JustKiddo/KiddosVault huggingface dataset:
Relative effectiveness of augmentation treatments for treatment-resistant depression: a systematic review and network meta-analysis.

Most interventions for treatment-resistant depression (TRD) are added as augmenters. We aimed to determine the relative effectiveness of augmentation treatments for TRD. This systematic review and network meta-analysis (NMA) sought all randomized trials of pharmacological and psychological augmentation interventions for adults meeting the most common clinical criteria for TRD. The NMA compared the intervention effectiveness of depressive symptoms for TRD augmentation. Of 36 included trials, 27 were suitable for inclusion in NMA, and no psychological trials could be included in the absence of a common comparator. Antipsychotics (13 trials), mood stabilizers (three trials), NMDA-targeting medications (five trials), and other mechanisms (3 trials) were compared against placebo. NMDA treatments were markedly superior to placebo (ES=0.91, 95% CI 0.67 to 1.16) and head-to-head NMA suggested that NMDA therapies had the highest chance of being an effective treatment option compared to other pharmacological classes. This study provides the most comprehensive evidence of augmenters' effectiveness for TRD, and our GRADE recommendations can be used to guide guidelines to optimize treatment choices. Although conclusions are limited by paucity of, and heterogeneity between, trials as well as inconsistent reports of treatment safety. This work supports the use of NMDA-targeting medications such as ketamine.
The use of biofeedback intervention in the improvement of depression levels: a randomised trial.

To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group. A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher's exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2. The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group. The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.
Semantic organizational strategy predicts verbal memory and remission rate of geriatric depression.

This study tests the hypothesis that the use of semantic organizational strategy during the free-recall phase of a verbal memory task predicts remission of geriatric depression. Sixty-five older patients with major depression participated in a 12-week escitalopram treatment trial. Neuropsychological performance was assessed at baseline after a 2-week drug washout period. The Hopkins Verbal Learning Test-Revised was used to assess verbal learning and memory. Remission was defined as a Hamilton Depression Rating Scale score of ≤ 7 for 2 consecutive weeks and no longer meeting the DSM-IV-TR criteria for major depression. The association between the number of clusters used at the final learning trial (trial 3) and remission was examined using Cox's proportional hazards survival analysis. The relationship between the number of clusters utilized in the final learning trial and the number of words recalled after a 25-min delay was examined in a regression with age and education as covariates. Higher number of clusters utilized predicted remission rates (hazard ratio, 1.26 (95% confidence interval, 1.04-1.54); χ(2) =4.23, df=3, p=0.04). There was a positive relationship between the total number of clusters used by the end of the third learning trial and the total number of words recalled at the delayed recall trial (F(3,58)=7.93; p<0.001). Effective semantic strategy use at baseline on a verbal list learning task by older depressed patients was associated with higher rates of remission with antidepressant treatment. This result provides support for previous findings indicating that measures of executive functioning at baseline are useful in predicting antidepressant response.
The effects of rational emotive behavior therapy for depressive symptoms in adults with congenital heart disease.

Over 30% of adults with congenital heart disease (CHD) experience depression. To evaluate the effectiveness of Rational Emotive Behavior Therapy (REBT) in reducing depressive symptoms in adults with CHD. Forty-two adults with CHD were recruited from an outpatient clinic and randomized to a study group (n = 21), which comprised 8-weekly group-based counseling sessions, or a control group (n = 21), which received usual care. REBT effectiveness was examined using the Hamilton Depression Rating Scale, Beck Depression Inventory, Shorten General Attitude and Belief Scale, and salivary cortisol levels before therapy, after the last session, and at follow-up 4 weeks later. Average participant ages were 30.1 ± 7.58 and 33.3 ± 7.1 years in study and control groups, respectively; 52.4% of participants in each group were female. After REBT, depression (p < 0.001), irrational beliefs (p < 0.001), and salivary cortisol levels (p = 0.006) were significantly lower in the study group than in the control group. Effects of REBT in the study group remained consistent at the 4-week follow-up. REBT may be effective in reducing depression in adults with CHD.
Complementary therapies for clinical depression: an overview of systematic reviews.

