scholarly journals Long-Term Outcomes of a Therapist-Supported, Smartphone-Based Intervention for Elevated Symptoms of Depression and Anxiety: Quasiexperimental, Pre-Postintervention Study

10.2196/14284 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e14284 ◽  
Author(s):  
Marcos Economides ◽  
Kristian Ranta ◽  
Albert Nazander ◽  
Outi Hilgert ◽  
Philippe R Goldin ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Intention To Treat ◽  
Symptoms Of Depression ◽  
Point Reduction ◽  
Patient Health ◽  
Common Mental Health Problems ◽  
Clinically Significant

Background Depression is one of the most common mental health disorders and severely impacts one’s physical, psychological, and social functioning. To address access barriers to care, we developed Ascend—a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. A previous feasibility study with 102 adults with elevated depression reported that Ascend is associated with a postintervention reduction in depression symptoms. Objective We aimed to examine whether Ascend is associated with a reduction in symptoms of anxiety, and importantly, whether reductions in symptoms of depression and anxiety are maintained up to 12-months postintervention. Methods We assessed whether the previously reported, end-of-treatment improvements seen in the 102 adults with elevated symptoms of depression extended up to 12 months posttreatment for depression symptoms (measured by the Patient Health Questionnaire-9 [PHQ-9]) and up to 6 months posttreatment for anxiety symptoms (added to the intervention later and measured using the Generalized Anxiety Disorder-7 [GAD-7] scale). We used linear mixed effects models with Tukey contrasts to compare time points and reported intention-to-treat statistics with a sensitivity analysis. Results The intervention was associated with reductions in symptoms of depression that were maintained 12 months after the program (6.67-point reduction in PHQ-9 score, 95% CI 5.59-7.75; P<.001; Hedges g=1.14, 95% CI 0.78-1.49). A total of 60% of the participants with PHQ-9 scores above the cutoff for major depression at baseline (PHQ≥10) reported clinically significant improvement at the 12-month follow-up (at least 50% reduction in PHQ-9 score and postprogram score <10). Participants also reported reductions in symptoms of anxiety that were maintained for at least 6 months after the program (4.26-point reduction in GAD-7 score, 95% CI 3.14-5.38; P<.001; Hedges g=0.91, 95% CI 0.54-1.28). Conclusions There is limited evidence on whether outcomes associated with smartphone-based interventions for common mental health problems are maintained posttreatment. Participants who enrolled in Ascend experienced clinically significant reductions in symptoms of depression and anxiety that were maintained for up to 1 year and 6 months after the intervention, respectively. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and anxiety.

scholarly journals Long-Term Outcomes of a Therapist-Supported, Smartphone-Based Intervention for Elevated Symptoms of Depression and Anxiety: Quasiexperimental, Pre-Postintervention Study (Preprint)

2019 ◽  
Author(s):  
Marcos Economides ◽  
Kristian Ranta ◽  
Albert Nazander ◽  
Outi Hilgert ◽  
Philippe R Goldin ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Intention To Treat ◽  
Symptoms Of Depression ◽  
Point Reduction ◽  
Patient Health ◽  
Common Mental Health Problems ◽  
Clinically Significant

BACKGROUND Depression is one of the most common mental health disorders and severely impacts one’s physical, psychological, and social functioning. To address access barriers to care, we developed Ascend —a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. A previous feasibility study with 102 adults with elevated depression reported that Ascend is associated with a postintervention reduction in depression symptoms. OBJECTIVE We aimed to examine whether Ascend is associated with a reduction in symptoms of anxiety, and importantly, whether reductions in symptoms of depression and anxiety are maintained up to 12 months postintervention. METHODS We assessed whether the previously reported, end-of-treatment improvements seen in the 102 adults with elevated symptoms of depression extended up to 12 months posttreatment for depression symptoms (measured by the Patient Health Questionnaire-9 [PHQ-9]) and up to 6 months posttreatment for anxiety symptoms (added to the intervention later and measured using the Generalized Anxiety Disorder-7 [GAD-7] scale). We used linear mixed effects models with Tukey contrasts to compare time points and reported intention-to-treat statistics with a sensitivity analysis. RESULTS The intervention was associated with reductions in symptoms of depression that were maintained 12 months after the program (6.67-point reduction in PHQ-9 score, 95% CI 5.59-7.75; P<.001; Hedges g=1.14, 95% CI 0.78-1.49). A total of 60% of the participants with PHQ-9 scores above the cutoff for major depression at baseline (PHQ≥10) reported clinically significant improvement at the 12-month follow-up (at least 50% reduction in PHQ-9 score and postprogram score <10). Participants also reported reductions in symptoms of anxiety that were maintained for at least 6 months after the program (4.26-point reduction in GAD-7 score, 95% CI 3.14-5.38; P<.001; Hedges g=0.91, 95% CI 0.54-1.28). CONCLUSIONS There is limited evidence on whether outcomes associated with smartphone-based interventions for common mental health problems are maintained posttreatment. Participants who enrolled in Ascend experienced clinically significant reductions in symptoms of depression and anxiety that were maintained for up to 1 year and 6 months after the intervention, respectively. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and anxiety.

