Depressed mood as a transdiagnostic target relevant to anxiety and/or psychosis: a scoping review protocol.

INTRODUCTION: Depressed mood is a psychological state characterised by sadness or loss of interest in activities. Depressed mood is a highly prevalent symptom across major mental disorders. However, there is limited understanding of the burden and management of comorbid depressed mood across major mental disorders. Therefore, this scoping review aims to summarise knowledge on depressed mood among persons with anxiety and/or psychosis. The specific aims are to describe the epidemiology and risk factors of depressed mood as a transdiagnostic target among persons with anxiety and/or psychosis, to identify commonly used outcome measures for depressed mood and to outline initial evidence of psychometric robustness and to identify and summarise the effectiveness of commonly applied depressed mood modification interventions. Our hope is that the proposed review will provide insights into the burden of depressed mood in persons with anxiety and psychosis and help to identify evidence gaps and recommendations for future research. METHODS AND ANALYSIS: This scoping review will be conducted per Arksey and O'Malley's framework. We will first search for peer-reviewed articles and grey literature published from 2004 to 2023 in PubMed, Scopus, Web of Science, Africa-Wide Information, CINAHL, PsycINFO, Academic Search Premier, Humanities International Complete, Sabinet, SocINDEX, Open Grey and Google Scholar. We will include articles reporting depressed mood (subthreshold depression) among persons with anxiety and/or psychosis. Studies recruiting participants meeting depression diagnostic criteria and those published in non-English languages will be excluded. Two independent researchers will extract the data. We will analyse and chart data collaboratively with researchers with lived experiences of depressed mood. ETHICS AND DISSEMINATION: This study does not require ethical approval as it is a literature review. The results will be submitted for publication in a peer-reviewed journal.

Evaluation of the Friendship Bench' Circle Kubatana Tose (CKT): an add-on support group intervention - a mixed-methods pilot interventional cohort study protocol.

INTRODUCTION: Mental disorders are endemic. However, the mental health treatment gap remains high, especially in low-resource settings. Task-shifting is a universally recommended strategy to mitigate the care gap. The Friendship Bench (FB), a task-shifting, low-intensity psychotherapy programme founded in Zimbabwe, is effective in managing anxiety and depression. The FB programme offers clients the choice of joining add-on mental health support groups known as Circle Kubatana Tose (CKT). These groups offer an opportunity for continued psychoeducation, social support and economic strengthening. However, the evidence base for the effectiveness of add-on support groups is sparse. We hypothesise that participation in CKT is associated with increased adherence to treatment regimens, social support and well-being. This mixed-methods prospective cohort study seeks to evaluate the intermediate effects (6-month follow-up) of CKT groups, including process outcome evaluation. METHODS AND ANALYSIS: We will recruit participants (N=178) receiving mental healthcare from the FB in Harare primary care clinics. Follow-up assessments will occur at enrolment, 6 weeks, 3 months and 6 months, assessing changes in common mental disorders (depression and anxiety), social support, positive psychological indices (hope and resilience), health-related quality of life, working alliance, economic outcomes (net income) and implementation outcome (feasibility, acceptability/satisfaction and uptake of services). Quantitative data will be analysed using descriptive analysis, bivariate statistics, Cox proportional hazard models and generalised mixed models (maximum likelihood estimation). Qualitative data will be analysed using thematic analysis. DISSEMINATION AND ETHICS: Ethical approval was granted by the Medical Research Council of Zimbabwe (MRCZ/A/2427). The findings will inform the potential utility of add-on support groups in the management of anxiety and depression using task-shifting. Dissemination study outcomes will be disseminated in academic journals, social media, conferences and policy briefs.

Perceived benefits and barriers to exercise and associated factors among Zimbabwean undergraduate students: a cross-sectional study.

Background: Despite the well-documented benefits of regular physical activity (PA), many university students are physically inactive. Personal, socio-economic, and environmental factors predict PA engagement behaviours in university students. There is a need to understand context-specific perceived barriers and benefits to exercise engagement and physical activity levels amongst university students from low-income settings. This study primarily evaluated the barriers and facilitators to PA engagement in Zimbabwean undergraduate students. We also assessed the correlates of perceived barriers and benefits to PA engagement, risk of common mental disorders (CMDs) and health-related quality of life (HRQoL). Methods: We used a cross-sectional study to recruit 465 university undergraduate students. The Exercise Benefits and Barriers Scale, International Physical Activity Questionnaire (IPAQ), Shona Symptoms Questionnaire (SSQ-8) and EuroQol 5 Dimension (EQ5D-5l) were used to measure barriers and facilitators, physical activity level, risk of depression and anxiety and HRQoL, respectively. Data were analysed through descriptive statistics and logistic regression. Results and conclusion: Most participants were male (58.5%) with a mean age of 21.7 (SD 1.6) years. Majority of the participants were first year students (37.2%), consumed alcohol (66.5%), did not smoke (88.2%) and had a normal BMI (64.7%). The prevalence of low PA levels was 17.4%, with 33.5% of students at risk of CMDs. The most perceived benefits were in the physical performance (e.g., exercise improves my level of physical fitness) and life enhancement (e.g., exercise improves my self-concept) domains, while the most perceived barriers were lack of exercise infrastructure (e.g., exercise facilities do not have convenient schedules) and physical exertion (e.g., exercise tires me). Food insecurity (AOR 2.51: 95% CI 1.62-3.88) and the risk of CMDs (AOR 0.49: 95% CI 0.32-0.76) were associated with increased odds of experiencing barriers to exercise. Not using substances (AOR = 2.14: 95% CI 1.11-4.14) and a higher self-rated HRQoL (AOR 24.34: 95% CI 1.77-335.13) were associated with increased odds of a high perception of exercise benefits. Improving access to community and on-campus exercise facilities and campus-wide health promotional interventions is necessary to enhance PA amongst university students.