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Schwarz R, Munkholm K, Christensen MS, Kessing LV, Vinberg M. Functioning in patients with major depressive disorder in remission: A systematic review and meta-analysis. J Affect Disord 2024; 363:112-123. [PMID: 39025440 DOI: 10.1016/j.jad.2024.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/18/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the leading causes of burden of disease globally. We aimed to investigate whether global functioning is impaired in patients with MDD in full or partial remission compared to healthy control individuals (HC). METHODS We conducted a systematic review and meta-analysis according to the PRISMA guideline. We searched the databases PubMed, EMBASE and PsycINFO from January 1st 1980 to February 1st 2023. We included studies of adults with a diagnosis/former diagnosis of MDD with assessment of global functioning performed during a state of full or partial remission. The methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Standardised mean differences (SMD) using random-effects models were calculated as the summary measure. We further performed meta-analyses of the mean raw score in patients with MDD for individual functioning scales. RESULTS Forty-two studies, comprising 17,999 patients with MDD and 35,550 HC, were included, 14 of which included both patients with MDD in full or partial remission and HC. Global functioning was lower in patients with MDD in full or partial remission compared with HC (SMD -2.00, 95 % CI: -0.9 to -3.03, 15 comparisons, I2: 99.8 %). LIMITATIONS Important information about the study participants and setting was not reported for most studies, or the reporting was unclear. CONCLUSION Patients with MDD have lower levels of functioning compared with HC also when in full or partial remission. Assessment of functioning should be an essential component of managing patients with MDD, also during remission.
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Affiliation(s)
- Rasmus Schwarz
- Mental Health Centre Northern Zealand, The Early Multimodular Prevention and Intervention Research Institution (EMPIRI) - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Klaus Munkholm
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg, Denmark; Mental Health Centre Copenhagen, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Mie S Christensen
- Mental Health Centre Northern Zealand, The Early Multimodular Prevention and Intervention Research Institution (EMPIRI) - Mental Health Services CPH, Copenhagen, Denmark
| | - Lars V Kessing
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg, Denmark; Mental Health Centre Copenhagen, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Maj Vinberg
- Mental Health Centre Northern Zealand, The Early Multimodular Prevention and Intervention Research Institution (EMPIRI) - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg, Denmark
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Abdin E, Seet V, Jeyagurunathan A, Tan SC, Mohmad Khalid MIS, Mok YM, Verma S, Subramaniam M. Mapping the World Health Organization Disability Assessment Scale 2.0 to the EQ-5D-5L in patients with mental disorders. Expert Rev Pharmacoecon Outcomes Res 2024:1-7. [PMID: 38967393 DOI: 10.1080/14737167.2024.2376100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE The current study aims to develop an algorithm for mapping the WHODAS 2.0 to the EQ-5D-5 L for patients with mental disorders. METHODS This cross-sectional study was conducted at the Institute of Mental Health and Community Wellness Clinics in Singapore between June 2019 and November 2022. We included four regression methods including the Ordinary Least Square (OLS) regression, the Tobit regression model (Tobit), the robust regression with MM estimator (MM), and the adjusted limited dependent variable mixture model (ALDVMM) to map EQ-5D-5 L utility scores from the WHODAS 2.0. RESULTS A total of 797 participants were included. The mean EQ-5D-5 L utility and WHODAS 2.0 total scores were 0.615 (SD = 0.342) and 11.957 (SD = 8.969), respectively. We found that the EQ-5D-5 L utility score was best predicted by the robust regression model with the MM estimator. Our findings suggest that the WHODAS 2.0 total scores were significantly and inversely associated with the EQ-5D-5 L utility scores. CONCLUSION This study provides a mapping algorithm for converting the WHODAS 2.0 scores into EQ-5D-5 L utility scores which can be implemented using a simple online calculator in the following web application: https://eastats.shinyapps.io/whodas_eq5d/.
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Affiliation(s)
- Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Vanessa Seet
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Sing Chik Tan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Abdin E, Seet V, Jeyagurunathan A, Tan SC, Mohmad Khalid MIS, Mok YM, Verma S, Subramaniam M. Equipercentile linking of the Sheehan Disability Scale and the World Health Organization Assessment Schedule 2.0 scales in people with mental disorders. J Affect Disord 2024; 350:539-543. [PMID: 38218260 DOI: 10.1016/j.jad.2024.01.046] [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: 06/14/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The Sheehan Disability Scale (SDS) and the World Health Organization Disability Assessment Scale (WHODAS 2.0) have been widely used to measure functional impairment and disability. To ensure that the scores from these two scales are practically exchangeable across diseases, therapies, and care programmes, the current study aimed to examine the linkage of the WHODAS 2.0 with the SDS and develop a simple and reliable conversion table for the two scales in people with mental disorders. METHODS A total of 798 patients (mean age = 36.1, SD = 12.7) were recruited from outpatient clinics of the Institute of Mental Health, and the Community Wellness Clinic in Singapore. Using a single-group design, an equipercentile equating method with log-linear smoothing was used to establish a conversion table from the SDS to the WHODAS 2.0 and vice versa. RESULTS The conversion table showed that the scores were consistent for the entire range of scores when the scores were converted either from the SDS to the WHODAS 2.0 or from the WHODAS 2.0 to the SDS. The agreement between the WHODAS 2.0's raw and converted scores and SDS's raw and converted scores were interpreted as good with intraclass correlation coefficient of 0.711 and 0.725, respectively. CONCLUSION This study presents a simple and reliable method for converting the SDS scores to the WHODAS 2.0 scores and vice versa, enabling interchangeable use of data across these two disability measures.
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Affiliation(s)
| | - Vanessa Seet
- Research Division, Institute of Mental Health, Singapore
| | | | - Sin Chik Tan
- Research Division, Institute of Mental Health, Singapore
| | | | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Birhan B, Eristu N. Positive Religious Coping and Associated Factors Among Participants with Severe Mental Illness Attending Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, 2021. Psychol Res Behav Manag 2023; 16:2931-2941. [PMID: 37551393 PMCID: PMC10404419 DOI: 10.2147/prbm.s421684] [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: 05/17/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
Background Religion has been reported to be the most widely used coping resource in stressful conditions including physical and mental illnesses. Different studies consistently find that positive religious coping is associated with a reduced level of severe mental illness such as depression. Despite its high prevalence and being a significant coping mechanism for persons with severe mental illness, there are no published studies on positive religious coping in Ethiopia. Objective To assess the prevalence of positive religious coping and associated factors among people with severe mental illness attending outpatient service at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, northwest Ethiopia, 2021. Methods A cross-sectional institution-based study was conducted and systematic random sampling was applied to select participants. Data were collected through a face-to-face interview. The collected data were entered into EpiData version 3.1 and exported to SPSS version 20 for processing and analysis. Multivariable logistic regression was used to identify independent factors associated with religious coping. P-value <0.05 was declared a statistically significant association with a 95% confidence interval. Results The prevalence of positive religious coping among severe mental illness was 72.4% (95% CI= 68.2, 76.4). Having no comorbid medical illness, good quality of life, good medication adherence, and mild subjective severity scale were associated with positive religious coping. Conclusion The magnitude of positive religious coping among severe mental illness was relatively high. Not having a comorbid medical illness, good medication adherence, good quality of life, and mild subjective severity scale were factors associated with it. Patients report different factors that affect practicing positive religious coping factors. In the other direction, positive religious coping was reported to contribute to symptom alleviating and increasing a sense of well-being.
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Affiliation(s)
- Belete Birhan
- Department of Psychiatry, Wolaita Sodo University, College of Health Science and Medicine, Wolaita Sodo, Ethiopia
| | - Netsanet Eristu
- Department of Psychiatry, Dire Dawa University, College of Medicine and Health Science, Dire Dawa, Ethiopia
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Hernando-Merino E, Baca-García E, Barrigón ML. A One-Year Follow Up Study on Disability in Mental Health Nursing Practice. Clin Nurs Res 2023; 32:384-392. [PMID: 35135378 DOI: 10.1177/10547738211073721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Disability is common in patients with mental disorders, and therapeutic approaches should promote functional recovery to achieve the highest quality of life. This study reports changes in WHODAS 2.0 scores at 1 year of follow-up among patients receiving care from a single mental-health nurse in a community setting in Spain and compare these changes by diagnosis (SMI vs. CMI). Baseline and 1-year follow-up scores were compared. For all participants, we collected sociodemographic information, clinical diagnosis, and disability scores according to WHODAS 2.0. Participating patients received the usual, non-manualized nursing intervention. Our sample comprised 133 patients, 75 of whom were assessed after 1 year. All patients had improved WHODAS 2.0 scores (difference of 9.20 ± 2.42; p < .001) in all domains except those domains related to work ("Life activities") and relationships ("Getting along"). Furthermore, almost half of the patients studied were no longer undergoing treatment with the nurse at 1-year follow-up.
