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Jenniskens K, Rasing S, Popma A, Creemers D, Ghalit C, van Vuuren L, Mérelle S, Spijker J, van Nassau F. Development of an implementation plan for a school-based multimodal approach for depression and suicide prevention in adolescents. Front Public Health 2024; 12:1386031. [PMID: 38799678 PMCID: PMC11122015 DOI: 10.3389/fpubh.2024.1386031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/12/2024] [Indexed: 05/29/2024] Open
Abstract
Strong Teens and Resilient Minds (STORM) is a multimodal, school-based approach for depression and suicide prevention in adolescents that is currently implemented in a region in the Netherlands. The STORM approach will be implemented in new regions in the coming years. This study used the implementation mapping protocol to report on the development of the STORM implementation plan. First, a needs assessment was conducted through semi-structured interviews with stakeholders and brainstorming sessions with regional programme leaders in the two regions that started implementing STORM in 2023. This led to the identification of six main barriers to implementation: high level of demands for schools, insufficient understanding of the programme content, insufficient network collaboration, no perceived relative advantage of STORM by stakeholders, lack of attention to sustainability, and high work pressure. Second, performance and change objectives were formulated based on these barriers. For example, a performance objective for potential providers was that they felt supported by STORM. Third, implementation strategies were selected from theory and translated into practical applications through brainstorming sessions with programme leaders. The following strategies were included in the implementation plan: collaborate with similar initiatives within the region, free up time for STORM tasks, tailor strategies, identify and prepare STORM champions, and promote network weaving. Last, a plan to evaluate the implementation of STORM and the application of the STORM implementation plan was formulated. Planned evaluation research will provide more insight into the usefulness and impact of the STORM implementation plan.
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Affiliation(s)
- Kristel Jenniskens
- GGZ Oost Brabant, Boekel, Netherlands
- 113 Suicide Prevention, Amsterdam, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Sanne Rasing
- GGZ Oost Brabant, Boekel, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, Netherlands
| | - Daan Creemers
- GGZ Oost Brabant, Boekel, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Chaimae Ghalit
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, Netherlands
| | | | | | - Jan Spijker
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Pro Persona, Nijmegen, Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, Netherlands
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Bjornstad G, Sonthalia S, Rouse B, Freeman L, Hessami N, Dunne JH, Axford N. A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1376. [PMID: 38188230 PMCID: PMC10771715 DOI: 10.1002/cl2.1376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/03/2023] [Indexed: 01/09/2024]
Abstract
Background Depression is a public health problem and common amongst adolescents. Cognitive behavioural therapy (CBT) is widely used to treat adolescent depression but existing research does not provide clear conclusions regarding the relative effectiveness of different delivery modalities. Objectives The primary aim is to estimate the relative efficacy of different modes of CBT delivery compared with each other and control conditions for reducing depressive symptoms in adolescents. The secondary aim is to compare the different modes of delivery with regard to intervention completion/attrition (a proxy for intervention acceptability). Search Methods The Cochrane Depression, Anxiety and Neurosis Clinical Trials Register was searched in April 2020. MEDLINE, PsycInfo, EMBASE, four other electronic databases, the CENTRAL trial registry, Google Scholar and Google were searched in November 2020, together with reference checking, citation searching and hand-searching of two databases. Selection Criteria Randomised controlled trials (RCTs) of CBT interventions (irrespective of delivery mode) to reduce symptoms of depression in young people aged 10-19 years with clinically relevant symptoms or diagnosis of depression were included. Data Collection and Analysis Screening and data extraction were completed by two authors independently, with discrepancies addressed by a third author. CBT interventions were categorised as follows: group CBT, individual CBT, remote CBT, guided self-help, and unguided self-help. Effect on depressive symptom score was estimated across validated self-report