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1.
J Affect Disord ; 356: 554-563, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38649104

ABSTRACT

BACKGROUND: Up to 55 % of students experience test anxiety (TA), which is characterized by intense physiological and psychological symptoms before or during exams, such as anxiety, fear of failure, sweating, or increased heart rate. Furthermore, TA increases graduation times and can result in discontinuance of the graduate program all together. Previous research demonstrated the beneficial effects of combining cognitive behavioral therapy with imagery rescripting, however, treatment programs are comparably long. Hence, they do not account for the students´ time-sensitive schedules. Therefore, the present study investigates a two-session short-intervention using imagery rescripting to treat TA. METHODS: 44 students and pupils were randomly assigned to either the two-session imagery rescripting intervention (22 participants) or the waitlist-control condition (22 participants). One week before the intervention clinical interviews were conducted and self-report questionnaires on TA, self-efficacy, symptoms of depression, and intrusive prospective images were completed (T1). The same questionnaires were completed one week (T2) and six months after the intervention (T3). RESULTS: Test anxiety significantly decreased from T1 to T2, as well as from T1 to T3 within the intervention group. Furthermore, there were medium to large within and between group effects for situational test anxiety, self-efficacy, symptoms of depression, as well as prospective intrusive images, showing significant improvements for the intervention group at six months follow-up. LIMITATIONS: The study is limited to the comparably small sample size, as well as the sole usage of self-report measurements. CONCLUSIONS: The presented short-intervention provides a feasible treatment technique, which can be easily applied within school and university counseling centers.


Subject(s)
Adaptation, Psychological , Imagery, Psychotherapy , Test Anxiety , Humans , Female , Male , Imagery, Psychotherapy/methods , Young Adult , Adult , Test Anxiety/therapy , Test Anxiety/psychology , Students/psychology , Self Efficacy , Depression/therapy , Depression/psychology , Treatment Outcome , Cognitive Behavioral Therapy/methods
2.
J Clin Neurosci ; 123: 186-193, 2024 May.
Article in English | MEDLINE | ID: mdl-38599032

ABSTRACT

BACKGROUND: Clay art therapy can be used as part of rehabilitation for chronic stroke patients. OBJECTIVE: The objective of this study is to examine the effect of clay therapy on hopelessness and depression levels in chronic stroke patients who receive physical therapy and compare them to patients who only receive physical therapy. METHODS: This randomized controlled study was conducted between August 1st - September 28th, 2022 in Turkiye, with 60 patients who agreed to participate in the study and met the inclusion criteria, which were chronic stroke patients who received physical therapy. The patients were divided into two groups (30 in the experimental group, 30 in the control group) with the control group receiving only their routine physical therapy and rehabilitation (5 days a week, 40 sessions in total), while the experimental group received their routine physical therapy and rehabilitation program as well as clay therapy twice a week, 60 min per session, for 8 weeks. Demographic information of all the participants was recorded, and the Beck Depression Inventory and Beck Hopelessness Scale were administered before and after treatment. RESULTS: The patients' depression posttest scores (t(58) = -11.386; p = 0.000 < 0,05), and hopelessness posttest scores (t(58) = -10.247; p = 0.000 < 0,05) differed significantly based on their groups. The control group's depression posttest scores (x¯ =25,033) and hopelessness posttest scores (x¯ =15,000) were higher than the experimental group's depression posttest scores (x¯ =9,067) and hopelessness posttest scores (x¯ =8,000). The control group's feeling about the future posttest scores (x¯ =2,967) were higher than the experimental group's posttest scores (x¯ =0,967). The control group's loss of motivation posttest scores (x¯ =6,400) were higher than the experimental group's posttest scores (x¯ =2,667). CONCLUSION: It was seen that clay therapy, in addition to physical therapy, was effective in reducing depression and hopelessness in chronic stroke patients.


Subject(s)
Clay , Depression , Hope , Physical Therapy Modalities , Stroke Rehabilitation , Stroke , Humans , Male , Female , Middle Aged , Depression/psychology , Depression/etiology , Depression/therapy , Stroke Rehabilitation/methods , Stroke Rehabilitation/psychology , Stroke/psychology , Stroke/complications , Stroke/therapy , Aged , Chronic Disease , Aluminum Silicates , Art Therapy/methods , Treatment Outcome
3.
J Affect Disord ; 354: 82-88, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38452937

