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Nandi A, Counts N, Bröker J, Malik S, Chen S, Han R, Klusty J, Seligman B, Tortorice D, Vigo D, Bloom DE. Cost of care for Alzheimer's disease and related dementias in the United States: 2016 to 2060. NPJ Aging 2024; 10:13. [PMID: 38331952 PMCID: PMC10853249 DOI: 10.1038/s41514-024-00136-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
Abstract
Medical and long-term care for Alzheimer's disease and related dementias (ADRDs) can impose a large economic burden on individuals and societies. We estimated the per capita cost of ADRDs care in the in the United States in 2016 and projected future aggregate care costs during 2020-2060. Based on a previously published methodology, we used U.S. Health and Retirement Survey (2010-2016) longitudinal data to estimate formal and informal care costs. In 2016, the estimated per patient cost of formal care was $28,078 (95% confidence interval [CI]: $25,893-$30,433), and informal care cost valued in terms of replacement cost and forgone wages was $36,667 ($34,025-$39,473) and $15,792 ($12,980-$18,713), respectively. Aggregate formal care cost and formal plus informal care cost using replacement cost and forgone wage methods were $196 billion (95% uncertainty range [UR]: $179-$213 billion), $450 billion ($424-$478 billion), and $305 billion ($278-$333 billion), respectively, in 2020. These were projected to increase to $1.4 trillion ($837 billion-$2.2 trillion), $3.3 trillion ($1.9-$5.1 trillion), and $2.2 trillion ($1.3-$3.5 trillion), respectively, in 2060.
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Affiliation(s)
- Arindam Nandi
- The Population Council, 1 Dag Hammarskjold Plaza, New York, NY, 10017, USA.
- One Health Trust, Washington, DC, USA.
| | - Nathaniel Counts
- Office of the Commissioner of Health & Mental Hygiene for the City of New York, New York, NY, USA
| | | | | | - Simiao Chen
- University of Heidelberg, Heidelberg, Germany
| | - Rachael Han
- Department of Molecular and Cellular Biology and The Center for Brain Science, Harvard University, Cambridge, MA, USA
| | | | - Benjamin Seligman
- Division of Geriatric Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Geriatrics Research, Education, and Clinical Center, Greater Los Angeles VA Health Care System, Los Angeles, CA, USA
| | | | - Daniel Vigo
- University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - David E Bloom
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Pei J, Amanvermez Y, Vigo D, Puyat J, Kessler RC, Mortier P, Bruffaerts R, Rankin O, Chua SN, Martínez V, Rapsey C, Fodor LA, David OA, Garcia C, Cuijpers P. Sociodemographic Correlates of Mental Health Treatment Seeking Among College Students: A Systematic Review and Meta-Analysis. Psychiatr Serv 2024:appips20230414. [PMID: 38291886 DOI: 10.1176/appi.ps.20230414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE College students have high rates of mental health problems and low rates of treatment. Although sociodemographic disparities in student mental health treatment seeking have been reported, findings have not been synthesized and quantified. The extent to which differences in perceived need for treatment contribute to overall disparities remains unclear. METHODS A systematic search of PubMed, PsycInfo, and Embase was conducted. Studies published between 2007 and 2022 were included if they reported treatment rates among college students with mental health problems, stratified by sex, gender, race-ethnicity, sexual orientation, student type, student year, or student status. Random-effects models were used to calculate pooled prevalence ratios (PRs) of having a perceived need for treatment and of receiving treatment for each sociodemographic subgroup. RESULTS Twenty-one studies qualified for inclusion. Among students experiencing mental health problems, consistent and significant sociodemographic differences were identified in perceived need for treatment and treatment receipt. Students from racial-ethnic minority groups (in particular, Asian students [PR=0.49]) and international students (PR=0.63) reported lower rates of treatment receipt than White students and domestic students, respectively. Students identifying as female (sex) or as women (gender) (combined PR=1.33) reported higher rates of treatment receipt than students identifying as male or as men. Differences in perceived need appeared to contribute to some disparities; in particular, students identifying as male or as men reported considerably lower rates of perceived need than students identifying as female or as women. CONCLUSIONS Findings highlight the need for policy makers to address barriers throughout the treatment-seeking pathway and to tailor efforts to student subgroups to reduce treatment disparities.
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Affiliation(s)
- Julia Pei
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Yagmur Amanvermez
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Daniel Vigo
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Joseph Puyat
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Ronald C Kessler
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Philippe Mortier
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Ronny Bruffaerts
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Osiris Rankin
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Sook Ning Chua
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Vania Martínez
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Charlene Rapsey
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Liviu A Fodor
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Oana A David
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Claudia Garcia
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
| | - Pim Cuijpers
- Department of Psychiatry (Pei, Vigo) and School of Population and Public Health (Pei, Vigo, Puyat), University of British Columbia, Vancouver; Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam (Amanvermez, Cuijpers); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Health Services Research Unit, Hospital del Mar Research Institute, Barcelona, Spain, and Consorcio Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid (Mortier); Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium (Bruffaerts); Department of Psychology, Harvard University, Cambridge, Massachusetts (Rankin); Relate Mental Health Malaysia, Kuala Lumpur, and School of Biological Sciences, Nanyang Technological University, Singapore (Chua); Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente, Facultad de Medicina, Universidad de Chile, and Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile (Martínez); Department of Psychological Medicine (Rapsey) and Department of Psychology (Garcia), University of Otago, Dunedin, New Zealand; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania (Fodor, David, Cuijpers)
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Munthali RJ, Richardson CG, Pei J, Westenberg JN, Munro L, Auerbach RP, Prescivalli AP, Vereschagin M, Clarke QK, Wang AY, Vigo D. Patterns of anxiety, depression, and substance use risk behaviors among university students in Canada. J Am Coll Health 2023:1-11. [PMID: 37943497 DOI: 10.1080/07448481.2023.2277201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
Objective: To identify subgroups of students with distinct profiles of mental health symptoms (MH) and substance use risk (SU) and the extent to which MH history and socio-demographics predict subgroup membership. Participants: University students (N = 10,935: 63% female). Methods: Repeated cross-sectional survey administered weekly to stratified random samples. Latent class analysis (LCA) was used to identify subgroups and multinomial regression was used to examine associations with variables of interest. Results: LCA identified an optimal 4-latent class solution: High MH-Low SU (47%), Low MH-Low SU (22%), High MH-High SU (19%), and Low MH-High SU (12%). MH history, gender, and ethnicity were associated with membership in the classes with high risk of MH, SU, or both. Conclusion: A substantial proportion of students presented with MH, SU, or both. Gender, ethnicity and MH history is associated with specific patterns of MH and SU, offering potentially useful information to tailor early interventions.
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Affiliation(s)
- Richard J Munthali
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Chris G Richardson
- School of Population and Public Health, University of British Columbia, British Columbia, Canada
| | - Julia Pei
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, British Columbia, Canada
| | - Jean N Westenberg
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Lonna Munro
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA
| | | | - Melissa Vereschagin
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Quinten K Clarke
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Angel Y Wang
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, British Columbia, Canada
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4
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Kaoser R, Jones W, Dove N, Tallon C, Small W, Vigo D, Samji H. Using novel methodology to estimate the prevalence of mental disorders in British Columbia, Canada. Soc Psychiatry Psychiatr Epidemiol 2023; 58:153-162. [PMID: 36114338 DOI: 10.1007/s00127-022-02366-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/02/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE A needs-based model of health systems planning uses a systematic estimate of service needs for a given population. Our objective was to derive annual prevalence estimates of specific mental disorders in the adult population of British Columbia, Canada and use a novel triangulation approach encompassing multiple data sources and stratifying these estimates by age, sex, and severity to inform Ministry partners, who commissioned this work. METHODS We performed systematic literature reviews and subsequent meta-analyses to derive an annual prevalence estimate for each mental disorder. We then generated age- and sex-specific estimates by triangulating published epidemiological studies, routinely collected province-wide health administrative data, and nationally representative health survey data sources. The age- and sex-specific estimates were further stratified by severity using the Global Burden of Disease severity distributions and published literature. RESULTS Anxiety disorders had the highest annual prevalence estimates (6.93%), followed by depressive disorders (6.42%). All other mental disorders had an annual prevalence of less than 1%. Prevalence estimates were consistently higher in younger age groups. Depressive disorders, anxiety disorders, and eating disorders were higher in women, while estimates for bipolar disorders, schizophrenia, and ADHD were slightly higher in men in younger age groups. CONCLUSION We generated robust annual prevalence estimates stratified by age, sex, and severity using a triangulation approach. Variation by age, sex, and severity implies that these factors need to be considered when planning for mental health services. Our approach is replicable and can be used as a model for needs-based planning in other jurisdictions.
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Affiliation(s)
- Ridhwana Kaoser
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Wayne Jones
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Naomi Dove
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Will Small
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.,British Columbia Centre On Substance Use, Vancouver, BC, Canada
| | - Daniel Vigo
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hasina Samji
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. .,British Columbia Centre for Disease Control, Vancouver, Canada.
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Nandi A, Counts N, Chen S, Seligman B, Tortorice D, Vigo D, Bloom DE. Global and regional projections of the economic burden of Alzheimer's disease and related dementias from 2019 to 2050: A value of statistical life approach. EClinicalMedicine 2022; 51:101580. [PMID: 35898316 PMCID: PMC9310134 DOI: 10.1016/j.eclinm.2022.101580] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The burden of Alzheimer's disease and related dementias (ADRDs) is expected to grow rapidly with population aging, especially in low- and middle-income countries, in the next few decades. We used a willingness-to-pay approach to project the global, regional, and national economic burden of ADRDs from 2019 to 2050 under status quo. METHODS We projected age group and country-specific disability-adjusted life years (DALYs) lost to ADRDs in future years based on historical growth in disease burden and available population projections. We used country-specific extrapolations of the value of a statistical life (VSL) year and its future projections based on historical income growth to estimate the economic burden - measured in terms of the value of lost DALYs - of ADRDs. A probabilistic uncertainty analysis was used to calculate point estimates and 95% uncertainty bounds of the economic burden. FINDINGS In 2019, the global VSL-based economic burden of ADRDs was an estimated $2.8 trillion. The burden was projected to increase to $4.7 trillion (95% uncertainty bound: $4 trillion-$5.5 trillion) in 2030, $8.5 trillion ($6.8 trillion-$10.8 trillion) in 2040, and $16.9 trillion ($11.3 trillion-$27.3 trillion) in 2050. Low- and middle-income countries (LMICs) would account for 65% of the global VSL-based economic burden in 2050, as compared with only 18% in 2019. Within LMICs, upper-middle income countries would carry the largest VSL-based economic burden by 2050 (92% of LMICs burden and 60% of global burden). INTERPRETATION ADRDs have a large and inequitable projected future VSL-based economic burden. FUNDING The Davos Alzheimer's Collaborative.
