Depression, demoralization, and suicidality

2015 ◽  
Author(s):  
David W. Kissane ◽  
Matthew Doolittle
Keyword(s):  
Symptom Control ◽  
Combined Treatment ◽  
Mental Condition ◽  
Medical Treatments ◽  
Cognitive Behavioural ◽  
Treatment Of Depression ◽  
Screening For Distress ◽  
Behavioural Therapies ◽  
Meta Analyses ◽  
Anxiety Depression

The development of clinical depression is common during palliative care, adversely affects quality of life and adherence to medical treatments, yet regrettably can pass unrecognized. Screening for distress as the sixth vital sign is therefore highly recommended. Demoralization is another form of distress where the apparent pointlessness of continued life may lead to suicidal thinking. As the mental condition deteriorates, co-morbid states of anxiety, depression, and demoralization become more likely. Rates of suicide are increased with advanced cancer and poor symptom control. Fortunately, combined treatment with medication and counselling is effective in ameliorating depression, demoralization, and suicidality. Meta-analyses of psychotherapy trials confirm clear benefits, with behavioural activation, supportive, interpersonal, and cognitive behavioural therapies all making contributions. Group, couple, and family therapies optimize support for all involved. All members of the multidisciplinary team contribute to the active treatment of depression, demoralization, and the prevention of suicide.

scholarly journals What we know, what we do not know, and where are we heading? Efficacy and acceptability of psychological interventions for depression

2015 ◽  
Vol 25 (4) ◽  
pp. 301-308 ◽  
Author(s):  
N. Solomonov ◽  
J. P. Barber
Keyword(s):  
Randomized Clinical Trials ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Interpersonal Therapy ◽  
Problem Solving Therapy ◽  
Cognitive Behavioural ◽  
Treatment Of Depression ◽  
Personalised Treatment ◽  
Meta Analyses ◽  
And Control

In the past several decades, increasing evidence supports the efficacy of psychotherapies for depression. The vast majority of findings from meta-analyses, randomized clinical trials (RCTs) and naturalistic studies have demonstrated that well-established psychotherapies (behavioural activation, problem-solving therapy, psychodynamic therapy, cognitive-behavioural therapy, interpersonal therapy and emotion-focused therapy) are superior to no-treatment and control conditions, and are in most cases equally effective in treating depression. However, despite this abundant support for psychotherapies, studies have also consistently shown high drop-out rates, high percentages of non-respondent patients who experience treatment failures, and mixed findings regarding the enduring effects of psychotherapy. Thus, there is a need to develop more personalised treatment models tailored to patients’ needs. A new integrative sequential stepwise approach to the treatment of depression is suggested.

scholarly journals A meta-synthesis of qualitative studies of the link between anxiety, depression and perfectionism: implications for treatment

2021 ◽  
pp. 1-17
Author(s):  
Sarah J. Egan ◽  
Tracey D. Wade ◽  
Grace Fitzallen ◽  
Amy O’Brien ◽  
Roz Shafran
Keyword(s):  
Young People ◽  
Negative Affect ◽  
Behavioural Therapy ◽  
Qualitative Studies ◽  
Effective Interventions ◽  
Cognitive Behavioural ◽  
Self Worth ◽  
Meta Analyses ◽  
Anxiety Depression ◽  
Qualitative Literature

Abstract Background: Meta-analyses show an association between perfectionism and depression and anxiety (negative affect), and that therapy for perfectionism impacts positively on negative affect. No systematic reviews have focused on qualitative studies of perfectionism. Aims: Our aim was to perform a systematic, meta-synthesis of qualitative literature to (i) help inform our understanding of how perfectionism is associated with negative affect, so that we can (ii) inform future development of treatment for perfectionism in young people and to make it more effective. Method: Included in the meta-synthesis were 37 qualitative studies. Results: Six themes related to perfectionism were found: (1) the association with negative affect, (2) self-worth dependent on achievement, (3) cognitive and behavioural maintaining factors, (4) the expectations of others, (5) effective elements of interventions, and (6) barriers to treatment. Conclusions: The qualitative literature supports the notion of perfectionism as an important construct to consider in reducing negative affect. While cognitive behavioural therapy for perfectionism holds promise as a treatment to target negative affect, there was a paucity of qualitative research, particularly related to young people. A greater understanding of the views of young people are required to help tailor more effective interventions for perfectionism that can impact negative affect in this group.

scholarly journals The effects of cognitive and behavioural therapies for anxiety disorders on depression: a meta-analysis

