Skip to main content

Table 1 Characteristics of included studies

From: Community-based mental health and well-being interventions for older adults in low- and middle-income countries: a systematic review and meta-analysis

Author/year

Intervention description

Country

Type of study/Study design

Population group (sample size, age ranges)

Length and frequency of intervention

Comparison group

Outcomes and assessment methods

Follow up time point

Findings

Therapy

 Established forms of short-term therapy

  Siviş and Demir (2007) [58]

Reminiscence therapy program

Turkey

quasi-experimental, controlled study and focus group interview with the intervention group participants Focus group interviews

10 participants with 5 in each group. Mean age: intervention 68 years and control 73 years

Not reported

No intervention

LSI A – Life satisfaction

Analysis approach for qualitative data not reported

post intervention

No significant difference between post-test Life Satisfaction scores of older adults in intervention group compared to control group

Participants reported positive feedback regarding the group experience, e.g., group’s role in facilitating interaction and friendship among participants, enhancing a more positive self-image and leading to enjoyment and pleasant feelings

  Cherian (2019) [7]

Reminiscence therapy

India

pretest–posttest study

50 older adults aged 60–80 years residing in greater Noida, Uttar Pradesh

Not reported

 

GDS long form—Depression

not reported

significant reduction in depressive symptoms

  Efendi et al. (2020) [8]

Cognitive behaviour therapy (CBT)

Indonesia

Randomised control trial

90 older adults > 60 years old living in the post-earthquake Lombok area experiencing PTSD based on the Clinician-Administered PTSD Scale (CAPS-5), GDS ≥ 5 and MMSE ≥ 24. 45 respondents in the intervention group and 45 respondents in the treatment group

Not reported

no intervention

Clinician-Administered PTSD Scale (CAPS-5)—post-traumatic stress disorder; GDS – depression and WHO Quality of Life-BREF – Quality of Life

6 weeks

decrease in post-traumatic stress disorder and depression scores, significant improvement in quality-of-life components

  Saisanan Na Ayudhaya et al. (2020) [46]

Behavioural activation sessions delivered subsequently included (1) activity monitoring- examining the effect of specific activities on mood, (2) activity scheduling-developing a plan to increase pleasant activities, and (3) modification-utilizing problem-solving to alter contextual problems that may be eliciting or maintaining depressed mood

Thailand

quasi-experimental, controlled study

82 older adults aged 60 years and above from two subdistricts of Muang district of Samut Songkram Province who were diagnosed with subthreshold depression GDS score between 13 and 24. 41 older adults from each district was enrolled into the study

12 weeks

Regular physical examinations, review of current health symptoms, and psychoeducation delivered by the local mental health nurse

Thai GDS- Depression; DASS- Anxiety

3, 6,and 9 months follow up

significant reductions in the TGDS score and DASS compared to usual care-only group. Lower TGDS and DASS depression and stress scores maintained up to 6 months. Reduction in DASS anxiety score maintained only for 3-month post-intervention

  Li et al. (2021) [30]

group reminiscence therapy based on Chinese traditional festival activities. participants attended a four-hour intervention session

China

Randomised control trial

64 Chinese rural older adults (aged 65.70 ± 3.69 years) living alone with 32 individuals each in the intervention group and the wait-list control group

one session each month for 8 months

no intervention

Perceived stress scale—Perceived stress; UCLA loneliness scale—loneliness

3 months

significantly decreased the perceived stress and loneliness of rural older adults living alone in intervention group compared to control group post intervention and at 3 months follow up

  Yujia et al. (2021) [36]

group reminiscence therapy intervention in combination with physical exercise

China

Randomised control trial

130 older adults aged 60 years and above from communities in Xiangtan City and Changsha City of Hunan Province, with 65 people in each group

8 weeks

listened to 4 routine health lectures

Spirituality Index of Well-Being—spiritual well-being; ULS Loneliness Scale—loneliness and Brief Resilience Scale – resilience

post intervention (8th week)

Reduction in loneliness and improvement in the spiritual well-being and resilience in the intervention compared to control group

  Sutinah (2020) [47]

Psychoeducation therapy was done first and then followed by reminiscence therapy in the next day

Indonesia

quasi-experimental, controlled study

72 older adults in the Simpang Kawat Village, Jambi Indonesia. 36 in the intervention group and 36 in the comparison group. The average age of participants in the intervention and control groups was 68 years

