1
|
Batterham PJ, Gulliver A, Heffernan C, Calear AL, Werner-Seidler A, Turner A, Farrer LM, Chatterton ML, Mihalopoulos C, Berk M. A Brief Workplace Training Program to Support Help-Seeking for Mental Ill-Health: Protocol for the Helipad Cluster Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55529. [PMID: 38787608 PMCID: PMC11161717 DOI: 10.2196/55529] [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: 12/18/2023] [Revised: 03/25/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Most people with mental health problems do not seek help, with delays of even decades in seeking professional help. Lack of engagement with professional mental health services can lead to poor outcomes and functional impairment. However, few effective interventions have been identified to improve help-seeking in adults, and those that exist are not widely implemented to deliver public health impact. Co-designing interventions with people with lived experience of mental ill-health and other relevant stakeholders is critical to increase the likelihood of uptake and engagement with these programs. OBJECTIVE This study aims to (1) test the effectiveness of a co-designed help-seeking program on increasing professional help-seeking intentions in employees in a workplace setting; (2) determine whether the program reduces mental illness stigma and improves help-seeking intentions and behavior, mental health literacy, mental health symptoms, and work and activity functioning relative to the control condition; (3) explore factors that facilitate broader implementation of the co-designed program; and (4) explore the cost-effectiveness of the co-designed program compared to the control condition over 6 months. METHODS A 2-arm cluster randomized controlled trial will be conducted (target sample: N=900 from 30 to 36 workplaces, with n=25 to 35 participants per workplace). The trial will compare the relative effectiveness of an enhanced interactive program (intervention condition) with a standard psychoeducation-alone program (active control condition) on the primary outcome of professional help-seeking intentions as measured by the General Help-Seeking Questionnaire. Secondary outcomes include the impact on mental illness stigma; mental health literacy; help-seeking attitudes and behavior; work and activity functioning; quality of life; and symptoms of mental ill-health including depression, anxiety, and general psychological distress. RESULTS Facilitators of and risks to the trial are identified and addressed in this protocol. Recruitment of workplaces is scheduled to commence in the first quarter of 2024. CONCLUSIONS If effective, the program has the potential to be ready for rapid dissemination throughout Australia, with the potential to increase appropriate and efficient service use across the spectrum of evidence-based services. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000270617p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385376. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55529.
Collapse
Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Cassandra Heffernan
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Alison L Calear
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | | | - Alyna Turner
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Louise M Farrer
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Mary Lou Chatterton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
2
|
Zainal NH, Jacobson NC. Reliability (or lack thereof) of smartphone ecological momentary assessment of visual dot probe attention bias toward threat indices. J Behav Ther Exp Psychiatry 2024; 82:101918. [PMID: 37907019 DOI: 10.1016/j.jbtep.2023.101918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/05/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Cognitive bias theories posit that generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are entwined with attention bias toward threats, commonly indexed by faster response time (RT) on threat-congruent (vs. threat-incongruent) trials on the visual dot probe. Moreover, although smartphone ecological momentary assessment (EMA) of the visual dot probe has been developed, their psychometric properties are understudied. This study thus aimed to assess the reliability of 8 smartphone-delivered visual dot probe attention bias and related indices in persons with and without GAD and SAD. METHODS Community-dwelling adults (n = 819; GAD: 64%; SAD: 49%; Mixed GAD and SAD: 37%; Non-GAD/SAD Controls: 24%) completed a five-trial smartphone-delivered visual dot probe for a median of 60 trials (12 sessions x 5 trials/session) and an average of 100 trials (20 sessions x 5 trials/session). RESULTS As hypothesized, Global Attention Bias Index, Disengagement Effect, and Facilitation Bias had low-reliability estimates. However, retest-reliability and internal reliability were good for Trial-Level Bias Scores (TLBS) (Bias Toward Treat: intra-class correlation coefficients (ICCs) = 0.626-0.644; split-half r = 0.640-0.670; Attention Bias Variability: ICCs = 0.507-0.567; split-half r = 0.520-0.580) and (In)congruent RTs. Poor retest-reliability and internal reliability estimates were consistently observed for all traditional attention bias and related indices but not TLBS. LIMITATIONS Our visual dot probe EMA should have administered ≥320 trials to match best-practice guidelines based on similar laboratory studies. CONCLUSIONS Future research should strive to examine attention bias paradigms beyond the dot-probe task that evidenced meaningful test-retest reliability properties in laboratory and real-world naturalistic settings.
Collapse
Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School, Department of Health Care Policy, USA; National University of Singapore, Department of Psychology, Singapore.
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
| |
Collapse
|
3
|
Lindberg MS, Brattmyr M, Lundqvist J, Roos E, Solem S, Hjemdal O, Havnen A. Sociodemographic factors and use of pain medication are associated with health-related quality of life: results from an adult community mental health service in Norway. Qual Life Res 2023; 32:3135-3145. [PMID: 37338784 PMCID: PMC10522514 DOI: 10.1007/s11136-023-03461-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE Health-related quality of life (HRQoL) is an important aspect of mental health outcomes. There are few studies on HRQoL in heterogeneous patient populations seeking help at community mental health services. The aims of the study were to compare how HRQoL, measured by the EuroQol five dimensions with five levels (EQ-5D-5L), was distributed compared to other samples from national and international studies, and to explore what factors are associated with HRQoL. METHODS In a cross-sectional study, 1379 Norwegian outpatients reported their HRQoL before starting treatment. Associations with demographic variables, job status, socio-economic status, and use of pain medication were examined using multiple regression analysis. RESULTS Most of the sample, 70% to 90%, reported problems with usual activities, pain/discomfort, and anxiety/depression; 30% to 65% reported that these problems were of a moderate to extreme degree. Forty percent reported problems with mobility, and about 20% reported problems with self-care. The sample's HRQoL was considerably lower than the general population, and comparable to patient-groups from specialist mental health services. Originating from a developing country, lower level of education, lower yearly household income, being on sick leave or unemployed, and using pain medication were associated with lower HRQoL. Age, gender, and relationship status were not associated with HRQoL. This is the first study to simultaneously examine the unique contribution of these variables in one study. CONCLUSION The most impacted domains of HRQoL were pain/discomfort, anxiety/depression, and usual activities. Lower HRQoL was associated with several socio-demographic factors and use of pain medication. These findings might have clinical implications and suggest that mental health professionals should routinely measure HRQoL in addition to symptom severity, to identify areas that should be targeted to improve HRQoL.