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Affiliation(s)
- Elena Hernando-Merino
- Hospital Universitario Infanta Elena, Valdemoro, España.,Hospital Clínico San Carlos, Madrid, España
| | - Enrique Baca-García
- Hospital Universitario Infanta Elena, Valdemoro, España.,Hospital Fundación Jiménez Díaz, Madrid, España.,Universidad Autónoma, Madrid, España.,Hospital Universitario Rey Juan Carlos, Móstoles, España.,Hospital General de Villalba, Madrid, España.,CIBERSAM (Centro de Investigación en Salud Mental), Instituto de Salud Carlos III, Madrid, España.,Universidad Católica del Maule, Talca, Chile
| | - Maria Luisa Barrigón
- Hospital Fundación Jiménez Díaz, Madrid, España.,Hospital Universitario Virgen del Rocío, Sevilla, España
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Richardson L, Minh A, McCormack D, Laing A, Barbic S, Hayashi K, Milloy MJ, Huyser KR, Leahy K, Li J. Cohort Profile: The Assessing Economic Transitions (ASSET) Study-A Community-Based Mixed-Methods Study of Economic Engagement among Inner-City Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610456. [PMID: 36012091 PMCID: PMC9408769 DOI: 10.3390/ijerph191610456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 05/07/2023]
Abstract
The Assessing Economic Transitions (ASSET) study was established to identify relationships between economic engagement, health and well-being in inner-city populations given that research in this area is currently underdeveloped. This paper describes the objectives, design, and characteristics of the ASSET study cohort, an open prospective cohort which aims to provide data on opportunities for addressing economic engagement in an inner-city drug-using population in Vancouver, Canada. Participants complete interviewer-administered surveys quarterly. A subset of participants complete nested semi-structured qualitative interviews semi-annually. Between April 2019 and May 2022, the study enrolled 257 participants ages 19 years or older (median age: 51; 40% Indigenous, 11.6% non-Indigenous people of colour; 39% cis-gender women, 3.9% transgender, genderqueer, or two-spirit) and 41 qualitative participants. At baseline, all participants reported past daily drug use, with 27% currently using opioids daily, and 20% currently using stimulants daily. In the three months prior to baseline, more participants undertook informal income generation (75%) than formal employment (50%). Employed participants largely had casual jobs (42%) or jobs with part-time/varied hours (35%). Nested qualitative studies will focus on how inner-city populations experience economic engagement. The resulting evidence will inform policy and programmatic initiatives to address socioeconomic drivers of health and well-being.
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Affiliation(s)
- Lindsey Richardson
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Correspondence:
| | - Anita Minh
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | - Deb McCormack
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
| | - Allison Laing
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
| | - Skye Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Providence Research, 1190 Hornby, Vancouver, BC V6Z 2K5, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - M.-J. Milloy
- British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Kimberly R. Huyser
- Department of Sociology, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Kathleen Leahy
- UBC Learning Exchange, University of British Columbia, 612 Main St., Vancouver, BC V6A 2V3, Canada
| | - Johanna Li
- EMBERS Eastside Works, 57 E Hastings St., Vancouver, BC V6A 0A7, Canada
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Hernando-Merino E, Baca-Garcia E, Barrigón ML. Comparison of disability between common mental disorders and severe mental disorders using WHODAS 2.0. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:205-210. [PMID: 36216725 DOI: 10.1016/j.rpsmen.2022.09.008] [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: 03/10/2021] [Accepted: 08/25/2021] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Mental disorders are among the leading causes of disability worldwide. Despite the fact that severe mental disorders (SMD) are associated with high disability, the impact of common mental disorders (CMD) is not negligible. In this work, we compare the disability measured with the WHODAS 2.0 scale of both diagnostic groups at the Mental Health Nurse facility. MATERIAL AND METHODS Sociodemographic data, clinical diagnosis and disability scores were collected, using the WHODAS 2.0 scale, of the patients attended by the Mental Health specialist nurse at the Infanta Elena de Valdemoro Hospital (Madrid) and disability was compared in patients with SMD and CMD, using the Student t test. RESULTS Our study sample consisted of 133 patients. Patients with CMD showed greater disability compared to patients with SMD. It was observed that the disability associated with CMD is higher, compared to SMD, this difference being significant for the domain of work (p < 0.001) and participation in society (p = 0.041). CONCLUSIONS In this study we showed that the level of disability associated with CMD was higher in certain areas compared to SMD, this difference was of special relevance for the «Work» and «Participation» domains. This may serve to adapt the interventions aimed at these people and improve their quality of life.
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Affiliation(s)
- Elena Hernando-Merino
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, Spain; Departamento de Psiquiatría, Hospital Clínico San Carlos, Madrid, Spain
| | - Enrique Baca-Garcia
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, Spain; Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Universidad Autónoma, Madrid, Spain; Departamento de Psiquiatría, Hospital Universitario Rey Juan Carlos, Móstoles, Spain; Departamento de Psiquiatría, Hospital General de Villalba, Madrid, Spain; CIBERSAM (Centro de Investigación en Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, France
| | - Maria Luisa Barrigón
- Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, Spain; Departamento de Psiquiatría, Universidad Autónoma, Madrid, Spain.
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Cai Y, Gong W, He W, He H, Hughes JP, Simoni J, Xiao S, Gloyd S, Lin M, Deng X, Liang Z, Dai B, Liao J, Hao Y, Xu DR. Residual Effect of Texting to Promote Medication Adherence for Villagers with Schizophrenia in China: 18-Month Follow-up Survey After the Randomized Controlled Trial Discontinuation. JMIR Mhealth Uhealth 2022; 10:e33628. [PMID: 35438649 PMCID: PMC9066323 DOI: 10.2196/33628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/12/2022] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Reducing the treatment gap for mental health in low- and middle-income countries is a high priority. Even with treatment, adherence to antipsychotics is rather low. Our integrated intervention package significantly improved medication adherence within 6 months for villagers with schizophrenia in resource-poor communities in rural China. However, considering the resource constraint, we need to test whether the effect of those behavior-shaping interventions may be maintained even after the suspension of the intervention.
Objective
The aim of this study is to explore the primary outcome of adherence and other outcomes at an 18-month follow-up after the intervention had been suspended.
Methods
In a 6-month randomized trial, 277 villagers with schizophrenia were randomized to receive either a government community mental health program (686 Program) or the 686 Program plus Lay health supporters, e-platform, award, and integration (LEAN), which included health supporters for medication or care supervision, e-platform access for sending mobile SMS text messaging reminders and education message, a token gift for positive behavior changes (eg, continuing taking medicine), and integrating the e-platform with the existing 686 Program. After the 6-month intervention, both groups received only the 686 Program for 18 months (phase 2). Outcomes at both phases included antipsychotic medication adherence, functioning, symptoms, number of rehospitalization, suicide, and violent behaviors. The adherence and functioning were assessed at the home visit by trained assessors. We calculated the adherence in the past 30 days by counting the percentage of dosages taken from November to December 2018 by unannounced home-based pill counts. The functioning was assessed using the World Health Organization Disability Assessment Schedule 2.0. The symptoms were evaluated using the Clinical Global Impression–Schizophrenia during their visits to the 686 Program psychiatrists. Other outcomes were routinely collected in the 686 Program system. We used intention-to-treat analysis, and missing data were dealt with using multiple imputation. The generalized estimating equation model was used to assess program effects on adherence, functioning, and symptoms.
Results
In phase 1, antipsychotic adherence and rehospitalization incidence improved significantly. However, in phase 2, the difference of the mean of antipsychotic adherence (adjusted mean difference 0.05, 95% CI −0.06 to 0.16; P=.41; Cohen d effect size=0.11) and rehospitalization incidence (relative risk 0.65, 95% CI 0.32-1.33; P=.24; number needed to treat 21.83, 95% CI 8.30-34.69) was no longer statistically significant, and there was no improvement in other outcomes in either phase (P≥.05).
Conclusions
The simple community-based LEAN intervention could not continually improve adherence and reduce the rehospitalization of people with schizophrenia. Our study inclined to suggest that prompts for medication may be necessary to maintain medication adherence for people with schizophrenia, although we cannot definitively exclude other alternative interpretations.
