerable jobs for developing depression. While they may not be clinically diagnosed as depressed, nurses often suffer from depression and anxiety symptoms, which can lead to a low level of patient care. However, there is no rigorous evidence base for determining an effective prevention strategy for these symptoms in nurses. After reviewing previous literature, we chose a strategy of treatment with omega-3 fatty acids and a mindfulness-based stress management program for this purpose. We aim to explore the effectiveness of these intervention options for junior nurses working in hospital wards in Japan. A factorial-design multi-center randomized trial is currently being conducted. A total of 120 nurses without a managerial position, who work for general hospitals and gave informed consent, have been randomly allocated to a stress management program or psychoeducation using a leaflet, and to omega-3 fatty acids or identical placebo pills. The stress management program has been developed according to mindfulness cognitive therapy and consists of four 30-minute individual sessions conducted using a detailed manual. These sessions are conducted by nurses with a managerial position. Participants allocated to the omega-3 fatty acid groups are provided with 1,200 mg/day of eicosapentaenoic acid and 600 mg/day of docosahexaenoic acid for 90 days. The primary outcome is the change in the total score of the Hospital Anxiety and Depression Scale (HADS), determined by a blinded rater via the telephone at week 26. Secondary outcomes include the change in HADS score at 13 and 52 weeks; presence of a major depressive episode; severity of depression, anxiety, insomnia, burnout, and presenteeism; utility scores and adverse events at 13, 26 and 52 weeks. An effective preventive intervention may not only lead to the maintenance of a healthy mental state in nurses, but also to better quality of care for inpatients. This paper outlines the background and methods of a randomized trial that evaluates the possible additive value of omega-3 fatty acids and a mindfulness-based stress management program for reducing depression in nurses. Clinicaltrials.gov: NCT02151162 (registered on 27 May 2014).

[Construction of a structural model about male and female adolescents' alienation, depression, and suicidal thoughts].

PubMed

Lee, Eunsook

2007-06-01

This study was designed to construct a structural model explaining alienation, depression, and suicidal thoughts in male and female adolescents. Data was collected by questionnairs from 204 male and 208 female students selected randomly in high schools in K city. This study found that depression was significantly affected by alienation, and was indirectly affected through alienation by school attachment, peer relationships, and academic performance. Suicidal thoughts were greatly affected by depression, and were directly and indirectly influenced by alienation. It was confirmed that alienation turned out to be a important mediating variable, while it had a effect significant on depression and suicidal thoughts. Also there were significant differences in affecting factors among male and female students. Intervention strategies for preventing alienation, depression and suicidal thoughts should be different according to gender. In addition, specific nursing intervention plans, including parent education and role training programs, fostering of humanistic and achievement-focused educational environment, peer support programs, and individual counselling, need to be developed and implemented to lessen a feeling of alienation from family and school.

Prevention effects on trajectories of African American adolescents' exposure to interparental conflict and depressive symptoms.

PubMed

Barton, Allen W; Beach, Steven R H; Kogan, Steven M; Stanley, Scott M; Fincham, Frank D; Hurt, Tera R; Brody, Gene H

2015-04-01

The present study investigates the trajectory of children's exposure to interparental conflict during adolescence, its effects on adolescents' psychological adjustment, as well as the ability of a family-centered prevention program to alter this trajectory. A total of 331 African American couples with an adolescent or preadolescent child participated in a randomized control trial of the Promoting Strong African American Families program, a newly developed program targeting couple and cocaregiving processes. Using a multi-informant, latent growth curve approach, child exposure to interparental conflict during adolescence was found to be stable over a period of 2 years among families in the control group, but significantly declined among families in the treatment condition. Rates of change were significantly different between intervention and control groups based on parents' report of youth exposure to interparental conflict, but not for child's report. Structural equation models found trajectory parameters of interparental conflict predicted changes in adolescent depressive symptoms, with increasing rates of changes in conflict associated with increases in adolescent internalizing symptoms over the 2-year duration of the study. Finally, a significant indirect effect was identified linking treatment, changes in parents' reports of child exposure to interparental conflict, and adolescent depressive symptoms. The implications for research and intervention are discussed. (c) 2015 APA, all rights reserved).

Prevention effects on trajectories of African American adolescents' exposure to interparental conflict and depressive symptoms

PubMed Central

Barton, Allen W.; Beach, Steven R. H.; Kogan, Steven M.; Stanley, Scott M.; Fincham, Frank D.; Hurt, Tera R.; Brody, Gene H.

2015-01-01

The present study investigates the trajectory of children's exposure to interparental conflict during adolescence, its effects on adolescents' psychological adjustment, as well as the ability of a family-centered prevention program to alter this trajectory. A total of 331 African American couples with an adolescent or pre-adolescent child participated in a randomized control trial of the Promoting Strong African American Families (ProSAAF) program, a newly-developed program targeting couple and co-caregiving processes. Using a multi-informant, latent growth curve approach, child exposure to interparental conflict during adolescence was found to be stable over a period of two years among families in the control group, but significantly declined among families in the treatment condition. Rates of change were significantly different between intervention and control groups based on parents' report of youth exposure to interparental conflict, but not for child's report. Structural equation models found trajectory parameters of interparental conflict predicted changes in adolescent depressive symptoms, with increasing rates of changes in conflict associated with increases in adolescent internalizing symptoms over the 2-year duration of the study. Finally, a significant indirect effect was identified linking treatment, changes in parents' reports of child exposure to interparental conflict, and adolescent depressive symptoms. The implications for research and intervention are discussed. PMID:25844492

[Fatigue syndrome: Stress, Burnout and depression in Urology.

PubMed

Rodríguez-Socarrás, Moisés; Vasquez, Juan Luis; Uvin, Pieter; Skjold-Kingo, Pernille; Gómez Rivas, Juan

2018-01-01

To determine the factors related to stress, Burnout and depression in urology, as well as consequences in residents and urologists, in addition to the possible applicable strategies to diminish and treat them. Depression, stress and Burnout syndrome has become a problem in urology specialty. These topics have gained interest in international congresses and urological associations. Efforts are being made to find related factors as well as possible strategies and applicable support programs. Burnout frequency is higher among health professionals than general population, 40-76% in students and residents, its incidence has skyrocketed in recent years, in addition Urology is one of the specialties with highest incidence and severity. Its increase has been related to work overload, documentation, administrative/bureaucratic workload, hostile work environment; its consequences include poor work performance, medical errors, depression, substance abuse, disruption in family and couple relationships and suicidal ideation. Strategies for prevention including resilience training, lifestyle balance, teamwork, and support programs. Stress, burnout and depression are problems in urology, early detection, promoting individual techniques in resilience, lifestyle and teamwork are fundamental now and for the future of the specialty. Developing and implementing support programs should be seriously considered by health systems and urological associations.

Does Internet-based cognitive behavioral therapy (iCBT) prevent major depressive episode for workers? A 12-month follow-up of a randomized controlled trial.

PubMed

Imamura, K; Kawakami, N; Furukawa, T A; Matsuyama, Y; Shimazu, A; Umanodan, R; Kawakami, S; Kasai, K

2015-07-01

In this study we investigated whether an Internet-based computerized cognitive behavioral therapy (iCBT) program can decrease the risk of DSM-IV-TR major depressive episodes (MDE) during a 12-month follow-up of a randomized controlled trial of Japanese workers. Participants were recruited from one company and three departments of another company. Those participants who did not experience MDE in the past month were randomly allocated to intervention or control groups (n = 381 for each). A 6-week, six-lesson iCBT program was provided to the intervention group. While the control group only received the usual preventive mental health service for the first 6 months, the control group was given a chance to undertake the iCBT program after a 6-month follow-up. The primary outcome was a new onset of DSM-IV-TR MDE during the 12-month follow-up, as assessed by means of the web version of the WHO Composite International Diagnostic Interview (CIDI), version 3.0 depression section. The intervention group had a significantly lower incidence of MDE at the 12-month follow-up than the control group (Log-rank χ2 = 7.04, p < 0.01). The hazard ratio for the intervention group was 0.22 (95% confidence interval 0.06-0.75), when estimated by the Cox proportional hazard model. The present study demonstrates that an iCBT program is effective in preventing MDE in the working population. However, it should be noted that MDE was measured by self-report, while the CIDI can measure the episodes more strictly following DSM-IV criteria.

Effectiveness of a school-based mindfulness program for transdiagnostic prevention in young adolescents.

PubMed

Johnson, Catherine; Burke, Christine; Brinkman, Sally; Wade, Tracey

2016-06-01

Anxiety, depression and eating disorders show peak emergence during adolescence and share common risk factors. School-based prevention programs provide a unique opportunity to access a broad spectrum of the population during a key developmental window, but to date, no program targets all three conditions concurrently. Mindfulness has shown promising early results across each of these psychopathologies in a small number of controlled trials in schools, and therefore this study investigated its use in a randomised controlled design targeting anxiety, depression and eating disorder risk factors together for the first time. Students (M age 13.63; SD = .43) from a broad band of socioeconomic demographics received the eight lesson, once weekly.b ("Dot be") mindfulness in schools curriculum (N = 132) or normal lessons (N = 176). Anxiety, depression, weight/shape concerns and wellbeing were the primary outcome factors. Although acceptability measures were high, no significant improvements were found on any outcome at post-intervention or 3-month follow-up. Adjusted mean differences between groups at post-intervention were .03 (95% CI: -.06 to -.11) for depression, .01 (-.07 to -.09) for anxiety, .02 (-.05 to -.08) for weight/shape concerns, and .06 (-.08 to -.21) for wellbeing. Anxiety was higher in the mindfulness than the control group at follow-up for males, and those of both genders with low baseline levels of weight/shape concerns or depression. Factors that may be important to address for effective dissemination of mindfulness-based interventions in schools are discussed. Further research is required to identify active ingredients and optimal dose in mindfulness-based interventions in school settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Trial for the Prevention of Depression (TriPoD) in final-year secondary students: study protocol for a cluster randomised controlled trial.

PubMed

Perry, Yael; Calear, Alison L; Mackinnon, Andrew; Batterham, Philip J; Licinio, Julio; King, Catherine; Thomsen, Noel; Scott, Jan; Donker, Tara; Merry, Sally; Fleming, Theresa; Stasiak, Karolina; Werner-Seidler, Aliza; Christensen, Helen

2015-10-12

Evidence suggests that current treatments cannot fully alleviate the burden of disease associated with depression but that prevention approaches offer a promising opportunity to further reduce this burden. Adolescence is a critical period in the development of mental illness, and final school examinations are a significant and nearly universal stressor that may act as a trigger for mental health difficulties such as depression. The aim of the present trial is to investigate the impact of SPARX-R, an online, gamified intervention based on cognitive behavioural principles, on the prevention of depression in secondary school students before their final examinations. Government, independent and Catholic secondary schools in New South Wales, Australia, will be recruited to participate in the trial. All students enrolled in their final year of high school (year 12) in participating schools will be invited to participate. To account for possible attrition, the target sample size was set at 1600 participants across 30 schools. Participating schools will be cluster randomised at the school level to receive either SPARX-R or lifeSTYLE, an attention-controlled placebo comparator. The control intervention is an online program aimed at maintaining a healthy lifestyle. The primary outcome will be symptoms of depression, and secondary outcomes will include symptoms of anxiety, suicidal ideation and behaviours, stigma and academic performance. Additional measures of cost-effectiveness, as well as process variables (e.g., adherence, acceptability) and potential predictors of response to treatment, will be collected. Consenting parents will be invited to complete measures regarding their own mental health and expectations for their child. Assessments will be conducted pre- and post-intervention and at 6- and 18-month follow-up. Primary analyses will compare changes in levels of depressive symptomatology for the intervention group relative to the attention control condition using mixed-effects model repeated-measures analyses to account for clustering within schools. This is the first trial of a universal depression prevention intervention delivered to school students in advance of a specific, significant stressor. If found to be effective, this program may offer schools a new approach to preparing students for their final year of schooling. Australian New Zealand Clinical Trials Registry identifier: ACTRN12614000316606 . Registered 25 March 2014.

Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan.

PubMed

Nomura, Osamu; Mishina, Hiroki; Kobayashi, Yoshinori; Ishiguro, Akira; Sakai, Hirokazu; Kato, Hiroyuki

2016-09-01

Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents.A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-sectional survey. We determined and compared the prevalence of depressive symptoms and the number of actual working hours before and after implementing the shift system. A follow-up focus-group interview with 4 residents was conducted to explore the factors that may trigger or prevent depression and burnout.Mean working hours significantly decreased from 75.2 hours to 64.9 hours per week. Prevalence of depressive symptoms remained similar before and after implementation of the shift system. Emotional exhaustion and depersonalization from the burnout scale were markedly associated with depression. High workload, stress intolerance, interpersonal difficulties, and generation gaps regarding work-life balance could cause burnout. Stress tolerance, workload monitoring and balancing, appropriate supervision, and peer support could prevent burnout.Although the overnight call shift system was effective in reducing working hours, its effectiveness in managing mental health issues among pediatric residents remains unclear. Resident wellness programs represent an additional strategy and they should be aimed at fostering peer support and improvement of resident-faculty interactions. Such an approach could be beneficial to the relationship between physicians of different generations with conflicting belief structures.

Limitation of duty hour regulations for pediatric resident wellness

PubMed Central

Nomura, Osamu; Mishina, Hiroki; Kobayashi, Yoshinori; Ishiguro, Akira; Sakai, Hirokazu; Kato, Hiroyuki

2016-01-01

Abstract Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents. A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-sectional survey. We determined and compared the prevalence of depressive symptoms and the number of actual working hours before and after implementing the shift system. A follow-up focus-group interview with 4 residents was conducted to explore the factors that may trigger or prevent depression and burnout. Mean working hours significantly decreased from 75.2 hours to 64.9 hours per week. Prevalence of depressive symptoms remained similar before and after implementation of the shift system. Emotional exhaustion and depersonalization from the burnout scale were markedly associated with depression. High workload, stress intolerance, interpersonal difficulties, and generation gaps regarding work–life balance could cause burnout. Stress tolerance, workload monitoring and balancing, appropriate supervision, and peer support could prevent burnout. Although the overnight call shift system was effective in reducing working hours, its effectiveness in managing mental health issues among pediatric residents remains unclear. Resident wellness programs represent an additional strategy and they should be aimed at fostering peer support and improvement of resident–faculty interactions. Such an approach could be beneficial to the relationship between physicians of different generations with conflicting belief structures. PMID:27631253

[Effects of a fall prevention program on falls in frail elders living at home in rural communities].

PubMed

Yoo, Jae-Soon; Jeon, Mi Yang; Kim, Chul-Gyu

2013-10-01

This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.

Evidence-based psychosocial treatments for child and adolescent depression.

PubMed

David-Ferdon, Corinne; Kaslow, Nadine J

2008-01-01

The evidence-base of psychosocial treatment outcome studies for depressed youth conducted since 1998 is examined. All studies for depressed children meet Nathan and Gorman's (2002) criteria for Type 2 studies whereas the adolescent protocols meet criteria for both Type 1 and Type 2 studies. Based on the Task Force on the Promotion and Dissemination of Psychological Procedures guidelines, the cognitive-behavioral therapy (CBT) based specific programs of Penn Prevention Program, Self-Control Therapy, and Coping with Depression-Adolescent are probably efficacious. Interpersonal Therapy-Adolescent, which falls under the theoretical category of interpersonal therapy (IPT), also is a probably efficacious treatment. CBT provided through the modalities of child group only and child group plus parent components are well-established intervention approaches for depressed children. For adolescents, two modalities are well-established (CBT adolescent only group, IPT individual), and three are probably efficacious (CBT adolescent group plus parent component, CBT individual, CBT individual plus parent/family component). From the broad theoretical level, CBT has well-established efficacy and behavior therapy meets criteria for a probably efficacious intervention for childhood depression. For adolescent depression, both CBT and IPT have well-established efficacy. Future research directions and best practices are offered.

Universal depression screening, diagnosis, management, and outcomes at a student-run free clinic.

PubMed

Soltani, Maryam; Smith, Sunny; Beck, Ellen; Johnson, Michelle

2015-06-01

Student-run free clinics (SRFCs) are now present at most medical schools. Reports regarding SRFCs have focused on the infrastructure of established clinics, characteristics of the patient populations served, and their contribution to patient care. Few studies discuss their role in preventive medicine and even fewer discuss mental health care. This study examined the outcomes of a medical student-run universal depression screening, diagnosis, and management program at two SRFC sites. Medical students implemented a universal depression screening, diagnosis, and management program within the electronic health record during routine adult primary care visits utilizing the Patient Health Questionnaire-2 (PHQ-2) as an initial screening tool, with a protocol to administer the Patient Health Questionnaire-9 (PHQ-9) if the PHQ-2 score was ≥3. This is a retrospective medical record review of visits from August 13, 2013, through February 13, 2014, to assess this program. Overall, 95.8 % (206/215) of the patients received either the PHQ-2 or the PHQ-9. Among the 174 patients without a previous diagnosis of depression, 166 were screened (95.4 %), of which 33 (19.9 %) had a positive PHQ-2 score of ≥3; 30 (of 33; 90.9 %) appropriately received a PHQ-9. Nineteen (of 166 screened; 11.4 %) previously undiagnosed patients were confirmed to have depression. Fourteen patients had two or more PHQ-9 tests at least 4 weeks apart and eight (57.1 %) had a clinically significant improvement, defined as PHQ-9 score decrease of ≥5. The prevalence of depression diagnosed prior to the implementation of this program in this cohort was 19.1 % (41/215) and after was 27.9 % (60/215). This study demonstrated that medical students with faculty supervision can successfully implement a universal depression screening, diagnosis, and management program at multiple SRFC sites, identify previously undiagnosed depression, and work with interdisciplinary support services to provide treatment options, leading to a clinically significant improvement in depression severity.

Mass Screening: An Aid to Competency Based Program Development.

ERIC Educational Resources Information Center

Siehl, Peterann M.; Studer, Jeannine

Adolescent suicide is the second leading cause of death in the adolescent population and is on the rise. This study used a mass screening concept as a pre-test identifier of at risk clients for suicide ideation and depressions; development of a competency-based prevention group treatment program, and the post-testing of the identified at-risk…

Depression knowledge in high school students: effectiveness of the adolescent depression awareness program.

PubMed

Ruble, Anne E; Leon, Phillip J; Gilley-Hensley, Laura; Hess, Sally G; Swartz, Karen L

2013-09-25

Major depression is a common disorder among teenagers and is associated with significant morbidity and mortality. Suicide is the third leading cause of death among 15-24 year olds. Early identification and treatment is essential to prevent suicide. Depression education is a potential intervention for improving knowledge about depression and help-seeking behavior. The Adolescent Depression Awareness Program (ADAP) is a school-based depression education intervention with a core message that depression is a treatable medical illness. 710 high school students from six schools in Tulsa, OK participated in the study comparing changes in knowledge about depression and attitudes toward treatment-seeking between students receiving the intervention and those who did not. Changes in depression knowledge and attitude toward help-seeking were measured using the ADAP Depression Knowledge Questionnaire (ADKQ). There was a significant positive change in ADKQ score for students receiving the intervention but not in the control group. The intervention group also demonstrated a significant difference in willingness to "tell someone" if concerned about depression in a peer, which was not present in the control group. The students were not randomized to the intervention and control groups. The ADKQ evaluates attitudes about help-seeking but not behavior. A school-based educational intervention improved knowledge about depression and attitudes toward help-seeking in adolescents. Future studies should investigate if such change in knowledge results in help-seeking behaviors. © 2013 Elsevier B.V. All rights reserved.

Control or involvement? Relationship between authoritative parenting style and adolescent depressive symptomatology.

PubMed

Piko, B F; Balázs, M A

2012-03-01

Among factors predicting adolescent mood problems, certain aspects of the parent-adolescent relationship play an important role. In previous studies, children whose parents had an authoritative style of parenting reported the best behavioral and psychological outcomes. Therefore, the main goal of this paper was to investigate the role of authoritative parenting style and other family variables (negative family interactions and positive identification with parents) in adolescents' depressive symptomatology. The study was carried out in all primary and secondary schools in Mako and the surrounding region in Hungary in the spring of 2010, students of grades 7-12 (N = 2,072): 49.2% of the sample were males; 38.1% primary school pupils; and 61.9% high school students. Self-administered questionnaires contained items of measuring depressive symptoms (CDI) and parental variables beyond sociodemographics. Beyond descriptive statistics and calculation of correlation coefficients, multiple linear regression analyses were applied to detect relationships between parental variables and depressive scores by gender. Overall, our data support a negative association between authoritative parenting style and adolescent mood problems, particularly among girls. Among boys, only mother's responsiveness was a significant predictor. Among girls, father's parenting played a decisive role; not only his responsiveness but also demandingness. Interestingly, mother's demandingness went together with an elevated depressive score for girls. Prevention programs cannot guarantee success without taking into account the role of parents. Teaching positive parenting seems to be a part of these prevention programs that may include facilitating intimate yet autonomous relationships.

Path analysis of suicide ideation in older people.

PubMed

Kim, Seolmin; Ha, Jee Hyun; Yu, Jaehak; Park, Doo-Heum; Ryu, Seung-Ho

2014-03-01

Suicide among older people is one of the most rapidly emerging healthcare issues. The objective of this study was to identify the factors associated with suicide ideation in the aged population in South Korea. The study recruited 684 subjects older than 65 years old (males = 147, females = 537, mean age = 78.20±7.02 years), and trained interviewers performed the interviews. The study was performed as part of a community mental health suicide prevention program. The subjects' socio-demographic data, physical health, alcohol problems, social relationships, psychological well-being, and depression severity were all considered. The Korean version of the Beck Scale for Suicide Ideation (K-BSI) was used to evaluate the intensity of suicide ideation. Correlation and hierarchical multiple regression analyses were performed to identify the factors associated with the K-BSI. The study results were tested using a path analysis. Depression severity was positively correlated with suicide ideation, and economic status, psychological well-being, and social relationships were negatively correlated with suicide ideation. Depression severity had the largest direct impact, and economic status and social relationships had indirect impacts on suicide ideation. Psychological well-being exerted both direct and indirect influences. Depression severity was the most important predictor of suicide ideation among older people. Other direct and indirect factors played secondary roles. Effective suicide prevention strategies should focus on early detection and active intervention for depression. Socio-economic programs may also indirectly reduce suicide ideation among the aged population.

A Meta-Analytic Review of the Penn Resiliency Program’s Effect on Depressive Symptoms

PubMed Central

Brunwasser, Steven M.; Gillham, Jane E.; Kim, Eric S.

2015-01-01

Objectives The purpose of this review was to evaluate whether the Penn Resiliency Program (PRP), a group cognitive-behavioral intervention, is effective in targeting depressive symptoms in youth. Data sources We identified 17 controlled evaluations of PRP (N = 2498) measuring depressive symptoms via an online search of PsycInfo, Medline, ERIC, and ProQuest Dissertations and Theses, and by requesting data from PRP researchers. Review methods We combined effect sizes (ESs; Glass’s d), using random effects models at post-intervention and two follow-up assessments. Results PRP participants reported fewer depressive symptoms at post-intervention and both follow-up assessments compared to youth receiving no intervention, with ESs ranging from 0.11 to 0.21. Limited data show no evidence that PRP is superior to active control conditions. Subgroup analyses showed that PRP’s effects were significant at 1 or more follow-up assessments among studies using both targeted and universal approaches, when group leaders were research team members and community providers, among participants with both low and elevated baseline symptoms, and among boys and girls. Preliminary analyses suggest that PRP’s effects on depressive disorders may be smaller than those reported in a larger meta-analysis of depression prevention programs for older adolescents and adults. Conclusion We found evidence that PRP significantly reduces depressive symptoms through at least 1 year post-intervention. Future PRP research should examine whether PRP’s effects on depressive symptoms lead to clinically meaningful benefits for its participants, whether the program is cost-effective, whether CBT skills mediate program effects, and whether PRP is effective when delivered under real-world conditions. PMID:19968381

Does a physical activity program in the nursing home impact on depressive symptoms? A generalized linear mixed-model approach.

PubMed

Diegelmann, Mona; Jansen, Carl-Philipp; Wahl, Hans-Werner; Schilling, Oliver K; Schnabel, Eva-Luisa; Hauer, Klaus

2018-06-01

Physical activity (PA) may counteract depressive symptoms in nursing home (NH) residents considering biological, psychological, and person-environment transactional pathways. Empirical results, however, have remained inconsistent. Addressing potential shortcomings of previous research, we examined the effect of a whole-ecology PA intervention program on NH residents' depressive symptoms using generalized linear mixed-models (GLMMs). We used longitudinal data from residents of two German NHs who were included without any pre-selection regarding physical and mental functioning (n = 163, M age = 83.1, 53-100 years; 72% female) and assessed on four occasions each three months apart. Residents willing to participate received a 12-week PA training program. Afterwards, the training was implemented in weekly activity schedules by NH staff. We ran GLMMs to account for the highly skewed depressive symptoms outcome measure (12-item Geriatric Depression Scale-Residential) by using gamma distribution. Exercising (n = 78) and non-exercising residents (n = 85) showed a comparable level of depressive symptoms at pretest. For exercising residents, depressive symptoms stabilized between pre-, posttest, and at follow-up, whereas an increase was observed for non-exercising residents. The intervention group's stabilization in depressive symptoms was maintained at follow-up, but increased further for non-exercising residents. Implementing an innovative PA intervention appears to be a promising approach to prevent the increase of NH residents' depressive symptoms. At the data-analytical level, GLMMs seem to be a promising tool for intervention research at large, because all longitudinally available data points and non-normality of outcome data can be considered.

Affect and eating behavior in obese adults with and without elevated depression symptoms.

PubMed

Goldschmidt, Andrea B; Crosby, Ross D; Engel, Scott G; Crow, Scott J; Cao, Li; Peterson, Carol B; Durkin, Nora

2014-04-01

Although there is a modest relation between obesity and depression, mechanisms that contribute to this co-occurrence are unclear. This study examined mood and eating behavior among obese adults with and without elevated depression symptoms. Obese adults (N = 50) were subtyped according to a Beck Depression Inventory (BDI) cutoff of 14, indicating "probable depression." Participants with (BDI ≥ 14; n = 15) and without (BDI < 14; n = 35) elevated depression symptoms were compared on affect- and eating-related variables measured via questionnaire and ecological momentary assessment (EMA) using ANCOVA and mixed model regression. After adjusting for group differences in body mass index (BMI; p = .03), participants with elevated depression symptoms reported greater emotional eating via self-report questionnaire [F(1,50) = 4.3; p = .04], as well as more frequent binge eating (Wald χ(2)  = 13.8; p < .001) and higher daily negative affect (Wald χ(2)  = 7.7; p = .005) on EMA recordings. Emotional eating mediated the relationship between depression status and BMI (indirect effect estimate = 3.79; 95% CI = 1.02-7.46). Emotional eating and binge eating were more commonly reported by obese adults with elevated depression symptoms compared to those without and may occur against a general backdrop of overall low mood. Intervention and prevention programs for obesity and/or depression should address disordered eating to prevent or minimize adverse health consequences. Copyright © 2013 Wiley Periodicals, Inc.

A family-based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change.

PubMed

Beardslee, William R; Gladstone, Tracy R G; Wright, Ellen J; Cooper, Andrew B

2003-08-01

Depression in parents is a prevalent and impairing illness that is encountered frequently in medical practice. Children of depressed parents are at risk for psychopathology and other difficulties. A series of recent national reports have recommended the development of prevention efforts targeting children of depressed parents. Yet, to date, few controlled prevention studies of depression in children and adolescents have been conducted. In this study, we report the evaluation of 2 preventive intervention strategies that target children living in homes with depressed parents. Both are public health approaches that were designed to be used by a wide range of practitioners from a variety of disciplines, including pediatricians, internists, school counselors, nurses, and mental health practitioners. We adopted a developmental perspective and intervened with families when children were entering the age of highest risk for depression onset (ie, adolescence). We chose a family-based approach to prevention and sought to reduce risk factors and enhance protective factors for early adolescents by increasing positive interactions between parents and children, and by increasing understanding of the illness for everyone in the family. Our prevention approaches were designed to provide information about mood disorders to parents, to equip parents with the skills they need to communicate information to their children, and to open a dialogue with their children about the effects of parental depression. We hypothesized that participation in these prevention programs would result in parental change in child-related behaviors and attitudes about depression and its impact on the family. In addition, we hypothesized that this parental change would produce change in children's self-understanding, and in children's depressive symptomatology. We conducted a large-scale efficacy trial of 2 manual-based preventive intervention programs that were designed to be used widely in public health settings. These interventions target the relatively healthy children (ages 8-15) of parents with mood disorder. Ninety-three families (88.5% of our initial sample), including 121 children, participated in this study through the fourth assessment point. These families were assigned randomly to either a lecture or a clinician-facilitated intervention. Both interventions were specified in manuals. The lecture condition consisted of 2 separate meetings delivered in a group format without children present. The clinician-facilitated condition consisted of 6 to 11 sessions, including separate meetings with parents and children, and a family meeting in which the parents led a discussion of the illness and of positive steps that can be taken to promote healthy functioning in the children. In addition, telephone contacts or refresher meetings were conducted at 6- to 9-month intervals. In both conditions, psychoeducational material about mood disorders, risk, and resilience was presented and efforts were made to decrease feelings of guilt and blame in children. Parents were helped to build resilience in their children through encouraging their friendships, their success outside of the home, and their understanding of parental illness and of themselves. In addition, in the clinician-facilitated condition, efforts were made to link the psychoeducational material presented to the family's own unique illness experience. To address directly how their lives had changed, all family members in both conditions were assessed for psychopathology and for overall functioning at intake, and for psychopathology, functioning, and response to intervention immediately postintervention, approximately 1 year postintervention, and again approximately 2.5 years postintervention. We examined the outcomes of child understanding and internalizing symptomatology, and a number of predictor variables, using repeated measures analyses with generalized estimating equations. We found that parents in both conditions reported significant change in child-related behaviors and and attitudes, and that the amount of change reported increased over time from time 3 to time 4 (chi2(1) = 18.1). Moreover, relative to parents in the lecture program (mean number of changes = 6.3), parents in the clinician-facilitated program reported more change in child-related behaviors and attitudes (mean number of changes = 9.8). Children in both conditions reported increased understanding of parental illness attributable to participation in our intervention programs. There was a positive association between the amount of change children reported in their understanding of parental illness and the number of changes couples reported in child-related behaviors/attitudes (chi2(1) = 37.3; ie, parents who had changed the most in response to intervention had children who also changed the most). Finally, internalizing scores for all children decreased with increased time since intervention (chi2(1) = 7.3). In addition, females had higher internalizing scores than males (chi2(1) = 5.3). There was no significant effect of group on children's change in internalizing symptomatology (chi2(1) = 0.2). We enrolled families with relatively healthy children, administered carefully designed preventive interventions that are manual-based and relatively brief, and found that these programs do have long-standing positive effects in how families problem solve around parental illness. Our results show significant benefits from both interventions. Moreover, changes in parents' perceptions translated directly into changes in children's own understanding of parental illness. Parental behavior and attitude changes and their connection to child changes in understanding identify an important mediating variable: family change. By increasing children's understanding of parental mood disorder, our interventions were found to promote resilience-related qualities in these children at risk. This presentation represents the first and only longitudinal primary prevention study of relatively healthy children at risk for psychopathology attributable to parental mood disorder and demonstrates a significant reduction in risk factors and increase in protective factors in these families over a long time interval--2(1/2) years. Our results provide support for a family-based approach to preventive intervention.

A longitudinal analysis of depressive symptoms among Asian and Pacific Islander mothers at-risk for child maltreatment.

PubMed

Ta, Van M; Juon, Hee-Soon; Gielen, Andrea C; Steinwachs, Donald; McFarlane, Elizabeth; Duggan, Anne

2009-02-01

This longitudinal study examined racial differences in depressive symptoms at three time points among Asian, Native Hawaiian/Other Pacific Islander (NHOPI) and white mothers at-risk for child maltreatment (n = 616). The proportion of mothers with depressive symptoms ranged from 28 to 35% at all time points. Adjusted analyses revealed that Asian and NHOPI mothers were significantly more likely than white mothers to have depressive symptoms but this disparity was present only among families at mild/moderate risk for child maltreatment. Future research should identify ways to reduce this disparity and involve the Asian and NHOPI communities in prevention and treatment program design and implementation.

¡HOLA, Amigos! Toward Preventing Anxiety and Depression in Older Latinos.

PubMed

Jimenez, Daniel E; Syed, Shariful; Perdomo-Johnson, Doris; Signorile, Joseph F

2018-02-01

Given the prevalence and morbidity of depression and anxiety in later life, the inadequacies of current treatment approaches for averting years living with disability, the disparities in access to the mental healthcare delivery system, and the workforce shortages to meet the mental health needs of older Latinos, development and testing of innovative strategies to prevent depression and anxiety are of great public health significance and have the potential to change practice. Although impediments to good depression and anxiety outcomes exist for all older adults, they are even more pronounced for older Latinos, who tend to have fewer socioeconomic resources. These factors underscore the need for prevention-based interventions that are effective, scalable, relevant, respectful, and specific to this population. The Happy Older Latinos are Active (HOLA) program is a community health worker-led, multicomponent, health promotion intervention. The diverse needs and circumstances of older Latinos (highly sedentary, culture-specific health beliefs, service disparities) were incorporated into the design of HOLA to reduce risk factors and improve health-related outcomes associated with common mental disorders in this group. The authors describe HOLA (highlighted in this case example) and why health promotion interventions like HOLA may hold promise as effective, practical, and nonstigmatizing interventions for preventing common mental disorders in older Latinos who are at risk for developing these disorders. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

An Internet-based program for depression using activity and physiological sensors: efficacy, expectations, satisfaction, and ease of use.

PubMed

Botella, Cristina; Mira, Adriana; Moragrega, Inés; García-Palacios, Azucena; Bretón-López, Juana; Castilla, Diana; Riera López Del Amo, Antonio; Soler, Carla; Molinari, Guadalupe; Quero, Soledad; Guillén-Botella, Verónica; Miralles, Ignacio; Nebot, Sara; Serrano, Berenice; Majoe, Dennis; Alcañiz, Mariano; Baños, Rosa María

2016-01-01

Computerized cognitive behavioral therapy (CCBT) has been shown to be efficacious. Moreover, CCBT can be enhanced by using physiological and activity sensors, but there is no evidence about the acceptability of all these tools. The objective of this study is to examine the efficacy, expectations, satisfaction, and ease of use of an Internet-based CCBT program for preventing depression, with and without sensors (electroencephalography, electrocardiograhpy ECG, and actigraphy), in a high-risk population (unemployed men). Sixty participants at risk of depression (unemployed men) were randomly assigned to three experimental conditions: 1) intervention program (N=22), 2) intervention program plus sensors (N=19), and 3) control group (N=19). Participants completed depression, anxiety, positive and negative affect, and perceived stress measures. Furthermore, they also completed the measures for expectation, satisfaction, and the ease of use of the program. Results showed that the two intervention groups improved significantly more than the control group on the clinical variables, and the improvements were greater in the group that used sensors than in the group that did not use them. Furthermore, participants in both intervention groups scored high on expectations and satisfaction with the CCBT program (with and without sensors). The mean score for usability was 88 out of 100 (standard deviation =12.32). No significant differences were found between groups on any of these variables. This is the first study to analyze the efficacy, expectations, satisfaction, and ease of use of an Internet-based program using physiological and activity sensors. These results suggest that an Internet program for depression with or without physiological and activity sensors is effective, satisfactory, and easy to use.

An Internet-based program for depression using activity and physiological sensors: efficacy, expectations, satisfaction, and ease of use

PubMed Central

Botella, Cristina; Mira, Adriana; Moragrega, Inés; García-Palacios, Azucena; Bretón-López, Juana; Castilla, Diana; Riera López del Amo, Antonio; Soler, Carla; Molinari, Guadalupe; Quero, Soledad; Guillén-Botella, Verónica; Miralles, Ignacio; Nebot, Sara; Serrano, Berenice; Majoe, Dennis; Alcañiz, Mariano; Baños, Rosa María

2016-01-01

Purpose Computerized cognitive behavioral therapy (CCBT) has been shown to be efficacious. Moreover, CCBT can be enhanced by using physiological and activity sensors, but there is no evidence about the acceptability of all these tools. The objective of this study is to examine the efficacy, expectations, satisfaction, and ease of use of an Internet-based CCBT program for preventing depression, with and without sensors (electroencephalography, electrocardiograhpy ECG, and actigraphy), in a high-risk population (unemployed men). Patients and methods Sixty participants at risk of depression (unemployed men) were randomly assigned to three experimental conditions: 1) intervention program (N=22), 2) intervention program plus sensors (N=19), and 3) control group (N=19). Participants completed depression, anxiety, positive and negative affect, and perceived stress measures. Furthermore, they also completed the measures for expectation, satisfaction, and the ease of use of the program. Results Results showed that the two intervention groups improved significantly more than the control group on the clinical variables, and the improvements were greater in the group that used sensors than in the group that did not use them. Furthermore, participants in both intervention groups scored high on expectations and satisfaction with the CCBT program (with and without sensors). The mean score for usability was 88 out of 100 (standard deviation =12.32). No significant differences were found between groups on any of these variables. Conclusion This is the first study to analyze the efficacy, expectations, satisfaction, and ease of use of an Internet-based program using physiological and activity sensors. These results suggest that an Internet program for depression with or without physiological and activity sensors is effective, satisfactory, and easy to use. PMID:27042067

The Impacts of Social Support and Cognitive Function on Depression among Community-Dwelling Older Japanese Americans.

PubMed

Kim, Bum Jung; Nakaoka, Susan; Underwood, Charna

2017-02-17

Research has demonstrated a relationship between social support, cognitive function, and depression among older adults, yet fewer studies have explored this association with Japanese American elders. This study aims to examine depression and describe its relationship with social support, cognitive function, and socioeconomic condition among Japanese American elders. A cross-sectional study of 205 Japanese American elders was conducted in Honolulu and Los Angeles County. A hierarchical regression model was used with depression as a dependent variable and with independent variables such as social support, cognitive function, and socioeconomic status. The study found that social support and cognitive function were significantly associated with depression for Japanese American elders. Also age and education were significantly associated with depression. Based on the findings, the study indicates the importance of developing preventive strategies to reduce the depression issue using culturally tailored programs to the study population.

Childhood depression: a systematic review

PubMed Central

Lima, Nádia Nara Rolim; do Nascimento, Vânia Barbosa; de Carvalho, Sionara Melo Figueiredo; de Abreu, Luiz Carlos; Neto, Modesto Leite Rolim; Brasil, Aline Quental; Junior, Francisco Telésforo Celestino; de Oliveira, Gislene Farias; Reis, Alberto Olavo Advíncula

2013-01-01

As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH]), “child” (MeSH), and “childhood depression” (keyword). Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children’s quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs concerning childhood depression are not always taken into consideration. In this context, this review demonstrated that childhood-onset depression commonly leads to other psychiatric disorders and co-morbidities. Many of the retrieved studies also confirmed the hypothesis that human resources (eg, health care team in general) are not yet adequately trained to address childhood depression. Thus, further research on the development of programs to prepare health care professionals to deal with childhood depression is needed, as well as complementary studies, with larger and more homogeneous samples, centered on prevention and treatment of childhood depression. PMID:24092979

Development of an Empirically Based Preventive Intervention for Depression in Preadolescent African American Girls.

PubMed

Duffy, Sophia; Brown, Tasha M; Katsonga-Phiri, Tiamo; Bouris, Alida; Grant, Kathryn E; Keenan, Kate

2016-05-01

We describe the development, feasibility, and acceptability of a novel preventive intervention for depression in African American girls living in urban poverty. Our approach targeted individual and interpersonal vulnerabilities that have been shown to confer risk for depression in samples of African American girls living in low-income, urban settings, including suppression of negative emotion and lack of assertiveness with peers, memory for positive emotion, active coping, and family connection. Focus groups and an open trial were conducted to refine the goals and mechanisms for skill building. A randomized controlled trial (RCT) of the new program (Cities Mother-Daughter Project) was conducted with 3rd-5th grade students from Chicago Public Schools (CPS). Three cycles of screening, randomization, and deployment were conducted to assess feasibility, satisfaction, and usability. Results indicate that feasibility was weak; whereas, satisfaction and usability were high. Future directions for testing efficacy are discussed.

Body esteem is a mediator of the association between physical activity and depression in Korean adolescents.

PubMed

Chae, Sun-Mi; Kang, Hee Sun; Ra, Jin Suk

2017-02-01

This study examined whether body-esteem would mediate the association between physical activity and depression in adolescents. A total of 848 Korean high school students aged 15 to 18years completed a questionnaire on body-esteem, physical activity recall, and depression. Path analysis was used to test mediating effects of body-esteem on the association between physical activity and depression. Girls showed a significantly higher level of depressive symptoms than boys. Boys showed significantly higher levels of physical activity and body-esteem than girls. Body-esteem mediated the relation of physical activity with depression. Physical activity might reduce the risk of depression in addition to supporting body-esteem in adolescents. Interventions that reinforce healthy body-esteem and encourage physical activity would help prevent depression in adolescents. Future studies should examine the effects of programs addressing physical activity and body-esteem among adolescents with depressive symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

Characteristics and effects of suicide prevention programs: comparison between workplace and other settings.

PubMed

Takada, Misato; Shima, Satoru

2010-01-01

The present study reviews the literature on suicide prevention programs conducted in the workplace and other settings, namely school, the community, medical facilities, jail, and the army, by conducting an electronic literature search of all articles published between 1967 and November 2007. From a total of 256 articles identified, various contents of suicide prevention programs were determined, and in 34 studies, the effect of programs was evaluated. A review of the literature reveals that the common contents of suicide prevention programs in the workplace and other settings are education and training of individuals, development of a support network, cooperation from internal and external resources, as well as education and training of managers and staff. Although the characteristic contents of suicide prevention programs at the workplace aimed at improving personnel management and health care, screening and care for high-risk individuals, as well as improvement of building structures, were not described. Although a reduction in undesirable attitudes and an increase in mental health knowledge and coping skills in the workplace are in agreement with findings in other settings, suicide rate, suicide-associated behavior, and depression, which were assessed in other settings, were not evaluated in the three studies targeting the workplace.

The prevention research centers' managing epilepsy well network.

PubMed

DiIorio, Colleen K; Bamps, Yvan A; Edwards, Ariele L; Escoffery, Cam; Thompson, Nancy J; Begley, Charles E; Shegog, Ross; Clark, Noreen M; Selwa, Linda; Stoll, Shelley C; Fraser, Robert T; Ciechanowski, Paul; Johnson, Erica K; Kobau, Rosemarie; Price, Patricia H

2010-11-01

The Managing Epilepsy Well (MEW) Network was created in 2007 by the Centers for Disease Control and Prevention's (CDC) Prevention Research Centers and Epilepsy Program to promote epilepsy self-management research and to improve the quality of life for people with epilepsy. MEW Network membership comprises four collaborating centers (Emory University, University of Texas Health Science Center at Houston, University of Michigan, and University of Washington), representatives from CDC, affiliate members, and community stakeholders. This article describes the MEW Network's background, mission statement, research agenda, and structure. Exploratory and intervention studies conducted by individual collaborating centers are described, as are Network collaborative projects, including a multisite depression prevention intervention and the development of a standard measure of epilepsy self-management. Communication strategies and examples of research translation programs are discussed. The conclusion outlines the Network's role in the future development and dissemination of evidence-based epilepsy self-management programs. Copyright © 2010 Elsevier Inc. All rights reserved.

The YouthMood Project: A Cluster Randomized Controlled Trial of an Online Cognitive Behavioral Program with Adolescents

ERIC Educational Resources Information Center

Calear, Alison L.; Christensen, Helen; Mackinnon, Andrew; Griffiths, Kathleen M.; O'Kearney, Richard

2009-01-01

The aim in the current study was to investigate the effectiveness of an online, self-directed cognitive-behavioral therapy program (MoodGYM) in preventing and reducing the symptoms of anxiety and depression in an adolescent school-based population. A cluster randomized controlled trial was conducted with 30 schools (N = 1,477) from across…

[Frailty and its related Factors in Vulnerable Elderly Population by Age Groups].

PubMed

Park, Eunok; Yu, Mi

2016-12-01

This study aimed to investigate factors affecting frailty by age groups among vulnerable elders in Korea. In this secondary analysis, data were collected from records for 22,868 eldesr registered in the Visiting Health Management program of Publci Health Centers in 2012. Health behaviors, clinically diagnosed disease, frailty, depression and cognitive condition were assessed. Data were analyzed using stepwise regression to determine the associated factors of frailty by age group. Alcohol consumption, physical activity, number of diseases, DM, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors significantly associated with frailty among the elders aged 65~74 (F=135.66, p<.001). Alcohol consumption, physical activity, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors associated with frailty in the elders aged 75~84 (F=245.40, p<.001). Physical activity, CVA, arthritis, depression and cognitive condition were factors associated with frailty in the elders over 85 years of age (F=96.48, p<.001). The findings show that frailty of elders and associated factors were different by age group, and common factors affecting frailty were physical activity, CVA, arthritis, depression and cognitive condition. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to age group.

Adding smartphone-based cognitive-behavior therapy to pharmacotherapy for major depression (FLATT project): study protocol for a randomized controlled trial.

PubMed

Watanabe, Norio; Horikoshi, Masaru; Yamada, Mitsuhiko; Shimodera, Shinji; Akechi, Tatsuo; Miki, Kazuhira; Inagaki, Masatoshi; Yonemoto, Naohiro; Imai, Hissei; Tajika, Aran; Ogawa, Yusuke; Takeshima, Nozomi; Hayasaka, Yu; Furukawa, Toshi A

2015-07-07

Major depression is one of the most debilitating diseases in terms of quality of life. Less than half of patients suffering from depression can achieve remission after adequate antidepressant treatment. Another promising treatment option is cognitive-behavior therapy (CBT). However, the need for experienced therapists and substantive dedicated time prevent CBT from being widely disseminated. In the present study, we aim to examine the effectiveness of switching antidepressants and starting a smartphone-based CBT program at the same time, in comparison to switching antidepressants only, among patients still suffering from depression after adequate antidepressant treatment. A multi-center randomized trial is currently being conducted since September 2014. The smartphone-based CBT program, named the "Kokoro-App," for major depression has been developed and its feasibility has been confirmed in a previous open study. The program consists of an introduction, 6 sessions and an epilogue, and is expected to be completed within 9 weeks by patients. In the present trial, 164 patients with DSM-5 major depressive disorder and still suffering from depressive symptoms after adequate antidepressant treatment for more than 4 weeks will be allocated to the Kokoro-App plus switching antidepressant group or the switching antidepressant alone group. The participants allocated to the latter group will receive full components of the Kokoro-App after 9 weeks. The primary outcome is the change in the total score on the Patient Health Questionnaire through the 9 weeks of the program, as assessed at week 0, 1, 5 and 9 via telephone by blinded raters. The secondary outcomes include the change in the total score of the Beck Depression Inventory-II, change in side effects as assessed by the Frequency, Intensity and Burden of Side Effects Rating, and treatment satisfaction. An effective and reachable intervention may not only lead to healthier mental status among depressed patients, but also to reduced social burden from this illness. This paper outlines the background and methods of a trial that evaluates the possible additive value of a smartphone-based CBT program for treatment-resistant depression. UMIN-CTR: UMIN000013693 (registered on 1 June 2014).

Effects of Biodanza on Stress, Depression, and Sleep Quality in University Students.

PubMed

López-Rodríguez, María Mar; Baldrich-Rodríguez, Ingrid; Ruiz-Muelle, Alicia; Cortés-Rodríguez, Alda Elena; Lopezosa-Estepa, Teresa; Roman, Pablo

2017-07-01

The existing literature shows dance to be an innovative and successful form of stress management. Previous research indicates that Biodanza is able to increase well-being and personal resources and prevent stress. However, Biodanza has not yet been empirically tested as a possible therapy for application outside the clinical context in young adults with perceived stress. This study aimed to determine the effectiveness of Biodanza in reducing symptoms of perceived stress and depression and in promoting sleep quality in young adults, comparing the changes with those observed in a control group. Randomized controlled trial. This study was carried out at the Faculty of Health Sciences of the University of Almería. One hundred and twenty-one university students with perceived stress were randomly placed into either a Biodanza group or a wait-list control group. Study participants attended Biodanza sessions for 90 min a week, over a period of 4 weeks. Depression, perceived stress, and sleep quality were assessed both before and after intervention. Ninety-five participants completed the program and were included in the statistical analysis. Significant differences in perceived stress [t (93) = 2.136; p = 0.015] and depression [t (93) = 2.738; p = 0.000] were observed after the Biodanza period. Pre/post analysis found that Biodanza also had a significant effect on depression (Cohen d = 1.88; p < 0.05) and perceived stress (Cohen d = 0.79; p < 0.05). The Biodanza program is an effective stress management strategy for students. The results of this study showed Biodanza to have a positive effect on perceived stress and depression in young adults. This demonstrates how artistic, collaborative, and psychophysical interventions are an effective means of preventing and managing these problems in university students.

Preventive Effects on Birth Outcomes: Buffering Impact of Maternal Stress, Depression, and Anxiety.

PubMed

Feinberg, Mark E; Jones, Damon E; Roettger, Michael E; Hostetler, Michelle L; Sakuma, Kari-Lyn; Paul, Ian M; Ehrenthal, Deborah B

2016-01-01

Although maternal stress, anxiety, and depression have been linked to negative birth outcomes, few studies have investigated preventive interventions targeting maternal mental health as a means of reducing such problems. This randomized controlled study examines whether Family Foundations (FF)-a transition to parenthood program for couples focused on promoting coparenting quality, with previously documented impact on maternal stress, depression, and anxiety-can buffer the negative effects of maternal mental health problems. To assess the effects of FF, we used a randomized block design with a sample of 259 expectant mothers assigned to FF or a control condition and analyzed using propensity score models. We examine two-way interactions of condition (intervention vs. control) with maternal mental health problems (financial stress, depression, and anxiety) on birth outcomes (birth weight, days in hospital for mothers and infants). For birth weight, we assess whether intervention effects depend on length of gestation by including a third interaction term. FF buffered (p < 0.05) the negative impact of maternal mental health problems on birth weight and both mother and infant length of post-partum hospital stay. For birth weight, assignment to FF was associated with higher birth weight for infants born before term. These results demonstrate that a psycho-educational program for couples focused on enhancing mutual coparental support, with preventive effects on maternal mental health, can reduce incidence of birth problems among women at elevated risk. Such improvements in birth outcomes could translate into substantial reductions in public and personal healthcare costs. Future work should assess mediating mechanisms of intervention impact and cost-benefit ratio of the intervention. The Family Foundations follow-up intervention study is currently registered with www.clinicaltrials.gov . The study identifier is NCT01907412.