Collapse
Affiliation(s)
- Martin Schevik Lindberg
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway.
- Health and Welfare, Trondheim Municipality, Trondheim, Norway.
| | - Martin Brattmyr
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
| | - Jakob Lundqvist
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
| | - Eirik Roos
- Health and Welfare, Trondheim Municipality, Trondheim, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
| | - Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
- Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olav's University Hospital, Trondheim, Norway
| |
Collapse
|
4
|
de Oliveira C, Saka M, Bone L, Jacobs R. The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:167-193. [PMID: 36376610 PMCID: PMC9663290 DOI: 10.1007/s40258-022-00761-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mental health disorders in the workplace have increasingly been recognised as a problem in most countries given their high economic burden. However, few reviews have examined the relationship between mental health and worker productivity. OBJECTIVE To review the relationship between mental health and lost productivity and undertake a critical review of the published literature. METHODS A critical review was undertaken to identify relevant studies published in MEDLINE and EconLit from 1 January 2008 to 31 May 2020, and to examine the type of data and methods employed, study findings and limitations, and existing gaps in the literature. Studies were critically appraised, namely whether they recognised and/or addressed endogeneity and unobserved heterogeneity, and a narrative synthesis of the existing evidence was undertaken. RESULTS Thirty-eight (38) relevant studies were found. There was clear evidence that poor mental health (mostly measured as depression and/or anxiety) was associated with lost productivity (i.e., absenteeism and presenteeism). However, only the most common mental disorders were typically examined. Studies employed questionnaires/surveys and administrative data and regression analysis. Few studies used longitudinal data, controlled for unobserved heterogeneity or addressed endogeneity; therefore, few studies were considered high quality. CONCLUSION Despite consistent findings, more high-quality, longitudinal and causal inference studies are needed to provide clear policy recommendations. Moreover, future research should seek to understand how working conditions and work arrangements as well as workplace policies impact presenteeism.
Collapse
Affiliation(s)
- Claire de Oliveira
- Centre for Health Economics, University of York, York, UK.
- Hull York Medical School, Hull and York, UK.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
| | | | | | - Rowena Jacobs
- Centre for Health Economics, University of York, York, UK
| |
Collapse
|
5
|
Lim MH, Yoon JH, Lee WT, Kim MS, Baek SU, Won JU. Performance-Based Pay System and Job Stress Related to Depression/Anxiety in Korea: Analysis of Korea Working Condition Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4065. [PMID: 36901074 PMCID: PMC10002074 DOI: 10.3390/ijerph20054065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/10/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The adoption rate of performance-based pay systems has increased in recent years, and the adverse effects of systems have been emphasized. However, no study has analyzed the increase in the risk of depression/anxiety symptoms caused by the pay system in Korea. This study aimed to reveal the association between performance-based pay systems and symptoms of depression/anxiety, using data from the fifth Korean Working Conditions Survey. Depressive/anxiety symptoms were assessed using "yes" or "no" questions regarding medical problems related to depression/anxiety. The performance-based pay system and job stress were estimated using self-response answers. Logistic regression analyses were conducted to determine the association between performance-based pay systems, job stress, and symptoms of depression/anxiety using data from 27,793 participants. The performance-based pay system significantly increased the risk of the symptoms. Additionally, risk increments were calculated after grouping by pay system and job stress. Workers with two risk factors had the highest risk of symptoms of depression/anxiety for both sexes (male: OR 3.05; 95% CI 1.70-5.45; female: OR 2.15; 95% CI 1.32-3.50), implying synergistic effect of performance-based pay system and job stress on depression/anxiety symptoms. Based on these findings, policies should be established for early detection and protection against the risk of depression/anxiety.
Collapse
Affiliation(s)
- Myeong-Hun Lim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jin-Ha Yoon
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Won-Tae Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Min-Seok Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| |
Collapse
|
6
|
Volz HP, Bartečků E, Bartova L, Bessa J, De Berardis D, Dragasek J, Kozhuharov H, Ladea M, Lazáry J, Roca M, Usov G, Wichniak A, Godman B, Kasper S. Sick leave duration as a potential marker of functionality and disease severity in depression. Int J Psychiatry Clin Pract 2022; 26:406-416. [PMID: 35373692 DOI: 10.1080/13651501.2022.2054350] [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: 10/18/2022]
Abstract
Objective: To discuss the impact of depression on work and how depression-related sick leave duration could be a potential indicator and outcome for measuring functionality in depression.Methods: Our review was based on a literature search and expert opinion that emerged during a virtual meeting of European psychiatrists that was convened to discuss this topic.Results: Current evidence demonstrates that depression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditions. A wide variety of pharmacological and non-pharmacological treatments and work-based interventions are effective in reducing depression-related sick leave duration and/or facilitating return to work. Recent real-world evidence showed that patients treated with antidepressant monotherapy appear to recover their working life faster than those receiving combination therapy. Although depression-related sick leave duration was found to correlate with severity of depressive symptoms, it cannot be used alone as a viable marker for disease severity.Conclusions: Given its multifactorial nature, depression-related sick leave duration is not on its own a viable outcome measure of depression severity but could be used as a secondary outcome alongside more formal severity measures and may also represent a useful measure of functionality in depression. Key pointsDepression in the working population and depression-related sick leave have a profound economic impact on societyDepression-related sick leave duration is influenced by multiple disease-, patient- and work-related factors, together with societal attitudes towards depression and socioeconomic conditionsA wide variety of pharmacological and non-pharmacological treatments and work-based interventions have been shown to be effective in reducing depression-related sick leave duration and/or facilitating return to workIn terms of pharmacological intervention, recent real-world evidence has shown that patients treated with antidepressant monotherapy are able to recover their working life faster than those treated with combination therapyAlthough depression-related sick leave duration has been shown to correlate with severity of depressive symptoms, it is not a viable outcome measure of depression severity on its own, but could be used as secondary outcome alongside more formal clinician- and patient-rated severity measuresDepression-related sick leave duration may, however, represent a viable outcome for measuring functionality in depression.
