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Hussain MA, Qaisar R, Karim A, Ahmad F, Franzese F, Awad A, Al-Masri AA, Alsaeed M, Alkahtani SA. Predictors of hip fracture in 15 European countries: a longitudinal study of 48,533 geriatric adults using SHARE dataset. Arch Osteoporos 2024; 19:60. [PMID: 39023661 DOI: 10.1007/s11657-024-01420-4] [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: 03/28/2024] [Accepted: 07/07/2024] [Indexed: 07/20/2024]
Abstract
We investigated the risk factors for hip fracture in 48,533 European older adults for 8 years from 2013 onward. We identified female gender, age above 80, low handgrip strength, and depression as significant risk factors for hip fracture. Our findings may help identify high-risk populations for hip fractures in pre-clinical settings. OBJECTIVES Hip fracture is a major cause of functional disability, mortality, and health costs. However, the identification and characterization of its causative factors remain poor. METHODS We investigated demography, handgrip strength (HGS), depression, and multiple age-associated comorbidities for predicting future hip fracture in individuals aged 50 or above from 15 European countries (n = 48,533). All participants were evaluated from 2013 to 2020 using four successive waves of the Survey of Health, Aging, and Retirement in Europe (SHARE). RESULTS Altogether, 1130 participants developed hip fractures during the study period. We identified female gender, an advancing age from quinquagenarians onward, and a poor socioeconomic status as critical risk factors for future hip fracture. Having mobility difficulty, a low HGS (< 27 kg in men, < 16 kg in women) and higher scores on Euro-D depression scales were also significant risk factors for hip fracture. Summated scales of hypertension, diabetes mellitus, cancer, Alzheimer's disease, and stroke did not appear as risk factors. CONCLUSION Collectively, we report advancing age, female gender, low HGS, and depression as independent risk factors for hip fracture. Our findings are useful in identifying high-risk populations for hip fractures in pre-clinical settings before rigorous evaluation and treatment in clinics.
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Affiliation(s)
- M Azhar Hussain
- Department of Finance and Economics, College of Business Administration, University of Sharjah, Sharjah, 27272, UAE
- Department of Social Sciences and Business, Roskilde University, 4000, Roskilde, Denmark
| | - Rizwan Qaisar
- Basic Medical Sciences, College of Medicine, University of Sharjah, 27272, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute for Medical and Health Sciences, University of Sharjah, 27272, Sharjah, United Arab Emirates
| | - Asima Karim
- Basic Medical Sciences, College of Medicine, University of Sharjah, 27272, Sharjah, United Arab Emirates
| | - Firdos Ahmad
- Basic Medical Sciences, College of Medicine, University of Sharjah, 27272, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute for Medical and Health Sciences, University of Sharjah, 27272, Sharjah, United Arab Emirates
| | - Fabio Franzese
- SHARE Berlin Institute, Chausseestraße 111, 10115, Berlin, Germany
| | - Atif Awad
- Department of Finance and Economics, College of Business Administration, University of Sharjah, Sharjah, 27272, UAE
| | - Abeer A Al-Masri
- Department of Physiology, College of Medicine, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Mohammed Alsaeed
- Department of Biomechanics & Motor Behavior, College of Sport Sciences and Physical Activity, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Shaea A Alkahtani
- Exercise Physiology Department, College of Sport Sciences and Physical Activity, King Saud University, PO Box: 1949, 11451, Riyadh, Saudi Arabia.
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Emıroglu C, Gorpelıoglu S, Ozagar SD, Demır P, Aypak C. Prevalence and risk factors of psychological symptoms and quality of life in COVID-19 survivors: A cross-sectional study of three different populations. Int J Nurs Pract 2024; 30:e13202. [PMID: 37771143 DOI: 10.1111/ijn.13202] [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: 01/17/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023]
Abstract
AIM Studies of the effects of COVID-19, especially post-acute COVID-19 syndrome, on psychological health in non-severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality-of-life in three groups of outpatients, hospitalized and intensive care patients. METHODS A total 276 patients, previously confirmed with SARS-CoV-2 infection, attending the COVID-19 follow-up outpatient clinic from December 2020 to July 2021 were interviewed face-to-face. In this cross-sectional, retrospective study, all participants were asked our self-designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL-BREF survey to evaluate quality of life. RESULTS In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post-traumatic stress disorder symptoms at a rate of 28.6% and obsessive-compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID-19 infection had a higher risk of developing psychological symptoms and decreased quality of life. CONCLUSION COVID-19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness.
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Affiliation(s)
- Canan Emıroglu
- Department of Family Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ziraat Mahallesi, Dışkapı Altındağ Ankara, Turkey
| | - Süleyman Gorpelıoglu
- Department of Family Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ziraat Mahallesi, Dışkapı Altındağ Ankara, Turkey
| | - Serap Demirelli Ozagar
- Department of Family Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ziraat Mahallesi, Dışkapı Altındağ Ankara, Turkey
| | - Pervin Demır
- Department of Statistics, University of Ankara Yıldırım Beyazıt, Ankara, Turkey
| | - Cenk Aypak
- Department of Family Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ziraat Mahallesi, Dışkapı Altındağ Ankara, Turkey
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Ning M, Chen Z, Yang J, Li X, Yu Q, Huang C, Li Y, Tian Y. Development and validation of a nomogram for predicting high-burnout risk in nurses. J Clin Nurs 2024. [PMID: 38736145 DOI: 10.1111/jocn.17210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/11/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024]
Abstract
AIM To develop a predictive model for high-burnout of nurses. DESIGN A cross-sectional study. METHODS This study was conducted using an online survey. Data were collected by the Chinese Maslach Burnout Inventory-General Survey (CMBI-GS) and self-administered questionnaires that included demographic, behavioural, health-related, and occupational variables. Participants were randomly divided into a development set and a validation set. In the development set, multivariate logistic regression analysis was conducted to identify factors associated with high-burnout risk, and a nomogram was constructed based on significant contributing factors. The discrimination, calibration, and clinical practicability of the nomogram were evaluated in both the development and validation sets using receiver operating characteristic (ROC) curve analysis, Hosmer-Lemeshow test, and decision curve analysis, respectively. Data analysis was performed using Stata 16.0 software. RESULTS A total of 2750 nurses from 23 provinces of mainland China responded, with 1925 participants (70%) in a development set and 825 participants (30%) in a validation set. Workplace violence, shift work, working time per week, depression, stress, self-reported health, and drinking were significant contributors to high-burnout risk and a nomogram was developed using these factors. The ROC curve analysis demonstrated that the area under the curve of the model was 0.808 in the development set and 0.790 in the validation set. The nomogram demonstrated a high net benefit in the clinical decision curve in both sets. CONCLUSION This study has developed and validated a predictive nomogram for identifying high-burnout in nurses. RELEVANCE TO CLINICAL PRACTICE The nomogram conducted by our study will assist nursing managers in identifying at-high-risk nurses and understanding related factors, helping them implement interventions early and purposefully. REPORTING METHOD The study adhered to the relevant EQUATOR reporting guidelines: TRIPOD Checklist for Prediction Model Development and Validation. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Meng Ning
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zengyu Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- School of Computer Science & Engineering, Central South University, Changsha, Hunan, China
| | - Xuting Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qiang Yu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chongmei Huang
- School of Nursing at Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Veçoso MC, Zalla S, Andreo-Filho N, Lopes PS, Bagatin E, Fonseca FLA, Benson HAE, Leite-Silva VR. Effect of Makeup Use on Depressive Symptoms: An Open, Randomized and Controlled Trial. Dermatol Ther (Heidelb) 2024; 14:777-791. [PMID: 38509378 PMCID: PMC10965876 DOI: 10.1007/s13555-024-01128-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Depression is one of the most disabling diseases globally, with a high disease burden that generates high direct and indirect costs. The incidence of depression is twofold higher in adult women than in men. Biological and psychosocial factors constitute the pathophysiological bases of the condition and due to the complexity of the condition, current understanding is that the "treatment strategy must be multimodal". The objective of this study was to measure the effect of introducing the frequent use of makeup on improving depressive symptoms in adult women of medium-low purchasing power METHODS: Participants with the targeted profile who did not frequently use makeup were selected and randomised to receive (test group) or not (control group) stimuli and makeup products intended for encouraging the frequent use of makeup. The Zung Depression Self-Assessment Scale was used to assess depressive symptoms, with additional assessments on self-image perception using the mirror test and salivary cortisol level. RESULTS The results demonstrated a sustained reduction in depressive symptoms (8.3 percentage points reduction in the Average Zung Index; P < 0.05), with a significant improvement in self-image perception (25% increase in the average score obtained in the mirror test; P < 0.05) and a specific influence on salivary cortisol levels (55% reduction in salivary cortisol concentration; P < 0.05) after the first makeup application. CONCLUSION The results show that encouraging the frequent use of makeup, a practice that can be achieved by most people and which is simple and inexpensive to implement, can contribute to effective and sustainable improvement in the well-being and mental health of a significant portion of the population.
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Affiliation(s)
- Marcos C Veçoso
- Programa de Pós-Graduação em Medicina Translacional, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Souvenir Zalla
- Programa de Pós-Graduação em Medicina Translacional, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Newton Andreo-Filho
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Patrícia S Lopes
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Edileia Bagatin
- Programa de Pós-Graduação em Medicina Translacional, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Fernando L A Fonseca
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Heather A E Benson
- Curtin Medical School, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Vânia R Leite-Silva
- Programa de Pós-Graduação em Medicina Translacional, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4102, Australia.
