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Article ; Online: Using brief measures to identify depression and other mental disorders: A challenge for research and clinical practice.

Titov, Nickolai / Andersson, Gerhard

2021 Volume 28, Page(s) 100450

Language	English
Publishing date	2021-09-01
Publishing country	Netherlands
Document type	Editorial
ZDB-ID	2764252-5
ISSN	2214-7829 ; 2214-7829
ISSN (online)	2214-7829
ISSN	2214-7829
DOI	10.1016/j.invent.2021.100450
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Article: Satisfaction, engagement, and outcomes in internet-delivered cognitive behaviour therapy adapted for people of diverse ethnocultural groups: an observational trial with benchmarking.

Sapkota, Ram P / Valli, Emma / Dear, Blake F / Titov, Nickolai / Hadjistavropoulos, Heather D

Frontiers in psychiatry

2024 Volume 15, Page(s) 1270543

Abstract: Introduction: Depression and anxiety are the most common mental health disorders worldwide. Internet-Delivered Cognitive Behaviour Therapy (ICBT) can reduce barriers to care to broad cross sections of the population. However, People of Diverse ... ...

Abstract	Introduction: Depression and anxiety are the most common mental health disorders worldwide. Internet-Delivered Cognitive Behaviour Therapy (ICBT) can reduce barriers to care to broad cross sections of the population. However, People of Diverse Ethnocultural Backgrounds (PDEGs) other than White/Caucasian underutilize mental health services and are under represented in clinical trials of psychological interventions. Methods: To address this research gap we adapted an evidence-based ICBT program for PDEGs. The current pilot study explores the engagement, satisfaction, and effectiveness in the adapted ICBT program by PDEGs (N=41) when benchmarked against a sample of PDEGs (N=134) who previously completed a non-adapted version of the ICBT program. Results: An intent-to-treat analyses showed that the adapted ICBT program is effective in reducing anxiety and depression symptoms among PDEGs. Large within-group pre-to post-treatment Cohen's effect sizes of Conclusion: No statistically significant differences in the clinical outcomes, engagement, and satisfaction were found between the pilot study and benchmark sample. Future directions for ICBT research with PDEGs are described. Clinical trial registration: https://beta.clinicaltrials.gov/study/NCT05523492, identifier NCT05523492.
Language	English
Publishing date	2024-03-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2024.1270543
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Article ; Online: A pilot study examining whether restricting and resuming specific actions systematically changes symptoms of depression and anxiety. A series of N-of-1 trials.

Titov, Nickolai / Dear, Blake F / Nielssen, Olav / Barrett, Victoria / Kayrouz, Rony / Staples, Lauren G

Behaviour research and therapy

2024 Volume 177, Page(s) 104536

Abstract: Anxiety and depressive disorders are highly prevalent and a leading cause of disability. Understanding how symptoms develop could lead to new preventive and clinical interventions. This pilot study examined whether systematically restricting specific ... ...

Abstract	Anxiety and depressive disorders are highly prevalent and a leading cause of disability. Understanding how symptoms develop could lead to new preventive and clinical interventions. This pilot study examined whether systematically restricting specific behaviours (target actions) associated with good psychological health would increase psychological symptoms in healthy participants, and whether resuming those actions would reduce symptoms to baseline levels. Twelve adults participated in a series of N-of-1 trials comprising baseline (A), restriction (B) and recovery (C) phases. Outcomes were assessed weekly using measures of depression (PHQ-9), anxiety (GAD-7), and a validated 15-item measure of target actions (Big 5). Symptoms of depression and anxiety increased significantly from Phase A to Phase B and returned to baseline by the end of Phase C. Increased symptoms during Phase B were only observed in participants who restricted actions by more than 25%. Symptom increases were evident within 2 weeks of restriction, but most participants appeared to take longer to recover to baseline levels. This study demonstrates that reducing the frequency of specific actions may increase symptoms of anxiety and depression, which is reversed when those actions are resumed. This contributes to our understanding of the aetiology, maintenance, and recovery from depression, anxiety, and possibly other disorders.
Language	English
Publishing date	2024-04-03
Publishing country	England
Document type	Journal Article
ZDB-ID	211997-3
ISSN	1873-622X ; 0005-7967
ISSN (online)	1873-622X
ISSN	0005-7967
DOI	10.1016/j.brat.2024.104536
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Article ; Online: Efficacy and acceptability of a self-guided internet-delivered cognitive-behavioral educational program for obsessive-compulsive symptoms with international recruitment.

