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Güney E, Aydemir AF, Iyit N, Alkan Ö. Gender differences in psychological help-seeking attitudes: a case in Türkiye. Front Psychol 2024; 15:1289435. [PMID: 38515972 PMCID: PMC10954894 DOI: 10.3389/fpsyg.2024.1289435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Background/aim Mental disorders pose a substantial public health challenge within the overall disease burden. This study aims to determine the factors associated with seeking psychological help among individuals experiencing depression according to gender differences in Türkiye. Methods The study utilized microdata from Türkiye Health Survey conducted by the Turkish Statistical Institute in 2016, 2019, and 2022. Binary logistic regression analysis was employed to determine the factors associated with seeking psychological help. Results The study's findings reveal that variables such as survey year, age, education level, employment status, general health status, disease status, depression status, day service status in the hospital, daily activity status, tobacco use status, and alcohol use status are associated with the status of receiving psychological help. Conclusion Gender-specific analysis indicated variations in the significance and impact of these variables among individuals seeking psychological help. In the development of preventive strategies for mental health protection, special attention should be given to factors associated with the psychological help-seeking behavior of both women and men. Prioritizing and addressing these factors will contribute to more effective mental health interventions.
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Affiliation(s)
- Esra Güney
- Department of Econometrics, Faculty of Political Sciences, Sakarya University, Sakarya, Türkiye
| | - Ahmet Fatih Aydemir
- Department of International Trade and Logistics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Türkiye
| | - Neslihan Iyit
- Department of Statistics, Faculty of Science, Selçuk University, Konya, Türkiye
| | - Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Türkiye
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd. Şti., Erzurum, Türkiye
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Reich H, Niermann HCM, Voss C, Venz J, Pieper L, Beesdo-Baum K. Sociodemographic, psychological, and clinical characteristics associated with health service (non-)use for mental disorders in adolescents and young adults from the general population. Eur Child Adolesc Psychiatry 2024; 33:391-400. [PMID: 36807526 PMCID: PMC10869368 DOI: 10.1007/s00787-023-02146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/19/2023] [Indexed: 02/21/2023]
Abstract
Most adolescents and young adults who experience psychological distress do not seek professional help. This study aims to enhance the understanding of sociodemographic, psychological, and clinical characteristics associated with the underuse of health services by adolescents and young adults with mental disorders. Data from a cross-sectional, epidemiological study with a population-based sample (N = 1180 participants, 14-21 years old) were used. Participants completed a fully standardized, computer-assisted diagnostic interview (DIA-X-5/D-CIDI) administered by trained clinical interviewers to assess lifetime mental disorders according to DSM-5 as well as lifetime health service use for mental health problems, and completed self-report questionnaires to assess various psychological variables (e.g., stigma). Predictors of health service use were examined using univariate and multiple logistic regression analyses, data were weighted for age and sex to improve representativeness Of n = 597 participants with any lifetime mental disorder, 32.4% [95% CI 28.4; 36.7] had ever used any health services because of a mental health, psychosomatic, or substance use problem. Even less had received psychotherapeutic or pharmacological treatment (Cognitive Behavioral Therapy: 12.1% [9.5; 15.2]; other psychotherapy: 10.7% [8.4; 13.7]; medication: 5.4% [3.7; 7.8]). High education was associated with less health service use (low/ middle/ other vs. high education: 53.8% vs. 26.9%; OR = 0.26, p < .001). In the multiple regression model, stigma toward mental disorders was the single psychological variable associated with a reduced likelihood of using health services (OR = 0.69 [0.52; 0.90], p < .01). These findings draw attention to the treatment gap for mental disorders during adolescence and highlight related factors to be addressed in public health contexts.
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Affiliation(s)
- H Reich
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Depression Research Centre of the German Depression Foundation, Department for Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, Frankfurt am Main, 60528, Frankfurt, Germany
| | - H C M Niermann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - C Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - J Venz
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - L Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - K Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
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3
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Panagi L, White SR, Howdle C, Bennett S, Heyman I, Shafran R, Ford T. Predictors of contact with services for mental health problems among children with comorbid long-term physical health conditions: a follow-up study. Eur Child Adolesc Psychiatry 2024; 33:21-31. [PMID: 36357554 PMCID: PMC10807016 DOI: 10.1007/s00787-022-02105-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022]
Abstract
Children with long-term physical health conditions (pLTCs) are at increased risk of developing mental health comorbidities, although most do not access services for their mental health. No previous studies have examined the determinants of contact with services for mental health concerns among this group of children. This 3-year longitudinal study involved a population-based sample of children aged 5-16 years from the British Child and Adolescent Mental Health Surveys conducted in 1999 and 2004. In children with comorbid pLTCs and mental health disorders at baseline (N = 397), we examined associations between several child-, family- and service-related factors and (a) contact with primary health care, (b) contact with paediatrics and (c) contact with child and adolescent mental health services over 3-year follow-up (2002 and 2007). Separate multivariable binary logistic regressions were conducted for each service. The impact of mental health difficulties on the child and contact with the teacher predicted contact with all three services. Adolescent age, female gender, larger family size, some or marked academic difficulties, and having parents with educational qualification(s) were specific predictors of contact with primary health care. Male gender, stressful life events, and contact with primary health care were specific predictors of contact with child and adolescent mental health services. No other factors predicted contact with paediatrics. Our findings highlight the role of child-, family-, and service-related factors in accessing mental health care in children with comorbid pLTCs and mental health disorders which could inform planning and provision of services to reduce unmet mental health needs.
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Affiliation(s)
- Laura Panagi
- Department of Psychiatry, University of Cambridge, The Clifford Allbutt Building, Biomedical Innovation Hub/Bay 13, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 OAH, UK.
| | - Simon R White
- Department of Psychiatry, University of Cambridge, The Clifford Allbutt Building, Biomedical Innovation Hub/Bay 13, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 OAH, UK
| | - Charlotte Howdle
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0SP, UK
| | - Sophie Bennett
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, The Clifford Allbutt Building, Biomedical Innovation Hub/Bay 13, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 OAH, UK
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Kim H, Lee K, Lee YH, Park Y, Park Y, Yu Y, Park J, Noh S. The Effectiveness of a Mobile Phone-Based Physical Activity Program for Treating Depression, Stress, Psychological Well-Being, and Quality of Life Among Adults: Quantitative Study. JMIR Mhealth Uhealth 2023; 11:e46286. [PMID: 37358905 DOI: 10.2196/46286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/10/2023] [Accepted: 05/16/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Depression is a substantial global health problem, affecting >300 million people and resulting in 12.7% of all deaths. Depression causes various physical and cognitive problems, leading to a 5-year to 10-year decrease in life expectancy compared with the general population. Physical activity is known to be an effective, evidence-based treatment for depression. However, people generally have difficulties with participating in physical activity owing to limitations in time and accessibility. OBJECTIVE To address this issue, this study aimed to contribute to the development of alternative and innovative intervention methods for depression and stress management in adults. More specifically, we attempted to investigate the effectiveness of a mobile phone-based physical activity program on depression, perceived stress, psychological well-being, and quality of life among adults in South Korea. METHODS Participants were recruited and randomly assigned to the mobile phone intervention or waitlist group. Self-report questionnaires were used to assess variables before and after treatment. The treatment group used the program around 3 times per week at home for 4 weeks, with each session lasting about 30 minutes. To evaluate the program's impact, a 2 (condition) × 2 (time) repeated-measures ANOVA was conducted, considering pretreatment and posttreatment measures along with group as independent variables. For a more detailed analysis, paired-samples 2-tailed t tests were used to compare pretreatment and posttreatment measurements within each group. Independent-samples 2-tailed t tests were conducted to assess intergroup differences in pretreatment measurements. RESULTS The study included a total of 68 adults aged between 18 and 65 years, who were recruited both through web-based and offline methods. Of these 68 individuals, 41 (60%) were randomly assigned to the treatment group and 27 (40%) to the waitlist group. The attrition rate was 10.2% after 4 weeks. The findings indicated that there is a significant main effect of time (F1,60=15.63; P=.003; ηp2=0.21) in participants' depression scores, indicating that there were changes in depression level across time. No significant changes were observed in perceived stress (P=.25), psychological well-being (P=.35), or quality of life (P=.07). Furthermore, depression scores significantly decreased in the treatment group (from 7.08 to 4.64; P=.03; Cohen d=0.50) but not in the waitlist group (from 6.72 to 5.08; P=.20; Cohen d=0.36). Perceived stress score of the treatment group also significantly decreased (from 2.95 to 2.72; P=.04; Cohen d=0.46) but not in the waitlist group (from 2.82 to 2.74; P=.55; Cohen d=0.15). CONCLUSIONS This study provided experimental evidence that mobile phone-based physical activity program affects depression significantly. By exploring the potential of mobile phone-based physical activity programs as a treatment option, this study sought to improve accessibility and encourage participation in physical activity, ultimately promoting better mental health outcomes for individuals with depression and stress.