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Affiliation(s)
- Yiyuan Cai
- Department of Epidemiology and Health Statistic, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Wenjun He
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
- Acacia Labs, Institute for Global Health and Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Hua He
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Jane Simoni
- Department of Psychology, University of Washington, Seattle, WA, United States
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Shuiyuan Xiao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Stephen Gloyd
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Meijuan Lin
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China
| | - Xinlei Deng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zichao Liang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bofeng Dai
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Liao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Dong Roman Xu
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
- Acacia Labs, Institute for Global Health and Dermatology Hospital, Southern Medical University, Guangzhou, China
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Badu E, O'Brien AP, Mitchell R, Osei A. Factors associated with the quality of mental health services and consumers' functionality using tertiary-based services. Perspect Psychiatr Care 2022; 58:592-607. [PMID: 33942311 DOI: 10.1111/ppc.12820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/25/2021] [Accepted: 04/09/2021] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Assess factors associated with the quality of mental health services. DESIGN AND METHODS Cross-sectional design, quantitative data, and 510 consumers from three psychiatric facilities. RESULTS The average age of consumers was 34 years and 51.57% males. Consumers reported mixed satisfaction with the quality of mental health services (mean = 3.2; SD = 0.56) but were dissatisfied with the range of interventions (mean = 1.57; SD = 0.77). Predisposing (age, education, and primary occupation), enabling (insurance status), and need factors (mental health status) were significantly associated with quality indicators (range of interventions, efficacy, and overall satisfaction). These factors were significantly associated with consumers' functionality (cognition, mobility, self-care, getting along, life activities, and participation). PRACTICE IMPLICATIONS Policymakers and clinicians are encouraged to incorporate the predisposing, enabling, and need factors into mental health planning, monitoring, and advocacy to improve service outcomes.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Anthony P O'Brien
- Faculty of Health, Southern Cross University, New South Wales, Australia
| | - Rebecca Mitchell
- Health & Wellbeing Research Unit (HoWRU), Macquarie Business School, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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Shafer LA, Sofia MA, Rubin DT, Steinhart AH, Ng SC, Reches L, Israeli E, Bernstein CN. An International Multicenter Comparison of IBD-Related Disability and Validation of the IBDDI. Clin Gastroenterol Hepatol 2021; 19:2524-2531. [PMID: 32858200 DOI: 10.1016/j.cgh.2020.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/29/2020] [Accepted: 08/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The IBD disability index (IBDDI) has been shown to be valid and reliable. We compared the distributional and predictive properties of the IBDDI, when collected from five populations of people living with IBD- from Winnipeg, Chicago, Toronto, Hong Kong, and Jerusalem. METHODS People with IBD from five jurisdictions were invited to complete a survey including the IBDDI, the World Health Organization Disability Assessment Scale, the Work and Social Adjustment Scale, the IBDQ, the Kessler-6 distress scale, and the Stanford presenteeism scale. Between sites, we compared the correlation between IBDDI and the other 4 measures of disability/quality of life/distress, and the association between IBDDI and presenteeism and having been hospitalized in the past year. RESULTS There were 1121 participants from Winnipeg, 511 from Chicago, 147 from Toronto, 97 from Hong Kong, and 96 from Jerusalem. The majority had Crohn's disease. Although the mean IBDDI score varied by site, the correlation between IBDDI and each of the other 4 measures of disability/QOL/distress was nearly identical. Similarly, the regression coefficient showing the association between IBDDI and presenteeism was nearly identical in all sites, and the risk ratios showing the association between hospitalization and high IBDDI was similar in all sites. CONCLUSION The correlation between IBDDI and different measures of disability/QOL/distress was similar across all sites. There is strong evidence of the association between IBD-related disability and presenteeism, and between hospitalization and high IBD-related disability, and that the associations are the same across different populations. The severity of disability that an individual with a given IBDDI score has is directly comparable across populations.
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Affiliation(s)
- Leigh Anne Shafer
- IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - M Anthony Sofia
- Inflammatory Bowel Disease Center, Oregon Health and Science University, Portland, Oregon
| | - David T Rubin
- Inflammatory Bowel Disease Center, University of Chicago Medical Center, Chicago, Illinois
| | - A Hillary Steinhart
- Mount Sinai Hospital Inflammatory Bowel Disease Centre, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Siew C Ng
- Department of Medicine, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Department of Medicine and Therapeutics, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong
| | - Liran Reches
- Department of Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Eran Israeli
- Institute of Gastroenterology and Liver Diseases, E. Wolfson Medical Center, Holon, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Charles N Bernstein
- IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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11
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Patten SB, Williams JV. The WHODAS-2 and Community Psychiatry. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:1094-1095. [PMID: 34009043 PMCID: PMC8689455 DOI: 10.1177/07067437211017868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Scott B Patten
- Department of Community Health Sciences, University of Calgary, Alberta, Canada
| | - Jeanne Va Williams
- Department of Community Health Sciences, University of Calgary, Alberta, Canada
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12
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Hoehne A, Giguère CE, Herba CM, Labelle R. Assessing Functioning across Common Mental Disorders in Psychiatric Emergency Patients: Results from the WHODAS-2. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:1085-1093. [PMID: 33353429 PMCID: PMC8689447 DOI: 10.1177/0706743720981200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Assessing global functioning in psychiatric emergency settings is important for clinicians to estimate severity of mental disorders, devise a treatment plan, and assess the evolution of their patients' progression over time. The World Health Organization Disability Assessment Schedule-2.0 (WHODAS-2) measures psychological, social, and professional functioning and is recommended as a standardized instrument of choice for use in psychiatric settings. Yet, studies investigating disability profiles of mental disorders using the WHODAS-2 are scarce, and psychometric properties have not been evaluated in a psychiatric emergency context. We describe and compare WHODAS-2 (12-item version) scores across mental disorders (anxiety, mood, psychotic, personality, and substance abuse) in adults admitted to psychiatric emergency. METHODS Data from the Signature Bank were used. Participants admitted to psychiatric emergency completed the WHODAS-2 at admission (n = 1,125). Mental disorders were evaluated by psychiatrists, and WHODAS-2 scores were compared across groups. Psychometric properties were evaluated using confirmatory factor analysis (CFA). RESULTS Higher mean WHODAS-2 scores were reported by those with anxiety, mood, and personality disorders (P < 0.001) compared to other psychopathologies. The measure showed good internal consistency (global score α = 0.88; domain subscores α = 0.59 to 0.85) and acceptable goodness of fit indices in CFA confirming the original structure of WHODAS-2. CONCLUSIONS Findings from this large-scale study could assist clinicians in interpreting WHODAS-2 scores in psychiatric populations and provide a more detailed portrait of disability profiles associated with different clinical diagnoses.
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Affiliation(s)
- A. Hoehne
- Research Center, Institut universitaire en santé mentale de
Montréal, Québec, Canada
- Department of Psychology, Université du Québec à Montréal, Québec,
Canada
| | - C.-E. Giguère
- Research Center, Institut universitaire en santé mentale de
Montréal, Québec, Canada
| | - C. M. Herba
- Department of Psychology, Université du Québec à Montréal, Québec,
Canada
- Research Center, CHU Ste-Justine, Montréal, Québec, Canada
- Department of Psychiatry and addictology, Université de Montréal,
Québec, Canada
| | - R. Labelle
- Research Center, Institut universitaire en santé mentale de
Montréal, Québec, Canada
- Department of Psychology, Université du Québec à Montréal, Québec,
Canada
- Department of Psychiatry and addictology, Université de Montréal,
Québec, Canada
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13
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Hernando-Merino E, Baca-Garcia E, Barrigón ML. Comparison of disability between common mental disorders and severe mental disorders using WHODAS 2.0. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 15:S1888-9891(21)00099-9. [PMID: 34534707 DOI: 10.1016/j.rpsm.2021.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/11/2021] [Accepted: 08/25/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Mental disorders are among the leading causes of disability worldwide. Despite the fact that severe mental disorders (SMD) are associated with high disability, the impact of common mental disorders (CMD) is not negligible. In this work, we compare the disability measured with the WHODAS 2.0 scale of both diagnostic groups at the Mental Health Nurse facility. MATERIAL AND METHODS Sociodemographic data, clinical diagnosis and disability scores were collected, using the WHODAS 2.0 scale, of the patients attended by the Mental Health specialist nurse at the Infanta Elena de Valdemoro Hospital (Madrid) and disability was compared in patients with SMD and CMD, using the Student t test. RESULTS Our study sample consisted of 133 patients. Patients with CMD showed greater disability compared to patients with SMD. It was observed that the disability associated with CMD is higher, compared to SMD, this difference being significant for the domain of work (p<0.001) and participation in society (p=0.041). CONCLUSIONS In this study we showed that the level of disability associated with CMD was higher in certain areas compared to SMD, this difference was of special relevance for the «Work» and «Participation» domains. This may serve to adapt the interventions aimed at these people and improve their quality of life.
