Sample size, sample size planning, and the impact of study context: systematic review and recommendations by the example of psychological depression treatment

Application of targeted next-generation sequencing for detecting respiratory pathogens in the sputum of patients with pulmonary infections

Targeted next-generation sequencing (tNGS) might be valuable for identifying disease-causing pathogens. Herein, we assessed the utility of tNGS in diagnosing pulmonary infections using sputum samples. We gathered complete clinical information and tested the specimens using both conventional microbiological tests (CMTs) and tNGS. The goal was to compare the effectiveness of these two methods in detecting viral, bacterial, and fungal pathogens. Notably, tNGS demonstrated a higher pathogen detection rate compared to CMTs (80.26 % [122/152] vs. 33.55 % [51/152], P = 0.029). Specifically, tNGS was more effective in detecting viruses than CMTs (90.00 % vs. 28.07 %, P = 0.003). Moreover, tNGS detected certain fungi, such as Candida albicans and Cryptococcus neoformans, although the difference between the two assays was not statistically significant (P > 0.05). Our findings reveal that tNGS offers significant advantages in detecting pathogens in patients with lung infections, particularly for bacteria and viruses, providing valuable information that complements CMTs.

Can One Donation a Day Keep Depression Away? Three Randomized Controlled Trials of an Online Micro-Charitable Giving Intervention

Prosocial interventions grounded in social interactions have shown limited effectiveness in alleviating depressive symptoms, possibly because of the discomfort and unease that depressed individuals experience during such interactions. We developed and examined an innovative prosocial intervention-an online micro-charitable giving intervention, in which individuals voluntarily donated at least one Chinese cent (¥0.01, or about $0.0014) daily. We conducted three preregistered, 2-month randomized controlled trials with depressed individuals (Sample 1: N = 125, Sample 2: N = 296, Sample 3: N = 462). Results showed that, compared with the waitlist group, the intervention group exhibited significantly greater improvements in both depressive symptoms (Cohen's ds = -0.19 to -0.46) and emotional positivity (Cohen's ds = 0.22 to 0.49), and that emotional positivity mediated the intervention's effect on the reduction of depressive symptoms. Exploratory analysis found a slightly larger intervention effect for generous donors than for minimal donors. This low-cost, easily accessible prosocial intervention holds potential for the prevention of depression.[Box: see text].

The Relation Between Passively Collected GPS Mobility Metrics and Depressive Symptoms: Systematic Review and Meta-Analysis

BACKGROUND

The objective, unobtrusively collected GPS features (eg, homestay and distance) from everyday devices like smartphones may offer a promising augmentation to current assessment tools for depression. However, to date, there is no systematic and meta-analytical evidence on the associations between GPS features and depression.

OBJECTIVE

This study aimed to investigate the between-person and within-person correlations between GPS mobility and activity features and depressive symptoms, and to critically review the quality and potential publication bias in the field.

METHODS

We searched MEDLINE, PsycINFO, Embase, CENTRAL, ACM, IEEE Xplore, PubMed, and Web of Science to identify eligible articles focusing on the correlations between GPS features and depression from December 6, 2022, to March 24, 2023. Inclusion and exclusion criteria were applied in a 2-stage inclusion process conducted by 2 independent reviewers (YT and JK). To be eligible, studies needed to report correlations between wearable-based GPS variables (eg, total distance) and depression symptoms measured with a validated questionnaire. Studies with underage persons and other mental health disorders were excluded. Between- and within-person correlations were analyzed using random effects models. Study quality was determined by comparing studies against the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines. Publication bias was investigated using Egger test and funnel plots.

RESULTS

A total of k=19 studies involving N=2930 participants were included in the analysis. The mean age was 38.42 (SD 18.96) years with 59.64% (SD 22.99%) of participants being female. Significant between-person correlations between GPS features and depression were identified: distance (r=-0.25, 95% CI -0.29 to -0.21), normalized entropy (r-0.17, 95% CI -0.29 to -0.04), location variance (r-0.17, 95% CI -0.26 to -0.04), entropy (r=-0.13, 95% CI -0.23 to -0.04), number of clusters (r=-0.11, 95% CI -0.18 to -0.03), and homestay (r=0.10, 95% CI 0.00 to 0.19). Studies reporting within-correlations (k=3) were too heterogeneous to conduct meta-analysis. A deficiency in study quality and research standards was identified: all studies followed exploratory observational designs, but no study referenced or fully adhered to the international guidelines for reporting observational studies (STROBE). A total of 79% (k=15) of the studies were underpowered to detect a small correlation (r=.20). Results showed evidence for potential publication bias.

CONCLUSIONS

Our results provide meta-analytical evidence for between-person correlations of GPS mobility and activity features and depression. Hence, depression diagnostics may benefit from adding GPS mobility and activity features as an integral part of future assessment and expert tools. However, confirmatory studies for between-person correlations and further research on within-person correlations are needed. In addition, the methodological quality of the evidence needs to improve.