Emotional Awareness: A Transdiagnostic Predictor of Depression and Anxiety for Children and Adolescents.

PubMed

Kranzler, Amy; Young, Jami F; Hankin, Benjamin L; Abela, John R Z; Elias, Maurice J; Selby, Edward A

2016-01-01

Research increasingly suggests that low emotional awareness may be associated with symptoms of depression and anxiety among children and adolescents. However, because most studies have been cross-sectional, it has remained unclear whether low emotional awareness predicts subsequent internalizing symptoms. The current study used longitudinal data to examine the role of emotional awareness as a transdiagnostic predictor of subsequent symptoms of depression and anxiety. Participants were 204 youth (86 boys and 118 girls) ages 7-16 who completed self-report measures of emotional awareness, depressive symptoms, and anxiety symptoms at baseline, as well as measures of depression and anxiety symptoms every 3 months for a year. Results from hierarchical mixed effects modeling indicated that low baseline emotional awareness predicted both depressive and anxiety symptoms across a 1-year period. These findings suggest that emotional awareness may constitute a transdiagnostic factor, predicting symptoms of both depression and anxiety, and that emotional awareness training may be a beneficial component of treatment and prevention programs for youth depression and anxiety.

Risky dieting amongst adolescent girls: Associations with family relationship problems and depressed mood.

PubMed

Hinchliff, Gemma L M; Kelly, Adrian B; Chan, Gary C K; Patton, George C; Williams, Joanne

2016-08-01

This study examined the association of risky dieting amongst adolescent girls with depressed mood, family conflict, and parent-child emotional closeness. Grade 6 and 8 females (aged 11-14years, N=4031) were recruited from 231 schools in 30 communities, across three Australian States (Queensland, Victoria, and Western Australia). Key measures were based on the Adolescent Dieting Scale, Short Mood and Feelings Questionnaire, and widely used short measures of family relationship quality. Controls included age, early pubertal onset, and socioeconomic status. Risky dieting was significantly related to family conflict and depressed mood, depressed mood mediated the association of family conflict and risky dieting, and these associations remained significant with controls in the model. Family conflict and adolescent depressed mood are associated with risky dieting. Prevention programs may benefit from a broadening of behavioural targets to include depressed mood and family problems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Emotional Clarity as a Mechanism Linking Emotional Neglect and Depressive Symptoms during Early Adolescence

PubMed Central

Jessar, Allison J.; Hamilton, Jessica L.; Flynn, Megan; Abramson, Lyn Y.; Alloy, Lauren B.

2017-01-01

The present study examined whether emotional abuse and neglect differentially predicted decreases in emotional clarity, and whether emotional clarity, in turn, predicted increases in depressive symptoms. Participants included 204 early adolescents (52% African-American; 54% female; Mean age= 12.85 years) who completed four assessments with measures of depressive symptoms, emotional clarity, and emotional abuse and neglect. Hierarchical linear regressions indicated that emotional neglect significantly predicted decreases in emotional clarity, whereas emotional abuse did not. Further, mediational analyses revealed that decreases in emotional clarity mediated the relationship between emotional neglect and increases in depressive symptoms. The current study suggests that emotional neglect (more so than emotional abuse) may hinder an individual’s ability to identify his or her own emotions, which may increase the risk of depressive symptoms during adolescence. These findings have significant implications for the development of intervention and prevention programs for depression. PMID:28824220

Different pathways explain alcohol related problems in female and male college students

PubMed Central

Pedrelli, P.; Collado, A.; Shapero, B. G.; Brill, C.; MacPherson, L.

2016-01-01

Objectives Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARP) and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways. Methods College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs. Results Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males. Conclusions Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption. PMID:27219280

Anxious and Depressive Symptomatology Among Male Youth: The Joint and Interactive Contribution of Temperament and Executive Functioning

PubMed Central

Shishido, Yuri; Latzman, Natasha E.; Clark, Lee Anna

2018-01-01

Few studies have investigated the combined effects of temperament and executive functioning (EF) on anxious and depressive symptomatology in youth. The current study is the first to investigate the joint and interactive contribution of mother- and youth self-reported affective dimensions of temperament and EF to the explanation of anxious and depressive symptomatology. Participants included 174 adolescent males (Mage = 13.6 ± 1.35). Results confirmed the joint and interactive contribution of temperament in the explanation of anxious and depressive symptomatology. Further, EF contributed to the explanation of anxious/depressive symptomatology via interaction with youth-, but not mother-reported, temperament; it was not a unique predictor. Results support the need to consider both affective dimensions of temperament and EF in etiological models of anxious and depressive symptomatology, which has implications for identifying at-risk youth and developing early intervention and targeted problem-specific prevention programs. PMID:26754748

Anxious and Depressive Symptomatology Among Male Youth: The Joint and Interactive Contribution of Temperament and Executive Functioning.

PubMed

Latzman, Robert D; Shishido, Yuri; Latzman, Natasha E; Clark, Lee Anna

2016-12-01

Few studies have investigated the combined effects of temperament and executive functioning (EF) on anxious and depressive symptomatology in youth. The current study is the first to investigate the joint and interactive contribution of mother- and youth self-reported affective dimensions of temperament and EF to the explanation of anxious and depressive symptomatology. Participants included 174 adolescent males (M age  = 13.6 ± 1.35). Results confirmed the joint and interactive contribution of temperament in the explanation of anxious and depressive symptomatology. Further, EF contributed to the explanation of anxious/depressive symptomatology via interaction with youth-, but not mother-reported, temperament; it was not a unique predictor. Results support the need to consider both affective dimensions of temperament and EF in etiological models of anxious and depressive symptomatology, which has implications for identifying at-risk youth and developing early intervention and targeted problem-specific prevention programs.

Authoritarian parenting and youth depression: Results from a national study.

PubMed

King, Keith A; Vidourek, Rebecca A; Merianos, Ashley L

2016-01-01

Depression is a prevalent illness affecting youth across the nation. The study purpose was to examine depression and authoritarian parenting among youth from 12 to 17 years of age. A secondary data analysis of the National Survey on Drug Use and Health was performed in the present study. All participants in the present study were youth (N = 17,399) nationwide. The results revealed that 80.6% of youth participants reported having five or more depressive symptoms. Parenting styles based on depression significantly differed among males, females, 12-13-year-olds, 14-15-year-olds, and 16-17-year-olds. Specifically, those who reported experiencing authoritarian parenting practices were more likely to report depressive symptoms compared to their counterparts who experienced authoritative parenting practices. Emphasizing the role of the parents and teaching positive parenting practices and authoritative parenting styles may increase success of prevention programs.

The Happy Older Latinos are Active (HOLA) health promotion and prevention study: study protocol for a pilot randomized controlled trial.

PubMed

Jimenez, Daniel E; Reynolds, Charles F; Alegría, Margarita; Harvey, Philip; Bartels, Stephen J

2015-12-18

Results of previous studies attest to the greater illness burden of common mental disorders (anxiety and depression) in older Latinos and the need for developing preventive interventions that are effective, acceptable, and scalable. Happy Older Latinos are Active (HOLA) is a newly developed intervention that uses a community health worker (CHW) to lead a health promotion program in order to prevent common mental disorders among at-risk older Latinos. This pilot study tests the feasibility and acceptability of delivering HOLA to older, at-risk Latinos. HOLA is a multi-component, health promotion intervention funded by the National Institute of Mental Health (NIMH). This prevention approach will be tested against a fotonovela, an enhanced psychoeducation control condition, in a sample of Latino elderly with minor or subthreshold depression or anxiety. A total of 60 older Latinos (aged 60+) will be randomized to receive HOLA or the fotonovela. The primary outcomes of interest are recruitment, adherence, retention, and acceptability. Data will also be collected on: preemption of incident and recurrent major depression, generalized anxiety, and social phobia; reduction in depression and anxiety symptom severity; physical functioning; sedentary behaviors; social engagement; and self-efficacy. The results of this study could have implications for other high-risk, highly disadvantaged populations. The development of a health promotion intervention designed to prevent common mental disorders could be a means of addressing multiple disparities (for example, mental health outcomes, mental health service use, stigma) among racial/ethnic minority elderly. CLINICALTRIALS. NCT02371954 . Date of registration: 21 January 2015.

Prevention of insulin resistance in adolescents at risk for type 2 diabetes with depressive symptoms: 1-year follow-up of a randomized trial.

PubMed

Shomaker, Lauren B; Kelly, Nichole R; Radin, Rachel M; Cassidy, Omni L; Shank, Lisa M; Brady, Sheila M; Demidowich, Andrew P; Olsen, Cara H; Chen, Kong Y; Stice, Eric; Tanofsky-Kraff, Marian; Yanovski, Jack A

2017-10-01

Depression is associated with poor insulin sensitivity. We evaluated the long-term effects of a cognitive behavioral therapy (CBT) program for prevention of depression on insulin sensitivity in adolescents at risk for type 2 diabetes (T2D) with depressive symptoms. One-hundred nineteen adolescent females with overweight/obesity, T2D family history, and mild-to-moderate depressive symptoms were randomized to a 6-week CBT group (n = 61) or 6-week health education (HE) control group (n = 58). At baseline, posttreatment, and 1 year, depressive symptoms were assessed, and whole body insulin sensitivity (WBISI) was estimated from oral glucose tolerance tests. Dual energy X-ray absorptiometry assessed fat mass at baseline and 1 year. Primary outcomes were 1-year changes in depression and insulin sensitivity, adjusting for adiposity and other relevant covariates. Secondary outcomes were fasting and 2-hr insulin and glucose. We also evaluated the moderating effect of baseline depressive symptom severity. Depressive symptoms decreased in both groups (P < .001). Insulin sensitivity was stable in CBT and HE (ΔWBISI: .1 vs. .3) and did not differ between groups (P = .63). However, among girls with greater (moderate) baseline depressive symptoms (N = 78), those in CBT developed lower 2-hr insulin than those in HE (Δ-16 vs. 16 μIU/mL, P < .05). Additional metabolic benefits of CBT were seen for this subgroup in post hoc analyses of posttreatment to 1-year change. Adolescent females at risk for T2D decreased depressive symptoms and stabilized insulin sensitivity 1 year following brief CBT or HE. Further studies are required to determine if adolescents with moderate depression show metabolic benefits after CBT. © 2017 Wiley Periodicals, Inc.

Relation between HIV status, risky sexual behavior, and mental health in an MSM sample from three Chilean cities.

PubMed

Gómez, Fabiola; Barrientos, Jaime; Cárdenas, Manuel

2017-04-20

To explore the association among HIV status; negative psychological symptoms (anxiety, depression, and hostility); and risky sexual behaviors (multiple sexual partners and unprotected sexual intercourse) in a Chilean sample of men who have sex with men (MSM). This study had a cross-sectional design and a sample of 325 MSM whose ages ranged from 18 to 64 years (mean: 30.8; standard deviation: 9.8). Association tests (chi-squared) and group mean comparisons (Student's t-tests and F-tests) were performed. No statistically significant differences were found for condom use or for the number of sexual partners between HIV-positive men and those who are not infected. In both groups, about 50% reported sexual encounters without condom use in the past six months. There were statistically significant differences in symptoms associated with depression between the two groups. These results reveal the need to strengthen messages about the importance of condom use, as the only way to prevent HIV, and as a means of preventing HIV infection and reinfection, in national prevention and self-care programs for sexually active subjects. More studies are needed in Latin America to advance HIV prevention efforts for the MSM population. The data generated by this study can be used to inform the development of HIV prevention programming strategies and interventions targeting the MSM population in Latin America.

The association between tobacco, alcohol, and drug use, stress, and depression among uninsured free clinic patients: U.S.-born English speakers, non-U.S.-born English speakers, and Spanish speakers.

PubMed

Kamimura, Akiko; Ashby, Jeanie; Tabler, Jennifer; Nourian, Maziar M; Trinh, Ha Ngoc; Chen, Jason; Reel, Justine J

2017-01-01

The abuse of substances is a significant public health issue. Perceived stress and depression have been found to be related to the abuse of substances. The purpose of this study is to examine the prevalence of substance use (i.e., alcohol problems, smoking, and drug use) and the association between substance use, perceived stress, and depression among free clinic patients. Patients completed a self-administered survey in 2015 (N = 504). The overall prevalence of substance use among free clinic patients was not high compared to the U.S. general population. U.S.-born English speakers reported a higher prevalence rate of tobacco smoking and drug use than did non-U.S.-born English speakers and Spanish speakers. Alcohol problems and smoking were significantly related to higher levels of perceived stress and depression. Substance use prevention and education should be included in general health education programs. U.S.-born English speakers would need additional attention. Mental health intervention would be essential to prevention and intervention.

[The influence of workplace violence on work-related anxiety and depression experience among Korean employees].

PubMed

Choi, Eun Sook; Jung, Hye Sun; Kim, Su Hyun; Park, Hyunju

2010-10-01

Work-related anxiety and depression are frequent work-related mental health problems. In this study the relationship between workplace violence and work-related anxiety and/or depression among Korean employees was evaluated. Data were obtained from the Korean Working Condition Survey of 2006. Participants were 9,094 Korean workers aged 15-64 yr. Multiple logistic regression using SAS version 9.1 was used. The incidence of work-related anxiety, work-related depression and workplace violence were 4.5%, 3.5%, and 1.8% respectively. When personal and occupational risk factors were adjusted, workplace violence was significantly associated with work-related anxiety and depression (OR for anxiety: 4.07, CI: 2.62-6.34; OR for depression: 4.60, CI: 2.92-7.25). Work-related anxiety was significantly related to type of employment, working period at present workplace, work time, shift work, job demand, and social support from superiors. Factors influencing work-related depression were gender, education, alcohol consumption, company size, type of employment, working period at present workplace, work time, shift work, and job demand. To promote psychological health in workers there is a need to develop work-related anxiety and depression prevention programs and to decrease in workplace violence. In developing these programs, consideration should be given to personal factors, working conditions, and psychosocial working environments.

Work-Related Depression in Primary Care Teams in Brazil.

PubMed

da Silva, Andréa Tenório Correia; Lopes, Claudia de Souza; Susser, Ezra; Menezes, Paulo Rossi

2016-11-01

To identify work-related factors associated with depressive symptoms and probable major depression in primary care teams. Cross-sectional study among primary care teams (community health workers, nursing assistants, nurses, and physicians) in the city of São Paulo, Brazil (2011-2012; n = 2940), to assess depressive symptoms and probable major depression and their associations with job strain and other work-related conditions. Community health workers presented higher prevalence of probable major depression (18%) than other primary care workers. Higher odds ratios for depressive symptoms or probable major depression were associated with longer duration of employment in primary care; having a passive, active, or high-strain job; lack of supervisor feedback regarding performance; and low social support from colleagues and supervisors. Observed levels of job-related depression can endanger the sustainability of primary care programs. Public Health implications. Strategies are needed to deliver care to primary care workers with depression, facilitating diagnosis and access to treatment, particularly in low- and middle-income countries. Preventive interventions can include training managers to provide feedback and creating strategies to increase job autonomy and social support at work.

Improving Suicide Prevention in Dutch Regions by Creating Local Suicide Prevention Action Networks (SUPRANET): A Study Protocol.

PubMed

Gilissen, Renske; De Beurs, Derek; Mokkenstorm, Jan; Mérelle, Saskia; Donker, Gé; Terpstra, Sanne; Derijck, Carla; Franx, Gerdien

2017-03-28

The European Alliance against Depression (EAAD) program is to be introduced in The Netherlands from 2017 onwards. This program to combat suicide consists of interventions on four levels: (1) increasing the awareness of suicide by local media campaigns; (2) training local gatekeepers, such as teachers or police officers; (3) targeting high-risk persons in the community; and (4) training and support of professionals in primary care settings. The implementation starts in seven Dutch pilot regions. Each region is designated as a Suicide Prevention Action NETwork (SUPRANET). This paper describes the SUPRANET program components and the evaluation of its feasibility and impact. The findings will be used to facilitate the national implementation of EAAD in The Netherlands and to add new findings to the existing literature on EAAD.

Improving Suicide Prevention in Dutch Regions by Creating Local Suicide Prevention Action Networks (SUPRANET): A Study Protocol

PubMed Central

Gilissen, Renske; De Beurs, Derek; Mokkenstorm, Jan; Mérelle, Saskia; Donker, Gé; Terpstra, Sanne; Derijck, Carla; Franx, Gerdien

2017-01-01

The European Alliance against Depression (EAAD) program is to be introduced in The Netherlands from 2017 onwards. This program to combat suicide consists of interventions on four levels: (1) increasing the awareness of suicide by local media campaigns; (2) training local gatekeepers, such as teachers or police officers; (3) targeting high-risk persons in the community; and (4) training and support of professionals in primary care settings. The implementation starts in seven Dutch pilot regions. Each region is designated as a Suicide Prevention Action NETwork (SUPRANET). This paper describes the SUPRANET program components and the evaluation of its feasibility and impact. The findings will be used to facilitate the national implementation of EAAD in The Netherlands and to add new findings to the existing literature on EAAD. PMID:28350367

DIABETES, DEPRESSION, AND DEATH: A RANDOMIZED CONTROLLED TRIAL OF A DEPRESSION TREATMENT PROGRAM FOR OLDER ADULTS BASED IN PRIMARY CARE (PROSPECT)

PubMed Central

Bogner, Hillary R; Morales, Knashawn H; Post, Edward P; Bruce, Martha L

2009-01-01

OBJECTIVE Our a priori hypothesis was that depressed patients with diabetes in practices implementing a depression management program would have a decreased risk of mortality compared to depressed patients with diabetes in usual care practices. RESEARCH DESIGN AND METHODS Multi-site practice-randomized controlled trial PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) with patient recruitment from 5/99-8/01 and supplemented with a search of the National Death Index. Twenty primary care practices participated from New York City, Philadelphia, and Pittsburgh. In all, 584 participants who were identified though a two-stage, age-stratified (60-74; 75+) depression screening of randomly sampled patients and were classified as depressed with complete information on diabetes status are included in these analyses. Of all the 584 participants, 123 (21.2%) reported a history of diabetes. A depression care manager worked with primary care physicians to provide algorithm-based care. Vital status was assessed at 5 years. RESULTS After a median follow-up of 52.0 months, 110 depressed patients had died. Depressed patients with diabetes in the Intervention Condition were less likely to have died during the 5-year follow-up interval than were depressed persons with diabetes in Usual Care after accounting for baseline differences among patients (adjusted hazard ratio 0.49, 95% CI [0.24, 0.98]). CONCLUSIONS Older depressed primary care patients with diabetes in practices implementing depression care management were less likely to die over the course of a 5-year interval than were depressed patients with diabetes in usual care practices. PMID:17717284

Stress spillover, African Americans' couple and health outcomes, and the stress-buffering effect of family-centered prevention.

PubMed

Barton, Allen W; Beach, Steven R H; Bryant, Chalandra M; Lavner, Justin A; Brody, Gene H

2018-03-01

This study investigated (a) the stress spillover pathways linking contextual stressors, changes in couple relationship functioning and depressive symptoms, and changes in individuals' physical health, and (b) the stress-buffering effect of participation in an efficacious, family centered prevention program designed to protect couples from the deleterious effects of stressors. The sample consisted of 346 rural African American couples (63% married) who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program. Participants were assessed at three time points across 17 months. Results examining stress spillover within the control group indicated that elevated current, but not prior, financial hardship was associated with decreased effective communication, relationship satisfaction, and relationship confidence as well as increased depressive symptoms; current levels of racial discrimination also predicted greater depressive symptoms. Relationship confidence and relationship satisfaction, but not communication or depressive symptoms, in turn predicted declines in self-reported physical health. Results examining stress-buffering effects suggested that participation in ProSAAF protected individuals' relationship confidence from declines associated with elevated financial hardship. In addition, the indirect effect linking financial hardship to declines in physical health through relationship confidence that emerged among participants in the control group was no longer evident for ProSAAF couples. Results highlight the effect of contextual stressors on African Americans' couple and individual well-being and the potential for the ProSAAF program to provide a constructed resilience resource, protecting couple's confidence in their relationship from the negative effects of financial hardship and, consequently, promoting physical health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Challenges and opportunities for preventing depression in the workplace: a review of the evidence supporting workplace factors and interventions.

PubMed

Couser, Gregory P

2008-04-01

To explore the literature regarding prevention of depression in the workplace. Literature review of what the author believes are seminal articles highlighting workplace factors and interventions in preventing depression in the workplace. Employees can help prevent depression by building protective factors such as better coping and stress management skills. Employees may be candidates for depression screening if they have certain risk factors such as performance concerns. Organizational interventions such as improving mental health literacy and focusing on work-life balance may help prevent depression in the workplace but deserve further study. A strategy to prevent depression in the workplace can include developing individual resilience, screening high-risk individuals and reducing that risk, improving organizational literacy, and integrating workplace and health care systems to allow access to proactive quality interventions.

Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial.

PubMed

Christensen, Helen; Batterham, Philip J; Gosling, John A; Ritterband, Lee M; Griffiths, Kathleen M; Thorndike, Frances P; Glozier, Nick; O'Dea, Bridianne; Hickie, Ian B; Mackinnon, Andrew J

2016-04-01

In view of the high co-occurrence of depression and insomnia, a novel way to reduce the risk of escalating depression might be to offer an insomnia intervention. We aimed to assess whether an online self-help insomnia program could reduce depression symptoms. We did this randomised controlled trial at the Australian National University in Canberra, Australia. Internet users (aged 18-64 years) with insomnia and depression symptoms, but who did not meet criteria for major depressive disorder, were randomly assigned (1:1), via computer-generated randomisation, to receive SHUTi, a 6 week, modular, online insomnia program based on cognitive behavioural therapy for insomnia, or HealthWatch, an interactive, attention-matched, internet-based placebo control program. Randomisation was stratified by age and sex. Telephone-based interviewers, statisticians, and chief investigators were masked to group allocation. The primary outcome was depression symptoms at 6 months, as measured with the Patient Health Questionnaire (PHQ-9). The primary analysis was by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000121965. Between April 30, 2013, and June 9, 2014, we randomly assigned 1149 participants to receive SHUTi (n=574) or HealthWatch (n=575), of whom 581 (51%) participants completed the study program assessments at 6 weeks and 504 (44%) participants completed 6 months' follow-up. SHUTi significantly lowered depression symptoms on the PHQ-9 at 6 weeks and 6 months compared with HealthWatch (F[degrees of freedom 2,640·1]=37·2, p<0·0001). Major depressive disorder was diagnosed in 22 (4%) participants at 6 months (n=9 in the SHUTi group and n=13 in the HealthWatch group), with no superior effect of SHUTi versus HealthWatch (Fisher's exact test=0·52; p=0·32). No adverse events were reported. Online cognitive behaviour therapy for insomnia treatment is a practical and effective way to reduce depression symptoms and could be capable of reducing depression at the population level by use of a fully automatised system with the potential for wide dissemination. Australian National Health and Medical Research Council. Copyright © 2016 Elsevier Ltd. All rights reserved.

Depressive Symptoms Are Associated with Excess Weight and Unhealthier Lifestyle Behaviors in Urban Adolescents

PubMed Central

Castillo, Fiorella; Francis, Lori; Wylie-Rosett, Judith

2014-01-01

Abstract Background: Adolescence is a critical period for the development of depressive symptoms and obesity. This study examined the association of depressive symptoms with standardized BMI (BMI z-score), lifestyle behaviors, and self-efficacy measures in a sample of urban adolescents. Methods: A school-based study was conducted among adolescents (N=1508) enrolled from 11 public schools. Depressive symptoms were assessed with Kandel's depressive symptoms scale for adolescents. Fruit and vegetable intake and intake of energy-dense foods were assessed by a short food frequency questionnaire. Sedentary behavior and physical activity (PA) were obtained by self-report. Height and weight were measured directly and BMI z-scores were calculated. Mixed-effects models were used to examine the association of depressive symptoms with BMI z-score and lifestyle behaviors, accounting for clustering at school level and adjusting for confounders. Self-efficacy measures were evaluated as potential mediators. Results: The sample was 53% female, 75% Hispanic, and 82% US born, with a mean age of 13.9 years. Higher depressive symptoms were associated with higher BMI z-score (β=0.02; p=0.02), intake of energy-dense foods (β=0.42; p<0.001), and sedentary behavior (β=0.48; p<0.001), but lower PA (β=−0.03; p=0.01). There was an interaction by gender in the association of depressive symptoms and PA. Self-efficacy mediated the association of depressive symptoms and PA. Conclusions: Obesity prevention and treatment programs should consider addressing the role of negative emotions as part of their preventive strategies. PMID:25181530

Social Network Status and Depression among Adolescents: An Examination of Social Network Influences and Depressive Symptoms in a Chinese Sample

PubMed Central

Okamoto, Janet; Johnson, C. Anderson; Leventhal, Adam; Milam, Joel; Pentz, Mary Ann; Schwartz, David; Valente, Thomas W.

2012-01-01

Despite the well established influence of peer experiences on adolescent attitudes, thoughts, and behaviors, surprisingly little research has examined the importance of peer context and the increased prevalence of depressive symptoms accompanying the transition into adolescence. Examination of social networks may provide some insight into the role of peers in the vulnerability of some adolescents to depression. To address this issue, we leveraged an existing sample of 5,563 Chinese 10th graders to incorporate social network data into a multilevel regression model of depressive symptoms. We found that, in this sample, being nominated as a friend was more important than being nominated as most liked. Social network centrality was significantly associated with depression; those adolescents who were less connected were more likely to suffer from depression. The risk of depression for those who were marginal members of classroom social networks was substantial. These findings suggest that a social network perspective could help to increase the effectiveness of programs aimed at preventing adolescent depression. PMID:23226988

Preventing the onset of major depressive disorder: a meta-analytic review of psychological interventions.

PubMed

van Zoonen, Kim; Buntrock, Claudia; Ebert, David Daniel; Smit, Filip; Reynolds, Charles F; Beekman, Aartjan T F; Cuijpers, Pim

2014-04-01

Depressive disorders are highly prevalent, have a detrimental impact on the quality of life of patients and their relatives and are associated with increased mortality rates, high levels of service use and substantial economic costs. Current treatments are estimated to only reduce about one-third of the disease burden of depressive disorders. Prevention may be an alternative strategy to further reduce the disease burden of depression. We conducted a meta-analysis of randomized controlled trials examining the effects of preventive interventions in participants with no diagnosed depression at baseline on the incidence of diagnosed depressive disorders at follow-up. We identified 32 studies that met our inclusion criteria. We found that the relative risk of developing a depressive disorder was incidence rate ratio = 0.79 (95% confidence interval: 0.69-0.91), indicating a 21% decrease in incidence in prevention groups in comparison with control groups. Heterogeneity was low (I(2) = 24%). The number needed to treat (NNT) to prevent one new case of depressive disorder was 20. Sensitivity analyses revealed no differences between type of prevention (e.g. selective, indicated or universal) nor between type of intervention (e.g. cognitive behavioural therapy, interpersonal psychotherapy or other). However, data on NNT did show differences. Prevention of depression seems feasible and may, in addition to treatment, be an effective way to delay or prevent the onset of depressive disorders. Preventing or delaying these disorders may contribute to the further reduction of the disease burden and the economic costs associated with depressive disorders.

Preventing the onset of major depressive disorder: A meta-analytic review of psychological interventions

PubMed Central

van Zoonen, Kim; Buntrock, Claudia; Ebert, David Daniel; Smit, Filip; Reynolds, Charles F; Beekman, Aartjan TF; Cuijpers, Pim

2014-01-01

Background Depressive disorders are highly prevalent, have a detrimental impact on the quality of life of patients and their relatives and are associated with increased mortality rates, high levels of service use and substantial economic costs. Current treatments are estimated to only reduce about one-third of the disease burden of depressive disorders. Prevention may be an alternative strategy to further reduce the disease burden of depression. Methods We conducted a meta-analysis of randomized controlled trials examining the effects of preventive interventions in participants with no diagnosed depression at baseline on the incidence of diagnosed depressive disorders at follow-up. We identified 32 studies that met our inclusion criteria. Results We found that the relative risk of developing a depressive disorder was incidence rate ratio = 0.79 (95% confidence interval: 0.69–0.91), indicating a 21% decrease in incidence in prevention groups in comparison with control groups. Heterogeneity was low (I2 = 24%). The number needed to treat (NNT) to prevent one new case of depressive disorder was 20. Sensitivity analyses revealed no differences between type of prevention (e.g. selective, indicated or universal) nor between type of intervention (e.g. cognitive behavioural therapy, interpersonal psychotherapy or other). However, data on NNT did show differences. Conclusions Prevention of depression seems feasible and may, in addition to treatment, be an effective way to delay or prevent the onset of depressive disorders. Preventing or delaying these disorders may contribute to the further reduction of the disease burden and the economic costs associated with depressive disorders. PMID:24760873

Evaluation of Technology-Based Peer Support Intervention Program for Preventing Postnatal Depression: Protocol for a Randomized Controlled Trial.

PubMed

Shorey, Shefaly; Chee, Cornelia; Chong, Yap-Seng; Ng, Esperanza Debby; Lau, Ying; Dennis, Cindy-Lee

2018-03-14

Multiple international agencies, including the World Health Organization and the International Monetary Fund, have emphasized the importance of maternal mental health for optimal child health and development. Adequate social support is vital for the most vulnerable to postpartum mood disorders. Hence, an urgent need for sustainable social support programs to aid mothers ease into their new parenting role exists. This study protocol aims to examine the effectiveness of a technology-based peer support intervention program among mothers at risk for postnatal depression in the early postpartum period. A randomized controlled 2-group pretest and repeated posttest experimental design will be used. The study will recruit 118 mothers from the postnatal wards of a tertiary public hospital in Singapore. Eligible mothers will be randomly allocated to receive either the peer support intervention program or routine perinatal care from the hospital. Peer volunteers will be mothers who have experienced self-reported depression and will be receiving face-to-face training to support new mothers at risk of depression. Outcome measures include postnatal depression, anxiety, loneliness, and social support. Data will be collected at immediate postnatal period (day of discharge from the hospital), at fourth week and twelfth week post childbirth. The recruitment and training of peer support volunteers (N=20) ended in June 2017, whereas recruitment of study participants commenced in July 2017 and is still ongoing. The current recruitment for new mothers stands at 73, with 36 in the control group and 37 in the intervention group. Data collection is projected to be completed by May 2018. This study will identify a potentially effective and clinically useful method to prevent postnatal depression in new mothers, which is the top cause of maternal morbidity. Receiving social support from others who share similar experiences may enhance the positive parenting experiences of mothers, which in turn can improve the psychosocial well-being of the mothers, tighten mother-child bond, and enhance overall family dynamics for mothers and infants. International Standard Randomized Controlled Trial Number ISRCTN14864807; http://www.isrctn.com/ISRCTN14864807 (Archived by WebCite at http://www.webcitation.org/6xtBNvBTX). ©Shefaly Shorey, Cornelia Chee, Yap-Seng Chong, Esperanza Debby Ng, Ying Lau, Cindy-Lee Dennis. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 14.03.2018.

Risk Factors for Substance Misuse and Adolescents’ Symptoms of Depression

PubMed Central

Siennick, Sonja E.; Widdowson, Alex O.; Woessner, Mathew K.; Feinberg, Mark E.; Spoth, Richard L.

2016-01-01

Purpose Depressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse. Methods The study used data from a place-randomized trial of the PROSPER (PROmoting School-Community-University Partnerships to Enhance Resilience) model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey and social network data from 636 adolescents followed from 6th through 9th grades. Results When adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts. Conclusions The PROSPER interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse. PMID:27751712

Preventing substance use among early Asian-American adolescent girls: initial evaluation of a web-based, mother-daughter program.

PubMed

Fang, Lin; Schinke, Steven P; Cole, Kristin C A

2010-11-01

This study examined the efficacy and generalizability of a family-oriented, web-based substance use prevention program to young Asian-American adolescent girls. Between September and December 2007, a total of 108 Asian-American girls aged 10-14 years and their mothers were recruited through online advertisements and from community service agencies. Mother-daughter dyads were randomly assigned to an intervention arm or to a test-only control arm. After pretest measurement, intervention-arm dyads completed a 9-session web-based substance use prevention program. Guided by family interaction theory, the program aimed to improve girls' psychological states, strengthen substance use prevention skills, increase mother-daughter interactions, enhance maternal monitoring, and prevent girls' substance use. Study outcomes were assessed using generalized estimating equations. At posttest, relative to control-arm girls, intervention-arm girls showed less depressed mood; reported improved self-efficacy and refusal skills; had higher levels of mother-daughter closeness, mother-daughter communication, and maternal monitoring; and reported more family rules against substance use. Intervention-arm girls also reported fewer instances of alcohol, marijuana, and illicit prescription drug use, and expressed lower intentions to use substances in the future. A family-oriented, web-based substance use prevention program was efficacious in preventing substance use behavior among early Asian-American adolescent girls. Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

[Anxiety-depressive disorders in elderly migrants of the far north in the period of re-adaptation to new climatic conditions].

PubMed

Iaskevich, R A; Khamnagadaev, I I; Dereviannykh, E V; Polikarpov, L S; Gogolashvili, N G; Taptygina, E V

2014-01-01

The article presents the results of studies of the anxious and depressed characteristics in elderly migrants of the Far North with arterial hypertension in the period of their stay in new climatic conditions with regard to their North experience, gender, age and timing of rehabilitation. There was a high frequency of disturbing-depressive symptomatology of the surveyed migrants in the Far North, the frequency and severity of which increases with age; women migrants of Far North are prone to depression 1,8 times, anxiety--3,2 times more often than men. With the increase of the period of stay in the new climate and geographical conditions, the severity and frequency of occurrence of anxiety and depression increase. The obtained results should be taken into account when building rehabilitation program and forecasting its effectiveness, while conducting psychotherapy and psychological prevention in this group of patients.

Depression, Compulsive Sexual Behavior, and Sexual Risk-Taking Among Urban Young Gay and Bisexual Men: The P18 Cohort Study.

PubMed

Storholm, Erik David; Satre, Derek D; Kapadia, Farzana; Halkitis, Perry N

2016-08-01

Young gay, bisexual, and other men who have sex with men (YMSM) are at increased likelihood of experiencing depression and engaging in condomless sexual behaviors. The goal of the current investigation was to examine the relationship between negative mood and compulsive sexual behavior (CSB) and to assess for their individual and combined influence on sexual risk-taking behavior among a diverse sample of YMSM in New York City (the P18 Cohort Study). We first analyzed sociodemographic, depressive symptoms, CSB, and sexual risk-taking from the cross-sectional data of 509, 18- or 19-year-old YMSM recruited using non-probability sampling. We found a significant positive correlation between CSB and depression and between CSB and frequency of condomless anal sex acts reported over the last 30 days. Multivariate results found that the presence of both depression and CSB contributed to elevated sexual risk-taking among these urban YMSM. Clinical implications include the importance of assessing for CSB when depression is present and vice versa in order to improve HIV prevention. Informed by minority stress theory and syndemic theory, our results suggest that interventions focused on the health of YMSM recognize that mental health and social context all interact to increase physical health vulnerability vis-a-vis sexual behaviors, depression, and CSB. Thus, HIV prevention and intervention programs need to incorporate mental health components and services that address these needs.

Depression, Compulsive Sexual Behavior, and Sexual Risk-Taking Among Urban Young Gay and Bisexual Men: The P18 Cohort Study

PubMed Central

Storholm, Erik David; Satre, Derek D.; Kapadia, Farzana; Halkitis, Perry N.

2015-01-01

Young gay, bisexual, and other men who have sex with men (YMSM) are at increased likelihood of experiencing depression and condomless sexual behaviors The goal of the current investigation was to examine the relationship between negative mood and compulsive sexual behavior (CSB) and to assess for their individual and combined influence on sexual risk-taking behavior among a diverse sample of YMSM in New York City (the P18 Cohort Study). We first analyzed sociodemographic, depressive symptoms, CSB, and sexual risk-taking from the cross-sectional data of 509, 18- or 19-year-old YMSM recruited using non-probability sampling. We found a significant positive correlation between CSB and depression and between CSB and frequency of condomless anal sex acts reported over the past 30 days. Multivariate results found that the presence of both depression and CSB contributed to elevated sexual risk-taking among these urban YMSM. Clinical implications include the importance of assessing for CSB when depression is present and vice versa in order to improve HIV prevention. Informed by Minority Stress Theory and Syndemic Theory, our results suggest that interventions focused on the health of YMSM recognize that mental health, CSB and social context all interact to increase physical health vulnerability vis-a-vis sexual behaviors, depression, and CSB. Thus, HIV prevention and intervention programs need to incorporate mental health components and services that address these needs. PMID:26310878

Developing a Web-Based Intervention to Prevent Drug Use among Adolescent Girls

PubMed Central

Schwinn, Traci Marie; Hopkins, Jessica Elizabeth; Schinke, Steven Paul

2014-01-01

Objectives Girls’ rates of drug use have met up with, and in some instances, surpassed boys’ use. Though girls and boys share risk and protective factors associated with drug use, girls also have gender-specific risks. Interventions to prevent girls’ drug use must be tailored to address the dynamics of female adolescence. Methods One such intervention, called RealTeen, is a 9-session, web-based drug abuse prevention program designed to address such gender-specific risk factors associated with young girls’ drug use as depressed mood, low self-esteem, and high levels of perceived stress as well as general drug use risk factors of peer and social influences. Web-based delivery enables girls to interact with the program at their own pace and in a location of their choosing. Implications This paper describes the processes and challenges associated with developing and programming a gender-specific, web-based intervention to prevent drug use among adolescent girls. PMID:26778909

Depression Prevention Research: Design, Implementation, and Analysis of Randomized Trials.

ERIC Educational Resources Information Center

Munoz, Ricardo F.; And Others

This document contains three papers concerned with prevention intervention research, a new area of depression research which has shown great promise for contributing new knowledge to the understanding of depression. The first paper, "Clinical Trials vs. Prevention Trials: Methodological Issues in Depression Research" (Ricardo F. Munoz), emphasizes…

The Trauma of Adolescent Suicide: A Time for Special Leadership by Principals.

ERIC Educational Resources Information Center

Dempsey, Richard A.

This monograph provides principals and school officials with information about coping with adolescent suicide. Section 1, "Introduction," discusses the uncomfortable nature of the topic, cites statistics, and recommends that preventive programs be developed. Section 2, "Causes of Suicide," analyzes stress and depression among youth and suggests…

Postpartum bonding: the impact of maternal depression and adult attachment style.

PubMed

Nonnenmacher, N; Noe, D; Ehrenthal, J C; Reck, C

2016-10-01

Maternal depression poses a risk for the developing mother-infant relationship. Similarly, maternal insecure attachment styles may limit the ability to adequately connect with the newborn during the postpartum period. The aim of this study was to investigate the effect of maternal depression and insecure attachment (insecure and dual/disorganized) on maternal bonding in a sample of n = 34 women with depression according to DSM-IV and n = 59 healthy women. Maternal depression was assessed 3 to 4 months postpartum with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), bonding with the Postpartum Bonding Questionnaire, and maternal attachment style with the Attachment Style Interview. Women with current and lifetime depression as well as women with dual/disorganized attachment style reported lower bonding. Explorative analysis revealed that depression partially mediated the link between dual/disorganized attachment style and bonding with a medium-sized mediation effect. The combination of maternal depression and dual/disorganized attachment style may pose a special risk constellation for the developing mother-infant bond that should be addressed in prevention and early intervention programs.

Factors associated with higher levels of depressive symptoms among international university students in the Philippines.

PubMed

Lee, Romeo B; Maria, Madelene Sta; Estanislao, Susana; Rodriguez, Cristina

2013-11-01

Over the years, the number of international university students has been increasing in the Philippines. Depression tends to be common among this demographic sector, because of the varying challenges and expectations associated with studying abroad. Depression can be prevented if its symptoms, particularly those at higher levels, are identified and addressed early and effectively. This survey examined the social and demographic factors that are significantly associated with higher levels of depressive symptoms. One hundred twenty-six international university students were interviewed using the University Students Depression Inventory. Of the 13 factors analyzed, 3 were found with statistically significant associations with more intense levels of depressive symptoms. These factors were: level of satisfaction with one's financial condition, level of closeness with parents, and level of closeness with peers. In identifying international students with greater risk for depression, characteristics related to their financial condition and primary group relationships can be considered. There is a need to carry out more studies to confirm this initial evidence. The findings can help guide further discourse, research and program to benefit international students with higher levels of depressive symptoms.

Family-centered prevention ameliorates the longitudinal association between risky family processes and epigenetic aging.

PubMed

Brody, Gene H; Yu, Tianyi; Chen, Edith; Beach, Steven R H; Miller, Gregory E

2016-05-01

Research has suggested that 'risky' family processes have unforeseen negative consequences for health later in life. The purpose of this study was to further understanding of risky family environments and development of health vulnerabilities by (a) examining the likelihood that elevated levels of parental depressive symptoms when children are age 11 forecast accelerated epigenetic aging 9 years later at age 20; (b) determining whether participation in an efficacious family-centered prevention program focused on enhancing supportive parenting and strengthening family relationships will ameliorate this association; and (c) testing a moderation-mediation hypothesis that prevention-induced reductions in harsh parenting across adolescence will account for prevention effects in reducing accelerated epigenetic aging. In the rural southeastern United States, parents and 11-year-old children from 399 families participated in the Strong African American Families (SAAF) program or a control condition. Parents reported their own depressive symptoms when their children were 11, and both youths and parents reported youth exposure to harsh parenting at ages 11 and 16. Blood was drawn from youths at age 20 to measure accelerated epigenetic aging using a marker derived from the DNA methylation of cells. Elevated parental depressive symptoms forecast accelerated epigenetic aging among youths in the control condition, but not among SAAF participants. Moderated-mediation analyses confirmed that reductions in harsh parenting accounted for SAAF's protective effects on epigenetic aging. Subsequent exploratory analyses indicated that accelerated epigenetic aging forecast emotional distress among young adults in the control condition but not among those who participated in SAAF. This study is unique in using a randomized prevention trial to test hypotheses about the ways risky family processes contribute to accelerated epigenetic aging. The results suggest that developmentally appropriate family-centered interventions designed to enhance parenting and strengthen families can buffer the biological residue of life in a risky family. © 2015 Association for Child and Adolescent Mental Health.

Adolescent preventive health and team-games-tournaments: five decades of evidence for an empirically based paradigm.

PubMed

Wodarski, John S; Feit, Marvin D

2011-01-01

The problematic behaviors of teenagers and the subsequent negative consequences are extensive and well documented: unwanted pregnancy, substance abuse, violent behavior, depression, and social and psychological consequences of unemployment. In this article, the authors review an approach that uses a cooperative learning, empirically based intervention that employs peers as teachers. This intervention of choice is Teams-Games-Tournaments (TGT), a paradigm backed by five decades of empirical support. The application of TGT in preventive health programs incorporates elements in common with other prevention programs that are based on a public health orientation and constitute the essential components of health education, that is, skills training and practice in applying skills. The TGT intervention supports the idea that children and adolescents from various socioeconomic classes, between the ages of 8 and 18 and in classrooms or groups ranging in size from 4 to 17 members, can work together for one another. TGT has been applied successfully in such diverse areas as adolescent development, sexuality education, psychoactive substance abuse education, anger control, coping with depression and suicide, nutrition, comprehensive employment preparation, and family intervention. This article reviews the extensive research on TGT using examples of successful projects in substance abuse, violence, and nutrition. Issues are raised that relate to the implementation of preventive health strategies for adolescents, including cognitive aspects, social and family networks, and intervention components.

Collecting mortality data to drive real-time improvement in suicide prevention.

PubMed

Ahmedani, Brian K; Coffey, Justin; Coffey, C Edward

2013-11-01

To evaluate the use of government mortality records compared with internally collected data to drive quality improvement in suicide prevention programs using suicide mortality data from the Perfect Depression Care initiative. Perfect Depression Care (PDC) is a quality improvement suicide prevention initiative within the Behavioral Health Services (BHS) division of the Henry Ford Health System. Eligible subjects were all patients who received services from BHS, were members of the health maintenance organization, and had a medical group physician during the 11-year study period. Mortality data were collected internally and from government-collected death records, and were linked to treatment utilization data from the medical record. The mean suicide rate was 96.6 per 100,000 during the 2-year baseline period (1999- 2000) and declined to 19.1 per 100,000 during the initiative (2002-2009) using both sources of data combined. We observed a similar statistically significant (P <.001) reduction in the suicide death rate using both the internal and government data sources. There were no significant differences between the 2 sources of data in the mean suicide rates for the baseline and intervention periods (P >.05). The data sources did differ in the capture of unique suicide deaths. Internally collected data were an effective measure of suicide deaths in the PDC initiative. A combination of internal and government-collected records may be most effective for future suicide prevention programs.

[Gender difference in risk factors for depression in community-dwelling elders].

PubMed

Kim, Chul-Gyu; Park, Seungmi

2012-02-01

This study was conducted to compare the degree of depression between men and women and to identify factors influencing their depression. Participants in this cross-sectional descriptive study were 263 persons over 65 years old (men: 103, women: 160). Data were collected through face to face interviews using questionnaires and were done in two urban areas in 2010. Research instruments utilized in this study were SGDS, MMSE-K, SRH, FILE, sleep pattern scale, family and friend support scale, and social support scale. Multivariate regression analysis was performed to identify factors influencing depression in elders. The proportions of participants with depression were significantly different between men and women (52.4% vs. 67.5%). Regression model for depression in elderly men significantly accounted for 54%; disease stress (32%), economic stress (10%), perceived health status (4%), and family support, educational level, age, and hypertension. Regression model for depression in elderly women significantly accounted for 47%; disease stress (25%), perceived social loneliness (8%), friend support (5%), family stress (4%), and sleep satisfaction, and family support. Results demonstrate that depression is an important health problem for elders, and show gender differences for factors influencing depression. These results could be used in the developing depression prevention programs.

Positive Impact of Social Media Use on Depression in Cancer Patients

PubMed

Farpour, Hamid Reza; Habibi, Leila; Owji, Seyed Hossein

2017-11-26

Objective: The focus of attention was the prevalence of depression among cancer patients using social networks. An attempt was made to determine if social media could help cancer patients overcome their stress and depression, causes of serious emotional and mental problems for them and their families. Methods: To ascertain the prevalence of depression among cancer patients with reference to use of social networks, 316 cancer patients in the Association of Cancer Patients and cancer-related centers in Tehran at 2015 were evaluated. Depression was measured using the Beck Depression Inventory. Data were analyzed by the Chi-square test with SPSS software. Results: Using the Beck criteria, 61% (N=192) of patients were depressed. Interestingly, a significant difference was observed between depression in users and non-users of social networks (p=0.001), 33.9% and 66.1% being affected, respectively. Conclusion: These results verified a high incidence of depression in cancer patients, but a beneficial effect of social network use. Therefore access to social networks should be promoted for prevention and amelioration of depression. Moreover, it is recommended that particular attention be paid to the patient sex and educational level in designing counseling and psychological skill training programs. Creative Commons Attribution License

Prevalence and treatment coverage for depression: a population-based survey in Vidarbha, India.

PubMed

Shidhaye, Rahul; Gangale, Siddharth; Patel, Vikram

2016-07-01

VISHRAM is a community-based mental health program to address psycho-social distress and risk factors for suicide in a predominantly rural population in Central India, through targeted interventions for the prevention and management of Depression and Alcohol Use Disorders (AUD). The evaluation was designed to assess the impact of program on the contact coverage of evidence-based treatments for depression and AUD through a repeated survey design. This paper describes the baseline prevalence of depression among adults in rural community, association of various demographic and socio-economic factors with depression and estimates contact coverage and costs of care for depression. Population-based cross-sectional survey of adults in 30 villages of Amravati district in Vidarbha region of Central India. The outcome of interest was a probable diagnosis of depression which was measured using the Patient Health Questionnaire (PHQ-9). Data were analyzed using simple and multiple logistic regression. The outcome of current depression (PHQ-9 ≥ 10) was observed in 14.6 % of the sample (95 % CI 12.8-16.4 %). The contact coverage for current depression was only 4.3 % (95 % CI 1.5-7.1 %). Prevalence of depression varied greatly between the two sites of the study; higher age, female gender, lower education, economic status below poverty line and indebtedness were associated with depression; and while a contact coverage with formal health care was very low, a large proportion of affected persons had consulted family members. Our findings clearly indicate that psycho-social distress in rural communities in Maharashtra is strongly associated with social determinants such as gender, poverty and indebtedness and affects the entire population and not just farmers.

Correlates of Mental Depression Among Female Sex Workers in Southern India.

PubMed

Patel, Sangram Kishor; Saggurti, Niranjan; Pachauri, Saroj; Prabhakar, Parimi

2015-11-01

Mental health is an integral part of overall health status but has been a largely neglected issue in the developing world especially among female sex workers (FSWs). This study examines the prevalence and correlates of major depression among FSWs in southern India. Major depression was assessed using Patient Health Questionnaire-2 depression scale data from a cross-sectional Behavioral Tracking Survey, 2010-2011 conducted among FSWs (n = 1986) in Andhra Pradesh, a state in southern India. Almost two-fifths of FSWs (39%) reported major depression. Multivariate logistic regression analysis shows a significant association between major depression and the following characteristics for FSWs: low autonomy, alcohol use, experience of violence, police arrest, inconsistent condom use with clients, mobility for sex work, and being HIV positive or not wanting to disclose HIV status. Research and advocacy efforts are needed to ensure that the mental health issues of marginalized groups are appropriately addressed in HIV prevention programs. © 2015 APJPH.

Depression in women in Indian context.

