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Depression: HELP
Articles by Steven D. Hollon
Based on 85 articles published since 2010
(Why 85 articles?)
HideThe current database of articles was compiled on:
Thu Jan 9 06:37:06 2020
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Between 2010 and 2020, S. D. Hollon wrote the following 85 articles about Depression.
+ Citations - Citations + Abstracts - Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial Treatment of Depression Versus Treatment of PTSD. 2019
Hollon, Steven D. ·The Department of Psychology, Vanderbilt University, Nashville, Tenn. ·Am J Psychiatry · Pubmed #30929505.
ABSTRACT: -- No abstract --
2 Editorial Reviewing psychological treatments for adult depression. 2013
Hollon, Steven D / Cuijpers, Pim. · ·Can J Psychiatry · Pubmed #23870718.
3 Review Recent Developments in the Treatment of Depression. 2019
Hollon, Steven D / Cohen, Zachary D / Singla, Daisy R / Andrews, Paul W. ·Vanderbilt University. Electronic address: steven.d.hollon@vanderbilt.edu. · University of Pennsylvania. · University of Toronto, Sinai Health System. · McMaster University. ·Behav Ther · Pubmed #30824244.
ABSTRACT: The cognitive and behavioral interventions can be as efficacious as antidepressant medications and more enduring, but some patients will be more likely to respond to one than the other. Recent work has focused on developing sophisticated selection algorithms using machine-learning approaches that answer the question, "What works best for whom?" Moreover, the vast majority of people suffering from depression reside in low- and middle-income countries where access to either psychotherapy or medications is virtually nonexistent. Great strides have been made in training nonspecialist providers (known as task sharing) to overcome this gap. Finally, recent work growing out of evolutionary psychology suggests that antidepressant medications may suppress symptoms at the expense of prolonging the underlying episode so as to increase the risk of relapse whenever someone tries to stop. We address each of these developments and their cumulative implications.
4 Review The Mortality and Myocardial Effects of Antidepressants Are Moderated by Preexisting Cardiovascular Disease: A Meta-Analysis. 2017
Maslej, Marta M / Bolker, Benjamin M / Russell, Marley J / Eaton, Keifer / Durisko, Zachary / Hollon, Steven D / Swanson, G Marie / Thomson, J Anderson / Mulsant, Benoit H / Andrews, Paul W. ·Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada. ·Psychother Psychosom · Pubmed #28903117.
ABSTRACT: BACKGROUND: Antidepressants (ADs) are commonly prescribed medications, but their long-term health effects are debated. ADs disrupt multiple adaptive processes regulated by evolutionarily ancient biochemicals, potentially increasing mortality. However, many ADs also have anticlotting properties that can be efficacious in treating cardiovascular disease. We conducted a meta-analysis assessing the effects of ADs on all-cause mortality and cardiovascular events in general-population and cardiovascular-patient samples. METHODS: Two reviewers independently assessed articles from PubMed, EMBASE, and Google Scholar for AD-related mortality controlling for depression and other comorbidities. From these articles, we extracted information about cardiovascular events, cardiovascular risk status, and AD class. We conducted mixed-effect meta-analyses testing sample type and AD class as moderators of all-cause mortality and new cardiovascular events. RESULTS: Seventeen studies met our search criteria. Sample type consistently moderated health risks. In general-population samples, AD use increased the risks of mortality (HR = 1.33, 95% CI: 1.14-1.55) and new cardiovascular events (HR = 1.14, 95% CI: 1.08-1.21). In cardiovascular patients, AD use did not significantly affect risks. AD class also moderated mortality, but the serotonin reuptake inhibitors were not significantly different from tricyclic ADs (TCAs) (HR = 1.10, 95% CI: 0.93-1.31, p = 0.27). Only "other ADs" were differentiable from TCAs (HR = 1.35, 95% CI: 1.08-1.69). Mortality risk estimates increased when we analyzed the subset of studies controlling for premedication depression, suggesting the absence of confounding by indication. CONCLUSIONS: The results support the hypothesis that ADs are harmful in the general population but less harmful in cardiovascular patients.
5 Review Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials. 2017
Furukawa, Toshi A / Weitz, Erica S / Tanaka, Shiro / Hollon, Steven D / Hofmann, Stefan G / Andersson, Gerhard / Twisk, Jos / DeRubeis, Robert J / Dimidjian, Sona / Hegerl, Ulrich / Mergl, Roland / Jarrett, Robin B / Vittengl, Jeffrey R / Watanabe, Norio / Cuijpers, Pim. ·Toshi A. Furukawa, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Erica S. Weitz, MA, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Shiro Tanaka, PhD, Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Stefan G. Hofmann, PhD, Department of Psychological and Brain Science, Boston University, Massachusetts, USA; Gerhard Andersson, PhD, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden and Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stokholm, Sweden; Jos Twisk, PhD, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Sona Dimidjian, PhD, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; Ulrich Hegerl, MD, PhD, Roland Mergl, PhD, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; Robin B. Jarrett, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Jeffrey R. Vittengl, PhD, Department of Psychology, Truman State University, Kirksville, Missouri, USA; Norio Watanabe, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Pim Cuijpers, PhD, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands furukawa@kuhp.kyoto-u.ac.jp. · Toshi A. Furukawa, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Erica S. Weitz, MA, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Shiro Tanaka, PhD, Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Stefan G. Hofmann, PhD, Department of Psychological and Brain Science, Boston University, Massachusetts, USA; Gerhard Andersson, PhD, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden and Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stokholm, Sweden; Jos Twisk, PhD, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Sona Dimidjian, PhD, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; Ulrich Hegerl, MD, PhD, Roland Mergl, PhD, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; Robin B. Jarrett, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Jeffrey R. Vittengl, PhD, Department of Psychology, Truman State University, Kirksville, Missouri, USA; Norio Watanabe, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Pim Cuijpers, PhD, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands. ·Br J Psychiatry · Pubmed #28104735.
6 Review Does Publication Bias Inflate the Apparent Efficacy of Psychological Treatment for Major Depressive Disorder? A Systematic Review and Meta-Analysis of US National Institutes of Health-Funded Trials. 2015
Driessen, Ellen / Hollon, Steven D / Bockting, Claudi L H / Cuijpers, Pim / Turner, Erick H. ·Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, Amsterdam, The Netherlands. · Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America. · Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. · Behavioral Health and Neurosciences Division, VA Portland Health Care System, Portland, Oregon, United States of America; Departments of Psychiatry and Pharmacology, Oregon Health & Science University, Portland, Oregon, United States of America. ·PLoS One · Pubmed #26422604.
ABSTRACT: BACKGROUND: The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression. METHODS AND FINDINGS: We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972-2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6%) of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges' g = 0.20; CI95% -0.11~0.51; k = 6) to published studies (g = 0.52; 0.37~0.68; k = 20) reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70) by 25%. Moreover, these findings may overestimate the "true" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively. CONCLUSION: The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression.
7 Review The effects of cognitive behavior therapy for adult depression on dysfunctional thinking: A meta-analysis. 2015
Cristea, Ioana A / Huibers, Marcus J H / David, Daniel / Hollon, Steven D / Andersson, Gerhard / Cuijpers, Pim. ·Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania; Clinical Psychology Branch, Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Pisa, Italy. Electronic address: ioana.cristea@ubbcluj.ro. · Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, The Netherlands. · Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania. · Department of Psychology, Vanderbilt University, Nashville, USA. · Department of Behavioural Sciences and Learning, Linköping University, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. ·Clin Psychol Rev · Pubmed #26319193.
ABSTRACT: BACKGROUND: It is not clear whether cognitive behavior therapy (CBT) works through changing dysfunctional thinking. Although several primary studies have examined the effects of CBT on dysfunctional thinking, no meta-analysis has yet been conducted. METHOD: We searched for randomized trials comparing CBT for adult depression with control groups or with other therapies and reporting outcomes on dysfunctional thinking. We calculated effect sizes for CBT versus control groups, and separately for CBT versus other psychotherapies and respectively, pharmacotherapy. RESULTS: 26 studies totalizing 2002 patients met inclusion criteria. The quality of the studies was less than optimal. We found a moderate effect of CBT compared to control groups on dysfunctional thinking at post-test (g=0.50; 95% CI: 0.38-0.62), with no differences between the measures used. This result was maintained at follow-up (g=0.46; 95% CI: 0.15-0.78). There was a strong association between the effects on dysfunctional thinking and those on depression. We found no significant differences between CBT and other psychotherapies (g=0.17; p=0.31), except when restrict in outcomes to the Dysfunctional Attitudes Scale (g=0.29). There also was no difference between CBT and pharmacotherapy (g=0.04), though this result was based on only 4 studies. DISCUSSION: While CBT had a robust and stable effect on dysfunctional thoughts, this was not significantly different from what other psychotherapies or pharmacotherapy achieved. This result can be interpreted as confirming the primacy of cognitive change in symptom change, irrespective of how it is attained, as well as supporting the idea that dysfunctional thoughts are simply another symptom that changes subsequent to treatment.
8 Review A lifetime approach to major depressive disorder: The contributions of psychological interventions in preventing relapse and recurrence. 2015
Bockting, Claudi L / Hollon, Steven D / Jarrett, Robin B / Kuyken, Willem / Dobson, Keith. ·Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. Electronic address: c.l.h.bockting@uu.nl. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK. · Department of Psychology, University of Calgary, Alberta, Canada. ·Clin Psychol Rev · Pubmed #25754289.
ABSTRACT: Major depressive disorder (MDD) is highly disabling and typically runs a recurrent course. Knowledge about prevention of relapse and recurrence is crucial to the long-term welfare of people who suffer from this disorder. This article provides an overview of the current evidence for the prevention of relapse and recurrence using psychological interventions. We first describe a conceptual framework to preventive interventions based on: acute treatment; continuation treatment, or; prevention strategies for patients in remission. In brief, cognitive-behavioral interventions, delivered during the acute phase, appear to have an enduring effect that protects patients against relapse and perhaps others from recurrence following treatment termination. Similarly, continuation treatment with either cognitive therapy or perhaps interpersonal psychotherapy appears to reduce risk for relapse and maintenance treatment appears to reduce risk for recurrence. Preventive relapse strategies like preventive cognitive therapy or mindfulness based cognitive therapy (MBCT) applied to patients in remission protects against subsequent relapse and perhaps recurrence. There is some preliminary evidence of specific mediation via changing the content or the process of cognition. Continuation CT and preventive interventions started after remission (CBT, MBCT) seem to have the largest differential effects for individuals that need them the most. Those who have the greatest risk for relapse and recurrence including patients with unstable remission, more previous episodes, potentially childhood trauma, early age of onset. These prescriptive indications, if confirmed in future research, may point the way to personalizing prevention strategies. Doing so, may maximize the efficiency with which they are applied and have the potential to target the mechanisms that appear to underlie these effects. This may help make this prevention strategies more efficacious.
9 Review Effectiveness of psychological interventions in preventing recurrence of depressive disorder: meta-analysis and meta-regression. 2015
Biesheuvel-Leliefeld, Karolien E M / Kok, Gemma D / Bockting, Claudi L H / Cuijpers, Pim / Hollon, Steven D / van Marwijk, Harm W J / Smit, Filip. ·Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: k.leliefeld@vumc.nl. · Department of Clinical and Experimental Psychology, Groningen University, Groningen, The Netherlands. · Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands. · Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands; Leuphana University, Lüneburg, Germany. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. · Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands; Department of Public Mental Health, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. ·J Affect Disord · Pubmed #25553400.
ABSTRACT: BACKGROUND: Major depression is probably best seen as a chronically recurrent disorder, with patients experiencing another depressive episode after remission. Therefore, attention to reduce the risk of relapse or recurrence after remission is warranted. The aim of this review is to meta-analytically examine the effectiveness of psychological interventions to reduce relapse or recurrence rates of depressive disorder. METHODS: We systematically reviewed the pertinent trial literature until May 2014. The random-effects model was used to compute the pooled relative risk of relapse or recurrence (RR). A distinction was made between two comparator conditions: (1) treatment-as-usual and (2) the use of antidepressants. Other sources of heterogeneity in the data were explored using meta-regression. RESULTS: Twenty-five randomised trials met inclusion criteria. Preventive psychological interventions were significantly better than treatment-as-usual in reducing the risk of relapse or recurrence (RR=0.64, 95% CI=0.53-0.76, z=4.89, p<0.001, NNT=5) and also more successful than antidepressants (RR=0.83, 95% CI=0.70-0.97, z=2.40, p=0.017, NNT=13). Meta-regression showed homogeneity in effect size across a range of study, population and intervention characteristics, but the preventive effect of psychological intervention was usually better when the prevention was preceded by treatment in the acute phase (b=-1.94, SEb=0.68, z=-2.84, p=0.005). LIMITATIONS: Differences between the primary studies in methodological design, composition of the patient groups and type of intervention may have caused heterogeneity in the data, but could not be evaluated in a meta-regression owing to poor reporting. CONCLUSIONS: We conclude that there is supporting evidence that preventive psychological interventions reduce the risk of relapse or recurrence in major depression.
10 Review [The efficacy of psychological treatments for depression: a review of recent research findings]. 2014
Driessen, E / Cuijpers, P / Hollon, S D / Van, H L / Dekker, J J M. · ·Tijdschr Psychiatr · Pubmed #25070570.
