1
|
Muschalla B. Psychological capacity profiles of different age groups and gender in a national representative sample. Psych J 2024. [PMID: 39188054 DOI: 10.1002/pchj.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/27/2024] [Indexed: 08/28/2024]
Abstract
Beyond the specific cognitive capacities like numerical or verbal intelligence and cognitive speed, the so-called soft skills, namely, psychological capacities, have become highly important in modern life. This is the first representative study on the distribution of work-relevant psychological capacities in the general population. We investigate capacities in different age groups, gender, and their relation with basic sociodemographics. A representative sample of 2531 people aged 14-95 years was investigated concerning work-relevant psychological capacities with the mini self-rating for psychological activities and participation (Mini-ICF-APP-S). The strongest capacities in young people were mobility, flexibility, proactivity, contact to thirds, and group interaction. Other capacities were stronger in midlife (30-59 years), such as adjustment to rules and routines, planning and structuring, decision making and judgement, application of competence and knowledge, assertiveness, dyadic relationships, endurance, and self-care. Women reported better dyadic relationship capacities, and men felt more assertive. The study provides, for the first time, representative data on a broad range of psychological capacities according to an internationally validated capacity concept. Good psychological capacities occur not primarily in youth, but especially in midlife and older age. Regarding demographic change, this implies older people are highly competent in the working world.
Collapse
Affiliation(s)
- Beate Muschalla
- Institute of Psychology, Technische Universität Braunschweig, Braunschweig, Germany
| |
Collapse
|
2
|
Bayer S, Bröcker AL, Stuke F, Just S, Bertram G, Grimm I, Maaßen E, Büttner M, Heinz A, Bermpohl F, Lempa G, von Haebler D, Montag C. Level of structural integration in people with schizophrenia and schizoaffective disorders - applicability and associations with clinical parameters. Front Psychiatry 2024; 15:1388478. [PMID: 38911709 PMCID: PMC11192590 DOI: 10.3389/fpsyt.2024.1388478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/13/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction The psychic structure of people with psychosis has been the subject of theoretical and qualitative considerations. However, it has not been sufficiently studied quantitatively. Therefore, the aim of this study was to explore the structural abilities of people diagnosed with schizophrenia and schizoaffective psychosis using the Levels of Structural Integration Axis of the Operationalized Psychodynamic Diagnosis System (OPD-2-LSIA). The study aimed to determine possible associations between the OPD-2-LSIA and central parameters of illness. Additionally, possible structural differences between people diagnosed with schizophrenia and schizoaffective psychosis were tested. Methods This cross-sectional study included 129 outpatients with schizophrenia or schizoaffective disorders. Measures of structural integration, symptom load, severity of illness, cognition, and social functioning were obtained. Descriptive statistics were used to analyze the overall structural level and the structural dimensions. Correlation coefficients were computed to measure the associations between OPD-2-LSIA and variables regarding the severity of illness and psychosocial functioning. Regression models were used to measure the influence of illness-related variables on OPD-2-LSIA, and the influence of OPD-2-LSIA on psychosocial functioning. Participants diagnosed with schizophrenia and schizoaffective disorders were examined with regard to possible group differences. Results The results of the OPD-2-LSIA showed that the overall structural level was between 'moderate to low' and 'low level of structural integration'. Significant correlations were found between OPD-2-LSIA and psychotic symptoms (but not depressive symptoms), as well as between OPD-2-LSIA and psychosocial functioning. It was found that variables related to severity of illness had a significant impact on OPD-2-LSIA, with psychotic, but not depressive symptoms being significant predictors. OPD-2-LSIA was found to predict psychosocial functioning beyond symptoms and cognition. No significant differences were found between participants with schizophrenia and schizoaffective psychosis. There was also no correlation found between OPD-2-LSIA and depressive symptomatology (except for the subdimension Internal communication). Discussion Contrary to theoretical assumptions, the results of the study show a heterogenous picture of the psychic structure of people with psychosis. The associations between OPD-2-LSIA and severity of illness, particularly psychotic symptomatology, as well as the influence of OPD-2-LSIA on psychosocial functioning, are discussed.
Collapse
Affiliation(s)
- Samuel Bayer
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Anna-Lena Bröcker
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Frauke Stuke
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sandra Just
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gianna Bertram
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Imke Grimm
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Eva Maaßen
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Marielle Büttner
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Dorothea von Haebler
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Psychotherapy, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
3
|
Werk LP, Muschalla B. Effects and Side Effects in a Short Work Coaching for Participants with and without Mental Illness. Behav Sci (Basel) 2024; 14:462. [PMID: 38920794 PMCID: PMC11201230 DOI: 10.3390/bs14060462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/17/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
Employees with mental illness are often the first to be unable to cope with increasingly complex psychosocial work demands. But people without mental illness can also suffer from, for example, high workload. This study compares a short coaching to stabilize work ability for employees with and without mental illness regarding coaching topics, effects on work-related resources, goal attainment, and unwanted events. Individual coaching of three sessions (problem exploration by behavior analysis, practice of new behavior, reflection) was conducted with employees from different professional fields. A medical history was taken to determine whether participants are affected by a mental disorder. All coaching was conducted by the same behavior therapist in training (L.P.W.) under the supervision of an experienced behavior therapist (B.M.). Two hundred and three coachings with three sessions were completed. In total, 103 participants did not have a mental illness (51%), and 100 participants reported a mental disorder (49%). The coaching participants with mental illness had lower initial levels of work-related capacities (more severe impairments) and coping behavior as compared to the participants without mental illness. In the pre-post comparisons, both groups achieved significant improvements in work-related coping after the coaching. There were no differences in goal attainment between both groups. While participants without mental illness reported more unwanted events in parallel to the coaching (30% reported negative developments in life), participants with mental illness reported coaching-related unwanted events (20% felt to be dependent on the coach). Coaching with an individual focus on one topic can improve work-related resources in participants with and without mental disorders. Since participants with and without mental illness experience different unwanted events in coaching, psychotherapeutic expertise is needed in order to set the right focus.
Collapse
Affiliation(s)
- Lilly Paulin Werk
- Department of Psychotherapy & Diagnostics, Institute of Psychology, Technische Universität Braunschweig, Humboldtstraße 33, 38106 Braunschweig, Germany;
| | | |
Collapse
|
4
|
Li Y, Wilke C, Shiyanov I, Muschalla B. Impact of Virtual Reality-Based Group Activities on Activity Level and Well-Being Among Older Adults in Nursing Homes: Longitudinal Exploratory Study. JMIR Serious Games 2024; 12:e50796. [PMID: 38551635 PMCID: PMC11015370 DOI: 10.2196/50796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/27/2023] [Accepted: 02/02/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND In addition to illness, inactivity is a risk factor for high mortality in nursing homes. Using innovative technology, such as virtual reality (VR), for meaningful group activities could provide new opportunities for solving this problem. VR interventions have already been approved as a promising method for enhancing the health of older adults. OBJECTIVE In this study, we examined whether VR-based group activities can have a positive impact on activity level and group interaction among older adults living in nursing homes. METHODS We conducted a longitudinal study and provided VR interventions as a group activity once a week for 4 consecutive weeks in nursing homes. Participants were recruited based on the experience of the nursing staff members and the natural decisions of the older adults. Within a virtual cottage, designed according to the needs of the target group, older adults were able to perform daily tasks that they were no longer able to do in real life, such as gardening and making pizza. Overall, 2 psychologists measured the psychosocial capacities, activities of daily life, and well-being before and after the interventions using standardized instruments. RESULTS The results focus on a total of 84 older adults from 14 nursing homes who completed at least 3 VR interventions. The results indicate that several psychosocial capacities among the older adults improved, including adherence to regulations (P<.001; η²=0.122), flexibility (P<.001; η²=0.109), and group integration (P<.001; η²=0.141). Problems related to competence also showed a slight decrease (P=.04; η²=0.039). In addition, the VR intervention promoted their proactivity (P<.001; η²=0.104) and mobility (P=.04; η²=0.039). During the VR group intervention, older adults' well-being could be maintained at a high level. The results highlight the beneficial effects of VR intervention as a meaningful activity in nursing homes, showcasing the potential of VR applications in this setting. CONCLUSIONS This study provides a novel and naturalistic perspective, offering new insights into the use of VR in nursing homes. The VR intervention was well accepted and fulfilled the aim of enhancing capacity and well-being. It could be a meaningful group activity in nursing homes to improve social group interaction. To provide stronger evidence, randomized controlled trials are necessary.
Collapse
Affiliation(s)
- Yijun Li
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Institute of Psychology, Braunschweig, Germany
| | - Carlotta Wilke
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Institute of Psychology, Braunschweig, Germany
| | | | - Beate Muschalla
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Institute of Psychology, Braunschweig, Germany
| |
Collapse
|
5
|
Neue DC, Muschalla B. Type, distribution, and frequency of psychological capacity disorders in patients with different somatic illnesses. Disabil Rehabil 2024; 46:705-713. [PMID: 36740780 DOI: 10.1080/09638288.2023.2175387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/28/2023] [Indexed: 02/07/2023]
Abstract
PURPOSE Somatic illnesses are often accompanied by (psychological) capacity impairments which impact on everyday life and work. The question is whether different somatic illnesses are associated with different capacity impairments, and whether impairment is more severe in cases of comorbid mental disorders. MATERIALS AND METHODS Patients with neurological (N = 318), cardiological (N = 307) and orthopedic illness (N = 311) with and without comorbid mental illness according to MINI were investigated in a rehabilitation hospital. Psychological capacity impairments were assessed with the Mini-ICF-APP observer rating. RESULTS The "baseline rate" of capacity impairment in patients without mental illnesses was 40.7% in orthopedic, in 36% of cardiology patients (36.1%) and in 74.9% of neurology patients. Patients with additional comorbid mental disorders had stronger impairments than those without mental illness. The most heavily impaired group overall were neurology patients with comorbid mental illness. CONCLUSIONS Somatic patients also have psychological impairments; these are more pronounced in the case of comorbid mental illnesses. It should be clearly explored whether psychological symptoms and impairment are an expression of the somatic illness per se, or due to a comorbid mental illness. Rehabilitation diagnostics should consider capacity impairments routinely in order to make indications for capacity trainings or context adjustment.
Collapse
Affiliation(s)
- Diana Carolina Neue
- Brandenburgklinik Bernau, Berlin, Germany
- Technische Universität Braunschweig, Psychotherapy and Diagnostics, Braunschweig, Germany
| | - Beate Muschalla
- Brandenburgklinik Bernau, Berlin, Germany
- Technische Universität Braunschweig, Psychotherapy and Diagnostics, Braunschweig, Germany
| |
Collapse
|
6
|
Muschalla B. Are retired persons fitter in their psychological capacities than unemployed? A cross-sectional representative study in Germany. BMJ Open 2024; 14:e065869. [PMID: 38238046 PMCID: PMC10806760 DOI: 10.1136/bmjopen-2022-065869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVES Beyond specific aspects of numerical or verbal intelligence or cognitive speed, a broad range of psychological capacities are generally important in school, job and social life for all age groups. People have to quit the labour market up from a certain age about 65, whereas (younger) unemployed are motivated for return to work. The question is which psychological capacity profiles can be found in different employment groups (employed, mini-jobbers, voluntary service, retired, unemployed). DESIGN A representative cross-sectional survey was conducted in Germany, reaching 2528 persons. SETTING Republic of Germany. PARTICIPANTS Randomly selected inhabitants throughout Germany. PRIMARY AND SECONDARY OUTCOME MEASURES Participants reported their sociodemographic and work characteristics, as well as their psychological capacity profiles (Mini-ICF-APP-S) and work-related specific mental health problems (work-anxiety, embitterment). RESULTS The unemployed had-compared with all other groups-highest rates of work-anxiety and embitterment (16.3%). In contrast to the unemployed, the 'older' (70 aged) retired group, who were no longer working on the labour market, seldomly reported work-anxiety (2.6%) or embitterment (4.2%). The unemployed had the worst capacity profiles, most frequently no school degree (11.5%), most unemployment in their history (four times, as compared with once in the older retired). The psychological capacity profiles of the retired were similar to employed persons. CONCLUSIONS Keeping older persons with high psychological capacity levels in working life could be an alternative to forced reintegration of people with chronic participation problems into the competitive labour market. Unemployed persons with chronic health and participation problems might benefit from other social inclusion means.
