JustKiddo/KiddosVault huggingface dataset:
Internet-based treatment of major depression for patients on a waiting list for inpatient psychotherapy: protocol for a multi-centre randomised controlled trial.

Major depressive disorder (MDD) is a prevalent and severe disorder. Although effective treatments for MDD are available, many patients remain untreated, mainly because of insufficient treatment capacities in the health care system. Resulting waiting periods are often associated with prolonged suffering and impairment as well as a higher risk of chronification. Web-based interventions may help to alleviate these problems. Numerous studies provided evidence for the efficacy of web-based interventions for depression. The aim of this study is to evaluate a new web-based guided self-help intervention (GET.ON-Mood Enhancer-WL) specifically developed for patients waiting to commence inpatient therapy for MDD. In a two-armed randomised controlled trial (n=200), the web-based guided intervention GET.ON-Mood Enhancer-WL in addition to treatment as usual (TAU) will be compared with TAU alone. The intervention contains six modules (psycho education, behavioural activation I & II, problem solving I & II, and preparation for subsequent inpatient depression therapy). The participants will be supported by an e-coach, who will provide written feedback after each module. Inclusion criteria include a diagnosis of MDD assessed with a structured clinical interview [SCID] and a waiting period of at least three weeks before start of inpatient treatment. The primary outcome is observer-rated depressive symptom severity (HRSD24). Further (explorative) questions include whether remission will be achieved earlier and by more patients during inpatient therapy because of the web-based preparatory intervention. If GET.ON-Mood Enhancer-WL is proven to be effective, patients may start inpatient therapy with reduced depressive symptom severity, ideally leading to higher remission rates, shortened inpatient therapy, reduced costs, and decreased waiting times. German Clinical Trial Registration (DRKS): DRKS00004708.
Patients' interpersonal problems as moderators of depression outcomes in a randomized controlled trial comparing mindfulness-based cognitive therapy and a group version of the cognitive-behavioral analysis system of psychotherapy in chronic depression.

Interpersonal problems were examined as moderators of depression outcomes between mindfulness-based cognitive therapy (MBCT) and cognitive behavioral analysis system of psychotherapy (CBASP) in patients with chronic depression. Patients received treatment-as-usual and, in addition, were randomized to 8-weeks of MBCT (n=34) or 8-weeks of CBASP (n=34). MBCT and CBASP were given in a group format. The Hamilton depression rating scale (HAM-D) was the primary and the Beck Depression Inventory (BDI-II) the secondary outcome. The subscales of the Inventory of interpersonal problems (IIP-32) were moderators. Multilevel models were performed. Higher scores on the "vindictive/self-centered" subscale were associated with a better outcome in MBCT than in CBASP (HAM-D: p<.01; BDI-II: p<.01). Higher scores on the "nonassertive" subscale were associated with a better outcome in CBASP than in MBCT (HAM-D: p<.01; BDI-II: p<.01). If these results can be replicated in larger trials, MBCT should be preferred to CBASP in chronically depressed patients being vindictive/self-centered, whereas CBASP should be preferred to MBCT in chronically depressed patients being nonassertive.
Efficacy of psychological interventions for young adults with mild-to-moderate depressive symptoms: A meta-analysis.

Psychological interventions are commonly used to treat mild-to-moderate depression, but their efficacy in young adults has not been exhaustively addressed. This meta-analysis aims to establish it in comparison to no treatment, wait-list, usual treatment, passive interventions, and other bona-fide treatments. The search was conducted in Scopus, MEDLINE, PsycINFO, ClinicalTrials.gov, the ISRCTN Registry, Cochrane CENTRAL, Clarivate BIOSIS Previews and the METAPSY database, retrieving studies from the start of records to April 2020. Eligibility criteria included samples of 16-30 years experiencing mild-to-moderate depressive symptoms and participating in randomized controlled trials (RCTs), non-RCTs, or pre-post studies measuring depressive symptomatology and featuring psychological treatments. Up to 45 studies met criteria, consisting of 3,947 participants, assessed using the Quality Assessment Tool for Quantitative Studies and their results meta-analyzed assuming random effects. Psychological interventions proved to be efficacious in RCTs compared to no treatment (g = -0.68; 95% CI = -0.87, -0.48) and wait-list (g = -1.04; 95% CI = -1.25, -0.82), while depressive symptoms also improved in pre-post studies (g = -0.99; 95% CI = -1.32, -0.66). However, intervention efficacy was similar to usual care, passive, and bona-fide comparators. The heterogeneity found, a likely reporting bias and the low quality of most studies must be considered when interpreting these results. Psychological treatments are efficacious to reduce depressive symptoms in young adults, but comparable to other interventions in the mild-to-moderate range. Moderators like depression severity or therapist involvement significantly influenced their efficacy, with results encouraging clinicians to adopt flexible and personalized approaches.
Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: a randomized pilot study.