2016 ◽  
Vol 46 (16) ◽  
pp. 3451-3462 ◽  
Author(s):  
P. Cuijpers ◽  
I. A. Cristea ◽  
E. Weitz ◽  
C. Gentili ◽  
M. Berking
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Effect Sizes ◽  
Cognitive Behavioural ◽  
Cochrane Database ◽  
Behavioural Therapies ◽  
Meta Analyses

BackgroundThe effects of cognitive behavioural therapy of anxiety disorders on depression has been examined in previous meta-analyses, suggesting that these treatments have considerable effects on depression. In the current meta-analysis we examined whether the effects of treatments of anxiety disorders on depression differ across generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder (PD). We also compared the effects of these treatments with the effects of cognitive and behavioural therapies of major depression (MDD).MethodWe searched PubMed, PsycINFO, EMBASE and the Cochrane database, and included 47 trials on anxiety disorders and 34 trials on MDD.ResultsBaseline depression severity was somewhat lower in anxiety disorders than in MDD, but still mild to moderate in most studies. Baseline severity differed across the three anxiety disorders. The effect sizes found for treatment of the anxiety disorders ranged from g = 0.47 for PD, g = 0.68 for GAD and g = 0.69 for SAD. Differences between these effect sizes and those found in the treatment of MDD (g = 0.81) were not significant in most analyses and we found few indications that the effects differed across anxiety disorders. We did find that within-group effect sizes resulted in significantly (p < 0.001) larger effect sizes for depression (g = 1.50) than anxiety disorders (g = 0.73–0.91). Risk of bias was considerable in the majority of studies.ConclusionsPatients participating in trials of cognitive behavioural therapy for anxiety disorders have high levels of depression. These treatments have considerable effects on depression, and these effects are comparable to those of treatment of primary MDD.

scholarly journals Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047212
Author(s):  
Anke de Haan ◽  
Caitlin Hitchcock ◽  
Richard Meiser-Stedman ◽  
Markus A Landolt ◽  
Isla Kuhn ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Risk Of Bias ◽  
Randomised Trials ◽  
First Line ◽  
Cognitive Behavioural ◽  
Individual Participant ◽  
Behavioural Therapies ◽  
First Line Treatment

IntroductionTrauma-focused cognitive behavioural therapies are the first-line treatment for posttraumatic stress disorder (PTSD) in children and adolescents. Nevertheless, open questions remain with respect to efficacy: why does this first-line treatment not work for everyone? For whom does it work best? Individual clinical trials often do not provide sufficient statistical power to examine and substantiate moderating factors. To overcome the issue of limited power, an individual participant data meta-analysis of randomised trials evaluating forms of trauma-focused cognitive behavioural therapy in children and adolescents aged 6–18 years will be conducted.Methods and analysisWe will update the National Institute for Health and Care Excellence guideline literature search from 2018 with an electronic search in the databases PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials and CINAHL with the terms (trauma* OR stress*) AND (cognitive therap* OR psychotherap*) AND (trial* OR review*). Electronic searches will be supplemented by a comprehensive grey literature search in archives and trial registries. Only randomised trials that used any manualised psychological treatment—that is a trauma-focused cognitive behavioural therapy for children and adolescents—will be included. The primary outcome variable will be child-reported posttraumatic stress symptoms (PTSS) post-treatment. Proxy-reports (teacher, parent and caregiver) will be analysed separately. Secondary outcomes will include follow-up assessments of PTSS, PTSD diagnosis and symptoms of comorbid disorders such as depression, anxiety-related and externalising problems. Random-effects models applying restricted maximum likelihood estimation will be used for all analyses. We will use the Revised Cochrane Risk of Bias tool to measure risk of bias.Ethics and disseminationContributing study authors need to have permission to share anonymised data. Contributing studies will be required to remove patient identifiers before providing their data. Results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration numberCRD42019151954.

Prisoner’s insomnia prevalence, insomnia associated factors and interventions with sleep as an outcome: a review and narrative analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chris Griffiths ◽  
Farah Hina
Keyword(s):  
Narrative Analysis ◽  
Associated Factors ◽  
Behavioural Therapy ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Cognitive Behavioural ◽  
High Prevalence ◽  
Randomised Control Trials ◽  
Post Traumatic ◽  
Anxiety Depression

