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Vicent-Gil M, Trujols J, Serra-Blasco M, Navarra-Ventura G, Puigdemont D, Alemany C, Crivillés S, de Diego-Adeliño J, Cardoner N, Portella MJ. If you feel you can't, you won't: the role of subjective and objective cognitive competence on psychosocial functioning in depression. Eur Psychiatry 2023; 66:e83. [PMID: 37855104 PMCID: PMC10755570 DOI: 10.1192/j.eurpsy.2023.2454] [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: 05/04/2023] [Revised: 07/27/2023] [Accepted: 08/21/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The purpose of this exploratory study is to examine the role of sociodemographic, clinical, and cognitive - both objective and subjective - factors in overall and in specific domains of psychosocial functioning, in patients with depression at different clinical states of the disease (remitted and non-remitted). METHODS A sample of 325 patients with major depressive disorder, 117 in remission and 208 in non-remission, were assessed with a semi-structured interview collecting sociodemographic, clinical, cognitive (with neuropsychological tests and the Perceived Deficit Questionnaire), and functional (Functioning Assessment Short Test) characteristics. Backward regression models were conducted to determine associations of global and specific areas of functioning with independent factors, for both clinical states. RESULTS Residual depressive symptomatology and self-appraisal of executive competence were significantly associated with psychosocial functioning in remitted patients, in overall and some subdomains of functioning, particularly cognitive and interpersonal areas. While depressive symptoms, executive deficits and self-appraisal of executive function were significantly related to functional outcomes in non-remitted patients, both in overall functioning and in most of subdomains. DISCUSSION This study evidences the strong association of one's appraisal of executive competence with psychosocial functioning, together with depressive symptoms, both in remitted and non-remitted patients with depression. Therefore, to achieve full recovery, clinical management of patients should tackle not only the relief of core depressive symptoms, but also the cognitive ones, both those that are objectified with neuropsychological tests and those that are reported by the patients themselves.
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Affiliation(s)
- Muriel Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Joan Trujols
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Serra-Blasco
- eHealth ICOnnecta’t Program and Psycho-Oncology Service, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Spain
| | - Guillem Navarra-Ventura
- Institut d’Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears, Palma, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES-ISCIII), Madrid, Spain
| | - Dolors Puigdemont
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Carlo Alemany
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Sara Crivillés
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Javier de Diego-Adeliño
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry and Legal Medicine, Institute of Neuroscience, Universitat Autònoma de Barcelona (UAB)
| | - Maria J. Portella
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Yang H, Gao S, Li J, Yu H, Xu J, Lin C, Yang H, Teng C, Ma H, Zhang N. Remission of symptoms is not equal to functional recovery: Psychosocial functioning impairment in major depression. Front Psychiatry 2022; 13:915689. [PMID: 35958633 PMCID: PMC9360322 DOI: 10.3389/fpsyt.2022.915689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
The ultimate goal of depression treatment is to achieve functional recovery. Psychosocial functioning is the main component of functional impairment in depressed patients. The concept of psychosocial functioning has an early origin; however, its concept and connotation are still ambiguous, which is the basic and key problem faced by the relevant research and clinical application. In this study, we start from the paradox of symptoms remission and functional recovery, describe the concept, connotation, and characteristics of psychosocial functioning impairment in depressed patients, and re-emphasize its importance in depression treatment to promote research and clinical applications related to psychosocial functioning impairment in depressed patients to achieve functional recovery.
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Affiliation(s)
- Hao Yang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shuzhan Gao
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiawei Li
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Haoran Yu
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jingren Xu
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chenchen Lin
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Hua Yang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Changjun Teng
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Ma
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ning Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Smith P, Kandakatla A, Frankel CW, Bacon DR, Bush E, Mentz RJ, Snyder LD. Sleep quality, depressive symptoms, and transplant outcomes: Follow-up analyses from the ADAPT prospective pilot study. Gen Hosp Psychiatry 2021; 72:53-58. [PMID: 34298477 DOI: 10.1016/j.genhosppsych.2021.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 06/14/2021] [Accepted: 06/24/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Previous studies suggested that depressive symptoms and sleep quality may be important for long-term clinical outcomes following cardiothoracic transplant. Few studies, however, have systematically examined objective markers of these behavioral factors among ambulatory transplant recipients, or their association with clinical outcomes. METHODS We examined sleep quality and depressive symptoms with subsequent clinical outcomes (hospitalizations and death) in a sample of 66 lung or heart transplant recipients using a single-center, prospective cohort study. Recipients were assessed at approximately 6 months post-transplant and completed one week of actigraphy assessment to examine sleep quality and self-report measures of mood (Centers for Epidemiologic Studies of Depression [CESD]). Recipients were followed for clinical outcomes. RESULTS At 6-months following transplantation, recipients spent the majority of daytime activity at a sedentary level (61% of daily activity [SD = 10]) and elevated depressive symptoms were common (subclinical = 17%, mild = 12%, or moderate = 8%). Over a median follow-up of 4.5 years (IQR = 0.9, 5.1), 51 participants (77%) had at least one unplanned hospitalization and 11 (17%) participants died. In addition, sleep efficiency measurements suggested that a subset of participants exhibited suboptimal sleep (mean efficiency = 87% [SD = 7]). Poorer sleep quality, indexed by lower sleep efficiency and greater sleep fragmentation, was associated with greater depressive symptoms (r's = 0.37-0.50, P < .01). Better sleep quality at 6-months (HR = 0.75 [0.60, 0.95], P = .015), including sleep efficiency (HR = 0.74 [0.56, 0.99], P = .041) and sleep fragmentation (HR = 0.71 [0.53, 0.95], P = .020) were associated with lower risk of hospitalization or death. Compared with individuals without elevated depressive symptoms or sleep difficulties, individuals with either factor (HR = 1.72 [1.05, 2.81], P = .031) or both factors (HR = 2.37 [1.35, 4.18], P = .003) exhibited greater risk of clinical events in adjusted analyses. CONCLUSIONS Sleep quality is associated with depressive symptoms among cardiothoracic transplant recipients and enhances the prognostic association between biobehavioral risk factors and clinical outcomes.
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Affiliation(s)
- PatrickJ Smith
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, United States of America; Duke University Medical Center, Department of Medicine, Durham, NC, United States of America; Duke Clinical Research Institute, Durham, NC, United States of America.
