BMC Psychiatry
July 2025
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.
View Article and Find Full Text PDFRes Sq
May 2025
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.
View Article and Find Full Text PDFBackground: Depression and anxiety are among the most common mental health concerns globally. Efficacious treatments such as cognitive behavioral therapy exist but remain difficult to access and scale. Cognitive behavioral immersion (CBI)-a cognitive behavioral skills training intervention delivered by peer coaches in the metaverse-has been developed to address these barriers.
View Article and Find Full Text PDFPLoS One
April 2025
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.
Task-sharing and telemedicine can increase access to effective psychotherapies. Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) is pragmatic, multisite, noninferiority, four-arm trial that tested the non-inferiority of provider (non-specialist vs. specialist providers) and modality (telemedicine vs.
View Article and Find Full Text PDFSituational factors can influence cognitive performance and should be considered for conducting cognitive assessments. The objective of this project was to develop a checklist for Cognitive Assessment Requirements (CARE) to identify these situational factors before conducting cognitive assessments and account for them. This study employed a four-round Delphi approach involving 22 experts to identify situational factors that can impact cognitive assessment results.
View Article and Find Full Text PDFIntroduction: Burnout, low motivation, and poor job satisfaction among community health workers (CHWs) have negative impacts on health workers and on patients. This study aimed to characterize levels of burnout, motivation, and job satisfaction in CHWs in Madhya Pradesh, India and to determine the relation between these levels and participant characteristics. This study can inform efforts to promote wellbeing and address stress in this population.
View Article and Find Full Text PDFInterpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses. This IPD meta-analysis compared the efficacy of IPT and antidepressants on various outcomes at post-treatment and follow-up (PROSPERO: CRD42020219891).
View Article and Find Full Text PDFDepression is an eminently treatable disorder that responds to psychotherapy or medications; the efficacy of each has been established in hundreds of controlled trials. Nonetheless, the prevalence of depression has increased in recent years despite the existence of efficacious treatments-a phenomenon known as the treatment-prevalence paradox. We consider several possible explanations for this paradox, which range from a misunderstanding of the very nature of depression, inflated efficacy of the established treatments, and a lack of access to efficacious delivery of treatments.
View Article and Find Full Text PDFThe paradigm is shifting with respect to how we think about depression and its treatment. Some of that shift can be attributed to new findings with respect to its epidemiology and genetics and the rest can be attributed to the incorporation of a new perspective derived from evolutionary theory. In brief, depression is far more prevalent than previously recognized with the bulk of additional cases involving individuals who do not go on to become recurrent.
View Article and Find Full Text PDFThe current study estimated effects of intervention dose (attendance) of a cognitive behavioral prevention (CBP) program on depression-free days (DFDs) in adolescent offspring of parents with a history of depression. As part of secondary analyses of a multisite randomized controlled trial, we analyzed the complete intention-to-treat sample of 316 at-risk adolescents ages 13 to 17 years. Youth were randomly assigned to the CBP program plus usual care (n = 159) or to usual care alone (n = 157).
View Article and Find Full Text PDFResearch investigating whether depression is an adaptation or a disorder has been hindered by the lack of an experimental paradigm that can test causal relationships. Moreover, studies attempting to induce the syndrome often fail to capture the suite of feelings, thoughts, and behaviors that characterize depression. An experimental paradigm for triggering depressive symptoms can improve our etiological understanding of the syndrome.
View Article and Find Full Text PDFA science-based approach to understanding health and disease emerged gradually over the past two centuries, while the modern evidence-based approach to health care emerged only about a half-century ago. The evidence-based approach to practice in health service psychology (HSP) gained significant traction after the American Psychological Association (APA) adopted it as policy in 2005, and in 2021, APA approved the first comprehensive set of guidelines for practicing HSP in an evidence-based manner. Several authors of this 2021 set of guidelines along with an additional subject matter expert wrote the current article.
View Article and Find Full Text PDFBackground: Cost-effective treatments are needed to reduce the burden of depression. One way to improve the cost-effectiveness of psychotherapy might be to increase session frequency, but keep the total number of sessions constant.
