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Kool-Goudzwaard N, Draisma S, van der Bijl J, Koekkoek B, Kerkhof A, van Meijel B. Development and Validation of the 'Self-Efficacy in Dealing with Self-Harm Questionnaire' (SEDSHQ). Int J Environ Res Public Health 2022; 20:788. [PMID: 36613114 PMCID: PMC9819985 DOI: 10.3390/ijerph20010788] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/09/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Clinicians find it challenging to engage with patients who engage in self-harm. Improving the self-efficacy of professionals who treat self-harm patients may be an important step toward accomplishing better treatment of self-harm. However, there is no instrument available that assesses the self-efficacy of clinicians dealing with self-harm. The aim of this study is to describe the development and validation of the Self-Efficacy in Dealing with Self-Harm Questionnaire (SEDSHQ). This study tests the questionnaire's feasibility, test-retest reliability, internal consistency, content validity, construct validity (factor analysis and convergent validity) and sensitivity to change. The Self-Efficacy in Dealing with Self-Harm Questionnaire is a 27-item instrument which has a 3-factor structure, as found in confirmatory factor analysis. Testing revealed high content validity, significant correlation with a subscale of the Attitude Towards Deliberate Self-Harm Questionnaire (ADSHQ), satisfactory test-retest correlation and a Cronbach's alpha of 0.95. Additionally, the questionnaire was able to measure significant changes after an intervention took place, indicating sensitivity to change. We conclude that the present study indicates that the Self-Efficacy in Dealing with Self-Harm Questionnaire is a valid and reliable instrument for assessing the level of self-efficacy in response to self-harm.
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Affiliation(s)
- Nienke Kool-Goudzwaard
- Parnassia Psychiatric Institute, Parnassia Academy, 2552DH The Hague, The Netherlands
- Department of Health, Sports & Welfare, Research Group Mental Health Nursing, Inholland University of Applied Sciences, 1081HV Amsterdam, The Netherlands
| | - Stasja Draisma
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), P.O. Box 725, 3500AS Utrecht, The Netherlands
| | - Jaap van der Bijl
- Department of Health, Sports & Welfare, Research Group Mental Health Nursing, Inholland University of Applied Sciences, 1081HV Amsterdam, The Netherlands
| | - Bauke Koekkoek
- Research Group Social Psychiatry and Mental Health Nursing, HAN University of Applied Sciences, 6503GL Nijmegen, The Netherlands
| | - Ad Kerkhof
- Department of Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, 1081HV Amsterdam, The Netherlands
| | - Berno van Meijel
- Department of Health, Sports & Welfare, Research Group Mental Health Nursing, Inholland University of Applied Sciences, 1081HV Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC (VUmc), 1081HZ Amsterdam, The Netherlands
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Heller HM, Draisma S, Honig A. Construct Validity and Responsiveness of Instruments Measuring Depression and Anxiety in Pregnancy: A Comparison of EPDS, HADS-A and CES-D. IJERPH 2022; 19:ijerph19137563. [PMID: 35805234 PMCID: PMC9266170 DOI: 10.3390/ijerph19137563] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/04/2022]
Abstract
Depression and anxiety occur frequently in pregnancy and may have unfavourable consequences for mother and child. Therefore, adequate symptom measurement seems important. Commonly used instruments are the Center for Epidemiologic Studies Depression Scale (CES-D), the Edinburgh Postpartum Depression Scale (EPDS), and the Hospital Anxiety and Depression Scale, anxiety subscale (HADS-A). We compared the (1) structural and (2) longitudinal validity of these instruments. The data originated from a study on the effectiveness of an Internet intervention for pregnant women with affective symptoms. (1) A confirmatory factor analysis was used to estimate the construct validity. The theoretical factorial structure that was defined in earlier studies of the CES-D and the EPDS, but not the HADS-A, could be sufficiently replicated with acceptable CFI and RMSEA values. (2) Since there were two measurements in time, the hypotheses concerning plausible directions of the change scores of subscales that were (un)related to each other could be formulated and tested. In this way, longitudinal validity in the form of responsiveness was estimated. Ten of sixteen hypotheses were confirmed, corroborating the longitudinal validity of all constructs, except anhedonia, probably due to inconsistent conceptualization. The HADS-A seems less suitable to screen for anxiety in pregnancy. Anhedonia needs better conceptualisation to assess the change of symptoms over time with the CES-D and the EPDS.
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Affiliation(s)
- Hanna Margaretha Heller
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, 1007 MB Amsterdam, The Netherlands; (S.D.); (A.H.)
- Correspondence: ; Tel.: +31-204-440-196
| | - Stasja Draisma
- Amsterdam Public Health, Mental Health Program, 1007 MB Amsterdam, The Netherlands; (S.D.); (A.H.)
- Department on Aging, Netherlands Institute of Health and Addiction (Trimbos Institute), Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - Adriaan Honig
- Amsterdam Public Health, Mental Health Program, 1007 MB Amsterdam, The Netherlands; (S.D.); (A.H.)
- Department of Psychiatry, OLVG Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands
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Waumans RC, Muntingh ADT, Draisma S, Huijbregts KM, van Balkom AJLM, Batelaan NM. Barriers and facilitators for treatment-seeking in adults with a depressive or anxiety disorder in a Western-European health care setting: a qualitative study. BMC Psychiatry 2022; 22:165. [PMID: 35247997 PMCID: PMC8898419 DOI: 10.1186/s12888-022-03806-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/17/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Previous research on barriers and facilitators regarding treatment-seeking of adults with depressive and anxiety disorders has been primarily conducted in the Anglosphere. This study aims to gain insight into treatment-seeking behaviour of adults with depressive and anxiety disorders in a European healthcare system. METHODS In-depth semi-structured interviews were conducted with 24 participants, aged ≥18 years and diagnosed with an anxiety disorder and/or depressive disorder according to DSM-IV. Participants were purposively sampled from an outpatient department for mental health care in the Netherlands. The seven steps of framework analysis were used to identify relevant themes emerging from the interviews. RESULTS Data analysis suggested an interplay between individual aspects, personal social system, healthcare system and sociocultural context influences. Amongst the most relevant themes were mental health illiteracy, stigma, a negative attitude toward professional help, the influence of significant others and general practitioner, and waiting time. Financial barriers were not of relevance. CONCLUSIONS Even in a country with a well-developed mental health care system and in absence of financial barriers, there are many barriers to treatment-seeking in adult patients with depressive and anxiety disorders. National campaigns to increase awareness and decrease stigma in the general population, and to empower the social environment might reduce the treatment gap.
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Affiliation(s)
- Ruth C. Waumans
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit (VU) Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Anna D. T. Muntingh
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit (VU) Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Stasja Draisma
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit (VU) Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Klaas M. Huijbregts
- grid.491146.f0000 0004 0478 3153GGNet, Mental Health – RGC Winterswijk, Winterswijk, The Netherlands
| | - Anton J. L. M. van Balkom
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit (VU) Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit (VU) Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Specialised Mental Health Care, Amsterdam, The Netherlands
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Krijnen-de Bruin E, Draisma S, Muntingh ADT, Evers A, van Straten A, Sinnema H, Spijker J, Batelaan NM, van Meijel B. Self-Management in Anxiety and Depression: A Psychometric Evaluation of a Questionnaire. Front Psychol 2021; 12:694583. [PMID: 34867583 PMCID: PMC8634107 DOI: 10.3389/fpsyg.2021.694583] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022] Open
Abstract
Objective: To examine the underlying factor structure and psychometric properties of the Assessment of Self-management in Anxiety and Depression (ASAD) questionnaire, which was specifically designed for patients with (chronic) anxiety and depressive disorders. Moreover, this study assesses whether the number of items in the ASAD can be reduced without significantly reducing its precision. Methods: The ASAD questionnaire was completed by 171 participants across two samples: one sample comprised patients with residual anxiety or depressive symptoms, while the other consisted of patients who have been formally diagnosed with a chronic anxiety or depressive disorder. All participants had previously undergone treatment. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. Internal consistency and test–retest reliability were also assessed. Results: Both EFA and CFA indicated three solid factors: Seeking support, Daily life strategies and Taking ownership [Comparative Fit Index = 0.80, Tucker Lewis Index = 0.78, Root Mean Square Error of Approximation = 0.09 (CI 0.08–1.00), Standardized Root Mean Square Residual = 0.09 (χ2 = 439.35, df = 168)]. The ASAD was thus reduced from 45 items to 21 items, which resulted in the ASAD-Short Form (SF). All sub-scales had a high level of internal consistency (> α = 0.75) and test–retest reliability (ICC > 0.75). Discussion: The first statistical evaluation of the ASAD indicated a high level of internal consistency and test–retest reliability, and identified three distinctive factors. This could aid patients and professionals’ assessment of types of self-management used by the patient. Given that this study indicated that the 21-item ASAD-SF is appropriate, this version should be further explored and validated among a sample of patients with (chronic or partially remitted) anxiety and depressive disorders. Alongside this, to increase generalizability, more studies are required to examine the English version of the ASAD within other settings and countries.
