Facilitating Thought Progression Reduces Depressive Symptoms: A Randomized Controlled Trial.

BACKGROUND: The constant rise in prevalence of Major Depressive Disorder calls for new, effective, and accessible interventions that can rapidly and effectively reach a wide range of audiences. Recent developments in the digital health domain suggest that dedicated online platforms may potentially address this gap. Focusing on targeting ruminative thought, a major symptomatic hallmark of depression, here we hypothesized that delivering a digital-health based intervention designed to systematically facilitate thought progression would significantly alleviate depression. OBJECTIVE: The study aimed to investigate the efficacy of a novel digital intervention on the reduction of depressive symptoms. This intervention was designed as an easy-to-use, gamified app, specifically aimed to facilitate thought progression (FTP) through intense practicing of associative, semantically broad, fast, and creative thought patterns. METHODS: A randomized clinical trial was conducted, comparing changes in depression symptoms between participants who played the app in the intervention group (n=74) and waitlist controls (n=27) over the course of eight weeks. All participants filled out a battery of clinical questionnaires to assess the severity of depression at baseline and four and eight weeks after starting the study. These primarily included the MADRS (Montgomery-Åsberg Depression Rating Scale) and the PHQ-9 (Patient Health Questionnaire-9), as well as PANAS-NA (Positive Affect Negative Affect Scale- Negative Affect Score), RRS (Rumination Response Scale) and SDQ (Symptoms of Depression Questionnaire). Additional questionnaires were implemented to assess anxiety, positive affect, anhedonia and quality of life. RESULTS: The results indicate that across multiple clinical measurements, participants in the intervention group who played the app showed greater and faster improvement in depressive symptoms compared with their waitlist control counterparts. The difference between the groups in MADRS improvement was -7.01 points (95% confidence interval [CI], -10.72 to -3.29; p=0.0003, Cohen's d=0.67). Furthermore, difference in improvement between groups persisted up to four weeks post-trial (MADRS differences at week twelve: F(49,2)= 6.62, p= 0.003, ηp2 =0.21). At the end of the trial playing participants showed high interest in continuing using the app. CONCLUSIONS: The results demonstrate that a gamified app designed to facilitate thought progression is associated with improvement in depressive symptoms. Given its innovative and accessibility features, this gamified method for facilitating thought progression may successfully complement traditional treatments for depression in the future, safely and effectively improving the lives of large populations suffering from depression and anxiety.

Physical and mental impact of COVID-19 outbreak on fibromyalgia patients.

OBJECTIVES: Acute or chronic stress may trigger or aggravate symptoms of fibromyalgia (FM). We aimed to evaluate the physical and mental health of fibromyalgia patients during the COVID 19 outbreak and identify protective/risk factors. METHODS: An online survey was published in May 2020, following two months of lockdown due to the COVID 19 outbreak, including questionnaires regarding demographic characteristics, access to medical services, anxiety, depression, life approach, coping strategies, perception of social support, widespread pain index (WPI) and symptoms severity scale (SSS), insomnia severity index (ISI) and patient global assessment. RESULTS: Of the 233 patients included in the study, 98% were forced to discontinue complementary or alternative treatments during lockdown. Up to 30% of responders who had been treated with medical cannabis had to stop due to logistic difficulties and this was associated with significantly higher scores of WPI/SSS (p=0.024). Higher levels of anxiety and depression were significantly correlated with higher levels of pain, sleep disorders and subjective perception of deterioration (p=0.00). Higher scores of social support and positive life approach were correlated with less anxiety and depression (p<0.01), lower levels of pain (p<0.05) and less sleep disturbances (p<0.01). Avoidant coping style was strongly associated to higher levels of pain, sleep disturbances, anxiety, depression, and subjective perception of worsening (p<0.01). CONCLUSIONS: Fibromyalgia patients reported adverse mental and physical outcomes during the COVID-19 outbreak. Factors such as stopping current treatments may play a central role. Social support and a positive life approach appear to be protective.

Unraveling sub-seasonal precipitation variability in the Middle East via Indian Ocean sea surface temperature.

This study examines sub-seasonal precipitation anomalies, challenging to predict yet vital for society and the environment. Focusing on October, we investigate correlations between the Indian Ocean Dipole Mode Index (DMI), West Tropical Indian Ocean Index (WTIO), and Middle Eastern precipitation. We find robust correlations (~ 0.7), up to a two-month lag, demonstrating strong links between these climate indices and rainfall patterns, potentially suggesting sub-seasonal precipitation predictability. Over the past four decades, DMI and WTIO have shown a significant upward trend of ~ 0.4 °C, intensifying their impact on precipitation dynamics. This trend signifies evolving Indian Ocean climate patterns with potential regional consequences and is projected to continue in the twenty-first century. Significant correlations also emerge between DMI, WTIO, and maximum daily precipitation, highlighting their role in extreme rainfall events. Finally, our study attributes most of October's precipitation variability to Indian Ocean sea surface temperature variations. These temperature anomalies influence the Indian Ocean's Walker circulation, affecting water vapor flux to the Middle East and shaping regional precipitation. Our findings underscore the importance of these indices in understanding and predicting Middle East climate variability, revealing intricate ocean-atmosphere interactions.