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Vila-Badia R, Ochoa S, Fábrega-Ruz J, Gonzalez-Caballero JL, Romero C, Cid J, Frigola-Capell E, Salvador-Carulla L, Moreno-Küstner B. Sex differences in patient-reported outcome measure of psychotic symptoms in schizophrenia. Arch Womens Ment Health 2024:10.1007/s00737-024-01472-y. [PMID: 38836873 DOI: 10.1007/s00737-024-01472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/07/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE to study sex differences in self-reported symptoms measured with the Scale of Patient-Reported Impact of Symptoms in Schizophrenia (PRISS), to investigated sex differences in the degree of agreements between self-reported symptoms and clinical symptoms assessed by professionals, and to identify which clinical and sociodemographic variables predicted a greater presence of self-reported symptoms split by sex. METHODS 161 patients (37 females; 124 males), aged between 18 and 65 years, with a diagnosis of schizophrenia assisted in non-acute mental health services at four mental health catchment areas in Andalucia and Catalonia were included. The PRISS scale was administered to asses self-reported symptoms. RESULTS males reported higher presence of excitement, grandiosity, motor retardation and poor attention) than women. There was less agreement in the presence of psychotic symptoms in men than in women when comparing self-reported symptoms and clinical symptoms assessed by professionals. Finally, in men the predictors variables for the greater presence of self-perceived symptoms were greater psychotic symptomatology and more disability, while in women were greater presence of alogia and higher doses of chlorpromazine. CONCLUSIONS Assessing and being aware of the self-perceived symptoms of patients with schizophrenia should be considered in the clinic, especially in men, as there appears to be a lack of agreement on certain items. This would allow treatments to be more focused on patients' need by sex, and would make them feel part of the therapeutic process, improving their therapeutic adherence, evolution and quality of life.
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Affiliation(s)
- Regina Vila-Badia
- Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Esplugues de Llobregat, Sant Boi de Llobregat. CIBERSAM, Spain.
| | - Susana Ochoa
- Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Esplugues de Llobregat, Sant Boi de Llobregat. CIBERSAM, Spain
| | - Julia Fábrega-Ruz
- Mental Health Department, Hospital Regional Universitario de Málaga, University of Malaga, Malaga, Spain
| | | | - Cristina Romero
- Department of Psychology, University of Cádiz, Asociación Científica Psicost, Cadiz, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, Institut d'Assistència Sanitària (IAS), Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Eva Frigola-Capell
- Mental Health & Addiction Research Group, Institut d'Assistència Sanitària (IAS), Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Luis Salvador-Carulla
- Deputy Director, Health Research Institute, University of Canberra, Canberra, Australia
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, Andalusian Group of Psychosocial Research (GAP), University of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
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Fernandes S, Brousse Y, Zendjidjian X, Cano D, Riedberger J, Llorca PM, Samalin L, Dassa D, Trichard C, Laprevote V, Sauvaget A, Abbar M, Misdrahi D, Berna F, Lancon C, Coulon N, El-Hage W, Rozier PE, Benoit M, Giordana B, Caqueo-Urízar A, Yon DK, Tran B, Auquier P, Fond G, Boyer L. Psychometric Assessment of an Item Bank for Adaptive Testing on Patient-Reported Experience of Care Environment for Severe Mental Illness: Validation Study. JMIR Ment Health 2024; 11:e49916. [PMID: 38753416 PMCID: PMC11140279 DOI: 10.2196/49916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/15/2023] [Accepted: 01/21/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The care environment significantly influences the experiences of patients with severe mental illness and the quality of their care. While a welcoming and stimulating environment enhances patient satisfaction and health outcomes, psychiatric facilities often prioritize staff workflow over patient needs. Addressing these challenges is crucial to improving patient experiences and outcomes in mental health care. OBJECTIVE This study is part of the Patient-Reported Experience Measure for Improving Quality of Care in Mental Health (PREMIUM) project and aims to establish an item bank (PREMIUM-CE) and to develop computerized adaptive tests (CATs) to measure the experience of the care environment of adult patients with schizophrenia, bipolar disorder, or major depressive disorder. METHODS We performed psychometric analyses including assessments of item response theory (IRT) model assumptions, IRT model fit, differential item functioning (DIF), item bank validity, and CAT simulations. RESULTS In this multicenter cross-sectional study, 498 patients were recruited from outpatient and inpatient settings. The final PREMIUM-CE 13-item bank was sufficiently unidimensional (root mean square error of approximation=0.082, 95% CI 0.067-0.097; comparative fit index=0.974; Tucker-Lewis index=0.968) and showed an adequate fit to the IRT model (infit mean square statistic ranging between 0.7 and 1.0). DIF analysis revealed no item biases according to gender, health care settings, diagnosis, or mode of study participation. PREMIUM-CE scores correlated strongly with satisfaction measures (r=0.69-0.78; P<.001) and weakly with quality-of-life measures (r=0.11-0.21; P<.001). CAT simulations showed a strong correlation (r=0.98) between CAT scores and those of the full item bank, and around 79.5% (396/498) of the participants obtained a reliable score with the administration of an average of 7 items. CONCLUSIONS The PREMIUM-CE item bank and its CAT version have shown excellent psychometric properties, making them reliable measures for evaluating the patient experience of the care environment among adults with severe mental illness in both outpatient and inpatient settings. These measures are a valuable addition to the existing landscape of patient experience assessment, capturing what truly matters to patients and enhancing the understanding of their care experiences. TRIAL REGISTRATION ClinicalTrials.gov NCT02491866; https://clinicaltrials.gov/study/NCT02491866.
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Affiliation(s)
- Sara Fernandes
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Yann Brousse
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Xavier Zendjidjian
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Delphine Cano
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Jérémie Riedberger
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Pierre-Michel Llorca
- Department of Psychiatry, Centre Hospitalier Universitaire de Clermont-Ferrand, University of Clermont Auvergne, Centre national de la recherche scientifique, Institut national polytechnique de Clermont Auvergne, Institut Pascal UMR 6602, Clermont-Ferrand, France
| | - Ludovic Samalin
- Department of Psychiatry, Centre Hospitalier Universitaire de Clermont-Ferrand, University of Clermont Auvergne, Centre national de la recherche scientifique, Institut national polytechnique de Clermont Auvergne, Institut Pascal UMR 6602, Clermont-Ferrand, France
| | - Daniel Dassa
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | | | - Vincent Laprevote
- Department of Addictology and Psychiatry, Centre Psychothérapique de Nancy, Laxou, France
- Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Université de Strasbourg, Institut national de la santé et de la recherche médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Anne Sauvaget
- Nantes Université, Centre Hospitalier Régional Universitaire de Nantes, Movement - Interactions - Performance - MIP UR 4334, Nantes, France
| | - Mocrane Abbar
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - David Misdrahi
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Fabrice Berna
- Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Université de Strasbourg, Institut national de la santé et de la recherche médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Christophe Lancon
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Nathalie Coulon
- Centre Expert Schizophrénie, Centre Expert TSA-SDI et Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive - C3R, Centre Hospitalier Alpes Isère, Grenoble, France
| | - Wissam El-Hage
- Centre Hospitalier Régional Universitaire de Tours, Clinique Psychiatrique Universitaire, Tours, France
| | | | - Michel Benoit
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | - Bruno Giordana
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | | | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Bach Tran
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Pascal Auquier
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Guillaume Fond
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Laurent Boyer
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
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Nair N, Xavier S, Rabouin D, Mohan G, Rangaswamy T, Ramachandran P, Joober R, Schmitz N, Malla A, Iyer SN. Patient-reported outcome measures in early psychosis: A cross-cultural, longitudinal examination of the self-reported health and self-reported mental health measures in Chennai, India and Montreal, Canada. Schizophr Res 2024; 267:75-83. [PMID: 38520813 DOI: 10.1016/j.schres.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/31/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE Despite their acknowledged value, patient-reported outcome measures (PROMs) are infrequently used in psychosis, particularly in low-and middle-income countries. We compared ratings on two single-item PROMs, Self-Rated Health (SRH) and Self-Rated Mental Health (SRMH), of persons receiving similar early psychosis services in Chennai, India and Montreal, Canada. We hypothesized greater improvements in SRH and SRMH in the Chennai (compared to the Montreal) sample. METHODS Participants (Chennai N = 159/168 who participated in the larger study; Montreal N = 74/165 who participated in the larger study) completed the SRH and SRMH during at least two out of three timepoints (entry, months 12 and 24). Repeated measures proportional odds logistic regressions examined the effects of time (baseline to month 24), site, and relevant baseline (e.g., gender) and time-varying covariates (i.e., symptoms) on SRH and SRMH scores. RESULTS SRH (but not SRMH) scores significantly differed between the sites at baseline, with Chennai patients reporting poorer health (OR: 0.33; CI: 0.18, 0.63). While Chennai patients reported similar significant improvements in their SRH (OR: 7.03; CI: 3.13; 15.78) and SRMH (OR: 2.29, CI: 1.03, 5.11) over time, Montreal patients only reported significant improvements in their SRMH. Women in Chennai (but not Montreal) reported lower mental health than men. Higher anxiety and longer durations of untreated psychosis were associated with poorer SRH and SRMH, while negative symptoms were associated with SRH. CONCLUSIONS As hypothesized, Chennai patients reported greater improvements in health and mental health. The marked differences between health and mental health in Montreal, in contrast to the overlap between the two in Chennai, aligns with previous findings of clearer distinctions between mind and body in Western societies. Cross-context (e.g., anxiety) and context-specific (e.g., gender) factors influence patients' health perceptions. Our results highlight the value of integrating simple PROMs in early psychosis.
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Affiliation(s)
- Neha Nair
- Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
| | - Salomé Xavier
- Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
| | - Daniel Rabouin
- Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
| | | | | | | | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
| | - Norbert Schmitz
- Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada; Department of Population-Based Medicine, University Hospital Tübingen, Tübingen, Germany.
| | - Ashok Malla
- Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
| | - Srividya N Iyer
- Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
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Harris M, Blanco E, Howie H, Rempfer M. The Discrepancy between Subjective and Objective Evaluations of Cognitive and Functional Ability among People with Schizophrenia: A Systematic Review. Behav Sci (Basel) 2023; 14:30. [PMID: 38247682 PMCID: PMC10812940 DOI: 10.3390/bs14010030] [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: 12/02/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND An important aspect of recovery in schizophrenia relates to one's subjective, lived experience. Self-report is a subjective measurement method with yet-uncertain utility in the assessment of functioning among individuals diagnosed with schizophrenia-spectrum disorder. No review to date has comprehensively synthesized existing research to evaluate the degree of correspondence, or lack thereof, between subjective and objective assessments of cognitive and everyday functioning, nor how extant data can inform the use of self-reported information in treatment and research. METHODS A systematic review was completed to provide a broad perspective of the literature on this topic. Relevant manuscripts were identified via a search strategy using key terms in PubMed and PsycINFO and a review of manuscript bibliographies. Twenty-six studies met the inclusion criteria. RESULTS These studies show minimal to modest associations between subjective assessments of cognition and everyday functioning and objective assessments of these domains, including informant reports and neuropsychological and behavioral measures. Individuals with schizophrenia appear to overestimate their functioning when compared to objective measures. Depression and greater cognitive ability tend to predict greater correspondence between subjective and objective assessments of cognition and everyday functioning. DISCUSSION This review discusses how we might understand the low correspondence between subjective and objective measures of functioning and provides recommendations for using and eliciting self-reported information in the pursuit of recovery-centered practices.
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Affiliation(s)
- Molly Harris
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO 64110-2499, USA
| | - Emily Blanco
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO 64110-2499, USA
| | - Hunter Howie
- Department of Psychology, University of Kansas, Lawrence, KS 66045, USA (M.R.)
| | - Melisa Rempfer
- Department of Psychology, University of Kansas, Lawrence, KS 66045, USA (M.R.)
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Chawla V, Bansal N, Spelber D, Desai A, Frehlich L, Ballon JS, Kalinowski A, Noordsy DL. Inspire self report scale (ISRS): A feasibility study of a Novel self report scale for people with schizophrenia spectrum disorders. J Psychiatr Res 2023; 165:248-253. [PMID: 37531843 DOI: 10.1016/j.jpsychires.2023.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 08/04/2023]
Abstract
Clinician-rated symptom scales are the current standard for outcome measures in Schizophrenia Spectrum Disorders (SSD) research. There has been growing interest in the development of self-report measures for people with SSD to support measurement-based care and inclusive research. We developed the Inspire Self Report Scale (ISRS), which measures the current magnitude of well-being, mood symptoms, psychosis, negative symptoms and cognition using 10 questions on a Likert or Visual analogue scale (VAS). The main aim of this report was to investigate the correlation and concordance between patient self-report and clinician ratings on the ISRS during a clinical encounter. When ratings were discordant, we sought to identify whether the participant's or psychiatrist's rating was more accurate. The results indicated a moderately strong statistically significant correlation between participant and clinician ratings. There was a moderate concordance between participant and clinician ratings on the ISRS. When the results were discordant, the participant ratings were assessed to be more accurate than the clinician rating over 70% of the time. The ISRS has distinct utility compared to existing scales due to the measurement of present symptom severity, capturing multiple clinical domains, and time efficiency and ease of use. Thus, it may be useful in clinical and research settings.
