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1.
Am J Geriatr Psychiatry ; 30(12): 1327-1329, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2149967
2.
J Med Internet Res ; 24(11): e40719, 2022 Nov 21.
Article in English | MEDLINE | ID: covidwho-2141432

ABSTRACT

BACKGROUND: Depression has a high prevalence among young adults, especially during the COVID-19 pandemic. However, mental health services remain scarce and underutilized worldwide. Mental health chatbots are a novel digital technology to provide fully automated interventions for depressive symptoms. OBJECTIVE: The purpose of this study was to test the clinical effectiveness and nonclinical performance of a cognitive behavioral therapy (CBT)-based mental health chatbot (XiaoE) for young adults with depressive symptoms during the COVID-19 pandemic. METHODS: In a single-blind, 3-arm randomized controlled trial, participants manifesting depressive symptoms recruited from a Chinese university were randomly assigned to a mental health chatbot (XiaoE; n=49), an e-book (n=49), or a general chatbot (Xiaoai; n=50) group in a ratio of 1:1:1. Participants received a 1-week intervention. The primary outcome was the reduction of depressive symptoms according to the 9-item Patient Health Questionnaire (PHQ-9) at 1 week later (T1) and 1 month later (T2). Both intention-to-treat and per-protocol analyses were conducted under analysis of covariance models adjusting for baseline data. Controlled multiple imputation and δ-based sensitivity analysis were performed for missing data. The secondary outcomes were the level of working alliance measured using the Working Alliance Questionnaire (WAQ), usability measured using the Usability Metric for User Experience-LITE (UMUX-LITE), and acceptability measured using the Acceptability Scale (AS). RESULTS: Participants were on average 18.78 years old, and 37.2% (55/148) were female. The mean baseline PHQ-9 score was 10.02 (SD 3.18; range 2-19). Intention-to-treat analysis revealed lower PHQ-9 scores among participants in the XiaoE group compared with participants in the e-book group and Xiaoai group at both T1 (F2,136=17.011; P<.001; d=0.51) and T2 (F2,136=5.477; P=.005; d=0.31). Better working alliance (WAQ; F2,145=3.407; P=.04) and acceptability (AS; F2,145=4.322; P=.02) were discovered with XiaoE, while no significant difference among arms was found for usability (UMUX-LITE; F2,145=0.968; P=.38). CONCLUSIONS: A CBT-based chatbot is a feasible and engaging digital therapeutic approach that allows easy accessibility and self-guided mental health assistance for young adults with depressive symptoms. A systematic evaluation of nonclinical metrics for a mental health chatbot has been established in this study. In the future, focus on both clinical outcomes and nonclinical metrics is necessary to explore the mechanism by which mental health chatbots work on patients. Further evidence is required to confirm the long-term effectiveness of the mental health chatbot via trails replicated with a longer dose, as well as exploration of its stronger efficacy in comparison with other active controls. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100052532; http://www.chictr.org.cn/showproj.aspx?proj=135744.


Subject(s)
COVID-19 , Mental Health , Humans , Young Adult , Female , Adolescent , Male , Depression/therapy , Single-Blind Method , Pandemics
3.
Psychiatr Danub ; 32(3-4): 527-535, 2020.
Article in English | MEDLINE | ID: covidwho-2100775

ABSTRACT

BACKGROUND: Adolescents' anxiety and depression during the coronavirus disease 2019 (COVID-19) pandemic outbreak cannot be ignored. In public health crisis events, adolescents are prone to negative psychological problems, such as anxiety and depression. Hence, this research focuses on the use of reasonable and efficient methods to intervene in adolescents' psychological problems during the COVID-19 pandemic. SUBJECTS AND METHODS: From February to April 2020, we conducted an anonymous online survey on a total of 1,200 adolescents in the provinces of Hunan and Guangxi in China. Moreover, we randomly divided a total of 150 middle school students with anxiety scores greater than 50 and volunteered to participate in the intervention experiment into control and intervention groups, with 75 members in each group. On the basis of the proposed routine treatment, we conducted 8 weeks of model 328-based peer education intervention in the intervention group. RESULTS: After the intervention, the self-rating anxiety scale scores (SAS) of the intervention group are better than those of the control group (P<0.001). Moreover, the self-rating depression scale (SDS) scores of both groups are reduced, but the effect is more significant on the intervention group (P<0.001) than on the control group. Finally, the total Pittsburgh sleep quality index (PSQI) scores of both groups are reduced, but the effect is more significant on the intervention group than on the control group (P=0.001 and <0.001, respectively). CONCLUSIONS: Model 328-based peer education intervention can significantly reduce the level of anxiety and depression in adolescents and improve their sleep quality.


