Heterogeneity in Symptoms in Depression - A replication study in a Digital Mental Health Intervention using the PHQ-9 Questionnaire (Preprint)

2021 ◽  
Author(s):  
Silvan Hornstein ◽  
Valerie Forman-Hoffman ◽  
Nicholas C. Peiper ◽  
Markus J. Rantala
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Severe Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Symptom Pattern ◽  
Patient Health ◽  
Symptom Patterns ◽  
Treatment Procedures ◽  
Core Symptoms

BACKGROUND Past work has shown massive variation in depressive symptoms between patients, challenging the perception of major depressive disorder (MDD) as being uniform. This appears quite relevant also for digital mental health (DMH) interventions. While individualization is one of the key potentials of these approaches, this is regularly not utilized and the same static depression treatment is offered to all patients. OBJECTIVE This paper aims to replicate the approach from Fried & Nesse (2015), analyzing the variation of depressive symptoms within 1757 participants in a DMH intervention for depression and anxiety. METHODS Participants’ answers to the single items of the Patient Health Questionnaire 9-item scale (PHQ-9) were used to identify distinct patterns out of the 9 core symptoms of the DSM-5. RESULTS Overall, the 1757 participants showed 231 different patterns of symptoms. The most regular pattern occurred for 8% of the patients. 85% of the participants had a symptom pattern that was shared with less than 4% of the whole sample. The number of unique symptom patterns per participant decreased with higher symptom severity, but the 342 patients with overall severe depression symptoms still exhibited 34 different constellations of single symptoms. CONCLUSIONS The large variation in symptoms challenges the assignment of static depression interventions in DMH and calls for more individualized treatment procedures. Luckily, such procedures can be implemented particularly easily in an app-based context, for example by modular program structures.

scholarly journals Depression and Anxiety Symptoms of British Adoptive Parents: A Prospective Four-Wave Longitudinal Study

2019 ◽  
Vol 16 (24) ◽  
pp. 5153 ◽  
Author(s):  
Rebecca E. Anthony ◽  
Amy L. Paine ◽  
Katherine H. Shelton
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Adoptive Parents ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Parental Anxiety ◽  
Depression And Anxiety ◽  
Negative Consequences ◽  
Adoptive Families ◽  
Prospective Longitudinal

The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 British adoptive parents over four time points in the first four years of an adoptive placement. Depression and anxiety symptom scores were relatively stable across time. Growth curve analysis showed that higher child internalizing scores and lower parental sense of competency at five months post-placement were associated with higher initial levels of parental depressive symptoms. Lower parental sense of competency was also associated with higher initial levels of parental anxiety symptoms. Parents of older children and those with higher levels of parental anxiety and sense of competency at five months post-placement had a steeper decrease in depressive symptoms over time. Support for adoptive families primarily focuses on child adjustment. Our findings suggest that professional awareness of parental mental health post-placement may be necessary, and interventions aimed at improving parents’ sense of competency may be beneficial.

scholarly journals Anxiety and Depression Among Adult Tobacco Users During the COVID-19 Restrictions in India.

2021 ◽  
Author(s):  
Shalini Bassi ◽  
Gaurang P. Nazar ◽  
Nishigandha Joshi ◽  
Nitika Sharma ◽  
Aishwarya Pandian ◽  
...  
Keyword(s):  
Mental Health ◽  
Tobacco Cessation ◽  
Descriptive Analysis ◽  
Easy Access ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Indian Government ◽  
Patient Health ◽  
Indian Cities

Abstract Background The world witnessed a highly contagious and deadly disease, COVID-19, towards the end of 2019. India is one of the worst affected countries. We aimed to assess anxiety and depression levels among adult tobacco users and people who recently quit tobacco during COVID − 19 lockdown in India. Methods The study was conducted across two Indian cities, Delhi and Chennai (July-August, 2020) among adult tobacco users (n = 801). Telephonic interviews were conducted using validated mental health tools (Patient Health Questionnaire-PHQ-9 and Generalized Anxiety Disorder-GAD-7) to assess the anxiety and depression levels of the participants. Descriptive analysis and multiple logistic regression were used to study the prevalence and correlates of depression and anxiety. Results We found that 20.6% of tobacco users had depression symptoms (3.9% moderate to severe); 20.7% had anxiety symptoms (3.8% moderate to severe). Risk factors associated with depression and anxiety included food, housing, and financial insecurity. Conclusion During COVID-19 lockdown, mental health of tobacco users (primarily women) was associated with food, housing and financial insecurity. The Indian Government rightly initiated several health, social and economic measures to shield the most vulnerable from COVID-19, including a ban on the sale of tobacco products. It is also necessary to prioritize easy access to tobacco cessation and mental health services to such vulnerable populations during pandemic situations.

