JustKiddo/KiddosVault huggingface dataset:
Forecasting success: patients' expectations for improvement and their relations to baseline, process and outcome variables in group cognitive-behavioural therapy for depression.

There is growing evidence for the important role of patients' outcome expectations to the process and outcome of psychotherapy, yet its relevance to group cognitive-behavioural therapy (CBT) for depression has not been examined. In an effort to fill this void, the present study investigated expectations for improvement among 80 psychiatric outpatients attending a group CBT program for depression. The study addressed the following four questions: (1) Which baseline patient characteristics might be associated with patients' expectations for improvement? (2) Does providing a rationale and outline for treatment affect patients' expectations? (3) Are patients' expectations related to the quality of therapeutic alliance? and (4) Are patients' expectations associated with the outcome of treatment? The main findings of the study are as follows: (a) baseline symptoms of depression, quality of life and current suicidal ideations were consistently associated with outcome expectancies; (b) outcome expectancies were unrelated to treatment completion status; (c) although expectancy ratings did not change significantly for the group as a whole, there was some variability in how individual patient's expectancy ratings changed; (d) baseline expectancies were related to early-treatment alliance quality, but not to mid-treatment alliance, whereas early-treatment expectancies were significantly associated with mid-treatment alliance; and (e) baseline expectations of favourable outcome had a negative association with improvement in anxiety symptoms, yet expectancy ratings from session 3 had a positive association with improvement in quality of life and interpersonal problems. Increases in expectancy ratings were significantly related to improvement in anxiety, quality of life and interpersonal problems. Patients who present in a particularly hopeless and demoralized state are likely to have low expectations for a positive outcome of treatment. Efforts should be made in the first few sessions of therapy to mobilize patients' hope and expectation of success, for increases in one's expectations may facilitate a favourable treatment outcome. An optimistic outlook on the probability of success in treatment may contribute to the development of a strong working relationship between the patient and the therapist.
A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression.

The aim of this meta-analysis was to systematically examine the short- and long-term effects of group Cognitive Behavioral Therapy (CBT) for adolescent depression and to examine the role of various moderators of the reported effect sizes. A comprehensive literature search of relevant randomized-controlled trials identified 23 studies containing 49 post-intervention and 56 follow-up comparisons. Standardized mean differences (SMD) were calculated both for post-intervention and follow-up. A three-level random effects approach was used to model the dependent effect sizes. Group CBT was more efficacious than control conditions both at post-intervention (SMD = -0.28, 95% CI [-0.36, -0.19]) and at follow-up (SMD = -0.21, 95% CI [-0.30, -0.11]). Having an inactive control group was associated with a larger post-intervention effect size, while having a longer follow-up duration was associated with a smaller follow-up effect size. Even though the effect sizes are low, research suggests that group CBT is a significant treatment for adolescent depression.
Cost-effectiveness of Cognitive Behavioral Therapy for Depressed Youth Declining Antidepressants.

Adolescents with depression identified in primary care settings often have limited treatment options beyond antidepressant (AD) therapy. We assessed the cost-effectiveness of a brief cognitive behavioral therapy (CBT) program among depressed adolescents who declined or quickly stopped using ADs. A total of 212 youth with depression were randomly assigned to treatment as usual (TAU) or TAU plus brief individual CBT. Clinical outcomes included depression-free days (DFDs) and estimated quality-adjusted life-years (QALYs). Costs were adjusted to 2008 US dollars. Incremental cost-effectiveness ratios (ICERs) comparing CBT to TAU were calculated over 12- and 24-month follow-up periods. Youth randomly assigned to CBT had 26.8 more DFDs (P = .044) and 0.067 more QALYs (P = .044) on average compared with TAU over 12 months. Total costs were $4976 less (P = .025) by the end of the 24-month follow-up among youth randomly assigned to CBT. Total costs per DFD were -$51 (ICER = -$51; 95% confidence interval [CI]: -$394 to $9) at 12 months and -$115 (ICER = -$115; 95% CI: -$1090 to -$6) at 24 months. Total costs per QALY were -$20282 (ICER = -$20282; 95% CI: -$156741 to $3617) at 12 months and -$45792 (ICER = -$45792; 95% CI: -$440991 to -$2731) at 24 months. Brief primary care CBT among youth declining AD therapy is cost-effective by widely accepted standards in depression treatment. CBT becomes dominant over TAU over time, as revealed by a statistically significant cost offset at the end of the 2-year follow-up.
Pilot of the brief behavioral activation treatment for depression in latinos with limited english proficiency: preliminary evaluation of efficacy and acceptability.