measures using Hedges' g standardised mean difference. Acceptability was estimated based on loss to follow-up as an odds ratio. Treatment rankings were developed using the surface under the cumulative ranking curve (SUCRA). Pairwise meta-analyses were conducted using random effects models where there were two or more head-to-head trials. Network analyses were conducted using random effects models. Main Results Sixty-eight studies were included in the review. The mean age of participants ranged from 10 to 19.5 years, and on average 60% of participants were female. The majority of studies were conducted in schools (28) or universities (6); other settings included primary care, clinical settings and the home. The number of CBT sessions ranged from 1 to 16, the frequency of delivery from once every 2 weeks to twice a week and the duration of each session from 20 min to 2 h. The risk of bias was low across all domains for 23 studies, 24 studies had some concerns and the remaining 21 were assessed to be at high risk of bias. Sixty-two RCTs (representing 6435 participants) were included in the pairwise and network meta-analyses for post-intervention depressive symptom score at post-intervention. All pre-specified treatment and control categories were represented by at least one RCT. Although most CBT approaches, except remote CBT, demonstrated superiority over no intervention, no approaches performed clearly better than or equivalent to another. The highest and lowest ranking interventions were guided self-help (SUCRA 83%) and unguided self-help (SUCRA 51%), respectively (very low certainty in treatment ranking). Nineteen RCTs (3260 participants) were included in the pairwise and network meta-analyses for 6 to 12 month follow-up depressive symptom score. Neither guided self-help nor remote CBT were evaluated in the RCTs for this time point. Effects were generally attenuated for 6- to 12-month outcomes compared to posttest. No interventions demonstrated superiority to no intervention, although unguided self-help and group CBT both demonstrated superiority compared to TAU. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking approaches were unguided self-help and individual CBT, respectively. Sixty-two RCTs (7347 participants) were included in the pairwise and network meta-analyses for intervention acceptability. All pre-specified treatment and control categories were represented by at least one RCT. Although point estimates tended to favour no intervention, no active treatments were clearly inferior. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking active interventions were individual CBT and group CBT respectively. Pairwise meta-analytic findings were similar to those of the network meta-analysis for all analyses. There may be age-based subgroup effects on post-intervention depressive symptoms. Using the no intervention control group as the reference, the magnitudes of effects appear to be larger for the oldest age categories compared to the other subgroups for each given comparison. However, they were generally less precise and formal testing only indicated a significant difference for group CBT. Findings were robust to pre-specified sensitivity analyses separating out the type of placebo and excluding cluster-RCTs, as well as an additional analysis excluding studies where we had imputed standard deviations. Authors' Conclusions At posttreatment, all active treatments (group CBT, individual CBT, guided self-help, and unguided self-help) except for remote CBT were more effective than no treatment. Guided self-help was the most highly ranked intervention but only evaluated in trials with the oldest adolescents (16-19 years). Moreover, the studies of guided self-help vary in the type and amount of therapist support provided and longer-term results are needed to determine whether effects persist. The magnitude of effects was generally attenuated for 6- to 12-month outcomes. Although unguided self-help was the lowest-ranked active intervention at post-intervention, it was the highest ranked at follow-up. This suggests the need for further research into whether interventions with self-directed elements enable young people to maintain effects by continuing or revisiting the intervention independently, and whether therapist support would improve long-term outcomes. There was no clear evidence that any active treatments were more acceptable to participants than any others. The relative effectiveness of intervention delivery modes must be taken into account in the context of the needs and preferences of individual young people, particularly as the differences between effect sizes were relatively small. Further research into the type and amount of therapist support that is most acceptable to young people and most cost-effective would be particularly useful.
