{"title":"The Neuroimaging Role of Modified Electroconvulsive Therapy in the Major Depressive Disorder: Effectiveness in First-Episode Antipsychotic-Naive Major Depressive Disorder Patients","authors":"Yi Zhong, Jianfeng Li, Haitao Li, Mingzhe Li, Yanaohai Lyu, Minghu Cui, Yujun Gao","doi":"10.1155/2024/9211145","DOIUrl":"https://doi.org/10.1155/2024/9211145","url":null,"abstract":"Objectives. It is a high risk for adolescents with first-episode major depressive disorder (MDD) to commit suicide. However, few studies reported the effect of modified electroconvulsive therapy (MECT) in first-episode antipsychotic-naive MDD adolescents. Methods. The study explores the alternations of regional homogeneity of modified electroconvulsive therapy to treat the first-episode antipsychotic-naive major depressive disorder. 72 first-episode MDD patients were recruited from Tianyou Hospital Affiliated to Wuhan University of Science and Technology from October 2017 to May 2020, and 65 of 72 completed the trial. Results. Before MECT treatment, ReHo values of the bilateral cerebellum and left cuneus were higher, and ReHo value of left postcentral and supramarginal gyrus was lower in MDD patients compared to healthy subjects (HS). After treatment, the MDD patients have higher ReHo values of the right insula and postcentral gyrus, while left fusiform gyrus were lower than the pretreatment. Compared to the HS, the ReHo values of left lingual gyrus, right calcarine cortex, and right mid occipital thalamus were higher in the posttreatment. In the posttreatment, left calcarine cortex and right cerebrum were lower than in healthy subjects. Conclusions. The study confirmed that MECT improves psychotic symptoms in patients with first-episode antipsychotic-naive MDD. These results further contributed to a more tailored treatment approach to MDD from the pathophysiological and neuroimaging views.","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139782247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sung Min, Raegan Mazurka, Diego A. Pizzagalli, Alexis E. Whitton, Roumen V. Milev, R. Michael Bagby, Sidney H. Kennedy, Kate L. Harkness
{"title":"Stressful Life Events and Reward Processing in Adults: Moderation by Depression and Anhedonia","authors":"Sung Min, Raegan Mazurka, Diego A. Pizzagalli, Alexis E. Whitton, Roumen V. Milev, R. Michael Bagby, Sidney H. Kennedy, Kate L. Harkness","doi":"10.1155/2024/8853631","DOIUrl":"10.1155/2024/8853631","url":null,"abstract":"<p><i>Background</i>. Exposure to acute stress is associated with reduced reward processing in laboratory studies in animals and humans. However, less clear is the association between reward processing and exposure to naturalistic stressful life events. The goal of the current study was to provide a novel investigation of the relation between past 6-month stressful life events and reward processing, and the extent to which this relation was moderated by depression diagnostic status and state symptoms of anhedonia. <i>Methods</i>. The current study included a secondary analysis of data from 107 adults (37 current-depressed, 25 past-depressed, 45 never-depressed; 75% women) drawn from two previous community studies. Past 6-month stressful life events were assessed with a rigorous contextual interview with independent ratings. Response to monetary reward was assessed with a probabilistic reward task. <i>Results</i>. Among current-depressed participants, and among both current- and past-depressed participants with high levels of anhedonia, greater exposure to independent life events outside of individuals’ control was significantly associated with poorer reward learning. In direct contrast, among those with <i>low</i> levels of anhedonia, greater exposure to independent life events was significantly associated with a greater overall bias toward the more frequently rewarded stimulus. <i>Conclusions</i>. Results suggest that depression and anhedonia are uniquely associated with vulnerability to blunted reward learning in the face of uncontrollable stressors. In contrast, in the absence of anhedonia symptoms, heightened reward processing during or following independent stressful life event exposure may represent an adaptive response.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sung Min, R. Mazurka, D. Pizzagalli, Alexis E. Whitton, R. Milev, R. M. Bagby, Sidney H. Kennedy, Kate L. Harkness
