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McCall H, Dear BF, Landry C, Beahm JD, Gregory J, Titov N, Carleton RN, Hadjistavropoulos HD. Internet-delivered cognitive behavioural therapy for symptoms of PTSD among public safety personnel: Initial outcomes of an open cohort preference trial of transdiagnostic and disorder-specific therapy. Internet Interv 2023; 33:100656. [PMID: 37609530 PMCID: PMC10440509 DOI: 10.1016/j.invent.2023.100656] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
Public safety personnel (PSP) face high rates of mental health problems and many barriers to care. Initial outcomes of transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) tailored for PSP are promising, but prior research has not evaluated outcomes of PTSD-specific ICBT among PSP or PSP's preferences for transdiagnostic or PTSD-specific ICBT. The current paper presents the initial outcomes (N = 150) of a mixed-methods observational study designed to (a) investigate preferences for transdiagnostic or PTSD-specific ICBT among PSP with elevated symptoms of PTSD and/or a primary concern with PTSD symptoms and (b) explore potential differences in client engagement, satisfaction, and symptom changes between the two forms of ICBT. PSP completed questionnaires before and after their preferred ICBT program. Mixed-methods analyses included generalized estimating equations, descriptive statistics, and inductive conventional qualitative content analysis. More clients (n = 85; 57 %) selected transdiagnostic ICBT than PTSD-specific ICBT (n = 65; 43 %), but the difference in the number of clients who selected each course was not statistically significant. Clients in both ICBT programs reported similar and favorable treatment satisfaction (e.g., 98 % would recommend the course to a friend), treatment engagement (i.e., 69 % accessed at least four of the five lessons), and pre-post improvement in symptoms (e.g., Hedges' g = 0.81 for reduction in PTSD symptom). Transdiagnostic ICBT resulted in greater reductions in symptoms of panic disorder than PTSD-specific ICBT. Qualitative analyses showed similarities across the ICBT programs in client feedback. The current study provides further evidence supporting the use and outcomes of ICBT for PSP in both transdiagnostic and disorder-specific formats. Implications for the literatures on PSP mental health and ICBT, as well as practical recommendations, are discussed.
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Affiliation(s)
- Hugh McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Blake F. Dear
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
- eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - Caeleigh Landry
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Janine D. Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Julia Gregory
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nickolai Titov
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
- eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
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102
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Murayama Y, Yamazaki S, Hasebe M, Kobayashi E. Effects of adverse life events on mental health in single older adults in Japan. Psychogeriatrics 2023; 23:838-846. [PMID: 37438095 DOI: 10.1111/psyg.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 04/18/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND This study tested a hypothesised model of the effects of adverse life events on the mental health of middle-aged and older adults living alone, as mediated by thought suppression and help-seeking behaviours, considering gender differences. METHODS A questionnaire survey was conducted on a sample of 1202 (622 men; 580 women) individuals from 247445 residents aged 50-79 in District A of Tokyo. The questionnaire items covered parameters on adverse life events, help-seeking behaviour, thought suppression, and mental health status. RESULTS Multiple group structural equation-modelling analysis revealed that the seriousness of adverse life events, help-seeking behaviours, and mental health scores were higher in women than in men. No significant gender differences were observed in thought suppression. The findings support all three proposed hypotheses: severe adverse life events will: (a) give rise to help-seeking behaviours, which will have a positive effect on mental health; (b) intensify thought suppression, which will harm mental health; and (c) inhibit help-seeking behaviour, especially in single middle-aged and older adult men. CONCLUSION There is a need to develop interventional programs based on the theory of replacement thinking to encourage help-seeking behaviours in middle-aged and older adults.
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Affiliation(s)
- Yoh Murayama
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Sachiko Yamazaki
- Department of Human Studies, Bunkyo Gakuin University, Saitama, Japan
| | - Masami Hasebe
- Department of Human Welfare, Seigakuin University, Saitama, Japan
| | - Erika Kobayashi
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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103
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Wen A, Wolitzky-Taylor K, Gibbons RD, Craske M. A randomized controlled trial on using predictive algorithm to adapt level of psychological care for community college students: STAND triaging and adapting to level of care study protocol. Trials 2023; 24:508. [PMID: 37553688 PMCID: PMC10410881 DOI: 10.1186/s13063-023-07441-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/08/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND There is growing interest in using personalized mental health care to treat disorders like depression and anxiety to improve treatment engagement and efficacy. This randomized controlled trial will compare a traditional symptom severity decision-making algorithm to a novel multivariate decision-making algorithm for triage to and adaptation of mental health care. The stratified levels of care include a self-guided online wellness program, coach-guided online cognitive behavioral therapy, and clinician-delivered psychotherapy with or without pharmacotherapy. The novel multivariate algorithm will be comprised of baseline (for triage and adaptation) and time-varying variables (for adaptation) in four areas: social determinants of mental health, early adversity and life stressors, predisposing, enabling, and need influences on health service use, and comprehensive mental health status. The overarching goal is to evaluate whether the multivariate algorithm improves adherence to treatment, symptoms, and functioning above and beyond the symptom-based algorithm. METHODS/DESIGN This trial will recruit a total of 1000 participants over the course of 5 years in the greater Los Angeles Metropolitan Area. Participants will be recruited from a highly diverse sample of community college students. For the symptom severity approach, initial triaging to level of care will be based on symptom severity, whereas for the multivariate approach, the triaging will be based on a comprehensive set of baseline measures. After the initial triaging, level of care will be adapted throughout the duration of the treatment, utilizing either symptom severity or multivariate statistical approaches. Participants will complete computerized assessments and self-report questionnaires at baseline and up to 40 weeks. The multivariate decision-making algorithm will be updated annually to improve predictive outcomes. DISCUSSION Results will provide a comparison on the traditional symptom severity decision-making and the novel multivariate decision-making with respect to treatment adherence, symptom improvement, and functional recovery. Moreover, the developed multivariate decision-making algorithms may be used as a template in other community college settings. Ultimately, findings will inform the practice of level of care triage and adaptation in psychological treatments, as well as the use of personalized mental health care broadly. TRIAL REGISTRATION ClinicalTrials.gov NCT05591937, submitted August 2022, published October 2022.
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Affiliation(s)
- Alainna Wen
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, 760 Westwood Plaza, Suite 28-216, CA, 90024, Los Angeles, USA
| | - Kate Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, 760 Westwood Plaza, Suite 28-216, CA, 90024, Los Angeles, USA
| | - Robert D Gibbons
- Center for Health Statistics, University of Chicago, 5841 S. Maryland Avenue MC 2007, Office W260, Chicago, IL, 60637, USA
| | - Michelle Craske
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, 760 Westwood Plaza, Suite 28-216, CA, 90024, Los Angeles, USA.
- Department of Psychology, University of California - Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, USA.
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104
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Norris LA, Rabner JC, Crane ME, Cervin M, Ney JS, Benito KG, Kendall PC, Frank HE. What caregivers like the most (and least) about cognitive behavioral therapy for youth anxiety: A mixed methods approach. J Anxiety Disord 2023; 98:102742. [PMID: 37343420 DOI: 10.1016/j.janxdis.2023.102742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/29/2023] [Accepted: 06/14/2023] [Indexed: 06/23/2023]
Abstract
Cognitive behavioral therapy (CBT) is an efficacious therapy for youth anxiety disorders. Caregivers are key stakeholders in youth therapy, and their feedback on treatment can help to inform intervention personalization. This mixed-methods study applied a systematic inductive thematic analysis to identify themes among most- and least-liked CBT features reported by caregivers using open-ended responses on the Client Satisfaction Questionnaire (CSQ-8). The sample included 139 caregivers of youth ages 7-17 (M = 12.21, SD = 3.05; 59% female; 79.1% Caucasian, 5.8% Black, 2.9% Asian, 2.2% Hispanic, 7.9% Multiracial, 2.2% Other) with principal anxiety diagnoses who completed 16-sessions of CBT. CSQ-8 quantitative satisfaction scores (M = 29.18, SD = 3.30; range: 16-32) and survey-based treatment response rates (responders n = 93, 67%) were high. Most-liked treatment features included: coping skills (i.e., exposure, understanding/identifying anxiety, rewards, homework), therapist factors (interpersonal style/skill, relationship, accessibility), caregiver involvement, one-on-one time with a therapist, structure, consistency, and personally tailored treatment. Least-liked treatment features included: questionnaires, logistical barriers, telehealth, need for more sessions, non-anxiety concerns not addressed, insufficient caregiver involvement, and aspects of exposure tasks. Proportional frequencies of most- and least-liked themes differed by treatment responder status (e.g., responders cited exposure and homework as most-liked more frequently).
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Affiliation(s)
- Lesley A Norris
- Department of Psychology, Temple University, Philadelphia, PA, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | | | - Margaret E Crane
- Department of Psychology, Temple University, Philadelphia, PA, USA; Department of Psychiatry, Weill Cornell Medicine, New York City, NY, USA
| | - Matti Cervin
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Julia S Ney
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Kristen G Benito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Hannah E Frank
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
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105
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Dan VH, Ponnuchamy L, Anand NK, Bhaskarapillai B, Sharma MK. Resilience and self-compassion among persons with depressive disorders: Prerequisite for a positive mental health approach. J Family Med Prim Care 2023; 12:1621-1628. [PMID: 37767454 PMCID: PMC10521843 DOI: 10.4103/jfmpc.jfmpc_2270_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/22/2023] [Accepted: 05/24/2023] [Indexed: 09/29/2023] Open
Abstract
Background Treatment gap for common mental health problems, especially of the depressive disorders is consequential in developing countries like India. Positive mental health domains like resilience and self-compassion have been long hailed as protective factors against depression and viable for use in therapeutic aspects. The objectives were to find an association between resilience, self-compassion, and depression. Methods The study was conducted using a cross-sectional design among 75 respondents who were seeking treatment for major depressive disorders from a tertiary care center during the second wave of COVID-19. Three scales were administered online, namely Beck's Depression Inventory-II (BDI-II), Connor Davidson Resilience Scale (CD RISC-25), and Self-Compassion Scale-Short Form (SCS-SF). Spearman's rank correlation test, Chi-square with Fisher's exact test, and Kruskal Wallis H test were used to study the relationships and differences in average scores with respect to the severity of depression. Results Most of the respondents had moderate depressive features along with moderately high levels of resilience (CD RISC 25) and self-compassion (SCS-SF) scores. Resilience and self-compassion were found to have no significant relationship with respect to the severity of depression. There was a weakly positive correlation between resilience and self-compassion among those with moderate and severe depression. Conclusion Since the individuals with depression had higher scores on resilience and self-compassion, the levels of depression remained at moderate levels of severity despite the devastating impact of the second wave of COVID-19 in the Indian sub-continent. Results are to be interpreted with respect to psychosocial contexts arising during the COVID-19 pandemic. Mental health programs can incorporate the variables of resilience and self-compassion in intervention among individuals with depression which have likely been beneficial in their process of recovery.
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Affiliation(s)
- V Hubert Dan
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Lingam Ponnuchamy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Nitin K. Anand
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Binukumar Bhaskarapillai
- Department of Biostatistics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Manoj K. Sharma
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
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106
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Pettus C, Fulmer R, Pederson SD, Eikenberry J. Study protocol paper for the multi-site feasibility evaluation of mobile and technology-assisted aftercare services for crisis stabilization units. Pilot Feasibility Stud 2023; 9:135. [PMID: 37525253 PMCID: PMC10388447 DOI: 10.1186/s40814-023-01361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/10/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Law enforcement frequently responds to substance abuse and mental health crises. Crisis stabilization units (CSUs) operate as a public-receiving facility to provide short-term stabilization services for individuals experiencing these crises and offer law enforcement an important alternative to arrest. However, there is limited understanding about how and when law enforcement decides to use CSUs. There is also the challenge of retaining individuals in treatment after CSU stabilization to prevent future crises and persistent engagement with police. This study will respond to these gaps by exploring CSU procedures and examining the feasibility and acceptability of a technology-assisted mobile aftercare intervention designed for individuals brought to a CSU by law enforcement. METHODS This study will consist of three aims. Aim 1 will include qualitative interviews with law enforcement and CSU-affiliated mental health staff (n=80) regarding CSU utilization and collaboration logistics between the groups. Findings from Aim 1 will be synthesized for the development of an implementation guide of our intervention, mobile, and technology-assisted aftercare, designed for individuals brought to a CSU by law enforcement, during Aim 2. During Aim 2, intervention services will be pilot-tested for 6 months through a small sample (n=24), randomized control trial (RCT). Control participants will receive standard services available for individuals discharging from a CSU. Treatment participants will receive the mobile aftercare intervention. Qualitative and quantitative data will be collected at 2 weeks, 3 months, and 6 months post-recruitment for all study participants. Aims 1 and 2 will inform the design of a multi-site RCT to compare CSUs with and without mobile and technology-assisted aftercare (Aim 3). DISCUSSION The study will offer decision making and procedural insight into law enforcement use of CSUs as an alternative to jail and provide opportunities to inform that process. This research will provide outcome trends for those who go through standard CSU services compared to those who receive mobile and technology-assisted aftercare services. The current study will inform a larger RCT efficacy study of CSUs with and without technology-assisted aftercare services. TRIAL REGISTRATION This study was registered on ClinicalTrials.gov (reference #NCT04899934) on May 25, 2021.