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Affiliation(s)
- Elena Hernando-Merino
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, España; Departamento de Psiquiatría, Hospital Clínico San Carlos, Madrid, España
| | - Enrique Baca-Garcia
- Departamento de Psiquiatría, Hospital Universitario Infanta Elena, Valdemoro, España; Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, España; Departamento de Psiquiatría, Universidad Autónoma, Madrid, España; Departamento de Psiquiatría, Hospital Universitario Rey Juan Carlos, Móstoles, España; Departamento de Psiquiatría, Hospital General de Villalba, Madrid, España; CIBERSAM (Centro de Investigación en Salud Mental), Instituto de Salud Carlos III, Madrid, España; Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Francia
| | - Maria Luisa Barrigón
- Departamento de Psiquiatría, Hospital Fundación Jiménez Díaz, Madrid, España; Departamento de Psiquiatría, Universidad Autónoma, Madrid, España.
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14
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Pietrini F, Tatini L, Santarelli G, Brugnolo D, Squillace M, Bozza B, Ballerini A, Ricca V, D'Anna G. Self- and caregiver-perceived disability, subjective well-being, quality of life and psychopathology improvement in long-acting antipsychotic treatments: a 2-year follow-up study. Int J Psychiatry Clin Pract 2021; 25:307-315. [PMID: 34057873 DOI: 10.1080/13651501.2021.1912358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Switching to long-acting injectable (LAI) antipsychotic maintenance treatment (AMT) represents a valuable strategy for schizophrenia. In a recovery-oriented approach, patient-reported outcomes (PROs) such as perceived disability, subjective well-being, and quality of life cannot be neglected. METHODS Forty clinically stable outpatients with schizophrenia treated with oral second-generation antipsychotics were enrolled at the time of switching to the equivalent dose of LAI. 35 subjects completed this 2-year longitudinal, prospective, open-label, observational study. Patients were assessed at baseline, after 1 year, and after 2 years of LAI-AMT, using psychometric scales (Positive And Negative Syndrome Scale, PANSS; Young Mania Rating Scale, YMRS; Montgomery-Åsberg Depression Rating Scale, MADRS), PROs (Subjective Well-Being under Neuroleptics short form, SWN-K; Short Form-36 health survey, SF-36; 12-item World Health Organisation Disability Assessment Schedule, WHODAS 2.0), and caregiver-reported outcomes (12-item WHODAS 2.0). RESULTS No psychotic relapses were observed. Psychopathology measures (PANSS total and subscales - excluding negative symptoms), mood symptoms (YMRS, MADRS), perceived disability (patient- and caregiver-administered WHODAS 2.0), subjective well-being (SWN-K), and quality of life (SF-36) showed a concomitant amelioration after 1 year, without further significant variations. DISCUSSION Switching to LAI-AMT may decrease perceived impairment, and increase subjective well-being and quality of life in clinically stable outpatients with schizophrenia.HighlightsLAI treatment may improve outcomes by reducing psychopathology levels and relapses.In a recovery-oriented approach, patient-reported outcomes cannot be neglected.LAI antipsychotics may optimise the subjective experience of treatment.Switching to LAI therapy may result in a reduction in perceived disability.There is a significant correlation between proxy- and patient-reported disability.
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Affiliation(s)
- Francesco Pietrini
- Department of Mental Health and Addictions, Central Tuscany NHS Trust, Florence, Italy
| | - Lorenzo Tatini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Gabriele Santarelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Dario Brugnolo
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Marco Squillace
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Bernardo Bozza
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Ballerini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giulio D'Anna
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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15
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Cai Y, Gong W, He H, Hughes JP, Simoni J, Xiao S, Gloyd S, Lin M, Deng X, Liang Z, He W, Dai B, Liao J, Hao Y, Xu DR. Mobile Texting and Lay Health Supporters to Improve Schizophrenia Care in a Resource-Poor Community in Rural China (LEAN Trial): Randomized Controlled Trial Extended Implementation. J Med Internet Res 2020; 22:e22631. [PMID: 33258788 PMCID: PMC7738261 DOI: 10.2196/22631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/23/2020] [Accepted: 10/29/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Schizophrenia is a severe and disabling condition that presents a dire health equity challenge. Our initial 6-month trial (previously reported) using mobile texting and lay health supporters, called LEAN, significantly improved medication adherence from 0.48 to 0.61 (adjusted mean 0.11, 95% CI 0.03 to 0.20, P=.007) for adults with schizophrenia living in a resource-poor village in rural China. OBJECTIVE We explored the effectiveness of our texting program in improving participants' medication adherence, functioning, and symptoms in an extended implementation of the intervention after its initial phase. METHODS In an approximated stepped-wedge wait-list design randomized controlled trial, 277 community-dwelling villagers with schizophrenia were assigned 1:1 in phase 1 into intervention and wait-list control groups. The intervention group received (1) lay health supporters (medication or care supervisors), (2) e-platform (mobile-texting reminders and education message) access, (3) a token gift for positive behavioral changes, and (4) integration with the existing government community-mental health program (the 686 Program) while the wait-listed control group initially only received the 686 Program. Subsequently (in the extended period), both groups received the LEAN intervention plus the 686 Program. The primary outcome was antipsychotic medication adherence (percentage of dosages taken over the past month assessed by unannounced home-based pill counts). The secondary outcomes were symptoms measured during visits to 686 Program psychiatrists using the Clinical Global Impression scale for schizophrenia and functioning measured by trained student assessors using the World Health Organization Disability Assessment Schedule 2.0. Other outcomes included data routinely collected in the 686 Program system (refill records, rehospitalization due to schizophrenia, death for any reason, suicide, wandering, and violent behaviors). We used intention-to-treat analysis and missing data were imputed. A generalized estimating equation model was used to assess program effects on antipsychotics medication adherence, symptoms, and functioning. RESULTS Antipsychotics medication adherence improved from 0.48 in the control period to 0.58 in the extended intervention period (adjusted mean difference 0.11, 95% CI 0.04 to 0.19; P=.004). We also noted an improvement in symptoms (adjusted mean difference -0.26, 95% CI -0.50 to -0.02; P=.04; Cohen d effect size 0.20) and a reduction in rehospitalization (0.37, 95% CI 0.18 to 0.76; P=.007; number-needed-to-treat 8.05, 95% CI 4.61 to 21.41). There was no improvement in functioning (adjusted mean difference 0.02, 95% CI -0.01 to 0.06; P=.18; Cohen d effect size 0.04). CONCLUSIONS In an extended implementation, our intervention featuring mobile texting messages and lay health workers in a resource-poor community setting was more effective than the 686 Program alone in improving medication adherence, improving symptoms, and reducing rehospitalization. TRIAL REGISTRATION Chinese Clinical Trial Registry; ChiCTR-ICR-15006053 https://tinyurl.com/y5hk8vng.
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Affiliation(s)
- Yiyuan Cai
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, Guizhou Medical University, Guiyang, China
| | - Wenjie Gong
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Hua He
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Jane Simoni
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Shuiyuan Xiao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Stephen Gloyd
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Meijuan Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinlei Deng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zichao Liang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjun He
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bofeng Dai
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Liao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Dong Roman Xu
- Acacia Lab for Health Systems Strengthening and Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
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16
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Umucu E, Schlegelmilch A, Brinck E, Hartman E, Iwanaga K, Estala V, Roskowski M, Lee B, Anderson CA, N. Tansey T. Psychometric Validation of a Measure Assessing Functional Limitations of Students With Disabilities: An Adaptation of the World Health Organization Disability Assessment Schedule 2.0. REHABILITATION COUNSELING BULLETIN 2020. [DOI: 10.1177/0034355220962176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) has been used to assess functional impairments in various disability populations and has been shown to be applicable to the youth population. The purpose of the study was to evaluate the psychometric properties of the World Health Organization Disability Assessment Schedule II–Youth Version (WHODAS-Y). Results of the study revealed a two-factor solution, including the socio-cognitive index and self-care index. The WHODAS-Y measurement appears to be a reliable and valid measure of function impairment in transition-age youth with disabilities in a community setting. This assessment tool can be integrated in vocational rehabilitation practices and guide rehabilitation counselors in identifying needs and facilitators related to education and employment-related services, as well as understanding health care needs in youth with disabilities.
