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 However, the study found fewer very-preterm-born adults had a romantic partner and were more withdrawn socially.

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.

 

School-Based Mindfulness Program and Depression in Adolescents

This study examined moderators of the effects of a universal school-based mindfulness program on adolescents’ depressive symptoms.

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Based on theory and previous research, we identified the following potential moderators:

  1. severity of symptoms of depression at baseline
  2. gender
  3. age
  4. school track.

The study uses a pooled dataset from two consecutive randomized controlled trials in adolescents (13–18 years) in secondary schools in Belgium.

We found no moderation effects of gender, age, and school track. Six months after the training, we found a marginally significant moderation effect for severity of symptoms of depression at baseline with greater decrease in symptoms for students with high levels of depression. The general absence of differential intervention effects for gender, age, and school track supports the broad scope of the school-based mindfulness group intervention.

Full reference: der Gucht, K.V. et al. (2017) Potential Moderators of the Effects of a School-Based Mindfulness Program on Symptoms of Depression in Adolescents. Mindfulness. 8(797)

Bullying’s lasting impact

A new study found that kids who are bullied in fifth grade are more likely to suffer from depression in seventh grade; and have a greater likelihood of using alcohol, marijuana or tobacco in tenth grade | ScienceDaily

legs-407196_960_720Although peer victimization is common during late childhood and early adolescence and appears to be associated with increased substance use, few studies have examined these associations longitudinally — meaning that data is gathered from the same subjects repeatedly over several years — or point to the psychological processes whereby peer victimization leads to substance use.

“We show that peer victimization in fifth grade has lasting effects on substance use five years later. We also show that depressive symptoms help to explain why peer victimization is associated with substance use, suggesting that youth may be self-medicating by using substances to relieve these negative emotions,” Earnshaw said.

Read the full overview via ScienceDaily here

The original research abstract is available here

Gender Differences in Depression

Salk, R. et al. Psychological Bulletin | Published online: 27 April 2017

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In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to

(a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages;

(b) use a developmental perspective to elucidate patterns of gender differences across the life span; and

(c) incorporate additional theory-driven moderators (e.g., gender equity).

The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13–15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked

Read the abstract here

Pharmacotherapy and adolescent depression – an important treatment option

Dubicka, B & Brent, D. Child and Adolescent Mental Health. 22(2) pp. 59-60

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Over the past decade, rates of depression and of suicide in adolescents have been increasing (Collishaw, Journal of Child Psychology and Psychiatry, 56, 2015, 370; Bor et al., The Australian and New Zealand Journal of Psychiatry, 48, 2014, 606). At the same time, there is some evidence that rates of diagnosis and, in the US at least, referral for depression in adolescents has been declining (Libby et al., Archives of General Psychiatry, 66, 2009, 633; John et al., Psychological Medicine, 46, 2016, 3315). These worrying statistics highlight the importance of disseminating accurate information about the risks and benefits of treatments for adolescent depression, in order to combat therapeutic nihilism.

Extant controversy about the best ways to treat adolescent depression, and in particular with regards to the use of antidepressants, may have contributed to these trends. More specifically, we believe that some recent, high profile publications have incorrectly interpreted the benefit to risk ratio for the use of antidepressants in adolescent depression as unfavourable (e.g. Cipriani et al., The Lancet, 388, 2016, 881). In this editorial, we review clinical trial and pharmaco-epidemiological data that supports the retention of the use of antidepressants in the management of depressed adolescents.

Read the editorial here