{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:22:40Z","timestamp":1792621360489,"version":"4.5.0"},"reference-count":54,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004564","name":"Ministarstvo Prosvete, Nauke i Tehnolo\u0161kog Razvoja","doi-asserted-by":"publisher","award":["451-03-136\/2025-03\/200015"],"award-info":[{"award-number":["451-03-136\/2025-03\/200015"]}],"id":[{"id":"10.13039\/501100004564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Affective Disorders"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.jad.2025.120859","type":"journal-article","created":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T15:14:24Z","timestamp":1765120464000},"page":"120859","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Real-world evaluation of at-home cranial electrotherapy stimulation (CES) for the management of sleep, anxiety, depression, stress, quality of life, and self-efficacy"],"prefix":"10.1016","volume":"396","author":[{"given":"Ksenija Maravic","family":"da Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clementine","family":"Broom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey","family":"Daly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Willis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovana","family":"Bjekic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jad.2025.120859_bb0005","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1017\/S0033291713001943","article-title":"Barriers to mental health treatment: results from the WHO World Mental Health surveys","volume":"44","author":"Andrade","year":"2014","journal-title":"Psychol. Med."},{"key":"10.1016\/j.jad.2025.120859_bb0010","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.cnp.2022.05.002","article-title":"Non-invasive brain stimulation and neuroenhancement","volume":"7","author":"Antal","year":"2022","journal-title":"Clin. Neurophysiol. Pract."},{"key":"10.1016\/j.jad.2025.120859_bb0015","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jad.2014.04.029","article-title":"A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression","volume":"164","author":"Barclay","year":"2014","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120859_bb0020","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jad.2014.04.029","article-title":"A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression","volume":"164","author":"Barclay","year":"2014","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120859_bb0025","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Med."},{"key":"10.1016\/j.jad.2025.120859_bb0030","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1192\/bjp.bp.115.164715","article-title":"Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data","volume":"208","author":"Brunoni","year":"2016","journal-title":"Br. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120859_bb0035","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/ana.25387","article-title":"Challenges of differential placebo effects in contemporary medicine: the example of brain stimulation","volume":"85","author":"Burke","year":"2019","journal-title":"Ann. Neurol."},{"key":"10.1016\/j.jad.2025.120859_bb0040","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"10.1016\/j.jad.2025.120859_bb0045","first-page":"383","article-title":"Remotely supervised transcranial direct current stimulation increases the benefit of at-home cognitive training in multiple sclerosis. neuromodulation: technology at the neural","volume":"21","author":"Charvet","year":"2018","journal-title":"Interface"},{"key":"10.1016\/j.jad.2025.120859_bb0050","article-title":"Efficacy and tolerability of cranial electrotherapy stimulation in the treatment of anxiety: a systemic review and meta-analysis","volume":"13","author":"Ching","year":"2022","journal-title":"Front. Psych."},{"key":"10.1016\/j.jad.2025.120859_bb0055","article-title":"Efficacy and tolerability of cranial electrotherapy stimulation in the treatment of anxiety: a systemic review and meta-analysis","volume":"13","author":"Ching","year":"2022","journal-title":"Front. Psych."},{"key":"10.1016\/j.jad.2025.120859_bb0060","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.jfma.2023.12.002","article-title":"Effect of cranial electrotherapy stimulation as an add-on therapy on late-life generalized anxiety disorder: an open-label study","volume":"123","author":"Chu","year":"2024","journal-title":"J. Formos. Med. Assoc."