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Affiliation(s)
- Vanika Chawla
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Nandini Bansal
- McMaster University, 90 Main St W, Hamilton, ON, L8P 1H6, Canada.
| | - David Spelber
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Aakash Desai
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Levi Frehlich
- Department of Community Health Sciences Cumming School of Medicine, University of Calgary, Canada.
| | - Jacob S Ballon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Agnieszka Kalinowski
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Douglas L Noordsy
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
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Schick A, Rauschenberg C, Ader L, Daemen M, Wieland LM, Paetzold I, Postma MR, Schulte-Strathaus JCC, Reininghaus U. Novel digital methods for gathering intensive time series data in mental health research: scoping review of a rapidly evolving field. Psychol Med 2023; 53:55-65. [PMID: 36377538 PMCID: PMC9874995 DOI: 10.1017/s0033291722003336] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 09/13/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022]
Abstract
Recent technological advances enable the collection of intensive longitudinal data. This scoping review aimed to provide an overview of methods for collecting intensive time series data in mental health research as well as basic principles, current applications, target constructs, and statistical methods for this type of data.In January 2021, the database MEDLINE was searched. Original articles were identified that (1) used active or passive data collection methods to gather intensive longitudinal data in daily life, (2) had a minimum sample size of N ⩾ 100 participants, and (3) included individuals with subclinical or clinical mental health problems.In total, 3799 original articles were identified, of which 174 met inclusion criteria. The most widely used methods were diary techniques (e.g. Experience Sampling Methodology), various types of sensors (e.g. accelerometer), and app usage data. Target constructs included affect, various symptom domains, cognitive processes, sleep, dysfunctional behaviour, physical activity, and social media use. There was strong evidence on feasibility of, and high compliance with, active and passive data collection methods in diverse clinical settings and groups. Study designs, sampling schedules, and measures varied considerably across studies, limiting the generalisability of findings.Gathering intensive longitudinal data has significant potential to advance mental health research. However, more methodological research is required to establish and meet critical quality standards in this rapidly evolving field. Advanced approaches such as digital phenotyping, ecological momentary interventions, and machine-learning methods will be required to efficiently use intensive longitudinal data and deliver personalised digital interventions and services for improving public mental health.
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Affiliation(s)
- Anita Schick
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Christian Rauschenberg
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Leonie Ader
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Maud Daemen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Lena M. Wieland
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Isabell Paetzold
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Mary Rose Postma
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Julia C. C. Schulte-Strathaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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Addington J, Chao A, Braun A, Miller M, Farris MS. Patient-Reported Outcome Measures in Clinical High Risk for Psychosis: A Systematic Review. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad006. [PMID: 37025755 PMCID: PMC10069322 DOI: 10.1093/schizbullopen/sgad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
A key issue in both research and clinical work with youth at clinical high risk (CHR) of psychosis is that there are clearly heterogenous clinical outcomes in addition to the development of psychosis. Thus, it is important to capture the psychopathologic outcomes of the CHR group and develop a core outcomes assessment set that may help in dissecting the heterogeneity and aid progress toward new treatments. In assessing psychopathology and often poor social and role functioning, we may be missing the important perspectives of the CHR individuals themselves. It is important to consider the perspectives of youth at CHR by using patient-reported outcome measures (PROMs). This systematic review of PROMs in CHR was conducted based on a comprehensive search of several databases and followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Sixty-four publications were included in the review examining PROMs for symptoms, functioning, quality of life, self-perceptions, stress, and resilience. Typically, PROMs were not the primary focus of the studies reviewed. The PROMs summarized here fit with results published elsewhere in the literature based on interviewer measures. However, very few of the measures used were validated for CHR or for youth. There are several recommendations for determining a core set of PROMs for use with CHR.
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Affiliation(s)
- Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Amanda Chao
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Amy Braun
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Madeline Miller
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Megan S Farris
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
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McIntyre RS, Ismail Z, Watling CP, Weiss C, Meehan SR, Musingarimi P, Thase ME. Patient-reported outcome measures for life engagement in mental health: a systematic review. J Patient Rep Outcomes 2022; 6:62. [PMID: 35689159 PMCID: PMC9187792 DOI: 10.1186/s41687-022-00468-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/17/2022] [Indexed: 01/07/2023] Open
Abstract
Background Life engagement in the context of mental health is a broad term that describes positive health aspects relating to cognition, vitality, motivation and reward, and the ability to feel pleasure—concepts that are meaningful to patients. The aim of this systematic literature review was to identify validated patient-reported outcomes (PROs) that can assess any aspect of life engagement in adults, in the field of general mental health. Methods This was a systematic literature review of articles in English from the MEDLINE database (date of search: September 9, 2020). The search strategy had three components: (1) terms to capture PROs; (2) terms to capture mental health; and (3) terms to capture aspects of life engagement. Articles were eligible if they included a PRO that: (1) is named; (2) can be used across mental health disorders; (3) is used to assess any aspect of life engagement; and (4) has undergone psychometric validation and/or qualitative content validation. A list of PROs was extracted. Results A total of 1585 records were screened and 233 articles were eligible for inclusion. Within these 233 articles, 49 distinct PROs were identified, two of which specifically captured their authors’ interpretation of life engagement: the Engaged Living Scale (ELS) and the Life Engagement Test (LET). However, while the ELS and LET covered motivation and reward, life fulfillment, and value-based living, neither scale captured the cognitive or vitality aspects of life engagement. The remaining identified PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy–apathy, pleasure–anhedonia, and mental/psychological well-being. Conclusion Numerous PROs are available that may capture aspects of life engagement. However, a need remains for a new PRO that can be used in clinical trials to provide a more comprehensive description of the improvements in life engagement that patients with mental health disorders may experience with successful treatment.
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Ferrari M, Pawliuk N, Pope M, MacDonald K, Boruff J, Shah J, Malla A, Iyer SN. A Scoping Review of Measures Used in Early Intervention Services for Psychosis. Psychiatr Serv 2022; 74:523-533. [PMID: 36321318 DOI: 10.1176/appi.ps.202100506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The early intervention service (EIS) model for psychosis has been implemented with increasing frequency; yet, improving outcomes across domains for all patients remains challenging. Measurement-based care can strengthen outcomes by optimizing interventions and promoting alignment with standards, but it is still not widely deployed in EIS. The authors conducted a scoping review by systematically identifying and synthesizing measures used in EIS related to purpose (i.e., to assess patients, families, and programs), domains (e.g., symptoms, quality of life), and reporting perspectives (of patients, families, and clinicians). METHODS EMBASE, MEDLINE, PsycINFO, CINAHL, and Cochrane Library databases were searched for pertinent literature published between 2000 and 2020. Two reviewers independently screened titles, abstracts, and full texts and extracted data. Measures were classified as clinician-reported outcome measures (CROMs), patient-reported outcome or experience measures (PROMs/PREMs), or family-reported outcome or experience measures (FROMs/FREMs). RESULTS In total, 172 measures of 27 domains were identified from 115 articles. Nineteen measures had been used to assess programs on fidelity, service engagement, and satisfaction; 136 to assess patients on duration of untreated psychosis, symptoms, functioning, quality of life, and others; and 17 to assess families on coping and burden, background, and others. Sixty percent were CROMs, 30% were PROMs/PREMs, and 10% were FROMs/FREMs. CONCLUSIONS Greater inclusion of PROMs and FROMs is needed because they align with the EIS philosophy of patient and family engagement and may improve shared decision making and outcomes. A comprehensive, meaningfully synthesized archive of measures can advance measurement-based care, services research, and data harmonization in early psychosis.
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Affiliation(s)
- Manuela Ferrari
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
| | - Nicole Pawliuk
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
| | - Megan Pope
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
| | - Kevin MacDonald
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
| | - Jill Boruff
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
| | - Jai Shah
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
| | - Srividya N Iyer
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal (Ferrari, Pawliuk, Pope, MacDonald, Shah, Malla, Iyer); Department of Psychiatry (Ferrari, Shah, Malla, Iyer) and Schulich Library of Physical Sciences, Life Sciences, and Engineering (Boruff), McGill University, Montreal
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10
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Geoffrion S, Nolet K, Giguère CÉ, Lecomte T, Potvin S, Lupien S, Marin MF. Psychosocial Profiles of Patients Admitted to Psychiatric Emergency Services: Results from the Signature Biobank Project. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:380-390. [PMID: 34011181 PMCID: PMC9065491 DOI: 10.1177/07067437211018793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Patients admitted to psychiatric emergency services (PES) are highly heterogenous. New tools based on a transdiagnosis approach could help attending psychiatrists in their evaluation process and treatment planning. The goals of this study were to: (1) identify profiles of symptoms based on self-reported, dimensional outcomes in psychiatric patients upon their admission to PES, (2) link these profiles to developmental variables, that is, history of childhood abuse (CA) and trajectories of externalizing behaviours (EB), and (3) test whether this link between developmental variables and profiles was moderated by sex. METHODS In total, 402 patients were randomly selected from the Signature Biobank, a database of measures collected from patients admitted to the emergency of a psychiatric hospital. A comparison group of 92 healthy participants was also recruited from the community. Symptoms of anxiety, depression, alcohol and drug abuse, impulsivity, and psychosis as well as CA and EB were assessed using self-reported questionnaires. Symptom profiles were identified using cluster analysis. Prediction of profile membership by sex, CA, and EB was tested using structural equation modelling. RESULTS Among patients, four profiles were identified: (1) low level of symptoms on all outcomes, (2) high psychotic symptoms, (3) high anxio-depressive symptoms, and (4) elevated substance abuse and high levels of symptoms on all scales. An indirect effect of CA was found through EB trajectories: patients who experienced the most severe form of CA were more likely to develop chronic EB from childhood to adulthood, which in turn predicted membership to the most severe psychopathology profile. This indirect effect was not moderated by sex. CONCLUSION Our results suggest that a transdiagnostic approach allows to highlight distinct clinical portraits of patients admitted to PES. Importantly, developmental factors were predictive of specific profiles. Such transdiagnostic approach is a first step towards precision medicine, which could lead to develop targeted interventions.
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Affiliation(s)
- Steve Geoffrion
- School of Psychoeducation, 5622University of Montreal, Quebec, Canada.,Centre de recherche de l'26612Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | - Kévin Nolet
- School of Psychoeducation, 5622University of Montreal, Quebec, Canada.,Centre de recherche de l'26612Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | - Charles-Édouard Giguère
- Centre de recherche de l'26612Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | - Tania Lecomte
- Centre de recherche de l'26612Institut universitaire en santé mentale de Montréal, Quebec, Canada.,Department of Psychology, 5622University of Montreal, Quebec, Canada
| | - Stéphane Potvin
- Centre de recherche de l'26612Institut universitaire en santé mentale de Montréal, Quebec, Canada.,Department of Psychiatry and Addictology, 5622University of Montreal, Quebec, Canada
| | - Sonia Lupien
- Centre de recherche de l'26612Institut universitaire en santé mentale de Montréal, Quebec, Canada.,Department of Psychiatry and Addictology, 5622University of Montreal, Quebec, Canada
| | - Marie-France Marin
- Centre de recherche de l'26612Institut universitaire en santé mentale de Montréal, Quebec, Canada.,Department of Psychiatry and Addictology, 5622University of Montreal, Quebec, Canada.,Department of Psychology, 14845Université du Québec à Montréal, Quebec, Canada
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11
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Buck B, Gagen EC, Halverson TF, Nagendra A, Ludwig KA, Fortney JC. A systematic search and critical review of studies evaluating psychometric properties of patient-reported outcome measures for schizophrenia. J Psychiatr Res 2022; 147:13-23. [PMID: 35007807 PMCID: PMC8882143 DOI: 10.1016/j.jpsychires.2021.12.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
Measurement-based care (MBC) involves the regular administration of outcome assessments to track and evaluate treatment progress and requires psychometrically sound instruments. While there are widely used patient-reported outcome measures (PROMs) for several psychiatric disorders and symptom categories (e.g., depression, anxiety), there is less consensus about self-report assessments for measurement-based care of schizophrenia. The present review provides an initial guide to this area by reporting on psychometric studies that introduce or evaluate PROMs designed for the ongoing treatment of schizophrenia. Out of an initial database of 6,153 articles, and review of 141 full-text articles, an analysis of 21 articles examining 12 measures is presented in this review. Findings suggest robust options exist for clinical and research institutions aiming to assess symptom outcomes in schizophrenia, with most measures showing strengths in internal consistency, test-retest reliability, and a number of measures with evidence of convergent or criterion validity. While there exist heterogeneous options, multiple measures demonstrated promising psychometric strengths. Future work validating consistent psychometric validity could involve measures which could be valuable in context of MBC for schizophrenia.