scholarly journals Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Aarathi Venkatesan ◽  
Lily Rahimi ◽  
Manpreet Kaur ◽  
Christopher Mosunic
Keyword(s):  
Mental Health ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Behavioral Therapy ◽  
Severe Depression ◽  
Cognitive Behavior ◽  
Depression And Anxiety ◽  
Point Reduction ◽  
Therapy Program ◽  
Patient Health

BACKGROUND Digital mental health interventions offer a scalable solution that reduces barriers to seeking care for clinical depression and anxiety. OBJECTIVE We aimed to examine the effectiveness of a 12-week therapist supported, app-based cognitive behavioral therapy program in improving symptoms of depression and anxiety within 9 months. METHODS A total of 323 participants with mild to moderately severe depression or anxiety were enrolled in a 12-week digital cognitive behavior therapy program. The analysis was restricted to participants who provided at least one follow-up assessment after baseline. As a result, 146 participants (45.2%) were included in the analysis—74 (50.7%) participants completed assessments at 3 months, 31 participants (21.2%) completed assessments at 6 months, and 21 participants (14.4%) completed assessments at 9 months. The program included structured lessons and tools (ie, exercises and practices) as well as one-on-one weekly video counseling sessions with a licensed therapist for 12 weeks and monthly check-in sessions for 1 year. The clinically validated Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety, respectively. Linear mixed-effects modeling was employed to examine changes in depression and anxiety over time. RESULTS We observed a significant positive effect of program time on improvement in depression (β=–0.12, <i>P</i>&lt;.001) and anxiety scores (β=–0.10, <i>P</i>&lt;.001). At the end of the 12-week intervention, we observed an average reduction of 3.76 points (95% CI –4.76 to –2.76) in PHQ-8 scores. Further reductions in depression were seen at program month 6 (4.75-point reduction, 95% CI –6.61 to –2.88) and program month 9 (6.42-point reduction, 95% CI –8.66 to –6.55, <i>P</i>&lt;.001). A similar pattern of improvement emerged for anxiety, with a 3.17-point reduction at the end of the 12-week intervention (95% CI –4.21 to –2.13). These improvements were maintained at program month 6 (4.87-point reduction, 95% CI –6.85 to –2.87) and program month 9 (5.19-point, 95% –6.85 to 4.81). In addition, greater program engagement during the first 12 weeks predicted a greater reduction in depression (β=–0.29, <i>P</i>&lt;.001) CONCLUSIONS The results suggest that digital interventions can support sustained and clinically meaningful improvements in depression and anxiety. Furthermore, it appears that strong initial digital mental health intervention engagement may facilitate this effect. However, the study was limited by postintervention participant attrition as well as the retrospective observational study design.

scholarly journals Impact on Mental Health of students due to restriction caused by COVID-19 pandemic: Cross-sectional study

2021 ◽  
Author(s):  
Amar Prashad Chaudhary ◽  
Narayan Sah Sonar ◽  
Jamuna TR ◽  
Moumita Banerjee ◽  
Shailesh Yadav
Keyword(s):  
Severe Depression ◽  
Cross Sectional Study ◽  
Depression Symptoms ◽  
Strong Positive Correlation ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Web Based ◽  
Psychometric Scales ◽  
Patient Health ◽  
Behavioral Impact

