Objective-To assess the efficacy of peer support for reducing symptoms of depression.Methods-Medline, PsycINFO, CINAHL, and CENTRAL databases were searched for clinical trials published as of April 2010 using Medical Subject Headings and free text terms related to depression and peer support. Two independent reviewers selected randomized controlled trials (RCTs) which compared a peer support intervention for depression to usual care or a psychotherapy control condition. Meta-analyses were conducted to generate pooled standardized mean differences (SMD) in the change in depressive symptoms between study conditions. Results-SevenRCTs of peer support versus usual care for depression involving 869 participants were identified. Peer support interventions were superior to usual care in reducing depressive symptoms, with a pooled SMD of -0.59 (95% CI: −0.98, −0.21; p=0.002). Seven RCTs with 301 total participants compared peer support to group cognitive behavioral therapy (CBT). There was not a statistically significant difference between group CBT and peer interventions, with a pooled SMD of 0.10 (95% CI: −0.20, 0.39 p=0.53).Conclusion-Based on the available evidence, peer support interventions help reduce symptoms of depression. Additional studies are needed to determine effectiveness in primary care and other settings with limited mental health resources.

BackgroundInsomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia.ObjectivesThe primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings.Data SourcesWe searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials.MethodsStudies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis.ResultsWe found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001) with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post-treatment assessment. There were no statistically significant differences between sleep efficiency, total sleep time, and insomnia severity index for internet-delivered versus in-person therapy with a trained therapist.ConclusionIn conclusion, internet-delivered cognitive behavioral therapy is effective in improving sleep in adults with insomnia. Efforts should be made to educate the public and expand access to this therapy. Registration Number, Prospero: CRD42015017622

der Auswertung hohere Alkoholumsatze, als die, die in die letzte Tabelle eingesetzt sind.Wir glauben durch die vorliegende Untersuchung die grundsatzliche Seite des Reaktionsverlaufs erfafit zu haben. Die Aussage, die wir in der I. Mitteilung iiber Hefe als Ergebnis des vorlaufigen Studiums der Reaktion gemacht haben, ,,der aufgenommene Sauerstoff diene fast ausschliefllich der Reaktion Alkohol ---+ Essigsaure''l) ist durch das jetzt vorliegende Material richtig gestellt.Eine kleine Unsicherheit besteht noch hinsichtlich der Eigenatmung der Hefe. Auch die verarmte Kefe nimmt ja fur sich allein eine geringe Menge Sauerstoff auf, den sie zur Oxydation noch vorhandener Substanzreste unter CO,-Bildung verwendet. Es handelt sich dehei um Betrlige von Sauerstoff, die etwa 10 Proc. von denen, die fur den Alkoholumsatz aufgenommen werden, ansmachen. Die Entscheidung dariiber, ob diese Eigenatmung anch bei Gegenwart vou leicht angreifbarem Substrat weiter geht oder nicht, laBt sich nicht treffen. Es ist vie1 wahrscheinlicher, daS sie ruht und deshalb ist sie hier nicht beriicksichtigt worden.Es sol1 in dieser Arbeit zunachst der Versuch gemacht werden, eine einfache Systematik der Nebenvalenzringverbindungen zu entwickeln; dann folgt eine Ubersicht der erhaltenen experimentellen Resultate, der sich die Beschreibung der neuen Verbindungen anschlieflt.