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Meditation with yoga, group therapy with hypnosis, and psychoeducation for long-term depressed mood: A randomized pilot trial

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Abstract

This randomized pilot study investigated the effects of meditation with yoga (and psychoeducation) versus group therapy with hypnosis (and psychoeducation) versus psychoeducation alone on diagnostic status and symptom levels among 46 individuals with long-term depressive disorders. Results indicate that significantly more meditation group participants experienced a remission than did controls at 9-month follow-up. Eight hypnosis group participants also experienced a remission, but the difference from controls was not statistically significant. Three control participants, but no meditation or hypnosis participants, developed a new depressive episode during the study, though this difference did not reach statistical significance in any case. Although all groups reported some reduction in symptom levels, they did not differ significantly in that outcome. Overall, these results suggest that these two interventions show promise for treating low- to moderate-level depression.

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... In 16 studies, patients with a diagnosis of MDD [49,50,52,54,56,59,[62][63][64][65][66][67][68][70][71][72] were included, six included mixed population [48,55,57,58,61,69]. ...
... One each compared different dosages [50,51] and components [72] of yoga intervention. [52, 57, 59, 61-63, 65-67, 71] and the Beck Depression Inventory (BDI) [49,54,56,59,64,66,68,72]. Remission was defined as a cutoff score of depression severity by nine studies [49,50,54,59,[65][66][67][68]70], two studies used diagnostic criteria [57,71], and one combination of both [61]. One study did not report its definition of remission [52]. ...
... In four studies, per protocol analysis was conducted [57,62,63,67]. High dropout rates led to a high risk of bias in missing outcome data in six studies [49,52,55,58,63,67]. ...
Article
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Background: The prevalence of depression has been increasing sharply. Given the existing treatment gap and the high prevalence of nonresponders to conventional therapies, the potential of complementary medicine becomes clear. The effect of yoga on depression has already been studied, but its efficacy in manifest depressive disorders remains unclear. Objective: To update and evaluate the current state of evidence for yoga as a therapy option for depressive disorders. Methods: PubMed/Medline, Cochrane Library, Scopus, PsycINFO, and BASE were searched systematically. Randomized controlled trials (RCTs), including participants with depressive disorders, were eligible. Analyses were conducted for active and passive control groups separately and for subgroups of major depressive disorder (MDD) and mixed samples. The risk of bias was assessed using the Cochrane risk of bias tool 2.0. Primary outcomes were the severity of depression and remission rates, and secondary outcomes were health-related quality of life and adverse events. The quality of evidence was assessed according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Results: Twenty-four studies (n = 1395) were included; of those, 20 studies (n = 1333) were meta-analyzed. Yoga showed a statistically significant short-term effect on depression severity when compared to passive control (standardized mean difference [SMD] = −0.43, 95% confidence interval [CI] = [−0.80; −0.07]) but not when compared to active control (SMD = −0.22, 95% CI = [−0.67; 0.23]). Regarding remission rates, statistically significant effects were observed when comparing yoga to passive (odds ratio [OR] = 3.20; 95% CI = [1.45; 7.10]) as well as to active control (OR = 2.04; 95% CI = [1.13; 3.69]). No differences on safety outcomes were observed for passive (OR = 1.00, 95% CI = [0.10; 9.98]) as well as for active control (OR = 0.80, 95% CI = [0.08; 8.09]). The quality of evidence ranged from moderate to very low. Due to the heterogeneity of outcome reporting, no meta-analysis for quality of life was possible. Conclusion: Yoga is an effective therapy approach for reducing depression severity when compared to passive control and obtains higher remission rates when compared to active and passive controls. Quality of evidence is inconsistent, but given the positive risk–benefit ratio of the intervention and the urge for therapy options for depression, yoga should be considered as a possible treatment option, particularly for MDD patients.
... Most studies implemented exclusion criteria to ensure the absence of comorbid conditions among participants, such as bipolar disorder, psychotic disorder, drug or alcohol dependence, and personality disorder (Alladin & Alibhai, 2007;Butler et al., 2008;Dobbin et al., 2009;Fuhr et al., 2021;Khazraee et al., 2023). Participants with active suicidal ideation or self-injury tendencies were also excluded in several studies (Butler et al., 2008;Dobbin et al., 2009;Fuhr et al., 2021;Khazraee et al., 2023). ...
... Most studies implemented exclusion criteria to ensure the absence of comorbid conditions among participants, such as bipolar disorder, psychotic disorder, drug or alcohol dependence, and personality disorder (Alladin & Alibhai, 2007;Butler et al., 2008;Dobbin et al., 2009;Fuhr et al., 2021;Khazraee et al., 2023). Participants with active suicidal ideation or self-injury tendencies were also excluded in several studies (Butler et al., 2008;Dobbin et al., 2009;Fuhr et al., 2021;Khazraee et al., 2023). Additional exclusion criteria encompassed individuals with eating disorders, obsessive-compulsive disorder, organic mental disorders, and pervasive developmental delays (Alladin & Alibhai, 2007). ...
... Additional exclusion criteria encompassed individuals with eating disorders, obsessive-compulsive disorder, organic mental disorders, and pervasive developmental delays (Alladin & Alibhai, 2007). Moreover, participants who had recently experienced remission from depressive episodes or had engaged in other forms of outpatient psychotherapy within the preceding months were excluded from participation (Butler et al., 2008;Fuhr et al., 2021;Khazraee et al., 2023). ...
Article
This scoping review aims to provide a comprehensive overview of studies that explore the use of hypnotherapy as a treatment for depression, adhering to the PRISMA-ScR guidelines. A total of 232 articles were identified through systematic search strategies in four databases. Following rigorous screening, 14 studies, varying from case studies to randomized controlled trials, were included in the final review. The age range of participants spanned from 18 to 70 years, and the number of female participants generally exceeded that of males in these studies. Hypnotherapy was found to be frequently used as an adjunct treatment alongside various types of psychotherapy such as cognitive behavioral therapy and often included techniques like hypnotic induction, ego strengthening, and self-hypnosis. The treatment duration varied from 3 sessions to as long as 20 weekly sessions. Most importantly, the majority of the studies found hypnotherapy to be effective in reducing symptoms of depression, with some studies suggesting it has superior effects to antidepressant treatment in areas such as overall health and vitality. This review highlights the potential of hypnotherapy as a viable treatment option for depression and highlights the need for further controlled studies to establish its efficacy.
... to detect medium effect size differences for the primary outcome measures of symptoms of depression (Cohen's d = 0.5;Cohen, 1988). We therefore recruited 171 participants (MYI + TAU: n = 88, TAU: n = 83), using a conservative attrition rate of 25% (comparable studies show rates of 15%-20%; Butler et al., 2008;Sarubin et al., 2014). At 12-month follow-up, we had n = 77 (MYI + TAU) and n = 70 (TAU) per group for our primary outcome measures. ...
... Several other studies that compared a yoga intervention to various control conditions have found positive results as well (Butler et al., 2008;Field et al., 2012Field et al., , 2013Mitchell et al., 2012;Prathikanti et al., 2017;Schuver & Lewis, 2016;Uebelacker et al., 2015). However, most of these studies used a psychoeducation control group (Butler et al., 2008;Field et al., 2012Field et al., , 2013Mitchell et al., 2012;Prathikanti et al., 2017;Uebelacker et al., 2015), controlling only for nonspecific factors. ...
... Several other studies that compared a yoga intervention to various control conditions have found positive results as well (Butler et al., 2008;Field et al., 2012Field et al., , 2013Mitchell et al., 2012;Prathikanti et al., 2017;Schuver & Lewis, 2016;Uebelacker et al., 2015). However, most of these studies used a psychoeducation control group (Butler et al., 2008;Field et al., 2012Field et al., , 2013Mitchell et al., 2012;Prathikanti et al., 2017;Uebelacker et al., 2015), controlling only for nonspecific factors. In contrast, yoga interventions have generally not been found to be more effective in reducing depression when compared to active control groups such as mindfulness training (Falsafi, 2016), massage therapy , or walking (Schuver & Lewis, 2016). ...
Article
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Objective: To examine the added value of a 9-week mindful yoga intervention (MYI) as add-on to treatment as usual (TAU) in reducing depression for young women (18-34 years) with major depressive disorder (MDD). Method: Randomized controlled trial (RCT; n = 171) comparing TAU + MYI with TAU-only. Assessments were at baseline, postintervention, and at 6- and 12-month follow-up. Primary outcome measures were clinician-rated and self-reported symptoms of depression, together with a diagnostic interview to establish MDD diagnosis that was restricted to the baseline and 12-month follow-up assessments. Quality of life in various domains was assessed as secondary outcome measure. As potential mediators for treatment efficacy, we included self-report measures of rumination, self-criticism, self-compassion, intolerance of uncertainty, perceived body awareness and dispositional mindfulness, together with behavioral measures of attentional bias (AB) and depression-related self-associations. Results: Adding MYI to TAU did not lead to greater reduction of depression symptoms, lower rate of MDD diagnosis or increase in quality of life in various domains of functioning at post and follow-up assessments. There were no indirect effects through any of the potential mediators, with the exception of self-compassion. Conclusion: Adding MYI to TAU appeared not more efficacious than TAU-only in reducing depression symptoms in young women. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
... Hypnobreastfeeding suggestion will block the signal of emergency pain and stress experienced by the mother, and help the release of endorphin hormones in the body. 10,11 On the other hand, acupressure has the same function as hypnobreaastfeeding. However, the way acupressure works is through the physical through the skin peripheral system and the meridian path of the body to activate the intended organ to function optimally. ...
... 12 Previous research on hypnobreastfeeding and acupressure has been done to reduce anxiety. 10,11 The merging of these two methods is expected to overcome the psychosocial and physical aspects to produce a more significant effect of therapy on pain and stress so that the condition of the mothers physically and psychologically can be resolved properly. 9 However, because of the intervention was just identified to deal with anxiety, the purpose of this study was to examine the effect of combination of hypnobreastfeeding and acupressure on anxiety and pain in post-caesarean section mothers. ...
... The DASS scale was calculated with certain levels, namely: 0 = if the given statement is absent or never, 1 = corresponding to the dialed at a certain level or sometimes, 2 = often, and 3 = very much in accordance with the experience or almost every moment. The level of anxiety was divided into 5 parts: normal (0-7), mild (8-9), moderate (10)(11)(12)(13)(14), severe (15)(16)(17)(18)(19), and very severe (> 20). 14 The pain variable was measured using the NRS scale (Numeric Rating Scale). ...
