RESUMO
BACKGROUND: Mindfulness-based stress reduction (MBSR) intervention has been widely used to reduce the burden of symptoms in cancer patients, and its effectiveness has been proven. However, the effectiveness of MBSR on depression, anxiety, fatigue, quality of life (QOL), posttraumatic growth (PTG), fear of cancer recurrence (FCR), pain, and sleep in breast cancer patients has not yet been determined. This study aims to determine the role of mindfulness-based stress reduction therapy in patients with breast cancer. OBJECTIVES: The objective was to systematically review the literature to explore the effect of MBSR on anxiety, depression, QOL, PTG, fatigue, FCR, pain, stress and sleep in breast cancer patients. To explore the effect of 8-week versus 6-week MBSR on the 9 indicators. Data were extracted from the original RCT study at the end of the intervention and three months after baseline to explore whether the effects of the intervention were sustained. METHODS: We conducted searches on PubMed, Web of Science, Embase, and China National Knowledge Infrastructure from inception to November 2023. Eligible studies included randomized controlled trials of breast cancer patients who received mindfulness stress reduction intervention, reporting outcomes for anxiety, depression, fatigue, QOL, PTG, FCR, pain, stress, and sleep. Two researchers conducted separate reviews of the abstract and full text, extracted data, and independently evaluated the risk of bias using the Cochrane 'Bias Risk Assessment tool'. The meta-analysis utilized Review Manager 5.4 to conduct the study, and the effect size was determined using the standardized mean difference and its corresponding 95% confidence interval. RESULTS: The final analysis included 15 studies with a total of 1937 patients. At the end of the intervention, the interventions with a duration of eight weeks led to a significant reduction in anxiety [SMD=-0.60, 95% CI (-0.78, -0.43), P < 0.00001, I2 = 31%], depression [SMD=-0.39, 95% CI (-0.59, -0.19), P = 0.0001, I2 = 55%], and QOL [542 participants, SMD = 0.54, 95% CI (0.30, 0.79), P < 0.0001, I2 = 49%], whereas no statistically significant effects were found in the intervention with a duration of six weeks. Similarly, in 3 months after baseline, the interventions with a duration of eight weeks led to a significant reduction in depression and QOL, however, no statistically significant effects were found at the 6-week intervention. MBSR led to a significant improvement in PTG at end of intervention [MD = 6.25, 95% CI (4.26, 8.25), P < 0.00001, I2 = 0%] and PTG 3 months after baseline. We found that MBSR reduced the fatigue status at end of intervention, but had no significant effect on fatigue status 3 months after baseline. There was no significant difference in improving pain, stress, and FCR compared to usual care. CONCLUSIONS: In terms of effects on QOL, anxiety, depression, and fatigue, the 8-week MBSR intervention showed better results than the 6-week MBSR intervention. The intervention of MBSR on PTG was effective, and the effect lasted until 3 months after baseline. Future studies could further identify the most effective intervention components in MBSR. TRIAL REGISTRATION: PROSPERO registration number: CRD42023483980.
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Ansiedade , Neoplasias da Mama , Atenção Plena , Qualidade de Vida , Estresse Psicológico , Humanos , Atenção Plena/métodos , Neoplasias da Mama/psicologia , Feminino , Estresse Psicológico/terapia , Estresse Psicológico/psicologia , Estresse Psicológico/prevenção & controle , Qualidade de Vida/psicologia , Ansiedade/terapia , Ansiedade/psicologia , Ansiedade/prevenção & controle , Depressão/terapia , Depressão/psicologia , Depressão/prevenção & controle , Fadiga/terapia , Fadiga/psicologia , Fadiga/prevenção & controle , Crescimento Psicológico Pós-TraumáticoRESUMO
Background and objective: Cancer, as the second leading cause of death worldwide, poses significant challenges to human health and socio-economic development. In recent years, the incidence of cancer has shown a trend toward younger populations, drawing attention to cancer prevention education among college students. However, research on the specific impact of cancer prevention education on the mental health of college students is limited. This study aims to explore the impact of cancer prevention education on the mental health of college students, revealing the mediating role of disease awareness and the moderating roles of psychological resilience and cultural differences. Methods: A difference-in-differences (DID) approach was used, involving 1,670 freshmen from a Chinese university, divided into an experimental group (n = 835) and a control group (n = 835). The experimental group received a semester-long cancer prevention education program. Data were collected monthly from November 2022 to June 2023 using the Depression Anxiety Stress Scales (DASS-21) and a custom Disease Awareness Scale. Results: The study found a significant improvement in mental health scores among the experimental group, with an average increase of 14.738 points on the DASS-21 scale (p < 0.001), representing a 23% reduction in stress, anxiety, and depression levels compared to the control group. Disease awareness in the experimental group improved by 17%, as measured by the Disease Awareness Scale, with a mediation effect of 3.563 points (p < 0.001). Furthermore, psychological resilience and cultural differences moderated the impact of the education program, with those scoring higher in resilience showing an additional 8% improvement in mental health scores (moderation effect = 0.892, p < 0.001), and cultural differences accounting for a 5% variance (moderation effect = 0.756, p < 0.001) in the outcomes. Conclusion: This study demonstrates that systematic and scientific cancer prevention education has a significant positive impact on the mental health of college students. Universities should promote comprehensive and personalized health education strategies to improve disease awareness, foster psychological resilience, and emphasize cultural differences, thereby enhancing the overall physical and mental health of college students and promoting their holistic development. This finding provides important empirical support and theoretical basis for the design and implementation of health education in universities.
