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Conway CR, Aaronson ST, Sackeim HA, Duffy W, Stedman M, Quevedo J, Allen RM, Riva-Posse P, Berger MA, Alva G, Malik MA, Dunner DL, Cichowicz I, Luing H, Zajecka J, Nahas Z, Mickey BJ, Kablinger AS, Kriedt CL, Bunker MT, Lee YCL, Shy O, Majewski S, Olin B, Tran Q, Rush AJ. Clinical characteristics and treatment exposure of patients with marked treatment-resistant unipolar major depressive disorder: A RECOVER trial report. Brain Stimul 2024; 17:448-459. [PMID: 38574853 DOI: 10.1016/j.brs.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND RECOVER is a randomized sham-controlled trial of vagus nerve stimulation and the largest such trial conducted with a psychiatric neuromodulation intervention. OBJECTIVE To describe pre-implantation baseline clinical characteristics and treatment history of patients with unipolar, major depressive disorder (MDD), overall and as a function of exposure to interventional psychiatric treatments (INTs), including electroconvulsive therapy, transcranial magnetic stimulation, and esketamine. METHODS Medical, psychiatric, and treatment records were reviewed by study investigators and an independent Study Eligibility Committee prior to study qualification. Clinical characteristics and treatment history (using Antidepressant Treatment History [Short] Form) were compared in those qualified (N = 493) versus not qualified (N = 228) for RECOVER, and among the qualified group as a function of exposure to INTs during the current major depressive episode (MDE). RESULTS Unipolar MDD patients who qualified for RECOVER had marked TRD (median of 11.0 lifetime failed antidepressant treatments), severe disability (median WHODAS score of 50.0), and high rate of baseline suicidality (77% suicidal ideation, 40% previous suicide attempts). Overall, 71% had received at least one INT. Compared to the no INT group, INT recipients were younger and more severely depressed (QIDS-C, QIDS-SR), had greater suicidal ideation, earlier diagnosis of MDD, and failed more antidepressant medication trials. CONCLUSIONS RECOVER-qualified unipolar patients had marked TRD and marked treatment resistance with most failing one or more prior INTs. Treatment with ≥1 INTs in the current MDE was associated with earlier age of MDD onset, more severe clinical presentation, and greater treatment resistance relative to patients without a history of INT. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03887715.
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Affiliation(s)
- Charles R Conway
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.
| | - Scott T Aaronson
- Department of Clinical Research, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Harold A Sackeim
- Departments of Psychiatry and Radiology, Columbia University, New York, NY, USA
| | | | | | - João Quevedo
- Center for Interventional Psychiatry, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX, USA
| | | | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Gustavo Alva
- ATP Clinical Research, Senior Brain Health, Hoag Hospital, Newport Beach, CA and Department of Psychiatry and Neuroscience, University of California, Riverside, CA, USA
| | | | - David L Dunner
- Center for Anxiety and Depression, Mercer Island, WA, USA
| | | | | | - John Zajecka
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Psychiatric Medicine Associates, LLC, Skokie, IL, USA
| | - Ziad Nahas
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Brian J Mickey
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - Anita S Kablinger
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Christopher L Kriedt
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Mark T Bunker
- LivaNova PLC (or a Subsidiary), London, Great Britain, United Kingdom
| | | | - Olivia Shy
- LivaNova PLC (or a Subsidiary), London, Great Britain, United Kingdom
| | - Shannon Majewski
- LivaNova PLC (or a Subsidiary), London, Great Britain, United Kingdom
| | - Bryan Olin
- LivaNova PLC (or a Subsidiary), London, Great Britain, United Kingdom
| | - Quyen Tran
- LivaNova PLC (or a Subsidiary), London, Great Britain, United Kingdom
| | - A John Rush
- Duke-NUS Medical School, Singapore; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
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2
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Zhang Z, Wang J, Duan W. The Impact of Adolescents' Character Strengths on Quality of Life in Stressful Situations During COVID-19 in China: A Moderated Mediation Approach. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2023; 20:881-895. [PMID: 37395636 DOI: 10.1080/26408066.2023.2231438] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
PURPOSE This study aimed to investigate the relationship between adolescents' character strengths and quality of life during the COVID-19 lockdown and to further explore the role of strengths use and perceived threats. METHOD A total of 804 adolescents from Wuhan, China were recruited to complete an online survey. The data collection was conducted between April and May 2020, during the lockdown of Wuhan due to the COVID-19 pandemic, which resulted in the suspension of school attendance for adolescents and the transition to online teaching. Mini Quality of Life Enjoyment and Satisfaction Questionnaire (Mini-Q-LES-Q) was used to measure adolescents' quality of life, while their character strengths, strengths use, and perceived threats were measured using the Three-Dimensional Inventory of Character Strengths (TICS), the Chinese version Strengths Use Scale (SUS) and Perceived threats of COVID-19 questionnaire. RESULTS The results of the study indicated that adolescents' character strengths could positively affect their quality of life, and strengths use played a partially mediating role, while the moderating effect of perceived threats was not significant. DISCUSSION AND CONCLUSIONS In the face of persistent pandemic effects or other similar stressful events in the future, the development of adolescents' character strengths and strengths use can effectively improve adolescents' quality of life, which provides a theoretical reference for future social work intervention.