Psychoeducation therapy:5 sessions with 5 meetings, and each session for 45–60 min

Reminiscence therapy: 5 sessions with 9 meetings and each session for 75 min. The intervention lasted for 6 weeks

reminiscence therapy

Indonesian version of GDS—depression

post intervention

Reminiscence therapy alone or in combination with psychoeducation therapy effective in reducing depression. The combination of reminiscence and

psychoeducation therapy was much more effective than reminiscence therapy alone

  Yuan et al. (2020)

[57, 59]

Adapted Cognitive behaviour therapy delivered by trained lay health workers

China

Randomised control trial

Focus group and in-depth interviews

50 older adults (age: mean 70.5 ± 5.6 years) with Geriatric depression scale score > 9: 24 to the Cognitive behaviour therapy group and 26 to the Control group

Eight sessions

usual care

GDS– depression; Self-rating Anxiety Scale – anxiety and WHO Quality of Life-BREF—social relationships

Qualitative data analysed based on thematic framework was developed and agreed on by consensus

week 4 and week 8 (or after the eighth session)

Cognitive behaviour therapy reduced more Geriatric Depression scores over 8-week follow-up compared with usual care

The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. Cultural and political factors facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered

  Viguer et al. (2017)

[48]

reminiscence program conducted by a trained psychologist

Dominican Republic

quasi-experimental, controlled study

168 healthy older adults aged 60 years and above recruited through four healthcare centers with no clinical depression (determined by a score of 14 or less on the Geriatric depression scale Spanish version). 84 in each group

10 weekly group sessions lasting two hours each

No intervention

Spanish version of GDS– depression; LSI-A – life satisfaction; Spanish version of the Psychological

Well-Being Scales – psychological well-being

post intervention and at three months follow up

significant increases in the time-group interaction, life satisfaction, and psychological well-being measures, and decreases in depressed mood, after treatment. The effects remained after three months in the case of life satisfaction and some dimensions of psychological well-being, but they were lower on depressed mood

  Xie et al. (2019) [34]

Modified behavioural activation treatment and regular treatment

China

randomised control trial

Eighty rural left-behind older adults, aged 60 years and above in Yankoutown town of Lengshuijiang City, Hunan Province who had a GDS score between 11 and 25. 40 participants in each group

8 weeks

received regular treatment

GDS—long form – depression; Beck Anxiety Inventory—anxiety and OHQ- happiness

post-intervention, and at 3 months post-intervention

GDS and BAI scores decreased significantly, but the scores of OHQ increased significantly in the intervention group. The reduction in depression symptoms after the intervention was maintained at the 3-month follow-up

  Zhou et al. (2012) [40]

health education and group reminiscence therapy by trained community nurses

China

cluster randomised control trial

129 older adults (8 communities) with 62 participants (4 communities) in the intervention group (4 communities) and 67 participants in the control group. average age of participants was 69.4 years

Once a week, for 90–120 min per session, and lasted for 6 weeks

three health education sessions—one every 2 weeks lasting 30–45 min each

GDS -depression; Self-Esteem Scale – self-esteem and Affect Balance Scale – affect balance

postintervention (6 weeks)

Depression scores in the intervention group decreased significantly compared to those in the control group. Scores on the positive affect subscale and affect balance in the intervention group increased significantly higher than control group, and scores on the negative affect subscale decreased significantly lower than control group

 Other forms of therapy

  Amigo and Mariati (2020) [51]

Classical music versus music-video therapies

Indonesia

pretest–posttest study with two intervention groups

24 older adults aged 60 years and over who experienced stress (Depression Anxiety Stress Scale score > 14), with 12 older adults in each group

  

DASS—stress

not reported

Significant effectiveness of both music and music video therapy in reducing stress in older adults

  Goksin and Asiret (2021) [29]

Progressive muscle relaxation that involves the controlled contraction and relaxation of large muscle groups in the human body along with regular breathing

Turkey

Randomised control trial

49 elderly women aged 65 and over who were not diagnosed with dementia or psychiatric illness (21 intervention and 28 controls) from a family health centre

