Pathway-Matched Resilience-Oriented Therapy in Rwanda

Conditions: Mental Health; Psychological Trauma; Stress Disorders, Post-Traumatic; Depression; Anxiety; Aggression; Substance-related Disorders; Psychosocial Functioning

Interventions: Behavioral: Resilience-Oriented Therapy – Emotion-Regulation Variant; Behavioral: Resilience-Oriented Therapy – Identity-Development Variant; Behavioral: Resilience-Oriented Therapy – Behavioural Self-Management Variant

Sponsors: Alexandros Lordos, PhD; Centre for Sustainable Peace and Democratic Development; University of Rwanda; Interpeace

Completed
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Exercise interventions for depressive symptoms in adults with lung and digestive cancer: a meta-analysis of randomized controlled trials

BackgroundDepressive symptoms are common among patients with cancer and can substantially impair quality of life, treatment adherence and overall well-being. Although exercise has been increasingly recognised as a promising non-pharmacological strategy for alleviating depression in oncology settings, existing evidence has focused predominantly on breast cancer, with limited attention to lung and digestive cancers. This meta-analysis aimed to evaluate the effects of exercise interventions on depressive symptoms in adults with lung and digestive cancer.MethodsA systematic search was conducted in PubMed, Web of Science, Embase, Cochrane Library and Scopus from database inception to March 2026. Randomized controlled trials investigating the effects of exercise interventions on depressive symptoms in adults with lung or digestive cancer were included. The primary outcome was depressive symptoms measured using validated instruments. Subgroup analyses were performed according to intervention format, exercise type and training frequency. Risk of bias was assessed using the Cochrane Risk of Bias tool version 1.ResultsEight randomized controlled trials were included in the meta-analysis. Baseline analysis showed no significant difference in depressive symptoms between the exercise and control groups before intervention. Post-intervention meta-analysis demonstrated that exercise significantly reduced depressive symptoms compared with control conditions (SMD = -0.45, P = 0.02), Although substantial heterogeneity was observed. Individually delivered programmes, walking-based exercise and moderate-frequency training (3–5 times per week) showed numerically larger effect estimates.ConclusionsExercise interventions may reduce depressive symptoms in adults with lung and digestive cancer and represent a promising adjunctive strategy for psychological care in these populations. Although subgroup differences were not statistically significant, certain intervention characteristics may be associated with greater benefit. Further large-scale, high-quality randomized trials are needed to confirm these findings and to establish the optimal exercise prescription for reducing depressive symptoms in adults with lung and digestive cancer.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420261336578.

Predictive value of antioxidant and thyroid function indicators for non-suicidal self-injury in adolescents with major depressive disorder

BackgroundNon-suicidal self-injury (NSSI) is highly prevalent in adolescents with major depressive disorder (MDD); however, its underlying pathophysiological mechanisms remain incompletely elucidated. Emerging evidence suggests a potential association between antioxidant markers, thyroid function parameters, and the occurrence of NSSI, although research in this domain remains limited. Accordingly, this study aimed to investigate the predictive efficacy of combining antioxidant and thyroid biomarkers with clinical symptoms for NSSI in adolescents with MDD.MethodsThis study recruited 162 adolescents with MDD between September 2022 and January 2026. Participants were stratified into groups based on the presence or absence of NSSI, in accordance with DSM-5 diagnostic criteria. Multidimensional scales were employed to assess the severity of depression, anxiety, perceived stress, and internet addiction (IA). Concurrently, blood samples were collected to measure bilirubin levels and thyroid function parameters. Stepwise logistic regression analysis was subsequently performed to identify independent risk factors associated with NSSI. Finally, receiver operating characteristic (ROC) curves were constructed to quantify the predictive performance of these identified independent factors.ResultsThe prevalence of NSSI in adolescents with MDD was 57.4%. Multivariate logistic regression analysis identified females (OR = 2.246, 95% CI = 1.032-4.888, P = 0.041), HAMD-17 score (OR = 1.183, 95% CI = 1.088-1.286, P < 0.001), indirect bilirubin (OR = 0.890, 95% CI = 0.797-0.995, P = 0.040), and TSH (OR = 2.060, 95% CI = 1.254-3.385, P = 0.004) as independent predictors of NSSI. Furthermore, ROC curve analysis further demonstrated that the four-item combination of sex, HAMD-17 score, indirect bilirubin, and TSH (AUC = 0.776, 95% CI = 0.701-0.850, P < 0.001) had a better ability to identify NSSI.ConclusionAdolescents with MDD, particularly females, represent a high-risk population for NSSI. Reduced levels of indirect bilirubin coupled with elevated TSH levels may constitute the underlying pathophysiological basis of NSSI and demonstrate significant clinical predictive value. In the future, targeted intervention strategies focusing on the antioxidant defense system and thyroid function may offer novel therapeutic avenues for the management of NSSI.