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Affiliation(s)
- Arindam Nandi
- The Population Council, New York, NY, USA
- One Health Trust, Washington DC, USA
- Corresponding author.
| | - Nathaniel Counts
- Mental Health America, New York, NY, USA
- Albert Einstein Medical College, New York, NY, USA
| | | | - Benjamin Seligman
- Division of Geriatric Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Geriatrics Research, Education, and Clinical Center, Greater Los Angeles VA Health Care System, Los Angeles, CA, USA
| | | | - Daniel Vigo
- University of British Columbia, Vancouver, BC, Canada
| | - David E. Bloom
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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6
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Vigo D. Suicidality in University Students Throughout the COVID-19 Pandemic. Eur Psychiatry 2022. [PMCID: PMC9565522 DOI: 10.1192/j.eurpsy.2022.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction The COVID-19 pandemic has greatly disrupted the day-to-day life of university students, as it has for the general population. University students have been reported to have high rates of mental health concerns, including suicidal ideation. Objectives Ascertaining the correlation of Covid-19 dissemination and proximity to University students in Vancouver, Canada, with suicidal ideation and suicidal plan. Methods We analyuzed weekly cross-sectional data from our Canadian World Mental Health International College Student survey by plotting the 30-day suicide ideation as a binary and the ordered 30-day suicide ideation outcomes using logistic and ordered generalized additive model (GAM) respectively, with a cubic spline and adjusting for demographics. We also ran an analysis on the association between binary 30-day ideation and different sample characteristics using logistic regression. Results The time trend analysis showed that suicidal ideation did not seem to increase during the COVID-19 pandemic. On the contrary, ideation levels were found to be high in the beginning (February 2020) with a downwards trend through June to September before gradually increasing around November, 2020. We identified sociodemographic risk factors that may be associated with suicidal ideation, and established that those most at risk were students who had been emotionally overwhelmed by Covid-19 and unable to find help. Conclusions Our results seem to indicate that, in general, students have remained resilient under the stress factors presented by the pandemic, and that trends in suicidality seem to follow seasonal or school calendar year stressors rather than respond to the pandemic. However, certain subpopulations appear to be more affected than others. Disclosure No significant relationships.
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7
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Vigo D, Jones W, Dove N, Maidana DE, Tallon C, Small W, Samji H. Estimating the Prevalence of Mental and Substance Use Disorders: A Systematic Approach to Triangulating Available Data to Inform Health Systems Planning. Can J Psychiatry 2022; 67:107-116. [PMID: 33827278 PMCID: PMC8978221 DOI: 10.1177/07067437211006872] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the prevalence of specific mental and substance use disorders (MSUDs), by age and sex, as a first step toward informing needs-based health systems planning by decision-makers. METHODS We developed a conceptual framework and a systematic methodology for combining available data sources to yield prevalence estimates for specific MSUDs. Data sources used included published, peer-reviewed literature from Canada and comparable countries, Canadian population survey data, and health administrative data from British Columbia. Several well-established methodologies including systematic review and meta-analyses of published prevalence estimates, modelling of age- and sex-specific distributions, and the Global Burden of Disease severity distribution model were incorporated in a novel mode of triangulation. RESULTS Using this novel approach, we obtained prevalence estimates for 10 MSUDs for British Columbia, Canada, as well as prevalence distributions across age groups, by sex. CONCLUSION Obtaining reliable assessments of disorder prevalence and severity is a useful first step toward rationally estimating service need and plan health services. We propose a methodology to leverage existing information to obtain robust estimates in a timely manner and with sufficient granularity to, after adjusting for comorbidity and matching with severity-specific service bundles, inform need-based planning efforts for adult (15 years and older) mental health and substance use services.
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Wayne Jones
- Centre for Applied Research in Mental Health and Addictions, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Naomi Dove
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Daniel E Maidana
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, The University of Illinois at Chicago, IL, USA
| | - Corinne Tallon
- Foundry, Providence Health Care, Vancouver, British Columbia, Canada
| | - Will Small
- Centre for Applied Research in Mental Health and Addictions, Simon Fraser University, Vancouver, British Columbia, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - Hasina Samji
- Centre for Applied Research in Mental Health and Addictions, Simon Fraser University, Vancouver, British Columbia, Canada.,British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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8
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Vigo D, Jones L, Atun R, Thornicroft G. The true global disease burden of mental illness: still elusive. Lancet Psychiatry 2022; 9:98-100. [PMID: 35026138 DOI: 10.1016/s2215-0366(22)00002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | - Laura Jones
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Rifat Atun
- Harvard University T H Chan School of Public Health, Boston, MA, USA
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9
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Leung C, Pei J, Hudec K, Shams F, Munthali R, Vigo D. The effects of non-clinician guidance on effectiveness and process outcomes of digital mental health interventions: A systematic review and meta-analysis (Preprint). J Med Internet Res 2021; 24:e36004. [PMID: 35511463 PMCID: PMC9244656 DOI: 10.2196/36004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/15/2022] [Accepted: 04/25/2022] [Indexed: 01/22/2023] Open
Abstract
Background Digital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (ie, psychologists and physicians) into digital mental health interventions has become common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other nonclinicians) can help reduce costs and increase accessibility. Objective This systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of nonclinician-guided digital mental health interventions. Methods Four databases (MEDLINE, Embase, CINAHL, and PsycINFO) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals that focus on digital intervention were hand searched; gray literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane risk-of-bias tool version 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Nonclinician-guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions. Results Thirteen studies qualified for inclusion. Nonclinician-guided interventions yielded higher posttreatment effectiveness outcomes when compared to conditions involving control programs (eg, online psychoeducation and monitored attention control) or wait-list controls (k=7, Hedges g=–0.73; 95% CI –1.08 to –0.38). There were also significant differences between nonclinician-guided interventions and unguided interventions (k=6, Hedges g=–0.17; 95% CI –0.23 to –0.11). In addition, nonclinician-guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08; 95% CI –0.01 to 0.17). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualifications of the individual performing the intervention, and that the presence of a nonclinician guide improves effectiveness outcomes compared to having no guide. Nonclinician-guided interventions did not yield significantly different adherence outcomes when compared with unguided interventions (k=3, odds ratio 1.58; 95% CI 0.51 to 4.92), although a general trend of improved adherence was observed within nonclinician-guided interventions. Conclusions Integrating paraprofessionals and nonclinicians appears to improve the outcomes of digital mental health interventions, and may also enhance adherence outcomes (though this trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (ie, psychosocial support, therapeutic alliance, and technical augmentation) and their associated outcomes. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020191226; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=191226
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Affiliation(s)
- Calista Leung
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julia Pei
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kristen Hudec
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Farhud Shams
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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10
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Schmidt RA, Genois R, Jin J, Vigo D, Rehm J, Rush B. The early impact of COVID-19 on the incidence, prevalence, and severity of alcohol use and other drugs: A systematic review. Drug Alcohol Depend 2021; 228:109065. [PMID: 34600257 PMCID: PMC8455354 DOI: 10.1016/j.drugalcdep.2021.109065] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this paper was to examine the early impact of COVID-19 on substance use to assess implications for planning substance use treatment and support systems. METHOD A systematic review of literature published up to March 2021 was conducted to summarize changes in prevalence, incidence, and severity of substance use associated with COVID-19 and the accompanying public health measures, including lockdown, stay-at-home orders, and social distancing. RESULTS We identified 53 papers describing changes to substance use at the population level. The majority of papers described changes related to alcohol use and most relied on self-reported measures of consumption during the COVID-19 pandemic, compared with pre-pandemic use. There was less evidence to support changes in non-alcohol substance use. In general, risky pre-pandemic alcohol use, caregiving responsibilities, stress, depression, anxiety, and current treatment for a mental disorder were found to be associated with increased substance use. CONCLUSION This review provides preliminary data on changes in substance use, indicating that certain segments of the population increased their alcohol use early on in the COVID-19 pandemic and may be at greater risk of harm and in need of additional services. There is a need for additional population-level information on substance use to inform evidence-based rapid responses from a treatment system perspective.
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Affiliation(s)
- Rose A. Schmidt
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5T 2S1, Canada,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada,Correspondence to: 33 Ursula Franklin Street, Toronto, ON, Canada
| | - Rosalie Genois
- Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada.
| | - Jonathan Jin
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5T 2S1, Canada.
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada.
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5T 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada; Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5T 2S1, Canada; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992 Moscow, Russian Federation; Agència de Salut Pública de Catalunya, 81-95 Roc Boronat St., 08005 Barcelona, Spain; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.
| | - Brian Rush
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5T 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5T 2S1, Canada.
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11
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Vigo D, Jones L, Munthali R, Pei J, Westenberg J, Munro L, Judkowicz C, Wang AY, Van den Adel B, Dulai J, Krausz M, Auerbach RP, Bruffaerts R, Yatham L, Gadermann A, Rush B, Xie H, Pendakur K, Richardson C. [Association of COVID-19 dissemination with symptoms of anxiety and depression among university students]. Vertex 2021; XXXII:53-69. [PMID: 34783787 DOI: 10.53680/vertex.v32i153.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations- such as university students-is needed as communities prepare for future waves. AIMS To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students. METHODS This trend study analyzed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as "knowing someone who tested positive for COVID-19", which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course, or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression. RESULTS Of 1,388 respondents (adjusted response rate=50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course, and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11 percentage-point increase in the probability of 30-day anxiety symptoms (SE=0,05; p≤0,05), moderated by gender, with a significant interaction of the exposure and being female (coefficient= 20(SE=0,09), p≤0,05). No association was found with depressive symptoms. CONCLUSION Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly amongst men. Most students report coping well, but additional supports are needed for an emotionally overwhelmed minority who report being unable to access help.
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Canada. E-mail:
| | - Laura Jones
- Department of Psychiatry, University of British Columbia, Canada
| | - Richard Munthali
- Department of Psychiatry, University of British Columbia, Canada
| | - Julia Pei
- Department of Psychiatry, University of British Columbia, Canada
| | - Jean Westenberg
- Department of Psychiatry, University of British Columbia, Canada
| | - Lonna Munro
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Angel Y Wang
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Joshun Dulai
- Department of Psychiatry, University of British Columbia, Canada
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, United States
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Belgium
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian Rush
- Department of Psychiatry & School of Public Health, University of Toronto, Toronto, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Krishna Pendakur
- Department of Economics, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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12
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Fernández D, Vigo D, Sampson NA, Hwang I, Aguilar-Gaxiola S, Al-Hamzawi AO, Alonso J, Andrade LH, Bromet EJ, de Girolamo G, de Jonge P, Florescu S, Gureje O, Hinkov H, Hu C, Karam EG, Karam G, Kawakami N, Kiejna A, Kovess-Masfety V, Medina-Mora ME, Navarro-Mateu F, Ojagbemi A, O’Neill S, Piazza M, Posada-Villa J, Rapsey C, Williams DR, Xavier M, Ziv Y, Kessler RC, Haro JM. Patterns of care and dropout rates from outpatient mental healthcare in low-, middle- and high-income countries from the World Health Organization's World Mental Health Survey Initiative. Psychol Med 2021; 51:2104-2116. [PMID: 32343221 PMCID: PMC8265313 DOI: 10.1017/s0033291720000884] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is a substantial proportion of patients who drop out of treatment before they receive minimally adequate care. They tend to have worse health outcomes than those who complete treatment. Our main goal is to describe the frequency and determinants of dropout from treatment for mental disorders in low-, middle-, and high-income countries. METHODS Respondents from 13 low- or middle-income countries (N = 60 224) and 15 in high-income countries (N = 77 303) were screened for mental and substance use disorders. Cross-tabulations were used to examine the distribution of treatment and dropout rates for those who screened positive. The timing of dropout was examined using Kaplan-Meier curves. Predictors of dropout were examined with survival analysis using a logistic link function. RESULTS Dropout rates are high, both in high-income (30%) and low/middle-income (45%) countries. Dropout mostly occurs during the first two visits. It is higher in general medical rather than in specialist settings (nearly 60% v. 20% in lower income settings). It is also higher for mild and moderate than for severe presentations. The lack of financial protection for mental health services is associated with overall increased dropout from care. CONCLUSIONS Extending financial protection and coverage for mental disorders may reduce dropout. Efficiency can be improved by managing the milder clinical presentations at the entry point to the mental health system, providing adequate training, support and specialist supervision for non-specialists, and streamlining referral to psychiatrists for more severe cases.