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Affiliation(s)
- Carrie Pettus
- Wellbeing and Equity Innovations, PO Box 14641, Tallahassee, FL, 32317, USA.
| | - Rachel Fulmer
- Wellbeing and Equity Innovations, PO Box 14641, Tallahassee, FL, 32317, USA
| | - Shelby D Pederson
- Institute for Justice Research and Development, Florida State University, 2010 Levy Ave, Suite 3400, Tallahassee, FL, 32310, USA
| | - Jacob Eikenberry
- Colorado Mesa University, 1100 North Avenue, Grand Junction, CO, 81501-3122, USA
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107
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Wolitzky-Taylor K, LeBeau R, Arnaudova I, Barnes-Horowitz N, Gong-Guy E, Fears S, Congdon E, Freimer N, Craske M. A Novel and Integrated Digitally Supported System of Care for Depression and Anxiety: Findings From an Open Trial. JMIR Ment Health 2023; 10:e46200. [PMID: 37486735 PMCID: PMC10407647 DOI: 10.2196/46200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND The global burden of anxiety and depression has created an urgent need for scalable approaches to increase access to evidence-based mental health care. The Screening and Treatment for Anxiety and Depression (STAND) system of care was developed to meet this need through the use of internet-connected devices for assessment and provision of treatment. STAND triages to level of care (monitoring only, digital therapy with coaches, digital therapy assisted by clinicians in training, and clinical care) and then continuously monitors symptoms to adapt level of care. Triaging and adaptation are based on symptom severity and suicide risk scores obtained from computerized adaptive testing administered remotely. OBJECTIVE This article discusses how the STAND system of care improves upon current clinical paradigms, and presents preliminary data on feasibility, acceptability, and effectiveness of STAND in a sample of US-based university students. METHODS US-based university students were recruited and enrolled in an open trial of the STAND system of care. Participants were triaged based on initial symptom severity derived from a computerized adaptive test and monitored over 40 weeks on anxiety, depression, and suicide risk to inform treatment adaptation and evaluate preliminary effectiveness. RESULTS Nearly 5000 students were screened and 516 received care. Depression and anxiety severity scores improved across all tiers (P<.001 in all cases). Suicide risk severity improved in the highest tier (ie, clinical care; P<.001). Acceptability and feasibility were demonstrated. CONCLUSIONS STAND is a feasible and acceptable model of care that can reach large numbers of individuals. STAND showed preliminary effectiveness on all primary outcome measures. Current directions to improve STAND are described.
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Affiliation(s)
- Kate Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, United States
| | - Richard LeBeau
- Department of Psychology, University of California - Los Angeles, Los Angeles, CA, United States
| | - Inna Arnaudova
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, United States
| | - Nora Barnes-Horowitz
- Department of Psychology, University of California - Los Angeles, Los Angeles, CA, United States
| | - Elizabeth Gong-Guy
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, United States
| | - Scott Fears
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, United States
- Greater Los Angeles Veterans Administration, Los Angeles, CA, United States
| | - Eliza Congdon
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, United States
| | - Nelson Freimer
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, United States
| | - Michelle Craske
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, United States
- Department of Psychology, University of California - Los Angeles, Los Angeles, CA, United States
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108
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Velten J, Margraf J. Exploring barriers and facilitators to women's intention and behavior to seek treatment for distressing sexual problems. PLoS One 2023; 18:e0288205. [PMID: 37463132 DOI: 10.1371/journal.pone.0288205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
Many women experience distressing problems with sexual functioning, most commonly in the form of low sexual desire or arousal, difficulties reaching orgasm, or genito-pelvic pain with sexual activity. Although effective treatments are available, more than half of the women who experience distressing sexual problems do not seek professional help. Understanding help-seeking patterns, experiences with treatment providers, and barriers to treatment is crucial to address this underutilization. Examining the role of personal characteristics, sexual problem symptoms, and cognitive factors in explaining the intention to seek treatment can help identify individuals who are most reluctant to seek help. Psychological online interventions are a promising resource to increase the availability of effective treatments. Knowledge about the predictors of women's intention to use internet-delivered treatments, as well as information about personal preferences regarding their scope, can help tailor them to women's needs. To address these research questions, cross-sectional data of 800 women (Mage = 30.49, range = 18-73) were analyzed. While many women considered clinical psychologists to be the most qualified treatment providers, gynecologists were cited as the most likely first point of contact. Among women not utilizing any treatments, many reported a preference for dealing with a sexual problem on their own as a reason not to seek help. Higher help-seeking intention was related to living in a larger city, experiencing higher sexual distress, experiencing pain or difficulties with vaginal penetration, higher self-stigma. and lower sexual assertiveness. Women who were convinced of the effectiveness of psychological online interventions and who appreciated the benefits of anonymity indicated that they were more likely to use them. Understanding what factors influence women's decisions about whether or not to seek professional help for distressing sexual problems is key to reducing the underutilization of available resources and developing treatments that meet their needs and preferences.
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Affiliation(s)
- Julia Velten
- Mental Health Research and Treatment Center, Ruhr University Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr University Bochum, Germany
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109
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Salimuddin S, Beshai S, Iskric A, Watson L. Framing Effects of Cognitive Behavioural Therapy for Depression on Perceptions of Believability, Acceptability, and Credibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6330. [PMID: 37510563 PMCID: PMC10379820 DOI: 10.3390/ijerph20146330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
While CBT is an effective treatment for depression, uptake can be low. This is largely due to attitudinal barriers. Accordingly, the goals of the current investigation were to (a) tailor and develop persuasive psychoeducational materials to match dominant cultural beliefs about the causes of depression and (b) examine the effectiveness of tailored CBT descriptions in improving CBT perceptions. We examined the believability of CBT mechanisms by invoking commonly endorsed etiological models of depression and investigated whether tailoring CBT descriptions to match etiological beliefs about depression influences perceptions of CBT. Participants were recruited using TurkPrime. In Study 1, participants (n = 425) read a CBT description that was generic or framed to match an etiological model of depression (biological, stress/environmental, or relationship/interpersonal). The participants indicated believability of each model as adopted by CBT. In study 2, the participants (n = 449) selected what they believed was the most important cause of depression. Subsequently, the participants were randomised to receive either a CBT description tailored to their endorsed model or a generic CBT description, and they provided ratings for CBT's acceptability, credibility, and expectancy. In Study 1, the believability of biological CBT mechanisms was low across conditions, but participants reported greater believability when receiving a biological description than when receiving other mechanistic descriptions. Participants who received the stress- and relationship-focused descriptions did not rate the respective models as more believable than those who received a generic description. In study 2, there were no differences in the perceptions of acceptability, credibility and expectancy between participants who received a tailored description and those who received a generic description. Our findings suggest that CBT is believed to be a psychologically appropriate treatment; however, the believability of biological mechanisms is improved by presenting a biology-focused description.
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Affiliation(s)
- Saba Salimuddin
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Shadi Beshai
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Adam Iskric
- Department of Psychology, Hofstra University, Hempstead, NY 11549, USA
| | - Lisa Watson
- Faculty of Business, Athabasca University, Athabasca, AB T9S 3A3, Canada
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110
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Holtz BE, Kanthawala S, Martin K, Nelson V, Parrott S. Young adults' adoption and use of mental health apps: efficient, effective, but no replacement for in-person care. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37399569 DOI: 10.1080/07448481.2023.2227727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/31/2023] [Accepted: 06/11/2023] [Indexed: 07/05/2023]
Abstract
Objective: Millions of people use mobile phone or computer-based applications-apps-to maintain their mental health and connect with treatment providers through text- and video-based chat functions. The present study sought to understand young adults' motivations for adopting this technology using the unified theory of acceptance and use of technology (UTAUT), how they use mental health apps, and the gratifications they receive from using mental health apps. Participants: One hundred-eighteen mental health app users responded to an online survey. Methods: A survey was conducted with students at a Midwestern university. The survey included questions regarding current mental health services, mental health apps used, UTAUT and gratifications survey items. Results: A regression analysis suggested users' performance expectancies, effort expectancies, and facilitating conditions predicted the adoption of mental health apps. Young adults most often use mental health apps for stress relief. While they preferred in-person treatment, users described mental health apps as efficient and helpful. Conclusion: Overall, the results reinforce the sense of optimism for the future of mental health apps, suggesting the potential for apps to supplement-but not necessarily replace-in-person care.
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Affiliation(s)
- Bree E Holtz
- College of Communication, Arts, & Sciences, Michigan State University, East Lansing, MI, USA
| | - Shaheen Kanthawala
- College of Communication and Information Sciences, University of Alabama, Tuscaloosa, AL, USA
| | - Kaley Martin
- College of Communication and Information Sciences, University of Alabama, Tuscaloosa, AL, USA
| | - Victoria Nelson
- College of Communication, Arts, & Sciences, Michigan State University, East Lansing, MI, USA
| | - Scott Parrott
- College of Communication and Information Sciences, University of Alabama, Tuscaloosa, AL, USA
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111
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Westbomke S, Schag K, Derntl B, Zipfel S, Stengel A. The impact of emotional stimuli on response inhibition in an inpatient and day-hospital patient psychosomatic cohort. Front Psychiatry 2023; 14:1176721. [PMID: 37457765 PMCID: PMC10347415 DOI: 10.3389/fpsyt.2023.1176721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
Objectives To correctly recognize and respond to your counterpart's emotion is essential for a successful get-together. To ensure this, emotional processes and inhibitory control are linked and interact with each other. However, this interaction can be altered in several mental disorders. In a group of psychosomatic patients, we investigated possible differences in the response inhibition between neutral and emotional stimuli and whether a psychosomatic inpatient and day-hospital patient treatment influences response inhibition profiles. Methods One hundred and one patients, diagnosed with different psychiatric diagnoses (77 women, 41.43 ± 13.13 years), completed an emotional stop-signal task (ESST) and an impulsive behavior scale upon admission in an inpatient and day-hospital patient treatment on a psychosomatic ward (T0) and at discharge (T1). Patients with depressive disorders completed the test again after 1 year (follow-up measurement T2, n = 22). Emotional stimuli were angry and neutral faces. Stop-signal reaction time (SSRT) and stop-signal delay (SSD) were calculated as the main behavioral parameters. Results We found a significantly higher SSRT for neutral than angry faces at both admission (8.538 ms, p < 0.001) and discharge (11.142 ms, p < 0.001), with a matching higher SSD for angry than neutral faces at both timepoints (T0: 8.360 ms, p < 0.001, T1: (6.950 ms, p < 0.001). The SSRT for angry faces significantly decreased after treatment (-8.485 ms, p = 0.0110). For neutral faces, the decrease failed to reach significance (-5.881 ms, p = 0.250). A significant decrease in SSRT for neutral faces in patients with depressive disorders was found 1 year after discharge compared with admission (-19.040 ms, p = 0.0380). Conclusion Our data demonstrate a decreased response inhibition for neutral compared with emotional stimuli and an improved response inhibition for angry faces after discharge in a psychosomatic inpatient and day-hospital patient cohort. Additionally, patients with depressive disorders displayed a significantly better response inhibition for neutral faces 1 year after discharge compared with the baseline measurement. With this study, we provide more evidence for altered emotional response inhibition in different mental disorders and a hint that psychosomatic inpatient and day-hospital patient treatment may help to normalize it, even if the effects remained small and it needs further research to prove causality.
