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Ustrup M, Christensen T, Curth NK, Heine K, Bojesen AB, Eplov LF. Predictors of Symptom Reduction and Remission Among People with Anxiety: Secondary Analyses from a Randomized Controlled Trial. Psychiatr Q 2024:10.1007/s11126-024-10081-y. [PMID: 39023677 DOI: 10.1007/s11126-024-10081-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2024] [Indexed: 07/20/2024]
Abstract
Despite the substantial disease burden of anxiety disorders, only limited or conflicting data on prognostic factors is available. Most studies include patients in the secondary healthcare sector thus, the generalizability of findings is limited. The present study examines predictors of symptom reduction and remission in patients with anxiety disorders in a primary care setting. 214 patients with anxiety disorders, recruited as part of the Collabri Flex trial, were included in secondary analyses. Data on potential predictors of anxiety symptoms at 6-month follow-up was collected at baseline, including patient characteristics related to demography, illness, comorbidity, functional level, life quality, and self-efficacy. The outcomes were symptom reduction and remission. Univariate and multivariate linear and logistic regression analyses were conducted to assess the associations between predictor variables and the outcome, and machine-learning methods were also applied. In multiple linear regression analysis, anxiety severity at baseline (β = -6.05, 95% CI = -7.54,-4.56, p < 0.001) and general psychological problems and symptoms of psychopathology (SCL-90-R score) (β = 2.19, 95% CI = 0.24,4.14, p = 0.028) were significantly associated with symptom change at 6 months. Moreover, self-efficacy was associated with the outcome, however no longer significant in the multiple regression model. In multiple logistic regression analysis, anxiety severity at baseline (OR = 0.54, 95% CI = -1.13,-0.12, p = 0.018) was significantly associated with remission at 6 months. There was no predictive performance of the machine-learning models. Our study contributes with information that could be valuable knowledge for managing anxiety disorders in primary care.
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Affiliation(s)
- Marte Ustrup
- Copenhagen Research Unit for Recovery, Mental Health Center Amager, Mental Health Services in the Capital Region of Denmark, Hans Bogbinders Allé 3, 2300, Copenhagen, Denmark.
| | - Thomas Christensen
- Copenhagen Research Unit for Recovery, Mental Health Center Amager, Mental Health Services in the Capital Region of Denmark, Hans Bogbinders Allé 3, 2300, Copenhagen, Denmark
| | - Nadja Kehler Curth
- Copenhagen Research Unit for Recovery, Mental Health Center Amager, Mental Health Services in the Capital Region of Denmark, Hans Bogbinders Allé 3, 2300, Copenhagen, Denmark
| | - Kimmie Heine
- Copenhagen Research Unit for Recovery, Mental Health Center Amager, Mental Health Services in the Capital Region of Denmark, Hans Bogbinders Allé 3, 2300, Copenhagen, Denmark
| | - Anders Bo Bojesen
- Copenhagen Research Unit for Recovery, Mental Health Center Amager, Mental Health Services in the Capital Region of Denmark, Hans Bogbinders Allé 3, 2300, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Unit for Recovery, Mental Health Center Amager, Mental Health Services in the Capital Region of Denmark, Hans Bogbinders Allé 3, 2300, Copenhagen, Denmark
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Ienna AF, Sicouri G, Peters L, Hudson JL. Psychometric properties of the Child Anxiety and Depression Life Interference Scale - Young Adult version. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 38938119 DOI: 10.1111/bjc.12486] [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: 02/21/2024] [Revised: 05/23/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES A life interference measure specifically designed for young adults with anxiety and depressive symptoms does not currently exist. This paper describes the development and psychometric evaluation of a brief self-report measure of life interference associated with young adult anxiety and depression, the Child Anxiety and Depression Life Interference Scale - Young Adult version (CADLIS-YA). DESIGN Cross-sectional, correlational and exploratory factor analysis (EFA). METHODS Five-hundred and thirty-two participants aged 18-24 years recruited from an undergraduate and community sample completed the CADLIS-YA. RESULTS An EFA supported a three-factor model describing the impact of young adult anxiety and depression on social life, family and daily life interference. Test-retest reliability and internal consistency were good to excellent. Convergent validity was demonstrated, and the scale differentiated between young adults with and without elevated anxiety and depressive symptoms. Support for divergent validity was limited. CONCLUSIONS The CADLIS-YA is a reliable and valid life interference measure for young adults with symptoms of anxiety and depression. It is potentially suitable for administration in low-resource research settings and it has promise for use in clinical settings; however, it needs validation in a clinical sample.
