scholarly journals An Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth Diagnosed With Major Depressive Disorders: Protocol for a Randomized Controlled Trial

10.2196/11591 ◽  
2019 ◽  
Vol 8 (7) ◽  
pp. e11591
Author(s):  
Paul Ritvo ◽  
Zafiris J Daskalakis ◽  
George Tomlinson ◽  
Arun Ravindran ◽  
Renee Linklater ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Mental Health Disorders ◽  
Major Depressive ◽  
Randomized Controlled ◽  
The Past ◽  
Health Disorders

Background About 70% of all mental health disorders appear before the age of 25 years. When untreated, these disorders can become long-standing and impair multiple life domains. When compared with all Canadian youth (of different ages), individuals aged between 15 and 25 years are significantly more likely to experience mental health disorders, substance dependencies, and risks for suicidal ideation and death by suicide. Progress in the treatment of youth, capitalizing on their online responsivity, can strategically address depressive disorders. Objective We will conduct a randomized controlled trial to compare online mindfulness-oriented cognitive behavioral therapy (CBT-M) combined with standard psychiatric care versus psychiatric care alone in youth diagnosed with major depressive disorder. We will enroll 168 subjects in the age range of 18 to 30 years; 50% of subjects will be from First Nations (FN) backgrounds, whereas the other 50% will be from all other ethnic backgrounds. There will be equal stratification into 2 intervention groups (INT1 and INT2) and 2 wait-list control groups (CTL1 and CTL2) with 42 subjects per group, resulting in an equal number of INT1 and CTL1 of FN background and INT2 and CTL2 of non-FN background. Methods The inclusion criteria are: (1) age 18 to 30 years, FN background or other ethnicity; (2) Beck Depression Inventory (BDI)-II of at least mild severity (BDI-II score ≥14) and no upper limit; (3) Mini-International Neuropsychiatric Interview (MINI)–confirmed psychiatric diagnosis of major depressive disorder; and (4) fluent in English. All patients are diagnosed by a Centre for Addiction and Mental Health psychiatrist, with diagnoses confirmed using the MINI interview. The exclusion criteria are: (1) individuals receiving weekly structured psychotherapy; (2) individuals who meet the Diagnostic and Statistical Manual of Mental Disorders criteria for severe alcohol/substance use disorder in the past 3 months, or who demonstrate clinically significant suicidal ideation defined as imminent intent, or who have attempted suicide in the past 6 months; and (3) individuals with comorbid diagnoses of borderline personality, schizophrenia, bipolar disorder, and/or obsessive compulsive disorder. All subjects are provided standard psychiatric care defined as 1 monthly session that focuses on appropriate medication, with session durations of 15 to 30 min. Experimental subjects receive an additional intervention consisting of the CBT-M online software program (in collaboration with Nex J Health, Inc). Exposure to and interaction with the online workbooks are combined with navigation-coaching delivered by phone and secure text message interactions. Results The outcomes selected, combined with measurement blinding, are key features in assessing whether significant benefits regarding depression and anxiety symptoms occur. Conclusions If results confirm the hypothesis that youth can be effectively treated with online CBT-M, effective services may be widely delivered with less geographic restriction. International Registered Report Identifier (IRRID) PRR1-10.2196/11591

scholarly journals Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth With Major Depressive Disorders: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Paul Ritvo ◽  
Yuliya Knyahnytska ◽  
Meysam Pirbaglou ◽  
Wei Wang ◽  
George Tomlinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Mental Health Disorders ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Score Difference ◽  
Health Disorders

