PURPOSE: This study was conducted to test the effects of a community-based depression prevention program on community people and the effectiveness was measured by assessing depression, self-esteem, and quality of life. The theoretical framework supporting the program was Ellis' REBT (Rational Emotive Behavior Therapy) theory (1962). METHODS: A nonequivalent control group pretest-posttest design was used. Study participants were 29 community residents (experimental: 14, control: 15). The depression prevention program consisted of music activity, bibliotherapy, and cognitive behavior therapy and was provided for 6 weeks (a twelve-session). Data were collected before and after the program and 3 months later for follow-up testing. Data were analyzed using the SPSS/WIN 12.0. RESULTS: There were no differences in outcome variables between the experimental and control groups. From the additional analyses, statistically significant differences by time point were observed for Self-esteem and Quality of life at 3 months later for experimental group. And 50% of the participants with depression symptoms no longer scored in the depression symptoms in the experimental group. CONCLUSION: The study findings indicate that depression prevention programs are positive in reducing depression in people suffering from depression symptoms. However some modifications are required to increase effectiveness.
Bibliotherapy ; Cognitive Therapy ; Depression* ; Follow-Up Studies ; Music ; Quality of Life*

PURPOSE: The purpose of this study was to explore the levels of depression and predictors of depression in middle-school girls. METHOD: A self-report survey was conducted with 2nd and 3rd grade students in a girls' middle school (N=401) in Pusan. Data were analyzed with descriptive statistics, Pearson correlation, and simultaneous multiple regression using the SPSS program. RESULTS: The mean score for the Center for Epidemiologic Studies-Depression Scale (CES-D) was 20.63. The level of depression was negatively related to problem-solving ability, self-esteem, total household income, school achievement, self-perception of body-image, and satisfaction in relationships with siblings, parents, and friends. A multivariate approach showed that predictors explained 61% of variance in depression. Significant predictors of depression were self-esteem (beta=-.38), problem-solving ability (beta=-.34), and satisfaction in relationships with friends (beta=-.14) and parents (beta=-.08). CONCLUSION: The findings suggest that it is important to develop educational programs to increase self-esteem and problem-solving abilities in middle school girls. Considering the high levels of depression in middle school girls, school nurses play an important role in detecting and reducing emotional tension among these students. Nursing interventions, including art therapy, problem-solving counseling, and bibliotherapy could be useful in enhancing self-esteem, problem-solving abilities, and satisfaction in relationship with friends, siblings and parents.
Achievement ; Art Therapy ; Bibliotherapy ; Body Image ; Counseling ; Depression ; Family Characteristics ; Friends ; Humans ; Parents ; Problem Solving ; Self Concept ; Siblings

Although pharmacological treatment constitutes the main therapeutic approach for depression, non-pharmacological treatments (self-care or psychotherapeutic approach) are usually regarded as more essential therapeutic approaches in clinical practice. However, there have been few clinical practice guidelines concerning self-care or psychotherapy in the management of depression. This study introduces the 'Evidence-Based, Non-Pharmacological Treatment Guideline for Depression in Korea.' For the first time, a guideline was developed for non-pharmacological treatments for Korean adults with mild-to-moderate depression. The guideline development process consisted of establishing several key questions related to non-pharmacologic treatments of depression, searching the literature for studies which answer these questions, assessing the evidence level of each selected study, drawing up draft recommendation, and peer review. The Scottish Intercollegiate Guidelines Network grading system was used to evaluate the quality of evidence. As a result of this process, the guideline recommends exercise therapy, bibliotherapy, cognitive behavior therapy, short-term psychodynamic supportive psychotherapy, and interpersonal psychotherapy as the non-pharmacological treatments for adult patients with mild-to-moderate depression in Korea. Hence, it is necessary to develop specific methodologies for several non-pharmacological treatment for Korean adults with depression.
Adult ; Bibliotherapy/*methods ; Clinical Protocols ; Cognitive Therapy/*methods ; Combined Modality Therapy/*methods ; Depression/*drug therapy/psychology/*therapy ; Exercise Therapy ; Humans ; Placebos/therapeutic use ; Questionnaires ; Republic of Korea