| | - Apoorva Kandakatla
- Duke University Medical Center, Department of Medicine, Durham, NC, United States of America
| | - Courtney W Frankel
- Duke University Medical Center, Department of Medicine, Durham, NC, United States of America
| | - Daniel R Bacon
- University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, United States of America
| | - Erika Bush
- Duke University Medical Center, Department of Medicine, Durham, NC, United States of America
| | - Robert J Mentz
- Duke University Medical Center, Department of Medicine, Durham, NC, United States of America; Duke Clinical Research Institute, Durham, NC, United States of America
| | - Laurie D Snyder
- Duke University Medical Center, Department of Medicine, Durham, NC, United States of America; Duke Clinical Research Institute, Durham, NC, United States of America
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Köhnen M, Dreier M, Seeralan T, Kriston L, Härter M, Baumeister H, Liebherz S. Evidence on Technology-Based Psychological Interventions in Diagnosed Depression: Systematic Review. JMIR Ment Health 2021; 8:e21700. [PMID: 33565981 PMCID: PMC7904404 DOI: 10.2196/21700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/30/2020] [Accepted: 11/18/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Evidence on technology-based psychological interventions (TBIs) for the treatment of depression is rapidly growing and covers a broad scope of research. Despite extensive research in this field, guideline recommendations are still limited to the general effectiveness of TBIs. OBJECTIVE This study aims to structure evidence on TBIs by considering different application areas (eg, TBIs for acute treatment and their implementation in health care, such as stand-alone interventions) and treatment characteristics (eg, therapeutic rationale of TBIs) to provide a comprehensive evidence base and to identify research gaps in TBIs for diagnosed depression. Moreover, the reporting of negative events in the included studies is investigated in this review to enable subsequent safety assessment of the TBIs. METHODS Randomized controlled trials on adults diagnosed with unipolar depression receiving any kind of psychotherapeutic treatment, which was at least partly delivered by a technical medium, were eligible for inclusion in our preregistered systematic review. We searched for trials in CENTRAL (Cochrane Central Register of Controlled Trials; until August 2020), MEDLINE, PsycINFO, PSYNDEX, CINAHL; until the end of January 2018), clinical trial registers, and sources of gray literature (until the end of January 2019). Study selection and data extraction were conducted by 2 review authors independently. RESULTS Database searches resulted in 15,546 records, of which 241 publications were included, representing 83 completed studies and 60 studies awaiting classification (ie, preregistered studies, study protocols). Almost all completed studies (78/83, 94%) addressed the acute treatment phase, being largely either implemented as stand-alone interventions (66/83, 80%) or blended treatment approaches (12/83, 14%). Studies on TBIs for aftercare (4/83, 5%) and for bridging waiting periods (1/83, 1%) were scarce. Most TBI study arms (n=107) were guided (59/107, 55.1%), delivered via the internet (80/107, 74.8%), and based on cognitive behavioral treatment approaches (88/107, 79.4%). Almost all studies (77/83, 93%) reported information on negative events, considering dropouts from treatment as a negative event. However, reports on negative events were heterogeneous and largely unsystematic. CONCLUSIONS Research has given little attention to studies evaluating TBIs for aftercare and for bridging waiting periods in people with depression, even though TBIs are seen as highly promising in these application areas; thus, high quality studies are urgently needed. In addition, the variety of therapeutic rationales on TBIs has barely been represented by identified studies hindering the consideration of patient preferences when planning treatment. Finally, future studies should use specific guidelines to systematically assess and report negative events. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42016050413; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42016050413. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2018-028042.
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Affiliation(s)
- Moritz Köhnen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mareike Dreier
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tharanya Seeralan
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Baumeister
- Department for Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sarah Liebherz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Reinhold AK, Magaard JL, Brütt AL. Influence of established and subjectively perceived as well as evaluated individual characteristics on the utilization of mental health services among individuals with depressive disorders: protocol of a longitudinal study examining how to supplement the "behavioral model of health services use" and on need-congruent use of mental health services. BMC Psychiatry 2021; 21:68. [PMID: 33530953 PMCID: PMC7851814 DOI: 10.1186/s12888-021-03065-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/21/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Approximately one out of every three people in Germany who meets the diagnostic criteria for major depression has contact with mental health services. Therefore, according to treatment guidelines, two thirds of all individuals with depression are insufficiently treated. In the past, the subjective perspective of people who (do not) make use of mental health services has been neglected. Factors related to the use of health services are described in Andersen's Behavioral Model of Health Services Use (ABM). The aim of this study is to supplement operationalizations of subjectively perceived and evaluated individual characteristics in the ABM and to evaluate whether the supplemented model can better explain mental health services use in individuals with depression than established operationalizations. METHODS A representative telephone study with two measurement points will be conducted. In an explanatory mixed-methods design, qualitative interviews will be added to further interpret the quantitative data. A nationwide sample scoring 5 or more on the Patient Health Questionnaire (PHQ-9) will be recruited and interviewed via telephone at T0 and 12 months later (T1). Data on established and subjective characteristics as well as mental health service use will be collected. At T1, conducting a diagnostic interview (Composite International Diagnostic Interview, DIA-X-12/M-CIDI) enables the recording of 12-month diagnoses according to DSM-IV-TR criteria. Ideally, n = 768 datasets will be available and analyzed descriptively by means of regression analysis. Up to n = 32 persons who use or do not use depression-specific health services incongruent with their objective or subjective needs will be interviewed (face-to-face) to better explain their behavior. In addition, theories of non-need-based mental health service use are developed within the framework of the grounded theory-based analysis of the qualitative interviews. DISCUSSION The study intends to contribute to the theoretical foundation of health services research and to specify the characteristics described in the ABM. Thus, after completion of the study, a further sophisticated and empirically tested model will be available to explain mental health services. The identified modifiable influencing factors are relevant for the development of strategies to increase mental health service use in line with the objective and subjective needs of individuals with depression.
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Affiliation(s)
- Anna Katharina Reinhold
- Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
| | - Julia Louise Magaard
- grid.13648.380000 0001 2180 3484Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Levke Brütt
- grid.5560.60000 0001 1009 3608Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010246. [PMID: 33396262 PMCID: PMC7795912 DOI: 10.3390/ijerph18010246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.
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Köhnen M, Kriston L, Härter M, Baumeister H, Liebherz S. Effectiveness and acceptance of technology-based psychological interventions for the acute treatment of unipolar depression: a systematic review and meta-analysis (Preprint). J Med Internet Res 2020; 23:e24584. [PMID: 36260395 PMCID: PMC8386371 DOI: 10.2196/24584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/08/2021] [Accepted: 04/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background Evidence on technology-based psychological interventions (TBIs) for the acute treatment of depression is rapidly growing. Despite extensive research in this field, there is a lack of research determining effectiveness and acceptance of TBIs considering different application formats in people with a formally diagnosed depressive disorder. Objective The goal of the review was to investigate the effectiveness and acceptance of TBIs in people with diagnosed depression with particular focus on application formats (stand-alone interventions, blended treatments, collaborative and/or stepped care interventions). Methods Studies investigating adults with diagnosed unipolar depressive disorders receiving any kind of psychotherapeutic treatment delivered (at least partly) by a technical medium and conducted as randomized controlled trials (RCTs) were eligible for inclusion. We searched CENTRAL (Cochrane Central Register of Controlled Trials; August 2020), MEDLINE, PsycINFO, PSYNDEX, CINAHL (January 2018), clinical trial registers, and sources of grey literature (January 2019). Two independent authors decided about study inclusion and extracted data. We performed random effects meta-analyses to synthesize the data. Results Database searches resulted in 15,546 records of which 78 completed studies were included. TBIs delivered as stand-alone interventions showed positive effects on posttreatment depression severity when compared to treatment as usual (SMD –0.44, 95% CI –0.73 to –0.15, k=10; I²=86%), attention placebo (SMD –0.51, 95% CI –0.73 to –0.30; k=12; I²=66%), and waitlist controls (SMD –1.01, 95% CI –1.23 to –0.79; k=19; I²=73%). Superior long-term effects on depression severity were shown when TBIs were compared to treatment as usual (SMD –0.24, 95% CI –0.41 to –0.07; k=6; I²=48%) attention placebo (SMD –0.23, 95% CI –0.40 to –0.07; k=7; I²=21%) and waitlist controls (SMD –0.74, 95% CI –1.31 to –0.18; k=3; I²=79%). TBIs delivered as blended treatments (providing a TBI as an add-on to face-to-face treatment) yielded beneficial effects on posttreatment depression severity (SMD –0.27, 95% CI –0.48 to –0.05; k=8; I²=53%) compared to face-to-face treatments only. Additionally, TBIs delivered within collaborative care trials were more effective in reducing posttreatment (SMD –0.20, 95% CI –0.36 to –0.04; k=2; I²=0%) and long-term (SMD –0.23, 95% CI –0.39 to –0.07; k=2; I²=0%) depression severity than usual care. Dropout rates did not differ between the intervention and control groups in any comparison (all P≥.09). Conclusions We found that TBIs are effective not only when delivered as stand-alone interventions but also when they are delivered as blended treatments or in collaborative care trials for people with diagnosed depression. Our results may be useful to inform routine care, since we focused specifically on different application formats, formally diagnosed patients, and the long-term effectiveness of TBIs. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42016050413; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42016050413 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2018-028042
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Affiliation(s)
- Moritz Köhnen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Baumeister
- Department for Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
| | - Sarah Liebherz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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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.
