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Dong T, Wang X, Jia Z, Yang J, Liu Y. Assessing the associations of 1,400 blood metabolites with major depressive disorder: a Mendelian randomization study. Front Psychiatry 2024; 15:1391535. [PMID: 38903637 PMCID: PMC11187323 DOI: 10.3389/fpsyt.2024.1391535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/13/2024] [Indexed: 06/22/2024] Open
Abstract
Background and objectives Major Depressive Disorder (MDD) is one of the most prevalent and debilitating health conditions worldwide. Previous studies have reported a link between metabolic dysregulation and MDD. However, evidence for a causal relationship between blood metabolites and MDD is lacking. Methods Using a two-sample bidirectional Mendelian randomization analysis (MR), we assessed the causal relationship between 1,400 serum metabolites and Major Depressive Disorder (MDD). The Inverse Variance Weighted method (IVW) was employed to estimate the causal association between exposures and outcomes. Additionally, MR-Egger regression, weighted median, simple mode, and weighted mode methods were used as supplementary approaches for a comprehensive appraisal of the causality between blood metabolites and MDD. Pleiotropy and heterogeneity tests were also conducted. Lastly, the relevant metabolites were subjected to metabolite function analysis, and a reverse MR was implemented to explore the potential influence of MDD on these metabolites. Results After rigorous screening, we identified 34 known metabolites, 13 unknown metabolites, and 18 metabolite ratios associated with Major Depressive Disorder (MDD). Among all metabolites, 33 were found to have positive associations, and 32 had negative associations. The top five metabolites that increased the risk of MDD were the Arachidonate (20:4n6) to linoleate (18:2n6) ratio, LysoPE(18:0/0:0), N-acetyl-beta-alanine levels, Arachidonate (20:4n6) to oleate to vaccenate (18:1) ratio, Glutaminylglutamine, and Threonine to pyruvate ratio. Conversely, the top five metabolites that decreased the risk of MDD were N6-Acetyl-L-lysine, Oleoyl-linoleoyl-glycerol (18:1 to 18:2) [2] to linoleoyl-arachidonoyl-glycerol (18:2 to 20:4) [2] ratio, Methionine to phosphate ratio, Pregnanediol 3-O-glucuronide, and 6-Oxopiperidine-2-carboxylic acid. Metabolite function enrichment was primarily concentrated in pathways such as Bile Acid Biosynthesis (FDR=0.177), Glutathione Metabolism (FDR=0.177), Threonine, and 2-Oxobutanoate Degradation (FDR=0.177). In addition, enrichment was noted in pathways like Valine, Leucine, and Isoleucine Biosynthesis (p=0.04), as well as Ascorbate and Aldarate Metabolism (p=0.04). Discussion Within a pool of 1,400 blood metabolites, we identified 34 known metabolites and 13 unknown metabolites, as well as 18 metabolite ratios associated with Major Depressive Disorder (MDD). Additionally, three functionally enriched groups and two metabolic pathways were selected. The integration of genomics and metabolomics has provided significant insights for the screening and prevention of MDD.
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Affiliation(s)
- Tiantian Dong
- Center for External Treatment of Traditional Chinese Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xingxin Wang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Zhixia Jia
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yuanxiang Liu
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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Ebrahimi OV, Borsboom D, Hoekstra RHA, Epskamp S, Ostinelli EG, Bastiaansen JA, Cipriani A. Towards precision in the diagnostic profiling of patients: leveraging symptom dynamics as a clinical characterisation dimension in the assessment of major depressive disorder. Br J Psychiatry 2024; 224:157-163. [PMID: 38584324 PMCID: PMC11039556 DOI: 10.1192/bjp.2024.19] [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: 08/13/2023] [Revised: 12/14/2023] [Accepted: 01/16/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND International guidelines present overall symptom severity as the key dimension for clinical characterisation of major depressive disorder (MDD). However, differences may reside within severity levels related to how symptoms interact in an individual patient, called symptom dynamics. AIMS To investigate these individual differences by estimating the proportion of patients that display differences in their symptom dynamics while sharing the same overall symptom severity. METHOD Participants with MDD (n = 73; mean age 34.6 years, s.d. = 13.1; 56.2% female) rated their baseline symptom severity using the Inventory for Depressive Symptomatology Self-Report (IDS-SR). Momentary indicators for depressive symptoms were then collected through ecological momentary assessments five times per day for 28 days; 8395 observations were conducted (average per person: 115; s.d. = 16.8). Each participant's symptom dynamics were estimated using person-specific dynamic network models. Individual differences in these symptom relationship patterns in groups of participants sharing the same symptom severity levels were estimated using individual network invariance tests. Subsequently, the overall proportion of participants that displayed differential symptom dynamics while sharing the same symptom severity was calculated. A supplementary simulation study was conducted to investigate the accuracy of our methodology against false-positive results. RESULTS Differential symptom dynamics were identified across 63.0% (95% bootstrapped CI 41.0-82.1) of participants within the same severity group. The average false detection of individual differences was 2.2%. CONCLUSIONS The majority of participants within the same depressive symptom severity group displayed differential symptom dynamics. Examining symptom dynamics provides information about person-specific psychopathological expression beyond severity levels by revealing how symptoms aggravate each other over time. These results suggest that symptom dynamics may be a promising new dimension for clinical characterisation, warranting replication in independent samples. To inform personalised treatment planning, a next step concerns linking different symptom relationship patterns to treatment response and clinical course, including patterns related to spontaneous recovery and forms of disorder progression.