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Affiliation(s)
- Gretchen Bjornstad
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
- Dartington Service Design LabBuckfastleighUK
| | - Shreya Sonthalia
- Dartington Service Design LabBuckfastleighUK
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Benjamin Rouse
- Center for Clinical Evidence and Guidelines, ECRI InstitutePlymouth MeetingPennsylvaniaUSA
| | | | | | - Jo Hickman Dunne
- The Centre for Youth ImpactLondonUK
- University of ManchesterManchesterUK
| | - Nick Axford
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of PlymouthPlymouthUK
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Bokolo NP, Van Niekerk RL, Mathews V, Leach L. A Systematic Review Protocol for the Effectiveness of Psycho-Educational Intervention Programmes in Addressing the Psychological Risk Factors Associated with Non-Communicable Diseases among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6467. [PMID: 37569009 PMCID: PMC10418932 DOI: 10.3390/ijerph20156467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/16/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023]
Abstract
The psychological health concerns and risk factors associated with non-communicable disease among adolescents have been prioritized on the agenda of international health institutions globally. The aims of this systematic review are to determine the various types of psycho-educational intervention programmes developed to address the psychological risk factors associated with non-communicable diseases among adolescents, and to assess the effectiveness of the psycho-educational intervention programmes. The systematic review will include case-control and randomized controlled studies. The review will be conducted using the following electronic databases, PubMed, CINAHL, Science Direct, Cochrane Library, SCOPUS, and ERIC, as well as the grey literature for the thesis repository from 2012 to 2022. The key search terms will include intervention programme, adolescents (aged 10-19 years), psychological risk factors and non-communicable diseases. The studies identified by the search strategy will be downloaded into Mendeley and exported to Covidence software for screening, quality assessment and data extraction. The quality assessment tool that will be utilized is the Joanna Briggs Institute critical appraisal checklists to ensure relevance and quality of the articles. This systematic review will use two types of data analysis: narrative synthesis of qualitative studies and meta-analysis of quantitative studies. The findings from this systematic review will provide evidence-based tools for the management of psychological risk factors associated with non-communicable diseases, as well as present key insights for future intervention programmes on the management of psychological risk factors associated with NCDs among adolescents.
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Affiliation(s)
- Nokwanda P. Bokolo
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
| | - Rudolph Leon Van Niekerk
- Department of Psychology, Faculty of Social Sciences and Humanities, University of Fort Hare, Private Bag X9083, 50 Church Street, East London 5201, South Africa
| | - Verona Mathews
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Bellville 7535, South Africa
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Tomé G, Guedes FB, Cerqueira A, Noronha C, de Freitas JC, Freire T, de Matos MG. How Is Leisure Related to Wellbeing and to Substance Use? The Probable Key Role of Autonomy and Supervision. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050773. [PMID: 37238321 DOI: 10.3390/children10050773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/31/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023]
Abstract
The present research is based on a large and representative national survey and intends to analyse the correlation of several leisure activities with risk, and with health and well-being outcomes. This work is part of the Health Behaviour in School-aged Children (HBSC) study, a collaborative WHO international study that aims to explore the school-aged children behaviour regarding health and risk behaviours in their life contexts. Participants were 8215 Portuguese adolescents, randomly chosen from those attending the 6th, 8th, 10th and 12th grades in 2018. The sample included 52.7% of girls and the mean age was 14.36 years old. Descriptive and comparative analyses were performed (ANOVAS and Chi-Square). The results of the present study suggested that several leisure activities, namely sports and social engagement activities (politic involvement and participation, religious activities, scouting and volunteer work), are associated with the adolescents' well-being and life satisfaction. However, these types of activities can also be associated with an increase in substance use. However, some activities are also associated with risky behaviour. Identifying activities that promote well-being in young people can be important for professionals, families and public policies.