ABSTRACT

BACKGROUND: It is a well-established fact that post-stroke depression (PSD) is a prevalent condition that affects a significant proportion of individuals who have suffered a stroke. Hence, our research endeavors to explore the safety, efficacy and the potential molecular mechanism of transcutaneous auricular vagus nerve stimulation (ta-VNS) for the treatment of depression in PSD patients by conducting a double-blind, sham-controlled, randomized trial. METHODS: Patients who had experienced strokes and exhibited depressive symptoms, with a Hamilton Depression Scale (HAMD-17) score of ≥8 and met the DSM-IV criteria, were diagnosed with PSD. A volunteer sample of participants (N = 80) were randomly divided into either the ta-VNS group (which received ta-VNS in addition to conventional treatment) or the control group (which received conventional treatment only), in a 1:1 ratio. The effectiveness of the interventions was evaluated using the 17-item Hamilton Rating Scale for Depression (HAMD-17), Zung Self-Rating Depression Scale (SDS), and Barthel Index (BI) scores. Furthermore, Plasma BDNF, CREB1, and 5-HT levels were measured before and after treatment. RESULTS: The concomitant application of ta-VNS demonstrated a remarkable reduction in HAMD-17 and SDS scores, leading to noteworthy enhancements in patients' daily functioning, as evidenced by improved activities of daily living, at all assessed time points, in contrast to the control group (p < 0.0001). Notably, the ta-VNS group exhibited superior effects in modulating the measured neurotrophic biomarkers when compared to the control group (p < 0.05). CONCLUSIONS: The synergistic approach of combining ta-VNS with conventional treatment has demonstrated remarkable efficacy and tolerability in managing depression following a stroke.


Subject(s)
Stroke , Transcutaneous Electric Nerve Stimulation , Vagus Nerve Stimulation , Humans , Depression/etiology , Depression/therapy , Vagus Nerve Stimulation/adverse effects , Activities of Daily Living , Stroke/complications , Stroke/therapy , Double-Blind Method , Vagus Nerve , Treatment Outcome
4.
Support Care Cancer ; 32(4): 235, 2024 Mar 19.
Article in English | MEDLINE | ID: mdl-38502260

ABSTRACT

OBJECTIVES: This review examined the effectiveness of using dance movement therapy (DMT) and dance movement interventions (DMIs) with cancer and palliative care patients. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched from inception to July 9, 2022, without limits on year or age. Searching was updated on July 10, 2023. The risk of bias was assessed by the Cochrane (RoB 2) and ROBINS-I tools. Meta-analyses were conducted to pool estimates of the effects of DMT and DMI on patients' health-related outcomes. A narrative synthesis of outcomes was performed where meta-analysis was not appropriate. RESULTS: Among a total of 16 studies included in this review, nine were randomized controlled trials and seven were non-randomized trials, with a total of 893 participants. Only six of these studies were fully or partially described as true DMTs (some with less clarity than others), whereas the majority (n = 10) were DMIs with unclear therapeutic alignment. Most studies focused on female patients with breast cancer. Cancer patients undergoing palliative care received little attention. The overall risk of bias from the evaluated studies was high. Meta-analysis of two trials revealed that DMTs had no effect on QOL in cancer patients (SMD - 0.09, 95% CI - 0.21-0.40, P = 0.54), while narrative analysis and non-randomized trials showed no overall effect of DMTs on anxiety, depression, body image, self-esteem, or sleep disturbance but significant positive effects on perceived stress, pain severity, and pain interference. DMIs had significant positive effects on cancer patients' depression (SMD - 0.53, 95% CI - 0.93 to - 0.14, P = 0.008) and fatigue (SMD - 0.42, 95% CI - 0.70 to - 0.14, P = 0.003). DMI trials synthesized narratively showed an effect on patients' body image, self-esteem, physical function, right and left handgrip strength, life satisfaction, and the mental component of QOL. CONCLUSION: Both DMT and DMIs had promising effects on several health outcomes, but results were inconsistent, and the evidence was weak. The reviewed studies' low evidence quality and small sample sizes affected the findings' robustness and reliability. Large-scale, high-quality randomized controlled trials with sufficient sample sizes, and clear and veracious DMT and DMI protocols and data are required to provide more credible research evidence and influence practice.


