The Political Economy of Adolescent Mental Health in Kenya.

Adolescent mental health remains a critical yet under-prioritized issue in low- and middle-income countries (LMICs) like Kenya, where resource limitations, stigma, and systemic barriers hinder access to care. While policies and strategies such as Kenya's Mental Health Action Plan (2021-2025) exist on paper, their implementation is constrained by limited resources and a weak mental health service delivery infrastructure. This qualitative descriptive study examines the perspectives of mental health actors and youth advocates on the development and implementation of adolescent mental health policy in Kenya.

Personalised & optimised therapy (POT) algorithm using five cognitive and behavioural skills for subthreshold depression.

Personalising psychotherapies for depression may enhance their efficacy. We conducted a randomised controlled trial of smartphone cognitive-behavioural therapy (CBT) among 4,469 adults in Japan (RESiLIENT trial, UMIN-CTR UMIN000047124). Participants received one of nine CBT skills or combinations, or a health information control (HI), over six weeks.

A qualitative process evaluation of group problem management plus for distressed Syrian refugees in Türkiye.

Syrian refugees in Türkiye show a high prevalence of mental health problems but encounter barriers to accessing mental health services. Group Problem Management Plus (gPM+), developed by the World Health Organization, is a low-intensity psychological intervention delivered by nonspecialist facilitators. This qualitative process evaluation explores the acceptability, feasibility and perceived effectiveness of gPM+ for Syrian refugees resettled in Türkiye, as well as facilitating factors and barriers to its implementation.

Optimizing treatment for depression in primary care using psychotherapy versus antidepressant medication in a low-resource setting: protocol for the OptimizeD randomized controlled trial.

Background: Psychotherapy and antidepressant medications are first-line treatments for depression, and they both have significant treatment effects on average. However, treatment response varies widely across patients, and neither approach is universally effective. Identifying the most effective treatment for each patient is critical everywhere, but particularly in low-resource settings where access to mental health care is limited.

Effectiveness of digital interventions for eight mental disorders: A meta-analytic synthesis.

Objectives: In this unified series of meta-analyses, we integrate the effects of digital interventions in adults with mental disorders compared to inactive controls. We cover eight indications: depressive disorder, insomnia, specific phobias, generalized anxiety, panic, social anxiety, obsessive-compulsive, and posttraumatic stress disorder.

Methods: Digital intervention trials in patients with a diagnosed mental disorder (confirmed by clinical interviews) were extracted from the Metapsy living databases for psychological treatments.

Development and evaluation of prompts for a large language model to screen titles and abstracts in a living systematic review.

Background: Living systematic reviews (LSRs) maintain an updated summary of evidence by incorporating newly published research. While they improve review currency, repeated screening and selection of new references make them labourious and difficult to maintain. Large language models (LLMs) show promise in assisting with screening and data extraction, but more work is needed to achieve the high accuracy required for evidence that informs clinical and policy decisions.

Machine-learning detection of stress severity expressed on a continuous scale using acoustic, verbal, visual, and physiological data: lessons learned.

Background: Early detection of elevated acute stress is necessary if we aim to reduce consequences associated with prolonged or recurrent stress exposure. Stress monitoring may be supported by valid and reliable machine-learning algorithms. However, investigation of algorithms detecting stress severity on a continuous scale is missing due to high demands on data quality for such analyses.

Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative.

Background: Mental disorders are highly prevalent among students worldwide. This study aims to examine comorbidity and temporal associations between mental disorders among students.

Methods: The study included 72,288 students from 18 countries as part of the World Mental Health International College Student (WMH-ICS) Initiative, with cross-sectional data collected between 2017 and 2023.

Childhood adversities and their associations with mental disorders in the World Mental Health International College Student surveys initiative.

Purpose: This study investigates associations of childhood adversities (CAs) with lifetime prevalence, 12-month prevalence, and 12-month persistence of mental disorders in a large cross-national sample of university students.

Methods: Data came from epidemiologic surveys carried out by the World Mental Health International College Student (WMH-ICS)Initiative across 18 countries (n=60,719). The web-based surveys screened for lifetime and 12-month prevalence and age-of-onset of common DSM-5 disorders (Major Depressive Disorder, Bipolar I/II Disorder, Generalized Anxiety Disorder, Panic Disorder, Posttraumatic Stress Disorder, Alcohol and Drug Use disorders, Attention-Deficit/Hyperactivity Disorder) and five types of CAs (family dysfunction, emotional abuse, physical abuse, sexual abuse, neglect).

Effectiveness of psychotherapy: Synthesis of a "meta-analytic research domain" across world regions and 12 mental health problems.

The scientific output generated in psychology has surged in recent decades, including the number of studies investigating psychological treatments. To keep track of all this evidence, we developed the "Metapsy" meta-analytic research domain: a comprehensive system of open databases and tailored software that allows for rapid evidence generation. We leverage this novel infrastructure to summarize the effect of psychological treatment across 12 mental health problems and trace back the global expansion of psychotherapy research over the past 50 years.

The value of mental science: we publish what matters.

Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

Optimizing Treatment for Depression in Primary Care Using Psychotherapy Versus Antidepressant Medication in a Low-Resource Setting: Protocol for the OptimizeD Randomized Controlled Trial.

Psychotherapy and antidepressant medications are first-line treatments for depression, and they both have significant treatment effects on average. However, treatment response varies widely across patients, and neither approach is universally effective. Identifying the most effective treatment for each patient is critical everywhere, but particularly in low-resource settings where access to mental health care is limited.