ABSTRACT: BACKGROUND: Psychological treatments for depression have been shown to be effective, but there is room for improvement. AIM: To summarise new research findings concerning the efficacy of psychological treatments for depression, as reported in a recent dissertation. METHOD: Four systematic reviews and meta-analyses and one randomised clinical trial are described. RESULTS: As has been shown in the case of patients treated with antidepressants, the efficacy of psychological treatments for depression when compared to strict control conditions, might be greater in patients with more severe depressive symptoms than in patients with milder symptoms. The efficacy of psychological treatments for depression when compared to control conditions is overestimated as a result of systematic publication of positive findings, as has been reported with regard to antidepressant medication too. There is increasing academic support for the efficacy of brief psychodynamic therapy for depression and there are no differences in the efficacy of short-term psychodynamic supportive psychotherapy and cognitive behavioural therapy for depression. Certain patient characteristics were found to be related to the differential efficacy of these two types of psychological treatments, but further validation is needed. A large number of patients with depression who seek help from second-line psychiatric clinics in the Netherlands fail to achieve remission following psychological treatment, irrespective of whether that treatment is combined with antidepressants. CONCLUSION: Improved efficacy of psychological treatments for depression is urgently needed and can be facilitated by means of high quality research.
11 Review The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. 2014
Cuijpers, Pim / Karyotaki, Eirini / Weitz, Erica / Andersson, Gerhard / Hollon, Steven D / van Straten, Annemieke. ·Department of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands; Leuphana University, Lüneburg, Germany. Electronic address: p.cuijpers@vu.nl. · Department of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands. · Department of Behavioral Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. · Vanderbilt University, Nashville, Tennessee, USA. ·J Affect Disord · Pubmed #24679399.
ABSTRACT: BACKGROUND: Standardised effect sizes have been criticized because they are difficult to interpret and offer little clinical information. This meta-analyses examine the extent of actual improvement, the absolute numbers of patients no longer meeting criteria for major depression, and absolute rates of response and remission. METHODS: We conducted a meta-analysis of 92 studies with 181 conditions (134 psychotherapy and 47 control conditions) with 6937 patients meeting criteria for major depressive disorder. Within these conditions, we calculated the absolute number of patients no longer meeting criteria for major depression, rates of response and remission, and the absolute reduction on the BDI, BDI-II, and HAM-D. RESULTS: After treatment, 62% of patients no longer met criteria for MDD in the psychotherapy conditions. However, 43% of participants in the control conditions and 48% of people in the care-as-usual conditions no longer met criteria for MDD, suggesting that the additional value of psychotherapy compared to care-as-usual would be 14%. For response and remission, comparable results were found, with less than half of the patients meeting criteria for response and remission after psychotherapy. Additionally, a considerable proportion of response and remission was also found in control conditions. In the psychotherapy conditions, scores on the BDI were reduced by 13.42 points, 15.12 points on the BDI-II, and 10.28 points on the HAM-D. In the control conditions, these reductions were 4.56, 4.68, and 5.29. DISCUSSION: Psychotherapy contributes to improvement in depressed patients, but improvement in control conditions is also considerable.
12 Review The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review. 2014
Chowdhary, N / Jotheeswaran, A T / Nadkarni, A / Hollon, S D / King, M / Jordans, M J D / Rahman, A / Verdeli, H / Araya, R / Patel, V. ·Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, and Sangath, India. · Institute of Psychiatry, King's College, London, UK, Public Health Foundation of India, and Sangath, India. · London School of Hygiene and Tropical Medicine, UK. · Vanderbilt University, Nashville, TN, USA. · Faculty of Brain Sciences, University College London Medical School, UK. · University of Liverpool, UK. · Teachers College, Columbia University and Columbia College of Physicians and Surgeons, NY, USA. · University of Bristol, UK. ·Psychol Med · Pubmed #23866176.
ABSTRACT: BACKGROUND: Cultural adaptations of evidence-based psychological treatments (PTs) are important to enhance their universal applicability. The aim of this study was to review systematically the literature on adaptations of PTs for depressive disorders for ethnic minorities in Western countries and for any population in non-Western countries to describe the process, extent and nature of the adaptations and the effectiveness of the adapted treatments. METHOD: Controlled trials were identified using database searches, key informants, previous reviews and reference lists. Data on the process and details of the adaptations were analyzed using qualitative methods and meta-analysis was used to assess treatment effectiveness. RESULTS: Twenty studies were included in this review, of which 16 were included in the meta-analysis. The process of adaptation was reported in two-thirds of the studies. Most adaptations were found in the dimensions of language, context and therapist delivering the treatment. The meta-analysis revealed a statistically significant benefit in favor of the adapted treatment [standardized mean difference (SMD) -0.72, 95% confidence interval (CI) -0.94 to -0.49]. CONCLUSIONS: Cultural adaptations of PTs follow a systematic procedure and lead primarily to adaptations in the implementation of the treatments rather than their content. Such PTs are effective in the treatment of depressive disorders in populations other than those for whom they were originally developed.
13 Review Double trouble: does co-morbid chronic somatic illness increase risk for recurrence in depression? A systematic review. 2013
Kok, Gemma D / Bockting, Claudi L H / Burger, Huibert / Hannig, Wiebke / Pijnenborg, Gerdina H M / Cuijpers, Pim / Hollon, Steven D. ·Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands. ·PLoS One · Pubmed #23472087.
ABSTRACT: OBJECTIVE: To perform a systematic review, and if possible a meta-analysis, to establish whether depressed patients with co-morbid chronic somatic illnesses are a high risk "double trouble" group for depressive recurrence. METHOD: The databases PubMed, EMbase and PsycINFO were systematically searched until the 4(th) of December 2012 by using MeSH and free text terms. Additionally, reference lists of retrieved publications and treatment guidelines were reviewed, and experts were consulted. Inclusion criteria were: depression had to be measured at least twice during the study with qualified instruments and the chronic somatic illness had to be assessed by self-report or by a medical professional. Information on depressive recurrence was extracted and additionally risk ratios of recurrence were calculated. RESULTS: The search generated four articles that fulfilled our inclusion criteria. These studies showed no differences in recurrence over one- two- three- and 6.5 years of follow-up for a total of 2010 depressed patients of which 694 patients with a co-morbid chronic somatic illness versus 1316 patients without (Study 1: RR = 0.49, 95% CI, 0.17-1.41 at one year follow-up and RR = 1.37, 95% CI, 0.78-2.41 at two year follow-up; Study 2: RR = 0.94, 95% CI, 0.65-1.36 at two year follow-up; Study 3: RR = 1.15, 95% CI, 0.40-3.27 at one year follow-up; RR = 1.07, 95% CI, 0.48-2.42 at two year follow-up and RR = 0.99, 95% CI,0.55-1.77 at 6.5 years follow-up; Study 4: RR = 1.16, 95% CI, 0.86-1.57 at three year follow-up). CONCLUSION: We found no association between a heightened risk for depressive recurrence and co-morbid chronic somatic illnesses. There is a need for more longitudinal studies to justify the current specific treatment advice such as long-term pharmacological maintenance treatment for this presumed "double trouble" group.
14 Review Cognitive and behavior therapy in the treatment and prevention of depression. 2011
Hollon, Steven D. ·Vanderbilt University, Tennessee. steven.d.hollon@Vanderbilt.Edu ·Depress Anxiety · Pubmed #21456036.
15 Clinical Trial Sudden gains in routine care cognitive behavioral therapy for depression: A replication with extensions. 2017
Wucherpfennig, Felix / Rubel, Julian A / Hollon, Steven D / Lutz, Wolfgang. ·Clinical Psychology and Psychotherapy, Department of Psychology, University of Trier, D-54296 Trier, Germany. Electronic address: wucherpfennig@uni-trier.de. · Clinical Psychology and Psychotherapy, Department of Psychology, University of Trier, D-54296 Trier, Germany. · Department of Psychology, Vanderbilt University, TN 37240 Nashville, United States. ·Behav Res Ther · Pubmed #27846418.
ABSTRACT: BACKGROUND: Over the last decade, a substantial amount of findings have been reported on the association between sudden gains (large symptom improvements in a between-session interval) and treatment outcome. Accurate replications of previous findings are needed to tackle inconsistencies and to shed light on the clinical implications of sudden gains. This study investigates whether similar effects of sudden gains can be expected under routine care conditions, when the patients are comparable to those examined in the original study by Tang and DeRubeis (1999). METHOD: Using propensity score matching (PSM), 462 patients treated with cognitive behavioral therapy (CBT) under routine conditions were matched stepwise to patients of the original study on sudden gains, a randomized controlled CBT trial (RCT). RESULTS: After the application of PSM, the effects of sudden gains on treatment outcome were similar to those found by Tang and DeRubeis (1999). The closer the match between the RCT and the naturalistic sample, the more similar the association between sudden gains and treatment outcome. CONCLUSION: Sudden gains seem to have a significant impact on recovery rates, even in treatments under routine care. Results suggest that one important aspect of replication success is to control for confounding baseline covariates.
16 Clinical Trial The clinical effectiveness of evidence-based interventions for depression: a pragmatic trial in routine practice. 2013
Peeters, Frenk / Huibers, Marcus / Roelofs, Jeffrey / van Breukelen, Gerard / Hollon, Steven D / Markowitz, John C / van Os, Jim / Arntz, Arnoud. ·Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands. f.peeters@maastrichtuniversity.nl ·J Affect Disord · Pubmed #22985486.
ABSTRACT: BACKGROUND: Controversy persists about how effectively empirically-supported treatments for major depression work in actual clinical practice as well as how patients choose among them. We examined the acute phase effectiveness of cognitive therapy (CT), interpersonal psychotherapy (IPT), and combined psychotherapy-pharmacotherapy (PHT) in a naturalistic setting, allowing patients their choice of treatment. METHODS: The study compared CT (n=63), IPT (n=56), CT-PHT (n=34), and IPT-PHT (n=21) for 174 subjects with major depression in a secondary care mood disorders clinic. Patient preference, rather than randomization, determined treatment selection. The Beck Depression Inventory-II (BDI) was the primary outcome variable. Exclusion criteria were minimal. RESULTS: All treatments were associated with a reduction in depressive symptoms, with a 35% remission rate by week 26. Overall improvement was well within ranges reported in efficacy trials. On average, treatment effects of the different interventions straddled the same range, but moderation analyses revealed that BDI scores dropped faster in the first 16 weeks in patients who received CT alone than patients who received CT and pharmacotherapy, a pattern not found in patients who received IPT (with or without pharmacotherapy). LIMITATIONS: Limitations consist of a modest sample size, choice of treatment was made by participants which may have been influenced by many sources, and the absence of a non-active control group. CONCLUSIONS: This study supports the effectiveness of empirically-supported antidepressant treatments selected by patients in routine settings, and provides an indication that speed of therapeutic response may vary amongst treatments.
17 Clinical Trial Is prior course of illness relevant to acute or longer-term outcomes in depressed out-patients? A STAR*D report. 2012
Rush, A J / Wisniewski, S R / Zisook, S / Fava, M / Sung, S C / Haley, C L / Chan, H N / Gilmer, W S / Warden, D / Nierenberg, A A / Balasubramani, G K / Gaynes, B N / Trivedi, M H / Hollon, S D. ·Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, Singapore. ·Psychol Med · Pubmed #22008447.
ABSTRACT: BACKGROUND: Major depressive disorder (MDD) is commonly chronic and/or recurrent. We aimed to determine whether a chronic and/or recurrent course of MDD is associated with acute and longer-term MDD treatment outcomes. METHOD: This cohort study recruited out-patients aged 18-75 years with non-psychotic MDD from 18 primary and 23 psychiatric care clinics across the USA. Participants were grouped as: chronic (index episode >2 years) and recurrent (n = 398); chronic non-recurrent (n=257); non-chronic recurrent (n=1614); and non-chronic non-recurrent (n = 387). Acute treatment was up to 14 weeks of citalopram (≤ 60 mg/day) with up to 12 months of follow-up treatment. The primary outcomes for this report were remission [16-item Quick Inventory of Depressive Symptomatology - Self-Rated (QIDS-SR(16)) ≤ 5] or response (≥ 50% reduction from baseline in QIDS-SR(16)) and time to first relapse [first QIDS-SR16 by Interactive Voice Response (IVR) ≥ 11]. RESULTS: Most participants (85%) had a chronic and/or recurrent course; 15% had both. Chronic index episode was associated with greater sociodemographic disadvantage. Recurrent course was associated with earlier age of onset and greater family histories of depression and substance abuse. Remission rates were lowest and slowest for those with chronic index episodes. For participants in remission entering follow-up, relapse was most likely for the chronic and recurrent group, and least likely for the non-chronic, non-recurrent group. For participants not in remission when entering follow-up, prior course was unrelated to relapse. CONCLUSIONS: Recurrent MDD is the norm for out-patients, of whom 15% also have a chronic index episode. Chronic and recurrent course of MDD may be useful in predicting acute and long-term MDD treatment outcomes.
18 Article Temporal pathways of change in two randomized controlled trials for depression and harmful drinking in Goa, India. 2020
Singla, Daisy R / Hollon, Steven D / Velleman, Richard / Weobong, Benedict / Nadkarni, Abhijit / Fairburn, Christopher G / Bhat, Bhargav / Gurav, Mahesh / Anand, Arpita / McCambridge, Jim / Dimidjian, Sona / Patel, Vikram. ·Department of Psychiatry, University of Toronto and Sinai Health System, Toronto, Canada. · Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA. · Department of Psychology, University of Bath, Bath, UK. · Sangath, Alto Porvorim, Goa, India. · Centre for Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. · Department of Social & Behavioral Sciences, School of Public Health, University of Ghana, Accra, Ghana. · Department of Psychiatry, Warneford Hospital, Oxford, UK. · Department of Health Sciences, University of York, York, UK. · Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA. · Department of Global Health & Social Medicine, Harvard Medical School, Cambridge, USA. · Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA. ·Psychol Med · Pubmed #30616698.
ABSTRACT: BACKGROUND: The current study explored the temporal pathways of change within two treatments, the Healthy Activity Program (HAP) for depression and the Counselling for Alcohol Problems (CAP) Program for harmful drinking. METHODS: The study took place in the context of two parallel randomized controlled trials in Goa, India. N = 50 random participants who met a priori criteria were selected from each treatment trial and examined for potential direct and mediational pathways. In HAP, we examined the predictive roles of therapy quality and patient-reported activation, assessing whether activation mediated the effects of therapy quality on depression (Patient Health Questionnaire-9) outcomes. In CAP, we examined the predictive roles of therapy quality and patient change- and counter-change-talk, assessing whether change- or counter-change-talk mediated the effects of therapy quality on daily alcohol consumption. RESULTS: In HAP, therapy quality (both general and treatment-specific skills) was associated with patient activation; patient activation but not therapy quality significantly predicted depression outcomes, and patient activation mediated the effects of higher general skills on subsequent clinical outcomes [a × b = -2.555, 95% confidence interval (CI) -5.811 to -0.142]. In CAP, higher treatment-specific skills, but not general skills, were directly associated with drinking outcomes, and reduced levels of counter-change talk both independently predicted, and mediated the effects of higher general skills on, reduced alcohol consumption (a × b = -24.515, 95% CI -41.190 to -11.060). Change talk did not predict alcohol consumption and was not correlated with counter-change talk. CONCLUSION: These findings suggest that therapy quality in early sessions operated through increased patient activation and reduced counter-change talk to reduce depression and harmful drinking respectively.