scholarly journals Sex and age differences in clinically significant symptoms of depression and anxiety among people in Australia in the first month of COVID-19 restrictions: a national survey

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042696
Author(s):  
Karin Hammarberg ◽  
Thach Tran ◽  
Maggie Kirkman ◽  
Jane Fisher
Keyword(s):  
Mental Health ◽  
Age Differences ◽  
Online Survey ◽  
Mental Health Problems ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Patient Health ◽  
Clinically Significant ◽  
Sex And Age Differences ◽  
Disproportionate Burden

ObjectivesTo identify sex and age differences in clinically significant symptoms of depression and anxiety and the factors associated with these differences among adults in Australia during COVID-19-related restrictions.DesignAnonymous online survey.SettingAustralia.ParticipantsAdults aged over 18 years living in Australia were eligible and 13 829 contributed complete data. Of these, 13 762 identified as female (10 434) or male (3328) and were included in analyses.InterventionsNone.Outcome measuresClinically significant symptoms of depression (≥10 on Patient Health Questionnaire 9) or anxiety (≥10 on Generalized Anxiety Disorder Scale 7 (GAD-7)), and experiences of irritability (GAD-7 item 6).ResultsWomen were more likely than men to have clinically significant symptoms of depression (26.3% (95% CI 25.4 to 27.1) vs 20.1% (95% CI 18.7 to 21.5), p<0.001) and anxiety (21.8% (95% CI 21.0 to 22.6) vs 14.2% (95% CI 13.0 to 15.4), p<0.001) and to have experienced irritability in the previous fortnight (63.1% (95% CI 62.1 to 64.0) vs 51.4% (95% CI 49.7 to 53.2), p<0.001). They were also more likely than men to be doing unpaid work caring for children (22.8% (95% CI 22.0 to 23.6) vs 8.6% (95% CI 7.7 to 9.6), p<0.001) and dependent relatives (9.8% (95% CI 9.2 to 10.3) vs 5.7% (95% CI 4.9 to 6.5), p<0.001) which made significant contributions to the mental health outcomes of interest. Loss of employment, fear of contracting COVID-19 and feeling a severe impact of the restrictions were associated with poorer mental health in women and men of all ages.ConclusionsRates of clinically significant symptoms of depression and anxiety were higher among women than men. Rather than being intrinsically more vulnerable to mental health problems during the COVID-19 pandemic, the higher risk of symptoms of anxiety and depression among women may in part be explained by their disproportionate burden of unpaid caregiving.

scholarly journals One-year outcomes of a therapist-supported, smartphone-based intervention for elevated symptoms of depression and anxiety

2019 ◽  
Author(s):  
Marcos Economides ◽  
Kristian Ranta ◽  
Albert Nazander ◽  
Outi Hilgert ◽  
philippe goldin ◽  
...  
Keyword(s):  
Post Treatment ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Intention To Treat ◽  
Symptoms Of Depression ◽  
End Of Treatment ◽  
Patient Health ◽  
Clinically Significant ◽  
One Year

