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Ahuvia IL, Schleider JL, Kneeland ET, Moser JS, Schroder HS. Depression self-labeling in U.S. college students: Associations with perceived control and coping strategies. J Affect Disord 2024; 351:202-210. [PMID: 38286232 DOI: 10.1016/j.jad.2024.01.229] [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: 10/31/2023] [Revised: 01/20/2024] [Accepted: 01/26/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Research on mental illness labeling has demonstrated that self-labeling (identifying with a mental illness label, e.g., "I have depression") is associated with internalized stigma, maladaptive responses to that stigma, and lower quality of life. However, research has not yet examined the link between self-labeling and how individuals cope with emotional distress. It is important to understand this relationship because adaptive and maladaptive methods of coping can lead to positive and negative mental illness outcomes. METHODS This cross-sectional study examined the link between depression self-labeling, depression symptoms, and three constructs related to depression self-management (perceived control over depression, cognitive emotion regulation strategies, and help-seeking beliefs) in a large (N = 1423) sample of U.S. college students. RESULTS Approximately one-fifth of students (22.2 %) self-labeled as having depression, while 39.0 % were estimated to meet diagnostic criteria for MDD. After controlling for depression symptom severity, self-labeling was associated with lower levels of perceived control over depression (p = .002), more catastrophizing (p = .013), less perspective taking, refocusing, reappraisal, and planning (ps < 0.05), and more positive help-seeking attitudes towards medication (p < .001) but not therapy. LIMITATIONS Results are non-causal and may not generalize to non-college populations. CONCLUSIONS Self-labeling may inform how individuals cope with emotional distress, with the potential for positive and negative effects on clinical outcomes. This is consistent with well-established research on self-labeling with regards to stigma, but extends this research in important new directions.
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Affiliation(s)
| | - Jessica L Schleider
- Northwestern University Feinberg School of Medicine, United States of America
| | | | | | - Hans S Schroder
- University of Michigan Medical School, United States of America
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2
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Baldofski S, Klemm SL, Kohls E, Mueller SME, Bauer S, Becker K, Diestelkamp S, Eschenbeck H, Hiery A, Kaess M, Koenig J, Lehner L, Moessner M, Thomasius R, Rummel-Kluge C. Reasons for non-participation of children and adolescents in a large-scale school-based mental health project. Front Public Health 2024; 11:1294862. [PMID: 38259782 PMCID: PMC10800647 DOI: 10.3389/fpubh.2023.1294862] [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: 10/02/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Background Non-participation in mental health studies is an under-explored but very important topic. Investigating reasons for non-participation holds promise for the planning of future study designs and recruitment strategies. This study aimed at investigating reasons for children and adolescents (C&A) not participating in a school-based mental health research project. Methods Data collection took place within the school-based recruitment of a large-scale multi-site project ("ProHEAD-Promoting Help-seeking using E-technology for Adolescents") in Germany. Participants were N = 534 C&A aged ≥ 12 years attending secondary schools. The present cross-sectional study analyzed anonymous survey data of C&A who themselves or whose parents, respectively, did not provide written consent to participate in the mental health research project. The questionnaire consisted of 14 items covering potential reasons for non-participation, and four free text fields. Besides descriptive statistics, free text field answers were analyzed using qualitative content analysis. Results Students indicated an average of M = 2.94 (SD = 1.75) reasons for their non-participation in the project. In the descriptive analysis of indicated items, the three most frequently reported reasons for non-participation included students reporting to not be concerned by the topic "mental health" (n = 290, 54.3%), not having returned the consent form to the teacher (n = 175, 32.8%), and not having time for participation (n = 149, 27.9%). In the qualitative content analysis, the most frequently assigned categories were organizational reasons (n = 216, 57.1%), general disinterest in study participation (n = 139, 36.8%), and personal attitudes toward the topic "mental health" (n = 84, 22.2%), such as not being concerned with the topic "mental health" (n = 23, 6.1%) or being too concerned with the topic "mental health" (n = 16, 4.2%). Conclusion The study provides unique insights into reasons for C&A and their caregivers not participating in a large federally funded mental health research project. The results suggest that in order to increase participation rates, stigma should be reduced, parents as well as teachers should be involved where possible, and the use of incentives might be helpful. The study highlights the importance of assessing reasons for non-participation, especially in online intervention studies on mental health.