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Affiliation(s)
- Omid V. Ebrahimi
- Department of Experimental Psychology, University of Oxford, Oxford, UK; and Department of Psychology , University of Oslo, Oslo, Norway
| | - Denny Borsboom
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Ria H. A. Hoekstra
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Sacha Epskamp
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Edoardo G. Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Laboratory, NIHR Oxford Health Biomedical Research Centre, Oxford, UK; and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Jojanneke A. Bastiaansen
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; and Friesland Mental Health Care Services, Leeuwarden, The Netherlands
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Laboratory, NIHR Oxford Health Biomedical Research Centre, Oxford, UK; and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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Selak Š, Šorgo A, Crnkovič N, Gabrovec B, Cesar K, Žmavc M. Three measures of internet use, social media use and video game playing as predictors of insomnia during the pandemic among students. Sci Rep 2024; 14:3290. [PMID: 38332170 PMCID: PMC10853167 DOI: 10.1038/s41598-024-53351-2] [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] [Received: 07/07/2023] [Accepted: 01/31/2024] [Indexed: 02/10/2024] Open
Abstract
Existing research indicates that the relationship between digital technology use and insomnia can largely depend on which digital technology measure and which insomnia measure is considered. Data on 4261 Slovenian tertiary students was gathered through an online survey in February 2021, which included measures of depression and insomnia symptoms, as well as measures of internet, social media and video game use divided into three measurement levels (use, duration of use, addictive use). Regression analysis revealed an apparent effect of measurement level, where addictive use measures consistently outperformed other technology use measures in predicting insomnia. Regardless of measurement level, social media use seems to produce more risk for insomnia, compared to playing video games or general internet use for leisure purposes. Importantly, a single measure of depression symptoms explained more variance in insomnia than the nine measures of digital technology use combined, meaning that the effect of digital technology on sleep should not be overstated. Most of the effect of social media use on insomnia may in fact be explained by understanding users' depression symptoms. In case of gaming, a larger part of its effect on insomnia is independent of depression symptoms.
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Affiliation(s)
- Špela Selak
- National Institute of Public Health, Ljubljana, Slovenia.
| | - Andrej Šorgo
- Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
| | - Nuša Crnkovič
- National Institute of Public Health, Ljubljana, Slovenia
| | | | - Katarina Cesar
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mark Žmavc
- National Institute of Public Health, Ljubljana, Slovenia
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Zimmermann C, Pope A, Hannon B, Bedard PL, Rodin G, Dhani N, Li M, Herx L, Krzyzanowska MK, Howell D, Knox JJ, Leighl NB, Sridhar S, Oza AM, Lheureux S, Booth CM, Liu G, Castro JA, Swami N, Sue-A-Quan R, Rydall A, Le LW. Symptom screening with Targeted Early Palliative care (STEP) versus usual care for patients with advanced cancer: a mixed methods study. Support Care Cancer 2023; 31:404. [PMID: 37341839 DOI: 10.1007/s00520-023-07870-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Although early palliative care is recommended, resource limitations prevent its routine implementation. We report on the preliminary findings of a mixed methods study involving a randomized controlled trial (RCT) of Symptom screening with Targeted Early Palliative care (STEP) and qualitative interviews. METHODS Adults with advanced solid tumors and an oncologist-estimated prognosis of 6-36 months were randomized to STEP or symptom screening alone. STEP involved symptom screening at each outpatient oncology visit; moderate to severe scores triggered an email to a palliative care nurse, who offered referral to in-person outpatient palliative care. Patient-reported outcomes of quality of life (FACT-G7; primary outcome), depression (PHQ-9), symptom control (ESAS-r-CS), and satisfaction with care (FAMCARE P-16) were measured at baseline and 2, 4, and 6 months. Semi-structured interviews were conducted with a subset of participants. RESULTS From Aug/2019 to Mar/2020 (trial halted due to COVID-19 pandemic), 69 participants were randomized to STEP (n = 33) or usual care (n = 36). At 6 months, 45% of STEP arm patients and 17% of screening alone participants had received palliative care (p = 0.009). Nonsignificant differences for all outcomes favored STEP: difference in change scores for FACT-G7 = 1.67 (95% CI: -1.43, 4.77); ESAS-r-CS = -5.51 (-14.29, 3.27); FAMCARE P-16 = 4.10 (-0.31, 8.51); PHQ-9 = -2.41 (-5.02, 0.20). Sixteen patients completed qualitative interviews, describing symptom screening as helpful to initiate communication; triggered referral as initially jarring but ultimately beneficial; and referral to palliative care as timely. CONCLUSION Despite lack of power for this halted trial, preliminary results favored STEP and qualitative results demonstrated acceptability. Findings will inform an RCT of combined in-person and virtual STEP.
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Affiliation(s)
- Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada.