Collapse
Affiliation(s)
- Hans-Peter Volz
- Department of Psychotherapy and Psychosomatic Medicine, Hospital for Psychiatry, Werneck, Germany
| | - Elis Bartečků
- Department of Psychiatry, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy (Division of General Psychiatry), Medical University of Vienna, Vienna, Austria
| | - João Bessa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
| | - Jozef Dragasek
- First Department of Psychiatry, Pavol Jozef Šafárik University and University Hospital, Košice, Slovakia
| | - Hristo Kozhuharov
- Department of Psychiatry, University Hospital, "St. Marina", Varna, Bulgaria
| | - Maria Ladea
- University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Judit Lazáry
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Miquel Roca
- School of Medicine, Son Espases University Hospital, IUNICS/IDISBA, University of Balearic Islands, Palma de Mallorca, Spain
| | | | - Adam Wichniak
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK.,School of Pharmacy, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, United Arab Emirates
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy (Division of General Psychiatry), Medical University of Vienna, Vienna, Austria.,Center for Brain Research, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
7
|
Smies M, Damhuis SE, Duijnhoven RG, Leemhuis AG, Gordijn SJ, Ganzevoort W. Study protocol for a randomized trial on timely delivery versus expectant management in late preterm small for gestational age pregnancies with an abnormal umbilicocerebral ratio (UCR): the DRIGITAT study. Trials 2022; 23:619. [PMID: 35915472 PMCID: PMC9344701 DOI: 10.1186/s13063-022-06561-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The clinical inability to correctly identify late fetal growth restriction (FGR) within a group of fetuses who are identified as small for gestational age (SGA) is an everyday problem for all obstetrician-gynecologists. This leads to substantial overtreatment of healthy small fetuses but also inadequate detection of the growth-restricted fetuses that may benefit from timely delivery. Redistribution of the fetal circulation, signaled by an abnormal ratio of the Doppler velocity flow profiles of the umbilical artery and the middle cerebral artery, more specifically an increased umbilicocerebral ratio (UCR) (or its inverse: a decreased cerebroplacental ratio (CPR)), is an adaptation to chronic hypoxemia and nutritional scarcity with long-term consequences in survivors. The relevance of an abnormal UCR has been signaled extensively, and there is a general consensus that it is a signal of FGR, independent of size, with a strong association with poor outcomes. Yet, in the current literature, no comparisons of a monitoring-delivery strategy based on unfavorable UCR have been published. The objective of the Doppler Ratio In fetal Growth restriction Intervention Trial At (near) Term (DRIGITAT) is to evaluate if the timing of the delivery based on an abnormal UCR in late preterm fetuses identified as SGA improves neurodevelopmental outcomes at 2 years of age. METHODS The DRIGITAT study is a national multicenter cohort study of women with singleton pregnancies between 32 and 37 weeks of gestation identified as SGA, with a nested randomized controlled trial (RCT) in case of an abnormal UCR (> 0.8). Recruiting centers are in The Netherlands. In the nested RCT, women are randomized to either immediate induction of labor or expectant management from 34 weeks in case of severely abnormal size (EFW or FAC < p3) and from 36 weeks in case of mildly abnormal size (EFW or FAC p3-p10). The primary outcome measure is the 7-point average difference in the composite cognitive score (CCS) and composite motor score (CMS) on the Bayley-3 at 2 years. Secondary outcome measures include a composite outcome of neonatal morbidity, perinatal mortality, mode of delivery, maternal quality of life, costs, and predictive value of serum biomarkers. Analyses will be by intention to treat. The required sample size is determined for the nested RCT as 185 patients. DISCUSSION This study will provide insight into the diagnostic efficacy of UCR measurement in the evaluation of SGA fetuses in order to differentiate the healthy SGA fetus from the growth-restricted fetus and to determine if a fetus with abnormal UCR benefits from early delivery. TRIAL REGISTRATION Healthcare Evaluation Netherlands NTR6663 . Registered on 14 August 2017.
Collapse
Affiliation(s)
- M Smies
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - S E Damhuis
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R G Duijnhoven
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - A G Leemhuis
- Department of Neonatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - S J Gordijn
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - W Ganzevoort
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
| |
Collapse
|
8
|
Deng J, Wu Z, Shi H, Yang T, Duan Z. Effect of Job Stressors on Presenteeism among Aging Workers: A Longitudinal Moderated Mediation Model. Am J Health Behav 2022; 46:39-48. [PMID: 35227368 DOI: 10.5993/ajhb.46.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: With the rapid global increase in the age of workforces, companies are increasingly concerned with improving the working conditions of older workers. Anxiety is an important psychological variable in sociological studies but has attracted less attention in studies of occupational health and management. In this study, we explored the mediating effect of anxiety on the relationship between job stressors and presenteeism, and the moderating effect of pessimism. Methods: We collected longitudinal data from 892 respondents who participated in the 2008 and 2012 waves of the Health and Retirement Study in the United States. We tested the proposed moderated mediation model using structural equation modeling. Results: Job stressors were positively related to anxiety and presenteeism. Anxiety was positively related to presenteeism and mediated the relationship between job stressors and presenteeism. Pessimism had a statistically significant negative effect on the relationship between anxiety and presenteeism. Conclusions: These results make theoretical and practical contributions to the literature on the influencing mechanisms of presenteeism. The use of longitudinal data ensured that the research conclusions were reliable; we suggest ways to improve the productivity of aging workers.