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Affiliation(s)
- Sina Westbomke
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
- Clinic for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charite - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
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Crane ME, Kendall PC, Chorpita BF, Sanders MR, Miller AR, Webster-Stratton C, McWilliam J, Beck JS, Ashen C, Embry DD, Pickering JA, Daleiden EL. The role of implementation organizations in scaling evidence-based psychosocial interventions. Implement Sci 2023; 18:24. [PMID: 37349845 PMCID: PMC10288683 DOI: 10.1186/s13012-023-01280-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND To bring evidence-based interventions (EBIs) to individuals with behavioral health needs, psychosocial interventions must be delivered at scale. Despite an increasing effort to implement effective treatments in communities, most individuals with mental health and behavioral problems do not receive EBIs. We posit that organizations that commercialize EBIs play an important role in disseminating EBIs, particularly in the USA. The behavioral health and implementation industry is growing, bringing the implementation field to an important inflection point: how to scale interventions to improve access while maintaining EBI effectiveness and minimizing inequities in access to psychosocial intervention. MAIN BODY We offer a first-hand examination of five illustrative organizations specializing in EBI implementation: Beck Institute for Cognitive Behavioral Therapy; Incredible Years, Inc.; the PAXIS Institute; PracticeWise, LLC; and Triple P International. We use the Five Stages of Small Business Growth framework to organize themes. We discuss practical structures (e.g., corporate structures, intellectual property agreements, and business models) and considerations that arise when trying to scale EBIs including balancing fidelity and reach of the intervention. Business models consider who will pay for EBI implementation and allow organizations to scale EBIs. CONCLUSION We propose research questions to guide scaling: understanding the level of fidelity needed to maintain efficacy, optimizing training outcomes, and researching business models to enable organizations to scale EBIs.
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Affiliation(s)
- Margaret E Crane
- Department of Psychology, Temple University, Weiss Hall, 1701 N 13th St, Philadelphia, PA, 19122, USA.
- Department of Psychiatry, New York Presbyterian-Weill Cornell Medicine, 425 E 61st St, New York, NY, 10065, USA.
| | - Philip C Kendall
- Department of Psychology, Temple University, Weiss Hall, 1701 N 13th St, Philadelphia, PA, 19122, USA.
| | - Bruce F Chorpita
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
- PracticeWise, LLC, 410 Coach Rd, Satellite Beach, FL, 32937, USA
| | - Matthew R Sanders
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, St Lucia, QLD, 4067, Australia
| | - Allen R Miller
- Beck Institute for Cognitive Behavior Therapy, 1 Belmont Ave #700, Bala Cynwyd, PA, 19004, USA
| | | | - Jenna McWilliam
- Triple P International, 11 Market St N, Indooroopilly, QLD, 4068, Australia
| | - Judith S Beck
- Beck Institute for Cognitive Behavior Therapy, 1 Belmont Ave #700, Bala Cynwyd, PA, 19004, USA
| | - Ceth Ashen
- C. Ashen Consulting, 222 North Canon Dr. Ste 205, Beverly Hills, CA, 90210, USA
| | | | | | - Eric L Daleiden
- PracticeWise, LLC, 410 Coach Rd, Satellite Beach, FL, 32937, USA
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Phillips DA, Ginsburg GS, Ehrenreich-May J, Jensen-Doss A. Treatment Engagement in Adolescents: The Associations of Sociodemographic Characteristics, Caregiver Perceived Barriers, and Clinical Impairment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-14. [PMID: 37347999 PMCID: PMC10739653 DOI: 10.1080/15374416.2023.2222387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To examine the associations between sociodemographic characteristics, perceived barriers to treatment, clinical impairment, and youth treatment engagement. METHOD Participants included 196 families (youth: ages 12 to 18; 64.3% cis-gender female; 23.5% Black, 60.7% White, and 12.2% Mixed/Other race; 41.3% Hispanic or Latinx ethnicity) recruited as part of a comparative effectiveness trial for adolescent anxiety and depression. Self-report measures of sociodemographic characteristics and caregiver perceived barriers were completed at intake. Youth clinical impairment was assessed at baseline via clinical interview. Measures of engagement were collected throughout treatment, including initiation status, session attendance, and termination status. Relationships were examined using analyses of variances and hierarchal linear and logistic modeling. RESULTS Perceived barriers did not differ by sociodemographic characteristics. Greater perceived stressors and obstacles predicted fewer sessions attended and a lower likelihood of successful termination. Youth of caregivers with an advanced degree and those with caregivers who were employed part time attended more sessions and were more likely to initiate and terminate treatment successfully compared to youth with caregivers of a lower education level or student or unemployed status. At higher levels of youth clinical impairment, greater perceived treatment demands and issues predicted reduced likelihood of treatment initiation. CONCLUSIONS Perceived barriers, sociodemographic characteristics, and clinical impairment were all associated with levels of engagement in the treatment process. Baseline and continued assessment of perceived and experienced barriers to treatment may promote individualized strategies for families identified as at-risk for reduced engagement.
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Affiliation(s)
| | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine
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114
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Escovar EL, Bocanegra ES, Craske MG, Bystritsky A, Roy-Byrne P, Sherbourne CD, Stein MB, Chavira DA. Mediators of Ethnic Differences in Dropout Rates From a Randomized Controlled Treatment Trial Among Latinx and Non-Latinx White Primary Care Patients With Anxiety Disorders. J Nerv Ment Dis 2023; 211:427-439. [PMID: 37252881 PMCID: PMC10234492 DOI: 10.1097/nmd.0000000000001533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
ABSTRACT Disparities in treatment engagement and adherence based on ethnicity have been widely recognized but are inadequately understood. Few studies have examined treatment dropout among Latinx and non-Latinx White (NLW) individuals. Using Andersen's Behavioral Model of Health Service Use (A behavioral model of families' use of health services. 1968; J Health Soc Behav. 1995; 36:1-10) as a framework, we examine whether pretreatment variables (categorized as predisposing, enabling, and need factors) mediate the relationship between ethnicity and premature dropout in a sample of Latinx and NLW primary care patients with anxiety disorders who participated in a randomized controlled trial (RCT) of cognitive behavioral therapy. Data from a total of 353 primary care patients were examined; 96 Latinx and 257 NLW patients participated. Results indicated that Latinx patients dropped out of treatment more often than NLW patients, resulting in roughly 58% of Latinx patients failing to complete treatment compared with 42% of NLW, and approximately 29% of Latinx patients dropping out before engaging in modules related to cognitive restructuring or exposure, relative to 11% of NLW patients. Mediation analyses suggest that social support and somatization partially explained the relationship between ethnicity and treatment dropout, highlighting the importance of these variables in understanding treatment disparities.
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Affiliation(s)
| | | | | | - Alexander Bystritsky
- Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Peter Roy-Byrne
- Center for Healthcare Improvement for Addictions, Mental Illness, and Medically Vulnerable Populations, University of Washington at Harborview Medical Center, Seattle, Washington
| | | | - Murray B Stein
- Department of Psychiatry and Department of Family Medicine and Pubic Health, University of California, San Diego, La Jolla, California
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Castro-Ramirez F, Paz-Pérez MA, McGuire TC, Rankin O, Alfaro MCG, Audirac AM, Campuzano MLG, Coady P, Núñez-Delgado M, Manana J, Hernández-de la Rosa C, Tambedou T, Vergara GA, Barranco LA, Cudris-Torres L, Nock MK, Naslund JA, Benjet C. A Qualitative Examination of the Impact of Suicidal Thoughts and Behavior on Help-Seeking Among University Students in Colombia and Mexico. JOURNAL OF BEHAVIORAL AND COGNITIVE THERAPY 2023; 33:67-80. [PMID: 37680902 PMCID: PMC10482072 DOI: 10.1016/j.jbct.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
This study examined descriptions of suicidal thoughts and behavior (STB) to identify risk and protective factors that may present in clinical settings among university students from Latin America. Our focus was on answering the following key questions: How are suicidal thoughts and behavior described? What are reasons for wanting to die and for living? What impact do STBs have on motivations to seek or avoid psychological treatment? To this end, 55 qualitative interviews were completed with university students from Colombia and Mexico who recently endorsed emotional difficulties in the World Mental Health International College Student (WMH-ICS) surveys. Interviews were coded to identify themes specific to STBs. Findings revealed insight on symptom presentations and consequences of STBs. Participants described uncontrollable somatic symptoms during periods of high suicide risk, which serves as a relevant clinical marker for health providers. An important reason for living was to avoid suffering for family, which was protective against suicide and motivates familial involvement in treatment planning. Participants sought solutions to emotional problems after experiencing STBs, including psychological treatment. Cultural stigma of mental illness induced feelings of shame and burden, which led to avolition, avoidance, and nondisclosure of symptom severity. This study provides insight into the utility of evaluating cultural context in (a) detecting antecedents to STBs frequently reported as somatic symptoms, (b) identifying protective factors against suicide, and (c) recognizing how stigma of mental illness and suicide, shame avoidance, and familism might influence personal motivations to seek or avoid help for emotional distress.
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Affiliation(s)
| | | | | | - Osiris Rankin
- Department of Psychology, Harvard University, United States
| | | | | | | | - Parker Coady
- Department of Psychology, Harvard University, United States
| | | | | | | | - Tida Tambedou
- Department of Psychology, Harvard University, United States
| | | | | | | | - Matthew K Nock
- Department of Psychology, Harvard University, United States
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, United States
| | - Corina Benjet
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, México
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Hidalgo-Mazzei D, Mantingh T, Pérez de Mendiola X, Samalin L, Undurraga J, Strejilevich S, Severus E, Bauer M, González-Pinto A, Nolen WA, Young AH, Vieta E. Clinicians' preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders around the world: a survey from the ISBD Lithium task force. Int J Bipolar Disord 2023; 11:20. [PMID: 37243681 DOI: 10.1186/s40345-023-00301-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/08/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Lithium has long been considered the gold-standard pharmacological treatment for the maintenance treatment of bipolar disorders (BD) which is supported by a wide body of evidence. Prior research has shown a steady decline in lithium prescriptions during the last two decades. We aim to identify potential factors explaining this decline across the world with an anonymous worldwide survey developed by the International Society for Bipolar Disorders (ISBD) Task Force "Role of Lithium in Bipolar Disorders" and distributed by diverse academic and professional international channels. RESULTS A total of 886 responses were received of which 606 completed the entire questionnaire while 206 completed it partially. Respondents were from 43 different countries comprising all continents. Lithium was the most preferred treatment option for the maintenance of BD patients (59%). The most relevant clinical circumstances in which lithium was the preferred option were in patients with BD I (53%), a family history of response (18%), and a prior response during acute treatment (17%). In contrast, Lithium was not the preferred option in case of patients´ negative beliefs and/or attitudes towards lithium (13%), acute side-effects or tolerability problems (10%) and intoxication risk (8%). Clinicians were less likely to prefer lithium as a first option in BD maintenance phase when practising in developing economy countries [X2 (1, N = 430) = 9465, p = 0.002) ] and private sectors [X2 (1, N = 434) = 8191, p = 0.004)]. CONCLUSIONS Clinicians' preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders appear to be affected by both the patients' beliefs and the professional contexts where clinicians provide their services. More research involving patients is needed for identifying their attitudes toward lithium and factors affecting its use, particularly in developing economies.
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Affiliation(s)
- Diego Hidalgo-Mazzei
- Bipolar and depressive disorders unit, Department of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, University of Barcelona, 170 Villarroel St, 08036, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), C. Casanova, 143, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience , King's College London, London, UK
| | - Tim Mantingh
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience , King's College London, London, UK
| | - Xavier Pérez de Mendiola
- Bioaraba, Psychiatry Service, Department of Neurosciences, Research Group on Severe Mental Illness, Araba University Hospital, University of the Basque Country UPV/EHU, Osakidetza, Vitoria-Gasteiz, Spain
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Juan Undurraga
- Department of Neurology and Psychiatry, Clinica Alemana Universidad Del Desarrollo, Santiago, Chile
| | - Sergio Strejilevich
- Área, Asistencia e investigación en trastornos del ánimo, Buenos Aires, Argentina
| | - Emanuel Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ana González-Pinto
- Bioaraba, Psychiatry Service, Department of Neurosciences, Research Group on Severe Mental Illness, Araba University Hospital, University of the Basque Country UPV/EHU, Osakidetza, Vitoria-Gasteiz, Spain
| | - Willem A Nolen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience , King's College London, London, UK
| | - Eduard Vieta
- Bipolar and depressive disorders unit, Department of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, University of Barcelona, 170 Villarroel St, 08036, Barcelona, Spain.
