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Abbasalizad Farhangi M, Dehghan P, Jahangiry L. Mental health problems in relation to eating behavior patterns, nutrient intakes and health related quality of life among Iranian female adolescents. PLoS One 2018; 13:e0195669. [PMID: 29702683 PMCID: PMC5922554 DOI: 10.1371/journal.pone.0195669] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 03/27/2018] [Indexed: 11/21/2022] Open
Abstract
Aims To identify the association between mental health problems, eating behavior patterns, nutrient intakes and health related quality of life (HRQoL) among Iranian female adolescents. Materials and methods The current cross-sectional study conducted among three high-schools randomly selected from 10-day-public high schools in the selected sub-county from Tabriz city-Iran between December 2015 through March 2016. Participants were a sample of 107 adolescent girls aged 15–17 years old. Anthropometric parameters were measured and assessments of HRQoL, mental health problems and eating behavioral patterns were performed by Short Form 36 (SF-36), Strengths and Difficulties Questionnaires (SDQ) and Eating Behavioral Pattern Questionnaire (EBPQ) respectively. Dietary intake was assessed using a semi-quantitative Food-Frequency Questionnaire (FFQ) adapted for the Iranian society. Quality of life was measured with HRQoL questionnaire. Quantitative analysis using independent sample t test was performed for comparison of continuous variables between two subgroups (unlikely, possible/probable) of each category of mental health problem. Multiple logistic regression was used to measure the potential predictors (e.g. eating patterns and HRQoL) of mental health problems in two models of crude and adjusted for age and body mass index (BMI). P values less than 0.05 were considered as statistically significant. Results Indicators of conduct problems and hyperactivity disorders were the most prevalent mental health problems among female adolescents (25.2% and 18.6% respectively). The prevalence of hyperactivity disorders among female adolescents was 35.5%. Female adolescents in high scores of ‘snacking and convenience’, ‘planning ahead’ and ‘meal skipping’ eating patterns were more likely to have indicators of emotional disorders (P < 0.05). Also, being in the high tertile of ‘low fat eating’ pattern made adolescents less likely to have hyperactivity disorders (P < 0.05). Moreover, according to our finding, high scores of vitality and mental health components of HRQoL were associated with reduced likelihood of emotional disorders, conduct disorders and hyperactivity disorders. No significant difference in terms of BMI and nutrient intakes in different categories of mental health problems according to SDQ scoring was identified. Conclusions In the current study unhealthy eating patterns including ‘snacking and convenience’, ‘planning ahead’ and ‘meal skipping’ eating patterns were positive predictors of “emotional disorders” while “low fat” eating pattern was negative predictor of hyperactivity disorders.
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Affiliation(s)
| | - Parvin Dehghan
- Drug Applied Research Center, Department of Nutrition and Biochemistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Jahangiry
- Tabriz Health Services Management Research Center, Health Education and Health Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran
- * E-mail:
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Ebert DD, Buntrock C, Reins JA, Zimmermann J, Cuijpers P. Efficacy and moderators of psychological interventions in treating subclinical symptoms of depression and preventing major depressive disorder onsets: protocol for an individual patient data meta-analysis of randomised controlled trials. BMJ Open 2018; 8:e018582. [PMID: 29549201 PMCID: PMC5857689 DOI: 10.1136/bmjopen-2017-018582] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately subgroups and moderator effects. The aim of the present study is, therefore, to examine the short-term and long-term as well as moderator effects of psychological interventions compared with control groups in adults with subthreshold depression on depressive symptom severity, treatment response, remission, symptom deterioration, quality of life, anxiety and the prevention of major depressive disorder (MDD) onsets on individual patient level and study level using an individual patient data meta-analysis approach. METHODS AND ANALYSIS Systematic searches in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials were conducted. We will use the following types of outcome criteria: (A) onset of major depression; (B) time to major depression onset; (C) observer-reported and self-reported depressive symptom severity; (D) response; (E) remission; (F) symptom deterioration; (G) quality of life, (H) anxiety; and (I) suicidal thoughts and behaviours. Multilevel models with participants nested within studies will be used. Missing data will be handled using a joint modelling approach to multiple imputation. A number of sensitivity analyses will be conducted in order test the robustness of our findings. ETHICS AND DISSEMINATION The investigators of the primary trials have obtained ethical approval for the data used in the present study and for sharing the data, if this was necessary, according to local requirements and was not covered from the initial ethic assessment.This study will summarise the available evidence on the short-term and long-term effectiveness of preventive psychological interventions for the treatment of subthreshold depression and prevention of MDD onset. Identification of subgroups of patients in which those interventions are most effective will guide the development of evidence-based personalised interventions for patients with subthreshold depression. PROSPERO REGISTRATION NUMBER CRD42017058585.
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Affiliation(s)
- David D Ebert
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany
| | - Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany
| | - Jo Annika Reins
- Institute of Psychology, Leuphana University of Luneburg, Luneburg, Germany
| | - Johannes Zimmermann
- Chair for Psychological Methods and Diagnostics, Psychologische Hochschule Berlin, Berlin, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
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Zeldetz V, Natanel D, Boyko M, Zlotnik A, Shiyntum HN, Grinshpun J, Frank D, Kuts R, Brotfain E, Peiser J. A New Method for Inducing a Depression-Like Behavior in Rats. J Vis Exp 2018. [PMID: 29553503 DOI: 10.3791/57137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Contagious depression is a phenomenon that is yet to be fully recognized and this stems from insufficient material on the subject. At the moment, there is no existing format for studying the mechanism of action, prevention, containment, and treatment of contagious depression. The purpose of this study, therefore, was to establish the first animal model of contagious depression. Healthy rats can contract depressive behaviors if exposed to depressed rats. Depression is induced in rats by subjecting them to several manipulations of chronic unpredictable stress (CUS) over 5 weeks, as described in the protocol. A successful sucrose preference test confirmed the development of depression in the rats. The CUS-exposed rats were then caged with naïve rats from the contagion group (1 naïve rat/2 depressed rats in a cage) for an additional 5 weeks. 30 social groups were created from the combination of CUS-exposed rats and naïve rats. This proposed depression-contagion protocol in animals consists mainly of cohabiting CUS-exposed and healthy rats for 5 weeks. To ensure that this method works, a series of tests are carried out - first, the sucrose preference test upon inducing depression to rats, then, the sucrose preference test, alongside the open field and forced-swim tests at the end of the cohabitation period. Throughout the experiment, rats are given tags and are always returned to their cages after each test. A few limitations to this method are the weak differences recorded between the experimental and control groups in the sucrose preference test and the irreversible traumatic outcome of the forced swim test. These may be worth considering for suitability before any future application of the protocol. Nonetheless, following the experiment, naïve rats developed contagion depression after 5 weeks of sharing the same cage with the CUS-exposed rats.
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Affiliation(s)
- Vladimir Zeldetz
- Department of Emergent Medicine, Soroka University Medical Center, Ben-Gurion University of the Negev
| | - Dmitry Natanel
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Matthew Boyko
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev;
| | - Alexander Zlotnik
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Honore N Shiyntum
- Department of Biophysics and Biochemistry, Oles' Honchar Dnipro National University
| | - Julia Grinshpun
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Dmitry Frank
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Ruslan Kuts
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Evgeni Brotfain
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
| | - Jochanan Peiser
- Division of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev
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Łaszewska A, Österle A, Wancata J, Simon J. Prevalence of mental diseases in Austria : Systematic review of the published evidence. Wien Klin Wochenschr 2018; 130:141-150. [PMID: 29368240 PMCID: PMC5816100 DOI: 10.1007/s00508-018-1316-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/08/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Addressing the growing burden of mental diseases is a public health priority. Nevertheless, many countries lack reliable estimates of the proportion of the population affected, which are crucial for health and social policy planning. This study aimed to collect existing evidence on the prevalence of mental diseases in Austria. METHODS A systematic review was conducted using MeSH, EMTREE and free-text terms in seven bibliographic databases. In addition, the references of included papers and relevant Austria-specific websites were searched. Articles published after 1996 pertaining to the Austrian adult population and presenting prevalence data for mental diseases were included in the analysis. RESULTS A total of 2612 records were identified in the database search, 19 of which were included in the analysis, 13 were community-based studies and 6 examined institutionalized populations. Sample sizes ranged from 200 to 15,474. The evidence was centered around depression (n = 6, 32%), eating disorders (n = 4, 21%) and alcohol dependence (n = 3, 16%). While most studies (n = 10, 53%) used questionnaires and scales to identify mental diseases, seven studies used structured clinical interviews, and two studies examined use of psychotropic drugs. Due to the diversity of methodologies, no statistical pooling of prevalence estimates was possible. CONCLUSION Information on the prevalence of mental diseases in Austria is limited and comparability between studies is restricted. A variety of diagnostic instruments, targeted populations and investigated diseases contribute to discrepancies in the prevalence rates. A systematic, large-scale study on the prevalence of mental diseases in Austria is needed for comprehensive and robust epidemiological evidence.
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Affiliation(s)
- Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090 Vienna, Austria
| | - August Österle
- Institute for Social Policy, Vienna University of Economics and Business, Welthandelsplatz 1, 1020 Vienna, Austria
| | - Johannes Wancata
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090 Vienna, Austria
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Zhang Y, Yuan S, Pu J, Yang L, Zhou X, Liu L, Jiang X, Zhang H, Teng T, Tian L, Xie P. Integrated Metabolomics and Proteomics Analysis of Hippocampus in a Rat Model of Depression. Neuroscience 2018; 371:207-220. [DOI: 10.1016/j.neuroscience.2017.12.001] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/29/2017] [Accepted: 12/02/2017] [Indexed: 02/06/2023]
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Saraulli D, Costanzi M, Mastrorilli V, Farioli-Vecchioli S. The Long Run: Neuroprotective Effects of Physical Exercise on Adult Neurogenesis from Youth to Old Age. Curr Neuropharmacol 2018; 15:519-533. [PMID: 27000776 PMCID: PMC5543673 DOI: 10.2174/1570159x14666160412150223] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/08/2016] [Accepted: 03/16/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The rapid lengthening of life expectancy has raised the problem of providing social programs to counteract the age-related cognitive decline in a growing number of older people. Physical activity stands among the most promising interventions aimed at brain wellbeing, because of its effective neuroprotective action and low social cost. The purpose of this review is to describe the neuroprotective role exerted by physical activity in different life stages. In particular, we focus on adult neurogenesis, a process which has proved being highly responsive to physical exercise and may represent a major factor of brain health over the lifespan. METHODS The most recent literature related to the subject has been reviewed. The text has been divided into three main sections, addressing the effects of physical exercise during childhood/ adolescence, adulthood and aging, respectively. For each one, the most relevant studies, carried out on both human participants and rodent models, have been described. RESULTS The data reviewed converge in indicating that physical activity exerts a positive effect on brain functioning throughout the lifespan. However, uncertainty remains about the magnitude of the effect and its biological underpinnings. Cellular and synaptic plasticity provided by adult neurogenesis are highly probable mediators, but the mechanism for their action has yet to be conclusively established. CONCLUSION Despite alternative mechanisms of action are currently debated, age-appropriate physical activity programs may constitute a large-scale, relatively inexpensive and powerful approach to dampen the individual and social impact of age-related cognitive decline.