},{"key":"10.1016\/j.jad.2025.120859_bb0065","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1590\/1516-4446-2020-1448","article-title":"\u201cI don\u2019t need any treatment\u201d \u2013 barriers to mental health treatment in the general population of a megacity","volume":"43","author":"Co\u00ealho","year":"2021","journal-title":"Braz. J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120859_bb0070","series-title":"The Social Psychology of Health","first-page":"31","article-title":"Perceived stress in a probability sample of the United States","author":"Cohen","year":"1988"},{"key":"10.1016\/j.jad.2025.120859_bb0075","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"10.1016\/j.jad.2025.120859_bb0080","article-title":"Transcranial direct current stimulation with the Halo Sport does not improve performance on a three-minute high intensity cycling test","volume":"14","author":"Garner","year":"2021","journal-title":"Int. J. Exerc. Sci."},{"key":"10.1016\/j.jad.2025.120859_bb0085","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1038\/s44220-025-00391-w","article-title":"Transforming the evidence landscape in mental health with platform trials","volume":"3","author":"Gold","year":"2025","journal-title":"Nat. Ment. Health"},{"key":"10.1016\/j.jad.2025.120859_bb0090","doi-asserted-by":"crossref","DOI":"10.1108\/MHRJ-11-2022-0068","article-title":"Alpha-Stim AID cranial electrotherapy stimulation (CES) anxiety treatment: anxiety, depression and health-related quality-of-life outcomes in primary health-care social prescribing services","author":"Griffiths","year":"2023","journal-title":"Ment. Health Rev. J."},{"key":"10.1016\/j.jad.2025.120859_bb0095","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4236\/ojd.2025.142003","article-title":"Transcranial direct current stimulation (tDCS) and online wellbeing training used at home for perinatal and maternal loss patients with a diagnosis of depression: depression, real world-functioning, and quality of life outcomes","volume":"14","author":"Griffiths","year":"2025","journal-title":"Open J. Depression"},{"key":"10.1016\/j.jad.2025.120859_bb0100","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res."},{"key":"10.1016\/j.jad.2025.120859_bb0105","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","article-title":"A new method for measuring daytime sleepiness: the epworth sleepiness scale","volume":"14","author":"Johns","year":"1991","journal-title":"Sleep"},{"key":"10.1016\/j.jad.2025.120859_bb0110","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/jlb\/lsv017","article-title":"Early adopters of the magical thinking cap: a study on do-it-yourself (DIY) transcranial direct current stimulation (tDCS) user community","volume":"2","author":"Jwa","year":"2015","journal-title":"J. Law Biosci."},{"key":"10.1016\/j.jad.2025.120859_bb0115","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/mpr.1359","article-title":"Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States","volume":"21","author":"Kessler","year":"2012","journal-title":"Int. J. Methods Psychiatr. Res."},{"key":"10.1016\/j.jad.2025.120859_bb0120","doi-asserted-by":"crossref","first-page":"186","DOI":"10.15540\/nr.10.3.186","article-title":"Effectiveness of low frequency noninvasive brain stimulation therapy for improving neuropsychological and neurophysiological functions: a systematic review","volume":"10","author":"Khan","year":"2023","journal-title":"NeuroRegulation"},{"key":"10.1016\/j.jad.2025.120859_bb0125","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.psc.2013.01.006","article-title":"Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia","volume":"36","author":"Kirsch","year":"2013","journal-title":"Psychiatr. Clin. N. Am."},{"key":"10.1016\/j.jad.2025.120859_bb0130","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: a new depression diagnostic and severity measure","volume":"32","author":"Kroenke","year":"2002","journal-title":"Psychiatr. Ann."},{"key":"10.1016\/j.jad.2025.120859_bb0135","first-page":"e260","article-title":"Adherence to medication under mandatory and voluntary mail benefit designs","volume":"17","author":"Liberman","year":"2011","journal-title":"Am. J. Manag. Care"},{"key":"10.1016\/j.jad.2025.120859_bb0140","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.neubiorev.2015.07.012","article-title":"Transcranial direct current stimulation (tDCS) in the treatment of depression: systematic review and meta-analysis of efficacy and tolerability","volume":"57","author":"Meron","year":"2015","journal-title":"Neurosci. Biobehav. Rev."