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), C. Casanova, 143, 08036, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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Boulos D, Garber B. Does recommended mental health follow-up care occur after postdeployment screening in the Canadian Armed Forces? A retrospective cohort study. BMJ Open 2023; 13:e065598. [PMID: 37164454 PMCID: PMC10174001 DOI: 10.1136/bmjopen-2022-065598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 03/23/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE To determine Canadian service members' level of adherence to a recommendation for mental health services follow-up that was assigned by clinicians during postdeployment screening. DESIGN Retrospective cohort study. SETTING Canadian military population. PARTICIPANTS The cohort consisted of personnel (n=28 460) with a deployment within the 2009-2014 time frame. A stratified random sample (n=3004) was selected for medical chart review. However, we restricted our analysis to individuals whose completed screening resulted in a recommendation for mental health services follow-up (sample n=316 (weighted n=2034) or 11.2% of screenings. INTERVENTIONS Postdeployment health screening. PRIMARY OUTCOME MEASURE The outcome was adherence to a screening-indicated mental health services follow-up recommendation, assessed within 90 days, a preferred delay, and within 365 days, a delay considered partially associated with the screening recommendation. RESULTS Adherence within 90 days of screening was 71.1% (95% CI 59.7% to 82.5%) for individuals with 'major' mental health concerns, 36.1% (95% CI 23.9% to 48.4%) for those with 'minor' mental health concerns, and 46.8% (95% CI 18.6% to 75.0%), for those with psychosocial mental health concerns; the respective 365-day adherence fractions were 85.3% (95% CI 76.1% to 94.5%), 55.7% (95% CI 42.0% to 69.4%) and 48.6% (95% CI 20.4% to 76.9%). Logistic regression indicated that a 90-day adherence among those with a 'major' mental health concern was higher among those screening after 2012 (adjusted OR (AOR) 5.45 (95% CI 1.08 to 27.45)) and lower, with marginal significance, among those with deployment durations greater than 180 days (AOR 0.35 (95% CI 0.11 to 1.06)). CONCLUSIONS On an individual level, screening has the potential to identify when a care need is present and a follow-up assessment can be recommended; however, we found that adherence to this recommendation is not absolute, suggesting that administrative checks and possibly, process refinements would be beneficial to ensure that care-seeking barriers are minimised.
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Affiliation(s)
- David Boulos
- Directorate of Mental Health, Canada Department of National Defense, Ottawa, Canada
| | - Bryan Garber
- Directorate of Mental Health, Canada Department of National Defense, Ottawa, Canada
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Ghosh A, Agnihotri J, Bhalotia S, Sati BK, Agarwal L, A A, Tandon S, Meena K, Raj S, Azad Y, Gupta S, Gupta N. Serious Games Based on Cognitive Bias Modification and Learned Helplessness Paradigms for the Treatment of Depression: Design and Acceptability Study. JMIR Serious Games 2023; 11:e37105. [PMID: 37133923 DOI: 10.2196/37105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/11/2022] [Accepted: 03/20/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Depression is a debilitating mental health disorder, with a large treatment gap. Recent years have seen a surge in digital interventions to bridge this treatment gap. Most of these interventions are based on computerized cognitive behavioral therapy. Despite the efficacy of computerized cognitive behavioral therapy-based interventions, their uptake is low and dropout rates are high. Cognitive bias modification (CBM) paradigms provide a complementary approach to digital interventions for depression. However, interventions based on CBM paradigms have been reported to be repetitive and boring. OBJECTIVE In this paper, we described the conceptualization, design, and acceptability of serious games based on CBM paradigms and the learned helplessness paradigm. METHODS We searched the literature for CBM paradigms that were shown to be effective in reducing depressive symptoms. For each of the CBM paradigms, we ideated how to create a game so that the gameplay was engaging while the active therapeutic component remained unchanged. RESULTS We developed 5 serious games based on the CBM paradigms and the learned helplessness paradigm. The games include various core elements of gamification, such as goals, challenges, feedback, rewards, progress, and fun. Overall, the games received positive acceptability ratings from 15 users. CONCLUSIONS These games may help improve the effectiveness and engagement levels of computerized interventions for depression.
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Affiliation(s)
- Arka Ghosh
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Jagriti Agnihotri
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Sradha Bhalotia
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Bharat Kumar Sati
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Latika Agarwal
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Akash A
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Swastika Tandon
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Komal Meena
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Shreyash Raj
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Yatin Azad
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
| | - Silky Gupta
- Department of Cognitive Science, Indian Institute of Technology Kanpur, Kanpur, India
| | - Nitin Gupta
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India
- Department of Cognitive Science, Indian Institute of Technology Kanpur, Kanpur, India
- Mehta Family Center for Engineering in Medicine, Indian Institute of Technology Kanpur, Kanpur, India
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119
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Stein DJ, Kazdin AE, Munthali RJ, Hwang I, Harris MG, Alonso J, Andrade LH, Bruffaerts R, Cardoso G, Chardoul S, de Girolamo G, Florescu S, Gureje O, Haro JM, Karam AN, Karam EG, Kovess-Masfety V, Lee S, Medina-Mora ME, Navarro-Mateu F, Posada-Villa J, Stagnaro JC, Ten Have M, Sampson NA, Kessler RC, Vigo DV. Determinants of effective treatment coverage for posttraumatic stress disorder: findings from the World Mental Health Surveys. BMC Psychiatry 2023; 23:226. [PMID: 37016378 PMCID: PMC10074702 DOI: 10.1186/s12888-023-04605-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/13/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with significant morbidity, but efficacious pharmacotherapy and psychotherapy are available. Data from the World Mental Health Surveys were used to investigate extent and predictors of treatment coverage for PTSD in high-income countries (HICs) as well as in low- and middle-income countries (LMICs). METHODS Seventeen surveys were conducted across 15 countries (9 HICs, 6 LMICs) by the World Health Organization (WHO) World Mental Health Surveys. Of 35,012 respondents, 914 met DSM-IV criteria for 12-month PTSD. Components of treatment coverage analyzed were: (a) any mental health service utilization; (b) adequate pharmacotherapy; (c) adequate psychotherapy; and (d) effective treatment coverage. Regression models investigated predictors of treatment coverage. RESULTS 12-month PTSD prevalence in trauma exposed individuals was 1.49 (S.E., 0.08). A total of 43.0% (S.E., 2.2) received any mental health services, with fewer receiving adequate pharmacotherapy (13.5%), adequate psychotherapy (17.2%), or effective treatment coverage (14.4%), and with all components of treatment coverage lower in LMICs than HICs. In a multivariable model having insurance (OR = 2.31, 95 CI 1.17, 4.57) and severity of symptoms (OR = .35, 95% CI 0.18, 0.70) were predictive of effective treatment coverage. CONCLUSION There is a clear need to improve pharmacotherapy and psychotherapy coverage for PTSD, particularly in those with mild symptoms, and especially in LMICs. Universal health care insurance can be expected to increase effective treatment coverage and therefore improve outcomes.
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Affiliation(s)
- Dan J Stein
- Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Richard J Munthali
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Meredith G Harris
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, CIBER en Epidemiología y Salud Pública (CIBERESP), Pompeu Fabra University (UPF), Barcelona, Spain
| | - Laura Helena Andrade
- Núcleo de Epidemiologia Psiquiátrica - LIM 23, Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Center (CHRC)/NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Stephanie Chardoul
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Aimee N Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Elie G Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Balamand University, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | | | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
| | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Margreet Ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Daniel V Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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120
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Carlbring P, Hadjistavropoulos H, Kleiboer A, Andersson G. A new era in Internet interventions: The advent of Chat-GPT and AI-assisted therapist guidance. Internet Interv 2023; 32:100621. [PMID: 37273936 PMCID: PMC10235420 DOI: 10.1016/j.invent.2023.100621] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 06/06/2023] Open
Affiliation(s)
- Per Carlbring
- Stockholm University, Department of Psychology, Stockholm, Sweden
| | | | - Annet Kleiboer
- VU Amsterdam, Department of Clinical Neuro- and Developmental Psychology, Amsterdam, Netherlands
| | - Gerhard Andersson
- Linkoping University, Department of Behavioural Sciences and Learning, SE-581 83 Linköping, Sweden
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Effectiveness of ACT-based intervention in compliance with the model for sustainable mental health: A cluster randomized control trial in a group of older adults. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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122
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Barceló-Soler A, García-Campayo J, Araya R, Doukani A, Gili M, García-Palacios A, Mayoral F, Montero-Marin J. Working alliance in low-intensity internet-based cognitive behavioral therapy for depression in primary care in Spain: A qualitative study. Front Psychol 2023; 14:1024966. [PMID: 37063543 PMCID: PMC10090318 DOI: 10.3389/fpsyg.2023.1024966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionPsychotherapies delivered via the Internet have been promoted as an alternative for improving access to psychological treatments. A conceptual working alliance model of blended (i.e., traditional face-to-face consultation combined with Internet-delivered psychotherapy) cognitive-behavioral therapy (b-CBT) for depression has been developed in the UK. However, little is known about how this important therapeutic process, namely the working alliance (WA), is developed and maintained in Internet-delivered cognitive-behavioral therapy without face-to-face consultation (i-CBT). The aim of this study was to evaluate the validity of the WA model of b-CBT in Spanish patients with depression receiving i-CBT.MethodsForty-one patients suffering from mild-moderate depression were interviewed to assess their experiences of an i-CBT program. Interviews were conducted with participants who received a self-guided application (n = 9), and low-intensity support (n = 10). Three group interviews were also conducted with patients who either did not start the program (n = 8) or did not complete it (n = 6), and with patients who did complete it (n = 8).ResultsQualitative thematic content analysis was performed using the constant comparative method, which revealed four main themes: “bond,” “goals,” “task,” and “usability heuristics,” all consistent with the existing literature. However, a new subcategory emerged, called “anonymity,” which may highlight the social stigma that mental illness still has in the Spanish context.ConclusionResults suggest that the development and maintenance of the WA through i-CBT could offer a better experience of the therapeutic process and improve the clinical impact.Clinical Trial RegistrationClinicaltrials.gov, identifier: NCT01611818.
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Affiliation(s)
- Alberto Barceló-Soler
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain
- Institute of Health Research of Aragon (IIS Aragon), Zaragoza, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragon), Zaragoza, Spain
- Department of Psychiatry, University of Zaragoza, Zaragoza, Spain
- *Correspondence: Javier García-Campayo,
| | | | - Asmae Doukani
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Margalida Gili
- Department of Psychology, University of the Balearic Islands, Palma, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | | | - Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health—CIBERESP), Madrid, Spain
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Skinner A, Occhipinti JA, Prodan A, Song YJC, Hickie IB. Bi-stability and critical transitions in mental health care systems: a model-based analysis. Int J Ment Health Syst 2023; 17:5. [PMID: 36959667 PMCID: PMC10037813 DOI: 10.1186/s13033-023-00573-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Delayed initiation and early discontinuation of treatment due to limited availability and accessibility of services may often result in people with mild or moderate mental disorders developing more severe disorders, leading to an increase in demand for specialised care that would be expected to further restrict service availability and accessibility (due to increased waiting times, higher out-of-pocket costs, etc.). METHODS We developed a simple system dynamics model of the interaction of specialised services capacity and disease progression to examine the impact of service availability and accessibility on the effectiveness and efficiency of mental health care systems. RESULTS Model analysis indicates that, under certain conditions, increasing services capacity can precipitate an abrupt, step-like transition from a state of persistently high unmet need for specialised services to an alternative, stable state in which people presenting for care receive immediate and effective treatment. This qualitative shift in services system functioning results from a 'virtuous cycle' in which increasing treatment-dependent recovery among patients with mild to moderate disorders reduces the number of severely ill patients requiring intensive and/or prolonged treatment, effectively 'releasing' services capacity that can be used to further reduce the disease progression rate. We present an empirical case study of tertiary-level child and adolescent mental health services in the Australian state of South Australia demonstrating that the conditions under which such critical transitions can occur apply in real-world services systems. CONCLUSIONS Policy and planning decisions aimed at increasing specialised services capacity have the potential to dramatically increase the effectiveness and efficiency of mental health care systems, promoting long-term sustainability and resilience in the face of future threats to population mental health (e.g., economic crises, natural disasters, global pandemics).