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Affiliation(s)
- Esther Krijnen-de Bruin
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands.,Department of Health, Sports & Welfare, Research Group Mental Health Nursing, Inholland University of Applied Sciences, Amsterdam, Netherlands
| | - Stasja Draisma
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Anna D T Muntingh
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Aagje Evers
- Department of Clinical Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Annemieke van Straten
- Department of Clinical Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Henny Sinnema
- Institute for Nursing Studies, Utrecht and General Practice Linschoten, HU University of Applied Sciences, Utrecht, Netherlands
| | - Jan Spijker
- Expertise Center Depression Pro Persona Mental Health, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Neeltje M Batelaan
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Berno van Meijel
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Health, Sports & Welfare, Research Group Mental Health Nursing, Inholland University of Applied Sciences, Amsterdam, Netherlands.,Parnassia Psychiatric Institute, Parnassia Academy, The Hague, Netherlands
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5
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Stevens AWMM, Draisma S, Goossens PJJ, Broekman BFP, Honig A, der Klein EAMKV, Nolen WA, Post RM, Kupka RW. The course of bipolar disorder in pregnant versus non-pregnant women. Int J Bipolar Disord 2021; 9:35. [PMID: 34734318 PMCID: PMC8566649 DOI: 10.1186/s40345-021-00239-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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background and rationale Although it has been suggested that pregnancy may influence the course of bipolar disorder (BD), studies show contradictory results. Until now, no studies included a finegrained validated method to report mood symptoms on a daily basis, such as the lifechart method (LCM). The aim of the present study is to investigate the course of BD during pregnancy by comparing LCM scores of pregnant and non-pregnant women. Methods Study design: Comparison of LCM scores of two prospective observational BD cohort studies, a cohort of pregnant women (n = 34) and a cohort of non-pregnant women of childbearing age (n = 52). Main study parameters are: (1) proportions of symptomatic and non-symptomatic days; (2) symptom severity, frequency, and duration of episodes; (3) state sequences, longitudinal variation of symptom severity scores. Results No differences in clinical course variables (symptomatic days, average severity scores, frequency, and duration of episodes in BD were found between pregnant and non-pregnant women. With a combination of State Sequence Analysis (SSA) and cluster analysis on the sequences of daily mood scores three comparable clusters were found in both samples: euthymic, moderately ill and severely ill. The distribution differences between pregnant and non-pregnant women were significant, with a majority of the pregnant women (68%) belonging to the moderately ill cluster and a majority of the non-pregnant women (46%) to the euthymic cluster. In pregnant women the average daily variation in mood symptoms as assessed with Shannon’s entropy was less than in non-pregnant women (respectively 0.43 versus 0.56). Conclusions Although the use of daily mood scores revealed no difference in overall course of BD in pregnant versus non-pregnant women, more pregnant than non-pregnant women belonged to the moderately ill cluster, and during pregnancy the variation in mood state was less than in non-pregnant women. Further research is necessary to clarify these findings.
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Affiliation(s)
- Anja W M M Stevens
- Center for Bipolar Disorders, Dimence Mental Health, Deventer, The Netherlands. .,Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Stasja Draisma
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZinGeest Specialized Mental Health Care, Research and Innovation Amsterdam, Amsterdam, The Netherlands
| | - Peter J J Goossens
- Center for Bipolar Disorders, Dimence Mental Health, Deventer, The Netherlands.,Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Birit F P Broekman
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Psychiatry, OLVG Hospital, Amsterdam, The Netherlands
| | - Adriaan Honig
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Psychiatry, OLVG Hospital, Amsterdam, The Netherlands
| | | | - Willem A Nolen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Bipolar Collaborative Network, Bethesda, MD, USA
| | - Robert M Post
- Bipolar Collaborative Network, Bethesda, MD, USA.,Department of Psychiatry and Behavioral Sciences, District of Columbia, George Washington University, Washington, USA
| | - R W Kupka
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZinGeest Specialized Mental Health Care, Research and Innovation Amsterdam, Amsterdam, The Netherlands.,Bipolar Collaborative Network, Bethesda, MD, USA
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Horsfall M, Eikelenboom M, Draisma S, Smit JH. The Effect of Rapport on Data Quality in Face-to-Face Interviews: Beneficial or Detrimental? Int J Environ Res Public Health 2021; 18:ijerph182010858. [PMID: 34682600 PMCID: PMC8535677 DOI: 10.3390/ijerph182010858] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/24/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022]
Abstract
The benefits of rapport between interviewers and respondents, in terms of recruiting the latter and motiving them to participate in research, have been generally endorsed. However, there has been less clarity with regard to the association between rapport and data quality. In theory, rapport could be beneficial if it motivates people to give complete and honest responses. On the other hand, efforts to maintain rapport by exhibiting pleasing and socially desirable behaviour could well be detrimental to data quality. In a large longitudinal epidemiological sample, generalized estimating equations (GEE) analyses were used to examine the association between rapport and the following three quality indicators: missing responses, responses to sensitive questions, and consistency of responses. The results of these analyses indicate an association between a high level of rapport and fewer missing responses. In contrast, we found more socially desirable responses for the high-rapport group. Finally, the high-rapport group did not differ from the low-rapport group in terms of the consistency of their responses.
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Affiliation(s)
- Melany Horsfall
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 HJ Amsterdam, The Netherlands; (M.E.); (S.D.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
- Correspondence:
| | - Merijn Eikelenboom
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 HJ Amsterdam, The Netherlands; (M.E.); (S.D.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Stasja Draisma
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 HJ Amsterdam, The Netherlands; (M.E.); (S.D.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Johannes H. Smit
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 HJ Amsterdam, The Netherlands; (M.E.); (S.D.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
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Ter Meulen WG, Draisma S, van Hemert AM, Schoevers RA, Kupka RW, Beekman ATF, Penninx BWJH. Depressive and anxiety disorders in concert-A synthesis of findings on comorbidity in the NESDA study. J Affect Disord 2021; 284:85-97. [PMID: 33588240 DOI: 10.1016/j.jad.2021.02.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [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: 12/17/2020] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Comorbidity of depressive and anxiety disorders is common and remains incompletely comprehended. This paper summarizes findings from the Netherlands Study of Depression and Anxiety (NESDA) regarding prevalence, temporal sequence, course and longitudinal patterns; sociodemographic, vulnerability and neurobiological indicators; and functional, somatic and mental health indicators of comorbidity. METHODS Narrative synthesis of earlier NESDA based papers on comorbidity (n=76). RESULTS Comorbidity was the rule in over three-quarter of subjects with depressive and/or anxiety disorders, most often preceded by an anxiety disorder. Higher severity and chronicity characterized a poorer comorbidity course. Over time, transitions between depressive and anxiety disorders were common. Consistent comorbidity risk indicators in subjects with depressive and anxiety disorders were childhood trauma, neuroticism and early age of onset. Psychological vulnerabilities, such as trait avoidance tendencies, were more pronounced in comorbid than in single disorders. In general, there were few differences in biological markers and neuroimaging findings between persons with comorbid versus single disorders. Most functional, somatic, and other mental health indicators, ranging from disability to cardiovascular and psychiatric multimorbidity, were highest in comorbid disorders. LIMITATIONS The observational design of NESDA limits causal inference. Attrition was higher in comorbid relative to single disorders. CONCLUSIONS As compared to single disorders, persons with comorbid depressive and anxiety disorders were characterized by more psychosocial risk determinants, more somatic and other psychiatric morbidities, more functional impairments, and poorer outcome. These results justify specific attention for comorbidity of depressive and anxiety disorders, particularly in treatment settings.
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Affiliation(s)
- Wendela G Ter Meulen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Stasja Draisma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Albert M van Hemert
- Leiden University, Leiden University Medical Centre, Department of Psychiatry, Leiden, the Netherlands.
