scholarly journals Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder: Case Report

10.2196/24331 ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. e24331
Author(s):  
Margot Paul ◽  
Kim Bullock ◽  
Jeremy Bailenson
Keyword(s):  
Virtual Reality ◽  
Major Depressive Disorder ◽  
Case Report ◽  
Depressive Disorder ◽  
Rating Scales ◽  
Behavioral Activation ◽  
Self Report ◽  
Clinical Population ◽  
Depression Symptoms ◽  
Major Depressive

Background Major depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. There has additionally been an increase in depression due to the COVID-19 pandemic. Behavioral activation is considered an evidence-based treatment for MDD. However, there are many barriers that could hinder one’s ability to engage in behavioral activation, with COVID-19 “shelter-in-place” and social distancing orders being current and large impediments. Virtual reality (VR) has been successfully used to help treat a variety of mental health conditions, but it has not yet been used as a method of administering behavioral activation to a clinical population. Using VR to engage in behavioral activation could eliminate barriers that pandemic precautions place and help decrease symptoms of depression that are especially exacerbated in these times. Objective The following case report examines the feasibility, acceptability, and tolerability of VR behavioral activation for an adult with MDD during a global pandemic. This participant was part of a larger pilot study, and the case serves as a description of the VR intervention. Methods The participant engaged in a weekly 50-minute psychotherapy Zoom session for 4 weeks, in which a modified behavioral activation protocol was administered using a VR headset to simulate activities. Data on mood ratings, homework compliance, and headset use were obtained from the headset. Acceptability, tolerability, and depression symptoms were obtained using self-report rating scales. Results The intervention was feasible, acceptable, and tolerable, as reported by this participant. The participant’s depressive symptoms decreased by five-points on the Patient Health Questionnaire-9 over a month, with a beginning score of 10 (moderate depression) and a final score of 5 (mild depression). Conclusions The implications of these findings for future research are discussed. Trial Registration ClinicalTrials.gov NCT04268316; http://clinicaltrials.gov/ct2/show/NCT04268316

scholarly journals Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder: Case Report (Preprint)

2020 ◽  
Author(s):  
Margot Paul ◽  
Kim Bullock ◽  
Jeremy Bailenson
Keyword(s):  
Virtual Reality ◽  
Major Depressive Disorder ◽  
Case Report ◽  
Depressive Disorder ◽  
Rating Scales ◽  
Behavioral Activation ◽  
Self Report ◽  
Clinical Population ◽  
Depression Symptoms ◽  
Major Depressive

BACKGROUND Major depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. There has additionally been an increase in depression due to the COVID-19 pandemic. Behavioral activation is considered an evidence-based treatment for MDD. However, there are many barriers that could hinder one’s ability to engage in behavioral activation, with COVID-19 “shelter-in-place” and social distancing orders being current and large impediments. Virtual reality (VR) has been successfully used to help treat a variety of mental health conditions, but it has not yet been used as a method of administering behavioral activation to a clinical population. Using VR to engage in behavioral activation could eliminate barriers that pandemic precautions place and help decrease symptoms of depression that are especially exacerbated in these times. OBJECTIVE The following case report examines the feasibility, acceptability, and tolerability of VR behavioral activation for an adult with MDD during a global pandemic. This participant was part of a larger pilot study, and the case serves as a description of the VR intervention. METHODS The participant engaged in a weekly 50-minute psychotherapy Zoom session for 4 weeks, in which a modified behavioral activation protocol was administered using a VR headset to simulate activities. Data on mood ratings, homework compliance, and headset use were obtained from the headset. Acceptability, tolerability, and depression symptoms were obtained using self-report rating scales. RESULTS The intervention was feasible, acceptable, and tolerable, as reported by this participant. The participant’s depressive symptoms decreased by five-points on the Patient Health Questionnaire-9 over a month, with a beginning score of 10 (moderate depression) and a final score of 5 (mild depression). CONCLUSIONS The implications of these findings for future research are discussed. CLINICALTRIAL ClinicalTrials.gov NCT04268316; http://clinicaltrials.gov/ct2/show/NCT04268316

scholarly journals The Symptom Structure of Postdisaster Major Depression: Convergence of Evidence from 11 Disaster Studies Using Consistent Methods