Aim: To evaluate the cost-effectiveness of twice-weekly compared with once-weekly psychotherapy sessions after 12 months, from a societal perspective.
Background: Twice weekly sessions of cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) lead to less drop-out and quicker and better response compared to once weekly sessions at posttreatment, but it is unclear whether these effects hold over the long run.
Aims: Compare the effects of twice weekly weekly sessions of CBT and IPT for depression up to 24 months since the start of treatment.
Methods: Using a 2 × 2 factorial design, this multicentre study randomized 200 adults with MDD to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions.
Background: Depressive and anxiety disorders are the most common mental disorders, and there is a critical need for effective, affordable, and accessible interventions. Cognitive Behavioral Immersion (CBI) is a novel group-based cognitive behavioral skills training program delivered by lay coaches in the metaverse that can be accessed through various modalities including virtual reality (VR) head-mounted displays or flat-screen devices. Combining its ability to offer empirically supported therapy skills in a digital setting that can still facilitate interpersonal variables (eg, working alliance and sense of social support) with the aid of lay coaches, CBI has the potential to help fill this critical need.
View Article and Find Full Text PDFBackground: The need for scalable delivery of mental health care services that are efficient and effective is now a major public health priority. Artificial intelligence (AI) tools have the potential to improve behavioral health care services by helping clinicians collect objective data on patients' progress, streamline their workflow, and automate administrative tasks.
Objective: The aim of this study was to determine the feasibility, acceptability, and preliminary efficacy of an AI platform for behavioral health in facilitating better clinical outcomes for patients receiving outpatient therapy.
Cognitive Behavioral Immersion (CBI) is a novel cognitive-behavioral skills program delivered by lay coaches in the metaverse through immersive virtual reality technology. The objective for this study was to run a feasibility and pilot study of CBI for individuals in recovery from a substance use disorder. Data from 48 participants were used and program usage was assessed.
View Article and Find Full Text PDFPsychotherapy (Chic)
September 2023
Cognitive restructuring (CR) is one method that is hypothesized to play a role in the process of change across many psychotherapies and for a variety of clinical presentations. In this article, we define and illustrate CR. We then present a meta-analysis of four studies (including a total of 353 clients) examining the effect of CR measured within session on psychotherapy outcomes.
View Article and Find Full Text PDFWe investigated if improving a patient's memory for the content of their treatment, via the Memory Support Intervention, improves illness course and functional outcomes. The platform for investigating this question was major depressive disorder (MDD) and cognitive therapy (CT). Adults diagnosed with MDD (N = 178) were randomly allocated to CT + Memory Support (n = 91) or CT-as-usual (n = 87).
View Article and Find Full Text PDFBackground: Cognitive therapy and behavioural activation are both widely applied and effective psychotherapies for depression, but it is unclear which works best for whom. Individual participant data (IPD) meta-analysis allows for examining moderators at the participant level and can provide more precise effect estimates than conventional meta-analysis, which is based on study-level data.
Aims: This article describes the protocol for a systematic review and IPD meta-analysis that aims to compare the efficacy of cognitive therapy and behavioural activation for adults with depression, and to explore moderators of treatment effect.
Background: Internet-based cognitive-behavioural therapy (iCBT) is effective for subthreshold depression. However, which skills provided in iCBT packages are more effective than others is unclear. Such knowledge can inform construction of more effective and efficient iCBT programmes.
View Article and Find Full Text PDFBMJ Open
May 2022
Introduction: Research is needed to investigate preventive strategies to reduce mental health burden and assess effective implementation among immigrants. Problem management plus (PMP) is a low-intensity multicomponent psychological intervention developed by the World Health Organization (WHO) that trained laypeople can deliver. PMP has been adapted as a prevention intervention and developed as PMP for immigrants (PMP-I), including psychoeducation, problem-solving, behavioural activations and mind-body exercise, to address immigrants' multiple stressors.
View Article and Find Full Text PDFObjectives: This study examined whether 'personality vulnerability' (i.e., self-critical perfectionism or dependency) predicts the trajectory of change, as well as variability and instability (i.
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