Tag: Depression

Posted on

Evaluation of Depression Screening Methods Administered by Registered Nurses in Chronic Hemodialysis Patients

Conditions: Depressive Disorders; End-stage Chronic Kidney Disease Treated With Hemodialysis

Interventions: Other: evaluate the psychometric performance of different modalities of hetero-assessment of depressive symptoms by nurses

Sponsors: Centre Hospitalier Annecy Genevois; GIRCI Auvergne Rhone-Alpes; SFNDT – Société Francophone de Néphrologie, Dialyse et Transplantation

Not yet recruiting
Posted on
<![CDATA[Meta-analysis finds intranasal esketamine boosts remission in MDD and TRD fast, but side effects and short trials leave long-term questions.]]>
Posted on
<![CDATA[Caplyta boosts antidepressants in MDD, showing 2–4 week response with minimal weight, metabolic, and EPS risks.]]>
Posted on

Group painting therapy for children and adolescents with bone tumors: a quasi-experimental trial evaluating anxiety, depression, post-traumatic growth, and health-related quality of life

BackgroundChildren and adolescents undergoing treatment for malignant bone tumors frequently experience heightened psychological distress, including anxiety, depression, and reduced health-related quality of life (HRQoL). Group painting therapy has been proposed as a supportive non-pharmacological strategy, yet empirical evidence in pediatric oncology remains limited. This study aimed to evaluate the impact of an eight-week structured group painting therapy program on anxiety, depression, post-traumatic growth (PTG), and HRQoL in this population.MethodsA quasi-experimental pretest–posttest study was conducted among children and adolescents (aged 8–18 years) with primary malignant bone tumors at Henan Cancer Hospital from December 2023 to December 2024. A total of 76 participants were consecutively enrolled and allocated to an intervention group receiving group painting therapy (n=39) or a control group receiving standard nursing care (n=37) using a nonrandomized ward-based approach. Anxiety, depressive symptoms, PTG, and HRQoL were assessed at baseline and post-intervention using validated instruments, including SCARED, DSRSC, PTGI, and PedsQL™ 3.0 Cancer Module.ResultsCompared with the control group, the intervention group demonstrated greater reductions in anxiety and depressive symptoms, along with significant improvements in PTG and selected HRQoL domains. Notable improvements were observed in emotional functioning, social communication, generalized anxiety, somatic symptoms, personal strength, and appreciation of life. No significant between-group differences were observed in physical symptom domains such as pain and nausea.ConclusionsGroup painting therapy was associated with improvements in emotional well-being, PTG, and selected HRQoL domains in children and adolescents with primary bone tumors. These findings suggest that painting therapy may be a promising adjunct to routine pediatric oncology care for promoting resilience and psychological recovery.
Posted on

Breaking Barriers in Student Mental Health Care With AI-Enhanced Group Cognitive Behavioral Therapy: Pilot Feasibility Study

Background: University students experience elevated psychological distress, with limited access to mental health services. While cognitive behavioral therapy (CBT) demonstrates efficacy for anxiety and depression, treatment gaps persist due to access barriers and insufficient between-session support. Large language model (LLM) chatbots could improve and scale CBT delivery. However, the scientific evaluation of chatbot-enhanced protocols is just emerging. Objective: This pilot study aimed to assess the feasibility, acceptability, and preliminary efficacy of an LLM-based ChatBot as an adjunct to group Unified Protocol (UP) therapy for between-session support in university students with subclinical anxiety and depression symptoms. Methods: A single-arm feasibility trial recruited university students aged 18 years and older with moderate subclinical symptoms (Social Phobia Inventory: 21‐40, Patient Health Questionnaire-9: 5‐14, or Generalized Anxiety Disorder-7: 5‐14), excluding those with current psychiatric disorders, suicidal ideation, or psychotropic medication use. The intervention comprised 4 weekly group UP counseling sessions complemented by an adjunctive Claude 3.7-Sonnet LLM ChatBot programmed with UP-based therapeutic prompts for between-session support rather than a stand-alone therapeutic agent. Primary feasibility outcomes included treatment adherence, chatbot engagement metrics, and system usability (System Usability Scale). Secondary outcomes assessed changes in generalized anxiety (Generalized Anxiety Disorder-7 Scale), social anxiety (Social Phobia Inventory), depression (Patient Health Questionnaire-9), and well-being (Short Warwick-Edinburgh Mental Wellbeing Scale) using paired tests. Qualitative feedback was collected through focus group interviews and analyzed using thematic analysis. Results: Of 72 screened participants, 37 met eligibility criteria and 19 initiated treatment (mean age 22.06, SD 1.78 years; 70.6% female). Retention was high with 17 completers (10.5% dropout rate). Among completers, 94.1% (16/17) attended ≥3 group sessions. The engagement with the CBT ChatBot was substantial: participants were active on a median of 23 days during the 34-day study period and exchanged a median of 15 messages in total. System usability was rated as excellent (mean 84.94, SD 10.98 out of 100). Pre-to-post comparisons revealed significant improvements in generalized anxiety (mean change −3.00, SD 3.46; =3.01, =.004; Cohen =0.71) and mental well-being (mean change +2.29, SD 3.65; =−2.17, =.02; Cohen =0.69). Social anxiety and depression showed nonsignificant trends toward improvement. Qualitative feedback highlighted the CBT ChatBot’s accessibility and nonjudgmental support while noting limitations in personalization. No adverse events or inappropriate chatbot interactions occurred. Conclusions: Augmenting a group UP therapy with an LLM ChatBot demonstrated high feasibility, acceptability, and preliminary efficacy signals for university students with subclinical symptoms. The hybrid intervention package achieved strong retention and engagement while maintaining safety. These findings support progression to a randomized controlled trial to definitively evaluate this technology-enhanced approach for expanding access to evidence-based mental health interventions.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/ceb992b5356218740d97471bbda48397" />