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Affiliation(s)
- Benjamin Buck
- Behavioral Research in Technology and Engineering (BRiTE) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Emily C. Gagen
- Department of Psychiatry, Harvard Medical School, Boston, MA,Massachusetts Mental Health Center, Boston, MA
| | | | - Arundati Nagendra
- Department of Psychiatry, Harvard Medical School, Boston, MA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Kelsey A. Ludwig
- Durham VA Health Care System – Durham, NC,Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill – Chapel Hill, NC
| | - John C. Fortney
- Division of Population Health, Department of Psychiatry and Behavioral Sciences, University of Washington,VA Puget Sound Health Services Research & Development, Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care
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12
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Association between subjective distress and symptom domains in patients with treatment-resistant schizophrenia receiving clozapine. Schizophr Res 2022; 240:228-230. [PMID: 35086033 DOI: 10.1016/j.schres.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/28/2021] [Accepted: 01/01/2022] [Indexed: 11/21/2022]
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13
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Relationship between satisfaction with mental health services, personal recovery and quality of life among service users with psychosis: a cross-sectional study. BMC Health Serv Res 2021; 21:439. [PMID: 33964917 PMCID: PMC8105980 DOI: 10.1186/s12913-021-06409-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Mental health policy internationally emphasizes patient centredness and personal recovery. This study investigated the relationship between satisfaction with mental health services among service users with psychosis in Norway, and personal recovery, perceived support for personal recovery, and quality of life. Methods Cross-sectional data were collected from 292 service users diagnosed with psychosis from 39 clinical sites across Norway. Satisfaction with services was assessed using the Client Satisfaction Questionnaire-8. A linear mixed model was estimated to explore the relationship between satisfaction with services and preselected covariates, and to control for confounding factors. Results A large majority of participants (89%) reported moderate-to-high levels of satisfaction. Satisfaction with services was positively associated with perceived support for personal recovery, but not with personal recovery or quality of life. In addition, service users under a Community Treatment Order (CTO) were significantly less satisfied than those who were not. Conclusions Satisfaction levels among service users were higher compared with similar, international studies. Those who feel supported in their personal recovery were more satisfied with the care they receive, which support the need for implementation of recovery-oriented practices for service users with psychosis. However, satisfaction with services was not related to service user-rated quality of life or level of personal recovery; thus, more follow-up studies are needed. The lower satisfaction of service users placed under CTOs shows the importance of targeted interventions to improve satisfaction with services among this group. Trial registration NCT03271242, date of registration: 5 sept. 2017.
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14
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Goula A, Margetis E, Stamouli MA, Latsou D, Gkioka V. Differences of mentally ill patients' satisfaction degree during their involuntary or voluntary stay in a psychiatric clinic. J Public Health Res 2021; 10. [PMID: 33769007 PMCID: PMC8239621 DOI: 10.4081/jphr.2021.2052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/23/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mental health illness is not considered as a private matter, as it affects not only the mental patient's life and those who are considered his/her immediate family, but also the society as a whole. The involuntary examination and/or hospitalization in the field of mental health as the basic first-line therapeutic solution in Greece, calls for an immediate intervention, which is supposed to counterbalance the need for therapy and patient's rights of personal freedom and safety. DESIGN AND METHODS A research using questionnaire was realized, consisting of 100 hospitalized patients in psychiatric clinics (50 voluntarily and 50 involuntarily hospitalized) at the Psychiatric Hospital of Attica. The sampling scheme was the stratified sampling and the level of statistical significance was set to α=0.05. RESULTS The results have shown that involuntarily and voluntarily hospitalized mental patients did not differ significantly with almost the entirety of the questionnaire; however, the involuntary patients were significantly more satisfied with the conditions of hospitalization as well as assessing the overall quality of the services provided during their hospitalization. CONCLUSIONS For mentally ill patients, greater importance and stronger correlation with gratification, does not constitute the admission procedure to the psychiatric clinic but the development of effective communication and therapeutic relationship with the staff, full knowledge and update about patient's health condition, medication, participation in therapeutic planning and hospitalization in a regime of autonomy and respect for their rights.
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Affiliation(s)
- Aspasia Goula
- Master of Health and Social Care Management, University of West Attica.
| | | | | | - Dimitra Latsou
- Master of Health and Social Care Management, University of West Attica.
| | - Vasiliki Gkioka
- Master of Health and Social Care Management, University of West Attica.
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15
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Berzina N, Petrošina E, Taube M. The assessment of factors associated with patient satisfaction in evaluation of mental health care center. Nord J Psychiatry 2021; 75:79-86. [PMID: 32707004 DOI: 10.1080/08039488.2020.1795715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIMS The study was conducted to explore patient satisfaction and to identify factors associated with patient satisfaction with the care in psychiatric wards using Psychiatric Inpatient Patient Experience Questionnaire On-Site (PIPEQ-OS) self-assessment tool. Such studies to detect factors associated with patient satisfaction in mental health care have not yet been conducted in Latvia. METHODS Cross-sectional study was conducted over 6-month period in 2018. Total amount of 773 mental health care patients were offered to fill in the questionnaire in subacute and acute wards. From them, 419 (54.2%) filled and returned the questionnaire and 354 (45.8%) refused to fill it. Descriptive statistical analysis and factor correlation was done. RESULTS Response rate was found to be 54.2%. Patients generally showed high satisfaction with received care. However, lower satisfaction rates were found in items related to engagement of relatives and patients in the treatment process, as well as patients were less satisfied with information provided. Statistically significant higher satisfaction was associated with organic mental disorders compared to schizophrenia spectrum disorders, as well as with female gender, older age, being employed or pensioner, being married or divorced. Patient education level did not show significant association with self-assessment scores. CONCLUSION The study revealed possible directions for improvement in the future in terms of providing information to patients, involvement of relatives and patients in the process of treatment. Further studies with more patients and involvement of other hospitals are required to assess factors associated with the satisfaction to organize care and to plan treatment according to the needs of the patients.
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Affiliation(s)
- Natalija Berzina
- Department of Psychiatry and Narcology, Riga Stradiņš University, Riga, Latvia
| | - Eva Petrošina
- Statistics Unit, Riga Stradiņš University, Riga, Latvia
| | - Maris Taube
- Department of Psychiatry and Narcology, Riga Stradiņš University, Riga, Latvia
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16
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Mosler F, Priebe S, Bird V. Routine measurement of satisfaction with life and treatment aspects in mental health patients - the DIALOG scale in East London. BMC Health Serv Res 2020; 20:1020. [PMID: 33167986 PMCID: PMC7654159 DOI: 10.1186/s12913-020-05840-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/20/2020] [Indexed: 12/03/2022] Open
Abstract
AIMS The DIALOG scale has been implemented as a routine patient outcome and experience measure (PROM/PREM) in a mental health trust in East London since 2017. The resulting healthcare dataset was used to estimate satisfaction with life and treatment aspects over time and factors associated with it. METHODS Variables available from the Trust were DIALOG items, service level, clinical and basic demographic data. Data was extracted in February 2019. Data is described using a range of descriptive statistics and looking at the subgroups: treatment stage, diagnosis, service type. Predictors for average DIALOG scores across patients was explored with clustered linear regression models. A fixed effect model was chosen to estimate the impact of clinical and service related variables on patient's average DIALOG scores over time. Sensitivity analyses with the whole data set and complete cases were carried out. RESULTS Of the original 18,481 DIALOG records 12, 592 were kept after data cleaning (5646 patients). The average DIALOG score was 4.8 (SD 1.0) on the 7-point scale. Average satisfaction with life aspects (PROM) was 4.65 (SD 1.1) and with treatment aspects (PREM) was 5.25 (SD 1.17). Across all 11 items, "job situation" scored lowest (mean 4.05) and "meetings with professionals" highest (mean 5.5). Satisfaction for all items increased over time (average increase 0.47). The largest increase was in "mental health" (0.94) and the smallest in "family relationships" (0.34). CONCLUSIONS Patients in mental healthcare services were "fairly satisfied" in both life and treatment aspects with improvements seen over time. These results will act as a benchmark for clinical services currently implementing DIALOG across the UK and inform local service developments.
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Affiliation(s)
- Franziska Mosler
- Unit for Social and Community Psychiatry, Institute of Population Health Sciences, Queen Mary University of London, London, UK.
- East London NHS Foundation Trust, London, UK.
- Present address: Unit for Social and Community Psychiatry, Newham Centre for Mental Health, London, E13 8SP, UK.
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Institute of Population Health Sciences, Queen Mary University of London, London, UK
- East London NHS Foundation Trust, London, UK
| | - Victoria Bird
- Unit for Social and Community Psychiatry, Institute of Population Health Sciences, Queen Mary University of London, London, UK
- East London NHS Foundation Trust, London, UK
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Chang CC, Beckstead JW, Lo SC, Yang CY. Depressive symptoms and quality of life in people with a diagnosis of schizophrenia: An exploratory study of the potential mediating role of health-promoting lifestyles. Perspect Psychiatr Care 2020; 56:939-948. [PMID: 32314381 DOI: 10.1111/ppc.12516] [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: 02/03/2020] [Revised: 03/23/2020] [Accepted: 04/07/2020] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To examine health-promoting lifestyles mediates the relationship between depressive symptoms and quality of life (QOL) in people with schizophrenia. DESIGN AND METHODS A cross-sectional exploratory study design was conducted. Two-hundred and seventy-three participants were administered demographic data, health-promoting lifestyle profile, Beck Depression Inventory II, and World Health Organization Quality of Life-BREF. The Hayes PROCESS macro was employed to analyze data. FINDINGS The results showed self-actualization fully mediated the environmental domain of QOL, physical health, psychological health, and social relationships domains were partial mediation. PRACTICE IMPLICATIONS This study recommends that professionals reinforce persons' self-actualization when the QOL is affected by depressive symptoms in people with schizophrenia.
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Affiliation(s)
- Chia-Chi Chang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Jason W Beckstead
- Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
| | - Su-Chen Lo
- Department of Nursing, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Chiu-Yueh Yang
- Department of Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan
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Badu E, O'Brien AP, Mitchell R. The Conceptualization of Mental Health Service Quality Assessment: Consumer Perspective. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:790-806. [PMID: 31286335 DOI: 10.1007/s10488-019-00955-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This review synthesises theoretical approaches and methodological considerations in mental health service quality assessment from consumers-perspective. We searched published articles from databases: EMBASE, MEDLINE, CIHNAL, Scopus, Web of Science, and PsycINFO. Of the 30 included papers, 16 contained instruments used to mental health quality assessment and 14 focused on theoretical constructs. The review finds that mental health quality assessment is explained and measured using constructs that focus on structure, process and outcome. The methodological issues that need critical consideration are the context and cultural norms of services, outcome perspectives, evaluator, sources of information as well as the selection of consumers and instruments. The review recommends that researchers and clinicians should consider the theoretical constructs and methodological issues in mental health quality assessment.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, Newcastle, Australia.
| | - Anthony Paul O'Brien
- Faculty of Health and Medicine, School Nursing and Midwifery, University of Newcastle, Callaghan, Newcastle, Australia
| | - Rebecca Mitchell
- Faculty of Business and Economics, Macquarie University, North Ryde, Sydney, Australia
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Development and psychometric properties of a new brief scale for subjective personal agency (SPA-5) in people with schizophrenia. Epidemiol Psychiatr Sci 2020; 29:e111. [PMID: 32272978 PMCID: PMC7214545 DOI: 10.1017/s2045796020000256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Personal agency is a variable which potentially facilitates personal recovery in people with serious mental illness. This study aimed to develop a new brief measure for subjective personal agency that can be completed by people with serious mental illness. METHODS Two focus group interviews were first conducted with 11 people with schizophrenia to understand the fundamental components of subjective personal agency for people with serious mental illness living in the community. One group comprised six people with schizophrenia living in the community, while the other consisted of five people with schizophrenia working as peer-support workers. We then developed scale items through collaboration with people with schizophrenia and qualitative analysis (stage 1). A cross-sectional survey was then conducted to test the psychometric properties of the new scale among service users with schizophrenia in 18 assertive community treatment teams (stage 2). Factor validity was tested via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We evaluated convergent validity with the Boston University Empowerment Scale (BUES), divergent validity with the global assessment of functioning (GAF), internal consistency, and test-retest reliability. RESULTS Seven items were included in the scale at stage 1. In stage 2, 195 participants completed this scale. EFA revealed a one-factor model with five items. CFA indicated good model fit (χ2 statistics [CMIN] = 8.445, df = 5 (CMIN/df = 1.689), p = 0.133, comparative fit index = 0.974, Tucker-Lewis fit index = 0.949, root mean square error of approximation = 0.077 and standardised root mean squared residual = 0.042). The new scale was significantly correlated with total BUES score (r = 0.526, p < 0.001), but not with GAF score. Cronbach's α for internal consistency was 0.79, and intra-class correlation coefficient for test-retest reliability was 0.70. CONCLUSION We developed a new, five-item Subjective Personal Agency scale (SPA-5) that can be completed by people with serious mental illness. Further studies are needed to confirm the results outside Japan.
