A Systematic Review and Meta-Analysis of Measurement Feedback Systems in Treatment for Common Mental Health Disorders

To investigate the efects of measurement feedback systems (MFSs) in therapy on mental health outcomes through a literature review and meta-analysis. Using a three-level modeling approach, we conducted a meta-analysis of all efect sizes from randomized controlled studies of MFSs used in the treatment of common mental health disorders. Eighty-two efect sizes were extracted from the thirty-one included studies. Analyses were performed to consider the post-treatment efects of the MFS-assisted treatment compared to treatment as usual. A separate analysis was done for the subgroup “not-on-track” patients as it is theorized that MFSs will be clinically useful because they make therapists aware of patients who fail to progress. MFSs had a signifcant efect on mental health outcomes (d=0.14, 95% CI [0.082–0.206], p<.001). Further analysis found a larger efect in patients identifed as less respondent to therapy, the “not-on-track” group (d=0.29, 95% CI [0.114, 0.464], p=.003). Moderation analyses indicated that the type of outcome measurement and type of feedback system used, and whether it was used for a child and youth or adult population, infuenced efect sizes. MFSs seem to have a small positive efect on treatment outcomes. The efects seem to be larger for “not-on-track” patients, the group of patients that would usually not beneft much from treatment

The Dresden Predictor Study of anxiety and depression: objectives, design, and methods

Objective: The present report describes the objectives, design, and methods of the Dresden Predictor Study (DPS) of anxiety and depression, a prospective epidemiological study investigating anxiety disorders and depression in 3,065 young German women (18-25years of age). Materials and methods: The DPS consists of a baseline and one follow-up investigation separated by approximately 17months. At both time points, respondents were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) using an extended German version of the Anxiety Disorders Interview Schedule (ADIS-IV-L). In addition to diagnostic assessment, respondents completed a battery of self-report questionnaires that provided detailed information about potential predictors of disorders and a comprehensive dimensional assessment of psychopathology. Discussion and conclusions: Results on both response bias in the baseline investigation and effects of dropout at follow-up are presented, and strengths and limitations of the study design are discusse

Kunnskapsoppsummering og klassifisering av tiltaket: VIP Snakk om det (2. utg.)

Bakgrunn: VIP Snakk om det (tidligere VIP-programmet) er et psykoedukativt program som retter seg mot elever i videregående skoler i alderen 16 og 17 år. Programmet gir informasjon om psykisk helse og psykiske lidelser samt veiledning i hvordan man håndterer slike vansker. Lærere og helsepersonell får opplæring i programmet og hvordan man oppdager problemer hos elevene tidlig for å kunne sette i verk hjelpetiltak gjennom helsesystemet. Metode: Denne kunnskapsoppsummeringen bygger på et systematisk litteratursøk i databasene Embase, Medline og Psykinfo, NORART, Cochrane, Cristin, NORA, SCOPUS og SweMed. Det er også søkt i internasjonale kunnskapsdatabaser samt innhentet informasjon om tiltaket fra tiltakseier. Litteratursøk og annen innhentet informasjon ble gjennomgått for å identifisere nordiske effektstudier, internasjonale oppsummeringsstudier og eventuelt andre norske studier om tiltaket. Resultater: VIP Snakk om det er evaluert i et kvasieksperimentelt design med test og kontrollgruppe, der data ble innhentet før intervensjonen, rett etter og 6, 12 og 24 måneder etter. Effektene som gjelder kunnskap om psykiske lidelser er moderate, både rett etter deltakelse i programmet og i etterundersøkelsen. Det er en svakhet at effektene ikke er konsistent rapportert for alle måletidspunkter. Psykiske problemer er bare rapportert for tidsrommet rett etter intervensjonen til ett år etter. På grunn av valgt design og spørreskjema er det vanskelig å sammenlikne effektene med andre resultater i feltet. I tillegg måles angstsymptomer med en skala som har fem spørsmål og uavklart validitet. Konklusjon: VIP Snakk om det klassifiseres på evidensnivå 3 – Tiltak med noe dokumentasjon på effekt

Kunnskapsoppsummering og klassifisering av tiltaket Psykologisk førstehjelp (2.utg.)

