Despite limitations, the findings from this study have important clinical and research implications for treating adolescent depression.
For clinicians, it may be beneficial at the beginning of a case of treatment for adolescent depression to develop a set of personalised outcome goals with the patient, with recognition that this is likely to vary greatly between individuals. Treatment could then be jointly chosen by the patient and clinician to ensure these priorities are addressed. This approach could also take into account what the patient thinks their key problem areas are, and what they consider to be valuable improvements. This would also provide a good framework when reviewing clinical decisions of whether to continue or change treatments.
In line with the categorical definition of mental disorders according to the DSM-5, almost all studies consider depression and personality disorders as two separate conditions, even though they frequently present in clinical practice as coincident rather than truly co-morbid conditions. A co-morbid personality disorder (mostly cluster B and C 1 ) is found in about half of patients with depression, and is consistently associated with unfavourable clinical indicators—such as duration of episode, symptom severity, recurrence of depression, and poor psychosocial functioning. Also, patients with personality disorder are at high risk for depression during their lifetime. Prevalence of depression can vary between personality disorders, but can be up to 90%. 2. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
In the most exhaustive investigation to date—an important contribution because of its broad scope and methodological rigour—Toshi A Furukawa and colleagues1 report findings that resonate well with earlier efforts: selective serotonin reuptake inhibitors (SSRIs) display dose-dependent beneficial effects up to the low-to-medium end of their licensed doses,2, 3, 4 and so do mirtazapine and venlafaxine. Offsetting this beneficial effect is the well-known increase in dropouts due to side-effects, which comes with higher doses.1, 2, 3 On balance, Furukawa and colleagues conclude that the lower range of licensed doses is likely to yield the best (achievable) balance between efficacy, tolerability, and acceptability.1 . Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
Young adults are particularly vulnerable to developing mental health problems including depression, and in developed countries an increasing proportion of 18 year olds now enter higher education. It is therefore timely to investigate the effects of psychological therapy for this group.
As the authors of this meta-analysis point out, college students might be particularly responsive to psychological interventions as their depression is more likely to be a first episode and they are a relatively intelligent group (and likely to have greater social advantages). On the other hand, they may be less responsive because in this age group depression may also indicate an early stage in a more severe mental health problem (e.g. bipolar disorder or psychosis), which is less likely to respond to a relatively brief and focused psychological intervention for depression.
The evidence for the effect of therapeutic alliance in group cognitive behaviour therapy (CBT) for anxiety disorders is unclear. Identifying whether the alliance–outcome relationship depends on (1) which components are assessed, (2) who is measuring the alliance and (3) when the alliance is measured will help to clarify the role of the client–therapist relationship in therapy. The present study explored the effects of alliance component (agreement vs. bond), rater perspective (client vs. therapist) and timing (early vs. late therapy) on the alliance–outcome relationship.. To read the full article, log in using your MPFT NHS OpenAthens details.
Understanding for whom treatments exert their greatest effects is crucial for prescriptive recommendations that can improve overall treatment efficacy. Anxiety and substance use disorder comorbidity is prevalent and a significant public health concern. Little is known about who should receive specialized, integrated treatments to address both problems.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Given that the Whooley questions feature prominently in NICE guidance, Bosanquet et al (2016) set out to determine their diagnostic accuracy in a systematic review, and also to examine the benefit of an additional question asking whether the person wanted help which is sometimes used with the two questions.
Our aims were to investigate discrepancies between depressed patients’ GlobalRating of Change (GRC) and scores on the Patient Health Questionnaire depression module (PHQ-9). Our objectives were to ascertain patients’ views on the source and meaning of mismatches and assess their clinical significance.
Open Access Article
Increased prevalence, severity, and burden of anxiety, trauma-related and stress-related disorders in women compared with men has been well documented. Evidence from a variety of fields has emerged suggesting that sex hormones, particularly oestradiol and progesterone, play a significant part in generation of these sex differences. In this Series paper, we aim to integrate the literature reporting on the effects of sex hormones on biological, behavioural, and cognitive pathways, to propose two broad mechanisms by which oestradiol and progesterone influence sex differences in anxiety disorders: augmentation of vulnerability factors associated with anxiety disorder development; and facilitation of the maintenance of anxious symptoms post-development. The implications for future research, along with novel approaches to psychological and pharmacological treatment of anxiety disorders, are also considered. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
CBT treatment for children and young people with anxiety appears to be equally effective with and without family/parental involvement. This suggests that it is appropriate to offer both approaches to patients under the age of 17. In deciding which approach to offer it would be helpful to consider the child’s age and developmental level, as well as the child’s preferences. It’s likely that treatment adherence and engagement can be improved if the child feels their voice is heard and that their views are considered during treatment.
Women are about twice as likely as are men to develop depression during their lifetime. This Series paper summarises evidence regarding the epidemiology on gender differences in prevalence, incidence, and course of depression, and factors possibly explaining the gender gap. Gender-related subtypes of depression are suggested to exist, of which the developmental subtype has the strongest potential to contribute to the gender gap. Limited evidence exists for risk factors to be specifically linked to depression. Future research could profit from a transdiagnostic perspective, permitting the differentiation of specific susceptibilities from those predicting general psychopathologies within and across the internalising and externalising spectra. An integration of the Research Domain Criteria framework will allow examination of gender differences in core psychological functions, within the context of developmental transitions and environmental settings. Monitoring of changing socioeconomic and cultural trends in factors contributing to the gender gap will be important, as well as the influence of these trends on changes in symptom expression across psychopathologies in men and women. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
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To take part, just visit http://goo.gl/AdN4ok by Friday 19th February.
Anxiety disorders, which often manifest as excessive worry, fear and a tendency to avoid potentially stressful situations, are some of the most common mental health problems in the Western world. To read the full article, log in using your NHS OpenAthens details
The researchers found that, compared to non-users, those who took the pill were 23% more likely to use antidepressants.
However, it's important to note this study is not able to prove that the contraceptive methods are responsible for the depression, only to find possible links to investigate further.
The researchers don't advise that women should stop using their contraception, just that further studies are needed. If this association is found to be true, depression may have to be added as a possible side effect of hormonal contraception.
Military Psychology29.5 (Sep 2017): 396-406.
Few studies have attempted to examine how changes in work stressors from predeployment to postdeployment and reintegration may be associated with changes in mental health symptoms and hazardous drinking. The present study examined associations between work stressors, depressive symptoms, and hazardous drinking, and whether depressive symptoms mediated the association between work stressors and hazardous alcohol use or vice versa across deployment (predeployment, postdeployment, and 6-month reintegration). To read the full article, log in using your NHS OpenAthens details.
Working memory (WM) deficits are recognized as serious cognitive impairment in patients with major depressive disorder (MDD). This review aims to clarify the effects of impaired WM function in patients with MDD and explore non-invasive and effective treatments that can be adopted in clinical practice. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.