},{"key":"10.1016\/j.jad.2025.120859_bb0145","doi-asserted-by":"crossref","first-page":"s34","DOI":"10.1017\/cjn.2023.24","article-title":"Placebo effects and neuromodulation: ethical considerations and recommendations","volume":"50","author":"Mollica","year":"2023","journal-title":"Can. J. Neurol. Sci."},{"key":"10.1016\/j.jad.2025.120859_bb0150","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.jad.2020.09.006","article-title":"Differential effects of cranial electrotherapy stimulation on changes in anxiety and depression symptoms over time in patients with generalized anxiety disorder","volume":"277","author":"Morriss","year":"2020","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120859_bb0155","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jad.2019.04.020","article-title":"Clinical effectiveness and cost minimisation model of Alpha-Stim cranial electrotherapy stimulation in treatment seeking patients with moderate to severe generalised anxiety disorder","volume":"253","author":"Morriss","year":"2019","journal-title":"J. Affect. Disord."},{"key":"10.1016\/j.jad.2025.120859_bb0160","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S2215-0366(23)00007-X","article-title":"Clinical effectiveness of active Alpha-Stim AID versus sham Alpha-Stim AID in major depression in primary care in England (Alpha-Stim-D): a multicentre, parallel group, double-blind, randomised controlled trial","volume":"10","author":"Morriss","year":"2023","journal-title":"Lancet Psychiatry"},{"key":"10.1016\/j.jad.2025.120859_bb0165","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.neubiorev.2018.05.015","article-title":"Efficacy and acceptability of non-invasive brain stimulation for the treatment of adult unipolar and bipolar depression: a systematic review and meta-analysis of randomised sham-controlled trials","volume":"92","author":"Mutz","year":"2018","journal-title":"Neurosci. Biobehav. Rev."},{"key":"10.1016\/j.jad.2025.120859_bb0170","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1179\/2045772313Y.0000000140","article-title":"Invasive and non-invasive brain stimulation for treatment of neuropathic pain in patients with spinal cord injury: a review","volume":"37","author":"Nardone","year":"2014","journal-title":"J. Spinal Cord Med."},{"key":"10.1016\/j.jad.2025.120859_bb0175","series-title":"Alpha-Stim AID for anxiety disorders [WWW Document]. Medical technologies guidance MTG56","author":"National Institute for Health and Care Excellence","year":"2021"},{"key":"10.1016\/j.jad.2025.120859_bb0180","doi-asserted-by":"crossref","DOI":"10.1111\/jsr.13628","article-title":"Sleep, insomnia and mental health","volume":"31","author":"Palagini","year":"2022","journal-title":"J. Sleep Res."},{"key":"10.1016\/j.jad.2025.120859_bb0185","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1002\/jrsm.1101","article-title":"Opportunities and challenges in using studies without a control group in comparative effectiveness reviews","volume":"5","author":"Paulus","year":"2014","journal-title":"Res. Synth. Methods"},{"key":"10.1016\/j.jad.2025.120859_bb0190","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.brs.2022.04.014","article-title":"Tolerability and feasibility of at-home remotely supervised transcranial direct current stimulation (RS-tDCS): single-center evidence from 6,779 sessions","volume":"15","author":"Pilloni","year":"2022","journal-title":"Brain Stimul."},{"key":"10.1016\/j.jad.2025.120859_bb0195","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.pnpbp.2017.10.016","article-title":"A systematic review and meta-analysis on placebo response to repetitive transcranial magnetic stimulation for depression trials","volume":"81","author":"Razza","year":"2018","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"10.1016\/j.jad.2025.120859_bb0200","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1080\/02687038.2022.2076279","article-title":"Feasibility of remotely supervised transcranial direct current stimulation (RS-tDCS) for people with stroke-induced and progressive aphasia","volume":"37","author":"Richardson","year":"2023","journal-title":"Aphasiology"},{"key":"10.1016\/j.jad.2025.120859_bb0205","series-title":"Measures in Health Psychology: A User\u2019s Portfolio. Causal and Control Beliefs","first-page":"35","article-title":"Generalized self-efficacy scale","author":"Schwarzer","year":"1995"},{"key":"10.1016\/j.jad.2025.120859_bb0210","doi-asserted-by":"crossref","first-page":"414","DOI":"10.7326\/M17-1970","article-title":"Benefits and harms of cranial electrical stimulation for chronic painful conditions, depression, anxiety, and