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Affiliation(s)
| | | | | | - Ellie Hartman
- Wisconsin Department of Workforce Development, Madison, USA
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17
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Ćwirlej-Sozańska A, Bejer A, Wiśniowska-Szurlej A, Wilmowska-Pietruszyńska A, de Sire A, Spalek R, Sozański B. Psychometric Properties of the Polish Version of the 36-Item WHODAS 2.0 in Patients with Low Back Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7284. [PMID: 33036141 PMCID: PMC7579066 DOI: 10.3390/ijerph17197284] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/26/2020] [Accepted: 09/30/2020] [Indexed: 12/15/2022]
Abstract
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is considered by the World Health Organization (WHO) to be a useful tool for assessing the functioning and disability of the general population as well as the effectiveness of the applied interventions. Until this study, no data regarding the validity of the 36-item WHODAS 2.0 in chronic low back pain (LBP) in Poland have been explored. This study was conducted on 92 patients suffering from chronic LBP admitted to the rehabilitation ward. The Polish version of the 36-item WHODAS 2.0, the Sf-36 Health Survey (SF-36), the Oswestry Disability Index (ODI), the Hospital Anxiety and Depression Scale (HADS) and the Visual Analogue Scale (VAS) questionnaires were applied to assess patients. The scale score reliability of the entire tool for the study population was very high. The Cronbach's alpha test result for the entire scale was 0.92. For the overall result of the WHODAS 2.0, the Intraclass Correlation Coefficient (ICC1,2) was 0.928, which confirmed that the scale was consistent over time. The total result and the vast majority of domains of the 36-item WHODAS 2.0 correlated negatively with domains of the SF-36 questionnaire; thus, a higher WHODAS 2.0 score was associated with a lower score on the SF-36 questionnaire. We found that the minimal clinically important difference (MCID) for the total WHODAS 2.0 score in patients after rehabilitation for LBP was 4.87. Overall, the results indicated that the Polish version of the 36-item WHODAS is suitable for assessing health and disability status in patients with LBP.
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Affiliation(s)
- Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
| | - Agnieszka Bejer
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
| | - Agnieszka Wiśniowska-Szurlej
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
| | | | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Viale Piazza D’Armi 1, 28100 Novara, Italy;
- Department of Geriatrics, Neurosciences, Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F.Vito 8, 00168 Rome, Italy; or
| | - Renata Spalek
- Department of Geriatrics, Neurosciences, Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F.Vito 8, 00168 Rome, Italy; or
- Rehabilitation Unit, ‘Mons. L. Novarese’ Hospital, Str. Sotto Cerca, 13040 Vercelli, Italy
| | - Bernard Sozański
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
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18
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Snell DL, Siegert RJ, Silverberg ND. Rasch analysis of the World Health Organization Disability Assessment Schedule 2.0 in a mild traumatic brain injury sample. Brain Inj 2020; 34:610-618. [PMID: 32078408 DOI: 10.1080/02699052.2020.1729417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study we examined the psychometric properties of the World Health Organization Disability Assessment Schedule (WHODAS 2.0 12-item version) in a mild traumatic brain injury (MTBI) sample.Materials and Methods: Treatment-seeking adults (n = 131) with MTBI recruited from outpatient clinics in Vancouver Canada, were assessed 1- and 3-months following clinic intake. Dimensionality, reliability, and differential item functioning of the WHODAS 2.0 were examined with Rasch analysis. Associations between change in WHODAS 2.0 scores and symptom, work and perceived improvement outcomes were examined.Results: Adequate fit to the Rasch model was achieved for 1-month follow-up assessment WHODAS 2.0 scores without altering the response format or item content [X2 (24, n = 130) = 21.2, p = .6]. The best model fit for 3-month follow-up assessment scores was achieved when two items (problems with dressing and washing) were combined [X2 (22, n = 115) = 20.9, p = .5]. Associations were evident between changes in WHODAS total Rasch scores and other outcome indicators such as return to productivity and percieved improvement.Conclusions: The WHODAS 2.0 (12-item version) is a psychometrically sound measure of functional outcome for adults seeking treatment following MTBI. Our table of ordinal to interval score conversions is recommended for future research examining MTBI outcomes.
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Affiliation(s)
- Deborah L Snell
- Concussion Clinic, Canterbury District Health Board, Christchurch, New Zealand.,Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Richard J Siegert
- Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand
| | - Noah D Silverberg
- Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, Canada.,Rehabilitation Research Program, GF Strong Rehab Centre, Vancouver, Canada.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
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19
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Grassi L, Caruso R, Da Ronch C, Härter M, Schulz H, Volkert J, Dehoust M, Sehner S, Suling A, Wegscheider K, Ausín B, Canuto A, Muñoz M, Crawford MJ, Hershkovitz Y, Quirk A, Rotenstein O, Santos-Olmo AB, Shalev A, Strehle J, Weber K, Wittchen HU, Andreas S, Belvederi Murri M, Zerbinati L, Nanni MG. Quality of life, level of functioning, and its relationship with mental and physical disorders in the elderly: results from the MentDis_ICF65+ study. Health Qual Life Outcomes 2020; 18:61. [PMID: 32143635 PMCID: PMC7060594 DOI: 10.1186/s12955-020-01310-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Background An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe. Method As part of the Ment_Dis65+ European Project, 3142 community-dwelling adults aged 65–84 years in six countries were assessed by using the adaptation for the elderly of the Composite International Diagnostic Interview (CIDI65+) to provide psychiatric diagnosis according to the International Classification of Diseases (10th edition) (ICD-10 Classification of Mental and Behavioural Disorders). Socio-demographic and clinical interviews, and two self-report tools, the World Health Organization QoL assessment (WHO QoL BREF), to assess QoL, and the WHO Disability Assessment Schedule -II (WHODAS-II), to assess LoF, were also administered. Results Most subjects reported good levels of QoL (56.6%) and self-rated health (62%), with no or mild disability (58.8%). There was a linear decrease of the QoL and the LoF by increase of age. Elderly with ICD-10 mental disorder (e.g. somatoform, affective and anxiety disorders) had poorer QoL and lower LoF. There were a number of predictors of lower levels of QoL and disability, including both socio-demographic variables (e.g. male gender, increase in age, poor financial situation, retirement, reduced number of close significant others), ICD-10 psychiatric diagnosis (mainly anxiety, somatoform disorders) and presence of medical disorders (mainly heart and respiratory diseases). Conclusions The study indicates that QoL and LoF were quite acceptable in European elderly people. A series of variables, including psychiatric and somatic disorders, as well as socio-demographic factor influenced in a negative way both QoL and LoF. More specific links between mental health, social and health services dedicated to this segment of the population, should be implemented in order to provide better care for elderly people with conditions impacting their QoL and functioning.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy.
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Chiara Da Ronch
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Martin Härter
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Jana Volkert
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany.,Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115, Heidelberg, Germany
| | - Maria Dehoust
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Susanne Sehner
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Anna Suling
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Karl Wegscheider
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Berta Ausín
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Alessandra Canuto
- Nant Foundation, East Vaud Psychiatric Institute, Route de Nant, 1804, Corsier-sur-Vevey, Switzerland
| | - Manuel Muñoz
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Mike J Crawford
- Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
| | - Yael Hershkovitz
- Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
| | - Alan Quirk
- Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
| | - Ora Rotenstein
- Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
| | - Ana Belén Santos-Olmo
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Arieh Shalev
- Department of Psychiatry, Langone Medical Center, New York, NY, USA
| | - Jens Strehle
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Kerstin Weber
- Curabilis, Medical Direction, University Hospitals of Geneva, Chemin de Champ-Dollon 20, 1241, Puplinge, Switzerland
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Sylke Andreas
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany.,Institute for Psychology, Alpen-Adria Universität Klagenfurt, A-9020, Klagenfurt, Austria
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
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Xu L, Guo Y, Cao Q, Li X, Mei T, Ma Z, Tang X, Ji Z, Yang L, Liu J. Predictors of outcome in early onset schizophrenia: a 10-year follow-up study. BMC Psychiatry 2020; 20:67. [PMID: 32059664 PMCID: PMC7023710 DOI: 10.1186/s12888-020-2484-x] [Citation(s) in RCA: 4] [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: 06/04/2019] [Accepted: 02/05/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Younger age at onset is generally thought to be a predictor of poor outcome in Early Onset Schizophrenia (EOS), but there is a paucity of epidemiological data supporting this belief. This study aims to describe long-term outcomes and predictors of patient functioning in EOS, with a focus on the effect of age at onset. METHODS We consecutively enrolled 118 EOS patients who were hospitalized in 2006. Mean age at baseline was 13.3 ± 2.3 years. Sixty-five subjects were successfully interviewed. Mean length of follow up was 10.4 ± 0.3 years. Baseline data were collected from inpatient medical records, while follow up was conducted primarily through telephone interviews of patient relatives. WHODAS 2.0 was used to measure global functioning at follow up. Outcomes included education, employment, marriage status, physical health, subsequent diagnoses and treatment, and patient functioning. Univariate and multivariate regression models were used to assess predictors of outcome, while propensity scores were used to adjust for confounding in analyzing the effect of age at onset on functional outcome. RESULTS Of the 65 subjects where follow-up data were available, 3 were deceased at follow up. Five (8%) discontinued treatment. Diagnostic stability was 76%. Nearly a quarter (24%) were using clozapine at follow up. In male and female patients, 61 and 55% respectively were overweight, while 29 and 32% respectively were obese. Sixteen (26%) were economically self-sufficient, while 34 (55%) were unemployed. Thirteen (21%) patients had ever been married. The median WHODAS score was 15 (IQR 2 to 35), roughly corresponding to the 78th percentile on population norms. Extroverted personality (p = 0.01), suspicious personality (p = 0.02), and high level of education (p = 0.001) predicted better functioning. Age of onset was not associated with function in either the univariate model (p = 0.24), full model (p = 0.17) or the final risk factor model (p = 0.11), nor after using propensity scores to further adjust for confounders. CONCLUSION The long-term functional outcome of EOS is more optimistic than generally believed. Age at disease onset does not predict long-term functional outcome in EOS populations.