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Petersen KS, Bjørkedal STB, Torsting AM, Eplov LF. Occupational therapy interventions in mental health: a scoping review of recent evidence. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2016.0070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/AimsStudies investigating the effect of occupational therapy in mental health are few. This scoping review aims to identify, present and assess studies that have investigated the effect of occupation- and activity-based/focused interventions performed by occupational therapists in mental health.MethodsThe scoping review involved searching six databases, covering articles from 2003 to 2018. ‘The Matrix Method’ was used to describe and synthesise the content of the included studies. The Oxford Level of Evidence was used to rank the evidence, and The Critical Appraisal Skills Programme was used to assess the quality of the study.ResultsA total of 21 original studies and 4 systematic reviews were included in this review. Interventions, approaches, programmes, training, and activities such as cooking, artwork, crafts, pottery, sports, calligraphy, horticulture, and music, organised individually or in groups, were investigated in the included studies. Individualised occupational therapy showed clinically significant improvements in social functioning and cognition, promising results were found on supported employment and education.ConclusionsFew high-quality studies that have investigated the effect of occupation-and activity-based/focused interventions performed by occupational therapists in mental health were found. This scoping review highlights the importance of future high quality studies to support evidence-based practice within mental health occupational therapy.
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Affiliation(s)
- Kirsten Schultz Petersen
- Associate Professor, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Siv Therese Bogevik Bjørkedal
- Assistant Researcher, Program for Research in Rehabilitation, Recovery and Shared Care, Mental Health Center Copenhagen, Hellerup, Denmark
| | - Anne Marie Torsting
- Head of Occupational Therapy, Mental Health Center Sct. Hans, Roskilde, Denmark
| | - Lene Falgaard Eplov
- Senior Consultant, Program for Research in Rehabilitation, Recovery and Shared Care, Mental Health Center Copenhagen, Hellerup, Denmark
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Au NH, Mather R, To A, Malvankar-Mehta MS. Sleep outcomes associated with dry eye disease: a systematic review and meta-analysis. Can J Ophthalmol 2019; 54:180-189. [DOI: 10.1016/j.jcjo.2018.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/16/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022]
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Köhnen M, Kriston L, Härter M, Dirmaier J, Liebherz S. Rationale and design of a systematic review: effectiveness and acceptance of technology-based psychological interventions in different clinical phases of depression management. BMJ Open 2019; 9:e028042. [PMID: 30918040 PMCID: PMC6475157 DOI: 10.1136/bmjopen-2018-028042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/20/2018] [Accepted: 01/22/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Although many effective treatment options exist, depression is still undertreated indicating gaps in the healthcare system. The complementary provision of mental healthcare through technologies (eg, computer, smartphone) has the potential to fill treatment gaps and to overcome access barriers to mental healthcare. Until now, no systematic review integrates the evidence on different technology-based psychological interventions (TBIs) concerning their effectiveness and acceptance in different clinical phases of depression management (bridging waiting periods, acute treatment and aftercare). The aim of this project is to structure evidence on TBIs regarding different phases of depression management, and to determine effectiveness and acceptance for each clinical phase considering both active (eg, face-to-face treatment) and inactive (eg, waitlist) controls as comparators. METHODS AND ANALYSIS We will include studies on adults with a formal diagnosis of unipolar depression. Treatments delivered by technologies based on scientific psychological theories will be considered as experimental interventions. The primary effectiveness outcome will be depressive symptoms at study endpoint measured by symptom severity rating scales, and the primary acceptance outcome will be dropping out of the study due to any reason. We will consider only randomised controlled trials, which will be identified by key database searches (including Cochrane Central Register of Controlled Trials, Medline, PsycINFO, PSYNDEX, CINAHL) complemented through searches in clinical trial registries (eg, clinicaltrials.gov) and grey literature searches (eg, Open Grey). Two review authors will independently conduct study selection, data extraction and quality assessment of included studies (using the Cochrane Collaboration's tool for assessing risk of bias). Meta-analyses applying random-effect models as well as subgroup, meta-regression and sensitivity analyses will be performed. ETHICS AND DISSEMINATION Ethics approval is not required for this study, as we conduct research on secondary data. We will disseminate results via peer-reviewed journal publications, presentations on conferences and via plain language summaries. PROSPERO REGISTRATION NUMBER CRD42016050413; Pre-results.
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Affiliation(s)
- Moritz Köhnen
- Departement of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Departement of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Departement of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Dirmaier
- Departement of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Liebherz
- Departement of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Perlick DA, Jackson C, Grier S, Huntington B, Aronson A, Luo X, Miklowitz DJ. Randomized trial comparing caregiver-only family-focused treatment to standard health education on the 6-month outcome of bipolar disorder. Bipolar Disord 2018. [PMID: 29528180 DOI: 10.1111/bdi.12621] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Caregivers of people with bipolar disorder often have depression and health problems. This study aimed to evaluate the sustained effects of a 12-15 week psychoeducational intervention on the health and mental health of caregivers of persons with bipolar disorder. We also evaluated the effects of the intervention on patients' mood symptoms over 6 months post-treatment. METHODS Caregivers of 46 persons with bipolar disorder were randomized to 12-15 weeks of a caregiver-only adaptation of family-focused treatment (FFT), in which caregivers were instructed on self-care strategies and ways to assist the patient in managing the illness, or to 8-12 sessions of standard health education. Independent evaluators assessed caregivers' depression and physical health and patients' mood symptoms before treatment, immediately after the treatment, and at 6 months post-treatment. RESULTS Randomization to FFT was associated with greater decreases in depression for both caregivers and patients over a 6-month follow-up period post-treatment. Reductions in patients' depression scores over 6 months post-treatment were mediated by reductions in caregivers' depression scores (z = -2.74, P < .01). CONCLUSIONS Interventions that are effective in reducing mood symptoms and improving health behavior in caregivers may have important health and mental health benefits for patients with bipolar disorder. Specifically, a treatment focused on caregiver education about bipolar disorder and the need for the caregiver to attend to his/her own health and mental health can benefit patients, even without their direct participation.
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Affiliation(s)
- Deborah A Perlick
- JJ Peters, Department of Veterans Affairs Medical Center and VISN 2, South Mental Illness Research, Education and Clinical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carlos Jackson
- JJ Peters, Department of Veterans Affairs Medical Center and VISN 2, South Mental Illness Research, Education and Clinical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Savannah Grier
- JJ Peters, Department of Veterans Affairs Medical Center and VISN 2, South Mental Illness Research, Education and Clinical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brittney Huntington
- JJ Peters, Department of Veterans Affairs Medical Center and VISN 2, South Mental Illness Research, Education and Clinical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Aronson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaodong Luo
- JJ Peters, Department of Veterans Affairs Medical Center and VISN 2, South Mental Illness Research, Education and Clinical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David J Miklowitz
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Meade T, Manolios N, Cumming SR, Conaghan PG, Katz P. Cognitive Impairment in Rheumatoid Arthritis: A Systematic Review. Arthritis Care Res (Hoboken) 2017; 70:39-52. [DOI: 10.1002/acr.23243] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/21/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Tanya Meade
- Western Sydney University and University of Sydney; Sydney New South Wales Australia
| | | | | | - Philip G. Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine; University of Leeds, and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit; Leeds UK
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Magaard JL, Seeralan T, Schulz H, Brütt AL. Factors associated with help-seeking behaviour among individuals with major depression: A systematic review. PLoS One 2017; 12:e0176730. [PMID: 28493904 PMCID: PMC5426609 DOI: 10.1371/journal.pone.0176730] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/14/2017] [Indexed: 11/01/2022] Open
Abstract
Psychological models can help to understand why many people suffering from major depression do not seek help. Using the 'Behavioral Model of Health Services Use', this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Observational studies investigating the associations between individual or contextual characteristics and professional help-seeking behaviour for emotional problems in adults formally diagnosed with major depression were included. The quality of the included studies was assessed, and factors associated with help-seeking behaviour were qualitatively synthesized. In total, 40 studies based on 26 datasets were included. Several studies investigated predisposing (age (N = 17), gender (N = 16), ethnicity (N = 9), education (N = 11), marital status (N = 12)), enabling (income (N = 12)), need (severity (N = 14), duration (N = 9), number of depressive episodes (N = 6), psychiatric comorbidity (N = 10)) and contextual factors (area (N = 8)). Socio-demographic and need factors appeared to influence help-seeking behaviour. Although existing studies provide insight into the characteristics associated with help seeking for major depression, cohort studies and research on beliefs about, barriers to and perceived need for treatment are lacking. Based on this review, interventions to increase help-seeking behaviour can be designed.