{"title":"Stressful Life Events and Reward Processing in Adults: Moderation by Depression and Anhedonia","authors":"Sung Min, R. Mazurka, D. Pizzagalli, Alexis E. Whitton, R. Milev, R. M. Bagby, Sidney H. Kennedy, Kate L. Harkness","doi":"10.1155/2024/8853631","DOIUrl":"https://doi.org/10.1155/2024/8853631","url":null,"abstract":"Background. Exposure to acute stress is associated with reduced reward processing in laboratory studies in animals and humans. However, less clear is the association between reward processing and exposure to naturalistic stressful life events. The goal of the current study was to provide a novel investigation of the relation between past 6-month stressful life events and reward processing, and the extent to which this relation was moderated by depression diagnostic status and state symptoms of anhedonia. Methods. The current study included a secondary analysis of data from 107 adults (37 current-depressed, 25 past-depressed, 45 never-depressed; 75% women) drawn from two previous community studies. Past 6-month stressful life events were assessed with a rigorous contextual interview with independent ratings. Response to monetary reward was assessed with a probabilistic reward task. Results. Among current-depressed participants, and among both current- and past-depressed participants with high levels of anhedonia, greater exposure to independent life events outside of individuals’ control was significantly associated with poorer reward learning. In direct contrast, among those with low levels of anhedonia, greater exposure to independent life events was significantly associated with a greater overall bias toward the more frequently rewarded stimulus. Conclusions. Results suggest that depression and anhedonia are uniquely associated with vulnerability to blunted reward learning in the face of uncontrollable stressors. In contrast, in the absence of anhedonia symptoms, heightened reward processing during or following independent stressful life event exposure may represent an adaptive response.","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139808383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pedro Amaro, César Fonseca, Anabela Afonso, Gonçalo Jacinto, Luís Gomes, Hélder Pereira, Helena José, Celso Silva, Andreia Lima, Helena Arco, João Nabais, Manuel Lopes, Anabela Pereira, Isabel Fragoeiro, Lara Guedes Pinho
{"title":"Depression and Anxiety of Portuguese University Students: A Cross-Sectional Study about Prevalence and Associated Factors","authors":"Pedro Amaro, César Fonseca, Anabela Afonso, Gonçalo Jacinto, Luís Gomes, Hélder Pereira, Helena José, Celso Silva, Andreia Lima, Helena Arco, João Nabais, Manuel Lopes, Anabela Pereira, Isabel Fragoeiro, Lara Guedes Pinho","doi":"10.1155/2024/5528350","DOIUrl":"10.1155/2024/5528350","url":null,"abstract":"<p><i>Background</i>. The mental health of university students has worsened over time, and it is young people who have suffered the most from the COVID-19 pandemic in terms of mental health. Anxiety and depression are the most common symptoms reported by university students and are often the cause of disabilities, either in academic performance or in other spheres of life. <i>Aim</i>. The aim of this study was to both assess the prevalence of depressive and anxiety symptoms in Portuguese university students and analyze the factors associated with these symptoms. <i>Methods</i>. A quantitative cross-sectional study with a sample of 3,399 university students from seven Portuguese higher education institutions was conducted. The following questionnaires were used: the generalized anxiety disorder assessment scale (GAD-7), the patient health questionnaire (PHQ-9), and a study-created sociodemographic questionnaire. The Kendall correlation coefficient, chi-square test of independence, Spearman correlation coefficient, Shapiro-Wilk test, Mann–Whitney-Wilcoxon test, and Kruskall-Wallis test were used to analyze the association between variables. The statistical analysis was done using the software R Statistics (Version 4.0.4), using a significance level of 0.05. <i>Results</i>. Mild to severe anxiety symptoms were reported by 75% of the participants, and 61.2% described mild to severe depressive symptoms. Of the sample, 19.5% reported a previous diagnosis of a mental disorder, with 38.7% diagnosed after the pandemic began. Additionally, 23% reported taking medication for mental health issues, and 26.7% had considered self-harm or harbored thoughts of being “better off dead.” The study found lower anxiety and depressive symptoms (<i>p</i> < 0.05) among men, students with higher socioeconomic status, those who frequently traveled home, individuals without prior mental health diagnoses, those with better academic performance, and those who avoided substances like coffee, tobacco, cannabis, and other illegal psychoactive substances. Interestingly, students in romantic relationships exhibited more anxiety symptoms (<i>p</i> < 0.05). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms (<i>p</i> < 0.001). <i>Conclusions</i>. There was a decrease in the mental health of university students after the pandemic compared to prepandemic studies, and the proportion of students with anxiety and depressive symptoms was alarming. There is an urgent need to implement programs in universities to promote students’ mental health.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139624441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Pearson, C. Mendoza, J. D. Coppin, S. K. Creech