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands.
| | - Ralph W Kupka
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
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van der Markt A, Klumpers UMH, Dols A, Draisma S, Boks MP, van Bergen A, Ophoff RA, Beekman ATF, Kupka RW. Exploring the clinical utility of two staging models for bipolar disorder. Bipolar Disord 2020; 22:38-45. [PMID: 31449716 PMCID: PMC7065163 DOI: 10.1111/bdi.12825] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the clinical utility of two staging models for bipolar disorder by examining distribution, correlation, and the relationship to external criteria. These are primarily defined by the recurrence of mood episodes (model A), or by intra-episodic functioning (model B). METHODS In the Dutch Bipolar Cohort, stages according to models A and B were assigned to all patients with bipolar-I-disorder (BD-I; N = 1396). The dispersion of subjects over the stages was assessed and the association between the two models calculated. For both models, change in several clinical markers were concordant with the stage was investigated. RESULTS Staging was possible in 87% of subjects for model A and 75% for model B. For model A, 1079 participants (93%) were assigned to stage 3c (recurrent episodes). Subdividing stage 3c with cut-offs at 5 and 10 episodes resulted in subgroups containing 242, 510, and 327 subjects. For model B, most participants were assigned to stage II (intra-episodic symptoms, N = 431 (41%)) or stage III (inability to work, N = 451 (43%)). A low association between models was found. For both models, the clinical markers "age at onset," "treatment resistance," and "episode acceleration" changed concordant with the stages. CONCLUSION The majority of patients with BD-I clustered in recurrent stage 3 of Model A. Model B showed a larger dispersion. The stepwise change in several clinical markers supports the construct validity of both models. Combining the two staging models and sub-differentiating the recurrent stage into categories with cut-offs at 5 and 10 lifetime episodes improves the clinical utility of staging for individual patients.
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Affiliation(s)
- Afra van der Markt
- PsychiatryAmsterdam UMCVrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Ursula M. H. Klumpers
- Psychiatry, Amsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Annemiek Dols
- PsychiatryAmsterdam UMCVrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
- Psychiatry, Amsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Stasja Draisma
- PsychiatryAmsterdam UMCVrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Marco P. Boks
- Department of PsychiatryUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Annet van Bergen
- Department of PsychiatryUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Roel A. Ophoff
- Department of PsychiatryBrain Center Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
- Center for Neurobehavioral GeneticsSemel Institute for Neuroscience and Human BehaviorUniversity of California Los AngelesLos AngelesCAUSA
- Department of Human GeneticsUniversity of CaliforniaLos AngelesCAUSA
| | - Aartjan T. F. Beekman
- PsychiatryAmsterdam UMCVrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Ralph W. Kupka
- PsychiatryAmsterdam UMCVrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
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Mol M, van Genugten C, Dozeman E, van Schaik DJF, Draisma S, Riper H, Smit JH. Why Uptake of Blended Internet-Based Interventions for Depression Is Challenging: A Qualitative Study on Therapists' Perspectives. J Clin Med 2019; 9:E91. [PMID: 31905834 PMCID: PMC7019532 DOI: 10.3390/jcm9010091] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 12/10/2019] [Accepted: 12/20/2019] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Blended cognitive behavioral therapy (bCBT; online and face-to-face sessions) seems a promising alternative alongside regular face-to-face CBT depression treatment in specialized mental health care organizations. Therapists are key in the uptake of bCBT. This study focuses on therapists' perspectives on usability, satisfaction, and factors that promote or hinder the use of bCBT in routine practice; (2) Methods: Three focus groups (n = 8, n = 7, n = 6) and semi-structured in-depth interviews (n = 15) were held throughout the Netherlands. Beforehand, the participating therapists (n = 36) completed online questionnaires on usability and satisfaction. Interviews were analyzed by thematic analysis; (3) Results: Therapists found the usability sufficient and were generally satisfied with providing bCBT. The thematic analysis showed three main themes on promoting and hindering factors: (1) therapists' needs regarding bCBT uptake, (2) therapists' role in motivating patients for bCBT, and (3) therapists' experiences with bCBT; (4) Conclusions: Overall, therapists were positive; bCBT can be offered by all CBT-trained therapists and future higher uptake is expected. Especially the pre-set structure of bCBT was found beneficial for both therapists and patients. Nevertheless, therapists did not experience promised time-savings-rather, the opposite. Besides, there are still teething problems and therapeutic shortcomings that need improvement in order to motivate therapists to use bCBT.
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Affiliation(s)
- Mayke Mol
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands; (C.v.G.); (E.D.); (D.J.F.v.S.); (S.D.); (H.R.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, 1081 Amsterdam, The Netherlands
| | - Claire van Genugten
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands; (C.v.G.); (E.D.); (D.J.F.v.S.); (S.D.); (H.R.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, 1081 Amsterdam, The Netherlands
| | - Els Dozeman
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands; (C.v.G.); (E.D.); (D.J.F.v.S.); (S.D.); (H.R.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, 1081 Amsterdam, The Netherlands
| | - Digna J. F. van Schaik
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands; (C.v.G.); (E.D.); (D.J.F.v.S.); (S.D.); (H.R.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, 1081 Amsterdam, The Netherlands
| | - Stasja Draisma
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands; (C.v.G.); (E.D.); (D.J.F.v.S.); (S.D.); (H.R.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, 1081 Amsterdam, The Netherlands
| | - Heleen Riper
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands; (C.v.G.); (E.D.); (D.J.F.v.S.); (S.D.); (H.R.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, 1081 Amsterdam, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Clinical Psychology Section, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, 1081 Amsterdam, The Netherlands
- Telepsychiatry and E-Mental Health, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Jan H. Smit
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands; (C.v.G.); (E.D.); (D.J.F.v.S.); (S.D.); (H.R.); (J.H.S.)
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, 1081 Amsterdam, The Netherlands
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van der Roest HG, van Eenoo L, van Lier LI, Onder G, Garms-Homolová V, Smit JH, Finne-Soveri H, Jónsson PV, Draisma S, Declercq A, Bosmans JE, van Hout HPJ. Development of a novel benchmark method to identify and characterize best practices in home care across six European countries: design, baseline, and rationale of the IBenC project. BMC Health Serv Res 2019; 19:310. [PMID: 31092244 PMCID: PMC6521361 DOI: 10.1186/s12913-019-4109-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 04/17/2019] [Indexed: 11/15/2022] Open
Abstract
Background Europe’s ageing society leads to an increased demand for long-term care, thereby putting a strain on the sustainability of health care systems. The ‘Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care’ (IBenC) project aims to develop a new benchmark methodology based on quality of care and cost of care utilization to identify best practices in home care. The study’s baseline data, methodology, and rationale are reported. Methods Home care organizations in Belgium, Finland, Germany, Iceland, Italy, and the Netherlands, home care clients of 65 years and over receiving home care, and professionals working in these organizations were included. Client data were collected according to a prospective longitudinal design with the interRAI Home Care instrument. Assessments were performed at baseline, after six and 12 months by trained (research) nurses. Characteristics of home care organizations and professionals were collected cross-sectionally with online surveys. Results Thirty-eight home care organizations, 2884 home care clients, and 1067 professionals were enrolled. Home care clients were mainly female (66.9%), on average 82.9 years (± 7.3). Extensive support in activities of daily living was needed for 41.6% of the sample, and 17.6% suffered cognitive decline. Care professionals were mainly female (93.4%), and over 45 years (52.8%). Considerable country differences were found. Conclusion A unique, international, comprehensive database is established, containing in-depth information on home care organizations, their clients and staff members. The variety of data enables the development of a novel cost-quality benchmark method, based on interRAI-HC data. This benchmark can be used to explore relevant links between organizational efficiency and organizational and staff characteristics. Electronic supplementary material The online version of this article (10.1186/s12913-019-4109-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Henriëtte G van der Roest
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, VU University medical center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Liza van Eenoo
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Lisanne I van Lier
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, VU University medical center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Graziano Onder
- Department of Geriatrics, Neuroscience and Orthopedics, Agostino Gemelli University Hospital, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vjenka Garms-Homolová
- Department of Economics and Law, HTW Berlin, University of Applied Sciences, Berlin, Germany
| | - Johannes H Smit
- Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, The Netherlands
| | - Harriet Finne-Soveri
- Department of Wellbeing, National Institute for Health and Welfare, Helsinki, Finland
| | - Pálmi V Jónsson
- Department of Geriatrics, Landspitali University Hospital, and Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Stasja Draisma
- Department of Wellbeing, National Institute for Health and Welfare, Helsinki, Finland
| | - Anja Declercq
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hein P J van Hout
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, VU University medical center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
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11
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van Hout HPJ, van Lier L, Draisma S, Smit J, Finne-Soveri H, Garms-Homolová V, Bosmans JE, Declercq A, Jónsson P, Onder G, van der Roest HG. Signs of Inequality? Variations in Providing Home Health Care Across Care Organizations and Across European Countries in the IBenC Study. Health Serv Insights 2019; 12:1178632919837632. [PMID: 31037031 PMCID: PMC6475854 DOI: 10.1177/1178632919837632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/01/2019] [Accepted: 02/13/2019] [Indexed: 11/24/2022] Open
Abstract
Most countries aim to allocate home health care to those in need in a fair and equal way. Equal allocation implies that the amount of home care a person receives would reflect the level of health impairment and the need for resources. It is not clear whether countries succeed in attaining this. Our objective was to explore signs of (un)equal home health care provisioning across care organizations and across European health countries. We used data of the IBenC study collected from 2718 older community care recipients from 33 organizations in 6 Western European countries (www.ibenc.eu). We benchmarked differences of provided and expected formal care time across organizations and countries. Expected formal care hours were estimated by multiplying the overall sample’s mean formal hours with recipients’ case mix weights from interRAI’s resources utilization group profiles. We found substantial variations in provided formal care time among organizations both within and across countries that could not be explained by the case mix differences of recipients. This implied presence of inequality of home care provisioning. These findings may alert professionals and policy makers striving for equal home health care provisioning for dependent older persons.