PubMed

Bohra, Neena; Srivastava, Shruti; Bhatia, M S

2015-07-01

The estimate of the global burden of disease predicts that depression will be the second-leading cause of disability worldwide by 2020. Depression is widely prevalent in women in all age groups especially in India where 1.2 billion population lives. In the current scenario of underdiagnosed, untreated cases of females suffering from depression, the hurdles faced by Indian women include inadequate number of mental health professionals, lack of awareness, stigma, disadvantaged position of women, multiple roles, increased levels of stress, and domestic violence. The literature search included an electronic database, published materials, and standard textbooks. The authors have provided a brief overview of different types of depression in females. Epidemiology, etiology, clinical presentation, and management linked to the reproductive cycle of women have been covered. Awareness through public education, early detection, organized national mental health programs, comprehensive management, with judicious utilization of the limited resources would tackle the rising number of cases of female depression, in a cost effective manner, thereby preventing suicide.

Preventing Mania: A Preliminary Examination of the GOALS Program

PubMed Central

Johnson, Sheri L.; Fulford, Daniel

2010-01-01

There is strong evidence of a relationship between goal dysregulation and mania. Building on these findings, we examined the feasibility of developing a mania prevention treatment program designed to improve goal regulation skills for those with bipolar disorder. Here, we describe the process of developing a manual, delivering the intervention to a series of cases, and then conducting a small open uncontrolled trial. All participants met diagnostic criteria for bipolar I disorder based on the Structured Clinical Interview for DSM-IV and were not currently experiencing episodes of depression or mania. Ten participants (8 female, mean age = 46.7 years) were enrolled in the GOALS program and completed an average of 13.2 weekly sessions. Participants were administered the Bech-Rafaelson Mania Scale (BRMS) and the Modified Hamilton Rating Scale for Depression at baseline and termination. Some participants completed self-report scales including the Altman Self-Rating Mania Scale, the Beck Depression Inventory, and the Willingly Approached Set of Statistically Unrealistic Pursuits at baseline and termination. In addition, participants were administered a consumer satisfaction questionnaire at termination. At termination, all 10 participants found the program highly relevant and helpful. Most importantly, even though levels of mania were low initially, mean levels of manic symptoms on the BRMS decreased significantly from baseline to termination, and all 10 participants were within a healthy range (BRMS <7) at termination. Although the lack of control group or follow-up data limits this study, preliminary evidence suggests that it is feasible to identify treatment targets by drawing from the basic research literature in bipolar disorder. Findings await replication and more careful testing within a randomized controlled trial. PMID:19433142

Community-based primary prevention programs decrease the rate of metabolic syndrome among socioeconomically disadvantaged women.

PubMed

Gilstrap, Lauren Gray; Malhotra, Rajeev; Peltier-Saxe, Donna; Slicas, Donna; Pineda, Eliana; Culhane-Hermann, Catherine; Cook, Nakela; Fernandez-Golarz, Carina; Wood, Malissa

2013-04-01

Metabolic Syndrome (MetSyn) is one of the strongest predictors of type 2 diabetes (DM2) and cardiovascular disease (CVD). It is associated with a 4- to 10-fold increased risk of DM2 and a 2- to 3-fold increased risk of CVD. Low income and minority women have some of the highest rates of MetSyn. This study examines the effect of a unique, community based, primary prevention program on the rates of MetSyn and health habits. Sixty-four low income and minority women were enrolled in the HAPPY (Health Awareness and Primary Prevention in Your neighborhood) Heart Program in an eastern suburb of Boston. Over these 2 years, patients were evaluated by an interdisciplinary medical team: their primary physician, cardiologist, nutritionist, physical therapist, and health coach. The rate of MetSyn was measured at baseline, year 1, and year 2. Comparisons were made either using the paired t test for normally distributed variables or the Wilcoxon Sign test for non-normal variables. The rate of MetSyn fell from 64.7% at baseline to 34.9% at year 1 (p=0.01) and 28.2% at year 2 (p<0.001). This was driven by increases in high-density lipoprotein (HDL-C) (p<0.001) and decreases in blood pressure (p=0.05). Fasting blood glucose trended down, but the hemoglobin A1c (HbA1c) reached significance (decreasing from 6 to 5.8, p<0.01). Nutrition and exercise habits trended toward improvement. There were significant decreases in anxiety (p<0.001), depression (p=0.006) and stress (p=0.002). This lifestyle intervention program is effective at decreasing MetSyn in a socioeconomically disadvantaged, largely minority, female population. This program also decreases anxiety, stress, and depression among participants.

The SOS Suicide Prevention Program: Further Evidence of Efficacy and Effectiveness.

PubMed

Schilling, Elizabeth A; Aseltine, Robert H; James, Amy

2016-02-01

This study replicated and extended previous evaluations of the Signs of Suicide (SOS) prevention program in a high school population using a more rigorous pre-test post-test randomized control design than used in previous SOS evaluations in high schools (Aseltine and DeMartino 2004; Aseltine et al. 2007). SOS was presented to an ethnically diverse group of ninth grade students in technical high schools in Connecticut. After controlling for the pre-test reports of suicide behaviors, exposure to the SOS program was associated with significantly fewer self-reported suicide attempts in the 3 months following the program. Ninth grade students in the intervention group were approximately 64% less likely to report a suicide attempt in the past 3 months compared with students in the control group. Similarly, exposure to the SOS program resulted in greater knowledge of depression and suicide and more favorable attitudes toward (1) intervening with friends who may be exhibiting signs of suicidal intent and (2) getting help for themselves if they were depressed or suicidal. In addition, high-risk SOS participants, defined as those with a lifetime history of suicide attempt, were significantly less likely to report planning a suicide in the 3 months following the program compared to lower-risk participants. Differential attrition is the most serious limitation of the study; participants in the intervention group who reported a suicide attempt in the previous 3 months at baseline were more likely to be missing at post-test than their counterparts in the control group.

Web-Based Tools and Mobile Applications To Mitigate Burnout, Depression, and Suicidality Among Healthcare Students and Professionals: a Systematic Review.

PubMed

Pospos, Sarah; Young, Ilanit Tal; Downs, Nancy; Iglewicz, Alana; Depp, Colin; Chen, James Y; Newton, Isabel; Lee, Kelly; Light, Gregory A; Zisook, Sidney

2018-02-01

Being a healthcare professional can be a uniquely rewarding calling. However, the demands of training and practice can lead to chronic distress and serious psychological, interpersonal, and personal health burdens. Although higher burnout, depression, and suicide rates have been reported in healthcare professionals, only a minority receive treatment. Concerns regarding confidentiality, stigma, potential career implications, and cost and time constraints are cited as key barriers. Web-based and mobile applications have been shown to mitigate stress, burnout, depression, and suicidal ideation among several populations and may circumvent these barriers. Here, we reviewed published data on such resources and selected a small sample that readily can be used by healthcare providers. We searched PubMed for articles evaluating stress, burnout, depression, and suicide prevention or intervention for healthcare students or providers and identified five categories of programs with significant effectiveness: Cognitive Behavioral Therapy (online), meditation, mindfulness, breathing, and relaxation techniques. Using these categories, we searched for Web-based (through Google and beacon.anu.edu.au -a wellness resource website) and mobile applications (Apple and mobile. va.gov/appstore ) for stress, burnout, depression, and suicide prevention and identified 36 resources to further evaluate based on relevance, applicability to healthcare providers (confidentiality, convenience, and cost), and the strength of findings supporting their effectiveness. We selected seven resources under five general categories designed to foster wellness and reduce burnout, depression, and suicide risk among healthcare workers: breathing (Breath2Relax), meditation (Headspace, guided meditation audios), Web-based Cognitive Behavioral Therapy (MoodGYM, Stress Gym), and suicide prevention apps (Stay Alive, Virtual Hope Box). This list serves as a starting point to enhance coping with stressors as a healthcare student or professional in order to help mitigate burnout, depression, and suicidality. The next steps include adapting digital health strategies to specifically fit the needs of healthcare providers, with the ultimate goal of facilitating in-person care when warranted.

Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression: randomized controlled trial design and protocol

PubMed Central

2011-01-01

Background Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The major contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Accordingly, efforts to reduce the disabling effects of this chronic condition should shift to preventing recurrence, especially in patients at high risk of recurrence. Given its high prevalence and the fact that interventions are necessary during the remitted phase, new approaches are needed to prevent relapse in depression. Methods/design The best established effective and available psychological intervention is cognitive therapy. However, it is costly and not available for most patients. Therefore, we will compare the effectiveness and cost-effectiveness of self-management supported by online CT accompanied by SMS based tele-monitoring of depressive symptomatology, i.e. Mobile Cognitive Therapy (M-CT) versus treatment as us usual (TAU). Remitted patients (n = 268) with at least two previous depressive episodes will be recruited and randomized over (1) M-CT in addition to TAU versus (2) TAU alone, with follow-ups at 3, 12, and 24 months. Randomization will be stratified for number of previous episodes and type of treatment as usual. Primary outcome is time until relapse/recurrence over 24 months using DSM-IV-TR criteria as assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). For the economic evaluation the balance between costs and health outcomes will be compared across strategies using a societal perspective. Discussion Internet-based interventions might be helpful in empowering patients to become their own disease managers in this lifelong recurrent disorder. This is, as far as we are aware of, the first study that examines the (cost) effectiveness of an E-mental health program using SMS monitoring of symptoms with therapist support to prevent relapse in remitted recurrently depressed patients. Trial registration Netherlands Trial Register (NTR): NTR2503 PMID:21235774

Adolescent Risk: The Co-Occurrence of Illness, Suicidality, and Substance Use

ERIC Educational Resources Information Center

Husler, Gebhard; Blakeney, Ronny; Werlen, Egon

2005-01-01

Illness is rarely considered a "risk factor" in adolescence. This study tests illness, suicidality and substance use as outcome measures in a path analysis of 1028 Swiss adolescents in secondary prevention programs. The model showed that negative mood (depression and anxiety) predicted two paths. One path led from negative mood to…

Prenatal Predictors of Maternal Attachment and Their Association with Postpartum Depressive Symptoms in Mexican Women at Risk of Depression.

PubMed

Nieto, Lourdes; Lara, Ma Asunción; Navarrete, Laura

2017-06-01

Objectives Although maternal attachment is an important predictor of infant developmental outcomes, little is known about its pre- and postnatal predictors. The purpose of this secondary data analysis is to assess several risk factors for maternal attachment at 6 months postpartum in a sample of Mexican women at risk of depression. The predictors included were prenatal depressive symptoms, pregnancy intendedness, partner relationship, social support, maternal history of childhood sexual abuse, and postpartum depressive symptoms. Methods A total of 156 pregnant women seeking antenatal care at three health centers were selected because they displayed depressive symptoms (CES-D ≥ 16) or had previously suffered depression. Women were interviewed during pregnancy and at 6 months postpartum. A step-wise multivariate logistic regression was conducted to evaluate the pre- and postpartum risk factors for postpartum depression related to low maternal attachment. Results Pre- and postpartum depressive symptoms increased the risk of low maternal attachment by factors of 3.00 and 3.97, respectively, compared with women who did not present these symptoms; low level of adjustment with the partner increased the risk by a factor of 3.11, low social support by a factor of 2.90, and CSA by a factor of 2.77. Conclusions for practice Prevention programs during pregnancy to reduce depressive symptoms should strengthen strategies to promote maternal attachment by improving partner relations and increasing social support. However, evidence shows that such programs alone are insufficient, so direct interventions should also be implemented. Women with a history of childhood sexual abuse should be given additional attention during prenatal care.

The associations between aggressive behaviors and internet addiction and online activities in adolescents.

PubMed

Ko, Chih-Hung; Yen, Ju-Yu; Liu, Shu-Chun; Huang, Chi-Fen; Yen, Cheng-Fang

2009-06-01

To evaluate (a) the association between Internet addiction and aggressive behaviors, as well as the moderating effects of gender, school, and depression on this association; and (b) to evaluate the association between Internet activities and aggressive behaviors. A total of 9405 adolescents were recruited into this study and completed the questionnaires. Their aggressive behaviors, with or without Internet addiction, Internet activities, demographic data, with or without depression, self-esteem, family function, and the watching of violent TV were assessed. The results demonstrated that after controlling for the effects of shared associated factors and watching violent TV programs, adolescents with Internet addiction were more likely to have aggressive behaviors during the previous year. The association was more significant among adolescents in junior high schools than in senior high/vocational schools. Online chatting, adult sex Web viewing, online gaming, online gambling, and Bulletin Board System were all associated with aggressive behaviors. The results suggest that preventive programs for aggressive behaviors should pay attention to Internet addiction among adolescents. Also, intervention to prevent the effects of Internet addiction on aggressive behaviors should be conducted as early as possible.

Risk Factors for Substance Misuse and Adolescents' Symptoms of Depression.

PubMed

Siennick, Sonja E; Widdowson, Alex O; Woessner, Mathew K; Feinberg, Mark E; Spoth, Richard L

2017-01-01

Depressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse. The study used data from a place-randomized trial of the Promoting School-Community-University Partnerships to Enhance Resilience model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey, and social network data from 636 adolescents followed from sixth through ninth grades. When adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts. The Promoting School-Community-University Partnerships to Enhance Resilience interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

[Effect of cognitive stimulation in elderly community].

PubMed

Apóstolo, João Luís Alves; Cardoso, Daniela Filipa Batista; Paúl, Constança; Rodrigues, Manuel Alves; Macedo, Marinha Sofia

2016-01-01

To demonstrate that the implementation of the Cognitive Stimulation (CS) program 'Making a Difference' (MD) improves cognition and depressive symptoms in retired community elders. This was a multicenter quasi-experimental study of 45 community dwelling elders (38 women and 7 men), with a mean age of 75.29, from 3 day-care centers in rural, semi-rural and urban environments in the central region of Portugal. Participants attended 14 sessions twice a week over seven weeks. The Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale (GDS-15) were administered at the following three time points: baseline, post-test, and follow-up. From baseline to post-test, there is a statistically significant difference in depressive symptoms (F=7.494; P=.010) explaining 21% of the variance (partial eta squared [ηp(2)]=.21), power=.75, but there is no statistically significant difference in cognition. From post-test to follow-up, there is no difference in both cognition and depression outcomes. Our results showed improvement in elders' depressive symptoms after a seven weeks intervention program but it did not have a protective effect after the three months follow-up. No evidence was found for its efficacy in improving cognition. Cognitive stimulation may be a useful in preventing elder's depressive symptoms when included in their health promotion care plan. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Pilot Trial of Inpatient Cognitive Therapy for the Prevention of Suicide in Military Personnel with Acute Stress Disorder or Post-Traumatic Stress Disorder

DTIC Science & Technology

2010-08-01

Therapy (PACT) as a targeted inpatient treatment for individuals admitted for a recent suicide attempt to a military hospital . (2) To assess the... therapy (PACT). Invited presentation at the Department of Defense Suicide Prevention Research Program Working Group, Frederick, MD. Martin, J. S ...depressed and anxious outpatients. Cognitive Behaviour Therapy , 36, 170-178. Bhar, S ., Ghahramanlou-Holloway, M., Brown, G., & Beck, A. T. (2008). Self

Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members.

PubMed

Vyas, Kartavya J; Fesperman, Susan F; Nebeker, Bonnie J; Gerard, Steven K; Boyd, Nicholas D; Delaney, Eileen M; Webb-Murphy, Jennifer A; Johnston, Scott L

2016-10-01

The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately $196, $288, and $597 million in annual treatment costs, respectively, or approximately $1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Cross-Lagged Associations Between Adolescents' Depressive Symptoms and Negative Cognitive Style: The Role of Negative Life Events.

PubMed

Kindt, Karlijn C M; Kleinjan, Marloes; Janssens, Jan M A M; Scholte, Ron H J

2015-11-01

Previous research has established that cognitive theory-based depression prevention programs aiming change in negative cognitive style in early adolescents do not have strong effects in universal settings. Although theories suggest that a negative cognitive style precedes depressive symptoms, empirical findings are mixed. We hypothesized that negative cognitive style may not predict depressive symptoms in adolescents with normative depressive symptoms. Depressive symptoms, negative cognitive style and dependent negative life events were assessed in young adolescents (N = 1343; mean age = 13.4 years, SD = 0.77; 52.3 % girls) at four time points over an 18-month period. Using a cross-lagged panel design, results revealed that depressive symptoms predicted a negative cognitive style but not vice versa. However, when including dependent negative life events as a variable, depressive symptoms did not prospect a negative cognitive style consistently. When dependent negative life events were used as a time-varying covariate, depressive symptoms and a negative cognitive style were not related. We concluded that negative cognitive style is not predictive of depressive symptoms in a community sample of young adolescents. Moreover, the findings suggest that longitudinal relationships between depressive symptoms and a negative cognitive style are not meaningful when dependent negative life events are not considered.

The depression in women in pregnancy and postpartum period: A follow-up study.

PubMed

Kirkan, Tulay Sati; Aydin, Nazan; Yazici, Esra; Aslan, Puren Akcali; Acemoglu, Hamit; Daloglu, Ali Gokhan

2015-06-01

This was a follow-up study to determine postpartum depression (PPD) and its causes in a population previously evaluated in the first trimester of pregnancy. The study sample consisted of pregnant women who were evaluated in the first trimester and 360 women who were re-evaluated in the postpartum period. Detailed sociodemographic data were obtained from the women, and depression was assessed with the Edinburgh Postpartum Depression scale (EPDS) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I Disorders (SCID-I). In this follow-up study, the prevalence of PPD was 35% (n = 126). A depressive disorder in the first trimester of pregnancy, previous mental disorder, somatic disorder, exposure to domestic violence during pregnancy, baby's staying in the incubator and not breastfeeding were predictors of PPD. Exposure to violence and a history of previous depression predicted depression both in pregnancy and in the postpartum period. Depression rates are high in Eastern Turkey. Exposure to violence during pregnancy and the existence of a previous mental disorder were risk factors for perinatal depression in this study. Performing screening tests can identify women at risk of pregnancy-related depression. Prevention programs should be established in areas where the prevalence of depression is high. © The Author(s) 2014.

Assessment of the efficacy of a psychological treatment for women victims of violence by their intimate male partner.

PubMed

Crespo, María; Arinero, María

2010-11-01

This study evaluates the long-term efficacy of a brief psychotherapeutic cognitive-behavioral program in group format for female victims of violence by their intimate partner. 53 battered women were randomized into one of two intervention programs: one including among others exposure technique (n = 28) and another one in which exposure procedures were substituted by communication skills training (n = 25). Additionally, both programs included: psycho-education, breath control, training to improve self-esteem, cognitive restructuring, problem-solving, planning pleasant activities, and relapse prevention. The treatment was carried out in 8 weekly sessions. Measures of posttraumatic symptoms, anxiety, depression, self-esteem and anger expression were analyzed at pre- and post-treatment, and at 1-, 3-, 6- and 12-months follow-ups. Results show a pronounced decrease of posttraumatic, depressive and anxiety symptoms, which maintained in the different measure moments, with scarce difference between the two programs. The results and their clinical implications are discussed.

A Randomized Controlled Trial to Prevent Depression and Ameliorate Insulin Resistance in Adolescent Girls at Risk for Type 2 Diabetes.

PubMed

Shomaker, Lauren B; Kelly, Nichole R; Pickworth, Courtney K; Cassidy, Omni L; Radin, Rachel M; Shank, Lisa M; Vannucci, Anna; Thompson, Katherine A; Armaiz-Flores, Sara A; Brady, Sheila M; Demidowich, Andrew P; Galescu, Ovidiu A; Courville, Amber B; Olsen, Cara; Chen, Kong Y; Stice, Eric; Tanofsky-Kraff, Marian; Yanovski, Jack A

2016-10-01

Prospective data suggest depressive symptoms worsen insulin resistance and accelerate type 2 diabetes (T2D) onset. We sought to determine whether reducing depressive symptoms in overweight/obese adolescents at risk for T2D would increase insulin sensitivity and mitigate T2D risk. We conducted a parallel-group, randomized controlled trial comparing a 6-week cognitive-behavioral (CB) depression prevention group with a 6-week health education (HE) control group in 119 overweight/obese adolescent girls with mild-to-moderate depressive symptoms (Center for Epidemiological Studies-Depression Scale [CES-D] ≥16) and T2D family history. Primary outcomes were baseline to post-intervention changes in CES-D and whole body insulin sensitivity index (WBISI), derived from 2-h oral glucose tolerance tests. Outcome changes were compared between groups using ANCOVA, adjusting for respective baseline outcome, puberty, race, facilitator, T2D family history degree, baseline age, adiposity, and adiposity change. Multiple imputation was used for missing data. Depressive symptoms decreased (p < 0.001) in CB and HE from baseline to posttreatment, but did not differ between groups (ΔCESD = -12 vs. -11, 95 % CI difference = -4 to +1, p = 0.31). Insulin sensitivity was stable (p > 0.29) in CB and HE (ΔWBISI = 0.1 vs. 0.2, 95 % CI difference = -0.6 to +0.4, p = 0.63). Among all participants, reductions in depressive symptoms were associated with improvements in insulin sensitivity (p = 0.02). Girls at risk for T2D displayed reduced depressive symptoms following 6 weeks of CB or HE. Decreases in depressive symptoms related to improvements in insulin sensitivity. Longer-term follow-up is needed to determine whether either program causes sustained decreases in depressive symptoms and improvements in insulin sensitivity. The trial was registered with clinicaltrials.gov (NCT01425905).

Effects of Training Program on Recognition and Management of Depression and Suicide Risk Evaluation for Slovenian Primary-care Physicians: Follow-up Study

PubMed Central

Roškar, Saška; Podlesek, Anja; Zorko, Maja; Tavčar, Rok; Dernovšek, Mojca Zvezdana; Groleger, Urban; Mirjanič, Milan; Konec, Nuša; Janet, Evgen; Marušič, Andrej

2010-01-01

Aim To implement and evaluate an educational program for primary care physicians on recognition and treatment of depression and suicide prevention. Method The study was conducted in 3 Slovenian neighboring regions (Celje, Ravne na Koroškem, and Podravska) with similar suicide rates and other health indicators. All primary care physicians from Celje (N = 155) and Ravne na Koroškem (N = 35) were invited to participate in the educational program on depression treatment and suicide risk recognition. From January to March 2003, approximately half of them (82 out of 190; educational group) attended the program, whereas the other half (108 out of 190; control group 1) and physicians from the Podravska region (N = 164; control group 2) did not attend the program. The prescription rates of antidepressants and anxiolytics before and after the intervention were compared between the studied regions. Also, suicide rates three-years before and after the intervention were compared. Results From 2002 to 2003, there was a 2.33-fold increase in the rate of antidepressant prescriptions in the educational group (P < 0.05) and only 1.28-fold (P < 0.05) and 1.34-fold (P < 0.05) increase in control groups 1 and 2, respectively. However, the 12% decrease in suicide rate in the intervention regions was not significantly greater than the 4% decrease in the non-intervention region (P > 0.05). Conclusion Our training program was beneficial for primary care physicians’ ability to recognize and manage depression. However, there was no significant decrease in local suicide rates. PMID:20564767

Internet-based motivation program for women with eating disorders: eating disorder pathology and depressive mood predict dropout.

PubMed

von Brachel, Ruth; Hötzel, Katrin; Hirschfeld, Gerrit; Rieger, Elizabeth; Schmidt, Ulrike; Kosfelder, Joachim; Hechler, Tanja; Schulte, Dietmar; Vocks, Silja

2014-03-31

One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology. The aim of the present study was to identify predictors of dropout from this Web program. A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants' age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method. The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout. Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.

Internet-Based Motivation Program for Women With Eating Disorders: Eating Disorder Pathology and Depressive Mood Predict Dropout

PubMed Central

Hirschfeld, Gerrit; Rieger, Elizabeth; Schmidt, Ulrike; Kosfelder, Joachim; Hechler, Tanja; Schulte, Dietmar; Vocks, Silja

2014-01-01

Background One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology. Objective The aim of the present study was to identify predictors of dropout from this Web program. Methods A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants’ age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method. Results The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout. Conclusions Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment. PMID:24686856

A Depression Prevention Intervention for Adolescents in the Emergency Department.

PubMed

Ranney, Megan L; Freeman, Joshua R; Connell, Gerianne; Spirito, Anthony; Boyer, Edward; Walton, Maureen; Guthrie, Kate Morrow; Cunningham, Rebecca M

2016-10-01

To evaluate acceptability and feasibility of a theoretically based two-part (brief in-person + 8-week automated text message) depression prevention program, "intervention for DepressiOn and Violence prevention in the Emergency department" (iDOVE), for high-risk adolescents. English-speaking emergency department (ED) patients (age 13-17, any chief complaint) were sequentially approached for consent on a convenience sample of shifts and screened for inclusion based on current depressive symptoms and past-year violence. After consent, baseline assessments were obtained; all participants were enrolled in the two-part intervention (brief in-ED + 8-week two-way text messaging). At 8 weeks, quantitative and qualitative follow-up assessments were obtained. Measures included feasibility, acceptability, and preliminary data on efficacy. Qualitative data were transcribed verbatim, double coded, and interpreted using thematic analysis. Quantitative results were analyzed descriptively and with paired t tests. As planned, 16 participants (eight each gender) were recruited (75% of those who were eligible; 66% nonwhite, 63% low income, mean age 15.4). The intervention had high feasibility and acceptability: 93.8% completed 8-week follow-up; 80% of daily text messages received responses; 31% of participants requested ≥1 "on-demand" text message. In-person and text message portions were rated as good/excellent by 87%. Qualitatively, participants articulated: (1) iDOVE was welcome and helpful, if unexpected in the ED; (2) the daily text message mood assessment was "most important"; (3) content was "uplifting"; and (4) balancing intervention "relatability" and automation was challenging. Participants' mean ΔBDI-2 (Beck Depression Inventory) from baseline to 8-week follow-up was -4.9, (p = .02). This automated preventive text message intervention is acceptable and feasible. Qualitative data emphasize the importance of creating positive, relevant, and interactive digital health tools for adolescents. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A Meta-analysis of universal mental health prevention programs for higher education students.

PubMed

Conley, Colleen S; Durlak, Joseph A; Kirsch, Alexandra C

2015-05-01

This meta-analysis investigated the effectiveness of universal mental health prevention programs for higher education students on a range of adjustment outcomes. A systematic literature search identified 103 controlled published and unpublished interventions involving college, graduate, or professional students. As hypothesized, skill-training programs that included a supervised practice component were significantly more effective overall (mean effect size = 0.45, confidence interval (CI) = 0.39 to 0.52) compared to skill-training programs without supervised practice (0.11, CI = -0.01 to 0.22) and psychoeducational (information-only) programs (0.13, CI = 0.06 to 0.21). When comparisons on specific outcomes were possible, skill-training programs including supervised practice were significantly more effective than the other two groups of programs in reducing symptoms of depression, anxiety, stress, and general psychological distress, and in improving social-emotional skills, self-perceptions, and academic behaviors and performance. The magnitude of effects achieved in several outcome areas is comparable to or higher than that reported in other reviews of universal programs, suggesting that skill-training programs for higher education students that incorporate supervised practice now join the ranks of other effective preventive mental health interventions. This review offers several recommendations to improve the experimental rigor of future research.

Teen Depression and Suicide: Effective Prevention and Intervention Strategies

ERIC Educational Resources Information Center

King, Keith A.; Vidourek, Rebecca A.

2012-01-01

Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…

Academic psychiatry's responsibility for increasing the recognition of mood disorders and risk for suicide in primary care.

PubMed

Lake, Charles R; Baumer, Joanie

2010-03-01

The authors seek solutions to better meet the healthcare needs of depressed patients in primary care by improving the recognition of depression, other mood disorders and of a risk for suicide. For 25 years academic psychiatry and primary care have known that only 10-50% of depressed patients are adequately treated, primarily because of the failure to recognize depression. There are substantial negative consequences including suicide. Suicide occurs during depression so the recognition of depression is the critical first step to preventing suicide. Recently noted is that one barrier to recognition is the traditional, comprehensive, psychiatric interview taught in academic departments of psychiatry that is impractical in primary care settings because it takes too much time. Some brief, initial psychiatric techniques have been developed but these typically have been introduced in primary care training programs and not by departments of psychiatry. A verbal four-question, 90 s screen for depression may be acceptable for routine use in primary care because it typically requires only seconds to a few minutes. Introduction of such a screening instrument to medical students on psychiatry and primary care clerkships could increase the recognition of depression and reduce death by suicide.

Toward scientific equity for the prevention of depression and depressive symptoms in vulnerable youth.

PubMed

Perrino, Tatiana; Beardslee, William; Bernal, Guillermo; Brincks, Ahnalee; Cruden, Gracelyn; Howe, George; Murry, Velma; Pantin, Hilda; Prado, Guillermo; Sandler, Irwin; Brown, C Hendricks

2015-07-01

Certain subgroups of youth are at high risk for depression and elevated depressive symptoms, and experience limited access to quality mental health care. Examples are socioeconomically disadvantaged, racial/ethnic minority, and sexual minority youth. Research shows that there are efficacious interventions to prevent youth depression and depressive symptoms. These preventive interventions have the potential to play a key role in addressing these mental health disparities by reducing youth risk factors and enhancing protective factors. However, there are comparatively few preventive interventions directed specifically to these vulnerable subgroups, and sample sizes of diverse subgroups in general prevention trials are often too low to assess whether preventive interventions work equally well for vulnerable youth compared to other youth. In this paper, we describe the importance and need for "scientific equity," or equality and fairness in the amount of scientific knowledge produced to understand the potential solutions to such health disparities. We highlight possible strategies for promoting scientific equity, including the following: increasing the number of prevention research participants from vulnerable subgroups, conducting more data synthesis analyses and implementation science research, disseminating preventive interventions that are efficacious for vulnerable youth, and increasing the diversity of the prevention science research workforce. These strategies can increase the availability of research evidence to determine the degree to which preventive interventions can help address mental health disparities. Although this paper utilizes the prevention of youth depression as an illustrative case example, the concepts are applicable to other health outcomes for which there are disparities, such as substance use and obesity.

Emotional Awareness: A Transdiagnostic Risk Factor for Internalizing Symptoms in Children and Adolescents?

PubMed Central

Kranzler, Amy; Young, Jami F.; Hankin, Benjamin L.; Abela, John R. Z.; Elias, Maurice J.; Selby, Edward A.

2015-01-01

The current study used longitudinal data to examine the role of emotional awareness as a transdiagnostic risk factor for internalizing symptoms. Participants were 204 youth, ages 7 to 16, who completed assessments every three months for a year. Results from hierarchical mixed effects modeling indicated that low emotional awareness predicted both depressive and anxiety symptoms for up to one year follow-up. In addition, emotional awareness predicted which youth went on to experience subsequent increases in depressive and anxiety symptoms over the course of the year. Emotional awareness also mediated both the cross-sectional and the longitudinal associations between anxiety and depressive symptoms. These findings suggest that emotional awareness may constitute a transdiagnostic risk factor for the development and/or maintenance of symptoms of depression and anxiety, which has important implications for youth treatment and prevention programs. PMID:25658297

The Relationships Between Functional Limitation, Depression, Suicidal Ideation, and Coping in Older Korean Immigrants.

PubMed

Ahn, Joonhee; Kim, Bum Jung

2015-12-01

Older adults with functional limitations may be at higher risk for depression and suicidal ideation compared to their counterparts without such limits. This study examined the structural relationships between functional limitation, depression, suicidal ideation, and coping strategies in older Korean immigrants. Using data from 220 community dwelling Korean immigrants (age ≧ 65) in Los Angeles County, path analysis was conducted to test the study hypotheses. The resulting model accounted for 56% of the variance in suicidal ideation, with functional limitation making significant contribution to suicidal ideation. Meanwhile, depression, which had the strongest direct effects on suicidal ideation, also played a significant role in mediating between functional limitation and suicidal ideation. Furthermore, adaptive coping was significantly associated with both functional limitation and suicidal ideation. Findings provide implications for implementing suicide-prevention programs for older Korean immigrants, especially those living with functional disability.

Gender differences in the longitudinal structure of cognitive diatheses for depression in children and adolescents.

PubMed

Cole, David A; Jacquez, Farrah M; Truss, Alanna E; Pineda, Ashley Q; Weitlauf, Amy S; Tilghman-Osborne, Carlos E; Felton, Julia W; Maxwell, Melissa A

2009-12-01

In a school-based, four-wave, longitudinal study, children (grades 4-7) and young adolescents (grades 6-9) completed questionnaires measuring depressive symptoms and depressive cognitions, including positive and negative cognitions on the Cognitive Triad Inventory for Children (CTI-C; Kaslow, Stark, Printz, Livingston, & Tsai, 1992) and self-perceived competence on the Self-Perception Profile for Children (SPPC; Harter, 1985). Application of the Trait-State-Occasion model (Cole, Martin, & Steiger, 2005) revealed the existence of a time-invariant trait factor and a set of time-varying occasion factors. Gender differences emerged, indicating that some cognitive diatheses were more trait-like for girls than for boys (i.e., positive and negative cognitions on the CTI-C; self-perceived physical appearance and global self-worth on the SPPC). Implications focus on the emergent gender difference in depression, the design of longitudinal studies, and clinical decisions about the implementation of prevention versus intervention programs.

Can technology and the media help reduce dysfunctional parenting and increase engagement with preventative parenting interventions?

PubMed

Calam, Rachel; Sanders, Matthew R; Miller, Chloe; Sadhnani, Vaneeta; Carmont, Sue-Ann

2008-11-01

In an evaluation of the television series "Driving Mum and Dad Mad," 723 families participated and were randomly assigned to either a standard or technology enhanced viewing condition (included additional Web-support). Parents in both conditions reported significant improvements from pre- to postintervention in their child's behavior, dysfunctional parenting, parental anger, depression, and self-efficacy. Short-term improvements were maintained at 6-months follow-up. Regressions identified predictors of program outcomes and level of involvement. Parents who watched the entire series had more severe problems at preintervention and high sociodemographic risk than parents who did not watch the entire series. Few sociodemographic, child, or parent variables assessed at preintervention predicted program outcomes or program engagement, suggesting that a wide range of parents from diverse socioeconomic status benefited from the program. Media interventions depicting evidence-based parenting programs may be a useful means of reaching hard to engage families in population-level child maltreatment prevention programs.

Factors related to suicidal ideation in stroke patients in South Korea.

PubMed

Park, Eun-Young; Kim, Jung-Hee

2016-01-01

Suicide rates in Korea have increased dramatically. Stroke is considered one of the most debilitating neurological disorders, resulting in physical impairment, disability, and death. The present study attempted to examine factors related to suicidal ideation in community-dwelling stroke patients. The Korea Welfare Panel Study was used to investigate the relationship between demographic and psychological variables and suicidal ideation among these individuals. Depression was assessed using the Center for Epidemiological Studies Depression Scale 11 (CES-D-11). Self-esteem was assessed using Rosenberg's Self-Esteem Scale. The prevalence of suicidal thought among stroke patients was estimated at 13.99%. Multiple logistic regression analysis indicated that both older age and depression were significant independent risk factors for suicidal ideation. High-priority health care plans can prevent suicide in stroke patients suffering from depression. Assessing risk for suicide and monitoring the high-risk group is integral to health care. Stroke patients with depression, particularly older patients, would be prime targets for suicide intervention programs.

Parent Mindfulness and Child Outcome: The Roles of Parent Depressive Symptoms and Parenting.

PubMed

Parent, Justin; Garai, Emily; Forehand, Rex; Roland, Erin; Potts, Jennifer; Haker, Kelly; Champion, Jennifer E; Compas, Bruce E

2011-01-01

The purpose of this study was to examine pathways in a model which proposed associations among parent mindfulness, parent depressive symptoms, two types of parenting, and child problem behavior. Participants' data were from the baseline assessment of a NIMH-sponsored Family-Group Cognitive-Behavioral intervention program (FGCB) for the prevention of child and adolescent depression (Compas et al., 2009). Participants consisted of 145 mothers and 17 fathers (mean age = 41.89 yrs, SD = 7.73) with a history of depression and 211 children (106 males) (mean age = 11.49 yrs, SD = 2.00). Analyses showed that (a) positive parenting appears to play a significant role in helping explain how parent depressive symptoms relate to child externalizing problems and (b) mindfulness is related to child internalizing and externalizing problems; however, the intervening constructs examined did not appear to help explain the mindfulness-child problem behavior associations. Suggestions for future research on parent mindfulness and child problem outcome are described.

Parent Mindfulness and Child Outcome: The Roles of Parent Depressive Symptoms and Parenting

PubMed Central

Parent, Justin; Garai, Emily; Roland, Erin; Potts, Jennifer; Haker, Kelly; Champion, Jennifer E.; Compas, Bruce E.

2011-01-01

The purpose of this study was to examine pathways in a model which proposed associations among parent mindfulness, parent depressive symptoms, two types of parenting, and child problem behavior. Participants’ data were from the baseline assessment of a NIMH-sponsored Family-Group Cognitive-Behavioral intervention program (FGCB) for the prevention of child and adolescent depression (Compas et al., 2009). Participants consisted of 145 mothers and 17 fathers (mean age = 41.89 yrs, SD = 7.73) with a history of depression and 211 children (106 males) (mean age = 11.49 yrs, SD = 2.00). Analyses showed that (a) positive parenting appears to play a significant role in helping explain how parent depressive symptoms relate to child externalizing problems and (b) mindfulness is related to child internalizing and externalizing problems; however, the intervening constructs examined did not appear to help explain the mindfulness-child problem behavior associations. Suggestions for future research on parent mindfulness and child problem outcome are described. PMID:21572927

[Beneficial effect of a cognitive behavioral and multidisciplinary program in Alzheimer Disease on spouse caregiver anxiety: French study ELMMA].

PubMed

Negovanska, V; Hergueta, T; Guichart-Gomez, E; Dubois, B; Sarazin, M; Bungener, C

2011-02-01

Over the last decade, several programs have been developed for caregivers of Alzheimer disease patients. In France however, studies exploring their effects are still scarce. We conducted a study to compare two different interventions: a structured multidisciplinary program versus a classical intervention designed for Alzheimer disease patients and their spouses. Sixteen couples (Alzheimer's disease patient and spouse) residing in our administrative district participated in this monocentric study. For at least two years, these couples participated in a multidisciplinary program (n=8 couples) or received usual care (n=8 couples). The multidisciplinary program involved biannual consultations with a neurologist, a neuropsychologist and a psychologist, in addition to an annual meeting, stratified on the patient's MMSE score, for spouses). Usual care involved biannual consultations with the neurologist. The multidisciplinary program included a psychological intervention based on cognitive behavioral theories and centered on psycho-education, problem solving, adaptation strategies and on prevention of depression and anxiety. The spouses and the patients evaluated the 2-year follow-up during clinical interviews, completed by questionnaires. Sociodemographic data were noted for the patients and their spouses. Levels of depression and anxiety (Mini International Neuropsychiatric Inventory, Montgomery and Asberg Depression Scale, State-Trait Anxiety Inventory), perceived stress (Perceived Stress Scale) and care burden (Zarit Burden Inventory) were evaluated in spouses. Levels of cognitive impairment (Mini Mental State Examination), autonomy (Instrumental Activities of Daily Living), psychological state (Montgomery and Asberg Depression Scale, Covi Anxiety Scale), and behavioral symptoms frequency (Neuropsychiatric Inventory) were assessed in patients. The main significant result showed that the spouses' state of anxiety was lower among participants in the multidisciplinary program, compared with the classical neurological intervention. It also was found that the spouses and the patients who participated in this multidisciplinary program were less depressed. This study shows that a multidisciplinary structured intervention, with only two annual consultations and one annual meeting for spouses, can contribute to decrease significantly the spouses' state of anxiety. Further studies including a larger number of subjects should be conducted to confirm these findings. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention.

PubMed

Markle-Reid, Maureen F; McAiney, Carrie; Forbes, Dorothy; Thabane, Lehana; Gibson, Maggie; Hoch, Jeffrey S; Browne, Gina; Peirce, Thomas; Busing, Barbara

2011-08-25

Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Data collection began in May 2010 and is expected to be completed by July 2012. A collaborative nurse-led strategy may provide a feasible, acceptable and effective means for improving the health of older home care clients by improving the prevention, recognition, and management of depression in this vulnerable population. The challenges involved in designing a practical, transferable and sustainable nurse-led intervention in home care are also discussed. ClinicalTrials.gov: NCT01407926.

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

PubMed Central

2011-01-01

Background Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. Methods/Design This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Discussion Data collection began in May 2010 and is expected to be completed by July 2012. A collaborative nurse-led strategy may provide a feasible, acceptable and effective means for improving the health of older home care clients by improving the prevention, recognition, and management of depression in this vulnerable population. The challenges involved in designing a practical, transferable and sustainable nurse-led intervention in home care are also discussed. Trial Registration ClinicalTrials.gov: NCT01407926 PMID:21867539

The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety.

PubMed

Teesson, Maree; Newton, Nicola C; Slade, Tim; Chapman, Cath; Allsop, Steve; Hides, Leanne; McBride, Nyanda; Mewton, Louise; Tonks, Zoe; Birrell, Louise; Brownhill, Louise; Andrews, Gavin

2014-02-05

Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined. Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge. This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000723785.

[Postpartum depression: we know the risks, can it be prevented?].

PubMed

Zinga, Dawn; Phillips, Shauna Dae; Born, Leslie

2005-10-01

In the past 20 years, there has been increasing recognition that for some women, pregnancy may be burdened with mood problems, in particular depression, that may impact both mother and child. With identification of risk factors for postpartum depression and a growing knowledge about a biologic vulnerability for mood change following delivery, research has accumulated on attempts to prevent postpartum depression using various psychosocial, psychopharmacologic, and hormonal strategies. The majority of psychosocial and hormonal strategies have shown little effect on postpartum depression. Notwithstanding, results from preliminary trials of interpersonal therapy, cognitive-behavioural therapy, and antidepressants indicate that these strategies may be of benefit. Information on prevention of postpartum depression using dietary supplements is sparse and the available evidence is inconclusive. Although a few studies show promising results, more rigorous trials are required. The abounding negative evidence in the literature indicates that postpartum depression cannot be easily prevented, yet.

A video-based transdiagnostic REBT universal prevention program for internalizing problems in adolescents: study protocol of a cluster randomized controlled trial.

PubMed

Păsărelu, Costina Ruxandra; Dobrean, Anca

2018-04-13

Internalizing problems are the most prevalent mental health problems in adolescents. Transdiagnostic programs are promising manners to treat multiple problems within the same protocol, however, there is limited research regarding the efficacy of such programs delivered as universal prevention programs in school settings. Therefore, the present study aims to investigate the efficacy of a video-based transdiagnostic rational emotive behavioral therapy (REBT) universal prevention program, for internalizing problems. The second objective of the present paper will be to investigate the subsequent mechanisms of change, namely maladaptive cognitions. A two-arm parallel randomized controlled trial will be conducted, with two groups: a video-based transdiagnostic REBT universal prevention program and a wait list control. Power analysis indicated that the study will involve 338 participants. Adolescents with ages between 12 and 17 years old, from several middle schools and high schools, will be invited to participate. Assessments will be conducted at four time points: baseline (T 1 ), post-intervention (T 2 ), 3 months follow-up (T 3 ) and 12 months follow-up (T 4 ). Intent-to-treat analysis will be used in order to investigate significant differences between the two groups in both primary and secondary outcomes. This is the first randomized controlled trial that aims to investigate the efficacy and mechanisms of change of a video-based transdiagnostic REBT universal prevention program, delivered in a school context. The present study has important implications for developing efficient prevention programs, interactive, that will aim to target within the same protocol both anxiety and depressive symptoms. ClinicalTrials.gov: NCT02756507 . Registered on 25 April 2016.

Confirmatory Factor Analysis of the Trinity Inventory of Precursors to Suicide (TIPS) and Its Relationship to Hopelessness and Depression

ERIC Educational Resources Information Center

Smyth, Caroline L.; MacLachlan, Malcolm

2005-01-01

Numerous existing measures assess attitudes toward suicide yet fail to account for contextual factors. The Trinity Inventory of Precursors to Suicide (TIPS) is presented as an alternative, with implications for the development of prevention programs. Having previously reported exploratory analysis of the TIPS; confirmatory factor analysis and…

Suicide Interventions Targeted toward At-Risk Youth

ERIC Educational Resources Information Center

Langhinrichsen-Rohling, Jennifer; Lamis, Dorian A.; McCullars, Adrianne

2012-01-01

Suicide is currently the third leading cause of death among youth; it has been named a public health concern. A number of programs have been developed to prevent suicide; many of these involve intervening with youth who are known to be at-risk because of their depression, expressed suicide ideation, or previous suicide attempts. This paper serves…

African American and White Mothers' Substance Abuse, Depression, and Criminality as Risk Factors for School Suspension

ERIC Educational Resources Information Center

Smith-McKeever, Chedgzsey; Gao, Weihua

2010-01-01

School social workers are often responsible for developing and implementing programs to prevent school suspension, particularly for African American students, who are overrepresented among all students suspended. This article uses data from the National Longitudinal Survey to examine the relative roles of maternal substance and alcohol abuse,…

Perceptions and Motivations to Prevent Heart Disease among Puerto Ricans

PubMed Central

Mattei, Josiemer; Mendez, Jacqueline; Falcon, Luis M.; Tucker, Katherine L.

2016-01-01

Objectives We performed a qualitative assessment of Puerto Ricans’ knowledge and perceptions of cardiovascular disease (CVD), and motivations/barriers and preferences to participate in community/ clinical programs for CVD-prevention. Methods Four guided focus group discussions were conducted on a total of 24 Puerto Ricans, aged 40–60 years in Boston, MA. Results Participants were aware of CVD, but less knowledgeable about its prevention. They perceived it as serious, and either had CVD or knew someone who had it. They favored education and activities on nutrition, exercise, clinical advice, and social interaction, in weekly/ biweekly small-group sessions with other Latinos, led in Spanish by a familiar health professional, in a convenient community location. Age- and culture-specific program content and educational materials were preferred. A theme emerged on ‘personal or family motivations’ such as to become healthier and live longer so they would feel better and support their families, or to learn about CVD-prevention. Main barriers included family obligations, weather, safety concerns, transportation, and depressive mood. Conclusions Culturally-tailored CVD-prevention programs for Puerto Ricans should include multiple behavioral and social approaches, and draw on intrinsic motivators while reducing barriers to help enhance efficacy and sustainability. PMID:27103411

Preliminary Evaluation of a Brief Web and Mobile Phone Intervention for Men With Depression: Men’s Positive Coping Strategies and Associated Depression, Resilience, and Work and Social Functioning

PubMed Central

Proudfoot, Judy; Whittle, Erin Louise; Clarke, Janine; Player, Michael J; Christensen, Helen; Wilhelm, Kay

2017-01-01

Background Previous research has identified that men experiencing depression do not always access appropriate health services. Web-based interventions represent an alternative treatment option for men, are effective in reducing anxiety and depression, and have potential for wide dissemination. However, men do not access Web-based programs at the same rate as women. Programs with content explicitly tailored to men’s mental health needs are required. Objective This study evaluated the applicability of Man Central, a new Web and mobile phone intervention for men with depression. The impact of the use of Man Central on depression, resilience, and work and social functioning was assessed. Methods A recruitment flier was distributed via social media, email networks, newsletters, research registers, and partner organizations. A single-group, repeated measures design was used. The primary outcome was symptoms of depression. Secondary outcomes included externalizing symptoms, resilience, and work and social functioning. Man Central comprises regular mood, symptom, and behavior monitoring, combined with three 15-min interactive sessions. Clinical features are grounded in cognitive behavior therapy and problem-solving therapy. A distinguishing feature is the incorporation of positive strategies identified by men as useful in preventing and managing depression. Participants were directed to use Man Central for a period of 4 weeks. Linear mixed modeling with intention-to-treat analysis assessed associations between the intervention and the primary and secondary outcomes. Results A total of 144 men aged between 18 and 68 years and with at least mild depression enrolled in the study. The symptoms most often monitored by men included motivation (471 instances), depression (399), sleep (323), anxiety (316), and stress (262). Reminders were scheduled by 60.4% (87/144). Significant improvements were observed in depression symptoms (P<.001, d=0.68), depression risk, and externalizing symptoms (P<.001, d=0.88) and work and social functioning (P<.001, d=0.78). No change was observed in measures of resilience. Participants reported satisfaction with the program, with a majority saying that it was easy (42/51, 82%) and convenient (41/51, 80%) to use. Study attrition was high; 27.1% (39/144) and 8.3% (12/144) of the participants provided complete follow-up data and partial follow-up data, respectively, whereas the majority (93/144, 64.6%) did not complete follow-up measures. Conclusions This preliminary evaluation demonstrated the potential of using electronic health (eHealth) tools to deliver self-management strategies to men with depressive symptoms. Man Central may meet the treatment needs of a subgroup of depressed men who are willing to engage with an e-mental health program. With further research, it may provide an acceptable option to those unwilling or unable to access traditional mental health services. Given the limitations of the study design, prospective studies are required, using controlled designs to further elucidate the effect of the program over time. PMID:28798009

Can a school-wide bullying prevention program improve the plight of victims? Evidence for risk × intervention effects.

PubMed

Juvonen, Jaana; Schacter, Hannah L; Sainio, Miia; Salmivalli, Christina

2016-04-01

This study was designed to examine whether a school-wide antibullying program, effective in reducing incidents of bullying, can also reduce the harm associated with victimization. Specifically, we test whether baseline victimization moderates the KiVa program intervention effects on school perceptions, depression, and self-esteem. Relying on a randomized control sample consisting of 7,010 fourth to sixth grade Finnish elementary school students, self-report data were examined using multilevel modeling across 39 intervention and 38 control schools over a 12-month period. The KiVa program was particularly effective in facilitating perceptions of a caring school climate among students who were most victimized before the intervention, while program benefits on attitudes toward school did not vary by level of victimization. The intervention effects on depression and self-esteem were strongest only among the most victimized sixth graders. The results suggest that antibullying programs designed to improve the school ecology can alleviate the plight of the victimized and underscore that harm reduction should be assessed by testing risk × intervention effects when evaluating effectiveness of such programs. (c) 2016 APA, all rights reserved).

Moderating Effects of Prevention-Focus on the Paths from Two Insecure Attachment Dimensions to Depression.

PubMed

Lee, Dong-Gwi; Park, Jae Joon; Bae, Byeong Hoon; Lim, Hyun-Woo

2018-04-03

The present study investigated the moderating effects of prevention-focus on the paths from the dimensions of insecure attachment (attachment avoidance and attachment anxiety) to depression. Two hundred twenty eight Korean college students completed the Experience in Close Relationship - Revised Scale; the Regulatory Focus Strategies Scale; and the Center for Epidemiologic Studies Depression Scale. Results revealed a significant moderating effect for prevention-focus on the path from attachment avoidance to depression, but not on the path from attachment anxiety to depression. They further suggest that different interventions are needed for different combinations of persons' insecure attachment dimensions and levels of prevention-focus. Counseling implications and suggestions for future research are discussed.