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Affiliation(s)
- Adrian F Ienna
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Gemma Sicouri
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
- Black Dog Institute and School of Psychology, Sydney, New South Wales, Australia
| | - Lorna Peters
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Jennifer L Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
- Black Dog Institute and School of Psychology, Sydney, New South Wales, Australia
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Gürbüz M, Bayram HM, Kabayel N, Türker ZS, Şahin Ş, İçer S. Association between breakfast consumption, breakfast quality, mental health and quality of life in Turkish adolescents: A high school-based cross-sectional study. NUTR BULL 2024; 49:157-167. [PMID: 38470057 DOI: 10.1111/nbu.12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/04/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
This study aimed to determine the frequency of breakfast consumption and breakfast quality among adolescents and to evaluate the relationships between breakfast consumption, breakfast quality, mental health, and health-related quality of life. This cross-sectional study included 449 students from 17 high schools between December 2022 and May 2023. A face-to-face questionnaire measuring the frequency of breakfast consumption, Mediterranean diet quality index (KIDMED), health-related quality of life (KIDSCREEN), and depression, anxiety and stress scales (DASS-21) was performed. Of the students, 54.1% skipped breakfast 2 or more times a week and 75.9% had poor breakfast quality. There were significant differences in breakfast quality classification according to the frequency of breakfast consumption (p = 0.003). Breakfast consumption ≤1 time/week or 2-5 times/week was associated with depression, anxiety and low adherence to the Mediterranean diet. No relationship was observed between breakfast quality and stress, depression or anxiety (p = 0.620, p = 0.586, p = 0.539, respectively) or between breakfast quality and the KIDSCREEN-27 subscales (p > 0.05). However, those eating poor-quality breakfasts had better results in physical wellbeing (p = 0.022), psychological wellbeing (p = 0.024), autonomy and parent relations (p = 0.017) than breakfast-skippers and also scored lower for depression, stress and anxiety (all p < 0.001). In conclusion, the frequency of breakfast consumption had a stronger association with reduced symptoms of stress, depression and anxiety, as well as improvements in all dimensions of health-related quality of life, compared to the quality of breakfast consumed. Given the association of breakfast consumption with mental health outcomes in adolescents, our findings are of great importance, especially to parents, clinicians and nutritional educators.
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Affiliation(s)
- Murat Gürbüz
- Faculty of Health Science, Trakya University, Edirne, Turkey
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Fernandes MDSV, Mendonça CR, da Silva TMV, Noll PRES, de Abreu LC, Noll M. Relationship between depression and quality of life among students: a systematic review and meta-analysis. Sci Rep 2023; 13:6715. [PMID: 37185375 PMCID: PMC10126541 DOI: 10.1038/s41598-023-33584-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 04/15/2023] [Indexed: 05/17/2023] Open
Abstract
The objectives of this systematic review were to estimate the prevalence of depression and to identify the relationship between depression and quality of life (QOL) among high school and university students. Literature search was performed in the Scopus, Embase, PubMed, Scielo, CINAHL and Web of Science databases, following the PRISMA methodology. The results were presented through descriptive approaches and meta-analysis. Thirty-six studies met the eligibility criteria, and twenty-six were included in the meta-analysis. The prevalence of depressive symptoms was 27% (95% CI 0.21-0.33) among students, being high school and university students was 25% (95% CI 0.14-0.37) and 27% (95% CI 0.20-0.34), respectively, and most studies have shown that depression was associated with low QOL. Among the limitations of the study is the difficulty of generalizing the results found, considering the large sample of health students. New studies should be conducted considering the severity, duration, and patterns of depressive symptoms in high school and university students, to better understand the relationship between depression and QOL.