AbstractBackgroundThe aim of the study was to investigate fear, depression and anxiety symptoms among students of India due to COVID-19 pandemic and its restriction.MethodThe cross-sectional web-based research was conducted between mid-November and mid-December 2020 with the objective of understanding the psychological and behavioral consequences of the COVID-19 pandemic effect on students due to the constraint of forced control. The questionnaire included a) socio-demographic questions and b) psychometric scales evaluating the psychological and behavioral impact caused by COVID-19 pandemic and restrictions.ResultsTotal number of 324 students participated in this study in which 44.4% were male and 55.6% were female. Fear of COVID-19 scale showed 68.8% of students had high fear, 24.4% had moderate to severe depression and 51.5% had moderate to severe anxiety. The correlation of fear of COVID-19 scale (FCV-19s) with Generalized Anxiety scale (GAD-7) and brief patient health questionnaire scale (PHQ-9) was found to be 0.492 and 0.474 respectively.ConclusionThis research concludes that there is a very strong fear of COVID-19 among students, along with anxiety and depression symptoms. This study also concludes that the fear of the COVID-19 scale has strong positive correlation with the anxiety (GAD-7) and depression (PHQ-9) scales.

Mental Health of Staff in a Key Frontline Hospital During COVID-19: A Single-Center Cross-Sectional China-Based Study

2021 ◽  
pp. 101053952110147
Author(s):  
Xin Huang ◽  
Yiming Liang ◽  
Buzohre Eli ◽  
Yufang Yang ◽  
Ru Han ◽  
...  
Keyword(s):  
Mental Health ◽  
Severe Depression ◽  
Severity Index ◽  
Depression Symptoms ◽  
Normal Body Mass Index ◽  
Cross Sectional ◽  
Female Age ◽  
Logistic Regression Models ◽  
Staff Members ◽  
Patient Health

Coronavirus disease-2019 has become a worldwide pandemic, threatening medical staff’s mental health. We aimed to investigate the mental health status of staff at Wuhan Jinyintan Hospital, the largest hospital specializing in infectious diseases in Wuhan. A total of 507 staff members (82.64% were female, age: mean = 37.53, SD = 10.08) in Wuhan Jinyintan Hospital were recruited from March 15, 2020, to May 1, 2020. Questionnaires of the PHQ-9 (Patient Health Questionnaire), GAD-7 (Generalized Anxiety Disorder Scale), and ISI (Insomnia Severity Index) were adopted. The results showed 39.64%,19.53%, and 6.90% had mild, moderate, and moderate-severe depression, respectively. In addition, 41.03%, 10.45%, and 3.94% had mild, moderate, and moderate-severe anxiety, respectively, and 27.02% and 12.03% had mild and moderate-severe insomnia, respectively. Multivariate logistic regression models revealed that those unmarried and females were more likely to exhibit depression symptoms, while being a nurse, having a normal body mass index, and not experiencing severe acute respiratory syndrome increased the likelihood for insomnia.

scholarly journals A Longitudinal Study on the Mental Health of College Students in Jinan During the Peak Stage of the COVID-19 Epidemic and the Society Reopening

2021 ◽  
pp. 102-110
Author(s):  
Xiaolei Zheng ◽  
Yuji Guo ◽  
Wen Ma ◽  
Hui Yang ◽  
Liyan Luo ◽  
...  
Keyword(s):  
Mental Health ◽  
College Students ◽  
Severe Depression ◽  
Severity Index ◽  
Depression And Anxiety ◽  
Health Issues ◽  
Mental Health Issues ◽  
Prevalence Of Depression ◽  
Patient Health ◽  
Peak Versus

<b><i>Introduction:</i></b> COVID-19, a continuously emerging human-to-human infectious disease, has exerted a significant impact on the mental health of college students. However, little is known regarding the variations in the mental health issues experienced by college students during the peak versus reopening stages of the COVID-19 epidemic in China. <b><i>Methods:</i></b> To assess these issues, an online longitudinal survey was conducted via a WeChat applet. Undergraduates (<i>n</i> = 300) were recruited from 26 universities throughout Jinan in February 2020 (T1 – the epidemic peak stage) and in January 2021 (T2 – the society reopening stage). Their mental status was determined using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 item, and the Insomnia Severity Index. <b><i>Results:</i></b> Of the original 300 college students recruited for this survey, 294 responses at T1 and 285 at T2 were analyzed. Compared with responses obtained at T1, college students at T2 showed a greater prevalence of depression (65.3 vs. 51.0%; <i>p</i> = 0.001) and anxiety (47.7 vs. 38.1%, <i>p</i> = 0.019), and experienced more severe depression (<i>p</i> &#x3c; 0.001) and anxiety (<i>p</i> &#x3c; 0.001). Both males (<i>p</i> = 0.03) and females (<i>p</i> &#x3c; 0.01) showed higher levels of depression at T2 versus T1, while no differences were obtained with regard to anxiety and insomnia. At T1, Grade 4 students showed greater levels of depression (<i>p</i> = 0.005) and anxiety (<i>p</i> = 0.008) than that of Grade 1 students. While at T2, only greater levels of depression (<i>p</i> = 0.004) were present when compared with that of Grade 1 students. Additionally, Grade 4 college students demonstrated a greater prevalence of depression at T2 versus T1 (<i>p</i> = 0.03), but no statistically differences were present for anxiety and insomnia. No statistically significant differences were obtained among the 4 grades of college students for insomnia at either the T1 or T2. <b><i>Conclusion:</i></b> With progression of the COVID-19 epidemic, college students showed increasing levels of depression and anxiety, with Grade 4 college students being most seriously affected. It is imperative that intervention strategies be implemented to mitigate against these mental health issues resulting from the COVID-19 epidemic.

