scholarly journals Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation (Preprint)

2019 ◽  
Author(s):  
Lena Jelinek ◽  
Sönke Arlt ◽  
Steffen Moritz ◽  
Johanna Schröder ◽  
Stefan Westermann ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Active Control ◽  
Behavioral Activation ◽  
Dysfunctional Attitudes ◽  
Patient Health Questionnaire ◽  
Control Group ◽  
Health Questionnaire ◽  
Web Based ◽  
Treatment Of Depression ◽  
Patient Health

BACKGROUND Web-based interventions have been shown to be effective for the treatment of depression. However, interventions are often complex and include a variety of elements, making it difficult to identify the most effective component(s). OBJECTIVE The aim of this pilot study was to shed light on mechanisms in the online treatment of depression by comparing a single-module, fully automated intervention for depression (internet-based behavioral activation [iBA]) to a nonoverlapping active control intervention and a nonactive control group. METHODS We assessed 104 people with at least mild depressive symptoms (Patient Health Questionnaire-9, &gt;4) via the internet at baseline (t<sub>0</sub>) and 2 weeks (t<sub>1</sub>) and 4 weeks (t<sub>2</sub>) later. After the t<sub>0</sub> assessment, participants were randomly allocated to one of three groups: (1) iBA (n=37), (2) active control using a brief internet-based mindfulness intervention (iMBI, n=32), or (3) care as usual (CAU, n=35). The primary outcome was improvement in depressive symptoms, as measured using the Patient Health Questionnaire-9. Secondary parameters included changes in activity, dysfunctional attitudes, and quality of life RESULTS While groups did not differ regarding the change in depression from t<sub>0</sub> to t<sub>1</sub> (η<sub>p</sub><sup>2</sup>=.007, <i>P</i>=.746) or t<sub>0</sub> to t<sub>2</sub> (η<sub>p</sub><sup>2</sup>=.008, <i>P</i>=.735), iBA was associated with a larger decrease in dysfunctional attitudes from t<sub>0</sub> to t<sub>2</sub> in comparison to CAU (η<sub>p</sub><sup>2</sup>=.053, <i>P</i>=.04) and a larger increase in activity from t<sub>0</sub> to t<sub>1</sub> than the pooled control groups (η<sub>p</sub><sup>2</sup>=.060, <i>P</i>=.02). A change in depression from t<sub>0</sub> to t<sub>2</sub> was mediated by a change in activity from t<sub>0</sub> to t<sub>1</sub>. At t<sub>1</sub>, 22% (6/27) of the participants in the iBA group and 12% (3/25) of the participants in the iMBI group indicated that they did not use the intervention. CONCLUSIONS Although we did not find support for the short-term efficacy of the single-module iBA regarding depression, long-term effects are still conceivable, potentially initiated by changes in secondary outcomes. Future studies should use a longer intervention and follow-up interval. CLINICALTRIAL DKRS (#DRKS00011562)

scholarly journals Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation

10.2196/15312 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e15312
Author(s):  
Lena Jelinek ◽  
Sönke Arlt ◽  
Steffen Moritz ◽  
Johanna Schröder ◽  
Stefan Westermann ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Active Control ◽  
Behavioral Activation ◽  
Dysfunctional Attitudes ◽  
Patient Health Questionnaire ◽  
Control Group ◽  
Health Questionnaire ◽  
Web Based ◽  
Treatment Of Depression ◽  
Patient Health