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Affiliation(s)
- Hein PJ van Hout
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health, Amsterdam, The Netherlands
- Hein PJ van Hout, Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health, Van der Boechorststraat 7, Amsterdam, 1081BT, The Netherlands.
| | - Lisanne van Lier
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Stasja Draisma
- GGZ InGeest Mental Health Organization, Amsterdam, The Netherlands
| | - Jan Smit
- GGZ InGeest Mental Health Organization, Amsterdam, The Netherlands
| | | | - Vjenka Garms-Homolová
- Department of Economics and Law, HTW Berlin University of Applied Sciences, Berlin, Germany
| | - Judith E Bosmans
- Department of Health Sciences, Faculty Science, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Anja Declercq
- Centre for Sociological Research, LUCAS—KU Leuven, Leuven, Belgium
| | - Pálmi Jónsson
- Department of Geriatrics, Landspitali University Hospital, University of Iceland, Reykjavík, Iceland
| | - Graziano Onder
- Department of Gerontology, Neuroscience and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Henriëtte G van der Roest
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health, Amsterdam, The Netherlands
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12
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van der Markt A, Klumpers UMH, Draisma S, Dols A, Nolen WA, Post RM, Altshuler LL, Frye MA, Grunze H, Keck PE, McElroy SL, Suppes T, Beekman ATF, Kupka RW. Testing a clinical staging model for bipolar disorder using longitudinal life chart data. Bipolar Disord 2019; 21:228-234. [PMID: 30447123 PMCID: PMC6590317 DOI: 10.1111/bdi.12727] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Bipolar disorder has a wide range of clinical manifestations which may progress over time. The aim of this study was to test the applicability of a clinical staging model for bipolar disorder and to gain insight into the nature of the variables influencing progression through consecutive stages. METHODS Using retrospectively reported longitudinal life chart data of 99 subjects from the Stanley Foundation Bipolar Network Naturalistic Follow-up Study, the occurrence, duration and timely sequence of stages 2-4 were determined per month. A multi-state model was used to calculate progression rates and identify determinants of illness progression. Stages 0, 1 and several other variables were added to the multi-state model to determine their influence on the progression rates. RESULTS Five years after onset of BD (stage 2), 72% reached stage 3 (recurrent episodes) and 21% had reached stage 4 (continuous episodes), of whom 8% recovered back to stage 3. The progression from stage 2 to 3 was increased by a biphasic onset for both the depression-mania and the mania-depression course and by male sex. CONCLUSIONS Staging is a useful model to determine illness progression in longitudinal life chart data. Variables influencing transition rates were successfully identified.
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Affiliation(s)
- Afra van der Markt
- Department of PsychiatryAmsterdam Public HealthAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ursula MH Klumpers
- Department of PsychiatryAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Stasja Draisma
- Department of PsychiatryAmsterdam Public HealthAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Annemiek Dols
- Department of PsychiatryAmsterdam Public HealthAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of PsychiatryAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Willem A Nolen
- Department of PsychiatryUniversity Medical CenterUniversity of GroningenGroningenThe Netherlands
| | - Robert M Post
- Bipolar Collaborative NetworkBethesdaMaryland
- Department of Psychiatry and Behavioral SciencesGeorge Washington UniversityWashingtonDistrict of Columbia
| | - Lori L Altshuler
- Department of Psychiatry and Biobehavioral SciencesDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesCalifornia
- Department of PsychiatryVA Greater Los Angeles Healthcare SystemWest Los Angeles Healthcare CenterLos AngelesCalifornia
| | - Mark A Frye
- Department of PsychiatryMayo ClinicRochesterMinnesota
| | - Heinz Grunze
- Klinikum am WeissenhofWeinsberg Germany & Paracelsus Medical UniversityNurembergGermany
| | - Paul E Keck
- University of Cincinnati College of MedicineCincinnatiOhio
- Lindner Center of HOPEMasonOhio
| | - Susan L McElroy
- Lindner Center of HOPEMasonOhio
- Biological Psychiatry ProgramUniversity of Cincinnati Medical CollegeCincinnatiOhio
| | - Trisha Suppes
- Department of Psychiatry and Behavioral SciencesStanford University School of MedicinePalo AltoCalifornia
- V.A. Palo Alto Health Care SystemPalo AltoCalifornia
| | - Aartjan TF Beekman
- Department of PsychiatryAmsterdam Public HealthAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ralph W Kupka
- Department of PsychiatryAmsterdam Public HealthAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
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13
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Stevens AWMM, Goossens PJJ, Knoppert-van der Klein EAM, Draisma S, Honig A, Kupka RW. Risk of recurrence of mood disorders during pregnancy and the impact of medication: A systematic review. J Affect Disord 2019; 249:96-103. [PMID: 30769297 DOI: 10.1016/j.jad.2019.02.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mood disorders can be difficult to treat during pregnancy. There is still lack of evidence whether pregnancy influences their natural course and whether continuation of pharmacotherapy, despite potential risks for the unborn child, is beneficial in preventing recurrence of mood episodes during pregnancy. METHODS Systematic review conducted according to the PRISMA guidelines, searching Pubmed, PsycINFO, Embase and Cochrane databases up till January 9th, 2018. Recurrence rates and various measures of risk were calculated. RESULTS Out of 1387 articles from an initial search 22 studies met the inclusion criteria. Included studies reported a wide variation in the recurrence rate of bipolar disorder and major depressive disorder during pregnancy (BD: mean = 19%, range = 4%-73%; MDD: mean = 8%, range = 1%-75%). Observational data showed a relative risk reduction of maintenance therapy during pregnancy of 66% in women with BD and 54% for women with MDD, a significant difference (95% CI 9.4-14.6; p < 0.001). LIMITATIONS heterogeneous samples, study designs, and reported outcomes in included studies. CONCLUSIONS Despite the importance of the topic there is a paucity of evidence on recurrence rates of mood episodes during pregnancy among women with MDD or BD. Unlike the impact of the postpartum period, it is still uncertain whether the course of mood disorders is influenced by pregnancy. Non-randomized studies show that maintenance pharmacotherapy during pregnancy in women with mood disorders significantly (p < 0.01) reduces the risk of recurrence.