Self-efficacy: a mediator of smoking behavior and depression among college students.

PubMed

Mee, Susan

2014-01-01

Cigarette smoking is a growing problem among adolescents. This correlational study tested theoretical relationships between the dependent variable (smoking behavior) and the independent variables (depression and smoking resistance self-efficacy) in a convenience sample of 364 college students ages 18 to 21 years recruited from a large urban public college. An a priori mediational model tested the role of smoking resistance self-efficacy as a mediator in the relationship between smoking behavior and depression. Findings showed there was a statistically significant positive relationship between depression and smoking behavior (r = 0.122, p = 0.01). There was a statistically significant negative relationship between smoking resistance self-efficacy and smoking behavior (r = -0.744, p = 0.01). Additionally, smoking resistance self-efficacy was a mediator of the relationship between depression and smoking behavior (beta = -0.757, p = 0.001). This study identifies a need for further theory-driven study of the relation of adolescent depression and smoking behavior. The findings of this study have implications for nursing interventions targeted to both current smokers and smoking initiation prevention programs.

A two-year longitudinal study of gender differences in responses to positive affect and depressive symptoms during middle adolescence.

PubMed

Gomez-Baya, Diego; Mendoza, Ramon; Paino, Susana; Gillham, Jane E

2017-04-01

This study aimed to analyze the prospective associations during adolescence between depressive symptoms and response styles to positive affect and to examine gender differences. A longitudinal study was conducted with three waves separated by 1 year each to assess a non-clinical sample of 622 Spanish adolescents who were 13 and 14 years old (50.2% boys, 49.8% girls). The participants completed self-report measures of depressive symptoms and responses to positive affect (emotion-focused positive rumination, self-focused positive rumination and dampening of positive emotion). The results showed that the increase in depressive symptoms was associated with an increase in dampening and decreases in emotion-focused and self-focused positive rumination. Furthermore, girls presented more depressive symptoms, as well as higher dampening and lower self-focused positive rumination, than boys. The conclusions highlight the need to consider responses to positive affect in explaining gender differences in depressive symptoms during mid-adolescence, as well as in designing prevention programs. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Methamphetamine use is associated with high levels of depressive symptoms in adolescents and young adults in Rural Chiang Mai Province, Thailand.

PubMed

DiMiceli, Lauren E; Sherman, Susan G; Aramrattana, Apinun; Sirirojn, Bangorn; Celentano, David D

2016-02-19

High levels of depressive symptoms often occur among individuals that use or that are dependent on methamphetamine (MA). Thailand is currently experiencing an epidemic of MA use among youth. Understanding the nature of the relationship between depressive symptoms and MA use and identifying those most at risk can further understanding of prevention and treatment options for youth who use MA and present with depressive symptoms. In 2011, we conducted a cross sectional epidemiologic study that examined associations between MA use and high levels of depressive symptoms among adolescents and young adults aged 14-29 living in Chiang Mai province, Thailand. A combination of cluster and systematic sampling was conducted to obtain a study sample of participants actively recruited in Chiang Mai province. Depressive symptoms were measured using a Thai translation of the Centers for Epidemiologic Studies Depression scale (CES-D). The independent variables measured reported lifetime and recent MA use within the past 3 months. Multivariate logistic regression models were used to assess associations between MA use and high levels of depressive symptoms. Approximately 19% (n = 394) of the sample reported ever having consumed MA and 31% (n = 124) of lifetime users reported recent MA use within the past 3 months. Recent MA use was associated with high levels of depressive symptoms (aPOR recent use: 2.60, 95% CI: 1.20, 5.63). This is one of the first studies to examine the association between MA use and high levels of depressive symptoms in a general Thai population. The odds of having high levels of depressive symptoms was significantly greater among recent MA users compared to non-users. These findings support the need for policies, programs and interventions to prevent and treat depressive symptoms presenting among MA using Thai adolescents and young adults in rural Chiang Mai province, Thailand to aid in cessation of MA use. Furthermore, additional research is needed to investigate treatment options for adolescents and young adults in Thailand that use MA and present with high levels of depressive symptoms.

The Spanish Version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: Study Protocol for a Cluster Randomized Controlled Trial.

PubMed

García-Escalera, Julia; Valiente, Rosa M; Chorot, Paloma; Ehrenreich-May, Jill; Kennedy, Sarah M; Sandín, Bonifacio

2017-08-21

Anxiety and depression are common, impairing conditions that evidence high comorbidity rates in adolescence. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is one of the few existing resources aimed at applying transdiagnostic treatment principles to target core dysfunctions associated with both anxiety and depression within a single protocol. To our knowledge, this is the first study examining the efficacy of the UP-A adapted as a universal preventive intervention program. The primary aim of this study is to examine whether the Spanish version of the UP-A is more effective than a waitlist (WL) control group in reducing and preventing symptoms of anxiety and depression when employed as a universal, classroom-based preventive intervention. The secondary aim is to investigate changes in a broad range of secondary outcome measures, including negative and positive affect, anxiety sensitivity, emotional avoidance, top problems ratings, school grades, depression and anxiety-related interference, self-esteem, life satisfaction, quality of life, conduct problems, hyperactivity/inattention symptoms, peer problems, prosocial behavior, school adjustment, and discipline problems. Other aims are to assess a range of possible predictors of intervention effects and to examine the feasibility and the acceptability of implementing UP-A in a prevention group format and in a school setting. A cluster, randomized, WL, controlled trial design with classroom as the unit of randomization was used in this study. Five classes including a total of 152 adolescents were randomized to the experimental or WL control groups. Participants in the experimental group received 9 55-minute sessions delivered by advanced doctoral and masters students in clinical psychology. The WL control group will receive the intervention once the 3-month follow-up assessment is completed. We have recruited participants to the cluster randomized controlled trial (RCT) and have conducted the intervention with the experimental group. We expect the WL control group to complete the intervention in July 2017. Data analysis will take place during the second semester of 2017. We expect the experimental group to outperform the WL control group at post-intervention and 3-month follow-up. We also expect the WL control group to show improvements in primary and secondary outcome measures after receiving the intervention. Results will have implications for researchers, families, and education providers. Clinicaltrials.gov NCT03123991; https://clinicaltrials.gov/ct2/show/NCT03123991 (Archived by WebCite at http://www.webcitation.org/6qp7GIzcR). ©Julia García-Escalera, Rosa M Valiente, Paloma Chorot, Jill Ehrenreich-May, Sarah M Kennedy, Bonifacio Sandín. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 21.08.2017.

The Spanish Version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: Study Protocol for a Cluster Randomized Controlled Trial

PubMed Central

García-Escalera, Julia; Valiente, Rosa M; Ehrenreich-May, Jill; Kennedy, Sarah M; Sandín, Bonifacio

2017-01-01

Background Anxiety and depression are common, impairing conditions that evidence high comorbidity rates in adolescence. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is one of the few existing resources aimed at applying transdiagnostic treatment principles to target core dysfunctions associated with both anxiety and depression within a single protocol. To our knowledge, this is the first study examining the efficacy of the UP-A adapted as a universal preventive intervention program. Objective The primary aim of this study is to examine whether the Spanish version of the UP-A is more effective than a waitlist (WL) control group in reducing and preventing symptoms of anxiety and depression when employed as a universal, classroom-based preventive intervention. The secondary aim is to investigate changes in a broad range of secondary outcome measures, including negative and positive affect, anxiety sensitivity, emotional avoidance, top problems ratings, school grades, depression and anxiety-related interference, self-esteem, life satisfaction, quality of life, conduct problems, hyperactivity/inattention symptoms, peer problems, prosocial behavior, school adjustment, and discipline problems. Other aims are to assess a range of possible predictors of intervention effects and to examine the feasibility and the acceptability of implementing UP-A in a prevention group format and in a school setting. Methods A cluster, randomized, WL, controlled trial design with classroom as the unit of randomization was used in this study. Five classes including a total of 152 adolescents were randomized to the experimental or WL control groups. Participants in the experimental group received 9 55-minute sessions delivered by advanced doctoral and masters students in clinical psychology. The WL control group will receive the intervention once the 3-month follow-up assessment is completed. Results We have recruited participants to the cluster randomized controlled trial (RCT) and have conducted the intervention with the experimental group. We expect the WL control group to complete the intervention in July 2017. Data analysis will take place during the second semester of 2017. Conclusions We expect the experimental group to outperform the WL control group at post-intervention and 3-month follow-up. We also expect the WL control group to show improvements in primary and secondary outcome measures after receiving the intervention. Results will have implications for researchers, families, and education providers. Trial Registration Clinicaltrials.gov NCT03123991; https://clinicaltrials.gov/ct2/show/NCT03123991 (Archived by WebCite at http://www.webcitation.org/6qp7GIzcR) PMID:28827212

Relapse and Recurrence Prevention in the Treatment for Adolescents with Depression Study

ERIC Educational Resources Information Center

Simons, Anne D.; Rohde, Paul; Kennard, Betsy D.; Robins, Michele

2005-01-01

Relapse and recurrence in adolescent depression are important problems. Much less is known about relapse prevention compared to the acute treatment of depression in adolescents. Based on previous research, theoretical predictions, and clinical experience, the Treatment for Adolescents With Depression Study (TADS) protocol was designed to determine…

Development, acceptability and efficacy of a standardized healthy lifestyle intervention in recurrent depression.

PubMed

Goracci, A; Rucci, P; Forgione, R N; Campinoti, G; Valdagno, M; Casolaro, I; Carretta, E; Bolognesi, S; Fagiolini, A

2016-05-15

Research evidence on the effects of integrated multifaceted lifestyle interventions for depression is scanty. The aim of the present study is to report on the development, acceptability and efficacy of a standardized healthy lifestyle intervention, including exercise, eating habits, sleep hygiene and smoking cessation in preventing relapses. One hundred-sixty outpatients with recurrent unipolar depression or bipolar disorder were recruited after achieving full remission or recovery from the most recent depressive episode. Patients were randomized to 3-months of usual care or to an intervention aimed at promoting a healthy lifestyle (HLI), as an augmentation of pharmacological maintenance treatment. Usual care consisted of clinical management visits. At the end of the intervention, follow-up visits were scheduled at 3,6,9 and 12 months. During the intervention phase, 1 relapse occurred in the HLI group and 4 in the control group. Over the 12 months of follow-up, relapses were 5 in the HLI group and 16 in control group. Using an intent-to-treat approach, the overall percentage of relapses was 6/81 (7.4%) in the HLI group vs. 20/79 (25.3%) in the control group.. In a Kaplan-Meier survival analysis the risk of relapse was significantly lower in patients receiving the HLI intervention (log-rank test, p=0.003) over the 60 weeks of observation. The majority of patients assigned to HLI adhered to the program, and were highly motivated throughout the intervention. The retention rate was low because patients were recruited during the maintenance phase and the 1-year follow-up was relatively short to detect a long-term effect of HLI. The HLI program proved to be efficacious in preventing relapses. Given the absence of contraindications and its cost-effectiveness in routine practice, the use of HLI should be encouraged to promote the well-being of patients with recurrent depression. Copyright © 2016 Elsevier B.V. All rights reserved.

Effectiveness of self-help psychological interventions for treating and preventing postpartum depression: a meta-analysis.

PubMed

Lin, Ping-Zhen; Xue, Jiao-Mei; Yang, Bei; Li, Meng; Cao, Feng-Lin

2018-04-04

Previous studies have reported different effect sizes for self-help interventions designed to reduce postpartum depression symptoms; therefore, a comprehensive quantitative review of the research was required. A meta-analysis was conducted to examine the effectiveness of self-help interventions designed to treat and prevent postpartum depression, and identified nine relevant randomized controlled trials. Differences in depressive symptoms between self-help interventions and control conditions, changes in depressive symptoms following self-help interventions, and differences in postintervention recovery and improvement rates between self-help interventions and control conditions were assessed in separate analyses. In treatment trials, depression scores continued to decrease from baseline to posttreatment and follow-up assessment in treatment subgroups. Changes in treatment subgroups' depression scores from baseline to postintervention assessment were greater relative to those observed in prevention subgroups. Self-help interventions produced larger overall effects on postpartum depression, relative to those observed in control conditions, in posttreatment (Hedges' g = 0.51) and follow-up (Hedges' g = 0.32) assessments; and self-help interventions were significantly more effective, relative to control conditions, in promoting recovery from postpartum depression. Effectiveness in preventing depression did not differ significantly between self-help interventions and control conditions.The findings suggested that self-help interventions designed to treat postpartum depression reduced levels of depressive symptoms effectively and decreased the risk of postpartum depression.

Attitude and knowledge changes in collegiate dancers following a short-term, team-centered prevention program on eating disorders.

PubMed

Torres-McGehee, Toni M; Green, James M; Leaver-Dunn, Deidre; Leeper, James D; Bishop, Phillip A; Richardson, Mark T

2011-06-01

Eating knowledge, nutritional knowledge, and psychological changes among female collegiate dancers were examined before and after a 4-wk. team-centered program on sport nutrition, exercise, and disordered eating consequences. Collegiate female dancers from two NCAA Division I institutions participated in a control (n = 19; M age = 19.1 yr., SD = 1.0) or intervention (n = 21; M age = 19.2 yr., SD = 1.2) group. Measures were administered to both groups before and after intervention to assess eating disorders, depression, and nutritional and disordered eating knowledge. There was a statistically significant increase in scores on nutritional and overall eating disorder knowledge in the intervention group compared to the control group. Mean scores on depression, drive for thinness, body dissatisfaction, and maturity fears decreased in the intervention group.

The Relationship between Neuroticism, Hopelessness, and Depression in Older Korean Immigrants

PubMed Central

Kim, Bum Jung; Linton, Kristen; Cho, Sean; Ha, Jung-Hwa

2016-01-01

Purpose This study aimed to investigate the relationship between neuroticism, hopelessness, and depression among older Korean immigrants. To extend this line of research, this study aimed to examine the effects of neuroticism and hopelessness in predicting depression among older Korean immigrants. Methods Data for this study came from a survey of 220 first generation Korean immigrants aged 65 years or older in Los Angeles County in 2012. Data were collected by face-to-face interviews with trained social workers using a structured questionnaire translated into Korean. All interviews were conducted in Korean. The neuroticism sub-scale of the Eysenck Personality Questionnaire was used to assess neuroticism (EPQN). Hopelessness was measured by the Beck Hopelessness Scale (BHS). Depression was measured by the 20-item Center of Epidemiological Studies Depression (CES-D) scale. Results The study found that age (β = .26, p< .01), gender (β = -.13, p< .01), income (β = -.13, p< .01), neuroticism (β = .51, p< .01), and hopelessness (β = .15, p< .01) were significant predictors of depression. Conclusion The study provides preventive strategies that would help in the development of depression-reduction services or programs for the population, especially for those living with neuroticism and hopelessness. PMID:26727476

Social Support and Postpartum Depression Revisited: The Traditional Female Role as Moderator among Mexican Women.

PubMed

Albuja, Analia F; Lara, M Asunción; Navarrete, Laura; Nieto, Lourdes

2017-08-01

Women who lack social support tend to have a higher risk of postpartum depression. The present study examined the traditional female role, understood here as the adoption of passive and submissive traits specific to Mexican women, as another risk factor for postpartum depressive symptomatology that interacts with social support. Using two waves of data from a longitudinal study of 210 adult Mexican women (20-44 years-old, M age = 29.50 years, SD = 6.34), we found that lacking social support during the third trimester of their pregnancy was associated with greater depressive symptoms at 6 months in the postpartum, although this relationship depended on the level of endorsement of the traditional female role during pregnancy. Lower social support during pregnancy predicted greater postpartum depressive symptoms for women with higher endorsement of the traditional female role, even when accounting for prenatal depressive symptoms. These results suggest that Mexican women's experience of social support may depend on their individual adherence to gender roles. Understanding the association between women's traditional roles and social support in the risk for postpartum depression can improve prevention and educational programs for women at risk.

Childhood Depression: Relation to Adaptive, Clinical and Predictor Variables

PubMed Central

Garaigordobil, Maite; Bernarás, Elena; Jaureguizar, Joana; Machimbarrena, Juan M.

2017-01-01

The study had two goals: (1) to explore the relations between self-assessed childhood depression and other adaptive and clinical variables (2) to identify predictor variables of childhood depression. Participants were 420 students aged 7–10 years old (53.3% boys, 46.7% girls). Results revealed: (1) positive correlations between depression and clinical maladjustment, school maladjustment, emotional symptoms, internalizing and externalizing problems, problem behaviors, emotional reactivity, and childhood stress; and (2) negative correlations between depression and personal adaptation, global self-concept, social skills, and resilience (sense of competence and affiliation). Linear regression analysis including the global dimensions revealed 4 predictors of childhood depression that explained 50.6% of the variance: high clinical maladjustment, low global self-concept, high level of stress, and poor social skills. However, upon introducing the sub-dimensions, 9 predictor variables emerged that explained 56.4% of the variance: many internalizing problems, low family self-concept, high anxiety, low responsibility, low personal self-assessment, high social stress, few aggressive behaviors toward peers, many health/psychosomatic problems, and external locus of control. The discussion addresses the importance of implementing prevention programs for childhood depression at early ages. PMID:28572787

Using effort-reward imbalance theory to understand high rates of depression and anxiety among clergy.

PubMed

Proeschold-Bell, Rae Jean; Miles, Andrew; Toth, Matthew; Adams, Christopher; Smith, Bruce W; Toole, David

2013-12-01

The clergy occupation is unique in its combination of role strains and higher calling, putting clergy mental health at risk. We surveyed all United Methodist clergy in North Carolina, and 95% (n = 1,726) responded, with 38% responding via phone interview. We compared clergy phone interview depression rates, assessed using the Patient Health Questionnaire (PHQ-9), to those of in-person interviews in a representative United States sample that also used the PHQ-9. The clergy depression prevalence was 8.7%, significantly higher than the 5.5% rate of the national sample. We used logistic regression to explain depression, and also anxiety, assessed using the Hospital Anxiety and Depression Scale. As hypothesized by effort-reward imbalance theory, several extrinsic demands (job stress, life unpredictability) and intrinsic demands (guilt about not doing enough work, doubting one's call to ministry) significantly predicted depression and anxiety, as did rewards such as ministry satisfaction and lack of financial stress. The high rate of clergy depression signals the need for preventive policies and programs for clergy. The extrinsic and intrinsic demands and rewards suggest specific actions to improve clergy mental health.

Depressive Symptoms, Self-Esteem and Perceived Parent–Child Relationship in Early Adolescence

PubMed Central

Babore, Alessandra; Trumello, Carmen; Candelori, Carla; Paciello, Marinella; Cerniglia, Luca

2016-01-01

Aims: Early adolescence represents a critical developmental period both from a psychological and a psychopathological point of view. During this period, one of the most common disorders that frequently arise is represented by depression, that tends to become chronic and may produce many subsequent psychosocial impairments. The present study aimed to analyze characteristics of depressive symptoms in an Italian sample of early adolescents, and to explore their connections with self-esteem levels and perceived maternal and paternal emotional availability. Methods: 594 adolescents (50% females) with a mean age of 12.11 years (SD = 0.98) were administered the Children’s Depression Inventory, the Rosenberg Self-Esteem Scale, and the maternal and the paternal forms of the Lum Emotional Availability of Parents. Results: Findings highlighted a slightly higher, though not statistically significant, level of depressive symptoms in girls than in boys. Regression analysis showed that, as far as predictors of depression, self-esteem was the most relevant one, followed by maternal and paternal emotional availability. Conclusion: Our results strongly suggested to plan intervention programs aimed at monitoring early adolescents’ self-esteem and supporting relationship with both parents, in order to prevent the emergence of depressive symptoms. PMID:27445941

Psychiatric disorder symptoms, substance use, and sexual risk behavior among African-American out of school youth.

PubMed

Turner, Alezandria K; Latkin, Carl; Sonenstein, Freya; Tandon, S Darius

2011-05-01

To examine the association between symptoms of psychiatric disorder (i.e. depression, anxiety, and substance use) and sexual risk behavior in a sample of African-American adolescents and young adults in an employment training program. Baseline data were used from a pilot study of an intervention to reduce depressive symptoms among youth disconnected from school and the workforce. Participants were recruited from two employment training programs in East and West Baltimore (N=617; age 16-23 years). Data were collected through audio computer-assisted self-interview (ACASI). Mental health indicators were measured using the Center for Epidemiological Studies Depression Scale and Beck Anxiety Inventory. Multivariate logistic regression was used to determine the odds of sexual risk behavior for each mental health condition and combinations of conditions. Lack of condom use at last sex was significantly associated with elevated anxiety symptoms. Number of sexual partners was associated with elevated depression symptoms and substance use. Early sexual debut was associated with substance use in the past 30 days. Also, there were differences in the likelihood of engaging in sexual risk behavior comparing groups with different combinations of mental health problems to those with no symptoms of disorder or substance use. The results demonstrate the need for HIV prevention programs that target out-of-school youth, as they are likely to engage in risky sexual behavior. Our findings highlight the need to develop behavioral interventions that address disorder symptoms, substance use, and risky sexual behavior among youth in employment training programs. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Depression in medical students: current insights.

PubMed

Moir, Fiona; Yielder, Jill; Sanson, Jasmine; Chen, Yan

2018-01-01

Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism), resilience, selection procedures, students' motivation, and the nature of the clinical environment. This review includes several recommendations to improve students' psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student population attracted to medicine and calls for educators to act, by noticing opportunities where they can introduce such initiatives into their medical programs.

Depression in medical students: current insights

PubMed Central

Moir, Fiona; Yielder, Jill; Sanson, Jasmine; Chen, Yan

2018-01-01

Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism), resilience, selection procedures, students’ motivation, and the nature of the clinical environment. This review includes several recommendations to improve students’ psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student population attracted to medicine and calls for educators to act, by noticing opportunities where they can introduce such initiatives into their medical programs. PMID:29765261

Effect of a Web-Based Guided Self-help Intervention for Prevention of Major Depression in Adults With Subthreshold Depression: A Randomized Clinical Trial.

PubMed

Buntrock, Claudia; Ebert, David Daniel; Lehr, Dirk; Smit, Filip; Riper, Heleen; Berking, Matthias; Cuijpers, Pim

2016-05-03

Evidence-based treatments for major depressive disorder (MDD) are not very successful in improving functional and health outcomes. Attention has increasingly been focused on the prevention of MDD. To evaluate the effectiveness of a web-based guided self-help intervention for the prevention of MDD. Two-group randomized clinical trial conducted between March 1, 2013, and March 4, 2015. Participants were recruited in Germany from the general population via a large statutory health insurance company (ie, insurance funded by joint employer-employee contributions). Participants included 406 self-selected adults with subthreshold depression (Centre for Epidemiologic Studies Depression Scale score ≥16, no current MDD according to Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition, Text Revision] criteria). All participants had unrestricted access to usual care (visits to the primary care clinician) and were randomized to either a web-based guided self-help intervention (cognitive-behavioral and problem-solving therapy supported by an online trainer; n = 202) or a web-based psychoeducation program (n = 204). The primary outcome was time to onset of MDD in the intervention group relative to the control group over a 12-month follow-up period as assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6- and 12-month follow-up, covering the period to the previous assessment. Among 406 randomized patients (mean age, 45 years; 73.9% women), 335 (82%) completed the telephone follow-up at 12 months. Fifty-five participants (27%) in the intervention group experienced MDD compared with 84 participants (41%) in the control group. Cox regression analyses controlling for baseline depressive symptom severity revealed a hazard ratio of 0.59 (95% CI, 0.42-0.82; P = .002) at 12-month follow-up. The number needed to treat to avoid 1 new case of MDD was 5.9 (95% CI, 3.9-14.6). Among patients with subthreshold depression, the use of a web-based guided self-help intervention compared with enhanced usual care reduced the incidence of MDD over 12 months. Further research is needed to understand whether the effects are generalizable to both first onset of depression and depression recurrence as well as efficacy without the use of an online trainer. German Clinical Trial Registry Identifier: DRKS00004709.

[Regular physical activity and mental health. The role of exercise in the prevention of, and intervention in depressive disorders].

PubMed

Takács, Johanna

2014-01-01

In our review we examine the relationship between physical activity and mental health; especially we determine the effectiveness of exercise in the prevention and treatment of depression. Over the past two decades the literature in the area of physical activity and mental health has been growing. However it seems that the findings and evidences not being utilized by mental health agencies and health practitioners. Depression is the most common disorder in the world, generally has a higher prevalence among women. In our study we overview and demonstrate that the exercise is a powerful intervention for prevention and treatment not only in non-clinical but also in clinical levels of depression. In sub-clinical levels of depression the meta-analytic findings and population surveys suggest that the exercise is associated with a significant moderate reduction of depression in different groups by gender and age; as well as a physically active lifestyle associates with lower levels of depression. In clinical levels of depression the physical activity is an effective tool in the prevention, studies support an association between higher levels of physical activity and lower levels of depression. In the treatment of clinical depression the randomized-controlled trials suggest the clear positive effects of exercise. This effect is similar to psychotherapeutic interventions and it was appeared under relatively short time (4-8 weeks). The exercise is one of the most important preventive health-related behaviors. Our review suggests a protective effect from activity on the development of clinical levels of depression and depressive symptoms. In addition the randomized controlled trials support a causal connection between exercise and reduction of depression. In sum the reviewed studies clearly support the antidepressant effect of exercise.

Beck's cognitive theory and the response style theory of depression in adolescents with and without mild to borderline intellectual disability.

PubMed

Weeland, Martine M; Nijhof, Karin S; Otten, R; Vermaes, Ignace P R; Buitelaar, Jan K

2017-10-01

This study tests the validity of Beck's cognitive theory and Nolen-Hoeksema's response style theory of depression in adolescents with and without MBID. The relationship between negative cognitive errors (Beck), response styles (Nolen-Hoeksema) and depressive symptoms was examined in 135 adolescents using linear regression. The cognitive error 'underestimation of the ability to cope' was more prevalent among adolescents with MBID than among adolescents with average intelligence. This was the only negative cognitive error that predicted depressive symptoms. There were no differences between groups in the prevalence of the three response styles. In line with the theory, ruminating was positively and problem-solving was negatively related to depressive symptoms. Distractive response styles were not related to depressive symptoms. The relationship between response styles, cognitive errors and depressive symptoms were similar for both groups. The main premises of both theories of depression are equally applicable to adolescents with and without MBID. The cognitive error 'Underestimation of the ability to cope' poses a specific risk factor for developing a depression for adolescents with MBID and requires special attention in treatment and prevention of depression. WHAT THIS PAPER ADDS?: Despite the high prevalence of depression among adolescents with MBID, little is known about the etiology and cognitive processes that play a role in the development of depression in this group. The current paper fills this gap in research by examining the core tenets of two important theories on the etiology of depression (Beck's cognitive theory and Nolen-Hoeksema's response style theory) in a clinical sample of adolescents with and without MBID. This paper demonstrated that the theories are equally applicable to adolescents with MBID, as to adolescents with average intellectual ability. However, the cognitive bias 'underestimation of the ability to cope' was the only cognitive error related to depressive symptoms, and was much more prevalent among adolescents with MBID than among adolescents with average intellectual ability. This suggests that underestimating one's coping skills may be a unique risk factor for depression among adolescents with MBID. This knowledge is important in understanding the causes and perpetuating mechanisms of depression in adolescents with MBID, and for the development of prevention- and treatment programs for adolescents with MBID. Copyright © 2017 Elsevier Ltd. All rights reserved.

Added benefits: Reduced depressive symptom levels among African-American female adolescents participating in an HIV prevention intervention

PubMed Central

Brown, Jennifer L.; Sales, Jessica M.; Swartzendruber, Andrea L.; Eriksen, Michael D.; DiClemente, Ralph J.; Rose, Eve S.

2014-01-01

Background Adolescents experience elevated depressive symptoms which health promotion interventions may reduce. Purpose This study investigated whether HIV prevention trial participation decreased depressive symptoms among African-American female adolescents. Methods Adolescents (N=701; M age = 17.6) first received a group-delivered HIV prevention intervention and then either 12 sexual health (intervention condition) or 12 general health (comparison condition) phone counseling contacts over 24 months. ACASI assessments were conducted at baseline, and at 6-, 12-, 18-, and 24-months post-baseline. Linear generalized estimating equations were used to detect percent relative change in depressive symptoms. Results Participants reported a 2.7% decrease in depressive symptoms (p = 0.001) at each assessment. Intervention participants endorsed an additional 3.6% decrease in depressive symptoms (p = 0.058). Conclusions Trial participation was associated with reduced depressive symptomatology, particularly among those receiving personalized sexual health counseling. HIV prevention interventions may benefit from incorporating additional content to address adolescents’ mental health needs. PMID:24366521

Deficits in Emotional Clarity and Vulnerability to Peer Victimization and Internalizing Symptoms among Early Adolescents

PubMed Central

Hamilton, Jessica L.; Kleiman, Evan M.; Rubenstein, Liza M.; Stange, Jonathan P.; Flynn, Megan; Abramson, Lyn Y.; Alloy, Lauren B.

2015-01-01

Peer victimization is a significant risk factor for a range of negative outcomes during adolescence, including depression and anxiety. Recent research has evaluated individual characteristics that heighten the risk of experiencing peer victimization. However, the role of emotional clarity, or the ability to understand one’s emotions, in being the target of peer victimization remains unclear. Thus, the present study evaluated whether deficits in emotional clarity increased the risk of experiencing peer victimization, particularly among adolescent girls, which, in turn, contributed to prospective levels of depressive and anxiety symptoms. In the present study, 355 early adolescents (ages 12–13; 53% female; 51% African American) who were part of the Adolescent Cognition and Emotion project completed measures of emotional clarity, depressive symptoms, and anxiety symptoms at baseline, and measures of peer victimization, depressive symptoms, and anxiety symptoms at follow-up. Moderation analyses indicated that deficits in emotional clarity predicted greater peer victimization among adolescent girls, but not adolescent boys. Moderated mediation analyses revealed that deficits in emotional clarity contributed to relational peer victimization, which, in turn, predicted prospective levels of depressive and anxiety symptoms among adolescent girls, but not boys. These findings indicate that deficits in emotional clarity represent a significant risk factor for adolescent girls to experience relational peer victimization, which, in turn, contributed to prospective levels of internalizing symptoms. Thus, prevention programs should target deficits in emotional clarity to prevent peer victimization and subsequent internalizing symptoms among adolescent girls. PMID:25680559

Risks for depression onset in primary care elderly patients: potential targets for preventive interventions.

PubMed

Lyness, Jeffrey M; Yu, Qin; Tang, Wan; Tu, Xin; Conwell, Yeates

2009-12-01

Prevention of late-life depression, a common, disabling condition with often poor outcomes in primary care, requires identification of seniors at highest risk of incident episodes. The authors examined a broad range of clinical, functional, and psychosocial predictors of incident depressive episodes in a well-characterized cohort of older primary care patients. In this observational cohort study, patients age >/=65 years without current major depression, recruited from practices in general internal medicine, geriatrics, and family medicine, received annual follow-up assessments over a period of 1 to 4 years. Of 617 enrolled subjects, 405 completed the 1-year follow-up evaluation. The Structured Clinical Interview for DSM-IV (SCID) determined incident major depressive episodes. Each risk indicator's predictive utility was examined by calculating the risk exposure rate, incident risk ratio, and population attributable fraction, leading to determination of the number needed to treat in order to prevent incident depression. A combination of risks, including minor or subsyndromal depression, impaired functional status, and history of major or minor depression, identified a group in which fully effective treatment of five individuals would prevent one new case of incident depression. Indicators routinely assessed in primary care identified a group at very high risk for onset of major depressive episodes. Such markers may inform current clinical care by fostering the early detection and intervention critical to improving patient outcomes and may serve as the basis for future studies refining the recommendations for screening and determining the effectiveness of preventive interventions.

Do better executive functions buffer the effect of current parental depression on adolescent depressive symptoms?

PubMed

Davidovich, Shiri; Collishaw, Stephan; Thapar, Ajay K; Harold, Gordon; Thapar, Anita; Rice, Frances

2016-07-15

Offspring of parents with a history of major depressive disorder (MDD) and especially those exposed to a current episode of parental depression have been found to be at increased risk for developing depression themselves. Exposure to a current parental depressive episode also reduces the efficacy of interventions in high risk or depressed adolescents. This highlights the need to identify protective factors for adolescents exposed to a current parental depressive episode. Executive functions serve as an important cognitive resource, involved in the ability to regulate mood and thoughts and cope with stressful events. This study examined the buffering role of two components of executive functioning, inhibitory control and mental flexibility, in the association between a current parental episode of MDD and adolescent depressive symptoms. A high-risk sample of 288 adolescent offspring of parents with recurrent major depressive disorder completed an Affective Go/No Go and a Verbal Fluency task. Parents and adolescents underwent psychiatric interviews. In the presence of a current parental depressive episode in the parent, adolescents with better inhibitory control and mental flexibility had fewer depressive symptoms after controlling for age, gender and IQ. Participants were the offspring of depressed parents and it is not clear whether the protective effects of executive functioning observed here would generalise to other populations. Executive functions may protect against adolescent depression in the presence of a parental depressive episode. It may be beneficial to target executive functions in preventive programs for individuals at high-risk for depression. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Alcohol use among Asian American adolescent girls: the impact of immigrant generation status and family relationships.

PubMed

Fang, Lin; Schinke, Steven P

2011-01-01

Underage drinking among Asian American adolescent girls is not well understood. Based on family interaction theory, the study examined the interrelationships among acculturation variables, family relationships, girls' depressed mood, peer alcohol use, and girls' alcohol use in a sample of 130 Asian American mother-daughter dyads. The mediating role of family relationships, girls' depressed mood, and peer alcohol use on girls' drinking was also assessed. The study advances knowledge related to alcohol use among early Asian American adolescent girls, highlights the effect of immigrant generation status and family relationships, and has implications for culturally specific underage drinking prevention programs.

Association of Periodontitis and Subsequent Depression: A Nationwide Population-Based Study.

PubMed

Hsu, Chih-Chao; Hsu, Yi-Chao; Chen, Hsuan-Ju; Lin, Che-Chen; Chang, Kuang-Hsi; Lee, Chang-Yin; Chong, Lee-Won; Kao, Chia-Hung

2015-12-01

Periodontitis is a systemic and chronic inflammatory disease associated with multiple physical conditions. Distress and depression are other problems affecting the progression of periodontitis. However, the causal relationship between depression and periodontitis has not been adequately investigated. This aim of this study was to determine the association between periodontitis and the subsequent development of depression.We identified 12,708 patients with newly diagnosed periodontitis from 2000 to 2005 and 50,832 frequency-matched individuals without periodontitis. Both groups were followed until diagnosed with depression, withdrawal from the National Health Insurance program, or the end of 2011. The association between periodontitis and depressio was analyzed using Cox proportional hazard regression models.The incidence density rate of depression was higher in the periodontitis group than in the nonperiodontitis group, with an adjusted hazard ratio of 1.73 (95% confidence interval 1.58-1.89) when adjusting for sex, age, and comorbidity. Cox models revealed that periodontitis was an independent risk factor for depression in patients, except for comorbidities of diabetes mellitus (DM), alcohol abuse, and cancer.Periodontitis may increase the risk of subsequent depression and was suggested an independent risk factor regardless of sex, age, and most comorbidities. However, DM, alcohol abuse, and cancer may prevent the development of subsequent depression because of DM treatment, the paradoxical effect of alcohol, and emotional distress to cancer, respectively. Prospective studies on the relationship between periodontitis and depression are warranted.

Association of Periodontitis and Subsequent Depression

PubMed Central

Hsu, Chih-Chao; Hsu, Yi-Chao; Chen, Hsuan-Ju; Lin, Che-Chen; Chang, Kuang-Hsi; Lee, Chang-Yin; Chong, Lee-Won; Kao, Chia-Hung

2015-01-01

Abstract Periodontitis is a systemic and chronic inflammatory disease associated with multiple physical conditions. Distress and depression are other problems affecting the progression of periodontitis. However, the causal relationship between depression and periodontitis has not been adequately investigated. This aim of this study was to determine the association between periodontitis and the subsequent development of depression. We identified 12,708 patients with newly diagnosed periodontitis from 2000 to 2005 and 50,832 frequency-matched individuals without periodontitis. Both groups were followed until diagnosed with depression, withdrawal from the National Health Insurance program, or the end of 2011. The association between periodontitis and depressio was analyzed using Cox proportional hazard regression models. The incidence density rate of depression was higher in the periodontitis group than in the nonperiodontitis group, with an adjusted hazard ratio of 1.73 (95% confidence interval 1.58–1.89) when adjusting for sex, age, and comorbidity. Cox models revealed that periodontitis was an independent risk factor for depression in patients, except for comorbidities of diabetes mellitus (DM), alcohol abuse, and cancer. Periodontitis may increase the risk of subsequent depression and was suggested an independent risk factor regardless of sex, age, and most comorbidities. However, DM, alcohol abuse, and cancer may prevent the development of subsequent depression because of DM treatment, the paradoxical effect of alcohol, and emotional distress to cancer, respectively. Prospective studies on the relationship between periodontitis and depression are warranted. PMID:26705230

Interactive models of depression vulnerability: The role of childhood trauma, dysfunctional attitudes, and coping

PubMed Central

Morris, Matthew C.; Kouros, Chrystyna D.; Fox, Kathryn R.; Rao, Uma; Garber, Judy

2013-01-01

Objectives This prospective study investigated whether within-individual relations between depression vulnerability factors (childhood trauma, dysfunctional attitudes, maladaptive coping) and depressive symptom trajectories varied as a function of the number of prior major depressive episodes experienced in their lifetime. Design Participants were 68 young adults who varied with regard to their history of depression; 32 were remitted depressed and 36 were never depressed Methods Depressive symptoms and disorders were assessed using semi-structured psychiatric interviews conducted twice over a 6-month period; interviews yielded weekly ratings of depressive symptoms during the follow-up interval. Childhood trauma, dysfunctional attitudes and coping were assessed with self-report measures. Data analyses were conducted using time-lagged multilevel models. Results Individuals with more previous major depressive episodes (MDEs) who reported greater childhood trauma exposure, more dysfunctional attitudes, or greater use of maladaptive coping strategies experienced more rapid increases in depressive symptoms during the follow-up period. A significant interaction of coping, number of previous MDEs, and time was found indicating that among individuals with less adaptive coping (i.e., lower primary or lower secondary control coping scores), depressive symptoms (DSR) increased significantly in relation to number of prior depressive episodes; no change in DSR was observed for never-depressed individuals. Among individuals with higher primary control coping scores, significant increases in DSR scores were observed for individuals with ≥ 3 prior MDEs only. Conclusions Findings highlight the need for treatment and prevention programs that target stress reactivity and coping strategies early in the course of depression. PMID:24372468

Preliminary Evaluation of a Brief Web and Mobile Phone Intervention for Men With Depression: Men's Positive Coping Strategies and Associated Depression, Resilience, and Work and Social Functioning.

PubMed

Fogarty, Andrea Susan; Proudfoot, Judy; Whittle, Erin Louise; Clarke, Janine; Player, Michael J; Christensen, Helen; Wilhelm, Kay

2017-08-10

Previous research has identified that men experiencing depression do not always access appropriate health services. Web-based interventions represent an alternative treatment option for men, are effective in reducing anxiety and depression, and have potential for wide dissemination. However, men do not access Web-based programs at the same rate as women. Programs with content explicitly tailored to men's mental health needs are required. This study evaluated the applicability of Man Central, a new Web and mobile phone intervention for men with depression. The impact of the use of Man Central on depression, resilience, and work and social functioning was assessed. A recruitment flier was distributed via social media, email networks, newsletters, research registers, and partner organizations. A single-group, repeated measures design was used. The primary outcome was symptoms of depression. Secondary outcomes included externalizing symptoms, resilience, and work and social functioning. Man Central comprises regular mood, symptom, and behavior monitoring, combined with three 15-min interactive sessions. Clinical features are grounded in cognitive behavior therapy and problem-solving therapy. A distinguishing feature is the incorporation of positive strategies identified by men as useful in preventing and managing depression. Participants were directed to use Man Central for a period of 4 weeks. Linear mixed modeling with intention-to-treat analysis assessed associations between the intervention and the primary and secondary outcomes. A total of 144 men aged between 18 and 68 years and with at least mild depression enrolled in the study. The symptoms most often monitored by men included motivation (471 instances), depression (399), sleep (323), anxiety (316), and stress (262). Reminders were scheduled by 60.4% (87/144). Significant improvements were observed in depression symptoms (P<.001, d=0.68), depression risk, and externalizing symptoms (P<.001, d=0.88) and work and social functioning (P<.001, d=0.78). No change was observed in measures of resilience. Participants reported satisfaction with the program, with a majority saying that it was easy (42/51, 82%) and convenient (41/51, 80%) to use. Study attrition was high; 27.1% (39/144) and 8.3% (12/144) of the participants provided complete follow-up data and partial follow-up data, respectively, whereas the majority (93/144, 64.6%) did not complete follow-up measures. This preliminary evaluation demonstrated the potential of using electronic health (eHealth) tools to deliver self-management strategies to men with depressive symptoms. Man Central may meet the treatment needs of a subgroup of depressed men who are willing to engage with an e-mental health program. With further research, it may provide an acceptable option to those unwilling or unable to access traditional mental health services. Given the limitations of the study design, prospective studies are required, using controlled designs to further elucidate the effect of the program over time. ©Andrea Susan Fogarty, Judy Proudfoot, Erin Louise Whittle, Janine Clarke, Michael J Player, Helen Christensen, Kay Wilhelm. Originally published in JMIR Mental Health (http://mental.jmir.org), 10.08.2017.

Eating styles in major depressive disorder: Results from a large-scale study.

PubMed

Paans, Nadine P G; Bot, Mariska; van Strien, Tatjana; Brouwer, Ingeborg A; Visser, Marjolein; Penninx, Brenda W J H

2018-02-01

Depressed persons have been found to present disturbances in eating styles, but it is unclear whether eating styles are different in subgroups of depressed patients. We studied the association between depressive disorder, severity, course and specific depressive symptom profiles and unhealthy eating styles. Cross-sectional and course data from 1060 remitted depressed patients, 309 currently depressed patients and 381 healthy controls from the Netherlands Study of Depression and Anxiety were used. Depressive disorders (DSM-IV based psychiatric interview) and self-reported depressive symptoms (Inventory of Depressive Symptomatology) were related to emotional, external and restrained eating (Dutch Eating Behavior Questionnaire) using analyses of covariance and linear regression. Remitted and current depressive disorders were significantly associated with higher emotional eating (Cohen's d = 0.40 and 0.60 respectively, p < 0.001) and higher external eating (Cohen's d = 0.20, p = 0.001 and Cohen's d = 0.32, p < 0.001 respectively). Little differences in eating styles between depression course groups were observed. Associations followed a dose-response association, with more emotional and external eating when depression was more severe (both p-values <0.001). Longer symptom duration was also associated to more emotional and external eating (p < 0.001 and p = 0.001 respectively). When examining individual depressive symptoms, neuro-vegetative depressive symptoms contributed relatively more to emotional and external eating, while mood and anxious symptoms contributed relatively less to emotional and external eating. No depression associations were found with restrained eating. Intervention programs for depression should examine whether treating disordered eating specifically in those with neuro-vegetative, atypical depressive symptoms may help prevent or minimize adverse health consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mother-Child Conflict and Its Moderating Effects on Depression Outcomes in a Preventive Intervention for Adolescent Depression

ERIC Educational Resources Information Center

Young, Jami F.; Gallop, Robert; Mufson, Laura

2009-01-01

This article reports on mother-child conflict as an outcome and moderator of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a preventive intervention for depression. Forty-one adolescents (average age = 13.37, SD = 1.19) with elevated depression symptoms were randomized to receive IPT-AST or school counseling (SC). Adolescents…

An interactive media program for managing psychosocial problems on long-duration spaceflights.

PubMed

Carter, James A; Buckey, Jay C; Greenhalgh, Leonard; Holland, Albert W; Hegel, Mark T

2005-06-01

Space crews must be self-reliant to complete long-duration missions successfully. This project involves the development and evaluation of a network of self-guided interactive multimedia programs to train and assist long-duration flyers in the prevention, assessment, and management of psychosocial problems that can arise on extended missions. The system is currently under development and is intended for use both during training and on orbit. A virtual space station 3-dimensional graphic was created to serve as a portal to multimedia-based training, assessment, and intervention resources. Additionally, original content on interpersonal conflict and depression is being developed for the system. Input on the best practices for managing conflict and depression on extended missions was obtained from 13 veteran long-duration flyers, as well as from clinical experts. Formative evaluation of a prototype of the system will be conducted with 10 members of the astronaut corps. Subsequently, the content on conflict and depression will be completed, and the depression self-treatment portion will be evaluated in a randomized controlled trial. Although this study involves developing countermeasures to assist long-duration flyers, it also provides a model that could be applied in many Earthbound settings, both in operational environments and in everyday life.

Preventing postpartum depression: A meta-analytic review

PubMed Central

Sockol, Laura E.; Epperson, C. Neill; Barber, Jacques P.

2014-01-01

This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g = 0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes. PMID:24211712

Adverse childhood experiences and intimate partner aggression in the US: sex differences and similarities in psychosocial mediation.

PubMed

Brown, Monique J; Perera, Robert A; Masho, Saba W; Mezuk, Briana; Cohen, Steven A

2015-04-01

Six in ten people in the general population have been exposed to adverse childhood experiences (ACEs). Intimate partner violence (IPV) is a major public health problem in the US. The main objective of this study was to assess sex differences in the role of posttraumatic stress disorder (PTSD), substance abuse, and depression as mediators in the association between ACEs and intimate partner aggression. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the mediational role of PTSD, substance abuse and depression in the association between ACE constructs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration/psychopathology) and intimate partner aggression. Among men, PTSD mediated the relationship between sexual abuse and intimate partner aggression. However, among men and women, substance abuse mediated the relationship between physical and psychological abuse and intimate partner aggression. IPV programs geared towards aggressors should address abuse (sexual, physical and psychological), which occurred during childhood and recent substance abuse and PTSD. These programs should be implemented for men and women. Programs aimed at preventing abuse of children may help to reduce rates of depression and PTSD in adulthood, and subsequent intimate partner aggression. Copyright © 2015 Elsevier Ltd. All rights reserved.

Adverse childhood experiences and intimate partner aggression in the US: Sex differences and similarities in psychosocial mediation

PubMed Central

Brown, Monique J.; Perera, Robert A.; Masho, Saba W.; Mezuk, Briana; Cohen, Steven A.

2015-01-01

Six in ten people in the general population have been exposed to adverse childhood experiences (ACEs). Intimate partner violence (IPV) is a major public health problem in the US. The main objective of this study was to assess sex differences in the role of posttraumatic stress disorder (PTSD), substance abuse, and depression as mediators in the association between ACEs and intimate partner aggression. Data were obtained from Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the mediational role of PTSD, substance abuse and depression in the association between ACE constructs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration/psychopathology) and intimate partner aggression. Among men, PTSD mediated the relationship between sexual abuse and intimate partner aggression. However, among men and women, substance abuse mediated the relationship between physical and psychological abuse and intimate partner aggression. IPV programs geared towards aggressors should address abuse (sexual, physical and psychological), which occurred during childhood and recent substance abuse and PTSD. These programs should be implemented for men and women. Programs aimed at preventing abuse of children may help to reduce rates of depression and PTSD in adulthood, and subsequent intimate partner aggression. PMID:25753285

RELATIONSHIP OF COGNITIVE BEHAVIORAL THERAPY EFFECTS AND HOMEWORK IN AN INDICATED PREVENTION OF DEPRESSION INTERVENTION FOR NON-PROFESSIONAL CAREGIVERS (.).

PubMed

Otero, Patricia; Vázquez, Fernando L; Hermida, Elisabet; Díaz, Olga; Torres, Ángela

2015-06-01

Activities designed to be performed outside of the intervention are considered an essential aspect of the effectiveness of cognitive-behavioral therapy. However, these have received little attention in interventions aimed at individuals with subclinical depressive symptoms who do not yet meet diagnostic criteria for depression (indicated prevention). In this study, the completion of tasks given as homework and their relationship with post-treatment depressive symptoms was with relation to an indicated prevention of depression intervention. Eighty-nine female non-professional caregivers recruited from an official registry completed an intervention involving 11 homework tasks. Tasks performed were recorded and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Among caregivers, 80.9% completed 9-11 tasks. The number of tasks performed was associated with post-treatment depressive symptoms, with 9 being optimal for clinically significant improvement. These findings highlight the relationship between homework and post-treatment depressive symptoms.

Family Functioning and Adolescent Alcohol Use: A Moderated Mediation Analysis

PubMed Central

Ohannessian, Christine McCauley; Flannery, Kaitlin M.; Simpson, Emily; Russell, Beth S.

2016-01-01

The primary goals of this longitudinal study were to examine the relationship between family functioning and adolescent alcohol use and to examine whether depressed mood mediates this relationship. An additional goal was to explore whether these relations were moderated by gender. The sample included 1,031 high school students from the Mid-Atlantic United States. Participants completed surveys in school during the spring of 2007, 2008, and 2009. Path analysis results indicated that family functioning predicted alcohol use for girls. Moreover, depressed mood mediated this relationship. None of the direct paths between family functioning and adolescent alcohol use were significant for boys. However, similar to girls, depressed mood negatively predicted alcohol use for boys. Taken together, the findings highlight the need for prevention programs targeting adolescent substance use to consider gender-specific trajectories. PMID:26994346

Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review.

PubMed

De Berardis, Domenico; Fornaro, Michele; Orsolini, Laura; Valchera, Alessandro; Carano, Alessandro; Vellante, Federica; Perna, Giampaolo; Serafini, Gianluca; Gonda, Xenia; Pompili, Maurizio; Martinotti, Giovanni; Di Giannantonio, Massimo

2017-01-01

It is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than non-alexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se . Therefore, the purpose of this narrative mini-review was to elucidate a possible relationship between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and an increased suicide risk. In several studies, this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, limitations of studies are discussed and must be considered.