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Affiliation(s)
- Julia Luise Magaard
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Tharanya Seeralan
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Levke Brütt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Health Services Research, Carl von Ossietzky University, Oldenburg, Germany
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Blier P, Gommoll C, Chen C, Kramer K. Effects of levomilnacipran ER on noradrenergic symptoms, anxiety symptoms, and functional impairment in adults with major depressive disorder: Post hoc analysis of 5 clinical trials. J Affect Disord 2017; 210:273-279. [PMID: 28068615 DOI: 10.1016/j.jad.2016.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/05/2016] [Accepted: 11/06/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the effects of levomilnacipran extended-release (LVM-ER; 40-120mg/day) on noradrenergic (NA) and anxiety-related symptoms in adults with major depressive disorder (MDD) and explore the relationship between these symptoms and functional impairment. METHODS Data were pooled from 5 randomized, double-blind, placebo-controlled trials (N=2598). Anxiety and NA Cluster scores were developed by adding selected item scores from the Montgomery-Åsberg Depression Rating Scale (MADRS) and 17-item Hamilton Depression Rating Scale (HAMD17). A path analysis was conducted to estimate the direct effects of LVM-ER on functional impairment (Sheehan Disability Scale [SDS] total score) and the indirect effects through changes in NA and Anxiety Cluster scores. RESULTS Mean improvements from baseline in NA and Anxiety Cluster scores were significantly greater with LVM-ER versus placebo (both P<0.001), as were the response rates (≥50% score improvement): NA Cluster (44% vs 34%; odds ratio=1.56; P<0.0001); Anxiety Cluster (39% vs 36%; odds ratio=1.19; P=0.041). Mean improvement in SDS total score was also significantly greater with LVM-ER versus placebo (-7.3 vs -5.6; P<0.0001). LVM-ER had an indirect effect on change in SDS total score that was mediated more strongly through NA Cluster score change (86%) than Anxiety Cluster score change (18%); the direct effect was negligible. LIMITATIONS NA and Anxiety Cluster scores, developed based on the face validity of individual MADRS and HAMD17 items, were not predefined as efficacy outcomes in any of the studies. CONCLUSION In adults with MDD, LVM-ER indirectly improved functional impairment mainly through improvements in NA symptoms and less so via anxiety symptoms.
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Affiliation(s)
- Pierre Blier
- Department of Psychiatry, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.
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Jha MK, Minhajuddin A, Greer TL, Carmody T, Rush AJ, Trivedi MH. Early Improvement in Psychosocial Function Predicts Longer-Term Symptomatic Remission in Depressed Patients. PLoS One 2016; 11:e0167901. [PMID: 28030546 PMCID: PMC5193346 DOI: 10.1371/journal.pone.0167901] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022] Open
Abstract
The goal of this study was to evaluate the relationship between early change in psychosocial function independent of depression severity and longer-term symptomatic remission. Participants of Combining Medications to Enhance Depression Outcomes trial were randomly selected for model selection (n = 334) and validation (n = 331). Changes in psychosocial function (Work and Social Adjustment Scale, WSAS) from baseline to week 6 were assessed and two data-driven sub-groups of WSAS change were identified in the randomly selected model selection half. Results of analyses to predict symptomatic remission at 3 and 7 months were validated for these sub-groups in the second half (validation sample). From baseline to week 6, psychosocial function improved significantly even after adjusting for depression severity at each visit and select baseline variables (age, gender, race, ethnicity, education, income, employment, depression onset before age 18, anxious features, and suicidal ideation), treatment-arm, and WSAS score. The WSAS change patterns identified two (early improvement and gradual change) subgroups. After adjusting for baseline variables and remission status at week 6, participants with early improvement in the second half (validation sample) had greater remission rates than those with gradual change at both 3 (3.3 times) and 7 months (2.3 times) following acute treatment initiation. In conclusion, early improvement in psychosocial function provides a clinically meaningful prediction of longer-term symptomatic remission, independent of depression symptom severity.
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Affiliation(s)
- Manish K. Jha
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Abu Minhajuddin
- Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Tracy L. Greer
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Thomas Carmody
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Augustus John Rush
- Department of Psychiatry and Behavioral Sciences, Duke-National University of Singapore, Singapore
| | - Madhukar H. Trivedi
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, United States of America
- * E-mail:
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Functioning in patients with schizophrenia: a systematic review of the literature using the International Classification of Functioning, Disability and Health (ICF) as a reference. Qual Life Res 2016; 26:531-543. [PMID: 28025717 DOI: 10.1007/s11136-016-1488-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE To identify and quantify the main concepts included in published studies focusing on individuals with schizophrenia using the International Classification of Functioning, Disability and Health (ICF). METHODS Searches (limited to those published from 2008 to 2012) were performed in MEDLINE, PsycINFO and CINAHL. Included studies described participants with schizophrenia, were original articles and included only subjects who were at least 18 years of age at study entry. All concepts underlying the measures and the text of the articles were extracted, and they were linked to ICF categories using standardized rules. RESULTS From the 3584 abstracts retrieved, 348 were randomly selected, and of these, 206 studies met the inclusion criteria. A total of 17,141 concepts were extracted, 84.8% of which could be linked to 491 ICF categories: 222 (45.21%) of the categories referred to Body Functions, 29 (5.91%) to Body Structures, 186 (37.88%) to Activities and Participation and 54 (11%) to Environmental Factors. Seventy second-level categories were reported in at least 5% of all studies: 30 of these categories referred to Body Functions, 2 to Body Structures, 34 to Activities and Participation and 4 to Environmental Factors. CONCLUSION The study has allowed us to identify and quantify the main concepts included in studies focusing on people with schizophrenia using the ICF. The majority of the concepts refer to Body Functions and Activities and Participation, rather than to Body Structures and Environmental Factors.
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Quintas R, Cerniauskaite M, Giovannetti AM, Schiavolin S, Raggi A, Covelli V, Villani F, Didato G, Deleo F, Franceschetti S, Binelli S, Canafoglia L, Casazza M, Leonardi M. PARADISE 24 instrument: An observational study on psychosocial difficulties, quality of life, and disability levels in patients with epilepsy. Epilepsy Behav 2016; 64:160-165. [PMID: 27743548 DOI: 10.1016/j.yebeh.2016.08.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/16/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of this observational study was to test the effectiveness of the PARADISE 24 instrument in describing the psychosocial difficulties (PSDs) reported by people with epilepsy, their relation with disability, and quality-of-life (QoL) levels and, overall, to explore a horizontal epidemiology methodology applied to a sample of patients with epilepsy. METHODS A convenience sample of 80 adult patients with epilepsy was included in this cross-sectional study. Patients were interviewed using a structured protocol composed of demographic, clinical, and patient-reported outcome measures to collect PSDs associated with epilepsy. RESULTS There were 80 patients, 40 females; mean age was 41.2years; mean disease duration was 18.7years; and mean number of AED was 2.09. Moderate severity rating according to clinicians' rating scale, low impact of comorbidities (mean: 2.36, SD: 2.97), high levels of QoL (mean: 30.00, SD: 4.4), medium levels of resilience (mean: 13.56, SD: 2.66), high levels of perceived empathy (mean: 15.05, SD: 4.74), poor or moderate perceived social support, and low levels of disability (mean: 10.85, SD: 10.05) were observed. The most frequently reported PSDs were related to tiredness (80%), emotional problems (73.75%), anxiety (68.75%), depressive mood (66.25%), and driving problems (61.25%). The EUROHIS-QOL (p=.003) had a negative significant relationship with PARADISE 24 while WHODAS-12 (p=.000) and CRS (p=.027) had a positive significant relationship with PARADISE 24. CONCLUSIONS The PARADISE 24 permits data comparison and the creation of a complete description of a person's functioning and of all of his/her PSDs and allows better and more tailored interventions.