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Ashley Pope
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Breffni Hannon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Canada
| | - Philippe L Bedard
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Neesha Dhani
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Madeline Li
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Leonie Herx
- Division of Palliative Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Monika K Krzyzanowska
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Jennifer J Knox
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Natasha B Leighl
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Srikala Sridhar
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Amit M Oza
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Stephanie Lheureux
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Christopher M Booth
- Division of Medical Oncology, Kingston Health Sciences Centre, Kingston, Canada
- Department of Oncology, Queen's University, Kingston, Canada
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada
| | - Geoffrey Liu
- Princess Margaret Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Medical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Jacqueline Alcalde Castro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Canada
| | - Nadia Swami
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Rachel Sue-A-Quan
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Anne Rydall
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Lisa W Le
- Department of Biostatistics, University Health Network, Toronto, Canada
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Martínez Herreros MC, Rodríguez Muñoz MF, Izquierdo Méndez N, Olivares Crespo ME. Psychological, Psychosocial and Obstetric Differences between Spanish and Immigrant Mothers: Retrospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11782. [PMID: 36142058 PMCID: PMC9517456 DOI: 10.3390/ijerph191811782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/09/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
This study analyzed the influence of psychological and psychosocial factors of pregnant women at an obstetric level. The possible differences between Spaniards and immigrants were studied. This was a retrospective observational study. The sample has been divided into two study cohorts, one consisting of Spanish pregnant women and one consisting of foreign pregnant women. Both completed the Revised Postpartum Depression Predictors Inventory and the Patient Health Questionnaire-9. A total of 15.9% of Spanish women and 23.2% of immigrants had depressive symptoms. Immigrants claim to have less support at the partner, family, and friendship levels than Spaniards. Moreover, 16.4% of Spaniards vs. 8.1% of immigrants had pregnancy complications; Cesarean section was performed in 16.2% of Spaniards vs. 7.9% of immigrants. A greater number of premature births were detected in immigrants than in Spaniards. Access to universal healthcare is a protective factor against socioeconomic and cultural conditions affecting the mental and obstetrical health of immigrants.
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Affiliation(s)
- María Carmen Martínez Herreros
- Department of Psychology, National University of Distance Education (UNED), C/Juan del Rosal No. 10, 28040 Madrid, Spain
| | - María Fe Rodríguez Muñoz
- Department of Psychology, National University of Distance Education (UNED), C/Juan del Rosal No. 10, 28040 Madrid, Spain
| | - Nuria Izquierdo Méndez
- Department of Obstetrics and Gynecology, San Carlos Clinic Hospital, 28040 Madrid, Spain
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Liu XK, Li QF, Han DC, Cheng W, Song N, Hu M, Xiao SY. The association between sleep and suicidality in the presence and absence of depressive symptoms: A cross-sectional study in rural China. Medicine (Baltimore) 2022; 101:e29725. [PMID: 35984179 PMCID: PMC9388002 DOI: 10.1097/md.0000000000029725] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This study aimed to explore the association between sleep and suicidality in the presence and absence of depressive symptoms in the rural Chinese population. The research involved a cross-sectional survey conducted in Liuyang, China, between November 2010 and August 2011. A total of 2052 participants were surveyed (987 males and 1065 females). To investigate the mediating effect of depressive symptoms in the correlation between sleep quality and suicidality. The association between sleep quality and suicidality in the absence of depressive symptoms was also explored. Suicide risk was measured using the Mini-International Neuropsychiatric Interview subscale. The visual analog scale was used to assess sleep quality. Patient Health Questionnaire-9 and Patient Health Questionnaire-2, avoiding the overlap in sleep and suicidality assessments, were used for detecting depressive symptoms in participants. Depressive symptoms partially mediated the association between sleep quality and suicidality among rural adults. Furthermore, some participants did not exhibit depressive symptoms in this study yet still exhibited a risk for suicidality, with poor sleep quality contributing significantly to their suicidality even after adjusting for cofounders. Poor sleep quality significantly increases the likelihood of suicidality in the presence and absence of depressive symptoms in the rural Chinese population. Poor sleep quality could correlate with increased suicide risk independently of depressive symptoms.
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Affiliation(s)
- Xiao-Kun Liu
- Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Qi-Fu Li
- Neurology Department, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Dong-Chou Han
- Rehabilitation Department, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Wei Cheng
- Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Na Song
- Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, China
| | - Shui-Yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, China
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Shui-Yuan Xiao, Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China (e-mail: )
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Perceived Satisfaction with Online Study during COVID-19 Lockdown Correlates Positively with Resilience and Negatively with Anxiety, Depression, and Stress among Slovenian Postsecondary Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127024. [PMID: 35742270 PMCID: PMC9222706 DOI: 10.3390/ijerph19127024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The purpose of this study is to fill the research gap regarding the influence of satisfaction with distance learning on the correlates of mental health during the COVID-19 pandemic. METHODS An online cross-sectional study was conducted in February and March 2021, involving 4661 postsecondary students. Five validated instruments-PHQ-9 (depression), GAD-7 (anxiety), PSS-4 (stress), CD-RISC-10 (resilience) and SAT-5 (satisfaction with online study)-were used in the present study. FINDINGS The correlations between anxiety, depression, and stress were so high that they were almost inextricably linked. Both satisfaction with online learning and psychological resilience were negatively correlated with anxiety, depression, and stress. Satisfaction with online learning was also negatively correlated with psychological resilience. Females showed higher levels of vulnerability to anxiety, depression, and stress, and exhibited lower levels of psychological resilience than males. CONCLUSION Home-based distance-learning during the COVID-19-induced lockdown had a significant impact on students' mental health. Low satisfaction with distance learning can lead to the development of anxiety and depression symptoms, increase stress, and decrease the psychological resilience of postsecondary students; therefore, it is critical that educational institutions focus on implementing interventions that promote students' satisfaction with distance learning, and their psychological resilience, to protect their mental health.