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Affiliation(s)
- Lingzi Xu
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Yanqing Guo
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Qingjiu Cao
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Xue Li
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Ting Mei
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Zenghui Ma
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Xinzhou Tang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Zhaozheng Ji
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Liu Yang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191 China
| | - Jing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuanbei Road, Haidian District, Beijing, 100191, China.
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Salza A, Giusti L, Ussorio D, Casacchia M, Roncone R. Cognitive behavioral therapy (CBT) anxiety management and reasoning bias modification in young adults with anxiety disorders: A real-world study of a therapist-assisted computerized (TACCBT) program Vs. "person-to-person" group CBT. Internet Interv 2020; 19:100305. [PMID: 32055452 PMCID: PMC7005461 DOI: 10.1016/j.invent.2020.100305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 11/26/2022] Open
Abstract
Computerized cognitive behavioral therapy (cCBT) appears to be a therapeutic strategy that is as effective as person-to-person CBT in the treatment of adults and young people with anxiety disorders. The aim of our controlled study was to evaluate the following in young adult users affected by anxiety disorders: (1) the feasibility of our simple "prototype" of a therapist-assisted computerized cognitive behavioral therapy (TacCBT); and (2) the effectiveness of two different interventions-group CBT and TacCBT-in an "enriched" format for anxiety management and reasoning bias modification as compared to a control group. Psychopathology, global functioning, and cognitive flexibility were examined in 13 users undergoing TacCBT and compared to those receiving "person-to-person" group CBT (CBT Group, n = 25), which controlled for their psychopharmacological treatment. Users were included in the arms of our real-word study on the basis of their treatment preferences. Twelve subjects were included in a Treatment as Usual (TAU) group. Following the intervention, all groups showed a significant improvement in symptoms. Both CBT groups showed an improvement in cognitive flexibility with respect to TAU, in addition to a reduction of their reasoning overconfidence. Our preliminary results show the benefits of the TacCBT program and highlight its advantages.
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Affiliation(s)
- Anna Salza
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Laura Giusti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Donatella Ussorio
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Massimo Casacchia
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rita Roncone
- Corresponding author at: Department of Life, Health and Environmental Sciences, University Unit Rehabilitation Treatment, Early Interventions in mental health, Hospital S. Salvatore, University of L'Aquila, Building Delta 6, Coppito, 67100 L'Aquila, Italy.
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Improvements in Workplace Productivity in Working Patients With Major Depressive Disorder: Results From the AtWoRC Study. J Occup Environ Med 2020; 62:e94-e101. [PMID: 31895735 DOI: 10.1097/jom.0000000000001805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess changes in workplace productivity and functioning in an open-label study in working patients receiving vortioxetine (10 to 20 mg/d) for major depressive disorder (MDD). METHODS Associations between items in the Work Limitations Questionnaire (WLQ), the Sheehan Disability Scale (SDS), and the Work Productivity and Activity Impairment (WPAI) questionnaire were assessed at 12 and 52 weeks by Pearson correlation coefficients. RESULTS Significant improvements were observed across all domains of workplace productivity and functioning after 12 and 52 weeks' vortioxetine treatment. Strong correlations were seen between improvements in WLQ mental domains and WPAI presenteeism and SDS work/school items. Presenteeism showed stronger correlations with other workplace productivity measures than absenteeism. CONCLUSIONS Presenteeism and absenteeism impact productivity in working patients with MDD. Vortioxetine confers long-term benefits across all workplace functioning domains.
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23
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Ko J, Frey JJ, Harrington D. Preventing Suicide Among Working-Age Adults: The Correlates of Help-Seeking Behavior. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 56:46958019850979. [PMID: 31130054 PMCID: PMC6537239 DOI: 10.1177/0046958019850979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We aimed to identify the correlates with not seeking help among working-age adults with suicidal ideation. By adapting the integrated model of suicide help-seeking, we examined help-seeking behavior in the following 3 stages: problem recognition, decision to seek help, and sources of help. We used a sample of working-age adults between 26 and 64 years old, who reported suicidal ideation in the past year (N = 1414). Data were drawn from the 2011 and 2012 National Survey on Drug Use and Health, and multinomial logistic regression analyses were applied. Findings suggested that being male, being nonwhite, being employed full-time, having lower levels of general mental health needs, and not having health insurance were associated with not seeking help. Results also indicated how each factor was related in the help-seeking pathway. Strategies to help problem recognition can be effective in enhancing help-seeking behavior among men, racial/ethnic minorities, and those without serious clinical conditions. Help-seeking interventions for working-age adults with suicidal ideation should also consider that race/ethnic minorities and those with lower levels of functional impairment might rely on alternative sources of help, such as family, friends, and religious advisors.
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24
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Bovin MJ, Meyer EC, Kimbrel NA, Kleiman SE, Green JD, Morissette SB, Marx BP. Using the World Health Organization Disability Assessment Schedule 2.0 to assess disability in veterans with posttraumatic stress disorder. PLoS One 2019; 14:e0220806. [PMID: 31390376 PMCID: PMC6685621 DOI: 10.1371/journal.pone.0220806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/23/2019] [Indexed: 02/04/2023] Open
Abstract
The introduction of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was accompanied by the elimination of the Global Assessment of Functioning (GAF) scale, which was previously used to assess functioning. Although the World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0) was offered as a measure for further study, widespread adoption of the WHODAS 2.0 has yet to occur. The lack of a standardized instrument for assessing posttraumatic stress disorder (PTSD)-related disability has important implications for disability compensation. Accordingly, this study was designed to determine and codify the utility of the WHODAS 2.0 for assessing PTSD-related disability. Veterans from several VA medical centers (N = 1109) were included. We examined PTSD using several definitions and modalities and considered results by gender and age. Across definitions and modalities, veterans with PTSD reported significantly greater WHODAS 2.0 total (large effects; all ts > 6.00; all ps < .01; all Cohen’s ds > 1.03) and subscale (medium-to-large effects; all ts > 2.29; all ps < .05; all Cohen’s ds > .39) scores than those without PTSD. WHODAS 2.0 scores did not vary by gender; however, younger veterans reported less disability than older veterans (small effects; all Fs > 4.30; all ps < .05; all η2s < .05). We identified 32 as the optimally efficient cutoff score for discriminating veterans with and without PTSD-related disability, although this varied somewhat by age and gender. Findings support the utility of the WHODAS 2.0 in assessing PTSD-related disability.
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Affiliation(s)
- Michelle J. Bovin
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
| | - Eric C. Meyer
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, United States of America
- Central Texas Veterans Healthcare System, Waco, Texas, United States of America
- Texas A&M University Health Science Center, College of Medicine, College Station, Texas, United States of America
| | - Nathan A. Kimbrel
- Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Sarah E. Kleiman
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Jonathan D. Green
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Sandra B. Morissette
- Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Brian P. Marx
- National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
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25
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Formánek T, Kagström A, Cermakova P, Csémy L, Mladá K, Winkler P. Prevalence of mental disorders and associated disability: Results from the cross-sectional CZEch mental health Study (CZEMS). Eur Psychiatry 2019; 60:1-6. [PMID: 31096115 DOI: 10.1016/j.eurpsy.2019.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/03/2019] [Accepted: 05/05/2019] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION We aimed to estimate the prevalence of current mental disorders in the Czech population, and to identify associated disability. METHODS We conducted a representative cross-sectional household survey of the Czech adult, community-dwelling population. We used the Mini International Neuropsychiatric Interview (M.I.N.I.), WHO Disability Assessment Schedule (WHODAS) 2.0, and Self-Identification as Mentally Ill (SELFI) scale alongside sociodemographic and other covariates. We reached 75% response rate. Descriptive statistics of the sample were assessed and median (M) disability levels with interquartile range (IQR) according diagnosis were calculated on a scale ranging from 12 to 50. Linear regression models were used to identify factors associated with disability. RESULTS In our sample of 3 306 participants, 21.9% experienced a mental disorder in 2017. Prevalence rates for mood, anxiety, alcohol use, non-alcohol substance use, and psychotic disorders corresponded to 5.5%, 7.3%, 10.8%, 2.9%, and 1.5% respectively. Alcohol dependence was identified in 6.6%, and major depression in 4.0% of the sample. Disability in the general population was significantly lower (M = 12; IQR = 12, 17) than in those with mood (M = 20; IQR = 14; 29), anxiety (M = 18; IQR = 13; 26), alcohol use (M = 14; IQR = 12; 18), non-alcohol substance use (M = 15; IQR = 12; 19), or psychotic disorders (M = 22; IQR = 16.4; 29.4). CONCLUSIONS People with mental disorders have considerably elevated disability in comparison to mentally healthy participants. The prevalence of mental disorders in the Czech Republic is mostly in line with European prevalence rates but it is lower for anxiety disorders and two times higher for alcohol use disorders.