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Affiliation(s)
- Rui Quintas
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy.
| | - Milda Cerniauskaite
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Neurosurgery Department, Radiotherapy Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Ambra Mara Giovannetti
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Department of Neuroimmunology and Neuromuscular Diseases, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Silvia Schiavolin
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Venusia Covelli
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; e-Campus University, Novedrate, Como, Italy
| | - Flavio Villani
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Giuseppe Didato
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Francesco Deleo
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Silvana Franceschetti
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Simona Binelli
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Laura Canafoglia
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Marina Casazza
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Ageing of people with Down's syndrome: a systematic literature review from 2000 to 2014. Int J Rehabil Res 2016; 39:20-8. [PMID: 26626417 DOI: 10.1097/mrr.0000000000000147] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Life expectancy of people with Down's syndrome (DS) has increased considerably, now exceeding 60 years. People with DS start to get old around the age of 45. By referring to the WHO's International Classification of Functioning, Disability and Health (ICF) biopsychosocial perspective, this study aimed to present an up-to-date review of the past 14 years of literature concerning the ageing of people with DS. PUBMED, PsycInfo and the Social Sciences Citation Index were searched for studies published between 2000 and 2014. Studies were selected if they were written in English, focused on people more than 45 years of age with DS, and if terms related to DS and ageing appeared in either the title or the abstract. A total of 30 studies were retrieved and their meaningful concepts were linked to the ICF. In total, 38 ICF categories were identified that were mainly related to intellectual functions (b117) (19%), general metabolic functions (b540) (7.4%), mobility of joint functions (b710), muscle power functions (b730) (4.2%), gait pattern functions (b770) (4.2%) and structure of the brain (s110) (4.3%). Only two studies considered environmental factors, and only one considered the joint analysis of health condition and environmental factors. Data about the ageing of people with DS are predominantly based on medical evaluations and descriptions of their physical impairments. Few attempts have been made towards a comprehensive assessment of elderly people with DS with a joint analysis of their health condition and its interaction with environmental factors.
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Kawashima M, Uchino M, Yokoi N, Uchino Y, Dogru M, Komuro A, Sonomura Y, Kato H, Kinoshita S, Tsubota K. The association of sleep quality with dry eye disease: the Osaka study. Clin Ophthalmol 2016; 10:1015-21. [PMID: 27330271 PMCID: PMC4898440 DOI: 10.2147/opth.s99620] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the association of dry eye disease with sleep quality. METHODS In 2011, a cross-sectional survey was conducted among all the employees, mainly young and middle-aged Japanese office workers, who used visual display technology, at a company in Osaka, Japan (N=672; age range =26-64 years). The participants were classified according to the Japanese dry eye diagnosis criteria by dry eye examination results including the Schirmer test, fluorescein and lissamine green staining, tear film break-up time, and symptom questionnaire into three groups as follows: definite dry eye disease, probable dry eye disease, and no dry eye disease. To determine sleep quality, Japanese version of the Pittsburgh Sleep Quality Index (global score) was implemented. The global score (range =0-21) was calculated by summing seven sleep variable scores (scale, 0-3); scores ≥5.5 indicated poor sleep. RESULTS The total mean global score was 5.1±2.3 (completed N=383); 45% of the dry eye disease participants reported having poor sleep quality, while 34% of the no dry eye disease participants did so, with a significant difference found in the global score (P=0.002). Furthermore, a statistically significant association was observed between the global score and dry eye disease (P=0.005). CONCLUSION Poor sleep quality is associated with dry eye disease, especially with dry eye symptoms.
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Affiliation(s)
- Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Ryogoku Eye Clinic, Sumida-ku, Tokyo, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuichi Uchino
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Ryogoku Eye Clinic, Sumida-ku, Tokyo, Japan
| | - Murat Dogru
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Aoi Komuro
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yukiko Sonomura
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Kato
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeru Kinoshita
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Scaratti C, Leonardi M, Sattin D, Schiavolin S, Willems M, Raggi A. Work-related difficulties in patients with traumatic brain injury: a systematic review on predictors and associated factors. Disabil Rehabil 2016; 39:847-855. [DOI: 10.3109/09638288.2016.1162854] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Chiara Scaratti
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Davide Sattin
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Silvia Schiavolin
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Michelle Willems
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
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Perlick DA, Berk L, Kaczynski R, Gonzalez J, Link B, Dixon L, Grier S, Miklowitz DJ. Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder. Bipolar Disord 2016; 18:183-91. [PMID: 27004622 DOI: 10.1111/bdi.12379] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 11/18/2015] [Accepted: 01/12/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Over one-third of caregivers of people with bipolar disorder report clinically significant levels of depressive symptoms. This study examined the causal relationship between depression and caregiver burden in a large sample of caregivers of adult patients with bipolar disorder. METHODS Participants were 500 primary caregivers of persons with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).This study evaluates the strength and direction of the associations between caregiver burden and depressive symptoms at baseline and at six- and 12-month follow-up using cross-lagged panel analyses, controlling for the clinical status of patients and sociodemographic variables. RESULTS Higher levels of overall caregiver burden at baseline were associated with increased levels of depressive symptoms among caregivers at follow-up (F = 8.70, df = 1,290, p < 0.001), after controlling for baseline caregiver depression, gender, race, age, social support, and patients' clinical status. By contrast, caregiver depression at baseline was not significantly associated with caregiver burden at follow-up (F = 1.65, p = 0.20). CONCLUSIONS Caregiver burden is a stronger predictor of caregiver depressive symptoms over time than the reverse. Interventions that help alleviate caregiver burden may decrease depressive symptoms.
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Affiliation(s)
- Deborah A Perlick
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Lesley Berk
- Mental Health and Wellbeing Research Centre, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Richard Kaczynski
- Veterans Affairs New England Mental Illness Research, Education and Clinical Center, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jodi Gonzalez
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Bruce Link
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa Dixon
- Department of Psychiatry, Columbia University, New York, NY, USA.,Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA
| | - Savannah Grier
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - David J Miklowitz
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Sabariego C, Coenen M, Ballert C, Cabello M, Leonardi M, Anczewska M, Pitkänen T, Raggi A, Mellor B, Covelli V, Świtaj P, Levola J, Schiavolin S, Chrostek A, Bickenbach J, Chatterji S, Cieza A. Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a 'Horizontal Epidemiology' Approach. PLoS One 2015; 10:e0141322. [PMID: 26675663 PMCID: PMC4682947 DOI: 10.1371/journal.pone.0141322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/07/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Persons with brain disorders experience significant psychosocial difficulties (PSD) in daily life, e.g. problems with managing daily routine or emotional lability, and the level of the PSD depends on social, physical and political environments, and psychologic-personal determinants. Our objective is to determine a brief set of environmental and psychologic-personal factors that are shared determinants of PSD among persons with different brain disorders. METHODS Cross-sectional study, convenience sample of persons with either dementia, stroke, multiple sclerosis, epilepsy, migraine, depression, schizophrenia, substance dependence or Parkinson's disease. Random forest regression and classical linear regression were used in the analyses. RESULTS 722 subjects were interviewed in four European countries. The brief set of determinants encompasses presence of comorbidities, health status appraisal, stressful life events, personality changes, adaptation, self-esteem, self-worth, built environment, weather, and health problems in the family. CONCLUSIONS The identified brief set of common determinants of PSD can be used to support the implementation of cross-cutting interventions, social actions and policy tools to lower PSD experienced by persons with brain disorders. This set complements a recently proposed reliable and valid direct metric of PSD for brain disorders called PARADISE24.
