The effects of psychological treatment of perinatal depression: an overview

Important Public Health Problem ◽

Treatment Of Depression ◽

Moderate Effect Size ◽

Abstract Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we will present the results of a series of meta-analyses on psychological treatments of perinatal depression. We report the results of a series of meta-analyses on psychological treatments of depression, including perinatal depression. The meta-analyses are based on a database of randomized trials on psychotherapies for depression that has been systematically developed and updated every year. Psychological interventions are effective in the treatment of perinatal depression with a moderate effect size of g = 0.67, corresponding with a NNT of about 4. These effects were still significant at 12 months after the start of the treatment. These interventions also have significant effects on social support, anxiety, functional impairment, parental stress, and marital stress. Possibly the effects are overestimated because of the use of waiting list control groups, the low quality of the majority of trials and publication bias. Research on psychotherapies for depression in general has shown that there are no significant differences between the major types of therapy, except for non-directive counseling that may have somewhat smaller effects. CBT can also be delivered in individual, group, telephone, and guided self-help format. Interventions in subthreshold depression are also effective and may prevent the onset of a full-blown depressive disorder, while therapies may be less effective in chronic depression. Psychological interventions are effective and deserve their place as first-line treatment of perinatal depression.

Psychological treatment of depression in children and adolescents

The British Journal of Psychiatry ◽

10.1192/bjp.173.4.291 ◽

1998 ◽

Vol 173 (4) ◽

pp. 291-298 ◽

Cited By ~ 71

Author(s):

Richard Harrington ◽

Jane Whittaker ◽

Philp Shoebridge

Keyword(s):

Depressive Symptoms ◽

Depressive Disorders ◽

Preventive Intervention ◽

Psychological Treatment ◽

Behavioural Therapy ◽

Literature Searches ◽

Cognitive Behavioural ◽

Treatment Of Depression

BackgroundThis paper reviews research on the psychological treatment of depression in children.MethodManual and computer literature searches were performed.ResultsThe most promising psychological interventions for depression in children are individual rather than family therapies. Cognitive – behavioural therapy seems to be an effective treatment for depressive symptoms and mild depressive disorders. It may also be a useful preventive intervention, though this remains to be conclusively demonstrated. There have been no systematic studies comparing psychological treatments with medication.ConclusionsStudies comparing psychological treatments and medication are now required.

Psychological treatment of perinatal depression: a meta-analysis

Psychological Medicine ◽

10.1017/s0033291721004529 ◽

2021 ◽

pp. 1-13

Author(s):

Pim Cuijpers ◽

Pamela Franco ◽

Marketa Ciharova ◽

Clara Miguel ◽

Lisa Segre ◽

...

Keyword(s):

Social Support ◽

Effect Size ◽

Parental Stress ◽

Perinatal Depression ◽

Psychological Treatment ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Control Group ◽

Marital Stress

Abstract Background Depression during pregnancy and after the birth of a child is highly prevalent and an important public health problem. Psychological interventions are the first-line treatment and, although a considerable number of randomized trials have been conducted, no recent comprehensive meta-analysis has evaluated treatment effects. Methods We used an existing database of randomized controlled trials of psychotherapies for adult depression and included studies aimed at perinatal depression. Random effects models were used in all analyses. We examined the effects of the interventions in the short and long term, and also examined secondary outcomes. Results Forty-three studies with 49 comparisons and 6270 participants between an intervention and control group were included. The overall effect size was g = 0.67 [95% confidence interval (CI) 0.45~0.89; numbers needed-to-be-treated = 4.39] with high heterogeneity (I2 = 80%; 95% CI 75~85). This effect size remained largely unchanged and significant in a series of sensitivity analyses, although some publication bias was found. The effects remained significant at 6–12 months follow-up. Significant effects were also found for social support, anxiety, functional limitations, parental stress and marital stress, although the number of studies for each outcome was low. All results should be considered with caution because of the high levels of heterogeneity in most analyses. Conclusions Psychological interventions are probably effective in the treatment of perinatal depression, with effects that last at least up to 6–12 months and probably also have effects on social support, anxiety, functional impairment, parental stress, and marital stress.

Effectiveness of psychological interventions in the treatment of perinatal depression: A systematic review of systematic reviews and meta-analyses

Journal of Affective Disorders ◽

10.1016/j.jad.2021.05.010 ◽

2021 ◽

Author(s):

Mariana Branquinho ◽

María de la Fe Rodriguez-Muñoz ◽

Berta Rodrigues Maia ◽

Mariana Marques ◽

Marcela Matos ◽

...

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Perinatal Depression ◽

Management of self-harm in adults: which way now?

The British Journal of Psychiatry ◽

10.1192/bjp.187.6.497 ◽

2005 ◽

Vol 187 (6) ◽

pp. 497-499 ◽

Cited By ~ 22

Author(s):

Navneet Kapur

Keyword(s):

Staff Training ◽

Service Provision ◽

Good Practice ◽

Public Health Problem ◽

Evidence Based ◽

Current Management ◽

Important Public Health Problem ◽

Low Intensity ◽

Self Harm

SummarySelf-harm remains an important public health problem and two sets of clinical guidelines have been published recently. While these include elements of accepted good practice they are not evidence-based. Further research might concentrate on either very large trials of low-intensity interventions or smaller trials of longer-term psychological treatments. The current management of self-harm may be improved by shifting professionals' views, involving users in staff training, and changing service provision – perhaps moving from risk assessment to needs assessment.