Depression is common and severely impacts physical, psychological and social functioning. To address access barriers to care, we developed Ascend - a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. We examined whether the previously-reported, end-of-treatment improvements among 102 adults with elevated symptoms of depression extended up to 12 months post-treatment for depression symptoms (measured by the Patient Health Questionnaire [PHQ-9]), and up to 6 months post-treatment for anxiety symptoms (added to the intervention later, and measured by the Generalized Anxiety Disorder scale [GAD-7]). An intention-to-treat analysis showed that participants maintained clinically significant improvements in depression (mean PHQ-9 reduction=6.67, Hedges’ g = 1.14 [0.78 to 1.49]) and in anxiety (mean GAD-7 reduction=4.26, Hedges’ g = 0.91 [0.54 to 1.28]) at follow-up. Also, 60% of participants above the cutoff for major depression at baseline (PHQ ≥ 10) experienced ≥ 50% reduction in PHQ-9 score and had PHQ-9 &lt; 10 at follow-up. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and/or symptoms of anxiety.

scholarly journals Impact of Longitudinal Social Support and Loneliness Trajectories on Mental Health during the COVID-19 Pandemic in France

2021 ◽  
Vol 18 (23) ◽  
pp. 12677
Author(s):  
Sandy Laham ◽  
Leticia Bertuzzi ◽  
Séverine Deguen ◽  
Irwin Hecker ◽  
Maria Melchior ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Study ◽  
Depression And Anxiety ◽  
Linear Regression Models ◽  
Symptoms Of Depression ◽  
Common Mental Health Problems ◽  
Mental Health Study

(1) Background: Little is known about how the COVID-19 pandemic has impacted social support and loneliness over time and how this may predict subsequent mental health problems. This study aims to determine longitudinal trajectories of social support and loneliness in the French general population during the first year of the COVID-19 pandemic and study whether variations in these trajectories are associated with symptoms of depression and anxiety; (2) Methods: Analyses were based on data from 681 French participants in the international COVID-19 Mental Health Study (COMET) study, collected at four periods of time between May 2020 and April 2021. Group-based trajectory modelling (GBTM) was used to determine social support and loneliness trajectories. Associations between the identified trajectories and symptoms of depression and anxiety, measured with the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7), were tested through multivariate linear regression models; (3) Results: Social support trajectories revealed four stable groups: ‘poor’ (17.0%), ‘moderate’ (42.4%), ‘strong’ (35.4%) and ‘very strong’ (5.1%). Loneliness trajectories also identified four groups: ‘low stable’ (17.8%), ‘low rising’ (40.2%), ‘moderate stable’ (37.6%) and ‘high rising’ (5.0%). Elevated symptoms of depression were associated with poor social support as well as all identified loneliness trajectories, while high levels of anxiety were associated with moderate stable and high rising loneliness trajectories; (4) Conclusions: High and increasing levels of loneliness are associated with increased symptoms of depression and anxiety during the pandemic. Interventions to address loneliness are essential to prevent common mental health problems during the pandemic and afterwards.

scholarly journals Ambient air pollution and depressive symptoms

2014 ◽  
Author(s):  
Mieczyslaw Szyszkowicz ◽  
Brian H Rowe
Keyword(s):  
Air Pollution ◽  
Mental Health Problems ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Depression Symptoms ◽  
Symptoms Of Depression ◽  
Common Mental Health Problems ◽  
Ed Visits ◽  
Clinically Significant

Background. Depression is among the most common mental health problems. Depression interferes with daily functioning and quality of life. Many factors can contribute to depression and air pollution can initiate or intensify symptoms of depression. Methods. Case-crossover method was used to study associations between emergency department (ED) visits for depression and ambient air pollution. The statistical analysis was applied for patients of different ages. Results. Positive and statistically significant results, (communicated as odds ratios), were obtained for exposure to ambient carbon monoxide and ED visits for depression. Discussion. The presented results support the hypothesis that recent exposures to ambient levels of air pollutants can contribute clinically significant worsening in depression symptoms leading to ED visits. As the results suggest the associations are age dependent.