insomnia","volume":"168","author":"Shekelle","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"10.1016\/j.jad.2025.120859_bb0215","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4236\/ojpsych.2025.152010","article-title":"Transcranial direct current stimulation (tDCS) used at home for people with a diagnosis of depression: sleep quality outcomes","volume":"15","author":"da Silva","year":"2025","journal-title":"Open J. Psychiatry"},{"key":"10.1016\/j.jad.2025.120859_bb0220","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1123\/jpah.10.3.359","article-title":"Are older adults who volunteer to participate in an exercise study fitter and healthier than nonvolunteers? The participation bias of the study population","volume":"10","author":"de Souto Barreto","year":"2013","journal-title":"J. Phys. Act. Health"},{"key":"10.1016\/j.jad.2025.120859_bb0225","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"10.1016\/j.jad.2025.120859_bb0230","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1477-7525-5-63","article-title":"The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation","volume":"5","author":"Tennant","year":"2007","journal-title":"Health Qual. Life Outcomes"},{"key":"10.1016\/j.jad.2025.120859_bb0235","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1089\/107555301300328070","article-title":"The efficacy paradox in randomized controlled trials of CAM and elsewhere: beware of the placebo trap","volume":"7","author":"Walach","year":"2001","journal-title":"J. Altern. Complement. Med."},{"key":"10.1016\/j.jad.2025.120859_bb0240","doi-asserted-by":"crossref","DOI":"10.1093\/jlb\/lsv039","article-title":"A pragmatic analysis of the regulation of consumer transcranial direct current stimulation (TDCS) devices in the United States: table 1","author":"Wexler","year":"2015","journal-title":"J. Law Biosci."},{"key":"10.1016\/j.jad.2025.120859_bb0245","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1136\/medethics-2015-102704","article-title":"The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals","volume":"42","author":"Wexler","year":"2016","journal-title":"J. Med. Ethics"},{"key":"10.1016\/j.jad.2025.120859_bb0250","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1080\/21507740.2019.1665138","article-title":"Direct-to-consumer neurotechnology: a grounded appraisal","volume":"10","author":"Wexler","year":"2019","journal-title":"AJOB Neurosci."},{"key":"10.1016\/j.jad.2025.120859_bb0255","first-page":"234","article-title":"Oversight of direct-to-consumer neurotechnologies","volume":"363","author":"Wexler","year":"2019","journal-title":"Science (1979)"},{"key":"10.1016\/j.jad.2025.120859_bb0260","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.euroneuro.2011.07.018","article-title":"The size and burden of mental disorders and other disorders of the brain in Europe 2010","volume":"21","author":"Wittchen","year":"2011","journal-title":"Eur. Neuropsychopharmacol."},{"key":"10.1016\/j.jad.2025.120859_bb0265","series-title":"Integrated operational framework for mental health, brain health and substance use. Geneva","author":"World Health Organization","year":"2024"},{"key":"10.1016\/j.jad.2025.120859_bb0270","doi-asserted-by":"crossref","DOI":"10.1016\/j.psychres.2024.116340","article-title":"Comparative efficacy of multiple non-invasive brain stimulation to treat major depressive disorder in older patients: a systematic review and network meta-analysis study based on randomized controlled trials","volume":"344","author":"Yang","year":"2025","journal-title":"Psychiatry Res."}],"container-title":["Journal of Affective Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165032725023018?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0165032725023018?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:31:46Z","timestamp":1767969106000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0165032725023018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":54,"alternative-id":["S0165032725023018"],"URL":"https:\/\/doi.org\/10.1016\/j.jad.2025.120859","relation":{},"ISSN":["0165-0327"],"issn-type":[{"value":"0165-0327","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Real-world evaluation of at-home cranial electrotherapy stimulation (CES) for the management of sleep, anxiety, depression, stress, quality of life, and self-efficacy","name":"articletitle","label":"Article Title"},{"value":"Journal of Affective Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jad.2025.120859","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"120859"}}