Collapse
|
7
|
Henning A, Linden M, Muschalla B. Self- and observer ratings of capacity limitations in patients with neurological conditions. BRAIN IMPAIR 2023; 24:586-600. [PMID: 38167355 DOI: 10.1017/brimp.2022.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients' ability to participate in work and social life and improving collaborative patient-clinician relationships. METHOD The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S). RESULTS Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings. CONCLUSIONS The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.
Collapse
Affiliation(s)
- Anne Henning
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
- Brandenburgklinik Berlin-Brandenburg, Bernau bei Berlin, Germany
| | - Michael Linden
- Research Group Psychosomatic Rehabilitation, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Beate Muschalla
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
- Brandenburgklinik Berlin-Brandenburg, Bernau bei Berlin, Germany
| |
Collapse
|
8
|
Smith A, Theil S, Hart SD, Liebrenz M. Mental health-related limitations and political leadership in Germany: A multidisciplinary analysis of legal, psychiatric, and ethical frameworks. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 89:101908. [PMID: 37467545 DOI: 10.1016/j.ijlp.2023.101908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/27/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
In recent years, political events have reignited contentious debates about psychiatry and democratic governance. This discourse has largely centred around the ethics and morality of public commentary, particularly in relation to the American Psychiatric Association's Goldwater Rule. Yet, few studies have examined the practical implications of health-related limitations due to mental illness in national leadership and the constitutional and legal provisions that surround these issues, including voluntary or involuntary proceedings. Accordingly, this theoretical paper analyses these topics in a German context using the position at the head of the executive: the chancellorship. Germany was selected as a case example as the biggest democracy in Europe with modern legal frameworks representative of the post-World War Two era in European constitutionalism, and for its economic and political influence within the European Union. Throughout this paper, we do not speculate on the mental health of any individual (past or present), but instead explore jurisdictional mechanisms around health-related limitations in German high office. Consequently, we outline relevant constitutional and legal scenarios, and how short- or long-term medical incapacity may determine requisite responses and contingent complexities. This underpins our discussion, where we consider legal ambiguities, functional capacity, and ethical concerns in psychiatric practice.
Collapse
Affiliation(s)
- Alexander Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland.
| | - Stefan Theil
- Faculty of Law, University of Cambridge, Cambridge, United Kingdom.
| | - Stephen D Hart
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland.
| |
Collapse
|
9
|
Bjørkedal STB, Bejerholm U, Hjorthøj C, Møller T, Eplov LF. Meaningful Activities and Recovery (MA&R): a co-led peer occupational therapy intervention for people with psychiatric disabilities. Results from a randomized controlled trial. BMC Psychiatry 2023; 23:406. [PMID: 37280561 DOI: 10.1186/s12888-023-04875-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities. AIM To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery. METHODS In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up. RESULTS Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes. CONCLUSION We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness. TRIAL REGISTRATION The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.
Collapse
Affiliation(s)
| | - Ulrika Bejerholm
- Department of Health Sciences, Centre of Evidence-Based Psychosocial Interventions, CEPI, Lund University, Lund, Sweden
- Department of Research, Development and Education, Division of Psychiatry and Habilitation, Region Skåne, Lund, Sweden
| | - Carsten Hjorthøj
- CORE: Copenhagen Research for Mental Health, Gentofte Hospitalsvej 15, 3A, 2900, Hellerup, Denmark
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen K, Denmark
| | - Tom Møller
- University Hospitals Centre for Health Research (UCSF), Department 9701, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen K, Denmark
| | - Lene Falgaard Eplov
- CORE: Copenhagen Research for Mental Health, Gentofte Hospitalsvej 15, 3A, 2900, Hellerup, Denmark
| |
Collapse
|
10
|
Parsapoor (Parsa) M(M, Alam MR, Mihailidis A. Performance of machine learning algorithms for dementia assessment: impacts of language tasks, recording media, and modalities. BMC Med Inform Decis Mak 2023; 23:45. [PMID: 36869377 PMCID: PMC9985301 DOI: 10.1186/s12911-023-02122-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 01/23/2023] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES Automatic speech and language assessment methods (SLAMs) can help clinicians assess speech and language impairments associated with dementia in older adults. The basis of any automatic SLAMs is a machine learning (ML) classifier that is trained on participants' speech and language. However, language tasks, recording media, and modalities impact the performance of ML classifiers. Thus, this research has focused on evaluating the effects of the above-mentioned factors on the performance of ML classifiers that can be used for dementia assessment. METHODOLOGY Our methodology includes the following steps: (1) Collecting speech and language datasets from patients and healthy controls; (2) Using feature engineering methods which include feature extraction methods to extract linguistic and acoustic features and feature selection methods to select most informative features; (3) Training different ML classifiers; and (4) Evaluating the performance of ML classifiers to investigate the impacts of language tasks, recording media, and modalities on dementia assessment. RESULTS Our results show that (1) the ML classifiers trained with the picture description language task perform better than the classifiers trained with the story recall language task; (2) the data obtained from phone-based recordings improves the performance of ML classifiers compared to data obtained from web-based recordings; and (3) the ML classifiers trained with acoustic features perform better than the classifiers trained with linguistic features. CONCLUSION This research demonstrates that we can improve the performance of automatic SLAMs as dementia assessment methods if we: (1) Use the picture description task to obtain participants' speech; (2) Collect participants' voices via phone-based recordings; and (3) Train ML classifiers using only acoustic features. Our proposed methodology will help future researchers to investigate the impacts of different factors on the performance of ML classifiers for assessing dementia.
Collapse
Affiliation(s)
| | - Muhammad Raisul Alam
- grid.17063.330000 0001 2157 2938Department of Computer Science, University of Toronto, Toronto, Canada
- grid.17063.330000 0001 2157 2938Department Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- grid.494618.6Vector Institute, Toronto, Canada
| | - Alex Mihailidis
- grid.17063.330000 0001 2157 2938Department Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- grid.17063.330000 0001 2157 2938Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| |
Collapse
|
11
|
Hofmann AB, Schmid HM, Jabat M, Brackmann N, Noboa V, Bobes J, Garcia-Portilla MP, Seifritz E, Vetter S, Egger ST. Utility and validity of the Brief Psychiatric Rating Scale (BPRS) as a transdiagnostic scale. Psychiatry Res 2022; 314:114659. [PMID: 35709637 DOI: 10.1016/j.psychres.2022.114659] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/15/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
The Brief Psychiatric Rating Scale (BPRS) was originally conceived to assess psychopathology in several psychiatric disorders, making it an appropriate candidate to be used as a transdiagnostic instrument. We analyzed the utility and validity of the BPRS in a diagnostically heterogeneous sample of 600 psychiatric inpatients. As a comparator, we chose the mini-ICF-APP, a scale used to measure functioning and impairment across the diagnostic spectrum. Both scales had good internal consistency. The BPRS and the mini-ICF-APP showed a moderate correlation, with good levels of agreement. We were able to identify general symptoms present across the diagnostic spectrum, influencing severity and a cluster of symptoms specific for each diagnosis. Our results show the utility and validity of the BPRS as a transdiagnostic assessment tool that could easily be introduced in routine clinical work.
Collapse
Affiliation(s)
- Andreas B Hofmann
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Hanna M Schmid
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Mounira Jabat
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Nathalie Brackmann
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Forensic Psychiatry, Zurich, Switzerland
| | - Vanessa Noboa
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland; University San Francisco de Quito, Faculty of Medicine, Quito, Ecuador
| | - Julio Bobes
- University of Oviedo, Faculty of Medicine, Department of Psychiatry, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Maria Paz Garcia-Portilla
- University of Oviedo, Faculty of Medicine, Department of Psychiatry, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Erich Seifritz
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Stefan Vetter
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Stephan T Egger
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland; University of Oviedo, Faculty of Medicine, Department of Psychiatry, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain.
| |
Collapse
|
12
|
Muschalla B, Jöbges M. [Patienten mit komorbiden somatischen und psychischen Erkrankungen haben ähnliche Fähigkeitsbeeinträchtigen wie Patienten mit psychischen Erkrankungen]. DIE REHABILITATION 2022; 62:86-93. [PMID: 35772729 PMCID: PMC10089765 DOI: 10.1055/a-1839-5048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES In patients with somatic illness and additional mental disorder, not only motor or sensory functions may be impaired, but also psychological capacities. These become more and more important for work ability in our modern working world. There are presently no data about the type and distribution of psychological capacity impairments in patients with comorbid somatic and mental disorders. These data are however important for estimation of diagnostic and therapy requirements. METHODS 402 orthopedic, cardiological, and neurological patients with additional mental disorders were investigated with a structured clinical assessment for mental disorders (MINI) and psychological capacity impairments (Mini-ICF-APP). RESULTS In all three somatic indications at least half of the comorbid patients had any clinically relevant psychological capacity impairment. Neurological patients (67%) and orthopedic patients (72%) were more often affected than cardiological patients (50.5%). Orthopedic patients are slightly more impaired in self-care; neurological and orthopedic patients are more impaired in mobility; and cardiological patients are less impaired in assertiveness. CONCLUSION In comparison of all three somatic patient groups with mental disorders the number of psychological capacity impairments is similar. In contrast to patients with mental disorders only (i. e. those without somatic comorbidity), the psychological impairment quality in comorbid patients may be influenced by the somatic illness. The data from this study are important in order to estimate diagnostic and therapeutic needs, such as capacity training or compensation of psychological capacity impairments.
Collapse
Affiliation(s)
- Beate Muschalla
- Psychotherapy and Diagnostics, Technische Universität Braunschweig, Humboldtstraße Braunschweig Germany
| | | |
Collapse
|
13
|
Jaeger S, Uhlmann C, Bichescu-Burian D, Flammer E, Steinert T, Schmid P. One-year follow-up of functional impairment in inpatients with mood and anxiety disorders - Potentials of the Mini-ICF-APP. BMC Psychiatry 2022; 22:334. [PMID: 35570275 PMCID: PMC9107757 DOI: 10.1186/s12888-022-03977-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 05/05/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of the study was to investigate functional impairment and its relationship to illness severity in a sample of patients with a diagnosis of mood or anxiety disorder during inpatient treatment and 1 year after discharge. METHODS Two hundred thirty-nine inpatients with primary diagnoses of mood or anxiety disorders were assessed at baseline and at follow-up by a range of validated instruments. Mini-ICF-APP was used for the assessment of functional impairment, BDI-II for the assessment of clinical symptoms and remission. Sample characteristics and measures of impairment at baseline and at follow-up were analysed descriptively. Symptomatically remitted and non-remitted patients were compared with regard to capacity limitations. RESULTS Initially, the sample showed considerable impairment in many capacities, particularly endurance, spontaneous activities, structuring of tasks, competency and flexibility. After 1 year, all capacities significantly improved. The level of impairment was correlated with employment status and severity of clinical symptoms. About 50% of the patients remitted in clinical symptomatology. Retrospectively, the remitted and the unremitted did not differ in functional impairment at baseline but there were considerable differences at follow-up. CONCLUSIONS Mini-ICF-APP is a useful instrument to monitor functional status and change in psychiatric samples, complementing the usual focus on symptom reduction.
Collapse
Affiliation(s)
- Susanne Jaeger
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany.
| | - Carmen Uhlmann
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Dana Bichescu-Burian
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Erich Flammer
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Tilman Steinert
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Petra Schmid
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| |
Collapse
|
14
|
Students or medical professionals: whose knowledge improved after social-medicine training? Results from a quasi-experimental evaluation study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1505-1514. [PMID: 34988614 PMCID: PMC9246797 DOI: 10.1007/s00127-021-02197-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022]
Abstract
Purpose Rehabilitation professionals are faced with judging and describing the social-medicine status of their patients. Rehabilitation professionals must know the core concepts of acute unfitness for work, psychological capacities, and long-term work capacity. Acquiring and applying this knowledge, requires training. The research question is if and to what extent medical professionals and students’ knowledge changes after social medicine training. Methods This quasi-experimental study was carried out in the real-life context of social medicine training. Psychology students (n = 42), physicians/psychotherapists (i.e. state-licensed health professionals) (n = 44) and medical assistant professionals (n = 29) were trained. Their social medicine knowledge was measured before and after training by a 10-min expert-approved and content valid knowledge questionnaire. Three free-text questions had to be answered on the essential aspects of present and prognostic work ability and psychological capacities. Answers were rated for correctness by two experts. Paired t tests and variance analysis have been calculated for group comparisons. Results All groups improved their social medicine knowledge from the pre- to the post-test. The students started with the lowest level of knowledge in the pre-test. After training, 69% of the physicians/psychotherapists and 56.8% of the medical assistant professionals, but only 7% of the students, obtained maximum scores for naming psychological capacities. Conclusions Social medicine knowledge increased after a training course consisting of eight lessons. The increase was greater for medical assistant professionals and physicians/psychotherapists than for students. Social medicine training must be adjusted to the trainee groups’ knowledge levels.
