1
|
Seelen-de Lang B, de Jong C, Hutschemaekers G, Didden R, Noorthoorn E. TAPS-tool reveals severe under detection of substance use problems in patients with severe mental illness. PLoS One 2024; 19:e0305142. [PMID: 39047031 PMCID: PMC11268639 DOI: 10.1371/journal.pone.0305142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/25/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Substance use disorders (SUD) and associated problems are highly prevalent but often undetected in patients with Severe Mental Illness (SMI). This study investigates the prevalence, under-detection, and variables associated with a high risk of SUD in a Dutch sample of adult outpatient SMI patients (N = 83). METHODS Substance use (The Tobacco, Alcohol, Prescription medication, and other Substance use -TAPS-tool), quality of life (Manchester Short Assessment of Quality of Life-MANSA), general functioning (Health of the Nation Outcome Scale-HoNOS), DSM-5 classifications and patient characteristics (age, education, marital status) were assessed. Detection of SUD was determined by calculating % agreement of DSM-5 classification to TAPS outcome. A logistic regression analysis was performed to determine the association of patient characteristics, quality of life and general functioning to an increased risk of SUD as determined by the TAPS. RESULTS Concerning prevalence, 89% of the patients used tobacco, above guideline-recommended daily limits of alcohol, illicit drugs or prescription medications for nonmedical purposes. Almost all smokers, half of the alcohol users and three-quarter of the patients that use marihuana or stimulant drugs had a high risk of SUD. All patients with high risk of SUD associated with alcohol, drugs or medications also had SUD associated with tobacco use. Concerning under detection less than half of the patients with a high risk of SUD according the TAPS had a SUD in their DSM-5 classification. Gender, partner, age and satisfaction about the relationship with family had a significant association with a high risk of SUD. CONCLUSIONS Screening for addiction in an SMI sample with the TAPS-tool revealed a high prevalence of substance use and a high risk of SUD. TAPS outcomes compared to the clinically obtained DSM-5 classification revealed a high degree of under-detection of substance use problems. Smoking seems to pose a specific additional risk of addiction and deserves more attention in treatment to achieve greater health care benefits.
Collapse
Affiliation(s)
- Birgit Seelen-de Lang
- GGZ Oost Brabant, Boekel, The Netherlands
- Behavioural Science Institute (BSI), Radboud University, Nijmegen, The Netherlands
| | - Cor de Jong
- Behavioural Science Institute (BSI), Radboud University, Nijmegen, The Netherlands
| | - Giel Hutschemaekers
- Behavioural Science Institute (BSI), Radboud University, Nijmegen, The Netherlands
| | - Robert Didden
- GGZ Oost Brabant, Boekel, The Netherlands
- Behavioural Science Institute (BSI), Radboud University, Nijmegen, The Netherlands
| | | |
Collapse
|
2
|
Foster M, Fix GM, Hyde J, Dunlap S, Byrne TH, Sugie NF, Kuhn R, Gabrielian S, Roncarati JS, Zhao S, McInnes DK. Capturing the Dynamics of Homelessness Through Ethnography and Mobile Technology: Protocol for the Development and Testing of a Smartphone Technology-Supported Intervention. JMIR Res Protoc 2024; 13:e53022. [PMID: 38648101 PMCID: PMC11074893 DOI: 10.2196/53022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/23/2024] [Accepted: 02/22/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND US military veterans who have experienced homelessness often have high rates of housing transition. Disruptions caused by these transitions likely exacerbate this population's health problems and interfere with access to care and treatment engagement. Individuals experiencing homelessness increasingly use smartphones, contributing to improved access to medical and social services. Few studies have used smartphones as a data collection tool to systematically collect information about the daily life events that precede and contribute to housing transitions, in-the-moment emotions, behaviors, geographic movements, and perceived social support. OBJECTIVE The study aims to develop and test a smartphone app to collect longitudinal data from veterans experiencing homelessness (VEH) and to evaluate the feasibility and acceptability of using the app in a population that is unstably housed or homeless. METHODS This study's design had 3 phases. Phase 1 used ethnographic methods to capture detailed data on day-to-day lived experiences of up to 30 VEH on topics such as housing stability, health, and health behaviors. Phase 2 involved focus groups and usability testing to develop and refine mobile phone data collection methods. Phase 3 piloted the smartphone mobile data collection with 30 VEH. We included mobile ethnography, real-time surveys through an app, and the collection of GPS data in phase 3. RESULTS The project was launched in June 2020, and at this point, some data collection and analysis for phases 1 and 2 are complete. This project is currently in progress. CONCLUSIONS This multiphase study will provide rich data on the context and immediate events leading to housing transitions among VEH. This study will ensure the development of a smartphone app that will match the actual needs of VEH by involving them in the design process from the beginning. Finally, this study will offer important insights into how best to develop a smartphone app that can help intervene among VEH to reduce housing transitions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53022.