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Affiliation(s)
- Daniele Saraulli
- Institute of Cell Biology and Neurobiology, National Research Council, & Fondazione S. Lucia, Rome. Italy
| | - Marco Costanzi
- Department of Human Sciences, LUMSA University, Rome. Italy
| | - Valentina Mastrorilli
- Institute of Cell Biology and Neurobiology, National Research Council, & Fondazione S. Lucia, Rome. Italy
| | - Stefano Farioli-Vecchioli
- Institute of Cell Biology and Neurobiology, National Research Council, Via del Fosso di Fiorano 64, 00143 Rome. Italy
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A (five-)level playing field for mental health conditions?: exploratory analysis of EQ-5D-5L-derived utility values. Qual Life Res 2017; 27:717-724. [PMID: 29248995 PMCID: PMC5845602 DOI: 10.1007/s11136-017-1768-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 10/29/2022]
Abstract
PURPOSE Economic evaluations of mental health interventions often measure health benefit in terms of utility values derived from the EQ-5D. For the five-level version of the EQ-5D, there are two methods of estimating utility [crosswalk and stated preference (5L-SP)]. This paper explores potential impacts for researchers and decision-makers when comparing utility values derived from either method in the specific context of mental health. METHODS Baseline EQ-5D-5L data from three large randomised controlled trials of interventions for mental health conditions were analysed. Utility values were generated using each method. Mean utility values were compared using a series of t tests on pooled data and subgroups. Scenario analyses explored potential impacts on cost-effectiveness decisions. RESULTS EQ-5D data were available for 1399 participants. The mean utility value for each trial was approximately 0.08 higher when estimated using the 5L-SP approach compared to crosswalk (p < 0.0001). The difference was greatest among people reporting extreme anxiety/depression (mean utility 5L-SP 0.309, crosswalk 0.084; difference = 0.225; p < 0.0001). Identical improvements in health status were associated with higher costs to gain one QALY with the 5L-SP approach; this is more pronounced when improvements are across all domains compared to improvements on the anxiety/depression domain only. CONCLUSIONS The two approaches produce significantly different utility values in people with mental health conditions. Resulting differences in cost per QALY estimates suggest that thresholds of cost-effectiveness may also need to be reviewed. Researchers and decision-makers should exercise caution when comparing or synthesising data from trials of mental health interventions using different utility estimation approaches.
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108
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Zhou SG, Hou YF, Liu D, Zhang XY. Effect of Cognitive Behavioral Therapy Versus Interpersonal Psychotherapy in Patients with Major Depressive Disorder: A Meta-analysis of Randomized Controlled Trials. Chin Med J (Engl) 2017; 130:2844-2851. [PMID: 29176143 PMCID: PMC5717864 DOI: 10.4103/0366-6999.219149] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Practice guidelines have recommended cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) as the treatment of choice for major depression disorder (MDD). However, whether one therapy is better than the other remains inconclusive. The aim of this study was to compare the treatment efficacy of the two treatment approaches for MDD. METHODS Using the terms "cognitive behavior therapy or cognitive therapy or CBT or CT or cognitive behavioral therapy" and "interpersonal psychotherapy or IPT," we systematically searched PubMed, Psyclnfo and Chinese National Knowledge Infrastructure databases up to February 2017. The language was restricted to be English and Chinese. Therapeutic outcomes, characteristics, and research quality were then extracted and analyzed independently. In accessing the included studies, we followed the criteria suggested by the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Data for 946 patients from 10 randomized controlled trials were included in the study. Methodological quality was not optimal in most trials. Meta-analysis showed a mean difference (MD) of -1.31, 95% confidence interval (CI) (-2.49, -0.12) (P < 0.05) in favor of CBT according to the Beck Depression Inventory (BDI), and however, we did not found any statistically significant difference between CBT and IPT on the Hamilton Rating Scale for depression (HRSD) (MD -0.90, 95% CI [-2.18, 0.38]). Subgroup analyses for the studies in which patients were treated only by psychotherapy (MD -1.26, 95% CI [-2.78, 0.35]) and for those which offered more sessions of therapies (MD -0.82, 95% CI [-2.23, 0.59]) showed there was no significant difference between CBT and IPT according to BDI. CONCLUSIONS Differences in treatment efficacy seem to vary according to different outcome measures. CBT shows an advantage over IPT for MDD according to BDI, and there is no significant difference between the two according to HRSD. These results should be interpreted with caution.
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Affiliation(s)
- She-Gang Zhou
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China
- Department of Psychology, Institute of Education, Henan Normal University, Xinxiang, Henan 453007, China
| | - Yan-Fei Hou
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Ding Liu
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xiao-Yuan Zhang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China
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Josephine K, Josefine L, Philipp D, David E, Harald B. Internet- and mobile-based depression interventions for people with diagnosed depression: A systematic review and meta-analysis. J Affect Disord 2017; 223:28-40. [PMID: 28715726 DOI: 10.1016/j.jad.2017.07.021] [Citation(s) in RCA: 222] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/05/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND To summarize and critically evaluate the effectiveness of internet- and mobile-based interventions (IMIs) for depression in adults with a diagnosed depression. METHODS Preregistered systematic review of RCTs investigating internet- and mobile-based interventions (IMIs) targeting adults with diagnosed depression. IMIs had to be compared with waitlist, attention placebo, other IMIs or other (face-to-face) therapies. A comprehensive search of primary studies was conducted. Study selection and data extraction was done by two independent researchers. Primary outcome was symptom severity of depression. Furthermore, treatment response, depression remission, treatment adherence, anxiety and quality of life were investigated. Random-effects meta-analyses were conducted where possible, as well as pre-planned subgroup and sensitivity analyses. RESULTS Database search resulted in 4858 references, of which 19 studies were eligible for inclusion and provided data on 29 IMIs. IMIs showed beneficial effects on depression severity when compared to waitlist conditions at the end of treatment (pooled standardized mean difference (SMD) g = -0.90, 95% CI -1.07 to -0.73, n = 10). The comparison between different IMIs did not result in any superiority or inferiority. All IMIs reduced depression symptoms from pre- to post-treatment (within group SMD range -2.24; -0.64, n = 29) and from pre-treatment to follow-up assessments (SMD range -3.07; -0.93, n = 27). CONCLUSION IMIs significantly reduce depression symptoms in adults with diagnosed depression at the end of treatment and at follow-up assessments when compared to waitlist conditions. These findings argue for IMIs to be recommended in depression treatment guidelines.
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Affiliation(s)
- Königbauer Josephine
- University of Ulm, Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Germany
| | - Letsch Josefine
- University of Ulm, Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Germany
| | - Doebler Philipp
- TU Dortmund University, Faculty of Statistics, Chair of Statistical Methods in Social Sciences, Germany
| | - Ebert David
- Friedrich-Alexander University of Erlangen-Nürnberg, Clinical Psychology and Psychotherapy, Germany
| | - Baumeister Harald
- University of Ulm, Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Germany.
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Boerema AM, ten Have M, Kleiboer A, de Graaf R, Nuyen J, Cuijpers P, Beekman ATF. Demographic and need factors of early, delayed and no mental health care use in major depression: a prospective study. BMC Psychiatry 2017; 17:367. [PMID: 29145820 PMCID: PMC5691833 DOI: 10.1186/s12888-017-1531-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 11/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the availability of evidence based treatments, many people with major depression receive no or delayed professional treatment, which may put them at risk for adverse outcomes. The aim of this study was to examine which demographic and need factors distinguish early, delayed and no treatment use. METHODS Data were obtained from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). People with a diagnosis of major depression in the past 12 months were included (N = 434). Mental health care use was assessed during this same period and at follow up (three years later). Multinomial regression analysis was used to distinguish early, delayed and no mental health care users with respect to demographic and need factors. RESULTS The majority of participants accessed treatment early (62%). Early treatment users were characterized by more severe and persistent symptoms and were more likely not to have a partner compared to no treatment users. The majority of those without treatment reached remission in three years (85%). Delayed treatment users were, compared to early users, characterized by relatively mild symptoms and a persistent or new major depressive disorder at follow up. CONCLUSIONS Early access to treatment and the finding that need factors determine mental health care use among people with depression show that the filters along the pathway to treatment are not influenced by unfavorable determinants like education or age.
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Affiliation(s)
- A. M. Boerema
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - M. ten Have
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - A. Kleiboer
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - R. de Graaf
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - J. Nuyen
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - P. Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Section clinical psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - A. T. F. Beekman
- EMGO+ institute for Health Care and Research, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Psychiatry, VU Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Improvements in Quality-Adjusted Life Years and Cost-Utility After Pharmacotherapy for Premenstrual Dysphoric Disorder: A Retrospective Study. Clin Drug Investig 2017; 38:49-55. [PMID: 29032438 DOI: 10.1007/s40261-017-0583-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the cost-effectiveness of pharmacotherapy for premenstrual dysphoric disorder (PMDD), a relatively new classification of depressive disorder that is characterized by recurrent depression during the premenstrual phase of the menstrual cycle. METHODS We performed a retrospective analysis of data from 49 previously untreated PMDD patients who visited our psychiatric department between October 2013 and February 2016 and received pharmacotherapy for 3 or 6 subsequent menstrual cycles. Quality-adjusted life years (QALYs) were estimated across individual menstrual cycles using mean EuroQoL-5D values. Direct costs per patient were estimated in order to conduct a preliminary cost-effectiveness analysis. RESULTS Pharmacotherapy produced a 0.190-point increase in mean EuroQoL-5D score per menstrual cycle after 6 menstrual cycles and an improvement of approximately 0.2 QALYs. Based on direct costs of 156,000 yen per patient, the cost-effectiveness of pharmacotherapy was calculated to be 823,000 yen per QALY. A cost-effectiveness acceptability curve analysis indicated that escitalopram tended to be superior to sertraline when willingness to pay per QALY was over 4,000,000 yen, whereas sertraline was superior when willingness to pay was below 2,000,000 yen. CONCLUSIONS Pharmacotherapy is cost effective for the treatment of PMDD. Moreover, escitalopram is a more cost-effective option than sertraline when willingness to pay is sufficiently high.
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Aas RW, Haveraaen L, Sagvaag H, Thørrisen MM. The influence of alcohol consumption on sickness presenteeism and impaired daily activities. The WIRUS screening study. PLoS One 2017; 12:e0186503. [PMID: 29040323 PMCID: PMC5645115 DOI: 10.1371/journal.pone.0186503] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/03/2017] [Indexed: 01/01/2023] Open
Abstract
Background Alcohol use is a global health issue and may influence activity performance in a variety of domains, including the occupational and domestic spheres. The aim of the study was to examine the influence of annual drinking frequency and binge drinking (≥6 units at one occasion) on activity impairments both at work (sickness presenteeism) and outside the workplace. Methods Employees (n = 3278), recruited from 14 Norwegian private and public companies, responded to a questionnaire containing questions from the Alcohol Use Disorders Identification Test (AUDIT) and the Workplace Productivity and Activity Impairment questionnaire (WPAI). Results Multiple hierarchical regression analyses revealed that binge drinking was associated with both sickness presenteeism and impaired daily activities, even after controlling for gender, age, educational level, living status and employment sector. Annual drinking frequency was associated with impaired daily activities, but not sickness presenteeism. Conclusions Binge drinking seems to have a stronger influence on activity performance both at work and outside the workplace than drinking frequency. Interventions targeting alcohol consumption should benefit from focusing on binge drinking behavior.