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Chandra JH, Kurniawan C, Puspitasari IM. Genetic Markers Associated with Postpartum Depression: A Review. Neuropsychiatr Dis Treat 2024; 20:281-293. [PMID: 38375417 PMCID: PMC10876008 DOI: 10.2147/ndt.s434165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 01/24/2024] [Indexed: 02/21/2024] Open
Abstract
Postpartum depression (PPD) is a common illness in mothers after childbirth. PPD negatively affect the mother's quality of life and the bond with the infant, which can interfere with the infant's emotional, social, and cognitive development. PPD is caused by various biological and psychosocial factors. The aim of this review is to summarize the latest evidence of the associations between genetic polymorphisms and PPD. PubMed and Scopus were used as the literature search databases for this review. The keywords used were postpartum depression, postnatal depression, genetic, and polymorphism. Twenty-seven articles were reviewed after screening and applying the inclusion criteria. As results, the serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes. Further research on PPD biomarkers should be conducted to diagnose and treat PPD patients.
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Affiliation(s)
- Joshua Harry Chandra
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Candy Kurniawan
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Irma Melyani Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, West Java, Indonesia
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Yan M, Chen L, Yang M, Zhang L, Niu M, Wu F, Chen Y, Song Z, Zhang Y, Li J, Tian J. Evidence mapping of clinical practice guidelines recommendations and quality for depression in children and adolescents. Eur Child Adolesc Psychiatry 2023; 32:2091-2108. [PMID: 35262810 DOI: 10.1007/s00787-022-01958-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 02/06/2022] [Indexed: 02/05/2023]
Abstract
This study systematically reviewed the clinical practice guidelines (CPGs) for depression in children and adolescents and assessed the quality and recommendation consistency of those CPGs. Evidence mapping was presented to illustrate the research trends and identify gaps to guide future research. Literature on CPGs for depression was systematically collected from PubMed, Embase, Web of Science, guideline databases, and psychiatric association/ society websites. The basic information, recommendations, methodological quality, and reporting quality of CPGs were extracted, and the supporting evidence strength for the included CPGs was analyzed in Excel. Four appraisers independently assessed the eligible CPGs using AGREE II instrument and the RIGHT checklist. All recommendations from the CPGs were summarized and analyzed, and the evidence mapping bubble charts were plotted in Excel. After excluding 15,184 records, 12 depression CPGs were eventually proved eligible, six of which were of high quality and six medium quality. A total of 39 major recommendations were summarized, 35 of which were supported by high-quality CPGs. Although direct comparisons are challenging due to differences in grading schemes and research quality, most CPGs share many pivotal recommendations that can help guide clinical practice. However, the evidence for some clinical problems is still lacking. Thus, more research is necessary on the screening and treatment of children and adolescents to put forward more evidence-based and high-quality recommendations.
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Affiliation(s)
- Meili Yan
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou, Gansu, China
| | - Lingmin Chen
- Department of Anesthesiology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University and The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Min Yang
- Comprehensive Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Zhang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou, Gansu, China
- The Third Ward of Cardiovascular Clinical Medical Center, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Mingming Niu
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou, Gansu, China
| | - Fangfang Wu
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou, Gansu, China
- Shangluo Vocational and Technical College, Shangluo, Shanxi, China
| | - Yamin Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou, Gansu, China
| | - Ziwei Song
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou, Gansu, China
| | - Yonggang Zhang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiang Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, China.
| | - Jinhui Tian
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou, Gansu, China.
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, Gansu, China.
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Matthew C, Dahle N, Roskvist R, Moir F, Arroll B. Burns Depression Scale Today (BDST): A validation study of BDST against the reference standard of PHQ-9. J Family Med Prim Care 2023; 12:1367-1370. [PMID: 37649750 PMCID: PMC10465026 DOI: 10.4103/jfmpc.jfmpc_9_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/14/2023] [Accepted: 04/04/2023] [Indexed: 09/01/2023] Open
Abstract
Background Case finding for low mood is essential in primary care, but it is time-consuming using current depression inventories. The Burns Depression Scale Today (BDST) is a short, simple inventory which assesses mood for today, and we aimed to validate it in this study. Materials and Methods Consecutive patients with emotional distress seen in a single primary care clinic by one of the authors over 22 months were eligible for this retrospective audit (N = 160). Multiple visits (N = 421) from the same patient were included in the study. The index test was BDST, which assesses the patient's mood for today. The reference standard was the 9-item Patient Health Questionnaire (PHQ-9), which assesses mood over the past 2 weeks. PHQ-9 had a cut-off point of ≥10 and BDST had a cut-off point of ≥6 for a significant mood issue. Results The median age of patients was 35 years, and 63% of the cohort were women. The median BDST score was 8, indicative of moderately low mood, and the median PHQ-9 score was 15, indicative of moderately severe depression. For patients with a BDST score ≥6, the likelihood ratio of a positive test was 2.67. The sensitivity was 85% (95% confidence interval [CI]: 89%-96%) and the specificity was 68% (95% CI: 60%-76%). The area under the curve was 84% (95% CI: 80%-87%). Conclusion This audit validates BDST against PHQ-9 and finds it an excellent case-finding tool compared to PHQ-9. This is the first validation study of BDST.
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Affiliation(s)
- Carolyn Matthew
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Nina Dahle
- Centre for Clinical Research, Uppsala University, Falun, Sweden
- Primary Health Care Center Britsarvet-Grycksbo, County of Dalarna, Falun, Sweden
| | - Rachel Roskvist
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Fiona Moir
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Bruce Arroll
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
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Veçoso MC, Bagatin E, Fonseca FLA, Andreo-Filho N, Lopes PS, Leite-Silva VR. Association Between Frequent Use of Makeup and Presence of Depressive Symptoms-Population-Based Observational Study, Including 2400 Participants. Dermatol Ther (Heidelb) 2023; 13:1083-1097. [PMID: 36864245 PMCID: PMC9980851 DOI: 10.1007/s13555-023-00911-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
INTRODUCTION The increased prevalence of depression is a global phenomenon, with an estimated 320 million cases worldwide. In Brazil, the World Health Organization (WHO) estimated that there are about 12 million cases or more, mainly among adult women with lower socioeconomic status, leading to a high consumption of health resources. Studies suggest a positive association of measures related to appearance care on depressive symptoms, but usually with no objective methodology. This study aimed to estimate the prevalence of depressive symptoms in adult Brazilian women with lower purchasing power and to verify the association between the intensity of symptoms and the use of makeup. METHODS A national sample of 2400 cases from all regions of the country, drawn randomly from an online panel representative of the Brazilian population, was studied using an online questionnaire accessible via computer or smartphone, from which the frequency of use of makeup was surveyed, and the Zung Depressive Self-Rating Scale was applied for the inventory of symptoms. RESULTS A prevalence of 61.4% (0.59-0.63) of depressive symptoms was identified. The association between frequent use of makeup and a lower prevalence of cases with a Zung index suggestive of mild depression was confirmed. Association between frequent use of makeup and lower intensity of depressive symptoms was also identified among cases with a Zung index suggestive of absence of depression. Additionally, an association was identified between the habit of frequent use of makeup and higher economic class as well as the younger age group. CONCLUSION The results suggest the hypothesis that use of makeup may contribute both to a lower prevalence of mild depression and less expressive symptoms when index of absence of depression is observed.
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Affiliation(s)
- Marcos C Veçoso
- Departamento de Medicina, Programa de Pós-Graduação Em Medicina Translacional, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Edileia Bagatin
- Departamento de Medicina, Programa de Pós-Graduação Em Medicina Translacional, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.
- Departamento de Dermatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, Alameda Irae. 184, ap. 111, Sao Paulo, SP, 04075-000, Brazil.
| | - Fernando L A Fonseca
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Newton Andreo-Filho
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Patrícia S Lopes
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Vânia R Leite-Silva
- Departamento de Medicina, Programa de Pós-Graduação Em Medicina Translacional, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Sao Paulo, Brazil
- Faculty of Medicine, Therapeutics Research Group, Frazer Institute, The University of Queensland, Brisbane, QLD, 4102, Australia
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Simbar M, Nazarpour S, KhodaKarami N, Nasiri Z, Rashidi Fakari F, Kiani Z, Keyvanfar S, Alavi Majd H. A situation analysis on postmenopausal women's self-care needs and priorities in Tehran: a population-based study. BMC Public Health 2023; 23:104. [PMID: 36641438 PMCID: PMC9840540 DOI: 10.1186/s12889-023-15040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Women need special care during and after menopause. Due to the emphasis of the World Health Organization on promoting self-care in postmenopausal women, this study aims to analyze the situation and prioritize the self-care needs of postmenopausal women in the Tehran-Iran. METHODS This was a descriptive-analytical study on 486 postmenopausal women aged 46-85 years living in Tehran in 2021. The Subjects were recruited using a multi-stage sampling method. Data were collected using a socio-demographic and a valid and reliable questionnaire to assess postmenopausal women's self-care status with four domains including physical health, psychosocial health, reproductive-sexual health, and screening tests. The data were analyzed by SPSS-24. RESULTS The mean age of the participants was 62.58 ± 7.75 years. The mean score of self-care was 44.63 ± 21.64% in the postmenopausal women. The lowest score and highest scores were related to psychosocial health (25.12 ± 28.21%) and periodic tests (50.62 ± 24.40%) respectively. There were significant positive correlations between self-care with women's education level (r = 0.277; p < 0.001), husband's education level (r = 0.258; p < 0.001), as well as monthly income (r = 0.153; p = 0.001). There was a negative correlation between self-care with the number of children (r = - 0.215; p < 0.001). The level of self-care was higher in employed women (p = 0.001) and also, in women whose husbands were employed (p = 0.012). Multiple linear regression test showed the level of education of the husband (B = 2.72, p = 0.038) and the family size (B = -1.54, p = 0.023) are predictors of the self-care of postmenopausal women. CONCLUSION The findings showed more than 55% of challenges in the self-care behaviors of postmenopausal women in Tehran. The most and least challenging self-care behaviors were related to psychosocial health and performing periodic tests. The priorities were in psychosocial health and reproductive-sexual health dimensions. Self-care promotion is necessary, especially in postmenopausal women, who need special care due to various physical, psychological, and social changes.