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Affiliation(s)
- Hyungsook Kim
- Hanyang Digital Healthcare Center, Hanyang University, Seoul, Republic of Korea
- Department of Cognitive Sciences, School of Intelligence, Hanyang University, Seoul, Republic of Korea
- Graduate School of Public Policy, Hanyang University, Seoul, Republic of Korea
| | - Kikwang Lee
- Department of Sport, Health, and Rehabilitation, College of Physical Education, Kookmin University, Seoul, Republic of Korea
| | - Ye Hoon Lee
- Division of Global Sport Industry, Hankuk University of Foreign Studies, Gyeonggi-do, Republic of Korea
| | - Yoonjung Park
- Department of Health & Human Performance, University of Houston, Houston, TX, United States
| | - Yonghyun Park
- Hanyang Digital Healthcare Center, Hanyang University, Seoul, Republic of Korea
| | - Yeonwoo Yu
- Department of Sport, Health, and Rehabilitation, College of Physical Education, Kookmin University, Seoul, Republic of Korea
| | - Jaeyoung Park
- Division of Global Sport Industry, Hankuk University of Foreign Studies, Gyeonggi-do, Republic of Korea
| | - Sihyeon Noh
- Division of Global Sport Industry, Hankuk University of Foreign Studies, Gyeonggi-do, Republic of Korea
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5
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Dobson R, Li LL, Garner K, Tane T, McCool J, Whittaker R. The Use of Sensors to Detect Anxiety for In-the-Moment Intervention: Scoping Review. JMIR Ment Health 2023; 10:e42611. [PMID: 36729590 PMCID: PMC9936367 DOI: 10.2196/42611] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND With anxiety a growing issue and barriers to accessing support services, there is a need for innovative solutions to provide early intervention. In-the-moment interventions support individuals to recognize early signs of distress and use coping mechanisms to prevent or manage this distress. There is potential for wearable sensors linked to an individual's mobile phone to provide in-the-moment support tailored to individual needs and physiological responses. OBJECTIVE The aim of this scoping review is to examine the role of sensors in detecting the physiological signs of anxiety to initiate and direct interventions for its management. METHODS Relevant studies were identified through searches conducted in Embase, MEDLINE, APA PsycINFO, ProQuest, and Scopus. Studies were identified if they were conducted with people with stress or anxiety or at risk of anxiety and included a wearable sensor providing real-time data for in-the-moment management of anxiety. RESULTS Of the 1087 studies identified, 11 studies were included in the review, including 5 randomized controlled trials and 6 pilot or pretesting studies. The results showed that most studies successfully demonstrated improvements in their target variables. This included overall anxiety and stress levels, and the implementation of in-the-moment stress and anxiety management techniques such as diaphragmatic breathing. There was wide variation in the types of sensors used, physiological measures, and sensor-linked interventions. CONCLUSIONS This review indicates that sensors are potentially a useful tool in detecting anxiety and facilitating the implementation of a known control mechanism to reduce anxiety and improve mood, but further work is needed to understand the acceptability and effectiveness of this type of intervention.
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Affiliation(s)
- Rosie Dobson
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.,Institute for Innovation and Improvement, Te Whatu Ora Waitematā, Auckland, New Zealand
| | - Linwei Lily Li
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Katie Garner
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Taria Tane
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Judith McCool
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.,Institute for Innovation and Improvement, Te Whatu Ora Waitematā, Auckland, New Zealand
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Berry KR, Gliske K, Schmidt C, Cray LDE, Killian M, Fenkel C. LGBTQIA+ Adapted Telehealth Intensive Outpatient Program for Youth and Young Adults: Subgroup Analysis of Acuity and Improvement Following Treatment (Preprint). JMIR Form Res 2023; 7:e45796. [PMID: 37083637 PMCID: PMC10163404 DOI: 10.2196/45796] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other minoritized gender and sexual identities (LGBTQIA+) youth have disproportionately high levels of depression, self-harm, and suicidal thoughts and behaviors. In addition, LGBTQIA+ youth frequently report lower levels of satisfaction or comfort with their health care providers because of stigmatization, which may prevent continuation of care, yet there is a lack of mental health treatment and outcome research addressing these disparities. However, there is some indication that LGBTQIA+ individuals feel more comfortable with web-based formats, indicating that telehealth services may be beneficial for this population. OBJECTIVE This program evaluation explored the effectiveness of a remote intensive outpatient program with a curriculum tailored specifically to LGBTQIA+ youth with high-acuity depression, anxiety, and suicidality. This study sought to understand baseline acuity differences between LGBTQIA+ and non-LGBTQIA+ youth and young adult patients and to determine if there were differences in clinically significant improvement by subtypes within the LGBTQIA+ population following participation in LGBTQIA+-specific programming. METHODS Data were collected from intake and discharge outcome surveys measuring depression, suicidality, and nonsuicidal self-injury (NSSI) in 878 patients who attended at least six sessions of a remote intensive outpatient program for youth and young adults. Of these 878 clients, 551 (62.8%) were identified as having at least one LGBTQIA+ identity; they participated in an LGBTQIA+-adapted program of the general curriculum. RESULTS LGBTQIA+ patients had more clinically severe intake for depression, NSSI, and suicidal ideation. Nonbinary clients had greater NSSI within the LGBTQIA+ sample at intake than their binary counterparts, and transgender clients had significantly higher depressive scores at intake than their nontransgender counterparts. LGBTQIA+ patients demonstrated improvements in all outcomes from intake to discharge. The Patient Health Questionnaire for Adolescents depression scores improved from 18.15 at intake to 10.83 at discharge, representing a 41.5% reduction in depressive symptoms. Overall, 50.5% (149/295) of the LGBTQIA+ youth who endorsed passive suicidal ideation at intake no longer reported it at discharge, 72.1% (160/222) who endorsed active suicidal ideation at intake no longer reported it at discharge, and 55.1% (109/198) of patients who met the criteria for clinical NSSI no longer met the criteria at discharge. In the subgroup analysis, transgender patients were still 2 times more likely to report clinical NSSI at discharge. CONCLUSIONS This program evaluation found substantial differences in rates of depression, NSSI, and suicidal ideation between LGBTQIA+ clients compared with their non-LGBTQIA+ counterparts. In addition, this evaluation showed a considerable decrease in symptoms when clients attended LGBTQIA+-affirming care. The findings provide support for the role of LGBTQIA+-specific programming to meet the elevated mental health needs of these youth and that more research is needed to understand barriers that may negatively affect transgender clients, specifically.
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Affiliation(s)
| | - Kate Gliske
- Charlie Health, Inc, Bozeman, MT, United States
| | | | | | - Michael Killian
- College of Social Work, Florida State University, Tallahassee, FL, United States
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Harris N, Warbrick I, Fleming T, Borotkanics R, Atkins D, Lubans D. Impact of high-intensity interval training including Indigenous narratives on adolescents' mental health: a cluster-randomised controlled trial. Aust N Z J Public Health 2022; 46:794-799. [PMID: 36259747 DOI: 10.1111/1753-6405.13312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES We investigated the efficacy of teacher-delivered high-intensity interval training (HIIT) with Indigenous narrative options on the mental health of school students in low-mid socioeconomic areas, compared to standard curriculum physical education practice. METHODS A cluster-randomised controlled trial was conducted in eight schools (N=368, age range 11-13 years) over 16 weeks. The primary outcome was the Strengths and Difficulties Questionnaire (SDQ) score. Generalised linear mixed models, controlling for the SDQ at baseline were applied, expressed as β, 95% confidence intervals, standardised effect, and p-value. Focus groups elicited experiences with participating in and delivering the intervention. RESULTS There were no clear effects for SDQ total score (β -0.15, CI -0.98 - 0.67, SE 0.42, p=0.714). Teachers did not deliver the Indigenous narrative options consistently owing to the perceived preparation needed and lack of confidence. CONCLUSIONS HIIT delivered in this manner had no effect on self-perceived psychological difficulty or mental wellbeing in a cohort of young adolescents. IMPLICATIONS FOR PUBLIC HEALTH Future research should continue to explore opportunities to improve mental wellbeing via physical activity, but HIIT should not be implemented as a universal intervention for mental health gains alone. Teachers need more support to utilise Indigenous narratives as part of HIIT delivery.