Subject(s)
Breast Neoplasms , Dance Therapy , Dancing , Female , Humans , Dance Therapy/methods , Depression/therapy , Hand Strength , Quality of Life , Randomized Controlled Trials as Topic , Reproducibility of Results , Male
5.
Neurochem Res ; 49(5): 1406-1416, 2024 May.
Article in English | MEDLINE | ID: mdl-38522048

ABSTRACT

Depression is characterized by the loss of pleasure and a depressed mood, and it is a common mental disorder in the twenty-first century. Multiple gene imbalances, which are considered pathological factors in depression, were detected in the brain. Electroacupuncture is an effective therapeutic approach for depression that has minimal side effects. As a crucial structure in the hypothalamus-pituitary-adrenal, the hypothalamus plays a key role in depression. Our study focused on the transcriptome level in the hypothalamus of depressive rats. After chronic unpredictable mild stress, the rats exhibited depressive-like behaviors, such as decreased sucrose consumption in the SPT, increased time in the central area of the OFT and increased immobility in the FST. Moreover, electroacupuncture alleviated depressive behaviors. Because of the importance of the hypothalamus in depression, we next detected gene expression in the hypothalamus. A total of 510 genes (125 upregulated genes and 385 downregulated genes) were detected in the hypothalamus of depressive rats. 15 of the 125 upregulated genes and 63 of the 385 downregulated genes could be altered by electroacupuncture, which suggests the antidepressant effect of electroacupuncture. Our study also provided the evidence that regulation of transcriptome in the hypothalamus might be a potential mechanism of electroacupuncture treatment.


Subject(s)
Depression , Electroacupuncture , Humans , Rats , Animals , Depression/therapy , Depression/drug therapy , Rats, Sprague-Dawley , Hypothalamus/metabolism , Gene Expression , Stress, Psychological/therapy , Stress, Psychological/metabolism , Disease Models, Animal , Hippocampus
6.
J Affect Disord ; 354: 662-672, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38484880

ABSTRACT

BACKGROUND: Effects of online contemplative practices, especially partner-based practices, on psychological well-being remain mixed, with sparse understanding of potential affective-cognitive mechanisms. The study aimed to assess the efficacy of two online contemplative interventions in improving depression, anxiety, emotion regulation (ER), and resilience, and to evaluate the mechanistic role of negative attention and interpretation biases. METHODS: Employing a randomized controlled design (n = 285), we compared the efficacy of 10-week online mindfulness-based and partner-based socio-emotional dyadic interventions, both supported by weekly coaching sessions. Mental health aspects were assessed using validated self-report measures and negative biases using the mouse-contingent Scrambled Sentences Task. RESULTS: Both interventions, compared to waitlist control, led to reductions in depression and ER difficulties, while trait anxiety decreased only after mindfulness training. Increases in multidimensional resilience were observed only after socio-emotional training and in stress recovery only after mindfulness-based training, both compared to waitlist control. Socio-emotional training led to significant reductions in negative interpretation bias and this mediated reductions in depression and trait anxiety. Neither training led to reductions in state anxiety or negative attention bias. LIMITATIONS: The subclinical nature and overrepresentation of females in the sample limits generalizability. CONCLUSIONS: Findings indicate that online mindfulness-based and socio-emotional partner-based interventions, supported by online coaching sessions, can reduce depression and ER difficulties. Though mindfulness practice reduced trait anxiety and enhanced stress recovery, socio-emotional training increased multidimensional resilience. Socio-emotional training reduced negative interpretation bias, which emerged as an intervention-specific mechanism. These findings highlight the potential benefits of online contemplative intervention approaches for psychological well-being.


Subject(s)
Mindfulness , Female , Humans , Animals , Mice , Mindfulness/methods , Mental Health , Depression/therapy , Depression/psychology , Psychological Well-Being , Anxiety/therapy , Anxiety/psychology , Bias
7.
PLoS One ; 19(3): e0298438, 2024.
Article in English | MEDLINE | ID: mdl-38452033

ABSTRACT

OBJECTIVE: To assess the effectiveness of acupuncture for treating depression and anxiety in patients diagnosed with functional dyspepsia (FD). METHODS: PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, Sinomed, and VIP Database were searched until April 30, 2023 for Randomized Controlled Trials (RCTs) comparing acupuncture to placebo or drugs for symptom alleviation. Two independent reviewers conducted the study search, data extraction, and bias risk assessment using the Cochrane Risk of Bias tool. Mean difference (MD), risk ratio (RR), and corresponding 95% confidence intervals (CI) were computed. Subgroup and sensitivity analyses were also performed. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was employed to evaluate the evidence level. RESULTS: A total of 16 RCTs involving 1315 participants were included. Acupuncture demonstrated marked superiority over placebo (MD = -7.07, 95%CI: -11.03 to -3.10, very low quality evidence) in mitigating Self-Rating Anxiety Scale (SAS) scores and was found to be more effective in reducing Self-Rating Depression Scale (SDS) scores than either placebo (MD = -4.63, 95%CI: -6.28 to -2.98, low quality evidence) or first-line drugs (MD = -2.71, 95%CI: -5.19 to -0.23, very low quality evidence). In terms of attenuating Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scores, acupuncture consistently outperformed both placebo (HAMA: MD = -2.58, 95%CI: -4.33 to -0.83, very low quality evidence; HAMD: MD = -1.89, 95%CI: -3.11 to -0.67, low quality evidence) and first-line drugs (HAMA: MD = -5.76, 95%CI: -10.18 to -1.35, very low quality evidence; HAMD: MD = -5.59, 95%CI: -7.59 to -3.59, very low quality evidence). However, no significant difference was observed between acupuncture and placebo in terms of improvement in Hospital Anxiety and Depression Scale (HADS) scores. CONCLUSIONS: Based on current clinical evidence, acupuncture might have a positive effect on depression and anxiety in patients with FD. Further large-sample, multi-center, high-quality RCTs validation are required, as the conclusion is limited by the quantity and quality of the included studies.


