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Delgado S, Vignola RCB, Sassi RJ, Belan PA, Araújo SAD. Symptom mapping and personalized care for depression, anxiety and stress: A data-driven AI approach. Comput Biol Med 2024; 182:109146. [PMID: 39265480 DOI: 10.1016/j.compbiomed.2024.109146] [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: 10/27/2023] [Revised: 09/08/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Depression, anxiety, and stress disorders have significant and widespread impacts worldwide, affecting millions of individuals and their communities. According to the World Health Organization, depression impacts the daily lives of more than 300 million people, making it one of the most important diseases globally. Treatment for these mental disorders (MD) typically involves medication and psychotherapies, but also incorporates technological resources like Artificial Intelligence (AI) to indicate personalized therapies and care. While various AI approaches have been applied in the context of MD in the literature, they often focus solely on aiding diagnosis. OBJECTIVE This research proposes an AI approach for mapping symptoms and assisting in the personalized care of depression, anxiety, and stress. METHODS Symptom mapping utilizes data mining (DM) techniques to generate rules representing knowledge extracted from data of 242 patients collected using the Depression, Anxiety, and Stress Scale (DASS-21). This knowledge elucidates how symptoms impact the severity degrees of considered MDs. Subsequently, the generated rules are employed to construct a Fuzzy Inference System (FIS) for inferring the severities of MDs based on patient symptoms and personal data. RESULTS AND CONCLUSIONS The results achieved in the DM (accuracy ≥92.98 %, sensibility ≥86.02 %, specificity ≥97.32 %, and kappa statistic ≥87.98 %), indicating consistent patterns, along with the results produced by the FIS, demonstrate the potential of the proposed approach to assist health professionals in rapidly predicting symptoms of depression, anxiety, and stress, thereby facilitating outpatient screening and emergency care. Furthermore, it can improve the association of symptoms, referral to specialized care, therapeutic proposals, and even investigations of other diseases unrelated to MD.
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Affiliation(s)
- Sabrinna Delgado
- Nove de Julho University - UNINOVE, Informatics and Knowledge Management Post-Graduation Program, Vergueiro Street, 235/249, São Paulo, SP, Brazil, 01504-001
| | - Rose Claudia Batistelli Vignola
- Federal University of São Paulo - UNIFESP, Department of Health, Education and Society, Ana Costa Avenue, 95, Vl. Mathias, Santos, SP, Brazil, 11060-001
| | - Renato José Sassi
- Nove de Julho University - UNINOVE, Informatics and Knowledge Management Post-Graduation Program, Vergueiro Street, 235/249, São Paulo, SP, Brazil, 01504-001
| | - Peterson Adriano Belan
- Nove de Julho University - UNINOVE, Informatics and Knowledge Management Post-Graduation Program, Vergueiro Street, 235/249, São Paulo, SP, Brazil, 01504-001
| | - Sidnei Alves de Araújo
- Nove de Julho University - UNINOVE, Informatics and Knowledge Management Post-Graduation Program, Vergueiro Street, 235/249, São Paulo, SP, Brazil, 01504-001.
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Busby Grant J, Gulliver A, Calear AL, Farrer LM, Batterham PJ. "I don't have time": an exploration of the role of time pressures in acceptance of internet interventions for mental health. J Ment Health 2024; 33:169-176. [PMID: 37212332 DOI: 10.1080/09638237.2023.2210663] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/23/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Internet interventions for common mental disorders are widely available, effective, and economical, yet community uptake remains low. One consistently cited reason for not engaging in mental health interventions is lack of time. AIMS This research examined whether lack of time as a rationale for not using online interventions reflects real time scarcity, and whether time availability impacts intention to use interventions. METHODS A nationally representative sample (N = 1094, 51% women) reported their time use in activity categories for a typical week. Participants rated their acceptance and likelihood of use of mental health internet interventions, and completed mental health symptom, help-seeking and stigma measures. RESULTS Amount of leisure time reported by participants was not associated with acceptance or likelihood of use of internet interventions for mental health. However, respondents who worked longer hours ranked time and effort factors as more influential in their intention to use internet-based mental health programs. Younger respondents and those with greater help-seeking attitudes reported higher acceptance of use. CONCLUSION These findings suggest lack of time is not a direct barrier to use of internet interventions, and that perceived time scarcity may be masking real barriers to uptake.