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Choi SH, McClintock CHY, Lau E, Miller L. The impact of perceived relationship to ancestors on the association between self-transcendence and psychopathology: A cross-cultural examination. Transcult Psychiatry 2022:13634615211049072. [PMID: 34986065 DOI: 10.1177/13634615211049072] [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: 11/16/2022]
Abstract
Self-transcendence has been associated with lower levels of psychopathology. Most studies of self-transcendence have focused on samples of Western participants, and used scales addressing such concepts as self-awareness and feelings of oneness with the larger universe. However, a common Eastern notion of transcendence-perception of ongoing relationships with ancestors-has not been studied. We conducted a cross-cultural investigation of the association between self-transcendence, perceived degree of relationship to ancestors and depression and anxiety in the United States (N = 1499), China (N = 3,150), and India (N = 863). Degrees of perceived relationship to ancestors differed across countries, with the highest rates in India and China, and lowest rates in the United States. Self-transcendence was negatively associated with risks for depression and anxiety in the United States. In India, self-transcendence was also negatively associated with risks for depression and anxiety, and a strong perceived relationship with ancestors had further protective benefit. In China, those with a high level of perceived relationship to ancestors and a high level of self-transcendence exhibited lower levels of psychopathology. Results suggest that measures of relationship to ancestors might be included in future cross-cultural studies of transcendence.
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Early Association Factors for Depression Symptoms in Pregnancy: A Comparison between Spanish Women Spontaneously Gestation and with Assisted Reproduction Techniques. J Clin Med 2021; 10:jcm10235672. [PMID: 34884374 PMCID: PMC8658584 DOI: 10.3390/jcm10235672] [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: 11/06/2021] [Revised: 11/15/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
Women with assisted reproduction techniques (ART) have a different psychological profile than women with a spontaneous pregnancy. These differences may put the former group at higher risk for depressive symptomatology. Our aim was to determine what sociodemographic factors and psychological variables interact with early depressive symptoms in pregnant women with ART. This is a cross-sectional, non-interventional, and observational study where a total of 324 women were analyzed in the first trimester of pregnancy at the Hospital Universitario Central de Asturias (Spain). Women completed a sociodemographic questionnaire, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item Scale, the Resilience inventory, the General concerns (ad hoc scale), the Stressful life events, and the prenatal version of Postpartum Depression Predictors Inventory-Revised (PDPI-R), including socioeconomic status, pregnancy intendedness, self-esteem, partner support, family support, friends support, marital satisfaction, and life stress. According to our models, women undergoing ART had significantly increased the PHQ-9 scores (β = 6.75 ± 0.74; p-value < 0.001). Being single also increased the PHQ-9 score. Related to the psychological variables, anxiety (β = 0.43 ± 0.06; p-value < 0.001) and stressful life events (β = 0.17 ± 0.06; p-value = 0.003) increased PHQ-9 scores. In contrast, resilience (β = -0.05 ± 0.02; p-value = 0.004), self-esteem (β = -1.21 ± 0.61; p-value = 0.048), and partner support (β = -1.50 ± 0.60; p-value = 0.013) decreased PHQ-9 scores. We concluded that women undergoing ART need interventions to reduce anxiety and stressful life events, and to improve resilience, self-esteem, and emotional partner support to prevent depressive symptomatology during this important phase in their lives.
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García-Velázquez R, Komulainen K, Gluschkoff K, Airaksinen J, Määttänen I, Rosenström TH, Jokela M. Socioeconomic inequalities in impairment associated with depressive symptoms: Evidence from the National Survey on Drug Use and Health. J Psychiatr Res 2021; 141:74-80. [PMID: 34175745 DOI: 10.1016/j.jpsychires.2021.06.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Individuals with low socioeconomic status have higher rates of depression, but it is unknown whether the socioeconomically disadvantaged also have more disabling depressive symptoms. We examined (1) the associations of three indicators of socioeconomic status with depression-related severe role impairment, and (2) whether socioeconomic factors moderate the association between individual depression symptoms and depression-related severe role impairment. METHODS We used data from the National Survey on Drug Use and Health (NSDUH). Depressive symptoms, role impairment and socioeconomic indicators (poverty, participation in workforce, educational attainment) were self-reported by participants. The analytic sample consisted of participants who screened positive for a depressive episode during past 12 months (n = 32 661). We used survey-weighted logistic models to examine the associations of depressive symptoms with severe role impairment and the modifying effects of socioeconomic indicators. RESULTS The association between depression symptom count and severe role impairment was stronger among those not in workforce (OR = 1.12[1.02-1.23]). The association between specific depression symptoms and severe role impairment was stronger for conditions of poverty (fatigue, OR = 2.97 [1.54-5.73]; and anhedonia, OR = 1.93[1.13-3.30]), workforce non-participation (inability to concentrate/indecisiveness, OR = 1.54[1.12-2.12]), and lower educational attainment (anhedonia, OR = 0.77 [0.59-0.99]). Feelings of worthlessness was the only symptom with independent associations for all socioeconomic groups (adjusted OR = 1.91[1.35-2.70]). CONCLUSION Depression was more frequent and also more disabling for socioeconomically disadvantaged groups, especially when assessed with workforce participation. Additionally, some specific symptoms showed socioeconomic differences. Our findings highlight the need to prioritize population groups with more severe impairment associated with depressive symptoms.