scholarly journals Long-Term Outcomes of a Therapist-Supported, Smartphone-Based Intervention for Elevated Symptoms of Depression and Anxiety: Quasiexperimental, Pre-Postintervention Study

10.2196/14284 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e14284 ◽  
Author(s):  
Marcos Economides ◽  
Kristian Ranta ◽  
Albert Nazander ◽  
Outi Hilgert ◽  
Philippe R Goldin ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Intention To Treat ◽  
Symptoms Of Depression ◽  
Point Reduction ◽  
Patient Health ◽  
Common Mental Health Problems ◽  
Clinically Significant

Background Depression is one of the most common mental health disorders and severely impacts one’s physical, psychological, and social functioning. To address access barriers to care, we developed Ascend—a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. A previous feasibility study with 102 adults with elevated depression reported that Ascend is associated with a postintervention reduction in depression symptoms. Objective We aimed to examine whether Ascend is associated with a reduction in symptoms of anxiety, and importantly, whether reductions in symptoms of depression and anxiety are maintained up to 12-months postintervention. Methods We assessed whether the previously reported, end-of-treatment improvements seen in the 102 adults with elevated symptoms of depression extended up to 12 months posttreatment for depression symptoms (measured by the Patient Health Questionnaire-9 [PHQ-9]) and up to 6 months posttreatment for anxiety symptoms (added to the intervention later and measured using the Generalized Anxiety Disorder-7 [GAD-7] scale). We used linear mixed effects models with Tukey contrasts to compare time points and reported intention-to-treat statistics with a sensitivity analysis. Results The intervention was associated with reductions in symptoms of depression that were maintained 12 months after the program (6.67-point reduction in PHQ-9 score, 95% CI 5.59-7.75; P<.001; Hedges g=1.14, 95% CI 0.78-1.49). A total of 60% of the participants with PHQ-9 scores above the cutoff for major depression at baseline (PHQ≥10) reported clinically significant improvement at the 12-month follow-up (at least 50% reduction in PHQ-9 score and postprogram score <10). Participants also reported reductions in symptoms of anxiety that were maintained for at least 6 months after the program (4.26-point reduction in GAD-7 score, 95% CI 3.14-5.38; P<.001; Hedges g=0.91, 95% CI 0.54-1.28). Conclusions There is limited evidence on whether outcomes associated with smartphone-based interventions for common mental health problems are maintained posttreatment. Participants who enrolled in Ascend experienced clinically significant reductions in symptoms of depression and anxiety that were maintained for up to 1 year and 6 months after the intervention, respectively. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and anxiety.

scholarly journals Depression and anxiety before and during the COVID-19 lockdown: a longitudinal cohort study with university students

2021 ◽  
Author(s):  
Virgínia da Conceição ◽  
Inês Rothes ◽  
Ricardo Gusmão ◽  
Henrique Barros
Keyword(s):  
Mental Health ◽  
University Students ◽  
Longitudinal Research ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Portuguese Version ◽  
Increased Risk ◽  
Patient Health ◽  
The Mean ◽  
The Impact