Background Web-based interventions have been shown to be effective for the treatment of depression. However, interventions are often complex and include a variety of elements, making it difficult to identify the most effective component(s). Objective The aim of this pilot study was to shed light on mechanisms in the online treatment of depression by comparing a single-module, fully automated intervention for depression (internet-based behavioral activation [iBA]) to a nonoverlapping active control intervention and a nonactive control group. Methods We assessed 104 people with at least mild depressive symptoms (Patient Health Questionnaire-9, >4) via the internet at baseline (t0) and 2 weeks (t1) and 4 weeks (t2) later. After the t0 assessment, participants were randomly allocated to one of three groups: (1) iBA (n=37), (2) active control using a brief internet-based mindfulness intervention (iMBI, n=32), or (3) care as usual (CAU, n=35). The primary outcome was improvement in depressive symptoms, as measured using the Patient Health Questionnaire-9. Secondary parameters included changes in activity, dysfunctional attitudes, and quality of life Results While groups did not differ regarding the change in depression from t0 to t1 (ηp2=.007, P=.746) or t0 to t2 (ηp2=.008, P=.735), iBA was associated with a larger decrease in dysfunctional attitudes from t0 to t2 in comparison to CAU (ηp2=.053, P=.04) and a larger increase in activity from t0 to t1 than the pooled control groups (ηp2=.060, P=.02). A change in depression from t0 to t2 was mediated by a change in activity from t0 to t1. At t1, 22% (6/27) of the participants in the iBA group and 12% (3/25) of the participants in the iMBI group indicated that they did not use the intervention. Conclusions Although we did not find support for the short-term efficacy of the single-module iBA regarding depression, long-term effects are still conceivable, potentially initiated by changes in secondary outcomes. Future studies should use a longer intervention and follow-up interval. Trial Registration DKRS (#DRKS00011562)

scholarly journals Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
María Urtasun ◽  
Federico Manuel Daray ◽  
Germán Leandro Teti ◽  
Fernando Coppolillo ◽  
Gabriela Herlax ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Convergent Validity ◽  
Patient Health Questionnaire ◽  
Receiver Operating Curve ◽  
Local Version ◽  
Health Questionnaire ◽  
Good Ability ◽  
Patient Health ◽  
Severity Of Depression ◽  
Degrees Of Severity

Abstract Background The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. Methods We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. Results One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach’s alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson’s correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6–8 for mild cases, 9–14 for moderate and 15 or more for severe depressive symptoms respectively. Conclusions The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms.

scholarly journals The reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with infertility

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Saman Maroufizadeh ◽  
Reza Omani-Samani ◽  
Amir Almasi-Hashiani ◽  
Payam Amini ◽  
Mahdi Sepidarkish
Keyword(s):  
Depressive Symptoms ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Univariate Analysis ◽  
Reliability And Validity ◽  
Well Being ◽  
Patient Health Questionnaire ◽  
Depression Symptoms ◽  
Health Questionnaire ◽  
Patient Health

Abstract Background Depression in patients with infertility often goes undiagnosed and untreated. The Patient Health Questionnaire-9 (PHQ-9) and its ultra-brief version (i.e. PHQ-2) are widely used measures of depressive symptoms. These scales have not been validated in patients with infertility. The aim of the present study was to examine the reliability and validity of the PHQ-9 and PHQ-2 in patients with infertility. Methods In this cross-sectional study, a total of 539 patients with infertility from a referral infertility clinic in Tehran, Iran completed the PHQ-9, along with other relevant scales: the WHO-five Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS), and the Generalized Anxiety Disorder-7 (GAD-7). Factor structure and internal consistency of PHQ-9 were examined via confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. Convergent validity was evaluated by relationship with WHO-5, HADS and GAD-7. Results The mean total PHQ-9 and PHQ-2 scores were 8.47 ± 6.17 and 2.42 ± 1.86, respectively, and using a cut-off value of 10 (for PHQ-9) and 3 (for PHQ-2), the prevalence of depressive symptoms was 38.6 and 43.6%, respectively. The Cronbach’s alphas for PHQ-9 and PHQ-2 were, respectively, 0.851 and 0.767, indicating good internal consistency. The CFA results confirmed the one-factor model of the PHQ-9 (χ2/df = 4.29; CFI = 0.98; RMSEA = 0.078 and SRMR = 0.044). Both PHQ-9 and PHQ-2 showed moderate to strong correlation with the measures of WHO-5, HADS-depression, HADS-anxiety, and the GAD-7, confirming convergent validity. In univariate analysis, female sex, long infertility duration, and unsuccessful treatment were significantly associated with depression symptoms. Conclusion Both PHQ-9 and PHQ-2 are brief and easy to use measures of depressive symptoms with good psychometric properties that appear suitable for routine use in patients with infertility.