BACKGROUND Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth to communicate online, can strategically address depressive disorders. OBJECTIVE We performed a randomized controlled trial (RCT) that compared online mindfulness-based cognitive behavioral therapy (CBT-M) combined with standard psychiatric care to standard psychiatric care alone in youth (18-30 years old) diagnosed with major depressive disorder. METHODS Forty-five participants were randomly assigned to CBT-M and standard care (n=22) or to standard psychiatric care alone (n=23). All participants were provided standard psychiatric care (ie, 1 session per month), while participants in the experimental group received an additional intervention consisting of the CBT-M online software program. Interaction with online workbooks was combined with navigation coaching delivered by phone and secure text messaging. RESULTS In a two-level linear mixed-effects model intention-to-treat analysis, significant between-group differences were found for the Beck Depression Inventory-II score (difference –8.54, <i>P</i>=.01), Quick Inventory of Depressive Symptoms score (difference –4.94, <i>P</i>=.001), Beck Anxiety Inventory score (difference –11.29, <i>P</i>&lt;.001), and Brief Pain Inventory score (difference –1.99, <i>P</i>=.03), while marginal differences were found for the Five Facet Mindfulness Questionnaire–Nonjudging subscale (difference –2.68, <i>P</i>=.05). CONCLUSIONS These results confirm that youth depression can be effectively treated with online CBT-M that can be delivered with less geographic restriction. CLINICALTRIAL Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052

scholarly journals A smartphone-online intervention for youth diagnosed with major depressive disorders: Protocol for a randomized controlled trial. (Preprint)

2018 ◽  
Author(s):  
Paul Ritvo ◽  
Zafiris Daskalakis ◽  
George Tomlinson ◽  
Arun Ravindran ◽  
Renee Linklater ◽  
...  
Keyword(s):  
Mental Health ◽  
First Nations ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Cognitive Behavioural

BACKGROUND Seventy percent of mental health problems appear before the age of 25 years and when untreated can become long-standing, and significant, impairing multiple life domains (1). Although the problem is especially acute for youth from First Nations backgrounds, all Canadian youth aged 15- to 25 years are highly likely to experience mental health disorders, substance dependencies and suicide. Progress in the treatment of youth that capitalizes on tendencies to respond to online contacts strategically addresses mental health problems, particularly depressive disorders. OBJECTIVE We will conduct a randomized controlled trial (RCT), to compare online mindfulness-based cognitive behavioural therapy combined with standard psychiatric care vs. psychiatric care alone (wait-list controls) in youth diagnosed with major depressive disorder. We will enrol N = 168 subjects in the age range of 18-30 years, 50% of whom will be from First Nations backgrounds and the other 50% from all other ethnic backgrounds, equally stratified in two intervention groups and two (wait-list) control groups (42 subjects per group, where INT1 and CTL1 are FN background, and INT2 and CTL2 are non-FN background). METHODS In this RCT, the primary outcome will be self-reported depression on the Beck Depression Inventory II. Secondary outcomes include anxiety (Beck Anxiety Inventory), depression (Quick Inventory of Depressive Symptomatology, 24-item Hamilton Rating Scale for Depression (HRSD-24)), pain (Brief Pain Inventory) and mindfulness (Five-Facet Mindfulness Questionnaire). RESULTS Recruitment/retention rates will be assessed with estimates for the proportion of participants with complete data per outcome and time points divided by the total number of study participants. Variability of the main and interaction effects will be examined in the primary clinical outcome and each secondary outcome using separate repeated measures ANCOVA models, with Bonferroni corrections applied to the models applied. Hedges' g and associated confidence intervals will be calculated as an estimate of the effect size both over time (within groups) and between groups. Missing data will be evaluated on a case-by-case basis such that drop-outs will be excluded. CONCLUSIONS If results confirm hypotheses that youth can be effectively treated with online mindfulness-based cognitive behavioural therapy at reduced costs, effective services can be delivered more widely with less geographic restrictions. CLINICALTRIAL Clinical Trials.gov

scholarly journals Mental Health of Canadian Firefighters: The Impact of Sleep

2021 ◽  
Vol 18 (24) ◽  
pp. 13256
Author(s):  
Heidi Cramm ◽  
Rachel Richmond ◽  
Laleh Jamshidi ◽  
Megan Edgelow ◽  
Dianne Groll ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Disorders ◽  
Work Organization ◽  
Mental Health Disorders ◽  
Fire Service ◽  
Major Depressive ◽  
Design Fire ◽  
Significant Difference ◽  
Health Disorders ◽  
The Impact