Purpose Insomnia is highly prevalent in prisoners. The purpose of this paper is a review of research evidence on interventions with sleep as an outcome (2000 to 2020) and rates of insomnia prevalence and associated factors in prisons (2015 to 2020). Design/methodology/approach An internet-based search used Medline, PubMed, PsycINFO (EBSCOhost), Embase, Web of Science and Scopus. Seven interventions and eight sleep prevalence or sleep-associated factor papers were identified. Findings Intervention research was very limited and the quality of the research design was generally poor. Interventions such as cognitive behavioural therapy for insomnia (CBT-I), yoga and mindfulness can be beneficial in a prison setting. This review identified a high prevalence of insomnia in prisons across the world, which was supported by recent evidence. Factors associated with insomnia include anxiety, depression, post-traumatic stress disorder, personality disorder and pain. Research limitations/implications There is a need for appropriately powered randomised control trials of CBT-I in prisons and a need to use objective measures of sleep quality. Originality/value Due to a lack of an up-to-date review, this paper fulfils the need for a review of the evidence on interventions in prison settings with sleep as an outcome, rates of insomnia prevalence and associated factors in prisons.

A Systematic Literature Review on the Importance of Anthropometric Data Toward the Malaysian Population Productivity and Quality of Life

2021 ◽  
Vol 39 (10) ◽  
Author(s):  
Nurashikin Saaludin ◽  
Amna Saad ◽  
Cordelia Mason ◽  
Norsaadah Zakaria
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Anthropometric Data ◽  
Identity Verification ◽  
Medical Treatments ◽  
Car Seat ◽  
Safety Work ◽  
Conducting Research ◽  
Meta Analyses

Anthropometric data is widely used in various applications such as manufacturing, healthcare, forensics, and medical treatments. In addition, the data can be applied to design ergonomic tools, equipment, clothing, and footwear to ensure that the products, facilities, and services fit the users. This paper aims to analyze the existing literature on the importance of anthropometric data on the Malaysian population's productivity and quality of life and look into any further research that needs improvement. Guided by the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), through Scopus and Web of Science databases, 15 related studies were identified. The review managed to extract six applications of anthropometric data and its seven perceived benefits. Data applications were classified into furniture, clothing and footwear, car seat, fitting and fixture, forensic investigation, and safety products. The benefits were grouped into easy to use, fit, well-being, welfare, safety, work efficiency, and identity verification by using thematic analysis. The review also highlighted the methodological issues related to the number of samples, locations coverage for a survey and the financial support in conducting research. Finally, several recommendations were drawn, including the importance of anthropometric database development at the end of this paper for reference by future scholars.

Effects of cognitive-behavioural therapy on anxiety, depression and condom use in people with HIV in Mexico City: a pilot study

2018 ◽  
Vol 24 (1) ◽  
pp. 115-125
Author(s):  
Nancy Patricia Caballero-Suárez ◽  
María Candela Iglesias ◽  
Evelyn Rodríguez Estrada ◽  
Gustavo Reyes Terán ◽  
Angélica Riveros Rosas
Keyword(s):  
Pilot Study ◽  
Condom Use ◽  
Mexico City ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Anxiety Depression

scholarly journals Effectivity of Psychotherapy Interventions for Anxiety in Medical Students: A Systematic Review

2021 ◽  
Vol 9 (F) ◽  
pp. 453-463
Author(s):  
Andrian Fajar Kusumadewi ◽  
Carla Raymondalexas Marchira ◽  
Widyandana Widyandana ◽  
Ronny Tri Wirasto
Keyword(s):  
Systematic Review ◽  
Medical Students ◽  
Systematic Reviews ◽  
Depression And Anxiety ◽  
Inclusion Criteria ◽  
Meta Analyses ◽  
And Behavior ◽  
Anxiety Depression ◽  
Suicidal Ideas ◽  
Psychotherapy Interventions

BACKGROUND: The mental health of medical students has long been a topic of concern in many countries. Much research in Europe reported that around 30% of medical students suffered from anxiety. Anxiety disorders have significant physical and emotional consequences. Various studies show that excessive, unmanaged stress related to poor academic performance in medical students leads to cynical personalities, lack of empathy, and suicidal ideas. AIM: This study aimed to identify studies for psychotherapy interventions carried out in medical students and analyze each impact on anxiety level in medical students. METHODS: This systematic review was conducted with evidence sourced from 2000 to 2020. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered with the Prospective Registering of Systematic Reviews database (Protocol ID: CRD42020180650). RESULTS: Twenty-three studies meet the inclusion criteria, and there are various psychotherapy interventions to deal with anxiety. Most studies reported that students who received mindfulness-based interventions reported lower anxiety, depression, and stress. CONCLUSION: There are various interventions carried out to decrease stress levels, depression, and anxiety in medical students. The most effective psychotherapy was found in cognitive and behavior intervention and mindfulness intervention.

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