19 Article Distress and anhedonia as predictors of depression treatment outcome: A secondary analysis of a randomized clinical trial. 2019
Khazanov, Gabriela K / Xu, Colin / Dunn, Barnaby D / Cohen, Zachary D / DeRubeis, Robert J / Hollon, Steven D. ·Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: kattang@sas.upenn.edu. · Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: colinxu@sas.upenn.edu. · Mood Disorders Centre, University of Exeter. Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Perry Road, EX4 4QG, UK. Electronic address: B.D.Dunn@exeter.ac.uk. · Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: zcohen@sas.upenn.edu. · Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: derubeis@psych.upenn.edu. · Department of Psychology, Vanderbilt University. 2301 Vanderbilt Place, Nashville, TN, 37240, USA. Electronic address: steven.d.hollon@vanderbilt.edu. ·Behav Res Ther · Pubmed #31896529.
ABSTRACT: Two core features of depression include depressed mood (heightened distress) and anhedonia (reduced pleasure). Despite their centrality to depression, studies have not examined their contribution to treatment outcomes in a randomized clinical trial providing mainstream treatments like antidepressant medications (ADM) and cognitive therapy (CT). We used baseline distress and anhedonia derived from a factor analysis of the Mood and Anxiety Symptom Questionnaire to predict remission and recovery in 433 individuals with recurrent/chronic major depressive disorder. Patients were provided with only ADM or both ADM and CT. Overall, higher baseline distress and anhedonia predicted longer times to remission within one year and recovery within three years. When controlling for treatment condition, distress improved prediction of outcomes over and above anhedonia, while anhedonia did not improve prediction of outcomes over and above distress. Interactions with treatment condition demonstrated that individuals with higher distress and anhedonia benefited from receiving CT in addition to ADM, whereas there was no added benefit of CT for individuals with lower distress and anhedonia. Assessing distress and anhedonia prior to treatment may help select patients who will benefit most from CT in addition to ADM. For the treatments and outcome measures tested, utilizing distress to guide treatment planning may yield the greatest benefit. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00057577.
20 Article What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database. 2019
Buckman, Joshua E J / Saunders, Rob / Cohen, Zachary D / Clarke, Katherine / Ambler, Gareth / DeRubeis, Robert J / Gilbody, Simon / Hollon, Steven D / Kendrick, Tony / Watkins, Edward / White, Ian R / Lewis, Glyn / Pilling, Stephen. ·Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, London, WC1E 7HB, UK. · Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, 90095, USA. · Statistical Science, University College London, London, WC1E 7HB, UK. · School of Arts and Sciences, Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104-60185, USA. · Department of Health Sciences, University of York, York, YO10 5DD, UK. · Department of Psychology, Vanderbilt University, Nashville, TN, 407817, USA. · Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Southampton, SO16 5ST, UK. · Department of Psychology, University of Exeter, Exeter, EX4 4QG, UK. · Institute of Clinical Trials and Methodology, MRC Clinical Trials Unit, University College London, London, WC1V 6LJ, UK. · Division of Psychiatry, University College London, London, W1T 7NF, UK. ·Wellcome Open Res · Pubmed #31815189.
21 Article Effects of psychological treatment of mental health problems in pregnant women to protect their offspring: randomised controlled trial. 2019
Burger, Huibert / Verbeek, Tjitte / Aris-Meijer, Judith L / Beijers, Chantal / Mol, Ben W / Hollon, Steven D / Ormel, Johan / van Pampus, Mariëlle G / Bockting, Claudi L H. ·Associate Professor of Clinical Epidemiology, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. · Professor of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia. · Professor of Psychology, Department of Psychology, Vanderbilt University, Tennessee, USA. · Professor of Social Psychiatry and Psychiatric Epidemiology, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. · Gynaecologist, Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, The Netherlands. · Professor of Clinical Psychology, Department of Psychiatry, Amsterdam University Medical Centre; and Institute for Advanced Study, University of Amsterdam, The Netherlands. ·Br J Psychiatry · Pubmed #31806071.
ABSTRACT: BACKGROUND: Perinatal depression and anxiety are associated with unfavourable child outcomes. AIMS: To assess among women with antenatal depression or anxiety the effectiveness of prenatally initiated cognitive-behavioural therapy (CBT) on mother and child compared with care as usual (CAU). Trial registration: Netherlands Trial Register number NTR2242. METHOD: Pregnant women (n = 282) who screened positive for symptoms of depression and/or anxiety were randomised to either CBT (n = 140) or CAU (n = 142). The primary outcome was child behavioural and emotional problems at age 18 months, assessed using the Child Behavior Checklist (CBCL). Secondary outcomes were maternal symptoms during and up to 18 months after pregnancy, neonatal outcomes, mother-infant bonding and child cognitive and motor development at age 18 months. RESULTS: In total, 94 (67%) women in the CBT group and 98 (69%) in the CAU group completed the study. The mean CBCL Total Problems score was non-significantly higher in the CBT group than in the CAU group (mean difference: 1.38 (95% CI -1.82 to 4.57); t = 0.85, P = 0.399). No effects on secondary outcomes were observed except for depression and anxiety, which were higher in the CBT group than in the CAU group at mid-pregnancy. A post hoc analysis of the 98 women with anxiety disorders showed lower infant gestational age at delivery in the CBT than in the CAU group. CONCLUSIONS: Prenatally initiated CBT did not improve maternal symptoms or child outcomes among non-help-seeking women with antenatal depression or anxiety. Our findings are not in line with present recommendations for universal screening and treatment for antenatal depression or anxiety, and future work may include the relevance of baseline help-seeking.
22 Article The Roles of Early Response and Sudden Gains on Depression Outcomes: Findings From a Randomized Controlled Trial of Behavioral Activation in Goa, India. 2019
Singla, Daisy R / Hollon, Steven D / Fairburn, Christopher G / Dimidjian, Sona / Patel, Vikram. ·Department of Psychiatry, University of Toronto, and Sinai Health System, Toronto, Canada. · Department of Psychology, Vanderbilt University. · Department of Psychiatry, Warneford Hospital, University of Oxford. · Department of Psychology and Neuroscience, University of Colorado Boulder. · Sangath Center, Goa, India. · Department of Global Health and Social Medicine, Harvard Medical School. · Department of Global Health and Population, Harvard TH Chan School of Public Health. ·Clin Psychol Sci · Pubmed #31380144.
ABSTRACT: The Healthy Activity Program (HAP), a brief, lay-counselor-delivered, behavioral activation psychological treatment, was found to be effective in reducing depressive symptoms among primary care attendees in India. We now examine whether early response predicts depression (PHQ-9) outcomes at the primary endpoint of 3 months and sustained recovery at 12 months after enrollment and the extent to which this effect is influenced by sudden gains in the context of the larger randomized controlled trial. HAP participants (
23 Article Resilience and anxiety or depression among resettled Bhutanese adults in the United States. 2019
Poudel-Tandukar, Kalpana / Chandler, Genevieve E / Jacelon, Cynthia S / Gautam, Bhuwan / Bertone-Johnson, Elizabeth R / Hollon, Steven D. ·1 College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA. · 2 Bhutanese Society of Western Massachusetts, Springfield, MA, USA. · 3 School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA. · 4 Department of Psychology, Vanderbilt University, Nashville, TN, USA. ·Int J Soc Psychiatry · Pubmed #31288604.
ABSTRACT: BACKGROUND: Resilience, or an individual's positive response in managing life's adversities, is of increasing interest in addressing the mental health disparities in refugees. Although the link between stressful life events and poor mental health is established, research on the role of resilience on the mental health of refugees is limited. AIMS: This study assessed the association between resilience and anxiety or depression in resettled Bhutanese adults in Western Massachusetts. METHODS: A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20-65 residing in Massachusetts. Resilience was measured with the 25-item Wagnild and Young's Resilience Scale including two constructs as follows: a 17-item 'personal competence' that measures self-reliance, independence, determination, resourcefulness, mastery and perseverance and an 8-item 'acceptance of self and life' that measures adaptability, flexibility and a balanced perspective of life. Higher total scores indicate greater resilience. The Hopkins Symptom Checklist-25 was used to measure anxiety (10-item) and depression (15-item) with a cutoff mean score of ⩾1.75 for moderate to severe symptoms. Associations of resilience with anxiety or depression scores were assessed using multiple-linear and logistic regression analyses. RESULTS: The proportion of participants with above threshold anxiety and depression were 34.2% and 24%, respectively. Resilience was inversely associated with both anxiety (beta for 1 unit change in resilience scores: β = -0.026; CONCLUSION: Higher resilience was associated with reduced anxiety and depression among Bhutanese with personal competence resilience accounting for most of the effects. These findings suggest the potential targets for mental-health intervention to improve resilience in refugees.
24 Article The symptom-specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta-analysis. 2019
Boschloo, Lynn / Bekhuis, Ella / Weitz, Erica S / Reijnders, Mirjam / DeRubeis, Robert J / Dimidjian, Sona / Dunner, David L / Dunlop, Boadie W / Hegerl, Ulrich / Hollon, Steven D / Jarrett, Robin B / Kennedy, Sidney H / Miranda, Jeanne / Mohr, David C / Simons, Anne D / Parker, Gordon / Petrak, Frank / Herpertz, Stephan / Quilty, Lena C / John Rush, A / Segal, Zindel V / Vittengl, Jeffrey R / Schoevers, Robert A / Cuijpers, Pim. ·Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. · Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA. · Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA. · Center for Anxiety and Depression, Mercer Island, Washington, WA, USA. · Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA. · Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Psychiatry, University of Toronto, Toronto, ON, Canada. · Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. · Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. · Department of Psychology, University of Notre Dame, Notre Dame, IN, USA. · School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr University Bochum, Bochum, Germany. · Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. · Duke-National University of Singapore Graduate Medical School, Singapore. · Department of Psychiatry, Duke Medical School, Durham, NC, USA. · Texas Tech University Health Sciences Center, Permian Basin, TX, USA. · Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada. · Department of Psychology, Truman State University, Kirksville, MO, USA. ·World Psychiatry · Pubmed #31059603.
ABSTRACT: A recent individual patient data meta-analysis showed that antidepressant medication is slightly more efficacious than cognitive behavioral therapy (CBT) in reducing overall depression severity in patients with a DSM-defined depressive disorder. We used an update of that dataset, based on seventeen randomized clinical trials, to examine the comparative efficacy of antidepressant medication vs. CBT in more detail by focusing on individual depressive symptoms as assessed with the 17-item Hamilton Rating Scale for Depression. Five symptoms (i.e., "depressed mood" , "feelings of guilt" , "suicidal thoughts" , "psychic anxiety" and "general somatic symptoms") showed larger improvements in the medication compared to the CBT condition (effect sizes ranging from .13 to .16), whereas no differences were found for the twelve other symptoms. In addition, network estimation techniques revealed that all effects, except that on "depressed mood" , were direct and could not be explained by any of the other direct or indirect treatment effects. Exploratory analyses showed that information about the symptom-specific efficacy could help in identifying those patients who, based on their pre-treatment symptomatology, are likely to benefit more from antidepressant medication than from CBT (effect size of .30) versus those for whom both treatments are likely to be equally efficacious. Overall, our symptom-oriented approach results in a more thorough evaluation of the efficacy of antidepressant medication over CBT and shows potential in "precision psychiatry" .
25 Article Preventive cognitive therapy versus care as usual in cognitive behavioral therapy responders: A randomized controlled trial. 2019
de Jonge, Margo / Bockting, Claudi L H / Kikkert, Martijn J / van Dijk, Maarten K / van Schaik, Digna J F / Peen, Jaap / Hollon, Steven D / Dekker, Jack J M. ·Department of Research, Arkin. · Department of Psychiatry, Amsterdam Universitair Medische Centra. · Dimence Mental Health Care Centre. · Department of Research and Innovation, GGZ inGeest. · Department of Psychology, Vanderbilt University. ·J Consult Clin Psychol · Pubmed #31008635.
ABSTRACT: OBJECTIVE: The optimization of long-term outcomes is an important goal in the treatment of major depressive disorder. Offering subsequent preventive cognitive therapy (PCT) to patients who responded to acute cognitive behavioral therapy (CBT) may reduce the risk of relapse/recurrence. METHOD: Therefore, a multicenter randomized controlled trial was conducted comparing the addition of eight weekly sessions of PCT to care as usual (CAU) versus CAU alone in patients with a history of depression in remission following treatment with CBT. A total of 214 recurrently depressed patients who remitted following treatment with CBT were randomized to PCT (n = 107) or CAU (n = 107). Primary outcome was time to relapse/recurrence over 15 months and was assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Secondary outcomes were depressive symptoms measured by the Inventory of Depressive Symptomatology-Self Report and number and severity of relapses/recurrences measured by the SCID-I. RESULTS: Over the 15-month follow-up, the addition of PCT significantly delayed time to relapse/recurrence relative to CAU alone, hazard ratio = 1.807 (number needed to treat = 8.1), p = .02, 95% CI [1.029, 3.174]. No significant differences were found between the conditions on number or severity of relapses/recurrences and residual symptoms. CONCLUSION: Adding PCT was significantly more effective than CAU alone in delaying time to relapse/recurrence of depression over a period of 15 months among CBT responders. After response on CBT, therapists should consider providing PCT to recurrently depressed patients. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Drug Class: What is Tazarotene Gel and why is it prescribed?
Drug Mechanism: How does Tazarotene Gel work?
Dosage: How should you take Tazarotene Gel?
Treating psoriasis and acne. It may also be used for other conditions as determined by your doctor. Tazarotene Gel is a retinoid. The specific way Tazarotene Gel works is not completely understood. It may decrease skin inflammation and skin changes associated with psoriasis.
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text:
Joseph Kolkmann (* 4. April 1839 in Verl/Westfalen; † 8. Dezember 1880 in Berlin) war ein deutscher Rechtswissenschaftler.