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Affiliation(s)
- Carla Sabariego
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
- * E-mail:
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | | | - Maria Cabello
- Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | - Marta Anczewska
- Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | - Blanca Mellor
- Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Venusia Covelli
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | - Piotr Świtaj
- Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Jonna Levola
- A-Clinic Foundation, Helsinki, Finland
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Silvia Schiavolin
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
- Division of Neurosurgery II, Neurological Institute Carlos Besta (IRCCS) Foundation, Milan, Italy
| | - Anna Chrostek
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta (IRCCS) Foundation, Milan, Italy
| | | | - Somnath Chatterji
- Department of Measurement and Health Information Systems, Multi-Country Studies, World Health Organization, Geneva, Switzerland
| | - Alarcos Cieza
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, United Kingdom
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24
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Association Between Prenatal Exposure to Maternal Infection and Offspring Mood Disorders: A Review of the Literature. Curr Probl Pediatr Adolesc Health Care 2015; 45:325-64. [PMID: 26476880 DOI: 10.1016/j.cppeds.2015.06.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 06/14/2015] [Indexed: 01/19/2023]
Abstract
The purpose of this article is to provide a systematic review of studies that have examined the association between prenatal exposure to maternal infection and development of mood disorders across the life course. Drawing from both human- and animal-based studies, we give an overview of hypothesized biological mechanisms by which exposure to maternal infection during critical periods of gestation may contribute to fetal programming of mood disorders in offspring. We discuss studies examining the association between prenatal exposure to maternal infection with pathogens including influenza as well as other respiratory viruses, herpesviruses, hepatitis viruses, and Toxoplasma gondii and mood disorders in human populations. Moreover, we outline strengths and limitations of the current body of evidence and make recommendations for future research. We also discuss findings in the context of well-documented gender and socioeconomic disparities in the prevalence and severity of mood disorders, particularly major depression, and the role that early exposure to infection may play in explaining the perpetuation of such disparities across generations. Overall, this review of the current knowledge on this topic has important implications for determining future research directions, designing interventions as well as prenatal care guidelines targeted at prevention or treatment of infection during pregnancy, and clinical practice for the identification of individuals that may be at increased risk for mood disorders beginning early in life. Importantly, such efforts may not only lower the overall burden of mood disorders but also serve to address social disparities in these adverse mental health conditions in the U.S.
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Cieza A, Anczewska M, Ayuso-Mateos JL, Baker M, Bickenbach J, Chatterji S, Hartley S, Leonardi M, Pitkänen T. Understanding the Impact of Brain Disorders: Towards a 'Horizontal Epidemiology' of Psychosocial Difficulties and Their Determinants. PLoS One 2015; 10:e0136271. [PMID: 26352911 PMCID: PMC4564202 DOI: 10.1371/journal.pone.0136271] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 08/02/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To test the hypothesis of ‘horizontal epidemiology’, i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders. Study Design A multi-method study involving systematic literature reviews, content analysis of patient-reported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson’s disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectional study including a convenience sample of persons with one of the nine brain disorders. PSDs endorsed by at least 25% of patients with a brain disorder were considered associated with the disorder. PSD were considered common across disorders if associated to 5 out of the 9 brain disorders and if among the 5 both neurological and psychiatric conditions were represented. Setting The data collection protocol with 64 PSDs and 20 determinants was used to collect data from a convenience sample of 722 persons in four specialized health care facilities in Europe. Results 57 of the PSDs and 16 of the determinants included in the protocol were found to be experienced across brain disorders. Conclusion This is the first evidence that supports the hypothesis of horizontal epidemiology in brain disorders. This result challenges the brain disorder-specific or vertical approach in which clinical and epidemiological research about psychosocial difficulties experienced in daily life is commonly carried in neurology and psychiatry and the way in which the corresponding health care delivery is practiced in many countries of the world.
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Affiliation(s)
- Alarcos Cieza
- Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, United Kingdom
- Department of Medical Informatics, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU), Munich, Germany
- Swiss Paraplegic Research, Nottwil, Switzerland
- * E-mail:
| | - Marta Anczewska
- Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Jose Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Department of Psychiatry, Universidad Autónoma de Madrid, Psychiatry Service, Instituto de Investigación del Hospital Universitario de La Princesa (IIS-IP), Madrid, Spain
| | - Mary Baker
- European Brain Council, Brussels, Belgium
| | | | - Somnath Chatterji
- Multi-Country Studies, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland
| | - Sally Hartley
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
- The London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
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Raggi A, Covelli V, Schiavolin S, Scaratti C, Leonardi M, Willems M. Work-related problems in multiple sclerosis: a literature review on its associates and determinants. Disabil Rehabil 2015. [DOI: 10.3109/09638288.2015.1070295] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Schneider M, Baron E, Davies T, Bass J, Lund C. Making assessment locally relevant: measuring functioning for maternal depression in Khayelitsha, Cape Town. Soc Psychiatry Psychiatr Epidemiol 2015; 50:797-806. [PMID: 25567235 PMCID: PMC4461654 DOI: 10.1007/s00127-014-1003-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 12/22/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE We developed a locally relevant functioning assessment instrument (FAI) for pregnant women and mothers of young babies to complement a widely validated instrument-the World Health Organization's Disability Assessment Schedule (WHODAS) 12-item version. The FAI is an outcome measure in a randomised controlled trial on the effectiveness of a lay counsellor administered intervention for distressed pregnant women in Khayelitsha, Cape Town. METHODS Nine items most commonly reported by 40 pregnant women or mothers with young babies in qualitative interviews were selected for the instrument, with a 10th item 'Other'. The FAI was validated with 142 pregnant women and mothers in Khayelitsha. Analysis was conducted to assess internal reliability, exploratory factor analysis and convergent validity. RESULTS The FAI had good internal reliability (Cronbach's alpha = 0.77) and the explanatory factor analysis showed a clear 3-factor solution, relating to domestic, childcare and social activities. The FAI scores showed floor effects, but were positively correlated with the two measures of functioning (WHODAS 2.0 and Washington Group Short Set). The FAI scores also correlated with the measure of depression (Edinburgh Postnatal Depression Scale-EPDS), reflecting increased functional limitations associated with increased depressive symptoms. CONCLUSION The results show that the FAI has good internal reliability, and good convergent and construct validity as a measure of functioning for this context. This paper reports on the process of developing an instrument and highlights the importance of using instruments that are locally relevant to ensure accurate measurement of functional status.