As clinical practice guidelines vary widely in their search strategies and recommendations of complementary and alternative medicine (CAM) for depression, this overview aimed at systematically summarising the level 1 evidence on CAM for patients with a clinical diagnosis of depression. PubMed, PsycInfo and Central were searched for meta-analyses of randomised controlled clinical trials (RCTs) until 30 June 2018. Outcomes included depression severity, response, remission, relapse and adverse events. The quality of evidence was assessed according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) considering the methodological quality of the RCTs and meta-analyses, inconsistency, indirectness, imprecision of the evidence and the potential risk of publication bias. The literature search revealed 26 meta-analyses conducted between 2002 and 2018 on 1-49 RCTs in major, minor and seasonal depression. In patients with mild to moderate major depression, moderate quality evidence suggested the efficacy of St. John's wort towards placebo and its comparative effectiveness towards standard antidepressants for the treatment for depression severity and response rates, while St. John's wort caused significant less adverse events. In patients with recurrent major depression, moderate quality evidence showed that mindfulness-based cognitive therapy was superior to standard antidepressant drug treatment for the prevention of depression relapse. Other CAM evidence was considered as having low or very low quality. The effects of all but two CAM treatments found in studies on clinical depressed patients based on low to very low quality of evidence. The evidence has to be downgraded mostly due to avoidable methodological flaws of both the original RCTs and meta-analyses not following the Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Further research is needed.
Feasibility and acceptability of a Whole-Body hyperthermia (WBH) protocol.

Whole-body hyperthermia (WBH) has shown promise as a non-pharmacologic treatment for major depressive disorder (MDD) in prior trials that used a medical (infrared) hyperthermia device. Further evaluation of WBH as a treatment for MDD has, however, been stymied by regulatory challenges. We examined whether a commercially available infrared sauna device without FDA-imposed limitations could produce the degree of core body temperature (101.3°F) associated with reduced depressive symptoms in prior WBH studies. We also assessed the frequency of adverse events and the amount of time needed to achieve this core body temperature. We explored changes (pre-post WBH) in self-reported mood and affect. Twenty-five healthy adults completed a single WBH session lasting up to 110min in a commercially available sauna dome (Curve Sauna Dome). We assessed core body temperature rectally during WBH, and mood and affect at timepoints before and after WBH. All participants achieved the target core body temperature (101.3°F). On average, it took participants 82.12min (SD=11.3) to achieve this temperature (range: 61-110min), and WBH ended after a participant maintained 101.3°F for two consecutive minutes. In exploratory analyses of changes in mood and affect, we found that participants evidenced reductions (t[24]=2.03, M diff = 1.00, p=.054, 95% CI [-2.02,0.02]) in self-reported depression symptoms from 1week pre- to 1week post-WBH, and reductions (t[24]= -2.93, M diff=-1.72, p=.007, 95% CI [-2.93, -0.51]) in self-reported negative affect pre-post-WBH session. This novel WBH protocol holds promise in further assessing the utility of WBH in MDD treatment. This trial was registered at clinicaltrivals.gov (NCT04249700).
Using mechanism of action to choose medications for treatment-resistant depression.

Remission rates for depression continue to be low, and for many patients, complex treatment regimens are needed for optimal response. Many physicians do not fully understand how and why depression medications work or which ones will complement each other. This CME Webcast covers the different mechanisms of action of current pharmacotherapeutic options for depression, both monotherapy and adjunctive medications, and shows clinicians how to use their understanding of mechanisms of action to choose the most effective treatment strategy for their patients, especially those with treatment-resistant or difficult-to-treat depression.
A randomized controlled trial of cognitive control training (CCT) as an add-on treatment for late-life depression: a study protocol.

Already a major health concern, late-life depression (LLD) is expected to form an increasing problem in the aging population. Moreover, despite current treatments, LLD is associated with a poor long-term prognosis and high rate of chronicity. Treatment provision and treatment accordingly warrant improvement, where add-on treatments might contribute to the efficacy of conventional therapies. Although it is known that impaired cognitive control contributes to LDD, it is not targeted sufficiently by current interventions. Research on cognitive control training (CCT) shows promising results on depressive symptoms, cognitive performance, and overall functioning. However, further research is needed to determine the long-term effects of CCT on LLD, its cost-effectiveness, and mechanisms of change. In the current multicenter randomized controlled trial (RCT) with a between-subjects design participants aged 60years and over with a current LLD receiving treatment as usual (TAU) are randomized to add-on CCT or placebo training. Randomization is stratified by depression severity. Participants will receive eight online CCT or placebo sessions spread across four consecutive weeks. They will complete a post-training assessment after 1 month and three follow-up assessments scheduled three, six and 12months after completing the training. We expect CCT and TAU to be more (cost-)effective in reducing depressive symptoms than placebo training and TAU. Additionally, we will be looking at secondary clinical, cognitive and global functioning outcomes and likely mechanisms of change (e.g., improved cognitive functioning, reduced rumination, and improved inhibition of negative stimuli). The proposed RCT aims to contribute to the clinical and scientific knowledge on the long-term effects of CCT as an add-on treatment for LLD. Cost-effectiveness is particularly relevant considering the expected volume of the target demographic. The study will be a pragmatic trial with few inclusion restrictions, providing information on feasibility of web-based trainings in clinical settings. The outcomes are potentially generalizable to guidelines for treatment of LLD. This trial is registered in the Netherlands Trial Register (code: NL7639 ). Registered 3 april 2019.
[The algorithm for the biological treatment of depression in the Dutch multidisciplinary guideline on depression].