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Affiliation(s)
- Janie Busby Grant
- Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Louise M Farrer
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
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Li L, Lu S, Xie C, Li Y. Stigmatizing attitudes toward mental disorders among non-mental health nurses in general hospitals of China: a national survey. Front Psychiatry 2023; 14:1180034. [PMID: 37599894 PMCID: PMC10433212 DOI: 10.3389/fpsyt.2023.1180034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Background Negative attitudes of nurses toward mental disorders have been reported in various countries. Nurses' stigmatizing attitudes can harm patients with mental disorders (PWMD), thereby delaying the provision of help to patients and leading to decreased quality of care. In this study, we aimed to assess Chinese nurses' stigmatizing attitudes toward patients with mental illness and provide a basis for future development and testing of appropriate and culturally adapted interventions to reduce it. Objective This study aimed to assess the attitudes of Non-mental Health Nurses (NMHNs) in general hospitals in China toward the stigma of PWMD and determine the factors influencing them. Methods A cross-sectional survey of NMHNs in general hospitals were conducted. A self-designed WeChat-based questionnaire was used that included demographic information about the need for training on mental health issues. Participants were provided with a vignette of a depression case with suicidal thoughts. The Depression Stigma Scale (DSS) and Social Distance Scale (SDS) were used to assess attitudes toward mental disorders. Nine questions on the adequacy of knowledge about anxiety and depression and the current status of scale use were used to assess the current status of training needs for mental disorders. Descriptive analysis, chi-square test, and multivariate logistic regression were used for the table. Results A total of 8,254 nurses in non-mental health professions participated in this study. The mean DSS score of NMHNs was (17.24 ± 6.700), and the SDS score was (10.34 ± 3.154). The total detection rate of stigma among the survey respondents was 13.40% (1,107/8254). Multivariate logistic regression showed that age between 30 and 39 years [p = 0.001, OR = 1.427 (1.154-1.764)], 4 years of work experience and above [p = 0.018, OR = 1.377 (1.056-1.796)], having a bachelor's degree [p < 0.001, OR = 0.742 (0.647-0.851)], adequate psychological knowledge [p < 0.001, OR = 1.567 (1.364-1.799)], full knowledge of communication with patients with anxiety and depression [p < 0.001, OR = 1.848 (1.389-2.459)], and the need to acquire skills to identify anxiety and depression were the influencing factors associated with stigma [p < 0.001, OR = 0.343 (0.236-0.499)]. Conclusion Stigmatizing attitudes toward PWMD exist among NMHNs in general hospitals in China. Thus, more mental health education programs for NMHNs are needed. Factors associated with higher morbidity stigma can be used to develop appropriate interventions to improve NMHNs' stigmatizing attitudes and provide better quality care to PWMD.
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Affiliation(s)
- Li Li
- Xiangya School of Nursing, Central South University, Changsha, China
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
- Department of Urology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Shurong Lu
- Centre for Mental Health | Melbourne School of Population and Global Health The University of Melbourne, Melbourne, VIC, Australia
| | - Chunyan Xie
- Xiangya School of Nursing, Central South University, Changsha, China
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
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Drissi N, Ouhbi S, Serhani MA, Marques G, de la Torre Díez I. Connected Mental Health Solutions: Global Attitudes, Preferences, and Concerns. Telemed J E Health 2023; 29:315-330. [PMID: 35730979 DOI: 10.1089/tmj.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Connected mental health (CMH) presents several technology-based solutions, which can help overcome many mental care delivery barriers. However, attitudes toward the use of CMH are diverse and differ from a cohort to another. Objective: The purpose of this study is to investigate the global attitudes toward CMH use and assess the use of technology for mental care. Methods: This study presents a synthesis of literature available in Scopus, Science Direct, and PubMed digital libraries, investigating attitudes toward CMH in different cohorts from different countries, based on a systematic review of relevant publications. This study also analyzes technology use patterns of the cohorts investigated, the reported preferred criteria that should be considered in CMH, and issues and concerns regarding CMH use. Results: One hundred and one publications were selected and analyzed. These publications were originated from different countries, with the majority (n = 23) being conducted in Australia. These studies reported positive attitudes of investigated cohorts toward CMH use and high technology use and ownership. Several preferred criteria were reported, mainly revolving around providing blended care functionalities, educational content, and mental health professionals (MHPs) support. Whereas concerns and issues related to CMH use addressed technical problems related to access to technology and to CMH solutions, the digital divide, lack of knowledge and use of CMH, and general reservations to use CMH. Concerns related to institutional and work barriers were also identified. Conclusions: Attitudes toward CMH show promising results from users and MHP views. However, factors such as providing blended care options and considering technical concerns should be taken into consideration for the successful adoption of CMH.
