It is unclear what role the experimental drug and convalescent plasma had in the recovery of these patients. Prospective clinical trials are needed to delineate the role of investigational therapies in the care of patients with EVD.
Poor sleep is a significant risk factor for depression across the lifespan and sleep problems have been hypothesised to contribute to the onset and maintenance of depression symptoms. However, sleep problems are usually not a direct target of interventions for depression. A range of non-pharmacological treatments can reduce sleep problems but it is unclear whether these interventions also reduce other depression symptoms. The aim of this review was to examine whether non-pharmacological interventions for sleep problems are effective in reducing symptoms of depression. We carried out a systematic search for randomised controlled trials of non-pharmacological sleep interventions that measured depression symptoms as an outcome. Forty-nine trials (n=5908) were included in a random effects metaanalysis. The pooled standardised mean difference for depression symptoms after treatment for sleep problems was-0.45 (95% CI:-0.55,-0.36). The size of the effect on depression symptoms was moderated by the size of the effect on subjective sleep quality. In studies of participants with mental health problems, sleep interventions had a large effect on depression symptoms (d=-0.81, 95% CI:-1.13,-0.49). The findings indicate that non-pharmacological sleep interventions are effective in reducing the severity of depression, particularly in clinical populations. This suggests that non-pharmacological sleep interventions could be offered as a treatment for depression, potentially improving access to treatment.
Aim: The PRODIGY trial is an ongoing randomised controlled trial of Social Recovery Cognitive Behavioural Therapy (SRCBT), a new intervention designed to improve social functioning in young people at risk of long-term social disability due to severe and complex mental health problems. The aim of this qualitative sub-study was to understand trial participants' experiences of SRCBT and the control condition, treatment as usual (TAU).
Method:Trial participants were aged 16 -25 with socially disabling severe and complex mental health problems. A purposive sample of trial participants took part in in-depth qualitative interviews which were transcribed verbatim and analysed thematically. Increased activity was an important goal of participants from both arms and most expressed high motivation and little hopelessness.
Conclusions:Currently available services do not meet the needs of some young people with socially disabling mental health problems. Motivation to change appears high at this early stage of disorder, supporting the potential value of intervening early to prevent longer-term social disability. SRCBT was well accepted by participants and so is a promising intervention to meet this objective.Running Title: Young People's Experiences in the PRODIGY Trial
Young people attempting to access mental health services in the United Kingdom often find traditional models of care outdated, rigid, inaccessible and unappealing. Policy recommendations, research and service user opinion suggest that reform is needed to reflect the changing needs of young people. There is significant motivation in the United Kingdom to transform mental health services for young people, and this paper aims to describe the rationale, development and implementation of a novel youth mental health service in the United Kingdom, the Norfolk Youth Service. The Norfolk Youth Service model is described as a service model case study. The service rationale, national and local drivers, principles, aims, model, research priorities and future directions are reported. The Norfolk Youth Service is an innovative example of mental health transformation in the United Kingdom, comprising a pragmatic, assertive and "youth-friendly" service for young people aged 14 to 25 that transcends traditional service boundaries. The service was developed in collaboration with young people and partnership agencies and is based on an engaging and inclusive ethos. The service is a social-recovery oriented, evidence-based and aims to satisfy recent policy guidance. The redesign and transformation of youth mental health services in the United Kingdom is long overdue. The Norfolk Youth Service represents an example of reform that aims to meet the developmental and transitional needs of young people at the same time as remaining youth-oriented.
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