Although antidepressants are effective in the treatment of depression, nonresponse is unfortunately a recurring problem. Treatment algorithms can help the health care professional to make consecutive step-by-step choices between the different available treatment options. To update the biological algorithm in the Dutch multidisciplinary guideline on the treatment of depression. The literature was reviewed systematically. There are five steps in the algorithm: 1. Treatment starts with an SSRI, a TCA, an SNRI, mirtazapine or buproprion. 2. If there is no response after 4-10 weeks, administer another antidepressant. 3. Augment medication with lithium. 4. Administer a monoamine oxidase inhibitor. 5. Apply electroconvulsive therapy. The algorithm is certainly worth using, but its efficacy needs to be fully investigated.s.
Association between decentering and reductions in relapse/recurrence in mindfulness-based cognitive therapy for depression in adults: A randomized controlled trial.

Decentering is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind (Safran & Segal, 1990), and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The present study sought to examine the role of decentering, and other related variables, in the efficacy of Mindfulness-based cognitive therapy (MBCT) as compared to two active comparison conditions. Formerly depressed individuals (N = 227), randomly assigned to MBCT (n = 74), relaxation group therapy (RGT; n = 77) or Treatment as usual (TAU; n = 76), completed self-report measures of decentering and symptoms of depression at pre-, mid-, and posttreatment, and relapse was assessed at 3, 6, 9, and 12 months, posttreatment. With regard to the acute treatment phase, results indicated that, whereas levels of depression increased in both RGT and TAU, MBCT patients remained free from symptom gains. Moreover, gains in decentering from mid- to posttreatment predicted reductions in depression from pre- to posttreatment for MBCT and TAU, but not for RGT. Participants who experienced increases in decentering, measured from mid- to posttreatment, generally evidenced the lowest levels of relapse/recurrence (during the four follow-up assessments), largely irrespective of treatment group. However, results related to change in decentering should be considered exploratory due to small cell sizes among participants who did not experience gains in decentering. Taken together, these results suggest that decentering is a potent mechanism for reduction of relapse in major depression, albeit one that is nonspecific to MBCT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Randomised controlled trial of Interpersonal and Social Rhythm Therapy and group-based Cognitive Remediation versus Interpersonal and Social Rhythm Therapy alone for mood disorders: study protocol.

Individuals with mood disorders frequently experience cognitive impairment, which impacts on the long-term trajectory of the disorders, including being associated with persisting difficulties in occupational and psychosocial functioning, residual mood symptoms, and relapse. Current first-line treatments for mood disorders do little to improve cognitive function. Targeting cognition in clinical research is thus considered a priority. This protocol outlines a prospectively-registered randomised controlled trial (RCT) which examines the impact of adding group-based Cognitive Remediation (CR) to Interpersonal and Social Rhythm Therapy (IPSRT-CR) for individuals with mood disorders. This is a pragmatic, two-arm, single-blinded RCT comparing IPSRT-CR with IPSRT alone for adults (n=100) with mood disorders (Major Depressive Disorder or Bipolar Disorder) with subjective cognitive difficulties, on discharge from Specialist Mental Health Services in Christchurch, New Zealand. Both treatment arms will receive a 12-month course of individual IPSRT (full dose=24 sessions). At 6 months, randomisation to receive, or not, an 8-week group-based CR programme (Action-based Cognitive Remediation - New Zealand) will occur. The primary outcome will be change in Global Cognition between 6 and 12 months (treatment-end) in IPSRT-CR versus IPSRT alone. Secondary outcomes will be change in cognitive, functional, and mood outcomes at 6, 12, 18, and 24 months from baseline and exploratory outcomes include change in quality of life, medication adherence, rumination, and inflammatory markers between treatment arms. Outcome analyses will use an intention-to-treat approach. Sub-group analyses will assess the impact of baseline features on CR treatment response. Participants' experiences of their mood disorder, including treatment, will be examined using qualitative analysis. This will be the first RCT to combine group-based CR with an evidence-based psychotherapy for adults with mood disorders. The trial may provide valuable information regarding how we can help promote long-term recovery from mood disorders. Many issues have been considered in developing this protocol, including: recruitment of the spectrum of mood disorders, screening for cognitive impairment, dose and timing of the CR intervention, choice of comparator treatment, and choice of outcome measures. Australian and New Zealand Clinical Trials Registry, ACTRN12619001080112 . Registered on 6 August 2019.
Mind-body medicine therapies for a range of depression severity: a systematic review.