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Affiliation(s)
- Randi Wågø Aas
- Department of Health Studies, University of Stavanger, Stavanger, Norway
- Presenter - Making Sense of Science, Stavanger, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
- * E-mail:
| | | | - Hildegunn Sagvaag
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | - Mikkel Magnus Thørrisen
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Cohan A, Young S, Yates A, Goharian N. Triaging content severity in online mental health forums. J Assoc Inf Sci Technol 2017. [DOI: 10.1002/asi.23865] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Arman Cohan
- Information Retrieval Lab, Department of Computer Science; Georgetown University; Washington DC USA
| | - Sydney Young
- Information Retrieval Lab, Department of Computer Science; Georgetown University; Washington DC USA
| | - Andrew Yates
- Max Planck Institute for Informatics, Saarland Informatics Campus; Saarbruecken Germany
| | - Nazli Goharian
- Information Retrieval Lab, Department of Computer Science; Georgetown University; Washington DC USA
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Batelaan NM, Bosman RC, Muntingh A, Scholten WD, Huijbregts KM, van Balkom AJLM. Risk of relapse after antidepressant discontinuation in anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder: systematic review and meta-analysis of relapse prevention trials. BMJ 2017; 358:j3927. [PMID: 28903922 PMCID: PMC5596392 DOI: 10.1136/bmj.j3927] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives To examine the risk of relapse and time to relapse after discontinuation of antidepressants in patients with anxiety disorder who responded to antidepressants, and to explore whether relapse risk is related to type of anxiety disorder, type of antidepressant, mode of discontinuation, duration of treatment and follow-up, comorbidity, and allowance of psychotherapy.Design Systematic review and meta-analyses of relapse prevention trials.Data sources PubMed, Cochrane, Embase, and clinical trial registers (from inception to July 2016).Study selection Eligible studies included patients with anxiety disorder who responded to antidepressants, randomised patients double blind to either continuing antidepressants or switching to placebo, and compared relapse rates or time to relapse.Data extraction Two independent raters selected studies and extracted data. Random effect models were used to estimate odds ratios for relapse, hazard ratios for time to relapse, and relapse prevalence per group. The effect of various categorical and continuous variables was explored with subgroup analyses and meta-regression analyses respectively. Bias was assessed using the Cochrane tool.Results The meta-analysis included 28 studies (n=5233) examining relapse with a maximum follow-up of one year. Across studies, risk of bias was considered low. Discontinuation increased the odds of relapse compared with continuing antidepressants (summary odds ratio 3.11, 95% confidence interval 2.48 to 3.89). Subgroup analyses and meta-regression analyses showed no statistical significance. Time to relapse (n=3002) was shorter when antidepressants were discontinued (summary hazard ratio 3.63, 2.58 to 5.10; n=11 studies). Summary relapse prevalences were 36.4% (30.8% to 42.1%; n=28 studies) for the placebo group and 16.4% (12.6% to 20.1%; n=28 studies) for the antidepressant group, but prevalence varied considerably across studies, most likely owing to differences in the length of follow-up. Dropout was higher in the placebo group (summary odds ratio 1.31, 1.06 to 1.63; n=27 studies).Conclusions Up to one year of follow-up, discontinuation of antidepressant treatment results in higher relapse rates among responders compared with treatment continuation. The lack of evidence after a one year period should not be interpreted as explicit advice to discontinue antidepressants after one year. Given the chronicity of anxiety disorders, treatment should be directed by long term considerations, including relapse prevalence, side effects, and patients' preferences.
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Affiliation(s)
- Neeltje M Batelaan
- Department of Psychiatry and Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, Netherlands
- GGZ inGeest, Academic Outpatient Department for Anxiety Disorders, Amsterdam, Netherlands
| | - Renske C Bosman
- Department of Psychiatry and Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - Anna Muntingh
- Department of Psychiatry and Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, Netherlands
- GGZ inGeest, Academic Outpatient Department for Anxiety Disorders, Amsterdam, Netherlands
| | - Willemijn D Scholten
- Department of Psychiatry and Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, Netherlands
- GGZ inGeest, Academic Outpatient Department for Anxiety Disorders, Amsterdam, Netherlands
| | - Klaas M Huijbregts
- Department of Psychiatry and Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, Netherlands
- GGZ inGeest, Academic Outpatient Department for Anxiety Disorders, Amsterdam, Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry and Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, Netherlands
- GGZ inGeest, Academic Outpatient Department for Anxiety Disorders, Amsterdam, Netherlands
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115
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Kalfa D, Kasmi L, Geronikola N, Calderon J, Lambert V, Belli E, Bonnet D, Montreuil M. Cognitive outcomes and health-related quality of life in adults two decades after the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg 2017; 154:1028-1035. [DOI: 10.1016/j.jtcvs.2017.03.119] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 02/13/2017] [Accepted: 03/16/2017] [Indexed: 01/19/2023]
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Kolovos S, Bosmans JE, Riper H, Chevreul K, Coupé VMH, van Tulder MW. Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review. PHARMACOECONOMICS - OPEN 2017; 1:149-165. [PMID: 29441493 PMCID: PMC5691837 DOI: 10.1007/s41669-017-0014-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND An increasing number of model-based studies that evaluate the cost effectiveness of treatments for depression are being published. These studies have different characteristics and use different simulation methods. OBJECTIVE We aimed to systematically review model-based studies evaluating the cost effectiveness of treatments for depression and examine which modelling technique is most appropriate for simulating the natural course of depression. METHODS The literature search was conducted in the databases PubMed, EMBASE and PsycInfo between 1 January 2002 and 1 October 2016. Studies were eligible if they used a health economic model with quality-adjusted life-years or disability-adjusted life-years as an outcome measure. Data related to various methodological characteristics were extracted from the included studies. The available modelling techniques were evaluated based on 11 predefined criteria. RESULTS This methodological review included 41 model-based studies, of which 21 used decision trees (DTs), 15 used cohort-based state-transition Markov models (CMMs), two used individual-based state-transition models (ISMs), and three used discrete-event simulation (DES) models. Just over half of the studies (54%) evaluated antidepressants compared with a control condition. The data sources, time horizons, cycle lengths, perspectives adopted and number of health states/events all varied widely between the included studies. DTs scored positively in four of the 11 criteria, CMMs in five, ISMs in six, and DES models in seven. CONCLUSION There were substantial methodological differences between the studies. Since the individual history of each patient is important for the prognosis of depression, DES and ISM simulation methods may be more appropriate than the others for a pragmatic representation of the course of depression. However, direct comparisons between the available modelling techniques are necessary to yield firm conclusions.
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Affiliation(s)
- Spyros Kolovos
- Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
| | - Karine Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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117
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Deady M, Choi I, Calvo RA, Glozier N, Christensen H, Harvey SB. eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis. BMC Psychiatry 2017; 17:310. [PMID: 28851342 PMCID: PMC5576307 DOI: 10.1186/s12888-017-1473-1] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/21/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Anxiety and depression are associated with a range of adverse outcomes and represent a large global burden to individuals and health care systems. Prevention programs are an important way to avert a proportion of the burden associated with such conditions both at a clinical and subclinical level. eHealth interventions provide an opportunity to offer accessible, acceptable, easily disseminated globally low-cost interventions on a wide scale. However, the efficacy of these programs remains unclear. The aim of this study is to review and evaluate the effects of eHealth prevention interventions for anxiety and depression. METHOD A systematic search was conducted on four relevant databases to identify randomized controlled trials of eHealth interventions aimed at the prevention of anxiety and depression in the general population published between 2000 and January 2016. The quality of studies was assessed and a meta-analysis was performed using pooled effect size estimates obtained from a random effects model. RESULTS Ten trials were included in the systematic review and meta-analysis. All studies were of sufficient quality and utilized cognitive behavioural techniques. At post-treatment, the overall mean difference between the intervention and control groups was 0.25 (95% confidence internal: 0.09, 0.41; p = 0.003) for depression outcome studies and 0.31 (95% CI: 0.10, 0.52; p = 0.004) for anxiety outcome studies, indicating a small but positive effect of the eHealth interventions. The effect sizes for universal and indicated/selective interventions were similar (0.29 and 0.25 respectively). However, there was inadequate evidence to suggest that such interventions have an effect on long-term disorder incidence rates. CONCLUSIONS Evidence suggests that eHealth prevention interventions for anxiety and depression are associated with small but positive effects on symptom reduction. However, there is inadequate evidence on the medium to long-term effect of such interventions, and importantly, on the reduction of incidence of disorders. Further work to explore the impact of eHealth psychological interventions on long-term incidence rates.
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Affiliation(s)
- M. Deady
- 0000 0004 4902 0432grid.1005.4School of Psychiatry, University of New South Wales, Sydney, NSW 2052 Australia ,0000 0001 0640 7766grid.418393.4Black Dog Institute, Randwick, NSW 2031 Australia
| | - I. Choi
- 0000 0004 1936 834Xgrid.1013.3Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050 Australia
| | - R. A. Calvo
- 0000 0004 1936 834Xgrid.1013.3School of Electrical and Information Engineering, University of Sydney, Sydney, NSW 2006 Australia
| | - N. Glozier
- 0000 0004 1936 834Xgrid.1013.3Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050 Australia
| | - H. Christensen
- 0000 0001 0640 7766grid.418393.4Black Dog Institute, Randwick, NSW 2031 Australia
| | - S. B. Harvey
- 0000 0004 4902 0432grid.1005.4School of Psychiatry, University of New South Wales, Sydney, NSW 2052 Australia ,0000 0001 0640 7766grid.418393.4Black Dog Institute, Randwick, NSW 2031 Australia ,0000 0004 0417 5393grid.416398.1St George Hospital, Kogarah, NSW 2217 Australia
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Reduction of quality-adjusted life years (QALYs) in patients with premenstrual dysphoric disorder (PMDD). Qual Life Res 2017; 26:3069-3073. [PMID: 28674766 DOI: 10.1007/s11136-017-1642-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Premenstrual dysphoric disorder (PMDD) refers to the depression that occurs during the premenstrual phase and remits soon after the onset of menses. It affects the quality of life (QOL) of patients with PMDD. Therefore, this preliminary survey from chart recordings aimed to understand the symptom appearance and QOL reduction patterns in patients with PMDD, and to examine the extent of the loss of their quality-adjusted life years (QALYs). METHODS Participants were 66 untreated female patients with PMDD. Data on symptom appearance and QOL reduction during the menstrual cycle, and the EuroQoL-5D (EQ-5D) scores during the premenstrual phase and immediately after the completion of a menstrual period were collected. RESULTS The mean EQ-5D score of the 66 patients with PMDD was 0.795 ± 0.120 (range 0.362-0.949), indicating that their expected mean loss of QALYs was about 0.14 years. CONCLUSIONS If untreated, PMDD is expected to cause a mean loss of QALYs of about 0.14 years. However, on accounting for the period from disease development to menopause, and subtracting the menstruation-free periods such as pregnancy and breastfeeding, patients with untreated PMDD are expected to experience a QALY loss of about 3 years during their lifetime.
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Prigent A, Kamendje-Tchokobou B, Chevreul K. Socio-demographic, clinical characteristics and utilization of mental health care services associated with SF-6D utility scores in patients with mental disorders: contributions of the quantile regression. Qual Life Res 2017. [PMID: 28638967 DOI: 10.1007/s11136-017-1623-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Health-related quality of life (HRQoL) is a widely used concept in the assessment of health care. Some generic HRQoL instruments, based on specific algorithms, can generate utility scores which reflect the preferences of the general population for the different health states described by the instrument. This study aimed to investigate the relationships between utility scores and potentially associated factors in patients with mental disorders followed in inpatient and/or outpatient care settings using two statistical methods. METHODS Patients were recruited in four psychiatric sectors in France. Patient responses to the SF-36 generic HRQoL instrument were used to calculate SF-6D utility scores. The relationships between utility scores and patient socio-demographic, clinical characteristics, and mental health care utilization, considered as potentially associated factors, were studied using OLS and quantile regressions. RESULTS One hundred and seventy six patients were included. Women, severely ill patients and those hospitalized full-time tended to report lower utility scores, whereas psychotic disorders (as opposed to mood disorders) and part-time care were associated with higher scores. The quantile regression highlighted that the size of the associations between the utility scores and some patient characteristics varied along with the utility score distribution, and provided more accurate estimated values than OLS regression. CONCLUSIONS The quantile regression may constitute a relevant complement for the analysis of factors associated with utility scores. For policy decision-making, the association of full-time hospitalization with lower utility scores while part-time care was associated with higher scores supports the further development of alternatives to full-time hospitalizations.