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Affiliation(s)
- Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Computer Simulation and Advanced Research Technologies (CSART), Sydney, Australia
| | - Ante Prodan
- Computer Simulation and Advanced Research Technologies (CSART), Sydney, Australia
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Sydney, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ian B Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Encina-Zúñiga E, Agrest M, Tapia-Munoz T, Vidal-Zamora I, Ardila-Gómez S, Alvarado R, Leiderman EA, Reavley N. Development of mental health first-aid guidelines for depression: a Delphi expert consensus study in Argentina and Chile. BMC Psychiatry 2023; 23:161. [PMID: 36918853 PMCID: PMC10013290 DOI: 10.1186/s12888-023-04661-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Depression is one of the most common mental health problems worldwide and, while prevalence rates in Latin America are relatively high, most people who meet the criteria for diagnosis do not receive treatment. Family and friends of a person with depression can play an important role in supporting a person to seek and engage with treatment. However, many people do not have the necessary skills or confidence to help. English-language mental health first aid guidelines have been developed to support people to provide such help. The aim of this study was to culturally adapt these guidelines for Chile and Argentina. METHODS A Delphi expert consensus study was conducted with two expert panels, one of people with lived experience of depression (either their own or as a carer; n = 26) and one of health professionals (n = 29). Overall, 172 statements from the English-language guidelines were translated and compiled into a questionnaire. Participants were asked to rate statements based on how essential or important those statements were for Chile and Argentina and to suggest new statements if necessary. RESULTS Data were obtained over two survey rounds. Consensus was achieved on 172 statements. A total of 137 statements were adopted from the English-language guidelines, whereas 35 new endorsed statements were generated from panel suggestions. There were similarities between the English-language guidelines and those for Chile and Argentina. The adapted guidelines did not include some of the items from the English-language guidelines related to commenting on a person's strengths or making judgements about their character, and also incorporated new items related to the incorporation of sociocultural considerations as causes of depression and attention to inequities in mental health. CONCLUSIONS The significant number of new items underscores the importance of undertaking a careful process of cultural adaptation. Further research on dissemination and incorporation of the guidelines into the Mental Health First Aid training course for Chile and Argentina is still required.
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Affiliation(s)
- Esteban Encina-Zúñiga
- grid.443909.30000 0004 0385 4466School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- grid.443909.30000 0004 0385 4466Department of Psychology, Faculty of Social Sciences, Universidad de Chile, Santiago, Chile
| | - Martín Agrest
- Proyecto Suma, Güemes 4130 (1425), Ciudad Autónoma de Buenos Aires, Argentina
| | - Thamara Tapia-Munoz
- grid.83440.3b0000000121901201Department of Behavioural Science and Health, University College London, London, UK
| | - Isidora Vidal-Zamora
- grid.443909.30000 0004 0385 4466Department of Psychology, Faculty of Social Sciences, Universidad de Chile, Santiago, Chile
| | - Sara Ardila-Gómez
- grid.7345.50000 0001 0056 1981Facultad de Psicología, Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
- grid.423606.50000 0001 1945 2152Consejo Nacional de Investigaciones Científicas Y Técnicas (CONICET), Buenos Aires, Argentina
| | - Rubén Alvarado
- grid.443909.30000 0004 0385 4466School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- grid.412185.b0000 0000 8912 4050Department of Public Health, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - Eduardo A. Leiderman
- grid.441624.10000 0001 1954 9157Departamento de Neurociencias, Facultad de Ciencias Sociales, Universidad de Palermo, Buenos Aires, Argentina
| | - Nicola Reavley
- grid.1008.90000 0001 2179 088XCentre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria Australia
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125
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Fisher A, Corrigan E, Cross S, Ryan K, Staples L, Tan R, Webb N, Titov N, Dear BF. Decision-making about uptake and engagement among digital mental health service users: a qualitative exploration of therapist perspectives. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2022.2163157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- A. Fisher
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - E. Corrigan
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - S. Cross
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - K. Ryan
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - L. Staples
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - R. Tan
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - N. Webb
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - N. Titov
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - B. F. Dear
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
- The MindSpot Clinic, MQ Health, Sydney, Australia
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Gooding NB, Williams JN, Williams RJ. The Differences Between Gamblers and Substance Users Who Seek Treatment. CANADIAN JOURNAL OF ADDICTION 2023. [DOI: 10.1097/cxa.0000000000000171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Garber BB, Chen J, Beliveau A, Farwell DG, Bewley AF, Birkeland AC, Abouyared M. Using the Patient Health Questionnaire-2 to improve depression screening in head and neck cancer patients. Am J Otolaryngol 2023; 44:103724. [PMID: 36493469 DOI: 10.1016/j.amjoto.2022.103724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE The purpose of this study is to examine the use of the Patient Health Questionnaire-2 (PHQ-2) to screen for depression in patients undergoing treatment for head and neck cancer and to evaluate potential patient-specific risk factors that may contribute to depression. MATERIALS AND METHODS This is a retrospective study at a tertiary-level hospital of outpatient adult patients with head and neck cancer who completed the PHQ-2/9 from 2019 to 2020. Patients were given a PHQ-2 during a surveillance visit. A positive PHQ-2 screen (score ≥ 3) prompted further evaluation with a PHQ-9. Patients were stratified into either low risk (PHQ-2 score < 3) or high risk (PHQ-2 score ≥ 3) for depression. Univariate regression was performed on all variables, and a multivariate logistic regression was performed on statistically significant variables (P < 0.05). RESULTS In total, 110 patients were included in this study. Fifteen (14 %) patients had a positive PHQ-2 screen with a score ≥ 3 and underwent evaluation with a PHQ-9. The median PHQ-9 score was 15 (6-26). The PHQ-2 ≥ 3 group were significantly younger (59 years vs. 67 years; P = 0.03) and had a greater number of patients with a psychiatric history (33 % vs. 8 %; P < 0.01). CONCLUSIONS There is a strong association between a PHQ-2 score ≥ 3 and detection of depressive symptoms among patients with head and neck cancer. Younger age and pretreatment mental illness are significant risk factors for developing depression following treatment. Early screening and treatment should be considered for all patients to mitigate the burden of depression and suicide in this patient population. Further research is warranted to investigate utilization of the PHQ-2/9 to detect depression and barriers that exist for timely screening and interventions.
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Affiliation(s)
- Beverly B Garber
- University of California, Davis, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA, United States of America
| | - Joy Chen
- University of California, Davis, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA, United States of America
| | - Angela Beliveau
- University of California, Davis, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA, United States of America
| | - D Gregory Farwell
- University of Pennsylvania, Department of Otorhinolaryngology-Head and Neck Surgery, Philadelphia, PA, United States of America
| | - Arnaud F Bewley
- University of California, Davis, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA, United States of America
| | - Andrew C Birkeland
- University of California, Davis, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA, United States of America
| | - Marianne Abouyared
- University of California, Davis, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA, United States of America.
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128
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Halme M, Rautava P, Sillanmäki L, Sumanen M, Suominen S, Vahtera J, Virtanen P, Salo P. Educational level and the use of mental health services, psychotropic medication and psychotherapy among adults with a history of physician diagnosed mental disorders. Int J Soc Psychiatry 2023; 69:493-502. [PMID: 35819228 PMCID: PMC9983050 DOI: 10.1177/00207640221111091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The prevalence of mental disorders is increased among people of low socioeconomic status or educational level, but it remains unclear whether their access to treatment matches their increased need. AIMS Our objective was to examine whether educational level as an indicator of socioeconomic status is associated with use of mental health services, psychotropic medication and psychotherapy in Finland. METHOD Cross-sectional data from a follow-up survey of a longitudinal, population-based cohort study were used to form a sample of 3,053 men and women aged 24 to 68 with a current or previous physician diagnosed mental disorder. The prevalence of mental disorders, mental health service use and educational level were assessed with self-report questionnaire. Educational level was determined by the highest educational attainment and grouped into three levels: high, intermediate and low. The associations between educational level and mental health service -related outcomes were assessed with binary logistic regression. Covariates in the fully adjusted model were age, gender and number of somatic diseases. RESULTS Compared to high educational level, low educational level was associated with higher odds of using antidepressants (OR 1.35, 95% CI [1.09, 1.66]), hypnotics (OR 1.33, 95% CI [1.07, 1.66]) and sedatives (OR 2.17, 95% CI [1.69, 2.78]), and lower odds of using mental health services (OR 0.80, 95% CI [0.65, 0.98]). No associations were found between educational level and use of psychotherapy. CONCLUSIONS The results do not suggest a general socioeconomic status related mismatch. A pharmacological emphasis was observed in the treatment of low educational background participants, whereas overall mental health service use was emphasized among high educational background participants.
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Affiliation(s)
- Marie Halme
- Department of Psychology, University of
Turku, Finland
- Marie Halme, Department of Psychology,
University of Turku, Turku 20014, Finland.
| | - Päivi Rautava
- Department of Public Health, University
of Turku, Finland
- Turku Clinical Research Centre, Turku
University Hospital, Finland
| | - Lauri Sillanmäki
- Department of Public Health, University
of Turku, Finland
- Turku Clinical Research Centre, Turku
University Hospital, Finland
- Department of Public Health, University
of Helsinki, Finland
| | - Markku Sumanen
- Faculty of Medicine and Health
Technology, Tampere University, Finland
| | - Sakari Suominen
- Department of Public Health, University
of Turku, Finland
- Turku Clinical Research Centre, Turku
University Hospital, Finland
- School of Health Sciences, University
of Skövde, Sweden
| | - Jussi Vahtera
- Department of Public Health and Centre
for Population Health Research, University of Turku, Finland
| | | | - Paula Salo
- Department of Psychology, University of
Turku, Finland
- Finnish Institute of Occupational
Health, Helsinki, Finland
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Sigal M, Plunkett SW. Gender and Ethnic Differences in University Students’ Attitudes about Mental Health Services. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2023. [DOI: 10.1080/87568225.2023.2179286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Marika Sigal
- Department of Psychology, California State University, Northridge, California, USA
| | - Scott W. Plunkett
- Department of Psychology, California State University, Northridge, California, USA
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Shroff A, Roulston C, Fassler J, Dierschke NA, Todd JSP, Ríos-Herrera Á, Plastino KA, Schleider JL. A Digital Single-Session Intervention Platform for Youth Mental Health: Cultural Adaptation, Evaluation, and Dissemination. JMIR Ment Health 2023; 10:e43062. [PMID: 36787180 PMCID: PMC9975917 DOI: 10.2196/43062] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Despite the proliferation of evidence-based digital mental health programs for young people, their low uptake and inconsistent implementation preclude them from benefiting youths at scale. Identifying effective implementation strategies for evidence-based supports is especially critical in regions where treatment access is lowest owing to mental health provider shortages. OBJECTIVE The goal of this academic-community partnership, funded by the City of San Antonio Metropolitan Health District, was to culturally adapt, disseminate, and gauge the acceptability and utility of an evidence-based digital mental health platform-Project Youth Empowerment and Support (YES)-among English- and Spanish-speaking youths living in south Texas. METHODS Project YES is an open-access, anonymous platform containing 3 evidence-based, self-guided interventions for youth mental health. Project YES was culturally adapted via focus groups and co-design sessions with San Antonio youths with lived experience of depression and anxiety; translated into Spanish; and disseminated throughout San Antonio, Texas, via community and school partnerships. RESULTS During the project period (April 2021 to December 2021), 1801 San Antonio youths began and 894 (49.64%) of them completed a 30-minute, single-session intervention within Project YES (aged 11-17 years; n=718, 39.87% male; n=961, 53.36% female; and n=3, 0.17% intersex; n=1477, 82.01% Hispanic; n=77, 4.28% non-Hispanic White; n=113, 6.27% Black; n=28, 1.55% Asian; and n=93, 5.16% other). This completion rate (49.64%) surpassed those previously observed for Project YES (eg, 34% when disseminated via social media). San Antonio youths rated Project YES as highly acceptable across all metrics, both in English and Spanish. In addition, the youths who completed Project YES-ENGLISH reported significant improvements in hopelessness (Cohen d=0.33; P<001), self-hate (Cohen d=0.27; P<001), and perceived agency (Cohen d=0.25; P<001) from before to after the intervention, and the youths who completed Project YES-SPANISH reported significant improvements in self-hate (Cohen d=0.37; P=.049) from before to after the intervention. CONCLUSIONS The results indicate that Project YES-an open-access, free, and anonymous web-based single-session intervention platform-is an acceptable, accessible, and applicable mental health support for English- and Spanish-speaking San Antonio youths.
