"Better together: Scotland's patient experience programme" works to use the public's experience of NHS Scotland to improve health services.  At the end of April they published provisional results for GP Practices throughout Scotland, and pilot results for a few initial hospitals are beginning to come through as well.  I find this fascinating, sobering, helpful stuff. 

The e-newsletter from Depression Alliance Scotland (DAS)  popped into my inbox last week.  What good work they do.  The new information that particularly caught my eye was access to an online facilitated self-help course.  The description runs: "We have a new service offering support for people to use Living Life to the Full Interactive, a computerised online self-help programme based on cognitive behaviour therapy.  You will work through a six session course and a DAS staff member will be there to offer 4 - 6 short telephone contacts on an individual basis over 6 weeks to help you get the most out of it.  Interested? Email info@dascot.org or call 0845 123 23 20"

This set of five papers documents, in part, our mixed viewpoints on depression.  Worryingly, Mehta & colleagues show deteriorating public attitudes towards mental illness in England (and to a lesser extent Scotland) between 1994 and 2003.  Meanwhile Blumner et al demonstrate a shift towards a more biological view on causes and treatment of depression in the US between 1996 and 2006.

In contrast, Miranda et al's editorial (and Grote et al's research) highlight the growing evidence showing psychotherapies for depression can be "very effective for low-income and minority populations in the United States and abroad" - extending their validity well beyond more privileged groups in developed countries.  Andersson too discusses a further way to make psychotherapies more widely available and helpful - in this case, the increasing literature documenting the widespread value of delivering cognitive behavioural therapy via the internet.     

Here are five papers on difficulties experienced by adolescents.  A couple of the papers are follow-up studies.  Colman et al looked at the multiple negative personal & relationship outcomes in a UK national cohort of adolescents with conduct problems followed over 40 years.  Wentz et al studied the somewhat more encouraging 18 year outcomes of a group of adolescents suffering from anorexia. 

A couple of the papers are about depression.  Kennard and colleagues report again on the well-known Treatment for Adolescents with Depression Study (TADS) comparing antidepressants, cognitive-behavioural therapy and combined treatment.  By about six months there was little difference between the three forms of treatment.  At nine months the remission rate for intent-to-treat cases was 60% overall.  Primack et al investigated the association between electronic media use in adolescence and subsequent depression in young adulthood.  They reported "Controlling for all covariates including baseline Center for Epidemiologic Studies-Depression Scale score, those reporting more television use had significantly greater odds of developing depression."

The fourth and final session of the "Non-pharmacological management of depression" SIGN seminar was entitled "Self help, guided and alternative/complementary therapies".<

There was some discussion at the SIGN "Non-pharmacological management of depression" seminar about the possible importance of the therapeutic alliance in depression treatment.  Profe