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The COVID-19 pandemic has potentially increased the risk for adolescent depression. Even pre-pandemic, <50% of youth with depression accessed care, highlighting needs for accessible interventions. Accordingly, this randomized controlled trial (ClinicalTrials.gov: NCT04634903) tested online single-session interventions (SSIs) during COVID-19 in adolescents with elevated depression symptoms (N = 2,452, ages 13–16). Adolescents from all 50 US states, recruited via social media, were randomized to one of three SSIs: a behavioural activation SSI, an SSI teaching that traits are malleable and a supportive control. We tested each SSI’s effects on post-intervention outcomes (hopelessness and agency) and three-month outcomes (depression, hopelessness, agency, generalized anxiety, COVID-19-related trauma and restrictive eating). Compared with the control, both active SSIs reduced three-month depressive symptoms (Cohen’s d = 0.18), decreased post-intervention and three-month hopelessness (d = 0.16–0.28), increased post-intervention agency (d = 0.15–0.31) and reduced three-month restrictive eating (d = 0.12–17). Several differences between active SSIs emerged. These results confirm the utility of free-of-charge, online SSIs for high-symptom adolescents, even in the high-stress COVID-19 context.In a randomized controlled trial, Schleider et al. show that single-session online interventions are able to reduce depression symptoms up to three months later in adolescents.

As depression is so complex, understanding it demands an integrative approach. Adopting a biopsychosocial perspective with an environmentalist emphasis, this study articulates a variety of levels: experiential, psychodynamic, developmental, evolutionary, neuroscientific, genetic and societal. In particular the impacts of the social changes in the late twentieth and early twenty-first centuries are invoked in an attempt to explain the ongoing escalation of depression worldwide.

Miscarriage is generally defined as the loss of a pregnancy before viability. An estimated 23 million miscarriages occur every year worldwide, translating to 44 pregnancy losses each minute. The pooled risk of miscarriage is 15·3% (95% CI 12·5–18·7%) of all recognised pregnancies. The population prevalence of women who have had one miscarriage is 10·8% (10·3–11·4%), two miscarriages is 1·9% (1·8–2·1%), and three or more miscarriages is 0·7% (0·5–0·8%). Risk factors for miscarriage include very young or older female age (younger than 20 years and older than 35 years), older male age (older than 40 years), very low or very high body-mass index, Black ethnicity, previous miscarriages, smoking, alcohol, stress, working night shifts, air pollution, and exposure to pesticides. The consequences of miscarriage are both physical, such as bleeding or infection, and psychological. Psychological consequences include increases in the risk of anxiety, depression, post-traumatic stress disorder, and suicide. Miscarriage, and especially recurrent miscarriage, is also a sentinel risk marker for obstetric complications, including preterm birth, fetal growth restriction, placental abruption, and stillbirth in future pregnancies, and a predictor of longer-term health problems, such as cardiovascular disease and venous thromboembolism. The costs of miscarriage affect individuals, health-care systems, and society. The short-term national economic cost of miscarriage is estimated to be £471 million per year in the UK. As recurrent miscarriage is a sentinel marker for various obstetric risks in future pregnancies, women should receive care in preconception and obstetric clinics specialising in patients at high risk. As psychological morbidity is common after pregnancy loss, effective screening instruments and treatment options for mental health consequences of miscarriage need to be available. We recommend that miscarriage data are gathered and reported to facilitate comparison of rates among countries, to accelerate research, and to improve patient care and policy development.

\"Depression is widely recognised as the leading disability worldwide. Though classified as a medical condition, depression also contains very personal and social aspects which are integral to the experience - as those who have experienced it know all too well. Drawing on research interviews with women who have experienced depression, this psychological study elucidates experiences of depression and the meanings attached to it. In so doing, Browne challenges current understandings of depression as a chronic and endogenous illness and stresses the importance of the perception of authenticity among depression sufferers. Written in plain language accessible to non-specialists, Depression and the Self argues that in depression, perceptions of control and the self are intertwined - and that this has important implications for diagnosis and recovery\"-- Provided by publisher.

Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11–18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.

Adolescents are often resistant to interventions that reduce aggression in children. At the same time, they are developing stronger beliefs in the fixed nature of personal characteristics, particularly aggression. The present intervention addressed these beliefs. A randomized field experiment with a diverse sample of Grades 9 and 10 students (ages 14–16, n = 230) tested the impact of a 6-session intervention that taught an incremental theory (a belief in the potential for personal change). Compared to no-treatment and coping skills control groups, the incremental theory group behaved significantly less aggressively and more prosocially 1 month postintervention and exhibited fewer conduct problems 3 months postintervention. The incremental theory and the coping skills interventions also eliminated the association between peer victimization and depressive symptoms.

