Development of a Group Intervention to Improve School Functioning in Adolescents with Chronic Pain and Depressive Symptoms: A Study of Feasibility and Preliminary Efficacy

The association between physical illness and depression implies a poorer management of chronic disease and a lower response to antidepressant treatments. Our study evaluates the effectiveness of a psychoeducational group intervention led by Primary Care (PC) nurses, aimed at patients of this kind. It is a randomized, multicenter clinical trial with intervention (IG) and control groups (CG), blind response variables, and a one year follow-up. The study included 380 patients ≥50 years of age from 18 PC teams. The participants presented depression (BDI-II > 12) and a physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. The IG (n = 204) received the psychoeducational intervention (12 weekly sessions of 90 min), and the CG (n = 176) had standard care. The patients were evaluated at baseline, and at 4 and 12 months. The main outcome measures were clinical remission of depressive symptoms (BDI-II ≤ 13) and therapeutic response (reduction of depressive symptoms by 50%). Remission was not significant at four months. At 12 months it was 53.9% in the IG and 41.5% in the CG. (OR = 0.61, 95% CI, 0.49–0.76). At 4 months the response in the IG (OR = 0.59, 95% CI, 0.44–0.78) was significant, but not at 12 months. The psychoeducational group intervention led by PC nurses for individuals with depression and physical comorbidity has been shown to be effective for remission at long-term and for therapeutic response at short-term.

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Light Therapy for QoL/Depression in AYA With Cancer: A Randomized Trial

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsab098 ◽

2021 ◽

Author(s):

Kayla N LaRosa ◽

Erin MacArthur ◽

Fang Wang ◽

Hui Zhang ◽

Haitao Pan ◽

...

Keyword(s):

Depressive Symptoms ◽

Negative Mood ◽

Red Light ◽

Light Therapy ◽

Self Esteem ◽

Physical Symptoms ◽

Self Report ◽

School Functioning ◽

Bright White Light

Abstract Objective Secondary outcomes from a published feasibility and acceptability trial were examined to explore the effect of bright white light (BWL) on quality of life (QoL) and depressive symptoms compared to dim red light (DRL) control in adolescents and young adults (AYAs) receiving cancer-directed therapy. Methods Fifty-one AYAs (12–22 years, 51% male) newly diagnosed with cancer were randomized to receive 8 weeks of BWL (n = 26) or DRL (n = 25). The CDI-2 (total score, negative mood/physical symptoms, interpersonal problems, ineffectiveness, and negative self-esteem) and parent- and self-report PedsQL (total score and subscales of physical, emotional, social, and school QoL) were completed at multiple timepoints. Results BWL produced improvements in self-reported total depression (d = −.64; 95% confidence interval [CI] = −1.26, −0.01), negative self-esteem (d = −.80; 95% CI = −1.43, −.14), negative mood/physical symptoms (d = −.73; 95% CI = −1.36, −0.08), ineffectiveness (d = −.43; 95% CI = −1.04, .19), total self-reported QoL (d = .41; 95% CI = −.16, .96), emotional (d = .78; 95% CI = .19, 1.37), school functioning (d = .48; 95% CI = −.09, 1.04), and parent-reported school functioning (d = .66; 95% CI = 0.02, 1.33). BWL reported a greater rate of improvement than DRL for total depression (β = .49, p < .05) and self-esteem (β = .44, p < .05), and parent-reported school functioning (β = −1.68, p < .05). Conclusions BWL improved QoL and depressive symptoms for AYAs with cancer. These findings will inform larger randomized controlled trials.

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Transdiagnostic Cognitive Processes in Chronic Pain and Comorbid PTSD and Depression in Veterans

Annals of Behavioral Medicine ◽

10.1093/abm/kaab033 ◽

2021 ◽

Author(s):

Melissa A Day ◽

Rhonda M Williams ◽

Aaron P Turner ◽

Dawn M Ehde ◽

Mark P Jensen

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Pain Intensity ◽

Cognitive Processes ◽

Cognitive Process ◽

Stress Disorder ◽

Secondary Analysis ◽

Lower Pain ◽

Depression Scales ◽

Ptsd Group

Abstract Background Chronic pain in Veterans is a major problem compounded by comorbid posttraumatic stress disorder (PTSD) and depression. Adopting a transdiagnostic framework to understanding “shared territory” among these diagnoses has the potential to inform our understanding of the underlying cognitive processes and mechanisms that transverse diagnostic boundaries. Purpose To examine the associations between pain-related cognitive processes (diversion, distancing, absorption, and openness), pain intensity, PTSD and depressive symptoms, and the extent to which Veterans with chronic pain with and without comorbid PTSD and depression engage in different/similar pain-related cognitive processes. Methods Secondary analysis of pretreatment data with a subsample (n = 147) of Veterans with chronic pain from a larger clinical trial. Pretreatment PCL-5 and PROMIS Depression scales were used to categorize participants into three groups: (a) Pain-only; (b) Pain-PTSD; and (c) Pain-PTSD-DEP. Results Compared to the Pain-only group, the Pain-PTSD and Pain-PTSD-DEP groups reported significantly greater pain intensity, PTSD and depressive symptoms, and ruminative pain absorption. The Pain-PTSD-DEP group had significantly lower pain diversion and pain openness scores. When diversion and openness were used within the Pain-PTSD-DEP group, however, they were both associated with lower pain intensity and openness was additionally associated with lower PTSD scores. However, in the Pain-PTSD group, pain openness was associated with higher depression scores. Conclusions Across increasing complexity of comorbidity profiles (i.e., one vs. two comorbid conditions), ruminative absorption with pain emerged as a cognitive process that transverses diagnoses and contributes to worse outcomes. Nonjudgmental acceptance may not be universally beneficial, potentially depending upon the nature of comorbidity profiles.

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Effect of Psychological Inflexibility on Depressive Symptoms and Sleep Disturbance among Japanese Young Women with Chronic Pain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207426 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7426

Author(s):

Tsukasa Kato

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Sleep Disturbance ◽

Sleep Disturbances ◽

Female College Students ◽

Psychological Inflexibility ◽

Management Interventions ◽

Pain Status ◽

Acceptance And Commitment ◽

Acceptance And Action Questionnaire

Background: Psychological inflexibility based on an acceptance and commitment therapy model is theoretically well-established as a process to exacerbate psychological distress, such as depressive symptoms and sleep disturbance. This study aimed to examine the associations of psychological inflexibility with depressive symptoms and sleep distribution. We hypothesized that psychological inflexibility would be associated with higher levels of depressive symptoms and sleep disturbance in women with chronic pain. Methods: Female college students in Japan answered a questionnaire on pain status, treatment, and psychological inflexibility as measured by the Acceptance and Action Questionnaire-Ⅱ before answering questionnaires on depressive symptoms and sleep disturbance eight months after. Results: Women with chronic pain (n = 320) reported more severe depressive symptoms and sleep disturbances compared to women without chronic pain (n = 90). Hierarchical multiple regressions revealed that psychological inflexibility predicted higher levels of depressive symptoms and sleep disturbance, independent of the pain intensity, whether they consulted a doctor or used pain medication. Conclusion: Based on our findings self-management interventions aimed at reducing psychological inflexibility should be developed for individuals who are experiencing chronic pain.

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