Abstract:
BACKGROUND:With a lifetime risk for major depressive disorder of up to 50%, depression is a common comorbidity in multiple sclerosis but remains widely underdiagnosed and untreated. We investigated the potential of a fully automated, internet-based, cognitive behavioural therapy programme, Deprexis, to reduce depressive symptoms in patients with multiple sclerosis. METHODS:For this randomised controlled trial, we recruited patients from an outpatient clinic in Hamburg, Germany. Patients aged 18-65 years were eligible for inclusion if they had multiple sclerosis and self-reported depressive symptoms. By use of a computer-generated randomisation sequence, we allocated 90 patients (1:1; no blocking or stratification) to either the intervention group or a waitlist control group for 9 weeks. The primary endpoint was the Beck Depression Inventory (BDI), as assessed by an intention-to-treat analysis. This trial is registered with ClinicalTrials.gov, number NCT01663649. FINDINGS:71 patients completed the trial: 35 patients in the intervention group and 36 patients in the control group. During the intervention, BDI scores decreased in the Deprexis group and increased in the control group, yielding a positive effect of Deprexis relative to the waitlist group (mean group difference -4·02 points [95% CI -7·26 to -0·79], p=0·015, effect size d=0·53). Worsening of depressive symptoms from below to above the clinical cutoff (BDI >13) occurred in three (7%) of 45 patients in the control group and no patients in the Deprexis group. We noted no adverse events with respect to new occurrence of suicidal ideation during the trial. INTERPRETATION:Psychological online-intervention programmes could be suitable for patients with multiple sclerosis who are unable to regularly attend therapeutic sessions because of mobility impairments. FUNDING:European Union and the Deutsche Forschungsgemeinschaft.
journal_name
Lancet Psychiatryjournal_title
The lancet. Psychiatryauthors
Fischer A,Schröder J,Vettorazzi E,Wolf OT,Pöttgen J,Lau S,Heesen C,Moritz S,Gold SMdoi
10.1016/S2215-0366(14)00049-2subject
Has Abstractpub_date
2015-03-01 00:00:00pages
217-23issue
3eissn
2215-0366issn
2215-0374pii
S2215-0366(14)00049-2journal_volume
2pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Exercise is known to be associated with reduced risk of all-cause mortality, cardiovascular disease, stroke, and diabetes, but its association with mental health remains unclear. We aimed to examine the association between exercise and mental health burden in a large sample, and to better understand the infl...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(18)30227-X
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Several small studies suggest that the adjunctive use of anti-inflammatory agents might improve depressive symptoms in bipolar disorder. However, there are few well designed, appropriately powered clinical trials assessing the efficacy of these novel treatment strategies. We aimed to assess the efficacy of a...
journal_title:The lancet. Psychiatry
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/S2215-0366(20)30138-3
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Social anxiety disorder-a chronic and naturally unremitting disease that causes substantial impairment-can be treated with pharmacological, psychological, and self-help interventions. We aimed to compare these interventions and to identify which are most effective for the acute treatment of social anxiety di...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(14)70329-3
更新日期:2014-10-01 00:00:00
abstract::The care of people with first-episode mania has been overlooked in comparison with the care of patients with other non-affective psychoses, despite evidence suggesting targeted treatments might be of benefit for this patient group. In this Personal View, we outline the general epidemiology of first-episode mania in th...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(19)30082-3
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Early social deprivation can negatively affect domains of functioning. We examined psychopathology at age 12 years in a cohort of Romanian children who had been abandoned at birth and placed into institutional care, then assigned either to be placed in foster care or to care as usual. METHODS:We used follow...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2215-0366(15)00095-4
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Depressive symptoms are a major cause of disability in bipolar disorder and there are few safe and effective treatments. The combination of lamotrigine plus quetiapine potentially offers improved outcomes for people with bipolar depression. We aimed to determine if combination therapy with quetiapine plus la...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2215-0366(15)00450-2
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Autism spectrum disorder (ASD) phenomenology is reported to be more common in individuals with some genetic syndromes than in the general population; however, no meta-analysis has provided prevalence data within and between syndromes. In this systematic review and meta-analysis, we aimed to synthesise data f...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,meta分析,评审
doi:10.1016/S2215-0366(15)00376-4
更新日期:2015-10-01 00:00:00
abstract::More than 10 million people are imprisoned worldwide, and the prevalence of all investigated mental disorders is higher in prisoners than in the general population. Although the extent to which prison increases the incidence of mental disorders is uncertain, considerable evidence suggests low rates of identification a...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(16)30142-0
更新日期:2016-09-01 00:00:00
abstract::This Review reports on a scoping review followed by a systematic review to consider interventions designed to address or manage depression or anxiety in children and young people up to the age of 25 years without the need to involve mental health professionals. The scoping review identified 132 approaches, 103 of whic...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(18)30465-6
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The PACE trial found that, when added to specialist medical care (SMC), cognitive behavioural therapy (CBT), or graded exercise therapy (GET) were superior to adaptive pacing therapy (APT) or SMC alone in improving fatigue and physical functioning in people with chronic fatigue syndrome 1 year after randomis...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2215-0366(15)00317-X
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Although clozapine is the treatment of choice for treatment-refractory schizophrenia, 30-40% of patients have an insufficient response, and others are unable to tolerate it. Evidence for any augmentation strategies is scarce. We aimed to determine whether cognitive behavioural therapy (CBT) is an effective t...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2215-0366(18)30184-6
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Compulsory community treatment (CCT) aims to reduce hospital readmissions among people with mental illness. However, research examining the usefulness of CCT is inconclusive. We aimed to assess the effectiveness of CCT in reducing readmission and length of stay in hospital and increasing community service us...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,meta分析