Collapse
Affiliation(s)
- Marva Foster
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, United States
- Department of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Gemmae M Fix
- Department of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
| | - Justeen Hyde
- Department of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
| | - Shawn Dunlap
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
| | - Thomas H Byrne
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
- Department of Social Welfare Policy, Boston University School of Social Work, Boston, MA, United States
| | - Naomi F Sugie
- Department of Criminology, Law and Society, University of California Irvine, Irvine, CA, United States
| | - Randall Kuhn
- Department of Community Health Services, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
| | - Sonya Gabrielian
- Department of Mental Health, VA Greater Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Jill S Roncarati
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
- Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, MA, United States
- Boston Health Care for the Homeless Program, Boston, MA, United States
| | - Shibei Zhao
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
| | - D Keith McInnes
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States
| |
Collapse
|
3
|
Coronado-Montoya S, Abdel-Baki A, Côté J, Crockford D, Dubreucq S, Fischer B, Lachance-Touchette P, Lecomte T, L'Heureux S, Ouellet-Plamondon C, Roy MA, Tatar O, Tibbo P, Villeneuve M, Wittevrongel A, Jutras-Aswad D. Evaluation of a Cannabis Harm Reduction Intervention for People With First-Episode Psychosis: Protocol for a Pilot Multicentric Randomized Trial. JMIR Res Protoc 2023; 12:e53094. [PMID: 38109196 PMCID: PMC10758938 DOI: 10.2196/53094] [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: 09/25/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Cannabis use is highly prevalent in young people with first-episode psychosis (FEP). Most report cannabis use and are often diagnosed with a cannabis use disorder upon admission to specialized services for psychosis. Cannabis use in this population is associated with worse clinical and psychosocial outcomes, rendering it an important clinical target. Despite this, few cannabis-specific interventions have been developed for FEP and empirically evaluated through randomized controlled trials. Most evaluated interventions have targeted cannabis abstinence, with limited efficacy, but none have centered on harm reduction outcomes for people with FEP who use cannabis. Early intervention services (EIS), the standard of care for FEP, have not successfully addressed problematic cannabis use in people with FEP either. Clinical trials are needed to explore the potential of harm reduction strategies, although these should be preceded by robust pilot studies to establish optimal design and approaches. OBJECTIVE Recognizing the need for harm reduction strategies for individuals with FEP who use cannabis and based on research on patients' preferences supporting harm reduction interventions, we developed a mobile app-based cannabis harm reduction intervention for this population. This intervention is called Cannabis Harm-reducing Application to Manage Practices Safely (CHAMPS). Here, we describe the protocol for a multicenter, 2-arm, parallel group, randomized pilot trial evaluating the acceptability of CHAMPS for people with FEP who use cannabis and the feasibility of conducting a full-scale trial in this population using CHAMPS. The impact on key clinical outcomes will also be explored. METHODS This pilot trial aims to recruit 100 young people with FEP using cannabis from 6 Canadian EIS clinics. Participants will be randomized in a 1:1 ratio to CHAMPS+EIS or EIS-only. CHAMPS acceptability will be assessed using completion rates for the intervention arm. Trial feasibility will be assessed using a retention rate for randomized participants. Secondary outcomes will explore tendencies of change in the use of protective behavioral strategies and in motivation to change strategies. Exploratory outcomes include cannabis use-related problems, other substance use, the severity of dependence, psychotic symptoms, and health care service use. RESULTS Recruitment began in December 2021. Data collection and analysis are expected to be completed in early 2024. Study results describing CHAMPS acceptability and trial feasibility will then be submitted for publication in a peer-reviewed journal. CONCLUSIONS CHAMPS uniquely combines evidence-based approaches, patient perspectives, and mobile health technology to support harm reduction in people with FEP who use cannabis. Attaining adequate acceptability and feasibility through this trial may justify further exploration of harm reduction tools, particularly within the context of conducting a larger-scale randomized controlled trial. This pilot trial has the potential to advance knowledge for researchers and clinicians regarding a feasible and user-acceptable research design in the cannabis and early psychosis fields. TRIAL REGISTRATION ClinicalTrials.gov NCT04968275, https://clinicaltrials.gov/ct2/show/NCT04968275. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53094.
Collapse
Affiliation(s)
- Stephanie Coronado-Montoya
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - José Côté
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - David Crockford
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Simon Dubreucq
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Benedikt Fischer
- Centre for Applied Research in Addiction and Mental Health, Simon Fraser University, Vancouver, BC, Canada
- Research & Graduate Studies Division, University of the Fraser Valley, Abbotsford, BC, Canada
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
- School of Population Health, University of Auckland, Auckland, New Zealand
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Tania Lecomte
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Sophie L'Heureux
- Clinique Notre-Dame des Victoires, Institut Universitaire en Santé Mentale, Centre Intégré Universitaire de Soins et Services Sociaux de la Capitale Nationale, Québec, QC, Canada
- Department of Psychiatry and Neurosciences, Laval University, Québec, QC, Canada
| | - Clairélaine Ouellet-Plamondon
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marc-André Roy
- Department of Psychiatry and Neurosciences, Laval University, Québec, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada
- Centre de Recherche CERVO, Québec, QC, Canada
| | - Ovidiu Tatar
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Phillip Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marie Villeneuve
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
| | - Anne Wittevrongel
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- University Institute on Addictions, Montreal, QC, Canada
| |
Collapse
|
4
|
Chatton A, Khazaal Y, Penzenstadler L. A 13-item Health of the Nation Outcome Scale (HoNOS-13): validation by item response theory (IRT) in patients with substance use disorder. Addict Sci Clin Pract 2023; 18:64. [PMID: 37876018 PMCID: PMC10594779 DOI: 10.1186/s13722-023-00416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND The Health of the Nation Outcome Scale (HoNOS) is a widely used 12-item tool to assess mental health and social functioning. The French version has an added 13th item measuring adherence to psychotropic medication. The aim of the current study is to uncover the unknown pattern of the new item 13 and to compare the unidimensional and multidimensional fit of the new HoNOS-13 using Item Response Theory (IRT). This research question was studied among inpatients with substance use disorder (SUD). METHODS Six hundred and nine valid questionnaires of HoNOS-13 were analyzed using unidimensional (one-factor) and multidimensional (two-factor) IRT modeling. RESULTS The multidimensional model suggesting a first factor capturing psychiatric/impairment-related issues and a second factor reflecting social-related issues yielded better goodness-of-fit values compared to the unidimensional solution. This resulted in an improvement of all slope parameters which in turn translates to better discriminative power. Significant improvement in item location parameters were observed as well. The new item 13 had a good discriminative power (1.17) and covered a wide range of the latent trait (- 0.14 to 2.64). CONCLUSIONS We were able to validate the 13-item questionnaire including medication compliance and suggest that the HoNOS-13 can be recommended as a clinical evaluation tool to assess the problems and treatment needs for inpatients with SUD. Interestingly, the majority of item response categories are endorsed by respondents who are below and above the average levels of HoNOS. This indicates that the scale is able to discriminate between participants both at the low and at the high ends of the latent trait continuum. More importantly, the new item 13 has a good discriminative power and covers a broad range of the latent trait below and above the mean. It therefore has the desired profile of a good item and is a useful measure for the assessment of mental health and social functioning. Trial registration ClinicalTrials.gov, Identifier: NCT03551301. Registered: 11.06.2018. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03551301 .
