***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Regular physical exercise may improve a variety of physiological and psychological factors in depressive persons . However , there is little experimental evidence to support this assumption for adolescent population s. We conducted a r and omized controlled trial to investigate the effect of physical exercise on depressive state , the excretions of stress hormones and physiological fitness variables in adolescent females with depressive symptoms . METHODS Forty-nine female volunteers ( aged 18 - 20 years ; mean 18.8 + /- 0.7 years ) with mild-to-moderate depressive symptoms , as measured by the Centre for Epidemiologic Studies Depression ( CES-D ) scale , were r and omly assigned to either an exercise regimen or usual daily activities for 8 weeks . The subjects were then crossed over to the alternate regimen for an additional 8-week period . The exercise program consisted of five 50-min sessions per week of a group jogging training at a mild intensity . The variables measured were CES-D rating scale , urinary cortisol and epinephrine levels , and cardiorespiratory factors at rest and during exercise endurance test . RESULTS After the sessions of exercise the CES-D total depressive score showed a significant decrease , whereas no effect was observed after the period of usual daily activities ( ANOVA ) . Twenty-four hour excretions of cortisol and epinephrine in urine were reduced due to the exercise regimen . The training group had a significantly reduced resting heart rate and increased peak oxygen uptake and lung capacity . CONCLUSIONS The findings of this study suggest that a group jogging exercise may be effective in improving depressive state , hormonal response to stress and physiological fitness of adolescent females with depressive symptoms This study set up and evaluated an online mutual support group for college students with psychological problems . In a 2 x 2 pre-post design , participants ( N = 238 ) were r and omly assigned to either the Information Only condition , giving access to a Web site containing information about student problems , or to the Support Group condition , giving access to an identical Web site with the addition of an online mutual support group . Participants in both conditions improved on two of the three outcome measures , the CORE-OM and the Satisfaction with Life Scale , but there was no evidence of differential outcome between the two conditions Background Web-based cognitive-behavioral therapeutic ( CBT ) apps have demonstrated efficacy but are characterized by poor adherence . Conversational agents may offer a convenient , engaging way of getting support at any time . Objective The objective of the study was to determine the feasibility , acceptability , and preliminary efficacy of a fully automated conversational agent to deliver a self-help program for college students who self-identify as having symptoms of anxiety and depression . Methods In an unblinded trial , 70 individuals age 18 - 28 years were recruited online from a university community social media site and were r and omized to receive either 2 weeks ( up to 20 sessions ) of self-help content derived from CBT principles in a conversational format with a text-based conversational agent ( Woebot ) ( n=34 ) or were directed to the National Institute of Mental Health ebook , “ Depression in College Students , ” as an information-only control group ( n=36 ) . All participants completed  Web-based versions of the 9-item Patient Health Question naire ( PHQ-9 ) , the 7-item Generalized Anxiety Disorder scale ( GAD-7 ) , and the Positive and Negative Affect Scale at baseline and 2 - 3 weeks later ( T2 ) . Results Participants were on average 22.2 years old ( SD 2.33 ) , 67 % female ( 47/70 ) , mostly non-Hispanic ( 93 % , 54/58 ) , and Caucasian ( 79 % , 46/58 ) . Participants in the Woebot group engaged with the conversational agent an average of 12.14 ( SD 2.23 ) times over the study period . No significant differences existed between the groups at baseline , and 83 % ( 58/70 ) of participants provided data at T2 ( 17 % attrition ) . Intent-to-treat univariate analysis of covariance revealed a significant group difference on depression such that those in the Woebot group significantly reduced their symptoms of depression over the study period as measured by the PHQ-9 ( F=6.47 ; P=.01 ) while those in the information control group did not . In an analysis of completers , participants in both groups significantly reduced anxiety as measured by the GAD-7 ( F1,54= 