28 min sessions three times a week for 8 weeks

no intervention

GDS– depression

post intervention (8th week)

a significant difference in the mean depression scores in the intervention group

  Dias, Azariah, Anderson, et al. (2019) [55, 60,61,62,63]

Lay counsellors provided problem-solving therapy, brief behavioural treatment for insomnia, education in self-care of common medical disorders such as diabetes, and assistance in accessing medical and social programs

India

Randomised control trial

semi structured, in-depth interviews with participants in the intervention arm

181 older adults (≥ 60 years) with subsyndromal depressive symptoms at rural and urban primary care clinics in Goa. with 91 participants in the intervention group and 90 in control group

Six intervention sessions, 30 to 40 min in length that spanned 6 to 10 weeks including 2 booster sessions, 1 each at months 7 and 10

Care as usual

Mini International Neuropsychiatric Interview 6.0; Depression (GHQ-12)

Framework analysis (qualitative data)

12 months

Incident episodes of major depression lower in the intervention. The incidence of depressive symptoms was also less

Participant Perceptions of the Psychoeducation and Active Coping Strategies, Engagement with the Lay Counsellor, Coping with Physical Health Issues, Engaging in More Pleasurable Activities, Improving Sleep Quality, Using Strategies to Reduce “Tension”, Where the Intervention Was Not Perceived to Be Helpful and Participant Recommendations

  Esmaeilzadeh and Oz (2020) [52]

Psychosocial care intervention delivered once a week group meeting session in total of nine sessions. The intervention used visual methods, question answer and discussion technique, homework, and warming games to address emotional, social, and physical problems that the elderly faced

Turkey

pretest–posttest study

44 older adults who are 65-year and above registered in the elderly day care center

each session lasted approx.. 2 h

 

GDS short form – depression; Turkish version of the WHO Quality of Life Instrument—Health-Related Quality of Life; UCLA loneliness scale—loneliness

post intervention

significant reduction in loneliness and improvement in quality of life but no significant reduction in depression

Exercise

 Ansai and Rebelatto (2015) [21]

Multicomponent training session: warm-up using cycle ergometer; aerobic exercise using cycle ergometer; strength exercises of major muscle groups; balance activities; and cool-down exercise. Resistance training group carried out three sets of 10–12 maximal repetitions, with moderate speed and 1-min resting periods between sets

Brazil

Three arm randomised control trial

69 community-dwelling older adults aged 80 years and older from São Carlos with 23 in each group

16 weeks and included three 1-h sessions per week on non-consecutive days

No intervention

GDS—Depression

Post intervention (16 weeks)

No significant differences between groups on Geriatric depression scale

 Azizan and Justine (2016) [41]

Exercise behaviour group: group-based exercise followed by behavioural program

Exercise group: only the exercise training. conducted

Malaysia

quasi-experimental, controlled study

63 older adults aged 60 and over recruited from three different villages. (a) exercise and behavioural program group (n = 18), (b) exercise only group (n = 23), and (c) control group (n = 22)

Exercise: three sessions per week, each session of 1 h for 6 weeks

Behavioural programme: two times per week for 5 weeks

advised to continue with their normal routines

Malay version of the GDS – Depression; SF-12 Health Survey – Health-related quality of life

12 weeks and 24 weeks

Significant main effect only in the level of depression among the three groups for Health-related quality of life, a significant main effect was found on the physical and mental component score

 Borbon-Castro et al. (2019) [42]

In a multidimensional exercise program, exercise classes were offered 5 days a week for 12 weeks with a total of 60 sessions. Each session lasted for 60 min, including a warm-up, a variety of exercises, and cool-down. The 12-weeks exercise sessions were divided in to six modules which increased in intensity every two weeks

Mexico

quasi-experimental, controlled study

45 older adults living in the urban community, intervention group (n = 23) and control group (n = 22). The mean age was 67.7 years for intervention and 66.6 for control group

12 weeks

advised to continue performing the activities of the center in which they were registered

GDS—Depression

1 week after the conclusion of intervention

Depression decreased in the intervention group

 Ibrahim et al. (2021) [53]

daily virtual group exercise

Malaysia

pretest–posttest study

Elderly aged 60 years and above recruited from the Promoting Independence in Seniors with Arthritis pilot cohort

4 weeks

 

Hospital Anxiety and Depression Scale – Anxiety and depression

post intervention

No significant difference in anxiety and depression scores before and after intervention