Wootton, Bethany M / McDonald, Sarah / Melkonian, Maral / Karin, Eyal / Titov, Nickolai / Dear, Blake F

Cognitive behaviour therapy

2023 Volume 53, Issue 2, Page(s) 133–151

Abstract: Cognitive-behavioural therapy is an effective treatment for obsessive-compulsive disorder (OCD). However, there are many barriers in accessing this treatment, with stigma being a particularly prominent barrier for many patients. Self-guided internet- ... ...

Abstract	Cognitive-behavioural therapy is an effective treatment for obsessive-compulsive disorder (OCD). However, there are many barriers in accessing this treatment, with stigma being a particularly prominent barrier for many patients. Self-guided internet-delivered cognitive-behavioural therapy (ICBT), which does not require any contact with a therapist, has the potential to overcome this barrier. However, there is limited research on the efficacy of self-guided ICBT for OCD. The aim of the current study was to examine the efficacy of self-guided ICBT for OCD in a large international sample. Two hundred and sixteen participants were included in the study (
MeSH term(s)	Humans ; Female ; Male ; Obsessive-Compulsive Disorder/therapy ; Treatment Outcome ; Cognitive Behavioral Therapy/methods ; Therapy, Computer-Assisted/methods ; Cognition ; Internet
Language	English
Publishing date	2023-11-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2076060-7
ISSN	1651-2316 ; 1650-6073
ISSN (online)	1651-2316
ISSN	1650-6073
DOI	10.1080/16506073.2023.2279492
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Article ; Online: Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study.

Hadjistavropoulos, Heather D / McCall, Hugh C / Dear, Blake F / Beahm, Janine D / Carleton, R Nicholas / Titov, Nickolai

Journal of anxiety disorders

2024 Volume 104, Page(s) 102861

Abstract: First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment ... ...

Abstract	First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment for various mental health concerns. Canadian PSP report favorable attitudes toward ICBT, and preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted of a longitudinal observational study of 560 Canadian PSP who participated in ICBT. It was designed to assess the longer term effectiveness of ICBT and moderators of outcomes by gender, linguistic and occupational group, and years of occupational experience. We evaluated symptom change at 8, 26, and 52 weeks post-enrollment, and results among PSP who had elevated clinical scores, showed large reductions (Hedges' g) in symptoms of depression (g = 1.3), anxiety (g =1.48), posttraumatic stress (g =1.24), panic (g =1.19), and anger (g =1.07) and moderate reductions in symptoms of social anxiety (g =.48-.56). Moderator analyses revealed modest differences in pre-treatment symptoms among certain groups but no group differences in symptom change over time. Clients showed good completion of treatment materials and reported high treatment satisfaction. The results suggest further study of ICBT tailored to PSP is warranted, including evaluating ICBT tailored for PSP in other countries.
Language	English
Publishing date	2024-04-12
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	619417-5
ISSN	1873-7897 ; 0887-6185
ISSN (online)	1873-7897
ISSN	0887-6185
DOI	10.1016/j.janxdis.2024.102861
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Article ; Online: Predictors of response to cognitive behavioural therapy (CBT) for individuals with obsessive-compulsive disorder (OCD): a systematic review.

McDonald, Sarah / Melkonian, Maral / Karin, Eyal / Dear, Blake F / Titov, Nickolai / Wootton, Bethany M

Behavioural and cognitive psychotherapy

2023 Volume 51, Issue 4, Page(s) 302–319

Abstract: Background: Cognitive behavioural therapy (CBT) is considered the first-line treatment for obsessive-compulsive disorder (OCD). However, some individuals with OCD remain symptomatic following CBT, and therefore understanding predictors of outcome is ... ...