Subject(s)
Anxiety , COVID-19 , Depression , Sleep Wake Disorders , Adolescent , Anxiety/epidemiology , Anxiety/therapy , China , Depression/epidemiology , Depression/therapy , Humans , Pandemics , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/therapy
4.
Trials ; 23(1): 899, 2022 Oct 22.
Article in English | MEDLINE | ID: covidwho-2089229

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had major impacts in many different spheres, including mental health. Children and adolescents are especially vulnerable because their central nervous system is still in development and they have fewer coping resources than do adults. Increases in the prevalence of depressive and anxiety symptomatology have been reported worldwide. However, access to mental health care is limited, especially for the paediatric population and in low- and middle-income countries. Therefore, we developed a brief internet-delivered cognitive-behavioural intervention for children and adolescents with symptoms of anxiety and depression. The aim of this proposed study is to test the efficacy of the intervention. METHODS: We will conduct a two-arm, parallel randomised controlled trial involving children and adolescents (8-11 and 12-17 years of age, respectively) with symptoms of anxiety, depression or both, according to the 25-item Revised Child Anxiety and Depression Scale (t-score > 70). A total of 280 participants will be randomised to the intervention group or the active control group, in a 1:1 ratio. Those in the intervention group will receive five weekly sessions of cognitive-behavioural therapy via teleconference. The sessions will focus on stress responses, family communication, diaphragmatic breathing, emotions, anger management, behavioural activation and cognitive restructuring. Participants in both groups will have access to 15 videos covering the same topics. Participant-guardian pairs will be expected to attend the sessions (intervention group), watch the videos (control group) or both (intervention group only). A blinded assessor will collect data on symptoms of anxiety, depression and irritability, at baseline, at the end of the intervention and 30 days thereafter. Adolescents with access to a smartphone will also be invited to participate in an ecological momentary assessment of emotional problems in the week before and the week after the intervention, as well as in passive data collection from existing smartphone sensors throughout the study. DISCUSSION: Internet-delivered interventions play a major role in increasing access to mental health care. A brief, manualised, internet-delivered intervention might help children and adolescents with anxiety or depressive symptomatology, even outside the context of the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT05139433. Registered prospectively in November 2021. Minor amendments made in July 2022.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Internet-Based Intervention , Adolescent , Child , Humans , Anxiety/diagnosis , Anxiety/therapy , Cognition , Cognitive Behavioral Therapy/methods , Depression/diagnosis , Depression/therapy , Pandemics , Randomized Controlled Trials as Topic , Treatment Outcome
5.
Psychiatr Danub ; 34(3): 564-571, 2022.
Article in English | MEDLINE | ID: covidwho-2081404

ABSTRACT

BACKGROUND: The COVID-19 pandemic has put enormous stress on the health care workers, threatening not only their physical health but also their mental well-being. No mental health support program (MHSP) addressing depression and anxiety in healthcare workers (HCWs), has been shown to be effective in Turkey previously. We aimed to measure the effect of our MHSP among healthcare workers who applied for psychological help associated with the COVID-19 pandemic. SUBJECTS AND METHODS: An MHSP has been created for healthcare professionals working in a pandemic hospital during the COVID-19 period. Health workers were recruited between July and September 2020. Anxiety, depression, and insomnia levels were evaluated with HAM-A (Hamilton Anxiety Scale), HDRS (Hamilton Depression Scale), and Insomnia Severity Index (ISI) before and after the intervention. Sexual complaints were questioned by a consultant psychiatrist. MHSP (n=31), and treatment as usual (TAU, n=27) groups were compared using repeated-measures ANOVA. RESULTS: Sociodemographic data, medical history of COVID-19, and psychiatric diagnoses were similar between the groups. There was no difference in baseline HAM-A, HDRS, and ISI scores (p>0.05). At the end of the study, there was a significant difference between study groups regarding anxiety scores (For post-treatment, MHSP=8.0±2.6 vs. TAU=17.9±3.1, p<0.001) and depression symptoms (For post-treatment, MHSP=8.8±2.7 vs. TAU=20.0±2.4, p<0.001) but not in insomnia levels (For post-treatment, MHSP=6.5±2.4 vs. TAU=7.3±2.4, p=0.499). Likewise, both groups reported similar levels of improvement in reduced sexual drive. CONCLUSIONS: Our study results suggest that the MHSP effectively alleviates the psychiatric complaints of healthcare professionals. It is recommended to have mental support teams for healthcare professionals in hospitals.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Humans , Pandemics , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/therapy , Depression/epidemiology , Depression/therapy , Depression/psychology , Turkey/epidemiology , SARS-CoV-2 , Anxiety/epidemiology , Anxiety/therapy , Anxiety/psychology , Health Personnel/psychology , Hospitals , Delivery of Health Care
6.
Int J Environ Res Public Health ; 19(19)2022 Oct 01.
Article in English | MEDLINE | ID: covidwho-2066005