2021 ◽  
Vol 11 (1) ◽  
pp. 8
Author(s):  
Carol S. North ◽  
David Baron
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Diagnostic Assessment ◽  
Self Report ◽  
Depression Symptoms ◽  
Symptom Scale ◽  
Major Depressive ◽  
Report Symptom ◽  
Symptom Patterns

Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using consistent research methods and full diagnostic assessment, addressing limitations of prior self-report symptom-scale studies. The sample included 808 directly-exposed survivors of 10 disasters assessed 1–6 months post disaster and 373 employees of 8 organizations affected by the September 11, 2001 terrorist attacks assessed nearly 3 years after the attacks. Consistent symptom patterns identifying postdisaster major depression were not found across the 2 databases, and database factor analyses suggested a cohesive grouping of depression symptoms. In conclusion, this study did not find symptom clusters identifying postdisaster major depression to guide the construction and validation of screeners for this disorder. A full diagnostic assessment for identification of postdisaster major depressive disorder remains necessary.

Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder: A Feasibility and Pilot Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Margot Paul ◽  
Kim Bullock
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Reality ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Behavioral Activation ◽  
Controlled Trial ◽  
Treatment Control ◽  
Major Depressive ◽  
Randomized Controlled ◽  
Pilot Randomized Controlled Trial

UNSTRUCTURED Context: Major depressive disorder (MDD) is a global crisis with increasing incidence and prevalence. There are many established evidence-based psychotherapies (EBP’s) for depression, but they present with various limitations. Virtual reality (VR) may offer some solutions to these limitations of existing MDD EBP’s. Objective: To examine the feasibility, acceptability, and tolerability of using VR as a method of delivering behavioral activation (BA) for adults diagnosed with MDD during a global pandemic. To explore the degree of clinical efficacy of using VR to engage in BA compared to (1) a BA treatment as usual and (2) a non-treatment control group for individuals diagnosed with MDD. Design, Settings, Participants: We conducted a feasibility trial and a three-arm nonblinded between-subjects pilot randomized controlled trial. This study took place remotely via Zoom telehealth between April 8, 2020 and January 15, 2021. Intervention: This study employed a three week, four-session BA protocol, where the VR BA participants used a VR headset to complete their BA homework. Outcome Measures: The primary outcome was measured by dropout rates, serious adverse events, completion of homework, an adapted telepresence scale, a simulator sickness questionnaire, a brief agitation measure, and an adapted technology acceptance model. The secondary outcome was measured by the Patient Health Questionnaire-9 (PHQ-9). Results: Of the 35 participants assessed for eligibility, 13 were randomized to VR BA (n=5), BA TAU (n=4), or a non-treatment control (n=4). The mean age of the 13 participants (5 male, 7 female, 1 non-binary/third gender) was 35.4 (SD = 12.3). This study demonstrated that VR is a feasible, acceptable, and tolerable method of experiencing pleasurable activities in conjunction with a brief BA protocol for individuals diagnosed with MDD. No adverse events were reported. This study also illustrated that VR BA has potential clinical utility in treating symptoms of depression, as the average VR BA participant diagnosis changed from a moderate severity level to mild depression, with a clinically significant average decrease of 5.67 on the PHQ-9. Conclusion: The findings of this study demonstrate that VR BA is a feasible treatment for MDD. This study documented evidence of VR BA’s efficacy and further justification to explore its true effect in an adequately powered RCT. This pilot documented the potential utility that VR could offer patients with MDD, especially those who have difficulty accessing real-world pleasant activities. VR may also be a viable alternative to psychiatric medications for MDD, given its high tolerability and lack of side effects. Additionally, for those having difficulty accessing care, VR BA could be adapted as a first step to help people improve mood and increase motivation while waiting to connect with a healthcare professional for other EBP’s. INTERNATIONAL REGISTERED REPORT RR2-10.2196/24331