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Affiliation(s)
- Zhiwen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingying Wang
- Social and Public Administration School, East China University of Science and Technology, Shanghai, China
| | - Wenjie Duan
- Social and Public Administration School, East China University of Science and Technology, Shanghai, China
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3
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Shi J, Wang X, Zhao N, Kang C, Yang L, Zheng Y, Liu J, Feng L, Zhu X, Ma C, Wu W, Wang G, Hu J. Sex differences in residual somatic symptoms in patients with first-episode depression after acute-phase treatment. BMC Psychiatry 2023; 23:119. [PMID: 36814241 PMCID: PMC9948378 DOI: 10.1186/s12888-023-04612-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Residual somatic symptoms (RSS) are common in depressed patients, predicting treatment effectiveness. However, sex differences in RSS have received little systematic study. This study was conducted to compare sex differences of RSS in patients with first-episode depression (FED). METHODS Nine hundred eighty-two patients with FED were selected and treated for 8 to 12 weeks. We evaluated the subjects' socio-demographic characteristics and residual depressive symptoms. Using the Patient Health Questionnaire-15 (PHQ-15) scale to assess residual somatic symptoms, the Sheehan Disability Scale (SDS) for the assessment of patients' function, the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) for quality of life. RESULTS The incidence of RSS with FED was 46.4%. For patients with residual symptoms, the age and age of onset in females were higher than males, but males had more years of education than females. The degree of "stomach pain" in females was more severe than in males, while "trouble sleeping" in males was more severe than that in females. Multiple regression analysis showed that the total Q-LES-Q-SF score was an independent influencing factor of RSS in both males and females, while the total SDS score only affected female RSS. CONCLUSIONS The prevalence of RSS in FED after acute-phase treatment is high. The symptom of "stomachache" is more pronounced in females, while "trouble sleeping" is more severe in males. Quality of life plays an essential role in RSS in both genders. Thus, sex needs to be considered when assessing the relationship between RSS and therapeutic effect in depression.
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Affiliation(s)
- Jingjing Shi
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Xiaohong Wang
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Na Zhao
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Chuanyi Kang
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Liying Yang
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Yue Zheng
- grid.11135.370000 0001 2256 9319Peking University Institute of Mental Health (Sixth Hospital), Beijing, China ,grid.11135.370000 0001 2256 9319National Clinical Research Center for Mental Disorders & NHC Key Laboratory of Mental Health, Peking University, Beijing, China
| | - Jiacheng Liu
- grid.412596.d0000 0004 1797 9737Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001 China
| | - Lei Feng
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xuequan Zhu
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Caina Ma
- Harbin First Specialized Hospital, Heilongjiang Province, Harbin, China
| | - Wenyuan Wu
- grid.412793.a0000 0004 1799 5032Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, China
| | - Gang Wang
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jian Hu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang DistrictHeilongjiang Province, Harbin, 150001, China.
