TY - JOUR
T1 - Feasibility Study of Stress Management and Resiliency Training (SMART) in Patients With Major Depressive Disorder
AU - Seshadri, Ashok
AU - Clark, Matthew M.
AU - Kung, Simon
AU - Fuller-Tyszkiewicz, Matthew
AU - Sood, Amit
AU - Dammen, Kristina C.
AU - Rico, Jose A.
AU - Tye, Susannah J.
AU - McGillivray, Jane
AU - Frye, Mark A.
N1 - Funding Information:
Submitted: October 17, 2019; accepted January 17, 2020. Published online: April 30, 2020. Potential conflicts of interest: Dr Clark has received consultant fees from Roche Diabetes Care GmbH. Dr Sood is the owner of Global Center for Resiliency and Wellbeing and the GRIT Institute. Dr Frye has received grant support from Assurex Health, Mayo Foundation, and Medibio; has received consultant fees from Actify Neurotherapies, Allergan, Intra-Cellular Therapies Inc, Janssen, Myriad, Neuralstem Inc, Takeda, and Teva; and has received fees for CME, travel, and honoraria from American Physician Institute, CME Outfitters, and Global Academy for Medical Education. Drs Seshadri, Kung, Fuller-Tyszkiewicz, Tye, and McGillivray; Ms Dammen; and Mr Rico report no conflicts of interest related to the subject of this article. Funding/support: None. Previous presentation: Presented in part at the Annual Meeting of the National Network of Depression Centers; Baltimore, MD; October 18, 2019.
Publisher Copyright:
© 2020 Physicians Postgraduate Press, Inc.
PY - 2020
Y1 - 2020
N2 - Objective: Stress is associated with the onset, maintenance, and recurrence of depression. This study investigated the feasibility of stress management and resiliency training (SMART) for enhancing resiliency in a group of patients with major depressive disorder. Methods: In an open-label study, patients with major depressive disorder were invited to participate in an adjunctive 8-week group therapy of SMART (from June 2017 to June 2018) that encompassed attention training and practice of gratitude, compassion, higher meaning, acceptance, and forgiveness. The primary outcome measure was baseline-to-endpoint change in resilience as measured by the Connor Davidson Resilience Scale (CD-RISC). Secondary outcome measures included baseline-to-endpoint change in stress using the Perceived Stress Scale (PSS) and in depression using the 17-item Hamilton Depression Rating Scale (HDRS-17) and 9-item Patient Health Questionnaire (PHQ-9). Results: Twenty-three participants enrolled in the study (mean ± SD age = 46 ± 13 years, female = 91%). Baseline ratings of mood were of mild-to-moderate symptom severity (mean HDRS-17 score = 14.5 and PHQ-9 score = 12), resilience (mean CD-RISC score = 53.8), and perceived stress (mean PSS score = 23.5). Of the participants, 74% were study completers (attended ≥ 6 sessions). In an intention-to-treat analysis, at study endpoint there was a significant improvement in resilience (mean CD-RISC score = 61.1, P = .03), reduction in perceived stress (mean PSS score = 19.4, P = .002), and improvement in depressio(mean HDRS-17 score = 9.1 and PHQ-9 score = 7.6, both P < .001). Conclusions: A resilience training program focused on wellness is feasible for patients who are currently symptomatic with major depressive disorder. A larger randomized controlled trial is needed to establish efficacy of this intervention and explore the long-term impact of stress management and resilience training in depression.
AB - Objective: Stress is associated with the onset, maintenance, and recurrence of depression. This study investigated the feasibility of stress management and resiliency training (SMART) for enhancing resiliency in a group of patients with major depressive disorder. Methods: In an open-label study, patients with major depressive disorder were invited to participate in an adjunctive 8-week group therapy of SMART (from June 2017 to June 2018) that encompassed attention training and practice of gratitude, compassion, higher meaning, acceptance, and forgiveness. The primary outcome measure was baseline-to-endpoint change in resilience as measured by the Connor Davidson Resilience Scale (CD-RISC). Secondary outcome measures included baseline-to-endpoint change in stress using the Perceived Stress Scale (PSS) and in depression using the 17-item Hamilton Depression Rating Scale (HDRS-17) and 9-item Patient Health Questionnaire (PHQ-9). Results: Twenty-three participants enrolled in the study (mean ± SD age = 46 ± 13 years, female = 91%). Baseline ratings of mood were of mild-to-moderate symptom severity (mean HDRS-17 score = 14.5 and PHQ-9 score = 12), resilience (mean CD-RISC score = 53.8), and perceived stress (mean PSS score = 23.5). Of the participants, 74% were study completers (attended ≥ 6 sessions). In an intention-to-treat analysis, at study endpoint there was a significant improvement in resilience (mean CD-RISC score = 61.1, P = .03), reduction in perceived stress (mean PSS score = 19.4, P = .002), and improvement in depressio(mean HDRS-17 score = 9.1 and PHQ-9 score = 7.6, both P < .001). Conclusions: A resilience training program focused on wellness is feasible for patients who are currently symptomatic with major depressive disorder. A larger randomized controlled trial is needed to establish efficacy of this intervention and explore the long-term impact of stress management and resilience training in depression.
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U2 - 10.4088/PCC.19m02556
DO - 10.4088/PCC.19m02556
M3 - Article
C2 - 32369689
AN - SCOPUS:85084276217
VL - 22
JO - The primary care companion for CNS disorders
JF - The primary care companion for CNS disorders
SN - 1523-5998
IS - 3
M1 - 19m02556
ER -