scholarly journals Direct Participation in and Indirect Exposure to the Occupy Central Movement and Depressive Symptoms: A Longitudinal Study of Hong Kong Adults

2016 ◽  
Vol 184 (9) ◽  
pp. 636-643 ◽  
Author(s):  
Michael Y. Ni ◽  
Tom K. Li ◽  
Herbert Pang ◽  
Brandford H. Y. Chan ◽  
Betty Y. Yuan ◽  
...  
Keyword(s):  
Hong Kong ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Personal Involvement ◽  
Patient Health ◽  
Population Mental Health ◽  
History Of ◽  
Occupy Central

Abstract Despite the extensive history of social movements around the world, the evolution of population mental health before, during, and after a social movement remains sparsely documented. We sought to assess over time the prevalence of depressive symptoms during and after the Occupy Central movement in Hong Kong and to examine the associations of direct and indirect exposures to Occupy Central with depressive symptoms. We longitudinally administered interviews to 909 adults who were randomly sampled from the population-representative FAMILY Cohort at 6 time points from March 2009 to March 2015: twice each before, during, and after the Occupy Central protests. The Patient Health Questionnaire-9 was used to assess depressive symptoms and probable major depression (defined as Patient Health Questionnaire-9 score ≥10). The absolute prevalence of probable major depression increased by 7% after Occupy Central, regardless of personal involvement in the protests. Higher levels of depressive symptoms were associated with online and social media exposure to protest-related news (incidence rate ratio (IRR) = 1.28, 95% confidence interval (CI): 1.06, 1.55) and more frequent Facebook use (IRR = 1.38, 95% CI: 1.12, 1.71). Higher levels of intrafamilial sociopolitical conflict was associated with more depressive symptoms (IRR = 1.05, 95% CI: 1.01, 1.09). The Occupy Central protests resulted in substantial and sustained psychological distress in the community.

scholarly journals 118 Use of Patient Health Questionnaire to Predict Relapses in Patients with Treatment-resistant Depression Treated With Esketamine + Oral Antidepressant

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 276-277
Author(s):  
Carol Jamieson ◽  
Nan Li ◽  
Ella Daly ◽  
Adam Janik ◽  
Rosanne Lane ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Patient Health Questionnaire ◽  
Controlled Study ◽  
Health Questionnaire ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Relapse Risk ◽  
Total Score Range ◽  
Patient Health ◽  
Resistant Depression

Abstract:Objective:To assess the Patient Health Questionnaire (PHQ-9) as a predictor of relapse of depressive symptoms in treatment-resistant depression (TRD).Method:Analysis included maintenance phase data from SUSTAIN-1 (NCT02493868), a randomized, double-blind, active-controlled study in TRD patients that evaluated efficacy of intranasal esketamine (ESK) + oral antidepressant (AD) vs AD + intranasal placebo in delaying relapse of depressive symptoms. A ≥50% reduction in initial symptom score and total score of ≤12 were considered as response and remission, respectively, using the Montgomery-Asberg Depression Rating Scale. PHQ-9 total score (range, 0–27), PHQ-2 total score (0–6), and individual items of the PHQ-9 (0–3) were examined as predictors of relapse. Data were collected every 2 weeks. Association between time-varying PHQ-9 and event of depression relapse was evaluated in Andersen-Gill Cox model.Results:Of 176 stable remitters, 63 had a relapse event (ESK+AD [n=24]; AD+placebo [n=39]). Of 121 stable responders, 50 had a relapse event (ESK+AD [n=16]; AD+placebo [n=34]). Among stable remitters, PHQ-9 total score (HR; 95% CI [1.12; 1.04–1.21]) and PHQ-2 total score (1.58; 1.25–1.99) were associated with relapse risk. PHQ-9 items #1 (loss of pleasure, 2.07; 1.38–3.09), #2 (feeling down, 2.18; 1.51–3.15), #4 (feeling tired, 1.54; 1.13–2.11), and #6 (negative self-view, 2.27; 1.41–3.66) were associated with relapse risk. PHQ-2 total scale yielded the smallest Akaike’s Information Criterion among stable remitters and responders.Conclusion:PHQ-9, PHQ-2 total scores or individual items may be useful for predicting relapse of depressive symptoms among stable TRD patients.Funding Acknowledgements:This study was sponsored by Janssen Research and Development, LLC.