 Moraes et al. (2020) [22]

Aerobic training group performed aerobic exercise on stationary bikes or treadmills. The strength training group performed exercises for the major muscle groups

Brazil

Three arm randomised control trial

27 outpatients from the Center for Alzheimer’s Disease and Related Disorders from the Institute of Psychiatry at the Federal University of Rio de Janeiro. 9 in each group

Both groups had to perform 30 min of moderate intensity physical exercise and had to attend at least 75% of the 24 sessions in 12 weeks

30 min of low-intensity exercise for 12 weeks

HDRS and BDI- depression

Post intervention

Aerobic training and strength training groups showed significant reductions in depressive symptoms

 Ojha and Yadav (2016) [31]

yogic techniques

India

Randomised control trial

500 subjects who were retired officials (in the age group of 65–75 years), 250 in each group from municipal areas of 12 towns of eastern Bihar

half an hour daily for six months

Usual activities

Composite psychological wellbeing score – psychological well-being

post intervention

Significant improvement in composite psychological wellbeing score in intervention group

 Prakhinkit et al. (2014) [32]

The Buddhist walking meditation program based on aerobic walking exercise incorporating the Buddhist meditations. Traditional walking exercise program involved walking at mild intensity

Thailand

Three arm randomised control trial

Forty-five elderly participants aged 60–90 years with mild-to-moderate depressive symptoms were recruited from university hospital. 15 in each group

Both interventions were performed for 20 min, 3 times/week for 12 weeks

Usual activities

Thai version of GDS (long form)—depression

post intervention

Depression score decreased only in the Buddhist walking meditation group

 Shahidi et al. (2011) [33]

laughter yoga (10 sessions) and group exercise program (10 sessions)

Iran

randomised control trial

Seventy depressed old women aged 60–80 years from cultural community of Tehran with GDS score > 10. Laughter Yoga (n = 23), exercise therapy (n = 23), and control groups (n = 24)

 

No intervention

GDS – depression; Diener life satisfaction scale – Life satisfaction

post intervention

significant decrease in depression scores of both Laughter Yoga and exercise therapy group in comparison to control group. There was no significant difference between Laughter Yoga and exercise therapy groups

 Chua and de Guzman (2014) [26]

program consisting of wellness, physical fitness, and livelihood training activities facilitated by volunteer faculty from a local university

Philippines

Randomised control trial

40 community dwelling Filipino elderly aged 60–80 years. Twenty-five subjects were assigned to the intervention group while 15 subjects to the control group

4 months

no intervention

Life Satisfaction Index for the Third Age Short Form (LSITA-SF)—Life satisfaction and GDS—Depression

4 months

The intervention group had significantly higher LSITA-SF scores after the program than before it was implemented and a significant decrease in the depression level

 Ghodsbin et al. (2015) [28]

Laughter therapy, including performing breathing and physical exercises as well as laughter techniques

Iran

Randomised control trial

72 senior citizens aged 60 and over referring to Jahandidegan (Khold-e-Barin) retirement community center in Shiraz. With 36 participants in each group

Consists of two 90-min sessions per week over 6 weeks

No intervention

General Health Questionnaire (GHQ-28)

post intervention

significant improvement in mean scores for anxiety but no significant improvement in mean scores for depression in the intervention group compared to the control group

 Xu et al. (2016) [35]

Collective exercise intervention that included Baduanjin (Chinese gymnastics) and elderly ballroom dancing

China

randomised control trial

115 elderly hypertensive patients aged 60–70 years old from Fuzhou City, Fujian Province. With 58 participants in Intervention group and 57 in control group

12 weeks

No intervention

Symptom checklist 90- mental disorders and psychological illnesses

post-intervention

After intervention, the Symptom Checklist-90, total score, somatization, obsessive–compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, and paranoia scores of the intervention group were significantly lower than those of the control group

Social engagement

 Aekwarangkoon and Noonil (2020) [35]

weekly positive interpersonal interactions with grandchildren and older adults involving using words of affirmation, spending quality time, offering gifts, performing acts of service and communicating emotional love through physical contacts

Thailand

Cluster randomised control trial

80 older adults aged 60-year and above, living in 4 villages of Thasala District, Nakhon Si Thammarat Province, with 40 older adults in each group