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Affiliation(s)
- Nigel Harris
- Human Potential Centre, Auckland University of Technology, New Zealand
| | - Isaac Warbrick
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, New Zealand
| | - Theresa Fleming
- Te Herena Waka, Victoria University of Wellington, New Zealand
| | - Robert Borotkanics
- School of Sport and Recreation, Auckland University of Technology, New Zealand
| | - Denise Atkins
- School of Sport and Recreation, Auckland University of Technology, New Zealand
| | - David Lubans
- Centre for Active Living & Learning, The University of Newcastle, New South Wales, Australia
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Barrow E, Thomas G. Exploring perceived barriers and facilitators to mental health help-seeking in adolescents: a systematic literature review. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2022. [DOI: 10.1080/02667363.2022.2051441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Emma Barrow
- School of Environment, Education and Development, University of Manchester, Manchester, UK
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9
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Xu H, Wang R, Li R, Jin Z, Wan Y, Tao F. Associations of Non-suicidal Self-Injury and Psychological Symptoms With Suicide Attempt in Adolescents: Are There Any Gender Differences? Front Psychiatry 2022; 13:894218. [PMID: 35795027 PMCID: PMC9251494 DOI: 10.3389/fpsyt.2022.894218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Psychological symptoms and non-suicidal self-injury (NSSI) are independently associated with suicide attempts (SA). Yet, no study has tested the interaction effects between NSSI and psychological symptoms on SA in community adolescent populations, or examined whether the interaction varies by gender. We sought to examine the interaction effects of NSSI and psychological symptoms on SA in adolescents and explore gender differences. METHODS A school-based health survey in 3 provinces in China was conducted between 2013-2014. 14,820 students aged 10-20 years completed standard questionnaires, to record the details of various psychological symptoms, SA and NSSI. RESULTS Psychological symptoms and NSSI were independently associated with a higher likelihood of SA in both boys and girls (p < 0.001). Adolescents with psychological, conduct or social adaptation symptoms without concurrent NSSI, were twice as likely to report SA (corresponding RORs were 1.80, 1.80 and 2.16, respectively; p < 0.01) than those who reported NSSI. Male adolescents with psychological, emotional, conduct or social adaptation symptoms had a higher risk of SA in the non-NSSI group than the NSSI group (corresponding RORs were 2.85, 2.26, 2.30 and 3.01 respectively; p < 0.01). While in girls, only adolescents with social adaptation symptoms had a higher risk of SA in the non-NSSI group than NSSI group (corresponding RORs was 1.71, p < 0.05). In the non-NSSI group, boys reporting psychological symptoms exhibited a higher likelihood of a SA than their female counterparts. CONCLUSION Psychological symptoms and NSSI are independently associated with an increased risk of SA in adolescents. However, to some extent, NSSI may reduce the risk of SA among individuals with psychological symptoms, especially in boys.
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Affiliation(s)
- Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Rui Wang
- Department of Information Technology, Anqing Medical College, Anqing, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
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10
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Martel R, Shepherd M, Goodyear-Smith F. Implementing the Routine Use of Electronic Mental Health Screening for Youth in Primary Care: Systematic Review. JMIR Ment Health 2021; 8:e30479. [PMID: 34807833 PMCID: PMC8663603 DOI: 10.2196/30479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adolescents often present at primary care clinics with nonspecific physical symptoms when, in fact, they have at least 1 mental health or risk behavior (psychosocial) issue with which they would like help but do not disclose to their care provider. Despite global recommendations, over 50% of youths are not screened for mental health and risk behavior issues in primary care. OBJECTIVE This review aimed to examine the implementation, acceptability, feasibility, benefits, and barriers of e-screening tools for mental health and risk behaviors among youth in primary care settings. METHODS Electronic databases-MEDLINE, CINAHL, Scopus, and the Cochrane Database of Systematic Reviews-were searched for studies on the routine screening of youth in primary care settings. Screening tools needed to be electronic and screen for at least 1 mental health or risk behavior issue. A total of 11 studies that were reported in 12 articles, of which all were from high-income countries, were reviewed. RESULTS e-Screening was largely proven to be feasible and acceptable to youth and their primary care providers. Preconsultation e-screening facilitated discussions about sensitive issues and increased disclosure by youth. However, barriers such as the lack of time, training, and discomfort in raising sensitive issues with youth continued to be reported. CONCLUSIONS To implement e-screening, clinicians need to change their behaviors, and e-screening processes must become normalized into their workflows. Co-designing and tailoring screening implementation frameworks to meet the needs of specific contexts may be required to ensure that clinicians overcome initial resistances and perceived barriers and adopt the required processes in their work.
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Affiliation(s)
- Rhiannon Martel
- Department of General Practice & Primary Health Care, Faculty of Medical & Health Science, University of Auckland, Auckland, New Zealand
| | | | - Felicity Goodyear-Smith
- Department of General Practice & Primary Health Care, Faculty of Medical & Health Science, University of Auckland, Auckland, New Zealand
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11
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Nasier B, Gibson K, Trnka S. “PM me” or “LOL”: Young peoples’ observations of supportive and unsympathetic responses to distress on social media. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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“Teachers Often See the Red Flags First”: Perceptions of School Staff Regarding Their Roles in Supporting Students with Mental Health Concerns. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09475-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Mehra K, Hawke LD, Watson P, Sheikhan NY, Leroux E, Henderson J. Youth Perspectives on Seeking Psychotherapy: A Concurrent Mixed Methods Study. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2021; 30:165-176. [PMID: 34381509 PMCID: PMC8315215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 04/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Psychotherapy is the recommended first line of treatment for depression among youth; however, few youth seek professional support. This study compares barriers and facilitators to seeking psychotherapy among both youth who have and have not seen a psychotherapist. The study further explores reasons youth discontinue psychotherapy. METHODS A concurrent mixed methods study design was used. Eligible participants completed a survey (N=104) and a subset of participants completed a semi-structured interview (N=60). The survey and interview data were analyzed concurrently using a triangulation design. RESULTS Surveys were conducted among youth who had experienced psychotherapy (N=53) and youth who had not (N=51). The majority of participants were female. Common reasons for not seeking psychotherapy included wanting to handle their problems on their own (87.6%), thinking their problems would improve on its own (87.6%), and not knowing who to see (74.3%). Several barriers were common across the two groups, including stigma, concerns about the therapeutic relationship, and a preference for self-management. Common facilitators included improving coping skills and addressing functional impairment. There was some overlap between the barriers to seeking psychotherapy and the reasons for discontinuing, although aging out of youth-oriented service also constituted a termination factor. CONCLUSIONS : As this study highlights the multiple factors that influence youth's psychotherapy-seeking behavior, a widespread, multi-level approach is needed to address barriers and facilitators at the individual level, but also at the community, policy, and organizational levels. Strategies such as increasing service availability and quality are needed to increase service seeking and improve retention.
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Affiliation(s)
- Kamna Mehra
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Priya Watson
- Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | | | | | - Joanna Henderson
- Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
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Bauer A, Stevens M, Purtscheller D, Knapp M, Fonagy P, Evans-Lacko S, Paul J. Mobilising social support to improve mental health for children and adolescents: A systematic review using principles of realist synthesis. PLoS One 2021; 16:e0251750. [PMID: 34015021 PMCID: PMC8136658 DOI: 10.1371/journal.pone.0251750] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/02/2021] [Indexed: 11/18/2022] Open
Abstract
Social support is a well-recognised protective factor for children's mental health. Whilst many interventions exist that seek to mobilise social support to improve children's mental health, not much is known about how to best do this. We sought to generate knowledge about the ways in which social support can be mobilised to improve children's mental health. We conducted a systematic review, which followed the principles of a realist synthesis. The following databases were searched: PubMed, CINAHL, Ovid MEDLINE, PsychINFO, EMBASE, Child and Adolescent Studies, EconLit and SocINDEX. Studies were included if the age of participants was between 0 and 18 years and they evaluated or described programme theories of interventions that sought to improve children's mental health by mobilising social support. Relevance and quality of studies were assessed, and data were extracted and analysed narratively. Thirty-three articles were included. Studies varied substantially with regard to the detail in which they described the processes of mobilising social support and expected mechanisms to improve children's mental health. Those that provided this detail showed the following: Intervention components included explaining the benefits of social support and relationships to families and modelling friendly relationships to improve social skills. Pathways to improved outcomes reflected bi-directional and dynamic relationships between social support and mental health, and complex and long-term processes of establishing relationship qualities such as trust and reciprocity. Parents' ability to mobilise social support for themselves and on behalf of children was assumed to impact on their children's mental health, and (future) ability to mobilise social support. Although interventions were considered affordable, some required substantial human and financial resources from existing systems. Mobilising social support for vulnerable children can be a complex process that requires careful planning, and theory-informed evaluations can have an important role in increasing knowledge about how to best address social support and loneliness in children.
