1
|
Gorn SB, Saavedra N, Bojorquez I, Reed G, Wainberg ML, Medina-Mora ME. Anxiety among Central American Migrants in Mexico: A Cumulative Vulnerability. Int J Environ Res Public Health 2023; 20:4899. [PMID: 36981807 PMCID: PMC10049226 DOI: 10.3390/ijerph20064899] [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] [Received: 02/15/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Migration exposes Central American migrants, particularly those who migrate without documents, to a range of incidents, dangers, and risks that increase their vulnerability to anxiety symptoms. In most cases, the poverty, conflict, and violence they experience in their countries of origin are compounded by the unpredictable conditions of their journey through Mexico. The objective of this study was to explore the association between the presence of emotional discomfort and the experience of various vulnerabilities from the perspective of a group of Central American migrants in transit through Mexico. This is a descriptive, mixed-methods study (QUALI-QUAN). During the qualitative phase, thirty-five migrants were interviewed (twenty in Mexico City and six in Tijuana). During the quantitative phase, a questionnaire was administered to 217 migrants in shelters in Tijuana. An analysis of the subjects' accounts yielded various factors associated with stress and anxiety, which were divided into five main groups: (1) precarious conditions during the journey through Mexico, (2) rejection and abuse due to their identity, (3) abuse by Mexican authorities, (4) violence by criminal organizations, and (5) waiting time before being able to continue their journey. The interaction of various vulnerabilities predisposes individuals to present emotional discomfort, such as anxiety. Migrants who reported experiencing three or more vulnerabilities presented the highest percentages of anxiety symptoms.
Collapse
Affiliation(s)
- Shoshana Berenzon Gorn
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramon de la Fuente Muñíz, Mexico City 14370, Mexico
| | - Nayelhi Saavedra
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramon de la Fuente Muñíz, Mexico City 14370, Mexico
| | - Ietza Bojorquez
- Departamento de Estudios de Población, El Colegio de la Frontera Norte, Tijuana 22560, Mexico
| | - Geoffrey Reed
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | | | - María Elena Medina-Mora
- Centro de Investigación en Salud Mental Global INPRFM, UNAM, Mexico City 14370, Mexico
- Facultad de Psicología, UNAM, Mexico City 04510, Mexico
- Seminario de Estudios Sobre la Globalidad, Facultad de Medicina, UNAM, Mexico City 04510, Mexico
| |
Collapse
|
2
|
Abadie B, Held M, Puri R, Krishnaswamy A, Yun J, Hanna M, Reed G, Kapadia S, Jaber W. Incidence and predictors of transthyretin cardiac amyloidosis in patients with degenerative aortic stenosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2022] Open
Abstract
Abstract
Background
The approval of new therapies for treating transthyretin (TTR) cardiac amyloidosis has led to significant interest in identifying patients at high risk for this disease. Investigators have identified a correlation between severe degenerative aortic stenosis (AS) and TTR cardiac amyloidosis in older patients, with several studies finding up to 20% of patients who undergo transcatheter aortic valve replacement (TAVR) having TTR cardiac amyloidosis. These initial TAVR studies were conducted when TAVR was performed almost exclusively in high surgical risk populations. Therefore, the true incidence of TTR cardiac amyloidosis in an all-comers with severe degenerative AS referred for TAVR is unknown.
Purpose
To identify the true burden of TTR cardiac amyloidosis in a contemporary population of severe degenerative AS undergoing TAVR screening.
Methods
All patients ≥70 years with severe native valve degenerative AS seen in a multidisciplinary valve clinic were referred for technetium-99m pyrophosphate cardiac scintigraphy (PYP scan) for evaluation of cardiac amyloidosis. Diagnosis was made via combination of planar grade and heart to contralateral lung ratio, confirmed on single positron emission computed tomography/computed tomography (SPECT/CT). Patients with a positive PYP scan were referred to a heart failure clinic where they underwent testing for AL amyloidosis.
Results
Over a 10 month period, 247 patients seen in valve clinic underwent a PYP scan. Of this cohort, 203 patients ultimately underwent TAVR, 15 surgical aortic valve replacement, and 2 balloon valvuloplasty with 27 patients having not yet undergone a procedure. The positivity rate was 4% (10/247) with 1 patient having an equivocal result. The patients with a positive PYP scan had higher rate of low-flow low-gradient (LFLG) AS (64% vs 29%, p=0.006) and classical LFLG AS (27% vs 8%, p=0.02). Echocardiographic measures associated with a positive PYP scan include a lower global longitudinal strain (−10.0% vs −16.1%, p=0.008), lower average e' (4.5 vs 6.5, p=0.003), and an increased E/A ratio (1.8 vs 1.1, p=0.018).
Conclusions
The incidence of TTR amyloidosis in a contemporary, severe AS population ≥70 years undergoing TAVR screening appears much lower than previously described in the literature. Echocardiographic traits may be able to predict which patients with severe AS should undergo evaluation for TTR cardiac amyloidosis.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- B Abadie
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - M Held
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - R Puri
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - J Yun
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - M Hanna
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - G Reed
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - S Kapadia
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - W Jaber
- Cleveland Clinic Foundation , Cleveland , United States of America
| |
Collapse
|
3
|
Askevis-Leherpeux F, Hazo JB, Agoub M, Baleige A, Barikova V, Benmessaoud D, Brunet F, Carta MG, Castelpietra G, Crepaz-Keay D, Daumerie N, Demassiet V, Fontaine A, Grigutyte N, Guernut M, Kishore J, Kiss M, Koenig M, Laporta M, Layoussif E, Limane Y, Lopez M, Mura G, Pelletier JF, Raharinivo M, Reed G, Richa S, Robles-Garcia R, Saxena S, Skourteli M, Tassi F, Stona AC, Thévenon C, Triantafyllou M, Vasilopoulos F, Wooley S, Roelandt JL. Accessibility of psychiatric vocabulary: An international study about schizophrenia essential features. Schizophr Res 2022; 243:463-464. [PMID: 35292181 DOI: 10.1016/j.schres.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/17/2020] [Revised: 02/27/2022] [Accepted: 03/02/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Françoise Askevis-Leherpeux
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France; Equipe Inserm-Eceve (UMR 1123), Paris, France.