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Saúde Mental , Neoplasias , Estudantes , Humanos , Estudantes/psicologia , Universidades , Masculino , Feminino , Neoplasias/prevenção & controle , Adulto Jovem , China , Educação em Saúde/métodos , Adolescente , Inquéritos e Questionários , Depressão/prevenção & controle , Ansiedade/prevenção & controle , Adulto , Estresse Psicológico/prevenção & controle , Estresse Psicológico/psicologiaRESUMO
INTRODUCTION: Caregivers of patients with end-stage kidney disease (ESKD) face significant challenges that contribute to caregiver burden, negatively impacting their psychosocial well-being. Virtual-reality (VR)-guided mindfulness interventions have shown promise in reducing stress, anxiety and depression in various populations. METHODS AND ANALYSIS: This pilot study aims to evaluate the efficacy and feasibility of a VR-guided mindfulness intervention for ESKD caregivers. A single-centre, single-blind, parallel-group pilot randomised controlled trial will be conducted. Thirty ESKD caregivers will be randomly allocated to either the VR-guided mindfulness intervention group or the sham VR control group. The intervention group will receive a 6 week home-based VR-guided mindfulness programme, while the control group will view relaxing nature videos without mindfulness content. Participants will be assessed at baseline, post-intervention (6 weeks) and follow-up (12 weeks) using validated questionnaires for caregiver burden (Zarit Burden Interview (ZBI)), stress, anxiety, depression (Depression Anxiety Stress Scale-21 (DASS-21)), quality of life (36-Item Short Form Health Survey (SF-36)) and mindfulness (Five Facet Mindfulness Questionnaire (FFMQ)). Feasibility outcomes include accrual rates, retention, adherence, questionnaire completion and side effect rates. Semi-structured interviews will explore participants' experiences with the intervention. ETHICS AND DISSEMINATION: The study has been approved by the NHG Domain Specific Review Board (Reference: 2024-3940-APP1). The results of this pilot study will be reported in peer-reviewed open-access journals and shared with participants and stakeholders. TRIAL REGISTRATION: NCT06479200.
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Cuidadores , Depressão , Falência Renal Crônica , Atenção Plena , Qualidade de Vida , Estresse Psicológico , Realidade Virtual , Humanos , Atenção Plena/métodos , Cuidadores/psicologia , Projetos Piloto , Falência Renal Crônica/terapia , Falência Renal Crônica/psicologia , Método Simples-Cego , Depressão/terapia , Depressão/prevenção & controle , Estresse Psicológico/terapia , Estresse Psicológico/prevenção & controle , Ansiedade/terapia , Ansiedade/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Masculino , Feminino , Sobrecarga do Cuidador/psicologiaRESUMO
Background/Objective: Although low-methoxy (LM) pectin (polysaccharides extracted from citrus peels) can reduce inflammation by binding to and inhibiting the TLR-2 pathway in animal models and in vitro studies, the anti-inflammatory effects of LM pectin in humans and mood have not been explored to date. The purpose of this study is to assess the role of dietary supplementation with LM pectin in healthy volunteers on inflammatory markers and on mood, specifically anxiety and depression. Methods: We carried out a 4-week dietary intervention with LM citrus pectin on healthy volunteers (N = 14, age 40 ± 16 y, BMI 24.7 ± 3.0 kg/m2, sex F 57%) comparing the effects of daily supplementation with 20 g of LM citrus pectin versus 10 g of maltodextrin as the control (N = 15 age 43.2 ± 11 y, BMI 25.18 ± 2.0 kg/m2, sex F 66%). The effects on mood and inflammation were also tested with LM pectin at 5 g, 10 g and 15 g (2 weeks each) in an independent cohort of n = 15 healthy volunteers (age 36 ± 21 y, BMI 23.5 ± 2.4 kg/m2, sex