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Whereof one cannot speak, thereof one can sing The article describes an in-depth psychoanalytic treatment of a man suffering from depression, inner emptiness and the consequences of earlier traumatic experiences. It begins with behavioral pre-treatment, which lays the foundation for later psychoanalytic psychotherapy. Over the course of the therapy, an intensive process unfolds in which the patient works through deep inner states and traumatic experiences. The article sheds light on the complexity of the treatment, which is characterized by the interweaving of structural, conflict-related and traumatic aspects, and shows how the therapeutic relationship and creative forms of expression contribute to healing. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to analyze interventions for bereaved families and evaluate their effectiveness, with the ultimate goal of supporting evidence-based nursing for bereaved families. Methods: Research trends were identified based on a search of domestic databases from January 2000 to December 2022, and a meta-analysis was conducted on interventions for bereaved families. Forty-five papers were selected, and information was extracted on participants, research design, and interventions. A meta-analysis of seven papers was performed, and the effect size was calculated. Results: Fourteen papers dealt with interventions for middle-aged women who had lost their spouses, 20 used qualitative research methods, and 20 were on art therapy programs. Thirty studies had fewer than 10 participants, and most interventions had 60~120 minutes per session and 9~16 sessions in total. There were seven randomized controlled trials, and all studies included in the quality evaluation showed a low risk of bias. Four papers measured grief as an outcome, and the effect size was -1.9577 (95% CI: -2.9206 to -0.9947), indicating that the treatment significantly decreased grief (P＜0.001). Six papers measured depression as an outcome, and the effect size was -1.6775 (95% CI: -2.1835 to -1.1716), showing that the treatment significantly decreased depression (P＜0.001). Conclusion: Intervention programs for bereaved families were shown to be effective in relieving grief and depression. However, programs should be developed that target middle-aged men who have lost their spouses and children who have lost their parents. Randomized controlled trials should also be conducted on interventions to reduce grief and depression. [ABSTRACT FROM AUTHOR]

This single-case study evaluated the effects of two levels of center-based behavioral intervention for a young child with diagnoses of autism, severe attention deficit hyperactivity disorder, bipolar disorder, and severe developmental delay. The child entered an applied behavior analysis school and residential program at age 4 years. At that time he was receiving fluoxetine and valproic acid for control of challenging behavior. Six other medication trials had been attempted previously. Assessments completed just before the child entered the behavioral program estimated his overall functioning at the 8–16 month level. Throughout the study, the child participated in comprehensive behavioral programming for about 30 hours per week. For the first (A) phase of the study, the teacher:student ratio was 1:1. This phase lasted 12 months. At that point resource limitations necessitated changing the teacher:student ratio to 1:2 (the B Phase), which continued for 9 months. Then 1:1 intervention was reinstated. Dependent variables included out-of-seat behavior, aberrant behavior, motor imitation, stereotypic responses, matching to sample, and appropriate communication (recognizable signs and pictures used as mands). By the end of the first A phase (1:1 intervention), substantial improvements were documented in five of six dependent variables, and fluoxetine was discontinued. These improvements were maintained for all dependent variables three months into the B phase, but after an additional six months of 1:2 intervention gains were maintained on only one dependent variable. Nine months after a return to 1:1 intervention, improvements over B-phase levels were evident for five dependent variables, four of which returned to levels comparable to those at the end of the first 1:1 phase. © 1998 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Basically, humans desire nothing but to be happy. Humans exert much effort to make their lives meaningful and worth living. For humans, obtaining the meaning of existence is the foundation of happiness. However, despite humans' desire to be happy, an ugly truth still remains: life is a tragedy. Friedrich Nietzsche argues that life is a constant struggle and that to live is to suffer. By seeing this ugly picture of life, humans gradually fall into depression. "Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure . . . and may lead to suicide (WHO, 2021)." More so, science contends that specific brain dysfunctions cause depression, and various solutions are offered to address this, like taking anti-depressants and undergoing psychotherapy, but amidst all these, depression remains. In this case, what other means can be utilized to address the problem of depression? Using the philosophical-qualitative method, this paper will attempt to address the perennial issue of depression. This paper attempts to understand the problem of depression by tracing it to the degradation of meaning and will resolve it by explaining the essential role aesthetics plays in man's existence. [ABSTRACT FROM AUTHOR]

Aim: To review the international evidence base on interventions to support the mental health of family carers of children with brain injuries in low and middle income countries (LMIC). Methods: Searches were conducted with five electronic databases (Pubmed, Web of Science, Embase, PsycINFO, CINAHL) using search terms related to "family carers", "brain injury", "children" and "low and middle income countries". Studies were independently screened using predetermined eligibility criteria by two authors. Data were extracted from included studies using standardised data extraction and quality appraisal tools. These data were then subjected to narrative synthesis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to govern the review process. Findings: One study met our inclusion criteria and described an acquired brain injury called nodding syndrome which occurs in Sub-Saharan Africa. The study was conducted in Ghana and provided group-based psychotherapy to carers and their children. As such we found no study which sought to solely support the mental health of family carers. Conclusions: There has been a lack of focus in the literature on the mental health of family carers of children with brain injuries in LMIC. Considering the vital importance of caregivers in supporting their children it is imperative that service providers and researchers devise programmes to better meet their needs. The mental health of family carers should be better supported to improve their overall wellbeing, which will in turn improve the wellbeing of their children. [ABSTRACT FROM AUTHOR]

The resurgence of interest in psychedelic substances for psychiatric treatment has sparked both excitement and scepticism within the scientific community. This paper addresses the moralisation and hype surrounding psychedelic therapies. Through a systematic review of the literature and a detailed case study, we illustrate that the therapeutic effect of psychedelics is not solely pharmacological but is instead facilitated by their ability to enhance psychotherapy. The paper explores the historical context of psychedelics in psychiatry, their mechanism of action, and evidence of their efficacy in treating depression. We highlight the necessity of integrating psychedelics with psychotherapeutic interventions and emphasise the importance of methodological rigour and ethical standards in psychedelic research and practice. By presenting an informed understanding of psychedelic treatments, we advocate for their consideration as legitimate alternatives alongside traditional therapies, offering a potential paradigm shift in psychiatric care. [ABSTRACT FROM AUTHOR]

The paper presents a computing procedure with the goal of suggesting applicable solutions to improve complex cases of major recurrent depression. The focus is on identifying the patients' illness patterns and on finding solutions for alleviating problematic symptoms. The illness patterns synthesize the outcomes of the relationship between the patients' life themes and symptoms. The testing of the effectiveness of illness improvement solutions was conducted by evaluating and comparing the Beck scores of patients after each psychotherapy session. In addition to latent semantic analysis used to identify semantic relationships between life themes and symptoms, the research also employed the correlation method to find life themes/symptoms that are experienced undistortedly and associations between life themes that amplify latent symptoms. The computing system was applied to eleven patients with severe forms of depression and their progress was monitored for six months. The results obtained following the application of the computing system demonstrated its ability to describe personalized illness patterns and to significantly improve, through its suggestions, the illness of all patients. These findings recommend the use of the computing system in severe cases of major recurrent depression. [ABSTRACT FROM AUTHOR]

Discusses the François Martin-Vallas' paper on the relationship between two people. Distinction between the terminology concrete and symbolic, dealing with the treatment of a psychiatric patient; Concreteness in the study of François; Comparison of the study with another psychiatric study.