Collapse
Affiliation(s)
- Jianwei Deng
- School of Management and Economics, Beijing Institute of Technology, and Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Zhennan Wu
- School of Management and Economics, Beijing Institute of Technology, and Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Hubin Shi
- School of Management and Economics, Beijing Institute of Technology, and Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Tianan Yang
- School of Management and Economics, Beijing Institute of Technology, and Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China; ; ,
| | - Zhezhe Duan
- Assistant Professor, Institute of Urban Governance, Shenzhen University, Shenzhen, China
| |
Collapse
|
9
|
Cabrera LY, Gilbert MMC, McCright AM, Achtyes ED, Bluhm R. Beyond the Cuckoo's Nest: Patient and Public Attitudes about Psychiatric Electroceutical Interventions. Psychiatr Q 2021; 92:1425-1438. [PMID: 33864542 PMCID: PMC8531080 DOI: 10.1007/s11126-021-09916-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2021] [Indexed: 12/28/2022]
Abstract
Recent research emphasizes the role of psychiatric electroceutical interventions (PEIs), bioelectronic treatments that employ electrical stimulation to affect and modify brain function, to effectively treat psychiatric disorders. We sought to examine attitudes about three PEIs-electroconvulsive therapy, transcranial magnetic stimulation, and deep brain stimulation-among patients with depression and members of the general public. As part of a larger study to assess different stakeholders' attitudes about PEIs, we conducted semi-structured key informant interviews with 16 individuals living with depression and 16 non-depressive members of the general public. We used a purposive sampling approach to recruit potential participants based on eligibility criteria. We performed qualitative content analysis of interview transcripts. Participants from both groups expressed an overall cautionary attitude towards PEIs, yet there were mixed attitudes in both groups. Patients commonly described electroconvulsive therapy as scary, traumatic, or intense, while members of the general public often referenced the treatment's negative portrayal in One Flew over the Cuckoo's Nest. Patients and the general public saw transcranial magnetic stimulation as a potentially viable option, but in most cases only if medication was not effective. Deep brain stimulation attitudes were predominantly negative among patients and cautionary among public. The overall cautionary attitudes towards PEIs, together with the technological features and social aspects underlying those attitudes, highlight the need for unbiased education to fill the gaps in knowledge and inform perceptions of those who may benefit from these treatments.
Collapse
Affiliation(s)
- Laura Y Cabrera
- Center for Neural Engineering, Department of Engineering Science and Mechanics, Penn State University, University Park, W-319 Millennium Science Complex, State College, PA, 16802, USA. .,Rock Ethics Institute, Penn State University, University Park, State College, PA, USA.
| | | | - Aaron M McCright
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI, USA
| | - Eric D Achtyes
- Division of Psychiatry & Behavioral Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.,Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Robyn Bluhm
- Department of Philosophy, College of Arts and Letters, Michigan State University, East Lansing, MI, USA.,Lyman Briggs College, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
10
|
Young L, Zhang Q, Lian E, Roberts K, Weintraub N, Dong Y, Zhu H, Xu H, Schafer P, Dunlap S. Factors Predicting the Utilization of Center-Based Cardiac Rehabilitation Program. Geriatrics (Basel) 2020; 5:geriatrics5040066. [PMID: 32998237 PMCID: PMC7709641 DOI: 10.3390/geriatrics5040066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 12/16/2022] Open
Abstract
Although cardiac rehabilitation (CR) is clearly beneficial to improving patients’ physical functioning and reducing heart disease progression, significant proportions of patients do not complete CR programs. To evaluate the prevalence and predictors of completion of a center-based CR program in eligible cardiac patients, existing data collected from electronic medical records were used. To identify the predictors of CR completion, we used principal components analysis (PCA) and an artificial neural network (ANN) module. Among 685 patients, 61.4% (n = 421) completed the program, 31.7% (n = 217) dropped out, and 6.9% (n = 47) were referred but failed to initiate the program. PCA was conducted to consolidate baseline data into three factors—(1) psychosocial factors (depression, anxiety, and quality of life), (2) age, and (3) BMI, which explained 66.8% of the total variance. The ANN model produced similar results as the PCA. Patients who completed CR sessions had greater extremity strength and flexibility, longer six-minute walk distance, more CR knowledge, and a better quality of life. The present study demonstrated that patients who were older, obese, and who had depression, anxiety, or a low quality of life were less likely to complete the CR program.
Collapse
Affiliation(s)
- Lufei Young
- College of Nursing, Augusta University, Augusta, GA 30912, USA
- Correspondence:
| | - Qi Zhang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Eric Lian
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
| | - Kimberly Roberts
- Department of Nursing, School of Health Sentences, Georgia Highlands College, Rome, GA 30161, USA;
| | - Neal Weintraub
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
- Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Yanbin Dong
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (Y.D.); (H.Z.)
| | - Haidong Zhu
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (Y.D.); (H.Z.)
| | - Hongyan Xu
- Department of Biostats & Data, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Pascha Schafer
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
| | - Stephanie Dunlap
- Departments of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (E.L.); (N.W.); (P.S.); (S.D.)
| |
Collapse
|
11
|
Depressive Symptomatology, Presenteeism Productivity, and Quality of Life: A Moderated Mediation Model. J Occup Environ Med 2019; 60:301-308. [PMID: 29252917 DOI: 10.1097/jom.0000000000001253] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: In this study, we intend to test if presenteeism productivity influences the relationship between depressive symptoms and quality of life and also if this relation is conditional upon levels of information processing speed. Data were collected from 231 participants who completed a neuropsychological test and self-reported measures. Results revealed a significant indirect effect and a significant moderation effect. The association between depressive symptoms and presenteeism productivity was moderated by information processing speed only in their medium and high levels. Our findings suggest that individuals with higher levels of processing speed may have more difficulty in focusing on work without being distracted by health problems. The present investigation has made a significant contribution to the existing literature about cognitive function and productivity in workers with depressive symptomatology and its effects on their quality of life.