Collapse
Affiliation(s)
- Anne Chatton
- Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, University of Geneva, Geneva, Switzerland
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Rue du Bugnon 23A, 1011, Lausanne, Switzerland.
- Department of Psychiatry and Addictology, Montréal University, Montréal, Canada.
- Department of Medicine, University of Geneva, Geneva, Switzerland.
| | - Louise Penzenstadler
- Division of Addiction Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
5
|
Mavragani A, Lecomte T, Potvin S, Riopel G, Vézina C, Villeneuve M, Abdel-Baki A, Khazaal Y. A Mobile Health App (ChillTime) Promoting Emotion Regulation in Dual Disorders: Acceptability and Feasibility Pilot Study. JMIR Form Res 2023; 7:e37293. [PMID: 36705963 PMCID: PMC9919461 DOI: 10.2196/37293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND A growing number of studies highlight the importance of emotion regulation in the treatment and recovery of individuals with psychosis and concomitant disorders such as substance use disorder (SUD), for whom access to integrated dual-disorder treatments is particularly difficult. In this context, dedicated smartphone apps may be useful tools to provide immediate support to individuals in need. However, few studies to date have focused on the development and assessment of apps aimed at promoting emotional regulation for people with psychosis. OBJECTIVE The aim of this study was to evaluate the feasibility, acceptability, and potential clinical impact of a dedicated app (ChillTime) for individuals with psychotic disorders and concurrent SUD. The app design process followed recommendations for reducing cognitive effort on a mobile app. A total of 20 coping strategies regrouped in four categories (behavioral, emotional, cognitive, spiritual) were included in the app. METHODS This open pilot study followed a pre-post design. After the initial assessment, researchers asked participants to use the app as part of their treatment over a 30-day period. Feasibility was determined by the frequency of use of the app and measured using the number of completed strategies. Acceptability was determined by measuring ease of use, ease of learning, satisfaction, and perceived utility at the end of the 30-day study period based on responses to satisfaction questionnaires. Clinical scales measuring emotion regulation, substance use (ie, type of substance, amount taken, and frequency of use), and various psychiatric symptoms were administered at the beginning and end of the 30-day period. RESULTS A total of 13 participants were recruited from two first-episode psychosis clinics in Montreal, Quebec, Canada. All participants were symptomatically stable, were between 18 and 35 years of age (mostly men; 70% of the sample), and had a schizophrenia spectrum disorder with a comorbid substance use diagnosis. A total of 11 participants completed the study (attrition<20%). Approximately half of the participants used the tool at least 33% of the days (11-21 days). Cognitive and emotion-focused techniques were rated the highest in terms of usefulness and were the most frequently used. The majority of participants gave positive answers about the ease of use and the ease of learning the tool. A nonsignificant association of ChillTime use with negative symptoms and drug use was observed. No other statistically significant changes were observed. CONCLUSIONS The ChillTime app showed good feasibility (approximately half of the participants used the tool at least 33% of the days) and acceptability among people with schizophrenia spectrum disorder and SUD. Trends suggesting a potential impact on certain clinical outcomes will need to be replicated in larger-sample studies before any conclusion can be drawn.
Collapse
Affiliation(s)
| | - Tania Lecomte
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Gabrielle Riopel
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Camille Vézina
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Marie Villeneuve
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Amal Abdel-Baki
- Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Département de Psychiatrie, Université de Montréal, Montreal, QC, Canada
| | - Yasser Khazaal
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Département de Psychiatrie, Université de Montréal, Montreal, QC, Canada
| |
Collapse
|
6
|
Khazaal Y, El Abiddine FZ, Penzenstadler L, Berbiche D, Bteich G, Valizadeh-Haghi S, Rochat L, Achab S, Khan R, Chatton A. Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12099. [PMID: 36231401 PMCID: PMC9566183 DOI: 10.3390/ijerph191912099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy. METHODS We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants. RESULTS Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use. CONCLUSIONS Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.
Collapse
Affiliation(s)
- Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, 1015 Lausanne, Switzerland
- Department of Psychiatry and Addictology, Montréal University, Montréal, QC H3T 1J4, Canada
| | - Fares Zine El Abiddine
- Laboratory Psychological and Educational Research, Department of Psychology, University Djillali Liabes of Sidi Bel Abbes, Sidi Bel Abbes 22000, Algeria
| | - Louise Penzenstadler
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Djamal Berbiche
- Charles-LeMoyne Hospital Research Centre, Sherbrooke University, Sherbrooke, QC J1K 2R1, Canada
| | - Ghada Bteich
- Faculty of Public Health, Lebanon University, Tripoli P.O. Box 6573/14, Lebanon
| | - Saeideh Valizadeh-Haghi
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lucien Rochat
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Sophia Achab
- Addiction Unit, Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Riaz Khan
- Department of Mental Health and Psychiatry, Frontier Medical College Affiliated to Bahria University Islamabad, Abbottabad 22010, Pakistan
| | - Anne Chatton
- Department of Psychiatry, Geneva University Hospitals, 1205 Geneva, Switzerland
| |
Collapse
|
7
|
McInnes DK, Dunlap S, Fix GM, Foster MV, Conti J, Roncarati JS, Hyde JK. Longitudinal high-frequency ethnographic interviewing to simulate and prepare for intensive smartphone data collection among veterans with homeless experience. Front Digit Health 2022; 4:897288. [PMID: 36033637 PMCID: PMC9411857 DOI: 10.3389/fdgth.2022.897288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
Objective While Veteran homelessness has steadily declined over the last decade, those who continue to be unhoused have complex health and social concerns. Housing instability interferes with access to healthcare, social services, and treatment adherence. Preventing unwanted housing transitions is a public health priority. This study is the first phase of a larger research agenda that aims to test the acceptability and feasibility of smartphone-enabled data collection with veterans experiencing homelessness. In preparation for the development of the smartphone data collection application, we utilized ethnographic methods guided by user-centered design principles to inform survey content, approach to recruitment and enrollment, and design decisions. Methods We used a case study design, selecting a small sample (n = 10) of veterans representing a range of homelessness experiences based on risk and length of time. Participants were interviewed up to 14 times over a 4-week period, using a combination of qualitative methods. Additionally, 2 focus group discussions were conducted. Interviews were audio-recorded and transcribed. Data were synthesized and triangulated through use of rapid analysis techniques. Results All participants had experience using smartphones and all but one owned one at the time of enrollment. Participants described their smartphones as “lifelines” to social network members, healthcare, and social service providers. Social relationships, physical and mental health, substance use, income, and housing environment were identified as being directly and indirectly related to transitions in housing. Over the course of ~30 days of engagement with participants, the research team observed dynamic fluctuations in emotional states, relationships, and utilization of services. These fluctuations could set off a chain of events that were observed to both help participants transition into more stable housing or lead to setbacks and further increase vulnerability and instability. In addition to informing the content of survey questions that will be programmed into the smartphone app, participants also provided a broad range of recommendations for how to approach recruitment and enrollment in the future study and design features that are important to consider for veterans with a range of physical abilities, concerns with trust and privacy, and vulnerability to loss or damage of smartphones. Conclusion The ethnographic approach guided by a user-centered design framework provided valuable data to inform our future smartphone data collection effort. Data were critical to understanding aspects of day-to-day life that important to content development, app design, and approach to data collection.