Transdiagnostic psychological interventions for emotional disorders: A comprehensive meta-analysis.

Previous meta-analyses have integrated evidence on the effects of transdiagnostic interventions for depression and anxiety symptoms. Nevertheless, no recent study covers all types of transdiagnostic interventions administered through a wide range of delivery formats, and targeting participants with different emotional disorders (i.e.

Exploring study dropout in drug trials for adults with PTSD: insights from a conventional and individual participant data meta-analysis.

Dropout rates and factors contributing to dropout in drug and placebo groups in pharmacotherapy trials for posttraumatic stress disorder (PTSD) are not well understood. This study aimed to examine differences in all-cause study dropouts between drug and placebo groups, using conventional meta-analysis and an exploratory predictor analysis of individual participant data from three trials. We included randomized controlled trials (RCTs) of adults with PTSD, comparing drug monotherapy with placebo.

Assessing the strength of innovations in the treatment of depression.

Although treatments for depression are effective, many patients do not respond. Many new innovations are currently being developed, claiming to substantially improve outcomes. We propose a new method to assess the strength of these innovations.

Efficacy of cognitive behavioral therapies with a trauma focus for posttraumatic stress disorder: An individual participant data meta-analysis.

Objective: This individual participant data meta-analysis aimed to investigate the effectiveness of cognitive behavioral therapy with a trauma focus (CBT-TF) for posttraumatic stress disorder (PTSD). Furthermore, we examined the effect of moderators on PTSD symptom severity.

Method: This study included randomized controlled trials comparing CBT-TF to an inactive or active comparison group for adults with PTSD.

Psychological intervention in individuals with subthreshold depression: individual participant data meta-analysis of treatment effects and moderators.

Background: It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.

Aims: To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.

Method: Randomised trials comparing psychological intervention with inactive control were identified via systematic search.

Delivery formats of cognitive behavior therapy in adults with eating disorders: a network meta-analysis.

Although CBT has been found to be effective in the treatment of eating disorders, it is not clear if there are differences between treatment formats. We conducted a network meta-analysis (NMA) of randomized trials of broadly defined CBT comparing individual, group, guided self-help (GSH) and unguided self-help (USH) with each other or with a control condition. The NMA used a frequentist graph-theoretical approach and included 36 trials (53 comparisons; 3,136 participants).

Data gaps in prevalence rates of mental health conditions around the world: a retrospective analysis of nationally representative data.

Background: Mental health conditions contribute substantially to the global burden of disease, affecting quality of life and leading to increased health-care expenses and mortality. Accurate data on the prevalence and correlates of these disorders are crucial for policy making, advocacy, and improving population health, but there are notable gaps in the available data on the magnitude of mental health difficulties around the world. This study aims to identify and quantify the data gaps on mental disorders across the lifespan in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021.

Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance.

Mental health disparities have been reported among sexual minority individuals; minority stress theory posits that such disparities are a result of stigma and discrimination. We estimated the prevalence of mental disorders across sexual orientation groups among first-year college students and whether differences across sexual orientation groups varied by gender and country-level LGBTQ+ (lesbian, gay, bisexual, transgender, queer) social acceptance. Using data (N = 53,175; 13 countries) from the World Mental Health Surveys International College Surveys, we performed multilevel logistic regressions to estimate the associations between sexual orientation (i.

Cognitive behavioral therapy skills via a smartphone app for subthreshold depression among adults in the community: the RESiLIENT randomized controlled trial.

Subthreshold depression, defined as a depressive status falling short of the diagnostic threshold for major depression, is common, disabling and constitutes a risk factor for future depressive episodes. Cognitive behavioral therapies (CBT) have been shown to be effective but are usually provided as packages of various skills. Little research has been done to investigate whether all their components are beneficial and contributory to mental health promotion.

Developing a multivariable prediction model to support personalized selection among five major empirically-supported treatments for adult depression. Study protocol of a systematic review and individual participant data network meta-analysis.

Background: Various treatments are recommended as first-line options in practice guidelines for depression, but it is unclear which is most efficacious for a given person. Accurate individualized predictions of relative treatment effects are needed to optimize treatment recommendations for depression and reduce this disorder's vast personal and societal costs.

Aims: We describe the protocol for a systematic review and individual participant data (IPD) network meta-analysis (NMA) to inform personalized treatment selection among five major empirically-supported depression treatments.

Cognitive Behavior Therapy for Mental Disorders in Adults: A Unified Series of Meta-Analyses.

Importance: Cognitive behavior therapy (CBT) is a first-line treatment for most mental disorders. However, no meta-analytic study has yet integrated the results of randomized clinical trials on CBT across different disorders, using uniform methodologies and providing a complete overview of the field.

Objective: To examine the effect sizes of CBT for 4 anxiety disorders, 2 eating disorders, major depression, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and psychotic and bipolar disorders on symptoms of the respective disorders using uniform methodologies for data extraction, risk of bias (RoB) assessment, and meta-analytic techniques.

Processes of change in digital interventions for depression: A meta-analytic review of cognitive and behavioral mediators.

The efficacy of digital interventions for depression has been established. In contrast, only limited knowledge on their change processes is currently available, and precise effect size estimates for mediators are pending. This study aimed to systematically review mediation studies and meta-analytically evaluate indirect effects of cognitive and behavioral mediators in digital interventions for adults with depression.