doi:10.1016/S2215-0366(18)30382-1
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The benefits and safety of medications for attention-deficit hyperactivity disorder (ADHD) remain controversial, and guidelines are inconsistent on which medications are preferred across different age groups. We aimed to estimate the comparative efficacy and tolerability of oral medications for ADHD in child...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,meta分析
doi:10.1016/S2215-0366(18)30269-4
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Anxiety in children is common, impairs everyday functioning, and increases the risk of severe mental health disorders in adulthood. We investigated the effect of a classroom-based cognitive behaviour therapy prevention programme (FRIENDS) on anxiety symptoms in children. METHODS:Preventing Anxiety in Childr...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(14)70244-5
更新日期:2014-08-01 00:00:00
abstract::The aim of this Review is to identify effective interventions and treatment guidelines to manage common types of psychiatric emergencies in non-specialist settings in low-income and middle-income countries. Mental health specialist services in low-income and middle-income countries are scarce. We did a systematic revi...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(15)00094-2
更新日期:2015-06-01 00:00:00
abstract::Neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder, although most commonly considered in childhood, can be lifelong conditions. In this Personal View that is shaped by clinical experience and research, we adopt a conceptual approach. First, we discuss what...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(16)30376-5
更新日期:2017-04-01 00:00:00
abstract::Substance use in young people (aged 10-24 years) might disrupt key periods of transition that occur as the adolescent brain undergoes cognitive and emotional development, and key psychosocial transitions are made. Adolescence is the peak time for initiation of substance use, with tobacco and alcohol usually preceding ...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(15)00508-8
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Many people with dementia living in care homes have distressing and costly agitation symptoms. Interventions should be efficacious, scalable, and feasible. METHODS:We did a parallel-group, cluster-randomised controlled trial in 20 care homes across England. Care homes were eligible if they had 17 residents ...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2215-0366(19)30045-8
更新日期:2019-04-01 00:00:00
abstract::The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health e...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(20)30307-2
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Substantial evidence suggests that cognitive deficits might persist after remission of a major depressive episode. However, results are inconsistent relative to the importance, pattern, severity, and moderating factors of this impairment. We aimed to determine how cognitive function following a major depress...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,meta分析
doi:10.1016/S2215-0366(19)30291-3
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Late-life depressive symptoms have been extensively studied for their relationship with incident dementia, but have been typically assessed at a single timepoint. Such an approach neglects the course of depression, which, given its remitting and relapsing nature, might provide further insights into the compl...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(16)00097-3
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Use of involuntary psychiatric hospitalisation varies widely within and between countries. The factors that place individuals and populations at increased risk of involuntary hospitalisation are unclear, and evidence is needed to understand these disparities and inform development of interventions to reduce ...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,meta分析
doi:10.1016/S2215-0366(19)30406-7
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Acting on command hallucinations in psychosis can have serious consequences for the individual and for other people and is a major cause of clinical and public concern. No evidence-based treatments are available to reduce this risk behaviour. We therefore tested our new cognitive therapy to challenge the per...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(14)70247-0
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Provision of early intervention services has increased the rate of social recovery in patients with first-episode psychosis; however, many individuals have continuing severe and persistent problems with social functioning. We aimed to assess the efficacy of early intervention services augmented with social r...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2215-0366(17)30476-5
更新日期:2018-01-01 00:00:00
abstract::We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskele...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(15)00505-2
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Long-standing concerns exist about reverse causation and residual confounding in the prospective association between job strain and risk of future common mental disorders. We aimed to address these concerns through analysis of data collected in the UK National Child Development Study, a large British cohort ...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(18)30137-8
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Suicidal ideation due to abortion has been used to justify restrictive US abortion policies. Much research examining abortion and mental health has relied on self-report, has had low participation rates, and did not consider confounding factors. In the present study, we used data that do not rely on self-rep...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(19)30400-6
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:The conceptualisation of transgender identity as a mental disorder has contributed to precarious legal status, human rights violations, and barriers to appropriate health care among transgender people. The proposed reconceptualisation of categories related to transgender identity in WHO's forthcoming Interna...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章
doi:10.1016/S2215-0366(16)30165-1
更新日期:2016-09-01 00:00:00
abstract::Over the past decade, concussion has become the most widely discussed injury in contact sports. However, concussions also occur in several other settings, such as non-contact sports, elderly individuals, young children, military personnel, and victims of domestic violence. Concussion is frequently undiagnosed as a cau...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,评审
doi:10.1016/S2215-0366(16)30266-8
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Housing First is increasingly implemented for homeless adults with mental illness in large urban centres, but little is known about its long-term effectiveness. The At Home/Chez Soi randomised controlled trial done in five cities in Canada showed that Housing First improved housing stability and other select...
journal_title:The lancet. Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2215-0366(19)30371-2
更新日期:2019-11-01 00:00:00