Understanding the potential of digital therapies in implementing the standard of care for depression in Europe.

Depressive disorders represent the largest proportion of mental illnesses, and by 2030, they are expected to be the first cause of disability-adjusted life years [1]. The COVID-19 pandemic exacerbated prevalence and burden of depression and increased the occurrence of depressive symptoms in general population [2]. The urgency of implementing mental health services to address new barriers to care persuaded clinicians to use telemedicine to follow patients and stay in touch with them, and to explore digital therapeutics (DTx) as potential tools for clinical intervention [2]. The combination of antidepressants and psychotherapy is widely recommended for depression by international guidelines [3] but is less frequently applied in real-world practice. Commonly used treatments are pharmacological, but while being effective, some aspects such as adherence to the drug regimen, residual symptoms, resistance, lack of information, and stigma may hinder successful treatment. In case of less severe depression, standalone psychological therapies should be the first-line treatment option [3], but access to trained psychotherapists remains inequitable. DTx are evidence-based therapies driven by software programs to treat or complement treatment of a specific disease. DTx are classified as Medical Devices, and given their therapeutic purpose, they need to be validated through randomized controlled clinical trials, as for drug-based therapies. In the last 10 years, studies of digital interventions have proliferated; these studies demonstrate that digital interventions increase remission rates and lower the severity of depressive symptoms compared with waitlist, treatment as usual, and attention control conditions [4]. Despite the efficacy demonstrated in clinical trials, many of these tools never reach real-life patients; thus, it might be necessary to implement DTx in the public health system to expand access to valid treatment options. In this framework, DTx represent a good opportunity to help people with depression receive optimal psychotherapeutic care [5].

Validation of the French version of the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale.

BACKGROUND: Self-criticism and self-reassurance are internal processes of self-to-self relating that have received increasing attention in psychology. The Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS), which was first studied by Gilbert, Clarke, Hempel, Miles, and Irons, is a self-report instrument that has been used in various populations and has shown satisfactory reliability. The goal of this work is to explore the psychometric properties of a French version of the scale in a large nonclinical sample. METHOD: Data from 285 nonclinical participants were analysed. RESULTS: Confirmatory factor analysis indicated an acceptable to good fit of the FSCRS items to a three-factor model. Good internal consistency and convergent validity were found. CONCLUSIONS: The French validation results corroborate previous findings in a nonclinical population and confirm that the French version of the FSCRS is a robust and reliable instrument.