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Posttraumatic growth in children aged 8-18 years with malignancies in China. BMC Pediatr 2022; 22:742. [PMID: 36581859 PMCID: PMC9798681 DOI: 10.1186/s12887-022-03799-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To establish a nomogram prediction model for posttraumatic growth (PTG) in children aged 8-18 years with malignancies in China and to convenient intuitively judge psychological tendencies. METHODS We recruited 358 children aged 8-18 years with malignancies in China as the study participants. Data from 250 cases collected from June 2019 to November 2019 were used as the model group, data from 108 cases collected from December 2019 to January 2020 were used as the validation group. Logistic regression was used to analyze the influencing factors of PTG in the model group. A prediction model was then established using a nomogram. The centrality measurement index(C-index) and receiver operating characteristic curves (ROC) were used to verify the model. RESULTS Among the 250 children in the model group, 65 children with malignancies had PTG, with an occurrence of 26%. The model showed that the child's age, diagnosis, coping style and self-efficacy level and the educational level of the caregiver were core predictors of PTG (P < 0.05). The ROC of the model was 0.837, the best cutoff value was 0.566. The C-indexes of the internal and external validation were 0.837 (95% CI: 0786 ~ 0.886) and 0.813 (95% CI: 0732 ~ 0.894), respectively. CONCLUSIONS The prediction model of PTG in children aged 8-18 years with malignancies in China has good discrimination and consistency and can accurately predict PTG. It can be used to clinically assess the psychological status of children in the future.
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Wang J, Eccles H, Nannarone M, Schmitz N, Patten S, Lashewicz B. Does providing personalized depression risk information lead to increased psychological distress and functional impairment? Results from a mixed-methods randomized controlled trial. Psychol Med 2022; 52:2071-2079. [PMID: 33143794 DOI: 10.1017/s0033291720003955] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Multivariable risk algorithms (MVRP) predicting the personal risk of depression will form an important component of personalized preventive interventions. However, it is unknown whether providing personalized depression risk will lead to unintended psychological harms. The objectives of this study were to evaluate the impact of providing personalized depression risk on non-specific psychological distress and functional impairment over 12 months. METHODS A mixed-methods randomized controlled trial was conducted in 358 males and 354 females who were at high risk of having a major depressive episode according to sex-specific MVRPs, and who were randomly recruited across Canada. Participants were assessed at baseline, 6 and 12 months. RESULTS Over 93% of participants were interested in knowing their depression risk. The intervention group had a greater reduction in K10 score over 12 months than the control group; complete-case analysis found a significant between-group difference in mean K10 change score (d = 1.17, 95% CI 0.12-2.23) at 12 months. Participants in the intervention group also reported significantly less functional impairment in the domains of home and work/school activities, than did those in the control group. A majority of the qualitative interviewees commented that personalized depression risk information does not have a negative impact on physical and mental health. CONCLUSIONS This study found no evidence that providing personalized depression risk information will lead to worsening psychological distress, functional impairment, and absenteeism. Provision of personalized depression risk information may have positive impacts on non-specific psychological distress and functioning. TRIAL REGISTRATION ClinicalTrials.gov NCT02943876.
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Affiliation(s)
- JianLi Wang
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Heidi Eccles
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Molly Nannarone
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Norbert Schmitz
- Douglas Mental Health Research Institute, McGill University, Montreal, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
| | - Scott Patten
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Li L, Sun W, Luo J, Huang H. Associations between education levels and prevalence of depressive symptoms: NHANES (2005-2018). J Affect Disord 2022; 301:360-367. [PMID: 34990632 DOI: 10.1016/j.jad.2022.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/21/2021] [Accepted: 01/02/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE Our study investigated the relationships between the prevalence of depressive symptoms and education levels in those aged ≥20 years. METHODS A total of 34,102 participants from the National Health and Nutrition Examination Surveys 2005-2018 were involved in our cross-sectional study. The relations of depressive symptoms (as outcome variable) and education levels (as an independent variable) were analyzed using multivariable logistic regression models in the main analyzes. Sensitivity analyzes, including a multiple sensitivity analysis, were also performed. RESULT The education levels were negatively associated with depressive symptoms after adjusting related covariates. Compared with the reference group of individuals with less than 9th grade, people with college graduate or above had an adjusted odds ratio (OR) of 0.464 (95% CI 0.361, 0.595, P < 0.0001). On the other hand, the statistically significant negative association disappeared among Mexican Americans, other races, separated, and high family poverty income ratio group. These results remained stable under a wide range of sensitivity analyzes. CONCLUSION Our study indicated the elevated education levels correlated with the decreased prevalence of depressive symptoms, and race, marital status, and family economic factors played a critical role in the relationship. This report reminds us to pay close attention to the further study of factors that affected the association between depressive symptoms and education levels. LIMITATIONS The cross-sectional study leaves problems about the direction of causality unclear.
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Affiliation(s)
- Lingli Li
- School of Education Science and Technology, Guangdong Polytechnic Normal University, Guangzhou, China
| | - Wang Sun
- School of Information Technology Education, South China Normal University, Guangzhou, China
| | - Jinglan Luo
- Department of Internal Medicine, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hao Huang
- Department of Pain Management, the First Affiliated Hospital of Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, China.