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In pursuit of full recovery in major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01487-5. [PMID: 36085532 DOI: 10.1007/s00406-022-01487-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
Many individuals with major depression disorder (MDD) who achieve remission of depressive symptoms, do not perceive themselves as fully recovered. This study explores whether clinical remission is related to functional remission and to patient's perception of recovery, as well as, which factors are associated with their functional and subjective remission. 148 patients with MDD in partial clinical remission were included. Demographics and clinical variables were collected through semi-structured interviews. Objective cognition was evaluated through a neuropsychological battery and subjective cognition through a specific questionnaire. The patient's psychosocial functioning and the perception of their remission were also assessed. Apart from descriptive analysis, Pearson correlations and backward stepwise regression models explored the relationship between demographic, clinical, and cognitive factors with patients' functional and self-perceived remission. From the whole sample, 57 patients (38.5%) were considered to achieve full clinical remission, 38 patients (25.7%) showed functional remission, and 55 patients (37.2%) perceived themselves as remitted. Depressive symptoms and objective and subjective executive function were the factors associated with psychosocial functioning. Besides, depressive symptoms, objective and subjective attention, and subjective executive function were the significant explanatory variables for self-perception of remission. The concept of full recovery from an episode of MDD should not only include the clinician's perspective but also the patient's psychosocial functioning along with their self-perceived remission. As residual depressive symptoms and cognition (objective and subjective) are factors with great contribution to a full recovery, clinicians should specifically address them when choosing therapeutic strategies.
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Bagheri Z, Chamanpara P, Jafari P, Balhara YPS, Arya S, Ransing R, Đorić A, Knez R, Thi TVV, Huong TN, Kafali HY, Erzin G, Vally Z, Chowdhury MRR, Sharma P, Shakya R, Campos LAM, Szczegielniak AR, Stevanović D. Cross-cultural measurement invariance of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short form across ten countries: the application of Bayesian approximate measurement invariance. BMC Psychol 2022; 10:160. [PMID: 35751087 PMCID: PMC9229907 DOI: 10.1186/s40359-022-00864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) is the most frequently used generic quality of life (QOL) measure in many countries and cultures worldwide. However, no single study has been carried out to investigate whether this questionnaire performs similarly across diverse cultures/countries. Accordingly, this study aimed to assess the cross-cultural measurement invariance of the Q-LES-Q-SF across ten different countries. Methods The Q-LES-Q-SF was administrated to a sample of 2822 university students from ten countries: Bangladesh, Brazil, Croatia, India, Nepal, Poland, Serbia, Turkey, the United Arab Emirates, and Vietnam. The Bayesian approximate measurement invariance approach was used to assess the measurement invariance of the Q-LES-Q-SF.
Results Approximate measurement invariance did not hold across the countries for the Q-LES-Q-SF, with only two out of 14 items being non-invariant; namely items related to doing household and leisure time activities.
Conclusions Our findings did not support the cross-cultural measurement invariance of the Q-LES-Q-SF; thus, considerable caution is warranted when comparing QOL scores across different countries with this measure. Item rewording and adaptation along with calibrating non-invariant items may narrow these differences and help researchers to create an invariant questionnaire for reliable and valid QOL comparisons across different countries.
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Affiliation(s)
- Zahra Bagheri
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Parisa Chamanpara
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Jafari
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yatan Pal Singh Balhara
- Behavioral Addictions Clinic, Department of Psychiatry and National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sidharth Arya
- Institute of Mental Health, Pt. Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Ramdas Ransing
- Department of Psychiatry, B K L Walawalkar Rural Medical College, Kasarwadi, Maharashtra, India
| | - Ana Đorić
- Department of Psychology, Faculty of Humanities and Social Sciences, Center for Applied Psychology, University of Rijeka, Rijeka, Croatia
| | - Rajna Knez
- Department of Women´S and Children´S Health, Skaraborgs Hospital, Skövde, Sweden.,Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tuong-Vi Vu Thi
- South Vietnam HIV Addiction Technical Transfer Centre, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Truong Ngoc Huong
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Helin Yilmaz Kafali
- Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Turkey
| | - Gamze Erzin
- Diskapi Training and Research Hospital, Ankara, Turkey.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Zahir Vally
- Department of Clinical Psychology, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Pawan Sharma
- Department of Psychiatry, School of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Rabi Shakya
- Department of Psychiatry, School of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Luís Antônio Monteiro Campos
- Catholic University of Petrópolis (UCP) and Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anna Rebeka Szczegielniak
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland
| | - Dejan Stevanović
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
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6
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Anderson JR, Killian M, Fuller A, Hughes JL, Byerly M, Lindow J, John Rush A, Trivedi MH. Psychometric Evaluation of the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire in a General Youth Population. Child Psychiatry Hum Dev 2022; 53:546-553. [PMID: 33713250 DOI: 10.1007/s10578-021-01148-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire is a brief 15-item self-report measure of quality of life and life satisfaction originally developed for clinical populations (6 to 17 years old). The current paper examines the initial factor structure proposed by the developers and underlying psychometric properties of the measure in a non-clinical population of teens. A cross-sectional adolescent sample (N = 3222) completed self-report measures as part of mental health promotion program. A confirmatory factor analysis was conducted with construct validity analyses. The original factor structure was replicated with strong internal consistency (Cronbach α = .912). Strong construct validity (e.g. resilience, well-being, depression, and anxiety) was found. Minimal differences were found based on gender, race, and ethnicity. PQ-LES-Q has strong, replicable psychometric properties, which makes it a generally reliable and valid assessment tool to evaluate the quality of life and life satisfaction in adolescents.