Article
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Background: Post-cesarean mothers often experience anxiety and discomfort due to long-term pain. The combination of hypnobreastfeeding and acupressure is considered to be effective in reducing anxiety and pain levels. Objective: This study aims to examine the effect of combination of hypnobreastfeeding and acupressure on anxiety and pain levels in post-caesarean mothers.Methods: This study was a true experiment with pretest-posttest control group design, conducted in the Ambarawa Public Hospital on 5 November to 9 December 2016. There were 36 participants selected using stratified random sampling, with 18 assigned in the experiment and control group. Data were analyzed using paired t-test and wilcoxon test.Results: There were statistically significant differences of anxiety and pain levels before and after intervention in the experiment and control group with p-value 0.001 (<0.05).Conclusion: The combination of hypnobreastfeeding and acupressure has a significant effect in reducing anxiety and pain levels in post-cesarean mothers. This intervention could be applied as an alternative therapy in treating post-caesarean mothers.
... The positive and lowest effect (d = 0.000, p = 0.999) belongs to the yoga practice applied to the patient diagnosed with posttraumatic stress disorder, 12 the positive and the highest effect (d = 6.857, p = 0.000) belongs to the laughter therapy practice applied to the patient diagnosed with depression. 72 The variance varies between 0.007 and 0.859.The smallest variance belongs to the study ofHallgren et al.,73 and the largest variance belongs to the study ofChoı et al. 23 According to the effect size of the studies included in the study, only four studies (practices in favor of the control group) were found to have a negative aspect.10,14,40,44 Some descriptive values of the studies and the representation of the effect sizes are given in the forest graph. ...
... 4.3 | Discussion of the effect size of the studies included in the study Eighty-one studies included in the analysis have effect size (d = 0.718, p = 0.000) according to the random effect model, and the studies according to Cohen (1988) have medium effect size and statisticalsignificance. The finding that draws attention to the study is the presence of the study results that have an effect in favor of the control group.10,14,40,44 We can say that this situation makes the effectiveness of some practices questionable. ...
Article
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Purpose This study examined the effect sizes of the complementary and traditional practices on the depressive symptom levels in psychiatric patients Design and Methods The “Health Evidence™ Quality Assessment Tool” and “Comprehensive Meta‐Analysis 3” program was used. Findings A total of 81 studies with 5934 patients were included. The effect size of the complementary and traditional methods applied to psychiatric patient on depressive symptoms was calculated as d = 0.718 (p = 0.000). According to Cohen, studies have moderate effect size. Practice Implications Complementary and traditional practices were found to be significant and effective on depressive symptoms in psychiatric patients.
... to detect medium effect size differences between groups. Allowing a conservative attrition rate of 25% (comparable studies show rates of 15-20%; Butler et al., 2008;Sarubin et al., 2014), we wanted to recruit 170 patients. With an inclusion rate of 50% (comparable studies show rates of 55-75%; Butler et al., 2008;Kinser et al., 2014), we planned to screen 340 patients in the project's first 20 months, allowing us to achieve the targeted sample size. ...
... Allowing a conservative attrition rate of 25% (comparable studies show rates of 15-20%; Butler et al., 2008;Sarubin et al., 2014), we wanted to recruit 170 patients. With an inclusion rate of 50% (comparable studies show rates of 55-75%; Butler et al., 2008;Kinser et al., 2014), we planned to screen 340 patients in the project's first 20 months, allowing us to achieve the targeted sample size. ...
Article
Full-text available
Objectives Despite the gains made by current first‐line interventions for major depressive disorder (MDD), modest rates of treatment response and high relapse indicate the need to augment existing interventions. Following theory and initial research indicating the promise of mindful yoga interventions (MYIs), this study examines mindful yoga as a treatment of MDD. Methods/Design This randomized controlled trial uses a sample of young females (18–34 years) to examine the efficacy and cost‐effectiveness of a 9‐week manualized MYI added to treatment as usual (TAU) versus TAU alone. Primary outcome measures consist of clinician‐administered (Hamilton Depression Rating Scale) and self‐report (Depression‐Anxiety‐Stress Scales) measures of depression. Underlying mechanisms will be examined, including rumination, negative self‐evaluation, intolerance of uncertainty, interoceptive awareness, and dispositional mindfulness. Assessments were conducted at preintervention and will be conducted at postintervention, 6‐, and 12‐month follow up. Results The baseline sample consists of 171 females (88 were randomized into the MYI), reporting a baseline Mage = 25.08 years (SDage = 4.64), MHamilton‐depression = 18.39 (SDHamilton = 6.00), and a MDASS‐depression = 21.02 (SDDASS = 9.36). Conclusion This trial will provide important information regarding the benefits of adding yoga‐based interventions to TAU for young women with MDD and the mechanisms through which such benefits may occur.
... Yoga also can be clinically therapeutic for depression either in combination with meditation (Waelde et al., 2004;in Butler, Waelde, Hastings, Chin, Symons, Marshal et al, 2008, p. 808). Meditation includes a variety of attention-control practices that enable practitioners to focus attention and maintain awareness of the present moment (Waelde, 2004;in Butler et al., 2008). Many studies reported that meditation programs could significantly reduce anxiety and depression, and improve general functioning in a variety of patients (Boorstein, 1983;DeBeri, Davis, & Reinhard, 1989;Kabat -Zinn, 1995;Shapiro, Schwartz, & Bonner, 1998;in Butler et al., 2008). ...
... Meditation includes a variety of attention-control practices that enable practitioners to focus attention and maintain awareness of the present moment (Waelde, 2004;in Butler et al., 2008). Many studies reported that meditation programs could significantly reduce anxiety and depression, and improve general functioning in a variety of patients (Boorstein, 1983;DeBeri, Davis, & Reinhard, 1989;Kabat -Zinn, 1995;Shapiro, Schwartz, & Bonner, 1998;in Butler et al., 2008). ...
Article
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This article attempts to reveal the prospects of yoga tourism in Nepal. Yoga is gaining popularity worldwide due to its inherent quality to transform a person from illness to wellness. This is the reason yoga tourism is studied in academia under the umbrella term of wellness tourism. There are potentialities how Nepal can be one of the best destinations for yoga tourism. Nepal is spiritually saturated country being the birthplace of Gautama Buddha and playground of Lord Shiva, the Yogishwara. At the same time, Nepal is a Himalayan country including the highest mountain, Mt. Everest. The cultural heritage is another attraction. The simplicity of people attracts tourists who aim to learn yoga practices while visiting places for refreshment. This article has dealt about how yoga tourism is spreading, what are its theoretical and philosophical background, prospects and potentialities and so on. The major methodology applied in this article is library research, case studies and visiting actual places where yoga tourists from all over the world gather. Yoga retreat survey has revealed actual scenario of yoga tourism. Historicity of yoga philosophy is uncovered using original Classical Sanskrit Cannons. A sample survey identified yoga retreat centers in Kathmandu, the facilities available and potential aspects of tourism and income generation. The finding section documented the actual problems and prospects faced by the hosts, i.e., travel agencies, owners of yoga retreat centers, hoteliers, and yoga masters. The research has reached in conclusion: if right policies and facilities are generated, Nepal will gain a new identity as best destination for yoga tourism in the world. There are potentialities to develop internal yoga tourism as well. One can visualize Nepal being famous and prosperous from yoga tourism and Nepalese people gaining health, wealth and wellbeing by living yogic lifestyle and collecting reputation as yoga masters by guiding tourists into yoga life.
... 抑郁症是全球发病率最高的精神障碍之一,临床 表现为持续性情绪低落、认知能力受损、睡眠改变、 食欲下降和出现自杀意念等 [1] 。全球近 3 亿人遭受抑 郁症困扰,且临床罹患率仍逐年升高 [2] 。药物疗法和 心理疗法是抑郁症的主要治疗方式 [3] ,但仍存在一定 问题,如药物治疗中的安慰剂效应 [4] 和副作用 [5] ,心理 治疗中的羞辱感和病耻感 [6] 身心锻炼可以帮助练习者减少消极情绪 [9] ,缓解 疲劳 [10] ,改善睡眠质量 [11] ,提升主观幸福感 [12] 。研究 表明身心锻炼可以减轻不同人群的抑郁症状。Field 等 [13][14] 对抑郁症孕妇进行瑜伽干预 12 周,抑郁评分显 著降低。老年女性和产后抑郁症患者也有相似的结 果 [15][16] 。太极拳和气功多用于老年慢性病伴抑郁患者 的研究中。周涛 [17] 采用气功干预 12 周,显著降低糖尿 病抑郁患者的抑郁症状。Meta 分析证实,身心锻炼对 非 临 床 抑 郁 者 [12] 、 重 度 抑 郁 症 患 者 [18][19] 和 慢 性 病 患 者 [20] 具有积极的效应。 但也有 Meta 分析表明,瑜伽并不能减轻女性癌 症伴抑郁患者 [21] 和产妇的抑郁感 [22] 。Liu 等 [23] 发现,数 周太极拳练习并未减轻练习者的抑郁症状。 循证医学将研究结果间的差异来源划分为临床异 质性和方法学异质性 [24] 。临床异质性是由受试者不 同、干预措施差异所引起的效应量变异;这在抑郁症 干预研究中较为常见,如身心锻炼对中老年抑郁人群 的干预效应要高于其他人群 [15,25] ;对非临床患者效应 明显,而对抑郁程度较高的临床患者效应较低 [26] 。锻 炼项目的差异也可能影响干预效应。气功对于健康人 抑郁感的调节效果优于太极拳 [23] 。剂量-效应是体育活 动促进健康的热点问题。一项 Meta 分析发现,持续 45~59 min、 10~16 周 的 有 氧 运 动 对 抑 郁 症 效 益 最 明 显 [27] 。方法学异质性一般由人为因素引起,通常指研 究方法学质量控制不佳。由于锻炼干预类研究在实施 中不可控因素较多,致使方法学质量风险较高。多项 研究认为,尽管得出积极的干预效应,但质量上的欠 缺可能会夸大实际效应量 [12,23,28 Chou(2004) [32] Sharma(2005) [33] Butler(2008) [34] Shahidi(2010) [15] 林以环(2010) [35] Lavretsky(2011) [36] 邱添莹(2011) [37] Field(2011) [13] Kinser(2013) [38] Field(2013) [14] Gangadhar(2013) [39] Tsang(2013) [20] 杨云秀(2013) [40] Kinser(2014) [41] 王俊清(2014) [42] 周涛(2014) [17] Buttner(2015) [16] Uebelacker(2015) [43] 王冬梅(2015) [45] 程香(2016) [46] Falsafi(2016) [47] Sudha(2016) [48] Schuver(2016) [49] 袁礼洪(2016) [50] 侯辰(2017) [51] Yeung(2017) [52] 张峰(2017) [ [31] Chou(2004) [32] Sharma(2005) [33] Butler(2008) [34] Shahidi(2010) [15] 林以环(2010) [35] Lavretsky(2011) [36] 邱添莹(2011) [37] Field(2011) [13] Field(2013) [14] Kinser(2013) [38] Gangadhar(2013) [39] Tsang(2013) [20] 杨云秀(2013) [40] Kinser(2014) [41] 王俊清(2014) [42] 周涛(2014) [17] Buttner(2015) [16] Uebelacker(2015) [43] 赵桂增(2015) [44] 王冬梅(2015) [45] Falsafi(2016) [47] Sudha(2016) [48] Schuver(2016) [49] 程香(2016) [46] 袁礼洪(2016) [50] 侯辰(2017) [51] Yeung(2017) [52] 张峰(2017) [53] ...