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Affiliation(s)
- Gina Tomé
- Institute of Environmental Health (ISAMB), Aventura Social, Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Faculty of Human Kinetics, University of Lisbon (FMH-UL), 1495-751 Lisbon, Portugal
| | - Fábio Botelho Guedes
- Institute of Environmental Health (ISAMB), Aventura Social, Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Faculty of Human Kinetics, University of Lisbon (FMH-UL), 1495-751 Lisbon, Portugal
| | - Ana Cerqueira
- Institute of Environmental Health (ISAMB), Aventura Social, Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- Faculty of Human Kinetics, University of Lisbon (FMH-UL), 1495-751 Lisbon, Portugal
| | - Catarina Noronha
- Institute of Environmental Health (ISAMB), Aventura Social, Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
| | | | - Teresa Freire
- School of Psychology, Psychology Research Centre, University of Minho, 4710-057 Braga, Portugal
| | - Margarida Gaspar de Matos
- Institute of Environmental Health (ISAMB), Aventura Social, Faculty of Medicine, University of Lisbon (FMUL), 1649-028 Lisbon, Portugal
- APPSYci-Applied Psychology Research Center Capabilities & Inclusion, ISPA-University Institute, 1100-304 Lisbon, Portugal
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Gijzen M, Rasing S, van den Boogaart R, Rongen W, van der Steen T, Creemers D, Engels R, Smit F. Feasibility of a serious game coupled with a contact-based session led by lived experience workers for depression prevention in high-school students. PLoS One 2021; 16:e0260224. [PMID: 34847158 PMCID: PMC8631635 DOI: 10.1371/journal.pone.0260224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stigma and limited mental health literacy impede adolescents getting the help they need for depressive symptoms. A serious game coupled with a classroom session led by lived experience workers (LEWs) might help to overcome these barriers. The school-based Strong Teens and Resilient Minds (STORM) preventive program employed this strategy and offered a serious game, Moving Stories. The current study was carried out to assess inhibiting and promoting factors for scaling up Moving Stories once its effectiveness has been ascertained. METHODS Moving Stories was offered in three steps: (1) introductory classroom session, (2) students playing the game for five days, (3) debriefing classroom session led by lived experience worker. Data was collected on the number of participating students, costs of offering Moving Stories, and was further based on the notes of the debriefing sessions to check if mental health first aid (MHFA) strategies were addressed. RESULTS Moving Stories was offered in seven high-schools. Coverage was moderate with 982 participating students out of 1880 (52%). Most participating students (83%) played the Moving Stories app three out of the five days. Qualitative data showed that the MHFAs were discussed in all debriefing sessions. Students showed great interest in lived experience workers' stories and shared their own experiences with depression. CONCLUSIONS Bringing Moving Stories to scale in the high-school setting appears feasible, but will remain logistically somewhat challenging. Future implementation and scale-up of Moving Stories could benefit from improved selection and training of LEWs that played such an important role in grabbing the full attention of students and were able to launch frank discussions about depressive disorder and stigma in classrooms. TRIAL REGISTRATION The study is registered in the Dutch Trial Register: Trial NL6444 (NTR6622: https://www.trialregister.nl/trial/6444).
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Affiliation(s)
- Mandy Gijzen
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
- GGZ Oost Brabant, Boekel, The Netherlands
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Sanne Rasing
- GGZ Oost Brabant, Boekel, The Netherlands
- Anxiety, Compulsion & Phobia Foundation; National Patient Organization, Driebergen-Rijsenburg, The Netherlands
| | | | | | - Twan van der Steen
- Anxiety, Compulsion & Phobia Foundation; National Patient Organization, Driebergen-Rijsenburg, The Netherlands
| | - Daan Creemers
- GGZ Oost Brabant, Boekel, The Netherlands
- Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Rutger Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Filip Smit
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology and Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands
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de Jonge-Heesen KWJ, Rasing SPA, Vermulst AA, Scholte RHJ, van Ettekoven KM, Engels RCME, Creemers DHM. Secondary Outcomes of Implemented Depression Prevention in Adolescents: A Randomized Controlled Trial. Front Psychiatry 2021; 12:643632. [PMID: 33708150 PMCID: PMC7940696 DOI: 10.3389/fpsyt.2021.643632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Our most recent RCT provides evidence that indicated depression prevention is effective in reducing depressive symptoms in adolescents when implemented in the school community. In the present study we further test the potential effects of this prevention approach on symptoms related to depression: anxiety, suicidality, somatic symptoms, and perfectionism. We conducted exploratory analyses in 130 adolescents with elevated depressive symptoms aged between 12 and 16 years old (M = 13.59; SD = 0.68; 63.8% girls) who were randomly assigned to the experimental (OVK 2.0) or active control condition (psycho-education). Self-reported anxiety, suicidality, somatic symptoms, and perfectionism were assessed at pretest, post intervention, as well as 6- and 12-months follow-up. Latent growth curve analyses revealed that there was a significant decrease in anxiety in both conditions and that this decrease was significantly larger in the intervention condition than in the control condition. Somatic symptoms and socially prescribed perfectionism decreased significantly in the intervention condition and suicidality decreased significantly in the control condition. Yet there was no difference in decrease in suicidality, somatic symptoms, and perfectionism between the two conditions. This study suggest that screening on depressive symptoms and providing a CBT depression prevention program for adolescents with elevated depressive symptoms, can decrease comorbid symptoms of anxiety and therefore ensure better outcomes. We discuss the clinical implications as well suggestions for future research. Clinical Trial Registration: The study is registered in the Dutch Trial Register for RCTs (NTR5725). Date registered: 11th of March 2016.