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Affiliation(s)
- Akash Shroff
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Chantelle Roulston
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Julia Fassler
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Nicole A Dierschke
- University of Texas Teen Health, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jennifer San Pedro Todd
- University of Texas Teen Health, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Ámbar Ríos-Herrera
- University of Texas Teen Health, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Kristen A Plastino
- University of Texas Teen Health, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
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Understanding veteran barriers to specialty outpatient PTSD clinical care. J Anxiety Disord 2023; 95:102675. [PMID: 36854224 DOI: 10.1016/j.janxdis.2023.102675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 12/28/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Veterans seeking treatment for posttraumatic stress disorder (PTSD) commonly report general and veteran-specific barriers to treatment such as stigma and challenges with navigating the Veterans Health Affairs (VHA) system. This study aimed to characterize barriers endorsed by a national sample of veterans seeking care in VHA PTSD specialty outpatient clinics, as well as to examine the impact of demographics on endorsed barriers. METHODS This study included 17,069 veterans referred to PTSD specialty outpatient clinics in the VHA during Fiscal Year 2019. Barriers to care, demographics, clinical concerns, and PTSD symptom severity (PCL-5) were assessed at intake. RESULTS Veterans (mean age=47.6 years, 83.3% male) endorsed an average of 2.39 barriers. The most commonly endorsed barriers included difficulty interacting with others (37.9%), difficulty being in public (33.8%), work (30.3%), concern for finances (20%), and difficulty getting out of bed (19.5%). A significant minority of veterans (22%) endorsed no barriers. Male sex (23.1%) and White race (23.6%) were associated with a greater likelihood of reporting no barriers. CONCLUSIONS These findings indicate the need for a comprehensive approach to addressing multi-faceted barriers for veterans seeking treatment in PTSD specialty clinics. Findings also highlight the potential importance of tailoring strategies to reduce barriers based on demographic and clinical characteristics such as race, sex, and degree of avoidance. Future research should seek to longitudinally examine the impact of barriers on treatment engagement.
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Martinez-Nicolas I, Basaraba C, Delgado-Gomez D, Lopez-Fernandez O, Baca-Garcia E, Wainberg ML. The Electronic Mental Wellness Tool as a Self-Administered Brief Screening Instrument for Mental Disorders in the General Spanish Population during the Post-COVID-19 Era. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3204. [PMID: 36833900 PMCID: PMC9959534 DOI: 10.3390/ijerph20043204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/29/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: In the "post-COVID-19 era", there is a need to focus on properly assessing and addressing the extent of its well-established mental health collateral damage. The "Electronic Mental Wellness Tool" (E-mwTool) is a 13-item validated stepped-care or stratified management instrument that aims at the high-sensitivity captures of individuals with mental health disorders to determine the need for mental health care. This study validated the E-mwTool in a Spanish-speaking population. (2) Methods: It is a cross-sectional validation study using the Mini International Neuropsychiatric Interview as a criterion standard in a sample of 433 participants. (3) Results: About 72% of the sample had a psychiatric disorder, and 67% had a common mental disorder. Severe mental disorders, alcohol use disorders, substance use disorders, and suicide risk had a much lower prevalence rate (6.7%, 6.2%, 3.2%, and 6.2%, respectively). The first three items performed excellently in identifying any mental health disorder with 0.97 sensitivity. Ten additional items classified participants with common mental disorders, severe mental disorders, substance use disorders, and suicide risk. (4) Conclusions: The E-mwTool had high sensitivity in identifying common mental disorders, alcohol and substance use disorders, and suicidal risk. However, the tool's sensitivity in detecting low-prevalence disorders in the sample was low. This Spanish version may be useful to detect patients at risk of mental health burden at the front line of primary and secondary care in facilitating help-seeking and referral by their physicians.
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Affiliation(s)
- Ismael Martinez-Nicolas
- Faculty of Life Sciences, Catholic University of Murcia (UCAM), 30107 Guadalupe, Spain
- Sistema Español de Notificación en Seguridad en Anestesia y Reanimación (SENSAR), IDEhA Simulation Centre, Fundación Alcorcon University Hospital, 28922 Alcorcon, Spain
| | - Cale Basaraba
- New York State Psychiatric Institute, Columbia University, New York, NY 10024, USA
| | - David Delgado-Gomez
- Department of Statistics, University Carlos III of Madrid, 28903 Getafe, Spain
- Santander Big Data Institute, Universidad Carlos III de Madrid, 28903 Getafe, Spain
| | - Olatz Lopez-Fernandez
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, 28040 Madrid, Spain
- Faculty of Psychology, Madrid Complutense University, 28049 Madrid, Spain
- Faculty of Psychology, Francisco de Vitoria University, 28049 Madrid, Spain
- Faculty of Psychology, Cardenal Cisneros Centro de Estudios Universitarios, 28223 Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, 28040 Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, 28933 Móstoles, Spain
- Department of Psychiatry, General University Hospital of Villalba, 28400 Collado Villalba, Spain
- Department of Psychiatry, University Hospital Infanta Elena, 28342 Valdemoro, Spain
- Department of Psychiatry, Madrid Autonomous University, 28049 Madrid, Spain
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, 28029 Madrid, Spain
- Faculty of Psychology, Universidad Catolica del Maule, Talca 3605, Chile
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, 30900 Nîmes, France
| | - Milton L. Wainberg
- New York State Psychiatric Institute, Columbia University, New York, NY 10024, USA
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Ma J, Zhou H, Fu Q, Lu G. Facilitators and barriers in the development and implementation of depression prevention and treatment policies in China: a qualitative study. BMC Public Health 2023; 23:276. [PMID: 36750813 PMCID: PMC9906929 DOI: 10.1186/s12889-023-15201-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Depression is one of the leading causes of avoidable suffering and premature death worldwide, leading to the disease burden among mental disorders. Depression-related deaths can be prevented by developing and implementing good depression prevention and treatment policies. The goal of this study is to provide theoretical direction and useful references for examining the outstanding service work of depression prevention and treatment. It also aims to describe how depression prevention and treatment policies were developed and put into practice in China, along with the associated facilitators and barriers. METHODS We integrated two data sources using a case study approach: a document review of relevant policy documents, published articles and reports between 2004 and 2022 (N = 12 papers) and in-depth interviews (N = 41). Participants were drawn from pertinent sectors to managing depression: research and academia, relevant government departments, health care providers, people with depression and their families, and community organisations. Thematic analysis was used to analyse all data. RESULTS A comprehensive programme of work exploring specific services for depression prevention and treatment was developed in China in 2020. Facilitators of policy development and implementation include (1) political commitment and strong leadership, (2) coordination mechanisms, (3) stakeholder enthusiasm and commitment, (4) resources, and (5) the use of digital technologies. The main barriers leading to delays in policy development and implementation include (1) insufficient awareness and lack of depression literacy, (2) lack of resources and (3) stigma and social discrimination (4) lack of united action. CONCLUSION Although the process of implementing a distinctive service programme for depression prevention and treatment in China has been long, the current policy is in line with current global efforts. Strategies to reduce Stigma and increase knowledge about depression are part of a national and international approach to reducing the burden of depression. Political commitment and the involvement of all stakeholders remain necessary. An adequate response to depression will require the involvement of society as a whole, with joint action to reduce the risk of exposure to adversity and enhance protective factors.
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Affiliation(s)
- Jinping Ma
- grid.268079.20000 0004 1790 6079School of Public health, Weifang Medical University, Weifang, China
| | - Hai Zhou
- Weifang Mental Health Center, Weifang, China
| | - Qinqin Fu
- Weifang Mental Health Center, Weifang, China
| | - Guohua Lu
- School of Psychology, Weifang Medical University, Weifang, China.
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Abo-Rass F, Abu-Kaf S, Matzri D, Braun-Lewensohn O. Mental Health Underutilization by Palestinian-Arabs in Israel: Stigma-Related, Attitudinal, and Instrumental Barriers. Int J Soc Psychiatry 2023:207640231152213. [PMID: 36738081 DOI: 10.1177/00207640231152213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Many studies show that members of minority groups underutilize mental health services and report more barriers to such utilization than majority groups. However, very little is known about these barriers and their relation to mental health service use among the Palestinian-Arab minority in Israel. AIMS This study examined barriers to mental health service use in this population based on the stigma-related, attitudinal, and instrumental barriers dimensions of the Barriers to Care Evaluation scale (BACE v3) and its correlates to mental health service use. METHODS The participants were a convenience sample of 231 Palestinian Arabs. They completed measures of BACE v3, mental health service use, and sociodemographic characteristics. RESULTS The findings showed that participants who reported using mental health services had lower levels of barriers in all dimensions compared to those who did not use such services. Attitudinal barriers were found to be the main determinants of mental health service use. CONCLUSIONS This study underscored the role of attitudinal barriers to the utilization of mental health services. The findings indicated that interventions addressing such barriers might be helpful in increasing mental health service use among the Palestinian-Arab minority in Israel as well as other minorities in Israel and elsewhere, who might share similar backgrounds and perceptions.
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Affiliation(s)
- Fareeda Abo-Rass
- Conflict Management and Resolution Program, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sarah Abu-Kaf
- Conflict Management and Resolution Program, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dvir Matzri
- Conflict Management and Resolution Program, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Orna Braun-Lewensohn
- Conflict Management and Resolution Program, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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135
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Simon L, Reimann J, Steubl LS, Stach M, Spiegelhalder K, Sander LB, Baumeister H, Messner EM, Terhorst Y. Help for insomnia from the app store? A standardized rating of mobile health applications claiming to target insomnia. J Sleep Res 2023; 32:e13642. [PMID: 35624078 DOI: 10.1111/jsr.13642] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/27/2022] [Accepted: 05/04/2022] [Indexed: 02/03/2023]
Abstract
A large number of mobile health applications claiming to target insomnia are available in commercial app stores. However, limited information on the quality of these mobile health applications exists. The present study aimed to systematically search the European Google Play and Apple App Store for mobile health applications targeting insomnia, and evaluate the quality, content, evidence base and potential therapeutic benefit. Eligible mobile health applications were evaluated by two independent reviewers using the Mobile Application Rating Scale-German, which ranges from 1 - inadequate to 5 - excellent. Of 2236 identified mobile health applications, 53 were included in this study. Most mobile health applications (68%) had a moderate overall quality. Concerning the four main subscales of the Mobile Application Rating Scale-German, functionality was rated highest (M = 4.01, SD = 0.52), followed by information quality (M = 3.49, SD = 0.72), aesthetics (M = 3.31, SD = 1.04) and engagement (M = 3.02, SD = 1.03). While scientific evidence was identified for 10 mobile health applications (19%), only one study employed a randomized controlled design. Fifty mobile health applications featured sleep hygiene/psychoeducation (94%), 27 cognitive therapy (51%), 26 relaxation methods (49%), 24 stimulus control (45%), 16 sleep restriction (30%) and 24 sleep diaries (45%). Mobile health applications may have the potential to improve the care of insomnia. Yet, data on the effectiveness of mobile health applications are scarce, and this study indicates a large variance in the quality of the mobile health applications. Thus, independent information platforms are needed to provide healthcare seekers and providers with reliable information on the quality and content of mobile health applications.
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Affiliation(s)
- Laura Simon
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Josephin Reimann
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Lena Sophia Steubl
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Michael Stach
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Kai Spiegelhalder
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Lasse Bosse Sander
- Institute of Psychology, Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Harald Baumeister
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Eva-Maria Messner
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
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136
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Tjokrowijoto P, Stolwyk RJ, Ung D, Kilkenny MF, Kim J, Dalli LL, Cadilhac DA, Andrew NE. Factors associated with mental health service access among Australian community-dwelling survivors of stroke. Disabil Rehabil 2023; 45:504-511. [PMID: 35139002 DOI: 10.1080/09638288.2022.2032413] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To describe types of mental health treatment accessed by community-based stroke survivors and factors associated with access. METHODS A sub-group of registrants from the Australian Stroke Clinical Registry completed a supplementary survey 2.5 years post-stroke. Self-reported information about depression/anxiety and treatment access were collected. Demographic and clinical data were obtained through linkages with registry and government data. Staged multivariable logistic regression was conducted to examine factors associated with treatment access. RESULTS Among 623 registrants surveyed (37% female, median age 69 years), 26% self-reported a medical diagnosis of depression/anxiety at 2.5 years post-stroke. Of these, only 30% reported having accessed mental health services, mostly through government-funded Medicare schemes. Younger age (odds ratio (OR) 0.95, 95% CI 0.93, 0.98), history of mental health treatment (OR 3.38, 95% CI 1.35, 8.48), feeling socially isolated (OR 2.32, 95% CI 1.16, 4.66), self-reported medical diagnosis of depression/anxiety (OR 4.85, 95% CI 2.32, 10.14), and government-subsidised team care plan arrangement (OR 4.05, 95% CI 1.96, 8.37) were associated with receiving treatment. CONCLUSIONS Many stroke survivors have untreated depression/anxiety. Primary care practitioners should be supported in undertaking effective detection and management. Older and newly diagnosed individuals should be educated about depression/anxiety and available supports.Implications for rehabilitationPrimary care providers play a pivotal role in the pathway to mental health care, and therefore should always screen for depression/anxiety and provide comprehensive assessment and referral to specialist services where necessary.Targeted psychoeducation should be provided to survivors of stroke who are older and newly diagnosed with depression/anxiety, to increase awareness about mood problems following stroke.Primary care providers should collaborate with other health professionals (e.g., through coordinating a team care arrangement plan), to address patients' multiple and complex rehabilitation needs.Rehabilitation professionals should remain informed about current evidence-based treatments for post-stroke depression/anxiety and pathways that enable their patients to access these services.