Nurses are at high risk of burnout and subsequent mental health concerns due to problems with overstaffing, immense workload volume, and personal health risks associated with the job. Effective mental health treatments are available but potential barriers to receiving care may prevent nurses from benefiting. The Emotional Health and Well-Being Clinic (EHWC) at Houston Methodist is an outpatient mental health clinic offering therapy and medication management services for employees and employee dependents of our institution. The EHWC is uniquely positioned to observe how nurses utilize mental health services and to address barriers to effective care for this vital group of healthcare professionals. This paper provides descriptive data on the utilization of mental health services by nurses in the EHWC and a discussion of possible challenges faced by this group when seeking care. Based on these data, we propose potential solutions to ensure that nurses can achieve maximum benefit from outpatient mental health services. [ABSTRACT FROM AUTHOR]

Background: According to the United Nations Commissioner for Refugees (UNHCR), children and adolescents represent 41% of all forcibly displaced individuals. They have to deal with conflicts, violence, and the many difficulties of flight and resettlement during a critical stage of their emotional, social, cognitive, and physical development. They are more likely to experience mental health problems during migration. Despite the several known risk factors, it is frequently challenging for refugees and asylum seekers to get mental health care. In this paper we review available studies on interventions aimed at promoting mental health and at preventing common mental disorders in immigrant adolescents and children. Methods: The relevant PubMed, Scopus, PsychINFO and Web of Science databases were searched for papers published until March 21, 2023, using ("immigrants" OR "migration" OR "asylum seekers" OR "refugees") AND ("promotion" OR "prevention") AND ("mental health" OR "mental disorders" OR "psych*") AND ("children" OR "adolescents" OR "young adults") as search string. Fourteen articles qualified for the detailed review. Results and Conclusions: The majority of available interventions, although highly heterogeneous in format and content, showed significant improvement in several psychopathological dimensions, including trauma-related symptoms, psychological stress, anxiety, depressive and cognitive symptoms. Available studies on interventions for the prevention of mental disorders and the promotion of mental health in refugees and asylum seekers children and adolescents indicate that provided interventions were associated with a global improvement for participants. Implementation strategies to improve their scalability are highly needed. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyze from an existential point of view the sources of anxiety and depression of modern man. Over time, both anxiety and depression have been lived and approached as one of the individual's maladaptations to the outside world, as its inability to create a balance between the outside world and the inner world. Every citizen of our society realizes, based on his own experience as well as by observing his peers, that anxiety and depression are ubiquitous. We are becoming more and more aware not only of the obvious situations of creating anxiety and depression today, such as the threats of war, the uncontrolled atomic bomb and of the radical political and economic upheavals but also of the least obvious but extremely profound, namely inner confusion, psychological disorientation and uncertainty about acceptable standards of conduct. Despite the fact that anxiety and depression have become a central issue in some of the cultural dimensions of our existence, often, addressing the issues has been hampered by a lack of coordination between these theories and approaches. In this sense, one of the remarkable and extremely useful works in creating an integrative vision of anxiety is the work of Rollo May, „The meaning of anxiety", which we will frequently quote in the chapter on anxiety. Thus, the paper debates and analyzes the concept of „ meaning and purpose in one's own life " and how its existence or absence influences the individual's ability to live a state of mental balance. Throughout the paper, we will review the main approaches and theories on anxiety and depression in order to have a broader perspective on the evolution of their understanding both from the point of view of psychologically and in terms of inner life. We aim to highlight the usefulness and contribution of integrative existential analysis in psychotherapeutic support for addressing anxiety and depression. Methodological support for the connection between living the existential meaning, anxiety and depression will be addressed in the chapter destined for it by which we aim to analyze the connection between the three variables and the way they are influenced. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: International reviews have looked at therapy outcomes for patients on mental health wards, showing it is associated with reduced emotional distress and readmission.Reviews have not looked at which specific treatments are most effective.No review has been done in England and Wales for patients detained specifically under the Mental Health Act. What the paper adds to existing knowledge: The paper gives an overview of the limited evidence in England and Wales.The paper shows which therapies have been measured. What are the implications for practice?: Larger studies are needed across all types of patient wards in England and Wales with random allocation to types of therapy and longer‐term follow‐up.More studies are needed where researchers are not aware of the therapy being delivered.More studies need to use a mixture of patient and clinician outcome measures.Outcomes should also measure incident, readmission and reoffending rates.More evidence is needed from patients who are female, non‐white and who are diagnosed with depression and anxiety. Introduction: The efficacy of psychological interventions delivered under the Mental Health Act (1983) (MHA) in England and Wales is unclear. While meta‐analyses have reviewed acute and forensic psychological interventions in wider geographical areas, there has been no review specifically in the unique MHA context. Aim: A systematic review was conducted of psychological outcomes for inpatients detained under the MHA in England and Wales. Method: Diagnoses and type of psychological intervention were not restricted, provided a psychological outcome measure was used. Studies were identified through APA PsychInfo, MEDLINE, CINAHL and Academic Search using a combination of key terms. Data extraction included effect direction, statistical significance, intervention type, format and duration, study size, inpatient setting, control group and study quality. Results: High‐quality evidence was sparse. Some improvements were found in overall well‐being, self‐esteem, social functioning, problem‐solving, substance use, anger, offending attitudes, fire‐setting, violence, anxiety, depression, personality disorder and psychosis. However, the overall evidence base is lacking. Discussion: Larger‐scale randomized controlled trials are needed across secure, acute and learning disability inpatient settings in England and Wales with longer term follow‐up, blind assessors and both self‐report and clinician‐rated measures, as well as incident, readmission and reoffending rates. Greater representation is needed of females, non‐white groups and affective disorders. Clinical Implications: The efficacy of psychological interventions for inpatients detained under the MHA in England and Wales remains unclear. Clinicians are encouraged to use relevant outcome measures in relation to treatment goals, to monitor the efficacy of interventions being offered to this client group. Relevance to Mental Health Nursing: This paper highlights the current body of evidence for psychological interventions in inpatient settings within England and Wales, which is an environment in which mental health nursing plays an important role in patients' recovery. This evidence is also particularly important as there is a shift in clinical practice to training nursing staff to deliver some of the low‐intensity psychological interventions, such as behavioural activation, solution‐focussed therapy and motivational interviewing. [ABSTRACT FROM AUTHOR]

Introduction: In pregnancy information to guide mothers and nursing practitioners for the treatment of depression is limited. Purpose: The purpose of this study was to investigate the responses to treatment of depression during pregnancy, in order to enable nurses to know the pros and cons of treatment for guiding and advising a pregnant woman properly. Material and method: Systematic review of the literature. The tools for the search of the literature were the electronic databases (PUBMED, GOOGLE SCHOLAR and CINAHL). The keywords used were: depression during pregnancy, perinatal depression, treatment, antidepressants during pregnancy. Results: In addition to drug therapy, there are alternative forms of depression treatment such as acupuncture, the use of morning light, individual psychotherapy, cognitive behavioral therapy, counseling and end psychodynamic therapy. But no one can guarantee their effectiveness. Conclusions: It should be further explored the issue of the treatment of pregnancy depression. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Women are more likely to experience intimate partner violence (IPV) than men; 19.2%–69.0% of women have experienced IPV, and the percentage is increasing.Survivors of IPV suffer from physical, psychological, social and reproductive health problems and numerous adverse health consequences such as post‐traumatic stress disorder, depression and anxiety. These are considered IPV comorbidities, especially among women. What the paper adds to existing knowledge?: This study reviews and reinforces existing scientific knowledge regarding the application of trauma‐informed care (TIC), including intervention content or type, frequency, duration of session and length.This study focused on the effects of TIC. Furthermore, it examines short‐term (3 months) and medium‐term (6 months) outcome effects, which are more significant for clinical practice. What are the implications for practice?: Development of a standardized protocol to address specific needs for TIC in IPV care settings.Among multidisciplinary teams, nurses are the ideal professionals to support women experiencing IPV. They can understand their traumatic experiences better, improve their therapeutic relationships and engage patients in collaborative care. Introduction: Post‐traumatic stress disorder (PTSD), depression and anxiety are considered intimate partner violence (IPV) comorbidities, especially among women. Trauma‐informed care (TIC) is the most common element of IPV care. Aim: This study analysed the short‐term (3 months) and medium‐term (6 months) outcomes of TIC on PTSD, depression and anxiety in women experiencing IPV. Method: The Preferred Items for Systematic Reviews and Meta‐Analysis guidelines were followed, and databases were searched from their inception to September 2022. Results: Thirteen randomized controlled trials included 850 women randomly assigned to the TIC and usual care groups. Overall, TIC showed a superior psychological health‐improving effect. Depression and anxiety significantly improved after treatment and at three and 6 months. No difference was observed in PTSD between the two groups at 3 and 6 months. Discussion: The growing evidence demonstrates that the lack of IPV intervention effects reported by reviews may be due to the attributes of PTSD, heterogeneity of TIC intervention design and components of TIC. Therefore, its clinical efficacy remains inconclusive. Implications for Practice: We analysed studies by stratifying intervention frequencies of once or twice a week. Regardless of the intervention frequency, length and design, PTSD decreased immediately after the TIC intervention. However, a significant difference in depression was observed after a TIC intervention of above 9 weeks. [ABSTRACT FROM AUTHOR]