| | - Jean-Baptiste Hazo
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France; Equipe Inserm-Eceve (UMR 1123), Paris, France
| | - Mohamed Agoub
- Centre Psychiatrique Universitaire Ibn Rochd, Casablanca, Morocco
| | - Antoine Baleige
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France
| | | | - Dalila Benmessaoud
- Etablissement HospitaloUniversitaire Spécialisé de Psychiatrie Mahfoud BOUCEBCI, Chéraga, Algeria
| | - Floriane Brunet
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France
| | - Mauro-Giovanni Carta
- Centro di Psichiatria e Psicosomatica Azienda Ospedaliero, Universitaria di Cagliari, Italy
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Trieste, Regione Friuli Venezia Giulia, Italy
| | | | - Nicolas Daumerie
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France
| | - Vincent Demassiet
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France; French Hearing Voices Network, France
| | - Audrey Fontaine
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France
| | | | - Mathilde Guernut
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France
| | | | - Marta Kiss
- Community Psychiatry Centre of Semmelweis University, Awakenings Foundation, Budapest, Hungary
| | - Marie Koenig
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France
| | - Marc Laporta
- Department of Psychiatry, McGill University, WHO CC, Montreal, Canada
| | | | | | - Marcelino Lopez
- Fundación Pública Andaluza para la Integración Social de Personas con Enfermedad Mental (FAISEM), Svilla, Spain
| | - Gioia Mura
- Centro di Psichiatria e Psicosomatica Azienda Ospedaliero, Universitaria di Cagliari, Italy
| | - Jean-François Pelletier
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | | | - Geoffrey Reed
- World Health Organization, Department of Mental Health and Substance Abuse, Genève, Switzerland
| | - Sami Richa
- Hôpital Hôtel de Dieu de France, Beyrouth, Lebanon
| | - Rebecca Robles-Garcia
- Instituto National Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Shekhar Saxena
- World Health Organization, Department of Mental Health and Substance Abuse, Genève, Switzerland
| | - Marina Skourteli
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | - Fabio Tassi
- University of Udine, Mental Health Department of Trieste, Italy
| | - Anne-Claire Stona
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France
| | | | | | - Fotis Vasilopoulos
- Association for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | | | - Jean-Luc Roelandt
- EPSM Lille-Métropole, French WHO CC, Armentières, France; French WHO CC, Lille-Hellemes, France; Equipe Inserm-Eceve (UMR 1123), Paris, France
| |
Collapse
|
4
|
Karatzias T, Knefel M, Maercker A, Cloitre M, Reed G, Bryant RA, Ben-Ezra M, Kazlauskas E, Jowett S, Shevlin M, Hyland P. The Network Structure of ICD-11 Disorders Specifically Associated with Stress: Adjustment Disorder, Prolonged Grief Disorder, Posttraumatic Stress Disorder, and Complex Posttraumatic Stress Disorder. Psychopathology 2022; 55:226-234. [PMID: 35344963 DOI: 10.1159/000523825] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 02/24/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The ICD-11 includes a new grouping for "disorders specifically associated with stress" that contains revised descriptions of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) and new diagnoses in the form of complex PTSD (CPTSD) and prolonged grief disorder (PGD). These disorders are similar in that they each require a life event for the diagnosis; however, they have not yet been assessed together for validity within the same sample. We set out to test the distinctiveness of the four main ICD-11 stress disorders using a network analysis approach. METHODS A population-based, cross-sectional design. A nationally representative sample of adults from the Republic of Ireland aged 18 years and older (N = 1,020) completed standardized measures of PTSD, CPTSD, AjD, and PGD. A network analysis was conducted at the symptom level. Outcome measures included the International Trauma Questionnaire, the Inventory of Complicated Grief, and the International Adjustment Disorder Questionnaire. RESULTS Consistent with the taxonomic structure of the ICD-11, our results showed that although the four conditions clustered independently at the disorder level, the specific symptoms of PTSD, CPTSD, PGD, and AjD clustered together very strongly but more strongly than with symptoms of the other disorders. The majority (61%) of the variation in each symptom could be explained by its neighboring symptoms. The strongest transdiagnostically connecting symptom was "startle response." DISCUSSION/CONCLUSION Mental health professionals caring for people who have experienced a range of stressors and traumatic life events can be confident in diagnosing these conditions that have clear diagnostic boundaries. Interventions addressing stress-associated disorders should be based on diagnostic assessment to ensure close fit between symptoms and treatment.
Collapse
Affiliation(s)
- Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, United Kingdom
| | - Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Andreas Maercker
- Division of Psychopathology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Geoffrey Reed
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Sally Jowett
- NHS Education for Scotland, NHS Lothian, Edinburgh, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| |
Collapse
|
5
|
Lak H, Sammour Y, Chahine J, Chawla S, Kadri A, Popovic Z, Tarakji K, Svensson LG, Reed G, Puri R, Krishnaswamy A, Kapadia S. Impact of new-onset left bundle branch block on clinical and echocardiographic outcomes after TAVR with SAPIEN-3 valve. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2022] Open
Abstract
Abstract
Background
New left bundle branch block (LBBB) is a common finding after transcatheter aortic valve replacement (TAVR) that can result in worse outcomes after TAVR. We aim to investigate the impact of new-onset LBBB after TAVR using the SAPIEN-3 (S3) valve.
Methods
Consecutive patients who underwent transfemoral-TAVR with S3 valve between April 2015 and December 2018 were included. Exclusion criteria included pre-existing LBBB, right bundle branch block, left anterior hemiblock, left posterior hemiblock, wide QRS ≥120 msec, prior permanent pacemaker (PPM), and non-transfemoral access.
Results
Among 612 patients, 11.4% developed new-onset LBBB upon discharge. Implantation depth was the only predictor of new-onset LBBB (OR 1.294; 95% CI 1.121–1.493; p<0.001). The median (IQR) length of stay was longer with new-onset LBBB [3 (2–5) days vs. 2 (1–3) days; p<0.001]. New-onset LBBB was associated with higher thirty-day PPM requirement (18.6% vs. 5.4%; p<0.001) including those implanted after discharge (4.3% vs. 0.9%; p=0.02). There was no difference in 3-year all-cause mortality between both groups (30.9% vs. 30.6%; log-rank p=0.829). Further, new-onset LBBB was associated with lower left ventricular ejection fraction (LVEF) at both 30 days (55.9±11.4% vs. 59.3±9%; p=0.026) and 1 year (55±12% vs. 60.1±8.9%; p=0.002) despite no differences at baseline. These changes were still present when we stratified patients according to baseline LVEF (≥50% or <50%). We also noted higher mean LV end-diastolic volume index (51.4±18.6 vs. 46.4±15.1 ml/m2; p=0.036), and LV end-systolic volume index (23.2±14.1 vs. 18.9±9.7 ml/m2; p=0.009) with new-onset LBBB at 1 year. Lastly, there were significantly higher rates of heart failure readmissions at 1 year with new-onset LBBB (10.7% vs. 4.4%; log-rank p=0.033).