\"What if depression could lead to positive change? Written by acceptance and commitment therapy (ACT) cofounder Kirk Strosahl and Patricia Robinson, this revised edition of the best-selling classic, The Mindfulness and Acceptance Workbook for Depression includes updated research on self-compassion, mindfulness, and neuroscience to help you live a more meaningful life. If you suffer from depression, you may feel like you are living under a perpetual raincloud, even when it's sunny outside. If left untreated, clinical depression can damage relationships, cause problems at work, lead to substance abuse, and even make it more difficult to overcome physical illnesses. You may feel too tired and scared to reach out for help, or you may try to avoid your feelings altogether. But you should know that there are little, effective ways you can overcome your depression, one day at a time. This fully revised and updated second edition of The Mindfulness and Acceptance Workbook for Depression will show you how changing daily behaviors and practicing new mindfulness skills can literally reshape your brain. Rather than fruitlessly trying to avoid your depression, you'll learn to focus on living a productive life by accepting your feelings. There are hundreds of books that will try to help you overcome or put an end to depression. But what if you could use your depression to change your life for the better? Your symptoms may be signals that something in your life needs to change. Learning to understand and interpret these signals is much more important than ignoring or avoiding them--approaches that only make the situation worse. This workbook uses techniques from acceptance and commitment therapy (ACT) to offer a new treatment plan for depression that will help accept your feelings instead of fruitlessly trying to avoid them. This new edition will include skills based on new research and contributions from mindfulness, self-compassion, and neuroscience. Using the skills outlined in this book, you'll be able to work through your depression, experience greater peace and well-being, and go on to create a better life\"-- Provided by publisher.

Depression is a common, debilitating, and costly disorder. Many patients request psychological therapy, but the best-evidenced therapy—cognitive behavioural therapy (CBT)—is complex and costly. A simpler therapy—behavioural activation (BA)—might be as effective and cheaper than is CBT. We aimed to establish the clinical efficacy and cost-effectiveness of BA compared with CBT for adults with depression. In this randomised, controlled, non-inferiority trial, we recruited adults aged 18 years or older meeting Diagnostic and Statistical Manual of Mental Disorders IV criteria for major depressive disorder from primary care and psychological therapy services in Devon, Durham, and Leeds (UK). We excluded people who were receiving psychological therapy, were alcohol or drug dependent, were acutely suicidal or had attempted suicide in the previous 2 months, or were cognitively impaired, or who had bipolar disorder or psychosis or psychotic symptoms. We randomly assigned participants (1:1) remotely using computer-generated allocation (minimisation used; stratified by depression severity [Patient Health Questionnaire 9 (PHQ-9) score of <19 vs ≥19], antidepressant use, and recruitment site) to BA from junior mental health workers or CBT from psychological therapists. Randomisation done at the Peninsula Clinical Trials Unit was concealed from investigators. Treatment was given open label, but outcome assessors were masked. The primary outcome was depression symptoms according to the PHQ-9 at 12 months. We analysed all those who were randomly allocated and had complete data (modified intention to treat [mITT]) and also all those who were randomly allocated, had complete data, and received at least eight treatment sessions (per protocol [PP]). We analysed safety in the mITT population. The non-inferiority margin was 1·9 PHQ-9 points. This trial is registered with the ISCRTN registry, number ISRCTN27473954. Between Sept 26, 2012, and April 3, 2014, we randomly allocated 221 (50%) participants to BA and 219 (50%) to CBT. 175 (79%) participants were assessable for the primary outcome in the mITT population in the BA group compared with 189 (86%) in the CBT group, whereas 135 (61%) were assessable in the PP population in the BA group compared with 151 (69%) in the CBT group. BA was non-inferior to CBT (mITT: CBT 8·4 PHQ-9 points [SD 7·5], BA 8·4 PHQ-9 points [7·0], mean difference 0·1 PHQ-9 points [95% CI −1·3 to 1·5], p=0·89; PP: CBT 7·9 PHQ-9 points [7·3]; BA 7·8 [6·5], mean difference 0·0 PHQ-9 points [–1·5 to 1·6], p=0·99). Two (1%) non-trial-related deaths (one [1%] multidrug toxicity in the BA group and one [1%] cancer in the CBT group) and 15 depression-related, but not treatment-related, serious adverse events (three in the BA group and 12 in the CBT group) occurred in three [2%] participants in the BA group (two [1%] patients who overdosed and one [1%] who self-harmed) and eight (4%) participants in the CBT group (seven [4%] who overdosed and one [1%] who self-harmed). We found that BA, a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT. Effective psychological therapy for depression can be delivered without the need for costly and highly trained professionals. National Institute for Health Research.