ABSTRACT

Worldwide, three out of four of the general population have reported experiencing violence. Governments should address solutions to violence and its effects on mental health. The study aimed to determine depressive, anxious, and posttraumatic stress symptoms related to the violence experienced during the COVID-19 pandemic in the general population. The study was conducted with 18,449 Mexicans of 33 years (SD = 11.00, range = 18-59), with 12,188 (66.10%) being women, 3559 (19.29%) having COVID-19, 2706 (14.67%) seeking psychological care, and 5712 (30.96%) experiencing violence. Subjects completed the Major Depressive Episode (MDE) Checklist, Generalized Anxiety (GA) Scale, and the Posttraumatic Stress (PTS) Checklists (PCL-5) programmed in a WebApp application. We assessed the dimensionality of the scales through the Confirmatory Factor Analysis (CFA), the measurement invariance, and a structural equation model (SEM). In the total sample, 28.10% fulfilled the MDE criteria, and 42.30% had high levels of GA. In the sample of those experiencing violence, 48.40% met the MDE criteria, 61.70% had high GA symptoms, and 50% met the criteria for a PTS disorder. Experiencing violence was associated with GA and severe PTS symptoms when the discomfort had bothered them for over a month since the onset of these symptoms. Subjects who had experienced violence and had mental health symptoms seemed ready for treatment. Further studies will evaluate the effect of remote psychological care to help reduce the treatment gap.


Subject(s)
COVID-19 , Depressive Disorder, Major , Stress Disorders, Post-Traumatic , Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Depression/therapy , Depressive Disorder, Major/epidemiology , Female , Humans , Male , Pandemics , Stress Disorders, Post-Traumatic/psychology , Violence/psychology
7.
BMJ Open ; 12(9): e062683, 2022 09 15.
Article in English | MEDLINE | ID: covidwho-2064158

ABSTRACT

INTRODUCTION: Depression is a common mental disorder and the (global) leading cause of all non-fatal burden of disease worldwide. Currently, supported treatment for depression is antidepressant medication and different psychotherapeutic interventions. Many patients experience, however, adverse effects of antidepressant medication, while at the same time the access to psychotherapeutic interventions are limited. Many patients who suffer from depression turn to complementary medicine and among those modalities often spiritual healing. There is some evidence that consulting a spiritual healer can be beneficial for patients who suffer from depression, and that spiritual healing is associated with low risk. The aim of this protocol is to conduct a pilot randomised controlled trial (RCT) (spiritual healing as addition to usual care vs usual care alone) in preparation of a larger trial in adults with moderate depression, to examine feasibility and individuals' experience of spiritual healing. METHODS AND ANALYSIS: This study is a pilot RCT with two parallel groups. A total of 28 adult patients with moderate depression, diagnosed by the physician and according to the Montgomery and Åsberg Depression Rating Scale criteria will be randomised to spiritual healing in addition to usual care (n=14) or usual care alone (n=14). To determine if there is a statistical indication of an effect of healing warranting a full-scale study; the separation test will be used. To investigate participants' experience with spiritual healing, a qualitative study will be included using semistructured interviews. The data will be analysed based on a direct content analysis. ETHICS AND DISSEMINATION: This protocol was approved by regional committees for medical and health research ethics by the identifier (63692). The results will be disseminated through open-access, peer-reviewed publications, in addition to stakeholders' reporting and presenting at conferences. TRIAL REGISTRATION: Norwegian Centre for Research Data (845302) and clinicaltrials.gov (ID: NCT04766242).