Conclusion
Among our cohort of S3 recipients, new-onset LBBB was associated with higher PPM requirement, worse LVEF, higher LV volumes and increased risk of heart failure hospitalizations. However, it did not affect mortality in the short-to-intermediate post-TAVR period.
Funding Acknowledgement
Type of funding sources: None. Figure 1. All-cause Survival
Collapse
Affiliation(s)
- H Lak
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - Y Sammour
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - J Chahine
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Chawla
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Kadri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - Z Popovic
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - K Tarakji
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - L G Svensson
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - G Reed
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Cleveland, United States of America
| |
Collapse
|
6
|
Lak H, Chawla S, Verma B, Vural A, Gad M, Shekhar S, Nair R, Yun J, Burns D, Puri R, Reed G, Harb S, Krishnaswamy A, Kapadia S. Outcomes of transfemoral-transcatheter aortic valve replacement with Sapien-3 valve in liver cirrhosis patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2022] Open
Abstract
Abstract
Background
Little is known about the outcomes of liver cirrhosis patients with severe aortic stenosis (AS) who undergo transcatheter aortic valve replacement (TAVR).
Methods
We undertook a retrospective analysis of consecutive patients with severe symptomatic AS who underwent transfemoral-TAVR with Sapien-3 valve at our Clinic between April 2015 and December 2018, yielding 32 patients with liver cirrhosis on imaging including ultrasound and/or computed tomography. Their baseline characteristics, procedural and long-term outcomes after TAVR with the non-cirrhotic group were compared, along with their management strategies as per the hepatology team.
Results
Among 1028 patients, 32 were assigned to the cirrhosis, and 996 were assigned to the non-cirrhosis (control) group. Compared with the control group cirrhotic patients were slightly younger in age (74.5 vs 81.2 years), had a slightly higher BMI (31.3 vs 29.3), and had a higher incidence of prior history of myocardial infarction (38% vs 33%). Baseline variables including the history of smoking, hypertension, diabetes, and atrial fibrillation were comparable in both groups. Among cirrhotic patients (n=32), the most common etiologies were non-alcoholic steatohepatitis (NASH) (37.5%), Alcoholism (18.75%), and Hepatitis C (12.5%). The mean MELD-NA score was 11.8 and 67% of patients were Child PUGH Class A and 33% were Child PUGH Class B and all patients had a Child PUGH score of ≥5. 53% of patients (n=17) in the cirrhosis group were evaluated by Hepatology and 12.5% (n=4) were evaluated for a liver transplant but only 1 patient had a liver transplant post-TAVR. Compared with the control group cirrhotic patients had similar 1-year mortality (12% vs 12%, p=1), had a lower rate of 30-day new pacemaker post tavr (6% vs 9% p=0.85), had a higher rate of 1-year readmission for heart failure (12% vs 5% p=0.12) and similar 1-year major adverse cardiac and cerebrovascular event (MACCE) rate (15% vs 14% p=0.98)
Conclusion
Patients with severe AS undergoing TAVR with concomitant liver cirrhosis demonstrate comparable outcomes compared with their non- cirrhotic counterparts. NASH followed by alcoholic cirrhosis was found to be most common etiology.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
Collapse
Affiliation(s)
- H Lak
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Chawla
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - B Verma
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Vural
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - M Gad
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Shekhar
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Nair
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - J Yun
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - D Burns
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - G Reed
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Harb
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Cleveland, United States of America
| |
Collapse
|
7
|
Rebello T, Reed G. The impact of COVID-19 on clinical practice and well-being of global mental health professionals. Eur Psychiatry 2021. [PMCID: PMC9471401 DOI: 10.1192/j.eurpsy.2021.105] [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: 11/23/2022] Open
Abstract
Some of the most direct and brutal effects of the COVID-19 pandemic are experienced by health care professionals who are working in demanding environments while having to deal with their own fears of infection and mortality. To assess the impact of COVID-19 on the practice and well-being of global mental health professionals, we designed a three-part, longitudinal, internet-based study. Here we present data from part 1, implemented in June-July 2020 in six languages to members of WHO’s Global Clinical Practice Network composed of 15,500 mental health practitioners. The study assessed COVID-19’s impact on: work circumstances; occupational well-being; use and transition to telehealth; and expectations, needs and recommendations. 2,505 mental health professionals from 126 countries responded to the study (47% psychiatrists). 93.7% of respondents were currently practicing and 70.9% continued to see patients in person. The impact on clinical workload varied in terms of direction and extent depending on type of service provided and country of practice. Most participants had started or increased their use of telehealth services, and we identified a need for training to support telehealth use. Overall, clinicians scored high on well-being indices. However, a subset scored above the cutoff for low well-being and reported a significant number of post-traumatic symptoms. Five factors affected work-related stress: fear of infection, severe COVID-related events, life disruption, lack of adequate protection and role disruption. Data from this study will provide information relevant for the design, development, and integration of mental health services in the continuing pandemic, and in similar future scenarios.