Leben
Wilhelm Joseph Konrad Kolkmann war der älteste Sohn des Landwirts und Gutsbesitzers Christoph Kolkmann und seiner Frau Carolina, geb. van Dyk. Sein Vater war Mitbegründer und Vorsitzender des demokratischen Vereins in Verl während der Revolution 1848/49. Joseph Kolkmann besuchte Schulen in Rietberg, Münster und Warendorf.

Im Wintersemester 1861/62 begann er ein Jurastudium an der Universität Göttingen und wurde Mitglied der Burschenschaft Brunsviga. Anschließend studierte er in Bonn und Berlin, wo er das Juristische Staatsexamen ablegte. 1867 wurde er beim Appellationsgericht Paderborn zum Referendar ernannt, stieg zum Gerichtsassessor auf und promovierte nebenbei 1870 in Göttingen. Im November 1871 erhielt er die Berufung zum Kreisrichter in Löbau in Westpreußen. In diesem Amt blieb er bis zu seiner Entlassung aus dem Staatsdienst im Jahre 1877.

Noch vor der Gründung eigener Gemeinden war Kolkmann in Paderborn als Anhänger des Altkatholizismus aufgetreten, was seine Heirat im Juni 1871 mit Emma Franzisca, geb. Emmerich erschwerte, da ihnen eine kirchliche Trauung verweigert wurde. Erst nach öffentlichem Protest wurde dem Paar schließlich das Trauzeugnis ausgehändigt.