Latinos with limited English proficiency (LEP) experience multiple barriers to accessing efficacious mental health treatments. Using a stage model of behavior therapy research, this Stage I investigation evaluated the Brief Behavioral Activation Treatment for Depression (BATD), an intervention that may be well equipped to address existing treatment barriers. A sample of 10 Latinos with LEP and depressive symptomatology participated in a 10-session, direct (i.e., literal) Spanish-language translation of BATD, with no other cultural modifications. Participants were assessed at each session for depressive symptomatology and for the proposed BATD mechanisms: activity engagement and environmental reward. One month after treatment, participants were reassessed and interviewed to elicit feedback about BATD. Hierarchical linear model analyses were used to measure BATD outcomes. Results showed depressive symptomatology decreased (p<.001), while both activation (p=.04) and environmental reward (p=.02) increased over the course of BATD. Increases in activation corresponded concurrently with decreases in depression (p=.01), while environmental reward preceded decreases in depressive symptomatology (all p's ≤ .04). Follow-up analyses revealed sustained clinical gains in depression and activation, and an increase in environmental reward at follow-up. Participant interviews conducted 1 month after treatment conclusion indicated that BATD is an acceptable treatment for our sample of interest. Despite the limitations inherent in a study restricted to a sample of 10, preliminary outcomes of this Stage I research suggest that members of this otherwise underserved group showed improvements in depressive symptomatology and are willing to participate in and adhere to BATD. The study's positive outcomes suggest that a Stage II randomized clinical trial is a logical next step.
The efficacy of psychoeducation on recurrent depression: a randomized trial with a 2-year follow-up.

The efficacy of psychoeducation is well documented in the treatment of relapse prevention of schizophrenia, and recently also in bipolar disorder; however, for recurrent depression only few controlled studies focusing on the efficacy of psychoeducation have been conducted. This randomized study tests the efficacy of treatment-as-usual supplemented with a psychoeducative programme for patients with recurrent depression, treated at Community Mental Health Centres (CMHC) in Denmark. The primary outcome measurements concern was decline in consumption of psychiatric inpatient services and decline in Beck's Depression Inventory (BDI). Eighty patients were randomized, either to the psychoeducative programme (consisting of eight sessions, each of 2hours duration) and 2-year outpatient follow-up (42 cases), or only to 2-year outpatient follow-up (38 controls). The patients were monitored during 2 years after randomization. Data were collected from interviews including BDI, drug treatment and social measurements, and register data concerning use of psychiatric services. At 2-year follow-up, a significant reduction in the consumption of psychiatric inpatient services and in BDI was found; however, it was uniform for case and control patients. Drop-out/non-compliance was significantly more frequent among patients randomized to the control group. Furthermore, during follow-up the case group got a significant stronger attachment to the Labour market than the control group. The primary hypothesis could not be confirmed. Secondary outcome measurements concerning drop-out/non-compliance and attachment to the Labour market were significantly in favour of cases.
Telephone cognitive-behavioral therapy for subthreshold depression and presenteeism in workplace: a randomized controlled trial.

Subthreshold depression is highly prevalent in the general population and causes great loss to society especially in the form of reduced productivity while at work (presenteeism). We developed a highly-structured manualized eight-session cognitive-behavioral program with a focus on subthreshold depression in the workplace and to be administered via telephone by trained psychotherapists (tCBT). We conducted a parallel-group, non-blinded randomized controlled trial of tCBT in addition to the pre-existing Employee Assistance Program (EAP) versus EAP alone among workers with subthreshold depression at a large manufacturing company in Japan. The primary outcomes were depression severity as measured with Beck Depression Inventory-II (BDI-II) and presenteeism as measured with World Health Organization Health and Work Productivity Questionnaire (HPQ). In the course of the trial the follow-up period was shortened in order to increase acceptability of the study. The planned sample size was 108 per arm but the trial was stopped early due to low accrual. Altogether 118 subjects were randomized to tCBT+EAP (n = 58) and to EAP alone (n = 60). The BDI-II scores fell from the mean of 17.3 at baseline to 11.0 in the intervention group and to 15.7 in the control group after 4 months (p<0.001, Effect size = 0.69, 95%CI: 0.32 to 1.05). However, there was no statistically significant decrease in absolute and relative presenteeism (p = 0.44, ES = 0.15, -0.21 to 0.52, and p = 0.50, ES = 0.02, -0.34 to 0.39, respectively). Remote CBT, including tCBT, may provide easy access to quality-assured effective psychotherapy for people in the work force who present with subthreshold depression. Further studies are needed to evaluate the effectiveness of this approach in longer terms. The study was funded by Sekisui Chemicals Co. Ltd. ClinicalTrials.gov NCT00885014.
Effects of clay art therapy on adults outpatients with major depressive disorder: A randomized controlled trial.