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Affiliation(s)
- Nidal Drissi
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sofia Ouhbi
- Department of Computer Science and Software Engineering, CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohamed Adel Serhani
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gonçalo Marques
- Polytechnic of Coimbra, School of Technology and Management of Oliveira do Hospital (ESTGOH), Coimbra, Portugal
| | - Isabel de la Torre Díez
- Department of Signal Theory and Communications and Telematics Engineering, University of Valladolid, Valladolid, Spain
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Zhang M, Zhang Y, Zhu Y, Lin X, Zhi Y, Zhu Y, Shi C, Kong Y. Stigmatized experience is associated with exacerbated pain perception in depressed patients. Behav Res Ther 2023; 161:104252. [PMID: 36645948 DOI: 10.1016/j.brat.2023.104252] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
Patients with depression not only have to cope with depressive and physical symptoms but also face stigmatization due to mental illness. Pain is a clinical symptom of many patients with depression. However, it is unclear whether stigmatized experience associated with mental illness directly affects depressed patients' pain perception. Here, using the event reflection task, Study 1 (N = 95) examined whether stigmatized experiences due to depression would affect patients' self-reported pain assessment. Study 2 (N = 43) further employed thermal stimuli at different intensities to examine whether stigmatization would affect patients' evoked pain. We found that patients with depression who experienced stigmatization based on mental illness reported higher pain catastrophizing and performed increased pain perception for noxious stimuli than those who did not. Our studies provide first-hand experimental evidence of the effect of stigmatized experiences on depressed patients' pain perception. The findings contribute insights for improving clinical treatment, suggesting that interventions should minimize stigmatization associated with mental illness to help patients maintain healthier physical and psychological states.
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Affiliation(s)
- Ming Zhang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yuqi Zhang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yue Zhu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191, China; NHC Key Laboratory of Mental Health, Peking University, Beijing, 100191, China
| | - Xiaomin Lin
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yongkang Zhi
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yupu Zhu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chuan Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191, China; NHC Key Laboratory of Mental Health, Peking University, Beijing, 100191, China.
| | - Yazhuo Kong
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK.
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Qiu L, Feng Y, Luo J, Zhang Y, Yang Q. Predictors of personal depression stigma in medical students in China: differences in male and female groups. MEDICAL EDUCATION ONLINE 2022; 27:2093427. [PMID: 35747998 PMCID: PMC9245981 DOI: 10.1080/10872981.2022.2093427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Depression is common worldwide, and stigmatizing attitudes toward depression have proved to be one of the major barriers to seeking professional help. The purpose of this study was to evaluate the level of personal depression stigma and identify its predictive factors among medical students in Hainan, China, as well as explore the gender difference. A total of 2,186 medical students were recruited using stratified random cluster sampling and interviewed by structured anonymous questionnaires. Personal stigma was measured by the standardized Depression Stigma Scale (DSS). Multivariate linear regression models were used to identify predictors of stigma, and the interactions between gender and each predictor were included to test its gender difference. The mean score on DSS Scale was 13.71 ± 5.35, with males significantly higher than females (14.85 vs 12.99, P < 0.0001). Compared to females, males were more likely to agree with 'I would not vote for a class cadre if I knew they had been depressed' and 'I would not make friends with him if I knew he had been depressed'. Multivariate linear regression analysis revealed that males' personal stigma was predicted by being only child (ß = 1.01, P = 0.0083), moderate-to-severe depression (ß = 1.12, P = 0.0302), and lower self-rated academic core competitiveness (Competitive: ß = 1.29, P = 0.0088, Not at all/Somewhat competitive: ß = 1.04, P = 0.0381), while females' personal stigma was only associated with moderate-to-severe depression (ß = 1.75, P < 0.0001). Significant interactions were found between gender and self-rated academic core competitiveness. Stigmatizing attitudes toward depression were prevalent among Chinese medical students, especially male students. Gender differences were found in the predictors of stigma. Effective measures must be taken to reduce the stigma of mental health among Chinese medical students.