Postnatal Depression Prevention Through Prenatal Intervention: A Literature Review

DTIC Science & Technology

2006-03-17

Healthy People 2010 is to reduce the rate of post - partum depression . One method to reach this goal is to prevent post -partun depression (PPD) by providing...20060505147 04/17/2006 06:59 13036779673 BUCKLEY AFB ITT PAGE 07 Introduction Depression during pregnancy is associated with "higher incidence of post ... partum depression , maternal psychosocial and lifestyle risks, death by suicide, and adverse fetal outcomes" (Jesse and Graham, 2005). According to

Fluoxetine Treatment for Prevention of Relapse of Depression in Children and Adolescents: A Double-Blind, Placebo-Controlled Study

ERIC Educational Resources Information Center

Emslie, Graham J.; Heiligenstein, John H.; Hoog, Sharon L.; Wagner, Karen Dineen; Findling, Robert L.; McCracken, James T.; Nilsson, Mary E.; Jacobson, Jennie G.

2004-01-01

Objective: To compare fluoxetine 20 to 60 mg/day with placebo for prevention of relapse of major depressive disorder in children and adolescents who had achieved Children's Depression Rating Scale, Revised scores of [less than or equal to]28 during treatment with fluoxetine 20 to 60 mg. Method: In this 32-week relapse-prevention phase of a…

Peer support for postpartum depression: volunteers' perceptions, recruitment strategies and training from a randomized controlled trial

PubMed Central

Dennis, Cindy-Lee

2013-01-01

A randomized controlled trial evaluated the effect of telephone-based peer support (mother-to-mother) on preventing postpartum depression among high-risk mothers. This paper reports volunteers' perceptions, which showed that peer support is an effective preventative intervention. Two-hundred and five (205) volunteers were recruited and trained to provide peer support to 349 mothers randomized to the intervention group. Volunteers' perceptions were measured at 12 weeks using the Peer Volunteer Experience Questionnaire, completed by 69% (121) of the 175 volunteers who provided support to at least one mother. Large majorities felt that the training session had prepared them for their role (94.2%), that volunteering did not interfere with their lives (81.8%) and that providing support helped them grow as individuals (87.8%). Over 90% stated that they would become a peer volunteer again, given the opportunity. Recruitment and retention of effective volunteers is essential to the success of any peer-support intervention. Results from this study can assist clinicians and program planners to provide effective training, sufficient on-going support and evaluation and appropriate matching of volunteers to mothers who desire peer support and are at high risk of postpartum depression. PMID:22388589

Preschool attachment, self-esteem and the development of preadolescent anxiety and depressive symptoms.

PubMed

Lecompte, Vanessa; Moss, Ellen; Cyr, Chantal; Pascuzzo, Katherine

2014-01-01

This study examined the longitudinal association between preschool attachment patterns, the development of anxiety and depression at preadolescence and the mediational role of self-esteem. Child-mother attachment classifications of 68 children (33 girls) were assessed between 3-4 years of age (M = 3.7 years, SD = 4.4 months) using the Separation-Reunion Procedure. At age 11-12 (M = 11.7 years, SD = 4.3 months), anxiety and depressive symptoms (Dominic Interactive Questionnaire), and self-esteem (Self-Perception Profile for Children) were also evaluated. Preadolescents who had shown disorganized attachment at preschool age scored higher on both anxiety and depression and lower on self-esteem than those who had shown secure and insecure-organized attachment strategies. Self-esteem was a partial mediator of the association between preschool disorganization and symptoms of preadolescent depression, but the model was not supported for anxiety. These findings support the idea that early attachment and self-esteem should be central themes in prevention programs with young children.

[Aggression and related factors in elementary school students].

PubMed

Ji, Eun Sun; Jang, Mi Heui

2010-10-01

This study was done to explore the relationship between aggression and internet over-use, depression-anxiety, self-esteem, all of which are known to be behavior and psychological characteristics linked to "at-risk" children for aggression. Korean-Child Behavior Check List (K-CBCL), Korean-Internet Addiction Self-Test Scale, and Self-Esteem Scale by Rosenberg (1965) were used as measurement tools with a sample of 743, 5th-6th grade students from 3 elementary schools in Jecheon city. Chi-square, t-test, ANOVA, Pearson's correlation and stepwise multiple regression with SPSS/Win 13.0 version were used to analyze the collected data. Aggression for the elementary school students was positively correlated with internet over-use and depression-anxiety, whereas self-esteem was negatively correlated with aggression. Stepwise multiple regression analysis showed that 68.4% of the variance for aggression was significantly accounted for by internet over-use, depression-anxiety, and self-esteem. The most significant factor influencing aggression was depression-anxiety. These results suggest that earlier screening and intervention programs for depression-anxiety and internet over-use for elementary student will be helpful in preventing aggression.

Perinatal depression prevention through home visitation: a cluster randomized trial of mothers and babies 1-on-1.

PubMed

Tandon, S Darius; Ward, Erin A; Hamil, Jaime L; Jimenez, Cindy; Carter, Mya

2018-05-15

Postpartum depression is highly prevalent in low-income women and has significant health effects on mother and child. This pilot study tested the effectiveness of the newly adapted Mothers and Babies (MB) 1-on-1 intervention. A cluster randomized trial was conducted with 8 programs using trained home visitors to deliver MB 1-on-1 and 6 delivering usual home visiting. One hundred twenty pregnant women not experiencing major depression were enrolled. Outcomes were assessed at baseline and 3- and 6-months postpartum. The rate of change in depressive and anxiety symptoms between groups was significant at 6 months, but not 3 months. No statistically significant differences between groups were found on secondary outcomes except perceptions of social support at 6 months. There was variability in use of MB skills, with fewer women using cognitive restructuring techniques. Although larger studies should be conducted, MB 1-on-1 appears promising in using home visitors to deliver a cognitive behavioral intervention to women at risk for postpartum depression.

Emotion-based preventive intervention: Effectively promoting emotion knowledge and adaptive behavior among at-risk preschoolers.

PubMed

Finlon, Kristy J; Izard, Carroll E; Seidenfeld, Adina; Johnson, Stacy R; Cavadel, Elizabeth Woodburn; Ewing, E Stephanie Krauthamer; Morgan, Judith K

2015-11-01

Effectiveness studies of preschool social-emotional programs are needed in low-income, diverse populations to help promote the well-being of at-risk children. Following an initial program efficacy study 2 years prior, 248 culturally diverse Head Start preschool children participated in the current effectiveness trial and received either the Emotion-Based Prevention Program (EBP) or the I Can Problem Solve (ICPS) intervention. Pre- and postdata collection included direct child assessment, teacher report, parent interview, and independent observations. Teachers implementing the EBP intervention demonstrated good and consistent fidelity to the program. Overall, children in EBP classrooms gained more emotion knowledge and displayed greater decreases in negative emotion expressions and internalizing behaviors across the implementation period as compared to children in ICPS classrooms. In addition, cumulative risk, parental depressive symptoms, and classroom climate significantly moderated treatment effects. For children experiencing more stress or less support, EBP produced more successful outcomes than did ICPS. These results provide evidence of EBP sustainability and program effectiveness, as did previous findings that demonstrated EBP improvements in emotion knowledge, regulation skills, and behavior problems replicated under unsupervised program conditions.

Risks for Depression Onset in Primary Care Elderly Patients: Potential Targets for Preventive Interventions

PubMed Central

Lyness, Jeffrey M.; Yu, Qin; Tang, Wan; Tu, Xin; Conwell, Yeates

2010-01-01

Objective Prevention of late-life depression, a common, disabling condition with often poor outcomes in primary care, requires identification of seniors at highest risk of incident episodes. The authors examined a broad range of clinical, functional, and psychosocial predictors of incident depressive episodes in a well-characterized cohort of older primary care patients. Method In this observational cohort study, patients age ≥65 years without current major depression, recruited from practices in general internal medicine, geriatrics, and family medicine, received annual follow-up assessments over a period of 1 to 4 years. Of 617 enrolled subjects, 405 completed the 1-year follow-up evaluation. The Structured Clinical Interview for DSM-IV (SCID) determined incident major depressive episodes. Each risk indicator’s predictive utility was examined by calculating the risk exposure rate, incident risk ratio, and population attributable fraction, leading to determination of the number needed to treat in order to prevent incident depression. Results A combination of risks, including minor or subsyndromal depression, impaired functional status, and history of major or minor depression, identified a group in which fully effective treatment of five individuals would prevent one new case of incident depression. Conclusions Indicators routinely assessed in primary care identified a group at very high risk for onset of major depressive episodes. Such markers may inform current clinical care by fostering the early detection and intervention critical to improving patient outcomes and may serve as the basis for future studies refining the recommendations for screening and determining the effectiveness of preventive interventions. PMID:19833788

Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach.

PubMed

Zwerenz, Rüdiger; Becker, Jan; Knickenberg, Rudolf J; Siepmann, Martin; Hagen, Karin; Beutel, Manfred E

2017-01-01

Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online information on depression) in addition to inpatient psychodynamic psychotherapy. Both groups had access to their respective experimental intervention for 12 weeks, regardless of inpatient treatment duration. Reduction of depressive symptoms, as measured with the Beck Depression Inventory-II, was the primary outcome at the end of the intervention (T2). Depressive symptoms were statistically significantly lower in the IG compared to the active CG at T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d = 0.38) at discharge from inpatient treatment (T1). No statistically significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. This is the first evidence for blended treatment combining online self-help with inpatient psychotherapy. The study opens new and promising avenues for increasing the efficacy of inpatient psychotherapy. Future studies should determine how integration of online self-help into the therapeutic process can be developed further. © 2017 S. Karger AG, Basel.

Depressive Symptoms and Problematic Internet Use Among Adolescents: Analysis of the Longitudinal Relationships from the Cognitive–Behavioral Model

PubMed Central

2014-01-01

Abstract Problematic Internet use—frequently called Internet addiction or compulsive use—represents an increasingly widespread problem among adolescents. The objective of this study was to analyze the temporal and reciprocal relations between the presence of depressive symptoms and various components of problematic Internet use (i.e., the preference for online relationships, use of the Internet for mood regulation, deficient self-regulation, and the manifestation of negative outcomes). Consequently, a longitudinal design was employed with two times separated by a 1 year interval. The sample consisted of 699 adolescents (61.1% girls) between 13 and 17 years of age. The results indicated that depressive symptoms at time 1 predicted an increase in preference for online relationships, mood regulation, and negative outcomes after 1 year. In turn, negative outcomes at time 1 predicted an increase in depressive symptoms at time 2. These results entail several practical implications for the design of prevention programs and the treatment of problematic Internet use. PMID:25405784

Depression prevention, labour force participation and income of older working aged Australians: A microsimulation economic analysis.

PubMed

Veerman, J Lennert; Shrestha, Rupendra N; Mihalopoulos, Cathrine; Passey, Megan E; Kelly, Simon J; Tanton, Robert; Callander, Emily J; Schofield, Deborah J

2015-05-01

Depression has economic consequences not only for the health system, but also for individuals and society. This study aims to quantify the potential economic impact of five-yearly screening for sub-syndromal depression in general practice among Australians aged 45-64 years, followed by a group-based psychological intervention to prevent progression to depression. We used an epidemiological simulation model to estimate reductions in prevalence of depression, and a microsimulation model, Health&WealthMOD2030, to estimate the impact on labour force participation, personal income, savings, taxation revenue and welfare expenditure. Group therapy is estimated to prevent around 5,200 prevalent cases of depression (2.2%) and add about 520 people to the labour force. Private incomes are projected to increase by $19 million per year, tax revenues by $2.4 million, and transfer payments are reduced by $2.6 million. Group-based psychological intervention to prevent depression could result in considerable economic benefits in addition to its clinical effects. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Impact of Mano a Mano-Mujer, an HIV prevention intervention, on depressive symptoms among Chilean women.

PubMed

Cianelli, R; Lara, L; Villegas, N; Bernales, M; Ferrer, L; Kaelber, L; Peragallo, N

2013-04-01

Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions. © 2012 Blackwell Publishing.

A Systematic Review of Elderly Suicide Prevention Programs

PubMed Central

Lapierre, Sylvie; Erlangsen, Annette; Waern, Margda; De Leo, Diego; Oyama, Hirofumi; Scocco, Paolo; Gallo, Joseph; Szanto, Katalin; Conwell, Yeates; Draper, Brian; Quinnett, Paul

2013-01-01

Background Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area. Aims We carried out a systematic review to examine the results of interventions aimed at suicidal elderly persons and to identify successful strategies and areas needing further exploration. Methods Searches through various electronic databases yielded 19 studies with an empirical evaluation of a suicide prevention or intervention program designed especially for adults aged 60 years and older. Results Most studies were centered on the reduction of risk factors (depression screening and treatment, and decreasing isolation), but when gender was considered, programs were mostly efficient for women. The empirical evaluations of programs attending to the needs of high-risk older adults seemed positive; most studies showed a reduction in the level of suicidal ideation of patients or in the suicide rate of the participating communities. However, not all studies used measures of suicidality to evaluate the outcome of the intervention, and rarely did they aim at improving protective factors. Conclusions Innovative strategies should improve resilience and positive aging, engage family and community gatekeepers, use telecommunications to reach vulnerable older adult, and evaluate the effects of means restriction and physicians education on elderly suicide. PMID:21602163

Impact of Mano a Mano Mujer, an HIV Prevention Intervention, on Depressive Symptoms among Chilean Women

PubMed Central

Cianelli, Rosina; Lara, Loreto; Villegas, Natalia; Bernales, Margarita; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda

2012-01-01

Background Worldwide, an in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low income Chilean women. Depressed people are less willing to participate in behaviors that protect them against HIV. Objectives To analyze the impact of Mano a Mano-Mujer (MM-M) on depressive symptoms among Chilean women. Methods A quasi-experimental design was used to test the impact of MM-M, an HIV prevention intervention. The research was conducted in Santiago- Chile, a total of 400 women participated in the study (intervention group, n = 182; control group, n = 218). The intervention was guided by the social-cognitive model and the primary health model. The intervention consists of six two-hour sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face to face interviews were conducted at baseline and at 3 months follow-up Results At 3 months post-intervention, Chilean women who participated in MM-M significantly decreased their reported depressive symptoms. Conclusions MM-M provided significant benefits for women's depression symptoms. This study offers a model that address depression, a risk factor for HIV. It uses nurses as leaders for the screening of depressive symptoms and as facilitators of community interventions. PMID:22452388

Preventing Depression in Later Life: Translation From Concept to Experimental Design and Implementation

PubMed Central

Sriwattanakomen, Roy; Ford, Angela F.; Thomas, Stephen B.; Miller, Mark D.; Stack, Jacqueline A.; Morse, Jennifer Q.; Kasckow, John; Brown, Charlotte; Reynolds, Charles F.

2009-01-01

Objective The authors detail the public health need for depression prevention research and the decisions made in designing an experiment testing problem solving therapy as “indicated” preventive intervention for high-risk older adults with subsyndromal depression. Special attention is given to the recruitment of African Americans because of well-documented inequalities in mental health services and depression treatment outcomes between races. Methods A total of 306 subjects (half white, half African American) with scores of 16 or higher on the Center for Epidemiological Studies of Depression Scale, but with no history of major depressive disorder in the past 12 months, are being recruited and randomly assigned to either problem solving therapy-primary care or to a dietary education control condition. Time to, and rate of, incident episodes of major depressive disorder are to be modeled using survival analysis. Level of depressive symptoms will be analyzed via a mixed models approach. Results Twenty-two subjects have been recruited into the study, and to date eight have completed the randomly assigned intervention and postintervention assessment. Four of 22 have exited after developing major depressive episodes. None have complained about study procedures or demands. Implementation in a variety of community settings is going well. Conclusion The data collected to date support the feasibility of translating from epidemiology to RCT design and implementation of empirical depression prevention research in later life. PMID:18515690

5-Hydroxytryptamine 1A/7 and 4alpha receptors differentially prevent opioid-induced inhibition of brain stem cardiorespiratory function.

PubMed

Wang, Xin; Dergacheva, Olga; Kamendi, Harriet; Gorini, Christopher; Mendelowitz, David

2007-08-01

Opioids evoke respiratory depression, bradycardia, and reduced respiratory sinus arrhythmia, whereas serotonin (5-HT) agonists stimulate respiration and cardiorespiratory interactions. This study tested whether serotonin agonists can prevent the inhibitory effects of opioids on cardiorespiratory function. Spontaneous and rhythmic inspiratory-related activity and gamma-aminobutyric acid (GABA) neurotransmission to premotor parasympathetic cardioinhibitory neurons in the nucleus ambiguus were recorded simultaneously in an in vitro thick slice preparation. The mu-opioid agonist fentanyl inhibited respiratory frequency. The 5-hydroxytryptamine 1A/7 receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin increased respiratory frequency by itself and also prevented the fentanyl-induced respiratory depression. The 5-hydroxytryptamine 4alpha agonist BIMU-8 did not by itself change inspiratory activity but prevented the mu-opioid-mediated respiratory depression. Both spontaneous and inspiratory-evoked GABAergic neurotransmission to cardiac vagal neurons were inhibited by fentanyl. 8-Hydroxy-2-(di-n-propylamino)tetralin inhibited spontaneous but not inspiratory-evoked GABAergic activity to parasympathetic cardiac neurons. However, 8-hydroxy-2-(di-n-propylamino)tetralin differentially altered the opioid-mediated depression of inspiratory-evoked GABAergic activity but did not change the opioid-induced reduction in spontaneous GABAergic neurotransmission. In contrast, BIMU-8 did not alter GABAergic neurotransmission to cardiac vagal neurons by itself but prevented the fentanyl depression of both spontaneous and inspiratory-elicited GABAergic neurotransmission to cardiac vagal neurons. In the presence of tetrodotoxin, the inhibition of GABAergic inhibitory postsynaptic currents with fentanyl is prevented by coapplication of BIMU-8, indicating that BIMU-8 acts at presynaptic GABAergic terminals to prevent fentanyl-induced depression. These results suggest that activation of 5-hydroxytryptamine receptors, particularly 5-hydroxytryptamine 4alpha agonists, may be a useful therapeutic approach in preventing opioid-evoked cardiorespiratory depression.

Obesity, eating behaviour and mental health among university students in Mexico City.

PubMed

Lazarevich, Irina; Irigoyen-Camacho, María Esther; Velázquez-Alva, María del Consuelo

2013-11-01

Psychological factors are important in the development of obesity; however these are frequently underestimated in intervention programs. To examine the association of mental health with altered eating behavior related to weigh gain, and with abdominal obesity among college students in order to provide more comprehensive guidelines for intervention programs. A cross-sectional study was performed with 1,122 university students (from a total population of 1,820 freshmen students) at the Metropolitan Autonomous University, Mexico City. Body mass index and waist circumference (WC) were recorded. A six items questionnaire was applied to assess altered eating behavior. Self-reported questionnaires for depression (Beck Depression Inventory), anxiety (General Anxiety Disorder Scale of Carrol and Davidson), and impulsiveness symptoms (Plutchik Impulsivity Scale) were used. Multiple logistic regression models were performed. An increased WC was associated with depression symptoms (OR=1.4), female sex (OR=1.5), and age (OR=1.1). Students with altered eating behaviors showed elevated levels of impulsivity (e.g. have difficulties to stop eating, OR=4.2) and depression (e.g. have problem to eat at regular times, OR=6.98). In addition, higher WC was associated with female sex, parents' obesity, and unhealthy eating behaviors (e.g. have difficulties to stop eating, OR=1.42; and constantly feel hungry, and eat too much, OR=2.25). Although preventive programs directed at development of adequate eating habits and physical activity are considered a key component of intervention programs, strategies for the management of emotions, the promotion of positive mood and impulsivity-reduction techniques are a necessary complement for a comprehensive approach to overweight and obesity. Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Attachment to Parents As a Moderator in the Association between Sibling Bullying and Depression or Suicidal Ideation among Children and Adolescents.

PubMed

Bar-Zomer, Jasmin; Brunstein Klomek, Anat

2018-01-01

Bullying is one of the most widespread phenomenon in childhood and adolescence. Interestingly, most research on bullying focuses on bullying at school and not on bullying among siblings at home. Sibling bullying is the most frequent form of repeated aggression that children experience in their lifetime. Furthermore, previous studies indicate that sibling bullying is associated with depression and self-harm behavior. However, the association between sibling bullying and suicidal ideation was never previously examined. Attachment to parents is one variable that can moderate the association between sibling bullying and depression/suicide ideation. To our knowledge, there is no existing study that examines the association between sibling bullying and attachment patterns. In addition, no previous study has examined the moderating role of attachment on the association between sibling bullying and depression or suicidal ideation among adolescents. The current study includes 279 Israeli students aged 10-17 (M = 13.5; SD = 1.98; 164, 58.8% females) who completed self-report questionnaires regarding school and sibling bullying, attachment to mother and father, depression, and suicidal ideation. The results indicated an association between bullying among siblings and school bullying. In addition, children and adolescents who were consistently involved in sibling bullying were at greater risk for depression and suicide ideation when compared to children and adolescents who were not involved in sibling bullying. A secure attachment to one's father (but not to one's mother) moderated the association between sibling bullying and depression/suicide ideation. It should be noted that when suicide ideation was examined above and beyond depression, attachment to one's father did not moderate the association between sibling bullying involvement and suicide ideation. This finding indicates that depression plays a central role in the association between sibling bullying and suicide ideation. These results suggest that sibling bullying is a risk factor for depressive symptoms and suicide ideation and that secure attachment to one's father may serve as a protective role. Future bullying prevention programs should include sibling bullying and encourage the increased availability of paternal emotional support. Other theoretical and applied implications for prevention of both sibling bullying and suicide are discussed.

Shared Risk Factors for the Perpetration of Physical Dating Violence, Bullying, and Sexual Harassment Among Adolescents Exposed to Domestic Violence.

PubMed

Foshee, Vangie A; McNaughton Reyes, H Luz; Chen, May S; Ennett, Susan T; Basile, Kathleen C; DeGue, Sarah; Vivolo-Kantor, Alana M; Moracco, Kathryn E; Bowling, J Michael

2016-04-01

The high risk of perpetrating physical dating violence, bullying, and sexual harassment by adolescents exposed to domestic violence points to the need for programs to prevent these types of aggression among this group. This study of adolescents exposed to domestic violence examined whether these forms of aggression share risk factors that could be targeted for change in single programs designed to prevent all three types of aggression. Analyses were conducted on 399 mother victims of domestic violence and their adolescents, recruited through community advertising. The adolescents ranged in age from 12 to 16 years; 64 % were female. Generalized estimating equations was used to control for the covariation among the aggression types when testing for shared risk factors. Approximately 70 % of the adolescents reported perpetrating at least one of the three forms of aggression. In models examining one risk factor at a time, but controlling for demographics, adolescent acceptance of sexual violence, mother-adolescent discord, family conflict, low maternal monitoring, low mother-adolescent closeness, low family cohesion, depressed affect, feelings of anger, and anger reactivity were shared across all three aggression types. In multivariable models, which included all of the risk factors examined and the demographic variables, low maternal monitoring, depressed affect and anger reactivity remained significant shared risk factors. Our findings suggest that programs targeting these risk factors for change have the potential to prevent all three forms of aggression. In multivariable models, poor conflict management skills was a risk for bullying and sexual harassment, but not dating violence; acceptance of dating violence was a risk for dating violence and bullying, but not sexual harassment; and none of the examined risk factors were unique to aggression type. The study's implications for the development of interventions and future research are discussed.

Illness Perception and Depressive Symptoms among Persons with Type 2 Diabetes Mellitus: An Analytical Cross-Sectional Study in Clinical Settings in Nepal.

PubMed

Joshi, Suira; Dhungana, Raja Ram; Subba, Usha Kiran

2015-01-01

Background. This study aimed to assess the relationship between illness perception and depressive symptoms among persons with diabetes. Method. This was an analytical cross-sectional study conducted among 379 type 2 diabetic patients from three major clinical settings of Kathmandu, Nepal. Results. The prevalence of depressive symptoms was 44.1% (95% CI: 39.1, 49.1). Females (p < 0.01), homemakers (p < 0.01), 61-70 age group (p = 0.01), those without formal education (p < 0.01), and people with lower social status (p < 0.01) had significantly higher proportion of depressive symptoms than the others. Multivariable analysis identified age (β = 0.036, p = 0.016), mode of treatment (β = 0.9, p = 0.047), no formal educational level (β = 1.959, p = 0.01), emotional representation (β = 0.214, p < 0.001), identity (β = 0.196, p < 0.001), illness coherence (β = -0.109, p = 0.007), and consequences (β = 0.093, p = 0.049) as significant predictors of depressive symptoms. Conclusion. Our study demonstrated a strong relationship between illness perception and depressive symptoms among diabetic patients. Study finding indicated that persons living with diabetes in Nepal need comprehensive diabetes education program for changing poor illness perception, which ultimately helps to prevent development of depressive symptoms.

The GoodNight study--online CBT for insomnia for the indicated prevention of depression: study protocol for a randomised controlled trial.

PubMed

Gosling, John A; Glozier, Nick; Griffiths, Kathleen; Ritterband, Lee; Thorndike, Frances; Mackinnon, Andrew; Hehir, Kanupriya Kalia; Bennett, Anthony; Bennett, Kylie; Christensen, Helen

2014-02-13

Cognitive Behaviour Therapy for Insomnia (CBT-I) delivered through the Internet is effective as a treatment in reducing insomnia in individuals seeking help for insomnia. CBT-I also lowers levels of depression in this group. However, it is not known if targeting insomnia using CBT-I will lower depressive symptoms, and thus reduce the risk of major depressive episode onset, in those specifically at risk for depression. Therefore, this study aims to examine whether Internet delivery of fully automated self-help CBT-I designed to reduce insomnia will prevent depression. A sample of 1,600 community-dwelling adults (aged 18-64), who screen positive for both subclinical levels of depressive symptoms and insomnia, will be recruited via various media and randomised to either a 9-week online insomnia treatment programme, Sleep Healthy Using The internet (SHUTi), or an online attention-matched control group (HealthWatch). The primary outcome variable will be depression symptom levels at the 6-month post-intervention on the Patient Heath Questionnaire-9 (PHQ-9). A secondary outcome will be onset of major depressive episodes assessed at the 6-month post-intervention using 'current' and 'time from intervention' criteria from the Mini International Neuropsychiatric Interview. This trial is the first randomised controlled trial of an Internet-based insomnia intervention as an indicated preventative programme for depression. If effective, online provision of a depression prevention programme will facilitate dissemination. Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12611000121965.

Smoking Cessation After Acute Myocardial Infarction in Relation to Depression and Personality Factors.

PubMed

Schlyter, Mona; Leosdottir, Margrét; Engström, Gunnar; André-Petersson, Lena; Tydén, Patrik; Östman, Margareta

2016-04-01

Smoking is an important cardiovascular risk factor and smoking cessation should be a primary target in secondary prevention after a myocardial infarction (MI). The purpose of this study was to examine whether personality, coping and depression were related to smoking cessation after an MI. MI patients ≤70 years (n = 323, 73 % men, 58.7 ± 8.3 years), participating in the Secondary Prevention and Compliance following Acute Myocardial Infarction study in Malmö, Sweden, between 2002 and 2005, were interviewed by a psychologist to assess coping strategies and completed Beck Depression and NEO Personality Inventories, in close proximity to the acute event. Correlation between smoking status (current, former and never), personality factors, coping and depression was assessed at baseline and 24 months after the MI using logistic regression and in a multivariate analysis, adjusting for age and sex. Of the participating patients, 46 % were current smokers. Two years after the event, 44 % of these were still smoking. At baseline, current smokers scored higher on the depression and neuroticism scales and had lower agreeableness scores. Patients who continued to smoke after 2 years had higher scores on being confrontational (i.e. confrontative coping style) compared to those who had managed to quit. Patients who continued to smoke had significantly lower agreeableness and were more often living alone. Personality, coping strategies and psychosocial circumstances are associated with smoking cessation rates in patients with MI. Considering personality factors and coping strategies to better individualise smoking cessation programs in MI patients might be of importance.

Information technology-enabled team-based, patient-centered care: The example of depression screening and management in cancer care.

PubMed

Randhawa, Gurvaneet S; Ahern, David K; Hesse, Bradford W

2017-03-01

The existing healthcare delivery systems across the world need to be redesigned to ensure high-quality care is delivered to all patients. This redesign needs to ensure care is knowledge-based, patient-centered and systems-minded. The rapid advances in the capabilities of information and communication technology and its recent rapid adoption in healthcare delivery have ensured this technology will play a vital role in the redesign of the healthcare delivery system. This commentary highlights promising new developments in health information technology (IT) that can support patient engagement and self-management as well as team-based, patient-centered care. Collaborative care is an effective approach to screen and treat depression in cancer patients and it is a good example of the benefits of team-based and patient-centered care. However, this approach was developed prior to the widespread adoption and use of health IT. We provide examples to illustrate how health IT can improve prevention and treatment of depression in cancer patients. We found several knowledge gaps that limit our ability to realize the full potential of health IT in the context of cancer and comorbid depression care. These gaps need to be filled to improve patient engagement; enhance the reach and effectiveness of collaborative care and web-based programs to prevent and treat depression in cancer patients. We also identify knowledge gaps in health IT design and implementation. Filling these gaps will help shape policies that enable clinical teams to deliver high-quality cancer care globally.

Quality of life, postnatal depression and baby gender.

PubMed

de Tychey, Claude; Briançon, Serge; Lighezzolo, Joëlle; Spitz, Elisabeth; Kabuth, Bernard; de Luigi, Valerie; Messembourg, Catherine; Girvan, Françoise; Rosati, Aurore; Thockler, Audrey; Vincent, Stephanie

2008-02-01

To study the impact of postnatal depression on the quality of life of young French mothers and to evaluate if the gender of their child influences this. Postnatal depression (PND) constitutes a major public health problem considering its high prevalence and consequences upon quality of life and parental skills. This research is a cross-sectional study during the postnatal period. This study was carried out during a two-month period. Data were collected by interview and questionnaires. The authors compared the prevalence rate of PND and life quality in a cohort of 181 women and measured the short-term impact of the child's birth. Postnatal depression strongly negatively influences all dimensions of life quality explored through the SF36, e.g. physical functioning (PF), physical Role (RP), bodily pain (BP), mental health (MH), emotional role (RE), social functioning (SF), vitality (VT), general health (GH), standardized physical component (PCS) and standardized mental component (MCS). The baby's gender (having a boy) also significantly reduces quality of life, irrespective of depressive state. There is a relationship between baby gender and PND. This research is the first to show that the birth of a boy reduces several dimensions of the mothers' quality of life. The importance of the impairment of quality of life in case of PND, as well as its effects on mother-child interaction, could justify prevention programs and early psychotherapeutic care. Further research needs to explore the effectiveness of programmes targeting the construction of parenting skills as a preventative measure against PND, especially for parents of boys.

Escalation to Major Depressive Disorder among Adolescents with Subthreshold Depressive Symptoms: Evidence of Distinct Subgroups at Risk

PubMed Central

Hill, Ryan M.; Pettit, Jeremy W.; Lewinsohn, Peter M.; Seeley, John R.; Klein, Daniel N.

2014-01-01

Background The presence of subthreshold depressive symptoms (SubD) in adolescence is associated with high prospective risk of developing Major Depressive Disorder (MDD). Little is known about variables that predict escalation from SubD to MDD. This study used a longitudinal prospective design in a community sample of adolescents to identify combinations of risk factors that predicted escalation from SubD to MDD. Methods Classification tree analysis was used to identify combinations of risk factors that improved the sensitivity and specificity of prediction of MDD onset among 424 adolescents with a lifetime history of SubD. Results Of the 424, 144 developed MDD during the follow-up period. Evidence for multiple subgroups was found: Among adolescents with poor friend support, the highest risk of escalation was among participants with lifetime histories of an anxiety or substance use disorder. Among adolescents with high friend support, those reporting multiple major life events in the past year or with a history of an anxiety disorder were at highest risk of escalation. Limitations Study findings may not inform prevention efforts for individuals who first develop SubD during adulthood. This study did not examine the temporal ordering of predictors involved in escalation from SubD to MDD. Conclusions Adolescents with a history of SubD were at highest risk of escalation to MDD in the presence of poor friend support and an anxiety or substance use disorder, or in the presence of better friend support, multiple major life events, and an anxiety disorder. Findings may inform case identification approaches for adolescent depression prevention programs. PMID:24655777

Risk factors for antenatal depression, postnatal depression and parenting stress.

PubMed

Leigh, Bronwyn; Milgrom, Jeannette

2008-04-16

Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors. Risk factor profiles for antenatal depression, postnatal depression and parenting stress differ but are interrelated. Antenatal depression was the strongest predictor of postnatal depression, and in turn postnatal depression was the strongest predictor for parenting stress. These results provide clinical direction suggesting that early identification and treatment of perinatal depression is important.

Depressive symptoms and compromised parenting in low-income mothers of infants and toddlers: distal and proximal risks.

PubMed

Beeber, Linda S; Schwartz, Todd A; Martinez, Maria I; Holditch-Davis, Diane; Bledsoe, Sarah E; Canuso, Regina; Lewis, Virginia S

2014-08-01

Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stress, mothers of toddlers reported more severe depressive symptoms than mothers of infants, supporting the need for depressive symptom screening and monitoring past the immediate postpartum period. Multivariate models revealed intervention targets that can focus depression prevention and intervention efforts, including helping mothers reduce chronic day-to-day stressors and conflicts with significant others, and to effectively handle challenging toddler behaviors, especially in the face of regional disciplinary norms. Presence of a live-in partner was linked to more effective parenting, regardless of participants' depressive symptom severity. © 2014 Wiley Periodicals, Inc.

The Relation of Parental Guilt Induction to Child Internalizing Problems When a Caregiver Has a History of Depression

PubMed Central

Rakow, Aaron; McKee, Laura; Coffelt, Nicole; Champion, Jennifer; Fear, Jessica; Compas, Bruce

2009-01-01

The purpose of this study was to examine the relation between parental guilt induction and child internalizing problems in families where a caregiver had experienced depression. A total of 107 families, including 146 children (age 9–15), participated. Child-reported parental guilt induction, as well as three more traditionally studied parenting behaviors (warmth/involvement, monitoring, and discipline), were assessed, as was parent-report of child internalizing problem behavior. Linear Mixed Models Analysis indicated parental guilt induction was positively related to child internalizing problems in the context of the remaining three parenting behaviors. Implications of the findings for prevention and intervention parenting programs are considered. PMID:20090863

Can community midwives prevent antenatal depression? An external pilot study to test the feasibility of a cluster randomized controlled universal prevention trial.

PubMed

Brugha, T S; Smith, J; Austin, J; Bankart, J; Patterson, M; Lovett, C; Morgan, Z; Morrell, C J; Slade, P

2016-01-01

Repeated epidemiological surveys show no decline in depression although uptake of treatments has grown. Universal depression prevention interventions are effective in schools but untested rigorously in adulthood. Selective prevention programmes have poor uptake. Universal interventions may be more acceptable during routine healthcare contacts for example antenatally. One study within routine postnatal healthcare suggested risk of postnatal depression could be reduced in non-depressed women from 11% to 8% by giving health visitors psychological intervention training. Feasibility and effectiveness in other settings, most notably antenatally, is unknown. We conducted an external pilot study using a cluster trial design consisting of recruitment and enhanced psychological training of randomly selected clusters of community midwives (CMWs), recruitment of pregnant women of all levels of risk of depression, collection of baseline and outcome data prior to childbirth, allowing time for women 'at increased risk' to complete CMW-provided psychological support sessions. Seventy-nine percent of eligible women approached agreed to take part. Two hundred and ninety-eight women in eight clusters participated and 186 termed 'at low risk' for depression, based on an Edinburgh Perinatal Depression Scale (EPDS) score of <12 at 12 weeks gestation, provided baseline and outcome data at 34 weeks gestation. All trial protocol procedures were shown to be feasible. Antenatal effect sizes in women 'at low risk' were similar to those previously demonstrated postnatally. Qualitative work confirmed the acceptability of the approach to CMWs and intervention group women. A fully powered trial testing universal prevention of depression in pregnancy is feasible, acceptable and worth undertaking.

Late-life depression in the primary care setting: Challenges, collaborative care, and prevention

PubMed Central

Hall, Charles A.; Reynolds, Charles F.

2014-01-01

Late-life depression is highly prevalent worldwide. In addition to being a debilitating illness, it is a risk factor for excess morbidity and mortality. Older adults with depression are at risk for dementia, coronary heart disease, stroke, cancer and suicide. Individuals with late-life depression often have significant medical comorbidity and, poor treatment adherence. Furthermore, psychosocial considerations such as gender, ethnicity, stigma and bereavement are necessary to understand the full context of late-life depression. The fact that most older adults seek treatment for depression in primary care settings led to the development of collaborative care interventions for depression. These interventions have consistently demonstrated clinically meaningful effectiveness in the treatment of late-life depression. We describe three pivotal studies detailing the management of depression in primary care settings in both high and low-income countries. Beyond effectively treating depression, collaborative care models address additional challenges associated with late-life depression. Although depression treatment interventions are effective compared to usual care, they exhibit relatively low remission rates and small to medium effect sizes. Several studies have demonstrated that depression prevention is possible and most effective in at-risk older adults. Given the relatively modest effects of treatment in averting years lived with disability, preventing late-life depression at the primary care level should be highly prioritized as a matter of health policy. PMID:24996484

Intervention development for the indicated prevention of depression in later life: the "DIL" protocol in Goa, India.

PubMed

Dias, Amit; Azariah, Fredric; Health, Public; Cohen, Alex; Anderson, Stewart; Morse, Jennifer; Cuijpers, Pim; Sequeira, Miriam; Psychology, M A; Gaude, Vithoba; Soares, Salvino; Patel, Vikram; Reynolds, Charles F

2017-06-01

Because depression is a major source of the global burden of illness- related disability, developing effective strategies for reducing its incidence is an important public health priority, especially in low-income countries, where resources for treating depression are scarce. We describe in this report an intervention development project, funded by the US National Institute of Mental Health, to address "indicated" prevention of depression in older adults attending rural and urban primary care clinics in Goa, India. Specifically, participants in the "DIL" ("Depression in Later Life") trial were older adults living with mild, subsyndromal symptoms of depression and anxiety and thus at substantial risk for transitioning to fully syndromal major depression and anxiety disorders. Building upon the MANAS treatment trial ("Promoting Mental Health") led by Patel et al in the same locale, we present here lessons learned in the development and implementation of a protocol utilizing lay health counsellors (LHCs) who deliver a multi-component depression prevention intervention organized conceptually around Problem Solving Therapy for Primary Care (PST), with additional components addressing brief behavioural treatment of sleep disturbances such as insomnia, meeting basic social casework needs, and education in self- management of prevalent comorbid chronic diseases, such as diabetes mellitus. To our knowledge, DIL is the first randomized clinical trial addressing the prevention of depressive disorders ever conducted in a low- or middle-income country.

Predictors of Disordered Eating in Young Males.

PubMed

Doumit, R; Abi Kharma, J; Sanchez-Ruiz, M J; Zeeni, N

2018-02-01

Recent findings suggest that disordered eating (DE) symptomatology may be underestimated in the male population. The present study examined depressive symptomatology as a potential mediator of the relationships between body image dissatisfaction, strategies to change body weight and muscles, media pressure, and DE (emotional, restrained and emotional eating) in 260 male undergraduates who completed a self-reported questionnaire. Path analyses indicated that media influence and strategies to decrease body weight had direct positive effects on depressive symptomatology, which in turn predicted emotional eating. Media influence had a direct positive effect on emotional eating, whereas strategies to decrease body weight did not exhibit a direct effect on emotional eating. Therefore, the latter pathway was removed from the model. The link between media pressure, strategies to decrease body weight and emotional eating was partially mediated by depressive symptomatology. The present findings can inform the development and implementation of prevention and education programs for DE in schools and universities.

Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review

PubMed Central

De Berardis, Domenico; Fornaro, Michele; Orsolini, Laura; Valchera, Alessandro; Carano, Alessandro; Vellante, Federica; Perna, Giampaolo; Serafini, Gianluca; Gonda, Xenia; Pompili, Maurizio; Martinotti, Giovanni; Di Giannantonio, Massimo

2017-01-01

It is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than non-alexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se. Therefore, the purpose of this narrative mini-review was to elucidate a possible relationship between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and an increased suicide risk. In several studies, this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, limitations of studies are discussed and must be considered. PMID:28855878

Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a health economic modeling study.

PubMed

Lokkerbol, Joran; Adema, Dirk; Cuijpers, Pim; Reynolds, Charles F; Schulz, Richard; Weehuizen, Rifka; Smit, Filip

2014-03-01

Depressive disorders are significant causes of disease burden and are associated with substantial economic costs. It is therefore important to design a healthcare system that can effectively manage depression at sustainable costs. This article computes the benefit-to-cost ratio of the current Dutch healthcare system for depression, and investigates whether offering more online preventive interventions improves the cost-effectiveness overall. A health economic (Markov) model was used to synthesize clinical and economic evidence and to compute population-level costs and effects of interventions. The model compared a base case scenario without preventive telemedicine and alternative scenarios with preventive telemedicine. The central outcome was the benefit-to-cost ratio, also known as return-on-investment (ROI). In terms of ROI, a healthcare system with preventive telemedicine for depressive disorders offers better value for money than a healthcare system without Internet-based prevention. Overall, the ROI increases from €1.45 ($1.72) in the base case scenario to €1.76 ($2.09) in the alternative scenario in which preventive telemedicine is offered. In a scenario in which the costs of offering preventive telemedicine are balanced by reducing the expenditures for curative interventions, ROI increases to €1.77 ($2.10), while keeping the healthcare budget constant. For a healthcare system for depressive disorders to remain economically sustainable, its cost-benefit ratio needs to be improved. Offering preventive telemedicine at a large scale is likely to introduce such an improvement. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

PubMed Central

2014-01-01

Background Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined. Discussion Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000723785. PMID:24499060

Interventions to reduce stress in university students: a review and meta-analysis.

PubMed

Regehr, Cheryl; Glancy, Dylan; Pitts, Annabel

2013-05-15

Recent research has revealed concerning rates of anxiety and depression among university students. Nevertheless, only a small percentage of these students receive treatment from university health services. Universities are thus challenged with instituting preventative programs that address student stress and reduce resultant anxiety and depression. A systematic review of the literature and meta-analysis was conducted to examine the effectiveness of interventions aimed at reducing stress in university students. Studies were eligible for inclusion if the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design. Retrieved studies represented a variety of intervention approaches with students in a broad range of programs and disciplines. Twenty-four studies, involving 1431 students were included in the meta-analysis. Cognitive, behavioral and mindfulness interventions were associated with decreased symptoms of anxiety. Secondary outcomes included lower levels of depression and cortisol. Included studies were limited to those published in peer reviewed journals. These studies over-represent interventions with female students in Western countries. Studies on some types of interventions such as psycho-educational and arts based interventions did not have sufficient data for inclusion in the meta-analysis. This review provides evidence that cognitive, behavioral, and mindfulness interventions are effective in reducing stress in university students. Universities are encouraged to make such programs widely available to students. In addition however, future work should focus on developing stress reduction programs that attract male students and address their needs. Copyright © 2012 Elsevier B.V. All rights reserved.

When self-reliance is not safe: associations between reduced help-seeking and subsequent mental health symptoms in suicidal adolescents.

PubMed

Labouliere, Christa D; Kleinman, Marjorie; Gould, Madelyn S

2015-04-01

The majority of suicidal adolescents have no contact with mental health services, and reduced help-seeking in this population further lessens the likelihood of accessing treatment. A commonly-reported reason for not seeking help is youths' perception that they should solve problems on their own. In this study, we explore associations between extreme self-reliance behavior (i.e., solving problems on your own all of the time), help-seeking behavior, and mental health symptoms in a community sample of adolescents. Approximately 2150 adolescents, across six schools, participated in a school-based suicide prevention screening program, and a subset of at-risk youth completed a follow-up interview two years later. Extreme self-reliance was associated with reduced help-seeking, clinically-significant depressive symptoms, and serious suicidal ideation at the baseline screening. Furthermore, in a subset of youth identified as at-risk at the baseline screening, extreme self-reliance predicted level of suicidal ideation and depressive symptoms two years later even after controlling for baseline symptoms. Given these findings, attitudes that reinforce extreme self-reliance behavior may be an important target for youth suicide prevention programs. Reducing extreme self-reliance in youth with suicidality may increase their likelihood of appropriate help-seeking and concomitant reductions in symptoms.

Cross-sectional evidence for a stress-negative affect pathway to substance use among sexual minority girls.

PubMed

Marshal, Michael P; Burton, Chad M; Chisolm, Deena J; Sucato, Gina S; Friedman, Mark S

2013-08-01

Sexual minority girls (SMGs) are four times more likely to engage in substance use than are heterosexual girls. A better understanding of the explanatory mechanisms of this disparity is needed to inform prevention and intervention programs. The goal of this study was to conduct a preliminary test of a "stress-negative affect" pathway by examining gay-related victimization and depression as mediators of substance use among SMGs. Adolescent girls (N = 156, 41% SMGs) were recruited from two urban adolescent medicine clinics to participate in an NIH-funded study of adolescent substance use. The average age was 17.0 years old and 57% were nonwhite. Mediation analyses were conducted in a multiple regression framework using SPSS and a mediation macro utilizing bias-corrected bootstrapping. Four models were estimated to test mediated pathways from sexual orientation to gay-related victimization (Mediator 1), to depression symptoms (Mediator 2), and then to each of four substance use variables: cigarettes, marijuana, alcohol, and heavy alcohol use. Significant mediated pathways (mediation tests with 95% CIs) were found for cigarette, alcohol and heavy alcohol use outcome variables. Results provide preliminary support for the minority stress hypothesis and the stress-negative affect pathway, and may inform the development of future prevention and intervention programs. © 2013 Wiley Periodicals, Inc.

Factors Associated with Binge Eating Behavior among Malaysian Adolescents

PubMed Central

Mohamad, Normasliana

2018-01-01

Although there are numerous studies on binge eating behavior in the Western countries, studies on this behavior in Malaysia are still limited. Therefore, this cross-sectional study aimed to determine the risk factors associated with binge eating behavior among adolescents in Malaysia. The study included 356 adolescents (42.7% males and 57.3% females), aged 13 to 16 years. They completed a self-administered questionnaire on demographic and socioeconomic backgrounds, frequency of family meals, family meal environments, family cohesion, perception of body size, self-esteem, depressive symptoms, perfectionistic self-presentation, and binge eating behavior. Furthermore, their weight, height, and waist circumference were measured. It was found that 14.0% of the participants engaged in binge eating behavior (15.2% in females and 12.5% in males). Additionally, it was identified that high levels of depressive symptoms, high levels of body dissatisfaction, poor family cohesion, and low self-esteem were significantly contributed to binge eating behavior after controlling for sex (adjusted R2 = 0.165, F = 15.056, p < 0.001). The findings may suggest that improving the relationships between family members, along with eliminating adolescents’ negative emotions could help in the prevention of binge eating behavior among adolescents. The identified modifiable risk factors should be incorporated into binge eating preventive programs to increase the effectiveness of the programs. PMID:29320461

Factors Associated with Binge Eating Behavior among Malaysian Adolescents.

PubMed

Gan, Wan Ying; Mohamad, Normasliana; Law, Leh Shii

2018-01-10

Although there are numerous studies on binge eating behavior in the Western countries, studies on this behavior in Malaysia are still limited. Therefore, this cross-sectional study aimed to determine the risk factors associated with binge eating behavior among adolescents in Malaysia. The study included 356 adolescents (42.7% males and 57.3% females), aged 13 to 16 years. They completed a self-administered questionnaire on demographic and socioeconomic backgrounds, frequency of family meals, family meal environments, family cohesion, perception of body size, self-esteem, depressive symptoms, perfectionistic self-presentation, and binge eating behavior. Furthermore, their weight, height, and waist circumference were measured. It was found that 14.0% of the participants engaged in binge eating behavior (15.2% in females and 12.5% in males). Additionally, it was identified that high levels of depressive symptoms, high levels of body dissatisfaction, poor family cohesion, and low self-esteem were significantly contributed to binge eating behavior after controlling for sex (adjusted R ² = 0.165, F = 15.056, p < 0.001). The findings may suggest that improving the relationships between family members, along with eliminating adolescents' negative emotions could help in the prevention of binge eating behavior among adolescents. The identified modifiable risk factors should be incorporated into binge eating preventive programs to increase the effectiveness of the programs.

When Self-Reliance Is Not Safe: Associations between Reduced Help-Seeking and Subsequent Mental Health Symptoms in Suicidal Adolescents

PubMed Central

Labouliere, Christa D.; Kleinman, Marjorie; Gould, Madelyn S.

2015-01-01

The majority of suicidal adolescents have no contact with mental health services, and reduced help-seeking in this population further lessens the likelihood of accessing treatment. A commonly-reported reason for not seeking help is youths’ perception that they should solve problems on their own. In this study, we explore associations between extreme self-reliance behavior (i.e., solving problems on your own all of the time), help-seeking behavior, and mental health symptoms in a community sample of adolescents. Approximately 2150 adolescents, across six schools, participated in a school-based suicide prevention screening program, and a subset of at-risk youth completed a follow-up interview two years later. Extreme self-reliance was associated with reduced help-seeking, clinically-significant depressive symptoms, and serious suicidal ideation at the baseline screening. Furthermore, in a subset of youth identified as at-risk at the baseline screening, extreme self-reliance predicted level of suicidal ideation and depressive symptoms two years later even after controlling for baseline symptoms. Given these findings, attitudes that reinforce extreme self-reliance behavior may be an important target for youth suicide prevention programs. Reducing extreme self-reliance in youth with suicidality may increase their likelihood of appropriate help-seeking and concomitant reductions in symptoms. PMID:25837350

Does the absence of a supportive family environment influence the outcome of a universal intervention for the prevention of depression?

PubMed

Spence, Susan H; Sawyer, Michael G; Sheffield, Jeanie; Patton, George; Bond, Lyndal; Graetz, Brian; Kay, Debra

2014-05-13

To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of universal versus targeted approaches to the prevention of depression.

A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial.

