Engagement with mobile health interventions for depression: A systematic review

Mekonen, T., Chan, G., Connor, J. P., Hides, L., & Leung, J. (2021). Estimating the global treatment rates for depression: A systematic review and meta-analysis. Journal of affective disorders, 295, 1234–1242. https://doi.org/10.1016/j.jad.2021.09.038

  • “Background: Depressive disorders are a major public health problem, and many people face barriers to accessing evidence-based mental health treatment. Mobile health (mHealth) interventions may circumvent logistical barriers to in-person care (e.g., cost, transportation), however the symptoms of depression (low motivation, concentration difficulties) may make it difficult for people with the disorder to engage with mHealth.”
  • Objective: The aim of this systematic review is to examine assessment and reporting of engagement in clinical trials of mHealth interventions for depression, including objective engagement (e.g., number of times program is used), subjective engagement (e.g., qualitative data on users’ experiences), and associations between engagement and other clinically important variables (e.g., symptom improvement, participant characteristics).
  • “Results: Thirty studies met inclusion criteria and were reviewed. Most studies reported objective engagement (N = 23, 76.7%), approximately half reported subjective engagement (N = 16, 53.3%), and relatively few examined associations between engagement and clinical improvement, participant characteristics, or other clinically relevant variables (N = 13, 43.3%).”
  • “Conclusions: Although most studies in this small but rapidly growing literature report at least one measure of engagement, there is substantial heterogeneity. Intentional, theory-driven, and consistent measurement of engagement with mHealth interventions for depression may advance the field’s understanding of effective engagement to facilitate clinical improvement, identify dose-response relationships, and maximize generalizability for underserved populations.”

Clinical interventions for adults with comorbid alcohol use and depressive disorders: A systematic review and network meta-analysis

Grant, S., Azhar, G., Han, E., Booth, M., Motala, A., Larkin, J., & Hempel, S. (2021). Clinical interventions for adults with comorbid alcohol use and depressive disorders: A systematic review and network meta-analysis. PLoS medicine18(10), e1003822. https://doi.org/10.1371/journal.pmed.1003822

  • “Background: Uncertainty remains regarding the effectiveness of treatments for patients diagnosed with both an alcohol use disorder (AUD) and depressive disorder. This study aimed to compare the effectiveness of clinical interventions for improving symptoms of adults with co-occurring AUDs and depressive disorders.”
  • “Methods and findings: We searched CINAHL, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Excerpta Medica Database, International Clinical Trials Registry Platform (ICTRP), PubMed, PsycINFO, and Web of Science from inception to December 2020. We included randomized controlled trials (RCTs) evaluating clinical interventions for adults with co-occurring AUDs and depressive disorders.”
  • “Conclusions: We are very uncertain about the existence (or not) of any non-null effects for our primary outcomes of remission from depression and remission from alcohol use. The available evidence does suggest that CBTs likely reduced, and TCAs may have resulted in a slight reduction of depressive symptoms. SSRIs likely increased functional status, and SSRIs and CBTs may have resulted in a slight reduction of alcohol use. However, patients receiving SSRIs also likely had an increased risk of experiencing an adverse event. In addition, these conclusions only apply to postintervention and are not against active comparators, limiting the understanding of the efficacy of interventions in the long term as well as the comparative effectiveness of active treatments. As we did not have high confidence in any outcomes, additional studies are warranted to provide more conclusive evidence.”

Efficacy and safety of acupuncture in the treatment of depression: A systematic review of clinical research

Zhang, Z., Li, S., Meng, H., Wang, Y., Zhang, Y., Wu, M., Chen, Y., Rong, P., & Wang, Y. (2021). Efficacy and safety of acupuncture in the treatment of depression: A systematic review of clinical research. Anatomical record (Hoboken, N.J. : 2007)304(11), 2436–2453. https://doi.org/10.1002/ar.24783

  • “As a common mental disorder, depression is one of the leading causes of disability around the world. Clinical studies have shown that acupuncture is an effective therapy without obvious side effects compared to limited efficacy and adverse reactions of drug therapy, cognitive behavioral therapy, and neuromodulation technology in treating depression.”
  • “The objective of this review is to systematically evaluate whether acupuncture therapies for depression are safe and effective in order to provide a high-quality reference for clinical trials of acupuncture. A systematic search of the literature was carried out through bibliographic search engine PubMed. Subsequently, the study design, intervention methods, control group, results, and safety of acupuncture were analyzed.”
  • “The results showed that acupuncture as an adjunct to antidepressants or as a single treatment can exert a positive impact on patients’ depressive symptoms. Compared with antidepressants, acupuncture has the advantages of fast onset and long-term efficacy in the treatment of depression, and can enhance the efficacy of antidepressants. Moreover, the efficacy and safety of acupuncture in the treatment of depression maybe related to the qualification of the acupuncturist, the selection of acupoints, and intervention measures.”

 

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