Subject(s)
Depressive Disorder , Spiritual Therapies , Adult , Antidepressive Agents/therapeutic use , Depression/complications , Depression/therapy , Depressive Disorder/drug therapy , Humans , Pilot Projects , Randomized Controlled Trials as Topic
8.
J Med Internet Res ; 24(9): e37753, 2022 09 06.
Article in English | MEDLINE | ID: covidwho-2054768

ABSTRACT

BACKGROUND: Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. OBJECTIVE: This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. METHODS: A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. RESULTS: A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD -0.54, 95% CI -0.79 to -0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD -0.61, 95% CI -0.95 to -0.26; P<.001) than in hospital settings (SMD -0.46, 95% CI -0.85 to -0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD -0.60, 95% CI -0.95 to -0.25; P<.001) and games for both (SMD -0.73, 95% CI -1.29 to -0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. CONCLUSIONS: Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. TRIAL REGISTRATION: PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5.


Subject(s)
Depression , Exercise , Aged , Cognition , Depression/therapy , Humans , Randomized Controlled Trials as Topic
9.
Eur J Public Health ; 32(5): 794-798, 2022 10 03.
Article in English | MEDLINE | ID: covidwho-2051382

ABSTRACT

BACKGROUND: The study explored the relationship between physical activity (PA) behaviour and severity of symptoms in people infected by coronavirus disease 2019 (COVID-19). METHODS: Five hundred and thirty-three people [16% males, mean age: 45 ± 11 years, body mass index (BMI): 23.3 ± 20] took part in the study. All participants were post-COVID-19 infection. An online questionnaire was used to gather data on; participants demographics, comorbidities and treatment, symptomatology of COVID-19, quality of life (QoL) and pre- and post-COVID-19 infection PA. RESULTS: Logistic regression revealed that only a high BMI (>25) increased the severity of (odds ratio 1.01; 95% confidence interval, 0.99-1.03) symptoms from none to mild-to-moderate. Weekly PA behaviour (min/week) did not affect the primary outcome (symptom severity) as a predictor variable and neither differ (P > 0.05) between symptomatology for both moderate (no symptoms: 181.3 ± 202.1 vs. mild-to-moderate symptoms: 173 ± 210.3) and vigorous (no symptoms: 89.2 ± 147 vs. mild-to-moderate symptoms: 88.9 ± 148.3) PA. QoL (i.e. mobility, self-care, usual activities, pain/discomfort, anxiety/depression and perceived health) was significantly (P < 0.05) worse post-COVID-19 infection. CONCLUSIONS: Our findings did not present an association between PA levels and mild-to-moderate COVID-19 symptoms. However, all participants exceeded the lower limit of the World Health Organization recommended, adult PA dose. This might explain the lack of PA effect, on mild-to-moderate symptoms post-COVID-19 infection. Future studies should explore the effects of PA levels in more severe cases (e.g. hospitalizations) and assess the effectiveness of PA to reduce hospitalizations, and mortality rates as a result of COVID-19 infection.


Subject(s)
COVID-19 , Adult , Depression/therapy , Exercise , Female , Humans , Male , Middle Aged , Quality of Life , Surveys and Questionnaires
10.
Psychiatr Danub ; 34(Suppl 8): 191-192, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2045236

ABSTRACT

The COVID-19 pandemic has created several problems with uncertainties and fears that have intensified over time, with a subsequent explosion. The requests were diversified, but all focused on the "sense of containment" resulting from the increase in fear and uncertainty. The work carried out has had a change in structure and depth, as the majority of professionals in the psychological sector have had to change their assessment of perspective and approach in the work. It was no longer possible to have face-to-face sessions. This "upheaval" was perceived in a very tiring way with subsequent even serious side effects, initially associated with a change in the therapeutic alliance, with great effort in recovery and "mending". Many have amplified their psychosomatic problems with damage that can be recovered over time.


Subject(s)
COVID-19 , Pandemics , Depression/therapy , Emotions , Fear , Humans
11.
Arch Psychiatr Nurs ; 41: 271-276, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2041575

ABSTRACT

BACKGROUND: Nursing students experienced mental symptoms when they switched to distance education due to the pandemic. AIMS: This study was conducted to evaluate the effects of online laughter therapy sessions on depression, anxiety, stress, and loneliness levels in first-year nursing students. METHODS: In this randomized controlled trial, 61 healthy nursing students were randomly assigned to intervention (n = 32) and control groups (n = 29). The intervention group received online laughter therapy twice weekly for four weeks. The control group received no intervention. The data were collected using a demographic questionnaire, the Depression Anxiety Stress Scale, and the De Jong Gierveld Loneliness Scale at the study initiation and week four in both groups. RESULTS: There was no difference between the mean scores of the groups in the pre-test (p > 0.05). There was a statistically significant difference between groups in terms of depression after online laughter therapy sessions (p < 0.05), but there was no significant difference between anxiety, stress, and loneliness levels (p > 0.05). CONCLUSIONS: Online laughter therapy sessions significantly reduced depression but had no effect on anxiety, stress, and loneliness. During the COVID-19 pandemic, online laughter therapy can be organized to reduce depression levels.