Six weeks

Usual care

Nine-Question Scale and HDRS- depression

at 6th, 12th and 24thweek follow-up

a significant decline in Hamilton Rating Scale scores after grandchildren’s love language program

 Jacob et al. (2007) [44]

Community based day care which included recreational activities, occupational therapy, counselling services, medical services and a noon meal

India

quasi-experimental, controlled study

41 elderly residents of Pennathur village whose scores were in the lowest third on the socioeconomic status scale and on the social support scale

 

no intervention

WHO Quality of Life—BREF – Quality of Life

3 months

a significant improvement in quality-of-life scores in those who attended day care compared to those who did not attend (p < 0.001)

 Malekafzali et al. (2010) [54]

community mobilization of trained volunteers who were assigned to following tasks: home visits and face to face elderly education, referral to physicians for elderly with health problems, distribution of educational pamphlets, a general meeting question and answer session with the presence of the experts

Iran

pretest–posttest study

200 elderly patient aged 60 years and over

  

Life satisfaction (No standard validated questionnaires were used)

Post intervention

No significant findings

 Rachasrimuang et al. (2018) [39]

Trained youth volunteers were assigned for home visit to the same 6 to 7 elderly persons’ households

Thailand

Cluster randomised control trial

elderly persons, aged 60 years and over living in the study area in 9 villages of Mainapiang Sub-district, Wangyai District, Khon Kaen province

18 weeks

received conventional care by their family and children

Thai version GDS – depression; Thai version of the EQ-5D-5L developed by Mahidol University—Health-related quality of life

9th week and 12th week follow up from baseline measurement

significant reduction in depression scores in intervention group compared to control groups in the 9th-week and 18th-week follow-up. There was significant improvement in self-health perception in overall health status in intervention group compared to control group in the 18th week

Education

 Moeini et al. (2020) [9]

Four weekly educational training sessions, each session lasting 60 min comprising of lectures, group discussions, colloquy, booklets and educational pamphlets by experts

Iran

quasi-experimental, controlled study

100 older adults aged 60‐75 years in Hamadan with 40 participants in intervention group and 60 participants in control group

 

no intervention

Persian version of Oxford Argyle Happiness Inventory – happiness and a questionnaire derived from social support questionnaire

3 months

a significant improvement in the scores of happiness, social support and their components in the intervention group compared to the control group three months after the intervention

 Wang et al. (2019) [49]

Mental health lecture and training in a nurse-led Path-oriented Psychological Self-help Intervention

China

quasi-experimental, controlled study

76 empty-nest older adults from 2 districts in the city of Chifeng. 38 in each group

1 month

mental health lecture

Chinese Mental Health Scale (geriatric edition)—mental health status

3 months

The mental health status scores improved in the intervention group 1 month after baseline and sustained for 3 months after the intervention

 Yodmai et al. (2021) [10]

Health promotion program that trained family member of older adults to change health behaviours such as eating healthy food, exercising, emotion management and disability preventive activities

Thailand

quasi-experimental, controlled study

Fifty-five older adults aged 60–80 years with chronic diseases, including hypertension, diabetes, hyperlipidaemia, and heart disease in Khon Kaen Province

12 months

usual health

promoting activities by health personnel

WHO-Quality of life measurement – Quality of Life; 30-item GDS- depression

postintervention at 9th and 12th months

After the intervention, social support and perception of health care from family members were significantly improved at the 9th month. At the 12th month, overall Quality of life, sensory ability, social participation, intimacy, social support, and perception of health care from family members significantly improved. Depression was also reduced at the 12th month

Other/Multi-component

 Abdi et al. (2019) [25]

a religion-spiritual program that included strategies such as reading verses from the Holy Quran and spiritual caring services

Iran

Randomised control trial

100 Older adults with cardiovascular disease from Mostafa–Khomini hospital having a religion of Islam-Shia, 50 older adults in each group

Six educational sessions, each in a week and lasted about 30–45 min

No intervention

BDI– depression; LSI-Z—Life satisfaction

3 months

Higher mean life satisfaction scores and lower mean depression scores in intervention group than control group post intervention

 Carandang et al.(2020) [43]

Peer counselling group: Peer counsellors performed 1-h home visits weekly to their assigned clients