Two years of COVID-19: persistently reduced well-being and increases in global psychopathology during the pandemic in a representative Austrian population-sample within the COH-FIT study

IntroductionThe COVID-19 pandemic worsened well-being and mental health worldwide, but effects have diminished over time. However, prospective national data within representative samples remain scarce. We aimed to examine the change in well-being and psychopathology from pre-pandemic to intra-pandemic times in an Austrian representative general population sample, to identify vulnerable subgroups, and explore most effective coping strategies to mitigate the impact of COVID-19.MethodsData were collected in Austria as part of the Collaborative Outcomes Study on Health and Functioning During Infection Times (COH-FIT) survey, an international, multilingual, anonymous online survey assessing mental health indicators during COVID-19. Adults ≥18 years old participated through nationally representative sampling across three waves from 05/2020-04/2022. Outcomes included the WHO well-being index (WHO-5) and a global psychopathology score (‘P-score’), alongside 12 predefined risk factors and 16 coping strategies.ResultsAcross 4,148 adults, the mean WHO-5 well-being score decreased by 7.5 ± 17.7 points from the pre-pandemic baseline (73.2 ± 19.7) to the intra-pandemic average (65.7 ± 24.1) (p<.001). Participants with female sex, pre-existing mental or physical health conditions, and unemployment experienced greater declines. The proportion of individuals scoring <50, indicating depression, increased from 12.6% pre-pandemic baseline to 25.1% intra-pandemic, and the proportion scoring <29, indicating major depression, increased from 3.3% to 9.7% (both p<.001). The ‘P-score’ increased by 9.6 ± 15.0 points from 24.1 ± 19.5 pre-pandemic baseline to 33.7 ± 22.4 intra-pandemic (p<.001) with the same risk groups (except female sex). Although the greatest deterioration in both outcomes occurred during the mid-pandemic period (04/2021), neither well-being nor ‘P-score’ levels returned to pre-pandemic baseline values by 04/2022, nor to values from 05/2020 (Wave 1). Greater deterioration in WHO-5 and the P-score were associated with female sex, unemployment, pre-existing mental or physical disorders, and COVID-19 infection. The most commonly reported helpful coping strategies included internet use, physical activity, media consumption, social media and remote interaction, and meaningful hobbies.DiscussionCOVID-19 had a persistent negative impact on well-being and mental health in Austria. Vulnerable subgroups – including those with prior health conditions and unemployment – were particularly affected. The findings underscore the importance of implementing public health measures together with targeted interventions, preventive measures, and long-term psychosocial support, especially for risk populations.

The efficacy of acupuncture for depression-associated chronic pain: a systematic review and meta-analysis

ObjectiveThe comorbidity of pain and depression is prevalent, adding difficulty to the treatment of depression. This systematic review with meta-analysis aims to determine the efficacy and safety of acupuncture in treating depression-associated chronic pain (DACP).MethodsA comprehensive search was conducted across four international databases, namely PubMed, Embase, Web of Science, and the Cochrane Library, along with four regional databases, including Wanfang Data, CNKI, VIP database, and SinoMed, from inception to March 2025. The Cochrane Risk of Bias 2 tool was utilized to assess risk of bias in the included research articles, and the Grading of Recommendations Assessment, Development, and Evaluations system was employed to evaluate the certainty of evidence. Meta-regression analysis was performed to explore the influence of patient age and treatment duration on the study results, and sensitivity analysis was used to verify the stability of the results. The publication bias was evaluated when the number of included studies exceeded ten. All data analyses were completed using Stata15.1.ResultsTen randomized controlled trials involving 761 participants were included. Acupuncture combined with conventional medications was more effective than medication alone in improving depressive symptoms (standardized mean difference (SMD): -0.72; 95% confidence interval (CI): -0.91 to -0.53; P < 0.01) and reducing pain (SMD: -0.85; 95% CI: -1.36 to -0.34; P < 0.01). Head-to-head comparisons revealed that acupuncture is similar to medication in improving the Hamilton Depression Rating Scale scores (SMD: -0.05; 95% CI: -0.61 to 0.51; P > 0.05) and the Visual Analogue Scale scores (SMD: -0.33; 95% CI: -0.94 to 0.29; P > 0.05), suggesting no statistically significant difference between the two treatments. In contrast, acupuncture was associated with a better safety profile (relative risk: 0.40; 95% CI: 0.27 to 0.60). Further subgroup analysis found the advantage of a 4-week acupuncture treatment in improving depressive symptoms, while longer-term treatment tended to be more effective in relieving pain.ConclusionsAcupuncture appears to have comparable antidepressant and analgesic effects to conventional oral medications. When applied as an adjuvant therapy, acupuncture may enhance the clinical efficacy of monotherapy for DACP. Regarding treatment duration, a 4-week acupuncture intervention may be superior to a longer cycle (> 4 weeks) in alleviating depressive symptoms, while long-term acupuncture treatment may provide greater benefits in analgesia.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD420251026454.