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Affiliation(s)
- Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Nahid KhodaKarami
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Nasiri
- General Directorate of Health, The Deputy of Social and Cultural Affairs of Tehran Municipality, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Zahra Kiani
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Keyvanfar
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Whitsett MP, Goswami Banerjee A, Serper M. Assessment of mental health in patients with chronic liver disease. Clin Liver Dis (Hoboken) 2022; 20:52-56. [PMID: 36033429 PMCID: PMC9405502 DOI: 10.1002/cld.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/21/2021] [Accepted: 01/19/2022] [Indexed: 02/04/2023] Open
Abstract
Content available: Audio Recording.
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Affiliation(s)
| | | | - Marina Serper
- Gastroenterology and HepatologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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11
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Chand S, Kapoor S, Naqvi A, Thakkar J, Fazzari MJ, Orsi D, Dieiev V, Lewandowski DC, Dicpinigaitis PV. Long-Term Follow up of Renal and Other Acute Organ Failure in Survivors of Critical Illness Due to Covid-19. J Intensive Care Med 2022; 37:736-742. [PMID: 34918990 PMCID: PMC9064678 DOI: 10.1177/08850666211062582] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/06/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Little is known about the long-term health sequelae and outcomes of various organ failures in ICU survivors of Covid-19. The aim of our research was to study the characteristics of 120-day ICU survivors of the initial pandemic surge and report their long term (>6 months) outcomes. METHODS We conducted a telephone questionnaire-based follow up study of 120- day survivors of Covid-19 admitted to ICUs at Montefiore Medical Center, Bronx, NY from 3/10/2020 to 4/11/2020. The study period was 2 months (11/1/2020-12/31/2020). RESULTS 126 out of 300 (42%) survived to 120-days post-hospital discharge. The median age of survivors was 54 (47-61) years. Seventy-eight (62%) patients developed acute kidney injury (AKI); thirty-five (44.9%) of them required renal replacement therapy (RRT). One hundred-five (83.3%) required invasive mechanical ventilation; ten of them required tracheotomy. 103 (81.7%) completed the telephone questionnaire-based study, at a median (IQR) of 216.5 (200-234.5) days after hospital discharge. 29 (28.2%) patients reported persistent shortness of breath, 24, (23.3%) complained of persistent cough, and persistent anosmia in 9 (8.8%). AKI resolved completely in 58 (74.4%) patients. Of 35 AKI patients who required initiation of RRT during hospitalization, 27 (77%) were liberated from RRT and 20 (57%) had resolution of AKI. Of 20 patients without AKI resolution, 12 developed chronic kidney disease, whereas 8 still require RRT. Thirty-three (32.4%) patients developed post-traumatic stress disorder (PTSD) and 10 (11.8%) reported major depression. Many of the patients (68%) regained baseline functional status. Readmissions occurred in 22.3% patients within first 6 months after discharge. CONCLUSION Persistent symptoms of long Covid have been reported in ICU survivors of Covid-19 for extended durations. Outcomes of Covid-19 associated acute kidney injury are excellent. There is a high incidence of PTSD and depression in COVID-19 ICU survivors. Functional outcomes are good, but these patients remain at increased risk of hospital readmission.
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Affiliation(s)
| | | | - Ali Naqvi
- Montefiore Medical Center, Bronx, NY, USA
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12
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Herreen D, Rice S, Zajac I. Brief assessment of male depression in clinical care: Validation of the Male Depression Risk Scale short form in a cross-sectional study of Australian men. BMJ Open 2022; 12:e053650. [PMID: 35351704 PMCID: PMC8961138 DOI: 10.1136/bmjopen-2021-053650] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To develop and validate a short form of the Male Depression Risk Scale (MDRS-22) for use in primary care, examining associations with prototypic depression symptoms, psychological distress and suicidality. DESIGN Cross-sectional study with 8-month follow-up. SETTING Community-based. PARTICIPANTS A community sample of younger (n=510; 18-64 years) and older (n=439; 65-93 years) men residing in Australia (M age=58.09 years, SD=17.77) participated in the study. A subset of respondents (n=159 younger men; n=169 older men) provided follow-up data approximately eight months later. PRIMARY AND SECONDARY OUTCOME MEASURES Quantitative data were obtained through a survey comprising a range of validated measures, including the MDRS-22, the Patient Health Questionnaire (PHQ-9) and the Kessler Psychological Distress Scale (K10). The MDRS-22 was refined using exploratory and confirmatory factor analysis in line with best practice guidelines. Analysis of variance and generalised linear models were conducted to explore relationships between variables. RESULTS The short-form MDRS consisted of seven items (MDRS-7) and captured all of the domains in the original tool. Participants with mixed symptoms (PHQ-9 ≥ 10 and MDRS-7 > 5) had significantly higher risk of mental illness (K10 ≥ 25) and current suicidality (PHQ-9 item 9 ≥ 1) than those with exclusively prototypic symptoms (PHQ-9 ≥ 10 and MDRS-7 ≤ 5). Furthermore, the MDRS-7 was shown to be effective at predicting elevated symptoms of depression at follow-up, after controlling for previous depression diagnosis. CONCLUSIONS Findings provide preliminary evidence of the potential utility of the MDRS-7 as a screening tool for externalised and male-type symptoms associated with major depression in men. Field trials of the MDRS-7 in primary care settings may facilitate identification of men at risk of suicide and psychological distress who do not meet cut-off scores for existing measures of major depression symptoms.
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Affiliation(s)
- Danielle Herreen
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, South Australia, Australia
| | - Simon Rice
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ian Zajac
- Health & Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, South Australia, Australia
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13
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Kamath J, Leon Barriera R, Jain N, Keisari E, Wang B. Digital phenotyping in depression diagnostics: Integrating psychiatric and engineering perspectives. World J Psychiatry 2022; 12:393-409. [PMID: 35433319 PMCID: PMC8968499 DOI: 10.5498/wjp.v12.i3.393] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/23/2021] [Accepted: 02/13/2022] [Indexed: 02/06/2023] Open
Abstract
Depression is a serious medical condition and is a leading cause of disability worldwide. Current depression diagnostics and assessment has significant limitations due to heterogeneity of clinical presentations, lack of objective assessments, and assessments that rely on patients' perceptions, memory, and recall. Digital phenotyping (DP), especially assessments conducted using mobile health technologies, has the potential to greatly improve accuracy of depression diagnostics by generating objectively measurable endophenotypes. DP includes two primary sources of digital data generated using ecological momentary assessments (EMA), assessments conducted in real-time, in subjects' natural environment. This includes active EMA, data that require active input by the subject, and passive EMA or passive sensing, data passively and automatically collected from subjects' personal digital devices. The raw data is then analyzed using machine learning algorithms to identify behavioral patterns that correlate with patients' clinical status. Preliminary investigations have also shown that linguistic and behavioral clues from social media data and data extracted from the electronic medical records can be used to predict depression status. These other sources of data and recent advances in telepsychiatry can further enhance DP of the depressed patients. Success of DP endeavors depends on critical contributions from both psychiatric and engineering disciplines. The current review integrates important perspectives from both disciplines and discusses parameters for successful interdisciplinary collaborations. A clinically-relevant model for incorporating DP in clinical setting is presented. This model, based on investigations conducted by our group, delineates development of a depression prediction system and its integration in clinical setting to enhance depression diagnostics and inform the clinical decision making process. Benefits, challenges, and opportunities pertaining to clinical integration of DP of depression diagnostics are discussed from interdisciplinary perspectives.
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Affiliation(s)
- Jayesh Kamath
- Department of Psychiatry and Immunology, University of Connecticut School of Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States
- Department of Psychiatry, University of Connecticut School of Medicine, University of Connecticut Health Center, Farmington, CT 06032, United States
| | - Roberto Leon Barriera
- Department of Psychiatry, University of Connecticut School of Medicine, University of Connecticut Health Center, Farmington, CT 06032, United States
| | - Neha Jain
- Department of Psychiatry, University of Connecticut School of Medicine, University of Connecticut Health Center, Farmington, CT 06032, United States
| | - Efraim Keisari
- Department of Psychiatry, University of Connecticut School of Medicine, University of Connecticut Health Center, Farmington, CT 06032, United States
| | - Bing Wang
- Department of Computer Science and Engineering, University of Connecticut, Storrs, CT 06269, United States
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14
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PAMUK G, GÜÇLÜ YA. Prevalence and accompanying factors for postpartum depression symptoms. FAMILY PRACTICE AND PALLIATIVE CARE 2022. [DOI: 10.22391/fppc.1024922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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15
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Rogers R, Hartigan SE, Sanders CE. Identifying Mental Disorders in Primary Care: Diagnostic Accuracy of the Connected Mind Fast Check (CMFC) Electronic Screen. J Clin Psychol Med Settings 2021; 28:882-896. [PMID: 34609692 PMCID: PMC8491449 DOI: 10.1007/s10880-021-09820-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 11/27/2022]
Abstract
Primary care physicians (PCPs) often daily address diagnoses and treatment of mental disorders in their practices. The current study examined the Connected Mind Fast Check (CMFC), a two-tiered electronic screen, assessing six common mental disorders. The eight-item Initial Screen assesses possible symptoms, whereas SAM modules establish provisional diagnoses and areas of clinical concern. With 234 patients from five independent PCP offices, diagnostic accuracy was tested with the SCID-5-RV as the external criterion. Concerningly, many patients were unaware of their current mental disorders and comorbidities. The CMFC Initial Screen evidenced strong sensitivity, identifying with very few missing diagnoses. About two-thirds of provisional SAM diagnoses were confirmed with high specificities. Bipolar Disorder posed the most challenges at both tiers. Importantly, the suicide screen identified all patients with suicide plans and three-fourths with ideation. In general, the CMFC effectively identified provisional diagnoses, impairment, and potential suicidality.
