Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types
Cuijpers P, Quero S, Noma H, Ciharova M, Miguel C, Karyotaki E, Cipriani A, Cristea IA, Furukawa TA. Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry. 2021 Jun;20(2):283-293. doi: 10.1002/wps.20860. PMID: 34002502.
- “The effects of psychotherapies for depression have been examined in several hundreds of randomized trials, but no recent network meta-analysis (NMA) has integrated the results of these studies. We conducted an NMA of trials comparing cognitive behavioural, interpersonal, psychodynamic, problem-solving, behavioural activation, life-review and “third wave” therapies and non-directive supportive counseling with each other and with care-as-usual, waiting list and pill placebo control conditions.”
- “Response (50% reduction in symptoms) was the primary outcome, but we also assessed remission, standardized mean difference, and acceptability (all-cause dropout rate). Random-effects pairwise and network meta-analyses were conducted on 331 randomized trials with 34,285 patients.”
- * All therapies were more efficacious than care-as-usual and waiting list control conditions, and all therapies – except non-directive supportive counseling and psychodynamic therapy – were more efficacious than pill placebo.”
- “Individual psychotherapies did not differ significantly from each other, with the only exception of non-directive supportive counseling, which was less efficacious than all other therapies.”
- “Our conclusion is that the most important types of psychotherapy are efficacious and acceptable in the acute treatment of adult depression, with few significant differences between them.”
- “Patient preference and availability of each treatment type may play a larger role in the choice between types of psychotherapy, although it is possible that a more detailed characterization of patients with a diagnosis of depression may lead to a more precise matching between individual patients and individual psychotherapies.”
A systematic review of neuropsychological and psychiatric sequalae of COVID-19: implications for treatment
Vanderlind WM, Rabinovitz BB, Miao IY, Oberlin LE, Bueno-Castellano C, Fridman C, Jaywant A, Kanellopoulos D. A systematic review of neuropsychological and psychiatric sequalae of COVID-19: implications for treatment. Curr Opin Psychiatry. 2021 May 19. doi: 10.1097/YCO.0000000000000713. Epub ahead of print. PMID: 34016818.
- “This systematic review aims to synthesize available literature on psychiatric and cognitive characteristics of community-dwelling survivors of COVID-19 infection.”
- “Thirty-three studies met inclusion/exclusion criteria for review. Emerging findings link COVID-19 to cognitive deficits, particularly attention, executive function, and memory. Psychiatric symptoms occur at high rates in COVID-19 survivors, including anxiety, depression, fatigue, sleep disruption, and to a lesser extent posttraumatic stress. Symptoms appear to endure, and severity of acute illness is not directly predictive of severity of cognitive or mental health issues.”
- “The course of cognitive and psychiatric sequelae is limited by lack of longitudinal data at this time. Although heterogeneity of study design and sociocultural differences limit definitive conclusions, emerging risk factors for psychiatric symptoms include female sex, perceived stigma related to COVID-19, infection of a family member, social isolation, and prior psychiatry history.”
- “Research using longitudinal, prospective study designs is needed to characterize cognitive and psychiatric functioning of COVID-19 survivors over the course of illness and across illness severity. Emphasis on delineating the unique contributions of premorbid functioning, viral infection, co-morbidities, treatments, and psychosocial factors to cognitive and psychiatric sequelae of COVID-19 is warranted.”
Characterization of gut microbiome in mice model of depression with divergent response to escitalopram treatment
Duan J, Huang Y, Tan X, Chai T, Wu J, Zhang H, Li Y, Hu X, Zheng P, Ji P, Zhao L, Yang D, Fang L, Song J, Xie P. Characterization of gut microbiome in mice model of depression with divergent response to escitalopram treatment. Transl Psychiatry. 2021 May 20;11(1):303. doi: 10.1038/s41398-021-01428-1. PMID: 34016954.
- “Depression is a common and heterogeneous mental disorder. Although several antidepressants are available to treat the patients with depression, the factors which could affect and predict the treatment response remain unclear.”
- “Here, we characterize the longitudinal changes of microbial composition and function during escitalopram treatment in chronic unpredictable mild stress (CUMS) mice model of depression based on 16 S rRNA sequencing and metabolomics. Consequently, we found that escitalopram (ESC) administration serves to increase the alpha-diversity of the gut microbiome in ESC treatment group.”
- “Together, our study demonstrated that the alterations of microbial compositions and metabolic functions might be relevant to the different response to ESC, which shed new light in uncovering the mechanisms of differences in efficacy of antidepressants.”
Transcriptomics identifies STAT3 as a key regulator of hippocampal gene expression and anhedonia during withdrawal from chronic alcohol exposure
Chen WY, Chen H, Hamada K, Gatta E, Chen Y, Zhang H, Drnevich J, Krishnan HR, Maienschein-Cline M, Grayson DR, Pandey SC, Lasek AW. Transcriptomics identifies STAT3 as a key regulator of hippocampal gene expression and anhedonia during withdrawal from chronic alcohol exposure. Transl Psychiatry. 2021 May 20;11(1):298. doi: 10.1038/s41398-021-01421-8. PMID: 34016951.
- “Alcohol use disorder (AUD) is highly comorbid with depression. Withdrawal from chronic alcohol drinking results in depression and understanding brain molecular mechanisms that drive withdrawal-related depression is important for finding new drug targets to treat these comorbid conditions.”
- “Here, we performed RNA sequencing of the rat hippocampus during withdrawal from chronic alcohol drinking to discover key signaling pathways involved in alcohol withdrawal-related depressive-like behavior. Data were analyzed by weighted gene co-expression network analysis to identify several modules of co-expressed genes that could have a common underlying regulatory mechanism.”
- “These results demonstrate activation of STAT3 signaling in the hippocampus during alcohol withdrawal in rats and in human AUD subjects, and suggest that STAT3 could be a therapeutic target for reducing comorbid AUD and depression.”
The Treatment Scout website helps people find effective inpatient and residential care. It can also help you explore other intensive care options for mental health, addiction, etc. Find out more at http://www.treatmentscout.com/
NAMI Montana’s has a resource guide for every county in Montana. Check it out at https://namimt.org/montana-county-mental-health-resource-guides/