BackgroundMental disorders are highly prevalent and associated with considerable disease burden and personal and societal costs. However, they can be effectively reduced through prevention measures. The Internet as a medium appears to be an opportunity for scaling up preventive interventions to a population level.ObjectiveThe aim of this study was to systematically summarize the current state of research on Internet-based interventions for the prevention of mental disorders to give a comprehensive overview of this fast-growing field.MethodsA systematic database search was conducted (CENTRAL, Medline, PsycINFO). Studies were selected according to defined eligibility criteria (adult population, Internet-based mental health intervention, including a control group, reporting onset or severity data, randomized controlled trial). Primary outcome was onset of mental disorder. Secondary outcome was symptom severity. Study quality was assessed using the Cochrane Risk of Bias Tool. Meta-analytical pooling of results took place if feasible.ResultsAfter removing duplicates, 1169 studies were screened of which 17 were eligible for inclusion. Most studies examined prevention of eating disorders or depression or anxiety. Two studies on posttraumatic stress disorder and 1 on panic disorder were also included. Overall study quality was moderate. Only 5 studies reported incidence data assessed by means of standardized clinical interviews (eg, SCID). Three of them found significant differences in onset with a number needed to treat of 9.3-41.3. Eleven studies found significant improvements in symptom severity with small-to-medium effect sizes (d=0.11- d=0.76) in favor of the intervention groups. The meta-analysis conducted for depression severity revealed a posttreatment pooled effect size of standardized mean difference (SMD) =−0.35 (95% CI, −0.57 to −0.12) for short-term follow-up, SMD = −0.22 (95% CI, −0.37 to −0.07) for medium-term follow-up, and SMD = −0.14 (95% CI, -0.36 to 0.07) for long-term follow-up in favor of the Internet-based psychological interventions when compared with waitlist or care as usual.ConclusionsInternet-based interventions are a promising approach to prevention of mental disorders, enhancing existing methods. Study results are still limited due to inadequate diagnostic procedures. To be able to appropriately comment on effectiveness, future studies need to report incidence data assessed by means of standardized interviews. Public health policy should promote research to reduce health care costs over the long term, and health care providers should implement existing, demonstrably effective interventions into routine care.
The PSI, based upon derived features of brain electrical activity in the anterior/posterior dimension, significantly co-varies with changes in state under general anaesthesia and can significantly predict the level of arousal in varying stages of anaesthetic delivery.
Tinnitus is the chronic perception of a phantom sound with different levels of related distress. Past research has elucidated interactions of tinnitus distress with audiological, affective and further clinical variables. The influence of tinnitus distress on cognition is underinvestigated. Our study aims at investigating specific influences of tinnitus distress and further associated predictors on cognition in a cohort of n = 146 out-ward clinical tinnitus patients. Age, educational level, hearing loss, Tinnitus Questionnaire (TQ) score, tinnitus duration, speech in noise (SIN), stress, anxiety and depression, and psychological well-being were included as predictors of a machine learning regression approach (elastic net) in three models with scores of a multiple choice vocabulary test (MWT-B), or two trail-making tests (TMT-A and TMT-B), as dependent variables. TQ scores predicted lower MWT-B scores and higher TMT-B test completion time. Stress, emotional, and psychological variables were not found to be relevant predictors in all models with the exception of small positive influences of SIN and depression on TMT-B. Effect sizes were small to medium for all models and predictors. Results are indicative of specific influence of tinnitus distress on cognitive performance, especially on general or crystallized intelligence and executive functions. More research is needed at the delicate intersection of tinnitus distress and cognitive skills needed in daily functioning.
BackgroundDespite progress in developing technologies for health promotion and disease treatment, mental disorders remain highly prevalent. In light of the associated personal and societal burden, primary prevention of new onset disorder can be seen as a primary challenge for health care systems and society. Internet- and mobile-based interventions (IMIs) are a promising approach to scale up preventive measures to a population level. The present protocol describes the rationale and design of a systematic review on the effectiveness of IMIs for the prevention of mental disorders.Methods/designA systematic literature search (MEDLINE, PsycINFO, CENTRAL) will be conducted. Keywords will target the topics “prevention”, “mental disorders”, and “Internet and mobile-based interventions”. Studies eligible for inclusion will be retrieved, and data will be extracted and evaluated (design, population, outcomes, sample size, duration of intervention and follow-up, drop-out rate) by two independent researchers. Quality of evidence will be assessed, and results will be synthesized qualitatively and pooled meta-analytically when outcome data are comparable in terms of endpoints, assessments, and target disorders.DiscussionPrevention of mental disorders is one of the major emerging global health challenges. This review and meta-analysis will contribute to our understanding of the potential role for IMIs to help address this challenge.Systematic review registrationPROSPERO CRD42015026781Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0209-5) contains supplementary material, which is available to authorized users.
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