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Affiliation(s)
- Richard Rogers
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, 311280, USA.
| | - Sara E Hartigan
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, 311280, USA
| | - Courtney E Sanders
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, 311280, USA
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16
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Ter Avest E, van Munster BC, van Wijk RJ, Tent S, Ter Horst S, Hu TT, van Heijst LE, van der Veer FS, van Beuningen FE, Ter Maaten JC, Bouma HR. Cohort profile of Acutelines: a large data/biobank of acute and emergency medicine. BMJ Open 2021; 11:e047349. [PMID: 34266842 PMCID: PMC8286769 DOI: 10.1136/bmjopen-2020-047349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Research in acute care faces many challenges, including enrolment challenges, legal limitations in data sharing, limited funding and lack of singular ownership of the domain of acute care. To overcome these challenges, the Center of Acute Care of the University Medical Center Groningen in the Netherlands, has established a de novo data, image and biobank named 'Acutelines'. PARTICIPANTS Clinical data, imaging data and biomaterials (ie, blood, urine, faeces, hair) are collected from patients presenting to the emergency department (ED) with a broad range of acute disease presentations. A deferred consent procedure (by proxy) is in place to allow collecting data and biomaterials prior to obtaining written consent. The digital infrastructure used ensures automated capturing of all bed-side monitoring data (ie, vital parameters, electrophysiological waveforms) and securely importing data from other sources, such as the electronic health records of the hospital, ambulance and general practitioner, municipal registration and pharmacy. Data are collected from all included participants during the first 72 hours of their hospitalisation, while follow-up data are collected at 3 months, 1 year, 2 years and 5 years after their ED visit. FINDINGS TO DATE Enrolment of the first participant occurred on 1 September 2020. During the first month, 653 participants were screened for eligibility, of which 180 were approached as potential participants. In total, 151 (84%) provided consent for participation of which 89 participants fulfilled criteria for collection of biomaterials. FUTURE PLANS The main aim of Acutelines is to facilitate research in acute medicine by providing the framework for novel studies and issuing data, images and biomaterials for future research. The protocol will be extended by connecting with central registries to obtain long-term follow-up data, for which we already request permission from the participant. TRIAL REGISTRATION NUMBER NCT04615065.
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Affiliation(s)
- Ewoud Ter Avest
- Emergency medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Raymond J van Wijk
- Emergency medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sanne Tent
- Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sanne Ter Horst
- Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ting Ting Hu
- Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Lisanne E van Heijst
- Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | | | | | - Jan Cornelis Ter Maaten
- Emergency Department & Department of internal medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Hjalmar R Bouma
- Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands
- Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, Groningen, The Netherlands
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17
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Gamsızkan Z, Sungur MA, Erdemir G. How do older age, gender and risk groups affect protective behaviours and mental health in the COVID-19 pandemic? Int J Clin Pract 2021; 75:e14150. [PMID: 33720469 PMCID: PMC8250116 DOI: 10.1111/ijcp.14150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/02/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND COVID-19 infection is severe in the presence of older age, male gender and risk factors. The aim of this study was to examine the relationship between the level of anxiety created by immensely spreading COVID-19-related information and age, gender and the presence of risk factors. MATERIAL AND METHODS The data used in this study were obtained by collecting a 25-question questionnaire created through Google forms with various communication tools. RESULTS The data of 929 people who answered the questionnaire were used. The level of anxiety increased with age significantly, upon hearing that a person from their age group was harmed by the virus (P < .001). The feelings of being depressed and hopeless significantly increased as the age increased (P < .001). There was no significant difference between the genders in terms of feeling depressed and feeling of lack of joy in life (P = .066, P = .308, respectively). Participants with chronic diseases stated that they felt more depressed and hopeless and a lack of joy in life more frequently (P < .001). CONCLUSION Our results indicated that individuals with older age and having risk factors were more vulnerable to the stress caused by the pandemic. It is necessary for healthcare providers to identify high-risk groups by considering these situations, in order to make early psychological interventions.
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Affiliation(s)
- Zerrin Gamsızkan
- Department of Family MedicineDüzce University Medical FacultyDuzceTurkey
| | - Mehmet Ali Sungur
- Department of Biostatistics and Medical InformaticsDüzce University Medical FacultyDuzceTurkey
| | - Gökhan Erdemir
- Department of Family MedicineDüzce University Medical FacultyDuzceTurkey
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18
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Dennis ML, Davis JP. Screening for more with less: Validation of the Global Appraisal of Individual Needs Quick v3 (GAIN-Q3) screeners. J Subst Abuse Treat 2021; 126:108414. [PMID: 34116811 DOI: 10.1016/j.jsat.2021.108414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Multi-morbidity is the norm among adolescents and adults with substance use and other mental disorders and warrants a multi-pronged screening approach. However, the time constraints on assessment inherent in clinical practice often temper the desire for a full understanding of multi-morbidity problems. The 15- to 25-minute Global Appraisal of Individual Needs Quick version 3 (GAIN-Q3) includes screeners for 9 common clinical problems that are short (4 to 10 items) and provide dimensional measures of problem severity in each area that are also categorized to guide clinical decision making. The screeners are summed into a total score that represents a 10th screener for multi-morbidity. This paper provides background on the development of the GAIN-Q3 screeners, their psychometric behaviors, efficiency, and predictive power relative to the 1-2 h full GAIN-I. Based on literature showing differential item and scale functioning by age, analyses were conducted separately using data from 10,625 adolescent and 10,167 adult treatment clients. Despite the condensed lengths of the screening measures compared with their longer versions, the reliability estimates are within the good to excellent range (0.7 to 0.9) in terms of internal consistency for 6 of the 10 screeners for adolescents and 7 of the 10 screeners for adults. In addition, the part to whole correlation for all 10 comparisons for both adolescents and adults are excellent (0.82 to 0.96). Moreover, there is strong evidence for the measures' convergent and discriminant validity and efficiency (i.e., maximum information gathered in as few items possible) relative to the full-length scales as well as relative to other scales in the full GAIN-I. Analyses of the interpretive cut-scores provide accurate identification of cases with high sensitivity and specificity, thus supporting the screeners' capacity to triage. PUBLIC SIGNIFICANCE STATEMENT: This study reports on the ability (GAIN-Q3) to efficiently screen for multiple co-occurring substance use, mental health, and associated problems. Multi-problem presentation in the social service sector is the normal expectation, yet time constraints prevent broad assessment of potentially many problematic areas. The GAIN-Q3 showed convergent and discriminant validity relative to the full-length scales as well as other scales assessed in the GAIN-I. The GAIN-Q3 achieves the desired balance between broad coverage and measurement efficiency to provide ample information to identify the best course of action for an individual.
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Affiliation(s)
- Michael L Dennis
- Chestnut Health Systems, GAIN Coordinating Center, Normal, IL, United States of America.
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, University of Southern California, United States of America
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19
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Tian Y, Yue Y, Liao X, Wang J, Ye M, Liu Y, Li Y, Zhou J. Mental health service use and its associated factors among nurses in China: a cross-sectional survey. PeerJ 2021; 9:e11181. [PMID: 33868823 PMCID: PMC8029656 DOI: 10.7717/peerj.11181] [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] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/08/2021] [Indexed: 01/26/2023] Open
Abstract
Background To facilitate mental health service planning for nurses, data on the patterns of mental health service use (MHSU) among nurses are needed. However, MHSU among Chinese nurses has seldom been studied. Our study aimed to explore the rate of MHSU among Chinese nurses and to identify the factors associated with MHSU. Methods A self-designed anonymous questionnaire was used in this study. MHSU was assessed by the question, “Have you ever used any kind of mental health services, such as mental health outpatient services or psychotherapies, when you felt that your health was suffering due to stress, insomnia, or other reasons?” The answer to the question was binary (yes or no). Sleep quality, burnout, and depressive symptoms were assessed using the Chinese version of the Pittsburgh Sleep Quality Index , the Chinese version of the Maslach Burnout Inventory-General Survey and the two-item Patient Health Questionnaire, respectively. Chi-square tests and binary logistic regression were used for univariate and multivariate analyses. Results A total of 10.94% (301/2750) of the nurses reported MHSU. 10.25% (282/2750) of the nurses had poor sleep quality, burnout and depressive symptoms, and only 26.95% of these nurses reported MHSU. Very poor sleep quality (OR 9.36, 95% CI [5.38-16.29]), mid-level professional title (OR 1.48, 95% CI [1.13-1.93]) and depressive symptoms (OR 1.66, 95% CI [1.28-2.13]) were independent factors associated with MHSU. Conclusions Most of the nurses have experienced burnout, poor sleep quality or depressive symptoms and the MHSU rate among them was low. Interventions to improve the mental health of nurses and to promote the use of mental health services are needed.