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Affiliation(s)
- Marguerite Schneider
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, 46 Sawkins Rd, Rondebosch, Cape Town, 7700, South Africa,
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Chien WT, Lam CKK, Ng BFL. Predictors of levels of functioning among Chinese people with severe mental illness: a 12-month prospective cohort study. J Clin Nurs 2015; 24:1860-73. [DOI: 10.1111/jocn.12843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Wai-Tong Chien
- School of Nursing; Faculty of Health & Social Sciences; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong SAR, China
| | - Claire K K Lam
- School of Nursing; Faculty of Health & Social Sciences; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong SAR, China
| | - Bacon F L Ng
- Chinese Medicine Department; Hospital Authority Hong Kong; Lok Fu Hong Kong SAR, China
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Levola J, Aalto M, Holopainen A, Cieza A, Pitkänen T. Health-related quality of life in alcohol dependence: a systematic literature review with a specific focus on the role of depression and other psychopathology. Nord J Psychiatry 2014; 68:369-84. [PMID: 24228776 DOI: 10.3109/08039488.2013.852242] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is considered a valid measure of treatment effectiveness in addictions. However, alcohol research has lagged behind other biomedical fields in using HRQOL outcomes as primary or secondary endpoints. Previous work has suggested that psychiatric co-morbidity may mediate the relationship between alcohol dependence and HRQOL. AIM The goal was to summarize the literature on HRQOL and its domains in the context of alcohol dependence. A specific focus was on the impact of depression and other psychopathology on these areas of life. MATERIALS AND METHODS A database search of MEDLINE and PsychINFO was performed within the scope of PARADISE (Psychosocial fActors Relevant to brAin DISorders in Europe); a European Commission funded coordination action. Using pre-defined eligibility criteria, 42 studies were identified. A systematic approach to data collection was employed. RESULTS AND CONCLUSIONS Alcohol dependence was shown to affect overall HRQOL and its domains, including general health, physical and mental health, general and social functioning, activities of daily living, pain and sleep. The evidence demonstrating that alcohol dependence is a primary cause of impairments in overall HRQOL, general health, mental and physical health and social functioning was fairly strong. Treatment interventions helped improve HRQOL and its aforementioned domains. The reduction or cessation of alcohol use facilitated these improvements; however, it was not reported to be predictive of improvement in all instances where improvement was reported. Depression was associated with further decreases in HRQOL. Personality disorders contributed to the severity of social functioning impairment.
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Affiliation(s)
- Jonna Levola
- Jonna Levola, A-clinic Foundation, Research Unit ; Helsinki , Finland , and National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services ; Helsinki , Finland
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Analysing psychosocial difficulties in depression: a content comparison between systematic literature review and patient perspective. BIOMED RESEARCH INTERNATIONAL 2014; 2014:319634. [PMID: 25009814 PMCID: PMC4070279 DOI: 10.1155/2014/319634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/06/2014] [Accepted: 05/27/2014] [Indexed: 11/17/2022]
Abstract
Despite all the knowledge on depression, it is still unclear whether current literature covers all the psychosocial difficulties (PSDs) important for depressed patients. The aim of the present study was to identify the gaps in the recent literature concerning PSDs and their related variables. Psychosocial difficulties were defined according to the World Health Organization International Classification of Functioning, Disability and Health (ICF). A comparative approach between a systematic literature review, a focus group, and individual interviews with depressed patients was used. Literature reported the main psychosocial difficulties almost fully, but not in the same degree of importance as patients' reports. Furthermore, the covered areas were very general and related to symptomatology. Regarding the related variables, literature focused on clinical variables and treatments above all but did not report that many psychosocial difficulties influence other PSDs. This study identified many existing research gaps in recent literature mainly in the area of related variables of PSDs. Future steps in this direction are needed. Moreover, we suggest that clinicians select interventions covering not only symptoms, but also PSDs and their modifiable related variables. Furthermore, identification of interventions for particular psychosocial difficulties and personalisation of therapies according to individuals' PSDs are necessary.
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Brütt AL, Schulz H, Andreas S. Psychometric properties of an instrument to measure activities and participation according to the ICF concept in patients with mental disorders. Disabil Rehabil 2014; 37:259-67. [PMID: 24833419 DOI: 10.3109/09638288.2014.918189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE The International Classification of Functioning, Disability and Health (ICF) conceptualizes the bio-psycho-social model of health and illness, but cannot be used as an assessment instrument in routine care. The objective of this study was to psychometrically test a self-report instrument for measuring activities and social participation (ICF-Mental-A&P) of psychotherapy patients. METHODS For the psychometric evaluation of the ICF-Mental-A&P, participants completed a questionnaire on symptoms, interpersonal problems and quality of life at admission and at discharge of in-patient treatment. A consecutive sample of 2256 patients diagnosed with at least one mental disorder was recruited from eight in-patient units in Germany. RESULTS After item selection, the ICF-Mental-A&P contained 31 items comprising six subscales examined by confirmatory factor analysis. Subscales had acceptable internal consistency (α = 0.78-0.90) and test-retest correlations (r = 0.71-0.86). There were several expected correlations (r ≥ 0.6) between ICF-Mental-A&P scores and measures of symptoms and interpersonal problems. CONCLUSIONS Findings suggest that the ICF-Mental-A&P is a comprehensive, reliable measure of activities and participation according to the ICF concept for patients with mental disorders. It may therefore be an important instrument in clinical practice and could help to determine and evaluate functioning-related and patient-focused treatment outcomes.
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Affiliation(s)
- Anna Levke Brütt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany and
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Hartley S, McArthur M, Coenen M, Cabello M, Covelli V, Roszczynska-Michta J, Pitkänen T, Bickenbach J, Cieza A. Narratives reflecting the lived experiences of people with brain disorders: common psychosocial difficulties and determinants. PLoS One 2014; 9:e96890. [PMID: 24805128 PMCID: PMC4013080 DOI: 10.1371/journal.pone.0096890] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 04/13/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND People with brain disorders - defined as both, mental disorders and neurological disorders experience a wide range of psychosocial difficulties (PSDs) (e.g., concentrating, maintaining energy levels, and maintaining relationships). Research evidence is required to show that these PSDs are common across brain disorders. OBJECTIVES To explore and gain deeper understanding of the experiences of people with seven brain disorders (alcohol dependency, depression, epilepsy, multiple sclerosis, Parkinson's disease, schizophrenia, stroke). It examines the common PSDs and their influencing factors. METHODS Seventy seven qualitative studies identified in a systematic literature review and qualitative data derived from six focus groups are used to generate first-person narratives representing seven brain disorders. A theory-driven thematic analysis of these narratives identifies the PSDs and their influencing factors for comparison between the seven disorders. RESULTS First-person narratives illustrate realities for people with brain disorders facilitating a deeper understanding of their every-day life experiences. Thematic analysis serves to highlight the commonalities, both of PSDs, such as loneliness, anger, uncertainty about the future and problems with work activities, and their determinants, such as work opportunities, trusting relationships and access to self-help groups. CONCLUSIONS The strength of the methodology and the narratives is that they provide the opportunity for the reader to empathise with people with brain disorders and facilitate deeper levels of understanding of the complexity of the relationship of PSDs, determinants and facilitators. The latter reflect positive aspects of the lives of people with brain disorders. The result that many PSDs and their influencing factors are common to people with different brain disorders opens up the door to the possibility of using cross-cutting interventions involving different sectors. This strengthens the message that 'a great deal can be done' to improve the lived experience of persons with brain disorders when medical interventions are exhausted.