F 80%). We assessed serum levels of TNF-alpha (downstream from TLR-2 activation), IL-1 beta, IL-6, IL-10, INF-gamma, CRP, zonulin and TLR-2 concentration which were measured using ELISA in blood samples collected at both the baseline and follow-up visits. Validated measures of anxiety and depression were collected at baseline and follow-up. Results: Supplementation with 20 g of LM pectin resulted in decreases in the pro-inflammatory markers TNF-alpha, IL-1 beta, IL-6 and INF-gamma (all p < 0.05) and an increase in anti-inflammatory marker IL-10 (p = 0.01) at the end of the 4 weeks. No such effects were observed in the control group. In addition, a significant drop in anxiety scores (from 8.38 to 4.46, p < 0.006) was found with the 20 g/day intervention but not in the control arm. In the dose-response study, anti-inflammatory effects were seen only at 15 g for TNFα (p < 0.003) and a suggestive increase in IL-10 (p = 0.08), alongside a drop in TLR-2 (p < 0.027). No significant anti-inflammatory effects were observed at 5 g and 10 g doses of LM pectin supplementation. Significant dose-dependent drops in both anxiety and depression scores were found with 10 g (p < 0.001) and 15 g per day (p < 0.0002). Conclusions: The current study identifies anxiety-reducing and anti-inflammatory effects of supplementation with 15 g/day LM pectin in healthy humans. Further research is needed to elucidate the precise mechanism and to validate the efficient dose and minimum duration of supplementation.
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Ansiedade , Suplementos Nutricionais , Inflamação , Pectinas , Humanos , Pectinas/farmacologia , Pectinas/administração & dosagem , Feminino , Adulto , Masculino , Inflamação/prevenção & controle , Projetos Piloto , Ansiedade/prevenção & controle , Pessoa de Meia-Idade , Voluntários Saudáveis , Citrus/química , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/administração & dosagem , Biomarcadores/sangue , Adulto Jovem , Citocinas/sangue , Depressão/prevenção & controle , Haptoglobinas/metabolismo , Fator de Necrose Tumoral alfa/sangueRESUMO
Background and Objectives: Certain lifestyle behaviors can act as either buffering or aggravating factors influencing the mental well-being of university students. The current investigation assessed the association between academic performance and the risk of anxiety, depression, and stress among university students and how physical activity might buffer the levels of these conditions. Materials and Methods: A cross-sectional design was utilized to reach a sample of university students from Saudi Arabia. Data about the demographics of the students, GPA, exercise regularity, and levels of anxiety, depression, and stress were collected. Logistic regression was performed to investigate the influence of exercise regularity on the presence of anxiety, depression, and stress, dividing the sample according to the GPA category. Result: A total of 506 students were recruited. The mean age of the students was 22 years, and 53% of the students were men. An assessment of the levels of depression, anxiety, and stress indicated that 60%, 57%, and 40% have abnormal levels of these conditions, respectively. Students with a GPA of "good" or lower exhibited higher levels of stress. Exercising regularly was associated with a protective effect against depression and stress (p < 0.05). However, the buffering effect of exercise was more apparent among students with a GPA of "very good" or above compared to students with lower academic achievement. Conclusions: The lack of a statistically significant association between physical activity regularity and mental well-being among students classified as low academic achievers may indicate the need for additional psychological support in addition to the promotion of a physically active lifestyle.