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Affiliation(s)
- Amélie Prigent
- AP-HP, URC Eco Ile-de-France, 1, place du parvis Notre Dame, 75004, Paris, France.
- University Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, 75010, Paris, France.
- Inserm, ECEVE, U1123, 75010, Paris, France.
- Fondation FondaMental, French National Science Foundation, Créteil, 94000, France.
| | - Blaise Kamendje-Tchokobou
- Centre Hospitalier Départemental Georges Daumézon, Fleury-Les-Aubrais, 45400, France
- Agence Régionale de Santé Centre-Val de Loire, Cité administrative Coligny, 131 Rue du Faubourg Bannier, 45000, Orléans, France
| | - Karine Chevreul
- AP-HP, URC Eco Ile-de-France, 1, place du parvis Notre Dame, 75004, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, 75010, Paris, France
- Inserm, ECEVE, U1123, 75010, Paris, France
- Fondation FondaMental, French National Science Foundation, Créteil, 94000, France
- Department of Public Health, AP-HP, Robert-Debré University Hospital, 75019, Paris, France
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Symptom Domain Groups of the Patient-Reported Outcomes Measurement Information System Tools Independently Predict Hospitalizations and Re-hospitalizations in Cirrhosis. Dig Dis Sci 2017; 62:1173-1179. [PMID: 28258378 DOI: 10.1007/s10620-017-4509-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 02/21/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patient-Reported Outcomes Measurement Information System (PROMIS) tools can identify health-related quality of life (HRQOL) domains that could differentially affect disease progression. Cirrhotics are highly prone to hospitalizations and re-hospitalizations, but the current clinical prognostic models may be insufficient, and thus studying the contribution of individual HRQOL domains could improve prognostication. AIM Analyze the impact of individual HRQOL PROMIS domains in predicting time to all non-elective hospitalizations and re-hospitalizations in cirrhosis. METHODS Outpatient cirrhotics were administered PROMIS computerized tools. The first non-elective hospitalization and subsequent re-hospitalizations after enrollment were recorded. Individual PROMIS domains significantly contributing toward these outcomes were generated using principal component analysis. Factor analysis revealed three major PROMIS domain groups: daily function (fatigue, physical function, social roles/activities and sleep issues), mood (anxiety, anger, and depression), and pain (pain behavior/impact) accounted for 77% of the variability. Cox proportional hazards regression modeling was used for these groups to evaluate time to first hospitalization and re-hospitalization. RESULTS A total of 286 patients [57 years, MELD 13, 67% men, 40% hepatic encephalopathy (HE)] were enrolled. Patients were followed at 6-month (mth) intervals for a median of 38 mths (IQR 22-47), during which 31% were hospitalized [median IQR mths 12.5 (3-27)] and 12% were re-hospitalized [10.5 mths (3-28)]. Time to first hospitalization was predicted by HE, HR 1.5 (CI 1.01-2.5, p = 0.04) and daily function PROMIS group HR 1.4 (CI 1.1-1.8, p = 0.01), independently. In contrast, the pain PROMIS group were predictive of the time to re-hospitalization HR 1.6 (CI 1.1-2.3, p = 0.03) as was HE, HR 2.1 (CI 1.1-4.3, p = 0.03). CONCLUSIONS Daily function and pain HRQOL domain groups using PROMIS tools independently predict hospitalizations and re-hospitalizations in cirrhotic patients.
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Health-related quality of life, anxiety and depression in parents of adolescents with Gilles de la Tourette syndrome: a controlled study. Eur Child Adolesc Psychiatry 2017; 26:603-617. [PMID: 27942998 DOI: 10.1007/s00787-016-0923-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 11/21/2016] [Indexed: 01/12/2023]
Abstract
Our objectives were to assess health-related quality of life (HRQoL), anxiety, depression of Gilles de la Tourette syndrome (GTS) adolescents' parents compared to controls; to assess GTS adolescents' HRQoL compared to controls; to investigate which parental and adolescent variables are associated with poorer parental HRQoL. The controlled study involved GTS outpatients and their parents, adolescent healthy controls matched for gender and age and their parents. Parents' HRQoL was assessed using SF-36 and WHOQOL-BREF; anxiety, depression using HADS. Adolescents' HRQoL was assessed by adolescents using VSP-A instrument and by their parents using VSP-P. A total of 75 GTS adolescents, 75 mothers, 63 fathers were compared to 75 control adolescents, 75 mothers, 62 fathers. GTS mothers had worse HRQoL than controls on 5 of the 8 SF-36 dimensions and 1 of the 4 WHOQOL-BREF dimensions, while GTS fathers had worse HRQoL on 2 of the WHOQOL-BREF dimensions. GTS mothers had poorer HRQoL than fathers. GTS mothers had more depression than control mothers and GTS fathers had more anxiety than control fathers. GTS adolescents had worse HRQoL than controls on 5 of the 9 VSP-A dimensions. Factors significantly related to parental HRQoL were anxiety, depression, GTS adolescents' HRQoL and, concerning mothers, behavioural and emotional adolescents' problems; concerning fathers, severity of vocal tics, duration since first symptoms. This study provides a better understanding of poorer HRQoL and psychiatric morbidity of GTS adolescents' parents. Clinicians should pay attention to their emotional well-being and HRQoL and be aware that mothers and fathers are differently affected.
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Kolovos S, Bosmans JE, van Dongen JM, van Esveld B, Magai D, van Straten A, van der Feltz-Cornelis C, van Steenbergen-Weijenburg KM, Huijbregts KM, van Marwijk H, Riper H, van Tulder MW. Utility scores for different health states related to depression: individual participant data analysis. Qual Life Res 2017; 26:1649-1658. [PMID: 28260149 PMCID: PMC5486895 DOI: 10.1007/s11136-017-1536-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Depression is associated with considerable impairments in health-related quality-of-life. However, the relationship between different health states related to depression severity and utility scores is unclear. The aim of this study was to evaluate whether utility scores are different for various health states related to depression severity. METHODS We gathered individual participant data from ten randomized controlled trials evaluating depression treatments. The UK EQ-5D and SF-6D tariffs were used to generate utility scores. We defined five health states that were proposed from American Psychiatric Association and National Institute for Clinical Excellence guidelines: remission, minor depression, mild depression, moderate depression, and severe depression. We performed multilevel linear regression analysis. RESULTS We included 1629 participants in the analyses. The average EQ-5D utility scores for the five health states were 0.70 (95% CI 0.67-0.73) for remission, 0.62 (95% CI 0.58-0.65) for minor depression, 0.57 (95% CI 0.54-0.61) for mild depression, 0.52 (95%CI 0.49-0.56) for moderate depression, and 0.39 (95% CI 0.35-0.43) for severe depression. In comparison with the EQ-5D, the utility scores based on the SF-6D were similar for remission (EQ-5D = 0.70 vs. SF-6D = 0.69), but higher for severe depression (EQ-5D = 0.39 vs. SF-6D = 0.55). CONCLUSIONS We observed statistically significant differences in utility scores between depression health states. Individuals with less severe depressive symptoms had on average statistically significant higher utility scores than individuals suffering from more severe depressive symptomatology. In the present study, EQ-5D had a larger range of values as compared to SF-6D.
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Affiliation(s)
- Spyros Kolovos
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
| | - Judith E Bosmans
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Birre van Esveld
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Dorcas Magai
- Department of Clinical, Neuro and Developmental Psychology, and the EMGO Institute for Health and Care Research, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro and Developmental Psychology, and the EMGO Institute for Health and Care Research, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Christina van der Feltz-Cornelis
- Department of Social Psychiatry Tranzo, Tilburg University, Tilburg, The Netherlands
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands
| | | | | | - Harm van Marwijk
- Centre for Primary Care, Institute for Population Health, University of Manchester, Manchester, UK
- Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, and the EMGO Institute for Health and Care Research, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Maurits W van Tulder
- Department of Health Sciences, and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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Sakuraya A, Imamura K, Inoue A, Tsutsumi A, Shimazu A, Takahashi M, Totsuzaki T, Kawakami N. Workplace social capital and the onset of major depressive episode among workers in Japan: a 3-year prospective cohort study. J Epidemiol Community Health 2017; 71:606-612. [PMID: 28235820 DOI: 10.1136/jech-2016-208561] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/19/2017] [Accepted: 01/23/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study examined the prospective association of workplace social capital (WSC) with major depressive episode (MDE) among Japanese employees. METHODS A 3-year prospective cohort study was conducted among 1058 employees from a private think-tank company who participated in a baseline survey; after excluding those with MDE in the past 12 months, 929 were followed up. WSC at baseline was measured using a 3-item scale. MDE was assessed at baseline and at follow-up every year, by using a web-based, self-administered version of the WHO Composite International Diagnostic Interview (WHO-CIDI) 3.0 depression section, based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition: Text Revision (DSM-IV-TR)/DSM-5 criteria. Cox discrete-time hazards analyses were used to estimate HRs and 95% CIs, adjusting for covariates. RESULTS A group with middle-level WSC scores had the lowest risk of MDE after being fully adjusted (HR 0.34, 95% CI 0.14 to 0.84, p=0.02). The relationship between WSC and MDE was U-shaped, although a non-linear model fit better than a linear model, with only marginally statistical significance (p=0.06). Dichotomised and continuous variables of WSC scores were significantly and negatively associated with MDE (p=0.03 and p<0.01, respectively). CONCLUSIONS The current study replicated a previous finding from Finland that WSC was a protective factor of the onset of MDE in Japan. The slightly U-shaped relationship, that is, the group with high WSC having a small elevated risk of MDE, may reflect a dark side of WSC in a country with collectivity-oriented and hierarchy-oriented culture, such as Japan.
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Affiliation(s)
- Asuka Sakuraya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiomi Inoue
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Akihito Shimazu
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaya Takahashi
- Occupational Epidemiology Research Group, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan
| | - Takafumi Totsuzaki
- Department of Work Systems and Health, Institute ofIndustrial Ecological Sciences, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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The Efficacy of Acupuncture for Treating Depression-Related Insomnia Compared with a Control Group: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9614810. [PMID: 28286776 PMCID: PMC5329663 DOI: 10.1155/2017/9614810] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 12/20/2016] [Accepted: 01/04/2017] [Indexed: 11/25/2022]
Abstract
Objective. To evaluate the effectiveness of acupuncture as monotherapy and as an alternative therapy in treating depression-related insomnia. Data Source. Seven databases were searched starting from 1946 to March 30, 2016. Study Eligibility Criteria. Randomized-controlled trials of adult subjects (18–75 y) who had depression-related insomnia and had received acupuncture. Results. 18 randomized-controlled clinical trials (RCTs) were introduced in this meta-analysis. The findings determined that the acupuncture treatment made significant improvements in PSQI score (MD = −2.37, 95% CI −3.52 to −1.21) compared with Western medicine. Acupuncture combined with Western medicine had a better effect on improving sleep quality (MD = −2.63, 95% CI −4.40 to −0.86) compared with the treatment of Western medicine alone. There was no statistical difference (MD = −2.76, 95% CI −7.65 to 2.12) between acupuncture treatment and Western medicine towards improving the HAMD score. Acupuncture combined with Western medicine (MD = −5.46, CI −8.55 to −2.38) had more effect on improving depression degree compared with the Western medicine alone. Conclusion. This systematic review indicates that acupuncture could be an alternative therapy to medication for treating depression-related insomnia.