Collapse
Affiliation(s)
- D. Keith McInnes
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States
| | - Shawn Dunlap
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
| | - Gemmae M. Fix
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
- Boston University School of Medicine, Section of General Internal Medicine, Boston, MA, United States
| | - Marva V. Foster
- Boston University School of Medicine, Section of General Internal Medicine, Boston, MA, United States
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, United States
- Department of Quality Management, VA Boston Healthcare System, Boston, MA, United States
| | - Jennifer Conti
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
| | - Jill S. Roncarati
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Boston Health Care for the Homeless Program, Boston, MA, United States
| | - Justeen K. Hyde
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
- Boston University School of Medicine, Section of General Internal Medicine, Boston, MA, United States
- *Correspondence: Justeen K. Hyde
| |
Collapse
|
8
|
Kim SK, Lee M, Jeong H, Jang YM. Effectiveness of mobile applications for patients with severe mental illness: A meta-analysis of randomized controlled trials. Jpn J Nurs Sci 2022; 19:e12476. [PMID: 35174976 DOI: 10.1111/jjns.12476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/25/2021] [Accepted: 12/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND A systematic review and meta-analysis was conducted to evaluate the effectiveness of mobile applications used by patients diagnosed with mental disorders. METHODS An electronic literature search in five databases including PubMed, Embase, the Cochrane Library, CINAHL, and PsychInfo was conducted. The keywords used were "mental disorder," "mental illness," "mobile phone," "smartphone," "mHealth," "application," and "app". The search was restricted to randomized controlled trials (RCTs) written in English and Korean. RESULTS Fourteen RCTs, involving 1307 patients diagnosed with depression, schizophrenia, and bipolar disorder were included in the analysis. The included studies were published between 2012 and 2020 and used mobile applications. The risk of bias tool was used to assess methodological quality and the overall risk of bias of the included studies was moderate. The pooled data favored mobile application interventions in reducing the disease-related symptoms of depression (standardized mean difference [SMD] = -0.255, 95% CI: -0.370 to -0.141), mania symptoms (SMD = -0.279, 95% CI: -0.456 to -0.102), and positive (SMD = -0.205, 95% CI: -0.388 to -0.022) and negative psychotic symptoms (SMD = -0.406, 95% CI: -0.791 to -0.020). In subgroup analysis, the incorporation of feedback, notification, and data tracking features in the mobile application intervention produced better outcomes. CONCLUSION This review provided evidence that mobile applications could well-assist patients diagnosed with mental disorders. Greater benefits could be achieved by well-designed interventions incorporating strategies with thoughtful consideration of the disease characteristics. Mobile applications present the potential to be effective supplements to clinical treatment.
Collapse
Affiliation(s)
- Sun Kyung Kim
- Department of Nursing, and Department of Biomedicine, Health & Life Convergence Sciences, BK21 Four, Biomedical and Healthcare Research Institute, Mokpo National University, Muan-gun, South Korea
| | - Mihyun Lee
- College of Nursing, Daejeon Health Institute of Technology, Daejeon, South Korea
| | - Hyun Jeong
- College of Nursing, Daejeon Health Institute of Technology, Daejeon, South Korea
| | - Young Mi Jang
- Department of Nursing, Daejeon Institute of Science and Technology, Daejeon, South Korea
| |
Collapse
|
9
|
von Hardenberg L, Leopold K, Stenzel N, Kallenbach M, Aliakbari N, Bechdolf A, Mehl S. Feasibility and efficacy of an acceptance and mindfulness-based group intervention for young people with early psychosis (Feel-Good group). Front Psychiatry 2022; 13:943488. [PMID: 36186856 PMCID: PMC9522968 DOI: 10.3389/fpsyt.2022.943488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Over the last decade, researchers have sought for alternative interventions that have better treatment effects than Cognitive Behavioral Therapy (CBT) when treating psychotic symptoms. Mindfulness-based interventions have been a proposed alternative to CBT, yet research regarding its feasibility, acceptance and effectiveness is lacking when treating individuals with early psychosis in inpatient settings. OBJECTIVE Before conducting a large-scale randomized-controlled trial (RCT), this pilot study evaluated the feasibility and the potential efficacy of a mindfulness-based inpatient group intervention that targets emotion regulation in patients with early psychosis, and thus indirectly improving psychotic symptoms. METHODS A pre-post study was performed. Thirty-six patients with early psychosis treated at the specialized inpatient treatment "Frühinterventions- und Therapiezentrum; FRITZ" (early intervention and therapy center) received eight group therapy sessions. Assessments were performed at baseline, after 8 weeks post treatment and at follow-up after 16 weeks. RESULTS Rates of patients who participated in the study suggests that a mindfulness-based group therapy is highly accepted and feasible for patients with early psychosis being treated in an inpatient ward. Friedman analyses revealed significant changes in the primary outcomes of emotional goal attainment (Goal 1: W = 0.79; Goal 2: W = 0.71) and psychotic symptoms (PANSS-T: W = 0.74). Significant, albeit small, effect sizes were found in patients' self-perception of emotion regulation skills (ERSQ: W = 0.23). DISCUSSION We found favorable findings regarding the feasibility and acceptance of the Feel-Good mindfulness-based intervention. Results of the study provide a basis for an estimation of an adequate sample size for a fully powered RCT that needs to be conducted to test whether Feel-Good is effective in the inpatient treatment of psychotic symptoms for individuals with early psychosis. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/ct2/show/NCT04592042], identifier [NCT04592042].