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Affiliation(s)
- Regina García-Velázquez
- Department of Psychology and Logopedics, University of Helsinki, Finland; Finnish National Institute for Health and Welfare, Helsinki, Finland.
| | - Kaisla Komulainen
- Department of Psychology and Logopedics, University of Helsinki, Finland
| | - Kia Gluschkoff
- Department of Psychology and Logopedics, University of Helsinki, Finland; Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Airaksinen
- Department of Psychology and Logopedics, University of Helsinki, Finland; Institute of Criminology and Legal Policy, University of Helsinki, Finland
| | - Ilmari Määttänen
- Department of Psychology and Logopedics, University of Helsinki, Finland
| | | | - Markus Jokela
- Department of Psychology and Logopedics, University of Helsinki, Finland
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11
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Schmit MK, Oller ML, Tapia‐Fuselier JL, Schmit EL. A Holistic Client Functioning Profile Comparison of People With Serious Mental Illness. JOURNAL OF COUNSELING AND DEVELOPMENT 2020. [DOI: 10.1002/jcad.12295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Marianna L. Oller
- Department of Counseling and Higher Education, University of North Texas
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12
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Gum AM, Epstein-Lubow GP, Gaudiano BA, Wittink M, Horvath C. Brief behaviour change strategies for distressed patients in primary care. BMJ 2019; 366:l5360. [PMID: 31551248 DOI: 10.1136/bmj.l5360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Amber M Gum
- Department of Mental Health Law and Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida
| | - Gary P Epstein-Lubow
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University; Department of Health Services, Policy and Practice, School of Public Health, Brown University, and Psychosocial Research Program, Butler Hospital
| | - Brandon A Gaudiano
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University; Department of Behavioral and Social Sciences, School of Public Health, Brown University, and Psychosocial Research Program, Butler Hospital
| | - Marsha Wittink
- Departments of Psychiatry and Family Medicine, University of Rochester School of Medicine
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13
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Liu XK, Xiao SY, Zhou L, Hu M, Liu HM. Different predictors of pain severity across age and gender of a Chinese rural population: a cross-sectional survey. BMJ Open 2018; 8:e020938. [PMID: 30007928 PMCID: PMC6082477 DOI: 10.1136/bmjopen-2017-020938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To investigate a 4-week period of pain prevalence and the risk factors of experiencing pain among a rural Chinese population sample. To explore the psychosocial and health condition predictors of pain severity and the interactions of age and gender with these factors in real-life situations among the general adult population in China. METHODS Data were collected from a random multistage sample of 2052 participants (response rate=95%) in the rural areas of Liuyang, China. Visual analogue scale was used to assess participants' pain experienced and a series of internationally validated instruments to assess their sociodemographic characteristics, self-reported health status, depression symptoms, anxiety symptoms, sleep quality, self-efficacy and perceived stress. RESULTS The pain prevalence over the 4-week period in rural China was 66.18% (62.84% for men and 68.82% for women). A logistic regression model revealed that being female (adjusted OR=1.58, 95% CI 1.24 to 2.02), age (adjusted OR=1.03, 95% CI 1.02 to 1.05), depressive symptoms (adjusted OR=1.07, 95% CI 1.02 to 1.13) and medium-quality sleep (adjusted OR=2.14, 95% CI 1.26 to 3.64) were significant risk factors for experiencing pain. General linear model analyses revealed that (1) pain severity of rural Chinese was related to self-rated physical health and social health; (2) the interactions of age, gender with employment status, depression symptoms, perceived stress and physical health were significant. Simple effect testing revealed that in different age groups, gender interacted with employment status, depression symptoms, perceived stress and physical health differently. CONCLUSIONS Improving physical and social health could be effective in reducing the severity of pain and the treatment of pain should be designed specifically for different ages and genders among the general population.
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Affiliation(s)
- Xiao-kun Liu
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shui-yuan Xiao
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Liang Zhou
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, China
| | - Mi Hu
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Hui-ming Liu
- Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
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14
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Muramatsu K, Miyaoka H, Kamijima K, Muramatsu Y, Tanaka Y, Hosaka M, Miwa Y, Fuse K, Yoshimine F, Mashima I, Shimizu N, Ito H, Shimizu E. Performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. Gen Hosp Psychiatry 2018; 52:64-69. [PMID: 29698880 DOI: 10.1016/j.genhosppsych.2018.03.007] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subjects (n = 284; male = 107, female = 177) had to return the questionnaires to their health care professional within 48 hours and undergo a diagnostic evaluation interview based on the Japanese version of M.I.N.I-Plus. RESULTS 93 patients were diagnosed as having major depressive disorder (MDD). In the J-PHQ-9, the optimal cutpoint ≥ 10 had sensitivity of 90.5% and specificity of 76.6%. As for the categorical algorithms, the sensitivity was 80.6%; specificity was 89.5%, and a positive likelihood ratio of 7.7. The Stratum-specific likelihood ratios (SSLRs) of the J-PHQ-9 scores of 0-9, 10-14, 15-19, and 20-27 for major depression were 0.10 (95% CI: 0.05-0.20), 1.67 (95% CI: 1.02-2.76), 5.41 (95% CI: 2.87-10.22), and 11.98 (95% CI: 5.39-26.63), respectively. The relationship between the severity of J-PHQ-9 and the MCS of SF-8 was significant (χ 2 = 85.72, df = 4, P ≤ 0.0001). CONCLUSIONS This study has validated the J-PHQ-9 as a useful tool for the assessment of MDD in primary care in Japan.