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20
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Comorbidity rates of depression and anxiety in first episode psychosis: A systematic review and meta-analysis. Schizophr Res 2020; 216:322-329. [PMID: 31791816 DOI: 10.1016/j.schres.2019.11.035] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/09/2019] [Accepted: 11/22/2019] [Indexed: 01/09/2023]
Abstract
Anxiety and depression symptoms are frequently experienced by individuals with psychosis, although prevalence rates have not been reviewed in first-episode psychosis (FEP). The aim of this systematic review was to focus on the prevalence rates for both anxiety and depression, comparing the rates within the same study population. A systematic review and meta-analysis was completed for all studies measuring both anxiety and depression in FEP at baseline. The search identified 6040 citations, of which n = 10 met inclusion criteria. These reported 1265 patients (age 28.3 ± 9.1, females: 39.9%) with diagnosed FEP. Studies which used diagnosis to define comorbidity count were included in separate meta-analyses for anxiety and depression, although the heterogeneity was high limiting interpretation of separate prevalence rates. A random-effects meta-analysis also compared the mean difference between anxiety and depression within the same studies. We show that anxiety and depression co-occur at a similar rate within FEP, although the exact rates are not reliable due to the heterogeneity between the small number of studies. Future research in FEP should consider routinely measuring anxiety and depression using continuous self-report measures of symptoms. Clinically we recommend that both anxiety and depression are equally targeted during psychological intervention in FEP, together with the psychotic symptoms.
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21
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Bird V, Miglietta E, Giacco D, Bauer M, Greenberg L, Lorant V, Moskalewicz J, Nicaise P, Pfennig A, Ruggeri M, Welbel M, Priebe S. Factors associated with satisfaction of inpatient psychiatric care: a cross country comparison. Psychol Med 2020; 50:284-292. [PMID: 30696510 DOI: 10.1017/s0033291719000011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patient satisfaction is a key indicator of inpatient care quality and is associated with clinical outcomes following admission. Different patient characteristics have been inconsistently linked with satisfaction. This study aims to overcome previous limitations by assessing which patient characteristics are associated with satisfaction within a large study of psychiatric inpatients conducted across five European countries. METHODS All patients with a diagnosis of psychotic (F2), affective (F3) or anxiety/somataform (F4) disorder admitted to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and the UK were included. Data were collected from medical records and face-to-face interviews, with patients approached within 2 days of admission. Satisfaction with inpatient care was measured on the Client Assessment of Treatment Scale. RESULTS Higher satisfaction scores were associated with being older, employed, living with others, having a close friend, less severe illness and a first admission. In contrast, higher education levels, comorbid personality disorder and involuntary admission were associated with lower levels of satisfaction. Although the same patient characteristics predicted satisfaction within the five countries, there were significant differences in overall satisfaction scores across countries. Compared to other countries, patients in the UK were significantly less satisfied with their inpatient care. CONCLUSIONS Having a better understanding of patient satisfaction may enable services to improve the quality of care provided as well as clinical outcomes for all patients. Across countries, the same patient characteristics predict satisfaction, suggesting that similar analytical frameworks can and should be used when assessing satisfaction both nationally and internationally.
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Affiliation(s)
- Victoria Bird
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | - Elisabetta Miglietta
- Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Domenico Giacco
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Lauren Greenberg
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Vincent Lorant
- Institute of Health and Society IRSS, Université Catholique de Louvain, Bruxelles, Belgium
| | | | - Pablo Nicaise
- Institute of Health and Society IRSS, Université Catholique de Louvain, Bruxelles, Belgium
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Marta Welbel
- Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
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22
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Wilson RS, Shryane N, Yung AR, Morrison AP. Distress related to psychotic symptoms in individuals at high risk of psychosis. Schizophr Res 2020; 215:66-73. [PMID: 31780347 DOI: 10.1016/j.schres.2019.11.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/11/2019] [Accepted: 11/19/2019] [Indexed: 11/29/2022]
Abstract
This study assessed the relationship between distress, severity and frequency of attenuated psychotic symptoms in individuals meeting Ultra High Risk (UHR) criteria, both at baseline and over time. It also assessed distress in relation to attenuated symptoms and whether cognitive behavioural therapy (CBT) reduced distress over time by symptom type. At baseline a combined total of 592 UHR participants (mean age 19.9; males, 53.9%) from two studies were assessed using a confirmatory factor analysis (CFA). Change over time from this baseline point was assessed using latent growth curve (LGC) models, based on participants from one of the studies. Distress associated with psychotic symptom was shown to be a separate psychological construct from severity and frequency. Distress was also significantly associated with severity but not frequency. Longitudinal LGC models with 244 participants showed that distress, severity and frequency all reduced over six months, although the rate of distress reduction varied across symptom type. Non-bizarre ideas (NBI) were more distressing and had the fastest rate of distress reduction over time. The baseline distress for some symptoms also strongly predicted the symptom severity change over time, suggesting that distress may cause change in the UHR criteria for unusual thought content (UTC) and NBI symptoms. CBT was not shown to be significantly different from treatment as usual (TAU) in its effect on distress. However, distress reduces over time, particularly in the first 3 months after presentation. We recommend that distress should be used as an outcome in future research and as a clinical indicator. (250 words).
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Affiliation(s)
- Rebecca S Wilson
- Division of Psychology and Mental Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Nick Shryane
- School of Social Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Alison R Yung
- Division of Psychology and Mental Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Anthony P Morrison
- Division of Psychology and Mental Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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23
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Treichler EBH, Thomas ML, Bismark AW, Hochberger WC, Tarasenko M, Nungaray J, Cardoso L, Joshi YB, Zhang W, Sprock J, Swerdlow N, Cohen AN, Light GA. Divergence of subjective and performance-based cognitive gains following cognitive training in schizophrenia. Schizophr Res 2019; 210:215-220. [PMID: 30660574 PMCID: PMC7032664 DOI: 10.1016/j.schres.2018.12.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/17/2018] [Accepted: 12/20/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cognitive training is effective for improving cognitive performance among people with schizophrenia. An individual's perception of their own cognition is dissociable from performance on objective cognitive tests. Since subjective cognitive benefit may impact engagement, motivation, and satisfaction with time-intensive cognitive interventions, this study aimed to determine whether subjective cognitive difficulties improve in conjunction with cognitive gains following 30 h of cognitive training. METHODS Patients with schizophrenia or schizoaffective disorder (N = 46) were randomized to treatment as usual (TAU) or TAU augmented with auditory-targeted cognitive training (TCT). All participants completed assessment batteries at baseline and follow-up. As previously reported, the TCT group showed significant improvements in verbal learning and memory and reductions in auditory hallucinations relative to the TAU group. RESULTS Subjective cognitive difficulties did not significantly improve following TCT, even among TCT participants who showed improvements in cognitive performance (all ps > 0.05). Subjective cognitive difficulties were significantly associated with severity of depressive symptoms and hallucinations (r = 0.48 and r = 0.28, p < 0.001), but not global or specific domains of cognition (all rs < 0.1) at baseline. There were no significant relationships between change in subjective cognitive difficulties and change in cognitive or clinical variables (all ps > 0.05). DISCUSSION Patients with schizophrenia do not detect change in their cognition following cognitive training, even among those who showed robust gains in cognitive performance. Failure to detect improvement may undermine treatment engagement, motivation, and satisfaction. Translating score improvements on the cognitive exercises into tangible metrics, and providing ongoing, clinician-delivered feedback on performance may facilitate patient ability to detect improvements and improve motivation to engage with cognitive training interventions.
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Affiliation(s)
- Emily B. H. Treichler
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Michael L. Thomas
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States,Department of Psychology, Colorado State University, Fort Collins, CO
| | - Andrew W. Bismark
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - William C. Hochberger
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Melissa Tarasenko
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - John Nungaray
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Lauren Cardoso
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Yash B. Joshi
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Wen Zhang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Neal Swerdlow
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Amy N. Cohen
- VA Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Gregory A. Light
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States,Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
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24
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Shields GE, Buck D, Elvidge J, Hayhurst KP, Davies LM. Cost-Effectiveness Evaluations of Psychological Therapies for Schizophrenia and Bipolar Disorder: A Systematic Review. Int J Technol Assess Health Care 2019; 35:317-326. [PMID: 31328702 PMCID: PMC6707812 DOI: 10.1017/s0266462319000448] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES This review aims to assess the cost-effectiveness of psychological interventions for schizophrenia/bipolar disorder (BD), to determine the robustness of current evidence and identify gaps in the available evidence. METHODS Electronic searches (PsycINFO, MEDLINE, Embase) identified economic evaluations relating incremental cost to outcomes in the form of an incremental cost-effectiveness ratio published in English since 2000. Searches were concluded in November 2018. Inclusion criteria were: adults with schizophrenia/BD; any psychological/psychosocial intervention (e.g., psychological therapy and integrated/collaborative care); probability of cost-effectiveness at explicitly defined thresholds reported. Comparators could be routine practice, no intervention, or alternative psychological therapies. Screening, data extraction, and critical appraisal were performed using pre-specified criteria and forms. Results were summarized qualitatively. The protocol was registered on the PROSPERO database (CRD42017056579). RESULTS Of 3,864 studies identified, 12 met the criteria for data extraction. All were integrated clinical and economic randomized controlled trials. The most common intervention was cognitive behavioral therapy (CBT, 6/12 studies). The most common measure of health benefit was the quality-adjusted life-year (6/12). Follow-up ranged from 6 months to 5 years. Interventions were found to be cost-effective in most studies (9/12): the probability of cost-effectiveness ranged from 35-99.5 percent. All studies had limitations and demonstrated uncertainty (particularly related to incremental costs). CONCLUSIONS Most studies concluded psychological interventions for schizophrenia/BD are cost-effective, including CBT, although there was notable uncertainty. Heterogeneity across studies makes it difficult to reach strong conclusions. There is a particular need for more evidence in the population with BD and for longer-term evidence across both populations.