Collapse
Affiliation(s)
- Laura von Hardenberg
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating Frühinterventions- und Therapiezentrum (FRITZ) and Soulspace, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichshain, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating Frühinterventions- und Therapiezentrum (FRITZ) and Soulspace, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichshain, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Nikola Stenzel
- Department of Psychology, Psychologische Hochschule Berlin (PHB), Berlin, Germany
| | - Michèle Kallenbach
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating Frühinterventions- und Therapiezentrum (FRITZ) and Soulspace, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichshain, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Navid Aliakbari
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating Frühinterventions- und Therapiezentrum (FRITZ) and Soulspace, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichshain, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating Frühinterventions- und Therapiezentrum (FRITZ) and Soulspace, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichshain, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Orygen, National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Stephanie Mehl
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany.,Department of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt, Germany
| |
Collapse
|
10
|
Adams Z, Grant M, Hupp S, Scott T, Feagans A, Phillips ML, Bixler K, Nallam PT, La Putt D. Acceptability of an mHealth App for Youth With Substance Use and Mental Health Needs: Iterative, Mixed Methods Design. JMIR Form Res 2021; 5:e30268. [PMID: 34951593 PMCID: PMC8742212 DOI: 10.2196/30268] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Treating substance use disorders (SUDs) during adolescence can prevent adult addiction and improve youth outcomes. However, it can be challenging to keep adolescents with SUDs engaged in ongoing services, thus limiting potential benefits. Developmentally appropriate tools are needed to improve treatment engagement during and between sessions for youth with SUDs and mental health disorders. Mobile health apps may augment or replace psychotherapy components; however, few have been developed specifically for youth with SUDs following user-guided design principles, which may limit their appropriateness and utility. Formative research on acceptability to intended end users is needed before the efficacy of such tools can be examined. OBJECTIVE This study involves user-centered, iterative development and initial user testing of a web-based app for adolescents with SUDs and mental health concerns. METHODS Adolescents aged 14 to 17 years with past-year involvement in outpatient psychotherapy and behavioral health clinicians with adolescent SUD treatment caseloads were recruited. Across 2 assessment phases, 40 participants (alpha: 10 youths and 10 clinicians; beta: 10 youths and 10 clinicians) viewed an app demonstration and completed semistructured interviews and questionnaires about app content and functionality. RESULTS Participants expressed positive impressions of the app and its potential utility in augmenting outpatient therapy for youth with SUDs and mental health concerns. Noted strengths included valuable educational content, useful embedded resources, and a variety of activities. Adolescents and clinicians favored the app over conventional (paper-and-pencil) modalities, citing convenience and familiarity. The app was found to be user-friendly and likely to improve treatment engagement. Adolescents suggested the inclusion of privacy settings, and clinicians recommended more detailed instructions and simplified language. CONCLUSIONS The novel app developed here appears to be a promising, acceptable, and highly scalable resource to support adolescents with SUDs and mental health concerns. Future studies should test the efficacy of such apps in enhancing adolescent behavioral health treatment engagement and outcomes.
Collapse
Affiliation(s)
- Zachary Adams
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Miyah Grant
- Department of Psychology, University of Indianapolis, Indianapolis, IN, United States
| | - Samantha Hupp
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Taylor Scott
- Department of Psychiatry, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Amanda Feagans
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Meredith Lois Phillips
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kristina Bixler
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Phani Teja Nallam
- Department of Psychiatry, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Dorothy La Putt
- Department of Psychiatry, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| |
Collapse
|
11
|
Ortiz A, Maslej MM, Husain MI, Daskalakis ZJ, Mulsant BH. Apps and gaps in bipolar disorder: A systematic review on electronic monitoring for episode prediction. J Affect Disord 2021; 295:1190-1200. [PMID: 34706433 DOI: 10.1016/j.jad.2021.08.140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/18/2021] [Accepted: 08/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Long-term clinical monitoring in bipolar disorder (BD) is an important therapeutic tool. The availability of smartphones and wearables has sparked the development of automated applications to remotely monitor patients. This systematic review focus on the current state of electronic (e-) monitoring for episode prediction in BD. METHODS We systematically reviewed the literature on e-monitoring for episode prediction in adult BD patients. The systematic review was done according to the guidelines for reporting of systematic reviews and meta-analyses (PRISMA) and was registered in PROSPERO on April 29, 2020 (CRD42020155795). We conducted a search of Web of Science, MEDLINE, EMBASE, and PsycINFO (all 2000-2020) databases. We identified and extracted data from 17 published reports on 15 relevant studies. RESULTS Studies were heterogeneous and most had substantial methodological and technical limitations. Models varied widely in their performance. Published metrics were too heterogeneous to lend themselves to a meta-analysis. Four studies reported sensitivity (range: 0.21 - 0.95); and two reported specificity for prediction of mood episodes (range: 0.36 - 0.99). Two studies reported accuracy (range: 0.64 - 0.88) and four reported area under the curve (AUC; range: 0.52-0.95). Overall, models were better in predicting manic or hypomanic episodes, but their performance depended on feature type. LIMITATIONS Our conclusions are tempered by the lack of appropriate information impeding our ability to synthesize the available evidence. CONCLUSIONS Given the clinical variability in BD, predicting mood episodes remains a challenging task. Emerging e-monitoring technology for episode prediction in BD requires more development before it can be adopted clinically.