Subject(s)
Acupuncture Therapy , Anxiety , Depression , Dyspepsia , Humans , Anxiety/therapy , Depression/therapy , Dyspepsia/therapy
8.
BMC Psychiatry ; 24(1): 194, 2024 Mar 08.
Article in English | MEDLINE | ID: mdl-38459520

ABSTRACT

BACKGROUND: This controlled pilot study investigates the effect of the combined use of cognitive restructuring (CR) and imagery rescripting (IR) compared to treatment as usual among inpatients with moderate and severe depression. Alongside expert ratings and self-report tools, fitness wristbands were used as an assessment tool. METHODS: In addition to the standard inpatient care (SIC) program, 33 inpatients with moderate and severe depression were randomly assigned to an intervention group (two sessions of IR and CR) or an active treatment-as-usual (TAU) control group (two sessions of problem-solving and build-up of positive activity). Depression severity was assessed by the Hamilton Depression Rating Scale-21 (HDRS-21), the Beck Depression Inventory-II (BDI-II), and as a diagnostic adjunct daily step count via the Fitbit Charge 3™. We applied for analyses of HDRS-21 and BDI-II, 2 × 2 repeated-measures analysis of variance (ANOVA), and an asymptotic Wilcoxon test for step count. RESULTS: The main effect of time on both treatments was η2 = .402. Based on the data from the HDRS-21, patients in the intervention group achieved significantly greater improvements over time than the TAU group (η2 = .34). The BDI-II data did not demonstrate a significant interaction effect by group (η2 = .067). The daily hourly step count for participants of the intervention group was significantly higher (r = .67) than the step count for the control group. CONCLUSIONS: The findings support the utilization of imagery-based interventions for treating depression. They also provide insights into using fitness trackers as psychopathological assessment tools for depressed patients. TRIAL REGISTRATION: The trial is registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien) under the registration number: DRKS00030809.


Subject(s)
Cognitive Restructuring , Depressive Disorder, Major , Humans , Depression/therapy , Depression/psychology , Inpatients , Depressive Disorder, Major/therapy , Pilot Projects , Treatment Outcome
9.
PLoS One ; 19(3): e0299300, 2024.
Article in English | MEDLINE | ID: mdl-38478509

ABSTRACT

Loneliness, perceived stress, depression, and anxiety have increased during the COVID-19 pandemic. Many of existing mindfulness and compassion-based intervention are effective, but are time-intensive, decreasing overall accessibility and scalability. Single-session interventions (SSIs) serve as a promising alternative. The current pre-registered randomized clinical trial evaluated a newly developed, manualized, mindfulness-based single-session intervention. 91 adults were randomly assigned to one of three conditions: (1) one-hour mindfulness only telehealth intervention; (b) one-hour mindfulness and compassion telehealth intervention; or (c) one-week waitlist control (before randomization to an active intervention). Intervention sessions were conducted by graduate students in clinical psychology. The primary outcome was self-reported loneliness; secondary outcomes were self-reported perceived stress, depression, and anxiety. Using Bayesian multilevel models, we found that compared to the waitlist-control, the inclusion of a compassion component led to meaningful reductions in perceived stress b = -3.75, 95% HDI [-6.95, -0.59], anxiety b = -3.79, 95% HDI [-6.99, -0.53], and depression b = -3.01, 95% HDI [-5.22, -0.78], but not loneliness at the 1-week follow-up. Results suggest that a single-session mindfulness and compassion intervention may lead to meaningful reductions in perceived stress, symptoms of anxiety, and symptoms of depression, but not loneliness. Implications of these findings are discussed.


