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Li VW, Sahota J, Dev DK, Gill DD, Evans VC, Axler A, Chakrabarty T, Do A, Keramatian K, Nunez JJ, Tam EM, Yatham LN, Michalak EE, Murphy JK, Lam RW. A Randomized Evaluation of MoodFX, a Patient-Centred e-Health Tool to Support Outcome Measurement for Depression: Une évaluation randomisée de MoodFX, un outil de santé en ligne centré sur le patient pour soutenir la mesure du résultat dans la dépression. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:493-502. [PMID: 38600892 PMCID: PMC11168344 DOI: 10.1177/07067437241245331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND e-Health tools using validated questionnaires to assess outcomes may facilitate measurement-based care for psychiatric disorders. MoodFX was created as a free online symptom tracker to support patients for outcome measurement in their depression treatment. We conducted a pilot randomized evaluation to examine its usability, and clinical utility. METHODS Patients presenting with a major depressive episode (within a major depressive or bipolar disorder) were randomly assigned to receive either MoodFX or a health information website as the intervention and control condition, respectively, with follow-up assessment surveys conducted online at baseline, 8 weeks and 6 months. The primary usability outcomes included the percentage of patients with self-reported use of MoodFX 3 or more times during follow up (indicating minimally adequate usage) and usability measures based on the System Usability Scale (SUS). Secondary clinical outcomes included the Quick Inventory of Depressive Symptomatology, Self-Rated (QIDS-SR) and Patient Health Questionnaire (PHQ-9). RESULTS Forty-nine participants were randomized (24 to MoodFX and 25 to the control condition). Of the 23 participants randomized to MoodFX who completed the user survey, 18 (78%) used MoodFX 3 or more times over the 6 months of the study. The mean SUS score of 72.7 (65th-69th percentile) represents good usability. Compared to the control group, the MoodFX group had significantly better improvement on QIDS-SR and PHQ-9 scores, with large effect sizes and higher response rates at 6 months. There were no differences between conditions on other secondary outcomes such as functioning and quality of life. CONCLUSION MoodFX demonstrated good usability and was associated with reduction in depressive symptoms. This pilot study supports the use of digital tools in depression treatment.
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Affiliation(s)
- Victor W. Li
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Jaspreet Sahota
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Deea K. Dev
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Dib D. Gill
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Vanessa C. Evans
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Auby Axler
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - André Do
- Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - John-Jose Nunez
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Edwin M. Tam
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Lakshmi N. Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Erin E. Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Jill K. Murphy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Raymond W. Lam
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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Murphy JK, Saker S, Ananyo Chakraborty P, Chan YM(M, Michalak EE, Irrarazaval M, Withers M, Ng CH, Khan A, Greenshaw A, O’Neil J, Nguyen VC, Minas H, Ravindran A, Paric A, Chen J, Wang X, Hwang TY, Ibrahim N, Hatcher S, Evans V, Lam RW. Advancing equitable access to digital mental health in the Asia-Pacific region in the context of the COVID-19 pandemic and beyond: A modified Delphi consensus study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002661. [PMID: 38857265 PMCID: PMC11164385 DOI: 10.1371/journal.pgph.0002661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/01/2024] [Indexed: 06/12/2024]
Abstract
The COVID-19 pandemic had an unprecedented impact on global mental health and well-being, including across the Asia-Pacific. Efforts to mitigate virus spread led to far-reaching disruption in the delivery of health and social services. In response, there was a rapid shift to the use of digital mental health (DMH) approaches. Though these technologies helped to improve access to care for many, there was also substantial risk of access barriers leading to increased inequities in access to mental health care, particularly among at-risk and equity-deserving populations. The objective of this study was to conduct a needs assessment and identify priorities related to equitable DMH access among at-risk and equity-deserving populations in the Asia Pacific region during the first year of the COVID-19 pandemic. The study consisted of a modified Delphi consensus methodology including two rounds of online surveys and online consultations with stakeholders from across the region. Study participants included policy makers, clinicians and service providers, and people with lived experience of mental health conditions. Results demonstrate that vulnerabilities to negative mental health impacts and access barriers were compounded during the pandemic. Access barriers included a lack of linguistically and culturally appropriate DMH options, low mental health literacy and poor access to technological infrastructure and devices, low levels of awareness and trust of DMH options, and lack of policies and guidelines to support effective and equitable delivery of DMH. Recommendations to improve equitable access include ensuring that diverse people with lived experience are engaged in research, co-design and policy development, the development and implementation of evidence-based and equity-informed guidelines and frameworks, clear communication about DMH evidence and availability, and the integration of DMH into broader health systems. Study results can inform the development and implementation of equitable DMH as its use becomes more widespread across health systems.