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Affiliation(s)
| | - Deborah Buck
- Personal and Social Services Research Unit, University of Manchester
| | - Jamie Elvidge
- National Institute for Health and Care Excellence, United Kingdom
| | | | - Linda Mary Davies
- Centre for Health Economics, Division of Population Health, University of Manchester
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25
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Yamaguchi S, Ojio Y, Koike J, Matsunaga A, Ogawa M, Tachimori H, Kikuchi A, Kimura H, Inagaki A, Watanabe H, Kishi Y, Yoshida K, Hirooka T, Oishi S, Matsuda Y, Fujii C. Associations between readmission and patient-reported measures in acute psychiatric inpatients: a study protocol for a multicenter prospective longitudinal study (the ePOP-J study). Int J Ment Health Syst 2019; 13:40. [PMID: 31182972 PMCID: PMC6555753 DOI: 10.1186/s13033-019-0298-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 05/28/2019] [Indexed: 02/06/2023] Open
Abstract
Background Several previous observational studies have reported the risk factors associated with readmission in people with mental illness. While patient-reported experiences and outcomes have become increasingly important in healthcare, only a few studies have examined these parameters in terms of their direct association with readmission in an acute psychiatric setting. This project will investigate multiple factors associated with readmission and community living in acute psychiatric patients in Japan. This study will primarily investigate whether patient-reported experiences at discharge, particularly quality of life (QoL), are associated with future readmission and whether readmission after the index hospitalization is associated with changes in patient-reported outcomes during the study period. Here, we describe the rationale and methods of this study. Methods This multicenter prospective cohort study is being conducted in 21 participating Japanese hospitals, with a target sample of approximately 600 participants admitted to the acute psychiatric ward. The study has four planned assessment points: time of index admission (T1), time of discharge (from the index admission) (T2), 6 months after discharge from the index admission (T3), and 12 months after discharge from the index admission (T4). Participants will complete self-reported measures including a QoL scale, a subjective disability scale, and an empowerment- and self-agency-related scale at each assessment point; additionally, service satisfaction, subjective view of need for services, and subjective relationships with family members will be assessed at T2 and T3. We will assess the participants’ hospitalization during the study period and evaluate several potential individual- and service-level factors associated with readmission and patient-reported experiences and outcomes. Multivariate analyses will be conducted to identify potential associations between readmission and patient-reported experiences and outcomes. Discussion The present study may produce evidence on how patient-reported experiences at discharge influence readmission and on the influence of readmission on the course of patient-reported outcomes from admission to community living after discharge. The study may contribute to improving care for both patients’ subjective views of their own health conditions and their community lives in an acute psychiatric setting. Trial registration University Hospital Medical Information Network—Clinical Trials Registry (UMIN-CTR) UMIN000034220. Registered on September 20, 2018. Electronic supplementary material The online version of this article (10.1186/s13033-019-0298-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sosei Yamaguchi
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Yasutaka Ojio
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Junko Koike
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Asami Matsunaga
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Makoto Ogawa
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Hisateru Tachimori
- 2Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan.,3The Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo, 162-8655 Japan
| | - Akiko Kikuchi
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Hiroshi Kimura
- 4Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan.,Department of Psychiatry, Gakuji-kai, Kimura Hospital, 6-19 Higashi-honcho, Chuo-ku, Chiba, 260-8670 Japan
| | - Ataru Inagaki
- 6College of Education, Psychology and Human Studies, Aoyama Gakuin University, 4-4-25 Shibuya, Shibuya-ku, Tokyo, 150-8366 Japan
| | - Hiroyuki Watanabe
- Department of Psychiatry, Gakuji-kai, Kimura Hospital, 6-19 Higashi-honcho, Chuo-ku, Chiba, 260-8670 Japan.,7Division of Medical Treatment and Rehabilitation, Center of Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Yoshiki Kishi
- 8Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikata-Honmachi, Kita-ku, Okayama, Japan
| | - Koji Yoshida
- 9Department of Human Care and Support, Toyo University, 48-1 Oka, Asaka, 351-8510 Japan
| | - Takaaki Hirooka
- 10Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami, Sagamihara, 252-0374 Japan
| | - Satoru Oishi
- 10Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami, Sagamihara, 252-0374 Japan
| | - Yasuhiro Matsuda
- 11Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo, Kashihara, 634-8521 Japan
| | - Chiyo Fujii
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
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26
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Priebe S, Miglietta E. Assessment and determinants of patient satisfaction with mental health care. World Psychiatry 2019; 18:30-31. [PMID: 30600613 PMCID: PMC6313237 DOI: 10.1002/wps.20586] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Elisabetta Miglietta
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
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27
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Reichert A, Jacobs R. The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England. HEALTH ECONOMICS 2018; 27:1772-1787. [PMID: 30014544 PMCID: PMC6221005 DOI: 10.1002/hec.3800] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 05/16/2018] [Accepted: 06/15/2018] [Indexed: 05/25/2023]
Abstract
Recently, new emphasis was put on reducing waiting times in mental health services as there is an ongoing concern that longer waiting time for treatment leads to poorer health outcomes. However, little is known about delays within the mental health service system and its impact on patients. We explore the impact of waiting times on patient outcomes in the context of early intervention in psychosis (EIP) services in England from April 2012 to March 2015. We use the Mental Health Services Data Set and the routine outcome measure the Health of the Nation Outcome Scale. In a generalised linear regression model, we control for baseline outcomes, previous service use, and treatment intensity to account for possible endogeneity in waiting time. We find that longer waiting time is significantly associated with a deterioration in patient outcomes 12 months after acceptance for treatment for patients that are still in EIP care. Effects are strongest for waiting times longer than 3 months, and effect sizes are small to moderate. Patients with shorter treatment periods are not affected. The results suggest that policies should aim to reduce excessively long waits in order to improve outcomes for patients waiting for treatment for psychosis.
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28
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Spanish translation and analysis of the metric properties of inpatient satisfaction scale in psychiatry: The Satispsy-22-E. Psychiatry Res 2018; 268:8-14. [PMID: 29986179 DOI: 10.1016/j.psychres.2018.06.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/14/2018] [Accepted: 06/21/2018] [Indexed: 11/23/2022]
Abstract
The Satispsy-22 scale is an instrument created for the specific evaluation of psychiatric inpatient satisfaction. Therefore, the study aims to carry out the Satispsy-22 scientific translation to Spanish and to learn its psychometric properties. The Satipsy-22-E was administered to discharged patients from four units of acute psychiatric admission, a unit of dual pathology and two units of subacute psychiatric admission (N = 268). Cronbach's alpha was 0.886, which can be interpreted as good internal reliability. All the dimensions showed a good internal consistency with scores from 0.722 to 0.919. Test-retest offered scores of 0.752-0.951 showing good stability. Confirmatory factor analysis showed that all elements load in the estimated dimensions of the original scale and these were significant and the adjustment measures showed, in general, a rather good adjustment, Root Mean Square Error (RMSE) showed that the error between observations and actual data is small and acceptable. Satispsy-22-E is a specific scale in Spanish language for the assessment of psychiatric inpatient satisfaction. It is an easy to use tool that offers good psychometric properties. The availability of a validated survey in Spanish may help to improve the care provided by psychiatric wards in Spanish-speaking countries.
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29
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Leendertse P, Myin-Germeys I, Lataster T, Simons CJP, Oorschot M, Lardinois M, Schneider M, van Os J, Reininghaus U. Subjective quality of life in psychosis: Evidence for an association with real world functioning? Psychiatry Res 2018; 261:116-123. [PMID: 29291477 DOI: 10.1016/j.psychres.2017.11.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/26/2017] [Accepted: 11/26/2017] [Indexed: 11/28/2022]
Abstract
Subjective quality of life (SQOL) is an established patient-reported outcome in psychosis. However, current self-report measures of SQOL may be affected by recall bias and may not fully capture dynamic changes in SQOL over time. This study aimed to examine the ecological validity of self-reported and momentary assessment measures of SQOL, and their association with emotional experience, social interaction and activity in real life, in both patients with psychotic disorder (n = 56) and controls (n = 71). Self-reported QOL was assessed with the WHO-QOL, momentary QOL and real life experiences were assessed with the Experience Sampling Method (ESM). Results show that both measures were significantly associated in patients and controls, and associations with emotional experience were most relevant, momentary QOL being a stronger predictor than self-reported QOL. The association between momentary QOL and negative affect was stronger in patients than in controls. Overall, momentary QOL was more consistently associated with affect, social interaction and activity, while self-reported QOL displayed a more narrow association with mostly affect. Concluding, concurrent assessment of self-reported QOL and momentary QOL showed that momentary QOL may enhance the ecological validity of SQOL measurement. Experience sampling research may broaden our perspective on SQOL and its associations with real life functioning.
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Affiliation(s)
- Pien Leendertse
- Emergis, Institute for Mental Health Care Zeeland, Goes, The Netherlands.
| | - Inez Myin-Germeys
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Tineke Lataster
- Maastricht University Medical Center, Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Claudia J P Simons
- Maastricht University Medical Center, Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands; GGzE, Institute for Mental Health Care Eindhoven and De Kempen, Eindhoven, The Netherlands
| | - Margreet Oorschot
- Maastricht University Medical Center, Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Mariëlle Lardinois
- Maastricht University Medical Center, Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Maude Schneider
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Jim van Os
- Maastricht University Medical Center, Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands; Center for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ulrich Reininghaus
- Maastricht University Medical Center, Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands; Center for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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30
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Rho SS, Woo YS, Bahk WM. Ginkgo biloba induced mood dysregulation: a case report. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:14. [PMID: 29334964 PMCID: PMC5769324 DOI: 10.1186/s12906-018-2081-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 01/03/2018] [Indexed: 01/12/2023]
Abstract
Background Impairment of cognitive function as well as negative symptom is the major factor causing the decline of a patient’s functioning in chronic stages of schizophrenia. However, until now, there were no definite treatment options that could effectively reduce the impairment. Case presentation We report a case of mood dysregulation associated with use of Ginkgo biloba in a patient with schizophrenia. After Ginkgo biloba was given, the patient experienced cluster symptoms of mood dysregulation including irritability, difficulty in controlling anger, agitation and restlessness. We estimated the possibility as “probable” according to Naranjo scale considering circumstantial evidence. Conclusions This case suggests that Ginkgo biloba may have caused mood dysregulation in this patient. Although it is generally accepted as safe, more attention should be given to the adverse effect when treating with Ginkgo biloba.
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31
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Vermeulen JM, Schirmbeck NF, van Tricht MJ, de Haan L. Satisfaction of psychotic patients with care and its value to predict outcomes. Eur Psychiatry 2017; 47:60-66. [PMID: 29102660 DOI: 10.1016/j.eurpsy.2017.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND A key indicator of quality of treatment from the patient's perspective is expressed by satisfaction with care. Our aim was to (i) explore satisfaction and its relation to clinical outcome measures; and (ii) explore the predictive value of satisfaction for the course of outcomes over three years. METHODS Data of 654 patients with a non-affective psychosis included in a naturalistic longitudinal cohort study were analyzed. We included 506 males and 148 females with a mean age of 30.47 (SD 7.24) from The Netherlands. Satisfaction was measured with the self-rating Client Satisfaction Questionnaire-8. A wide range of interviewer-rated (e.g., Positive and Negative Symptom Scale) and self-rated (e.g., World Health Organization Quality of Life); outcomes of low, intermediate and high satisfied patients were compared using ANOVA, Chi2 or Kruskal-Wallis tests. The predictive value of satisfaction level on clinical outcomes after three years was tested using regression models. RESULTS Satisfaction levels were low (19.4%), intermediate (48.9%) or high (31.7%). High satisfied patients showed significantly better interviewer-rated outcomes, e.g., less severe psychotic symptoms, and self-rated outcomes, e.g., better quality of life, compared to patients with intermediate or low satisfaction. Higher levels of satisfaction with care at baseline predicted a reduction of positive symptoms three years later (B=-.09, P-value=.013). CONCLUSIONS Satisfaction of patients with psychosis is a valuable monitoring measure since high satisfied patients show more favorable outcomes ranging from psychopathological symptoms to quality of life. Further research into explanations of lower levels of satisfaction is commendable in order to improve outcomes.
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Affiliation(s)
- J M Vermeulen
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - N F Schirmbeck
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M J van Tricht
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - L de Haan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | -
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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32
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Krupchanka D, Khalifeh H, Abdulmalik J, Ardila-Gómez S, Armiya'u AY, Banjac V, Baranov A, Bezborodovs N, Brecic P, Čavajda Z, de Girolamo G, Denisenko M, Dickens HA, Dujmovic J, Ergovic Novotny D, Fedotov I, Fernández MA, Frankova I, Gasparovic M, Giurgi-Oncu C, Grahovac T, James BO, Jomli R, Kekin I, Knez R, Lanfredi M, Lassman F, Mehta N, Nacef F, Nawka A, Nemirovsky M, Ola BA, Oshodi YO, Ouali U, Peharda T, Razic Pavicic A, Rojnic Kuzman M, Roventa C, Shamenov R, Smirnova D, Smoljanic D, Spikina A, Thornicroft A, Tomicevic M, Vidovic D, Williams P, Yakovleva Y, Zhabenko O, Zhilyaeva T, Zivkovic M, Thornicroft G, Sartorius N. Satisfaction with psychiatric in-patient care as rated by patients at discharge from hospitals in 11 countries. Soc Psychiatry Psychiatr Epidemiol 2017; 52:989-1003. [PMID: 28285452 DOI: 10.1007/s00127-017-1366-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 02/16/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE There is disregard in the scientific literature for the evaluation of psychiatric in-patient care as rated directly by patients. In this context, we aimed to explore satisfaction of people treated in mental health in-patient facilities. The project was a part of the Young Psychiatrist Program by the Association for the Improvement of Mental Health Programmes. METHODS This is an international multicentre cross-sectional study conducted in 25 hospitals across 11 countries. The research team at each study site approached a consecutive target sample of 30 discharged patients to measure their satisfaction using the five-item study-specific questionnaire. Individual and institution level correlates of 'low satisfaction' were examined by comparisons of binary and multivariate associations in multilevel regression models. RESULTS A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards the upper end of the scale, with a median total score of 44 (interquartile range 38-48) out of 50. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio. CONCLUSION Further studies on patients' satisfaction should additionally pay attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients' disempowerment, and power imbalance.