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Affiliation(s)
- Yusheng Tian
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.,Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Yuchen Yue
- Department of Psychiatry at the Center for Addiction & Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Xiaoli Liao
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China.,Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jianjian Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Man Ye
- Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yiting Liu
- Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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20
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Gateau K, Song A, Vanderbilt DL, Gong C, Friedlich P, Kipke M, Lakshmanan A. Maternal post-traumatic stress and depression symptoms and outcomes after NICU discharge in a low-income sample: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:48. [PMID: 33435907 PMCID: PMC7802207 DOI: 10.1186/s12884-020-03536-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background Having a preterm newborn and the experience of staying in the neonatal intensive care unit (NICU) has the potential to impact a mother’s mental health and overall quality of life. However, currently there are few studies that have examined the association of acute post-traumatic stress (PTS) and depression symptoms and infant and maternal outcomes in low-income populations. Design/ methods In a cross-sectional study, we examined adjusted associations between positive screens for PTS and depression using the Perinatal Post-traumatic stress Questionnaire (PPQ) and the Patient Health-Questionnaire 2 (PHQ-2) with outcomes using unconditional logistic and linear regression models. Results One hundred sixty-nine parents answered the questionnaire with 150 complete responses. The majority of our sample was Hispanic (68%), non-English speaking (67%) and reported an annual income of <$20,000 (58%). 33% of the participants had a positive PPQ screen and 34% a positive PHQ-2 screen. After adjusting for confounders, we identified that a positive PHQ-2 depression score was associated with a negative unit (95% CI) change on the infant’s Vineland Adaptive Behavior Scales, second edition of − 9.08 (− 15.6, − 2.6) (p < 0.01). There were no significant associations between maternal stress and depression scores and infant Bayley Scales of Infant Development III scores or re-hospitalizations or emergency room visits. However, positive PPQ and screening score were associated with a negative unit (95% CI) unit change on the maternal Multicultural Quality of Life Index score of − 8.1 (− 12, − 3.9)(p < 0.01) and − 7.7 (− 12, − 3) (p = 0.01) respectively. Conclusions More than one-third of the mothers in this sample screened positively for PTS and depression symptoms. Screening scores positive for stress and depression symptoms were associated with a negative change in some infant development scores and maternal quality of life scores. Thoughtful screening programs for maternal stress and depression symptoms should be instituted. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03536-0.
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Affiliation(s)
- Kameelah Gateau
- Division of Neonatology, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA
| | - Ashley Song
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA.,Department of Preventive Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Douglas L Vanderbilt
- Section of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Cynthia Gong
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA.,Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA
| | - Philippe Friedlich
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA
| | - Michele Kipke
- Division of Research on Children, Youth and Families, Children's Hospital, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ashwini Lakshmanan
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA. .,Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA. .,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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21
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Depression Screening in a Primary Care Setting: Examining Perceptions and Experiences of English- and Spanish-Speaking Patients. J Clin Psychol Med Settings 2020; 28:584-595. [PMID: 33113042 DOI: 10.1007/s10880-020-09746-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
Depression is highly prevalent in primary care settings, but screening rates remain sub-optimal and patients' screening perspectives are poorly understood. This study examined depression screening experiences and beliefs among primary care patients (N = 100, Mage = 51.9, SD = 17.03, 49% Spanish speakers). Participants completed a survey regarding screening experiences, stigma concerns, and perceptions of screening-related importance, barriers, and concerns. While 83% of participants were screened for depression, only 44.6% had screening results explained. Levels of depression treatment-related stigma concerns were low, with English speakers endorsing higher levels of such concerns. Importance and barriers of screening scores were significantly, negatively correlated rs = - .52, p < .001. Patients' self-identification as 'long-standing' to the clinic was associated with greater endorsed screening concerns t(98) = - 2.08, p < .05. Results suggest that improved understanding of patients' screening-related perceptions and experiences is critical to ensuring delivery of quality care. Communication practices around screening should be studied, reviewed, and revised to ensure the success of screening efforts.
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22
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Birnbaum ML, Wen H, Van Meter A, Ernala SK, Rizvi AF, Arenare E, Estrin D, De Choudhury M, Kane JM. Identifying emerging mental illness utilizing search engine activity: A feasibility study. PLoS One 2020; 15:e0240820. [PMID: 33064759 PMCID: PMC7567375 DOI: 10.1371/journal.pone.0240820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 10/04/2020] [Indexed: 11/18/2022] Open
Abstract
Mental illness often emerges during the formative years of adolescence and young adult development and interferes with the establishment of healthy educational, vocational, and social foundations. Despite the severity of symptoms and decline in functioning, the time between illness onset and receiving appropriate care can be lengthy. A method by which to objectively identify early signs of emerging psychiatric symptoms could improve early intervention strategies. We analyzed a total of 405,523 search queries from 105 individuals with schizophrenia spectrum disorders (SSD, N = 36), non-psychotic mood disorders (MD, N = 38) and healthy volunteers (HV, N = 31) utilizing one year's worth of data prior to the first psychiatric hospitalization. Across 52 weeks, we found significant differences in the timing (p<0.05) and frequency (p<0.001) of searches between individuals with SSD and MD compared to HV up to a year in advance of the first psychiatric hospitalization. We additionally identified significant linguistic differences in search content among the three groups including use of words related to sadness and perception, use of first and second person pronouns, and use of punctuation (all p<0.05). In the weeks before hospitalization, both participants with SSD and MD displayed significant shifts in search timing (p<0.05), and participants with SSD displayed significant shifts in search content (p<0.05). Our findings demonstrate promise for utilizing personal patterns of online search activity to inform clinical care.
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Affiliation(s)
- Michael L. Birnbaum
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States of America
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America
- * E-mail:
| | - Hongyi Wen
- Cornell Tech, Cornell University, New York, NY, United States of America
| | - Anna Van Meter
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States of America
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America
| | - Sindhu K. Ernala
- Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Asra F. Rizvi
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States of America
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America
| | - Elizabeth Arenare
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States of America
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America
| | - Deborah Estrin
- Cornell Tech, Cornell University, New York, NY, United States of America
| | | | - John M. Kane
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States of America
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America
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23
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Vaughan EM, Johnston CA, Moreno JP, Cheskin LJ, Dutton GR, Gee M, Gaussoin SA, Knowler WC, Rejeski WJ, Wadden TA, Yanovski SZ, Foreyt JP. Symptom prevalence differences of depression as measured by BDI and PHQ scales in the Look AHEAD study. Obes Sci Pract 2020; 6:28-38. [PMID: 32128240 PMCID: PMC7042097 DOI: 10.1002/osp4.378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To compare depressive symptomatology as assessed by two frequently used measures, the Beck Depression Inventory (BDI-1A) and Patient Health Questionnaire (PHQ-9). METHODS Investigators conducted a cross-sectional secondary analysis of data collected as part of the follow-up observational phase of the Look AHEAD study. Rates of agreement between the BDI-1A and PHQ-9 were calculated, and multivariable logistic regression was used to examine the relationship between differing depression category classifications and demographic factors (ie, age, sex, race/ethnicity) or comorbidities (ie, diabetes control, cardiovascular disease). RESULTS A high level of agreement (κ = 0.47, 95% CI (0.43 to 0.50)) was found in the level of depressive symptomatology between the BDI-1A and PHQ-9. Differing classifications (minimal, mild, moderate, and severe) occurred in 16.8% of the sample. Higher scores on the somatic subscale of the BDI-1A were significantly associated with disagreement as were having a history of cardiovascular disease, lower health-related quality of life, and minority racial/ethnic classification. CONCLUSIONS Either the BDI-1A or PHQ-9 can be used to assess depressive symptomatology in adults with overweight/obesity and type 2 diabetes. However, further assessment should be considered in those with related somatic symptoms, decreased quality of life, and in racial/ethnic minority populations.