Von 1868 bis 1876, inmitten des Kulturkampfes, war Kolkmann als Verfasser von Streitschriften und Zeitungsartikeln gegen die romtreuen Ultramontanisten, gegen Mönchsorden, sowie gegen die Infallibilität (Unfehlbarkeit) des Papstes mit der katholischen Kirche in Konflikt geraten. Auf ihn geht die während des Deutsch-Französischen Kriegs geäußerte Parole "Erst die Franzosen, dann die Jesuiten!" zurück. Insbesondere aber ist sein Name mit der Rebbert-Kolkmann-Kontroverse verknüpft, in der er sich gegen die judenfeindlichen Schriften des Priesters Joseph Rebbert und des Paderborner Bischofs Konrad Martin positionierte:

Der Historiker Olaf Blaschke zählt Kolkmanns Buch von 1876 und mit Bezug auf das Deutsche Kaiserreich unter "das magere halbe dutzend katholischer Schriften, das sich mit den Juden solidarisierte und die Absurdität des Antisemitismus aufdeckte." Unter dem Pseudonym Nicolaus Planenberg veröffentlichte er bei seinem Verleger Richard Skrzeczek in Löbau auch justizkritische, polemische Schriften. Skrzeczek, bei dem Kolkmann wohnte, wurde daraufhin mit Zeugnishaft belegt, um die wahre Autorschaft herauszufinden. Dies führte letztlich 1878 zur Entlassung Kolkmanns aus dem preußischen Staatsdienst.

Auch das Pseudonym "J. Perinhart" lässt sich Kolkmann zuordnen. Als Verfasser der Schrift "Die deutschen Juden und Wilhelm Marr", 1879 ebenfalls bei Skrzeczek in Löbau erschienen, vermutete die Redaktion der "Israelitischen Wochenschrift" den Kreisrichter Kolkmann, "den Verfasser der trefflichen Broschüre: Die gesellschaftliche Stellung der Juden.". Perinharts, mutmaßlich Kolkmanns Streitschrift, war wider Wilhelm Marrs Rassenantisemitismus gerichtet.

Nach seiner Entlassung strebte Kolkmann, obwohl bereits erkrankt, seine Zulassung als Rechtsanwalt an. Er starb am 8. Dezember 1880 im Kaiserin-Augusta-Hospital in Berlin. Seine Witwe ist noch 1888 in Warendorf als Inhaberin eines Tapisseriegeschäftes nachweisbar, ebenso die Töchter Charlotte, geboren 1873 und Käthe, geboren 1875.