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Affiliation(s)
- Dzmitry Krupchanka
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic. .,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Hind Khalifeh
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Sara Ardila-Gómez
- Research Institute, School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Visnja Banjac
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, Banjaluka, Bosnia and Herzegovina
| | | | | | | | - Zoran Čavajda
- Department of Acute and Biological Psychiatry, Clinical Hospital Centre Osijek, Osijek, Croatia
| | - Giovanni de Girolamo
- Unit of Psychiatric Epidemiology and Evaluation, Saint John of God Clinical Research Centre, Brescia, Italy
| | - Maria Denisenko
- Mental Health Clinic No1, Nizhny Novgorod, Russian Federation
| | | | | | | | - Ilya Fedotov
- Ryazan State Medical University, Ryazan, Russian Federation
| | - Marina A Fernández
- Research Institute, School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | | | | | - Catalina Giurgi-Oncu
- ″Victor Babes" University of Medicine and Pharmacy of Timisoara, Timisoara, Romania
| | | | - Bawo O James
- Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
| | - Rabaa Jomli
- Department of Psychiatry "A" at Razi Hospital, Manouba, Tunisia.,Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Ivana Kekin
- University Hospital Centre Zagreb, Zagreb, Croatia
| | - Rajna Knez
- University Hospital Center Rijeka, Rijeka, Croatia
| | - Mariangela Lanfredi
- Unit of Psychiatry, Saint John of God Clinical Research Centre, Brescia, Italy
| | | | | | - Fethi Nacef
- Department of Psychiatry "A" at Razi Hospital, Manouba, Tunisia.,Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Alexander Nawka
- Institute of Neuropsychiatric Care (INEP), Prague, Czech Republic
| | | | | | - Yewande O Oshodi
- Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Uta Ouali
- Department of Psychiatry "A" at Razi Hospital, Manouba, Tunisia.,Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | | | | | - Martina Rojnic Kuzman
- University Hospital Centre Zagreb, Zagreb, Croatia.,Zagreb School of Medicine, Zagreb, Croatia
| | | | | | - Daria Smirnova
- Department of Psychiatry, Samara State Medical University, Samara, Russian Federation
| | | | - Anna Spikina
- Medical University Named After I.I. Mechnikov, Saint Petersburg, Russian Federation
| | - Amalia Thornicroft
- Occupational Therapy Department, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Marko Tomicevic
- Neuropsychiatric Hospital "Dr. Ivan Barbot", Popovaca, Croatia
| | | | - Paul Williams
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Yulia Yakovleva
- Saint Petersburg Bekhterev Psychoneurological Research Institute, Saint Petersburg, Russian Federation
| | - Olena Zhabenko
- Railway Clinical Hospital #1 Station Kyiv, Kyiv, Ukraine
| | - Tatiana Zhilyaeva
- Department of Psychiatry and Medical Psychology, Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russian Federation
| | - Maja Zivkovic
- University Psychiatric Hospital Vrapce, Zagreb, Croatia
| | - Graham Thornicroft
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneve, Switzerland
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Lloyd J, Lloyd H, Fitzpatrick R, Peters M. Treatment outcomes in schizophrenia: qualitative study of the views of family carers. BMC Psychiatry 2017; 17:266. [PMID: 28732482 PMCID: PMC5521073 DOI: 10.1186/s12888-017-1418-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 07/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schizophrenia is a complex, heterogeneous disorder, with highly variable treatment outcomes, and relatively little is known about what is important to patients. The aim of the study was to understand treatment outcomes informal carers perceive to be important to people with schizophrenia. METHOD Qualitative interview study with 34 individuals and 8 couples who care for a person with schizophrenia/schizoaffective disorder. Interviews were transcribed verbatim and analysed by a thematic framework based approach. RESULTS Carers described well-recognised outcomes of importance, alongside more novel outcomes relating to: Safety (of the patient/others); insight (e.g. into non-reality of psychotic phenomena); respite from fear, distress or pain; socially acceptable behaviour; getting out of the house; attainment of life milestones; changes in personality and/or temperament; reduction of vulnerability to stress; and several aspects of physical health. CONCLUSIONS These findings have the potential to inform the development of patient- or carer- focused outcome measures that take into account the full range of domains that carers feel are important for patients.
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Affiliation(s)
- Joanne Lloyd
- School of Psychology, Sport and Exercise, Staffordshire University, Stoke on Trent, UK
| | - Helen Lloyd
- Peninsula Medical School, Plymouth University, Plymouth, Devon UK
| | - Ray Fitzpatrick
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
| | - Michele Peters
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
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Blanchard JJ, Bradshaw KR, Garcia CP, Nasrallah HA, Harvey PD, Casey D, Csoboth CT, Hudson JI, Julian L, Lentz E, Nuechterlein KH, Perkins DO, Skale TG, Snowden LR, Tandon R, Tek C, Velligan D, Vinogradov S, O'Gorman C. Examining the reliability and validity of the Clinical Assessment Interview for Negative Symptoms within the Management of Schizophrenia in Clinical Practice (MOSAIC) multisite national study. Schizophr Res 2017; 185:137-143. [PMID: 28087270 DOI: 10.1016/j.schres.2017.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 01/05/2017] [Accepted: 01/05/2017] [Indexed: 11/28/2022]
Abstract
The current study sought to expand on prior reports of the validity and reliability of the CAINS (CAINS) by examining its performance across diverse non-academic clinical settings as employed by raters not affiliated with the scale's developers and across a longer test-retest follow-up period. The properties of the CAINS were examined within the Management of Schizophrenia in Clinical Practice (MOSAIC) schizophrenia registry. A total of 501 participants with a schizophrenia spectrum diagnosis who were receiving usual care were recruited across 15 national Patient Assessment Centers and evaluated with the CAINS, other negative symptom measures, and assessments of functioning, quality of life and cognition. Temporal stability of negative symptoms was assessed across a 3-month follow-up. Results replicated the two-factor structure of the CAINS reflecting Motivation and Pleasure and expression symptoms. The CAINS scales exhibited high internal consistency and temporal stability. Convergent validity was supported by significant correlations between the CAINS subscales with other negative symptom measures. Additionally, the CAINS was significantly correlated with functioning and quality of life. Discriminant validity was demonstrated by small to moderate associations between the CAINS and positive symptoms, depression, and cognition (and these associations were comparable to those found with other negative symptom scales). Findings suggest that the CAINS is a reliable and valid tool for measuring negative symptoms in schizophrenia across diverse clinical samples and settings.
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Affiliation(s)
| | | | | | - Henry A Nasrallah
- Saint Louis University, 1438 S. Grand Boulevard, Saint Louis, MO 63104 3, USA
| | - Philip D Harvey
- University of Miami, Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136, USA
| | - Daniel Casey
- Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | | | - James I Hudson
- Harvard Medical School/McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Laura Julian
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Ellen Lentz
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Keith H Nuechterlein
- University of California, Los Angeles, 300 UCLA Medical Plaza, Los Angeles, CA 90095-6968, USA
| | | | - Tracey G Skale
- Greater Cincinnati Behavioral Health Services, 1501 Madison Road, Walnut Hills, OH 45206, USA
| | | | - Rajiv Tandon
- University of Florida, Gainesville, FL 32611, USA
| | - Cenk Tek
- Yale University/Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA
| | - Dawn Velligan
- University of Texas Health Science Center, 7703 Floyd Curl Dr. San Antonio, San Antonio, TX 78240, USA
| | - Sophia Vinogradov
- University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143, USA; San Francisco Veterans Administration Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA
| | - Cedric O'Gorman
- Formerly of Genentech. Currently at Intra-Cellular Therapies, Inc., 430 East 29th Street, New York City, NY 10016, USA
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35
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Taylor J, Böhnke JR, Wright J, Kellar I, Alderson SL, Hughes T, Holt RIG, Siddiqi N. A core outcome set for evaluating self-management interventions in people with comorbid diabetes and severe mental illness: study protocol for a modified Delphi study and systematic review. Trials 2017; 18:70. [PMID: 28196512 PMCID: PMC5309993 DOI: 10.1186/s13063-017-1805-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 01/14/2017] [Indexed: 12/31/2022] Open
Abstract
Background People with diabetes and comorbid severe mental illness (SMI) form a growing population at risk of increased mortality and morbidity compared to those with diabetes or SMI alone. There is increasing interest in interventions that target diabetes in SMI in order to help to improve physical health and reduce the associated health inequalities. However, there is a lack of consensus about which outcomes are important for this comorbid population, with trials differing in their focus on physical and mental health. A core outcome set, which includes outcomes across both conditions that are relevant to patients and other key stakeholders, is needed. Methods This study protocol describes methods to develop a core outcome set for use in effectiveness trials of self-management interventions for adults with comorbid type-2 diabetes and SMI. We will use a modified Delphi method to identify, rank, and agree core outcomes. This will comprise a two-round online survey and multistakeholder workshops involving patients and carers, health and social care professionals, health care commissioners, and other experts (e.g. academic researchers and third sector organisations). We will also select appropriate measurement tools for each outcome in the proposed core set and identify gaps in measures, where these exist. Discussion The proposed core outcome set will provide clear guidance about what outcomes should be measured, as a minimum, in trials of interventions for people with coexisting type-2 diabetes and SMI, and improve future synthesis of trial evidence in this area. We will also explore the challenges of using online Delphi methods for this hard-to-reach population, and examine differences in opinion about which outcomes matter to diverse stakeholder groups. Trial registration COMET registration: http://www.comet-initiative.org/studies/details/911. Registered on 1 July 2016
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Affiliation(s)
- Johanna Taylor
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, YO10 5DD, UK.
| | - Jan R Böhnke
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9LJ, UK
| | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Sarah L Alderson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9LJ, UK
| | - Tom Hughes
- Leeds and York Partnership NHS Foundation Trust, 2150 Century Way, Thorpe Park, Leeds, LS15 8ZB, UK
| | - Richard I G Holt
- Diabetes and Endocrinology, Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK.,University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Najma Siddiqi
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, YO10 5DD, UK.,Bradford District Care NHS Foundation Trust, New Mill, Victoria Road, Saltaire, Bradford, BD18 3LD, UK
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36
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Trousselard M, Steiler D, Dutheil F, Claverie D, Canini F, Fenouillet F, Naughton G, Stewart-Brown S, Franck N. Validation of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) in French psychiatric and general populations. Psychiatry Res 2016; 245:282-290. [PMID: 27565700 DOI: 10.1016/j.psychres.2016.08.050] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 08/16/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
Abstract
The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) has been validated in general population samples in many countries. Interest in using this measure in clinical populations is growing, particularly for tertiary prevention and mental health promotion. This paper reports validation of the French WEMWBS in healthy and chronic remitted schizophrenia populations. The French WEMWBS was administered to 319 workers, 75 students and 121 patients. For non-patients, self-reported Trait- and State-Anxiety, Mindfulness, Positive and Negative Affect and the General Health Questionnaire were completed. For patients, the Positive and Negative Syndrome Scale, Clinical Global Impression Severity Scale, Birchwood Insight Scale, Social Adjustment Scale, and Global Assessment of Functioning scale were completed. Test-retest reliability and responsiveness to intervention was assessed at 6 months. Whatever the sample, response frequencies showed normal distributions, and internal consistency was good (Cronbach's α). Scree plots of eigenvalues suggested a single factor in the samples. The one-dimensional solution yielded suboptimal fit indices. Construct validity was confirmed. Significant improvement in scores was observed before and after intervention. Test-retest variation was non-significant. Impairment of insight and cognition in the assessed patients implies that attention must be paid before applying WEMWBS to all patients. Nevertheless, WEMWBS proved valid and reliable in a further European population, suggesting transcultural validity for both monitoring and evaluation of interventions in healthy as well as chronic remitted schizophrenia populations.