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Affiliation(s)
- T Formánek
- National Institute of Mental Health, Klecany, Czech Republic
| | - A Kagström
- National Institute of Mental Health, Klecany, Czech Republic
| | - P Cermakova
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University Prague, Czech Republic
| | - L Csémy
- National Institute of Mental Health, Klecany, Czech Republic
| | - K Mladá
- National Institute of Mental Health, Klecany, Czech Republic
| | - P Winkler
- National Institute of Mental Health, Klecany, Czech Republic; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neurosciences, King's College London, United Kingdom.
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26
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Shafer LA, Walker JR, Restall G, Chhibba T, Ivekovic M, Singh H, Targownik LE, Bernstein CN. Association Between IBD Disability and Reduced Work Productivity (Presenteeism): A Population-Based Study in Manitoba, Canada. Inflamm Bowel Dis 2019; 25:352-359. [PMID: 29992248 DOI: 10.1093/ibd/izy236] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND One effect of IBD disability is reduced productivity when at work (presenteeism). We explored potential predictors of work presenteeism and compared the predictive ability of the recently developed IBD Disability Index (IBDDI) with 4 other scales in predicting presenteeism. METHODS Participants (aged 18-65 years) were recruited from the University of Manitoba IBD Research Registry. We calculated a presenteeism score (range, 0-24) from the Stanford Presenteeism Scale (SPS), with higher scores representing greater degrees of presenteeism. Using receiver operating characteristic curves and linear regression, we explored associations between presenteeism and the IBDDI, the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the Work and Social Adjustment Scale (WSAS), the Inflammatory Bowel Disease Questionnaire (IBDQ), and the Kessler-6 (K6) distress scale. RESULTS Out of 744 respondents working at least half-time (20+ hours/wk), 472 (63%) reported no reduced productivity in the previous 14 days. Reduced productivity was reported for 1-2 days by 131 (18%), for 3-9 days by 119 (16%), and on most days by 22 (3%). When predicting the SPS, similar model fits were found for the IBDDI, WHODAS, WSAS, IBDQ, and K6. Each increase of 10 on the IBDDI score was associated with an increase of 2.19 (95% confidence interval, 2.00-2.37) on the SPS. Each additional year of disease duration was associated with a reduction in SPS score of 0.08 (P < 0.01). CONCLUSIONS More than one-third of persons with IBD report presenteeism. We found strong associations between presenteeism and disability, lower quality of life, and emotional distress. The IBDDI performs equally as well as the more established scales in predicting presenteeism.
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Affiliation(s)
- Leigh Ann Shafer
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada.,Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - John R Walker
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada.,Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Gayle Restall
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada.,Department of Occupational Therapy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tarun Chhibba
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada
| | - Meloney Ivekovic
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada
| | - Harminder Singh
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada.,Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Laura E Targownik
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Charles N Bernstein
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, MB, Canada.,Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Process Evaluation of a Pilot Intervention for Psychosocial Rehabilitation for Service Users with Schizophrenia in North West Province, South Africa. Community Ment Health J 2018; 54:1089-1096. [PMID: 30094739 DOI: 10.1007/s10597-018-0318-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
This study investigated a non-specialist delivered programme for psychosocial rehabilitation for service users with schizophrenia in a low-resource South African setting. Forty-four service users with schizophrenia living in the community, receiving ongoing medication through primary care, participated in a structured support group. Quantitative measures (WHODAS 12 item, Brief Psychiatric Rating Scale and Internalized Stigma of Mental Illness Inventory) were assessed at baseline and 12 months. Sixteen service users were interviewed on their experiences. WHODAS data showed a small reduction. ISMI assessment showed a statistically significant reduction. Qualitative data revealed: improved self-esteem and increased illness knowledge, reduced risk taking, reduced social isolation and improved pro-social behavior, improved financial management and engagement in income generation activities as well as improved acceptance by the community. This study provides preliminary evidence on the benefits of this programme that warrant further study incorporating experimental methods.
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28
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Shafer LA, Walker JR, Chhibba T, Ivekovic M, Singh H, Targownik LE, Peyrin-Biroulet L, Gower-Rousseau C, Sarter H, Bernstein CN. Independent Validation of a Self-Report Version of the IBD Disability Index (IBDDI) in a Population-Based Cohort of IBD Patients. Inflamm Bowel Dis 2018; 24:766-774. [PMID: 29554260 DOI: 10.1093/ibd/izx063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION A new clinician-administered inflammatory bowel disease (IBD) Disability Index (IBDDI) was recently developed and validated among a population in France. We aimed to validate the IBDDI in a North American setting and adapt for use as a self-report tool. METHODS Persons 18-65 years old from the population-based University of Manitoba IBD Research Registry were mailed a self-administered survey. This survey included the IBDDI and several scales that should correlate with a disability measure- the World Health Organization (WHO) Disability Assessment Scale (WHODAS) 2.0, Work and Social Adjustment Scale (WSAS), the Inflammatory Bowel Disease Questionnaire (IBDQ), and the K6-Kessler Emotional Distress Scale. We used Pearson correlation coefficients to assess construct validity, Cronbach's alpha to assess internal consistency, and Factor analysis to assess which of the IBDDI items likely belonged to a single IBD-related disability factor. RESULTS In response to the survey request,1143 (46% of those contacted) participated (61% female, mean age 51, 52% with Crohn's disease). On an index scale from 0-100, 14% had a score ≥50 (extreme disability, 18% of those with Crohn's disease; 10% of those with ulcerative colitis). There were strong correlations between IBDDI and WSAS (0.76), WHODAS (0.76), K6 (0.73), and an inverse correlation with IBDQ (-0.86). The Cronbach's alpha was high (0.88). All but 2 items (number of liquid stools in the past week and arthritis/arthralgia) of the 14 identified for IBDDI loaded highly onto a single factor (factor loading > 0.40). CONCLUSIONS The findings support the validity of this new self-report version of the IBDDI as a sound measure of disability in IBD.
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Affiliation(s)
- L A Shafer
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - J R Walker
- University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - T Chhibba
- University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - M Ivekovic
- University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - H Singh
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - L E Targownik
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - L Peyrin-Biroulet
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - C Gower-Rousseau
- Gastroenterology Department and Inserm U954, Nancy University Hospital, Université de Lorraine, Nancy, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm/Université Lille 2/CHRU de Lille; Equipe IBD and environmental factors: epidemiology and functional analyses, Lille University, France
| | - H Sarter
- Gastroenterology Department and Inserm U954, Nancy University Hospital, Université de Lorraine, Nancy, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm/Université Lille 2/CHRU de Lille; Equipe IBD and environmental factors: epidemiology and functional analyses, Lille University, France
| | - C N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
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29
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Ilie G, Adlaf EM, Mann RE, Ialomiteanu A, Hamilton H, Rehm J, Asbridge M, Cusimano MD. Associations between self-reported lifetime history of traumatic brain injuries and current disability assessment in a population sample of Canadian adults. PLoS One 2018; 13:e0188908. [PMID: 29304117 PMCID: PMC5755742 DOI: 10.1371/journal.pone.0188908] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 11/15/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study describes the association between history of lifetime traumatic brain injury (TBI) and current disabling functional restrictions among Ontario adults. SETTING AND DESIGN A two-stage rolling cross-sectional sample of 6,048 adults aged 18 to 93 were interviewed by computer assisted telephone interviewing between 2011-2013 regarding their mental health and substance use in Ontario, Canada. TBI criteria were defined by loss of consciousness for minimum five minutes or at least one overnight hospitalization. Dimensions of functionality restrictions in the last 30 days were measured with the WHO Disability Assessment Schedule (WHODAS). RESULTS The estimated mean for global disability in this sample of Ontario adults was 2.75 (SD = 5.4, range 0-40). The estimated means of global disability for individuals who reported a history of lifetime TBI was 4.16 (SD = 7.12) and compared with 2.46 (SD = 4.98) for individuals who never had a TBI (p < 0.001). Adults with a history of lifetime TBI had greater odds of global and item disability including restricted cognition, decreased self-care, difficulties with social relationships, fewer life activities and reduced participation in society compared to adults without a history of TBI (p < 0.001), even after adjusting for values of age, sex, marital status, household income and education. CONCLUSION The co-occurrence of history of lifetime TBI with self-reported disability within the past 30 days provide evidence that careful consideration, planning and understanding of short and long term health needs of TBI survivors are critical.