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Affiliation(s)
- Karlijn W J de Jonge-Heesen
- GGZ Oost Brabant, Boekel, Netherlands.,Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Sanne P A Rasing
- GGZ Oost Brabant, Boekel, Netherlands.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
| | | | - Ron H J Scholte
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands.,Praktikon, Nijmegen, Netherlands
| | - Kim M van Ettekoven
- GGZ Oost Brabant, Boekel, Netherlands.,Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Rutger C M E Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Daan H M Creemers
- GGZ Oost Brabant, Boekel, Netherlands.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
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de la Peña FR, Cruz-Fuentes C, Palacios L, Girón-Pérez MI, Medina-Rivero E, Ponce-Regalado MD, Alvarez-Herrera S, Pérez-Sánchez G, Becerril-Villanueva E, Maldonado-García JL, Jiménez-Martínez MC, Pavón L. Serum levels of chemokines in adolescents with major depression treated with fluoxetine. World J Psychiatry 2020; 10:175-186. [PMID: 32874955 PMCID: PMC7439300 DOI: 10.5498/wjp.v10.i8.175] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/31/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a global health issue that affects 350 million people of all ages. Although between 2% and 5.6% of affected individuals are adolescents, research on young patients is limited. The inflammatory response contributes to the onset of depression, and in adult MDD patients, symptom severity has been linked to chemokine levels.
AIM To determine the differences in circulatory levels of chemokines in healthy volunteers (HVs) and adolescents with MDD, and assess the changes induced by fluoxetine consume.
METHODS The 22 adolescents with MDD were monitored during the first 8 wk of clinical follow-up and clinical psychiatric evaluation was done using the Hamilton depresión rating scale (HDRS). The serum levels of monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein (MIP)-1α, MIP-1β, interleukin (IL)-8, interferon gamma-induced protein (IP)-10, and eotaxin were measured in patients and HVs.
RESULTS In all cases, significant differences were detected in circulating chemokine levels between patients before treatment and HVs (P < 0.0001). All chemokines decreased at 4 wk, but only MCP-1 and IL-8 significantly differed (P < 0.05) between 0 wk and 4 wk. In the patients, all chemokines rose to their initial concentrations by 8 wk vs 0 wk, but only IP-10 did so significantly (P < 0.05). All patients experienced a significant decrease in HDRS scores at 4 wk (P < 0.0001) and 8 wk (P < 0.0001) compared with 0 wk.
CONCLUSION Despite the consumption of fluoxetine, patients had significantly higher chemokine levels, even after considering the improvement in HDRS score. The high levels of eotaxin, IP-10, and IL-8 partially explain certain aspects that are affected in MDD such as cognition, memory, and learning.
