scholarly journals Mobile Phone and Web-based Cognitive Behavior Therapy for Depressive Symptoms and Mental Health Comorbidities in People Living With Diabetes: Results of a Feasibility Study

2016 ◽  
Vol 3 (2) ◽  
pp. e23 ◽  
Author(s):  
Janine Clarke ◽  
Judith Proudfoot ◽  
Howard Ma
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Mobile Phone ◽  
Feasibility Study ◽  
User Satisfaction ◽  
Mental Health Problems ◽  
Controlled Study ◽  
Web Based ◽  
Health Comorbidities

Background Depression is often comorbid with diabetes; however, undertreatment of depressive symptoms in people affected is common. Objective We studied preliminary acceptability and effectiveness of a fully automated, mobile phone, and web-based public health intervention, myCompass, for reducing depressive symptoms and improving mental health comorbidities in people with diabetes. Methods In this single-group feasibility study, 89 volunteers with type 1 (n=34) or type 2 (n=55) diabetes and at least mild depressive symptoms used myCompass for 7 weeks. Web-based measures of depressive and anxious symptoms, functional impairment, diabetes-specific variables, and user satisfaction were completed at baseline, postintervention, and 3-month follow-up. Results Retention rates were 54% (n=48) at postintervention and 36% (n=32) at follow-up. Depressive symptoms were significantly improved at postintervention (P<.001; within-group effect size d=1.05), with gains persisting at follow-up. Mental health comorbidities, including anxiety (P<.001), functioning (P<.001), and diabetes-specific distress (P<.001), also showed significant and sustained improvement. Satisfaction with myCompass was high, with convenience and ease of program use, and relevance of program content rated positively by participants. Conclusions The myCompass program shows promise as an acceptable and effective treatment for depression and comorbid mental health problems in people with diabetes. The program is broadly available, free to use, and may benefit patients with diabetes who do not access services and/or wish to manage their mental health themselves. Replication of these findings in a controlled study is warranted.

The Mental Health of Visitors of Web-Based Support Forums for Bereaved by Suicide

Crisis ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Jeannet Kramer ◽  
Brigitte Boon ◽  
Marijke Schotanus-Dijkstra ◽  
Wouter van Ballegooijen ◽  
Ad Kerkhof ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Repeated Measures ◽  
Complicated Grief ◽  
Well Being ◽  
Self Report ◽  
Online Support ◽  
Mutual Support ◽  
Web Based

Background: Persons bereaved by suicide are reluctant to ask for social support when they experience feelings of guilt and blame. A web-based peer forum may provide a safe and anonymous place for mutual support. Aims: This study examined the mental health changes of visitors of two online support forums for persons bereaved by suicide and their experiences with the forum over 1 year. Method: Visitors of two forums completed self-report measures at baseline and at 6 and 12 months' follow-up. Repeated measures analyses were used to study changes in well-being, depressive symptoms, and complicated grief. Additionally, participants were interviewed about their experiences with the forum. Results: The 270 participants were mostly female, low in well-being, with high levels of depressive symptoms and complicated grief. Suicidal risk was high for 5.9%. At 12 months, there were small to medium-sized significant improvements in well-being and depressive symptoms (p < .001) and nearly as much for grief (p = .08). About two thirds reported benefit from visiting the forum. Because of the pre–post design we cannot determine whether a causal relationship exists between the form and changes in mental health. Conclusion: After 1 year some positive changes but a large group was still struggling with their mental health. Interviews indicate that the forum was valued for finding recognition.

scholarly journals Mindfulness-Based Intervention for Children with Mental Health Problems: a 2-Year Follow-up Randomized Controlled Study

Mindfulness ◽  
2021 ◽  
Author(s):  
Katarina Laundy ◽  
Peter Friberg ◽  
Walter Osika ◽  
Yun Chen
Keyword(s):  
Mental Health ◽  
Disruptive Behavior ◽  
Mental Health Problems ◽  
Intervention Group ◽  
Health Problems ◽  
Controlled Study ◽  
Control Group ◽  
Registration Number ◽  
Group A