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Affiliation(s)
- Jacqueline R Anderson
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, USA
| | - Michael Killian
- College of Social Work, Florida State University, 296 Champions Way, Tallahassee, FL, 32304, USA
| | - Anne Fuller
- School of Psychology, Xavier University, 1 Drexel Drive, New Orleans, LA, 70125, USA
| | - Jennifer L Hughes
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, USA
| | - Matthew Byerly
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, 85724, USA.,Southern Arizona VA Healthcare System, Tucson, AZ, 85723, USA
| | - Janet Lindow
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, 85724, USA.,Biomedical Research and Education Foundation of Southern Arizona, Tucson, AZ, 85723, USA
| | - A John Rush
- Duke National University of Singapore, 8 College Rd, Singapore, 169857, Singapore.,Duke Medical School, Durham, NC, 27710, USA.,Texas Tech Health Science Center, 3600 N Garfield St., Midland, TX, 79705, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9119, USA.
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7
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Duan W, Kong Y, Bu H, Guan Q, Chen Z, Luo Q, Zhang J. The Online Strength-Informed Acceptance and Commitment Therapy Among COVID-19-Affected Adolescents. RESEARCH ON SOCIAL WORK PRACTICE 2022; 32:465-474. [PMID: 38603081 PMCID: PMC8841394 DOI: 10.1177/10497315211067270] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose: This study develops and investigates the changes in anxiety symptoms and quality of life (QoL) among participants of the online Strength-informed Acceptance and Commitment Therapy (SACT) across three tests. METHODS A small-scale, quasi-experiment with no control group was conducted. Repeated-measures analysis was employed to assess the changes of the three tests, which were the pre-experimental, post-test, and 3-month follow-up test. A total of 47 adolescents (ages 10-12) completed the 45-min intervention that lasted 10 weeks. RESULTS Compared with the pre-experimental, the post-test indicated significant anxiety symptoms reduction but not a statistically significant increase in QoL. The 3-month follow-up test indicated reduced anxiety symptoms and improved QoL compared with the pre-experimental. The with-in subject changes were substantial. CONCLUSIONS The online SACT is a promising model to reduce anxiety symptoms and promote QoL among adolescents during the current COVID-19 pandemic, which show both short- and long-term benefit to the participants.
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Affiliation(s)
- Wenjie Duan
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Yansi Kong
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - He Bu
- Department of Social & Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Qiujie Guan
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Zheng Chen
- Institute of Education, Wuhan University, Wuhan, China
| | - Qiansheng Luo
- Wuhan Economic and Technological Development Zone Huangling Primary School, Wuhan, China
| | - Jing Zhang
- Wuhan Economic and Technological Development Zone Huangling Primary School, Wuhan, China
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8
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Shimels T, Bogale G, Asrat Kassu R, Gedif T. Quality of life and its predictors among clients visiting antiretroviral therapy clinics in Addis Ababa, Ethiopia. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2022; 21:15-22. [PMID: 35361062 DOI: 10.2989/16085906.2021.2013907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 06/14/2023]
Abstract
This study assessed the quality of life (QoL) and associated factors among a group of clients visiting ART clinics in Addis Ababa, Ethiopia. A multi-site cross-sectional study was conducted from 1 to 30 August 2020. Adults with HIV and who fulfilled the inclusion criteria were considered. A systematic random sampling technique with proportional size allocation was employed. Data were collected using a modified EQ-5D and EQ-VAS tool. The analysis was done using SPSS version 26. Non-parametric statistical analyses were done using Mann-Whitney U, Kruskal-Wallis and Spearman's correlation tests. A p-value ≤ 0.05 and 95% confidence level were considered for analysis. The majority of the clients were from health centres (58%), were 43 years old or less (54%), and were males (63%). Pain/discomfort and depression/anxiety were the most prominent dimensions in the age group above 43 years. The mean score of EQ-5D index values was 0.87 (SD 0.05; 95% CI 0.86-0.87) and that of EQ-VAS was 81 (SD 15; 95% CI 80-83). About 38% and 43% of the clients showed an altered health state of some degree in functional and current overall status respectively. Comorbidity, history of current substance use, facility type, social support and sleep disturbance showed a statistically significant association with both outcomes. A considerable proportion of clients have altered functional and overall health status, with pain/discomfort and depression/anxiety most affected. Inclusion of multidisciplinary treatments for HIV and the highlighting of psychosocial issues that are likely among this group are warranted.