Collapse
|
15
|
Muschalla B. Prevalence and Correlates of Work-Phobic Anxiety in a National Representative Sample. ZEITSCHRIFT FUR ARBEITS-UND ORGANISATIONSPSYCHOLOGIE 2022. [DOI: 10.1026/0932-4089/a000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. Work anxiety is a common mental health problem that is often overlooked and often causes long periods of sick leave. This is the first representative survey on the distribution of work-phobic anxiety in Germany. Of the 2,030 working-age participants (18 – 67 years), 7 % had increased work-phobic anxiety of a moderate (5 % with scores >1.5 – 2.5 on a scale from 0 – 4) or high (2 % with scores >2.5 – 4) degree. People with high levels of work-phobic anxiety reported the longest sick leave durations during the past 12 months (8 weeks) and the most periods of unemployment in their professional lives. The three groups were similar in age, sex, and partnership status. People with high work-phobic anxiety perceived themselves least competent in almost all dimensions of psychological capacity. Occupational health must consider work-phobic anxiety as a specific mental health problem closely linked to work-ability problems.
Collapse
|
16
|
Papst L, Köllner V. Using machine learning to investigate earning capacity in patients undergoing psychosomatic rehabilitation-A retrospective health data analysis. Front Psychiatry 2022; 13:1039914. [PMID: 36339869 PMCID: PMC9630905 DOI: 10.3389/fpsyt.2022.1039914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022] Open
Abstract
Psychiatric disorders increasingly contribute to disability and early retirement. This study was conducted to investigate whether machine learning can contribute to a better understanding and assessment of such a reduced earning capacity. It analyzed whether impaired earning capacity is reflected in missing treatment effects, and which interventions drive treatment effects during psychosomatic rehabilitation. Analyses were based on routine clinical data encompassing demographics, diagnoses, psychological questionnaires before, and after treatment, interventions, and an interdisciplinary assessment of earning capacity for N = 1,054 patients undergoing psychosomatic rehabilitation in 2019. Classification of patients by changes in self-reported mental health and interventions predictive of changes were analyzed by gradient boosted model. Clustering results revealed three major groups, one of which was comprised almost exclusively of patients with full earning capacity, one of patients with reduced or lost earning capacity and a third group with mixed assessments. Classification results (Kappa = 0.22) indicated that patients experienced modestly divergent changes over the course of rehabilitation. Relative variable influence in the best model was highest for changes in psychological wellbeing (HEALTH-49). Regression analysis identified intervention A620 (physical exercise therapy with psychological goal setting) as most influential variable predicting changes in psychological wellbeing with a model fit of R 2 = 0.05 (SD = 0.007). Results suggest that disability due to psychiatric disorders does associate with distinct demographic and clinical characteristics but may be less clear-cut in a subgroup of patients. Trajectories of treatment response show moderately divergent paths between patient groups. Moreover, results support both physical exercise therapy as efficient intervention in reducing disability-associated impairments and the complementarity of a multimodal treatment plan.
Collapse
Affiliation(s)
- Lilia Papst
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité University Medicine Berlin, Berlin, Germany
| | - Volker Köllner
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité University Medicine Berlin, Berlin, Germany.,Department of Psychosomatics and Behavioural Psychotherapy, Rehabilitation Centre Seehof, Teltow, Germany
| |
Collapse
|
17
|
Exploring the factor structure of the mini-ICF-APP in an inpatient clinical sample, according to the psychiatric diagnosis. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:186-195. [PMID: 34861928 DOI: 10.1016/j.rpsmen.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 05/16/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Psychosocial functioning is a key factor determining prognosis, severity, impairment and quality of life in people who have a mental disorder. The mini-ICF-APP was developed to provide a standardised classification of functioning and disability. However, despite its gaining popularity little is known about its structure and performance. This paper examines the structure of the mini-ICF-APP using factor analysis techniques. MATERIALS AND METHODS In a clinical sample of 3178 patients, with psychiatric diagnoses from several ICD-10 categories, we analysed internal consistency, item inter-correlations and the factorial structure of the data, with reference to ICD-10 diagnostic categories; Neurocognitive Disorders; Alcohol Use Disorders; Substance Use Disorders; Schizophrenia and Psychotic Disorders; Bipolar Disorder; Major Depressive Disorder; Anxiety Disorders; Personality Disorders; and Neurodevelopmental Disorders. RESULTS We found good internal consistency and item inter-correlations (Cronbach alpha=0.92) for the mini-ICF-APP. We were able to identify pivotal domains (flexibility, assertiveness and intimate relationships), which demonstrate sub-threshold influences on other domains. The factor analysis yielded a one-factor model as ideal for the whole sample and for all diagnostic categories. For some diagnostic categories the data suggested a two or three-factor model, however, with poorer fit indices. CONCLUSIONS The factor structure of the mini-ICF-APP appears to modify according to the main diagnosis. However, a one-factor model demonstrates better fit regardless of diagnostic category. Consequently, we consider the mini-ICF-APP to be a trans-diagnostic measurement instrument for the assessment and grading of psychosocial functioning. The use of the mini-ICF-APP sum score seems to best reflect the degree of impairment in an individual, even taking into account that affected domains may lead to sub-threshold effects on other domains.
Collapse
|
18
|
Rosburg T, Kunz R, Trezzini B, Schwegler U, Jeger J. The assessment of capacity limitations in psychiatric work disability evaluations by the social functioning scale Mini-ICF-APP. BMC Psychiatry 2021; 21:480. [PMID: 34592979 PMCID: PMC8485557 DOI: 10.1186/s12888-021-03467-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Insurers frequently commission medical experts to estimate the degree of the remaining work capacity (RWC) in claimants for disability benefits. The social functioning scale Mini-ICF-APP allows for a rating of activity and participation limitations in thirteen capacity domains, considered as particularly relevant for work ability. The current study sought to evaluate the role of the Mini-ICF-APP ratings in psychiatric work disability evaluations, by examining how the capacity limitation ratings varied with the claimants' primary psychiatric diagnoses and how the ratings were related to RWC estimates. METHODS Medical experts estimated the RWC of 946 claimants with mental disorders and rated their activity and participation limitations using the Mini-ICF-APP, with higher ratings reflecting more severe limitations. The ratings were compared between claimants with different psychiatric diagnoses by analyses of variance. The mean Mini-ICF-APP rating across all capacity domains as well as all capacity-specific ratings were entered in simple or multiple regression models to predict the RWC in an alternative job. RESULTS The Mini-ICF-APP capacity limitation ratings in all domains but mobility were higher for claimants with personality and behavior disorders as compared to those with mood disorders or with neurotic, stress-related and somatoform disorders. The largest differences were observed in social capacities (e.g. group integration: F 2, 847 = 78.300, P < 0.001). In claimants with depression, all ratings increased with the severity of the diagnosis (all Fs 2, 203 > 16.393, all Ps < 0.001). In the overall sample, the mean Mini-ICF-APP rating showed a strong negative correlation with the estimated RWC (r = -.720, P < 0.001). Adding the capacity-specific ratings to the prediction model improved this prediction only marginally. DISCUSSION The Mini-ICF-APP allows for documenting claimants' activity and participation limitations, which is likely to increase the transparency of medical experts' RWC estimates and enables them to check the plausibility of such estimates. However, our study showed that despite the strong association between RWC and Mini-ICF-APP ratings, half of the RWC variance was unrelated to the capacity limitations documented in the Mini-ICF-APP.
Collapse
Affiliation(s)
- Timm Rosburg
- Department of Clinical Research, EbIM Research & Education, University of Basel Hospital, Basel, Switzerland.
| | - Regina Kunz
- grid.410567.1Department of Clinical Research, EbIM Research & Education, University of Basel Hospital, Basel, Switzerland
| | - Bruno Trezzini
- grid.419770.cSwiss Paraplegic Research, Nottwil, Switzerland ,grid.449852.60000 0001 1456 7938Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Urban Schwegler
- grid.419770.cSwiss Paraplegic Research, Nottwil, Switzerland ,grid.449852.60000 0001 1456 7938Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jörg Jeger
- MEDAS Zentralschweiz, Lucerne, Switzerland
| |
Collapse
|
19
|
Muschalla B. Soft Skills wanted?! – (Arbeits)Fähigkeiten und Fähigkeitsanforderungen am Arbeitsplatz beschreiben mit dem Fähigkeitsrating Mini-ICF-APP. GIO-GRUPPE-INTERAKTION-ORGANISATION-ZEITSCHRIFT FUER ANGEWANDTE ORGANISATIONSPSYCHOLOGIE 2021. [DOI: 10.1007/s11612-021-00570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungDieser Beitrag der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) informiert über ein etabliertes Standardkonzept zur fähigkeitsorientierten Arbeitsanforderungs- und Arbeitsfähigkeitsbeschreibung, welches sich im Rahmen der Arbeitsfähigkeitsbegutachtung bewährt hat. Es beschreibt die Fremd- und Selbstbeschreibung psychischer Fähigkeiten sowie die psychischen Arbeitsanforderungen.Arbeitsplatz- und Aufgabenzuweisungen und auch betriebliche Wiedereingliederungen von Mitarbeitenden mit (chronischen) Gesundheitsbeeinträchtigungen erfordern Kenntnisse über die (Arbeits‑)Fähigkeiten von Mitarbeitenden. Bei psychischen Arbeitsanforderungen ist es notwendig, das psychische Fähigkeitsprofil Mitarbeitender zu kennen und mit den Anforderungen abzugleichen.Das Mini-ICF Rating für Aktivitäts- und Partizipationsstörungen bei psychischen Störungen (Mini-ICF-APP) ist ein international validiertes und in der Arbeitsfähigkeitsbeschreibung und Sozialmedizin etabliertes Assessment zur Beschreibung von Fähigkeitsniveaus und -profilen auf 13 psychischen Fähigkeitsdimensionen. Es wird in Leitlinien (AWMF, DRV, SGPP) zur Verwendung empfohlen. Die 13 Fähigkeitsdimensionen ermöglichen einen Abgleich des Fähigkeitsprofils der Person mit dem Anforderungsprofil des Arbeitsplatzes. Die zu beurteilenden Fähigkeitsdimensionen sind (1) Fähigkeit zur Anpassung an Regeln und Routinen, (2) Fähigkeit zur Planung und Strukturierung von Aufgaben, (3) Flexibilität und Umstellungsfähigkeit, (4) Kompetenz- und Wissensanwendung, (5) Entscheidungs- und Urteilsfähigkeit, (6) Proaktivität und Spontanaktivitäten, (7) Widerstands- und Durchhaltefähigkeit, (8) Selbstbehauptungsfähigkeit, (9) Konversation und Kontaktfähigkeit zu Dritten, (10) Gruppenfähigkeit, (11) Fähigkeit zu engen dyadischen Beziehungen, (12) Fähigkeit zur Selbstpflege und Selbstversorgung, und (13) Mobilität und Verkehrsfähigkeit.Neben dem Fähigkeiten-Fremdrating sind weitere Instrumentenversionen auf Basis dieses Fähigkeitskonzepts entstanden: eine Fähigkeiten-Selbstratingversion (Mini-ICF-APP-S), und eine Version zur fähigkeitsorientierten Arbeitsplatzbeschreibung (Mini-ICF-APP-W) für die Herstellung passender Arbeitsplätze im Sinne des Arbeitsschutzgesetzes (§ 5 ArbSchG) (Muschalla 2020).
