Wade Gunn

Evidence-based treatments for depression and anxiety versus treatment-as-usual: A meta-analysis of direct comparisons☆

OBJECTIVE The aim of this study was to examine the relative efficacy of evidence-based treatments (EBTs) versus treatment-as-usual (TAU) in routine care for anxiety and depression in adults. METHOD A computerized search of studies that directly compared an EBT with a TAU was conducted. Meta-analytic methods were used to estimate effectiveness of EBTs relative to TAU and to model how various confounding variables impacted the results of this comparative research. RESULTS A total of 14 studies were included in the final meta-analysis. There was significant heterogeneity in the TAU conditions, which ranged from unknown and/or minimal mental health treatment to psychotherapeutic interventions provided by trained professionals. Although the effect for EBT vs. TAU was significantly greater than zero, the effect for EBT vs. TAUs that were psychotherapeutic interventions was not statistically different from zero. CONCLUSIONS Heterogeneity of TAU conditions in this meta-analysis highlight the importance of clarifying the research questions being asked when investigating and drawing conclusions from EBT-TAU comparisons. Researchers need to clarify if they are comparing an EBT to psychotherapeutic services in routine care or to minimal mental health services. Extant research on EBT versus TAU reveals that there is insufficient evidence to recommend the transportation of EBTs for anxiety and depression to routine care, particularly when the routine care involves psychotherapeutic services.

THE LIVING WELL TOGETHER PROGRAM: A QUALITATIVE ANALYSIS OF A HEALTH SELF-MANAGEMENT PROGRAM FOR AGING AFRICAN AMERICANS WITH CHRONIC ILLNESS

easy 12 minute/day yoga meditation. The control group consisted of either music listening or memory enhancement training (MET). Memory, cognitive function and various biomarkers were measured at baseline, 3 and 6months. Results:Practicing KK 12minutes a day for 8 12 weeks improves cognitive function, increases cerebral blood flow, augments neurotransmitters and neuroanatomical plasticity in the anterior and posterior cingulate gyrus, hippocampus, & prefrontal cortex. Moreover, these studies show improved mental health, better sleep, reduced stress, increased telomerase and longer telomeres, reduced inflammatory markers, strengthened neuro-connectivity, increased plasma amyloid beta, and a rise in aspects of psycho-spiritual well-being such as selfacceptance and a sense of purpose in life. All of these benefits may help prevent or reverse cognitive decline. Gains were sustained or improved at 6 months. No side effects were reported. Conclusions:Kirtan Kriya is a simple and effective yoga meditation with striking results, including an improvement in cognitive function in SCD and MCI. KK has significant potential to be valuable in the fight against AD in women.

RACIAL DIFFERENCES POTENTIALLY INFLUENCING SELF-IDENTIFICATION OF MILD COGNITIVE IMPAIRMENT

per se, particularly oily fish rich in omega 3 fatty acids, further limits the potential protective effect on dementia(3-4). Given the role of diet modification in dementia prevention, understanding the link between diet and dementia in Lebanon can be an important dementia prevention intervention for Lebanon and for the Middle East.Methods: 510 participants 65 years old residing in Beirut and Mount Lebanon governorates were included in a cross-sectional survey. Data collection by trained interviewers took place in randomly selected clusters from the capital Beirut andMount Lebanon area. The 10/66 Dementia Research Group diagnostic assessment for dementia and risk factor questionnaires were administered to the participants and their caregivers. Results: Preliminary analysis was carried on 303 participants, 174 females (57.4%) and 129 males (42.6%). The mean age was 72.28 years (SD 7.03). 24 participants were diagnosed with dementia (8%). There was a high prevalence of overweight (54.4%) and obesity (27.7%) among the study population. Neither fish nor meat consumption in this sample was related to dementia prevalence (OR: 0.83; 95%CI: 0.30, 2.33; and OR: 1.48; CI: 0.33,6.56, respectively). Conclusions: Preliminary findings do not support the protective effect of fish consumption, but more definitive conclusions can be made once the entire sample of 510 randomly selected individuals are analyzed. Still, the trends of a lower odds of dementia among older people who consumed fish, and a higher odds of dementia amongmeat consumers is consistent with the results of the large 10/66 study carried out in five LMIC. The latter finding, combined with the nutritional transitions observed in Lebanon and the Arab region and the mounting evidence of the role of diet on dementia, warrants further investigation on a larger national and regional scale.