scholarly journals The Effectiveness of Cognitive Behavioral Therapy for People with Depression Following Stroke: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 4 ◽  
Author(s):  
Victor K.-L. Cheung
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Data Extraction ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Cognitive Behavioral ◽  
Public Understanding ◽  
Service Development ◽  
Potential Threat ◽  
Psychotherapeutic Treatment

Post-stroke depression (PSD) is a common psychiatric manifestation of stroke, which has a devastating impact on survivors’ quality of life with an increasing burden on caregivers and the public medical system. Even so, no meta-analysis on specific psychotherapeutic treatment has been conducted. How effective is cognitive behavioral therapy (CBT) in reducing depressive symptoms in randomized-controlled trials (RCTs) targeting community-dwelling stroke survivors with PSD? Through systematic procedures of screening and data extraction, four RCTs were synthesized for meta-analysis (N= 270) on effect size estimates. Overall, CBT groups showed significant improvement in depression compared with controls. Methodological quality, intensity of CBT, and duration of post-treatment follow-up proved critical to treatment effects. Despite the potential threat of external validity, this paper had reviewed their content comprehensively with the implication of facilitating public understanding, research, and service development of PSD using CBT. To fill the knowledge gap, standardized protocol and further subgroup analyses are necessary.

Examining the Effectiveness of Gamification and Reward in Mental Health Applications for Depression: A Systematic Review and Meta-Analysis (Preprint)

2021 ◽  
Author(s):  
Stephanie G. Six ◽  
Kaileigh A. Byrne ◽  
Thomas P. Tibbett ◽  
Irene Pericot-Valverde
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Post Intervention ◽  
Significant Difference ◽  
Health Applications

BACKGROUND Previous research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health applications incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce depressive symptoms over and above mental health applications without gamification. OBJECTIVE The objective of this study was to determine whether mental health applications with gamification elements differ in their effectiveness to reduce depressive symptoms when compared to those which lack these elements. METHODS A meta-analysis of studies that examined the effect of app-based therapy, including cognitive behavioral therapy; acceptance and commitment therapy; and mindfulness on depressive symptoms was performed. A total of 5,597 articles were identified via five databases. After screening, 39 studies (n= 8,713 participants) remained for data extraction. From these studies, 51 total comparisons between post-intervention mental health application interventions groups and control groups were included in the meta-analysis. RESULTS A random effects model was performed with gamification elements included as a moderator. This moderating variable compared mental health applications with gamification elements (n=25) to those without such elements (n=26). Results indicated a small to moderate effect size across all mental health applications in which the mental health applications intervention effectively reduced depressive symptoms compared to controls (Hedge’s g = -.28; (95% CI: -0.38; -0.18), P<.01). The gamification moderator was not a significant predictor of depressive symptoms (β= -.013, SE=.115, P=.909), demonstrating no significant difference in effectiveness between mental health applications with and without gamification features. CONCLUSIONS Results show that both mental health applications with and without gamification elements are effective in reducing depressive symptoms. There was no significant difference in the effectiveness of mental health applications with gamification elements on depressive symptoms. This research has important clinical implications for understanding how gamification elements influence the effectiveness of mental health applications on depressive symptoms.

349 Cognitive Behavioral Therapy for Insomnia in Patients with Chronic Pain - A Systematic Review and Meta-Analysis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A139-A140
Author(s):  
Janannii Selvanathan ◽  
Chi Pham ◽  
Mahesh Nagappa ◽  
Philip Peng ◽  
Marina Englesakis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioral Therapy ◽  
Cancer Pain ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Comorbid Insomnia ◽  
Patient Reported

Abstract Introduction Patients with chronic non-cancer pain often report insomnia as a significant comorbidity. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment for insomnia, and several randomized controlled trials (RCTs) have examined the efficacy of CBT-I on various health outcomes in patients with comorbid insomnia and chronic non-cancer pain. We conducted a systematic review and meta-analysis on the effectiveness of CBT-I on sleep, pain, depression, anxiety and fatigue in adults with comorbid insomnia and chronic non-cancer pain. Methods A systematic search was conducted using ten electronic databases. The duration of the search was set between database inception to April 2020. Included studies must be RCTs assessing the effects of CBT-I on at least patient-reported sleep outcomes in adults with chronic non-cancer pain. Quality of the studies was assessed using the Cochrane risk of bias assessment and Yates quality rating scale. Continuous data were extracted and summarized using standard mean difference (SMD) with 95% confidence intervals (CIs). Results The literature search resulted in 7,772 articles, of which 14 RCTs met the inclusion criteria. Twelve of these articles were included in the meta-analysis. The meta-analysis comprised 762 participants. CBT-I demonstrated a large significant effect on patient-reported sleep (SMD = 0.87, 95% CI [0.55–1.20], p &lt; 0.00001) at post-treatment and final follow-up (up to 9 months) (0.59 [0.31–0.86], p &lt; 0.0001); and moderate effects on pain (SMD = 0.20 [0.06, 0.34], p = 0.006) and depression (0.44 [0.09–0.79], p= 0.01) at post-treatment. The probability of improving sleep and pain following CBT-I at post-treatment was 81% and 58%, respectively. The probability of improving sleep and pain at final follow-up was 73% and 57%, respectively. There were no statistically significant effects on anxiety and fatigue. Conclusion This systematic review and meta-analysis showed that CBT-I is effective for improving sleep in adults with comorbid insomnia and chronic non-cancer pain. Further, CBT-I may lead to short-term moderate improvements in pain and depression. However, there is a need for further RCTs with adequate power, longer follow-up periods, CBT for both insomnia and pain, and consistent scoring systems for assessing patient outcomes. Support (if any):

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