What is known on the subject?: Reminiscence therapy is a common psychosocial intervention in mental health nursing.Numerous secondary studies have explored the effects of reminiscence therapy interventions in older adults, and while the effects are significant, conflicting results remain. What this paper adds to existing knowledge?: To date, research on reminiscence therapy has examined different disorders in isolation from one another.By illustrating the evidence gaps between studies, this paper highlights the need for a new evidence‐based summary overview of reminiscence therapy research.The results suggest that reminiscence therapy can be beneficial to the improvement of mental health and quality of life for older people.However, we found that the secondary studies were not of high quality and that further high‐quality literature supporting the evidence is still needed. What are the implication for practice?: Reminiscence therapy may be considered a useful non‐pharmacological intervention for older people with mental and psychological problems.However, there is a lack of normative guidelines for reminiscence therapy in terms of intervention time, frequency, and form.The development of a global standard protocol for the application of reminiscence therapy may be necessary for future randomized controlled trials (RCTs). Introduction: Reminiscence therapy is an alternative to pharmaceutical intervention provided during long‐term care, especially for older people with mental and psychological problems. However, the effects of reminiscence therapy remain inconclusive. Aim: The present study aimed to systematically identify, synthesize and describe the research evidence and quality of systematic reviews (SRs) related to reminiscence interventions for older people through an evidence‐mapping approach. Methods: Commonly used English and Chinese databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, WANFANG, VIP and SinoMed, were searched from inception till 31 March 2022. The study type was restricted to SRs with or without meta‐analysis. The methodological quality of the included SRs was assessed by A Measurement Tool to Assess Systematic Reviews (AMSTAR‐2). The Microsoft Excel 2019 tool was used for data extraction and coding, and bubble charts were used to synthesize information on the study population, intervention category, original study sample size and classification of findings. Results: A total of 28 SRs were enrolled, including 514 original studies, 91.4% of which were randomized controlled trials. The main participants of the study were depressed older people (7 publications), older people with dementia (10 publications) and ordinary older people (8 publications). The findings of 26 (92.8%) publications were categorized as either "beneficial" or "potentially beneficial." The primary outcome indicators of the effectiveness of the reminiscence intervention for older people are mental and psychological problems (especially depressive symptoms and cognitive functioning), quality of life and categories of positive psychology (e.g., life satisfaction, happiness and self‐esteem). The main factors influencing the intervention effect were the intervention period, residential setting, intervention format (group/individual) and intervention intensity. The intervention settings/contexts were mainly community and long‐term care facilities. However, the methodological quality of 27 (96.4%) of the SRs was scored as either "Low" or "Critically Low." Discussion: Reminiscence therapy has been used to study the mental health and quality of life of older people in various conditions, with significant results. However, due to the limited evidence included in the studies and the low methodological quality, there is still a need to focus on the issue of effectiveness and evidence gaps for different interventions in the field of recall in the future, in addition to efforts to improve the methodological quality and standardize the reporting process for the evaluation of reminiscence intervention systems. Implications for Practice: Reminiscence therapy may be considered a useful non‐pharmacological intervention for older people with mental and psychological problems. A standard protocol for reminiscence therapy may be necessary for future studies. [ABSTRACT FROM AUTHOR]

This paper uncovers the complexity of the term "Jian kang/health 健康" and "Fu/wellbeing (福)" by analysing their etymological origins and cultural connotations in the context of China. The paper introduces a Taoist philosophy of tradition to understand health and wellbeing. This paper argues that in Chinese cultural connotations, "Jian kang" (health) and "Fu" (wellbeing) entail the integration of human beings' physical and mental status and beyond. Notwithstanding the contextual and culturally specific philosophy and traditions of understanding health and wellbeing, this paper initiates intercultural epistemological dialogue, engages with contemporary psychotherapy, and argues that health and wellbeing is regarded and understood as a concept across cultural boundaries, while emphasising its pivotal features of being holistic, comprised of multifaceted and interrelated components of body, mind, and spirit, focusing on lifestyle behaviours, and recognising the interweaving relationship between human and the environment. [ABSTRACT FROM AUTHOR]

Background & Aims: Personality disorder is a type of mental disorder in which a rigid and unhealthy pattern of thought, performance, and behavior is observed in a person. A person with a personality disorder has difficulty in understanding and communicating with situations and people. This causes significant problems and limitations in relationships, social activities, and understanding of diseases. The presence of personality disorders in sick people leads to the development of the disease and increases the level of stress and depression in patients. Among the diseases observed in patients suffering from personality disorders such as dual personality, the presence of stress, depression, harming themselves, scratching the skin, and causing self-inflicted wounds are mentioned. Personality disorders usually start in adolescence or early adulthood. There are different types of personality disorders. Some types may become less apparent during middle age. Types of personality disorders are classified into three clusters based on similar characteristics and symptoms. Many people with one personality disorder also have signs and symptoms of at least one other personality disorder. To diagnose a disorder, showing all signs and symptoms is unnecessary. Cluster A personality disorders are characterized by abnormal and unusual thinking or behavior. They include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. Cluster B personality disorders are characterized by dramatic, overly emotional, or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder. Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder, and obsessivecompulsive personality disorder. There is increasing evidence about the negative impact of personality disorders on various physical, mental, and emotional aspects of healthy and sick people. Psychotherapy can help a person understand the effects of their behavior on others, learn to manage or cope with symptoms and reduce behaviors that cause problems in functioning and relationships. The type of treatment depends on the specific personality disorder, its severity, and the individual's condition. If personality disorders are not treated in people, the level of many diseases such as depression, cardiovascular diseases, and skin diseases will increase. Skin diseases are conditions that affect the skin. These diseases may cause rashes, inflammation, itching, or other skin changes. Some skin diseases may be genetic, while lifestyle and psychological factors such as severe obsessions and personality disorders may cause others. Both the skin and the central nervous system are derived from the ectoderm during embryogenesis. Their anatomicalfunctional relationship has been known for a long time. However, many aspects of this relationship are not fully understood. There are several studies that confirm the link between Dermatosis and mental illness. The findings of studies conducted in the field of psychiatry show that infectious-parasitic Dermatoses are the most common skin diseases in more than 70% of patients with mental disorders. The general explanation for this complication is that the physical condition of many mental patients decreases, which is associated with a decrease in immune defense and, as a result, an increase in sensitivity to skin infections. Considering the importance of skin diseases and the effect of personality disorders on this type of disease and the explanations provided, the question raised here is the relationship between personality disorders and skin diseases in various studies in the field of psychiatry. What results have been obtained and what requirements have been recommended regarding the reduction of this disease through psychotherapy? Methods: The current study is a review study that includes papers published in domestic and foreign journals available in SID, PubMed, Google Scholar, Magiran, Springer, Wiley, Web of Science (ISI), Scopus, Science direct, and ProQuest databases. The range of years 2020 to 2022 was used. Papers were searched using the keywords "acute skin diseases, skin diseases, personality disorders, mental disorders" and their English equivalents. As a result of the initial search of papers, there were 156 articles, of which 74 apapers remained in the screening stage, and at the end, 12 papers were subjected to content analysis. Results: This review study showed that personality and mental disorders have an effect on the development of skin diseases and controlling these disorders is considered as a solution to reduce the complications of skin diseases. Conclusion: In general, it can be concluded that in order to reduce the complications of skin diseases, paying attention to the personality and mental disorders of people can increase the patient's understanding of the disease and reduce the level of complications of this disease. Psychotherapy of the last century uses biological, psychological, and social factors at different levels significantly in the pathogenesis of each disease, through complex interactions in the treatment of diseases. There are many ontogenetic, anatomical, and functional connections between the skin, the psyche, and the immune system. These connections are the reason that Neuro-immunological mechanisms are often involved in the pathogenesis of Dermatoses. This is why skin diseases are classified as "paradigm" psychosomatic diseases. The skin is the only organ that is completely visible, and therefore the patient can always observe it closely. Patients are free to act on their ideas about pathogenic mechanisms. This means that, as mentioned above, clinicians, especially in the field of dermatology, must examine (and respect) patient disease models. However, skin lesions are visible not only to the patients themselves but often to other people as well. For example, patients with Dermatosis are often exposed to stigma: skin diseases may cause hatred or fear of contagion. Therefore, feelings such as embarrassment about one's illness, or disgust expressed by other people, may affect the patient's outlook on life. Some patients actually anticipate and experience imaginary stigma even in the case of minimal skin lesions. The fact that skin is very visible has also contributed to psychoanalytic theories and interpretations of psychoanalysts interested in psychosomatic medicine for skin diseases. [ABSTRACT FROM AUTHOR]

The article provides information on the linked projects concerned with training of therapists in the Conversational Model of psychotherapy. A comparative evaluation of the model and a cognitive-behavioral method in the treatment of depression and anxiety is presented. The Conversational Model involves a process of interpersonal learning through a focused conversation. Findings of studies show that the model entails specifiable therapist behaviors which can be readily taught to trainee psychiatrists.