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Affiliation(s)
- Kumiko Muramatsu
- Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Japan.
| | - Hitoshi Miyaoka
- Department of Psychiatry, Kitasato University School of Medicine, Japan
| | | | | | - Yutaka Tanaka
- Niigata University Graduate School of Medicine and Dental Sciences, Japan
| | | | - Yusuke Miwa
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Japan
| | | | | | | | - Natsue Shimizu
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Hiroto Ito
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Japan
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15
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Liu XK, Xiao SY, Zhou L, Hu M, Zhou W, Liu HM. Sleep quality and covariates as predictors of pain intensity among the general population in rural China. J Pain Res 2018; 11:857-866. [PMID: 29731663 PMCID: PMC5927145 DOI: 10.2147/jpr.s156731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aims of this study were to investigate the distribution of sleep quality and its relationship with the prevalence of pain among rural Chinese people and to explore the association between sleep quality and pain intensity among the general population in real-life settings. Methods This cross-sectional survey included a total of 2052 adults from rural areas in Liuyang, Hunan Province, recruited through random multistage sampling. The distributions of sleep quality and pain prevalence among the participants over a 4-week period were described. Because of multicollinearity among variables, the influence of self-rated sleep quality and psychosocial covariates on pain intensity was explored using a ridge regression model. Results The data showed that participants reporting all categories of sleep quality experienced some degree of pain. Sleep quality, along with physical and mental health, was a negative predictor of pain intensity among the general population. Symptoms of depression positively predicted pain intensity. Conclusion Poor sleep quality increased pain intensity among the participants. Both previous research and the present data suggest that improving sleep quality may significantly decrease pain intensity in the general population. The relationship between sleep and pain may be bidirectional. This finding also suggests that treatment for sleep disorders and insomnia should be addressed in future efforts to alleviate pain intensity.
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Affiliation(s)
- Xiao-Kun Liu
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shui-Yuan Xiao
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Liang Zhou
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Wei Zhou
- Hospital Administration Institute, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui-Ming Liu
- Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
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16
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Hollinger KR, Franke C, Arenivas A, Woods SR, Mealy MA, Levy M, Kaplin AI. Cognition, mood, and purpose in life in neuromyelitis optica spectrum disorder. J Neurol Sci 2016; 362:85-90. [DOI: 10.1016/j.jns.2016.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 12/23/2015] [Accepted: 01/05/2016] [Indexed: 12/19/2022]
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17
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Bech P, Timmerby N, Martiny K, Lunde M, Soendergaard S. Psychometric evaluation of the Major Depression Inventory (MDI) as depression severity scale using the LEAD (Longitudinal Expert Assessment of All Data) as index of validity. BMC Psychiatry 2015; 15:190. [PMID: 26242577 PMCID: PMC4526416 DOI: 10.1186/s12888-015-0529-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 06/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Major Depression Inventory (MDI) was developed to cover the universe of depressive symptoms in DSM-IV major depression as well as in ICD-10 mild, moderate, and severe depression. The objective of this study was to evaluate the standardization of the MDI as a depression severity scale using the Visual Analogue Scale (VAS) as index of external validity in accordance with the LEAD approach (Longitudinal Expert Assessment of All Data). METHODS We used data from two previously published studies in which the patients had a MINI Neuropsychiatric Interview verified diagnosis of DSM-IV major depression. The conventional VAS scores for no, mild, moderate, and severe depression were used for the standardization of the MDI. RESULTS The inter-correlation for the MDI with the clinician ratings (VAS, MES, HAM-D17 and HAM-D6) increased over the rating weeks in terms of Pearson coefficients. After nine weeks of therapy the coefficient ranged from 0.74 to 0.83. Using the clinician-rated VAS depression severity scale, the conventional MDI cut-off scores for no or doubtful depression, and for mild, moderate and severe depression were confirmed. CONCLUSIONS Using the VAS as index of external, clinical validity, the standardization of the MDI as a measure of depression severity was accepted, with an MDI cut-off score of 21 for mild depression, 26 for moderate depression severity, and 31 for severe depression. TRIAL REGISTRATION Martiny et al. Acta Psychiatr Scand 112:117-25, 2005: None - due to trial commencement date. Straaso et al. Acta Neuropsychiatr 26:272-9; 2014: ClinicalTrials.gov ID NCT01353092 .
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Affiliation(s)
- Per Bech
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Dyrehavevej 48, DK-3400, Hillerød, Denmark.
| | - N. Timmerby
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Dyrehavevej 48, DK-3400 Hillerød, Denmark
| | - K. Martiny
- Intensive outpatient unit for Affective Disorders (IAA), Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - M. Lunde
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Dyrehavevej 48, DK-3400 Hillerød, Denmark
| | - S. Soendergaard
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Dyrehavevej 48, DK-3400 Hillerød, Denmark
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18
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Wiersma JE, Van Schaik DJF, Hoogendorn AW, Dekker JJ, Van HL, Schoevers RA, Blom MBJ, Maas K, Smit JH, McCullough JP, Beekman ATF, Van Oppen P. The effectiveness of the cognitive behavioral analysis system of psychotherapy for chronic depression: a randomized controlled trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2015; 83:263-9. [PMID: 25116461 DOI: 10.1159/000360795] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 02/18/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND It is widely agreed that chronic depression is difficult to treat, knowledge about optimal treatment approaches is emerging. METHOD A multisite randomized controlled trial was conducted comparing the cognitive behavioral analysis system of psychotherapy (CBASP), a psychotherapy model developed specifically to treat chronic depression (n = 67) with care as usual (CAU; evidence-based treatments, n = 72) over a period of 52 weeks, with 23 sessions on average, in 3 outpatient clinics in the Netherlands. In both arms algorithm-based pharmacotherapy was provided. Patients (aged 18-65) met criteria for a DSM-IV diagnosis of major depressive disorder with diagnostic specifiers (chronic, without interepisode recovery) or with co-occurring dysthymic disorder indicating a chronic course. The Inventory for Depressive Symptomatology (IDS) Self-Report was used as the primary outcome measure. Mixed-effects linear regression analysis was used to compare the changes on the IDS scores between CBASP and CAU. The IDS was administered before treatment, and after 8, 16, 32 and 52 weeks. RESULTS At week 52, patients assigned to CBASP had a greater reduction of depressive symptoms compared to patients assigned to CAU (t = -2.00, p = 0.05). However, CBASP and CAU did not differ from each other on the IDS after 8 weeks (t = 0.49, p = 0.63), 16 weeks (t = -0.03, p = 0.98) and 32 weeks (t = -0.17, p = 0.86) of treatment. CONCLUSIONS This trial shows that CBASP is at least as effective as standard evidence-based treatments for chronic depression. In the long run, CBASP appears to have an added effect.