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Affiliation(s)
- Annette Bauer
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, United Kingdom
- * E-mail:
| | - Madeleine Stevens
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, United Kingdom
| | - Daniel Purtscheller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - Martin Knapp
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, United Kingdom
| | - Peter Fonagy
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, United Kingdom
| | - Jean Paul
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
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15
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Gómez-Restrepo C, Malagón NR, Eslava-Schmalbach J, Ruiz R, Gil JF. Associated factors for recognition of mental problems and disorders in adolescents in the Colombian National Mental Health Survey. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 50:3-10. [PMID: 33648693 DOI: 10.1016/j.rcp.2019.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 09/24/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Mental problems and disorders are prevalent in the adolescent population. It is estimated that around 10% of adolescents have mental disorders that require attention and are generally not recognised as such. The aim was to determine potential factors associated with whether or not mental disorders and problems are recognised in the Colombian population. METHODS Adolescents aged 12 to 17 who said they had been diagnosed with a mental health problem or disorder by a healthcare professional were identified from the National Mental Health Survey conducted in Colombia in 2015. This group was compared with those who scored positive for mental disorders measured by CIDI 3.0 or mental problems detected by SRQ-20. RESULTS A sample of 1,754 adolescents was obtained, of whom 7.3% (n=129) had disorders and 22.6% (n=396) had problems. Of the total with disorders and problems, 13.9% (n=18) of people with disorders and 8.3% (n=33) with problems knew they had them. Bivariate analyses were performed with the possible related variables, and with the results we constructed a multivariate regression model that identified factors associated with the recognition of disorders or problems, such as family dysfunction (OR=2.5; 95% CI, 1.3-4.5) or counting on family when having financial problems (OR=2.7; 95% CI, 1.0-7.2). CONCLUSIONS Recognition is of great importance for initiating access to care by adolescents. The results provide associated variables which can aid planning of interventions to improve the detection of disorders and problems in this population.
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Affiliation(s)
- Carlos Gómez-Restrepo
- Departamento Epidemiología Clínica y Psiquiatría y Salud Mental, Facultad de Medicina, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
| | - Nelcy Rodriguez Malagón
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Javier Eslava-Schmalbach
- Profesor titular de la Facultad de Medicina, Universidad Nacional de Colombia, director del Grupo de Equidad en Salud, Bogotá, Colombia
| | - Rafael Ruiz
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jacky Fabian Gil
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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Luo Y, Cui Z, Zou P, Wang K, Lin Z, He J, Wang J. Mental Health Problems and Associated Factors in Chinese High School Students in Henan Province: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165944. [PMID: 32824313 PMCID: PMC7459448 DOI: 10.3390/ijerph17165944] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 12/20/2022]
Abstract
Approximately one in five adolescents experience mental health problems globally. However, studies on mental health problems in Chinese high school students are few. Therefore, this study examined the status and associated factors of mental health problems in high school students in China. A stratified two-stage cluster sampling procedure was adopted, leading to a final sample of 15,055 participants from 46 high schools in all 17 provincial cities of Henan province, China. Self-reported questionnaires were used to collect the data. A mental health problems variable was assessed using the Mental Health Inventory of Middle School Students. The positive rate of mental health problems among high school students was 41.8%, with a male predominance (43.3% versus 40.2% in females; p < 0.01). The most frequent mental health problem was academic stress (58.9%). Higher grades, physical disease, chronic constipation, alcohol consumption, engagement in sexual behavior, residence on campus, and living in nonurban areas and with single-parent families were significantly associated with higher odds of having mental health problems (p < 0.05). We suggest that the prevention of mental health problems in high school students be strengthened, especially in students with physical illnesses, unhealthy behaviors, and single-parent families.
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Affiliation(s)
- Yan Luo
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, Shaanxi Province, China; (Z.C.); (Z.L.); (J.H.); (J.W.)
- Correspondence: ; Tel.: +86-29-8265-7015
| | - Zhenti Cui
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, Shaanxi Province, China; (Z.C.); (Z.L.); (J.H.); (J.W.)
| | - Ping Zou
- School of Nursing, Nipissing University, 750 Dundas West, Room 209, Toronto, ON M6J3S3, Canada;
| | - Kai Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13# Hang Kong Road, Wuhan 430030, Hubei Province, China;
| | - Zihan Lin
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, Shaanxi Province, China; (Z.C.); (Z.L.); (J.H.); (J.W.)
| | - Jinjie He
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, Shaanxi Province, China; (Z.C.); (Z.L.); (J.H.); (J.W.)
| | - Jing Wang
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, Shaanxi Province, China; (Z.C.); (Z.L.); (J.H.); (J.W.)
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Halladay J, Bennett K, Weist M, Boyle M, Manion I, Campo M, Georgiades K. Teacher-student relationships and mental health help seeking behaviors among elementary and secondary students in Ontario Canada. J Sch Psychol 2020; 81:1-10. [PMID: 32711720 DOI: 10.1016/j.jsp.2020.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/04/2020] [Accepted: 05/29/2020] [Indexed: 12/18/2022]
Abstract
This study examined associations between teacher-student relationship quality at school and teachers' responsiveness to students' emotional concerns in a classroom and (a) students' intention to seek help at school for mental health concerns and (b) mental health-related service use. Data for analyses came from the School Mental Health Survey, a cross-sectional survey of 31,120 grade 6-12 students, in 1968 classrooms, attending 248 schools in Ontario, Canada. Three-level (student, classroom, school) binary logistic regression was used to address the study objectives. Student ratings of the quality of teacher-student relationships and teachers' responsiveness were included as predictors, both at the individual student level and aggregated to represent a contextual level characteristic at the school and classroom level, respectively. At the student level, both teacher-student relationship quality and teacher responsiveness were positively associated with intentions to seek help at school among both elementary and secondary students (ORs ranged from 1.14-1.19 for relationships and 1.06-1.08 for responsiveness). Aggregated to the school level, teacher-student relationship quality was positively associated with mental health service use for secondary students (OR = 1.36, 95% CI [1.10, 1.69]). Positive and responsive teacher-student relationships were associated with help-seeking behaviors among students. Longitudinal studies are warranted to disentangle the temporality of these associations.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Methods, Evidence, and Impact at McMaster University, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada
| | - Mark Weist
- Department of Psychology at the University of South Carolina, United States of America
| | - Michael Boyle
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada
| | - Ian Manion
- Youth Research Unit at The Royal's Institute of Mental Health Research and the School of Psychology at the University of Ottawa, Canada
| | | | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada.
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Aguirre Velasco A, Cruz ISS, Billings J, Jimenez M, Rowe S. What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review. BMC Psychiatry 2020; 20:293. [PMID: 32527236 PMCID: PMC7291482 DOI: 10.1186/s12888-020-02659-0] [Citation(s) in RCA: 191] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. METHODS Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 and updated in April 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed, and findings summarised using a narrative synthesis. RESULTS Ninety studies meet the inclusion criteria for this review for barrier and facilitators (n = 54) and interventions (n = 36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements. CONCLUSION Most of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.
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Affiliation(s)
- Antonia Aguirre Velasco
- Child and Adolescent Mental Health Service, Children’s Hospital Dr. Roberto del Río, Santiago, Chile
| | | | - Jo Billings
- División of Psychiatry, University College London, London, UK
| | | | - Sarah Rowe
- División of Psychiatry, University College London, London, UK
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Teng E, Anthony V, Helen W, Shona C. Is Knowledge Enough? The Relationship Between Mental Health Knowledge and Stigmatising Attitudes Among Australian Adolescents. ADOLESCENT PSYCHIATRY 2020. [DOI: 10.2174/2210676609666181204145835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Young people carry mental health problems disproportionate to the
size of their population, and rates of help-seeking are low. School mental health programs
have been developed to address these issues, founded on an educational approach to target
mental health literacy, and indirectly improve help-seeking. However, it has been suggested
that knowledge does not necessarily predict health behaviour in young people.
Objective/Methods:
A cross-sectional study was conducted to explore whether knowledge
about mental illness was related to attitudes towards mental illness and intentions to seek
help in a sample of adolescent girls (N=327).
Results:
Results indicated a weak negative relationship between knowledge about mental
health and stigmatising attitudes about mental illness, but no relationship between
knowledge about mental health and intentions to seek help for mental health problems.
When mental health was categorised (e.g., optimal vs. poorer mental health), a negative
relationship between knowledge about and stigmatising attitudes toward mental health was
shown in those with poor mental health, but not for adolescents categorised as having
moderate or optimal mental health.
Conclusion:
Findings suggest that while the traditional adage - more information on mental
health equals better attitude to mental health - may be true for those with ‘poorer’ levels of
mental health (e.g., high levels of psychological distress), it may not reduce stigma
associated with mental illness or motivate positive health behaviour in adolescent girls with
‘optimal’ mental health (e.g., low or no levels of psychological distress).