Introduction: Evidence suggests group walking in natural environments is more beneficial to the general population's mental health than walking indoors, in urban environments, and alone. Such 'green walking groups' have been suggested as an occupational therapy intervention that could be suitable for adults with mental health problems. However, there have been no reviews of the mental health outcomes of participating in green walking groups for this population. Method: A mixed-methods literature review was conducted. A range of databases was systematically searched electronically. Papers that met pre-defined inclusion criteria were selected, critically appraised, and qualitative and quantitative data were extracted. Thematic analysis was used to identify key qualitative outcomes. Findings: Six papers were included and eight mental health outcomes identified. The evidence suggests participants can experience connections with other people, connections with nature, and a sense of freedom. There is some limited evidence to support improvements to mood, self-esteem, reflection on life tasks, and symptoms of depression, with mixed evidence for experiencing a sense of achievement. Conclusion: This review can be used to build the evidence base for the link between occupation and mental health, and inform the clinical decision-making of occupational therapists, who are well-placed to design and implement green walking groups. [ABSTRACT FROM AUTHOR]

This perspective paper explores the choice of psychotherapy for psilocybin‐assisted psychotherapy for treatment‐resistant depression. There is evidence to support the use of some psychotherapies in treating 'treatment‐resistant' depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta‐synthesis of the experience of psilocybin. The paper will examine whether three one‐to‐one psychotherapies identified as effective in the treatment of treatment‐resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short‐term dynamic psychotherapy align with that experience, although others are currently being trialled. [ABSTRACT FROM AUTHOR]

Children of parents with mental illness are at higher risk of developing cognitive, mental health or physical health difficulties. Previous studies have described several barriers for reaching parents with mental health problems (MHPs) and their utilization of psychosocial services. We conducted a cluster randomized controlled study in 24 pediatric and gynecologic practices to evaluate KID-PROTEKT, a psychosocial healthcare intervention that comprises a psychosocial assessment to identify families with psychosocial needs and refer them to support services. In this paper, we analyzed whether psychosocially distressed parents with additional MHPs (identified by the PHQ-9 and GAD-7) had higher support needs, could be referred to support and utilized it in comparison to parents with psychosocial burden only. In total, 178 pregnant women and mothers with psychosocial burden were included, of whom 55 had MHPs. Participants with MHPs were distressed in their relationships more often and medical staff rated their level of support needs higher compared to parents without MHPs. There were no significant differences between the groups regarding whether they were referred to support services or utilized the recommended services. All participants were most frequently referred to family or parent counseling/care or childcare assistance. The results indicate that despite existing barriers, parents with MHPs could be reached and identified by the KID-PROTEKT psychosocial assessment. A psychosocial intervention like KID-PROTEKT can help to provide support for mentally ill parents. [ABSTRACT FROM AUTHOR]

Background: Children and adolescents with Autism Spectrum Disorder (ASD) often experience symptoms of various mental disorders along with the characteristics that define ASD. High rates of several psychiatric disorders have been reported in people with ASD such as anxiety, depression, cognitive problems, emotional regulation difficulties and related behavioral problems can occur in children of all ages with ASD. There are many treatment programs that can help autistic persons cope with these symptoms. Cognitive and Behavioral Therapy (CBT), Information and Communication Technology (ICT) and more are treatment programs that can help people with autism recognize and manage their symptoms. Aim: This paper examines through bibliographic sources of the last 15 years the possible mental disorders that a child or adolescent with ASD may experience, as well as the therapeutic interventions that can help to manage them. Methodology: For the present bibliographic research, 15 scientific articles from English journals were used. The databases from which the scientific articles were found were PubMed, PsycINFO, MEDLINE, and Google Scholar. Results: According to the results of various studies, children and adolescents with autism show various symptoms of psychological disorders such as Anxiety Disorders, Depression and Obsessive-Compulsive Disorder. The combination of CBT and ICT can help people with autism recognize and manage their symptoms. Discussion: The various symptoms of disorders that children and adolescents with autism experience can have a major impact on their family, their daily life, their schooling, and their future work. It is of the utmost importance that these children enter into a treatment program in order to better manage and treat their symptoms. The support of the school is also very important. [ABSTRACT FROM AUTHOR]

Objectives: Problem adaptation therapy (PATH) is a relatively new psychotherapy that recognises the importance of simultaneously targeting cognitive impairment and functional disability in the treatment of late‐life depression. This is the first systematic review to examine the effectiveness of PATH. Methods: Ageline, Embase, Medline, PsycINFO, Scopus and ProQuest databases were searched from 2010 until 5 April 2024, for studies that evaluated PATH for older people. Where possible, effect sizes (Hedges' g) with 95% confidence intervals and p values were calculated and pooled using a random effects model. The reporting quality of included studies was assessed using Joanna Briggs Institute Critical Appraisal tools and certainty of the evidence behind each result assessed with The Grading of Recommendations Assessment, Development and Evaluation method. Results: Twelve papers, from seven independent studies and a pooled sample of 579 older adults with multiple comorbidities, were included in this review. PATH participants experienced immediate reductions in depression symptom ratings (gw = 0.72, p < 0.01, Nstudies = 5), alongside small improvements in disability (gw = 0.61, p = 0.04, Nstudies = 4) compared to peers that received supportive therapy, brief psychoeducation, or usual care. The overall evidence quality was, however, characterised by bias, inconsistency, and imprecision in effect estimates. Positive participant feedback and low dropout rates (15%–31%) suggested treatment satisfaction, although these data were not routinely provided. Conclusions: PATH may be a viable treatment for older people living with mental and cognitive disorders, however there is a need for more rigorous research incorporating follow‐up assessments to consolidate the effectiveness of PATH relative to other treatments. Incorporating measures of treatment fidelity are also critical to interpreting and generalising these data. The protocol for this study was prospectively published on the Open Science Framework (https://osf.io/gx57a). [ABSTRACT FROM AUTHOR]

Background: Remote measurement technologies, such as smartphones and wearable devices, can improve treatment outcomes for depression through enhanced illness characterization and monitoring. However, little is known about digital outcomes that are clinically meaningful to patients and clinicians. Moreover, if these technologies are to be successfully implemented within treatment, stakeholders' views on the barriers to and facilitators of their implementation in treatment must be considered. Objective: This study aims to identify clinically meaningful targets for digital health research in depression and explore attitudes toward their implementation in psychological services. Methods: A grounded theory approach was used on qualitative data from 3 focus groups of patients with a current diagnosis of depression and clinicians with >6 months of experience with delivering psychotherapy (N=22). Results: Emerging themes on clinical targets fell into the following two main categories: promoters and markers of change. The former are behaviors that participants engage in to promote mental health, and the latter signal a change in mood. These themes were further subdivided into external changes (changes in behavior) or internal changes (changes in thoughts or feelings) and mapped with potential digital sensors. The following six implementation acceptability themes emerged: technology-related factors, information and data management, emotional support, cognitive support, increased self-awareness, and clinical utility. Conclusions: The promoters versus markers of change differentiation have implications for a causal model of digital phenotyping in depression, which this paper presents. Internal versus external subdivisions are helpful in determining which factors are more susceptible to being measured by using active versus passive methods. The implications for implementation within psychotherapy are discussed with regard to treatment effectiveness, service provision, and patient and clinician experience. [ABSTRACT FROM AUTHOR]

