Translating the BDI and BDI-II into the HAMD and vice versa with equipercentile linking

Abstract Aims The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale. Methods We obtained individual participant data from the randomised controlled trials of psychological and pharmacological treatments for major depressive disorders. We then identified corresponding scores of the HAMD and the BDI (369 patients from seven trials) or the BDI-II (683 patients from another seven trials) using the equipercentile linking method. Results The HAMD total scores of 10, 20 and 30 corresponded approximately with the BDI scores of 10, 27 and 42 or with the BDI-II scores of 13, 32 and 50. The HAMD change scores of −20 and −10 with the BDI of −29 and −15 and with the BDI-II of −35 and −16. Conclusions The results can help clinicians interpret the HAMD or BDI scores of their patients in a more versatile manner and also help clinicians and researchers evaluate such scores reported in the literature or the database, when scores on only one of these scales are provided. We present a conversion table for future research

The DARE study of relapse prevention in depression: design for a phase 1/2 translational randomised controlled trial involving mindfulness-based cognitive therapy and supported self monitoring

<p>Abstract</p> <p>Background</p> <p>Depression is a common condition that typically has a relapsing course. Effective interventions targeting relapse have the potential to dramatically reduce the point prevalence of the condition. Mindfulness-based cognitive therapy (MBCT) is a group-based intervention that has shown efficacy in reducing depressive relapse. While trials of MBCT to date have met the core requirements of phase 1 translational research, there is a need now to move to phase 2 translational research - the application of MBCT within real-world settings with a view to informing policy and clinical practice. The aim of this trial is to examine the clinical impact and health economics of MBCT under real-world conditions and where efforts have been made to assess for and prevent resentful demoralization among the control group. Secondary aims of the project involve extending the phase 1 agenda to an examination of the effects of co-morbidity and mechanisms of action.</p> <p>Methods/Design</p> <p>This study is designed as a prospective, multi-site, single-blind, randomised controlled trial using a group comparison design between involving the intervention, MBCT, and a self-monitoring comparison condition, Depression Relapse Active Monitoring (DRAM). Follow-up is over 2 years. The design of the study indicates recruitment from primary and secondary care of 204 participants who have a history of 3 or more episodes of Major Depression but who are currently well. Measures assessing depressive relapse/recurrence, time to first clinical intervention, treatment expectancy and a range of secondary outcomes and process variables are included. A health economics evaluation will be undertaken to assess the incremental cost of MBCT.</p> <p>Discussion</p> <p>The results of this trial, including an examination of clinical, functional and health economic outcomes, will be used to assess the role that this treatment approach may have in recommendations for treatment of depression in Australia and elsewhere. If the findings are positive, we expect that this research will consolidate the evidence base to guide the decision to fund MBCT and to seek to promote its availability to those who have experienced at least 3 episodes of depression.</p> <p>Trial Registration</p> <p>Australian New Zealand Clinical Trials Registry: <a href="http://www.anzctr.org.au/ACTRN12607000166471.aspx">ACTRN12607000166471</a></p

Mindfulness based psychological interventions : developing emotional awareness for better being

This paper presents and discusses the psychological interventions that are primarily based oil the development Of mindful awareness as a psychotherapeutic tool. Mindfulness based psychological interventions are defined and situated in their historical context, in the larger perspective of the evolution of psychotherapies in the Western world in the last two decades. A special focus is given to mindfulness based stress reduction (MBSR, Kabat-Zinn, 1982) and to mindfulness based cognitive therapy (MBCT Segal, Williams & Teasdale, 2002). The structure and core elements of these interventions are presented. Then, we examine their effectiveness ill improving psychological and physical well-being. In the next section, we speculate about the underlying psychological mechanisms that might account for the effects of mindfulness based interventions. Special attention is devoted to the cognitive processes underlying emotion regulation and self-awareness. Finally, we examine how a first person approach might contribute to the understanding of mindfulness based interventions

Exploring Dispositional Mindfulness as a protective factor for outcomes following Mild Traumatic Brain Injury

Although the majority of individuals who have sustained a mild Traumatic Brain Injury (TBI) recover within 1-3 months post-injury, a significant proportion consistently report ongoing cognitive, psychological, and somatic symptoms. Often, such symptoms can be functionally disabling in the context of an individual’s return to work and active participation in society following injury. Previously identified risk and protective factors for outcomes following mTBI have been largely immutable (e.g., age). Novel, targetable protective factors would be instrumental in informing rehabilitative programmes and recommendations for such individuals. The present study will examine dispositional mindfulness as a novel protective factor as it pertains to various outcomes following mTBI. Mindfulness meditation has demonstrated efficacy in reducing symptoms associated with several medical and psychiatric disorders. More recently, mindfulness has also been considered as a trait with considerable intraindividual variation, and one that has proven to be enhanced through mindfulness training. This study employs a modified version of a measure of dispositional mindfulness, the Five-Facet Mindfulness Questionnaire (FFMQ), which requires individuals to complete the measure twice, one reflecting their current status and one reflecting their pre-injury status. Functional, cognitive, and psychological outcomes will be obtained

Thérapie cognitive basée sur la pleine conscience : état actuel et applications futures

Objectifs : Cette revue vise à résumer les recherches antérieures et en cours portant sur la thérapie cognitive basée sur la pleine conscience (TCBPC) et à illustrer en pratique comment cette forme d’intervention peut aider les personnes à éviter la spirale qui les fera retomber dans la rumination, laquelle fait partie intégrante des épisodes dépressifs majeurs. Méthodologie : Des études comprenant des périodes de suivi à court et à long terme et reposant sur une revue de la documentation sur la TCBPC pour la prévention de rechutes chez les personnes qui présentent des antécédents de dépression majeure ont été incluses. De plus, des études récentes sur des adaptations novatrices de la TCBPC chez de nouvelles populations ont aussi été passées en revue et prises en compte dans le but de dégager les orientations à donner à la recherche future et aux nouvelles applications cliniques. Résultats : Dans la dernière décennie, la TCBPC s’est appuyée sur de solides données probantes en mettant en évidence son efficacité dans la prévention des taux de rechutes dépressives et dans le prolongement des périodes de bien-être. Des études récentes ont fait ressortir plusieurs mécanismes de changement possibles comme une diminution de la réactivité cognitive et une meilleure capacité de décentration, lesquelles déterminent et contribuent à une diminution des symptômes dépressifs. Discussion : Actuellement, de nouvelles applications de la TCBPC s’étendent au-delà de son objectif initial. Des travaux de recherche seront nécessaires pour éclairer l’efficacité et les mécanismes d’action à l’oeuvre une fois la TCBPC appliquée à ces nouvelles populations.Against the backdrop of dauntingly high prevalence rates of clinical depression and subsequent relapse, Segal, Teasdale and Williams (2002) sought to develop an intervention that would address the long-term sequence of depression. In the past decade, Mindfulness-Based Cognitive Therapy has been supported with a robust evidence base, highlighting its efficacy in the short, and long-term follow-up studies. Currently, novel adaptations of this intervention are being developed and piloted with a wide range of clinical issues that share amplified ruminative processes as a core feature of pathology. This review aims to summarize current and past research on MBCT, and to practically illuminate how this intervention can aid individuals in stepping out of the ruminative spirals that are part-and-parcel with major depressive episode