Collapse
Affiliation(s)
- Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Marta M Maslej
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - M Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, United States
| | - Benoit H Mulsant
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| |
Collapse
|
12
|
Mayer G, Hummel S, Gronewold N, Oetjen N, Hilbel T, Schultz JH. Validity and Reliability of the Self-administered Psycho-TherApy-SystemS (SELFPASS) Item Pool for the Daily Mood Tracking of Depressive Symptoms: Cross-sectional Web-Based Survey. JMIR Ment Health 2021; 8:e29615. [PMID: 34661547 PMCID: PMC8561414 DOI: 10.2196/29615] [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: 04/14/2021] [Revised: 07/16/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND e-Mental health apps targeting depression have gained increased attention in mental health care. Daily self-assessment is an essential part of e-mental health apps. The Self-administered Psycho-TherApy-SystemS (SELFPASS) app is a self-management app to manage depressive and comorbid anxiety symptoms of patients with a depression diagnosis. A self-developed item pool with 40 depression items and 12 anxiety items is included to provide symptom-specific suggestions for interventions. However, the psychometric properties of the item pool have not yet been evaluated. OBJECTIVE The aim of this study is to investigate the validity and reliability of the SELFPASS item pool. METHODS A weblink with the SELFPASS item pool and validated mood assessment scales was distributed to healthy subjects and patients who had received a diagnosis of a depressive disorder within the last year. Two scores were derived from the SELFPASS item pool: SELFPASS depression (SP-D) and SELFPASS anxiety (SP-A). Reliability was examined using Cronbach α. Construct validity was assessed through Pearson correlations with the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder Scale-7 (GAD-7), and the WHO-5-Wellbeing-Scale (WHO-5). Logistic regression analysis was performed as an indicator for concurrent criterion validity of SP-D and SP-A. Factor analysis was performed to provide information about the underlying factor structure of the item pool. Item-scale correlations were calculated in order to determine item quality. RESULTS A total of 284 participants were included, with 192 (67.6%) healthy subjects and 92 (32.4%) patients. Cronbach α was set to .94 for SP-D and α=.88 for SP-A. We found significant positive correlations between SP-D and PHQ-9 scores (r=0.87; P<.001) and between SP-A and GAD-7 scores (r=0.80; P<.001), and negative correlations between SP-D and WHO-5 scores (r=-0.80; P<.001) and between SP-A and WHO-5 scores (r=-0.69; P<.001). Increasing scores of SP-D and SP-A led to increased odds of belonging to the patient group (SP-D: odds ratio 1.03, 95% CI 1.01-1.05; P<.001; SP-A: 1.05, 1.05-1.01; P=.01). The item pool yielded 2 factors: one that consisted of mood-related items and another with somatic-related items. CONCLUSIONS The SELFPASS item pool showed good psychometric properties in terms of reliability, construct, and criterion validity. The item pool is an appropriate source for daily mood tracking in future e-mental health apps among patients with depression. Our study provides general recommendations for future developments as well as recommendations within the item pool.
Collapse
Affiliation(s)
- Gwendolyn Mayer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Svenja Hummel
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Nadine Gronewold
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Neele Oetjen
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Hilbel
- Electrical Engineering and Applied Sciences, Westphalian University of Applied Sciences, Gelsenkirchen, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
13
|
Khazaal Y, Potvin S, Pennou A, Djomo W, Borgeat F, Lecomte T. Des repères pour la conception des apps ? SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1081512ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectif Proposer quelques repères pour faciliter le processus de création d’applications pour téléphones intelligents (apps) en santé mentale.
Méthode Présentation brève de l’intérêt potentiel des apps et proposition argumentée d’étapes clés pour la création des apps. L’article se base sur une revue narrative, un retour d’expérience et des discussions de groupes d’experts.
Résultats Les apps ont des caractéristiques ubiquitaires particulièrement intéressantes pour le domaine de la santé mentale. Potentiellement connectées à de multiples technologies, mobiles et disponibles en tout temps, elles permettent une grande flexibilité de conception. Afin d’augmenter les chances d’efficacité et de bonne dissémination d’une app donnée, certains principes pourraient guider de manière utile le travail de conception des apps : 9 repères sont proposés, en particulier une bonne intégration des utilisateurs finaux autour d’objectifs cibles bien définis durant tout le processus de création de tels outils.
Conclusion Les repères proposés pourraient faciliter le processus de création d’apps pour la santé mentale.
Collapse
Affiliation(s)
- Yasser Khazaal
- Service de médecine des addictions, Département de Psychiatrie CHUV et Université de Lausanne
- Département de psychiatrie et d’addictologie, Université de Montréal
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Stéphane Potvin
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
- Département de psychologie, Université de Montréal
| | - Antoine Pennou
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
- Département de psychologie, Université de Montréal
| | - William Djomo
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - François Borgeat
- Département de psychiatrie et d’addictologie, Université de Montréal
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Tania Lecomte
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal
- Département de psychologie, Université de Montréal
| |
Collapse
|
14
|
Askew DA, Foley W, Kirk C, Williamson D. "I'm outta here!": a qualitative investigation into why Aboriginal and non-Aboriginal people self-discharge from hospital. BMC Health Serv Res 2021; 21:907. [PMID: 34479571 PMCID: PMC8414851 DOI: 10.1186/s12913-021-06880-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Occasions of self-discharge from health services before being seen by a health profession or against medical advice are often used by health systems as an indicator of quality care. People self-discharge because of factors such as dissatisfaction with care, poor communication, long waiting times, and feeling better in addition to external factors such as family and employment responsibilities. These factors, plus a lack of cultural safety, and interpersonal and institutional racism contribute to the disproportionately higher rates of Indigenous people self-discharging from hospital. This qualitative study aimed to increase understanding about the causative and contextual factors that culminate in people self-discharging and identify opportunities to improve the hospital experience for all. METHODS Semi-structured interviews with five Aboriginal and/or Torres Strait Islander (hereafter, respectfully, Indigenous) people and six non-Indigenous people who had self-discharged from a major tertiary hospital in Brisbane, Australia, were audio-recorded, transcribed and thematically analysed. RESULTS Study participants all respected hospitals' vital role of caring for the sick, but the cumulative impact of unmet needs created a tipping point whereby they concluded that remaining in hospital would compromise their health and wellbeing. Five key categories of unmet needs were identified - the need for information; confidence in the quality of care; respectful treatment; basic comforts; and peace of mind. Although Indigenous and non-Indigenous participants had similar unmet needs, for the former, the deleterious impact of unmet needs was compounded by racist and discriminatory behaviours they experienced while in hospital. CONCLUSIONS Respectful, empathetic, person-centred care is likely to result in patients' needs being met, improve the hospital experience and reduce the risk of people self-discharging. For Indigenous people, the ongoing legacy of white colonisation is embodied in everyday lived experiences of interpersonal and institutional racism. Racist and discriminatory behaviours experienced whilst hospitalised are thus rendered both more visible and more traumatic, and exacerbate the deleterious effect of unmet needs. Decreasing self-discharge events requires a shift of thinking away from perceiving this as the behaviour of a deviant individual, but rather as a quality improvement opportunity to ensure that all patients are cared for in a respectful and person-centred manner.