Introduction: Clinically significant symptoms of depression and anxiety in coronary heart disease (CHD) patients are common and associated with adverse outcomes. Psychological treatments have shown limited effectiveness and more effective treatments have been requested. Attention training technique (ATT), a component of metacognitive therapy, can potentially be effective as a standalone treatment for anxiety and depression. In an open study, ATT delivered face-to-face in a group format was feasible and potentially effective for improving depression and anxiety symptoms in CHD patients. The next progressive step is to test the effectiveness of ATT in a randomized controlled trial. This paper describes the methodology of this trial. Methods: ATT-CHD is a randomized wait-list (WL) controlled study. Eligible CHD patients from two hospitals with Hospital Anxiety and Depression Scale (HADS)- Anxiety and/or HADS-Depression subscales scores =8 will be randomized into ATT (n = 32) or WL control (n = 32). After 6-8 weeks, WL patients will be allocated to ATT. Participants will be evaluated pre-, mid- and post-treatment, and at 6-months follow-up using changes in HADS as primary outcome. Secondary outcomes will be changes in psychiatric disorders, rumination, worry, type D-personality, metacognitions, insomnia, quality of life, and C-Reactive protein (CRP). Discussion: To our knowledge, this will be the first WL-controlled randomized study testing the effectiveness of group-based ATT as treatment of symptoms of anxiety and depression in CHD patients. It will also explore correlations between changes in psychological distress and CRP. A qualitative analysis will reveal patients' experience with ATT including processes that may facilitate or serve as barriers to effectiveness. Recruitment into the study commenced in December 2022. Ethics and dissemination: The Regional Committees for Medical and Health Research Ethics (REK), Norway has granted approval for the study (ID 52002). The trial results will be published in peer-reviewed journals. According to Norwegian legislation, the Norwegian Data Protection Authority, and the Committee of Ethics, we are not allowed to share original study data publicly. [ABSTRACT FROM AUTHOR]

Purpose: Bipolar disorder is associated with poor mental and physical health outcomes, and therefore, it is crucial to research and develop effective interventions for this population (Grande et al., 2016). Unfortunately, research on the efficacy of current interventions shows only small improvements in symptoms and quality of life (Oud et al., 2016). Additionally, individuals with bipolar disorder face barriers to accessing care like social stigma, isolation and financial constraints (Blixen et al., 2016). This paper aims to introduce and examine the effectiveness of an accessible, peer-led group program, Mood Lifters (Votta and Deldin, 2022), in those who completed the program and also self-reported a diagnosis of bipolar disorder. Design/methodology/approach: Mood Lifters is a 15-week, peer-led group program that approaches mental wellness from a biopsychosocial framework using strategies from a variety of evidence-based treatment methods (e.g. cognitive-behavioral therapy, dialectical behavior therapy, interpersonal psychotherapy, etc.). Participants meet once a week for 1 hour to review various mental health topics, including behavioral changes and insight into mood patterns. Individuals who participated in nonacademic groups in a company setting and self-reported a bipolar diagnosis were surveyed at the beginning and end of their program to measure various aspects of psychological functioning. Findings: Results suggest that these individuals experienced significant improvements in depression, anxiety, social functioning and perceived stress, along with flourishing and positive and negative affect. Originality/value: These findings are promising, given that bipolar disorder is historically difficult to treat (Grande et al., 2016). Based on this preliminary evidence, the authors have developed a Mood Lifters program specifically for individuals with bipolar disorder and are launching a randomized control clinical trial. [ABSTRACT FROM AUTHOR]

Over the past 16 years, we have developed a 'Meta-analytic Research Domain' (MARD) of all randomized trials of psychological treatments of depression. A MARD is a living systematic review of a research field, that cannot be otherwise covered by one (network) meta-analysis and includes multiple PICOs. In this paper we give an overview of the findings of this MARD. A narrative review of the results of the 118 meta-analyses on psychotherapies for depression that were published within our MARD. Most research has been conducted on cognitive-behavioral therapy (CBT), but several other psychotherapies are also effective, with few differences between therapies. They can be effectively delivered in individual, group, telephone and guided self-help format and are effective in many different target groups and across different age groups, although the effects are significantly smaller in children and adolescents. Psychotherapies have comparable effects as pharmacotherapy at the short term but are probably more effective at the longer term. Combined treatment is more effective than either psychotherapy or pharmacotherapy alone at the short, but also at the longer term. We did not summarize all published meta-analyses (protocols, methodological studies) and have not compared our results to those found in other meta-analyses on comparable subjects. Psychotherapies can contribute considerably to a reduction of the disease burden of depression. MARDs are an important next step in the aggregation of knowledge from randomized controlled trials in psychological treatments of depression as well as in other healthcare sectors. • The paper gives a complete overview of what is known about therapies for depression. • Several different types of therapy are effective. • Therapy can be effectively be delivered in different formats. • Therapy is as effective as drugs at the short, but more effective at the long term. • Combined treatment is better than drugs or psychotherapy alone. [ABSTRACT FROM AUTHOR]

The intention of this paper is to explore how societal food choices may be affecting our clients' mentation and to discuss alternative drivers behind their feelings of anger, sadness and fear that potentially lead to fixed moods of anxiety and depression. The current perception of nutrition within psychotherapy is framed within lifestyle, self‐care enquiry and a rich, metaphorical use of digestive systems within the therapeutic process. Yet over the last two decades the synthesis of nutritional therapy with psychiatry has theorized a network of ideas under the umbrella title of 'nutritional psychiatry', which links positivist research to suggest poor diet and gut microbiome health are also factors behind the development of mental illnesses. The differing epistemological positions in these two fields create a challenge to the case study used which explores working psychotherapeutically with a client's food choices, whilst interrogating whether nutritional psychiatric‐derived theories relate to the client work and how to incorporate these ideas within psychotherapeutic practice. [ABSTRACT FROM AUTHOR]

Background: The treatment of anxiety and depressive symptoms following acquired brain injury is complex and more evidence-based treatment options are needed. We are currently evaluating the BrainACT intervention; acceptance and commitment therapy for people with acquired brain injury. Rationale: This paper describes the theoretical underpinning, the development and content of BrainACT. Acceptance and commitment therapy focuses on the acceptance of feelings, thoughts and bodily sensations and on living a valued life, without fighting against what is lost. Since the thoughts that people with acquired brain injury can experience are often realistic or appropriate given their situation, this may be a suitable approach. Theory into practice: Existing evidence-based protocols were adapted for the needs and potential cognitive deficits after brain injury. General alterations are the use of visual materials, summaries and repetition. Acceptance and commitment therapy-specific adaptions include the Bus of Life metaphor as a recurrent exercise, shorter mindfulness exercises, simplified explanations, a focus on experiential exercises and the monitoring of committed actions. The intervention consists of eight one-hour sessions with a psychologist, experienced in acceptance and commitment therapy and in working with people with acquired brain injury. The order of the sessions, metaphors and exercises can be tailored to the needs of the patients. Discussion: Currently, the effectiveness and feasibility of the intervention is evaluated in a randomised controlled trial. The BrainACT intervention is expected to be a feasible and effective intervention for people with anxiety or depressive symptoms following acquired brain injury. [ABSTRACT FROM AUTHOR]

The effects of war on combat veterans' mental health are numerous and well established. Several effective interventions exist based on cognitive-behavioural therapy that aim to reduce the symptoms of anxiety, depression and PTSD that many veterans struggle with. However, little attention has been paid to psychodynamic psychotherapy and documenting its use in treating the sequelae of war trauma. Furthermore, very few writings discuss how working with combat veterans within a psychodynamic framework can affect the therapist. This paper presents the case of 'Sam', a combat veteran who suddenly disappeared from psychotherapy after some years in treatment. The author reflects on the issues that arose in this course of therapy with the aim to stimulate further reflection in practitioners working with veterans drawing upon a psychodynamic model. It is hoped that readers and organisations supporting veteran mental health will develop an appreciation of the intricacies of psychodynamic psychotherapy with combat veterans, understand the importance of the therapeutic alliance, appreciate the impact that working with combat veterans may have on themselves and the importance of seeking and maintaining high-quality supervision and reflection. [ABSTRACT FROM AUTHOR]

Social isolation and reduced social participation are common after traumatic brain injury (TBI). Developing interventions that aim to increase social participation through recreation or leisure activities continues to be challenging. This scoping review was conducted to provide an overview of interventions used to increase social participation through in-person recreation or leisure activity for adults with moderate to severe TBI living in the community. Using the Arksey and O'Malley framework, a scoping review of the literature published from 2005 to 2023 was conducted across four databases: Medline, CINAHL, PsycINFO and Scopus. Quality appraisals were conducted for included studies. Following the removal of duplicates, 10,056 studies were screened and 52 were retained for full-text screening. Seven papers were included in the final review. Studies varied with respect to the type of intervention and program outcomes. The interpretation was impeded by study quality, with only two studies providing higher levels of evidence. Barriers and facilitators to successful program outcomes were identified. Few studies with interventions focused on increasing social participation in leisure or recreation activity were identified. Further research incorporating mixed methods and longitudinal design to evaluate effectiveness over time is needed to build the evidence base for increasing social participation through leisure activity. There is evidence to support participating in recreation and leisure activities that involve interactions with others can increase social participation outcomes for adults with moderate to severe traumatic brain injury. Participating in leisure-based interventions not only provides opportunities for social connection but may also impact positively on personal wellbeing, enjoyment, and confidence. Understanding the range of personal, practical, support, and activity factors that can facilitate or obstruct participation in leisure or recreational activity programs at an individual level may improve social participation outcomes. Measuring the impact of an intervention for social participation should include post-intervention changes across outcome domains and over time [ABSTRACT FROM AUTHOR]