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Affiliation(s)
- Daniel Fernández
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
- Serra Húnter fellow. Department of Statistics and Operations Research, Polytechnic University of Catalonia, Barcelona, Spain
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - Ali O. Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya Governorate, Iraq
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | - Laura Helena Andrade
- Núcleo de Epidemiologia Psiquiátrica - LIM 23, Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA
| | | | - Peter de Jonge
- Department of Developmental Psychology, Rijksuniversiteit Groningen, Groningen, Netherlands
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Hristo Hinkov
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Chiyi Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Beirut, Lebanon
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Georges Karam
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Beirut, Lebanon
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Norito Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Andrzej Kiejna
- Wroclaw Medical University; University of Lower Silesia, Wroclaw, Poland
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | | | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - Akin Ojagbemi
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Siobhan O’Neill
- School of Psychology, Ulster University, Londonderry, United Kingdom
| | | | - Jose Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Charlene Rapsey
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Miguel Xavier
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Yuval Ziv
- Mental Health Services, Israeli Ministry of Health, Jerusalem, Israel
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Josep M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
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13
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Coates MM, Ezzati M, Robles Aguilar G, Kwan GF, Vigo D, Mocumbi AO, Becker AE, Makani J, Hyder AA, Jain Y, Stefan DC, Gupta N, Marx A, Bukhman G. Burden of disease among the world's poorest billion people: An expert-informed secondary analysis of Global Burden of Disease estimates. PLoS One 2021; 16:e0253073. [PMID: 34398896 PMCID: PMC8366975 DOI: 10.1371/journal.pone.0253073] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/27/2021] [Indexed: 12/12/2022] Open
Abstract
Background The health of populations living in extreme poverty has been a long-standing focus of global development efforts, and continues to be a priority during the Sustainable Development Goal era. However, there has not been a systematic attempt to quantify the magnitude and causes of the burden in this specific population for almost two decades. We estimated disease rates by cause for the world’s poorest billion and compared these rates to those in high-income populations. Methods We defined the population in extreme poverty using a multidimensional poverty index. We used national-level disease burden estimates from the 2017 Global Burden of Disease Study and adjusted these to account for within-country variation in rates. To adjust for within-country variation, we looked to the relationship between rates of extreme poverty and disease rates across countries. In our main modeling approach, we used these relationships when there was consistency with expert opinion from a survey we conducted of disease experts regarding the associations between household poverty and the incidence and fatality of conditions. Otherwise, no within-country variation was assumed. We compared results across multiple approaches for estimating the burden in the poorest billion, including aggregating national-level burden from the countries with the highest poverty rates. We examined the composition of the estimated disease burden among the poorest billion and made comparisons with estimates for high-income countries. Results The composition of disease burden among the poorest billion, as measured by disability-adjusted life years (DALYs), was 65% communicable, maternal, neonatal, and nutritional (CMNN) diseases, 29% non-communicable diseases (NCDs), and 6% injuries. Age-standardized DALY rates from NCDs were 44% higher in the poorest billion (23,583 DALYs per 100,000) compared to high-income regions (16,344 DALYs per 100,000). Age-standardized DALY rates were 2,147% higher for CMNN conditions (32,334 DALYs per 100,000) and 86% higher for injuries (4,182 DALYs per 100,000) in the poorest billion, compared to high-income regions. Conclusion The disease burden among the poorest people globally compared to that in high income countries is highly influenced by demographics as well as large disparities in burden from many conditions. The comparisons show that the largest disparities remain in communicable, maternal, neonatal, and nutritional diseases, though NCDs and injuries are an important part of the “unfinished agenda” of poor health among those living in extreme poverty.
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Affiliation(s)
- Matthew M. Coates
- Program in Global Noncommunicable Diseases and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- WHO Collaborating Centre on NCD Surveillance and Epidemiology, Imperial College London, London, United Kingdom
| | | | - Gene F. Kwan
- Program in Global Noncommunicable Diseases and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Section of Cardiovascular Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Partners In Health, Boston, Massachusetts, United States of America
| | - Daniel Vigo
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ana O. Mocumbi
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Anne E. Becker
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Julie Makani
- Sickle Cell Programme, Muhimbili University of Health & Allied Sciences, Dar-es-Salaam, Tanzania
- Department of Haematology & Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Adnan A. Hyder
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Yogesh Jain
- Jan Swasthya Sahyog, Bilaspur, Chhattisgarh, India
| | - D. Cristina Stefan
- African Medical Research and Innovation Institute, Cape Town, South Africa
- SingHealth Duke-NUS Global Health Institute (SDGHI), Duke-NUS Medical School, Singapore, Singapore
| | - Neil Gupta
- Program in Global Noncommunicable Diseases and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Partners In Health, Boston, Massachusetts, United States of America
| | - Andrew Marx
- Program in Global Noncommunicable Diseases and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gene Bukhman
- Program in Global Noncommunicable Diseases and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Partners In Health, Boston, Massachusetts, United States of America
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- * E-mail:
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14
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de Vries YA, Harris MG, Vigo D, Chiu WT, Sampson NA, Al-Hamzawi A, Alonso J, Andrade LH, Benjet C, Bruffaerts R, Bunting B, de Almeida JMC, de Girolamo G, Florescu S, Gureje O, Haro JM, Hu C, Karam EG, Kawakami N, Kovess-Masfety V, Lee S, Moskalewicz J, Navarro-Mateu F, Ojagbemi A, Posada-Villa J, Scott K, Torres Y, Zarkov Z, Nierenberg A, Kessler RC, de Jonge P. Perceived helpfulness of treatment for specific phobia: Findings from the World Mental Health Surveys. J Affect Disord 2021; 288:199-209. [PMID: 33940429 PMCID: PMC8154701 DOI: 10.1016/j.jad.2021.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although randomized trials show that specific phobia treatments can be effective, it is unclear whether patients experience treatment as helpful in clinical practice. We investigated this issue by assessing perceived treatment helpfulness for specific phobia in a cross-national epidemiological survey. METHODS Cross-sectional population-based WHO World Mental Health (WMH) surveys in 24 countries (n=112,507) assessed lifetime specific phobia. Respondents who met lifetime criteria were asked whether they ever received treatment they considered helpful and the number of professionals seen up to the time of receiving helpful treatment. Discrete-event survival analysis was used to calculate conditional-cumulative probabilities of obtaining helpful treatment across number of professionals seen and of persisting in help-seeking after prior unhelpful treatment. RESULTS 23.0% of respondents reported receiving helpful treatment from the first professional seen, whereas cumulative probability of receiving helpful treatment was 85.7% after seeing up to 9 professionals. However, only 14.7% of patients persisted in seeing up to 9 professionals, resulting in the proportion of patients ever receiving helpful treatment (47.5%) being much lower than it could have been with persistence in help-seeking. Few predictors were found either of perceived helpfulness or of persistence in help-seeking after earlier unhelpful treatments. LIMITATIONS Retrospective recall and lack of information about either types of treatments received or objective symptomatic improvements limit results. CONCLUSIONS Despite these limitations, results suggest that helpfulness of specific phobia treatment could be increased, perhaps substantially, by increasing patient persistence in help-seeking after earlier unhelpful treatments. Improved understanding is needed of barriers to help-seeking persistence.
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Affiliation(s)
- Ymkje Anna de Vries
- Department of Developmental Psychology, University of Groningen, Groningen, NL; Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, NL
| | - Meredith G. Harris
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, QLD 4072, Australia
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Wai Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain
| | - Laura H. Andrade
- Núcleo de Epidemiologia Psiquiatrica - LIM 23, Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil Section of Psychiatric Epidemiology - LIM 23, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Brendan Bunting
- School of Psychology, Ulster University, Londonderry, United Kingdom
| | - José Miguel Caldas de Almeida
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain; Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia
| | - Chiyi Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon; Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Norito Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | | | - Fernando Navarro-Mateu
- UDIF-SM, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Región de Murcia, Spain
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Nigeria
| | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia (Cundinamarca University, calle 28 # 5B 02, Bogotá, 11001000 (zip), Colombia)
| | - Kate Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
| | - Zahari Zarkov
- Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Andrew Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, NL; Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, NL
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15
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Chau LW, Erickson M, Vigo D, Lou H, Pakhomova T, Winston ML, MacPherson D, Thomson E, Small W. The perspectives of people who use drugs regarding short term involuntary substance use care for severe substance use disorders. Int J Drug Policy 2021; 97:103208. [PMID: 34058669 DOI: 10.1016/j.drugpo.2021.103208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND In the Canadian Province of British Columbia (BC), the BC Mental Health Act permits involuntary care for treating mental disorders. However, the Act has also been applied to provide involuntary care to individuals with a primary substance use disorder, in the absence of specific guidelines and legislation, and with insufficient understanding of perspectives of people who use drugs (PWUD) regarding this approach. METHODS As part of a larger mixed-methods research project providing an overview of involuntary care for severe substance use disorders in BC, three focus groups were convened with: PWUD, families and caregivers, and Indigenous community stakeholders. This analysis examines perspectives from the focus group of PWUD, consisting of nine participants from local and regional drug user and advocacy organizations regarding involuntary care. A qualitative descriptive approach and thematic analysis were conducted, using a coding framework developed deductively and inductively, and participant perspectives were interpreted drawing on problematization theory. RESULTS Participants did not endorse the use of involuntary care, instead emphasizing significant changes were needed to address shortcomings of the wider voluntary care system. When asked to conceptualize what an acceptable involuntary care scenario might look like (under hypothetical and ideal conditions), participants recommended it should include: individual control and autonomy, peer advocacy in decision-making, and elimination of police and criminal justice system involvement from treatment encounters. Participants saw involuntary care to be an inappropriate approach given the shortcomings of the current system, noting also problems inherent in its use to manage severe SUDs and imminent harm, and prioritized alternate approaches to offsetting risks. CONCLUSION Improving voluntary care for substance use, along with addressing the social determinants of health that put individuals at risk of problematic substance use and harm, were prioritized in participant perspectives. Participant comments regarding the use of involuntary care bring forward alternate solutions in the context of the opioid overdose crisis, and a reconceptualization of the 'problem' of managing severe substance use disorders.
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Affiliation(s)
- Leena W Chau
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Margaret Erickson
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Daniel Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, David Strangway Building, 4th Floor 209, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Hayami Lou
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Tatiana Pakhomova
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Mark L Winston
- Morris J. Wosk Centre for Dialogue, Simon Fraser University, 3309-515 West Hastings Street, Vancouver, BC, V6B 5K3, Vancouver, Canada
| | - Donald MacPherson
- Canadian Drug Policy Coalition, 101-515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Erica Thomson
- BC and Yukon Association of Drug War Survivors, 416 Columbia St, New Westminster, BC, V3L 1B1, Canada; Harm Reduction Program, Fraser Health Authority, BC, Canada
| | - Will Small
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, 515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada; British Columbia Centre on Substance Use.