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Affiliation(s)
- Anja W M M Stevens
- Dimence Mental Health, Center for Bipolar Disorders, Deventer, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Peter J J Goossens
- Dimence Mental Health, Center for Bipolar Disorders, Deventer, the Netherlands; University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Stasja Draisma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health research Institute, GGZ inGeest Specialized Mental Health Care, Research and Innovation Amsterdam, the Netherlands
| | - Adriaan Honig
- Department of Psychiatry OLVG/msterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Ralph W Kupka
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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van den Berg SRN, Stringer B, van de Sande R, Draisma S. Care provider allocation on admissions to acute mental health wards: The development and validation of the Admission Team Score List. Int J Ment Health Nurs 2019; 28:86-95. [PMID: 29777566 DOI: 10.1111/inm.12476] [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] [Accepted: 04/16/2018] [Indexed: 11/30/2022]
Abstract
Currently, support tools are lacking to prioritize steps in the care coordination process to enable safe practice and effective clinical pathways in the first phase of acute psychiatric admissions. This study describes the development, validity, and reliability of an acute care coordination support tool, the Admission Team Score List (ATSL). The ATSL assists in care provider allocation during admissions. Face validity and feasibility of the ATSL were tested in 77 acute admissions. Endscores of filled out ATSL's were translated to recommended team compositions. These ATSL team (ATSL-T) compositions were compared to the actually present team (AP-T) and the most preferred team (MP-T) composition in hindsight. Consistency between the ATSL-T and the MP-T was substantial; Kw = 0.70, P < 0.001, 95% CI [0.55-0.84]. The consistency between the ATSL-T and AP-T was moderate; Kw = 0.43, P < 0.001, 95% CI [0.23-0.62]. The ATSL has an adequate (inter-rater) reliability; ICC = 0.90, P < 0.001, 95% CI [0.65-0.91]. The ATSL study is an important step to promote safety and efficient care based on care provider allocation, for service users experiencing an acute admission. The ATSL may stimulate structured clinical decision-making during the hectic process around acute psychiatric admissions.
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Affiliation(s)
| | | | - Roland van de Sande
- Utrecht University of Applied Science & Parnassia Psychiatric Insitute, Utrecht, The Netherlands
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15
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van Oudheusden LJB, Draisma S, van der Salm S, Cath D, van Oppen P, van Balkom AJLM, Meynen G. Perceptions of free will in obsessive-compulsive disorder: a quantitative analysis. BMC Psychiatry 2018; 18:400. [PMID: 30587170 PMCID: PMC6307295 DOI: 10.1186/s12888-018-1985-3] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/13/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of this study was to explore perceptions of free will in the repetitive behaviors of patients with obsessive-compulsive disorder (OCD) and to explore their relation with core clinical characteristics. METHODS Experiences of free will were assessed with the Symptomatology And Perceived Free will rating scale (SAPF) in 295 subjects with a lifetime diagnosis of OCD. Patients' scores on the SAPF were subjected to an explorative principal axis factor analysis (PAF). Factor scores were regressed on five OCD symptom dimensions and on seven clinical variables: illness duration, severity of OCD, insight, anxiety and depression, suicidal ideation and quality of life. RESULTS The PAF revealed three factors: the perceived ability to control and change one's course of action when faced with an obsession or compulsion (the "alternative possibilities" factor); the experience of obsessions or compulsions as intentional (the "intentionality" factor); and the experience of being the source or owner of the obsessions or compulsions (the "ownership" factor). Lower scores on the "alternative possibilities" factor were associated with lower scores on the washing dimension (β = 0.237, p = 0.004) and higher scores on the precision dimension (β = - 0.190, p = 0.025) and independently associated with longer illness duration (β = - 0.134, p = 0.039), higher illness severity (β = - 0.298, p < 0.001) and lower quality of life (β = 0.172, p = 0.046). Lower scores on the "intentionality" factor were independently associated with lower quality of life (β = 0.233, p = 0.027). Higher scores on the "ownership" factor were associated with higher scores on the precision dimension (β = 0.207, p = 0.023) and independently associated with poorer insight (β = 0.170, p = 0.045). CONCLUSIONS The most notable finding of this study is that a diminished experience of free will in OCD is associated with core clinical characteristics: illness duration and severity, insight and quality of life.
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Affiliation(s)
- Lucas J. B. van Oudheusden
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Stasja Draisma
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Sandra van der Salm
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands
| | - Danielle Cath
- Department of Clinical and Health psychology, Altrecht Academic Anxiety Centre, Utrecht University, Utrecht, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Anton J. L. M. van Balkom
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Gerben Meynen
- Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- GGZ inGeest, Amsterdam, The Netherlands
- Willem Pompe Institute for Criminal Law and Criminology, Utrecht University, Utrecht, The Netherlands
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ter Meulen WG, van Zaane J, Draisma S, Beekman AT, Kupka RW. Does the number of previous mood episodes moderate the relationship between alcohol use, smoking and mood in bipolar outpatients? BMC Psychiatry 2017; 17:185. [PMID: 28506220 PMCID: PMC5432990 DOI: 10.1186/s12888-017-1341-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 04/30/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Evidence suggests that alcohol use and smoking are negatively associated with mood in bipolar disorders (BD). It is unknown if this relationship is moderated by the number of previous mood episodes. Therefore, this paper aims to examine whether the number of previous mood episodes moderates the relationship between alcohol use and smoking, and mood. METHOD This study assessed the outcomes of 108 outpatients with BD I and II in a prospective observational cohort study. For 1 year, subjects daily registered mood symptoms and substance use with the prospective Life Chart Method. The relationship between the average daily consumption of alcohol and tobacco units in the whole year and mood were examined by multiple linear regression analyses. Number of previous mood episodes, grouped into its quartiles, was added as effect moderator. Outcome was the number of depressive, hypomanic and manic days in that year. RESULTS The number of depressive days in a year increased by 4% (adjusted β per unit tobacco = 1.040; 95% CI 1.003-1.079; p = 0.033) per unit increase in average daily tobacco consumption in that same year. Interaction analyses showed that in those subjects with less than 7 previous mood episodes, the number of manic and hypomanic days increased by 100.3% per unit increase in alcohol consumption (adjusted β per unit alcohol = 2.003; 95% CI 1.225-3.274; p = 0.006). In those with 7 to 13 previous mood episodes, the number of manic and hypomanic days decreased by 28.7% per unit increase in alcohol consumption (adjusted β per unit alcohol = 0.713; 95% CI 0.539-0.944; p = 0.019); and in subjects with 14 to 44 previous mood episodes, the number of manic and hypomanic days decreased by 7.2% per unit increase in tobacco consumption (adjusted β per unit tobacco = 0.928; 95% CI 0.871-0.989; p = 0.021). CONCLUSIONS The number of previous mood episodes moderates the relationship between alcohol use and smoking and mood; and smoking is adversely associated with the number of depressive days.
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Affiliation(s)
- Wendela G. ter Meulen
- 0000 0004 0435 165Xgrid.16872.3aGGZ inGeest and Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Jan van Zaane
- 0000 0004 0435 165Xgrid.16872.3aGGZ inGeest and Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Stasja Draisma
- 0000 0004 0435 165Xgrid.16872.3aGGZ inGeest and Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Aartjan T.F. Beekman
- 0000 0004 0435 165Xgrid.16872.3aGGZ inGeest and Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Ralph W. Kupka
- 0000 0004 0435 165Xgrid.16872.3aGGZ inGeest and Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
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Kleiboer A, Smit J, Bosmans J, Ruwaard J, Andersson G, Topooco N, Berger T, Krieger T, Botella C, Baños R, Chevreul K, Araya R, Cerga-Pashoja A, Cieślak R, Rogala A, Vis C, Draisma S, van Schaik A, Kemmeren L, Ebert D, Berking M, Funk B, Cuijpers P, Riper H. European COMPARative Effectiveness research on blended Depression treatment versus treatment-as-usual (E-COMPARED): study protocol for a randomized controlled, non-inferiority trial in eight European countries. Trials 2016; 17:387. [PMID: 27488181 PMCID: PMC4972947 DOI: 10.1186/s13063-016-1511-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/17/2016] [Indexed: 12/28/2022] Open
Abstract