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Affiliation(s)
- Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sarah-Lena Klemm
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Sophia M. E. Mueller
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Philipps-University and University Hospital Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Silke Diestelkamp
- German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Eschenbeck
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Alisa Hiery
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, Philipps-University and University Hospital Marburg, Marburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Laya Lehner
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Rainer Thomasius
- German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Schladitz K, Weitzel EC, Löbner M, Soltmann B, Jessen F, Pfennig A, Riedel-Heller SG, Gühne U. Experiencing (Shared) Decision Making: Results from a Qualitative Study of People with Mental Illness and Their Family Members. Healthcare (Basel) 2023; 11:2237. [PMID: 37628436 PMCID: PMC10454232 DOI: 10.3390/healthcare11162237] [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: 06/19/2023] [Revised: 07/17/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: There is a fundamental shift in healthcare toward shared decision making (SDM). This study explores SDM from the perspective of individuals affected by mental illness and their family members and investigates factors which promote and hinder the process. (2) Methods: We conducted N = 15 telephone interviews (n = 4 adults affected by mental illness, n = 5 family members, n = 6 both applicable, the majority reporting experiences with affective and anxiety disorders). Data were recorded, transcribed, and analyzed according to procedures established by Mayring. (3) Results: Individuals affected by mental illness and their family members have a strong desire to be involved in treatment decisions and to participate in finding a diagnosis. Often these stakeholders are denied the opportunity to participate; sometimes enabling behaviors impede participation. The stigmatization of mental illnesses is a major barrier. There are also structural barriers to SDM within the healthcare system. Peer support, self-help associations, and psychosocial counseling services are important to empowering individuals and promoting SDM. (4) Conclusions: SDM has the potential to improve the quality of mental healthcare. Barriers can be mitigated and new approaches for interventions in the psychiatric sector have been identified. This study has also shown the importance of understanding SDM as a process that should begin at the diagnostic phase.
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Affiliation(s)
- Katja Schladitz
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (E.C.W.); (M.L.); (S.G.R.-H.); (U.G.)
| | - Elena C. Weitzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (E.C.W.); (M.L.); (S.G.R.-H.); (U.G.)
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (E.C.W.); (M.L.); (S.G.R.-H.); (U.G.)
| | - Bettina Soltmann
- Department of Psychiatry and Psychotherapy, Medizinische Fakultät Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Medizinische Fakultät Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (E.C.W.); (M.L.); (S.G.R.-H.); (U.G.)
| | - Uta Gühne
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (E.C.W.); (M.L.); (S.G.R.-H.); (U.G.)
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Hogg B, Moreno-Alcázar A, Tóth MD, Serbanescu I, Aust B, Leduc C, Paterson C, Tsantilla F, Abdulla K, Cerga-Pashoja A, Cresswell-Smith J, Fanaj N, Meksi A, Ni Dhalaigh D, Reich H, Ross V, Sanches S, Thomson K, Van Audenhove C, Pérez V, Arensman E, Purebl G, Amann BL. Supporting employees with mental illness and reducing mental illness-related stigma in the workplace: an expert survey. Eur Arch Psychiatry Clin Neurosci 2023; 273:739-753. [PMID: 35867155 PMCID: PMC9305029 DOI: 10.1007/s00406-022-01443-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/29/2022] [Indexed: 11/28/2022]
Abstract
An expert survey was designed to support the development of a workplace-based multi-country intervention tackling depression, anxiety, and mental illness-related stigma in small- and medium-sized enterprises (SMEs). Academic experts and representatives of SME organisations, specific sector organisations, labour or advocacy groups, and occupational health organisations, were contacted across eight European countries and Australia. The survey comprised closed and open text questions to assess expert opinion about interventions for employees with mental health difficulties, interventions supporting their managers, and anti-stigma interventions. The survey was available in six languages. The online platform Qualtrics was used for data collection. Quantitative data was analysed through descriptive statistics and qualitative data was analysed through thematic analysis. Sixty-five of 146 experts responded, representing a 42% response rate. Results showed only 26.2% of experts agreed that employees could speak openly about mental health issues, and 81.5% of experts indicated a large or medium unmet need for support for employees with mental health issues. Psychoeducational materials, face-to-face workshops and interventions based on cognitive behavioural therapy were ranked most likely to be taken up by employees. Experts rated as most useful for managers' guidelines on how to act if an employee has mental health issues (67.7%). The greatest number of experts indicated workshops of people with lived experience of mental illness (80.0%) and awareness campaigns (78.5%) were most required to tackle stigma. Responses were consistent between experts from different countries and areas of expertise. Experts in this multinational survey assessed that interventions supporting mental health in the workplace and tackling stigma are greatly needed. A multicomponent intervention with a wide range of materials and tools is supported.