... 抑郁症是全球发病率最高的精神障碍之一,临床 表现为持续性情绪低落、认知能力受损、睡眠改变、 食欲下降和出现自杀意念等 [1] 。全球近 3 亿人遭受抑 郁症困扰,且临床罹患率仍逐年升高 [2] 。药物疗法和 心理疗法是抑郁症的主要治疗方式 [3] ,但仍存在一定 问题,如药物治疗中的安慰剂效应 [4] 和副作用 [5] ,心理 治疗中的羞辱感和病耻感 [6] 身心锻炼可以帮助练习者减少消极情绪 [9] ,缓解 疲劳 [10] ,改善睡眠质量 [11] ,提升主观幸福感 [12] 。研究 表明身心锻炼可以减轻不同人群的抑郁症状。Field 等 [13][14] 对抑郁症孕妇进行瑜伽干预 12 周,抑郁评分显 著降低。老年女性和产后抑郁症患者也有相似的结 果 [15][16] 。太极拳和气功多用于老年慢性病伴抑郁患者 的研究中。周涛 [17] 采用气功干预 12 周,显著降低糖尿 病抑郁患者的抑郁症状。Meta 分析证实,身心锻炼对 非 临 床 抑 郁 者 [12] 、 重 度 抑 郁 症 患 者 [18][19] 和 慢 性 病 患 者 [20] 具有积极的效应。 但也有 Meta 分析表明,瑜伽并不能减轻女性癌 症伴抑郁患者 [21] 和产妇的抑郁感 [22] 。Liu 等 [23] 发现,数 周太极拳练习并未减轻练习者的抑郁症状。 循证医学将研究结果间的差异来源划分为临床异 质性和方法学异质性 [24] 。临床异质性是由受试者不 同、干预措施差异所引起的效应量变异;这在抑郁症 干预研究中较为常见,如身心锻炼对中老年抑郁人群 的干预效应要高于其他人群 [15,25] ;对非临床患者效应 明显,而对抑郁程度较高的临床患者效应较低 [26] 。锻 炼项目的差异也可能影响干预效应。气功对于健康人 抑郁感的调节效果优于太极拳 [23] 。剂量-效应是体育活 动促进健康的热点问题。一项 Meta 分析发现,持续 45~59 min、 10~16 周 的 有 氧 运 动 对 抑 郁 症 效 益 最 明 显 [27] 。方法学异质性一般由人为因素引起,通常指研 究方法学质量控制不佳。由于锻炼干预类研究在实施 中不可控因素较多,致使方法学质量风险较高。多项 研究认为,尽管得出积极的干预效应,但质量上的欠 缺可能会夸大实际效应量 [12,23,28 Chou(2004) [32] Sharma(2005) [33] Butler(2008) [34] Shahidi(2010) [15] 林以环(2010) [35] Lavretsky(2011) [36] 邱添莹(2011) [37] Field(2011) [13] Kinser(2013) [38] Field(2013) [14] Gangadhar(2013) [39] Tsang(2013) [20] 杨云秀(2013) [40] Kinser(2014) [41] 王俊清(2014) [42] 周涛(2014) [17] Buttner(2015) [16] Uebelacker(2015) [43] 王冬梅(2015) [45] 程香(2016) [46] Falsafi(2016) [47] Sudha(2016) [48] Schuver(2016) [49] 袁礼洪(2016) [50] 侯辰(2017) [51] Yeung(2017) [52] 张峰(2017) [ [31] Chou(2004) [32] Sharma(2005) [33] Butler(2008) [34] Shahidi(2010) [15] 林以环(2010) [35] Lavretsky(2011) [36] 邱添莹(2011) [37] Field(2011) [13] Field(2013) [14] Kinser(2013) [38] Gangadhar(2013) [39] Tsang(2013) [20] 杨云秀(2013) [40] Kinser(2014) [41] 王俊清(2014) [42] 周涛(2014) [17] Buttner(2015) [16] Uebelacker(2015) [43] 赵桂增(2015) [44] 王冬梅(2015) [45] Falsafi(2016) [47] Sudha(2016) [48] Schuver(2016) [49] 程香(2016) [46] 袁礼洪(2016) [50] 侯辰(2017) [51] Yeung(2017) [52] 张峰(2017) [53] ...
Article
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Objective To determine the effectiveness of mind-body exercise, named Yoga, Taijiquan and Qigong, as a complementary and alternative therapy, on depression. Methods Randomized controlled trials (RCTs) about Yoga, Taijiquan and Qigong for depression were searched from Web of Science, PubMed, EMbase, Cochrane Library, PaycINFO, SPORTDiscu, CBM and CNKI. They were assessed methodological quality, and analyzed with Revman 5.3. Results A total of 29 RCTs involving 1379 subjects were included. Mind-body exercise alone was an effective intervention on depression (SMD = -0.73, 95%CI -1.00 to -0.47, P < 0.01), with significant heterogeneity and publica‐tion bias. Mind-body exercise combined with medicine was also effective on depression (SMD = -0.54, 95%CI -0.71 to -0.36, P < 0.01), without significant heterogeneity and publication bias. Conclusion Mind-body exercise can be a complement of medicine for depression. Single mind-body exercise is not stable for depression intervention. More long-term and high-quality researches are needed to determine the actual effectiveness on depression in the future.
... Given that the average time to publish a new clinical trial on hypnotherapy for MDD over the past two decades is approximately 149 weeks (Alladin & Alibhai, 2007;Butler et al., 2008;Chiu et al., 2018;Fuhr et al., 2021;Hernández et al., 2021;Khazraee et al., 2023;Ramondo et al., 2024), the hypnotherapy research community cannot afford to waste investment opportunities, patients, and human resources on low-quality research. Low-quality research constitutes the vast majority of published studies in the biomedical sciences, negatively impacting both the scientific and civil communities by disseminating information that is accepted as true solely because it appears in a "scientific article." ...
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This commentary critically evaluates the randomized controlled trial “Cognitive Behavioral Therapy and Hypnosis in the Treatment of Major Depressive Disorder” by Ramondo et al. (2024), highlighting significant methodological concerns that undermine the study’s conclusions. Key issues include the lack of allocation concealment, with the lead clinician involved in both patient assignment and treatment, raising the risk of performance bias. Additionally, the study’s approach to handling missing data assumes data, potentially compromising the validity of the intention-to-treat analysis. Finally, fidelity assessments were conducted retrospectively by a single research assistant, with no real-time monitoring, raising concerns about protocol adherence. These methodological shortcomings limit the reliability of the study’s findings and emphasize the need for greater rigor in future hypnotherapy research for Major Depressive Disorder.
... The use of hypnosis to enhance autobiographical memory in connection with judicial proceedings, sometimes called "forensic hypnosis," was discredited in U.S. courts in the 1980s, before the 'false memory" movement began (Winter, 2013). But hypnosis has also been widely and successfully used "to treat a variety of conditions, including stress, anxiety, and psychological aspects of pain" (Butler et al., 2008). A recent article (Van der Hart, 2021) summarizes the clinical lessons on integrating traumatic war memories through hypnosis. ...
Article
Those promoting the idea of "false memory syndrome" often invoke the specter of hypnosis to discredit those making accusations of sexual abuse and anyone they might have spoken to for investigative or therapeutic purposes. Capturing the Friedmans demonstrates that accusations of hypnosis have strong rhetorical value, even when they are not true. The film, classified as a documentary, tells the story of a family that is shattered when the father and son both plead guilty to sexually abusing boys in the after-school classes in their basement. Using tropes about hypnosis and misrepresenting the actual facts in the case, the movie persuaded many people that Jesse Friedman was actually innocent. A detailed Conviction Integrity Review that was prompted by the movie demonstrates that the conviction was sound, and that the movie is suspect.
... Yoga uses mild physical poses to boost strength, flexibility, and balance, giving practitioners of this ancient modality a way of control over the body. As a form of mindful, low-impact exercise, the physical movements in yoga could have medicament and anxiolytic effects ( [93] . The appeal of yoga as a treatment for depression is also associated with its comparatively low cost, easy access, high social acceptance, and also the perception that yoga focuses on the complete person mind, body, and spirit (Stussman BJ, Black LI, et. ...
Article
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COVID-19 is a driblet transmitted probably fatal corona virus pandemic that affecting the world in 2020. The world Health Organization suggested that social distancing and human to human contact was discouraged to regulate the transmission of viruses. The Covid-19 had an unexampled impact on not only physical but also mental health. The disease collapsed healthy systems everywhere the world. To live through this lockdown & pandemic period, yoga is that the best thing to adopt as a lifestyle habit. It helps to build a strong physical, mental and spiritual health system. When combined with breathing and meditation, it acts care of our mind, body and soul also. There are different styles of yoga that may help us to stay physically strong and mentally balanced throughout lockdown. Yogic practices enhance muscular strength and body flexibility, promote and improve metabolism and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns and enhance overall well-being and quality of life during lockdown.
... [27][28][29][30][31][32][33][34] The practice of yoga is associated with a reduced number of episodes of major depression, and lower risk of dysthymia, which is a milder form of depression. 11,14,25,27,29,33,[35][36][37][38] The meta-analyses and systematic reviews indicate that both yoga and meditative therapies are equally effective against conventional antidepressants in the treatment of depression and anxiety. 39,40 Stress and insomnia. ...
Article
Yoga is a codex of exercises for the body and mind originated in India. It has a series of benefits for health. However, it is challenging to find a standardized system of meditation and asanas, with a simple application so that it is readily applicable to a large population, as well as easy scientific reproducibility. Aiming to test a reproducible 8–week Yoga learning model, two healthy male subjects, one with 51 and the other with 54 years old, underwent eight sessions of meditation and carefully selected asanas for secure execution. Evaluations occurred before the first session and one day after the last session. The measured variables were blood pressure, heart rate, and global stretch. Both subjects presented improvements in the investigated variables. The proposed model is appropriate for the scientific study of Yoga.