Collapse
|
8
|
Roelandt JL, Baleige A, Koenig M, Demassiet V, Agoub M, Barikova V, Benmessaoud D, Brunet F, Carta MG, Castelpietra G, Crepaz-Keay D, Daumerie N, Fontaine A, Grigutyte N, Kishore J, Kiss M, Laporta M, Layoussif E, Limane Y, Lopez M, Mura G, Pelletier JF, Raharinivo M, Richa S, Robles-Garcia R, Stona AC, Skourteli M, Thévenon C, Triantafyllou M, Vasilopoulos F, Wooley S, Reed G, Guernut M, Saxena S, Askevis-Leherpeux F. How service users and carers understand, perceive, rephrase, and communicate about "depressive episode" and "schizophrenia" diagnoses: an international participatory research. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1201-1213. [PMID: 32086537 PMCID: PMC7471108 DOI: 10.1007/s00127-020-01836-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/03/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND For ICD-11, the WHO emphasized the clinical utility of communication and the need to involve service users and carers in the revision process. AIMS The objective was to assess whether medical vocabulary was accessible, which kinds of feelings it activated, whether and how users and carers would like to rephrase terms, and whether they used diagnosis to talk about mental health experiences. METHOD An innovative protocol focused on two diagnoses (depressive episode and schizophrenia) was implemented in 15 different countries. The same issues were discussed with users and carers: understanding, feelings, rephrasing, and communication. RESULTS Most participants reported understanding the diagnoses, but associated them with negative feelings. While the negativity of "depressive episode" mostly came from the concept itself, that of "schizophrenia" was largely based on its social impact and stigmatization associated with "mental illness". When rephrasing "depressive episode", a majority kept the root "depress*", and suppressed the temporal dimension or renamed it. Almost no one suggested a reformulation based on "schizophrenia". Finally, when communicating, no one used the phrase "depressive episode". Some participants used words based on "depress", but no one mentioned "episode". Very few used "schizophrenia". CONCLUSION Data revealed a gap between concepts and emotional and cognitive experiences. Both professional and experiential language and knowledge have to be considered as complementary. Consequently, the ICD should be co-constructed by professionals, service users, and carers. It should take the emotional component of language, and the diversity of linguistic and cultural contexts, into account.
Collapse
Affiliation(s)
- Jean-Luc Roelandt
- EPSM Lille-Métropole, French WHO CC, Armentières, France. .,French WHO CC, Lille- Hellemes, France. .,Equipe Inserm, Eceve (UMR 1123), Paris, France.
| | - Antoine Baleige
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France
| | - Marie Koenig
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France
| | - Vincent Demassiet
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France ,French Hearing Voices Network, Paris, France
| | - Mohamed Agoub
- Centre Psychiatrique Universitaire Ibn Rochd, Casablanca, Morocco
| | | | - Dalila Benmessaoud
- Etablissement Hospitalo-Universitaire Spécialisé de Psychiatrie Mahfoud BOUCEBCI, Chéraga, Algérie
| | - Floriane Brunet
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France
| | - Mauro-Giovanni Carta
- grid.460105.6Centro di Psichiatria e Psicosomatica Azienda Ospedaliero, Universitaria di Cagliari, Cagliari, Italia
| | - Giulio Castelpietra
- Primary Care Services Area, Central Health Directorate, Regione Friuli Venezia Giulia, Trieste, Italy
| | - David Crepaz-Keay
- grid.474126.20000 0004 0381 1108Mental Health Foundation, London, UK
| | - Nicolas Daumerie
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France
| | - Audrey Fontaine
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France
| | - Neringa Grigutyte
- grid.6441.70000 0001 2243 2806Vilnius University, Vilnius, Lithuania
| | - Jugal Kishore
- grid.416410.60000 0004 1797 3730Safdarjung Hospital, New Delhi, India
| | - Marta Kiss
- Community Psychiatry Centre of Semmelweis, Awakenings Foundation, Budapest, Hungary
| | - Marc Laporta
- grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, WHO CC, Montreal, Canada
| | | | | | - Marcelino Lopez
- Fundación Pública Andaluza para la Integración Social de Personas con Enfermedad Mental (FAISEM), Seville, Spain
| | - Gioia Mura
- grid.460105.6Centro di Psichiatria e Psicosomatica Azienda Ospedaliero, Universitaria di Cagliari, Cagliari, Italia
| | - Jean-François Pelletier
- grid.414210.20000 0001 2321 7657Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
| | | | - Sami Richa
- grid.413559.f0000 0004 0571 2680Hôpital Hôtel de Dieu de France, Beyrouth, Lebanon
| | | | - Anne-Claire Stona
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France
| | - Marina Skourteli
- grid.475864.cAssociation for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | | | | | - Fotis Vasilopoulos
- grid.475864.cAssociation for Regional Development and Mental Health (EPAPSY), Athens, Greece
| | | | - Geoffrey Reed
- Department of Mental Health and Substance Abuse, World Mental Health Organization, Geneva, Switzerland
| | - Mathilde Guernut
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France
| | - Shekhar Saxena
- Department of Mental Health and Substance Abuse, World Mental Health Organization, Geneva, Switzerland
| | - Françoise Askevis-Leherpeux
- EPSM Lille-Métropole, French WHO CC, Armentières, France ,French WHO CC, Lille- Hellemes, France ,Equipe Inserm, Eceve (UMR 1123), Paris, France
| |
Collapse
|
9
|
Baranda J, Bur A, Tsue T, Shnayder L, Kakarala K, Telfah M, Lin T, Williamson S, Al-Kasspooles M, Ashcraft J, Lakis N, Madan R, Khan Q, Saeed A, Reed G, Weir S, Godwin A, Thomas S, Komiya T, Iwakuma T. A window of opportunity trial of atorvastatin targeting p53 mutant malignancies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.105] [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: 11/12/2022] Open
|
10
|
Lobato MI, Soll BM, Brandelli Costa A, Saadeh A, Gagliotti DAM, Fresán A, Reed G, Robles R. Psychological distress among transgender people in Brazil: frequency, intensity and social causation - an ICD-11 field study. ACTA ACUST UNITED AC 2019; 41:310-315. [PMID: 30843958 PMCID: PMC6804302 DOI: 10.1590/1516-4446-2018-0052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/26/2018] [Indexed: 11/22/2022]
Abstract
Objective: To describe self-reported experiences of gender incongruence related to discomfort and body changes to be more congruent to the desired gender, and to examine whether experiences of psychological distress related to gender identity were more strongly related to the experience of gender incongruence per se or to experiences of social rejection. Methods: This field study used a structured interview design in a purposive sample of transgender adults (aged >18 years or older) receiving health-care services in two main reference centers in Brazil. Results: A high proportion of participants (90.3%, n=93) reported experiencing psychological distress related to their gender identity and report having experienced social rejection related to their gender identity during the interview index period and that rejection by friends was the only significant predictor for psychological distress. Conclusions: Gender incongruence variables were not significant predictors of distress. This result supports the recent changes proposed by the Word Health Organization in ICD-11 to move transgender conditions from the Mental and Behavioral Disorders chapter to a new chapter on Sexual Disorders and Conditions Related to Sexual Health.