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16
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Vigo D, Jones L, Munthali R, Pei J, Westenberg J, Munro L, Judkowicz C, Wang AY, Van den Adel B, Dulai J, Krausz M, Auerbach RP, Bruffaerts R, Yatham L, Gadermann A, Rush B, Xie H, Pendakur K, Richardson C. Investigating the effect of COVID-19 dissemination on symptoms of anxiety and depression among university students. BJPsych Open 2021; 7:e69. [PMID: 33736744 PMCID: PMC8058823 DOI: 10.1192/bjo.2021.24] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Evidence about the impact of the COVID-19 pandemic on the mental health of specific subpopulations, such as university students, is needed as communities prepare for future waves. AIMS To study the association of proximity of COVID-19 with symptoms of anxiety and depression in university students. METHOD This trend study analysed weekly cross-sectional surveys of probabilistic samples of students from the University of British Columbia for 13 weeks, through the first wave of COVID-19. The main variable assessed was propinquity of COVID-19, defined as 'knowing someone who tested positive for COVID-19', which was specified at different levels: knowing someone anywhere globally, in Canada, in Vancouver, in their course or at home. Proximity was included in multivariable linear regressions to assess its association with primary outcomes, including 30-day symptoms of anxiety and/or depression. RESULTS Of 1388 respondents (adjusted response rate of 50%), 5.6% knew someone with COVID-19 in Vancouver, 0.8% in their course and 0.3% at home. Ten percent were overwhelmed and unable to access help. Knowing someone in Vancouver was associated with an 11-percentage-point increase in the probability of 30-day anxiety symptoms (s.e. 0.05, P ≤ 0.05), moderated by gender, with a significant interaction of the exposure and being female (coefficient -20, s.e. 0.09, P ≤ 0.05). No association was found with depressive symptoms. CONCLUSIONS Propinquity of COVID-19 cases may increase the likelihood of anxiety symptoms in students, particularly among men. Most students reported coping well, but additional support is needed for an emotionally overwhelmed minority who report being unable to access help.
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Canada
| | - Laura Jones
- Department of Psychiatry, University of British Columbia, Canada
| | - Richard Munthali
- Department of Psychiatry, University of British Columbia, Canada
| | - Julia Pei
- Department of Psychiatry, University of British Columbia, Canada
| | - Jean Westenberg
- Department of Psychiatry, University of British Columbia, Canada
| | - Lonna Munro
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Angel Y. Wang
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Joshun Dulai
- Department of Psychiatry, University of British Columbia, Canada
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Canada
| | | | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Belgium
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Canada
| | - Brian Rush
- Department of Psychiatry & School of Public Health, University of Toronto, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Canada
| | | | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Canada
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17
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Gallardo J, Bellone G, Plano S, Vigo D, Risk M. Heart Rate Variability: Influence of Pre-processing Methods in Identifying Single-Night Sleep-Deprived Subjects. J Med Biol Eng 2021. [DOI: 10.1007/s40846-020-00595-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Gratzer D, Torous J, Lam RW, Patten SB, Kutcher S, Chan S, Vigo D, Pajer K, Yatham LN. Our Digital Moment: Innovations and Opportunities in Digital Mental Health Care. Can J Psychiatry 2021; 66:5-8. [PMID: 32603188 PMCID: PMC7890581 DOI: 10.1177/0706743720937833] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- David Gratzer
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario, Canada
| | - John Torous
- Department of Psychiatry, 1859Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott B Patten
- Departments of Psychiatry and Community Health Sciences, 2129University of Calgary, Alberta, Canada
| | - Stanley Kutcher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Senate of Canada, Ottawa, Ontario, Canada
| | - Steven Chan
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA.,Palo Alto VA Health, Palo Alto, CA, USA
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Kathleen Pajer
- Department of Psychiatry, University of Ottawa, Ontario, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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19
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Puyat JH, Ahmad H, Avina-Galindo AM, Kazanjian A, Gupta A, Ellis U, Ashe MC, Vila-Rodriguez F, Halli P, Salmon A, Vigo D, Almeida A, De Bono CE. A rapid review of home-based activities that can promote mental wellness during the COVID-19 pandemic. PLoS One 2020; 15:e0243125. [PMID: 33270755 PMCID: PMC7714353 DOI: 10.1371/journal.pone.0243125] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/16/2020] [Indexed: 01/21/2023] Open
Abstract
Background During the COVID-19 pandemic, public health measures such as isolation, quarantine, and social distancing are needed. Some of these measures can adversely affect mental health. Activities that can be performed at home may mitigate these consequences and improve overall mental well-being. In this study, home-based activities that have potential beneficial effects on mental health were examined. Methods A rapid review was conducted based on a search of the following databases: MEDLINE, EMBASE, CINAHL, PyscINFO, Global Health, epistemonikos.org, covid19reviews.org, and eppi.ioe.ac.uk/covid19_map_v13.html. Eligible studies include randomized controlled trials and non-randomized studies published between 1/1/2000 and 28/05/2020 and that examined the impact of various activities on mental health outcomes in low-resource settings and contexts that lead to social isolation. Studies of activities that require mental health professionals or that could not be done at home were excluded. Two review authors performed title/abstract screening. At the full-text review stage, 25% of the potentially eligible studies were reviewed in full by two review authors; the rest were reviewed by one review author. Risk of bias assessment and data extraction were performed by one review author and checked by a second review author. The main outcome assessed was change or differences in mental health as expressed in Cohen’s d; analysis was conducted following the synthesis without meta-analysis guidelines (SWiM). PROSPERO registration: CRD42020186082. Results Of 1,236 unique records identified, 160 were reviewed in full, resulting in 16 included studies. The included studies reported on the beneficial effects of exercise, yoga, progressive muscle relaxation, and listening to relaxing music. One study reported on the association between solitary religious activities and post traumatic stress disorder symptoms. While most of the included studies examined activities in group settings, particularly among individuals in prisons, the activities were described as something that can be performed at home and alone. All included studies were assessed to be at risk of bias in one or more of the bias domains examined. Conclusions There is some evidence that certain home-based activities can promote mental wellness during the COVID-19 pandemic. Guidelines are needed to help optimize benefits while minimizing potential risks when performing these activities.
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Affiliation(s)
- Joseph H. Puyat
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care and The University of British Columbia, Vancouver, Canada
- School of Population & Public Health, The University of British Columbia, Vancouver, Canada
- * E-mail:
| | - Haroon Ahmad
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Ana Michelle Avina-Galindo
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, The University of British Columbia, Vancouver, Canada
| | - Arminee Kazanjian
- School of Population & Public Health, The University of British Columbia, Vancouver, Canada
| | - Aanchel Gupta
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care and The University of British Columbia, Vancouver, Canada
- School of Population & Public Health, The University of British Columbia, Vancouver, Canada
| | - Ursula Ellis
- Woodward Library, The University of British Columbia, Vancouver, Canada
| | - Maureen C. Ashe
- Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, The University of British Columbia, Vancouver, Canada
| | - Priyanka Halli
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Amy Salmon
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care and The University of British Columbia, Vancouver, Canada
- School of Population & Public Health, The University of British Columbia, Vancouver, Canada
| | - Daniel Vigo
- School of Population & Public Health, The University of British Columbia, Vancouver, Canada
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Alberto Almeida
- Mental Health Program, Providence Health Care, Vancouver, British Columbia, Canada
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20
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Instituto Superior de Formación de Postgrado, Asociación de Psiquiatras Argentinos, Buenos Aires, Argentina
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Oye Gureje
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria
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21
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Goswami N, Abulafia C, Vigo D, Moser M, Cornelissen G, Cardinali D. Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives. Clin Interv Aging 2020; 15:2165-2174. [PMID: 33204081 PMCID: PMC7666981 DOI: 10.2147/cia.s283342] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/03/2020] [Indexed: 01/31/2023] Open
Abstract
Aging is associated with weakening of the circadian system. The circadian amplitude of most physiological variables is reduced, while the circadian phase becomes more labile and tends to occur earlier with advancing age. As the incidence of falls in older persons could follow circadian variations, a better understanding of conditions in which falls occur can lead to the implementation of countermeasures (such as adjusting the scheduling of hospital staff, or changing the timing of anti-hypertensive medication if falls are related to undesirable circadian patterns of blood pressure and/or heart rate). This includes knowing the times of the day, days of the week, and times of the year when falls are more likely to occur at home or in the hospital. Additionally, the links between aging processes and factors associated with an increased risk of developing autonomic dysfunction are well established. A strong association between heart rate variability indexes and aging has been shown. Circadian rhythms of autonomous nervous system activity may play important role for maintenance of orthostatic tolerance. Whether one is concerned with disease prediction and prevention or maintenance of healthy aging, the study of circadian rhythms and the broader time structure underlying physiopathology is helpful in terms of screening, early diagnosis and prognosis, as well as the timely institution of prophylactic and/or palliative/curative treatment. Timing the administration of such treatment as a function of circadian (and other) rhythms also could lead to reduction of falls in older persons. Finally, a prominent circadian rhythm characterizes melatonin, which peaks during the night. The circadian amplitude of melatonin decreases as a function of age, raising the questions whether such a decrease in the circadian amplitude of melatonin relates to a higher risk of falls and, if so, whether melatonin supplementation may be an effective countermeasure. This narrative review assesses the relationships between fall risk and the potential role circadian rhythms and melatonin play in mitigating this risk. We aim to provide healthcare workers adequate information about fall risk in older persons, including the potential role of the circadian rhythms and/or melatonin, as well as to lay foundations for future fall prevention interventional studies.
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Affiliation(s)
- Nandu Goswami
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | - Carolina Abulafia
- Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina
| | - Daniel Vigo
- Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina
| | - Maximilian Moser
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | | | - Daniel Cardinali
- Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina
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22
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Vigo D, Haro JM, Hwang I, Aguilar-Gaxiola S, Alonso J, Borges G, Bruffaerts R, Caldas-de-Almeida JM, de Girolamo G, Florescu S, Gureje O, Karam E, Karam G, Kovess-Masfety V, Lee S, Navarro-Mateu F, Ojagbemi A, Posada-Villa J, Sampson NA, Scott K, Stagnaro JC, Have MT, Viana MC, Wu CS, Chatterji S, Cuijpers P, Thornicroft G, Kessler RC. Toward measuring effective treatment coverage: critical bottlenecks in quality- and user-adjusted coverage for major depressive disorder. Psychol Med 2020; 52:1-11. [PMID: 33077023 PMCID: PMC9341444 DOI: 10.1017/s0033291720003797] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a leading cause of morbidity and mortality. Shortfalls in treatment quantity and quality are well-established, but the specific gaps in pharmacotherapy and psychotherapy are poorly understood. This paper analyzes the gap in treatment coverage for MDD and identifies critical bottlenecks. METHODS Seventeen surveys were conducted across 15 countries by the World Health Organization-World Mental Health Surveys Initiative. Of 35 012 respondents, 3341 met DSM-IV criteria for 12-month MDD. The following components of effective treatment coverage were analyzed: (a) any mental health service utilization; (b) adequate pharmacotherapy; (c) adequate psychotherapy; and (d) adequate severity-specific combination of both. RESULTS MDD prevalence was 4.8% (s.e., 0.2). A total of 41.8% (s.e., 1.1) received any mental health services, 23.2% (s.e., 1.5) of which was deemed effective. This 90% gap in effective treatment is due to lack of utilization (58%) and inadequate quality or adherence (32%). Critical bottlenecks are underutilization of psychotherapy (26 percentage-points reduction in coverage), underutilization of psychopharmacology (13-point reduction), inadequate physician monitoring (13-point reduction), and inadequate drug-type (10-point reduction). High-income countries double low-income countries in any mental health service utilization, adequate pharmacotherapy, adequate psychotherapy, and adequate combination of both. Severe cases are more likely than mild-moderate cases to receive either adequate pharmacotherapy or psychotherapy, but less likely to receive an adequate combination. CONCLUSIONS Decision-makers need to increase the utilization and quality of pharmacotherapy and psychotherapy. Innovations such as telehealth for training and supervision plus non-specialist or community resources to deliver pharmacotherapy and psychotherapy could address these bottlenecks.