Collapse
|
20
|
Capacity Limitations and Workplace Problems in Patients With Mental Disorders. J Occup Environ Med 2021; 63:609-613. [PMID: 34184654 DOI: 10.1097/jom.0000000000002194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES According to the bio-psycho-social health model of the WHO, chronic illness should not only be described at the level of symptoms, but in respect to capacity limitations. METHODS Patients with common mental disorders (N = 1143, n = 808 employed, n = 581 workplace problems) were investigated concerning their self-rated capacities (Mini-ICF-APP-S). RESULTS Employed patients reported better capacities than unemployed patients. Among the employed patients, those without workplace problems reported better capacities than those with workplace-problems. Different types of workplace-problems were related with specific capacity levels, for example, problems with bullying or conflicts were associated with lower interactional capacities (assertiveness, group integration, dyadic relations), whereas patients with over-taxation problems perceived lower levels of flexibility, competency, structuring of tasks, proactivity and endurance. CONCLUSIONS The capacity self-rating Mini-ICF-APP-S can depict differentiated capacity profiles that may be indicative for specific types of workplace problems.
Collapse
|
21
|
Muschalla B, Kutzner I. Mental work ability: young professionals with mental health problems perceive lower levels of soft skills. GIO-GRUPPE-INTERAKTION-ORGANISATION-ZEITSCHRIFT FUER ANGEWANDTE ORGANISATIONSPSYCHOLOGIE 2021. [DOI: 10.1007/s11612-021-00552-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractThis article published in Gruppe Interaktion Organisation (GIO) reports study results on soft skills and mental work ability in young professionals ready to enter the job market. The so-called soft skills (psychological capacities) are nowadays an entrance ticket into the modern working world. Thus, the question is to which degree young professionals who will soon enter the labor market are fit in their soft skills. Are physical or mental health problems related with deficits in soft skills? Which dimensions of soft skills are impaired?365 young professionals in advanced education from a technical college, who will soon enter the labor market, were investigated via online-questionnaire. Participants were asked to rate their self-perceived capacity level according to Mini-ICF-APP, mental and physical health problems, exam and education-related anxiety, self-efficacy and procrastination.Students with mental health problems had higher exam anxiety, and lower study-related self-efficacy as compared to students without health problems at all, or students with physical health problems. But, procrastination behavior was similarly present among students with mental health problems and students with physical health problems. Students with health problems did not report globally weaker capacity levels. Lower levels of capacities depend on the type of health problem: In students with mental health problems, social soft skills were impaired rather than content-related capacities. Physical health problems do not affect the self-perceived psychological capacities.In conclusion, focusing on specific soft skills in training and work adjustment could be fruitful in addition (or as an alternative) to training of profession-specific expertise.
Collapse
|
22
|
Kossmann C, Heller J, Brüne M, Schulz C, Heinze M, Cordes J, Mühlbauer B, Rüther E, Timm J, Gründer G, Juckel G. Assessment of Psychosocial Functioning in a Large Cohort of Patients with Schizophrenia. Psychiatr Q 2021; 92:177-191. [PMID: 32519208 PMCID: PMC8918154 DOI: 10.1007/s11126-020-09773-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study addresses the question of whether psychosocial functioning measured by the Personal and Social Performance (PSP) Scale is related to various psychopathological measures in a cohort of patients with schizophrenia. METHODS The 'Neuroleptic Strategy Study' (NeSSy) performed at 14 German hospitals between 2010 and 2013 compared two treatment strategies instead of individual drugs. Secondary end-points were the two PSP scales as well as measures of quality of life (SF-36) and the Positive and Negative Syndrome Scale (PANSS). RESULTS 149 patients were randomised. There was no difference between the two treatment strategies (first-generation versus second-generation antipsychotics) with regard to the PSP. There were differences in doctors' assessments regarding psychosocial functioning compared with patients' own assessments. Furthermore, there were relationships between the PSP and quality of life, level of skills (ICF), and severity of disease (PANSS), level of sexual activities and poor well-being under antipsychotic medication but not with cognitive changes. CONCLUSIONS The findings on psychosocial functioning of patients with schizophrenia related to severity and skill level could be confirmed. Further findings were the correlation between psychosocial functioning and quality of life, well-being under treatment, and sexuality what emphasizes the substantial importance of a reduced psychosocial functioning.
Collapse
Affiliation(s)
- C Kossmann
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Alexandrinenstr. 1-3, 44791, Bochum, Germany
| | - J Heller
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Alexandrinenstr. 1-3, 44791, Bochum, Germany
| | - M Brüne
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Alexandrinenstr. 1-3, 44791, Bochum, Germany
| | - C Schulz
- Competence Centre for Clinical Trials - Biometry, University of Bremen, Bremen, Germany
| | - M Heinze
- Brandenburg Medical School, University Clinic for Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - B Mühlbauer
- Department of Pharmacology, Klinikum Bremen Mitte, Bremen, Germany
- Competence Centre for Clinical Trials - Biometry, University of Bremen, Bremen, Germany
| | - E Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - J Timm
- Competence Centre for Clinical Trials - Biometry, University of Bremen, Bremen, Germany
| | - G Gründer
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - G Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Alexandrinenstr. 1-3, 44791, Bochum, Germany.
| |
Collapse
|
23
|
Muschalla B, Linden M, Rose M. Patients Characteristics and Psychosocial Treatment in Psychodynamic and Cognitive Behavior Therapy. Front Psychiatry 2021; 12:664975. [PMID: 34054618 PMCID: PMC8160362 DOI: 10.3389/fpsyt.2021.664975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The most prevalent psychotherapy schools are psychodynamic (PDT) and cognitive behavior therapy (CBT). There are no scientific guidelines on which type of patient should be treated by which therapist, and how they can find the best one. Part of the answer can be derived from data on who is treated in which way. Objective: Objective of this study was to compare patients in routine PDT and CBT to describe similarities and differences in regard to patient status and treatment. Materials and Methods: A research psychotherapist visited 73 cognitive behavior therapists and 58 psychodynamic psychotherapists in their office and asked them to report about the last cases they had seen. There were 188 CBT and 134 PD case reports. Results: There were no significant differences in socio-demographics between PDT and CBT patients. The average number of treatment session so far was significantly higher in PDT than CBT. There were longer duration of illness, more parallel medical treatments and higher rates of sick leave in CBT patients. While assessment of capacities with the Mini-ICF-APP showed no differences, more participation restrictions were found in CBT patients. Correspondingly there were more sociomedical interventions, especially in regard to work. Conclusions: The differences between PDT and CBT may be explained by the fact that PDT requires analytical capabilities on the side of the patient, which may exclude patients with social problems, while CBT is coping oriented which allows the inclusion of all kinds of patients. Still, in both treatment modes, complex patients are treated with multidimensional interventions.
Collapse
Affiliation(s)
- Beate Muschalla
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Michael Linden
- Research Group Psychosomatic Rehabilitation, Department of Psychosomatic Medicine, Charité University Medicine Berlin, Berlin, Germany
| | - Matthias Rose
- Research Group Psychosomatic Rehabilitation, Department of Psychosomatic Medicine, Charité University Medicine Berlin, Berlin, Germany
| |
Collapse
|
24
|
Bjørkedal STB, Bejerholm U, Eplov LF, Møller T. Meaningful Activities and Recovery (MA&R): the effect of a novel rehabilitation intervention among persons with psychiatric disabilities on activity engagement-study protocol for a randomized controlled trial. Trials 2020; 21:789. [PMID: 32928298 PMCID: PMC7491082 DOI: 10.1186/s13063-020-04722-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/03/2020] [Indexed: 01/06/2023] Open
Abstract
Background Engagement in activities meaningful to the individual may support the process of recovery in those with mental illness. Persons with psychiatric disabilities may reduce their engagement in meaningful activities to various degrees with possible fluctuations over time. We hypothesized that activity engagement can be altered when opportunities and support are offered at an individual and a group peer-based level. Evidence is lacking regarding mental health interventions that enable engagement in meaningful activities, and powered effect studies are warranted. Methods We propose an 8-month combined individual and group peer-based intervention, Meaningful Activities and Recovery (MA&R), and a study protocol for a multicentre two-armed parallel randomized controlled trial (RCT). The trial investigates the effects of MA&R in community mental health centres in Copenhagen and municipality services in Denmark. The trial will comprise 128 participants with psychiatric disabilities who will be randomized to one of two groups: (1) MA&R in addition to standard mental healthcare or (2) standard mental healthcare alone. The primary outcome is self-reported activity engagement, measured by Profiles of Engagement in People with Severe Mental Illness. Secondary outcomes are recovery, functioning and quality of life. Data will be collected at baseline and at follow-up at the end of the intervention. Discussion This study adds new knowledge to a field with limited evidence, i.e. the clinical effectiveness of rehabilitation interventions among people with psychiatric disabilities, directly targeting activity engagement. The pragmatic design, regarding in- and exclusion criteria and settings, may allow assessment of the intervention’s effect under real-life conditions. The randomization, adequate power and fidelity monitoring allow testing of the intervention’s efficacy. The multicentre study design increases the potential for implementation in various mental health settings if the findings are positive. As the nature of the intervention does not permit blinding of the participants or staff, it may increase the risk of expectancy and performance bias. This must be considered when interpreting the findings. Trial registration ClinicalTrials.gov NCT03963245. Registered on 29 May 2019
Collapse
Affiliation(s)
- Siv Therese Bogevik Bjørkedal
- Team for Inclusion and Recovery, CORE: Copenhagen Research Center for Mental Health, Gentofte Hospitalsvej 15, opg. 3A, 2900, Hellerup, Denmark.
| | - Ulrika Bejerholm
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Centre for Evidence Based Psychosocial Interventions (CEPI), Lund University, Box 157, SE-221 00, Lund, Sweden
| | - Lene Falgaard Eplov
- Team for Inclusion and Recovery, CORE: Copenhagen Research Center for Mental Health, Gentofte Hospitalsvej 15, opg. 3A, 2900, Hellerup, Denmark
| | - Tom Møller
- CKO University Hospital of Copenhagen Rigshospitalet dep. 8513, 2100, Copenhagen East, Denmark
| |
Collapse
|
25
|
Egger ST, Weniger G, Bobes J, Seifritz E, Vetter S. Exploring the factor structure of the mini-ICF-APP in an inpatient clinical sample, according to the psychiatric diagnosis. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 14:S1888-9891(20)30066-5. [PMID: 32712046 DOI: 10.1016/j.rpsm.2020.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/14/2020] [Accepted: 05/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Psychosocial functioning is a key factor determining prognosis, severity, impairment and quality of life in people who have a mental disorder. The mini-ICF-APP was developed to provide a standardised classification of functioning and disability. However, despite its gaining popularity little is known about its structure and performance. This paper examines the structure of the mini-ICF-APP using factor analysis techniques. MATERIALS AND METHODS In a clinical sample of 3178 patients, with psychiatric diagnoses from several ICD-10 categories, we analysed internal consistency, item inter-correlations and the factorial structure of the data, with reference to ICD-10 diagnostic categories; Neurocognitive Disorders; Alcohol Use Disorders; Substance Use Disorders; Schizophrenia and Psychotic Disorders; Bipolar Disorder; Major Depressive Disorder; Anxiety Disorders; Personality Disorders; and Neurodevelopmental Disorders. RESULTS We found good internal consistency and item inter-correlations (Cronbach alpha=0.92) for the mini-ICF-APP. We were able to identify pivotal domains (flexibility, assertiveness and intimate relationships), which demonstrate sub-threshold influences on other domains. The factor analysis yielded a one-factor model as ideal for the whole sample and for all diagnostic categories. For some diagnostic categories the data suggested a two or three-factor model, however, with poorer fit indices. CONCLUSIONS The factor structure of the mini-ICF-APP appears to modify according to the main diagnosis. However, a one-factor model demonstrates better fit regardless of diagnostic category. Consequently, we consider the mini-ICF-APP to be a trans-diagnostic measurement instrument for the assessment and grading of psychosocial functioning. The use of the mini-ICF-APP sum score seems to best reflect the degree of impairment in an individual, even taking into account that affected domains may lead to sub-threshold effects on other domains.