Volunteer and career firefighters are at risk of major depressive disorders, posttraumatic stress disorder (PTSD), alcohol use disorder, and other mental health disorders due to the demanding and unpredictable nature of their employment. The mental health risks are exacerbated by the need to work extended hours, night shifts, and/or rotating schedules, or the competing demands of other employment, especially in volunteer firefighters. The mental health disorders and risk factors interact with altered sleeping patterns. In the current study, we examined volunteer and career firefighters regarding the association between mental health and sleep, drawing from a national Canadian mental health survey of 1217 firefighters. Most (69%) of the firefighters reported less than ideal sleep quality and 21% screened positive for clinical insomnia, with no significant difference between volunteer and career subgroups. Firefighters with insomnia had higher odds ratios (OR) and frequencies for PTSD (OR = 4.98), generalized anxiety disorder (OR = 7.15), panic disorder (OR = 6.88), social phobia (OR = 4.98), and major depressive disorder (OR = 7.91), than firefighters without insomnia. The burden of sleep disorders and their association with mental health disorders suggests that sleep should be considered in health monitoring and self-management, environmental design, fire service work-organization policies, and health programming.

A Telephone- and Text Message-Based Telemedicine Concept for Patients with Mental Health Disorders: Results of a Randomized Controlled Trial

2015 ◽  
Vol 84 (2) ◽  
pp. 82-89 ◽  
Author(s):  
Neeltje van den Berg ◽  
Hans-J�rgen Grabe ◽  
Sebastian E. Baumeister ◽  
Harald J. Freyberger ◽  
Wolfgang Hoffmann
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Text Message ◽  
Mental Health Disorders ◽  
Randomized Controlled ◽  
Health Disorders

Harnessing mobile technology to reduce mental health disorders in college populations: A randomized controlled trial study protocol

2021 ◽  
Vol 103 ◽  
pp. 106320
Author(s):  
Ellen E. Fitzsimmons-Craft ◽  
C. Barr Taylor ◽  
Michelle G. Newman ◽  
Nur Hani Zainal ◽  
Elsa E. Rojas-Ashe ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Mobile Technology ◽  
Study Protocol ◽  
Controlled Trial ◽  
Mental Health Disorders ◽  
Randomized Controlled ◽  
Health Disorders

Transdiagnostic versus Diagnosis-Specific Group Cognitive Behavioral Therapy for Anxiety Disorders and Depression: A Randomized Controlled Trial

2021 ◽  
pp. 1-14
Author(s):  
Nina Reinholt ◽  
Morten Hvenegaard ◽  
Anne Bryde Christensen ◽  
Anita Eskildsen ◽  
Carsten Hjorthøj ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
Major Depressive ◽  
Outpatient Mental Health ◽  
End Of Treatment

<b><i>Introduction:</i></b> The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments. <b><i>Objective:</i></b> This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services. <b><i>Methods:</i></b> In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. The primary test was non-inferiority, using a priori criteria, on the World Health Organisation 5 Well-Being Index (WHO-5) at the end of the treatment. Secondary outcomes were functioning and symptoms. We assessed outcomes at baseline, end-of-treatment, and at a 6-month follow-up. A modified per-protocol analysis was performed. <b><i>Results:</i></b> At end-of-treatment, WHO-5 mean scores for patients in UP (<i>n</i> = 148) were non-inferior to those of patients in dCBT (<i>n</i> = 143; mean difference –2.94; 95% CI –8.10 to 2.21). Results were inconclusive for the WHO-5 at the 6-month follow-up. Results for secondary outcomes were non-inferior at end-of-treatment and the 6-month follow-up. Client satisfaction and rates of attrition, response, remission, and deterioration were similar across conditions. <b><i>Conclusions:</i></b> This RCT demonstrated non-inferior acute-phase outcomes of group-delivered UP compared with dCBT for major depressive disorder, social anxiety disorder, panic disorder, and agoraphobia in outpatient mental health services. The long-term effects of UP on well-being need further investigation. If study findings are replicated, UP should be considered a viable alternative to dCBT for common anxiety disorders and depression in outpatient mental health services.

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