{"title":"Associations between Predictors of PTSD and Psychosocial Functioning in Veterans: Results from a Longitudinal Assessment Study","authors":"R. Pearson, C. Mendoza, J. D. Coppin, S. K. Creech","doi":"10.1155/2024/9719635","DOIUrl":"10.1155/2024/9719635","url":null,"abstract":"<p>Impairments in psychosocial functioning are common in veterans, especially in those with significant mental health symptoms. Although available treatments are aimed at alleviating these symptoms, impairments in psychosocial functioning do not appear to be fully addressed. To achieve rehabilitation and full societal participation, there is a need to identify longitudinal associations of both symptoms and functional outcomes which can be targeted in treatment. United States veterans (<i>N</i> = 491) of the Iraq and Afghanistan wars were recruited as part of a longitudinal assessment study which examined predictors of postdeployment adjustment. Veterans were assessed at four timepoints over the course of a two-year period. A Bayesian multivariate multilevel model was used to estimate the association of predictors of PTSD (depression, alcohol use, suicidal ideation, and sleep) on psychosocial functioning as encompassed by quality of life (Quality of Life Scale (QLS)) and disability (World Health Organization Disability Assessment Schedule (WHODAS)) scores over time. As female veterans have unique environmental exposures and functional demands, interactions between predictors and gender were included in all models. There was significant overlap between predictors of PTSD and predictors of disability across domains and quality of life. Depressive symptoms and social support emerged as the strongest predictors of psychosocial functioning. Additionally, suicidality and alcohol use emerged as predictors of quality of life, but not disability. As expected, increases in PTSD symptoms predicted increased disability and decreased quality of life. The effect of depressive symptoms on quality of life was more pronounced for male veterans, and the effect of PTSD and alcohol use on quality of life was more pronounced for female veterans. Findings highlight various treatment targets which have the potential to improve symptoms of PTSD and functional outcomes. Findings highlight an opportunity to leverage intervention and prevention efforts focused on decreasing depression and increasing social support to improve trauma symptoms and maximize rehabilitation and functional recovery in veterans.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of Antidepressant and Anxiolytic Drugs in Scandinavian Countries between 2006 and 2021: A Prescription Database Study","authors":"Ivana Bojanić","doi":"10.1155/2024/5448587","DOIUrl":"10.1155/2024/5448587","url":null,"abstract":"<p><i>Introduction</i>. The use of antidepressant and anxiolytic drugs has changed in Scandinavian countries over recent decades, with notable national variations. <i>Objective</i>. To describe and compare antidepressant and anxiolytic drug use in Norway, Sweden, and Denmark. <i>Methods</i>. Data included each country’s prescription registers from 2006 to 2021. The measures were period (1-year) prevalence (users per 1000 inhabitants) and therapeutic intensity (TI; daily defined dose (DDD) per 1000 inhabitants per day), overall, by drug classes and age groups. <i>Results</i>. The prevalence of antidepressant use increased from 2006 to 2021 and was highest in Sweden (78 to 107 users per 1000 inhabitants) and lowest in Norway (61 to 69 users per 1000 inhabitants). The prevalence of anxiolytic use decreased, most steeply in Denmark (50 to 18 users per 1000 inhabitants). The TI of antidepressants increased consistently in Norway and Sweden, but more variably in Denmark. Sweden had the highest increase in TI of antidepressants (56%). The TI of anxiolytics declined most markedly in Denmark (by 75%). The prevalence of antidepressant and anxiolytic use was highest among adults ≥65 years. The prevalence of antidepressant use increased across age groups in Sweden and young people (5-19 years) in Norway, but not in Denmark. <i>Conclusions</i>. The use of antidepressants increased in Scandinavia in 2006-2021, but decreased for anxiolytics, with country variations in the number of users and the amount used. Future research should target factors underlying high antidepressant and anxiolytic use in older adults across countries and increasing antidepressant use in Sweden and among young Norwegians.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139382736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anouk van der Straten, Willem Bruin, Laurens van de Mortel, Freek ten Doesschate, Maarten J. M. Merkx, Pelle de Koning, Nienke Vulink, Martijn Figee, Odile A. van den Heuvel, Damiaan Denys, Guido van Wingen