Depression, frequently associated with cancer, significantly impacts health outcomes, necessitating effective treatments. This systematic review and meta-analysis aim to synthesize and critically evaluate the evidence from randomized controlled trials (RCTs) for the efficacy of nurse-led psychological interventions in managing depression among adult cancer patients. It focuses on the unique contribution of these interventions to improving depression management in oncology care, an underrepresented area in the existing literature. We conducted a comprehensive search in databases including Scopus, Medline, CINAHL, and PsycINFO, applying strict criteria to select RCTs assessing nurse-led psychological interventions for depression in cancer patients. We used the Cochrane Risk of Bias 2 tool to assess study quality. Out of 425 screened abstracts, nine papers describing seven distinct interventions involving 1463 participants were selected. The overall effect size estimate of −0.75 (95% confidence interval: −1.23 to −0.27) indicates significant effectiveness of these interventions in reducing depression compared to treatment as usual. Additionally, the calculated prediction interval highlights the variability in effectiveness across different settings, suggesting that contextual factors play a crucial role in the success of these interventions. The findings advocate for the integration of nurse-led psychological interventions into standard cancer care, highlighting their efficacy in improving depressive symptoms in adult cancer patients. These interventions show promise but require further refinement and research to optimize their effectiveness across diverse patient groups and healthcare settings. This review underscores the potential of nurse-led psychological interventions in enriching oncology care and addresses a critical gap in the existing body of research. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused concern regarding suicide risk mitigation while requiring many clinicians to transition to telehealth. We hypothesized that this transition would increase suicide intent, suicide desire, and depressive symptom ratings from pre-COVID-19 to peri-COVID-19. Patients at a southeastern US outpatient psychotherapy training clinic reported on suicide risk and depressive symptoms before and after the transition to telehealth treatment. Additionally, the effect of continuation of treatment on suicide risk was also analyzed. Suicide risk levels (n=39) and depressive symptoms (n=25) did not increase following the transition to telehealth. Self-reported suicide desire ratings significantly decreased from pre- to peri-pandemic assessments. Findings suggest that telehealth, among other sociocultural factors, became somewhat of a "port in a storm," such that it may have provided protections from exacerbations of mental health concerns and further vulnerabilities towards increased suicide risk. This paper concludes with relevant implications and suggestions for community health clinics. [ABSTRACT FROM AUTHOR]

INTRODUCTION With the advent of new tobacco products, poly-tobacco use among adolescents is increasing. Smoking among adolescents negatively impacts both their physical and mental health. This study aimed to determine poly-tobacco use among adolescents in South Korea and to identify the mental health problems caused by single-, dual-, and poly-tobacco use. METHODS Data from 54948 adolescents in the 2020 Korea Youth Behavior Web-based Survey were included. Mental health variables of our primary outcome were loneliness, anxiety, and depression. Descriptive statistics, Rao-Scott χ² test and complex sample multivariable logistic regression analysis were conducted to determine the association between the type of tobacco product use and mental health. RESULTS Among the subjects, 95.2% were non-tobacco users, followed by single (3.0%), dual (1.1%), and poly users (0.7%). The subjects with poly-tobacco use had significantly higher rates of loneliness (33.2%, p<0.001), anxiety (22.3%, p<0.001), and depression (49.9%, p<0.001) than those who used fewer tobacco products. Subjects who used poly-tobacco products were 2.13 (95% CI: 1.61-2.83) times more likely to report loneliness, 1.52 (95% CI: 1.12-2.07) times more likely to report anxiety, and 2.18 (95% CI: 1.68-2.82) times more likely to report depression than non-tobacco users. CONCLUSIONS Among adolescents, poly-tobacco use is associated with symptoms of loneliness, depression, and anxiety, which are internalized mental health problems. Poly-tobacco use warrants early assessment of high-risk groups, education on the need for tobacco-use cessation, and active intervention for the psychological difficulties that these high-risk groups experience. [ABSTRACT FROM AUTHOR]

Simple Summary: Genesis and definition of the VGT® approach. Video games have been increasingly used as a form of therapy for various mental health conditions. Research has shown that video games can be used to treat conditions such as depression, anxiety, PTSD, and addiction. One of the main benefits of video games in therapy is that they can provide a sense of engagement and immersion that traditional therapy methods may lack. Additionally, video games can teach valuable skills such as problem solving, decision making, and coping strategies. Video games can also simulate real-life scenarios, allowing individuals to practice and improve social skills in a safe and controlled environment. Furthermore, video games can provide feedback and track progress objectively and quantifiably. This paper proposes an approach, the Video Game Therapy® (VGT®) approach, where game experience is put at the center of the therapy in a tailored way, connecting the individual patient's personality, the therapy's goals, and the suggested type of video game through the Myers Briggs Type Indicator (MBTI).VGT®'s core assumption is that playing video games could facilitate patients in reaching conditions where traditional methodologies and therapeutic approaches could work best. VGT® was elaborated according to the Adlerian therapy vision and, consequently, the different phases of Adlerian therapy and VGT® match. Despite the use of video games in psychotherapy might have some adverse effects in specific cases, VGT® is currently used in three associations with positive results in promoting emotional experimentation and literacy, social feeling, sense of identity, and activating cognitive processes. Future developments include expanding the use of VGT® further to validate such results from a statistical point of view. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) contributes to a significant proportion of disease burden, disability, economic losses, and impact on need of treatment and health care in Brazil, but systematic information about its treatment coverage is scarce. This paper aims to estimate the gap in treatment coverage for MDD and identify key bottlenecks in obtaining adequate treatment among adult residents in the São Paulo Metropolitan area, Brazil. Methods: A representative face-to-face household survey was conducted among 2942 respondents aged 18+ years to assess 12-month MDD, characteristics of 12-month treatment received, and bottlenecks to deliver care through the World Mental Health Composite International Diagnostic Interview. Results: Among those with MDD (n = 491), 164 (33.3% [SE, 1.9]) were seen in health services, with an overall 66.7% treatment gap, and only 25.2% [SE, 4.2] received effective treatment coverage, which represents 8.5% of those in need, with a 91.5% gap in adequate care (66.4% due to lack of utilization and 25.1% due to inadequate quality and adherence). Critical service bottlenecks identified were: use of psychotropic medication (12.2 percentage points drop), use of antidepressants (6.5), adequate medication control (6.8), receiving psychotherapy (19.8). Conclusions: This is the first study demonstrating the huge treatment gaps for MDD in Brazil, considering not only overall coverage, but also identifying specific quality- and user-adjusted bottlenecks in delivering pharmacological and psychotherapeutic care. These results call for urgent combined actions focused in reducing effective treatment gaps within services utilization, as well as in reducing gaps in availability and accessibility of services, and acceptability of care for those in need. [ABSTRACT FROM AUTHOR]

Objectives: This paper aimed to explore the experiences of depressed adolescents who completed but did not 'respond' to standard psychotherapy, based on a lack of improvement in pre‐post symptoms scores. Design: This was a qualitative study employing interpretative phenomenological analysis (IPA). Method: Seventy‐seven adolescents with moderate to severe depression were interviewed as part of a qualitative arm of a randomised controlled trial. Five adolescents' post‐treatment interviews were purposively sampled, based on lack of improvement on pre‐post symptom scores, and adolescents still scoring above the clinical threshold for depression. The interviews were analysed using IPA. Results: Adolescents made sense of their depression as part of their identity and held negative expectations of therapy. Some aspects of therapy brought up intolerable feelings that contributed to disengagement in the therapeutic process and culminated in disappointing and hopeless endings. On the other hand, where a stronger therapeutic relationship was developed, some participants experienced certain improvements. Conclusions: Findings highlight how actively exploring the adolescent's therapy expectations, developing a strong early therapeutic relationship and being mindful of the potential impact of endings are important in therapeutic work with adolescents with depression, especially where they may have a strong sense of hopelessness and self‐criticism. Moreover, the finding that adolescents experienced improvements in other domains despite a lack of symptom reduction highlights the need to review how treatment outcomes are currently defined. Integrating individual perspectives of therapy with quantitative outcome measures can provide a more nuanced insight of treatment effects. [ABSTRACT FROM AUTHOR]