Werke
 Die Diöcesan-Synode vom 8., 9. und 10. October 1867: zur Beleuchtung des Kirchenregimentes in der Diöcese Paderborn unter dem Bischofe Dr. Conrad Martin, E. C. Brunn's Verlag, Münster 1866 (Digitalisierte Ausgabe)
 Das christliche Begräbniß. Ein Beitrag zur Reform des Begräbnißwesens, den Vertretern des Deutschen Volkes gewidmet, Ferdinand Beyer, Königsberg 1874
 Die gesellschaftliche Stellung der Juden, R. Skrzeczek, Löbau 1876 (3. Auflage, Verlag der Buchdruckerei der Volks-Zeitung, Berlin 1881, mit einem Vorwort von Adolph Phillips; Neudruck der Erstauflage durch die Union der Österreichischen Juden, Wien 1932, mit einer Vorbemerkung von Chajim Bloch) (Digitalisierte Ausgabe)
 Die königlich-preußische Staatsanwaltschaft und die freie Rede, Löbau, o. J. (1876) ()
 Das Recht der deutschen Schenke und die Schanknovelle, R. Skrzeczek, Löbau 1878
 Die Charakterlosigkeit in Deutschland, R. Skrzeczek, Löbau 1878
 Weg mit dem preußischen Schulzwange!, R. Skrzeczek, Löbau 1880

Unter dem Pseudonym "Nicolaus Planenberg":

 Der Preußische Richter von seiner Schattenseite gezeichnet, R. Skrzeczek, Löbau 1877 (bis 1878 vier Auflagen, Digitalisierte Ausgabe)
 Die Majestätsbeleidigungen und die preußische Justiz, R. Skrzeczek, Löbau 1878
 Die Zivilgerichtsreform und die Beschränkung des Anwaltszwanges, R. Skrzeczek, Berlin 1907 (posthum unter dem Namen "Nicolaus Planenberg Redivivus" herausgegeben)

Unter dem Pseudonym "J. Perinhart" (zugeschrieben):

 Die deutschen Juden und Herr W. Marr, Druck und Verlag von Richard Skrzeczek, Löbau 1879 (Digitalisierte Ausgabe)

Weblinks

 Hajo van Freeden: Dr. Joseph Kolkmann, Richter am Kreisgericht in Löbau, ein kritischer, mutiger Humanist

Einzelnachweise

Rechtswissenschaftler (19. Jahrhundert)
Burschenschafter (19. Jahrhundert)
Person (Verl)
Deutscher
Geboren 1839
Gestorben 1880
Mann

redpajama_set_name: RedPajamaWikipedia


text:
Psychopsis meyricki is een insect uit de familie van de Psychopsidae, die tot de orde netvleugeligen (Neuroptera) behoort.

Psychopsis meyricki is voor het eerst wetenschappelijk beschreven door McLachlan in 1887.

Psychopsidae


text:
homeaboutcontactmouthfullifestyle - ishtravelrelationshipsshake my headdaytrippingMOST RECENT
As an author and humorist, Reid Champagne is known for his absurd & sophomoric observations of everyday life. While the story of how Reid met wife Carol (after being widowed late in life) is so sweet it belongs on Hallmark, his family would argue his inept & smart-ass tendencies belong on a 2020 reboot of Grumpier Old Men.
Talking Head
They may seem like innocent baby blues, but they can see through concrete
I recently got a new eyeglass prescription. Two things had happened to my eyeballs. All of a sudden, I needed reading glasses, first for ingredient labels and the small print on prescription bottles, and then for reading regular text. The second thing was that I could see farther better without my previous near-sighted correction than with it. Thinking this trend might be leading to x-ray vision, I put off a visit to the optometrist for awhile. When I finally made the appointment, the doctor casually told me that it was normal for vision to flip from near-sighted to far-sighted, "especially as we age." My dream of x-ray vision in time for the summer beach season was dashed upon an horizon I could now see more clearly, even without glasses.
It could be I'm thinking how big a Hershey bar was when I was a kid…
I bring up the subject of eyes, only because over the last year, I've come to "see" that Carol doesn't have eyes so much as a pair of extremely efficient and profoundly panoramic surveillance cameras. She misses nothing, from indiscreet scratchings, to inept uses of utensils or tools, inadvertent and minor trips, stumbles or wobbles, socks with tiny holes, shirts with even tinier stains and inside out skivvies. Those baby blues capture it all with prosecutorial precision.
….and here at happy hour suddenly remembering how big a Hershey bar was when I was a kid
In other avenues of our life together, if Carol is not the first person to see me lost in thought, but with my lips moving, she's the first to call me out on it, and inquire who it is I'm interlocuting with, and in such a stentorian manner. This I find to be the threshold of my inner dimensional world that I had hoped to conceal from prying eyes, but apparently not from prying eyes equipped with miltary strength night vision lenses. (If it turns out she's the one with x-ray vision, my goose is totally cooked.)
Most times I can escape discovery by telling Carol that it's nothing, really. I can get away with it when she's caught me staring blankly into space. But when it's clear I'm having it out with some figment of my imagination, she tends to want to be part of the conversation. The thing is, most of the time it's silly stuff bordering on the infantile (and once in a while sneaking over that border). Depending on the season, I might be coaching Drew Brees on a critical interception the previous week, or criticizing Javey Baez for striking out with the bases loaded the previous season. Or maybe just counseling Homer Simpson to go easier on himself. (Although, really, I think that's just me talking to me.)
The only time my mind does not wander aimlessly: waiting for a train
But it's the times that I'm confronting my nemeses from politics and my personal life that I am most loathe to divulge. It's simply my way of blowing off steam and venting without the stigma of having to take it back, apologize, experience remorse or have to defend myself against a disturbing the peace charge. There hasn't been an instance, where, following one of these internal outbursts of righteous indignation or "airing of grievances," even when it's not Festivus that I'm riddled with guilt and humiliation for having actually risked such an exchange in real life. It's a gift, as far as I'm concerned. I don't have to apologize profusely to anyone or perform community service.
But I don't like to admit to having those confrontations, even in my make-believe world. "I'm just telling Homer to encourage Lisa's individuality and show more tough love to Bart," I will tell Carol, which she doesn't believe for a minute, because she's no doubt already reviewed the surveillance tape of my subconscious, which her eyes can evidently penetrate as well.
« A happy New Year
Time Lord »

redpajama_set_name: RedPajamaCommonCrawl


text:
Ana Sayfa Alaturka Saudi Crown Prince has gone 'full gangster': US Senator
Saudi Crown Prince has gone 'full gangster': US Senator
By Umar Farooq

WASHINGTON (AA) – U.S. Senator Marco Rubio ripped Saudi Crown Prince Mohammed bin Salman on Wednesday, saying he has gone "full gangster" and is making the U.S.-Saudi relationship "increasingly untenable".

"He has a pension for escalation, for taking high risks, confrontational on his foreign policy approach, and I think increasingly willing to test the limits on what he can get away with," Rubio said.

He further called bin Salman "reckless" and "ruthless", with his actions over the past two years being reminiscent of a James Bond film.

Rubio was speaking during a Senate confirmation hearing for President Donald Trump's nominee for U.S. ambassador to Saudi Arabia, retired Army Gen. John Abizaid.

The hearing was used by senators to air grievances they had towards the Trump administration's approach to the U.S. relationship with Saudi Arabia, and more specifically with the crown prince.

"I have been disappointed with the administration's public posture towards Saudi Arabia," said Senator Bob Menendez. "Our leaders cannot credibly call on the world stage and demand accountability for human rights abuses while giving a wink and a nod to the crown prince."

Saudi Arabia is "also our most difficult partner right now, because it almost asks us to agree to stay silent on grotesque violations of human rights, both domestically and abroad," Rubio added. "And their crown prince is not making things easier. He is increasingly making it untenable."

The position of U.S. ambassador to Saudi Arabia has remained vacant since Trump took office. In November, the president had announced that he would be nominating Abizaid for the position after the death of Saudi journalist Jamal Khashoggi.

Khashoggi was brutally murdered inside the Saudi Consulate in Istanbul last October shortly after he entered the diplomatic facility. Riyadh initially denied any role in the killing but has since sought to blame his death on a botched rendition operation carried out by rogue agents.

In November, the CIA concluded with high confidence that bin Salman ordered Khashoggi's killing, according to The Washington Post.

Trump and his administration, however, have shied away from placing any blame on the crown prince.

Abizaid stressed that the U.S.-Saudi relationship is much bigger than Washington's relationship with bin Salman and said he wants to help the Kingdom move forward.