Collapse
Affiliation(s)
- Stephan T Egger
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Zurich, Switzerland; Department of Psychiatry, Faculty of Medicine, University of Oviedo, CIBERSAM, Oviedo. Spain.
| | - Godehard Weniger
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Julio Bobes
- Department of Psychiatry, Faculty of Medicine, University of Oviedo, CIBERSAM, Oviedo. Spain
| | - Erich Seifritz
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Stefan Vetter
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
26
|
Danielsson L, Fornazar R, Holmgren K, Lundgren Nilsson Å, Hensing G. Development and Construct Validity of the Work Instability Scale for People With Common Mental Disorders in a Sample of Depressed and Anxious Workers: A Rasch Analysis. Rehabil Process Outcome 2020; 9:1179572720936664. [PMID: 34497467 PMCID: PMC8282151 DOI: 10.1177/1179572720936664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 06/01/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sick leave due to common mental disorders, encompassing depression and anxiety disorders, is high. Capturing early signs of reduced function could aid adjustments of work tasks and environment and, thus, endorse a pro-active approach to occupational and health care interventions to prevent long-term sick-leave spells. However, few measurements exist to identify early signs of imbalance, and none that is illness-specific. The aim of this study was to develop a work instability scale for people with common mental disorders and to test the fundamental psychometric properties of the scale. METHODS Participants were working adults 18-65 years old with depression or anxiety. The scale development started with qualitative interviews (n = 27) which informed the drafting of a dichotomous, self-report questionnaire. Cognitive debriefing (n = 12) was used to check face validity and modify the draft. Internal construct validity of the draft was tested using Rasch analysis (n = 128). The work ability index was used as a comparator measure. RESULTS The initial 63-item draft showed poor fit to Rasch model expectations. Items displaying poor fit or local response dependency were stepwise removed, resulting in a unidimensional 34-item scale fitting the model expectations, and with no differential item functioning. Person-item threshold distribution showed that the scale is better suited to measure low to moderate work instability, than to measure high instability. Correlations between the newly developed scale and the work ability index showed a significant, moderately strong correlation. CONCLUSIONS In the initial target sample, the 34-item scale showed acceptable fundamental properties and internal construct validity. Further validation of the scale in a larger sample, including tests for external validity, is warranted.
Collapse
Affiliation(s)
- Louise Danielsson
- Research Unit, Angered Hospital, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Robin Fornazar
- Administration for Allocation of Social Welfare, Gothenburg, Sweden
- Department of Public Health and Community Medicine, School of Public Health, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Holmgren
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Lundgren Nilsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- Department of Public Health and Community Medicine, School of Public Health, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
27
|
Zhang M, Yu J, Shen W, Zhang Y, Xiang Y, Zhang X, Lin Z, Yan T. A mobile app implementing the international classification of functioning, disability and health rehabilitation set. BMC Med Inform Decis Mak 2020; 20:12. [PMID: 31992289 PMCID: PMC6988202 DOI: 10.1186/s12911-020-1019-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/03/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Chinese assessment standards of the International Classification of Functioning, Disability and Health Rehabilitation Set is available now. It is coming to be used as a basic functional evaluation tool in China. With data accumulating, a mobile application is needed to eliminate the extra cost of data entry, storage, and graphical presentation of trends. This study aimed to design, develop and test a mobile app based on the International Classification of Functioning, Disability and Health Rehabilitation Set Rehabilitation Set. METHODS The study had three phases. The first involved specifying the functional requirements of the app. Then an app was designed and refined to meet those requirements. In a pilot test, the app was used by rehabilitation professionals in clinical practice and their comments were collected for its further modification in one-on-one interviews. RESULTS The app met the initial requirements, and the pilot study showed it worked as designed. The pilot study also showed that the app is user-friendly and convenient to use in rehabilitation practice. Some feedback was given to improve the app. CONCLUSION An Android mobile app implementing the International Classification of Functioning, Disability and Health Rehabilitation Set was successfully developed.
Collapse
Affiliation(s)
- Malan Zhang
- Department of Rehabilitation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
- Hexian Memorial Affiliated Hospital of Southern Medical University, Guangzhou, 511400, China
| | - Jiani Yu
- Department of Rehabilitation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Wei Shen
- GuangDong 999Brain Hospital, Guangzhou, China
| | - Yun Zhang
- The Fifth Hospital of Xiamen, Xiamen, China
| | - Yun Xiang
- Shenzhen Nanshan People's Hospital, Shenzhen, China
| | | | - Ziling Lin
- The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Tiebin Yan
- Department of Rehabilitation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
- Engineering Technology Research Center for Rehabilitation and Elderly Care, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
28
|
Use of psychiatric hospitals and social integration of patients with psychiatric disorders: a prospective cohort study in five European countries. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1425-1438. [PMID: 32409885 PMCID: PMC7578147 DOI: 10.1007/s00127-020-01881-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 05/02/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE Long lengths of stay (LoS) in psychiatric hospitals or repeated admission may affect the social integration of patients with psychiatric disorders. So far, however, studies have been inconclusive. This study aimed to analyse whether long LoS or repeated admissions in psychiatric wards were associated in different ways with changes in the social integration of patients. METHODS Within a prospective cohort study, data were collected on 2181 patients with a main ICD-10 diagnosis of psychotic, affective, or anxiety disorder, hospitalised in the UK, Italy, Germany, Poland, and Belgium in 2015. Social integration was measured at baseline and 1 year after admission using the SIX index, which includes four dimensions: employment, housing, family situation, and friendship. Regression models were performed to test the association between LoS, the number of admissions, and the change in social integration over the study period, controlling for patients' characteristics (trial registration ISRCTN40256812). RESULTS A longer LoS was significantly associated with a decrease in social integration (β = - 0.23, 95%CI - 0.32 to - 0.14, p = 0.03), particularly regarding employment (OR = 2.21, 95%CI 1.18-3.24, p = 0.02), housing (OR = 3.45, 95%CI 1.74-5.16, p < 0.001), and family situation (OR = 1.94, 95%CI 1.10-2.78, p = 0.04). In contrast, repeated admissions were only associated with a decrease in friendship contacts (OR = 1.15, 95CI% 1.08-1.22, p = 0.03). CONCLUSIONS Results suggest that a longer hospital LoS is more strongly associated with a decrease in patients' social integration than repeated admissions. Special attention should be paid to helping patients to find and retain housing and employment while hospitalised for long periods.
Collapse
|
29
|
Egger ST, Weniger G, Müller M, Bobes J, Seifritz E, Vetter S. Assessing the severity of functional impairment of psychiatric disorders: equipercentile linking the mini-ICF-APP and CGI. Health Qual Life Outcomes 2019; 17:174. [PMID: 31744498 PMCID: PMC6862821 DOI: 10.1186/s12955-019-1235-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 10/18/2019] [Indexed: 12/02/2022] Open
Abstract
Background The assessment of functioning and impairment due to psychiatric illness has been acknowledged to be crucial for research and practice. This led to the development of the mini-ICF-APP, which provides a reliable and time-efficient measure of functioning and impairment. Although its use is increasing, it remains unclear how it reflects severity and how change might be interpreted from a clinical perspective. Methods In a clinical sample of 3067 individuals hospitalized for mental health treatment, we used an equipercentile approach to link the mini-ICF-APP with the Clinical Global Impression scale (CGI) at admission and discharge. We linked the mini-ICF-APP sum score to the CGI-S scale and the mini-ICF-APP proportional change between admission and discharge to the CGI-I scale. Results The mini-ICF-APP and CGI scales showed a Spearman correlation of 0.50 (p < .000). CGI-S: “borderline-ill” corresponded to a mini-ICF-APP score 1–2; “mildly-ill” to 3–7; “moderately-ill” to 8–15; “markedly-ill” to 16–24; “severely-ill” to 25–37; and “extremely-ill” to a score ≥ 38. The Spearman correlation between the percentage change of mini-ICF-APP sum score and the CGI-I was 0.32 (p > .000); “no-change” in the CGI-I corresponded to an increase or decrease of 2%; “minimally-improved” to a mini-ICF-APP reduction of 3–30%; “much-improved” to a reduction of 31–63%; “very-much-improved” to a reduction of ≥64% “minimally-worse” to an increase of 3–34% “much-worse” to an increase of 35–67%; and finally “very-much-worse” with an increase of ≥68%. Conclusions Our findings improve understanding of the clinical meaning of the mini-ICF-APP sum score and percentage change in patients hospitalized for treatment.
Collapse
Affiliation(s)
- Stephan T Egger
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland. .,Department of Psychiatry, Faculty of Medicine, University of Oviedo, CIBERSAM, Oviedo, Spain.
| | - Godehard Weniger
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Mario Müller
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Julio Bobes
- Department of Psychiatry, Faculty of Medicine, University of Oviedo, CIBERSAM, Oviedo, Spain
| | - Erich Seifritz
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Stefan Vetter
- Centre for Integrative Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital of Zurich, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| |
Collapse
|
30
|
International classification of diseases/disorders diagnosis and International Classification of Functioning, Disability and Health activity/participation limitation among psychiatric patients: a cross-sectional and exploratory study. Int J Rehabil Res 2019; 43:48-54. [PMID: 31688222 DOI: 10.1097/mrr.0000000000000383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To explore the relationships between international classification of diseases/disorders (ICD)-10 diagnoses and International Classification of Functioning, Disability and Health (ICF) disability dimensions - activity and participation restriction among mental health service users. Three hundred sixty patients from different health services diagnosed with diverse mental disorders (ICD-10) participated in the study. Functioning restrictions were evaluated by use of the Mini-ICF-APP. Selected sociodemographic and clinical variables were also analysed. The Mini-ICF-APP scores correlated positively with the clinical impression of disease severity and negatively with general functioning. As independent factors determining the Mini-ICF-APP score, regression analysis suggests diagnosis and severity of disorder but also contextual factors such as general functioning and active occupation. Percentage and percentile distributions of activity and participation restrictions in diagnostic sections and categories revealed noticeable variability regardless of diagnosis-related differences. The diagnosis determines them neither in an ambiguous nor an absolute manner. There is a need to further explore the covariability between clinical diagnosis and ICF activity and participation restriction, particularly in regard the rationalization of social welfare benefits.
Collapse
|
31
|
Starzmann K, Hjerpe P, Boström KB. The quality of the sickness certificate. A case control study of patients with symptom and disease specific diagnoses in primary health care in Sweden. Scand J Prim Health Care 2019; 37:319-326. [PMID: 31409170 PMCID: PMC6713132 DOI: 10.1080/02813432.2019.1639905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: To compare information in sickness certificates and rehabilitation activities for patients with symptom diagnoses vs patients with disease specific diagnoses. Design: Retrospective case control study 2013-2014. Setting: Primary health care, Sweden. Subjects. Patients with new onset sickness certificates with symptom diagnoses n = 222, and disease specific diagnoses (controls), n = 222. Main outcome measures: Main parameters assessed were: information about body function and activity limitation in certificates, duration of sick leave, certificate renewals by telephone, diagnostic investigations, health care utilisation, contacts between patients, rehabilitation coordinators, social insurance officers, employers and occurrence of rehabilitation plans. Results: Information about body function and activity limitation was sufficient according to guidelines in half of all certificates, less in patients with symptom diagnoses compared to controls (44% vs. 56%, p = 0.008). Patients with symptom diagnoses had shorter sick leave than controls (116 vs. 151 days p = 0.018) and more certificates issued by telephone (23% vs. 15% p = 0.038). Furthermore, they underwent more diagnostic investigations (32% vs. 18%, p < 0.001) and the year preceding sick leave they had more visits to health care (82% vs. 68%, p < 0.001), but less follow-up (16% vs. 26%, p < 0.008). In both groups contacts related to rehabilitation and with employers were scarce. Conclusion: Certificates with symptom diagnoses compared to disease specific diagnoses could be used as markers for insufficient certificate quality and for patients with higher health care utilisation. Overall, the information in half of the certificates was insufficient and early contacts with employers and rehabilitation activities were in practice missing. KEY POINTS Symptom diagnoses are proposed as markers of sickness certification quality. We investigated this by comparing certificates with and without symptom diagnoses. Certificates with symptom diagnoses lacked information to a higher degree compared to certificates with disease specific diagnoses. Regardless of diagnoses, early contacts between patients, rehabilitation coordinators and social insurance officers were rare and contacts with employers were absent.
