The Thinking about Thinking Skills in Depression fact sheet—a simple psychoeducational resource— is an acceptable, safe, and pragmatic way to deliver information regarding cognitive difficulties and compensatory strategies to young patients with depression. Researchers conducted a study at a tertiary public mental health service, the Youth Mood Clinic at Orygen Youth Health in Melbourne, Australia, and published their findings in Early Intervention in Psychiatry.
The primary study outcomes included acceptability, safety, distress and cognitive awareness, and confidence and self-management. These endpoints were measured with the use of 2 scales that were developed by the research team—the Acceptability and Safety Questionnaire (ASQ) and the Cognitive Awareness and Self-Questionnaire (CASMQ)—together with a Subjective Units of Distress scale (SUDs). Exploratory aims of the study included changes in subjective cognition deficits, symptoms of depression, self-esteem, and self-efficacy following delivery of the fact sheet. An anonymous online survey was used to obtain the case managers’ perspectives.
A total of 23 participants (age range, 15-25 years) who were receiving community-based treatment for a depressive disorder were enrolled in the study. All of the participants received the fact sheet from their case managers and completed pre- and post-assessments 3 weeks apart. Ratings of ≥70% were used as an indication of high agreement on acceptability, as well as cognitive awareness, confidence, and strategy use items from the ASQ and CASMQ. In comparison, ratings of ≤30% indicated higher safety on related ASQ items.
Among the participants, 91% reported that the amount of content provided in the fact sheet was appropriate, 83% looked over the fact sheet again after having received it, and 57% attempted to use ≥1 strategy. Significant increases were reported among the participants with respect to their ratings on all items of the CASMQ—from pre- to post-assessment delivery (varying from P <.05 to P <.01 to P <.001). Following fact sheet delivery, participants’ level of distress did not change. Moreover, perceived improvements in symptoms of depression and cognitive deficits, but not self-efficacy or self-esteem, were observed. Positive perspectives were reported on the part of the case managers.
A major limitation of the study is the fact that the Thinking about Thinking Skills in Depression fact sheet delivery was not compared with a control group who did not receive the fact sheet. The investigators concluded that fact sheet delivery among young individuals who experience depression may enhance cognition-specific knowledge and may support individualized symptom-based discussions within tertiary public mental health services.
Bryce S, Cooke M, Yuen HP, Allott K. Acceptability, safety and perceived impact of providing a fact sheet to young people about cognitive symptoms in depression [published online February 11, 2020]. Early Interv Psychiatry. doi: 10.1111/eip.12945.