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | - Guilherme Borges
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Jose Miguel Caldas-de-Almeida
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Georges Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Nigeria
| | - Jose Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Kate Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Margreet ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital & College of Medicine, Taipei, Taiwan
| | - Somnath Chatterji
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University, Amsterdam
- The Netherlands & EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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23
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Vigo D, Patten S, Pajer K, Krausz M, Taylor S, Rush B, Raviola G, Saxena S, Thornicroft G, Yatham LN. Mental Health of Communities during the COVID-19 Pandemic. Can J Psychiatry 2020; 65:681-687. [PMID: 32391720 PMCID: PMC7502878 DOI: 10.1177/0706743720926676] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Global Health and Social Medicine; Harvard Medical School, Harvard University, Boston, MA, USA
| | - Scott Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Kathleen Pajer
- Department of Psychiatry, University of Ottawa, Ontario, Canada
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian Rush
- Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Giuseppe Raviola
- Department of Global Health and Social Medicine; Harvard Medical School, Harvard University, Boston, MA, USA
| | - Shekhar Saxena
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Graham Thornicroft
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Lakshmi N. Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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24
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Harris MG, Kazdin AE, Chiu WT, Sampson NA, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Altwaijri Y, Andrade LH, Cardoso G, Cía A, Florescu S, Gureje O, Hu C, Karam EG, Karam G, Mneimneh Z, Navarro-Mateu F, Oladeji BD, O’Neill S, Scott K, Slade T, Torres Y, Vigo D, Wojtyniak B, Zarkov Z, Ziv Y, Kessler RC. Findings From World Mental Health Surveys of the Perceived Helpfulness of Treatment for Patients With Major Depressive Disorder. JAMA Psychiatry 2020; 77:830-841. [PMID: 32432716 PMCID: PMC7240636 DOI: 10.1001/jamapsychiatry.2020.1107] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE The perceived helpfulness of treatment is an important patient-centered measure that is a joint function of whether treatment professionals are perceived as helpful and whether patients persist in help-seeking after previous unhelpful treatments. OBJECTIVE To examine the prevalence and factors associated with the 2 main components of perceived helpfulness of treatment in a representative sample of individuals with a lifetime history of DSM-IV major depressive disorder (MDD). DESIGN, SETTING, AND PARTICIPANTS This study examined the results of a coordinated series of community epidemiologic surveys of noninstitutionalized adults using the World Health Organization World Mental Health surveys. Seventeen surveys were conducted in 16 countries (8 surveys in high-income countries and 9 in low- and middle-income countries). The dates of data collection ranged from 2002 to 2003 (Lebanon) to 2016 to 2017 (Bulgaria). Participants included those with a lifetime history of treated MDD. Data analyses were conducted from April 2019 to January 2020. Data on socioeconomic characteristics, lifetime comorbid conditions (eg, anxiety and substance use disorders), treatment type, treatment timing, and country income level were collected. MAIN OUTCOMES AND MEASURES Conditional probabilities of helpful treatment after seeing between 1 and 5 professionals; persistence in help-seeking after between 1 and 4 unhelpful treatments; and ever obtaining helpful treatment regardless of number of professionals seen. RESULTS Survey response rates ranged from 50.4% (Poland) to 97.2% (Medellín, Columbia), with a pooled response rate of 68.3% (n = 117 616) across surveys. Mean (SE) age at first depression treatment was 34.8 (0.3) years, and 69.4% were female. Of 2726 people with a lifetime history of treatment of MDD, the cumulative probability (SE) of all respondents pooled across countries of helpful treatment after seeing up to 10 professionals was 93.9% (1.2%), but only 21.5% (3.2%) of patients persisted that long (ie, beyond 9 unhelpful treatments), resulting in 68.2% (1.1%) of patients ever receiving treatment that they perceived as helpful. The probability of perceiving treatment as helpful increased in association with 4 factors: older age at initiating treatment (adjusted odds ratio [AOR], 1.02; 95% CI, 1.01-1.03), higher educational level (low: AOR, 0.48; 95% CI, 0.33-0.70; low-average: AOR, 0.62; 95% CI, 0.44-0.89; high average: AOR, 0.67; 95% CI, 0.49-0.91 vs high educational level), shorter delay in initiating treatment after first onset (AOR, 0.98; 95% CI, 0.97-0.99), and medication received from a mental health specialist (AOR, 2.91; 95% CI, 2.04-4.15). Decomposition analysis showed that the first 2 of these 4 factors were associated with only the conditional probability of an individual treatment professional being perceived as helpful (age at first depression treatment: AOR, 1.02; 95% CI, 1.01-1.02; educational level: low: AOR, 0.48; 95% CI, 0.33-0.70; low-average: AOR, 0.62; 95% CI, 0.44-0.89; high-average: AOR, 0.67; 95% CI, 0.49-0.91 vs high educational level), whereas the latter 2 factors were associated with only persistence (treatment delay: AOR, 0.98; 95% CI, 0.97-0.99; treatment type: AOR, 3.43; 95% CI, 2.51-4.70). CONCLUSIONS AND RELEVANCE The probability that patients with MDD obtain treatment that they consider helpful might increase, perhaps markedly, if they persisted in help-seeking after unhelpful treatments with up to 9 prior professionals.
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Affiliation(s)
- Meredith G. Harris
- The University of Queensland School of Public Health, Herston, Queensland, Australia,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - Alan E. Kazdin
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Wai Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | | | - Ali Al-Hamzawi
- Al-Qadisiya University College of Medicine, Diwaniya Governorate, Iraq
| | - Jordi Alonso
- IMIM–Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain,Departament de Ciències Experimentals i de la Salut, Pompeu Fabra University, Barcelona, Spain,CIBER en Epidemiología y Salud Pública, Barcelona, Spain
| | - Yasmin Altwaijri
- Epidemiology Section, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Laura Helena Andrade
- Núcleo de Epidemiologia Psiquiátrica (LIM 23), Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Alfredo Cía
- Anxiety Disorders Center, Buenos Aires, Argentina
| | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Chiyi Hu
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen, China
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon,Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon,Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon
| | - Georges Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon,Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon,Institute for Development Research Advocacy and Applied Care, Beirut, Lebanon
| | - Zeina Mneimneh
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor
| | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
| | | | - Siobhan O’Neill
- Ulster University School of Psychology, Londonderry, United Kingdom
| | - Kate Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, New South Wales, Australia
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University, Medellín, Colombia
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada,Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Bogdan Wojtyniak
- National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Zahari Zarkov
- National Center of Public Health and Analyses, Directorate of Mental Health and Prevention of Addictions, Sofia, Bulgaria
| | - Yuval Ziv
- Mental Health Services, Israeli Ministry of Health, Jerusalem, Israel
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
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25
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Abstract
BACKGROUND Despite civilization and progress, burns occur frequently in the world. Remarkable discoveries of wound healing mechanisms have been reported. On the other hand, long-term outcomes from burn injuries represent a barrier to improvement of patients' social, functional, and psychological condition. Lipofilling, described since the 1980s, currently is used for several clinical applications. This study aimed to verify whether lipofilling could ameliorate scar remodeling in three clinical cases. METHODS Three adult patients with hemifacial hypertrophic scars and keloids resulting from severe burns 2 to 13 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. Two injections (with a 13-month interval between) were administered at the dermohypodermal junction. Histologic examination of scar tissue punch biopsies (hematoxylin-eosin staining) before and after the treatment was performed as well as magnetic resonance scan with contrast. RESULTS The clinical appearance and subjective patient feelings after a 6-month follow-up period suggest considerable improvement in the mimic features, skin texture, and thickness. Histologic examination shows patterns of new collagen deposition, local hypervascularity, and dermal hyperplasia in the context of new tissue, with high correspondence to the original. CONCLUSIONS The preliminary results show that lipofilling improves scar quality and suggest a tissue regeneration enhancing process.
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Affiliation(s)
- M Klinger
- Università degli Studi di Milano, Istituto di Chirurgia Plastica, Unità Operativa di Chirurgia Plastica, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Italy.
| | - M Marazzi
- Centro di Riferimento Regionale Colture Cellulari, Ospedale Niguarda ''Ca' Granda'', Milano, Italy
| | - D Vigo
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Università degli Studi di Milano, Milano, Italy
| | - M Torre
- Dipartimento di Chimica Farmaceutica, Università degli Studi di Pavia, Pavia, Italy
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26
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Pinto JV, Saraf G, Vigo D, Keramatian K, Chakrabarty T, Yatham LN. Cariprazine in the treatment of Bipolar Disorder: A systematic review and meta-analysis. Bipolar Disord 2020; 22:360-371. [PMID: 31618503 DOI: 10.1111/bdi.12850] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Cariprazine is a partial agonist at D2/D3 receptors that has been approved for the treatment of mania associated with bipolar disorder (BD). This meta-analysis aimed to assess the efficacy and tolerability of cariprazine in the treatment of BD. METHODS Randomized controlled trials investigating the efficacy of cariprazine in BD were included. Of the 391 studies yielded by search, 7 were included. The PRISMA protocol was followed and a set of analyses involving random-effects model with restricted maximum-likelihood estimator were used to synthesize effect sizes. RESULTS Cariprazine was associated with a moderate and significant reduction of manic symptoms based on YMRS change scores (SMD: -0.52; 95%CI: -0.82 to -0.21; P = .018). Cariprazine resulted in significantly higher remission (OR: 2.05; 95%CI: 1.61-2.61; P = .006) and response rates (OR: 2.31; 95%CI: 1.35-3.95; P = .021) for manic and mixed episodes compared with placebo. Both cariprazine 1.5 mg and 3 mg doses were associated with small but significant reduction in depressive symptoms assessed with MADRS scores (SMD: -0.26, 95%CI: -0.49 to -0.02; P = .040) (SMD: -0.21, 95%CI: -0.41 to -0.01; P = .045), respectively. Cariprazine was significantly associated with the development of adverse effects but not with dropouts due to these adverse effects, when compared to placebo. CONCLUSION Cariprazine appears to be safe and efficacious in the treatment of acute mania and mixed episodes associated with BD. Cariprazine at doses of 1.5-3 mg/day is efficacious in acute bipolar depression but the effect sizes were smaller. Controlled studies evaluating its efficacy for prophylaxis are needed.
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Affiliation(s)
- Jairo Vinícius Pinto
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gayatri Saraf
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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27
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Krausz M, Westenberg JN, Vigo D, Spence RT, Ramsey D. Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management. JMIR Public Health Surveill 2020; 6:e18995. [PMID: 32401218 PMCID: PMC7236607 DOI: 10.2196/18995] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/30/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Public health emergencies like epidemics put enormous pressure on health care systems while revealing deep structural and functional problems in the organization of care. The current coronavirus disease (COVID-19) pandemic illustrates this at a global level. The sudden increased demand on delivery systems puts unique pressures on pre-established care pathways. These extraordinary times require efficient tools for smart governance and resource allocation. OBJECTIVE The aim of this study is to develop an innovative web-based solution addressing the seemingly insurmountable challenges of triaging, monitoring, and delivering nonhospital services unleashed by the COVID-19 pandemic. METHODS An adaptable crisis management digital platform was envisioned and designed with the goal of improving the system's response on the basis of the literature; an existing shared health record platform; and discussions between health care providers, decision makers, academia, and the private sector in response to the COVID 19 epidemic. RESULTS The Crisis Management Platform was developed and offered to health authorities in Ontario on a nonprofit basis. It has the capability to dramatically streamline patient intake, triage, monitoring, referral, and delivery of nonhospital services. It decentralizes the provision of services (by moving them online) and centralizes data gathering and analysis, maximizing the use of existing human resources, facilitating evidence-based decision making, and minimizing the risk to both users and providers. It has unlimited scale-up possibilities (only constrained by human health risk resource availability) with minimal marginal cost. Similar web-based solutions have the potential to fill an urgent gap in resource allocation, becoming a unique asset for health systems governance and management during critical times. They highlight the potential effectiveness of web-based solutions if built on an outcome-driven architecture. CONCLUSIONS Data and web-based approaches in response to a public health crisis are key to evidence-driven oversight and management of public health emergencies.