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Affiliation(s)
- Jenneke E Wiersma
- Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center and GGZinGeest, Amsterdam, The Netherlands
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19
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Kersting A, Dölemeyer R, Steinig J, Walter F, Kroker K, Baust K, Wagner B. Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2014; 82:372-81. [PMID: 24061387 DOI: 10.1159/000348713] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 02/05/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND The loss of a child during pregnancy causes significant psychological distress for many women and their partners, and may lead to long-lasting psychiatric disorders. Internet-based interventions using exposure techniques and cognitive restructuring have proved effective for posttraumatic stress disorder (PTSD) and prolonged grief. This study compared the effects of an Internet-based intervention for parents after prenatal loss with a waiting list condition (WLC). METHODS The Impact of Event Scale - Revised assessed symptoms of PTSD; the Inventory of Complicated Grief and the Brief Symptom Inventory assessed depression, anxiety, and general mental health. The 228 participants (92% female) were randomly allocated to a treatment group (TG; n = 115) or a WLC group (n = 113). The TG received a 5-week cognitive behavioral intervention including (1) self-confrontation, (2) cognitive restructuring, and (3) social sharing. RESULTS The TG showed significantly reduced symptoms of posttraumatic stress, prolonged grief, depression, and anxiety relative to the WLC control group. Intention-to-treat analysis revealed treatment effects of between d = 0.84 and d = 1.02 for posttraumatic stress and prolonged grief from pre- to posttreatment time points. Further significant improvement in all symptoms of PTSD and prolonged grief was found from the posttreatment evaluation to the 12-month follow-up. The attrition rate of 14% was relatively low. CONCLUSIONS The Internet-based intervention proved to be a feasible and cost-effective treatment, reducing symptoms of posttraumatic stress, grief, depression, anxiety, and general mental health after pregnancy loss. Low-threshold e-health interventions should be further evaluated and implemented routinely to improve psychological support after pregnancy loss.
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Affiliation(s)
- Anette Kersting
- Department of Psychosomatic Medicine, University of Leipzig, Leipzig, Germany
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20
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Popovic D, Reinares M, Scott J, Nivoli A, Murru A, Pacchiarotti I, Vieta E, Colom F. Polarity index of psychological interventions in maintenance treatment of bipolar disorder. PSYCHOTHERAPY AND PSYCHOSOMATICS 2014; 82:292-8. [PMID: 23942231 DOI: 10.1159/000348447] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 12/29/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although several adjunctive psychological interventions are effective in the maintenance of bipolar disorders (BD), no attempt has been made to classify them according to their ability to prevent manic versus depressive episodes. Our study aims to rank the adjunctive psychotherapies for the prophylaxis of BD by means of their polarity index (PI). METHODS Randomized controlled trials comparing the efficacy of a psychological intervention with a comparator in BD maintenance treatment in patients aged over 18 were systematically reviewed. Exclusion criteria were a small sample size, a study sample not exclusively composed of bipolar patients and the absence of a control group. PI is a novel metric indicating the relative antimanic versus antidepressive preventive efficacy of treatments. PI was retrieved by calculating the ratio of the number needed to treat (NNT) for prevention of depression and the NNT for prevention of mania. PI >1.0 indicates a relatively higher antimanic prophylactic efficacy and PI <1.0 a greater antidepressive efficacy. RESULTS A total of 9 studies were included. PI was 0.33, 0.63 and 0.89 for cognitive-behavioral therapy, 0.42 for family-focused therapy, 0.73 and 0.78 for psychoeducation, 1 for enhanced relapse prevention, 1.78 for caregiver group psychoeducation and 3.36 for brief technique-driven interventions. With regard to the PI for 1 cognitive-behavioral study, enhanced relapse prevention and brief technique-driven interventions may not be reliable since those trials were negative. CONCLUSIONS The PI provides a measure of how much depression-preventive or (hypo) mania-preventive an intervention is and may guide the choice of adjunctive psychotherapy in the context of individualized long-term treatment of BD.
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Affiliation(s)
- Dina Popovic
- Bipolar Disorders Unit, Department of Psychiatry, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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21
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Mojtabai R. Clinician-identified depression in community settings: concordance with structured-interview diagnoses. PSYCHOTHERAPY AND PSYCHOSOMATICS 2013; 82:161-9. [PMID: 23548817 DOI: 10.1159/000345968] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Accepted: 11/15/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Relatively little is known about the prevalence and correlates of overdiagnosis of depression in community settings. This study examined the extent to which individuals with clinician-identified depression in the community meet the criteria for DSM-IV major depressive episodes (MDE) and characteristics of these individuals. METHODS In a sample of 5,639 participants with clinician-identified depression drawn from the 2009-2010 United States National Survey of Drug Use and Health, the proportion of participants who met the 12-month MDE criteria, ascertained by a structured interview, and variations in MDE diagnosis across different groups of participants were examined. Mental health profiles and service use of participants who met the MDE criteria were compared to those who did not meet these criteria. RESULTS Only 38.4% of participants with 12-month clinician-identified depression met the 12-month MDE criteria. Older adults were less likely than younger adults to meet the criteria - only 14.3% of those 65 years old or older met the criteria, whereas participants with more education and those with poorer overall health were more likely to meet the criteria. Participants who did not meet the 12-month MDE criteria reported less distress and impairment in role functioning and used fewer services. A majority of both groups, however, were prescribed and used psychiatric medications. CONCLUSIONS Depression overdiagnosis and overtreatment is common in community settings in the USA. There is a need for improved targeting of diagnosis and treatments of depression and other mental disorders in these settings.