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Ebert DD, Cuijpers P, Muñoz RF, Baumeister H. Prevention of Mental Health Disorders Using Internet- and Mobile-Based Interventions: A Narrative Review and Recommendations for Future Research. Front Psychiatry 2017; 8:116. [PMID: 28848454 PMCID: PMC5554359 DOI: 10.3389/fpsyt.2017.00116] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 06/15/2017] [Indexed: 01/08/2023] Open
Abstract
Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD), their current impact on the reduction of disease burden is questionable. Possible reasons include that it is not practical to deliver those interventions to the community en masse due to limited health care resources and the limited availability of evidence-based interventions and clinicians in routine practice, especially in rural areas. Therefore, new approaches are needed to maximize the impact of psychological preventive interventions. Limitations of traditional prevention programs could potentially be overcome by providing Internet- and mobile-based interventions (IMIs). This relatively new medium for promoting mental health and preventing MHD introduces a fresh array of possibilities, including the provision of evidence-based psychological interventions that are free from the restraints of travel and time and allow reaching participants for whom traditional opportunities are not an option. This article provides an introduction to the subject and narratively reviews the available evidence for the effectiveness of IMIs with regard to the prevention of MHD onsets. The number of randomized controlled trials that have been conducted to date is very limited and so far it is not possible to draw definite conclusions about the potential of IMIs for the prevention of MHD for specific disorders. Only for the indicated prevention of depression there is consistent evidence across four different randomized trial trials. The only trial on the prevention of general anxiety did not result in positive findings in terms of eating disorders (EDs), effects were only found in post hoc subgroup analyses, indicating that it might be possible to prevent ED onset for subpopulations of people at risk of developing EDs. Future studies need to identify those subpopulations likely to profit from preventive. Disorders not examined so far include substance use disorders, bipolar disorders, stress-related disorders, phobic disorders and panic disorder, obsessive-compulsive disorder, impulse-control disorders, somatic symptom disorder, and insomnia. In summary, there is a need for more rigorously conducted large scale randomized controlled trials using standard clinical diagnostic instruments for the selection of participants without MHD at baseline and the assessment of MHD onset. Subsequently, we discuss future directions for the field in order to fully exploit the potential of IMI for the prevention of MHD.
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Affiliation(s)
- David Daniel Ebert
- Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ricardo F Muñoz
- Palo Alto University, Palo Alto, CA, United States.,University of California, San Francisco, San Francisco, CA, United States
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
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Kaess M, Fischer-Waldschmidt G, Resch F, Koenig J. Health related quality of life and psychopathological distress in risk taking and self-harming adolescents with full-syndrome, subthreshold and without borderline personality disorder: rethinking the clinical cut-off? Borderline Personal Disord Emot Dysregul 2017; 4:7. [PMID: 28484600 PMCID: PMC5420401 DOI: 10.1186/s40479-017-0058-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 03/14/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diagnostic standards do not acknowledge developmental specifics and differences in the clinical presentation of adolescents with borderline personality disorder (BPD). BPD is associated with severe impairments in health related quality of life (HRQoL) and increased psychopathological distress. Previously no study addressed differences in HRQoL and psychopathology in adolescents with subthreshold and full-syndrome BPD as well as adolescents at-risk for the development but no current BPD. METHODS Drawing on data from a consecutive sample of N = 264 adolescents (12-17 years) presenting with risk-taking and self-harming behavior at a specialized outpatient clinic, we investigated differences in HRQoL (KIDSCREEN-52) and psychopathological distress (SCL-90-R) comparing adolescents with no BPD (less than 3 criteria fulfilled), to those with subthreshold (3-4 BPD criteria) and full-syndrome BPD (5 or more BPD criteria). Group differences were analyzed using one-way analysis of variance with Sidak corrected contrasts or Chi-Square test for categorical variables. RESULTS Adolescents with subthreshold and full-syndrome BPD presented one year later at our clinic and were more likely female. Adolescents with subthreshold and full-syndrome BPD showed greater Axis-I and Axis-II comorbidity compared to adolescents with no BPD, and reported greater risk-taking behaviour, self-injury and suicidality. Compared to those without BPD, adolescents with subthreshold and full-syndrome BPD reported significantly reduced HRQoL. Adolescents with sub-threshold BPD and those with full-syndrome BPD did not differ on any HRQoL dimension, with the exception of Self-Perception. Similar, groups with sub-threshold and full-syndrome BPD showed no significant differences on any dimension of self-reported psychopathological distress, with the exception of Hostility. CONCLUSIONS Findings highlight that subthreshold BPD in adolescents is associated with impairments in HRQoL and psychopathological distress comparable to full-syndrome BPD. Findings raise awareness on the importance of early detection and question the diagnostic validity and clinical utility of existing cut-offs. Findings support a lower diagnostic cut-off for adolescent BPD, to identify those at-risk at an early stage.
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Affiliation(s)
- Michael Kaess
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstraße 8, Heidelberg, 69115 Germany.,Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Gloria Fischer-Waldschmidt
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstraße 8, Heidelberg, 69115 Germany
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstraße 8, Heidelberg, 69115 Germany
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Kolovos S, Kleiboer A, Cuijpers P. Effect of psychotherapy for depression on quality of life: meta-analysis. Br J Psychiatry 2016; 209:460-468. [PMID: 27539296 DOI: 10.1192/bjp.bp.115.175059] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 01/14/2016] [Accepted: 04/27/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several meta-analyses have shown that psychotherapy is effective for reducing depressive symptom severity. However, the impact on quality of life (QoL) is as yet unknown. AIMS To investigate the effectiveness of psychotherapy for depression on global QoL and on the mental health and physical health components of QoL. METHOD We conducted a meta-analysis of 44 randomised clinical trials comparing psychotherapy for adults experiencing clinical depression or elevated depressive symptoms with a control group. We used subgroup analyses to explore the influence of various study characteristics on the effectiveness of treatment. RESULTS We detected a small to moderate effect size (Hedges' g = 0.33, 95% CI 0.24-0.42) for global QoL, a moderate effect size for the mental health component (g = 0.42, 95% CI 0.33-0.51) and, after removing an outlier, a small but statistically significant effect size for the physical health component (g = 0.16, 95% CI 0.05-0.27). Multivariate meta-regression analyses showed that the effect size of depressive symptoms was significantly related to the effect size of the mental health component of QoL. The effect size of depressive symptoms was not related to global QoL or the physical health component. CONCLUSIONS Psychotherapy for depression has a positive impact on the QoL of patients with depression. Improvements in QoL are not fully explained by improvements in depressive symptom severity.
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Affiliation(s)
- Spyros Kolovos
- Spyros Kolovos, MSc, Department of Health Sciences, VU University Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Annet Kleiboer, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University, Department of Clinical and Health Psychology, Utrecht University, The Netherlands; Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands, and Leuphana University, Lunebrug, Germany
| | - Annet Kleiboer
- Spyros Kolovos, MSc, Department of Health Sciences, VU University Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Annet Kleiboer, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University, Department of Clinical and Health Psychology, Utrecht University, The Netherlands; Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands, and Leuphana University, Lunebrug, Germany
| | - Pim Cuijpers
- Spyros Kolovos, MSc, Department of Health Sciences, VU University Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Annet Kleiboer, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University, Department of Clinical and Health Psychology, Utrecht University, The Netherlands; Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands, and Leuphana University, Lunebrug, Germany
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Rodríguez-Míguez E, Mosquera Nogueira J. Measuring the impact of alcohol-related disorders on quality of life through general population preferences. GACETA SANITARIA 2016; 31:89-94. [PMID: 27894816 DOI: 10.1016/j.gaceta.2016.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/14/2016] [Accepted: 07/15/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To estimate the intangible effects of alcohol misuse on the drinker's quality of life, based on general population preferences METHODS: The most important effects (dimensions) were identified by means of two focus groups conducted with patients and specialists. The levels of these dimensions were combined to yield different scenarios. A sample of 300 people taken from the general Spanish population evaluated a subset of these scenarios, selected by using a fractional factorial design. We used the probability lottery equivalent method to derive the utility score for the evaluated scenarios, and the random-effects regression model to estimate the relative importance of each dimension and to derive the utility score for the rest of scenarios not directly evaluated. RESULTS Four main dimensions were identified (family, physical health, psychological health and social) and divided into three levels of intensity. We found a wide variation in the utilities associated with the scenarios directly evaluated (ranging from 0.09 to 0.78). The dimensions with the greatest relative importance were physical health (36.4%) and family consequences (31.3%), followed by psychological (20.5%) and social consequences (11.8%). CONCLUSIONS Our findings confirm the benefits of adopting a heterogeneous approach to measure the effects of alcohol misuse. The estimated utilities could have both clinical and economic applications.
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Vasconcelos M, Stein DJ, de Almeida RMM. Social defeat protocol and relevant biomarkers, implications for stress response physiology, drug abuse, mood disorders and individual stress vulnerability: a systematic review of the last decade. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2016. [PMID: 26222297 DOI: 10.1590/2237-6089-2014-0034] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Social defeat (SD) in rats, which results from male intraspecific confrontations, is ethologically relevant and useful to understand stress effects on physiology and behavior. METHODS A systematic review of studies about biomarkers induced by the SD protocol and published from 2002 to 2013 was carried out in the electronic databases PubMed, Web of Knowledge and ScienceDirect. The search terms were: social defeat, rat, neurotrophins, neuroinflammatory markers, and transcriptional factors. RESULTS Classical and recently discovered biomarkers were found to be relevant in stress-induced states. Findings were summarized in accordance to the length of exposure to stress: single, repeated, intermittent and continuous SD. This review found that the brain-derived neurotrophic factor (BDNF) is a distinct marker of stress adaptation. Along with glucocorticoids and catecholamines, BDNF seems to be important in understanding stress physiology. CONCLUSION The SD model provides a relevant tool to study stress response features, development of addictive behaviors, clinic depression and anxiety, as well as individual differences in vulnerability and resilience to stress.
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Affiliation(s)
- Mailton Vasconcelos
- Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Dirson João Stein
- Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil
| | - Rosa Maria M de Almeida
- Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Ebert DD, Donkin L, Andersson G, Andrews G, Berger T, Carlbring P, Rozenthal A, Choi I, Laferton JAC, Johansson R, Kleiboer A, Lange A, Lehr D, Reins JA, Funk B, Newby J, Perini S, Riper H, Ruwaard J, Sheeber L, Snoek FJ, Titov N, Ince BÜ, van Bastelaar K, Vernmark K, van Straten A, Warmerdam L, Salsman N, Cuijpers P. Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials. Psychol Med 2016; 46:2679-2693. [PMID: 27649340 PMCID: PMC5560500 DOI: 10.1017/s0033291716001562] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach. METHOD Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data. RESULTS A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29-0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit-risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration. CONCLUSIONS Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.