{"title":"Pharmacological and Psychological Treatment Have Common and Specific Effects on Brain Activity in Obsessive-Compulsive Disorder","authors":"Anouk van der Straten, Willem Bruin, Laurens van de Mortel, Freek ten Doesschate, Maarten J. M. Merkx, Pelle de Koning, Nienke Vulink, Martijn Figee, Odile A. van den Heuvel, Damiaan Denys, Guido van Wingen","doi":"10.1155/2024/6687657","DOIUrl":"https://doi.org/10.1155/2024/6687657","url":null,"abstract":"<p>Initial treatment for obsessive-compulsive disorder (OCD) consists of pharmacological treatment with selective serotonin reuptake inhibitors (SSRIs) and/or psychological treatment with cognitive behavioral therapy (CBT). The assumption is that both treatments have different neural working mechanisms, but empirical evidence is lacking. We investigated whether these treatments induce similar or different functional neural changes in OCD. We conducted a longitudinal nonrandomized controlled trial in which thirty-four OCD patients were treated with sixteen weeks of CBT or SSRIs. Functional magnetic resonance imaging was performed before and after treatment during emotional processing (emotional face matching and symptom provocation tasks) and response inhibition (stop signal task). Twenty matched healthy controls were scanned twice with a similar time interval. Both CBT and SSRIs were successful in reducing OCD symptoms. Compared to healthy controls, treatment led to a reduction of insula activity in OCD patients during symptom provocation. The comparison between treatment groups revealed widespread divergent brain changes in the cerebellum, posterior insula, caudate nucleus, hippocampus, and occipital and prefrontal cortex during all tasks, explained by relative increases of activity following CBT compared to relative decreases of activity following SSRIs. Pharmacological and psychological treatment primarily lead to opposite changes in brain function, with a common reduction of insula activity during symptom provocation. These findings provide insight into common and specific neural mechanisms underlying treatment response, suggesting that CBT and SSRIs support recovery from OCD along partly distinct pathways. This trial is registered with NTR6575.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141096390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Tong, Y. H. Shi, Y. Yang, L. P. Dong, L. L. Wu, T. T. Sun, W. Lu, X. Y. Zhang
{"title":"Clinical Characteristics, Metabolic Parameters, and Risk Factors for Suicide Attempts Vary with Untreated Major Depressive Disorder Duration","authors":"P. Tong, Y. H. Shi, Y. Yang, L. P. Dong, L. L. Wu, T. T. Sun, W. Lu, X. Y. Zhang","doi":"10.1155/2023/4869276","DOIUrl":"https://doi.org/10.1155/2023/4869276","url":null,"abstract":"Suicidal attempts (SAs) are common in major depressive disorder (MDD). However, only few studies have so far assessed how risk factors for SAs in patients with MDD might be related to the duration of untreated illness (DUI). We interviewed 1,718 drug-naive outpatients with MDD with first-episode SAs and divided them into groups that had and had not attempted suicide. DUI was used as an additional grouping criterion. The patients (20.14%; 346/1718) who had a history of SAs were older and had a longer DUI; lower educational level (middle school-educated only); more psychotic symptoms; higher scores on depression and anxiety scales; and higher BP, plasma BG, TC, and LDL-C levels, but lower HDL-C concentrations. Anxiety symptoms, high education level, and being unmarried were risk factors for SA in patients with MDD with DUIs of <3 months; anxiety symptoms, low BMI, high plasma TC, and low plasma HDL-C were risk factors for SA in the group with DUIs between 3 and 8 months; age, anxiety symptoms, and higher systolic blood pressure were risk factors for those with DUIs>8 months. This study was a single-center cross-sectional survey, and its limitations include a lack of outside validation. Patients with MDD with and without a SA history have different clinical characteristics and metabolic parameters, and risk factors for suicide vary across DUI stages. Anxiety was a general risk factor, suggesting that clinicians should strengthen their assessment of SA risk in patients with MDD during diagnosis and treatment.","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138953681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Nassif, Ian A. Gutierrez, Carl D. Smith, A. Jha, Amy B. Adler
