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What is the effectiveness of structured lifestyle interventions (diet, exercise, sleep hygiene) in preventing relapse among adults with recurrent major depressive disorder ? : A Systematic Review Ratu Qurroh' Ain; Melsha Syarahhandi; Melati Rosa Sitorus; Yudi Dwi Atmanto
The International Journal of Medical Science and Health Research Vol. 15 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/e9d77371

Abstract

Introduction: Major Depressive Disorder (MDD) is a recurrent condition where preventing subsequent episodes is a primary clinical goal. While various non-pharmacological strategies exist, the evidence for structured lifestyle interventions in preventing MDD relapse is notably heterogeneous. This systematic review aims to evaluate the effectiveness of structured diet, exercise, and sleep hygiene interventions in preventing relapse among adults with recurrent MDD. Methods: This systematic review adhered to PRISMA 2020 guidelines. A comprehensive search was conducted across PubMed, Semantic Scholar, Springer, Google Scholar, and Wiley Online Library for studies published since 2015. We included randomized controlled trials, meta-analyses, and prospective cohort studies that assessed non-pharmacological lifestyle interventions in adults with a history of at least two MDD episodes, with relapse/recurrence as a primary outcome. A total of 22 studies were included in the final synthesis. Results: The evidence base was varied. Psychological interventions demonstrated the strongest and most consistent evidence for reducing relapse risk, with meta-analyses reporting hazard ratios around 0.60. Dietary interventions, primarily the Mediterranean diet, improved depressive symptoms but did not consistently show a significant reduction in relapse rates. Combined lifestyle and exercise interventions were promising, particularly when patient adherence was high, with one multi-component study showing a relapse rate of 7.4% versus 25.3% in the control group. Conclusion: Based on the comprehensive analysis, the most significant finding is the clear distinction in efficacy among non-pharmacological interventions for preventing Major Depressive Disorder relapse. Psychological interventions, particularly those grounded in mindfulness and cognitive therapy, stand out with the most robust and consistent evidence, establishing them as a reliable strategy for reducing relapse risk. In contrast, while specific lifestyle modifications like diet and exercise are significant for improving symptoms, their direct impact on relapse prevention is less definitive and highly conditional upon sustained patient adherence.
Effectiveness of Parent Training Programs for ADHD : A Systematic Review Fitria Luluk Mukhasona; Ratu Qurroh' Ain; Yuniar Pukuk Kesuma
The International Journal of Medical Science and Health Research Vol. 19 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/wyrczk22

Abstract

Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that significantly impacts children's functioning and family dynamics. Parent Training (PT) is a cornerstone non-pharmacological intervention designed to equip parents with skills to manage challenging behaviors. However, effectiveness varies across different programs, delivery formats, and combinations with medication, creating a need for clear evidence synthesis. This review systematically evaluates the evidence for PT's effectiveness on child symptoms, parenting, and family dynamics. Methods Following PRISMA 2020 guidelines , a systematic search of PubMed, Google Scholar, Springer, Wiley Online Library, and Semantic Scholar was conducted. Inclusion criteria targeted randomized controlled and quasi-experimental studies published in the last decade that evaluated a structured PT program for children with ADHD. After screening over 3,000 records, 40 studies were selected for the final qualitative analysis. Results The synthesis of 40 studies revealed that PT is highly effective; 35 studies reported significant reductions in core ADHD symptoms and related disruptive behaviors. Substantial secondary benefits were also found, with 27 studies documenting improved parenting practices, reduced parental stress, and increased parental competence. Therapist-led, in-person programs demonstrated advantages in adherence and satisfaction over blended or remote formats. Furthermore, combining PT with medication, particularly using a "behavior-first" approach, was found to be superior to medication alone. Discussion The findings confirm PT as a robust, evidence-based intervention with a dual benefit for both children and their caregivers. While broadly effective, the evidence underscores that a one-size-fits-all approach is insufficient. Optimal outcomes depend on tailoring the program type and delivery format to individual family needs, resources, and circumstances to maximize engagement and positive results. Conclusion Parent Training is a fundamental component of comprehensive ADHD care that effectively reduces child symptoms while enhancing parenting skills and overall family well-being. A personalized clinical approach is recommended, prioritizing behavioral interventions as a first-line treatment to achieve durable and meaningful success.