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Affiliation(s)
- Bridget Hogg
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Programme, Dept. of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Semmelweis Egyetem Magatartástudományi Intézet, Budapest, Hungary
| | - Ilinca Serbanescu
- Faculty of Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Charlotte Paterson
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, Scotland
| | - Fotini Tsantilla
- LUCAS, Center for Care Research and Consultancy, Faculty of Medicine, KU Leuven, Louvain, Belgium
| | - Kahar Abdulla
- European Alliance Against Depression E.V, Leipzig, Germany
| | - Arlinda Cerga-Pashoja
- Population Health, London School of Hygiene and Tropical Medicine, London, England
- Global Public Health, Public Health England, Greenwich, UK
| | | | | | | | | | - Hanna Reich
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
- German Depression Foundation, Leipzig, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Qld, Australia
| | - Sarita Sanches
- Phrenos Center of Expertise for Severe Mental Illness, Utrecht, the Netherlands
| | - Katherine Thomson
- International Association for Suicide Prevention (IASP), Washington, DC, USA
| | - Chantal Van Audenhove
- LUCAS, Center for Care Research and Consultancy, Faculty of Medicine, KU Leuven, Louvain, Belgium
| | - Victor Pérez
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Dept. of Psychiatry and Forensic Medicine, Pompeu Fabra University, Barcelona, Spain
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Qld, Australia
- International Association for Suicide Prevention (IASP), Washington, DC, USA
| | - Gyorgy Purebl
- Institute of Behavioural Sciences, Semmelweis University, Semmelweis Egyetem Magatartástudományi Intézet, Budapest, Hungary.
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
- Mental Health Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Dept. of Psychiatry and Forensic Medicine, Pompeu Fabra University, Barcelona, Spain
- Dept. of Psychiatry and Psychotherapy, Ludwig Maximilian University Hospital Munich, Nussbaumstraße 7, Munich, Germany
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5
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McLaren T, Peter LJ, Tomczyk S, Muehlan H, Schomerus G, Schmidt S. The Seeking Mental Health Care model: prediction of help-seeking for depressive symptoms by stigma and mental illness representations. BMC Public Health 2023; 23:69. [PMID: 36627597 PMCID: PMC9831378 DOI: 10.1186/s12889-022-14937-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Only about half the people with depression seek professional health care services. To constitute the different predictors and associating variables of health care utilisation, we model the process and aim to test our hypothesised Seeking Mental Health Care Model. The model includes empirical influences on the help-seeking process to predict actual behaviour and incorporates superordinate (stigma, treatment experiences) as well as intermediate attitudinal variables (continuum and causal beliefs, depression literacy and self-efficacy). METHOD All variables are examined in an online study (baseline, three- and six-month follow-up). The sample consisted of adults with depressive symptoms (PHQ-9 sum score ≥ 8), currently not receiving mental health care treatment. To examine the prediction of variables explaining help-seeking behaviour, a path model analysis was carried out (lavaan package, software R). RESULTS Altogether, 1368 participants (Mage = 42.38, SDage = 15.22, 65.6% female) were included, 983 participating in at least one follow-up. Model fit was excellent (i.e., RMSEA = 0.059, CFI = 0.989), and the model confirmed most of the hypothesised predictions. Intermediary variables were significantly associated with stigma and experiences. Depression literacy (ß = .28), continuum beliefs (ß = .11) and openness to a balanced biopsychosocial causal model (ß = .21) significantly influenced self-identification (R2 = .35), which among the causal beliefs and self-efficacy influenced help-seeking intention (R2 = .10). Intention (ß = .40) prospectively predicted help-seeking behaviour (R2 = .16). CONCLUSION The Seeking Mental Health Care Model provides an empirically validated conceptualisation of the help-seeking process of people with untreated depressive symptoms as a comprehensive approach considering internal influences. Implications and open questions are discussed, e.g., regarding differentiated assessment of self-efficacy, usefulness of continuum beliefs and causal beliefs in anti-stigma work, and replication of the model for other mental illnesses. TRIAL REGISTRATION German Clinical Trials Register: DRKS00023557. Registered 11 December 2020. World Health Organization, Universal Trial Number: U1111-1264-9954. Registered 16 February 2021.