{"title":"The Effect of a Combined Mindfulness and Yoga Intervention on Soldier Mental Health in Basic Combat Training: A Cluster Randomized Controlled Trial","authors":"T. Nassif, Ian A. Gutierrez, Carl D. Smith, A. Jha, Amy B. Adler","doi":"10.1155/2023/6869543","DOIUrl":"https://doi.org/10.1155/2023/6869543","url":null,"abstract":"Background. Depression, anxiety, and sleep problems are prevalent in high-stress occupations including military service. While effective therapies are available, scalable preventive mental health care interventions are needed. This study examined the impact of a combined mindfulness and yoga intervention on the mental health of soldiers in Basic Combat Training (BCT). Methods. U.S. Army soldiers (\u0000 \u0000 N\u0000 =\u0000 1,896\u0000 \u0000 ) were randomized by platoon to an intervention or training-as-usual condition. Soldiers in the intervention condition completed Mindfulness-Based Attention Training (MBAT), engaged in daily 15 min mindfulness practice, and participated in 30 minutes of hatha yoga 6 days per week. Surveys were administered at baseline (T1, prior to training), week 4 of BCT (T2), week 6 (T3), and week 9 (T4). Results. A significant time-by-condition interaction predicting positive screens for depression found that screens decreased at a faster rate from T1 to T4 in the intervention condition (-12.6%) compared to training-as-usual (-7.2%) (\u0000 \u0000 b\u0000 =\u0000 −\u0000 0.18\u0000 \u0000 , \u0000 \u0000 SE\u0000 =\u0000 0.07\u0000 \u0000 , \u0000 \u0000 p\u0000 =\u0000 0.028\u0000 \u0000 ). While positive anxiety screens decreased over time across conditions, the time-by-condition interaction found no significant differences in the rate of these decreases by condition (\u0000 \u0000 b\u0000 =\u0000 0.09\u0000 \u0000 , \u0000 \u0000 SE\u0000 =\u0000 0.09\u0000 \u0000 , \u0000 \u0000 p\u0000 =\u0000 0.273\u0000 \u0000 ). A significant time-by-condition interaction predicting positive screens for sleep problems found that sleep problems decreased in the intervention condition (-1.4%) but increased in training-as-usual (2.0%) (\u0000 \u0000 b\u0000 =\u0000 −\u0000 0.68\u0000 \u0000 , \u0000 \u0000 SE\u0000 =\u0000 0.16\u0000 \u0000 , \u0000 \u0000 p\u0000 =\u0000 0.027\u0000 \u0000 ). Conclusion. The mindfulness and yoga intervention was associated with a greater reduction in positive screens for depression and sleep problems among soldiers during high-stress training. Limitations include reliance on self-report and the inability to disaggregate the effects of mindfulness versus yoga. Mindfulness and yoga may enable personnel in high-stress occupations to sustain their mental health even in the context of significant psychological demands. This trial is registered with NCT05550610.","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138609769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan C. Senda, Kevin A. Johnson, Isabelle M. Taylor, Mariah M. Jensen, Yang Hou, F. A. Kozel
{"title":"A Pilot Trial of Stepwise Implementation of Virtual Reality Mindfulness and Accelerated Transcranial Magnetic Stimulation Treatments for Dysphoria in Neuropsychiatric Disorders","authors":"Megan C. Senda, Kevin A. Johnson, Isabelle M. Taylor, Mariah M. Jensen, Yang Hou, F. A. Kozel","doi":"10.1155/2023/9025984","DOIUrl":"https://doi.org/10.1155/2023/9025984","url":null,"abstract":"Dysphoria is a transdiagnostic symptom that causes considerable suffering. Implementation of established self-care and clinical treatment options, such as mindfulness and transcranial magnetic stimulation (TMS), is typically disjointed for conditions involving dysphoria. There is a need for a rapid progression of accessible treatments that can be efficacious across multiple comorbidities. In a pilot stepwise implementation study to assess feasibility and effectiveness, adult participants with dysphoria (depression, anxiety, PTSD, and/or chronic pain) went through a treatment course of VR mindfulness, then accelerated TMS (accel-TMS) over the left dorsolateral prefrontal cortex (left dlPFC), then accel-TMS over the dorsomedial prefrontal cortex (dmPFC). Participants who did not benefit from one treatment phase progressed to the next until remission or study completion. Twenty-four participants were enrolled with 23 in VR mindfulness (phase 1), 19 in accel-TMS left dlPFC (phase 2A), and 13 in accel-TMS dmPFC (phase 2B). For our primary outcome measure of the short form-36 emotional well-being subscale (paired t -test), no significant change was found in phase 1 ( n = 19 , p = .226 ), significant improvement was found in phase 2A ( n = 19 , p = .038 ), and no significant change was found in the smaller sample of phase 2B ( n = 12 , p = .089 ). Symptom improvement was largely supported by clinician-administered scales, with more significant changes found in accel-TMS left dlPFC and dmPFC. The benefits of VR mindfulness were limited; however, both accel-TMS phases showed a significant impact on secondary measures of depression, anxiety, and PTSD. This stepwise protocol shows promise in providing an approach to rapidly improve symptoms of dysphoria in transdiagnostic populations. This trial is registered with NCT05061745.","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139250222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}