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Affiliation(s)
- Michele da Silva Valadão Fernandes
- Instituto Federal de Educação, Ciência e Tecnologia Goiano, GO-154, Km 03, Ceres, Goiás, 76300-000, Brazil.
- Rede Estadual e Municipal de Educação de São Luís de Montes Belos, Ceres, Goiás, Brazil.
| | | | | | - Priscilla Rayanne E Silva Noll
- Instituto Federal de Educação, Ciência e Tecnologia Goiano, GO-154, Km 03, Ceres, Goiás, 76300-000, Brazil
- Universidade de São Paulo, São Paulo, Brazil
| | | | - Matias Noll
- Instituto Federal de Educação, Ciência e Tecnologia Goiano, GO-154, Km 03, Ceres, Goiás, 76300-000, Brazil.
- Universidade Federal de Goiás, Goiânia, Brazil.
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Xie J, Xu D, Wang C, Huang J. Jiawei Xiaoyao San in treatment of anxiety disorder and anxiety: A review. CHINESE HERBAL MEDICINES 2023. [DOI: 10.1016/j.chmed.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Bond L, Power P. The young adult service: An evaluation of a youth mental health service in the independent sector in Ireland. Early Interv Psychiatry 2021; 15:1349-1361. [PMID: 33145989 DOI: 10.1111/eip.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/05/2020] [Accepted: 10/18/2020] [Indexed: 11/28/2022]
Abstract
AIMS Increasing concerns about the specific needs and rates of mental illness among young adults have spurred the development of youth mental health services. Yet few outcome studies exist. This study aims to evaluate a young adult service in an independent mental health sector in Ireland. METHODS This is a service evaluation using a retrospective, descriptive and naturalistic study design. Routine demographic, diagnostic and service usage data were collected at entry into the service. Outcomes were recorded at discharge from the service using the Clinical Global Impression (CGI) improvement scores. Factors associated with better or worse outcomes were analyzed. RESULTS Five hundred and sixty-seven young adults were assessed and managed during a 3-year period by the Young Adult Service. Their characteristics fell midway between adolescent and adult mental health service populations. They had high levels of Axis I & II co-morbidities reflecting the complex and fluid nature of emerging conditions in this age group. The majority (62.8%) had clinically improved by the end of follow-up. Outcomes were significantly better in those who were hospitalized, prescribed psychotropic medication, received 1:1 psychology sessions and attended a group-based psychology program or group program for specific disorders. One hundred and sixty-six patients (29.3%) dropped out of follow-up. Drop out was associated with longer time spent in the service, being treated solely in the community, without medication, not having a developmental disorder and not transferring from CAMHS. CONCLUSIONS This study demonstrates that it is possible to establish an effective youth mental health service with favourable outcomes within a broader mental health system. It provides a benchmark for similar services, bridging the gap between adolescent and adult mental health services.
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Affiliation(s)
- Laura Bond
- St. Patrick's Mental Health Services, Dublin, Ireland
| | - Paddy Power
- St. Patrick's Mental Health Services, Dublin, Ireland.,Trinity College Dublin, Dublin, Ireland
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Hermassi S, Hayes LD, Salman A, Sanal-Hayes NEM, Abassi E, Al-Kuwari L, Aldous N, Musa N, Alyafei A, Bouhafs EG, Schwesig R. Physical Activity, Sedentary Behavior, and Satisfaction With Life of University Students in Qatar: Changes During Confinement Due to the COVID-19 Pandemic. Front Psychol 2021; 12:704562. [PMID: 34659019 PMCID: PMC8515034 DOI: 10.3389/fpsyg.2021.704562] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/07/2021] [Indexed: 12/21/2022] Open
Abstract
This study explored the effects of home confinement on physical activity (PA) and satisfaction with life (SL) among university students during the COVID-19 pandemic. A total of 531 subjects participated [male: n=203; female: n=328; age: 33.1±5.2years; mass: 72.1±17.5kg; height: 1.67±0.12m; and body mass index (BMI): 25.7±5.06 kg/m2]. Online survey questions considered "before" and "during" confinement. Confinement reduced all PA intensities (ηp 2=0.09-0.45, p<0.001) and increased daily sitting time (ηp 2=0.58, p<0.001). The largest reduction was in moderate intensity PA [metabolic equivalent of task-minutes/week (MET), ηp 2=0.45, p<0.001]. SQL decreased, with the score for "I am satisfied with my life" (ηp 2=0.42, p<0.001) decreasing from 28.4±5.7 to 20.6±9.7 arbitrary units (AU). Concerning SL, the largest change was detected for "the conditions of my life are excellent" (ηp 2=0.54, p<0.001). Time changes in all variables were demonstrative of large negative changes in both sexes. The difference in change between sexes was largest in terms of magnitude for the variable "the conditions of my life are excellent" (difference between groups, Δd=0.98). In sum, COVID-19 confinement reduced PA, heightened sitting time, and reduced SL in Qatar University students. This investigation could have a significant impact in developing PA guidelines for health maintainance during COVID-19 and successive pandemics in university students.