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Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Edward M. Adlaf
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Robert E. Mann
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Anca Ialomiteanu
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Hayley Hamilton
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jürgen Rehm
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Michael D. Cusimano
- Injury Prevention Research Office, St. Michael’s Hospital, Toronto, Canada
- Division of Neurosurgery, University of Toronto, Toronto, Canada
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Axelsson E, Lindsäter E, Ljótsson B, Andersson E, Hedman-Lagerlöf E. The 12-item Self-Report World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Administered Via the Internet to Individuals With Anxiety and Stress Disorders: A Psychometric Investigation Based on Data From Two Clinical Trials. JMIR Ment Health 2017; 4:e58. [PMID: 29222080 PMCID: PMC5741825 DOI: 10.2196/mental.7497] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/19/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a widespread measure of disability and functional impairment, which is bundled with the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) for use in psychiatry. Administering psychometric scales via the Internet is an effective way to reach respondents and allow for convenient handling of data. OBJECTIVE The aim was to study the psychometric properties of the 12-item self-report WHODAS 2.0 when administered online to individuals with anxiety and stress disorders. The WHODAS 2.0 was hypothesized to exhibit high internal consistency and be unidimensional. We also expected the WHODAS 2.0 to show high 2-week test-retest reliability, convergent validity (correlations approximately .50 to .90 with other self-report measures of functional impairment), that it would differentiate between patients with and without exhaustion disorder, and that it would respond to change in primary symptom domain. METHODS We administered the 12-item self-report WHODAS 2.0 online to patients with anxiety and stress disorders (N=160) enrolled in clinical trials of cognitive behavior therapy, and analyzed psychometric properties within a classical test theory framework. Scores were compared with well-established symptom and disability measures, and sensitivity to change was studied from pretreatment to posttreatment assessment. RESULTS The 12-item self-report WHODAS 2.0 showed high internal consistency (Cronbach alpha=.83-.92), high 2-week test-retest reliability (intraclass correlation coefficient=.83), adequate construct validity, and was sensitive to change. We found preliminary evidence for a three-factorial structure, but one strong factor accounted for a clear majority of the variance. CONCLUSIONS We conclude that the 12-item self-report WHODAS 2.0 is a psychometrically sound instrument when administered online to individuals with anxiety and stress disorders, but that it is probably fruitful to also report the three subfactors to facilitate comparisons between studies. TRIAL REGISTRATION Clinicaltrials.gov NCT02540317; https://clinicaltrials.gov/ct2/show/NCT02540317 (Archived by WebCite at http://www.webcitation.org/6vQEdYAem); Clinicaltrials.gov NCT02314065; https://clinicaltrials.gov/ct2/show/NCT02314065 (Archived by WebCite at http://www.webcitation.org/6vQEjlUU8).
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Affiliation(s)
- Erland Axelsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Gustavsberg Primary Care Clinic, Gustavsberg, Sweden
| | - Elin Lindsäter
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Gustavsberg Primary Care Clinic, Gustavsberg, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erik Andersson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Gustavsberg Primary Care Clinic, Gustavsberg, Sweden.,Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Snell DL, Iverson GL, Panenka WJ, Silverberg ND. Preliminary Validation of the World Health Organization Disability Assessment Schedule 2.0 for Mild Traumatic Brain Injury. J Neurotrauma 2017; 34:3256-3261. [DOI: 10.1089/neu.2017.5234] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Deborah L. Snell
- Concussion Clinic, Canterbury District Health Board, Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Burwood Hospital, Christchurch, New Zealand
| | - Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, and Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
| | - William J. Panenka
- British Columbia Neuropsychiatry Program, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Noah D. Silverberg
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Rehabilitation Research Program, GF Strong Rehab Centre, Rehabilitation Research Program, Vancouver, British Columbia, Canada
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Cognitive impairment as measured by the THINC-integrated tool (THINC-it): Association with psychosocial function in major depressive disorder. J Affect Disord 2017; 222:14-20. [PMID: 28667888 DOI: 10.1016/j.jad.2017.06.036] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 05/11/2017] [Accepted: 06/17/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Psychosocial impairment represents an important treatment target in major depressive disorder (MDD). The majority of patients with MDD do not regain premorbid levels of psychosocial functioning despite the resolution of core depressive symptoms. This study aimed to investigate the respective effects of cognitive function and depression severity on impaired psychosocial function in MDD. METHODS Adults aged 18-65 with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls participated in a cross-sectional study validating the THINC-integrated tool (THINC-it), a cognitive screening tool comprised of objective and subjective measures of cognitive function. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale and psychosocial function was assessed using the Sheehan Disability Scale (SDS). RESULTS Subjects with MDD reported greater impairment in psychosocial function than healthy controls, with significant differences in SDS total and domain scores (ps < .01) after controlling for age, sex, and education. Generalized linear models indicated that subjective cognitive function was most strongly associated with SDS total score (RR = .14, p = .01) and SDS domains of work/school (RR = .15, p = .03), family and home responsibilities (RR = .15, p = .02), and economic days lost (RR = .18, p =.03). Depression severity was most strongly associated with SDS social life (RR = .08, p < .01) and economic days underproductive (RR = .07, p < .01). Objective cognitive function was not significantly associated with any SDS outcomes. LIMITATIONS The cross-sectional, observational study design limits temporal inferences. The self-report nature of measures included may have influenced associations observed. Potential medication effects are not noted. CONCLUSIONS Cognitive deficits, as measured by the THINC-it, are associated with significant psychosocial impairment in MDD. These results provide empirical support for the assessment of both subjective and objective measures of cognition, as they are not associated with each other and have differential effects on functional trajectory.
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Cha DS, Best MW, Bowie CR, Gallaugher LA, Woldeyohannes HO, Soczynska JK, Lewis G, MacQueen G, Sahakian BJ, Kennedy SH, Lui JP, Mansur RB, McIntyre RS. A randomized, double-blind, placebo-controlled, crossover trial evaluating the effect of intranasal insulin on cognition and mood in individuals with treatment-resistant major depressive disorder. J Affect Disord 2017; 210:57-65. [PMID: 28013123 DOI: 10.1016/j.jad.2016.12.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/27/2016] [Accepted: 12/04/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cognitive dysfunction in major depressive disorder (MDD) is identified as a primary therapeutic target; no current treatment is approved for the treatment of cognitive dysfunction in MDD. We examined whether intranasal insulin offered a beneficial effect across measures of cognitive function in adults with MDD. METHODS Thirty-five adults (18-65 years of age: 47.09±9.89) meeting criteria for a major depressive episode as per the Diagnostic and Statistical Manual (DSM)-IV-Treatment Revised were included in this randomized, double blind, placebo-controlled, crossover design study. Subjects were not stratified based on baseline cognitive deficit. Subjects were randomized to 4 weeks of either intranasal insulin 40 International Units (IU) taken four times a day (i.e., morning, afternoon, evening, and before bed) (QID) (n=19) or placebo (n=16). RESULTS No between group differences were observed in change from baseline on total Montgomery Åsberg Depression Rating Scale (MADRS) score (25.98±2.81), in either of the Positive or Negative subscales of the Positive and Negative Affect Schedule (PANAS), or on a global index of neurocognition. The possibility of practice and/or carry over effect could not be excluded. Methodological refinement (e.g., stratification of subjects based on baseline cognitive deficit) may have augmented assay sensitivity. CONCLUSION Intranasal insulin did not demonstrate statistically significant improvements on overall mood, aspects of emotional processing, neurocognitive function, or self-reported quality of life patient reported outcomes.
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Affiliation(s)
- Danielle S Cha
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Michael W Best
- Cognitive and Psychotic Disorders Lab, Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Christopher R Bowie
- Director of Clinical Training, Department of Psychology, Queen's University, Kingston, ON, Canada; Clinician Scientist, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Hanna O Woldeyohannes
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Joanna K Soczynska
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Gary Lewis
- Department of Endocrinology, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Glenda MacQueen
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Barbara J Sahakian
- London Imperial Affiliated Professor, University of Cambridge, United Kingdom
| | - Sidney H Kennedy
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Jane P Lui
- Pharmacist, Investigational Pharmacy Services, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
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