Depression has become a critical global health problem, affecting millions of people. Cost-effective nonpharmacological treatment in community settings has been proposed to complement medical treatment. Short-term clay art therapy (CAT) is an alternative treatment that promotes the enhancement of various aspects of mental health for depressed individuals. One-hundred and six adults with depression were randomized into a CAT group or visual art (VA) control group for six 2.5-h weekly sessions. Intervention effects were measured using the Beck Depression Inventory, 12-Item General Health Questionnaire (Chinese version), Body-Mind-Spirit Well-Being Inventory, and 20-Item Toronto Alexithymia Scale (Chinese version) at baseline, immediately postintervention (T1), and 3-weeks postintervention (T2). Multivariate analysis of covariance results indicated a more significant time × group effect for CAT than for VA on depressive signs, general health, and body-mind-spirit well-being (all p<0.05). Significant within-groups changes were observed in these three aspects after treatment and at T2 (all p<0.001) and in alexithymia at T2 (p<0.01) in the CAT group, but the change was nonsignificant in the VA group at T1 and T2. The homogeneity of the participants affected the generalizability of the study findings. The short-term postintervention follow-up (3 weeks) presented difficulties in demonstrating the long-term effects of CAT. CAT can aid emotion regulation and benefit various aspects of mental health in adults. The short duration of the intervention suggests additional application value in treating depression. Further investigation is warranted regarding the potential effect of CAT on alleviating physical symptoms and improving social function.
Pilot randomized controlled trial of a Spanish-language Behavioral Activation mobile app (¡Aptívate!) for the treatment of depressive symptoms among united states Latinx adults with limited English proficiency.

To address the need for disseminable, evidence-based depression treatment options for Latinx adults with limited English proficiency (LEP), our team developed ¡Aptívate!, a Spanish-language Behavioral Activation self-help mobile application. Primary aims of this study were to: 1) examine feasibility and uptake of ¡Aptívate! among depressed Latinx adults with LEP and 2) preliminarily examine ¡Aptívate! efficacy for depression treatment. Participants (N = 42) with elevated depressive symptoms were randomized 2:1:1 to: 1) ¡Aptívate! (n = 22), 2) an active control Spanish-language app ("iCouch CBT"; n = 9), or 3) Treatment As Usual (i.e., no app; n = 11). Feasibility was assessed via self-reported app utilization and app analytics data. Depressive symptoms were assessed weekly for eight weeks via self report. All ¡Aptívate! participants used the app at least once, 81.8% of participants used the app ≥8 times, and 36.4% of participants used the app ≥56 times. Weekly retention was strong: 72.7% and 50% of participants continued to use the app at one- and two-months post-enrollment, respectively. Generalized Estimating Equation models indicated a significant interaction between time and treatment, such that ¡Aptívate! participants reported significantly lower depressive symptoms over time than TAU. Depressive symptoms did not differ on average across time between the iCouch and TAU conditions, nor between iCouch and ¡Aptívate!. Limitations include small sample size, limited follow-up, and lack of analytics data for the active control condition. With further research, ¡Aptívate! may offer a feasible, efficacious approach to extend the reach of evidence-based depression treatment for Latinx adults with LEP.
Use of a Fully Automated Internet-Based Cognitive Behavior Therapy Intervention in a Community Population of Adults With Depression Symptoms: Randomized Controlled Trial.

Although internet-based cognitive behavior therapy (iCBT) interventions can reduce depression symptoms, large differences in their effectiveness exist. The aim of this study was to evaluate the effectiveness of an iCBT intervention called Thrive, which was designed to enhance engagement when delivered as a fully automated, stand-alone intervention to a rural community population of adults with depression symptoms. Using no diagnostic or treatment exclusions, 343 adults with depression symptoms were recruited from communities using an open-access website and randomized 1:1 to the Thrive intervention group or the control group. Using self-reports, participants were evaluated at baseline and 4 and 8 weeks for the primary outcome of depression symptom severity and secondary outcome measures of anxiety symptoms, work and social adjustment, psychological resilience, and suicidal ideation. Over the 8-week follow-up period, the intervention group (n=181) had significantly lower depression symptom severity than the control group (n=162; P<.001), with a moderate treatment effect size (d=0.63). Moderate to near-moderate effect sizes favoring the intervention group were observed for anxiety symptoms (P<.001; d=0.47), work/social functioning (P<.001; d=0.39), and resilience (P<.001; d=0.55). Although not significant, the intervention group was 45% less likely than the control group to experience increased suicidal ideation (odds ratio 0.55). These findings suggest that the Thrive intervention was effective in reducing depression and anxiety symptom severity and improving functioning and resilience among a mostly rural community population of US adults. The effect sizes associated with Thrive were generally larger than those of other iCBT interventions delivered as a fully automated, stand-alone intervention. ClinicalTrials.gov NCT03244878; https://clinicaltrials.gov/ct2/show/NCT03244878.
Psychotherapy for subclinical depression: meta-analysis.