Collapse
Affiliation(s)
- Karin Starzmann
- Department of Public Health and Community Medicine, Primary Health Care, the Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
- R&D Centre Skaraborg Primary Care , Skövde , Sweden
| | - Per Hjerpe
- Department of Public Health and Community Medicine, Primary Health Care, the Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
- R&D Centre Skaraborg Primary Care , Skövde , Sweden
| | - Kristina Bengtsson Boström
- Department of Public Health and Community Medicine, Primary Health Care, the Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
- R&D Centre Skaraborg Primary Care , Skövde , Sweden
| |
Collapse
|
32
|
Psychological capacity limitations according to Mini-ICF-APP are differently related with sick leave in patients from different professional fields. J Psychosom Res 2019; 124:109741. [PMID: 31443813 DOI: 10.1016/j.jpsychores.2019.109741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/12/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Up to 29% of the working population suffer from (chronic) mental disorders and work disability. As different professions pose different psychological capacity demands, one core aspect for describing work disability is psychological capacity limitations. The distribution of capacity limitations in patients with chronic mental disorders (CMD) from different professional fields is unknown, as well as their relation with sick leave. OBJECTIVE Are there different work ability limitations in CMD patients working in different professions? METHODS 263 CMD patients from different professions were investigated cross-sectionally in a thorough medical and psychological assessment by a trained psychosomatic study physician. Besides CMD diagnostic (MINI) and subjective work ability limitations (IMET), an observer rating on capacity limitations was conducted with Mini-ICF-APP. RESULTS No relevant differences in perceived work ability limitations were found between the professions. Differences of capacity limitations were better explained by psychopathology than by profession. But capacity limitations were differently related with sick leave in different professions and there are differences in sick leave duration. CONCLUSIONS The variance of capacity limitations was explained by psychopathology. The variance of sick leave duration was explained by profession. Similar capacity limitations are associated differently with sick leave in different professions. Different professional fields may have different tolerances towards the same capacity limitations. Therefore, similar capacity limitations are more or less strongly associated with sick leave in different professions.
Collapse
|
33
|
Łaszewska A, Schwab M, Leutner E, Oberrauter M, Spiel G, Simon J. Measuring broader wellbeing in mental health services: validity of the German language OxCAP-MH capability instrument. Qual Life Res 2019; 28:2311-2323. [PMID: 31030365 PMCID: PMC6620251 DOI: 10.1007/s11136-019-02187-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE The OxCAP-MH capabilities questionnaire was developed and validated in the UK for outcome measurement in mental health clinical studies. Its broader wellbeing construct or validity in routine mental health services so far has not been assessed. The objectives were to investigate the extent the OxCAP-MH measures broader wellbeing compared to the EQ-5D-5L and to test psychometric properties of the German language OxCAP-MH in routine mental health services in Austria. METHODS Study sample consisted of patients in socio-psychiatric services (n = 159) assessed at baseline and 6-month follow-up. Underlying factors associated with quality-of-life/wellbeing concepts measured by the OxCAP-MH and EQ-5D-5L were identified in exploratory factor analysis (EFA). Responsiveness was assessed using anchor questionnaires and standardised response mean (SRM). For discriminant validity, subgroups of respondents were compared using t test and one-way ANOVA. Test-retest analysis was assessed for a period of maximum 30 days from the baseline assessment with intra-class correlation coefficient (ICC). RESULTS EFA identified a two-factor structure. All EQ-5D-5L items and seven OxCAP-MH items loaded on one factor and nine remaining OxCAP-MH items loaded on a separate factor. Responsiveness was found for patients who improved in anchor questionnaire scores with large or moderate SRM statistics. OxCAP-MH discriminated between various groups in univariable and multivariable analyses. Reliability of the German language OxCAP-MH was confirmed by ICC of 0.80. CONCLUSIONS Besides providing evidence that the OxCAP-MH measures broader wellbeing constructs beyond traditional health-related quality of life, the study also confirms the validity of the instrument for implementation in routine evaluation of mental health services.
Collapse
Affiliation(s)
- Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Markus Schwab
- pro mente Forschung, Villacher Straße 161, 9020, Klagenfurt am Wörthersee, Austria
| | - Eva Leutner
- pro mente kärnten GmbH, Villacher Straße 161, 9020, Klagenfurt am Wörthersee, Austria
| | - Marold Oberrauter
- pro mente kärnten GmbH, Villacher Straße 161, 9020, Klagenfurt am Wörthersee, Austria
| | - Georg Spiel
- pro mente Forschung, Villacher Straße 161, 9020, Klagenfurt am Wörthersee, Austria
- pro mente kärnten GmbH, Villacher Straße 161, 9020, Klagenfurt am Wörthersee, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
- Department of Psychiatry, Warneford Hospital, University of Oxford, Warneford Ln, Oxford, OX3 7JX, UK.
- HERC, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| |
Collapse
|
34
|
Caponnetto P, Auditore R, Maglia M, Pipitone S, Inguscio L. Psychological wellness, yoga and quality of life in patients affected by schizophrenia spectrum disorders: A pilot study. Ment Illn 2019; 11:8003. [PMID: 31281606 PMCID: PMC6589643 DOI: 10.4081/mi.2019.8003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/20/2019] [Indexed: 12/04/2022] Open
Abstract
Schizophrenia is a serious psychiatric disorder characterized by positive symptoms, negative symptoms and neurocognitive deficits. The aim of this study was to estimate relationships between wellness, yoga and quality of life in patients affected by schizophrenia spectrum disorders. Participants were 30 patients with a diagnosis of schizophrenia in care at the Rehabilitative Psychiatry and Research Villa Chiara Clinic in Mascalucia (Catania, Italy), after that randomly assigned to two groups. The first group followed the experimental treatment with sets of yoga exercises conducted by a yoga trainer and a psychiatrist or a clinical psychologist expert in yoga, while a second control group was treated with usual care. The results revealed a significant difference, before and after treatment, between the experimental group and the control group in quality of life.
Collapse
Affiliation(s)
- Pasquale Caponnetto
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, Mascalucia, Italy.,Department of Clinical and Experimental Biomedicine, University of Catania, Italy.,Institute for Social Marketing, University of Stirling, UK
| | - Roberta Auditore
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, Mascalucia, Italy
| | - Marilena Maglia
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, Mascalucia, Italy.,Department of Clinical and Experimental Biomedicine, University of Catania, Italy
| | - Stefano Pipitone
- Vidya Vahini Trust, Uttarkashi, Himalayas, India.,Yoga Vidya, Siracusa, Italy
| | - Lucio Inguscio
- Department of Psychology, La Sapienza University, Rome, Italy
| |
Collapse
|
35
|
Muschalla B, Poguntke KJ, Linden M. Assessment of Capacity Impairment in Patients with Mental Disorders by Routine Clinical Assessment and by Structured Assessment with the Mini-ICF-APP. Psychopathology 2019; 52:248-255. [PMID: 31578018 DOI: 10.1159/000502123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/10/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Physicians and therapists are also consulted to give judgments on working ability. Ability to work cannot simply be derived from the patient's symptom status but from the illness-related capacity impairments in relation to the work demands. A structured assessment of capacity impairments has been evaluated and applied internationally: the Mini-ICF-APP Social Functioning Scale. It is currently unclear whether a free-text clinical report (i.e., usual clinical practice: clinical exploration according to clinical standards, but without a standardized documentation form, instead a text is written) and a structured capacity assessment correspond to the overall work ability judgment, i.e., the decision whether a patient is "fit for work" or "unfit for work." OBJECTIVES This investigation assessed, for the first time, whether usual clinical judgment and the additional structured capacity rating support the work ability decision. METHODS A total of 100 medical reports from patients in a psychotherapy hospital were excerpted for psychopathological symptoms and capacity disorders using a checklist. Additionally, a structured assessment of capacity disorders was documented on the Mini-ICF-APP rating for all patients. RESULTS In the free-text clinical medical report, endurance, flexibility, and contacts to others were the things mainly reported as impaired. This was similar to the structured Mini-ICF-APP rating. However, other capacity impairments were also reported in the Mini-ICF-APP, i.e., adherence to rules and regulations, planning and structuring, assertiveness, and group integration. When the free-text clinical report and the structured Mini-ICF-APP rating were compared, there was a higher rate of stated impairments covering all capacity dimensions in the Mini-ICF-APP rating. CONCLUSIONS The free-text report in the medical report shows the differences between patients who are fit for work and those who are not, and thus speak for the validity of work ability decisions. However, optimization is possible in terms of depth and differentiation of capacity impairment description by adhering to the standard set by the Mini-ICF-APP.
Collapse
Affiliation(s)
- Beate Muschalla
- Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany,
| | | | - Michael Linden
- Research Group Psychosomatic Rehabilitation at the Charité University Medicine Berlin, Berlin, Germany
| |
Collapse
|
36
|
Caponnetto P, Maglia M, Auditore R, Bocchieri M, Caruso A, DiPiazza J, Polosa R. Improving neurocognitive functioning in schizophrenia by addition of cognitive remediation therapy to a standard treatment of metacognitive training. Ment Illn 2018; 10:7812. [PMID: 30746055 PMCID: PMC6342025 DOI: 10.4081/mi.2018.7812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/04/2018] [Indexed: 11/23/2022] Open
Abstract
Cognitive dysfunctions are a common clinical feature of schizophrenia and represent important indicators of outcome among patients who are affected. Therefore, a randomized, controlled, monocentric, singleblind trial was carried out to compare two different rehabilitation strategies adopted for the restoration and recovery of cognitive functioning of residential patients with schizophrenia. A sample of 110 residential patients were selected and, during the experimental period, a group of 55 patients was treated with sets of domain-specific exercises (SRT+CRT), whereas an equal control group was treated with sets of nondomain- specific exercises (SRT+PBO) belonging to the Cogpack® software. The effects on the scores (between T0 and T1) of the variables treatment and time and of the interaction time X treatment were analyzed: for the total BACS, the main effect of the between-factors variable treatment is statistically significant (F=201.562 P=0.000), as well as the effect of the within-factors variable “time” (F=496.68 P=0.000).The interaction of these two factors is also statistically significant (F=299.594 P=0.000). The addition of cognitive remediation therapy (CRT) to a standard treatment of metacognitive training (MCT) resulted in a significant improvement in global neurocognitive functioning and has reported positive effects with regard to the strengthening of verbal and working memory, selective and sustained attention at T1. A relevant result is the statistically significance of “time X treatment” for all the tests administered: we can assume that the domain-specific cognitive training amplifies the effects of SRT, as the primary and secondary goals of the present study were achieved.
Collapse
Affiliation(s)
- Pasquale Caponnetto
- CTA Villa Chiara Psychiatric Rehabilitation and Research, University of Catania, Italy
| | - Marilena Maglia
- CTA Villa Chiara Psychiatric Rehabilitation and Research, University of Catania, Italy
| | - Roberta Auditore
- CTA Villa Chiara Psychiatric Rehabilitation and Research, University of Catania, Italy
| | - Marta Bocchieri
- CTA Villa Chiara Psychiatric Rehabilitation and Research, University of Catania, Italy
| | - Antonio Caruso
- CTA Villa Chiara Psychiatric Rehabilitation and Research, University of Catania, Italy
| | - Jennifer DiPiazza
- CTA Villa Chiara Psychiatric Rehabilitation and Research, University of Catania, Italy
| | - Riccardo Polosa
- CTA Villa Chiara Psychiatric Rehabilitation and Research, University of Catania, Italy
| |
Collapse
|
37
|
Muschalla B. A concept of psychological work capacity demands: First evaluation in rehabilitation patients with and without mental disorders. Work 2018; 59:375-386. [PMID: 29630582 DOI: 10.3233/wor-182691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Work capacity demands are a concept to describe which psychological capacities are required in a job. Assessing psychological work capacity demands is of specific importance when mental health problems at work endanger work ability. Exploring psychological work capacity demands is the basis for mental hazard analysis or rehabilitative action, e.g. in terms of work adjustmentOBJECTIVE:This is the first study investigating psychological work capacity demands in rehabilitation patients with and without mental disorders. METHODS A structured interview on psychological work capacity demands (Mini-ICF-Work; Muschalla, 2015; Linden et al., 2015) was done with 166 rehabilitation patients of working age. All interviews were done by a state-licensed socio-medically trained psychotherapist. Inter-rater-reliability was assessed by determining agreement in independent co-rating in 65 interviews. For discriminant validity purposes, participants filled in the Short Questionnaire for Work Analysis (KFZA, Prümper et al., 1994). RESULTS In different professional fields, different psychological work capacity demands were of importance. The Mini-ICF-Work capacity dimensions reflect different aspects than the KFZA. Patients with mental disorders were longer on sick leave and had worse work ability prognosis than patients without mental disorders, although both groups reported similar work capacity demands. CONCLUSIONS Psychological work demands - which are highly relevant for work ability prognosis and work adjustment processes - can be explored and differentiated in terms of psychological capacity demands.