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Affiliation(s)
- Tariku Shimels
- Research Directorate, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Gelila Bogale
- United Vision Medical Services, Addis Ababa, Ethiopia
| | - Rodas Asrat Kassu
- Department of Neurology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Teferi Gedif
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, Addis Ababa University, Ethiopia
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9
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Goodman MS, Ackermann N, Pierce KA, Bowen DJ, Thompson VS. Development and Validation of a Brief Version of the Research Engagement Survey Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10020. [PMID: 34639323 PMCID: PMC8507896 DOI: 10.3390/ijerph181910020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022]
Abstract
The Research Engagement Survey Tool (REST) examines the level of partner engagement in research studies. This study used mixed methods, including web-based surveys (N = 336), a modified Delphi process (N = 18), and cognitive response interviews (N = 16), with convenience sampling to develop and validate a short version of the REST. We conducted factor analysis and calculated internal consistency for the condensed REST. We validated the condensed REST against the comprehensive REST. All analyses were carried out on two scales (quality and quantity) based on Likert-type response options. We examined convergent validity with other measures theoretically associated with the REST (e.g., the Community Engagement Research Index and the Partnership Self-Assessment Tool). This study produced a 9-item condensed version of the REST. The condensed REST loads on 1 factor, has high internal consistency (Cronbach's alpha = 0.92 for the quantity scale; 0.94 for the quality scale), is significantly correlated (ρ = 0.97; p < 0.001 for both scales) with the comprehensive (32-item) REST, and has negligible, low, and moderate correlation with other measures (e.g., the Partnership Assessment In community-based Research, trust in medical researchers, and the Coalition Self-Assessment Survey). Use of the condensed REST will reduce participant burden and time to complete. This standardized and validated quantitative measure is useful to compare engagement across projects or within a project over time.
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Affiliation(s)
- Melody S. Goodman
- School of Global Public Health, New York University, New York, NY 10003, USA;
| | - Nicole Ackermann
- Division of Public Health Sciences, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA;
| | - Kristyn A. Pierce
- School of Global Public Health, New York University, New York, NY 10003, USA;
| | - Deborah J. Bowen
- Department of Bioethics and Humanities, University of Washington, Seattle, WA 98195, USA;
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10
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Rush AJ, South C, Jain S, Agha R, Zhang M, Shrestha S, Khan Z, Hassan M, Trivedi MH. Clinically Significant Changes in the 17- and 6-Item Hamilton Rating Scales for Depression: A STAR*D Report. Neuropsychiatr Dis Treat 2021; 17:2333-2345. [PMID: 34295161 PMCID: PMC8290193 DOI: 10.2147/ndt.s305331] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/30/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To develop clinically meaningful improvement thresholds in both the 17-item and the 6-item Hamilton Rating Scale for Depression (HRSD) total scores in depressed outpatients. METHODS The post-hoc analysis included all adult outpatients with non-psychotic major depressive disorder in the STAR*D trial who entered and exited the first treatment step (up to 14 weeks of citalopram) with a complete set of study measures at baseline and exit and at least one post-baseline measure. Within-patient change and linear regression anchor-based analyses were conducted to define meaningful and substantial changes in the HRSD17 and HRSD6 using three patient-reported outcomes [Work and Social Adjustment Scale (WSAS), Quality of Life Enjoyment and Satisfaction-Short Form (Q-LES-Q-SF); Mini-Q-LES-Q] obtained at baseline and exit from the first treatment step in STAR*D. RESULTS Linear regression analyses identified a meaningful change threshold for the HRSD17 as 3.9 [3.7-4.1] [lower, upper 95% CI] and a substantial change as 7.8 [7.4-8.3] with the WSAS. Analogous thresholds based on the Q-LES-Q-SF were 5.8 [5.5-6.1] and 11.6 [11.0-12.2], respectively, and 4.9 [4.7-5.2] and 9.9 [9.3-10.4] for the Mini-QLES-Q, respectively. For the HRSD6, linear regression analyses with the WSAS identified a meaningful change as 2.2 [2.1-2.4], while a substantial change was 4.5 [4.2-4.7]. Analogous figures based on the Q-LES-Q-SF were 3.2 [3.0-3.4] and 6.4 [6.1-6.8]. Similarly, based on the Mini-QLESQ, results were 2.8 [2.6-2.9] and 5.6 [5.3-5.9]. For both the HRSD17 and the HRSD6, within-patient analyses produced less precise estimates of the same change thresholds with substantial overlap between groups. Based on the WSAS, a clinically meaningful change in the HRSD17 total score was 9.6 (SD = 6.5), while a substantial change was 15.0 (SD = 6.7). Analogous change thresholds based on the Q-LESQ-SF were 12.9 (SD = 6.2) and 16.8 (SD = 6.4), respectively. For the Mini-Q-LES-Q, thresholds were 10.9 (SD = 6.5) and 16.1 (SD = 6.2). CONCLUSION A 4-6 point change in the HRSD17 is clinically meaningful; a 7-12 point change is clinically substantial. For the HRSD6, analogous estimates were 2-3 and 4-7 point changes, respectively.
