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Suicidal ideation (SI) is a significant public health concern with increasing prevalence. Therapist-supported digital mental health interventions (DMHI) are an emergent modality to address common mental health problems like depression and anxiety, although less is known about SI. This study examined SI trajectories among 778 patients who participated in a therapist-supported DMHI using multilevel models during and up to 6-months post-treatment. Estimates of associated suicide attempts and deaths by suicide were calculated using published data linking PHQ-9-assessed SI to records of suicide attempts and deaths by suicide. The proportion of participants reporting no SI significantly increased between baseline and end-of-treatment (78.02% to 91.00%). Effect sizes of SI changes between baseline and end-of-treatment, 3-month, and 6-month follow-ups were 0.33 (95%CI = 0.27–0.38), 0.32 (95%CI = 0.27–0.38), and 0.32 (95%CI = 0.27–0.38), respectively. Results also indicated an estimated 30.49% reduction (95%CI = 25.15%-35.13%) in suicide attempts and death by suicide across treatment. This study provides preliminary evidence of the effectiveness of a therapist-supported DMHI in reducing SI. [ABSTRACT FROM AUTHOR]

Purpose: This study examined treatment outcomes (depression and anxiety symptoms) up to 24 months after completion of a therapist‐supported digital mental health intervention (DMHI). Methods: The sample consisted of 380 participants who participated in an eight‐week DMHI from February 6, 2017 to May 20, 2019. Participants reported depression and anxiety symptoms at eight timepoints from baseline to 24 months. Mixed‐effects modelling was used to investigate symptom changes over time. The proportion of participants meeting criteria for treatment response, clinically significant change, and remission of depression and anxiety symptoms were calculated, including proportions demonstrating each outcome sustained up to each timepoint. Results: Multivariate analyses yielded statistically significant reductions in depression (β = −5.40) and anxiety (β = −3.31) symptoms from baseline to end of treatment (8 weeks). Symptom levels remained significantly reduced from baseline through 24 months. The proportion of participants meeting criteria for clinical treatment outcomes remained constant over 24 months, although there were linear decreases in the proportions experiencing sustained clinical outcomes. Conclusions: Treatment gains were made for depression and anxiety symptoms at the end of treatment and up to 24 months. Future studies should determine the feasibility of integrating post‐treatment programmes into DMHIs to address symptom deterioration. [ABSTRACT FROM AUTHOR]

Objective: This study examined the temporal dynamics of anxiety and depressive symptoms during a 12‐week therapist‐supported, smartphone‐delivered digital health intervention for symptoms of depression and anxiety. Methods: A total of 290 participants were included in the present analyses (age Mean = 39.64, SD = 10.25 years; 79% female; 54% self‐reported psychotropic medication use). Linear mixed models were used to examine the concurrent anxiety‐depression association and (2) the lead‐lag anxiety‐depression relationship, with greater anxiety predicted to precede an increase in depression. Results: In support of Hypothesis 1, greater anxiety during the current biweekly assessment was associated with greater depressive symptoms during the current biweekly assessment. In support of Hypothesis 2, greater anxiety during the prior biweekly assessment was associated with greater depressive symptoms during the current biweekly assessment but not vice‐versa. Conclusion: These findings demonstrate that anxiety and depressive symptoms may overlap and fluctuate in concert, with anxiety symptoms predicting subsequent depressive symptoms but not vice‐versa. With sensitivity to study limitations, implications for future intervention designs are discussed. [ABSTRACT FROM AUTHOR]

Objectives. Older adults may experience weight changes upon retirement for a number of reasons, such as being less physically active; having less structured meal times; and consuming food in response to losing personal identity, the potential for social interactions, or the sense of accomplishment derived from working. The purpose of this study was to determine whether retirement was associated with either weight gain or weight loss. Methods. We used the 1994-2002 Health and Retirement Study to determine whether retirement between biennial interviews was associated with weight change, separately for men (n = 1,966) and women (n = 1,759). We defined weight change as a 5% increase or decrease in body mass index between interviews. Results. We did not find a significant association between retirement and weight change among men. Women who retired were more likely to gain weight than women who continued to work at least 20 hr per week (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.04-1.48). We found a significant relationship between retirement and weight gain only for women who were normal weight upon retiring (OR = 1.30, 95% CI = 1.01-1.69) and who retired from blue-collar jobs (OR = 1.58, 95% CI = 1.13-2.21). Discussion. Public health interventions may be indicated for women, particularly those working in blue-collar occupations, in order to prevent weight gain upon retirement. Key Words: Weight Retirement--Longitudinal research--Aging.

Increased adoption of empirically supported treatments (ESTs) has been hindered in part by inadequate and inconvenient access to EST information and training. To improve diffusion of ESTs, the authors developed a Web application to provide practitioners with concise information by disorder on ESTs. The resulting site, therapyadvisor.com, was evaluated by 239 practicing psychologists to assess the usefulness of the site and explore possible interactions of EST attitudes on ratings of usefulness and impact. Two thirds of participants indicated using ESTs in practice, and limited time and resources were cited as primary barriers to EST adoption. The Web application was rated positively by most participants and was reported to increase awareness of and commitment to try ESTs among approximately 60% of participants. The results of this project support the feasibility of a Web application to increase diffusion and promote further adoption of ESTs. Technological and e-learning advances are promising directions for encouraging the adoption of ESTs specifically and evidence-based practice generally, particularly among busy practitioners who have inadequate time and resources for more traditional forms of dissemination and training. Keywords: empirically supported treatment, treatment diffusion, evidence-based practice, Internet, technology

Objectives. The purpose of this study was to clarify the direction of the relationship between changes in depressive symptoms and changes in weight in older adults. Methods. The sample included a prospective cohort of individuals aged 53-63 (n = 9,130) enrolled in the Health and Retirement Study. We used separate cross-lagged models for men and women in order to study the impact of weight change on subsequent increases in depressive symptoms 2 years later and vice versa. Results. Weight gain did not lead to increased depressive symptoms, ,and weight loss preceded increased depressive symptoms only in unadjusted models among men (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.04-1.53). Increased depressive symptoms were not predictive of subsequent weight loss, but they were predictive of subsequent weight gain in unadjusted models only (men: OR = 1.24, 95% CI = 1.00-1.54; women: OR = 1.12, 95% CI = 1.00-1.26). In adjusted models, baseline depressive symptoms predicted both weight loss and weight gain among both men and women. Increase in functional limitations and medical conditions were significant predictors of both weight loss and weight gain. Baseline functional limitations also predicted increased depressive symptoms. Discussion. Based on our findings, it is apparent that researchers need to examine the pathways between changes in weight and increases in depressive symptoms in the context of functional limitations and medical comorbidity.

This study tests the association between past-year residential transience (RT), substance use disorder (SUD), major depressive episode (MDE), and suicidal outcomes in a nationally representative sample of noninstitutionalized, civilian, community-dwelling adults who participated in the 2008-2013 National Surveys on Drug Use and Health. RT, SUD, and MDE were each significantly associated with suicidal thoughts, plans, and attempts in models adjusted for each other and sociodemographic covariates. Because RT is independently associated with each suicidal outcome, even when there is no co-occurring SUD or MDE, assessment of RT should occur when screening for suicide. [ABSTRACT FROM AUTHOR]