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Affiliation(s)
- Priscilla Tjokrowijoto
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Stroke and Telehealth Research, Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Stroke and Telehealth Research, Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - David Ung
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Australia
| | - Monique F Kilkenny
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Australia
| | - Lachlan L Dalli
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Australia
| | - Nadine E Andrew
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Australia
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Lamahewa K, Griffin S, Seward N, Temmerman M, West J, de Melo M, Raby E, Alonso A, Burnside B, Chissale F, Gheerawo R, Chepchichir EL, Mandlate F, Mahangue D, Mohiddin A, Neagu E, Salisbury TT. Protocol for intervention development to improve adolescent perinatal mental health in Kenya and Mozambique: The INSPIRE project. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2023.100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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138
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Brunault P, Bourbao-Tournois C, Ballon N, de Luca A. Psychiatric, psychological and addiction management in obesity surgery: Early identification for better support. J Visc Surg 2023; 160:S22-S29. [PMID: 36725454 DOI: 10.1016/j.jviscsurg.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although bariatric surgery results in a significant weight reduction and an improvement in the quality of life in most people who undergo surgery, there are inter-individual differences in terms of postoperative results. Psychological, psychiatric and addictive disorders contribute substantially to these difficulties. Between 20% and 50% of bariatric surgery candidates have a current psychiatric/addictive disorder and approximately 30-75% have a history of a psychiatric/addictive disorder within their lifetime. Surgery is accompanied in the short-term by an improvement in depressive symptoms and binge eating, but these symptoms tend to increase again beyond the 3rd postoperative year. Over the long-term, only the improvement in depression remains durable, whilepostoperative anxiety and disordered eating symptoms do not differ significantly from the preoperative levels. There is a two to four fold increased risk of post-surgical suicide and suicide attempts (from the 1st postoperative year onward), as well as an increased risk of alcohol-abuse (beyond two years after surgery). Psychological support must therefore continue long-term. Several psychotherapeutic and pharmacological treatments have demonstrated their effectiveness in improving the postoperative prognosis of patients with psychological/psychiatric disorders. The early integration of psychological/psychiatric/addiction evaluation and support into multidisciplinary management makes it easier to identify these difficulties and to optimize the postoperative prognosis, both in terms of weight and quality of life. Prior to surgery, patients should be systematically evaluated by a psychologist or psychiatrist in order to identify and to manage disorders that could negatively impact the postoperative prognosis. After surgery, this assessment and support can be carried out in a programmed and systematic way for those patients who were identified preoperatively as the most vulnerable, but support can also be offered during follow-up in the event of specific symptoms (i.e., loss of control over food intake, failure in terms of weight or quality of life, suicidal ideation, loss of control over alcohol use, significant depression or anxiety symptoms).
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Affiliation(s)
- P Brunault
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Université de Tours, QualiPsy, EE 1901, Tours, France; Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France.
| | - C Bourbao-Tournois
- Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France; CHRU de Tours, Service de Chirurgie Digestive et Endocrinienne, Tours, France
| | - N Ballon
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France
| | - A de Luca
- Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France; Inserm U1069, Université de Tours, Tours, France; CHRU de Tours, Unité Mobile de Nutrition, Tours, France
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139
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Shkel J, Green G, Le S, Kaveladze B, Marcotte V, Rushton K, Nguyen T, Schueller SM. Understanding Users’ Experiences of a Novel Online Cognitive-Behavioral Therapy Platform for Depression and Anxiety: Qualitative Interviews from Pilot Trial Participants (Preprint). JMIR Form Res 2023. [DOI: 10.2196/46062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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140
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Freund J, Ebert DD, Thielecke J, Braun L, Baumeister H, Berking M, Titzler I. Using the Consolidated Framework for Implementation Research to evaluate a nationwide depression prevention project (ImplementIT) from the perspective of health care workers and implementers: Results on the implementation of digital interventions for farmers. Front Digit Health 2023; 4:1083143. [PMID: 36761450 PMCID: PMC9907445 DOI: 10.3389/fdgth.2022.1083143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/28/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Depression has a significant impact on individuals and society, which is why preventive measures are important. Farmers represent an occupational group exposed to many risk factors for depression. The potential of guided, tailored internet-based interventions and a personalized telephone coaching is evaluated in a German project of the Social Insurance for Agriculture, Forestry and Horticulture (SVLFG). While user outcomes are promising, not much is known about actual routine care use and implementation of the two digital health interventions. This study evaluates the implementation from the perspective of social insurance employees to understand determinants influencing the uptake and implementation of digital interventions to prevent depression in farmers. Methods The data collection and analysis are based on the Consolidated Framework for Implementation Research (CFIR). Health care workers (n = 86) and implementers (n = 7) completed online surveys and/or participated in focus groups. The surveys consisted of validated questionnaires used in implementation research, adapted items from the CFIR guide or from other CFIR studies. In addition, we used reporting data to map implementation based on selected CFIR constructs. Results Within the five CFIR dimensions, many facilitating factors emerged in relation to intervention characteristics (e.g., relative advantage compared to existing services, evidence and quality) and the inner setting of the SVLFG (e.g., tension for change, compatibility with values and existing working processes). In addition, barriers to implementation were identified in relation to the outer setting (patient needs and resources), inner setting (e.g., available resources, access to knowledge and information) and characteristics of individuals (e.g., self-efficacy). With regard to the implementation process, facilitating factors (formal implementation leaders) as well as hindering factors (reflecting and evaluating) were identified. Discussion The findings shed light on the implementation of two digital prevention services in an agricultural setting. While both offerings seem to be widely accepted by health care workers, the results also point to revealed barriers and contribute to recommendations for further service implementation. For instance, special attention should be given to "patient needs and resources" by raising awareness of mental health issues among the target population as well as barriers regarding the inner setting. Clinical Trial Registration German Clinical Trial Registration: [DRKS00017078]. Registered on 18.04.2019.
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Affiliation(s)
- Johanna Freund
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,TUM Department of Sport and Health Sciences, TU Munich, Munich, Germany,Correspondence: Johanna Freund
| | | | - Janika Thielecke
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,TUM Department of Sport and Health Sciences, TU Munich, Munich, Germany
| | - Lina Braun
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ingrid Titzler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Dzemaili S, Pasquier J, Oulevey Bachmann A, Mohler-Kuo M. The Effectiveness of Mental Health First Aid Training among Undergraduate Students in Switzerland: A Randomized Control Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1303. [PMID: 36674060 PMCID: PMC9859566 DOI: 10.3390/ijerph20021303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Half to three-fourths of mental disorders appear during adolescence or young adulthood, and the treatment gap is mainly due to lack of knowledge, lack of perceived need, and the stigmatization of mental illness. The aims of this study were to implement and evaluate a Mental Health First Aid (MHFA) training program among undergraduates. Participants were second-year students from two universities in the French-speaking region of Switzerland (N = 107), who were randomly assigned to an intervention group (n = 53) or control group (n = 54). The intervention group received a 12-h MHFA course. Online questionnaires were completed before the intervention (T0), and both 3 months (T1) and 12 months (T2) after the intervention in order to evaluate the participants' mental health knowledge, recognition of schizophrenia, and attitudes and behaviors towards mental illness. We used Generalized Estimating Equations (GEE) to examine the effects of intervention over time. After the MHFA course, the intervention group showed significantly increased basic knowledge and confidence helping others with mental illness and reduced stigmatization at both T1 and T2 compared to their baseline scores and compared to control groups. This suggests that the MHFA training program is effective and has significant short-term and long-term impacts, in terms of enhancing basic knowledge about mental health and improving attitudes towards mental illness among undergraduate students.
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Affiliation(s)
- Shota Dzemaili
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, 1004 Lausanne, Switzerland
| | - Jérôme Pasquier
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1011 Lausanne, Switzerland
| | - Annie Oulevey Bachmann
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, 1004 Lausanne, Switzerland
| | - Meichun Mohler-Kuo
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, 1004 Lausanne, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland
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142
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Bruhns A, Baumeister A, Demeroutis G, Jahn H, Willenborg B, Shaffy A, Moritz S, Bücker L. A mobile-based aftercare intervention to increase self-esteem in inpatients diagnosed with depression: A randomized controlled trial. Psychother Res 2023:1-20. [PMID: 36628469 DOI: 10.1080/10503307.2022.2157226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE In this randomized controlled trial, we investigated the effectiveness, side effects and user satisfaction of the self-help smartphone app "MCT & More" among inpatients with a diagnosis of depression after their discharge from a psychiatric hospital over a period of 4 weeks. METHODS A total of 159 inpatients were recruited in four German psychiatric hospitals three days before hospital discharge (intervention group: n = 79; treatment as usual: n = 80). Based on the vulnerability model (low self-esteem contributes to depression), self-esteem represented the primary outcome, quality of life and depressive symptoms the secondary outcomes. RESULTS Intention-to-treat analyzes showed no statistical significance for the primary and secondary outcome parameters, except for the subscale self-competence in favor of the intervention group (with a small effect size of d = 0.35), in the context of an exploratory approach (post hoc). The more positive the attitude toward mobile-based interventions and the more positive the treatment expectations, the more frequently the app was used (r = .35, p = .008; r = .34, p = .009). CONCLUSION Further symptom reduction could not be obtained. However, the results suggest that an effect on improvement in self-competence could be achieved by low-threshold aftercare programs. Future studies should include long-term assessments to examine the impact of mobile-based aftercare on relapse.Trial registration: DRKS00022559.
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Affiliation(s)
- Alina Bruhns
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Baumeister
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Holger Jahn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,AMEOS Klinikum Heiligenhafen, Heiligenhafen, Germany
| | | | - Athif Shaffy
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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McLaren T, Peter LJ, Tomczyk S, Muehlan H, Schomerus G, Schmidt S. The Seeking Mental Health Care model: prediction of help-seeking for depressive symptoms by stigma and mental illness representations. BMC Public Health 2023; 23:69. [PMID: 36627597 PMCID: PMC9831378 DOI: 10.1186/s12889-022-14937-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Only about half the people with depression seek professional health care services. To constitute the different predictors and associating variables of health care utilisation, we model the process and aim to test our hypothesised Seeking Mental Health Care Model. The model includes empirical influences on the help-seeking process to predict actual behaviour and incorporates superordinate (stigma, treatment experiences) as well as intermediate attitudinal variables (continuum and causal beliefs, depression literacy and self-efficacy). METHOD All variables are examined in an online study (baseline, three- and six-month follow-up). The sample consisted of adults with depressive symptoms (PHQ-9 sum score ≥ 8), currently not receiving mental health care treatment. To examine the prediction of variables explaining help-seeking behaviour, a path model analysis was carried out (lavaan package, software R). RESULTS Altogether, 1368 participants (Mage = 42.38, SDage = 15.22, 65.6% female) were included, 983 participating in at least one follow-up. Model fit was excellent (i.e., RMSEA = 0.059, CFI = 0.989), and the model confirmed most of the hypothesised predictions. Intermediary variables were significantly associated with stigma and experiences. Depression literacy (ß = .28), continuum beliefs (ß = .11) and openness to a balanced biopsychosocial causal model (ß = .21) significantly influenced self-identification (R2 = .35), which among the causal beliefs and self-efficacy influenced help-seeking intention (R2 = .10). Intention (ß = .40) prospectively predicted help-seeking behaviour (R2 = .16). CONCLUSION The Seeking Mental Health Care Model provides an empirically validated conceptualisation of the help-seeking process of people with untreated depressive symptoms as a comprehensive approach considering internal influences. Implications and open questions are discussed, e.g., regarding differentiated assessment of self-efficacy, usefulness of continuum beliefs and causal beliefs in anti-stigma work, and replication of the model for other mental illnesses. TRIAL REGISTRATION German Clinical Trials Register: DRKS00023557. Registered 11 December 2020. World Health Organization, Universal Trial Number: U1111-1264-9954. Registered 16 February 2021.