Prevalence of depressive symptoms and associated factors in an urban, ophthalmic population

2020 ◽  
pp. 112067212090170 ◽  
Author(s):  
Eileen L Mayro ◽  
Ann P Murchison ◽  
Lisa A Hark ◽  
Marlee Silverstein ◽  
Olivia Y Wang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Depressive Symptoms ◽  
Odds Ratio ◽  
Low Vision ◽  
Adult Patients ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Diabetes Status ◽  
Patient Health ◽  
Clinically Significant

Objective: To determine the prevalence of depressive symptoms in an adult ophthalmic patient population and to delineate correlates. Design: Cross-sectional study. Participants: Adult patients (⩾18 years) were approached in general and sub-specialty cornea, retina, and glaucoma ophthalmic clinics. A total of 367 patients from the four clinics were enrolled. Methods: Depressive symptoms were assessed using the Patient Health Questionnaire-9. A cut-off score of ⩾10 was used to indicate clinically significant depressive symptoms. Patient Health Questionnaire-9 scores were used to evaluate bivariate relationships between depressive symptoms and distance visual acuity, ocular diagnosis, diabetes status, smoking status, demographic information, and medications. Results: The majority of patients were female (52.9%) and Caucasian (48.6%). The mean age was 52.0 years (standard deviation: 16.7). Clinically significant depressive symptoms were present in 19.9% of patients overall; this rate varied slightly by clinic. Patients with low vision and blindness (visual acuity worse than 20/60) were more likely to have depressive symptoms (odds ratio = 2.82; 95% confidence interval: 1.90–4.21). Smoking and diabetes were also associated with depressive symptoms (odds ratio = 3.11 (2.66–3.64) and 3.42 (1.90–6.16), respectively). Conclusion: In a sample of urban ophthalmic adult patients, depressive symptoms were highly associated with low vision, smoking, and diabetes. This information can be used to target interventions to those at greatest risk of depressive symptoms.

Two-Step Screening for Depressive Symptoms and Prediction of Mortality in Patients With Heart Failure

2017 ◽  
Vol 26 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Debra K. Moser ◽  
Michele Pelter ◽  
Martha J. Biddle ◽  
Kathleen Dracup
Keyword(s):  
Heart Failure ◽  
Depressive Symptoms ◽  
Hazard Ratio ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Step Method ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Patient Health

Background Comorbid depression in patients with heart failure is associated with increased risk for death. In order to effectively identify depressed patients with cardiac disease, the American Heart Association suggests a 2-step screening method: administering the 2-item Patient Health Questionnaire first and then the 9-item Patient Health Questionnaire. However, whether the 2-step method is better for predicting poor prognosis in heart failure than is either the 2-item or the 9-item tool alone is not known. Objective To determine whether the 2-step method is better than either the 2-item or the 9-item questionnaire alone for predicting all-cause mortality in heart failure. Methods During a 2-year period, 562 patients with heart failure were assessed for depression by using the 2-step method. With the 2-step method, results are considered positive if patients endorse either depressed mood or anhedonia on the 2-item screen and have scores of 10 or higher on the 9-item screen. Results Screening results with the 2-step method were not associated with all-cause mortality. Patients with scores positive for depression on either the 2-item or 9-item screen alone had 53% and 60% greater risk, respectively, for all-cause death than did patients with scores negative for depression after adjustments for covariates (hazard ratio, 1.530; 95% CI, 1.029–2.274 for the 2-item screen; hazard ratio, 1.603; 95% CI, 1.079–2.383 for the 9-item screen). Conclusions The 2-step method has no clear advantages compared with the 2-item screen alone or the 9-item screen alone for predicting adverse prognostic effects of depressive symptoms in heart failure.

Sign in / Sign up

Export Citation Format

Share Document