Earlier school start times may increase risk of adolescent depression and anxiety

Teenagers with school starting times before 8:30 a.m. may be at particular risk of experiencing depression and anxiety due to compromised sleep quality, according to a recent study. | Sleep Health 2017 | story via ScienceDaily

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The findings of this study provide additional evidence in the debate over how school start times impact adolescent health.  The study,  published in the journal Sleep Health found that Teenagers who start school before 8:30 a.m. are at higher risk of depression and anxiety, even if they’re doing everything else right to get a good night’s sleep.

The authors used an online tool to collect data from 197 students across the USA between the ages of 14 and 17. All children and parents completed a baseline survey that included questions about the child’s level of sleep hygiene, family socioeconomic status,  and their school start times. They were separated into two groups: those who started school before 8:30 a.m. and those who started after 8:30 a.m.

Over a period of seven days, the students were instructed to keep a sleep diary, in which they reported specifically on their daily sleep hygiene, levels of sleep quality and duration, and their depressive/anxiety symptoms.

The results showed that good baseline sleep hygiene was directly associated with lower average daily depressive/anxiety symptoms across all students, and the levels were even lower in students with school start times after 8:30. However, students with good baseline sleep hygiene and earlier school start times had higher average daily depressive/anxiety symptoms.

Link to the research:  Peltz, J. S. et al. A process-oriented model linking adolescents’ sleep hygiene and psychological functioning: the moderating role of school start times  Sleep Health

Full story at ScienceDaily

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Brief, intensive and concentrated CBT for anxiety disorders in children

This review aims to evaluate brief, intensive and concentrated (BIC) cognitive behavioural therapy, adapted from “standard” CBT treatments for anxiety disorders in young people | Simon Brett for the Mental Elf

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Image source: Samantha Cimino – Flickr // CC BY-NC 2.0

Anxiety disorders affect 10% of children and 20% of adolescents at any one time. These disorders frequently persist into adulthood and are often associated with significant difficulties across the life span (e.g., major depression, substance abuse) (Woodward & Fergusson, 2001).

However, despite the existence of evidence-based interventions, the majority of young people do not access treatment. Young people face substantial barriers to seeking and receiving treatment; stigma, infrequent contact with health services, waiting times, lack of knowledge about mental health and few sufficiently trained mental health professionals.

Given the sound underlying therapeutic principles and evidence-base of CBT, it appears to be an ideal therapy to adapt and develop brief, intensive and concentrated (BIC) approaches designed to reach more young people, be more efficient and more cost-effective.

 

 

Very preterm birth not associated with mood & anxiety disorders

Do very-preterm or very-low-weight babies develop anxiety and mood disorders later in life? Researchers have concluded a study to answer this question | ScienceDaily

The team studied nearly 400 individuals from birth to adulthood. Half of the participants had been born before 32 weeks gestation or at a very low birth weight (less than 3.3 pounds), and the other half had been born at term and normal birth weight. They assessed each participant when they were 6, 8 and 26 years old using detailed clinical interviews of psychiatric disorders.

“Previous research has reported increased risks for anxiety and mood disorders, but these studies were based on small samples and did not include repeated assessments for over 20 years,”

Their results? At age 6, children were not at an increased risk of any anxiety or mood disorders, but by age 8 — after they had entered school — more children had an anxiety disorder. By 26, there was a tendency to have more mood disorders like depression, but the findings were not meaningfully different between the two groups.

This study is the first investigation of anxiety and mood disorders in childhood and adulthood using clinical diagnoses in a large whole-population study of very preterm and very-low-birth-weight individuals as compared to individuals born at term.

The team also found that having a romantic partner who is supportive is an important factor for good mental health because it helps protect one from developing anxiety or depression. However, the study found fewer very-preterm-born adults had a romantic partner and were more withdrawn socially.

Quality of life in anxious adolescents

The aim of this study was to examine associations between health-related quality of life (HRQoL) and anxiety symptoms across anxiety domains in a general adolescent population | Child and Adolescent Psychiatry and Mental Health

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Purpose: To examine associations between health-related quality of life (HRQoL) and anxiety symptoms across anxiety domains (obsessions/compulsions, social anxiety, panic disorder, agoraphobia, separation anxiety, physical injury fears, generalised anxiety, and posttraumatic stress) in a general adolescent population. Expanded knowledge about these associations can provide valuable information for improving interventions and prevention strategies for adolescent anxiety.

Methods: Cross-sectional data about anxiety were collected via a school survey from a community sample of Norwegian adolescents aged 12–17 (N = 1719). Based on scores from the Spence Children’s Anxiety Scale (SCAS), each adolescent was categorized as reporting a low, medium, or high level of anxiety. Each adolescent’s HRQoL was then measured using the Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents Revised Version (KINDL-R). Hierarchical regression analyses were performed to determine any relationship between anxiety symptoms and HRQoL.

Results: Across domains of anxiety, anxiety symptoms were inversely associated with overall HRQoL. All HRQoL-dimensions were inversely associated with overall level of anxiety symptoms. In adolescents with medium and high anxiety symptoms, poor HRQoL was documented in all HRQoL dimensions with the exception of the family dimension.

Conclusions: The strong association between elevated levels of anxiety symptoms and poor HRQoL demonstrate the importance of improved mental health interventions and prevention initiatives targeting anxious adolescents.

Full reference: Pallesen, S. et al. (2017) Quality of life in anxious adolescents. Child and Adolescent Psychiatry and Mental Health. Vol. 11 (no. 33)

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester

There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services | BMJ Open

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Results: Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive and Sleepio  groups. Promising improvements in mental health scores were found within all three groups, as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties. Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online.

Conclusion: Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services.

Full reference: Elison, S. et al. (2017) Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self Help Services’. BMJ Open. 7:e016392

New programme will assess how digital therapies can help treat anxiety and depression

NICE is to start assessing new digital therapies that will help treat more people with anxiety and depression.

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Guided self-help, which can track people’s mood or advise on breathing exercises for example, is recommended by NICE guidance to help treat mild to moderate anxiety and depression.

As part of NHS England’s Improving Access to Psychological Therapies (IAPT) programme, NICE has been asked to assess digital applications or computer programmes, which will sit alongside face-to-face, phone and online therapy.

Developers of therapy applications are being invited to submit their product to NICE to see if it meets the criteria to be entered into the new programme. An eligible product will be assessed by NICE for its content, how effective it is at treating anxiety and depression, how cost effective it is and whether it complies with technical NHS standards. NICE will then produce an IAPT assessment briefing (IAB) on the product which will be looked at by an expert panel, made up of mental health clinicians, statisticians, an economist and a patient representative. They will look at NICE’s briefing and make a decision on whether the product can be recommended for real-life testing in selected IAPT services, where further evidence can be collected on its effectiveness.

Over the next two years, NICE’s expert panel will review data from this evaluation in practice and decide if the digital therapy should be adopted for use across the whole of NHS England’s IAPT service. Funding will also be made available from NHS England for digital therapies that are identified by the expert panel as promising, but need further development.

 

Cognitive behavioral and mindfulness-based group sleep improvement intervention for at-risk adolescents

Blake, M. et al. Sleep | Published online: 18 April 2017

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Objective: The aim of this study was to test whether a cognitive-behavioral and mindfulness-based sleep intervention could improve sleep and anxiety on school nights in a group of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and pre-sleep hyperarousal.

Conclusion: This study provides evidence that pre-sleep arousal but not sleep hygiene awareness is important for adolescents’ perceived sleep quality, and could be a target for new treatments of adolescent sleep problems.

Read the abstract here