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Affiliation(s)
- Emmelin Teng
- School of Psychology, The University of Adelaide, North Terrace, Adelaide, South Australia 5005, Australia
| | - Venning Anthony
- Faculty of Medicine, Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Winefield Helen
- School of Psychology, The University of Adelaide, North Terrace, Adelaide, South Australia 5005, Australia
| | - Crabb Shona
- School of Population Health, The University of Adelaide, North Terrace, Adelaide, South Australia 5005, Australia
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20
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Gibson K, Trnka S. Young people's priorities for support on social media: “It takes trust to talk about these issues”. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2019.08.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Fleming TM, Stasiak K, Moselen E, Hermansson-Webb E, Shepherd M, Lucassen M, Bavin LM, Merry SN. Revising Computerized Therapy for Wider Appeal Among Adolescents: Youth Perspectives on a Revised Version of SPARX. Front Psychiatry 2019; 10:802. [PMID: 31824344 PMCID: PMC6883402 DOI: 10.3389/fpsyt.2019.00802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/07/2019] [Indexed: 01/17/2023] Open
Abstract
Background: The way in which computerized therapy is presented may be important for its uptake. We aimed to explore adolescents' views on the appeal of a tested computerized cognitive behavioral therapy (CCBT) for depression (SPARX), and a revised version (SPARX-R). The versions were similar but while SPARX is presented explicitly as a treatment for depression, SPARX-R is presented as providing skills that could be useful for young people for when they were depressed, down, angry, or stressed. Methods: We held 9 focus groups with a total of 79 adolescents (13-19 years old; 47 females; 34 New Zealand European; 22 Māori or Pacific; 60 reported having experienced feeling down or low for at least several days in a row). Groups viewed the opening sequences of SPARX and SPARX-R (in random order), then took part in a semi-structured discussion and completed a brief questionnaire. Responses were analyzed using a general inductive approach. Results: Participants considered both SPARX and SPARX-R useful and considered the stated purpose of the program to be important. Four themes contrasted the two approaches. The first, "naming depression is risky", referred to perceptions that an explicit focus on depression could be off-putting, including for adolescents with depression. The second theme of "universality" reflected preferences for a universal approach as young people might not recognize that they were depressed, and all would benefit from the program. In contrast, "validation" reflected the view of a significant minority that naming depression could be validating for some. Finally, the theme of "choice" reflected a near-unanimously expressed preference for both options to be offered, allowing user choice. In questionnaire responses, 40 (68%) of participants preferred SPARX-R, 13 (18%) preferred SPARX, while 10 (14%) "didn't mind". Responses were similar among participants who reported that they had experienced at least a few days of low mood and those who had not. Conclusions: The way a CCBT program is presented may have implications for its appeal. The potential population impact of CCBT programs explicitly targeting depression and those targeting more universal feelings such as being stressed or feeling depressed should be explored for varied user groups.
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Affiliation(s)
- Theresa M. Fleming
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Emma Moselen
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Eve Hermansson-Webb
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | | | - Mathijs Lucassen
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, United Kingdom
| | - Lynda M. Bavin
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Sally Nicola Merry
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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Fleming T, Merry S, Stasiak K, Hopkins S, Patolo T, Ruru S, Latu M, Shepherd M, Christie G, Goodyear-Smith F. The Importance of User Segmentation for Designing Digital Therapy for Adolescent Mental Health: Findings From Scoping Processes. JMIR Ment Health 2019; 6:e12656. [PMID: 31066705 PMCID: PMC6707580 DOI: 10.2196/12656] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/07/2019] [Accepted: 03/24/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND New Zealand youth, especially those of Māori and Pacific descent, have high rates of depression, anxiety, and self-harm, but have low rates of help-seeking from mental health professionals. Apps, computerized therapy, and other digital tools can be effective, highly scalable treatments for anxiety and depression. Co-design processes are often used to foster engagement with end users, but this does not always lead to high levels of engagement. OBJECTIVE We aimed to carry out preliminary scoping to understand adolescents' current internet use and diversity of preferences to inform a planned co-design process for creating digital mental health tools for teenagers. METHODS Interactive workshops and focus groups were held with young people. Data were analyzed using a general inductive approach. RESULTS Participants (N=58) engaged in 2 whānau (extended family) focus groups (n=4 and n=5), 2 school- or community-based focus groups (n=9 each), and 2 workshops (n=11 and n=20). The authors identified 3 overarching themes: (1) Digital mental health tools are unlikely to be successful if they rely solely on youth help-seeking. (2) A single approach is unlikely to appeal to all. Participants had diverse, noncompatible preferences in terms of look or feel of an app or digital tool. The authors identified 4 user groups players or gamers, engagers, sceptics, and straight-talkers. These groups differed by age and degree of current mental health need and preferred gamified or fun approaches, were open to a range of approaches, were generally disinterested, or preferred direct-to-the-point, serious approaches, respectively. (3) Digital mental health tools should provide an immediate response to a range of different issues and challenges that a young person may face. CONCLUSIONS Defining the preferences of different groups of users may be important for increasing engagement with digital therapies even within specific population and mental health-need groups. This study demonstrates the importance of scoping possible user needs to inform design processes.
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Affiliation(s)
- Theresa Fleming
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.,Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Sally Merry
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Sarah Hopkins
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Tony Patolo
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Stacey Ruru
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Manusiu Latu
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Matthew Shepherd
- Department of Social Work, University of Auckland, Auckland, New Zealand
| | - Grant Christie
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Felicity Goodyear-Smith
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
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Associations Between Depression Literacy and Help-Seeking Behavior for Mental Health Services Among High School Students. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09325-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gebreegziabher Y, Girma E, Tesfaye M. Help-seeking behavior of Jimma university students with common mental disorders: A cross-sectional study. PLoS One 2019; 14:e0212657. [PMID: 30794639 PMCID: PMC6386312 DOI: 10.1371/journal.pone.0212657] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/08/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Globally, the mental health help-seeking behavior of university students is reported to be poor; less than one-third of university students with common mental disorders (CMDs) report having sought help from formal sources. Failure to seek treatment is associated with prolonged disability and poor mental health outcomes, including suicide. In Ethiopia, little is known about the help-seeking behavior of university students for CMDs. OBJECTIVE This study aimed to assess the prevalence and determinants of help seeking, and sources of help sought by Jimma University undergraduate students with CMDs. METHOD Seven hundred and sixty students were selected to participate in this cross-sectional study using multi-stage sampling. Sources of help were identified using the Actual Help-Seeking Questionnaire. CMDs were assessed using the 10-item Kessler Psychological Distress Scale. Binary logistic regression analysis was used for both univariate and multivariable analysis. RESULTS Of the sampled students, 58.4% were found to have current CMDs. Of those with current CMDs, 78.4% had sought help for their problems. The majority (83.8%) of participants who sought help did so from informal sources. Compared to students who had 'very good' overall levels of satisfaction with life, those who had 'good', 'fair', and 'poor or very poor' overall level of satisfaction with life were less likely to seek help (p-value = 0.021, 0.014, and 0.011, respectively). Lastly, having no previous history of help-seeking was significantly associated with seeking help for CMDs (p-value<0.001). CONCLUSION More than half of Jimma University students were found to have a high risk of CMDs and the majority of those with CMDs sought help from informal sources. Future studies are needed to explore the barriers of seeking help from formal resources, and the effects of not receiving help from formal sources for CMDs symptoms.