Subject(s)
COVID-19 , Laughter Therapy , Students, Nursing , Humans , Loneliness , Pandemics , Depression/therapy , Anxiety/therapy
12.
J Affect Disord ; 319: 437-445, 2022 Dec 15.
Article in English | MEDLINE | ID: covidwho-2041887

ABSTRACT

BACKGROUND: In the global pandemic of the coronavirus disease 2019 (COVID-19), depression and post-traumatic stress disorder (PTSD) have commonly occurred among COVID-19 patients, whose experiences of infection and subsequent treatment might develop negative consequences on their mental well-being even after recovery. Despite the general recognition of efficacy of mindfulness-based interventions in reducing psychological distress among various populations, there were insufficient studies on the relationship between mindfulness and mental health among individuals who have recovered from COVID-19. OBJECTIVE: The current study aims to identify the prevalence of common mental health challenges among recovered COVID-19 patients in Jianghan District, Wuhan, China and to explore the potential mechanism through which mindfulness alleviate depression and PTSD. METHODS: A cross-sectional survey on mental health was conducted among a convenience sample of adults recovered from COVID-19 in Jianghan District, Wuhan, China. The study participants completed questionnaires under the assistance of trained investigators. The questionnaire included Chinese version of Five Facets of Mindfulness Questionnaire-Short Form (FFMQ-SF), Generalized Anxiety Disorder Questionnaire (GAD-7), Resilience Style Questionnaire (RSQ), Impact of Events Scale-Revised (IES-R), and Patient Health Questionnaire (PHQ-9) to measure mindfulness, anxiety, resilience, PTSD, and depression respectively. Structural equation modeling was used to explore the relationship between mindfulness and mental health outcomes of this population. RESULTS: 1541 respondents (654 [42.4 %] men and 887 [57.6 %] women) completed the questionnaire between June 10 and July 25, 2021, of whom 36.2 % and 27.1 % had mild and severe levels of depressive and anxiety symptoms respectively, and 15.2 % was indicated with PTSD. The average score of mindfulness of the study participants was (3.100 ± 0.387), and that of resilience was (3.560 ± 0.877). The structural equation model fit the data well, demonstrating that mindfulness was negatively associated with depressive symptoms directly (ß = -0.031, P = 0.021) or indirectly through the mediation effect of resilience (ß = -0.019, P = 0.009) and anxiety symptoms (ß = -0.208, P < 0.001), and was negatively associated with PTSD through the mediation effect of anxiety symptoms (ß = -0.142, P < 0.001). CONCLUSION: Individuals who have recovered from COVID-19 commonly experienced psychological distress. Mindfulness is associated with alleviation of depressive and PTSD symptoms directly or indirectly. Interventions based on mindfulness are suggested to improve the mental well-being of this population.


Subject(s)
COVID-19 , Mindfulness , Adult , Male , Humans , Female , COVID-19/epidemiology , Cross-Sectional Studies , SARS-CoV-2 , Depression/epidemiology , Depression/therapy , Depression/psychology , Anxiety/epidemiology , Anxiety/therapy , Anxiety/psychology , China/epidemiology
13.
Trials ; 23(1): 797, 2022 Sep 21.
Article in English | MEDLINE | ID: covidwho-2038855