Depression and anxiety symptoms in 17 teams of female football players including 10 German first league teams

2018 ◽  
Vol 53 (8) ◽  
pp. 471-477 ◽  
Author(s):  
Astrid Junge ◽  
Birgit Prinz
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Mental Health Problems ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Football Players ◽  
Depression And Anxiety ◽  
Generalised Anxiety Disorder ◽  
Symptoms Of Depression ◽  
Prevalence Of Depression

BackgroundInformation on the prevalence of mental health problems of elite athletes is inconclusive, most probably due to methodological limitations, such as low response rates, heterogeneous samples.AimsTo evaluate the prevalence and risk factors of depression and anxiety symptoms in high-level female football players.MethodsFemale football players of 10 German first league (Bundesliga) and 7 lower league teams were asked to answer a questionnaire on players’ characteristics, the Center of Epidemiologic Studies Depression Scale (CES-D) and the Generalised Anxiety Disorder (GAD-7) scale.ResultsA total of 290 players (184 first and 106 lower league players) took part in the study. The CES-D score indicated mild to moderate symptoms of depression in 48 (16.6%) and severe symptoms in 41 (14.1%) players. The GAD-7 score indicated an at least moderate generalised anxiety disorder in 24 (8.3%) players. The prevalence of depression symptoms and generalised anxiety disorders was similar to the female general population of similar age. However, significantly more second league players reported symptoms of depression than first league players, and thus the prevalence of depression symptoms in second league players was higher than in the general population. Only a third of the 45 (15.7%) players who stated that they currently wanted or needed psychotherapeutic support received it.ConclusionThe prevalence of depression and generalised anxiety symptoms in elite football players is influenced by personal and sport-specific variables. It is important to raise awareness of athletes’ mental health problems in coaches and team physicians, to reduce stigma and to provide low-threshold treatment.

scholarly journals Ambient air pollution and depressive symptoms

2014 ◽  
Author(s):  
Mieczyslaw Szyszkowicz ◽  
Brian H Rowe
Keyword(s):  
Air Pollution ◽  
Mental Health Problems ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Depression Symptoms ◽  
Symptoms Of Depression ◽  
Common Mental Health Problems ◽  
Ed Visits ◽  
Clinically Significant

Background. Depression is among the most common mental health problems. Depression interferes with daily functioning and quality of life. Many factors can contribute to depression and air pollution can initiate or intensify symptoms of depression. Methods. Case-crossover method was used to study associations between emergency department (ED) visits for depression and ambient air pollution. The statistical analysis was applied for patients of different ages. Results. Positive and statistically significant results, (communicated as odds ratios), were obtained for exposure to ambient carbon monoxide and ED visits for depression. Discussion. The presented results support the hypothesis that recent exposures to ambient levels of air pollutants can contribute clinically significant worsening in depression symptoms leading to ED visits. As the results suggest the associations are age dependent.

scholarly journals Anxiety and Depression Among Adult Tobacco Users During the COVID-19 Restrictions in India.

2021 ◽  
Author(s):  
Shalini Bassi ◽  
Gaurang P. Nazar ◽  
Nishigandha Joshi ◽  
Nitika Sharma ◽  
Aishwarya Pandian ◽  
...  
Keyword(s):  
Mental Health ◽  
Tobacco Cessation ◽  
Descriptive Analysis ◽  
Easy Access ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Indian Government ◽  
Patient Health ◽  
Indian Cities

Abstract Background The world witnessed a highly contagious and deadly disease, COVID-19, towards the end of 2019. India is one of the worst affected countries. We aimed to assess anxiety and depression levels among adult tobacco users and people who recently quit tobacco during COVID − 19 lockdown in India. Methods The study was conducted across two Indian cities, Delhi and Chennai (July-August, 2020) among adult tobacco users (n = 801). Telephonic interviews were conducted using validated mental health tools (Patient Health Questionnaire-PHQ-9 and Generalized Anxiety Disorder-GAD-7) to assess the anxiety and depression levels of the participants. Descriptive analysis and multiple logistic regression were used to study the prevalence and correlates of depression and anxiety. Results We found that 20.6% of tobacco users had depression symptoms (3.9% moderate to severe); 20.7% had anxiety symptoms (3.8% moderate to severe). Risk factors associated with depression and anxiety included food, housing, and financial insecurity. Conclusion During COVID-19 lockdown, mental health of tobacco users (primarily women) was associated with food, housing and financial insecurity. The Indian Government rightly initiated several health, social and economic measures to shield the most vulnerable from COVID-19, including a ban on the sale of tobacco products. It is also necessary to prioritize easy access to tobacco cessation and mental health services to such vulnerable populations during pandemic situations.