Collapse
Affiliation(s)
- Maria I Lobato
- Programa de Identidade de Gênero, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Bianca M Soll
- Programa de Identidade de Gênero, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Angelo Brandelli Costa
- Programa de Identidade de Gênero, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Alexandre Saadeh
- Ambulatório Transdisciplinar de Identidade de Gênero e Orientação Sexual (AMTIGOS), Centro de Psicologia e Instituto Psiquiatria Forense, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Daniel A M Gagliotti
- Ambulatório Transdisciplinar de Identidade de Gênero e Orientação Sexual (AMTIGOS), Centro de Psicologia e Instituto Psiquiatria Forense, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Ana Fresán
- Departamento de Epidemiología Clínica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Geoffrey Reed
- Global Mental Health Program, Columbia University Medical Center, New York, NY, USA.,Centro de Investigación de Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Rebeca Robles
- Departamento de Modelos de Intervención, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| |
Collapse
|
11
|
Agarwal M, Garg L, Aggarwal S, Reed G. 5803Contemporary trends of incidence, management and outcomes of non-acute coronary syndrome associated cardiogenic shock: data from 2003 to 2011. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5803] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
12
|
Parenti D, Reed G, Kafka S, Ellis L, Greenberg J, DeHoratius R. THU0130 Comorbidities and Efficacy of anti-TNF Therapies: History of Depression as A Possible Indicator of Lower Response:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2782] [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: 11/04/2022]
|
13
|
Cohen S, Reed G, Magner R, Kafka S, Ellis L, DeHoratius R, Greenberg J. THU0156 Achievement of Low Disease Activity in Patients Initiating Infliximab with and without Dose Escalation. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2771] [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: 11/03/2022]
|
14
|
Kavanaugh A, Greenberg J, Reed G, Griffith J, Friedman A, Saunders K, Ganguli A. FRI0105 Benefit of Biologic Initiation in Moderate VS Severe Rheumatoid Arthritis: Evidence from a Real-World Registry. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1182] [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: 11/03/2022]
|
15
|
Avasthi A, Grover S, Maj M, Reed G, Thirunavukarasu M, Garg UC. Indian Psychiatric Society-World Psychiatric Association - World Health Organization survey on usefulness of International Classification of Diseases-10. Indian J Psychiatry 2014; 56:350-8. [PMID: 25568475 PMCID: PMC4279292 DOI: 10.4103/0019-5545.146522] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND World Health Organization (WHO) is in the process of revising the International Classification of Diseases 10 (ICD-10). For increasing the acceptability of the ICD-11, WHO along with World Psychiatric Association (WPA), conducted a survey of psychiatrists around the world, in which 386 psychiatrists from India participated. AIM To present the findings of "WPA-WHO Global Survey of Psychiatrists' Attitudes toward Mental Disorders Classification" for Indian psychiatrists who participated in the survey as members of Indian Psychiatric Society. METHODOLOGY The online survey was sent to qualified psychiatrists who are members of Indian Psychiatric Society and are residing in India. RESULTS Of the 1702 members who were urged to participate in the survey, 386 (22.7%) participated. Most(79%) of the psychiatrists opined that they use formal classificatory systems in their day-to-day clinical practice. ICD-10 was the most commonly (71%) followed classificatory system. Nearly half (48%) felt the need for only 10-30 categories for use in clinical settings and another 44% opined that 31-100 categories are required for use. Most of the participants (85%) suggested that a modified/simpler classificatory system should be designed for primary care practitioners. Similarly, the same number of participants (89%) argued that for maximum utility of a nosological system diagnostic criteria should provide flexible guidance that allows cultural variation and clinical judgement. About 75% opined that the diagnostic system they were using was difficult to apply across cultures. CONCLUSION Findings of the survey suggest that classificatory systems are routinely used in day-to-day practice by most of the participating psychiatrists in India and most expect that future classificatory system should provide flexible guidance that allows cultural variation and clinical judgement.
Collapse
Affiliation(s)
- Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Mario Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Geoffrey Reed
- Department of Mental Health and Substance Abuse (MER/MSD), World Health Organization 20, Revision of ICD-10 Mental and Behavioural Disorders, Geneva, Switzerland
| | - M Thirunavukarasu
- Department of Psychiatry, SRM Medical College Hospital and Research Center, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu, India
| | | |
Collapse
|
16
|
Baranda J, Reed G, Williamson S, Stoltz M, Perez R, Mackay C, Madan R, Scott J, Godwin A. A Phase I Trial of Irinotecan (Iri) and Buparlisib in Previously Treated Patients (Pts) with Metastatic Colorectal Cancer (Mcrc): Final Results. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.39] [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: 11/12/2022] Open
|
17
|
Geier J, Saunders K, Reed G. AB1057 Contextualisation of Safety Endpoints in the Tofacitinib Rheumatoid Arthritis (RA) Development Programme: Collaboration with the Consortium of Rheumatology Researchers of North America (CORRONA) Registry. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
18
|
Harrold L, Greenberg J, Bao Y, Grant S, Kremer J, Reed G, Florentinus S, Karki C, Lacerda A, Ganguli A. THU0180 Time to Biologic Therapy Driven by Rheumatoid Arthritis Disease Activity and Severity. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1161] [Citation(s) in RCA: 2] [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: 11/04/2022]
|
19
|
Reed G, Ganguli A, Saunders K, Magner R, Greenberg J. FRI0177 Biologic Drug Initiators: Real World Patterns of Monotherapy and Combination Therapy after One Year. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1544] [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: 11/04/2022]
|
20
|
Yoshida K, Radner H, Mjaavatten M, Greenberg J, Kavanaugh A, Kishimoto M, Matsui K, Okada M, Reed G, Saeki Y, Tohma S, Kremer J, Solomon D. THU0179 Cross-National Comparison of Biological Disease-Modifying Antirheumatic Drug Discontinuation Practice among Rheumatoid Arthritis Patients in Remission: Corrona and Ninja Collaboration. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1367] [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: 11/04/2022]
|
21
|
Harrold L, Reed G, Magner R, Shewade A, John A, Greenberg J, Kremer J. FRI0334 Comparative Effectiveness of Rituximab versus Subsequent Anti-Tumor Necrosis Factor in Cumulative Prednisone Exposure in Patients with Rheumatoid Arthritis with Prior Exposure to Tnfi. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1534] [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: 11/03/2022]
|
22
|
Maercker A, Reed G, Watts A, Lalor J, Perkonigg A. Wie sehen Psychologen die klassifikatorische Diagnostik: WHO-IUPsyS-Survey in Deutschland und der Schweiz zur Vorbereitung der ICD-11. Psychother Psychosom Med Psychol 2014; 64:315-21. [DOI: 10.1055/s-0034-1370956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Andreas Maercker
- Psychologisches Institut, Psychopathologie und Klinische Intervention, Universität Zürich, Schweiz
| | - Geoffrey Reed
- Weltgesundheitsorganisation, Abteilung Seelische Gesundheit und Substanzmissbrauch, Genf, Schweiz
| | - Ann Watts