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Affiliation(s)
- Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA.
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Bech P, Christensen EM, Vinberg M, Østergaard SD, Martiny K, Kessing LV. The performance of the revised Major Depression Inventory for self-reported severity of depression--implications for the DSM-5 and ICD-11. PSYCHOTHERAPY AND PSYCHOSOMATICS 2013; 82:187-8. [PMID: 23548877 DOI: 10.1159/000346456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 12/11/2012] [Indexed: 11/19/2022]
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Kocalevent RD, Hinz A, Brähler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry 2013; 35:551-5. [PMID: 23664569 DOI: 10.1016/j.genhosppsych.2013.04.006] [Citation(s) in RCA: 425] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 04/03/2013] [Accepted: 04/03/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The nine-item depression module from the Patient Health Questionnaire (PHQ-9) is widely used as an open access screening instrument for depression in different health care and community settings; thus far, normative data from the general population are still scarce. The objectives of the study were to generate normative data and to further investigate the construct validity and factor structure of the PHQ-9 in the general population. METHODS Nationally representative face-to face household surveys were conducted in Germany between 2003 and 2008 (n=5018). The survey questionnaires included the PHQ-9, the Satisfaction with Life Scale, the 12-item Short Form Health Survey (SF-12) for the measurement of health-related quality of life and demographic characteristics. RESULTS Normative data for the PHQ-9 were generated for both genders (53.6% female) and different age levels [mean age (S.D.) of 48.9 (18.1) years]. Women had significantly higher mean (S.D.) scores compared with men [3.1 (3.5) vs. 2.7 (3.5)]. A prevalence rate of moderate to high severity of depressive symptoms of 5.6% was identified. Intercorrelations with depression were highest for the Mental Component Scale of the SF-12, followed by the Physical Component Scale of health-related quality of life, and life satisfaction. Results supported a one-factor model of depression. CONCLUSIONS The normative data provide a framework for the interpretation and comparisons of depression with other populations. Evidence supports reliability and validity of the unidimensional PHQ-9 as a measure of depression in the general population.
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Affiliation(s)
- Rüya-Daniela Kocalevent
- Institute and Policlinic for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W26, 20246 Hamburg, Germany.
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Cosci F, Fava GA. Staging of mental disorders: systematic review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2013; 82:20-34. [PMID: 23147126 DOI: 10.1159/000342243] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 07/28/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND The staging method, whereby a disorder is characterized according to its seriousness, extension, development and features, is attracting increasing attention in clinical psychology and psychiatry. The aim of this systematic review was to critically summarize the tools that are available for reproducing and standardizing the clinical intuitions that are involved in a staging formulation. METHODS A comprehensive research was conducted on the MEDLINE, PsycINFO, EMBASE and Cochrane databases from inception to May 2012. The following search terms were used: 'stage/staging' AND 'psychiatric disorder/mental disorder/schizophrenia/mood disorder/anxiety disorder/substance use disorder/eating disorder'. RESULTS A total of 78 studies were identified for inclusion in the review. We discussed studies addressing or related to the issue of staging in a number of mental disorders (schizophrenia, unipolar depression, bipolar disorder, panic disorder, substance use disorders, anorexia and bulimia nervosa). The literature indicates that disorders have a longitudinal development or a treatment history that can be categorized according to stages. We proposed staging formulations for the above-mentioned psychiatric disorders. CONCLUSION Staging models offer innovative assessment tools for clinical psychologists and psychiatrists. Characterizing each stage of an illness demarcates major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same psychiatric diagnosis. A stage 0 to denote an at-risk condition does not appear to be warranted at the current state of research.
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Affiliation(s)
- Fiammetta Cosci
- Department of Psychology, University of Florence, Florence, Italy.
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25
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Fava GA, Tomba E, Tossani E. Innovative trends in the design of therapeutic trials in psychopharmacology and psychotherapy. Prog Neuropsychopharmacol Biol Psychiatry 2013; 40:306-11. [PMID: 23123361 DOI: 10.1016/j.pnpbp.2012.10.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 10/15/2012] [Accepted: 10/23/2012] [Indexed: 02/08/2023]
Abstract
The standard randomized controlled trial design is still based on the acute disease model. This is in sharp contrast with the fact that the patient is likely to have experienced other treatments before, that may actually modify clinical course and responsiveness. The current standard of therapeutic trial in psychiatry is represented by the large, multi-center, controlled randomized trial with broad inclusion criteria, and little attention to other factors such as the clinical history of patients and comorbidity. The heterogeneous features of these patients would then affect the outcome of the trial. Conflicting results among randomized controlled trials can represent a spectrum of outcomes, based on different patient groups, more than bias or random variability. If a treatment is tested by a series of small trials with inclusion criteria for specific characteristics (including treatment history, subgroups and comorbidity), we may have a better knowledge of its indications and contraindications. Further, there is increasing need of expanding the content of customary clinical information, by including evaluation of variables such as stress, lifestyle, well-being, illness behavior and psychological symptoms. These joint strategies would actually constitute a paradigm shift in psychopharmacology and psychotherapy research.
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Affiliation(s)
- Giovanni A Fava
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Italy.
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