A Review of the literature published between September 1970 and August 1971
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Nine remaining articles were reviewed further, and it was decided that the five studies published before had decreased relevance and would be excluded from this review in light of the growing availability of selective serotonin reuptake inhibitor medications since , which substantially changed the treatment of depression among college students. In addition, the demographic characteristics of U. Only four articles 8 , 9 , 10 , 11 remained for this review of depression and treatment outcomes of U.
Table 1 summarizes the four studies on depression and treatment outcomes that were reviewed in this study. Table 1Studies after of outcomes of depression for U. In Kelly and colleagues 8 conducted a nonexperimental study that recruited from introductory psychology classes university students with depression who were not currently in treatment, offering both financial compensation and class credit for research involvement.
However, before the end of the nine-week observation period, more than half of these sudden gains reversed. The authors concluded that sudden gains may be part of the natural course of depression for some college students, irrespective of treatment, and that self-evaluation processes may play an important role in recovery. In Lara and colleagues 9 conducted a nonexperimental study in which undergraduate students taking psychology classes who had a recent-onset major depressive episode were paid or received course credit for their research participation.
Lara and colleagues concluded that college students with depression may sometimes spontaneously recover and relapse and that harsh discipline in childhood was significantly associated with higher mean levels of depression at follow-up and relapse but not with recovery. In Geisner and colleagues 10 conducted a four-week randomized controlled trial of depression treatment and recruited undergraduates with depression who were enrolled in psychology courses to participate for course credit.
The authors found that depressive symptoms improved for both the intervention and control groups, but in the intervention condition there was a significantly greater improvement of depressive symptoms, as measured by the DSM-IV-Based Depression Scale.
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There was no significant difference between the intervention and control groups on symptoms measured by the Beck Depression Inventory BDI. Geisner and colleagues concluded that an intervention using personalized mailed feedback may be useful for reducing depressive symptoms among college students. In Pace and Dixon 11 conducted a four- to seven-week randomized controlled trial to assess the treatment effectiveness of individual cognitive therapy for college students with depressive symptoms.
Participating undergraduate students earned course credit for their research involvement. Outcomes at both time points were statistically significant in favor of cognitive therapy. The authors concluded that brief individual cognitive therapy may effectively reduce mild to moderate depressive symptoms as well as depressive self-schemata among college students. The current body of literature on depression and treatment outcomes among U. Whereas Kelly and colleagues 8 and Lara and colleagues 9 used the Structured Clinical Interview for DSM-IV to diagnose participants with major depressive disorder, Geisner and colleagues 10 and Pace and Dixon 11 used self-report scales to measure depressive symptoms for study inclusion and Pace and Dixon excluded students with severe levels of depressive symptoms.
All four studies recruited students who were not seeking treatment and who were offered course credit for participating, a reward that might have influenced the degree of improvement in outcomes. There was no consistent standard used across studies to define a student with depression, even when using the same assessment tool.
In terms of length of treatment, only two of the four reviewed studies followed students for more than nine weeks. The length of time over which students are assessed is especially critical for the college population, where time is defined by a semester calendar, moods are often influenced by exam schedules, and treatments are adjusted to accommodate upcoming vacations Today's college mental health services tend to employ short-term models of care eight to 16 sessions , with referral to outside clinicians if longer-term treatment is necessary Given these dynamics, future research in college mental health will need to establish quality standards for ongoing monitoring and follow-up of students' treatment outcomes.
Unfortunately, the results from these four studies may not be fully applicable to college students today or in the future, particularly in light of the changing demographic characteristics of those attending universities as well as the rapidly evolving role of pharmacology in the treatment of depression.
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Only two of the four studies reviewed offered any active treatment for depression, and none of the studies included any form of pharmacological treatment. Consistent with current medical literature and best practices, many treatment-seeking college students diagnosed as having depression currently receive psychotherapy and psychopharmacological treatment 1. Because major depression can be a chronic recurring condition, future research needs to evaluate the effectiveness of the various treatment modalities used to treat college students with depression.
This is particularly important in light of the recent addition of a black-box warning for the use of antidepressant medications among young adults aged 18 to 24 years, which recommends the close monitoring of patients taking antidepressant medication for clinical worsening, suicidality, or unusual changes in behavior. In light of the high prevalence of depression among college students today and the risks and sequelae this illness poses if not diagnosed and treated early and effectively, it is imperative that research funding be increased for both naturalistic and intervention studies of depression and treatment outcomes in the college health setting.
First, research documenting depression and treatment outcomes in this cohort should be identified in order to evaluate the adequacy of current care. Second, research should be directed to assessing specific short-term or semester-based interventions for students with depression. Models that explore the effectiveness of integration with primary care, care management, medication, and short-term psychotherapy are all important targets for future study.
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Albert J. November 16, September 18, September , Its Use and Misuse in Research Evaluation. Scientometrics Guidebooks Series - Volume 2, p. Braun Editor, pp. June , Published Version. Bolte, Sr. Award for Supporting Industries, Philadelphia, May 17 Brynko B. A new dimension in documentation through association of ideas?
International Journal of Epidemiology 35 5 : October Award Recipient : Dr.
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Baykoucheva S. June 8, Garfield, E. Abridged version. Hopkins K.
Hane, Paula J. Kevin Murphy and Dr. Robert H. Washington D. Doi: September 16, Identifying core literature through Citation Analysis and visualization? January 27, Knowledge: Our Competitive Weapon? December 9, November 17, Published version. Garfield E, and Pudovkin AI. Presented at the Francisco J. Ayala 70th anniversary celebration. October 16, Sherry Glied " Inaugural Presentation. Sherry Glied. Moed H. Glanzel W.
Original article in The Scientist. Merton " Scientometrics 60 1 : , Istomin VS. Published Letter No Garfield E, " A memorial tribute to Anthony E. Seoul, Korea. Garfield and Pudovkin have been colleagues for nearly three decades. Photo taken in Nakhodka, David Cutler ". Inaugural Presentation. David Cutler. Garfield E,. Garfield E, " Introducing Daniel C. Dennett " at the Free Library of Philadelphia on March 6, Philadelphia, PA. October , Published in the Proceedings of the Conference, p.
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Garfield E, " Introduction to a lecture by E. Wilson at the Free Library of Philadelphia " February 7, Nalimov " Scientometrics, 52 2 , October No Unpublished. Cawkell, AE and Garfield, E. Fredriksson, IOS Press, Article - Unpublished. Information Today, Inc. Nature , March 29 The President? Modified version published in Croation Medical Journal 41 4 , December Eugene Garfield, Ph.
No: Article, No Caraway, Beatrice " Interview with Dr. Eugene Garfield" , Serial Conversations , 25 3 , Interview, No Presentation, Unpublished. Louis, Missouri. April 5, Presentation Unpublished. Letter, No Erratum ," Cell Death and Differentiation , 5 1 p. See paper by the same name. Paper, No Meadow, Ronald E. Rice, Christine L. Borgman Letter, No Oral History - Interview by Robert V.