- Internationale Vereinigung für wissenschaftliche Psychologie, Kapstadt, Südafrika
| | - John Lalor
- Psychologisches Institut, Psychopathologie und Klinische Intervention, Universität Zürich, Schweiz
| | - Axel Perkonigg
- Psychologisches Institut, Psychopathologie und Klinische Intervention, Universität Zürich, Schweiz
| |
Collapse
|
23
|
Kotak S, Koenig A, Collier D, Saunders K, He P, Kremer J, Reed G. AB0330 Characteristics of a moderate rheumatoid arthritis patient population who lost remission or low disease activity: Data from the consortium of rheumatology researchers of north america, INC. (CORRONA). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
24
|
Harrold L, Reed G, Magner R, Shewade A, John A, Reiss W, Greenberg J, Kremer J. FRI0254 Comparative effectiveness of rituximab versus anti-tumor necrosis factor switching for rheumatoid arthritis patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.1381] [Citation(s) in RCA: 2] [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: 11/04/2022]
|
25
|
Labitigan M, Shrestha A, Jordan N, Reed G, Magner R, Bahce-Altuntas A, Broder A. OP0302 Moderate to High Disease Activity in Psoriatic Arthritis is Associated with Elevated Total Cholesterol and Triglycerides. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.507] [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: 11/03/2022]
|
26
|
Pala O, Messing S, Hopkins A, Reed G, Perez-Rivera M, Acosta M, Kremer J, Lozada C, Pappas D. FRI0170 Effect of alcohol on response to therapy with TNF-a inhibitors for rheumatoid arthritis: Results from corrona registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
27
|
Pappas DA, John A, Kremer J, Reed G, Greenberg J, Shewade A, Solomon DH, Curtis JR. OP0005 Effect of Biologic Agents on Lipids and Cardiovascular Risk in Rheumatoid Arthritis Patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.210] [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: 11/03/2022]
|
28
|
Harrold L, Cifaldi M, Saunders K, Reed G, Ganguli A, Shan Y, Greenberg J. SAT0469 Factors associated with work status and missed work days in rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3415] [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: 11/04/2022]
|
29
|
Finckh A, Scherer A, Kremer J, Greenberg J, Lubbeke A, Schwarz H, Rathbun A, Gabay C, Reed G. FRI0099 Obese patients with rheumatoid arthritis have reduced response rates to biologic anti-rheumatic agents: a comparison between european and american ra patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1226] [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: 11/04/2022]
|
30
|
Reed G, von Morze C, Bok R, Koelsch B, Smith K, van Criekinge M, Larson P, Kurhanewicz J, Vigneron D. WE-C-116-02: High Resolution C-13 MRI with Hyperpolarized [C-13,N-15] Urea. Med Phys 2013. [DOI: 10.1118/1.4815564] [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: 11/07/2022] Open
|
31
|
Mease P, Saunders K, Bolge S, Bolce R, Decktor D, Reed G, Greenberg J. SAT0310 The effect of dactylitis and enthesitis on disease burden in patients with psoriatic arthritis in the corrona registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3257] [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: 11/03/2022]
|
32
|
Pala O, Messing S, Hopkins A, Reed G, Perez-Rivera M, Acosta M, Kremer J, Lozada C, Pappas D. SAT0147 Effect of smoking on response to therapy with TNF-A inhibitors for rheumatoid arthritis: Results from the corrona registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3094] [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: 11/04/2022]
|
33
|
Pappas D, Hooper M, Reed G, Shan Y, Wenkert D, Zhang J, Greenberg J, Curtis J. FRI0108 Risk for herpes zoster after treatment with biologic and synthetic disease modifying agents for rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2565] [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: 11/04/2022]
|
34
|
Harrold L, Reed G, Saunders K, Shan Y, Spruill T, Greenberg J. FRI0434 Patient and provider factors associated with compliance with rheumatoid arthritis treatment recommendations. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
35
|
Harrold L, John A, Reed G, Reiss W, Magner R, Chung C, Saunders K, Kremer J, Greenberg J. AB0551 The use and effectiveness of rituximab in patients with rheumatoid arthritis observational study: Corrona registry:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.551] [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: 11/03/2022]
|
36
|
Levitus S, Matishov G, Smolyar I, Baranova OK, Zweng MM, Tielking T, Mikhailov N, Kizu S, Nast F, Reed G, Keeley R, Rickards L, Korablev A. World War II (1939-1945) Oceanographic Observations. Data Sci J 2013. [DOI: 10.2481/dsj.13-030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
37
|
|
38
|
Baranda J, Reed G, Williamson S, Dickman E, Stoltz M, Madan R, Wright L, Bhalla K, Godwin A. A Phase I Trial of Irinotecan (IRI) and BKM120 in Previously Treated Patients (PTS) With Metastic Colorectal Cancer (MCRC). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33138-0] [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: 10/25/2022] Open
|
39
|
Ueda U, Chen J, Hsu I, Reed G, Pouliot J. SU-E-J-94: Investigating the Use of Deformable Algorithms to Register MR Images Acquired with and Without an Endo-Rectal Coil. Med Phys 2012; 39:3674. [DOI: 10.1118/1.4734930] [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: 11/07/2022] Open
|
40
|
Reed G. AS13-01 - Towards ICD-11: world health organization field studies on clinicians’ conceptualizations of mental disorders. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)73988-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
41
|
Reed G. W04-01 - Psychosocial functioning - relationship to ICF. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75678-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
42
|
Anandarajah AP, El-Taha M, Peng C, Reed G, Greenberg JD, Ritchlin CT. Association between focal erosions and generalised bone loss in psoriatic arthritis. Ann Rheum Dis 2011; 70:1345-7. [DOI: 10.1136/ard.2010.148452] [Citation(s) in RCA: 9] [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: 11/03/2022]
|
43
|
Erickstad L, Reed G, Bhat D, Roehrborn CG, Lotan Y. Use of electronic medical records to identify patients at risk for prostate cancer in an academic institution. Prostate Cancer Prostatic Dis 2010; 14:85-9. [PMID: 21151199 DOI: 10.1038/pcan.2010.50] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
One purported advantage of electronic medical records (EMRs) is to improve patient care. This study uses a search of EMR to identify patients at risk for prostate cancer who were not evaluated by an urologist. The University of Texas Southwestern Medical Center (UTSW) has an institutional outpatient EMR that is used by all providers in all specialties. Since March 2009, all PSA tests were reported with specific interpretative comments including a recommendation for referral to urology for a PSA >2.5 ng ml(-1). All PSA tests were performed on campus since institution of these recommendations were analyzed, and charts reviewed for all patients not seen in urology with a serum PSA >2.5 ng ml(-1). Of the 2884 non-urology patients that had a serum PSA drawn between March 2009 and February 2010 at UTSW, 293 patients had a serum PSA >2.5 ng ml(-1). Of these, 39 patients had known prostate cancer and were seeing an oncologist. There were 59 patients seeing urologists outside the institution. A total of 195 patients were not seen by an urologist and only 11 patients were recommended to see one but did not make an appointment. There were 151 patients with more than one PSA in the system, and of these 103 had a rise in PSA with a median rise of 0.53 ng ml(-1) per year. EMR allows identification of patients at increased risk of prostate cancer who are not evaluated. Prospective studies are needed to identify ways to improve appropriate evaluation and detection of prostate cancer.