... Different types of yoga and meditation have proven to be effective against depressive symptoms and dysthymia. 100 Because it can buffer stress, meditation is also helpful to prevent depression. 101 The difference to praying is the dyadic relationship: Whereas people can address their sorrows and problems to a higher being, that is God, in praying, meditation does not require an explicitly religious framework and can also be useful for nonreligious persons. ...
Chapter
This chapter focuses on the relationship between depression and religion/spirituality. It claims a double edged and ambivalent potential of religion/spirituality concerning mental health and depression.
... Similar to yoga, it is a nonpharmacological intervention with at least one published comparative study of the two interventions in unipolar depression. 36 The aim of this study was to determine the feasibility and identify any signals of benefit of a manualized yoga protocol in participants with unipolar and bipolar depression. The primary hypothesis was that while both interventions will improve residual symptoms of depression (measured by Montgomery-Å sberg Depression Rating Scale [MADRS]), yoga would be associated with a significantly greater improvement, including among secondary measures of well-being, given its potentially beneficial effect on psychological and physical functioning. ...
Article
Objective Patients with depression frequently experience persistent residual symptoms even with optimal interventions. These patients often use complementary treatments, including yoga, as a preferred alternative or adjunctive treatment. There is evidence for the benefit of yoga for depression, but this has not been rigorously evaluated, particularly in bipolar depression. We aimed to determine the feasibility and benefit of manualized breathing-focused yoga in comparison to psychoeducation as augmentation to pharmacotherapy for improving residual symptoms of depression in unipolar and bipolar patients. Methods Using a randomized single-blind crossover design, 72 outpatients with unipolar or bipolar depression were augmented with the two 8-week interventions at separate times, as add-ons to current first-line antidepressants and mood stabilizers. The primary outcome measure was the Montgomery-Åsberg Depression Rating Scale (MADRS). Due to the high dropout of participants after crossover at Week 8, analysis focused on between-group comparisons of yoga and psychoeducation during the initial 8 weeks of the study. Results There was a significant decline in depressive symptoms, as measured by the MADRS, following 8 weeks of yoga. However, there was no significant difference in MADRS ratings between intervention groups. Similar improvements in self-rated depressive symptoms and well-being were also observed across time. Conclusions Both yoga and psychoeducation may improve residual symptoms of unipolar and bipolar depression as add-on to medications. In-class group sessions and long study durations may reduce feasibility for this population. Larger trials with parallel group design and shorter duration may be more feasible.
... Of the remaining 35 studies, a further ten studies were excluded for methodological or quality issues. Butler et al. (2008) investigated long-term depression and screened for trauma, but did not report trauma exposure. Caldwell and Shaver (2015) examined attachment-based mindfulness in women maltreated in childhood, but used outcomes of rumination and emotion regulation. ...
Article
Mindfulness-based interventions (MBIs), with postures, breath, relaxation, and meditation, such as Mindfulness-based Stress Reduction (MBSR) and yoga, are complex interventions increasingly used for trauma-related psychiatric conditions. Prior reviews have adopted a disorder-specific focus. However, trauma is a risk factor for most psychiatric conditions. We adopted a transdiagnostic approach to evaluate the efficacy of MBIs for the consequences of trauma, agnostic to diagnosis. AMED, CINAHL, Central, Embase, Pubmed/Medline, PsycINFO, and Scopus were searched to 30 September 2018 for controlled and uncontrolled trials of mindfulness, yoga, tai chi, and qi gong in people specifically selected for trauma exposure. Of >12,000 results, 66 studies were included in the systematic review and 24 controlled studies were meta-analyzed. There was a significant, pooled effect of MBIs (g = 0.51, 95%CI 0.31 to 0.71, p < .001). Similar effects were observed for mindfulness (g = 0.45, 0.26 to 0.64, p < .001), yoga (g = 0.46, 0.26 to 0.66, p < .001), and integrative exercise (g = 0.94, 0.37 to 1.51, p = .001), with no difference between interventions. Outcome measure or trauma type did not influence the effectiveness, but interventions of 8 weeks or more were more effective than shorter interventions (Q = 8.39, df = 2, p = .02). Mindfulness-based interventions, adjunctive to treatment-as-usual of medication and/or psychotherapy, are effective in reducing trauma-related symptoms. Yoga and mindfulness have comparable effectiveness. Many psychiatric studies do not report trauma exposure, focusing on disorder-specific outcomes, but this review suggests a transdiagnostic approach could be adopted in the treatment of trauma sequelae with MBIs. More rigorous reporting of trauma exposure and MBI treatment protocols is recommended to enhance future research.
... 7 Literature further suggests that hypnotherapy is a beneficial part of some treatment regimes. 8 According to a study, hypnotic intervention showed promising results for treating low to moderate level depression, 9 and found it to be a successful non-pharmacological treatment to address symptoms of depression. 10 Kirsch et al. compared the efficacy of cognitive behaviour hypnotherapy with CBT alone through meta-analysis and concluded that CBT was more effective when integrated with hypnosis compared to CBT alone. ...
Article
Full-text available
The current study was planned to assess how the integration of brief cognitive behaviour therapy (CBT) with hypnotherapy can be productive for a client's quick progress in treatment. It illustrates the effectiveness of two methods of treatment integrated to make better prognosis in the treatment of a depressed Pakistani housewife aged 25 years, who had been suffering for a year. The sessions included hypnotic induction, teaching self-hypnosis with positive suggestions, mood monitoring, use of imagery and relaxation techniques along with specific strategies of brief CBT. Predominant feature of her clinical presentation was the belief of being unloved, and the negative thoughts of being devalued by the husband. Hypnotherapy contributed to achieving remarkable therapeutic progress in a relatively short time. At initial presentation, the depressive symptoms were extremely high as demonstrated by psychological assessment tests and Beck Depression Inventory (BDI). Subsequent test results indicated that she had returned to normal level of functioning (81-90) as assessed through the Global Assessment of Functioning Scale (GAFS). At the time of reporting the case, she was in the follow-up phase. The case highlights the value of hypnosis as a tool of empowerment especially important to diminish depression when used as an adjunct with cognitive behaviour therapy.
... Virtually all forms of meditation lead to a more calm and objective mental, emotional and spiritual poise (e.g. Arambula et al., 2001;Butler et al., 2008;Ditto et al., 2006;Kanojia, 2010;Waelde et al. 2008). Thus, it would seem that the practice of yoga, including meditation, leads in the direction of integral consciousness of identification-ofself (Bose, 2011). ...
Article
Full-text available
This article examines a heuristic paradigm of a yoga-spirit-travel nexus and its agency on the identification-of-self. In the ancient Sanskrit yoga means union or yoke. Yoga practice may act as a yoking or linking element between self-identity and spiritual development such that yoga travel may lead to the enhancement of self-identity for the yogi traveler. Conceptually, the practice of yoga acts as a catalyst for travel to partake in foreign yoga experiences. Both during travel and in the travel destination, the engaged spiritual capital via yoga may act as an uplifting transformative agent for identity formation. We conclude that by linking self-identification to a yoga-travel-spirit nexus a foundation of self-enlightenment may emerge.
... Major aim of yoga professional is to receive the required authorization to teach yoga in their own country'' (Ponder & Holladay, 2013). Butler et al. (2008) studied on ''Meditation with yoga, group therapy with hypnosis, and psychoeducation for long-term depression mood: a randomized pilot trail'' in which they found these interventions show promise for treating low to moderate level of depression. ...
Article
The dimensions of travelling and tourism have become manifold in recent decades. People love to travel with various purposes. Religious tourism, yoga tourism, peace tourism and spiritual tourism are some dimensions. Lumbini can be a best destination for meditation tourism, which could be much rewarding for individual, social and national development. The travelers and stakeholders have yet to be aware of this aspect. In Buddhism, Lumbini is a best destination for meditation tour. Exploring the importance of travelling Lumbini for meditation is the main objective of this article. Tourists and pilgrims would benefit immensely if they understand the significance of meditation tourism to Lumbini, its philosophy and practice. This article aims to explore the spiritual significance of Lumbini and it will provide visions of a purposeful development and publicity that would shape Lumbini as a best destination for meditation tourism. The government and private sectors are interested to develop Lumbini as best tourist destination. People all over the world are attracted to visit Lumbini for different reasons. Most tourists are unaware of the core aspect of visiting Lumbini. People who visit Lumbini are unaware about meditation practice or involving in charity works. Meditation and compassion are the core aspects of Buddha’s teachings, which are neither realized nor practiced. There seems a vast gap between the actual philosophy of Buddhism and the attitude of most of the visitors. This research study attempts to reveal the significance of meditation tourism in Lumbini.
... The study proved that Raja Yoga would be effective in treating Depression among women who have PMS. Researchers conducted a pilot study to investigate the effects of meditation with yoga among 46 individuals with long term depressive disorder and found that there was not much of a difference in the depressive patients but it displayed a higher significance for treating low to high level depression 15 Painful menstrual periods and PMS are the most common gynecologic problems, and are the most common reasons for increased absenteeism and more workdays with 50% or less of typical productivity per month in female employees 16 . A Swiss population-based health survey revealed that 57% women report having at least a mild degree of "premenstrual anger/irritability" or "premenstrual tearfulness/mood swings"; the median duration of physical and emotional symptoms is 3 days, and relationships with co-workers and/or family are most affected 17 Recent studies reported an association between exercise and PMS, and indicated that a regular exercise habit might decrease some physical and psychologic premenstrual symptoms 18,19 Pain, a common symptom of PMS, is a complex experience that affects mood and behavior, and can modify thought patterns leading to activation of different brain regions during cognitive tasks. ...
Chapter
Mindfulness is defined as ‘awareness that arises through paying attention, on purpose, in the present moment, nonjudgmentally' (Kabat-Zinn, 2013). Mindfulness-based interventions are common in the field of health because they can have a key role in decreasing the level of stress and anxiety. Education has become more competitive in the new world, and teachers and learners can sometimes experience challenges adapting to this new academic world. Mindfulness can be one of the ways to enhance the resilience that the students and teachers experience. The current chapter explores mindfulness and its origins, its relation to science, mindfulness attitudes, academic resilience in students, and the relationship between mindfulness and stress. Then, the chapter offers several mindful practices for both adults and young learners. Finally, it suggests some digital tools for mindful practices
Article
Introduction: Major Depressive Disorder (MDD) is one of the most debilitating diseases worldwide and has seen a significant increase in diagnoses during the pandemic, demanding more and better therapeutic tools to manage the post-pandemic scenario. Objective: The aim of this systematic review is to provide a comprehensive analysis of the last 20 years of clinical research on Hypnotherapy (HT) to determine whether this intervention has evidence to support its recommendation for the treatment of MDD. Methods: This review included only randomized clinical trials (RCTs) involving adult populations diagnosed with MDD, regardless of the severity level (mild, moderate, or severe) according to any validated diagnostic criteria, compared to a control group (active treatment or none), with any follow-up duration and free access to the manuscript. The bibliographic survey was conducted across seven distinct databases: MEDLINE (PubMed), Embase, CENTRAL, PsycINFO, Scopus, ScieELO, and Latin American and Caribbean Health Sciences Literature (LILACS). The risk of bias was assessed by two independent investigators using Cochrane’s revised tool (RoB 2), and the final judgment was made by consensus. To better analyze the included studies, the certainty of the evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: There is not enough evidence to indicate that hypnosis-based interventions may reduce the severity of depression, which precludes the clinical recommendation of this intervention for patients in the real world, pending the production of better evidence of effectiveness and safety, although no evidence of significant adverse effects was found.