TRIAL REGISTRATION

OSF Registeries cwder; https://osf.io/cwder.

Changes in Spousal Intimacy in Women Suffering Trauma Symptoms from Domestic Abuse: A Culturally Embedded Intervention Study in Pakistan

While emerging research is highlighting the significant effects of culture on marital and family relationships, studies investigating relationship intimacy and abuse in non-Western cultures are non-existent. This investigation assessed relationship intimacy in Pakistani women experiencing trauma symptoms (PTSD) from domestic abuse (DA) who received a culturally informed trauma intervention in a context that differs greatly in values and assumptions about marital relationships relative to Western traditions. Forty women meeting inclusion criteria were assessed on domestic violence type and characteristics (both victim and perpetrator characteristics), PTSD symptomology, and three aspects of relationship intimacy: engagement, communication, and shared friendships. PTSD symptomology and relationship intimacy were reassessed post-intervention. Results indicated significant changes in engagement and communication intimacy following the intervention, with engagement decreasing and communication increasing. The third aspect of intimacy, namely, shared friendships, showed no change. Engagement and overall intimacy showed significant negative correlations with physical abuse, though not with sexual or psychological/emotional abuse. These findings are interpreted within a cultural context where women have few options for leaving an abusive relationship. As such, the results highlight the importance of culture when studying facets of intimate relationships and the need to use culturally informed assessments to better understand the experience of intimacy within abusive relationships.

Targeted psychological and psychosocial interventions for auditory hallucinations in persons with psychotic disorders: Protocol for a systematic review and meta-analysis

BACKGROUND

In recent years, a growing body of evidence has demonstrated the efficacy of non-pharmacological interventions for schizophrenia spectrum disorders (SSD) including positive symptoms such as auditory hallucinations (AH). However, clinical trials predominantly examine general treatment effects for positive symptoms. Therefore, previous research is lacking in comprehensive and clear evidence about psychological and psychosocial approaches that are primarily tailored to treat AH. To overcome this knowledge gap in the current literature, we will conduct a systematic review and meta-analysis to assess the efficacy of clearly targeted psychological and psychosocial interventions for AH in persons with SSD.

METHODS AND ANALYSIS

This study protocol has been developed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will include all randomized controlled trials analyzing the efficacy of targeted psychological and psychosocial interventions especially aimed at treating AH in SSD. We will include studies on adult patients with SSD experiencing AH. The primary outcome will be the change on a published rating scale measuring AH. Secondary outcomes will be delusions, overall symptoms, negative symptoms, depression, social functioning, quality of life, and acceptability (drop-out). We will search relevant databases and the reference lists of included literature. The study selection process will be conducted by two independent reviewers. We will conduct a random-effect meta-analysis to consider heterogeneity across studies. Analyses will be carried out by software packages in R. The risk of bias in each study will be evaluated using the Cochrane Risk of Bias tool. Assessment of heterogeneity and sensitivity analysis will be conducted.

DISCUSSION

The proposed study will augment the existing evidence by providing an overview of effective treatment approaches and their overall efficacy at treating AH in SSD. These findings will complement existing evidence that may impact future treatment implementations in clinical practice by addressing effective strategies to treat AH and therefore improve outcomes for the addressed population.

ETHICS AND DISSEMINATION

No ethical issues are foreseen. We will publish the results from this study in peer-reviewed journals and at relevant scientific conferences.

TRIAL REGISTRATION

PROSPERO registration number: CRD42023475704.

Free choice of treatment content, support on demand and supervision in internet-delivered CBT for adults with depression: A randomized factorial design trial

Even if much is known regarding the effects of internet-delivered cognitive behaviour therapy (ICBT) for depression there are several topics that have not been studied. In this factorial design trial with 197 participants we investigated if clients in ICBT could select treatment modules themselves based on a selection of 15 tailored treatment modules developed for use in ICBT for depression. We contrasted this against clinician-tailored module selection. We also investigated if support on demand (initiated by the client) could work as well as scheduled support. Finally, we tested if clients that were mentioned in supervision would improve more than clients not mentioned (with the exception of acute cases). The treatment period lasted for 10 weeks, and we measured effects at post-treatment and two-year follow-up. Measures of depression and secondary outcomes were collected at pre-treatment, post-treatment and two-year follow-up. Overall, within-group effects were large across conditions (e.g., d = 1.73 on the BDI-II). We also found a small but significant difference in favour of self-tailored treatment over clinician-tailored (d = 0.26). Within-group effects for the secondary measures were all moderate to large including a test of knowledge about CBT. The other two contrasts "support on demand" and "supervision" yielded mostly non-significant differences, with the exception of a larger dropout rate in the support on demand condition. There were few negative effects (2.2%). Effects were largely maintained at a two-year follow-up. We conclude that clients can choose treatment modules and that support on demand may work. The role of supervision is not yet clear as advice can be transferred across clients.