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Affiliation(s)
- D. D. Ebert
- Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - L. Donkin
- The Brain and Mind Research Institute, University of Sydney, NSW, Australia
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - G. Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - G. Andrews
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, Darlinghurst, NSW, Australia
| | - T. Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - P. Carlbring
- Department of Psychology, Stockholm University, Sweden
| | - A. Rozenthal
- Department of Psychology, Stockholm University, Sweden
| | - I. Choi
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - R. Johansson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - A. Kleiboer
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - A. Lange
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - D. Lehr
- Leuphana University Lüneburg, Germany
| | | | - B. Funk
- Leuphana University Lüneburg, Germany
| | - J. Newby
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, Darlinghurst, NSW, Australia
| | - S. Perini
- Centre for Emotional Health, Macquarie University, Australia
| | - H. Riper
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - J. Ruwaard
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - L. Sheeber
- Oregon Research Institute, Eugene, Oregon, USA
| | - F. J. Snoek
- Department of Medical Psychology, VU University Medical Center Amsterdam, The Netherlands
- Academic Medical Center/University of Amsterdam, The Netherlands
| | - N. Titov
- eCentreClinic and MindSpot Clinic, Department of Psychology, Macquarie University, Australia
| | - B. Ünlü Ince
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - K. van Bastelaar
- Department of Medical Psychology, VU University Medical Center Amsterdam, The Netherlands
| | - K. Vernmark
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Psykologpartners, Private Practice, Linköping, Sweden
| | - A. van Straten
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - L. Warmerdam
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - N. Salsman
- School of Psychology, Xavier University, Cincinnati, USA
| | - P. Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
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Imamura K, Kawakami N, Tsuno K, Tsuchiya M, Shimada K, Namba K. Effects of web-based stress and depression literacy intervention on improving symptoms and knowledge of depression among workers: A randomized controlled trial. J Affect Disord 2016; 203:30-37. [PMID: 27280960 DOI: 10.1016/j.jad.2016.05.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 04/14/2016] [Accepted: 05/22/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The present randomized controlled trial aimed to examine whether a newly developed psychoeducational information website on stress and depression was effective in improving depressive symptoms at one- and four-month follow-ups among workers in Japan. METHODS Participants were recruited from registered members of a web survey site in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to intervention or control groups. Immediately after the baseline survey, the intervention group was invited to access a psychoeducational website named the "UTSMed" within 4 months after the baseline survey. Depressive symptoms (Beck Depression Inventory II; BDI-II) were assessed as a primary outcome, at baseline, and one- and four-month follow-ups for both intervention and control groups. The analyses were conducted separately by the three subgroups (high-risk, moderate-risk, and low-risk). RESULTS A total of 1236 workers completed the baseline survey. Participants were randomly allocated to an intervention or control group (N=618 for each), with the subgroups of high-risk (7-8%), moderate-risk (47%) and low-risk (45-46%) in each group. A significant intervention effect on improving depressive symptoms (t=-2.35, P =0.02, d=-0.57) was observed at 1-month follow-up only in the high-risk subgroup. LIMITATIONS The present study did not use a stratified permuted-block randomization. CONCLUSIONS A web-based psychoeducation approach may not be effective enough in improving depressive symptoms in a general population of workers, while it may be effective for workers who had recently sought help for mental health.
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Affiliation(s)
- Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Kanami Tsuno
- Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masao Tsuchiya
- Health Administration and Psychosocial Factor Research Group, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan
| | - Kyoko Shimada
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Abdin E, Subramaniam M, Picco L, Pang S, Vaingankar JA, Shahwan S, Sagayadevan V, Zhang Y, Chong SA. The importance of considering differential item functioning in investigating the impact of chronic conditions on health-related quality of life in a multi-ethnic Asian population. Qual Life Res 2016; 26:823-834. [PMID: 27679497 DOI: 10.1007/s11136-016-1418-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The present study aims to examine the impact of chronic conditions after adjusting for differential item functioning (DIF) on the various aspects of health-related quality of life (HRQoL) in a multi-ethnic Asian population in Singapore. METHOD Data on 3006 participants from a nation-wide cross-sectional survey of mental health literacy conducted in Singapore were used. Multiple Indicators Multiple Causes model was used to investigate the effects of chronic medical conditions on various HRQoL dimensions assessed with the 36-item Medical Outcomes Study Short Form Health Survey (SF-36) after adjusting for DIF. RESULTS Twenty out of 36 items were detected with DIF for chronic conditions including high blood pressure, cardiovascular disorders, diabetes, cancer, neurological disorders and ulcer as well as for a few demographic factors such age, gender and marital status. Twenty significant associations between chronic conditions and SF-36 domains were observed. After controlling for all chronic conditions, socio-demographic and DIF items, a significant association emerged between cardiovascular disorders and physical functioning, while the association between diabetes and ulcer and general health became nonsignificant. All other associations remained statistically significant. CONCLUSION Our findings provide useful information and important implications of DIF on the impact of chronic conditions on HRQoL. We found the impact of DIF with respect to the impact of chronic conditions on HRQoL to be minimal after accounting for measurement bias in this multiracial Asian population.
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Affiliation(s)
- Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Louisa Picco
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shirlene Pang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Vathsala Sagayadevan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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Villoro R, Merino M, Hidalgo-Vega A. Quality of life and use of health care resources among patients with chronic depression. PATIENT-RELATED OUTCOME MEASURES 2016; 7:145-155. [PMID: 27713651 PMCID: PMC5045235 DOI: 10.2147/prom.s101595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE This study estimates the health-related quality of life and the health care resource utilization of patients diagnosed with chronic depression (CD) in Spain. PATIENTS AND METHODS We used the Spanish National Health Survey 2011-2012, a cross-sectional survey representative at the national level, that selects people aged between 18 and 64 years (n=14,691). We estimated utility indices through the EuroQol five-dimensional descriptive system questionnaire included in the survey. We calculated percentage use of health care resources (medical visits, hospitalizations, emergency services, and drug consumption) and average number of resources used when available. A systematic comparison was made between people diagnosed with CD and other chronic conditions (OCCs). The chi-square test, Mann-Whitney U-test, and Kruskal-Wallis test were used to determine the statistical significance of differences between comparison groups. Multivariate analyses (Poisson regression, logistic regression, and linear regression) were also carried out to assess the relationship between quality of life and consumption of health care resources. RESULTS Approximately, 6.1% of the subjects aged between 18 and 64 years were diagnosed with CD (average age 48.3±11 years, 71.7% females). After controlling for age, sex, and total number of comorbidities, a diagnosis of CD reduced utility scores by 0.09 (P<0.05) vs OCCs, and increased the average number of hospitalizations by 15%, the average number of days at hospital by 51%, and the average number of visits to emergency services by 15% (P<0.05). CD also increased the average number of visits to secondary care by 14% and visits to general practitioners by 4%. People with CD had a higher probability of consuming drugs than people with OCCs (odds ratio [OR]: 1.24, P<0.05), but only 38.6% took antidepressants. CONCLUSION People with CD had significantly lower health-related quality of life than people with OCCs. CD was associated with increased hospital length of stay and involved a higher consumption of emergency services and drugs than OCCs.
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Affiliation(s)
- Renata Villoro
- Department of Health Economics, Instituto Max Weber, Madrid
| | - María Merino
- Department of Health Economics, Instituto Max Weber, Madrid
| | - Alvaro Hidalgo-Vega
- Department of Economics and Finance, University of Castilla-La Mancha, Toledo, Spain
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Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder. J Affect Disord 2016; 202:53-7. [PMID: 27253217 DOI: 10.1016/j.jad.2016.05.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 05/22/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND There have been few studies investigating quality of life (QoL) in pediatric bipolar disorder (BD) patients and none comparing it with that observed in unaffected offspring of parents with BD and healthy controls. METHODS The self-report Youth Quality of Life Instrument-Research version (YQoL-R) was administered in 26 pediatric BD patients, 17 unaffected offspring of parents with BD, and 24 individuals with no history of DSM-IV Axis I psychiatric disorders. All diagnoses were determined through interviews based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. RESULTS There were statistical differences among the groups for all YQoL-R domains. Pairwise comparisons showed that perceived QoL was significantly worse in the BD group than in the unaffected offspring and healthy subjects, a difference that persisted even when only euthymic subjects were analyzed. There were no significant differences between the unaffected offspring and healthy subjects for any YQoL-R domain. LIMITATIONS Our sample was small. There was no QoL report from subjects parents nor data about family environment or BD parents' mood state. CONCLUSIONS There is a need for studies to investigate in greater detail the relationship between QoL and psychological resilience, particularly in the unaffected offspring of parents with BD.
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135
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Victor M, Lau B, Ruud T. Patient characteristics in a return to work programme for common mental disorders: a cross-sectional study. BMC Public Health 2016; 16:745. [PMID: 27502950 PMCID: PMC4977655 DOI: 10.1186/s12889-016-3431-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 08/03/2016] [Indexed: 11/10/2022] Open
Abstract
Background Mental health problems are a growing cause of sickness absence. There are programmes in many countries to facilitate return to work (RTW) after sickness absence. In Norway, there has been some controversy about patients on sick-leave being prioritized over other patient groups, such as those with more severe diagnoses. However, it is not clear whether patients in RTW programmes actually do differ from patients in regular services. Methods This study compared 270 patients treated in an RTW outpatient clinic and 86 patients treated in a regular outpatient clinic, both in specialized mental health care, on patient characteristics, history of treatment and mental health status. Analyses of differences between groups were done by ANOVA tests, chi-square test and logistic regression. Results Patients in the RTW clinic had lower scores on the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). There was no difference in health-related quality of life. RTW patients were somewhat older and more likely to live in relationships and have children, and they had higher incomes. Work participation, previous psychiatric hospitalization and present diagnosis contributed uniquely to an explanation of which patients were included in the respective clinics. The RTW clinic seems to reach its intended target group. Almost all of the patients in this group participated in the work arena, and their psychopathologies were clearly dominated by common mental disorders. Most RTW patients’ general practitioners had followed them fairly closely in the year before referral, suggesting previous attempts at treatment in primary care settings. Conclusions Relative to outpatients in a specialized mental health care setting, RTW patients had lower symptoms, but still in the same moderate range of severity. They suffered the same reduction in quality of life. Almost all of the RTW patients were diagnosed with illnesses that can be treated effectively, about half of them had recurring mental health problems and many of them had been treated in primary care settings before referral. These findings indicate that this group has significant health problems that can benefit from treatment in specialized health care settings.
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Affiliation(s)
- Mattias Victor
- Lovisenberg Hospital, Oslo, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Bjørn Lau
- Lovisenberg Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Torleif Ruud
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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136
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Karpov B, Joffe G, Aaltonen K, Suvisaari J, Baryshnikov I, Näätänen P, Koivisto M, Melartin T, Oksanen J, Suominen K, Heikkinen M, Paunio T, Isometsä E. Anxiety symptoms in a major mood and schizophrenia spectrum disorders. Eur Psychiatry 2016; 37:1-7. [PMID: 27447101 DOI: 10.1016/j.eurpsy.2016.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/07/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Comorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear. METHODS The Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n=113), bipolar disorder (BD, n=99), or depressive disorder (DD, n=188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups. RESULTS Frequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P=0.010) and less often avoided anxiety-provoking situations (P=0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders. CONCLUSIONS Comorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis.
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Affiliation(s)
- B Karpov
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - G Joffe
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - K Aaltonen
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - J Suvisaari
- Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271 Helsinki, Finland
| | - I Baryshnikov
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - P Näätänen
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - M Koivisto
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - T Melartin
- Department of Psychiatry, Helsinki University Central Hospital, PO Box 590, 00029 Helsinki, Finland
| | - J Oksanen
- Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271 Helsinki, Finland
| | - K Suominen
- Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271 Helsinki, Finland; Department of Social Services and Health Care, Helsinki, Finland
| | - M Heikkinen
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - T Paunio
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland; Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271 Helsinki, Finland
| | - E Isometsä
- Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland; Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271 Helsinki, Finland.
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137
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Alpha oscillations and their impairment in affective and post-traumatic stress disorders. Neurosci Biobehav Rev 2016; 68:794-815. [PMID: 27435239 DOI: 10.1016/j.neubiorev.2016.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 06/26/2016] [Accepted: 07/06/2016] [Indexed: 12/28/2022]
Abstract
Affective and anxiety disorders are debilitating conditions characterized by impairments in cognitive and social functioning. Elucidating their neural underpinnings may assist in improving diagnosis and developing targeted interventions. Neural oscillations are fundamental for brain functioning. Specifically, oscillations in the alpha frequency range (alpha rhythms) are prevalent in the awake, conscious brain and play an important role in supporting perceptual, cognitive, and social processes. We review studies utilizing various alpha power measurements to assess abnormalities in brain functioning in affective and anxiety disorders as well as obsessive compulsive and post-traumatic stress disorders. Despite some inconsistencies, studies demonstrate associations between aberrant alpha patterns and these disorders both in response to specific cognitive and emotional tasks and during a resting state. We conclude by discussing methodological considerations and future directions, and underscore the need for much further research on the role of alpha functionality in social contexts. As social dysfunction accompanies most psychiatric conditions, research on alpha's involvement in social processes may provide a unique window into the neural mechanisms underlying these disorders.