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Introduction: Major Depressive Disorder (MDD) is one of the most debilitating diseases worldwide and has seen a significant increase in diagnoses during the pandemic, demanding more and better therapeutic tools to manage the post-pandemic scenario. Objective: The aim of this systematic review is to provide a comprehensive analysis of the last 20 years of clinical research on Hypnotherapy (HT) to determine whether this intervention has evidence to support its recommendation for the treatment of MDD. Methods: This review included only randomized clinical trials (RCTs) involving adult populations diagnosed with MDD, regardless of the severity level (mild, moderate, or severe) according to any validated diagnostic criteria, compared to a control group (active treatment or none), with any follow-up duration and free access to the manuscript. The bibliographic survey was planned to be as sensitive as possible, conducted across seven distinct databases: MEDLINE (PubMed), Embase, CENTRAL, PsycINFO, Scopus, ScieELO, and Latin American and Caribbean Health Sciences Literature (LILACS). To identify potentially eligible studies in the grey literature, researchers also searched the U.S. National Library of Medicine (ClinicalTrials.gov). The risk of bias was assessed by two independent investigators using Cochranes revised tool (RoB 2), and the final judgment was made by consensus. To better analyze the included studies, the certainty of the evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Due to the lack of comparable studies, it was not possible to perform a meta-analysis; therefore, the studies were graphically displayed in Descriptive Forest Plots. Results: There is very low quality evidence suggesting that hypnosis-based interventions may reduce the severity of depression, which precludes the clinical recommendation of this intervention for patients in the real world, pending the production of better evidence of effectiveness and safety, although no evidence of significant adverse effects was found. Other: This review was pre-registered with PROSPERO and can be accessed using the registration number CRD42023409631.
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This Clinical Handbook for the Management of Mood Disorders will equip clinicians with the knowledge to refine their diagnostic skills and implement treatment plans for mood disorders based on the most up-to-date evidence on interventions that work. Covering the widest range of treatments and techniques, it provides clear guidance for the management of all types and subtypes of both minor and major depression. Chapters cover the latest and most innovative treatments, including use of ketamine, deep brain stimulation and transcranial magnetic stimulation, effective integration of pharmacological and psychotherapeutic approaches, as well as providing a thought-provoking look at the future research agenda and the potential for reliable biomarkers. This is the most comprehensive review of depression available today. Written and edited by leading experts mostly from Columbia University, this is an essential resource for anyone involved in the care and treatment of patients with mood disorders.
Article
Objective To summarise the effect of mind–body exercises on anxiety and depression symptoms in adults with anxiety or depressive disorders. Design Systematic review with meta-analysis and meta-regression. Data sources Five electronic databases were searched from inception to July 2022. Manual searches were conducted to explore clinical trial protocols, secondary analyses of clinical trials and related systematic reviews. Eligibility criteria Randomised clinical trials evaluating qigong, tai chi or yoga styles with anxiety or depression symptoms as the outcomes were included. No intervention, waitlist or active controls were considered as control groups. The risk of bias and the certainty of the evidence were assessed. Meta-analyses, meta-regressions and sensitivity analyses were performed. Results 23 studies, comprising 22 different samples (n=1420), were included. Overall, meta-analyses showed yoga interventions were superior to controls in reducing anxiety symptoms in anxiety disorders. Furthermore, yoga-based interventions decreased depression symptoms in depressive disorders after conducting sensitivity analyses. No differences between groups were found in the rest of the comparisons. However, the certainty of the evidence was judged as very low for all outcomes due to concerns of high risk of bias, indirectness of the evidence, inconsistency and imprecision of the results. In addition, there was marked heterogeneity among yoga-based interventions and self-reported tools used to evaluate the outcomes of interest. Conclusion Although yoga-based interventions may help to improve mental health in adults diagnosed with anxiety or depressive disorders, methodological improvements are needed to advance the quality of clinical trials in this field. PROSPERO registration number CRD42022347673.
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Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
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Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
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Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
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Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Chapter
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Chapter
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Chapter
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Chapter
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
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Yoga has been demonstrated to improve well-being and mental health in diverse populations; however, understanding of the mechanisms of action is still developing. This chapter explores the impact of yoga-based interventions on psychological and/or biological mechanisms related to mental health. This chapter highlights that yoga-based interventions decrease stress reactivity, influence physiological markers of stress reactivity, resulting in overall improved health and well-being, in diverse populations of adults. Yoga-based interventions influence psychological processes important in the regulation of mood and emotion, including dispositional mindfulness, self-compassion, rumination, attention, metacognition, and memory. Finally, yoga-based interventions result in structural and functional changes in several brain regions. Yoga-based interventions impact several processes relevant to mental health and maybe a useful complementary intervention for a number of mental health concerns.
Article
Adolescence is a transitional period where a myriad of developmental changes will occur. Counselors working with grieving adolescents need to have a variety of techniques to use. Creative techniques have been found to be viable in coping with the death of a loved one. This article was crafted with the intent of exploring creative practices and strategies as viable treatment options for grieving adolescents.
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Background: Interest in the use of yoga to enhance engagement with and augment the benefits of psychological treatment has grown. However, a systematic approach to reviewing existing research examining the use of yoga with psychological treatment is lacking. Materials and Methods: This mapping review identified and synthesised research trialling yoga as an integrated or adjunct therapy with evidence‐based psychological interventions for the treatment of anxiety, depression, PTSD, and eating disorders. Results: Overall, the review identified ten published and three unpublished studies, representing either single group or small quasi‐experimental research designs. Discussion: Limited but promising findings were shown for yoga with CBT for anxiety and depression, and the integration of yoga within intensive treatment models for PTSD. Conclusions: Future research is encouraged to focus on controlled trials that enable examination of the component effect of yoga when applied with evidence‐based psychological treatment and acceptability and feasibility data to further knowledge regarding a role for yoga in clinical practice. KEYWORDS: anxiety, complementary therapy, depression, eating disorders, evidence‐based psychological treatment, mapping review, posttraumatic stress disorder, yoga
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Objectives: Previous studies reported about the influence of early changes on treatment response. However, the question of whether early changes can predict the subsequent course of depressive symptoms during treatment with psychotherapy has not yet been clearly answered. We aimed to investigate whether symptom course in the first weeks at the level of individual session can predict the further symptom progression on a session to session level during psychotherapy treatment in patients with Major Depression (MD). Design: Monocentric randomized controlled trial with psychotherapeutic treatment either with cognitive-behavioural therapy (CBT) or hypnotherapy (HT). The longitudinal course of weekly depressive symptoms during the six months treatment period was examined. Methods: In this RCT with 152 randomized patients suffering from current mild-to-moderate MD, depressive symptoms were assessed on a weekly basis during the 20 sessions' treatment with individual psychotherapy. We only included patients for which sufficient data for our analysis were available. Three different linear and quadratic mixed model analyses with random effects for each patient were tested: Early change was defined as the individual percentage symptom change during the first two, three, four and five weeks. Symptoms from session four, five, six and seven onward were predicted using different models, with early change added to the model in a final step. Calculating all models separately for CBT and HT lead to comparable results. Result: A slow symptom decrease after session four, five, six, seven onward to the end of the treatment was found. However, adding early change to the model, had no effect on the further symptom course in all models. Conclusion: Symptom changes at early stages of psychotherapy should not be considered as being predictive for further symptom course. Practitioner points: The individual early symptom change in a treatment with psychotherapy in the first two, three, four, or five weeks of treatment does not predict the subsequent symptom course from session four, five, six, or seven onward at a session to session level. Symptom changes at early stages of psychotherapy should not be considered as being predictive for further symptom course. We found a symptom reduction ranging from 3% to 16% in the first two, three, four, or five weeks. Treatment response between the first and last therapy session was found in 54.5%, the number of remitted patients (with PHQ-9 scores < 5) was 44.7%. A small symptom improvement of between 0.21 and 0.42 points in the PHQ-9 scores per week in later stages of psychotherapy is likely in all patients (with and without early symptom improvement).
Article
Although hypnosis has played a part in psychotherapy for a long time, it is not yet seen as an evidence-based therapy and is absent from many practice guidelines when it comes to the treatment of psychiatric disorders. At present, the applications and methods of hypnotherapy are poorly understood and other methods of psychotherapy tend to be favoured. This review article aims to introduce the role of hypnotherapy and its application for certain common psychiatric presentations, as well as examine its efficacy by summarising recent evidence from high-quality outcome studies and meta-analyses.
Article
Bu derleme makale; duygudurum bozukluğu, anksiyete bozukluğu ve travma sonrası stres bozukluğu deneyimlemiş bireylerde yoga tabanlı uygulamalarının etkililiğini araştırmak üzere, literatür araştırması yapılarak oluşturulmuştur. Derleme makaleye dahil edilen çalışmalar, hakemli ve indeksli dergilerde yayınlanmış olan araştırma makaleleri ile sınırlandırılmıştır. Bu bağlamda; çalışmanın amacı, söz konusu endikasyonlar için yoganın etkililiği konusundaki araştırma kanıtlarını gözden geçirmektir. Tamamlayıcı terapi olarak ele alınan yoganın, iyileştirici unsurları ile ilişkisi araştırılırken, duygudurum, anksiyete/kaygı ve travma sonrası stres bozukluğu konularının üzerinde durulmuştur. Yoga tabanlı uygulamalar, söz konusu bozuklukların remisyonu için çekici bir seçenek olabilmektedir. Araştırmalar, yoga tabanlı uygulamaların, duygudurum, anksiyete ve travma sonrası stres bozukluklarının remisyon süreci ile anlamlı bir ilişkinin bulunduğuna dair veriler sunmaktadır. Ancak, uygulamaların etkililik çalışmalarının olmasıyla birlikte, etkinlik çalışmalarının çok yetersiz olması, literatürdeki bir eksiklik olarak dikkat çekmekte ve yoga tabanlı uygulamaların söz konusu bozuklukların remisyon sürecindeki etkinliğini ve etkililiğini araştıran daha fazla güncel, kanıta dayalı, yüksek kaliteli ve uzun vadeli bilimsel araştırma ve çalışmalara ihtiyaç duyulmaktadır. Sonuç olarak, yardımcı olarak kullanıldığı çalışmalarda yoga uygulamasının, ilaç veya terapi tedavileri ile birlikte, depresyon ve anksiyeteyi azaltmada bir katalizör görevi görmüş olabileceği sonucuna varılmıştır.