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Affiliation(s)
- Souhail Hermassi
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
| | - Lawrence D. Hayes
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, United Kingdom
| | - Ahmad Salman
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
| | | | - Emna Abassi
- The Movement and Sport Research Center (CeRSM), University of Paris Nanterre, Nanterre, France
| | | | - Nada Aldous
- College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Nemah Musa
- College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Amna Alyafei
- College of Arts and Sciences, Qatar University, Doha, Qatar
| | - El Ghali Bouhafs
- Department of Sports Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - René Schwesig
- Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Amendola S, von Wyl A, Volken T, Zysset A, Huber M, Dratva J. A Longitudinal Study on Generalized Anxiety Among University Students During the First Wave of the COVID-19 Pandemic in Switzerland. Front Psychol 2021; 12:643171. [PMID: 33776867 PMCID: PMC7990874 DOI: 10.3389/fpsyg.2021.643171] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/18/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic and government measures implemented to counter the spread of the infection may be a major stressor affecting the psychological health of university students. This study aimed to explore how anxiety symptoms changed during the pandemic. METHODS 676 students (76% females) at Zurich University of Applied Sciences participated in the first (T0) and second (T1) survey waves. Anxiety symptoms were assessed using the Generalized Anxiety Disorder-Scale-7 (GAD-7). Risk and protective factors (e.g., COVID-19-related variables) were examined. RESULTS GAD-7 scores decreased significantly from T0 to T1 (mean change: -0.446, SE = 0.132, 95% CI: -0.706, -0.186, t = -3.371, df = 659, p = 0.001). Participants with moderate-to-severe anxiety score were 20.2 and 15.6% at T0 and T1, respectively. The following positively predicted anxiety: older age, female gender, non-Swiss nationality, loneliness, participants' concern about their own health, and interaction between time and participants' concern about their own health. Resilience and social support negatively predicted anxiety. CONCLUSIONS Our findings provide information for public health measures and psychological interventions supporting the mental health of university students during the COVID-19 emergency.
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Affiliation(s)
- Simone Amendola
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Agnes von Wyl
- School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Thomas Volken
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Annina Zysset
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Marion Huber
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Julia Dratva
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
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Wilmer MT, Anderson K, Reynolds M. Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research. Curr Psychiatry Rep 2021; 23:77. [PMID: 34613508 PMCID: PMC8493947 DOI: 10.1007/s11920-021-01290-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW Anxiety disorders are highly prevalent conditions that have a detrimental impact on quality of life (QOL), particularly when left untreated. In the present review, we summarize recent literature, published within the last 3 years, on QOL in anxiety disorders, with a focus on factors that may play a role in the relationship between anxiety and QOL. RECENT FINDINGS We organize our findings into four categories: (1) subjective distress, (2) behavioral responses, (3) functional impairment, and (4) clinical factors. Results indicate that greater anxiety symptom severity is linked with poorer QOL, and cognitive behavioral therapies for anxiety yield positive effects on QOL. Additional transdiagnostic mechanisms are highlighted, including anxiety sensitivity, distress tolerance, emotion regulation, and avoidant coping. We examine the role of functional impairment, and we discuss factors related to treatment, including comorbidity and longitudinal effects. We also consider early research from the COVID-19 pandemic. Understanding the underlying factors that contribute to QOL detriments provides important insight into the impact of anxiety disorders and identifies targets for enhancing QOL through treatment.