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Desempenho Acadêmico , Ansiedade , Depressão , Exercício Físico , Estresse Psicológico , Estudantes , Humanos , Masculino , Feminino , Exercício Físico/psicologia , Arábia Saudita , Estudos Transversais , Depressão/psicologia , Depressão/prevenção & controle , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Ansiedade/psicologia , Ansiedade/prevenção & controle , Estresse Psicológico/psicologia , Desempenho Acadêmico/psicologia , Desempenho Acadêmico/estatística & dados numéricos , Adulto Jovem , Adulto , Inquéritos e Questionários , Modelos LogísticosRESUMO
BACKGROUND: Perioperative neurocognitive disorder and postoperative depressive symptoms are significant complications after surgery. Studies have indicated that esketamine possesses neuroprotective and antidepressant qualities. METHODS: This trial included 209 patients aged 60 to 86 years undergoing tumor resection who received esketamine (Group E) or not (Group C) during and after surgery. In group E, patients were given an intravenous dose of 0.5 mg/kg of esketamine 10 minutes after induction of general anaesthesia. In addition, esketamine (2 mg/kg) in combination with sufentanil was used for PCIA during 48 hours postoperatively. On the other hand, saline was used as a substitute for esketamine in group C. Cognitive function was evaluated using neuropsychological tests and telephone interview for cognitive status-modified, and symptoms of depression were assessed using Hamilton Depression Rating Scale 17. RESULTS: Compared to Group C, patients in Group E exhibited lower rates of depressive symptoms at 3, 7, and 90 days post-surgery (53.9% vs 67.7%, 26.3% vs 47.9%, and 13.3% vs 28.4%). Group E also showed decreased time for Trail Making Test on days 7 and 90. However, there were no significant differences in the incidence of delirium 1 to 5 days post-surgery or cognitive impairment 90 days post-surgery between the 2 groups (12.1% vs 10.9% and 8.4% vs 9.7%). CONCLUSIONS: Intraoperative low-dose esketamine and postoperative low-dose esketamine combined with sufentanil for patient-controlled intravenous analgesia has been shown to improve postoperative analgesia, alleviate postoperative depressive symptoms, and aid in the recovery of social executive ability. However, this approach did not reduce the incidence of postoperative delirium or postoperative cognitive dysfunction.
Assuntos
Depressão , Procedimentos Cirúrgicos Eletivos , Ketamina , Transtornos Neurocognitivos , Complicações Pós-Operatórias , Humanos , Ketamina/administração & dosagem , Masculino , Idoso , Feminino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Idoso de 80 Anos ou mais , Transtornos Neurocognitivos/prevenção & controle , Transtornos Neurocognitivos/etiologia , Depressão/prevenção & controle , Depressão/etiologia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Neoplasias/cirurgia , Neoplasias/complicações , Sufentanil/administração & dosagem , Testes Neuropsicológicos , Método Duplo-CegoRESUMO
BACKGROUND: The aim of this study was to clarify the effects of a theater training program intervention on the physical and cognitive functions in community-dwelling older people. METHODS: Of the 59 participants, 30 were the control group, and 29 were the intervention group. We assessed physical and mental/cognitive functions and criteria of physical frailty. RESULTS: Statistical analysis showed that the usual walking speed (UWS) (p < 0.01), grip strength (GS) (p < 0.01), and GDS-15 (p < 0.05) improved significantly in the intervention group, whereas the Geriatric Depression Scale short-form (GDS-15) (p < 0.01) worsened significantly in the control group. Cognitive function was not significantly different between the two groups. Physical frailty was unchanged in the control group but significantly improved in the intervention group (p < 0.05), and a significant interaction was found for GDS-15 in ANOVA (F = 5.76, p < 0.05). CONCLUSIONS: The results of this study suggest that a theater intervention for the older adults may be effective in preventing and improving depression and physical frailty in old age.
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Depressão , Humanos , Idoso , Depressão/prevenção & controle , Masculino , Feminino , Idoso de 80 Anos ou mais , Cognição , Força da Mão , Drama , Fragilidade/prevenção & controle , Fragilidade/psicologiaRESUMO
BACKGROUND: Men at risk for suicide are a challenging population group to reach with suicide prevention strategies. Gatekeepers hold a pivotal role in the prevention of male suicide, yet effective intervention requires them to have a level of knowledge and strategies to provide support. AIM: This study aimed to examine the efficacy of an online gatekeeper program for gatekeepers in male suicide prevention, assessing knowledge, perceived preparedness, self-efficacy, and psychopathological symptoms of gatekeepers. METHODS: Eighty-four participants were randomized to either the intervention (n = 43) or the waitlist control group (n = 41). The intervention comprised four modules providing knowledge and strategies for addressing men in suicidal crises. Outcomes included depression (PHQ-9), distress (PSS-10), burden (BAS), involvement (IEQ), as well as gatekeeper outcomes and knowledge. RESULTS: Completer analyses revealed significant improvement of depressive symptoms (d = 0.39) and an increase in gatekeeper outcomes (d = 0.58 to d = 0.84) and knowledge (d = 0.62) from baseline to post-assessment. The effects were maintained for 3 months. No significant effects could be found for burden, distress, and involvement. CONCLUSIONS: The findings indicate that a brief gatekeeper program can serve as a valuable resource. Future research should focus on examining the mental health of gatekeepers themselves and its long-term effects on intervention behavior. TRIAL REGISTRATION: German Clinical Trials Register, DRKS00030758, registered on 05.12.2022.
