Venlafaxine XR treatment for older patients with major depressive disorder: decision trees for when to change treatment
Conclusion
Our decision trees have the potential to guide treatment in older patients with MDD but they require to be validated in other larger samples.
Clinical implications
Once confirmed, our findings may be used to guide changes in antidepressant treatment in older patients with poor early response. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Kim, H. K., Blumberger, D. M., Karp, J. F., Lenze, E., Reynolds, C. F., Mulsant, B. H. Tags: Pharmacological treatments Source Type: research
Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies
Conclusions
A wide range of predisposing and precipitating factors are associated with suicide among adults in the general population, but with clear differences in their relative strength.
PROSPERO registration number
CRD42021232878. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Favril, L., Yu, R., Uyar, A., Sharpe, M., Fazel, S. Tags: Open access Systematic review Source Type: research
From living systematic reviews to meta-analytical research domains
Because of the rapidly increasing number of randomised controlled trials (RCTs) and meta-analyses in many fields, there is an urgent need to step up from meta-analyses to higher levels of aggregation of outcomes of RCTs. Network meta-analyses and umbrella reviews allow higher levels of aggregation of RCT outcomes, but cannot adequately cover the evidence for a whole field. The ‘Meta-Analytic Research Domain’ (MARD) may be a new methodology to aggregate RCT data of a whole field. A MARD is a living systematic review of a research domain that cannot be covered by one PICO. For example, a MARD of psychotherapy for...
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Cuijpers, P., Miguel, C., Papola, D., Harrer, M., Karyotaki, E. Tags: Open access, Editor's choice Perspective Source Type: research
Carpe diem
Nine years ago, in my first editorial for Evidence-Based Mental Health (EBMH) as editor in chief, I wrote that ‘EBMH should be seen as a tool to engage new generations of psychiatrists and psychologists to develop and implement the evidence-based approach into daily clinical practice.’ I took the job when I moved to Oxford and one of the main reasons why I accepted the challenge of editing this journal was the name of the journal itself. Evidence is anything presented in support of an assertion. Even if ‘evidence’ is not necessarily ‘evident’, be it strong (ideal scenario) or weak (too o...
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Cipriani, A. Tags: Editorials Source Type: research
Comment on: 'Vitruvian plot: a visualisation tool for multiple outcomes in network meta-analysis
Ostinelli et al developed an interesting visualisation tool, the Vitruvian plot, to present multiple outcomes in network meta-analysis.1 We write to make some suggestions and potential improvements. First, to present the strength of statistical evidence, the authors colour the sectors according to the p values of a Z-test. According to the Cochran handbook,2 this could lead to over-reliance and misinterpretation of p values, and assertive judgements about imprecision. One solution is to use a partially contextualised approach, according to the guidance of the GRADE working group.3 This approach also encourages researchers ...
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Lai, H., Sun, M., Pan, B., Ge, L. Tags: Letter Source Type: research
How to measure mental pain: a systematic review assessing measures of mental pain
Conclusions and clinical implications
There is not enough evidence of validity to recommend using one measure over others in research or clinical practice. Heterogeneous use of disparate measures across studies limits comparison and combination of their results in meta-analyses. Development by all stakeholders (especially patients) of a consensual patient-reported measure for mental pain is needed.
PROSPERO registration number
CRD42021242679. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Charvet, C., Boutron, I., Morvan, Y., Le Berre, C., Touboul, S., Gaillard, R., Fried, E., Chevance, A. Tags: Systematic review Source Type: research
Predictors of longer-term depression trajectories during the COVID-19 pandemic: a longitudinal study in four UK cohorts
Conclusions
Feeling lonely and isolated had a large effect on depression trajectories across all generations, while social distancing measures did not.
Clinical implications
These findings highlight the importance of fostering the feeling of connectedness during COVID-19-related distancing measures. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Rosa, L., Godwin, H. J., Cortese, S., Brandt, V. Tags: COVID-19 Adult mental health Source Type: research
COP27 climate change conference: urgent action needed for Africa and the world
Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change The 2022 report of the Intergovernmental Panel on Climate Change paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction and climate hazards such as heatwaves and floods.1 These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals...
Source: Evidence-Based Mental Health - November 17, 2022 Category: Psychiatry & Psychology Authors: Zielinski, C., on behalf of the authorship group listed below Tags: Open access Editorials Source Type: research
Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials
Conclusions
The enthusiasm for MBPs in youth has arguably run ahead of the evidence. While MBPs show promising results for some outcomes, in general, the evidence is of low quality and inconclusive. We discuss a conceptual model and the theory-driven innovation required to realise the potential of MBPs in supporting youth mental health. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - July 21, 2022 Category: Psychiatry & Psychology Authors: Dunning, D., Tudor, K., Radley, L., Dalrymple, N., Funk, J., Vainre, M., Ford, T., Montero-Marin, J., Kuyken, W., Dalgleish, T. Tags: Open access Systematic review Source Type: research
Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial
Conclusions
SBMT supports short-term changes in teacher burnout and school climate. Further work is required to explore how best to sustain improvements.