Social engagement group: Senior citizens joined 3-h weekly social events held at the OSCA Center

Combination group: both peer counselling and social engagement interventions

Philippines

4-arm quasi-experimental, controlled study

270 community-dwelling Filipino senior citizens with mean age was 68.3 years, who had tendency towards depression based on the 15-item Geriatric Depression Scale. peer counselling (n = 65), social engagement (n = 66), and combination (n = 65) and control group (n = 68)

3 months

usual or standard care from

health and aged care services

GDS—Depression. 8-item UCLA Loneliness Scale—Loneliness

3 months

Social engagement and combined intervention had a large effect on reducing depressive symptoms while peer counselling had only moderate effect. All interventions had only small effect on improving loneliness

 Ebrahimi et al. (2020) [27]

In one group, older adults received intergenerational programs plus aerobic exercises in the presence of young adults, and in other group they received intergenerational programs only

Iran

Three arm randomised control trial

150 older adults (mean age, 71.4 years) and 100 students (mean age, 21.8 years) living in Mashhad

8 weeks

Daily routine activities

WHO Quality of Life, BREF – Quality of Life

postintervention at 8 weeks from baseline assessment

a significant difference in the mean scores of quality-of-life dimensions between the three groups

 Zhan et al. (2018) [50]

mental health services including knowledge about healthy mental state, psychological consultation/treatment, and access to a psychiatric hotline

China

quasi-experimental, controlled study

2,000 elderly residents, aged 60 years and above in the Longhua sub-district of Shanghai

1 year

Only the basic mental health services

Generalized Anxiety Disorder 7-item scale – Anxiety and depression; PHQ-9 and Quality of Life Index – quality of life and General Well-Being Schedule (GWB) – wellbeing

6 months and 12 months

PHQ-9 and GAD-7 scores gradually decreased and GWB score gradually increased in intervention group. After 12 months, compared the control group, the scores of subscales in GWB satisfaction and interest in life, worries about health, depressed versus cheerful mood, and relaxation versus tension (anxiety) were significantly better

 Rana et al. (2009) [45]

Community based intervention that included physical activity, advice on healthy food intake and other aspects of management. Social awareness was provided by means of information about the contribution of and challenges faced by older adults at home and the community, including information about older adults’ health and health care. Intervention activities provided to older adults, caregivers, household members and community people

Bangladesh

quasi-experimental, controlled study

839 elderly persons (≥ 60 years) eight randomly selected villages (Intervention: n = 4; Control: n = 4) in rural Bangladesh. 425 elderly persons in the intervention group and 414 in the control group

15 months

No intervention

Health related quality of life – generic instrument

3 months after intervention

significant differences noted in the physical, social, spiritual, environment and overall Health related quality of life

 Zhang et al. (2021) [37]

Self-Mutual-Group based intervention, which consisted of three stages: self-management (2 months), mutual management (2 months), and group-management (3 months)

China

randomised control trial

396 empty-nest older adults in Taiyuan, Shanxi. With 204 participants in the intervention group and 192 in control group

7 months

No intervention

Short Form 36-Item Health Survey – Quality of Life

postintervention (7th month)

After the intervention, participants’ scores on Mental Component Summary, Physical Component Summary, role emotional, vitality, social function, mental health and general health increased significantly in the intervention group

 Li et al. (2020) [56, 64]

The Collaborative Care for Older People with Comorbid Hypertension and Depression (COACH) model integrates the care provided by the older person's primary care provider (PCP) with that delivered by an Aging Worker (AW) from the village's Aging Association, supervised by a psychiatrist consultant

China

Five focus groups: two with VDs, two with AWs, and one with psychiatrists

   

iterative process

 

Facilitators to implementation include training, leaders’ support, geographic proximity between VD and AW pairs, pre-existing relationships among care team members, comparability of COACH activities and existing practices of VDs and AWs, and care team members’ caring about older members of their villages. Barriers to sustainability include frustration of some VDs related to their low wages and feelings of overload of some AWs

  1. Legend. DASS Depression Anxiety Stress Scales, GDS Geriatric depression scale, WHO World Health Organization, LSI Life Satisfaction Index A, HDRS Hamilton Depression Rating Scale, BDI Beck Depression Inventory, OHQ Oxford Happiness Questionnaire.