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Prevenção do Suicídio , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Família/psicologia , Avaliação de Programas e Projetos de Saúde , Intervenção Baseada em Internet , Depressão/psicologia , Depressão/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Adulto Jovem , AutoeficáciaRESUMO
BACKGROUND: Tackling poor mental health in university students has been identified as a priority in higher education. However, there are few evidence-based prevention initiatives designed for students. Repetitive Negative Thought (RNT, e.g. worry, rumination) is elevated in university students and is a well-established vulnerability factor for anxiety and depression. Furthermore, there are now evidence-based cognitive-behavioural interventions to tackle RNT. A mobile self-help cognitive-behavioural app targeting RNT, adapted for students may therefore be an effective, scalable, and acceptable way to improve prevention in students. METHODS: An online single blind, two-arm parallel-group Randomised Controlled Trial (RCT) to examine the incidence of major depression and symptoms of anxiety and depression across 12 months in university students aged over 16 who screen into the study with self-reported high levels of worry and/or rumination and no current diagnosis of major depression. Eligible participants will be randomised to the active intervention arm (usual practice plus using a self-guided mobile app targeting RNT) or to the control arm (usual practice). In total, 648 participants aged over 16, with no current major depression, bipolar disorder or psychosis will be recruited from UK universities. Assessments will take place at baseline (pre-randomisation), 3 months and 12 months post- randomisation. Primary endpoint and outcome is incidence of major depression as determined by self-reported diagnostic criteria at 12-month follow-up. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and academic outcomes are secondary outcomes. Compliance, adverse events, and potentially mediating variables will be carefully monitored. DISCUSSION: The trial aims to provide a better understanding of the causal role of tackling RNT (worry, rumination) using a self-help mobile app with respect to preventing depression in university students. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective mobile-health public health strategies for preventing common mental health problems. TRIAL REGISTRATION: https://www.isrctn.com/ISRCTN86795807 Date of registration: 27 October 2022.
Assuntos
Ansiedade , Depressão , Aplicativos Móveis , Estudantes , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Ansiedade/prevenção & controle , Ansiedade/psicologia , Terapia Cognitivo-Comportamental/métodos , Depressão/prevenção & controle , Depressão/psicologia , Transtorno Depressivo Maior/prevenção & controle , Transtorno Depressivo Maior/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Ruminação Cognitiva , Método Simples-Cego , Estudantes/psicologia , UniversidadesRESUMO
Background: Internet-based cognitive behavioral therapy (iCBT) shows promise in the prevention of depression. However, the specific iCBT components that contribute to its effectiveness remain unclear. Objective: We aim to evaluate the effects of iCBT components in preventing depression among university students. Methods: Using a smartphone cognitive behavioral therapy (CBT) app, we randomly allocated university students to the presence or absence of 5 different iCBT components: self-monitoring, behavioral activation, cognitive restructuring, assertiveness training, and problem-solving. The active intervention lasted 8 weeks but the app remained accessible through the follow-up. The primary outcome was the onset of a major depressive episode (MDE) between baseline and the follow-up after 52 weeks, as assessed with the computerized World Health Organization Composite International Diagnostic Interview. Secondary outcomes included changes in the 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder, and CBT Skills Scale. Results: During the 12-month follow-up, 133 of 1301 (10.22%) participants reported the onset of an MDE. There were no significant differences in the incidence of MDEs between the groups with or without each component (hazard ratios ranged from 0.85, 95% CI 0.60-1.20, for assertiveness training to 1.26, 95% CI 0.88-1.79, for self-monitoring). Furthermore, there were no significant differences in the changes on the 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder, or for CBT Skills Scale between component allocation groups. However, significant reductions in depression and anxiety symptoms were observed among all participants at the 52-week follow-up. Conclusions: In this study, we could not identify any specific iCBT components that were effective in preventing depression or the acquisition of CBT skills over the 12-month follow-up period, but all participants with and without intervention of each iCBT component demonstrated significant improvements in depressive and anxiety symptoms. Further research is needed to explore the potential impact of frequency of psychological assessments, nonspecific intervention effects, natural change in the mental state, and the baseline depression level.