Psychotherapy for patients with complex disorders and chronic symptoms

The British Journal of Psychiatry ◽

10.1192/bjp.177.2.131 ◽

2000 ◽

Vol 177 (2) ◽

pp. 131-137 ◽

Cited By ~ 40

Author(s):

E. Guthrie

Keyword(s):

External Validity ◽

Psychological Treatment ◽

Internal Validity ◽

Outcome Study ◽

Complex Disorders ◽

Efficacy Trials ◽

Methods Of Evaluation ◽

To Receive

BackgroundA clear distinction has been made between efficacy and effectiveness in relation to the methods of evaluation of new psychological treatments in psychiatry. Efficacy trials target patients with relatively pure conditions, who may not be representative of the patients who are usually referred for psychological treatment in a clinical setting. Few studies have explored the benefits of psychotherapy in patients with complex disorders and enduring symptoms.AimsTo explore the rationale for the distinction between efficacy and effectiveness, particularly in relation to outcome studies of patients with complex and enduring disorders.MethodA narrative review with examples drawn from the literature, and an illustration of a recent naturalistic outcome study which combines features of both efficacy and effectiveness.ResultsStudies of patients with complex and mixed disorders can be designed so that they retain internal validity, but also have external validity and are relevant to clinical practice.ConclusionStudies which evaluate psychological interventions should be carried out in populations of patients clinically representative of those who are likely to receive the intervention, should it be shown to be of benefit.

Comparison of Perceived Barriers and Treatment Preferences Associated with Internet-Based and Face-to-Face Psychological Treatment of Depression

International Journal of Cyber Behavior Psychology and Learning ◽

10.4018/ijcbpl.2014100102 ◽

2014 ◽

Vol 4 (4) ◽

pp. 16-22 ◽

Cited By ~ 12

Author(s):

Leanne M. Casey ◽

Marie-Ann Wright ◽

Bonnie A. Clough

Keyword(s):

Online Survey ◽

Barriers To Care ◽

Psychological Treatment ◽

Treatment Preferences ◽

Barriers To Treatment ◽

Face To Face ◽

Treatment Of Depression ◽

Participation Restrictions ◽

Receive Treatment

One of the major reasons that internet-based psychological treatments are strongly advocated is the belief that they may enable consumers to overcome many of the barriers to treatment otherwise encountered in seeking face to face treatment. A corollary to this belief is the assumption that many consumers may then be more likely to prefer to receive treatment via the internet because of the reduced barriers to care offered by internet-based treatments. However, there has been no formal examination of the barriers perceived by consumers to internet-based treatments in comparison to face to face treatment to ascertain whether these hypothesized differences impact on treatment preferences. This study compared consumer perceptions of barriers to treatment for both internet and face-to-face psychological treatments for depression. Of interest was whether consumers continue to report a preference for face-to-face treatment over internet-based treatment, even if perceptions of barriers to care were deemed greater for traditional than internet based delivery of services. Potential consumers of a structured online psychological program for workplace depression were targeted. An online survey was accessed by fifty-three employed individuals (female = 35, male = 18) with ages ranging from 18 to 60 (M = 35.57, SD = 12.15). Results indicated that participants perceived that internet-based treatment was associated with fewer barriers than face-to-face treatment for depression. Participants perceived that time constraints and participation restrictions would make it more difficult to access face-to-face treatment than internet-based treatment. However, the participants reported that they would be more likely to access face-to-face treatment for depression than internet-based treatment. These results suggest that there is a need to further investigate ways in which consumers can be encouraged to consider engaging in internet-based treatment.

Psychological treatment of depression: Results of a series of meta-analyses

Nordic Journal of Psychiatry ◽

10.3109/08039488.2011.596570 ◽

2011 ◽

Vol 65 (6) ◽

pp. 354-364 ◽

Cited By ~ 166

Author(s):

Pim Cuijpers ◽

Gerhard Andersson ◽

Tara Donker ◽

Annemieke van Straten

Keyword(s):

Psychological Treatment ◽

Treatment Of Depression ◽

eHealth Interventions for Treatment of Depression, Anxiety and Insomnia during Pregnancy: A Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.31116 ◽

2021 ◽

Author(s):