Abstract	Background: Cognitive behavioural therapy (CBT) is considered the first-line treatment for obsessive-compulsive disorder (OCD). However, some individuals with OCD remain symptomatic following CBT, and therefore understanding predictors of outcome is important for informing treatment recommendations. Aims: The current study aimed to provide the first synthesis of predictors of outcome following CBT for OCD in adults with a primary diagnosis of OCD, as classified by Method: Eight studies ( Results: Congruent with past reviews, there was great heterogeneity of predictors measured across the included studies. Therefore, a narrative synthesis of findings was conducted. Findings from this systematic review indicated that some OCD-related pre-treatment variables (i.e. pre-treatment severity, past CBT treatment, and levels of avoidance) and during treatment variables (i.e. poor working alliance and low treatment adherence) may be important to consider when making treatment recommendations. However, the results also indicate that demographic variables and psychological co-morbidities may not be specific predictors of treatment response. Conclusions: These findings add to the growing body of literature on predictors of CBT treatment outcomes for individuals with OCD.
MeSH term(s)	Adult ; Humans ; Female ; Male ; Cognitive Behavioral Therapy/methods ; Obsessive-Compulsive Disorder/therapy ; Obsessive-Compulsive Disorder/psychology ; Treatment Outcome ; Comorbidity
Language	English
Publishing date	2023-04-04
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	1168441-0
ISSN	1469-1833 ; 1352-4658 ; 0141-3473
ISSN (online)	1469-1833
ISSN	1352-4658 ; 0141-3473
DOI	10.1017/S1352465823000103
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Article ; Online: The Timing and Magnitude of Improvements in Depression, Anxiety, Disability, and Pain Intensity During an Internet-delivered Program for Chronic Pain.

Bisby, Madelyne A / Chandra, Shianika S / Scott, Amelia J / Dudeney, Joanne / Titov, Nickolai / Dear, Blake F

The journal of pain

2023 Volume 24, Issue 11, Page(s) 1968–1979

Abstract: Numerous studies have found that pain management programs are an effective treatment option for people with chronic pain. However, little is known about when people experience improvements during these programs and why they are effective. Using a ... ...

Abstract	Numerous studies have found that pain management programs are an effective treatment option for people with chronic pain. However, little is known about when people experience improvements during these programs and why they are effective. Using a secondary analysis, the current study examined the timing and magnitude of symptom change during an 8-week internet-delivered psychological pain management program for people with chronic pain. The change in 4 outcomes was examined: depression (n = 881), anxiety (n = 561), disability (n = 484), and pain intensity (n = 484). The largest improvements in depression, anxiety, and disability were reported during the first half of treatment (ie, 4 weeks), whereas the largest reductions in pain intensity were reported during the second half of treatment. Half the participants had experienced a clinically meaningful improvement in depression or anxiety, and a third of participants had reported such an improvement in disability by midtreatment (ie, 5 weeks after baseline). In a subgroup analysis (n = 397), this pattern of change in depression and anxiety symptoms did not differ based on the level of therapist guidance. This study highlights the importance of the first few weeks of psychological pain management programs and encourages future work to examine how the mechanisms underpinning rapid change may be harnessed to optimize care for people with chronic pain. PERSPECTIVE: This study found that depression, anxiety, and disability improved rapidly during the first half of an 8-week internet-delivered pain management program, and most of the prepost change had occurred by midtreatment. This work highlights the therapeutic potential of the first few treatment sessions and prompts future research into a rapid responding.
MeSH term(s)	Humans ; Chronic Pain/therapy ; Chronic Pain/psychology ; Depression/therapy ; Pain Measurement ; Anxiety/therapy ; Anxiety Disorders ; Treatment Outcome ; Internet
Language	English
Publishing date	2023-07-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2018789-0
ISSN	1528-8447 ; 1526-5900
ISSN (online)	1528-8447
ISSN	1526-5900
DOI	10.1016/j.jpain.2023.06.004
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Article ; Online: Effectiveness of internet delivered cognitive behaviour therapy provided as routine care for people in the depressed phase of bipolar disorder treated with Lithium.