Posted on

Using a Virtual Reality CAVE–Based Mindfulness Intervention to Promote Mental Well-Being in Adolescents With Anxiety Symptoms: Pre-Post Mixed Methods Pilot Study

Background: Adolescent anxiety is a growing public health concern associated with significant social and emotional impairment. Mindfulness-based interventions (MBIs) have shown promise in reducing anxiety and improving well-being; however, engagement remains challenging. Virtual reality (VR)–based delivery may enhance immersion and attention, potentially addressing barriers of traditional mindfulness formats. Evidence on VR-based mindfulness interventions for adolescents, particularly in Hong Kong, remains limited. Objective: This study aimed to evaluate the feasibility and acceptability of a VR-MBI delivered via a CAVE, an enclosed VR environment with three projected walls displaying immersive natural scenes and ambient sounds, for adolescents with mild-to-moderate anxiety symptoms in Hong Kong. Secondary aims were to explore preliminary effects on psychological outcomes and physiological stress regulation and to identify facilitators and barriers to engagement. Methods: A mixed methods, single-group pre-post study was conducted with adolescents experiencing mild-to-moderate anxiety symptoms, recruited from secondary schools and youth service organizations in Hong Kong. Participants completed an 8-week group-based VR-MBI. Feasibility and acceptability were assessed using recruitment, attendance, retention, homework practice frequency, dropouts, and adverse events. Psychological outcomes were measured using the Depression Anxiety Stress Scale–21 and the Mindful Attention Awareness Scale. Heart rate variability indices, including the standard deviation of normal-to-normal intervals and root-mean-square of successive differences, were collected at baseline and postintervention using a wearable device. Focus group interviews explored participants’ experiences. Paired-sample tests and Wilcoxon signed rank tests examined pre-post changes, and qualitative data were analyzed using thematic analysis, with findings integrated through triangulation. Results: A total of 42 participants (mean age 14.88, SD 1.90 years; 20/42, 47.6% female; 22/42, 52.4% male) enrolled and completed both assessments. Attendance was high, with 73.8% (31/42) of participants attending at least 80% (8/10) sessions, and participants engaged in regular homework practice. No dropouts or adverse events were reported. No significant pre-post changes were observed in self-reported distress, anxiety, depression, stress, or trait mindfulness (all >.05). However, significant improvements were observed in both heart rate variability indices, standard deviation of normal-to-normal intervals (mean difference 17.6 ms, 95% CI −33.88 to −1.32; =.04; Cohen =0.38) and root-mean-square of successive differences (mean difference 20.20 ms, 95% CI −38.76 to −1.65; =.03; Cohen =0.39), which may suggest preliminary enhancements in physiological stress regulation. Qualitative findings suggested perceived benefits in emotional regulation, stress reduction, focus, and sleep, with the immersive environment and group-based format identified as key facilitators. Conclusions: The CAVE-based VR-MBI was feasible and acceptable for adolescents with mild-to-moderate anxiety symptoms in Hong Kong. Despite no significant changes in self-reported outcomes, physiological improvements and positive qualitative feedback suggest early benefits not captured by self-report measures. These findings support further investigation of using controlled designs and longer follow-up periods.
Posted on