ABSTRACT

BACKGROUND: Depression and anxiety are common among pregnant women. Internet-delivered psychological therapies such as cognitive behavioral therapy (iCBT) have been developed to increase accessibility and address common help-seeking barriers, especially during pandemic period. The objective of this trial is to evaluate the short-term and long-term effects of iCBT on reducing depressive symptoms among pregnant women during the COVID-19 pandemic with the overall goal of preventing depression recurrence in the first 12 months postpartum. METHODS: A multi-site randomized controlled trial will be conducted where 300 pregnant women early in their third trimester will be screened for depression symptoms using the Edinburgh Postnatal Depression Scale (EPDS) during a routine obstetrical visit. Eligible and consenting women with a score greater than 9 will be randomly allocated (1:1) to either intervention group or control group. ICBT involving the completion of 7 weekly online modules will be delivered via a well-designed perinatal mental healthcare app. The primary objective is to evaluate the effect of iCBT on reducing depression symptoms among pregnant Chinese women starting from their third trimester. The secondary objectives are to examine the effect of iCBT on anxiety, sleep quality, social support, parenting stress, co-parenting relationship, and infant development. DISCUSSION: This multi-center randomized controlled trial has been planned in accordance with best practices in behavioral trial design. The internet-based intervention addressed the needs of pregnant women during a major pandemic where face-to-face therapy is not preferable. The trial has a relatively large sample size with sufficient power to evaluate the efficacy of iCBT intervention for the primary and secondary outcomes. One year follow-up evaluation in the study is designed to determine the longer-term effect of the intervention on both maternal and infant outcomes. Although a limitation is the assessment of depression and anxiety using self-report measures, these easily incorporated and maternal-preferred assessments allow for real-life scalability if the intervention is proven to be effective. ETHICS AND DISSEMINATION: Ethics was approved by the institutional review board of International Peace Maternity and Child Health Hospital (GKLW2020-25). Dissemination of results will be published in peer-reviewed academic journals and presented at scientific conferences. TRIAL STATUS: The first patient was enrolled on 19 August 2020. To date, 203 participants have met eligibility requirements and been randomized to either the intervention group or control group. Data collection aims to be complete in September 2022. Date and version identifier: 2020715-version1.0. TRIAL REGISTRATION: ChiCTR2000033433. Registered 31 May 2020, http://www.chictr.org.cn/showproj.aspx?proj=54482 .


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Child , Cognitive Behavioral Therapy/methods , Depression/diagnosis , Depression/therapy , Female , Humans , Internet , Multicenter Studies as Topic , Pandemics , Pregnancy , Randomized Controlled Trials as Topic , Treatment Outcome
14.
Am J Geriatr Psychiatry ; 30(10): 1083-1092, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2031412

ABSTRACT

OBJECTIVE: To evaluate the effect of case management with problem solving therapy (CM-PST) on depression and disability among rural older adults and compare its effect with outcomes derived from a previous, but similar study among 84 urban older adults. METHODS: This study examined the comparative effectiveness of a CM-PST intervention for older adults with depression and unmet needs across rural and urban settings. Participants received 12 one-hour sessions of CM-PST with a master's-level clinician. A total of 56 rural and 84 urban adults aged 60 and older experiencing mild to moderate depression received services in their homes. RESULTS: The rural CM-PST intervention resulted in significantly reduced depression (reduction of 13.9 points, 95% CI 12.2 to 15.7, t(422)= 15.35, p<0.0001) and disability by week 12 (reduction of 6.7 points, 95% CI 4.8 to 8.5, t(425)= 7.01, p<0.0001). Reductions in depression and disability were sustained through week 24. The reductions in depression (F=3.98 df=4,388. p=0.0035) and disability (F=2.71, df=4,381, p=0.03) found in the rural sample were comparable to, or better than, those found in the urban sample. Improvements in unmet need and resilience predicted lower depression scores at 12 weeks, while improvements in unmet need and hopelessness predicted improvements in disability. No moderators of depression were identified, but baseline values of self-efficacy, resilience, and hopelessness moderated disability. CONCLUSIONS: CM-PST was as effective at reducing depression and disability among rural older adults as it was for urban older adults. Home-delivered CM-PST can be successfully adapted to meet the specific needs of rural seniors using resources often available in rural communities.


Subject(s)
Case Management , Depression , Aged , Depression/therapy , Humans , Middle Aged , Problem Solving , Rural Population , Treatment Outcome
15.
Holist Nurs Pract ; 36(5): E48-E56, 2022.
Article in English | MEDLINE | ID: covidwho-1992377

ABSTRACT

Evidence has been found of how the coronavirus disease-2019 (COVID-19) pandemic has increased stress and anxiety indicators. Against this background, the present research aims to determine the effect of a distance Reiki intervention program on stress and anxiety during the period of isolation due to COVID-19 among people working in the city of Lima, Peru. The related hypothesis was that distance Reiki would generate a reduction in stress and anxiety levels. It was a quasiexperimental design with pre- and posttests, with nonprobabilistic purposive sampling. In total, 28 employees participated (12 in the experimental group and 16 in the control group). As part of the method, the following instruments were used: the EPGE, IDARE, and Coronavirus Anxiety Scale (CAS). There was a large decrease in the distress parameter (Cohen's d = 1.006), as well as in the state anxiety parameter (d = 1.678) and a large increase in eustress (d = 0.921). Similarly, there was an overall reduction in the trait anxiety parameter (d = 0.373) in all cases as compared with the control group. Coronavirus anxiety showed no major impact. These results provide initial evidence on the effects of distance Reiki among Peruvians and provide the basis for promoting this cost-effective therapy, generating a practical and social contribution.