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Affiliation(s)
- Thomas McLaren
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany.
| | - Lina-Jolien Peter
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany.
| | - Samuel Tomczyk
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany
| | - Holger Muehlan
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Silke Schmidt
- Department of Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum Str. 13, 17489, Greifswald, Germany
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Parker M, Barlow S, Hoe J, Aitken LM. The Bubble of Normalisation: A Qualitative Study of Carers of People With Dementia Who Do Not Seek Help for a Diagnosis. J Geriatr Psychiatry Neurol 2022; 35:717-732. [PMID: 34951319 PMCID: PMC9386763 DOI: 10.1177/08919887211060018] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Improving dementia diagnosis rates are a key feature of dementia strategy and policy worldwide. This study aimed to explore the experience of carers of people diagnosed with dementia during or following a hospital admission in order to identify factors that had prevented them from seeking help beforehand. Semi-structured interviews were conducted with 12 informal carers including adults caring for a parent, a friend or a spouse diagnosed with dementia between 2010-2019, following an acute hospital admission for a physical health problem, having not sought help previously. MAIN FINDINGS Carers created a 'bubble of normalisation' around themselves and the person living with dementia (PLWD) to reject the label of dementia and protect the PLWD from a loss of independence, discrimination and prejudice they felt would be the result of a diagnosis. Carers struggled to talk to the PLWD about dementia reinforcing denial and stigma. Post-diagnosis carers felt unsupported and questioned the value of diagnosis. PRINCIPAL CONCLUSIONS Stigma related to images of dementia as a disease that takes away independence and identity prevented discussion about dementia between carers and the PLWD. A lack of open discussion about memory concerns between health care professionals and carers also served to delay diagnosis.
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Affiliation(s)
- Michelle Parker
- Division of Nursing, City University of London, London, UK,Michelle Parker, Division of Nursing, City University of London, Northampton Square, London EC1V 0HB, UK.
| | - Sally Barlow
- Division of Nursing, City University of London, London, UK
| | - Juanita Hoe
- Division of Nursing, City University of London, London, UK
| | - Leanne M. Aitken
- School of Health Sciences, City University of London, London, UK,School of Nursing & Midwifery, Griffith University, Australia
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Kilkku N, Halkoaho A. Informed consent, genomic research and mental health: A integrative review. Nurs Ethics 2022; 29:973-987. [PMID: 35119339 PMCID: PMC9289972 DOI: 10.1177/09697330211066573] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research on genomics has increased while the biobank activities are becoming more common in different countries. In the mental health field, the questions concerning the potential participants' vulnerability as well as capacity to give the informed consent can cause reluctancy in recruiting persons with mental health problems, although the knowledge and understanding of mental health problems has remarkable changed, and practice is guided with inclusive approaches, such as recovery approach. AIM The aim of this study was to describe the current knowledge of informed consent practices in the context of genomic research on mental health from the nurses' viewpoint. METHODS An integrative review was conducted with search from seven international databases. Data consist 14 publications which were analyzed with thematic analysis. ETHICAL CONSIDERATIONS Ethical requirements were respected in every phase of the research process. FINDINGS Most of the papers were published in USA and between 2000-2010. Eight reports were categorized as discussion papers, four qualitative studies and one quantitative study. The thematic analysis provided information on five themes: complexity with the capacity to consent, mixed emotions towards participation, factors influencing the decision to participate, nurses' informed consent process competence and variations between consent procedures. DISCUSSION In the informed consent practices, there are various aspects which may affect both the willingness to participate in the study and the informed consent process itself. Implications for practice, education, research, and policies are discussed. CONCLUSION There is a need for more updated international research on the topic in the context of different international and national guidelines, legislation, and directives. This study provided a viewpoint to the more collaborative research activities with people with lived experiences also in this field of research following the ideas of recovery approach.