PubMed

Fernández, Anna; Mendive, Juan M; Conejo-Cerón, Sonia; Moreno-Peral, Patricia; King, Michael; Nazareth, Irwin; Martín-Pérez, Carlos; Fernández-Alonso, Carmen; Rodríguez-Bayón, Antonina; Aiarzaguena, Jose Maria; Montón-Franco, Carmen; Serrano-Blanco, Antoni; Ibañez-Casas, Inmaculada; Rodríguez-Sánchez, Emiliano; Salvador-Carulla, Luis; Garay, Paola Bully; Ballesta-Rodríguez, María Isabel; LaFuente, Pilar; Del Mar Muñoz-García, María; Mínguez-Gonzalo, Pilar; Araujo, Luz; Palao, Diego; Gómez, María Cruz; Zubiaga, Fernando; Navas-Campaña, Desirée; Aranda-Regules, Jose Manuel; Rodriguez-Morejón, Alberto; de Dios Luna, Juan; Bellón, Juan Ángel

2018-02-23

Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care. Cost-effectiveness analyses are nested within a multicentre, clustered, randomized controlled trial of a personalized intervention to prevent depression. The study was carried out in 70 primary care centres from seven cities in Spain. Two general practitioners (GPs) were randomly sampled from those prepared to participate in each centre (i.e. 140 GPs), and 3326 participants consented and were eligible to participate. The intervention included the GP communicating to the patient his/her individual risk for depression and personal risk factors and the construction by both GPs and patients of a psychosocial programme tailored to prevent depression. In addition, GPs carried out measures to activate and empower the patients, who also received a leaflet about preventing depression. GPs were trained in a 10- to 15-h workshop. Costs were measured from a societal and National Health care perspective. Qualityadjustedlife years were assessed using the EuroQOL five dimensions questionnaire. The time horizon was 18 months. With a willingness-to-pay threshold of €10,000 (£8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to €30,000 (£25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. Compared with usual care, an intervention based on personal predictors of risk of depression implemented by GPs is a cost-effective strategy to prevent depression. This type of personalized intervention in primary care should be further developed and evaluated. ClinicalTrials.gov, NCT01151982. Registered on June 29, 2010.

The GoodNight study—online CBT for insomnia for the indicated prevention of depression: study protocol for a randomised controlled trial

PubMed Central

2014-01-01

Background Cognitive Behaviour Therapy for Insomnia (CBT-I) delivered through the Internet is effective as a treatment in reducing insomnia in individuals seeking help for insomnia. CBT-I also lowers levels of depression in this group. However, it is not known if targeting insomnia using CBT-I will lower depressive symptoms, and thus reduce the risk of major depressive episode onset, in those specifically at risk for depression. Therefore, this study aims to examine whether Internet delivery of fully automated self-help CBT-I designed to reduce insomnia will prevent depression. Method/design A sample of 1,600 community-dwelling adults (aged 18–64), who screen positive for both subclinical levels of depressive symptoms and insomnia, will be recruited via various media and randomised to either a 9-week online insomnia treatment programme, Sleep Healthy Using The internet (SHUTi), or an online attention-matched control group (HealthWatch). The primary outcome variable will be depression symptom levels at the 6-month post-intervention on the Patient Heath Questionnaire-9 (PHQ-9). A secondary outcome will be onset of major depressive episodes assessed at the 6-month post-intervention using ‘current’ and ‘time from intervention’ criteria from the Mini International Neuropsychiatric Interview. Discussion This trial is the first randomised controlled trial of an Internet-based insomnia intervention as an indicated preventative programme for depression. If effective, online provision of a depression prevention programme will facilitate dissemination. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12611000121965. PMID:24524214

Behavioral and psychosocial factors associated with suicidal ideation among adolescents.

PubMed

Lee, GyuYoung; Ham, Ok Kyung

2018-04-10

Suicidal ideation poses a serious threat to the well-being of adolescents and is the strongest risk factor for suicide. Indeed, Korea ranks first among Organisation for Economic Cooperation and Development countries regarding the age-standardized suicide rates. In the present study, we examined multiple levels of factors associated with the suicidal ideation of adolescents in Korea by applying the Ecological Models of Health Behavior. A cross-sectional study was conducted with a convenience sample of 860 adolescents. The instruments included the Beck Depression Inventory and the Adolescent Mental Health and Problem Behavior Questionnaire. The data were analyzed using hierarchical multiple regression. Sixteen percent of participants reported suicidal ideation. Intrapersonal (sleep disturbance, Internet game addiction, destructive behavior, and depressive symptoms) and interpersonal factors (family conflicts and peer victimization) were associated with suicidal ideation. Because multiple factors were associated with suicidal ideation among adolescents, both intrapersonal (sleep disturbance, Internet game addiction, and depression) and interpersonal factors (family conflicts and peer problems) should be considered in the development of suicide-prevention programs. These programs could include campaigns changing the norms (permissive attitudes toward school violence) and the development of strict and rigorous school non-violence policies. © 2018 John Wiley & Sons Australia, Ltd.

Effectiveness and cost-effectiveness of a guided Internet- and mobile-based intervention for the indicated prevention of major depression in patients with chronic back pain-study protocol of the PROD-BP multicenter pragmatic RCT.

PubMed

Sander, L; Paganini, S; Lin, J; Schlicker, S; Ebert, D D; Buntrock, C; Baumeister, H

2017-01-21

Reducing the disease burden of major depressive disorder (MDD) is of major public health relevance. The prevention of depression is regarded as one possible approach to reach this goal. People with multiple risk factors for MDD such as chronic back pain and subthreshold depressive symptoms may benefit most from preventive measures. The Internet as intervention setting allows for scaling up preventive interventions on a public mental health level. This study is a multicenter pragmatic randomized controlled trial (RCT) of parallel design aiming to investigate the (cost-) effectiveness of an Internet- and mobile-based intervention (IMI) for the prevention of depression in chronic back pain patients (PROD-BP) with subthreshold depressive symptoms. eSano BackCare-DP is a guided, chronic back pain-specific depression prevention intervention based on cognitive behavioral therapy (CBT) principles comprising six weekly plus three optional modules and two booster sessions after completion of the intervention. Trained psychologists provide guidance by sending feedback messages after each module. A total of 406 patients with chronic back pain and without a depressive disorder at baseline will be recruited following orthopedic rehabilitation care and allocated to either intervention or treatment-as-usual (TAU). Primary patient-relevant endpoint of the trial is the time to onset of MDD measured by the telephone-administered Structured Clinical Interview for DSM (SCID) at baseline and 1-year post-randomization. Key secondary outcomes are health-related quality of life, depression severity, pain intensity, pain-related disability, ability to work, intervention satisfaction and adherence as well as side effects of the intervention. Online assessments take place at baseline and 9 weeks as well as 6 and 12 months post-randomization. Cox regression survival analysis will be conducted to estimate hazard ratio at 12-month follow-up. Moreover, an economic analysis will be conducted from a societal and public health perspective. This is the first study examining an IMI for depression prevention in a sample of chronic pain patients. If this implementation of a depression prevention IMI into orthopedic aftercare proves effective, the intervention could be integrated into routine care with minimal costs and extended for use with other chronic diseases. Results will have implications for researchers, health care providers and public health policy makers. The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (DRKS): DRKS00007960 . Registered 12 August 2015.

[A Group Cognitive-Behavioural Intervention to Prevent Depression Relapse in Individuals Having Recently Returned to Work: Protocol and Feasibility].

PubMed

Lecomte, Tania; Corbière, Marc

Workplace depression is one of the major causes for sick leave and loss of productivity at work. Many studies have investigated factors predicting return to work for people with depression, including studies evaluating return to work programs and organizational factors. Yet, a paucity of studies have targeted the prevention of depressive relapses at work, even though more than half of those having had a depression will have a depressive relapse in the near future.Objectives This article describes a research protocol involving a novel group intervention based on cognitive behavioural principles with the aim to optimize return to work and diminish risk of depressive relapses.Method This pilot study follows a randomized controlled trial design, with half the participants (N=25) receiving the group intervention and the other half (N=25) receiving usual services. The theoretical and empirical underpinnings of the intervention are described, along with a detailed presentation of the intervention and of the study's objectives. The group intervention consists of 8 sessions whereby Cognitive behavioural therapy (CBT) principles and techniques are applied to the following themes: (1) Coping with stress at work; (2) Recognizing and modifying my dysfunctional beliefs linked to work; (3) Overcoming obstacles linked to work functioning and maintaining work; (4) Negotiating needed work adjustments with the support of the immediate supervisor; (5) Finding my strengths and competencies related to work; (6) Accepting criticism and asserting myself appropriately at work; (7) Uncovering my best coping strategies for work.Results Qualitative information pertaining to the first two cohorts' participants' subjective appreciation of the group experience revealed that the intervention was perceived as very useful by all, with group support, namely harmony and interpersonal support, as well as CBT strategies being mentioned specifically.Conclusion Finally, the potential relevance of the group intervention will be brought forward.

Randomized Controlled Trial of a Preventive Intervention for Perinatal Depression in High-Risk Latinas

ERIC Educational Resources Information Center

Le, Huynh-Nhu; Perry, Deborah F.; Stuart, Elizabeth A.

2011-01-01

Objective: A randomized controlled trial was conducted to evaluate the efficacy of a cognitive-behavioral (CBT) intervention to prevent perinatal depression in high-risk Latinas. Method: A sample of 217 participants, predominantly low-income Central American immigrants who met demographic and depression risk criteria, were randomized into usual…

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis.

PubMed

Lindsay, Ana Cristina; Greaney, Mary L; Wallington, Sherrie F; Wright, Julie A; Hunt, Anne T

2017-08-02

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15-44). Participants ( n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers' Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m²), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24-6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02-1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when designing interventions targeting Latina immigrants.

An online intervention for reducing depressive symptoms: secondary benefits for self-esteem, empowerment and quality of life.

PubMed

Crisp, Dimity; Griffiths, Kathleen; Mackinnon, Andrew; Bennett, Kylie; Christensen, Helen

2014-04-30

Internet-based interventions are increasingly recognized as effective for the treatment and prevention of depression; however, there is a paucity of research investigating potential secondary benefits. From a consumer perspective, improvements in indicators of wellbeing such as perceived quality of life may represent the most important outcomes for evaluating the effectiveness of an intervention. This study investigated the 'secondary' benefits for self-esteem, empowerment, quality of life and perceived social support of two 12-week online depression interventions when delivered alone and in combination. Participants comprised 298 adults displaying elevated psychological distress. Participants were randomised to receive: an Internet Support Group (ISG); an automated Internet psycho-educational training program for depression; a combination of these conditions; or a control website. Analyses were performed on an intent-to-treat basis. Following the automated training program immediate improvements were shown in participants׳ self-esteem and empowerment relative to control participants. Improvements in perceived quality of life were reported 6-months following the completion of the intervention when combined with an ISG. These findings provide initial evidence for the effectiveness of this online intervention for improving individual wellbeing beyond the primary aim of the treatment. However, further research is required to investigate the mechanisms underlying improvement in these secondary outcomes. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

An idiographic and nomothetic approach to the study of Mexican-origin adolescent mothers' socio-cultural stressors and adjustment.

PubMed

Zeiders, Katharine H; Umaña-Taylor, Adriana J; Updegraff, Kimberly A; Jahromi, Laudan B

2015-04-01

The current study examined the longitudinal relations of socio-cultural stressors (i.e., acculturative stressors, enculturative stressors, ethnic discrimination) and Mexican-origin adolescent mothers' depressive symptoms and risk-taking behaviors. Utilizing an idiographic and nomothetic approach, we conducted lagged analyses to examine how individuals' fluctuations in stressors predicted subsequent adjustment. Further, we investigated potential threshold effects by examining if the impact of fluctuations in stressors differed at varying levels of stressors. Mexican-origin adolescent females (N = 184) participated in yearly in-home assessments across 5 years and reported on their experiences of acculturative and enculturative stressors, ethnic discrimination, depressive symptoms, and risk-taking behaviors. Findings revealed that within-person fluctuations in acculturative stressors and, to a lesser extent, perceived discrimination related to youths' depressive symptoms. For risk-taking behaviors, however, only within-person fluctuations in enculturative stressors emerged as significant. Further, a threshold effect emerged in the link between enculturative stressors and risk-taking behaviors, suggesting that fluctuations in enculturative stressors predicted changes in risk-taking behaviors at high levels of enculturative stressors but not low levels. Our findings highlight the differential relations between socio-cultural stressors and adolescent females' adjustment and suggest that prevention programs aimed at reducing depressive symptoms should attend to any degree of change in socio-cultural stressors, whereas programs focused on risk-taking behaviors should be especially attuned to levels of enculturative stress.

Gender-related risk and protective factors for depressive symptoms and disordered eating in adolescence: a 4-year longitudinal study.

PubMed

Ferreiro, Fátima; Seoane, Gloria; Senra, Carmen

2012-05-01

The interplay between intrapersonal risk (low self-esteem, perfectionism and body dissatisfaction) and interpersonal protection (social support) appears relevant for delineating gender-specific pathways that lead to both depressive and eating psychopathology. The aims of this longitudinal study were to examine gender differences in the levels of depressive symptoms, disordered eating and the co-occurrence of both problems from preadolescence to mid-adolescence and to identify gender-specific risk and protective factors of depressive symptoms and disordered eating. A Spanish community-based sample initially comprising 942 early adolescents (49% females) was assessed at baseline (T1; X (age) = 10.8 years) and at 2 and 4-year follow-up (T2 and T3). Gender differences emerged at T2 for disordered eating and at T3 for depressive symptoms and for co-occurring depressive symptoms and disordered eating. Predictors of depressive symptoms were body dissatisfaction, low self-esteem and fear of getting fat, for girls, and body dissatisfaction and low self-esteem, for boys. Predictors of disordered eating were body dissatisfaction, depressive symptoms, BMI and perfectionism, for girls, and low social support and BMI, for boys. In addition, for boys only, social support moderated the effect of body dissatisfaction on depressive symptoms and the effect of depressive symptoms on disordered eating. The hypotheses of the study were partially supported. Clinical implications are derived regarding the components that should be included in programs for preventing depression and eating disorders in both girls and boys.

A Mood Management Intervention in an Internet Stop Smoking Randomized Controlled Trial Does Not Prevent Depression: A Cautionary Tale

PubMed Central

Schueller, Stephen M.; Pérez-Stable, Eliseo J.; Muñoz, Ricardo F.

2014-01-01

Smoking and depression are related, and mood management interventions included in smoking cessation interventions can increase smoking abstinence rates. Could a mood management intervention embedded in an Internet-based smoking cessation intervention prevent major depressive episodes? Spanish- and English-speaking smokers (N = 17,430) from 191 countries were randomized to one of four online self-help intervention conditions (two with mood management). We analyzed preventive effects among those participants without a major depressive episode at baseline. The mood management intervention did not reduce the incidence of major depressive episodes in the following 12 months. However, we found a mood management by depression risk interaction (OR = 1.77, p = .004), such that high-risk participants who received the mood management intervention had an increased occurrence of major depressive episodes (32.8% vs. 26.6%), but not low-risk participants (11.6% vs. 10.8%). Further research on whether mood management interventions may have deleterious effects on subsets of smokers appears warranted. PMID:25525565

Cost-effectiveness of In-Home Cognitive Behavioral Therapy for low-income depressed mothers participating in early childhood prevention programs.

PubMed

Ammerman, Robert T; Mallow, Peter J; Rizzo, John A; Putnam, Frank W; Van Ginkel, Judith B

2017-01-15

To determine the cost-effectiveness of In-Home Cognitive Behavioral Therapy (IH-CBT) for low-income mothers enrolled in a home visiting program. A cost-utility analysis was conducted using results from a clinical trial of IH-CBT and standard of care for depression derived from the literature. A probabilistic, patient-level Markov model was developed to determine Quality Adjusted Life Years (QALYs). Costs were determined using the Medical Expenditure Panel Survey. A three-year time horizon and payer perspective were used. Sensitivity analyses were employed to determine robustness of the model. IH-CBT was cost-effective relative to standard of care. IH-CBT was expected to be cost-effective at a three-year time horizon 99.5%, 99.7%, and 99.9% of the time for willingness-to-pay thresholds of US$25,000, US$50,000, and US$100,000, respectively. Patterns were upheld at one-year and five-year time horizons. Over the three-year time horizon, mothers receiving IH-CBT were expected to have 345.6 fewer days of depression relative to those receiving standard home visiting and treatment in the community. IH-CBT is a more cost-effective treatment for low-income, depressed mothers than current standards of practice. These findings add to the growing literature demonstrating the cost-effectiveness of CBT for depression, and expand it to cover new mothers. From a payer perspective, IH-CBT is a sound option for treatment of depressed, low-income mothers. Limitations include a restricted time horizon and estimating of standard of care costs. Copyright © 2016 Elsevier B.V. All rights reserved.

Major Depression Can Be Prevented

ERIC Educational Resources Information Center

Munoz, Ricardo F.; Beardslee, William R.; Leykin, Yan

2012-01-01

The 2009 Institute of Medicine report on prevention of mental, emotional, and behavioral disorders (National Research Council & Institute of Medicine, 2009b) presented evidence that major depression can be prevented. In this article, we highlight the implications of the report for public policy and research. Randomized controlled trials have shown…

Pharmacological prevention of suicide in patients with major mood disorders.

PubMed

Rihmer, Zoltan; Gonda, Xenia

2013-12-01

The risk of self-destructive behavior in mood disorders is an inherent phenomenon and suicidal behavior in patients with unipolar or bipolar major mood disorders strongly relates to the presence and severity of depressive episodes. Consequently, early recognition, and successful acute and long-term treatment of depressive disorders is essential for suicide prevention in such patients. Large-scale, retrospective and prospective naturalistic long-term clinical studies, including severely ill, frequently suicidal depressives show that appropriate pharmacotherapy markedly reduces suicide morbidity and mortality even in this high-risk population. Supplementary psycho-social interventions further improve the effect. The slightly elevated (but in absolute sense quite low) risk of suicidal behavior among patients taking antidepressants compared to those taking placebo in randomized controlled antidepressant trials on unipolar major depression might be the consequence of the depression-worsening potential of antidepressant monotherapy in subthreshold and mixed bipolar depressed patients included in these trials and falsely diagnosed as suffering from unipolar major depression. Concurrent depression-focused psychotherapies increase the effectiveness of pharmacotherapy and this way contribute to suicide prevention for patients with mood disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Effects of diazepam on mixed anxiety/depression state in male mice].

PubMed

Galiamina, A G; Smagin, D A; Kovalenko, I L; Bondar', N P; Kudriavtseva, N N

2013-11-01

Chronic social defeat stress in daily agonistic interactions leads to the development of mixed anxiety/depression state in male mice. This paper aimed to study the effects of chronic diazepam treatment on the psychoemotional state of these animals. Diazepam (0.5 mg/kg, i/p, Polfa Tarchomin S. A.) or saline was chronically injected into male mice for two weeks on the background of continuing agonistic interactions (preventive treatment) or into male mice with mixed anxiety/depression state after stopping of social confrontations (therapeutic treatment). Then, the animals were studied in the partition, plus-maze and Porsolt' tests, estimating the levels of communicativeness, anxiety and depressiveness, respectively. Preventive diazepam treatment had a weak protective anxiolytic and pro-depressive effect. The therapeutic diazepam treatment didn't influence on the anxiety and depression-like state. Chronic diazepam was ineffective for the treatment of the mixed anxiety/depression state in male mice. Different effects ofdiazepam on anxiety and depression-like states under preventive treatment confirmed our conclusion shown earlier about the independent development of these pathologies at least in our experimental paradigm.

The influence of caregiver depression on adolescent mental health outcomes: findings from refugee settlements in Uganda.

PubMed

Meyer, Sarah R; Steinhaus, Mara; Bangirana, Clare; Onyango-Mangen, Patrick; Stark, Lindsay

2017-12-19

Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health concern, yet there is very limited literature from humanitarian settings focusing on the relationship between caregiver mental health and adolescent mental health. In the context of a larger study on child protection outcomes in refugee settings, researchers explored the relationship between caregiver depression and adolescent mental health in two refugee settlements, Kiryandongo and Adjumani, in Uganda. Adolescents between 13 and 17 and their caregivers participated in a household survey, which included measures of adolescent anxiety and depression, and caregiver depression. Analysis was conducted using multiple logistic regression models, and results were reported for the full sample and for each site separately. In Kiryandongo, a one-unit increase in a caregiver's depression score tripled the odds that the adolescent would have high levels of anxiety symptoms (AOR: 3.0, 95% CI: 1.4, 6.1), while in Adjumani, caregiver depression did not remain significant in the final model. Caregiver depression, gender and exposure to violence were all associated with higher symptoms of adolescent depression in both sites and the full sample, for example, a one unit increase in caregiver depression more than tripled the odds of higher levels of symptoms of adolescent depression (AOR: 3.6, 95% CI: 2.0, 6.2). Caregiver depression is a consistently significantly associated with adverse mental health outcomes for adolescents in this study. Adolescent well-being is significantly affected by caregiver mental health in this refugee context. Child protection interventions in humanitarian contexts do not adequately address the influence of caregivers' mental health, and there are opportunities to integrate child protection programming with prevention and treatment of caregivers' mental health symptoms.

Preventing Diabetes Problems

MedlinePlus

... Problems Diabetes, Sexual, & Bladder Problems Clinical Trials Preventing Diabetes Problems View or Print All Sections Heart Disease & ... to help control symptoms and restore intimacy. Depression & Diabetes Depression is common among people with a chronic, ...

What Is Chiropractic?

MedlinePlus

... Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic Pain and Depression Preventing ... Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic Pain and Depression Preventing ...

Physical activity in the prevention and treatment of anxiety and depression.

PubMed

Martinsen, Egil W

2008-01-01

Anxiety and depressive disorders are major public health problems, and desirable changes in lifestyle, such as physical exercise, can have great potential in prevention and treatment. There is growing evidence that physically active people are at a reduced risk of developing depression, and that exercise interventions are associated with significant benefits for patients with mild to moderate forms of depression as well as in reducing anxiety. These findings have led to the proposal that exercise may serve as an alternative or a supplement to traditional forms of therapy. This paper will present a broad overview of research involving the efficacy of exercise as means to prevent and treat depression and anxiety, and related issues regarding dosage and compliance. Finally, exercise will be discussed in the frame of cognitive-behavioural theory.

Prevention of depression through nutritional strategies in high-risk persons: rationale and design of the MooDFOOD prevention trial.

PubMed

Roca, Miquel; Kohls, Elisabeth; Gili, Margalida; Watkins, Ed; Owens, Matthew; Hegerl, Ulrich; van Grootheest, Gerard; Bot, Mariska; Cabout, Mieke; Brouwer, Ingeborg A; Visser, Marjolein; Penninx, Brenda W

2016-06-08

Obesity and depression are two prevalent conditions that are costly to individuals and society. The bidirectional association of obesity with depression, in which unhealthy dietary patterns may play an important role, has been well established. Few experimental studies have been conducted to investigate whether supplementing specific nutrients or improving diet and food-related behaviors can prevent depression in overweight persons. The MooDFOOD prevention trial examines the feasibility and effectiveness of two different nutritional strategies [multi-nutrient supplementation and food-related behavioral change therapy (FBC)] to prevent depression in individuals who are overweight and have elevated depressive symptoms but who are not currently or in the last 6 months meeting criteria for an episode of major depressive disorder (MDD). The randomized controlled prevention trial has a two-by-two factorial design: participants are randomized to daily multi-nutrient supplement (omega-3 fatty acids, calcium, selenium, B-11 vitamin and D-3 vitamin) versus placebo, and/or FBC therapy sessions versus usual care. Interventions last 12 months. In total 1000 participants aged 18-75 years with body mass index between 25-40 kg/m(2) and with a Patient Health Questionnaire-9 score ≥ 5 will be recruited at four study sites in four European countries. Baseline and follow-up assessments take place at 0, 3, 6, and 12 months. Primary endpoint is the onset of an episode of MDD, assessed according to DSM-IV based criteria using the MINI 5.0 interview. Depressive symptoms, anxiety, food and eating behavior, physical activity and health related quality of life are secondary outcomes. During the intervention, compliance, adverse events and potentially mediating variables are carefully monitored. The trial aims to provide a better understanding of the causal role of specific nutrients, overall diet, and food-related behavior change with respect to the incidence of MDD episodes. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective nutritional public health strategies for the prevention of clinical depression. ClinicalTrials.gov. Number of identification: NCT02529423 . August 2015.

Design and evaluation of a peer network to support adherence to a web-based intervention for adolescents

PubMed Central

Ho, Joyce; Corden, Marya E.; Caccamo, Lauren; Tomasino, Kathryn Noth; Duffecy, Jenna; Begale, Mark; Mohr, David C.

2016-01-01

Background Depression during adolescence is common but can be prevented. Behavioral intervention technologies (BITs) designed to prevent depression in adolescence, especially standalone web-based interventions, have shown mixed outcomes, likely due to poor intervention adherence. BIT research involving adults has shown that the presence of coaches or peers promotes intervention use. Developmentally, adolescence is a time when peer-based social relationships take precedence. This study examines whether peer-networked support may promote adherence to BITs in this age group. Objective Adopting the framework of the Supportive Accountability model, which defines the types of human support and interactions required to maintain engagement and persistence with BITs, this paper presents a feasibility study of a peer-networked online intervention for depression prevention among adolescents. We described the development of the peer network, the evaluation of participant use of the peer networking features, and qualitative user feedback to inform continued BIT development. Method Two groups of adolescents (N = 13) participated in 10-week programs of the peer networked based online intervention. Adolescents had access to didactic lessons, CBT based mood management tools, and peer networking features. The peer networking features are integrated into the site by making use expectations explicit, allow network members to monitor the activities of others, and to supportively hold each other accountable for meeting use expectations. The study collected qualitative feedback from participants as well as usage of site features and tools. Results Participants logged in an average of 12.8 sessions over an average of 10.4 unique days during the 10-week program. On average, 66% of all use sessions occurred within the first 3 weeks of use. The number of “exchange comments”, that is, comments posted that were part of an exchange between two or more participants, was significantly positively correlated with mean time spent on site (r = 0.62, p = 0.032), use of the Activity Tracker (r = 0.70, p = 0.012) and Didactic Lesson (r = 0.73, p = 0.007). Qualitative interviews revealed that adolescents generally liked and were motivated by the peer networking features during the first weeks of the intervention when general site use by group members was high. However, the decrease of site use by group members during the subsequent weeks negatively affected participants’ desire to log on or engage with group members. Conclusions This pilot study highlights the potential that a BIT designed to harness the connection among a peer network, thereby promoting supportive accountability, may improve adolescent adherence to BITs for depression prevention. PMID:27722095

Trajectories of change and long-term outcomes in a randomised controlled trial of internet-based insomnia treatment to prevent depression.

PubMed

Batterham, Philip J; Christensen, Helen; Mackinnon, Andrew J; Gosling, John A; Thorndike, Frances P; Ritterband, Lee M; Glozier, Nick; Griffiths, Kathleen M

2017-09-01

Insomnia treatment using an internet-based cognitive-behavioural therapy for insomnia (CBT-I) program reduces depression symptoms, anxiety symptoms and suicidal ideation. However, the speed, longevity and consistency of these effects are unknown. To test the following: whether the efficacy of online CBT-I was sustained over 18 months; how rapidly the effects of CBT-I emerged; evidence for distinct trajectories of change in depressive symptoms; and predictors of these trajectories. A randomised controlled trial compared the 6-week Sleep Healthy Using the Internet (SHUTi) CBT-I program to an attention control program. Adults ( N =1149) with clinical insomnia and subclinical depression symptoms were recruited online from the Australian community. Depression, anxiety and insomnia decreased significantly by week 4 of the intervention period and remained significantly lower relative to control for >18 months (between-group Cohen's d =0.63, 0.47, 0.55, respectively, at 18 months). Effects on suicidal ideation were only short term. Two depression trajectories were identified using growth mixture models: improving (95%) and stable/deteriorating (5%) symptoms. More severe baseline depression, younger age and limited comfort with the internet were associated with reduced odds of improvement. Online CBT-I produced rapid and long-term symptom reduction in people with subclinical depressive symptoms, although the initial effect on suicidal ideation was not sustained. P.J.B. has received grants from the National Health and Medical Research Council (NHMRC) during the conduct of the study. H.C. has received grants from the NHMRC and the Australian Research Council during the conduct of the study. L.M.R. receives research funding from the National Institutes of Health (NIH) that, in part, focuses on insomnia. F.P.T. and L.M.R. have equity ownership in BeHealth Solutions (Charlottesville, VA, USA), a company that develops and makes available products related to the research reported in this manuscript. BeHealth Solutions has licensed the SHUTi program and the software platform on which it was built from the University of Virginia. The terms of this arrangement have been reviewed and approved by the University of Virginia in accordance with its conflict of interest policy. N.G. has received grants from the NHMRC during the conduct of the study and personal fees from Lundbeck, Servier and Janssen outside the submitted work. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement.

PubMed

Siu, Albert L; Bibbins-Domingo, Kirsten; Grossman, David C; Baumann, Linda Ciofu; Davidson, Karina W; Ebell, Mark; García, Francisco A R; Gillman, Matthew; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Owens, Douglas K; Phillips, William R; Phipps, Maureen G; Pignone, Michael P

2016-01-26

Update of the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for depression in adults. The USPSTF reviewed the evidence on the benefits and harms of screening for depression in adult populations, including older adults and pregnant and postpartum women; the accuracy of depression screening instruments; and the benefits and harms of depression treatment in these populations. This recommendation applies to adults 18 years and older. The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. (B recommendation).

Evaluation of a depression screening and treatment program in primary care for patients with diabetes mellitus: insights and future directions.

PubMed

Palmer, Carrie; Vorderstrasse, Allison; Weil, Amy; Colford, Cristin; Dolan-Soto, Diane

2015-03-01

To evaluate a collaborative depression care program by assessing adherence to the program by internal medicine clinic (IMC) staff, and the program's effectiveness in treating depression in patients with diabetes mellitus. We also describe the rate of depression among patients with diabetes in the IMC. Data for this program were obtained from a de-identified disease registry and included 1312 outpatient IMC visits in adult patients with diabetes between March 2011 and September 2011. Collaborative depression care results in high rates of screening for and identification of depression, high rates of antidepressant utilization, and improved depression scores; however, more focused interventions are needed to improve diabetes outcomes in patients with depression and diabetes. The results indicate that the multidisciplinary IMC staff can work together with patients to identify and monitor depression within primary care. This study provides valuable information about models of depression care that can be implemented and evaluated in a clinical setting. ©2014 American Association of Nurse Practitioners.

HIV status and gender: a brief report from heterosexual couples in Thailand.

PubMed

Li, Li; Liang, Li-Jung; Lee, Sung-Jae; Farmer, Shu C

2012-01-01

Although the impact of HIV falls on both partners of a married couple, the burden of stress may not be necessarily shared evenly. The researchers in this study examined the relations among HIV status, gender, and depressive symptoms among 152 married or cohabitating couples living with HIV in the northern and northeastern regions of Thailand. Depressive symptoms were assessed using a 15-item depressive symptom screening test that was developed and used previously in Thailand. Among the 152 couples, 59% were couples in which both members were people living with HIV (seroconcordant; both people living with HIV couples), 28% had only female members with HIV (serodiscordant; females living with HIV couples), and 13% had only male members with HIV (serodiscordant; males living with HIV couples). The prevalence of depressive symptoms between seroconcordant and serodiscordant groups was similar. However, females living with HIV reported significantly higher levels of depressive symptoms, regardless of their partners' HIV status. Future prevention programs focusing on serodiscordant couples should be planned to target HIV risk, as well as emphasis on mental health, with a particular focus on women's increased susceptibility to negative mental health outcomes.

The impact of depressive symptomatology on risky sexual behavior and sexual communication among African American female adolescents.

PubMed

Seth, Puja; Patel, Shilpa N; Sales, Jessica M; DiClemente, Ralph J; Wingood, Gina M; Rose, Eve S

2011-05-01

Adolescents, particularly African American adolescents, are at high risk for sexually transmitted infections (STIs). The association between psychosocial factors and risky sexual behavior has been well established. However, only a small number of studies have examined the relationship between depressive symptomatology among African American female adolescents, specifically over time. The present study examined depressive symptoms as a predictor of risky sexual behavior, sexual communication, and STIs longitudinally among African American female adolescents between the ages 15 and 21. Binary generalized estimating equation models were conducted assessing the impact of depressive symptoms at baseline on risky sexual behavior and STIs over six- and 12-months follow-up. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high levels of depressive symptoms predicted no condom use during last sexual encounter and multiple sexual partners over six-months follow-up. Depressive symptoms also predicted having a main partner with concurrent partners, high fear of communication about condoms, and sex while high on alcohol or drugs over six- and 12-months follow-up. These findings could be used to inform HIV/STI prevention intervention programs and clinicians providing regular health care maintenance to African American female adolescents engaging in risky sexual behavior. © 2011 Taylor & Francis

The Impact of Depressive Symptomatology on Risky Sexual Behavior and Sexual Communication among African American Female Adolescents

PubMed Central

Seth, Puja; Patel, Shilpa N.; Sales, Jessica M.; DiClemente, Ralph J.; Wingood, Gina M.; Rose, Eve S.

2011-01-01

Adolescents are at high risk for sexually transmitted infections (STIs), particularly African American adolescents. The association between psychosocial factors and risky sexual behavior has been well established. However, only a small number of studies have examined the relationship between depressive symptomatology among African American female adolescents, specifically over time. The present study examined depressive symptoms as a predictor of risky sexual behavior, sexual communication, and STIs longitudinally among African American female adolescents between the ages of 15-21. Binary generalized estimating equation (GEE) models were conducted assessing the impact of depressive symptoms at baseline on risky sexual behavior and STIs over 6- and 12-months follow-up. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high levels of depressive symptoms predicted no condom use during last sexual encounter and multiple sexual partners over 6-months follow-up. Depressive symptoms also predicted having a main partner with concurrent partners, high fear of communication about condoms, and sex while high on alcohol or drugs over 6- and 12-months follow-up. These findings could be used to inform HIV/STI prevention intervention programs and clinicians providing regular health care maintenance to African American female adolescents engaging in risky sexual behavior. PMID:21491342

Acculturative family distancing (AFD) and depression in Chinese American families.

PubMed

Hwang, Wei-Chin; Wood, Jeffrey J; Fujimoto, Ken

2010-10-01

Knowledge of acculturative processes and their impact on immigrant families remains quite limited. Acculturative family distancing (AFD) is the distancing that occurs between immigrant parents and their children and is caused by breakdowns in communication and cultural value differences. It is a more proximal and problem-focused formulation of the acculturation gap and is hypothesized to increase depression via family conflict. Data were collected from 105 Chinese American high school students and their mothers. Rasch modeling was used to refine the AFD measure, and structural equation modeling was used to determine the effects of AFD on youth and maternal depression. Findings indicate that greater AFD was associated with higher depressive symptoms and risk for clinical depression. Family conflict partially mediated this relation for youths, whereas for mothers, AFD directly increased risk for depression. Greater mother-child heritage enculturation discrepancies were associated with greater mother and child AFD. Mainstream acculturation discrepancies and language gaps between mothers and youths were not significantly associated with any of the primary outcome variables. Results highlight the need for better understanding of how AFD and other acculturation-gap phenomena affect immigrant mental health. They also underscore the need for prevention and intervention programs that target communication difficulties and intergenerational cultural value differences. Copyright 2010 APA, all rights reserved.

Effects of a suicide prevention programme for hospitalised patients with mental illness in South Korea.

PubMed

Jun, Won Hee; Lee, Eun Ju; Park, Jeong Soon

2014-07-01

To investigate the effects of a suicide prevention programme on the levels of depression, self-esteem, suicidal ideation and spirituality in patients with mental illness. Instances of suicide have significant correlations with depression, low self-esteem, suicidal ideation and a low level of spirituality in the victims. Therefore, addressing depression, low self-esteem and suicidal ideation as suicide risk factors and increasing levels of spirituality can constitute an effective programme to prevent suicide among patients with mental illness. The study was a quasi-experimental study with a nonequivalent control group, nonsynchronised design. The study sample consisted of 45 patients with mental illness who had been admitted to the psychiatric unit in a university hospital in South Korea. The patients were assigned to control and experimental groups of 23 and 22 members, respectively. The suicide prevention programme was conducted with the experimental group over four weeks and included eight sessions (two per week). The control group received only routine treatments in the hospital. The experimental group that participated in the programme had significantly decreased mean scores for depression and suicidal ideation compared with the control group. However, there were no significant differences in the mean scores for self-esteem and spirituality between the groups. The suicide prevention programme might be usefully applied as a nursing intervention for patients hospitalised in psychiatric wards or clinics where the goals are to decrease depression and suicidal ideation. Typical treatments for hospitalised patients with mental illness are not enough to prevent suicide. Intervention for suicide prevention needs to apply an integrated approach. The suicide prevention programme using an integrated approach is more effective in reducing depression and suicidal ideation in patients with mental illness than applying routine treatments in the hospital. © 2013 John Wiley & Sons Ltd.

A systematic review of rehabilitation interventions to prevent and treat depression in post-stroke aphasia.

PubMed

Baker, Caroline; Worrall, Linda; Rose, Miranda; Hudson, Kyla; Ryan, Brooke; O'Byrne, Leana

2018-08-01

Stepped psychological care is the delivery of routine assessment and interventions for psychological problems, including depression. The aim of this systematic review was to analyze and synthesize the evidence of rehabilitation interventions to prevent and treat depression in post-stroke aphasia and adapt the best evidence within a stepped psychological care framework. Four databases were systematically searched up to March 2017: Medline, CINAHL, PsycINFO and The Cochrane Library. Forty-five studies met inclusion and exclusion criteria. Level of evidence, methodological quality and results were assessed. People with aphasia with mild depression may benefit from psychosocial-type treatments (based on 3 level ii studies with small to medium effect sizes). For those without depression, mood may be enhanced through participation in a range of interventions (based on 4 level ii studies; 1 level iii-3 study and 6 level iv studies). It is not clear which interventions may prevent depression in post-stroke aphasia. No evidence was found for the treatment of moderate to severe depression in post-stroke aphasia. This study found some interventions that may improve depression outcomes for those with mild depression or without depression in post-stroke aphasia. Future research is needed to address methodological limitations and evaluate and support the translation of stepped psychological care across the continuum. Implications for Rehabilitation Stepped psychological care after stroke is a framework with levels 1 to 4 which can be used to prevent and treat depression for people with aphasia. A range of rehabilitation interventions may be beneficial to mood at level 1 for people without clinically significant depression (e.g., goal setting and achievement, psychosocial support, communication partner training and narrative therapy). People with mild symptoms of depression may benefit from interventions at level 2 (e.g., behavioral therapy, psychosocial support and problem solving). People with moderate to severe symptoms of depression require specialist mental health/behavioral services in collaboration with stroke care at levels 3 and 4 of stepped psychological care.

Influence of a Family-Focused Substance Use Preventive Intervention on Growth in Adolescent Depressive Symptoms

ERIC Educational Resources Information Center

Mason, W. Alex; Kosterman, Rick; Hawkins, J. David; Haggerty, Kevin P.; Spoth, Richard L.; Redmond, Cleve

2007-01-01

Preparing for the Drug Free Years (PDFY) is a preventive intervention that targets parenting behaviors, family interaction patterns, and adolescent substance use, factors that have been shown to predict depression among teenagers. Effects of PDFY on trajectories of self-reported adolescent depressive symptoms from 6th through 12th grade were…

Development and pilot study of a marketing strategy for primary care/internet-based depression prevention intervention for adolescents (the CATCH-IT intervention).

PubMed

Van Voorhees, Benjamin W; Watson, Natalie; Bridges, John F P; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A; Ellis, Justin; Prochaska, Micah; Bell, Carl

2010-01-01

Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. The marketing plan focused on "resiliency building" rather than "depression intervention" and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1-10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care.

Development and Pilot Study of a Marketing Strategy for Primary Care/Internet–Based Depression Prevention Intervention for Adolescents (The CATCH-IT Intervention)

PubMed Central

Watson, Natalie; Bridges, John F. P.; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A.; Ellis, Justin; Prochaska, Micah; Bell, Carl

2010-01-01

Background: Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. Objective: To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. Method: A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. Results: The marketing plan focused on “resiliency building” rather than “depression intervention” and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1–10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Conclusions: Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care. PMID:20944776

Frequently Asked Questions about Chiropractic

MedlinePlus

... Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic Pain and Depression Preventing ... Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic Pain and Depression Preventing ...

Back Pain Facts and Statistics

MedlinePlus

... Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic Pain and Depression Preventing ... Spinal Health Winter Activities Kids and Sports Exercising Outdoors with Baby Gardening Chronic Pain and Depression Preventing ...

Racial and Ethnic Disparity in Major Depressive Disorder.

PubMed

Shao, Zhili; Richie, William D; Bailey, Rahn Kennedy

2016-12-01

Major depressive disorder (MDD) is one of the most common and disabling psychiatric disorders in the USA. Early diagnosis and appropriate treatment are extremely important to prevent disability and improve quality of life. Recent studies have demonstrated racial and ethnic disparities in the diagnosis and treatment of MDD. African Americans (AA), Hispanics, and Asian Americans were significantly less likely to receive a depression diagnosis from a health-care provider than were non-Hispanic whites. The underdiagnosis of MDD in minority groups may be due to differences in socioeconomic status (SES), care affordability, cultural beliefs about depression, help-seeking patterns, access to culturally and linguistically appropriate care, patient-physician relationship, clinical presentation of depression, etc. Meanwhile, the likelihood of both having access to and receiving adequate care for depression was significantly low for AA, Hispanics, and Asian Americans, in contrast to whites. Similar disparities also exist in treatment outcomes. Besides the reasons for MDD underdiagnosis, additional contributing factors include access barriers to preferred mode of treatment, cultural concerns about antidepressants and different metabolism of antidepressants, etc. There are many ways to address these disparities and improve MDD care in minority populations, including universal depression screening, public financial incentives to ensure access to care in low-income and minority neighborhoods, quality improvement programs, cultural competency of mental health professionals, collaborative care management, community engagement and planning, and enhanced participation of minorities in clinical research.

Protective Factors Against Depression and Suicidal Behaviour in Adolescence

PubMed Central

Breton, Jean-Jacques; Labelle, Réal; Berthiaume, Claude; Royer, Chantal; St-Georges, Marie; Ricard, Dominique; Abadie, Pascale; Gérardin, Priscille; Cohen, David; Guilé, Jean-Marc

2015-01-01

Objectives: To examine whether protective factors in the Protection for Adolescent Depression Study (PADS) moderate the impact of stressful events on depression and suicidal behaviour in the community and a clinical setting; and to study the influence of sex. Method: Participants were 283 adolescents from the community and 119 from a mood disorder clinic in Montreal. The participants were evaluated on 6 instruments measuring individual risk and protective factors. Descriptive analyses and univariate and multiple logistic regression models were carried out. Results: Risk factors predicted higher levels of depression and presence of suicidal behaviour, and protective factors predicted lower levels of depression and absence of suicidal behaviour, as expected under the vulnerability-resilience stress model. Several sex differences were observed in terms of the predictive power of risk factors (for example, hopelessness among girls and keep to themselves among boys) and protective factors (for example, focusing on the positive among girls and self-discovery among boys). Conclusions: Findings from the PADS suggest that protective factors moderate the impact of stress on depression and suicidal behaviour. Developing protection appears important in the presence of chronic conditions, such as depressive disorders, to reduce the likelihood of further episodes. The influence of sex makes it all the more relevant to target different factors for boys and girls to increase protection and decrease risk in prevention and intervention programs. PMID:25886672

The association of Internet addiction symptoms with anxiety, depression and self-esteem among adolescents with attention-deficit/hyperactivity disorder.

PubMed

Yen, Cheng-Fang; Chou, Wen-Jiun; Liu, Tai-Ling; Yang, Pinchen; Hu, Huei-Fan

2014-10-01

The aims of this study were to examine the associations of the severity of Internet addiction symptoms with various dimensions of anxiety (physical anxiety symptoms, harm avoidance, social anxiety, and separation/panic) and depression symptoms (depressed affect, somatic symptoms, interpersonal problems, and positive affect) and self-esteem among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. A total of 287 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their severity of Internet addiction symptoms was assessed using the Chen Internet Addiction Scale. Anxiety and depression symptoms and self-esteem were assessed using the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T), the Center for Epidemiological Studies Depression Scale (CES-D), and the Rosenberg Self-Esteem Scale (RSES), respectively. The association between the severity of Internet addiction symptoms and anxiety and depression symptoms and self-esteem were examined using multiple regression analyses. The results indicated that higher physical symptoms and lower harm avoidance scores on the MASC-T, higher somatic discomfort/retarded activity scores on the CES-D, and lower self-esteem scores on the RSES were significantly associated with more severe Internet addiction symptoms. Prevention and intervention programs for Internet addiction in adolescents with ADHD should take anxiety, depression, and self-esteem into consideration. Copyright © 2014 Elsevier Inc. All rights reserved.

Violence and other stressful life events as triggers of depression and anxiety: what psychosocial resources protect African American mothers?

PubMed

Mitchell, Stephanie J; Ronzio, Cynthia R

2011-11-01

Understanding the risk and protective factors related to maternal mental health problems is important for improving the well-being of mothers and children, particularly in African American populations which may be at greater risk for maternal depression and resulting child behavior problems. This study explored whether three psychosocial resources--emotional resilience, social support, and ethnic identity--serve as protective factors in the face of specific stressful events that may trigger African American mothers' depression and anxiety symptoms. Standard self-report measures of depression, anxiety, negative life events, community violence, abuse, emotional resilience, social support, and ethnic identity were administered to African American mothers (N=209) of 2-18 month-old children. Linear regression models revealed main effects of negative life events and abuse on increased depression and anxiety symptoms, while emotional resilience and social support predicted decreased symptoms. There was also a significant interaction revealing a protective-reactive effect of ethnic identity on the associations of witnessed community violence with depression and anxiety symptoms. It is important for primary care providers to screen African American mothers for negative life events and abuse to identify those at increased risk for maternal depression and anxiety symptoms. Treatment programs should target emotional resilience, enhanced social support, and stronger ethnic group affiliation, which may be most effective at preventing mental health problems among mothers exposed to relative lower levels of community violence.

Symptoms of Depression and Anxiety as Barriers to Participation in Cardiac Rehabilitation Programs Among Arab and Jewish Patients in Israel.

PubMed

Vilchinsky, Noa; Reges, Orna; Leibowitz, Morton; Khaskia, Abdulrahim; Mosseri, Morris; Kark, Jeremy D

2018-05-01

Despite its proven efficacy, low participation rates in cardiac prevention and rehabilitation programs (CPRPs) prevail worldwide, especially among ethnic minorities. This is strongly evident in Israel's Arab minority. Since psychological distress has been found to be associated with CPRP participation and minorities are subjected to higher levels of distress, it is plausible that distress may be an important barrier for CPRP participation among minority patients. The current prospective study assessed the contribution of depression and anxiety symptoms to participation in a CPRP after acute coronary syndrome, both in the enrollment phase and when considering adherence over time, among Jewish (majority) and Arab (minority) patients in Israel. Patients were interviewed during hospitalization about their emotional status and at a 6-mo follow-up concerning participation in a CPRP. Analyses were performed on 397 patients. The Brief Symptom Inventory was used. Logistic regression modeling was applied. Symptoms of depression, but not anxiety, were frequently observed among Arab patients compared with their Jewish counterparts. In analyses adjusted for age, sex, ethnicity, and sociodemographic and clinical characteristics, having symptoms of anxiety was associated with less participation in a CPRP, evident for both Jews and Arabs; this association was less evident for symptoms of depression. Multivariable adjusted models did not show a significant association of symptoms of anxiety or depression with adherence in a CPRP. Accounting for psychological distress did not reduce the sharp difference between Jews and Arabs in CPRP participation. Symptoms of distress may serve as barriers to CPRP participation, regardless of ethnic origin.

Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario, Canada.

PubMed

Logie, Carmen; James, Llana; Tharao, Wangari; Loutfy, Mona

2013-02-01

Abstract African, Caribbean, and Black (ACB) women are greatly overrepresented in new HIV infections in comparison with Canada's general population. Social and structural factors such as HIV-related stigma, gender discrimination, and racial discrimination converge to increase vulnerability to HIV infection among ACB women by reducing access to HIV prevention services. Stigma and discrimination also present barriers to treatment, care, and support and may contribute to mental health problems. We administered a cross-sectional survey to HIV-positive ACB women (n=173) across Ontario in order to examine the relationships between HIV-related stigma, gender discrimination, racial discrimination, and depression. One-third of participants reported moderate/severe depression scores using the Beck Depression Inventory Fast-Screen guidelines. Hierarchical block regression, moderation, and mediation analyses were conducted to measure associations between independent (HIV-related stigma, gender discrimination, racial discrimination), moderator/mediator (social support, resilient coping), and dependent (depression) variables. Findings included: (1) HIV-related stigma was associated with increased depression; (2) resilient coping was associated with reduced depression but did not moderate the influence of HIV-related stigma on depression; and (3) the effects of HIV-related stigma on depression were partially mediated through resilient coping. HIV-related stigma, gender discrimination, and racial discrimination were significantly correlated with one another and with depression, highlighting the salience of examining multiple intersecting forms of stigma. Generalizability of findings may be limited due to nonrandom sampling. Findings emphasize the importance of multi-component interventions, including building resilient coping skills, mental health promotion and assessment, and stigma reduction programs.

Violence at work and depressive symptoms in primary health care teams: a cross-sectional study in Brazil.

PubMed

da Silva, Andréa Tenório Correia; Peres, Maria Fernanda Tourinho; Lopes, Claudia de Souza; Schraiber, Lilia Blima; Susser, Ezra; Menezes, Paulo Rossi

2015-09-01

Implementation of primary care has long been a priority in low- and middle-income countries. Violence at work may hamper progress in this field. Hence, we examined the associations between violence at work and depressive symptoms/major depression in primary care teams (physicians, nurses, nursing assistants, and community health workers). A cross-sectional study was undertaken in the city of Sao Paulo, Brazil. We assessed a random sample of Family Health Program teams. We investigated depressive symptoms and major depression using the nine-item Patient Health Questionnaire (PHQ-9), and exposure to violence at work in the previous 12 months using a standardized questionnaire. Associations between exposure to violence and depressive symptoms/major depression were analyzed using multinomial logistic regression. Of 3141 eligible workers, 2940 (93 %) completed the interview. Of these, 36.3 % (95 % CI 34.6-38.1) presented intermediate depressive symptoms, and 16 % (95 % CI 14.6-17.2), probable major depression. The frequencies of exposure to the different types of violence at work were: insults (44.9 %), threats (24.8 %), physical aggression (2.3 %), and witnessing violence (29.5 %). These exposures were strongly and progressively associated with depressive symptoms (adjusted odds ratio 1.67 for exposure to one type of violence; and 5.10 for all four types), and probable major depression (adjusted odds ratio 1.84 for one type; and 14.34 for all four types). Primary care workers presenting depressive symptoms and those who have experienced violence at work should be assisted. Policy makers should prioritize strategies to prevent these problems, since they can threaten primary care sustainability.

Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

PubMed

Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

2015-10-01

Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.

The effects of multifactorial fall prevention on depressive symptoms among the aged at increased risk of falling.

PubMed

Sjösten, Noora M; Vahlberg, Tero J; Kivelä, Sirkka-Liisa

2008-05-01

The aim was to determine the effects of multifactorial fall prevention on depressive symptoms among aged Finns at increased risk of falling. This study is part of a multifactorial fall prevention trial with a randomised controlled design implemented in the town of Pori, western Finland. The study population consisted of ambulatory, 65-year-old or older Finns, with moderate or high cognitive and physical abilities who had fallen at least once during the previous 12 months. The participants (n=591) were randomised into a risk-based multifactorial fall prevention programme (intervention group, IG) or into a one-time counselling group (control group, CG). The 1-year intervention included individual geriatric assessment followed by treatment recommendations, individual guidance regarding fall prevention, physical exercise in small groups twice a month, psychosocial group activities and lectures once a month, home-exercises and home hazard assessment. The outcome, depressive symptoms, was measured by the 30-item Geriatric Depression Scale (GDS). The full GDS data with no missing items were available for 464 persons. A significant decrease in depressive symptoms during the 12-month intervention was found both in IG and in CG, but the difference in change was not significant (p=0.110). However, a significant difference in change between the groups was found among men and older subjects (>or=75) in favour of the IG. Multifactorial fall prevention had no effects on depressive symptoms among the community-dwelling aged. However, men and older participants benefited from the intervention.

Efficacy and moderators of psychological interventions in treating subclinical symptoms of depression and preventing major depressive disorder onsets: protocol for an individual patient data meta-analysis of randomised controlled trials

PubMed Central

Reins, Jo Annika; Zimmermann, Johannes; Cuijpers, Pim

2018-01-01

Introduction The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately subgroups and moderator effects. The aim of the present study is, therefore, to examine the short-term and long-term as well as moderator effects of psychological interventions compared with control groups in adults with subthreshold depression on depressive symptom severity, treatment response, remission, symptom deterioration, quality of life, anxiety and the prevention of major depressive disorder (MDD) onsets on individual patient level and study level using an individual patient data meta-analysis approach. Methods and analysis Systematic searches in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials were conducted. We will use the following types of outcome criteria: (A) onset of major depression; (B) time to major depression onset; (C) observer-reported and self-reported depressive symptom severity; (D) response; (E) remission; (F) symptom deterioration; (G) quality of life, (H) anxiety; and (I) suicidal thoughts and behaviours. Multilevel models with participants nested within studies will be used. Missing data will be handled using a joint modelling approach to multiple imputation. A number of sensitivity analyses will be conducted in order test the robustness of our findings. Ethics and dissemination The investigators of the primary trials have obtained ethical approval for the data used in the present study and for sharing the data, if this was necessary, according to local requirements and was not covered from the initial ethic assessment. This study will summarise the available evidence on the short-term and long-term effectiveness of preventive psychological interventions for the treatment of subthreshold depression and prevention of MDD onset. Identification of subgroups of patients in which those interventions are most effective will guide the development of evidence-based personalised interventions for patients with subthreshold depression. PROSPERO registration number CRD42017058585. PMID:29549201

A Double Blind Trial of Divalproex Sodium for Affective Liability and Alcohol Use Following Traumatic Brain Injury

DTIC Science & Technology

2014-10-01

approved it in 1995 for this indication. Also, it is used in conjunction with lithium or carbamazepine to prevent recurrent manic or depressive...TITLE: A Double Blind Trial of Divalproex Sodium for Affective L ability and Alcohol Use Following Traumatic Brain Injury PRINCIPAL...NUMBER Liability and Alcohol Use Following Traumatic Brain Injury 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

Subthreshold Symptoms of Depression in Preadolescent Girls Are Stable and Predictive of Depressive Disorders

ERIC Educational Resources Information Center

Keenan, Kate; Hipwell, Alsion; Feng, Xin; Babinski, Dara; Hinze, Amanda; Rischall, Michal; Henneberger, Angela

2008-01-01

Symptoms of depression are investigated among 232 preadolescent girls to study if they were predictive and stable of depression. Findings show that early symptoms of depression among preadolescent girls predict depressive disorders. Implications for preventive measures are discussed.

Suicide by cop in film and society: dangerousness, depression, and justice.

PubMed

Stack, Steven; Bowman, Barbara; Lester, David

2012-08-01

Provoking police officers to kill oneself or "suicide by cop" (SBC) has received scholarly as well as public attention. The extent to which film representations of SBC reflect SBC in society in relation to danger, depression, and other features was assessed in this study. Data on cinematic portrayals of SBC are from 16 American films; corresponding data on SBC in the real world are taken from 19 empirical studies. While the demographic features of SBC in the real world are largely reflected in film, major differences exist on motivations and incident characteristics. Motives for cinematic SBC were unlike SBC in society, wherein, respectively, 0% vs. 35% had attempted suicide in the past, 6% vs. 47% were chronically depressed, and 77% vs. 7% had recently killed someone. Cinematic SBC events disproportionately involve murderous, dangerous persons who are not depressed, and their deaths convey a sense of justice. While such media distortions can be profitable and entertain the audience, they also contribute to public misunderstandings of the nature of deviance and hinder the development of effective suicide and violence prevention programs. © 2012 The American Association of Suicidology.

Father absence and timing of menarche in adolescent girls from a UK cohort: the mediating role of maternal depression and major financial problems.

PubMed

Culpin, Iryna; Heron, Jon; Araya, Ricardo; Melotti, Roberto; Lewis, Glyn; Joinson, Carol

2014-04-01

In a prospective birth cohort study of 5295 girls from the UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the association between biological father absence in childhood and age at menarche whilst adjusting for antenatal indicators of socioeconomic disadvantage and maternal characteristics. We also examined whether exposure to maternal depression and financial problems during middle childhood mediate the association between father absence and age at menarche. There was stronger evidence for an association between father absence during the first 5 years of life and early timing of menarche compared with father absence between 5 and 10 years. There was evidence that maternal depression and major financial problems explained some of the association between early childhood father absence and age at menarche. Although father absence cannot be a direct target of prevention, family-based programs to address family processes influenced by maternal depression and socioeconomic disadvantage may be effective. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Interpersonal Problem Areas and Alexithymia in Adolescent Girls with Loss of Control Eating

PubMed Central

Berger, Sarah Shafer; Elliott, Camden; Ranzenhofer, Lisa M.; Shomaker, Lauren B.; Hannallah, Louise; Field, Sara E.; Young, Jami F.; Sbrocco, Tracy; Wilfley, Denise E.; Yanovski, Jack A.; Tanofsky-Kraff, Marian

2014-01-01

This study investigated the links among interpersonal problem areas, depression, and alexithymia in adolescent girls at high-risk for excessive weight gain and binge eating disorder. Participants were 56 girls (Mage = 14.30, SD = 1.56; 53% non-Hispanic White) with a body mass index (BMI, kg/m2) between the 75th and 97th percentiles (MBMI-z = 1.57, SD = 0.32). By design, all participants reported loss of control eating patterns in the past month. Adolescents were individually interviewed prior to participating in a group interpersonal psychotherapy obesity and eating disorder prevention program, termed IPT for the prevention of excessive weight gain (IPT-WG). Participants’ interpersonal problem areas were coded by trained raters. Participants also completed questionnaires assessing depression and alexithymia. Primary interpersonal problem areas were categorized as interpersonal deficits (as defined in the eating disorders (ED) literature) (n = 29), role disputes (n = 22), or role transitions (n = 5). Girls with interpersonal deficits-ED had greater depressive symptoms and alexithymia than girls with role disputes (ps ≤ 0.01). However, girls with role transitions did not differ from girls with interpersonal deficits-ED or role disputes. Interpersonal problem area had an indirect association with depression via alexithymia; interpersonal deficits-ED were related to greater alexithymia, which in turn, was related to greater depressive symptoms (p = 0.01). Among girls at-risk for excess weight gain and eating disorders, those with interpersonal deficits-ED appear to have greater distress as compared to girls with role disputes or role transitions. Future research is required to elucidate the impact of interpersonal problem areas on psychotherapy outcomes. PMID:24139852

Escalation to Major Depressive Disorder among adolescents with subthreshold depressive symptoms: evidence of distinct subgroups at risk.

PubMed

Hill, Ryan M; Pettit, Jeremy W; Lewinsohn, Peter M; Seeley, John R; Klein, Daniel N

2014-04-01

The presence of subthreshold depressive symptoms (SubD) in adolescence is associated with high prospective risk of developing Major Depressive Disorder (MDD). Little is known about variables that predict escalation from SubD to MDD. This study used a longitudinal prospective design in a community sample of adolescents to identify combinations of risk factors that predicted escalation from SubD to MDD. Classification tree analysis was used to identify combinations of risk factors that improved the sensitivity and specificity of prediction of MDD onset among 424 adolescents with a lifetime history of SubD. Of the 424, 144 developed MDD during the follow-up period. Evidence for multiple subgroups was found: among adolescents with poor friend support, the highest risk of escalation was among participants with lifetime histories of an anxiety or substance use disorder. Among adolescents with high friend support, those reporting multiple major life events in the past year or with a history of an anxiety disorder were at highest risk of escalation. Study findings may not inform prevention efforts for individuals who first develop SubD during adulthood. This study did not examine the temporal ordering of predictors involved in escalation from SubD to MDD. Adolescents with a history of SubD were at highest risk of escalation to MDD in the presence of poor friend support and an anxiety or substance use disorder, or in the presence of better friend support, multiple major life events, and an anxiety disorder. Findings may inform case identification approaches for adolescent depression prevention programs. Copyright © 2014 Elsevier B.V. All rights reserved.

Agomelatine, venlafaxine, and running exercise effectively prevent anxiety- and depression-like behaviors and memory impairment in restraint stressed rats

PubMed Central

Lapmanee, Sarawut; Teerapornpuntakit, Jarinthorn; Krishnamra, Nateetip; Charoenphandhu, Narattaphol

2017-01-01

Several severe stressful situations, e.g., natural disaster, infectious disease out break, and mass casualty, are known to cause anxiety, depression and cognitive impairment, and preventive intervention for these stress complications is worth exploring. We have previously reported that the serotonin-norepinephrine-dopamine reuptake inhibitor, venlafaxine, as well as voluntary wheel running are effective in the treatment of anxiety- and depression-like behaviors in stressed rats. But whether they are able to prevent deleterious consequences of restraint stress in rats, such as anxiety/depression-like behaviors and memory impairment that occur afterward, was not known. Herein, male Wistar rats were pre-treated for 4 weeks with anti-anxiety/anti-depressive drugs, agomelatine and venlafaxine, or voluntary wheel running, followed by 4 weeks of restraint-induced stress. During the stress period, rats received neither drug nor exercise intervention. Our results showed that restraint stress induced mixed anxiety- and depression-like behaviors, and memory impairment as determined by elevated plus-maze, elevated T-maze, open field test (OFT), forced swimming test (FST), and Morris water maze (MWM). Both pharmacological pre-treatments and running successfully prevented the anxiety-like behavior, especially learned fear, in stressed rats. MWM test suggested that agomelatine, venlafaxine, and running could prevent stress-induced memory impairment, but only pharmacological treatments led to better novel object recognition behavior and positive outcome in FST. Moreover, western blot analysis demonstrated that venlafaxine and running exercise upregulated brain-derived neurotrophic factor (BDNF) expression in the hippocampus. In conclusion, agomelatine, venlafaxine as well as voluntary wheel running had beneficial effects, i.e., preventing the restraint stress-induced anxiety/depression-like behaviors and memory impairment. PMID:29099859

Agomelatine, venlafaxine, and running exercise effectively prevent anxiety- and depression-like behaviors and memory impairment in restraint stressed rats.

PubMed

Lapmanee, Sarawut; Charoenphandhu, Jantarima; Teerapornpuntakit, Jarinthorn; Krishnamra, Nateetip; Charoenphandhu, Narattaphol

2017-01-01

Several severe stressful situations, e.g., natural disaster, infectious disease out break, and mass casualty, are known to cause anxiety, depression and cognitive impairment, and preventive intervention for these stress complications is worth exploring. We have previously reported that the serotonin-norepinephrine-dopamine reuptake inhibitor, venlafaxine, as well as voluntary wheel running are effective in the treatment of anxiety- and depression-like behaviors in stressed rats. But whether they are able to prevent deleterious consequences of restraint stress in rats, such as anxiety/depression-like behaviors and memory impairment that occur afterward, was not known. Herein, male Wistar rats were pre-treated for 4 weeks with anti-anxiety/anti-depressive drugs, agomelatine and venlafaxine, or voluntary wheel running, followed by 4 weeks of restraint-induced stress. During the stress period, rats received neither drug nor exercise intervention. Our results showed that restraint stress induced mixed anxiety- and depression-like behaviors, and memory impairment as determined by elevated plus-maze, elevated T-maze, open field test (OFT), forced swimming test (FST), and Morris water maze (MWM). Both pharmacological pre-treatments and running successfully prevented the anxiety-like behavior, especially learned fear, in stressed rats. MWM test suggested that agomelatine, venlafaxine, and running could prevent stress-induced memory impairment, but only pharmacological treatments led to better novel object recognition behavior and positive outcome in FST. Moreover, western blot analysis demonstrated that venlafaxine and running exercise upregulated brain-derived neurotrophic factor (BDNF) expression in the hippocampus. In conclusion, agomelatine, venlafaxine as well as voluntary wheel running had beneficial effects, i.e., preventing the restraint stress-induced anxiety/depression-like behaviors and memory impairment.

Internet-based interventions for the prevention and treatment of depression in people living in developing countries: A systematic review.

PubMed

Martínez, Pablo; Rojas, Graciela; Martínez, Vania; Lara, María Asunción; Pérez, J Carola

2018-07-01

Internet-based interventions for depression may be a valuable resource to reduce the treatment gap for those living in developing countries. However, evidence comes mainly from developed countries. This systematic review summarized the evidence on preventive or therapeutic Internet-based interventions for depression for people who reside in developing countries. CINAHL, EMBASE, PubMed, SciELO Citation Indexes, the Journal of Medical Internet Research, and the Telemedicine and e-Health journal, were searched up to June 2017, to identify feasibility or effectiveness studies of preventive or therapeutic Internet-based interventions for depression, with or without human support. Studies included subjects residing in developing countries, and were published in English or Spanish. Study protocols were included. Risk of bias and/or quality of the reporting of the studies included was assessed. Five feasibility studies, aimed at the prevention of depression, and a study protocol were included in this systematic review. Reports came mostly from the Americas (n = 4). Internet-based interventions aimed at the prevention of depression presented low levels of human support, were useful and acceptable to their users, and require further design refinements to improve their use and retention. No gray literature was searched or included in this systematic review. Searches were limited to English and Spanish languages. Internet-based interventions aimed at the prevention of depression in people who reside in developing countries are in an early phase of development, limiting the generalizability of the results. Future studies must employ persuasive designs to improve user retention, incorporating larger samples and a control group to conclusively determine feasibility. Copyright © 2018 Elsevier B.V. All rights reserved.

Community-based opioid overdose prevention programs providing naloxone - United States, 2010.

PubMed

2012-02-17

Drug overdose death rates have increased steadily in the United States since 1979. In 2008, a total of 36,450 drug overdose deaths (i.e., unintentional, intentional [suicide or homicide], or undetermined intent) were reported, with prescription opioid analgesics (e.g., oxycodone, hydrocodone, and methadone), cocaine, and heroin the drugs most commonly involved . Since the mid-1990s, community-based programs have offered opioid overdose prevention services to persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of these programs have provided the opioid antagonist naloxone hydrochloride, the treatment of choice to reverse the potentially fatal respiratory depression caused by overdose of heroin and other opioids. Naloxone has no effect on non-opioid overdoses (e.g., cocaine, benzodiazepines, or alcohol) . In October 2010, the Harm Reduction Coalition, a national advocacy and capacity-building organization, surveyed 50 programs known to distribute naloxone in the United States, to collect data on local program locations, naloxone distribution, and overdose reversals. This report summarizes the findings for the 48 programs that completed the survey and the 188 local programs represented by the responses. Since the first opioid overdose prevention program began distributing naloxone in 1996, the respondent programs reported training and distributing naloxone to 53,032 persons and receiving reports of 10,171 overdose reversals. Providing opioid overdose education and naloxone to persons who use drugs and to persons who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern.

Emotionally troubled teens' help-seeking behaviors: an evaluation of surviving the Teens® suicide prevention and depression awareness program.

PubMed

Strunk, Catherine M; Sorter, Michael T; Ossege, Julianne; King, Keith A

2014-10-01

Many school-based suicide prevention programs do not show a positive impact on help-seeking behaviors among emotionally troubled teens despite their being at high risk for suicide. This study is a secondary analysis of the Surviving the Teens(®) program evaluation to determine its effect on help-seeking behaviors among troubled youth. Results showed significant increases in mean scores of the Behavioral Intent to Communicate with Important Others Regarding Emotional Health Issues subscale (p < .0005) from pretest to 3-month follow-up. There was a significant increase (p = .006) in mean scores of the Behavioral Intent Regarding Help-Seeking Behaviors when Suicidal subscale from pretest to posttest, but not at 3-month follow-up. Also, there was a significant increase (p = .016) in mean scores in the item "I would tell an adult if I was suicidal" from pretest to 3-month follow-up. These findings suggest that the Surviving the Teens program has a positive effect on help-seeking behaviors in troubled youth. © The Author(s) 2013.

Relapse prevention after index electroconvulsive therapy in treatment-resistant depression

PubMed Central

Youssef, Nagy A.; McCall, W. Vaughn

2015-01-01

Background One-third of patients who suffer from depression are resistant to conventional treatments. An acute course of electroconvulsive therapy (ECT) can lead to remission of depressive symptoms in a substantial portion of the treatment-resistant patients. However, prevention of relapse with depressive symptoms after the index course of ECT can be challenging. We review pertinent studies on the topic and analyze the best strategies to avoid relapse and recurrence of depressive symptoms. Methods We performed a systematic literature review of PubMed through April 2014 for clinical trials published in English to determine if continuation ECT, continuation medication, continuation psychotherapy, or combinations of these are the best strategy to avoid relapse and recurrence of depressive symptoms after an acute course of ECT. Clinical trials comparing ≥2 of the above strategies were included in the review. Results Although there are few rigorous randomized clinical trials in this area, most studies suggest that combined continuation ECT (C-ECT) and continuation pharmacotherapy are the most effective strategy in relapse prevention. Conclusions C-ECT and continuation pharmacotherapy may be more effective than either alone for preventing relapse. However, more definitive randomized clinical trials are needed. PMID:25401716

The Relationship of Sexual Abuse with Self-Esteem, Depression, and Problematic Internet Use in Korean Adolescents

PubMed Central

Kim, Bung-Nyun; Park, Min-Hyeon

2017-01-01

The association of sexual victimization with self-esteem, depression, and problematic internet use was examined in Korean adolescents. A total of 695 middle and high school students were recruited (413 boys, 282 girls, mean age, 14.06±1.37 years). The participants were administered the Early Trauma Inventory Self Report-Short Form (ETISR-SF), Rosenberg's Self-Esteem Scale (RSES), the Children's Depression Inventory (CDI), and Young's Internet Addiction Test (IAT). The associations between sexual abuse and the level of self-esteem, depressive symptoms, and problematic internet use were analyzed. Adolescents who had experienced sexual abuse showed lower self-esteem, more depressive symptoms, and greater problematic internet use compared with adolescents who had not experienced sexual abuse. In the path model, sexual abuse predicted lower self-esteem (β=-0.11; 95% CI=-0.20, -0.04; p=0.009), which predicted higher depressive symptoms (β=-0.34; 95% CI=-0.40, -0.27; p=0.008). Depressive symptoms predicted problematic internet use in a positive way (β=0.23; 95% CI=0.16–0.29; p=0.013). Sexual abuse also predicted problematic internet use directly (β=0.20; 95% CI=0.12–0.27; p=0.012). The results of the present study indicate that sexually abused adolescents had a higher risk of depression and problematic internet use. For sexually abused adolescents, programs aimed at raising self-esteem and preventing internet addiction, as well as mental health screening, are needed. PMID:28539957

The Relationship of Sexual Abuse with Self-Esteem, Depression, and Problematic Internet Use in Korean Adolescents.

PubMed

Kim, Bung-Nyun; Park, Subin; Park, Min-Hyeon

2017-05-01

The association of sexual victimization with self-esteem, depression, and problematic internet use was examined in Korean adolescents. A total of 695 middle and high school students were recruited (413 boys, 282 girls, mean age, 14.06±1.37 years). The participants were administered the Early Trauma Inventory Self Report-Short Form (ETISR-SF), Rosenberg's Self-Esteem Scale (RSES), the Children's Depression Inventory (CDI), and Young's Internet Addiction Test (IAT). The associations between sexual abuse and the level of self-esteem, depressive symptoms, and problematic internet use were analyzed. Adolescents who had experienced sexual abuse showed lower self-esteem, more depressive symptoms, and greater problematic internet use compared with adolescents who had not experienced sexual abuse. In the path model, sexual abuse predicted lower self-esteem (β=-0.11; 95% CI=-0.20, -0.04; p=0.009), which predicted higher depressive symptoms (β=-0.34; 95% CI=-0.40, -0.27; p=0.008). Depressive symptoms predicted problematic internet use in a positive way (β=0.23; 95% CI=0.16-0.29; p=0.013). Sexual abuse also predicted problematic internet use directly (β=0.20; 95% CI=0.12-0.27; p=0.012). The results of the present study indicate that sexually abused adolescents had a higher risk of depression and problematic internet use. For sexually abused adolescents, programs aimed at raising self-esteem and preventing internet addiction, as well as mental health screening, are needed.

Facts about Chickenpox and Shingles for Adults

MedlinePlus

... heart failure, heart attack, type II diabetes and major depression. Prevention Chickenpox can be prevented by vaccination. Children ... heart failure, heart attack, type II diabetes and major depression. Antiviral medications can be used to treat shingles ...

Disruption of Fetal Hormonal Programming (Prenatal Stress) Implicates Shared Risk for Sex Differences in Depression and Cardiovascular Disease

PubMed Central

Goldstein, JM; Handa, RJ; Tobet, SA

2014-01-01

Comorbidity of major depressive disorder (MDD) and cardiovascular disease (CVD) represents the fourth leading cause of morbidity and mortality worldwide, and women have a two times greater risk than men. Thus understanding the pathophysiology has widespread implications for attenuation and prevention of disease burden. We suggest that sex-dependent MDD-CVD comorbidity may result from alterations in fetal programming consequent to the prenatal maternal environments that produce excess glucocorticoids, which then drive sex-dependent developmental alterations of the fetal hypothalamic-pituitary-adrenal (HPA) axis circuitry impacting mood, stress regulation, autonomic nervous system (ANS), and the vasculature in adulthood. Evidence is consistent with the hypothesis that disruptions of pathways associated with gamma aminobutyric acid (GABA) in neuronal and vascular development and growth factors have critical roles in key developmental periods and adult responses to injury in heart and brain. Understanding the potential fetal origins of these sex differences will contribute to development of novel sex-dependent therapeutics. PMID:24355523

Attachment to Parents As a Moderator in the Association between Sibling Bullying and Depression or Suicidal Ideation among Children and Adolescents

PubMed Central

Bar-Zomer, Jasmin; Brunstein Klomek, Anat

2018-01-01

Bullying is one of the most widespread phenomenon in childhood and adolescence. Interestingly, most research on bullying focuses on bullying at school and not on bullying among siblings at home. Sibling bullying is the most frequent form of repeated aggression that children experience in their lifetime. Furthermore, previous studies indicate that sibling bullying is associated with depression and self-harm behavior. However, the association between sibling bullying and suicidal ideation was never previously examined. Attachment to parents is one variable that can moderate the association between sibling bullying and depression/suicide ideation. To our knowledge, there is no existing study that examines the association between sibling bullying and attachment patterns. In addition, no previous study has examined the moderating role of attachment on the association between sibling bullying and depression or suicidal ideation among adolescents. The current study includes 279 Israeli students aged 10–17 (M = 13.5; SD = 1.98; 164, 58.8% females) who completed self-report questionnaires regarding school and sibling bullying, attachment to mother and father, depression, and suicidal ideation. The results indicated an association between bullying among siblings and school bullying. In addition, children and adolescents who were consistently involved in sibling bullying were at greater risk for depression and suicide ideation when compared to children and adolescents who were not involved in sibling bullying. A secure attachment to one’s father (but not to one’s mother) moderated the association between sibling bullying and depression/suicide ideation. It should be noted that when suicide ideation was examined above and beyond depression, attachment to one’s father did not moderate the association between sibling bullying involvement and suicide ideation. This finding indicates that depression plays a central role in the association between sibling bullying and suicide ideation. These results suggest that sibling bullying is a risk factor for depressive symptoms and suicide ideation and that secure attachment to one’s father may serve as a protective role. Future bullying prevention programs should include sibling bullying and encourage the increased availability of paternal emotional support. Other theoretical and applied implications for prevention of both sibling bullying and suicide are discussed. PMID:29593583

Efficacy and Moderators of a Family Group Cognitive-Behavioral Preventive Intervention for Children of Depressed Parents

PubMed Central

Compas, Bruce E.; Forehand, Rex; Thigpen, Jennifer; Hardcastle, Emily; Garai, Emily; McKee, Laura; Keller, Gary; Dunbar, Jennifer P.; Watson, Kelly H.; Rakow, Aaron; Bettis, Alexandra; Reising, Michelle; Cole, David; Sterba, Sonya

2015-01-01

Building on an earlier study (Compas et al., 2011), tests of main effects and potential moderators of a family group cognitive-behavioral (FGCB) preventive intervention for children of parents with a history of depression are reported in a sample of 180 families (242 children ages 9-15 years) in a randomized controlled trial assessed at 2-, 6-, 12-, 18- and 24-months after baseline. Significant effects favoring the FGCB intervention over a written information (WI) comparison condition were found on measures of children's symptoms of depression, mixed anxiety/depression, internalizing problems, and externalizing problems, with multiple effects maintained at 18- and 24-months, and on incidence of child episodes of major depressive disorder over the 24-months. Effects were stronger for child self-reports than for parent-reports. Minimal evidence was found for child age, child gender, parental education, parental depressive symptoms, or presence of a current parental depressive episode at baseline as moderators of the FGCB intervention. The findings provide support for sustained and robust effects of this preventive intervention. PMID:26009786

Efficacy and moderators of a family group cognitive-behavioral preventive intervention for children of parents with depression.

PubMed

Compas, Bruce E; Forehand, Rex; Thigpen, Jennifer; Hardcastle, Emily; Garai, Emily; McKee, Laura; Keller, Gary; Dunbar, Jennifer P; Watson, Kelly H; Rakow, Aaron; Bettis, Alexandra; Reising, Michelle; Cole, David; Sterba, Sonya

2015-06-01

Building on an earlier study (Compas, Forehand, Thigpen, et al., 2011), tests of main effects and potential moderators of a family group cognitive-behavioral (FGCB) preventive intervention for children of parents with a history of depression are reported. Assessed a sample of 180 families (242 children ages 9-15 years) in a randomized controlled trial assessed at 2, 6, 12, 18 and 24 months after baseline. Significant effects favoring the FGCB intervention over a written information comparison condition were found on measures of children's symptoms of depression, mixed anxiety/depression, internalizing problems, and externalizing problems, with multiple effects maintained at 18 and 24 months, and on incidence of child episodes of major depressive disorder over the 24 months. Effects were stronger for child self-reports than for parent reports. Minimal evidence was found for child age, child gender, parental education, parental depressive symptoms, or presence of a current parental depressive episode at baseline as moderators of the FGCB intervention. The findings provide support for sustained and robust effects of this preventive intervention. (c) 2015 APA, all rights reserved).

Risk factors for antenatal depression, postnatal depression and parenting stress

PubMed Central

Leigh, Bronwyn; Milgrom, Jeannette

2008-01-01

Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program [1]. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Results Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors. Conclusion Risk factor profiles for antenatal depression, postnatal depression and parenting stress differ but are interrelated. Antenatal depression was the strongest predictor of postnatal depression, and in turn postnatal depression was the strongest predictor for parenting stress. These results provide clinical direction suggesting that early identification and treatment of perinatal depression is important. PMID:18412979

Maternal depressive symptoms and child obesity in low-income urban families.

PubMed

Gross, Rachel S; Velazco, Nerissa K; Briggs, Rahil D; Racine, Andrew D

2013-01-01

To characterize the relationship between maternal depressive symptoms and child weight status, obesity-promoting feeding practices, and activity-related behaviors in low-income urban families. We conducted a cross-sectional survey of mothers with 5-year-old children receiving pediatric care at a federally qualified community health center. We used regression analyses to examine the relationship between maternal depressive symptoms (trichotomized: none, mild, moderate to severe) and 1) child weight status; 2) obesity-promoting feeding practices, including mealtime practices and feeding styles; and 3) activity-related behaviors, including sleep time, screen time, and outdoor playtime. The sample included 401 mother-child pairs (78.3% response rate), with 23.4% of mothers reporting depressive symptoms (15.7% mild, 7.7% moderate to severe). Mothers with moderate to severe depressive symptoms were more likely to have overweight and obese children than mothers without depressive symptoms (adjusted odds ratio 2.62; 95% confidence interval 1.02-6.70). Children of mildly depressed mothers were more likely to consume sweetened drinks and to eat out at restaurants and were less likely to eat breakfast than children of nondepressed mothers. Mothers with depressive symptoms were less likely to set limits, to use food as a reward, to restrict their child's intake, and to model healthy eating than nondepressed mothers. Children with depressed mothers had less sleep and outdoor playtime per day than children of nondepressed mothers. Maternal depressive symptoms are associated with child overweight and obese status and with several obesity-promoting practices. These results support the need for maternal depression screening in pediatric obesity prevention programs. Further research should explore how to incorporate needed mental health support. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A feasibility trial of an Internet-delivered and transdiagnostic cognitive behavioral therapy treatment program for anxiety, depression, and disability among adults with epilepsy.

PubMed

Gandy, Milena; Karin, Eyal; Fogliati, Vincent J; McDonald, Sarah; Titov, Nick; Dear, Blake F

2016-11-01

Anxiety and depression are highly prevalent in people with epilepsy (PWE) and contribute to increased disability. Unfortunately, there are numerous barriers (e.g., cost, distance, and stigma) and service gaps (e.g., lack of services and trained clinicians) that prevent many PWE from accessing traditional face-to-face psychological services. The aim of the present study was to examine the feasibility of a new transdiagnostic Internet-delivered cognitive behavioral therapy (iCBT) program, the Chronic Conditions Course, to simultaneously treat symptoms of anxiety, depression, and disability. A single-group feasibility open trial was employed involving 27 adults with epilepsy. The program comprises five online lessons delivered over 8 weeks and is provided with weekly contact from a mental health professional via e-mail and telephone. High treatment completion rates and levels of satisfaction were reported. Evidence of significant improvements in our primary outcomes (within-group Cohen's d [d]; average [avg.] reductions) of anxiety (d ≥ 1.28; avg. reduction ≥ 54%), depression (d ≥ 1.24; avg. reduction ≥ 54%), epilepsy-specific depression (d ≥ 0.95; avg. reduction ≥ 35%), and disability (d ≥ 0.62; avg. reduction ≥ 33%) were observed at posttreatment, which were sustained at or further improved to 3-month follow-up. On our secondary outcomes there were significant improvements for life satisfaction (d ≥ 0.70; avg. improvement ≥ 26%) but not for perceived cognitive difficulties (d ≥ 0.48; avg. reduction ≥ 15%). Highlighting the potential of the approach, relatively little clinician time was required per participant (mean 80.62 min, standard deviation [SD] 54.78), and the trial involved a broad range of geographically dispersed patients. The findings of the current study support the feasibility and potential of transdiagnostic Internet-delivered treatments for adults with epilepsy. Further large-scale controlled trials are warranted. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Dietary recommendations for the prevention of depression.

PubMed

Opie, R S; Itsiopoulos, C; Parletta, N; Sanchez-Villegas, A; Akbaraly, T N; Ruusunen, A; Jacka, F N

2017-04-01

Major depressive disorder is a common, chronic condition that imposes a substantial burden of disability globally. As current treatments are estimated to address only one-third of the disease burden of depressive disorders, there is a need for new approaches to prevent depression or to delay its progression. While in its early stages, converging evidence from laboratory, population research, and clinical trials now suggests that dietary patterns and specific dietary factors may influence the risk for depression. However, largely as a result of the recency of the nutritional psychiatry field, there are currently no dietary recommendations for depression. The aim of this paper is to provide a set of practical dietary recommendations for the prevention of depression, based on the best available current evidence, in order to inform public health and clinical recommendations. Five key dietary recommendations for the prevention of depression emerged from current published evidence. These comprise: (1) follow 'traditional' dietary patterns, such as the Mediterranean, Norwegian, or Japanese diet; (2) increase consumption of fruits, vegetables, legumes, wholegrain cereals, nuts, and seeds; (3) include a high consumption of foods rich in omega-3 polyunsaturated fatty acids; (4) replace unhealthy foods with wholesome nutritious foods; (5) limit your intake of processed-foods, 'fast' foods, commercial bakery goods, and sweets. Although there are a number of gaps in the scientific literature to date, existing evidence suggests that a combination of healthful dietary practices may reduce the risk of developing depression. It is imperative to remain mindful of any protective effects that are likely to come from the cumulative and synergic effect of nutrients that comprise the whole-diet, rather than from the effects of individual nutrients or single foods. As the body of evidence grows from controlled intervention studies on dietary patterns and depression, these recommendations should be modified accordingly.

STroke imAging pRevention and treatment (START): A longitudinal stroke cohort study: Clinical trials protocol.

PubMed

Carey, Leeanne M; Crewther, Sheila; Salvado, Olivier; Lindén, Thomas; Connelly, Alan; Wilson, William; Howells, David W; Churilov, Leonid; Ma, Henry; Tse, Tamara; Rose, Stephen; Palmer, Susan; Bougeat, Pierrick; Campbell, Bruce C V; Christensen, Soren; Macaulay, S Lance; Favaloro, Jenny; O' Collins, Victoria; McBride, Simon; Bates, Susan; Cowley, Elise; Dewey, Helen; Wijeratne, Tissa; Gerraty, Richard; Phan, Thanh G; Yan, Bernard; Parsons, Mark W; Bladin, Chris; Barber, P Alan; Read, Stephen; Wong, Andrew; Lee, Andrew; Kleinig, Tim; Hankey, Graeme J; Blacker, David; Markus, Romesh; Leyden, James; Krause, Martin; Grimley, Rohan; Mahant, Neil; Jannes, Jim; Sturm, Jonathan; Davis, Stephen M; Donnan, Geoffrey A

2015-06-01

Stroke and poststroke depression are common and have a profound and ongoing impact on an individual's quality of life. However, reliable biological correlates of poststroke depression and functional outcome have not been well established in humans. Our aim is to identify biological factors, molecular and imaging, associated with poststroke depression and recovery that may be used to guide more targeted interventions. In a longitudinal cohort study of 200 stroke survivors, the START-STroke imAging pRevention and Treatment cohort, we will examine the relationship between gene expression, regulator proteins, depression, and functional outcome. Stroke survivors will be investigated at baseline, 24 h, three-days, three-months, and 12 months poststroke for blood-based biological associates and at days 3-7, three-months, and 12 months for depression and functional outcomes. A sub-group (n = 100), the PrePARE: Prediction and Prevention to Achieve optimal Recovery Endpoints after stroke cohort, will also be investigated for functional and structural changes in putative depression-related brain networks and for additional cognition and activity participation outcomes. Stroke severity, diet, and lifestyle factors that may influence depression will be monitored. The impact of depression on stroke outcomes and participation in previous life activities will be quantified. Clinical significance lies in the identification of biological factors associated with functional outcome to guide prevention and inform personalized and targeted treatments. Evidence of associations between depression, gene expression and regulator proteins, functional and structural brain changes, lifestyle and functional outcome will provide new insights for mechanism-based models of poststroke depression. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

Tragedy prompts depression awareness, suicide prevention campaigns.

PubMed

Rees, T

1998-01-01

The tragic suicide of Robert C. Goltz prompted associates at the integrated marketing and communications company he founded in Green Bay, Wis., to develop two multimedia campaigns, one focusing on depression awareness and the other on suicide prevention.

Stepped-care to prevent depression and anxiety in visually impaired older adults--design of a randomised controlled trial.

PubMed

van der Aa, Hilde P A; van Rens, Ger H M B; Comijs, Hannie C; Bosmans, Judith E; Margrain, Tom H; van Nispen, Ruth M A

2013-08-09

Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in The Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Identifier: NTR3296.

Perceived reasons for, opinions about, and suggestions for elders considering suicide: elderly outpatients' perspectives.

PubMed

Chen, Ying-Jen; Tsai, Yun-Fang; Ku, Yan-Chiou; Lee, Shwu-Hua; Lee, Hsiu-Lan

2014-07-01

The purposes of this study were to explore elderly outpatients' perceived reasons for, opinions of, and suggestions for elderly people considering suicide in Taiwan. Elderly outpatients (N = 83) were recruited in 2011-2012 by convenience sampling from three randomly selected medical centers in Taiwan. Data were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Findings revealed that most participants had heard of elderly suicide, with television news as the main source for their information. Their opinions about elderly suicide reflected judgmental attitudes, negative emotional reactions, expectations of social welfare, and could happen after losing one's meaning in life. Their suggestions for elderly people considering suicide fell into four major themes: give up suicidal ideas, seek help, enhance social welfare, and attend religious activities. Since television news was the main source for participants' information about elderly suicide, this mass medium should be used in suicide prevention to disseminate suicide knowledge, increase access to help, and strengthen suicide-protective factors among the elderly. Furthermore, no participants mentioned depression as a reason for attempted or completed suicide among older people despite depression being a well-known suicide-risk factor. Future suicide-prevention programs should emphasize the role of depression in suicide among older people. Participants also did not suggest that older people considering suicide seek help from the health system. Thus, older people should be educated about the role of the health system in suicide prevention and trained as gatekeepers to recognize signs of suicide ideation and respond appropriately.

Attitude toward depression, its complications, prevention and barriers to seeking help among ethnic groups in Penang, Malaysia

PubMed Central

2009-01-01

This study aims to explore attitudes towards, complications of and preventive measures for depression and the barriers that result in delays in seeking help among the various ethnic groups in Penang, Malaysia. In June 2007 a questionnaire‐based survey was undertaken in Penang. Face‐to‐face interviews were conducted, and 1855 respondents were approached to participate in the study by adopting a cluster random sampling method. A 25‐item questionnaire was used to explore public attitudes towards, complications of and preventive measures for depression and delays in seeking help. A total of 1149 (61.94%) showed willingness to participate in the survey. Ethnically, 490 (42.6%) of the respondents who participated in the survey were Malay, while 413 (35.9%) were Chinese, 149 (13%) Indian and 97 (8.4%) from other ethnic minorities. The mean age of the respondents was 30 years (SD ± 11.5). In evaluating public attitudes, the majority (n = 910, 79.2%) agreed with the statement that family and friends can enhance the depression recovery process by providing more care and attention to the patient and this was found to be statistically significant (P ≤0.001). More than one‐third of the respondents (n = 437, 38.0%) perceived depression as a normal medical condition and believed that it subsides automatically. The majority (n = 830, 72.2%) stated that depression results in social problems, while some felt that it can lead to raised blood pressure (n = 518, 45.1%). In terms of prevention, most of the respondents indicated that one can prevent depression by maintaining a good social life. In evaluating the barriers to seeking professional help, the majority (n = 582, 50.7%) stated that they did not believe they were at risk, with the next largest group identifying a lack of awareness regarding the signs and symptoms. However, a positive attitude was observed towards the complications and prevention of depression. Initiatives to increase mental health literacy will prove fruitful in neutralising the negative public perceptions towards the treatment of depression and barriers to seeking professional help. PMID:22477913

Subthreshold symptoms of depression in preadolescent girls are stable and predictive of depressive disorders.

PubMed

Keenan, Kate; Hipwell, Alison; Feng, Xin; Babinski, Dara; Hinze, Amanda; Rischall, Michal; Henneberger, Angela

2008-12-01

Given the risk for adolescent depression in girls to lead to a chronic course of mental illness, prevention of initial onset could have a large impact on reducing chronicity. If symptoms of depression that emerge during childhood were stable and predictive of later depressive disorders and impairment, then secondary prevention of initial onset of depressive disorders would be possible. Drawing from the Pittsburgh Girls Study, an existing longitudinal study, 232 nine-year-old girls were recruited for the present study, half of whom screened high on a measure of depression at age 8 years. Girls were interviewed about depressive symptoms using a diagnostic interview at ages 9, 10, and 11 years. Caregivers and interviewers rated impairment in each year. The stability coefficients for DSM-IV symptom counts for a 1- to 2-year interval were in the moderate range (i.e., intraclass coefficients of 0.40-0.59 for continuous symptom counts and Kendall tau-b coefficients of 0.34-0.39 for symptom level stability). Depressive disorders were also relatively stable at this age. Poverty moderated the stability, but race and pubertal stage did not. Among the girls who did not meet criteria for a depressive disorder at age 9 years, the odds of meeting criteria for depressive disorders and for demonstrating impairment at age 10 or 11 years increased by 1.9 and 1.7, respectively, for every increase in the number of depression symptoms. Early-emerging symptoms of depression in girls are stable and predictive of depressive disorders and impairment. The results suggest that secondary prevention of depression in girls may be accomplished by targeting subthreshold symptoms manifest during childhood.

Preventing the onset of major depression based on the level and profile of risk of primary care attendees: protocol of a cluster randomised trial (the predictD-CCRT study)

PubMed Central

2013-01-01

Background The ‘predictD algorithm’ provides an estimate of the level and profile of risk of the onset of major depression in primary care attendees. This gives us the opportunity to develop interventions to prevent depression in a personalized way. We aim to evaluate the effectiveness, cost-effectiveness and cost-utility of a new intervention, personalized and implemented by family physicians (FPs), to prevent the onset of episodes of major depression. Methods/Design This is a multicenter randomized controlled trial (RCT), with cluster assignment by health center and two parallel arms. Two interventions will be applied by FPs, usual care versus the new intervention predictD-CCRT. The latter has four components: a training workshop for FPs; communicating the level and profile of risk of depression; building up a tailored bio-psycho-family-social intervention by FPs to prevent depression; offering a booklet to prevent depression; and activating and empowering patients. We will recruit a systematic random sample of 3286 non-depressed adult patients (1643 in each trial arm), nested in 140 FPs and 70 health centers from 7 Spanish cities. All patients will be evaluated at baseline, 6, 12 and 18 months. The level and profile of risk of depression will be communicated to patients by the FPs in the intervention practices at baseline, 6 and 12 months. Our primary outcome will be the cumulative incidence of major depression (measured by CIDI each 6 months) over 18 months of follow-up. Secondary outcomes will be health-related quality of life (SF-12 and EuroQol), and measurements of cost-effectiveness and cost-utility. The inferences will be made at patient level. We shall undertake an intention-to-treat effectiveness analysis and will handle missing data using multiple imputations. We will perform multi-level logistic regressions and will adjust for the probability of the onset of major depression at 12 months measured at baseline as well as for unbalanced variables if appropriate. The economic evaluation will be approached from two perspectives, societal and health system. Discussion To our knowledge, this will be the first RCT of universal primary prevention for depression in adults and the first to test a personalized intervention implemented by FPs. We discuss possible biases as well as other limitations. Trial registration ClinicalTrials.gov identifier: NCT01151982 PMID:23782553

Cognitive-Behavioral Therapy to Prevent Relapse in Pediatric Responders to Pharmacotherapy for Major Depressive Disorder

ERIC Educational Resources Information Center

Kennard, Betsy D.; Emslie, Graham J.; Mayes, Taryn L.; Nightingale-Teresi, Jeanne; Nakonezny, Paul A.; Hughes, Jennifer L.; Jones, Jessica M.; Tao, Rongrong; Stewart, Sunita M.; Jarrett, Robin B.

2008-01-01

The outcome of a sequential treatment strategy that included cognitive behavioral therapy (CBT) in the prevention of major depressive disorder relapse among 46 youths is examined. Results show that youths under the antidepressant medication management plus relapse prevention CBT treatment was at lower risk for relapse than those under the…

Risk factor modifications and depression incidence: a 4-year longitudinal Canadian cohort of the Montreal Catchment Area Study

PubMed Central

Meng, Xiangfei; Brunet, Alain; Turecki, Gustavo; Liu, Aihua; D'Arcy, Carl; Caron, Jean

2017-01-01

Objective Few studies have examined the effect of risk factor modifications on depression incidence. This study was to explore psychosocial risk factors for depression and quantify the effect of risk factor modifications on depression incidence in a large-scale, longitudinal population-based study. Methods Data were from the Montreal Longitudinal Catchment Area study (N=2433). Multivariate modified Poisson regression was used to estimate relative risk (RR). Population attributable fractions were also used to estimate the potential impact of risk factor modifications on depression incidence. Results The cumulative incidence rate of major depressive disorder at the 2-year follow-up was 4.8%, and 6.6% at the 4-year follow-up. Being a younger adult, female, widowed, separated or divorced, Caucasian, poor, occasional drinker, having a family history of mental health problems, having less education and living in areas with higher unemployment rates and higher proportions of visible minorities, more cultural community centres and community organisations, were consistently associated with the increased risk of incident major depressive disorder. Although only 5.1% of the disease incidence was potentially attributable to occasional drinking (vs abstainers) at the 2-year follow-up, the attribution of occasional drinking doubled at the 4-year follow-up. A 10% reduction in the prevalence of occasional drinking in this population could potentially prevent half of incident cases. Conclusions Modifiable risk factors, both individual and societal, could be the targets for public depression prevention programmes. These programmes should also be gender-specific, as different risk factors have been identified for men and women. Public health preventions at individual levels could focus on the better management of occasional drinking, as it explained around 5%~10% of incident major depressive disorders. Neighbourhood characteristics could also be the target for public prevention programmes. However, this could be very challenging. A cost-effectiveness analysis of a variety of prevention efforts is warranted. PMID:28601831

Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association.

PubMed

Lichtman, Judith H; Bigger, J Thomas; Blumenthal, James A; Frasure-Smith, Nancy; Kaufmann, Peter G; Lespérance, François; Mark, Daniel B; Sheps, David S; Taylor, C Barr; Froelicher, Erika Sivarajan

2008-10-21

Depression is commonly present in patients with coronary heart disease (CHD) and is independently associated with increased cardiovascular morbidity and mortality. Screening tests for depressive symptoms should be applied to identify patients who may require further assessment and treatment. This multispecialty consensus document reviews the evidence linking depression with CHD and provides recommendations for healthcare providers for the assessment, referral, and treatment of depression.

An Idiographic and Nomothetic Approach to the Study of Mexican-Origin Adolescent Mothers’ Socio-Cultural Stressors and Adjustment

PubMed Central

Zeiders, Katharine H.; Umaña-Taylor, Adriana J.; Updegraff, Kimberly A.; Jahromi, Laudan B.

2014-01-01

The current study examined the longitudinal relations of socio-cultural stressors (i.e., acculturative stressors, enculturative stressors, ethnic discrimination) and Mexican-origin adolescent mothers’ depressive symptoms and risk-taking behaviors. Utilizing an idiographic and nomothetic approach, we conducted lagged analyses to examine how individuals’ fluctuations in stressors predicted subsequent adjustment. Further, we investigated potential threshold effects by examining if the impact of fluctuations in stressors differed at varying levels of stressors. Mexican-origin adolescent females (N = 184) participated in yearly in-home assessments across 5 years and reported on their experiences of acculturative and enculturative stressors, ethnic discrimination, depressive symptoms, and risk-taking behaviors. Findings revealed that within-person fluctuations in acculturative stressors, and to a lesser extent, perceived discrimination, related to youths’ depressive symptoms. For risk-taking behaviors, however, only within-person fluctuations in enculturative stressors emerged as significant. Further, a threshold effect emerged in the link between enculturative stressors and risk-taking behaviors, suggesting that fluctuations in enculturative stressors predicted changes in risk-taking behaviors at high levels of enculturative stressors, but not low levels. Our findings highlight the differential relations between socio-cultural stressors and adolescent females’ adjustment, and suggest that prevention programs aimed at reducing depressive symptoms should attend to any degree of change in socio-cultural stressors, whereas programs focused on risk-taking behaviors should be especially attuned to levels of enculturative stress. PMID:25099084

Postpartum depression peer support: maternal perceptions from a randomized controlled trial.

PubMed

Dennis, Cindy-Lee

2010-05-01

Peer support in the early postpartum period is effective in the prevention of postpartum depression among women identified as high-risk. To describe maternal perceptions of peer support received while participating in a trial. Cross-sectional survey of women participating in a randomized controlled trial to evaluate the effect of peer support in the prevention of postpartum depression. Seven health regions across Ontario Canada. 701 women were recruited between November 2004 and September 2006. Women eligible for the study were all mothers with an Edinburgh Postnatal Depression Scale score >9 who were within 2 weeks postpartum, at least 18 years of age, able to speak English, had a live birth, and had been discharged home from the hospital. Exclusion criteria included an infant not discharged home with the mother and current use of antidepressant or antipsychotic medication. Two hundred and twenty-one mothers completed the mailed questionnaire. Women were randomly allocated to receive usual postpartum care (control group) or usual postpartum care plus telephone-based peer support (intervention group). Maternal perceptions of peer support were evaluated at 12 weeks postpartum using the validated Peer Support Evaluation Inventory. Interactions provided by the peer volunteer included the provision of emotional (92.7%), informational (72.4%), and appraisal (72.0%) support. Mothers reported high levels of positive relationship qualities such as trust (83.6%) and perceived acceptance (79.1%). Most (80.5%) mothers indicated they were very satisfied with their peer support experience. Maternal satisfaction was associated with the number and duration of peer volunteer contacts. The majority of mothers perceived their peer volunteer experience positively lending further support to telephone-based peer support as a preventative strategy for postpartum depression. The following program modifications were suggested: (a) adapt training to enhance the provision of appraisal support; (b) improve matching of volunteers to participants based on age, number of children, and breastfeeding status; and (c) ensure participating mothers want to receive peer support in order to facilitate the development of relationships with their assigned peers. Copyright 2009 Elsevier Ltd. All rights reserved.