Subject(s)
Mindfulness , Adult , Humans , Mindfulness/methods , Depression/therapy , Depression/psychology , Bayes Theorem , Pandemics , Anxiety/therapy , Anxiety/psychology
10.
Int J Clin Exp Hypn ; 72(2): 155-188, 2024.
Article in English | MEDLINE | ID: mdl-38416132

ABSTRACT

This scoping review aims to provide a comprehensive overview of studies that explore the use of hypnotherapy as a treatment for depression, adhering to the PRISMA-ScR guidelines. A total of 232 articles were identified through systematic search strategies in four databases. Following rigorous screening, 14 studies, varying from case studies to randomized controlled trials, were included in the final review. The age range of participants spanned from 18 to 70 years, and the number of female participants generally exceeded that of males in these studies. Hypnotherapy was found to be frequently used as an adjunct treatment alongside various types of psychotherapy such as cognitive behavioral therapy and often included techniques like hypnotic induction, ego strengthening, and self-hypnosis. The treatment duration varied from 3 sessions to as long as 20 weekly sessions. Most importantly, the majority of the studies found hypnotherapy to be effective in reducing symptoms of depression, with some studies suggesting it has superior effects to antidepressant treatment in areas such as overall health and vitality. This review highlights the potential of hypnotherapy as a viable treatment option for depression and highlights the need for further controlled studies to establish its efficacy.


Subject(s)
Cognitive Behavioral Therapy , Hypnosis , Male , Humans , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Hypnosis/methods , Depression/therapy , Psychotherapy/methods , Cognitive Behavioral Therapy/methods
11.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 53(1): 108-115, 2024 Jan 31.
Article in English, Chinese | MEDLINE | ID: mdl-38310084

ABSTRACT

OBJECTIVES: To explore the effects of online mindfulness-based stress reduction (MBSR) on the anxiety and depression status, and quality of life in the caregivers of patients with severe mental disorders. METHODS: Ninety-three caregivers for patients with schizophrenia or bipolar disorder, who were hospitalized in Yunnan Provincial Mental Hospital in March 2021, were enrolled and randomly divided into control group (n=47) and MBSR intervention group (n=46). Both groups received basic health education and rehabilitation skill training, while the intervention group received additional online MBSR for 8 weeks. The anxiety and depression status, and the quality of life of the caregivers were evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and the 36-item Short Form Health Survey (SF-36) before and 8 weeks after intervention, respectively. RESULTS: Thirteen caregivers dropped out of the study, and 80 subjects (40 in each group) were included in the final analysis. At the baseline, there were no significant differences in SAS, SDS and SF-36 scores between two groups (all P>0.05). Compared with the baseline, SAS and SDS scores in the intervention group significantly decreased after 8 weeks of intervention (both P<0.01) and were significantly lower than those in the control group (both P<0.01). There were no significant changes in the control group (all P>0.05). Except the physiological function dimension, the total score and the scores of each dimension of SF-36 in the intervention group were significantly increased after 8-week intervention (all P<0.05), and were significantly higher than those in the control group (all P<0.01). There were no significant changes in the control group before and after intervention (all P>0.05). CONCLUSIONS: Online MBSR can reduce the anxiety and depression levels, improve the quality of life in the caregivers of patients with severe mental disorders.


Subject(s)
Mental Disorders , Mindfulness , Humans , Quality of Life , Caregivers , Depression/therapy , China , Anxiety/therapy
12.
Integr Cancer Ther ; 23: 15347354241233517, 2024.
Article in English | MEDLINE | ID: mdl-38385326