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Affiliation(s)
- Thomas McLaren
- grid.5603.0Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489 Greifswald, Germany
| | - Lina-Jolien Peter
- grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, 04103 Leipzig, Germany
| | - Samuel Tomczyk
- grid.5603.0Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489 Greifswald, Germany
| | - Holger Muehlan
- grid.5603.0Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489 Greifswald, Germany
| | - Georg Schomerus
- grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, 04103 Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103 Leipzig, Germany
| | - Silke Schmidt
- grid.5603.0Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489 Greifswald, Germany
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144
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Choi J. Promoting Mental Health Literacy at Schools in South Korea. Soa Chongsonyon Chongsin Uihak 2023; 34:15-20. [PMID: 36636500 PMCID: PMC9816008 DOI: 10.5765/jkacap.220037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/10/2022] [Indexed: 01/06/2023] Open
Abstract
The onset of many lifelong mental illnesses is during childhood and adolescence. There has been an increase in these conditions among children and adolescents especially, during the COVID-19 pandemic. It is essential to promote mental health literacy (MHL) as a preventive and universal intervention for children and adolescents. Positive mental health status in adolescence is related to an increased level of MHL, and various MHL programs at schools have been reported to be effective for adolescent students worldwide. Recently, MHL programs have been developed in South Korea to be used by schoolteachers. There is a need for active dissemination and development of future programs. For continuous and effective education, it is desirable to include MHL education in regular school curricula.
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Affiliation(s)
- Jeewook Choi
- Department of Psychiatry, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea,Address for correspondence: Jeewook Choi, Department of Psychiatry, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon 34943, Korea Tel: +82-42-220-9020, Fax: +82-42-252-6807, E-mail:
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145
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Zhao R, Amarnath A, Karyotaki E, Struijs SY, Cuijpers P. Effects of psychological treatment for depression among people not actively seeking help: a meta-analysis. Psychol Med 2023; 53:320-331. [PMID: 36404636 PMCID: PMC9899569 DOI: 10.1017/s0033291722003518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 09/22/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022]
Abstract
Although psychological treatments have been found to be effective for depression in adults, many individuals with depression do not actively seek help. It is currently unclear whether psychological treatments are effective among those not actively seeking help. Besides, little is known about the proportion of patients who completed a screening questionnaire who end up in a clinical trial. Therefore, we conducted a meta-analysis of 52 randomized trials comparing psychotherapies for adults with a diagnosis or elevated symptoms of depression against control conditions (care-as-usual, waiting list, and other inactive treatment). Only studies recruiting participants who do not actively seek help (participants who have been recruited through screening instead of advertisements and clinical referrals) were included. To obtain an overall effect estimate of psychotherapy, we pooled all post-test differences with a random-effects model. We found that psychological treatments had a moderate to high effect on reducing depressive symptoms compared to control groups [g = 0.55; 95% confidence interval (CI) 0.41-0.69]. Heterogeneity was high (I2 = 75%; 95% CI 68-80). At 12 months' follow-up, the effects were small but significant (6-8 months: g = 0.33; 95% CI 0.14-0.52; 9-12 months: g = 0.24; 95% CI 0.11-0.37). As a secondary outcome, we found that 13% of patients who completed a screening questionnaire met the inclusion criteria for depression and agreed to be randomized in the trial. Based on the current evidence, psychological treatments for depression might be effective for depressed patients who are not actively seeking help.
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Affiliation(s)
- Ruiying Zhao
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Arpana Amarnath
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sascha Y. Struijs
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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146
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[Video-based psychotherapy: current framework conditions, developments, and recommendations for practical implementation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:154-159. [PMID: 36648497 PMCID: PMC9843682 DOI: 10.1007/s00103-022-03644-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/06/2022] [Indexed: 01/18/2023]
Abstract
Video-based psychotherapy is a digital way to deliver psychotherapeutic treatment when traditional on-site psychotherapy cannot be provided due to structural barriers, such as those related to the COVID-19 pandemic. The use of this digital approach has proven to be both effective and accepted among therapists and patients. Legal frameworks for German therapists and recommendations for practical implementation are summarized in this article.
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147
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Lafortune D, Girard M, Dussault É, Philibert M, Hébert M, Boislard MA, Goyette M, Godbout N. Who seeks sex therapy? Sexual dysfunction prevalence and correlates, and help-seeking among clinical and community samples. PLoS One 2023; 18:e0282618. [PMID: 36877709 PMCID: PMC9987801 DOI: 10.1371/journal.pone.0282618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/20/2023] [Indexed: 03/07/2023] Open
Abstract
Sexual dysfunctions (SD; e.g., female sexual interest/arousal disorder, erectile disorder, female orgasmic disorder, delayed ejaculation, genito-pelvic pain/penetration disorder, etc.) affect up to a third of individuals, impairing sexuality, intimate relationships, and mental health. This study aimed to compare the prevalence of SDs and their sexual, relational, and psychological correlates between a sample of adults consulting in sex therapy (n = 963) and a community-based sample (n = 1,891), as well as examine barriers to sexual health services for SD and the characteristics of individuals seeking such services. Participants completed an online survey. Analyses showed that participants in the clinical sample reported lower levels of sexual functioning and sexual satisfaction and higher levels of psychological distress than participants in the community-based sample. Moreover, higher SD rates were related to lower relational satisfaction and higher psychological distress in the community sample, and to lower sexual satisfaction in both samples. Among participants in the community sample who sought professional services for SD, 39.6% reported that they were unable to access services, and 58.7% reported at least one barrier to receiving help. This study provides important data regarding the prevalence of SD and the link between SD and psychosexual health in clinical and nonclinical samples, as well as barriers to treatment access.
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Affiliation(s)
- David Lafortune
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
- * E-mail:
| | - Marianne Girard
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
| | - Éliane Dussault
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
| | - Mathieu Philibert
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
| | | | - Mathieu Goyette
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
| | - Natacha Godbout
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
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148
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Smith J, Cvejic E, Lal TJ, Fisher A, Tracy M, McCaffery KJ. Impact of alternative terminology for depression on help-seeking intention: A randomized online trial. J Clin Psychol 2023; 79:68-85. [PMID: 35802773 PMCID: PMC10953448 DOI: 10.1002/jclp.23410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 04/08/2022] [Accepted: 06/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE People with depression experience barriers to seeking professional help. Different diagnostic terminology can influence people's treatment/management preferences. The aim of this study was to investigate how alternative depression diagnostic labels and recommendations impact help-seeking intentions and psychosocial outcomes. METHODS Participants (18-70 years) were recruited using an online panel (Australia) to complete a randomized controlled trial. They read a hypothetical scenario where they discussed experiencing depressive symptoms with their GP and were randomized to receive one of four diagnoses ("depression," "burnout," "functional impairment syndrome" [fictitious label], no label [control]), and one of two follow-up recommendations ("clinical psychologist," "mind coach"). PRIMARY OUTCOME help-seeking intention (5-point scale, higher = greater intention); secondary outcomes: intention to speak to boss, self-stigma, worry, perceived severity, illness perceptions, and personal stigma. RESULTS A total of 676 participants completed the survey. There was no main effect of diagnostic label on help-seeking intention or stigma outcomes. Intention to speak to a boss was higher with the depression compared to burnout label (MD = 0.40, 95% CI: 0.14-0.66) and perceived severity was higher with the depression label compared to control (MD = 0.48, 95% CI: 0.22-0.74) and all other labels. Those who received the "clinical psychologist" recommendation reported higher help-seeking intention (MD = 0.43, 95% CI: 0.25-0.60) and treatment control (MD = 0.69, 95% CI: 0.29-1.10) compared to the "mind coach" recommendation. CONCLUSION Findings highlight the success of efforts to promote help-seeking from clinical psychologists for depression. If burnout is considered a separate diagnostic entity to depression, greater awareness around what such a diagnosis means may be needed. Future research should examine how different terminologies surrounding other mental health conditions impact help-seeking and stigma.
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Affiliation(s)
- Jenna Smith
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Erin Cvejic
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Tara J. Lal
- University of New EnglandArmidaleNew South WalesAustralia
| | - Alana Fisher
- eCentre Clinic, School of Psychological SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Marguerite Tracy
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kirsten J. McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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Mishra N, Singh P. Community-Based Intervention Targeting Depressive Symptomatology in Indian Women: An Exploration of Its Efficacy in a Non-Specialized Healthcare Setting. Community Ment Health J 2023; 59:999-1012. [PMID: 36587370 DOI: 10.1007/s10597-022-01083-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/21/2022] [Indexed: 01/02/2023]
Abstract
Depressive symptomatology casts a more adverse impact on the well-being of women in countries with unfavourable societal norms. The prevalence of depressive symptomatology in Indian women and the treatment gap in case of mental health issues are alarming and thus may require interventions at a community level. The present study tested the efficacy of a psychosocial community-based intervention in managing depressive symptomatology and associated factors like rumination, reappraisal, psychological resilience, and self-efficacy using a pre-test post-test control group design. A total of 114 (Mage=23.03, SD = 5.29) and 37 (Mage=24.89, SD = 6.44) adult females were there in the experimental and the control group, respectively. A series of ANOVAs showed that participants' scores on depressive symptomatology and associated vulnerabilities and defences improved as compared to the baseline and the control group. The findings support the use of psychosocial community-based intervention in a non-specialized healthcare setting to manage depressive symptomatology, associated vulnerability and defences.
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Affiliation(s)
- Navneet Mishra
- Department of Humanities and Social Science, Indian Institute of Technology Ropar, Ropar, Punjab, 140001, India.
| | - Parwinder Singh
- Department of Humanities and Social Science, Indian Institute of Technology Ropar, Ropar, Punjab, 140001, India
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150
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Puyat JH, Mohebbian M, Gupta A, Ellis U, Ranote H, Almeida A, Ridgway L, Vila-Rodriguez F, Kazanjian A. Home-based and community-based activities that can improve mental wellness: a protocol for an umbrella review. BMJ Open 2022; 12:e065564. [PMID: 36585148 PMCID: PMC9809256 DOI: 10.1136/bmjopen-2022-065564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Mental disorders affect about 13% of the world's population. While evidence-based mental health treatments are available, a significant number of persons with mental illnesses are untreated or do not receive adequate mental healthcare due to various reasons, including costs, stigma and the desire to self-manage symptoms. In the past few years, there has been an increase in the body of evidence regarding leisure activities and mental wellness. However, there is currently no published overview of the state of the evidence on these activities and their potential preventive and therapeutic effects on mental health. METHODS AND ANALYSIS Using Joanna Briggs Institute (JBI) review guidelines, an umbrella review will be undertaken to synthesise findings from systematic reviews and meta-analyses on the mental health benefits of home-based and community-based activities. MEDLINE, PsycInfo, Embase, CINAHL, Web of Science, Epistemonikos, Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews and Implementation Reports will be searched for potentially relevant systematic reviews and meta-analyses published from January 1991 to present. Title/abstract screening, full-text review, data extraction and assessment of methodological quality will each be performed independently by two reviewers. A third review author will be available to resolve discrepancies in any of the review tasks. To assess the quality of potentially eligible reviews, the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses will be used. Findings will be presented in table form and will be summarised by study population, type of home-based or community-based activity or intervention, and type of mental health outcomes. Overall assessment of the strength of existing evidence from eligible systematic reviews will be provided following the grading of recommendation, assessment, development and evaluation approach. ETHICS AND DISSEMINATION No ethical approval is required. Results of this umbrella review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021266989.
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Affiliation(s)
- Joseph H Puyat
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mana Mohebbian
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Aanchel Gupta
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ursula Ellis
- Woodward Library, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Harmanpreet Ranote
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Alberto Almeida
- BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
| | - Lisa Ridgway
- BC Support Unit, Vancouver, British Columbia, Canada
| | - Fidel Vila-Rodriguez
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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