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Affiliation(s)
- Michael Krausz
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Richard Trafford Spence
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,InputHealth Systems Inc, Vancouver, BC, Canada
| | - Damon Ramsey
- InputHealth Systems Inc, Vancouver, BC, Canada.,Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
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28
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Abstract
Objective: To review the current evidence for efficacy of cannabidiol in the treatment of mood disorders. Methods: We systematically searched PubMed, Embase, Web of Science, PsychInfo, Scielo, ClinicalTrials.gov, and The Cochrane Central Register of Controlled Trials for studies published up to July 31, 2019. The inclusion criteria were clinical trials, observational studies, or case reports evaluating the effect of pure cannabidiol or cannabidiol mixed with other cannabinoids on mood symptoms related to either mood disorders or other health conditions. The review was reported in accordance with guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Results: Of the 924 records initially yielded by the search, 16 were included in the final sample. Among them, six were clinical studies that used cannabidiol to treat other health conditions but assessed mood symptoms as an additional outcome. Similarly, four tested cannabidiol blended with Δ-9-tetrahydrocannabinol in the treatment of general health conditions and assessed affective symptoms as secondary outcomes. Two were case reports testing cannabidiol. Four studies were observational studies that evaluated the cannabidiol use and its clinical correlates. However, there were no clinical trials investigating the efficacy of cannabidiol, specifically in mood disorders or assessing affective symptoms as the primary outcome. Although some articles point in the direction of benefits of cannabidiol to treat depressive symptoms, the methodology varied in several aspects and the level of evidence is not enough to support its indication as a treatment for mood disorders. Conclusions: There is a lack of evidence to recommend cannabidiol as a treatment for mood disorders. However, considering the preclinical and clinical evidence related to other diseases, cannabidiol might have a role as a treatment for mood disorders. Therefore, there is an urgent need for well-designed clinical trials investigating the efficacy of cannabidiol in mood disorders.
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Affiliation(s)
- Jairo Vinícius Pinto
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gayatri Saraf
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christian Frysch
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Márcia Kauer-Sant'Anna
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Vigo D, Jones L, Thornicroft G, Atun R. Burden of Mental, Neurological, Substance Use Disorders and Self-Harm in North America: A Comparative Epidemiology of Canada, Mexico, and the United States. Can J Psychiatry 2020; 65:87-98. [PMID: 31747307 PMCID: PMC6997975 DOI: 10.1177/0706743719890169] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To estimate the burden of mental, neurological, substance use disorders and self-harm (MNSS) in Canada, Mexico, and the United States. METHOD We extracted 2017 data from the Global Burden of Disease online database. Based on a previously developed framework to classify and aggregate the burden of specific disorders and symptoms, we reestimated the MNSS burden to include suicide, alcohol use, drug use, specific neurological, and painful somatic symptom disorders. We analyzed age-sex-specific patterns within and between countries. RESULTS The MNSS burden is the largest of all disorder groupings. It is lowest in Mexico, intermediate in Canada, and highest in the United States. Exceptions are alcohol use, bipolar, conduct disorders, and epilepsy, which are highest in Mexico; and painful somatic syndromes and headaches, which are highest in Canada. The burden of drug use disorders in the United States is twice the burden in Canada, and 7 times the burden in Mexico. MNSS become the most burdensome of all disorder groups by age 10, staying at the top until age 60, and show a distinct pattern across the lifetime. The top three MNSS disorders for men are a combination of substance use disorders and self-harm (United States), with the addition of painful somatic syndromes (Canada), and headaches (Mexico). For women, the top three are headaches and depression (all countries), drug use (United States), neurocognitive disorders (Mexico), and painful somatic syndromes (Canada). CONCLUSION MNSS are the most burdensome disease grouping and should be prioritized for funding in Canada, Mexico, and the United States.
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Affiliation(s)
- Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver,
Canada
- Department of Global Health & Social Medicine, Harvard Medical School,
Harvard University, Boston, MA, USA
| | - Laura Jones
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Graham Thornicroft
- Institute of Psychiatry, Psychology & Neuroscience, King’s College,
London, United Kingdom
| | - Rifat Atun
- Department of Global Health and Population, Harvard T. H. Chan School of
Public Health, Harvard University, Boston, MA, USA
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30
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Tabi K, Randhawa AS, Choi F, Mithani Z, Albers F, Schnieder M, Nikoo M, Vigo D, Jang K, Demlova R, Krausz M. Mobile Apps for Medication Management: Review and Analysis. JMIR Mhealth Uhealth 2019; 7:e13608. [PMID: 31512580 PMCID: PMC6786858 DOI: 10.2196/13608] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/31/2019] [Accepted: 06/22/2019] [Indexed: 12/31/2022] Open
Abstract
Background Pharmacotherapy remains one of the major interventional strategies in medicine. However, patients from all age groups and conditions face challenges when taking medications, such as integrating them into the daily routine, understanding their effects and side effects, and monitoring outcomes. In this context, a reliable medication management tool adaptable to the patient’s needs becomes critical. As most people have a mobile phone, mobile apps offer a platform for such a personalized support tool available on the go. Objective This study aimed to provide an overview of available mobile apps, focusing on those that help patients understand and take their medications. We reviewed the existing apps and provided suggestions for future development based on the concept understand and manage, instead of the conventional adhere to medication. This concept aims to engage and empower patients to be in charge of their health, as well as see medication as part of a broader clinical approach, working simultaneously with other types of interventions or lifestyle changes, to achieve optimal outcomes. Methods We performed a Web search in the iOS Apple App Store and Android Google Play Store, using 4 search terms: medication management, pill reminder, medication health monitor, and medication helper. We extracted information from the app store descriptions for each eligible app and categorized into the following characteristics: features, author affiliation, specialty, user interface, cost, and user rating. In addition, we conducted Google searches to obtain more information about the author affiliation. Results A total of 328 apps (175 Android and 153 iOS) were categorized. The majority of the apps were developed by the software industry (73%, 11/15), a minority of them were codeveloped by health care professionals (15%, 3/20) or academia (2.1%; 7/328). The most prevalent specialty was diabetes (23 apps). Only 7 apps focused on mental health, but their content was highly comprehensive in terms of features and had the highest prevalence of the education component. The most prevalent features were reminder, symptom tracker, and ability to share data with a family member or doctor. In addition, we highlighted the features considered innovative and listed practical suggestions for future development and innovations. Conclusions We identified detailed characteristics of the existing apps, with the aim of informing future app development. Ultimately, the goal was to provide users with effective mobile health solutions, which can be expected to improve their engagement in the treatment process and long-term well-being. This study also highlighted the need for improved standards for reporting on app stores. Furthermore, it underlined the need for a platform to offer health app users an ongoing evaluation of apps by health professionals in addition to other users and to provide them with tools to easily select an appropriate and trustworthy app.
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Affiliation(s)
- Katarina Tabi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Pharmacology, Masaryk University, Brno, Czech Republic
| | | | - Fiona Choi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
| | - Zamina Mithani
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Friederike Albers
- Center of Human Movement Sciences, University of Groningen, Groningen, Netherlands
| | - Maren Schnieder
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, United Kingdom
| | - Mohammadali Nikoo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Kerry Jang
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Regina Demlova
- Department of Pharmacology, Masaryk University, Brno, Czech Republic
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
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31
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Filipe J, Bronzo V, Curone G, Castiglioni B, Vigo D, Smith B, Herrera V, Roccabianca P, Moroni P, Riva F. Staphylococcus aureus intra-mammary infection affects the expression pattern of IL-R8 in goat. Comp Immunol Microbiol Infect Dis 2019; 66:101339. [PMID: 31437679 DOI: 10.1016/j.cimid.2019.101339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 01/23/2023]
Abstract
IL-1R8 is a member of Interleukin-1 receptor family acting as a negative regulator of inflammation reliant on ILRs and TLRs activation. IL-1R8 role has never been evaluated in acute bacterial mastitis. We first investigated IL-1R8 sequence conservation among different species and its pattern of expression in a wide panel of organs from healthy goats. Then, modulation of IL-1R8 during natural and experimental mammary infection was evaluated and compared in blood, milk and mammary tissues from healthy and Staphylococcus aureus infected goats. IL-1R8 has a highly conserved sequence among vertebrates. Goat IL-1R8 was ubiquitously expressed in epithelial and lymphoid tissues with highest levels in pancreas. IL-1R8 was down-regulated in epithelial mammary cells following S. aureus infection. Interestingly it was up-regulated in leukocytes infiltrating the infected mammary tissues suggesting that it could represent a target of S. aureus immune evasion.
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Affiliation(s)
- J Filipe
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - V Bronzo
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - G Curone
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - B Castiglioni
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale delle Ricerche, 26900, Lodi, Italy.
| | - D Vigo
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - B Smith
- University of California, Davis, Wildlife Health Center, Davis, CA 95616, USA.
| | - V Herrera
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - P Roccabianca
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - P Moroni
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy; Cornell University, Animal Health Diagnostic Center, Quality Milk Production Services, Ithaca, NY 14853, USA.
| | - F Riva
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
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32
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Vigo D, Jones L, Maidana DE, Krausz M, Kestel D. [The burden of mental disorders, neurological, substance use and suicide: Report on mental health priorities in Argentina]. Vertex 2018; XXIX:304-312. [PMID: 30785972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The objective of this study is to provide an estimate of the burden of disease related to mental health in Argentina, in order to provide elements for the rational prioritization of resource allocation and the development of services. Based on the estimations made by the Study of the Global Burden of Disease (1) we add an analysis of the load product of: a) self-injuries and suicide; b) common neurological disorders with severe psychological and behavioral manifestations; c) somatic consequences of alcohol use disorder; and iv) an estimate of the disorder by somatic symptoms with prominent pain. The burden of disease caused by mental, neurological, substance use and suicide disorders (MNSS) is approximately one fifth of the years of life adjusted for disability (DALYs) and more than a third of the years lived with disability (ADLs) total, resulting in the most disabling subgroup of all non-communicable diseases (NCDs), and far exceeding the combined group of infectious and maternal-child diseases, and the group of non-self-inflicted accidents and injuries. The analysis of DALYs by age and sex allows a hierarchy of the disorders that should guide the development of services for MNSS disorders, their integration in primary care, and the allocation of resources. The first level of care is the only one with a relatively homogeneous presence throughout the country, being the only one capable of effectively increasing coverage and reducing inequality. The strengthening of the first level of care can be achieved through training in mental health of non-specialized personnel and the use of computer and communication technology resources to counteract regional inequities in coverage. Such strategic vision will allow to diminish: the excessive expenses in specialized resources, which by definition are more expensive and intervene only when the pathology exceeded a certain threshold; and the indirect costs caused by the loss of labor productivity. Fundamentally, it will allow increasing coverage and reversing regional and socioeconomic inequality in the quality of mental health care in a country rich in professional resources.
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Affiliation(s)
- Daniel Vigo
- Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada. Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA. Department of Psychiatry, University of British Columbia, Vancouver, Canada.