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Affiliation(s)
- Augustus John Rush
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Professor Emeritus, Duke-National University of Singapore, Singapore
| | - Charles South
- Department of Statistical Science, Southern Methodist University, Dallas, TX, USA
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Raafae Agha
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Mingxu Zhang
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Shristi Shrestha
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Zershana Khan
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Mudasar Hassan
- Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Baker J, Berzins K, Canvin K, Benson I, Kellar I, Wright J, Lopez RR, Duxbury J, Kendall T, Stewart D. Non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings: the COMPARE systematic mapping review. HEALTH SERVICES AND DELIVERY RESEARCH 2021. [DOI: 10.3310/hsdr09050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
ObjectivesThe study aimed to provide a mapping review of non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings; classify intervention components using the behaviour change technique taxonomy; explore evidence of behaviour change techniques and interventions; and identify the behaviour change techniques that show most effectiveness and those that require further testing.BackgroundIncidents involving violence and aggression occur frequently in adult mental health inpatient settings. They often result in restrictive practices such as restraint and seclusion. These practices carry significant risks, including physical and psychological harm to service users and staff, and costs to the NHS. A number of interventions aim to reduce the use of restrictive practices by using behaviour change techniques to modify practice. Some interventions have been evaluated, but effectiveness research is hampered by limited attention to the specific components. The behaviour change technique taxonomy provides a common language with which to specify intervention content.DesignSystematic mapping study and analysis.Data sourcesEnglish-language health and social care research databases, and grey literature, including social media. The databases searched included British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CCRCT), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), EMBASE, Health Technology Assessment (HTA) Database, HTA Canadian and International, Ovid MEDLINE®, NHS Economic Evaluation Database (NHS EED), PsycInfo®and PubMed. Databases were searched from 1999 to 2019.Review methodsBroad literature search; identification, description and classification of interventions using the behaviour change technique taxonomy; and quality appraisal of reports. Records of interventions to reduce any form of restrictive practice used with adults in mental health services were retrieved and subject to scrutiny of content, to identify interventions; quality appraisal, using the Mixed Methods Appraisal Tool; and data extraction, regarding whether participants were staff or service users, number of participants, study setting, intervention type, procedures and fidelity. The resulting data set for extraction was guided by the Workgroup for Intervention Development and Evaluation Research, Cochrane and theory coding scheme recommendations. The behaviour change technique taxonomy was applied systematically to each identified intervention. Intervention data were examined for overarching patterns, range and frequency. Overall percentages of behaviour change techniques by behaviour change technique cluster were reported. Procedures used within interventions, for example staff training, were described using the behaviour change technique taxonomy.ResultsThe final data set comprised 221 records reporting 150 interventions, 109 of which had been evaluated. The most common evaluation approach was a non-randomised design. There were six randomised controlled trials. Behaviour change techniques from 14 out of a possible 16 clusters were detected. Behaviour change techniques found in the interventions were most likely to be those that demonstrated statistically significant effects. The most