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138
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Health-related quality of life and burden of disease in chronic pain measured with the 15D instrument. Pain 2016; 157:2269-2276. [DOI: 10.1097/j.pain.0000000000000641] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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139
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Abstract
Investigation for a possible anxiety disorder should be considered in patients with multiple or persistent anxiety symptoms or multiple somatic complaints without a clear somatic etiology. The ideal treatment for anxiety disorders is a combination of pharmacologic and behavioral strategies. As primary care health care evolves, it is expected that the management of mental health disorders (including anxiety disorders) will largely occur in the context of collaborative care models in which patients and primary care clinicians are assisted by trained case managers who help facilitate a more comprehensive, holistic treatment plan between primary care and mental health providers.
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140
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Clark GI, Rock AJ. Processes Contributing to the Maintenance of Flying Phobia: A Narrative Review. Front Psychol 2016; 7:754. [PMID: 27313550 PMCID: PMC4887486 DOI: 10.3389/fpsyg.2016.00754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/06/2016] [Indexed: 01/30/2023] Open
Abstract
Flying phobia is a highly prevalent anxiety disorder, which causes sufferers significant distress and life interference. The processes which maintain flying phobia remain poorly understood. A systematic search of the literature was performed to identify what research has been conducted into the processes which may be involved in the fear of flying and whether processes which are believed to maintain other anxiety disorder diagnoses have been investigated in flying phobia. The results of the literature review are presented and related to existing cognitive behavioral theory and research. The results indicate that little research has been conducted into a number of areas considered important in the wider cognitive behavioral literature on anxiety disorders: namely attention, mental imagery, memory, worry, and safety-seeking behaviors. The review proposes a hypothetical model, derived from cognitive behavioral theory, for the processes which may be involved in maintaining flying phobia, and considers a number of areas for future research.
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Affiliation(s)
- Gavin I. Clark
- School of Behavioural, Cognitive and Social Sciences, University of New EnglandArmidale, NSW, Australia
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141
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Nussbaumer M, Asara JM, Teplytska L, Murphy MP, Logan A, Turck CW, Filiou MD. Selective Mitochondrial Targeting Exerts Anxiolytic Effects In Vivo. Neuropsychopharmacology 2016; 41:1751-8. [PMID: 26567514 PMCID: PMC4869042 DOI: 10.1038/npp.2015.341] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 10/22/2015] [Accepted: 11/08/2015] [Indexed: 12/31/2022]
Abstract
Current treatment strategies for anxiety disorders are predominantly symptom-based. However, a third of anxiety patients remain unresponsive to anxiolytics highlighting the need for more effective, mechanism-based therapeutic approaches. We have previously compared high vs low anxiety mice and identified changes in mitochondrial pathways, including oxidative phosphorylation and oxidative stress. In this work, we show that selective pharmacological targeting of these mitochondrial pathways exerts anxiolytic effects in vivo. We treated high anxiety-related behavior (HAB) mice with MitoQ, an antioxidant that selectively targets mitochondria. MitoQ administration resulted in decreased anxiety-related behavior in HAB mice. This anxiolytic effect was specific for high anxiety as MitoQ treatment did not affect the anxiety phenotype of C57BL/6N and DBA/2J mouse strains. We furthermore investigated the molecular underpinnings of the MitoQ-driven anxiolytic effect and found that MitoQ treatment alters the brain metabolome and that the response to MitoQ treatment is characterized by distinct molecular signatures. These results indicate that a mechanism-driven approach based on selective mitochondrial targeting has the potential to attenuate the high anxiety phenotype in vivo, thus paving the way for translational implementation as long-term MitoQ administration is well-tolerated with no reported side effects in mice and humans.
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Affiliation(s)
| | - John M Asara
- Division of Signal Transduction, Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | - Michaela D Filiou
- Max Planck Institute of Psychiatry, Munich, Germany,Proteomics and Biomarkers, Max Planck Institute of Psychiatry, Kraepelinstr. 2, Munich 80804, Germany, Tel: +49 89 30622 506, Fax: +49 89 30622 200, E-mail:
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142
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Hussain A, Nygaard E, Siqveland J, Heir T. The relationship between psychiatric morbidity and quality of life: interview study of Norwegian tsunami survivors 2 and 6 years post-disaster. BMC Psychiatry 2016; 16:173. [PMID: 27245669 PMCID: PMC4888632 DOI: 10.1186/s12888-016-0868-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 05/16/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The study investigated the impact of psychiatric disorders on Quality of Life (QOL) cross-sectionally and longitudinally in a group of Norwegian tourists severely exposed to the 2004 tsunami. METHODS Sixty-two adult Norwegian tsunami survivors were interviewed face to face 2 years post-tsunami (T1) and 58 were interviewed again by telephone 6 years post-tsunami (T2). The majority (81 %) reported direct exposure to the waves, and 14 participants (23 %) lost a close family member in the tsunami. Psychiatric morbidity was measured by structured clinical interviews and QOL was assessed with WHO's Quality of Life-Bref scale. Multiple linear regression analyses were performed to assess the independent effects of psychiatric disorders on QOL 2 and 6 years after the tsunami. RESULTS Psychiatric disorders, especially depression, but also PTSD and other anxiety disorders, were associated with reduced QOL. Psychiatric disorders were more strongly related to QOL at 6 years after the tsunami than at 2 years. CONCLUSIONS Psychiatric disorders, and especially depression, is related to reduced QOL in a disaster exposed population. Post-disaster psychiatric disorders, such as PTSD and especially depression, should be addressed properly in the aftermath of disasters.
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Affiliation(s)
- Ajmal Hussain
- Division of Mental Health Services, Akershus University Hospital, 1478, Lørenskog, Norway. .,Groruddalen Community Mental Health Center, Outpatient psychiatric clinic, Division of Mental Health Services, Akershus University Hospital, P.O box 1000, 1478, Lørenskog, Norway.
| | - Egil Nygaard
- Department of Psychology, University of Oslo, P.O box 1094, Blindern, 0317 Oslo, Norway ,Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), P.O. box 4623, Nydalen, 0405 Oslo, Norway
| | - Johan Siqveland
- Division of Mental Health Services, Akershus University Hospital, 1478 Lørenskog, Norway ,Institute of Clinical of Medicine, University of Oslo, P.O box 1078, Blindern, 0316 Oslo, Norway
| | - Trond Heir
- Institute of Clinical of Medicine, University of Oslo, P.O box 1078, Blindern, 0316 Oslo, Norway ,Norwegian Centre for Violence and Traumatic Stress Studies, University of Oslo, P.O box 181, Nydalen, 0409 Oslo, Norway
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143
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Nikendei C, Haitz M, Huber J, Ehrenthal JC, Herzog W, Schauenburg H, Dinger U. Day clinic and inpatient psychotherapy of depression (DIP-D): qualitative results from a randomized controlled study. Int J Ment Health Syst 2016; 10:41. [PMID: 27222663 PMCID: PMC4877763 DOI: 10.1186/s13033-016-0074-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 05/10/2016] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Depressive disorders are among the most common psychiatric disorders. For severely depressed patients, day clinic and inpatient settings represent important treatment options. However, little is known about patients' perceptions of the different levels of care. This study aimed to obtain an in-depth analysis of depressive patients' experiences of day clinic and inpatient treatment in a combined clinical setting. METHODS Following a randomized controlled trial comparing day clinic and inpatient psychotherapy for depression (Dinger et al. in Psychother Psychosom 83:194-195, 2014), a sample of depressive patients (n = 35) was invited to participate in a semi-structured interview during an early follow up 4 weeks after discharge. A qualitative analysis of interview transcripts was performed following the principles of constructivist thematic analysis. RESULTS Following analysis, 1355 single codes were identified from which five main categories and 26 themes were derived for both groups. In regard to patient group integration and skill transfer to everyday life, distinct differences could be observed between the day clinic and inpatient group. CONCLUSION While adjustment to therapeutic setting and patient group integration seem to be facilitated by inpatient treatment, the day clinical setting appears to promote treatment integration into patients' everyday contexts, aiding treatment-related skill transfer to everyday life as well as alleviating discharge from clinic treatment. Further studies on depressive subject groups in day clinic and inpatient treatment should investigate aspects of group cohesion and treatment integration in relation to therapeutic outcome.
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Affiliation(s)
- Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstrasse 2, 69115 Heidelberg, Germany
| | - Mirjam Haitz
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstrasse 2, 69115 Heidelberg, Germany
| | - Julia Huber
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstrasse 2, 69115 Heidelberg, Germany
| | - Johannes C Ehrenthal
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstrasse 2, 69115 Heidelberg, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstrasse 2, 69115 Heidelberg, Germany
| | - Henning Schauenburg
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstrasse 2, 69115 Heidelberg, Germany
| | - Ulrike Dinger
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstrasse 2, 69115 Heidelberg, Germany
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144
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Biesheuvel-Leliefeld KE, Kok GD, Bockting CL, de Graaf R, ten Have M, van der Horst HE, van Schaik A, van Marwijk HW, Smit F. Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study. BMC Psychiatry 2016; 16:139. [PMID: 27176611 PMCID: PMC4865028 DOI: 10.1186/s12888-016-0843-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depression is the leading cause of non-fatal disease burden. Because major depression is not a homogeneous condition, this study estimated the non-fatal disease burden for mild, moderate and severe depression in both single episode and recurrent depression. All estimates were assessed from an individual and a population perspective and presented as unadjusted, raw estimates and as estimates adjusted for comorbidity. METHODS We used data from the first wave of the second Netherlands-Mental-Health-Survey-and-Incidence-Study (NEMESIS-2, n = 6646; single episode Diagnostic and Statistical Manual (DSM)-IV depression, n = 115; recurrent depression, n = 246). Disease burden from an individual perspective was assessed as 'disability weight * time spent in depression' for each person in the dataset. From a population perspective it was assessed as 'disability weight * time spent in depression *number of people affected'. The presence of mental disorders was assessed with the Composite International Diagnostic Interview (CIDI) 3.0. RESULTS Single depressive episodes emerged as a key driver of disease burden from an individual perspective. From a population perspective, recurrent depressions emerged as a key driver. These findings remained unaltered after adjusting for comorbidity. CONCLUSIONS The burden of disease differs between the subtype of depression and depends much on the choice of perspective. The distinction between an individual and a population perspective may help to avoid misunderstandings between policy makers and clinicians.