Background Effective, accessible, and affordable depression treatment is of high importance considering the large personal and economic burden of depression. Internet-based treatment is considered a promising clinical and cost-effective alternative to current routine depression treatment strategies such as face-to-face psychotherapy. However, it is not clear whether research findings translate to routine clinical practice such as primary or specialized mental health care. The E-COMPARED project aims to gain knowledge on the clinical and cost-effectiveness of blended depression treatment compared to treatment-as-usual in routine care. Methods/design E-COMPARED will employ a pragmatic, multinational, randomized controlled, non-inferiority trial in eight European countries. Adults diagnosed with major depressive disorder (MDD) will be recruited in primary care (Germany, Poland, Spain, Sweden, and the United Kingdom) or specialized mental health care (France, The Netherlands, and Switzerland). Regular care for depression is compared to “blended” service delivery combining mobile and Internet technologies with face-to-face treatment in one treatment protocol. Participants will be followed up at 3, 6, and 12 months after baseline to determine clinical improvements in symptoms of depression (primary outcome: Patient Health Questionnaire-9), remission of depression, and cost-effectiveness. Main analyses will be conducted on the pooled data from the eight countries (n = 1200 in total, 150 participants in each country). Discussion The E-COMPARED project will provide mental health care stakeholders with evidence-based information and recommendations on the clinical and cost-effectiveness of blended depression treatment. Trial registration France: ClinicalTrials.gov NCT02542891. Registered on 4 September 2015; Germany: German Clinical Trials Register DRKS00006866. Registered on 2 December 2014; The Netherlands: Netherlands Trials Register NTR4962. Registered on 5 January 2015; Poland: ClinicalTrials.Gov NCT02389660. Registered on 18 February 2015; Spain: ClinicalTrials.gov NCT02361684. Registered on 8 January 2015; Sweden: ClinicalTrials.gov NCT02449447. Registered on 30 March 2015; Switzerland: ClinicalTrials.gov NCT02410616. Registered on 2 April 2015; United Kingdom: ISRCTN registry, ISRCTN12388725. Registered on 20 March 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1511-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Annet Kleiboer
- Section Clinical Psychology, Vrije Universiteit Amsterdam and EMGO+ Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
| | - Jan Smit
- Department of Psychiatry, VU University Medical Centre and EMGO+ Institute for Health Care and Research, Amsterdam, The Netherlands
| | - Judith Bosmans
- Department of Health Sciences, Vrije Universiteit Amsterdam and EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Jeroen Ruwaard
- Section Clinical Psychology, Vrije Universiteit Amsterdam and EMGO+ Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
| | - Naira Topooco
- Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tobias Krieger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Cristina Botella
- Department of Psychology and Technology, Jaume University, Castellon, Spain.,Department of Personalidad, Evaluación y Tratamiento Psicológicos, Valencia, Spain
| | - Rosa Baños
- Department of Personalidad, Evaluación y Tratamiento Psicológicos, Valencia, Spain
| | | | - Ricardo Araya
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Arlinda Cerga-Pashoja
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Roman Cieślak
- Department of Psychology, Szkoła Wyzsza Psychologii Społeczne, University of Social Sciences and Humanities, Warsaw, Poland
| | - Anna Rogala
- Department of Psychology, Szkoła Wyzsza Psychologii Społeczne, University of Social Sciences and Humanities, Warsaw, Poland
| | - Christiaan Vis
- Section Clinical Psychology, Vrije Universiteit Amsterdam and EMGO+ Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - Stasja Draisma
- Department of Psychiatry, VU University Medical Centre and EMGO+ Institute for Health Care and Research, Amsterdam, The Netherlands
| | - Anneke van Schaik
- Department of Psychiatry, VU University Medical Centre and EMGO+ Institute for Health Care and Research, Amsterdam, The Netherlands
| | - Lise Kemmeren
- Department of Psychiatry, VU University Medical Centre and EMGO+ Institute for Health Care and Research, Amsterdam, The Netherlands
| | - David Ebert
- Department of Clinical Psychology, Philipps University, Marburg, Germany
| | - Matthias Berking
- Department of Clinical Psychology, Philipps University, Marburg, Germany
| | - Burkhardt Funk
- Institut für elektronische Geschäftsprozesse, Leuphana University Lüneburg, Lüneburg, Germany
| | - Pim Cuijpers
- Section Clinical Psychology, Vrije Universiteit Amsterdam and EMGO+ Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - Heleen Riper
- Section Clinical Psychology, Vrije Universiteit Amsterdam and EMGO+ Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.,Department of Psychiatry, VU University Medical Centre and EMGO+ Institute for Health Care and Research, Amsterdam, The Netherlands
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Draisma S, van Zaane J, Smit JH. Data quality indicators for daily life chart methodology: prospective self-ratings of bipolar disorder and alcohol use. BMC Res Notes 2015; 8:473. [PMID: 26403942 PMCID: PMC4582622 DOI: 10.1186/s13104-015-1436-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 09/11/2015] [Indexed: 12/04/2022] Open
Abstract
Background Self-rating instruments which require a large number of repeated assessments over time are increasingly popular in psychiatry. They are well suited to describing variations in mental states, especially in order to investigate effects of behaviour and events on functioning and mood. For bipolar disorder, the self-rating instrument ‘NIMH daily life chart’ was developed to assess the course of the illness. This instrument has been validated in the customary ways, yet information about data quality (e.g. completeness, consistency, construct validity, reactivity) was lacking. The goal of this study was to develop several data quality indicators computed from data, in order to be able to detect respondents that provide less valid or reliable data. Methods During approximately 1 year on average, 137 patients with DSM-IV diagnosed bipolar disorder rated their mood, functioning and number of alcohol units consumed on a daily basis. Three kinds of quality indicators were developed: (1) compliance (i.e. completeness of recording on a daily basis), (2) the association between conceptually related variables—construct validity—and (3) reactivity: any changes in alcohol-drinking behaviour due to the assessments themselves. Relations were measured with Spearman’s rho. Results A relation was found between data quality and illness severity: respondents with lower data quality, according to our operationalisations, were more strongly affected by the illness, as expressed in the number of ill days, than respondents with higher data quality. Conclusion The more affected patients are by the illness, the lower the data quality to be expected in life chart reports.
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Affiliation(s)
- Stasja Draisma
- Department of Psychiatry and EMGO+ Institute, VU University Medical Centre Amsterdam, A.J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands.
| | - Jan van Zaane
- Department of Psychiatry and EMGO+ Institute, VU University Medical Centre Amsterdam, A.J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands.
| | - Johannes H Smit
- Department of Psychiatry and EMGO+ Institute, VU University Medical Centre Amsterdam, A.J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands.
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van der Voort TYG, van Meijel B, Goossens PJJ, Hoogendoorn AW, Draisma S, Beekman A, Kupka RW. Collaborative care for patients with bipolar disorder: randomised controlled trial. Br J Psychiatry 2015; 206:393-400. [PMID: 25792695 DOI: 10.1192/bjp.bp.114.152520] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 06/12/2014] [Accepted: 09/10/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND A substantial number of people with bipolar disorder show a suboptimal response to treatment. AIMS To study the effectiveness of a collaborative care programme on symptoms and medication adherence in patients with bipolar disorder, compared with care as usual. METHOD A two-armed, cluster randomised clinical trial was carried out in 16 out-patient mental health clinics in The Netherlands, in which 138 patients were randomised. Patient outcomes included duration and severity of symptoms and medication adherence, and were measured at baseline, 6 months and 12 months. Collaborative care comprised contracting, psychoeducation, problem-solving treatment, systematic relapse prevention and monitoring of outcomes. Mental health nurses functioned as care managers in this programme. The trial was registered with The Netherlands Trial Registry (NTR2600). RESULTS Collaborative care had a significant and clinically relevant effect on number of months with depressive symptoms, both at 6 months (z = -2.6, P = 0.01, d = 0.5) and at 12 months (z = -3.1, P = 0.002, d = 0.7), as well as on severity of depressive symptoms at 12 months (z = -2.9, P = 0.004, d = 0.4). There was no effect on symptoms of mania or on treatment adherence. CONCLUSIONS When compared with treatment as usual, collaborative care substantially reduced the time participants with bipolar disorder experienced depressive symptoms. Also, depressive symptom severity decreased significantly. As persistent depressive symptoms are difficult to treat and contribute to both disability and impaired quality of life in bipolar disorder, collaborative care may be an important form of treatment for people with this disorder.