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Eccles H, Nadouri D, Nannarone M, Lashewicz B, Schmitz N, Patten SB, Manuel DG, Wang J. Users' perceptions about receiving personalized depression risk information: findings from a qualitative study. BMC Psychiatry 2021; 21:581. [PMID: 34794426 PMCID: PMC8600908 DOI: 10.1186/s12888-021-03590-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To understand users' perceptions about receiving their personalized depression risk score and to gain an understanding about how to improve the efficiency of risk communication from the user perspective. METHODS A qualitative study embedded in a randomized controlled trial (RCT) on evaluating the impact of providing personalized depression risk information on psychological harms and benefits. The participants (20 males and 20 females) were randomly selected from the intervention arm of the RCT after the 12-month assessment. The qualitative interviews were conducted through telephone, audio recorded and transcribed verbatim. We conducted a content analysis to describe the content and contextual meaning of data collected from participants. RESULTS The first theme explained the motivation for receiving a risk score. Most participants chose to receive their personalised depression risk score with the goal of improving their self-awareness. The results revealed three sub-themes surrounding perceptions and implication of receiving their risk score: positive, negative, and neutral. Most participants found that receiving their score was positive because it improved their awareness of their mental health, but some participants could see that some people would have negative feelings when getting the score causing them to be more likely to get depression. The final theme focussed on improvements including: the best delivery methods, having resources and strategies, and targeting younger people. CONCLUSION The most significant motivation for, and benefit of receiving one's personalized depression risk score was improved awareness of one's mental health. A comprehensive risk communication program may improve the uptake and maximize the impact on behavior changes and risk reduction.
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Affiliation(s)
- Heidi Eccles
- grid.28046.380000 0001 2182 2255The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Doaa Nadouri
- grid.28046.380000 0001 2182 2255The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Molly Nannarone
- grid.28046.380000 0001 2182 2255The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Bonnie Lashewicz
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Norbert Schmitz
- grid.14709.3b0000 0004 1936 8649Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
| | - Scott B. Patten
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Douglas G. Manuel
- grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - JianLi Wang
- The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, Canada. .,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada. .,Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Ave. Halifax, Nova Scotia, B3H 1V7, Canada.
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Wang JL, Eccles H, Schmitz N, Patten SB, Lashewicz B, Manuel D. The impact of providing personalized depression risk information on self-help and help-seeking behaviors: Results from a mixed methods randomized controlled trial. Depress Anxiety 2021; 38:917-924. [PMID: 34196445 DOI: 10.1002/da.23192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To evaluate the impact of providing personalized depression risk information on self-help and help-seeking behaviors among individuals who are at high risk of having a major depressive episode (MDE). MATERIALS AND METHODS In a mixed methods randomized controlled trial, participants who were at high risk of having a MDE, were recruited from across Canada, and were randomized into intervention (n = 358) and control (n = 354) groups. Participants in the intervention group received their personalized depression risk estimated by sex-specific risk prediction models for MDE. All participants were assessed at baseline, 6 and 12 months. RESULTS Repeated measure mixed effects modeling showed significant between group differences in self-help scores. In the complete case analysis, the between group difference in mean self-help change score was 1.13 at 12 months (effect size = 0.16). Among participants who reported "fair" or "poor health," the between group difference in mean self-help change score was 2.78 at 12 months (effect size = 0.35). The qualitative data revealed three themes and the findings are consistent with the quantitative results. CONCLUSIONS Providing personalized depression risk information has a positive impact on self-help in high-risk individuals, particularly in those with poor health.
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Affiliation(s)
- Jian Li Wang
- Work & Mental Health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Heidi Eccles
- Work & Mental Health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Norbert Schmitz
- Department of Psychiatry, Faculty of MedicineMcG, McGill University, Montreal, Quebec, Canada.,Department of Population-Based Medicine, Institute of Health Sciences, University Hospital Tuebingen, Tuebingen, Germany
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary., Calgary, Alberta, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary., Calgary, Alberta, Canada
| | - Douglas Manuel
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Self-help behaviors partially mediate the relationship between personalized depression risk disclosure and psychological distress: A mediation analysis using data from a randomized controlled trial. J Psychiatr Res 2021; 140:7-14. [PMID: 34087753 DOI: 10.1016/j.jpsychires.2021.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/03/2021] [Accepted: 05/18/2021] [Indexed: 11/21/2022]
Abstract
Major depressive disorder (MDD) is one of the most prevalent forms of mental illness. Multivariate risk predictive (MVRP) algorithms provide a new means of identifying high-risk individuals for mental health disorders. Self-help behaviors may provide accessible methods to mitigate depression risk. The objective of this study is to investigate the mediating effects of self-help behavior on the relationship between depression risk disclosure and psychological distress. A sample (n = 556) of high-risk Canadians for a major depressive episode (MDE) were randomized into risk-disclosure or control groups and followed-up at 6 and 12 months. Mediation analysis using repeated measure mixed effects models was used to investigate the mediating effects of self-help behaviors on the relationship between depression risk disclosure and psychological distress over time. Self-help behavior was found to partially mediate the relationship between risk disclosure and psychological distress at month 12. Both unadjusted and adjusted associations were found to be negative and significant (ßunadj = -0.16 [-0.30, -0.03]) (ßadj = -0.15[-0.29, -0.02]). Self-help plays a partial mediating role in the relationship between depression risk disclosure and psychological distress over time. More research is required in this field to increase knowledge about the role of self-help in mental health treatment.