Collapse
|
12
|
Marques AP, Macedo AF, Lima Ramos P, Moreno LH, Butt T, Rubin G, Santana R. Productivity Losses and Their Explanatory Factors Amongst People with Impaired Vision. Ophthalmic Epidemiol 2019; 26:378-392. [PMID: 31280630 DOI: 10.1080/09286586.2019.1632904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To estimate productivity losses amongst people with impaired vision in Portugal and to investigate explanatory factors associated with non-participation in the labour market.Methods: A total of 546 visually impaired individuals participated in face-to-face interviews. Participants were asked about their workforce participation to determine productivity (employment status questionnaire), their health-related quality of life - HRQoL (EQ-5D) and their visual acuity and visual ability (Activity Inventory). Productivity losses included absenteeism and reduction in workforce participation. Logistic regression was used to determine independent factors associated with participation in the labour market.Results: From the 546 participants, 50% were retired, 47% were of working age and 3% were students. The employment rate was 28%, and the unemployment rate was 21% for the working age sample. For those of working age, productivity losses were estimated at €1.51 million per year, mean of €5496 per participant. The largest contributor to productivity losses was reduced workforce participation, estimated from 159 early retired or unemployed participants. After controlling for visual acuity and ability, younger individuals, with more years of education, without comorbidities and high HRQoL had a higher probability of being employed.Conclusions: Our findings show a high unemployment rate and high productivity losses amongst people with impaired vision. The probability of being employed was associated with education, HRQoL and comorbidities. We speculate that promoting education and health through effective visual rehabilitation programs may help to increase participation in the labour market. These findings can inform decisions to intervene to reduce the burden of vision loss.
Collapse
Affiliation(s)
- Ana Patricia Marques
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Antonio Filipe Macedo
- Department of Medicine, Optometry Linnaeus University Kalmar, Kalmar, Sweden.,Low Vision and Visual Rehabilitation Lab, Department and Center of Physics-Optometry and Vision Science, University of Minho Braga, Braga, Portugal
| | - Pedro Lima Ramos
- Department of Medicine, Optometry Linnaeus University Kalmar, Kalmar, Sweden.,Low Vision and Visual Rehabilitation Lab, Department and Center of Physics-Optometry and Vision Science, University of Minho Braga, Braga, Portugal
| | - Laura Hernandez Moreno
- Low Vision and Visual Rehabilitation Lab, Department and Center of Physics-Optometry and Vision Science, University of Minho Braga, Braga, Portugal
| | - Thomas Butt
- National School of Development, Peking University, Beijing, China.,Institute of Ophthalmology, University College London, London, UK
| | - Gary Rubin
- Institute of Ophthalmology, University College London, London, UK
| | - Rui Santana
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| |
Collapse
|
13
|
Iwata M, Han S, Hays R, Doorenbos AZ. Predictors of Depression and Anxiety in Family Members 3 Months After Child's Admission to a Pediatric ICU. Am J Hosp Palliat Care 2019; 36:841-850. [PMID: 31256606 DOI: 10.1177/1049909119859517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Family members of children admitted to intensive care units (ICUs) suffer from severe stress, which sometimes results in long-term psychological problems. We aimed to identify associations between demographic and psychosocial variables at early stages of a child's admission to the ICU and depression and anxiety in family members at approximately 3 months after admission. We also explored predictive models for depression and anxiety at 3 months after admission. METHODS This study is a secondary analysis of data from a previous clinical trial of palliative care for family members in ICUs, in which 380 family members of 220 children reported demographic and psychosocial status at approximately 1 week after ICU admission (baseline), at discharge from the ICUs, and at 3 months after the child's admission to the ICU. Clinical data were extracted from the children's medical records. We used linear regression models and stepwise linear regression for the analyses. RESULTS After controlling for significant confounders of gender (female) and child mortality, worse psychological status at baseline, represented by reported depression, anxiety, and acute stress symptoms, was associated with more severe depression and anxiety at 3 months. Also, a better family relationship at baseline was associated with lower depression and anxiety at 3 months. CONCLUSION We suggest a need to screen family members of children admitted to the ICU with validated scales and intervening with those at high risk of depression and anxiety. CLINICAL TRIALS Registry number NCT02144779 on ClinicalTrials.gov . https://clinicaltrials.gov/ct2/show/NCT02144779?term=NCT02144779&rank=1 .
Collapse
Affiliation(s)
- Masayuki Iwata
- 1 Graduate School of Health Management, Keio University, Shinjuku, Japan.,2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Soojeong Han
- 2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Ross Hays
- 3 Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.,4 Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Ardith Z Doorenbos
- 2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA.,5 Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| |
Collapse
|
14
|
Sebastianski M, Gates M, Gates A, Nuspl M, Bialy LM, Featherstone RM, Breault L, Mason-Lai P, Hartling L. Evidence available for patient-identified priorities in depression research: results of 11 rapid responses. BMJ Open 2019; 9:e026847. [PMID: 31256024 PMCID: PMC6609077 DOI: 10.1136/bmjopen-2018-026847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Patient priority setting projects (PPSPs) can reduce research agenda bias. A key element of PPSPs is a review of available literature to determine if the proposed research priorities have been addressed, identify research gaps, recognise opportunities for knowledge translation (KT) and avoid duplication of research efforts. We conducted rapid responses for 11 patient-identified priorities in depression to provide a map of the existing evidence. DESIGN Eleven rapid responses. DATA SOURCES Single electronic database (PubMed). ELIGIBILITY CRITERIA Each rapid response had unique eligibility criteria. For study designs, we used a stepwise inclusion process that started with systematic reviews (SRs) if available, then randomised controlled trials and observational studies as necessary. RESULTS For all but one of the rapid responses we identified existing SRs (median 7 SRs per rapid response, range 0-179). There were questions where extensive evidence exists (ie, hundreds of primary studies), yet uncertainties remain. For example, there is evidence supporting the effectiveness of many non-pharmacological interventions (including psychological interventions and exercise) to reduce depressive symptoms. However, targeted research is needed that addresses comparative effectiveness of promising interventions, specific populations of interest (eg, children, minority groups) and adverse effects. CONCLUSIONS We identified an extensive body of evidence addressing patient priorities in depression and mapped the results and limitations of existing evidence, areas of uncertainty and general directions for future research. This work can serve as a solid foundation to guide future research in depression and KT activities. Integrated knowledge syntheses bring value to the PPSP process; however, the role of knowledge synthesis in PPSPs and methodological approaches are not well defined at present.