There is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder. To examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression. We conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group. The target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23-0.47; NNT = 5, 95% CI 4-8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment. Psychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.
Patient characteristics and the therapist as predictors of depressed patients' outcome expectation over time: A multilevel analysis.

Objective: Although there is an established link between patients' early positive outcome expectation for and their actual improvement from therapy, there is little research on patients' change in outcome expectation across therapy and both patient and therapist correlates of early outcome expectation level and change. The present study examined: (i) the overall trajectory of change in patients' outcome expectation through cognitive-behavioral therapy (CBT) for depression; (ii) patient characteristics as predictors of both initial outcome expectation and change in outcome expectation; and (iii) between-therapist effects in outcome expectation change. Method: Depressed patients (N=143) received a brief course of CBT. Outcome expectation was measured at screening, pretreatment, session 7, and session 14. Results: Outcome expectation linearly increased from screening to session 14. When controlling for other patient characteristics at intake, having previous depressive episodes was negatively associated with initial outcome expectation and higher well-being was positively associated with initial outcome expectation. When controlling for early alliance and early symptom change, outcome expectation change was predicted by previous depressive episodes. Finally, therapist effects emerged in outcome expectation over time. Conclusions: Various depressed patients' characteristics predict initial outcome expectation level and change, with significant between-therapists' differences related to outcome expectation change.
Internet-delivered treatment for young adults with anxiety and depression: Evaluation in routine clinical care and comparison with research trial outcomes.

Mood and anxiety disorders typically emerge in adolescence and early adult life, but young adults are often reluctant to seek treatment. The Mood Mechanic course is a transdiagnostic internet-delivered psychological intervention for symptoms of depression and anxiety, targeted at people aged 18-24 years. The current study compared the efficacy of the course when delivered under strict research trial conditions (research trial; n = 192) with its effectiveness in a routine health-care setting (routine care; n = 222). Symptoms of depression, anxiety and general distress at baseline, during, and after treatment were measured by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and Kessler 10-Item Scale (K-10), respectively. Both groups showed significant symptom reductions on all measures at post-treatment and 3-month follow-up. Deterioration rates were low, within-group effect sizes were large (>1.0) and both groups reported high levels of treatment satisfaction. Patients in routine care were less likely to complete post-treatment or follow-up symptom questionnaires. The study is based on self-reported data from treatment-seeking individuals that were motivated enough to start the course, and the absence of a control group and a formal diagnosis in the routine care sample means that some caution is needed in generalising the results. The results show that the Mood Mechanic course is effective and acceptable in routine clinical care, and that online psychological interventions designed for young adults are an effective treatment option for this hard-to-reach group.
Morita Therapy for depression (Morita Trial): a pilot randomised controlled trial.

To address uncertainties prior to conducting a fully powered randomised controlled trial of Morita Therapy plus treatment as usual (TAU) versus TAU alone, or to determine that such a trial is not appropriate and/or feasible. Pilot parallel group randomised controlled feasibility trial. Participants aged ≥18 years with Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV major depressive disorder, with or without DSM-IV anxiety disorder(s), recruited from general practice record searches in Devon, UK. We randomised participants on a 1:1 basis stratified by symptom severity, concealing allocation using a secure independent web-based system, to receive TAU (control) or 8-12 sessions of Morita Therapy, a Japanese psychological therapy, plus TAU (intervention). Rates of recruitment, retention and treatment adherence; variance and estimated between-group differences in follow-up scores (on the Patient Health Questionnaire 9 (PHQ-9) (depressive symptoms); Generalised Anxiety Disorder Questionnaire 7 (anxiety symptoms); Short Form 36 Health Survey Questionnaire/Work and Social Adjustment Scale (quality of life); Morita Attitudinal Scale for Arugamama (attitudes)) and their correlation with baseline scores. We recruited 68 participants, 5.1% (95% CI 3.4% to 6.6%) of those invited (34 control; 34 intervention); 64/68 (94%; 95% CI 88.3% to 99.7%) provided 4-month follow-up data. Participants had a mean age of 49 years and mean PHQ-9 score of 16.8; 61% were female. Twenty-four of 34 (70.6%) adhered to the minimum treatment dose. The follow-up PHQ-9 (future primary outcome measure) pooled SD was 6.4 (95% CI 5.5 to 7.8); the magnitude of correlation between baseline and follow-up PHQ-9 scores was 0.42 (95% CI 0.19 to 0.61). Of the participants, 66.7% and 30.0% recovered in the intervention and control groups, respectively; 66.7% and 13.3% responded to treatment in the intervention and control groups, respectively. A large-scale trial of Morita Therapy would require 133 participants per group and is feasible with minor modifications to the pilot trial protocol. Morita Therapy shows promise in treating depression and may provide patients with a distinct alternative to current treatments. ISRCTN17544090; Pre-results.