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Affiliation(s)
- M. Taylor Wilmer
- Center for Anxiety and Behavioral Change, 1487 Chain Bridge Road, Suite #203, McLean, VA 22101 USA
| | - Kelley Anderson
- Center for Anxiety and Behavioral Change, 1487 Chain Bridge Road, Suite #203, McLean, VA 22101 USA
| | - Monique Reynolds
- Center for Anxiety and Behavioral Change, 1487 Chain Bridge Road, Suite #203, McLean, VA 22101 USA
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Gudjonsson SO, Sveinbjarnardottir EK, Arnardottir RH. Recovery of patients with severe depression in inpatient rural psychiatry: a descriptive clinical study. Nord J Psychiatry 2020; 74:407-414. [PMID: 32129118 DOI: 10.1080/08039488.2020.1733659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: The aim of this study was to investigate the level of and the relationship between symptoms and health-related quality of life (HRQoL) at admittance and recovery at discharge in patients with severe depression, in a rural inpatient psychiatric setting. Furthermore, whether the anxiety level at admission and/or, if the extent of patients' perception of family support from professionals were related to recovery.Method: Patients admitted with depression were consecutively invited to participate during a 12-month period. Depression, anxiety and stress were measured with DASS (The Depression Anxiety Stress Scale) and HRQoL with The Icelandic Quality of Life scale at admission and discharge. Family support was measured with Icelandic Family Perceived Support Questionnaire at discharge.Results: Majority of the participants had severe depression and anxiety scores (93.8% and 76.9%, respectively) at admission and HRQoL was impaired, especially in men. At discharge, almost three quarters of the participants had recovered into the outpatient or functional symptoms level and HRQoL had increased significantly. Morbid anxiety delayed recovery significantly, but perceived cognitive family support was positively related to depression recovery.Conclusion: Hospitalisation is an effective intervention for severe depression in rural Iceland. Positive benefits in both depression and HRQoL occur, where most of the participants reach outpatient or normal level of depression.
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Affiliation(s)
| | | | - Ragnheidur Harpa Arnardottir
- School of Health Sciences, University of Akureyri, Akureyri, Iceland.,Department of Rehabilitation, Akureyri Hospital, Akureyri, Iceland.,Department of Medical Sciences, Respiratory-, Allergy- and Sleep Research, Academic Hospital, Uppsala University, Uppsala, Sweden
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Kieseppä V, Torniainen-Holm M, Jokela M, Suvisaari J, Gissler M, Markkula N, Lehti V. Immigrants' mental health service use compared to that of native Finns: a register study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:487-496. [PMID: 31542796 DOI: 10.1007/s00127-019-01774-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 09/03/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Many aspects related to migration might predispose immigrants to mental health problems. Yet immigrants have been shown to underuse mental health services. The aim of this study was to compare the intensity of psychiatric care, as an indicator of treatment adequacy, between natives and immigrants living in Finland. METHODS We used nationwide register data that included all the immigrants living in Finland at the end of 2010 (n = 185,605) and their matched controls. Only those who had used mental health services were included in the analyses (n = 14,285). We used multinomial logistic regression to predict the categorized treatment intensity by immigrant status, region and country of origin, length of residence, and other background variables. RESULTS Immigrants used mental health services less than Finnish controls and with lower intensity. The length of residence in Finland increased the probability of higher treatment intensity. Immigrants from Eastern Europe, sub-Saharan Africa, the Middle East, and Northern Africa were at the highest risk of receiving low-intensity treatment. CONCLUSIONS Some immigrant groups seem to persistently receive less psychiatric treatment than Finnish-born controls. Identification of these groups is important and future research is needed to determine the mechanisms behind these patterns.