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Affiliation(s)
| | - Eshetu Girma
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Markos Tesfaye
- Department of Psychiatry, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Martel RM, Darragh ML, Lawrence AJ, Shepherd MJ, Wihongi T, Goodyear-Smith FA. YouthCHAT as a Primary Care E-Screening Tool for Mental Health Issues Among Te Tai Tokerau Youth: Protocol for a Co-Design Study. JMIR Res Protoc 2019; 8:e12108. [PMID: 30626568 PMCID: PMC6329425 DOI: 10.2196/12108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 01/13/2023] Open
Abstract
Background In New Zealand (NZ), 1 in 4 adolescents is affected by mental health issues (eg, depression and anxiety) and engages in risk behaviors (eg, harmful drinking and substance abuse), with rates among Māori youth being significantly higher. The majority of NZ secondary school students visit their local primary health care providers (PHPs) at least annually, yet most do not seek help for mental health and risk behavior (MHB) concerns. While youth think it acceptable to discuss sensitive issues during a consultation with their PHPs, unless problems are severe, such conversations are not initiated by PHPs. Early intervention for MHB concerns can prevent long-term health and well-being issues. However, this relies on the early identification of developing problems and youth being offered and accepting help. YouthCHAT is an electronic, multi-item screening tool developed in 2016 to assess MHB concerns among youth. YouthCHAT is completed before a consultation with the PHP, who can access a summary report straight away. A help question allows young people to identify issues that need addressing. A resource pack uses stepped care pathways to guide providers to use appropriate brief interventions. Objective This study aimed to explore the utility, feasibility, and acceptability of YouthCHAT when tailored for use with youth in primary care settings with large Māori populations. Objectives of the study are to evaluate the implementation of YouthCHAT in nurse-led youth clinics, school-based clinics, and general practice in Te Tai Tokerau (Northland, NZ); to develop a framework for the scaling up of YouthCHAT across further settings; to assess health provider and youth acceptability of the tool; to improve screening rates for mental health and help-seeking behavior; to enable early identification of emerging problems; and to improve brief intervention delivery. Methods Using a bicultural mixed-methods co-design approach, 3 phases over a 3-year period will provide an iterative evaluation of the utility, feasibility, and acceptability of YouthCHAT, aiming to create a framework for wider-scale rollout and implementation. Results Recruitment for the first phase began in September 2018. YouthCHAT was implemented at the first site in October 2018 and is expected to be at a further two sites in late January to early February 2019. The study is due for completion at the end of 2021. Conclusions YouthCHAT has potential as a user-friendly, time efficient, and culturally safe screening tool for early detection of MHB issues in NZ youth. The resource pack assists the clinician to provide appropriate interventions for emerging and developed youth mental health and lifestyle issues. Involving input from community providers, users, and stakeholders will ensure that modifiable elements of YouthCHAT are tailored to meet the health needs specific to each context and will have a positive influence on future mental, physical, and social outcomes for NZ youth. International Registered Report Identifier (IRRID) PRR1-10.2196/12108
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Affiliation(s)
- Rhiannon Mary Martel
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Margot Louise Darragh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Aniva Joanne Lawrence
- Manaia Health Primary Health Organisation, Whangarei, New Zealand.,Te Tai Tokerau Primary Health Organisation, Kerikeri, New Zealand
| | - Matthew John Shepherd
- Faculty of Education and Social Work, Department of Counselling, Human Services and Social Work, The University of Auckland, Auckland, New Zealand
| | | | - Felicity Anne Goodyear-Smith
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
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Arps ER, Friesen MD, Overall NC. Promoting Youth Mental Health via Text-Messages: A New Zealand Feasibility Study. Appl Psychol Health Well Being 2018; 10:457-480. [PMID: 30230691 DOI: 10.1111/aphw.12143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND A growing body of research has documented the positive effects of gratitude programs on participants' mental health and well-being. For children and adolescents, these programs typically rely on school-based group designs tied with a health curriculum, whereas innovative technology-based programs are relatively understudied. METHODS This experiment investigated the feasibility and efficacy of a gratitude text-messaging program for promoting adolescent mental health relative to a positive reflective control condition. RESULTS Young people showed positive changes over the course of the program in their general sense of gratitude, subjective well-being, and reduced depressive symptoms, with some evidence that those with higher levels of depressive symptoms benefited more from the gratitude program. However, there were no significant differences across the two groups in the magnitude of these mental health changes. Participants in both conditions valued and were highly engaged with the interactive text-messaging approach. CONCLUSION This interactive e-health promotion strategy seemed to promote strong engagement and showed promising effectiveness with young people, with some challenges to feasibility due to the labor intensive nature of sending and responding to a large number of text-messages. The importance of carefully considering risk management strategies when developing such programs was also highlighted.
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Shepherd M, Merry S, Lambie I, Thompson A. Indigenous Adolescents' Perception of an eMental Health Program (SPARX): Exploratory Qualitative Assessment. JMIR Serious Games 2018; 6:e13. [PMID: 29980495 PMCID: PMC6053605 DOI: 10.2196/games.8752] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 04/05/2018] [Accepted: 04/09/2018] [Indexed: 12/03/2022] Open
Abstract
Background Depression is a major health issue for indigenous adolescents, yet there is little research conducted about the efficacy and development of psychological interventions for these populations. In New Zealand there is little known about taitamariki (Māori adolescent) opinions regarding the development and effectiveness of psychological interventions, let alone computerized cognitive behavioral therapy. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computerized intervention developed in New Zealand to treat mild-to-moderate depression in young people. Users are engaged in a virtual 3D environment where they must complete missions to progress to the next level. In each level there are challenges and puzzles to completeIt was designed to appeal to all young people in New Zealand and incorporates several images and concepts that are specifically Māori. Objective The aim was to conduct an exploratory qualitative study of Māori adolescents’ opinions about the SPARX program. This is a follow-up to an earlier study where taitamariki opinions were gathered to inform the design of a computerized cognitive behavior therapy program. Methods Taitamariki were interviewed using a semistructured interview once they had completed work with the SPARX resource. Six participants agreed to complete the interview; the interviews ranged from 10 to 30 minutes. Results Taitamariki participating in the interviews found SPARX to be helpful. The Māori designs from the SPARX game were appropriate and useful, and the ability to customize the SPARX characters with Māori designs was beneficial and appeared to enhance cultural identity. These helped young people to feel engaged with SPARX which, in turn, assisted with the acquisition of relaxation and cognitive restructuring skills. Overall, using SPARX led to improved mood and increased levels of hope for the participants. In some instances, SPARX was used by wider whānau (Māori word for family) members with reported beneficial effect. Conclusions Overall, this small group of Māori adolescents reported that cultural designs made it easier for them to engage with SPARX, which, in turn, led to an improvement in their mood and gave them hope. Further research is needed about how SPARX could be best used to support the families of these young people.
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Affiliation(s)
- Matthew Shepherd
- School of Counselling, Human Services and Social Work, Faculty of Education, The University of Auckland, Auckland, New Zealand.,Ngāti Tama, Māori tribe, Taranaki area, New Zealand
| | - Sally Merry
- Department of Psychological Medicine, School of Medicine, The University of Auckland, Auckland, New Zealand
| | - Ian Lambie
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Andrew Thompson
- School of Counselling, Human Services and Social Work, Faculty of Education, The University of Auckland, Auckland, New Zealand
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Utter J, Lucassen M, Denny S, Fleming T, Peiris-John R, Clark T. Using the Internet to access health-related information: results from a nationally representative sample of New Zealand secondary school students. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0096/ijamh-2017-0096.xml. [PMID: 29168960 DOI: 10.1515/ijamh-2017-0096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/29/2017] [Indexed: 11/15/2022]
Abstract
Objective To determine if secondary school students in New Zealand who report greater health concerns (e.g. significant depressive symptoms) are more likely to use the Internet to access health-related information. Methods A nationally representative health and wellbeing survey was undertaken in 2012 (n = 8500). Multiple regression models were used to examine the associations between students' use of the Internet to access health-related information and selected outcomes or indicators. Results Over 90% of students used the Internet on a daily basis, with 15.4% of students reporting that they had used the Internet to access health-related information. Students experiencing household poverty were more likely to report not using the Internet daily (17.4% compared to 4.2%). Odds ratios (ORs) for accessing the Internet for this sort of information were highest for students who reported self-harm [OR 2.7, 95% confidence interval (CI) 2.3-3.3], disordered eating (OR 2.7, 95% CI 2.4-3.2), or a suicide attempt (OR 2.5, 95% CI 1.9-3.3). Conclusion Our findings suggest that Internet-based health interventions may be a viable way to reach young people with high health needs, but consideration needs to be given to those with limited Internet access.
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Affiliation(s)
- Jennifer Utter
- School of Population Health, University of Auckland, Private Bag 92019, 1142 Auckland, New Zealand
| | - Mathijs Lucassen
- Open University, Faculty of Wellbeing, Education and Language Studies, Milton Keynes, United Kingdom of Great Britain and Northern Ireland
| | - Simon Denny
- University of Auckland, Paediatrics: Child and Youth Health, Private Bag 92019 Auckland, New Zealand
| | - Terry Fleming
- University of Auckland, Paediatrics: Child and Youth Health, Private Bag 92019 Auckland, New Zealand
| | - Roshini Peiris-John
- School of Population Health, University of Auckland, 1142Auckland, New Zealand
| | - Terryann Clark
- School of Nursing, University of Auckland, Auckland, New Zealand
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Goodyear-Smith F, Martel R, Darragh M, Warren J, Thabrew H, Clark TC. Screening for risky behaviour and mental health in young people: the YouthCHAT programme. Public Health Rev 2017; 38:20. [PMID: 29450092 PMCID: PMC5810064 DOI: 10.1186/s40985-017-0068-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/23/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prevalence of mental health concerns and risky health behaviours among young people is of global concern. A large proportion of young people in New Zealand (NZ) are affected by depression, suicidal ideation and other mental health concerns, but the majority do not access help. For NZ indigenous Māori, the burden of morbidity and mortality associated with mental health is considerably higher. Targeted screening for risky behaviours and mental health concerns among youth in primary care settings can lead to early detection and intervention for emerging or current mental health and psychosocial issues. Opportunistic screening for youth in primary care settings is not routinely undertaken due to competing time demands, lack of context-specific screening tools and insufficient knowledge about suitable interventions. Strategies are required to improve screening that are acceptable and appropriate for the primary care environment. This article outlines the development, utilisation and ongoing evaluation and implementation strategies for YouthCHAT. YOUTHCHAT YouthCHAT is a rapid, electronic, self-report screening tool that assesses risky health-related behaviours and mental health concerns, with a 'help question' that enables youth to prioritise areas they want help with. The young person can complete YouthCHAT in the waiting room prior to consultation, and after completion, the clinician can immediately access a summary report which includes algorithms for stepped-care interventions using a strength-based approach. A project to scale up the implementation is about to commence, using a co-design participatory research approach to assess acceptability and feasibility with successive roll-out to clinics. In addition, a counter-balanced randomised trial of YouthCHAT versus clinician-administered assessment is underway at a NZ high school. CONCLUSION Opportunistic screening for mental health concerns and other risky health behaviours during adolescence can yield significant health gains and prevent unnecessary morbidity and mortality. The systematic approaches to screening and provision of algorithms for stepped-care intervention will assist in delivering time efficient, early, more comprehensive interventions for youth with mental health concerns and other health compromising behaviours. The early detection of concerns and facilitation to evidence-based interventions has the potential to lead to improved health outcomes, particularly for under-served indigenous populations.