After graduating from the United States Military Academy, Abizaid went on to serve as a four-star general who oversaw U.S. Central Command, which conducted military operations in the Middle East.
Bob Menendez
John Abizaid
Senatör Marco Rubio
Önceki haber"ABD'nin bombaları insani yardımınından önce Yemen'e ulaşıyor"
Sonraki haberUK police link London, Glasgow IED probes


Rashtriya Swayamsevak Sangh (RSS) worker Sandeep Sharma was shot dead by two bike-borne miscreants on Tuesday late night. The body was brought to the district hospital for post-mortem. While the police have begun investigating the case, no arrests have been made so far. A resident of Nikau village here, Sandeep was the district environment chief of the RSS.


on April 14th, 2015 April 16th, 2015 .
London, 15th April 2015 – Teknometry, the on-demand performance analysis software provider for investment managers, today announces the launch of TekGAM, a multi-currency composite solution that simplifies the challenges of GIPS compliance.
GIPS (Global Investment Performance Standards) are universal, voluntary standards used by investment managers for quantifying and presenting investment performance. A type of 'investment passport' that involves a monthly reporting cycle, GIPS creates a level playing field for all firms, promotes comparability and gives current and potential clients more confidence in the integrity of the performance presentations.
TekGAM has been designed as a standalone GIPS solution with the facility to import calculated performance data. It can, however, also be integrated with Teknometry's TekPAR system to provide a complete solution for the performance function. A cloud-based system, TekGAM is inexpensive, easy to use and clearly shows all of an investment manager's GIPS information, data omissions and task priorities.
The launch of TekGAM follows the arrival in 2014 of Anthony Howland, the co-founder of GIPS software specialist Performa Consultants. Howland is now a shareholder and director at Teknometry and has been key to the development of the new functionality.
"GIPS compliance is usually a bolt-on to a standard performance measurement platform. This means that the user interface is not set up for the GIPS practitioner, so it takes longer to find and interact with the relevant composites data. A standalone system will make life much easier for a GIPS specialist," says Steve Young, CEO of Citisoft PLC, the global investment management consulting firm. "The commercial model of 'unlimited users, unlimited locations' should also bring some much needed disruption to the sector," adds Young.


Played by millions around the world, the most acclaimed Tower Defense saga is back!
The time has come! The first day of Vez'nan's reign will be November 22!
Armies are rallying, sword are being sharpened, orcs are pillaging, reinforcements are getting ready to reinforce because...well that's what they do!
Get ready cause the horns of battle are almost upon us! This time no one will stop our dark army… muahaha.
Hold on to your seat and feast your eyes with this epic trailer!
Also check out the Dark Lord's website for all the information about the game and to download some awesome wallpapers that will make your desktop cry in joy!
And don't forget to pre-order the game on the App Store and on Google Play!


Pool Table Room Gorgeous A Few Decor Ideas And Suggestions For Your Billiards As Well 18 | Olivierblondel.com pool table room decorating ideas. basement pool table room ideas. pool table room size calculator.


text:
Q: Where should I place application specific directives with ngBoilerplate? With ngBoilerplate, where should I place and how should I structure my application wide filters, services and directives?
src/app
The app directory seems to be arranged around routing.

Apart from app.js and its accompanying tests (discussed below), this directory is filled with subdirectories corresponding to high-level sections of the application, often corresponding to top-level routes.

This is not the case, these do not correspond to a high-level section of the application, let alone to routes.

src/common
There is also a common directory however. The README.md states:

The src/common/ directory houses internal and third-party re-usable
  components. Essentially, this folder is for everything that isn't completely specific to this application.
Every component contained here should be drag-and-drop reusable in any other project; they should depend on no other components that aren't similarly drag-and-drop reusable.

Which doesn't seem to apply in my case, as these items are specific to this application and wouldn't work in other apps.
(Edited to address the src/common folder)

A: If its application wide, you would put filters, services, and directives in the common folder.

redpajama_set_name: RedPajamaStackExchange


text:
Die Vedelspangbüchse (dän.: Vedelspangbøssen) ist die älteste erhaltene Handfeuerwaffe Dänemarks.

Die Waffe, hergestellt um das Jahr 1400, wurde 1859 bei Ausgrabungen in der 1426 zerstörten Burg Wedelspang (dän. Vedelspang) nahe Selk im damals dänischen Südschleswig aufgefunden und am 15. März 1860 dem Königlichen Zeughaus in Kopenhagen übergeben.

Die Büchse ist ein schmiedeeisernes Handrohr mit einem Haken. Zum Abfeuern wurde sie über eine Mauerbrüstung gelegt, wobei sich der Haken an der Außenseite der Mauer befand und so den Rückstoß abfing. Die Konstruktion zeigt, dass die Waffe vornehmlich zur Verteidigung von Befestigungsanlagen gedacht war.

Das Kaliber der Vedelspangbüchse beträgt etwa 18 mm unmittelbar an der Kammer und 28 mm an der Mündung. Der Lauf ist ca. 270 mm lang, die Gesamtlänge der Büchse beträgt 810 mm und ihr Gewicht 2,44 kg. Sie wurde mittels einer Lunte gezündet und hatte eine geschätzte Reichweite von 75 Metern.

Die Vedelspangbüchse befindet sich heute im Königlich Dänischen Zeughausmuseum und ist die älteste Handfeuerwaffe des Museums.

Weblinks
 Königliches Zeughausmuseum

Gedruckte Quellen
 Tøjhusmuseet - Billedkatalog for den permanente udstilling = The Royal Danish Arsenal Museum. Tøjhusmuseet, Kopenhagen 1979.

Handfeuerwaffe
Archäologischer Fund (Dänemark)


Published 04/24/2019 04:44:14 pm at 04/24/2019 04:44:14 pm in Green Quartz Stone.
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Bryan Pankoff joined our firm as an articled student in May 2016 and was called to the BC Bar on May 15, 2017. The remaining biography for Bryan will be added shortly.
Bryan's preferred area of practice is Family Law and Criminal Law.