Of the 34 million adult Americans (17%) using mind-body medicine therapies, 8 million (24%) have anxiety/depression. The evidence for using mind-body therapies to address varying depressive symptoms in populations with and without other chronic comorbidities is reviewed. Systematic literature searches of PubMed (Medline), Embase, CINAHL, and the seven databases encompassed by Current Contents, Web of Science, and Web of Knowledge were conducted. Studies designed as prospective control-comparison, adult population, English, at least 2 weeks long, sample size >30, and with primary or secondary outcome as depression measured on an established scale were included. Methodologic quality was evaluated using the modified scale for assessing scientific quality of investigations (SASQI) for Complementary and Alternative Medicine (CAM). Ninety papers of about 2900 met both inclusion and exclusion criteria; 60% of them scored a SASQI >9 and were deemed of sufficient quality to be included in the review; 74% of these selected quality papers demonstrated positive effects on the improvement of depressive symptoms. All mind-body modalities included in the study had at least one positive study. For cancer patients, several studies noted the positive effects of yoga and combination therapies on depression severity. For both diagnosed depression and fibromyalgia, several studies noted the positive effects of mindfulness on depression severity. The use of evidence-based mind-body therapies can alleviate depression severity. They could be used with established psychiatric treatments of therapy and medications. The likely long-term increased cost-effectiveness of integrating these therapies deserves further investigation.
Sequential Interventions for Major Depression and Heart Failure Self-Care: A Randomized Clinical Trial.

Major depression and inadequate self-care are common in patients with heart failure (HF). Little is known about how to intervene when both problems are present. This study examined the efficacy of a sequential approach to treating these problems. Stepped Care for Depression in HF was a single-site, single-blind, randomized controlled trial of cognitive behavior therapy (CBT) versus usual care (UC) for major depression in patients with HF. The intensive phase of the CBT intervention lasted between 8 and 16 weeks, depending upon the rate of improvement in depression. All participants received a tailored HF self-care intervention that began 8 weeks after randomization. The intensive phase of the self-care intervention ended at 16 weeks post-randomization. The coprimary outcome measures were the Beck Depression Inventory (version 2) and the Maintenance scale of the Self-Care of HF Index (v6.2) at week 16. One hundred thirty-nine patients with HF and major depression were enrolled; 70 were randomized to UC and 69 to CBT. At week 16, the patients in the CBT arm scored 4.0 points ([95% CI, -7.3 to -0.8]; P=0.02) lower on the Beck Depression Inventory, version 2 than those in the usual care arm. Mean scores on the Self-Care of HF Index Maintenance scale were not significantly different between the groups ([95% CI, -6.5 to 1.5]; P=0.22). CBT is more effective than usual care for major depression in patients with HF. However, initiating CBT before starting a tailored HF self-care intervention does not increase the benefit of the self-care intervention. URL: https://www. gov; Unique identifier: NCT02997865.
Effectiveness of an alternative intervention in the treatment of depressive symptoms.

There is a scarcity of studies in the international literature regarding alternative treatment to the pharmacological and psychotherapeutic intervention in the face of depression symptoms. This study aimed to test a protocol based on natural therapy, alternatives to pharmacological and psychotherapeutic, through Mindfulness Meditation, Reiki, Acupuncture and Auriculotherapy, to treat the symptoms of depression for those who were with no pharmacological or psychotherapeutic treatment for these symptoms. this is a randomized single-blind controlled pilot study. The final sample was 21 participants divided in two groups: experimental and control. Participants were evaluated by validated instruments during the screening process and after the intervention. The instruments were: Depression, Anxiety and Stress Scale and Beck Depression Inventory. Intervention was performed in eight sessions, during two months. All the techniques were used in the experimental group. Analysis of variance with repeated measures was used to compare pre-intervention to post-intervention moments. the result of analysis indicates a significant reduction in the symptoms of depression after the intervention among the experimental group. there is no way to determine which of the techniques used produced the most significant result. The protocol proposed in this study was effective in reducing the symptoms of depression to whom are not eligible for traditional treatment.