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Terapia Cognitivo-Comportamental , Estudantes , Humanos , Terapia Cognitivo-Comportamental/métodos , Masculino , Feminino , Estudantes/psicologia , Universidades , Adulto Jovem , Adulto , Intervenção Baseada em Internet , Depressão/prevenção & controle , Depressão/terapia , Depressão/psicologia , Transtorno Depressivo Maior/terapia , Transtorno Depressivo Maior/prevenção & controle , Transtorno Depressivo Maior/psicologia , Seguimentos , Internet , AdolescenteRESUMO
BACKGROUND: Preventing anxiety and depression among college students is a pressing public health need. Recent meta-analyses have examined mobile mindfulness interventions in adult populations; however, college students are in a unique developmental stage and institutional setting. METHODS: We conducted a systematic literature review and meta-analysis of published and unpublished studies in English language on the acceptability, usage, and efficacy of mindfulness training apps on mental health among non-clinical samples of college students. Out of 167 reviewed studies, 47 were included in the narrative review. Additionally, we summarized effects from 19 stress, 12 anxiety, 13 depression, and 8 emotional well-being trials (total N = 2974) using robust variance estimation meta-regression and evaluated certainty of evidence with the GRADE approach. RESULTS: Apps were acceptable, with usage levels varying. They reduced stress by 0.435 standard deviation units, 95 % CI (-0.615,-0.255), and increased emotional well-being by 0.431 (0.162,0.7) approaching medium effect sizes. The apps had small effects on depression (B = -0.219 (-0.374, -0.065)) and anxiety (B = -0.218 (-0.42, -0.016)). Certainty of evidence was moderate for stress, depression, and well-being; and low-to-moderate for anxiety. Distressed participants had larger improvements in all outcomes except depression. LIMITATIONS: Small sample sizes in the original studies and small numbers of studies limit the precision of our effect estimates. The small number of studies with objective usage data impedes our ability to characterize the optimal dose. CONCLUSIONS: With moderate certainty of evidence, mindfulness training apps may improve student mental health with similar or larger effect sizes than in the general adult population. However, sustained usage may be a challenge, and more research is needed on the optimal implementation strategy, dose, and equity.
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Ansiedade , Depressão , Atenção Plena , Aplicativos Móveis , Estudantes , Humanos , Atenção Plena/métodos , Estudantes/psicologia , Depressão/terapia , Depressão/prevenção & controle , Ansiedade/terapia , Ansiedade/prevenção & controle , Universidades , Estresse Psicológico/terapia , Estresse Psicológico/prevenção & controle , Saúde Mental , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem , Adulto , Aceitação pelo Paciente de Cuidados de Saúde/psicologiaRESUMO
BACKGROUND: Mental health problems are high among refugees due to their traumatic experiences of fleeing war and witnessing disasters and deaths due to violence and conflict. Refugees are exposed to various socio-cultural stressors during their migration journey before, during, and after arriving at the host country, which may increase their risk of mental health problems. Strength-based interventions may be beneficial to address their socio-cultural and psychological stressors by strengthening individual's strengths to address their problems. AIMS: This study evaluated the effect of a Social and Emotional Wellbeing intervention on mental health (stress, anxiety, and depression) and emotional health outcomes (coping, self-efficacy, social support, and conflict resolution) among Ukrainian refugees in Massachusetts. METHODS: We implemented intervention (once-weekly/5-week) among 31 Ukrainian refugees with pre-and post-assessment of mental and emotional health outcomes (2022-2023). The intervention consisted 5-module: managing stress and mind-body exercise, strengthening communication and social networking, problem-solving, and creating a healthy family environment. Validated scales were used to measure mental and emotional health outcomes, such as the Hopkins-Symptom-Checklist-25 for anxiety and depression and the Cohen-Perceived-Stress scale for stress. Paired t-test was used for data analysis. RESULTS: The pre versus post-intervention proportion reduced for anxiety (61.29% vs. 22.58%) and depression (58.06% vs. 22.58%). The mean scores significantly decreased from pre- to post-intervention by 6.26 points for stress, by 7.07 points for anxiety, and by 6.29 points for depression (both p's < .01). The mean scores significantly increased for coping (by 15.71), emotion-focused engagement (4.48), problem-focused engagement (4.80), social support (8.77), problem-focused coping self-efficacy (14.93), stop unpleasant emotions and thoughts (12.74), and friends networking (3.48; all p's < .01). CONCLUSIONS: The stress, anxiety, and depression were reduced, and coping, self-efficacy, and social support networking skills were improved among Ukrainians after intervention. This program should be replicated in the larger community for a wider benefit.