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Affiliation(s)
| | - Craig A. Johnston
- Department of Health and Human PerformanceUniversity of HoustonHoustonTexas
| | - Jennette P. Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics‐NutritionBaylor College of MedicineHoustonTexas
| | - Lawrence J. Cheskin
- Department of Nutrition and Food Studies, College of Health and Human ServicesGeorge Mason UniversityFairfaxVirginia
- Department of Health, Behavior & SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreMaryland
| | - Gareth R. Dutton
- Division of Preventive MedicineUniversity of Alabama at BirminghamBirminghamAlabama
| | - Molly Gee
- Department of MedicineBaylor College of MedicineHoustonTexas
| | - Sarah A. Gaussoin
- Department of Biostatistical Sciences and Data Science, Division of Public Health ServicesWake Forest School of MedicineWinston‐SalemNorth Carolina
| | - William C. Knowler
- Diabetes Epidemiology and Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthPhoenixArizona
| | - W. Jack Rejeski
- Division of Public Health SciencesWake Forest School of MedicineWinston‐SalemNorth Carolina
| | - Thomas A. Wadden
- Department of PsychiatryPerelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Susan Z. Yanovski
- Division of Digestive Diseases and NutritionNational Institute of Diabetes and Digestive and Kidney DiseasesBethesdaMaryland
| | - John P. Foreyt
- Department of MedicineBaylor College of MedicineHoustonTexas
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24
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Luo SC, Duan KM, Fang C, Li DY, Zheng SS, Yang SQ, Yang ST, Yang M, Zhang LB, Wang SY. Correlations Between SIRT Genetic Polymorphisms and Postpartum Depressive Symptoms in Chinese Parturients Who Had Undergone Cesarean Section. Neuropsychiatr Dis Treat 2020; 16:3225-3238. [PMID: 33380799 PMCID: PMC7769146 DOI: 10.2147/ndt.s278248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/30/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To investigate the association of genetic polymorphisms of SIRT with postpartum depressive symptoms and analyze the risk factors for postpartum depressive symptoms in women following cesarean section. METHODS A total of 368 Chinese woman undergoing cesarean section were enrolled in this study. A cutoff of ≥10 for the Edinburgh Postnatal Depression Scale identified postpartum depressive symptoms. Genotypes of SIRT1, SIRT 2, and SIRT 6 were determined using Sequenom MassArray single-nucleotide polymorphism (SNP) analysis. We analyzed the contribution of genetic factors (SNPs, linkage disequilibrium, and haplotype) to postpartum depressive symptoms and performed logistic regression analysis to identify all potential risk factors for postpartum depressive symptoms and define interactions between genetic and environmental factors. RESULTS The incidence of postpartum depressive symptoms was 18.7% in this cohort. Univariate analysis suggested that SIRT2 polymorphism at rs2873703 (TT genotype) and rs4801933 ((TT genotype) and SIRT6 polymorphism at rs350846 (CC genotype) and rs107251 (TT genotype) were significantly correlated with the occurrence of postpartum depressive symptoms (p<0.05). Linkage disequilibrium was identified between SIRT6 polymorphisms rs350846 and rs107251. Incidence of postpartum depressive symptoms in cesarean-section parturients with SIRT2 haplotype CCC was decreased (OR 0.407, 95% CI 0.191-0.867; p=0.016). SIRT2 polymorphisms rs2873703 and rs4801933 were multiply collinear. Logistic regression analysis showed that SIRT2 polymorphism at rs2873703 (TT genotype) and rs4801933 (TT genotype), domestic violence, stress during pregnancy, and depressive prenatal mood were risk factors for postpartum depressive symptoms (p<0.05). CONCLUSION Pregnant women with SIRT2 genotypes rs2873703 TT and rs4801933 TT and experiencing domestic violence, stress during pregnancy, and prenatal depression are more likely to suffer from postpartum depressive symptoms.
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Affiliation(s)
- Shi-Chao Luo
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Kai-Ming Duan
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Chao Fang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China.,Postdoctoral Research Workstation of Clinical Medicine, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Dan-Yang Li
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Shan-Shan Zheng
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Si-Qi Yang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Shu-Ting Yang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Mi Yang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Liang-Bin Zhang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
| | - Sai-Ying Wang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, People's Republic of China
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25
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Röhrig G, Lindner R. [Survey on psychosomatic treatment options in geriatric clinical routine: state of the art]. Z Gerontol Geriatr 2019; 53:430-436. [PMID: 31720831 DOI: 10.1007/s00391-019-01658-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/28/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mental and physical disorders form a common body of experience and suffering in old age that can negatively influence aging. Experience and handling of age-associated functional impairments are challenging for multimorbid patients, their relatives and the healthcare providers involved. Among patients aged 70 years or older more than 50% suffer from psychopathological symptoms and 30-40% of geriatric inpatients have a psychosomatic or psychiatric comorbidity; however, despite this high prevalence of mental problems in older patients they are hardly ever treated and if treatment is offered it is carried out by specialists for somatic medicine. The aim of the present study of the working group on gerontopsychosomatics of the German Geriatric Society (DGG) was the evaluation of interdisciplinary co-management opportunities for geriatricians who treat inpatients with gerontopsychosomatic needs. METHOD Online survey among members of the DGG regarding experiences with interdisciplinary co-management of inpatients with gerontopsychosomatic needs. RESULTS The majority of the respondents were senior physicians in a department for geriatrics. While every second institution had access to a psychiatric consultation service, psychosomatic cooperation was only offered in every fifth department. Psychosomatic co-management was particularly required in connection with neurogeriatric problems. CONCLUSION There is need of gerontopsychosomatic co-management among geriatric inpatients; however, in comparison to gerontopsychiatric co-management the options are deficient and need to be strengthened.
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Affiliation(s)
- Gabriele Röhrig
- Zentrum für spezialisierte geriatrische Diagnostik, MVZ Medicum Köln-Ost, Johann Classen Straße 68, 51103, Köln, Deutschland.
| | - Reinhard Lindner
- Institut für Sozialwesen, Fachbereich Humanwissenschaften, FG Theorie, Empirie und Methoden der Sozialen Therapie, Universität Kassel, Kassel, Deutschland
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26
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Yu HY, Wang SY, Quan CX, Fang C, Luo SC, Li DY, Zhen SS, Ma JH, Duan KM. Dexmedetomidine Alleviates Postpartum Depressive Symptoms following Cesarean Section in Chinese Women: A Randomized Placebo-Controlled Study. Pharmacotherapy 2019; 39:994-1004. [PMID: 31411762 DOI: 10.1002/phar.2320] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Few studies have investigated the prophylactic efficacy of dexmedetomidine (DEX) in postpartum depressive symptoms (PDS). A randomized double-blind placebo-controlled trial was conducted to investigate whether the administration of DEX, immediately after delivery and for patient-controlled intravenous analgesia (PCIA), can attenuate PDS. METHODS A total of 600 parturients scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated into the control group (infusion with 0.9% normal saline after delivery and PCIA with sufentanil) and the DEX group (DEX infusion 0.5 μg/kg after delivery and PCIA with DEX plus sufentanil). The prevalence of postpartum depressive disorders was indicated by the Edinburgh Postnatal Depression Scale (EPDS). Postoperative analgesia, sedation, and sleep quality of parturients were also assessed. RESULTS Postpartum blues and PDS prevalence in the DEX, versus control, group were significantly lower (5.0% vs 14.1%, p<0.001; 5.7% vs 16.3%, p<0.001, respectively), especially in parturients with antenatal depression or moderate stress during pregnancy. Compared with the control group, the EPDS score at postpartum days 7 and 42 in the DEX group was significantly lower (4.23 ± 4.37 vs 1.93 ± 3.36, p<0.001; 4.68 ± 4.78 vs 1.99 ± 3.18, p<0.001, respectively), as was the incidence of postpartum self-harm ideation at postpartum days 7 and 42 in the DEX group versus the control group (1.1% vs 4.0%, p=0.03; 0.4% vs 2.9%, p=0.04, respectively). The pain score and the sleep quality in the DEX group were better than that in the control group (p<0.001). CONCLUSION The application of DEX in the early postpartum period can significantly attenuate the incidence of postpartum depressive disorders.
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Affiliation(s)
- He-Ya Yu
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Sai-Ying Wang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Cheng-Xuan Quan
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Chao Fang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Shi-Chao Luo
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Dan-Yang Li
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Shan-Shan Zhen
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Jia-Hui Ma
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Kai-Ming Duan
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
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Yan C, Rittenbach K, Souri S, Silverstone PH. Cost-effectiveness analysis of a randomized study of depression treatment options in primary care suggests stepped-care treatment may have economic benefits. BMC Psychiatry 2019; 19:240. [PMID: 31382932 PMCID: PMC6683422 DOI: 10.1186/s12888-019-2223-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 07/29/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The stepped-care pathway (SCP) model has previously been found to be clinically effective for depressive disorder in some studies, but not all. Several groups have suggested that a stepped-care approach is the most appropriate in primary care. There is relatively little information, however, regarding which specific stepped-care pathway may be best. This analysis aimed to determine cost-effectiveness of a stepped-care pathway for depression in adults in primary care versus standard care (SC), treatment-as-usual (TAU), and online cognitive behavioural therapy (CBT). METHODS We conducted a randomized trial with 1400 participants and 12-week follow-up to assess the impact of the four treatment options on health-related quality of life and depression severity. Costs for the groups were calculated on the basis of physician, outpatient, and inpatient services using administrative data. We then calculated the incremental cost-effectiveness ratios using this information. Cost-effectiveness acceptability curves and incremental cost-effectiveness scatterplots were created using Monte Carlo simulation with 10,000 replications. A subgroup analysis was conducted for participants who screened as depressed at baseline. RESULTS For all participants, TAU was the most expensive followed by CBT, SC, and SCP. QALYs were highest in SCP, followed by SC, CBT, and TAU. In the depressed subgroup, TAU was still the most expensive, followed by SC, SCP, and CBT, while QALYs were still highest in SCP, followed by SC, CBT, and TAU. The cost-effectiveness acceptability curves suggested that SCP had a higher probability for cost-effectiveness than the other three alternatives in all participants. In the depressed subgroup, CBT was associated with the highest probability of cost-effectiveness for a willingness-to-pay cut-off of less than approximately $50,000, while SCP was the highest at a cut-off higher than $50,000. There is considerable uncertainty around the cost-effectiveness estimates. CONCLUSIONS Our analysis showed that even where there are no clinically significant differences in health outcomes between treatment approaches, there may be economic benefit from implementing the stepped-care model. While more work is required to identify the most clinically effective versions of a stepped-care pathway, our findings suggest that the care pathway may have potential to improve health care system value. TRIAL REGISTRATION NCT01975207 . The trial was prospectively registered on 4 November 2013.