Subject(s)
COVID-19 , Therapeutic Touch , Anxiety/epidemiology , Anxiety/therapy , COVID-19/epidemiology , COVID-19/prevention & control , Depression/therapy , Humans , Pandemics , Peru/epidemiology , Therapeutic Touch/methods
16.
S Afr Fam Pract (2004) ; 64(1): e1-e9, 2022 07 28.
Article in English | MEDLINE | ID: covidwho-1988187

ABSTRACT

BACKGROUND: Depression is a major contributor to the overall global burden of disease, impacting social life, family life and occupational functioning if left untreated. Despite its high prevalence and morbidity, the evidence suggests that men are hesitant to seek help, with a large percentage remaining undiagnosed. This study aimed to determine the attitudes and perceptions related to depression and its treatment amongst black men in a rural district of South Africa. METHODS: The design used was an exploratory descriptive qualitative design. Participants were selected by purposive sampling. Individual semistructured interviews were conducted, which were audio-recorded and transcribed verbatim. The data were subsequently analysed thematically to develop themes and subthemes. RESULTS: Participants described depression as a psychological problem associated with lack of sleep, loneliness, feeling unwanted, increased stress, deep sadness, weight loss, forgetfulness, crying over small things and lack of concentration. Collectively, the interviews with participants showed a good understanding of the psychosocial determinants of depression but exposed a lack of awareness of its biological determinants. A large proportion (n = 13; 68.4%) of participants reported not having knowledge of available services in their area for people seeking treatment for depression. Barriers to help-seeking behaviours were fear of social stigma, fear of expressing their feelings, gender norms and stereotypes and lack of trust in others. CONCLUSION: Interventions such as support groups and mental health awareness programmes to counteract personal perceptions may help to improve and expand the effectiveness of depression treatment. The results highlight the future need to raise awareness of depressive symptoms and expand health outreach programmes.


Subject(s)
Depression , Rural Population , Attitude , Depression/epidemiology , Depression/psychology , Depression/therapy , Humans , Male , Social Stigma , South Africa/epidemiology
17.
J Affect Disord ; 316: 120-131, 2022 11 01.
Article in English | MEDLINE | ID: covidwho-1983301

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, interventions for public mental health were mostly delivered through online modalities. Although many studies have explored the effectiveness of online psychosocial interventions through randomized controlled trials, there is a lack of quantitative synthesis of the effectiveness of online psychosocial interventions and an examination of their overall application. OBJECTIVE: To understand the commonly used psychosocial interventions during the COVID-19 pandemic and the effectiveness of the interventions. METHODS: Risk bias was assessed in the included studies according to the Cochrane Collaboration criteria, and data from post-test and follow-up were combined for standardized mean differences using Stata 16.0 software, and sources of heterogeneity were explored by subgroup analysis, and risk bias was assessed in the included studies using Review Manager 5.4 software. The study was written in strict accordance with PRISMA specifications, and registration was completed on the PROSPERO platform (CRD42022302917). RESULTS: The online psychosocial intervention had an ameliorating effect on anxiety (SMD = -0.78), depression (SMD = -0.80), and insomnia (SMD = -0.19) in the public during the COVID-19 pandemic, was ineffective for the intervention on stress, and the effectiveness of the intervention on depression continued at follow-up. Subgroup analyses showed that the type of intervention, intervention form, Duration of intervention, and setting of the control group influenced the trial results to some extent, with cognitive behavioral therapy being the most effective intervention for anxiety and depressive symptoms, self-help interventions being more effective than interventions with therapist interventions, and 1-4 week interventions being more effective than 5-8 week interventions. Due to the limited number of studies included in the analysis and variability in quality, more randomized controlled trials are needed to test the findings. CONCLUSION: Online psychosocial interventions can be effective in improving symptoms of anxiety, depression, stress, and insomnia in the public during the COVID-19 pandemic. However, additional randomized controlled trial studies are needed to determine which types of interventions are more appropriate for which populations and how they can be implemented to achieve better intervention outcomes.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Depression/epidemiology , Depression/therapy , Humans , Mental Health , Pandemics , Psychosocial Intervention , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/therapy
18.
J Osteopath Med ; 122(11): 571-580, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-1974379