Collapse
Affiliation(s)
- Deborah A Askew
- Primary Care Clinical Unit, The University of Queensland, Royal Brisbane & Women's Hospital, Level 8, Health Sciences Building, Qld, 4029, Brisbane, Australia.
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, 37 Wirraway Parade, 4077, Inala, Qld, Australia.
| | - Wendy Foley
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, 37 Wirraway Parade, 4077, Inala, Qld, Australia
| | - Corey Kirk
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, 37 Wirraway Parade, 4077, Inala, Qld, Australia
| | - Daniel Williamson
- Aboriginal and Torres Strait Islander Health Division, Queensland Health, 33 Charlotte Street, Qld, 4001, Brisbane, Australia
| |
Collapse
|
15
|
Zidaru T, Morrow EM, Stockley R. Ensuring patient and public involvement in the transition to AI-assisted mental health care: A systematic scoping review and agenda for design justice. Health Expect 2021; 24:1072-1124. [PMID: 34118185 PMCID: PMC8369091 DOI: 10.1111/hex.13299] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/07/2021] [Accepted: 05/26/2021] [Indexed: 12/16/2022] Open
Abstract
Background Machine‐learning algorithms and big data analytics, popularly known as ‘artificial intelligence’ (AI), are being developed and taken up globally. Patient and public involvement (PPI) in the transition to AI‐assisted health care is essential for design justice based on diverse patient needs. Objective To inform the future development of PPI in AI‐assisted health care by exploring public engagement in the conceptualization, design, development, testing, implementation, use and evaluation of AI technologies for mental health. Methods Systematic scoping review drawing on design justice principles, and (i) structured searches of Web of Science (all databases) and Ovid (MEDLINE, PsycINFO, Global Health and Embase); (ii) handsearching (reference and citation tracking); (iii) grey literature; and (iv) inductive thematic analysis, tested at a workshop with health researchers. Results The review identified 144 articles that met inclusion criteria. Three main themes reflect the challenges and opportunities associated with PPI in AI‐assisted mental health care: (a) applications of AI technologies in mental health care; (b) ethics of public engagement in AI‐assisted care; and (c) public engagement in the planning, development, implementation, evaluation and diffusion of AI technologies. Conclusion The new data‐rich health landscape creates multiple ethical issues and opportunities for the development of PPI in relation to AI technologies. Further research is needed to understand effective modes of public engagement in the context of AI technologies, to examine pressing ethical and safety issues and to develop new methods of PPI at every stage, from concept design to the final review of technology in practice. Principles of design justice can guide this agenda.
Collapse
Affiliation(s)
- Teodor Zidaru
- Department of Anthropology, London School of Economics and Political Science (LSE), London, UK
| | | | - Rich Stockley
- Surrey Heartlands Health and Care Partnership, Guildford and Waverley CCG, Guildford, UK.,Insight and Feedback Team, Nursing Directorate, NHS England and NHS Improvement, London, UK.,Surrey County Council, Kingston upon Thames, UK
| |
Collapse
|
16
|
Michalska P, Chatton A, Penzenstadler L, Izdebski P, Jeannot E, Simon O, Dufour M, Rochat L, Lischer S, Khazaal Y. Perspective of Internet Poker Players on Harm-Reduction Strategies: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239054. [PMID: 33291669 PMCID: PMC7730654 DOI: 10.3390/ijerph17239054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 12/19/2022]
Abstract
Background: Internet gambling may increase rates of gambling harm. This current study aimed to assess Internet poker players’ views on various harm-reduction (HR) strategies. It also examined differences in these views according to the games played (poker only vs. poker plus other gambling activities), indebtedness, and problem gambling severity. Methods: Internet poker players (n = 311; 94.2% Male) recruited online between 2012 and 2014 were included in the analyses and completed a survey on indebtedness, problem gambling severity index, and ten statements regarding HR features. Results: Among the whole sample, the most frequently endorsed HR strategy was setting money limits, specialized online help, and peer support forums. People who play poker only (70%) are less prone to endorse the utility of information on excessive gambling and specialized healthcare centers. No differences were found between those people with debt versus those without regarding HR assessment. Participants with severe problem gambling were more skeptical about HR strategies based on information on specialized healthcare centers. Conclusion: Setting money limits, online help, and peer support forums are the most commonly endorsed strategies. Future research is needed to evaluate the effectiveness of online harm reduction strategies.