Katherine A. Silang ◽

Pooja R. Sohal ◽

Katherine Bright ◽

Jennifer Leason ◽

Leslie Roos ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Effect Sizes ◽

Face To Face ◽

Treatment Of Depression ◽

Increased Risk ◽

Moderate Effect Size ◽

Ehealth Intervention ◽

Meta Analyses ◽

The University

BACKGROUND Pregnancy is associated with an increased risk for depression, anxiety and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face intervention. OBJECTIVE The objective of this systematic review and meta-analysis was to determine the effectiveness of eHealth interventions to prevent and/or treat depression, anxiety and insomnia during pregnancy. Secondary aims were to identify demographic and intervention moderators of effectiveness. METHODS Five databases (PsycINFO, Medline, CINAHL, Embase, Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials, depression, anxiety, and insomnia were included. RCTs were included if they reported (a) an eHealth intervention for (b) the prevention or treatment of depression, anxiety or insomnia (c) in pregnant women. Study screening, data extractions and quality assessment were conducted independently by two reviewers. Random effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. RESULTS In total, 17 studies were included in the current review that assessed changes in depression (11), anxiety (n=10), and insomnia (n=3). Several studies included both depression and anxiety symptoms as outcomes (n=7). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where Mindfulness interventions outperformed other intervention types, no significant moderators were detected. CONCLUSIONS eHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. CLINICALTRIAL The study was registered with PROSPERO through the University of York Center for Reviews and Dissemination (Registration No. CRD42020205186).

Theories of Change and Mediators of Psychotherapy Effectiveness in Adolescents With Externalising Behaviours: A Systematic Review

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.730921 ◽

2022 ◽

Vol 12 ◽

Author(s):

José M. Mestre ◽

Svenja Taubner ◽

Catarina Pinheiro Mota ◽

Margarida Rangel Henriques ◽

Andrea Saliba ◽

...

Keyword(s):

Systematic Review ◽

Psychological Treatment ◽

Positive Balance ◽

Externalising Behaviours ◽

Externalising Symptoms ◽

Theories Of Change ◽

Randomised Controlled ◽

Family Variables ◽

BackgroundExternalising behaviours are becoming a remarkably prevalent problem during adolescence, often precipitating both externalising and internalising disorders in later adulthood. Psychological treatments aim to increase the social functioning of adolescents in order for them to live a more balanced life and prevent these negative trajectories. However, little is known of the intervening variables and mediators involved in these treatments' change mechanisms. We conducted a systematic review, exploring the available evidence on mediators of psychological treatments for externalising behaviours and symptoms amongst adolescents (10 to 19 years old).MethodsA systematic search was performed on Medline and PsycINFO databases, which identified studies from inception to February 23, 2020. Eligible studies included randomised controlled trials that enrolled adolescents with externalising symptoms and behaviours as, at least, one of the primary outcomes. A group of 20 reviewers from the COST-Action TREATme (CA16102) were divided into 10 pairs. Each pair independently screened studies for inclusion, extracted information from the included studies, and assessed the methodological quality of the included studies and the requirements for mediators, following Kazdin's criteria. Risk of bias of RCTs was assessed by the Mixed Methods Appraisal Tool. Extracted data from the included studies were reported using a narrative synthesis.ResultsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), after removing duplicates, 3,660 articles were screened. Disagreements were resolved by consensus. In a second stage, 965 full-text articles were assessed for eligibility. A total of 14 studies fulfilled all inclusion criteria. The majority were related to systemic psychological treatment approaches. Two types of mediators were identified as potentially being involved in the mechanisms of change for better social improvements of adolescents: to increase healthier parent–adolescent relationships and parental discipline. However, there were significant and non-significant results amongst the same mediators, which led to discussing the results tentatively.ConclusionsFamily variables were found to be the largest group of investigated mediators, followed by relational, behavioural, and emotional variables. No cognitive or treatment-specific mediators were identified. Both adequate behavioural control of adolescents' peer behaviour and a better positive balance in their relationships with their parents seemed to buffer the effects of externalising behaviours in adolescents. Several methodological limitations concerning mediation testing design, outcome measures, and mediator selection have been identified.Ethics and DisseminationEthical approval was not required. PROSPERO registration number: CRD42021231835.

Suicide on the Indian Subcontinent

Crisis ◽

10.1027//0227-5910.23.3.104 ◽

2002 ◽

Vol 23 (3) ◽

pp. 104-107 ◽

Cited By ~ 36

Author(s):

Murad M. Khan

Keyword(s):

Sri Lanka ◽

Mental Health Professionals ◽

Indian Subcontinent ◽

Interpersonal Relationship ◽

Public Health Problem ◽

Elderly Subjects ◽

Important Public Health Problem ◽

Policy Makers ◽

Formidable Challenge ◽

Causative Factors

Summary: The Indian subcontinent comprises eight countries (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, and the Maldives) and a collective population of more than 1.3 billion people. 10% of the world's suicides (more than 100,000 people) take place in just three of these countries, viz. India, Sri Lanka, and Pakistan. There is very little information on suicides from the other four countries. Some differences from suicides in Western countries include the high use of organophosphate insecticides, larger numbers of married women, fewer elderly subjects, and interpersonal relationship problems and life events as important causative factors. There is need for more and better information regarding suicide in the countries of the Indian subcontinent. In particular, studies must address culture-specific risk factors associated with suicide in these countries. The prevention of this important public health problem in an area of the world with myriad socio-economic problems, meager resources, and stigmatization of mental illness poses a formidable challenge to mental health professionals, policy makers, and governments of these countries.