ABSTRACT

BACKGROUND: Cancer is a chronic condition associated with a substantial symptom burden, which can impair recovery after treatment. Investigating interventions with potential to improve self-reported disease and/or treatment effects-known as patient-reported outcomes (PROs)-is paramount to inform cancer care. The objective of this study was to evaluate the effects of a yoga therapy (YT) intervention on key PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life [QoL]) among adults after treatment for cancer. METHODS: Data from 20 adults (Mage = 55.74 years, 85% female; Mtime since diagnosis = 2.83 years) who had completed treatment for cancer were analyzed for this study. In this single-subject exploratory experimental study, the YT intervention comprised a 1:1 YT session (ie, 1 participant with 1 yoga therapist) followed by 6 weekly small (ie, 2-3 participants) group YT sessions. Group sessions were facilitated by the same yoga therapist who delivered participants' 1:1 session to ensure an in-depth personalized approach. PROs were assessed before (ie, pre-intervention) and after the 1:1 YT session (ie, during the intervention), as well as after the last group YT session (ie, post-intervention). Hierarchical linear modeling was used to analyze the data. RESULTS: Participants showed improvements in cancer-related fatigue, state anxiety, trait anxiety, perceived cognitive impairments, impacts of perceived cognitive impairments on QoL, and 1 dimension of QoL (ie, functional wellbeing) over time. Notably, cancer-related fatigue and state anxiety increased immediately after the 1:1 session, but showed greater improvements over time afterward (ie, during the intervention phase). No changes were observed for the remaining PROs. CONCLUSION: Although results require confirmation in future trials, this study highlights the importance of continuing to investigate YT as an intervention to enhance important PROs (ie, cancer-related fatigue and state anxiety) after treatment for cancer. More research is needed to identify additional beneficial effects and factors that influence participants' responses to 1:1 and group YT (ie, moderators and mediators). REGISTRATION NUMBER: ISRCTN64763228. DATE OF REGISTRATION: December 12, 2021. This trial was registered retrospectively. URL OF TRIAL REGISTRY RECORD: https://www.isrctn.com/ISRCTN64763228. PUBLISHED PROTOCOL: Brunet, J., Wurz, A., Hussien, J., Pitman, A., Conte, E., Ennis, J. K., . . . & Seely, D. (2022). Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integrative Cancer Therapies, 21, 15347354221075576.


Subject(s)
Neoplasms , Yoga , Adult , Humans , Female , Middle Aged , Male , Yoga/psychology , Quality of Life , Depression/etiology , Depression/therapy , Depression/psychology , Research Design , Retrospective Studies , Neoplasms/therapy , Neoplasms/psychology , Fatigue/etiology , Fatigue/therapy , Patient Reported Outcome Measures
13.
Recenti Prog Med ; 115(3): 127-130, 2024 Mar.
Article in Italian | MEDLINE | ID: mdl-38411680

ABSTRACT

Depression is a prevalent mental disorder that can have severe impacts. Despite medical efforts, some individuals develop treatment-resistant depression (TRD) or difficult-to-treat depression (DTD). TRD includes those unresponsive to standard treatments, whereas DTD encompasses a broader range of factors affecting treatment outcomes. This article examines the distinctions between TRD and DTD, highlighting the need for personalized multidisciplinary approaches. It discusses various therapeutic options, including pharmacological, psychological, and neurostimulation therapies, emphasizing the significance of considering psychosocial factors and individualized care. Raising awareness among the public, experts, and clinicians about the importance of psychosocial and multidisciplinary aspects in managing DTD can help reduce the stigma associated with depression and improve patient quality of life.


Subject(s)
Depression , Mental Disorders , Humans , Depression/therapy , Drug Resistance, Neoplasm , Quality of Life
14.
BMJ ; 384: e075847, 2024 02 14.
Article in English | MEDLINE | ID: mdl-38355154

ABSTRACT

OBJECTIVE: To identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions. DESIGN: Systematic review and network meta-analysis. METHODS: Screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Bayesian arm based, multilevel network meta-analyses were performed for the primary analyses. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA) online tool. DATA SOURCES: Cochrane Library, Medline, Embase, SPORTDiscus, and PsycINFO databases. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Any randomised trial with exercise arms for participants meeting clinical cut-offs for major depression. RESULTS: 218 unique studies with a total of 495 arms and 14 170 participants were included. Compared with active controls (eg, usual care, placebo tablet), moderate reductions in depression were found for walking or jogging (n=1210, κ=51, Hedges' g -0.62, 95% credible interval -0.80 to -0.45), yoga (n=1047, κ=33, g -0.55, -0.73 to -0.36), strength training (n=643, κ=22, g -0.49, -0.69 to -0.29), mixed aerobic exercises (n=1286, κ=51, g -0.43, -0.61 to -0.24), and tai chi or qigong (n=343, κ=12, g -0.42, -0.65 to -0.21). The effects of exercise were proportional to the intensity prescribed. Strength training and yoga appeared to be the most acceptable modalities. Results appeared robust to publication bias, but only one study met the Cochrane criteria for low risk of bias. As a result, confidence in accordance with CINeMA was low for walking or jogging and very low for other treatments. CONCLUSIONS: Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff. These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018118040.