Clinical implications
SBMT has limited effects on teachers’ mental and school climate. Innovative approaches to support and preserve teachers’ mental health and school climate are needed. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - July 21, 2022 Category: Psychiatry & Psychology Authors: Kuyken, W., Ball, S., Crane, C., Ganguli, P., Jones, B., Montero-Marin, J., Nuthall, E., Raja, A., Taylor, L., Tudor, K., Viner, R. M., Allwood, M., Aukland, L., Dunning, D., Casey, T., Dalrymple, N., De Wilde, K., Farley, E.-R., Harper, J., Hinze, V., Ka Tags: Open access Child and adolescent mental health Source Type: research
School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?
Background
Preventing mental health problems in early adolescence is a priority. School-based mindfulness training (SBMT) is an approach with mixed evidence.
Objectives
To explore for whom SBMT does/does not work and what influences outcomes.
Methods
The My Resilience in Adolescence was a parallel-group, cluster randomised controlled trial (K=84 secondary schools; n=8376 students, age: 11–13) recruiting schools that provided standard social–emotional learning. Schools were randomised 1:1 to continue this provision (control/teaching as usual (TAU)), and/or to offer SBMT (‘.b’ (intervention)). Risk ...
Source: Evidence-Based Mental Health - July 21, 2022 Category: Psychiatry & Psychology Authors: Montero-Marin, J., Allwood, M., Ball, S., Crane, C., De Wilde, K., Hinze, V., Jones, B., Lord, L., Nuthall, E., Raja, A., Taylor, L., Tudor, K., MYRIAD Team, Blakemore, S.-J., Byford, S., Dalgleish, T., Ford, T., Greenberg, M. T., Ukoumunne, O. C., Willia Tags: Open access, Editor's choice Child and adolescent mental health Source Type: research
The impact of mindfulness training in early adolescence on affective executive control, and on later mental health during the COVID-19 pandemic: a randomised controlled trial
Conclusions
There is no evidence that MT improves affective control or downstream mental health of young people during stressful periods.
Clinical implications
We need to identify interventions that can enhance affective control and thereby young people’s mental health. (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - July 21, 2022 Category: Psychiatry & Psychology Authors: Dunning, D., Ahmed, S., Foulkes, L., Griffin, C., Griffiths, K., Leung, J. T., Parker, J., Piera Pi-Sunyer, B., Sakhardande, A., Bennett, M., Haag, C., Montero-Marin, J., Packman, D., Vainre, M., Watson, P., The MYRIAD Team, Kuyken, W., Williams, J. M. G. Tags: Open access, COVID-19 Child and adolescent mental health Source Type: research
Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial
Conclusions
Findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence.
Clinical implications
There is need to ask what works, for whom and how, as well as considering key contextual and implementation factors.
Trial registration
Current controlled trials ISRCTN86619085. This research was funded by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z). (Source: Evidence-Based Mental Health)
Source: Evidence-Based Mental Health - July 21, 2022 Category: Psychiatry & Psychology Authors: Kuyken, W., Ball, S., Crane, C., Ganguli, P., Jones, B., Montero-Marin, J., Nuthall, E., Raja, A., Taylor, L., Tudor, K., Viner, R. M., Allwood, M., Aukland, L., Dunning, D., Casey, T., Dalrymple, N., De Wilde, K., Farley, E.-R., Harper, J., Kappelmann, N Tags: Open access Child and adolescent mental health Source Type: research
Universal prevention of depression at schools: dead end or challenging crossroad?
Universal school programmes aimed at the prevention of depression and other common mental health problems in adolescents are attractive because they are less stigmatising than targeted interventions, have a high uptake and may shift the ‘normal distribution’ of mental health problems in the positive direction. Research up to now shows small effects of these interventions, but even small effects may have a large impact because of the large number of people receiving these interventions. However, such small effects may also be related to the modest quality of the trials in this area. This means that current resea...
Source: Evidence-Based Mental Health - July 21, 2022 Category: Psychiatry & Psychology Authors: Cuijpers, P. Tags: Perspective Source Type: research
How can we optimise learning from trials in child and adolescent mental health?
Improving child and adolescent mental health requires the careful development and rigorous testing of interventions and delivery methods. This includes universal school-based mindfulness training, evaluated in the My Resilience in Adolescence (MYRIAD) trial reported in this special edition. While discovering effective interventions through randomised controlled trials is our ultimate aim, null or negative results can and should play an important role in progressing our understanding of what works. Unfortunately, alongside publication bias there can be a tendency to ignore, spin or unfairly undermine disappointing findings....
Source: Evidence-Based Mental Health - July 21, 2022 Category: Psychiatry & Psychology Authors: Axford, N., Berry, V., Lloyd, J., Wyatt, K. Tags: Perspective Source Type: research
