Vanessa Blanco

An adaptation of the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations

To adapt the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations, a Spanish translation of the scale was interviewer-administered to 554 subjects aged 18-34 years (65.9% women) and the ratings so obtained were compared with the SCID-CV-based diagnoses of expert clinicians. The internal consistency of the scale was satisfactory (Cronbachs alpha=0.89). Four factors identified by exploratory factor analysis (Depressive/Somatic, Positive Affect, Retarded Activity and Interpersonal Relations) accounted for 55.9% of the variance. A score of 26 was identified as a suitable cut-off for screening purposes, affording a sensitivity of 0.906 and a specificity of 0.918.

Comparison of relaxation training with a cognitive-behavioural intervention for indicated prevention of depression in university students: A randomized controlled trial

Although cognitive-behavioural programmes for preventing depression have produced promising findings, their administration requires extensive training. Relaxation techniques are more straightforward psychological strategies, but they have not been investigated in the prevention of depression. This trial aimed to compare the results of relaxation training (RT) with that of a cognitive-behavioural programme (CBT) for prevention of depression in university students with elevated depressive symptoms. The 133 participants (mean age 23.3 years, 82% women) were randomly assigned to CBT or RT. Both programmes were administered to groups of 5 or 6 participants in eight weekly 90-min sessions. Participants were evaluated by independent raters before, immediately after, and 3 and 6 months after taking part in the programmes. By itself, intervention type had no significant effect on either depression or anxiety scores. The scores were lower at the follow-up time points with respect to pre-intervention scores. Effect size was greatest between pre- and immediately post-intervention scores for CBT, d = 1.32, 95% CI [1.00, 1.64], and between pre- and 6-month post-intervention scores for RT, d = 0.75, 95% CI [0.47, 1.03]. Anxiety symptoms were significantly improved by both interventions at 3-month follow-up, and by CBT at 6-month follow-up also. In the medium term (3-6 months), relaxation training produced similar reductions in depressive and anxiety symptoms as a more complex cognitive-behavioural programme.

Symptoms of Depression and Related Factors among Spanish University Students

A 554-member stratified random sample of students at a Spanish university (65.9% women; aged 18–34 years) was screened for symptoms of depression using a new Castilian Spanish translation of the Center for Epidemiologic Studies Depression Scale (CES-D) that had been validated by back-translation. Mean CES-D score was 14.2 (SD = 10.3, range 0-54), with a significant difference between the scores of women (M = 15.5; SD = 10.9) and men (M = 11.8; SD = 8.4; t552 = 4.06, p <.0005). Some 33% of the sample screened positive with the usual CES-D screening threshold of 16, and 16% with the threshold of 24 recommended by Clarke and coworkers. The symptoms most commonly experienced all or most of the time were hopelessness, given the maximum rating by 18.8% of students, difficulty in concentration (17.7%), fatigue (13.9%), inadequacy (13.0%), and disturbance of sleep (12.4%).

Prevalence of major depressive episodes in non-professional caregivers.

Despite research demonstrating the psychological burden associated with caregiving, there is limited information regarding the real rates of clinical depression among non-professional caregivers (NCs) of dependent patients. The goals of the current study are (a) to report the prevalence of major depressive episodes (MDEs) and the frequency of depressive symptoms in NCs from Galicia (Spain) and (b) to examine the relationship between MDEs and characteristics of caregivers, care recipients, and the care situation. A sample of 504 NCs providing care to persons with all kinds of disorders that result in dependency was randomly selected, and the occurrence of MDEs was assessed by trained interviewers who applied the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version (SCID-CV). Overall, 8.9% of NCs met the criteria for a current MDE. Sleep problems, diminished ability to think or concentrate, and depressed mood were the clinical depressive symptoms most frequently reported. MDEs were significantly more common among NCs older than 55 years old (odds ratio [OR]=1.96; 95% confidence interval [CI]: 1.02-3.75) and those who were unemployed (OR=3.43; 95% CI 1.02-11.48). The findings highlight the magnitude of major depression in this population.

Identification of caregivers at greatest risk of major depression in two prevention studies

Abstract Object: The high prevalence and negative consequences of depression in caregivers have led to the development of depression prevention programs for this population. Their efficacy might be influenced by depression risk factors, and different interventions might fit specific caregiver profiles. Study goals were to examine (1) which subgroups of female caregivers had the highest likelihood of major depression (MDD) onset by 12-month follow-up based on depression risk factors and participation in two depression prevention programs, and (2) specific MDD predictors for each prevention approach. Method: Data were analyzed from two randomized trials: (1) cognitive-behavioral group (CB) vs. usual care (UC); n = 165; (2) problem-solving group (PS) vs. UC; n =165 (mean age = 54.5). Results: Classification tree analysis showed that emotional distress (ED) was the strongest predictor in both trials. Additional MDD predictors were (i) lower age (for caregivers with low ED); (ii) working outside the home (for caregivers with intermediate ED); and (iii) higher autonomy in the care-recipient (for homemakers). The strongest predictors for each prevention intervention were lower age for CB, higher social class for PS, and ED and depressive symptoms for UC. Conclusions: Results implicate the utility of emotional distress for depression screening and the need to develop tailored interventions.