Collapse
Affiliation(s)
- Beate Muschalla
- University of Potsdam, Work and Organizational Psychology, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany. E-mail:
| |
Collapse
|
38
|
Abstract
The current study focused on the association between resilience and social functioning in patients with bipolar disorder (BD). Forty clinically stable patients with BD type I and BD type II, as well as 40 healthy controls, matched for age, sex, and educational background were enrolled. Clinical status was assessed by the Montgomery-Åsberg Depression Rating Scale and the Young Mania Rating Scale. Functioning was evaluated by the Mini International Classification of Functioning, Disability and Health rating of activities and participation in mental illnesses, and the Social and Occupational Functioning Scale. Resilience was measured by the Connor-Davidson Resilience scale. Patients demonstrated significantly lower resilience levels compared with healthy individuals. A stepwise regression analysis indicated that only resilience contributed significantly to social functioning's outcome. Because resilience may constitute a social functioning moderator in clinically stable patients with BD, a paradigm shift toward protective factors could lead to implementation of resilience-oriented interventions designed specifically for patients with BD.
Collapse
|
39
|
Muschalla B. Work Ability Impairment and Facets of Workplace Perception Are Predictive of Sick Leave Duration in Persons With Work Anxiety. ZEITSCHRIFT FUR ARBEITS-UND ORGANISATIONSPSYCHOLOGIE 2018. [DOI: 10.1026/0932-4089/a000271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. Individuals with work anxiety are at risk for long-term sick leave and create high costs for society, companies, and their own work biography. Understanding psychological return-to-work predictors is important for early reintegration of these persons into the work context. This longitudinal study for the first time investigates the predictive value of workplace perception and objective work ability impairment for future sick leave duration in persons with work anxiety. The investigation was carried out with 103 individuals with work anxieties. They were of working age and confronted with a return-to-work situation after somatic illness. Work ability impairment was assessed in a structured interview by a state-licensed sociomedical specialist using the established Mini-ICF-APP Scale. Participants completed a questionnaire on their workplace perception (KFZA). The degree of work ability impairment (Mini-ICF-APP) was predictive of longer sick leave as well as workplace perception (KFZA dimensions scope of action, social support, need for cooperation). Training and return-to-work support in persons with work anxiety should focus on both work ability impairment and on workplace perception.
Collapse
Affiliation(s)
- Beate Muschalla
- SRH University of Applied Health Sciences, Department of Psychology
| |
Collapse
|
40
|
Assessing psychological work demands with an ICF-oriented concept of psychological capacities. GIO-GRUPPE-INTERAKTION-ORGANISATION-ZEITSCHRIFT FUER ANGEWANDTE ORGANISATIONSPSYCHOLOGIE 2018. [DOI: 10.1007/s11612-018-0406-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
41
|
Schleifer R, Gamma A, Warnke I, Jabat M, Rössler W, Liebrenz M. Online Survey of Medical and Psychological Professionals on Structured Instruments for the Assessment of Work Ability in Psychiatric Patients. Front Psychiatry 2018; 9:453. [PMID: 30319460 PMCID: PMC6167551 DOI: 10.3389/fpsyt.2018.00453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/31/2018] [Indexed: 11/21/2022] Open
Abstract
Objective: To evaluate perceived needs and difficulties related to instruments for assessing work ability in individuals with mental disorders. Method: We conducted an online survey of 104 German-speaking medico-legal experts (forensic psychiatric and psychology experts, insurance physicians) and therapists. Results: The large majority of respondents reported they would welcome a standardized, structured instrument for the assessment of work ability. High predictiveness, inter-rater agreement, comprehensibility for laymen, and symptom validity were desired in roughly equal measure as the main characteristic of such an instrument. More women than men, and more medico-legal experts than therapists, considered symptom validation as always necessary. Pain, personality, and affective disorders were perceived to be the most difficult disorders in the context of work ability assessments. Conclusion: Our survey documents professionals' wish for a structured assessment of work ability in both medico-legal and therapeutic settings.
Collapse
Affiliation(s)
- Roman Schleifer
- Institute of Forensic Medicine, Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | - Alex Gamma
- Institute of Forensic Medicine, Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | - Ingeborg Warnke
- Institute of Forensic Medicine, Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | - Mounira Jabat
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Michael Liebrenz
- Institute of Forensic Medicine, Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
42
|
Vornholt K, Villotti P, Muschalla B, Bauer J, Colella A, Zijlstra F, Van Ruitenbeek G, Uitdewilligen S, Corbière M. Disability and employment – overview and highlights. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2017. [DOI: 10.1080/1359432x.2017.1387536] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Katharina Vornholt
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Patrizia Villotti
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CRIUSMM), Department of Education, Career Counselling, Université du Québec à Montréal, Montréal, Canada
| | - Beate Muschalla
- Research Group Psychosomatic Rehabilitation (FPR), Charité Berlin, Hindenburgdamm, Berlin, Germany
| | - Jana Bauer
- Lehrstuhl für Arbeit und Berufliche Rehabilitation, Universität zu Köln, Köln
| | - Adrienne Colella
- A.B. Freeman School of Business, Tulane University, New Orleans, LA, USA
| | - Fred Zijlstra
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Gemma Van Ruitenbeek
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sjir Uitdewilligen
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marc Corbière
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CRIUSMM), Department of Education, Career Counselling, Université du Québec à Montréal, Montréal, Canada
| |
Collapse
|
43
|
[Assement of incapacity to work and the Mini-ICF-APP]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2017; 31:182-186. [PMID: 28856567 DOI: 10.1007/s40211-017-0246-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/10/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE According to recent recommendations the Mini-ICF Rating for Limitations of Activities and Participation in Psychological Disorders (Mini-ICF-APP) should be used in the assessment of incapacity to work. However evidence from empirical research in the field is missing. METHODS The application of the Mini-ICF-APP in the psychiatric assessment of 121 cases was analysed. RESULTS A significant correlation between capacity to work and the duration of sick-leave with the Mini-ICF-APP sum-score was confirmed. The probability that criteria for disability insurance compensations was fulfilled according to the assessor increased with the Mini-ICF-APP-sum-score. CONCLUSION Our study provides first empirical evidence regarding the application of the Mini-ICF-APP in the psychiatric assessment of incapacity to work.
Collapse
|
44
|
Burgess PM, Harris MG, Coombs T, Pirkis JE. A systematic review of clinician-rated instruments to assess adults' levels of functioning in specialised public sector mental health services. Aust N Z J Psychiatry 2017; 51:338-354. [PMID: 28118728 DOI: 10.1177/0004867416688098] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Functioning is one of the key domains emphasised in the routine assessment of outcomes that has been occurring in specialised public sector mental health services across Australia since 2002, via the National Outcomes and Casemix Collection. For adult consumers (aged 18-64), the 16-item Life Skills Profile (LSP-16) has been the instrument of choice to measure functioning. However, review of the National Outcomes and Casemix Collection protocol has highlighted some limitations to the current approach to measuring functioning. A systematic review was conducted to identify, against a set of pre-determined criteria, the most suitable existing clinician-rated instruments for the routine measurement of functioning for adult consumers. METHOD We used two existing reviews of functioning measures as our starting point and conducted a search of MEDLINE and PsycINFO to identify articles relating to additional clinician-rated instruments. We evaluated identified instruments using a hierarchical, criterion-based approach. The criteria were as follows: (1) is brief (<50 items) and simple to score, (2) is not made redundant by more recent instruments, (3) relevant version has been scientifically scrutinised, (4) considers functioning in a contemporary way and (5) demonstrates sound psychometric properties. RESULTS We identified 20 relevant instruments, 5 of which met our criteria: the LSP-16, the Health of the Nation Outcome Scales, the Illness Management and Recovery Scale-Clinician Version, the Multnomah Community Ability Scale and the Personal and Social Performance Scale. CONCLUSION Further work is required to determine which, if any, of these instruments satisfy further criteria relating to their appropriateness for assessing functioning within relevant service contexts, acceptability to clinicians and consumers, and feasibility in routine practice. This should involve seeking stakeholders' opinions (e.g. about the specific domains of functioning covered by each instrument and the language used in individual items) and testing completion rates in busy service settings.
Collapse
Affiliation(s)
- Philip M Burgess
- 1 School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Meredith G Harris
- 1 School of Public Health, The University of Queensland, Herston, QLD, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Tim Coombs
- 3 Illawarra Institute for Mental Health, University of Wollongong, Wollongong, NSW, Australia
| | - Jane E Pirkis
- 4 Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
45
|
Schreiner A, Bergmans P, Cherubin P, Hargarter L. The effect of long-acting paliperidone palmitate once-monthly on negative and depressive symptoms in patients with schizophrenia switched from previous unsuccessful treatment with oral aripiprazole. Ther Adv Psychopharmacol 2017; 7:59-65. [PMID: 28255435 PMCID: PMC5315228 DOI: 10.1177/2045125316673012] [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] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The negative symptoms of schizophrenia are generally harder to recognize, more difficult to treat than positive symptoms, and have a significant impact on patient functioning and overall outcomes. Treatment with aripiprazole may be associated with benefits on negative symptoms and functioning given its partial agonism to the dopamine D2 receptor. The aim of this subanalysis was to explore the impact of flexibly dosed, long-acting paliperidone palmitate once monthly (PP1M) on negative and depressive symptoms, disorganized thoughts, anxiety, extrapyramidal symptoms, and patient functioning in nonacute adult patients with schizophrenia previously unsuccessfully treated with oral aripiprazole monotherapy. METHODS Post-hoc subanalysis of 46 nonacute but symptomatic patients enrolled in a prospective, interventional, single-arm, multicenter, open-label 6-month study. RESULTS At endpoint, improvements of ⩾ 20% and ⩾ 50% in the Positive and Negative Syndrome Scale (PANSS) total score were observed in 52.2% and 21.7% of patients, respectively. Significant and clinically relevant improvements were observed at endpoint in mean (standard deviation [SD]) PANSS negative subscale score (-3.0 (5.0); p < 0.0001) and in the PANSS Marder factor scores for negative symptoms (-2.9 (5.4); p = 0.0006), disorganized thoughts (-2.8 (4.3); p < 0.0001) and anxiety/depression (-1.8 (3.9); p = 0.0031). Patient functioning assessed by mean (SD) Personal and Social Performance scale score (3.9 (13.2); p = 0.0409), Mini International Classification of Functioning rating for Activity and Participation Disorders in Psychological Illnesses total scores (-2.9 (7.1); p = 0.0079), and Extrapyramidal Symptom Rating Scale scores (-0.6 (3.4); p = 0.0456) improved significantly at endpoint. PP1M was well tolerated with no new safety signals. CONCLUSIONS Six-month treatment with flexibly dosed PP1M was associated with significant and clinically relevant improvements in negative and depressive symptoms, disorganized thoughts, functioning, and extrapyramidal symptoms in nonacute but symptomatic patients with schizophrenia previously unsuccessfully treated with oral aripiprazole.