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Adaptação Psicológica , Ansiedade , Depressão , Refugiados , Apoio Social , Estresse Psicológico , Humanos , Refugiados/psicologia , Feminino , Masculino , Adulto , Depressão/psicologia , Depressão/prevenção & controle , Ucrânia , Massachusetts , Pessoa de Meia-Idade , Saúde Mental , Adulto Jovem , Autoeficácia , EmoçõesRESUMO
Families are key in the healthy development of Latinx sexual minority youth (Latinx SMY), a group that experiences behavioral, mental, and sexual health disparities. Despite this, there are no family-based interventions for Latinx SMY and their families to prevent drug use, sexual risk behaviors, and depressive symptoms. The purpose of this pilot study was to evaluate the preliminary impact (i.e., estimated effect sizes) of Familias con Orgullo (FcO) and examine its feasibility and acceptability among 30 Latinx SMY and their parents. Parents and adolescents were randomized to FcO or a control condition and assessed pre/post-intervention. Feasibility was measured based on session completion and effect sizes. Focus groups were conducted to evaluate intervention acceptability. Findings showed promising effects favoring FcO on parent-adolescent communication (d = 0.46) and parental involvement (d = 0.34). There were also promising effects favoring FcO on suicidal thoughts (OR = 0.75) and depression symptoms (OR = 0.69). Finally, 100% of the adolescents in FcO either continued to remain drug-free or transitioned from current use to no use (from baseline to post-intervention) compared to 74% in the control. Effect sizes for condomless sex, parental monitoring, and positive parenting were small. Session completion (above 80%) and focus group findings indicated strong feasibility and acceptability. FcO holds promise for reducing drug use and depressive symptoms and improving family functioning among Latinx SMY.
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Depressão , Hispânico ou Latino , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Humanos , Projetos Piloto , Adolescente , Feminino , Masculino , Depressão/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Minorias Sexuais e de Gênero/psicologia , Comportamento Sexual , Assunção de Riscos , Adulto , Grupos FocaisRESUMO
Compared to traditional psychosocial interventions, the transdiagnostic approach focuses on common processes or factors that contribute to the development and maintenance of emotional problems. In Spain, the Super Skills Program has proven its effectiveness, but issues with displacement or scheduling for families can hinder access to the intervention. This study aims to examine the program's effectiveness in preventing children's psychosocial problems through learning socio-emotional skills when self-administered via the Internet. Participants were 283 Spanish children between the ages of 8 and 12. The children and their parents completed anxiety and depression scales before and after receiving the intervention and 12 months later. The program consisted of 8 self-applied sessions, at a rate of two per week, which included emotional education, cognitive restructuring, self-regulation techniques, training in social skills, problem-solving, and video feedback with cognitive preparation. Significant differences in anxiety and depression symptoms were found after the intervention. A significant reduction in anxiety scores and a marginally significant decrease in depression scores was observed at the long-term follow-up. The "intention to treat" analysis revealed a tendency for children who improved to drop out of the program, completing the intervention children with more symptomathology. Learning socio-emotional skills through a self-applied intervention via the Internet effectively reduced emotional symptoms in school children and is a valuable resource to improve child well-being and prevent future psychological problems.
Assuntos
Ansiedade , Depressão , Habilidades Sociais , Humanos , Masculino , Feminino , Criança , Espanha , Depressão/prevenção & controle , Ansiedade/prevenção & controle , Multimídia , Terapia Cognitivo-Comportamental/métodos , Sintomas Afetivos/prevenção & controle , Intervenção Psicossocial/métodosRESUMO
OBJECTIVE: This study aimed to explore the effect of comprehensive noise reduction management on the postoperative recovery of burn patients. METHODS: Data of 156 patients admitted to Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University from October 2022 to July 2023 were retrospectively analysed. The patients were divided into two groups according to the management method: group A (n = 76, standard care of burns) and group B (n = 80, standard care of burns+comprehensive noise reduction management). The stress response level, anxiety and depression level, sleep quality and satisfaction of the two groups were compared before and after the management. RESULTS: Before the management, no statistically significant differences in cortisol (Cor), anxiety and depression scores and sleep quality were found between the two groups (P > 0.05). After the management, significant differences in Cor, anxiety scores, sleep quality and patient satisfaction were observed between the two groups (P < 0.001). CONCLUSIONS: Comprehensive noise reduction management can reduce postoperative stress hormone levels, alleviate negative emotions, such as anxiety, and improve sleep quality and patient satisfaction.