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Affiliation(s)
- Lei Qiu
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Yawen Feng
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Jiaxin Luo
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Yinuo Zhang
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Qin Yang
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, P. R. China
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Factors influencing attitudes toward cyber-counseling among China's Generation Z: A structural equation model. Arch Psychiatr Nurs 2022; 40:124-131. [PMID: 36064235 DOI: 10.1016/j.apnu.2022.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 06/12/2022] [Accepted: 07/03/2022] [Indexed: 11/20/2022]
Abstract
Information technology developments have combined traditional face-to-face counseling with online- or cyber-counseling. As digital natives, Generation Z has easy access to cyber-counseling. However, their attitudes toward cyber-counseling remain unknown. This study explored these attitudes and relevant influencing factors among 1216 Chinese adolescents using self-report questionnaires. Descriptive analyses and structural equation modeling were used for data analysis. The model explained 27.7 % of the total variance, attitudes toward psychological help was the most influential, followed by attitudes toward the Internet and perceived behavioral control. The model was effective in explaining attitudes toward cyber-counseling, emphasizing the influence of attitudes toward psychological help.
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Research on the MEG of Depression Patients Based on Multivariate Transfer Entropy. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:7516627. [PMID: 35909866 PMCID: PMC9328977 DOI: 10.1155/2022/7516627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/27/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
The pathogenesis of depression is complex, and the current means of medical diagnosis is single. Patients with severe depression may even have great physical pain and suicidal tendencies. Magnetoencephalography (MEG) has the characteristics of ultrahigh spatiotemporal resolution and safety. It is a good medical means for the diagnosis of depression. In this paper, multivariate transfer entropy algorithm is used to study MEG of depression. In this paper, the subjects are divided into the same brain region and the multichannel combination between different brain regions, and the multivariate transfer entropy of patients with depression and healthy controls under different EEG signal frequency bands is calculated. Finally, the significant difference between the two groups of experimental samples is verified by the results of independent sample t-test. The experimental results show that for the same combination of brain channels, the multivariate transfer entropy in the depression group is generally lower than that in the healthy control group, and the difference is the best in γ frequency band and the largest in the frontal region.
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Cheung T, Ho YS, Yeung JWF, Leung SF, Fong KNK, Fong T, Kranz GS, Beisteiner R, Cheng CPW. Effects of Transcranial Pulse Stimulation (TPS) on Young Adults With Symptom of Depression: A Pilot Randomised Controlled Trial Protocol. Front Neurol 2022; 13:861214. [PMID: 35401418 PMCID: PMC8990306 DOI: 10.3389/fneur.2022.861214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023] Open
Abstract
Background Since the emergence of the COVID-19 pandemic, there have been lots of published work examining the association between COVID-19 and mental health, particularly, anxiety and depression in the general populations and disease subpopulations globally. Depression is a debilitating disorder affecting individuals' level of bio-psychological-social functioning across different age groups. Since almost all studies were cross-sectional studies, there seems to be a lack of robust, large-scale, and technological-based interventional studies to restore the general public's optimal psychosocial wellbeing amidst the COVID-19 pandemic. Transcranial pulse stimulation (TPS) is a relatively new non-intrusive brain stimulation (NIBS) technology, and only a paucity of studies was conducted related to the TPS treatment on older adults with mild neurocognitive disorders. However, there is by far no study conducted on young adults with major depressive disorder nationwide. This gives us the impetus to execute the first nationwide study evaluating the efficacy of TPS on the treatment of depression among young adults in Hong Kong. Methods This study proposes a two-armed single-blinded randomised controlled trial including TPS as an intervention group and a waitlist control group. Both groups will be measured at baseline (T1), immediately after the intervention (T2), and at the 3- month follow-up (T3). Recruitment A total of 30 community-dwelling subjects who are aged 18 and above and diagnosed with major depressive disorder (MDD) will be recruited in this study. All subjects will be computer randomised into either the intervention group or the waitlist control group, balanced by gender and age on a 1:1 ratio. Intervention All subjects in each group will have to undertake functional MRI (fMRI) before and after six 30-min TPS sessions, which will be completed in 2 weeks' time. Outcomes Baseline measurements and post-TPS evaluation of the psychological outcomes (i.e., depression, cognition, anhedonia, and instrumental activities of daily living) will also be conducted on all participants. A 3-month follow-up period will be usedto assess the long-term sustainability of the TPS intervention. For statistical analysis, ANOVA with repeated measures will be used to analyse data. Missing data were managed by multiple mutations. The level of significance will be set to p < 0.05. Significance of the Study Results of this study will be used to inform health policy to determine whether TPS could be considered as a top treatment option for MDD. Clinical Trial Registration ClinicalTrials.gov, identifier: NCT05006365.