Major depressive disorder is a common, recurrent, disabling and costly disorder that is often severe and/or chronic, and for which non-remission on guideline concordant first-line antidepressant treatment is the norm. A sizeable percentage of patients diagnosed with MDD do not achieve full remission after receiving antidepressant treatment. How to understand or approach these 'refractory', 'TRD' or 'difficult to treat' patients need to be revisited. Treatment resistant depression (TRD) has been described elsewhere as failure to respond to adequate treatment by two different antidepressants. This definition is problematic as it suggests that TRD is a subtype of major depressive disorder (MDD), inferring a boundary between TRD and depression that is not treatment resistant. However, there is scant evidence to suggest that a discrete TRD entity exists as a distinct subtype of MDD, which itself is not a discrete or homogeneous entity. Similarly, the boundary between TRD and other forms of depression is predicated at least in part on regulatory and research requirements rather than biological evidence or clinical utility. This paper aims to investigate the notion of treatment failure in order to understand (i) what is TRD in the context of a broader formulation based on the understanding of depression, (ii) what factors make an individual patient difficult to treat, and (iii) what is the appropriate and individualised treatment strategy, predicated on an individual with refractory forms of depression? Expert contributors to this paper were sought internationally by contacting representatives of key professional societies in the treatment of MDD – World Federation of Societies for Biological Psychiatry, Australasian Society for Bipolar and Depressive Disorders, International Society for Affective Disorders, Collegium Internationale Neuro-Psychopharmacologium and the Canadian Network for Mood and Anxiety Treatments. The manuscript was prepared through iterative editing. The concept of TRD as a discrete subtype of MDD, defined by failure to respond to pharmacotherapy, is not supported by evidence. Between 15 and 30% of depressive episodes fail to respond to adequate trials of 2 antidepressants, and 68% of individuals do not achieve remission from depression after a first-line course of antidepressant treatment. Failure to respond to antidepressant treatment, somatic therapies or psychotherapies may often reflect other factors including; biological resistance, diagnostic error, limitations of current therapies, psychosocial variables, a past history of exposure to childhood maltreatment or abuse, job satisfaction, personality disorders, co-morbid mental and physical disorders, substance use or non-adherence to treatment. Only a subset of patients not responding to antidepressant treatment can be explained through pharmacokinetic or pharmacodynamics mechanisms. We propose that non remitting MDD should be personalised, and propose a strategy of 'deconstructing depression'. By this approach, the clinician considers which factors contribute to making this individual both depressed and 'resistant' to previous therapeutic approaches. Clinical formulation is required to understand the nature of the depression. Many predictors of response are not biological, and reflect a confluence of biological, psychological, and sociocultural factors, which may influence the illness in a particular individual. After deconstructing depression at a personalised level, a personalised treatment plan can be constructed. The treatment plan needs to address the factors that have contributed to the individual's hard to treat depression. In addition, an individual with a history of illness may have a lot of accumulated life issues due to consequences of their illness, and these should be addressed in a recovery plan. A 'deconstructing depression' qualitative rubric does not easily provide clear inclusion and exclusion criteria for researchers wanting to investigate TRD. MDD is a polymorphic disorder and many individuals who fail to respond to standard pharmacotherapy and are considered hard to treat. These patients are best served by personalised approaches that deconstruct the factors that have contributed to the patient's depression and implementing a treatment plan that adequately addresses these factors. The existence of TRD as a discrete and distinct subtype of MDD, defined by two treatment failures, is not supported by evidence. [ABSTRACT FROM AUTHOR]

SUMMARY: Depression has a large socioeconomic burden, affecting an estimated 280 million people worldwide. Up to 55% remain symptomatic following pharmacological and psychological treatment and may be classified as having treatment-resistant depression. This commentary assesses two treatment options for this group – electroconvulsive therapy (ECT) and a novel approach, magnetic seizure therapy (MST) – with reference to a Cochrane Review comparing the two. The Cochrane analysis showed no clear benefit for MST, but the evidence is currently insufficient to draw firm conclusions. [ABSTRACT FROM AUTHOR]

Satisfying daily life functioning is essential in mental healthcare. Standard assessments focus on symptoms and are designed to detect underlying vulnerabilities. However, they offer insufficient insight into patterns of contextual variability and resilience. Consequently, interventions are planned using incomplete information. The experience‐sampling method (ESM) is a structured moment‐to‐moment diary assessing the individual's affect, thoughts, perception and behaviour in the daily life context. ESM helps to understand variation in mental states (e.g., anxiety or sleeping problems) as adaptational processes in relation to contextual challenges (functional analysis). Although ESM has been extensively studied across psychological disorders, the adoption by mental health professionals and their patients remains limited because the 'how to' is unclear. This paper presents a practical guide for ESM application in routine clinical care. It integrates empirical knowledge with expert experiences and provides real‐world examples and recommendations for successful implementation. The guide comprises how to engage and motivate patients and how to customize assessments to the patient's needs. It also includes instructions to interpret results and create an atmosphere of shared decision‐making. Experience‐sampling technology has merits for patients with various mental health complaints and across healthcare settings, although the exact use and implementation may vary depending on the individual case. [ABSTRACT FROM AUTHOR]

Objective. The purpose is to understand the depression status of the elderly in the community, explore its influencing factors, formulate a comprehensive psychological intervention plan according to the influencing factors, implement demonstration psychological intervention, and evaluate and feedback the effect, so as to provide a reference for improving the mental health of the elderly. Method. In order to make the output of different emotional data in LSTM more discriminative, a method to dynamically filter the output of LSTM is proposed. Combining the methods of Attention-LSTM, time-dimensional AI attention, and feature-dimensional AI attention, the best model in this paper is obtained. The multistage stratified cluster sampling method was used to conduct a questionnaire survey on the elderly aged 60 and above in a certain area, including the general demographic characteristics questionnaire of the elderly, the self-rating scale of mental health symptoms, and the health self-management ability of adults. All data were entered into a database using Excel software, and SPSS 19.0 statistical software was used for statistical analysis. Results/Discussion. The detection rate of depression (GDS ≥ 11 points) among the elderly in a community in a certain area was 39.38%. Multivariate logistic regression analysis showed that family history of mental illness, more negative life events, decreased ability of daily living, living alone, and suffering from physical diseases in the past six months were the risk factors for depression in the elderly. Community health education can partially alleviate depression in the elderly. The detection rate and degree of depression of the elderly in the comprehensive psychological intervention group were significantly lower than those in the control group, and the difference was statistically significant (P < 0.05). [ABSTRACT FROM AUTHOR]

The United Kingdom IAPT (Improving Access to Psychological Therapies) approach of delivering low intensity therapies for symptoms of depression and anxiety was adapted for Australia and named NewAccess. Clinical outcomes of the service were evaluated in three sites between October 2013 and 2016. This paper describes the clinical outcomes in the Australian health setting. Prospective cohort study with repeated measures. Both intent-to-treat and per protocol analyses were conducted for primary outcomes measures Patient Health Questionnaire-9 (nine item), and Generalised Anxiety Disorder (seven item). Secondary measures were Phobia Scale and Work and Social Adjustment Scale. Three thousand nine hundred and forty-six individuals were assessed, and 3269 attended at least two treatment sessions. Forty percent were males. There was a clinically meaningful reduction (improvement) shown by reliable recovery rates in both depression and anxiety symptoms at post-treatment assessment (68%; 95% CI: 66–70%) with large effect sizes (1.23 for depression and 1.25 for anxiety). Outcomes in PHQ-9 and GAD-7 were not influenced by age or sex, but recovery rates were significantly reduced by relationship status (single or separated). Unemployment reduced PHQ-9 outcomes but not GAD-7 outcomes. NewAccess demonstrated positive clinical outcomes in Australia, that compared favourably with international studies with the same methodology. [ABSTRACT FROM AUTHOR]