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Affiliation(s)
- Sally Hartley
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
- The London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maggie McArthur
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Michaela Coenen
- Department of Medical Informatics, Biometry and Epidemiology – IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Maria Cabello
- Instituto de Salud Carlos lll CIBERSAM, Faculty of Medicine, Universidad Autonoma de Madrid, Instituto de investigacion de la Princesa (IIS-IP), Madrid, Spain
| | - Venusia Covelli
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | | | - Tuuli Pitkänen
- A-Clinic Foundation (A-klinikkasäätiö), Helsinki, Finland
| | | | - Alarcos Cieza
- Department of Medical Informatics, Biometry and Epidemiology – IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU), Munich, Germany
- Swiss Paraplegic Research (SPR), Nottwil, Switzerland
- Faculty of Social and Human Sciences, University of Southampton, Southampton, United Kingdom
- * E-mail:
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Loneliness, social contacts and Internet addiction: A cross-lagged panel study. COMPUTERS IN HUMAN BEHAVIOR 2014. [DOI: 10.1016/j.chb.2013.08.007] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Meltzer AC, Bregman B, Blanchard J. Depression is associated with repeat emergency department visits in patients with non-specific abdominal pain. West J Emerg Med 2013; 15:325-8. [PMID: 24868312 PMCID: PMC4025531 DOI: 10.5811/westjem.2013.7.15635] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 05/10/2013] [Accepted: 07/31/2013] [Indexed: 11/11/2022] Open
Abstract
Introduction: Patients with abdominal pain often return multiple times despite no definitive diagnosis. Our objective was to determine if repeat emergency department (ED) use among patients with non-specific abdominal pain might be associated with a diagnosis of moderate to severe depressive disorder. Methods: We screened 987 ED patients for major depression during weekday daytime hours from June 2011 through November 2011 using a validated depression screening tool, the PHQ-9. Each subject was classified as either no depression, mild depression or moderate/severe depression based on the screening tool. Within this group, we identified 83 patients with non-specific abdominal pain by either primary or secondary diagnosis. Comparing depressed patients versus non-depressed patients, we analyzed demographic characteristics and number of prior ED visits in the past year. Results: In patients with non-specific abdominal pain, 61.9% of patients with moderate or severe depression (PHQ9≥10) had at least one visit to our ED for the same complaint within a 365-day period, as compared to 29.2% of patients with no depression (PHQ9<5), (p=0.013). Conclusion: Repeat ED use among patients with non-specific abdominal pain is associated with moderate to severe depressive disorder. Patients with multiple visits for abdominal pain may benefit from targeted ED screening for depression. [West J Emerg Med. 2014;15(3):325–328.]
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Affiliation(s)
- Andrew Charles Meltzer
- George Washington University, Department of Emergency Medicine, Washington, District of Columbia
| | - Benjamin Bregman
- George Washington University, Department of Psychiatry, Washington, District of Columbia
| | - Janice Blanchard
- George Washington University, Department of Emergency Medicine, Washington, District of Columbia
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Secular changes in the relation between social factors and depression: a study of two birth cohorts of Swedish septuagenarians followed for 5 years. J Affect Disord 2013; 150:245-52. [PMID: 23642402 DOI: 10.1016/j.jad.2013.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/02/2013] [Accepted: 04/02/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Rapid societal changes occurred in the Western world during the 20(th) century. It is not clear whether this has changed the relation between social factors and depression in older people. METHODS Representative samples of 70-year-olds from Gothenburg, Sweden, were examined with identical psychiatric examinations in 1971-72 (N=392; 226 women and 166 men) and 2000-01 (N=499; 270 women and 229 men). Follow-up studies were conducted after five years. Social factors were obtained by self-report and depression was diagnosed according to DSM-IV-TR. RESULTS Feelings of loneliness were related to both concurrent depression at baseline and new depression at follow-up in both birth cohorts. Visits with others than children and neighbours once per month or less, compared to having more visits, and the perception of having too little contact with others, were related to both concurrent and new depression in 70-year-olds examined 1971-72, but not in those examined 30 years later. LIMITATIONS The response rate declined from 85.2% in 1971-72 to 65.8% in 2000-01. Participation bias may have resulted in an underestimation of depression in the later-born cohort. CONCLUSIONS Social contacts with others were related to depression in 70-year-olds examined in the 1970s, but not in those examined in the 2000s. This may reflect period changes in the ways of socialising, communicating and entertaining, e.g. due to technological development and expansion of mass media. Findings may be useful when developing modern and effective programs for the prevention of mental ill-health in older people.
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Świtaj P, Anczewska M, Chrostek A, Sabariego C, Cieza A, Bickenbach J, Chatterji S. Disability and schizophrenia: a systematic review of experienced psychosocial difficulties. BMC Psychiatry 2012; 12:193. [PMID: 23137171 PMCID: PMC3539983 DOI: 10.1186/1471-244x-12-193] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 11/06/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schizophrenia is a significantly disabling disease that affects all major areas of life. There is a lack of comprehensive synthesis of research findings on the full extent of psychosocial difficulties (PSDs) experienced by people living with schizophrenia. This paper provides a systematic review of the literature concerning PSDs and their associated factors in schizophrenia. PSDs were conceptualized in accordance with the International Classification of Functioning, Disability and Health (ICF) as disabilities, in particular impairments of mental functions, activity limitations and participation restrictions. METHODS An electronic search using MEDLINE and PsychINFO plus a manual search of the literature was performed for qualitative and longitudinal studies published in English between 2005 and 2010 that examined PSDs in persons with schizophrenia. The ICF was used as a conceptual framework. RESULTS A total of 104 papers were included. The most frequent PSDs addressed in the literature were not specific ones, directly linkable to the ICF categories of mental functions, activity limitations or participation restrictions, but broad areas of psychosocial functioning, such as psychopathological symptoms (53% of papers) or global disability and functioning (37%). Among mental functions, the most extensively studied were cognitive functions (27%) and emotional functions (27%). Within the domain of activities and participation, the most widely investigated were difficulties in relationships with others (31%) and employment (20%). Of the factors associated with the intensity or course of PSDs, the most commonly identified were treatment modalities (56%), psychopathological symptoms (26%), and socio-demographic variables (24%). Medication tended to improve the most relevant PSD, but at the same time was the only consistently reported determinant of onset of PSDs (emerging as unwanted side-effects). CONCLUSIONS The present review illustrates the remarkably broad scope and diversity of psychosocial areas affected in schizophrenia and shows how these areas are interconnected and how they interact with contextual factors. The need for a shift in focus of schizophrenia research is suggested--from an excessive reliance on global measures of psychopathology and disability for defining outcomes to the creation of profiles of specific PSDs that have a more direct bearing on the disabling experience and real-world functioning of patients and can serve to guide interventions and monitoring over time.
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Affiliation(s)
- Piotr Świtaj
- Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, Warsaw 02-957, Poland.
| | - Marta Anczewska
- I Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, Warsaw, 02-957, Poland
| | - Anna Chrostek
- I Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, Warsaw, 02-957, Poland
| | - Carla Sabariego
- Research Unit for Biopsychosocial Health, Chair for Public Health and Health Care Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
| | - Alarcos Cieza
- Research Unit for Biopsychosocial Health, Chair for Public Health and Health Care Research, Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
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Raggi A, Giovannetti AM, Quintas R, D'Amico D, Cieza A, Sabariego C, Bickenbach JE, Leonardi M. A systematic review of the psychosocial difficulties relevant to patients with migraine. J Headache Pain 2012; 13:595-606. [PMID: 23001069 PMCID: PMC3484254 DOI: 10.1007/s10194-012-0482-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 08/30/2012] [Indexed: 01/11/2023] Open
Abstract
Migraine is a common disease which causes significant burden to individuals, in terms of personal suffering and activity reduction, and to societies, in terms of disease cost. The purpose of this study is to identify the most relevant psychosocial difficulties related to migraine, the variables associated with them and the most relevant determinants of their evolution over time. MEDLINE and PsychINFO were searched for studies published in English between 2000 and 2010 that examined psychosocial difficulties in persons with migraine with and without aura, from clinical trials and observational studies. Information on the description of each difficulty, its determinants of onset and change over time and associated variables were extracted and categorized at a higher level. In total, 34 difficulties have been collected from 51 papers: the most frequent were reduced vitality and fatigue, emotional problems, pain, difficulties at work, general physical and mental health, social functioning and global disability. Evidence exists that pharmacological treatments have an impact toward improvement in patients’ difficulties, in particular emotional problems, physical and mental health, difficulties with employment and global disability. Migraine treatments and decreased headaches frequency are the major determinants of improvements in psychosocial difficulties, while no information is available for determinants of worsening; understanding the role of such factors is of primary public health relevance, given the high prevalence and the relevant personal and societal costs of migraine.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy.
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