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Filipe J, Curone G, Bronzo V, Pisoni G, Cremonesi P, Pollera C, Turin L, Vigo D, Roccabianca P, Caniatti M, Moroni P, Riva F. Pentraxin 3 is up-regulated in epithelial mammary cells during Staphylococcus aureus intra-mammary infection in goat. Comp Immunol Microbiol Infect Dis 2018; 59:8-16. [PMID: 30290890 DOI: 10.1016/j.cimid.2018.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/17/2018] [Accepted: 08/29/2018] [Indexed: 02/06/2023]
Abstract
Pentraxin 3 is the prototypic long pentraxin and is produced by different cell populations (dendritic cells, monocytes/macrophages, endothelial cells, and fibroblasts) after pro-inflammatory stimulation. Different studies demonstrated the up-regulation of PTX3 during mastitis in ruminants, but its role is still unknown. We first investigated the conservation of PTX3 sequence among different species and its pattern of expression in a wide panel of organs from healthy goats. We studied the modulation of PTX3 during natural and experimental mammary infection, comparing its expression in blood, milk and mammary tissues from healthy and Staphylococcus aureus infected animals. We confirmed the high conservation of the molecule among different species. Goat PTX3 was expressed at high levels in bone marrow, mammary gland, aorta, rectum, pancreas, skin and lungs. PTX3 was up-regulated in epithelial mammary cells and in milk cells after S. aureus infection, suggesting that it represents a first line of defense in goat udder.
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Affiliation(s)
- J Filipe
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | - G Curone
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | - V Bronzo
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | | | - P Cremonesi
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale delle Ricerche, 26900 Lodi, Italy.
| | - C Pollera
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | - L Turin
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | - D Vigo
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | - P Roccabianca
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | - M Caniatti
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
| | - P Moroni
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy; Cornell University, Animal Health Diagnostic Center, Quality Milk Production Services, Ithaca, NY 14853, USA.
| | - F Riva
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Via Celoria 10, 20133 Milan, Italy.
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Song MJ, Ward J, Choi F, Nikoo M, Frank A, Shams F, Tabi K, Vigo D, Krausz M. A Process Evaluation of a Web-Based Mental Health Portal (WalkAlong) Using Google Analytics. JMIR Ment Health 2018; 5:e50. [PMID: 30126832 PMCID: PMC6121139 DOI: 10.2196/mental.8594] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 02/26/2018] [Accepted: 05/19/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Despite the increasing amount of research on Web-based mental health interventions with proven efficacy, high attrition rates decrease their effectiveness. Continued process evaluations should be performed to maximize the target population's engagement. Google Analytics has been used to evaluate various health-related Web-based programs and may also be useful for Web-based mental health programs. OBJECTIVE The objective of our study was to evaluate WalkAlong.ca, a youth-oriented mental health web-portal, using Google Analytics to inform the improvement strategy for the platform and to demonstrate the use of Google Analytics as a tool for process evaluation of Web-based mental health interventions. METHODS Google Analytics was used to monitor user activity during WalkAlong's first year of operation (Nov 13, 2013-Nov 13, 2014). Selected Google Analytic variables were overall website engagement including pages visited per session, utilization rate of specific features, and user access mode and location. RESULTS The results included data from 3076 users viewing 29,299 pages. Users spent less average time on Mindsteps (0 minute 35 seconds) and self-exercises (1 minute 08 seconds), which are important self-help tools, compared with that on the Screener tool (3 minutes 4 seconds). Of all visitors, 82.3% (4378/5318) were desktop users, followed by 12.7 % (677/5318) mobile phone and 5.0% (263/5318) tablet users. Both direct traffic (access via URL) and referrals by email had more than 7 pages viewed per session and longer than average time of 6 minutes per session. The majority of users (67%) accessed the platform from Canada. CONCLUSIONS Engagement and feature utilization rates are higher among people who receive personal invitations to visit the site. Low utilization rates with specific features offer a starting place for further exploration of users in order to identify the root cause. The data provided by Google Analytics, although informative, can be supplemented by other evaluation methods (ie, qualitative methods) in order to better determine the modifications required to improve user engagement. Google Analytics can play a vital role in highlighting the preferences of those using Web-based mental health tools.
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Affiliation(s)
- Michael Jae Song
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - John Ward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - Fiona Choi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - Mohammadali Nikoo
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - Anastasia Frank
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - Farhud Shams
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Katarina Tabi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Daniel Vigo
- Centre for Applied Research in Mental Health and Addictions, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Tomassini A, Curone G, Solè M, Capuani G, Sciubba F, Conta G, Miccheli A, Vigo D. NMR-based metabolomics to evaluate the milk composition from Friesian and autochthonous cows of Northern Italy at different lactation times. Nat Prod Res 2018; 33:1085-1091. [PMID: 29658316 DOI: 10.1080/14786419.2018.1462183] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
It is well established that different factors affect milk composition in cows and that milk composition, in turn, affect both technological and nutritional qualities. In this respect the comprehension of the metabolic variability of milk composition in relation to the lactation time as well as to the genetic background may be of paramount importance for the agri-food industries. In the present study we investigated the variations of the metabolic profiles during lactation in milks obtained from Friesian and autochthonous races from Northern Italy by 1H NMR metabolomics. Furthermore, the external factors influencing the milk composition were minimized: the cows were breeded in the same farm, were fed with the same diet and were paired for the lactation interval and lactation stage. Our results showed a difference in milk composition between races and in relation to late lactation. The PLS-DA analysis permitted to distinguish the Friesian and autochthonous cow milks at the investigated different lactation times. Interestingly, the metabolites significantly involved into the discrimination between races appeared to be also technological property parameters, highlighting the importance of maintaining the biodiversity of cow breeds. Therefore, NMR-based metabolomics of milk could represent an informative tool to identify metabolites involved in milk quality both from a nutritional and industrial perspective.
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Affiliation(s)
- A Tomassini
- a Department of Chemistry , University of Rome "La Sapienza" , Rome , Italy
| | - G Curone
- b Department of Veterinary Medicine , Università degli Studi di Milano , Milano , Italy
| | - M Solè
- b Department of Veterinary Medicine , Università degli Studi di Milano , Milano , Italy
| | - G Capuani
- a Department of Chemistry , University of Rome "La Sapienza" , Rome , Italy
| | - F Sciubba
- a Department of Chemistry , University of Rome "La Sapienza" , Rome , Italy
| | - G Conta
- a Department of Chemistry , University of Rome "La Sapienza" , Rome , Italy
| | - A Miccheli
- a Department of Chemistry , University of Rome "La Sapienza" , Rome , Italy
| | - D Vigo
- b Department of Veterinary Medicine , Università degli Studi di Milano , Milano , Italy
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Szmulewicz AG, Angriman F, Samamé C, Ferraris A, Vigo D, Strejilevich SA. Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis. Acta Psychiatr Scand 2017; 135:527-538. [PMID: 28256707 DOI: 10.1111/acps.12712] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To systematically examine the effects of dopaminergic agents (modafinil, armodafinil, pramipexole, methylphenidate, and amphetamines) on bipolar depression outcomes. METHODS Meta-analysis of randomized controlled trials was performed to assess the efficacy and safety of treatment with dopaminergic agents in bipolar depression. In a secondary analysis, findings from both randomized controlled trials and high-quality observational studies were pooled by means of meta-analytic procedures to explore dopaminergic treatment-related new mania. RESULTS Nine studies (1716 patients) were included in our meta-analysis of randomized controlled trials. Treatment with dopaminergic agents for bipolar depression was associated with an increase in both response (1671 individuals, RR 1.25, 95% CI 1.05 to 1.50) and remission rates (1671 individuals, RR 1.40, 95% CI 1.14, 1.71). There was no evidence of an increased risk of mood switch associated with this treatment (1646 individuals, RR 0.96, 95% CI 0.49, 1.89). Our secondary analysis (1231 individuals) yielded a cumulative incidence of mood switch of 3% (95% CI 1.0, 5.0) during a mean follow-up period of 7.5 months. CONCLUSIONS Preliminary findings suggest that dopaminergic agents may represent a useful alternative for the treatment of bipolar depression, with no evidence for a related increase in the risk of mood destabilization during short-term follow-up.
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Affiliation(s)
- A G Szmulewicz
- Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina.,Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina.,Pharmacology Department, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - F Angriman
- Pharmacology Department, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.,Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - C Samamé
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - A Ferraris
- Pharmacology Department, University of Buenos Aires School of Medicine, Buenos Aires, Argentina
| | - D Vigo
- Global Health Systems Cluster, Harvard TH Chan School of Public Health, Boston, MA, USA.,International Consortium for Bipolar Disorder Research, Mc Lean Hospital, Belmont, MA, USA.,Center for Applied Research in Mental Health and Addictions, Simon Fraser University, Vancouver, Canada
| | - S A Strejilevich
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina.,Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
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Morselli MG, Canziani S, Vigo D, Luvoni GC. A three-dimensional alginate system for in vitro culture of cumulus-denuded feline oocytes. Reprod Domest Anim 2016; 52:83-88. [PMID: 27688153 DOI: 10.1111/rda.12806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 08/23/2016] [Indexed: 11/30/2022]
Abstract
In the case of high valuable individuals with very precious genetic material, widening the genetic pool including gametes with poor morphological characteristics, as cumulus-denuded oocytes (CDOs), could be an option. To improve the in vitro culture of low-competence feline CDOs, an enriched three-dimensional (3D) system in association with competent cumulus-oocyte complexes (COCs) was developed. For this purpose, domestic cat CDOs were cultured with or without companion COCs in the 3D barium alginate microcapsules. The overall viability and the meiotic progression of feline CDOs cocultured with COCs or cultured separately in 3D or in 2D (traditional microdrops) system were compared. The 3D system was able to support viability and meiotic resumption of the feline oocytes, as well as the 2D microdrops. In 3D microcapsules, the presence of COCs resulted in a higher viability of CDOs (91.1%, p < .05), than that obtained without COCs or in 2D microdrops (71.2% and 67.3%, respectively), but the percentages of meiotic resumption were similar of those of CDOs cultured separately (55.4% vs. 40.4%, p > .05). It is notable that the presence of CDOs seemed to enhance the meiotic progression of the associated COCs. In conclusion, the 3D barium alginate microcapsules are a suitable system for feline oocytes in vitro culture, but more specific enriched conditions should be developed to improve the CDOs full competence in vitro.
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Affiliation(s)
- M G Morselli
- Dipartimento di Scienze Veterinarie per la Salute, La Produzione Animale e la Sicurezza Alimentare, Universita degli Studi di Milano, Milano, Italy
| | - S Canziani
- Dipartimento di Scienze Veterinarie per la Salute, La Produzione Animale e la Sicurezza Alimentare, Universita degli Studi di Milano, Milano, Italy
| | - D Vigo
- Dipartimento di Scienze Veterinarie e Sanità Pubblica, Universita degli Studi di Milano, Milano, Italy
| | - G C Luvoni
- Dipartimento di Scienze Veterinarie per la Salute, La Produzione Animale e la Sicurezza Alimentare, Universita degli Studi di Milano, Milano, Italy
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Atun R, Vigo D, Thornicroft G. Challenges to estimating the true global burden of mental disorders - Authors' reply. Lancet Psychiatry 2016; 3:403-4. [PMID: 27155512 DOI: 10.1016/s2215-0366(16)30045-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 04/11/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Rifat Atun
- Harvard T H Chan School of Public Health, Harvard University, Cambridge, MA, USA.
| | - Daniel Vigo
- Harvard T H Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - Graham Thornicroft
- Department of Health Services & Population Research, King's College London, London, UK
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Abstract
We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness.