This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM + EFT). MM followed the Texas Medication Algorithm Project guidelines. Fifteen EFT sessions were delivered following the EFT treatment manual. The primary outcome was severity of depressive symptoms (assessed by the 30-item Inventory of Depressive Symptomatology-Clinician Rated version [IDS-C(30) ] administrated by evaluators blinded to cell assignment). Secondary outcome was relationship quality as assessed by the Quality of Marriage Index. Results from assessments at intake, termination, and two posttreatment follow-ups were analyzed using growth analysis techniques. IDS-C(30) scores improved over 6 months of treatment, regardless of the treatment assignment, and women receiving MM + EFT experienced significantly more improvement in relationship quality compared with women in MM. Because relationship discord after depression treatment predicts worse outcome, interventions improving relationship quality may reduce depression relapse and recurrence. Testing this hypothesis in larger samples with longer follow-up could contribute to knowledge on the mechanisms involved in determining the course of depressive illness.
A review of empirically supported psychological therapies for mood disorders in adults.

The mood disorders are prevalent and problematic. We review randomized controlled psychotherapy trials to find those that are empirically supported with respect to acute symptom reduction and the prevention of subsequent relapse and recurrence. We searched the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to identify appropriate articles. One hundred twenty-five studies were found evaluating treatment efficacy for the various mood disorders. With respect to the treatment of major depressive disorder (MDD), interpersonal psychotherapy (IPT), cognitive behavior therapy (CBT), and behavior therapy (BT) are efficacious and specific and brief dynamic therapy (BDT) and emotion-focused therapy (EFT) are possibly efficacious. CBT is efficacious and specific, mindfulness-based cognitive therapy (MBCT) efficacious, and BDT and EFT possibly efficacious in the prevention of relapse/recurrence following treatment termination and IPT and CBT are each possibly efficacious in the prevention of relapse/recurrence if continued or maintained. IPT is possibly efficacious in the treatment of dysthymic disorder. With respect to bipolar disorder (BD), CBT and family-focused therapy (FFT) are efficacious and interpersonal social rhythm therapy (IPSRT) possibly efficacious as adjuncts to medication in the treatment of depression. Psychoeducation (PE) is efficacious in the prevention of mania/hypomania (and possibly depression) and FFT is efficacious and IPSRT and CBT possibly efficacious in preventing bipolar episodes. The newer psychological interventions are as efficacious as and more enduring than medications in the treatment of MDD and may enhance the efficacy of medications in the treatment of BD.
Optimizing Treatment of Complicated Grief: A Randomized Clinical Trial.