Subject(s)
Depression , Depressive Disorder, Major , Humans , Network Meta-Analysis , Depression/therapy , Depressive Disorder, Major/therapy , Bayes Theorem , Exercise , Antidepressive Agents , Quality of Life , Randomized Controlled Trials as Topic
15.
J Affect Disord ; 352: 51-59, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38360361

ABSTRACT

OBJECTIVE: We synthesized the effects of mindfulness-based interventions (MBIs) on depression in pregnant women. METHOD: Ten electronic databases were searched from inception to September 2022. We reviewed studies on outcomes for pregnant women with depression receiving mindfulness-based interventions. We only reviewed studies written in English. A random-effects model was used to compute the effect size. Funnel plot, Q statistics, and I2 were used to test the heterogeneity across studies. We examined moderators to explore sources of heterogeneity. RESULTS: Across 19 included studies (N = 1480), 717 pregnant women participated in mindfulness interventions; 763 served as controls. Mean age ranged from 25.3 to 33.6 years. Overall, mindfulness-based interventions showed reduced depression compared to control groups (g = 0.457, 95%CI 0.254, 0.659, I2 = 68 %). With subgroup analysis, mindfulness-based cognitive therapy had a greater effect on reducing depressive symptoms (g = 1.13) than mindfulness-based stress reduction (g = 0.64) and adapted mindfulness-based interventions (g = 0.31). No quality indicators moderated the ES of mindfulness-based interventions on depression. CONCLUSION: Mindfulness-based interventions significantly improved depression among pregnant women, especially mindfulness-based cognitive therapy (MBCT). Clinicians and health providers should consider using MBIs as alternative complementary treatment for improving and preventing depression in pregnant women.


Subject(s)
Cognitive Behavioral Therapy , Depression , Mindfulness , Adult , Female , Humans , Pregnancy/psychology , Depression/therapy
16.
Geriatr Nurs ; 56: 304-311, 2024.
Article in English | MEDLINE | ID: mdl-38417183

ABSTRACT

Despite the increasing use of music therapy to treat patients with dementia, studies focused on developing nations are still in their embryonic stages. In this view, this study examined the impact of group music therapy intervention in ameliorating depression levels among older people in two care homes. A randomized control trial (RCT) was carried out in which a total of 121 patients were randomly divided into control 61 and experimental group 60. After 6 weeks, 12-session experiment which involved passive and active music therapy, it was found that music group therapy intervention reduced the depression level of older persons in the experimental group, compared to those who were not exposed to the music therapy; control group. The music therapy session also influenced the salivary cortisol of the patients as it was shown to reduce their salivary cortisol levels. It was also observed that after three months of follow-up, participants in the experimental group still maintained a low level of depression and salivary cortisol level, but the control group's level was still high, thus, substantiating the effect of music in reducing depression among older people. We encouraged clinicians, nursing practitioners and care homes in Nigeria to incorporate music therapy as part of the treatment offered to patients with dementia.


Subject(s)
Dementia , Music Therapy , Music , Psychotherapy, Group , Humans , Aged , Aged, 80 and over , Depression/therapy , Nursing Homes , Dementia/complications , Dementia/therapy , Hydrocortisone
17.
Int J Nurs Pract ; 30(2): e13243, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38351900

ABSTRACT

AIMS: This review aims to assess the effect of comprehensive nursing care on liver cancer patients undergoing interventional therapy in China. METHODS: In accordance with PRISMA guidelines, we reviewed randomized controlled trials and observational studies assessing the effect of comprehensive nursing care against standard care on liver cancer patients undergoing specific interventional therapies in China, including PubMed, Embase, CENTRAL and CINAHL till June 2023. Data synthesis was conducted using a random-effects model and reported as pooled odds ratio (OR) or mean difference (MD) or standardized mean differences (SMD). RESULTS: Ten Chinese studies with 1682 participants were evaluated. Comprehensive nursing care significantly enhanced patient outcomes in liver cancer treatment. Quality of life improved markedly (OR: 0.16, 95% CI: 0.06-0.41). Notable reductions were observed in anxiety (MD: -8.96, 95% CI: -11.52 to -6.40) and depression (MD: -9.47, 95% CI: -11.79 to -7.14). Patients also experienced increased physical (SMD: 1.70, 95% CI: 1.15-2.25), social (SMD: 1.65, 95% CI: 1.14-2.16) and activity scores (SMD: 1.94, 95% CI: 1.49-2.39), alongside a decrease in post-treatment complications (OR: 0.28, 95% CI: 0.21-0.37), demonstrating the multifaceted benefits of comprehensive care. CONCLUSION: Comprehensive nursing care may improve patient outcomes in liver cancer treatment, offering potential benefits in reducing the side effects of interventional therapy.