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Affiliation(s)
- Trijntje Y G van der Voort
- Trijntje Y. G. van der Voort, RN, Msc, VU University, Amsterdam; Berno van Meijel, PhD, Inholland University of Applied Sciences, Amsterdam; Peter J. J. Goossens, MANP, PhD, Dimence, Deventer; Adriaan W. Hoogendoorn, PhD, GGZ inGeest, Amsterdam; Stasja Draisma, PhD, VU University, Amsterdam; Aartjan Beekman, MD, PhD, VU University Medical Centre, Amsterdam; Ralph W. Kupka, MD, PhD, VU University, Amsterdam, The Netherlands
| | - Berno van Meijel
- Trijntje Y. G. van der Voort, RN, Msc, VU University, Amsterdam; Berno van Meijel, PhD, Inholland University of Applied Sciences, Amsterdam; Peter J. J. Goossens, MANP, PhD, Dimence, Deventer; Adriaan W. Hoogendoorn, PhD, GGZ inGeest, Amsterdam; Stasja Draisma, PhD, VU University, Amsterdam; Aartjan Beekman, MD, PhD, VU University Medical Centre, Amsterdam; Ralph W. Kupka, MD, PhD, VU University, Amsterdam, The Netherlands
| | - Peter J J Goossens
- Trijntje Y. G. van der Voort, RN, Msc, VU University, Amsterdam; Berno van Meijel, PhD, Inholland University of Applied Sciences, Amsterdam; Peter J. J. Goossens, MANP, PhD, Dimence, Deventer; Adriaan W. Hoogendoorn, PhD, GGZ inGeest, Amsterdam; Stasja Draisma, PhD, VU University, Amsterdam; Aartjan Beekman, MD, PhD, VU University Medical Centre, Amsterdam; Ralph W. Kupka, MD, PhD, VU University, Amsterdam, The Netherlands
| | - Adriaan W Hoogendoorn
- Trijntje Y. G. van der Voort, RN, Msc, VU University, Amsterdam; Berno van Meijel, PhD, Inholland University of Applied Sciences, Amsterdam; Peter J. J. Goossens, MANP, PhD, Dimence, Deventer; Adriaan W. Hoogendoorn, PhD, GGZ inGeest, Amsterdam; Stasja Draisma, PhD, VU University, Amsterdam; Aartjan Beekman, MD, PhD, VU University Medical Centre, Amsterdam; Ralph W. Kupka, MD, PhD, VU University, Amsterdam, The Netherlands
| | - Stasja Draisma
- Trijntje Y. G. van der Voort, RN, Msc, VU University, Amsterdam; Berno van Meijel, PhD, Inholland University of Applied Sciences, Amsterdam; Peter J. J. Goossens, MANP, PhD, Dimence, Deventer; Adriaan W. Hoogendoorn, PhD, GGZ inGeest, Amsterdam; Stasja Draisma, PhD, VU University, Amsterdam; Aartjan Beekman, MD, PhD, VU University Medical Centre, Amsterdam; Ralph W. Kupka, MD, PhD, VU University, Amsterdam, The Netherlands
| | - Aartjan Beekman
- Trijntje Y. G. van der Voort, RN, Msc, VU University, Amsterdam; Berno van Meijel, PhD, Inholland University of Applied Sciences, Amsterdam; Peter J. J. Goossens, MANP, PhD, Dimence, Deventer; Adriaan W. Hoogendoorn, PhD, GGZ inGeest, Amsterdam; Stasja Draisma, PhD, VU University, Amsterdam; Aartjan Beekman, MD, PhD, VU University Medical Centre, Amsterdam; Ralph W. Kupka, MD, PhD, VU University, Amsterdam, The Netherlands
| | - Ralph W Kupka
- Trijntje Y. G. van der Voort, RN, Msc, VU University, Amsterdam; Berno van Meijel, PhD, Inholland University of Applied Sciences, Amsterdam; Peter J. J. Goossens, MANP, PhD, Dimence, Deventer; Adriaan W. Hoogendoorn, PhD, GGZ inGeest, Amsterdam; Stasja Draisma, PhD, VU University, Amsterdam; Aartjan Beekman, MD, PhD, VU University Medical Centre, Amsterdam; Ralph W. Kupka, MD, PhD, VU University, Amsterdam, The Netherlands
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Buwalda V, Swinkels J, Draisma S, Van de Brug S, Smit J, Van Tilburg W. Attitudes of Patients and Clinicians Towards Routine Outcome Monitoring in Clinical Practice. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30804-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: 11/30/2022] Open
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van Zaane J, van de Ven PM, Draisma S, Smit JH, Nolen WA, van den Brink W. Effect of alcohol use on the course of bipolar disorder: one-year follow-up study using the daily prospective Life Chart method. Bipolar Disord 2014; 16:400-9. [PMID: 24673879 DOI: 10.1111/bdi.12191] [Citation(s) in RCA: 5] [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: 10/17/2012] [Accepted: 10/16/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Relatively little is known about the temporal relationship between alcohol use and subsequent mood changes in patients with bipolar disorder, and the available findings are inconsistent. The present study was a fine-grained analysis of the temporal relationship between alcohol use and short-term mood-switching probabilities. METHODS The study included 137 patients with bipolar disorder who performed daily self-ratings of their mood symptoms and the number of alcohol units consumed for a period of up to 52 weeks by using the National Institute of Mental Health self-rated prospective Life Chart Method. At baseline, the Structured Clinical Interview for DSM-IV was administered and demographic, social, and clinical characteristics were obtained. Multi-state models were used to assess the impact of the number of alcoholic drinks on patients' transition through different states of mood (depression, euthymia, and mania). RESULTS The effect of alcohol use on the change in mood states was limited. For women in a depressive state, higher alcohol use was associated with a shorter time before entering the euthymic state [hazard ratio (HR) = 1.18, 95% confidence interval (CI): 1.03-1.36, p < 0.05], whereas, for men in an euthymic state, higher alcohol use was associated with a longer time before entering a manic state (HR = 0.81, 95% CI: 0.71-0.92, p < 0.05). The correlation between the consumed number of drinks per week and the average mood severity score of the following week was -0.01 (p < 0.001), indicating that only 0.01% of the variance in mood severity in this population is explained by alcohol use. Possible explanations for these findings are discussed. CONCLUSIONS The current study, using a fine-grained analysis, suggests that alcohol use does not have a direct effect on the course of bipolar disorder in patients using mood stabilizers.
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Affiliation(s)
- Jan van Zaane
- Department of Psychiatry, EMGO Institute, VU University Medical Center, Amsterdam, the Netherlands
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Langerak W, Langeland W, van Balkom A, Draisma S, Terluin B, Draijer N. A validation study of the Four-Dimensional Symptom Questionnaire (4DSQ) in insurance medicine. Work 2012; 43:369-80. [PMID: 22927600 DOI: 10.3233/wor-2012-1393] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] Open
Abstract
OBJECTIVE This study aimed to evaluate the criterion validity and the diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) regarding the identification of depressive and anxiety disorders in an insurance medicine setting. PARTICIPANTS Our sample consisted of 230 individuals who applied for a work disability benefit due to mental health problems. METHODS Depressive and anxiety disorders were assessed using the 4DSQ and the Composite International Diagnostic Interview (CIDI). Internal consistency was determined by calculating Cronbach's alpha values. Criterion validity was evaluated by regression techniques. A Receiver Operating Characteristic (ROC) analysis was performed to evaluate diagnostic accuracy. RESULTS Of the 230 participants 109 (47.4%) had a current DSM-IV depressive disorder and 146 (63.5%) an anxiety disorder. The 4DSQ scales showed an excellent internal consistency. The depression scale of the 4DSQ had specific sensitivity for major depressive disorder. The anxiety scale was also sensitive for the anxiety disorders. The area under the ROC curve (AUC) indicated good diagnostic accuracy of the 4DSQ for assessing depressive and/or anxiety disorders: AUC-value 0.81 for both depression and anxiety. CONCLUSIONS Although the 4DSQ shows good criterion validity and diagnostic accuracy with respect to depressive and anxiety disorders in applicants for a work disability benefit due to mental health problems, the feasibility of the 4DSQ as a screening measure for depressive and anxiety disorders is limited due to the high prevalence of depressive and anxiety disorders.
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Affiliation(s)
- Wendy Langerak
- Department of Review and Appeal, The Dutch Institute for Employee Benefit Schemes, Utrecht, The Netherlands.
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van Zaane J, van den Berg B, Draisma S, Nolen WA, van den Brink W. Screening for bipolar disorders in patients with alcohol or substance use disorders: performance of the mood disorder questionnaire. Drug Alcohol Depend 2012; 124:235-41. [PMID: 22341144 DOI: 10.1016/j.drugalcdep.2012.01.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 08/12/2011] [Revised: 11/24/2011] [Accepted: 01/20/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Screening properties of the mood disorder questionnaire (MDQ) to detect bipolar disorder (BD) in patients with substance use disorders are unknown. METHODS 403 treatment seeking patients with a substance use disorder completed the MDQ and subsequently 111 MDQ positives and 59 MDQ negatives were assessed with the Structured Clinical Interview for DSM-IV to diagnose BD. In addition, given the overlap with BD symptoms, the presence of borderline personality disorder (BPD), antisocial personality disorder (APD) and attention deficit/hyperactivity disorder (ADHD), were assessed using the Diagnostic Interview Schedule and the Structured Interview for DSM-IV Personality. RESULTS Of the 170 patients with a SCID interview, 35 patients (20.6%) met criteria for a lifetime diagnosis of BD. Twenty-three patients (62.8%) with BD had a positive MDQ score and 47 of the 135 patients (34.8%) without BD had a negative MDQ score resulting in a weighted sensitivity of .43, a weighted specificity of .57, a positive predictive value of .21, a negative predictive value (NPV) of .80 and an area under the curve of .50. The area under the curve of the MDQ to detect BPD, APD, ADHD and any externalizing disorder ranged from .55 (APD) to .63 (ADHD). CONCLUSIONS The MDQ is not a suitable screening instrument for the detection of BD or other externalizing disorders but it could be used for ruling out the presence of BD in treatment seeking substance use disorder patients.