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Affiliation(s)
- Daniel Vigo
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Waverley Place Program, Psychotic Disorder Division, McLean Hospital, Belmont, MA, USA
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
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Perteghella S, Vigani B, Crivelli B, Spinaci M, Galeati G, Bucci D, Vigo D, Torre ML, Chlapanidas T. Sperm Encapsulation from 1985 to Date: Technology Evolution and New Challenges in Swine Reproduction. Reprod Domest Anim 2015; 50 Suppl 2:98-102. [DOI: 10.1111/rda.12538] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/20/2015] [Indexed: 11/29/2022]
Affiliation(s)
- S Perteghella
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - B Vigani
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - B Crivelli
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - M Spinaci
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - G Galeati
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - D Bucci
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - D Vigo
- Department of Veterinary Sciences and Public Health; University of Milan; Milan Italy
| | - ML Torre
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - T Chlapanidas
- Department of Drug Sciences; University of Pavia; Pavia Italy
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Spinaci M, Perteghella S, Chlapanidas T, Galeati G, Vigo D, Tamanini C, Bucci D. Storage of sexed boar spermatozoa: Limits and perspectives. Theriogenology 2015; 85:65-73. [PMID: 26116059 DOI: 10.1016/j.theriogenology.2015.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/22/2015] [Accepted: 05/24/2015] [Indexed: 11/20/2022]
Abstract
Despite the great potential application of sex-sorted spermatozoa in swine, the technology is not practiced in the pig industry because of technical factors and species-specific issues. The susceptibility of boar spermatozoa to stresses induced by the sorting procedure, the relative slowness of the sex-sorting process together with the high sperm numbers required for routine artificial insemination in pig are some of the main factors limiting the commercial application of this technology in pigs. This review briefly describes the damage to spermatozoa during sex sorting, focusing on an additional limiting factor: increased susceptibility of sexed boar spermatozoa to injuries induced by liquid storage and cryopreservation that, in turn, impairs sperm quality leading to unsatisfactory results in vivo. Strategies to extend the lifespan of sex-sorted boar spermatozoa and to improve their fertilizing ability after liquid storage or cryopreservation need to be implemented before this technology can be used in pig farms. In this regard, encapsulation in barium alginate membranes could be a promising technique to optimize the in vivo use of sexed boar spermatozoa, by protecting, targeting, and controlling the release of sperm into the female genital tract.
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Affiliation(s)
- M Spinaci
- Department of Veterinary Medical Sciences-DIMEVET, University of Bologna, Bologna, Italy.
| | - S Perteghella
- Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - T Chlapanidas
- Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - G Galeati
- Department of Veterinary Medical Sciences-DIMEVET, University of Bologna, Bologna, Italy
| | - D Vigo
- Department of Veterinary Science and Public Health, University of Milan, Milano, Italy
| | - C Tamanini
- Department of Veterinary Medical Sciences-DIMEVET, University of Bologna, Bologna, Italy
| | - D Bucci
- Department of Veterinary Medical Sciences-DIMEVET, University of Bologna, Bologna, Italy
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Chlapanidas T, Tosca MC, Faragò S, Perteghella S, Galuzzi M, Lucconi G, Antonioli B, Ciancio F, Rapisarda V, Vigo D, Marazzi M, Faustini M, Torre ML. Formulation and characterization of silk fibroin films as a scaffold for adipose-derived stem cells in skin tissue engineering. Int J Immunopathol Pharmacol 2013; 26:43-9. [PMID: 24046948 DOI: 10.1177/03946320130260s106] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Skin substitutes are epidermal, dermal or complete bilayered constructs, composed by natural or synthetic scaffolds and by adherent cells such as fibroblasts, keratinocytes or mesenchymal stem cells. Silk fibroin is a promising polymer to realize scaffolds, since it is biocompatible, biodegradable, and exhibits excellent mechanical properties in terms of tensile strength. Moreover, fibroin can be added of others components in order to modify the biomaterial properties for the purpose. The aim of this work is to prepare silk fibroin films for adipose-derived stem cell (ADSCs) culture as a novel feeder layer for skin tissue engineering. Pectin has been added to promote the protein conformational transition and construct strength, while glycerol as plasticizer, providing biomaterial flexibility. Eighteen formulations were prepared by casting method using fibroin, pectin (range 1-10% w/w), and glycerol (range 0-20% w/w); films were characterized by Fourier transform infrared spectroscopy and differential scanning calorimetry assay, to select the optimal composition. A stable fibroin conformation was obtained using 6% w/w pectin, and the best mechanical properties were obtained using 12% w/w glycerol. Films were sterilized, and human ADSCs were seeded and cultured for 15 days. Cells adhere to the support assuming a fibroblastic-like shape and reaching confluence. The ultrastructural analysis evidences typical active-cell features and adhesion structures that promote cell anchorage to the film, thus developing a multilayered cell structure. This construct could be advantageously employed in cutaneous wound healing or where the use of ADSCs scaffold is indicated either in human or veterinary field.
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Affiliation(s)
- T Chlapanidas
- Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
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Perez-Lloret S, Videla AJ, Richaudeau A, Vigo D, Rossi M, Cardinali DP, Perez-Chada D. A multi-step pathway connecting short sleep duration to daytime somnolence, reduced attention, and poor academic performance: an exploratory cross-sectional study in teenagers. J Clin Sleep Med 2013; 9:469-73. [PMID: 23674938 DOI: 10.5664/jcsm.2668] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A multi-step causality pathway connecting short sleep duration to daytime somnolence and sleepiness leading to reduced attention and poor academic performance as the final result can be envisaged. However this hypothesis has never been explored. OBJECTIVE To explore consecutive correlations between sleep duration, daytime somnolence, attention levels, and academic performance in a sample of school-aged teenagers. METHODS We carried out a survey assessing sleep duration and daytime somnolence using the Pediatric Daytime Sleepiness Scale (PDSS). Sleep duration variables included week-days' total sleep time, usual bedtimes, and absolute weekday to-weekend sleep time difference. Attention was assessed by d2 test and by the coding subtest from the WISC-IV scale. Academic performance was obtained from literature and math grades. Structural equation modeling was used to assess the independent relationships between these variables, while controlling for confounding effects of other variables, in one single model. Standardized regression weights (SWR) for relationships between these variables are reported. RESULTS Study sample included 1,194 teenagers (mean age: 15 years; range: 13-17 y). Sleep duration was inversely associated with daytime somnolence (SWR = -0.36, p < 0.01) while sleepiness was negatively associated with attention (SWR = -0.13, p < 0.01). Attention scores correlated positively with academic results (SWR = 0.18, p < 0.01). Daytime somnolence correlated negatively with academic achievements (SWR = -0.16, p < 0.01). The model offered an acceptable fit according to usual measures (RMSEA = 0.0548, CFI = 0.874, NFI = 0.838). A Sobel test confirmed that short sleep duration influenced attention through daytime somnolence (p < 0.02), which in turn influenced academic achievements through reduced attention (p < 0.002). CONCLUSIONS Poor academic achievements correlated with reduced attention, which in turn was related to daytime somnolence. Somnolence correlated with short sleep duration.
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Affiliation(s)
- Santiago Perez-Lloret
- Departamento de Docencia e Investigación, Facultad de Ciencias Médicas, Universidad Católica Argentina, Buenos Aires, Argentina.
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Faustini M, Vigo D, Spinaci M, Galeati G, Torre ML. Enhancing Insemination Performance in Pigs Through Controlled Release of Encapsulated Spermatozoa. Reprod Domest Anim 2012; 47 Suppl 4:353-8. [DOI: 10.1111/j.1439-0531.2012.02098.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Ladrón-de-Guevara M, Castro M, Vigo D, Gustafson D, Vila-Pérez I, Massaro P, Montoyo J, Figueras-Bellot J, Cardinali D, Guinjoan S. DEPRESSION-RELA TED ABNORMALITIES IN CIRCADIAN RHYTHM OF CARDIAC AUTONOMIC ACTIVITY IN SURVIVORS OF ACUTE CORONARY SYNDROMES. BIOMED ENG-BIOMED TE 2012. [DOI: 10.1515/bmt-2012-4496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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46
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Wan L, Ogrinz B, Vigo D, Bersenev E, Tuerlinckx F, Van den Bergh O, Aubert AE. Cardiovascular autonomic adaptation to long-term confinement during a 105-day simulated Mars mission. Aviat Space Environ Med 2011; 82:711-716. [PMID: 21748910 DOI: 10.3357/asem.2986.2011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Long-term confinement and microgravity may entail alteration in the regulation of the cardiovascular system. A 105-d pilot study of a Mars mission simulation was conducted to test the cardiovascular response to slow-paced breathing and mental stress. METHODS Finger blood pressure and beat-to-beat heart rate were monitored in six male volunteers taking part in a 105-d Mars mission simulation. Data were collected before, during (Days 35-38, 70-72, and 100), and after confinement. Recordings were performed in the sitting position during 5-min spontaneous breathing, 3-min 12 cycle/min breathing, 3-min 6 cycle/min breathing, and 5-min mental task performance. RESULTS We found significant U-shaped changes across the confinement period in systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP). In the first month of confinement, mental task performance significantly lowered SAP by 34.23 mmHg and MAP by 19.89 mmHg compared to spontaneous breathing, whereas these changes were reversed during other periods. Furthermore, no differences in arterial pressure and heart rate were found between spontaneous, 12 cycle/min, and 6 cycle/min breathing. CONCLUSIONS Our findings are in line with and extend previous findings on the alteration of blood pressure regulation due to long-term confinement.
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Affiliation(s)
- Li Wan
- Research Group on Health Psychology, Department of Psychology, University of Leuven, Tiensestraat 102, B-3000 Leuven, Belgium.
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Faustini M, Bucco M, Galeati G, Spinaci M, Villani S, Chlapanidas T, Ghidoni I, Vigo D, Torre ML. Boar Sperm Encapsulation ReducesIn VitroPolyspermy. Reprod Domest Anim 2010; 45:359-62. [DOI: 10.1111/j.1439-0531.2008.01213.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mazaira S, Leiderman EA, Nemirovsky M, Vigo D, Wikinski S. [How do Argentinean psychiatrists treat bipolar depression?]. Vertex 2010; 21:85-96. [PMID: 20661481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We show the results of a survey on bipolar depression treatment using a sample of 359 argentine psychiatrists in the context of The National Psychiatry Congress that took place in the City of Buenos Aires, between September 26th and 29th, 2007. The objective was to study the attendant psychiatrists' prescribing habits in the treatment of bipolar depression. The discussion is based on the comparison between the answers and the recommendations taken from the main consensus, guidelines and from articles published by experts. The differences found point to the distance often present between guidelines and expert consensus series (based on patients meeting the strict criteria used in randomized controlled studies) on one hand, and a clinician's everyday real world practice, on the other hand.
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Vigo D, Faustini M, Villani S, Orsini F, Bucco M, Chlapanidas T, Conte U, Ellis K, Torre ML. Semen controlled-release capsules allow a single artificial insemination in sows. Theriogenology 2009; 72:439-44. [PMID: 19505716 DOI: 10.1016/j.theriogenology.2009.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 02/18/2009] [Accepted: 03/29/2009] [Indexed: 11/28/2022]
Abstract
Controlled-release capsules containing boar spermatozoa were developed to extend the preservation time of spermatozoa and maximize the efficiency of a single artificial insemination. A large trial (4245 sows) was performed with these capsules using double/triple conventional artificial insemination as a control. The effect of treatment on pregnancy diagnosis, delivery, and born piglets was investigated, with allowance being made for considering season, spermatozoa amount, and the weaning-to-estrus interval as confounding variables. The same pregnancy rate and prolificacy were obtained by two insemination techniques, and a higher parturition frequency was reached with capsules. The reproductive performance in pigs has therefore been optimized by a single instrumental insemination with controlled-release capsules.
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Affiliation(s)
- D Vigo
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, University of Milan, 20133 Milan, Italy
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Faustini M, Riccardi A, Villani S, Russo V, Torre ML, Conte U, Vigo D. A single insemination intervention in the sow with barium alginate-encapsulated boar semen. Vet Res Commun 2008; 32 Suppl 1:S147-9. [DOI: 10.1007/s11259-008-9115-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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