Abstract Objectives Moderate mental health problems are highly prevalent and increasing in Swedish schoolchildren, elevating risk for future mental and somatic disability. The aim of this study was to determine whether an 8-week mindfulness-based intervention, Training for Mindfulness and Resilience (TMR), mitigates mental health symptoms and increases resilience during a 2-year follow-up. Methods Schoolchildren (aged 9–14 years) reporting moderate mental health problems were randomized into either TMR intervention group (N = 22) or control group, receiving best current practice (N = 12). We used validated questionnaires to measure anxiety, depression, anger, disruptive behavior, self-concept, resilience, stress, and mindfulness before treatment with either TMR or control, as well as at 6 months, 1 year, and 2 years follow-up. Results We found a statistically significant effect of TMR intervention vs control, on resilience, anxiety, anger, and disruptive behavior. Compared to baseline, TMR increased the level of resilience at 6 months (p < .001); anxiety at 1 (p <  = .033) and 2 years (p = .04); anger at 6 months (p = .004) and 2 years (p = .039); disruptive behavior at 6 months (p = .006). In the control group, a decrease in resilience between 6 months and 2 years (p = .05) was observed. No other significant effects were found in the control group. Conclusions This study suggested that TMR improved mental health in schoolchildren with effects on anxiety and anger lasting for 2 years, and on resilience and disruptive behavior lasting for 6 months. Trial Registration Number NCT04806542, date of registration 18th of March 2021, retrospectively registered.

scholarly journals Preliminary Evaluation of a Brief Web and Mobile Phone Intervention for Men With Depression: Men’s Positive Coping Strategies and Associated Depression, Resilience, and Work and Social Functioning

2017 ◽  
Vol 4 (3) ◽  
pp. e33 ◽  
Author(s):  
Andrea Susan Fogarty ◽  
Judy Proudfoot ◽  
Erin Louise Whittle ◽  
Janine Clarke ◽  
Michael J Player ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Mobile Phone ◽  
Social Functioning ◽  
Externalizing Symptoms ◽  
Preliminary Evaluation ◽  
Treatment Needs ◽  
Web Based ◽  
Secondary Outcomes

Background Previous research has identified that men experiencing depression do not always access appropriate health services. Web-based interventions represent an alternative treatment option for men, are effective in reducing anxiety and depression, and have potential for wide dissemination. However, men do not access Web-based programs at the same rate as women. Programs with content explicitly tailored to men’s mental health needs are required. Objective This study evaluated the applicability of Man Central, a new Web and mobile phone intervention for men with depression. The impact of the use of Man Central on depression, resilience, and work and social functioning was assessed. Methods A recruitment flier was distributed via social media, email networks, newsletters, research registers, and partner organizations. A single-group, repeated measures design was used. The primary outcome was symptoms of depression. Secondary outcomes included externalizing symptoms, resilience, and work and social functioning. Man Central comprises regular mood, symptom, and behavior monitoring, combined with three 15-min interactive sessions. Clinical features are grounded in cognitive behavior therapy and problem-solving therapy. A distinguishing feature is the incorporation of positive strategies identified by men as useful in preventing and managing depression. Participants were directed to use Man Central for a period of 4 weeks. Linear mixed modeling with intention-to-treat analysis assessed associations between the intervention and the primary and secondary outcomes. Results A total of 144 men aged between 18 and 68 years and with at least mild depression enrolled in the study. The symptoms most often monitored by men included motivation (471 instances), depression (399), sleep (323), anxiety (316), and stress (262). Reminders were scheduled by 60.4% (87/144). Significant improvements were observed in depression symptoms (P<.001, d=0.68), depression risk, and externalizing symptoms (P<.001, d=0.88) and work and social functioning (P<.001, d=0.78). No change was observed in measures of resilience. Participants reported satisfaction with the program, with a majority saying that it was easy (42/51, 82%) and convenient (41/51, 80%) to use. Study attrition was high; 27.1% (39/144) and 8.3% (12/144) of the participants provided complete follow-up data and partial follow-up data, respectively, whereas the majority (93/144, 64.6%) did not complete follow-up measures. Conclusions This preliminary evaluation demonstrated the potential of using electronic health (eHealth) tools to deliver self-management strategies to men with depressive symptoms. Man Central may meet the treatment needs of a subgroup of depressed men who are willing to engage with an e-mental health program. With further research, it may provide an acceptable option to those unwilling or unable to access traditional mental health services. Given the limitations of the study design, prospective studies are required, using controlled designs to further elucidate the effect of the program over time.