9.24 ; P=.004 ) . Participants ’ comments suggest that process factors were more influential on their acceptability of the program than content factors mirroring traditional therapy . Conclusions Conversational agents appear to be a feasible , engaging , and effective way to deliver CBT Objectives Computer-administered cognitive – behavioural therapy ( CCBT ) may be a promising treatment for adolescents with depression , particularly due to its increased availability and accessibility . The feasibility of delivering a r and omised controlled trial ( RCT ) comparing a CCBT program ( Stressbusters ) with an attention control ( self-help websites ) for adolescent depression was evaluated . Design Single centre RCT feasibility study . Setting The trial was run within community and clinical setting s in York , UK . Participants Adolescents ( aged 12–18 ) with low mood/depression were assessed for eligibility , 91 of whom met the inclusion criteria and were consented and r and omised to Stressbusters ( n=45 ) or websites ( n=46 ) using remote computerised single allocation . Those with comorbid physical illness were included but those with psychosis , active suicidality or postnatal depression were not . Interventions An eight-session CCBT program ( Stressbusters ) design ed for use with adolescents with low mood/depression was compared with an attention control ( accessing low mood self-help websites ) . Primary and secondary outcome measures Participants completed mood and quality of life measures and a service Use Question naire throughout completion of the trial and 4 months post intervention . Measures included the Beck Depression Inventory ( BDI ) ( primary outcome measure ) , Mood and Feelings Question naire ( MFQ ) , Spence Children 's Anxiety Scale ( SCAS ) , the EuroQol five dimensions question naire ( youth ) ( EQ-5D-Y ) and Health Utility Index Mark 2 ( HUI-2 ) . Changes in self-reported measures and completion rates were assessed by treatment group . Results From baseline to 4 months post intervention , BDI scores and MFQ scores decreased for the Stressbusters group but increased in the website group . Quality of life , as measured by the EQ-5D-Y , increased for both groups while costs at 4 months were similar to baseline . Good feasibility outcomes were found , suggesting the trial process to be feasible and acceptable for adolescents with depression . Conclusions With modifications , a fully powered RCT is achievable to investigate a promising treatment for adolescent depression in a climate where child mental health service re sources are limited . Trial registration number IS RCT N31219579 OBJECTIVE : The Humulus lupulus L. plant ( hops ) is used as a herbal medicinal product for anxiety/mood disorders . Our aim was to study the effects of a hops dry extract on self-reported depression , anxiety and stress levels in young adults . DESIGN : Apparently healthy young adults from our university completed the Depression Anxiety Stress Scale-21 ( DASS-21 ) and those reporting at least mild depression , anxiety and stress were invited to complete the study intervention . This followed a r and omized ( 1:1 ) , placebo-controlled , double-blind , crossover design with two 4-week intervention periods ( Melcalin hops or placebo ; two 0.2 gr capsules once daily ) separated by a 2-week wash-out . Anthropometric measurements , DASS-21 assessment s and measurements of morning Cortisol plasma levels were performed at the beginning and the end of the 4-week treatment periods . RESULTS : 36 participants ( Females/Males : 31/5 ; age : 24.7±0.5 years ) completed the study intervention ( attrition : 6/42 ) . No significant changes in body weight and composition or morning circulating Cortisol were noted with the hops or placebo . Significantly decreased DASS-21 anxiety , depression and stress scores were documented with hops ( 9.2±7.3 vs. 5.1±5.9 , 11.9±7.9 vs. 9.2±7.4 , and 19.1±8.1 vs. 11.6±8.1 ; all p values < 0.05 ) , which were significantly greater compared to those caused by the placebo ( all p values < 0.05 ) . CONCLUSION : In otherwise healthy young adults reporting at least mild depression , anxiety and stress symptoms , daily supplementation with a hops dry extract can significantly improve all these symptoms over a 4-week period . These beneficial effects agree with the indication of hops for anxiety/mood disorders and restlessness , as approved by the German Commission This study offers data about the efficacy of " Talk to Me , " an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy ( CBT ) for social phobia ( exposure and cognitive therapies ) . One hundred twenty-seven participants with social phobia were r and omly assigned to three experimental conditions : ( a ) an Internet-based self-administered program ; ( b ) the same program applied by a therapist ; ( c ) a waiting-list control group . Results showed that both treatment conditions were equally efficacious . In addition , Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition . Treatment gains were maintained at 1-year follow-up . The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT . Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT BACKGROUND Threat-related attention biases have been implicated in the etiology and maintenance of anxiety disorders . As a result , attention bias modification ( ABM ) protocol s have been employed as treatments for anxious adults . However , they have yet to emerge for children . A r and omized , double-blind placebo-controlled trial was conducted to examine the efficacy of an ABM protocol design ed to facilitate attention disengagement from threats , thereby reducing anxiety and stress vulnerability in children . METHODS Participants were 34 chronically high-anxious 10-year-olds . An emotional attention spatial cueing task was used . In the ABM condition ( n=18 ) , threat faces never cued the targets ' locations , such that the valid-invalid ratio was 0%/100 % , respectively . The valid-invalid ratio on neutral cue trials was 25%/75 % , respectively . In the control condition , the valid-invalid ratio was 25%/75 % for both neutral and threat faces . Anxiety and depression were measured pre- and post-training and pre- and post-stress induction . RESULTS ABM facilitated attention disengagement from threat . In response to the stressor task , children in the ABM condition reported less state anxiety relative to controls . CONCLUSION Computerized attention training procedures may be beneficial for reducing stress vulnerability in anxious children Objective To evaluate whether a new computerised cognitive behavioural therapy intervention ( SPARX , Smart , Positive , Active , Realistic , X-factor thoughts ) could reduce depressive symptoms in help seeking adolescents as much or more than treatment as usual . Design Multicentre r and omised controlled non-inferiority trial . Setting 24 primary healthcare sites in New Zeal and ( youth clinics , general practice s , and school based counselling services ) . Participants 187 adolescents aged 12 - 19 , seeking help for depressive symptoms , with no major risk of self harm and deemed in need of treatment by their primary healthcare clinicians : 94 were allocated to SPARX and 93 to treatment as usual .  Interventions Computerised cognitive behavioural therapy ( SPARX ) comprising seven modules delivered over a period of between four and seven weeks , versus treatment as usual comprising primarily face to face counselling delivered by trained counsellors and clinical psychologists . Outcomes The primary outcome was the change in score on the children ’s depression rating scale-revised . Secondary outcomes included response and remission on the children ’s depression rating scale-revised , change scores on the Reynolds adolescent depression scale-second edition , the mood and feelings question naire , the Kazdin hopelessness scale for children , the Spence children ’s anxiety scale , the paediatric quality of life enjoyment and satisfaction question naire , and overall satisfaction with treatment ratings . Results 94 participants were allocated to SPARX ( mean age 15.6 years , 62.8 % female ) and 93 to treatment as usual ( mean age 15.6 years , 68.8 % female ) . 170 adolescents ( 91 % , SPARX n=85 , treatment as usual n=85 ) were assessed after intervention and 168 ( 90 % , SPARX n=83 , treatment as usual n=85 ) were assessed at the three month follow-up point . Per protocol analyses ( n=143 ) showed that SPARX was not inferior to treatment as usual . Post-intervention , there was a mean reduction of 10.32 in SPARX and 7.59 in treatment as usual in raw scores on the children ’s depression rating scale-revised ( between group difference 2.73 , 95 % confidence interval −0.31 to 5.77 ; P=0.079 ) . Remission rates were significantly higher in the SPARX arm ( n=31 , 43.7 % ) than in the treatment as usual arm ( n=19 , 26.4 % ) ( difference 17.3 % , 95 % confidence interval  
    Output:
    
Evidence suggested that light therapy could be effective for season depression and that digital interventions based on attention bias modification are ineffective for anxiety .