Collapse
Affiliation(s)
- L Erickstad
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | | | | |
Collapse
|
44
|
Reed G, Lofts C, Coyle T. A population study of polyurethane foam fragments recovered from the surface of 100 outer-garments. Sci Justice 2010; 50:127-37. [PMID: 20709273 DOI: 10.1016/j.scijus.2009.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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] [Received: 06/14/2009] [Revised: 11/08/2009] [Accepted: 11/09/2009] [Indexed: 11/19/2022]
Abstract
One hundred outer-garments were examined for microscopic fragments of polyurethane foam. Low power stereomicroscopy was used to classify fragments into 18 groups according to macroscopic colour. Amber, pale yellow and black were the most frequently encountered, whilst navy, pale blue, bright pink, beige, brown, pale green, peach and white were the least frequently encountered. High power comparison/fluorescence microscopy was used to discriminate 166 populations within 16 colour groupings. The majority (95.2%) of populations consisted of three fragments or less. This study demonstrates that the background population of foam fragments on an outer-garment consists of low numbers representing various colours. Therefore, finding a large population of microscopically indistinguishable fragments within a casework situation has the potential to be considered highly significant evidentially.
Collapse
Affiliation(s)
- G Reed
- LGC Forensics, F5 Culham Science Centre, Abingdon, Oxfordshire, OX14 3ED, UK.
| | | | | |
Collapse
|
45
|
de Pedro-Cuesta J, Comín Comín M, Virués-Ortega J, Almazán Isla J, Avellanal F, Alcalde Cabero E, Burzaco O, Castellote JM, Cieza A, Damián J, Forjaz MJ, Frades B, Franco E, Larrosa LA, Magallón R, Martín García G, Martínez C, Martínez Martín P, Pastor-Barriuso R, Peña Jiménez A, Población Martínez A, Reed G, Ruíz C. ICF-Based Disability Survey in a Rural Population of Adults and Older Adults Living in Cinco Villas, Northeastern Spain: Design, Methods and Population Characteristics. Neuroepidemiology 2010; 35:72-82. [DOI: 10.1159/000311040] [Citation(s) in RCA: 10] [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] [Received: 01/05/2010] [Accepted: 03/22/2010] [Indexed: 11/19/2022] Open
|
46
|
Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, Reed G, Strand V, Kremer JM. Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/or leflunomide. Ann Rheum Dis 2010; 69:43-7. [PMID: 19147616 PMCID: PMC2794929 DOI: 10.1136/ard.2008.101378] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Potential hepatotoxicity associated with disease-modifying antirheumatic drugs (DMARDs) requires laboratory monitoring. In patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA), the incidence of elevated alanine aminotransferase/aspartate aminotransferase (ALT/AST) enzymes associated with methotrexate (MTX), leflunomide (LEF) and MTX+LEF versus other DMARDs was examined. METHODS Patients with RA and PsA enrolled in the Consortium of Rheumatology Researchers of North America (CORRONA) initiating DMARDs were identified. Abnormalities were identified when either was 1- or 2-fold times above the upper limits of normal (ULN). Odds ratios (OR) between MTX/LEF dose and elevated ALT/AST enzymes were estimated using generalised estimating equations. Interaction terms for use of MTX+LEF quantified the incremental risk of the combination compared with each individually. RESULTS Elevated ALT/AST levels (>1x ULN) occurred in 22%, 17%, 31% and 14% of patients with RA receiving MTX, LEF, MTX+LEF or neither, respectively; elevations were 2.76-fold (95% CI 1.84 to 4.15) more likely in patients with PsA. Elevations >2x ULN occurred in 1-2% of patients on MTX or LEF monotherapy compared with 5% with the combination. After multivariable adjustment and compared with either monotherapy, the combination of MTX and LEF was associated with a greater risk according to MTX dose used as part of the combination: MTX 10-17.5 mg/week, OR 2.91 (95% CI 1.23 to 6.90); MTX > or =20 mg/week, OR 3.98 (95% CI 1.72 to 9.24). CONCLUSIONS Abnormal ALT/AST levels developed in 14-35% of patients with RA or PsA initiating DMARD therapy. The risks were incrementally greater in those with PsA and in those receiving MTX (> or =10 mg/day) + LEF. These findings should help inform monitoring for potential hepatotoxicity in these patient populations.