common intervention target was seclusion and restraint reduction. The most common strategy was staff training. Over two-thirds of the behaviour change techniques mapped onto four clusters, that is ‘goals and planning’, ‘antecedents’, ‘shaping knowledge’ and ‘feedback and monitoring’. The number of behaviour change techniques identified per intervention ranged from 1 to 33 (mean 8 techniques).LimitationsMany interventions were poorly described and might have contained additional behaviour change techniques that were not detected. The finding that the evidence was weak restricted the study’s scope for examining behaviour change technique effectiveness. The literature search was restricted to English-language records.ConclusionsStudies on interventions to reduce restrictive practices appear to be diverse and poor. Interventions tend to contain multiple procedures delivered in multiple ways.Future workPrior to future commissioning decisions, further research to enhance the evidence base could help address the urgent need for effective strategies. Testing individual procedures, for example, audit and feedback, could ascertain which are the most effective intervention components. Separate testing of individual components could improve understanding of content and delivery.Study registrationThe study is registered as PROSPERO CRD42018086985.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 9, No. 5. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | | | - Krysia Canvin
- School of Healthcare, University of Leeds, Leeds, UK
| | - Iris Benson
- Mersey Care NHS Foundation Trust, Prescot, UK
| | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Joy Duxbury
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | | | - Duncan Stewart
- Department of Health Sciences, University of York, York, UK
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Martin-Cook K, Palmer L, Thornton L, Rush AJ, Tamminga CA, Ibrahim HM. Setting Measurement-Based Care in Motion: Practical Lessons in the Implementation and Integration of Measurement-Based Care in Psychiatry Clinical Practice. Neuropsychiatr Dis Treat 2021; 17:1621-1631. [PMID: 34079260 PMCID: PMC8164712 DOI: 10.2147/ndt.s308615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/13/2021] [Indexed: 01/18/2023] Open
Abstract
Measurement-based care (MBC) involves the systematic use of standardized measurements to inform treatment decisions. MBC can enhance clinical decision-making and quality of care by prompting personalized changes in treatment based on measured patient outcomes. MBC can also promote more precise communications between patients and clinicians around individual patient care. While commonly employed in psychiatric clinical research, the use of MBC in everyday practice can be complicated by clinic operations and variability across patients. We implemented MBC in the UT Southwestern Psychiatry Multispecialty Outpatient Clinic during the expansion of our general psychiatry clinic and subspecialty targeted programs. This article describes the top 10 lessons we learned as we confronted practical obstacles around implementing the ideals of MBC into a pre-existing, busy psychiatric clinical practice and how doing so impacts care, provider engagement, patient engagement, and research opportunity.
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Affiliation(s)
- Kristin Martin-Cook
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lucy Palmer
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Larry Thornton
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - A John Rush
- National University of Singapore, Singapore; Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry, Texas Tech Health Sciences Center, Midland, TX, USA
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hicham M Ibrahim
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Minhajuddin A, Jha MK, Fatt CC, Trivedi MH. Psychometric Properties of the Concise Associated Symptom Tracking Scale and Validation of Clinical Utility in the EMBARC Study. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2020; 2:10-18. [PMID: 36101888 PMCID: PMC9175787 DOI: 10.1176/appi.prcp.20190041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/21/2019] [Accepted: 12/05/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Abu Minhajuddin
- Center for Depression Research and Clinical CareUniversity of Texas Southwestern Medical CenterDallas
| | - Manish K. Jha
- Center for Depression Research and Clinical CareUniversity of Texas Southwestern Medical CenterDallas
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew York
| | - Cherise Chin Fatt
- Center for Depression Research and Clinical CareUniversity of Texas Southwestern Medical CenterDallas
| | - Madhukar H. Trivedi
- Center for Depression Research and Clinical CareUniversity of Texas Southwestern Medical CenterDallas
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