Mental health care Monitor Older adults (MEMO): monitoring patient characteristics and outcome in Dutch mental health services for older adults

Development and application of emotion recognition technology - a systematic literature review

BACKGROUND

There is a mutual influence between emotions and diseases. Thus, the subject of emotions has gained increasing attention.

OBJECTIVE

The primary objective of this study was to conduct a comprehensive review of the developments in emotion recognition technology over the past decade. This review aimed to gain insights into the trends and real-world effects of emotion recognition technology by examining its practical applications in different settings, including hospitals and home environments.

METHODS

This study followed the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and included a search of 4 electronic databases, namely, PubMed, Web of Science, Google Scholar and IEEE Xplore, to identify eligible studies published between 2013 and 2023. The quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) criteria. The key information from the studies, including the study populations, application scenarios, and technological methods employed, was summarized and analyzed.

RESULTS

In a systematic literature review of the 44 studies that we analyzed the development and impact of emotion recognition technology in the field of medicine from three distinct perspectives: "application scenarios," "techniques of multiple modalities," and "clinical applications." The following three impacts were identified: (i) The advancement of emotion recognition technology has facilitated remote emotion recognition and treatment in hospital and home environments by healthcare professionals. (ii) There has been a shift from traditional subjective emotion assessment methods to multimodal emotion recognition methods that are grounded in objective physiological signals. This technological progress is expected to enhance the accuracy of medical diagnosis. (iii) The evolving relationship between emotions and disease throughout diagnosis, intervention, and treatment processes holds clinical significance for real-time emotion monitoring.

CONCLUSION

These findings indicate that the integration of emotion recognition technology with intelligent devices has led to the development of application systems and models, which provide technological support for the recognition of and interventions for emotions. However, the continuous recognition of emotional changes in dynamic or complex environments will be a focal point of future research.

A systematic review of patient-reported outcome measurement (PROM) and provider assessment in mental health: goals, implementation, setting, measurement characteristics and barriers

PURPOSE

To review and integrate the literature on mental-health-related patient-reported outcome measures (PROMs) and routine outcome measures (ROMs), namely in the domains of goals, characteristics, implementation, settings, measurements and barriers. PROM/ROM aims mainly to ascertain treatment impact in routine clinical practice through systematic service users' health assessment using standardized self-report, caretaker and/or provider assessment.

DATA SOURCES

Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science's Direct.

STUDY SELECTION

Systemized review of literature (2000-2018) on implementation and sustainability of PROMs/ROMs in adult mental health settings (MHS).

DATA EXTRACTION AND SYNTHESIS

Systemized review of literature (2000-2018) on numerous aspects of PROM/ROM implementation and sustainability in adult MHS worldwide.

RESULTS

Based on 103 articles, PROMs/ROMs were implemented mostly in outpatient settings for people with assorted mental health disorders receiving a diversity of services. Frequency of assessments and completion rates varied: one-third of projects had provider assessments; about half had both provider and self-assessments. Barriers to implementation: perceptions that PROM/ROM is intrusive to clinical practice, lack of infrastructure, fear that results may be used for cost containment and service eligibility instead of service quality improvement, difficulties with measures, ethical and confidentiality regulations and web security data management regulations.

CONCLUSION

Improving data input systems, sufficient training, regular feedback, measures to increase administrative and logistic support to improve implementation, acceptability, feasibility and sustainability, follow-up assessments and client attrition rate reduction efforts are only some measures needed to enhance PROM/ROM efficiency and efficacy.

Patient-reported outcome measurements (PROMs) and provider assessment in mental health: a systematic review of the context of implementation

Purpose

To review and integrate the vast amount of literature yielded by recent growing interest in patient-reported outcome measurement and routine outcome measures (PROMs/ROMs), in order to suggest options and improvements for implementation. PROMs are the systematic assessment of service users’ health using standardized self-report measures. Specifically, for ROMs, it includes routine provider or caretaker assessment measures. Both are administered to ascertain routinely, the impact of treatment in mental health settings and to improve care. A review is needed because of the large differences in setting, conceptualization, practice and implementation. Here, we examine the different major projects worldwide.

Data sources

Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science’s Direct.

Study selection

We conducted a systematized review of the literature published from 2000 to 2018 on the implementation and sustainability of PROMs and ROMs in mental health services for adults.