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Affiliation(s)
- Nina Kilkku
- School of Social Services and Health Care, 20615Tampere University of Applied Sciences, Tampere, Finland
| | - Arja Halkoaho
- School of Health, 52917Tampere University of Applied Sciences, Tampere, Finland Corresponding author
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8
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Mental health, substance use, and suicidal ideation among unpaid caregivers of adults in the United States during the COVID-19 pandemic: Relationships to age, race/ethnicity, employment, and caregiver intensity. J Affect Disord 2021; 295:1259-1268. [PMID: 34706440 PMCID: PMC8413485 DOI: 10.1016/j.jad.2021.08.130] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/30/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unpaid caregivers of adults play critical roles in health care systems by providing care to older adults and those with chronic conditions. The COVID-19 pandemic has heightened caregiving needs, forcing some into caregiving roles and disrupting others. We sought to estimate the prevalence of and identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation amongst unpaid caregivers of adults versus non-caregivers. METHODS During June 24-30, 2020, surveys were administered to U.S. adults. Quota sampling and survey weighting were implemented to improve sample representativeness of age, gender, and race/ethnicity. RESULTS Of 9,896 eligible invited adults, 5,412 (54.7%) completed surveys and 5,011 (92.6%) met screening criteria and were analyzed, including 1,362 (27.2%) caregivers. Caregivers had higher adverse mental health symptom prevalences than non-caregivers, including suicidal ideation (33.4% vs 3.7%, p < 0.0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18-24 vs ≥65 years, aPR 2.75, 95% CI 1.95-3.88, p < 0.0001) and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65-3.23; 2.81, 2.00-3.94; both p < 0.0001). LIMITATIONS Self-report data may be subject to recall, response, and social desirability biases; unpaid caregivers were self-identified; child caregiving roles were not assessed; and internet-based survey samples might not fully represent the U.S. CONCLUSIONS Caregivers experienced disproportionately high levels of adverse mental health symptoms. Younger caregivers and those with higher caregiving intensity were disproportionately affected. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.
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Kahl KG, Westhoff-Bleck M. Psychokardiologische Aspekte bei Erwachsenen mit angeborenem Herzfehler (EMAH). AKTUELLE KARDIOLOGIE 2021. [DOI: 10.1055/a-1580-7079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ZusammenfassungBedingt durch die verbesserte medizinische Versorgung von Patienten mit angeborenen
Herzfehlern und die damit einhergehende verlängerte Lebenserwartung treten
psychokardiologische Aspekte stärker in den Vordergrund. Hierzu zählen u. a. die Inzidenz
komorbider psychischer Störungen, Fragen nach den Faktoren, die eine optimale Lebensqualität
ermöglichen, den Einfluss eines angeborenen Herzfehlers auf Partnerschaft und Lebensgestaltung
sowie Lebensstilfaktoren und Adhärenz. In Zeiten knapper Personalressourcen und zunehmenden
ökonomischen Drucks ist darüber hinaus eine effektive Diagnostik psychosozialer Probleme und
ggf. Einleitung einer wirkungsvollen psychosozialen Therapie wichtig. Die interdisziplinäre
Zusammenarbeit unter Einbezug moderner psychokardiologischer Konzepte ist daher in der
langfristigen Therapie von EMAH-Patienten von entscheidender Bedeutung.