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Affiliation(s)
- Jill K. Murphy
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shirley Saker
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Erin E. Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Mellissa Withers
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Chee H. Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Amna Khan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - John O’Neil
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - Harry Minas
- Centre for Mental Health, University of Melbourne, Melbourne, Australia
| | - Arun Ravindran
- Centre for Addiction and Mental Health/ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Angela Paric
- Centre for Addiction and Mental Health/ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jun Chen
- Shanghai Mental Health Centre, Shanghai, China
| | - Xing Wang
- Shanghai Mental Health Centre, Shanghai, China
| | - Tae-Yeon Hwang
- Korea Foundation for Suicide Prevention, Seoul, South Korea
| | - Nurashikin Ibrahim
- Mental Health, Injury and Violence Prevention and Substance Abuse Sector Section, Ministry of Health, Kuala Lumpur, Malaysia
| | - Simon Hatcher
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Vanessa Evans
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raymond W. Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Murphy JK, Chau LW, Nguyen VC, Minas H, Anh DV, O'Neil J. An integrated knowledge translation (iKT) approach to advancing community-based depression care in Vietnam: lessons from an ongoing research-policy collaboration. BMC Health Serv Res 2024; 24:142. [PMID: 38279141 PMCID: PMC10821570 DOI: 10.1186/s12913-023-10518-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/22/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Evidence-based mental health policies are key to supporting the expansion of community-based mental health care and are increasingly being developed in low and middle-income countries (LMICs). Despite this, research on the process of mental health policy development in LMICs is limited. Engagement between researchers and policy makers via an integrated Knowledge Translation (iKT) approach can help to facilitate the process of evidence-based policy making. This paper provides a descriptive case study of a decade-long policy and research collaboration between partners in Vietnam, Canada and Australia to advance mental health policy for community-based depression care in Vietnam. METHODS This descriptive case study draws on qualitative data including team meeting minutes, a focus group discussion with research team leaders, and key informant interviews with two Vietnamese policy makers. Our analysis draws on Murphy et al.'s (2021) findings and recommendations related to stakeholder engagement in global mental health research. RESULTS Consistent with Murphy et al.'s findings, facilitating factors across three thematic categories were identified. Related to 'the importance of understanding context', engagement between researchers and policy partners from the formative research stage provided a foundation for engagement that aligned with local priorities. The COVID-19 pandemic acted as a catalyst to further advance the prioritization of mental heath by the Government of Vietnam. 'The nature of engagement' is also important, with findings demonstrating that long-term policy engagement was facilitated by continuous funding mechanisms that have enabled trust-building and allowed the research team to respond to local priorities over time. 'Communication and dissemination' are also crucial, with the research team supporting mental health awareness-raising among policy makers and the community, including via capacity building initiatives. CONCLUSIONS This case study identifies factors influencing policy engagement for mental health system strengthening in an LMIC setting. Sustained engagement with policy leaders helps to ensure alignment with local priorities, thus facilitating uptake and scale-up. Funding agencies can play a crucial role in supporting mental health system development through longer term funding mechanisms. Increased research related to the policy engagement process in global mental health will further support policy development and improvement in mental health care in LMICs.
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Affiliation(s)
- Jill K Murphy
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Leena W Chau
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - Harry Minas
- Global and Cultural Mental Health Unit, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Duong Viet Anh
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - John O'Neil
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.