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Bu çalışmanın amacı; az gören bireylerde rekreatif faaliyetlere katılmanın önündeki engellerin ve az gören bireylerin algılanan streslerinin incelenmesidir. Bu doğrultuda Rekreatif Faaliyetlere Katılımın Önündeki Engeller ölçeği ve Algılanan Stres ölçeğinden oluşan anket formu 125 az gören bireye uygulanmıştır. Anket kapsamında kullanılan ölçek maddeleri arasındaki içsel tutarlılık Cronbach alpha katsayısı ile ölçülmüştür. Çalışmada Rekreatif Faaliyetlere Katılım Engelleri ölçeğinin yapısal geçerliliği ölçmek amacıyla faktör analizi uygulanmıştır. Rekreatif Faaliyetlere Katılım Engelleri değişkenleri ve Algılanan Stres arasındaki ilişkinin kuvvetini ve yönünü belirlemek amacıyla korelasyon analizi yapılmıştır. Rekreatif Faaliyetlere Katılımın Önündeki Engeller boyutlarının Algılanan Stres üzerindeki etkisini belirlemek amacı ile regresyon analizi gerçekleştirilmiştir. Elde edilen bulgulara göre az gören bireylerin Algılanan Stres düzeylerini etkileyen Rekreatif Faaliyetlere Katılımın Önündeki Engeller değişkenleri Psikolojik ve Sosyal Yetersizlikler, Maddi Yetersizlikler ve Fiziksel Yetersizlikler olarak belirlenmiştir. Algılanan Stres ile Psikolojik ve Sosyal Yetersizlikler ve Maddi Yetersizlikler boyutları arasında pozitif yönde anlamlı bir ilişki belirlenmiştir. Regresyon analizinde elde edilen bulgulara göre, az gören bireylerin Algılanan Stres düzeylerini etkileyen Rekreatif Faaliyetlere Katılım Engelleri değişkenleri Psikolojik ve Sosyal Yetersizlikler ve Maddi Yetersizlikler olarak belirlenmiştir. Bu kapsamda az gören bireylerin de bu faaliyetlere katılıp kazanımlardan faydalanmalarını sağlamak amacıyla az gören bireyin ailesi ve çevresinin daha duyarlı olması ve yerel yönetimlerin bu engellere yönelik geliştirici düzenlemeler gerçekleştirmeleri önerilebilir.
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Objectives Meditation practices and the therapeutic interventions that involve them are numerous, heterogeneous, and multidimensional. Despite this, many researchers have noted a tendency for studies of meditation- and mindfulness-based interventions to inadequately describe the interventions themselves, limiting valid comparisons, generalizations, and identification of mediators and moderators of therapeutic change. To address this, we identified and organized features of meditation-based interventions reported in study publications as an initial step toward systematically developing a reporting guideline.MethodsA content analysis of 118 meditation-based intervention studies, informed by existing theoretical proposals of key features of meditation practices and interventions.ResultsSignificant variability and inconsistency were found in the reporting of structural features of meditation-based programs as well as descriptions of the practices and activities within them. Based on features’ prevalence, co-occurrences, and defining themes, a preliminary Meditation-based Intervention Design (MInD) framework and reporting checklist were developed.Conclusions Findings can inform further development of a reporting guideline and aid in identifying variables of meditation practices and their contexts that are responsible for or influence their effects. This can enhance the quality of research in the field and contribute to improving the effectiveness of meditation- and mindfulness-based interventions.
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Contrary to Western stereotypes that depict yoga as a practice of physical fitness, yoga is an integrated lifestyle consisting of varied practices, including ethics- and values-related commitments, physical practices, breathing practices, and interior practices (e.g., concentration, meditation), carried out with mindfulness and intention. Integrated yoga is suitable for all persons, regardless of age, physical abilities, gender, or body shape. All yoga practices, even yoga postures can be adapted, modified, and performed with the use of props that make them accessible to all. Integrated yoga is a powerful, effective intervention or adjunctive treatment for many physical and mental disorders through profound effects on anatomy, neurophysiology, cognition, emotion, behavior, and relationships. Salutary effects are mediated through enhancement of top-down processing that activates higher-level brain structures and networks (facilitating cognitive self-regulation through attentional control, mindfulness, executive functioning, and metacognititon) and bottom-up processing that activates lower-level brain structures and networks (facilitating physiological and emotional self-regulation, vagal tone, and parasympathetic nervous system engagement). Clinical trials have consistently demonstrated yoga interventions improve a variety of chronic conditions. Referral to yoga is underutilized by clinicians who fail to appreciate the powerful effects of yoga. Clinicians who want to make yoga resources available to their patients are best served by building a referral network of yoga teachers and therapists.
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This study examined the clinical utility of a meditation, mindfulness, and mantra intervention for youth experiencing serious mental illness while incarcerated. Participants were 17 adolescent males, aged 16 to 18, from two units of a county detention center in the San Francisco Bay Area. Eleven (64.7%) participants were Latino-American, one (5.9 %) was Black/African American, three (17.6 %) were Caucasian-American, one (5.9%) was Asian-American and one (5.9%) self-identified as “other/mixed race.” The intervention consisted of a four-session adaptation of the Inner Resources for Teens (IRT) manualized intervention, designed to teach and practice skills for developing sustained mindfulness. Participants completed the intervention over a four-week period, attending one hour per week. They were asked to practice the techniques for ten minutes a day. Participants were assessed using the Child Acceptance and Mindfulness Measure (CAMM) and the Brief Symptom Inventory (BSI) at pre-treatment, mid-treatment, and immediate post-treatment. Intent-to-treat analyzes found statistically significant reductions in global severity (d = − 0.44), positive symptoms distress (d = − 0.54), obsessive compulsive symptoms (d = − 0.65), paranoid ideation (d = − 0.49), and psychoticism (d = − 0.71). Positive symptoms, somatization, depression, hostility, and mindfulness non-significantly improved with small effect sizes. These findings suggest that IRT may improve symptoms of mental illness among youth in detention facilities.
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Four relatively independent emotion-regulation constructs (suppression of negative affect, restraint, repression, and emotional self-efficacy) were tested as outcomes in a randomized trial of supportive-expressive group therapy for women with metastatic breast cancer. Results indicate that report of suppression of negative affect decreased and restraint of aggressive, inconsiderate, impulsive, and irresponsible behavior increased in the treatment group as compared with controls over 1 year in the group. Groups did not differ over time on repression or emotional self-efficacy. This study provides evidence that emotion-focused therapy can help women with advanced breast cancer to become more expressive without becoming more hostile. Even though these aspects of emotion-regulation appear trait-like within the control group, significant change was observed with treatment.
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This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients (n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.
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Several studies have shown that people who engage in ruminative responses to depressive symptoms have higher levels of depressive symptoms over time, after accounting for baseline levels of depressive symptoms. The analyses reported here showed that rumination also predicted depressive disorders, including new onsets of depressive episodes. Rumination predicted chronicity of depressive disorders before accounting for the effects of baseline depressive symptoms but not after accounting for the effects of baseline depressive symptoms. Rumination also predicted anxiety symptoms and may be particularly characteristic of people with mixed anxiety/depressive symptoms.
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The purpose of the current paper is to compare meditational and dissociative states in terms of their effects on consciousness, attention, affect, cognition, identity, and pain sensitivity. To illustrate these dimensions of dissociation, a case example is presented of a veteran with combat-related posttraumatic stress disorder who had particularly severe dissociation symptoms. The Classical Yoga literature is reviewed to examine these dimensions as they pertain to meditational states. Although dissociative and meditational states can involve alterations in consciousness, attention, affect, cognition, identity, and pain sensitivity, the nature of changes in these two states is distinct. Applications of meditation in treatment contexts have made use of some of the powerful techniques for attention control but do not incorporate the full range of practices because of the secular setting of treatment and the goal of symptom relief. The use of meditation as a treatment for dissociation has not been systematically evaluated.
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This study was designed to determine the effectiveness of a group stress reduction program based on mindfulness meditation for patients with anxiety disorders. The 22 study participants were screened with a structured clinical interview and found to meet the DSM-III-R criteria for generalized anxiety disorder or panic disorder with or without agoraphobia. Assessments, including self-ratings and therapists' ratings, were obtained weekly before and during the meditation-based stress reduction and relaxation program and monthly during the 3-month follow-up period. Repeated measures analyses of variance documented significant reductions in anxiety and depression scores after treatment for 20 of the subjects--changes that were maintained at follow-up. The number of subjects experiencing panic symptoms was also substantially reduced. A comparison of the study subjects with a group of nonstudy participants in the program who met the initial screening criteria for entry into the study showed that both groups achieved similar reductions in anxiety scores on the SCL-90-R and on the Medical Symptom Checklist, suggesting generalizability of the study findings. A group mindfulness meditation training program can effectively reduce symptoms of anxiety and panic and can help maintain these reductions in patients with generalized anxiety disorder, panic disorder, or panic disorder with agoraphobia.
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The validity of the General Behavior Inventory (GBI) in screening outpatients for chronic unipolar and bipolar affective conditions was evaluated. The GBI was administered to 492 consecutive patients at a university clinic and a community mental health center. Using a stratified random sampling plan, 167 patients were selected and administered blind structured diagnostic interviews. In addition, unipolar depressives were followed up 6 months after the initial evaluation. Overall, the GBI exhibited fair-to-good positive predictive power and good-to-excellent negative predictive power. In addition, GBI scores in the case range were consistently associated with poor outcome at the 6-month follow-up. These findings suggest that the GBI may provide an economical means of screening for chronic unipolar and bipolar affective conditions in outpatient settings.
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This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.