Collapse
Affiliation(s)
- Patrycja Michalska
- Faculty of Psychology, Kazimierz Wielki University, 85-867 Bydgoszcz, Poland; (P.M.); (P.I.); (Y.K.)
| | - Anne Chatton
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland; (A.C.); (L.P.); (L.R.)
| | - Louise Penzenstadler
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland; (A.C.); (L.P.); (L.R.)
| | - Paweł Izdebski
- Faculty of Psychology, Kazimierz Wielki University, 85-867 Bydgoszcz, Poland; (P.M.); (P.I.); (Y.K.)
| | - Emilien Jeannot
- Institute of Global Health, Geneva University, 1211 Geneva, Switzerland
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Correspondence:
| | - Olivier Simon
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Faculty of Biology and Medicine, Lausanne University, 1005 Lausanne, Switzerland
| | - Magali Dufour
- Department of Psychology, Université du Québec à Montréal, Montreal, CP 8888, Canada;
| | - Lucien Rochat
- Department of Psychiatry, Geneva University Hospital, 1205 Geneva, Switzerland; (A.C.); (L.P.); (L.R.)
| | - Suzanne Lischer
- Institute for Social Management, Social Policy and Prevention, Lucerne University of Applied Sciences and Arts, 6002 Lucerne, Switzerland;
| | - Yasser Khazaal
- Faculty of Psychology, Kazimierz Wielki University, 85-867 Bydgoszcz, Poland; (P.M.); (P.I.); (Y.K.)
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- Faculty of Biology and Medicine, Lausanne University, 1005 Lausanne, Switzerland
- Research Center, Montreal University Institute of Mental Health, Montreal, QC H3C 3P8, Canada
| |
Collapse
|
17
|
Mundt AP, Baranyi G. The Unhappy Mental Health Triad: Comorbid Severe Mental Illnesses, Personality Disorders, and Substance Use Disorders in Prison Populations. Front Psychiatry 2020; 11:804. [PMID: 32922316 PMCID: PMC7456858 DOI: 10.3389/fpsyt.2020.00804] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Information on the comorbidity of mental health problems in prison populations is scarce. The aim of the present study was to assess the prevalence of comorbidities at intake to prison between three diagnostic groups: severe mental illnesses (SMIs), personality disorders (PDs), and substance use disorders (SUDs). The co-occurrence of those disorders in prison populations may require the integration of differential treatment approaches and novel treatment trials. METHODS A consecutive sample of N = 427 (229 male and 198 female) individuals committed to imprisonment in Santiago de Chile was assessed with the Mini Neuropsychiatric Interview and the Structured Clinical Interview for DSM-IV (module for borderline personality disorders) on arrival at prison. Diagnoses were a priori grouped as SMI including psychosis, bipolar disorder and major depression, PD including borderline and antisocial PD and SUD including alcohol and drug abuse or dependence. Sex stratified multivariate binary logistic regression analyses were conducted to assess sociodemographic, criminal and treatment characteristics of individuals with at least one diagnosis from each of the three diagnostic groups. RESULTS The triad of SMI, PD, and SUD was present in n = 138 (32.3%; 95% IC: 28.0-36.9) study participants, n = 105 (45.9%; 95% CI: 39.4-52.4) of the men and n = 33 (16.7%; 95% CI: 12.1-22.6) of the women. Among those with the disorder triad, n = 129 (30.2%; 95% CI: 26.0-34.8) had major depression, PD and SUD; n = 54 (12.6%; 95% CI: 9.8-16.2) had psychosis, PD and SUD. The disorder triad was more common in men (OR = 4.86; 95% IC: 2.63-8.95), younger age (OR = 0.94; 95% CI: 0.91-0.97), and participants with lower educational levels (OR = 1.69; 95% CI: 1.01-2.82). The disorder triad was significantly associated with previous incarcerations (OR 2.60; 95% CI: 1.55-4.34) and histories of psychiatric hospitalizations (OR 2.82; 95% CI: 1.27-6.28). DISCUSSION The complex triad of disorders from different diagnostic groups is common in prison populations, especially among young men. Successful treatment interventions may have the potential to break a cycle of repeat institutionalization in prisons and psychiatric institutions.
Collapse
Affiliation(s)
- Adrian P Mundt
- Faculty of Medicine, Universidad Diego Portales, Santiago, Chile.,Department of Psychiatry, Faculty of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
18
|
Marmet S, Studer J, Wicki M, Bertholet N, Khazaal Y, Gmel G. Unique versus shared associations between self-reported behavioral addictions and substance use disorders and mental health problems: A commonality analysis in a large sample of young Swiss men. J Behav Addict 2019; 8:664-677. [PMID: 31891314 PMCID: PMC7044575 DOI: 10.1556/2006.8.2019.70] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS Behavioral addictions (BAs) and substance use disorders (SUDs) tend to co-occur; both are associated with mental health problems (MHPs). This study aimed to estimate the proportion of variance in the severity of MHPs explained by BAs and SUDs, individually and shared between addictions. METHODS A sample of 5,516 young Swiss men (mean = 25.47 years old; SD = 1.26) completed a self-reporting questionnaire assessing alcohol, cannabis, and tobacco use disorders, illicit drug use other than cannabis, six BAs (Internet, gaming, smartphone, Internet sex, gambling, and work) and four MHPs (major depression, attention-deficit hyperactivity disorder, social anxiety disorder, and borderline personality disorder). Commonality analysis was used to decompose the variance in the severity of MHPs explained (R2) by BAs and SUDs into independent commonality coefficients. These were calculated for unique BA and SUD contributions and for all types of shared contributions. RESULTS BAs and SUDs explained between a fifth and a quarter of the variance in severity of MHPs, but individual addictions explained only about half of this explained variance uniquely; the other half was shared between addictions. A greater proportion of variance was explained uniquely or shared within BAs compared to SUDs, especially for social anxiety disorder. CONCLUSIONS The interactions of a broad range of addictions should be considered when investigating their associations with MHPs. BAs explain a larger part of the variance in MHPs than do SUDs and therefore play an important role in their interaction with MHPs.
Collapse
Affiliation(s)
- Simon Marmet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Corresponding author: Simon Marmet; Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23, CH-1011 Lausanne, Switzerland; Phone: +41 21 314 18 97; Fax: +41 21 314 05 62; E-mail:
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Wicki
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Research Centre, University Institute of Mental Health at Montréal, Québec, Canada
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Research Department, Addiction Switzerland, Lausanne, Switzerland,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Health and Social Sciences, University of the West of England, Bristol, UK
| |
Collapse
|