Collapse
Affiliation(s)
- Meghan Sebastianski
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Gates
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Allison Gates
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Megan Nuspl
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Liza M Bialy
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Robin M Featherstone
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lorraine Breault
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Ping Mason-Lai
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Patient Engagement Platform, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
15
|
Psychiatric Neurosurgery: A Survey on the Perceptions of Psychiatrists and Residents. Can J Neurol Sci 2019; 46:303-310. [PMID: 30975240 DOI: 10.1017/cjn.2019.5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To evaluate the attitudes and perceptions of psychiatrists and psychiatry residents regarding neurosurgical procedures for treating psychiatric disorders and to identify potential barriers to patient referral. METHODS A survey consisting of 25 questions was created using SurveyMonkey and was distributed to psychiatrists and psychiatry residents in Quebec. The study was approved by the McGill University Health Center's Research Ethics Board. Descriptive statistics and Friedman's test were performed using SPSS software. RESULTS A total of 99 participants, including 64 residents and 35 psychiatrists, completed more than 75% of the survey and were included in data analysis. Overall, participants were significantly (p < 0.0005) more comfortable in referring patients suffering from treatment-resistant obsessive-compulsive disorder than from treatment-resistant major depressive disorder and preferred to refer patients for deep brain stimulation (DBS) rather than for anterior cingulotomy/capsulotomy (AC). Only 11.43% of psychiatrists had ever referred a patient for AC or DBS, and 34.69% of respondents felt that these procedures were dangerous. Lack of knowledge (82.83%) was viewed as the principal limiting factor, and 57.58% of respondents identified ≥6 different barriers to patient referral. The majority of participants (69.39%) were interested in improving their knowledge on psychiatric neurosurgery, and 82.65% felt that this subject should be included in the psychiatry residency curriculum. CONCLUSION Overall, participants acknowledged having many limitations to referring patients for neurosurgical interventions. While informative conferences discussing neuromodulation/neuroablation could easily address many barriers, further studies are required to assess how these could change attitudes and patterns of referral.
Collapse
|
16
|
Can social support and physical activity buffer cognitive impairment in individuals with depressive symptoms? Results from a representative sample of young to older adults. J Affect Disord 2018; 239:102-106. [PMID: 29990655 DOI: 10.1016/j.jad.2018.07.003] [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] [Received: 04/19/2018] [Revised: 06/25/2018] [Accepted: 07/01/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous study results on associations between depressive symptoms and cognitive functioning, mainly based on clinical samples and explanatory mechanisms including potential protective factors, are yet to be clarified. To this end, we investigated relations between depressive symptoms and executive functioning as well as episodic memory in a representative population sample. Furthermore, we determined the role of social support and physical activity in the explanation of cognitive performance differences in individuals with depressive symptoms. METHODS A total of N = 3661 participants (52% female) from the German Health and Examination Interview for Adults (18-79 years; M = 52.71, SD = 16.06) were included in the present study. Within a larger assessment protocol, participants answered a depressive symptom questionnaire and completed a neuropsychological test battery including executive functioning and episodic memory. RESULTS Depressive symptoms significantly predicted executive functioning and episodic memory scores with small effects of β = -0.04. Social support and physical activity mediated the relationships between depressive symptoms and cognitive functioning. LIMITATIONS As the present study is cross-sectional, future research is warranted to provide more insight into causality by following individuals with depressive symptoms over time. CONCLUSIONS The present findings indicate that effects from depressive symptoms on cognitive functioning (a) have been overestimated and do not generalize to non-clinical populations and (b) vary owing to behavioral lifestyle factors such as social support and physical activity. Thereby, the present results highlight opportunities for buffering cognitive decline in individuals with depressive symptoms in the general population.
Collapse
|
17
|
Health-related work productivity loss is low for patients in a methadone maintenance program in Vietnam. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 60:1-7. [DOI: 10.1016/j.drugpo.2018.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 05/17/2018] [Accepted: 07/15/2018] [Indexed: 01/01/2023]
|
18
|
Ebert B, Miskowiak K, Kloster M, Johansen J, Eckholm C, Wærner T, Holme M, Bruun LM. An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder: the IMPACT study. BMC Psychiatry 2017; 17:370. [PMID: 29157207 PMCID: PMC5697414 DOI: 10.1186/s12888-017-1523-8] [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: 11/10/2016] [Accepted: 10/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The manifestation of major depressive disorder (MDD) may include cognitive symptoms that can precede the onset of MDD and persist beyond the resolution of acute depressive episodes. However, little is known about how cognitive symptoms are experienced by MDD patients and the people around them. METHODS In this international (Brazil, Canada, China, France, and Germany) ethnographic study, we conducted semi-structured interviews and observations of remitted as well as symptomatic MDD patients (all patients self-reported being diagnosed by an HCP and self-reported being on an antidepressant) aged 18-60 years with self-reported cognitive symptoms (N = 34). In addition, participating depressed patients' close family or friends (N = 31) were interviewed. Separately recruited from depressed participants, work colleagues (N = 21) and healthcare providers (HCPs; N = 13) of depressed individuals were interviewed. RESULTS Key insights were that: (1) patients were generally unaware that their cognitive symptoms were linked to their depression and, instead, attributed these symptoms to negative aspects of their person (e.g., age, separate disease, laziness, exhaustion); (2) cognitive symptoms in MDD appeared to negatively impact patients' social relationships and patients' ability to handle daily tasks at work and at home; (3) patients' cognitive symptoms also impacted relationships with family members and coworkers; (4) patients' cognitive symptoms increased stress and feelings of failure, which in turn seemed to worsen the cognitive symptoms, thereby creating a destructive cycle; and (5) although HCPs recommended that patients re-engage in everyday activities to help overcome their depression, cognitive symptoms seemed to impede such functional recovery. CONCLUSIONS Taken together, these findings highlight a negative impact of patients' cognitive symptoms on their social functioning, work performance, and quality of life on the people close to them, and consequently on the degree of functional recovery after depression.