Psychiatric shades of grey: mirtazapine-induced hair discoloration and hair loss

2016 ◽  
Vol 33 (3) ◽  
pp. 175-178 ◽  
Author(s):  
M. Osman ◽  
M. D. McCauley
Keyword(s):  
Major Depressive Disorder ◽  
Case Report ◽  
Adverse Effects ◽  
Depressive Disorder ◽  
Hair Loss ◽  
Temporal Relationship ◽  
Relevant Literature ◽  
Major Depressive ◽  
Hair Colour ◽  
Medical Reason

IntroductionMirtazapine is indicated in the treatment of major depressive disorder particularly in selective serotonin re-uptake inhibitors resistance. Its effect on hair loss is rare with no previous documented effect on hair colour.MethodReview of relevant literature and description of a case report of a 54-year-old male patient who developed alopecia and hair discoloration after initiation of mirtazapine treatment.ResultsUpon cessation of mirtazapine treatment full restoration of hair colour and regrowth of hair was attained within 10 weeks.DiscussionThere was clear temporal relationship between experiencing hair loss and commencing mirtazapine treatment. No other more likely medical reason to explain such experience was established. A noticeable restoration of the hair colour occurred following mirtazapine cessation.ConclusionMirtazapine is associated with hair discoloration and hair loss. The possibility of such distressing adverse effects needs to be conveyed to patients by clinicians and to be further explored by researchers.

scholarly journals Comparison of frontal alpha asymmetry among schizophrenia patients, major depressive disorder patients, and healthy controls

2020 ◽  
Author(s):  
Kuk-In Jang ◽  
Chany Lee ◽  
Sangmin Lee ◽  
Seung Huh ◽  
Jeong-Ho Chae
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Left Hemisphere ◽  
Rating Scales ◽  
Healthy Controls ◽  
Major Depressive ◽  
Alpha Asymmetry ◽  
Alpha Frequency ◽  
Frontal Alpha Asymmetry ◽  
The Difference

Abstract Background: Electroencephalography (EEG) frontal alpha asymmetry (FAA) has been observed in several psychiatric disorders. Dominance in left or right frontal alpha activity remains inconsistent in patients with major depressive disorder (MDD), patients with schizophrenia, and healthy controls. This study compared FAA among patients with MDD and schizophrenia, and healthy controls.Methods: We recruited 20 patients with MDD, 18 patients with schizophrenia, and 16 healthy individuals. The EEG alpha frequency ranged from 8 Hz to 12 Hz. FAA was expressed as the difference between absolute power values of right and left hemisphere electrodes in the alpha frequency range (common-log-transformed frontal right- and left-hemisphere electrodes: F4–F3, F8–F7, FP2–FP1, AF4–AF3, F6–F5, and F2–F1). Hamilton depression and anxiety rating scales were evaluated in patients with MDD. Positive and negative syndrome scales were evaluated in patients with schizophrenia.Results: Patients with schizophrenia showed significantly lower left FAA than healthy controls (F4–F3, schizophrenia vs. healthy controls: -0.10 ± 0.04 vs. -0.05 ± 0.05). There were no significant differences in FAA between patients with schizophrenia and MDD as well as between patients with MDD and healthy controls.Conclusions: The present study suggests that FAA indicates a relatively lower activation of left frontal electrodes in schizophrenia. The left-lateralized FAA could be a neuropathological attribute in patients with schizophrenia, but a lack of sample size and information such as medication and duration of illness might obscure the interpretation and generalization of our findings. Thus, further studies to verify the findings would be warranted.

Sign in / Sign up

Export Citation Format

Share Document