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Affiliation(s)
- Valentina Kieseppä
- Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Minna Torniainen-Holm
- Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Markus Jokela
- Department of Psychology and Logopedics, Medicum, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland
| | - Jaana Suvisaari
- Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Mika Gissler
- Information Services Department, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 171 77, Stockholm, Sweden
| | - Niina Markkula
- Department of Psychiatry, Helsinki University Hospital and University of Helsinki, P.O. Box 100, 00029, Helsinki, Finland
| | - Venla Lehti
- Department of Psychiatry, Helsinki University Hospital and University of Helsinki, P.O. Box 100, 00029, Helsinki, Finland
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Cao J, Truong AL, Banu S, Shah AA, Sabharwal A, Moukaddam N. Tracking and Predicting Depressive Symptoms of Adolescents Using Smartphone-Based Self-Reports, Parental Evaluations, and Passive Phone Sensor Data: Development and Usability Study. JMIR Ment Health 2020; 7:e14045. [PMID: 32012072 PMCID: PMC7007590 DOI: 10.2196/14045] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/19/2019] [Accepted: 09/24/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Depression carries significant financial, medical, and emotional burden on modern society. Various proof-of-concept studies have highlighted how apps can link dynamic mental health status changes to fluctuations in smartphone usage in adult patients with major depressive disorder (MDD). However, the use of such apps to monitor adolescents remains a challenge. OBJECTIVE This study aimed to investigate whether smartphone apps are useful in evaluating and monitoring depression symptoms in a clinically depressed adolescent population compared with the following gold-standard clinical psychometric instruments: Patient Health Questionnaire (PHQ-9), Hamilton Rating Scale for Depression (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A). METHODS We recruited 13 families with adolescent patients diagnosed with MDD with or without comorbid anxiety disorder. Over an 8-week period, daily self-reported moods and smartphone sensor data were collected by using the Smartphone- and OnLine usage-based eValuation for Depression (SOLVD) app. The evaluations from teens' parents were also collected. Baseline depression and anxiety symptoms were measured biweekly using PHQ-9, HAM-D, and HAM-A. RESULTS We observed a significant correlation between the self-evaluated mood averaged over a 2-week period and the biweekly psychometric scores from PHQ-9, HAM-D, and HAM-A (0.45≤|r|≤0.63; P=.009, P=.01, and P=.003, respectively). The daily steps taken, SMS frequency, and average call duration were also highly correlated with clinical scores (0.44≤|r|≤0.72; all P<.05). By combining self-evaluations and smartphone sensor data of the teens, we could predict the PHQ-9 score with an accuracy of 88% (23.77/27). When adding the evaluations from the teens' parents, the prediction accuracy was further increased to 90% (24.35/27). CONCLUSIONS Smartphone apps such as SOLVD represent a useful way to monitor depressive symptoms in clinically depressed adolescents, and these apps correlate well with current gold-standard psychometric instruments. This is a first study of its kind that was conducted on the adolescent population, and it included inputs from both teens and their parents as observers. The results are preliminary because of the small sample size, and we plan to expand the study to a larger population.
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Affiliation(s)
- Jian Cao
- Electrical and Computer Engineering Department, Rice University, Houston, TX, United States
| | - Anh Lan Truong
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Sophia Banu
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Asim A Shah
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Ashutosh Sabharwal
- Electrical and Computer Engineering Department, Rice University, Houston, TX, United States
| | - Nidal Moukaddam
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
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13
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Kotiaho S, Korniloff K, Vanhala M, Kautiainen H, Koponen H, Ahonen T, Mäntyselkä P. Psychiatric diagnosis in primary care patients with increased depressive symptoms. Nord J Psychiatry 2019; 73:195-199. [PMID: 30929594 DOI: 10.1080/08039488.2019.1584240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Screening of depression has been recommended in primary care and Beck's 21-item Depression Inventory (BDI-21) is a commonly used tool for screening. Depression has been shown to be frequently accompanied by comorbidities. AIMS This study aimed to analyze the characteristics, psychiatric diagnoses, and psychiatric comorbidity of primary care patients who have been screened for depression and referred to a depression nurse. METHODS The study subjects were primary care patients aged ≥ 35 years with depressive symptoms (BDI-21 > 9). Their psychiatric diagnosis were based on a diagnostic interview (Mini-International Neuropsychiatric Interview; M.I.N.I.) conducted by a trained study nurse. RESULTS Of the 705 study subjects, 617 (87.5%) had at least one and 66.1% had at least two psychiatric diagnoses. The most common diagnosis was depression (63.4%). The next most common diagnoses were generalized anxiety disorder (GAD) (48.1%) and panic disorder (22.8%). Only 8.8% of the study subjects had depression without other psychiatric disorders. Ten percent of the subjects had both depression and a generalized anxiety disorder (GAD). Also other psychiatric comorbidities were common. Age was inversely associated with the psychiatric diagnosis in the M.I.N.I. CONCLUSIONS This study suggests that most of the primary care patients with increased depressive symptoms have a psychiatric disorder. Although depression is the most common diagnosis, there are several other concurrent psychiatric comorbidities. Therefore, diagnostic assessment of primary care patients with a screening score over 9 in the BDI-21 should be reconsidered.