Objectives: Presentation of persistent physical symptoms is associated with increased health care utilization, yet clinical outcomes often remain suboptimal. This systematic review aimed to determine whether psychological interventions are effective for the management of PPS and if so, what are the features of the interventions and at what level of care are they delivered. The review also set out to establish which symptoms in those diagnosed with PPS can be effectively managed with psychological intervention. Methods: Studies were included if they clearly reported a psychological intervention, specified the study sample as adults with a diagnosis of persistent physical symptoms, included a comparator and as a minimum an outcome measure of somatic symptoms. Risk of bias was assessed using the EPHPP. Meta‐analysis was conducted to estimate the overall effect of interventions on somatic symptoms (the primary outcome), anxiety and depression (secondary outcomes). Results: Seventeen papers of varying quality indicated that psychological interventions can be effective for the management of somatic symptoms reported by individuals with PPS within a primary care setting. Psychological interventions were also found to be effective at reducing depression symptoms in individuals with PPS in twelve of the included studies. However, the meta‐analysis results suggest that the psychological interventions utilized within eleven of the included studies did not significantly impact anxiety symptoms. Conclusions: Psychological interventions have some success in managing somatic symptoms in PPS patients within primary care settings although their effects on other psychological symptoms is more mixed. The review highlights the importance of establishing a clearer diagnostic classification to inform treatment trajectories and the need for appropriate training and support within a multi‐disciplinary team to enable the provision of such therapies. [ABSTRACT FROM AUTHOR]

Objective: Stepped care models are a possible solution to address service gaps in the provision of psychological therapies for anxiety and/or depression. The benefits may be particularly relevant for people in rural and remote areas and other under‐serviced and/or hard to reach populations, such as older adults. Design: Narrative literature review. Participants: Narrative literature review of the PubMed, Medline, and Psycinfo databases for studies reporting on the results of stepped care psychological interventions for older adults with anxiety and/or depressive symptoms. Main outcomes: Seventy‐seven papers were identified for evaluation of which nine papers met the study criteria (reporting on four individual trials). Results: We identified four controlled studies. Three of the four studies found stepped care intervention to be associated with significantly better clinical outcomes and cost‐effectiveness compared to treatment as usual. Studies primarily targeted subthreshold symptoms, mostly in primary care. Various interventions and stepping models were used. Conclusion: Stepped care has been associated with improved clinical outcomes and costs in older adults, particularly in primary care. There have been no rigorous studies of stepped delivery of psychological interventions to older depressed and anxious adults in alternative settings such as in specialist older adult mental health services or in private clinics. Although the evidence‐base for stepped care interventions is growing, it is not clear what evidence‐based treatment model should be adopted and in what services it could apply. More research is needed. However, the evidence to date is promising and suggests that stepped care approaches are feasible in older adults, and are likely to increase access to high quality interventions for older adults living in rural communities. [ABSTRACT FROM AUTHOR]

Background: Worldwide, hepatobiliary cancers are frequent diseases and often accompanied by a poor prognosis. These cancers, with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CHC) being the most frequent, are often associated with a considerable amount of psychological burden such as anxiety, depressiveness, and reduced health-related quality of life (HRQOL) which may lead to psychiatric comorbidities. This systematic review gives an overview on psychological burden and on the effectiveness of psycho-oncological interventions for patients with HCC and CHC. Methods: The databases PubMed, PubPsych, and PsycINFO were used and searched using the following combination of terms: (Neoplasm OR Cancer OR Tumor OR Carcinoma) AND (Psycho-Oncology OR Psychotherapy OR Psychiatr∗) AND (Liver OR Hepatic OR Hepatocellular OR Gallbladder OR Bile∗). Studies were eligible for inclusion if investigating patients affected with tumors of the liver (HCC/CHC) and using diagnostic instruments to assess mental health symptoms and research concerning specific psycho-oncological interventions. In total, 1027 studies were screened by one author with regard to title and abstracts. Afterward, the two authors of the paper discussed inclusion of possible articles. Results: Twelve studies focusing on distress, anxiety, and depression symptoms as well as quality of life among patients with HCC/CHC and three studies on psycho-oncological interventions were included. Patients suffering from hepatobiliary cancers often experience considerable psychological burden. A quarter of patients suffer from depressive symptoms; anxiety is even more common among these patients with almost 40%. The HRQOL of those affected is reduced in almost all areas, suicide rates increased and the level of distress is considerably increased in one third of patients even in comparison to those with other kinds of cancer. By psycho-oncological intervention the prevalence of depressive symptoms and anxiety can be reduced, while the quality of life and also the survival rate of patients with hepatobiliary cancer can be increased. Discussion and Conclusion: Psychological burden is high in patients with hepatobiliary cancers as reflected in high levels of depressiveness and anxiety as well as reduced quality of life. The use of psycho-oncological interventions can reduce psychological burden and increase quality of life compared to patients receiving standard support only. Systematic Review Registration: (prospero), identifier (CRD42021243192). [ABSTRACT FROM AUTHOR]

Patients with mild cognitive impairment (MCI) and dementia are more prone to depression than people without MCI or dementia. Some studies have found nonpharmacological multi‐component intervention to be more effective than single‐component intervention in improving the condition of patients with MCI and dementia; however, their effect on depressive symptoms is still inconsistent. Therefore, it is necessary to explore the effectiveness of nonpharmacological multi‐component intervention in improving depressive symptoms in patients with MCI and dementia. This review retrieved papers from PubMed, Embase, Cochrane Library, CINAHL, PsycINFO and CNKI. The retrieval time limit was set from 1 January 1990 to 25 November 2022. The PRISMA 2020 guideline was used to report the included studies. The result showed that nonpharmacological multi‐component intervention could improve depressive symptoms in patients with MCI and dementia. Among them, nonpharmacological multi‐component intervention with a duration of <6 months, physical and cognitive activities, or other activities had significant effects. However, each study differed in terms of specific measures, duration and frequency of intervention methods. Accordingly, more randomized controlled trials with larger samples are required to discover the best scheme for nonpharmacological multi‐component intervention. [ABSTRACT FROM AUTHOR]

The increasing need for mental health support and a shortage of therapists have led to the development of the eXtended-reality Artificial Intelligence Assistant (XAIA). This platform combines spatial computing, virtual reality (VR), and artificial intelligence (AI) to provide immersive mental health support. Utilizing GPT-4 for AI-driven therapy, XAIA engaged participants with mild-to-moderate anxiety or depression in biophilic VR environments. Speaking with an AI therapy avatar in VR was considered acceptable, helpful, and safe, with participants observed to engage genuinely with the program. However, some still favored human interaction and identified shortcomings with using a digital VR therapist. The study provides initial evidence of the acceptability and safety of AI psychotherapy via spatial computing, warranting further research on technical enhancements and clinical impact. [ABSTRACT FROM AUTHOR]

Background: Almost no research has been published reporting on evaluations of the effectiveness of psychological interventions for people with severe to profound intellectual disabilities and depression. This paper describes the development and initial feasibility testing of an adapted Behavioural Activation therapy (BeatIt2) for this population. Method: Phase 1 of the study examined participant recruitment and willingness to be randomised in the context of a planned Randomised Controlled Trial (RCT). Phase 2 examined the feasibility of delivering the intervention. Results: Twenty adults with a severe or profound intellectual disability and clinically significant depression were recruited to Phase 1 of the study. In Phase 2, there was 100% participant retention for those recruited to the study at 6‐month follow‐up. The BeatIt2 therapy was reported to be acceptable for participants. Conclusion: COVID disruption meant that it was not possible to complete the planned feasibility RCT. The positive findings suggest that additional evaluation of BeatIt2 is warranted. [ABSTRACT FROM AUTHOR]

Objectives: Dysfunctional attitudes (DA) are higher in depression; however, less is understood about their role in bipolar disorder (BD). This paper aimed to explore the presence of DA in BD in comparison to clinical and non‐clinical groups. Also explored were the associations between DA and mood states of depression, mania or euthymia in BD. Methods: A systematic review and meta‐analysis were conducted. A total of 47 articles were included in the systematic review of which 23 were included in the meta‐analysis. The quality of each study was rated. Results: The meta‐analysis showed significantly higher DA in BD than healthy controls (d =.70). However, no difference was observed between BD and unipolar participants (d = −.16). When reviewing mood state within BD, a significant mean difference was found between DA scores for euthymic and depressed participants (d = −.71), with those who were depressed scoring higher. Three studies found that psychological therapies significantly reduce DA in BD (d = −.38). Conclusions: These findings imply not only that DA are both a characteristic of BD that is not as prevalent in healthy populations but also that a depressed mood state is associated with increased severity. This implies that DA could possibly go 'offline' when mood symptoms are not present. Psychological therapies appear to reduce DA in BD. Implications for future research as well as practice‐based implications are expanded on in the discussion. [ABSTRACT FROM AUTHOR]