Analysis of epidemiology, lifestyle, and psychosocial factors in patients with back pain admitted to an orthopedic emergency unit.

PubMed

Gotfryd, Alberto Ofenhejm; Valesin Filho, Edgar Santiago; Viola, Dan Carai Maia; Lenza, Mario; Silva, Joselito Adriano da; Emi, Angélica Santos; Tomiosso, Raylton; Piccinato, Carla de Azevedo; Antonioli, Eliane; Ferretti, Mario

2015-01-01

To correlate epidemiological data, lifestyle, and psychosocial factors as predictors for clinical manifestation of back pain in patients treated at the orthopedic emergency unit of a Brazilian tertiary care hospital, and to evaluate their interest in participating in a hypothetical program for physical rehabilitation. This is an observational cross-sectional study. We evaluated 210 patients from the emergency department of a tertiary hospital with a major complaint of back pain. We used: epidemiological multiple-choice questionnaires developed for this study; Oswestry questionnaire for physical disability; Hospital Anxiety and Depression Scale (HAD) scale. Data analyses were performed using SAS - Statistical Analysis System (SAS Institute, 2001). Measurements were performed with the SAS functions Proc MEANS and Proc Freq. The mean age was 39.1 years and there was no predominance between genders. The usual work activity was administrative (65.2% of cases). The mean body mass index was 26.0, indicating overweight. The majority (83.3%) of patients had low physical disability (Oswestry 0 - 40%). The number of medical visits in the previous 6 months (p=0.04) and the scores of anxiety and depression (p=0.05), independently, were correlated with physical disability. Most patients (77%) would agree to participate in a hypothetical program of physical rehabilitation for prevention of back pain. Patients with back pain complaints were predominantly young adults, sedentary or hypoactive, overweight, and with recurrent complaints of symptoms. Most participants had low levels of physical disability and would accept participation in a hypothetical physical rehabilitation program for the prevention of back pain.

Aerobic exercise training and burnout: a pilot study with male participants suffering from burnout

PubMed Central

2013-01-01

Background Occupational burnout is associated with severe negative health effects. While stress management programs proved to have a positive influence on the well-being of patients suffering from burnout, it remains unclear whether aerobic exercise alleviates burnout severity and other parameters related to occupational burnout. Therefore, the main purpose of this study was to pilot-test the potential outcomes of a 12-week exercise training to generate hypotheses for future larger scale studies. Methods The sample consisted of 12 male participants scoring high on the MBI emotional exhaustion and depersonalization subscales. The training program took place in a private fitness center with a 17.5 kcal/kg minimum requirement of weekly energy expenditure. Results The key findings are that increased exercise reduced overall perceived stress as well as symptoms of burnout and depression. The magnitude of the effects was large, revealing changes of substantial practical relevance. Additionally, profiles of mood states improved considerably after single exercise sessions with a marked shift towards an iceberg profile. Conclusion Among burnout patients, the findings provide preliminary evidence that exercise has the potential to reduce stress and prevent the development of a deeper depression. This has important health implications given that burnout is considered an antecedent of depressive disorders. Trial registration ClinicalTrials.gov Identifier: ISRNCT01575743 PMID:23497731

Viscosity Depressants for Coal Liquefaction

NASA Technical Reports Server (NTRS)

Kalfayan, S. H.

1983-01-01

Proposed process modification incorporates viscosity depressants to prevent coal from solidifying during liquefaction. Depressants reduce amount of heat needed to liquefy coal. Possible depressants are metallic soaps, such as stearate, and amides, such as stearamide and dimer acid amides.

Alcohol use in an academic medical school environment: A UC San Diego Healer Education Assessment and Referral (HEAR) Report.

PubMed

Martinez, Stephanie; Tal, Ilanit; Norcross, William; Newton, Isabel Gala; Downs, Nancy; Seay, Kathryn; McGuire, Tara; Kirby, Brittany; Chidley, Brittany; Tiamson-Kassab, Maria; Lee, Daniel; Hadley, Allison; Doran, Neal; Jong, Pam; Lee, Kelly; Moutier, Christine; Norman, Marc; Zisook, Sidney

2016-05-01

Medical students and physicians in training and in practice are at risk for excessive alcohol use and abuse, potentially impacting the affected individuals as well as their family members, trainees, and patients. However, several roadblocks to care, including stigma, often keep them from seeking treatment. We analyzed data from anonymous questionnaires completed by medical students, house staff, and faculty from 2009 to 2014 as part of a depression awareness and suicide prevention program at a state-supported medical school in the United States. The authors explored associations between self-reported "drinking too much" and depression, suicidal ideation, substance use, intense affective states, and mental health treatment. Approximately one-fifth of the respondents reported "drinking too much." "Drinking too much" was associated with more severe depression and impairment, past suicide attempts and current suicidal ideation, intense affective states, and other substance use. Those who were "drinking too much" were more likely than others to accept referrals for mental health treatment through the anonymous interactive screening program, suggesting that this program may be effective in skirting the stigma barrier for accessing mental health care for this at-risk population. The self-reported prevalence of "drinking too much" among medical students, house staff, and faculty is high and associated with negative mental health outcomes. Targeted, anonymous screenings may identify at-risk individuals and provide mental health care referrals to those in need.

Effects of an internet-based cognitive behavioural therapy intervention on preventing major depressive episodes among workers: a protocol for a randomised controlled trial

PubMed Central

Imamura, Kotaro; Kawakami, Norito; Furukawa, Toshi A; Matsuyama, Yutaka; Shimazu, Akihito; Kasai, Kiyoto

2015-01-01

Introduction The aim of this study is to examine the effects of an internet-based cognitive behavioural therapy (iCBT) program on decreasing the risk of major depressive episodes (MDEs) among workers employed in a private corporate group in Japan, using a randomised controlled trial design. Methods and analysis All of the workers in a corporate group (n=20 000) will be recruited through an invitation email. Participants who fulfil the inclusion criteria will be randomly allocated to intervention or control groups (planned N=4050 for each group). They will be allowed to complete the six lessons of the iCBT program within 10 weeks after the baseline survey. Those in the control group will receive the same iCBT after 12 months. The program includes several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem-solving and relaxation. The primary outcome measure is no new onset of MDE (using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)/DSM-5 criteria) during the 12-month follow-up. Assessment will use the web version of the WHO Composite International Diagnostic Interview V.3.0 depression section. Ethics and dissemination The Research Ethics Review Board of Graduate School of Medicine, the University of Tokyo (No. 3083-(2)), approved the study procedures. Trial registration number The study protocol is registered at the UMIN Clinical Trials Registry (UMIN-CTR; ID=UMIN000014146). PMID:25968004

Psychiatric disorders and suicide attempts among adolescents victimized by school bullying.

PubMed

Bang, Young Rong; Park, Jae Hong

2017-08-01

We conducted a cross-sectional school-based study to investigate psychiatric disorders and suicide risk among adolescents victimized by bullying. The study was designed in two stages. In the screening stage, 33,038 middle school students were screened for psychopathology. Next, in the face-to-face interview stage, 1196 participants were assessed for psychiatric disorders using a structured diagnostic instrument. We also collected information about the participants' experiences of bullying and history of suicidal ideation/attempts. The results indicate that adolescents with a history of bullying victimization were more likely to be diagnosed with depression and psychosis than those without such a history. Multivariate logistic regression models revealed that bullying victimization was significantly associated with suicide attempts even after adjusting for demographic characteristics, depression and psychosis. Bullying victimization is a risk factor for depression, psychosis, and suicide ideation and attempts. The findings warrant an early intervention and suicide prevention program for victimized students and anti-bullying policies in schools.

What can parents do? Examining the role of parental support on the negative relationship between racial discrimination, depression, and drug use among African American youth

PubMed Central

Zapolski, Tamika C. B.; Fisher, Sycarah; Hsu, Wei-Wen; Barnes, Jessica

2016-01-01

African American youth who experience racial discrimination are at heightened risk to use drugs as a coping response to distress. Based on the buffer-stress hypothesis, we proposed that parental support would attenuate this effect. Participants were 1,521 African American youth between 4th and 12th grade. As hypothesized, a mediation pathway was observed between racial discrimination, depression symptoms, and drug use. This effect was observed for both genders, although the pathway was partially mediated for males. Additionally, as hypothesized, parental support buffered the negative effect of depression symptomatology on drug use as a consequence of discrimination. Our findings highlight the impact racial discrimination has on health outcomes for African American youth and the importance of managing youth's emotional responses to discrimination. Moreover, findings illuminate the protective role of supportive parenting within the risk model and should thus be considered as an important component within prevention programming for this population of youth. PMID:27747140

Internet-delivered eating disorder prevention: A randomized controlled trial of dissonance-based and cognitive-behavioral interventions.

PubMed

Chithambo, Taona P; Huey, Stanley J

2017-10-01

The current study evaluated two web-based programs for eating disorder prevention in high-risk, predominantly ethnic minority women. Two hundred and seventy-one women with elevated weight concerns were randomized to Internet dissonance-based intervention (DBI-I), Internet cognitive-behavioral intervention (CBI-I), or no intervention (NI). Both interventions consisted of four weekly online sessions. Participants were assessed at pre- and post intervention. Outcome measures included eating pathology, body dissatisfaction, dieting, thin-ideal internalization, and depression. At postintervention, DBI-I and CBI-I led to greater reductions in body dissatisfaction, thin-ideal internalization, and depression than NI. In addition, CBI-I was effective at reducing dieting and composite eating pathology relative to NI. No outcome differences were found between the active conditions. Moderation analyses suggested that both active conditions were more effective for ethnic minorities than Whites relative to NI. Results suggest that both DBI-I and CBI-I are effective at reducing eating disorder risk factors in a high-risk, predominantly minority population relative to no intervention. © 2017 Wiley Periodicals, Inc.

Effects of a Memory and Visual-Motor Integration Program for Older Adults Based on Self-Efficacy Theory.

PubMed

Kim, Eun Hwi; Suh, Soon Rim

2017-06-01

This study was conducted to verify the effects of a memory and visual-motor integration program for older adults based on self-efficacy theory. A non-equivalent control group pretest-posttest design was implemented in this quasi-experimental study. The participants were 62 older adults from senior centers and older adult welfare facilities in D and G city (Experimental group=30, Control group=32). The experimental group took part in a 12-session memory and visual-motor integration program over 6 weeks. Data regarding memory self-efficacy, memory, visual-motor integration, and depression were collected from July to October of 2014 and analyzed with independent t-test and Mann-Whitney U test using PASW Statistics (SPSS) 18.0 to determine the effects of the interventions. Memory self-efficacy (t=2.20, p=.031), memory (Z=-2.92, p=.004), and visual-motor integration (Z=-2.49, p=.013) increased significantly in the experimental group as compared to the control group. However, depression (Z=-0.90, p=.367) did not decrease significantly. This program is effective for increasing memory, visual-motor integration, and memory self-efficacy in older adults. Therefore, it can be used to improve cognition and prevent dementia in older adults. © 2017 Korean Society of Nursing Science

Depression and its association with self-esteem, family, peer and school factors in a population of 9586 adolescents in southern Taiwan.

PubMed

Lin, Huang-Chi; Tang, Tze-Chun; Yen, Ju-Yu; Ko, Chin-Hung; Huang, Chi-Fen; Liu, Shu-Chun; Yen, Cheng-Fang

2008-08-01

The aim of the present study was to gain insight into the prevalence of depression and its association with self-esteem, family, peer and school factors in a large-scale representative Taiwanese adolescent population. A total of 12,210 adolescent students were recruited into the present study. Subjects with a score >28 on the Center for Epidemiological Studies' Depression Scale were defined as having significant depression; the Rosenberg Self-Esteem Scale, Adolescent Family and Social Life Questionnaire and Family C-APGAR Index were applied to assess subjects' self-esteem, family, peer and school factors. The association between depression and correlates were examined on t-test and chi(2) test. The significant factors were further included in logistic regression analysis. Among 9586 participants (response rate: 86.3%), the prevalence of depression was 12.3%. The risk factors associated with depression in univariate analysis included female gender, older age, residency in urban areas, lower self-esteem, disruptive parental marriage, low family income, family conflict, poorer family function, less satisfaction with peer relationships, less connectedness to school, and poor academic performance. After adjusting the effects of sex, age and location, only subjects with lower self-esteem, higher family conflict, poorer family function, lower rank and decreased satisfaction in their peer group, and less connectedness to school were prone to depression on logistic regression. The prevalence of depression is high in Taiwanese adolescents, and the multiple factors of family, peer, school and individuals are associated with adolescent depression. The factors identified in the present study may be helpful when designing and implementing preventive intervention programs.

Depression symptoms and stressful life events among college students in Puerto Rico.

PubMed

Reyes-Rodríguez, Mae Lynn; Rivera-Medina, Carmen L; Cámara-Fuentes, Luis; Suárez-Torres, Alba; Bernal, Guillermo

2013-03-05

The transition from adolescence to adulthood is associated with stressful adaptation experiences that may increase symptoms of depression. We explored the prevalence and sex differences of depressive symptoms and suicidal ideation in freshmen Latino college students in Puerto Rico, and identified stressful life events that could contribute to symptoms of depression. Two thousand one hundred sixty-three freshmen college students from the University of Puerto Rico (UPR) public education system were assessed for depression symptoms using the Beck Depression Inventory (BDI) and stressful life events using open questions. Nine percent of the sample reported depression symptoms at a moderate or severe level (BDI>20). Chi square analyses revealed a significantly higher prevalence for three of the stressful life events in females than males: relocation (10.2% females vs. 7.3% males; X(2) (1)=4.13, p=.042), break-up of a significant relationship (25.3% females vs. 17.8% males; X(2) (1)=13.76, p<.001), and illness (11.2% females vs. 7.3% males; X(2) (1)=7.23, p=.007). The model that best explained the variance of BDI scores among females was the presence of suicide risk, relationship break-up, illness, and relocation for college, whereas for males a similar model without the relationship break-up variable resulted in a better fit. Freshmen college students present a broad range of depression symptoms and certain stressful life events are associated with an increased prevalence of depression symptoms. Early detection of depression and tailored prevention programs should be developed to improve both mental health and academic performance among the college population. Published by Elsevier B.V.

Depression symptoms and stressful life events among college students in Puerto Rico

PubMed Central

Reyes-Rodríguez, Mae Lynn; Rivera-Medina, Carmen L.; Cámara-Fuentes, Luis; Suárez-Torres, Alba; Bernal, Guillermo

2012-01-01

Background The transition from adolescence to adulthood is associated with stressful adaptation experiences that may increase symptoms of depression. We explored the prevalence and sex differences of depressive symptoms and suicidal ideation in freshmen Latino college students in Puerto Rico, and identified stressful life events that could contribute to symptoms of depression. Methods Two thousand one hundred sixty-three freshmen college students from the University of Puerto Rico (UPR) public education system were assessed for depression symptoms using the Beck Depression Inventory (BDI) and stressful life events using open questions. Results Nine percent of the sample reported depression symptoms at a moderate or severe level (BDI ≥ 20). Chi square analyses revealed a significantly higher prevalence for three of the stressful life events in females than males: relocation (10.2% females vs. 7.3% males; X2 (1) = 4.13, p=.042), break-up of a significant relationship (25.3% females vs. 17.8% males; X2 (1) = 13.76, p<.001), and illness (11.2% females vs. 7.3% males; X2 (1) = 7.23, p=.007). The model that best explained the variance of BDI scores among females was the presence of suicide risk, relationship break-up, illness, and relocation for college, whereas for males a similar model without the relationship break-up variable resulted in a better fit. Conclusions Freshmen college students present a broad range of depression symptoms and certain stressful life events are associated with an increased prevalence of depression symptoms. Early detection of depression and tailored prevention programs should be developed to improve both mental health and academic performance among the college population. PMID:22939390

How Academic Psychiatry Can Better Prepare Students for Their Future Patients: Part II--A Course in Ultra-Brief Initial Diagnostic Screening Suitable for Future Primary Care Physicians

ERIC Educational Resources Information Center

Lake, C. Raymond

2008-01-01

Depression is inadequately treated in primary care (PC), primarily because of a failure to recognize symptoms of depression. The results can be catastrophic and include death by suicide. The prevention of suicide is a critical function of physicians. The recognition of depression is the first step to preventing suicide because suicide…

Family-Centered Preventive Intervention for Military Families: Implications for Implementation Science

DTIC Science & Technology

2011-01-01

Gladstone, T . R. G., Wright, E. J., & Cooper, A. B. (2003). A family-based approach to the prevention of depressive symptoms in children at risk: Evidence...intervention that addresses obstacles to communication and the lack of attention to parenting common in families affected by parental depression (Beardslee...trauma, and depression /life adversity), as well as being integrated with the military public health model. Furthermore, although each of the

Efficacy and moderators of psychological interventions in treating subclinical symptoms of depression and preventing major depressive disorder onsets: protocol for an individual patient data meta-analysis of randomised controlled trials.

PubMed

Ebert, David D; Buntrock, Claudia; Reins, Jo Annika; Zimmermann, Johannes; Cuijpers, Pim

2018-03-16

The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately subgroups and moderator effects. The aim of the present study is, therefore, to examine the short-term and long-term as well as moderator effects of psychological interventions compared with control groups in adults with subthreshold depression on depressive symptom severity, treatment response, remission, symptom deterioration, quality of life, anxiety and the prevention of major depressive disorder (MDD) onsets on individual patient level and study level using an individual patient data meta-analysis approach. Systematic searches in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials were conducted. We will use the following types of outcome criteria: (A) onset of major depression; (B) time to major depression onset; (C) observer-reported and self-reported depressive symptom severity; (D) response; (E) remission; (F) symptom deterioration; (G) quality of life, (H) anxiety; and (I) suicidal thoughts and behaviours. Multilevel models with participants nested within studies will be used. Missing data will be handled using a joint modelling approach to multiple imputation. A number of sensitivity analyses will be conducted in order test the robustness of our findings. The investigators of the primary trials have obtained ethical approval for the data used in the present study and for sharing the data, if this was necessary, according to local requirements and was not covered from the initial ethic assessment.This study will summarise the available evidence on the short-term and long-term effectiveness of preventive psychological interventions for the treatment of subthreshold depression and prevention of MDD onset. Identification of subgroups of patients in which those interventions are most effective will guide the development of evidence-based personalised interventions for patients with subthreshold depression. CRD42017058585. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Depression in an older adult rural population in India.

PubMed

Sinha, Sati P; Shrivastava, Saurabh R; Ramasamy, Jegadeesh

2013-10-01

With a rapidly aging society, geriatric mental health is emerging as an important public health concern. According to the WHO, prevalence of depression in adults aged ≥60 years in developed and developing countries was 0.5 million and 4.8 million respectively in 2004. In India, increased life expectancy led to a rise in the older adult population between 2001 and 2011, expected to reach 324 million by 2050. To estimate the prevalence of depression and assess association between sociodemographic parameters and depression among older adults in a rural Indian community. A cross-sectional descriptive study was conducted in February and March 2012 in the rural village of Sembakkam, Kancheepuram District in the state of Tamil Nadu, India; the village has a population of 5948, 3.1% of whom are aged ≥60 years. Universal sampling technique was employed, in which every household in the community was visited and all elderly persons were selected. After obtaining written informed consent (a thumbprint was taken if the person was illiterate), participants were assessed face to face for depression using the Short Form Geriatric Depression Scale. The inclusion criterion was a score >24 on the mini-mental state examination. Final sample size was 103. Study variables included sociodemographic parameters such as age, sex, education, occupation, socioeconomic status, and marital status. Data entry and statistical analysis used SPSS version 17. Of 103 respondents interviewed, 73 (70.9%) were aged 60-69 years and 58 (56.3%) were male. Forty-four (42.7%) individuals (17 males, 27 females) were found to be depressed; 23 (22.3%) with mild depression, 14 (13.6%) moderate depression and 7 (6.8%) severe depression. Female sex and widowhood were significantly associated with depression. Depression, particularly mild depression, is common in this rural population of older adults, particularly among women and widowed elderly. These study findings can help program managers implement a more comprehensive strategy in this community for timely interventions to promote mental health and prevent geriatric depression.

Shared Risk Factors for the Perpetration of Physical Dating Violence, Bullying, and Sexual Harassment Among Adolescents Exposed to Domestic Violence

PubMed Central

McNaughton Reyes, H. Luz; Chen, May S.; Ennett, Susan T.; Basile, Kathleen C.; DeGue, Sarah; Vivolo-Kantor, Alana M.; Moracco, Kathryn E.; Bowling, J. Michael

2016-01-01

The high risk of perpetrating physical dating violence, bullying, and sexual harassment by adolescents exposed to domestic violence points to the need for programs to prevent these types of aggression among this group. This study of adolescents exposed to domestic violence examined whether these forms of aggression share risk factors that could be targeted for change in single programs designed to prevent all three types of aggression. Analyses were conducted on 399 mother victims of domestic violence and their adolescents, recruited through community advertising. The adolescents ranged in age from 12 to 16 years; 64 % were female. Generalized estimating equations was used to control for the covariation among the aggression types when testing for shared risk factors. Approximately 70 % of the adolescents reported perpetrating at least one of the three forms of aggression. In models examining one risk factor at a time, but controlling for demographics, adolescent acceptance of sexual violence, mother–adolescent discord, family conflict, low maternal monitoring, low mother–adolescent closeness, low family cohesion, depressed affect, feelings of anger, and anger reactivity were shared across all three aggression types. In multivariable models, which included all of the risk factors examined and the demographic variables, low maternal monitoring, depressed affect and anger reactivity remained significant shared risk factors. Our findings suggest that programs targeting these risk factors for change have the potential to prevent all three forms of aggression. In multivariable models, poor conflict management skills was a risk for bullying and sexual harassment, but not dating violence; acceptance of dating violence was a risk for dating violence and bullying, but not sexual harassment; and none of the examined risk factors were unique to aggression type. The study’s implications for the development of interventions and future research are discussed. PMID:26746242

A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews.

PubMed

Bennett, Kathryn; Rhodes, Anne E; Duda, Stephanie; Cheung, Amy H; Manassis, Katharina; Links, Paul; Mushquash, Christopher; Braunberger, Peter; Newton, Amanda S; Kutcher, Stanley; Bridge, Jeffrey A; Santos, Robert G; Manion, Ian G; Mclennan, John D; Bagnell, Alexa; Lipman, Ellen; Rice, Maureen; Szatmari, Peter

2015-06-01

We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision makers is recommended to implement and evaluate promising interventions; to eliminate the use of ineffective or harmful interventions; and to clarify prevention intervention effects on death by suicide, suicide attempts, and suicidal ideation. Such a network could position Canada as a leader in youth suicide prevention.

A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews

PubMed Central

Bennett, Kathryn; Rhodes, Anne E; Duda, Stephanie; Cheung, Amy H; Manassis, Katharina; Links, Paul; Mushquash, Christopher; Braunberger, Peter; Newton, Amanda S; Kutcher, Stanley; Bridge, Jeffrey A; Santos, Robert G; Manion, Ian G; McLennan, John D; Bagnell, Alexa; Lipman, Ellen; Rice, Maureen; Szatmari, Peter

2015-01-01

Objective: We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. Methods: Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. Results: No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. Conclusions: Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision makers is recommended to implement and evaluate promising interventions; to eliminate the use of ineffective or harmful interventions; and to clarify prevention intervention effects on death by suicide, suicide attempts, and suicidal ideation. Such a network could position Canada as a leader in youth suicide prevention. PMID:26175322

Prevention of Depression.

ERIC Educational Resources Information Center

Compas, Bruce E.; Connor, Jennifer; Wadsworth, Martha

Substantial numbers of children and adolescents experience symptoms of sadness, dysphoria, and other characteristics associated with depression. The nature of depression in children and adolescents has presented challenges in identification and definition. This chapter reviews research on depression in children and adolescents. Three current…

Application of the multiphase optimization strategy to a pilot study: an empirical example targeting obesity among children of low-income mothers.

PubMed

Kugler, Kari C; Balantekin, Katherine N; Birch, Leann L; Savage, Jennifer S

2016-11-22

Emerging approaches to building more efficient and effective behavioral interventions are becoming more widely available. The current paper provides an empirical example of the use of the engineering-inspired multiphase optimization strategy (MOST) to build a remotely delivered responsive parenting intervention to prevent obesity among children of low-income mothers with and without depressive symptoms. Participants were 107 mothers with (n = 45) and without (n = 62) depressive symptoms who had a child aged 12 to 42 months participating in the Women, Infants and Children program. Participants were randomized to one of sixteen experimental conditions using a factorial design that included a combination of the following eight remotely delivered intervention components: responsive feeding curriculum (given to all participants), parenting curriculum, portion size guidance, obesogenic risk assessment, personalized feedback on mealtime routines, feeding curriculum counseling, goal setting, mobile messaging, and social support. This design enabled efficient identification of components with low feasibility and acceptability. Completion rates were high (85%) and did not statistically differ by depressive symptoms. However, mothers with depressive symptoms who received obesogenic risk assessment and personalized feedback on mealtime routines components had lower completion rates than mothers without depressive symptoms. All intervention components were feasible to implement except the social support component. Regardless of experimental condition, most participants reported that the program increased their awareness of what, when, and how to feed their children. MOST provided an efficient way to assess the feasibility of components prior to testing them with a fully powered experiment. This framework helped identify potentially challenging combinations of remotely delivered intervention components. Consideration of how these results can inform future studies focused on the optimization phase of MOST is discussed.

A randomized controlled trial of the effectiveness of brief-CBT for patients with symptoms of posttraumatic stress following a motor vehicle crash.

PubMed

Wu, Kitty K; Li, Frendi W; Cho, Valda W

2014-01-01

Motor vehicle crashes (MVCs) are leading contributors to the global burden of disease. Patients attending accident and emergency (A&E) after an MVC may develop symptoms of posttraumatic stress disorder (PTSD). There is evidence that brief cognitive behavioural therapy (B-CBT) can be effective in treating PTSD; however, there are few studies of the use of B-CBT to treat PTSD in MVC survivors. This study examined the effects of B-CBT and a self-help program on the severity of psychological symptoms in MVC survivors at risk of developing PTSD. Sixty participants who attended A&E after a MVC were screened for PTSD symptoms and randomized to a 4-weekly session B-CBT or a 4-week self-help program (SHP) booklet treatment conditions. Psychological assessments were completed at baseline (1-month post-MVC) and posttreatment (3- and 6-month follow-ups) by utilizing Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). There were significant improvements in the measures of anxiety, depression, and PTSD symptoms over time. Participants treated with B-CBT showed greater reductions in anxiety at 3-month and 6-month follow-ups, and in depression at 6-month follow-up. A comparison of effect size favoured B-CBT for the reduction of anxiety and depression symptoms measured by HADS. A high level of pretreatment anxiety and depression were predictive of negative outcome at 6-month follow-up in the SHP condition. There was no differential effect on PTSD symptoms measured by IES-R. This trial supports the efficacy of providing B-CBT as a preventive strategy to improve psychological symptoms after an MVC.

Associations between sexual abuse and family conflict/violence, self-injurious behavior, and substance use: the mediating role of depressed mood and anger.

PubMed

Asgeirsdottir, Bryndis Bjork; Sigfusdottir, Inga Dora; Gudjonsson, Gisli H; Sigurdsson, Jon Fridrik

2011-03-01

To examine whether depressed mood and anger mediate the effects of sexual abuse and family conflict/violence on self-injurious behavior and substance use. A cross-sectional national survey was conducted including 9,085 16-19 year old students attending all high schools in Iceland in 2004. Participants reported frequency of sexual abuse, family conflict/violence, self-injurious behavior, substance use, depressed mood, and anger. Sexual abuse and family conflict/violence had direct effects on self-injurious behavior and substance use among both genders, when controlling for age, family structure, parental education, anger, and depressed mood. More importantly, the indirect effects of sexual abuse and family conflict/violence on self-injurious behavior among both males and females were twice as strong through depressed mood as through anger, while the indirect effects of sexual abuse and family conflict/violence on substance use were only significant through anger. These results indicate that in cases of sexual abuse and family conflict/violence, substance use is similar to externalizing behavior, where anger seems to be a key mediating variable, opposed to internalizing behavior such as self-injurious behavior, where depressed mood is a more critical mediator. Practical implications highlight the importance of focusing on a range of emotions, including depressed mood and anger, when working with stressed adolescents in prevention and treatment programs for self-injurious behavior and substance use. Copyright © 2011 Elsevier Ltd. All rights reserved.

Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis.

PubMed

Pilkington, Pamela D; Milne, Lisa C; Cairns, Kathryn E; Lewis, James; Whelan, Thomas A

2015-06-01

Perinatal distress is a significant public health problem that adversely impacts the individual and their family. The primary objective of this systematic review and meta-analysis was to identify factors that partners can modify to protect each other from developing perinatal depression and anxiety. In accordance with the PRISMA statement, we reviewed the risk and protective factors associated with perinatal depression and anxiety symptoms that partners can potentially modify without professional assistance (PROSPERO reference CRD42014007524). Participants were new or expectant parents aged 16 years or older. The partner factors were sub-grouped into themes (e.g., instrumental support) based on a content analysis of the scale items and measure descriptions. A series of meta-analyses were conducted to estimate the pooled effect sizes of associations. We included 120 publications, reporting 245 associations with depression and 44 with anxiety. Partner factors with sound evidence that they protect against both perinatal depression and anxiety are: emotional closeness and global support. Partner factors with a sound evidence base for depression only are communication, conflict, emotional and instrumental support, and relationship satisfaction. This review is limited by the lack of generalizability to single parents and the inability to systematically review moderators and mediators, or control for baseline symptoms. The findings suggest that future prevention programs targeting perinatal depression and anxiety should aim to enhance relationship satisfaction, communication, and emotional closeness, facilitate instrumental and emotional support, and minimize conflict between partners. Copyright © 2015 Elsevier B.V. All rights reserved.

Accounting for the association of family conflict and heavy alcohol use among adolescent girls: the role of depressed mood.

PubMed

Chan, Gary C K; Kelly, Adrian B; Toumbourou, John W

2013-05-01

Heavy alcohol use increases dramatically at age 14, and there is emerging cross-sectional evidence that when girls experience family conflict at younger ages (11-13 years) the risk of alcohol use and misuse is high. This study evaluated the role of family conflict and subsequent depressed mood in predicting heavy alcohol use among adolescent girls. This was a three-wave longitudinal study with annual assessments (modal ages 12, 13, and 14 years). The participants (N = 886, 57% female) were from 12 metropolitan schools in Victoria, Australia, and participants completed questionnaires during school class time. The key measures were based on the Communities That Care Youth Survey and included family conflict (Wave 1), depressed mood (Wave 2), and heavy alcohol use (Wave 3). Control variables included school commitment, number of peers who consumed alcohol, whether parents were living together, and ethnic background. With all controls in the model, depressed mood at Wave 2 was predicted by family conflict at Wave 1. The interaction of family conflict with gender was significant, with girls showing a stronger association of family conflict and depressed mood. Depressed mood at Wave 2 predicted heavy alcohol use at Wave 3. Girls may be especially vulnerable to family conflict, and subsequent depressed mood increases the risk of heavy alcohol use. The results support the need for gender-sensitive family-oriented prevention programs delivered in late childhood and early adolescence.

Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-analysis.

PubMed

Pennant, Mary E; Loucas, Christina E; Whittington, Craig; Creswell, Cathy; Fonagy, Peter; Fuggle, Peter; Kelvin, Raphael; Naqvi, Sabrina; Stockton, Sarah; Kendall, Tim

2015-04-01

One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD -0.77, 95% CI -1.45 to -0.09, k = 6, N = 220) and depression (SMD -0.62, 95% CI -1.13 to -0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD -0.15, 95% CI -0.26 to -0.03; N = 1273) and depression (SMD -0.15, 95% CI -0.26 to -0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of school staff health on work productivity in secondary schools in Massachusetts.

PubMed

Alker, Heather J; Wang, Monica L; Pbert, Lori; Thorsen, Nancy; Lemon, Stephenie C

2015-06-01

Healthy, productive employees are an integral part of school health programs. There have been few assessments of work productivity among secondary school staff. This study describes the frequency of 3 common health risk factors--obesity, depressive symptoms, and smoking--and their impact on work productivity in secondary school employees. Employees of secondary schools in Massachusetts (N = 630) participated in a longitudinal weight gain prevention intervention study. Assessment completed at baseline, 1-year and 2-year follow-up included survey assessments of health risk factors as well as measurements for height, weight, and body mass index (BMI). The survey also included a depression inventory and Work Limitations Questionnaire. Data analysis included multivariate mixed effect models to identify productivity differences in relation to BMI, depressive symptoms, and smoking in this population stratified by position type (teacher and other school staff). The sample included 361 teachers and 269 other school staff. Obesity, depressive symptoms, and smoking were significantly associated with work productivity, including workdays missed because of health concerns (absenteeism) and decreases in on-the-job productivity because of health concerns (presenteeism). Three common health conditions, namely obesity, depressive symptoms, and smoking, adversely affect the productivity of high school employees. © 2015, American School Health Association.

Depression in the workplace: a systematic review of evidence-based prevention strategies.

PubMed

Dietrich, Sandra; Deckert, Stefanie; Ceynowa, Martin; Hegerl, Ulrich; Stengler, Katarina

2012-01-01

Depression is one of the most common mental disorders, causing enormous personal and economic burden. In its early stages, however, it is the most manageable of mental disorders. The workplace, where a large proportion of the adult population can be reached, might be a good setting for prevention interventions that target depression directly. Identify evidence-based indicated/secondary prevention strategies for depression in the workplace. Systematic review of articles published until February 2010 using PubMed, EbscoHost and the Cochrane Library. Studies were selected based on different inclusion criteria, such as diagnosis of depression with validated screening instruments and presence of a control group. A total of 9,173 articles were found. One evaluated intervention study in the workplace met all inclusion criteria (French APRAND programme). The intervention, which combined the provision of diagnosis and psychoeducation, had a positive effect on people with depression, with a significant trend towards chances of recovery or remission after 1 year. The remaining studies did not meet the predefined inclusion criteria of this systematic review. The findings are quite sobering given the high prevalence of depression and the individual and societal burden caused by it. More tailor-made interventions in the workplace targeting depression directly are needed.

Suicide Attempts and Associated Factors in Male and Female Korean Adolescents A Population-Based Cross-Sectional Survey.

PubMed

Chin, Young Ran; Choi, Kyungwon

2015-10-01

Using data from the Korea Youth Risk Behavior Web-based Survey, this study seeks to investigate associations of suicide attempts with family, individual, and behavioral factors on the basis of gender. Among male adolescents, those who did not live with their parents, who had poor subjective academic achievement, depression, experiences of smoking and sexual coitus, drug abuse, suicidal ideation and plans were more likely to attempt suicide. Among the female adolescents, those who did not live with their parents, had depression, low self-rated health, experiences of drug abuse and sexual coitus, and expressed unhappiness, suicidal ideation and suicide plans were more likely to attempt suicide. Thus, the development of a suicide prevention program for Korean adolescents requires different approaches for males and females.

Trajectories of change and long-term outcomes in a randomised controlled trial of internet-based insomnia treatment to prevent depression

PubMed Central

Christensen, Helen; Mackinnon, Andrew J.; Gosling, John A.; Thorndike, Frances P.; Ritterband, Lee M.; Glozier, Nick; Griffiths, Kathleen M.

2017-01-01

Background Insomnia treatment using an internet-based cognitive–behavioural therapy for insomnia (CBT-I) program reduces depression symptoms, anxiety symptoms and suicidal ideation. However, the speed, longevity and consistency of these effects are unknown. Aims To test the following: whether the efficacy of online CBT-I was sustained over 18 months; how rapidly the effects of CBT-I emerged; evidence for distinct trajectories of change in depressive symptoms; and predictors of these trajectories. Method A randomised controlled trial compared the 6-week Sleep Healthy Using the Internet (SHUTi) CBT-I program to an attention control program. Adults (N=1149) with clinical insomnia and subclinical depression symptoms were recruited online from the Australian community. Results Depression, anxiety and insomnia decreased significantly by week 4 of the intervention period and remained significantly lower relative to control for >18 months (between-group Cohen’s d=0.63, 0.47, 0.55, respectively, at 18 months). Effects on suicidal ideation were only short term. Two depression trajectories were identified using growth mixture models: improving (95%) and stable/deteriorating (5%) symptoms. More severe baseline depression, younger age and limited comfort with the internet were associated with reduced odds of improvement. Conclusions Online CBT-I produced rapid and long-term symptom reduction in people with subclinical depressive symptoms, although the initial effect on suicidal ideation was not sustained. Declaration of interest P.J.B. has received grants from the National Health and Medical Research Council (NHMRC) during the conduct of the study. H.C. has received grants from the NHMRC and the Australian Research Council during the conduct of the study. L.M.R. receives research funding from the National Institutes of Health (NIH) that, in part, focuses on insomnia. F.P.T. and L.M.R. have equity ownership in BeHealth Solutions (Charlottesville, VA, USA), a company that develops and makes available products related to the research reported in this manuscript. BeHealth Solutions has licensed the SHUTi program and the software platform on which it was built from the University of Virginia. The terms of this arrangement have been reviewed and approved by the University of Virginia in accordance with its conflict of interest policy. N.G. has received grants from the NHMRC during the conduct of the study and personal fees from Lundbeck, Servier and Janssen outside the submitted work. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28959453

Stepped-care to prevent depression and anxiety in visually impaired older adults – design of a randomised controlled trial

PubMed Central

2013-01-01

Background Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. Method/design A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in the Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Discussion Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Trial registration Identifier: NTR3296 PMID:23937975

Prevention of generalized anxiety disorder using a web intervention, iChill: randomized controlled trial.

PubMed

Christensen, Helen; Batterham, Philip; Mackinnon, Andrew; Griffiths, Kathleen M; Kalia Hehir, Kanupriya; Kenardy, Justin; Gosling, John; Bennett, Kylie

2014-09-02

Generalized Anxiety Disorder (GAD) is a high prevalence, chronic disorder. Web-based interventions are acceptable, engaging, and can be delivered at scale. Few randomized controlled trials evaluate the effectiveness of prevention programs for anxiety, or the factors that improve effectiveness and engagement. The intent of the study was to evaluate the effectiveness of a Web-based program in preventing GAD symptoms in young adults, and to determine the role of telephone and email reminders. A 5-arm randomized controlled trial with 558 Internet users in the community, recruited via the Australian Electoral Roll, was conducted with 6- and 12-month follow-up. Five interventions were offered over a 10-week period. Group 1 (Active website) received a combined intervention of psycho-education, Internet-delivered Cognitive Behavioral Therapy (ICBT) for anxiety, physical activity promotion, and relaxation. Group 2 (Active website with telephone) received the identical Web program plus weekly telephone reminder calls. Group 3 (Active website with email) received the identical Web program plus weekly email reminders. Group 4 (Control) received a placebo website. Group 5 (Control with telephone) received the placebo website plus telephone calls. Main outcome measures were severity of anxiety symptoms as measured by the GAD 7-item scale (GAD-7) (at post-test, 6, and 12 months). Secondary measures were GAD caseness, measured by the Mini International Neuropsychiatric Interview (MINI) at 6 months, Centre for Epidemiologic Studies-Depression scale (CES-D), Anxiety Sensitivity Index (ASI), Penn State Worry Questionnaire (PSWQ), and Days out of Role. GAD-7 symptoms reduced over post-test, 6-month, and 12-month follow-up. There were no significant differences between Group 4 (Control) and Groups 1 (Active website), 2 (Active website with telephone), 3 (Active website with email), or 5 (Control with telephone) at any follow-up. A total of 16 cases of GAD were identified at 6 months, comprising 6.7% (11/165) from the Active groups (1, 2, 3) and 4.5% (5/110) from the Control groups (4, 5), a difference that was not significant. CES-D, ASI, and PSWQ scores were significantly lower for the active website with email reminders at post-test, relative to the control website condition. Indicated prevention of GAD was not effective in reducing anxiety levels, measured by GAD-7. There were significant secondary effects for anxiety sensitivity, worry, and depression. Challenges for indicated prevention trials are discussed. International Standard Randomized Controlled Trial Number (ISRCTN): 76298775; http://www.controlled-trials.com/ISRCTN76298775 (Archived by WebCite at http://www.webcitation.org/6S9aB5MAq).

Recovery from depression among clients transitioning out of poverty.

PubMed

Ali, Alisha; Hawkins, Robert L; Chambers, Debbie Ann

2010-01-01

The objective of this study was to investigate whether a program designed to change the economic conditions of clients' lives could also have an impact on reducing their level of depression. The study focused on a sample of men and women attending a program designed to transition clients out of poverty through microlending and peer support. Results revealed that 40.5% of participants who met diagnostic criteria for major depression before beginning the program were no longer clinically depressed after participating in the program for 6 months. The results also revealed that the clients who reported that they felt a strong sense of interpersonal connection within the program were the most likely to recover from depression.

Defining subgroups of low socioeconomic status women at risk for depressive symptoms: the importance of perceived stress and cumulative risks.

PubMed

van der Waerden, Judith E B; Hoefnagels, Cees; Hosman, Clemens M H; Jansen, Maria W J

2014-12-01

Most disadvantaged women are exposed to risk factors for depression, but not all necessarily have an identical risk for this mental health problem. A better prediction of which low socioeconomic status (SES) women are most at risk for depressive symptoms can help target preventive interventions at high-risk subgroups most in need of support. Exploring which demographic, socioeconomic and psychological risk factors are associated with self-reported depressive symptoms in a sample of low-SES women and whether the number of risk factors might expose them to an accumulated risk. Between April 2005 and November 2007, 519 disadvantaged women from urban neighbourhoods in Maastricht, a southern Dutch city, participated in a cross-sectional survey on stress and depressive symptoms. Lower education levels, no current employment and lower net monthly family incomes were socioeconomic risk factors associated with higher scores for depressive symptoms. The psychological risk factor 'perceived stress' had the highest explained variance and was most strongly associated with depressive symptoms. Women exposed to multiple risk factors across domains had a cumulated risk for depressive symptomatology. Low-SES women who seem most eligible for targeted preventive action are those with cumulative risks. Depression prevention strategies for this population may benefit from focusing on perceived stress since this is an important modifiable risk factor. © The Author(s) 2014.

Psychosocial risk factors for HIV sexual risk among Indian men who have sex with men

PubMed Central

Mimiaga, Matthew J.; Biello, Katie Brooks; Sivasubramanian, Murugesan; Mayer, Kenneth H.; Anand, Vivek Raj; Safren, Steven A.

2013-01-01

Indian men who have sex with men (MSM) are at increased risk for HIV compared to the general Indian population. Psychosocial factors may be uniquely associated with HIV risk among Indian MSM and may moderate the beneficial impact of standard HIV prevention approaches. Psychiatric diagnostic interviews and psychosocial and sexual risk assessments were conducted among 150 MSM in Mumbai, India. Logistic regression was employed to examine the association of psychiatric disorders and psychosocial problems to recent sexual risk behavior. Twenty-five percent of participants reported engaging in unprotected anal sex (UAS) during their last sexual contact with a man. Men who were married to a woman were more likely to have engaged in UAS during their last sexual contact with a man (35% vs. 17%, p = 0.018). In multivariable models, significant predictors of engaging in UAS were current major depression (adjusted odds ratio [AOR] = 2.61; 95% confidence interval [CI] 1.07, 6.39) and number of stressful life events (AOR = 0.91; 95% CI 0.83, 0.99). Alcohol dependence, anxiety, and self-esteem were not associated with engaging in UAS. Indian MSM with depression are at higher odds of engaging in UAS compared to MSM without depression. HIV prevention programs for Indian MSM may benefit from incorporating treatment or triage for mental health problems. PMID:23339580

Assessing mental health literacy: What medical sciences students' know about depression.

PubMed

Sayarifard, Azadeh; Ghadirian, Laleh; Mohit, Ahmad; Eftekhar, Mehrdad; Badpa, Mahnaz; Rajabi, Fatemeh

2015-01-01

Mental health literacy is an individual's knowledge and belief about mental disorders which aid their recognition, management and prevention. The aim of this study was to investigate mental health literacy among students of Tehran University of Medical Sciences. In this cross-sectional study, data were collected by the anonymous self-administered questionnaires and finally 324 students participated in the study. Random cluster sampling was used. Questions were in different areas of the mental health literacy for depression include recognition of disorder, intended actions to seek help and perceived barriers, beliefs about interventions, prevention, stigmatization and impact of media. T-test was used for statistical analysis. The mean (±SD) age was 23.5±2.8. The participants were 188 (58.1%) females and 136 (41.9%) males. In response to the recognition of the disorder 115 (35.6%) students mentioned the correct answer. In help-seeking area, 208 (64.3%) gave positive answer. The majority of affected students sought for help from their friends and parents. Stigma was the greatest barrier for seeking help. Television and Internet were the most common sources of information related to mental health. Generally students' mental health literacy on depression was low in some areas. Appropriate educational programs specifically for reducing mental disorders stigma seems necessary. Organizing networks of co-helper students for mental health could be considered.

Assessing mental health literacy: What medical sciences students’ know about depression

PubMed Central

Sayarifard, Azadeh; Ghadirian, Laleh; Mohit, Ahmad; Eftekhar, Mehrdad; Badpa, Mahnaz; Rajabi, Fatemeh

2015-01-01

Background: Mental health literacy is an individual’s knowledge and belief about mental disorders which aid their recognition, management and prevention. The aim of this study was to investigate mental health literacy among students of Tehran University of Medical Sciences. Methods: In this cross-sectional study, data were collected by the anonymous self-administered questionnaires and finally 324 students participated in the study. Random cluster sampling was used. Questions were in different areas of the mental health literacy for depression include recognition of disorder, intended actions to seek help and perceived barriers, beliefs about interventions, prevention, stigmatization and impact of media. T-test was used for statistical analysis. Results: The mean (±SD) age was 23.5±2.8. The participants were 188 (58.1%) females and 136 (41.9%) males. In response to the recognition of the disorder 115 (35.6%) students mentioned the correct answer. In help-seeking area, 208 (64.3%) gave positive answer. The majority of affected students sought for help from their friends and parents. Stigma was the greatest barrier for seeking help. Television and Internet were the most common sources of information related to mental health. Conclusion: Generally students’ mental health literacy on depression was low in some areas. Appropriate educational programs specifically for reducing mental disorders stigma seems necessary. Organizing networks of co-helper students for mental health could be considered. PMID:26000256

[Is the cognitive-behavioural therapy an effective strategy also in the prevention of post partum depression? a critical review].

PubMed

Nardi, Bernardo; Laurenzi, Sabrina; Di Nicolò, Marzia; Bellantuono, Cesario

2012-01-01

The aim of this study was to evaluate the efficacy of cognitive-behavioural therapy (CBT) in the prevention of post partum depression (PPD) in pregnant women at risk. PubMed, Medline, PsychInfo, Embase, and the Cochrane Library databases were searched from January 1991 to June 2011 to review studies on the efficacy of CBT in the prevention of PD. The literature analyzed recommends that depression in pregnancy requires an efficient management to provide mother's symptoms relief as well as to prevent PD. While several studies demonstrated the efficacy of CBT in the treatment of PD, only a few controlled studies focused on its efficacy in the prevention of PD in women identified at risk during pregnancy. The efficacy of CBT in preventing PD in pregnant women at risk is supported by only a few studies, presenting some methodological flaws. Better designed trials are needed to strongly support the efficacy of such psychotherapeutic preventive strategy in women at risk for PD.

Feasibility Study of an Interactive Multimedia Electronic Problem Solving Treatment Program for Depression: A Preliminary Uncontrolled Trial

PubMed Central

Berman, Margit I.; Jr., Jay C. Buckey; Hull, Jay G.; Linardatos, Eftihia; Song, Sueyoung L.; McLellan, Robert K.; Hegel, Mark T.

2014-01-01

Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9 weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a mini mally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4 weeks), and study endpoint (10 weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated. PMID:24680231

Depression in women aged 75-89--predisposing factors and preventive measures.

PubMed

Chrzan, Renata; Karmowski, Andrzej; Pawelec, Małgorzata; Łatkowski, Krzysztof J; Karmowski, Mikołaj

2012-01-01

There are analyses showing the relationship between low and irregular physical activity and the risk of more frequent occurrences of depression symptoms in the future. There are studies that do not prove the connection between those two dependencies. The aim of this study was to find the relationship between physical activity before menopause and the occurrence of depression in senium. The study was comprised of 200 randomly selected women, aged 75-89 years, who were treated in the local department of general surgery and oncology from January to June 2009. The study used a 15-point Geriatric Depression Scale which is an integral part of the EASY care (Polish version 1999-2002) questionnaire to assess emotional efficiency, and the Questionnaire Survey for Research on Physical Activity in Older People which contains 8 questions. The results were statistically analyzed using a Student's test and basic probabilities calculations. The probability of depression in women aged 75-89 is 0.8. Increased physical activity in pre-menopausal women neither affects the level of depression, nor prevents it (p < 0.1). Depression was more common in people living alone, in which case the probability is 0.85. Postmenopausal women enjoy a beneficial impact on physical activity in the following areas: previous activity (p < 0.001), family support (p < 0.0001), GP support (p < 0.001), and television education (p < 0.001). Depression among elderly women is very common. In this study, depression was found in 80% of senior women. There is a relationship between depression and physical activity. Increased physical activity in premenopausal women neither affects the level of depression, nor prevents it. There was no correlation between age, weight, education, place of residence and depression. Depression was more common in people living alone.

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis

PubMed Central

Lindsay, Ana Cristina; Greaney, Mary L.; Wallington, Sherrie F.; Hunt, Anne T.

2017-01-01

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15–44). Participants (n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers′ Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m2), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24–6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02–1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when designing interventions targeting Latina immigrants. PMID:28767094