scholarly journals Efficacy of a Guided Web-Based Self-Management Intervention for Depression or Dysthymia: Randomized Controlled Trial With a 12-Month Follow-Up Using an Active Control Condition (Preprint)

2019 ◽  
Author(s):  
Caroline Oehler ◽  
Frauke Görges ◽  
Mandy Rogalla ◽  
Christine Rummel-Kluge ◽  
Ulrich Hegerl
Keyword(s):  
Depressive Symptoms ◽  
Active Control ◽  
User Satisfaction ◽  
Life Quality ◽  
Self Management ◽  
Wait List ◽  
Web Based ◽  
Management Intervention ◽  
Symptoms Of Depression

BACKGROUND An increasing number of studies suggest that web-based interventions for patients with depression can reduce their symptoms and are expected to fill currently existing treatment gaps. However, evidence for their efficacy has mainly been derived from comparisons with wait-list or treatment as usual controls. In particular, designs using wait-list controls are unlikely to induce hope and may even have nocebo effects, making it difficult to draw conclusions about the intervention’s efficacy. Studies using active controls are rare and have not yielded conclusive results. OBJECTIVE The main objective of this study is to assess the acute and long-term antidepressant efficacy of a 6-week, guided, web-based self-management intervention building on the principles of cognitive behavioral therapy (iFightDepression tool) for patients with depression compared with web-based progressive muscle relaxation as an active control condition. METHODS A total of 348 patients with mild-to-moderate depressive symptoms or dysthymia (according to the Mini International Neuropsychiatric Interview) were recruited online and randomly assigned to 1 of the 2 intervention arms. Acute antidepressant effects after 6 weeks and long-term effects at 3-, 6-, and 12-month follow-up were studied using the Inventory of Depressive Symptomatology–self-rating as a primary outcome parameter and change in quality of life (Short Form 12) and user satisfaction (client satisfaction questionnaire) as secondary outcome parameters. Treatment effects were assessed using mixed model analyses. RESULTS Over the entire observation period, a greater reduction in symptoms of depression (<i>P</i>=.01) and a greater improvement of life quality (<i>P</i>&lt;.001) was found in the intervention group compared with the active control group. Separate tests for each time point revealed significant effects on depressive symptoms at the 3-month follow-up (<i>d</i>=0.281; 95% CI 0.069 to 0.493), but not after 6 weeks (<i>main outcome:</i> <i>d</i>=0.192; 95% CI −0.020 to 0.404) and 6 and 12 months. The intervention was significantly superior to the control condition with respect to user satisfaction (25.31 vs 21.97; t<sub>259</sub>=5.804; <i>P</i>&lt;.01). CONCLUSIONS The fact that antidepressant effects have been found for a guided self-management tool in comparison with an active control strengthens the evidence base for the efficacy of web-based interventions. The antidepressant effect became most prominent at the 3-month follow-up. After 6 weeks of intervention, significant positive effects were observed on life quality but not on depressive symptoms. Although the effect size of such web-based interventions on symptoms of depression might be smaller than that suggested by earlier studies using wait-list control conditions, they can be a cost-effective addition to antidepressants and face-to-face psychotherapy. CLINICALTRIAL International Clinical Trials Registry Platform ICTRP080-15-09032015; https://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00009323

scholarly journals Web-based training and supervision for LGBT-affirmative mental health practice: A randomized controlled trial

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Lelutiu-Weinberger ◽  
J E Pacjankis
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Clinical Skills ◽  
Controlled Trial ◽  
Future Research ◽  
Provider Attitudes ◽  
Web Based ◽  
The Impact ◽  
Lgbt Individuals