Collapse
Affiliation(s)
- Bjarke Ebert
- , H. Lundbeck A/S, Ottiliavej 9, 2500, Valby, Denmark.
| | - Kamilla Miskowiak
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark
| | - Morten Kloster
- ReD Associates, Kronprinsessegade 20, DK-1306 København, Denmark
| | - Jon Johansen
- H. Lundbeck A/S, Ottiliavej 9, 2500 Valby, Denmark
| | - Cara Eckholm
- ReD Associates, Kronprinsessegade 20, DK-1306 København, Denmark
| | | | - Mads Holme
- ReD Associates, Kronprinsessegade 20, DK-1306 København, Denmark
| | - Louise Meldgaard Bruun
- 0000 0004 0512 597Xgrid.154185.cAarhus University Hospital, Skovagervej 2, 8240 Risskov, Denmark
| |
Collapse
|
19
|
Mukuria C, Rowen D, Hernández-Alava M, Dixon S, Ara R. Predicting Productivity Losses from Health-Related Quality of Life Using Patient Data. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2017; 15:597-614. [PMID: 28364369 DOI: 10.1007/s40258-017-0326-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This paper estimates productivity loss using the health of the patient in order to allow indirect estimation of these costs for inclusion in economic evaluation. METHODS Data from two surveys of inpatients [Health outcomes data repository (HODaR) sample (n = 42,442) and health improvement and patient outcomes (HIPO) sample (n = 6046)] were used. The number of days off paid employment or normal activities (excluding paid employment) was modelled using the health of the patients measured by the EQ-5D, international classification of diseases (ICD) chapters, and other health and sociodemographic data. Two-part models (TPMs) and zero-inflated negative binomial (ZINB) models were identified as the most appropriate specifications, given large spikes at the minimum and maximum days for the dependent variable. Analysis was undertaken separately for the two datasets to account for differences in recall period and identification of those who were employed. RESULTS Models were able to reflect the large spike at the minimum (zero days) but not the maximum, with TPMs doing slightly better than the ZINB model. The EQ-5D was negatively associated with days off employment and normal activities in both datasets, but ICD chapters only had statistically significant coefficients for some chapters in the HODaR. CONCLUSIONS TPMs can be used to predict productivity loss associated with the health of the patient to inform economic evaluation. Limitations include recall and response bias and identification of who is employed in the HODaR, while the HIPO suffers from a small sample size. Both samples exclude some patient groups.
Collapse
Affiliation(s)
- Clara Mukuria
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
- Health Economics and Decision Science, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
- Health Economics and Decision Science, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Mónica Hernández-Alava
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
- Health Economics and Decision Science, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Simon Dixon
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
- Health Economics and Decision Science, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Roberta Ara
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
- Health Economics and Decision Science, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| |
Collapse
|
20
|
Uribe JM, Pinto DM, Vecino-Ortiz AI, Gómez-Restrepo C, Rondón M. Presenteeism, Absenteeism, and Lost Work Productivity among Depressive Patients from Five Cities of Colombia. Value Health Reg Issues 2017; 14:15-19. [PMID: 29254536 DOI: 10.1016/j.vhri.2017.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/23/2016] [Accepted: 03/01/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To estimate productivity losses due to absenteeism and presenteeism and their determinants in patients with depression from five Colombian cities. METHODS We used data from a multicenter, mixed-methods study of adult patients diagnosed with major depressive disorder or double depression (major depressive disorder plus dysthymia) during 2010. The World Health Organization's Health and Work Performance Questionnaire was used to assess absenteeism and presenteeism. We explored the determinants of productivity losses using a two-part model. We also used a costing model to calculate the corresponding monetary losses. RESULTS We analyzed data from 107 patients employed in the last 4 weeks. Absenteeism was reported by 70% of patients; presenteeism was reported by all but one. Half of the patients reported a level of performance at work at least 50% below usual. Average number of hours per month lost to absenteeism and presenteeism was 43 and 51, respectively. The probability of any absenteeism was 17 percentage points lower in patients rating their mental health favorably compared with those rating it poorly (standard error [SE] 0.09; P < 0.10) and 19 percentage points higher in patients with at least one comorbidity compared with patients with none (SE 0.10; P < 0.10). All other covariates showed no significant associations on hours lost to absenteeism. Patients with favorable mental health self-ratings had 16.4 fewer hours per month of presenteeism compared with those with poor self-ratings (SE 4.52; P < 0.01). The 2015 monetary value of productivity losses amounted to US $840 million. CONCLUSIONS This study in a middle-income country confirms the high economic burden of depression. Health policies and workplace interventions ensuring adequate diagnosis and treatment of depression are recommended.