Collapse
Affiliation(s)
- J R Curtis
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20 Street South, FOT 840, Birmingham, AL 35294, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Furst DE, Chang H, Greenberg JD, Ranganath VK, Reed G, Ozturk ZE, Kremer JM. Prevalence of low hemoglobin levels and associations with other disease parameters in rheumatoid arthritis patients: evidence from the CORRONA registry. Clin Exp Rheumatol 2009; 27:560-566. [PMID: 19772785] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To estimate the prevalence of low hemoglobin (Hb) levels in a large US cohort of patients with rheumatoid arthritis (RA) and examine the relationship between Hb levels and RA severity, associated comorbidities, and quality-of-life parameters by cross-sectional analysis of data from the Consortium of Rheumatology Researchers of North America (CORRONA) registry. METHODS The study population comprised patients with RA >18 years of age and clinical information recorded in the CORRONA registry between October 1, 2001 and February 1, 2007. Patients were separated into low (Hb <13 g/dl for men; <12 g/dl for women) and normal Hb groups (Hb >13 g/dl for men; >12 g/dl for women). Hb levels were calculated from recorded hematocrit values. RESULTS Of the 10,397 study patients, 1734 (16.7%) had low Hb levels and 8663 (83.3%) had normal Hb levels. More patients in the low Hb group had a history of comorbid cardiovascular disease, diabetes, and gastrointestinal disease. The low Hb group exhibited greater disease severity and activity (p<0.05) as reported by patients and rheumatologists. In multivariate analyses, RA severity ([odds ratio] OR 1.24; 95% confidence interval [CI]: 1.07-1.44) and ESR (OR 1.04; 95% CI: 1.03-1.05), and comorbid bleeding ulcers (OR 2.04; 95% CI: 1.01-4.12) were predictive of low Hb levels. CONCLUSION Despite changes in treatment paradigms, low Hb levels remain prevalent in RA patients. This analysis suggests that low Hb levels may be associated with RA disease severity and the presence of certain comorbidities.
Collapse
Affiliation(s)
- D E Furst
- University of California Los Angeles, Los Angeles, California, USA.
| | | | | | | | | | | | | |
Collapse
|
48
|
Greenberg JD, Reed G, Kremer JM, Tindall E, Kavanaugh A, Zheng C, Bishai W, Hochberg MC. Association of methotrexate and tumour necrosis factor antagonists with risk of infectious outcomes including opportunistic infections in the CORRONA registry. Ann Rheum Dis 2009; 69:380-6. [PMID: 19359261 DOI: 10.1136/ard.2008.089276] [Citation(s) in RCA: 189] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the association of methotrexate (MTX) and tumour necrosis factor (TNF) antagonists with the risk of infectious outcomes including opportunistic infections in patients with rheumatoid arthritis (RA). METHODS Patients with RA enrolled in the Consortium of Rheumatology Researchers of North America (CORRONA) registry prescribed MTX, TNF antagonists or other disease-modifying antirheumatic drugs (DMARDs) were included. The primary outcomes were incident overall and opportunistic infections. Incident rate ratios were calculated using generalised estimating equation Poisson regression models adjusted for demographics, comorbidities and RA disease activity measures. RESULTS A total of 7971 patients with RA were followed. The adjusted rate of infections per 100 person-years was increased among users of MTX (30.9, 95% CI 29.2 to 32.7), TNF antagonists (40.1, 95% CI 37.0 to 43.4) and a combination of MTX and TNF antagonists (37.1, 95% CI 34.9 to 39.3) compared with users of other non-biological DMARDs (24.5, 95% CI 21.8 to 27.5). The adjusted incidence rate ratio (IRR) was increased in patients treated with MTX (IRR 1.30, 95% CI 1.12 to 1.50) and TNF antagonists (IRR 1.52, 95% CI 1.30 to 1.78) compared with those treated with other DMARDs. TNF antagonist use was associated with an increased risk of opportunistic infections (IRR 1.67, 95% CI 0.95 to 2.94). Prednisone use was associated with an increased risk of opportunistic infections (IRR 1.63, 95% CI 1.20 to 2.21) and an increased risk of overall infection at doses >10 mg daily (IRR 1.30, 95% CI 1.11 to 1.53). CONCLUSIONS MTX, TNF antagonists and prednisone at doses >10 mg daily were associated with increased risks of overall infections. Low-dose prednisone and TNF antagonists (but not MTX) increased the risk of opportunistic infections.
Collapse
Affiliation(s)
- J D Greenberg
- New York University Hospital for Joint Diseases, New York, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Bernabeu M, Laxe S, Lopez R, Stucki G, Ward A, Barnes M, Kostanjsek N, Reed G, Tate R, Whyte J, Zasler N, Cieza A. Developing core sets for persons with traumatic brain injury based on the international classification of functioning, disability, and health. Neurorehabil Neural Repair 2009; 23:464-7. [PMID: 19221004 DOI: 10.1177/1545968308328725] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors outline the process for developing the International Classification of Functioning, Disability, and Health (ICF) Core Sets for traumatic brain injury (TBI). ICF Core Sets are selections of categories of the ICF that identify relevant categories of patients affected by specific diseases. Comprehensive and brief ICF Core Sets for TBI should become useful for clinical practice and for research. The final definition of the ICF Core Sets for TBI will be determined at an ICF Core Sets Consensus Conference, which will integrate evidence from preliminary studies. The development of ICF Core Sets is an inclusive and open process and rehabilitation professionals are invited to participate.
Collapse
Affiliation(s)
- Montserrat Bernabeu
- Brain Injury Unit, Institut Guttmann, Neurorehabilitation Hospital, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Rutten M, Reed G. A comparative analysis of some policy options to reduce rationing in the UK's NHS: lessons from a general equilibrium model incorporating positive health effects. J Health Econ 2009; 28:221-233. [PMID: 19062116 PMCID: PMC7114148 DOI: 10.1016/j.jhealeco.2008.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2006] [Revised: 09/19/2008] [Accepted: 10/10/2008] [Indexed: 05/27/2023]
Abstract
This paper seeks to determine the macro-economic impacts of changes in health care provision. The resource allocation issues have been explored in theory, by applying the Rybczynski theorem, and empirically, using a computable general equilibrium (CGE) model for the UK with a detailed health component. From the theory, changes in non-health outputs are shown to depend on factor-bias and scale effects, the net effects generally being indeterminate. From the applied model, a rise in the National Health Service (NHS) budget is shown to yield overall welfare gains, which fall by two-thirds assuming health care-specific factors. A nominally equivalent migration policy yields even higher welfare gains.
Collapse
Affiliation(s)
- Martine Rutten
- Erasmus University Rotterdam, Institute for International and Development Economics and Royal Tropical Institute, P.O. Box 95001, 1090 HA, Amsterdam, The Netherlands.
| | | |
Collapse
|