In treatment of depression, non-pharmacological treatment is as important as pharmacological treatment. However, in clinical practice in Korea, non-pharmacological treatment is not provided sufficiently and patients are not satisfied with psychiatric interviews. Accordingly, patients ask for more information from clinicians. Clinicians should be aware of the characteristics of depression in Korean patients, because the manifestations of symptoms are influenced by cultural factors. In particular, depressed patients complain about somatic symptoms more frequently than they complain about depressed mood itself. In order to establish a therapeutic relationship with depressed patients, clinicians should be aware of these characteristics of depressed patients and clinicians should also address the needs of their patients. The author introduces evidence-based self-care methods for Korean patients with depression. St. John's wort, acupuncture, air ionization, light therapy, massage bibliotherapy, exercise, meditation, relaxation, and yoga can be helpful for overcoming depression. Among them, the Clinical Research Center for Depression, an organization supported by the Ministry of Health and Welfare, has recommended several non-pharmacological treatments for depression. First of all, exercise, such as walking more than 30 min. everyday, is strongly recommended. Other recommendations include bibliotherapy, interpersonal psychotherapy, cognitive behavioral therapy, and short-term psychodynamic supportive psychotherapy. For the nationwide management of depression, social bias against the treatment of depression should be reduced and non-pharmacological treatment for depression should be encouraged.
Acupuncture ; Air Ionization ; Bias (Epidemiology) ; Bibliotherapy ; Cognitive Therapy ; Depression ; Humans ; Hypericum ; Korea ; Massage ; Meditation ; Phototherapy ; Psychotherapy ; Relaxation ; Self Care ; Walking ; Yoga

OBJECTIVES: Depression disturbs the individual life from the loss of productivity to suicide. Furthermore the whole society is also influenced by depression in social and economic areas. Many scientific treatment methods are known to be effective in depression. But in reality more than half of patients with depression prefer self help treatment rather than medically based treatment. For the patients with mild depression and primary physicians, it is reasonable to provide the evidence based self care including self help or alternative treatment. This study is supported by the Korean Health 21 R&D Project for the Depression Center to establish the Korean treatment guideline for depression. METHODS: The members of Depression Center including the authors attended the workshops where the methods of evidence based medicine such as literature search, quality evaluation of the articles, making the level of evidence were educated. The professional librarians helped the authors for get the searched articles. Among the total of 354 abstracts of systemic review and 300 abstracts of random controlled trials, 3 systemic reviews and 2 random controlled trials were the main structure of evaluation. RESULT: Among the 37 self care methods known to be effective for depression, 11 kinds of methods were worth of evaluation. The first step for the self care of mild depression is to use St. John's wort, exercise, bibliotherapy, and light therapy in depression during winter season. Acupuncture, negative ion therapy, massage, relaxation technique are known to be efective with evidence. Music therapy, hypnotherapy, and aromatherapy are known to be effective but until now the evidences is insufficient and further evaluations are needed. CONCLUSION: Among 11 listed self-care methods, several methods need more evidence especially in Korean situation. Exercise is the most recommendable evidence based self care method in Korea nowadays. St. John's wort is effective with evidence, but it is not the OTC drug in Korea, so it is not recommendable now. For the bibliotherapy, there is no book such as"Feeling Good"in Korea. Only the introductory book about depression is available. Publishing the self help book based upon cognitive behavioral approach or psychodynamic approach is needed. Light therapy is practiced in a few clinics, but not self-help style. Exposure to the sunlight is recommended in the level of commen sense. These self care methods are for the mild patient. Moderate to severe patients with depression should seek the professional treatment.
Acupuncture ; Aromatherapy ; Bibliotherapy ; Depression* ; Education ; Efficiency ; Evidence-Based Medicine ; Humans ; Hypericum ; Korea ; Librarians ; Massage ; Music Therapy ; Phototherapy ; Relaxation ; Seasons ; Self Care* ; Suicide ; Sunlight