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The purpose of this study was to determine the effects of antidepressant pharmacotherapy on mood symptoms and psychosocial outcomes in dysthymia. In a multicenter, double-blind, parallel-group trial, 416 patients with a diagnosis of early-onset primary dysthymia (DSM-III-R) of at least 5 years' duration without concurrent major depression were randomly assigned to 12 weeks of acute-phase therapy with sertraline, imipramine, or placebo. The psychosocial outcome measures used in the study were the Global Assessment of Functioning Scale, the Social Adjustment Scale, the Longitudinal Interval Follow-up Evaluation psychosocial ratings, and the Quality of Life Enjoyment and Satisfaction Questionnaire. Sertraline and imipramine were significantly better than placebo in improving psychosocial outcomes as measured by the first three instruments. The Quality of Life Enjoyment and Satisfaction Questionnaire scores demonstrated significant improvements from baseline, and both active treatments produced significantly greater improvements than placebo. Significantly fewer patients discontinued sertraline (6.0%) than discontinued imipramine (18.4%) because of adverse events. Pharmacotherapy is an effective treatment for dysthymia in terms of psychosocial functioning as well as depressive symptoms, even when the dysthymia is long-standing.
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This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients (n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.
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The nosology of chronic depression in Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV, American Psychiatric Association, 1994) is highly complex and requires clinicians to differentiate among several chronic course subtypes. This study replicates an earlier investigation (J. McCullough et al., 2000; see record 2000-05424-007) that found few differences among Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.; DSM-III-R; American Psychiatric Association, 1987) categories of chronic depression. In the present study, 681 outpatients with chronic major depression, double depression, recurrent major depression without full interepisode recovery, and chronic major depression superimposed on antecedent dysthymia were compared. Few differences were observed on a broad range of demographic, clinical, psychosocial, family history, and treatment response variables. The authors suggest that chronic depression should be viewed as a single, broad condition that can assume a variety of clinical course configurations.
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DC): American Psychiatric Press; 1999. 1762 pp. with index. ISBN 0-88048-819-0 (cloth). US$175. As would be expected of both the American Psychiatric Press and the American Psychiatric Associa-tion as an organization, the latest edition of the Textbook ofPsychiatry, edited by Hales, Yudofsky and Talbott, is an impressive book. Members of the editorial board, the intemational advisory board and the individual chapter authors, make up a Who's Who of modern psychiatry, although with a strong American bias. As examples, the chapter entitled "Psychiatric edu-cation" is written by Jonathan Borus, "Clinical neuropsychiatry" by Jeffrey Cummings, contribu-tions on hypnosis and dissociation are provided by David Spiegel, and "Group therapy" is by Irvin Yalom. Thus, in most cases, the chapters have been prepared by leading experts in a particular field. But there is a problem. In many ways, it is one that is illustrated, in parallel fashion, by the inclusion of DSM-IV on CD-ROM in a kind of "book within a book." The CD-ROM is fun easy to load on the computer and browse through but, in the end, not particularly useful.
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Fragestellung Unterschiede in Patientenmerkmalen und stationären therapeutischen Maßnahmen während des Aufenthalts bei chronisch und nicht-chronisch depressiven Patienten sollten ermittelt werden. Methode 1402 konsekutive stationäre Patienten wurden anhand der Kriterien Symptompersistenz, Hospitalisation, Krankheitsdauer und soziale Konsequenzen in die Gruppen chronisch depressiv (n=603) und nicht-chronisch depressiv (n=799) aufgeteilt und bezüglich soziodemographischer und krankheitsrelevanter BADO-Variablen verglichen. Ergebnisse Beide Gruppen unterschieden sich nicht hinsichtlich Geschlecht, Alter, Schweregrad der Erkrankung bzw. psychosozialer Leistungsfähigkeit bei Einweisung. Bei chronisch depressiven Patienten wurde signifikant häufiger non-compliantes Verhalten bei der Psychotherapie sowie der Psychopharmakotherapie dokumentiert. Es kam vermehrt zu einem Behandlungsabbruch gegen ärztlichen Rat. Schlussfolgerungen Compliance fördernde und sichernde Maßnahmen sollten bei chronisch depressiven Patienten intensiviert werden. Zur genaueren Feststellung möglicher Ursachen für eine Chronifizierung und zur Optimierung der Behandlung dieser Patienten werden weitere Studien benötigt. Objective Differences between chronic and nonchronic depressive patients regarding patients' traits and inpatient care should be addressed. Methods 1402 psychiatric in-patients were classified as chronic depressive (n=603) or nonchronic depressive (n=799) using the criteria symptom persistence, hospitalisation, duration of illness and social consequences. These two groups were compared with respect to selected demographic and disease related variables. Results Chronicity was not related to gender, age, severity of illness and psychosocial capability at admission. Chronic depressive in-patients were significantly more non-compliant to psychotherapy and psychopharmacology and dropped out of treatment more frequently. Conclusions Efforts should be made to achieve and secure patients' compliance. Further studies are necessary to evaluate the causes of chronification and to improve the treatment of chronic depressive patients.
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The effects of Zen breath meditation were compared with those of relaxation on college adjustment. 75 undergraduates (aged 17–40 yrs) were divided into 3 groups using randomized matching on the basis of initial anxiety scores of the College Adjustment Scales. Ss also completed the Taylor Manifest Anxiety Scale. The 3 groups included, meditation, relaxation, and control. Training for the meditation and relaxation groups took place during a 1-hr instructional session with written instructions being distributed. After 6 wks anxiety and depression scored significantly decreased for the meditation and relaxation groups. Interpersonal problem scores also significantly decreased for the meditation group. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Describes the medical hypnoanalytic workup and intensive treatment (two and one-half days) of a 24-yr-old woman presenting with poor affect and reporting dissatisfaction with herself. After giving a history, taking a word association test, and receiving a dream suggestion, the S underwent dream analysis and 2 sessions of age regression. The case illustrates that the modality of medical hypnoanalysis is short term, directed, and goal-oriented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Chronic depression appears to be a common, frequently disabling illness that is often inadequately treated. Unlike episodic depressions with shorter illness duration, neither acute nor long-term treatment approaches for chronic depression have been well studied. 635 outpatients at 12 sites who met DSM-III-R criteria for chronic major depression or double depression were randomly assigned to 12 weeks of double-blind treatment with either sertraline (in daily doses of 50-200 mg) or imipramine (in daily doses of 50-300 mg). Efficacy and safety were assessed either weekly or every 2 weeks during the 12 weeks of acute treatment. Despite high rates of chronicity (mean duration of major depression = 8.9+/-9.1 years; mean duration of dysthymia = 23+/-13 years) and high rates of comorbidity, 52% of patients achieved a satisfactory therapeutic response to sertraline or imipramine (by a conservative, intent-to-treat analysis). Approximately 21% of the patients who had achieved a therapeutic response at week 12 had not done so at week 8, confirming the longer time to response in depressions with high chronicity. Patients treated with sertraline reported significantly fewer adverse events and were significantly less likely to discontinue treatment due to side effects than imipramine-treated patients (6.3% vs. 12.0%). These results indicate that patients suffering from depression with high chronicity can achieve a good therapeutic response to acute treatment with either sertraline or imipramine, although sertraline is better tolerated.
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There is an extremely high rate of comorbidity between Dysthymic Disorder (DD) and Major Depressive Disorder (MDD). We used family study data to test four competing models of the relationship between DD, MDD, and comorbid DD/MDD: (1) DD, MDD, and DD/MDD are all variants of a single condition; (2) MDD and DD/MDD are similar, but differ from DD; (3) DD and DD/MDD are similar, but differ from MDD; and (4) all three conditions are distinct disorders. Subjects were the first-degree relatives of 22 outpatients with DD (n=103), 45 outpatients with MDD (n=207), 75 outpatients with comorbid DD/MDD (n=343), and 45 normal controls (n=229). Best-estimate diagnoses of relatives were derived using direct and family history interviews. Relatives of patients with DD and comorbid DD/MDD exhibited significantly higher rates of DD than relatives of patients with MDD and normal probands. The rate of comorbid DD/MDD was significantly higher in the relatives of patients with DD/MDD than the relatives of normal probands. Finally, the relatives of patients with MDD and comorbid DD/MDD exhibited significantly higher rates of MDD than the relatives of normal controls. Although none of the models received unambiguous support, some were more plausible than others.
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Forty five couples in which both partners were complaining of marital discord and in which the wife met DSM-III diagnostic criteria for either major depression and/or dysthymia participated in 15–20 treatment sessions. Couples were randomly assigned to marital therapy (BMT, n=15), individual cognitive therapy for the depressed wife (CBT, n=15), or wait-list control group (WL, n=15). Women in both cognitive therapy and marital therapy experienced significantly greater reductions in depressive symptomatology than did women in the wait-list control group. In addition women in marital therapy had significantly greater increases in marital adjustment than either women in cognitive therapy or women in the wait-list condition. Of special importance in this report, and complimenting our earlier work, were process analyses which indicated that reductions in level of depression among wives in the marital therapy condition were mediated by increases in marital adjustment. Further, exploratory analyses suggested that pre-therapy levels of marital variables and dysfunctional cognitions could predict differential response to marital therapy and cognitive therapy.
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We investigated prevalence and comorbidity of DSM-III dysthymic disorder in a psychiatric outpatient clinic. Seventy-five consecutive outpatients received structured interviews. Prevalence of dysthymic disorder was 36% in the consecutive sample. Thirty-four dysthymic and 56 non-dysthymic patients were compared for comorbidity. Dysthymic subjects were more likely to meet criteria for major depression, social phobia, and avoidant, self-defeating, dependent, and borderline personality disorders. Dysthymic disorder was usually of early onset, predating comorbid disorders, and had often not received adequate antidepressant treatment. These results help define dysthymic disorder as prevalent, usually predating axis I comorbidity, and associated with particular axis II diagnoses.
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Patient resources for coping with breast cancer can be enhanced by attention to cognitive, affective, psychosomatic, and social components of the illness. The diagnosis and treatment of breast cancer constitutes an immediate confrontation with mortality, and sympathetic but direct examination of the patient's vulnerability and means of coping with it will reduce rather than amplify death anxiety. The development and pursuit of realistic goals influenced by the prognosis can help patients adjust constructively. Extremes of emotion are to be expected at times, but persistent depression and/or anxiety should be vigorously treated, including the use of appropriate psychoactive medication when the symptoms are primarily somatic (e.g., sleep disturbance and reductions in energy). Physical symptoms such as pain, nausea, and vomiting can be controlled by teaching patients such techniques as self-hypnosis, biofeedback, and systemic desensitization. Finally, a feeling of social isolation is the rule, not the exception, with cancer patients. Group and family treatment can effectively counter this. Systematic studies of such treatment interventions have shown favorable results, including significant reductions in mood disturbance and pain.
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Vigilance is necessary to identify psychiatric patients with significant physical illness. Amyloidosis is an uncommon disease with symptoms that overlap those of depression. A clinical and pathological review of amyloidosis is presented.