Assuntos
Ansiedade , Queimaduras , Hidrocortisona , Qualidade do Sono , Humanos , Estudos Retrospectivos , Masculino , Feminino , Adulto , Queimaduras/psicologia , Pessoa de Meia-Idade , Ansiedade/prevenção & controle , Ansiedade/etiologia , Ruído/efeitos adversos , Estresse Psicológico , Depressão/prevenção & controle , Satisfação do Paciente , Período Pós-Operatório , Sono/fisiologia , EmoçõesRESUMO
BACKGROUND: This study evaluated the effectiveness of an online intervention designed to improve parent-child interactions and address disordered eating behaviors in children. Using remote video-feedback sessions based on observations of mother-child feeding interactions, the intervention offers a cost-effective and environmentally friendly alternative to traditional in-person methods. AIMS: The study aimed to assess the impact of online intervention on the quality of mother-child interactions during feeding and its effectiveness in reducing psychopathological symptoms in both mothers and children. METHODS: The intervention was conducted entirely online, with improvements measured using SVIA scores for mother-child interactions and the SCL-90/R Global Severity Index (GSI) for maternal psychopathological symptoms, alongside evaluations of children's emotional and behavioral functioning, particularly anxiety, depression, and aggression. RESULTS: The intervention significantly improved the quality of mother-child interactions across all SVIA subscales and led to reductions in maternal symptoms of depression and anxiety, as well as decreases in children's emotional and behavioral symptoms. CONCLUSIONS: These findings suggest that online video-feedback interventions can effectively enhance mother-child relationships and reduce psychopathological symptoms in both mothers and children, although further research with larger sample sizes and more robust statistical analyses is needed to confirm these results.
Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Relações Mãe-Filho , Humanos , Feminino , Criança , Relações Mãe-Filho/psicologia , Masculino , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Adulto , Depressão/psicologia , Depressão/terapia , Depressão/prevenção & controle , Ansiedade/prevenção & controle , Ansiedade/psicologia , Ansiedade/terapia , Pré-Escolar , Gravação em Vídeo , InternetRESUMO
BACKGROUND: Mental health disorders still rank as leading causes of morbidity worldwide despite increasing awareness and improvements in treatment. Notably, low- and middle-income countries like Uganda, are disproportionately affected by such disorders. The burden of depressive symptoms in these countries is particularly high among students, aggravated by poverty, malnutrition, and inadequate public health governance, yet it is clearly under-researched, making it hard to achieve several of UN Sustainability Development Goals. Current treatment options are insufficient to tackle the increased burden of depressive disease. This is more challenging for low-resource regions especially in Sub-Saharan Africa, suggesting the need for alternative treatments that can swiftly be applied if proven effective. The main aim of this randomized controlled trial (RCT) is therefore to examine if a low-cost healthy diet (based on local Ugandan foods) combined with easy-to access mindfulness cognitive therapy can reduce depressive symptoms among university students in Uganda. METHODS: We will recruit female and male students at Makerere University, the largest public university in Uganda, to an open, intention-to-treat, two-armed RCT. Those who score above a predefined threshold on a self-reported assessment of depressive symptoms, measured by the Center for Epidemiological Studies - Depression score (CES-D), are eligible for study inclusion and will be randomized to either an intervention (n = 125) or a control (n = 125) group. The intervention group will receive educational group-based sessions on how to prepare a Mediterranean-type of healthy diet and how to adhere to the principles of mindfulness-based cognitive therapy. Outcome measures include self-reported depression symptoms, quality of life, and dietary intakes. In addition we will perform a cost-effectiveness analysis. The RCT intervention will last 9 months, followed by additional 15 months with regular data collections. DISCUSSION: We here describe a novel approach to treat depressive symptoms among university students living in resource constraint settings, by combining a healthy diet with low threshold psychotherapy. If this intervention succeeds, our project can be viewed as a step towards evidence-based behavior practices for young adults with a common mental disorder (depression) that are beneficial to public mental health initiatives and management. TRIAL REGISTRATION: The RCT is registered in ClinicalTrials.gov (ID: NCT05848973). The date of registration was August 14, 2023.
Assuntos
Depressão , Dieta Saudável , Atenção Plena , Estudantes , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Terapia Combinada/métodos , Depressão/terapia , Depressão/prevenção & controle , Depressão/psicologia , Dieta Saudável/métodos , Dieta Saudável/psicologia , Atenção Plena/métodos , Ensaios Clínicos Pragmáticos como Assunto , Estudantes/psicologia , Uganda , UniversidadesRESUMO
Objectives: This study aimed to examine whether China's Targeted Poverty Alleviation (TPA) program mitigates depression and explores the mechanisms through which the TPA program affects individuals' depression. Methods: Using the data from the China Family Panel Studies (CFPS) survey from 2012 to 2020, we employ a Difference-in-Difference model to analyze the effect of the TPA program on individuals' depression levels. Results: Our findings indicate that the TPA program reduces depression scores by 0.116 points, accounting for 6.82% of the standard deviation of depression scores. Further analyses indicate that these effects are mediated through improvements in local medical conditions, reductions in household healthcare spending, increases in household entertainment expenditures, and greater likelihood of living in family. Conclusion: This study showed that the TPA program significantly mitigates individuals' depression levels. The possible channels include (1) improving local medical conditions, (2) cutting down household healthcare spending, (3) increasing household entertainment expenses, and (4) increasing the likelihood of living in family.