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Warner E, Nannarone M, Smail-Crevier R, Manuel D, Lashewicz B, Patten S, Schmitz N, MacQueen G, Wang JL. The relationship between depression risk perception and self-help behaviours in high risk Canadians: a cross-sectional study. BMC Public Health 2020; 20:876. [PMID: 32505198 PMCID: PMC7276077 DOI: 10.1186/s12889-020-08983-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 05/24/2020] [Indexed: 12/21/2022] Open
Abstract
Background Self-help may reduce the risk of depression, and risk perception of depression may influence initiating self-help. It is unknown how risk perception is associated with self-help behaviours. The objectives of this study are to (1) describe the self-help strategies used by high-risk Canadians in relation to the accuracy of perceived depression risk, by sex, and (2) identify demographic and clinical factors associated with self-help behaviours. Methods Baseline data from a randomized controlled trial including 358 men and 356 women at high-risk of developing depression were used. Following methods used in cancer research, risk perception accuracy was determined by comparing the participant’s self-perceived and objective risk of developing depression and classifying as accurate, over-estimation and under-estimation based on a ± 10% threshold. The participant’s objective depression risk was assessed using sex-specific multivariable risk predictive algorithms. Frequency of using 14 self-help strategies was assessed. One-way ANOVA testing was used to detect if differences in risk perception accuracy groups existed, stratified by sex. Linear regression was used to investigate the clinical and demographic factors associated with self-help behaviours, also stratified. Results Compared to accurate-estimators, male over-estimators were less likely to “leave the house daily,” and “participate in activities they enjoy.” Male under-estimators were also less likely to “participate in activities they enjoy.” Both male ‘inaccurate’ perception groups were more likely to ‘create lists of strategies which have worked for feelings of depression in the past and use them’. There were no significant differences between self-help behaviours and risk perception accuracy in women. Regression modeling showed negative relationships between self-rated health and self-help scores, irrespective of sex. In women, self-help score was positively associated with age and educational attainment, and negatively associated with perceived risk. In men, a positive relationship with unemployment was also seen. Conclusions Sex differences exist in the factors associated with self-help. Risk perception accuracy, work status, and self-rated health is associated with self-help behaviours in high-risk men. In women, factors related to self-help included age, education, self-rated health status, and perceived risk. More research is needed to replicate findings. Trial registration Prospectively registered at ClinicalTrials.gov (NCT02943876) as of 10/21/16.
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Affiliation(s)
- Emily Warner
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Molly Nannarone
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | | | - Douglas Manuel
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Scott Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Norbert Schmitz
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
| | - Glenda MacQueen
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jian Li Wang
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Canada. .,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
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Wang J, Smail-Crevier R, Nannarone M, Manuel D, MacQueen G, Patten SB, Lashewicz B, Schmitz N. The accuracy of depression risk perception in high risk Canadians. J Affect Disord 2020; 265:410-415. [PMID: 32090767 DOI: 10.1016/j.jad.2020.01.099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/21/2019] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prevention and early detection of depression is a top public health priority. Accurate perception of depression risk may play an important role in health behavior change and prevention of depression. However, the way in which people in the community perceive their risk of developing depression is currently unknown. METHODS We analyzed the baseline data from a randomized controlled trial in 358 men and 356 women who are at high risk of having a major depressive episode (MDE). The predicted risk was assessed by sex-specific multivariable risk predictive algorithms for MDE. We compared participants' perceived risk and their predicted risk. Accurate risk perception was defined as perceived risk is in the range of predicted risk ± 10%. RESULTS In men, 29.7% perceived their risk accurately; 47.5% overestimated their risk; 22.8% underestimated their risk. In women, the proportions were 21.7%, 59.6% and 18.7%, respectively. Compared to men, women were more likely to overestimate their risk and less likely to be accurate. Regression modeling revealed that poor self-rated health and higher predicted depression risk were associated with inaccuracy of risk perception in men; a family history of MDE, higher psychological distress and lower predicted risk were associated with inaccuracy of risk perception in women. CONCLUSIONS Individuals who are at high risk of developing depression tend to overestimate their risk, especially women. Inaccurate depression risk perception is related to people's health status. Educational interventions are needed to enhance the accuracy of risk perception to encourage positive behavior change and uptake of preventive strategies.
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Affiliation(s)
- JianLi Wang
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Rachel Smail-Crevier
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Molly Nannarone
- The Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Douglas Manuel
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Glenda MacQueen
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Scott B Patten
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Norbert Schmitz
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
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