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Affiliation(s)
- Charles Yan
- Institute of Health Economics, 1200 - 10405 Jasper Avenue, Edmonton, Alberta, T5J 3N4, Canada.
| | - Katherine Rittenbach
- grid.17089.37Department of Psychiatry, Addiction & Mental Health Strategic Clinical Network, Alberta Health Services, University of Alberta, 10030 107 St, NW, Edmonton, Alberta T5J 3E4 Canada
| | - Sepideh Souri
- 0000 0004 1936 7697grid.22072.35Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1 Canada
| | - Peter H. Silverstone
- grid.17089.37Department of Psychiatry, University of Alberta, 8440 112 St NW, Edmonton, Alberta T6G 2B7 Canada
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Mohammad D, Herrmann N, Saleem M, Swartz RH, Oh PI, Bradley J, Chan P, Ellis C, Lanctôt KL. Validity of a novel screen for cognitive impairment and neuropsychiatric symptoms in cardiac rehabilitation. BMC Geriatr 2019; 19:163. [PMID: 31185923 PMCID: PMC6558737 DOI: 10.1186/s12877-019-1177-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/31/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Currently, there is no composite screening tool that can efficiently and effectively assess prevalent yet under-recognized cognitive and neuropsychiatric comorbidities in patients with cardiovascular disease. We aimed to determine the validity and feasibility of a novel screen assessing cognitive impairment, anxiety, apathy and depression (CAAD screen) in those attending cardiac rehabilitation (CR). METHODS All patients diagnosed with cardiovascular disease or cardiovascular risk factors entering CR were screened as part of clinical care. A subset of those patients agreed to complete validation assessments (n = 127). Screen results were compared to widely accepted standards for cognition, anxiety, apathy, and depression using a modified receiver operating characteristic (ROC) and area under the curve analysis. RESULTS The screen was completed by 97% of participants in 10 min or less with an average completion time of approximately 5 min. Screening scores adjusted for age, sex and years of education had acceptable or excellent validity compared to widely accepted standard diagnoses: CAAD-Cog (AUC = 0.80); CAAD-Anx (AUC = 0.81); CAAD-Apathy (AUC = 0.79) and CAAD-Dep (AUC = 0.85). CONCLUSIONS The CAAD screen may be a valid and feasible tool for detecting cognitive impairment, anxiety, apathy and depression in CR settings.
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Affiliation(s)
- Dana Mohammad
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
| | - Mahwesh Saleem
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario Canada
| | - Richard H. Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario Canada
| | - Paul I. Oh
- University Health Network at Toronto Rehabilitation Institute, Toronto, Ontario Canada
| | - Janelle Bradley
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario Canada
| | - Parco Chan
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario Canada
| | - Courtney Ellis
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario Canada
| | - Krista L. Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
- University Health Network at Toronto Rehabilitation Institute, Toronto, Ontario Canada
- Sunnybrook Hospital, FG-08, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada
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29
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Choosing Pre-conception Planning for Women/Families: Counselling and Informed Consent (Part 2) – Pre-conception Reproductive Planning, Lifestyle, Immunization, and Psychosocial Issues. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:666-678. [DOI: 10.1016/j.jogc.2017.08.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 11/23/2022]
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30
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Coppola G, Operto FF, Matricardi S, Verrotti A. Monitoring And Managing Depression In Adolescents With Epilepsy: Current Perspectives. Neuropsychiatr Dis Treat 2019; 15:2773-2780. [PMID: 31576132 PMCID: PMC6765392 DOI: 10.2147/ndt.s192714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 09/02/2019] [Indexed: 11/23/2022] Open
Abstract
Epilepsy is associated with a significantly increased risk of developing depressive disorder during adolescence. On the other hand, depression is highly detected in adolescents with epilepsy. These findings highlight the importance of early identification and proper management of comorbid depression in adolescent age. The prevalence of depressive disorders in adolescents with epilepsy ranges between 8 and 35% and is higher than the general population of the same age. The relationship between epilepsy and depression is complex and potentially bidirectional, thereby suggesting a common underlying pathophysiology. Furthermore, failure to detect and treat depressive disorder mostly in adolescence could lead to several negative implications such as an increased risk of suicidal ideation or behavior and poor quality of life. A number of methods are available to detect depressive disorder, such as psychiatric or psychological assessments, structured or semi-structured interviews, and self-report screening tools. Thus, physicians should be able to regularly screen depressive symptoms in youths with epilepsy. Recently, the NDDI-E-.Y inventory has been developed from the adult NDDI-E, and has been validated in many countries. NDDI-E-Y has showed reliable validity, being a brief screening tool (12 items) that can be easily included in routine epilepsy care. The first step to be considered for the management of depressive disorder in adolescents with epilepsy is to consider potential reversible causes of anxiety and depression (i.e., a new AEDs; seizure control). Secondly, great attention has to be given to the education of the child/adolescent and his/her family, trying to improve knowledge about epilepsy as well as to decrease parental stress and improving the child's sense of competence. Pharmacological treatment should also be considered in adolescents diagnosed with depression.
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Affiliation(s)
- Giangennaro Coppola
- Child and Adolescent Neuropsychiatry, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, Salerno, Italy
| | - Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, Salerno, Italy
| | - Sara Matricardi
- Department of Pediatric Neurology, Ospedali Riuniti, Ancona, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
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Boztepe H, Çınar S, Ay A, Kerimoğlu Yıldız G, Kılıç C. Predictors of caregiver burden in mothers of children with leukemia and cerebral palsy. J Psychosoc Oncol 2018; 37:69-78. [PMID: 30422097 DOI: 10.1080/07347332.2018.1489441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Caring for a sick child can lead to considerable burden in the caregiver. Comparative studies of burden in mothers of children with different types of disorders are rare. METHODS We assessed levels of and risk factors for burden in mothers of children with leukemia (n: 70) or with cerebral palsy (CP) (n: 69). Subjects were recruited from two hospitals in Ankara. RESULTS Levels of burden or depression were not different between groups. Burden was predicted by the presence of depression in the mother and severity of illness in both groups. In the leukemia group, mothers reported higher burden if the child was male or younger; no such relationship was observed in the CP group. CONCLUSION Our results show that type of illness has an effect on levels of burden. Mothers of children with leukemia should receive more attention, especially if their child is male or younger, to take preventive measures against burden.
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Affiliation(s)
- Handan Boztepe
- a Department of Pediatric Nursing, Faculty of Nursing , Hacettepe University , Ankara , Turkey
| | - Sevil Çınar
- a Department of Pediatric Nursing, Faculty of Nursing , Hacettepe University , Ankara , Turkey
| | - Ayşe Ay
- a Department of Pediatric Nursing, Faculty of Nursing , Hacettepe University , Ankara , Turkey
| | - Gizem Kerimoğlu Yıldız
- b Department of Pediatric Nursing, Florence Nightingale Nursing Faculty , Istanbul University , Istanbul, Turkey
| | - Cengiz Kılıç
- c Department of Psychiatry, Faculty of Medicine , Hacettepe University , Ankara , Turkey
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Mulvaney-Day N, Marshall T, Downey Piscopo K, Korsen N, Lynch S, Karnell LH, Moran GE, Daniels AS, Ghose SS. Screening for Behavioral Health Conditions in Primary Care Settings: A Systematic Review of the Literature. J Gen Intern Med 2018; 33:335-346. [PMID: 28948432 PMCID: PMC5834951 DOI: 10.1007/s11606-017-4181-0] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 06/14/2017] [Accepted: 08/30/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Mounting evidence indicates that early recognition and treatment of behavioral health disorders can prevent complications, improve quality of life, and help reduce health care costs. The aim of this systematic literature review was to identify and evaluate publicly available, psychometrically tested tools that primary care physicians (PCPs) can use to screen adult patients for common mental and substance use disorders such as depression, anxiety, and alcohol use disorders. METHODS We followed the Institute of Medicine (IOM) systematic review guidelines and searched PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, and Health and Psychosocial Instruments databases to identify literature addressing tools for screening of behavioral health conditions. We gathered information on each tool's psychometrics, applicability in primary care, and characteristics such as number of items and mode of administration. We included tools focused on adults and the most common behavioral health conditions; we excluded tools designed for children, youth, or older adults; holistic health scales; and tools screening for serious but less frequently encountered disorders, such as bipolar disorder. RESULTS We identified 24 screening tools that met the inclusion criteria. Fifteen tools were subscales stemming from multiple-disorder assessments or tools that assessed more than one mental disorder or more than one substance use disorder in a single instrument. Nine were ultra-short, single-disorder tools. The tools varied in psychometrics and the extent to which they had been administered and studied in primary care settings. DISCUSSION Tools stemming from the Patient Health Questionnaire had the most testing and application in primary care settings. However, numerous other tools could meet the needs of primary care practices. This review provides information that PCPs can use to select appropriate tools to incorporate into a screening protocol.