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Affiliation(s)
- Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Yuen Shan Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jerry Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Sau Fong Leung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Kenneth N. K. Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Tommy Fong
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Georg S. Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Roland Beisteiner
- Department of Neurology, Functional Diagnostics and Therapy, Medical University of Vienna, Vienna, Austria
| | - Calvin Pak Wing Cheng
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Mitchell KM, Holtz BE, McCarroll AM. Assessing College Students' Perceptions of and Intentions to Use a Mobile App for Mental Health. Telemed J E Health 2021; 28:566-574. [PMID: 34166099 DOI: 10.1089/tmj.2021.0106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: College students face high rates of depression, anxiety, and suicide. Therefore, the focus of this study was to examine college students' intention to use a mental health app provided by the university, called MySSP, through use of the unified theory of acceptance and use of technology (UTAUT). Materials and Methods: An online survey was developed based on responses to focus groups previously conducted by the authors regarding MySSP. A multiple linear regression was conducted to test the associations between the UTAUT variables and behavioral intention. In addition, moderation analyses were conducted to explore the effects of depression, anxiety, stigma, and quality of life as moderators. Results: Results suggest that performance expectancy (PE) (t = 3.088, p = 0.003) and social influence (SI) (t = -2.163, p = 0.03) were the only significant predictors of behavioral intention. The only significant moderator was stigma in the relationship between effort expectancy and behavioral intention (b = -1.6081, standard error (SE) = 0.7454, confidence interval (CI): -3.0691 to -0.1472) as well as facilitating conditions (FCs) and behavioral intention (b = -2.2292, SE = 0.8580, CI: -3.9110 to -0.5475). Conclusions: This study provides an initial exploration of college students' intentions to use MySSP. The results suggest that successful interventions include features related to PE (usefulness) and SI (norms), which should be focused on when developing and testing apps for mental health. Additionally, the stigma of mental health has significant negative impacts on the adoption of mental health apps and should be considered in implementation of mental health interventions geared toward college students.
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Affiliation(s)
- Katharine M Mitchell
- Department of Advertising and Public Relations, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Bree E Holtz
- Department of Advertising and Public Relations, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Alexis M McCarroll
- Department of Communication and Media, University of Michigan, Ann Arbor, Michigan, USA
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Baumeister H, Bauereiss N, Zarski AC, Braun L, Buntrock C, Hoherz C, Idrees AR, Kraft R, Meyer P, Nguyen TBD, Pryss R, Reichert M, Sextl T, Steinhoff M, Stenzel L, Steubl L, Terhorst Y, Titzler I, Ebert DD. Clinical and Cost-Effectiveness of PSYCHOnlineTHERAPY: Study Protocol of a Multicenter Blended Outpatient Psychotherapy Cluster Randomized Controlled Trial for Patients With Depressive and Anxiety Disorders. Front Psychiatry 2021; 12:660534. [PMID: 34054617 PMCID: PMC8160118 DOI: 10.3389/fpsyt.2021.660534] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/12/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction: Internet- and mobile-based interventions (IMIs) and their integration into routine psychotherapy (i.e., blended therapy) can offer a means of complementing psychotherapy in a flexible and resource optimized way. Objective: The present study will evaluate the non-inferiority, cost-effectiveness, and safety of two versions of integrated blended psychotherapy for depression and anxiety compared to standard cognitive behavioral therapy (CBT). Methods: A three-armed multicenter cluster-randomized controlled non-inferiority trial will be conducted comparing two implementations of blended psychotherapy (PSYCHOnlineTHERAPYfix/flex) compared to CBT. Seventy-five outpatient psychotherapists with a CBT-license will be randomized in a 1:1:1 ratio. Each of them is asked to include 12 patients on average with depressive or anxiety disorders resulting in a total sample size of N = 900. All patients receive up to a maximum of 16 psychotherapy sessions, either as routine CBT or alternating with Online self-help sessions (fix: 8/8; flex: 0-16). Assessments will be conducted at patient study inclusion (pre-treatment) and 6, 12, 18, and 24 weeks and 12 months post-inclusion. The primary outcome is depression and anxiety severity at 18 weeks post-inclusion (post-treatment) using the Patient Health Questionnaire Anxiety and Depression Scale. Secondary outcomes are depression and anxiety