text:
Data Sharing Support
Other Article Types
PLOS Pathogens publishes Open Access research and commentary that significantly advance the understanding of pathogens and how they interact with host organisms.
Opinion Opinion articles provide a forum for expression of views, and responses to previous statements, on a range of topical, emerging and controversial issues.
See all article types »
Individuals cannot rely on COVID-19 herd immunity: Durable immunity to viral disease is limited to viruses with obligate viremic spread
Jonathan W. Yewdell
* E-mail: jyewdell@nih.gov
Affiliation Cellular Biology Section, Laboratory of Viral Diseases, NIAID, Bethesda, Maryland, United States of America
https://doi.org/10.1371/journal.ppat.1009509
Citation: Yewdell JW (2021) Individuals cannot rely on COVID-19 herd immunity: Durable immunity to viral disease is limited to viruses with obligate viremic spread. PLoS Pathog 17(4): e1009509. https://doi.org/10.1371/journal.ppat.1009509
Editor: Thomas E. Morrison, University of Colorado Denver, UNITED STATES
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Funding: JWY is supported by direct funding from the National Institute of Allergy and Infectious Diseases Division of Intramural Research (https://www.niaid.nih.gov/about/dir). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
It is often messaged that herd immunity to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2 (CoV-2)), the causative agent of Coronavirus Disease 2019 (COVID-19), will protect nonvaccinated individuals from infection. Herd immunity refers to the concept that when a sufficient fraction of individuals in a population develop immunity from infection or vaccination, viral transmission is reduced to a near negligible level. However, seasonal CoVs, which cause approximately 20% of common colds, remain endemic, even though demonstrating only limited antigenic evolution in epitopes targeted by neutralizing antibodies [1,2]. Although there are only 4 circulating seasonal CoVs, infections frequently recur, even yearly, likely related to waning antibody levels [3]. Human challenge studies established that seasonal CoV reinfection with the identical strain can occur within a year after initial exposure, though typically with reduced shedding and milder symptoms [4]. Reinfection also appears to occur following mild COVID-19 cases, where the serum neutralizing antibody half-life is only approximately 5 weeks [5].
If immunity to SARS-CoV-2 and seasonal CoVs are similar, COVID-19 herd immunity is a pipe dream, even more so given the relatively rapid selection of mutants with amino acid substitutions in the spike protein that reduce the efficiency of serum antibody neutralization [6]. Absent effective herd immunity, over the next few years, individuals can choose whether their first exposure to SARS-CoV-2 immunogens occurs via vaccination or infection. With the age-related increase in COVID 19 severity, it is critical that individuals be vaccinated sooner rather than later.
Coronaviruses are hardly unique in their ability to reinfect humans. Infection with none of the common endemic human respiratory viruses consistently induces durable immunity (Table 1). Although influenza A and B viruses are notorious in this regard, they are, in a sense, less adept than the other respiratory viruses, which reinfect individuals without resorting to significant antigenic variation. Similarly, many viruses that infect the gastrointestinal (GI) tract can infect vaccinated or previously infected individuals, most likely due to waning immunity (Table 1). Unlike respiratory viruses, however, several GI viruses are well controlled by infection or vaccination, including poliovirus, now on the brink of vaccine-induced extinction.
Table 1. Characteristics of infection and immunity for human viruses.
https://doi.org/10.1371/journal.ppat.1009509.t001
Poliovirus vaccination provides insight into the nature of protective antiviral immunity. Intramuscular immunization with inactivated virus prevents paralytic disease but not GI infection, with repeat vaccination necessary to reduce shedding of infectious virus. Similarly, even natural respiratory infections with measles or variola (smallpox) viruses, famous for inducing life-long immunity to disease, do not prevent respiratory reinfection, which though asymptomatic and nontransmissible, can be detected by increased antiviral antibody titers [7,8].
What polio-, variola, and measles virus share is dissemination from the initial infection site via lymph and (secondarily) blood as an obligate step in pathogenesis or transmission. Virus-programmed interorgan dissemination occurs in stages over days, as the virus productively infects one organ and proceeds to the next via lymph and blood [9]. Table 1 [10] summarizes the protection conferred by natural infection/vaccination for 20 common human viral pathogens. Blood/lymph-based dissemination or tropism is clearly implicated as the critical vulnerability of viruses to infection/vaccination-induced immunity.
By contrast, immune memory routinely fails to control viral reinfections on mucosae. At first glance, this might be surprising, as 90% of synthesized antibodies (the vast majority being immunoglobulin A (IgA)) are delivered to mucosae. Yet selective IgA deficiency, the most common inherited immune deficiency in Caucasians, has modest effects on susceptibility to mucosal viruses [11]. This suggests that evolution may have focused antiviral immunity on preventing virus dissemination via body fluids rather than blocking mucosal infection.
Antiviral antibodies are present at relatively high concentrations in blood and lymph, where they can function directly by neutralizing viral infectivity and indirectly via Fc-mediated viral clearance by phagocytic cells and natural killer (NK) cell killing. Phagocytic clearance is particularly effective in the lymph nodes, which evolved in part to eradicate particulate pathogens. Critically, limiting virus dissemination in body fluids blocks virus pathogenicity in end-organs and prevents end-organ participation in viral transmission.
While vaccines are unlikely to provide long-lasting sterilizing immunity to CoV-2, they should durably reduce viral replication in the upper airway and prevent, or at least attenuate, pulmonary disease and virus transmission. Further, vaccines should be highly effective at preventing pathogenicity resulting from viremia, which includes intestinal and renal dysfunction, systemic hypercoagulation, and endothelial inflammation. Although the degree to which the Moderna and BioNTech mRNA vaccines owe their remarkable protectiveness is due to humoral versus cellular immunity remains to be determined, the extremely robust antibody response they elicit is consistent with a major role for neutralizing antibodies in disease protection [12,13].
Why does the immune system have difficulty controlling mucosal viral infections? In part, this may be due to the wiliness of viruses, whose survival requires staying one step ahead of host immunity. As the skin provides an extremely effective physical barrier to viruses, typically only breached by insect bites, mucosae are the primary site of viral transmission. Mucosae are replete with immune tissues that possess the bulk of antibody-secreting B cells. Most mucosal antibodies function to control the commensal cellular microbiome, which requires constant shepherding lest it overwhelm the host. Enteric viruses can bind to bacteria to enhance attachment and infection of epithelial cells [14,15]. Could this also shield them from antibodies?
Several other possible factors contribute to the limited human mucosal immunity to virus reinfection. First, until approximately 10,000 years ago, humans evolved in isolated small populations, and viral infections were likely mostly limited to viruses capable of vertical transmission (herpesviruses, papillomaviruses) and arboviruses (i.e., transmitted to the blood by insects). Under these conditions, there may have been little selection pressure to deal with horizontally transmitted viruses that infect mucosae. Comparing mucosal immunity between vertebrates that evolved in small versus large population clusters may reveal immune mechanisms that more effectively control mucosal infections, leading to insights for improved vaccination and treatment.
Second, the immune system may have evolved to permit viral mucosal infections. If mucosal infection was a significant threat to host reproduction, wouldn't innate antiviral mechanisms (e.g., type I interferon (IFN)-stimulated genes) be employed constitutively in mucosae rather than conditionally? Although antiviral cytokines exert potent effects on the nervous system that would impact evolutionary fitness if present chronically (fever, malaise, etc.), it seems likely that evolution could have crafted a solution to localize innate antiviral effects. Could virus-mediated horizontal gene transfer provide sufficient evolutionary advantages to temper antiviral immunity [16]? Could limited, but repeated, mucosal infections play a role in maintaining basal immunity to more serious pathogens, as described for chronic herpesvirus infections [17]?
With better understanding of immunity, it may be possible to develop vaccines that provide far more robust immunity than natural infections and overcome mucosal immunity's limitations. An example is the effectiveness of the Salmonella typhi Vi capsular polysaccharide vaccine, which targets a bacterial component nonimmunogenic in natural infections. Indeed, it is possible that mRNA immunization provides more durable protection than SARS-CoV-2 infection, given that vaccination induces higher antibody titers than infection [18]. The cost of developing effective vaccines to the many present (and future) mucosal viruses that plague humanity is a pittance relative to the havoc caused by our ignorance. COVID 19, as terrible as it has been, should be a wake-up call: Far more dangerous viruses lurk in nature.
Brian Kelsall (NIAID) generously provided insightful suggestions on mucosal immunity.
1. Kistler KE, Bedford T. Evidence for adaptive evolution in the receptor-binding domain of seasonal coronaviruses OC43 and 229E. Elife. 2021;10. Epub 2021/01/20. pmid:33463525.
2. Starr TN, Greaney AJ, Addetia A, Hannon WW, Choudhary MC, Dingens AS, et al. Prospective mapping of viral mutations that escape antibodies used to treat COVID-19. Science. 2021;371(6531):850–4. Epub 2021/01/27. pmid:33495308.
3. Macnaughton MR. Occurrence and frequency of coronavirus infections in humans as determined by enzyme-linked immunosorbent assay. Infect Immun. 1982;38(2):419–23. Epub 1982/11/01. pmid:6292101; PubMed Central PMCID: PMC347755.
4. Callow KA, Parry HF, Sergeant M, Tyrrell DA. The time course of the immune response to experimental coronavirus infection of man. Epidemiol Infect. 1990;105(2):435–46. Epub 1990/10/01. pmid:2170159; PubMed Central PMCID: PMC2271881.
5. Ibarrondo FJ, Fulcher JA, Goodman-Meza D, Elliott J, Hofmann C, Hausner MA, et al. Rapid Decay of Anti-SARS-CoV-2 Antibodies in Persons with Mild Covid-19. N Engl J Med. 2020;383(11):1085–7. Epub 2020/07/21. pmid:32706954.
6. Chen RE, Zhang X, Case JB, Winkler ES, Liu Y, VanBlargan LA, et al. Resistance of SARS-CoV-2 variants to neutralization by monoclonal and serum-derived polyclonal antibodies. Nat Med. 2021. Epub 2021/03/06. pmid:33664494.
7. Panum PL, Petersen JJ. Observations made during the epidemic of measles on the Faroe Islands in the year 1846: Delta Omega Society New York; 1940.
8. Fenner FHD, Arita I, Jezek Z, Ladnyi I. Smallpox and Its Eradicaiton. World Health Organization, Geneva. 1988:1460.
9. Nash AA, Dalziel RG, Fitzgerald JR. Mims' pathogenesis of infectious disease: Academic Press; 2015.
10. Plotkin SA. Vaccination against the major infectious diseases. C R Acad Sci III. 1999;322(11):943–51. Epub 2000/01/26. [pii]. pmid:10646088.
11. Yazdani R, Azizi G, Abolhassani H, Aghamohammadi A. Selective IgA Deficiency: Epidemiology, Pathogenesis, Clinical Phenotype, Diagnosis, Prognosis and Management. Scand J Immunol. 2017;85(1):3–12. pmid:27763681
12. Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020;383(27):2603–15. Epub 2020/12/11. pmid:33301246; PubMed Central PMCID: PMC7745181.
13. Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med. 2020. Epub 2020/12/31. pmid:33378609.
14. Erickson AK, Jesudhasan PR, Mayer MJ, Narbad A, Winter SE, Pfeiffer JK. Bacteria facilitate enteric virus co-infection of mammalian cells and promote genetic recombination. Cell Host Microbe. 2018;23(1):77–88. e5. pmid:29290575
15. Neu U, Mainou BA. Virus interactions with bacteria: Partners in the infectious dance. PLoS Pathog. 2020;16(2):e1008234. pmid:32045465
16. Roossinck MJ. The good viruses: viral mutualistic symbioses. Nat Rev Microbiol. 2011;9(2):99–108. pmid:21200397
17. Barton ES, White DW, Cathelyn JS, Brett-McClellan KA, Engle M, Diamond MS, et al. Herpesvirus latency confers symbiotic protection from bacterial infection. Nature. 2007;447(7142):326–9. Epub 2007/05/18. pmid:17507983.
18. Sahin U, Muik A, Derhovanessian E, Vogler I, Kranz LM, Vormehr M, et al. COVID-19 vaccine BNT162b1 elicits human antibody and TH1 T cell responses. Nature. 2020;586(7830):594–9. pmid:32998157
Viral vaccines
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Is the Subject Area "Antibodies" applicable to this article?
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Hepatitis A virus
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Hepatitis B virus
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Infectious disease immunology
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Smallpox virus
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text:
Filmfare ist mit einer Auflage von 140.000 Exemplaren Indiens größte und bekannteste Film- und Unterhaltungszeitschrift. Sie wird von der Times Group verlegt und organisiert jeweils im Februar die Filmfare Awards – die älteste und wichtigste Auszeichnung, die Hindi-Filmen in Indien verliehen werden. Die Filmfare Awards sind für die Hindi-Filmindustrie so bedeutsam wie der Oscar für die US-amerikanische.

Eine deutsche Ausgabe des Filmfare-Magazins erschien ab 2008 bei Threebros Media in Offenbach mit einer Auflage von einigen tausend Exemplaren.

Weblinks
 Website von Filmfare

Einzelnachweise

Filmzeitschrift
Zeitschrift (Indien)
Englischsprachige 14-tägliche Zeitschrift
Ersterscheinung 1952
!