Nielssen, Olav / Staples, Lauren / Karin, Eyal / Kayrouz, Rony / Dear, Blake / Titov, Nickolai

PLOS digital health

2023 Volume 2, Issue 2, Page(s) e0000194

Abstract: There is little research reporting the outcome of internet delivered cognitive behaviour therapy, (iCBT), which helps patients identify and modify unhelpful cognitions and behaviours, for the depressed phase of bipolar disorder as part of routine care. ... ...

Abstract	There is little research reporting the outcome of internet delivered cognitive behaviour therapy, (iCBT), which helps patients identify and modify unhelpful cognitions and behaviours, for the depressed phase of bipolar disorder as part of routine care. Demographic information, baseline scores and treatment outcomes were examined for patients of MindSpot Clinic, a national iCBT service who reported taking Lithium and their clinic records confirmed the diagnosis of bipolar disorder. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), compared to clinic benchmarks. Out of 21,745 people who completed a MindSpot assessment and enrolled in a MindSpot treatment course in a 7 year period, 83 reported taking Lithium and had a confirmed a diagnosis of bipolar disorder. Outcomes of reductions in symptoms were large on all measures (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. MindSpot treatments appear to be effective in treating anxiety and depression in people diagnosed with bipolar, and suggest that iCBT has the potential to overcome the under-use of evidence based psychological treatments of people with bipolar depression.
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Journal Article
ISSN	2767-3170
ISSN (online)	2767-3170
DOI	10.1371/journal.pdig.0000194
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Article ; Online: An online therapist-guided ultra-brief treatment for depression and anxiety: a randomized controlled trial.

Bisby, Madelyne A / Balakumar, Tanya / Scott, Amelia J / Titov, Nickolai / Dear, Blake F

Psychological medicine

2023 Volume 54, Issue 5, Page(s) 902–913

Abstract: Background: There are many barriers to engaging in current psychological treatments, including time, cost, and availability. Ultra-brief treatments overcome some of these barriers by delivering therapeutic information and skills using significantly less ...

Abstract	Background: There are many barriers to engaging in current psychological treatments, including time, cost, and availability. Ultra-brief treatments overcome some of these barriers by delivering therapeutic information and skills using significantly less time than standard-length treatments. We developed a therapist-guided online ultra-brief treatment for depression and anxiety and compared it to an existing 8-week, 5-lesson therapist-guided standard-length treatment and a waitlist control. Methods: In a randomized controlled trial, adults with self-reported depression or anxiety were randomized (1:1:1) to the ultra-brief treatment, standard-length treatment, or waitlist control. The primary outcomes were depression symptoms and anxiety symptoms assessed at baseline, 5-weeks later, 9-weeks later (primary timepoint), and 3-months later. The trial was prospectively registered. Results: Between 7 February 2022, and 16 August 2022, 242 participants were enrolled in the ultra-brief treatment ( Conclusions: The online ultra-brief treatment resulted in significant reductions in depression and anxiety that were non-inferior to a longer treatment course after 9-weeks. Remotely delivered ultra-brief treatments have the potential to provide accessible and effective care for those who cannot, or would prefer not to, access longer psychological interventions.
MeSH term(s)	Adult ; Humans ; Female ; Middle Aged ; Male ; Depression/therapy ; Depression/diagnosis ; Crisis Intervention ; Cognitive Behavioral Therapy/methods ; Anxiety/therapy ; Anxiety/diagnosis ; Anxiety Disorders/therapy ; Treatment Outcome ; Internet
Language	English
Publishing date	2023-09-01
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	217420-0
ISSN	1469-8978 ; 0033-2917
ISSN (online)	1469-8978
ISSN	0033-2917
DOI	10.1017/S003329172300260X
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Article ; Online: Preparing mental health systems for climate crisis.

Newnham, Elizabeth A / Titov, Nickolai / McEvoy, Peter

The Lancet. Planetary health

2020 Volume 4, Issue 3, Page(s) e89–e90

MeSH term(s)	Australia ; Climate Change ; Humans ; Mental Health ; Mental Health Services/organization & administration ; Wildfires
Language	English
Publishing date	2020-03-24
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2542-5196
ISSN (online)	2542-5196
DOI	10.1016/S2542-5196(20)30036-X
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