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Affiliation(s)
- Marion Trousselard
- Département de Neurosciences et Contraintes Opérationnelles, BP 73, 91223 Brétigny sur Orge Cedex, France; APEMAC-EPSam UDL UFR SHS, Ile de Saulcy, 57045 Metz Cedex 1, France; Chaire de Mindfulness, Bien-être au Travail et Paix Économique, Grenoble École de Management, 12 rue Pierre Sémard, BP 127, 38003 Grenoble Cedex 01, France; École du Val de Grâce, 1 place A Lavéran, 75005 Paris, France.
| | - Dominique Steiler
- Chaire de Mindfulness, Bien-être au Travail et Paix Économique, Grenoble École de Management, 12 rue Pierre Sémard, BP 127, 38003 Grenoble Cedex 01, France; Département Homme, Organisations et Société, Grenoble École de Management, 12 rue Pierre Sémard, BP 127, 38003 Grenoble Cedex 01, France.
| | - Frédéric Dutheil
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Blaise Pascal University, Clermont-Ferrand, France; School of Exercise Science, Australian Catholic University, East Melbourne, Victoria, Australia; Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France; INRA, UNH, CRNH Auvergne, University of Auvergne, Clermont-Ferrand, France.
| | - Damien Claverie
- Département de Neurosciences et Contraintes Opérationnelles, BP 73, 91223 Brétigny sur Orge Cedex, France.
| | - Frédéric Canini
- Département de Neurosciences et Contraintes Opérationnelles, BP 73, 91223 Brétigny sur Orge Cedex, France; École du Val de Grâce, 1 place A Lavéran, 75005 Paris, France.
| | - Fabien Fenouillet
- Human and Artificial Cognition (CHArt UPON - EA 4004), University of Paris Nanterre La Défense, France.
| | - Geraldine Naughton
- Occupational Medicine, University Hospital CHU G. Montpied, Clermont-Ferrand, France.
| | - Sarah Stewart-Brown
- Division of Health Sciences, Warwick Medical School, University of Warwick, CV4 7AL Coventry, UK.
| | - Nicolas Franck
- Université de Lyon (Université Lyon 1), CNRS UMR 5229 & Centre Référent Lyonnais en Réhabilitation et en Remédiation Cognitive (CL3R), 4 rue Jean Sarrazin, 69008 Lyon, France.
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37
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Takeuchi H, Fervaha G, Remington G. Reliability of a patient-reported outcome measure in schizophrenia: Results from back-to-back self-ratings. Psychiatry Res 2016; 244:415-9. [PMID: 27543916 DOI: 10.1016/j.psychres.2016.07.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/28/2016] [Accepted: 07/09/2016] [Indexed: 10/21/2022]
Abstract
This study aimed to assess patient's capacity to perform a patient-reported outcome (PRO) measure (i.e., a self-rating scale) and examine its relationship with clinical characteristics including cognition. Fifty patients with schizophrenia were asked to rate the Subjective Well-being under Neuroleptics scale - Short form (SWNS) twice; the second rating was started immediately after they completed the first to minimize the gap between ratings. At the same time, the Positive and Negative Symptoms Scale (PANSS) and Brief Neurocognitive Assessment (BNA) were administered. The correlations between the two ratings for the SWNS total and each item scores were high (rs=0.94 and rs=0.60-0.84, respectively); however, for 16 (80%) of 20 items, 5 or more patients (i.e., ≥10%) demonstrated a>1 point score difference. There was no significant correlation between the SWNS total score difference and any clinical characteristics including age, education duration, illness duration, antipsychotic dose, psychopathology, and cognition. In contrast, the number of items with a>1 point score difference was significantly correlated with disorganized symptoms and overall severity (rs=0.29 for both), as well as working memory and global cognition (rs=-0.41 and rs=-0.40, respectively). These findings suggest that PROs should be interpreted with caution in patients with schizophrenia with prominent disorganization and cognitive impairment.
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Affiliation(s)
- Hiroyoshi Takeuchi
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
| | - Gagan Fervaha
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Gary Remington
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
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38
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Takeuchi H, Fervaha G, Lee J, Remington G. What symptom domains are associated with patient distress in schizophrenia? Schizophr Res 2016; 176:329-330. [PMID: 27261417 DOI: 10.1016/j.schres.2016.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Hiroyoshi Takeuchi
- Schizophrenia Division, Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
| | - Gagan Fervaha
- Schizophrenia Division, Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Jimmy Lee
- Department of General Psychiatry, Institute of Mental Health, Singapore; Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
| | - Gary Remington
- Schizophrenia Division, Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
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39
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Böhnke JR, Croudace TJ. Calibrating well-being, quality of life and common mental disorder items: psychometric epidemiology in public mental health research. Br J Psychiatry 2016; 209:162-8. [PMID: 26635327 PMCID: PMC4967770 DOI: 10.1192/bjp.bp.115.165530] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/04/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The assessment of 'general health and well-being' in public mental health research stimulates debates around relative merits of questionnaire instruments and their items. Little evidence regarding alignment or differential advantages of instruments or items has appeared to date. AIMS Population-based psychometric study of items employed in public mental health narratives. METHOD Multidimensional item response theory was applied to General Health Questionnaire (GHQ-12), Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and EQ-5D items (Health Survey for England, 2010-2012; n = 19 290). RESULTS A bifactor model provided the best account of the data and showed that the GHQ-12 and WEMWBS items assess mainly the same construct. Only one item of the EQ-5D showed relevant overlap with this dimension (anxiety/depression). Findings were corroborated by comparisons with alternative models and cross-validation analyses. CONCLUSIONS The consequences of this lack of differentiation (GHQ-12 v. WEMWBS) for mental health and well-being narratives deserves discussion to enrich debates on priorities in public mental health and its assessment.
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Affiliation(s)
- Jan R. Böhnke
- Correspondence: Jan R. Böhnke, Department of Health Sciences and Hull York Medical School, Mental Health and Addiction Research Group, University of York ARRC Area 4, Department of Health Sciences, York YO10 5DD, UK.
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40
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Gómez-de-Regil L. Psychometric properties of the Seville quality of life questionnaire in Mexican patients with psychosis. BMC Psychiatry 2016; 16:160. [PMID: 27225464 PMCID: PMC4880981 DOI: 10.1186/s12888-016-0877-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 05/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Seville Quality of Life Questionnaire (CSCV) was designed to assess quality of life in patients with schizophrenia taking into account those facets particularly important in this disorder. The study aimed at applying the CSCV to a sample of Mexican patients with psychosis in an effort further substantiates the psychometric properties of the CSCV. METHODS This cross-sectional study included 61 patients (56 % female) with psychosis. Item-scale and item-factor correlations were analyzed, as well as scale-factor correlations. Cronbach's Alpha and principal component analysis with varimax rotation were used to assess internal consistency and construct validity, respectively. RESULTS Analyses of both, disfavorable and favorable dimensions, showed a stronger item-scale than item-factor correlation, in most cases significant, though. Internal consistency was significant and adequate; higher for scales than for factors. For the disfavorable and the favorable scales 11 and 2 factors were obtained, respectively; explained variance was low. CONCLUSIONS In this sample of Mexican patients it was replicated that the CSCV is a valid and reliable instrument to assess quality of life in people with psychosis; the use of scale scores is recommended.
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Affiliation(s)
- Lizzette Gómez-de-Regil
- Hospital Regional de Alta Especialidad de la Península de Yucatán (HRAEPY), Calle 7, No. 433 por 20 y 22, Fraccionamiento Altabrisa, Mérida, Yucatán, 97130, Mexico.
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41
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Reininghaus U, Depp CA, Myin-Germeys I. Ecological Interventionist Causal Models in Psychosis: Targeting Psychological Mechanisms in Daily Life. Schizophr Bull 2016; 42:264-9. [PMID: 26707864 PMCID: PMC4753613 DOI: 10.1093/schbul/sbv193] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Integrated models of psychotic disorders have posited a number of putative psychological mechanisms that may contribute to the development of psychotic symptoms, but it is only recently that a modest amount of experience sampling research has provided evidence on their role in daily life, outside the research laboratory. A number of methodological challenges remain in evaluating specificity of potential causal links between a given psychological mechanism and psychosis outcomes in a systematic fashion, capitalizing on longitudinal data to investigate temporal ordering. In this article, we argue for testing ecological interventionist causal models that draw on real world and real-time delivered, ecological momentary interventions for generating evidence on several causal criteria (association, time order, and direction/sole plausibility) under real-world conditions, while maximizing generalizability to social contexts and experiences in heterogeneous populations. Specifically, this approach tests whether ecological momentary interventions can (1) modify a putative mechanism and (2) produce changes in the mechanism that lead to sustainable changes in intended psychosis outcomes in individuals' daily lives. Future research using this approach will provide translational evidence on the active ingredients of mobile health and in-person interventions that promote sustained effectiveness of ecological momentary interventions and, thereby, contribute to ongoing efforts that seek to enhance effectiveness of psychological interventions under real-world conditions.
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Affiliation(s)
- Ulrich Reininghaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK;
| | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, CA; VA San Diego Healthcare System, San Diego, CA
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven, Belgium
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Sandhu S, Killaspy H, Krotofil J, McPherson P, Harrison I, Dowling S, Arbuthnott M, Curtis S, King M, Leavey G, Shepherd G, Priebe S. Development and psychometric properties of the client's assessment of treatment scale for supported accommodation (CAT-SA). BMC Psychiatry 2016; 16:43. [PMID: 26911904 PMCID: PMC4766675 DOI: 10.1186/s12888-016-0755-3] [Citation(s) in RCA: 8] [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: 10/13/2015] [Accepted: 02/17/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Patient-Reported Outcome Measures (PROMs) are important for evaluating mental health services. Yet, no specific PROM exists for the large and diverse mental health supported accommodation sector. We aimed to produce and validate a PROM specifically for supported accommodation services, by adapting the Client's Assessment of Treatment Scale (CAT) and assessing its psychometric properties in a large sample. METHODS Focus groups with service users in the three main types of mental health supported accommodation services in the United Kingdom (residential care, supported housing and floating outreach) were conducted to adapt the contents of the original CAT items and assess the acceptability of the modified scale (CAT-SA). The CAT-SA was then administered in a survey to service users across England. Internal consistency was assessed using Cronbach's alpha. Convergent validity was tested through correlations with subjective quality of life and satisfaction with accommodation, as measured by the Manchester Short Assessment of Quality of Life (MANSA). RESULTS All seven original items of the CAT were regarded as relevant to appraisals of mental health supported accommodation services, with only slight modifications to the wording required. In the survey, data were obtained from 618 clients. The internal consistency of the CAT-SA items was 0.89. Mean CAT-SA scores were correlated with the specific accommodation item on the MANSA (r s = 0.37, p ˂ .001). CONCLUSIONS The content of the CAT-SA has relevance to service users living in mental health supported accommodation. The findings from our large survey show that the CAT-SA is acceptable across different types of supported accommodation and suggest good psychometric properties. The CAT-SA appears a valid and easy to use PROM for service users in mental health supported accommodation services.
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Affiliation(s)
- Sima Sandhu
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, UK.
| | - Helen Killaspy
- Division of Psychiatry, University College London, London, UK.
| | - Joanna Krotofil
- Division of Psychiatry, University College London, London, UK.
| | - Peter McPherson
- Division of Psychiatry, University College London, London, UK.
| | - Isobel Harrison
- Division of Psychiatry, University College London, London, UK.
| | - Sarah Dowling
- Division of Psychiatry, University College London, London, UK.
| | - Maurice Arbuthnott
- North London Service User Research Forum, Division of Psychiatry, University College London, London, UK.
| | - Sarah Curtis
- Department of Geography, Durham University, Durham, UK.
| | - Michael King
- Division of Psychiatry, University College London, London, UK.
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Londonderry, UK.
| | | | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, UK.
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Williams J, Leamy M, Pesola F, Bird V, Le Boutillier C, Slade M. Psychometric evaluation of the Questionnaire about the Process of Recovery (QPR). Br J Psychiatry 2015; 207:551-5. [PMID: 26450585 DOI: 10.1192/bjp.bp.114.161695] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/13/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Supporting recovery is the aim of national mental health policy in many countries. However, only one measure of recovery has been developed in England: the Questionnaire about the Process of Recovery (QPR), which measures recovery from the perspective of adult mental health service users with a psychosis diagnosis. AIMS To independently evaluate the psychometric properties of the 15- and 22-item versions of the QPR. METHOD Two samples were used: data-set 1 (n = 88) involved assessment of the QPR at baseline, 2 weeks and 3 months. Data-set 2 (n = 399; trial registration: ISRCTN02507940) involved assessment of the QPR at baseline and 1 year. RESULTS For the 15-item version, internal consistency was 0.89, convergent validity was 0.73, test-retest reliability was 0.74 and sensitivity to change was 0.40. Confirmatory factor analysis showed the 15-item version offered a good fit. For the 22-item version, the interpersonal subscale was found to underperform and the intrapersonal subscale overlaps substantially with the 15-item version. CONCLUSIONS Both the 15-item and the intrapersonal subscale of the 22-item versions of the QPR demonstrated satisfactory psychometric properties. The 15-item version is slightly more robust and also less burdensome, so it can be recommended for use in research and clinical practice.