Bakgrunn - Denne artikkelen er en kunnskapsoppsummering av effektene for tiltaket Psykologisk førstehjelp. Artikkelen er en revisjon av en tidligere beskrivelse av det samme tiltaket i Ungsinn (Neumer & Eng, 2013), men videreutviklet i henhold til Ungsinn sine nye prosedyrer og kriterier (Martinussen m. fl., 2019). Psykologisk førstehjelp (PF) er i hovedsak et selvhjelpsmateriell som retter seg mot barn og unge i alderen 8-18 år. Hovedmålet med PF er å forebygge psykiske vansker gjennom å bruke førstehjelpsskrinet for å håndtere vanskelige følelser og situasjoner. Metode - Denne kunnskapsoppsummeringen bygger på et systematisk litteratursøk i databasene Embase, Medline og Psykinfo, NORART Cochrane, Cristin, NORA, SCOPUS og SweMed. I tillegg har vi innhentet informasjon fra tiltakseier i Norge. Resultat - Resultatene er basert på en vurdering av tiltakets beskrivelse, relevante studier og informasjon knyttet til implementeringskvalitet. Tiltaket PF er enkelt, men godt fremstilt gjennom heftene som følger med i førstehjelpsskrinene og bygger på en solid teoretisk forankring knyttet til kognitiv atferdsterapi. Veilederen gir en god innføring i de viktigste elementene for gjennomføring av tiltaket i førstelinjetjenesten. Litteratursøket viste at det ikke foreligger noen effektstudier knyttet til PF slik tiltaket er beskrevet og vurdert i denne kunnskapsoppsummeringen. Implementeringskvaliteten er ikke tilfredsstillende i henhold til de kriteriene som vurderes i Ungsinn, særlig med tanke på manglende kvalitetssikring og monitorering/etterlevelse av gjennomføringen. Det er grunnlag til å tro at tiltaket utøves forskjellig avhengig av hvem som leverer det. Konklusjon - Tiltaket fremstår som enkelt å ta i bruk, og med sine konkrete hjelpemidler (figurer og hjelpehånd) ser det ut til å appellere til de ulike tjenestene som jobber med barn og unge. For å kunne hevde at tiltaket er virksomt, er det nødvendig med effektstudier av god metodisk kvalitet, samt et økt fokus på implementeringskvalitet

School children’s mental health during the COVID-19 pandemic

Introduction: The COVID-19 pandemic significantly impacted the daily routines of children, with social distancing and quarantine leading to reduced social interactions and potential increased conflicts within families. These factors can increase the risk for anxiety and depression while reducing overall quality of life. Methods: Our study included 1843 school children aged 8 to 12 from 56 schools over a 2.5-year period before and during the pandemic. This multi-wave cross-sectional study utilized baseline data from an optimization trial of an indicated preventive intervention. The main outcomes were self-reported symptoms of anxiety and depression, and quality of life was the secondary outcome measure. Furthermore, responses to COVID-relevant questions were measured using a self-composed scale. Our objectives were to compare anxiety and depression symptom levels between cohorts of children who participated in the study before and during the pandemic, to examine if anxiety or depression predicted the COVID response, and whether anxiety and depression and subtypes of anxiety had an impact on quality of life during the pandemic. Linear regression and interaction models were used to examine relevant associations. Results: Levels of anxiety and depression were higher in all waves compared to pre-pandemic levels. Quality of life was lower during the pandemic than before the pandemic, particularly among children with generalized anxiety symptoms. Quality of life was negatively associated with loneliness. Discussion: Our study revealed that children reported higher anxious and depressive symptoms during the pandemic compared to pre-pandemic levels, as well as reduced quality of life. Lockdowns and restrictions may have contributed to this burden. Additionally, self-reported loneliness was a significant possible consequence of the restrictive measures imposed on children during the pandemic. Additional research is needed to investigate the long-term effects of the pandemic on children, particularly regarding the stability of elevated levels of anxiety and depression. Such studies could examine whether these conditions are indicative of a trajectory toward more severe internalizing disorders.School children’s mental health during the COVID-19 pandemicpublishedVersio

Inside the Clockwork of the ECHO Factorial Trial: A Conceptual Model With Proposed Mediators for Prevention of Emotional Problems in Children

Having interventions that are not only evidence-based and effective but also cost-effective and efficient is important for the prevention and treatment of child and adolescent emotional problems. A randomized clinical trial (RCT) tests the total interventions effect but does not address specific components of the intervention. In this article the hypothesis and a conceptual model of the ECHO study are presented and discussed. The ECHO intervention consists of three different components each containing two levels of intervention. By using a cluster randomized factorial design, children aged 8–12 at 40 schools across Norway will be randomized to eight different experimental conditions investigating the optimal balance between effect, cost-effectiveness, and efficiency. The article presents the design and the different components being tested and discusses how optimalization can be reached through this innovative design. The article also discusses how interventions can be improved by investigating and understanding the mechanisms of change within psychological interventions. For each of the three components in the study we consider the mediators that could be active within the intervention and how the study investigates such mediation. The results will contribute to a better understanding of how psychological interventions work and how we intend to optimize the EMOTION intervention

Inside the clockwork of the ECHO factorial trial: A conceptual model with proposed mediators for prevention of emotional problems in children

Having interventions that are not only evidence-based and effective but also cost-effective and efficient is important for the prevention and treatment of child and adolescent emotional problems. A randomized clinical trial (RCT) tests the totalinterventions effect but does not address specific components of the intervention. In this article the hypothesis and a conceptual model of the ECHO study are presented and discussed. The ECHO intervention consists of three different components each containing two levels of intervention. By using a cluster randomized factorial design, children aged 8–12 at 40 schools across Norway will be randomized to eight different experimental conditions investigating the optimal balance between effect, cost-effectiveness, and efficiency. The article presents the design and the different components being tested and discusses how optimalization can be reached through this innovative design. The article also discusses how interventions can be improved by investigating and understanding the mechanisms of change within psychological interventions. For each of the three components in the study we consider the mediators that could be active within the intervention and how the study investigates such mediation. The results will contribute to a better understanding of how psychological interventions work and how we intend to optimize the EMOTION intervention