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Affiliation(s)
- Karolien E.M. Biesheuvel-Leliefeld
- Department of General Practice and Elderly Care Medicine, and EMGO+ Institute for Health and Care Research, VU University medical centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Gemma D. Kok
- Department of Clinical and Experimental Psychology, University of Groningen, Groningen, The Netherlands
| | - Claudi L.H. Bockting
- Department of Clinical and Experimental Psychology, University of Groningen, Groningen, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Henriette E. van der Horst
- Department of General Practice and Elderly Care Medicine, and EMGO+ Institute for Health and Care Research, VU University medical centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Anneke van Schaik
- Department of Psychiatry, and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Harm W.J. van Marwijk
- Department of General Practice and Elderly Care Medicine, and EMGO+ Institute for Health and Care Research, VU University medical centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Filip Smit
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands ,Department of Clinical Psychology, and EMGO+ Institute for Health and Care Research, VU University and VU University medical centre, Amsterdam, The Netherlands ,Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University medical centre, Amsterdam, The Netherlands
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Gasparini R, Landa P, Amicizia D, Icardi G, Ricciardi W, de Waure C, Tanfani E, Bonanni P, Lucioni C, Testi A, Panatto D. Vaccinating Italian infants with a new multicomponent vaccine (Bexsero®) against meningococcal B disease: A cost-effectiveness analysis. Hum Vaccin Immunother 2016; 12:2148-2161. [PMID: 27163398 PMCID: PMC4994748 DOI: 10.1080/21645515.2016.1160177] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The European Medicines Agency has approved a multicomponent serogroup B meningococcal vaccine (Bexsero®) for use in individuals of 2 months of age and older. A cost-effectiveness analysis (CEA) from the societal and Italian National Health Service perspectives was performed in order to evaluate the impact of vaccinating Italian infants less than 1 y of age with Bexsero®, as opposed to non-vaccination. The analysis was carried out by means of Excel Version 2011 and the TreeAge Pro® software Version 2012. Two basal scenarios that differed in terms of disease incidence (official and estimated data to correct for underreporting) were considered. In the basal scenarios, we considered a primary vaccination cycle with 4 doses (at 2, 4, 6 and 12 months of age) and 1 booster dose at the age of 11 y, the societal perspective and no cost for death. Sensitivity analyses were carried out in which crucial variables were changed over probable ranges. In Italy, on the basis of official data on disease incidence, vaccination with Bexsero® could prevent 82.97 cases and 5.61 deaths in each birth cohort, while these figures proved to be three times higher on considering the estimated incidence. The results of the CEA showed that the Incremental Cost Effectiveness Ratio (ICER) per QALY was €109,762 in the basal scenario if official data on disease incidence are considered and €26,599 if estimated data are considered. The tornado diagram indicated that the most influential factor on ICER was the incidence of disease. The probability of sequelae, the cost of the vaccine and vaccine effectiveness also had an impact. Our results suggest that vaccinating infants in Italy with Bexsero® has the ability to significantly reduce meningococcal disease and, if the probable underestimation of disease incidence is considered, routine vaccination is advisable.
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Affiliation(s)
- Roberto Gasparini
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Paolo Landa
- b Department of Economics , University of Genoa , Genoa , Italy.,c University of Exeter , Medical School , Exeter , UK
| | - Daniela Amicizia
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Giancarlo Icardi
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Walter Ricciardi
- d Institute of Hygiene and Public Health , Catholic University of Sacred Heart , Rome , Italy
| | - Chiara de Waure
- d Institute of Hygiene and Public Health , Catholic University of Sacred Heart , Rome , Italy
| | - Elena Tanfani
- b Department of Economics , University of Genoa , Genoa , Italy
| | - Paolo Bonanni
- e Department of Health Sciences , University of Florence , Florence , Italy
| | | | - Angela Testi
- b Department of Economics , University of Genoa , Genoa , Italy
| | - Donatella Panatto
- a Department of Health Sciences , University of Genoa , Genoa , Italy
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Henriksson S, Anclair M, Hiltunen AJ. Effectiveness of cognitive behavioral therapy on health-related quality of life: An evaluation of therapies provided by trainee therapists. Scand J Psychol 2016; 57:215-22. [PMID: 27119256 DOI: 10.1111/sjop.12291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 03/07/2016] [Indexed: 11/27/2022]
Abstract
The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health-related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism.
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Affiliation(s)
- Sophie Henriksson
- Department of Social and Psychological Studies, Section of Psychology, Karlstad University, Sweden
| | - Malin Anclair
- Department of Social and Psychological Studies, Section of Psychology, Karlstad University, Sweden
| | - Arto J Hiltunen
- Department of Social and Psychological Studies, Section of Psychology, Karlstad University, Sweden
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147
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Boerema AM, Kleiboer A, Beekman ATF, van Zoonen K, Dijkshoorn H, Cuijpers P. Determinants of help-seeking behavior in depression: a cross-sectional study. BMC Psychiatry 2016; 16:78. [PMID: 27009062 PMCID: PMC4806501 DOI: 10.1186/s12888-016-0790-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although evidence-based and effective treatments are available for people with depression, a substantial number does not seek or receive help. Therefore, it is important to gain a better understanding of the reasons why people do or do not seek help. This study examined what predisposing and need factors are associated with help-seeking among people with major depression. METHODS A cross-sectional study was conducted in 102 subjects with major depression. Respondents were recruited from the general population in collaboration with three Municipal Health Services (GGD) across different regions in the Netherlands. Inclusion criteria were: being aged 18 years or older, a high score on a screening instrument for depression (K10 > 20), and a diagnosis of major depression established through the Composite International Diagnostic Interview (CIDI 2.1). RESULTS Of the total sample, 65 % (n = 66) had received help in the past six months. Results showed that respondents with a longer duration of symptoms and those with lower personal stigma were more likely to seek help. Other determinants were not significantly related to help-seeking. CONCLUSIONS Longer duration of symptoms was found to be an important determinant of help-seeking among people with depression. It is concerning that stigma was related to less help-seeking. Knowledge and understanding of depression should be promoted in society, hopefully leading to reduced stigma and increased help-seeking.
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Affiliation(s)
- Anke M. Boerema
- />Department of Clinical, Neuro, and Developmental Psychology, Section Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- />EMGO Institute for Health Care and Research, VU University Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Annet Kleiboer
- />Department of Clinical, Neuro, and Developmental Psychology, Section Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- />EMGO Institute for Health Care and Research, VU University Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Aartjan T. F. Beekman
- />EMGO Institute for Health Care and Research, VU University Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- />Department of Psychiatry, VU University Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Kim van Zoonen
- />Statistics Netherlands (CBS), Henri Faasdreef 312, 2492 JT Den Haag, The Netherlands
| | | | - Pim Cuijpers
- />Department of Clinical, Neuro, and Developmental Psychology, Section Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- />EMGO Institute for Health Care and Research, VU University Medical Centre, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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148
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Kasteenpohja T, Marttunen M, Aalto-Setälä T, Perälä J, Saarni SI, Suvisaari J. Treatment adequacy of anxiety disorders among young adults in Finland. BMC Psychiatry 2016; 16:63. [PMID: 26993796 PMCID: PMC4799592 DOI: 10.1186/s12888-016-0766-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 03/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety disorders are common in early adulthood, but general population studies concerning the treatment adequacy of anxiety disorders taking into account appropriate pharmacological and psychological treatment are scarce. The aims of this study were to examine treatments received for anxiety disorders in a Finnish general population sample of young adults, and to define factors associated with receiving minimally adequate treatment and with dropping out from treatment. METHODS A questionnaire containing several mental health screens was sent to a nationally representative two-stage cluster sample of 1894 Finns aged 19 to 34 years. All screen positives and a random sample of screen negatives were invited to a mental health assessment including a SCID interview. For the final diagnostic assessment, case records from mental health treatments for the same sample were obtained. This article investigates treatment received, treatment adequacy and dropouts from treatment of 79 participants with a lifetime anxiety disorder (excluding those with a single specific phobia). Based on all available information, receiving antidepressant or buspirone medication for at least 2 months with at least four visits with any type of physician or at least eight sessions of psychotherapy within 12 months or at least 4 days of hospitalization were regarded as minimally adequate treatment for anxiety disorders. Treatment dropout was rated if the patient discontinued the visits by his own decision despite having an adequate treatment strategy according to the case records. RESULTS Of participants with anxiety disorders (excluding those with a single specific phobia), 41.8 % had received minimally adequate treatment. In the multivariate analysis, comorbid substance use disorder was associated with antidepressant or buspirone medication lasting at least 2 months. Those who were currently married or cohabiting had lower odds of having at least four visits with a physician a year. None of these factors were associated with the final outcome of minimally adequate treatment or treatment dropout. Participants with comorbid personality disorders received and misused benzodiazepines more often than others. CONCLUSIONS More efforts are needed to provide adequate treatment for young adults with anxiety disorders. Attention should be paid to benzodiazepine prescribing to individuals with personality disorders.
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Affiliation(s)
- Teija Kasteenpohja
- />Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271 Finland
- />Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Mauri Marttunen
- />Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271 Finland
- />Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Jonna Perälä
- />Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271 Finland
- />Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Samuli I. Saarni
- />Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271 Finland
- />Turku University Hospital and University of Turku, Turku, Finland
| | - Jaana Suvisaari
- />Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271 Finland
- />Department of Social Psychiatry, School of Public Health, University of Tampere, Tampere, Finland
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149
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Bauer A, Knapp M, Parsonage M. Lifetime costs of perinatal anxiety and depression. J Affect Disord 2016; 192:83-90. [PMID: 26707352 DOI: 10.1016/j.jad.2015.12.005] [Citation(s) in RCA: 175] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/25/2015] [Accepted: 12/07/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anxiety and depression are common among women during pregnancy and the year after birth. The consequences, both for the women themselves and for their children, can be considerable and last for many years. This study focuses on the economic consequences, aiming to estimate the total costs and health-related quality of life losses over the lifetime of mothers and their children. METHOD A pathway or decision modelling approach was employed, based on data from previous studies. Systematic and pragmatic literature reviews were conducted to identify evidence of impacts of perinatal anxiety and depression on mothers and their children. RESULTS The present value of total lifetime costs of perinatal depression (anxiety) was £75,728 (£34,811) per woman with condition. If prevalence estimates were applied the respective cost of perinatal anxiety and depression combined was about £8500 per woman giving birth; for the United Kingdom, the aggregated costs were £6.6 billion. The majority of the costs related to adverse impacts on children and almost a fifth were borne by the public sector. LIMITATIONS The method was exploratory in nature, based on a diverse range of literature and encountered important data gaps. CONCLUSIONS Findings suggest the need to allocate more resources to support women with perinatal mental illness. More research is required to understand the type of interventions that can reduce long-term negative effects for both mothers and offspring.
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Affiliation(s)
- Annette Bauer
- Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK.
| | - Martin Knapp
- Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK
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Imamura K, Kawakami N, Inoue A, Shimazu A, Tsutsumi A, Takahashi M, Totsuzaki T. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE) among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study. PLoS One 2016; 11:e0148157. [PMID: 26841020 PMCID: PMC4739688 DOI: 10.1371/journal.pone.0148157] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 01/13/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE). METHODS The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270), and 1,058 (24.8%) of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. MDE was measured at baseline and at each of the follow-ups as the outcome, using the web-based, self-administered version of the Japanese WHO-CIDI 3.0 depression section based upon DSM-IV-TR/DSM-5 criteria. Cox discrete-time hazards analyses were conducted to estimate hazard ratios (95% confidence intervals CIs). RESULTS Follow-up rates of participants (N = 929) were 78.4%, 67.2%, and 51.6% at 1-, 2-, and 3-year follow-ups, respectively. The association between work engagement at baseline and the onset of MDE was U-shaped. Compared with a group with low work engagement scores, groups with the middle and high scores showed significantly (HR = 0.19, 95% CI = 0.05 to 0.64; p = 0.007) and marginally significantly (HR = 0.48, 95% CI = 0.20 to 1.15, p = 0.099) lower risks of MDE, respectively, over the follow-ups, after adjusting for covariates. The pattern remained the same after additionally adjusting for psychological distress. CONCLUSIONS The present study first demonstrated work engagement as an important predictor of the onset of MDE diagnosed according to an internationally standard diagnostic criteria of mental disorders.
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Affiliation(s)
- Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- * E-mail:
| | - Akiomi Inoue
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Akihito Shimazu
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaya Takahashi
- Health Administration and Psychosocial Factor Research Group, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan
| | - Takafumi Totsuzaki
- Uchisaiwaicho Medical Center, Mizuho Health Insurance Society, Tokyo, Japan
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