Abstract Background Lesbian, gay, bisexual, and transgender (LGBT) individuals in most countries remain stigmatized, requiring culturally sensitive mental health care to foster coping and resilience. This trial tested the efficacy of an LGBT-affirmative mental health training for psychologists and psychiatrists in Romania, where such resources are scarce. The trial compared in-person and web-based training modalities. Methods Participants were randomized to a 2-day training either in-person (n = 56) or via web by viewing the live-streamed training (n = 54), and assessed pre- and 5-, 10- and 15-months post-training, with optional monthly web-based supervision (n = 47) after the first follow-up. Generalized linear mixed models were conducted to assess for change across time. Results The sample (M age=34.98) was mostly female (88%) and heterosexual (84%). Trainees, regardless of in-person or web-based attendance, reported significant decreases from baseline to 15-month follow-up in explicitly (b = 0.21, 95% CI 0.06 − 0.37, p &lt; 0.01) and implicitly (b = 0.26, 95% CI 0.10 − 0.41, p &lt; 0.001) assessed homonegativity, and significant increases in LGBT-affirmative clinical skills (b = -1.19, 95% CI -1.41− -1.00, p &lt; 0.001), beliefs (b = -0.17, 95% CI -0.31 − -0.03, p &lt; 0.05) and behavior (b = -1.17, 95% CI -1.72 − -0.61, p &lt; 0.05). Conclusions Training in LGBT-affirmative mental health can change provider attitudes and practice in high-stigma countries. The fact that web-based trainings were equally efficacious as in-person trainings suggests that such education can have widespread reach. As LGBT individuals represent one of the highest-risk global populations for mental health problems driven by stigma, findings hold strong public health potential. Future research should assess the impact of such trainings across high-need settings and include patient outcomes.

scholarly journals Web-based decision aid tool for disclosure of a mental health condition in the workplace: a randomised controlled trial

2019 ◽  
Vol 76 (9) ◽  
pp. 595-602 ◽  
Author(s):  
Elizabeth Stratton ◽  
Isabella Choi ◽  
Rafael calvo ◽  
Ian Hickie ◽  
Claire Henderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Depressive Symptoms ◽  
Randomised Controlled Trial ◽  
Decision Aid ◽  
Controlled Trial ◽  
Decisional Conflict ◽  
Web Based ◽  
Randomised Controlled

ObjectivesMaking decisions about disclosing a mental illness in the workplace is complicated. Decision aid tools are designed to help an individual make a specific choice. We developed a web-based decision aid to help inform decisions about disclosure for employees. This study aimed to examine the efficacy of this tool.MethodWe conducted a randomised controlled trial with recruitment, randomisation and data collection all online. Participants had access to the intervention for 2 weeks. Assessments occurred at baseline, postintervention and 6 weeks’ follow-up. The primary outcome was decisional conflict. Secondary outcomes were stage and satisfaction of decision-making and mental health symptoms.Results107 adult employees were randomised to READY (n=53) or the control (n=54). The sample was predominantly female (83.2%). Participants using READY showed greater reduction in decisional conflict at postintervention (F(1,104)=16.8, p<0.001) (d=0.49, 95% CI 0.1 to 0.9) and follow-up (F(1,104)=23.6, p<0.001) (d=0.61, 95% CI 0.1 to 0.9). At postintervention the READY group were at a later stage of decision-making (F(1,104)=6.9, p=0.010) which was sustained, and showed a greater reduction in depressive symptoms (F(1,104)=6.5, p=0.013). Twenty-eight per cent of READY users disclosed, and reported a greater improvement in mental health than those who did not disclose.ConclusionsREADY provides a confidential, flexible and effective tool to enhance employee’s decision-making about disclosure. Its use led to a comparative improvement in depressive symptoms compared with the current information provided by a leading mental health non-governmental organisation, without apparent harm. READY seems worth evaluating in other settings and, if these results are replicated, scaling for wider use.Trial registration numberACTRN12618000229279.

scholarly journals Efficacy of a Guided Web-Based Self-Management Intervention for Depression or Dysthymia: Randomized Controlled Trial With a 12-Month Follow-Up Using an Active Control Condition

10.2196/15361 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e15361
Author(s):  
Caroline Oehler ◽  
Frauke Görges ◽  
Mandy Rogalla ◽  
Christine Rummel-Kluge ◽  
Ulrich Hegerl
Keyword(s):  
Depressive Symptoms ◽  
Active Control ◽  
User Satisfaction ◽  
Life Quality ◽  
Self Management ◽  
Wait List ◽  
Web Based ◽  
Management Intervention ◽  
Symptoms Of Depression