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Chau LW, Murphy JK, Nguyen VC, Xie H, Lam RW, Minas H, Zheng Y, Krebs E, Hayashi K, Dao S, Nguyen X, Duong VA, Fiume E, O’Neil J. Evaluating the effectiveness and cost-effectiveness of a digital, app-based intervention for depression (VMood) in community-based settings in Vietnam: Protocol for a stepped-wedge randomized controlled trial. PLoS One 2023; 18:e0290328. [PMID: 37669289 PMCID: PMC10479903 DOI: 10.1371/journal.pone.0290328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/02/2023] [Indexed: 09/07/2023] Open
Abstract
The COVID-19 pandemic has amplified mental health problems and highlighted inequitable gaps in care worldwide. In response there has been an explosion of digital interventions such as smartphone applications ("apps") to extend care. The objective of this trial is to evaluate the effectiveness and cost-effectiveness of a digital depression intervention (VMood), delivered via a smartphone app. VMood is adapted from an in-person intervention that was delivered by non-specialist providers and shown to be effective in the Vietnamese context in our previous trial (2016-2019). A stepped-wedge, randomized controlled trial will be conducted across eight provinces in Vietnam. Adults aged 18 years and over will be recruited through community-based primary care centres and screened for depression using the embedded Patient Health Questionnaire-9 (primary outcome measure). Participants scoring 10-19, indicating depression caseness, will be randomly allocated to the intervention or control group until the target of 336 is reached. Secondary outcome measures will examine the effect of the intervention on commonly co-occuring anxiety, quality of life and work productivity, along with use of alcohol and tobacco products. Assessments will be administered through an online survey platform (REDCap) at baseline, and at every 3 months until 3 months post-intervention. Intervention-group participants will receive VMood for a 3-month period, with online support provided by social workers. Control-group participants will receive a limited version of the app until they cross into the intervention group. Generalized Linear Mixed-effect Models for clustered measures will be used for all outcomes data. We will conduct a cost-effectiveness analysis alongside the trial to capture VMood's costs and benefits. This trial will provide evidence on the effectiveness and cost-effectiveness of a digital mental health intervention adapted from an in-person intervention. This trial will also contribute important information to the growing and promising field of digital mental health. Trail regulation. Registered at ClinicalTrials.gov, identifier [NCT05783531].
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Affiliation(s)
- Leena W. Chau
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Jill K. Murphy
- Faculty of Medicine, Department of Psychiatry, The University of British Columbia, Vancouver, Canada
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Raymond W. Lam
- Faculty of Medicine, Department of Psychiatry, The University of British Columbia, Vancouver, Canada
| | - Harry Minas
- Global and Cultural Mental Health Unit, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Yufei Zheng
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Emanuel Krebs
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Kanna Hayashi
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Son Dao
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - Xuan Nguyen
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - Viet Anh Duong
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - Eugene Fiume
- Faculty of Applied Sciences, Simon Fraser University, Vancouver, Canada
| | - John O’Neil
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
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Jin J, Goud R, Al-Shamali H, Dzunic A, Lyons T, Reeson M, Pazderka H, Dennett L, Polzin W, Wei Y, Silverstone PH, Greenshaw AJ. Early Mental Health Foundations: A Scoping Review of Reflective Functioning in Caregiver-Child Dyads. PSYCHIAT CLIN PSYCH 2023; 33:58-69. [PMID: 38764527 PMCID: PMC11082638 DOI: 10.5152/pcp.2023.22549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/20/2023] [Indexed: 05/21/2024] Open
Abstract
International public health strategies indicate a need for equitable resources for wellness in younger children and their caregivers. Reflective functioning, a proxy for emotional regulation abilities, is a key area in this domain. As an emerging area, reflective functioning has not been mapped comprehensively and requires systematic investigation. This review examines "what qualitative and quantitative evidence is there for the value of reflective functioning assessment and intervention studies in caregiver-child dyads?" This scoping review focused on data published to September 2021, focusing on caregivers of children ≤36 months of age (including Medline, PsycINFO, CINAHL, ERIC, Scopus, Web of Science, and Embase). Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were followed. From 5162 initial articles, 608 papers were screened for full text yielding a final 181 papers. Only 69 studies included multiple ethnicities. Seven of the 69 studies included at least 1 Indigenous person. No studies were conducted in low- to middle-income countries, and no studies reported data on gender identity. This review comprises a novel and comprehensive mapping of the reflective functioning literature in terms of both assessment and intervention studies. The present mapping of the reflective functioning literature indicates the importance of health disparities in caregiver-child dyads (these include gaps and needs for future research). In relation to gaps, studies of adverse childhood experience, consideration of equity, diversity, and inclusion, and global mental health are underrepresented. Future research is needed to provide information on the relevance of gender identity and low- to middle-income countries in relation to the impact on reflective functioning in this context.