Data extraction, synthesis and Results

We described and characterized the programs in different countries worldwide. We identified 103 articles that met the inclusion criteria, representing over 80 PROMs/ROMs initiatives in 15 countries. National policy and structure of mental health services were found to be major factors in implementation. We discuss the great variability in PROMs/ROMs models in different countries, making suggestions for their streamlining and improvement.

Conclusion

We extracted valuable information on the different characteristics of the numerous PROMs/ROMs initiatives worldwide. However, in the absence of a strong nationwide policy effort and support, implementation seems scattered and irregular. Thus, development of the implementation of PROMs/ROMs is left to groups of enthusiastic clinicians and researchers, making sustainability problematic.

Predisposing, enabling, and need factors of service utilization in the elderly with mental health problems

ABSTRACTBackground:Empirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly.

METHODS

As part of the MentDis_ICF65+ study, N = 3,142 people aged 65-84 living in the community in six European and associated countries were interviewed. Based on Andersen's behavioral model predisposing, enabling, and need factors were analyzed with logistic regression analyses.

RESULTS

Overall, 7% of elderly and 11% of those with a mental disorder had used a service due to mental health problems in the last 12 months. Factors significantly associated with underuse were male sex, lower education, living in the London catchment area, higher functional impairment and more comorbid mental disorders. The most frequently reported barrier to service use was personal beliefs, e.g. "I can deal with my problem on my own" (90%).

CONCLUSION

Underutilization of mental health services among older people in the European community is common and interventions are needed to achieve an adequate use of services.

Effectiveness and predictors of outcome in routine out-patient mental health care for older adults

ABSTRACT Background: Meta-analyses show efficacy of several psychological and pharmacological interventions for late-life psychiatric disorders, but generalization of effects to routine mental health care for older people remains unknown. Aim of this study is to investigate the improvement of functioning within one year of referral to an outpatient mental health clinic for older adults. Methods: Pre-post measurement of the Health of Nations Outcome Scale 65+ (HoNOS 65+) in 704 older people referred for psychiatric problems (no dementia) to any of the seven participating mental health care organizations. Results: The pre-post-test Cohen's d effect size was 1.08 in the total group and 1.23 in depressed patients, the largest subgroup. Linear regression identified better functioning at baseline, comorbid personality disorder, somatic comorbidity and life events during treatment as determinants of a worse outcome. Conclusions: Functioning of older persons with psychiatric problems largely improves after treatment in routine mental health care.

Psychometric properties of the Dutch version of the Health of the Nation Outcome Scales for older adults (HoNOS 65+) in daily care

BACKGROUND

The Health of the Nation Outcome Scales (HoNOS) is widely used to evaluate mental health care outcomes. For appropriate use and interpretation in routine clinical practice, further validation of the adapted version for older clients (HoNOS 65+) is needed.

OBJECTIVE

The aim of this study is to compare scoring profiles produced by different categories of professionals, assess the internal consistency of the sum score and proposed subscales, and concurrent validity of the total sum score of the Dutch version of HoNOS 65+.

METHODS

We used baseline data from fourteen mental health care organizations participating in the MEntal health care Monitor Older adults (MEMO), a nationwide routine outcome monitoring system. A total of 767 older clients, referred for gerontopsychiatric disorders, were administered HoNOS 65+ by non-academic (primarily nurses, n=430) or academic professionals (psychologists/physicians, n=337). Demographics and full DSM-IV classification, including the Global Assessment of Functioning (GAF), were derived from the electronic medical dossier.

RESULTS

HoNOS 65+ seemed to discriminate between clients with and without a depressive disorder, adjustment disorder, anxiety disorder and psychotic disorder on the items expected. In clients suffering from a depressive or psychotic disorder, nurses/social workers and physicians/psychologists did not differ in scoring on all items of HoNOS 65+. In clients with an adjustment disorder or anxiety disorder, professions differed in rating on two items. Confirmatory Factor Analyses supported neither the factor structure of the original HoNOS nor the initially reported structure of HoNOS 65+ version. Cronbach's alpha of the total sum score was 0.60. Internal consistency of previously identified subscales was low. A new set of subscales could not be identified satisfactorily. A medium-sized correlation of the HoNOS 65+ sum score and the GAF was found (r=-.30, p<.001).

CONCLUSIONS

It is preferable to use individual HoNOS 65+ items, to evaluate care outcomes. The HoNOS 65+ items discriminate between clients with and without a particular diagnosis. Nonetheless, in some of the most prevalent gerontopsychiatric disorders rating differs between professionals with different educational backgrounds.