scholarly journals Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Aarathi Venkatesan ◽  
Lily Rahimi ◽  
Manpreet Kaur ◽  
Christopher Mosunic
Keyword(s):  
Mental Health ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Behavioral Therapy ◽  
Severe Depression ◽  
Cognitive Behavior ◽  
Depression And Anxiety ◽  
Point Reduction ◽  
Therapy Program ◽  
Patient Health

BACKGROUND Digital mental health interventions offer a scalable solution that reduces barriers to seeking care for clinical depression and anxiety. OBJECTIVE We aimed to examine the effectiveness of a 12-week therapist supported, app-based cognitive behavioral therapy program in improving symptoms of depression and anxiety within 9 months. METHODS A total of 323 participants with mild to moderately severe depression or anxiety were enrolled in a 12-week digital cognitive behavior therapy program. The analysis was restricted to participants who provided at least one follow-up assessment after baseline. As a result, 146 participants (45.2%) were included in the analysis—74 (50.7%) participants completed assessments at 3 months, 31 participants (21.2%) completed assessments at 6 months, and 21 participants (14.4%) completed assessments at 9 months. The program included structured lessons and tools (ie, exercises and practices) as well as one-on-one weekly video counseling sessions with a licensed therapist for 12 weeks and monthly check-in sessions for 1 year. The clinically validated Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety, respectively. Linear mixed-effects modeling was employed to examine changes in depression and anxiety over time. RESULTS We observed a significant positive effect of program time on improvement in depression (β=–0.12, <i>P</i>&lt;.001) and anxiety scores (β=–0.10, <i>P</i>&lt;.001). At the end of the 12-week intervention, we observed an average reduction of 3.76 points (95% CI –4.76 to –2.76) in PHQ-8 scores. Further reductions in depression were seen at program month 6 (4.75-point reduction, 95% CI –6.61 to –2.88) and program month 9 (6.42-point reduction, 95% CI –8.66 to –6.55, <i>P</i>&lt;.001). A similar pattern of improvement emerged for anxiety, with a 3.17-point reduction at the end of the 12-week intervention (95% CI –4.21 to –2.13). These improvements were maintained at program month 6 (4.87-point reduction, 95% CI –6.85 to –2.87) and program month 9 (5.19-point, 95% –6.85 to 4.81). In addition, greater program engagement during the first 12 weeks predicted a greater reduction in depression (β=–0.29, <i>P</i>&lt;.001) CONCLUSIONS The results suggest that digital interventions can support sustained and clinically meaningful improvements in depression and anxiety. Furthermore, it appears that strong initial digital mental health intervention engagement may facilitate this effect. However, the study was limited by postintervention participant attrition as well as the retrospective observational study design.

scholarly journals The profile of quality of life and mental health of university students in the healthcare field

2022 ◽  
Vol 11 (1) ◽  
pp. e35011125095
Author(s):  
Pedro Henrique Batista de Freitas ◽  
Adriana Lúcia Meireles ◽  
Sabrina Martins Barroso ◽  
Marina de Bittencourt Bandeira ◽  
Mery Natali Silva Abreu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Nursing Students ◽  
University Students ◽  
Mental Health Problems ◽  
Well Being ◽  
Depression Symptoms ◽  
Symptoms Of Depression ◽  
Environment Domain

Objective: to present the profile of quality of life and symptoms of anxiety, depression and stress in university students in the healthcare area. Method: a descriptive study with a quantitative approach to data, carried out with university students in the healthcare field of three Federal Institutions of Higher Education in Minas Gerais. Variables such as sociodemographic, lifestyle, presence of depression symptoms, anxiety and stress, and quality of life (QoL) were measured. The QoL was assessed using the WHOQUOL-bref scale and symptoms of depression, anxiety and stress using the DASS-21 scale. A descriptive data analysis was performed. Results: 321 students participated in the study, mostly female (71.0%). More than 50% of the students had symptoms of depression, anxiety and stress, regardless of the level of severity, while severe/very severe symptoms were present in more than 20% of them, presenting a higher proportion in the nursing course. The psychological domain had the lowest overall QoL score (58.33), and the best was observed in the social relationships domain (66.67). Nursing students had the lowest scores while physical education students had the best scores in most domains. Medical students had the best score in the environment domain (68.75). Conclusion: Suggest the planning of policies and strategies that promote the physical and mental well-being of students, as well as screening and monitoring of most vulnerable ones, as well as those with mental health problems; such strategies can positively impact QoL.

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