Long-term Follow-up of a Randomized Clinical Trial Assessing the Efficacy of a Brief Cognitive-Behavioral Depression Prevention Intervention for Caregivers with Elevated Depressive Symptoms.

OBJECTIVES To evaluate the efficacy of a cognitive-behavioral intervention for the prevention of depression in caregivers with elevated depressive symptoms through 12 months of follow-up. DESIGN Randomized controlled trial. SETTING Community in Galicia (Spain). PARTICIPANTS 170 caregivers with elevated depressive symptoms. INTERVENTIONS Caregivers were randomized to a cognitive-behavioral intervention (N = 88), administered to groups of five participants in five weekly 90-min sessions, or to a usual care control group (N = 82). MEASUREMENTS Major depressive episodes (according to the Structured Clinical Interview for Axis I Disorders of the DSM-IV), depressive symptoms, emotional distress, caregiver burden, pleasant activities, depressive thoughts, social contacts. Trained blinded interviewers conducted assessments at 1, 3, 6, and 12 months of follow-up. RESULTS At the 12-month follow-up, there was a lower incidence of major depressive episodes in the intervention group compared with the control group (3.4% versus 22.0%). The relative risk was 0.15 (95% CI: 0.05-0.51) and the number needed to treat was 5 (95% CI: 3-11). The time of delay of the depressive episode onset in the intervention group was significant. Caregivers with good compliance to the intervention had a lower incidence of depression. The effects of the intervention on depressive symptoms, emotional distress, and caregiver burden were maintained for 12 months. Younger caregivers were more likely to benefit from the intervention. The change in depressive thoughts mediated the reduction in depressive symptoms. CONCLUSIONS Depressive episodes can be successfully prevented in caregivers, with long-term effects.

Intervenciones psicológicas para cuidadores con síntomas depresivos: revisión sistemática y metanálisis

It has been well determined that nonprofessional caregiving, which is a fundamental component of care to dependent persons, may lead to an increased risk for mental disorders in caregivers, especially depression. This paper sought to conduct a systematic

Analysis of the components of a cognitive-behavioral intervention administered via conference call for preventing depression among non-professional caregivers: a pilot study

ABSTRACT Objectives: The primary aim was to assess the feasibility/acceptability of a preventive cognitive-behavioral intervention implemented via conference call for caregivers. The secondary aim was to conduct a preliminary assessment of the efficacy of the behavioral activation component alone compared to the complete cognitive-behavioral intervention. Method: Sixty-one caregivers (mean age 58.4 years) were randomly assigned to a cognitive-behavioral intervention via conference call (CBC, n = 20), a behavioral activation intervention via conference call (BAC, n = 22) or a control group receiving usual care (CG, n = 19). Both interventions consisted of five 90-minute group sessions implemented weekly. Results: Only 6.6% of caregivers discontinued the study. In the CBC and BAC groups, attendance and satisfaction with the intervention were similarly high among both groups. Homework adherence was also high in both groups. At post-treatment, there was a lower incidence of depression in the CBC and BAC groups compared to the CG (0.0% for BAC and CBC vs. 10.5% for CG). The relative risk was 0.0, and number needed to treat was 10 in both groups. Depressive symptoms were significantly reduced in the CBC and BAC groups compared to the CG (d = 2.18 and d = 2.06). Conclusion: The results support the feasibility of the intervention. Moreover, the BAC intervention was non-inferior to the CBC intervention for reducing depressive symptoms.

Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force.

Intervenciones psicológicas administradas por teléfono para la depresión: una revisión sistemática y meta-análisis

The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of telephone-administered psychological interventions for mood disor - ders. A systematic search was conducted using the databases PsycINFO, Medline, the Cochrane Library Database, from 1974 to December 2013; seventeen studies were selected. In the studies different kinds of psychological interventions were assessed, mostly cognitive-behavioral, with results, at least, as positive as those obtained in face-to-face psychotherapy, with a combined small- medium effect size of −0.42 according to Cohens d 95% CI (−0.50, −0.34). The data obtai- ned in most of the studies suggest that the telephone constitutes an useful tool in the field of KEYWORDS Depression; Review; Psychotherapy; Telehealth; Telephone psychological interventions