Background An increasing number of studies suggest that web-based interventions for patients with depression can reduce their symptoms and are expected to fill currently existing treatment gaps. However, evidence for their efficacy has mainly been derived from comparisons with wait-list or treatment as usual controls. In particular, designs using wait-list controls are unlikely to induce hope and may even have nocebo effects, making it difficult to draw conclusions about the intervention’s efficacy. Studies using active controls are rare and have not yielded conclusive results. Objective The main objective of this study is to assess the acute and long-term antidepressant efficacy of a 6-week, guided, web-based self-management intervention building on the principles of cognitive behavioral therapy (iFightDepression tool) for patients with depression compared with web-based progressive muscle relaxation as an active control condition. Methods A total of 348 patients with mild-to-moderate depressive symptoms or dysthymia (according to the Mini International Neuropsychiatric Interview) were recruited online and randomly assigned to 1 of the 2 intervention arms. Acute antidepressant effects after 6 weeks and long-term effects at 3-, 6-, and 12-month follow-up were studied using the Inventory of Depressive Symptomatology–self-rating as a primary outcome parameter and change in quality of life (Short Form 12) and user satisfaction (client satisfaction questionnaire) as secondary outcome parameters. Treatment effects were assessed using mixed model analyses. Results Over the entire observation period, a greater reduction in symptoms of depression (P=.01) and a greater improvement of life quality (P<.001) was found in the intervention group compared with the active control group. Separate tests for each time point revealed significant effects on depressive symptoms at the 3-month follow-up (d=0.281; 95% CI 0.069 to 0.493), but not after 6 weeks (main outcome:d=0.192; 95% CI −0.020 to 0.404) and 6 and 12 months. The intervention was significantly superior to the control condition with respect to user satisfaction (25.31 vs 21.97; t259=5.804; P<.01). Conclusions The fact that antidepressant effects have been found for a guided self-management tool in comparison with an active control strengthens the evidence base for the efficacy of web-based interventions. The antidepressant effect became most prominent at the 3-month follow-up. After 6 weeks of intervention, significant positive effects were observed on life quality but not on depressive symptoms. Although the effect size of such web-based interventions on symptoms of depression might be smaller than that suggested by earlier studies using wait-list control conditions, they can be a cost-effective addition to antidepressants and face-to-face psychotherapy. Trial Registration International Clinical Trials Registry Platform ICTRP080-15-09032015; https://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00009323

African American Women and Depression: Promoting the Need for Culturally Competent Treatment

2018 ◽  
Author(s):  
Bernice Kennedy ◽  
Chalice Jenkins ◽  
Keyword(s):  
Mental Health ◽  
African American ◽  
Depressive Symptoms ◽  
African American Women ◽  
Mental Health Problems ◽  
American Woman ◽  
Stressful Events ◽  
Mental Illnesses ◽  
Diagnostic Process ◽  
American Women

Abstract Depression is gradually increasing in African American women. These women are experiencing role changes and additional life stressors. Depressed African American women may perceive themselves as being devalued by society with fewer support systems to buffer stressful events. Depressive symptoms may develop into clinical depression and a further decrease in the quality of life for the African American woman. The assumption that all women share similar experiences does not allow for differences to emerge regarding the diagnostic process, measuring tools, and successful treatment strategies for various cultures. The authors developed a Multifaceted Model of Depression in African American Women for improving treatment of African American women with depression and future research needs. Cultural background plays a vital role in how the symptoms of mental illnesses are developed, reported, interpreted, and how women are treated. African Americans who subscribed to the Strong Black Women Archetype (SBWA) are naturally strong, resilient, self-contained, and self-sacrificing. This self-reliance prevents them from reaching out for social support. This, in turn, can contribute to depressive symptoms with negative health outcomes. The African American women are more apt to have less access to routine medical care where early diagnosis and interventions can be done, so their mental health problems (e.g., depression, stress, etc.) are often more developed, complicated, and their social supports more depleted when they do access treatment. When African American women do have access to mental health care, they receive poor quality care compared to Whites.

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