AbstractBackgroundFor young people, just as in the general population, COVID-19 caused many changes in their lives, including an increased risk for mental illness symptoms. We aimed to study the impact of the COVID-19 pandemic in anxiety and depression symptoms in a cohort of university students.MethodsThis study is part of broader longitudinal research on university students’ mental health with data of the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information.Results341 university students (257 females and 84 males) were included, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived wellbeing loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. The proportion of students with scores equal to or above 15 in the PHQ-9 ranged between 22.6% and 25.5% in 2019 and 37.0% in June 2020. The proportion of GAD-7 scores above cut-off ten ranged between 46.0% and 47.8% in 2019 and 64.5% in 2020. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher.DiscussionCOVID-19 impacted negatively depressive and anxiety symptoms, confirming previous studies and young people’s vulnerability in such uncertain times.

scholarly journals Impact of COVID -19 on Depression and Anxiety among Healthcare Professionals in Abu Dhabi

2021 ◽  
Author(s):  
Amal Abdul Rahim Al Zarooni ◽  
Aljazia Khalfan Alghfeli ◽  
Hamda Musabbah Alremeithi ◽  
Roqayah Abdulla Almadhaani ◽  
Latifa Baynouna Alketbi
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Severe Depression ◽  
Well Being ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Care Providers ◽  
Cross Sectional

COVID-19 have affected Healthcare workers is many ways. One of the important areas is the psychological impact. The aim of this study is to examine the effects of the COVID-19 outbreak on the mental health of healthcare Professionals (HCP). A cross-sectional study was conducted between April 11th, and July 23rd, 2020, to assess depression and anxiety of healthcare workers, during the COVID-19 pandemic. An online, self-administered, anonymous questionnaire evaluated 1,268 HCP. More than half of the participants reported symptoms of anxiety (51.5%). Mild anxiety was reported in 28.8% of participating HCP, and 12.68 % of the participants registered moderate anxiety scores, while 9.95 % reported severe anxiety. Depression symptoms were revealed in 38.3 % of participating providers. Among all participates, 4.3 % and 2.7 % reported moderately severe and severe depression, accordingly, while 22.5%, and 8.8 % of the participating health care providers documented mild and moderate depression. The high prevalence of anxiety and depression recorded among HCP during the pandemic suggests that mental health intervention and support are necessary to ensure the psychological well-being of HCP.

scholarly journals Mobile Intervention Outcomes Compared Pre and Post-Shelter-in-Place for Middle Aged and Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 861-861
Author(s):  
Chalise Carlson ◽  
Ana Alfaro ◽  
Christina Chick ◽  
Martha Bruce ◽  
Valerie Forman Hoffman ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Mobile App ◽  
Depression Symptoms ◽  
Older Individuals ◽  
Middle Aged ◽  
Behavioral Skills ◽  
Patient Health ◽  
Health Quality

Abstract The Meru Health Program (MHP), a mobile app-based intervention targeting depressive symptoms, teaches mindfulness and cognitive behavioral skills through video lessons and practices. MHP includes integrated asynchronous therapist and peer support. Our aim was to examine whether using the MHP reduced loneliness and improved mental health quality of life (QoL) in middle-aged and older adults with depressive symptoms (Patient Health Questionairre-9 [PHQ-9] ≥ 7). The timing of this study partially overlapped with the emergence of the SARS-CoV-2 (COVID-19) pandemic resulting in California’s shelter-in-place (SIP) orders. Fifty participants (42 enrolled prior to SIP) completed baseline assessments with a mean age of 57.06 (SD = 11.26; Range: 40-81 years) exhibiting mild to moderate depression symptoms (PHQ-9: M = 12.28, SD = 5.47). Participants enrolled pre-SIP exhibited significant improvements in QoL, F(1,38) = 12.61, p = .001, η2 = .25, and significant declines in loneliness, F(1,38) = 5.42, p = .03, η2 = .13. Improvements in QoL were found for post-SIP participants as well, F(1,44) = 6.02, p = .02, η2 = .12. In contrast, loneliness did not improve for the post-SIP cohort, perhaps alluding to the increased impact of social isolation during SIP. Our findings indicate MHP can improve QoL symptoms before and during SIP. It is possible that middle-aged and older individuals may require more individualized support during SIP to help alleviate loneliness when social connection is severely restricted. MHP remains a promising and scalable solution for those middle-aged and older adults struggling with mental health symptoms.

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