To our knowledge, this is the first placebo-controlled randomized clinical trial to evaluate the efficacy of antidepressant pharmacotherapy, with and without complicated grief psychotherapy, in the treatment of complicated grief. To confirm the efficacy of a targeted complicated grief treatment (CGT), determine whether citalopram (CIT) enhances CGT outcome, and examine CIT efficacy without CGT. Included in the study were 395 bereaved adults who met criteria for CG recruited from March 2010 to September 2014 from academic medical centers in Boston, Massachusetts; New York, New York; Pittsburgh, Pennsylvania; and San Diego, California. Co-occurring substance abuse, psychosis, mania, and cognitive impairment were exclusionary. Study participants were randomized using site-specific permuted blocks stratified by major depression into groups prescribed CIT (n=101), placebo (PLA; n=99), CGT with CIT (n=99), and CGT with PLA (n=96). Independent evaluators conducted monthly assessments for 20 weeks. Response rates were compared under the intention-to-treat principle, including all randomized participants in a logistic regression with inverse probability weighting. All participants received protocolized pharmacotherapy optimized by flexible dosing, psychoeducation, grief monitoring, and encouragement to engage in activities. Half were also randomized to receive manualized CGT in 16 concurrent weekly sessions. Complicated grief-anchored Clinical Global Impression scale measurments every 4 weeks. Response was measured as a rating of "much improved" or "very much improved." Of the 395 study participants, 308 (78.0%) were female and 325 (82.3%) were white. Participants' response to CGT with PLA vs PLA (82.5% vs 54.8%; relative risk [RR], 1.51; 95% CI, 1.16-1.95; P=.002; number needed to treat [NNT], 3.6) suggested the efficacy of CGT, and the addition of CIT did not significantly improve CGT outcome (CGT with CIT vs CGT with PLA: 83.7% vs 82.5%; RR, 1.01; 95% CI, 0.88-1.17; P=.84; NNT, 84). However, depressive symptoms decreased significantly more when CIT was added to treatment (CGT with CIT vs CGT with PLA: model-based adjusted mean [standard error] difference, -2.06 [1.00]; 95% CI, -4.02 to -0.11; P=.04). By contrast, adding CGT improved CIT outcome (CIT vs CGT with CIT: 69.3% vs 83.7%; RR, 1.21; 95% CI, 1.00-1.46; P=.05; NNT, 6.9). Last, participant response to CIT was not significantly different from PLA at week 12 (45.9% vs 37.9%; RR, 1.21; 95% CI, 0.82-1.81; P=.35; NNT, 12.4) or at week 20 (69.3% vs 54.8%; RR, 1.26; 95% CI, 0.95-1.68; P=.11; NNT, 6.9). Rates of suicidal ideation diminished to a substantially greater extent among participants receiving CGT than among those who did not. Complicated grief treatment is the treatment of choice for CG, and the addition of CIT optimizes the treatment of co-occurring depressive symptoms. clinicaltrials.gov Identifier: NCT01179568.
Challenges and Solutions for Depression Prevention Research: Methodology for a Depression Prevention Trial for Older Adults with Knee Arthritis and Emotional Distress.

To describe the methodology, challenges, and baseline characteristics of a prevention development trial entitled "Reducing Pain, Preventing Depression." A sequential multiple assignment randomized trial (SMART) compared sequences of cognitive behavioral therapy (CBT) and physical therapy for knee pain and prevention of depression and anxiety. Participants were randomized to CBT, physical therapy, or enhanced usual care and followed for 12 months for new-episode depression or anxiety. Participants were age≥60 with knee osteoarthritis and subsyndromal depression, defined as 9-item Patient Health Questionnaire (PHQ-9) score≥1 (which included the endorsement of one of the cardinal symptoms of depression [low mood or anhedonia]) and no diagnosis of major depressive disorder per the Structured Clinical Interview for DSM-IV. Depression and anxiety severity and characterization of new episodes were assessed with the PHQ-9, Generalized Anxiety Disorder-7, and the PRIME-MD. Knee pain was characterized with the Western Ontario McMaster Arthritis Index. Response was defined as at least "Very Much Better" on a Patient Global Impression of Change. At baseline there were 99 patients with an average age of 71; 61.62% were women and 81.8% white. The average PHQ-9 was 5.6 and average Generalized Anxiety Disorder-7, was 3.2. Most were satisfied with the interventions and study procedures. The challenges and solutions described here will also be used in a confirmatory clinical trial of efficacy. A SMART design for depression and anxiety prevention, using both CBT and physical therapy, appears to be feasible and acceptable to participants. The methodologic innovations of this project may advance the field of late-life depression and anxiety prevention.
Biological markers evaluated in randomized trials of psychological treatments for depression: a systematic review and meta-analysis.

Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding. We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression. Fifty-one trials (5123 participants) and a pooled analysis were included. Biological markers were outcomes in 43 studies and predictors of treatment response in 9. At post-treatment, psychotherapy could not be distinguished from control conditions for glycaemic control (Hb1AC), 7 trials, Hedges' g= -.01, 95% CI -0.30 to 0.29, I2=65% and cortisol concentration after-wake, 5 trials, Hedges' g= -.19, 95% CI -0.45 to 0.06, I2=0%. Follow-up results were similar. For the other biological domains (immunological, neurobiological, inflammatory, weight, blood pressure), overall findings were mixed and often inconsistent. Few trials investigated prediction of response, with only neuroimaging markers showing promise. Across domains, we found limited evidence that benefits of psychological treatments for depression translate to biological outcomes.
The applicability of bright light therapy in adults with moderate, severe or profound intellectual disabilities: a brief report.

Bright light therapy (BLT) is effective in the treatment of depression in the general population. It may be a good treatment option for adults with intellectual disabilities (ID) too. However, its applicability and effectiveness are not studied in groups of adults with ID, yet. Our aim was to study the applicability of BLT in adults with ID. Bright light therapy was offered for 2 weeks, using a 10 000 lux light box, to 14 adults with moderate, severe or profound ID. Applicability of BLT and change in depressive symptoms were studied with questionnaires. Bright light therapy was successfully applied for ≥10 days in 10 participants. It was also applicable in participants with rather severe challenging behaviour. Before BLT, nine participants scored above the cut-off score of the ADAMS' depressive mood subscale. After BLT, six of them scored below cut-off. Bright light therapy is applicable in adults with moderate, severe of profound ID. Its effectiveness as a treatment for depression in adults with ID should be further studied.
Treatment expectations for cognitive-behavioral therapy and light therapy for seasonal affective disorder: Change across treatment and relation to outcome.

To examine the dynamic relationship between treatment expectations and treatment outcome over the course of a clinical trial for winter seasonal affective disorder (SAD). Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern (N = 177) were randomized to 6 weeks of group-delivered cognitive-behavioral therapy for SAD (CBT-SAD) or light therapy (LT). The majority were female (83.6%) and white (92.1%), with a mean age of 45.6 years. Treatment expectations for CBT-SAD and LT were assessed using a modification of the Treatment Expectancy and Credibility Survey (Borkovec & Nau, 1972). Depression severity was assessed using the Beck Depression Inventory-Second Edition (Beck, Steer, & Brown, 1996). All measures were administered at pretreatment, midtreatment, and posttreatment. As treatment progressed, expectations for the treatment received increased across time steeply in CBT-SAD patients and moderately in LT patients. Collapsing across time, patients with higher treatment expectations had lower depression severity than those with lower treatment expectations. In a cross-lagged panel path analysis, there was a significant effect of treatment expectations at midtreatment on depression severity at posttreatment among CBT-SAD patients. Treatment expectations changed across treatment, affected outcome, and should be assessed and monitored repeatedly throughout treatment. Findings suggest that treatment expectations at midtreatment are a mechanism by which CBT-SAD reduces depression, which should be replicated in SAD samples and examined for generalizability to nonseasonal depression. These findings underscore the importance of further research examining treatment expectations in mediating CBT's effects in depression and other types of psychopathology. (PsycINFO Database Record
Circadian reinforcement therapy in combination with electronic self-monitoring to facilitate a safe post-discharge period of patients with depression by stabilizing sleep: protocol of a randomized controlled trial.

