Temporal and specific pathways of change in cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression

Progress of systematic psychological interventions in elderly patients with femoral fractures: A comprehensive review

This review aims to gain a deeper understanding of the psychological state of elderly patients with femoral fractures and provide more theoretical and practical support for clinical treatment and care. Through a literature analysis, we found that elderly patients with femoral fractures face various psychological issues such as anxiety, depression, sleep disorders, and social isolation. The application of systematic nursing interventions in clinical practice, including cognitive-behavioral therapy, mindfulness therapy, family therapy, art therapy, interpersonal therapy, emotion-focused therapy, and relaxation training, has yielded significant results. Systematic psychological interventions can improve the psychological state and quality of life of elderly patients with femoral fractures. Therefore, promoting the application and practice of systematic psychological interventions in the clinical care of elderly patients with fractures will provide more effective psychological services to a wider group of patients with fractures in the future.

Effect of cyclodextrin-complexed lyophilized nanosuspension of Nigella sativa seeds oleoresin on chronic unpredictable mild stress (CUMS)-induced depression in mice

Depression is a prevalent global health concern necessitating alternative approaches to conventional antidepressant medications due to its associated adverse effects. Nigella sativa (NS) is recognized for its potential as an antidepressant, offering a promising solution with fewer side effects. This study investigated the antidepressant efficacy of cyclodextrin-complexed lyophilized nanosuspension of NS oleoresin (NSOR) in a murine model of chronic unpredictable mild stress (CUMS)-induced depression. This study sought to evaluate and contrast the antidepressant potential of the nano-NSOR with that of the NS ethanolic extract (NSEE). The prepared nano-NSOR was characterized physicochemically and evaluated for in vitro drug release and in vivo antidepressant activity. The particle size of nano-NSOR was determined to be 164.6 nm. In vitro drug release studies suggested the higher drug release from nano-NSOR (90.15 % after 72 h) compared to the native NSOR (59.55 % after 72 h). Furthermore, nano-NSOR exhibited a more pronounced antidepressant effect than NSEE in the context of CUMS-induced depression. This study highlights a potential alternative for managing depression, addressing the need for improved antidepressant treatments with reduced side effects. These results suggest that nano-NSOR ameliorates CUMS-induced depression by modulating neurotransmitter levels, reducing inflammation, and enhancing neuroprotection.

Web-Based Imagery Behavioral Activation (WIMBA): Study Protocol for a Randomized Controlled Trial Testing the Effects, Acceptability, and Feasibility of a Mental Imagery Activity Scheduling Training Delivered Online

Background

Behavioral activation (BA) is an effective and efficacious treatment for depression. Activity scheduling is the central treatment component of BA and involves planning of potentially enjoyable and rewarding activities. Evidence from non-clinical studies suggests that mental imagery simulations of planned activities can increase motivation and anticipated pleasure for these activities.

Method

We describe a randomized controlled trial testing a mental imagery activity scheduling training delivered online in four weekly sessions (total training duration approximately 90 minutes) in a sample meeting diagnostic criteria of a major depressive episode, as indicated by the Diagnostic Short-Interview for Mental Disorders (Mini-DIPS), and not currently receiving treatment. Participants (N = 140) will be randomized to either mental imagery activity scheduling or a wait-list control condition. Depressive symptoms (BDI-II) and behavioral activation (BADS) are the primary outcomes; BDI-II will be measured at Session 1, Session 4, and at two-week follow-up, BADS at Sessions 1-4 and at two-week follow-up.

Discussion

It is discussed how the expected results may reflect mechanisms and effects of a mental imagery activity scheduling training delivered online in a sample of individuals with depression. Concluding we outline next steps for future research and highlight the potential of this novel treatment for dissemination in the wider community and integration into routine care.

A meta-analysis of mindfulness-based interventions for improving mental health and burden among caregivers of persons living with dementia

BACKGROUND

Mindfulness-based interventions are becoming increasingly popular and are effective in lowering depressive symptoms and caregiver burden. However, the overall efficacy of therapies in stress and anxiety management is unreported, and no study to date has performed a subgroup analysis to investigate the intervention dose response of outcomes.

AIMS

To quantitatively identify the effectiveness of mindfulness-based interventions for caregivers of persons living with dementia.

METHODS

A comprehensive literature search of six databases was undertaken from the date of inception to June 18, 2023. The DerSimonian-Laird model with random effects was used to examine the overall effect and its heterogeneity in the studies. Version 2 of the risk of bias (RoB 2) tool was employed to analyze the publication bias of each randomized study. Funnel and forest plots were created to represent the findings.

RESULTS

Thirteen randomized trials were included in the meta-analysis. Mindfulness-based interventions significantly reduced stress and anxiety of caregivers of persons living with dementia. In addition, interventions provided for ≥8 weeks were beneficial in reducing depression in caregivers. However, mindfulness-based interventions did not offer significant benefits in reducing depression or caregiver burden immediately after the intervention.

CONCLUSION

Mindfulness-based interventions have the potential to help caregivers of people living with dementia. This study could be used as a model for future research into and implementation of mindfulness-based therapies for caregivers.