ABSTRACT

CONTEXT: Health-related quality of life (HRQOL) represents a new approach for guiding chronic pain management because it is patient-centered and more likely to be understood and accepted by patients. OBJECTIVES: To assess the value and utility of an eHealth intervention for patients with chronic low back pain (CLBP) that was primarily based on HRQOL measures and to measure the clinical outcomes associated with its use. METHODS: A randomized controlled trial was conducted within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION Pain Research Registry) using participants screened from November 2019 through February 2021. A total of 331 registry participants within the 48 contiguous states and the District of Columbia met the eligibility criteria, which included having CLBP and HRQOL deficits. Almost three-fourths of the participants were enrolled after onset of the COVID-19 pandemic. The participants were randomized to an eHealth intervention for HRQOL or wait list control. The primary outcome measures involved HRQOL based on the Patient-Reported Outcomes Measurement Information System (PROMIS), including the SPADE cluster (Sleep disturbance, Pain interference with activities, Anxiety, Depression, and low Energy/fatigue) and each of its five component scales. Secondary outcome measures involved low back pain intensity and back-related functioning. Changes over time for each outcome measure reported by participants in each treatment group were compared utilizing the student's t-test for statistical significance and Cohen's d statistic for clinical importance. Outcomes were reported as between-group differences in change scores and the d statistic, with positive values favoring the experimental treatment group. RESULTS: There were no significant differences between the experimental and control treatment groups for changes over time in any primary outcome measure. The d statistic (95% confidence interval) for the difference between the experimental and control treatment groups on the SPADE cluster was 0.04 (-0.18-0.25). The corresponding d statistics for the SPADE scales ranged from -0.06 (-0.27 to 0.16) for anxiety to 0.11 (-0.10 to 0.33) for sleep disturbance. There were also no significant or clinically important differences between the experimental and control treatment groups on the secondary outcome measures. Additionally, in subgroup analyses involving participants treated by osteopathic vs allopathic physicians, no significant interaction effects were observed. CONCLUSIONS: The eHealth intervention studied herein did not achieve statistically significant or clinically important improvements in any of the primary or secondary outcome measures. However, the validity and generalizability of the findings may have been limited by the unforeseen onset and impact of the COVID-19 pandemic shortly after beginning the trial.


Subject(s)
COVID-19 , Low Back Pain , Sleep Wake Disorders , Humans , Quality of Life , Health Status , Low Back Pain/epidemiology , Low Back Pain/therapy , Patient Participation , Depression/therapy , COVID-19/epidemiology , Pain Management , Pandemics , Sleep Wake Disorders/therapy
19.
PLoS One ; 17(7): e0271350, 2022.
Article in English | MEDLINE | ID: covidwho-1963027

ABSTRACT

OBJECTIVE: Anxiety, fatigue and depression are common neurological manifestations after COVID-19. So far, post-COVID complications were treated by rehabilitation, oxygen therapy and immunotherapy. Effects of neurofeedback on post-COVID complications and their potential interrelatedness have not been studied yet. In this pilot study, we investigated the effectiveness of neurofeedback (Othmer method) for treatment of fatigue, anxiety, and depression after COVID-19. METHODS: 10 participants met inclusion criteria for having positive anamnesis of at least one of the following complications following COVID-19: fatigue, anxiety, and depression which were measured by questionnaires. ANOVA was used for calculating differences in questionnaire score before and after neurofeedback. Pearson's correlation coefficient was used to calculate correlations between anxiety, depression and fatigue. RESULTS: After five neurofeedback sessions, there came to significant reduction of severity of post-COVID anxiety and depression persisting for at least one month. Effect of neurofeedback on fatigue was insignificant. Severity of anxiety, fatigue and depression as well as reductions in depression and fatigue were positively correlated with each other. CONCLUSION: These findings showed effectiveness neurofeedback for reducing anxiety and depression after COVID-19 and for studying correlations between neurological complications after COVID-19. However, since our pilot clinical trial was open-label, it is hard to differentiate between neurofeedback-specific and unspecific effects on our participants. Future randomized controlled trials with more robust sample are necessary to investigate feasibility of neurofeedback for post-COVID neurological complications. The study has identification number trial ID ISRCTN49037874 in ISRCTN register of clinical trials (Retrospectively registered).


Subject(s)
COVID-19 , Neurofeedback , Anxiety/etiology , Anxiety/therapy , COVID-19/complications , COVID-19/therapy , Depression/etiology , Depression/therapy , Fatigue/etiology , Fatigue/therapy , Humans , Neurofeedback/methods , Pilot Projects
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