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Affiliation(s)
- Felicity Goodyear-Smith
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Rhiannon Martel
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Margot Darragh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Jim Warren
- Department of Computer Science, Faculty of Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Hiran Thabrew
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Terryann C. Clark
- School of Nursing, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
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Sundram F, Hawken SJ, Stasiak K, Lucassen MF, Fleming T, Shepherd M, Greenwood A, Osborne R, Merry SN. Tips and Traps: Lessons From Codesigning a Clinician E-Monitoring Tool for Computerized Cognitive Behavioral Therapy. JMIR Ment Health 2017; 4:e3. [PMID: 28077345 PMCID: PMC5266827 DOI: 10.2196/mental.5878] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 09/05/2016] [Accepted: 12/13/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts). OBJECTIVE The objectives of our study were as follows: (1) assess clinicians' and adolescents' views on using an e-monitoring tool and to use this information to help shape the development of the tool and (2) assess clinician experiences with a fully developed version of the tool that was implemented in their clinical service. METHODS A descriptive qualitative study using semistructured focus groups was conducted in New Zealand. In total, 7 focus groups included clinicians (n=50) who worked in primary care, and 3 separate groups included adolescents (n=29). Clinicians were general practitioners (GPs), school guidance counselors, clinical psychologists, youth workers, and nurses. Adolescents were recruited from health services and a high school. Focus groups were run to enable feedback at 3 phases that corresponded to the consultation, development, and postimplementation stages. Thematic analysis was applied to transcribed responses. RESULTS Focus groups during the consultation and development phases revealed the need for a simple e-monitoring registration process with guides for end users. Common concerns were raised in relation to clinical burden, monitoring risk (and effects on the therapeutic relationship), alongside confidentiality or privacy and technical considerations. Adolescents did not want to use their social media login credentials for e-monitoring, as they valued their privacy. However, adolescents did want information on seeking help and personalized monitoring and communication arrangements. Postimplementation, clinicians who had used the tool in practice revealed no adverse impact on the therapeutic relationship, and adolescents were not concerned about being e-monitored. Clinicians did need additional time to monitor adolescents, and the e-monitoring tool was used in a different way than was originally anticipated. Also, it was suggested that the registration process could be further streamlined and integrated with existing clinical data management systems, and the use of clinician alerts could be expanded beyond the scope of simply flagging adolescents of concern. CONCLUSIONS An e-monitoring tool was developed in consultation with clinicians and adolescents. However, the study revealed the complexity of implementing the tool in clinical practice. Of salience were privacy, parallel monitoring systems, integration with existing electronic medical record systems, customization of the e-monitor, and preagreed monitoring arrangements between clinicians and adolescents.
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Affiliation(s)
- Frederick Sundram
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Susan J Hawken
- Department of General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Mathijs Fg Lucassen
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, United Kingdom
| | - Theresa Fleming
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Paediatrics, Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Matthew Shepherd
- School of Counselling, Human Services and Social Work, The University of Auckland, Auckland, New Zealand
| | - Andrea Greenwood
- Department of Clinical Psychology, The University of Auckland, Auckland, New Zealand
| | | | - Sally N Merry
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Goodwin J, Behan L, Kelly P, McCarthy K, Horgan A. Help-seeking behaviors and mental well-being of first year undergraduate university students. Psychiatry Res 2016; 246:129-135. [PMID: 27693865 DOI: 10.1016/j.psychres.2016.09.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 11/30/2022]
Abstract
University students demonstrate poor help-seeking behatabviors for their mental health, despite often reporting low levels of mental well-being. The aims of this study were to examine the help-seeking intentions and experiences of first year university students in terms of their mental well-betabing, and to extaplore these students' views on formal (e.g. psychiatrists) and informal (e.g. friends) help-seeking. Students from a universitytab in the Republic of Ireland (n=220) completed an online questionnaire which focused on mental well-being and help-seeking behaviors. Almost a third of students had sought help from a mental health professional. Very few students reported availing of university/online supports. Informal sources of help were more popular than formal sources, and those who would avail and had availed of informal sources demonstrated higher well-being scores. Counselors were the source of professional help most widely used. General practitioners, chaplains, social workers, and family therapists were rated the most helpful. Those with low/average well-being scores were less likely to seek help than those with higher scores. Findings indicate the importance of enhancing public knowledge of mental health issues, and for further examination of students' knowledge of help-seeking resources in order to improve the help-seeking behaviors and mental well-being of this population group.
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Affiliation(s)
- John Goodwin
- School of Nursing and Midwifery, University College Cork, Republic of Ireland; Mercy University Hospital, Cork, Republic of Ireland
| | - Laura Behan
- School of Applied Psychology, University College Cork, Republic of Ireland; Department of Clinical and Experimental Sciences, University of Southampton, United Kingdom
| | - Peter Kelly
- School of Nursing and Midwifery, University College Cork, Republic of Ireland
| | - Karen McCarthy
- Department of Occupational Science and Occupational Therapy, University College Cork, Republic of Ireland
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Republic of Ireland.
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Goodwin J, Savage E, Horgan A. Adolescents' and Young Adults' Beliefs about Mental Health Services and Care: A Systematic Review. Arch Psychiatr Nurs 2016; 30:636-44. [PMID: 27654250 DOI: 10.1016/j.apnu.2016.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/04/2016] [Accepted: 04/09/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adolescents and young people are known to hold negative views about mental illness. There is less known about their beliefs about mental health services and care. OBJECTIVE The aim of this study was to systematically examine literature on the beliefs of adolescents and young people from the general population about mental health services and care. Factors that positively and negatively influence these beliefs are also explored. METHODS Relevant electronic databases were searched for papers published in the English language between January 2004 and October 2015. RESULTS Culture seemed to influence how adolescents and young adults perceived mental health interventions. This was particularly evident in countries such as Palestine and South Africa where prayer was highly valued. Adolescents and young people were uninformed about psychiatric medication. They believed that accessing mental health care was a sign of weakness. Furthermore, they viewed psychiatric hospitals and various mental health professionals negatively. Film was found to have a negative impact on how adolescents and young people perceived mental health services, whereas open communication with family members was found to have a positive impact. CONCLUSION Adolescents and young adults hold uninformed and stigmatizing beliefs about mental health treatments, mental health professionals, and access to care. The sources of these beliefs remain unclear although some at least seem influenced by culture. Further research, (particularly qualitative research) in this area is recommended in order to address current gaps in knowledge.
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Affiliation(s)
- John Goodwin
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Republic of Ireland; North Lee Mental Health Services, Cork, Republic of Ireland.
| | - Eileen Savage
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Republic of Ireland
| | - Aine Horgan
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Republic of Ireland
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Rainbow SPARX: A Novel Approach to Addressing Depression in Sexual Minority Youth. COGNITIVE AND BEHAVIORAL PRACTICE 2015. [DOI: 10.1016/j.cbpra.2013.12.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ekornes S. Teacher Perspectives on Their Role and the Challenges of Inter-professional Collaboration in Mental Health Promotion. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9147-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McMartin SE, Kingsbury M, Dykxhoorn J, Colman I. Time trends in symptoms of mental illness in children and adolescents in Canada. CMAJ 2014; 186:E672-8. [PMID: 25367419 PMCID: PMC4259795 DOI: 10.1503/cmaj.140064] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Existing research and media reports convey conflicting impressions of trends in the prevalence of mental illness. We sought to investigate trends in the prevalence of symptoms of mental illness in a large population-based cohort of Canadian children and adolescents. METHODS We obtained population-based data from the National Longitudinal Survey of Children and Youth. Every 2 years, participants completed self-reported measures of mental illness indicators, including conduct disorder, hyperactivity, indirect aggression, suicidal behaviour, and depression and anxiety. We analyzed trends in mean scores over time using linear regression. RESULTS We evaluated 11 725 participants aged 10-11 years from cycles 1 (1994/95) through 6 (2004/05), 10 574 aged 12-13 years from cycles 2 (1996/97) through 7 (2006/07), and 9835 aged 14-15 years from cycles 3 (1998/99) through 8 (2008/09). The distribution of scores on depression and anxiety, conduct and indirect aggression scales remained stable or showed small decreases over time for participants of all ages. The mean hyperactivity score increased over time in participants aged 10-11 years (change per 2-year cycle: 0.16, 95% CI 0.02 to 0.12) and those aged 12-13 years (0.13, 95% CI 0.09 to 0.18). Over time, fewer participants aged 12-13 years (0.40% per cycle, 95% CI -0.78 to -0.07) and aged 14-15 years (0.56% per cycle, 95% CI -0.91 to -0.23) reported attempting suicide in the previous 12 months. INTERPRETATION With the exception of hyperactivity, the prevalence of symptoms of mental illness in Canadian children and adolescents has remained relatively stable from 1994/95 to 2008/09. Conflicting reports of escalating rates of mental illness in Canada may be explained by differing methodologies between studies, an increase in treatment-seeking behaviour, or changes in diagnostic criteria or practices.