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Affiliation(s)
| | | | | | - Neil Korsen
- Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, USA
| | - Sean Lynch
- Substance Abuse and Mental Health Services Administration, Rockville, MD, USA
| | - Lucy H Karnell
- Truven Health Analytics, an IBM Company, Cambridge, MA, USA
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Gill SJ, Lukmanji S, Fiest KM, Patten SB, Wiebe S, Jetté N. Depression screening tools in persons with epilepsy: A systematic review of validated tools. Epilepsia 2017; 58:695-705. [DOI: 10.1111/epi.13651] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Stephanie J. Gill
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| | - Sara Lukmanji
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| | - Kirsten M. Fiest
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Department of Critical Care Medicine; University of Calgary; Calgary Alberta Canada
| | - Scott B. Patten
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Mathison Centre for Mental Health Research & Education; University of Calgary; Calgary Alberta Canada
- Department of Psychiatry; University of Calgary; Calgary Alberta Canada
| | - Samuel Wiebe
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
| | - Nathalie Jetté
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
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Silverstone PH, Rittenbach K, Suen VYM, Moretzsohn A, Cribben I, Bercov M, Allen A, Pryce C, Hamza DM, Trew M. Depression Outcomes in Adults Attending Family Practice Were Not Improved by Screening, Stepped-Care, or Online CBT during a 12-Week Study when Compared to Controls in a Randomized Trial. Front Psychiatry 2017; 8:32. [PMID: 28373846 PMCID: PMC5357781 DOI: 10.3389/fpsyt.2017.00032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/15/2017] [Indexed: 11/13/2022] Open
Abstract
There is uncertainty regarding possible benefits of screening for depression in family practice, as well as the most effective treatment approach when depression is identified. Here, we examined whether screening patients for depression in primary care, and then treating them with different modalities, was better than treatment-as-usual (TAU) alone. Screening was carried out for depression using the 9-item Patient Health Questionnaire (PHQ-9), with a score of ≥10 indicating significant depressive symptoms. PHQ-9 scores were given to family physicians prior to patients being seen (except for the Control group). Patients (n = 1,489) were randomized to one of four groups. Group #1 were controls (n = 432) in which PHQ-9 was administered, but results were not shared. Group #2 was screening followed by TAU (n = 426). Group #3 was screening followed by both TAU and the opportunity to use an online cognitive behavioral therapy (CBT) treatment program (n = 440). Group #4 utilized an evidence-based Stepped-care pathway for depression (n = 191, note that this was not available at all clinics). Of the study sample 889 (60%) completed a second PHQ-9 rating at 12 weeks. There were no statistically significant differences in baseline PHQ-9 scores between these groups. Compared to baseline, mean PHQ-9 scores decreased significantly in the depressed patients over 12 weeks, but there were no statistically significant differences between any groups at 12 weeks. Thus, for those who were depressed at baseline Control group (Group #1) scores decreased from 15.3 ± 4.2 to 4.0 ± 2.6 (p < 0.001), Screening group (Group #2) scores decreased from 15.5 ± 3.9 to 4.6 ± 3.0 (p < 0.001), Online CBT group (Group #3) scores decreased from 15.4 ± 3.8 to 3.4 ± 2.7 (p < 0.01), and the Stepped-care pathway group (Group #4) scores decreased from 15.3 ± 3.6 to 5.4 ± 2.8 (p < 0.05). In conclusion, these findings from this controlled randomized study do not suggest that using depression screening tools in family practice improves outcomes. They also suggest that much of the depression seen in primary care spontaneously resolves and do not support suggestions that more complex treatment programs or pathways improve depression outcomes in primary care. Replication studies are required due to study limitations.
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Affiliation(s)
- Peter H Silverstone
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada; Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada; Department of Finance and Statistical Analysis, University of Alberta, Edmonton, AB, Canada
| | - Katherine Rittenbach
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Victoria Y M Suen
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | | | - Ivor Cribben
- Department of Finance and Statistical Analysis, University of Alberta , Edmonton, AB , Canada
| | - Marni Bercov
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Andrea Allen
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Catherine Pryce
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Deena M Hamza
- Department of Psychiatry, University of Alberta , Edmonton, AB , Canada
| | - Michael Trew
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
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Abstract
INTRODUCTION The updated American Geriatrics Society (AGS) 2015 Beers Criteria include the following antidepressant classes as potentially inappropriate medications to be used with caution in older adults: selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and mirtazapine. METHODS A search of the medical literature using PubMed and references included in the AGS 2015 Beers Criteria. RESULTS The treatment of depression in the older adult can additionally be complicated by comorbid conditions, as 80% of older adults have at least 1 comorbid condition and 50% have at least 2. These considerations limit the pharmacologic treatment options for depression in older adults. However, the treatment of major depression should not be overlooked, as it is quite common, with estimates of up to 5% of older adults in the community and up to 13.5% in older adults who receive home health care. DISCUSSION This article reviews treatment considerations of depression in the older adult, including both available screening tools and a discussion balancing the need for treatment of depression in this population with the concerns addressed in the 2015 Beers Criteria.
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Affiliation(s)
- Bridget Bradley
- Assistant Professor, Pacific University School of Pharmacy, Hillsboro, Oregon,
| | - Danielle Backus
- Assistant Professor, Pacific University School of Pharmacy, Hillsboro, Oregon
| | - Emily Gray
- PharmD Candidate, Pacific University School of Pharmacy, Hillsboro, Oregon
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Liu ZW, Yu Y, Hu M, Liu HM, Zhou L, Xiao SY. PHQ-9 and PHQ-2 for Screening Depression in Chinese Rural Elderly. PLoS One 2016; 11:e0151042. [PMID: 26978264 PMCID: PMC4792401 DOI: 10.1371/journal.pone.0151042] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 02/23/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to explore cut-off scores of the 9-item Patient Health Questionnaire (PHQ-9) and 2-item Patient Health Questionnaire (PHQ-2) for depression screening in Chinese rural elderly. Methods A cross-sectional study was conducted on 839 residents aged 60 years and above in rural areas of Liuyang County. PHQ-9 was adopted to evaluate depression. The Structured Clinical Interview for DSM Disorders (SCID-I) was adopted to diagnose major depressive disorder (MDD) as a golden standard. Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, Youden’s index and the receiver operating characteristic (ROC) curve were analyzed on PHQ-9 and PHQ-2. Results The Cronbach's alphas of PHQ-9 and PHQ-2 were 0.82 and 0.76, respectively. The score of 8 of the PHQ-9 showed the highest Youden’s index of 0.85, with a sensitivity of 0.97 and specificity of 0.89 respectively, and the area under the ROC curve (AUC) was 0.97 (95% CI: 0.96–0.98). The score of 3 of PHQ-2 showed the highest Youden’s index of 0.79, with both sensitivity and specificity were 0.90 and the AUC was 0.94 (95% CI: 0.90–0.97). Conclusions Both PHQ-9 and PHQ-2 are valid screening instruments for depression in the rural elderly in China, with recommended cut-off scores of 8 and 3 respectively.
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Affiliation(s)
- Zi-wei Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Hui-ming Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Liang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shui-yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
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Developing a brief depression screen and identifying associations with comorbid physical and psychological illness in Australian Gulf War veterans. J Psychosom Res 2015; 79:566-73. [PMID: 26477979 DOI: 10.1016/j.jpsychores.2015.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Major depression occurs frequently in veterans, and is associated with comorbid psychological and physical disorders and poorer quality of life. Depression can be difficult to detect in primary care, while lengthy assessment instruments can deter use. Our study aimed to develop a brief depression screen that could be used by veterans and caregivers, and then to compare the association between the brief screen and comorbidities and quality of life with that of a longer instrument. METHODS Our dataset comprised 1204 male Royal Australian Navy veterans of the 1990/91 Gulf War. Depressive symptoms were assessed using the General Health Questionnaire (GHQ-12), health-related quality of life by the Short-Form Health Survey (SF-12), major depression and comorbid psychiatric diagnoses such as posttraumatic disorder (PTSD) using Diagnostic and Statistical Manual (DSM-IV) criteria. Comorbid physical illnesses including musculoskeletal disorders, chronic fatigue and diabetes were examined. RESULTS A brief depression screen of three key self-reported symptoms was identified. Veterans with major depression present according to the screen were over four times more likely to have multisymptom illness or PTSD, and almost twice as likely to have musculoskeletal disorders. Having depression according to the brief screen and having at least one other physical or psychological condition was associated with poorer quality of life. Similar results were obtained for a longer screen based on all GHQ-12 items. CONCLUSION A 3 item depression screen performed as well as a 12 item one in identifying major depression, comorbid physical and psychological illness and poorer quality of life in veterans.
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Borisovskaya A, Chen K, Borson S. Are we providing the best possible care for dementia patients? Neurodegener Dis Manag 2015; 5:217-24. [DOI: 10.2217/nmt.15.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
SUMMARY Healthcare for patients with dementia is often reactive, poorly organized and fragmented. We discuss opportunities for improvements in the care of individuals living with dementia at home that can be implemented by physicians in their practices today. In particular, we argue that systematic identification and diagnosis of cognitive impairment and dementia in their early stages, coupled with a coherent, evidence-informed management framework, would benefit patients with dementia substantially and ease the burden of their caregivers. We emphasize that dementia influences all aspects of patient care, and each medical decision must be passed through the filter of knowledge that patients with dementia have special needs that can be identified and addressed.
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Affiliation(s)
- Anna Borisovskaya
- University of Washington, Veterans’ Affairs Medical Center, 1660 South Columbian Way, S-116, Seattle, WA 98108, USA
- University of Washington, Department of Psychiatry & Behavioral Sciences, 1959 NE Pacific Street, Seattle, WA 98108, USA
| | - Kathryn Chen
- University of Washington, Veterans’ Affairs Medical Center, 1660 South Columbian Way, S-116, Seattle, WA 98108, USA
| | - Soo Borson
- University of Washington, Veterans’ Affairs Medical Center, 1660 South Columbian Way, S-116, Seattle, WA 98108, USA
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