Prevalence and Predictors of Self-Reported Adverse Experiences in Digital Meditation Training: 2 Randomized Controlled Trials

Background: Digital meditation-based interventions (MBIs) reach vast global audiences with millions of active users, yet concerns persist about the frequency and nature of adverse experiences (ie, AExs) occurring during meditation training. Some researchers have argued that AExs are substantially underdetected and reflect iatrogenic harm caused by meditation (ie, adverse effects [AEfs]). Others contend that these experiences largely reflect common stressors that would be experienced without meditation. These competing perspectives underscore the need for further research, particularly in the context of digital MBIs, the most widely used form of meditation training. Objective: This study examined the prevalence, predictors, and subjective evaluations of AExs during a digital MBI and tested whether reported experiences may be caused by meditation practice via comparisons between meditation-exposed and nonexposed participants. Methods: Data were drawn from 2 trials of the Healthy Minds Program. Exploratory study 1 (n=315) consisted of a sample of distressed US undergraduate students to estimate the prevalence of AExs and identify baseline predictors. Preregistered confirmatory study 2 (n=594) sampled distressed US adults from all 50 states to replicate findings from study 1 and to examine participants’ subjective evaluations of AExs. Study 2 additionally compared AEx rates between participants who did and did not complete guided meditations to assess whether AExs could be caused by meditation exposure. Study 3 (n=87) used qualitative methods to analyze study 1 participants’ responses to an open-ended question regarding their strategies for coping with AExs. Results: In studies 1 and 2, 27.9% (88/315) and 10.1% (40/396) of participants, respectively, reported at least one AEx during the study period, with 6.7% (21/315) and 3% (12/396) reporting functional impairment, largely aligning with previous research. Critically, in study 2, rates of AExs did not significantly differ between participants who did and did not complete guided meditations, suggesting that these experiences were not caused by meditation practice. Higher baseline depression, anxiety, loneliness, experiential avoidance, and perceived barriers to meditation predicted more frequent AExs. In studies 1 and 2, 89.8% (79/88) and 90% (36/40) of participants who reported AExs, respectively, indicated that they were glad to have learned to meditate. Qualitative analyses showed that participants used diverse coping strategies, often using skills learned through the Healthy Minds Program. Conclusions: AExs were relatively common but occurred at comparable rates among participants who did and did not meditate, challenging claims that such experiences were caused by meditation practice in distressed individuals. Although a small subset of participants reported some degree of functional impairment, most evaluated their AExs as tolerable and described their overall MBI experience as positive. Together, these findings highlight the importance of distinguishing AExs that likely reflect epiphenomena of preexisting distress or symptoms from iatrogenic harm attributable to MBIs. Trial Registration: Study 1: ClinicalTrials.gov NCT04741529; https://clinicaltrials.gov/study/NCT04741529; Study 2: ClinicalTrials.gov NCT06282523; https://clinicaltrials.gov/study/NCT06282523
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/09106e6bad7f3f15798304e0c00626ec" />

Posted on

Logotherapy techniques to unlock resilience among Ukrainian refugees: a pre-post quasi-experimental design

The ongoing Russian-Ukrainian war has triggered a significant refugee crisis, resulting in widespread trauma, displacement, and mental health challenges among affected populations. This study aimed to explore the potential usefulness of logotherapy, a meaning-centered therapy, in addressing the mental health needs of Ukrainian refugees. The research was conducted in a naturalistic scenario of a group of 20 Ukrainian refugees residing in Europe who received a tailored logotherapy or meaning-centered psychological support, compared with controls who did not. Meaning-oriented techniques, namely, Socratic Dialogue, Modification of Attitude, Paradoxical Intention, and Dereflection were used during the intervention. Participants were assessed in a pre-post quasi-experimental design using validated self-report measures for anxiety (Generalized Anxiety Disorder-7), depression (Beck Depression Inventory), and general health (General Health Questionnaire-12). The improvements were clearly observed as reductions in their self-reported anxiety and depressive symptoms after the meaning-centeres psychological support. Overall, these preliminary findings indicate that logotherapy may be a promising and feasible approach to psychological support for refugee populations. However, given its pilot nature and quasi-experimental design, causal conclusions cannot be drawn, and further research using larger, randomized, and methodologically rigorous designs is warranted to examine long-term effects and broader applicability.