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Affiliation(s)
- Seanna E McMartin
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ont
| | - Mila Kingsbury
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ont
| | - Jennifer Dykxhoorn
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ont
| | - Ian Colman
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ont.
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Laukkanen M, Hakko H, Räsänen P, Riala K. Does the use of health care and special school services, prior to admission for psychiatric inpatient treatment, differ between adolescents housed by child welfare services and those living with their biological parent(s)? Community Ment Health J 2013; 49:528-39. [PMID: 23392732 DOI: 10.1007/s10597-013-9600-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 01/23/2013] [Indexed: 11/27/2022]
Abstract
We examined whether the use of health care and special school services, prior to admission for psychiatric inpatient treatment, differed between adolescents from child welfare units and those living at their parental home. 208 boys and 300 girls aged 12-17 years were admitted for psychiatric hospital between 2001 and 2006. Child welfare adolescents had used more health services/treatments prior to psychiatric hospital admission than adolescents living with their biological family. The best discriminating factors between study groups for both genders, were previous psychiatric hospitalizations, unemployed parents, use of special school services and self-perceived serious anxiety/tension or trouble controlling violent behavior. Repeated school grades and previous use of psychotropic medications were discriminating factors only in girls. Adolescents in child welfare deserve adequate mental health evaluations at an early stage, with referral to appropriate adolescent psychiatric services if required. Appropriate service provision and properly planned treatments may reduce the amount of intensive and sometimes unnecessary psychiatric inpatient treatments.
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Affiliation(s)
- Matti Laukkanen
- Department of Psychiatry, Oulu University Hospital, Finland.
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Polycystic ovary syndrome and depression in New Zealand adolescents. J Pediatr Adolesc Gynecol 2013; 26:142-7. [PMID: 23452749 DOI: 10.1016/j.jpag.2012.11.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 11/20/2012] [Accepted: 11/21/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine whether adolescents with polycystic ovary syndrome (PCOS) are more depressed than adolescent girls in the community and to examine factors associated with depression. DESIGN An observational study comparing clinical and community samples. SETTING Two specialist reproductive endocrine clinics in Auckland, New Zealand. PARTICIPANTS 102 girls aged 14-19 presenting for clinical assessment, fulfilling the Rotterdam consensus for PCOS. The comparison group was 1349 girls from a school-based survey of New Zealand youth. INTERVENTIONS Clinically significant depression was identified by the long and short form Reynolds Adolescent Depression Scale. BMI, androgen levels, oral contraceptive use, objective symptom severity, age, ethnicity, and socioeconomic grouping were recorded. MAIN OUTCOME MEASURES Clinically significant depression in the PCOS and community samples. Potential determinants of depression. RESULTS Clinically significant depression in adolescent girls with PCOS was not increased compared with the community sample (OR 1.3; 95%CI 0.7-2.7, P = .42). Within the PCOS cohort, depression was correlated with increased BMI (P = .01) and possibly acne (P = .08). CONCLUSIONS Lean adolescent girls with PCOS did not have more clinically significant depression than girls in the community. Within the PCOS cohort, however, there was a clear association between higher depression scores and elevated BMI. There is a potentially important interaction between obesity and depression in PCOS.
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38
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Donner NC, Lowry CA. Sex differences in anxiety and emotional behavior. Pflugers Arch 2013; 465:601-26. [PMID: 23588380 DOI: 10.1007/s00424-013-1271-7] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 03/13/2013] [Accepted: 03/13/2013] [Indexed: 12/14/2022]
Abstract
Research has elucidated causal links between stress exposure and the development of anxiety disorders, but due to the limited use of female or sex-comparative animal models, little is known about the mechanisms underlying sex differences in those disorders. This is despite an overwhelming wealth of evidence from the clinical literature that the prevalence of anxiety disorders is about twice as high in women compared to men, in addition to gender differences in severity and treatment efficacy. We here review human gender differences in generalized anxiety disorder, panic disorder, posttraumatic stress disorder and anxiety-relevant biological functions, discuss the limitations of classic conflict anxiety tests to measure naturally occurring sex differences in anxiety-like behaviors, describe sex-dependent manifestation of anxiety states after gestational, neonatal, or adolescent stressors, and present animal models of chronic anxiety states induced by acute or chronic stressors during adulthood. Potential mechanisms underlying sex differences in stress-related anxiety states include emerging evidence supporting the existence of two anatomically and functionally distinct serotonergic circuits that are related to the modulation of conflict anxiety and panic-like anxiety, respectively. We discuss how these serotonergic circuits may be controlled by reproductive steroid hormone-dependent modulation of crfr1 and crfr2 expression in the midbrain dorsal raphe nucleus and by estrous stage-dependent alterations of γ-aminobutyric acid (GABAergic) neurotransmission in the periaqueductal gray, ultimately leading to sex differences in emotional behavior.
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Affiliation(s)
- Nina C Donner
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, 1725 Pleasant Street, 114 Clare Small, Boulder, CO 80309-0354, USA.
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Merry SN, Stasiak K, Shepherd M, Frampton C, Fleming T, Lucassen MFG. The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial. BMJ 2012; 344:e2598. [PMID: 22517917 PMCID: PMC3330131 DOI: 10.1136/bmj.e2598] [Citation(s) in RCA: 313] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2012] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate whether a new computerised cognitive behavioural therapy intervention (SPARX, Smart, Positive, Active, Realistic, X-factor thoughts) could reduce depressive symptoms in help seeking adolescents as much or more than treatment as usual. DESIGN Multicentre randomised controlled non-inferiority trial. SETTING 24 primary healthcare sites in New Zealand (youth clinics, general practices, and school based counselling services). PARTICIPANTS 187 adolescents aged 12-19, seeking help for depressive symptoms, with no major risk of self harm and deemed in need of treatment by their primary healthcare clinicians: 94 were allocated to SPARX and 93 to treatment as usual. INTERVENTIONS Computerised cognitive behavioural therapy (SPARX) comprising seven modules delivered over a period of between four and seven weeks, versus treatment as usual comprising primarily face to face counselling delivered by trained counsellors and clinical psychologists. OUTCOMES The primary outcome was the change in score on the children's depression rating scale-revised. Secondary outcomes included response and remission on the children's depression rating scale-revised, change scores on the Reynolds adolescent depression scale-second edition, the mood and feelings questionnaire, the Kazdin hopelessness scale for children, the Spence children's anxiety scale, the paediatric quality of life enjoyment and satisfaction questionnaire, and overall satisfaction with treatment ratings. RESULTS 94 participants were allocated to SPARX (mean age 15.6 years, 62.8% female) and 93 to treatment as usual (mean age 15.6 years, 68.8% female). 170 adolescents (91%, SPARX n = 85, treatment as usual n = 85) were assessed after intervention and 168 (90%, SPARX n = 83, treatment as usual n = 85) were assessed at the three month follow-up point. Per protocol analyses (n = 143) showed that SPARX was not inferior to treatment as usual. Post-intervention, there was a mean reduction of 10.32 in SPARX and 7.59 in treatment as usual in raw scores on the children's depression rating scale-revised (between group difference 2.73, 95% confidence interval -0.31 to 5.77; P=0.079). Remission rates were significantly higher in the SPARX arm (n = 31, 43.7%) than in the treatment as usual arm (n = 19, 26.4%) (difference 17.3%, 95% confidence interval 1.6% to 31.8%; P = 0.030) and response rates did not differ significantly between the SPARX arm (66.2%, n = 47) and treatment as usual arm (58.3%, n = 42) (difference 7.9%, -7.9% to 24%; P = 0.332). All secondary measures supported non-inferiority. Intention to treat analyses confirmed these findings. Improvements were maintained at follow-up. The frequency of adverse events classified as "possibly" or "probably" related to the intervention did not differ between groups (SPARX n = 11; treatment as usual n = 11). CONCLUSIONS SPARX is a potential alternative to usual care for adolescents presenting with depressive symptoms in primary care settings and could be used to address some of the unmet demand for treatment. TRIAL REGISTRATION Australian New Zealand Clinical Trials ACTRN12609000249257.
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Affiliation(s)
- Sally N Merry
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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