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Affiliation(s)
- Jonathan Jin
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Rachel Goud
- University of Toronto, Temerty Faculty of Medicine, Toronto, Canada
| | - Huda Al-Shamali
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Anja Dzunic
- University of Alberta, School of Public Health, Edmonton, Canada
| | - Tirzah Lyons
- University of Alberta, Faculty of Education, Edmonton, Canada
| | - Matthew Reeson
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, Canada
- Little Warriors Be Brave Ranch, Edmonton Alberta, Canada
| | - Liz Dennett
- JW Scott Health Sciences Library, University of Alberta, Edmonton, Canada
| | - Wanda Polzin
- Little Warriors Be Brave Ranch, Edmonton Alberta, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, Edmonton, Canada
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Witteveen A, Young S, Cuijpers P, Ayuso-Mateos J, Barbui C, Bertolini F, Cabello M, Cadorin C, Downes N, Franzoi D, Gasior M, John A, Melchior M, McDaid D, Palantza C, Purgato M, Van der Waerden J, Wang S, Sijbrandij M. Remote mental health care interventions during the COVID-19 pandemic: An umbrella review. Behav Res Ther 2022; 159:104226. [PMID: 36410111 PMCID: PMC9661449 DOI: 10.1016/j.brat.2022.104226] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/13/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Mitigating the COVID-19 related disruptions in mental health care services is crucial in a time of increased mental health disorders. Numerous reviews have been conducted on the process of implementing technology-based mental health care during the pandemic. The research question of this umbrella review was to examine what the impact of COVID-19 was on access and delivery of mental health services and how mental health services have changed during the pandemic. A systematic search for systematic reviews and meta-analyses was conducted up to August 12, 2022, and 38 systematic reviews were identified. Main disruptions during COVID-19 were reduced access to outpatient mental health care and reduced admissions and earlier discharge from inpatient care. In response, synchronous telemental health tools such as videoconferencing were used to provide remote care similar to pre-COVID care, and to a lesser extent asynchronous virtual mental health tools such as apps. Implementation of synchronous tools were facilitated by time-efficiency and flexibility during the pandemic but there was a lack of accessibility for specific vulnerable populations. Main barriers among practitioners and patients to use digital mental health tools were poor technological literacy, particularly when preexisting inequalities existed, and beliefs about reduced therapeutic alliance particularly in case of severe mental disorders. Absence of organizational support for technological implementation of digital mental health interventions due to inadequate IT infrastructure, lack of funding, as well as lack of privacy and safety, challenged implementation during COVID-19. Reviews were of low to moderate quality, covered heterogeneously designed primary studies and lacked findings of implementation in low- and middle-income countries. These gaps in the evidence were particularly prevalent in studies conducted early in the pandemic. This umbrella review shows that during the COVID-19 pandemic, practitioners and mental health care institutions mainly used synchronous telemental health tools, and to a lesser degree asynchronous tools to enable continued access to mental health care for patients. Numerous barriers to these tools were identified, and call for further improvements. In addition, more high quality research into comparative effectiveness and working mechanisms may improve scalability of mental health care in general and in future infectious disease outbreaks.
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Affiliation(s)
- A.B. Witteveen
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands,Corresponding author
| | - S. Young
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - P. Cuijpers
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - J.L. Ayuso-Mateos
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - F. Bertolini
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - M. Cabello
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Cadorin
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - N. Downes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. Franzoi
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Gasior
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - A. John
- Health Data Science, Swansea University Medical School, Swansea, UK
| | - M. Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - C. Palantza
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - J. Van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - S. Wang
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Sijbrandij
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
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Li W, Zhao YJ, Zhang SF, Yang B, Cheung T, Jackson T, Sha S, Xiang YT. Mapping post-traumatic stress disorder symptoms and quality of life among residents of Wuhan, China after the COVID-19 outbreak: A network perspective. J Affect Disord 2022; 318:80-87. [PMID: 36030998 PMCID: PMC9420032 DOI: 10.1016/j.jad.2022.08.074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/06/2022] [Accepted: 08/22/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES The Coronavirus Disease 2019 (COVID-19) outbreak may have a long-term impact on mental health in the general population. This study examined inter-relationships between post-traumatic stress disorder symptoms (PTSS) and quality of life (QOL) in Wuhan residents after the COVID-19 outbreak using network approach. METHODS A cross-sectional survey was conducted between May 25 and June 18, 2020. PTSS and QOL were measured using Chinese versions of the Post -Traumatic Stress Disorder Checklist - Civilian Version and the World Health Organization Quality of Life Questionnaire - brief version, respectively. RESULTS A total of 2598 participants were included. A network analysis revealed "Avoiding reminders", "Feeling emotionally numb", "Avoiding thoughts", "Hypervigilance", and "Reliving experiences" as the most central (influential) nodes in PTSS network models both before and after controlling for covariates. The connection between "Avoiding thoughts" and "Avoiding reminders" had the strongest edge. Three symptom communities were detected and can be summarized as "re-experiencing and avoidance", "negative changes in thinking and mood", and "hyperarousal". The bridge symptoms connecting PTSS and QOL were "Sleep disturbances", "Irritability", and "Loss of interest". LIMITATIONS Limitations included the cross-sectional study design, self-report measures in data collection, and lack of follow-ups beyond the initial phase of the pandemic. CONCLUSIONS PTSS were common among Wuhan residents even after the initial COVID-19 outbreak had passed. Attention should be paid to lingering symptoms of avoiding reminders, emotional numbness, avoiding thoughts, hypervigilance, and reliving experiences in treating PTSS related to the COVID-19 outbreak.