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Affiliation(s)
- Francisco Rafael de la Peña
- Adolescent Clinic, Clinical Services, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
| | - Carlos Cruz-Fuentes
- Department of Psychiatric Genetics, Clinical Research Branch, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
| | - Lino Palacios
- Adolescent Clinic, Clinical Services, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
| | - Manuel Iván Girón-Pérez
- Universidad Autónoma de Nayarit, Laboratorio de Inmunotoxicología, Boulevard Tepic-Xalisco s/n, Cd de la Cultura Amado Nervo, Tepic 63000, Mexico
- Centro Nayarita de Innovación y Transferencia de Tecnología A.C. Laboratorio Nacional para la Investigación en Inocuidad Alimentaria-Unidad Nayarit, Calle Tres s/n. Cd Industrial, Tepic 63000, Nayarit, Mexico
| | - Emilio Medina-Rivero
- Unidad de Desarrollo e Investigación en Bioprocesos, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Lázaro Cárdenas, Mexico City 11340, Mexico
| | - Maria Dolores Ponce-Regalado
- Departamento de Ciencias de Salud, Centro Universitario de los Altos, Universidad de Guadalajara Av Rafael Casillas Aceves No.1200, Tepatitlán de Morelos, Jalisco, 47610, Mexico
| | - Samantha Alvarez-Herrera
- Laboratory of Psychoimmunology, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
| | - Gilberto Pérez-Sánchez
- Laboratory of Psychoimmunology, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
| | - Enrique Becerril-Villanueva
- Laboratory of Psychoimmunology, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
| | - José Luis Maldonado-García
- Laboratory of Psychoimmunology, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
| | - María C Jiménez-Martínez
- Department of Immunology and Research Unit, Institute of Ophthalmology “Conde de Valenciana Foundation”, Mexico City 06800, Mexico
- Department of Biochemistry, Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Lenin Pavón
- Laboratory of Psychoimmunology, National Institute of Psychiatry, “Ramón de la Fuente”, Mexico City 14370, Mexico
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8
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de Jonge-Heesen KWJ, Rasing SPA, Vermulst AA, Scholte RHJ, van Ettekoven KM, Engels RCME, Creemers DHM. Randomized control trial testing the effectiveness of implemented depression prevention in high-risk adolescents. BMC Med 2020; 18:188. [PMID: 32703288 PMCID: PMC7379355 DOI: 10.1186/s12916-020-01656-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/03/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adolescent depression is a global mental health concern. Identification and effective prevention in an early stage are necessary. The present randomized, controlled trial aimed to examine the effectiveness of Cognitive Behavioral Therapy (CBT)-based depression prevention in adolescents with elevated depressive symptoms. This prevention approach is implemented in school communities, which allows to examine effects under real-life circumstances. METHODS A total of 5222 adolescents were screened for elevated depressive symptoms in the second grade of secondary schools; 130 adolescents aged between 12 and 16 years old (M = 13.59; SD = 0.68; 63.8% girls) were randomly assigned to the experimental (OVK 2.0) or control condition (psycho-education). Self- and parent-reported depressive symptoms were assessed at pretest and post intervention, as well as 6- and 12-months follow-up. Clinical assessment of depression was assessed at pretest and 6-months follow-up. RESULTS Intent-to-treat analyses revealed that the decrease in adolescent-rated depressive symptoms was significantly larger in the intervention condition than in the control condition. There was no significant difference in decrease of parent-rated depressive symptoms between both conditions. CONCLUSIONS Based on the findings, we recommend the implementation of screening and prevention in schools, according the basics of this study design. Since this is a new step forward, we discuss the clinical impact and challenges, as well possibilities for future research. TRIAL REGISTRATION The study is registered in the Dutch Trial Register for RCT's ( NTR5725 ). Date registered: 11 March 2016.