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Data from a survey of five U.S. communities showed that dysthymia affected approximately 3% of the adult population. It was more common in women under age 65, unmarried persons, and young persons with low income and was associated with greater use of general health and psychiatric services and psychotropic drugs. Dysthymia had a high comorbidity with other psychiatric disorders, particularly major depression; only about 25%-30% of cases occur over a lifetime in the absence of other psychiatric disorders. The findings suggest that although the onset and highest risk periods of major depression and bipolar disorder are in young adulthood, a residual state of dysthymia occurs in middle and old age.
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Hypnotic age-progression and posthypnotic suggestion were used to facilitate a predetermined therapeutic change in a 24-year-old female, whose problems included depression, anxiety, social isolation and a very poor self-concept. Hypnosis enabled this patient to project herself into a successful future and to “remember” the events that had led her to that imagined successful outcome. A posthypnotic suggestion to carry out those “remembered” events led to rapid alterations in behavior, personality, and emotional adjustment.
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A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
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The author reviews empirical research on the psychotherapy of dysthymia. Dysthymia, a prevalent mood disorder, has been shown frequently to respond to antidepressant medication. The need for a treatment for dysthymic subjects unable or unwilling to take, or unresponsive to, medication still remains. Studies were located by computerized search and the author's knowledge of the literature. All reports of studies on psychotherapy outcome for dysthymic patients, except studies of late-life chronic major depression, were included. Psychotherapy research on dysthymia has been confined to small, usually uncontrolled studies with varying methods and limited follow-up. Cognitive approaches have been most frequently studied; the results have not been dramatic but do suggest that some dysthymic patients respond to brief cognitive therapies. Preliminary results of an ongoing study of interpersonal psychotherapy are promising. Given the public health importance of dysthymia and the availability of treatments, the time is ripe for clinical trials of antidysthymic psychotherapy. The author proposes the following guidelines for such trials: time-limited, manual-based psychotherapy, interpersonal focus, serial design, continuation and maintenance treatment, combined treatments, and follow-up assessments.
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Subdysthymic depression occurs in 20-50% of hospitalized elderly and is associated with physical and social disability, delayed recovery, and excess health service use. Despite this, little is known regarding the nature of such depressive symptomatology, or its responsivity to treatment. To address this, a randomized clinical trial assessing the feasibility and efficacy of Interpersonal Counseling (IPC), a short-term psychotherapy, was conducted. Patients 60+ with a Geriatric Depression Scale (GDS) score > 10 not meeting DSM-III-R criteria for major depression or dysthymia were recruited from the acute hospital. Thirty-five individuals were randomized to IPC and 41 to usual care (UC). IPC was delivered following hospital discharge by psychiatric clinical nurse specialists. Interviews were conducted at recruitment and 3, 6, and 12 months later. Primary outcomes were GDS scores, health ratings, and measures of physical and social functioning. At 3 months, IPC group members showed greater improvement than UC members on all outcome variables; between-group differences did not reach statistical significance. At 6 months, a statistically significant difference in the rate of improvement in GDS, indicated by scores of 10 or less, was observed for IPC compared to UC members (60.6% vs 35.1%). Multivariate analyses confirmed a positive treatment effect on depressive symptoms. Similar multivariate analyses showed a statistically significant positive treatment effect on self-rated health but not on physical or social functioning. IPC appears feasible, acceptable, and effective in short-term depressive symptom reduction and in improvement in self-rated health. Implementation of IPC interventions for subdysthymic hospitalized elderly is recommended.
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Dysthymia is a chronic depressive condition that is quite prevalent. This condition can exact a significant toll on the general health and quality of life in the affected individual. Despite the frequency and consequences of dysthymia, however, the condition is often not diagnosed or treated. We present data on prior treatment from 410 patients with DSM-III-R dysthymia, primary type, early onset without concurrent major depression. Axis I and II diagnoses were made by using the Structured Clinical Interviews for DSM-III-R, Patient Version (SCID-P) and SCID II for Personality Disorders. The Hamilton Rating Scale for Depression and the Clinical Global Impressions scale were also completed. Prior treatment was assessed, with special attention paid to previous antidepressant drug therapy and psychotherapy. Although the mean duration of dysthymia was about 30 years and almost half of the patients had previous episodes of major depression, only 41.3% had been treated with antidepressants and 56.1% with psychotherapy. A past history of major depression increased the frequency of prior antidepressant pharmacotherapy (45.7%) and psychotherapy (59.4%) compared with no history of major depression (36.8% and 40.9%, respectively). Comorbid personality disorder increased the likelihood of prior psychotherapy (70.7% vs. 49.6%) while having no effect on past pharmacotherapy. A history of substance abuse did not affect the history of antidepressant or psychotherapy treatment. In this study, dysthymia and psychosocial outcomes improved with sertraline and imipramine treatment. Dysthymic patients in this sample were significantly undertreated. Newer antidepressant agents may alter the potential for pharmacotherapy interventions in this vulnerable population.
Article
The aim of this article is to review and put in their historical context today's data, methodologies and concepts concerning subaffective disorders. The historic roots of dysthymic and cyclothymic disorders--part of the subaffective spectrum--are essentially Greek, but the first use of the word 'dysthymia' in psychiatry was by C.F. Flemming in 1844. E. Hecker introduced the term 'cyclothymia' in 1877. K.L. Kahlbaum (1882) further developed the concepts of hyperthymia, cyclothymia and dysthymia--with possible subthreshold symptomatology--in 1882. After Kraepelin's rubric of 'manic-depressive insanity', the term 'dysthymia' was widely forgotten, and 'cyclothymia' became ill defined. Nowadays the latter term is used in three, partially contradictory, senses: (1) a synonym for bipolar disorder (K. Schneider), (2) a temperament (E. Kretschmer) and (3) a subaffective disorder (DSM-IV, ICD-10). A renaissance of subaffective disorders began with the development of DSM-III. Therapeutically important research has focused on dysthymic disorder and its relationship to major depressive disorder, while cyclothymic disorder is relatively neglected; nonetheless, operationalized as a subaffective dimension or temperament, cyclothymia appears to be a likely precursor or ingredient of the construct of bipolar II disorder.
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This chapter focuses on recent developments in our understanding of the etiology, epidemiology, and treatment of recurrent mood disorders. It addresses the changing relationship between endogenous and exogenous factors over time in the etiology of mood episodes. In the area of epidemiology, the chapter presents new information on the prevalence of various subtypes and male/female differences in lifetime risk. Complications of the mood disorders, such as suicide, and important comorbidities, including alcoholism and substance abuse, are discussed. In the area of treatment, the life-long nature of many of the mood disorders is described, as is the consequent role of the primary care physician in their management. The evidence for the efficacy of the depression-specific psychotherapies, cognitive therapy and interpersonal therapy, is reviewed. Current issues in the pharmacotherapy of mood disorders are discussed, including the relative efficacy of the older antidepressants versus the newer selective serotonin reuptake inhibitors (SSRIs) and the treatment of various subtypes of mood disorders, including dysthymia, chronic depression, and atypical depression. Finally, the chapter describes recent advances in the treatment of bipolar disorder.
Article
This article provides an update on the diagnosis of chronic depression subtypes, the clinical and public health significance of chronic depression, and a review of what is known about its treatment. The efficacy of antidepressant medications for pure dysthymia and double depression has been established, yet fewer than 50% of patients have achieved full remission with a single agent. Traditional antidepressant psychotherapies appear to have limited effectiveness for chronic depression. In one recent study, a combination of cognitive behavioral analysis system of psychotherapy and a newer antidepressant, nefazodone, yielded the highest response and remission rates ever reported in this population (73% response rate, 48% remission rate in an intent-to-treat sample). This combination merits further study for treatment of chronic depression.
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Several studies have shown that people who engage in ruminative responses to depressive symptoms have higher levels of depressive symptoms over time, after accounting for baseline levels of depressive symptoms. The analyses reported here showed that rumination also predicted depressive disorders, including new onsets of depressive episodes. Rumination predicted chronicity of depressive disorders before accounting for the effects of baseline depressive symptoms but not after accounting for the effects of baseline depressive symptoms. Rumination also predicted anxiety symptoms and may be particularly characteristic of people with mixed anxiety/depressive symptoms.
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The Hamilton Depression Rating Scale (HAM-D) has become the most widely used depression severity rating scale in the world. It was originally published by Max Hamilton in 1960 to measure severity of depression in previously diagnosed depressed inpatients. Since that time, multiple versions of the scale have been created, although authors are rarely clear about which version they used. In addition, structured interview guides, self-report forms, and computerized versions have been developed in an effort to standardize administration of the scale and improve the psychometric characteristics of the individual items. The history of the development of these features is discussed, and the various versions of the scale are summarized in tables. This article is a fitting tribute to Per Bech, who has contributed so much to the assessment of depression severity.
Article
Mason et al. developed the Cornell Dysthymia Rating Scale (CDRS), a 20-item clinician-rated inventory, and hypothesized that it may be superior to the commonly-used Hamilton Depression Rating Scale (HDRS) in assessing the symptoms of dysthymia, a form of chronic depression. The purpose of this study was to compare these instruments in an outpatient sample of dysthymic patients. The CDRS and the HDRS and other inventories (including the Hopkins Symptom Check List (SCL)) were administered to 110 patients meeting DSM-IIIR diagnosis of dysthymia. There was a significant correlation between the CDRS and the HDRS at baseline and termination, indicating concurrent validity. Distributional statistics were compared for baseline and termination severity scores, showing that the CDRS has greater severity range scores than the HDRS. Furthermore, results of the DSM-IV Mood Disorders Field Trial suggest that the CDRS has better content validity than the HDRS when it comes to the dysthymic population. The results are limited by the use of a homogeneous sample, the absence of observer ratings of divergent symptoms, and less than excellent validity of self-report divergent symptoms. Our results support the value of the CDRS in assessing symptoms of dysthymia.
Article
A large number of rating scales has been developed to assess depression severity and change during antidepressant therapy. When reviewing the literature, the choice of the rating scales used in a particular study often seems arbitrary. The most frequently used observer rating scales, the Hamilton Depression Rating Scale (HDRS) and the Montgomery-Asberg Depression Rating Scale (MADRS), and the most frequently used self-rating scale (the Beck Depression Inventory, or BDI) were developed more than 20 years ago. Their historical background is too often forgotten and they are reflections of their origin: the HDRS and the MADRS reflect antidepressant activity while the BDI reflects psychotherapy. Moreover, the HDRS is at risk of putting 'all depressions in one basket', while the MADRS is at risk of putting 'all antidepressants in one basket'. Therefore, the question whether a particular antidepressant could be more effective in a particular subtype of depression cannot be answered. Observer rating scales are more frequently used than self-rating scales, and when scales are used that do exist in an observer rating and a self-rating version, interesting differences are found. The present paper does not suggest that one scale is better than another, but suggests that a better knowledge of their differential background can help the researcher choose the correct scale for his purposes.