Collapse
Affiliation(s)
- Andreas Schreiner
- Medical and Scientific Affairs, Janssen Cilag EMEA, Johnson & Johnson Platz 1, Neuss, 41470, Germany
| | - Paul Bergmans
- Biometrics, Janssen Cilag Benelux, Tilburg, The Netherlands
| | - Pierre Cherubin
- EMEA Medical Affairs, Janssen Cilag, Issy-les-Moulineaux, France
| | | |
Collapse
|
46
|
Switching from oral atypical antipsychotic monotherapy to paliperidone palmitate once-monthly in non-acute patients with schizophrenia: A prospective, open-label, interventional study. Psychopharmacology (Berl) 2017; 234:3-13. [PMID: 27815602 PMCID: PMC5203852 DOI: 10.1007/s00213-016-4445-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 09/03/2016] [Indexed: 02/06/2023]
Abstract
RATIONALE Long-acting injectable antipsychotic therapies may offer benefits over oral antipsychotics in patients with schizophrenia. OBJECTIVE This study aimed to explore the safety, tolerability, and treatment response of paliperidone palmitate once-monthly in non-acute but symptomatic adult patients switched from previously unsuccessful monotherapy with frequently used oral atypical antipsychotics. METHODS This was a post hoc analysis of a prospective, interventional, single-arm, international, multicenter, open-label, 6-month study. RESULTS The patients (N = 472) were switched to paliperidone palmitate once-monthly (PP1M) from daily oral treatment with either aripiprazole (n = 46), olanzapine (n = 87), paliperidone extended-release (n = 104), quetiapine (n = 44), or risperidone (n = 191). In all groups, mean Positive and Negative Syndrome Scale total (p < 0.0001) and Clinical Global Impression-Severity scores improved significantly (p = 0.0004 to p < 0.0001). An improvement of ≥50 % in the Positive and Negative Syndrome Scale total score was observed in 21.7 % (aripiprazole), 29.9 % (olanzapine), 29.8 % (paliperidone extended-release), 27.3 % (quetiapine), and 37.2 % (risperidone) of patients. The patients showed significant improvements in the Personal and Social Performance score (aripiprazole p = 0.0409, all others p ≤ 0.0015); Mini International Classification of Functionality, Disability and Health Rating for Activity and Participation Disorders in Psychological Illnesses total scores (all p < 0.01); and Treatment Satisfaction Questionnaire for Medication Global Satisfaction score (olanzapine and risperidone p < 0.0001, quetiapine p = 0.0465, paliperidone extended-release p = 0.0571, aripiprazole p = NS). Paliperidone palmitate once-monthly was well tolerated, presenting no new safety signals. CONCLUSIONS These data illustrate that stable, non-acute but symptomatic patients on oral antipsychotic monotherapy may show clinically meaningful improvement of symptoms, functioning, and treatment satisfaction after direct transition to PP1M. The findings are limited by the naturalistic study design; thus, further studies are required to confirm the current findings.
Collapse
|
47
|
Bachmann M, de Boer W, Schandelmaier S, Leibold A, Marelli R, Jeger J, Hoffmann-Richter U, Mager R, Schaad H, Zumbrunn T, Vogel N, Bänziger O, Busse JW, Fischer K, Kunz R. Use of a structured functional evaluation process for independent medical evaluations of claimants presenting with disabling mental illness: rationale and design for a multi-center reliability study. BMC Psychiatry 2016; 16:271. [PMID: 27474008 PMCID: PMC4966817 DOI: 10.1186/s12888-016-0967-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/12/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Work capacity evaluations by independent medical experts are widely used to inform insurers whether injured or ill workers are capable of engaging in competitive employment. In many countries, evaluation processes lack a clearly structured approach, standardized instruments, and an explicit focus on claimants' functional abilities. Evaluation of subjective complaints, such as mental illness, present additional challenges in the determination of work capacity. We have therefore developed a process for functional evaluation of claimants with mental disorders which complements usual psychiatric evaluation. Here we report the design of a study to measure the reliability of our approach in determining work capacity among patients with mental illness applying for disability benefits. METHODS/DESIGN We will conduct a multi-center reliability study, in which 20 psychiatrists trained in our functional evaluation process will assess 30 claimants presenting with mental illness for eligibility to receive disability benefits [Reliability of Functional Evaluation in Psychiatry, RELY-study]. The functional evaluation process entails a five-step structured interview and a reporting instrument (Instrument of Functional Assessment in Psychiatry [IFAP]) to document the severity of work-related functional limitations. We will videotape all evaluations which will be viewed by three psychiatrists who will independently rate claimants' functional limitations. Our primary outcome measure is the evaluation of claimant's work capacity as a percentage (0 to 100 %), and our secondary outcomes are the 12 mental functions and 13 functional capacities assessed by the IFAP-instrument. Inter-rater reliability of four psychiatric experts will be explored using multilevel models to estimate the intraclass correlation coefficient (ICC). Additional analyses include subgroups according to mental disorder, the typicality of claimants, and claimant perceived fairness of the assessment process. DISCUSSION We hypothesize that a structured functional approach will show moderate reliability (ICC ≥ 0.6) of psychiatric evaluation of work capacity. Enrollment of actual claimants with mental disorders referred for evaluation by disability/accident insurers will increase the external validity of our findings. Finding moderate levels of reliability, we will continue with a randomized trial to test the reliability of a structured functional approach versus evaluation-as-usual.
Collapse
Affiliation(s)
- Monica Bachmann
- Division Evidence-based Insurance Medicine, University Hospital Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland ,Department Clinical Research, University of Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland
| | - Wout de Boer
- Division Evidence-based Insurance Medicine, University Hospital Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland ,Department Clinical Research, University of Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland
| | - Stefan Schandelmaier
- Division Evidence-based Insurance Medicine, University Hospital Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland ,Department Clinical Research, University of Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland ,Basel Institute for Clinical Epidemiology & Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Andrea Leibold
- School of Applied Psychology, Institute Humans in Complex Systems, Olten, Switzerland
| | - Renato Marelli
- Swiss Society of Insurance Psychiatry, SGVP, Basel, Switzerland
| | - Joerg Jeger
- Institute of Medical Disability Evaluations of Central Switzerland, Lucerne, Switzerland
| | - Ulrike Hoffmann-Richter
- Department of Insurance Psychiatry, Swiss Accident Insurance Fund, Lucerne, Switzerland ,Private practice for Psychiatry and Psychotherapy, Lucerne, Switzerland
| | - Ralph Mager
- Psychiatric University Clinic of Basel, Basel, Switzerland
| | - Heinz Schaad
- Institute for Medical Disability Evaluation Interlaken, Lucerne, Switzerland
| | - Thomas Zumbrunn
- Department Clinical Research, University of Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland ,Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
| | - Nicole Vogel
- Division Evidence-based Insurance Medicine, University Hospital Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland ,Department Clinical Research, University of Basel, Spitalstrasse 8 + 12, CH-4031 Basel, Switzerland
| | - Oskar Bänziger
- Zurich Office of the Swiss National Disability Insurance, Zurich, Switzerland ,Private practice, Wetzikon, Switzerland
| | - Jason W. Busse
- Department of Clinical Epidemiology and Biostatics, McMaster University, Hamilton, ON Canada ,The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON Canada ,Department of Anesthesia, McMaster University, Hamilton, ON Canada
| | - Katrin Fischer
- School of Applied Psychology, Institute Humans in Complex Systems, Olten, Switzerland
| | - Regina Kunz
- Division Evidence-based Insurance Medicine, University Hospital Basel, Spitalstrasse 8 + 12, CH-4031, Basel, Switzerland. .,Department Clinical Research, University of Basel, Spitalstrasse 8 + 12, CH-4031, Basel, Switzerland.
| |
Collapse
|
48
|
Hargarter L, Bergmans P, Cherubin P, Keim S, Conca A, Serrano-Blanco A, Bitter I, Bilanakis N, Schreiner A. Once-monthly paliperidone palmitate in recently diagnosed and chronic non-acute patients with schizophrenia. Expert Opin Pharmacother 2016; 17:1043-53. [PMID: 27042990 PMCID: PMC4898156 DOI: 10.1080/14656566.2016.1174692] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective: To explore the treatment response, tolerability and safety of once-monthly paliperidone palmitate (PP1M) in non-acute patients switched from oral antipsychotics, stratified by time since diagnosis as recently diagnosed (≤3 years) or chronic patients (>3 years). Research design and methods: Post hoc analysis of a prospective, interventional, single-arm, multicentre, open-label, 6-month study performed in 233 recently diagnosed and 360 chronic patients. Main outcome measures: The proportion achieving treatment response (defined as ≥20% improvement in Positive and Negative Syndrome Scale [PANSS] total score from baseline to endpoint) and maintained efficacy (defined as non-inferiority in the change in PANSS total score at endpoint [Schuirmann’s test]). Results: 71.4% of recently diagnosed and 59.2% of chronic patients showed a ≥20% decrease in PANSS total score (p = 0.0028 between groups). Changes in PANSS Marder factors, PANSS subscales, and the proportion of patients with a Personal and Social Performance scale (PSP) total score of 71–100 were significantly greater in recently diagnosed compared with chronic patients. PP1M was well tolerated, presenting no unexpected safety findings. Conclusion: These data show that recently diagnosed patients treated with PP1M had a significantly higher treatment response and improved functioning, as assessed by the PSP total score, than chronic patients.
Collapse
Affiliation(s)
- L Hargarter
- a Medical & Scientific Affairs , Janssen Cilag EMEA , Neuss , Germany
| | - P Bergmans
- b Biometrics & Reporting , Janssen Cilag Benelux , Tilburg , The Netherlands
| | - P Cherubin
- c Medical Affairs , Janssen Cilag EMEA , Issy-les-Moulineaux , France
| | - S Keim
- d Global Clinical Operations EMEA MAO, Janssen Cilag , Barcarena , Portugal
| | - A Conca
- e Department of Psychiatry , General Hospital , Bolzano , Italy
| | - A Serrano-Blanco
- f Acute Inpatient Unit , Parc Sanitari Sant Joan de Déu , Barcelona , Spain and redIAPP, Spain
| | - I Bitter
- g Department of Psychiatry and Psychotherapy , Semmelweis University , Budapest , Hungary
| | - N Bilanakis
- h Department of Psychiatric , General Hospital of Arta , Arta , Greece
| | - A Schreiner
- a Medical & Scientific Affairs , Janssen Cilag EMEA , Neuss , Germany
| |
Collapse
|
49
|
Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting. J Occup Environ Med 2016; 58:398-406. [DOI: 10.1097/jom.0000000000000678] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
50
|
Pinna F, Fiorillo A, Tusconi M, Guiso B, Carpiniello B. Assessment of functioning in patients with schizophrenia and schizoaffective disorder with the Mini-ICF-APP: a validation study in Italy. Int J Ment Health Syst 2015; 9:37. [PMID: 26526168 PMCID: PMC4628277 DOI: 10.1186/s13033-015-0030-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/21/2015] [Indexed: 11/19/2022] Open
Abstract
Background The aim of the study was to evaluate validity of the Italian Mini-ICF-APP (Mini-ICF Rating for Limitations of Activities and Participation in Psychological Disorders) in schizophrenia and related disorders. Methods 74 outpatients affected by schizophrenia or schizoaffective disorders attending a University-based community mental health centre were recruited to the study. All participants underwent comprehensive evaluation using standardized instruments to assess clinical, neurocognitive and functional status. Concurrent validity of Mini-ICF-APP was evaluated and compared to severity scores obtained using the Clinical Global Impression-Schizophrenia scale (CGI-SCH), Positive and Negative Syndrome scale (PANSS), Mini Mental State Examination test (MMSE), Brief Assessment of Cognition in Schizophrenia scale (BACS) and Personal and Social Performance scale (PSP). Construct validity was evaluated by comparing scores obtained at Mini-ICF-APP by remitted versus non-remitted patients, and by recovered versus unrecovered patients. Discriminant validity was evaluated comparing scores on Mini-ICF-APP and Subjective Well-being (SWN) scale. Results: the total score and 12 out of the 13 Mini-ICF-APP items correlated significantly with total score at PSP; Mini-ICF-App total score was moreover significantly correlated with total scores at CGI-SCH, PANSS, MMSE, as well as with several BACS items. Total scores obtained at Mini-ICF-APP were significantly higher among remitted and recovered patients. No relevant correlations were found between scores of Mini-ICF-APP and SWN scales. Results The total score and 12 out of the 13 Mini-ICF-APP items correlated significantly with total score at PSP; Mini-ICF-App total score was moreover significantly correlated with total scores at CGI-SCH, PANSS, MMSE, as well as with several BACS items. Total scores obtained at Mini-ICF-APP were significantly higher among remitted and recovered patients. No relevant correlations were found between scores of Mini-ICF-APP and SWN scales. Conclusion the Italian version of Mini-ICF-APP is a valid instrument for use in evaluating functioning in chronic patients with schizophrenia and related disorders.
Collapse
Affiliation(s)
- Federica Pinna
- Department of Public Health, Clinical and Molecular Medicine-Unit of Psychiatry, University of Cagliari, Via Liguria 13, 0917 Cagliari, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Massimo Tusconi
- Department of Public Health, Clinical and Molecular Medicine-Unit of Psychiatry, University of Cagliari, Via Liguria 13, 0917 Cagliari, Italy
| | - Beatrice Guiso
- Department of Public Health, Clinical and Molecular Medicine-Unit of Psychiatry, University of Cagliari, Via Liguria 13, 0917 Cagliari, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Clinical and Molecular Medicine-Unit of Psychiatry, University of Cagliari, Via Liguria 13, 0917 Cagliari, Italy
| |
Collapse
|