Depressive disorders are a major public health issue in Western societies, particularly among adolescents, young adults and women. The COVID-19 pandemic has exacerbated mental health challenges, increasing depression and anxiety symptoms, especially in younger people. This study focuses on the hard-hit Emilia-Romagna Region (ERR) in Italy, examining changes in antidepressant (AD) drug use post-COVID-19 to understand the pandemic’s effect on mental health.

A population-based interrupted time series design and a segmented regression analysis was carried out on ERR pharmaceutical data (FED, direct dispensation pharmaceuticals, AFT, territorial pharmaceutical assistance) out to estimate changes in AD use during the three pandemic years (2020, 2021 and 2022) compared to 2017–2019.Analyses were stratified by age, gender, citizenship, population density of the area of residence.

A notable increase in AD consumption compared to what was expected was observed among younger age groups, and especially in females. In the 12–19 age group, a gradual increase was recorded from January 2021 until it reached +48% in 2022 (+58% among women, +30% among men). An even more remarkable growth in AD usage among non-Italian residents in the same age group was recorded compared to expected. A relevant increase, although smaller, was detected among individuals in the 20–34 age group, with a peak of +9% in 2022. These differences persisted up until the end of the observation period.

The study suggests that the COVID-19 pandemic may have had a lasting negative impact on the mental health of younger individuals. The observed increase in AD use may foreshadow a potential long-term need for enhanced mental healthcare and services directed at this subpopulation.

This study aimed to examine the feasibility and preliminary effectiveness of a behavioral activation (BA) program for the bereaved of cancer patients toward reducing depressive symptoms.

The BA program for the bereaved was a partially modified version for cancer patients. This program encompassed a preinterview and seven 50-minute sessions every 1–2 weeks, using worksheets, with homework assignments each day. To examine feasibility, the completion rates of intervention and 3 months of follow-up were examined. To examine the preliminary effectiveness, psychological symptoms were assessed with the Patient Health Questionnaire (PHQ-9; primary outcome) and Beck Depression Inventory-II (BDI-II) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. These were evaluated 3 times: before, immediately after, and 3-month post-intervention. Non-parametric tests were used for comparison of scores at 3 time points and calculation of effect size.

Of the 42 bereaved who were contacted, 21 were eligible and 20 were participated, while 19 and 18 were in the completed intervention and completed 3-month post-intervention categories (intervention completion rate was 95% and follow-up completion rate was 90%). PHQ-9, BDI-II, and GAD-7 showed significant reductions immediately and 3 months after the intervention compared to pre-intervention, and the effect sizes were all large after 3 months, although they were less than immediately after (PHQ-9: 0.89, 0.71; BDI-II: 0.88, 0.67; GAD-7: 0.57, 0.53).

This study indicated that the BA program for the bereaved of cancer patients was feasible and effective vis-à-vis reducing depressive symptoms.

There is considerable evidence that waiting list (WL) control groups overestimate the effect sizes of psychotherapies for depression. It is not clear, however, what are the exact causes for this overestimation. We decided to conduct a meta-analytic study to compare trials on psychotherapy for depression with a WL control group against trials with a care-as-usual (CAU) control group.

We used an existing meta-analytic database of randomized trials comparing psychological treatments of adult depression with control groups and selected trials using a WL or a CAU control group. We used subgroup and meta-regression analyses to examine differences in effect sizes between WL and CAU controlled trials.

We included 333 randomized controlled trials (472 comparisons; total number participants: 41,480), 141 with a WL and 195 with a CAU control group (3 included both). We found several significant differences between WL and CAU controlled trials (in type of therapy examined, treatment format, recency, target group, recruitment strategy, number of treatment arms and number of depression outcome measures). The overall effect size indicating the difference between treatment and control at post-test for all comparisons was g = 0.77 (95% confidence interval [CI]: 0.71; 0.84) with high heterogeneity (I2 = 84; 95% CI: 82; 85). A highly significant difference was observed between studies with a CAU control group (g = 0.63; 95% CI: 0.55; 0.71; I2 = 85; 95% CI: 83; 86) and studies with a WL (g = 0.95; 95% CI: 0.85; 1.04; I2 = 80; 95% CI: 78; 82; p for difference < 0.001). This difference remained significant in all sensitivity analyses, including a meta-regression analysis in which we adjusted for all differences in characteristics of studies with a WL versus CAU control group. We also found that pre-post effect sizes in WL control conditions (g = 0.37; 95% CI: 0.28; 0.46) were significantly smaller than change within CAU conditions (g = 0.64; 95% CI: 0.50; 0.78). We found few indications that pre-post effect sizes within therapy conditions differed between WL and CAU controlled trials.

WL control conditions considerably overestimate the effect sizes of psychological treatments, compared to trials using CAU control conditions. This overestimation is probably caused by a smaller improvement within the WL condition compared to the improvement in the CAU condition. WL control conditions should be avoided in randomized trials examining psychological treatments of adult depression.

Low-intensity psychological interventions are effective for children and young people (CYP) with mental health difficulties and can help bridge the demand–capacity gap. Despite increasing awareness, training and use of low-intensity psychological interventions, it is not yet understood what is being implemented in clinical practice in the UK and the associated evidence base.

This paper presents two studies; first, a national survey (n=102) of practitioners to identify low-intensity psychological interventions currently delivered in practice and second, an exploration of the availability and the strength of empirical support (characterised as ‘gold’, ‘silver’ and ‘bronze’) of low-intensity CBT interventions for CYP.

The first study found a wide variety of interventions being used across different services; 101/102 respondents reported using routine outcome measures. The second study identified 44 different low-intensity interventions, 28 of which were rated as having gold empirical support. However, only 13 of the gold interventions were considered accessible for practitioners and only two were reported being used in routine practice.

These findings highlight that these interventions have been developed and empirically tested, but many are not easily accessible, highlighting the ‘research–practice’ gap in the provision of low-intensity interventions. There is a need for an increase in standardisation of care and accessibility of gold interventions. This paper hopes to begin the process of creating a hub of low-intensity interventions that are accessible and empirically supported to improve equity of access and outcomes of low-intensity psychological interventions for CYP.

Existing self-rated depression measurement tools possess a range of psychometric drawbacks, spanning a range of validity and reliability constructs. The gold standard self-rated depression scales contain several variable items that are often non-specific, require respondents to have a certain level of language understanding and limited scoring options resulting in low sensitivity. The Maudsley three-item visual analogue scale (M3VAS) was developed to address these challenges.

This study aimed to translate the M3VAS into Chinese and test its reliability and validity.

First, both M3VAS scales (assessing current severity and change in severity) were translated according to a standardised protocol to finalise the Chinese version. Reliability and validity were then examined among 550 young people with moderate to severe depression (patient health questionnaire-9 (PHQ-9) score ≥15) in a cross-sectional opportunistic questionnaire survey.

The content validity of each item (six items, across both scales) ranged from 0.83 to 1.00. Exploratory factor analysis denoted a total of two common factors, with a variance contribution rate of 64.34%. The total score correlated positively with the PHQ-9 total score (r = 0.241, P < 0.01). The Chinese version of the M3VAS had good reliability and validity values, and the confirmatory factor model fit well.

The psychometric properties of the Chinese version of the M3VAS suggest that this scale can feasibly evaluate depression among young people in China.