Collapse
Affiliation(s)
| | - Diana M Pinto
- GESESM (Grupo de Estudios Socioeconómicos en Salud Mental)
| | | | - Carlos Gómez-Restrepo
- Department of Clinical Epidemiology, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Martín Rondón
- Department of Clinical Epidemiology, Pontificia Universidad Javeriana, Bogotá, Colombia
| |
Collapse
|
21
|
The impact of suicidality on health-related quality of life: A latent growth curve analysis of community-based data. J Affect Disord 2016; 203:14-21. [PMID: 27285722 DOI: 10.1016/j.jad.2016.05.067] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/10/2016] [Accepted: 05/28/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The subjective burden of suicidality on mental and physical health-related quality of life (HRQoL) remains to be examined. Eight-year trajectories of mental and physical components of HRQoL were compared for suicidal and non-suicidal participants at baseline. The effect of poor mental and/or physical HRQoL on subsequent suicidality was also investigated. METHOD Randomly-selected community data (W1=7485; W2=6715; W3=6133) were analysed with multivariate latent growth curve (LGC) and logistic regression models. RESULTS Adjusted LGC modelling identified that baseline ideation was associated with poorer mental, but better physical HRQoL at baseline (b=-3.93, 95% CI=-4.75 to -3.12; b=1.38, 95% CI=0.53-2.23, respectively). However, ideation was associated with a declining physical HRQoL trajectory over 8 subsequent years (b=-0.88, 95% CI=-1.42 to -0.35). Poorer mental HRQoL was associated with higher odds of ideation onset (OR=0.98, 95% CI=0.96-0.99). LIMITATIONS Frequency of data collection was four-yearly, while suicidality was reported for the previous 12-months; analyses did not control for physical health problems at baseline, baseline depression may have influenced physical QoL; suicidality was assessed with binary measures; and, prior analyses of attrition over time showed those with poorer health were less likely to continue participating in the study. CONCLUSIONS Suicidality has differential longitudinal effects on mental and physical HRQoL. Findings emphasise the considerable subjective HRQoL burden upon suicidal individuals. HRQoL may be useful to compare relative social and economical impacts.
Collapse
|
22
|
Lam RW, McIntosh D, Wang J, Enns MW, Kolivakis T, Michalak EE, Sareen J, Song WY, Kennedy SH, MacQueen GM, Milev RV, Parikh SV, Ravindran AV. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 1. Disease Burden and Principles of Care. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:510-23. [PMID: 27486151 PMCID: PMC4994789 DOI: 10.1177/0706743716659416] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. METHODS Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section is the first of six guidelines articles. RESULTS In Canada, the annual and lifetime prevalence of MDD was 4.7% and 11.3%, respectively. MDD represents the second leading cause of global disability, with high occupational and economic impact mainly attributable to indirect costs. DSM-5 criteria for depressive disorders remain relatively unchanged, but other clinical dimensions (sleep, cognition, physical symptoms) may have implications for depression management. e-Mental health is increasingly used to support clinical and self-management of MDD. In the 2-phase (acute and maintenance) treatment model, specific goals address symptom remission, functional recovery, improved quality of life, and prevention of recurrence. CONCLUSIONS The burden attributed to MDD remains high, whether from individual distress, functional and relationship impairment, reduced quality of life, or societal economic cost. Applying core principles of care, including comprehensive assessment, therapeutic alliance, support of self-management, evidence-informed treatment, and measurement-based care, will optimize clinical, quality of life, and functional outcomes in MDD.
Collapse
Affiliation(s)
- Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Diane McIntosh
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - JianLi Wang
- Department of Psychiatry, University of Calgary, Calgary, Alberta
| | - Murray W Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Theo Kolivakis
- Department of Psychiatry, McGill University, Montréal, Quebec
| | - Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Wei-Yi Song
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | | | - Roumen V Milev
- Department of Psychiatry, Queen's University, Kingston, Ontario
| | - Sagar V Parikh
- Department of Psychiatry, University of Toronto, Toronto, Ontario Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | | |
Collapse
|
23
|
Koohpaei A, Khandan M, Gaeeni M, Momenyan S. General Health status of workers among different workplaces in Qom Province, Iran. Electron Physician 2015; 7:1658-65. [PMID: 26813624 PMCID: PMC4725421 DOI: 10.19082/1658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 10/20/2015] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION In a healthy organization, psychological health and physical health are as important as production and productivity; and healthy workers have higher productivity. Regarding lack of information about workers' general health profile in Qom Province, this study aimed to assess and compare the staffs' general health and its components among different workplaces in 2014. METHODS In a cross-sectional study, 2,276 employees working at 46 industries and organizations completed a standardized General Health Questionnaire (GHQ 28) and a demographic questionnaire. Data were analyzed using t-test, ANOVA, and Pearson product-moment correlation coefficient by IBM SPSS version 20. RESULTS The mean age of the participants was 32.22 (±7.55) years. Seventy-nine point four percent of participants were married and the rest were single. Highest and lowest scores belonged to social dysfunction and depression, respectively. Also, total score of staffs' general health was 17.87 ± 10.93. The results showed that, in spite of the non-relationship between general health score difference among married and single personnel (p > 0.05), there was a significant difference between men and women and among organizations and industries with regards to general health score (p < 0.05), and drivers had the most difference with others. The relationship between workers' ages and GH was significant (p < 0.05, Pearson's bivariate correlation coefficient = -0.05). CONCLUSION The findings of this study collectively indicated that participants had an acceptable condition for mental factors, such as depression, but not in viewpoints of social dysfunction. In other words, staffs' interfaces with circumstances and personal innovation/creativity in the workplaces are at risk. Altogether, the general health score in the studied population was suitable in its entirety.
Collapse
Affiliation(s)
- Alireza Koohpaei
- Ph.D. of Occupational Health, Assistant Professor, Department of Occupational Health, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Khandan
- M.Sc. of Ergonomics, Instructor, Department of Ergonomics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Mahdi Gaeeni
- B.Sc. of Psychology, Pouyandegan Hafeze Salamat Co., Qom, Iran
| | - Somayeh Momenyan
- Ph.D. Candidate of Biostatistics, Department of Biostatistics, Paramedical sciences Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|