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Affiliation(s)
- Karlijn W. J. de Jonge-Heesen
- GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Sanne P. A. Rasing
- GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
- Child and Adolescent Studies, Utrecht University, P.O. Box 80125, 3508 TC Utrecht, The Netherlands
| | - Ad A. Vermulst
- GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
| | - Ron H. J. Scholte
- Praktikon, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Kim M. van Ettekoven
- GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Rutger C. M. E. Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Daan H. M. Creemers
- GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
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Abootalebi M, Dehghani M, Akbarzadeh M. Implementing of mental health training programs for promotion of health affected teenage girls to premenstrual syndrome: A community-based study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:155. [PMID: 32766340 PMCID: PMC7377132 DOI: 10.4103/jehp.jehp_118_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/07/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Mental health is one of the major determinants of a person's health which has a significant impact on the quality of life. Implementing of mental health training programs for promotion of health affected teenage girls to premenstrual syndrome (PMS) in Shiraz, southern Iran: a community-based study. MATERIALS AND METHODS This study is randomized controlled trial done on 100 teenage girls affected to PMS in Shiraz-Iran (selected from400 girls). Multistage cluster sampling method was used f or sampling. In the intervention group, six training sessions were held twice a week for 2 h. For data collection, Standard Goldberg Mental Health Questionnaire-28 and Premenstrual Symptoms Screening Tool were used. For data analysis, independent t-test and Chi-square statistics were used at significant level of 0.05. RESULTS The average age was (16.56 ± 0.92) and (16.24 ± 1.45) in the intervention and control groups, respectively. The average intensity of physical complaints, level of anxiety and sleep disorder, level of social functions disorders and depression were significantly lower in the group of training classes than control group (P < 0.001). CONCLUSION Appropriate training-care programs are effective in reducing stress and improving mental health, prevention and treatment of mental disorders, emotional growth, and development of communication skills among female students with premenstrual syndrome.
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Affiliation(s)
- Maliheh Abootalebi
- Department of Community Health Nursing, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansoureh Dehghani
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Akbarzadeh
- Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Inflammatory Profiles in Depressed Adolescents Treated with Fluoxetine: An 8-Week Follow-up Open Study. Mediators Inflamm 2018; 2018:4074051. [PMID: 30662368 PMCID: PMC6312587 DOI: 10.1155/2018/4074051] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/30/2018] [Accepted: 08/28/2018] [Indexed: 12/17/2022] Open
Abstract
Changes in cytokine levels in major depression and during treatment have been reported in adults. However, few studies have examined cytokine levels in an adolescent sample despite this being a common age of onset. Methods. We measured proinflammatory (IL-2, IFN-γ, IL-1β, TNF-α, IL-6, IL-12, and IL-15) and anti-inflammatory (IL-4, IL-5, IL-13, IL-1Ra, and IL-10) cytokine serum levels in 22 adolescents with major depression and 18 healthy volunteers. Cytokines were measured by multiplex bead-based immunoassays at baseline, and 4 and 8 weeks after commencement of fluoxetine administration in the clinical group. Results. Compared to healthy volunteers, adolescents with major depression at baseline showed significant increases in all pro- and anti-inflammatory cytokines, except IL-1Ra and IL-10. Significant changes were observed in fluoxetine treatment compared to baseline: proinflammatory cytokines IFN-γ, IL-1β, TNF-α, IL-6, IL-12, and IL-15 were decreased only at week 4 whereas IL-2 was increased only at week 8; anti-inflammatory cytokines IL-4 and IL-5 were increased at week 8 while IL-1Ra was reduced only at week 4. There were no significant correlations between cytokine levels and symptomatic improvement in HDRS. Discussion. The results suggest a significant interplay between cytokine levels, the depressive state, and the stage of treatment with an SSRI. To the best of our knowledge, this is the first report in depressed adolescents with elevated IL-12, IL-13, and IL-15 levels. Further studies are necessary to clarify the role and mechanisms of altered cytokine levels in the pathogenesis and physiopathology of major depressive disorder.