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Affiliation(s)
- Kai G. Kahl
- Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Deutschland
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Heinz I, Baldofski S, Beesdo-Baum K, Knappe S, Kohls E, Rummel-Kluge C. "Doctor, my back hurts and I cannot sleep." Depression in primary care patients: Reasons for consultation and perceived depression stigma. PLoS One 2021; 16:e0248069. [PMID: 33667268 PMCID: PMC7935275 DOI: 10.1371/journal.pone.0248069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/18/2021] [Indexed: 12/03/2022] Open
Abstract
Background General practitioners (GPs) play a significant role in depression care. Recognition of depression is crucial for adequate treatment but is impeded by a high portion of depressed patients only reporting physical symptoms to their GP. Among the many reasons for this phenomenon is mental health stigma. We investigated how patients with depression differed from patients without depression regarding the types and number of complaints presented to their GP, as well as their depression stigma. For the subgroup of patients with depression, potential associations between perceived depression stigma and number and types of presented complaints were investigated to see if these might reflect the patient’s intention to conceal mental health symptoms due to fear of being stigmatized by others. Further, we investigated if perceived depression stigma is related to depression treatment. Methods Data on depressive symptoms (assessed by the Depression Screening Questionnaire; DSQ), depression stigma (assessed by the Depressions Stigma Scale; DSS), type of complaints reported to the GP and treatment-related factors were collected from 3,563 unselected primary care patients of 253 GPs in a cross-sectional epidemiological study (“VERA study”) in six different German regions. Data of a total of 3,069 patients was used for analysis on complaints reported to the GP (subsample of the VERA study), and for 2,682 out of 3,069 patients data on a stigma questionnaire was available. Results Nearly half of the primary care patients with depression (42.2%) reported only physical complaints to their GP. Compared to patients without a depression diagnosis, patients with depression reported twice as many complaints to their GP with a mean of 2.02 (1.33) vs. 1.2 (0.69), including a more frequent combination of physical and mental symptoms (28.8% vs. 3.5%). Patients with depression showed higher total stigma compared to patients without depression, Mdn = 48 (IQR 40–54) vs. Mdn = 46.3 (IQR 29–53), due to higher perceived stigma, Mdn = 27 (IQR 21–32) vs. Mdn = 25.9 (IQR 20–29). Perceived stigma was associated with male gender (beta -.14, p = .005) and a lack of pharmacological treatment (beta -.14, p = .021) in patients with a depression diagnosis. Conclusion The number of complaints presented to the GP might function as a marker to actively explore depression in primary care patients, in particular when both physical and mental symptoms are reported. Perceived depression stigma should also be addressed especially in male patients. Further research should clarify the role of perceived stigma as a potential inhibitor of pharmacological treatment of depression in primary care.
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Affiliation(s)
- Ines Heinz
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
- German Alliance Against Depression, Leipzig, Germany
- * E-mail:
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
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Manescu EA, Robinson EJ, Henderson C. Attitudinal and demographic factors associated with seeking help and receiving antidepressant medication for symptoms of common mental disorder. BMC Psychiatry 2020; 20:579. [PMID: 33272233 PMCID: PMC7711251 DOI: 10.1186/s12888-020-02971-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/17/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Despite the increased attention given to improvement of mental health-related knowledge and attitudes, rates of help-seeking for mental illness remain low even in countries with well-developed mental health services. This study examines the relationships between attitudes to mental illness, symptoms of common mental disorder and seeking-help and receiving medication for a mental health problem. METHODS We used data from the nationally representative Health Survey for England 2014 to design three logistic regression models to test for the effects of attitudes to mental illness (measured by a shortened version of the Community Attitudes toward the Mentally Ill, CAMI scale) on: recent contact with a doctor for a mental health problem; use of any type of mental health service in the last 12 months; and having antidepressants currently prescribed, while controlling for symptoms of common mental disorder (measured by the General Health Questionnaire, GHQ). We also tested for an interaction between attitudes to mental illness and symptoms of common mental disorder on the outcomes. RESULTS A significant but very small effect of CAMI score was found on 'antidepressants currently prescribed' model (OR = 1.01(1.00, 1.02) but not on the two indicators of help-seeking. We also found a significant but very small interaction between CAMI and GHQ scores on recent contact with a doctor (OR = 0.99, 95% CI (0.990, 0.998); adjusted Wald test P = 0.01)). Knowing someone with a mental illness had a significant positive effect on help-seeking indicated by: (a) recent contact with a doctor (2.65 (1.01, 6.98)) and (b) currently prescribed antidepressant (2.67 (1.9, 3.75)) after controlling for attitudes to mental illness. CONCLUSIONS Our results suggest that knowing someone with a mental health problem seems to have a further positive effect on help-seeking, beyond improving attitudes to mental illness. Furthermore, multiple different types and aspects of stigma may contribute to help-seeking behaviours, consequently multi-faceted approaches are likely to be most efficient.
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Affiliation(s)
- Elena A Manescu
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
- Psychiatry Department, University of Medicine, Pharmacy, Science and Technology, Tirgu-Mures, Romania.
| | - Emily J Robinson
- Research Data & Statistics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Claire Henderson
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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