Depression Treatment: Work Reintegration for Veterans With Mental Disorders: A Systematic Literature Reviewto Inform Research.

Work Reintegration for Veterans With Mental Disorders: A Systematic Literature Reviewto Inform Research.

Filed under: Depression Treatment

Phys Ther. 2012 Oct 4;
Vantil L, Fikretoglu D, Pranger T, Patten S, Wang J, Wong M, Zamorski M, Loisel P, Corbiére M, Shields N, Thompson J, Pedlar D

BackgroundSome Veterans, and especially those with mental disorders, have trouble reintegrating into the civilian workforce. PURPOSE: The objectives were to describe the scope of the existing literature on mental disorders and unemployment; and to identify factors potentially associated with reintegration of workers with mental disorders into the workforce.Data Sources.The following databases were searched from their respective inception dates: MEDLINE, EMBASE, Cumulative Index Nursing Allied Health (CINAHL), and PsycINFO.Study Selection.In-scope studies had both (a) quantitative measures of employment and (b) study populations with well-described mental disorders (eg. anxiety, depression, PTSD, substance-use disorders).Data Extraction.A systematic and comprehensive search of the relevant published literature up to July 2009 was conducted that identified a total of 5,195 articles. From that list 81 in-scope studies were identified. An update to July 2012 identified 1,267 new articles, resulting in an additional 16 in-scope articles.Data Synthesis.Three major categories emerged from the in-scope articles: Return to Work, Supported Employment, and Reintegration. The literature on Return to Work and Supported Employment is well summarized by existing reviews. Reintegration literature included 32 inscope articles; only 10 of these were conducted in populations of Veterans.LimitationsStudies of Reintegration to work were not similar enough to synthesize, and it was inappropriate to pool results for this category of literature. CONCLUSIONS:/b>This comprehensive literature review found limited knowledge about how to integrate people with mental disorders into a new workplace following a prolonged absence (over one year). Even more limited knowledge was found for Veterans. The results informed the next steps for our research team, to enhance successful reintegration of Veterans with mental disorders into the civilian workplace.
HubMed – depression


Magnetic flimmers: ‘light in the electromagnetic darkness’

Filed under: Depression Treatment

Brain. 2012 Oct 5;
Martens JW, Koehler PJ, Vijselaar J

Transcranial magnetic stimulation has become an important field for both research in neuroscience and for therapy since Barker in 1985 showed that it was possible to stimulate the human motor cortex with an electromagnet. Today for instance, transcranial magnetic stimulation can be used to measure nerve conduction velocities and to create virtual lesions in the brain. The latter option creates the possibility to inactivate parts of the brain temporarily without permanent damage. In 2008, the American Food and Drugs Administration approved repetitive transcranial magnetic stimulation as a therapy for major depression under strict conditions. Repetitive transcranial magnetic stimulation has not yet been cleared for treatment of other diseases, including schizophrenia, anxiety disorders, obesity and Parkinson’s disease, but results seem promising. Transcranial magnetic stimulation, however, was not invented at the end of the 20th century. The discovery of electromagnetism, the enthusiasm for electricity and electrotherapy, and the interest in Beard’s concept of neurasthenia already resulted in the first electromagnetic treatments in the late 19th and early 20th century. In this article, we provide a history of electromagnetic stimulation circa 1900. From the data, we conclude that Mesmer’s late 18th century ideas of ‘animal magnetism’ and the 19th century absence of physiological proof had a negative influence on the acceptance of this therapy during the first decades of the 20th century. Electromagnetism disappeared from neurological textbooks in the early 20th century to recur at the end of that century.
HubMed – depression


Classroom based cognitive behavioural therapy in reducing symptoms of depression in high risk adolescents: pragmatic cluster randomised controlled trial.

Filed under: Depression Treatment

BMJ. 2012; 345: e6058
Stallard P, Sayal K, Phillips R, Taylor JA, Spears M, Anderson R, Araya R, Lewis G, Millings A, Montgomery AA

OBJECTIVE: To compare the effectiveness of classroom based cognitive behavioural therapy with attention control and usual school provision for adolescents at high risk of depression. DESIGN: Three arm parallel cluster randomised controlled trial. SETTING: Eight UK secondary schools. PARTICIPANTS: Adolescents (n=5030) aged 12-16 years in school year groups 8-11. Year groups were randomly assigned on a 1:1:1 ratio to cognitive behavioural therapy, attention control, or usual school provision. Allocation was balanced by school, year, number of students and classes, frequency of lessons, and timetabling. Participants were not blinded to treatment allocation. INTERVENTIONS: Cognitive behavioural therapy, attention control, and usual school provision provided in classes to all eligible participants. MAIN OUTCOME MEASURES: Outcomes were collected by self completed questionnaire administered by researchers. The primary outcome was symptoms of depression assessed at 12 months by the short mood and feelings questionnaire among those identified at baseline as being at high risk of depression. Secondary outcomes included negative thinking, self worth, and anxiety. Analyses were undertaken on an intention to treat basis and accounted for the clustered nature of the design. RESULTS: 1064 (21.2%) adolescents were identified at high risk of depression: 392 in the classroom based cognitive behavioural therapy arm, 374 in the attention control arm, and 298 in the usual school provision arm. At 12 months adjusted mean scores on the short mood and feelings questionnaire did not differ for cognitive behavioural therapy versus attention control (-0.63, 95% confidence interval -1.85 to 0.58, P=0.41) or for cognitive behavioural therapy versus usual school provision (0.97, -0.20 to 2.15, P=0.12). CONCLUSION: In adolescents with depressive symptoms, outcomes were similar for attention control, usual school provision, and cognitive behavioural therapy. Classroom based cognitive behavioural therapy programmes may result in increased self awareness and reporting of depressive symptoms but should not be undertaken without further evaluation and research. TRIAL REGISTRATION: Current Controlled Trials ISRCTN19083628.
HubMed – depression



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