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Affiliation(s)
- Satu Kotiaho
- a School of Medicine, General Practice , University of Eastern Finland , Kuopio , Finland.,b Saarikka Primary Health Care Public Utility , Saarijärvi , Finland
| | - Katariina Korniloff
- c School of Health and Social Studies , JAMK University of Applied Sciences , Jyväskylä , Finland
| | - Mauno Vanhala
- a School of Medicine, General Practice , University of Eastern Finland , Kuopio , Finland
| | - Hannu Kautiainen
- d Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland.,e Primary Health Care Unit , Kuopio University Hospital , Kuopio , Finland
| | | | - Tiina Ahonen
- g Department of Psychiatry , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Pekka Mäntyselkä
- a School of Medicine, General Practice , University of Eastern Finland , Kuopio , Finland.,d Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland
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14
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Thunander Sundbom L, Hedborg K. Association between prescribed antidepressants and other prescribed drugs differ by gender: a nationwide register-based study in Sweden. Nord J Psychiatry 2019; 73:73-79. [PMID: 30661437 DOI: 10.1080/08039488.2018.1536766] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND People with depression are prescribed more drugs than people in general, partly due to comorbidity with other conditions. However, little research has been done on depression-related drug use from a gender perspective. AIM Examine the association between antidepressants, other types of prescribed drugs, and polypharmacy, by gender. METHODS Data on drugs dispensed October to December 2016 to all Swedish citizens aged 18-84 years were collected from the Swedish prescribed drug register. Logistic regression analyses were performed to examine the associations between antidepressants and other drugs, by gender. RESULTS For both men and women, associations were found between antidepressants and drugs for alimentary tract problems, respiratory problems, blood, nervous system, analgesics, and polypharmacy. However, for women, but not men, associations were also found for drugs for diabetes, musculoskeletal problems, dermatological problems, and systemic hormones. CONCLUSIONS Associations were found between antidepressants and many other types of drugs for both men and women; indicating comorbidity between depression and other conditions. Further, some of the associations between antidepressants and other drugs were found to be specific among women. Whether this indicates that men and women differ in comorbidity between depression and other conditions cannot be concluded based on this cross-sectional study. However, comorbidity impairs the possibility of recovery; in the somatic condition as well as the depression. Thus, physicians need to be aware that the association between antidepressants and other types of drugs are more common among women than men.