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Affiliation(s)
- Wen Li
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice China, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao; Centre for Cognitive and Brain Sciences, University of Macau, Macao; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao
| | - Shu-Fang Zhang
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei, China,; Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei province, China
| | - Bingxiang Yang
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong kong
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao; Centre for Cognitive and Brain Sciences, University of Macau, Macao; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao.
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8
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Sabado-Liwag MD, Zamora M, Esmundo S, Sumibcay JR, Kwan PP. Preliminary Observations from The FILLED Project (FILipino Lived Experiences during COVID-19). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12303. [PMID: 36231606 PMCID: PMC9566375 DOI: 10.3390/ijerph191912303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Health outcomes for Asian American subgroups are often aggregated, masking unique experiences and disparities exacerbated by the COVID-19 pandemic, specifically among Filipino Americans (FilAms). The FILLED (Filipino Lived Experiences during COVID-19) Project launched a cross-sectional online survey between April-August 2021 among FilAm adults in Southern California to document community issues and outcomes during the pandemic. Among 223 participants, 47.5% were immigrants, 50.9% identified as essential workers, and 40.6% had a pre-existing health condition before the pandemic. Despite high rates of health insurance (93.3%), 24.4% of the sample did not have a regular health care provider. During the pandemic, 32.7% needed mental health help but did not get it and 44.2% did not know where to get such services. Most respondents felt that the COVID-19 vaccination was a personal responsibility to others (76.9%) and the majority had received at least one dose of a COVID-19 vaccine (82.4%). Regarding COVID-19 impact, participants reported moderate-severe changes in their daily routines (73.5%), access to extended social support (38.9%), housing issues (15.4%), and access to medical care (11.6%). To our knowledge, this study is the first community-driven effort highlighting FilAm community experiences in Southern California, where the highest proportion of FilAms in the United States reside, specifically after the COVID-19 vaccine was made widely available. The observational findings may help community leaders, policy makers, and public health researchers in the design, development, and implementation of post-pandemic intervention strategies used by community-partnered projects that address FilAm and sub-Asian group health disparities at grassroots to societal levels.
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Affiliation(s)
| | - Mayra Zamora
- Department of Public Health, California State University, Los Angeles, CA 90032, USA
| | - Shenazar Esmundo
- Department of Health Sciences, California State University, Northridge, CA 91330, USA
| | - Jake Ryann Sumibcay
- Department of Public Health, California State University, Los Angeles, CA 90032, USA
| | - Patchareeya P. Kwan
- Department of Health Sciences, California State University, Northridge, CA 91330, USA
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Potential and Pitfalls of Mobile Mental Health Apps in Traditional Treatment: An Umbrella Review. J Pers Med 2022; 12:jpm12091376. [PMID: 36143161 PMCID: PMC9505389 DOI: 10.3390/jpm12091376] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 12/25/2022] Open
Abstract
While the rapid growth of mobile mental health applications has offered an avenue of support unbridled by physical distance, time, and cost, the digitalization of traditional interventions has also triggered doubts surrounding their effectiveness and safety. Given the need for a more comprehensive and up-to-date understanding of mobile mental health apps in traditional treatment, this umbrella review provides a holistic summary of their key potential and pitfalls. A total of 36 reviews published between 2014 and 2022—including systematic reviews, meta-analyses, scoping reviews, and literature reviews—were identified from the Cochrane library, Medline (via PubMed Central), and Scopus databases. The majority of results supported the key potential of apps in helping to (1) provide timely support, (2) ease the costs of mental healthcare, (3) combat stigma in help-seeking, and (4) enhance therapeutic outcomes. Our results also identified common themes of apps’ pitfalls (i.e., challenges faced by app users), including (1) user engagement issues, (2) safety issues in emergencies, (3) privacy and confidentiality breaches, and (4) the utilization of non-evidence-based approaches. We synthesize the potential and pitfalls of mental health apps provided by the reviews and outline critical avenues for future research.
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