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Affiliation(s)
- Jan van Zaane
- Department of Psychiatry, EMGO institute, VU University Medical Center, Amsterdam, The Netherlands.
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Nugter MA, Buwalda VJA, Dhondt ADF, Draisma S. [The use of HoNOS in the treatment of patients]. Tijdschr Psychiatr 2012; 54:153-159. [PMID: 22331537] [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: 05/31/2023]
Abstract
BACKGROUND In order to use outcome scores for making decisions about treatment, practitioners need to know the course of scores of several groups of patients. AIM To test the applicability of methods for computing cut-off scores and individual changes. METHOD Using Health of the Nation Outcome Scales (HoNOS), we analysed repeated assessments of 699 adults and 414 elderly patients in different treatment settings. RESULTS Mean HoNOS scores and cut-off scores differentiated between patient groups reasonably well. Scores and threshold values for elderly patients were relatively high. The reliable change index showed few individual changes even for groups where change was expected. The effect size and the standard error of measurement were found to be more sensitive to change. CONCLUSION More research is needed before the findings can be generalised.
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Affiliation(s)
- M A Nugter
- Hoofd Afdeling Onderzoek en Monitoring van GGZ Noord-Holland-Noord, heerhugowaard.
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Buwalda VJA, Nugter MA, van de Brug SY, Draisma S, Smit JH, Swinkels JA, van Tilburg W. [ROM in adult psychiatry: an evaluation of measurement instruments]. Tijdschr Psychiatr 2012; 54:147-152. [PMID: 22331536] [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: 05/31/2023]
Abstract
BACKGROUND An evaluation of the most commonly used ROM measures in Dutch psychiatry is lacking, both for severe mental illnesses and for common psychiatric disorders. AIM To provide an overview of the characteristics and quality of outcome measures. METHOD A literature study yielded six outcome measures. The psychometrical, clinical and practical aspects of these scales are described. RESULTS The measures are suitable and are of adequate quality. DISCUSSION It remains to be seen if any of the outcome measures are suitable for both serious and less serious mental illnesses. The use of a combination of a self-rating scale and an observerrating scale that measure symptoms and domains of functioning may be the most promising choice.
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Affiliation(s)
- V J A Buwalda
- Altrecht GGZ, en Onderzoeker, VUmc/GGZ InGeest, Amsterdam.
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Buwalda VJA, Draisma S, Smit JH, Swinkels J, van Tilburg W. [Validation of two measuring instruments for routine outcome monitoring in psychiatry: the HORVAN study]. Tijdschr Psychiatr 2011; 53:715-726. [PMID: 21989750] [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: 05/31/2023]
Abstract
BACKGROUND Transparency in psychiatry can be increased by the use of routine outcome monitoring (rom) instruments. Instruments should be easy to use and take very little time to complete; they also need to have psychometric qualities, be sensitive to change, and provide information about patients' symptoms, and about interpersonal and social functioning. AIM To investigate to what extent the combination of Health of the Nation Outcome Scales (HoNOS) and the Outcome Questionnaire (OQ) in the Dutch situation meets the above-mentioned quality criteria and to examine how the combination relates to the Symptom CheckList (SCL-90). METHOD Data for 148 patients collected at three measurement moments were available for analysis. The psychometric qualities of the instruments and their sensitivity to change were checked carefully. RESULTS The three scales showed high values for internal consistency (Cronbach's alpha). The HoNOS total score and the subscales of the OQ correlated reasonably well with the SCL-90 total score (convergence validity). At the first measurements, patients with a comorbid diagnosis had the lowest scores (discrimination validity). The clinically significant change between T1 and T2 and between T2 and T3 was sufficiently high for all three measuring instruments. CONCLUSION The combination of the HoNOS rating scale and the self-report list OQ seems to be suitable for ROM in psychiatry.
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van Zaane J, van den Brink W, Draisma S, Smit JH, Nolen WA. The effect of moderate and excessive alcohol use on the course and outcome of patients with bipolar disorders: a prospective cohort study. J Clin Psychiatry 2010; 71:885-93. [PMID: 20122372 DOI: 10.4088/jcp.09m05079gry] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [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: 01/27/2009] [Accepted: 03/16/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Comorbid alcohol use disorders (AUDs) are frequently associated with negative effects on course and outcome of bipolar disorder. This prospective cohort study assessed the effect of actual alcohol use (no, moderate, and excessive) on the course and outcome of patients with bipolar disorders. METHOD Between June 2003 and November 2005, 137 outpatients (aged 23-68 years) with DSM-IV-diagnosed bipolar I (66%) or II (34%) disorder rated their mood and the number of alcohol units consumed daily for a period up to 52 weeks with the National Institute of Mental Health Self-Rating Prospective Life-Chart Method (LCM). At baseline, the Structured Clinical Interview for DSM-IV was administrated, and demographic, social, and clinical characteristics were obtained. At monthly visits, the Clinical Global Impressions Scale-Bipolar Version (CGI-BP), the Global Assessment of Functioning (GAF) scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS-SF-36) were rated. Based on the alcohol use in the first 4 weeks of follow-up, patients were assigned to 1 of 3 groups: no/incidental, moderate, or excessive alcohol use. RESULTS None of the sociodemographic and clinical characteristics at baseline were significantly different between the 3 drinking groups, with the exception of-and as a consequence of the group assignment-the prevalence of lifetime and current diagnosis of AUD. Also, no differences between the 3 drinking groups were found on any of the clinical outcome variables, ie, number of days ill (depressed, hypomanic/manic, and total); severity of depression, mania, and overall bipolar illness (LCM); GAF score; CGI-BP (depression, mania, and overall); and all the subscales of the MOS-SF-36. Also, the number of episodes according to DSM-IV and the Leapfrog method showed no significant differences between the drinking groups. CONCLUSIONS In this sample of patients and with the sensitive measurement of mood and drinking status over a full year, we could not confirm the findings of other studies indicating a negative effect of excessive alcohol use on the course of bipolar illness. This study found that neither moderate nor excessive use of alcohol has a negative effect on the course and outcome of bipolar illness. Possible explanations for these findings are discussed.
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Affiliation(s)
- J van Zaane
- Department of Psychiatry, EMGO Institute for Health and Care Research, Vrije Universiteit, University Medical Center Amsterdam, Bennebroek, Amsterdam, The Netherlands.
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Verhaak PFM, Prins MA, Spreeuwenberg P, Draisma S, van Balkom TJLM, Bensing JM, Laurant MGH, van Marwijk HWJ, van der Meer K, Penninx BWJH. Receiving treatment for common mental disorders. Gen Hosp Psychiatry 2009; 31:46-55. [PMID: 19134510 DOI: 10.1016/j.genhosppsych.2008.09.011] [Citation(s) in RCA: 53] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Revised: 09/05/2008] [Accepted: 09/06/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Anxiety and depressive disorders are widely prevalent, but patients are only treated in a minority of cases. In this study, the explanation of receiving mental health treatment is sought in predisposing and enabling characteristics and indicators for objective and self-perceived need. METHODS Cross-sectional analysis of data collected in the Netherlands Study of Depression and Anxiety (NESDA) among 743 persons with an anxiety and/or depression diagnosis as assessed by the CIDI. Receipt of mental health treatment was assessed in the face-to-face interview, as well as indicators of predisposing and enabling factors and variables evaluating need for care. RESULTS Of the total sample, 57% received treatment in the past 6 months in the general practice setting (50%) or the mental health care setting (14%). Younger patients, patients who evaluated their providers better on communicative abilities and patients who perceived mental health problems themselves had greater odds of having professional mental health contacts in the primary care setting. Confidence in professional help and higher severity of mental problems were associated with greater odds of having specialized mental health care. CONCLUSION Receiving help for common mental disorders depends not only on the objective need of the patient but also at least as much on the patients' own recognition that their problems have a mental health origin. Furthermore, in primary care especially, the patients' judgment of their providers' affective abilities may be decisive for being treated. For receiving specialized care, patients are also directed by their confidence in professional help.
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Affiliation(s)
- Peter F M Verhaak
- NIVEL, Netherlands Institute for Health Services Research, 3500BH Utrecht, The Netherlands.
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