LINKING EVIDENCE TO ACTION

Mindfulness-based therapies appear to alleviate stress and anxiety but are ineffective in reducing depression and burden in caregivers of persons living with dementia. Well-designed RCTs with more rigorous methodology and a larger sample size should be conducted to firm the conclusion of the effectiveness of mindfulness-based interventions for caregivers of persons living with dementia.

A cross talk on the role of contemporary biomarkers in depression

Introduction: Biomarkers can be used to identify determinants of response to various treatments of mental disorders. Evidence to date demonstrates that markers of inflammatory, neurotransmitter, neurotrophic, neuroendocrine, and metabolic function can predict the psychological and physical consequences of depression in individuals, allowing for the development of new therapeutic targets with fewer side effects. Extensive research has included hundreds of potential biomarkers of depression, but their roles in depression, abnormal patients, and how bioinformatics can be used to improve diagnosis, treatment, and prognosis have not been determined or defined. To determine which biomarkers can and cannot be used to predict treatment response, classify patients for specific treatments, and develop targets for new interventions, proprietary strategies, and current research projects need to be tailored.Material and Methods: This review article focuses on - biomarker systems that would help in the further development and expansion of newer targets - which holds great promise for reducing the burden of depression.Results and Discussion: Further, this review point to the inflammatory response, metabolic marker, and microribonucleic acids, long non-coding RNAs, HPA axis which are - related to depression and can serve as future targets.

The regulatory effects of the apelin/APJ system on depression: A prospective therapeutic target

Depression is a debilitating neuropsychological disorder characterized by high incidence, high recurrence, high suicide, and high disability rates, which poses serious threats to human health and imposes heavy psychological and economic burdens on family and society. The pathogenesis of depression is extremely complex, and its etiology is multifactorial. Mounting evidence suggests that apelin and apelin receptor APJ, which compose the apelin/APJ system, are related to the development of depression. However, the specific mechanism is still unclear, and research in this area in human is still insufficient. Acceleration of research into the regulatory effects and underlying mechanisms of the apelin/APJ system in depression may identify attractive therapeutic targets and contribute to the development of novel intervention strategies against this devastating psychological disorder. In this review, we mainly discuss the regulatory effects of apelin/APJ system on depression and its potential therapeutic applications.

Skill Improvement Through Learning in Therapy (SKILT): A Study Protocol for a Randomized Trial Testing the Direct Effects of Cognitive Behavioral Therapy Skill Acquisition and Role of Learning Capacity in Depression

Background

To improve psychological treatments for major depressive disorder (MDD), a better understanding on how symptoms ameliorate during treatment is essential. In cognitive behavioral therapy (CBT), it is unclear whether procedures focused on the acquisition of CBT skills play a causal role in the improvement of CBT skills. In this randomized trial, we isolate a single CBT Skill Acquisition Procedure (CBTSAP) and test its direct effects on CBT skills and related therapy processes (i.e., change in (idiosyncratic) dysfunctional thinking and reward processing). We hypothesize that the CBTSAP causes improvements in CBT skills and related therapy processes compared to an active control condition. In addition, we hypothesize that individual differences in attentional bias and memory functioning (defined as learning capacity) moderate the effects of CBTSAP on outcomes and that using mental imagery as a cognitive support strategy to strengthen the effects of the CBTSAP will be most beneficial for patients with low learning capacity.

Method

150 patients with MDD will be randomized to one of three conditions: 1. an active control condition, 2. CBTSAP, 2. CBTSAP plus mental imagery, all consisting of three sessions. Primary outcomes will be change in CBT skills, changes in (idiosyncratic) dysfunctional thoughts and behaviors, reward processing. Depressive symptoms are a secondary outcome. Measures of learning capacity will be conducted at baseline and tested as a potential moderator.

Discussion

Knowing whether and for whom the acquisition of CBT skills leads to change in therapy processes and a subsequent reduction of depressive symptoms will inform on how to personalize and optimize psychotherapy outcomes for depression.

Trial registration

The trial is registered at the German Clinical Trial Register (DKTR; registration number: DRKS00024116).

Life Satisfaction Prevents Decline in Working Memory, Spatial Cognition, and Processing Speed: Latent Change Score Analyses Across 23 Years

Background

Within-person growth in life satisfaction (LS) can protect against declines in cognitive functioning, and, conversely, over time. However, most studies have been cross-sectional, thereby precluding causal inferences. Thus, we used bivariate dual latent change score modeling to test within-person change-to-future change relations between LS and cognition.

Method

Community adults completed in-person tests of verbal working memory (WM), processing speed, spatial cognition, and an LS self-report. Five waves of assessment occurred across 23 years.

Results

Reduction in LS predicted future decreases in spatial cognition, processing speed, and verbal WM (|d | = 0.150–0.354). Additionally, depletion in processing speed and verbal WM predicted a future decrease in LS (d  = 0.142–0.269). However, change in spatial cognition did not predict change in LS (|d | = 0.085).

Discussion

LS and verbal WM and processing speed predicted one another across long durations. Evidence-based therapies can be augmented to target LS and cognition.