Subject(s)
Liver Neoplasms , Quality of Life , Humans , Depression/therapy , Anxiety/therapy , Liver Neoplasms/therapy , China
18.
Mult Scler ; 30(6): 747-750, 2024 May.
Article in English | MEDLINE | ID: mdl-38372030

ABSTRACT

BACKGROUND: Multiple studies have highlighted elevated rates of depression among individuals with Multiple Sclerosis (MS), with its associated symptoms posing a significant threat to overall well-being. Moreover, existing literature suggests a potential interconnection between depressive manifestations and the decline of physical functionalities in the context of MS. OBJECTIVE: to examine the viability of the Eye Movement Desensitization Reprocessing (EMDR) therapy protocol for the treatment of depressive disorders (DeprEND) for alleviating depression in individuals with MS. METHODS: We conducted a process-outcome study to examine the feasibilty and effectiveness DeprEND enrolling 13 individuals with MS and depressive symtpoms. Psychological and physical assessment pre-, post-intervention and 3-month follow-up were included. Pre- and post-magnetic resonance imaging (MRI) scans were conducted to analyze potential alterations in brain function. RESULTS: The EMDR DeprEND treatment showed a high level of adherence and feasibility. Significant reductions in depressive symptoms were found at post-intervention and at 3 months follow-up. No significant differences were observed in terms of physical symptoms. A significant modulation observed in parietal and premotor areas when examining negative valence stimuli post-treatment was found. CONCLUSION: for The EMDR DeprEND protocol may represent a feasible and cost-effective treatment for reducing depressive symptoms in MS patients and improving their mental well-being.


Subject(s)
Depression , Eye Movement Desensitization Reprocessing , Multiple Sclerosis , Humans , Pilot Projects , Eye Movement Desensitization Reprocessing/methods , Female , Male , Adult , Middle Aged , Multiple Sclerosis/therapy , Multiple Sclerosis/complications , Multiple Sclerosis/physiopathology , Depression/therapy , Depression/etiology , Magnetic Resonance Imaging , Treatment Outcome , Depressive Disorder/therapy
19.
Eur J Psychotraumatol ; 15(1): 2314913, 2024.
Article in English | MEDLINE | ID: mdl-38362742

ABSTRACT

Background: Stressful events increase the risk for treatment-resistant depression (TRD), and trauma-focused psychotherapy can be useful for TRD patients exposed to early life stress (ELS). Epigenetic processes are known to be related to depression and ELS, but there is no evidence of the effects of trauma-focused psychotherapy on methylation alterations.Objective: We performed the first epigenome-wide association study to investigate methylation changes related to trauma-focused psychotherapies effects in TRD patients.Method: Thirty TRD patients assessed for ELS underwent trauma-focused psychotherapy, of those, 12 received trauma-focused cognitive behavioural therapy, and 18 Eye Movement Desensitization and Reprocessing (EMDR). DNA methylation was profiled with Illumina Infinium EPIC array at T0 (baseline), after 8 weeks (T8, end of psychotherapy) and after 12 weeks (T12 - follow-up). We examined differentially methylated CpG sites and regions, as well as pathways analysis in association with the treatment.Results: Main results obtained have shown 110 differentially methylated regions (DMRs) with a significant adjusted p-value area associated with the effects of trauma-focused psychotherapies in the entire cohort. Several annotated genes are related to inflammatory processes and psychiatric disorders, such as LTA, GFI1, ARID5B, TNFSF13, and LST1. Gene enrichment analyses revealed statistically significant processes related to tumour necrosis factor (TNF) receptor and TNF signalling pathway. Stratified analyses by type of trauma-focused psychotherapy showed statistically significant adjusted p-value area in 141 DMRs only for the group of patients receiving EMDR, with annotated genes related to inflammation and psychiatric disorders, including LTA, GFI1, and S100A8. Gene set enrichment analyses in the EMDR group indicated biological processes related to inflammatory response, particularly the TNF signalling pathway.Conclusion: We provide preliminary valuable insights into global DNA methylation changes associated with trauma-focused psychotherapies effects, in particular with EMDR treatment.


Stressful events increase treatment-resistant depression, and trauma-focused psychotherapy can be useful for these patients.Epigenome-wide data shows changes associated with trauma-focused psychotherapies, especially eye movement desensitization and reprocessing therapy, in treatment-resistant depression patients.Genes and biological pathways related to inflammatory and immune systems are among the most statistically significant results.


Subject(s)
DNA Methylation , Stress Disorders, Post-Traumatic , Humans , DNA Methylation/genetics , Depression/genetics , Depression/therapy , Prospective Studies , Longitudinal Studies , Stress Disorders, Post-Traumatic/therapy , Psychotherapy
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