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Affiliation(s)
- Julie Williams
- Julie Williams, MSc, Mary Leamy, PhD, Francesca Pesola, PhD, Victoria Bird, PhD, Clair Le Boutillier, MSc, Mike Slade, PhD, King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Mary Leamy
- Julie Williams, MSc, Mary Leamy, PhD, Francesca Pesola, PhD, Victoria Bird, PhD, Clair Le Boutillier, MSc, Mike Slade, PhD, King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Francesca Pesola
- Julie Williams, MSc, Mary Leamy, PhD, Francesca Pesola, PhD, Victoria Bird, PhD, Clair Le Boutillier, MSc, Mike Slade, PhD, King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Victoria Bird
- Julie Williams, MSc, Mary Leamy, PhD, Francesca Pesola, PhD, Victoria Bird, PhD, Clair Le Boutillier, MSc, Mike Slade, PhD, King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Clair Le Boutillier
- Julie Williams, MSc, Mary Leamy, PhD, Francesca Pesola, PhD, Victoria Bird, PhD, Clair Le Boutillier, MSc, Mike Slade, PhD, King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Mike Slade
- Julie Williams, MSc, Mary Leamy, PhD, Francesca Pesola, PhD, Victoria Bird, PhD, Clair Le Boutillier, MSc, Mike Slade, PhD, King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Paludetto M, Camuccio CA, Cutrone F, Cocchio S, Baldo V. Can we have routine measurement of patient satisfaction in acute psychiatric settings? A cross sectional study. Arch Psychiatr Nurs 2015; 29:447-53. [PMID: 26577561 DOI: 10.1016/j.apnu.2015.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 07/06/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022]
Abstract
Patient satisfaction is considered an important indicator of the quality of care in psychiatric services. Its importance has been widely studied, but the literature identifies methodological problems deriving from samples with low response rates and exclusion criteria which would seem to imply a kind of exclusion in the evaluations of less compliant patients. The aim of this study is to test a methodology to assess patient satisfaction with the quality of care received at an acute psychiatric ward in terms of its application in daily routine. In this cross sectional survey inpatients were given the Rome Opinion Questionnaire (ROQ). Our patients, involuntary patients included, with a 92.3% participation rate (47 patients out of 51), returned a mean general satisfaction score of 7.7/9. This response rate is higher than that reported in most previously published studies, which shows that a good level of both voluntary and involuntary patient participation may be achieved when an appropriate methodological approach is adopted. Not acknowledging patient satisfaction reduces the possibility of more effective caring actions. Measuring patient satisfaction, through use of short questionnaires, should become a routine in daily practice.
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Affiliation(s)
- Marta Paludetto
- East Kent Hospitals University, William Harvey Hospital, Cambridge J Ward, Kennington Road, Willesborough, Ashford, Kent, England.
| | - Carlo Alberto Camuccio
- University of Padua, School of Medicine, Corso di Laurea in Infermieristica c/o Unità Locale Socio Sanitaria 12 Veneziana, Piazzale San Lorenzo Giustiniani 11/E, Venezia/Mestre, Italy.
| | - Francesco Cutrone
- Acute Psychiatric Ward, Department of Mental Health of Venice, Unità Locale Socio Sanitaria 12 Veneziana, Cannaregio 6000, Venezia, Italy.
| | - Silvia Cocchio
- Department Molecular Medicine, Section of Public Health - University of Padua, via Loredan 18, Padova, Italy.
| | - Vincenzo Baldo
- Department of Molecular Medicine, Section of Public Health - University of Padua, via Loredan 18, Padova, Italy.
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Kuokkanen R, Aho-Mustonen K, Muotka J, Lappalainen R, Tiihonen J. A Pilot Study of Group Administered Metacognitive Training (MCT) for Schizophrenia Patients in a High-Security Forensic Setting: Subjective Training Success and Health-Related Quality of Life. JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE 2015. [DOI: 10.1080/15228932.2015.1053546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Revicki DA, Kleinman L, Cella D. A history of health-related quality of life outcomes in psychiatry. DIALOGUES IN CLINICAL NEUROSCIENCE 2015. [PMID: 25152652 PMCID: PMC4140507 DOI: 10.31887/dcns.2014.16.2/drevicki] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Health-related quality of life (HRQoL) is a multidimensional concept that includes subjective reports of symptoms, side effects, functioning in multiple life domains, and general perceptions of life satisfaction and quality. Rather than estimating it from external observations, interview, or clinical assessment, it is best measured by direct query. Due to a perception that respondents may not be reliable or credible, there has been some reluctance to use self-report outcomes in psychiatry. More recently, and increasingly, HRQoL assessment through direct patient query has become common when evaluating a range of psychiatric, psychological, and social therapies. With few exceptions, psychiatric patients are credible and reliable reporters of this information. This article summarizes studies that highlight the development, validation, and application of HRQoL measures in psychiatry. Thoughtful application of these tools in psychiatric research can provide a much-needed patient perspective in the future of comparative effectiveness research, patient-centered outcomes research, and clinical care.
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Affiliation(s)
| | | | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA
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Factors of psychological distress: clinical value, measurement substance, and methodological artefacts. Soc Psychiatry Psychiatr Epidemiol 2015; 50:515-24. [PMID: 25682108 DOI: 10.1007/s00127-015-1022-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 02/07/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE Psychometric models and statistical techniques are cornerstones of research into latent structures of specific psychopathology and general mental health. We discuss "pivot points" for future research efforts from a psychometric epidemiology perspective, emphasising sampling and selection processes of both indicators that guide data collection as well as samples that are confronted with them. METHOD First, we discuss how a theoretical model of psychopathology determines which empirical indicators (questions, diagnoses, etc.) and modelling methods are appropriate to test its implications. Second, we deal with how different research designs introduce different (co-)variances between indicators, potentially leading to a different understanding of latent structures. Third, we discuss widening the range of statistical models available within the "psychometrics class": the inclusion of categorical approaches can help to enlighten the debate on the structure of psychopathology and agreement on a minimal set of models might lead to greater convergence between studies. Fourth, we deal with aspects of methodology that introduce spurious (co-)variance in latent structure analysis (response styles, clustered data) and differential item functioning to gather more detailed information and to guard against over-generalisation of results, which renders assessments unfair. CONCLUSIONS Building on established insights, future research efforts should be more explicit about their theoretical understanding of psychopathology and how the analysis of a given indicator-respondent set informs this theoretical model. A coherent treatment of theoretical assumptions, indicators, and samples holds the key to building a comprehensive account of the latent structures of different types of psychopathology and mental health in general.
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Bejerot S, Edman G, Anckarsäter H, Berglund G, Gillberg C, Hofvander B, Humble MB, Mörtberg E, Råstam M, Ståhlberg O, Frisén L. The Brief Obsessive-Compulsive Scale (BOCS): a self-report scale for OCD and obsessive-compulsive related disorders. Nord J Psychiatry 2014; 68:549-59. [PMID: 24568661 PMCID: PMC4221004 DOI: 10.3109/08039488.2014.884631] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive-compulsive symptoms and diagnosis of obsessive-compulsive disorder (OCD). It is widely used throughout child, adolescent and adult psychiatry settings in Sweden but has not been validated up to date. AIM The aim of the current study was to examine the psychometric properties of the BOCS amongst a psychiatric outpatient population. METHOD The BOCS consists of a 15-item Symptom Checklist including three items (hoarding, dysmorphophobia and self-harm) related to the DSM-5 category "Obsessive-compulsive related disorders", accompanied by a single six-item Severity Scale for obsessions and compulsions combined. It encompasses the revisions made in the Y-BOCS-II severity scale by including obsessive-compulsive free intervals, extent of avoidance and excluding the resistance item. 402 adult psychiatric outpatients with OCD, attention-deficit/hyperactivity disorder, autism spectrum disorder and other psychiatric disorders completed the BOCS. RESULTS Principal component factor analysis produced five subscales titled "Symmetry", "Forbidden thoughts", "Contamination", "Magical thoughts" and "Dysmorphic thoughts". The OCD group scored higher than the other diagnostic groups in all subscales (P < 0.001). Sensitivities, specificities and internal consistency for both the Symptom Checklist and the Severity Scale emerged high (Symptom Checklist: sensitivity = 85%, specificities = 62-70% Cronbach's α = 0.81; Severity Scale: sensitivity = 72%, specificities = 75-84%, Cronbach's α = 0.94). CONCLUSIONS The BOCS has the ability to discriminate OCD from other non-OCD related psychiatric disorders. The current study provides strong support for the utility of the BOCS in the assessment of obsessive-compulsive symptoms in clinical psychiatry.
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Affiliation(s)
- Susanne Bejerot
- Susanne Bejerot, M.D., Ph.D., Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden
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Negative affectivity as a transdiagnostic factor in patients with common mental disorders. J Affect Disord 2014; 166:270-8. [PMID: 25012441 DOI: 10.1016/j.jad.2014.05.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/17/2014] [Accepted: 05/19/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Screening and monitoring systems are increasingly used in psychotherapy, but it has been questioned whether outcome measurement using multiple questionnaires is warranted. Arguably, type and number of assessment instruments should be determined by empirical research. This study investigated the latent factor structure of a multi-dimensional outcome measurement strategy used in English services aligned to the Improving Access to Psychological Therapies (IAPT) programme. METHODS Factor analyses and structural equation models were performed on 11,939 intake assessments of outpatients accessing an IAPT service between 2008 and 2010. We examined whether three routinely employed instruments (PHQ-9 for depression, GAD-7 for anxiety, WSAS for functional impairment) assess empirically different dimensions. RESULTS The instruments were found to assess mainly one general dimension and only some items of the GAD-7 and WSAS assess unique variance beyond this general dimension. In a structural equation model the disorder-specific factor scores were predicted by patients׳ diagnostic categories. LIMITATIONS Since a large naturalistic data base was used, missing data for diagnoses and scale items were encountered. Diagnoses were obtained with brief case-finding measures rather than structured diagnostic interviews. CONCLUSION Although the items seem to address mostly one dimension, some variance is due to differences between individuals in anxiety and impairment. While this generally supports multi-dimensional assessment in a primary care population, the clinical upshot of the study is to concentrate attention on transdiagnostic factors as a target for treatment.
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Raij TT, Korkeila J, Joutsenniemi K, Saarni SI, Riekki TJ. Association of stigma resistance with emotion regulation - functional magnetic resonance imaging and neuropsychological findings. Compr Psychiatry 2014; 55:727-35. [PMID: 24290886 PMCID: PMC4712360 DOI: 10.1016/j.comppsych.2013.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 10/14/2013] [Accepted: 10/20/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND [corrected] Personal characteristics contribute to whether negative attitudes in society are internalized as deteriorating self-stigma. Studies in healthy subjects suggest that resilience is associated with the regulation of amygdala activation by the medial prefrontal cortex (mPFC), but little is known about the factors that contribute to individual stigma resistance in psychiatric patients. METHODS We assessed stigma (by measuring association strengths between social inferiority and schizophrenia by an implicit association test) in 20 patients with schizophrenia and in 16 age- and sex-matched healthy control subjects. The brain activation strengths were measured by functional magnetic resonance imaging during evaluation of schizophrenia-related statements and of control statements. RESULTS Association strengths between social inferiority and schizophrenia were inversely related to the strength of the activation of the rostro-ventral mPFC. This inverse correlation survived adjustment for global functioning, depression symptom scores, and insight. Activation of the rostro-ventral mPFC was negatively correlated with activation of the amygdala. The association strengths between social inferiority and schizophrenia correlated with the compromised performance in a Stroop task, which is a measure of cognitive regulation. DISCUSSION Our findings suggest that individual stigma resistance is associated with emotion regulation. These findings may help to understand better stigma resistance and thereby aid the development of patient interventions that add to the public anti-stigma work in reducing devastating effects of stigma.
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Affiliation(s)
- Tuukka T. Raij
- Department of Psychiatry, Helsinki University Central Hospital, Finland
,Brain Research Unit, O.V. Lounasmaa Laboratory and Advanced Magnetic Imaging Centre, Aalto University, Finland
,Corresponding author. Brain Research Unit, O.V. Lounasmaa Laboratory, Aalto University School of Science, P.O. Box 15100, FI-00076 AALTO, Finland. tel: +358-40-7634251, fax: +358-9-47163744 ,
| | - Jyrki Korkeila
- Department of Psychiatry, University of Turku
,Harjavalta Hospital, Satakunta Hospital district, Finland
| | | | - Samuli I. Saarni
- Department of Psychiatry, Helsinki University Central Hospital, Finland
,National institute for health and welfare, department of mental health and substance abuse services, Helsinki, Finland
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