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Affiliation(s)
- Lena Thunander Sundbom
- a Faculty of Health and Occupational Studies, Department of Health and Caring Sciences , University of Gävle , Gävle , Sweden.,b Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy , Uppsala University , Uppsala , Sweden
| | - Kerstin Hedborg
- a Faculty of Health and Occupational Studies, Department of Health and Caring Sciences , University of Gävle , Gävle , Sweden
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15
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Aluoja A, Tõru I, Raag M, Eller T, Võhma Ü, Maron E. Personality traits and escitalopram treatment outcome in major depression. Nord J Psychiatry 2018; 72:354-360. [PMID: 29688152 DOI: 10.1080/08039488.2018.1465590] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Selective serotonin re-uptake inhibitors (SSRI) have proven to be effective in treatment of depression. Still, treatment efficacy varies significantly from patient to patient and about 40% of patients do not respond to initial treatment. Personality traits have been considered one source of variability in treatment outcome. AIM Current study aimed at identifying specific personality traits that could be predictive of treatment response and/or the dynamics of symptom change in depressive patients. METHOD In a sample of 132 outpatients with major depressive disorder (MDD) treated with an SSRI-group antidepressant escitalopram, the Swedish universities Scales of Personality (SSP) were used in order to find predictive personality traits. For the assessment of the severity of depressive symptoms and the improvement rates, the Hamilton Depression Scale (HAM-D) and Montgomery-Åsberg Depression Rating Scale (MADRS) were used. RESULTS Escitalopram-treated MDD patients with higher social desirability achieved more rapid decrease in symptom severity. None of the studied traits predicted the end result of the treatment. CONCLUSION The findings suggest that specific personality traits may predict the trajectory of symptom change rather than the overall improvement rate.
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Affiliation(s)
- Anu Aluoja
- a Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Innar Tõru
- a Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Mait Raag
- b Institute of Family Medicine and Public Health, University of Tartu , Tartu , Estonia
| | - Triin Eller
- a Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Ülle Võhma
- c Psychiatry Clinic , North Estonia Medical Centre Foundation , Tallinn , Estonia
| | - Eduard Maron
- a Department of Psychiatry , University of Tartu , Tartu , Estonia.,c Psychiatry Clinic , North Estonia Medical Centre Foundation , Tallinn , Estonia.,d Centre for Neuropsychopharmacology , Imperial College London , London , UK
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16
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Qiu H, Ren W, Yang Y, Zhu X, Mao G, Mao S, Lin Y, Shen S, Li C, Shi H, Jiang S, He J, Zhao K, Fu Y, Hu X, Gu Y, Wang K, Guo X, He J. Effects of cognitive behavioral therapy for depression on improving insomnia and quality of life in Chinese women with breast cancer: results of a randomized, controlled, multicenter trial. Neuropsychiatr Dis Treat 2018; 14:2665-2673. [PMID: 30349264 PMCID: PMC6188154 DOI: 10.2147/ndt.s171297] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Cognitive behavioral therapy (CBT) for depression had been found to be effective in reducing depressive and anxiety symptoms in breast cancer survivors. It is not known whether CBT for depression would also improve insomnia and quality of life (QOL). The aim of this study was to investigate whether CBT for depression would improve insomnia and QOL in a randomized controlled multicenter trial. PATIENTS AND METHODS In this study, breast cancer survivors (n=392) were randomly allocated to the following three groups: CBT (n=98), self-care management (SCM, n=98), and usual care (UC, n=196) in a ratio of 1:1:2. CBT and SCM received a series of nine sessions for 12 weeks, whereas UC received UC only. Insomnia and QOL were evaluated using Athens Insomnia Scale (AIS) and Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire at baseline, 4, 12, and 24 weeks. RESULTS There was a significant intergroup difference in AIS and FACT-B scores (both P<0.01). CBT showed less insomnia problems and better overall QOL compared with those in SCM and UC (both P<0.01). No significant differences were found between SCM and UC in insomnia problems and overall QOL. Moreover, the effects of CBT on insomnia and QOL were maintained during the follow-up period. CONCLUSION CBT for depression can be effective in improving insomnia problems and QOL in the Chinese breast cancer survivors.
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Affiliation(s)
- Huihua Qiu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Wenwei Ren
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Yanjie Yang
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Harbin, People's Republic of China
| | - Xiongzhao Zhu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Guangyun Mao
- Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Shanping Mao
- Department of Neurology, RenMin Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yan Lin
- Department of Neurology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Shanshan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, People's Republic of China
| | - Changjin Li
- Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Hongying Shi
- Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Suo Jiang
- Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Jingjing He
- Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China
| | - Ke Zhao
- Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Ye Fu
- Yinzhou Hospital Affiliated To Medical School of Ningbo University, Ningbo, People's Republic of China
| | - Xiaoqu Hu
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yingying Gu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Kai Wang
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Xiuchan Guo
- Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People's Republic of
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China, .,Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
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