remission, treatment response, health-related quality of life, patient satisfaction, working alliance, psychotherapy adherence, and patient safety. Additionally, several potential moderators and mediators including patient characteristics and attitudes toward the interventions will be examined, complemented by ecological day-to-day digital behavior variables via passive smartphone sensing as part of an integrated smart-sensing sub-study. Data-analysis will be performed on an intention-to-treat basis with additional per-protocol analyses. In addition, cost-effectiveness and cost-utility analyses will be conducted from a societal and a public health care perspective. Additionally, qualitative interviews on acceptance, feasibility, and optimization potential will be conducted and analyzed. Discussion: PSYCHOnlineTHERAPY will provide evidence on blended psychotherapy in one of the largest ever conducted psychotherapy trials. If shown to be non-inferior and cost-effective, PSYCHOnlineTHERAPY has the potential to innovate psychotherapy in the near future by extending the ways of conducting psychotherapy. The rigorous health care services approach will facilitate a timely implementation of blended psychotherapy into standard care. Trial Registration: The trial is registered in the German Clinical Trials Register (DRKS00023973; date of registration: December 28th 2020).
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Affiliation(s)
- Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Natalie Bauereiss
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Anna-Carlotta Zarski
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Lina Braun
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Christian Hoherz
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Abdul Rahman Idrees
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
- Institute of Databases and Information Systems (DBIS), Ulm University, Ulm, Germany
| | - Robin Kraft
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
- Institute of Databases and Information Systems (DBIS), Ulm University, Ulm, Germany
| | - Pauline Meyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Tran Bao Dat Nguyen
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Rüdiger Pryss
- Medical Informatics, Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Manfred Reichert
- Institute of Databases and Information Systems (DBIS), Ulm University, Ulm, Germany
| | - Theresa Sextl
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Maria Steinhoff
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lena Stenzel
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lena Steubl
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ingrid Titzler
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - David Daniel Ebert
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
- Department of Sport & Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany
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Liu J, Gao L. Analysis of topics and characteristics of user reviews on different online psychological counseling methods. Int J Med Inform 2020; 147:104367. [PMID: 33401170 DOI: 10.1016/j.ijmedinf.2020.104367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Psychological support is available more widely supported by emerging technologies as an addition to face-to-face consultations, more and more people are accessing psychological support using online resources. OBJECTIVE This research provides insights into the perception of the key factors that affect the effectiveness of different online psychological counseling methods through the user reviews of four online psychological counseling modes and the tendency to choose the different counseling methods for users with different psychological problems. METHODS Using topic modeling analysis, Gooseeker content analysis, and the TextMind Chinese psychological analysis system, we analyzed 163,377 online reviews from 2,375 psychological consultants extracted from a leading online psychological consultation platform in China. RESULTS (1) Telephone counseling gains the most preferences among users. Text counseling has strong privacy protection. Video and face-to-face consultations are more authentic and comprehensive. (2) Parent-child education consultation users are more likely to choose face-to-face consultation, patients with common mental illnesses are more inclined to choose online counseling methods than offline consultation, career planning consultation clients prefer video consultation, and text counseling is more consistent with the periodical characteristics of relationship counseling. CONCLUSION The research examined user reviews and used content analysis to understand patients' views on the effectiveness of online counseling methods, which supplement the current research gap through innovation in research methods.
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Affiliation(s)
- Jingfang Liu
- School of Management, Shanghai University, Shanghai, 201800, China
| | - Lu Gao
- School of Management, Shanghai University, Shanghai, 201800, China.
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