The transition phase from inpatient to outpatient care for patients suffering from Major Depressive Disorder represents a vulnerable period associated with a risk of depression worsening and suicide. Our group has recently found that the sleep-wake cycle in discharged depressive patients became irregular and exhibited a drift towards later hours, associated with worsening of depression. In contrast, an advancement of sleep phase has earlier been shown to have an antidepressant effect. Thus, methods to prevent drift of the sleep-wake cycle may be promising interventions to prevent or reduce worsening of depression after discharge. In this trial, we apply a new treatment intervention, named Circadian Reinforcement Therapy (CRT), to patients discharged from inpatient psychiatric wards. CRT consists of a specialized psychoeducation on the use of regular time signals (zeitgebers): daylight exposure, exercise, meals, and social contact. The aim is to supply stronger and correctly timed zeitgebers to the circadian system to prevent sleep drift and worsening of depression. The CRT is used in combination with an electronic self-monitoring system, the Monsenso Daybuilder System (MDB). By use of the MDB system, all patients self-monitor their sleep, depression level, and activity (from a Fitbit bracelet) daily. Participants can inspect all their data graphically on the MDB interface and will have clinician contact. The aim is to motivate patients to keep a stable sleep-wake cycle. In all, 130 patients referred to an outpatient service will be included. Depression rating is blinded. Patients will be randomized 1:1 to a Standard group or a CRT group. The intervention period is 4 weeks covering the transition phase from inpatient to outpatient care. The primary outcome is score change in interviewer rated levels of depression on the Hamilton Depression Rating Scale. A subset of patients will be assessed with salivary Dim Light Melatonin Onset (DLMO) as a validator of circadian timing. The trial was initiated in 2016 and will end in 2020. If the described intervention is beneficial it could be incorporated into usual care algorithms for depressed patients to facilitate a better and safer transition to outpatient treatment. Posted prospectively at ClinicalTrials.gov at February 10, 2016 with identifier NCT02679768 .
Effectiveness of light therapy for depression among active duty service members: A nonrandomized controlled pilot trial.

The authors investigated the potential effectiveness of light therapy as an augmentation treatment for depression among active duty service members. This pilot study recruited active duty service members deployed to an area of combat operations. Enrollment was offered to service members scoring 50 or greater on the Zung Self-Rating Depression Scale. The authors implemented a systematic sampling technique randomly assigning the first subject and then alternating each subsequent subject to either a reference group which received the usual standard of care plus light therapy at 10,000 lux or a control group which received the usual standard of care and light therapy at 50 lux. Both groups received 90 min light sessions for five days. The study was conducted at Walter Reed Army Medical Center's Psychiatry Continuity Service. Zung Self-Rating Depression Scale collected at baseline, after five consecutive daily light sessions, and one week later. A repeated measures analysis of variance (RM ANOVA) was conducted to examine the change in Zung Depression results which showed a significant main effect for time F(2, 21)=5.05, p<0.02, indicating that depression scores reduced over time for both participant groups. Post hoc comparisons (with Bonferroni correction) demonstrated that the post-treatment Zung score was significantly lower indicating less depression than the baseline Zung score (p<0.004) and there was a statistical trend (p<0.05) for depression scores to be reduced halfway through the study in the treatment group. The post hoc analysis hints at the possibility of a reduction in depression during the active phase of light treatment.
Wake and light therapy for moderate-to-severe depression - a randomized controlled trial.

To examine the efficacy of using wake and light therapy as a supplement to standard treatment of hospitalized patients with depression. In this randomized, controlled study, 64 patients with moderate-to-severe depression were allocated to standard treatment or to the intervention, which additionally consisted of three wake therapy sessions in one week, 30-min daily light treatment and sleep time stabilization over the entire nine-week study period. Patients in the wake therapy group had a significant decrease in depressive symptoms in week one as measured by HAM-D17 , 17.39 (CI 15.6-19.2) vs. 20.19 (CI 18.3-22.09) (P = 0.04), whereas no statistically significant differences were found between the groups in weeks two to nine. At week nine, the wake therapy group had a significantly larger increase in general self-efficacy (P = 0.001), and waking up during nights was a significantly less frequent problem (1.9 times vs. 3.2) (P = 0.0008). In most weeks, significantly fewer patients in the wake therapy group slept during the daytime, and if they slept, their naps were shorter (week three: 66 min vs. 117 min P = 0.02). The antidepressant effect initially achieved could not be maintained during the nine-week study period. However, sleep and general self-efficacy improved.