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Gijzen MWM, Creemers DHM, Rasing SPA, Smit F, Engels RCME. Evaluation of a multimodal school-based depression and suicide prevention program among Dutch adolescents: design of a cluster-randomized controlled trial. BMC Psychiatry 2018; 18:124. [PMID: 29747618 PMCID: PMC5946540 DOI: 10.1186/s12888-018-1710-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since 2010, suicide has been the most important cause of mortality in youth aged 15 to 29 years in the Netherlands. Depression is an important risk factor for suicidal behaviors (i.e., suicide ideation, deliberate self-harm, planning, and suicide attempts) in adolescents. Adolescents who develop depressive symptoms, are also at risk for adult depression. This developmental continuity is especially noticeable in adolescents compared to other age groups; therefore, it is necessary to develop preventive strategies for teens. This study will test a multimodal school-based approach to suicide and depression prevention, which integrates universal and targeted approaches and includes various stakeholders (schools, adolescents, parents, and mental health professionals) simultaneously. METHODS We will perform a cluster randomized controlled trial (RCT) with an intervention and control condition to test the effectiveness of a school-based multimodal stepped-prevention program for depression and suicidal behaviors in adolescents. Adolescents in their second year of secondary education will participate in the study. The participants in the intervention condition will receive the entire multimodal stepped-preventive program comprising early screening and detection of suicidal behaviors and depressive symptoms, a safety net consisting of gatekeepers at school, followed by universal and indicated prevention. The participants in the control condition will undergo only the screening and the safety net of gatekeepers at schools. They will complete assessments at baseline, post-intervention, and 6, 12, and 24-month follow-up. Primary outcome will be suicidal behaviors measured at 12-months follow-up. Additionally, the present study will identify mechanisms that mediate and moderate the program effects and test the effect of the program on various secondary outcomes. DISCUSSION If the school-based multimodal stepped-prevention program proves to be effective, it could be implemented in schools on a large scale. TRIAL REGISTRATION The study is registered in the Dutch Trial Register ( NTR6622 ).
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Affiliation(s)
- Mandy W. M. Gijzen
- 0000 0001 0835 8259grid.416017.5Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS Utrecht, The Netherlands ,0000000092621349grid.6906.9Erasmus School of Social and Behavioural Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands ,0000 0004 0377 6226grid.476319.eGGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
| | - Daan H. M. Creemers
- 0000 0004 0377 6226grid.476319.eGGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands ,0000000122931605grid.5590.9Behavioral Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Sanne P. A. Rasing
- 0000 0004 0377 6226grid.476319.eGGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands ,0000000120346234grid.5477.1Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - Filip Smit
- 0000 0001 0835 8259grid.416017.5Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS Utrecht, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aDepartment of Clinical, Neuro and Developmental Psychology and Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Rutger C. M. E. Engels
- 0000000092621349grid.6906.9Erasmus School of Social and Behavioural Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
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Fréchette-Simard C, Plante I, Bluteau J. Strategies included in cognitive behavioral therapy programs to treat internalized disorders: a systematic review. Cogn Behav Ther 2017; 47:263-285. [PMID: 29103355 DOI: 10.1080/16506073.2017.1388275] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This review aimed to identify the strategies used in programs based on cognitive behavioral therapy (CBT) to prevent and treat symptoms of anxiety, depression, and internalized behaviors of children and adolescents. Based on an online search (ERIC, PsycInfo, Virtuose UQAM, and Google Scholar), 61 studies describing different cognitive behavioral programs were selected. Results showed that 40 strategies were implemented in at least one program. However, none of the strategies were systematically present in all programs, and only few were reported in more than 50% of the studies. Cognitive restructuring and problem-solving were the most popular strategies to treat depressive symptoms, whereas anxiety programs also generally included relaxation and exposure. Furthermore, six strategies were identified in a single anxiety program, whereas nine strategies were implemented in only one depression program. These results suggest that in anxiety and depression programs designed for children and adolescents, the label "CBT" encompasses a wide variety of programs with only few similar strategies. Such findings highlight the need to define a common basis for CBT programs, in order to better reflect CBT theory and to identify the effectiveness of the strategies included in these programs.
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Affiliation(s)
- Catherine Fréchette-Simard
- a Department of Special Education , Universite du Quebec a Montreal , Montreal , Quebec H3C 3P8 , Canada
| | - Isabelle Plante
- a Department of Special Education , Universite du Quebec a Montreal , Montreal , Quebec H3C 3P8 , Canada
| | - Jonathan Bluteau
- a Department of Special Education , Universite du Quebec a Montreal , Montreal , Quebec H3C 3P8 , Canada
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